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임한혁,최득린,고은석,이혜경,임철완,이상진,홍현숙,최교창,김영화,박재성 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.2
Purpose : To evaluate the utility of mammography and ultrasonography in study of morphologic differential diagnosis between malignant and benign mass. Materials and Methods : Average age of patients with breast cancer was 48.4 year-old, and that of fibroadenoma was 29.4 year-old. The equipments used for examination were MF-159 high frequency mammography(Bennet Co.) and Acoustic image 5200S. We evaluated mammographic findings about breast parenchymal pattern, calcification, margin and size of the mass associated tumor nature, and ultrasonographic findings about shape, height and width, internal homogenicity and echo pattern, wall contour, boundary echo, and posterior shadow in breast mass. Thirty-seven of mammographic findings and 34 cases of ultrasonogreaphic findings in pathologically proven breast cancer and 34 case of mammographic findings and 71 cases of ultrasonographic findings in breast fibroadenoma were reviewed retrospectively. Results : In mammographic study, the parenchymal patterns of breast cancer according to Wolfe classification were NI(16.2%), PI(24.3%), P@(37.8%), and DY(21.6%) and those in fibroadenoma were NI(3.1%), Pl(11.7%), P2(35.2%),and DY(50%). Mammographic findings about presence of calcification were as follows; only calcification(16.2%), only mass(51.3%), and mass with calcification(32.5%) in breast cancer, and only mass(91.2%), mass with calcification(8.8%) in fibroadenoma. The features of mass margins were classified as ill-defined margin(45.9%), well-defined(5.4%), and well-defined with partial spiculation(48.6%) in breast cancer and ill-defined(20.5%), well-defined(73.5%), and well-defined with partial spiculation(5.8%) in fibroadenoma. The mass were grouped by size; 1-2cm(37.8%), 2-4cm(45.9%), and 4-6cm(16.3%) in breast cancer and 1-2cm(79.4%), 2-4cm(17.6%), and 4-6cm (3.0%) in fibroadenoma. On ultrasonographic study, the shape of masses in breast cancer were lobulated(82.3%),oval(14.7%), and round(3.0%),and those in fibroadenoma were lobulated(14.0%), oval(57.7%), and round(18.3%). The cases that the height was longer than width were 32.3% in breast cancer and 0% in fibroadenoma. The findings about homogenecity and echo patterns were as follows; hypoechoic(52.9%) and mixed(47.1%) in breast cancer and hypoechoic(2.8%), hypoechoic(63.4%), and mixed(33.8%) in fibroadenoma. The margin of masses were smooth in 85.9% of fibroadenoma, and irregular in 73.6% of breast cancer. The boundary echoes of masses and decreased posterior echo shadow were seen only in 61.8% and 55.9% of breast cancer, respectively. Conclusion: The margin and calcifications are more clearly delineated on mammography but breast cancer and fibroadenoma, both are more commonly developed in dense parenchymal pattern(P2+DY),and there findings are easily obscured in mammography. So ultrasoography is very useful in these masses evaluation, especially amoung young patients.
조은득(Eun Deuk Cho),김동섭(Dong Sup Kim),정기화(Ki Hwa Jung) 한국응용약물학회 2001 Biomolecules & Therapeutics(구 응용약물학회지) Vol.9 No.1
N/A The chicken meat has been reported as one of the food causing allergic reactions predominantly to Korean. At present, several in vitro tests for immunoglobulinG (IgG)-mediated as well as IgE-mediated food allergy are available. 13 clinically chicken meat-allergic patients were investigated together with 4control subjects for identification of chicken meat-specific reactivity by ELISA. Also, protein profile and IgE, IgGtotal and IgG4-reacting allergens were detected by means of sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE)and immunoblotting. Chicken meat extracts were prepared as raw, heated, heat and simulated gastric fluid (SGF) treated samples to characterize the stability of allergen to physicochemical treatment. SDS-PAGE revealed 9∼200 kDa bands. And in immunoblotting 7 sera were identified most major bands between 10 and 78 kDa. In case of IgE, six proteins (17, 26, 35, 40, 78 kDa)were predominant in heat-treated extract, and the one (35 kDa) was present in SGF-treated preparations. In case of IgG_(total) and IgG4, most of them showed a pattern simmilar to IgE. There were significant differences (P<0.05) in IgE, IgG_(total), IgG4 Abs to chicken meat between the allergic and control subjects in ELISA. In addition, the concentration of IgG4Abs in the challenge-positive subjects was significantly higher than that of control subjects. It is considered that the specific IgE response to chicken meat was rarely prevalent to Koreans. However, the specific IgG4 response play an important role in the development of allergic symptoms.
Preclinical safety evaluation of hepatic arterial infusion of oncolytic poxvirus
Cho, Euna,Ryu, Eun Jin,Jiang, Fen,Jeon, Ung Bae,Cho, Mong,Kim, Cy Hyun,Kim, Miyoung,Kim, Nam Deuk,Hwang, Tae-Ho Dove Medical Press 2018 Drug design, development and therapy Vol.12 No.-
<P><B>Purpose</B></P><P>Oncolytic poxvirus has shown promise in treating various solid tumors, such as liver cancer, and administration of oncolytic poxvirus via the hepatic artery may provide more survival benefits than other routes of administration. However, there is a lack of safety information to guide the application of hepatic arterial infusion (HAI) of oncolytic poxvirus in human studies. To investigate the acute and chronic toxicity of HAI administration of oncolytic poxvirus in animals and provide safety information for future human studies.</P><P><B>Methods</B></P><P>VV<SUP>tk−</SUP>, a vaccinia poxvirus with inactivated <I>thymidine kinase</I> gene, was administered via HAI to rabbits with normal liver function under angiography (1×10<SUP>8</SUP> or 1×10<SUP>9</SUP> pfu), and rats with N-nitrosomorpholine-induced precancerous liver cirrhosis under open surgery (1×10<SUP>8</SUP> pfu). Body weights and survival were monitored and blood samples were collected for hematological and biochemical tests. Distribution of A56 (a specific marker for poxvirus infection) in rabbit organs was evaluated using immunofluorescence assays.</P><P><B>Results</B></P><P>HAI of high doses of VV<SUP>tk−</SUP> did not cause any acute or chronic changes in body weight, survival or in biochemical, hematological tests in the 2 animal models, and none of the changes showed dose dependency (in rabbit study), or were influenced by liver cirrhosis (in rat study). A56 was not detected in any of the major rabbit organs.</P><P><B>Conclusion</B></P><P>HAI may provide a safe alternative route of oncolytic poxvirus administration for human studies.</P>
( Eun Sun Hong ),( Eun Jung Byun ),( Seok Hoon Moon ),( Jeong Deuk Lee ),( Sang Hyun Cho ),( Hei Sung Kim ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.2
Background: While some studies report a lower incidence of skin cancer in Caucasian vitiligo patients compared to their non-vitiligo controls, skin cancer incidence in Asian vitiligo patients is unknown. Objectives: We sought to quantify the incidence and survival of melanoma and nonmelanoma skin cancer (NMSC) in Korean vitiligo patients and compare it with that of their non-vitiligo controls. Methods: This study extracted all incident vitiligo cases registered between January 2005 and December 2015 from the Korean National Health Insurance, which covers the entire population of more than 50,000,000 people in Korea. Patients were followed up until December 2016 to detect subsequent skin cancer and identify their vital status. A total of 136,954 patients with newly diagnosed vitiligo were included in the study. The incidence and standardized incidence ratios (SIR) of skin cancer in vitiligo patients were measured. We used the age and gender matched multivariable Cox proportional hazards model to examine the risk of skin cancer from UV treatment. A Kaplan-Meier survival plot was drawn to compare the survival of skin cancer patients with and without vitiligo. Results: The incidence of melanoma in vitiligo patients were: overall, 3.57/100,000; male, 4.64/100,000; female, 2.71/100,000. The incidence of NMSC in vitiligo were: overall, 14.85/100,000; male, 16.75/100,000; female, 13.32/100,000. Adjusted for confounders, vitiligo patients had a higher risk of developing melanoma (SIR, 2.67; 95% CI, 1.88-3.79) and NMSC (SIR, 1.42; 95% CI, 1.19-1.68) than those without vitiligo. UV treatment was not a significant risk factor for both melanoma and NMSC. Vitiligo had little effect on skin cancer survival. Conclusion: Unlike in Caucasians, the incidence of skin cancer was increased in the Korean vitiligo population compared to their non-vitiligo controls. We feel that the difference is largely attributable to one’s skin tone. It is noteworthy that even with the increased risk, the skin cancer incidence in Korean vitiligo patients is lower than that of Caucasian vitiligo patients. With ethnic difference in susceptibility to skin cancer, skin cancer surveillance in the vitiligo population should be adjusted to race.
Mycobacterium marinum infection with sporotrichoid spread following acupuncture therapy
( Eun Sun Hong ),( Jeong Deuk Lee ),( Hei Sung Kim ),( Sang Hyun Cho ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1
A 53-year-old woman presented with painful, multiple, erythematous nodules and crusts on the Rt. forearm. She washed dishes in a restaurant and usually didn’t use gloves during work. She had a history of acupuncture therapy on the Rt. hand one month before the lesions appeared. The lesions were present on the site of acupuncture and continued to progress for 6 months. On clinical examination, erythemaotus papulonodules spanned from the patient’s Rt. hand to Rt. forearm in a sporotrichoid pattern. Skin biopsy showed dermal granulomatous inflammation with multinucleate giant cells although AFB stain, mycobacterial culture were negative. Real time PCR of the lesion identified Mycobacterium marinum and therefore, a diagnosis of M.marinum infection was made. M. marinum is a water-borne pathogen common in both fresh and saltwater fish. Infection typically occurs on the upper limbs several weeks after injury in aquatic environments or after handling fish. Although lesions are initially few in number, a linear distribution of papules or nodules along lymphatic channels resembling sporotrichosis can occur. Since AFB smear is not very specific and culture takes several weeks to yield results, immunohistochemistry and PCR for mycobacterial 16S rRNA can be helpful for diagnosis. Treatment typically includes single- or double-agent coverage with tetracyclines, clarithromycin, ethambutol or rifampin for at least three to four months.
Multiple eruptive dermatofibroma in a patient under chronic immunosuppressive therapy
( Eun Jung Byun ),( Sang Hyun Cho ),( Hei Sung Kim ),( Jeong Deuk Lee ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1
A 56-year-old woman was referred to our department for multiple papules on the lower limbs which had appeared years earlier. She had been diagnosed with chronic idiopathic thrombocytopenia and was repeatedly treated with prednisolone and danazol for more than 7 years. Clinical examination showed seven dome-shaped, skin-colored papules randomly dispersed on anterior surface of both legs. A biopsy specimen of a lesion showed a well-circumscribed proliferation of fibrohistiocytic spindle-shaped cells interspersed among thick collagen bundles. The patient was diagnosed with multiple eruptive dermatofibroma (MEDF). The definition of MEDF is the presence of five to eight dermatofibromas developing in less than a 4-month period. It is reported that the incidence of MEDF is higher in patients under immunosuppression. However, the number lesions is not related to the degree of immunosuppression. One review article declared that MEDF is associated with various immunodeficiency states such as systemic lupus erythematous, dermatomyositis, Sjogren’s disease, HIV infections, pemphigus vulgaris, ulcerative colitis, sarcoidosis, acute and chronic myeloid leukemia, and kidney transplantation. Herein, we report a rare case of MEDF in a patient with chronic idiopathic thrombocytopenia.
Successful treatment of a case of lichen amyloidosis with oral alitretinoin
( Eun Jung Byun ),( Sang Hyun Cho ),( Jeong Deuk Lee ),( Hei Sung Kim ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1
Lichen amyloidosis (LA) is a chronic pruritic skin disorder characterized by amyloid deposits in the papillary dermis. No standard treatment has been established. Several treatment options such as topical corticosteroids, topical vitamin A, dermabrasion or ablative CO<sub>2</sub> laser have been reported. Several reports also describe good responses to treatment with oral retinoids. A 79-year-old man presented with pruritic papules on the lower legs. His skin was notably dry. Histologic examination showed amyloid deposition in the dermal papillae and the patient was subsequently diagnosed with LA. We decided to use oral alitretinoin (9-cis-retinoid acid). It is a retinoid receptor pan-agonist with the capacity to bind all six known retinoid receptors. In contrast to isotretinoin or acitretin, it exerts strong anti-inflammatory and immune-modulatory effects without suppressing the activity of the sebaceous glands too much. Daily administration of oral alitretinoin 30 mg dramatically improved the pruritus and the hyperkeratotic papules after a month. The disease further, improved after tapering the dosage to 10 mg/day for 5 months. Herein, we report a case of LA successfully treated with alitretinoin.
( Eun Jung Byun ),( Sang Hyun Cho ),( Jeong Deuk Lee ),( Hei Sung Kim ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.2
Background: Vitamin D deficiency is not only a problem to the older population but is also an important health concern among younger generations. Objectives: The objectives of this study was to determine the prevalence of suboptimal vitamin D status in Korean children and to assess its relationship with atopic dermatitis and asthma. Methods: A cross-sectional study was performed using data from 2515 individuals aged 10-18 years who participated in the Korean National Health and Nutrition Examination Survey from 2008-2011. Results: Overall, 73.3% of subjects were vitamin D deficient (25(OH)D<20 ng/ml) and 24.4% vitamin D insufficient (25(OH)D, 20-29.9 ng/ml). Older age (p<0.001), female gender (p<0.001), urban residence (p=0.019), higher body mass index (p=0.003) and winter months (November-March) (compared to summer months (April-October); p<0.001) were independently associated with low serum 25(OH)D levels. Conclusion: After adjusting for potential cofounders, serum 25(OH)D status had no association with atopic dermatitis or asthma. Vitamin D deficiency is highly prevalent in Korean children which should be a matter of public health concern. Our results provide epidemiologic evidence against the association of vitamin D status with atopic dermatitis and asthma in this population sample of Asian children.
[P415] Klippel-Trenaunay syndrome
( Eun Sun Hong ),( Sang Hyun Cho ),( Jeong Deuk Lee ),( Hei Sung Kim ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1
A 17-year-old woman presented with asymptomatic, multiple, purpuric to dark-blue nodules and masses lined from the right lower back to right knee since childhood. Laboratory analyses showed anemia with hemoglobin 7.9 g/dl, hematocrit 26.8 %. Upper and lower gastrointestinal endoscopy and meckel scan showed no abnormality. Abdomen-pelvis CT showed extensive unilateral soft tissue masses with several macrocalcifications, with venous malformations in the lesion. Histopathologic finding from the lesion showed increased number of vessels and red blood cells. Based on the clinicopathological features, a diagnosis of klippel-trenaunay syndrome was made. Klippel-Trenaunay syndrome is characterized by triad of features, which are cutaneous capillary malformations, soft tissue or bony hypertrophy, and varicose veins or venous malformations. The etiology remains obscure and unresolved. It can be diagnosed on the basis of any two of three features, where echo/doppler and duplex scanning with MRI are the most efficacious methods. The patients need to be treated on the basis of individual presentation. Pulse dye laser has been used with excellent clinical effectiveness in the treatment of capillary malformation. Elevation, elastic compression stockings, or intermittent pneumatic compression pumps are frequently used edema. The syndrome is a lifelong condition. Prognosis is dependent on severity of the malformations and associated anomalies.