Our results indicate that a higher serum leptin level has stronger association with mild-to-moderate persistent AS compared with AR. Hence, serum leptin may be a stronger predictor for childhood AS compared with AR. Among the asthmatic children, higher serum leptin levels also showed stronger associations with female gender and being overweight.

Intermediate-dose oral erythromycin is effective and safe for the treatment of feeding intolerance in VLBW infants. The incidences of PNAC and ≥ stage II NEC were significant lower in the erythromycin group.

Hydranencephaly is a rare and fatal central nervous system disorder where all or nearly all of the bilateral cerebral hemispheres are absent. The extensive hollow cerebrum is replaced with cerebrospinal fluid. Clinically, the differential diagnoses of hydranencephaly include severe hydrocephalus and alobar holoprosencephaly. Nearly all cases are sporadic, involving approximately 1 in 5000 continuing pregnancies. The exact main cause is still unknown, but hydranencephaly is usually found to develop secondarily to the occlusion of cerebral arteries above the supraclinoid level. We present the case of a 1-month-old male infant with hydranencephaly initially thought to be severely hydrocephalus via routine antenatal intrauterine sonography performed at 35 weeks of gestation. Hydranencephaly was confirmed by brain sonography, brain magnetic resonance imaging and magnetic resonance angiography postnatally. We discuss several imaging features that are helpful in distinguishing hydranencephaly from extreme hydrocephaly. Different theories that have been recently proposed regarding the origin of hydranencephaly are reviewed.

Transcatheter closure of subarterial VSD with ADO is technically feasible and safe in patients older than 7 years of age. However, development or worsening of aortic regurgitation requires long-term follow-up.

Spinal abscess is rare in children, especially in young infants. The most common etiology is bacteria, Staphylococcus aureus in particular. Mycobacterium tuberculosis is another cause. We report an unusual cervical spinal abscess with spinal cord compression in a 13-month-old child. The presenting symptoms were weakness in the right arm and, predominantly, the right leg for 1 month. Magnetic resonance imaging showed an abscess of the cervical spine, extension with bony destruction, and spinal cord compression. The patient underwent an emergency neurosurgical decompression and laminectomy. Pathology and culture results confirmed Mycobacterium tuberculosis. After 12 months of antituberculosis treatment, the child could walk with a walker. At 37 months, he was able to walk without assistance. We conclude that spinal tuberculosis should be considered in cases of children with spinal cord-compression symptoms and an image showing an extraspinal abscess. Early diagnosis and prompt treatment are critical for maximizing a functional recovery.

Background Studies have confirmed the detrimental effects of air pollutants on allergic disease patients. However, individuals who are most vulnerable have not been completely identified. Methods Clinical study: During 2007 to 2011, 225 children aged 6 to 15 years with allergic rhinitis (AR) were recruited from a hospital in Taichung City, Taiwan. They were classified based on sensitivity to house dust mites, such as Dermatophagoides pteronyssinus, Blomia tropicalis (Bt), or Dermatophagoides microceras. Correlations between Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ) scores, allergen-specific immunoglobulin E levels, and air pollution levels were evaluated. Epidemiological study: Records of 9868 children with AR who were matched for study years, age, and city of the clinical study were obtained from a national database. Correlations between clinic visits for AR, topical AR drug prescriptions, and air pollution levels were evaluated. The air pollutants included sulfur dioxide (SO2), carbon monoxide (CO), ozone (O3), particles <10 μm in diameter (PM10), particles <2.5 μm in diameter (PM2.5), nitric oxide (NO), nitrogen dioxide (NO2), nonmethane hydrocarbon (NMHC), and methane (CH4). Results Epidemiological study: CO, NO, NO2, and CH4 levels were significantly correlated with topical AR drug prescriptions in boys. However, in girls, only CH4 level was significantly correlated. Clinical study: Positive correlations between the PRQLQ score and air pollutants were noted in boys but not in girls. After adjusting for confounders, correlations between CO, PM2.5, and NO2 levels were noted in boys sensitized to Bt but not in those sensitized to other mites. Conclusion Boys with AR were more vulnerable to air pollutants than girls. Bt-sensitized boys with AR were more vulnerable to air pollutants than girls and those sensitized to other mites.

<b><i>Background:</i></b> Asthma animal models provide valuable information about the pathogenesis and the treatment of asthma. An ovalbumin (OVA)/complete Freund’s adjuvant (CFA)-sensitized model was developed to induce neutrophil-dominant asthma and to investigate whether fungal immunomodulatory peptide-<i>fve</i> (FIP-<i>fve</i>) could improve asthma features in the OVA/CFA-sensitized model. <b><i>Methods:</i></b> We used female BALB/c mice and sensitized them intraperitoneally with OVA/CFA on days 1, 2, and 3. On days 14, 17, 21, 24, and 27, they were challenged with intranasal OVA. The airway hyper-responsiveness (AHR) was detected by BUXCO, inflammatory cells were stained with Liu’s stain, the cytokines were detected using ELISA, and the airway inflammation was analyzed with hematoxylin and eosin stain. <b><i>Results:</i></b> According to the results, OVA/CFA sensitization could induce AHR, high levels of IgE, and inflammatory cells especially neutrophils infiltration in the lung and airway inflammation. IL-4, IL-5, IL-6, IL-8, IL-10, IL-13, IL-17, IL-25, IL-33, and transforming growth factor-β (TGF-β) increased in the OVA/CFA-sensitized mice. OVA/CFA-sensitized mice treated with FIP-<i>fve</i> not only increased IL-12 and IFN-γ but also decreased IL-4, IL-5, IL-6, IL-8, IL-13, IL-17, IL-25, IL-33, and TGF-β in the bronchoalveolar lavage fluid. Moreover, FIP-<i>fve</i> significantly decreased neutrophil infiltration in the lung. <b><i>Conclusion:</i></b> The OVA/CFA model induced neutrophilic asthma successfully, and FIP-<i>fve</i> improved neutrophil-dominant asthma.

Introduction: Pancreaticoduodenectomy (PD) is a technically challenging surgery requiring longer period of recovery post operatively. The introduction of ERAS after PD has been debatable with no conclusive success. This study aims to compare early post-operative outcome of PD after implementation of ERAS protocol with previous conservative postoperative care. Method: 81 patients who underwent PD in UKMMC were recruited from Jan 2011 to April 2015. The control group were patients (n = 47) operated before January 2013 (pre-ERAS) while the case group were patients who were operated after implementation of ERAS protocol (n = 34). Demographic, pre-operative clinical data and early postoperative outcome are collected retrospectively. Results: The median length of stay of the post ERAS group were 11.7 days compared to 15.4 days in the pre ERAS group (p = 0.002). The rate of post-operative morbidity such as delayed gastric emptying, post operative pancreatic fistula, and post pancreatic haemorrhage were similar. There were no difference with regards to relaparotomy, readmission and mortality rate. The postoperative complications such as deep vein thrombosis, pulmonary embolism and pneumonia is significantly lower from 27.7% in the pre-ERAS group to 5.9% in the post ERAS group (p = 0.019). Conclusions: This study provides conclusive results of ERAS benefit with regards to recovery and a significant reduction of length of stay without affecting patient morbidity, mortality and readmission rate. It also proves to be the best management in reducing postoperative complications.