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Background. Autoimmune hepatitis (AIH) and cryptogenic chronic hepatitis (CCH) are important causes of liver failure in children, frequently necessitating orthotopic liver transplantation (OLT). The aim of this study is to review disease progression and potential differences between subgroups of children with AIH and CCH.

ABSTRAa. The effects of three isocaloric intravenous nutritional regimens were studied in seven infants and children, ages 2 months to 9 yr, with congenital gastrointestinal anomalies (four patients) or with prior history of malignant disease admitted in remission for bone marrow transplantation (three patients). Energy metabolism, as measured by the basal metabolic rate (BMR), and substrate utilization, as measured by the respiratory quotient (RQ), were studied to determine the effect of different levels of carbohydrate and fat on nitrogen retention in each patient. Solution A provided 8% of energy as amino acids, 87% as carbohydrate, and 5% as fat. Solution B provided 8% of energy as amino acids, 60% as carbohydrate, and 32% as fat. Solution C provided 8% of energy as amino acids, 34% as carbohydrate, and 58% as fat. Administration of solution A (high carbohydrate, low fat) was associated with moderately increased mean (fSD) BMR and RQ and with low nitrogen retention (19.1 f 12.7%, 1.06 f 0.14, and 98 f 28 mg N/kg/day). Both the BMR and the RQ decreased when less carbohydrate and more lipid was given: BMR 4.3 2 11.6% ( p < 0.005), RQ 0.92 f 0.09 ( p < 0.001) for solution B; BMR 3.94 k 10.6% ( p < 0.005), RQ 0.86 f 0.09 ( p < 0.001) for solution C. Among the solutions tested, optimal nitrogen retention 1163 f 60 mg N/kg/day ( p < 0.01)j was noted with solution B. Our data support the conclusion that a physiologic balance of fat and carbohydrate results in optimal nitrogen retention. (Pediatr Res 21: 538-541, 1987) Abbreviations TPN, total parenteral nutrition CBC, complete blood count V02, oxygen consumption VCOz, carbon dioxide production RQ, respiratory quotient FeC02, measured C 0 2 concentration of expired air FeOz, measured Oz concentration of expired air FiOz, O2 concentration in room air VE, flow rate BMR, basal metabolic rate ANOVA, two-way analysis of variance and children with short bowel syndrome, seriously damaged intestinal mucosa, or failure to develop intestinal villi. Several reports (1-4) have assessed the relationship between nitrogen balance and the energy sources. In adult patients with severe catabolic states, most of the patients were recovering from severe injuries or had septic complications of accidental or surgical trauma. However, no similar studies are available in infants or children. The present study examined, in children, the metabolic effects, including nitrogen retention, of three different isocaloric TPN solutions which varied only in the proportion of calories derived from fat and carbohydrate. PATIENTS AND METHODSPatients. Seven patients were studied over a period of 15 days (Table 1). Four were infants, ages 2 to 5 months, with congenital gastrointestinal anomalies. They had been stable on TPN at least 10 days after the acute postoperative period. Three others were children, 3 to 9 yr of age, with arrested malignant disease (one had acute lymphoblastic leukemia and two had neuroblastoma). All had been on chemotherapy and were presently hospitalized for bone marrow transp...

This paper presents a critical review of studies that apply life-cycle assessment or life-cycle-based environmental analysis methods to geotechnical systems. The goal of this review is to evaluate the current state of practice for life-cycle assessment in geotechnical engineering and to identify critical gaps in current practice and key issues for future research efforts. Additionally, this review examines sources of variability and uncertainty across the studies and provides recommendations for best practice in future assessments. Aside from challenges in creating a practicable framework, many barriers to implementation exist – including the availability of region-specific data, the quality and granularity of data and challenges in comparing geotechnical systems due to spatial heterogeneity and design decisions, among others. Further research is needed to develop guidelines for life-cycle assessments tailored to geotechnical systems to establish common criteria and methods for future studies.