The Origin, Principles of Intense Pulsed Light and Its Proper Application in Clinical Practice / 대한피부과학회지

Intense pulsed light (IPL) is a high-intensity polychromatic incoherent light of a determined wavelength spectrum, fluence, and pulse duration. Clinicians can combine these variable factors of IPL for the purpose of selective destruction of target chromophores. Due to these properties, IPL has been widely used for numerous indications including hair removal and treatment of vascular or pigmented lesions. For skilled and experienced clinicians, IPL is a great treatment modality; however it can be a source of serious adverse effects when performed by untrained clinicians. Thus, to promote the proper and safe use of IPL, we summarized the origin, history, basic principles, and clinical application of IPL and discussed qualification factors needed for clinicians who use IPL.

Shortage of public healthcare personnel, is it a problem of number of doctors?

In 2012, the Korean government and various civic groups are insisting to increase in the number of Korean medical graduates by 20% to 100% because of the shortage of public healthcare doctors. However, we have to think of the real point of what makes the pulic heathcare system. In fact, Korea is the country with the least public spending on health care within the Organization for Economic Cooperation and Development. Moreover, the problem with Korean public healthcare are many and profound; regional disparity of medical personnel including doctors and nurses, out-rageously low spending on the public healthcare sector, wrong allocation of public health doctors in lieu of compulsory military service, and no coordination between the public and private health care sector, which thus indicate a very complicated problem with numerous variables. The proper way to solve this problem would be to understand these variables and act accordingly.

The Use of Medical Devices for Medical Skin Care and the Legal Issues / 대한피부과학회지

BACKGROUND: Medical skin care is essential for the treatment of skin diseases all over the world. Medical skin care is also part of medical practice and this must be differentiated from the simple skin care that is given for normal healthy skin. OBJECTIVE: We wanted to discuss medical skin care and the related medical devices and legal issues. METHODS: We reviewed the related laws and regulations, we consulted experts and associations and we analyzed the result of the survey. RESULTS: Legally, medical skin care and simple skin care are well classified. However, many illegal procedures are still performed by non-medical personnel and many adverse effects have been reported as a result. Furthermore, there are no legal restrictions for the performer based on the grade of each medical skin care procedure. CONCLUSION: For the best results and safe procedures, medical skin care must be performed by approved medical equipment under the supervision of a physician or medical personnel. Continuous control and guidance by the government is strongly needed.

Partial Unconstitutional Clauses in the Korean Public Sanitation Administration Law / 대한피부과학회지

In 2007, the Public Sanitation Administration Law in Korea was partially amended to subdivide cosmetology into general and skin cosmetology. Thus starting from 2008, a skin cosmetology qualification requirement license was newly created in Korea. Instead of improving the health standards concerning public health, the amendments have exaggerated the monopolistic right of trade of the Korean Central Esthetician's Association with the assistance of the Division of Sanitary Policy in the Korean Ministry for Health. In addition, the amended ordinances stipulate that cosmetologists can analyze skin conditions, hence allowing medical diagnostic procedures by non-medical personnel which has serious health problems causing serious conflict with Korean Medical Law. Legislation precedents from around the world demonstrate that medical supervision by physicians is absolutely necessary with fastidious requisitions in order to safeguard public health. However, in Korea there is a subversive attempt by some esthetician groups to limit the employment of estheticians by medical institutions in order to safeguard their private privileges. The newly amended Public Sanitation Administration Law should be revised in order to preserve the fundamental rights of the people, to enhance public health, and to uphold the well being of the people instead of catering to special interest groups.

Mutations of the NF1 gene in Korean Neurofibromatosis type 1 patients

BACKGROUND: Neurofibromatosis type 1 (NF1) is one of the most common inherited disorders and is characterized by abnormalities in multiple tissues derived from the neural crest. OBJECTIVES: We analyzed the presence of mutations of NF1 gene in unrelated 56 Korean NF-1 patients. METHODS: Mutations were detected by polymerase chain reaction, single strand conformational polymorphism analysis and direct DNA sequencing. RESULTS: We found five different kinds of mutations in the NF1 gene from 5 out of 56 unrelated Korean NF1 patients. Sequence analysis revealed a nucleotide substitution at codon 1276 of exon 22 (CGA to TGA, R1276X), 4 by insertion at codon 1270 of exon 22 (3809 ins TGGA), a base pair deletion at codon 1398 of exon 24 (4192 del G), 4 by deletion at codon 1638 of exon 28 (4914 del CTCT), and a base pair substitution at codon 1947 of exon 31 (CGA to TGA, R1947X). All of these mutations resulted in premature termination of the mutant alleles. CONCLUSION: Results showed that common consequences of NF1 mutations are introduction of a premature stop codon, and these mutant genes may encode truncated forms of neurofibromin.

Risk factors influencing to mortality and recurrence after first cerebral infarction

BACKGROUND: Cerebral infarction is one of the common cause of death in Korea. There are many studies about risk factors of cerebral infarction in the world and Korea, and there are some studies about risk factors of mortality and recurrence after first cerebral infarction in the world, but there are no reliable epidemiologic studies about risk factors of mortality and recurrence after first cerebral infarction in Korea. So this study was designed to investigate the risk factors of mortality and recurrence after first cerebral infarction in Korea. METHODS: A cohort of 257 patients with diagnosing first cerebral infarction at our hospital were selected and followed for at least 5 years. 30 days, 1 year, 5 year cumulative mortality and recurrence was calculated. Risk factors classified at the time of first cerebral infarction, and then entered into a Cox proportional harzards model for mortality and for recurrence. RESULTS: The cumulative risk of mortality after first cerebral infarction was 13% at 30days, 21% at 1year, 49% at 5years. The cumulative risk of recurrence after first cerebral infarction was 4% at 30days, 11% at 1year, 24% at 5years. The significant risk factors of mortality after first cerebral infarction were age(> OR =65), heavy alcohol drinking history, heart failure, untreated diabetes mellitus history, untreated hypertension history, high admission Hct(> OR =50%), high admission glucose(> OR =200), atrial fibrillation at admission, under drowsy mental state at admission, embolic infarction type, high admission systolic blood pressure(> OR =160), high admission diastolic blood pressure(> OR =100). The significant risk factors of recurrence were age( OR =200). CONCLUSION: Diabetes mellitus, hypertension, heavy alcohol drinking, cardiovascular disease were important factor of cerebral infarction prognosis on our study. So primary care physicians focus on these factors when treating cerebral infarction patient.

The relationship between alcohol consumption and serum liver enzymes in men

BACKGROUND: It is well known that heavy alcohol consumption may result in various lesions on multiple organs and tissue, especially liver. The aim of this study was to measure prevalence of raised liver derived enzymes in healthy men and possible association with alcohol consumption, smoking and body mass index. METHODS: All subjects were 450 men who received Adult Health Examination at Seoul Hospital of Konkuk medical center from May, 1998 to October, 1998. We carried out telephone survey and analyzed 360 men, excluding men with HBs Ag(+), hepatic problems within 6 months, medication drug that could change serum activity of hepatic enzyme or joints, myscles, cardiac problem and non responder to telephone survey. We examined prevalence of raised liver enzymes and its possible association with alcohol consumption, smoking, and body mass index, applying logistic regression analysis. RESULTS: In 20.3% of study subjects, we found raised levels of lver derived enzymes. If the alcohol consumption was higher than 270 g/week, the odds ratio(OR) for raised liver enzymes, adjusted for body mass index and smoking, increased ; serum gamma glutamyltransferase(gamma GTP)(OR: 9.48), serum aspartate aminotransferase(AST)(OR: 13.09), and serum alanine aminotransferase(ALT)(OR: 7.40). Smoking was not associated with the risk of raised liver enzymes and obesity(body mass index 25 kg/m2) showed a positive association with two enzymes; gamma GTP(OR: 1.92) and ALT(OR: 2.08). CONCLUSION: If alcohol consumption was higher than 270 g/week, the risk of raised liver enzymes increased dramatically and gamma GTP, AST were shown more sensitive than ALT in alcoholic liver disease.

Identification of two novel frame shift mutations of the NF1 gene in Korean patients with neurofibromatosis type 1

Neurofibromatos is type 1 (NF1) is one of the most common inherited disorders and is characterized by abnormalities in multiple tissues derived from the neural crest. The NF-1 gene has been cloned and mapped to human chromosome 17q11.2. The NF-1 gene has an open reading frame that predicts a protein consisting of 2,818 amino acids, known as neurofibromin. Here, we report two kinds of novel frame shift mutations of the NF1 gene from 2 out of 56 unrelated Korean NF1 patients. These mutations were detected using polymerase chain reaction and single strand conformational polymorphism analysis. Sequencing analysis revealed four base pair insertion at codon 1270 of exon 22, and a base pair deletion at codon 1398 of exon 24. These mutations resulted in premature termination of the mutant alleles and may encode truncated forms of neurofibromin.

A Study of the Safety and Efficacy of Children's Skin Products / 대한피부과학회지

BACKGROUND: Atopic dermatitis, characterized by dry, flasky, easily irritated skin, is the most common form of dermatitis seen during childhood. Infants with atopic dermatitis and other eczematous conditions need special dermatologic care to hydrate their skin and to minimize contact with irritants or allergens. OBJECTIVE: The purpose of our study is to evaluate the safety and efficacy of the skin products developed for children. METHODS: Twenty-eight normal children and 26 children with atopic dermatitis were evaluated clinically after using following commercal skin products : (lotion, cream, shampoo, soap, face wash wash) for 2 weeks. Water content of the skin of 14 volunteers was measured serialy over 8 haurs at 2 hour intervals after the application of each skin product. The skin pH of 16 volunteers was also measured serialy over 60 minutes at 30 minute intervals after application. We performed visual skin erythema grading, skin erythema grading by dermaspectrometer, transepidermal water loss measurement, skin water content measurement, and keratinocyte morphology observation by D-squame after the application of the skin products to 13 volunteers for 4 days.

Occurrence of Respiratory Atopy in Atopic Dermatitis

BACKGROUND: Respiratory atopy (RA) is frequently associated with atopic dermatitis (AD) and the age of onset is usually later than that of the dermatitis. OBJECTIVE: The aim of this study was to investigate the prevalence, the onset, and the duration of RA associated with AD in Korea. We also tried to correlate the existence of RA with the severity and prognosis of AD. METHODS: One hundred and eighty one patients with AD were studied. Information about the age at onset and the duration of RA were obtained from the medical history of patients or from the medical records. The severity of AD was graded. RESULTS: RA was found in 66 cases of AD (36.5%). The average age at onset of asthma was 6 years and the average duration of asthma was 6 years. The average age at onset of allergic rhinitis (AR) was 12.4 years and the average duration of AR was 6.8 years. The prevalence of asthma with AD was the most common in the age group between 8 and 11 years while the prevalence of AR was the most common in the age group between 20 and 23 years. The higher occurrence of RA in the older age group was considered to represent persistence of AD in-to adult life. We could not find any difference in the severity of AD between pure AD patients and AD patients with RA. CONCLUSION: The prevalence of RA in AD in Korea was considered to be similar to that of other reports. The average onset of asthma in Korea was a little later, whereas the average on-set of AR was a little earlier than that in the other reports. The duration of RA, which has hardly been mentioned in the literature, was considered to be about 6 years in Korea. It is likely that RA is a poor prognostic factor for AD, but does not affect severity of dermatitis.

Ultraviolet B-Induced Apoptosis of Normal Human Melanocytes and G361 Cells

BACKGROUND: Ultraviolet(UV) light is one of the injurious environmental agents which is known to lead to apoptosis of cells. However, studies on UVB-induced apoptosis of melanocytes are still lacking and there are some discrepancies between researchers. OBJECTIVE: Our purpose was to evaluate the characteristics of UVB-induced apoptosis of melanocytes and G361 cells. METHODS: Cultured normal human melanocytes and malignant melanoma cell lines (G361 cells) were analyzed by several detection methods including morphological examination of propidium iodide(PI) stained cells under fluorescence microscopy, quantitation of fragmented DNA, and flow cytometric analysis. RESULTS: Both melanocytes and G361 cells showed similar rate of apoptosis with gradual increment of UVB doses by the quantitation of fragmented DNA. However, flow cytometric analysis using scatter properties and PI stainability revealed that the melanocytes were more resistant to UVB than G361 cells. CONCLUSION: We suggest that melanocytes seem to be more resistant to UVB-induced injury than G361 cells. In addition, various methods for the detection of apoptosis might be necessary for its study. (Ann Dermatol 10:(3) 147152, 1998).

A Statistical Study of Cutaneous Malignant Tumors / 대한피부과학회지

BACKGROUND: There is concem about the rising incidence of skin cancer. However, few articles have reported the change in the clinical and epidemiological aspects of skin cancer. OBJECTIVE: We performed this study in order to clarifiy the recent changes in cutaneous premalignant and malignant lesions. METHODS: A statistical analysis was made using 101 cases of cutaneous premalignant lesions and 205 cases of ma]ignant tumors out of a total number of 20,175 new outpatients that visited the Department of Dermatology at the Seoul National University Hospital during a 6 year period(1990-1995). RESULTS: The frequency of premalignant lesions was 0.50% and that of malignant tumors was 1.02%. The frequency showed an increasing tendency compared to previous reports. In the premalignant lesion cases, actinic keratosis was most common and represented a figure of 82.2%. Among the malignant tumors, basal cell carcinoma was most frequent at 24.4%. Age, sex and anatomical site distribution of basal cell carcinoma, malignant melanoma was no different. The mean age of squamous cell carcinoma was greater than in previous reports and main preceding lesions were actinic keratosis and cheilitis. The frequency of lymphoma was markedly increased but the reason for this remains to be determined. CONCLUSION: Our findings showed the continous increasing incidence of skin cancers and emphasize the need for public eduacation, early diagnosis and proper treatment.

Molecular Analysis of Oculocutaneous Albinism Patients in Korea

BACKGROUND: Oculocutaneous albinism (OCA) is a genetic disorder of the melanin pigment system in which melanin synthesis is reduced or absent in the skin, hair, and eyes. OCA is classified into two major types, and tyrosinase-related OCA can be produced by mutations of the structural gene for tyrosinase enzyme (TYR gene). OBJECTIVE: The purpose of this study was to analyze the segregation of mutant alleles of the TYR gene in tyrosinase-negative and tyrosinase-positive Korean OCA patients and families. METHODS: We amplified exon I, II, and III of the TYR gene of Korean OCA patients and their families by polymerase chain reactions (PCR), and analyzed the mutations by restriction fragment length polymorphism (RFLP) analysis in exon I and single-strand conformation polymorphism (SSCP) analyses in exon II and exon III. RESULTS: Two tyrosinase-negative cases showed mutations in exon I. Four tyrosinase-nega-tive cases and one tyrosinase-positive case showed mutations in exon II, and one tyrosinase-neg- ative case showed mutations in exon III. In summary, we found three kinds of mutation in four tyrosinase-negative OCA patients and one tyrsinase-positive OCA patient. CONCLUSIONS: RFLP and SSCP analysis can provide a basis for a rapid and sensitive screening system to detect TYR gene mutations of Korean OCA patients and their families.

A Case of Malignant Histiocytosis Showing Papulosquamous Skin Lesions and Fever as Initial Manifestations

We report a case of malignant histiocytosis which began with intermittent fever and scaly skin lesions. A 3-year-old girl presented with erythematous scaly papules on the face and the trunk, and high fever for 3 months. The cutaneous lesions consisted of widespread coin-sized erythematous scaly papules with marginal brownish pigmentation. She was anemic and thrombocytopenic and had impairment of the liver function. Histopathologic study of the skin lesions showed non-specfic findings except for hyperkeratosis. However, bone marrow examination revealed an increased number of histiocytes, mostly immature with active phagocytosis of erythroid cells, myeloid cells, and platelets. She was diagnosed as having malignant histiocytosis and treated with cyclophosphamide and vincristine. She died the next day after the treatment had begun.

A Case of Juvenile Chronic Myelogenous Leukemia Presented as Recurrent Erythema Nodosum-Like Lesions

No abstract available.