Galactose half-life is a useful tool in assessing prognosis of chronic liver disease in children.

In children, optimal timing of liver transplantation (LT) is crucial, but reliable prognostic tools for chronic liver diseases are scarce. We assessed the predictive value of galactose half-life (Gal½) for LT or death. A retrospective search of hospital database 2003-2010 revealed 92 consecutive children with chronic liver disease (36 biliary atresia) whose liver function was assessed with Gal½ measurement.

Dynamic defecography in the diagnosis of paediatric rectal prolapse and related disorders.

Background And Aim: Paediatric rectal prolapse (RP) is rarely a diagnostic problem and resolves often spontaneously. We studied whether the assessment of recurrent RP (RP), postoperative relapsed RP (RRP) or anorectal discomfort without RP (ARD) benefits from dynamic defecography (DD) and describe DD findings in relation with outcome.

Patients And Methods: Fifteen patients (7 males), median age of 10 (range 3.

Lower urinary tract symptoms from childhood to adulthood: a population based study of 594 Finnish individuals 4 to 26 years old.

Purpose: We evaluated voiding habits and lower urinary tract symptoms by age and gender in a large population of individuals from childhood to adulthood.

Materials And Methods: We studied a cross-sectional sample of 594 individuals 4 to 26 years old randomly selected from the population register of Finland. Participants anonymously answered a detailed postal questionnaire on lower urinary tract symptoms.

Cholesterol metabolism altered and FGF21 levels high after pediatric liver transplantation despite normal serum lipids.

Liver transplantation (LT) predisposes to metabolic derangements and increases the risk for cardiovascular disease. We conducted a national cross-sectional study of all pediatric recipients who underwent LT between 1987 and 2007. We measured serum levels of noncholesterol sterols (surrogate markers of cholesterol synthesis and intestinal absorption) and fibroblast growth factor 21 (FGF21) in 49 patients (74% of survivors) at a median of 10 years posttransplant and in 93 controls matched for age and gender.

Endoscopic surveillance and primary prophylaxis sclerotherapy of esophageal varices in biliary atresia.

Objectives: Evidence-based recommendations on endoscopic screening and prophylactic treatment of esophageal varices in patients with biliary atresia (BA) are scarce. We assessed the efficiency of endoscopic surveillance and risk factors of esophageal varices and associated upper gastrointestinal bleeding.

Methods: A total of 47 consecutive children with BA and portoenterostomy underwent yearly endoscopies and prophylactic injection sclerotherapy of esophageal varices between 1987 and 2009.

Evaluation of bowel function and fecal continence in 594 Finnish individuals aged 4 to 26 years.

Background: Limited information exists on what constitutes normal bowel function in children and adolescents. This information is essential for determining outcomes of surgery for anorectal malformations and other colonic disorders.

Objective: The aim of this study was to define bowel function and fecal continence in a large sample of individuals aged 4 to 26 years.

Mesoportal bypass using a constructed saphenous vein graft for extrahepatic portal vein obstruction--technique, feasibility, and outcomes.

Background: The internal jugular vein is routinely used as a graft for the Rex shunt. We analyzed results of mesoportal bypass using an alternative autologous graft.

Methods: Twenty-one children with extrahepatic portal vein obstruction were treated with a Rex shunt constructed using both greater saphenous veins.

Magnetic resonance enterography guiding treatment in children with Crohn's jejunoileitis.

Aim: To determine the usefulness of magnetic resonance enterography (MRE) in treatment for paediatric patients with Crohn's disease.

Methods: To evaluate small bowel involvement, 45 children with Crohn's disease were scheduled for MRE. Two radiologists blinded to the patient data independently re-evaluated the images.

[Applications of botulin].

Among the ailments of the ocular region, the use of botulin has become established in the treatment of blepharospasm and hemifacial spasm in Finland. Botulin has also been used successfully after peripheral facial palsy to improve facial symmetry, reduce lachrymal flow, treat dribbling of saliva as well as spasmodic dysphonia of laryngeal muscles. It may be effective in dysphagia caused by tightness of the upper esophageal sphincter or in several dyshidroses.

Parenteral plant sterols and intestinal failure-associated liver disease in neonates.

Objectives: We prospectively evaluated incidence of prolonged (>28 days) parenteral nutrition (PN), associated complications, and significance of parenteral plant sterols (PS) in neonatal intestinal failure-associated liver disease (IFALD) compared with children.

Methods: We recruited 28 neonates (mean age 50 days, range 28-126) and 11 children (6.9 y, 2.

National centralization of biliary atresia care to an assigned multidisciplinary team provides high-quality outcomes.

Background And Aims: Effects of caseload and organization of care on outcomes of biliary atresia (BA) remain unclear. We compared outcomes before and after national centralization of BA treatment in Finland with a population of 5.4 million people and 60,000 live births/year.

General health, health-related quality of life and sexual health after pediatric liver transplantation: a nationwide study.

The long-term impact of pediatric liver transplantation (LT) and its complications on general health, health-related quality of life (HRQoL) and sexual health were assessed. We conducted a national cross-sectional study of all pediatric recipients who underwent LT between 1987 and 2007. Of 66 survivors, 57 participants (86%) were compared to randomly chosen healthy controls (n = 141) at 10.

Assessment and treatment of gastroesophageal reflux in healthy infants with apneic episodes: a retrospective analysis of 87 consecutive patients.

This retrospective study sought to assess whether gastroesophageal reflux (GER) is associated with recurrent infant apneic episodes (AEs) and whether its treatment prevents AEs. Symptoms, diagnostic measures, and treatment of GER in 87 infants admitted for AEs were recorded. The effect of GER on recurrent AEs and survival were assessed.

Donor-specific HLA antibodies and graft function in children after renal transplantation.

Background: The presence of circulating donor-specific human leukocyte antigen antibodies (HLA-DSA) has been associated with chronic antibody-mediated rejection, leading to progressive graft dysfunction and poor graft survival.The aim of this study was to investigate the incidence and significance of HLA-DSA in paediatric renal transplantation(RTx) patients.

Methods: A total of 294 post-transplant serum samples from 123 RTx patients were retrospectively analysed for HLA antibodies.

Long-term results of esophageal atresia: Helsinki experience and review of literature.

Esophageal atresia (EA) affects one in 2,840 newborns, and over half have associated anomalies that typically affect the midline. After EA repair in infancy, gastroesophageal reflux (GER) and esophageal dysmotility and respiratory problems are common. Significant esophageal morbidity associated with EA extends into adulthood.

In-hospital treated pediatric injuries are increasing in Finland--a population based study between 1997 and 2006.

Background And Aims: Injuries are an important public health problem as well as the leading cause of death and disability among children. Our aim was to longitudinally explore the incidence of in-hospital treated traumas, their operative treatment and related mortality among pediatric patients in Finland.

Methods: The National Hospital Discharge Register and the Official Cause-of-Death Statistics data of in-hospital treated pediatric trauma patients between 1997 and 2006 in Finland were evaluated for hospitalizations, treatment modality and mortality.

Effects of long-term parenteral nutrition on serum lipids, plant sterols, cholesterol metabolism, and liver histology in pediatric intestinal failure.

Background And Objective: Plant sterols (PS) in parenteral nutrition (PN) may contribute to intestinal failure-associated liver disease. We investigated interrelations between serum PS, liver function and histology, cholesterol metabolism, and characteristics of PN.

Patients And Methods: Eleven patients with intestinal failure (mean age 6.

Surgery of biliary atresia.

Biliary atresia (BA) is a progressive fibro-obliterative cholangiopathy of unclear etiology affecting varying degrees of both extra- and intrahepatic biliary tree resulting in obstructive bile flow and cholestasis in neonates. The diagnostic work-up is designed to diagnose or rule out BA without any unnecessary delay. Kasai portoenterostomy is a palliative operation performed to establish bile drainage from microscopic bile ductules that remain in the porta hepatis.

Long-term renal function in children after liver transplantation.

Background: Reduced renal function after liver transplantation (LT) is a long-term extrahepatic complication of major concern caused at least partly by calcineurin inhibitor nephrotoxicity. We report on long-term renal function after LT in children from a single center and analyze the usefulness of glomerular filtration rate (GFR) estimation methods in the follow-up of pediatric LT patients.

Methods: Fifty-seven pediatric patients were included.

Bowel function and gastrointestinal quality of life among adults operated for Hirschsprung disease during childhood: a population-based study.

Objective: To assess bowel function and gastrointestinal quality of life among adults with operated Hirschsprung's disease (HD).

Summary Background Data: Outcomes of HD extending to adulthood are unclear; bowel function and quality of life may deteriorate by aging.

Methods: Bowel function and gastrointestinal quality of life were cross-sectionally assessed in a population-based manner among adults operated for HD during childhood between 1950 and 1986.

Management and outcome of low anorectal malformations.

Low anorectal malformation comprises about half of all anorectal anomalies. Most of the literature concerning management of anorectal anomalies is centred around the treatment and outcome of high anomalies. The management of low anomalies has been considered significantly less challenging than high anomalies.

Surrogate markers of cholesterol metabolism in children with native liver after successful portoenterostomy for biliary atresia.

Purpose: Cholestasis gradually ensues after portoenterostomy for biliary atresia (BA) and may deteriorate liver function. Cholesterol metabolism and its relationships with serum markers of liver function were evaluated in children living with native liver after successful portoenterostomy for BA.

Subjects And Methods: Serum lipids, noncholesterol sterol ratios to cholesterol, that is, surrogate markers of cholesterol metabolism, and liver function were cross-sectionally studied in 17 consecutive children after successful (postoperative bilirubin <20 micromol/L) portoenterostomy for BA with native liver and a mean age of 5.

Cholesterol metabolism in pediatric short bowel syndrome after weaning off parenteral nutrition.

Background: Small intestine essentially regulates cholesterol homeostasis.

Aims: To evaluate cholesterol metabolism in short bowel syndrome (SBS).

Methods: Cholesterol precursors (e.

Secular trend in the menopausal age in Finland 1997-2007 and correlation with socioeconomic, reproductive and lifestyle factors.

Background And Aims: Only few studies have studied secular trend of menopausal age during last decade. The aim of our study is to analyze secular trend of menopausal age and to evaluate the role of socioeconomic, reproductive and lifestyle factors.

Material And Methods: National FINRISK Study sample from years 1997 and 2007 was utilized.