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

OBJECTIVES: This study was conducted in order to examine the reliability and validity of the Children's Color Trails Test (CCTT). The objective of the study was also to provide the Korean normative data for the CCTT. METHODS: Normative samples consisted of 766 children and adolescents living in Seoul and aged from 5 to 15 years. Eighty children who were diagnosed with ADHD, based on the DSM-IV criterion, were recruited from Seoul National University Children's Hospital. Among them, 46 ADHD children were receiving medication, while 34 children were drug-free. RESULTS: The scores of the CCTT were significantly correlated with those of the Stroop test. Three factors were extracted through factor analysis.visual tracking and cognitive flexibility, distractibility and susceptibility to interference, and simple attention and impulsivity. The completion time of the CCTT for all children tended to decrease as age increased. There were significant differences in the CCTT scores between the ADHD group receiving medication, the ADHD-drug free group and the normal groups. The CCTT also showed sound test-retest reliability. These results confirmed the relia-bility and validity of the CCTT. Finally, we provided the Korean normative data for the CCTT. CONCLUSION: These results suggest that the CCTT is a reliable and valid test, which can be used to assess frontal function related to child psychiatric disorders in Korean children.
Adolescent ; Aged ; Child ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Pliability ; Reproducibility of Results ; Stroop Test ; Track and Field

The T cell antigen receptor (TcR) in combination with costimulatory signals triggered by accessory molecules present on the surface of the antigen-presenting cells (APC) regulates the activation and growth of T lymphocytes. Calyculin A and Okadaic acid is known to be an inhibitor of serine/threonine phosphatase and RK-682 specifically blocks functions of tyrosine phosphatase. To investigate roles of these inhibitors in TcR-mediated signaling cascade, chimeric molecule CD8-5 which contains the extracellular and transmembrane domains of the human CD8a molecule and the cytoplasmic tail of TcR 5 chain were stably expressed in Jurkat cell line. CD8-5 chimeric protein induced tyrosine phosphorylation of various cytoplasmic substrates and IL-2 gene expression in a NFAT dependent manner by stimulation with anti-CD8 mAb OKT8 as seen in TcR stimulation. When CD8-5 transfectants were preincubated with Okadaic acid, Calyculin or RK682, they differentially affected tyrosine phosphorylation of signaling mediators including CD8-5 molecule. When Jurkat Tag cell line was used where SV40 T antigen is stably expressed and the expression of p-galactosidase is driven by the multiple NFAT binding sites plus minimal IL-2 promoter, these phosphatase inhibitors -RK682, Calyculin A, Okadaic acid- effectively inhibited IL-2 gene expression at the concentration of 1.2832 x 10 ' M, 3.9924 x 10 M, 7.2707 x 10 M respectively. These results suggested that Okadaic acid, Calyculin or RK682 modulate TcR-proximal as well as TcR-distal signaling events during T cell activation.
Antigen-Presenting Cells ; Antigens, Viral, Tumor ; Binding Sites ; Cell Line ; Cytoplasm ; Gene Expression ; Humans ; Interleukin-2 ; Jurkat Cells ; Okadaic Acid* ; Phosphorylation ; Receptors, Antigen, T-Cell ; T-Lymphocytes ; Tyrosine

OBJECTIVE: Embryonic stem cells (ES cells) are pluripotential, and are therefore used to construct gene knock-out mice and to study cell differentiation and early developmental processes in mice. This study was designated to examine apoptotic processes in ES cells according to culture conditions and to study roles of extracellular matrix on the process. METHODS: Apoptosis was determined by DNA fragmentation and kinase activity during apoptotic process was measured. RESULTS: The apoptosis of mouse ES cells was induced when the cells were dispersed as single cells, whereas this process was suppressed when they proliferated in aggregates. Single cell suspension culture did not affect expression of bcl-2 and bax mRNA. Single cell suspension culture activated stress-activated protein kinase/c-jun-N-terminal kinase (SAPK/JNK), but not p38 kinase. The apoptosis of ES cells was repressed when the cells were cultured on feeders prepared from mouse embryonic fibroblasts (MEF), or on the petri dishes coated with fibronectin or laminin, but not with collagen or poly-L-lysine. Culture supernatants from MEF cells did not block the apoptosis of ES cells, which suggests that a direct interaction between ES cells and MEF cells is required for the suppression of apoptosis. Activation of SAPK/JNK by single cell suspension was protected by interaction of cells with laminin or fibronectin, but not with collagen or poly-L-lysine. CONCLUSION: The suspension of ES cells as single cells causes serious damage and induces apoptosis, and the apoptotic process is mediated by the activation of SAPK/JNK and is inhibited by the interaction of ES cells with extracellular matrix.
Animals ; Apoptosis* ; Cell Differentiation ; Collagen ; DNA Fragmentation ; Embryonic Stem Cells* ; Extracellular Matrix ; Fibroblasts ; Fibronectins ; Laminin ; Mice* ; Mice, Knockout ; Phosphotransferases ; RNA, Messenger

It is well documented that cardiac myxomas are associated with immunologic features that can simulate systemic autoimmune diseases. Recently, it was reported that cardiac myxomas produce IL-6 constitutively, which could partly explain the immunologic features observed in these patients. However, only a few investigators have studied cytokines in regards to symptoms they may cause in patients with cardiac myxoma. Also there is very little information in the literature on the immunohistochmical localization of IL-6. We performed immunobistochemical stains for IL-4, TNF, and IL-6 on paraffm embbeded tissue of cardiac myxoma tissue. A bioassay of IL-6 activity in patient's serum and in cultured cells from fresh myxoma tissue was performed to ascertain the role of these cytokines in myxomas. In this study, we demonstrated inununohistochemically that there was a local overproduction of IL-4, TNF, and IL-6 in cytoplasm of the tumor cells in about half cases. Bioassays of the serum and cultured tumor cells revealed elevated IL-6 activities. Also these findings correlate to production of patient's constitutional symptoms with statistical significance (P<0.05). In conclusion, these results are of considerable importance in understanding the role of IL-4, TNF, and IL-6 in cardiac myxoma patient with constitutional symptoms, and have an impact on strategies for diagnosis and therapy of cardiac myxoma.

The subepidermal calcified nodule, also known as a form of calcinosis cutis, is characterized by solitary circumscribed deposits of insoluble calcium within the subepidermis. The disease is not associated with any systemic or cutaneous diseases, or any biochemical abnormalities. The pathogenesis is still unknown. A 55-year-old female presented with a 4-month history of solitary skin-colored, hyperkeratotic papule on the left upper eyelid. The lesion was asymptomatic and had increased slowly in size. It is interesting that excisional biopsy showed typical histopathologic features of the subepidermal calcified nodule and the clear cell syringoma.
Biopsy ; Calcinosis ; Calcium ; Eyelids ; Female ; Humans ; Middle Aged ; Syringoma*

BACKGROUND: The criteria established by Light et al in 1972 have been used widely for the differential diagnosis of the pleural effusions in transudates and exsudates. However, in recent years, several reports have agreed that these criteria misclassified an important number of effusions. For this reason, different parameters have been proposed for differentiation the transudates from exudates. Nevertheless, all these alternative parameters have not been better than the past criteria of Light et al. In response the usefulness of two parameters for differentiation pleural transudate from exudates were evaluated : pleural fluid cholinesterase level and pleural fluid to serum cholinesterase ratio. METHODS: A total of forty-three patient with know causes of the pleura effusion by diagnostic thoracentesis were studied. The following criteria for differentiating the pleural effusions in transudates and exsudates were analyzed : Light's criteria, the pleural fluid cholesterol level, the pleural fluid to serum cholesterol ratio. the pleural fluid cholinesterase level, and the pleural fluid to serum cholinesterase ratio. RESULTS: The conditions of forty-three patients were diagnosed. Ten were classified as having transudates and thirty-three as exudates. The percentage of effusions misclassified by each parameter was as follows : Light's criteria, 9.3% ; pleural fluid cholesterol, 2.3% ; pleural fluid to serum cholesterol ratio, 2.3% ; pleural fluid cholinesterase, 4.7% ; and pleural fluid to serum cholinesterase ratio, 2.3%. CONCLUSIONS: The pleural fluid to serum cholinesterase ratio is one of the accurate criteria for differentiating pleural transudates from exudates. If further studies confirm these results, the cholinesterase ratio could be used as the first step in the evaluation of pleural effusion and if evaluated together with the other criteria, the differentiation of pleural transudate from exsudates will become more accurate.
Cholesterol ; Cholinesterases* ; Diagnosis, Differential* ; Exudates and Transudates* ; Humans ; Pleura ; Pleural Effusion

BACKGROUND/AIMS: Melanoma antigen gene (MAGE)-A which have more than 12 subtypes is a gene family for tumor specific shared antigens, recognized by the cytotoxic T cell. Since these genes are expressed only in tumor cells and silent in normal adult tissues except in the male germ line, they may be used as diagnostic markers in detecting malignancy. During the carcinogenesis of gastrointestinal tract, the hyperplastic epithelium-adenoma-adenocarcinoma sequence is largely accepted and the molecular studies on each step have been issued. However, in the aspect of carcinogenesis in the gastrointestinal tract, MAGE genes have not studied yet. To explore the functional role and clinical significance of MAGE-A genes in the carcinogenesis of the colon, mRNA expression of MAGE-A1 to -A6 in the mucosal tissues obtained from the colonoscopy was investigated and the relationship between their expressions and clinicopathologic parameters was analysed. METHODS: We investigated the expression of MAGE 1~6 in 65 endoscopically biopsied samples of neoplastic and nonneoplastic tissues from the colon, using a MAGE common primer by the reverse transcription-nested polymerase chain reaction and DNA sequencing. RESULTS: Of the 31 colorectal adenocarcinoma specimens examined, MAGE genes were expressed in 11 cases (36%). In contrast, no expression of these genes was observed in any of the 12 samples of tubular adenoma and 12 of non-specific colitis and 5 cases of normal colonic tissues. There was no significant correlation between the expression of the MAGE genes and clinicopathologic factors, such as gender, disease stage, lymph node metastasis and perineural and vascular invasion in colonic carcinoma. CONCLUSIONS: It is postulated that the expression of MAGE genes could reflect the late event of oncogenesis of the colon because no MAGE expression was noticed in chronic inflamamtion and adenomas which might have the important role in the process of malignant transformation.
Adenocarcinoma ; Adenoma ; Adult ; Carcinogenesis* ; Colitis ; Colon* ; Colonic Neoplasms ; Colonoscopy ; Gastrointestinal Tract ; Genes, vif ; Germ Cells ; Humans ; Lymph Nodes ; Male ; Melanoma ; Mucous Membrane ; Neoplasm Metastasis ; Polymerase Chain Reaction ; RNA, Messenger ; Sequence Analysis, DNA

Phospholipase D (PLD) is an enzyme involved in signal transduction and widely distributed in mammalian cells. The signal transduction pathways and role for phospholipid metabolism during hormonal response in cortical collecting duct remain partly undefined. It has been reported that dexamethasone increases transepithelial transport in M-1 cells that are derived from the mouse cortical collecting duct. We investigated the expression and activity of PLD in M-1 cells. Basal PLD activity of M-1 cells cultured in the presence of dexamethasone (5 microM) was higher than in the absence of dexamethasone. Dexamethasone and ATP activated PLD in M-1 cells but phorbol ester did not stimulate PLD activity. Vasopressin, bradykinin, dibutyryl cyclic AMP, and ionomycin were ineffective in activating PLD of the cells. The PLD2 isotype was detected by immunoprecipitation but PLD1 was not detected in M-1 cells. Addition of GTPgammaS and ADP-ribosylation factor or phosphatidylinositiol 4,5-bisphosphate to digitonin-permeabilized cells did not augment PLD activity. In intact cells PLD activity was increased by sodium oleate but there was no significant change between dexamethasone treated- and untreated cells by oleate. These results suggest that at least two types of PLD are present in M-1 cells and PLD plays a role in the corticosteroid-mediated response of cortical collecting duct cells.
Animal ; Biological Transport/drug effects ; Dexamethasone/pharmacology* ; Dose-Response Relationship, Drug ; Drug Interactions ; Glycerophospholipids/analysis ; Isoenzymes/drug effects ; Kidney Cortex/cytology ; Kidney Tubules, Collecting/drug effects* ; Kidney Tubules, Collecting/cytology ; Mice ; Mice, Transgenic ; Oleic Acid/pharmacology ; Phospholipase D/drug effects*

The first case of chyle ascites in childhood was reported by Morton in 1683. Its reported incidence varies between 1 in 50,000 to 100,000 in hospital admissions. The clinical picture is similar to that of acute diffuse peritonitis, and is most commonly mistaken as perforated appendicitis. Paracetesis, if performed, is the most useful diagnostic option. Treatment modalities fall into four areas-: Exploratory laparotomy with either direct ligation or drainage, A medium chain triglyceride diet, NPO and hyperalimentation or Venoperitoneal shunting. An 11-years old boy was admitted with RLQ pain. He had diffuse abdominal guarding. The initial diagnosis was perforated appendicitis, and appendectomy was performed. During the operation, the abdomen was found to contain 750cc of a thin, milky fluid. It was later diagnosed as chyle ascites. The small bowel mesentery and transverse colon were thickened and edematous, with a pale white subserosal exudate. The laboratory analysis of the ascites was as follows-: protein 4.6 g/dL, albumin 3.0 g/dL, triglyceride 700 mg/dL, cholesterol 113 mg/dL, glucose 209 mg/dL, LDH 848 U/L, and amylase 32 U/dL, with a pH of 9.0. An appendectomy was performed, and two drains placed in the pelvic cavity. In the postoperative-work-up from the abdominal CT scan, the results were normal. The patient-recovered and was discharged without complication 21 days postoperatively.
Abdomen ; Amylases ; Appendectomy ; Appendicitis* ; Ascites* ; Child ; Cholesterol ; Chyle* ; Colon, Transverse ; Diagnosis ; Diet ; Drainage ; Exudates and Transudates ; Glucose ; Humans ; Hydrogen-Ion Concentration ; Incidence ; Laparotomy ; Ligation ; Male ; Mesentery ; Peritonitis ; Tomography, X-Ray Computed ; Triglycerides