1. Elevated serum soluble E-selectin is associated with poor outcome and correlated with serum ALT in biliary atresia Serum levels of soluble E-selectin were determined from 53 post-operative Biliary atresia (BA) patients and 10 healthy children. Results: Serum E-selectin of BA patients was higher than the controls (p=0.01). Further analysis showed that there was an increase in serum E-selectin of BA patients with jaundice compared to those without jaundice (p=0.035). Serum E-selectin was positively correlated with serum ALT. Conclusion: Serum E-selectin was elevated in BA patients. The elevated serum E-selectin was also associated with poor outcome. Additionally, there was a positive correlation between serum E-selectin and serum ALT. These suggest that E-selectin plays a role in the pathophysiology of liver injury in post-operative BA. 2. High-dose steroids do not improve early clinical outcome in biliary atresia BA patients between 2001 and 2005 were reviewed. The use of steroids for 1 to 3 months has been implemented since 2003. Results: At 6 months post-op, 30 patients (56.6%) were jaundice-free and 24 patients (45.3%) experienced cholangitis at least once. Of the 53 patients, there were 33 patients in steroid group and 20 patients in non-steroid group. The proportion of jaundicefree patients in steroid group was higher than that in non-steroid group, and the proportion of patients with cholangitis in steroid group was lower than that in non-steroid group. However, these discrepancies did not reach a statistically significant difference Conclusions: Although the use of steroids seems to have benefits, it did not statistically improve early outcome in BA patients. 3. Serum transforming growth factor-_1 and epidermal growth factor in biliary atresia Serum levels of TGF-_1 and EGF were determined from 67 BA patients and 10 healthy children. Results: Serum TGF-_1 levels of BA patients were higher than the controls (P=0.036). However, there was no difference in serum EGF between BA patients and the controls (P=0.74). Further analysis showed that patients with good outcome had their serum TGF-_1 and serum EGF levels higher than those of patients with poor outcome. In addition, serum TGF-_1 was positively correlated with serum EGF. Conclusions: The elevated serum TGF-_1 and serum EGF levels were associated with good outcome in BA. These suggest that the resultant actions of TGF-_1 and EGF pathways possibly involve in the pathophysiologic process in post-operative BA. 4. Overexpression of inducible nitric oxide synthase in biliary atresia Hepatic iNOS expression was determined from liver biopsies of 24 BA patients, and 16 non-BA patients. The iNOS expression was evaluated based on its intensity using ImageJ software. Results: Hepatic iNOS expression of BA was significantly stronger than that of non-BA (P<0.0001). The largest area of hepatic iNOS expression was the area of hepatocytes. Subgroup analysis of BA patients at 6 months post-op revealed that there was no difference in iNOS expression between the patients with good outcome and those with poor outcome (P=0.732). Conclusions: Overexpression of hepatic iNOS in BA was demonstrated. Hepatocytes were the major source of hepatic iNOS production. These suggest that iNOS plays a role in the liver pathology of BA but its expression cannot be used as a predictor for therapeutic outcome. 5. Non-correctable Biliary Atresia with Large Extrahepatic Cyst: a Report of Two Cases We report 2 unusual cases of biliary atresia type III with cystic structure that is possibly mistaken as a correctable biliary atresia or choledochal cyst. 6. Hepatic Expression of hepatocyte growth factor and its receptor in biliary atresia Hepatic HGF and C-met expression were studied from liver biopsies of 41 BA patients at the time of Kasai operation, and 17 non-cholestatic pediatric patients. The HGF and C-met expression of hepatocyte areas was scored as per its intensity and percentage of stained area. Results: Hepatic HGF and C-met staining scores of BA patients were higher than those of noncholestatic patients (P<0.0001). Analysis of BA patients at 6 months post-Kasai revealed that there was no difference in either hepatic HGF or C-met expression at the time of surgery between the patients with good outcome and those with poor outcome. Conclusions: Strong expression of hepatic HGF and its receptor in BA patients was demonstrated. However, the expression was not associated with the early therapeutic outcome. These suggest that resultant actions of HGF involve in the liver pathology of BA but its expression cannot be used as a predictor for therapeutic outcome.