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( Geun-hwi Park ),( Kihyuk Shin ),( Woo-il Kim ),( Min-young Yang ),( Won-ku Lee ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ),( Hoon-soo Kim ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.2
Background: It is difficult to determine the appropriate resection margin of extramammary Paget’s diseae (EMPD). Although Mohs micrographic surgery (MMS) is used effectively for surgical treatment of EMPD, it is important to form an appropriate negative margin in the preoperative stage because of its long surgical time. And the mismatch between clinical margin and histopathologic margin was frequently found depending on the location of EMPD. Objectives: The aim of our study was to find appropriate surgical margin determination for MMS in male EMPD patient. Methods: Retrospective evaluation of 34 EMPD patients was conducted concerning clinical and histopathological margin in preoperative scouting biopsy and MMS stage depending on location (abdomen vs. penis or scrotum) respectively. Results: A total of 34 cases of preoperative scouting biopsy were performed. The results of preoperative scouting biopsy which done 1 centimeter margin from clinical margin were as follow; 17 cases (abdomen< penis or scrotum), 2 (abdomen >penis or scrotum), and 15 (abdomen=penis or scrotum). And a total of 34 cases of MMS were performed on 33 primary tumors, 1 tumor recurrent after MMS. Mean age at time of MMS was 70.0 years (range: 54-90 years). The mean number of MMS stage was 1.7 (range: 1-4 stages). The mean margin needed to clear all tumors was 1.9cm (range: 1-5cm). Conclusion: The margin setting for MMS or preoperative scouting biopsy requires more than the standard clinical margin of 1cm for penis and scrotum.
( Geun-hwi Park ),( Kihyuk Shin ),( Woo-il Kim ),( Min-young Yang ),( Won-ku Lee ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ),( Gun-wook Kim ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1
Fungal infections are a significant cause of morbidity and mortality after organ transplantation. Especially, reports of cutaneous lesion as a first sign of systemic aspergillosis are extremely rare. Galactomannan, a diagnostic tool for aspergillosis, is a major component of the aspergillus cell walls, and the molecule is released during invasive disease. The test is extremely sensitive and specific in diagnosing aspergillosis. Herein, we present a patient with cutaneous aspergillosis as a first sign of systemic aspergillosis diagnosed with galactomannan. A 70-year-old male present for evaluation of knee with a purple-colored nodule within 2 months after renal transplantation. Histopathologic analysis showed dermal neutrophilic and granulomatous inflammation. In additional D-PAS stain, multiple fungal hyphae were observed, and the patient was diagnosed with cutaneous fungal infection. Unexpectedly, the patient visited emergency department with left side weakness and dysarthria. On the brain MRI, brain abscess suspected of fungal infection was observed. In addition, the patient diagnosed with systemic aspergillosis based on fungal ball on chest CT and positive result in the broncho-alveolar lavage fluid galactomannan test. Although the patient received systemic antifungal therapy, the patient died of systemic mycoses. Our case showed that cutaneous aspergillosis could be the first manifestation in patient with systemic infection.
Clinical analysis of localized hypertrichosis: a single center experience
( Geun-hwi Park ),( Woo-il Kim ),( Min-young Yang ),( Won-ku Lee ),( Tae-wook Kim ),( Sung-min Park ),( Hyun-joo Lee ),( Gun-wook Kim ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.2
Background: Hypertrichosis describes the growth of an excessive amount of hair on any area of the body. It can be classified based on its distribution (generalized versus localized) and the age of onset (congenital versus acquired). Many cases of localized hypertrichosis have been reported, but clinical research focused on clinical features in accordance with causes of localized hypertrichosis is rarely reported. Objectives: The purpose of this study was to investigate the clinical features of localized hypertrichosis. Methods: We performed a retrospective review of medical chart during a period of 12 years. Localized hypertrichosis with various causes were included, but hypertrichosis accompanied with congenital melanocytic nevus and Becker’s nevus were excluded in this study. Results: We included 48 patients with localized hypertrichosis. The ratio of congenital to acquired hypertrichosis was 1:2.2. The most common suspected cause of congenital and acquired hypertrichosis was ‘congenital smooth muscle hamartoma’ (46.7%), and ‘topical minoxidil’ (27.2%), respectively. The most common site of involvement was lower extremities (32.7%), followed by face (25.6%), and trunk (14.5%). Coexistent hyperpigmentation was also observed in 16 cases (33.3%), especially highly in patients with history of previous trauma (87.5%). Conclusion: Clinical features in accordance with various causes of localized hypertrichosis in this study could be helpful for dermatologists managing hypertrichosis
Dermoscopic findings of metastatic skin cancers: a single center experience
( Geun-hwi Park ),( Woo-il Kim ),( Min-young Yang ),( Won-ku Lee ),( Tae-wook Kim ),( Sung-min Park ),( Hyun-joo Lee ),( Gun-wook Kim ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.2
Background: Though skin metastasis is rare, it can seriously affect the prognosis and management. The role of dermoscopy in primary skin cancers are established well, but its role in skin metastasis hasn’t been clear. Objectives: This study was performed to elucidate the dermoscopic patterns of metastatic skin cancers. Methods: We analyzed the dermoscopic patterns and clinical data of 46 patients with metastatic skin cancers at Pusan National University Hospitals (Busan and Yangsan) from 2005 to 2018. Results: Mean age and disease free interval were 62.0±14.2 years and 29.2±41.2 months, respectively. The most common primary origin of cancer was breast (11/46, 23.9%), followed by lung (8/46, 17.4%), and upper gastrointestinal tract (8/46, 17.4%). Any dermoscopic patterns was not found in 8 cases, who showed subcutaneous nodules without surface change. Most common dermoscopic pattern was vascular pattern (30/46, 65.2%), followed by homogenous structureless pattern (16/46, 34.8%). Most common vascular pattern was serpentine and arborizing vessel (23/46, 50%), followed by dotted vessel (7/46, 15.2%). There was no significant difference in dermoscopic vascular pattern among cancers, because the number of subjects was insufficient. Conclusion: Based on our study, when vascular patterns such as serpentine and arborizing vessel or dotted vessel are seen on dermoscopy within a nodule in a patient already diagnosed with cancer, metastatic skin cancer should be strongly considered.
Acquired Port-Wine Stain Following Minor Trauma: Fegeler Syndrome
( Geun-hwi Park ),( Woo-il Kim ),( Min-young Yang ),( Won-ku Lee ),( Tae-wook Kim ),( Sung-min Park ),( Hyun-joo Lee ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ),( Gun-wook 대한피부과학회 2019 Annals of Dermatology Vol.31 No.Suppl
( Geun-hwi Park ),( Hyang-suk Ryu ),( Woo-il Kim ),( Min-young Yang ),( Won-ku Lee ),( Tae-wook Kim ),( Hyun-joo Lee ),( Gun-wook Kim ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1
Dermatofibroma is fibrohistiocytic tumor of the skin, commonly occurs as a solitary lesion on the lower extremities of young women. Multiple eruptive dermatofibromas (MEDFs), defined as presence of 5 to 8 dermatofibromas appearing within a period of 4 months, are rare and etiology of MEDFs is still unknown. However, they are frequently thought to be associated with altered immunity, such as autoimmune diseases and immunosuppression. It is unclear why MEDFs occur in association with these conditions, but this relationship may suggest that MEDFs are the result of an abortive immunoreactive process. We herein describe a middle-aged women who developed multiple dermatofibroma. She had myasthenia gravis for 8 years, and developed MEDFs after undergoing oral corticosteroid treatment (245 mg/wk) for 3 months. Therefore, our case could attribute to theory that using immunosuppressants works more dominant factor on occurrence of MEDFs than underlying immune disease.
Metastatic penoscrotal and vulvar extramammary Paget’s disease: Case series of four patients
( Geun-hwi Park ),( Kihyuk Shin ),( Woo-il Kim ),( Min-young Yang ),( Won-ku Lee ),( Gun-wook Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ),( Hoon-soo Kim ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1
malignancy. The most common presentation of EMPD is the vulvar followed by scrotum, perineum, and perianal involvement. Patient with EMPD tend to have a good prognosis because the spread of tumor cells progresses slowly and is restricted to the epidermis and cutaneous adnexal structures. However, once the tumor invades the dermis, the risks of lymph node metastases and distant metastases increase, sometimes resulting in a poor outcome. Although local recurrence is common after inadequate excision, systemic metastases are seldom reported in the literature. Herein, we report on four cases with metastatic EMPD not associated with any underlying neoplasm. Three male and one female patients underwent Mohs micrographic surgery and confirmed margin negative after having been diagnosed with EMPD. During follow-up period, local, regional, and distant metastases were observed in four patients. There were local recurrence of the penile root in all three male patients, and local recurrence of the labia majora in female patient. Because metastatic EMPD was rarely reported, metastatic pathways and risky location were not well known yet. In these cases, it is characteristic that the recurrence site is near the groin lymphatic drainage site. Furthermore, penile root and labia majora is considered to be a homologous organ, it can be assumed that drainage will be done by similar pathways.
Mechanism Development and Position Control of Smart Buoy Robot
Hwi-Geun Park,Hyun-Sik Kim 한국해양공학회 2021 韓國海洋工學會誌 Vol.35 No.4
There is a gradual increase in the need for energy charging in marine environments because of energy limitations experienced by electric ships and marine robots. Buoys are considered potential energy charging systems, but there are several challenges, which include the need to maintain a fixed position and avoid hazards, dock with ships and robots in order to charge them, be robust to actions by birds, ships, and robots. To solve these problems, this study proposes a smart buoy robot that has multiple thrusters, multiple docking and charging parts, a bird spike, a radar reflector, a light, a camera, and an anchor, and its mechanism is developed. To verify the performance of the smart buoy robot, the position control under disturbance due to wave currents and functional tests such as docking, charging, lighting, and anchoring are performed. Experimental results show that the smart buoy robot can operate under disturbances and is functionally effective. Therefore, the smart buoy robot is suitable as an energy charging system and has potential in realistic applications.
Long second toe: its nail and skin changes
( Geun-hwi Park ),( Woo-il Kim ),( Min-young Yang ),( Won-ku Lee ),( Tae-wook Kim ),( Sung-min Park ),( Hyun-joo Lee ),( Gun-wook Kim ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.2
Background: Nail can be affected by trauma, infection, and systematic disorders. In particular, the toe nails are exposed to the repeated and cumulative minor traumas, which usually result in thickened, splitted, and discolorated nails. Considering these, it can be inferred that the long second toe can be related to various nail and skin changes by repeated minor traumas such as friction in shoes, but the study or report on this topic hasn’t been done yet. Objectives: The purpose of this study was to introduce various nail and skin changes on long second toe. Methods: We analyzed the kinds of nail/skin changes of 50 patients with long second toe, enrolled at Pusan National University Hospitals (Busan and Yangsan) from 2013 to 2018. Results: There was no significant difference in the incidence of left and right toe and toenail, and 7 (14%) patients presented bilateral distribution. The most common nail change on long second toe was melanonychia (23, 46%), followed by subungual hematoma (15, 30%), onycholysis (2, 4%), subungual hyperkeratosis (2, 4%), onychomadesis (1, 2%), and retronychia (1, 2%). The most common skin change was corn (9, 18%), followed by paronychia (2, 4%). Twenty (20/50, 40%) patients also had other toe or toenail changes. Among them, the most common site was big toe/nail (13, 62%), and the most common change was subungual hematoma (8, 42%). Conclusion: Through this study, the dermatologists can recognize and diagnose the nail and skin changes of long second toe.
Acquired port-wine stain following minor trauma: fegeler syndrome
( Geun-hwi Park ),( Woo-il Kim ),( Min-young Yang ),( Won-ku Lee ),( Tae-wook Kim ),( Sung-min Park ),( Hyun-joo Lee ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ),( Gun-wook 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1
Fegeler syndrome, also known as acquired port-wine stains (PWS), is rare skin disease that occurs after age. It is morphologically the same as congenital PWS in well-demarkated, bright red to purple colored macules or patches. While most of congenital PWS are located on the head-neck, acquired PWS can occur on anywhere. In literature, various causes such as trauma, hormone, thermal damage, and solar damages may contribute to the development of acquired PWS. Acquired PWS also shows identical features on histopathologic characteristics to congenital PWS by dilatation of capillaries in the upper dermis with normal endothelial cells. We report here a 28-year-old female presented with acquired PWS on the right hand dorsum, and right forearm. The lesion appeared after a cast due to sprain in 6-year-old. Histopathologic analysis of a biopsy specimen reveals a reasonable finding for PWS. We recommended pulsed dye laser therapy, however she didn’t want to receive treatment. To our knowledge, there are some case reports about acquired PWS in literature. However, this is a rare case for acquired PWS caused by minor trauma and first report in Korean literature.