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( Seong Geun Chi ),( Jun Young Kim ),( Ho Youn Kim ),( Seok Jong Lee ),( Do Won Kim ),( Weon Ju Lee ) 대한피부과학회 2011 Annals of Dermatology Vol.23 No.3
Nevus sebaceous (NS) is a benign neoplasm occurring mainly on the face and scalp. It commonly occurs as a solitary, well-demarcated lesion. This paper presents a case of multiple nevus sebaceous, which presented as multiple lesions occurring on the temporal scalp and on the contralateral side of the chin. Multiple NS have only rarely been reported.
Silicone Wound Contact Layer를 이용한 전층 피부이식편의 고정
지성근 ( Seong Geun Chi ),이석종 ( Seok Jong Lee ),이재철 ( Jae Chul Lee ),김병수 ( Byung Soo Kim ),이원주 ( Weon Ju Lee ),김도원 ( Do Won Kim ) 대한피부과학회 2010 대한피부과학회지 Vol.48 No.2
Background: The tie-over dressing is the classic dressing method for a full thickness skin graft (FTSG) to secure the graft on the skin defect. Although many methods to secure the graft have currently been employed, they have some disadvantages such as stretching discomforts and irregular pressure delivery to the graft, resulting in partial necrosis or surface irregularity. Objective: The aim of this study was to evaluate the usefulness of a porous, flexible and distensible silicone wound contact layer (Mepitel(R)) for securing a graft as a bolster fixation in FTSG reconstruction. Methods: Sixty seven patients with surgical defects following mainly malignant tumor excision were included in this study. After suturing and bolstering the graft in place, a piece of silicone contact layer was used to cover the graft, and then second sutures were placed to apply uniform pressure. Results: Thirty three cases of basal cell carcinoma, 14 cases of malignant melanoma and 10 cases of squamous cell carcinoma were included as a cause of the defects. Forty six defects were located on the head and neck, and the rest were on the trunk and extremities. The size of the surgical defects ranged from 0.5 to 14.0 cm at the greatest diameter (mean: 4.0 cm). One major and 1 minor loss of graft developed. Mild to moderate scar formation, mainly marginal elevation, occurred in 9 patients. Sixty five percents of the patients who had facial defects were satisfied with their results. Conclusion: We suggested that a silicone wound contact layer for bolster fixation might be a useful material to secure a FTSG, and this is easy to apply and the resulting cosmesis is good and there are few problems with using it. (Korean J Dermatol 2010;48(2):87∼92)
Nasalis Island Pedicle Flap을 이용한 코 하부의 결손부 재건
지성근 ( Seong Geun Chi ),정홍대 ( Hong Dae Jung ),이석종 ( Seok Jong Lee ),최윤석 ( Yoon Seok Choe ),김병수 ( Byung Soo Kim ),김도원 ( Do Won Kim ),박병철 ( Byung Cheol Park ) 대한피부과학회 2008 대한피부과학회지 Vol.46 No.12
Reconstruction of surgical defects of the nose, particularly the lower one third, is often challenging. The skin of this area is less mobile and fixed on lower structures without a subcutaneous fatty layer. Thus, dissection of tissues is rather difficult and more bleeding can occur during dissection. Furthermore, flap surgery will fail if the flap extends too far. Local flap surgery is one of the more useful techniques that maintains the function and aesthetics of a normal nose. Among these, the nasalis muscle is relatively easy and provides better outcomes. More importantly, vascular supplies from the underlying muscular structure provide greater viability. Additional movement can be achieved by either dissecting under the transverse nasalis or by dividing the transverse nasalis beyond the midline. We report 5 cases of nasalis island pedicle flaps using nasalis muscles. The final results were relatively satisfactory for both functional and cosmetic aspects. (Korean J Dermatol 2008;46(12):1634∼1639)
지성근 ( Seong Geun Chi ),김호연 ( Ho Youn Kim ),박병철 ( Byung Cheol Park ),이석종 ( Seok Jong Lee ),최윤석 ( Yoon Seok Choe ),김병수 ( Byung Soo Kim ),김도원 ( Do Won Kim ) 대한피부과학회 2008 대한피부과학회지 Vol.46 No.10
Cutaneous squamous cell carcinoma (SCC) is the second most common skin cancer and the majority of such patients can be easily treated with a relatively low risk of recurrence and metastasis. However, there are subgroups of SCC that are at a higher risk, depending on patient`s or tumor`s characteristics. A greater part of the metastases from these high-risked SCCs spread towards the regional lymph nodes, whereas distant metastases are relatively uncommon. Early identification of nodal metastasis can allow the selective and timely inclusion of possible high-risked SCC patients into more aggressive treatments and meticulous follow-up protocols for achieving potential survival benefit. Therefore, sentinel lymph node biopsy (SLNB) is popular in the management of malignant melanoma, and it may also be useful to detect regional metastasis of high-risked SCCs. This procedure could also spare node-negative patients the morbidity of unnecessary additional therapy, like elective lymph node dissection. We report herein on a case of SCC with regional nodal metastasis, which is confirmed by SLNB. (Korean J Dermatol 2008;46(10):1387∼1390)
유아혈관종의 임상병리조직학적 고찰: GLUT-1염색의 진단적 유용성
지성근 ( Seong Geun Chi ),정홍대 ( Hong Dae Jung ),이석종 ( Seok Jong Lee ),김병수 ( Byung Soo Kim ),이원주 ( Weon Ju Lee ),김도원 ( Do Won Kim ),정호윤 ( Ho Yun Chung ),윤길숙 ( Ghil Suk Yoon ) 대한피부과학회 2009 大韓皮膚科學會誌 Vol.47 No.4
Background: Hemangioma of infancy (HOI) is one of the most common tumors in childhood. Their clinical features can on occasion look like those of other vascular tumors and malformations, so the correct differentiation of HOI may not always be easy. Objective: The purpose of this study was to review the clinicopathological features of HOIs and to particularlyexamine the usefulness of glucose transporter protein isoform-1 (GLUT-1) immunohistochemical stain (IHS) as a specific marker of HOI. Methods: This study was conducted at the Vascular Anomaly Clinic of Kyungpook National University Hospital during 11 years (1998~2008). Sixty-two cases were selected in addition to selecting other tumors and malformation as a control group. We then reviewed their clinical features and the results of H&E and GLUT-1 IHS for making the differential diagnosis.Results: The male to female ratio was 1: 2.88. The head and neck were the most commonly involved sites. The complications included ulceration and/or bleeding (12.9%), scarring (9.7%), infection (4.8%), ocular complications (4.8%) like visual axis occlusion, and pain (1.6%). Three phases of proliferating, involuting and involuted of a HOI comprised 11.3%, 37.1% and 51.6% of the lesions, respectively, from the clinical view point and 11.3%, 48.4% and 40.3% of the lesions, respectively, from the pathological point of view. GLUT-1 was positively expressed on almost all of the HOIs (47/57, 82.5%), except for 10 HOIs of the involuted phase and the other controls. Conclusion: The clinicopathological findings of this study were similar with those of the previous reports. The expression of GLUT-1 by a HOI can be helpful to make the correct diagnosis from other vascular tumors and malformations. (Korean J Dermatol 2009;47(4):386~394)
Capillary Aneurysm 4예 -흑색종과의 임상적 감별진단-
지성근 ( Seong Geun Chi ),정홍대 ( Hong Dae Jung ),이석종 ( Seok Jong Lee ),김병수 ( Byung Soo Kim ),이원주 ( Weon Ju Lee ),김도원 ( Do Won Kim ),윤길숙 ( Ghil Suk Yoon ) 대한피부과학회 2007 대한피부과학회지 Vol.45 No.12
Capillary aneurysm is classically described as a suddenly growing dark papule, and is also known as thrombosed capillary or vein. It is clinically significant that the clinical features of capillary aneurysm are closely similar to those of malignant melanoma or dysplastic nevus. The histopathological finding of capillary aneurysm reveals dilated thin-walled venule(s) just beneath the hyperplastic epidermis, lined by a single layer of endothelium and a thrombus in the lumen. This abstract focuses on four patients who presented with a dark black-colored dome-shaped nodule and clinical impression included malignant melanoma, dysplastic nevus, angiokeratoma and lymphangioma circum-scriptum. We herein report four cases histologically diagnosed as capillary aneurysm, which should be considered for differential diagnosis. (Korean J Dermatol 2007;45(12):1265∼1269)
연부 조직 내 원격전이를 보이는 악성흑색종 환자에서 시도한 Metastasectomy
지성근 ( Seong Geun Chi ),김준영 ( Jun Young Kim ),이석종 ( Seok Jong Lee ),이재철 ( Jae Chul Lee ),김병수 ( Byung Soo Kim ),이원주 ( Weon Ju Lee ),김도원 ( Do Won Kim ),박호용 ( Ho Yong Park ),김유찬 ( You Chan Kim ) 대한피부과학회 2009 대한피부과학회지 Vol.47 No.12
Patients with stage IV metastatic melanoma have been traditionally managed with mainly palliative therapy such as chemotherapy, radiation therapy or biologic therapy, yet their overall survival is unsatisfactory. Several recent series have indicated a long-term survival benefit after complete resection, (termed metastasectomy) of distant metastatic foci in patients with metastatic melanoma. Unlike other palliative modalities, surgery like metastasectomy can rapidly render a patient clinically disease-free with rather minimal morbidity, a short-term of hospitalization and a quick recovery time. This may prolong the survival and improve the quality of life of patients with stage IV melanoma if all the clinicoradiologically-evident tumors can be completely resected. We report herein on a case of performing metastasectomy in a patient who had malignant melanoma with soft tissue metastasis of the breast (T3a/bN0M1a), even though there was a regrettable result. (Korean J Dermatol 2009;47(12):1379∼1384)