Metastatic pancreatic cancer mimicking keratoacanthoma: Dermoscopic features

( Seol Hwa Seong ),( Ji Yun Jang ),( Jong Bin Park ),( Min Soo Jang ),( Kee Suck Suh ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1

Cutaneous metastasis of internal malignancy is a rare phenomenon that accounts for less than 5% of the patients with cancer and can be confused with benign skin disorders. A 47-year-old male suffering from the pancreatic cancer presented with a well-defined, erythematous coin sized solitary tumor with central ulceration on the face, clinically similar to a keratoacanthoma (KA). On dermoscopy, the ulcerated central amorphous area surrounded by white structureless area and white circles on the erythematous to orange colored background were seen. Polymorphous vascular patterns were asymmetrically distributed with densely aligned, linear serpentine vessels, dotted vessels, and arborizing vessels. The hairpin vessel, a well-known dermoscopic feature of KA, was not seen. Histologic findings showed atypical hyperchromatic cells densely involving the dermis and subcutaneous tissue, transepidermal elimination, and uninvolved epidermis separated from underlying tumor cell infiltration by Grenz zone. Moderately differentiated neoplastic glands and tumor cells showing the ‘Indian file’ arrangment were seen. In the immunohistochemical staining, CA19-9, CK19, and CK7 were positive, whereas, CK20 were negative. On the basis of dermoscopic and histologic findings, the diagnosis of metastatic pancreatic cancer was made. Herein, we report a case of metastatic pancreatic cancer mimicking KA for which the dermoscopy was used as a helpful diagnostic tool.

Epidemiology and clinical outcomes of 151 patients with mycosis fungoides at the Kosin University Gospel Hospital: retrospective 27-year review

( Seol Hwa Seong ),( Do Ik Kwon ),( Ji Yun Jang ),( Jong Bin Park ),( Kee Suck Suh ),( Min Soo Jang ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.2

Background: Mycosis fungoides (MF) is the most common form of cutaneous T-cell lymphoma with a variety of clinicopathological features. A single center-based large scale study with long-term follow up in Korea has not been reported. Objectives: To investigate epidemiologic features and clinical outcomes of MF patients at the authors’ hospital over a 27-year period. Methods: This is a pilot study conducted on 151 patients diagnosed as MF, from 1991 to 2018, with the retrospective review. Results: Of 151 patients, 62.9% were male and 37.1% female. The mean age at the diagnosis was 44.2 years (range, 5-82). The mean duration of symptoms was 50.4 months (range, 0.25-360). The mean follow-up duration was 57.6 months (range, 2-251). Common subtypes were classic MF (45.0%), mycosis fungoides palmaris et plantaris (MFPP) (23.8%), and folliculotropic MF (7.9%). In early-stage MF (IA-IIA) of 143 patients (94.7%), the 10-year overall survival (OS) was 93.6%. In advancedstage MF (IIB-IVB) of eight patients (5.3%), the 10-year OS was 23.4%. Complete remission (CR) and disease progression were found in 63.6% and 4.6% of the patients. The recurrence after CR was observed in 33 patients (21.9%) and the mean recurrence free-duration was 24.1 months (range, 1-118). Conclusion: Clinical outcomes generally paralleled the previous reports with favorable prognosis in the earlystage MF. Recurrence was not uncommon, largely due to greater prevalence of MFPP.

Distinction of bowenoid papulosis, seborrheic keratosis and condyloma acuminatum in genital area with dermoscopic features and human papilloma virus related entities

( Seol Hwa Seong ),( Do Ik Kwon ),( Ji Yun Jang ),( Jong Bin Park ),( Kee Suck Suh ),( Min Soo Jang ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.2

Background: Making a clear diagnosis of bowenoid papulosis (BP), seborrheic keratosis (SK) and condyloma acuminatum (CA) in genital area can be difficult. Skin biopsy can be helpful but its invasiveness and low cost-effectiveness provoke to seek other diagnostic methods. Objectives: To investigate distinctive dermoscopic features and human papillomavirus (HPV) related entities that can differentiate BP, SK, and CA. Methods: Dermoscopic patterns and real-time polymerase chain reaction (PCR) to detect HPV were evaluated in 44 biopsy specimens. 10, 13, and 21 specimens of them were histologically confirmed as BP, SK, and CA. Results: The most common site of occurrence was penile shaft in BP, inguinal area in SK and equally penile shaft or inguinal area in CA. Dermoscopic features tend to be different showing structureless pattern (80%) with glomerular vessels (70%) in BP, cobblestone pattern (46%) without specific visible vessels (69%) in SK, and exophytic papillary structures (86%) with high vascularity including hairpin, glomerular, and comma-like vessels (71%, 57%, and 52%, respectively) in CA. Detection rate of HPV in PCR was 90% in BP, 61.5% in SK, and 100% in CA. Commonly found subtype was HPV 16 in BP (46.2%), SK (60.0%), and HPV 6 in CA (42.9%). Conclusion: Dermoscopy can be useful for differential diagnosis of BP, SK, and CA. High-risk HPV was predominant in BP, SK and low-risk HPV in CA implying distinctive HPV related entities.

Successful treatment of Kimura’s disease with cyclosporine

( Seol Hwa Seong ),( Ji Yun Jang ),( Myeong Hyeon Yang ),( Min Soo Jang ),( Kee Suck Suh ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1

Kimura’s disease (KD) is a rare chronic inflammatory disease of unknown etiology. Clinically, painless subcutaneous swellings and lymphadenopathy mainly involving the head and neck region can be seen. The histopathologic findings of KD show lymphoid follicular hyperplasia with germinal centers, massive eosinophilic infiltration often with the formation of abscess, varying degree of fibrosis, and vascular proliferation. Surgical excision, regional or systemic steroid therapy have formed the mainstay of the treatment, but the consensus on the optimal treatment is not well established. Cyclosporine also can be used and its therapeutic effects are related to the decrease in production of cytokines including IL-2, IL-4, IL-5, which inhibits T-cell proliferation. A 34-year-old female patient presented with localized pruritic solitary erythematous swollen patches on the right cheek. The lesions gradually grew up during last 18 months. Histopathologic findings showed dense lymphocytic follicular hyperplasia, stromal fibrosis, marked eosinophilic infiltration with flat epithelial cells of venules. On the basis of these clinical and histopathologic findings, the diagnosis of KD was made. The patient was treated with oral cyclosporine (200mg/day). A significant improvement in skin lesions was achieved after 20 weeks of treatment and maintained during follow-up period. Herein, we report a case of KD successfully treated with oral cyclosporine.

Localized mycosis fungoides that predominantly affects knuckles of hands

( Seol Hwa Seong ),( Jang Hwan Jung ),( Do Ik Kwon ),( Kang Hoon Lee ),( Jong Bin Park ),( Kee Suck Suh ),( Min Soo Jang ) 대한피부과학회 2020 대한피부과학회 학술발표대회집 Vol.72 No.1

Background: Mycosis fungoides palmaris et plantaris (MFPP) is a variant of mycosis fungoides (MF) that localized on the palms and soles, which often spreads to the dorsal aspect of hands, fingers, and feet. However, it is argumentative to classify localized MF that mainly affects knuckles of hands, with or without involvement of palms, as MFFP. Further, it can be overlooked as chronic hand eczema unless a biopsy is performed. Objectives: To investigate the clinicopathologic features of localized MF that mainly affects the dorsal aspect of hands. Methods: This study was conducted on nine patients diagnosed clinicopathologically MF, and who presented discrete eczematous lesions predominantly on the dorsal aspect of hands. Results: The mean age at the diagnosis was 47.6 years (range, 38-59). The mean duration of the disease was 46.7 months (range, 12-120). Knuckles were the most common site of involvement shown in all nine patients, followed by the volar side of fingers shown in six patients. Five patients reported an occupational history with frequent minor injuries on the hands. During 78.5 months of the mean follow-up, none of the patients had progressive disease. While most histopathologic findings were similar to that of classic MF, spongiosis was more pronounced in our patients. Conclusion: We suppose that trauma may play a role in the development of localized MF, and a high index of suspicion is needed for this diagnostic challenge.

Unusual clinicohistopathologic features of cutaneous nontuberculous mycobacterial infection caused by Mycobacterium marinum

( Seol Hwa Seong ),( Ji Yun Jang ),( Jong Bin Park ),( Min Soo Jang ),( Kee Suck Suh ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1

Nontuberculous mycobacteria (NTM), which rarely cause cutaneous lesions, are a heterogeneous group of acid-fast bacilli other than Mycobacterium tuberculosis and Mycobacterium leprae. Among the cutaneous NTM infections, Mycobacterium marinum is the most common pathogen and its clinical manifestation can be variable. A 74-year-old woman presented with diffuse tender erythematous to yellow cellulitis-like patches on the left arm along the discrete papules on the left flank. Histopathologic findings showed caseating granuloma that distinctly had central necrosis with a palisaded lymphohistiocytic infiltration and multinucleated giant cells in the upper dermis. Non-caseating granulomas, nonspecific mixed cell infiltration in the deep dermis, and abscesses in the subcutaneous tissue were seen. Cultures for the NTM and sequencing of the polymerase chain reaction confirmed M. marinum infection. Retrospectively, acid-fast bacilli were found in the Ziehl-Neelsen stain. On the basis of histopathologic, microbiologic, and molecular findings, the diagnosis of cutaneous NTM infection caused by M. marinum was made. Among the variable clinicohistopathologic features of cutaneous NTM infection, cellulitis-like appearance is rarely observed and caseating granuloma surrounded by palisading lymphohistiocytic infiltration is not common. Herein, we report a case of unusual clinicohistopathologic features of cutaneous NTM infection caused by M. marinum.

Determination of Optimal Storage Condition for Pre-packed Hanwoo Loin

Seol, Kuk-Hwan,Park, Tu San,Oh, Mi-Hwa,Park, Beom-Young,Cho, Seong In,Lee, Mooha Korean Society for Food Science of Animal Resource 2013 한국축산식품학회지 Vol.33 No.3

The aim of this study was to determine the optimal storage condition of pre-packed Hanwoo beef without freezing. Hanwoo loin was purchased from a local distributor at 48 h after slaughter, then sliced in $1.5{\pm}0.5$ cm thickness, and packed in a polyethylene (PE) tray covered with linear low-density polyethylene (LLDPE) film. The studied factors to set the optimal storage condition were chamber temperature (5, 2.5 and $-1^{\circ}C$ for 14 d), cooling method (direct and indirect cooling system), and ultraviolet (UV) light irradiation for beef surface sterilization (0, 30, 60, and 120 min). The changes of pH, thiobarbituric acid reactive substances (TBARS) and number of aerobic bacteria were measured during storage. Beef samples stored in $-1^{\circ}C$ showed the minimal increasing rate in TBARS and microbial growth. After 15 d of storage, there was no significant difference in pH and TBARS values. However, the microbial population of beef stored in direct type cooling chamber ($4.25{\pm}0.66$ Log CFU/g) was significantly lower than that of beef stored in indirect type chamber ($6.47{\pm}0.08$ Log CFU/g) (p<0.05). After 4 d of storage, 60 or 120 min UV light irradiated beef samples showed significantly lower microbial population, and at 14 d of storage, 60 min UV irradiated beef sample showed significantly lower microbial population ($3.14{\pm}0.43$ Log CFU/g) than control ($4.46{\pm}0.13$ Log CFU/g) (p<0.05). However, TBARS values of 60 or 120 min UV light irradiated beef samples were significantly higher than non-irradiated beef sample after 4 d of storage (p<0.05).

MAC Scheme for Multi-Band System based on Ultra Wide-Band

Seong Seol Hong(홍성설),Yun Hwa Choi(최윤화) 한국통신학회 2003 한국통신학회 학술대회논문집 Vol.2003 No.11

항유약호르몬 활성물질이 누에탈피에 미치는 영향

홍성진,이화준,설광열,문재유 한국잠사학회 1997 한국잠사곤충학회지 Vol.39 No.2

To clarify the effect of anti-juvenile hormone analogue (AJH) on the larval ecdysis by feeding at early stage of the 4th instar, the total amount of protein and activity of chitinolytic enzymes in the integument of Bombyx mori were analyzed, PAGE pattern of the protein was observed and the morphological changes of integument during molting period were also observed by means of TEM. The total amount of protein was greatly increased in premolting, then reached maximum level just before ecdysis, and rapidly decreased after the larval ecdysis in the control, while in the AJH treatment, increased 12 hr later than the control and its maximum was only 82.6% of the control. Two specific proteins, which were presumed as the protein originated from endornticle, also appeared 12 hr later than the control and were maintained to 132 hr after AJH treatment from the aspects of the Native- and SDS-PAGE patterns, although those of the control disappeared instantly after ecdysis. Chitinase and ß-N-acetylglucosaminidase activities were also suppressed and delayed by AJH treatment. Furthermore, it was observed that the apolysis took place 12 hr later than the control but new epicuticle was not formed at least until 132 hr after AJH treatment. From these results, it is suggested that the larval molting process of silkworm develops 12 hr later than the control by AJH treatment but no further processing takes place just after apolysis.

보물 제 1853호 완주 정수사 목조아미타여래삼존좌상의 보존상태 진단 및 수종분석

김설희 ( Seol Hui Kim ),유영경 ( Yeonggyeong Yu ),이나라 ( Nara Lee ),김요정 ( Yojung Kim ),이화수 ( Hwa Soo Lee ),한규성 ( Gyu-seong Han ) 한국목재공학회 2019 한국목재공학회 학술발표논문집 Vol.2019 No.2

본 연구는 보물 제1853호로 지정된 완주 정수사 목조아미타여래삼존좌상에 대한 보존상태조사 및 수종분석을 실시하였다. 보존상태 조사 결과, 금박마모로 인한 손상유형이 가장 크게 나타났으며, 그 다음 개금층 박리 및 박락, 오염, 균열 순서로 확인되었다. 세 구의 불상 모두 물리적인 손상이 주로 발견되었다. 존상별 손상정도에서는 아미타여래좌상이 가장 큰 손상정도를 나타냈으며 관세음보살좌상, 대세지보살좌상 순서로 나타났다. 적외선 열화상 촬영 결과, 불상 세구 모두 하단부에서 상이한 온도분포가 확인되었고 이는 개금층의 박리 등으로 판단된다. 초음파 탐상 결과, 아미타여래좌상, 관세음보살좌상, 대세지보살좌상 순서로 높게 측정되었다. 세 구 모두 배면보다 정면의 초음파 속도가 높았으며 정면과 배면 초음파 값을 종합하면 최댓값과 마찬가지로 아미타여래좌상, 관세음보살좌상, 대세지보살좌상 순서로 나타났다. 그리고 세 구의 불상 모두 정면 상반신과 하반신 연결부위에서 초음파 속도가 낮게 확인되었다. 불상 상받침 부위에서 채취된 3점 시료에 대한 수종분석 결과, 우리나라 전역에 자생하는 대표적인 나무인 소나무류(hard pine)로 분석되었다. 개금층위 분석 결과, 아미타여래좌상과 대세지보살좌상은 <토분층-직물층-칠층-그을음층-칠층-칠층-금박층>의 총 7개의 층으로 구분되었고, 관세음보살좌상은 <직물층-칠층-그을음층-칠층-칠층-금박층>의 6개의 층으로 구분되었다. 개금층위 분석 과정에서 아미타여래좌상에 사용된 직물을 분석하였으며 이는 마섬유로 추정되었다. 연구 결과, 정수사 목조아미타여래삼존좌상은 오염에 의한 손상은 적은 편이나 균열, 개금층 박리 및 박락, 금박 마모 등의 물리적인 손상이 전체적으로 발생하였다. 적외선 열화상 촬영과 초음파 탐상을 통해서도 균열과 박리부위 주변의 손상을 확인할 수 있었다. 목재수종분석과 재질특성 분석을 통해 목조아미타여래삼존좌상을 구성하는 재료에 대한 파악이 가능하였다. 진단 결과를 종합하면 정수사 목조아미타여래삼존좌상은 물리적인 보존상태가 취약하기에 보존처리가 시급한 것으로 판단되며, 전반적인 예방적 보존관리가 필요하다.