물집질환으로 오인된 만성 단순포진바이러스 피부감염 1예

박경덕 ( Kyung Duck Park ),이현지 ( Hyun Ji Lee ),이석종 ( Seok-jong Lee ) 대한피부과학회 2020 대한피부과학회지 Vol.58 No.4

피부 악성 흑색종의 임상 및 병리조직학적 소견

박경덕 ( Kyung Duck Park ),이석종 ( Seok Jong Lee ),이원주 ( Weon Ju Lee ),김도원 ( Do Won Kim ),정호윤 ( Ho Yun Chung ),조병채 ( Byung Chae Cho ) 대한피부과학회 2007 대한피부과학회지 Vol.45 No.2

Background: Malignant melanoma is the leading cause of death among skin cancers in western countries. The incidence of melanoma has been steadily increasing over the last 20 years, and age and sex distribution, anatomic location, clinicopathologic subtypes, and prognostic factors of malignant melanoma are also well known. However, various clinicopathologic aspects such as incidence, clinicopathologic subtypes and tumor behaviors are quite different in Asian and black skin. Objective: The purpose of this study was to investigate the clinicopathologic behavior and statistics of malignant melanoma patients of Kyungpook National University Hospital, and to evaluate prognostic predictors. Methods: Of the 97 out of 103 patients diagnosed with malignant melanoma at the Department of Dermatology of Kyungpook National University Hospital over a 14 year period (l992~2006), we analyzed mean age of onset, gender, tumor location, duration, tumor number, color, tumor thickness, Clark`s level, pathologic ulceration, tumor-infiltration lymphocytes, clinicopathologic subtype, and clinical AJCC stage. Univariate analysis and multivariate analyses for survival, according to clinical and histologic tumor settings, were performed by means of the Cox proportional hazard model. Survival curves were plotted by the Kaplan-Meier method. Results: Ninety-seven melanomas were identified and analyzed by both clinical behavior and pathology. Of these, 44 were male and 53 were female patients and the mean age was 59.7 years. Most of the tumors were located on the hands and feet. Thin melanoma was the most common tumor and histologic ulcerations were observed in 37 out of 81 patients who were available for evaluation. For tumor-infiltrating lymphocytes (TIL), 22 out of 76 patients were confirmed with TIL in the pathologic review. Acral lentiginous melanoma was the most common type, followed by nodular melanoma, superficial spreading melanoma, and lentigo maligna melanoma. Univariate analysis for overall survival of melanoma revealed that thickness of tumor, the presence of ulceration, the presence of tumor-infiltrating lymphocytes, clinicopathological subtype, and clinical stage have a tendency for a poorer prognosis. Multivariate analysis demonstrated that advanced stages (III and IV) and tumor thickness were the independent risk factors for poor prognosis. Conclusion: Few similar large studies have been conducted to assess the prognostic factors of melanoma in Korea. Therefore, further prospective studies are needed to assess the biological behavior of malignant melanoma, of which the incidence has been steadily increasing in Korea. (Korean J Dermatol 2007;45(2):149~158)

낙엽상 천포창 환자에서 발생한 노르웨이 옴

박경덕 ( Kyung Duck Park ),정홍대 ( Hong Dae Jung ),이원주 ( Weon Ju Lee ),나건연 ( Gun Yoen Na ),이석종 ( Seok Jong Lee ),김도원 ( Do Won Kim ) 대한피부과학회 2006 대한피부과학회지 Vol.44 No.11

Norwegian scabies can be defined as a generalized, severe scabies infestation which usually affects immunocompromised patients. The diagnosis is commonly missed, and can lead to mismanagement. We describe a patient with Norwegian scabies affecting the whole body. The patient had suffered with pemphigus foliaceus for several years and had an immunosuppressed status due to long-term use of oral corticosteroids. He was admitted to our hospital. At first, we made a diagnosis of exfoliative dermatitis secondary to pemphigus foliaceus. However, no improvement of the condition was seen after an increased dosage of oral corticosteroids, azathioprine, and mycophenolate mofetil. We then identified adult scabietic mites, eggs and scybala upon microscopic examination of skin scales. He was treated with an application of gamma benzene hexachloride cream. We recommend that the diagnosis of scabies be considered in immunocompromised patients with thick skin scales and associated night pruritus. (Korean J Dermatol 2006;44(11):1345~1348)

HCVD 방법으로 제조된 MgH2의 Cycling 특성

박경덕 ( Kyung Duck Park ),한정섭 ( Jeong Seb Han ) 대한금속재료학회(구 대한금속학회) 2011 대한금속·재료학회지 Vol.49 No.12

The cycling characteristics of MgH2 made by hydriding chemical vapor deposition method have been investigated. The particle size of MgH2 made by HCVD was about 1 μm. The cycling experiment was performed by measuring hydrogen quantity absorbed at 673 K and under 35 atm of hydrogen pressure for 30 min. Up to 3 cycles the hydrogen storage capacity increased, but from 4 to 6 cycles the hydrogen storage capacity decreased rapidly. During this cycling test the particle size increased gradually from 1㎛to 6㎛. This increase was due to sintering by the high reaction temperature and the heat of reaction during hydrogen absorption. From 7 to 30 cycles, the hydrogen storage capacity was maintained at 5.8 wt%. Even after 30 cycles, the plateau pressure was constant.

Diagnosis and treatment of aspergillosis

박경덕 ( Kyung Duck Park ) 대한피부과학회 2021 대한피부과학회 학술발표대회집 Vol.72 No.2

Aspergillosis is an opportunistic mycosis that is caused by fungi in the genus Aspergillus, most often A. fumigatus and A. flavus. Burns, sites of trauma, surgical wounds, intravenous catheters and macerated skin underlying occlusive dressings typically serve as portals of entry in primary cutaneous aspergillosis. The risk of dissemination is significant in immunocompromised individuals. Worldwide, disseminated candidiasis and aspergillosis are the two most common systemic mycoses in neutropenic patients. In secondary cutaneous aspergillosis, the conidia are inhaled, producing a primary lung infection that is followed by dissemination to the skin. Skin findings range from firm papules and necrotic papulonodules to hemorrhagic bullae and ulcers. Subcutaneous nodules and cellulitis can also be seen. In disseminated aspergillosis, the CNS, kidneys and heart are often involved in severe widespread disease. The prognosis is poor but improves when the patient is no longer neutropenic or corticosteroids are discontinued. Histologic examination of lesions of cutaneous aspergillosis demonstrates 45˚ dichotomous branching of hyaline, septate hyphae that are best demonstrated with silver or PAS staining. Suppurative and granulomatous inflammation and/or necrosis may be observed. Prophylaxis with systemic antifungals is commonly administered to patients receiving myelosuppressive chemotherapy and hematopoietic stem cell transplant recipients, both before and during periods of neutropenia. Nowadays, a febrile neutropenic patient unresponsive to systemic broad-spectrum antibiotics might empirically receive voriconazole, posaconazole or one of the echinocandins. Voriconazole is a triazole that has activity against Aspergillus and Fusarium as well as Candida. Posaconazole is used for both treatment and prophylaxis of opportunistic fungal infections. Primary cutaneous aspergillosis, if localized, can be surgically excised, followed by administration of oral antifungals. Isavuconazole and voriconazole are the preferred agents for first-line treatment of pulmonary invasive aspergillosis, whereas liposomal amphotericin B is moderately supported.

한의원 외 여러 군데에서 받았던 침술로 인해 생겼을 것으로 추정되는 문신 1예

박경덕 ( Kyung Duck Park ),정현 ( Hyun Chung ),박준수 ( Joon Soo Park ) 대한피부과학회 2015 대한피부과학회지 Vol.53 No.4

63세 여자 환자가 등에 다수의 쌀알 크기의 청색 반점을 주소로 내원하였다. 반점들은 내원 1년 전부터 생겼다고 하였다. 가려움이나 통증을 포함한 특별한 증상은 없었고 우연히 발견하였다고 하였으며, 서서히 숫자가 증가하는 양상을 보였다. 과거력 상에는 특이 사항은 없었고, 십수 년간 한의원을 비롯한 여러 곳에서 침술을 받아왔다고 하였다. 은용액을 복용한 과거력은 없었다. 또한 청색 반점이 생긴 위치가 침술을 받은 자리와 일치하는 양상을 보였다(Fig. 1). 병리조직학적 검사에서는 진피 내 혈관 주위와 에크린땀샘 주변으로 작고 둥근 검은색의 과립이 관찰되었고(Fig. 2), 그 외 표피나 진피에 특이 소견은 관찰되지 않았다. 이상의 임상 및 병리조직학적 소견을 바탕으로 외상성 문신으로 진단하였고, 레이저 시술을 권유하였으나 환자가 나중에 치료하기로 하였다. 현재까지 침술과 관련된 부작용으로 보고된 국내 피부과 문헌은 한의원 침술 및 정맥 배액에 의한 전염이 추정되는 2기 매독1, 침술 후 발생한 이영양성 피부석회증2, 침술 요법 부위에 발생한 Mycobacterium fortuitum 감염3, 한의원 침술을 이용한 색소성 모반의 제거 후 발생한 다발성 반흔4, 침술 후 발생한 연조직염, 침술 후 발생한 국소형물집유사천포창5 등이 있다. 침술은 고대 중국의 전통의학에 기원을 둔 역사가 오래된 치료법 중에 하나로 여기에 사용되는 침의 재료는 스테인레스강, 금, 은 등이 일반적으로 사용된다. 침술의 부작용으로는 피로감, 가려움증, 자반증, 그리고 드물게는 국소부위 감염과 기흉이 보고된 바있다. 현재 침술은 한의사와 1962년 침구사제도 폐지 이전에 면허를 받은 침구사에 의해서 합법적으로 시술될 수 있지만, 실제로는 검증되지 않은 침술 행위도 이루어지고 있는 것이 현실이다. 만약 일회용 침을 사용하지 않고 반영구적인 침을 소독을 통해서 계속적으로 사용하거나 또는 검증 받지 않거나 부식이 가능한 불량 재질의 침을 사용할경우, 외상성 문신 또는 국소적 은피증이 발생할 가능성이 있다고 생각되며, 이에 대해서 경각심을 가지야 한다고 생각한다. 최근에서야 멸균침에 대한 식품의약품 안전청 고시로 납, 주석, 아연, 철, 카드뮴과 같은 중금속 함량의 제한, 부식시험 항목 추가, 포장 기준 신설이 이루어졌다. 본 증례는 아직 국내 피부과 문헌에 보고된 적이 없는 침술을 통한 외상성 문신에 대해서 고찰하고 보고하는 바이다.

Retinoids in dermatology

박경덕 ( Kyung Duck Park ) 대한피부과학회 2021 대한피부과학회 학술발표대회집 Vol.72 No.2

노인의 두피에 발생한 혈관육종 7예

박경덕 ( Kyung Duck Park ),정홍대 ( Hong Dae Jung ),이석종 ( Seok Jong Lee ),김병수 ( Byung Soo Kim ),이원주 ( Weon Ju Lee ),김도원 ( Do Won Kim ),서보익 ( Bo Ik Suh ),정호윤 ( Ho Yun Chung ),배한익 ( Han Ik Bae ) 대한피부과학회 2007 대한피부과학회지 Vol.45 No.12

Cutaneous angiosarcoma is a rare, aggressive vascular malignancy with a grave prognosis. It usually arises in the scalp or face as a locally-advanced patch, plaque or tumor at presentation and most often affects males and the elderly. Histopathologically, well-differentiated angiosarcomas are composed of well- or ill-formed vascular channels, often lined by flattened atypical endothelial cells and are distinguished from benign counterparts by their so-called collagen dissection pattern and anastomosing architecture. Varied differentiation may be observed even in the same tumor. Epithelioid angiosarcoma is a rare variant of poorly-differentiated angiosarcoma. The patients were seven cases of angiosarcomas including an epithelioid variant. They were six males and one female with an age range between 65∼84 years (avg. 74 years). Lesions resembled seborrheic dermatitis, erysipelas or spreading bruise that varied from blue to red in color and from papule to mass in size. They revealed satellite lesions far from the main lesion in some cases. Skin biopsies were performed for all patients and histopathologic features were compatible with angiosarcoma and epithelioid angiosarcoma. We herein report seven angiosarcomas of diverse clinical features because their early detection and precise differential diagnosis should be mandatory for effective management. (Korean J Dermatol 2007;45(12):1284∼1290)

임상연구 : 기관내 삽관 시 심혈관계 반응에 대한 Alfentanil과 Fentanyl의 영향 비교

박경덕 ( Geong Duck Park ),유경연 ( Kyung Yeon Yoo ),정성수 ( Sung Soo Chung ),윤명하 ( Myung Ha Yoon ) 대한마취과학회 2003 Korean Journal of Anesthesiology Vol.45 No.2

Sievert`s type 자동장치에 의한 마그네슘 수소화합물의 열분석

한정섭 ( Jeong Seb Han ),박경덕 ( Kyung Duck Park ) 대한금속·재료학회 2010 대한금속·재료학회지 Vol.48 No.12

In order to apply the Sievert`s type automatic apparatus to thermal analysis of hydrogen absorbing materials, the dehydrogenation of the Mg-H system was investigated. As the initial wt% of hydrogen was increased to 4.4, the peak temperature of evolution rate shifted to higher temperature. However, with the initial wt% of hydrogen higher than 4.4, peak temperature of evolution rate did not change. The peak temperatures of evolution rate obtained by automatic apparatus were almost the same as those measured by a manual apparatus. As the heating rate was increased, the peak temperatures increased; the peak temperatures for heating rates 1, 2 and 3 K/min were 664, 687 and 702 K, respectively. The activation energy for the decomposition of Mg hydride was 101 kJ/mol. The Sievert`s type automatic apparatus can be successively applied to the thermal analysis of metal hydride.