국소 스테로이드에 의해 발생한 의인성 쿠싱 증후군 의증

김현대 ( Hyun Dai Kim ),원태혁 ( Tai Hyok Won ),서필승 ( Phil Seung Seo ),윤녕훈 ( Nyung Hoon Yoon ),박석돈 ( Seok Don Park ) 대한피부과학회 2007 대한피부과학회지 Vol.45 No.9

Chronic exogenous steroid therapy can result in hypothalamic-pituitary-adrenal axis dysfunction; this usually results from systemic steroid therapy, and is rarely associated with topical steroid therapy. We report a case of suspected iatrogenic Cushing syndrome that developed after the treatment of annular pustular psoriasis. The patient applied clobetasol-17-propionate cream (Betabate(R)) 15∼30 g daily, for 4 months, without a dermatologist`s prescription. After 4 months of application, the following symptoms developed; a moon face; facial flushing; hypertrichosis; central obesity; purple striae; and multiple erythematous scaly annular patches. The development of Cushing syndrome from exogenous corticosteroid treatment was supported by the typical clinical manifestations and the low basal state of the blood cortisol level, which was perhaps due to secondary suppression of the hypothalamic pituitary-adrenal axis. Steroid-containing drugs, especially during childhood, should be used with caution and monitored carefully. (Korean J Dermatol 2007;45(9):947∼950)

대한건축사협회 건축사(建築士)지를 중심으로

김현대(주저자) ( Hyun Dai Kim ),윤정원(공동저자) ( Jung Won Yoon ),박지영(교신저자) ( Ji Young Park ) 디자인융복합학회 2016 디자인융복합연구 Vol.15 No.2

This study is to examine the trends and characteristics of design values inherent in architecture industries through the analysis of Korean architecture magazine ``Architect``. Material advertisements in the ``Architect`` published from 1970 to 2010 were analyzed and investigated in terms of both material division and advertisement contents. The analysis framework for the material division follows the CSI MasterFormat published in 2014. Twelve value indicators for the contents analysis method were proposed to introduce design-associated indicators. Material advertisements in the ``Architect`` reflected the changes of architectural profession and industries projecting the design values implied in the sociocultural, socioeconomic trends. The correlations of the material division statistics and design -associated indicators were established through the chronological analysis. This study focused on the historical narratives and interrelations of the material advertisements and promoted design values they provide.

연조직염 환자에서 원인균 검출률 향상을 위한 새로운 액체 증균 배지

김현대 ( Hyun Dai Kim ),김신무 ( Shin Moo Kim ),박석돈 ( Seok Don Park ) 대한피부과학회 2008 대한피부과학회지 Vol.46 No.3

Background: Staphylococcus aureus and Group A beta-hemolytic Streptococci are the etiologic agents most commonly associated with cellulitis, but many other bacteria have also been shown to cause this condition. The positive bacterial culture rate is the most important factor in the treatment of cellulitis. However, the positive bacterial culture rate in the commonly used media, tends to be quite low. Objective: The principal objective of this study was to improve the positive culture rate in cellulitis patients by using a new enriched broth. Methods: Brewer modified thioglycollate medium (BTM) and Columbia broth (CB), both of which are widely utilized in clinical bacteriology for enriched growth, were compared with several novel enriched broths. These new enriched broths were mixtures of BTM-CB broth and added growth supplement factors. They included BTM-CB (BC), Modified BTM-CB (MBC) and supplement VX-BTM-CB (VXBC). MBC media included several growth supplements, such as hemin, vitamin K1, VX supplement, and Campylobacter growth supplement. Strains utilized in this study were common pathogens (Staphylococcus aureus, Streptococcus pyogenes, et al.), anaerobes, fastidious pathogens (Bacteroides fragilis, Campylobacter jejuni, Prevotella melaninogenica), uncommon pathogens (Actinobacter baumannii, Enterococcus faecalis, Streptococcus agalactiae). Positive culture rates were evaluated in each medium and measured via spectrophotometry at 660 nm. Results: In vitro, all strains used in this study grew more quickly and densely in MBC media. Conclusion: Our results suggest that MBC media in a new enriched broth may improve bacterial culture rates in cellulitis patients. It will be necessary to study the efficacy of the MBC media in the culturing etiologic agents from tissues of cellulitis patients. (Korean J Dermatol 2008;46(3):310∼318)

신장 이식 후 Cyclosporine 투여 중 발생한 다발성 피지선 증식증 2예

김현대 ( Hyun Dai Kim ),이재영 ( Jae Young Lee ),윤녕훈 ( Nyung Hoon Yoon ),박석돈 ( Seok Don Park ) 대한피부과학회 2007 대한피부과학회지 Vol.45 No.1

Sebaceous hyperplasia can occur on the face during middle age, particularly in men. The risk of sebaceous hyperplasia is significantly increased in adult transplant patients, particularly males, following renal transplantation, and this is related to therapy with cyclosporine. We report on 2 cases of sebaceous hyperplasia in renal transplant patients who were treated with cyclosporine. The condition was improved, without scarring, by treatment with carbon dioxide laser or cryotherapy. (Korean J Dermatol 2007;45(1):69~71)

골수 이식 후 백반증양 병변과 경피증양 병변이 동반된

김현대 ( Hyun Dai Kim ),원태혁 ( Tai Hyok Won ),서필승 ( Phil Seung Seo ),윤녕훈 ( Nyung Hoon Yoon ),박석돈 ( Seok Don Park ) 대한피부과학회 2007 대한피부과학회지 Vol.45 No.8

Vitiligo and morphea are two distinct entities of unknown etiology, although their existence implies that the immune system and/or the central or peripheral nervous system has been incriminated. Only a few reports of their simultaneous occurrence are on record. Here we report a case of a 39 year old woman affected with both vitiligo of the face, chest and hand and morphea of shoulder and trunk. Since the two diseases appeared after bone marrow transplantation, if could be deduced that there is a possible association between them. Two diseases observed simultaneously in this patient may be derived from the common pathomechanism. An autoimmune etiology is thought to play a part in both of these diseases. (Korean J Dermatol 2007;45(8):832∼835)

Vibrio vulnificus 패혈증의 역학적 연구

박석돈 ( Seok Don Park ),김현대 ( Hyun Dai Kim ),원태혁 ( Tai Hyok Won ),서필승 ( Phil Seung Seo ) 대한피부과학회 2008 대한피부과학회지 Vol.46 No.2

Background: Vibrio vulnificus is an estuarine bacterium which is capable of causing rapidly fatal infections in humans following either ingestion of raw seafoods or entry from seawater into wounds. Although V. vulnificus sepsis (called as Vibrio sepsis) has been well known in Korea since 1982 and was designated as a legal communicable disease (group III) since August 2000, many patients occurr annually. Objective: We investigated the epidemiological features of Vibrio sepsis to offer basic data such as correlation among disease occurrence, seawater temperature, salinity and pH, amount of rainfall, incidence rate and consumed seafoods, in order to further prevent this disease. Methods: We reviewed the epidemiologic data on monthly disease occurrence, history of raw seafood consumption and kinds of consumed seafoods in 141 patients with Vibrio sepsis obtained from 105 admitted patients in hospitals and 36 case reports published in the Korean medical journals between 1982 and 2004. Environmental data on seawater temperature, salinity and pH were obtained from the National Fisheries Research & Development Institute. The monthly amount of rainfall was obtained from the Korea Meteorological Administration. The yearly occurrence of Vibrio vulnificus regional areas was obtained from the Korea Center for Disease Control & Prevention. Population data were obtained from the Korea National Statistical Office. Results: Patients began to develop in June when mean seawater temperature was over 18.9oC, and with a peak from July to September when seawater temperature was over 22oC. The majority of the patients were found in the southern and western coastal areas of Korea, especially, estuaries, where sea mud is abundant. Also disease occurrence was positively correlated with the amount of rainfall which can lower the salt concentration of seawater. Yearly occurrence of patients by regional area was the highest in the Jellanam-do during the 5 years since August 2000. The incidence rates per 100,000 population were highest in the Jellanam-do (0.69), lowest in the Jeju-do (0.01) and 0.10 in the whole areas. Seventy two percent of patients ingested 38 kinds of seafoods raw such as blue crab, goby, blood ark shell and many kinds of fishes and shellfishes. 9% of patients had not eaten seafood and 17% had either no records or unknown. 2% developed sepsis resulted from exposure of wounds to seawater. Conclusion: Vibrio sepsis develops in summer months with much rain and mostly in the estuaries. These results suggest that Vibrio vulnificus multiply well in the warm and in relatively low salt seawater. We think that weather, environmental and geographic factors are important for the outbreak of Vibrio sepsis. (Korean J Dermatol 2008; 46(2):171∼180)

손가락으로 전이된 Vater씨 팽대부암

원태혁 ( Tai Hyok Won ),김현대 ( Hyun Dai Kim ),서필승 ( Phil Seung Seo ),박석돈 ( Seok Don Park ) 대한피부과학회 2007 대한피부과학회지 Vol.45 No.6

Skin metastasis from internal malignancy is relatively rare. Skin metastasis from biliary tract cancer is known to be extremely uncommon (around 0.4∼0.7%). In most cases, biliary tract cancer metastasizes into neighboring organs or other internal organs, but rarely into the skin. The authors have experienced a case of skin metastasis into a finger of a patient with carcinoma of Ampulla of Vater. This is thought to be the first case reported in Korea. (Korean J Dermatol 2007;45(6):596∼598)

Reed 증후군 (가족성 피부-자궁 평활근종증)

이재영 ( Jae Young Lee ),김현대 ( Hyun Dai Kim ),서필승 ( Phil Seung Seo ),윤녕훈 ( Nyung Hoon Yoon ),박석돈 ( Seok Don Park ) 대한피부과학회 2007 대한피부과학회지 Vol.45 No.6

Reed`s syndrome is a rare, autosomal dominant disease with incomplete penetrance that is characterized by uterine and cutaneous leiomyomas. We report a case of Reed`s syndrome in a 50-year-old woman. The patient underwent removal of the uterine leiomyoma at the age of 36. Following this the patient noticed development of multiple, cutaneous nodules on both arms at the age of 45. These nodules progressively increased in both number and size, while appearing in other sites. The histopathologic finding of an isolated, single skin lesion showed typical leiomyoma arising from arrector pilorum muscle. Familial history revealed that her father had been affected with similar cutaneous lesions. (Korean J Dermatol 2007;45(6):612∼616)

직업성 크롬 궤양 1예

원태혁 ( Tai Hyok Won ),김현대 ( Hyun Dai Kim ),서필승 ( Phil Seung Seo ),윤녕훈 ( Nyung Hoon Yoon ),박석돈 ( Seok Don Park ) 대한피부과학회 2007 大韓皮膚科學會誌 Vol.45 No.5

Chrome may have a corrosive, necrotizing effect on tissue, so repeated skin contact to chromate might induce perforations or ulcers on the skin. This condition is called a "chrome ulcer" or "chrome hole". It appears as a small, punched-out mark with a rolled-out border. It is rarely associated with pain, but a severe itching sensation is common. We report a case of a 33-year-old man who presented with a 3 month history of several ulcers on his abdomen. He was employed at a chromate alloying process. He had several hole-like atrophic scars and unbearable pruritus. After changing his occupation, plus treatment with oral corticosteroids and antihistamines, the lesions were healed and the itching sensation faded away. However, atrophic scarring remained. (Korean J Dermatol 2007;45(5): 524~527)

Vibrio vulnificus 패혈증의 임상적 연구

박석돈 ( Seok Don Park ),이재영 ( Jae Young Lee ),김현대 ( Hyun Dai Kim ),윤녕훈 ( Nyung Hoon Yoon ) 대한피부과학회 2006 대한피부과학회지 Vol.44 No.6

Background: Vibrio (V.) vulnificus is a pathogenic marine bacterium that can cause rapid progression of a life-threatening infection. Although V. vulnificus sepsis is well-known to Koreans and was designated as a legal communicable disease in August 2000, many people still become infected each year. Objective: The purpose of this study was to investigate the clinical features of V. vulnificus sepsis, in order to offer basic data for the treatment and prevention of this disease. Methods: We reviewed the available data of 141 patients with V. vulnificus sepsis, which were obtained from 105 patients admitted to hospital and 36 case reports published in the Korean medical journals between 1982 and 2004. Results: Eighty-five percent of patients were 40 to 60 years old. Men were affected 10.5 times more often than women. Patients with underlying chronic diseases (94%) such as alcohol abuse and liver diseases displayed primary sepsis starting with fever, chills, and/or diarrhea, often within 2.3 days of consumption of various kinds of raw seafood. Skin lesions appeared initially as a painful, localized swelling like a bee-sting, followed by edema, blisters, purpura, necrosis and, less commonly, maculopatch, cyanosis, papules, wheals, pustules or erythema multiforme-like lesions. The cutaneous lesions that were present in 91.5% of patients on admission, appeared on the lower extremities in 88.9% of the cases. Of the 141 patients, 88 patients (62.4%) died. The mortality rate increased as initiation of treatment was delayed. Laboratory findings revealed thrombocytopenia and elevated levels of liver enzymes in many tested cases. V. vulnificus was cultivated more easily from the skin lesion (95%) than blood (69%). There were significant differences in systolic blood pressure, leukocyte count and creatinine between survivors and nonsurvivors (p<0.05). V. vulnificus was highly susceptible to several kinds of antibiotics such as ampicillin, ciprofloxacin, and 3rd generation cephalosporins. Mortality rate increased as the delay from the onset of illness to the initiation of treatment was prolonged. Conclusion: Clinicians should promptly initiate appropriate therapy for patients with underlying chronic disease if they exhibit unexplained fever and diarrhea after ingesting raw seafood. (Korean J Dermatol 2006;44(6):696~707)