Lentigo maligna, a precancerous tumor arising from abnormal melanocytes, is a chronic, slowly progressive, pigmented lesion with a range of colors from pale tan to black and an irregular shape, The commonest location of lentigo maligna is the face during the sixth and seventh decades of life. Less frequently, the lesion occurs on an extrafacial area such as the hand or lower leg. In the late stage, lentigo maligna transforms into invasive malignant melanoma. A 50-year-old male patient had a well-defined, black pigmented patch on the right sole for 30 years. The histopathologic examination revealed numerous vacuolated melanocytes clusters at the dermo-epidermal junction with invasion of the epidermis. There was no evidence of dermal invasion by atypical melanocytes.
Epidermis ; Hand ; Humans ; Hutchinson's Melanotic Freckle* ; Leg ; Lentigo* ; Male ; Melanocytes ; Melanoma ; Middle Aged ; Triacetoneamine-N-Oxyl

Colonization of mammary cancers by melanocytes with heavy pigmentation of cancer cells by melanin can occur very rarely. It is not certain which mechanism operates to achieve this transfer. However, the melanocytes might inject melanin through their dendritic processes or alternatively, the cancer cells phagocytose the terminal parts of the dendritic processes with subsequent dispersal of the contained melanin contained melanin granules. We report a case of infiltrating ductal carcinoma of breast with melanocyte colonization and pigmentation in a 59-year old female.
Female ; Humans

PURPOSE: The purpose of this study was to describe differences in turnover intention according to work period for new nurses and to explore factors influencing differences in turnover intention.METHODS: A longitudinal survey design was used. A structured questionnaire regarding CC (Clinical competence), MNC (Missed Nursing Care), WE (Work Engagement) and turnover intention was administered twice(at 2 months and 5 months of employment) to 98 new nurses working at a tertiary hospital.RESULTS: The regression model with each of the differences for MNC, WE, and subjective satisfaction with department against differences of turnover intention was statistically significant (F=11.98, p < .001). This model explained 26% of differences in turnover intention (Adj. R²=.26). Especially, differences in WE (β=-.43, p < .001), and differences in MNC (β=.18 p=.044) were identified as factors influencing differences in turnover intention.CONCLUSION: The turnover intention of new nurses decreased between the first 2 months and 5 months and this difference was influenced by WE and MNC. Therefore, it is necessary to provide social and institutional supports such as effective adaptation programs with sufficient periods of time for newly graduated nurses.
Clinical Competence ; Intention ; Longitudinal Studies ; Nursing ; Tertiary Care Centers

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne infectious disease that is caused by the genus phlebovirus in the family Bunyaviridae. The syndrome is characterized by fever, gastrointestinal symptoms, neutropenia, and thrombocytopenia. The number of reported cases and deaths in endemic areas, such as China and Japan, has increased each year. Since the first SFTS patient was identified in 2013, the number of cases have also been increasing every year in South Korea and the disease is posing a great public health concern. The number of patients is increasing and there is a high mortality rate, but there is no established treatment that has proven to be effective. The purpose of this review was to elucidate the various treatment modalities, such as plasma exchange, antiviral agents, e.g. ribavirin, high-dose steroids, and interferon.
Antiviral Agents ; Bunyaviridae ; China ; Communicable Diseases ; Fever* ; Humans ; Interferons ; Japan ; Korea* ; Mortality ; Neutropenia ; Phlebovirus ; Plasma Exchange ; Public Health ; Ribavirin ; Steroids ; Thrombocytopenia*

Extracorporeal membrane oxygenation (ECMO) may be required in patients with corona virus disease-19 (COVID-19) and respiratory failure. Anticoagulation is the standard treatment to prevent complications of ECMO and COVID-19 coagulopathy, however, there is a risk of bleeding. Some patients with retroperitoneal hemorrhage (RPH) have been treated with angiography-embolization. We report on a patient with COVID-19 on ECMO who underwent multiple operations (×5) for recurrent RPH. A 46-year-old man was admitted with COVID-19 pneumonia. ECMO with anticoagulation therapy was initiated. The patient developed RPH, caused by external compression of the inferior vena cava interrupting the ECMO inflow, and surgical hematoma evacuation was performed, with no obvious bleeding focus during the multiple surgeries. Following the patient’s recovery, a follow-up computed tomography scan showed the hematoma had been resolved, but there was a dilemma regarding anticoagulation. Lowering the threshold for surgical treatment, enabled treatment of a patient with serious RPH.

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease in South Korea with clinical features similar to those of scrub typhus. Infected patients with these two diseases usually visited the emergency department (ED) complaining of fever that was not responsive to treatment in a local clinic. Aggressive management of SFTS is required in order to prevent rapid progression and human-to-human transmission, thus rapid and accurate differential diagnosis of the two diseases in the ED is important. We reported three laboratory confirmed cases of SFTS during 2013-2014 in a single center, with fever, skin lesions, and history of outdoor activities in order to help in differential diagnosis between SFTS and scrub typhus in the ED.
Communicable Diseases, Emerging ; Diagnosis, Differential ; Emergency Service, Hospital ; Fever* ; Humans ; Korea ; Scrub Typhus* ; Skin ; Thrombocytopenia*

PURPOSE: Although breast milk is considered the best source of nutrition for infants because of its superiority over powdered milk, there are circumstances when breast milk is unavailable. Committee on Nutrition of the Korean Pediatric Society conducted an investigation into the current status of formula feeding in Korea. METHODS: This investigation was conducted using questionnaires produced by our committee and distributed to mothers of children under the age of two who were using formula feeding at 10 university hospitals and 22 public health centers nationwide between March 1999 to September 1999. A comparative analysis according to location, birth order, mother's occupation, education, housing tenure and normal birth status was performed on all 2696 questionnaires using the chi-square test. RESULTS: Formula feeding was found in 49.4% and formula feeding combined with breast milk were 21.5% of the respondents. The percentage of formula feeding was higher in working mothers who underwent a Cesarean section in metropolitan areas. The inadequacy of breast milk was the most common reason for feeding powdered rnilk followed by the unhealthy condition of the mother and mother's return to work. Of those investigated, 94.9% said that they changed products at each stage as recommended by the manufacturer. Promotions for special formulas were more active in metropolitan areas than other areas, and 57.7M said that they used special formulas based on recornmendations by the doctor and acquaintances(15.5%) or after seeing an advertisement(14.0%). CONCLUSION: This investigation revealed that many rnothers were misinformed concerning formula feeding and pediatricians should provide mothers with education, shedding light on proper feeding methods.
Birth Order ; Cesarean Section ; Child ; Surveys and Questionnaires ; Education ; Feeding Methods ; Female ; Hospitals, University ; Housing ; Humans ; Infant* ; Korea ; Milk ; Milk, Human ; Mothers ; Occupations ; Parturition ; Pregnancy ; Public Health ; Return to Work

PURPOSE: Body mass index(BMI), skinfold thickness and arm circumference are commonly used to evaluate obesity in children. There is a need for new standards of these items on Korean children. We performed this study to provide up-to-date reference percentile values and percentile charts for these three items. METHODS: Standardized measurements of height, weight, skinfold thickness(triceps, subscapular) and arm circumference on a total of 31,188 infants and children from age 1 to 18 years during January to December 1998 were used to calculate percentile values and to develop smoothed percentile charts. RESULTS: The mean BMI increased with age and showed similar values in both sexes, but 95th percentile values were slightly higher for boys than girls. The percentile values of BMI were consistently higher than those reported previously in Korea, particularly for the 95th percetile values. Triceps and subscapular skinfold thickness showed significant increase compared with previous studies and significantly higher for females than males. Arm circumference also showed significant increase compared with the previous studies. It was significantly higher for males than females. BMI was more closely related with arm circumference than skinfold thickness. CONCLUSION: The percentile values and percentile charts of BMI, skinfold thickness and arm circumference will allow pediatricians to evaluate obesity in Korean children.
Arm* ; Body Mass Index* ; Child* ; Female ; Humans ; Infant ; Korea ; Male ; Obesity ; Skinfold Thickness*