The T(-13910) variant located in the enhancer element of the lactase (LCT) gene correlates perfectly with lactase persistence (LP) in Eurasian populations whereas the variant is almost nonexistent among Sub-Saharan African populations, showing high prevalence of LP. Here, we report identification of two new mutations among Saudis, also known for the high prevalence of LP. We confirmed the absence of the European T(-13910) and established two new mutations found as a compound allele: T/G(-13915) within the -13910 enhancer region and a synonymous SNP in the exon 17 of the MCM6 gene T/C(-3712), -3712 bp from the LCT gene. The compound allele is driven to a high prevalence among Middle East population(s). Our functional analyses in vitro showed that both SNPs of the compound allele, located 10 kb apart, are required for the enhancer effect, most probably mediated through the binding of the hepatic nuclear factor 1 alpha (HNF1 alpha). High selection coefficient (s) approximately 0.04 for LP phenotype was found for both T(-13910) and the compound allele. The European T(-13910) and the earlier identified East African G(-13907) LP allele share the same ancestral background and most likely the same history, probably related to the same cattle domestication event. In contrast, the compound Arab allele shows a different, highly divergent ancestral haplotype, suggesting that these two major global LP alleles have arisen independently, the latter perhaps in response to camel milk consumption. These results support the convergent evolution of the LP in diverse populations, most probably reflecting different histories of adaptation to milk culture.

This nation-wide seroprevalence of H. pylori infection in South Korea was 46.6%, which showed the transition from a developing country to a developed country. More studies on the epidemiological factors and the route of transmission of H. pylori infection should be warranted.

Transoral protrusion of a peritoneal catheter is rare. Only two cases have been reported in the English literature. We now report the case of a 5-year-old girl who presented with a catheter that had been inserted 4 years previously, protruding from her mouth. Signs of cerebrospinal fluid infection or peritonitis were absent. The peritoneal catheter was cut and externalized at the chest. The distal portion, which had perforated the stomach wall, was removed using endoscopic procedures. After 3 weeks of antibiotic treatment, a new shunt was inserted. Analysis of 50 cases of bowel perforation extracted from the English literature showed that among the suggested factors such as age, gender, nutritional state, history of abdominal surgery, and length and type of the catheter, age was the only predisposing factor. In the treatment of bowel perforation by a peritoneal catheter, suspected shunt infection should be managed properly and contamination be minimized during removal of the peritoneal catheter.

A novel homozygous Fas ligand mutation leads to early protein truncation, abrogation of death receptor and reverse signaling and a severe form of the autoimmune lymphoproliferative syndrome. Clin Immunol 2014;155:231-7. 6. Bi LL, Pan G, Atkinson TP, Zheng L, Dale JK, Makris C, et al. Dominant inhibition of Fas ligand-mediated apoptosis due to a heterozygous mutation associated with autoimmune lymphoproliferative syndrome (ALPS) type Ib.

APRI and FIB4 might be useful noninvasive hepatic fibrosis scores for predicting hepatic fibrosis in children with NAFLD.

Serum ferritin levels are reduced in children with H. pylori infection. The H. pylori infection may lead to iron deficiency in children.

Measurement of hepatic artery diameter can be helpful in the US diagnosis of biliary atresia.

Genetic and antigenic characterizations of 70 strains of adenovirus type 41 (Ad41), isolated between 1998 and 2001 from children in Japan, Vietnam, and Korea, were done by DNA restriction enzyme (RE) analysis, sequencing analysis, and monoclonal antibody (MAb)-based enzyme-linked immunosorbent assay (ELISA). Eight genome types were observed in the present study, among which D25, D26, D27, and D28 were novel genome types. These eight genome types were divided into two genome-type clusters (GTCs) based on phylogenetic analysis of the hypervariable regions (HVRs) of the hexon. GTC1 includes D1, D25, D26, D27, and D28, and the GTC2 contains D4, D12, and D22. The amino acid homologies among the members within a GTC were 97 to 100%, whereas between the members of different GTCs the homologies were 92 to 94%. The specificity of the GTC classification was confirmed by ELISA with MAb 1F, which was selected by the Ad41 prototype Tak strain. It was found that only the isolates of GTC1 but not of GTC2 reacted with MAb 1F. These results suggest that Ad41 isolates from the three countries should be classified into two subtypes. The accumulation of amino acid mutations located in HVRs of hexon are indicative for the classification of Ad41 subtype.Adenoviruses are responsible for a wide range of disease symptoms. To date, there are 51 recognized serotypes of human adenovirus that are classified into six subgenera (A to F) based on several antigenic, morphological and molecular criteria. Among them, subgenus F, represented by the two serotypes adenovirus type 40 (Ad40) and Ad41, is associated with diarrhea in children; it is found in 1 to 20% of fecal specimens from children with acute gastroenteritis (3,9,12,15,22,35). The two serotypes (Ad40 and Ad41) of subgenus F are termed enteric adenovirus (EAd) because of their tropism for the gastrointestinal tract (10, 32). The subgenus F adenoviruses grow poorly in most cell culture systems, in contrast to other cultivable "nonenteric" adenoviruses, and are therefore also termed "noncultivable" or "fastidious" adenovirus (7, 16).Earlier surveys had shown that the occurrences of Ad40 and Ad41 are approximately equal (6, 11). However, several studies have recently reported a decrease in the rate of isolation of Ad40 and a concomitant increase in the rate of isolation of Ad41 (5,8,25,34). After 1986, Ad41 infection became dominant over Ad40. Our previous studies confirmed that Ad41 was the prevailing serotype of adenovirus associated with acute diarrhea among children also in Japan, Vietnam, and Korea (19). The change in prevalence of Ad41 might have been caused by an antigenic drift, thus increasing the incidence of infection in susceptible individuals (3). Therefore, it is important to characterize these Ad41 strains. In the last decade, there were relatively few comprehensive epidemiological studies of subgenus F adenoviruses from children with diarrhea in Asian countries. The objectives of the present study were (i) to describe the genome types of Ad41 isolates by DNA restriction end...