Long second toe: its nail and skin changes

( Geun-hwi Park ),( Woo-il Kim ),( Min-young Yang ),( Won-ku Lee ),( Tae-wook Kim ),( Sung-min Park ),( Hyun-joo Lee ),( Gun-wook Kim ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.2

Background: Nail can be affected by trauma, infection, and systematic disorders. In particular, the toe nails are exposed to the repeated and cumulative minor traumas, which usually result in thickened, splitted, and discolorated nails. Considering these, it can be inferred that the long second toe can be related to various nail and skin changes by repeated minor traumas such as friction in shoes, but the study or report on this topic hasn’t been done yet. Objectives: The purpose of this study was to introduce various nail and skin changes on long second toe. Methods: We analyzed the kinds of nail/skin changes of 50 patients with long second toe, enrolled at Pusan National University Hospitals (Busan and Yangsan) from 2013 to 2018. Results: There was no significant difference in the incidence of left and right toe and toenail, and 7 (14%) patients presented bilateral distribution. The most common nail change on long second toe was melanonychia (23, 46%), followed by subungual hematoma (15, 30%), onycholysis (2, 4%), subungual hyperkeratosis (2, 4%), onychomadesis (1, 2%), and retronychia (1, 2%). The most common skin change was corn (9, 18%), followed by paronychia (2, 4%). Twenty (20/50, 40%) patients also had other toe or toenail changes. Among them, the most common site was big toe/nail (13, 62%), and the most common change was subungual hematoma (8, 42%). Conclusion: Through this study, the dermatologists can recognize and diagnose the nail and skin changes of long second toe.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

출산에 따른 그레이브스병의 재발 및 관련이자

임창훈,최현아,한승석,김해성,이창욱,정호연,한기옥,장학철,박원근,윤현구,한인권 대한내분비학회 2002 Endocrinology and metabolism Vol.17 No.2

Background: Pregnancy affects the course of Graves' Disease (GD), and patients who initially maintain euthyroid function into their middle trimester with minimum doses of antithyroid drugs become exacerbated after delivery. Even patients who are completely cured, requiring no treatment during pregnancy, can relapse after delivery. In this study, we examined the postpartum changes in the thyroid functions of patients with GD, and attempted to determine the factors contributing to these changes. Methods: The study subjects were recruited from pregnant women visiting our outpatient clinic for routine prenatal evaluations. 45 women previously diagnosed with GD, who had been treated and cured with hyperthyroidism, and were no longer taking any thyroid medications, were evaluated for 1 year post delivery. Results: Among 45 patients, 20 (44.4%) developed thyroid disorders following delivery. Postpartum thyroiditis (PPT) developed in 8 patients (17.8%), and GD developed in 12 (26.0%). The onset of the PPT disease 3.1 ± 1.4 months following delivery, which was significantly earlier than the 6.7 ± 2.7 months required for the post delivery onset of GD (p=0.003). The TBII values, measured during the thyrotoxic state in each womaen, were negative in women with PPT and positive in 71.4% of women with GD (p=0.030). The duration of treatment for hyperthyroidism prior or pregnancy, the number of recurrences, and the time interval without treatment, were not associated with the development of postpartum thyroid disorders. Whereas, the mean number of past pregnancies for women who developed PPT was 3.9 ± 2.1, and was significantly higher than the 2.2 ± 1.7 for women developing no thyroid dysfunctions (p=0.044). In 13 women their initial onset of GD occurred within one year postpartum, 7 (53.8%) having had a recurrence, which was significantly higher than in women whose disease onset occurred unrelated to delivery (5 of 32 women: 15.6%). Conclusion: Women with GD developed postpartum thyroid dysfunctions in 44.4% of cases. Women whose initial disease onset occurred within one year postpartum had higher recurrences of GD, and women who developed PPT had a history of higher gravidity compared to the euthyroid women postpartum. Therefore, if women with GD develop postpartum thyroid dysfunctions, the diagnosis should be made, and a treatment modality planned, following careful considerations of the patients' past obstetric history, changes in clinical manifestations and the TBII values

NFI-C 결손 생쥐의 상아모세포 분화과정에서 DSPP와 BSP mRNA의 발현

정현구,이창섭,,이상호,이난영,김홍중,박주철 大韓小兒齒科學會 2005 大韓小兒齒科學會誌 Vol.32 No.4

NFI-C는 정상적으로 상아모세포, 골모세포에 존재하며,NFI-C가 결손된 경우 치근상아질을 형성하는 상아모세포의 분화에 이상이 있다고 알려져있다. 본 연구는 NFI-C(-/-) 생쥐에서 치관 및 치근의 상아질을 형성하는 상아모세포의 표현형을 상아모세포에 특이적으로 발현하는 DSPP와 골모세포에 특이적으로 반응하는 BSP 유전자를 이용한 in-situ hybridization을 통하여 연구하여 다음과 같은 결과를 얻었다. 1.NFI-C(-/-) 생쥐의 구치에서 치관 상아질은 정상적으로 형성되었으나, 치근 상아질은 형성되지 않았다. 2.NFI-C(-/-) 생쥐의 하악 절치의 순측 상아질은 비교적 많이 형성되었으나, 설측의 상아질은 형성되지 않았다. 3.NFI-C (-/-) 생쥐의 하악 절치의 상아모세포는 형태가 변화되었으며, 형성된 상아질 내에 세포가 함입되는 양상을 보였다. 4.NFI-C (-/-)생주의 구치에서 치관부위의 상아모세포에서는 DSPP가 강하게 발현되었으나. 치근부위의 상아모세포에서는 발현되지 않았다. 또한 NFI-C(-/-) 생쥐에서 절치의 순측 상아모세포에서는 DSPP가 약하게 발현되었다. 5. 정상 생쥐에서 절치의 상아모세포에서는 BSP가 발현되지 않았으나. NFI-C (-/-) 생쥐에서는 BSP가 강하게 발현되었다. 이상의 결과를 종합하여 볼 때 NFI-C가 결손된 경우 상아모세포가 골모세포로 분화되는 표현형의 변화를 보이는 것으로 사료된다. Nuclear factor I (NFI) exists in the odontoblast and osteoblast.NFI-C null mice demonstrated aberrant odontoblast differentiation, abnormal dentin formation, and molar lacking roots. The purpose of this study was to examine phenotype of the aberrant odontoblast in NFI-C null mice and to evaluate the expression of DSPP and BSP mRNAs in NFI-C null mice with in-situ hybridization. The results were as follows: 1.In the NFI-C (-/-) mice, the crown dentin of molar showed normally formation, but there was no root dentin. 2.In the NFI-C (-/-) mice, the labial dentin of mandibular incisors showed relatively a lot of dentin formation, but the lingual dentin showed defect. 3.In the NFI-C (-/-) mice, the odontoblast of mandibular incisors revealed abnormal shape and trapped in osteodentin-like mineralized tissue. 4.In the NFI-C (-/-) mice, the odontoblast in the crown dentin of molars showed strong expression of DSPP, the odontoblast in the root dentin of molars was not expression of DSPP. In the NFI-C (-/-) mice the odontoblast in the mandibular incisors showed weekly expression of DSPP. 5.In the wild mice, the odontoblasts of mandibular incisors were not expression of BSP, but in the NFI-C (-/-) mice the odontoblast of mandibular incisors showed strong expression of BSP. These results suggest that odontoblst in the NFI-C (-/-) mice changes the phenotype into osteoblast.

월경전 기분 변화와 출산후 불안-우울 증상간의 상관성

한창수,김용구,이낙우,김 탁,김해중,김 현,조숙행 대한생물치료정신의학회 2001 생물치료정신의학 Vol.7 No.1

To investigate the relationship between premenstrual mood changes and anxiety, and mood symptoms in the perinatal period , questionaire survey was carried out. There was no significant correlation between premenstrual symptom scale value and Edinburgh postpartum depression scale value. And theme was no relationship between premenstrual symptom scale value and state anxiety inventory scale value in the perinatal period. This findings suggest that premenstrual mood changes are not directly correlated with mood changes in the perinatal period.

소의 대동맥 내피세포에서 산화저밀도 지단백에 의한 아포프토시스에 백일해 독소 및 콜레라 독소가 미치는 영향

손호영(Ho Young Son),강성구(Sung Ku Kang),강무일(Moo Il Kang),차봉연(Bong Youn Cha),이광우(Kwang Woo Lee),장상아(Sang Ah Chang),최윤희(Yoon Hee Choi),문성대(Sung Dae Moon),안유배(Yoo Bae Ahn),손현식(Hyun Sik Son),윤건호(Kun Ho Yoon) 대한내과학회 1999 대한내과학회지 Vol.56 No.5

N/A Objectives : Oxidized LDL is thought to play a key role in atherogenesis. Among their wide variety of biological properties, oxidized LDL injures the endothelium as an early event of atherogenesis. However, the mechanisms by which oxidized LDL injures endothelial cells are not definitely known. In order to evaluate the involvement of GTP-binding protein on the mechanism of apoptosis, we studied the effects of pertussis and cholera toxin on oxidized LDL-induced apoptosis in bovine aortic endothelial cells(BAECs). Methods : Oxidized LDL elicited apoptosis in cultured BAECs as shown by characteristic morphological and biochemical changes. Chromatin condensation and nucleus fragmentation were visualized by using fluorescence microscopy of intact cells staining by acridine orange/ ethidium bromide. DNA fragmentation was quantified by an ELISA with specific antibody for bromodeoxyuridine- labelled DNA fragments and confirmed with DNA ladder formation. Results : Studies using a combination of bacterial toxins which change the function of GTP-binding protein suggest that oxidized LDL-induced apoptosis was regulated by GTP-binding protein. Oxidized LDL-induced apoptosis was not changed by pretreatment of BAECs with pertussis toxin. In contrast, pretreatment with cholera toxin completely prevented the oxidized LDL- induced apoptosis. Conclusion : These results show that oxidized LDL induces apoptosis of BAECs and suggest that cholera toxin-sensitive G-proteins are involved in signal transduction of oxidized LDL-induced apoptosis of BAEC.

Acral calcified angioleiomyoma: a rare clinicopathologic variant of cutaneous angioleiomyoma

( Kihyuk Shin ),( Woo-il Kim ),( Min-young Yang ),( Won-ku Lee ),( Tae-wook Kim ),( Sung-min Park ),( Hyun-joo Lee ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ),( Gun-wook Ki 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1

Cutaneous angioleiomyomas are benign tumors with vascular smooth muscle differentiation. The tumor usually involves the lower extremity, but acral sites such as toes, fingers, feet, and hands are rarely affected. Leiomyoma of deep soft tissue commonly shows regressive changes including prominent fibrosis, and calcification, however, cutaneous angioleiomyoma rarely manifests these changes. A 61-year-old female presented with subcutaneous nodule on the right heel. The lesion began to develop 3 months ago without history of trauma or infection, and the patient reported no subjective symptom. The lesion was totally excised, and histopathology revealed a well-circumscribed, non-encapsulated tumor composed of interlacing fascicles of spindled cells with elongated blunt-ended nuclei. A major finding was extensive calcifications, which dominated over the cellular component. On immunohistochemical examination, the spindle cells expressed strong immunoreactivity for α -smooth muscle actin. Based on these findings, a diagnosis of acral calcified angioleiomyoma was made. We have described a rare clinicopathologic variant of angioleiomyoma which has a predilection for acral locations and shows extensive calcifications predominating over the tumor itself. To our knowledge, this is the first report of a patient with acral calcified angioleiomyoma in Korean dermatologic literature.

Salt and pepper appearance of the skin associated with mixed connective tissue disease

( Sang-hyeon Won ),( Woo-il Kim ),( Min-young Yang ),( Won-ku Lee ),( Tae-wook Kim ),( Sung-min Park ),( Hyun-joo Lee ),( Gun-wook Kim ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1

The salt-and-pepper appearance of skin is composed of salt (vitiligo-like depigmentation) and pepper(perifollicular pigmentation). This characteristic feature can be a clinical clue for the diagnosis of systemic sclerosis. Mixed connective tissue disease(MCTD) is a distinct disease entity with mixed features of systemic lupus erythematosus, systemic sclerosis, myositis and rheumatoid arthritis with high titers of antibodies to U1 small nuclear ribonucleoprotein(U1 snRNP). Therefore, MCTD is known to have a wide spectrum of cutaneous manifestations which may be the presenting signs of the disease. However, there are few reports of pigmentary changes in MCTD. A 51-year old woman presented with variably sized hypopigmented macules along with relative hyperpigmentation of the perifollicular areas. She was diagnosed with MCTD by Raynaud’s phenomenon and high titer anti-RNP corresponding to a speckled antinuclear antibody of 1:1280 in Rheumatology clinic. A biopsy specimen showed dermal sclerosis. Pigment loss and melanophages were observed in the papillary dermis. Hypo- and hyperpigmentation were confirmed histologically by S100 and Fontana-Masson stain. To our knowledge, ‘salt and pepper appearance of the skin’ has rarely been reported in MCTD. The diagnosis of MCTD can be challenging due to its diverse characteristics. Therefore, we suggest that MCTD should be regarded as a differential diagnosis in patient with this pigmentary change.

Pendulum 장치의 상악대구치의 원심이동에 대한 효과

이창섭,김재광,강덕일,송광철,정현구,이상호 대한소아치과학회 2001 大韓小兒齒科學會誌 Vol.28 No.3

Ⅱ급 치성교합을 가진 환자에서는 I급 구치부 교합관계를 형성하기 위하여 상악 대구치의 원심이동이 필요하다 본 연구에서는 pendulum장치를 이용한 상악 대구치의 원심이동시 대구치의 이동양상과 고정원의 전방이동 및 정출정도 등 치아와 골격에 미치는 영향을 평가하기 위하여 시행되었다. 상악 제1대구치를 원심이동시켜 1급 구치관계가 형성된 19명의 환자 (남: 8명. 여: 11명, 평균연령 11.68±1.52세)에서 장치 장착 전과 장치제거 직후에 얻어진 측면두부방사선사진을 비교 ·분석하여 다음과 같은 결과를 얻었다. 1.I급 교합관계를 형성하기 위해서 제 1대구치는 평균 2.94± 1.54mm 원심이동하였으며 . 1.17±0.97mm 함입되었고, 소요기간은 평균 18.13±7.95일이었다. 2.고정 원으로 사용된 치아는 1.34± 1.40mm로 유의하게 전방 이동하였으며, 0.48±0.99mm 정출되었다. 또한 절치는 유의한 전방이동 및 순측경사가 발생하였다(P<0.05) . 3.구개평면과 하악평면이 이루는 각은 유의한 증가를 보였다(P(0.05). 4.제1소구치 또는 제1유구치가 고정 원으로 이용된 경우 제2소구치 또는 제2유구치가 이용된 경우 보다 전방이동이 증가하였다(P<0.005). 5. 제2대구치의 발육단계에 따른 제1대구치 및 제2대구치의 이동양상은 어떤 항목과도 유의성이 없었다(P<0.05). 6.얻어진 총 공간 중 74%는 제1대구치의 원심이동이,26%는 소구치의 전방이동에 의하여 얻어졌다. 이상의 결과를 종합하여 볼 때 pendulum appliance는 상악 대구치의 원심이동에 매우 효과적이었으며. 고정원의 소실을 최소화하기 위해 제2유구치 또는 제 2소구치가 포함되어야 한다. 또한 제1대구치의 원심경사는 필연적으로 일어나며. 이를 최소화하기 위한 노력이 계속되어야 할 것으로 사료된다. Treatment of class Ⅱ malocclusions require distalization of maxillary molars into class I relationship. Intra-arch distal molar movement techniques have recently assumed an important role in young patients. In this study, the dental and skeletal effects of the pendulum appliance were evaluated by means of cephalometric radi-ographs. The samples were consisted of 19 patients: 11 females and 8 males, mean age 11.68± 1.52 years. Measurements were obtained from cephalometric prior to and the day of removal of the pendulum appliance. Treatment changes were analyzed. The following results were obtain : 1. The pendulum appliance produced 2.94±1.54mm distal molar movement with a mean intrusion of 1 17± 0.97mm, mean period 18.13±7.95 weeks. 2. The anchor tooth was 1.34± 1.40mm forward movement and 0.48±0.99mm extrusion, and labial tilting of incisors. 3. The angle between palatal plane and mandibular plane increased significantly 4 There was no significant difference in according to 2nd molar position. 5. Total movement was consisted of 74% distal movement of 1st molar and 26% forward movement of the an-chor tooth

강섬유 보강 콘크리트의 인장강성 및 피로파괴특성

이봉학,윤경구,홍창우,김동호 강원대학교 부설 석재복합신소재 제품연구센터 2000 석재연 논문집 Vol.5 No.-

콘크리트의 취성적 성질을 개선하고 부재의 인성을 증가시킨 강섬유보강 콘크리트는 건설분야에 활용할 가치가 크다. 그러나 설계규준이나 해석방법이 정비되지 못한 현 실정에서 거동 특성을 규명하고 이에 유효하고 타당한 해석모델을 제시하는 것이 요구된다. 본 논문에서는 강섬유보강 콘크리트의 강도특성실험, 직접인장실험 및 피로실험을 수행하여 이에 대한 역학적 특성을 고찰하고 거동특성을 규명함으로서 설계와 해석의 기초 자료로 활용하고자 하였다. This study is conducted on the test to find tension stiffening, flexural fatigue characteristics and mechanical properties of steel fiber reinforced concrete. Experimental investigation is examined accord to hooked type fiber contents(0, 0.4 , 0.7, 1.0%), fiber aspect ratio(60.83). The principal results obtain through this study are as follows; steel fiber reinforced concrete is increased completely tensile & flex strength properties compared with normal concrete. The tension stiffening and fatigue life tend considerably increase with fiber contents, fiber aspect ratio.