Various cancer types have been associated with cancer-related cerebral infarction. In this study, we describe the first case of cancer-related cerebral infarction in which the underlying disease was primary bone marrow lymphoma (PBML). A 79-year-old man presented with abruptly developed bilateral lower extremity weakness and confusion. Diffusion-weighted imaging on admission showed multiple cortical and subcortical embolic infarction lesions in multiple vascular territories. Diagnostic evaluations to determine the embolic source revealed no abnormalities. Laboratory testing demonstrated elevated D-dimer (2.59 μg/mL) but no other prothrombotic abnormalities. In suspicion of cancer-related stroke, we performed chest CT, abdomen CT, and FDG-PET to detect the hidden malignancy. Findings revealed no evidence of cancer; however, they did reveal signs of anemia (hemoglobin 9.0 g/dL). Bone marrow aspiration biopsy showed large atypical B cell involvement suggestive of high-grade B cell lymphoma. The patient was diagnosed with primary bone marrow diffuse large B-cell lymphoma initially presenting with ischemic stroke. Our case suggests that primary bone marrow cancer may be a candidate for the differential diagnosis of hidden malignancy in patients with suspected cancer-related stroke. Bone marrow biopsy may be essential for establishing an appropriate differential diagnosis in patients with abnormal hematologic findings.

We report here on a 71-year-old female who had well-demarcated erythematous patches, along with some pearly papules, on the right cheek. Histopathological examination of the lesions revealed a basaloid cell mass, which appeared to be a superficial basal cell carcinoma, and a small keratin-filled cyst that appeared to be a milium. A part of the milium was surrounded by the basaloid cells of tumor islands and milia later developed on the lesion of basal cell carcinoma. We suggest that basal cell carcinoma may be one of the causes of secondary milia.
Aged ; Carcinoma, Basal Cell ; Cheek ; Female ; Humans ; Islands

We present a case of accessory tragus (AT) which developed at an unusual site, the nasal vestibule, of a 1-day-old girl. To our knowledge, this is the first report of an accessory tragus that appears on the nasal vestibule.

Familial cutaneous collagenoma is a rare hereditary disease that is inherited in an autosomal dominant pattern. It is characterized by early onset of multiple, skin-colored, sometimes hypopigmented cutaneous nodules, which initially show a symmetrical arrangement on the trunk, and later on the neck and upper limbs. We report on a case of a 45-year-old female who presented with multiple oval to round hypopigmented papules measuring 5~15 mm on her trunk. Histopathologically, the lesions showed an increased amount of collagen fibers and decreased, fragmented elastic fibers in the dermis. The skin lesions were diagnosed as familial cutaneous collagenoma and no treatment was administered. To the best of our knowledge, our case is the first reported case of familial cutaneous collagenoma (FCC) in the Korean literature.
Collagen ; Dermis ; Elastic Tissue ; Female ; Genetic Diseases, Inborn ; Humans ; Middle Aged ; Neck ; Skin ; Upper Extremity

PURPOSE: The purpose of this study was to determine characteristics of nursing science and identify expected outcomes from baccalaureate graduates, and to develop accreditation standards and criteria reflecting the characteristics of the nursing profession. METHODS: A methodological research design was utilized in this study. Related literature reviews and the nursing education program goals and objectives of the 99 nursing schools in Korea were analyzed. A cross-sectional survey research design was utilized to test the validity of the developed characteristics of the nursing profession and their accreditation criteria and standards. The face validity was from the advisory committee and public committee hearing. RESULTS: The characteristics of nursing science were defined with five concepts including humanity, scientific knowledge, professionalism, therapeutic relationship, and facilitating well-being. The expected outcomes from graduates were identified as providing holistic nursing, critical thinking, establishing professionalism and leadership, construction of a therapeutic relationship, and skilled nursing practice. Finally6 standards and 14 criteria reflecting the unique characteristics of the nursing profession were developed for accreditation. These proposed accreditation standards and criteria are a challenge to promote the quality of nursing science.
Accreditation/organization & administration/*standards ; Cross-Sectional Studies ; Curriculum/standards ; Education, Nursing, Baccalaureate/organization & administration/*standards ; Humans ; Nursing Methodology Research ; Organizational Objectives

BACKGROUND: Photodynamic therapy (PDT) in the treatment of warts is known to be a relatively effective and safe cure. However, the pain, which occurs during being exposed to a light source and after its exposure, is being reported to be the most frequent and serious limitation in this therapy. OBJECTIVE: The purpose of this study is to examine whether the level of pain can be lowered, by comparing EMLA(R), which is a topical anesthesia, with placebo, during topical ALA-PDT, and to try to compare the range and characteristics in pain. METHODS: Twenty two patients with common warts were treated with ALA-PDT twice in the interval of 4 weeks, and were divided into two groups by the random distribution table. The distribution was made so that the patients, who used EMLA(R) as the topical anesthesia given at the first visit, could use a placebo at the second visit, and so that the patients who used placebo at the first visit, could use EMLA(R) at the second visit. Thus, a randomized, double-blind, placebo-controlled crossover study was carried out. The pain was evaluated during the treatment, right after the treatment, and one day after the treatment by using Visual Analogue Scale (VAS). Also four different ranges of the pain and its six characteristics were evaluated. RESULTS: Of the 22 patients with common warts who underwent this study. 1 patient, was completely cured after the first visit, and did not participate further in the study. The data of the patients with complete recovery wasn't included in the final statistical analysis. As a result of the evaluation of pain, the mean VAS score that was measured during the treatment, right after the treatment, and one day after the treatment was measured to be a little lower in the case of applying EMLA(R) versus placebo, but a statistically significant difference was not observed. Regarding the degree of pain, regardless of applying EMLA(R), most patients felt painful locally on the surface, and the majority complained of burning and shooting pain. CONCLUSION: Dermatologists tend to routinely apply EMLA(R), prior to a procedure in order to decrease pain. However, as a result of this research, the routine use of EMLA(R) given at PDT is thought to be unreasonable.
Anesthesia ; Burns ; Cross-Over Studies ; Humans ; Light ; Photochemotherapy ; Triazenes ; Warts

Lichen amyloidosis (LA) is a chronic pruritic skin disorder characterized by the deposition of amyloid in the papillary dermis. A variety of therapeutic regimens for LA have been described. However, many of these have been shown to have limited effect. We report the successful, long-lasting resolution of LA and marked improvement of pruritus in one patient who was treated with the combination of topical corticosteroid and salicylic acid 25% ointment. We suggest this combination therapy as an efficacious treatment for LA.
Amyloid ; Amyloidosis ; Dermis ; Humans ; Lichens ; Pruritus ; Salicylic Acid ; Skin

BACKGROUND: Topical and systemic drugs have been successfully used in the treatment of acne. However, many people are concerned about the side effects of these medicines, especially the childbearing women. Recent reports demonstrated that sequential treatment with laser- and light-based devices lead to a clinical improvement in acne. Recently, we witnessed experienced a case of improvement of inflammatory acne lesions during the treatment of acne scars using a 1,550-nm non-ablative fractional erbium-glass laser. OBJECTIVE: This study was designed to investigate the efficacy and safety of 1,550-nm non-ablative fractional erbium-glass laser in the treatment of facial inflammatory acne vulgaris. METHODS: 11 patients with facial inflammatory acne vulgaris were recruited. These patients received three treatment sessions at a 3-week interval. Inflammatory lesions were counted before and after treatment. The sebum production was quantified using the Sebumeter(R). We graded the patients' self-assessment and the investigator's global assessment using a five-point scale used by the dermatologist. We also investigated the histological changes after the treatment sessions, and the adverse effects during the study. RESULTS: Treatment with 1,550-nm non-ablative fractional erbium-glass laser was well tolerated, resulting in the reduction of inflammatory lesions by 61% (p<0.05). However, the reduction in sebum production from the baseline was not statistically significant. Histopathologic examination of the inflammatory lesions showed a marked decrease in the dermal inflammatory cell infiltration around the perivascular and periappendageal area and the sebaceous glands became smaller after laser treatments. Side-effects were minimal, and were resolved within a few days. CONCLUSION: 1,550-nm non-ablative fractional erbium-glass laser was safe and effective for the treatment of facial inflammatory acne lesions.
Acne Vulgaris ; Cicatrix ; Female ; Humans ; Sebaceous Glands ; Sebum ; Self-Assessment ; Wit and Humor as Topic

PURPOSE: This study was conducted to investigate whether breast cancer with p53 protein overexpression (p53+) and loss of p16 protein expression (p16-) shows different body size indicator (height, weight, body mass index) associations as compared with breast tumors without p53 protein overexpression and the loss of p16 expression (p53-, p16+). MATERIALS AND METHODS: A hospital based case-control study was conducted among 92 women patients and 122 control subjects. The p53 protein overexpression and loss of p16 protein expression in the tissue sections of patients with breast cancer were determined using immunohistochemistry. RESULTS: A total of 26 tumors (28%) demonstrated p53 overexpression and 35 tumors (46%) showed abnormal p16 expression. The heaviest women had a higher risk with p53- and p16+ breast tumors. The odds ratios (OR) adjusted for age, menopausal status, smoking, and drinking revealed a significant gradient of increasing risk of breast cancer with increasing BMI in p53- and p16+ breast cancer. The adjusted ORs for the highest quintile of BMI was 8.51 with p53+ tumors and 14.2 with p53- tumors, and 55.6 with p16+ tumors and 3.72 with p16- tumors. p53 protein overexpression and the loss of p16 expression did not significantly correlate with nodal status, tumor size, estrogen or progesterone receptor status. CONCLUSION: The study concluded that a strong association between p53-/p16+ tumors and BMI suggests the occurrence of p53-/p16+ tumors is related with obesity as compared to p53-/p16+ tumors.
Body Mass Index* ; Body Size ; Body Weight ; Breast Neoplasms* ; Breast* ; Case-Control Studies ; Drinking ; Estrogens ; Female ; Humans ; Immunohistochemistry ; Obesity ; Odds Ratio ; Receptors, Progesterone ; Smoke ; Smoking

Reactive Perforating Collagenosis (RPC) is a kind of perforating dermatosis, which shows transepidermal elimination of altered collagens. Acquired form is developed in an adult without family history, is favorably developed in scratched region due to pruritic sense. Acquired RPC has been reported to be associated with various systemic disorders, such as diabetes mellitus, liver disease, chronic renal failure, lymphoma, AIDS, hypothyroidism, hyperparathyroidism, and neurodermatitis, accompanied by itching & scratching. We report a case of acquired RPC in a patient with HCV hepatitis who was treated with interferon alpha. Skin lesions showed multiple erythematous centrally umbilicated, crusted papules of variable sizes on the extensor surfaces of both shins.
Adult ; Collagen ; Diabetes Mellitus ; Hepatitis ; Humans ; Hyperparathyroidism ; Hypothyroidism ; Interferon-alpha ; Interferons ; Kidney Failure, Chronic ; Liver Diseases ; Lymphoma ; Neurodermatitis ; Pruritus ; Skin ; Skin Diseases