We herein report a case of transient acrodermatitis enteropathica in a 3-month-old, breast-fed, full-term infant. The patient was presented with a 2-month history of diarrhea and crusted erythema- tous patches on the periorificial area. Similar lesions were seen in his siblings. His serum zinc level and the zinc level in his mother's breast milk were markedly reduced. Diarrhea and skin lesions disappeared promptly with oral zinc supplementation and did not recur when zinc was discontinued after three weeks. Our case indicates that even full-term infants, who feed excl-usively on mothers milk, run a risk of developing zinc deficiency, if the concentration of zinc in the breast milk is very low.
Acrodermatitis* ; Diarrhea ; Humans ; Infant* ; Milk ; Milk, Human ; Mothers ; Siblings ; Skin ; Zinc

Apoptosis plays a role in the pathophysiology of many kinds of diseases and in the response of treatment. Compared to the necrosis, the apoptosis is a genetically controlled and energy-dependent process which removes the unwanted cells from the body; programmed cell death or cell suicide. During the apoptosis, phosphatidylserine is expressed in the cytoplasmic outer membrane in the early phase. Annexin V, an endogenous human protein (MW=35 kD), has an affinity of about 10 (-9) M for the phosphatidylserine exposed on the outer membrane of apoptotic cells. Annexin V can be radiolabeled with 99mTc by HYNIC or EC chelators, which can be used as an radiotracer for the in vivo imaging of apoptosis. In this article, we reviewed the apoptosis, radiolabeling of annexin V, and the experimental and clinical data using annexin V imaging.
Annexin A5 ; Apoptosis* ; Cell Death ; Chelating Agents ; Cytoplasm ; Humans ; Membranes ; Necrosis ; Suicide

PURPOSE: This study aimed to investigate the correlation between the plasma level of N-terminal pro-B-type natriuretic peptide (pro-BNP) and several known risk factors influencing outcomes after Fontan operations, and to assess whether pro-BNP levels can be used as predictive risk factors in Fontan operations. METHODS: Plasma pro-BNP concentrations were measured in 35 patients with complex cardiac anomalies before catheterization. Cardiac catheterization was performed in all subjects. Mean right atrium pressure, mean pulmonary artery pressure (PAP), and ventricular end-diastolic pressure (EDP) were obtained. Cardiac output and pulmonary vascular resistance were calculated by Fick method. RESULTS: Plasma pro-BNP levels exhibited statistically significant positive correlations with mean PAP (r=0.70, P< 0.001), pulmonary vascular resistance (r=0.57, P< 0.001), RVEDP (r=0.63, P< 0.001), LVEDP (r=0.74, P< 0.001), and cardiothoracic ratio (r=0.71, P< 0.001). The area under the ROC curve using pro-BNP level to differentiate risk groups in Fontan operations was high: 0.868 (95 percent CI, 0.712-1.023, P< 0.01). The cutoff value of pro-BNP concentrations for the detection of risk groups in Fontan operations was determined to be 332.4 pg/mL (sensitivity 83.3 percent, specificity 82.7 percent). CONCLUSION: These data suggest that plasma pro-BNP levels may be used as a predictive risk factor in Fontan operations, and as a guide to determine the mode of therapy during follow-up after Fontan operations.
Risk Factors

Constrictive pericarditis represents a rare cause of protein-losing enteropathy in children. Reported is an 11-year-old girl with protein-losing enteropathy (PLE) as the principal manifestations of constrictive pericarditis. After total pericardiectomy, symptoms and signs of PLE disappeared. Doppler echocardiography including tissue Doppler imaging is a useful noninvasive initial diagnostic tool for differential diagnosis of diastolic heart failure.
Child ; Diagnosis, Differential ; Echocardiography, Doppler ; Female ; Heart Failure, Diastolic ; Humans ; Pericardiectomy ; Pericarditis, Constrictive* ; Protein-Losing Enteropathies*

Cavernous hemangioma in the ventricle is extremely rare. One case of cavernous hemangioma in the right lateral ventricle near the foramen of Monro is reported. The patient was a 41-year-old male who had a headache of 1 month duration without any neurological signs. Brain CT and MRI were taken. It was totally removed via anterior transcallosal approach. The authors reviewed the literatures and discussed this extremely rare case.
Adult ; Brain ; Cerebral Ventricles ; Headache ; Hemangioma, Cavernous* ; Humans ; Lateral Ventricles* ; Magnetic Resonance Imaging ; Male

PURPOSE: To evaluate retinal damage following internal limiting membrane (ILM) peeling in macular hole and diabetic macular edema (DME) surgeries. METHODS: Forty-five eyes with macular holes and thirty-five eyes with DME underwent pars plana vitrectomy with ILM peeling. The structures of the ILM were investigated using transmission electron microscopy, and the grades of retinal tissue damage were analyzed. We additionally observed the clinicopathologic association of retinal damage with the development of retinal hemorrhage during ILM peeling and that seen with indocyanine green (ICG) staining. RESULTS: In all specimens, cellular fragments were observed on the retinal side of the ILM in both macular hole and DME patients. The thickness of the ILM in DME significantly increased (3.13+/-1.12 micrometer compared with that in patients with macular holes (2.41+/-0.77 micrometer, p=0.002). The frequency of minute retinal bleeding during ILM peeling was higher in macular hole patients (46.7%) than in those with diabetic macular edema (22.9%m p=0.028). Twenty-two eyes of 45 macular hole patients (48.9%) and 16 eyes of 35 DME patients (45.7%) had relative retinal damage. Overall, ILM performed in eyes which had minute bleeding during the peeling had more retinal damage (62.1%) than did those without hemorrhage (39.2%, p=0.049). ICG staining did not appear to influence retinal damage (p=0.81). CONCLUSIONS: ILM peeling can cause minor, but demonstrable, damage of the adjacent retina.
Eye ; Hemorrhage ; Humans ; Indocyanine Green ; Macular Edema ; Membranes ; Microscopy, Electron, Transmission ; Retina ; Retinal Hemorrhage ; Retinal Perforations ; Retinaldehyde ; Vitrectomy

PURPOSE: This study evaluated the differences of intraocular pressure (IOP), corneal thickness, and corneal endothelial morphology compared with age-matched, healthy control subjects, as well as the correlation according to the duration of diabetes. METHODS: Goldmann applanation tonometry, ultrasound pachymetry, and non-contact specular microscopy were performed in 200 patients with diabetes and 100 control subjects. RESULTS: The diabetic subjects had higher IOP, thicker cornea and less cell density, less hexagonality, and more irregular cell size of corneal endothelium than the controls (P<0.05). Central corneal thickness and coefficient of variation in cell size were higher in diabetes of over 10 years duration than in diabetes of under 10 years duration (P<0.05), while endothelial cell density and percentage of hexagonal cells were lower in the diabetes of over 10 years group (P<0.05). Central corneal thickness was correlated with duration of diabetes but IOP and corneal endothelial morphologic characteristics were not. CONCLUSIONS: Especially, those with a diabetes duration of over 10 years have more corneal morphological abnormalities and a higher IOP than normal subjects. Therefore, any surgical procedures should be performed carefully in the diabetic cornea that is easily damaged by, for example, phacoemulsification.
Cell Count ; Cell Size ; Cornea ; Endothelial Cells ; Endothelium, Corneal* ; Humans ; Intraocular Pressure* ; Manometry ; Microscopy ; Phacoemulsification ; Ultrasonography

Sacroccygeal teratoma(SCT) occurs in every 40,000 births and is the most common tumor in newborns. SCT predominantly develops in females and is almost always located in the gonadal or coccygeal region. Althoug the majority of tumors are usually benign, malignant degeneration is common and the prognosis is generally guraded. Therefore the early prenatal diagnosis and treatment are very important. The authors observed a case of SCT which was diagnosed by ultrasonagrapy at 30 weeks' gestation following IVF-ET procedure. Surgical removal of SCT of newborn was performed successfully following cesarean delivery at 38 weeks' gestation. The authors report this case with a brief review of the literatures.
Female ; Gonads ; Humans ; Infant, Newborn ; Parturition ; Pregnancy ; Prenatal Diagnosis ; Prognosis ; Sacrococcygeal Region ; Teratoma* ; Ultrasonography*

PURPOSE: The purpose of this study was to evaluate the effect of anti-inflammatory mediators like dexamethasone, nordihyroguaratic acid (NDGA), and diclofenac sodium on proliferation of human corneal keratocytes, and to investigate the cellular morphology of keratocyte. METHODS: Human corneal keratocytes were exposed to 0.05, 0.1, 0.3, 0.8, and 1.0 mM concentration of each drug for period of 24, 48, and 72 hours. MTT based colorimetric assay was performed to assess the metabolic activity and inhibition of cellular proliferation. Cellular morphology was evaluated by inverted phase contrast micrograph and electron microscopy. RESULTS: The higher the concentration of inoculated each drugs was, the more the inhibitory effect of human keratocyte proliferation was found (P<0.05). NDGA, over 0.3 mM and diclofenac, more than 0.1 mM had significant more inhibitory effect on keratocyte proliferation compared with dexamethasone within 48 hours of exposure to each drug. With the concentration and exposure time of each drug, human corneal keratocytes were visible more rounded and swollen rather than spindle shape, and detached from the bottom of the dish. The damaged keratocytes had degenerative changes like cellular membrane disruption, microvilli disappearance, enlarged rough surfaced endoplasmic reticulum and mitochondria, vacuole formation and nuclear membrane damage by TEM. CONCLUSIONS: On basis of this study, the anti-inflammatory mediators such as NDGA and diclofenac sodium have less side effects and stronger inhibitory effects of human keratocyte proliferation than dexamethasone.
Cell Proliferation ; Corneal Keratocytes* ; Dexamethasone ; Diclofenac ; Endoplasmic Reticulum ; Humans* ; Membranes ; Microscopy, Electron ; Microvilli ; Mitochondria ; Nuclear Envelope ; Vacuoles

OBJECTIVE: This study was carried out to evaluate the clinicopathologic significance of hepatocyte growth factor (HGF) and c-met expression as well as tumor angiogenesis in endometrial hyperplasia and adenocarcinoma. METHOD: By means of immunohistochemical staining, HGF, c-met expression, and angiogenesis were investigated in total of 49 patients (19 endometrial hyperplasia, 30 endometrial adenocarcinoma). HGF and c-met were identified with specific corresponding antibodies. To evaluate angiogenesis, the microvessels were highlighted by staining their endothelial cells immunohistochemically for anti-CD31. Areas close to the deepest myometrial invasion or those with the highest grade of endometrial hyperplasia and the highest angiogenic intensity were selected. Three fields of 400 magnification were selected for each slide, and the mean microvessel count was obtained. RESULTS: Diffuse staining for HGF was demonstrated in normal, endometrial hyperplasia and endometrial adenocarcinoma tissue in 45.5, 52.6 and 63.3 percent, respectively, while that for c-met was demonstrated in 9.1, 36.8 and 60.0 percent, respectively. c-Met overexpression was significantly correlated with high surgical stage as well as poor cellular differentiation. There were significant differences in microvessel count among normal, complex endometrial hyperplasia and adenocarcinoma (median 5, 9 vs. 22) and was between simple and complex endometrial hyperplasia (median 6 vs. 9). The microvessel counts were also significantly correlated with high surgical stage, poor cellular differentiation, lymph node involvement and deep myometrial invasion. CONCLUSION: This results suggested that both c-met overexpression and angiogenesis measured by microvessel count could be significantly important prognostic indicators for the prognosis of endometrial adenocarcinoma.
Adenocarcinoma* ; Antibodies ; Endometrial Hyperplasia* ; Endothelial Cells ; Female ; Hepatocyte Growth Factor* ; Hepatocytes* ; Humans ; Lymph Nodes ; Microvessels ; Prognosis