In situ graft-trimming method using polyester vascular prosthesis for inferior vena cava reconstruction after hepatectomy.

Hepatectomy for secondary liver cancer that has invaded the inferior vena cava (IVC) can be the only way to achieve long-term survival. We describe a method for hepatectomy combined with partial IVC resection without venous bypass circulation and an in situ graft-trimming method to avoid graft size mismatch after reconstruction. We carried out left hepatectomy extended to segment 1 with partial IVC resection first. During resection and reconstruction of the IVC, it was clamped below the right hepatic vein and above the inferior right hepatic vein to maintain systemic circulation. The graft was trimmed in situ, after a half running suture of the graft was finished to ensure the correct size. Preservation of both inferior right hepatic vein and right hepatic vein helps to maintain systemic circulation during reconstruction of the IVC. The in situ graft-trimming method is an easy and safe method to ensure the correct graft size after IVC reconstruction.

Prevention of mildly overweight children from development of more overweight condition.

BACKGROUND: A follow-up study has reported that not only highly obese but also mildly obese children are becoming heavier during the elementary school children. Then we determined the effect of programs for the screening and treatment of overweight elementary school children whether the programs prevented mildly overweight children from development of more overweight condition. METHODS: Subjects were 40 overweight children who participated in both screening and treatment programs. As controls, only 240 children who participated in the screening program were used. The mean observation periods of the subjects and controls were 14 and 12 months, respectively. RESULTS: In both groups, older and heavier children significantly decreased their indices of overweight (percent relative body weight; %RBW), indicating that mildly obese children worsened their %RBW. However, the incidence of children who worsened their %RBW was significantly lower in the subjects (5 of 40) than in the controls (133 of 240) (P < 0.0001). Finally, the subjects significantly reduced their mean %RBW (P < 0.0001) and the controls significantly worsened it (P = 0.0093). CONCLUSION: The treatment program was found important because it prevents mildly overweight children who may worsen their overweight indices without the program from developing more overweight condition.

Effect of age and overweight on the QT interval and the prevalence of long QT syndrome in children.

The change in QT interval with age during childhood of normal children and children with long QT syndrome (LQTS) and the effects of body mass index on the QT interval have not been studied in detail. The prevalence of LQTS in children is not well known. We measured 3 consecutive QT and RR intervals in 4,655 children. Their electrocardiograms along with their height and weight were recorded when they were in the first grade in 1994 and again when they were in the seventh grade in 2000. The QT interval was corrected by Bazett's formula. The longer corrected QT intervals in female subjects than male subjects start at elementary school age, earlier than previously reported. Overweight did not have an impact on the uncorrected or corrected QT interval. None of the 4 children diagnosed with LQTS in the seventh grade had characteristic electrocardiographic findings of LQTS in the first grade. All 4 are nonfamilial cases. The prevalence of LQTS in children was found to be 1 of 1,164. These data suggest that abnormal electrocardiographic phenotypes in children with nonfamilial LQTS may appear during the elementary school year. The longer QT intervals in female subjects than male subjects start at the same period. No correlation was found between obesity and length of the QT interval. Finally, the prevalence of LQTS in children is greater than previously suspected.