Heparin-binding epidermal growth factor-like growth factor (HB-EGF) protected intestinal ischemia-reperfusion injury through JNK and p38/MAPK-dependent pathway for anti-apoptosis.

Background: Heparin-Binding Epidermal Growth Factor-Like Growth Factor (HB-EGF) is a potent cytoprotective factor in various body systems, including gastrointestinal tract. In this study, we intended to examine whether HB-EGF exerts its protective effects through MAPK dependent anti-apoptosis after intestinal I/R injury.

Methods: We randomly divided 30 laboratory 30 rats into 5 groups: (A) normal control group, (B) ischemia group with normal saline, (C) I/R group with normal saline, (D) ischemia group with HB-EGF (400 ug/kg), and (E) I/R group with HB-EGF (400 ug/kg).

Trends in diagnostic approaches for pediatric appendicitis: nationwide population-based study.

Background: To define the benefits of different methods for diagnosis of pediatric appendicitis in Taiwan, a nationwide cohort study was used for analysis.

Methods: We identified 44,529 patients under 18 years old who had been hospitalized with a diagnosis of acute appendicitis between 2003 and 2012. We analyzed the percentages of cases in which ultrasound (US) and/or computed tomography (CT) were performed and non-perforated and perforated appendicitis were diagnosed for each year.

Therapeutic effectiveness of percutaneous drainage and factors for performing an interval appendectomy in pediatric appendiceal abscess.

Background: In this study, we studied the therapeutic effectiveness of percutaneous drainage with antibiotics and the need for an interval appendectomy for treating appendiceal abscess in children with a research-oriented dataset released by the Bureau of National Health Insurance in Taiwan through the Collaboration Center for Health Information Application (CCHIA).

Methods: We identified 1225 patients under 18 years of age who had non-surgical treatment for an appendiceal abscess between 2007 and 2012 in a Taiwan CCHIA dataset. The treatment included percutaneous drainage with antibiotics or antibiotics alone.

Students' Interest in Surgery Affects Laparoscopic Practicing Performance.

Background And Objective: Earlier exposure to laparoscopic techniques is thought to be beneficial for medical students. Reports have demonstrated that practice improves performance in laparoscopies. In this study, we intended to evaluate whether medical students' interest in surgery is affected by the amount of practice and the performance on a laparoscopic simulator.

Calcitonin Gene-Related Peptide Downregulates Expression of Inducible Nitride Oxide Synthase and Caspase-3 after Intestinal Ischemia-Reperfusion Injury in Rats.

Background: Various investigations have demonstrated that calcitonin gene-related peptide (CGRP) plays an important role in mediating ischemic preconditioning. CGRP has been shown to mimic the protective effects of ischemic preconditioning and mitigate ischemia-reperfusion (I/R) injury in the heart, brain, gastrointestinal system, and other tissues. This study aimed to examine whether CGRP, a proven intestinal cytoprotective molecule, exerted its protective effects through modulation of inducible nitride oxide synthase (iNOS) and apoptosis after intestinal I/R injury.

National trends in therapeutic approaches and outcomes for pediatric appendicitis: a Taiwanese nationwide cohort study.

Purpose: To define the pattern of therapeutic approaches for pediatric appendicitis and compare their benefits in Taiwan, we analyzed a research-oriented dataset released by the Bureau of National Health Insurance in Taiwan through the Collaboration Center for Health Information Application (CCHIA) to document the impact of the rise of laparoscopic treatment on outcomes.

Methods: We identified 22,161 patients under 18 years who had been hospitalized with a diagnosis of acute appendicitis between 2007 and 2012 in the CCHIA. Statistical comparisons between the Laparoscopic appendectomy (LA) and open appendectomy (OA, control) groups were computed using a Chi squared test.

Genome-wide gene expression profiling of ischemia-reperfusion injury in rat kidney, intestine and skeletal muscle implicate a common involvement of MAPK signaling pathway.

The mechanisms of ischemia‑reperfusion (I/R) injury have not been fully elucidated to date. In order to determine the genetic involvement across different organs during I/R injury, a DNA microarray approach was used to analyze the gene expression profiles of the kidney, intestine, and skeletal muscle in a rat model of I/R injury. Fifteen male Lewis rats were divided randomly into three different organ groups; a sham operation (control group), 60‑min‑ischemia (Is group) only, and 60‑min‑ischemia plus 60‑min‑reperfusion (I/R group), respectively.

Preoperative lip measurement in patients with complete unilateral cleft lip/palate and its comparison with norms.

Purpose: There is prominent lip asymmetry in patients with unilateral complete cleft lip and palate. Measurement of the lip on cleft and non-cleft sides provides appraisal of the lip deformity and information for planning of surgical correction. The purpose of this retrospective study is to evaluate the degree of lip deformity and to compare it with normative data.

Elimination of postoperative pyloric stricture by endoscopic electrocauterization and balloon dilatation in an infant with congenital antral web.

We, herein, report a male infant who presented with recurrent pyloric stricture after two surgeries (web excision and antropyloroplasty), which were done, respectively, at 5 days of age for congenital antral web and 6 months of age for the subsequent pyloric stricture. The patient suffered from anorexia, progressed vomiting, and weight loss gradually after the first and second surgeries, and then, endoscopy revealed severe pyloric deformity and stricture. Poor inflation was noted during endoscopic balloon dilatation because of tight pylorus; a subsequent electrocauterization and balloon dilatation were done, and the patient's clinical symptoms improved significantly 2 weeks later.

Inguinal hernia containing uterus and uterine adnexa in female infants: report of two cases.

We herein report two female cases, aged 1 and 1.5 months, of inguinal sliding hernias containing the uterus, fallopian tube, and ovary. The diagnosis of inguinal hernia with uterus and uterine adnexa was highly suspected preoperatively by ultrasonography and was confirmed during surgical correction.

Risk factors for intestinal gangrene in children with small-bowel volvulus.

Objectives: Pediatric small-bowel volvulus (SBV) is a surgical emergency, and early diagnosis is difficult. We analyzed the clinical manifestations, imaging findings, and laboratory parameters in children with SBV and attempted to determine the risk factors for bowel gangrene.

Patients And Methods: Forty-nine children (35 boys and 14 girls) with SBV who were admitted to the hospital for a period of 13 years were enrolled.

Heparin-binding epidermal growth factor-like growth factor downregulates expression of activator protein-1 transcription factor after intestinal ischemia-reperfusion injury.

The pathogenesis of necrotizing enterocolitis (NEC) is unknown. Ischemia and reperfusion (I/R) injury have been considered to be major contributing factors. More recent reports have noted that apoptosis is a significant and perhaps the principal contributor to cell death after I/R injury.

Duodenal derotation and extent tapering jejunoplasty as primary repair for neonates with high jejunal atresia.

Background: The dilated bowel segment usually involves the entire jejunum, as well as the duodenum in patients with high jejunal atresia. Classical approaches with a limited tapering enteroplasty and anastomosis frequently fail to restore intestinal function. A novel technique using duodenal derotation and extent tapering jejunoplasty (DDETJ) is reported here.

Clinical and nutritional outcomes in children with idiopathic superior mesenteric artery syndrome.

Objective: There are no available data for outcomes in children's idiopathic superior mesenteric artery syndrome (SMAS) strictly treated conservatively. The aim of the study was to evaluate clinical and nutritional outcome in children with idiopathic SMAS.

Patients And Methods: A 1-year prospective observation study of effects of treatment and outcome was performed in 27 children (8 boys, 19 girls) with idiopathic SMAS who underwent an upper gastrointestinal (UGI) series, ultrasound measurement of the aortomesenteric angle, treatment, clinical assessment, growth evaluation, and regular clinical visits for more than 12 months.

Ovarian tumors in the pediatric age group: 37 cases treated over an 8-year period.

Background: Ovarian tumors have generally been considered rare in the pediatric age group. We reported our experience dealing with pediatric ovarian tumors during an 8-year period.

Methods: Between January 1998 and December 2006, 37 girls with ovarian tumors were treated at the Department of Pediatric Surgery, Chang Gung Childrenfs Medical Center.

Individualized management of upper rectal atresia.

Background/purpose: Congenital colonic atresia (CA) or stenosis is an infrequent cause of low intestinal obstruction in the neonate. Atresias can occur at any level, and the management of CA is determined by the atretic site and by the presence or absence of associated anomalies. We report our experience dealing with upper rectal atresia during a 5-year period.

Single-Center Experience: immunosuppressive therapy as frontline treatment for 33 children with acquired severe aplastic anemia.

The authors retrospectively analyzed the records of 33 children with acquired severe aplastic anemia (SAA) diagnosed from July 1998 to October 2007 and first treated by immunosuppressive therapy (IST). Serial hematologic parameters, complications, transfusion requirements, and time to response were assessed. Allogeneic hematopoietic stem cell transplantation (HSCT) was attempted in 7 patients after failure of IST (n = 6) or relapse following an initial response to IST (n = 1).

Clinical manifestations in infants with symptomatic meconium peritonitis.

Background: Meconium peritonitis (MP) develops when bowel perforation occurs in utero or soon after birth, resulting in leakage of meconium into the peritoneal cavity. The clinical features are often variable and prenatal ultrasonography plays an important role in prenatal diagnosis.

Methods: We conducted a retrospective review of neonates diagnosed with MP in our hospital from January 1998 to December 2007.

An accessory labioscrotal fold associated with anorectal malformation in female neonates.

The association of perineal lipomas with anorectal malformations in the newborn has been reported previously (Shaul DB, Monforte HL, Pena A, et al. Surgical management of perineal masses in patients with anorectal malformations. J Pediatr Surg 2005;40:188-191; Wester T, Rintala RJ.

Choledochoduodenal fistula caused by blunt abdominal trauma in a child.

We report a 15-year boy who presented with obstructive cholangiopathy and pancreatitis after blunt abdominal trauma. A magnetic resonance cholangiopancreatography showed dilated common bile duct, dilated hepatic ducts, and a suspicious choledochoduodenal fistula. An endoscopic retrograde cholangiopancreatography revealed a parapapillary choledochoduodenal fistula.

Adnexal torsion in children.

Objectives: Adnexal torsion is an acute abdominal condition often confused with other diseases in children. The objective of this study is to evaluate the diagnosis and characteristics of adnexal torsion in children.

Methods: We reviewed the medical records of all cases of children whose adnexal torsion diagnosis was proven by surgery from 1992 to 2005.

Free radial forearm flap in an adult with hypospadias.

A 22-year-old man presented with a scarred neophallus and complex hypospadias. The local penile skin was inadequate for urethral repair. A 16 cm free radial forearm flap was used for urethral replacement.

Perforated peptic ulcer in children: a 20-year experience.

Background: Although the detection of pediatric peptic ulcer disease (PUD) has recently been increasing, perforated peptic ulcer (PPU) in children is rare. We report our experience with PPU in children.

Materials And Methods: The charts of children diagnosed with PPU at our hospital from January 1986 to June 2005 were reviewed.

Congenital mesenteric hernia causing intestinal obstruction in children.

Unlabelled: A mesenteric hernia is one type of intraperitoneal hernia. There is no hernia sac in this situation but only a mesenteric defect, which is present at birth. Strangulated mesenteric hernia is a rare cause of intestinal obstruction especially in the pediatric population.