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이갑석 ( Kap Sok Li ),변희진 ( Hee Jin Byun ),이동훈 ( Dong Hun Lee ),원종현 ( Chong Hyun Won ),조소연 ( So Yun Cho ),김범준 ( Beom Joon Kim ),김명남 ( Myueng Nam Kim ) 대한피부과학회 2007 대한피부과학회지 Vol.45 No.9
Pellagra is a chronic wasting disorder characterized by 3 clinical distinct symptoms; dermatitis; dementia; and diarrhea. It results from a marked cellular deficiency of water-soluble vitamin B3, also called niacin. Dermatitis begins as an erythema and shows bilateral symmetrical eruption at cutaneous sites of solar exposure. Herein we report 2 cases of pellagra in chronic alcoholics. (Korean J Dermatol 2007;45(9):956∼958)
Pitfalls in dermoscopy: “A sheep in the wolf`s clothing”
이갑석 ( Kap Sok Li ) 대한피부과학회 2013 대한피부과학회 학술발표대회집 Vol.65 No.2
As a medical student, we always learned that it is of paramount importance not to miss one case of severe disease, even though mis-diagnosing thousands of minor diseases. In other words, motto in medical school is rather “OVER-diagnosis” than “MISS-diagnosis”. We are trained to find a wolf in the sheep`s clothing in the flock of sheep. In the realm of skin cancer, above-mentioned motto is more appealing than any other sub-field of dermatology. Thus, we learned and learned numerous signs suggestive of underlying malignancy. One of the most famous dermoscopic sign for acral melanoma is so-called parallel ridge pattern. In real world, however, doctors usually meet many cases of benign lesion masquerading under parallel ridge pattern. In this educational lecture, first I will try to review the anatomical background of parallel ridge/ furrow pattern, then introduce several benign conditions which show parallel ridge pattern on dermoscopic examination, discuss their clinical implications. In conclusion, I believe that a competent dermatologist should not miss a wolf in the sheep`s clothing, at the same time, not over-diagnose a sheep in the wolf`s clothing.
김동하 ( Dong Ha Kim ),이갑석 ( Kap Sok Li ),서성준 ( Seong Jun Seo ),조선진 ( Sun Jin Jo ),임현우 ( Hyeon Woo Yim ),김철민 ( Churl Min Kim ),김규한 ( Kyu Han Kim ),김도원 ( Do Won Kim ),김문범 ( Moon Bum Kim ),김진우 ( Jin Woo Ki 대한피부과학회 2012 대한피부과학회지 Vol.50 No.3
Background: Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disease with genetic and environmental backgrounds. While the prevalence of AD is increasing, many patients lack accurate information and understanding about AD. Objective: This study was performed to investigate the understanding of AD among Korean AD patients. Methods: We developed a survey instrument to assess patient understanding of AD. Surveys were conducted over a 6-month period (from May 2010 to October 2010) among 415 patients with AD who visited 10 dermatology clinics at a university teaching hospital affiliated with the Korean Atopic Dermatitis Association. Results: We identified points of understanding in Korean AD patients, such as knowledge and attitudes about AD, awareness of AD treatment, reliability of health care providers and information sources, and acting with AD treatment. As the results of this survey, it was confirmed that the patients` understanding of the cause and prognosis of AD was relatively inadequate, and it could be seen that the perception of the negative attitude toward the medical treatment of AD and inconveniences caused by AD was high. However, the results of the survey on the perception about the medical treatment methods of AD showed that they perceived medical doctors` treatment and prescriptions to have the best curative value, and as the criteria for choosing the treatment methods for AD, they chose the curative value rather than safety and cost. With regard to the information source for AD, they evaluated the treatment postscript on the internet sites and reliability of news media more highly than other information sources, and they responded that the main channel through which they obtain information related to AD was the medical doctors` explanations. Conclusion: We conducted the first systematic questionnaire survey to assess the understanding of AD among Korean AD patients. The results of this survey indicate that in the education and promotion on AD patients, additional education with regard to the cause and prognosis of AD is needed, and it is considered that efforts should be made to reduce the negative perception of AD through smooth communication with the medical team. In education and promotion related to AD, treatment postscripts on news media and the internet sites should also be addressed. Ultimately, the patients` self-discipline capabilities should be reinforced through proper education and development of programs related to AD. (Korean J Dermatol 2012;50(3):201~211)
민성욱 ( Seong Uk Min ),이갑석 ( Kap Sok Li ),원종현 ( Chong Hyun Won ),조소연 ( So Yun Cho ),허창훈 ( Chang Hun Huh ),김범준 ( Beom Joon Kim ),김명남 ( Myeung Nam Kim ),김성은 ( Sung Eun Kim ),김찬웅 ( Chan Woong Kim ),박하나 ( H 대한피부과학회 2007 대한피부과학회지 Vol.45 No.11
Background: Ramsay Hunt syndrome (herpes zoster oticus) is characterized by vesicles on the pinna, otalgia, facial nerve palsy and sensorineural hearing loss. It is not such a common dermatological disease like herpes zoster. However, reactivation of the latent varicella zoster virus causes facial palsy and therapeutic onset is one of the prognostic factors in Ramsay Hunt syndrome. Objective: The aim of this study was to elucidate the epidemiology, the clinical characteristics of Ramsay Hunt syndrome and prognosis according to therapeutic ways. Methods: The 84 cases diagnosed as Ramsay Hunt syndrome from January 2000 to July 2007 were assessed in regard to age, sex, clinical characteristics, electromyography (EMG) results, onset of neurological recovery according to medication and onset of rehabilitation therapy by review of medical records. Results: Ramsay Hunt syndrome consisted 4.7% (84 cases of 1787) of total herpes zoster patients. The ratio of male to female patients was 37:47. Frequency was slightly higher in female patients. The mean age was 62±14.7 and the age distribution was in the range of 26∼87 years. The most common clinical appearance was vesicular eruptions and facical nerve palsy including change in nasolabial fold and location of the lip (73.8%), followed by vesicular eruptions and vestibulocochlear symptoms like tinnitus and vertigo (16.7%), facial nerve palsy and vestibulocochlear symptoms appearing together (9.5%). EMG showed abnormal results in 67.9%. More than one kind of abnormality was commonly observed. The most common abnormal EMG result was fibrillation potential (42.2%), followed by positive sharp wave (31.3%), polyphasia (10.8%), high frequency discharge (8.4%), increased insertional activity (4.8%) and fasciculation (2.5%). There was no significant difference in onset of neurological recovery between acyclovir injections and oral famciclovir or valaciclovir treatment. The patients who had received physical therapy a week after the symptoms had developed, had a faster onset of recovery (2.8 week Vs 4.1 week, p<0.05). Conclusion: This study suggests that antiviral agents of a different kind may not affect recovery onset and earlier rehabilitation therapy seems to be effective in neurological recovery in Ramsay Hunt syndrome. (Korean J Dermatol 2007;45(11):1121∼1126)