한국인 건선환자에서 발병하는 질환에 대한 연구 - 다기관 연구

김광호(Kwang Ho Kim),전현진(Hyun Jin Jeon),김광중(Kwang Joong Kim),윤재일(Jai Il Youn),김낙인(Nack In Kim),김태윤(Tae Yoon Kim),최지호(Jee Ho Choi),박기범(Ki Beom Park) 대한피부과학회 2001 대한피부과학회지 Vol.39 No.7

N/A Background: The prevalence of other diseases associated with psoriasis has been investigated in recent years. Objective: This study was performed to see diseases associated with psoriasis in Korea. Methods: From September 1999 to May 2000, a total of 293 patients with psoriasis, who visited the department of dermatology in 6 hospitals, were enrolled in a subject group for the study. We surveyed the incidence rates of associated diseases. Results: In our study, diseases more concomitantly present in patients with psoriasis were dermatophyte infection, seborrhea dermatitis and benign tumor & nevus in skin diseases and obesity, diabetes mellitus, hypertension, gastritis and hepatitis in systemic diseases. Less concomitantly present in-patients with psoriasis were erythroderma, acne, contact dermatitis, atomic dermatitis, bacterial infection, tonsillitis, and internal cancer. Conclusion: Our observations show a distinct pattern of diseases associated with psoriasis in Korea. Further investigation will be mandatory to elucidate concomitant diseases in psoriasis. (Korean J Dermatol 2001;39 (7): 743~748)

P067 A retrospective analysis of low dose acitretin and cyclosporine combination therapy in psoriasis patients

( In-hye Kang ),( Hye-jin Ahn ),( Eun-jae Shin ),( Min Jae Gwak ),( Min Kyung Shin ),( Nack-in Kim ) 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: Psoriasis is a chronic in.ammatory disorder. Approximately 25% of patients present with a moderate-to-severe form of psoriasis and may require lifelong systemic therapy. Up until recently, there have been few reports showing the effectiveness and safety of adding cyclosporine to acitretin for treatment. Objectives: The aim of our study was to gain more knowledge about systemic combination therapies with retinoids and cyclosporine. Methods: Retrospective review of the databases of dermatological departments at Kyung Hee Medical Center was performed. 11 patients treated with oral acitretin and cyclosporine combination therapy, 12 and 14 patients treated with acitretin and cyclosporine monotherapy, respectively were included in the study. The data including age, gender, comorbidity, treatment regimen, period, presence of adverse events, and the PASI score were collected. Results: There were no significant differences in the degree of reduction of PASI scores after 12 weeks among the three groups. The number of patients with adverse events was 19 in the acitretin monotherapy group, 10 in the cyclosporine monotherapy group, and 9 in the combination treatment group. Conclusion: Although low dose combination therapy of acitretin and cyclosporine has similar effects compared to the monotherapy, side effects was lower in combination therapy because of drug sparing effects. We suggest combination therapy employing systemic agents are becoming more widely used for the treatment of psoriasis.

組織素 分解酵素를 生成하는 高溫性 곰팡이의 分離 및 特性

성낙계,강인수,박채규,정영철,김두현 慶尙大學校 1990 論文集 Vol.29 No.1

고온에서 잘 생육하고 cellulose 및 xylan 분해력 이 우수한 곰팡이를 분리할 목적으로 pH5.0, 50℃, Czapek-Dox pulp 배지에서 celluase complex와 xylanase생산이 우수한 곰팡이 H-702균주를 최종선정하여 균학적 성상을 조사한 결과, Aspergillus속과 거의 일치하였으며, 본 공시균주가 효소 생산에 미치는 영향과 효소학적 성질의 결과를 요약하면 다음과 같다. 생육 및 효소생성의 최적온도는 50℃이고, 균체증식 최적 pH는 5.0, cellulase 생산 최적 pH 는 4.5 xyanases는 4.0으로 나타났으며, 효소최대 생성 배양 4일째에, 균체증식은 약 3일경에 최대에 도달하였다.또한 α-1, 4-linkage를 가진 섬유성 물질 왕성하였으며 glucose 와 같은 저분자물질에서는 효소생합성이 현저히 저해되었는데 이런 결과로 볼때 이균주는 carbon catabolite repression을 받고 있었다. 효소생산에 적합한 탄소원으로는 α-cellulose,avicel, filter paper 등 이였으며, 질소원으로는 암모니아가 효과적이었으며 무기염류는 Ca??, Mg??, Mn??, Co??에서 효소생합성이 좋은것으로 나타났다. 계면활성제는 0.15% Tween 80이 좋았다. 개선된 KD배지에서는 각종 효소활성도가 1.2-1.6배 증가하였으며 또한 KD배지에서 각종탄소원을 지질로하여 효소 생합성을 조사한 결과 3% a-cellulose 에서 효소활성도가 좋았고 값싼 기질인폐신문지에서도 효소활성이 높게 나타났다. 조효소의 최적 온도는 cellulas complex 는 70℃, xylanase는 60℃로 나타났으며 열안정성은 cellulas complex 70℃까지는 30분간 , 80℃에서는 잔존활성이 약 93%였고 xylanase는 70℃에서도 거의 안정하였다.최적 pH는 cellulas complex는 5.0, xylanase는 5.5였으며, pH안정성은 3.0-8.0까지 안정하였다.조효소의 미치는 금속이온의 영향은 Ca??,Mg?? Mn??에의해 활성화 되었으며 Pb??, Cu??, Mg?? 에 의해 현저히 저해 현상을 나타냈다. In order to isolate a fungus which grow well in the high temperature and has the excellent decomposing power of cellulose and xylose a fungus. H-702 which produced potently cellulase complex(CMCase,avicelase and β-glucosidase) and xylanase in Czapek-Dox pulp medium (pH 5.0, 50℃) was finally selected. Then as a result of its bacteriological properties investigated it was almost the same properties as Apergillus sp.. The effect influencing to the enzyme production of the isolated strain and enzymological properties are followed. The optimal temperature and pH for cell growth and enzyme production were 50℃, 5.0, 4.5 and 4.0.respectively . The highest production of enzyme was shown when the culture time was three days and the greatest growth of cell was shown about after two days. In the cellulosic materials(CMC.avicel and α-cellulose etc.) containing α-1.4-linking the vigorous production if enzyme was shown and in the small molecular substance such as glucose was remarkably repressed. According to these results, this stain was under the control of carbon catabolite repression.α-cellulose , avicel and filter paper were suitable for carbon source in the enzyme production and NH? for nitrogen source and Ca??, Mg??, Mn?? and Co?? for inorganic salt. 0.15% Tween 80 was a good surface active agent. In improved KD medium each enzyme activity was increased 1.2 to 1.4 times. As a result of investigating enzyme biosynthesis, which each carbon source was used as substrate in the KD medium, it was shown a good enzyme activity. The optimal temperature of crude enzyme in cellulase complex and xylanase were 70 ℃and 60℃, respectively. Thermal stability was shown for 30 minutes until 70℃in cellulase complex and its residual activity at 80℃ was about 93%. It almost was stable at 70℃in xylanase. The optimal pH for cellulase complex and xylanase were 5.0 and 5.5.respectively and they were stable in the range of pH 3.0 TO 8.0. The crude enzyme was activated by Ca?? , Mg??and Mn?? but inhibited by Pb??, Cu?? and Ag?? remarkably.

The Clinical Profile of Patients with Psoriasis in Korea: A Nationwide Cross-Sectional Study (EPI-PSODE)

( Hae Jun Song ),( Chul Jong Park ),( Tae Yoon Kim ),( Yong Beom Choe ),( Seok-Jong Lee ),( Nack In Kim ),( Jae We Cho ),( Jie Hyun Jeon ),( Min Soo Jang ),( Jai Il Youn ),( Myung Hwa Kim ),( Joonsoo 대한피부과학회 2017 Annals of Dermatology Vol.29 No.4

Background: Psoriasis is an immune-mediated, chronic in-flammatory disease affecting multiple aspects of patients` lives. Its epidemiology varies regionally; however, nation-wide epidemiologic data on psoriasis depicting profile of Korean patients has not been available to date. Objective: To understand nationwide epidemiologic characteristics and clinical features of adult patients with psoriasis visited uni-versity hospitals in Korea. Methods: This multicenter, non-in-terventional, cross-sectional study recruited 1,278 adult pa-tients with psoriasis across 25 centers in Korea in 2013. Various clinical data including PASI, BSA, DLQI, SF-36 and PASE were collected. Results: A total of 1,260 patients com-pleted the study (male:female=1.47:1). The mean age was 47.0 years with a distribution mostly in the 50s (24.9%). Early onset (<40 years) of psoriasis accounted for 53.9% of patients. The mean disease duration was 109.2 months; mean body mass index was 23.9 kg/m2; and 12.7% of patients had a family history of psoriasis. Plaque and guttate types of psoriasis accounted for 85.8% and 8.4%, respectively. Patients with PASI ≥10 accounted for 24.9%; patients with body surface area ≥10 were 45.9%. Patients with DLQI ≥6 accounted for 78.8%. Between PASI <10 and PASI ≥10 groups, significant difference was noted in age at diagnosis, disease duration, blood pressure, waist cir-cumference of female, and treatment experiences with pho-totherapy, systemic agents, and biologics. Conclusion: This was the first nationwide epidemiologic study of patients with psoriasis in Korea and provides an overview of the epidemio-logic characteristics and clinical profiles of this patient population. (Ann Dermatol 29(4) 462∼470, 2017)

칸디다균에 의해 발생된 피부 궤양

김낙인,조항래,김형섭 대한의진균학회 1996 대한의진균학회지 Vol.1 No.1

Cutaneous ulcers due to candida infection are very rare condition, occurring almost in immunocompromised host or occuring as cutaneous manifestation of systemic candidal infection. A 52-year-old woman presented with cutaneous ulcer on dorsum of left hand which had lasted for about 15 days. Bacterial culture showed nonpathogenic organism, Enterobacter cloacae. Mycologic studies including KOH mount and fungus culture were positive for pseudohyphae and colonies of Candida species. A biopsy specimen from the center of ulcer revealed numerous spores and fungal hyphae in the upper dermis and necrotic epidermis. Bacterial culture and fungus culture of patient's serum and urine were negative. Initial treatment with antibiotics had no effectiveness for 2 weeks. After then we treated with antifungal drug, itraconazole 100mg/day. After 6 weeks of antifungal therapy, the skin lesion was much improved. We report this case, because it showed cutaneous ulcer due to candida infection but had neither systemic candidal infection nor clinical sign of immunosuppression.

유방외 Paget 병 1예

조항래,김낙인 경희대학교 1997 慶熙醫學 Vol.13 No.1

소아복벽원심성 지방위축증 2예

윤정빈,허충림,김낙인 경희대학교 1997 慶熙醫學 Vol.13 No.4

한국의 발톱진균증 환자의 삶의 질에 관한 연구

조백기,박종갑,김형옥,김성욱,백승철,김진우,김시용,안규중,전재복,오지원,김낙인,이규석,오칠환,김수남,김상태,손숙자,신용우,김동석,이원우,권경술,서대헌,황규왕,이종석,고재경,강원형,정기양,최응호,김기홍,박석돈,강승주,함정희,명기범,김방순,구상완,김병수,원영호,김한욱,송은섭,정병수,노병인,홍창권,박장규,한지윤,김광중,구대원,김종민,김재홍,유희준,양경미 대한의진균학회 1998 대한의진균학회지 Vol.3 No.2

Background: Onychomycosis, especially toenail onychomycosis has become one of the common fungal infection and has historically been regarded as a cosmetic rather than medical problem by many patients, even by physicians. Recently, however, there are several reports that is a refractory disease which may cause a deleterious effect on patiets quality of life (QOL). Objective: The purpose of this study was to investigate the impact of toenail onychomycosis on QOL in Korea and to assess the chandes of QOL after treatment. Methods: Total 1004 patients with toenail onychomycosis which was confirmed by clinical findings and KOH preparation were were enrolled at 47 dermatologic centers in Korea, and interviewed with standardized QOL questionnaire before and after sytemic antifungal treatment. Responses to the questionnaire were scored by 5-point scale (1∼4) and averaged, and were analyzed for 5 dimensions of emotional impact, social impact, symptorn and functional impact, patients views concerning treatment, and relationship with doctor. Results: 1. Before and after treatment, the most serious impact was emotional dimension showing 1.90 and 1.30 in average score (AS), and social (AS: 1.14 and 0.83) and symptom and functional impact (AS: 1.05 and 0.92) was also affected. 2. In female rather than male, statistically more significant impact on patients QOL was observed in all dimensions. 3. After treatment, 3 of 5 dimensions were improved significantly - emotional dimension (AS : from 1.90 to 1.30), social dimension (AS: from 1.14 to 0.83), patients view concerning treatment (AS: from 1.34 to 1.02). 4. The drgree of patients satisfaction at the therapeutic effect was very high- 62.4% (immediately after treatment) and 65.8% (9 months affer initiation of treatment) of patients answered excellent or good. Conclusion: This study confirms that toenail onychomycosis has significant impact on the overall QOL of patients. Also the effect of antifungal therapy on patients QOL were watisfactory. Therefore, both doctor and patient should pay more attention to the treatment of onychomycosis. [Kor J Med Mycol 3(1): 115∼124]

건선병소에서 Interleukin 1 Inhibitor의 분리 및 그 특성에 관한 연구

김낙인,김수남 고려대학교 의과대학 1991 고려대 의대 잡지 Vol.28 No.1

Psoriasis is an inflammatory papulosquamous skin disease associated with rapid epideral proliferation. Several recent reports have implicated immunologic mechanisms in the pathogenesis of psoriasis. It has been demonstrated that the lymphocytic infiltrate in the dermis of psoriatic lesions is largely composed of T cells and macrophages. Immunohisto-chemical studies reveals that active psoriatic lesions are associated with epidermal influx of activated T cells, and HLA-DR expresson by keratinocytes, and presence of Langerhans cells in the dermal infiltrate. The presence of increased antigen presenting cell activity, macrophages and activated T cells In active psoriatic lesions suggest that alteration in immunologic cytokine regulation in the skin may play a role in of psoriasis. The author isolated epidermal interleukin-1 (IL-1) inhibitor from the cytosol of active psoriatic epidermis which has been purified by Fast Protein Liquid Chromatography(FPLC) and its functional activity charcterized. The epidermal IL-1 inhibitor consistently demonstrates a molecular weight of 30kD(n=4). It has not been observed in normal epidermis. The inhibitor is capable of partially inhibiting IL-1 activity four hours after exposure of the IL-1 responsive cell line, LBRM. 33 cell. to a pulse and washout of IL-1 and PHA. This suggested that an action on post receptor-binding events, since the activity of the inhibitor is not dependent on blocking the IL-1 receptor or binding to IL-1 itself. The inhibitor does not inhibit the response of an IL-2 dependent cell line, HT-2 cell, to production of IL-2. Despite their similarity in molecular weight the inhibitor is not transforming growth factor β(TGF-β), since experiments with a neutralizing monoclonal antibody against TGF-β failed to remove the activity. In addition, stimulation of human mononuclear cells with a specific antigen (tetanus toxoid) is not affected by the inhibitor. Based upon the molecular weight, inhibitory assay, and antibody neutralization experiments, the IL-1 inhibitor isolated from the cytosol of psoriatic epidermis is not like other known IL-1 inhibitors present in the epidermis or elsewhere. The inhibitory activity is restricted since it does not affect cell proliferation in general or all forms of T cell activation. The presence of the inhibitor in psoriatic epidermis suggests that may result in a selective propagation of T cell subsets activated by inhibitor-resistant mechanisms.

여드름 환자의 혈중 Testosterone 및 Dehydroepiandrosterone - sulfate 농도에 관한 연구

김낙인(Nack In Kim),오희수(Hee Soo Oh),이상수(Sang Soo Lee),이무형(Moo Hyung Lee),허충림(Choong Rim Haw) 대한피부과학회 1989 대한피부과학회지 Vol.27 No.1

This study was performed to detect the hormonal abnormalities and to investigate the relationship between the levels of plasma testosterone and DHEA-S in 21 female patients with acne vulgaris using radioimmunoassay. The results were as follows : 1. The levels of plasma testosterone in patients group and control group(n=9) were 352+11.8 ng/dl, 223+ 9.7 ng/dl, respectively, and significantly elevated in patient group(p < 0.01), 2. The levels of plasma DHEA-S in patient group and control group were 286.6+ 126.8 pg/dl, 238.6+60.0 pg/dl, respectively, and did not show statistical significance. 3. The levels of plasma testosterones in patient subgroups classified by modified Pillsbury method were as follows minor group 32.6+5.3 ng/dl, mild group 33.4+15,5 ng/dl, moderate group 39.6+12.6 ng/dl. The testosterone levels in all the subgroups increased significantly than those in control group(352-t11.8 ng/dl) (p<0.05, p<0.05 p < 0.01) 4. The levels of plasrna DHEA-S in patient subgroups were follows minor group 242.5+412 pg/dl, mild group 263.9+166.1 pg/dl, moderate group 353.4+-1273 pg/dl. The DE3EA-S levels in moderate group increased significantly than those in cotrol (238,6+60,0 pg/dl) and minor group(p<0.05). 5. There was no correlation between the plasma testosterone levels and the plasma DHEA-S levels in the acne patients.