A 5-year-old boy developed painful erythematous indurated patch at vertex that rapidly progressed to central necrotic ulceration with peripheral granulation after chemotherapy for acute lymphoblastic leukemia. Cultures at the lesion sites demonstrated a fungus, Aspergillus niger, as the etiologic agent. No evidence of involvement of other organs or of systemic dissemination by Aspergillus niger was found. Surgical debridement was performed and the patient received treatment with intravenous Amphotericine B followed by oral itraconazole. No evidence of recurrent fungal infection was noted during several months of follow-up.
Amphotericin B ; Aspergillosis* ; Aspergillus niger ; Child* ; Child, Preschool ; Debridement ; Drug Therapy ; Follow-Up Studies ; Fungi ; Humans ; Itraconazole ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Skin ; Ulcer

Skip lesion is not uncommon feature in osteosarcoma and considered to be importantly associated with poor prognosis factor, and thus, should be excised with the main mass. The accurate pre-operative evaluation of the intramedullary extent of osteosarcoma is essential, because it determines the level of bone resection. Among the reliable detection methods, bone scan has a drawback of high rate of false negative results and regional MRI has a difficulty to cover the whole involved lesions without clinical suspicion. The authors report a case of osteosarcoma of the distal femur with a proximal skip lesion that was not detected by either regional MR imaging or by bone scan, but which was visualized by FDG-PET/CT.
Complement System Proteins ; Femur ; Neoplasm Metastasis ; Osteosarcoma ; Prognosis

BACKGROUND/AIMS: The prognosis of primary hepatocellular carcinoma is extremely poor because of its large size, portal vein thrpombosis, extrahepatic metastasis and underlying liver cirrhosis. The aim, of this study is to evaluate the usefulness of ultrasound screening test for early detection of hepatocellular carcinoma in high-ridk populations. METHODS: We analysed 119 patients who were diagnosed with hepatocellular carcinoma by ultrasonography screening test in Yonsei University Severance Hospital from the period of January 1990 to December 1996. RESULT: The mean follow-up duration to the diagnosis of hepatocellular carcinoma was 30 months (range 3-75). The number of patients with single lesion was 89(75%). The mean diameter of the tumor was 3.0 cm (range 1-10) , 82 patients (70%) had masses measured less than 3cm in diameter. The Number of patients with elevated serum alphafetoprotein level above 400ng/ml was 29(25%). The median survival was 28 months in screening group, significant compared with 7 months in control group (p<0.001). CONCLUSIONS: Ultrasound follow-up in high-ridk group of hepatocellular carcinoma mede it possible to detect small tumors in a high percentage of cases. This may lead to an increase in the number of potentially curable tumors and hence an increase in the overall survival rate. So ultrasound screening test is important in the high-ridk group of hepatocellular carcinoma.
Carcinoma, Hepatocellular* ; Diagnosis ; Early Diagnosis ; Follow-Up Studies ; Humans ; Liver Cirrhosis ; Mass Screening* ; Neoplasm Metastasis ; Portal Vein ; Prognosis ; Survival Rate ; Ultrasonography*

PURPOSE: To clarify whether Mycoplasma pneumoniae-induced respiratory infections are associated with allergic disorder. METHODS: We studied ninety-two preschool children with pneumonia who were hospitalized at the pediatric ward of Korea University Medical Center from December 1995 to June 1997. Patients who had evidence of Mycoplasma pneumoniae infection(Group I) were compared with non-infected group(Group II) in terms of serologic parameters, ie, eosinophil count, total IgG, IgA, IgM, IgE levels and specific IgE(MAST). RESULTS: 1) Number of Group I was 46(male 23, female 23, mean age=3.4 years old), and that of Group II was also 46(male 29, female 17, mean age=3.4 years old). There was no age difference between two groups. 2) Total eosinophil count in Group I(185.0+/-179.3/mm3) was significantly higher than that of Group II(123.3+/-148.3/mm3)(P<0.05). 3) Total IgE in Group I(245.4+/-279.2IU/mL) was significantly higher than that of Group II(135.1+/-207.8IU/mL)(P<0.05). 4) Higher levels of IgG, IgM, and IgA were observed in the group I as compared to a non-infected group, but there were no significant differences between two groups. 5) Positive rates of specific IgE(MAST) in each group were not significantly different. CONCLUSIONS: We concluded that Mycoplasma pneumoniae pneumonia in preschool children is highly associated with allergy, and follow-up studies are expected to know the occurrence rate of allergic disease in children with a previous history of Mycoplasma pneumoniae pneumonia.
Academic Medical Centers ; Child ; Child, Preschool* ; Eosinophils ; Female ; Humans ; Hypersensitivity* ; Immunoglobulin A ; Immunoglobulin E ; Immunoglobulin G ; Immunoglobulin M ; Korea ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia* ; Pneumonia, Mycoplasma* ; Respiratory Tract Infections

Infectious mononucleosis is an acute infectious disease occurring predominantly in older children and young adults due to primary Epstein-Barr virus infection. The clinical picture is extremely variable in both severity and duration. The disease in children is generally mild. It is characterized clinically by fever, exudative or membranous pharyngitis, generalized lymphadenopathy, and splenomegaly. Rarely, it complicates neurologic involvement such as cranial nerve palsy, meningoencephalitis, and transverse myelitis, hematologic involvement such as hemolytic anemia, immune thrombocytopenic purpura, and aplastic anemia, rupture of spleen, myocarditis, interstitial pneumonia, and orchitis, etc. We experienced a case of infectious mononucleosis with pleural effusion and ascites in a 5-year-old male with the chief complaint of fever, sore throat and vomiting 3 days prior to admission. The diagnosis was made on the clinical findings, immunologic findings and the typical findings of peripheral blood smear. On peripheral blood smear, leukocytosis with atypical lymphocytosis were seen. On immunologic study, anti-VCA IgM and IgG were positive by ELISA method. We reported this case and reviewed related literatures briefly.
Anemia, Aplastic ; Anemia, Hemolytic ; Ascites* ; Child ; Child, Preschool ; Communicable Diseases ; Cranial Nerve Diseases ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Fever ; Herpesvirus 4, Human ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Infectious Mononucleosis* ; Leukocytosis ; Lung Diseases, Interstitial ; Lymphatic Diseases ; Lymphocytosis ; Male ; Meningoencephalitis ; Myelitis, Transverse ; Myocarditis ; Orchitis ; Pharyngitis ; Pleural Effusion* ; Purpura, Thrombocytopenic, Idiopathic ; Rupture ; Spleen ; Splenomegaly ; Vomiting ; Young Adult

PURPOSE: Clusterin is a heterodimeric glycoprotein and its expression is related with tissue injury and apotosis. Angitensisn II(ANG II) is known to be associated with the progression of renal disease by inducing renal fibrosis and cell proliferation. This study was designed to investigate the relationship between ANG II and clusterin expression in the kindey and the heart. We also attempted to discriminate the effect of ANG II-mediated hypertension by experimenting with two doses of ANG II-one is high enough to cause hypertension, and the other is not. METHODS: Three groups of Sprague-Dawley rats received ANG II infusion by osmotic minipump at a dose of 50ng/min, 100ng/min and placebo infusion, respectively. After 7 days, their kidneys and hearts were harvested and underwent immunohistochemical staining, RT-PCR, and Western blotting of clusterin. RESULTS: There were no differences in body weight nor organ weight/body weight among the three groups. Blood pressures of control and low-dose ANG group were not changed throughout the study, but that of high-dose ANG group was increased significantly at day 3 and 7. Staining for renal clusterin was diffusely distributed over the cortex and medulla in all 3 groups, but the intensity of staining was different notably in the medulla of control group which showed stronger staining than the ANG II infused groups. Staining intensity was not significantly different between the low and high ANG groups in the heart and kidney. In the kidney, expression of clusterin mRNA and protein were decreased in low-and high-dose ANG groups compared with control. In the heart, expression of clusterin mRNA was decreased in the low- and high-dose ANG groups compared with control. CONCLUSION: We conclude that ANG II decreases clusterin expression in the kidney and heart regardless of systemic hypertension induced by ANG II.
Angiotensin II* ; Angiotensins* ; Animals ; Blotting, Western ; Body Weight ; Cell Proliferation ; Clusterin* ; Fibrosis ; Glycoproteins ; Heart* ; Hypertension ; Kidney* ; Rats* ; Rats, Sprague-Dawley ; RNA, Messenger

OBJECTIVES: The Korean Food Composition Table (KFCT) was first published in 1970, and has since been updated every five years by the Rural Development Administration (RDA). This study was conducted to introduce the development strategies, features, and challenges of the 9th revision of the KFCT. METHODS: Due to the increasing demands of nutrient database users and generators, the RDA started a new research project in 2013 to improve the quantity and quality of data for the 9th revision of the KFCT. Over 1,000 food items frequently consumed in Korea were selected as key foods using the results of the Korean National Health and Nutrition Examination Survey. About 200 raw materials and processed food items were collected and analyzed every year. Target nutrients that were analyzed by collaborative labs, such as, sugars, selenium, iodine, and biotin, were increased from 22 to 43. Analytical sample handling procedures and data quality evaluation systems were also established in collaboration with 10 contracted labs. Data were evaluated for data quality according to the FAO/INFOODS, CODEX, and AOAC guidelines. RESULTS: The 9th revision contains data on 3,000 food items and up to 43 and 140 food nutrients for the printed table and the excel database file, respectively. Overall, 1,485 data items were newly added, 973 of which were provided by the RDA and 512 were cited from foreign nutrient databases. The remaining 1,515 food items were maintained as in the 8th revision. CONCLUSIONS: The KFCT provides the basic infrastructure for food and nutrition policy, research, and dietary practice in South Korea. The use of the KFCT has increased exponentially in the past few years in both public and private sectors; accordingly, increased efforts should be paid to the preparation, improvement, and maintenance of KFCT.
Biotin ; Carbohydrates ; Cooperative Behavior ; Data Accuracy ; Iodine ; Korea ; Nutrition Policy ; Nutrition Surveys ; Private Sector ; Selenium ; Social Planning

OBJECTIVES: The Korean Food Composition Table (KFCT) was first published in 1970, and has since been updated every five years by the Rural Development Administration (RDA). This study was conducted to introduce the development strategies, features, and challenges of the 9th revision of the KFCT. METHODS: Due to the increasing demands of nutrient database users and generators, the RDA started a new research project in 2013 to improve the quantity and quality of data for the 9th revision of the KFCT. Over 1,000 food items frequently consumed in Korea were selected as key foods using the results of the Korean National Health and Nutrition Examination Survey. About 200 raw materials and processed food items were collected and analyzed every year. Target nutrients that were analyzed by collaborative labs, such as, sugars, selenium, iodine, and biotin, were increased from 22 to 43. Analytical sample handling procedures and data quality evaluation systems were also established in collaboration with 10 contracted labs. Data were evaluated for data quality according to the FAO/INFOODS, CODEX, and AOAC guidelines. RESULTS: The 9th revision contains data on 3,000 food items and up to 43 and 140 food nutrients for the printed table and the excel database file, respectively. Overall, 1,485 data items were newly added, 973 of which were provided by the RDA and 512 were cited from foreign nutrient databases. The remaining 1,515 food items were maintained as in the 8th revision. CONCLUSIONS: The KFCT provides the basic infrastructure for food and nutrition policy, research, and dietary practice in South Korea. The use of the KFCT has increased exponentially in the past few years in both public and private sectors; accordingly, increased efforts should be paid to the preparation, improvement, and maintenance of KFCT.
Biotin ; Carbohydrates ; Cooperative Behavior ; Data Accuracy ; Iodine ; Korea ; Nutrition Policy ; Nutrition Surveys ; Private Sector ; Selenium ; Social Planning

BACKGROUND: It has been suggested that all components of the renin-angiotensin-aldosterone system (RAAS) are present in the vascular wall and that the vascular RAAS modulates vascular tone and vascular hypertrophy. One of the catalytic step in the RAAS cascade is the local conversion of angiotensin I to angiotensin II (Ang II) by angiotensin converting enzyme (ACE). One of the major sources of ACE in the vasculature is vascular smooth muscle cells (VSMC). Here, we provide insight into the intrinsic mechanisms by which the components of RAAS regulate gene expression of ACE in cultured smooth muscle cells of the rat and we also investigated the effects of cytokines on ACE mRNA. METHODS: RNA was extracted from the primary cultured VSMCs. We analyzed the expression levels of ACE by competitive reverse transcription-PCR using recombinant RNA as an internal standard. RESULTS: 1) ACE mRNA level was increased markedly by aldosterone in a dose- and time-dependent manner, indicating that there exists positive feedback mechanism within RAAS. 2) The induction of ACE mRNA by aldosterone was inhibited by spironolactone. 3) Aldosterone-stimulated expression of ACE was also inhibited by Ang II, which shows that Ang II acts as a negative regulator of the expression of ACE in RAAS cascade. 4) Interleukin-1beta or TNF-alpha did not induce ACE mRNA expression. 5) However, mixture of interleukin-1betaand TNF-alpha(CytoMix) significantly increased the expression of ACE. It was also shown that CytoMix increased aldosterone-stimulated ACE mRNA expression in an additative manner. CONCLUSION: These results indicate that the expression of ACE in smooth muscle cells is modulated by the components of RAAS and cytokines. The intrinsic positive and negative feedback controls of RAAS would play an important role in the pathogenesis of vascular diseases.
Aldosterone* ; Angiotensin I ; Angiotensin II ; Angiotensins* ; Animals ; Cytokines* ; Gene Expression ; Hypertrophy ; Interleukin-1beta ; Muscle, Smooth, Vascular* ; Myocytes, Smooth Muscle ; Peptidyl-Dipeptidase A* ; Rats ; Renin-Angiotensin System ; RNA ; RNA, Messenger ; Spironolactone ; Tumor Necrosis Factor-alpha* ; Vascular Diseases

BACKGROUND: The analysis of ACE gene expression in vital to study the role of angiotensin conveting enzyme(ACE) in the pathogenesis of cardiovascular disease. Traditionally, levels of individual mRNA expression have been analyzed by semiquantitative Northern blotting, which requires a large quantity of tissue. Therefore, gene expression of a little biopsy specimen from the human heart or atherectomy specimen from the blood vessel cannot be measured easily. Reverse transcription-polymerase chain reaction(RT-PCR) is very effective, sensitive and rapid method of detecting the method of quantitative RT-PCR(QRT-PCR) using recombinant RNA template as internal standard to measure the expression of ACE. METHOD: Recombinant RNA(rcRNA) was designed to yield PCR product which differs in size by about 200bp from that of the target RNA. Initially, spacer gene, which was composed of ACE sense primer, antisense primer, T7 promotor and poly(dT) tail with glutathione transferase(GSTM) gene of 180bp in the middle, was constructed. Then, standard rcRNA was obtained by in vitro transcription. Target RNA was mixed with rcRNA and amplified by PCR, togather with P-dCTP. PCR products were analyzed by gel electrophoresis. For quantitation, either gel was cut and radioactivity was counted or gel was dried and exposed to X-ray film and density was measured using image densitometer. We carried out semiquantitative RT-PCR to study the modulation of ACE expression in vascular smooth muscle cell(VSMC) by dexamethasone and basis FGF(bFGF). RESULT: The size difference of PCR products from the standard RNA and the extracted target RNA was matched as designed. By using QRT-PCR, there was 1.7*10(8) ACE mRNA molecules in 1 ng of rat lung total RNA. bFGF and dexamethasone upregulated ACE mRNA expression in cultured VSMC. CONCLUSION: These results suggest that RT-PCR using rcRNA as internal standard is a very useful method for quantitation or semiquantitation of ACE mRNA from a small amount of tissue or cultured cells. Expression of ACE in VSMC can be modulated by various stimuli such as basic FGF and dexamethasone. QRT-PCR could be widely used in the studies of expression of specific human genes.
Angiotensins* ; Animals ; Atherectomy ; Biopsy ; Blood Vessels ; Blotting, Northern ; Cardiovascular Diseases ; Cells, Cultured ; Dexamethasone ; Electrophoresis ; Gene Expression ; Glutathione ; Heart ; Humans ; Lung ; Muscle, Smooth, Vascular ; Peptidyl-Dipeptidase A* ; Polymerase Chain Reaction ; Radioactivity ; Rats ; RNA ; RNA, Messenger* ; X-Ray Film