Purpose: Biliary atresia (BA) is a rare but progressive cholangiopathy and the leading cause of pediatric liver transplantation worldwide. The Korean Association of Pediatric Surgeons (KAPS) has conducted three national surveys (2001, 2011, and 2023) to assess long-term trends in the diagnosis, treatment, and outcomes of BA. This study provides a comparative analysis of the 2nd and 3rd national surveys, with reference to selected findings from the 1st survey. Methods: This study included 453 patients from the 3rd national survey (2011–2021) and 435 patients from the 2nd survey (2001–2010), all of whom underwent Kasai portoenterostomy. Data were collected via electronic case report forms from pediatric surgical centers nationwide. Comparisons were made regarding demographics, clinical features, diagnostic patterns, operative details, follow-up outcomes, and survival. Kaplan–Meier analysis was used to evaluate long-term survival. Results: The mean number of BA patients per year remained stable between surveys (43.5 in the 2nd, 41.18 in the 3rd), though centralization of care increased, with 61.5% of cases managed by two major institutions in the 3rd survey. The median age at surgery decreased, and the use of preoperative imaging (especially magnetic resonance cholangiopancreatography) increased. The 10-year native liver survival rate declined from 59.8% to 53.7%, while overall 10-year survival improved slightly (92.9% to 93.2%). Postoperative complications, such as cholangitis and liver failure, persisted but were better categorized. The 3rd survey also reported improved mortality (4.9%) and reduced follow-up loss (11.5%) compared to the 2nd survey. Conclusion While overall survival after Kasai operation has remained high and even improved, native liver survival has slightly declined. The findings reflect earlier diagnosis, more consistent diagnostic imaging, and increasing centralization of care. These trends underscore the importance of long-term nationwide data collection in guiding future strategies for BA management in Korea.

Purpose: This study aims to investigate and compare the incidence, demographic characteristics, clinical manifestations, preoperative diagnostic methods, anatomical classifications, associated anomalies, operative treatments, and postoperative outcomes of patients with intestinal atresia treated by the members of the Korean Association of Pediatric Surgeons (KAPS) through three nationwide surveys. Methods: KAPS conducted 3 national surveys in 1998, 2010, and 2024 to examine the patients diagnosed with intestinal atresia. In preparation for the survey, we developed a customized case registration form to obtain data on patient sex, birth weight, gestational age, clinical manifestations, preoperative diagnostic methods, anatomical types, associated anomalies, operative treatments, and postoperative outcomes. Authorized KAPS members completed the case registration form. Results: The first, second, and third national surveys included 218, 222, and 236 individuals diagnosed with intestinal atresia, respectively. The male-to-female ratios were 1.5:1, 1.1:1, and 1.1:1, respectively. The first, second, and third national surveys revealed that 34.3%, 43.3%, and 53.4% of patients were born before 37 weeks of gestation, respectively. Additionally, 28.7%, 32.0%, and 40.7% of patients had a birth weight under 2,500 g. In the third national survey, duodenoduodenostomy was the most common procedure, performed in 70 out of 82 patients diagnosed with duodenal atresia. Resection and anastomosis were the main surgical procedures conducted in 47 out of 54 cases of jejunal atresia and 74 out of 92 cases of ileal atresia. The mortality rates in the first, second, and third national surveys were 13.8%, 3.6%, and 1.3% respectively, with the lowest rate observed in the third national survey. Conclusion These national surveys offer valuable insights into the current state of intestinal atresia, including specific surgical interventions and postoperative outcomes in South Korea. For pediatric surgeons aiming to enhance their understanding of intestinal atresia and its treatment options, these surveys could be an indispensable resource and guide.

Purpose: This study provides insights into the prevalence at birth, clinical characteristics, and outcomes of gastroschisis and omphalocele in Korea over the past decade, addressing the lack of localized data despite advanced healthcare capabilities. Methods: The study retrospectively analyzed data from 20 pediatric surgical centers in Korea from January 2012 to December 2021, including 269 patients diagnosed with gastroschisis or omphalocele. Data variables included gender, gestational age, birth weight, associated anomalies, type of defect, surgical interventions, and outcomes. Results: The study covered 269 patients, with 80 gastroschisis and 189 omphalocele cases. Gastroschisis prevalence at birth remained stable at 2.15 per 100,000 live births, while omphalocele increased to 5.08 per 100,000. Both conditions had similar gender ratios (0.95). Gastroschisis patients had lower birth weights (2,463.90±505.50 g) and smaller head circumferences (31.97±1.86 cm) compared to omphalocele patients (2,757.65±761.24 g, 32.78±2.64 cm). Omphalocele cases had more associated anomalies, especially cardiovascular issues. Prenatal diagnosis rates were high: 93.7% for gastroschisis and 86.4% for omphalocele. About 96.3% of gastroschisis and 84.1% of omphalocele patients were born in their treatment hospitals. Gastroschisis patients underwent surgery sooner (average 3.5 days) and started feeding later (16.5 days) than omphalocele patients (average 56.5 days to surgery, 6.6 days to start feeding). Hospital stays and follow-up durations were similar, averaging around 782.6 days for gastroschisis and 800.3 days for omphalocele patients. Survival rates were 89.7% for gastroschisis and 87.1% for omphalocele. Conclusion The study highlights the need for early diagnosis, centralized care, and specialized surgical approaches to optimize outcomes for gastroschisis and omphalocele patients in Korea. Enhanced prenatal screening and surgical protocols are recommended to improve these patients' prognosis.

This study aimed to compare the pharmacokinetic (PK) and safety profiles of 2 fenofibric acid formulations under fasting and fed conditions. The reference was a 135 mg capsule, while the test was a 110 mg enteric-coated tablet. This randomized, open-label, two-sequence, two-period crossover phase 1 clinical trial was conducted in healthy Korean men. Sixty participants were enrolled in each of the fasting and feeding groups. Blood samples were collected 72 hours after drug administration. PK parameters were calculated using a noncompartmental method with Phoenix WinNonlin ® . A total of 53 and 51 participants from the fasting and feeding groups, respectively, completed the study. The geometric mean ratio and 90% confidence intervals of the maximum concentration (C max ) and area under the concentration-time curve to the last measurable plasma concentration were 0.9195 (0.8795–0.9614) and 0.8630 (0.8472–0.8791) in the fasting study and 1.0926 (1.0102–1.1818) and 0.9998 (0.9675–1.0332) in the fed study, respectively. The time to reach C max of the enteric-coated tablet compared to that of the capsule was extended by 1 and 3 hours under fasting and fed conditions, respectively. In conclusion, enteric-coated tablets have a higher bioavailability than capsules. In addition, the enteric-coated tablet was smaller than the capsule, making it easier for patients to swallow.

UI026 is an expectorant and antitussive agent which is a new combination of Pelargonium sidoides extract andCoptis extract. The bioactive compounds of Pelargonium sidoides and Coptis extracts were identified as epicatechin and berberine, respectively. This study evaluated the effect of food on the pharmacokinetics (PKs) and safety of UI026. A randomized, openlabel, single-dose, 2-treatment, parallel study in 12 healthy male subjects was performed. Subjects received a single oral dose of UI026 (27 mL of syrup) under a fed or fasted condition according to their randomly assigned treatment. Blood samples for the PK analysis were obtained up to 24 hours post-dose for berberine and 12 hours post-dose for epicatechin. The PK parameters were calculated by non-compartmental analysis. In the fed condition, the mean maximum plasma concentration (C max ) and mean area under the plasma concentrationtime curve from time zero to the last observed time point (AUC last ) for berberine were approximately 33% and 67% lower, respectively, compared with the fasted condition, both showing statistically significant difference. For epicatechin, the mean C max and mean AUC last were about 29% and 45% lower, respectively, compared to the fasting condition, neither of which showed a statistically significant difference. There were no drug-related adverse events. This finding suggests that food affects the systemic exposure and bioavailability of berberine and epicatechin.

OBJECTIVES: Recently, the number of adolescent criminals hospitalized for evaluation or treatment of mental illness is increasing. The aim of this study was to provide basic information for the evaluation and treatment of adolescent misconducts, based on their impulsivity. METHODS: Barrat's impulsivity test was done to 64 adolescent criminals under age of 18 who were admitted to a Juvenile School between Oct. 1, 2003 and June 30, 2004. According to their recognizing impulsivity scores, the upper 30% group (high impulsivity group: HIG) and the lower 30% group (low impulsivity group: LIG) were selected. The two groups were compared on socio-demographic data, crime characteristics, psychiatric diagnoses, Evoked Potential Latency and Amplitude, Cognitron and IQ. RESULTS: 1) The high impulsivity group had lower IQ than the low impulsivity group (p<0.01). 2) No difference was found in the seriousness of committed crimes, number of crimes and the age of first committed crimes. However, the high impulsivity group fended acting alone in committing crimes (p<0.05), and more frequently upeated same crimes (p<0.01). 3) Evoked potential latency was prolonged on FzN100 (p<0.05), CzN100 (p<0.05), PzN100 (p<0.01) and amplitude was increased on FzN100 (p<0.05), CzN100 (p<0.05), PzN100 (p<0.05) in high impulsivity group. 4) High impulsivity group showed lower scores on NOCR (p<0.01), NOCYR (p<0.01), NOCNR (p<0.01) in Cognitron. PzN100 (p<0.05) latency prolongation. CzN100 latency prolongation had positive correlation with PzN100 latency prolongation (p<0.05). 5) While the misconduct was most common problem in both groups, more ADHD diagnosis was identified in the high impulsivity group. The most frequent medical problem in low impulsivity group was with diseases of internal medicine (p<0.01) and anxiety disorders (p<0.01). CONCLUSION: The adolescent criminals with high impulsivity tend to have lower intelligence and commit crimes repeatedly. They are frequently diagnosed to have ADHD. When they are compared to low impulsivity group, big differences are found in prolonged evoked potential latency and increased amplitude on N100. Hence, in the treatment and rehabilitative programs for them, considering these characteristics may be helpful.
Adolescent* ; Anxiety Disorders ; Brain* ; Crime ; Criminals* ; Diagnosis ; Evoked Potentials ; Humans ; Impulsive Behavior* ; Intelligence ; Internal Medicine

OBJECTIVES: Recently, the number of adolescent criminals hospitalized for evaluation or treatment of mental illness is increasing. The aim of this study was to provide basic information for the evaluation and treatment of adolescent misconducts, based on their impulsivity. METHODS: Barrat's impulsivity test was done to 64 adolescent criminals under age of 18 who were admitted to a Juvenile School between Oct. 1, 2003 and June 30, 2004. According to their recognizing impulsivity scores, the upper 30% group (high impulsivity group: HIG) and the lower 30% group (low impulsivity group: LIG) were selected. The two groups were compared on socio-demographic data, crime characteristics, psychiatric diagnoses, Evoked Potential Latency and Amplitude, Cognitron and IQ. RESULTS: 1) The high impulsivity group had lower IQ than the low impulsivity group (p<0.01). 2) No difference was found in the seriousness of committed crimes, number of crimes and the age of first committed crimes. However, the high impulsivity group fended acting alone in committing crimes (p<0.05), and more frequently upeated same crimes (p<0.01). 3) Evoked potential latency was prolonged on FzN100 (p<0.05), CzN100 (p<0.05), PzN100 (p<0.01) and amplitude was increased on FzN100 (p<0.05), CzN100 (p<0.05), PzN100 (p<0.05) in high impulsivity group. 4) High impulsivity group showed lower scores on NOCR (p<0.01), NOCYR (p<0.01), NOCNR (p<0.01) in Cognitron. PzN100 (p<0.05) latency prolongation. CzN100 latency prolongation had positive correlation with PzN100 latency prolongation (p<0.05). 5) While the misconduct was most common problem in both groups, more ADHD diagnosis was identified in the high impulsivity group. The most frequent medical problem in low impulsivity group was with diseases of internal medicine (p<0.01) and anxiety disorders (p<0.01). CONCLUSION: The adolescent criminals with high impulsivity tend to have lower intelligence and commit crimes repeatedly. They are frequently diagnosed to have ADHD. When they are compared to low impulsivity group, big differences are found in prolonged evoked potential latency and increased amplitude on N100. Hence, in the treatment and rehabilitative programs for them, considering these characteristics may be helpful.
Adolescent* ; Anxiety Disorders ; Brain* ; Crime ; Criminals* ; Diagnosis ; Evoked Potentials ; Humans ; Impulsive Behavior* ; Intelligence ; Internal Medicine