연화제와 UVB를 이용한 병용치료로 호전된 요독성 소양증 6예

성경제(Kyung Jeh Sung),김성범(Sung Bum Kim),최지호(Jee Ho Choi),고재경(Jai Kyoung Koh) 대한피부과학회 1992 대한피부과학회지 Vol.30 No.4

Phototherapy with UVB has become a cornerstone in treating uremic pruritus. To investigate the additional benefit of emollient, we performed emollien-phototherapy in six uremic pruritus patients on hemodialysis, one of which was not responding with UVB only. After applying mineral oil over the whole body, UVB phototh.rapy was performed two to three times weekly. Improvement was noted within one to three treatments and after three to ten treatments, pruritus markedly or totally disappeared in al six patients. This result suggests that emollient-phototherapy is as effective as, or in some patients, more effective than phototherapy with UVB only in managing uemic pruritus. (Kor J Dermatol 1992;30(4):546-550)

한선종양에 대한 면역조직화학적 연구

성경제(Kyung Jeh Sung),조광현(Kwang Hyun Cho),정홍근(Hong Keun Chung),김성범(Sung Bum Kim),최지호(Jee Ho Choi),고재경(Jai Kyoung Koh) 대한피부과학회 1992 대한피부과학회지 Vol.30 No.3

The histogenesis and differentiation of sweat gland tumors are controversial. Twenty-two cases of sweat gland tumors were stained by immunoperoxidase technique (ABC method) for the presence of S-100 protein, CEA, and two kinds of keratin. Four syringomas, 4 eccrine poromas, 2 eccrine porocarcinomas, 2 eccrine spiradenomas, 1 papillary eccrine adenoma, 3 clear cell hidradenomas, 3 mixed tumors of skin, 2 papillary syringocystadenomas, and 1 cylindroma were included. All samples were formalin-fixed and paraffin-erribedded. Two monoclonal cytokeratin ant.ibodies, MA-902 (specific for cytokeratin No. 8) and MA-903 (specific for cytokeratins No.1,5,10,11) were used. In normal eccrine and apocrine glands, MA-902 stains cells of the intradermal duct and secretory portion. While MA-903 stains cells of the intraepidermal and intradermal duct and myoepithelial cells of eccine and apocrine glands, S-100 protein is found in the secretory cells of the intradermalduct and secretory portion, while CEA stains the secretory and ductal cells of eccrine and apocrine glands. All sweat gland tumors we studied stained by 4 antibodies in variable positive rates, Based on these findings, we discuss the histogenesis of various sweat gland tumors. (Kor J Dermatol 1992; 30(3): 303-316)

S - 100α 및 β 단백질에 대한 단세포군 항체를 이용한 한선종양의 면역조직화학연구

성경제(Kyung Jeh Sung),조광현(Kwang Hyun Cho),서호석(Ho Seok Suh),최지호(Jee Ho Choi),고재경(Jai Kyoung Koh) 대한피부과학회 1992 대한피부과학회지 Vol.30 No.4

S-100 protein is a mixture of three proteins, that is, S-100 ao(aa), S-100 a(ab) and, S- 100 b(bb). Twenty-two case, of sweat gland tumors were stained with immunoperoxidase technique (ABC method) for the presence of S-100a and b-subunit. Four syringomas, four eccrine poromas, two eccrine porocarcinomas, two ecerine spirdeiomas, one papillary eccrine adenoma, three clear cell hidradenomas, three mixed tumr rs of the skin, two papillary syringocystadenomas, and one cylindroma were included. All specimens were formalin-fixed and paraffin-embedded. The results were as follows : 1) The staining patterns of anti-S-100a and b-protein antibodies we e simillar to those of anti-S-100 protein antibody except in eccrine poroma and porocare nomal. 2) In eccrine poroma and porocarcinoma, scattered S-100-positive dendritic cells within tumor cell nests were stained by S-100-protein antibody (3/6), but not by anti-S-100a protein antibody. S-100p is present in normal Langerhans cells. Therefore this finding suggests that these cells niay be Langerhans cells. (Kor J Dermatol 1992;30(4):446-453)

5 - FU로 인한 홍반성감각둔감 증후군

성경제(Kyung Jeh Sung),정환교(Hwang Gyo Jeong),고재경(Jai Kyoung Koh) 대한피부과학회 1990 대한피부과학회지 Vol.28 No.4

Erythr odysesthesia syndrome is a. peculiar toxic reaction due to anti-cancer drug. lt is characterized by a painful, purple-colored patch on the palms and soles, and may form bullae. We report a case of erythrodysesthesia syndrome in a 46-year-old woman. 5-FU and leucovorin were administered for 5 days because of her colon cancer. Two weeks after anti-cancer therapy, purple-colored erosive patch appeared on the face, and 10 days later, purple-colored vesicular patches were seen on both palms and soles, accompanied with pain. Histopathologic examination reveals a severe epidermal necrosis. Individual keratinocyte shows cytologic atypia and apoptotic body. (Kor J Oermatol 28(4): 450 455, 1990)

구리 증기 레이저와 Flashlamp Pumped Pulsed 색소 레이저 치료에 따른 부작용의 비교에 관한 연구

성경제 ( Kyung Jeh Sung ),이상협 ( Sang Hyup Lee ),이화정 ( Hwa Jung Lee ),고재경 ( Jai Kyoung Koh ),최지호 ( Jee Ho Choi ) 대한피부과학회 1995 대한피부과학회지 Vol.33 No.5

Background : There are two kinds of mechanism for laser therapy according to selectie photothermolysis. Selective photothermolysis means that a chromophore can be selectively dei, stroyed with a laser of n appropriate wavelength and of a short pulse duration that is shortor than the thermal relaxation time of the chromophore. It is supposed that the side effects of the continuous wave laser, in which selective photothermolysis does not exist occur more often than when a pulsed wave laser is used. Objective : We compar.d the side effects of flashlamp-pumped pulsed tunable dye laser(SPTL), whose treatment is baseal on selective photothermolysis, with those of copper vapor laser(CVL , which is a quasi-continuous thermal laser. Methods : The laser cl arts of 498 patients with SPTL treatment and 485 patients with CVL, treatment in Asan Medical Center from 1989 to 1994 were examined, retrospectively. Results : 1) Among 498 patients, with SPTL treatment, we observed various side effects in 47(9.4%). The incidences of individial side effects are as follows, hyperpigmentation in 6.2%(31), vesicl formation in 1.6% (8), surface texture change in 0.8% (4), Hypopigmentation in 0.6% (3), scar format,ion in 0.2% (1). 2) After CVL treatment, side effects occurred in 30(6.2%) among 485 patient.. Hyperpigmentation in 3.1%(15), vesicle formation in 2.5%(12), surface texture change in 0.2%(1), hypopigmentation in 0.2%(1), and scar formation in 0.1%(1) were observed. Conclusion : The total incidence of side effect.s after CVL treatment is not statistically different, from that after SPTL treatment, which contradicts the previous theory. (Kor J Dermatol 1995;33(5): 815-820)

그람음성 지간 감염증

성경제(Kyong Jeh Sung),이미우(Mi Woo Lee),최지호(Jee Ho Choi),고재경(Jai Kyoung Koh) 대한피부과학회 1990 대한피부과학회지 Vol.28 No.6

Gram-negative toeweb infections have clinical manifest,ations of variable severity. In its mildest form, the affected tissue is damp, softened, boggy and white. But. more severe form may progress to marked denudation of second, third and fourth toewebs with a profuse serous or purulent discharge, and its treatment is difficult. We described a 39-year-old man who had ulcerated arid oozing patches on several toewebs. Pseudomonas aeruginosa was detected in bacterial cultures. We successfullg treated with split-thickness skin graft, and enoxacin on first, visit and enoxacin with gentamicin ointment, for 2 weeks on second visit. (Kor J Dermatol 28(6):779 782, 1990)

혈액투석중인 만성 신부전증 환자의 피부증상 및 이에 대한 혈액투석의 영향

성경제(Kyung Jeh Sung),이미우(Mi Woo Lee),최지호(Jee Ho Choi),고재경(Jai Kyoung Koh),박수길(Soo Kil Park) 대한피부과학회 1991 대한피부과학회지 Vol.29 No.3

The purpose of this study was to examine the frequency of eutaneous disorders in patients with chronie renal failure presently on hemodialysis(HD). The results were as follows. 1. Cutaneous lesions were present in all 78(100% ) patients with chronic renal failure. 2. The frequency of msjor cutaneous problems associated with chronic renal failure was as follows: xerosis(82.1%), pruritus(74.4%), nail changes(74.4%), hyperpigmentation(70.5 % ), xerostomia(42.3'Yo), poor wound healing(37.2%), easy bruisability(30,8%), hypotrichosis(21.896), and purpura(14.1 % ). 3. Cutaneous problems which appeared after the initiation of HD were. appearance of new pigmented nevi or lentigines(9 patients), appearance or aggravation of acne(6), contact dermatitis at AV fistula site(2), gynecomastia(1), extensive flat warts(1), extensive tinea versicolor(1), and extensive vitiligo(1). 4. Among 55 patients with hyperpigmentation, 11 patients reported decreased pigmentation following HD. In 15 patients, hyperpigmentation worsened following HD, and in 9 patients hyperpigmentation first appeared after HD was initiated. 5. Cutaneous disorders favorably affected by HD were as follows: easy bruisability(3/ 24), xerostomia(3/33), gingival friability(2/7), and hypotrichosis(5/17). 6. Poor wound healing and xerosis were not improved by HD. 7. Among 58 pruritic patients, 7 patients were improved after HD, 7 patients became worse during each HD, and 3 patients were not pruritic only for 2 to 3 days after each HD. Four patients experinced pruritus only during each HD. 8. There was no significant statistical difference between the frequency of pruritus and xerosis and the levels of blood urea nitrogen, calcium, phosphorus, and parathyroid hormone. (Kor J Dermetol 20(3): 313 321,1901)

Bcl - 2 단백을 이용한 면역조직학적 방법에 의한 기저세포암과 모낭 상피종의 감별

이상협 ( Sang Hyub Lee ),서호석 ( Ho Suk Suh ),최지호 ( Jee Ho Choi ),성경제 ( Kyung Jeh Sung ),문기찬 ( Kee Chan Moon ),고재경 ( Jai Kyoung Koh ) 대한피부과학회 1996 대한피부과학회지 Vol.34 No.1

Background: It is important to distinguish trichoepitheliomas from basal cell carcinomas because, despite the similarity of clinical and histological findings, the treatments and prognoses are different. bcl-2 is a newly characterized protooncogene that has been shown to suppress programmed cell death(apoptosis), which is involved in tumorigenesis, and its expression has been demonstrated within tumor cells in a variety of neoplasms. Objective : We tried to evaluate the staining pattern of bcl-2 protooncogene in basal cell carcinomas and trichoepitheliomas. Methods : We examined cases of basal cell carcinomas and trichoepitheliomas with the immunohistochemical method of labelled streptavidin-biotin complex in paraffin-embedded sections using the antigen retrieval method. Results : 1. The bcl-2 staining pattern in basal cell carcinomas was diffuse throughout the tumor lobules, but multifocal absences of bcl-2 staining were identified in sites of follicular differentiation. Also, inhomogeneous staining patterns were observed around the cystic, glandular structure of several subtypes of basal cell carcinoma. 2. The trichoepitheliomas showed staining of tumor cells limited to the outer layers of the tumor lobules. 3. Normal skin showed staining of basal keratinocytes, rnelanocytes in the epidermis, and eccrine gland secretory cells, basal layer of follicular structures, and dermal hair papilla in the dermis. Conclusion : The immunohistcchemical bcl-2 staining is helpful for the differentiation of basal cell carcinomas from trichoepitheliomas particularly in borderline cases and the explanation of different biologic courses for the two diseases. Further investigation of bcl-2 staining in other malignant skin diseases should be undertaken, and its practical adaptation should be more widely used in borderline cases. (Kor J Dermatol 1996;34(1): 31-37)

중독성 표피 괴사융해증에서 고용량 면역 글로불린 정맥주사의 치료효과에 대한 고찰

김경진(Kyoung Jin Kim),지민선(Min Sun Jee),한만회(Man Heui Han),최지호(Jee Ho Choi),성경제(Kyung Jeh Sung),문기찬(Kee Chan Moon),고재경(Jai Kyoung Koh) 대한피부과학회 2002 대한피부과학회지 Vol.40 No.7

N/A Background : Toxic epidermal necrolysis(TEN) is the most dramatic and life-threatening cutaneous drug reaction. However, specific and effective treatment for TEN have not yet been identified. Recently several reports suggested that high dose intravenous immunoglobulin(Ⅳ Ig) treatment has produced good results in patients with TEN. Objective : To analyze the efficacy and side effects of Ⅳ Ig in treatement of TEN. Methods : Ten patients with clinicopathological diagnosis of TEN were treated with IV Ig(1.6-3.4g/㎏), and clinical efficacy and side effects were observed. Results : Nine patients were healed and one died of sepsis. Interruption of further epidermal detachment occurred after an average 3 days from the onset of Ⅳ Ig therapy. Complete wound healing occurred after an average of 14.3 days. The side effects of Ⅳ Ig including headache, myalgia, nausea, transient neutropenia, and coombs positive hemolytic anemia were observed in 4 patients but normalized after cessation of Ⅳ Ig therapy. Three of them showed complete healing of detached skin but died with aggravation of underlying disease. Conclusion : Ⅳ Ig therapy represents a safe and very effective treatment for TEN. Furthermore, intensive care for underlying diseases is also very important for reducing the mortality rate in patients with TEN.

건선 표피에서의 p53, pRb, p16, p21 및 PCNA에 대한 면역조직화학적 고찰

장성은(Sung Eun Chang),성경제(Kyung Jeh Sung),문기찬(Kee Chan Moon),고재경(Jai Kyoung Koh),최지호(Jeo Ho Choi) 대한피부과학회 1999 대한피부과학회지 Vol.37 No.9

N/A Background : Psoriasis is a chronic disorder which is characterized by hyperproliferation and abnormal differentiation of keratinocytes with T-cell infiltration. There is increasing evidence that inactivation of tumor-suppressor genes can promote uncontrolled cell proliferation and tumor formation. The products of p53, Rb, p16, p21 genes are examples of the molecules the cell growth cycle. Objective : In this study, immunhistochemical analysis of cell cycle-related molecules (p53, pRb, p16, p21Wafl, and PCNA) was done to elucidate the roles and interactions of those molecules in the pathogenesis of psoriatic keratinocytes. Materials and methods : Formalin-fixed skin samples composed of 20 chronic plaque type psoriatic, 20 nonlesional and 20 normal epidermis, and 5 squamous cell carcinomas were included in this study. Results : Our results suggest that p53 protein accumulation is an early event in cutaneous SCC, but not in psoriasis. In our study, diffuse expression of p16 with almost negative expression of pRb in psoriatic epidermis suggest that inverse relationship is maintained. Although loss of p16 expression is frequently associated with many kinds of cancers, we speculate there is a possibility that is a strong expression of p16 is related to localized cancer as well as in benign hyperproliferative lesions. In psoriasis, p21 may be overexpressed via a p53-independent pathway. The number of PCNA positive cells was higher in the psoriatic epidermis in contrast to scattered staining in the psoriatic nonlesional and normal epidermis Conclusion : The proliferative status of psoriatic leratinocytes dose not implicate Rb gene and may not implicate the p53 gene significantly. It is associated with the strong expression of PCNA and moderately increased expressions of p16 and p21. (Korean J Dermatol 1999;37(9) : 1286∼1295)