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( Uri Shon ),( Mi Soo Choi ),( Byung Cheol Park ),( Myung Hwa Kim ) 대한피부과학회 2022 대한피부과학회지 Vol.60 No.2
Background: Patients with dermatologic diseases refractory to conventional treatments including corticosteroids, immunosuppressants, and phototherapy require new treatment options. Limited studies have investigated the efficacy of alitretinoin for various diseases. Objective: This study aimed to evaluate the efficacy and safety of oral alitretinoin for various refractory dermatologic diseases. Methods: A total of 168 patients treated with oral alitretinoin for various dermatologic diseases such as psoriasis, contact dermatitis, hand eczema, and pityriasis rubra pilaris were reviewed. Treatment response was measured according to the Physician’s Global Assessment scale and adverse events (AEs) based on medical records. Results: Patients with a mean age of 46.6±14.7 years were treated with oral alitretinoin for 26.1±27.6 weeks. The overall response rate (very good or excellent) was 49.5%. The response rate was the highest (74.4%) in the eczema disease group. Overall, 80 patients (74.8%) experienced AEs, and headache (46.7%) was the most common AE, followed by decreased serum free T4 (16.8%) and elevated triglycerides (12.1%). Most AEs were tolerable, except for one case of benign intracranial hypertension. Conclusion: Despite its limited approval for severe chronic hand eczema, oral alitretinoin may be a relatively safe and effective option for various refractory dermatologic diseases. (Korean J Dermatol 2022;60(2):91∼98)
Safety and Efficacy of botulinum toxin on male pattern baldness
( Uri Shon ),( Gi Hyun Seong ),( Myeong Jin Park ),( Minkee Park ),( Eun Mi Jin ),( Myunghwa Kim ),( Seung Phil Hong ),( Byung Cheol Park ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.2
Background: Previous studies have reported that botulinum toxin inhibits transforming growth factor beta(TGF-β), which is known to be one of the causes of alopecia. Objectives: This study aimed to see the safety and efficacy of botulinum toxin type A on male pattern baldness(MPB). Methods: 22 patients with MPB participated in this study. They got intradermal injection with 30 units of botulinum toxin type A around hair follicles every 4 weeks for 24 weeks. The primary endpoint of this study was change in number of hairs per ㎠ in phototrichogram analysis and Physician’s global assessment scale based on clinical photography after 24 weeks of treatment. Also, adverse effects were monitored through blood tests and history taking. Results: The number of the hairs significantly increased at 24 weeks by 6.61±9.96 per ㎠(p=0.0119). There was significant improvement in Physician’s global assessment scale(p=0.0313). Subjective improvement and treatment satisfaction also showed significant difference. No serious adverse event occurred except temporary local pain on injection site and transient erythema. Conclusion: Intradermal injection of botulinum toxin type A in MPB is safe and effective, and it can be used as adjunctive or alternative therapy for medical treatment of MPB.
URI KAPLAN 계명대학교 한국학연구원 2016 Acta Koreana Vol.19 No.2
The Four-Character Elementary Learning (Saja sohak) is a short 1250-character-long collection of basic Confucian decorum and moralistic aphorisms, which is by far the most commonly-used Confucian primer in Korea today. It is studied, at least partially, by approximately half of all Korean elementary school students as part of the burgeoning ‘decorum’ or ‘humanistic’ courses and camps (yejŏl kyoyuk, insŏng kyoyuk), now organized in public schools, hyanggyo’s, and sŏdang’s throughout the peninsula.1 In many of these programs the text is learned by communal chanting and memorization, a method which certainly imbues its moralistic instructions with certain authority and sanctity. I have met several twenty-year-old students who could still chant from memory parts of this text, ten years after spending a few days in one of these camps. In fact, the Saja sohak is the only Confucian book actually taught on a large scale to Koreans today. Its particular injunctions are internalized and often guide the attitudes and actions of many, and as such—it certainly deserves further attention. Unlike the Dizi gui (弟子規), a comparable seventeenth-century Confucian primer often used in China and Taiwan,2 the Saja sohak seems to be a modern compilation. There have been no references to it prior to the twentieth-century, and its earliest existing anonymous woodblock edition was dated to 1932.3 Although the title seems to refer to Zhu Xi’s Elementary Learning (小學, C. Xiao xue, K. Sohak), the Saja sohak is not a simple summary of this predominant work but a whole new alternative.4 Unlike Zhu Xi’s text, the Saja sohak centers on decorum and behavioral codes and mostly shies away from theoretical expositions. Additionally, many of the aphorisms in the Saja sohak are not taken directly from the Elementary Learning but are rather selectively extracted from the ancient Book of Rites, the Analects, the Book of Poems, the Book of Changes, the Twenty-four Paragons of Filial Piety, and from the writings of Korean Confucian scholar Yi I Yulgok (1536– 1584).5 I have divided the following translation into eight subsections according to specific social-relationship comportments: filial piety and dutifulness, distinctions between husband and wife, sharing between older and younger siblings, respecting teachers, honoring elders, receiving guests, proper friends, and general decorum attitudes. As might be expected from a Confucian primer aimed mainly for children, the largest sections are the ones dealing with filial piety (about 33%), sibling behaviors (about 20%), and the proper making of friends (almost 20%). Some of the injunctions in the Saja sohak may seem anachronistic, overly severe, paternalistic, and sexist to the reader. Nevertheless, the fact that it is still used today in the instruction of a substantial portion of the Korean population, certainly makes it a crucial literary snippet of Korean culture in the twenty-firstcentury.
( Uri Shon ),( Dea Kwan Yun ),( Gi Hyun Seong ),( Myung Hwa Kim ),( Byung Cheol Park ) 대한피부과학회 2020 대한피부과학회 학술발표대회집 Vol.72 No.1
Background: Basal cell carcinoma (BCC) is the most common skin cancer in Korea. Mohs micrographic surgery (MMS) has shown the best therapeutic results with lowest recurrence rates. However, there are limited comparative data about the characteristics and prognosis of BCC in H-zone and non-H-zone. Objectives: We aimed to retrospectively review the clinical and histopathological characteristics of head and neck BCC treated with MMS and see the difference between H-zone and non-H-zone BCC. Methods: We retrospectively reviewed the size, distribution, clinical subtypes, pathologic subtypes, Mohs stages, reconstruction methods, recurrences, and complications of 252 BCC lesions in 239 patients who received MMS for head and neck BCC. Results: 192 (76.2%) lesions were located in the H-zone. Clinically, noduloulcerative type was more common in H-zone while morpheaform type was more common in non-H-zone. Histopathologically, infiltrative subtype was particularly more common in H-zone (7.3% vs 1.7%). There were 33 recurrent BCC lesions with prior treatments, 27 (81.8%) of them being on H-zone. Two (6.1%) of the lesions recurred after MMS in our institution. Stage of MMS was higher in the H-zone (1.59 vs 1.45). Conclusion: This study provides clinicopathologic and surgical characteristics of H-zone and non-H-zone BCCs. H-zone BCCs showed more frequent infiltrative histologic type and recurrence irrelevant of the prior treatment.
A rare case of morphea accompanied by generalized vitiligo and scarring alopecia
( Uri Shon ),( Dea Kwan Yun ),( Gi Hyun Seong ),( Myeong Jin Park ),( Myung Hwa Kim ),( Seung Phil Hong ),( Byung Cheol Park ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1
Morphea is a chronic autoimmune disease characterized by sclerosis of skin. Rarely, it occurs with vitiligo, another autoimmune disorder. A 54-year-old male presented with solitary hair lost patch with white patches on scalp for 2 years. He had en coup de sabre on his forehead for 7-8 years and vitiligo on both hands and axillae for 5 years. The alopecic patch became prominent as white patches appeared. He had a 20-year history of portal hypertension, esophageal varix, and liver cirrhosis. Laboratory examinations including complete blood cell count, chemistry, and autoimmune markers were normal except slightly elevated AST, total bilirubin, and PT, aPTT. Anti-HCV antibody and urobilinogen were positive. Skin biopsy was done on white sclerotic alopecic lesion. Histopathologic finding showed absent melanocyte. Hair follicles were decreased and located in upper dermis. There was perifollicular fibrosis and slight inflammation around dermal papilla. Thick and homogeneous collagen bundles were arranged in horizontal direction to the epidermis. The patient was diagnosed as scarring alopecia, vitiligo, and morphea on scalp. The alopecia was treated with hair transplantation. It is perceived that autoimmunity plays a role in the pathogenesis of both morphea and vitiligo. HCV antibody positivity can also be related to immunologic abnormality. Herein, we report a rare case of morphea concurred with generalized vitiligo and scarring alopecia.