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ÇÇºÎ¹Ì¿ë ºÐ¾ß¿¡ ÀÔ¹®ÇÑÁöµµ ÀÌÁ¦ 10³âÀÌ µÇ¾ú½À´Ï´Ù. 10³â µ¿¾È ÇÇºÎ¹Ì¿ë ½ÃÀåÀº ¸¹Àº º¯È°¡ ÀÖ¾ú°í, Àúµµ 10³âµ¿¾È ¸¹Àº ½ÃÇàÂø¿À¸¦ °Þ¾ú½À´Ï´Ù.
¾ÆÁ÷µµ Àú´Â ÀÌ ±æÀ» ¼±ÅÃÇÑ °ÍÀÌ Àß ÇÑ ÀÏÀÎÁö Àǹ®ÀÌ ³²¾Æ ÀÖ½À´Ï´Ù. ÇÏÁö¸¸ °Å²Ù·Î »ý°¢Çϸé ÇÐȸ³ª ¾ÆÄ«µ¥¹Ì¸¦ ÅëÇؼ Áø½É ¾î¸° °ÀǸ¦ ÇØÁֽŠ¿©·¯ °»ç´Ôµé°ú Àú¿Í °°Àº ±æÀ» °É¾î°¡´Â ¿©·¯ µ¿·á ¿øÀå´Ôµé ´öºÐ¿¡ ÀÌ 10³âÀ» ¹öÅß¿Â °ÍÀÌ ¾Æ´Ñ°¡ ½Í½À´Ï´Ù.
ÀÌ Ã¥Àº ¾´ ÀÌÀ¯´Â ¡®Ã¥Àº ±â¾ïÀ» ³²±â±â À§ÇÑ °ÍÀÌ´Ù¡¯¶õ Á¤Á¾¿µ ȸÀå´ÔÀÇ ¸»¾¸¿¡ °ø°¨À» ÇÏ¿© Á¦°¡ °øºÎÇØ¿Ô°í ¹ßÇ¥ÇØ¿Ô´ø ÀÚ·áµéÀ» Á¤¸®ÇÏ°í ±Û·Î ³²±â±â À§ÇØ ½ÃÀÛÇß½À´Ï´Ù.
Àú´Â ÇǺΰú¸¦ Àü°øÇÏÁö ¾Ê¾Ò°í, ´ÜÁö °³¿ø °¡¿¡¼ ·¹ÀÌÀú¸¦ »ç¿ëÇÏ¸é¼ ´ä´äÇÏ°í ±Ã±ÝÇÑ Á¡À» ³í¹®À̳ª Ã¥À» ã¾Æ¼ °øºÎÇÏ°í ¹ßÇ¥ÇÑ °ÍÀ» ÀÌ Ã¥À¸·Î Á¤¸®ÇÑ °ÍÀÔ´Ï´Ù.
µû¶ó¼ Á¦°¡ ¾´ ³»¿ë Áß¿¡´Â ÇмúÀûÀ¸·Î Áõ¸íµÇÁö ¾ÊÀº »ç½ÇÀ̳ª ¡®¿ì¹° ¾È °³±¸¸®¡¯Ã³·³ Àú È¥ÀÚ¸¸ÀÇ »ý°¢¿¡ »ç·ÎÀâÇô¼ ¾´ À߸øµÈ ³»¿ëµµ ÀÖÀ» °Ì´Ï´Ù.
Á¦ Ã¥À» ÀÐÀ¸½Ã¸é¼ À߸øµÈ ³»¿ëÀÌ ÀÖ´Ù¸é ³Ê±×·¯ÀÌ ¿ë¼ÇØÁֽðí, À߸øµÈ ºÎºÐÀ» ¸ÞÀÏ·Î º¸³»Áּż Á¦ ¹«Áö¸¦ ±ú¿ìÃÄ ÁÖ½Ã¸é °¨»çÇÏ°Ú½À´Ï´Ù.
Á¦°¡ ·¹ÀÌÀú °ÀǸ¦ ½ÃÀÛÇÏ°í, Ã¥À» ¾²µµ·Ï ±ÇÀ¯ÇØÁֽŠ´ëÇÑÀÓ»óÇǺΰü¸®ÇÐȸ¿Í ´ëÇÑÀÓ»ó·¹ÀÌÀúÇÐȸ Á¤Á¾¿µ ȸÀå´Ô²² °¨»ç µå¸®¸ç, ¶ÇÇÑ ·¹ÀÌÀú¸¦ °øºÎÇϴµ¥ ¸¹Àº ¿µ°¨À» ÁֽŠ´ëÇÑÀÏÂ÷Áø·áÇÐȸ ·¹ÀÌÀú¾ÆÄ«µ¥¹ÌÀÇ °»ç´ÔµéÀ̽Š¹Úµ¿ÁØ, À̺´ÇÐ, ÀÌ¿í, ÇÑ¿µÈÆ, ȲÁ¦¿Ï ¿øÀå´Ô²² °¨»ç µå¸³´Ï´Ù. ¶ÇÇÑ ÀÌ Ã¥ÀÇ ¸¹Àº ³»¿ë°ú ¾ÆÀ̵ð¾î°¡ ÀÌ ºÐµéÀÇ °ÀÇ¿¡¼ ³ª¿Â °ÍÀÓÀ» ¹àÈü´Ï´Ù.
Á¡Á¡ ¾î·Á¿öÁö´Â °³¿ø °¡¿¡¼ ¹¬¹¬È÷ Áø·á¿¡ ÀÓÇϽô ¿øÀå´Ôµé¿¡°Ô Á¦ Ã¥ÀÌ Á¶±×¸¶ÇÑ È°·ÂÀÌ µÇ¾úÀ¸¸é ÁÁ°Ú½À´Ï´Ù. Çѹø ÈûÂ÷°Ô ¿ÜÃĺ¸°í ½ÃÀÛÇÏ°Ú½À´Ï´Ù.
¾ÆÀÚ¾ÆÀÚ ÈÀÌÆÃ!
2017³â 10¿ù 21ÀÏ ÀÌÀ絿
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PART 01 ·¹ÀÌÀúÀÇ ¿ø¸®
ºû°ú ¹°ÁúÀÇ ¼¼°è ?15
ÀüÀÚ±âÆÄ(Electromagnetic radiation, EMR) ?16
·¹ÀÌÀúÀÇ ¹ß»ý ¿ø¸® ?17
·¹ÀÌÀúÀÇ ±¸¼º ?24
·¹ÀÌÀúÀÇ Æ¯¼º ?29
ÆĶó¹ÌÅÍ(Parameters) ?31
ºöÀÇ Á¾·ù ?33
Á¶»ç¹æ½Ä¿¡ µû¸¥ ºÐ·ù ?35
Å¥½ºÀ§Ä¡·¹ÀÌÀú(Q-switched laser) ?37
ÇǺΠ±¤ÇÐ(Skin optics) ?38
±¤Ä§Åõ±íÀÌ(Optical penetration depth, OPD) ?40
»ê¶õ(Scattering) ?44
½ºÆÌ Å©±â(Spot size) ?46
´Ü»ö¼º(Monochromaticity) ?50
¹ß»ö´Ü(Chromophore) ?50
Èí¼ö°è¼ö(Absorption coefficient) ?51
·¹ÀÌÀú¿Í Á¶Á÷ÀÇ ¹ÝÀÀ(Laser-tissue interaction) ?52
¼±ÅÃÀû ±¤¿ºÐÇØ ÀÌ·Ð(Selective photothermolysis) ?55
¿À̿Ͻð£(Thermal relaxation time, TRT) ?58
Á¶»ç ½Ã°£°ú ¿À̿Ͻð£(Pulse duration vs TRT) ?60
¼±ÅÃÀû ±¤¿ºÐÇØ À̷п¡ ÇÊ¿äÇÑ 3´ë ÆĶó¹ÌÅÍ ?62
ÆĶó¹ÌÅÍÀÇ ÀÇ¹Ì ?63
Clinical end point ?64
Ç¥Çdzð¢(Surface cooling) ?67
·¹ÀÌÀú Ä¡·áÀÇ ¿ø¸® ?69
´çºÎÀÇ ¸» ?70
PART 02 ·¹ÀÌÀúÀÇ Áß¿äÇÑ ÀÌ·Ð
¹ßÀüµÈ ÀÌ·Ð(Advanced theory of selective photothermolysis) 75
¿¿îµ¿ÀÇ ¼±Åüº(Thermal kinetic selectivity, TKS) ?75
È®Àå ÀÌ·Ð(Extended theory of selective photothermolysis) 77
¼¼Æ÷³» ¼±ÅÃÀû ±¤¿ºÐÇØ ÀÌ·Ð
(¼¼Æ÷³» ÀÌ·Ð, Subcellular selective photothermolysis) 79
ÆĶó¹ÌÅÍ(Parameter) °áÁ¤ÀÇ ¾î·Á¿ò ?81
È¿°ú vs ¾ÈÀü? ?82
Èí¼ö°è¼ö(Absorption coefficient) 83
±¤Ä§Åõ±íÀÌ(Optical penetration depth, OPD) ?86
ÈĹæ»ê¶õ(Backscattering) ?87
¿À̿Ͻð£(Thermal relaxation time, TRT) ?89
ÆÄÀå¿¡ µû¸¥ ¿À̿Ͻð£(TRT in wavelength) ?90
ÇǺΠ±¸Á¶¿¡ µû¸¥ ¿À̿Ͻð£(TRT in skin ¡®unit¡¯) ?90
Fluence ?93
Spot size effect ?95
Àü·«(strategy) ?101
±¤¿Àû È¿°ú¿Í ±¤±â°èÀû È¿°ú(Photothermal vs photomechanical effect) ?102
PART 03 ¿°Áõ ÈÄ »ö¼ÒħÂø(PIH)ÀÇ ¿øÀΰú Ä¡·á
PIH in Fitzpatrick¡¯s dermatology in general medicine, 8th edition ?109
¿ªÇÐ ?109
¼±Çà ¿øÀÎ ?110
Çѱ¹Àο¡¼ PIH ¹ß»ýÀ» ¿¹ÃøÇÏ´Â ¹æ¹ý ?111
Áõ»ó ?112
Áø´Ü ?113
°¨º° ?114
¿¹ÈÄ ?114
¿¹ÈÄ ÀÎÀÚ ?114
±âÀü ?115
Ä¡·á ?117
°á·Ð ?120
PART 04 Çѱ¹ÀÎÀÇ ÇÇºÎ¿Í ·¹ÀÌÀúÀÇ Á¾·ù
À¯»öÀÎ(Darker skin)°ú ¹éÀÎÀÇ ÇǺΠÂ÷ÀÌ ?125
¸á¶ó´ÑÀÇ Èí¼öµµ ?127
Ç¥ÇÇÃþÀÇ ³ôÀº ¸á¶ó´Ñ ÇÔ·®(High melanin content) ?128
À¯»öÀÎ(Darker skin)¿¡°Ô¼ ·¹ÀÌÀú Ä¡·áÀÇ ºÎÀÛ¿ëÀ»
ÁÙÀÏ ¼ö ÀÖ´Â ¹æ¹ý ?129
ȯÀÚÀÇ ¼±ÅÃ(Patient selection) ?130
Longer wavelength(Epidermal bypass effect) ?134
Longer pulse duration ?138
Ç¥Çdzð¢(Epidermal cooling) ?139
½ÃÇè Á¶»ç(Test shot), ½Ã¼ú Àü óġ(Preoperative procedure) ?140
ȨÄɾî(Homecare) ? strict sun avoidance, sun protection
and topical bleaching agents ?141
°á·Ð ?142
·¹ÀÌÀúÀÇ Á¾·ù ?143
PART 05 Ç÷°ü ·¹ÀÌÀú
Çì¸ð±Û·ÎºóÀÇ Èí¼ö°î¼± ?147
ÆÄÀå¿¡ µû¸¥ Ç÷°üÄ¡·á ?149
Ç÷°ü·¹ÀÌÀúÀÇ Á¾·ù ?153
Çѱ¹Àο¡¼ Ç÷°ü·¹ÀÌÀúÀÇ ¼±Åà ?155
½ºÆÌ Å©±â(Spot size) ?156
Macropulse ?157
Á¶»ç ½Ã°£(Pulse duration)ÀÇ °áÁ¤ ?160
Á¶Á÷º¯¼º ´Ü°è(Tissue degeneration process) ?162
MetHb ?163
Clot ?166
Increase in blood flow ?167
Pulse sequence ?169
Repeat pulse method ?171
PART 06 »ö¼Ò ·¹ÀÌÀú
À¯»öÀÎ(Darker skin)¿¡°Ô¼ÀÇ »ö¼Òº´º¯ ?175
»ö¼Ò·¹ÀÌÀúÀÇ Á¾·ù ?176
»ö¼Ò Á¦°ÅÀÇ ±âÀü ?177
À§Ä¡¿¡ µû¸¥ »ö¼Ò·¹ÀÌÀúÀÇ Á¾·ù ?181
Çѱ¹ÀÎÀ» À§ÇÑ »ö¼Ò·¹ÀÌÀúÀÇ ¼±Åà ?182
Å¥½ºÀ§Ä¡·¹ÀÌÀúÀÇ ¼±Åà ?184
·ÕÆÞ½º·¹ÀÌÀú¿¡¼ Á¶»ç ½Ã°£ÀÇ ¼±Åà ?185
Ç¥ÇÇ»ö¼Òº´º¯¿¡ ´ëÇÑ Àü·« ?187
ÁøÇÇ»ö¼Òº´º¯¿¡ ´ëÇÑ Àü·« ?189
Á¶Á÷º¯¼º ´Ü°è(Tissue degeneration process) ?191
Repeat pulse method ?192
R20 method ?193
Kono technique ?194
PART 07 Á¦¸ð ·¹ÀÌÀú
·¹ÀÌÀú Á¦¸ðÀÇ °á°ú¿¡ ¿µÇâÀ» ¹ÌÄ¡´Â ¿äÀÎ
(Factors affecting treatment outcome) ?199
·¹ÀÌÀú Á¦¸ðÀÇ ¹ß»ö´Ü°ú ¸ñÇ¥¼¼Æ÷ ?199
¿µ±¸Á¦¸ð ȤÀº ¿µ±¸°¨¸ð(Permanent hair removal or reduction) ?201
Optical window¿Í Á¦¸ð ·¹ÀÌÀúÀÇ Á¾·ù ?203
·ÕÆÞ½º¿£µð¾ß±×·¹ÀÌÀú(Long-pulsed Nd:YAG) ?206
Hair removal in ethnic skin ?207
Çѱ¹Àο¡¼ Á¦¸ð ·¹ÀÌÀúÀÇ ¼±Åà ?209
Á¶»ç ½Ã°£(Pulse duration) ?210
Á¦¸ðÀÇ clinical end point ?211
½ºÆÌ Å©±â¿Í Ç¥Çdzð¢ ?213
°¡½ÃÅÐÁ¤Ã¼Áõ(¸ð¹ß¸ð°ø°¢ÈÁõ, trichostasis spinulosa) ?214
PART 08 ºñ¹ÚÇǼº·¹ÀÌÀú
ÇǺÎÀç»ý¼ú(Skin rejuvenation) ?219
Çѱ¹Àο¡¼ÀÇ ±¤³ëÈ(Photoaging in ethnic skin) ?219
Çѱ¹Àο¡¼ ºñ¹ÚÇǼº ·¹ÀÌÀú(Non-ablative laser in ethnic skin) ?220
Äݶó°Õ ÀçÇÕ¼º(Collagen remodeling) ?221
Äݶó°ÕÀÇ Èí¼ö°î¼± ?223
¹°ÀÇ Èí¼ö°î¼±(Absorption curve of Water) ?224
2 targets of nonablative laser ?225
ºñ¹ÚÇǼº ÇǺÎÀç»ý¼úÀÇ ±âÀü ?226
Çѱ¹Àο¡¼ ºñ¹ÚÇǼº ·¹ÀÌÀúÀÇ ¼±Åà ?226
¿¿¡ ÀÇÇÑ Äݶó°Õ º¯È ?227
¾Æ·¹´Ï¿ì½º °ø½Ä(Arrhenius equation) ?228
ºñ¹ÚÇǼº ÇǺÎÀç»ý¼ú(Nonablative rejuvenation)ÀÇ È¿°ú°¡ ¶³¾îÁö´Â ÀÌÀ¯ ?236
°á·Ð ?237
PART 09 ¹ÚÇǼº ·¹ÀÌÀú¿Í ÇÁ¶ô¼Å³Î ·¹ÀÌÀú
¿øÀû¿Ü¼±(Far-infrared, FIR)¿¡¼ ¹°ÀÇ Èí¼ö°î¼± ?241
¹ÚÇǼº ÇǺÎÀç»ý¼ú(Ablative rejuvenation)ÀÇ ±âÀü ?242
ÀÜ¿© ¿¼Õ»ó(Residual thermal damage, RTD) ?243
Èí¼ö°è¼ö(Absorption coefficient)¿Í ±¤Ä§Åõ±íÀÌ
(optical penetration depth, OPD) ?244
¹°ÀÇ ±âÈ ¿ªÄ¡(Water vaporization threshold) ?245
CO2·¹ÀÌÀú¿¡¼ ¿À̿Ͻð£(TRT in CO2 laser) ?246
¹ÚÇǼº ·¹ÀÌÀú(Ablative lasers)ÀÇ ºñ±³ ?246
CO2·¹ÀÌÀú¿¡¼ ½ºÆÌ Å©±â(Spot size in CO2 laser) ?247
Fluence in CO2 laser ?248
Focusing vs Defocusing ?249
Defocusing methods(Low fluence methods) ?251
ÀúÃâ·Â vs °íÃâ·Â ·¹ÀÌÀú ?252
źÈ(Charring, ½¡, carbon) ?254
Er:YAG laser ?254
Er:YAG laserÀÇ Àå´ÜÁ¡ ?255
Çѱ¹Àο¡¼ ¹ÚÇǼº ·¹ÀÌÀúÀÇ ¼±Åà ?257
Single-pass technique in CO2 laser treatment ?257
Dermo-epidermal sliding effect ?259
Å¥½ºÀ§Ä¡¿£µð¾ß±×·¹ÀÌÀú¸¦ ÀÌ¿ëÇÑ Á¡ Á¦°Å ?260
My protocol of CO2 laser in removal of melanocytic nevus ?261
µ¿¾çÀο¡¼ ÇÁ¶ô¼Å³Î·¹ÀÌÀú(Fractional laser in ethnic skin) ?262
ÇÁ¶ô¼Å³Î·¹ÀÌÀú(Fractional lasers)ÀÇ Á¾·ù ?263
ÇǺÎÀç»ý¼ú(Skin resurfacing or rejuvenation) ?263
Çѱ¹Àο¡¼ ÇÁ¶ô¼Å³Î·¹ÀÌÀúÀÇ ¼±Åà ?266
Parameters in ethnics ?266
PART 10 ±â¹ÌÀÇ ¿øÀΰú Ä¡·á
±â¹Ì¿¡ ´ëÇÑ ±âÁ¸ ¿øÀΰú Ä¡·áÀÇ Á¤¸® ?271
±â¹ÌÀÇ ¹®Á¦Á¡ ?279
±â¹ÌÀÇ Á¶Á÷ÇÐÀû ¼Ò°ß ?281
±â¹ÌÀÇ ¿øÀο¡ ´ëÇÑ ÃÖ±Ù ³í¹® ?282
¹Î°¨ÇÑ ÇǺÎ(Sensitive skin) ?284
ÃßÁ¤µÇ´Â ±â¹ÌÀÇ ¿øÀÎ ?284
Æ®¶ó³Ø»ï»ê(Tranexamic acid) ?286
·¹ÀÌÀú Åä´×(Laser toning) ?287
·¹ÀÌÀú Åä´×ÀÇ ºÎÀÛ¿ë ?290
±â¹Ì¿¡¼ Ç÷°üº´º¯ÀÇ Ä¡·á ?292
»õ·Î¿î Ä¡·á ³í¹® ?293
Á¦³×½Ã½º Å×Å©´Ð(Genesis technique) ?294
Effective therapy ?295
»ö ÀÎ 299
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