역모낭성 각화증의 임상 및 병리조직학적 고찰

천승현 ( Seung Hyun Chun ),최응호 ( Eung Ho Choi ),황상민 ( Sang Min Hwang ),이승헌 ( Seung Hun Lee ),안성구 ( Sung Ku Ahn ) 대한피부과학회 2003 대한피부과학회지 Vol.41 No.5

N/A Background : Inverted follicular keratosis has distinctive histopathological features and is infre-quently encountered by dermatologists. To date, the pathogenesis of inverted follicular keratosis has not been elucidated. Many authors have suggested several theories for the nature of inverted follicular keratosis including verruca vulgaris with squamous eddies, irritated seborrheic keratosis and distinctive follicular tumors. There are no comprehensive studies about the clinical and histopathological features of inverted follicular keratosis in Korea. Objective : The purpose of this study was to analyze the clinical features and histopathological findings of inverted follicular keratosis with literature review. Methods : We studied 14 patients with inverted follicular keratosis for clinical features including the duration of the disease, the location and size of the lesions, the clinical impressions at the first visit and we made a record of the patients` age and sex, histopathological findings. Results : 1. Eight of the 14 patients were male and the ages ranged from 40 to 83 years (mean 59.3 years). The lesions were situated on the face (5/14), scalp (3/14), abdomen (2/14), hand (2/14), buttocks(1/14), shin (1/14). The average size of the lesions was 1.38㎝ 2. Seborrheic keratosis was the most common clinical diagnosis (6/14), followed by verruca vulgaris(4/14), cutaneous horn (1/14), melanoma (1/14), soft fibroma (1/14) and pigmented nevus (1/14). 3. Solid and nodular types were the most common histopathological type (7/14). followed by keratoacanthoma-like type (5/14), filiform or wart like type (2/14). Conclusion : Inverted follicular keratosis have unusual clinical and histopathological features. We recommend that verrucous plaque lesions should be diagnosed correctly by histopathologic examination and it may be helpful to avoid inappropriate therapeutic approach. (Korean J Dermatol 2003;41(5) : 597~601)

Clinical features of atopic dermatitis are different according to onset age

( Jee Hee Son ),( Yong Se Cho ),( Yun Sun Byun ),( Yoon Seok Yang ),( Bo Young Chung ),( Hee Jin Cho ),( Hye One Kim ),( Chun Wook Park ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.2

Background: Few studies have evaluated differences between early and late onset adult AD in epidemiological associations and clinical features. Objectives: To compare the clinical features of AD in adult patients according to age of onset. Methods: This study recruited subjects with AD visiting the dermatology outpatient department of Kangnam Sacred Heart Hospital and comprised clinical evaluation by a dermatologist and a survey of demographics and onset of AD-associated signs and symptoms. They are also tested total IgE and Multiple allergen simultaneous test (MAST). Results: A total of 270 adult AD patients were enrolled. Among 270 adult AD patients, 225 patients (83.33%) showed early onset (before 18yr-old) and 45 patients (16.67%) had late onset (after 18yr-old) of AD. Between two groups, There were not significantly different in sex, family history, BMI, EASI score and total IgE, but significantly different in treatment history (p=0.031) and initial involvement area (p=0.011). Interestingly, patients with BMI?25 showed significantly higher EASI score than patients with BMI<25 in early onset adult AD (p=0.047). However, there was no significant difference in late onset adult AD. Conclusion: Significant differences exist between early onset and late onset adult AD patients in AD-associated features. These results can be helpful for the prediction of prognosis and treatment of AD.

Merkel 세포암 환자들의 임상 양상에 대한 고찰

최영환 ( Younghwan Choi ),배재희 ( Jai Hee Bae ),오세진 ( Se Jin Oh ),김현제 ( Hyun Je Kim ),박지혜 ( Ji-hye Park ),이종희 ( Jong Hee Lee ),이동윤 ( Dong-youn Lee ) 대한피부과학회 2020 大韓皮膚科學會誌 Vol.58 No.9

Background: Merkel cell carcinoma is an uncommon primary cutaneous neuroendocrine cancer. It is a highly aggressive cancer with high rates of local recurrence and nodal metastasis. While there are some case reports on Korean patients with Merkel cell carcinoma, there has been no comparison study between Western patients and Korean patients regarding its clinical features. Objective: This study aimed to identify the clinical features of Merkel cell carcinoma in Korean patients and compare them with those seen in Western studies. Methods: We retrospectively reviewed the medical records of patients who were diagnosed with Merkel cell carcinoma between January 1995 and May 2019. Clinical features were compared with those seen in Western studies. Results: Thirty-one patients were enrolled in the analysis. The mean age of onset was 67.6 years, and there were more female patients (1:1.58). The head and neck was the most common primary site (38.7%, 12/31). Patients treated by surgical methods alone were the most common (58.1%, 18/31). Twelve patients (38.7%) had recurrence, and seven patients (22.6%) died of Merkel cell carcinoma. Patients younger than 70 years were more frequent in Korea than in Western countries (Fishers exact test, p<0.05). In addition, patients with distant metastasis were less frequent in Korea than in Western countries (Fishers exact test, p<0.05). Conclusion: Compared with Western studies, there were no differences between demographic and clinical features, except that older patients and patients with distant metastasis were less frequent in Korea. (Korean J Dermatol 2020;58(9):583∼589)

IgA 신증의 임상상 및 예후인자에 대한 고찰

장미경(Mi Kyung Chang),이영호(Young Ho Lee),김난희(Nan Hee Kim),차대룡(Dae Ryong Cha),구자룡(Ja Ryong Koo),권영주(Young Joo Kwon),조원용(Won Yong Cho),표희정(Hee Jeong Pyo),김형규(Hyoung Kyu Kim),원남희(Nam Hee Won) 대한내과학회 1995 대한내과학회지 Vol.49 No.1

N/A Objectives: IgA nephropathy is a primary renal disease characterizedy prominent mesangial IgA deposition without systemic disease. The main clinical manifestaion is recurrent hematuria and proteinuria and it is most common renal disease in patients with recurrent hematuria. IgA nephropathy was initially regarded as a glomerulonephritis with a favourable course but the later investigators have found that more than 20% of the patients will progrss to end stage renal failure within 10-20 years from the diagnosis. The natutal course of the patients is very variable so that the clinical manifestations and the factors affecting the prognosis of this disease have a very important clinical aspects. Authors purposed to invastigate the clinical features and renal pathologic findings for 43 patients of IgA nephropathy in association with prognosis during recent four years. Methods: Patients were considered for entry into the study on the basis of a renal biopsy specimen which showed predominently IgA mesangial deposits an immunofluorescence(IF). They were excluded if there were clinical or serological evidence of systemic lupus erythematosus, chronic liver disease, or Henoch-Schonlein purpura. The clinical features and pathologic findings were abtained by careful retrospective study of the hospital records of each patient only after selection on the basis of the immunohistological features. Results: 1) Mean age of the patients was 28.8 years and 79% of the patients were distributed between 20-40years. Male to female ratio was 1:l. 2) The most common clinical symptom was gross hematuria(47% ). 3) Significant proteinuria(more than 1g/day) was noted in 10cases(44%) including 5 cases(12%) of nephrotic range proteinuria. 4) The most common renal pathologic finding is tubular atrophy and has significant positive correlation with mean blood pressure, level of serum creatinine and the amount of 24 hour urinary protein. 5) 9% of the cases progressed to deterioration of renal function during mean 29 months of follow up duration. Mean arterial blood pressure and the amout of 24 hour protein of these patients were 141mmHg, 4.25g/day respectively. renal biopsy showed tubular atrophy and nephrosclerosis in all cases. 6) Serum crearinine level showed statistically significant positive correlation with age(r=0.34), mean arterial blood pressure(r=0.71) and the amout of 24 hour urine proteine(r= 0.35)(p<0.05). Conclusion: Old age, mean arterial blood pressure, the amout of 24 hour urine protein and the pathologic findings of tubular atrophy or glomerulosclerosis correlate with the prognosis of the patients with IgA nephropathy

국내에서 편두통성 현훈의 임상 양상 및 치료에 대한 다기관 연구

고의경,안성기,강규식,구자원,김범규,김규성,김병건,김지수,박경호,박시내,박은호,박홍주,변재용,서명환,성기범,오선영,이정구,이태경,정성해,정원호,차창일,채성원 대한평형의학회 2009 Research in Vestibular Science Vol.8 No.2

Background and Objectives It is being increasing recognized that the morbidities of migraine and balance disorders are interrelated. In fact, migrainous vertigo (MV) is one of frequent causes of recurrent vertigo in patients presenting to specialized dizziness clinics. Nevertheless, not many studies have reported clinical manifestations and treatment. Therefore, the aim of study was designed to assess clinical features and treatment patterns by a nationwide multicenter study. Materials and Methods Patients between 9 and 74 years of age who visited 17 Korean tertiary referral centers and 1 clinic from February to March 2009 were investigated using two forms of questionnaires. Results Overall, 318 patients with MV were enrolled. MV was responsible for ~8.45% of visits to the specialized dizziness clinics. One hundred seventy-five of these patients had definite MV and were included in assessing the clinical features. Vertigo characteristics of patients with definite MV were various. Vertigo was regularly as-sociated with headache in 87% of the patients. The duration of vertigo ranged from seconds to days. For the treatment patterns, an acute and prophylactic therapies were carried in most clinics. There were no differences in either acute or prophylactic therapies between department of neurology and otorhinolaryngology. Conclusions The results of this study suggest that MV the clinical features of MV also varies in Korea. In addition, most clinics provide similar patterns of practice in treatment for MV. The syndrome of MV deserves further research activity as it is relatively common and clinically relevant. Background and Objectives It is being increasing recognized that the morbidities of migraine and balance disorders are interrelated. In fact, migrainous vertigo (MV) is one of frequent causes of recurrent vertigo in patients presenting to specialized dizziness clinics. Nevertheless, not many studies have reported clinical manifestations and treatment. Therefore, the aim of study was designed to assess clinical features and treatment patterns by a nationwide multicenter study. Materials and Methods Patients between 9 and 74 years of age who visited 17 Korean tertiary referral centers and 1 clinic from February to March 2009 were investigated using two forms of questionnaires. Results Overall, 318 patients with MV were enrolled. MV was responsible for ~8.45% of visits to the specialized dizziness clinics. One hundred seventy-five of these patients had definite MV and were included in assessing the clinical features. Vertigo characteristics of patients with definite MV were various. Vertigo was regularly as-sociated with headache in 87% of the patients. The duration of vertigo ranged from seconds to days. For the treatment patterns, an acute and prophylactic therapies were carried in most clinics. There were no differences in either acute or prophylactic therapies between department of neurology and otorhinolaryngology. Conclusions The results of this study suggest that MV the clinical features of MV also varies in Korea. In addition, most clinics provide similar patterns of practice in treatment for MV. The syndrome of MV deserves further research activity as it is relatively common and clinically relevant.

Clinical Evaluation of Minor Clinical Features of Atopic Dermatitis

Kim, Kyu Han,Chung, Jin Ho,Park, Kyoung Chan Korean Dermatological Association 1993 Annals of Dermatology Vol.5 No.1

성인 피부근염 환자 52명의 임상적 분석

정인순 ( In Soon Jung ),윤숙정 ( Sook Jung Yun ),이지범 ( Jee Bum Lee ),김성진 ( Seong Jin Kim ),이승철 ( Seung Chul Lee ),원영호 ( Young Ho Won ) 대한피부과학회 2018 대한피부과학회지 Vol.56 No.1

Background: Dermatomyositis is one of the idiopathic inflammatory myopathies, characterized by unique cutaneous features. Unfortunately, there is little data regarding the clinical features of dermatomyositis in Korea patients. Objective: The study aimed to analyze the clinical features of Korean patients with adult-onset dermatomyositis. Methods: A total of 52 patients from 2002 to 2016 were analyzed retrospectively. Clinical features such as sex, age, symptoms, associated connective tissue disorders and malignancy were studied using medical records. Results: The mean onset age was 43.4 years, and the male to female ratio was 1 : 1.9. Forty-two patients (80.8%) were classified as having dermatomyositis, and 8 patients (15.4%), as having amyopathic dermatomyositis. Skin rash (94.2%) was the most common clinical feature, followed by proximal muscle weakness (61.5%), itching (55.8%), arthralgia (36.5%), and muscle pain (32.7%). Among skin rashes, symmetric violaceous erythema (67.3%) was the most frequent, followed by heliotrope rash (63.5%) and Gottron’s papule (59.6%). Serum aldolase level was elevated in 77.8%, and LDH in 69.6%. The prevalence of malignancy (23.1%) was similar to that in previous studies. Cervical cancer made up 25% (3/12) of the associated malignancies, followed by ovarian cancer and lung cancer (16.7%). Ten patients (19.2%) had other accompanying connective tissue diseases. Conclusion: To date, this is the first large-scale case study that analyzed the clinical features of Korean patients with adult-onset dermatomyositis. (Korean J Dermatol 2018;56(1):24∼29)

노년기 기분장애의 임상증상 및 예후

이민수(Min Soo Lee) 대한노인정신의학회 1998 노인정신의학 Vol.2 No.1

The clinical features of elderly depression are similar to those of younger's, but there are some differences in frequency. First, compared with younger adults, elderly depressive patients are more likely to show melancholic feature. They complain more physical symptoms rather than depressive mood, so they are occasionally regarded as having "atypical depression". Second, geriatric depression frequently has psychotic feature, especially delusion of guilt or nihilism. Finally sometimes they may have decline of cognitive functions, i.e. pseudodementia, so it is important and hard to distinghush it from dementia. In the case that have longer duration of episode, severe depression, non-melancholic symptoms, or delusion, illness is prone to be chronic and develop dementia. Bipolar disorder in elderly is also similar to that in adults in overall clinical manifestation, but has some differences in the following ponits;fewer hyperactivity, fewer thought problem, and less association with life-event. Also, manic delirium is frequent in elderly. The prognosis of elderly mania is various.

의료진단 및 중요 검사 항목 결정 지원 시스템을 위한 랜덤 포레스트 알고리즘 적용

尹泰鈞(Taegyun Yun),李寬洙(Gwan-Su Yi) 대한전기학회 2008 전기학회논문지 Vol.57 No.6

In clinical decision support system (CDSS), unlike rule-based expert method, appropriate data-driven machine learning method can easily provide the information of individual feature (clinical test) for disease classification. However, currently developed methods focus on the improvement of the classification accuracy for diagnosis. With the analysis of feature importance In classification, one may infer the novel clinical test sets which highly differentiate the specific diseases or disease states. In this background, we introduce a novel CDSS that integrate a classifier and feature selection module together. Random forest algorithm is applied for the classifier and the feature importance measure. The system selects the significant clinical tests discriminating the diseases by examining the classification error during backward elimination of the features. The superior performance of random forest algorithm in clinical classification was assessed against artificial neural network and decision tree algorithm by using breast cancer, diabetes and heart disease data in DCI Machine Learning Repository. The test with the same data sets shows that the proposed system can successfully select the significant clinical test set for each disease.

정신병적 증상을 동반한 메스암페타민 사용자들의 임상적 특성

김민혜(Min-Hye Gim),권성민(Sung-Min Kwon),김양태(Yang-Tae Kim),조성남(Sung-Nam Cho),권도훈(Do-Hoon Kwon) 한국중독정신의학회 2006 중독정신의학 Vol.10 No.1

Objectives:The purpose of this study was to clarify the socio-demographic and clinical characteristics such as use pattern, the history of other substances use and preoccupation behavior in methamphetamine users with psychotic features admitted in Bugok National Hospital. Methods:The subjects were 51 hospitalized male patients who met the DSM-IV criteria for methamphetamine abuse or dependence. Psychotic symptoms in methamphetamine users were evaluated using the Brief Psychiatric Rating Scale (BPRS). Their family members were interviewed in order to complete premorbid sociodemographic profiles, the history of other substances use including smoking and alcohol, and use patterns and preoccupation behavior during methamphetamine use. Results:Compared with their non-psychotic counterparts, methamphetamine users with psychotic features were younger in terms of age at first use, first psychiatric hospitalization, and faced socio-occupational problem firstly. In addition, they were admitted to psychiatric hospitals more frequently. Conclusion:Futher large, welldesigned trial will be needed to treat and manage of domestic methamphetamine users with psychotic features.