bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic factors in patients with small hepatocellular carcinoma treated by percutaneous ethanol injection
Authors: Kuriyama Hitoshi , Okada Shuichi , Okusaka Takuji , Ueno Hideki , Ikeda Masafumi 
Published: March 2003

AbstractBackground:Percutaneous ethanol injection (PEI) has been widely performed and is now accepted as a viable alternative to hepatic resection in patients with small hepatocellular carcinomas (HCC). However, only a few extensive investigations have been conducted regarding the prognostic factors for HCC patients treated with PEI.Methods:We investigated the prognostic factors in 100 patients with small HCC who had undergone PEI. Univariate analysis and multivariate analysis with Cox's proportional hazards model were used to determine the factors potentially related to survival. For clinical application, a prognostic index was calculated based on the regression coefficients of the independent variables identified from the multivariate analysis.Results:Median survival time and 1, 3 and 5 year survival rates were 71 months and 100, 84 and 62%, respectively. Among the 15 potential prognostic variables investigated, only three variables, namely a serum albumin level ≤ 3.5 g/dL, the presence of tumor stain and a serum glutamic oxaloacetic transaminase level> 66 IU/L, were identified as factors independently associated with a shorter survival. A prognostic index based on the regression coefficients of these three factors was proposed to classify patients into three groups, those with a good (5 year survival rate 91%), intermediate (64%) and poor prognosis (22%).Conclusions:The results of the present study may be useful in predicting the survival of HCC patients treated with PEI and in the design and analysis of future clinical trials of PEI for HCC.© 2002 Blackwell Publishing Asia Pty Ltd
Fatty liver in non‐alcoholic non‐overweight Japanese adults: Incidence and clinical characteristics
Authors: Omagari Katsuhisa , Kadokawa Yoshiko , Masuda Jun‐Ichi , Egawa Ichiei , Sawa Takafumi , Hazama Hiroaki , Ohba Kazuo , Isomoto Hajime , Mizuta Yohei , Hayashida Kenji , Murase Kunihiko , Kadota Takehiko , Murata Ikuo , Kohno Shigeru 
Published: March 2003

AbstractBackground and Aims: Fatty liver is not uncommon in many countries, including Japan, and is mainly caused by alcohol usage and obesity. The aim of this study was to determine the incidence and causative factors of fatty liver in Japanese adults.Methods: The clinical characteristics of 3432 Japanese adults who visited our hospital between January and December 2000 for thorough medical examinations were recorded including sex, age, body mass index (BMI), percentage body fat measurement using a bipedal bioimpedance instrument, history of alcohol intake, blood pressure, serum levels of aspartate aminotransferase, alanine aminotransferase (ALT), γ‐glutamyl transpeptidase, total cholesterol, triglyceride, uric acid, fasting blood glucose (FBG), and liver status by ultrasonography (USG).Results: Of 3432 participants, 747 (21.8%) were diagnosed as having fatty liver by USG, 1873 (54.6%) were ‘daily alcohol drinkers’, and 698 (20.3%) were overweight (BMI ≥ 25 kg/m2). Fatty liver was more frequent in men and overweight subjects (P < 0.01), whereas there was no significant difference in the proportion of the ‘daily alcohol drinker’ between fatty liver and non‐fatty liver participants. The logistic regression analysis showed that BMI, ALT, and triglyceride were independent predictors of fatty liver in both sexes, and FBG, uric acid, percentage body fat, and total cholesterol were independent predictors of fatty liver only in men. It was noted that 319 (9.3%) were non‐alcoholic individuals with fatty liver, and 141 (4.1%) were non‐alcoholic and non‐overweight individuals with fatty liver. The logistic regression analysis showed that percentage body fat was an independent predictor of fatty liver in non‐alcoholic and non‐overweight participants in both sexes, although non‐significant in women in the whole group.Conclusions: In our study population, 21.8% had fatty liver diagnosed by USG, 9.3% were non‐alcoholic with fatty liver, and 4.1% were non‐alcoholic and non‐overweight with fatty liver. Our results suggest that central body fat distribution can correlate with the development of fatty liver, and that measurement of percentage body fat is useful to assess the etiology of fatty liver in non‐alcoholic and non‐overweight participants, particularly women.
Clinical characteristics and distribution of genotypes of TT virus infection in a hepatitis C virus‐hyperendemic township of a hepatitis B virus‐endemic country (Taiwan)
Authors: Dai Chia‐Yen , Yu Ming‐Lung , Hou Cheng , Lu Sheng‐Nan , Wang Jing‐Houng , Huang Jee‐Fu , Chen Shinn‐Cherng , Lin Zu‐Yau , Hsieh Ming‐Yuh , Tsai Jung‐Fa , Wang Liang‐Yen , Chuang Wan‐Long , Chang Wen‐Yu 
Published: March 2003

Abstract
Background:
The prevalence of TT virus (TTV) viremia, without definite clinical significance, has been reported to be higher among chronic hepatitis C patients. The status and clinical characteristics of TT virus (TTV) infection and distribution of TTV genotypes in a hepatitis C virus (HCV) hyperendemic township (Masago community) in a hepatitis B virus (HBV) endemic country (Taiwan) were investigated.
Methods:
Sera from 100 Masago residents were tested for alanine aminotransferase (ALT) and markers of HBV, HCV and GB virus C/hepatitis G virus (GBV‐C/HGV) and TTV‐DNA. Sera of 250 blood donors as a control group were tested for TTV‐DNA. Sera of Masago residents and blood donors with positive TTV‐DNA were directly sequenced, and phylogenetic analyses were performed subsequently.
Results:
The prevalences of TTV viremia in different age groups among individuals from Masago were significantly higher than that among blood donors. In regard to the subtypes of TTV, 23, seven, two, eight, one, six and one isolate were related to the genotypes 1a, 1b, 2a, 2b, 3, 4 and 5, respectively, from Masago and 21, 14, one, nine and three isolates were related to the genotypes 1a, 1b, 2a, 2b, and 4, respectively, from donors. No clinical or virological factor was associated with TTV viremia or TTV genotypes.
Conclusions:
TT Virus prevalence was higher among HCV hyperendemic township residents than blood donors with similar genotype distributions (genotype 1 was the most prevalent) in Taiwan. Neither TTV viremia nor a particular genotype was associated with HBV, HCV or GBV‐C/HGV infection and abnormal ALT levels.© 2002 Blackwell Publishing Asia Pty Ltd
Infrared spectrometry based 13C‐octanoic acid breath test in measuring human solid gastric emptying
Authors: CHEN CHIH‐PING , CHEN CHIH‐YEN , LU CHING‐LIANG , CHANG FULL‐YOUNG , LEE SHOU‐DONG , CHU LEE‐SHING , LIU REN‐SHYAN , WU HAN‐CHANG 
Published: March 2003

AbstractBackground and Aims: Because of the convenience of non‐dispersive infrared spectrometry (NDIRS), we attempted to validate the usefulness of NDIRS compared with scintigraphy in human solid gastric emptying (GE) measurement, and tried to establish the normal range of solid GE based on NDIRS.Methods: Twelve healthy volunteers (three men, nine women) were recruited for simultaneous scintigraphy and 13C‐octanoic acid breath test (13C‐OABT) studies. Stomach half‐emptying time (t1/2) and lag phase (tlag) were the two main GE parameters measured and correlated. The breath samples were analyzed using NDIRS every 10–15 min for a total of 6 h, while scintigraphy was taken minute by minute for the first 30 min, then hourly for 4 h. Another 32 healthy volunteers (19 men, 13 women) received only the 13C‐OABT to measure their solid GE.Results: A significant correlation for t1/2 was found between the breath test and scintigraphy (r = 0.85, P = 0.001), while tlag was also positively correlated (r = 0.73, P = 0.007). The reference range of t1/2B based on all 44 subjects was 89.4–185.1 min (135.9 ± 21.1 min (mean ± SD)), while the range for tlagB was 37.1–117.8 min (81.9 ± 17.4 min). No demographic characteristics were found to influence the GE parameters.Conclusions: 13C‐octanoic acid breath test determined by NDIRS is a simple, non‐invasive and reliable measurement, which may provide an ‘office‐based’ tool to detect solid GE.© 2003 Blackwell Publishing Asia Pty Ltd
Establishment of a normal range of penile length in preterm infants
Authors: TULADHAR R , DAVIS PG , BATCH J , DOYLE LW 
Published: March 2003

Rationale:Recognition of micropenis is important because it may be the only obvious manifestation of pituitary or hypothalamic hormone deficiencies. Alternatively it may indicate the presence of dysgenetic testicular tissue with malignant potential. Previously published normal ranges for premature males are based on small sample sizes, with few infants <30 weeks and none <28 weeks.Setting:Intensive and Special Care Nurseries, Royal Women’s Hospital, Melbourne, Victoria.Subjects:188 consecutive male infants, inborn and outborn, with gestational age <37 completed weeks were examined in the first week of life. They included multiple births (n=51) and small for gestational age infants (n=16). Infants with hypospadias (n=3) or an endocrine disorder (n=1) were excluded from the study.Manoeuvre:Stretched penile length was determined by a single examiner (RT) using a standardized measure.Results:A mean penile length with associated 95% confidence intervals is described for infants between 24 and 36 weeks inclusive. The relationship between penile length (PL, cm) and gestational age (GA, weeks) was: PL=2.27+0.16 GA.Conclusion:This study confirms the normal range for penile length of premature male infants 30–36 weeks and defines the normal range <30 weeks. This should prove useful to paediatricians, paediatric surgeons and endocrinologists dealing with the increasing number of surviving male infants <30 weeks in whom penile size is questioned.
Post‐extubation prophylactic nasal continuous positive airway pressure in preterm infants: Systematic review and meta‐analysis
Authors: Davis PG , Henderson‐Smart DJ 
Published: March 2003

Objectives: To determine whether management with nasal continuous positive airway pressure (NCPAP) in preterm infants having their endotracheal tube removed following a period of intermittent positive pressure ventilation (IPPV), leads to an increased proportion remaining free of additional ventilatory support, compared to extubation directly to headbox oxygen. Methodology:
Search Strategy– Searches were made of the Oxford Database of Perinatal Trials, Medline, abstracts of conferences and symposia proceedings, expert informants, journal hand searching mainly in the English language and expert informant searches in the Japanese language. Selection criteria– All trials utilising random or quasi‐random patient allocation, in which NCPAP (delivered by any method) was compared with headbox oxygen for postextubation care were included. Methodological quality was assessed independently by the two authors. Data collection and analysis– Data were extracted independently by the two authors. Meta‐analysis using event rate ratios (ERRs) and event rate differences (ERDs) was performed using Revman 3.0 statistical software. Prespecified subgroup analysis to determine the impact of different levels of NCPAP and use of aminophylline were also performed using the same package. Similar analysis to investigate the effect of postnatal age on outcomes of interest was also undertaken. Results: Nasal CPAP, when applied to preterm infants being extubated following IPPV, reduces the incidence of adverse clinical events (apnoea, respiratory acidosis and increased oxygen requirements) indicating the need for additional ventilatory support. This result is both statistically significant and clinically important; ERR, 0.62 (0.49, 0.79) and ERD, – 0.175 (– 0.256, – 0.095). A trend towards reduction in the incidence of oxygen dependency at 28 days of age is also seen in the group extubated to NCPAP; ERR, 0.86 (0.67, 1.10) and ERD, – 0.069 (– 0.177, 0.039). Conclusions: Nasal CPAP is effective in preventing failure of extubation in preterm infants following a period of endotracheal intubation and IPPV. Further definition of the patient gestational age and weight groups to whom these results apply is required. Optimal levels of NCPAP as well as methods of administration remain to be determined.
Subglottic haemangioma: Controversies in management
Authors: Walker PJ , Cooper D , Macdonald D 
Published: March 2003

Objective: To discuss treatment modalities for subglottic haemangioma (SGH). Methodology: Case report of two children definitively managed by different modalities. Results: Management by CO2 laser vaporization in one child, and laser followed by interferon 2‐alpha in the second child were both successful in controlling the SGH without the need for tracheostomy. Conclusions: The stepped‐care approach at John Hunter Children’s Hospital, Newcastle, New South Wales, is presented. Both laser surgery and interferon can help control SGH. Careful surveillance and interdisciplinary cooperation are essential to achieve a good outcome.
Sepsis, severe sepsis and septic shock in paediatric multiple organ dysfunction syndrome
Authors: Goh AYT , Chan PWK , Lum LCS 
Published: March 2003

Objectives: To determine the association between severity of sepsis with outcome and severity of illness in children with multiple organ dysfunction syndrome (MODS). Materials: Four hundred and ninety‐five consecutive paediatric intensive care unit (PICU) admissions were analysed. multiple organ dysfunction syndrome was defined as simultaneous dysfunction of ≥ 2 organ system and sepsis by the American College of Chest Physicians and Society of Critical Care Medicine Consensus Conference definition. Results: Eighty‐four patients developed MODS. The incidence of sepsis, severe sepsis and septic shock in these patients was 10.7%, 23.8% and 17.9%, respectively. Worsening categories of sepsis were associated with: (1) a higher mean admission Paediatric Risk of Mortality (PRISM II): 36.6 Â± 25.9, 56.8 Â± 32.1 and 73.6 Â± 28.5%, respectively (P = 0.005), (2) a larger number of organ dysfunctions: mean MODS index of 37%, 46% and 58%, respectively (P = 0.007), and (3) a higher mortality: 22.2%, 65% and 80%, respectively (P = 0.03). Conclusion: Presence of sepsis, severe sepsis and septic shock was associated with an increasing severity of illness, increased number of organ dysfunctions and a distinct risk of mortality among critically ill children.
Ethnic comparisons of disease severity in children hospitalized with pneumonia in New Zealand
Authors: Grant CC , Pati A , Tan D , Vogel S , Aickin R , Scragg R 
Published: March 2003

Objective: To determine if there are ethnic differences in disease severity in children hospitalized with pneumonia in New Zealand. Methodology: A population based audit of children hospitalized in Auckland with pneumonia over 12 months from 1 November 1994 to 31 October 1995. The study population was children aged from 0 to 14 years with a discharge diagnosis of pneumonia. The sample was stratified by ethnicity and included 151 Pacific, 85 Mäori and 151 European children. Measurements were made of demographics and prehospital care; vital signs and therapy received in the emergency department and inpatient wards and laboratory investigations performed. Comparisons between the three ethnic groups were adjusted for age, weight, gender, socio‐economic status and relationship with primary care. Results: A larger proportion of Pacific (15%) and Mäori (22%) children than European children (8%) had a respiratory rate elevated for ≥ 2 days, odds ratio (OR) (95% CI): Pacific versus European 2.7 (1.1, 6.8), Mäori versus European 4.3 (1.7, 11.6). A larger proportion of Pacific (15%) and Mäori (15%) children than European children (< 1%) had a heart rate elevated for ≥ 2 days, OR Pacific versus European 17.2 (3.2, 320), Mäori versus European 26.1 (4.4, 508). Compared with European children, a larger proportion of Pacific and Mäori children received intravenous fluids and antibiotics. A larger proportion of Pacific (29%) and Mäori (27%) children than European children (11%) received oxygen for ≥ 2 days, OR Pacific versus European 3.2 (1.6, 6.6), Mäori versus Europeans 2.6 (1.2, 6.2). Conclusions: Based on the comparisons of vital signs and intensity of therapy, Pacific and Mäori children hospitalized with pneumonia have more severe pneumonia than European children.
Post‐transfusion white cell count in the sick preterm neonate
Authors: Wright IMR , Skinner AM 
Published: March 2003

Objective: A previous report demonstrated post‐transfusion leucocytosis as a potential confounding factor in the diagnosis of sepsis in critically ill adult patients. In We wished to establish if the same phenomenon occurred in the sick preterm neonate and whether this significantly altered the indices considered for potential neonatal infection. Methodology: Transfusion and full blood count data in a level 3 neonatal intensive care unit were prospectively recorded for 3 months. Results: One hundred and fourteen transfusion events were recorded from 37 infants. Median white blood cell count increased 0.9 × 109/L (confidence interval (CI) 0.4–2.4) in the first 8 h following transfusion (P = 0.032). Median neutrophil count increased by 0.4 × 109/L (CI 0.1–1.7) in the same 8 h (P = 0.05). Median neutrophil left shift decreased 1.2% (CI 1.1–5.8%) over the 24 h post‐transfusion. No change in band count was observed. Conclusions: A mild post‐transfusion white cell increase occurs in sick neonates. Because of the magnitude of effect, it is unlikely that this interesting physiological response would interfere with the diagnosis of sepsis in this population.
Severe chronic neutropenia in Chinese children in Hong Kong
Authors: Leung TF , Li CK , Kwok KL , Chik KW , Shing MMK , Yuen PMP 
Published: March 2003

Objective: Severe chronic neutropenia (SCN) is a rare and heterogeneous disorder in children. The epidemiology, clinical features and outcomes of SCN in Chinese children were reviewed. Methodology: A retrospective analysis of case records was undertaken for 18 children with SCN managed during a 12‐year period in a university teaching hospital in Hong Kong. Results: The median (range) age of the patients at initial presentation was 6.5 months (4 days–19 months). The initial and lowest median absolute neutrophil counts (ANC) were 0.29 × 109 /L and 0.06 × 109 /L, respectively. Patients with congenital SCN had significantly fewer neutrophils in peripheral blood at diagnosis. Only five subjects received granulocyte colony‐stimulating factor (G‐CSF) treatment. All children were free from serious infection on follow up for 51 months. Only one child suffered from long‐term infection‐related morbidity. One patient with chronic neutropenia was subsequently shown to have common variable immunodeficiency. Conclusions: Most children with SCN in our series had favourable clinical outcomes. Our results support the recommendation that G‐CSF should be used only in those with recurrent or severe infections.
Inspired gas temperature during mechanical ventilation: Effects of environmental temperature and airway temperature probe position
Authors: Todd DA , Boyd J , Lloyd J , John E 
Published: March 2003

Objectives: To determine the inspired gas temperature during mechanical ventilation with: (i) five different humidicrib temperatures; (ii) two airway temperature probe (ATP) positions; and (iii) four ATP adaptors. Methodology: An observational study in the Neonatal Intensive Care Laboratory, Westmead Hospital. The inspired gas temperature was measured at the proximal end of the endotracheal tube (ETT) during conventional mechanical ventilation using a Tele‐thermometer. Inspired gas temperature measurements were made with: (i) the humidicrib temperature set at 30.8, 32.9, 35.2, 36.2, or 37.2°C; (ii) the ATP either (A) positioned inside the humidicrib at the distal end of the inspiratory tubing or (B) positioned outside the humidicrib 50 cm proximal to the ETT, with the inspired gas temperatures set at 36.5 and 39.0°C, respectively; and (iii) the measurements repeated with four different ATP adaptors at each humidicrib temperature and each ATP position. Results: With the ATP inside the humidicrib, there were no significant differences between set and actual inspired gas temperature. However, with the ATP outside the humidicrib, there were significant decreases in inspired gas temperature at each humidicrib temperature. For instance, with the ATP outside the humidicrib and set at 39.0°C, the inspired gas temperature decreased to 34.7 ± 0.2°C at a humidicrib temperature of 30.8°C and to 37.7 ± 0.2°C at a humidicrib temperature of 37.2°C. The type of ATP adaptor also had a significant effect on inspired gas temperature. Conclusions: With the ATP placed outside the humidicrib and with variations of humidicrib temperature, infants are likely to have inspired gas temperatures that are significantly different to the desired temperature. Certain ATP adaptors cause these variations in inspired gas temperature to be more pronounced. Extreme care must be used to avoid suboptimal inspired gas temperatures with these environmental variations and the ATP positioned outside the humidicrib.
Penetrating injuries in children: Is there a message?
Authors: Holland AJA , Kirby R , Browne GJ , Ross FI , Cass DT 
Published: March 2003

Objectives:  To determine the frequency, management and outcome of penetrating trauma in children.Methods:  A retrospective review of penetrating injuries in children under 16 years of age admitted to the Children's Hospital at Westmead (CHW), and deaths reported to the New South Wales Paediatric Trauma Death (NPTD) Registry, from January 1988 to December 2000. Patient details, circumstances of trauma, injuries identified, management and outcome were recorded.Results:  Thirty‐four children were admitted to the CHW with penetrating injuries during the 13‐year period. This represented 0.2% of all trauma admissions, but 3% of those children with major trauma. The injury typically involved a male, school‐age child that fell onto a sharp object or was assaulted with a knife or firearm by a parent or person known to them. Twenty‐five children (75%) required operative intervention for their injuries and 14 survivors (42%) suffered long‐term morbidity. Thirty children were reported to the NPTD Registry over the same interval, accounting for 2.3% of all trauma deaths in New South Wales. Of these, a significant minority was injured by falls from a mower or a tractor towing a machine with blades.Conclusions:  Penetrating injuries are uncommon, but cause serious injury in children. There are two clear groups: (i) those dead at the scene or moribund on arrival, in whom prevention must be the main aim; and (ii) those with stable vital signs. Penetrating wounds should be explored in the operating theatre to exclude major injury. Young children should not ride on mowers or tractors.
Primary cardiac tumours in a paediatric population
Authors: Elderkin RA , Radford DJ 
Published: March 2003

Objective: To review the presentation, diagnosis, histology and outcome of primary cardiac tumours presenting to a paediatric cardiac unit over a 20‐year period. Methods: Hospital records and data bases were searched for the years 1980–2000. Results: There were 12 patients with four histological tumour types including
a predominance of rhabdomyoma, as well as myxoma, fibroma and myocardial hamartoma.
Diagnosis was made in utero, by ultrasound in five cases and in the neonatal
period in a further three cases. Six cases (50%) required surgical intervention
and there were three tumour‐related deaths. Two infants with large left ventricular
tumours diagnosed in utero developed univentricular physiology, acting like hypoplastic left heart syndrome at birth. Conclusions: Despite an absence of malignant histology there was significant mortality and morbidity among the patients reviewed. The development of univentricular physiology in infants with large left ventricular tumours is rare and is a difficult management problem.