최근 6년간 피부과에 의뢰된 매독환자의 임상적 고찰(2002~2007) -임상 양상 및 증상기 변화-

신봉석 ( Bong Seok Shin ),송지영 ( Ji Young Song ),정병수 ( Byoung Soo Chung ),최규철 ( Kyu Churl Choi ) 대한피부과학회 2008 대한피부과학회지 Vol.46 No.9

Background: There are many differences in the prevalence of syphilis according to the objects and districts. Recently, the incidence of syphilis increased in the world because of various factors. Objective: The purpose of this study is to investigate the changes of the epidemiological, clinical characteristics, and stages of syphilis. Methods: We selected 357 patients with reactive results on VDRL among 79,991 cases who visited in our hospital, between January 2002 and December 2007. We assessed the age, gender, skin lesion, serologic result, clinical stage, treatment history, and underlying disease. Results: During the 7-year period under study, the reactive rate of serum VDRL test was 4.5% in 79,991 people (preoperation or admission examinees: 35.0%. physical examinees: 30.8%, skin lesion: 21.3%, partner`s (+): 9.0%, pregnant women: 3.7%). The annual incidence of syphilis had increased from 3.5% in 2002 to 6.3% in 2007. On a total 357 sera with reactive results on VDRL, the symptomatic syphilis rate was 21.3%, increased from 13.6% in 2002 to 26.8% in 2007 (p=0.001). Statistically, there are differences in age distribution between both sexes. The male:female ratio was 1:3.3 in 0~19 years and 1.9:1 in 60~69 years (p=0.029). The incidence of symptomatic syphilis cases was 8 (66.7%) in 0~19 years, 22 (39.3%) in 20~29 years, while latent syphilis was 53 (74.6%) in 50~59 years and 35 (60.3%) in 60~69 years (p<0.001). Conclusion: This study suggests that the incidence of symptomatic syphilis may be increasing. Further observation, analysis, and continued vigilance in the general population are required. (Korean J Dermatol 2008;46(9):1179~1185)

Jessner`s Lymphocytic Infiltration of the Skin

신봉석 ( Bong Seok Shin ),서현덕 ( Hyun Deok Seo ),나찬호 ( Chan Ho Na ),최규철 ( Kyu Churl Choi ),정병수 ( Byoung Soo Chung ) 대한피부과학회 2008 대한피부과학회지 Vol.46 No.7

Jessner`s lymphocytic infiltration of the skin (JLIS) is a well-known but poorly understood disorder. Some doubt still exists about whether it is a distinct disease or a variant of lupus erythematosus or, less commonly, polymorphous light eruption, cutaneous lymphoid hyperplasia. An effective therapy is still unavailable for JLIS. We report a patient with JLIS which was successfully treated with dapsone and intermittent systemic glucocorticoid therapy. (Korean J Dermatol 2008;46(7):977~980)

A Case of Renal Crisis in a Korean Scleroderma Patient with Anti-RNA polymerase I and III Antibodies

Kang, Eun Ha,Im, Churl Hyun,Kim, Su Ho,Chung, Jae Rak,Lee, Eun Young,Kim, Dong Jo,Lee, Eun Bong,Song, Yeong Wook The Korean Academy of Medical Sciences 2006 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.21 No.6

<P>Scleroderma (SSc) renal crisis has been reported to be associated with anti-RNA polymerase I and III (RNAP I/III) antibodies in Caucasians and the Japanese. However, no report is available for Korean SSc patients. Here, we describe the case of a 65-yr-old female SSc patient who developed renal crisis and whose serum contained anti-RNAP I/III antibodies. She was finally diagnosed as having diffuse cutaneous SSc based on skin thickening proximal to the elbows and knees. Sudden hypertension, oliguria, and pulmonary edema were features of her renal crisis. Despite the use of captopril and adequate blood pressure control, her renal function deteriorated. Subsequent renal biopsy findings showed severe fibrinoid necrosis with luminal obliteration in interlobar arteries and arterioles consistent with SSc renal crisis. Serum anti-RNAP I/III antibodies were detected by radioimmunoprecipitation. This is the first report of a renal crisis in a Korean SSc patient with RNAP I/III antibodies.</P>

A Case of Renal Crisis in a Korean Scleroderma Patient with Anti-RNA polymerase I and III Antibodies

Eun Ha Kang,Churl Hyun Im,Su Ho Kim,Jae Rak Chung,Eun Young Lee,Dong Jo Kim,Eun Bong Lee,Yeong Wook Song 대한의학회 2006 Journal of Korean medical science Vol.21 No.6

출산 후 휴지기 탈모증의 유병률에 대한 연구

서현덕 ( Hyun Deok Seo ),정병수 ( Byoung Soo Chung ),최규철 ( Kyu Churl Choi ),신봉석 ( Bong Seok Shin ) 대한피부과학회 2009 大韓皮膚科學會誌 Vol.47 No.2

Background: Telogen effluvium (TE) is a form of nonscarring alopecia, characterized by diffuse scalp hair thinning in response to some form of physiologic stress. It is commonly described in women subsequent to childbirth. Objective: The purpose of this study was to evaluate the prevalence of TE after childbirth. Methods: Medical records from January 2006 to June 2007 of 240 postpartum patients from our obstetric department were reviewed. Telephone interviews with TE patients were conducted to investigate the initial occurrence time, restoration time, and treatment history. Results: Prevalence of TE according to parity is higher in multiparas than primiparas (p=0.026). In addition, the prevalence of TE after a cesarean section delivery is higher than that after non-surgical delivery (p=0.014). Prevalence of TE with respect to weight gain is higher in the groups displaying agreater increase in weight (p=0.014). Finally, prevalence of TE according to gestational age is higher in groups giving birth after 38 weeks gestational age (p=0.015). Conclusion: Prevalence of telogen effluvium may be associated with multiparity, cesarean section, marked weight gain, and high gestational age. (Korean J Dermatol 2009;47(2):127∼131)

99mTc - HMPAO SPECT를 이용한 어린이 국소뇌혈류의 정량적 분석 : 정량적 지표들의 참고값 및 연령에 따른 변화

고창순(Chang Soon Koh),이명철(Myung Chul Lee),정준기(June Key Chung),이동수(Dong Soo Lee),김상은(Sang Eun Kim),노재규(Jae Kyu Roh),명호진(Ho Jin Myung),윤병우(Byung Woo Yoon),조수철(Soo Churl Cho),홍승봉(Seung Bong Hong) 대한핵의학회 1991 핵의학 분자영상 Vol.25 No.1

N/A Regional cerebral blood flow (rCBF) was evaluated in 12 children ranging in age from 2.7 to 10.0 yr using 99mTc-HMPAO SPECT. For quantitative analysis, 13 pairs of homologous regions of interest (ROIs) were created on three attenuation-corrected 18,8 mm thick transverse slices matching the cerebral cortical regions, deep gray matter, cerebellar hemisphere, and vascular territories, and the semiquantitative indices including right to left ratio [(mean countjvoxel of homologous right ROI) /(mean count/voxel of homologous left ROI) ] and regional index (RI) [ (mean count/voxel of a ROI) /(rnean count/voxel of all ROIs of each hemisphere)] were calculated. Mean values of right to left ratios of homologous tegions ranged frorn 0.984 to 1.028 in children under 5 yr (group 1) and from 0.982 to 1.012 in children between 5 and 10 yr (group 2), and the mean value +-2 S.D. for each region did not exceed 11%. and 12% in group 1 and group 2, respective]y. There were no statis- tically significant differences between the RIs of the homologous right and left regions. Significant differences of RIs were found both between vascular regions (p<0,0005 for goup 1, and p=0,0001 for goup 2) and between regions of cerebral cortices (p<0,0005 for group 1, and p<0,005 for group 2) with a relatively high value in the occipital cortex and the Iower values in the r.erebellum and deep gray matter among the regions of cerebral cortices in both groups. There were no significant differences between the Rls of corresponding regions of group 1 and group 2, except a significantly higher value of right deep gray matter in group 2 than in group 1(p=0.0301). The RIs of the superior frontal cortex and deep gray matter showed to be positively correlated with age (superior frontal cortex; right: rs=0.5254, p =0.0814, left: rs=0.5919, p=0.0496/deep gray matter; right: rs=0.8246, p=0.0062, left: rs=0.6266, p=0,0377). The results suggest that the rCBF pattern of children approaches that of adults in an occipito-rostraJ direction. This time course of rCBF changes is in agreement with behavioral, neurophysiological, and anatomical alterations known to occur in the developing brain.

그레이브스병 환자에게서 항갑상선제 투여 후 발생한 무과립구증 1 예 및 10 년 간의 증례 고찰

송영수,임승길,허갑범,이현철,김경래,송영득,차봉수,강신명,박정수,안철우,장항석,정웅윤 대한내과학회 2001 대한내과학회지 Vol.60 No.4

Since introduce of antithyroid drugs (ATDs) in 1941, they have been widely used for treatment of Graves' disease and other hyperthyroid disorders. However, agranulocytosis, the most serious adverse effect of ATD treatment, has been occasionally reported. Agranulocytosis should be diagnosed and be treated promptly due to possible fatality. We have experienced a 17 year-old girl with PTU (propylthiouracil)- induced agranulocytosis. Initial graulocyte count was 400/㎣, and presenting symtoms were fever and sore throat. She has recovered from agranulocytosis without complications after use of G-CSF (granulocyte-colony stimulating fact or). We reviewed and analyzed additional 7 cases of ATD-induced agranulocytosis in Yonsei University Hospital (From 1988 to 1998). We found that ATD-induced agranulocytosis, of which incidence is known to be ranged from 0.1 to 1 percent , does not seem to have a distinct correlation with sex, age, dosage, and the kind of ATD. Event of agranulocytosis has a tendency to occur within3 months, and in a few case it has been occasionally detected in asymptomatic patients, routine monitoring of the white blood cell count within 3 months after the start of ATD medication can be helpful in predicting and in detecting agranulocytosis. The treatment of ATD-induced agranulocytosis has been mainly composed of conservative care, but according t o introduction and popular application of G- CSF, the use of G-CSF seems to be a promise of a reduction in morbidity and mortality.(Korean J Med 60:398- 403, 2001)

잔위암

오영석,김영식,신연명,이상호,문연창,최경현,정봉철,Oh Young Seok,Kim Young Sik,Sin Yeon Myung,Lee Sang Ho,Moon Yeon Chang,Choi Kyung Hyun,Chung Bong Churl 대한위암학회 2001 대한위암학회지 Vol.1 No.3

Purpose: Gastric stump cancer is defined as a cancer that develops in the stomach after a resection in cases of non-malignant or malignant gastric disease. The interval between the gastrectomy and the detection of gastric stump cancer must be over 5 years. Since duodenogastric reflux gastritis is a precancerous condition and one of the most important factors inducing gastric stump cancer, we compared the bile-acid content of gastric juice between gastric stump cancer patients and controls. Materials and Methods: To evaluate retrospectively the surgical treatment of patients with gastric stump cancer, we reviewed the cases histories of 1016 stomach cancer patients who had been operated on at the Department of General Surgery, Kosin University Gospel Hospital, between 1995 and 1998. The gastric juice was collected during the operations on the gastric stump cancer patients by using a needle puncture of the fundus of the stomach and during the endoscopic examinations of the control subjects. The samples were analyzed for various bile acids (gas chromatography/mass spectrometry). Results: The 6 gastric stump cancer cases accounted for $0.6\%$ of all gastric cancer patients; 5 patients were first operated on for a peptic ulcer and the remaining one for an adenocarcinoma of the stomach. All of the cases were men. The reconstruction method after the initial gastrectomy was a Billroth II in all cases. The sites of the gastric stump cancer were the anastomotic sitein 2 patients, the upper body in 2, the fundus in 1 and the cardia in 1. The operative methods were 3 total gastrectomies, 2 subtotal gastrectomies with Roux en Y anastomosis, and 1 partial gastrectomy with lymph node dissection and had a curative intention in all patients. All of the patients were still surviving at the time of this report. The gastric juices of 4 gastric stump patients showed significantly higher contents of cholic acid ($36.42{\mu}g/ml$) compared to the gastric juices of 35 control subjects ($36.42{\mu}g/ml$)(p$\leq0.0001$). Chenodeoxycholic acid and lithocholic acid were not significantly different. Conclusion: The gastric juice of gastric stump cancer patients contained a significantly higher cholic acid content. At the time of the initial gastrectomy, an operative method that prevents duodenogastric reflux may prevent or minimize the development of gastric stump cancer, and more aggressive surgical treatment may improve survival.