수종의 피부질환에서 Transglutaminase K 발현에 대한 연구

김태원 ( Tae Won Kim ),서기범 ( Ki Beom Shur ),이증훈 ( Jeung Hoon Lee ),박장규 ( Jang Kyu Park ),김수열 ( Soo Youl Kim ) 대한피부과학회 1998 大韓皮膚科學會誌 Vol.36 No.3

To understand the role of Transglutaminase K(TGase K) in skin diseases, the expression of TGase K protein was studied in hyperkeratotic inflammatory skin diseases, and in several different kinds of benign and malignant skin tumors. Immunohistochemistry was used to detect the TGase K protein with a new anti-human TGase K polyclonal antibody. This antibody showed the same immuno- histochemical staining pattern as in previously published immunofluorescence data with the exception that the immunohistochemical stain showed a slightly weaker stain in the granular layer. However, the staining intensity was decreased in psoriasis, which is opposite for results obtained with the widely used TGase K monoclonal antibody B.C1. In other hyperkeratotic inflammatory skin diseases, like pityriasis rubra pilaria, lichen planus, and pityriasis rosea, the staining patterns were similar while the staining intensity was decreased, compared to normal epidermis. Squamous cell carcinoma showed a diffuse staining pattern in tumor cells with a small intensity increase in well differentiated tumor cells. However, in actinic keratosis and Bowen's disease, which are thought to be precursors of squamous cell carcinoma, the staining intensity was weak. The tumor cells of basal cell carcinoma, malignant melanoma, and seborrheic keratosis showed a weak staining intensity. (Korean J Dermatol 1998;36(3): 399-406)

윤상 육아종의 임상 및 병리 조직학적 고찰

김경호(Kyung Ho Kim),서기범(Ki Beom Shur),이증훈(Jeung Hoon Lee),박장규(Jang Kyu Park) 대한피부과학회 2001 大韓皮膚科學會誌 Vol.39 No.8

N/A Background: Granuloma annulare is a chronic inflammatory condition of unknown cause. There are only two clinicopathologic studies in Korea. Objectives: Our purpose was to investigate the clinicopathologic findings of granuloma annulare and literature review. Methods: Twenty two biopsy-proved cases of granuloma annulare were reviewed. We examined their clinical and pathological findings. Results: The incidence showed a peak under 20 years old(59.1%) and females affected twice as much as males. Average onset years was 21.5 years old and mean disease duration was 20 months. The lesions were located almost in dermis(77.2%) and interstitial infiltration type was most common. Conclusion: There were no large epidemiologic difference from previously reported studies. Granuloma annulare is not an uncommon disease. It is important to distinguish granuloma annulare from many other mucin producing, granuloma forming diseases. (Korean J Dermatol 2001;39(8) . 861-865)

피부과 영역에서의 원격진료

노하석(Ha Seok Rho),서기범(Ki Beom Shur),이증훈(Jeung Hoon Lee),박장규(Jang Kyu Park),곽상태(Sang Tae Kwak),정희경(Hoe Kyung Jung) 대한피부과학회 2000 大韓皮膚科學會誌 Vol.38 No.11

Background:Telemedicine can be useful in dermatology in which there is a physical barrier between the dermatologist and patient or primary care giver. Objective:Our purpose of this study is to examine a usefulness of teledermatology system in Korean situation. Methods:We made store-and forward teledermatology system on world wide web for it's usefulness. We examined the difference of diagnostic accuracy, level of certainty, and quality of images of photographs and still digital images. Results:The merits of our teledermatology system are summarized as follows 1. It has more diagnostic accuracy than classic store-and forward system. 2. The real-time additional history taking and request of laboratory examinations are possible by chatting system between dermatologist and primary care giver. 3. Patient follow-up is easier than store-and forward system. The difference of diagnostic accuracy, level of certainty, and quality of images of photographs and still digital images are summarized as follows. 1. There is no difference of diagnostic accuracy between photographic readers and digital image readers. 2. There is no difference of level of certainty between photographic readers and digital image readers. 3. In assesment of quality of photographs, no difference was founded between photographic readers and digital image readers 4. The satisfaction of quality of photographs is very high in all groups. The average is 97.5%. Conclusion:This study provides evidence that our teledermatology system is useful in korean situation and still digital image can substitute historic photographs in teledermatology. (Korean J Dermatol 2000;38(11):1468~1474)

한국인 13세에서 19세까지 앞머리선의 변화

김형주(Hyoung Joo Kim),박영옥(Young Ok Park),서기범(Ki Beom Shur),이증훈(Jeung Hoon Lee),박장규(Jang Kyu Park) 대한피부과학회 2000 대한피부과학회지 Vol.38 No.12

Background:Frontal hair line dose not exist in the same form for a lifetime, and each individual has a different form of frontal hair line. But, the study of the change of the frontal hair line still dose not exist. Objective:The objective of this study of the change of frontal hair line was to analyze whether the change of age, puberty, and the family history of androgenic alopecia was related to the change of frontal hair line. Method:This study held a survey which consists of male and female students of each class from middle school to high school. In this survey, the shape of frontal hair line was classified into the egg shape, square shape, and M shape. Result:1. When the age increased, the egg shape type of frontal hair line decreased, and the square type of frontal hair line increased. Especially, men were more salient. 2. During puberty, the egg shape type of frontal hair line decreased, and the square shape type of frontal hair line increased. 3. Before puberty, the m shape type of frontal hair line did not exist, but during puberty the M shape type of frontal hair line appeared. 4. Statistically, the family history of androgenic alopecia of the relationship of the change of the egg shape type decreased, the square shape increased. Conclusion:This study shows that frontal hair line is related to the change of age, and existence of puberty. (Korean J Dermatol 2000;38 (12) 1641~1645)

흡입수포 표피 자가이식술에 의한 백반증의 치료

노영우 ( Young Woo Rho ),김태원 ( Tae Won Kim ),이웅재 ( Woong Jae Lee ),서기범 ( Ki Beom Shur ),이증훈 ( Jeung Hoon Lee ),박장규 ( Jang Kyu Park ) 대한피부과학회 1998 대한피부과학회지 Vol.36 No.1

Background: Vitiligo is an acquired depigmentary disorder characterized by loss of melanocytes from the epidermis. Autografting using the suction blistered epidermis technique is one of the surgical modalities of vitiligo treatment, and has been successfully used by several authots. Objective : The purpose of this study was to evaluate the effect of the autografting using the suction blistered epidermis technique for the treatment of vitiligo. Methods : 142 sites from 39 patients with vitiligo were treated with autografting using the suction blistered epidermis technique. The recipient sites were prepared by freezing with liquid nitrogen of the sites 48 hours prior to grafting. Results: Better results were seen in cases with the following Factors : a) cases where the disease had been present for more than 3 years b) the post-operative period had been Longer than a year c) the Lesional sites of the vitiligo were on the trunk and neck rather than the neck and extremities d) the vitiligo had affected the grabous rather than the hairy areas on the face. However, there were no differences between the clinical types(such as generalized, localized, and segmental) in the success rate of treatment. Preopera'tive PUVA or post operative PUVA also did not affect the statistical results. Conclusion: On autografting using the suction blistered epidermis, it is better to select the patients who have had the disease for more than 3 years, and graft the epidermis which has increased melanocytes by preoperative PUVA for good treatment results and even pigmentation. (Korean J Dermatol 1998;36(1): l03-106)

백반증 환자의 PUVA 치료 반응에 관한 연구

이증훈,박장규,서기범,김연수 대한피부과학회 1999 大韓皮膚科學會誌 Vol.37 No.12

Background:Psoralen and UVA(PUVA) are the most common and effective treatments for vitiligo. UVA treatment requires measurement of the minimal phototoxic dose (MPD) in order to determine adequate UVA irradiation for safe and effective photochemotherapy. There have been only a few reports about the efficacy of PUVA therapy in which the exposure dose was determined by the MPD. Objective:The purpose of this study was to measure the MPD on vitiliginous lesions and to evaluate the response of vitiligo patients to photochemotherapy. Methods:The minimal phototoxic dose of UVA was measured in 82 vitiligo patients. Thirty two of the 82 patients were treated by PUVA therapy for at least three months. The initial exposure dose was two thirds of the MPD. Subsequently we evaluated the initial exposure dose, the total exposure dose, and the total number of exposures until initial repigmentation appeared. Adverse effects of PUVA therapy were also evaluated. Results: 1. The initial repigmentation rate for systemic PUVA therapy was highest for the trunk (68.4%), followed by the face and neck (33.3%), and the extremities(6.3%). 2. For topical PUVA treatment the mean total exposure dose was 2.3J/cm2, the number of treatments was 5.3, and the duration until initial repigmentaion appeared was 16.5 days. In the case of systemic PUVA treatment the same parameters were 12.0J/cm2, 7.1, 27.3 days, respectively. 3. In the systemic PUVA therapy group the total exposure dose was 21.4±15.0J/cm2 for patients with lesions of less than one year duration and 8.7±5.1J/cm2 for patients with lesions of longer than one year duration. 4. The adverse effects of topical PUVA therapy were erythema (7 of 11 cases), prickling (3 of 11 cases), pruritus (2 of 11 cases), and desquamation (1 of 11 cases). 5. Side effects in 23 patients with systemic PUVA therapy were erythema (78.3%), pruritus (47.8%), gastrointestinal symptoms (21%), burn (8.7%), and headache (1.9%). There were no side effects in topical and systemic PUVA therapy as much as PUVA therapy discontinued. Conclusion : These results indicate that PUVA therapy in cases where the initial exposure dose is determined by MPD, subsequently the exposure dose is determined by visual inspection of vitiliginous lesions and history taking of subjective symptoms on each treatment is safe and effective.

온라인 피부과학 이미지 데이터베이스의 개발

곽상태,이웅재,정회경,조인준,이증훈,박장규,서기범 대한피부과학회 1999 大韓皮膚科學會誌 Vol.37 No.12

Background:Most dermatologic diseases are diagnosed based on typical clinical and histopathologic features. Consequently, image databases for these diseases are necessary for educational and diagnostic purposes. Objective:To establish a general visual reference for dermatologic diseases and supporting materials for basic medical education. Methods:Approximately 2000 clinical images were selected from our archive of 50,000 slides. These images were digitized and catagorized according to the key system developed by the Department of Dermatology, Erlangen University with minor modification. The architecture and components of this image database are presented in this paper. Results:The database allows a search for appropriate dermatologic images according to diagnosis, localisation, and appearance of skin lesions. Conclusion:We have established a WWW (world-wide-web) based online dermatologic image database which can be used as a useful tool for general reference and for educational material.