Association between the Korean Triage and Acuity Scale level and hospitalization of children with abdominal pain in the emergency department

PURPOSE: The Korean Triage and Acuity Scale (KTAS) is a triage tool for patients in the emergency department (ED). We aimed to investigate the association between the KTAS level and hospitalization of children with abdominal pain, a common chief complaint in the ED. METHODS: This study retrospectively reviewed medical records of children aged 3 to 14 years who visited the ED with abdominal pain as a chief complaint. KTAS level (1–3 vs. 4–5), age, gender, presence of associated symptoms (vomiting, diarrhea, hematochezia, and fever), and disposition (rapid discharge, discharge after intravenous hydration, and hospitalization) were collected and compared between the children with KTAS 1–3 and 4–5. RESULTS: Of 1,050 children enrolled, 618 (58.9%) were classified as KTAS 1–3, and 36 (3.4%) were hospitalized. Vomiting was the most common associated symptom in both groups (63.6%), and 41.5% underwent discharge after intravenous hydration. The children with KTAS 1–3 were more frequently hospitalized (5.0% vs. 1.2%, P < 0.001). CONCLUSION: The KTAS may be reliable to predict the hospitalization of children with abdominal pain in the ED with additional consideration of the associated symptoms.

Development of Advanced Atherosclerotic Plaque by Injection of Inflammatory Proteins in a Rabbit Iliac Artery Model

PURPOSE: Appropriate animal models of atherosclerotic plaque are crucial to investigating the pathophysiology of atherosclerosis, as well as for the evaluation of the efficacy and safety of vascular devices. We aimed to develop a novel animal model that would be suitable for the study of advanced atherosclerotic lesions in vivo. MATERIALS AND METHODS: Atherosclerotic plaque was induced in 24 iliac arteries from 12 rabbits by combining a high cholesterol diet, endothelial denudation, and injection into the vessel wall with either saline (n=5), olive oil (n=6), or inflammatory proteins [n=13, high-mobility group protein B1 (HMGB1) n=8 and tumor necrosis factor (TNF)-α n=5] using a Cricket™ Micro-infusion catheter. Optical coherence tomography (OCT) was performed to detect plaque characteristics after 4 weeks, and all tissues were harvested for histological evaluation. RESULTS: Advanced plaque was more frequently observed in the group injected with inflammatory proteins. Macrophage infiltration was present to a higher degree in the HMGB1 and TNF-α groups, compared to the oil or saline group (82.1±5.1% and 94.6±2.2% compared to 49.6±14.0% and 46.5±9.6%, p-value<0.001), using RAM11 antibody staining. On OCT, lipid rich plaques were more frequently detected in the inflammatory protein group [saline group: 2/5 (40%), oil group: 3/5 (50%), HMGB1 group: 6/8 (75%), and TNF-α group: 5/5 (100%)]. CONCLUSION: These data indicate that this rabbit model of atherosclerotic lesion formation via direct injection of pro-inflammatory proteins into the vessel wall is useful for in vivo studies investigating atherosclerosis.

The toxicity and behavioural effects of neem limonoids on Cnaphalocrocis medinalis (Guenée), the rice leaffolder.

Meliaceae plant products have been shown to exert pesticidal properties against a variety of insect species. In agricultural pest control programs, such products may have the potential to be used successfully as botanical insecticides. The effect of the neem (Azadirachta indica) limonoids azadirachtin, salannin, deacetylgedunin, gedunin, 17-hydroxyazadiradione and deacetylnimbin on the biology and mortality of rice leaffolder larvae was investigated. In laboratory experiments, treatment with neem limonoids suppressed leaf folding behaviour of C. medinalis. Biological parameters (larval duration, pupal duration adult longevity and fecundity) were also affected by the treatment. Azadirachtin, salannin, and deacetylgedunin showed high bioactivity at all doses, while the rest of the neem limonoids were less active, and were only biologically active at high doses. Azadirachtin was most potent in all experiments and produced almost 100% larval mortality at 1 ppm concentration. These results indicate neem limonoids affect the larval behaviour. These effects are most pronounced in early instars.

Effects of Dysoxylum malabaricum Bedd. (Meliaceae) extract on the malarial vector Anopheles stephensi Liston (Diptera: Culicidae).

In recent years, use of environmentally friendly and biodegradable natural insecticides of plant origin have received renewed attention as agents for disease vector control. Methanol extracts of leaves from the Indian white cedar Dysoxylum malabaricum Bedd. (Meliaceae) were tested against mature and immature Anopheles stephensi Liston (Diptera) mosquitoes under laboratory conditions. The extract showed strong larvicidal, pupicidal, adulticidal, and antiovipositional activity. The maximum leaf extract concentration tested in this study was 4%, which produced pronounced effects. In general, first and second instars were more susceptible to leaf extract than older insects. Clear dose-response relationships were established, with the highest dose of 4% plant extract causing 97% mortality of first instars.