약물오남용 및 부작용에 관한 피부과 영역의 전향적 다기관 임상 역학연구

이원수(Won Soo Lee),은희철(Hee Chul Eun),박한성(Han Sung Park),이승헌(Seung Hun Lee),문상은(Sang Eun Moon),신학철(Hack Chul Shin),김홍직(Hong Jig Kim) 대한피부과학회 1999 대한피부과학회지 Vol.37 No.10

N/A Background : The abuse, nmisuse, and resultant adverse reactions of various drugs have been widespread due to lack of division of work of medicine and pharmacy in Korea. Objective : A multicenter, prospective, clinico-epidemiologic evaluation was made from patients with adverse drug reactions who visited 126 dermatologic departments in university hospitals(21) or private clinics(105) nationwide from Iuly 1st to July 31st, 1999. Results : The prevalence of adverse drug reaction was 10.4% among them 47.9% of the patients had adverse cutaneous effects from external use of topical steroids and 24.1% of the patients had contact dermatitis from external use of various topical agents. The rate(66.3%) of misuse of topical steroids was higher than that(33.7%) of abuse of the drugs. 79.8% of patients had obtained drugs without an accurate diagnosis and prescription from their doctors. Regarding the potency of topical steroids, it was revealed that the lowest potency drugs also caused adverse effects. Conclusion : The strict grouping of drugs as prescription drugs or over-the-counter drugs based on drug safety is the key factor to avoid the abuse and misuse of drugs, and to protect the public health from harmful drug effects. (Korean J Dermatol 1000;37(10) : 1385∼1398)

임질의 임상적 고찰 : 제5보 ; Sodium penicillin G. 2회 근주의 단순남성임질 치료효과 Ⅴ ; Double dose of sodium penicillin G. in the treatment of male gonorrhea

김중환,신학철 대한피부과학회 1982 大韓皮膚科學會誌 Vol.20 No.4

We reported previously that, combined with l. 0 gm of probenecid, sodium penicillin G. 4, 0 m.u.i.m. was slightly less effective than procaine penicillin G. 4. 8 m.u. i.m. in the treatment of uncomplicated male gonorrhea. We now present the effect of double dose of sodium penicillin G. in the treatment of uncomplicated gonorrhea. We now present the effect of double dose of sodium penicillin G. in the treatment of uncomplicated gonorrhea. The subjects were 262 male patients with uncomplicated gonoccccal urethritis at the VD clinic of Choong Ku Public Health Center in Seoul during 5 months period from January to May 198l. The following criteria were used to identify gonococcal infection - Gram negative intracellular diplococci in urethral smear and/or oxidase positive typical colony formation on Thayer-Martin media composed of Gram negative diplococci. They were given 4.0 m.u. sodium penicillin G. i.m. proceeded 15 to 30 min. by 1. 0 gm. probenecid p.o.. Four hours later, same amount of sodium peniciIlin G. i.m. was repeated. Concornitant eomparison of procaine penicillin G. was not done because of recent unavailability of the drug in Korea. To avoid pain, the drug is dissolved in 6 ml of normal saline plus 2 ml of 2% lidacaine. One hundred eighty five patients were able to be followed 3 to 7 days after the treatment. There were .24 (13%) failures and 17 (10. 6%) postgonococcal urethritis. During this study, l4 strains of PPNG (Penicillinase Producing Keisseria Gonarrhoeae) were detected with chromogenic cephalosporin slide method. There were 10 (5. 8%) failures among 171 patients with urethritis caused by non-PPNG. It is suggested that double dose of sodium penicillin G. is effective in the treatment of urethritis caused by non-PPNG. It is also suggested that beta-lactamase production should be tested before the initiation of treatment.

임질의 임상적 고찰

김중환,신학철 대한피부과학회 1980 대한피부과학회지 Vol.18 No.3

The efficacy of Thayer-Martin media (abbreviated TM media) recently introduced by the government, is a great concern to us. The results of culture on TM media are compared with the results obtained from Gram stained filrn. The subjects were 235 male patients with urethral discharge who visited the VD clinic of Choong-ku Puhlic Health Center in Seoul during 3 months period from 21th May to 20th August 1979. CDC recommendations are closely followed for Gram staining as well as for cultural identification. Among 151 positives with Gram staining, 142 were also culture positive (94.0%) while 8 were negative(5.2%) indicating reasonably good correlation. One patient was culturally positive(0. 8%) while negative by Gram staining. TM media supplied by Seoul Metropolitian Institute of Public Health which was used for this study is considered to be adequate.

임질의 임상적 고찰

김중환,신학철 대한피부과학회 1982 대한피부과학회지 Vol.20 No.2

임균의 균학적 연구

김영태,신학철,김중환 한양대학교 의과대학 1986 한양의대 학술지 Vol.6 No.2

Recently, in Korea, we have encountered difficulties in the treatment of gonococcal infections because Neisseria gonorrhoea has become increasingly less sensitive to penicillins and the most of other antibiotics. Although Penicillinase Producing Neisseria Gonorrhoeae (PPNG) strains have spread to the most of the world, its prevalence varies from region to region. In 1981 a sudden and unusually steep increase of PPNG strains had occured in Korea. In this study bacteriological characteristics of circulating Neisseria gonorrhoeae are evaluate. Plasmid analysis, serological classification and auxotyping were carried out on 82 Clinic of Choong-Ku Public Health Center in Seolu during 8 months period from February to October 1982. Plamid analysis showed that 2.6 mega daltons plasmid was detected from all PPNG and non-PPNG strains, 4.4 mega daltons plasmid from only, and every, PPNG strains and 24.5 mega daltons plasmid was detected from 40 (97.6%) of 41 PPNG strains and 26 (63.4%) of 41 non-PPNG strains. The serogroup of gonococcal isolates was limited to W Ⅱ type. The most common auxotype of gonococcal isolates was xero or wild type strain (PPNG: 89.7%, non-PPNG: 70%). No bacteriological charcteristics responsible for unusually steep increase of PPNG strains in Seoul in 1981 is found suggesting that the steep increase of PPNG strain in 1981 in Seoul had occured some other unknown factor or factors other than bacteriological one.

Gold 제제 사용후 발생한 약진 1 예

김중환,신학철,김출상,전중한 대한피부과학회 1981 大韓皮膚科學會誌 Vol.19 No.4

Gold preparation had been used frequently in the past in the treatment of rheumatoid arthritis, tuberculosis and lupus erythematosua, etc. It is still used. when other more potent remedies, such as steroid, failed. We report a case of drug eruption following the use of gold preparation. A 38 year-old female was referred to our department from orthopedic surgery because of generalized, multiple, pin head sized, violaceous and flat topped papules of 1 x 2 mm in size and mucosal erosions and ulcers following gold therapy for rheumatoid arthritis. She had received 5 intramuscular injections of gold preparation (Myochrysine'), 220mg in total amounts. Our clinical impression was lichen planus like drug eruption, but histopathological picture disclosed nonapecific dermatitis. The eruption had disappeared gradually following oral administration of antihistaminics and prednisolone and daily starch tub baths.

구강점막에 발생된 편평태선 : Report of A Case

이창우,김중환,신학철 대한피부과학회 1982 大韓皮膚科學會誌 Vol.20 No.3

Lichen planus is rare in Korea. and oral lichen planus is even rarer. To our knowledge, this is the first case reporting in Korean dermatological literature. 57 year-old man was seen for erythema with white striation on the oral mucosa in December 1981. The initial lisior s appeared on the buccal mucosa of left side of oral cavity 10 months ago. Thereafter he noticed similar lesions on the right side of buccal mucosa, hard palate, left side of upper and lower gingiva and left side of the lower lip. Histopathological and direct immunofluorescence studies showed typical features of lichen planus. Administration of griseofulvin(0. 5gm. of Fulvicin^R daily) for 4 weeks resulted in no clinical improvement. Oral retinoid(25mg of Ro 10-9359 daily) for 11 weeks resulte3 in healing of lesions with no side effect except slight dryness of the mouth.