Long second toe: its nail and skin changes

( Geun-hwi Park ),( Woo-il Kim ),( Min-young Yang ),( Won-ku Lee ),( Tae-wook Kim ),( Sung-min Park ),( Hyun-joo Lee ),( Gun-wook Kim ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.2

Background: Nail can be affected by trauma, infection, and systematic disorders. In particular, the toe nails are exposed to the repeated and cumulative minor traumas, which usually result in thickened, splitted, and discolorated nails. Considering these, it can be inferred that the long second toe can be related to various nail and skin changes by repeated minor traumas such as friction in shoes, but the study or report on this topic hasn’t been done yet. Objectives: The purpose of this study was to introduce various nail and skin changes on long second toe. Methods: We analyzed the kinds of nail/skin changes of 50 patients with long second toe, enrolled at Pusan National University Hospitals (Busan and Yangsan) from 2013 to 2018. Results: There was no significant difference in the incidence of left and right toe and toenail, and 7 (14%) patients presented bilateral distribution. The most common nail change on long second toe was melanonychia (23, 46%), followed by subungual hematoma (15, 30%), onycholysis (2, 4%), subungual hyperkeratosis (2, 4%), onychomadesis (1, 2%), and retronychia (1, 2%). The most common skin change was corn (9, 18%), followed by paronychia (2, 4%). Twenty (20/50, 40%) patients also had other toe or toenail changes. Among them, the most common site was big toe/nail (13, 62%), and the most common change was subungual hematoma (8, 42%). Conclusion: Through this study, the dermatologists can recognize and diagnose the nail and skin changes of long second toe.

기관내 삽관을 위한 Atracurium 의 적정량에 대한 임상적 고찰

이혜원,신정순,장성호,임혜자,김종욱,정형근 대한마취과학회 1990 Korean Journal of Anesthesiology Vol.23 No.6

The usefulness of a nondepolarizing muscle relaxant for endotracheal intubation is limited by its relatively slow onset of neuromuscular block compared to that achieved with succinylcholine. Several attempts have been made to produce a more rapid onset of muscle relaxation for endotracheal intubation. A large dose of nondepoarizing muscle relaxant may produce rapid onset but cauae undesirable side effects and a prolonged duration of neuromuscular block. The authors observed the degree of vocal cord relaxation and intubation condition 2 minutes after administration of atracurium and measured changes in mean arterial blood pressure and heart rate at the time of arrival in the operating room, just before abministration of atracurium, 2minutes after administration, and 5mins after intubation. The 40 of patients in this observation were divided into four groups. Group 1; 10patients, received 0.3 mg/kg of atracurium Group 2; 10patients, received 0.4 mg/kg of atracurium Group 3; 10patients, received 0.5 mg/kg of atracurium Group 4; 10patients, received 0.6 mg/kg of atracurium The results were as follows; 1) There were better intubating conditions in Group 3 and 4 than in Group 1 and 2(p$lt;0.001). 2) Mean arterial blood pressure and heart rate did not change significantly after administration of atracurium in all four groups. From the above results we conclude that 0.5~0.6 mg/kg of atracurium provides satisfactory intubation condition 2 minutes after administration without hemodynamic changes.

조혈모세포이식 환자에서 침습성 진균 감염에 대한 Micafungin의 예방 효과 및 안전성

김시현,이동건,최수미,권재철,박선희,최정현,유진홍,이성은,조병식,김유진,이석,김희제,민창기,조석구,김동욱,이종욱,민우성,박종원 대한감염학회 2010 감염과 화학요법 Vol.42 No.3

Background: Micafungin, a potent inhibitor of 1,3-β-D-glucan synthase, is a novel antifungal agent of the echinocandin class. In vitro study showed that micafungin was effective against Aspergillus species as well as Candida species, but clinical data on the prophylactic efficacy against invasive fungal infections (IFIs) other than candidiasis are still lacking. Materials and Methods: We identified 60 consecutive adult hematopoietic stem cell transplantation (HSCT) recipients who received at least 3 doses of micafungin during neutropenic period. Micafungin was started as an alternative in patients who were intolerant or had adverse events (AEs) to primary prophylactic antifungal agents. We retrospectively reviewed the medical records and analyzed the efficacy and safety of micafungin for prophylaxis against IFIs. Results: The patients either had autologous (n=9) or allogeneic (n=51: 1 syngeneic, 24 sibling, 26 unrelated donor) HSCT. Itraconazole oral solution (n=58) was the most frequently used first line antifungal agent for prophylaxis and was administered for median 11 days. The most frequent cause of switch to micafungin was vomiting (n=42). The duration of neutropenia and micafungin administration was median 13 and 12 days, respectively. A successful outcome was achieved in 45 (75%) patients. Empirical antifungal therapy was initiated in 13 (22%) patients. There were 2 cases (3.3%) of breakthrough fungal infections which comprised a probable invasive pulmonary aspergillosis and a possible invasive fungal sinusitis. There was no case of invasive candidiasis. A total of 53 (88%) patients experienced at least one AE regardless of causality during micafungin administration. The most frequent AEs were hypokalemia, vomiting, diarrhea, and elevated serum aspartate aminotransferase or alanine aminotransferase. Among the aforementioned AEs, only 1 case of diarrhea could be classified as a probable relation with micafungin when causality was assessed. There was no AEs that caused discontinuation of micafungin. Conclusions: Micafungin seems to be a safe and effective agent for prophylaxis of IFIs including aspergillosis as well as candidiasis in HSCT recipients. However, further large, prospective, and randomized comparative studies are warranted for aspergillosis.

조혈모세포이식 환자에서 발생한 Cytomegalovirus 질환의 특징 : 일개 대학변원에서 최근 10년간의 경험

최수미,이동건,박선희,김시현,김유진,민창기,김희제,이석,최정현,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2009 감염과 화학요법 Vol.41 No.1

Background : Studies on cytomegalovirus (CMV) diseases in Korean hematopoietic stem cell transplant (HSCT) recipients are lacking and do not reflect the recent trends of advances and changes. Therefore, we tried to analyze the clinical features of CMV diseases in HSCT recipients over the past 10 years at a tertiary university hospital in Korea. Methods : Retrospective review of medical records was done for all adult HSCT patients who received transplant at the Catholic HSCT Center from January 1998 to January 2008. Results : Forty-four cases (2.2%) of CMV diseases were identified. CMV pneumonia was diagnosed in 17 patients, retinitis in 16 patients, enterocolitis in 7 patients, esophagitis 1 patient, gastritis in 1 patient, duodenitis in 1 patient, and hepatitis in 1 patient. The median onset of symptom was 90 days after transplantation. Late CMV diseases accounted for 47.7%. CMV related death varied from 0 to 58.8% according to the involved organ. CMV retinitis was diagnosed relatively later in the course of transplantation mostly in patients who had chronic graft versus host disease (GVHD). On the contrary, CMV enterocolitis mainly occurred in patients who suffered from acute GVHD. The overall concurrent CMV reactivation was documented to be 63.6%: the concurrent CMV reactivation was observed only in 37.5% of patients with retinitis. Conclusions : We observed some differences in the pattern of CMV disease manifestation according to the involved organ and reconfirmed the fact that CMV pneumonia is the most common and fatal disease in HSCT recipients. Additionally, CMV retinitis was not uncommon in HSCT recipients. Since specific marker does not exist in predicting retinitis, regular ocular examination should be done thoroughly, especially in patients with chronic GVHD.

Analysis of Research Trends in Nitrous Oxide Emissions from Upland in Korea

Sun-Il Lee,Chang-Kyu Lee,Gun-Yeob Kim,Hyo-Suk Gwon,Jong-Sik Lee,Eun-Jung Choi,Joung-Du Shin 한국토양비료학회 2019 한국토양비료학회지 Vol.52 No.4

Global climate change, especially global warming is considered as threat to our future and posterity. Increasing concentrations of greenhouse gas such as carbon dioxide (CO₂), methane (CH₄) and nitrous oxide (N₂O) are the main causes of global warming. The Korean government has set a goal to cut the carbon emissions by 37% based on business-as-usual levels by 2030. According to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change (IPCC), agricultural sector is an important source of greenhouse gas emissions. In this regard, it is common belief that reducing of such emission is of great significance to global climate change. In Korea, upland is one of the main sources of agricultural N₂O emission. In order to analyze domestic research trends related to N₂O emissions in the upland, 53 academic publications from 2009 to September 2019 were critically reviewed. The results were classified according to the research purposes. Reduction technologies of N₂O emission account for approximately 28.3%. N₂O characteristics and assessment for 24.5%, development of N₂O emission factors for 22.6%, and N₂O inventory assessment for 20.8% etc. Biochar, green manure, no tillage, and inhibitor were studied as a means of reducing N₂O release. The optimum technologies to reduce N₂O emission in Korea were discussed and proposed through the previous researches.

Rock Magnetic Approaches Used on Deep-sea Sediments in the Northeastern Equatorial Pacific

Park, Cheong Kee,Lee, Gun Chang The Korean Society of Oceanography 2018 OCEAN SCIENCE JOURNAL Vol.53 No.2

Rock magnetic properties of unconsolidated sediments from the Korea Deep Ocean Study area of the northeastern equatorial Pacific were analyzed to trace the time-dependent variations of sedimentary environments. For upper Pleistocene sediments, light-brown sediments predominate, whereas the lower sediments deposited in the late Pliocene are dark brown. Rock magnetic properties also clearly differ among the two distinct color environments. Values of anhysteretic remanent magnetization and low-field magnetic susceptibility are highly responsive to changes in the color of the sediment. For example, comparatively low values denote a dominance of coarse-grained magnetic minerals as observed in the lower dark-brown layers. With respect to the content of magnetic minerals, coarse magnetic grains are highly concentrated in the darker-colored sediment layers. However, both the magnetic mineral dependent parameter (S ratio) and results of the scanning electron microscope observation indicate that magnetic mineral changes did not occur along the core depth, which means that there was no apparent source change. Without distinctive source changes, the variations in the rock magnetic properties likely reflect a process by which the magnetic grains were primarily transported by enhanced wind and bottom currents and affected by diagenetic dissolution as a function of both the time from burial and the extremely low sedimentation rates after deposition.

냉기 치료에 따른 둔근에서의 피부 및 근육내 온도 변화

정우성,김미정,박시복,이상건,김영호,양길태,장윤희 大韓再活醫學會 1998 Annals of Rehabilitation Medicine Vol.22 No.2

냉기치료후 슬관절강내의 온도변화

백승석,최기섭,박시복,이상건,김영호,양길태,장윤희 大韓再活醫學會 1998 Annals of Rehabilitation Medicine Vol.22 No.2

Salt and pepper appearance of the skin associated with mixed connective tissue disease

( Sang-hyeon Won ),( Woo-il Kim ),( Min-young Yang ),( Won-ku Lee ),( Tae-wook Kim ),( Sung-min Park ),( Hyun-joo Lee ),( Gun-wook Kim ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1

The salt-and-pepper appearance of skin is composed of salt (vitiligo-like depigmentation) and pepper(perifollicular pigmentation). This characteristic feature can be a clinical clue for the diagnosis of systemic sclerosis. Mixed connective tissue disease(MCTD) is a distinct disease entity with mixed features of systemic lupus erythematosus, systemic sclerosis, myositis and rheumatoid arthritis with high titers of antibodies to U1 small nuclear ribonucleoprotein(U1 snRNP). Therefore, MCTD is known to have a wide spectrum of cutaneous manifestations which may be the presenting signs of the disease. However, there are few reports of pigmentary changes in MCTD. A 51-year old woman presented with variably sized hypopigmented macules along with relative hyperpigmentation of the perifollicular areas. She was diagnosed with MCTD by Raynaud’s phenomenon and high titer anti-RNP corresponding to a speckled antinuclear antibody of 1:1280 in Rheumatology clinic. A biopsy specimen showed dermal sclerosis. Pigment loss and melanophages were observed in the papillary dermis. Hypo- and hyperpigmentation were confirmed histologically by S100 and Fontana-Masson stain. To our knowledge, ‘salt and pepper appearance of the skin’ has rarely been reported in MCTD. The diagnosis of MCTD can be challenging due to its diverse characteristics. Therefore, we suggest that MCTD should be regarded as a differential diagnosis in patient with this pigmentary change.

Acral calcified angioleiomyoma: a rare clinicopathologic variant of cutaneous angioleiomyoma

( Kihyuk Shin ),( Woo-il Kim ),( Min-young Yang ),( Won-ku Lee ),( Tae-wook Kim ),( Sung-min Park ),( Hyun-joo Lee ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ),( Gun-wook Ki 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1

Cutaneous angioleiomyomas are benign tumors with vascular smooth muscle differentiation. The tumor usually involves the lower extremity, but acral sites such as toes, fingers, feet, and hands are rarely affected. Leiomyoma of deep soft tissue commonly shows regressive changes including prominent fibrosis, and calcification, however, cutaneous angioleiomyoma rarely manifests these changes. A 61-year-old female presented with subcutaneous nodule on the right heel. The lesion began to develop 3 months ago without history of trauma or infection, and the patient reported no subjective symptom. The lesion was totally excised, and histopathology revealed a well-circumscribed, non-encapsulated tumor composed of interlacing fascicles of spindled cells with elongated blunt-ended nuclei. A major finding was extensive calcifications, which dominated over the cellular component. On immunohistochemical examination, the spindle cells expressed strong immunoreactivity for α -smooth muscle actin. Based on these findings, a diagnosis of acral calcified angioleiomyoma was made. We have described a rare clinicopathologic variant of angioleiomyoma which has a predilection for acral locations and shows extensive calcifications predominating over the tumor itself. To our knowledge, this is the first report of a patient with acral calcified angioleiomyoma in Korean dermatologic literature.