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Dystrophic cutaneous calcification may arise at sites of local trauma or in association with various disorders. Calcified nodules of the heel have been reported in high-risk neonates following repeated heel sticks to draw blood. We present a healthy 2-year-old boy with a calcified nodule on the heel secondary to a single heel stick in the neonatal period. The patient was born full-term at 38 weeks' gestation, with a birth weight appropriate for gestational age. A firm nodule was noticed at the age of 8 months; this became tender. Histology revealed epidermal and subepidermal deposition of calcium. Serum calcium and phosphate levels were normal. Although calcified heel nodules occur mostly in high-risk neonates, this case suggests that this condition also can occur in healthy children after only a single heel stick. Dermatologists should include this entity in the differential diagnosis of warty papules on the heels of children.

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We isolated a rotavirus in cell culture, named the GRV strain, from a stool specimen of a Korean goat with diarrhea, and performed an in-depth characterization. At various passage levels in cell culture, the GRV strain retained its pathogenicity for goat kids, thereby for the first time establishing that a caprine rotavirus can cause diarrhea in goat kids. The GRV strain grew to a high titer and agglutinated group O human erythrocytes. The GRV VP7 protein was 96% identical with the RRV (simian rotavirus) and R2 (lapine rotavirus) VP7 proteins, and slightly less similar to the SA11 (simian rotavirus) and HCR3 (feline/canine-like human rotavirus) VP7 proteins. The GRV VP4 protein was 93% identical with the RRV VP4 (P[3]) and 90% identical with the SA11 VP4 (P[2]). However, phylogenetic analysis including more VP4 sequences from representative P[3] strains unambiguously placed the GRV VP4 in the cluster of P[3] VP4s. A high level of two-way cross neutralization with RRV substantiated that GRV was a G3P5[3] strain, thus identifying GRV as the first caprine rotavirus with such a phenotype. The GRV NSP4 sequence belonged to the AU-1 allele, as does the RRV NSP4 sequence. Genetic analysis by RNA-RNA hybridization revealed that the overall genomic RNA constellation of the GRV strain was unique among mammalian rotavirus genogroups and that it was almost equally related to, yet distant from, simian rotavirus RRV, feline/canine rotavirus FRV64 (or CU-1), feline/human rotavirus FRV-1 (or AU-1), and lapine rotavirus R2. The availability of the GRV strain will further expand our limited knowledge of caprine rotaviruses.

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We have observed an epilayer-thickness-dependent polarity inversion for the growth of CdTe on Sb(Bi)/CdTe(111)B. For films with Sb(Bi) thicknesses of less than 40 A (15 A), the CdTe layer shows a B (Te-terminated) face, but it switches to an A (Cd-terminated) face for thicker layers. On the other hand, a CdTe layer grown on Bi(Sb)/CdTe(111)A always shows the A face regardless of Sb or Bi layer thicknesses. In order to address the observations we have performed ab initio calculations, which suggest that the polarity of a polar material on a nonpolar one results from the binding energy difference between the two possible surface configurations.

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The genetic status of cagA, vacA subtype, iceA1, and babA, and the relationship to gastroduodenal diseases were assessed in Helicobacter pylori isolates in Korea. Seventy-six strains of H. pylori were isolated from the antrum and the corpus of 41 adult patients (22 with peptic ulcer and 19 with gastritis). The cagA, iceA1, and babA genes were assessed by polymerase chain reaction and the vacA subtypes were determined by reverse hybridization-line probe assay. The positive rates of 349-bp cagA, 208-bp cagA, iceA1, and babA genes were 97.4%, 96.1%, 84.2%, and 36.1%, respectively. The vacA s1a, s1b, s1c, and s2 variants were detected in 11.8%, 3.9%, 80.4%, and 1.3%, respectively. m1 (78.9%) is more prevalent than m2 (5.3%). The most common vacA genotype was s1c/m1 (61.9%), and 14 isolates (18.4%) contained mixed vacA genotypes from a single biopsy specimen. Twenty-one (60%) of 35 patients were infected with more than two strains of different cagA, iceA1, babA, and vacA genotypes. None of cagA, iceA1, babA, and vacA s1/m1 were associated with peptic ulcer. In conclusion, most H. pylori isolates in Korea carry cagA, iceA1, and vacA s1c/m1 genes, and reside with multiple strains. These genes do not correlate with the peptic ulcer in the Korean patients.

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STATEMENT OF PROBLEM: Titanium is a biocompatible material, but it is not widely used in clinical dentistry for conventional removable denture frameworks. Little research exists on its applicability. PURPOSE: This study compared the casting accuracy and roughness of titanium and cobalt-chromium denture frameworks. MATERIAL AND METHODS: Twenty Kennedy Class II, Division 1 removable partial denture frameworks were fabricated with commercially pure titanium (n = 10) and a cobalt-chromium alloy (n = 10). The casting accuracy of each framework was determined by visual, radiographic, and microscopic methods. The roughness of each polished framework surface was analyzed with atomic force microscopy. RESULTS: The clinical fit, porosities, and microporosities of both types of metal frameworks were qualitatively similar. The surface roughness of polished pure titanium and cobalt-chromium frameworks was 104.43 +/- 69.24 nm and 133.91 +/- 40.92 nm, respectively. This difference was not statistically significant (P >.05). CONCLUSION: The clinical fit, porosity, and surface roughness of the titanium and cobalt-chromium frameworks fabricated for this study were comparable.

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BACKGROUND: The requirement for subsequent cholecystectomy in patients with gallbladder in situ after endoscopic removal of stones from the common bile duct (CBD) is controversial. The aims of this study were to assess the requirement for subsequent cholecystectomy for gallbladder-related symptoms, and to identify the patients who develop symptoms after the endoscopic removal of CBD stones. METHODS: Of 241 patients with gallbladder in situ following endoscopic removal of stones from the CBD, 146 patients (78 men and 68 women; mean age 69 +/- 13 years, range 20-93) with a follow-up time of more than three months without elective cholecystectomy were enrolled in the study. Fifty-nine patients had gallbladder stones (single stones in 27 and multiple stones in 32) and 87 patients had gallbladder in situ without stones. The time from entry to the occurrences of death or cholecystectomy was evaluated retrospectively. Cox regression analysis was used to evaluate the risk factors associated with these events. RESULTS: The mean duration of follow-up was 24.1 +/- 18.0 months (range 3-70 months). During follow-up, seven patients (4.8%) underwent cholecystectomy, on average 18.4 months after CBD stone removal, as the result of acute cholecystitis in four cases, biliary pain in two cases and acute pancreatitis in one case. Laparoscopic cholecystectomy was performed in four patients and open cholecystectomy in three patients. Post-operative morbidity occurred in two patients, with improvement after conservative management. Nine patients (6.2%) died as the result of unrelated biliary disease. Age, sex, presence of gallbladder stones, multiplicity of gallbladder stones and underlying disease did not correlate with subsequent cholecystectomy by Cox regression analysis. CONCLUSION: Elective cholecystectomy is not warranted in patients with bile duct stones when the common duct can be cleared of stones by endoscopic sphincterotomy. We could not find any clinical predictors of further symptoms or complications arising from the retained gallbladder.

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OBJECTIVES: The aim of this study was to evaluate changes of body composition in cirrhotic patients. Dual energy x-ray absorptiometry (DEXA) and anthropometry were used, and the values obtained were compared. METHODS: Mid-arm fat and muscle areas were calculated by anthropometry in 66 cirrhotic patients and 94 healthy controls. In 37 of the cirrhotic patients and 39 of the controls, fat mass, lean soft tissue mass and bone mineral contents were measured with DEXA. RESULTS: The number of cirrhotic patients with measured values below the fifth percentile of normal controls was 21 (31.8%) by mid-arm fat area, six (9.1%) by mid-arm muscle area, 15 (40.5%) by fat mass and 0 (0%) by lean soft tissue mass. The fat mass in cirrhotic patients was less than in controls, whereas lean soft tissue mass and bone mineral content were not different. Fat depletion was severe in Child-class C patients and with severe ascites. Mid-arm fat area and fat mass showed close correlation (r = 0.85, p < 0.01), but mid-arm muscle area and lean soft tissue mass showed poor correlation (r = 0.32, p < 0.05). CONCLUSION: Cirrhotic patients showed lower fat component, with preserved lean soft tissue mass and bone mineral content. In clinical practice, the measurement of mid-arm fat area was useful for the assessment of fat mass.

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