켈로이드와 비후성 반흔에서 냉동 외과술 후 스테로이드 병변내 주사의 병용 요법에 관한 임상적 분석

황규광,박혜진,명기범 ( Kyu Kwang Whang,Hae Jin Park,Ki Bum Myung ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.3

Background: Keloids and hypertrophic scars are benign fibrous growths which usually occur in predisposed individuals after trauma. Numerous modalities have been used to treat keloids and hypertrophic scars, but the final results have been so far unsatisfactory. Objective : The purpose of tlis study was to evaluate the effect of the combination of cryosurgery and intralesional corticoster oid for treatment of these scars. Method : Thirty patients, aged 17 to 45 years old, with keloids or hypertrophic scars(mean duration, 6.4 years) were treated using solid CO2 followed by intralesional injection of triamcinolone acetonide(13.3 mg/ml). Two freeze-thaw cycles per lesion were employed. Freezing time was chosen arbitrarily from 7 to 20 sec depending on the characteristics of each scar. Results . The results are summarized as follows. 1. Excellent and good results were achieved in 57% of all subjects on average, 77% of those who were treated more than 3 times, and 48% of those treated less than twice. 2. The keloid of less than 2 years duration showed better results than older ones. 3. No recurrence was seen in 63% of patients, but partial recurrence in 21% of patients and complete recurrence in 10% were observed. Lesions on the trunk showed less improvement(p<0. 05) and were more recurrent than other lesions. 4. There were complications in 9 patients, such as hyperpigmentation(6), hypopigmentation(1), infection(1) and telangiectasia(1). Conclusion : Cryosurgery and intralesional corticosteroid injections produced synergistic advantages. A cornbination of these modalities might be an effective treatment modality in keloids and hypertrophic scars. (Kor J Dermatol 1997;35(3): 450-457)

오타 모반의 임상 양상에 관한 조사 연구

이민재(Min Jae Lee),황규광(Kyu Kwang Whang),명기범(Ki Bum Myung) 대한피부과학회 1995 대한피부과학회지 Vol.33 No.3

Background: Ota's nevus is not an uncommon pigmenta y disorder in Asian people including Koreans. Objective : The purpose of this study was to examine the clinical features of the patients and to determine the existince of any relevance between them. Methods : We arrid out a retrospective study with cialreviews and phone interviews or direct examinatior. for clinical features of the lesions in acesible patients. Results : The peak age of onset was at birth, pubertyed adolescence in decreasing order. The most frequen1,ly involved site was the eyelid, and the type I was the most common. Bluish black color was pie edorninant. The lesions which did not inili the eyelid or the lesions which developed after birtten were more likely to be light brown in cilc(p<0.05). Cpnclusipn : The clrical features of Otas nevus were revwed and analyzed statistically. (Kor J Dermatol 1995;33(3): 430-436)

냉동외과술의 치료효과 극대화를 위한 시술방법 및 적용시간 고찰 - 선택적 냉동용해이론

신나라(Na La Shin),황규광(Kyu Kwang Whang),함정희(Jeong Hee Hahm),명기범(Ki Bum Myung) 대한피부과학회 2001 대한피부과학회지 Vol.39 No.7

N/A Background: Cryosurgery uses freezing temperatures to achieve specific effects on tissues, and this method has been used to treat various skin diseases for the last five decades. The modern cryosurgery is especially effective on the treatment of benign, premalignant and malignant lesions including keloid, hypertrophic scar and pigmented disease such as Ota nevus. The results of cryosurgery depend on such factors as types of cryogen, freezing and thawing time, and numbers of the freezing-thawing cycle. Objective : The purpose of this study is to show differences among groups of disease, sites of treatment and applying methods through comparing freezing and thawing time. And specifying the optimum applying methods for the treatment of each specific disease is studied. Method: To attain the goal of the study, operation records of 224 patients, who received cryosurgical treatment at the Ewha Woman's University Dongdaemoon Hospital, have been analyzed. Results: 1. The numbers of male and female patients of selected group were 74 and 150, respectively, and their ages between 2 and 54 years. Among the group, 42 patients had epidermal pigmentary disease, 77 had dermal pigmentary disease and 105 had scars. 2. Ratios of TT (thawing time) to FT (freezing time) were significantly different among groups of disease (p<0.05). 3. Ratios of TT to FT were significantly different among groups of treatment site (p<0.05). 4. Ratios of TT to FT showed great difference between the group of rolling method applied and one of pressure method applied (p<0.05). Conclusion. The output of this study indicates that the result of the cryosurgery tends to be heavily influenced by the surgical method that is employed. It also proves that the pressure method tends to inflict more severe cryoinjury on the tissues than the rolling method. Each different tissue (Korean J Dermatol 2001;39 (7) 768-774) shows different sensitivity to the cold injury, and the longer the thawing time is, the more cryoinjury of tissues occurs. Therefore, to achieve the maximum therapeutic result while minimizing the undesired effect, adequate surgical method should be selected and applied to each specific disease. This concept is introduced in this study as Theory of Selective Cryolysis .

베커 모반, 반문상 모반 및 선천성 모반세포성 모반에서 냉동외과술의 치료효과에 대한 임상평가

김진형,명기범,황규광 대한피부과학회 2000 大韓皮膚科學會誌 Vol.38 No.3

Background:Cryosurgery for epidermal pigment lesions such as Becker's nevus and nevus spilus could be inexpensive, simple and effective, but has not been published much in detail. Objective:We evaluated the clinical efficacy according to its determinants, complications and recurrence rate of the cryosurgery, and compared with those of pigment laser. Methods:Hard chalk dry ice were applied on the lesions of 17 patients with Becker's nevus, 8 patients with nevus spilus and 6 patients with congenital nevocytic nevus. Two freeze-thaw cycles per lesion were employed, freezing time was chosen arbitarily depending on the characteristics of each lesion. Nineteen patients of the above 31 patients were also treated with PLDL(xenon flashlamp -pumped dye laser: 2.5-3.0J/㎠) or PLTL (Q-Switched alexandrite laser:7.5-8.5J/㎠). Accessible patients were evaluated by direct interview or phone. Results: 1. The clinical efficacy of the cryosurgery was better in nevus spilus than in Becker's nevus or congenital nevocytic nevus. 2. In nevus spilus, the clinical efficacy of the cryosurgery was similar to that of pigment laser, while cryosurgery was more effective than laser surgery in Becker's nevus. 3. The most common complication was transient perilesional hyperpigmentation, which could be removed with chemical peeling or dermabrasion. Conclusion:Cryosurgery for epidermal pigment lesions was an inexpensive, simple and effective procedure. In some cases, cryosurgery showed better results than pigment laser, and its efficacy may be improved by adjunctive laser treatment. The rate of recurrence after cryosurgery was lower than that of laser surgery. Cryosurgery would be recommendable for treating epidermal pigment lesions.

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]