摘要:

In order to evaluate liver function in postoperative biliary atresia (BA) patients, the indocyanine green (ICG) clearance test was performed. Nineteen patients, ranging in age from 2 to 9 years, were classified into three groups. Group I were those who had no jaundice throughout the postoperative period (n = 9), Group II were those who had recurrent or intermittent jaundice (n = 7), and Group III were those who had persistent jaundice after hepatic portojejunostomy (n = 3). Forty-four volunteers of comparative age and sex served as controls to establish a normal range of ICG-K values in infants and children. The normal minimal ICG-K value in those 2–9 years of age was defined as 0.19. ICG-K values in BA patients were 0.262 ± 0.073 (Group I), 0.150 ± 0.060 (Group II), and 0.054 ± 0.011 (Group III). All nine patients with ICG-K below the normal level had esophageal varices, and seven of nine had a history of gastrointestinal hemorrhage. Two patients with ICG-K values within the normal range had esophageal varices, and none had a history of gastrointestinal hemorrhage. Five of nine patients with ICG-K values below normal had low serum albumin levels, and all had low prealbumin levels. Of those with ICG-K within the normal range, none had low serum albumin or prealbumin levels. On the other hand, serum bilirubin and other liver function tests did not accurately reflect clinical findings. In conclusion, the ICG test using the ICG-K value was confirmed to be a reliable indicator of postoperative liver function in BA patients.

ISSN:0277-2116    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Horizontal transmission of hepatitis B virus (HBV) is responsible for about half of the hepatitis B surface antigen (HBsAg) carriers in Taiwan. To investigate the routes and risk factors of horizontal HBV transmission, 131 HBsAg carrier children of HBsAg seronegative mothers were compared with 98 age-matched children seronegative for all hepatitis B markers. Possible factors influencing transmission of HBV, including family size, age at attending kindergarten, frequency of intramuscular injection during infancy and at the toddler stage, contact with HBsAg carriers, and HBV status of parents, siblings and caretakers were studied by questionnaire survey. Intramuscular injection frequency during infancy and at the toddler stage and prevalence of HBsAg positivity among siblings were significantly higher in carrier children than in the control group. Other factors studied were not different in these two groups. The results indicated that unsterilized, multiple intramuscular injections and intrafamilial spread among siblings might be the major routes of horizontal HBV transmission in children in Taiwan.

ISSN:0277-2116    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Although an integration of hepatitis B virus (HBV) DNA in children with chronic HBV infection has been documented at early phases of the disease, the incidence of this process is not known. Therefore we examined nine liver DNA specimens from chronic HBV carriers ages 5–14 years and one sample from a neonate delivered of a carrier mother, in order to determine the HBV DNA patterns of these patients at different ages and phases of chronic infection. The integrated HBV DNA was detected by Southern blot hybridization and analyzed by molecular cloning. Southern blot showed a smear pattern of HBV DNA integration in four of six chronic hepatitis patients (ages 5–14), as well as in one asymptomatic carrier (age 12). Multiple and random integrations occurred during chronic infections in childhood. The neonate did not, however, show signs of any integrations, suggesting that integration starts after HBV multiplication. A band pattern that suggested clonal growth of integrated liver cells was found in a chronic active hepatitis patient (age 9) and in one of two hepatocellular carcinoma patients (age 11). Molecular cloning in two cases with chronic active hepatitis showed that the HBV genome structure was preserved in five of six HBV DNA inserts. Our findings confirm that HBV DNA integration can occur at early stages of chronic HBV infection. In Japanese children, the process of integration seems to be common regardless of HBeAg/anti-HBe status. Thus, repetitive liver biopsies in chronic hepatitis B are useful not only to provide prognostic information referring to the histological progress of the disease but also to reflect the change of HBV DNA pattern in liver tissue during follow-up

ISSN:0277-2116    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Since the Poison Prevention Packaging Act took effect, the number of ingestions of caustic alkali from household products has been significantly reduced. Commercial caustic alkalis used on farms, however, were not included in this legislation. Fourteen children over a 5 year period were seen after ingestion of commercial caustic alkalis used on farms. Seven of the children had ingested liquid pipeline cleaners and seven had ingested solid agents used for a variety of reasons. Six of seven children ingesting liquid agents did so from nonoriginal containers into which the caustic had been transferred for convenience. All seven children ingesting solid agents did so from the original container. Eight of the 14 children were found to have second-degree or worse esophageal involvement. Both solid and liquid caustic agents used commercially on farms can cause significant morbidity. Development of a child-resistant container for daily transfer of liquid pipeline agents could be helpful in preventing injuries from liquid pipeline cleaners. Pediatric gastroen-terologists as well as primary care physicians in rural areas should be familiar with this type of injury and should take an active role in instructing parents of children living on farms to prevent such injuries. Extension of the Poison Prevention Packaging Act to caustic alkalis used on farms needs to be considered

ISSN:0277-2116    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1993

数据来源: OVID