PURPOSE: Neonatal surgical conditions affecting the gastrointestinal tract are varied, can affect any part of the intestinal tract, and frequently require urgent surgical intervention. Unfortunately, nonspecific and overlapping symptomatology exists among the conditions affecting the intra-aMominal intestinal tract and requires of the evaluating physician a thorough understanding of their pathophysiology. So we studied signs and symptoms, frequency and incidence, ages at diagnosis, and diagnostic method of the neonatal gastrointestinal obstructions. METHOD: We reviewed retrospectively the charts of patients, who had been diagnosed as gastrointestinal obstruction during the neonatal period, and had been admitted to Gyeongsang National University Hospital from Feb. 1988 to Feb. 1997. RESULT: Total 77 cases were enrolled in this study. There were 59 rnales (76.796) and female 18 cases (23.4%). The male to female ratio was 3.28: 1. Twenty-two cases of imperforate anus (28.6%), 18 cases of hypertrophic pyloric stenosis (23.4%), 15 cases of congenital megacolon (19.5%) were observed. Other diseases causing the neonatal gastrointastinal obstruction were annulus pancreas (7.8%), jejunal atresia (6.5%), duodenal atresia (1.3%), duodenal web (2.6%), ileal atresia (2.6%), midgut volvulus (2.6%), intussusception (1.3%), and trachoesophageal fistula (2.6%). The rnost common symptom was vomiting with 32 cases (41.6%), followed by abdominal distension with 31 cases (40.3%), absence of anus with 17 cases (22.1%), and delayed meconium passage with 9 cases (11.7%). Associated other anomalies were observed in 18 cases (23%). Imperforate anus was seen with the highest rate of associated anomalies. The most common associated anomaly was the cardiac anomaly. Colon study (26%), physical examination (24.7%), abdominal sonography (15.6%), upper GI series (11.7%), and simple abdomen (9.1%) were diagnostic in the neonatal gastrointestinal obstructions. Seventeen cases (22%) were died before or after the surgical intervention. CONCLUSION: Neonatal gastrointestinal obstructions were associated with the high mortality rate. Abdominal distension and vomiting were the specific symptoms of neonatal gastrointe- stinal obstructions. Extensive search for the associated anomalies are reqiured because of its high frequency in the patients of the neonatal gastrointestinal obstructions. Thorough physical examination, colon study, abdominal sonography, upper GI series, and simple abdomen were essential in the diagnosis of the neonatal intestinal obstructions.
Abdomen ; Anal Canal ; Anus, Imperforate ; Colon ; Diagnosis ; Female ; Fistula ; Gastrointestinal Tract ; Hirschsprung Disease ; Humans ; Incidence ; Infant, Newborn ; Intestinal Atresia ; Intestinal Obstruction ; Intestinal Volvulus ; Intussusception ; Male ; Meconium ; Mortality ; Pancreas ; Physical Examination ; Pyloric Stenosis, Hypertrophic ; Retrospective Studies ; Vomiting

Objective To investigate the role of transforming growth factor-β1 (TGF-β1), Smad2/3 and Smad7 expressions in carotid artery remodeling in renovascular hypertensive rats, and also the therapeutic effect of Enalapril and Amlodipine. Methods The renovascular hypertensive rat (RHR) models with two-kidney and one-clip were established, including model group (n = 6), sham-operated group (n = 6), Enalapril group (10 mg/kg per day, n = 6), Amlodipine group (5 mg/kg per day, n = 6) and combination group (Amlodipine 2.5 mg/kg per day + Enalapril 5mg/kg per day, n = 6). The medication were continuous administrated for six weeks. Carotid artery morphological and structural changes in the media were observed by HE staining, Masson staining and immuno histochemical staining. Media thickness (MT), MT and lumen diameter ratio (MT/LD), and the expression levels of media α-smooth muscle actin (α-actin), proliferating cell nuclear antigen (PCNA), TGF-β1, phosphorylated Smad2/3 (p-Smad2/3) and Smad7 in carotid arteries were measured. Results The media of carotid arteries in RHR model group was significantly thickened, the volume of smooth muscle cell was increased, and the array was in disorder; MT, MT/LD, the proliferation index of smooth muscle cell and collagen fiber area percentage of carotid arteries in the model group were significantly higher than those in the sham-operated group (P < 0.01). Compared to sham-operated group, the model group had significantly higher expressions of TGF-β1 and p-Smad2/3 (P < 0.05) and lower Smad7 expression. Both Enalapril and Amlodipine improved smooth muscle hypertrophy and collagen deposition, reduced RHR carotid MT, MT/LD, proliferation index of smooth muscle cell, collagen fiber area percentage and the expressions of TGF-β1 and p-Smad2/3 (P < 0.05), increased Smad7 expression (P < 0.05). Moreover, the combination treatment of Enalapril and Amlodipine had significantly better effects than single Amlodipine group (P < 0.05), but not single Enalapril group. Conclusions TGF-β1/Smads pathway may participate in the mechanism of carotid artery remodeling in RHR; the role of Amlodipine and Enalapril in inversing carotid artery remodeling may be related to the change of TGF-β1/Smads pathway, the combination treatment of Amlodipine and Enalapril had better effects than single administration of Amlodipine.

GJ-4 is crocin enrichments extracted from Gardenia jasminoides J. Ellis, and our previous studies have shown that GJ-4 significantly improved learning and memory impairment induced by Aβ in mice. Herein, a memory deficit model was developed by injecting okadaic acid (OA) into the lateral ventricle of mice, and the neuroprotection and underlying mechanism of GJ-4 on neuronal injury caused by Tau hyperphosphorylation were investigated. The Animal Care & Welfare Committee, Institute of Materia Medica, CAMS & PUMC has approved all procedures (No.00000318). GJ-4 at different doses was intragastric administration to mice for 16 days. Step-down test and Morris water maze test showed that GJ-4 could significantly improve OA-induced memory impairment in mice, and reduced the loss of Nissl bodies in the hippocampus of mice. GJ-4 could also decrease the phosphorylation level of Tau protein at Ser396, Thr231 and Ser404 via increasing protein phosphatase 2A (PP2A) activity and inhibiting glycogen synthase kinase-3β (GSK-3β) activity. Besides, further researches indicated that GJ-4 could inhibit the level of oxidative stress in the brain of OA mice, reduce neuronal apoptosis and inhibit the neuroinflammation mediated by activation of astrocytes in the hippocampus of mice, and eventually achieve its effects in improving learning and memory impairment in mice. According to these findings, we anticipated that GJ-4 might be a potential therapeutic drug for Alzheimer's disease.

This study aimed at investigating the antiviral constituents from the active fractions of Tong-An (TA) injection.In this study,the active constituents of TA injection were screened by LPS-induced PGE2 production mode to detect the contents of PGE2.The chemical constituents were isolated by HP-20 macroporous resin,silica gel column chromatography,ODS column chromatography,Sephadex LH-20 column chromatography and preparative and semi-preparative HPLC.The structures were identified by spectral data and physicochemical property.As a result,the 95％ ethanol eluate of TA injection on the macroporous adsorption resin column was proved to be the active fraction of TA injection.Seventeen compounds were isolated from TA injection and identified as syringaresinol (1),N-Trans-Feruloyltyramine (2),chelerythrine (3),sinomenine (4),coptisine (5),sanguinarine (6),chelidoniny (7),magnoflorine (8),allocryptopine (9),protopine (10),farrerol (11),dihydrosanguinarine (12),heptadec-(9Z)-enoic acid (13),chlorogenic acid (14),cryptochlorogenin acid (15),3,5-di-O-caffeoylquinic acid (16) and 4,5-di-O-caffeoylquinic acid (17).PGE2 inhibitory activities of these compounds were determined,among which six compounds presented inhibitory activities against PGE2.It was concluded that all the isolated compounds from TA injection were firstly reported with the favorable inhibitory activities of compounds 2,5,9,10,11,12 against PGE2.

Treatment guidelines of the neurointerventional procedures are continuously updated. However, these guidelines differ between countries and even medical societies within the same country because of the differing interests and patient groups. The differences between guidelines are confusing to many neurointerventionalists. Recently "Clinical Research Center for Stroke" in Korea updated "Clinical Practice Guidelines for Stroke" for the patients in Korea. So we introduce those guidelines and compare several recent guidelines of international medical societies for neurointerventionalists.
Aneurysm ; Humans ; Korea ; Societies, Medical

PURPOSE: The aim of this study was to identify the predictive factors in the early laboratory findings for cardiac sequelae in Kawasaki disease(KD). METHODES: A retrospective review of the records was conducted of all children with KD who were admitted to the Ulsan Dongkang General Hospital, Masan Samsung Hospital, and Gyeongsang National University Hospital between January 1995 and December 1999. We analyzed and compared the early laboratory findings between the patients with and without coronary artery dilatation. RESULTS: A total of 981 patients were divided into two groups : 826 patients(84.3%) with normal coronary artery and 155 patients(15.7%) with coronary artery dilatation. Age and sex were not significantly different between the two groups. The mean serum C-reactive protein(CRP) in the coronary artery dilatation group and in the normal coronary artery group were 5.0 mg/dl(+/-5.3) and 4.1 mg/dl(+/-5.0), respectively, with a significant difference(P<0.05), whereas the other early laboratory findings had no difference between the groups. CONCLUSION: This study shows that the early serum CRP was higher in patients with KD who had coronary artery dilatation than in those with normal coronary artery. There may be a strong possibility of cardiac sequelae at a high level of serum CRP. However, the cut-off value of serum CRP could not be determined for the prediction of cardiac sequelae in patients with KD.
Child ; Coronary Vessels ; Dilatation ; Hospitals, General ; Humans ; Mucocutaneous Lymph Node Syndrome* ; Retrospective Studies ; Staphylococcal Protein A* ; Ulsan

INTRODUCTIONSleep problems are common in all ages, but may be particularly acute in urban Singapore. This study aims to describe the sleep behaviour of, and to identify any sleep problems in, preschool children.

MATERIALS AND METHODSThis was a cross-sectional questionnaire survey of 372 children attending local childcare centers. The questionnaire was based on the Children's Sleep Habits Questionnaire (CSHQ), a validated parent-report sleep screening questionnaire that contains 54 items identifying sleep behaviours in children.

RESULTSA total of 372 (40.0%) children participated. The mean age was 4.1 (SD 1.3) years (range, 2 to 6 years). Average total sleep duration was 10.8 hours (SD 1.1) with average night-time sleep duration of 8.5 hours (SD 0.6) and average nap duration of 1.6 hours (SD 1.0). Co-sleeping was common; 80.9% of children shared a room with someone else. The most common sleep problems were in the domains of sleep resistance and morning behaviour; namely: requiring company to fall asleep (n = 272, 73.1%), being afraid to sleep alone (n = 228, 61.6%) and diffi culty in waking up (n = 165, 44.4%). Among parents, 84.1 % (n = 313) perceived that their child's sleep duration was adequate.

CONCLUSIONThe duration of sleep in the Singaporean preschool population sampled is signifi cantly lower than recommended values and that of previously described Caucasian populations. Parental perception of sleep adequacy deviates from current recommendations. Given the clear relation of sleep duration with cognitive functioning, learning, and physical growth, this sleep deprivation should be addressed with parental education and opportunistic screening of sleep in well-child follow-ups.

Child ; Child, Preschool ; Cross-Sectional Studies ; Female ; Habits ; Humans ; Male ; Prevalence ; Singapore ; Sleep ; Sleep Deprivation ; epidemiology ; Sleep Wake Disorders ; epidemiology ; Surveys and Questionnaires ; Urban Population

Primary peritonitis usually refers to a bacterial infection of the peritoneal cavity without a demonstrable intra-abdominal source. Most cases occur in children with ascites resulting from nephrotic syndrome or cirrhosis. Rarely, it may occur in previously healthy children less than 7 years of age, usually a girl. Distinguishing primary peritonitis from appendicitis may be impossible in patients without a history of nephrotic syndrome or cirrhosis. Accordingly, the diagnosis of primary peritonitis is made only at laparotomy. We report one case of primary pneumococcal peritonitis in a 27-month-old female who underwent explorative laparotomy to discover the cause of suspicious intestinal perforation and mechanical ileus. Later, pneumococci were cultured in blood and gram-positive diplococci were isolated from the pus of peritoneal cavity.
Appendicitis ; Ascites ; Bacterial Infections ; Child* ; Child, Preschool ; Diagnosis ; Female ; Fibrosis ; Humans ; Ileus ; Intestinal Perforation ; Laparotomy ; Nephrotic Syndrome ; Peritoneal Cavity ; Peritonitis* ; Suppuration

We experienced two cases of congenital localized skin defect and neonatal onset of relapsing subepidermal blisters associated with minor trauma in a female newborn infant and her mother. The mother of index case showed toe nail dystrophy at delivery of her daughter, but the index case did not reveal nail dystrophy until 14 months of age. The congenital skin defects healed with hypopigment, and mild atrophic scars and relapsing blisters healed without scars in both mother and daughter. These cases were considered as hereditary Bart's syndrome with respects to family history, clinical manifestations and histopathological findings.
Blister ; Cicatrix ; Epidermolysis Bullosa ; Female ; Humans ; Infant, Newborn ; Mothers* ; Nuclear Family* ; Skin ; Toes

Purpose: To evaluate the safety and efficacy of stent-assisted coil embolization (SAC) in acutely ruptured cerebral aneurysms without severe symptoms, and thus, the usefulness of the stent itself in patients with subarachnoid hemorrhages. Materials and Methods: From January 2017 to June 2019, 118 patients were treated with coil embolization for acutely ruptured cerebral aneurysms without severe symptoms (Hunt & Hess grade ≤ 3). The periprocedural complications, six-month modified Rankin scores (mRS), and six-month radiologic outcomes were compared between 56 patients with SAC and 62 patients without SAC (non-SAC). Results: The rate of good clinical outcomes (mRS ≤ 2), as well as the rate of hemorrhagic and ischemic complications, showed no significant difference between the SAC and non-SAC groups.Moreover, compared to the non-SAC group, the SAC group showed a lower recanalization rate on the six-month follow-up angiogram (20% vs. 39.3%, p = 0.001). Conclusion Although stent use was not significantly associated with clinical outcomes in coil embolization of ruptured cerebral aneurysms with non-severe symptoms (Hunt & Hess grade ≤ 3), it significantly decreased the rate of recanalization on follow-up cerebral angiograms.