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.

아시아 지역 폐렴 구균의 항균제 내성 현황 및 변화 양상 : Asian Network for Surveillance of Resistant Pathogens (ANSORP) Study

정숙인,김나영,손준성,기현균,고관수,서지연,장현하,김연숙,오원섭,백경란,이남용,송재훈,항생제 내성 감시를 위한 아시아 연합 (ANSORP) 대한감염학회 2004 감염과 화학요법 Vol.36 No.1

목적 : 1980년대부터 페니실린을 비롯한 β-lactam 계열과 비 β-lactam 계열 항균제에 대한 폐렴구균의 항생제 내성이 급격하게 증가하여 국내 뿐 아니라 세계적인 문제로 대두되고 있다. ANSORP 에서는 아시아 지역에서 폐렴구균의 항균제 내성과 그 변화 추이, 내성의 기전 및 위험인자를 분석하고자 본 국제 공동 연구를 시행하였다. 재료 및 방법 : 1999년 11월부터 2001년 8월까지 아시아 지역 12개국의 14개 기관에서 폐렴구균 감염증 환자의 임상 검체로 분리된 침습성 폐렴구균을 대상으로 액체배지 미량희석법을 이용하여 16개 항생제의 MIC를 구하였다. 위험인자의 분석을 위하여 폐렴구균 감염증 환자를 대상으로 의무기록지를 조사하였다. Quellung 반응을 통해 혈청형을 결정하였다. 결과 : 총 685균주 중 52.4%가 페니실린에 대하여 비감수성(중등도 내성 22.9%, 내성 29.5%)을 보였고, 그 빈도는 베트남(92.1%), 스리랑카(85.7%), 홍콩(67.9%), 한국(64.5%)의 순이었다. Erythromycin에 대한 비감수성 비율은 베트남(92.1%), 대만(87.7%), 한국(80.6%), 홍콩(76.8%) 등에서 높게 나타났고, 베트남, 대만, 한국, 홍콩 등의 erythromycin의 MIC_(90)이 32㎍/mL를 넘는 고도내성을 보였다. 홍콩, 싱가포르, 대만, 인도에서는 fluoroquinolone에 대한 내성 균주가 출현하였다. 전체 균주 중 다제내성 균주의 비율은 47.7%였다. 혈청형은 19형과 23형이 가장 많았고, 그 외 6형, 14형 등이 있었다. 페니실린 비감수성 감염증의 위험인자로는 5세 미만(OR=1.7; 95%, CI, 1.2-2.4; P=0.002), 기관지폐질환(OR=2.0; 95%, CI, 1.3-3.1; P=0.003), 악성종양(OR=2.3; 95%, CI, 1.2-4.6; P=0.015), 스테로이드의 사용(OR=2.8; 95%, CI, 1.1-7.4; P=0.032)이 확인되었다. 결론 : 침습성 폐렴구균 균주를 대상으로 한 본 연구의 결과 아시아 국가들에서 페니실린, β-lactam 및 macrolide에 대한 폐렴구균의 내성률 및 내성 정도가 급증하고 있음을 확인하였다. Background : Emergence of pneumococcal resistance became a global issue since 1990s. According to the ANSORP studies with clinical isolates and carriage isolates between 1996 and 1999, some Asian countries showed alarmingly high prevalence of resistance to penicillin and other antimicrobial agents. To investigate the changing trends of pneumococcal resistance, ANSORP study group has performed a multinational surveillance study with invasive pneumococcal isolates from Asian countries. Methods : All isolates from various invasive pneumococcal diseases were prospectively collected from 14 centers in 12 countries between November 1999 to August 2001. Broth microdilution tests with 16 antimicrobial agents were performed according to the NCCLS procedures. Serotyping was performed by means of Quelling reaction with use of group-specific antisera. Results : A total of 685 isolates were collected. Overall, 52.4% of invasive isolates from Asian countries were not susceptible to penicillin (intermediate (1), 22.9%, Resistant (R), 29.5%). Vietnam showed the highest prevalence of penicillin non-susceptibility (1 20.6%, R 71.4%) followed by Sri Lanka (1 71.4%, R 14.3%), Hong Kong (1 24.1%, R 76%) and Korea (1 9.7%, R 54.8%). China (I 19.8%, R 23.4%) and Malaysia (1 9.1%, R 29.5%) also showed remarkable increase in penicillin resistance compared with previous ANSORP data, which were less than 10%. Vietnam (92.1%), Taiwan (87.7%), Korea (80.6%), and Hong Kong (76.8%) showed high prevalence of erythromycin resistance. MIG_(90)S for ciprofloxacin were 4 ㎍/mL (Hong Kong) and 2 ㎍/mL (11 Asian countries except Hong Kong), respectively. Conclusion : Compared with previous data from ANSORP studies, antimicrobial resistance among invasive pneumococcal isolates has markedly increased in Vietnam, Sri Lanka, Taiwan, China, and Malaysia. Continuous surveillance of pneumococcal resistance in Asia is strongly warranted.

Association Between Gut Regulatory Hormones and Post-operative Weight Loss Following Gastrectomy in Patients With Gastric Cancer

Hye-Kyung Jung,Chung Hyun Tae,Hye Ah Lee,Ko Eun Lee,Chang Mo Moon,Seong Eun Kim,Ju Young Seoh,Joo-Ho Lee 대한소화기 기능성질환·운동학회 2022 Journal of Neurogastroenterology and Motility (JNM Vol.28 No.3

Background/AimsPost-operative weight loss in patients with gastric cancer lead to a poor quality of life and long-term survival. This study aims to evaluate the effects of gut regulatory hormones on post-operative weight loss in patients with subtotal gastrectomy for gastric cancer. MethodsThis prospective study was conducted for 12 months post-surgery in 14 controls and 13 gastrectomy patients who underwent subtotal gastrectomy for gastric cancer. Serum plasma ghrelin, glucagon-like peptide-1, gastric inhibitory peptide-1, peptide YY, insulin, and homeostatic model assessment for insulin resistance responses to a standardized test meal were recorded at multiple time points before and after gastrectomy at 4 and 12 months. ResultsThe mean weight difference between the pre-operative state and the 4-month period was significantly reduced to 6.6 kg (P = 0.032), but significant weight reduction was not observed from 4 months to 12 months. The plasma levels of glucagon-like peptide-1, gastric inhibitory peptide-1, and peptide YY were significantly increased 4 months postoperatively compared to the pre-operative state (all P = 0.035); however, pre-operative levels and relative changes over a period of 0-4 months of hormones were not correlated with body weight changes. Only the pre-operative ghrelin at peak had a negative correlation with changes in weight reduction in the 4 months after surgery (ρ = −0.8, P = 0.024). ConclusionsSignificant weight reduction was common after subtotal gastrectomy for gastric cancer with a negative correlation pre-operative plasma ghrelin levels. Incretin hormones are modestly but significantly increased after subtotal gastrectomy; however, these changes did not affect the weight changes.

Factors associated with inflammatory change of epidermal cyst

( Jisang Yun ),( Kyung-nam Bae ),( Jin-hwa Son ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byungsoo Kim ),( Moon-bum Kim ),( Kihyuk Shin ) 대한피부과학회 2021 대한피부과학회 학술발표대회집 Vol.73 No.1

Background: Epidermal cysts (EC) are the most common tumors found on the skin and accompanying inflammation is also frequent. However, the predictors for inflammatory change have not been investigated yet. Objectives: This study was performed to investigate the difference between inflamed and uninflamed epidermal cysts, and to assess associated factors for inflammatory change. Methods: We analyzed the biopsy-proven 1723 epidermal cysts (515 inflamed and 1208 uninflamed) at two tertiary hospitals from 2011 to 2021. Results: The proportion of inflamed epidermal cysts (IEC) and uninflamed epidermal cyst (UIEC) were 29.9 % and 70.1 %, respectively. Inflammatory change was less frequently observed on the face (25.5 %) than the other sites (32.1 %) (p=0.0046). The anatomic location with the highest rate of inflammatory change was back (40.8 %, p=0.0004). Mean duration of inflammatory change from UIEC to IEC on the face was shorter than the other sites (12.5 months vs 17.9 months, respectively, p= 0.0473). On ultrasonography, long axis of IEC (20.7mm) was generally longer than that of UIEC (15.7mm) (p=0.0218). Moreover, Inflammatory change was more frequent on the EC with punctum compared to those without punctum (35.3 % vs 30.3 %, P=0.0471). Conclusion: Based on the location, size and presence of punctum, decision on the optimal treatment strategies can be established when encountering patients with EC.

P177 Dermoscopic findings during the course of β -blocker treatment for infantile hemangioma

( Jin-hwa Son ),( Hyun-ju Jin ),( Hyang-suk You ),( Woo-haing Shim ),( Jeong-min Kim ),( Gun-wook Kim ),( Hoon-soo Kim ),( Byung-soo Kim ),( Moon-bum Kim ),( Hyun-chang Ko ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.2

<div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div> Background: Dermoscopy is a useful tool for examining morphology and structure of blood vessels in vascular skin lesions like infantile hemangioma (IH). However, dermoscopic findings are not fully elucidated in the course of β-blocker treatment for IH. Objectives: To investigate changes of dermoscopic findings during the course of β-blocker treatment for IH. Methods: Superficial or mixed-type IH patients treated with topical timolol solution or oral propranolol were enrolled in Pusan National University Hospitals (Busan and Yangsan) from November 2011 to January 2016. Clinical photograph and dermoscopic findings were recorded and assessed at the baseline, 1, 2, 3 and 6 months. Results: Total 115 patients (male: 38 and female: 77 / superficial type: 48 and mixed type: 67 / timolol: 77 and propranolol: 38) were included. Diffuse light erythema tended to be diminished but milky-red area increased gradually during the course of treatment. The patients treated with oral propranolol showed more prominent changes on each dermoscopic findings than those treated with topical timolol (p=0.023 and p=0.018, respectively). But, other findings like red-globular vessels, red-dot vessels, red-circulated vessels, red-linear vessels did not show significant changes. Conclusion: Dissolution of diffuse light erythema and increase of milky-red area were significant dermoscopic findings in accordance with clinical improvement after β -blocker therapy for IH.

FC 2-8 : Factors associated with inflammatory change of epidermal cyst

( Jisang Yun ),( Kyung-nam Bae ),( Jin-hwa Son ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byungsoo Kim ),( Moon-bum Kim ),( Kihyuk Shin ) 대한피부과학회 2021 대한피부과학회 학술발표대회집 Vol.73 No.-

Background: Epidermal cysts (EC) are the most common tumors found on the skin and accompanying inflammation is also frequent. However, the predictors for inflammatory change have not been investigated yet. Objectives: This study was performed to investigate the difference between inflamed and uninflamed epidermal cysts, and to assess associated factors for inflammatory change. Methods: We analyzed the biopsy-proven 1723 epidermal cysts (515 inflamed and 1208 uninflamed) at two tertiary hospitals from 2011 to 2021. Results: The proportion of inflamed epidermal cysts (IEC) and uninflamed epidermal cyst (UIEC) were 29.9 % and 70.1 %, respectively. Inflammatory change was less frequently observed on the face (25.5 %) than the other sites (32.1 %) (p=0.0046). The anatomic location with the highest rate of inflammatory change was back (40.8 %, p=0.0004). Mean duration of inflammatory change from UIEC to IEC on the face was shorter than the other sites (12.5 months vs 17.9 months, respectively, p= 0.0473). On ultrasonography, long axis of IEC (20.7mm) was generally longer than that of UIEC (15.7mm) (p=0.0218). Moreover, Inflammatory change was more frequent on the EC with punctum compared to those without punctum (35.3 % vs 30.3 %, P=0.0471). Conclusion: Based on the location, size and presence of punctum, decision on the optimal treatment strategies can be established when encountering patients with EC.

Salt and pepper appearance of the skin associated with mixed connective tissue disease

( Sang-hyeon Won ),( 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.1

The salt-and-pepper appearance of skin is composed of salt (vitiligo-like depigmentation) and pepper(perifollicular pigmentation). This characteristic feature can be a clinical clue for the diagnosis of systemic sclerosis. Mixed connective tissue disease(MCTD) is a distinct disease entity with mixed features of systemic lupus erythematosus, systemic sclerosis, myositis and rheumatoid arthritis with high titers of antibodies to U1 small nuclear ribonucleoprotein(U1 snRNP). Therefore, MCTD is known to have a wide spectrum of cutaneous manifestations which may be the presenting signs of the disease. However, there are few reports of pigmentary changes in MCTD. A 51-year old woman presented with variably sized hypopigmented macules along with relative hyperpigmentation of the perifollicular areas. She was diagnosed with MCTD by Raynaud’s phenomenon and high titer anti-RNP corresponding to a speckled antinuclear antibody of 1:1280 in Rheumatology clinic. A biopsy specimen showed dermal sclerosis. Pigment loss and melanophages were observed in the papillary dermis. Hypo- and hyperpigmentation were confirmed histologically by S100 and Fontana-Masson stain. To our knowledge, ‘salt and pepper appearance of the skin’ has rarely been reported in MCTD. The diagnosis of MCTD can be challenging due to its diverse characteristics. Therefore, we suggest that MCTD should be regarded as a differential diagnosis in patient with this pigmentary change.

Acral calcified angioleiomyoma: a rare clinicopathologic variant of cutaneous angioleiomyoma

( Kihyuk Shin ),( 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 Ki 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1

Cutaneous angioleiomyomas are benign tumors with vascular smooth muscle differentiation. The tumor usually involves the lower extremity, but acral sites such as toes, fingers, feet, and hands are rarely affected. Leiomyoma of deep soft tissue commonly shows regressive changes including prominent fibrosis, and calcification, however, cutaneous angioleiomyoma rarely manifests these changes. A 61-year-old female presented with subcutaneous nodule on the right heel. The lesion began to develop 3 months ago without history of trauma or infection, and the patient reported no subjective symptom. The lesion was totally excised, and histopathology revealed a well-circumscribed, non-encapsulated tumor composed of interlacing fascicles of spindled cells with elongated blunt-ended nuclei. A major finding was extensive calcifications, which dominated over the cellular component. On immunohistochemical examination, the spindle cells expressed strong immunoreactivity for α -smooth muscle actin. Based on these findings, a diagnosis of acral calcified angioleiomyoma was made. We have described a rare clinicopathologic variant of angioleiomyoma which has a predilection for acral locations and shows extensive calcifications predominating over the tumor itself. To our knowledge, this is the first report of a patient with acral calcified angioleiomyoma in Korean dermatologic literature.

동종 조혈모세포이식 후 발생한 크립토콕쿠스 척추염 1예

고윤호,임동준,이성수,조유경,이동건,최정현,김유진,민창기,김동욱,박정미,김춘추,신완식 대한감염학회 2001 감염 Vol.33 No.4

Skeletal cryptococcosis is an uncommon infection. Cryptococcus is a common cause of meningitis and infects 7∼10% of patients with AIDS. As well as AIDS, the infection may be seen in association with leukemia, lymphoma, Hodgkin's disease, sarcoidosis, tuberculosis and diabetes, also in patients on steroid medication. But there is no case report of skeletal cryptococcosis following allogeneic hematopoietic stem cell transplantation. A 40-year-old woman was admitted to the hospital because of low back pain. She had chronic myelogenous leukemia for 2 years and underwent allogeneic hematopoietic stem cell transplantation 8 months ago. She have been treated with steroid and cyclosporine orally because of chronic graft versus host disease. On examination she was afebrile and had posterior lower lumbar tenderness. But, she had no reduced strength of low extremities. Open biopsy was underwent. Histology demonstrated budding, round-to-oval, refractile yeast-like organisms within debris. The results of a lumbar puncture were unremarkable and cerebrospinal fluid culture failed to grow bacteria and yeast. The patient was treated with amphotericin B (1 gram) and AmBisome□ (2.8 gram) over 6 weeks. Three months after cessation of therapy, the patient was doing well.(Korean J Infect Dis 33:298∼301, 2001)

전공별 무용 상해에 관한 조사 연구

장명재,고경아,최현희 경희대학교 체육과학연구소 2000 體育學論文集 Vol.28 No.-

The studies is aimed to find out the problems and to devise its proper measure for prevention by reviewing and by analyzing the information derived from questionnaire method regarding the injury situation. At the result of survey conducted subject to the current 301 student dancer who are sampled from Universities throughout the seoul by random sampling. 1. It was found that 95% of dancer experienced injury while they play the dance and 63.5% of dancer experienced frequently 2. As the term of major is longer, the more the probability of injury, and the mortal the injury. 3. 66.1% of dancer had sawn the other dancer stop major because of injury. As we found in this article, in spite of the many studios on dance injury in many aspects, Injury prevention and self-cure was very lack. I conclude that more studies on prevention dance injury must be carried and most important thing is that dancer must take care oneself whenever dance and exercise.