Purpose: Advanced pediatric emergency centers play an important role in professional treatment of children. We analyzed the characteristics of children who visited an advanced pediatric emergency center. Methods: The study enrolled children younger than 15 years who had visited Keimyung University Dongsan Medical advanced pediatric emergency center between April 2016 and March 2018. We reviewed the children’s age group characteristics, time of visit, triage results by the Korean Triage and Acuity Scale (KTAS), use of the emergency medical service ambulances, emergency department length of stay, final diagnosis, and final disposition. Results: A total 41,355 children (mean age of 3.1 ± 3.0 years) were enrolled, and those aged 1-4 years accounted for 65.7%. The visit was most frequent in December, at night (40.2%), and at holiday hours (30.2%) (c.f., business hours, 11.5%). Fever (33.2%) and eyelid laceration (11.5%) were the most common final diagnoses of diseases and injuries, respectively. The children triaged as the KTAS 1-2 accounted for 5.9% of the study children (c.f., KTAS 3-4, 91.5%). According to time of visit, the proportion of hospitalization (31.4%) and transfer from other hospitals (34.7%) were most frequent at business hours than other times of visit (P < 0.001). Conclusion The children tended to visit the center with minor diseases or injuries, especially during holidays and at night. Further research is needed for optimizing the roles of advanced pediatric emergency centers, taking into account the characteristics of patients and demand for the centers.

Trimethyltin chloride (TMT) has been used as a neurotoxin for inducing brain dysfunction and neuronal death. Neuronal death in the hippocampus by TMT may generate excessive nitric oxide, but there are few studies about nitric oxide synthase enzyme involved in the synthesis of nitric oxide. The purpose of present study is to analyze the TMT toxicity in each region of rat hippocampus. To evaluate the involvement of nitric oxide, we analyzed the effects of aminoguanidine known as a selective inhibitor for inducible nitric oxide synthase on behavioral changes and the hippocampus of rat by TMT toxicity. 6-week-old male Sprague-Dawley rats were administered with a single dose of TMT (8 mg/kg b.w., i.p.) and the control group was similarly administered with distilled water. TMT + aminoguanidine-treated groups were administered with aminoguanidine (10 mg/kg or 100 mg/kg b.w., i.p.) for 3 days prior to TMT injection. The rats were sacrificed 2 days after TMT administration. In the TMT-treated group, a number of cell losses were seen in CA1, CA3 and the dentate gyrus. In the TMT + aminoguanidine-treated group, neuronal death was seen in CA1 and CA3, but reduced in the dentate gyrus compared to the TMT-treated group. Western blot analysis showed that cleaved caspase-3 expression was increased in the TMT-treated group compared to the control group. However, the expression significantly declined in the TMT + aminoguanidine-treated group. The present findings suggest that inducible nitric oxide synthase is involved in neuronal death induced by TMT.
Animals ; Blotting, Western ; Brain ; Caspase 3 ; Dentate Gyrus ; Guanidines ; Hippocampus ; Humans ; Male ; Neurons ; Nitric Oxide ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type II ; Rats ; Rats, Sprague-Dawley ; Trimethyltin Compounds ; Water