Enlarging vascular stents after pediatric liver transplantation.

Background: Endovascular intervention with stent placement to treat portal vein (PV) and hepatic vein (HV) stenosis after pediatric liver transplantation (LT) is still controversial in small children owing to the potential risk of functional stenosis after growth. The aim of this study is to evaluate the safety and efficacy of stent placement in this population.

Methods: Between 2004 and 2016, 6 children (all <3 years) received HV (n = 2) and PV (n = 4) stents placement among 46 pediatric LT patients at our institution.

Surgical outcomes of total colonic aganglionosis in children: a 26-year experience in a single institute.

Background: There is a lack of consensus regarding the treatment of total colonic aganglionosis (TCA) with respect to perioperative morbidity, mortality, complications, and functional outcomes. The aim of this study was to review the results of surgical TCA treatment over a 26-year period and characterize the outcomes.

Methods: We retrospectively reviewed the clinical characteristics, surgical courses, and outcomes of TCA patients who underwent definitive pull-through operations from 1986 to 2012.

A newly designed total implantable venous access device in rats for research with high efficiency and low cost.

Background: In this study, we introduced a newly designed totally implantable device for long-term vascular access in rats and compared its efficacy, related complications, and cost-effectiveness with conventional exteriorized jugular vein catheters.

Methods: Forty adult male Sprague-Dawley rats, weighing 250-300 g, were equally divided into two groups (I and II) and all underwent jugular vein catheterization surgery. The totally implanted device was used in group I and conventional exteriorized catheters were used in group II.

Amelioration of paraquat-induced pulmonary injury by mesenchymal stem cells.

Acute paraquat (PQ) poisoning induces redox cycle and leads to fatal injury of lung. Clinical management is supportive in nature due to lack of effective antidote, and the mortality is very high. Mesenchymal stem cells (MSCs) process the properties of immunomodulation, anti-inflammatory, and antifibrotic effects and oxidative stress resistance.

Augmentation cystoplasty and simultaneous ureteral reimplantation reduce high-grade vesicoureteral reflux in children with neurogenic bladder.

Background: To compare the incidence of residual high-grade vesicoureteral reflux (HVUR) (≥Grade III) in neurogenic bladder patients receiving augmentation cystoplasty alone or with simultaneous ureteral reimplantation. Furthermore, we also tried to find the risk factors of residual VUR and febrile urinary tract infection.

Methods: Between 1999 and 2009, urinary bladder augmentation was performed in 21 children with neurogenic bladder.

Using vote cards to encourage active participation and to improve critical appraisal skills in evidence-based medicine journal clubs.

Rationale, Aims And Objectives: Evidence-based medicine (EBM) journal clubs are used by health care practitioners to critique and remain updated on relevant health literature. Vote cards, in three different colours (green/yellow/red), allow participants to express their opinions (agree/doubt/reject) on the quality and possibility of clinical application regarding the article being reviewed. Our aim is to assess the efficacy of using vote cards in EBM journal clubs.

Successful redo pull-through for Hirschsprung's disease in a Haddad syndrome patient.

Haddad syndrome is characterized by congenital central hypoventilation syndrome (Ondine's curse) associated with segmental distal gut aganglionosis (Hirschsprung's disease). The prognosis of Haddad syndrome is very poor, and survival is often less than 2 years. Treatment of Hirschsprung's disease is usually influenced by the association with Ondine's curse.

Outcome and risk factors for mortality in pediatric peritoneal dialysis.

Background: The mortality rate among children requiring renal replacement therapy is higher than in children without end-stage renal disease (ESRD). Some factors, such as hypoalbuminemia, high peritoneal transport rate, age, malnutrition, cardiovascular disease, and recurrent peritonitis, appear to be associated with lower survival in adult peritoneal dialysis patients. Data regarding risk factors of mortality in children with continuous ambulatory peritoneal dialysis (CAPD) are limited.

Retrograde arterial flush of the liver graft in living donor liver transplantation.

Formal hepatic arterial flush to preserve the liver graft in living donor liver transplantation (LDLT) is not recommended by most transplant centers because direct cannulation may injure the intima of the hepatic artery. The authors describe a method of retrograde arterial flush of the liver graft without arterial cannulation by hepatic venous outflow occlusion (HVOO) in LDLT. First, we proved no backflow of the hepatic artery without HVOO by portal flush to pig livers.

Multi-potent differentiation of human purified muscle-derived cells: potential for tissue regeneration.

Objective: To investigate whether CD34+ purified human muscle-derived cells (hMDCs) are capable of multiple lineage differentiation.

Materials And Methods: The hMDCs were isolated from human skeletal muscle and purified using a CD34+ cell selection system (Dynal Biotech, Oslo, Norway). Adherent populations of cells were expanded in culture and cell differentiation was induced using different kinds of growth factors and different differentiation-conditional media.

Domino liver graft from a patient with homozygous familial hypercholesterolemia.

HFH is a metabolic disease caused by a defect in the gene that encodes the synthesis of the cellular receptor for LDL-Rs. A high plasma level of cholesterol is present from birth and leads to severe atherosclerosis in childhood, and death from myocardial infarction usually occurs before the age of 20 yr. The liver contains approximately 50-75% of the total body LDL-Rs; therefore, liver transplantation has been carried out to treat this metabolic disorder effectively.

Isolation and characterization of human muscle-derived cells.

Objectives: To isolate and characterize human muscle-derived cells (MDCs) for future management applications on lower urinary tract symptoms, including stress urinary incontinence and bladder reconstitution. The development of muscle stem cells for transplantation or gene transfer in patients with muscle disorders has become more attractive and challenging recently.

Methods: Human MDCs were isolated from the skeletal muscles of the limbs.

Duct-to-duct biliary reconstruction in selected cases in pediatric living-donor left-lobe liver transplantation.

The feasibility of D-D biliary reconstruction in pediatric LDLT using left-lobe graft has been discussed in few reports. The use of a trans-anastomotic biliary tube seemed to be the favorable method to avoid the complications according to these reports. We had performed left-lobe LDLT for seven pediatric cases and D-D was done originally.

A technique of diamond-shape venoplasty to reconstruct the hepatic venous outflow in living donor liver transplantation for a case of Budd-Chiari syndrome.

It is difficult to reconstruct the hepatic venous outflow in LDLT for the case of BCS, especially when the thrombosis extends to the retro-hepatic and supra-hepatic vena cava. We reported on a technique of diamond-shape venoplasty which successfully treated such a case. The venoplasty used autologous vein grafts to overcome the size discrepancy between the orifices of supra-diaphragmatic inferior vena cava and hepatic vein of the liver graft.

Modifications of preputial unfurling to reduce postoperative edema in buried penis.

Objective: Buried penis is a result of penile skin deficiency and inadequate attachment of the skin to the Buck's fascia. Prolonged postoperative edema (>1 month) has been seen in some patients after preputial unfurling. Some modifications which may reduce this complication are described.

Analysis of the RET gene in subjects with sporadic Hirschsprung's disease.

Background: Hirschsprung's disease (HSCR), or aganglionic megacolon, is a hereditable disease of the enteric nervous system. It is an embryonic developmental disorder characterized by the absence of ganglion cells in the lower enteric plexus. Gut motility is compromised in HSCR, with consequent risk of intestinal obstruction.

Prepubertal testicular germ cell tumors: 25-year experience in Taipei Veterans General Hospital.

Background: Due to the rarity of testicular tumors in the prepubertal population, adequate information about their biological course is difficult to document well in a single institution. The purpose of this study was to focus on prepubertal males in an attempt to evaluate clinical features and optimal management among various testicular germ cell tumors with long-term follow-up.

Methods: We retrospectively reviewed the records of children younger than 12 years of age with primary testicular germ cell tumors between February 1981 and December 2005 at Taipei Veterans General Hospital.

Severe necrotizing fasciitis of the abdominal wall secondary to colon perforation in a child.

We discuss the successful saving of an 18-month-old boy with necrotizing fasciitis of the abdominal wall secondary to colon perforation and peritonitis. The patient underwent emergency surgery with exploratory laparotomy, repeated procedures of debridement, and reconstructive abdominal wall surgery with skin graft. He recovered 6 months after admission.

Totally implantable venous access ports via the external jugular vein: safety and effectiveness for young pediatric patients.

Background And Aims: Various venous approaches are possible during implanting a totally venous access port. The veins, which are commonly used in pediatric patients are internal and external jugular veins. Comparison of different venous approaches has been discussed in a few reports only.

Vaginal reconstruction using urinary bladder flap in a patient with cloacal malformation.

We report a case of vaginal reconstruction using a flap from urinary bladder in a young girl. This girl was born with cloacal malformation and hemivaginas connected to the urinary bladder. Repeated urinary tract infection and vesicoureteral reflux were noted.

Clamping the supra-celiac aorta can effectively increase the success rate of orthotopic rat liver transplantation by increasing the tolerable time of the anhepatic phase.

Background: Although using a Kamada model with a cuff approach for vascular anastomosis shortens the anhepatic time in orthotopic rat liver transplantation (ORLT), cardiac arrest is still often encountered during the anhepatic phase. We hypothesize that low cardiac output is the reason for this. In this study, we used the supra-celiac aorta clamp (SCAC) method during the anhepatic phase in ORLT to evaluate the success rate.

Esophageal atresia with tracheoesophageal fistula: ten years of experience in an institute.

Background: Esophageal atresia (EA), tracheoesophageal fistula (TEF), or both is a complicated problem. The purpose of this study was to evaluate the outcomes and postoperative complications in patients with EA/TEF who were admitted to our hospital.

Methods: In total, 15 patients were enrolled from 1994 to 2003, including 8 males and 7 females.