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RISS 인기검색어
- 검색키워드
- 저자 : ( Cheng Che. E. Lan ) (검색결과 3 건)
- 무료
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Plenary Session 3-2 (PS 3-2) : Phototherapy in dermatology: Focusing on UV and visible light
( Cheng Che E. Lan ) 대한피부과학회 2014 대한피부과학회 학술발표대회집 Vol.66 No.2
Phototherapy is an essential part of dermatology practice for treating various skin disorders. This presentation focuses on our recent findings regarding ultraviolet (UV) and visible light therapies. The proposed mechanisms responsible for UV phototherapy mostly focused on the immune suppressive effects. However, it is clear that UV radiation also has significant biostimulatory effect that can be exemplified by vitiligo repigmentation. Vitiligo is a depigmentary disorder resulting from disappearance of functional melanocytes. Vitiligo repigmentation depends on the activation, migration, and functional development of primitive melanoblast cells. The process of vitiligo repigmentation presents a perfect model for studying the biostimulatory effect of UV therapy. We recently demonstrated that the capacity of UVB irradiation to induce functional development of melanoblast depends on the irradiance (W/cm2) of the radiation source. The high irradiance UVB induces stronger activation of aryl hydrocarbon receptor pathway, stimulates more prominent epidermal growth factor receptor nuclear translocation, and initiates tyrosinase transcription and translation while equivalent fluence (J/cm2) delivered by low irradiance UVB failed to do so. Therefore, irradiance is an often neglected but clinically important parameter to consider when UV phototherapy administered. In 2003, our team proposed and demonstrated that visible light from Helium-Neon (632.8nm) laser induces repigmentation of vitiligo. Mechanistically, we showed that 632.8nm light initiates mitochondrial retrograde signaling via a Ca2+-dependent cascade, leading to activation of peroxisome proliferators-activated receptor γ coactivator-1α (PGC-1α), the master regulator for mitochondrial biogenesis and antioxidant enzyme production, and ultimately resulting in melanoblast cell differentiation. These studies provide clinical and scientific evidences indicating that visible light has significant biostimulatory effect. Another clinical application of visible light is to reduce sun-associated aging by decreasing metalloproteinase-1 (MMP-1) expression in the dermis. It is known that UVA-associated skin aging is mediated by increased MMP-1 expression via reactive oxygen species (ROS) formation. Very recently, we demonstrated that 590nm photomodulation attenuates UVA-induced ROS and MMP-1 expressions via mitochondrial retrograde signaling that augments the antioxidant enzyme expression in a PGC-1αdependent manner and provided a theoretical basis explaining the therapeutic effects of visible light on treating clinical conditions associated with ROS-mediated dysfunctions. Dermatologists routinely use phototherapy for treatment of different conditions. However, our understanding regarding the effects of light, even the most commonly encountered UV radiation, remained far from complete. Delineation of the photobiological effects of lights at different region will not only enhance the therapeutic efficacy of phototherapy, but will also promote better health since human beings will continue to have intimate interactions with lights at different spectrums.
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( Jung Min Bae ),( Sang Ho Oh ),( Hee Young Kang ),( Young Wook Ryoo ),( Cheng-che E. Lan ),( Lei-hong Xiang ),( Ki-ho Kim ),( Tamio Suzuki ),( Ichiro Katayama ),( Seung-chul Lee ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.2
Background: Patients with vitiligo are more likely to have limited involvement than widespread one. Therefore, localized treatment is essential and a reliable instrument for target evaluation is needed. Objectives: To validate the accuracy and reliability of the Vitiligo Extent Score for a Target Area (VESTA) for assessing treatment response in a target lesion. Methods: A validation study was performed for 17 pairs of vitiligo images (pre- and post-treatment) between March and April 2017 by 65 dermatologists in 10 institutes, using both a rough estimate and the VESTA. Accuracy was evaluated by calculating concordance correlation coefficients (CCCs) between the true values and each measurement. Inter- and intra-rater reliabilities were assessed by deriving intraclass correlation coefficients (ICCs). The smallest detectable change (SDC) was calculated with each coefficient. Results: The VESTA (CCC: 0.949, 95% confidence interval [CI] 0.942-0.955) was significantly more accurate than the rough estimate (CCC: 0.896, 95% CI 0.883-0.908). These corresponded to an SDC95 of 1.5% for the VESTA and 4.1% for the rough estimate. Inter-rater reliability showed an ICC of 0.928 (SDC95: 12.8%) for the VESTA and 0.900 (SDC95: 19.6%) for the rough estimate. Intra-rater reliability showed an ICC of 0.944 (SDC95: 1.7%) for the VESTA and 0.943 (SDC95: 1.8%) for the rough estimate. Conclusion: The VESTA afforded accurate and reliable assessments of treatment response in a target area.
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