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( Seung Hwan Choi ),( Seung Min Ha ),( Dong Yeob Ko ),( Ki Ho Kim ),( Ki Hoon Song ) 대한피부과학회 2014 대한피부과학회 학술발표대회집 Vol.66 No.2
Background: Premalignant lesions has recently continuously increased in Koreans. However, there has been little research into the distribution and incidence of cutaneous premalignant lesions in the south-eastern part of korea Objectives: To analyze recent trends in incidence and clinical patterns of cutaneous premalignant lesions in Busan city and the eastern Gyeongnam province Methods: We reviewed 1,292 cases (3,651 lesions) of cutaneous premalignant lesions that include actinic keratosis (AK) and bowen’s disease (BD) at the Department of Dermatology in Dong-A University Hospital Results: The average annual incidence of cutaneous premalignant lesions among total outpatients was 1.82% and has continuously increased from 0.70% to 4.25% over the last 19 years. The most common cutaneous premalignant lesionwas AK (75.85%), followed by BD (24.15%). The mean age of onset was 68.76 years. A major skin cancer was found in 15.79% of patients with cutaneous premalignant lesions, including SCC (11.54%), BCC (6.09%), and malignant melanoma (0.64%). Additionally, 59.13% of the patients had a single lesion, while 40.87% had multiple lesions. Age, occupation-related exposure to ultraviolet radiation, and a past history of skin cancer were higher in the patients with multiple lesions than single lesion Conclusion: The incidence of cutaneous premalignant lesions has gradually increased in Busan city and the eastern Gyeongnam Province, which was relatively higher than incidence in other areas
최근 15년간 부산 및 동부 경남 지역 주요 피부 악성종양에 관한 임상적 및 통계적 고찰(1996∼2010)
하승민 ( Seung Min Ha ),고동엽 ( Dong Yeob Ko ),전수영 ( Su Young Jeon ),김기호 ( Ki Ho Kim ),송기훈 ( Ki Hoon Song ) 대한피부과학회 2013 大韓皮膚科學會誌 Vol.51 No.3
Background: The incidence of cutaneous malignant tumors, especially basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and malignant melanoma (MM), has continuously increased in Korea. However, there has been little research into the distribution and incidence of malignant skin tumors in the south-eastern part of Korea. Objective: The purpose of this study was to analyze recent trends in incidence and clinical patterns of cutaneous malignant tumors in Busan city and the eastern Gyeongnam Province. Methods: We reviewed 714 cases of cutaneous malignant tumors that include BCC, SCC, and MM from January 1996 to December 2010 at the Department of Dermatology in Dong-A University Hospital. Results: The average annual incidence of cutaneous malignant tumors among the total number of outpatients was 1.18% and has continuously increased from 0.63% to 1.91% over the last 15 years (1996∼2010). In particular, the average annual incidence of BCC and SCC has markedly increased from 0.35% and 0.25% to 0.94% and 0.79%, respectively. The most common cutaneous malignant tumor was BCC (48.32%), followed by SCC (41.18%) and MM (10.50%). The mean age of onset in patients who had been diagnosed with cutaneous malignant tumors was 65.07 years (males: 62.04, females: 67.87). There was a similar incidence between males and females in cutaneous malignant tumors (1:1.08). The most common site of cutaneous malignant tumors was the face (66.25%); the cheek (34.04%) was the most preferential site on the face, followed by the nose (30.23%). Conclusion: The incidence of cutaneous malignant tumors has gradually increased in Busan city and the eastern Gyeongnam Province, which was relatively higher than the incidence in other areas. It was thought to be due to the higher proportion of the elderly than in other areas of the country and skin cancer centers in our hospital. (Korean J Dermatol 2013;51(3):167∼172)
( Dong Yeob Ko ),( Seung Hwan Choi ),( Seung Min Ha ),( Ki Hoon Song ),( Ki Ho Kim ) 대한피부과학회 2013 대한피부과학회 학술발표대회집 Vol.65 No.2
Background: Chronic actinic dermatitis (CAD) is an uncommon eczematous photosensitive disorders. Other dermatological conditions such as allergic contact dermatitis, sometimes precede CAD. It has been suggested that CAD is a type IV hypersensitivity generated by photo-induced endogenous allergens exhibiting. But, the exact pathomechanism is still unclear despite the considerable research. Objectives: The purpose of this study was to determine the pathomechanism among the Th1 and Th2 cells. We evaluated a clinical severity to assess the correlation with various laboratory parameters. Methods: We conducted photopatch/patch testing in 73 CAD patients. Also, we evaluated the total IgE, percentage of eosinophils, and chemokine receptor profiles in the peripheral blood and analyzed correlations between laboratory data and the clinical severity of CAD. Results: Positive patch test and photopatch reactions were observed in 52 and 60 of the 73 tested patients. The total IgE levels and duration of disease were higher in the severe group than other group. The percentage of eosinophils was not significantly difference between mild group and severe group. Expression of Th2 cells significantly increased in parallel with clinical severity but, level of Th1 cells decreased with clinical severity score. Conclusion: The clinical severity seemed to correlate with the duration of disease, total IgE level and expression of Th2 cells. We suggest that Th1/Th2 dysbalance affect the disease severity in CAD.
( Dong Yeob Ko ),( Seung Hwan Choi ),( Seung Min Ha ),( Ki Ho Kim ),( Ki Hoon Song ) 대한피부과학회 2013 대한피부과학회 학술발표대회집 Vol.65 No.2
Background: Methyl aminolaevulinate photodynamic therapy (MAL-PDT) is an effective treatment for nodular basal cell carcinoma (nBCC). Er:YAG ablative fractional laser (AFL) treatment removes the stratum corneum to increase MAL uptake and may improve the efficacy of MAL-PDT. However, There was no studies compared with the efficacy of AFL-assisted MAL-PDT (AFL-PDT) and standard MAL-PDT in treating nBCC in Asians. Objectives: We investigated the efficacy, recurrence rates, cosmetic outcome and safety after AFL-PDT versus MAL-PDT for nBCC. Methods: 34 patients with a total of 37 nBCC lesions (AFL-PDT/MAL-PDT 19/18) randomly received either 1 session of AFL-PDT or 2 sessions of MAL-PDT. AFL therapy was performed with 550-600 μm ablation depth, level 1 coagulation, 22% treatment density, and a single pulse. MAL cream was then applied under occlusion for 3 hours and illuminated by red light-emitting diode light at 37 J/cm2. A second session of MAL-PDT was administered 7 days later. Results: After 3 months, AFL-PDT was significantly more effective (94.7%) than MAL-PDT (66.7%) (P=0.029), and recurrence rate was significantly lower for AFL-PDT (10.5%) than MAL-PDT (36.2%) at 12 months (P=0.037). No significant difference was found between AFL-PDT and MAL-PDT in terms of cosmetic outcomes or safety. Conclusion: We demonstrated that AFL-PDT is an alternative treatment modality in nBCC.
P073 : Increased arsenic level and its impacts on skin cancers in Korean
( Dong Yeob Ko ),( Seung Hwan Choi ),( Seung Min Ha ),( Byoung Gwon Kim ),( Young Seoub Hong ),( Ki Ho Kim ),( Ki Hoon Song ) 대한피부과학회 2013 대한피부과학회 학술발표대회집 Vol.65 No.2
Background: Epidemiological evidence shows an association between arsenic exposure and increased risk of skin cancers. Arsenic is a heavy metal and defiened as a carcinogen. Arsenic induces skin lesions including Bowen`s disease (BD), Basal cell carcinoma (BCC), Squamous cell carcinoma (SCC) and malignant melanoma (MM). However, there is no epidemiologic studies between the exposure of arsenic and increased incidence of skin cancers for association in Korea. Objectives: We investigate to assess the total arsenic concentration using urinary analysis in premalignant skin disease and skin cancers. Methods: A total of 258 (skin cancer = 60, normal controls = 198) were investigated to analysis arsenic concentration in urinary analysis. Patients from this study, consisting of 33 BCC, 14 SCC, 7 MM, 6 patients of other skin cancer. Arsenic levels were analysed with clinical and histopathologic data by using Pearson Chi-Square test. Results: There were no significant differences in the sex, age and duration of disease in each groups. Total arsenic concentration of the urine in skin cancer groups was significantly higher than normal control (P < 0.001). There was no significantly difference in terms of total arsenic level on each skin cancer groups (P = 0.630). Conclusion: Our data shows that increased the exposure of arsenic may influence the induction of skin cancers in Korean population.
( Dong Yeob Ko ),( Ki Ho Kim ),( Ki Hoon Song ) 대한피부과학회 2014 Annals of Dermatology Vol.26 No.3
Background: Few studies have compared the efficacy, cosmetic outcomes, and adverse events between 5-aminolevulinic acid photodynamic therapy (ALA-PDT) and methyl aminolevulinate-PDT (MAL-PDT) for actinic keratoses (AKs) in Asian ethnic populations with dark-skin. Objective: We retrospectively compared the long-term efficacy, recurrence rates, cosmetic outcomes, and safety of ALA-PDT versus MAL-PDT for facial AKs in Koreans. Methods: A total of 222 facial AKs in 58 patients were included in this study. A total of 153 lesions (29 patients) were treated with 5-ALA, and 69 lesions (29 patients) with MAL. ALA and MAL creams were applied for 6 hours and 3 hours, respectively; the lesions were then illuminated with a halogen lamp at 150 J/cm2 for ALA-PDT and a diode lamp at 37 J/cm2 for MAL-PDT. Results: The complete response rates of ALA-PDT and MAL-PDT were 56.9% and 50.7%, respectively, with no significant difference at 12 months after treatment. No significant difference in recurrence rates was observed between the 2 PDT modalities at either 6 or 12 months after treatment. There was no significant difference in the cosmetic outcomes between the 2 treatment modalities at 12 months after PDT. However, ALA-PDT caused significantly more painful than MAL-PDT (p=0.005). The adverse events were mild to moderate, transient, and self-limiting for both modalities. Conclusion: MAL-PDT was similar to ALA-PDT in terms of long-term efficacy, recurrence rates, cosmetic outcomes, and adverse events; however, it was a significantly less painful procedure than ALA-PDT in our study. (Ann Dermatol 26(3) 321∼331, 2014)
( Dong Yeob Ko ),( Seung Hwan Choi ),( Seung Min Ha ),( Ki Ho Kim ),( Ki Hoon Song ) 대한피부과학회 2013 대한피부과학회 학술발표대회집 Vol.65 No.2
Background: Methyl aminolaevulinate photodynamic therapy (MAL-PDT) is an effective treatment for Bowen`s disease (BD) of the lower extremities. Er:YAG ablative fractional laser (AFL) treatment removes the stratum corneum to increase MAL uptake and may improve efficacy. However, no studies have directly compared the efficacy of MAL-PDT with and without AFL therapy in treating BD of the lower extremities in Asians. Objectives: Our aims were to compare the efficacy, recurrence rate, cosmetic outcomes, and safety between Er:YAG AFL-assisted MAL-PDT (AFL-PDT) and standard MAL-PDT. Methods: Twenty-one patients with a total of 58 BD lesions randomly received either 1 session of AFL-PDT or 2 sessions of MAL-PDT in 2 symmetrical areas. AFL therapy was performed with 550-600 μm ablation depth, level 1 coagulation, 22% treatment density, and a single pulse. MAL cream was then applied under occlusion for 3 h and illuminated with a red light-emitting diode light at 37 J/cm2. A second session of MAL-PDT was administered 7 days later. Results: After 3 months, AFL-PDT was significantly more effective (93.8%) than MAL-PDT (73.1%) (P = 0.031), and recurrence rate was significantly lower for AFL-PDT (6.7%) than MAL-PDT (31.6%) at 12 months (P = 0.022). No significant difference was found between AFL-PDT and MAL-PDT in terms of cosmetic outcomes or safety. Conclusion: AFL-PDT showed significantly higher efficacy and lower recurrence rate than did standard MAL-PDT for treating lower extremity BD in an Asian.