BACKGROUND: The bcl-2 is a newly known oncogene involved in tumorigenisis by blocking apoptosis or programmed cell death. Overexpression of bcl-2 protein has been detected in a variety of human malignancies. However, recent studies of the expression of bcl-2 protein in human melanoma and melanocytic nevus have been controversial. OBJECTIVE: The purpose of this study was to examine whether there are any differences in the expression of bcl-2 protein between melanocytic nevus and rnalignant melanoma. METHODS: Immunohistochemical analysis of bcl-2 protein expression was performed on the formalin-fixed, paraffin-embedded tissue sections of 22 melanocytic nevus and 29 malignant melanomas (20 primary and 9 metastatic) using anti bcl-2 monoclonal antibody with an avidin-biotin peroxidase complex procedure. RESULTS: The results were as follows. 1. The positive rate for bcl-2 protein was observed in 95.4% (21/22) of melanocytic nevus and 95.0% (19/20) of primary malignant melanomas. Therefore, there was no significant difference between the two groups in the positive rate for bcl-2 prtoein. 2. The percentage of stained cells and the staining intensity of bcl-2 protein were significantly increased in melanocytic nevus compared to malignant melanoma (p<0.05). 3. The positive rate for bcl-2 expression of metastatic malignant melanoma [44.4% (4/9)] was significantly decreased compared to that of primary malignant melanoma [95.0%(19/20) ] (p<0. 05). But, there was no significant difference betweeen tumor thickness and histological type of malignant, melanoma in the expression of bcl-2 protein. 4. In melanocytic nevus, immunoreactivity of bcl-2 protein gradually diminished or even disappeared towards the deep dermis. CONCLUSION: the bcl-2 expression was decreased in malignant melanoma compared to melanocytic nevus. It. suggests that the loss of bcl-2 expression may play a significant role in the progression and metastasis of malignant melanoma.
Apoptosis ; Cell Death ; Dermis ; Humans ; Melanoma* ; Neoplasm Metastasis ; Nevus, Pigmented* ; Oncogenes ; Peroxidase

No abstract available.

Cutaneous cholesterol embolism is a disease with severe arterosclercsis of the abdominal aorta in which emboli of cholesterol crystals from atheromatous plaques occlude airterioles. We report a case of cutaneous cholesterol embolism in a 61-year-old man who had livedo reticularis on both his feet for 10 days. Histopathologic findings showed needle-shaped cholesterol clefts viithin the lumina of arterioles. The patient died of myocardial infarction 3 months later.
Acrospiroma ; Aorta, Abdominal ; Arterioles ; Cholesterol* ; Embolism, Cholesterol* ; Foot ; Humans ; Livedo Reticularis ; Middle Aged ; Myocardial Infarction ; Plaque, Atherosclerotic

The pseudolymphoma syndrome that may mimic malignant lymphoma clinically and histopathologically has been described as a hypersensitivity reaction to anticonvulsant drugs. It consists of the triad of a fever, generalized rash and lyrnphadenopathy. In some cases, varying degrees of malaise, hepatosplenornegaly, abnormal liver function tests, arthralgias, eosinophilia and blood dyscriasias may also be present. We report a case of pseudolymphoma syndrome due to carbamazepine in a 47-year-old man. He had a diffuse edematous and erythematous patches, papules and vesicles associated with high fever, hepatosplenomegaly and lymphadenopathy. The histopathologic finding slowed a dense atypical mononuclear cell infiltrate of the upper dermis associated with Pautriers microabscess like structures and severe dermal edema. Laboratory findings revealed leukocytosis and an abnormal liver function test. Three weeks after the withdrawal of carbamazepine and treatment with oral prednisolone, his skin lesion and general condition markedly improved.
Anticonvulsants ; Arthralgia ; Carbamazepine* ; Dermis ; Edema ; Eosinophilia ; Exanthema ; Fever ; Humans ; Hypersensitivity ; Leukocytosis ; Liver Function Tests ; Lymphatic Diseases ; Lymphoma ; Middle Aged ; Prednisolone ; Pseudolymphoma* ; Skin

Penile melanosis is a beniign macular hyperpigmentation of the penile shaft and/or glans. Clinically the lesions are irregular in outline and show variegated pigmentation. The main differential diagnostic problem is with acral levtiginous melanoma. A 28-year-old man was seen with slowly growing, asymptomatic, multifocal, and variegated hyperpigmented maculs on the glans penis of 28-year-duration. The post and family history were non-contributory. Hostogologic examination showed acanthosis and basal layer hyperpigrnentation but atypical melanocytes were not seen. Fontana-Masson stain showed increased melanin pigmentation with dendritic elongation of melanocytes in the basal layer of the epidermis. Little is known about the natural history and melnona risk of penile melanosis and we believe that a long-term follow-up is warranted. This patient showed no change during the follow-up period of 2 years and we will continue to monitor him long-term.
Adult ; Epidermis ; Follow-Up Studies ; Humans ; Hyperpigmentation ; Male ; Melanins ; Melanocytes ; Melanoma ; Melanosis* ; Natural History ; Penis ; Pigmentation ; Vitiligo

Woringer-Kolopp(W-K) disease is a rare, localized, histologically malignant, but clinically indolent lymphoproliferative disorder. It usually shows only a single slowly enlarging skin lesion mainly on the extremities. Some authors have regarded W-K disease as a variant of mycosis fungoides. However, recent studies suggest that W-K disease may represent a spectrum of T cell lymphoproliferative disoreers that may not be related to mycosis fungoides. We report a case of Woringer-Kolopp disease in a 60-year-old male who presented with a solitary slowly growing tumor on his left palm for 3 years. Histopathologic examination showed marked acanthosis and pagetoid infiltration confined to the epidermis. He was treated with 4,000 red electron beam irradiation to the area with complete resolution of the lesion. Three years later, a similar lesion appeared on his left foot dorsum. He was treated as previously with a good response and there has been no new lesion during the last 1 year follow up period.
Epidermis ; Extremities ; Follow-Up Studies ; Foot ; Humans ; Lymphoproliferative Disorders ; Male ; Middle Aged ; Mycosis Fungoides ; Pagetoid Reticulosis* ; Skin

PURPOSE: As Korea has been rapidly transformed to be a multicultural society, it becomes essential for nurses to develop cultural competency. The purpose of this descriptive study was to assess the cultural competency level of general hospital nurses and to examine its contributing factors adopting ecological model. METHOD: A convenience sample of 327 nurses from six general hospitals in Seoul metropolitan area was recruited between November 14 to 28, 2011. Cultural competency was measured using the Korean version of the Caffrey Cultural Competence in Healthcare Scale (CCCHS) and Cultural Competence Assessment(CCA). Hierarchical multiple regression analysis was performed to assess the influence of intrapersonal, cultural-experience, and organizational factors on cultural competency. RESULTS: Mean cultural competency in this study was 2.57(+/-0.43). Cultural competency was associated with job position (p=.044) at the intrapersonal level. At the cultural experience level, foreign language classes experience (p=.005), fluency in a foreign language (p=.000), experience of working with foreign health care professionals (p=.000) were associated cultural competency. At the organizational level, training program (p=.000), job description (p=.002), health education materials (p=.016), insufficient job control (p=.000), and interpersonal conflicts (p=.011) showed significant difference. Foreign language class experience, foreign language fluency, experience of working with foreign health care professionals, and job control were the most consistent predictors of cultural competence and explained 20.4% of the total variance in the proposed ecological model. CONCLUSIONS: The findings suggest that to enhance cultural competency in general hospital nurses, cultural experience and organizational factors need to be more fully considered than intrapersonal factors.
Cultural Competency ; Delivery of Health Care ; Health Education ; Hospitals, General ; Job Description ; Korea

No abstract available.
Mitral Valve* ; Quinidine*

BACKGROUND: Minimal erythema dose(MED), minimal melanogenic dose (MMD) and minimal phototoxic dose(MPD) of UVA-1 in Koreans has not been determined, although MED and MMD of UVB and MPD of UVA-2 in Koreans have been reported. OBJECTIVE: This study was done to measure the MED and MMDs including minimal immediate tanning dose(MITD) and minimal delayed tanning dose(MDTD) of UVA-1 radiation and compare the MPD of UVA-1 with that of UVA-2. METHODS: In this study, a metal halide lamp (SUPUVASUN 3000) and a fluorescent blacklight lamp (Philips TL 20W/09N UVA lamp) were used as the UVA-1 and UVA-2 light sources, respectively. After the determining of Fitzpatrick's skin phototypes, the back skins of young adults were irradiated and the MED, MITD and MDTD of UVA-1 were assessed at 24 hours, 1 hour, and 7 days after irradiation, respectively. The minimal doses of phototoxic reaction, which was induced by oral 8-MOP plus UVA-1 or UVA-2, were assessed visually 72 hours after irradiation. RESULTS: MED,was 61.20+/-11.50J/cm(mean+S.D.). MITD and MDTD of UVA-1 were 48.00+/-8.57J/cm and 65.30+/-12.10J/cm respectively. MPDs of UVA-1 and UVA-2 were 14.88+/-3.88J/cm and 4.40+/-1.69J/cm, respectively. CONCLUSION: In this study, the MED and MMD of UVA-1 radiation and the MPD of UVA-1 and UVA-2 radiation were measured in young adult Koreans. The MITD was less than the MED, and the MDTD was almost the same as the MED. The MPD of UVA-1 was three times higher than that of UVA-2. There vere no significant correlations between the MEDs, MMDs or MPDs and the skin phototypes.
Erythema* ; Humans ; Methoxsalen ; Skin ; Tanning ; Triacetoneamine-N-Oxyl ; Young Adult*

BACKGROUND: Minimal erythema dose(MED), minimal melanogenic dose (MMD) and minimal phototoxic dose(MPD) of UVA-1 in Koreans has not been determined, although MED and MMD of UVB and MPD of UVA-2 in Koreans have been reported. OBJECTIVE: This study was done to measure the MED and MMDs including minimal immediate tanning dose(MITD) and minimal delayed tanning dose(MDTD) of UVA-1 radiation and compare the MPD of UVA-1 with that of UVA-2. METHODS: In this study, a metal halide lamp (SUPUVASUN 3000) and a fluorescent blacklight lamp (Philips TL 20W/09N UVA lamp) were used as the UVA-1 and UVA-2 light sources, respectively. After the determining of Fitzpatrick's skin phototypes, the back skins of young adults were irradiated and the MED, MITD and MDTD of UVA-1 were assessed at 24 hours, 1 hour, and 7 days after irradiation, respectively. The minimal doses of phototoxic reaction, which was induced by oral 8-MOP plus UVA-1 or UVA-2, were assessed visually 72 hours after irradiation. RESULTS: MED,was 61.20+/-11.50J/cm(mean+S.D.). MITD and MDTD of UVA-1 were 48.00+/-8.57J/cm and 65.30+/-12.10J/cm respectively. MPDs of UVA-1 and UVA-2 were 14.88+/-3.88J/cm and 4.40+/-1.69J/cm, respectively. CONCLUSION: In this study, the MED and MMD of UVA-1 radiation and the MPD of UVA-1 and UVA-2 radiation were measured in young adult Koreans. The MITD was less than the MED, and the MDTD was almost the same as the MED. The MPD of UVA-1 was three times higher than that of UVA-2. There vere no significant correlations between the MEDs, MMDs or MPDs and the skin phototypes.
Erythema* ; Humans ; Methoxsalen ; Skin ; Tanning ; Triacetoneamine-N-Oxyl ; Young Adult*