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.

Systematic Review of Reciprocal Changes after Spinal Reconstruction Surgery : Do Not Miss the Forest for the Trees

Kim, Chang-Wook,Hyun, Seung-Jae,Kim, Ki-Jeong The Korean Neurosurgical Society 2021 Journal of Korean neurosurgical society Vol.64 No.6

The purpose of this review was to synthesize the research on global spinal alignment and reciprocal changes following cervical or thoracolumbar reconstruction surgery. We carried out a search of PubMed, EMBASE, and Cochrane Library for studies through May 2020, and ultimately included 11 articles. The optimal goal of a truly balanced spine is to maintain the head over the femoral heads. When spinal imbalance occurs, the human body reacts through various compensatory mechanisms to maintain the head over the pelvis and to retain a horizontal gaze. Historically, deformity correction has focused on correcting scoliosis and preventing scoliotic curve progression. Following substantial correction of a spinal deformity, reciprocal changes take place in the flexible segments proximal and distal to the area of correction. Restoration of lumbar lordosis following surgery to correct a thoracolumbar deformity induces reciprocal changes in T1 slope, cervical lordosis, pelvic shift, and lower extremity parameters. Patients with cervical kyphosis exhibit different patterns of reciprocal changes depending on whether they have head-balanced or trunk-balanced kyphosis. These reciprocal changes should be considered to in order to prevent secondary spine disorders. We emphasize the importance of evaluating the global spinal alignment to assess postoperative changes.

건축 프로젝트 적정 설계변경 관리를 위한 사례조사

김성욱(Kim Sung-Wook),남혜원(Nam Hye-Won),이종식(Lee Jong-Sik),신창현(Shin Chang-Hyun),전재열(Chun Jae-Youl) 대한건축학회 2009 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.29 No.1(구조계)

Recent design changes in the existing research on the factors and issues of design changes and analysis, responsible for analyzing the relationship, procedural issues, and issues of research that can be active. However, changes in the design of problems are essentially designed to complement the book is for the procedure. Methodology for dealing with design changes in the characteristics of the country and to reflect more realistically, and various design changes and looked at trends in related research. the design Change of this study to examine the domestic status and problems, identify the status of the country about the design changes, and in suggesting the direction to the development of the design changes.

Bone Marrow T Cells are Superior to Splenic T Cells to Induce Chimeric Conversion After Non-Myeloablative Bone Marrow Transplantation

( Hyun Sil Park ),( Seok Goo Cho ),( Min Jung Park ),( So Youn Min ),( Hong Seok Chang ),( Hee Je Kim ),( Seok Lee ),( Chang Ki Min ),( Jong Wook Lee ),( Woo Sung Min ),( Chun Choo Kim ),( Ho Youn Kim 대한내과학회 2009 The Korean Journal of Internal Medicine Vol.24 No.3

Background/Aims: The bone marrow functions not only as the primary B-lymphocyte-producing organ but also as a secondary lymphoid organ for CD4 and CD8 cell responses and a site of preferential homing and persistence for memory T cells. Bone marrow T (BM-T) cells are distinguished from peripheral blood T cells by surface phenotype, cytokine secretion profile, and immune functions. In this study, we evaluated the alloreactive potential of donor lymphocyte infusion (DLI) using BM-T cells in mixed chimerism compared to that using spleen T (SP-T) cells. Methods: Cells were prepared using established procedures. BM-T cells were obtained as a by-product of T-cell depletion in BM grafting and then cryopreserved for subsequent DLI. We performed DLI using BM-T cells in allogeneic mixed chimera mice on post-BMT day 21. Results: When the same dose of T cells, 5-10×105 (Thy1.2+), fractionated from BM and spleen were administered into mixed chimeras, the BM-T group showed complete chimeric conversion, with self-limited graftversus-host disease (GVHD) and no pathological changes. However, the SP-T group showed persistent mixed chimerism, with pathological signs of GVHD in the liver and intestine. Conclusions: Our results suggest that DLI using BM-T cells, even in small numbers, is more potent at inducing chimeric conversion in mixed chimerism than DLI using SP-T cells. Further study is needed to determine whether cryopreserved BM-T cells are an effective cell source for DLI to consolidate donor-dominant chimerism in clinical practice without concerns about GVHD. (Korean J Intern Med 2009;24:252-262)

Clinical characteristics of green nail syndrome: A retrospective analysis

( Gi-wook Lee ),( Dae-lyong Ha ),( Jin-hwa Son ),( Jung-soo Lee ),( Kihyuk Shin ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ) 대한피부과학회 2020 대한피부과학회 학술발표대회집 Vol.72 No.1

Background: Green nail syndrome (GNS) is an infectious disease developing greenish discoloration of the nail with accompanying nail disorder such as onycholysis and paronychia. However the data about its clinical characteristics and treatment response has been limited. Objectives: To investigate the clinical characteristics of green nail syndrome in Korean patients. Methods: We retrospectively reviewed medical records and clinical photos of 80 patients with 96 GNS lesions who diagnosed with GNS in the Pusan National University Hospitals (Busan and Yangsan) from 2009 through 2020. Results: 52 patients (65%) had risk factors for GNS include frequent wet conditions, immunosuppressive conditions, and trauma. Involvement of the thumbnail or great toenail was found in 62 lesions (64.6%). Pseudomonas aeruginosa was detected on 23 nails (48.9%) among 47 nails showing positive bacterial culture, and fungal infection was found on 19 nails (19.7%). Several treatments including bleaching and drying nail, topical antibiotics, topical antifungals, and surgical avulsion were tried. And there were some differences of therapeutic responses according to the selected treatment modalities. Bleaching and drying showed better effect on color changes of nail, while topical antibiotics and antifungal cream showed better effect on preventing spreading. Conclusion: The result of this study could be helpful for dermatologists when encountering patients with greenish nail change.

백서에서 동종 신경이식시 항 T임파구 단일클론항체 분포에 관한 조직화학적 연구

홍창섭,김경욱,임창준,정대현 단국대학교 치의학연구소 1991 논문집 Vol.3 No.-

Nerve allografts as a bridge through which lost nerve can regenerate is useful in the repair of peripheral nerve defect resulting from trauma, neoplasm and leprosy. But immunological rejection and complicated scar formation is an unaboidable problem in the application of allogenic nerves. This article is intended to study histopathological and immunohistochemical response after fresh allogenic sciatic nerve grafts in rats. 12 male Sprague- Dawley rats were used as the experimental animals. A 2cm skin incision was made on the lateral aspects of limb, parallel to the femur. 1cm-long sciatic nerve trunk taken from the one rat was resected at the middle of the to high, and it was transplanted to the same area of the other rat with perineural suture method. Observation was made at the postoperative 1, 3, 8, 16 day. The results were as follows. 1. Histopathologically, destruction of the perineural sheath was observed only in 1-day group. 2. Mild degenerative changes of the nucleus and cytoplasm of Schwann cells were ovserved in the 1-day and 3-day groups. These changes gradually resolved. 3. Hollow space phenomena of the nucleus and cytoplasm of schwann cells were observed. The response was mild in the 1 day and 3 day groups, and moderate in the 8 day group. The phenomena were not identified in the 16 day group. 4. Immunohistochemical studies revealed pan T cells and cytotoxic T cells in the 1 day group. Increased numbers of cytotoxic T Cells and helper T cells were observed in the 3 and 8 day groups. 5. According to these results, after transplantation of fresh allogenic sciatic nerve an inflammatory response was observed up to 8 days and then gradually resolved. Degenerative changes were more severe up to 8 days, but an the 16th day they had resolved histopathologically and immunopathologically.

발열을 동반한 호중구감소증에서 Cefepime 단독투여와 Ceftazidime 및 Tobramycin 병합투여의 효능비교

정현욱,채제욱,강미라,양정채,문치숙,기현균,장현하,오원섭,김기현,백경란,이남용,송재훈 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

목적 : 국내에서 발열을 동반한 호중구감소증이 있는 악성 종양환자에게 경험적 항생제로 베타락탐계 항생제와 아미노배당체의 병합요법의 사용이 일반적이다. Cefepime은 광범위 항균 작용을 가지고 있어, 그람 음성균 뿐만 아니라 그람 양성균에 대해서도 우수한 효과를 나타낸다. 재료 및 방법: 발열을 동반한 호중구감소증이 있는 악성 종양환자를 대상으로 무작위, 공개, 비교 연구를 시행하였다. 대상 환자를 무작위로 cefepime 단독요법군과 ceftazidime 및 tobramycin 병합요법군으로 나누어 투여하고 각각의 임상적 효능과 안전성을 비교하였다. 구강및 인후 점막염이 있는 환자에서 분리된 녹색 연쇄알 구균에 대한 항생제 내성 정도를 조사하였다. 결과 : 대상환자 89명 중 CA 투여군이 48예(53.9%), CT 투여군이 41예(46.1%)이었다. 발열의 유형별로 MDI는 18예(20.2%), CDI는 9예(10.1%), UF는 62예(69.7%)로 두 군 간에 차이가 없었다. CA 투여군과 CT 투여군의 임상적 호전률은 시험약 투여 후 2-4일째 각각 91.7%, 85.4% (P=0.31), 치료 종료 시 각각 91.7%, 100% (P=0.15)로 두 군간에 유의한 차이가 없었다. 치료 종료 시 CA 투여군과 CT 투여군의 세균학적 소실률은 모두 100%로 두 군간의 유의한 차이가 없었다(P=0.78). 점막염이 있는 환자로부터 녹색 연쇄알 구균이 분리된 경우는 25예(28.1%)이었으며, 분리된 녹색 연쇄알 구균은 penicillin, ceftriaxone, cefepime, vancomycin에 모두 감수성을 보였다. 약제 관련 이상 반응의 발생 빈도도 두 군간에 유의한 차이가 없었다. 결론 : 발열을 동반한 호중구감소증이 있는 악성 종양환자의 경험적 항생제로서 cefepime 단독요법은 ceftazidime 및 아미노배당체의 병합요법만큼 효과적이고 안전하였다. Background : Broad-spectrum antibiotic therapy has been recommended as an empirical regimen in cancer patients with febrile neutropenia. Cefepime is a fourth generation cephalosporin with good activity against both gram-positive cocci and gram-negative bacilli. Materials and Methods : To compare the efficacy and safety of cefepime alone with ceftazidime plus tobramycin as empirical regimen for adult cancer patients with febrile neutropenia, a randomized, open label, comparative trial was performed. If the patient showed clinical improvent 72 hours, antibiotic could be changed to oral ciprofloxacin. Clinical and microbiological responses were determined at 72 hours and at the end of therapy. To investigate the antimicrobial resistance of viridans streptococci, swab cultures were obtained from throat in all enrolled patients and antimicrobial susceptibility tests were performed by using microdilution method according to the NCCLS. Results : A total of 89 patients were enrolled. Forty-eight patients received cefepime alone (CA), and 41 patients received ceftazidime plus tobramycin (CT). Demographic and baseline clinical characteristics were similar in both groups (P>0.05). The initial clinical success rate at day 2-4 in group CA (91.7%) was similar with that in CT group (85.4%) (P=0.31). At the end of therapy, the final clinical success rate in CA group (91.7%) was similar to that in CT group (100%) (P=0.15). In 18 patients, with microbiologically defined infections, the eradication rate was 100% in both groups. Adverse events including liver dysfunction (21.3%) and renal dysfunction (2.2%), were similar in both groups (P=0.87). Viridans streptococci were isolated from the throat cultures in 25 cases, and all of these strains were susceptible to penicillin (MIC_(90) 0.12 ㎍/mL), cefepime (1 ㎍/mL), and vancomycin (0.12 ㎍/mL). Conclusion : Efficacy and safety of cefepime monotherapy was comparable to the combination of ceftazidime and tobramycin. It could be used as an alternative empirical regimen for treating cancer patients with febrile neutropenia.

상피성 암세포주에 대한 녹차 Catechin의 효과

박정현(Jeong Hyun Park),김대중(Dae Joong Kim),한장희(Jang Hee Hahn),김홍태(Hong Tae Kim),정용욱(Yong Wook Jung),성훈기(Hoon Ki Sung),김주영(Joo Young Kim),송인환(In Hwan Song),성언기(Eon Gi Sung),이융창(Yung Chang Lee) 대한해부학회 2001 Anatomy & Cell Biology Vol.34 No.5

Catechin은 녹차에서 추출되는 폴리페놀의 주요성분으로 고혈압 및 동맥경화의 예방효과, 당뇨억제효과, 항산화작용, 항암작용 등에 직접 관여하는 물질이다. 본 연구에서는 태평양에서 제공받은 녹차 catechin을 이용하여 상피성 암세포주인 A549 (폐암)와 EATC (복수암)세포에 투여한 후 처리농도와 시간에 따른 변화를 비교, 관찰함으로써 녹차의 효과와 작용기전을 밝혀내는데 목적이 있었다. 본실험은 A549 세포와 EATC 세포를 배양한 후 녹차 catechin을 1, 10, 100, 500 μg/ml의 농도로 48시간 동안 처리하였고, 광학현미경, 공초점현미경, 전자현미경 등을 이용하여 세포의 구조적 변화를 확인하였으며 MTT분석, 전기영동, 유세포분석기 등을 사용하여 세포 손상정도를 파악하였다. A549 세포에서는 catechin 1 μg/ml와 10 μg/ml 농도에서는 대조군에 비하여 큰 변화를 관찰할 수 없었다. 100 μg/ml catechin을 처리하였을 때 세포내의 검은 과립들의 수가 증가하였고 층판소체의 손상이 나타났다. 세포주기의 장애가 나타나 DNA 합성전기에 있는 세포들의 수가 급격히 증가하였다. 500 μg/ml 농도에서는 층판소체와 사립체의 파괴가 심하게 나타났으며 세포생존율이 감소하였고 세포주기의 장애도 관찰되었다. EATC 세포에서는 catechin의 농도가 A549 세포의 경우보다 낮은 농도에서도 세포증식 억제 및 세포손상 효과가 나타났다. 10 μg/ml 농도에서도 세포의 위축과 생존율의 감소가 일어났으며 전기영동상에 괴사되는 세포들이 파악되었다. 100μg/ml catechin을 처리하였을 때 자연사의 형태학적 관찰, 전기영동, 유세포분석 등에서 자연사 과정에 있는 세포들이 많이 나타났다. 결과적으로 녹차 catechin을 배양한 상피성 암세포에 투여함으로서 세포의 생존율과 증식이 억제되었고 그 과정에서 괴사, 자연사, 세포주기의 장애 등이 관여하는 것으로 생각된다. 그러나 일련의 세포손상과정을 유도하는 데 있어 세포의 종류, 처리 시간, 농도에 따라 다소 차이가 있음을 확인하였다. Catechin is main component of polyphenol extracts from green tea, it is associated with prevention of hypertension and atherosclerosis, anti-diabetic effect, antioxidant, antitumor. The purpose of this research is to investigate the effect and its mechanism of green tea catechin on epithelial cancer cell lines in various concentrations and durations. For this study, epithelial cancer cell lines, A549 (lung cancer), EATC (Ehrlich-Lettre ascites tumor cell) were used. Inverted, light, confocal and electron microscopes were applied to find morphological changes. MTT assay, flowcytometric analysis, gel electrophoresis were used to compare severity of cellular damages to control after exposure to 1, 10, 100 and 500 μg/ml catechin for 48 hours. In the A549 cells, after 1 μg/ml and 10 μg/ml catechin treatments, there was no notable changes. However, exposure to 100 μg/ml catechin induced increase of cytoplasmic granules, destruction of lamellar body, inhibition of cell cycle, especially G0/G1. In the early phase of 500 μg/ml catechin administration, decrease of cell population, severe destruction of lamellar bodies and mitochondria, derangement of cell cycle were shown. In the EATC, such as those effects occurred after exposure to lower concentration of catechin than in that of A549 cells. After exposure of 10 μg/ml catechin, rounded-up cells and necrotic cells were found. Whereas, most of cells were under apoptotic changes-cytoplasmic condensation, nuclear fragmentation, cellular shrinkage, ladder pattern in the electrophoresis, when administrated 100 μg/ml catechin. These results suggested that exposure of catechin induced severe cellular damage and growth inhibition in dose- and time-dependent manner. And we confirmed that these effects of catechin were involved with apoptosis, necrosis and cell cycle arrest and were quite different according to cancer type. Therefore, much more research would be demanded before clinical application of catechin to human cancer therapy and this study would be the basic source for further study of green tea.

P177 Dermoscopic findings during the course of β -blocker treatment for infantile hemangioma

( Jin-hwa Son ),( Hyun-ju Jin ),( Hyang-suk You ),( Woo-haing Shim ),( Jeong-min Kim ),( Gun-wook Kim ),( Hoon-soo Kim ),( Byung-soo Kim ),( Moon-bum Kim ),( Hyun-chang Ko ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.2

<div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div> Background: Dermoscopy is a useful tool for examining morphology and structure of blood vessels in vascular skin lesions like infantile hemangioma (IH). However, dermoscopic findings are not fully elucidated in the course of β-blocker treatment for IH. Objectives: To investigate changes of dermoscopic findings during the course of β-blocker treatment for IH. Methods: Superficial or mixed-type IH patients treated with topical timolol solution or oral propranolol were enrolled in Pusan National University Hospitals (Busan and Yangsan) from November 2011 to January 2016. Clinical photograph and dermoscopic findings were recorded and assessed at the baseline, 1, 2, 3 and 6 months. Results: Total 115 patients (male: 38 and female: 77 / superficial type: 48 and mixed type: 67 / timolol: 77 and propranolol: 38) were included. Diffuse light erythema tended to be diminished but milky-red area increased gradually during the course of treatment. The patients treated with oral propranolol showed more prominent changes on each dermoscopic findings than those treated with topical timolol (p=0.023 and p=0.018, respectively). But, other findings like red-globular vessels, red-dot vessels, red-circulated vessels, red-linear vessels did not show significant changes. Conclusion: Dissolution of diffuse light erythema and increase of milky-red area were significant dermoscopic findings in accordance with clinical improvement after β -blocker therapy for IH.

고빌리루빈혈증을 동반한 자가면역성 간염 1례

서영범,김성욱,장재식,강혁주,이중현,윤병구,김욱년,이광헌,이구,유석동,양창헌,이정호,이영현,이창우,서정일 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

자가면역성 간염은 대개 만성 경과를 가지며, 혈중 자가면역항체와 혈청 글로불린치의 상승, 그리고 조직학적으로 괴사 염증성 변화를 특징으로 하는 질환으로 아직 정확한 병인이 밝혀져 있지 않은 상태이다. 발병연령은 대개 젊은 영자(15-25세)에서 호발한다. 이 질환은 급성 간염의 임상경과를 보일 수 있으나, 심한 급성 간염이나 전격성 간염으로도 나타날 수 있는데, 이 경우 아주 나쁜 예후를 보인다고 한다. 치료는 자가면역성 간염 임상 경과의 다양성이나 병인, 병리기전의 불확실성에도 불구하고 대개 steroid 치료에 반응하는 것으로 알려져 있으며 대개 80%의 관해율을 나타내며 궁극적으로 간경변으로의 진행을 막을 수 있는 것으로 보인다. 저자들은 58세 남자에서 발생한 급성의 경과를 가지고 심한 황달을 동반한 자가면역성 간염을 경험하였기에 문헌고찰과 함께 보고하는 바이다. Autoimmune hepatitis (AIH) is a chronic necroinflammatory liver disorder of unknown cause associated with circulating autoantibodies and a high serum globulin level. The age of onset of AIH show a peak between the age of 15 and 25 years. AIH can develop and be manifested as acute hepatitis, but severe form of acute hepatitis or fulminant hepatic failure has a poor prognosis. Although AIH is likely to progress from chronic active hepatitis to cirrhosis, steroid therapy can control the disease activity, prolong survival, improve the quality of life , and defer liver transplantation. In the present report we describe a 58-year-old man who admitted because of progressive jaundice and fatigue. He was diagnosed with AIH from laboratory test result showing positivity for antinuclear antibodies, anti-smooth muscle antibodies, and negativity for hepatitis viral markers and from liver biopsy. Steroid therapy, oral administration of prednisolone, was effective in improving the liver function test. Following liver biopsy 6 months after onset shows markedly improved necroinflammatory activity.