Primary or metastatic malignant melanoma can mimic benign blue nevus in rare cases, making the diagnosis challenging. Herein, we report an exceptionally rare case of blue nevus-like melanoma and its blue nevus-like metastasis which was detected by catheterized urine cytology. The patient presented with blue-colored papuloplaques on his temple which were diagnosed as blue nevus-like melanoma on punch biopsies. While he was admitted for administration of chemotherapy, hematuria was detected. Catheterized urine cytology revealed singly scattered oval to spindle-shaped pigmented cells with a moderate degree of variation in shape and size. Many of them had small nuclei with indiscernible to inconspicuous nucleoli while only a few cells showed nuclear enlargement and nuclear hyperchromasia, which could be diagnostic pitfalls. Most of the cells on the smear were positive for HMB45 immunostaining, which confirmed the diagnosis of metastatic blue nevus-like melanoma. To the best of our knowledge, the present case is the first report describing cytomorphologic findings of blue nevus-like metastasis of melanoma in the urine specimen.
Biopsy ; Catheters* ; Diagnosis ; Drug Therapy ; Hematuria ; Humans ; Melanoma* ; Neoplasm Metastasis ; Nevus, Blue

BACKGROUND: Compared with other chronic diseases, hearing loss is generally overlooked from the perspective of disease burden. However, hearing loss is emerging as an important issue in the current society. The objective of this study was to investigate disease burdens and marginal utilities associated with hearing loss and other chronic diseases. METHODS: This study analyzed the cross-sectional data of 32,986 participants aged 19 years and older who completed the Korea National Health and Nutrition Examination Surveys between 2009 and 2013. Additionally, this study used the pure tone audiometric test, European Quality of Life-Five Dimensions Questionnaire, and chronic disease status. The data were analyzed using a multiple linear regression method. RESULTS: The data of 23,297 people who underwent a pure tone audiogram and completed the European Quality of Life-Five Dimensions Questionnaire were used in this analysis. The marginal utility of hearing loss ranked fifth among nine chronic diseases. The estimated loss of quality-adjusted life years associated with hearing loss was −93.69 years per 100,000 people, which is similar to other chronic diseases. CONCLUSION: This study assessed the marginal utilities and public burdens of hearing loss and eight chronic diseases in a South Korean population. Although the values may vary depending on country and race, this study may provide an indispensable foundation for more detailed studies on hearing loss.
Chronic Disease* ; Continental Population Groups ; Hearing Loss* ; Hearing* ; Humans ; Korea ; Linear Models ; Methods ; Quality-Adjusted Life Years

The causes of sudden death after medullary infarction involve arrhythmia, central respiratory failure, and dysautonomia. Sudden cardiac arrest in a medullary infarction is uncommon. Most of these cases experienced sudden cardiopulmonary arrest within 2 weeks from stroke onset as the extent of lesion increased. Here, we report two cases of medullary infarction presenting as sudden cardiac arrest. These cases indicate that medullary infarction could be one of the causes of sudden cardiac arrest.
Arrhythmias, Cardiac ; Death, Sudden ; Death, Sudden, Cardiac ; Heart Arrest ; Infarction ; Medulla Oblongata ; Primary Dysautonomias ; Respiratory Insufficiency ; Stroke

BACKGROUND: The differential diagnosis of psoriasis and seborrheic dermatitis can be difficult when both conditions are localized to the scalp without the involvement of other skin sites. OBJECTIVE: We aimed to evaluate the histopathological differences between psoriasis and seborrheic dermatitis on the scalp and identify favorable criteria for their differential diagnosis. METHODS: We evaluated 15 cases of psoriasis and 20 cases of seborrheic dermatitis of the scalp that had been clinicopathologically diagnosed. Skin biopsy sections stained with H&E were examined. Additional immunohistochemistry was performed, including Ki-67, keratin 10, caspase-5, and GLUT-1. RESULTS: On histopathological examination, mounds of parakeratosis with neutrophils, spongiform micropustules of Kogoj, and clubbed and evenly elongated rete ridges were significantly more frequently observed in psoriasis. Follicular plugging, shoulder parakeratosis and prominent lymphocytic exocytosis were significantly more common in seborrheic dermatitis. Moreover, significantly higher mitotic figures were observed in psoriatic lesions than in seborrheic dermatitis. Immunohistochemistry did not show any difference between psoriasis and seborrheic dermatitis. CONCLUSION: Histopathological features favoring psoriasis include mounds of parakeratosis with neutrophils, spongiform micropustules of Kogoj, clubbed and evenly elongated rete ridges, and increased mitotic figures (≥6/high-powered field). Features indicating seborrheic dermatitis are follicular plugging, shoulder parakeratosis and prominent lymphocytic exocytosis. Immunohistochemistry was not helpful in differentiating psoriasis from seborrheic dermatitis.
Biopsy ; Dermatitis, Seborrheic* ; Diagnosis, Differential* ; Exocytosis ; Immunohistochemistry ; Keratin-10 ; Neutrophils ; Parakeratosis ; Psoriasis* ; Scalp* ; Shoulder ; Skin

Fitz-Hugh-Curtis syndrome is an extrapelvic manifestation of PID. It is associated with right upper quadrant pain that likely results from the inflammation of liver capsule and diaphragm. The liver capsule becomes involved with inflammatory exudates that later forms violin string adhesion between two liver capsule and adjacent diaphragm or peritoneum. Previously, Neisseria gonorrhea was thought to be the only etiological agent, but recent studies have reported cases of Fitz-Hugh-Curtis syndrome due to Chlamydia trachomatis infection. 15 to 30 percents of women with PID develop symptom of Fitz-Hugh-Curtis syndrome. It is often mistakenly diagnosed as either pneumonia or acute cholecystitis. Laparoscopy may be the definitive method in diagnosis of Fitz-Hugh-Curtis syndrome. However, we have experienced one cases of Fitz-Hugh-Curtis syndrome, which was diagnosed preoperative by pelvic CT imaging and report with the brief review of the literatures.
Chlamydia trachomatis ; Cholecystitis, Acute ; Diagnosis ; Diaphragm ; Exudates and Transudates ; Female ; Gonorrhea ; Humans ; Inflammation ; Laparoscopy* ; Liver ; Neisseria ; Peritoneum ; Pneumonia

PURPOSE: The purpose of this study was to investigate the effects of emotional labor, emotional intelligence and social support on job stress in clinical nurses. METHODS: Participants were 123 clinical nurses and data were collected from October to December, 2011 and analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients and multiple regression with SPSS 18.0. RESULTS: A positive correlation was found between job stress and emotional labor. Emotional labor showed a significant negative correlation with emotional intelligence and social support, whereas a positive correlation was found between emotional intelligence and social support. The strongest predictor of job stress was emotional labor. In addition, institution satisfaction (dissatisfaction) and the reason for selecting the job (opportunities for service) accounted for 21% of variance in job stress. CONCLUSION: The results of this study suggest that it is important to manage emotional labor as well as to improve job satisfaction in order to reduce job stress in clinical nurses.
Emotional Intelligence ; Job Satisfaction

BACKGROUND: Semantic dementia (SD) is a temporal variant of frontotemporal lobar degeneration (FTLD), which is characterized by naming difficulty, decreased comprehension of words, prosopagnosia and object visual agnosia. We report clinical features, neuropsychological and neuroimaging findings of 4 patients with SD. METHODS: Of 55 patients diagnosed as having FTLD between Jan 1995 and May 2001 at Samsung Medical Center, four patients fulfilled the diagnostic criteria of SD proposed by consensus on FTLD diagnostic criteria. We investigated their clinical features such as presenting symptoms and abnormal behaviors, neuropsychological and neuroimaging findings. Neuropsychological tests included the Seoul Neuropsychological Screening Battery, the Korean-version of Western Aphasia Battery and Hanja reading and writing. All patients underwent brain MRI and FDG-PET. RESULTS: All of the patients showed naming difficulty as a presenting symptom. Language assessments showed severe naming and compre-hension difficulties with preserved fluency and repetition, which were compatible with transcortical sensory aphasia. Whereas Hangul reading aloud and writing were intact, three patients were impaired at Hanja reading and writing. Other neuropsychological tests were remarkable for prosopagnosia, object visual agnosia and memory loss. Brain MRI showed asymmetric temporal atrophies, mainly left antero-inferior temporal cortices. FDG-PET also showed hypome-tabolism in bilateral anterior temporal lobes, more severe on the left. CONCLUSIONS: Our SD patients had characteristic neuropsychological and neuroimaging findings, which can be differentiated from other neurodegenerative diseases. We also found Hanja alexia and agraphia in SD patients, which has not been reported yet.
Agnosia ; Agraphia ; Aphasia ; Aphasia, Wernicke ; Atrophy ; Brain ; Comprehension ; Consensus ; Dyslexia ; Frontotemporal Dementia* ; Frontotemporal Lobar Degeneration ; Humans ; Magnetic Resonance Imaging ; Mass Screening ; Memory Disorders ; Neurodegenerative Diseases ; Neuroimaging* ; Neuropsychological Tests ; Prosopagnosia ; Semantics* ; Seoul ; Temporal Lobe ; Writing

PURPOSE: The purpose of this study was to develop a critical thinking disposition scale for nursing students. METHOD: The developmental process was construction of a conceptual framework, development of preliminary items, verification of content validity, development of secondary items, verification of construct validity and extraction of final items. The conceptual framework and first preliminary 60 items were obtained through a review of relevant literature and the development of critical disposition scales by 10 researchers who had been studying critical thinking for one year. These items were reviewed by five specialists for content validity and finally 55 items were chosen. The data was collected from October 1 to 15, 2004 and was analyzed using factor analysis and Cronbach's alpha with the SPSS program. The subjects were composed of 560 Bachelor of Science nursing students from 8 nursing schools. RESULT: There were 35 final items which were sorted into 8 factors. The factors were identified as 'intellectual integrity(6 items)', 'creativity(4 items)', 'challenge(6 items)', 'open-mindedness(3 items)', 'prudence(4 items)', 'objectivity(4 items)', 'truth seeking(3 items)' and 'inquisitiveness(5 items)'. The cumulative percent of variance was 55.107%. The reliability of the scale, Cronbach's alpha was .892 and the factors' ranged from .562-.836. CONCLUSION: The result of this study could be used for measuring critical thinking dispositions of nursing students. However, for further validity and reliability, repeated research is necessary.
Adult ; Data Collection ; Education, Nursing, Baccalaureate ; Factor Analysis, Statistical ; Female ; Humans ; *Judgment ; Male ; Research Design ; Students, Nursing/*psychology ; *Thinking

BACKGROUND: Neglect dyslexia is a type of neglect syndrome, in which patients with unilateral hemisphere injury omit or misread the contralateral side of a text or the initial letters of a word. Hangul can be arrayed vertically (vertical reading, VR) as well as horizontally (horizontal reading, HR). Thus, HR and VR can be differentially affected in neglect dyslexia. We conducted an experiment in a 66 year-old woman who suffered from neglect dyslexia after a right cerebral infarction. We compared HR with VR in terms of error frequencies and patterns. METHODS: Stimuli for neglect dyslexia consisted of 227 words. The 227 words were written horizontally or vertically (total 554 words) and were pre-sented in random order. The patient was asked to read the words and the examiner recorded the patient's responses and reaction times. RESULTS: The differences in HR and VR were as follows: 1) the error frequency in HR (59.0%) was higher than the error frequency in VR (20.3%), 2) the most frequent error in HR was syllabic deletion (79.1%) whereas phonemic substitution (89.1%) predominated in VR, 3) the error rate was highest at the first syllabic position in HR whereas no position effect was noted in VR. CONCLUSIONS: Patients with neglect dyslexia make less error in VR than in HR. The neural processing of HR may be different from that of VR. VR may be an alternative reading strategy that may be useful during the recovery stage of neglect dyslexia.
Aged ; Cerebral Infarction ; Dyslexia* ; Female ; Humans ; Reaction Time

OBJECTIVES: Vulnerability marker in biological relatives of schizophrenia may be very useful in identifying the propensity for the development of schizophrenia. This study suggests that the relatives at risk for genetically developing schizophrenia have impairments in several domains of cognition, social function and affective function as a vulnerability marker. METHODS: A neurocognitve function test, a social function test and an affective function test were administered to fifteen healthy relatives from families with two or more patients with schizophrenia (geneticallly high risk subjects). Fifteen healthy controls matched for age and gender were recruited in this study. RESULTS: Compared to the control subject, the genetic high risk subjects performed significantly more poorly in the selective attention and recall memory of neurocognitive function. The high risk subjects also had lower scores in independence-performance and independence-competence of the social function test and emotion control of the affective function test. CONCLUSION: Selective attention, recall memory, independence-performance, independence-competence and emotion control ability may be a valuable marker for genetic study of schizophrenia.
Cognition* ; Humans ; Memory ; Schizophrenia*