Vibrio Vulnificus 세포용해소에 의한 마우스 독혈증시 Cytokine ( TNF - α , IL - β , IL - 6 ) 의 변화

박석돈 ( Seok Don Park ),김주섭 ( Ju Seob Kim ),차승훈 ( Seung Hoon Cha ) 대한피부과학회 1998 大韓皮膚科學會誌 Vol.36 No.1

Background: Cytokines such as TNF-a, and IL-1, 6, 8 are thought to mediate many host responses in patients with sepsis through the release of many kinds of inflammatory mediators. Vibrio vulnificus is a virulent, halophilic, marine, and Gram-negative bacterium causing wound infections or primary sepsis with fulminant course. It has been known to produce many exocellular factors, such as cytolysin and exozymes, which are possible causes of shock and tissue damage. Objective : Our purpose was to investigate the changes of cytokines(TNF-a, Il-l p, and IL-6) after intravenous administration of V. vulnificus cytolysin which have known to be a major virulent factor for elucidating pathogenesis of septic shock. Methods : After administration of V. vulnificus cytolysin(20 hemolytic units) and physiologic saline through a mouse tail vein, we obtained blood samples from the heart according to a time course(0, 30, 60, 90, 120, 240, and 360 minutes). We measured serum concentrations of circulating TNF- a, IL-1 p, and IL-6 using commercially available immunoassay kits. Results . The serum concentration of TNF- a peaked at 60 min (1894 pg/ml, as compared with 829 pg/ml after saline administration), began to decrease at 90 min and fell to baseline at 360min. Concentration of IL-6 rose significantly at 90 min(>3,839 pg/ml) and began to decrease at 120 min, whereas the level of IL-1 0 increased slightly and the peaked around 90min(117 pg/ml) after the cytolysin injection. Conclusion: We conclude that the host response to cytolysin is associated with a brief pulse of circulating cytokines in the early stage of sepsis caused by V. vulnipcus infection. (Korean J Dermatol 1998;36(1): 23-29)

Phenol - Chloroform - Petroleum ether 법을 이용한 Vibrio vulnificus lipopolysaccharide의 추출 및 생물학적 활성 측정

김주섭,박석돈 ( Ju Seob Kim,Seok Don Park ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.4

Background: Vibrio vulnificus is a pathogenic, marine, halophilic, gram-negative bacillus which causes fulminant infecticn in humans through the ingestion of raw seafood or skin wounds. V. vulnificus produces seveal kinds of virulent factors including cytolysin, endotoxin, exoenzymes, and siderphores. Among these, the lipopolysaccharide(LPS) of V. vulnificus has recently been purified, but the biological activity of this endotoxin is not well clarified as yet. Objective : The purpose of this study was to extract LPS from Vibrio vulnificus and to test the biological activity of extracted LPS for the elucidation of the role in V. vulnificas septicemia. Methods : V. vulnificus LPS was extracted by the Phenol Chloroform-Petroleurn ether(PCP) method. The biological activity of LPS was evaluated with a limulus amebocyte lysate assay and by assessment of lethality to ICR mice. Results : Five hundreds mg of LPS were extracted from 10g of dried V. vulnificus. Lirnulus amebocyte lysate formed a hard gel in response to the extracted LPS. This LPS showed low level of protein contaminatior in SDS-PAGE electophoresis and spectrophotometry. A High dose of LPS(200 mg/ml body weight) was lethal to mice. Conclusion : The PCP extraction yield relatively large amounts of LPS from V. vnlnificus. with out significant protein contamination and e xtrated LPS has endotoxin activity. This extrated LPS can be used for further studies such as making antibody or characterizing pathogenic roles in the V. vulnificus infection. (Kor J Dermatol 1997;35(4): 645-650)

할미꽃에 의해 발생한 자극피부염

김주섭,차승훈,박석돈 ( Ju Seob Kim,Seung Hoon Cha,Seok Don Park ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.2

Pulsatilla koreana is a member of the buttercup familly(Ranuculaceae) which contains the unsaturated lactone, protoanemonin(C3H4O2), formed after injury to the plant by the breakdown of the glycoside ranunculin. It has been prescribed as a herbal medicine or a folk medicine for antipyretic, analgesic, anti-inflammatory, astringent and hemostatic effects in Korea. A 20 year-old famale patient presented with confluent vesicobullae on the erythematous base with a burning sensation on her upper back. This was caused by contact with crushed Pulsatilla koreana, a folk medicine for the treatment of left facial nerve palsy, that had occurred 10 days before her visit. A provocation patch test with Pulsatilla koreana upon a heathy male volunteers upper back showed strong positive reactions with the stalk and leaf in fresh and frozen stat.e and after thaw ing resptively. However no reaction was seen when the folk medicine was used in a dried form or with the root in any state. This case indicates that misadvice and ignorant folk remedies could cause misfortunate results to innocent people, (Kor J Dermatol 1997;35(2): 339-343)

개심술 후 발생한 후천성 림프관종

박재훈(Jae Hoon Park),김주섭(Ju Seob Kim),박석돈(Seok Don Park) 대한피부과학회 1995 대한피부과학회지 Vol.33 No.2

Lymphangiectasis(=acquirecl lymphangioma) ate dilated lymph caillaris and may be due to the obstruction of the lymphatic circulation from surgery, irradiation, chronic recurrent infection or trauma. The patient was a 5 years old girl who developed a straw-colcre, asymptomatic grouped vesicular mass resembling frog spawn measuring 9 cm in diameter the left axilla and arm, 2 months after the total excision of a previous lymphangiectatic mass. She had a history of previous open heart surgery at 2 years of age. Histopathologic findings showed large, irregularly shaped cysticalation lined by a single layer of endothelium in the superficial dermis. Immunohistochemical stainig showed vimentin positive and negative results in Factor VIII and HLA-DR antigen which was compatible with a lymphatic vessel. (Kor J Dermatal 1995;33(2): 374-378)

당뇨병성 경화부종 - 임상 - 병리조직학적 연구 및 문헌고찰 -

황호근(Ho Geun Hwang),이승하(Seoung Ha Lee),형근영(Keun Young Hyoung),신봉주(Bong Joo Shin),김경년(Kyoung Nyeon Kim),조정구(Chung Gu Cho),김주섭(Ju Seob Kim),차승훈(Seung Hoon Cha),박석돈(Seok Don Park) 대한내과학회 1996 대한내과학회지 Vol.51 No.4

N/A Objectives: We studied clinical feature, underlying disease and histo-pathologic finding of scleredema diabeticorum that was observed as non-pitting indurated edematous skin of the nape, occiput in non-insulin dependent diabetes mellitus. Methods: We performed clinico-histopathologic study in 5 cases of scleredema diabeticorum which were diagnosed at our hospital and reviewed 6 cases in Korean literatures. Results: 1) The male to female ratio was 4:1, The overweight or obese middle-aged (mean:54.6) males were prone to develop these cutaneous changes. There was no relationship between the development of diabetic scleredema and the duration, the severity of diabetes. Hypertension and hyperlipidemia were frequent associated finding among the patients. 2) The increased level of fasting C-peptide implicated that the ability of insulin secretion was preserved. 3) Non-pitting hardening of the skin on the nape, head and surrounding parts of the body was common skin change in all patients. No evidence of systemic involvements was found. 4) Typical histopathologic findings, consisted of the thickening of dermis, the degeneration of collagen bundles in mid- to deep dermis, and the deposition of acid mucopoleysaccharides, hyaluronic acid, were noted in 4 cases of our study. 5) The therapeutic responses of cutaneous changes were generally poor. Conclusion: These results implies that scleredema diabeticorum is not a rare cutaneous manifestation among the diabetic dermadromes, and special histopathologic stainings with skin tissue sections are necessary for diagnosis. Although the exact mechanisms of this disease are not known, and no effective therapy is available, it needs to be studied exactly that the facts of hyperlipidemia, overweight, hypertension and well-preservation of fasting C-peptide observed in our cases, may be related to syndrome-X.

Bleomycin에 의한 채찍양(flagellate) 피부 색소 침착 1예

김주섭,신성욱,박석돈 圓光大學校 醫科學硏究所 1995 圓光醫科學 Vol.11 No.2

Bleomycin is one of the widely-used chemotherapeutic agents. It may cause non-specific changes in the skin including stomatitis, hair loss, nail changes, inflammatory nodules, multiform erythema and vesicobullous eruptions. Cutaneous flagellate pigmentation on pressure or trauma sites is known as specific cutaneous reaction to bleomycin, although its pathomechanism is not clearly elucidated. We experienced a rare flagellate pigmentation due to bleomycin injection in a patient with metastatic testicular tumor. A 25-year-old male showed linear brown flagellate pigmentations on the trunk, axillae, dorsa of hands, which were developed after BEP(bleomycin. etoposide, cisplatin) combination chemotherapy. He underwent left radical orchiectomy and artificial testicular replacement because of metastatic testicular endodermal sinus tomor(stage D_2). Gentle rubbing or scratching on the skin caused linear brownish edema and residual pigmentation. Histopathologic finding of the pigmented sites revealed melanin pigmentation of basal cell layer and patchy pigmentation of low prickle cells. The flagellate pigmentation became paler during 7 months follow-up period. Authors report a cutaneous flagellate pigmentation after bleomycin chemotherapy.