대상 포진 환자의 포진후 신경통 방지에 관한 교감신경 차단술의 효과

고우석,박상만,김방순,신동엽 ( Woo Seok Koh,Sang Man Park,Band Soon Kim,Dong Yeop Shin ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.4

Background: Many investigators have advocated neural and especially regional sympathetic blockade for acute herpe. zoster pain. Some believe that nerve blocks not. only relieve acute pain but also, if given early in the course of clinical disease, prevent progression to postherpetic neuralgia. Objective : The purpose of this study was to evaluate the preventive effect of sympathetic blockade on herpes zoster Methods : Fifteen patients with herpes zoster were treated with sympathetic blocks according to the severity of pain. Results : The total score of pain degree decreased from 3.4 to 1.1 with sympathetic blocks in 15 patients in 2 months. Sympathetic blocks prevented or relieved postherpetic neuralgia in more than 90% of patients treated within 2 weeks of the onset of the acute phase of the disease and in more than 85% of patients over 60. Conclusion . Sympathetic blocks are effective in preventing postherpetic neuralgia if applied soon after the onset of the acute phase of herpes zoster. (Kor J Dermatol 1997;35(4): 620-626)

Calcipotriol연고로 치료한 건선

고우석(Woo Seok Koh),윤재일(Jai Il Youn) 대한피부과학회 1992 대한피부과학회지 Vol.30 No.5

Calcipotriol, a synthetic analogue of calcitriol(1,25-dihydroxyvitamin D) is as active as calcitriol in inducing cell differentiation and inhibiting cell pralifiration but at least 100 times less active than calcitriol in its effect on calcium metabolism. We report a case of psoriasis in a 28 year old male who was treated with calcipotriol ointment on the right forearm. The therapeutic effect of calcinoipotriol ointment was compared with desoxymethason, cream applied on the left forearm. Both topical agents reduced equally the degrees of scale, erythema and thickness of the lesions. We observed that the calcipotriol ointment was effective in the treatment of psoriasis n this case. (Kor J Dermatol 1992,30(5):674-678)

구리증기레이저의 출력과 광량에 따른 기니픽 피부의 조직학적 변화에 관한 연구

고우석(Woo Seok Koh),정진호(Jin Ho Chung),윤재일(Jai Il Youn) 대한피부과학회 1994 大韓皮膚科學會誌 Vol.32 No.4

Background : Recentliy copper vapor laser(CVL) has been applied with encouraging results in the treatment of port wine stain. The CVL emits yellow light(578nm) in a sequence of about 10,000 to 15,000 pulses/second(10-15kHz) with a pulse duration of 15-50 cases. One of the basic methods of evaluationg the effects of laser lights is to study histologic changes after laser irradiation. Objective : The effects of power output and energy density on the histologic change of guinea pig skin following CVL irradiation was evaluted to suggest a way of deciding parameters of CVL to achieve the best clinical results. Methods : After setting the power output for one of 0.8W, 1.6W and 2.4W, the laser was irradiated with an energy density of 10, 12, 14, 16, 18, 20J/cm. A biopsy was done 15 minutes after irradiation and the biopsy specimens was stained with H&E and NBTC histocberr ical method. Results: 1. At the power of 0.8W, specimens irradiated with an energy density above 14J/cm showed diffuse nonspecific coagulation necrosis of the epidermis and upper dermis. 2. At the power of 1.6W, specimens irradiated with energy density of 14, 16J/cm showed coagulation necrosis of dermal vessel and perivascular collagen. With energe density of 18, 20J/cm, diffuse nonspecific coagulat,ion necrosis of epidermis and upper dermis were observed. 3. At the power of 2.4W, specimens irradiated with an anergy density of 12, 14, 16, 18J/cm showed coagulation necrosis of the dermal vessel and perivascular collagen. With an energy density of 20J/cm, diffuse nonspecific coagulation necrosis of the epidermis and upper dermis was observed. Conclusions : With the above results it was found that t,he higher power output of CVL enlarged the range of energy density confining thermal damage to the dermal v-ssels and perivascular collagen. Additionally the higher power raised the upper limit of energy density with which t,he epidermis was viable. (Kor J Dermatol 1994; 32(4): 591-598)

제53차 춘계학술대회 : 수혜자보고 ; 제모 레이저의 작용기전

고우석 ( Woo Seok Koh ) 대한피부과학회 2001 초록집 Vol.39 No.10

UVB에 의한 한국 청년층의 최소홍반량과 최소색소량에 관한 연구

고우석(Woo Seok Koh),정진호(Jin Ho Chung),윤재일(Jai Il Youn),신용우(Young Woo Shin) 대한피부과학회 1994 대한피부과학회지 Vol.32 No.2

Background : The erythemal response and delayed tanning of the skin to UV radiations which are used as diagnostic phototest and guideline of phototherapy are different according to the races and light sources. Objective : The MED and MMD induced by UVB radiation were measured in 130 normal young adult Koreans. Methods : In this study, a high pressure mercury are lamp(Burdick UV-800) and a sunlight fluorescent lamp(Waldmann UV 800) were used as UVB light sources. Multiple sites of the lower baek or buttock skin were irradiated with an increasing dose by a constant, anount. The minimal doses of erythema response and delayed tanning of the skin were assessed visaually at 24 hours and 7 days after irradiation, respectively. Results : MED and MMD of Burdick UV-800 are 18.0+9.8mJ/cm(mean+S.D.), 29.7+12.5mJ/cm, respectively. MED and MMD of Waldmann UV 800 are 70.8+28.5mJ/cm and 91.2+33.1mJ/cm, respecively. The most frequent MED by Burdick UV-800 is 10mJ/cm and those by Waldmann UV 800 are 50m J/cm and 60m J/cm. Conclusion : In this study MED and MMD of young adult Koreans by two kinds of UVB light sources were assessed. The results : how that MED is less than MMD and the levels of MED under which the photosensitivity is suggested are 5.6mJ/cm by Burdick UV-800 anr 32.4mJ/cm by Waldmann UV 800. (Kor J Dermatol 1994; 32(2): 253-257)

Hydrochlorothiazide에 의한 광과민증

고우석(Woo Seok Koh),문상은(Sang Eun Moon),김방순(Bang Soon Kim),윤재일(Jai Il Youn) 대한피부과학회 1992 대한피부과학회지 Vol.30 No.3

Hydrochlorothiazide is a diuretic drug used in the treatement of edema and hypertension. We report a case of hydrochlorothiazide induced photosensitivity in a 54 year old woman who had taken hydrochlorothiazide for 3 years for hypertension. She complained of itching and burning sensation with erythematous papules and lichenified plaques on light-exposed areas. Fhototest showed marked decrease of the minimal erythema dose(MED) for UVA. The symptoms subsided after the use of topical steroid and the substitution atenolol for hydrochlorothiazide. (Kor J Dermatol 1992; 30(3): 373-376)

건선에서의 Calcipotriol 연고의 치료효과

유재학(Jae Hak Yoo),고우석(Woo Seok Koh),윤재일(Jai Il Youn) 대한피부과학회 1994 대한피부과학회지 Vol.32 No.4

Background : Topical vitamine D analogues have been reported to bean effective treatment in patients with psoriasis. Calcipotriol, a new vitamin D analogue, is effect ve and at least 100 times less calcemic than calcitriol. Objective : Our purpose was to study the clinical efficacy, safety and tolerability of calcipotriol ointment in the treatment of psoriasis. Methods : Twenty five patients with chronic poriasis were treated with calcipotriol ointment(50pg/g) twice daily. Efficacy as meaaured by the clinical degree of erythcimor, scale and thickness of the lesions, and safety were assessecl every 2 weeks. Results : The total score of erythema, scale and thickness of the lesions decreased in 6 weeks from 8.52+0.76 to 3.80+1.7 with calcipotriol. Some patients developed mild and transient local side effects. The laboratory tests including serum calcium remained unchanged. Conclusion : Topical applicalion of calcipotriol ointment for 6 week was found to bean effective and safe treatment of psoriasis vulgaris. (Kor J Dermatol 1994; 32(4): 655-661)

피부과를 전공하지 않은 의사들의 흔한 피부질환에 대한 의학 지식 평가

서구일(Koo-Il Seo),고우석(Woo-Seok Koh),은희철(Hee Chul Eun) 한국의학교육학회 1999 Korean journal of medical education Vol.11 No.1

의과대학 교육목표로 많은 수의 대학이 일차진료를 담당하는 의사의 양성을 표방하고 있다1. 피부과교육 역시 한국의과대학장협의회에서 정한 의과대학 학습목표 중 피부과학 학습목적으로 ‘피부의 정상 및 병적 상태를 이해하여 흔한 피부질환의 진단과 치료에 응용한다’고 기술되어 있으나7 피부과를 전공하지 않은 의사들이 일반인에서 유병률이 높은 피부질환에 대해서도 제대로 진단을 못 내리거나 치료를 못해 곤혹스러운 경우가 많은 것이 현실이다. 본 연구는 흔한 피부질환의 진단 및 치료에 대한 피부과를 전공하지 않은 일반 의사들의 지식을 평가하여 우리 나라 피부과 임상교육의 취약한 부분을 보충할 수 있는 자료로 삼고자 공중보건의와 군의사관후보생을 대상으로 설문조사 및 흔한 피부질환에 대한 지식 평가와 임상 슬라이드 시험을 시행하였다. 교육부문에 관한 설문조사 결과에서 피부과를 전공하지 않은 의사들이 피부질환을 진단할 때 84%가 어려움을 느낀다고 응답하였으며 그 원인으로서 일반의를 위한 교재의 부족과 미흡한 의과대학 피부과 교육을 지적하였다. 치료부문의 경우 국소 스테로이드 연고의 적응증,여드름 치료, 족부백선의 치료, 두드러기 치료, 옴치료 등에 대해서는 50% 내외만이 정답을 맞추어 흔한 피부질환의 치료도 제대로 알지 못하는 문제점을 보여주었다. 그룹별로 평균 점수를 살펴보면 학부만 졸업한 일반의 군이 전문의 군에 비해 통계적으로 유의하게 낮게 나왔는데 평가 문항이 치료약제 위주이므로 의과대학을 갓 졸업한 의사보다 직접 치료 경험이 많은 전문의 군이 좋은 점수를 보여주었다고 생각된다. 전문의 군에서 전공과목별 점수 차이를 보면 가정의학과와 비뇨기과 두 군만이 유의하게 높은 점수를 보여주었다. 진단 부문에서 전형적인 임상양상을 보여준 질환은 높은 점수를 나타낸 반면 본 평가문항의 둔부에 발생한 완선과 안면백선과 같이 조금 변형된 임상양상을 보이는 경우는 진단률이 현격히 떨어졌다. 즉 흔히 알고 있는 질환이라 할지라도 비전형적인 임상양상에 대해서는 일반의들의 진단이 쉽지 않음을 알 수 있었다. 어루러기와 농가진같이 1차 의료기관에서 흔히 볼 수 있는 피부질환들 역시 평균에도 못 미치는 상대적으로 낮은 진단률을 보여 주었는데 이것은 의과대학 피부과 교육에서 흔한 질환에대해 상대적으로 소홀히 교육받았다는 증거이기도 하며 아마도 3차 의료기관인 대학 병원에 이러한 유병률이 높은 피부 질환자가 상대적으로 적기 때문에 임상 실습의 기회가 적은데서 기인한다고도 생각한다. 전공과목에 따른 진단률의 차이를 조사한 결과 가정의학과만 유의하게 높은 진단률을 보였주었는데 이것은 의과대학 졸업 후의 수련과정 중 피부과 임상 실습 교육을 다시 받는 가정의학과 수련과정의 특성 때문으로 생각된다. 반면 치료부문의 평가에서 가정의학과와 함께 높은 점수를 보여준 비뇨기과 군은 진단부문에서는 다른 전문의 군과 차이가 없는 것으로 나타나 피부과 임상 실습 교육의 중요성을 재삼 확인할 수 있었다. 이상의 결과를 종합해보면 피부과 전문의가 아닌 의사들이 일반인에서 유병률이 높은 피부질환에 대해서도 제대로 진단을 못 내리거나 진단은 내려도 치료를 잘 모르는 경우가 많은 것으로 나타났다. 이를 보완하기 위해서는 의과대학 피부과 교육에서 희귀하고 학문적 관심이 많은 질환들에 중점을 둘게 아니라 유병률이 높은 흔한 질환들을 중심으로 전형적인 양상 뿐아니라 변형된 양상에 대해서도 교육을 해야 하며 실제 진단과 치료에 도움이 되는 내용이 강조되어야 할 것이다. 또한 대학병원에서의 실습만을 고집할 것이 아니라 1차 의료기관과 연계해서 지역사회에 흔한 질환에 대해 어느 정도의 경험을 가질 수 있도록 배려해야 된다고 생각한다. 본 조사 결과에서는 가정의 뿐아니라 일차 진료를 맡게될 내과나 소아과 전문의들도 레지던트 교육과정에 흔한 피부질환에 대한 추가적인 임상 교육이 필요하다고 판단된다. Proper education about dermatology in medical college would have physicians appropriately diagnose and treat common dermatoses without referring patients to dermatologists. However, physicians who are not dermatologists have difficulty in diagnosing and treating common dermatoses. We have made up a questionnaire about treatment and a slide test for clinical diagnosis of common dermatoses in order to evaluate the knowledge of physicians about common dermatoses, which reflects indirectly the current status of medical education of dermatology in Korea and can be used as a basic data for modifying directions for education in medical college. Total 654 physicians answered the questionnaire, including 125 just graduated general physicians, 111 general physicians who had just finished internship and 418 medical specialists. 11 data from dermatologists were analyzed as a control for evaluation. The result showed that 84%(545) of them have difficulty in diagnosing dermatologic diseases. The probable causes answered by them are lack of easy illustrative textbook for general physician(48%), inadequate education of dermatology in their medical colleges(27%) and so on. In the field of therapy in the questionnaire, only 53% of them had proper knowledge about indication of topical steroids, 56% about acne therapy, 22% about treatment of tinea pedis, 35% about scabies and 41% about urticaria. The average score was 53%. The score of family medicine group and urologist group was 69% and 66% each, which were significantly higher than that of other major groups except 98% of dermatologist group. In the slide test for clinical diagnosis, the average score was 71%. The score of family medicine group which had received postgraduate education on dermatology in their resident training was 84%, also significantly higher than that of other major groups except 100% of dermatologist group. The percentage of correct responders about tinea faciei is only 13%, tinea versicolor 42%, tinea cruris 49%, impetigo 53%, pityriasis rosea 60%, atopic dermatitis 67%, psoriasis 72% and fixed drug eruption 74%, etc. The average score was 71%. In conclusion, this study showed that physicians who are not dermatologists have difficulty in diagnosing and treating even common dermatoses. We think it is important to put stress on the common dermatoses in the field of dermatologic education in medical college. Moreover we could find the importance and need of postgraduate education on dermatology in the resident training of primary care physicians such as not only family medicine doctors but also internists and pediatricians.

변형된 희소 상태 천이 방식을 이용한 효율적인 ADSL용 비터비 복호화기의 구조

류주현(Joo-Hyeon Ryu),김준석(Joon-Seok Kim),고우석(Woo-Suk Ko),고태호(Tai-ho Koh),윤대희(Dae-Hee Youn) 한국통신학회 1999 한국통신학회 학술대회논문집 Vol.1999 No.7

유육종증 3예

김방순 ( Bang Soon Kim ),박상만 ( Sang Man Park ),고우석 ( Woo Seok Koh ) 대한피부과학회 1996 대한피부과학회지 Vol.34 No.4

We report three cases of sarcoidosis with pulmonary involvement. The skin lesions showed three types of cutaneous manifestations which were erythema nodosum, pruritic maculopapular eruptions, and subcutaneous nodules respectively. Erythema nodosum in our cases accompanied by arthralgia and bilateral hilar adenopathy, so we call it Lofgrens syndrome. Histopathologic findings of the case with eythema nodosum revealed septal panniculitis and the others showed characteristic histopathologic findings of sarcoidosis so-called naked tubercle. Regressions of the skin lesions were obtained with systemic and/or topical corticosteroid therapy except for subcutaneous nodules. Subcutaneous nodules initially improved but new lesions have been found. (Kor J Dermatol 1996;34(4): 678-683)