멜라닌 세포성 병변에서 화상분석법을 이용한 DNA 배수성에 관한 연구

이길주,김동준,오칠환 ( Gil Ju Yi,Dong Jun Kim,Chil Hwan Oh ) 대한피부과학회 1997 大韓皮膚科學會誌 Vol.35 No.6

Backgroutld: In the cutaneou; neoplasms, especially melanocytic skin lesions, the degree of t.he nuclear atypia such as the hyp rchromatism, pleomorphism, and giantism is a very impor tant factor when determining the differntial diagnosis between the malignant. and the benign turnors and the prognosis. Objective : So we measured and cornpared the nuclear atypia of the malignant melanoma, and acquired and congenital melanocytic nevi(AMN and CMN) using the computerized image analysis (IA). Methods : Five micron ser,t ons were cut from each paraffin block. The sections were Feulgen-stained and image analysis was perforrned with an AIC image analysis system. In each case, 50 lymphocytes nuclei fnim the sarne specimen slide were measured as an internal diploid control. Each 100 cells of the MM, CMN and AMN were measured and are referred to in this report as the upper part and the lower part. The morphological parameters such as mean nuclear area, coefficient of variation(CV) of the nuclear area, roundness of the nucleus and CV of the roundness were measured. For the nuclear content, mean ploidy, CV of the mean ploidy ind 2c Deviation Index(2cI3I) were calculated and then the DNA histograms were produced. Results : Nuclear area, CV of the nuclear area, mean ploidy, CV of the mean ploidy and 2cDI were found to be significantly reat.er for rnalignant melanoma than for CMN and AMN. The nuclear area of AMN is significantly lar ger than that of CMN and there were no significant differences between the uper and the lower part.s of three melanocytic lesions in any of the measured parameters. Conclusion . The results of o ir study suggest that the IA of the melanocytic cells might reflect the biologic behavior rnore sensitively t,han do clinical or histologic criteria, therefore important information for differentiating thi benign and the malignant melanocytic lesions may be obtained by the DNA profile and morphomi try on Feulgen st,ained tissue specirnens using IA.(Korean J Dermatol 1997;35(6): 10591065)

건강한 성인에서 Sodium Lauryl Sulfate와 Ethanol에 의한 피부반응 및 Chroma Meter 를 이용한 홍반의 정량적 측정에 관한 연구

이길주(Gil Ju Yi),문기찬(Kee Chan Moon),김수남(Soo Nam Kim) 대한피부과학회 1992 大韓皮膚科學會誌 Vol.30 No.6

Irritant skin reactions can be evaluated by several techniques. Using different scores for the degree of erythema, edema, scaling and fissuring is the time-honored approach but implies t,he disadventagrs of lacking objectivity and pararretric properties. This paper describes the objective nteasurement of irritant. skin responses to various concentrations of Sodium Lauryl Sulfate(SLS) and Ethanol by a color reflectance meter(Chroma Meter) and compares with visual scoring The results are summarized as follows : 1. Pretreatment assessments by a Chroma Meter on normal forearm area showed an average score of 7.70+1.53 for Chroma Meter value a*(rediies:; score). 2. Skin responses to SLS in various concentrations of 0.5, 1.0, 2.0, 3.0, 4.0, 5.0, 7.5% under occlusion for 24 hours were assessed by visual scoring system. They are measured 0.56+1.10, 0.74+1.29, 1.19 1.36, 2.11+1.69, 2.19+1.91, 2.56+1.50 2.81+2.16 respectively. 3. Skin responses to SLS in various concentrations of 0.5, 1.0, 2.0, 3.0, 4.0, 5.0, 7.5% under occlusion for 24 hour were assessed by a Chroma Meter valu a*(redness score). They are measured 8.29+1.98, 8.37+2.47, 9.31+2.27, 10.34+2.97, 10.35+3.18, 10.51+2.47, 11.61+3.45 respectively. 4. Skin responses to Ethanol in various concentrations were nearly negligible. 5. We have demonstrated there is a highly significant correlation between skin redness measured by the Chroma Meter and visually assessed erypthma(p<0.0001). It yields reproducible, objective, quantitative measurements of iryhema that parallel the subjective visual assessments. (Kor J Dermatd 1992;30(6):857-863)

제장간막관 용종

조창근 ( Chang Geun Cho ),홍승현 ( Seung Hyun Hong ),이길주 ( Gil Ju Yi ),송해준 ( Hae Jun Song ),오칠환 ( Chil Hwan Oh ) 대한피부과학회 1998 대한피부과학회지 Vol.36 No.1

A umbilical omphalomesenteric duct polyp is the result of incomplete closure of the omphalomesenteric duct, which connects the midgut with the yolk sac of the embryo. It may be associated with underlying embryologic anomalies such as Meckels diverticulum and umbilical enteric fistula, the complications of which may at times be fatal. This rare malformation should be clinically discerned from persistent granulation tissue or pyogenic granuloma. Histologically, it shows a polypoid lesion consisting of ectopic gastrointestinal epithelium with the appearance of gastric, intestinal, or colonic mucosa. We report a case of an umbilical omphalomesenteric duct polyp in an 8-year-old male patient, who had had a bright-red polyp on the umbilicus from the age of 1 month and had not had any other types of underlying abnormalities. (Korean J Dermatol 1998;36(1): 107-110)

색소레이저 ( Flashlamp Pulsed Tunable Dye Laser ) 로 치료한 국한성 혈관각화종

손상욱 ( Sang Wook Son ),홍승현 ( Seung Hyun Hong ),이길주 ( Gil Ju Yi ),송해준 ( Hae Jun Song ),오칠환 ( Chil Hwan Oh ) 대한피부과학회 1998 대한피부과학회지 Vol.36 No.1

Angiokeratoma circumscriptum is present at birth or early childhood and is an uncommon dermatosis characterized by papules and small nodules that may coalesce to form plaques. Histopathologically, there are varying degrees of hyperkeratosis, papillomatosis, and irregular acanthosis. In the papillary dermis, greatly dilated capillaries are observed, The acanthotic epidermis encircles the vascular spaces(blood cysts) where, occasionally, organized thrombi may be found. The use of pulsed-dye lasers to treat cutaneous vascular lesions is based on the theory of selective photothermolysis. We report a case of an angiokeratoma circumscriptum in an 48-year-old woman for whom the flashlamp pulsed tunable dye laser proved to be a highly successful means of treatment. (Korean J Dermatol 1998;36(1) : 152-155)

편평사마귀의 임상적 연구

최현철,이길주 건국대학교 의과학연구소 1997 건국의과학학술지 Vol.7 No.-

Verrucae planae(VP), also called juvenile warts, usually involve exposed parts of the skin and appear as numerous small pigmented papules. Human papilloma virus types 3, 10 and 28 are most commonly found in flat warts. It is not uncommon in VP showing spontaneous regression with typical clinicopathologic findings. Even though the clinical findings of VP are well known, there have been no collective clinical studies in Korea. The purpose of this study was to investigate the clinical characteristics of VP and the specific findings of VP during regression. A retrospective study of 30 cases of VP was performed to find the clinical characteristics. All the cases were confirmed by histopathologically and the clinical data during regression were analysed. Among 30 patients with VP, the mean age of onset was 23.3+7.14 years and the male to female ratio was 1.5:1. Main sites of involvement were face(93.3%), upper extremity(23.3%), dorsum of hands(20.0%), lower extremity(20.0%) and neck(13.3%). 56.7% of all cases were developed during summer. The rate of positive sensitivity of 1% DNCB in 28 patients was 96.4%. The mean duration of disease, in 17 cases was 17.24+6.95 months. Clinical signs during regression in 17 patients were as follows: itching(58.8%), increase in the number of lesions(35.3%), changes of colour(29.4), crusts formation(17.6) and erythematous swelling(5.9%). VP were more prevalent in the third decade rather than juveniles. The most frequent site of involvement was the face. Upper extremity and dorsum of hands were frequent sites of systemic involvement. Although there were some cases which showed no clinical signs during regression, typical signs and histopathologic findings were noticed in flat warts with spontaneous involution.

피부표면 외형의 정량적 측정을 위한 Stereoimage Optical Profilometer(SOP)의 개발에 관한 연구

이길주,오칠환 고려대학교 의과대학 1998 고려대 의대 잡지 Vol.35 No.3

Dermatologists use the eye t o evaluate the skin disease. Subjective clinical assessment of the skin lesions is rapid, inexpensive and at hand, but it is sometimes unreliable, depending on the examiner's skill, environmental factors(e.g. brightness of the room) or individual skin color, etc. It must be important to obtain the objective assessment of the skin lesions when we come to treat the patients or investigate the skin problems. Several non-invasive techniques based on different principles have been developed to investigate the skin functions. The skin surface contour has been a good subject for investigators to apply their techniques. There are several techniques for the evaluation of the skin surface contours such as stylus profilometer, laser profilometer and conventional optical profilometer (COP), but these methods have some drawbacks because their data are basically obtained from the two dimensional algorithm. So a new instrument has been developed based on a new concept 'stereoimage' processing technique in this study. The stereoimage optical profilometer(SOP) system, stores digital data of a pair of stereo images using the frame grabber. A pair of stereo images contains depth information. The depth can be extracted from right and left side of the stereo images. The difference between left and right side image is called 'disparity' which contains the depth information of the three dimensional view. The studies of three research plans have been tried to evaluate the skin surface contours quantitatively by using the SOP. 103 Korean healthy men in four age groups(0-20, 21-40, 41-60, above 61 year old) were participated in the first and the second study, where the new instrument named SOP has been applied. First of all, for comparing the usefulness and the reliability between the SOP and the COP, the coefficient variation(CV) of Rz(mean depth of roughness) was calculated by using the SOP and the COP as a validity study. The CVs of Rz using the COP are quite larger than those using the SOP. This result suggests that the SOP is much more reliable and a valid tool than ordinary COP. The second study was to evaluate the change of skin furrows according to aging process. The SOP is a new instrument for three dimensional evaluation of skin furrows, so the new six parameters such as Ra(mean surface roughness). Rz(mean depth of roughness), TL(three dimensional length), TA(three dimensional area), TV(three dimensional volume), TRz(three dimensional Rz) were to be developed, Ra, TL and TA showed statistically significant increase, in the age groups of after sixties. Rz also showed significant increase in over twenties and over sixties. In the third study, the SOP was used to apply for quantitative assessment of the patch test result of allergic contact dermatitis. Seventy-three Korean workers who had personal history of allergic contact dermatitis were participated in this study. Ninety-two positive patch test sites were obtained and were measured by the SOP. It was observed that there was statistically significant difference between the negative patch test site and the positive patch test site, when using the parameters such as TRz, TL and TV. In conclusion. the SOP system is more reliable and a useful method to evaluate skin furrows than the COP. Among the parameters which were made in this study, TA, TL, Ra and Rz seem to be useful as a reliable algorithm for evaluating skin furrows in aging process. The SOP is a very useful tool for objective measurement of the various changes of the skin surface contours, according to aging process and patch test.

편평사마귀의 임상적 연구

최현철,이길주 건국대학교 의과학연구소 1997 건국의과학학술지 Vol.- No.7

Glutaraldehyde(Wydex)에 의한 접촉 피부염 1예

최현철,안규중,이길주 대한피부과학회 1999 대한피부과학회지 Vol.37 No.4

Glutaraldehyde is commonly used as a biocide to disinfect delicate instruments such as dental instruments, to treat warts, hyperhidrosis and bullous diseases and as a preservative in various materials. Contact sensitivity to glutaraldehyde may not be detected, because it is not included in the standard screening chemicals recommended in the screening tests. We report a case of allergic contact dermatitis caused by Wydex輹(2% glutaraldehyde). A 54-year-old female made a visit to our departrnent with eczematous dermatitis of both hands, neck and face. She worked as a cleaner in delivery room and newborn nursery, and had developed the dermatitis 1 month after Wydex輹 containing 2% glutaraldehyde had been to clean the rooms. She had no family or personal history of atopy or contact dermatitis. Patch tests with Korean Standard(KS-1000) and Wydex輹 were performed, and patch tests with 2% glutaraldehyde, 0.2% gluteraldehyde and rubber mix followed. The positive results were, Wydex輹 2% ++, 0.2% +, 0.02% + and glutaraldehyde 2% aq. +, 0.2% aq. + on day 2 and day 4. We confirmed that the skin lesions had been caused by Wydex輹. The symptoms were eradicated after she changed her work environment and there has been no evidence of recurrence.

전풍에서 Itraconazole 1주 요법의 효과

안규중,김경진,이길주,양경미 대한의진균학회 1999 대한의진균학회지 Vol.4 No.2

Background: Pityriasis versicolor is often found following pathologic transformation of Malassezia fungi from yeast to mycelial forms by a poorly understood mechanism and is characterized by squamous skin lesions manifesting hyper- or hypo-pigmentation. Itraconazole is a synthetic oral antifungal agent of triazole family, which acts as a selective inhibitor of the cytochrome P-450-dependent synthesis of ergosterol and is reported to demonstrate a potent antifungal efficacy against Malassezia yeasts. Object: The present clinical study was designed to evaluate the therapeutic efficacy of one-week regimen of itraconazole by studying 20 patients with pityriasis versicolor, who were diagnosed both clinically and mycologically. In addition, we wished to identify Malassezia species from skin lesions of pityriasis versicolor and examine the possible correlation of a certain Malassezia(M.) species and pityriasis versicolor. Methods: Twenty patients (ages, 18 to 49) were included in the study, following the diagnosis of pityriasis versicolor, which was based on clinical examinations and mycological studies (microscopy and culture). Patients received a single 200 mg dose of itraconazole (Sporanox^�) capsules daily with a full meal for one week. For all patients, clinical examinations and culture and microscopic studies were done before treatment, at the end of treatment, and 4 weeks later. Scales obtained from skin lesions were studied by Parker-KOH smear examination and culture studies to identify Malassezia yeasts. Cultures were done using agar media of Leeming & Notman. Results: By comparing skin lesions before and immediately after treatment, marked improvement was observed in 7 patients (35%) and moderate improvement in 12 patients (60%) among a total of 20 patients, and 1 patient (5%) showed no response. On the other hand, by comparing skin lesions examined before treatment and 4 weeks after completing medication, complete cure was observed in 13 cases (65%), marked improvement in 5 (25%), and moderate improvement in 2(10%). With culture studies before treatment, M. globosa, M. furfur, and M. restricta were isolated as a major fungal species in 18, 1, and 1 patients, respectively. Conclusion: The result suggested that administration of a single dose of 200 mg itraconazole(Sporanox^�) capsules daily for a week is a very effective treatment for pityriasis versicolor and also indicated that pityriasis versicolor is very closely related with the infection of M. globosa. [Kor J Med Mycol 4(2): 124-130]

A Case of Cutaneous Pseudallescheriasis

Kim, Dong Jun,Jo, Ho Youn,Hong, Seung Hyun,Yi, Gil Ju,Kim, Il Hwan,Oh, Chil Hwan 대한의진균학회 1996 대한의진균학회지 Vol.1 No.1

Pseudallescheria boydii는 토양과 오염된 물 등에 광범위하게 존재하는 ascomycotina 계통의eumycota로서 피부에 균종을 발생시키는 흔한 원인균이며 간혹 면역손상환자에서 폐, 부비동, 각막, 뇌, 골수, 심내막 등을 침범할 수 있다 환자는 70세 여자로서 내원 5개월 전부터 양측 전박부와 수부의 배측 부위에 소양감을 동반한 피부병변을 주소로 내원하였다. 환자의 직업은 농부로 과거력 및 가족력상 특이사항은 없었으며 특히 외상의 병력은 없었다. 내원시 시행한 이학적검사상 양측 전박부와 수부의 배측 부위에 삼출성의 홍반성 판과, 다수의 구진, 가피소견이 관찰되었다. 병변에서 시행한 KOH 진균도말검사상 음성소견 보였으나, 피부생검상 상부진피에 미세농양 주위로 주로 림프구, 호중구, 조직구로 구성된 염증세포의 침윤과 포자가 관찰되었다. 병변부 조직에서 시행한 진균 배양검사에서 회백색의 집락이 1주 후에 관찰되었으며 집락을 현미경하에서 관찰한 결과 1개 또는 여러 개의 conidia를 갖는 분리된 conidiophores가 관찰되었고, 병변조직의 전자현미경 검사상 spore 구조가 관찰되었다. 이상의 소견으로 Pseudallescheria boydii에 의한 피부감염으로 진단하고 itraconazole 1일 200mg씩 8주간 경구투여하여 피부증상의 호전이 있었으나 4개월 후 사망하였다.