모세혈관 확장성 윤상 자반병양 피부 병변을 보인 매독진

김희옥(Hee Ok Kim),최연상(Yeon Sang Choi),유희준(Hee Joon Yu),손숙자(Sook Ja Son) 대한피부과학회 1994 대한피부과학회지 Vol.32 No.5

The skin manifestations of secondary syphilis, termed syphilid, show macular, papular and papulosquamous rashes in most cases, but may show lots of other clinical findings. We report a case of syphitid simulating purpura annulsris telangieitodes in 25-year-old male who had a history of genital ulcer 2 months ago. The skin lesion showed diffuse erythematous, 1-3 cm sized, telangiectatic annular patchea and purpuric plaques on both lower extremities and discrete papulosquamous rashes on both soles. The results of the serologic test for syphili was found to be reactive to 32 dilution in serum VDRL test and positive in serum TPHA test. Histovathologically, we could observe the obscuring of dermoepidermal juction, coat-sleeve-like perivascular infiltrate composed of mononuclear cells and a few plasma cells, and endothelial swellings. Afte the treatment with benzathine penicillin G, the titer of serurn VDRL test was decreased abruptly to 4 dilution and the skin lesions disappeared completely. (Kor J Dermatol 1994;32(5):926-930)

매독진의 병리조직학적 고찰

김희옥(Hee Ok Kim),유희준(Hee Joon Yu),손숙자(Sook Ja Son),유태연(Tae Yun Yoo) 대한피부과학회 1993 대한피부과학회지 Vol.31 No.2

Background : The differentiation of syphilids from other skin decreases is frequently difficult due to considerable variations of clinical and histologic pattern. The most common histologic changes in secondary syphilis are swelling & proliferation of endothelial cells and the presence of a perivascular infiltrate containing plasmia cells. But often, these findings are absert or inconspicuous. Objectlve : We examined the histopathologic findings of secondary syphilis in relation to the clinical types of the skin lesion. Methods : 36 biopsy specimens from twenty-nine serologically and clinically confirmed cases of secondary syphilis (15 macules, 8 papules, 2 condylomata latas and 11 papulosquamous lesions) were examined. Raeults : The histopath,ologic findings of secondary syphilis showed comparative differences according to the clinical types of the skin lesion. The plasms cell infltrates were absent or sparse in 14 csses(39%) and the plasma cell infiltration was significantly correhted with the age of skin lesions(p=0.02197). Vascular changes were seen in 32 cases (89%), but the incidence of endothelial proliferation was less(25%). Conclvsion : This study demonstrates the histopathologic findirigs of secondary syphilis in accordance to the clinical morphology of the eruption and thus, help to differentiate syphilids from other skin diseases. (Kor J Dermatol 1993; 31(2): 197-203)

The Effect of Single Estrogen and Continuous Combined Estrogen + Progestin on Lipid Profile and Bone Mineral Density in Premenopausal Hysterectomised and Natural Menopausal Women

김희옥 ( Hee Ok Kim ),( Min Young Yoo ),( Eun Hee Yoo ),( Han Ki Yu ) 대한산부인과학회 1999 대한산부인과학회 학술대회 Vol.84 No.-

유두상 한관선종과 병리조직학적 유사성을 보인 유두 유두상 선종

김희옥(Hee Ok Kim),최연상(Yeon Sang Choi),유희준(Hee Joon Yu),손숙자(Sook Ja Son),양정현(Jung Hyun Yang) 대한피부과학회 1994 대한피부과학회지 Vol.32 No.6

A 24-year-old woman was seen for evaluation of an skin lesion on thiright nipple. Examination revealed a solitary 1.5 x 1cm-sized, erythematous, oozing, eroded andruted, verrucous nodule on the right nipple. A small amount of serous discharge was found but there was no pain or tenderness. Histopathologic findings showed cystic invaginations extending down vard from the epidermis and papillary projections extending into the lumina of the invagination. Pupiae were lined by two rows of cells. In stroma, there were marked inflammatory infiltrates containing any plasma cells. The overlying dermis showed an adenomatous growth pattern with a prolifertion of round, oval or irregular shaped ducts and fibrotic stroma. (Kor J Dermatol 1994; 32(6): 1123-1126)

폐경전 자궁적출술을 시행받은 여성과 자연폐경 여성에서 에스트로겐 단독투여와에스트로겐+프로게스틴의 지속적 병합투여시 지질 및 고밀도의 변화에 대한 연구

김희옥(Hee Ok Kim),유민영(Min Young Yoo),김연정(Youn Jung Kim),박지은(Ji Eun Park),양훈진(Hoon Jin Yang),유은희(Eun Hee Yoo),전선희(Sun Hee Chun),김종일(Chong Il Kim),유한기(Han Ki Yu) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.10

목적 : 폐경전 자궁적출술을 시행받은 여성과 자연폐경 여성에서 에스트로겐 단독투여시와 에스트로겐과 프로게스테론의 지속적 병합투여시 지질 및 골밀도의 변화에 대한 차이를 비교하기 위한 연구이다. 연구방법 : 총 80명의 환자중 치료 1군(50명)은 폐경전 자궁적출술을 시행받은 환자로 접합 에스트로겐 0.625mg을 48개월간 지속적으로 투여받았고, 치료 2군(30명)은 접합 에스트로겐 0.625mg과 MPA 2.5mg을 지속적으로 병합 투여 받았다. 투여전과 투여후 6개월, 12개월, 24개월, 36개월, 48개월 후에 혈청 지질 및 지단백과 골밀도의 변화를 측정하였다.결과 : 총콜레스테롤치는 두 군에서 각각 치료 48개월후 9.9%, 10.8% 감소하였고, LDL-콜레스테롤치는 20.1%, 16.3% 감소하였다. HDL-콜레스테롤치는 각각 21%, 31.9% 증가하였다. 척추골 골밀도는 두 군에서 각각 치료 48개월후 11.6%, 14.9% 증가하였고, 대퇴골 골밀도는 12.9%, 14.9% 증가하였다.두 군 사이의 통계적 유의한 차이는 없었다.결론 : 에스트로겐 단독 투여와 에스트로겐과 프로게스테론의 지속적 병합 투여는 모두 심혈관질환과 골다공증에 유익한 효과가 있다. 자연 폐경 여성에서는 에스트로겐 단독 투여보다 에스트로겐과 프로게스테론의 지속적 병합 요법이 더 바람직하다고 할 수 있다. Objective : Our purpose was to investigate the effect of single estrogen and continuous combined estrogen + progestin on lipid profile and bone mineral density.Method : We have treated two groups of menopausal women for 4 years, ; Group 1(hysterectomised women) received conjugated equine estrogen(CEE) 0.625mg per day for 30 days ; Group 2(natural menopausal women) received continuous combined therapy(CEE 0.625mg and MPA 2.5mg per day) for 30 days.We compared pre-and poststudy serum lipid profile and bone mineral density in two groups.Result : The data demonstrated a beneficial effect in lipoprotein profile that total cholestrol decreased in two groups by 9.9% and 10.8% from the baseline values. Low density lipoproten(LDL)-cholesterol decreased in two groups by 20.1% and 16.3% in post HRT 48 months, high density lipoproten(HDL)-cholesterol increased in two groups by 21% and 31.9%. And HRT shows the beneficial effect in bone mineral densities. Lumbar BMD increased in two groups by 11.6% and 14.9% and femur BMD increased in two groups by 12.9% and 14.9% from the baseline value.Conclusion : Our result suggest that single estrogen therapy and continuous combined estrogen-progestin therapy has beneficial effect on cardiovascular disease and osteoporosis. Their effects were not significantly different among two groups. So we suggest that continuous combined estrogen-progestin therapy is preferable to single estrogen therapy.

Bart 증후군

김희옥(Hee Ok Kim),백영곤(Young Gon Baik),유희준(Hee Joon Yu),손숙자(Sook Ja Son) 대한피부과학회 1993 대한피부과학회지 Vol.31 No.4

Barts syndrome was desrribed by Bart(Bart et al, 1966) with hereditary congenital localized absence of skin from the lovrer legs associated with blistering of the sun and mouth and nail abnormalities. A newborn girl presented with a congenital localized absence of skn over both shins & dorsa of both feet which were covered with the thin, translucent, brown red glistening membranes. A number of blisters were seen on the back, thighs upper extremities, and both 2rd toe nails were absent. Electron microscopic examination of defected skin revealed dermo-epidermal . paration with focal disruption of basal lamina. (Kor J Dermatol 1993;31(4):620-623)

절삭유 취급 근로자의 피부질환에 관한 연구

천병철,김희옥,김순덕,오칠환,염용태,Chun, Byung-Chul,Kim, Hee-Ok,Kim, Soon-Duck,Oh, Chil-Hwan,Yum, Yong-Tae 대한예방의학회 1996 예방의학회지 Vol.29 No.4

절삭유의 사용과 피부질환의 관계를 알아보기 위하여 한 자동차공장의 엔진 및 구동부서 근로자 1,004명을 대상으로 피부 이상 증세에 대한 기초설문조사를 실시하여 응답을 해준 근로자 667명을 대상으로 분석 및 피부과적 검진을 실시하였다. 또한 절삭유의 노출 정도를 알기 위한 방법으로 공기 중 오일 미스트를 측정하였다. 이 조사의 결과를 요약하면 다음과 같다. 1. 공기 중 오일미스트는 3개 부서로 나누어서 측정 하였는데, 전체 52건의 측정건수 중에서 8시간가중 평균 기준치인 $5mg/m^3$을 넘는 건수는 9건(17.3%)이었고, 로그정규분포상에서 95% 신뢰한계의 전체 상한치는 기준치 미만이었다. 2. 조사한 부서는 엔진가공부(258명), 가솔린 엔진조립부(210명), 디젤엔진조립부(96명), 구동부 가공반(86명), 구동부 조립반(17명)의 5개 부서였으며, 조사한 667명의 평균 나이는 34.5세였고, 근무연수의 중앙값은 7년 7개월이었다. 3. 이들 부서 중 엔진가공부와 구동부 가공반(A군)은 절삭유를 공정상 많이 사용하는 부서로 근로자 344명 중 298명 (86.6%)이 한 가지 이상의 절삭유를 사용하고 있는 반면, 가솔린엔진 조립부, 디젤엔진 조립부, 구동부 조립반의 근로자 323명(B군) 중에는 31명 (9.1%)만이 절삭유를 사용하고 있었다. 4. 피부 이상 증세의 경험자 227명 중 213명에 대하여 피부과전문의의 진찰을 시행하였는데, 이중에 172명이 검진당시 증세를 호소했는데, 1인당 평균 호소증세 건수가 1.5건 정도였다. 가장 많은 증세는 가려움증(32.5%), 구진(21.6%), 인설(15.7%), 소수포(12.5%), 반점(9.4%)의 순서였다. 5. 검진을 받은 근로자 231명 중 정상소견이나 뚜렷한 병변이 없는 사람으로 분류된 경우는 53명이었고, 나머지 160명에서 피부과적 질환이 발견되었다. 가장 많은 것은 접촉 피부염으로 전체 질환자 중 92명 (57.5%)을 차지하였고, 이들 중에는 여드름이나 낭포염 등 기타 다른 피부질환을 동반한 경우가 23명 (25%) 이었다. 기타 낭포염, 여드름만 있는 경우도 각각 9명(5.6%), 8명(5.0%)이었으며 , 각질화와 색소 이상도 1명 씩 발견되었다. 기타의 수부 습진은 비특이성 수부습진으로 분류되었는데 이들은 47명이었다. 6.피부질환이 있다고 진단받은 160명에서 발견된 피부과적 이상부위는 1인당 1.3부위였다. 이상이 발견된 부위는 손바닥(27.6%), 손가락과 손톱(22.7%), 상박부(16.0%), 손등(11.8%), 손가락 사이(10.3%)의 순이었고, 이들 수부 및 상박부위의 이상이 전체 이상의 약 88.7%였다. 7. 전체 피부질환의 유병상태는 각 부서별로 차이가 많았는데, 특히 접촉 피부염의 경우 엔진가공부는 1,000명당 213명, 가솔린엔진 조립부는 1,000명당 29명, 디젤엔진 조립부는 1,000명당 73명이었고, 구동부 가공반은 1,000명당 267명, 구동부 조립반은 1,000명당 59명으로 부서별로 차이가 매우 켰다. 이러한 경향은 절삭유 사용에 따라서 특히 수용성 절삭유만 사용하는 군과 두 종류의 절삭유를 모두 사용하는 근로자에서 마찬가지로 높게 관찰되었다. 8. 감별진단이 필요하다고 판단된 접촉 피부염 환자 49명은 첩포 검사를 시행하였다. 첩포 검사 결과, 기본 표준시료에 양성이 나타난사람이 12명, 기본표준시료와 오일시료에 모두 양성이 나타난 사람 3명, 그리고 오일 시료에만 양성이 나타난 사람 3명이 있었고, 기본 표준시료와 유기용제시료에 양성이 나타난 사람, 유기용제 시료에만 양성이 나타난 사람이 각각 1명 있었다. 9. 전체 피부질환의 유무에 대하여, 근 We investigated the 1,004 workers who worked in a automobile factory to study the epidemiologic characterists of dermatoses due to cutting oils. Among the workers, 667(66.4%) answered the questionaire. They are belong to 5 departments of the factory-the Engine-Work(258 workers), Gasoline engine Assembly(210), Diesel engine Assembly(96), Power train Work(86), Power train Assembly(17). We measured the oil mist concentration in air of the departments and examined the workers who had dermatologic symptoms. The results were follows; 1) Oil mist concentration ; Of all measured points(52),9 points(17.2%) exeeded $5mg/m^3$- the time-weighed PEL-and one department had a upper confidence limit(95%) higher than $5mg/m^3$. 2) Dermatologists examined 213 workers. 172 of them complained any skin symptoms at that time - itching(32.5%), papule(21.6%), scale(15.7%), vesicle(12.5%) in order. The abnormal skin site found by dermatologist were palm(29.3%), finger & nail(24.6%), forearm(16.2%), back of hand(8.4%) in order. 3) As the result of physical examination, we found that 160 workers had skin diseases. Contact dermatitis was the most common; 69 workers had contact dermatitis alone(43.1%), 11 had contact dermatitis with acne(6.9%), 10 had contact dermatitis with folliculitis(6.3%), 1 had contact dermatitis with acne & folliculitis, and 1 had contact dermatitis with abnormal pigmentation. Others were folliculitis(9 workers, 5.6%), acne(8, 5.0%), folliculitis & acne (2, 1.2%), keratosis(1, 0.6%), abnormal pigmentation (1, 0.6%), and non-specific hand eczema (47, 29.3%). 4) The prevalence of any skin diseases was 34.0 pet 100 in cutting oil users, and 13.3 per 100 in non- users. Especially, the prevalence of contact dermatitis was 23.0 per 100 in cutting oil users and 23.0 per 100 in non-users. 5) We tried patch test(standard serise, oil serise, organic solvents) on 49 patients to differentiate allergic contact dermatitis from irritant contact dermatitis and found 20 were positive. 6) In a multivariate analysis(independant=age, tenure, kinds of cutting oil), the risk of skin diseases was higher in the water-based cutting oil user and both oil user than non-user or neat oil user(odds ratio were 2.16 and 2.78, respectively). And the risk of contact dermatitis was much higher at the same groups(odds ratio were 5.16 and 6.82, respectively).

금속작업유 취급 근로자의 직업성 피부질환에 관한 연구

허광회,김희옥,박시룡,오칠환 ( Kwang Hoi Hur,Hee Ok Kim,See Ryong Park,Chil Hwan Oh ) 대한피부과학회 1996 대한피부과학회지 Vol.34 No.3

최근 과학의 발전으로 각종 신소재 물질이 개발되고 직업도 다양화함에 따라 각종 직업병이 문제되고 있으며, 이중 직업성 피부병에 의한 경제적 손실이 직업병 중 가장 큰 것으로 알려져 있다. 특히 금속작업자에서 발생되는 직업성 피부병은 비교적 발생빈도가 높은 것으로 알려져 있으나 이에 대한 연구는 미진한 실정이고, 국내에서도 아직 보고된 바 없다. 금속작업자가 금속을 가공시 각종 금속작업유(metal working fluid)가 사용되며 이들 금속작업유는 공구와 피가공물 사이에서 냉각작용과 윤활작용을 통해 가공물의 변형을 막고 공구의 마모를 방지하는 역할을 한다. 과거에는 이런 작용을 위해 물이나 기름만을 사용했으나 점차 여러 성분들이 첨가되고 합성화됨에 따라 다양한 금속작업유 제품들이 등장했다. 금속작업유에는 비수용성 금속작업유(neat 또는 insoluble oil), 수용성 금속작업유(conventional soluble oil), 반합성 금속작업유(semi-synthetic fluid), 합성 금속작업유(synthetic fluid) 등이 있는데 비수용성 금속작업유를 제외한 3가지 금속작업유를 수용성 금속작업유(water-based cutting fluid, WBF)라 하며 이들의 성분을 표1에 요약하였다. 수용성 금속작업유에는 비수용성 금속작업유와 달리 물, 유화제, 살균제 등의 성분이 포함되어 있다. 저자들은 금속작업자에서 직업성 피부병에 대한 역학적 조사와 함께 금속작업유와 관련된 피부병의 유병률을 알아보기 위하여 국내 최초로 본 연구를 시도하였다. Background:Occupational skin disease is one of the most prevalent occupational health problems, resulting in long period of discomfort and loss of earning. The size of the problem is probably underestimated and no exact datas are available about the prevalence of skin problems in metal workers(MWs) exposed to metal working fluid(MWF). Objective:This study was done to determine the prevalence of skin abnormalities in relation to exposure to MWF. Materials & Methods:An epidemiological study was performed using questionnaire in 771 workers in 9 departments of motor company. A questionnaire was designed to ascertain information about working procedures, the way of handling MWF, degreasers and soap, the extent and duration of individual exposure, and any history of dermatoses. 278 workers out of 771 workers are actually contacted with MWF. A selection was made on 315 metal workers who have experienced past or present dermatitis in questionnaire. A detailed history from each workers via interview with 315 workers about past or present occupational exposure, dermatoses, atopy and injury preceded a dermatological examination by dermatologist. Patch test: Patch tests were performed in 73 metal workers who were suspected dermatitis in relation to exposure of MWF during interviews and dermatologic examination. Patch tests were included with a routine series and common components of MWF(material obtained from chemotechnique, sweden) and solvent seried. Workers were also tested with the various crude metalworking fluids(8 species. The concentrations of crude MWFs were determined after testing the various dilutions of MWF. Results: 1. Out of 278 metalworkers who exposed to MWF, dermatitis was detected in 106 metalworkers(38%). Primary irritant dermatitis was established in 92 persons(33% of 278 metalworkers) and allergic contact dermatitis in 14 persons(5% of 278 metalworkers). 2. Workers with exposure to soluble oil showed primary irritant contact dermatitis significantly more often than workers exposed with neat oil(p<0.05). 3. Workers with frequent of variable exposure to soluble oil showed primary irritant dermatitis significantly more often than did workers with infrequent exposure(p<0.05). 4. The occurrence of primary irritant dermatitis showed a tendency towards a higher incidence of primary irritant dermatitis relation to duration of work.(p<0.05, X2-test for linear trend) 5. Primary irritant dermatitis was significantly more often present in atopics than in nonatopics(p<0.05). 6. The severity of primary irritant dermatitis was not significantly influenced by the type of MWF or the extent of exposure 7. Exposure to soluble oils lead more often to the occurrence of chronic paronychia than exposure to neat oil(p<0.05). 8. The occurrence of acne & folliculitis was more often in metal workers exposed to neat oil than soluble oil. Conclusion:The results showed that primary irritant dermatitis was the most common skin disorder of workers handling MWF and the prevalence of primary irritant dermatitis had a correlation with the types of MWF, the frequency and the duration of exposure to MWF and atopy history of each workers. Although the prevalence was low, other occupational skin problems-chronic paronychia, oil acne, folliculitis-were showed. Oil acne and folliculitis chiefly developed in workers handling insoluble-MWF and chronic paronychia chiefly developed in workers handling soluble-MWF.

서울키즈센터

김상길(Kim, Sang-Gi),김희옥(Kim Hee-Ok) 현대건축사 2008 월간 CONCEPT Vol.- No.115

서초장애인정보문화센터 - 에이텍 종합건축사 사무소

김상길(Kim, Sang-gil),김희옥(Kim, Hee-ok) 현대건축사 2006 월간 CONCEPT Vol.- No.85