The aim of the study was to present the safety and feasibility of pure laparoscopic donor right hepatectomy (PLDRH) in comparison with those of conventional donor right hepatectomy. Summary Background Data: Although the use of PLDRH is gradually spreading worldwide, its outcomes, including the long-term outcomes in both donors and recipients, have not yet been evaluated in a large comparative study. Methods: We retrospectively reviewed the medical records of 894 donors who underwent living donor liver transplantation between January 2010 and September 2018 at Seoul National University Hospital. We performed 1:1 propensity score matching between the PLDRH and conventional donor right hepatectomy groups. Subsequently, 198 donor-recipient pairs were included in each group. Results: The total operation time (P < 0.001), time to remove the liver (P < 0.001), and warm ischemic time (P < 0.001) were longer in the PLDRH group. None of the donors required intraoperative transfusion or experienced any irreversible disabilities or mortalities. The length of postoperative hospital stay was significantly shorter in the PLDRH group (P < 0.001). The rate of complications in donors was similar between the 2 groups. Although other complication rates in recipients were, however, similar, the rates of early (P ¼ 0.019) and late (P < 0.001) biliary complications in recipients were higher in the PLDRH group. There was no significant difference in overall survival and graft survival between the 2 groups. Conclusions: PLDRH is feasible when performed at an experienced living donor liver transplantation center. Further studies on long-term recipient outcomes including biliary complications are needed to confirm the safety.

No abstract

FCM was effective in increasing the key blood indices with no adverse outcomes in children less than 14 years of age, with a range of different conditions, majority with gastrointestinal disorders such as IBD. What is Known: • Ferric carboxymaltose (FCM) given via the intravenous (IV) route has been used widely in adults for the treatment of iron deficiency anaemia. • Sparse data exists on FCM use in paediatric population, including young children What is New: • FCM infusion should be considered as a means of iron administration in the paediatric population less than 14 years of age • No adverse outcomes were recorded following FCM in a young paediatric population (less than 14 years of age); the majority of whom had gastrointestinal disorders.

No abstract

Selective assembly has traditionally been used to achieve tight specifications on the clearance of two mating parts. However, its applicability is not limited to this particular type of assembly. This article develops a generalized version of selective assembly called GSA. It is a powerful tool that can be used to improve the quality of assemblies of single units of different component types. Two variants of GSA are considered: Direct Selective Assembly (DSA) and Fixed Bin Selective Assembly (FBSA). The former is selective assembly using information from measurements on component characteristics directly, whereas the latter is selective assembly of components sorted into bins. For each variant, the problem of matching the N components of each type to give N assemblies that minimize quality cost is formulated as a linear integer program. The component matching problem for DSA is an axial multi-index assignment problem, whereas for FBSA, it is an axial multi-index transportation problem. Simulations are performed to evaluate the performance of GSA and to find the optimal number of bins. Realistic examples are given to show that the proposed methods can significantly improve the quality of assemblies.

Gaussian process (GP) models are widely used to approximate time consuming deterministic computer codes, which are often models of physical systems based on partial differential equations (PDEs). Limiting or boundary behavior of the PDE solutions (e.g., behavior when an input tends to infinity) is often known based on physical considerations or mathematical analysis. However, widely used stationary GP priors do not take this information into account. It should be expected that if the GP prior is forced to reproduce the known limiting behavior, it will give better prediction accuracy and extrapolation capability. This paper shows how a GP prior that reproduce known boundary behavior of the computer model can be constructed. Real examples are given to demonstrate the improved prediction performance of the proposed approach.

METHODSThis was a retrospective study of children diagnosed with AIH in the paediatric unit of National University Hospital, Singapore, over the last 12 years. Children with de novo AIH after liver transplantation were excluded. The demographic and clinical features of the patients, and their laboratory, treatment and clinical outcomes were reviewed. RESULTSThis study comprised ten patients (six females, four males), with a median age of 5.1 (range 2.1-13.8) years at diagnosis. Five patients had inflammatory bowel disease (IBD). Seven patients had type 1 AIH, and three had autoimmune sclerosing cholangitis (ASC) and IBD; none had type 2 AIH. The median level of aspartate aminotransferase at diagnosis was 183 (range 45-2,649) U/L. Prednisolone 1 mg/kg/day was prescribed at diagnosis for eight patients. Two patients were lost to follow-up and were treated symptomatically when they re-presented with end-stage liver disease. Azathioprine or mycophenolate mofetil was prescribed after 3-7 months of treatment. Normalisation of aminotransferase levels took an average of 5.3 (range 1-39) months.CONCLUSION AIH is a rare but important cause of liver pathology. Children in this region with elevated aminotransferases or unexplained hepatomegaly should be screened for AIH.

Background: The pathogenesis of inflammatory bowel disease (IBD) is complex and involves the contribution of genetic and environmental factors. Many patients with very early onset IBD are difficult to treat. The current antibiotic medication that targets gram-negative and anaerobic bacteria provides only moderate efficacy in subsets of patients with IBD. Methods: We report a case series of 5 children with a mean age of 1.6 years (range 6 months to 2.7 years) during IBD onset, who were previously refractory to standard treatments and who received oral vancomycin with or without gentamicin. Results: Four out of 5 children demonstrated substantial therapeutic effect, and the effect was sustained in 3 children over a follow-up period of 12-33 months. Conclusion: Our findings are consistent with model systems and suggest that randomized trials are required to establish whether a change in therapeutic paradigm, that is, targeting gram-positive bacteria with nonabsorbable antibiotics, may have therapeutic benefits.