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        Erbium YAG 레이저 조사 후 Guinea Pig 피부에서 관찰된 조직학적 변화

        양재석,계영철,김수남 ( Jae Seok Yang,Young Chul Kye,Soo Nam Kim ) 대한피부과학회 1997 大韓皮膚科學會誌 Vol.35 No.4

        Background: Laser resurfacing has beneficial effects in the treatment of several skin problems such as acne and chicken pox scars. Recently pulsed erbium YAG laser has been used for skin resurfacing, but not enough is known about the scientific basis of such treatment. Objectiye : The purpose of the study was to assess the macroscopic and microscopie changes after irradiation with the pulsed Er-YAG laser. Methods : We did two tests on guinea pig skin, First, the laser was used to irradiate the skin of a guinea pig with the intensity of 500 mJ, 5 watt until pinpoint bleeding began. Skin biopsies were performed immediately, one, two and four weeks after the irradiation. Second, the laser was used to irradiate the skin of a guinea pig with the intensity of 300mJ(3watt), 500mJ(5watt), 700mJ(7watt) until pinpoint bleeding began, Skin biopsies were examined immediately, one, two and four weeks after the irradiation. Results : 1. Histological changes to the dermis over time after laser irradiation with 500 mJ, 5 watt are as follows: After one week, complete reepithelization and proliferation of the blood vessels within the dermis occured. A reaction of th dermis which consisted of newly formed collagen and was distinguisbed from the lower dermis was also examined. The reaction was rnost active after two weeks and lasted up to four weeks. 2. Histological changes to the dermis over time after laser irradiations with different intensities of 300 mJ(3watt), 500 mJ(5watt), and 700 mJ(7watt) are as follows : In all the cases of laser irradiation with different intensities, edema, neovascularization and fine collagen fiber in the upper dermis were observed. At higher intensities, the dermal reactions were stronger and were sustained for a longer time. Conclusion : Pulsed erbium YAG laser had effects on the epidermis and dermis. Therefore, pulsed erbium YAG laser can be used for skin resurfacing effectively and safely. (Kor J Dermatol 1997;35(4): 851-659)

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        한국의 발톱진균증 환자의 삶의 질에 관한 연구

        조백기,박종갑,김형옥,김성욱,백승철,김진우,김시용,안규중,전재복,오지원,김낙인,이규석,오칠환,김수남,김상태,손숙자,신용우,김동석,이원우,권경술,서대헌,황규왕,이종석,고재경,강원형,정기양,최응호,김기홍,박석돈,강승주,함정희,명기범,김방순,구상완,김병수,원영호,김한욱,송은섭,정병수,노병인,홍창권,박장규,한지윤,김광중,구대원,김종민,김재홍,유희준,양경미 대한의진균학회 1998 대한의진균학회지 Vol.3 No.2

        Background: Onychomycosis, especially toenail onychomycosis has become one of the common fungal infection and has historically been regarded as a cosmetic rather than medical problem by many patients, even by physicians. Recently, however, there are several reports that is a refractory disease which may cause a deleterious effect on patiets quality of life (QOL). Objective: The purpose of this study was to investigate the impact of toenail onychomycosis on QOL in Korea and to assess the chandes of QOL after treatment. Methods: Total 1004 patients with toenail onychomycosis which was confirmed by clinical findings and KOH preparation were were enrolled at 47 dermatologic centers in Korea, and interviewed with standardized QOL questionnaire before and after sytemic antifungal treatment. Responses to the questionnaire were scored by 5-point scale (1∼4) and averaged, and were analyzed for 5 dimensions of emotional impact, social impact, symptorn and functional impact, patients views concerning treatment, and relationship with doctor. Results: 1. Before and after treatment, the most serious impact was emotional dimension showing 1.90 and 1.30 in average score (AS), and social (AS: 1.14 and 0.83) and symptom and functional impact (AS: 1.05 and 0.92) was also affected. 2. In female rather than male, statistically more significant impact on patients QOL was observed in all dimensions. 3. After treatment, 3 of 5 dimensions were improved significantly - emotional dimension (AS : from 1.90 to 1.30), social dimension (AS: from 1.14 to 0.83), patients view concerning treatment (AS: from 1.34 to 1.02). 4. The drgree of patients satisfaction at the therapeutic effect was very high- 62.4% (immediately after treatment) and 65.8% (9 months affer initiation of treatment) of patients answered excellent or good. Conclusion: This study confirms that toenail onychomycosis has significant impact on the overall QOL of patients. Also the effect of antifungal therapy on patients QOL were watisfactory. Therefore, both doctor and patient should pay more attention to the treatment of onychomycosis. [Kor J Med Mycol 3(1): 115∼124]

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