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Sample records for bilirubin

  1. Bilirubin Test

    Science.gov (United States)

    ... Bilirubin; Indirect Bilirubin; Unconjugated Bilirubin Formal name: Bilirubin - blood Related tests: Liver Panel ; GGT ; ALP ; AST ; ALT ; Hepatitis A ; Hepatitis B ; Hepatitis C ; Complete Blood Count ; Urinalysis ; Direct Antiglobulin ...

  2. Inherited Disorders of Bilirubin Clearance

    OpenAIRE

    Memon, Naureen; Weinberger, Barry I; Hegyi, Thomas; Aleksunes, Lauren M

    2015-01-01

    Inherited disorders of hyperbilirubinemia may be caused by increased bilirubin production or decreased bilirubin clearance. Reduced hepatic bilirubin clearance can be due to defective 1) unconjugated bilirubin uptake and intrahepatic storage, 2) conjugation of glucuronic acid to bilirubin (e.g. Gilbert syndrome, Crigler-Najjar syndrome, Lucey-Driscoll syndrome, breast milk jaundice), 3) bilirubin excretion into bile (Dubin-Johnson syndrome), or 4) conjugated bilirubin re-uptake (Rotor syndrom...

  3. [Cytoprotective effects of bilirubin].

    Science.gov (United States)

    Vítek, L

    2005-01-01

    Bilirubin, a major product of heme catabolism, belongs to compounds with pleiotropic biologic effects. For a long time bilirubin was considered as a metabolite dangerous for human health, neonatologists know well serious clinical complication of neonatal jaundice called bilirubin encephalopathy. Nevertheless, recent data has demonstrated that bilirubin exhibits potent antioxidant and even anti-inflammatory effects with substantial clinical impacts. The aim of the present study was to summarize present knowledge in this rapidly evolving field and suggest further possible clinical consequences. PMID:15981989

  4. Blood Test: Bilirubin

    Science.gov (United States)

    ... the blood. Babies with high levels may need phototherapy (treatment with a special light that makes bilirubin ... are afraid of needles. Explaining the test in terms your child can understand might help ease some ...

  5. Inherited Disorders of Bilirubin Clearance

    Science.gov (United States)

    Memon, Naureen; Weinberger, Barry I; Hegyi, Thomas; Aleksunes, Lauren M

    2016-01-01

    Inherited disorders of hyperbilirubinemia may be caused by increased bilirubin production or decreased bilirubin clearance. Reduced hepatic bilirubin clearance can be due to defective 1) unconjugated bilirubin uptake and intrahepatic storage, 2) conjugation of glucuronic acid to bilirubin (e.g. Gilbert syndrome, Crigler-Najjar syndrome, Lucey-Driscoll syndrome, breast milk jaundice), 3) bilirubin excretion into bile (Dubin-Johnson syndrome), or 4) conjugated bilirubin re-uptake (Rotor syndrome). In this review, the molecular mechanisms and clinical manifestations of these conditions are described, as well as current approaches to diagnosis and therapy. PMID:26595536

  6. Bilirubin measurements in neonates

    Science.gov (United States)

    Newman, Gregory J.

    2000-04-01

    Infant Jaundice is a physiologic condition of elevated bilirubin in the tissue that affects nearly 60 percent of all term newborns and virtually 100 percent of premature infants. The high production of bilirubin in the newborn circulatory system and the inability of the immature liver to process and eliminate it case the condition. When the bilirubin levels rise, it starts to deposit in the baby's skin and in the brain. The deposits in the brain can cause neurologic impairment and death. The BiliCheck is a handheld, battery-powered device that measures the level of jaundice non-invasively using BioPhotonics at the point of care. The result is displayed on an LCD screen immediately, so physicians can now make treatment decision without waiting for results to return from the lab. The BiliCheck System has been marketed worldwide since April of 1998 and has received FDA clearance for use in the USA on pre-photo therapy infants in March of 1999.

  7. Bilirubin Binding to PPARα Inhibits Lipid Accumulation.

    Science.gov (United States)

    Stec, David E; John, Kezia; Trabbic, Christopher J; Luniwal, Amarjit; Hankins, Michael W; Baum, Justin; Hinds, Terry D

    2016-01-01

    Numerous clinical and population studies have demonstrated that increased serum bilirubin levels protect against cardiovascular and metabolic diseases such as obesity and diabetes. Bilirubin is a potent antioxidant, and the beneficial actions of moderate increases in plasma bilirubin have been thought to be due to the antioxidant effects of this bile pigment. In the present study, we found that bilirubin has a new function as a ligand for PPARα. We show that bilirubin can bind directly to PPARα and increase transcriptional activity. When we compared biliverdin, the precursor to bilirubin, on PPARα transcriptional activation to known PPARα ligands, WY 14,643 and fenofibrate, it showed that fenofibrate and biliverdin have similar activation properties. Treatment of 3T3-L1 adipocytes with biliverdin suppressed lipid accumulation and upregulated PPARα target genes. We treated wild-type and PPARα KO mice on a high fat diet with fenofibrate or bilirubin for seven days and found that both signal through PPARα dependent mechanisms. Furthermore, the effect of bilirubin on lowering glucose and reducing body fat percentage was blunted in PPARα KO mice. These data demonstrate a new function for bilirubin as an agonist of PPARα, which mediates the protection from adiposity afforded by moderate increases in bilirubin. PMID:27071062

  8. PPARα: A Master Regulator of Bilirubin Homeostasis

    OpenAIRE

    Cyril Bigo; Jenny Kaeding; Diala El Husseini; Iwona Rudkowska; Mélanie Verreault; Marie Claude Vohl; Olivier Barbier

    2014-01-01

    Hypolipidemic fibrates activate the peroxisome proliferator-activated receptor (PPAR) α to modulate lipid oxidation and metabolism. The present study aimed at evaluating how 3 PPARα agonists, namely, fenofibrate, gemfibrozil, and Wy14,643, affect bilirubin synthesis and metabolism. Human umbilical vein epithelial cells (HUVEC) and coronary artery smooth muscle cells (CASMC) were cultured in the absence or presence of the 3 activators, and mRNA, protein, and/or activity levels of the bilirubin...

  9. Intermolecular interactions in the bilirubin-cholate-silica system

    Science.gov (United States)

    Vlasova, N. N.; Golovkova, L. P.; Severinovskaya, O. V.

    2007-06-01

    Bilirubin-cholate interactions in aqueous solutions were studied. The constants of binding of bilirubin with taurocholate dimers and taurodeoxycholate trimers were calculated. The adsorption of bilirubin and cholates on the surface of highly dispersed silica was studied. It was shown that taurine-conjugated cholates are poorly adsorbed from micellar solutions on the silica surface, the specific amount of bilirubin adsorbed decreases with increasing concentration of cholates in the solution, the affinity of free bilirubin for the silica surface is independent of the nature of the cholic acid, and that the affinity of cholate-bilirubin complexes for the silica surface is lower than the affinity of free bilirubin.

  10. PPARα: A Master Regulator of Bilirubin Homeostasis

    Directory of Open Access Journals (Sweden)

    Cyril Bigo

    2014-01-01

    Full Text Available Hypolipidemic fibrates activate the peroxisome proliferator-activated receptor (PPAR α to modulate lipid oxidation and metabolism. The present study aimed at evaluating how 3 PPARα agonists, namely, fenofibrate, gemfibrozil, and Wy14,643, affect bilirubin synthesis and metabolism. Human umbilical vein epithelial cells (HUVEC and coronary artery smooth muscle cells (CASMC were cultured in the absence or presence of the 3 activators, and mRNA, protein, and/or activity levels of the bilirubin synthesizing heme oxygenase- (HO- 1 and biliverdin reductase (BVR enzymes were determined. Human hepatocytes (HH and HepG2 cells sustained similar treatments, except that the expression of the bilirubin conjugating UDP-glucuronosyltransferase (UGT 1A1 enzyme and multidrug resistance-associated protein (MRP 2 transporter was analyzed. In HUVECs, gemfibrozil, fenofibrate, and Wy14,643 upregulated HO-1 mRNA expression without affecting BVR. Wy14,643 and fenofibrate also caused HO-1 protein accumulation, while gemfibrozil and fenofibrate favored the secretion of bilirubin in cell media. Similar positive regulations were also observed with the 3 PPARα ligands in CASMCs where HO-1 mRNA and protein levels were increased. In HH and HepG2 cells, both UGT1A1 and MRP2 transcripts were also accumulating. These observations indicate that PPARα ligands activate bilirubin synthesis in vascular cells and metabolism in liver cells. The clinical implications of these regulatory events are discussed.

  11. Initial photochemistry of bilirubin probed by femtosecond spectroscopy.

    Science.gov (United States)

    Zietz, Burkhard; Gillbro, Tomas

    2007-10-18

    Bilirubin is a breakdown product from heme catabolism, and reduced excretion of bilirubin can lead to jaundice. Phototherapy is the most common treatment for neonatal jaundice, a condition frequently encountered in newborn infants. Knowledge of the photochemistry of bilirubin, which is dominated by (ultra)fast components, is necessary for the profound understanding of the processes in phototherapy. Here, we report results from femtosecond fluorescence upconversion measurements on bilirubin and half-bilirubin model compounds, as well as pump-probe absorption measurements on bilirubin. A fast component of ca. 120 fs in the multiexponential fluorescence decay, being only visible in the bilirubin molecule, is interpreted as exciton localization within the molecular halves. The slower components of several hundreds of femtoseconds and a few picoseconds, occurring in bilirubin and the half-bilirubin model, are interpreted as relaxation to a (twisted) intermediate, which decays further with ca. 15 ps to the ground state. PMID:17927274

  12. Prognostic significance of serum bilirubin in stroke

    International Nuclear Information System (INIS)

    Background: Oxidative injury is an important cause of the neurologic lesion in stroke. Serum bilirubin is considered a natural antioxidant that may affect the prognosis of stroke. The purpose of this study was to evaluate the prognostic significance of bilirubin in stroke patients. Methods: A prospective cross-sectional study was conducted in Medical Units of Khyber Teaching Hospital, Peshawar. Inpatients admitted with acute attack of stroke were included in this study. Data regarding serum bilirubin and concurrent cerebrovascular risk factors were collected. National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) were used to analyse stroke's severity and functional outcomes, respectively. Results: Hypertension, diabetes mellitus and heart diseases were the most common risk factors. Patients were divided into 3 groups on the basis of serum bilirubin, i.e., =0.6 mg/dl (Group-1), 0.7-0.9 mg/dl (Group-2), and =1.0 mg/dl (Group-3). The mean pre-hospitalisation NIHSS score for Groups 1, 2 and 3 was 5.62, 11.66 and 25.33, respectively; and post-hospitalisation score was 0.875, 3.76 and 16.26, respectively. The pre-hospitalisation mRS score was 4 for Group-1, 4.52 for Group-2 and 4.93 for Group-3; while post-hospitalisation Mrs Score was 1.50, 2.38 and 4.26, respectively. Average serum bilirubin level was significantly higher in patients with poor outcomes as compared with good outcomes (p<0.01). Conclusions: This study suggests that higher serum bilirubin levels were associated with increased stroke severity, longer hospitalisation and poor prognosis. (author)

  13. Serum Bilirubin Levels and Developmental Outcome

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    J Gordon Millichap

    2006-05-01

    Full Text Available The neurodevlopmental risks associated with neonatal total serum bilirubin levels of 25 mg/dL or higher in 140 affected infants were compared with 419 randomly selected controls from a cohort of term-infants born 1995-1998 in Kaiser Permanente hospitals in northern California.

  14. Mechanisms of bilirubin toxicity: clinical implications.

    Science.gov (United States)

    Hansen, Thor Willy Ruud

    2002-12-01

    The basic mechanism of kernicterus and bilirubin encephalopathy has not been unequivocally determined. Much knowledge has been gained about phenomena that contribute to bilirubin neurotoxicity, and this knowledge has implications for clinical practice. Conditions that impact on blood-brain barrier function, increase brain blood flow, or impact on bilirubin metabolism, including its transport in serum, should be avoided, if possible. Such conditions include drugs and drug stabilizers that compete with bilirubin binding to albumin, or that inhibit P-glycoprotein in the blood-brain barrier, prematurity/immaturity, and clinically significant illness in the infant that involves hemolysis, respiratory and metabolic acidosis, infection, asphyxia, hypoxia and (perhaps) hyperoxia, and hyperosmolality. If these conditions are not avoidable then there should be a more aggressive approach to the treatment of hyperbilirubinemia. The limits of tolerance for hyperbilirubinemia varies among neonates and there are no tools to determine with certainty when a particular infant is approaching the danger zone. Neurological symptoms in a jaundiced infant require extreme vigilance, and, in most cases, immediate intervention. PMID:12516745

  15. BILIRUBIN AS AN INDIRECT MEASURE OF LABORATORY PERFORMANCE OF BILIRUBIN DETERMINATIONS

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    Suresh Babu

    2015-09-01

    Full Text Available OBJECTIVE : To correlate Total Serum Bilirubin (TSB values to the clinical course of hyperbilirubinemia in newborns as this can be an indirect method of quality assurance in the laboratory. METHODS : An observational study of bilirubin values from 100 randomly selected case records of newborn jaundice for a period of 6 months. TSB values were determined by diazo reaction on venous blood samples on a semi auto analyzer. MS excel sheet used for statistical analysis. RESULTS : Clinical course of hyperbilirubinemia in all subjects correlated well to the reported TSB values in first to last zones corresponding to 15 mg /dL on 3rd day to 5th day of age. Zones 3, 4 and 5 varied from 7th day of birth, as phototherapy and recovery altered visual assessment of jaundice. One patient was expired with kernicterus had very high TSB value. The median bilirubin values trend downfall which correlated clinically to recovery from jaundice and 33% rapid decline in TSB also indicated the intervention by phototherapy. CONCLUSIONS : Bilirubin is one parameter with higher inter laboratory variability since its discovery till today. Hence more quality methods are to be developed to minimize this bias in clinical interpretation of reported bilirubin levels. Our study is an intermediary quality measure useful for both clinicians and lab personnel. This study can be adopted for retrospective quality evaluation and can be adopted for other parameters as well.

  16. Hepatocyte cotransport of taurocholate and bilirubin glucuronides: Role of microtubules

    International Nuclear Information System (INIS)

    Modulation of bile pigment excretion by bile salts has been attributed to modification of canalicular membrane transport or a physical interaction in bile. Based on the observation that a microtubule-dependent pathway is involved in the hepatocellular transport of bile salts, the authors investigated the possibility that bilirubin glucuronides are associated with bile salts during intracellular transport. Experiments were conducted in intact rats (basal) or after overnight biliary diversion and intravenous reinfusion of taurocholate (depleted/reinfused). All rats were pretreated with intravenous low-dose colchicine or its inactive isomer lumicolchicine. Biliary excretion of radiolabeled bilirubin glucuronides derived from tracer [14C]bilirubin-[3H]bilirubin monoglucuronide (coinjected iv) was unchanged in basal rats but was consistently delayed in depleted/reinfused rats. This was accompanied by a significant shift toward bilirubin diglucuronide formation from both substrates. In basal Gunn rats, with deficient bilirubin glucuronidation, biliary excretion of intravenous [14C]bilirubin monoglucuronide-[3H]bilirubin diglucuronide was unaffected by colchicine but was retarded in depleted/reinfused Gunn rats. Colchicine had no effect on the rate of bilirubin glucuronidation in vitro in rat liver microsomes. They conclude that a portion of the bilirubin glucuronides generated endogenously in hepatocytes or taken up directly from plasma may be cotransported with bile salts to the bile canalicular membrane via a microtubule-dependent mechanism

  17. Rapid clearance of a structural isomer of bilirubin during phototherapy.

    OpenAIRE

    Ennever, J F; Costarino, A T; Polin, R A; Speck, W T

    1987-01-01

    During phototherapy for neonatal jaundice, bilirubin is converted into a variety of photoproducts. Determination of the relative importance of these photoproducts to the elimination of bilirubin requires knowledge of their rates of excretion. We have measured the rate at which the structural isomer of bilirubin, lumirubin, disappeared from the serum of nine jaundiced premature infants after the cessation of phototherapy. In all patients studied, the decline in serum lumirubin could be approxi...

  18. Bilirubin and its oxidation products damage brain white matter

    OpenAIRE

    Lakovic, Katarina; Ai, Jinglu; D'abbondanza, Josephine; Tariq, Asma; Sabri, Mohammed; Alarfaj, Abdullah K; Vasdev, Punarjot; Macdonald, Robert Loch

    2014-01-01

    Brain injury after intracerebral hemorrhage (ICH) occurs in cortex and white matter and may be mediated by blood breakdown products, including hemoglobin and heme. Effects of blood breakdown products, bilirubin and bilirubin oxidation products, have not been widely investigated in adult brain. Here, we first determined the effect of bilirubin and its oxidation products on the structure and function of white matter in vitro using brain slices. Subsequently, we determined whether these compound...

  19. Antioxidant mechanism of bilirubin: both HAT and SET are possible

    International Nuclear Information System (INIS)

    Bilirubin (BR) plays two extreme roles in physiology, one hand it is a toxic metabolite while at micromolar concentration it acts as antioxidant. It has been observed that hydroxyl, glutathiyl and Linoleic peroxyl radicals abstract hydrogen atom from bilirubin, whereas N3, Br2, CCl3OO, NO2 radicals react via single electron transfer action. Our study demonstrates that oxidation of bilirubin occurs via both hydrogen atom transfer and single electron transfer depending on the nature of the radical. (author)

  20. Bilirubin/Albumin Ratio for Predicting Acute Bilirubin-induced Neurologic Dysfunction

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    Gholamreza Esmaeeli Djavid

    2011-03-01

    Full Text Available Objective:The aim of this study was to evaluate the bilirubin albumin (B/A ratio in comparison with total serum bilirubin (TSB for predicting acute bilirubin-induced neurologic dysfunction (BIND. Methods:Fifty two term and near term neonates requiring phototherapy and exchange transfusion for severe hyperbilirubinemia in Childrens Medical Center, Tehran, Iran, during September 2007 to September 2008, were evaluated. Serum albumin and bilirubin were measured at admission. All neonates were evaluated for acute BIND based on clinical findings. Findings:Acute BIND developed in 5 (3.8% neonates. B/A ratio in patients with BIND was significantly higher than in patients without BIND (P<0.001. Receiver operation characteristics (ROC analysis identified a TSB cut off value of 25 mg/dL [area under the curve (AUC 0.945] with a sensitivity of 100% and specificity of 85%. Also, according to the ROC curve, B/A ratio cut off value for predicting acute BIND was 8 (bil mg/al g (AUC 0.957 with sensitivity of 100% and specificity of 94%. Conclusion:Based on our results, we suggest using B/A ratio in conjunction with TSB. This can improve the specificity and prevent unnecessary invasive therapy such as exchange transfusion in icteric neonates.

  1. Comparison of serum bilirubin estimation with transcutaneous bilirubinometry in neonates

    International Nuclear Information System (INIS)

    Objective: To assess usefulness of Minolta Air shield transcutaneous bilirubinometer by comparing bilirubin values obtained by transcutaneous jaundice meter with serum bilirubin estimation. Design: Analytical cross sectional study. Place and duration: NICU Military Hospital Rawalpindi Pakistan Jun 2002 to May 2005. Subjects and Methods: One hundred and fifty neonates admitted to NICU because of visible jaundice were included in the study. Serum was sent to laboratory for total bilirubin estimation. At the same time bilirubin was also checked by a Jaundice Meter. Data was tabulated and t-test applied to compare the two values. Results: One hundred and fifty paired estimations were performed. The transcutaneous bilirubin values ranged from 8.0 mg/dl to 20.4 mg/dl. While serum bilirubin by jaundice meter values ranged between 5.3 mg/dl and 26.0 mg/dl. A Scatter diagram was plotted. It showed a correlation coefficient of 0.78. Conclusion: Bilirubin values obtained by transcutaneous bilirubin meter were not significantly different from laboratory values thus proving the fact that transcutaneous bilirubinometer is a useful device to measure bilirubin. (author)

  2. Bilirubin and its oxidation products damage brain white matter.

    Science.gov (United States)

    Lakovic, Katarina; Ai, Jinglu; D'Abbondanza, Josephine; Tariq, Asma; Sabri, Mohammed; Alarfaj, Abdullah K; Vasdev, Punarjot; Macdonald, Robert Loch

    2014-11-01

    Brain injury after intracerebral hemorrhage (ICH) occurs in cortex and white matter and may be mediated by blood breakdown products, including hemoglobin and heme. Effects of blood breakdown products, bilirubin and bilirubin oxidation products, have not been widely investigated in adult brain. Here, we first determined the effect of bilirubin and its oxidation products on the structure and function of white matter in vitro using brain slices. Subsequently, we determined whether these compounds have an effect on the structure and function of white matter in vivo. In all, 0.5 mmol/L bilirubin treatment significantly damaged both the function and the structure of myelinated axons but not the unmyelinated axons in brain slices. Toxicity of bilirubin in vitro was prevented by dimethyl sulfoxide. Bilirubin oxidation products (BOXes) may be responsible for the toxicity of bilirubin. In in vivo experiments, unmyelinated axons were found more susceptible to damage from bilirubin injection. These results suggest that unmyelinated axons may have a major role in white-matter damage in vivo. Since bilirubin and BOXes appear in a delayed manner after ICH, preventing their toxic effects may be worth investigating therapeutically. Dimethyl sulfoxide or its structurally related derivatives may have a potential therapeutic value at antagonizing axonal damage after hemorrhagic stroke. PMID:25160671

  3. Cell damage by bilirubin and light

    International Nuclear Information System (INIS)

    Large doses of light are given to newborns during phototherapy for hyperbilirubinemia. Tissues containing concentrations of bilirubin almost in the mM range may be subjected to irradiation. Therefore it is of interest to study cellular effects of light and bilirubin on cells. In order to select the optimal wavelength, possible detrimental effects of light on cells must be taken into consideration among a number of other factors. In this study cellular effects of selected wavelengths of blue-green light are compared. It is not clear whether cullular damage occurs in vivo during phototherapy of newborns. Since a possibility exists that some adverse effects are caused by light, one should choose wavelengths where these effects are minimal without loosing therapeutic efficiency. Todays knowledge of the photochemical mechanisms of phototherapy, indicates that short waved light with wavelengths below 450 nm has a low therapeutic effect. The data in this paper indicate that the cellular damage is most severe at short wavelengths, and these should be reduced to a minimum in the spectra of phototherapy lamps. Further studies of possible side effects of phototherapy should be made. 64 refs., 34 figs., 1 tab

  4. Genetically elevated bilirubin and risk of ischaemic heart disease

    DEFF Research Database (Denmark)

    Stender, Stefan; Frikke-Schmidt, R; Nordestgaard, B G;

    2013-01-01

    Elevated plasma levels of bilirubin, an endogenous antioxidant, have been associated with reduced risk of ischaemic heart disease (IHD) and myocardial infarction (MI). Whether this is a causal relationship remains unclear.......Elevated plasma levels of bilirubin, an endogenous antioxidant, have been associated with reduced risk of ischaemic heart disease (IHD) and myocardial infarction (MI). Whether this is a causal relationship remains unclear....

  5. Low-normal free thyroxine confers decreased serum bilirubin in type 2 diabetes mellitus

    NARCIS (Netherlands)

    Deetman, Petronella E.; Kwakernaak, Arjan J.; Bakker, Stephan J. L.; Dullaart, Robin P. F.

    2013-01-01

    Background: Bilirubin may confer cardiovascular protection because of its strong antioxidative properties. Both thyroid dysfunction and the diabetic state affect bilirubin metabolism. Here we tested whether low-normal thyroid function affects serum bilirubin among euthyroid subjects with and without

  6. The inverse association of incident cardiovascular disease with plasma bilirubin is unaffected by adiponectin

    NARCIS (Netherlands)

    Dullaart, Robin P. F.; Boersema, Jeltje; Lefrandt, Joop D.; Wolffenbuttel, Bruce H. R.; Bakker, Stephan J. L.

    2014-01-01

    Objective: Bilirubin may protect against atherosclerotic cardiovascular disease (CVD). The heme oxygenase pathway is crucial for bilirubin generation, and is stimulated by adiponectin. We tested the relationship of plasma bilirubin with adiponectin, and determined whether the association of incident

  7. Transcutaneous Bilirubin Measurement in Preterm Neonates

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    Paymaneh Alizadeh Taheri

    2012-11-01

    Full Text Available Hyperbilirubinemia is a common problem during neonatal period especially in preterm neonates. Transcutaneous bilirubin measurement (TcB by special devices had been documented as an effective tool for predicting neonatal jaundice in full term neonate, but for preterm infants the present evidences are controversial. We carried out a prospective study in Shariati Hospital NICU. 126 paired TcB/total serum bilirubin (TSB measurements were obtained. TcB (on forehead and sternum were measured using JH2-1A device for every admitted preterm infant who clinically showed jaundice and TSB measurements was obtained within 30 min of TcB. 58 (46% were male and 68 (54% were female. The mean gestational age was 31 week and mean birth weight was 1728 ± 60 g. 30 percent of neonates were ill. The mean value obtained by TBS was 8.8 mg/dl and for frontal TcB was 8.2mg/dl and for sternal TcB was 7.4mg/dl. There were good correlation between TBS and TcB and the maximum correlation were seen in 33-37 weeks of gestation and birth weight more than 2500 g with forehead TcB measurement. Healthy preterm infants had significant correlation of TSB and TcB (r=0.56, P<0.001 and ill preterm neonate had r =0.82, P<0.001. The correlation between TBS and TcB with and without phototherapy was r=0.66, P=0.000 and r=0.69, P=0.000 respectively. Although TcB measurement may underestimate TBS but there is significant correlation between TcB and TBS in preterm cases even in ill neonate or who receiving phototherapy. This method can be used for determination of bilirbin level in preterm neonate and reduces the number of blood sampling.

  8. Trans-Cutaneous Bilirubinometery versus Serum Bilirubin in Neonatal Jaundice.

    Science.gov (United States)

    Mahram, Manoochehr; Oveisi, Sonia; Jaberi, Najmeh

    2015-12-01

    Hyperbilirubinemia is a common problem in neonates and causes serious complications. Thus, serial measurements of bilirubin should be done. This assessment is done through two methods of laboratory measurement in serum sample and transcutaneous bilirubinometer. This descriptive study compared transcutaneous bilirubin assessment and laboratory serum bilirubin. Bilirubin level was assessed among 256 neonates admitted to the Qods Children's Hospital in Qazvin- Iran, because of neonatal indirect jaundice, through two methods of transcutaneous bilirubinometery from two sites of forehead and sternum and laboratory measurement of bilirubin in serum. The cases were non-hemolytic icteric term neonates weighing 2500 gram or more and had not received phototherapy or other treatments. Neonates with hemolytic forms of jaundice, sepsis and suspicious to metabolic disorders were excluded. Assessments by means of KJ-8000 transcutaneous bilirubinometer from two sites of forehead and sternum and through laboratory measurement of serum bilirubin were registered and analyzed. The results of the current study showed that there was a correlation of 0.82 between serum bilirubin and transcutaneous forehead bilirubin assessment and for the used device sensitivity of 0.844; specificity of 0.842, Youden Index of 0.709 and Shortest of 0.042 for a cut-off of 12.4 in bilirubin of participants. Furthermore, Likelihood Ratio positive and negative (LR) were 5.665 and 0.164, respectively and diagnostic Odds Ratio (LR+/LR-) was 34.56. Transcutaneous bilirubinometery can be considered as a reliable tool to assess bilirubin for the screening of neonatal jaundice in term neonates. PMID:26749233

  9. Trans-Cutaneous Bilirubinometery versus Serum Bilirubin in Neonatal Jaundice

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    Manoochehr Mahram

    2015-12-01

    Full Text Available Hyperbilirubinemia is a common problem in neonates and causes serious complications. Thus, serial measurements of bilirubin should be done. This assessment is done through two methods of laboratory measurement in serum sample and transcutaneous bilirubinometer. This descriptive study compared transcutaneous bilirubin assessment and laboratory serum bilirubin. Bilirubin level was assessed among 256 neonates admitted to the Qods Children’s Hospital in Qazvin- Iran, because of neonatal indirect jaundice, through two methods of transcutaneous bilirubinometery from two sites of forehead and sternum and laboratory measurement of bilirubin in serum. The cases were non-hemolytic icteric term neonates weighing 2500 gram or more and had not received phototherapy or other treatments. Neonates with hemolytic forms of jaundice, sepsis and suspicious to metabolic disorders were excluded. Assessments by means of KJ-8000 transcutaneous bilirubinometer from two sites of forehead and sternum and through laboratory measurement of serum bilirubin were registered and analyzed. The results of the current study showed that there was a correlation of 0.82 between serum bilirubin and transcutaneous forehead bilirubin assessment and for the used device sensitivity of 0.844; specificity of 0.842, Youden Index of 0.709 and Shortest of 0.042 for a cut-off of 12.4 in bilirubin of participants. Furthermore, Likelihood Ratio positive and negative (LR were 5.665 and 0.164, respectively and diagnostic Odds Ratio (LR+/LR- was 34.56. Transcutaneous bilirubinometery can be considered as a reliable tool to assess bilirubin for the screening of neonatal jaundice in term neonates.

  10. [Does bilirubin interfere with capillary electrophoresis of serum proteins?].

    Science.gov (United States)

    Hellara, Ilhem; Fekih, Ons; Triki, Sonia; Elmay, Ahlem; Neffati, Fadoua; Najjar, Mohamed Fadhel

    2014-01-01

    Capillary electrophoresis of serum proteins is a fast, reliable and simple technique, but many interference exist. The objective of our work is to study the interference of bilirubin on this technique; 70 icteric sera were analysed on Capillarys ™ (Sebia). A second electrophoresis was performed on 40 samples after bilirubin photodegradation. The bilirubin and serum proteins were determinated respectively by Jendrassik and Grof and biuret methods on Konélab 20i ™ (Thermo Electron Corporation). We found abnormal spreading of the albumin fraction of the anode side wich constitute sometimes an isolated fraction in the traditional area of pre-albumin migration. This fraction varies from 2.0 ± 2.0% (0.0 to 7.3%) or 0.98 ± 1.53 g/L (0 to 5.3 g/L) and it seems to be related to the direct bilirubin since, following overloading sera with a solution of bilirubin, no further fraction was recovered. An average decrease of bilirubin after photodegradation of 58 ± 17% (26-89%) is followed by a decrease in the same order 64 ± 38% (10-100%) of the additional fraction. Acetate cellulose electrophoresis of the same samples showed no variation. The high bilirubin levels seem modify slightly the electrophoretic profile. However the impact of the interference on the interpretation of electrophoretic trace is negligible. PMID:24492101

  11. Atazanavir–bilirubin interaction: a pharmacokinetic–pharmacodynamic model

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    Lozano R

    2013-09-01

    Full Text Available Roberto Lozano,1 Nieves Domeque,2 Alberto-Fermin Apesteguia3 1Pharmacy Department, 2Psychiatry Department, Hospital Real Nuestra Señora de Gracia, 3Pharmacy Department, Hospital Clinico Universitario "Lozano Blesa", Zaragoza, Spain Purpose: The aim of this work was to analyze the atazanavir–bilirubin relationship, using a new mathematical approach to pharmacokinetic–pharmacodynamic models, for competitive drug interactions based on Michaelis–Menten equations. Patients and methods: Because atazanavir induces an increase of plasma bilirubin levels, in a concentration-dependent manner, we developed a mathematical model, based on increments of atazanavir and bilirubin concentrations at steady state, in HIV infected (HIV+ patients, and plotted the corresponding nomogram for detecting suboptimal atazanavir exposure. Results: By applying the obtained model, the results indicate that an absolute value or an increment of bilirubin at steady state below 3.8 µmol/L, are predictive of suboptimal atazanavir exposure and therapeutic failure. Conclusion: We have successfully implemented a new mathematical approach to pharmacokinetic–pharmacodynamic model for atazanavir–bilirubin interaction. As a result, we found that bilirubin plasma levels constitute a good marker of exposure to atazanavir and of viral suppression. Keywords: atazanavir, bilirubin, HIV/AIDS, pharmacodynamics, pharmacokinetics

  12. Relationship between serum bilirubin levels and optic neuritis

    Institute of Scientific and Technical Information of China (English)

    DENG Juan; LIANG Xue-mei; ZHANG Xiu-lan; LING Shi-qi; YANG Ting-ting; LI Min; PENG Fu-hua

    2013-01-01

    Background Bilirubin is the end product of heme catabolism and has strong antioxidant properties.Serum bilirubin levels are reported to be reduced in patients with multiple sclerosis (MS) and neuromyelitis optica (NMO).The pathophysiology of optic neuritis (ON) resembles that of MS; however,the role of endogenous bilirubin in ON is unclear.The aim of this study is to measure serum bilirubin levels in patients with ON,and to investigate the correlation between ON and serum antioxidant status of bilirubin.Methods Serum levels of bilirubin were measured in 42 patients with ON,50 patients with multiple sclerosis (MS),48 patients with neuromyelitis optica (NMO) and 48 healthy control subjects.Results Serum total bilirubin (Tbil),direct bilirubin (Dbil) and indirect bilirubin (Ibil) levels in patients with ON were significantly lower than those in the healthy controls.However,no statistical significance was found between levels in the ON and MS,ON and NMO,and MS and NMO groups.In patients with ON,serum Tbil,Dbil,and Ibil levels were lower in those with recurrence or those with ON for a longer duration (>1 year).Moreover,Tbil,Dbil,and Ibil concentrations were lower in patients with papillitis than in those with retrobulbar type ON,but the differences were not statistically significant.Conclusions Low antioxidant status may exist in patients with ON.But serum levels of Tbil,Dbil,and Ibil did not correlate with clinical presentations,such as recurrence,duration of disease and subtypes of ON.Low antioxidant status already existed in MS or NMO patients before systemic symptoms appeared.

  13. Influence of bilirubin on surface tension properties of lung surfactant.

    OpenAIRE

    Amato, M; Schürch, S; Grunder, R; Bachofen, H.; Burri, P H

    1996-01-01

    AIM: To investigate the influence of bilirubin on the surface tension activity of a porcine derived (Curosurf) and synthetic (Exosurf) surfactant. METHODS: The captive bubble surfactometer at phospholipid doses of 0.5 mg/ml (low dose) and 1 mg/ml (high dose) in solutions of increasing bilirubin concentrations (0.25, 0.5, and 1.0 mg/ml) was used. RESULTS: Curosurf (without bilirubin) showed a higher surface f1p4ion activity than Exosurf, as shown by area compression of 30 (SD 0.6)% compared wi...

  14. Determinants of bilirubin neurotoxicity by an in vitro molecular approach

    OpenAIRE

    Coda Zabetta, Carlos Daniel

    2012-01-01

    Unconjugated Bilirubin (UCB) is the final product of the heme catabolism. The high serum UCB concentrations in the first days of life of the newborns, due to immature mechanisms for hepatic uptake, conjugation and biliary secretion, is called physiological neonatal jaundice. This common condition is generally a benign and transient phenomenon, but in some cases the hyperbilirubinemia can progress to bilirubin encephalopaties ranging from minimally neurological injury to severe and permanent n...

  15. Relationship between bilirubin free radical and formation of pigment gallstone

    Institute of Scientific and Technical Information of China (English)

    Xiang-Tao Liu; Jian Hu

    2002-01-01

    In this paper, we summarize the main progresses made inour group in the field of the mechanism of pigment gallstoneformation. It was found that after treetment with freeradicals, bilirubin (BR) was changed into free radical itself,and a semiquinone free radical and a superoxide free radicalbound with metal were recognized, which was detected byESR (electron spin resonance). By the meana of NMR(nuclear magnetic resonance) and IR (Infra-red spectra), itwas postulated that bilirubin polymerized through thereaction between the vinyl group and the hydroxyl groupunder the attack of free radicals. It was also found thatbilirubin free radical were liable to calcify in a kinetic study.Because of its chemical properties, bilirubin free radical wasshown to be cytotoxic to hepetocyte, which wasdemonstrated based on the following facts: induction ofphospholipid peroxidation (LPO), leakage of lactatedehydrogenase (LDH) and decrease of glutathione. As tothe mechanism of bilirubin-induced cytotoxicity, it waspostulated that the main target of bilirubin free radical wasthe cell membrane, including phospholipid and membranebound proteins, especially spectrin, a content ofcytoskeleton. Based on the results mentioned above, it wasdeduced that bilirubin free radical is the key factor thatinitiates and promotes the formation of pigment gallstone,which is consistent with other researches in recent years.

  16. Study on Removal of Bilirubin with Magnetic Affinity Separation Technique

    Institute of Scientific and Technical Information of China (English)

    张凤宝; 王淑兰; 徐辉; 张国亮

    2003-01-01

    An affinity adsorbent, Cibacron Blue 3GA immobilized magnetic polyvinyl alcohol (PVA) microspheres was used for bilirubin removal taking the advantage of easy separation of magnetic sorbent from the biosystem.Fe3 O4 superparamagnetic particles was synthesized with hydrothermal reaction of ferrous chloride (FeC12) and ferric chloride (FeCl3). Such magnetic particles are then encapsulated in biocompatible PVA to form magnetic polymer microspheres sized from 2 to 15 nm with hydroxyl groups on its surface. Cibacron Blue 3GA, a dye-ligand, was covalently coupled with the polyvinyl alcohol through the nucleophilic reaction between the chloride of its triazine ring and the hydroxyl groups of PVA molecules under alkaline condition. The affinity adsorbent carried 21.1μmol Cibacron Blue 3GA per gram magnetic polymer microspheres was used to remove unconjugated and conjugated bilirubin from the solution which was composed of bilirubin or bilirubin and protein. After the adsorption, the adsorbent loaded with bilirubin was removed easily in the magnetic field.

  17. Anti-Genotoxic Potential of Bilirubin In Vivo

    DEFF Research Database (Denmark)

    Wallner, Marlies; Antl, Nadja; Rittmannsberger, Barbara;

    2013-01-01

    The bile pigment bilirubin is a known antioxidant and is associated with protection from cancer and cardiovascular disease (CVD) when present in too strong concentrations. Unconjugated bilirubin (UCB) might also possess anti-genotoxic potential by preventing oxidative damage to DNA. Moderately...... (age- and sex-matched) were allocated into Gilbert syndrome (UCB ≥17.1 μmol/L; n = 38) or control groups (UCB < 17.1 μmol/L; n = 38). In addition, 40 Gunn rats were used to support the results of the human trial. Single-cell gel electrophoresis (SCGE) assay measuring standard conditions (strand breaks...

  18. Effect of pH and temperature on the binding of bilirubin to human erythrocyte membranes

    Indian Academy of Sciences (India)

    H Rashid; Mohammad K Ali; S Tayyab

    2000-06-01

    Effect of pH and temperature on the binding of bilirubin to human erythrocyte membranes was studied by incubating the membranes at different pH and temperatures and determining the bound bilirubin. At all pH values, the amount of membrane-bound bilirubin increased with the increase in bilirubin-to-albumin molar ratios (B/As), being highest at lower pH values in all cases. Further, linear increase in bound bilirubin with the increase in bilirubin concentration in the incubate was observed at a constant B/A and at all pH values. However, the slope value increased with the decrease in pH suggesting more bilirubin binding to membranes at lower pH values. Increase in bilirubin binding at lower pH can be explained on the basis of increased free bilirubin concentration as well as more conversion of bilirubin dianion to monoanion. Temperature dependence of bilirubin binding to membranes was observed within the temperature range of 7°–60°C, showing minimum binding at 27°C and 37°C which increased on either side. Increase in bilirubin binding at temperatures lower than 20°C and higher than 40°C can be ascribed to the change in membrane topography as well as bilirubin-albumin interaction.

  19. Interaction of bilirubin with Ag and Au ions: green synthesis of bilirubin-stabilized nanoparticles

    International Nuclear Information System (INIS)

    We report a simple green chemistry to synthesize and stabilize monodispersed silver and gold nanoparticles sols by reducing aqueous solution of the respective metal salts in the presence of bilirubin (BR). No additional capping agent was used in the process of stabilization of the nanoparticles. As a completely new finding, we have observed that BR known to be toxic at higher concentration in one hand and conversely an antioxidant at physiological concentration reduces these metal ions to form the respective metal nanoparticles. Moreover, BR and its oxidized products also serve as capping agents to the nanoparticles. The particles were characterized by transmission electron microscopy. BR and its oxidized products capped nanoparticles are stable for months. The UV–Vis absorption spectra of the silver sol show the plasmon peak of symmetric spherical particles which was further reflected in the TEM images. The sizes of the silver particles were about 5 nm. These silver particles showed reasonably high antibacterial activity in Gram negative wild type E. coli. In the case of interaction of BR with gold ions, we could obtain cubic gold nanoparticles of average sizes 20–25 nm. Possible modes of anchorage of BR and/its oxidized products to silver nanoparticles were demonstrated by surface-enhanced resonance Raman spectroscopy (SERS) that in turn demonstrated the feasibility of using these nanoparticles as SERS substrates.

  20. Interaction of bilirubin with Ag and Au ions: green synthesis of bilirubin-stabilized nanoparticles

    Energy Technology Data Exchange (ETDEWEB)

    Shukla, Shashi P. [Bhabha Atomic Research Centre, Radiation and Photochemistry Division (India); Roy, Mainak [Bhabha Atomic Research Centre, Chemistry Division (India); Mukherjee, Poulomi [Bhabha Atomic Research Centre, Nuclear Agriculture and Biotechnology Division (India); Tyagi, A. K. [Bhabha Atomic Research Centre, Chemistry Division (India); Mukherjee, Tulsi [Bhabha Atomic Research Centre, Chemistry Group (India); Adhikari, Soumyakanti, E-mail: asoumya@barc.gov.in [Bhabha Atomic Research Centre, Radiation and Photochemistry Division (India)

    2012-07-15

    We report a simple green chemistry to synthesize and stabilize monodispersed silver and gold nanoparticles sols by reducing aqueous solution of the respective metal salts in the presence of bilirubin (BR). No additional capping agent was used in the process of stabilization of the nanoparticles. As a completely new finding, we have observed that BR known to be toxic at higher concentration in one hand and conversely an antioxidant at physiological concentration reduces these metal ions to form the respective metal nanoparticles. Moreover, BR and its oxidized products also serve as capping agents to the nanoparticles. The particles were characterized by transmission electron microscopy. BR and its oxidized products capped nanoparticles are stable for months. The UV-Vis absorption spectra of the silver sol show the plasmon peak of symmetric spherical particles which was further reflected in the TEM images. The sizes of the silver particles were about 5 nm. These silver particles showed reasonably high antibacterial activity in Gram negative wild type E. coli. In the case of interaction of BR with gold ions, we could obtain cubic gold nanoparticles of average sizes 20-25 nm. Possible modes of anchorage of BR and/its oxidized products to silver nanoparticles were demonstrated by surface-enhanced resonance Raman spectroscopy (SERS) that in turn demonstrated the feasibility of using these nanoparticles as SERS substrates.

  1. Serum bilirubin kinetics in intermittent phototherapy of physiological jaundice.

    OpenAIRE

    Lau, S. P.; Fung, K P

    1984-01-01

    Thirty four term babies with physiological jaundice were subjected to continuous phototherapy and to two regimens of intermittent phototherapy. The difference in serum bilirubin kinetics between the three groups of treated babies was insignificant; a schedule of one in four hours of irradiation achieved the same treatment effect as continuous phototherapy.

  2. Biphasic Effect of Rifampicin on Bilirubin- A Case Report.

    Science.gov (United States)

    Gopi, Manigandan; Seshadri, Mandalam Subramanian

    2016-04-01

    Drug induced hepatitis is a major problem which a physician encounters in his clinical practice. In view of increasing incidence of tuberculosis in our country a large number of infected individuals are started on Antituberculous (ATT) drugs and rifampicin is invariably part of the regimen. One of the major adverse effects of ATT drugs is drug- induced hepatitis which is characterized by elevation of liver enzymes and bilirubin. Hepatotoxicity is usually idiosyncratic or dose-dependent. Rifampicin causes transient elevation of transaminases in 10-20 percent of individuals and this does not warrant dose adjustments of the drug. Rarely rifampicin can lead to severe hepatitis with hyperbilirubinaemia and marked elevations of SGOT and SGPT and in some patients this can be fatal. The exact mechanism of Rifampicin induced hepatotoxicity is not known but it is postulated to be due to idiosyncratic reaction to rifampicin metabolites which may be directly toxic or induce an immunologically mediated liver injury. Rarely rifampicin may cause hyperbilirubinaemia without enzyme elevation. Here we report a patient with bilateral pulmonary tuberculosis who developed transient severe indirect hyperbilirubinaemia on rifampicin. On review of relevant literature we find that rifampicin can have a biphasic effect on bilirubin, an initial increase in indirect bilirubin and later normalization of bilirubin. We have reported this case because of its rarity in clinical practice. PMID:27190870

  3. The pharmacological features of bilirubin: the question of the century.

    Science.gov (United States)

    Zahir, Farhana; Rabbani, Gulam; Khan, Rizwan Hasan; Rizvi, Shamim J; Jamal, Mohammad Sarwar; Abuzenadah, Adel M

    2015-09-01

    This review looks at the toxicity and metabolism of bilirubin in terms of its pharmacological potential. Its role has gained importance as more research has revealed the functional significance and interrelationship between the gasotransmitters nitric oxide and carbon monoxide. The biological actions of bilirubin have mostly been characterized in the high micromolar range where toxic effects occur. However, it could also prove to be an important cytoprotector for brain tissue, which is inherently less equipped for antioxidant defense. Plasma bilirubin levels negatively correlate to a number of disease states. Higher levels of bilirubin that are still within the normal range provide a protective effect to the body. The effects on various disorders could be tested using controlled pharmacological upregulation of the molecule with animal models. At nanomolar concentrations, considerable benefits have been obtained when the molecule was delivered pharmacologically under in vitro or in vivo test conditions, particularly in neurodegenerative disorders and after tissue or organ transplantation. The induction of heme oxygenase-1 (HMOX-1) via the activation of nuclear factor erythroid 2-related factor or the use of bile pigments in the harvesting of diseased tissue are novel applications, and like every new therapy, should be used with caution. HMOX-1 is tissue specific, and in exceptional states, such as schizophrenia and specific types of renal disorder, the same therapy may have disastrous effects. PMID:26208389

  4. Clinical Significance of Serum Bilirubin Detection of Patient with Coronary Heart Disease

    Institute of Scientific and Technical Information of China (English)

    TAO Li; LUO Rui; ZHUANG Diankui

    2004-01-01

    Objective To explore the relation between serum bilirubin and coronary heart disease.Methods Compare the level of serum bilirubin among patients with coronary heart disease, patients with other disease and normal persons. Results The level of serum bilirubin of patients with coronary heart disease is higher than that of normal persons. Conclusion The reduction of density of serum bilirubin is one of the independent risk factors of coronary heart disease.

  5. Intestinal excretion of unconjugated bilirubin in man and rats with inherited unconjugated hyperbilirubinemia

    NARCIS (Netherlands)

    Kotal, P; VanderVeere, CN; Sinaasappel, M; Elferink, RO; Vitek, L; Brodanova, M; Jansen, PLM; Fevery, J

    1997-01-01

    Patients with Crigler-Najjar syndrome and Gunn rats cannot form bilirubin glucuronides owing to a lack of bilirubin UDP-glucuronosyltransferase activity. Because increased serum and tissue bilirubin levels remain constant, an alternative excretory route has to substitute for this deficiency. Gunn ra

  6. Bilirubin Neurotoxicity in Preterm Infants: Risk and Prevention

    OpenAIRE

    Bhutani, Vinod K.; Wong, Ronald J

    2013-01-01

    Hemolytic conditions in preterm neonates, including Rhesus (Rh) disease, can lead to mortality and long-term impairments due to bilirubin neurotoxicity. Universal access to Rh immunoprophylaxis, coordinated perinatal-neonatal care, and effective phototherapy has virtually eliminated the risk of kernicterus in many countries. In the absence of jaundice due to isoimmunization and without access to phototherapy or exchange transfusion (in 1955), kernicterus was reported at 10.1%, 5.5%, and 1.2% ...

  7. Bilirubin: an endogenous molecule with antiviral activity in vitro.

    Directory of Open Access Journals (Sweden)

    CesareMancuso

    2012-03-01

    Full Text Available Bilirubin-IX-alpha (BR is the final product of heme metabolism through the heme oxygenase/biliverdin reductase (HO/BVR system. Previous papers reported on the microbicidal effects of the HO by-products biliverdin-IX-alpha, carbon monoxide and iron, through either direct or indirect mechanisms. In this paper the evidence of a virucidal effect of BR against human herpes simplex virus type 1 (HSV-1 and the enterovirus EV71 was provided. Bilirubin-IX-alpha, at concentrations 1-10 µM, close to those found in blood and tissues, significantly reduced HSV-1 and EV71 replication in Hep-2 and Vero cell lines, respectively. Bilirubin-IX-alpha inhibited viral infection of Hep-2 and Vero cells when given 2 hours before, concomitantly and 2 hours after viral infection. Furthermore, BR retained its antiviral activity even complexed with a saturating concentration of human serum-albumin. Moreover, 10 µM BR increased the formation of nitric oxide and the phosphorylation of JNK in Vero and Hep-2 cell lines, respectively, thus implying a role of these two pathways in the mechanism of antiviral activity of the bile pigment. In conclusion, these results support the antiviral effect of BR against HSV-1 and enterovirus in vitro, and put the basis for further basic and clinical studies to understand the real role of BR as an endogenous antiviral molecule.

  8. Multistimuli-Responsive Bilirubin Nanoparticles for Anticancer Therapy.

    Science.gov (United States)

    Lee, Yonghyun; Lee, Soyoung; Lee, Dong Yun; Yu, Byeongjun; Miao, Wenjun; Jon, Sangyong

    2016-08-26

    Although stimuli-responsive materials hold potential for use as drug-delivery carriers for treating cancers, their clinical translation has been limited. Ideally, materials used for the purpose should be biocompatible and nontoxic, provide "on-demand" drug release in response to internal or external stimuli, allow large-scale manufacturing, and exhibit intrinsic anticancer efficacy. We present multistimuli-responsive nanoparticles formed from bilirubin, a potent endogenous antioxidant that possesses intrinsic anticancer and anti-inflammatory activity. Exposure of the bilirubin nanoparticles (BRNPs) to either reactive oxygen species (ROS) or external laser light causes rapid disruption of the BRNP nanostructure as a result of a switch in bilirubin solubility, thereby releasing encapsulated drugs. In a xenograft tumor model, BRNPs loaded with the anticancer drug doxorubicin (DOX@BRNPs), when combined with laser irradiation of 650 nm, significantly inhibited tumor growth. This study suggests that BRNPs may be used as a drug-delivery carrier as well as a companion medicine for effectively treating cancers. PMID:27485478

  9. Ambivalent property of bilirubin in human bile juice

    Directory of Open Access Journals (Sweden)

    Anna Blázovics, Péter Sípos, Ferenc Örsi,* Mervat Abdel Rahman

    2005-03-01

    Full Text Available Gallstones are formed as a result of many metabolic disorders e.g. chronic haemolytic anaemia, diabetes mellitus, ileal diseases, short bowel syndrome, gluten sensitive enteropathy, elevated serum lipids or Crohn's disease. The relationship between gallstone disease and free radical reactions is not known exactly even today. Free radicals are involved in many clinical conditions e.g. in hyperlipidemia and in fatty liver. Oxygen free radicals are produced and accumulated while the function of mitochondrial and microsomal electron transport or in peroxisomes and the activated arachidonic acid cascade. Spontaneous lipid peroxidation and oxygen free radical products of respiratory burst of Kupffer cells can be added to peroxide pool of liver tissue. Tissues, cells and subcellular particles exhibit different specific defence activities in pathological processes, which involve free radicals. The activity of microsomal P450 enzyme system and the microsomal structure are changed during pathological free radical attack and the cholesterol/bile acid ratio in bile juice is also altered. At the same time bilirubin metabolism can also be modified. Bile samples of 88 cholecystectomysed patients in both sexes (male: 29, female: 59 were examined. HPLC analysis (HP1090 liquid chromatograph with diode array detector was used for the detection of free bilirubin and bilirubin derivates. HP5890 gas chromatograph and flame ionization detector was used for fatty acid analysis. The induced chemiluminescence intensity was also determined in bile juice with (Berthold Lumat 9501 luminometer. As results show, the occurrence of C18:1 9, C18:2 6, C20:4 6 fatty acids were in high percentage in gallbladder bile in every case of randomly chosen 17 cholecystectomysed patients in both sexes suffered from cholecystitis chronica with gallstone. Lipid peroxidation products (diene conjugates and malondialdehyde were detected in all cases of bile as well. Mathematical statistical

  10. Bilirubin binding with liver cystatin induced structural and functional changes.

    Science.gov (United States)

    Mustafa, Mir Faisal; Bano, Bilqees

    2014-05-01

    Cysteine proteinases and their inhibitors play a significant role in the proteolytic environment of the cells. Inhibitors of cysteine proteinases regulate the activity of these enzymes helping in checking the degdration activity of cathepsins. The bilirubin secreated by liver cells can bind to cystatin present in the liver resulting in its functional inactivation, which may further lead to the increase in cathepsins level causing liver cirrhosis. In case of some pathophysiological conditions excess bilirubin gets accumulated e.g. in presence of Fasciola hepatica (liver fluke) in mammals and humans, leading to liver cirrhosis and possibly jaundice or normal blockade of bile duct causing increased level of bilirubin in blood. Protease-cystatin imbalance causes disease progression. In the present study, Bilirubin (BR) and liver cystatin interaction was studied to explore the cystatin inactivation and structural alteration. The binding interaction was studied by UV-absorption, FT-IR and fluorescence spectroscopy. The quenching of protein fluorescence confirmed the binding of BR with buffalo liver cystatin (BLC). Stern-Volmer analysis of BR-BLC system indicates the presence of static component in the quenching mechanism and the number of binding sites to be close to 1. The fluorescence data proved that the fluorescence quenching of liver cystatin by BR was the result of BR-cystatin complex formation. FTIR analysis of BR-Cystatin complex revealed change in the secondary structure due to perturbation in the microenvironment further confirmed by the decreased caseinolytic activity of BLC against papain. Fluorescence measurements also revealed quenching of fluorescence and shift in peak at different time intervals and at varying pH values. Photo-illumination of BR-cystatin complex causes change in the surrounding environment of liver cystatin as indicated by red-shift. The binding constant for BR-BLC complex was found to be 9.279 × 10(4) M(-1). The cystatin binding with

  11. Depurative capacity of molecular adsorbent recycling system (MARS): A focus on bilirubin removal.

    Science.gov (United States)

    Gong, D; Cruz, D; Ronco, C

    2008-10-01

    The molecular adsorbent recycling system (MARS) is now widely used in the treatment of patients with hepatic failure (HF). A great deal of interest has been directed toward its effect on clinical outcome, whereas its depurative capacity also needs attention. Bilirubin, a tightly albumin-bound toxin accumulating in patients with HF, is regarded as a surrogate to evaluate the depurative capacity of albumin-bound toxins by blood purification modalities. The removal of bilirubin by MARS is difficult to predict, because both the clearance of bilirubin and the reduction ratio of bilirubin after a single session differ between patients and sessions. A reduction of depurative capacity over the course of a treatment is observed. Furthermore, the later sessions are likely less efficient than previous ones. It cannot be taken for granted that the reduction of depurative capacity is due to the saturation and reduced efficiency of the adsorbent columns used in MARS. The answer lies in the property of bilirubin/albumin binding. The removal of bilirubin by MARS is a diffusion process, dependent on the free bilirubin concentration. Bilirubin binds to albumin in 3 ways with different affinity. High-affinity binding bilirubin is difficult to dissociate from albumin and is accompanied by a smaller free fraction, which means it is also difficult for MARS to remove. The factors affecting the free fraction of bilirubin will impact on bilirubin removal by MARS. Among them, the molar ratio of bilirubin to albumin is the most important one. Other factors include the interaction of other agents with bilirubin/albumin binding, the albumin concentration, plasma ion strength, and pH. PMID:19009505

  12. An hour-specific transcutaneous bilirubin nomogram for Mongolian neonates

    OpenAIRE

    Akahira-Azuma, Moe; Yonemoto, Naohiro; Mori, Rintaro; Hosokawa, Shinichi; Matsushita, Takeji; Sukhbat, Khulan; Nansal, Gerelmaa; Bavuusuren, Bayasgalantai; Shonkhuuz, Enkhtur

    2015-01-01

    Transcutaneous bilirubin (TcB) nomograms have been developed for different populations. However, the TcB level, rate of rise and peak varies among countries and ethnicities. The aim of this study was to establish an hour-specific TcB nomogram for healthy term and late preterm Mongolian neonates during the first 144 h after birth. A total of 5084 TcB measurements from 1297 healthy neonates (gestational age ≥35 weeks, birth weight ≥2000 g) were obtained from October 2012 to October 2013. All me...

  13. "The effect of fluid supplementation on serum bilirubin level during phototerapy in term infants "

    OpenAIRE

    Torkaman M; Afsharpeyman SH; Khalili Matinzadeh Z; Amirsalary S; Kavehmanesh Z; Hashemi S.A.

    2007-01-01

    Background: Jaundice is a common and benign problem in neonatal period. Several therapeutic procedures for decreasing of serum bilirubin level has been recommended. phototherapy is most common them. Our goal Form this study is the evaluation of serum therapy effects in decreasing of serum bilirubin concentration in icteric infants that are treated with phototherapy. Methods: This is a prospective clinical trial in Najmeih Hospital in 2002. In this study 80 term icteric infants with bilirubin ...

  14. Dexmedetomidine Attenuates Bilirubin-Induced Lung Alveolar Epithelial Cell Death In Vitro and In Vivo*

    OpenAIRE

    Cui, Jian; Zhao, Hailin; Yi, Bin; Zeng, Jing; Lu, Kaizhi; Ma, Daqing

    2015-01-01

    Objective: To investigate bilirubin-induced lung alveolar epithelial cell injury together with the protection afforded by dexmedetomidine. Design: Prospective, randomized, controlled study. Setting: Research laboratory. Subjects: Sprague Dawley rats. Interventions: Alveolar epithelial A549 cell lines were cultured and received bilirubin (from 0 to 160 μM) to explore the protective pathway of dexmedetomidine on bilirubin-induced alveolar epithelial cell injury assessed by immunochemistry and f...

  15. In vitro displacement of bilirubin by antibiotics and 2-hydroxybenzoylglycine in newborns.

    OpenAIRE

    Wadsworth, S J; Suh, B

    1988-01-01

    Hyperbilirubinemia is frequently observed in neonates, and serious neurological complications such as kernicterus can be precipitated when the concentration of unconjugated bilirubin is abnormally increased. The administration of drugs which bind to albumin and compete with bilirubin can increase the possibility of such a complication. To test the bilirubin-displacing activity of pharmacological agents that are used with newborns, 52 antimicrobial agents were investigated in vitro. A glycine ...

  16. Unconjugated bilirubin mediates heme oxygenase-1-induced vascular benefits in diabetic mice.

    Science.gov (United States)

    Liu, Jian; Wang, Li; Tian, Xiao Yu; Liu, Limei; Wong, Wing Tak; Zhang, Yang; Han, Quan-Bin; Ho, Hing-Man; Wang, Nanping; Wong, Siu Ling; Chen, Zhen-Yu; Yu, Jun; Ng, Chi-Fai; Yao, Xiaoqiang; Huang, Yu

    2015-05-01

    Heme oxygenase-1 (HO-1) exerts vasoprotective effects. Such benefit in diabetic vasculopathy, however, remains unclear. We hypothesize that bilirubin mediates HO-1-induced vascular benefits in diabetes. Diabetic db/db mice were treated with hemin (HO-1 inducer) for 2 weeks, and aortas were isolated for functional and molecular assays. Nitric oxide (NO) production was measured in cultured endothelial cells. Hemin treatment augmented endothelium-dependent relaxations (EDRs) and elevated Akt and endothelial NO synthase (eNOS) phosphorylation in db/db mouse aortas, which were reversed by the HO-1 inhibitor SnMP or HO-1 silencing virus. Hemin treatment increased serum bilirubin, and ex vivo bilirubin treatment improved relaxations in diabetic mouse aortas, which was reversed by the Akt inhibitor. Biliverdin reductase silencing virus attenuated the effect of hemin. Chronic bilirubin treatment improved EDRs in db/db mouse aortas. Hemin and bilirubin reversed high glucose-induced reductions in Akt and eNOS phosphorylation and NO production. The effect of hemin but not bilirubin was inhibited by biliverdin reductase silencing virus. Furthermore, bilirubin augmented EDRs in renal arteries from diabetic patients. In summary, HO-1-induced restoration of endothelial function in diabetic mice is most likely mediated by bilirubin, which preserves NO bioavailability through the Akt/eNOS/NO cascade, suggesting bilirubin as a potential therapeutic target for clinical intervention of diabetic vasculopathy. PMID:25475440

  17. 21 CFR 862.1115 - Urinary bilirubin and its conjugates (nonquantitative) test system.

    Science.gov (United States)

    2010-04-01

    ... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems § 862.1115 Urinary bilirubin and its conjugates (nonquantitative)...

  18. 21 CFR 862.1113 - Bilirubin (total and unbound) in the neonate test system.

    Science.gov (United States)

    2010-04-01

    ... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems § 862.1113 Bilirubin (total and unbound) in the neonate test system....

  19. Association of bilirubin and protein thiols in relation to copper and ceruloplasmin in hyperbilirubinemic patients

    Institute of Scientific and Technical Information of China (English)

    Mungli Prakash; Jeevan K Shetty; Roshan D'Souza; Suhasa Upadhya; Vijay Kumar

    2009-01-01

    Objective:Bilirubin is a double edged sword in biological system,acting as a toxic molecule and cytoprotecrant.Unconjugated bilirubin is proved to show antioxidant activity in vitro and in vivo.In the current work we tried to know the relationship between both conjugated and unconjugated bilirubin with copper and protein thiols in patients with hyperbilirnbinemia.Methods:Study was conducted on 56 hyperbilirubinemic cases and 56 healthy controls.Serum copper,ceruloplasmin,protein thiols,total bilirubin,conjugated and unconjugated bilirubin,unconjugated bilimbin/albumin ratio,total protein,albumin,AST,ALT and ALP were estimated.Results:There was significant increase in serum copper,total bilirubin,conjugated and unconjugated bilimbin.uriconjugated bilirubin/albumin ratio,AST,ALT,and ALP,and decrease in serum ceruloplasmin,protein thiols,total protein,and albumin in hyperbilimbinemic cases when compared to healthy controls.Conjugated bilimbin correlated positively with liver enzymes AST and ALP,and negatively with protein thials,total protein and albumin.Unconjugated bilirubin correlated positively with ALT.Protein thiols correlated negatively with copper and positively with ceruloplasmin,and also correlated negativelv with liver enzymes like AST,ALT and ALP,and positively with total protein and albumin.Conclusion:Combination of elevated levels of trace elements like copper and availability of reducing agent like bilimbin may prove deleterious by generating free radicals.

  20. Protein-Support Interactions for Rationally Designed Bilirubin Oxidase Based Cathode: A Computational Study.

    Science.gov (United States)

    Matanovic, Ivana; Babanova, Sofia; Chavez, Madelaine Seow; Atanassov, Plamen

    2016-04-21

    An example of biocathode based on bilirubin oxidase (BOx) was used to demonstrate how density functional theory can be combined with docking simulations in order to study the interface interactions between the enzyme and specifically designed electrode surface. The electrode surface was modified through the adsorption of bilirubin, the natural substrate for BOx, and the prepared electrode was electrochemically characterized using potentiostatic measurements. The experimentally determined current densities showed that the presence of bilirubin led to significant improvement of the cathode operation. On the basis of the computationally calculated binding energies of bilirubin to the graphene support and BOx and the analysis of the positioning of bilirubin relative to the support and T1 Cu atom of the enzyme, we hypothesize that the bilirubin serves as a geometric and electronic extension of the support. The computational results further confirm that the modification of the electrode surface with bilirubin provides an optimal orientation of BOx toward the support but also show that bilirubin facilitates the interfacial electron transfer by decreasing the distance between the electrode surface and the T1 Cu atom. PMID:27015361

  1. Metabolism of bilirubin by human cytochrome P450 2A6

    International Nuclear Information System (INIS)

    The mouse cytochrome P450 (CYP) 2A5 has recently been shown to function as hepatic “Bilirubin Oxidase” (Abu-Bakar, A., et al., 2011. Toxicol. Appl. Pharmacol. 257, 14–22). To date, no information is available on human CYP isoforms involvement in bilirubin metabolism. In this paper we provide novel evidence for human CYP2A6 metabolising the tetrapyrrole bilirubin. Incubation of bilirubin with recombinant yeast microsomes expressing the CYP2A6 showed that bilirubin inhibited CYP2A6-dependent coumarin 7-hydroxylase activity to almost 100% with an estimated Ki of 2.23 μM. Metabolite screening by a high-performance liquid chromatography/electrospray ionisation mass spectrometry indicated that CYP2A6 oxidised bilirubin to biliverdin and to three other smaller products with m/z values of 301, 315 and 333. Molecular docking analyses indicated that bilirubin and its positively charged intermediate interacted with key amino acid residues at the enzyme's active site. They were stabilised at the site in a conformation favouring biliverdin formation. By contrast, the end product, biliverdin was less fitting to the active site with the critical central methylene bridge distanced from the CYP2A6 haem iron facilitating its release. Furthermore, bilirubin treatment of HepG2 cells increased the CYP2A6 protein and activity levels with no effect on the corresponding mRNA. Co-treatment with cycloheximide (CHX), a protein synthesis inhibitor, resulted in increased half-life of the CYP2A6 compared to cells treated only with CHX. Collectively, the observations indicate that the CYP2A6 may function as human “Bilirubin Oxidase” where bilirubin is potentially a substrate and a regulator of the enzyme. -- Highlights: ► Human CYP2A6 interacts with bilirubin with a high affinity. ► Bilirubin docking to the CYP2A6 active site is more stable than biliverdin docking. ► Recombinant CYP2A6 microsomes metabolised bilirubin to biliverdin. ► Bilirubin increased the hepatic CYP2A6

  2. Metabolism of bilirubin by human cytochrome P450 2A6

    Energy Technology Data Exchange (ETDEWEB)

    Abu-Bakar, A' edah, E-mail: a.abubakar@uq.edu.au [The University of Queensland, National Research Centre for Environmental Toxicology (Entox), 4072 Brisbane, Queensland (Australia); Arthur, Dionne M. [The University of Queensland, National Research Centre for Environmental Toxicology (Entox), 4072 Brisbane, Queensland (Australia); Cooperative Research Centre for Contamination Assessment and Remediation of the Environment, Adelaide (Australia); Wikman, Anna S. [The University of Queensland, National Research Centre for Environmental Toxicology (Entox), 4072 Brisbane, Queensland (Australia); Department of Pharmaceutical Biosciences, Uppsala University, SE-75123 Uppsala (Sweden); Rahnasto, Minna; Juvonen, Risto O.; Vepsäläinen, Jouko; Raunio, Hannu [School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, POB 1627, 70211 Kuopio (Finland); Ng, Jack C. [The University of Queensland, National Research Centre for Environmental Toxicology (Entox), 4072 Brisbane, Queensland (Australia); Cooperative Research Centre for Contamination Assessment and Remediation of the Environment, Adelaide (Australia); Lang, Matti A. [The University of Queensland, National Research Centre for Environmental Toxicology (Entox), 4072 Brisbane, Queensland (Australia)

    2012-05-15

    The mouse cytochrome P450 (CYP) 2A5 has recently been shown to function as hepatic “Bilirubin Oxidase” (Abu-Bakar, A., et al., 2011. Toxicol. Appl. Pharmacol. 257, 14–22). To date, no information is available on human CYP isoforms involvement in bilirubin metabolism. In this paper we provide novel evidence for human CYP2A6 metabolising the tetrapyrrole bilirubin. Incubation of bilirubin with recombinant yeast microsomes expressing the CYP2A6 showed that bilirubin inhibited CYP2A6-dependent coumarin 7-hydroxylase activity to almost 100% with an estimated K{sub i} of 2.23 μM. Metabolite screening by a high-performance liquid chromatography/electrospray ionisation mass spectrometry indicated that CYP2A6 oxidised bilirubin to biliverdin and to three other smaller products with m/z values of 301, 315 and 333. Molecular docking analyses indicated that bilirubin and its positively charged intermediate interacted with key amino acid residues at the enzyme's active site. They were stabilised at the site in a conformation favouring biliverdin formation. By contrast, the end product, biliverdin was less fitting to the active site with the critical central methylene bridge distanced from the CYP2A6 haem iron facilitating its release. Furthermore, bilirubin treatment of HepG2 cells increased the CYP2A6 protein and activity levels with no effect on the corresponding mRNA. Co-treatment with cycloheximide (CHX), a protein synthesis inhibitor, resulted in increased half-life of the CYP2A6 compared to cells treated only with CHX. Collectively, the observations indicate that the CYP2A6 may function as human “Bilirubin Oxidase” where bilirubin is potentially a substrate and a regulator of the enzyme. -- Highlights: ► Human CYP2A6 interacts with bilirubin with a high affinity. ► Bilirubin docking to the CYP2A6 active site is more stable than biliverdin docking. ► Recombinant CYP2A6 microsomes metabolised bilirubin to biliverdin. ► Bilirubin increased the hepatic

  3. Hepatic bilirubin UDP-glucuronyltransferase in patients with sickle cell anemia.

    Science.gov (United States)

    Maddrey, W C; Cukier, J O; Maglalang, A C; Boitnott, J K; Odell, G B

    1978-02-01

    In sickle cell anemia the shortened survival of red blood cells presents the liver with an augmented load of bilirubin for hepatic clearance. To determine the effects of this excessive bilirubin load on the microsomal conjugating enzyme, hepatic bilirubin UDP-glucuronyltransferase, levels of this enzyme were measured in liver biopsies from patients with sickle cell anemia and several comparison groups. UDP-glucuronyltransferase activity in 14 patients with sickle cell anemia was 2-fold greater (P less than 0.005) than in 14 nonjaundiced comparison patients without liver disease. The elevated UDP-glucuronyltransferase activity in sickle cell anemia was similar to that found in 10 patients who chronically ingested drugs (barbiturates or estrogens) known to increase UDP-glucuronyltransferase activity. These observations suggest enhanced conjugation of bilirubin in patients with sickle cell anemia may result from substrate (bilirubin) induction of UDP-glycuronyltransferase. PMID:413760

  4. Bilirubin enhances neuronal excitability by increasing glutamatergic transmission in the rat lateral superior olive.

    Science.gov (United States)

    Li, Chun-Yan; Shi, Hai-Bo; Song, Ning-Ying; Yin, Shan-Kai

    2011-06-18

    Hyperbilirubinemia is one of the most common clinical phenomena observed in human newborns. To achieve effective therapeutic treatment, numerous studies have been done to determine the molecular mechanisms of bilirubin-induced neuronal excitotoxicity. However, there is no conclusive evidence for the involvement of glutamatergic synaptic transmission in bilirubin-induced neuronal hyperexcitation and excitotoxicity. In the present study, using gramicidin-perforated patch-clamp techniques, spontaneous excitatory postsynaptic currents (sEPSCs) were recorded from lateral superior olive (LSO) neurons isolated from postnatal 11-14-day-old (P11-14) rats. The application of 3 μM bilirubin increased the frequency, but not the amplitude, of sEPSCs. The action of bilirubin was tetrodotoxin (TTX)-insensitive, as bilirubin also increased the frequency, but not the amplitude, of mEPSCs. The amplitudes of GABA-activated (I(GABA)) and glutamate-activated (I(glu)) currents were not affected by bilirubin. Under current-clamp conditions, no spontaneous action potentials were observed in control solution. However, the application of 3 μM bilirubin for 4-6 min evoked a considerable rate of action-potential firing. The evoked firing was partially occluded by D,L-2-amino-5-phosphonovaleric acid (APV), an NMDA receptor antagonist, but completely inhibited by a combination of APV and 2,3-dihydroxy-6-nitro-7-sulfamoyl-benzo[f]quinoxaline-2,3-dione (NBQX), an AMPA receptor antagonist. These results indicate that bilirubin facilitates presynaptic glutamate release, enhances glutamatergic synaptic transmission by activating postsynaptic AMPA and NMDA receptors, and leads to neuronal hyperexcitation. This study provides a better understanding of the mechanism of bilirubin-induced excitotoxicity and determines for the first time that both AMPA and NMDA receptors are likely involved in the excitotoxicity produced by bilirubin. PMID:21440030

  5. Unilobar versus bilobar biliary drainage: effect on quality of life and bilirubin level reduction

    Directory of Open Access Journals (Sweden)

    Shivanand Gamanagatti

    2016-01-01

    Conclusion: Percutaneous biliary drainage provides good palliation of malignant obstructive jaundice. Partial-liver drainage achieved results as good as those after complete liver drainage with significant improvements in QOL and reduction of the bilirubin level.

  6. Neonatal bilirubin management as an implementation example of interdisciplinary continuum of care tools

    OpenAIRE

    Thornton, Sidney N.; Thompson, Bryce S.; Millar, Jean A.; Eggert, Larry D.; Wilcox, Adam B

    2007-01-01

    Management of newborn bilirubin spans the inpatient and outpatient continuum of care. Intermountain Healthcare has developed and implemented a web-based tool for managing bilirubin that follows newborn patients across care settings and providers with a consistent plan of care. The underlying model for the tool is derived from published guidelines. The model divides the time-sensitive data into risk zones and associates each zone with the appropriate order set for follow-up care. The tool inte...

  7. Studies on The Adsorption Capacity for Bilirubin of The Adsorbent Chitosan-β-Cyclodextrin

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    The adsorbent crosslinked chitosan-β-cyclodextrin (β-CD) was prepared by the reaction of glutaraldehyde with chitosan and β-cyclodextrin. This type of adsorbent has high adsorption capacity for unconjugated bilirubin. The adsorption capacity was related to the β-CD content of the adsorbent; phosphate buffer concentration; temperature; pH value; ionic strength and the adsorbent beads. The results indicated that the chitosan-β-CD was a good adsorbent for unconjugated bilirubin with high capacity.

  8. The origins and kinetics of bilirubin in dogs with hepatobiliary and haemolytic diseases.

    Science.gov (United States)

    Rothuizen, J; van den Brom, W E; Fevery, J

    1992-05-01

    In 35 dogs with spontaneous hepatobiliary liver disease the kinetics and the sources of bilirubin were quantified. The disorders were extrahepatic bile duct obstruction (n = 4), fulminant hepatitis (n = 2), (sub)acute hepatitis (n = 5), chronic active hepatitis (CAH) with cirrhosis (n = 6), hepatic lymphosarcoma (n = 5), centrizonal necrosis secondary to haemolytic anaemia (n = 6) and other (n = 2). The plasma disappearance of [3H]bilirubin was analyzed with a two-compartment model in all dogs. The ratio early labeled/late labeled bilirubin was determined by measuring the incorporation of [14C]glycine into erythrocyte haem and faecal stercobilin. By introducing this relation in the model analysis the bilirubin production rates from erythrocyte destruction (PE), ineffective erythropoiesis (PI) and hepatic haemoprotein (PL) could be quantified. Total bilirubin turnover was increased in both primary haemolytic disease and most cases of hepatobiliary disease. Erythrocyte survival was reduced in all cases but one. The bilirubin clearance was impaired to 30-50% of the normal value in most cases of hepatobiliary disease and also in primary haemolysis. In dogs with fulminant hepatitis, and cirrhosis with or without CAH, the clearance rates were reduced to values below 15% of normal. In these dogs both an impaired clearance and an increased production were important determinants of hyperbilirubinaemia. In other cases plasma bilirubin was primarily determined by increased production. These clearances and production rates were similar in haemolysis and in many cases of primary hepatobiliary disease. The hepatic haemoprotein turnover was quite variable in all subgroups, ranging from 1-74% of the total bilirubin turnover.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1506635

  9. Relationship of serum bilirubin concentration to kidney function and 24-hour urine protein in Korean adults

    OpenAIRE

    Jung Yeon Soon; Shin Ho Sik; Rim Hark

    2011-01-01

    Abstract Background The relationships among serum bilirubin concentration, kidney function and proteinuria have yet to be fully elucidated, nor have these relationships been investigated in Korean adults. Method We retrospectively reviewed the medical records of Korean adults who were evaluated at Kosin University Gospel Hospital (Busan, Republic of Korea) during a five-year period from January 2005 to December 2009. We evaluated the relationships among serum bilirubin concentration, estimate...

  10. "The effect of fluid supplementation on serum bilirubin level during phototerapy in term infants "

    Directory of Open Access Journals (Sweden)

    Torkaman M

    2007-04-01

    Full Text Available Background: Jaundice is a common and benign problem in neonatal period. Several therapeutic procedures for decreasing of serum bilirubin level has been recommended. phototherapy is most common them. Our goal Form this study is the evaluation of serum therapy effects in decreasing of serum bilirubin concentration in icteric infants that are treated with phototherapy. Methods: This is a prospective clinical trial in Najmeih Hospital in 2002. In this study 80 term icteric infants with bilirubin level greater than 17 mg/dl were randomized in two groups, both groups underwent phototherapy and in the case group intravenous fluid supplementation was added. There were no significant differences in the mean gestational age, birth weight, hemoglobin, and also in total serum bilirubin level at admission in the two groups. Results: There were no significant differences in the mean rate of of serum bilirubin level decline during first 24 and 48 hours of hospitalization and also the time of bilirubin decreasing to less than 15 mg/dl and the length of hospitalization in two groups. Conclution: Our study showed intravenous fluid supplementation could be limited to special cases of neonatal icter such as moderate to severe dehydration.

  11. The evaluation of the effect of different anesthetic techniques on neonatal bilirubin levels

    Directory of Open Access Journals (Sweden)

    Fatma Eskicioğlu

    2014-01-01

    Full Text Available Objective: The aim of the present study was to determine whether different anesthetic techniques applied for vaginal delivery and cesarean section affect neonatal bilirubin levels in the first 24 hours of life .Materials and Methods: A total of 511 neonates delivered by vaginal route or cesarean section were included in the study. The neonates were classified according to method of delivery and anesthetic agents as group A (cesarean section / general anesthesia with sevoflurane, group B (cesarean section / spinal anesthesia with bupivacaine hydrochlorur , group C (vaginal delivery with episiotomy / local anesthesia with prilocaine hydrochloride and group D (vaginal delivery/ no anesthesia . The levels of neonatal serum bilirubin in the groups were compared.Results: There was no difference between group A and group B when compared in terms of neonatal bilirubin levels (p = 0.98. Depending on the use of prilocaine hydrochloride as local anesthetic agent in the vaginal delivery, there was no significant difference between the groups C and D ,who had vaginal delivery, in terms of the neonatal bilirubin levels (p = 0.99. The serum levels of bilirubin in cesarean section groups were significantly higher than those of the vaginal delivery groups (p < 0.001.Conclusion: Prilocaine hydrochloride used for episiotomy is not effective on neonatal hyperbilirubinemia. However, sevoflurane and bupivacaine hydrochloride used in cesarean section seem to be increasing bilirubin levels.

  12. Stopped-flow studies of spectral changes in bilirubin-human serum albumin following an alkaline pH jump and following binding of bilirubin

    DEFF Research Database (Denmark)

    Honoré, B

    1987-01-01

    changes were analyzed according to a scheme of consecutive unimolecular reactions. Spectral monitoring of a pH jump from 11.3 to 11.8 reveals that the bilirubin-albumin complex changes its structure in several steps. The UV absorption spectra show that 3.8 tyrosine residues ionize in the first step, 2...

  13. Development of a System Model for Non-Invasive Quantification of Bilirubin in Jaundice Patients

    Science.gov (United States)

    Alla, Suresh K.

    Neonatal jaundice is a medical condition which occurs in newborns as a result of an imbalance between the production and elimination of bilirubin. Excess bilirubin in the blood stream diffuses into the surrounding tissue leading to a yellowing of the skin. An optical system integrated with a signal processing system is used as a platform to noninvasively quantify bilirubin concentration through the measurement of diffuse skin reflectance. Initial studies have lead to the generation of a clinical analytical model for neonatal jaundice which generates spectral reflectance data for jaundiced skin with varying levels of bilirubin concentration in the tissue. The spectral database built using the clinical analytical model is then used as a test database to validate the signal processing system in real time. This evaluation forms the basis for understanding the translation of this research to human trials. The clinical analytical model and signal processing system have been successful validated on three spectral databases. First spectral database is constructed using a porcine model as a surrogate for neonatal skin tissue. Samples of pig skin were soaked in bilirubin solutions of varying concentrations to simulate jaundice skin conditions. The resulting skins samples were analyzed with our skin reflectance systems producing bilirubin concentration values that show a high correlation (R2 = 0.94) to concentration of the bilirubin solution that each porcine tissue sample is soaked in. The second spectral database is the spectral measurements collected on human volunteers to quantify the different chromophores and other physical properties of the tissue such a Hematocrit, Hemoglobin etc. The third spectral database is the spectral data collected at different time periods from the moment a bruise is induced.

  14. Serum total bilirubin levels and coronary heart disease--Causal association or epiphenomenon?

    Science.gov (United States)

    Kunutsor, Setor K

    2015-12-01

    Observational epidemiological evidence supports a linear inverse and independent association between serum total bilirubin levels and coronary heart disease (CHD) risk, but whether this association is causal remains to be ascertained. A Mendelian randomization approach was employed to test whether serum total bilirubin is causally linked to CHD. The genetic variant rs6742078--well known to specifically modify levels of serum total bilirubin and accounting for up to 20% of the variance in circulating serum total bilirubin levels--was used as an instrumental variable. In pooled analysis of estimates reported from published genome-wide association studies, every copy of the T allele of rs6742078 was associated with 0.42 standard deviation (SD) higher levels of serum total bilirubin (95% confidence interval, 0.40 to 0.43). Based on combined data from the Coronary Artery Disease Genome wide Replication and Meta-analyses and the Coronary Artery Disease (C4D) Genetics Consortium involving a total of 36,763 CHD cases and 76,997 controls, the odds ratio for CHD per copy of the T allele was 1.01 (95% confidence interval, 0.99 to 1.04). The odds ratio of CHD for a 1 SD genetically elevated serum total bilirubin level was 1.03 (95% confidence interval, 0.98 to 1.09). The current findings casts doubt on a strong causal association of serum total bilirubin levels with CHD. The inverse associations demonstrated in observational studies may be driven by biases such as unmeasured confounding and/or reverse causation. However, further research in large-scale consortia is needed. PMID:26408227

  15. Predictors of the change in bilirubin levels over twelve weeks of treatment with atazanavir

    LENUS (Irish Health Repository)

    Cotter, Aoife G

    2013-05-16

    AbstractObjectiveTo determine the factors associated with change in bilirubin concentration 12 weeks after the initiation of an atazanavir (ATV)-containing antiretroviral regimen.MethodsWe performed a retrospective case note review of all patients prescribed ATV between January 2004 and October 2007 in a cohort of HIV infected subjects. Data collected included baseline demographics, hepatitis B and C serology, current antiretroviral therapy, baseline and week 12 routine bloods. The primary endpoint was the change in bilirubin concentration at 12 weeks after start of ATV. Multvariable linear regression was performed to assess the relationships between the change in bilirubin and variables of interest. Results: Eighty-three ATV-treated patients were included in the analysis of whom 46 (60.5%) were hepatitis C antibody positive. The median (interquartile range) change in bilirubin by week 12 was 16 (4, 22) umol\\/L; only 1 patient developed grade 4 hyperbilirubinaemia at week 12. After controlling for baseline bilirubin levels, HCV seropositivity and baseline ALP were associated with a smaller change in bilirubin over the 12 weeks with a trend towards lower increases in those receiving tenofovir. Sensitivity analyses reported similar associations with methadone use and injection drug use, when these variables replaced HCV sero-positivity in the model. Conclusion: Patients with hepatitis C co-infection experience smaller changes in bilirubin upon exposure to ATV. Although the underlying mechanism for this association remains unclear, these data support the safe use of this drug in this patient setting. Further research into the clinical predictors of ATV-related hyperbilirubinaemia is warranted.

  16. Bilirubin modulated cytokines, growth factors and angiogenesis to improve cutaneous wound healing process in diabetic rats.

    Science.gov (United States)

    Ram, Mahendra; Singh, Vishakha; Kumawat, Sanjay; Kant, Vinay; Tandan, Surendra Kumar; Kumar, Dinesh

    2016-01-01

    Bilirubin has shown cutaneous wound healing potential in some preliminary studies. Here we hypothesize that bilirubin facilitates wound healing in diabetic rats by modulating important healing factors/candidates and antioxidant parameters in a time-dependent manner. Diabetes was induced in male Wistar rats by streptozotocin. In all diabetic rats wounds were created under pentobarbitone anesthesia. All the rats were divided into two groups, of which one (control) was treated with ointment base and other with bilirubin ointment (0.3%). Wound closer measurement and tissue collection were done on days 3, 7, 14 and 19 post-wounding. The relative expressions of hypoxia inducible factor-1 alpha (HIF-1α), vascular endothelial growth factor (VEGF), stromal cell-derived factor-1 alpha (SDF-1α), transforming growth factor- beta1 (TGF-β1()), tumor necrosis factor-α (TNF-α) and interlukin-10 (IL-10) mRNA and proteins and the mRNA of interlukin-1 beta (IL-1β) and matrix metalloprteinase-9 (MMP-9) were determined in the wound tissues. CD-31 staining and collagen content were evaluated by immunohistochemistry and picrosirius red staining, respectively. Histopathological changes were assessed by H&E staining. The per cent wound closer was significantly higher from day 7 onwards in bilirubin-treated rats. HIF-1α, VEGF, SDF-1α, TGF-β1, IL-10 mRNA and protein levels were significantly higher on days 3, 7 and 14 in bilirubin-treated rats. The mRNA expression and protein level of TNF-α and the mRNA of IL-1β and MMP-9 were progressively and markedly reduced in bilirubin-treated rats. The collagen deposition and formation of blood vessels were greater in bilirubin-treated rats. Bilirubin markedly facilitated cutaneous wound healing in diabetic rats by modulating growth factors, cytokines, neovasculogenesis and collagen contents to the wound site. Topical application of bilirubin ointment might be of great use in cutaneous wound healing in diabetic patients. PMID:26679676

  17. Physiological antioxidative network of the bilirubin system in aging and age-related diseases

    Directory of Open Access Journals (Sweden)

    Sung Young eKim

    2012-03-01

    Full Text Available Oxidative stress is detrimental to life processes and is particularly responsible for aging and age-related diseases. Thus, most organisms are well equipped with a spectrum of biological defense mechanisms against oxidative stress. The major efficient antioxidative mechanism is the glutathione system, operating a redox cycling mechanism for glutathione utilization, which consists of glutathione and its peroxidase and reductase. However, this system is mainly effective for hydrophilic oxidants, while lipophilic oxidants require another scavenging system. Since many age-related pathological conditions are related to lipid peroxidation, especially in association with the aging process, the physiological role of the scavenging system for lipophilic oxidants should be considered. In this regard, the biliverdin to bilirubin conversion pathway, via biliverdin reductase, is suggested to be another major protective mechanism that scavenges lipophilic oxidants because of the lipophilic nature of bilirubin. The efficiency of this bilirubin system might be potentiated by operation of the intertwined bicyclic systems of the suggested redox metabolic cycle of biliverdin and bilirubin and the transcriptional control cycle of biliverdin reductase and heme oxygenase-1. In order to combat oxidative stress, both anti-oxidative systems, against hydrophilic and lipophilic oxidants, respectively, are required to work cooperatively. In this regard, the roles of the bilirubin system in aging and age-related diseases are reassessed in this review, and their interacting networks are evaluated.

  18. STUDY TO PREDICT NEWBORN AT RISK OF DEVELOPING NEONATAL HYPERBILIRUBINAEMIA BY MEASURING CORD BLOOD BILIRUBIN

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    Uthaya

    2016-04-01

    Full Text Available BACKGROUND NNH is a common problem in neonates during 1st week of life. Early discharge of healthy-term newborn is a common practice and NNH is a cause for readmission in most babies. Our aim was to predict the risk of NNH using cord bilirubin values. METHODS Around 150 intramurally delivered healthy term neonates were prospectively enrolled. Cord bilirubin and serum bilirubin at or after 72 hours were estimated. RESULTS AND DISCUSSION Using statistical analysis SPSS 19.0.2 program for windows, significant hyperbilirubinaemia was found in 14% of the neonates. Using cord bilirubin >2 mg/dL, significant hyperbilirubinaemia can be predicted with sensitivity of 90.4%, specificity of 75.1%, PPV of 37.2%, NPV of 97.9% and a p value of <0.05. CONCLUSION A high NPV in our study suggests that healthy term babies with cord bilirubin <2 mg/dL can be discharged early with assurance to parents.

  19. Pro-healing effects of bilirubin in open excision wound model in rats.

    Science.gov (United States)

    Ahanger, Azad A; Leo, Marie D; Gopal, Anu; Kant, Vinay; Tandan, Surendra K; Kumar, Dinesh

    2016-06-01

    Bilirubin, a by-product of heme degradation, has an important role in cellular protection. Therefore, we speculated that bilirubin could be of potential therapeutic value in wound healing. To validate the hypothesis, we used a full-thickness cutaneous wound model in rats. Bilirubin (30 mg/kg) was administered intraperitoneally every day for 9 days. The surface area of the wound was measured on days 0, 2, 4, 7 and 10 after the creation of the wound. The granulation tissue was collected on day 10 post-wounding for analysing various parameters of wound healing. Bilirubin treatment accelerated wound contraction and increased hydroxyproline and glucosamine contents. mRNA expression of pro-inflammatory factors such as intercellular cell adhesion molecule-1 (ICAM-1) and tumour necrosis factor-α (TNF-α) were down-regulated and that of anti-inflammatory cytokine interleukin-10 (IL-10) was up-regulated. The findings suggest that bilirubin could be a new agent for enhancing cutaneous wound healing. PMID:24947136

  20. Comparison of transcutaneous and total serum bilirubin measurement in Turkish newborns.

    Science.gov (United States)

    Şimşek, Fatih Mehmet; Narter, Fatma; Ergüven, Müferet

    2014-01-01

    Severe neonatal hyperbilirubinemia can be prevented by screening for neonatal jaundice. Transcutaneous bilirubin (TcB) measurement is a noninvasive method for screening neonates. The aim of this study was to examine the correlation between TcB measurement (using the JM-103 bilirubinometer) and total serum bilirubin (TSB) measurement. To our knowledge, this is the first study evaluating the usefulness of the JM-103 bilirubinometer in Turkish neonates. Two hundred and fifty healthy infants in our well-baby nurseries and follow-up clinic with a gestational age of ≥36 weeks who were ≤15 days old were enrolled in this study. TcB measurements were taken usinng the JM-103; almost simultaneously, TSB was checked using a spectrophotometric method. The mean±SD TSB level was 11.2±4.6 mg/dl (range, 0.9-27.0 mg/dl); 17.2% of cases had TSB>15 mg/dl. There was good correlation between transcutaneous bilirubin and total serum bilirubin measurements (Pearson's correlation coefficient 0.87 for TcB from the forehead, 0.88 for TcB from the sternum; pjaundiced infants that require a serum bilirubin check and may reduce the need for TSB measurements. PMID:26388591

  1. Potential Cardiovascular Risk Protection of Bilirubin in End-Stage Renal Disease Patients under Hemodialysis

    Directory of Open Access Journals (Sweden)

    Maria do Sameiro-Faria

    2014-01-01

    Full Text Available We evaluated the potential cardiovascular risk protection of bilirubin in hemodialysis (HD patients. An enlarged set of studies were evaluated in 191 HD patients, including hematological study, lipid profile, iron metabolism, nutritional, inflammatory markers, and dialysis adequacy. The TA duplication screening in the UDP-glucuronosyltransferase 1 A1 (UGT1A1 promoter region was also performed. The UGT1A1 genotype frequencies in HD patients were 49.2%, 42.4%, and 8.4% for 6/6, 6/7, and 7/7 genotypes, respectively. Although no difference was found in UGT1A1 genotype distribution between the three tertiles of bilirubin, significant differences were found with increasing bilirubin levels, namely, a decrease in platelet, leukocyte, and lymphocyte counts, transferrin, oxidized low-density lipoprotein (ox-LDL, ox-LDL/low-density lipoprotein cholesterol ratio, apolipoprotein (Apo A, Apo B, and interleukin-6 serum levels and a significant increased concentration of hemoglobin, hematocrit, erythrocyte count, iron, transferrin saturation, Apo A/Apo B ratio, adiponectin, and paraoxonase 1 serum levels. After adjustment for age these results remained significant. Our data suggest that higher bilirubin levels are associated with beneficial effects in HD patients, by improving lipid profile and reducing the inflammatory grade, which might contribute to increase in iron availability. These results suggest a potential cardiovascular risk protection of bilirubin in HD patients.

  2. Bilirubin Levels and Thrombus Burden in Patients With ST-Segment Elevation Myocardial Infarction.

    Science.gov (United States)

    Hamur, Hikmet; Duman, Hakan; Bakirci, Eftal Murat; Kucuksu, Zafer; Demirelli, Selami; Kalkan, Kamuran; Degirmenci, Husnu

    2016-07-01

    We investigated whether serum bilirubin level (a marker of heme oxygenase activity) is a predictor of thrombus burden in patients with acute myocardial infarction. Patients (n = 229; male 72.9%; mean age 63 ± 13.4 years) who were admitted with ST-segment elevation myocardial infarction (STEMI) were enrolled. Patients were divided into 2 groups. Group 1 was defined as low thrombus burden and group 2 was defined as high thrombus burden. Patients with high thrombus burden had higher total bilirubin levels (14.4 [4.3-22.9] vs 7.7 [2.4-20.3] µmol/L, P ≤ .001), (0.84 [0.25-1.34] vs 0.45 [0.14-1.19] mg/dL P ≤ .001) and direct bilirubin levels (3.1 [2.1-8.4] vs 1.7 [0.5-6.5] µmol/L, P ≤ .001), (0.18 [0.03-0.49] vs 0.10 [0.03-0.38] mg/dL, P ≤ .001). At multivariate analysis, total bilirubin (odds ratio: 1.05, 95% confidence interval: 1.03-1.08, P ≤ .001) was the independent predictor of high thrombus burden. In conclusion, total bilirubin level is independently associated with high thrombus burden in patients with STEMI. PMID:26339042

  3. Bilirubin Encephalopathy in a Domestic Shorthair Cat With Increased Osmotic Fragility and Cholangiohepatitis.

    Science.gov (United States)

    Contreras, E T; Giger, U; Malmberg, J L; Quimby, J M; Schaffer, P A

    2016-05-01

    A 7-month-old female domestic shorthair cat was diagnosed with chronic regenerative hemolytic anemia characterized by increased osmotic fragility of unknown etiology. At 13 months of age, the cat was evaluated for acute collapse. The cat was icteric with severe hyperbilirubinemia but no hematocrit changes. Severe obtundation and lateral recumbency progressed to tetraparesis and loss of proprioception in all 4 limbs, and a cerebellar or brainstem lesion was suspected. Postmortem examination revealed suppurative cholangiohepatitis and acute neuronal necrosis in the nuclei of the brainstem and cerebellum, consistent with bilirubin encephalopathy. This is the first known occurrence of cholangiohepatitis and bilirubin encephalopathy in an adult cat with chronic hemolytic anemia. Although rare, bilirubin encephalopathy should be considered a possible sequela to hyperbilirubinemia in adult patients. It remains unknown whether increased osmotic fragility was related to the cholangiohepatopathy. PMID:26354310

  4. Persistent high serum bilirubin level after percutaneous transhepatic biliary drainage: analysis of 32 cases

    Energy Technology Data Exchange (ETDEWEB)

    Choo, In Wook; Choi, Byung Ihn; Park, Jae Hyung; Han, Man Chung; Kim, Chu Wan [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1986-12-15

    The aim of percutaneous transhepatic biliary drainage (PTBD) is to decrease serum bilirubin level and promote liver function in patient with biliary tract disease, especially obstruction by malignant disease. But some patients showed persistent high serum bilirubin level or higher than pre-PTBD level. Percutaneous transhepatic biliary drainage was performed in 341 patients of obstructive jaundice for 5 years form July, 1981 to July, 1986 at department of radiology, Seoul National University Hospital. Follow up check of the serum bilirubin level was possible in 188 patients. Among them the authors analysed 32 patients who showed persistent high serum bilirubin level after PTBD. The results were as follows: 1. The male to female ratio was 3.4:1 and the age ranged from 33 to 75. 2. The causes of obstructive jaundice included 30 malignant diseases and 2 benign diseases. Malignant disease were 16 cases of bile duct carcinoma, 7 cases of pancreatic cancer and 7 cases of metastasis from stomach, colon and uterine cervix. Benign disease were 1 case of common hepatic duct stone and 1 case of intrahepatic duct stones. 3. The most common level of obstruction was trifurcation in 17 cases. 4. The most common indication of PTBD was palliative drainage of obstruction secondary to malignant tumor in 28 cases. 5. Change of serum bilirubin level ratio (post-PTBD level/pre-PTBD level) was 1.28, 1.22, 1.38, 1.51 in serial period of 1-3 days, 4-6 days, 1-2 week 2-3 week after PTBD. 6. Causes of persistent high serum bilirubin level after PTBD were 12 cases of partial drainage of intrahepatic bile, 13 cases of hepatic dysfunction including 9 cases of metastatic nodule, 2 cases of biliary cirrhosis, 2 cases of multiple liver abscess, and 7 cases of poor function of catheter including 4 cases of hemobilia, 1 case of multiple intrahepatic stones, pyobilia and intrahepatic Clonorchis sinensis.

  5. Persistent high serum bilirubin level after percutaneous transhepatic biliary drainage: analysis of 32 cases

    International Nuclear Information System (INIS)

    The aim of percutaneous transhepatic biliary drainage (PTBD) is to decrease serum bilirubin level and promote liver function in patient with biliary tract disease, especially obstruction by malignant disease. But some patients showed persistent high serum bilirubin level or higher than pre-PTBD level. Percutaneous transhepatic biliary drainage was performed in 341 patients of obstructive jaundice for 5 years form July, 1981 to July, 1986 at department of radiology, Seoul National University Hospital. Follow up check of the serum bilirubin level was possible in 188 patients. Among them the authors analysed 32 patients who showed persistent high serum bilirubin level after PTBD. The results were as follows: 1. The male to female ratio was 3.4:1 and the age ranged from 33 to 75. 2. The causes of obstructive jaundice included 30 malignant diseases and 2 benign diseases. Malignant disease were 16 cases of bile duct carcinoma, 7 cases of pancreatic cancer and 7 cases of metastasis from stomach, colon and uterine cervix. Benign disease were 1 case of common hepatic duct stone and 1 case of intrahepatic duct stones. 3. The most common level of obstruction was trifurcation in 17 cases. 4. The most common indication of PTBD was palliative drainage of obstruction secondary to malignant tumor in 28 cases. 5. Change of serum bilirubin level ratio (post-PTBD level/pre-PTBD level) was 1.28, 1.22, 1.38, 1.51 in serial period of 1-3 days, 4-6 days, 1-2 week 2-3 week after PTBD. 6. Causes of persistent high serum bilirubin level after PTBD were 12 cases of partial drainage of intrahepatic bile, 13 cases of hepatic dysfunction including 9 cases of metastatic nodule, 2 cases of biliary cirrhosis, 2 cases of multiple liver abscess, and 7 cases of poor function of catheter including 4 cases of hemobilia, 1 case of multiple intrahepatic stones, pyobilia and intrahepatic Clonorchis sinensis.

  6. Transport and metabolism at blood-brain interfaces and in neural cells: relevance to bilirubin-induced encephalopathy

    Directory of Open Access Journals (Sweden)

    Silvia eGazzin

    2012-05-01

    Full Text Available Bilirubin, the end-product of heme catabolism, circulates in non pathological plasma mostly as a protein-bound species. When bilirubin concentration builds up, the free fraction of the molecule increases. Unbound bilirubin then diffuses across blood-brain interfaces into the brain, where it accumulates and exerts neurotoxic effects. In this classical view of bilirubin neurotoxicity, blood-brain interfaces act merely as structural barriers impeding the penetration of the pigment-bound carrier protein, and neural cells are considered as passive targets of its toxicity. Yet, the role of blood-brain interfaces in the occurrence of bilirubin encephalopathy appears more complex than being simple barriers to the diffusion of bilirubin, and neural cells such as astrocytes and neurons can play an active role in controlling the balance between the neuroprotective and neurotoxic effects of bilirubin. This article reviews the emerging in vivo and in vitro data showing that transport and metabolic detoxification mechanisms at the blood-brain and blood-CSF barriers may modulate bilirubin flux across both cellular interfaces, and that these protective functions can be affected in chronic hyperbilirubinemia. Then the in vivo and in vitro arguments in favor of the physiological antioxidant function of intracerebral bilirubin are presented, as well as with the potential role of transporters such as ABCC-1 and metabolizing enzymes such as cytochromes P-450 in setting the cerebral cell- and structure-specific toxicity of bilirubin following hyperbilirubinemia. The relevance of these data to the pathophysiology of bilirubin-induced neurological diseases is discussed.

  7. Association between bilirubin and risk of Non-Alcoholic Fatty Liver Disease based on a prospective cohort study

    Science.gov (United States)

    Tian, Jianbo; Zhong, Rong; Liu, Cheng; Tang, Yuhan; Gong, Jing; Chang, Jiang; Lou, Jiao; Ke, Juntao; Li, Jiaoyuan; Zhang, Yi; Yang, Yang; Zhu, Ying; Gong, Yajie; Xu, Yanyan; Liu, Peiyi; Yu, Xiao; Xiao, Lin; Du, Min; Yang, Ling; Yuan, Jing; Wang, Youjie; Chen, Weihong; Wei, Sheng; Liang, Yuan; Zhang, Xiaomin; He, Meian; Wu, Tangchun; Yao, Ping; Miao, Xiaoping

    2016-01-01

    The study aimed to assess the association between total, direct, and indirect bilirubin and nonalcoholic fatty live disease (NAFLD) risk given its high prevalence and serious clinical prognosis. Among 27,009 subjects who participated in a healthy screening program from the Dongfeng-Tongji cohort study in 2008, 8189 eligible subjects (aged 35–86 years; males, 43.95%) were ultimately enrolled. The incidence rates of NAFLD in 2013 were compared with respect to baseline bilirubin levels among subjects free of NAFLD, and the effect sizes were estimated by logistic regression analysis. During 5 years follow-up, we observed 1956 cases of newly developed NAFLD with the overall incidence of 23.88%. Direct bilirubin was presented to inversely associate with NAFLD risk. Compared with quartile 1 of direct bilirubin, the multivariable-adjusted ORs (95% CIs) for NAFLD of quartile 2 to 4 were 1.104 (0.867–1.187), 0.843 (0.719–0.989), and 0.768 (0.652–0.905), respectively, P for trend 0.002). Similarly, inverse effects of direct bilirubin on NAFLD incidence were also observed when stratified by sex and BMI. However, no significant associations were found between total, and indirect bilirubin and NAFLD risk. Direct bilirubin reduced NAFLD risk independent of possible confounders among middle-aged and elderly Chinese population, probably based on the endogenous antioxidation of bilirubin. PMID:27484402

  8. Association between bilirubin and risk of Non-Alcoholic Fatty Liver Disease based on a prospective cohort study.

    Science.gov (United States)

    Tian, Jianbo; Zhong, Rong; Liu, Cheng; Tang, Yuhan; Gong, Jing; Chang, Jiang; Lou, Jiao; Ke, Juntao; Li, Jiaoyuan; Zhang, Yi; Yang, Yang; Zhu, Ying; Gong, Yajie; Xu, Yanyan; Liu, Peiyi; Yu, Xiao; Xiao, Lin; Du, Min; Yang, Ling; Yuan, Jing; Wang, Youjie; Chen, Weihong; Wei, Sheng; Liang, Yuan; Zhang, Xiaomin; He, Meian; Wu, Tangchun; Yao, Ping; Miao, Xiaoping

    2016-01-01

    The study aimed to assess the association between total, direct, and indirect bilirubin and nonalcoholic fatty live disease (NAFLD) risk given its high prevalence and serious clinical prognosis. Among 27,009 subjects who participated in a healthy screening program from the Dongfeng-Tongji cohort study in 2008, 8189 eligible subjects (aged 35-86 years; males, 43.95%) were ultimately enrolled. The incidence rates of NAFLD in 2013 were compared with respect to baseline bilirubin levels among subjects free of NAFLD, and the effect sizes were estimated by logistic regression analysis. During 5 years follow-up, we observed 1956 cases of newly developed NAFLD with the overall incidence of 23.88%. Direct bilirubin was presented to inversely associate with NAFLD risk. Compared with quartile 1 of direct bilirubin, the multivariable-adjusted ORs (95% CIs) for NAFLD of quartile 2 to 4 were 1.104 (0.867-1.187), 0.843 (0.719-0.989), and 0.768 (0.652-0.905), respectively, P for trend 0.002). Similarly, inverse effects of direct bilirubin on NAFLD incidence were also observed when stratified by sex and BMI. However, no significant associations were found between total, and indirect bilirubin and NAFLD risk. Direct bilirubin reduced NAFLD risk independent of possible confounders among middle-aged and elderly Chinese population, probably based on the endogenous antioxidation of bilirubin. PMID:27484402

  9. Evaluation of the Predictive Value of Umbilical Cord Serum Bilirubin Level for the Development of Subsequent Hyperbilirubinemia in Term and Late-Preterm Neonates

    Directory of Open Access Journals (Sweden)

    Fariba Hemmati

    2016-03-01

    Conclusion: Based on the findings, UCS bilirubin level could not predict subsequent hyperbilirubinemia. Therefore, the best predictive marker for neonatal jaundice is the assessment of clinical risk factors and predischarge bilirubin level.

  10. Identification of bilirubin reduction products formed by Clostridium perfringens isolated from human neonatal fecal flora

    Czech Academy of Sciences Publication Activity Database

    Vítek, L.; Majer, F.; Muchová, L.; Zelenka, J.; Jirásková, A.; Branny, Pavel; Malina, J.; Ubik, Karel

    2006-01-01

    Roč. 833, - (2006), s. 149-157. ISSN 1570-0232 R&D Projects: GA ČR GA310/02/1436 Institutional research plan: CEZ:AV0Z50200510; CEZ:AV0Z40550506 Keywords : bilirubin * bacterial reduction * intestinal microflora Subject RIV: EE - Microbiology, Virology Impact factor: 2.647, year: 2006

  11. Profile of Minocycline Neuroprotection in Bilirubin-Induced Auditory System Dysfunction

    OpenAIRE

    Rice, Ann C.; Chiou, Victoria; Zuckoff, Sarah B; Shapiro, Steven M

    2010-01-01

    Excessive hyperbilirubinemia in human neonates can cause permanent dysfunction of the auditory system, as assessed with brainstem auditory evoked potentials (BAEPs). Jaundiced Gunn rat pups (jjs) exhibit similar BAEP abnormalities as hyperbilirubinemic neonates. Sulfadimethoxine (sulfa) administration to jjs, which displaces bilirubin from serum albumin into tissues including brain, exacerbates acute toxicity. Minocycline administered prior to sulfa in jjs protects against BAEP abnormalities....

  12. 21 CFR 862.1110 - Bilirubin (total or direct) test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Bilirubin (total or direct) test system. 862.1110 Section 862.1110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry...

  13. Preparation and adsorption property of aminated cross linking microbeads of GMA/EGDMA for bilirubin

    Indian Academy of Sciences (India)

    Zhiping Chen; Baojiao Gao; Xiaofeng Yang

    2009-11-01

    Cross linking microbeads with a controllable diameter were synthesized by suspension copolymerization of the monomer glycidyl methacrylate (GMA) and the cross linking agent ethylene glycol dimethylacrylate (EGDMA). By the ring-opening reaction of the epoxy groups, the microbeads GMA/EGDMA were modified with different aminating agents and resulting in the aminated microbeads. The morphology of the microbeads was characterized by SEM. The adsorption property of aminated microbeads for bilirubin was investigated, and the effects of various factors, such as the chemical structures of the aminating agents, pH values of the medium and the presence of bovine serum albumin in the adsorption medium, on the adsorption property were examined. The experimental results show that the aminated microbeads have strong adsorption ability for bilirubin, and the isotherm adsorption behaviour is fitted to Freundlich equation satisfactorily. The adsorption ability of the aminated microbeads modified with hexanediamine is stronger than that of others, and the longer the molecule of multi-ethylene multiamine, the weaker the adsorption ability for bilirubin. The pH value of the medium affects the adsorption ability greatly, as pH = 6, the adsorption ability is strongest. In the presence of BSA, the microbeads still have a higher adsorption capacity towards bilirubin.

  14. Surface modifying of microporous PTFE capillary for bilirubin removing from human plasma and its blood compatibility

    Energy Technology Data Exchange (ETDEWEB)

    Jin Gu [Department of Chemistry, University of Science and Technology of China, HeFei, 230026 (China)], E-mail: Gjin@ustc.edu.cn; Yao Qizhi; Zhang Shanzi [Department of Chemistry, University of Science and Technology of China, HeFei, 230026 (China); Zhang Lei [Department of Chemistry, University of Science and Technology of China, HeFei, 230026 (China); AnHui Entry Exit Inspection and Quarantine Bureau, HeFei, 230001 (China)

    2008-12-01

    In this study, human serum albumin (HSA) was covalently immobilized onto the inner surface of microporous poly(tetrafluoroethylene) (MPTFE) capillaries for direct bilirubin removal from human plasma. To obtain active binding sites for HSA, the MPTFE capillaries were chemically functionalized by using a coating of poly(vinyl alcohol) (PVA)-glycidyl methacrylate (GMA) copolymers. Characterization of grafted MPTFE capillaries was verified by XPS, Fourier transform infrared spectroscopy (FT-IR), scanning electronic microscopy (SEM). Non-specific adsorption on the PVA-GMA coated capillary remains low (< 0.38 mg bilirubin/g), and higher affinity adsorption capacity, of up to 73.6 mg bilirubin/g polymer was obtained after HSA is immobilized. Blood compatibility of the grafted MPTFE capillary was evaluated by SEM and platelet rich plasma (PRP) contacting experiments. The experimental data on blood compatibility indicated that PVA-coated and PVA-GMA-HSA coated PTFE capillary showed a sharp suppress on platelets adhesion. The proposed method has the potential of serving in bilirubin removal in clinical application.

  15. Prognostic value of serum total bilirubin in patients with acute coronary syndrome after percutaneous coronary intervention

    Institute of Scientific and Technical Information of China (English)

    孙同文

    2013-01-01

    Objective To investigate the predictive value of serum total bilirubin (STB) level in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI) .Methods A total of 1273 consecutive patients treated with PCI in cardiology department,First Affiliated Hospital of Zhengzhou University from June

  16. A novel predictor of infarct-related artery patency before percutaneous intervention and in-hospital outcomes for ST-segment elevation myocardial infarction patients: serum bilirubin level

    OpenAIRE

    Acet, Halit; Ertş, Faruk; Akıl, Mehmet Ata; Polat, Nihat; Aydın, Mesut; Akyüz, Abdurrahman; Ayçiçek, Hilal; Alan, Sait

    2014-01-01

    Introduction Previous studies have reported a relationship between serum bilirubin levels and coronary artery disease (CAD). However, data are rare up to now regarding the relation of bilirubin levels with infarct-related artery (IRA) patency in the setting of ST-segment elevation myocardial infarction (STEMI). Moreover, previous studies reported that increased bilirubin was related to impaired post-intervention coronary flow. To our knowledge, the association between serum total bilirubin (T...

  17. [Quantifying intestino-esophageal reflux with a fiberoptic bilirubin detection probe].

    Science.gov (United States)

    Stein, H J; Kraemer, S J; Feussner, H; Siewert, J R

    1994-05-01

    Currently available methods to assess reflux of duodenal contents into the esophagus are cumbersome, unphysiologic, and inaccurate. The role of intestino-esophageal reflux has therefore been controversial. We assessed intestino-esophageal reflux using a new system which allows prolonged intraesophageal measurement of bilirubin, the major pigment of bile. Measurements were made with a newly developed fiber-optic sensor electrode connected to a portable data processing unit (BILITEC 2000, Synectics Medical Inc., Sweden). Light absorption was measured at the absorption peak of bilirubin and a reference point. Studies were performed in 9 subjects without esophagitis, 9 subjects with esophagitis and primary reflux disease and 7 subjects with erosive esophagitis after a total or subtotal gastrectomy. The fiberoptic electrode was placed 5 cm above the lower esophageal sphincter. In vitro studies showed linear correlations between absorbance measurements obtained with the BILITEC-unit and known bilirubin and bile acid concentrations, respectively (p < 0.01). Compared to both other groups, light absorption was markedly increased in the subjects who had esophagitis after a total or subtotal gastrectomy (p < 0.05) indicating severe biliary reflux. An increase in bilirubin absorption occurred particularly during the post-prandial and supine periodes (p < 0.01). A Roux-en-Y biliary diversion procedure completely abolished bile reflux in 2 of these patients. These data indicate that ambulatory 24-hour fiberoptic measurement of bilirubin in the esophagus is feasible and allows quantitation of intestino-esophageal reflux. Intestino-esophageal reflux occurs particularly during the postprandial period and the early morning hours in patients who had a previous subtotal or total gastrectomy. PMID:8073796

  18. Assessment of duodenogastric reflux by combined continuous intragastric pH and bilirubin monitoring

    Institute of Scientific and Technical Information of China (English)

    Fei Dai; Jun Gong; Ru Zhang; Jin-Yan Luo; You-Ling Zhu; Xue-Qin Wang

    2002-01-01

    AIM: To assess the diagnostic value of a combination of continuous intragastric pH and bilirubin monitoring in the detection of duodenogastric reflux (DGR), and the effects of diet on the bilirubin absorbance.METHODS: 30 healthy volunteers were divided into twogroups: standard diet group (Group 1) 18 cases, free diet group (Group 2) 12 cases. Each subjects were subjected to simultaneous 24 hour intragastric pH and spectrophotometric bilirubin concentration monitoring (Bilitec 2000).RESULTS: There was no difference of preprandial phasebilirubin absorbance between two groups. The absorbanceof postprandial phase was significantly increased in group 2than group 1. There was no difference between preprandialphase and postprandial phase absorbance in group 1.Postprandial phase absorbance was significantly higher ingroup 2. In a comparison of bile reflux with intragastric pHduring night time, there were 4 types of reflux:Simultaneous increase in absorbance and pH in only 19.6%, increase in bilirubin with unchanged pH 33. 3 %, pHincrease with unchanged absorbance 36. 3 %, and bothunchanged in 10. 8 %. Linear regression analysis showed nocorrelation between percertage total time of pH < 4 aridpercentage total time of absortance > 0. 14, r=0.068, P<0.05.CONCLUSION: Because of the dietary effect, highabsorbance fluids or foods should be avoided in detection.Intrsgastric pH and bilirubin monitoring separately predictthe presence of duodenal (and/or pancreatic) reflux and bilereflux. They can not substitute for each other. The detectionof DGR is improved if the two parameters are combinedsimultanoously.

  19. Inducible bilirubin oxidase: A novel function for the mouse cytochrome P450 2A5

    International Nuclear Information System (INIS)

    We have previously shown that bilirubin (BR), a breakdown product of haem, is a strong inhibitor and a high affinity substrate of the mouse cytochrome P450 2A5 (CYP2A5). The antioxidant BR, which is cytotoxic at high concentrations, is potentially useful in cellular protection against oxygen radicals if its intracellular levels can be strictly controlled. The mechanisms that regulate cellular BR levels are still obscure. In this paper we provide preliminary evidence for a novel function of CYP2A5 as hepatic “BR oxidase”. A high-performance liquid chromatography/electrospray ionisation mass spectrometry screening showed that recombinant yeast microsomes expressing the CYP2A5 oxidise BR to biliverdin, as the main metabolite, and to three other smaller products with m/z values of 301, 315 and 333. The metabolic profile is significantly different from that of chemical oxidation of BR. In chemical oxidation the smaller products were the main metabolites. This suggests that the enzymatic reaction is selective, towards biliverdin production. Bilirubin treatment of primary hepatocytes increased the CYP2A5 protein and activity levels with no effect on the corresponding mRNA. Co-treatment with cycloheximide (CHX), a protein synthesis inhibitor, resulted in increased half-life of the CYP2A5 compared to cells treated only with CHX. Collectively, the observations suggest that the CYP2A5 is potentially an inducible “BR oxidase” where BR may accelerate its own metabolism through stabilization of the CYP2A5 protein. It is possible that this metabolic pathway is potentially part of the machinery controlling intracellular BR levels in transient oxidative stress situations, in which high amounts of BR are produced. -- Highlights: ► CYP2A5 metabolizes bilirubin to biliverdin and dipyrroles. ► Bilirubin increased the hepatic CYP2A5 protein and activity levels. ► Bilirubin does not change the hepatic CYP2A5 mRNA levels. ► Co-treatment with a protein synthesis inhibitor

  20. Interaction of bilirubin and indocyanine green with the binding and conjugation of sulfobromophthalein by rat liver cytosol proteins.

    Science.gov (United States)

    Davis, D R; Yeary, R A

    1980-02-01

    The interaction of bilirubin and indocyanine green with sulfobromophthalein (BSP) binding and conjugation by rat liver cytosol proteins was studied. BSP bound to cytosol proteins X, ligandin and Z and the BSP-glutathione conjugate were isolated by sephadex gel chromatography. Neither bilirubin nor indocyanine green affected the binding of BSP to ligandin and Z protein. However, indocyanine green did significantly reduce BSP conjugation in both in vitro and in vivo experiments. Diethyl maleate significantly reduced liver glutathione levels and BSP conjugation. It is suggested that indocyanine gree competitively binds at the ligandin catalytic site whereas the primary binding site for bilirubin is probably a noncatalytic site. PMID:7367753

  1. Fully Oriented Bilirubin Oxidase on Porphyrin-Functionalized Carbon Nanotube Electrodes for Electrocatalytic Oxygen Reduction.

    Science.gov (United States)

    Lalaoui, Noémie; Le Goff, Alan; Holzinger, Michael; Cosnier, Serge

    2015-11-16

    The efficient immobilization and orientation of bilirubin oxidase from Myrothecium verrucaria on multi-walled carbon nanotube electrodes by using π-stacked porphyrins as a direct electron-transfer promoter is reported. By comparing the use of different types of porphyrin, the rational effect of the porphyrin structure on both the immobilization and orientation of the enzyme is demonstrated. The best performances were obtained for protoporphyrin IX, which is the natural precursor of bilirubin. These electrodes exhibit full orientation of the enzyme, as confirmed by the observable non-catalytic redox system corresponding to the T1 copper center associated with pure Nernstian electrocatalytic behavior with high catalytic currents of almost 5 mA cm(-2) at neutral pH. PMID:26449635

  2. THE ROLE OF DIETARY PROPOLIS ON ALBUMINS AND BILIRUBIN CONTENT IN CHICKENS

    Directory of Open Access Journals (Sweden)

    Marcela Capcarová

    2013-12-01

    Full Text Available The present study was designed to determinate the effect of propolis as a feed additive on the serum bilirubin and albumin content of female and male chickens. Broiler chickens hybrid Hubbard JV (n=500 were divided into five groups in each gender (control – C and four experimental groups E1 – E4. Experimental chickens received a propolis extract in feed mixture in various doses (E1 – 150 mg/kg; E2 – 450 mg/kg; E3 – 600 mg/kg; E4 – 800 mg/kg. The group that received feed without propolis addition served as the control. Contents of albumin and bilirubin were determined with spectrophotometer. Supplementation of the diet with propolis in the dose of 600 mg/kg significantly (P<0.05 increased albumin content in male chickens. Propolis addition to diets may be a source for antioxidant capacity in human and animals.

  3. THE ASSOCIATION BETWEEN G6PD DEFICIENCY AND TOTAL SERUM BILIRUBIN LEVEL IN ICTERIC NEONATES

    OpenAIRE

    S. Behjati-Ardakani; A. Nikkhah M. Sedaghat

    2007-01-01

    "nGlucose-6-phosphate dehydrogenase (G6PD) deficiency is the most important disease of the hexose monophosphate pathway. Deficiency of this enzym can lead to hemolysis of red blood cells. Our aim was to study the prevalence of G6PD deficiency in relation to neonatal jaundice. We studied 456 clinically icteric neonates Laboratory investigations included determination of direct and indirect serum bilirubin concentrations, blood group typing, direct coomb's test, hemoglobin, blood smea...

  4. Bilirubin oxidase based enzymatic air-breathing cathode: Operation under pristine and contaminated conditions

    OpenAIRE

    Santoro, Carlo; Babanova, Sofia; Erable, Benjamin; Schuler, Andrew; Atanassov, Plamen

    2016-01-01

    The performance of bilirubin oxidase (BOx) based air breathing cathode was constantly monitored over 45 days. The effect of electrolyte composition on the cathode oxygen reduction reaction (ORR) output was investigated. Particularly, deactivation of the electrocatalytic activity of the enzyme in phosphate buffer saline (PBS) solution and in activated sludge (AS) was evaluated. The greatest drop in current density was observed during the first 3 days of constant operation with a decrease of ~6...

  5. Effect of Intravenous Fluid Supplementation on Serum Bilirubin Level in Jaundiced Healthy Neonates during Conventional Phototherapy

    OpenAIRE

    R.Iranpour; R Nohekhan; I Haghshenas

    2004-01-01

    Background: Adequate hydration and good urine output improve the efficacy of phototherapy. The aim of this study was to evaluate the effect of intravenous fluid supplementation on decrease of serum bilirubin levels in jaundiced healthy term infants during conventional phototherapy. Methods: Sixty healthy breast-fed neonates with non-hemolytic hyperbilirubinemia were assigned randomly to receive either breast milk exclusively (non-supplemented group; n=30) or intravenous fluid in addition to b...

  6. The Effect of Clofibrate on Decreasing Serum Bilirubin in Healthy Term Neonates under Home Phototherapy

    OpenAIRE

    Simin Sharafi; Zhaleh Mortazavi; Reza Sharafi; Reza Moradi Parashkouh

    2010-01-01

    Objective: this study was designed to determine the effect of clofibrate on neonatal uncomplicated jaundice treated with home phototherapy. Methods:This clinical trial study was performed on 60 newborns with jaundice that received home phototherapy. Inclusion criteria were body weight between 2500 to 4000 gr, breastfed, total serum bilirubin (TSB) between 14 to 20 mg/dl, aged over 72 hours. The neonates were randomly divided into two groups. All received home phototherapy. Group i received a ...

  7. Bilirubin influence on oxidative lung damage and surfactant surface tension properties

    OpenAIRE

    Dani C.; Martelli E.; Tronchin M.; Buonocore G.; Longini M.; Di Filippo A; Giossi M.; Rubaltelli F.F.

    2004-01-01

    To study the hypothesis that hyperbilirubinemia might reduce in vivo oxidative lung damage while also diminishing lung surfactant surface tension properties during acute lung injury, we performed a randomized study in a rabbit model of acute lung injury. Twenty rabbits were randomized to receive bilirubin or saline intravenously. Acute lung injury was induced by lung lavages with saline. Lung tissue oxidation was evaluated by measuring total hydroperoxide (TH), advanced oxidation protein prod...

  8. Bilirubin and heme as growth inhibitors of chicken embryos in ovo.

    Science.gov (United States)

    Vassilopoulou-Sellin, R; Foster, P; Oyedeji, C O

    1990-06-01

    The increased morbidity during pregnancies complicated by hematologic or liver disease has generally been attributed to the metabolic abnormalities of the illness itself. Because tetrapyrrole concentrations are elevated in these conditions, we introduced bilirubin or heme (prepared as 10 mM solutions) into the air sac of fertilized chicken eggs to study their effect on the growth of normal chicken embryos. In 9-d eggs, the injection of 0.06 mL heme resulted in significant embryo growth inhibition as indicated by overall wt (91 +/- 3% versus control), tibia length (84 +/- 2%), tibia wt (81 +/- 3%), femur length (88 +/- 1%), and femur wt (78 +/- 3%); doses greater than 0.10 mL resulted in substantial fetal losses. The injection of 0.06 mL bilirubin into the same-age eggs also resulted in less than normal tibia length (87 +/- 2% versus control), tibia wt (75 +/- 4%), femur length (91 +/- 2%), and femur wt (81 +/- 3%); larger doses resulted in more pronounced growth inhibition, but fetal losses were less common than with heme. Older chick embryos (12-d) appeared more resistant to the effects of bilirubin: 0.15 mL bilirubin inhibited only tibia and femur wt; larger doses were required to significantly suppress the other growth parameters. The same-age chicken embryos, however, remained exquisitely sensitive to heme; 0.05 mL resulted in less than normal whole embryo wt (88 +/- 2% versus control), tibia length (80 +/- 1%), tibia wt (76 +/- 1%), femur length (78 +/- 1%), and femur wt (77 +/- 1%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2356106

  9. Low solubility of unconjugated bilirubin in dimethylsulfoxide – water systems: implications for pKa determinations

    Directory of Open Access Journals (Sweden)

    Ostrow J Donald

    2002-06-01

    Full Text Available Abstract Background Aqueous pKa values of unconjugated bilirubin are important determinants of its solubility and transport. Published pKa data on an analog, mesobilirubin-XIIIα, studied by 13C-NMR in buffered solutions containing 27 and 64 vol% (C2H32SO because of low aqueous solubility of mesobilirubin, were extrapolated to obtain pKa values in water of 4.2 and 4.9. Previous chloroform-water partition data on bilirubin diacid led to higher estimates of its pKa, 8.12 and 8.44, and its aqueous solubility. A thermodynamic analysis, using this solubility and a published solubility in DMSO, suggested that the systems used to measure 13C-NMR shifts were highly supersaturated. This expectation was assessed by measuring the residual concentrations of bilirubin in the supernatants of comparable DMSO-buffer systems, after mild centrifugation to remove microprecipitates. Results Extensive sedimentation was observed from numerous systems, many of which appeared optically clear. The very low supernatant concentrations at the lowest pH values (4.1-5.9 were compatible with the above thermodynamic analysis. Extensive sedimentation and low supernatant concentrations occurred also at pH as high as 7.2. Conclusions The present study strongly supports the validity of the aqueous solubility of bilirubin diacid derived from partition data, and, therefore, the corresponding high pKa values. Many of the mesobilirubin systems in the 13C-NMR studies were probably supersaturated, contained microsuspensions, and were not true solutions. This, and previously documented errors in pH determinations that caused serious errors in pKa values of the many soluble reference acids and mesobilirubin, raise doubts regarding the low pKa estimates for mesobilirubin from the 13C-NMR studies.

  10. Unilobar Versus Bilobar Biliary Drainage: Effect on Quality of Life and Bilirubin Level Reduction

    OpenAIRE

    Shivanand Gamanagatti; Tejbir Singh; Raju Sharma; Srivastava, Deep N; Nihar Ranjan Dash; Pramod Kumar Garg

    2016-01-01

    Background: Percutaneous biliary drainage is an accepted palliative treatment for malignant biliary obstruction. Purpose: To assess the effect on quality of life (QOL) and bilirubin level reduction in patients with inoperable malignant biliary obstruction treated by unilobar or bilobar percutaneous transhepatic biliary drainage (PTBD). Materials and Methods: Over a period of 2 years, 49 patients (age range, 22–75 years) of inoperable malignant biliary obstruction were treated by PTBD. T...

  11. Effect of Intravenous Fluid Supplementation on Serum Bilirubin Level in Jaundiced Healthy Neonates during Conventional Phototherapy

    Directory of Open Access Journals (Sweden)

    R Iranpour

    2004-08-01

    Full Text Available Background: Adequate hydration and good urine output improve the efficacy of phototherapy. The aim of this study was to evaluate the effect of intravenous fluid supplementation on decrease of serum bilirubin levels in jaundiced healthy term infants during conventional phototherapy. Methods: Sixty healthy breast-fed neonates with non-hemolytic hyperbilirubinemia were assigned randomly to receive either breast milk exclusively (non-supplemented group; n=30 or intravenous fluid in addition to breast milk (supplemented group; n=30 during conventional phototherapy. Results: The mean total serum bilirubin (TSB levels at the time of enrollment and within 84 hours after phototherapy were not statistically different between two groups. Similarly, the mean rate of decrease in TSB levels during the first 12 h of phototherapy were 0.13±0.06 and 0.10 ± 0.1 mg/dL/h in supplemented and non supplemented groups , respectively (P=0.13. Duration of phototherapy required in supplemented and non-supplemented groups was 58 ± 13.02 and 63.20 ± 13.71 hours, respectively (P=0.13. Conclusion: These data show that administration of extra intravenous fluid in jaundiced healthy, term, breastfed neonates have no beneficial effect on the rate of serum bilirubin reduction during conventional phototherapy. Keywords: Hyperbilirubinemia, Phototherapy, Neonates, Fluid Supplementation, Dehydration.

  12. Ternary complexes of albumin-Mn(II)-bilirubin and Electron Spin Resonance studies of gallstones

    CERN Document Server

    Chikvaidze, E N; Kirikashvili, I N; Mamniashvili, G I

    2009-01-01

    The stability of albumin-bilirubin complex was investigated depending on pH of solution. It was shown that the stability of complex increases in presence of Mn(II) ions. It was also investigated the paramagnetic composition of gallstones by the electron spin resonance (ESR) method. It turned out that all investigated gallstones contain a free bilirubin radical-the stable product of its radical oxidation. Accordingly the paramagnetic composition gallstones could be divided on three main types: cholesterol, brown pigment and black pigment stones. ESR spectra of cholesterol stones is singlet with g=2.003 and splitting between components 1.0 mT. At the same time the brown gallstones, besides aforementioned signal contain the ESR spectrum which is characteristics for Mn(II) ion complexes with inorganic compounds and, finally, in the black pigment stones it was found out Fe(III) and Cu(II) complexes with organic compounds and a singlet of bilirubin free radical. It is supposed that crystallization centers of gallst...

  13. Fluorescence Excitation Spectrum of Bilirubin in Blood: A Model for the Action Spectrum for Phototherapy of Neonatal Jaundice†

    OpenAIRE

    Lamola, Angelo A.; Russo, Marie

    2013-01-01

    A recent report (Lamola et al. 2013 Pediatric Research, 74, 54–60) presents a semi-empirical model for facile calculation of an action spectrum for bilirubin photochemistry in vivo using the most current knowledge of the optics of neonatal skin. The calculations indicate that competition for phototherapy light by hemoglobin in the skin is the predominant factor that defines the spectrum of light absorbed by bilirubin. If the latter is correct, a valid physical analog of the calculated spectru...

  14. Serum bilirubin value predicts hospital admission in carbon monoxide-poisoned patients. Active player or simple bystander?

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    Gianfranco Cervellin

    2015-09-01

    Full Text Available OBJECTIVES: Although carbon monoxide poisoning is a major medical emergency, the armamentarium of recognized prognostic biomarkers displays unsatisfactory diagnostic performance for predicting cumulative endpoints. METHODS: We performed a retrospective and observational study to identify all patients admitted for carbon monoxide poisoning during a 2-year period. Complete demographical and clinical information, along with the laboratory data regarding arterial carboxyhemoglobin, hemoglobin, blood lactate and total serum bilirubin, was retrieved. RESULTS: The study population consisted of 38 poisoned patients (23 females and 15 males; mean age 39±21 years. Compared with discharged subjects, hospitalized patients displayed significantly higher values for blood lactate and total serum bilirubin, whereas arterial carboxyhemoglobin and hemoglobin did not differ. In a univariate analysis, hospitalization was significantly associated with blood lactate and total serum bilirubin, but not with age, sex, hemoglobin or carboxyhemoglobin. The diagnostic performance obtained after combining the blood lactate and total serum bilirubin results (area under the curve, 0.90; 95% CI, 0.81-0.99; p<0.001 was better than that obtained for either parameter alone. CONCLUSION: Although it remains unclear whether total serum bilirubin acts as an active player or a bystander, we conclude that the systematic assessment of bilirubin may, alongside lactate levels, provide useful information for clinical decision making regarding carbon monoxide poisoning.

  15. Utility of bilirubins and bile acids as endogenous biomarkers for the inhibition of hepatic transporters.

    Science.gov (United States)

    Watanabe, Tomoko; Miyake, Manami; Shimizu, Toshinobu; Kamezawa, Miho; Masutomi, Naoya; Shimura, Takesada; Ohashi, Rikiya

    2015-04-01

    It is useful to identify endogenous substrates for the evaluation of drug-drug interactions via transporters. In this study, we investigated the utility of bilirubins, substrates of OATPs and MRP2, and bile acids and substrates of NTCP and BSEP, as biomarkers for the inhibition of transporters. In rats administered 20 and 80 mg/kg rifampicin, the plasma levels of bilirubin glucuronides were elevated, gradually decreased, and almost returned to the baseline level at 24 hours after administration without an elevation of alanine aminotransferase (ALT) and aspartate aminotransferase (AST). This result indicates the transient inhibition of rOatps and/or rMrp2. Although the correlation between free plasma concentrations and IC50 values of rOatps depended on the substrates used in the in vitro studies, the inhibition of rOatps by rifampicin was confirmed in the in vivo study using valsartan as a substrate of rOatps. In rats administered 10 and 30 mg/kg cyclosporin A, the plasma levels of bile acids were elevated and persisted for up to 24 hours after administration without an elevation of ALT and AST. This result indicates the continuous inhibition of rNtcp and/or rBsep, although there were differences between the free plasma or liver concentrations and IC50 values of rNtcp or rBsep, respectively. This study suggests that the monitoring of bilirubins and bile acids in plasma is useful in evaluating the inhibitory potential of their corresponding transporters. PMID:25581390

  16. Inverse association between serum bilirubin levels and arterial stiffness in Korean women with type 2 diabetes.

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    Eun Sook Kim

    Full Text Available BACKGROUND: Considerable evidence suggests that bilirubin is a potent physiologic antioxidant that may provide important protection against cardiovascular disease (CVD and inflammation. We investigated the relationship between serum total bilirubin (TB levels and arterial stiffness, measured by the brachial-ankle pulse wave velocity (baPWV, in patients with type 2 diabetes. METHODS: We conducted a cross-sectional analysis of 1,711 subjects with type 2 diabetes (807 men and 904 women; mean age, 57.1 years. The subjects were stratified based on gender-specific tertiles of TB values, and a high baPWV was defined as greater than 1,745 cm/s ( >75th percentile. RESULTS: The serum TB concentration was negatively correlated with the duration of diabetes, HbA1c, the 10-year Framingham risk score, and baPWV and was positively correlated with high-density lipoprotein cholesterol and the eGFR in both genders. Inverse association between TB categories and unadjusted prevalence of high PWV was only observed in women. After adjusting for confounding factors, the TB levels were inversely associated with a greater risk of a high baPWV, both as a continuous variable [a 1-SD difference; odds ratio (OR, 0.70; 95% confidence interval (CI, 0.54-0.90; P = 0.005] and when categorized in tertiles (the highest vs. the lowest tertile; OR, 0.49; 95% CI, 0.28-0.85; P = 0.011 in women but not in men. The relationship remained significant even after adjusting for retinopathy and nephropathy. CONCLUSIONS: Low TB levels were significantly associated with arterial stiffness in Korean women with type 2 diabetes. Our data suggested that bilirubin may protect against macrovascular disease in diabetic women.

  17. Potential Cardiovascular Risk Protection of Bilirubin in End-Stage Renal Disease Patients under Hemodialysis

    OpenAIRE

    Maria do Sameiro-Faria; Michaela Kohlova; Sandra Ribeiro; Petronila Rocha-Pereira; Laetitia Teixeira; Henrique Nascimento; Flávio Reis; Vasco Miranda; Elsa Bronze-da-Rocha; Alexandre Quintanilha; Luís Belo; Elísio Costa; Alice Santos-Silva

    2014-01-01

    We evaluated the potential cardiovascular risk protection of bilirubin in hemodialysis (HD) patients. An enlarged set of studies were evaluated in 191 HD patients, including hematological study, lipid profile, iron metabolism, nutritional, inflammatory markers, and dialysis adequacy. The TA duplication screening in the UDP-glucuronosyltransferase 1 A1 (UGT1A1) promoter region was also performed. The UGT1A1 genotype frequencies in HD patients were 49.2%, 42.4%, and 8.4% for 6/6, 6/7, and 7/7 g...

  18. Total bilirubin in nasogastric aspirates: A potential new indicator of postoperative gastrointestinal recovery

    OpenAIRE

    Go Miyano; Hiroki Nakamura; Toshiaki Takahashi; Lane, Geoffrey J.; Atsuyuki Yamataka

    2013-01-01

    Background: The aim of our study was to investigate if total bilirubin (T-bil), amylase (Amy), and sodium (Na) in nasogastric (NG) aspirates can reflect gastrointestinal motility reliably. Materials and Methods: NG aspirates from all laparotomies lasting more than 150 min in children less than 12 months old were studied for 3 months. Color of aspirates and intensity of bowel sounds were graded every 3 h by nursing staff and aspirate samples for measuring T-bil, Amy, and Na were collected inde...

  19. Mitochondrial targeting of bilirubin regulatory enzymes: An adaptive response to oxidative stress

    Energy Technology Data Exchange (ETDEWEB)

    Muhsain, Siti Nur Fadzilah, E-mail: sitinurfadzilah077@ppinang.uitm.edu.my [The University of Queensland, National Research Centre for Environmental Toxicology (Entox), 4072 Brisbane, Queensland (Australia); Faculty of Pharmacy, University Teknologi Mara (Malaysia); Lang, Matti A., E-mail: m.lang@uq.edu.au [The University of Queensland, National Research Centre for Environmental Toxicology (Entox), 4072 Brisbane, Queensland (Australia); Abu-Bakar, A' edah, E-mail: a.abubakar@uq.edu.au [The University of Queensland, National Research Centre for Environmental Toxicology (Entox), 4072 Brisbane, Queensland (Australia)

    2015-01-01

    The intracellular level of bilirubin (BR), an endogenous antioxidant that is cytotoxic at high concentrations, is tightly controlled within the optimal therapeutic range. We have recently described a concerted intracellular BR regulation by two microsomal enzymes: heme oxygenase 1 (HMOX1), essential for BR production and cytochrome P450 2A5 (CYP2A5), a BR oxidase. Herein, we describe targeting of these enzymes to hepatic mitochondria during oxidative stress. The kinetics of microsomal and mitochondrial BR oxidation were compared. Treatment of DBA/2J mice with 200 mg pyrazole/kg/day for 3 days increased hepatic intracellular protein carbonyl content and induced nucleo-translocation of Nrf2. HMOX1 and CYP2A5 proteins and activities were elevated in microsomes and mitoplasts but not the UGT1A1, a catalyst of BR glucuronidation. A CYP2A5 antibody inhibited 75% of microsomal BR oxidation. The inhibition was absent in control mitoplasts but elevated to 50% after treatment. An adrenodoxin reductase antibody did not inhibit microsomal BR oxidation but inhibited 50% of mitochondrial BR oxidation. Ascorbic acid inhibited 5% and 22% of the reaction in control and treated microsomes, respectively. In control mitoplasts the inhibition was 100%, which was reduced to 50% after treatment. Bilirubin affinity to mitochondrial and microsomal CYP2A5 enzyme is equally high. Lastly, the treatment neither released cytochrome c into cytoplasm nor dissipated membrane potential, indicating the absence of mitochondrial membrane damage. Collectively, the observations suggest that BR regulatory enzymes are recruited to mitochondria during oxidative stress and BR oxidation by mitochondrial CYP2A5 is supported by mitochondrial mono-oxygenase system. The induced recruitment potentially confers membrane protection. - Highlights: • Pyrazole induces oxidative stress in the mouse liver. • Pyrazole-induced oxidative stress induces mitochondrial targeting of key bilirubin regulatory enzymes, HMOX1

  20. Evaluation of 99mTc-Mercaptoacetyltriglycine-Biocytin as a new hepatobiliary imaging agent in mice coinjected with bilirubin

    International Nuclear Information System (INIS)

    We evaluated 99mTc-labeled mercaptoacetyltriglycine (99mTc-MAG3)-biocytin as a hepatobiliary imaging agent in the absence and presence of bilirubin in mice. We then compared its pharmacokinetic parameters; peak liver/heart activity ratio (rmax) and half clearance time (HCT) with those of 99mTc-labeled diisopropyl-iminodiacetic acid (99mTc-disofenin). Balb/c mice were injected intravenously with hepatobiliary agent (99mTc-MAG3-biocytin or 99mTc-disofenin) alone or in combination with bilirubin at two doses (7 and 14 mg/kg) dissolved in 5% human serum albumin. Images were acquired every 15 s for 30 min with a gamma-camera equipped with a pinhole collimator. Dynamic images showed rapid hepatic uptake of 99mTc-MAG3-biocytin, with rapid clearance from the blood and rapid excretion via the biliary system. Its hepatic uptake was not affected by bilirubin coinjection, whereas 99mTc-disofenin coinjected with bilirubin showed a higher blood background than 99mTc-disofenin alone. These qualitative findings were reflected in pharmacokinetic parameters, rmax and HCT. The rmax was obtained from plots of time versus liver/heart activity ratios obtained in equal-area regions of interest over the heart and liver. The HCT was calculated from the hepatic clearance curve from plots of time versus liver activity. 99mTc-MAG3-biocytin without bilirubin coinjection showed an rmax of 8.9±1.3 and an HCT of 399±36 s. These values did not change even when 14 mg/kg of bilirubin were coinjected. By contrast, the parameters for 99mTc-disofenin with bilirubin were significantly (pmax was decreased from 7.9±2.5 to 1.4±0.2 and HCT was increased from 292±32 s to 782±133 s. 99mTc-MAG3-biocytin hepatobiliary scintigraphy in mice is not affected by bilirubin coinjection, and this hepatobiliary agent appears to offer promise for estimating hepatic function in patients with high bilirubin levels

  1. The predictive value of first day bilirubin levels for early discharged newborns.

    Directory of Open Access Journals (Sweden)

    MUSTAFA TOLGA ÜNSÜR

    2015-09-01

    Full Text Available Objective: Early discharge of newborns is essential because of social, economic an medical reasons in our area, but it increases readmission rates especially for hyperbilirubinemia. Hence, predicting the high risk neonates for subsequent hyperbilirubinemia is required. This study was designed to investigate which level of total serum bilirubin (TSB at the first day could be used to predict hyperbilirubinemia .Methods: The venous blood samples obtained from 300 newborns at post-partum 24±6 hours for blood group, direct coomb’s, TSB and direct bilirubin level (DBL. These newborns were followed up during 5- day and TSB and DBLwere detected in 90 newborns with jaundice again according to Kramer dermal zones at 120±6 hours of age.Results: In 23.3% of 90 newborns phototherapy was needed. The cut off value of TSB at the first day to define newborns at high risk for subsequent hyperbilirubinemia was 6.50 mg/dl with positive predictive value 19.75%, negative predictive value 97.72%. At that point sensitivity was 76.19%, specificity was 76.70%.Conclusion: The cut-off point of 6.5 mg/dl of TSB at the first day might be used to predict subsequent hyperbilirubinemia risk at healthy, full-term early discharged newborns as the test is economic and available in all healthcare units.

  2. Impact of Rhesus disease on the global problem of bilirubin-induced neurologic dysfunction.

    Science.gov (United States)

    Zipursky, Alvin; Bhutani, Vinod K

    2015-02-01

    Clinical experience with Rhesus (Rh) disease and its post-icteric sequelae is limited among high-income countries because of nearly over four decades of effective prevention care. We hypothesized that Rh disease is prevalent in other regions of the world because it is likely that protection is limited or non-existent. Following a worldwide study, it has been concluded that Rh hemolytic disease is a significant public health problem resulting in stillbirths and neonatal deaths, and is a major cause of severe hyperbilirubinemia with its sequelae, kernicterus and bilirubin-induced neurologic dysfunction. Knowing that effective Rh-disease prophylaxis depends on maternal blood-type screening, healthcare afforded to the high-risk mothers needs to be free of bottlenecks and coupled with unfettered access to effective Rh-immunoglobulin. Future studies that match the universal identification of Rh-negative status of women and targeted use of immunoprophylaxis to prevent childhood bilirubin neurotoxicity are within reach, based on vast prior experiences. PMID:25582277

  3. Bilirubin oxidase bound to multi-walled carbon nanotube-modified gold

    International Nuclear Information System (INIS)

    We report on direct electron transfer (DET) reactions of bilirubin oxidase at multi-walled carbon nanotube-(MWCNT) modified gold electrodes. MWCNTs are very suitable for protein immobilisation and provide surface groups that can be used for the stable fixation on electrodes. They can also effectively replace the natural substrate of BOD - bilirubin, the electron donor for oxygen reduction. The bioelectrocatalytic oxygen reduction was recorded using linear sweep voltammetry (LSV) with BOD covalently linked to the nanotubes. The start potential of the bioelectrocatalytic oxygen reduction at pH 7 and a scan rate of 10 mV/s was determined to be 485 ± 10 mV vs. Ag/AgCl, 1 M KCl (720 mV vs. SHE). Current densities up to 500 μA/cm2 were detected in an air-saturated buffer at room temperature (25 ± 5 deg. C). Experiments with a rotating disk electrode (RDE) indicate a diffusion controlled electrode reaction. A ks value in the range of 80-100 s-1 could be estimated. The DET could also be observed directly by the redox conversion of a copper centre of BOD under anaerobic conditions. A peak pair with a formal potential of 680 ± 10 mV vs. SHE was found. The T1 site is probably addressed by the electrode as indicated by several experimental studies

  4. Effects of aluminum chloride on serum proteins, bilirubin, and hepatic trace elements in chickens.

    Science.gov (United States)

    Wang, Ben; Zhu, Yanzhu; Zhang, Hongling; Liu, Liming; Li, Guojiang; Song, Yongli; Li, Yanfei

    2016-09-01

    The aim of this study was to reveal the effects of aluminum chloride (AlCl3) on the hepatic metabolism function and trace elements' distribution. Two hundred healthy male chickens (1 day old) were intraperitoneally administered with AlCl3 (0, 18.31, 27.47, and 36.62 mg kg(-1) day(-1) of Al(3+)) consecutively for 3 days. Then the chickens were allowed to rest for 1 day. The cycle lasted four days. The cycle was repeated 15 times (60 days). The contents of serum total protein (TP), albumin (ALB), total bilirubin (TBI), direct bilirubin (DBI), hepatic aluminum (Al), copper (Cu), iron (Fe), and zinc (Zn) were examined. The results showed that the contents of serum TP and ALB and hepatic Fe and Zn decreased and the contents of serum TBI and DBI and hepatic Al and Cu increased in the chickens with AlCl3 This indicates that chronic administration of AlCl3 impairs the hepatic metabolism function and disorders the hepatic trace elements' distribution. PMID:25896954

  5. Spontaneous evolution in bilirubin levels predicts liver-related mortality in patients with alcoholic hepatitis.

    Directory of Open Access Journals (Sweden)

    Minjong Lee

    Full Text Available The accurate prognostic stratification of alcoholic hepatitis (AH is essential for individualized therapeutic decisions. The aim of this study was to develop a new prognostic model to predict liver-related mortality in Asian AH patients. We conducted a hospital-based, retrospective cohort study using 308 patients with AH between 1999 and 2011 (a derivation cohort and 106 patients with AH between 2005 and 2012 (a validation cohort. The Cox proportional hazards model was constructed to select significant predictors of liver-related death from the derivation cohort. A new prognostic model was internally validated using a bootstrap sampling method. The discriminative performance of this new model was compared with those of other prognostic models using a concordance index in the validation cohort. Bilirubin, prothrombin time, creatinine, potassium at admission, and a spontaneous change in bilirubin levels from day 0 to day 7 (SCBL were incorporated into a model for AH to grade the severity in an Asian patient cohort (MAGIC. For risk stratification, four risk groups were identified with cutoff scores of 29, 37, and 46 based on the different survival probabilities (P<0.001. In addition, MAGIC showed better discriminative performance for liver-related mortality than any other scoring system in the validation cohort. MAGIC can accurately predict liver-related mortality in Asian patients hospitalized for AH. Therefore, SCBL may help us decide whether patients with AH urgently require corticosteroid treatment.

  6. Fluorescence excitation spectrum of bilirubin in blood: a model for the action spectrum for phototherapy of neonatal jaundice.

    Science.gov (United States)

    Lamola, Angelo A; Russo, Marie

    2014-01-01

    A recent report (Lamola et al. 2013 Pediatric Research, 74, 54-60) presents a semiempirical model for facile calculation of an action spectrum for bilirubin photochemistry in vivo using the most current knowledge of the optics of neonatal skin. The calculations indicate that competition for phototherapy light by hemoglobin in the skin is the predominant factor that defines the spectrum of light absorbed by bilirubin. If the latter is correct, a valid physical analog of the calculated spectrum is the excitation spectrum of bilirubin in blood. The fluorescence excitation spectrum was recorded and, indeed, found to be very similar to the calculated spectrum. Both spectra exhibit maxima near 476 nm and widths at half height of about 50 nm. This result supports the conclusion that light between 460 and 490 nm is most effective for phototherapy of neonatal jaundice. PMID:23998276

  7. Correlation of third day TSH and thyroxine values with bilirubin levels detected by a neonatal screening system

    Directory of Open Access Journals (Sweden)

    Sinan Mahir Kayıran

    2010-01-01

    Full Text Available Objective: For the purpose of screening for congenital hypothyroidism and metabolic diseases blood is drawn for analysis from all newborns about 72 hours of postnatal age, which coincides with the approximate peak-time of bilirubin levels. Adding the measurement of serum bilirubin concentrations to the blood tests in programs of this kind will serve to detect high levels of bilirubin. The present study was designed to investigate a relationship, between neonatal TSH, T4 and total bilirubin levels in the blood samples of postnatal third day. Material and Methods: The population of the present study, which was conducted retrospectively in department of pediatrics in our hospital, was 450 healthy full-term newborns who had been born by cesarean section during the period January 1, 2008 and April 30, 2008. All data were analyzed by using SPSS 15.0 . Correlation between total bilirubin and thyroid hormone levels was computed by the Pearson’s correlation coefficient. Results: The mean age of the neonates when discharged from the hospital after birth was 76±1.2 hours. The mean birth weight was 3306±432 g and the mean gestational age was 269±8 days (384/7±11/7 weeks. The mean serum levels of T4 and TSH in the neonates of the study group were 13,73±2,2 µg/dl and 6,96±3,97 mU/mL respectively. The mean serum level of total bilirubin in the study group was 8,95±3,23 mg/dl. The Pearson’s correlation analysis revealed that r was -0.19 between TSH and total bilirubin levels and was significant but not so much powerful. Conclusion: Our results suggest that simultaneously measurement of T4, TSH, and bilirubin levels is a useful clinical tool for screening but there seems to be no significant clinical correlation between these parameters in healthy term newborns.

  8. Development of a theory of the variable quantum yield of the photoproducts from asymmetric bilirubin

    International Nuclear Information System (INIS)

    Full text: Bilirubin (BR) is the molecule responsible for neonatal jaundice, curable by phototherapy, and hence has been extensively studied. It is an asymmetric bichromophoric molecule; the excited states of the chromophores undergo the Davidoff (exciton, electric dipole) interaction. One of the peculiarities of BR is that the quantum yield of its photoproducts varies with wavelength. An account of the development of a theory for this will be given: part was given at a previous Wagga conference. It may well be that the Davidoff interaction parameter varies with wavelength, even though a constant interaction parameter gives rise to a variable quantum yield. Differences in the linewidths of the Davidoff lines also affect the quantum yield behaviour

  9. THE ASSOCIATION BETWEEN G6PD DEFICIENCY AND TOTAL SERUM BILIRUBIN LEVEL IN ICTERIC NEONATES

    Directory of Open Access Journals (Sweden)

    S. Behjati-Ardakani

    2007-07-01

    Full Text Available "nGlucose-6-phosphate dehydrogenase (G6PD deficiency is the most important disease of the hexose monophosphate pathway. Deficiency of this enzym can lead to hemolysis of red blood cells. Our aim was to study the prevalence of G6PD deficiency in relation to neonatal jaundice. We studied 456 clinically icteric neonates Laboratory investigations included determination of direct and indirect serum bilirubin concentrations, blood group typing, direct coomb's test, hemoglobin, blood smear, reticulocyte count and G6PD level. We divided these neonates to 3 groups based on total serum bilirubin level (TSB: TSB< 20 mg%, TSB=20-25 mg%, and TSB>25 mg%. In only 35 (7.6% of cases G6PD deficiency was diagnosed. All of these babies were male. From 456 icteric neonates, 213 cases belong to group 1 (TSB<20 mg%, 158 cases belong to group 2 (TSB=20-25 mg% and 85 cases belong to group 3 (TSB>25 mg%. 16 neonates from 213 neonates of group 1, 6 neonates from 158 neonates of group 2 and 13 neonates from 85 neonates of group 3 had G6PD deficiency. There was statistically significant difference of prevalence of G6PD deficiency between group 2 and 3 ( 15.3% vs 3.8%( P = 0.001. Between groups 1 vs 2 and 1 vs 3 no statistically significant difference was found. Early detection of this enzymopathy regardless of sex and close surveillance of the affected newborns may be important in reducing the risk of severe hyperbilirubinemia. This emphasizes the necessity of neonatal screening on cord blood samples for G6PD deficiency.

  10. The Effect of Clofibrate on Decreasing Serum Bilirubin in Healthy Term Neonates Under Home Phototherapy

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    Simin Sharafi

    2010-03-01

    Full Text Available Objective: this study was designed to determine the effect of clofibrate on neonatal uncomplicated jaundice treated with home phototherapy. Methods:This clinical trial study was performed on 60 newborns with jaundice that received home phototherapy. Inclusion criteria were body weight between 2500 to 4000 gr, breastfed, total serum bilirubin (TSB between 14 to 20 mg/dl, aged over 72 hours. The neonates were randomly divided into two groups. All received home phototherapy. Group i received a single dose of 50 mg/kg clofibrate and the other group served as control group. Total serum bilirubin level was measured every 24 hours. Findings:Two groups were matched regarding weight, sex, age and first TSB. At 24 and 48 hours of treatment, the mean values of TSB in the clofibrate group were 13.72 (1.56, 9.5 (0.56 and in the control group 15.30 (1.44, 12.6 (1.44. The results show that TSB was significantly decreased after 24 and 48 hours in clofibrate group (P<0.001. The mean duration of phototherapy in group I was 72(0.0 hours and in the control group 76.80 (±9.76 hours. The duration of phototherapy was significantly shorter in clofibrate group (P<0.001. Conclusion:Clofibrate is effective for outpatients with neonatal hyperbilirubinemia who are under home phototherapy. Of course, further studies are needed for approved routine use of this drug in the treatment of neonatal jaundice.

  11. Serum bilirubin concentration in healthy adult North-Europeans is strictly controlled by the UGT1A1 TA-repeat variants.

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    Marianne K Kringen

    Full Text Available The major enzyme responsible for the glucuronidation of bilirubin is the uridine 5'-diphosphoglucose glucuronosyltransferase A1 (UGT1A1 enzyme, and genetic variation in the UGT1A1 gene is reported to influence the bilirubin concentration in the blood. In this study, we have investigated which gene-/haplotype variants may be useful for genetic testing of Gilbert's syndrome. Two groups of samples based on serum bilirubin concentrations were obtained from the Nordic Reference Interval Project Bio-bank and Database (NOBIDA: the 150 individuals with the highest bilirubin (>17.5 µmol/L and the 150 individuals with normal bilirubin concentrations (TA7 variant in the UGT1A1 promoter and 7 tag-SNPs in an extended promoter region of UGT1A1 (haplotype analysis and in selected SNPs in candidate genes (SLCO1B3, ABCC2 and NUP153. We found significant odds ratios for high bilirubin level for all the selected UGT1A1 variants. However, in stepwise multivariate logistic regression analysis of all genetic variants together with age, sex, country of origin and fasting time, the repeat variants of UGT1A1 TA6>TA7 and SLCO1B3 rs2117032 T>C were the only variants significantly associated with higher bilirubin concentrations. Most individuals with high bilirubin levels were homozygous for the TA7-repeat (74% while only 3% were homozygous for the TA7-repeat in individuals with normal bilirubin levels. Among individuals heterozygous for the TA7-repeat, a low frequent UGT1A1-diplotype harboring the rs7564935 G-variant was associated with higher bilirubin levels. In conclusion, our results demonstrate that in testing for Gilbert's syndrome, analyzing for the homozygous TA7/TA7-genotype would be appropriate.

  12. Anti-cancer effects of blue-green alga Spirulina platensis, a natural source of bilirubin-like tetrapyrrolic compounds

    Czech Academy of Sciences Publication Activity Database

    Koníčková, R.; Vaňková, K.; Vaníková, J.; Váňová, K.; Muchová, L.; Subhanová, I.; Zadinová, M.; Zelenka, Jaroslav; Dvořák, Aleš; Kolář, Michal; Strnad, Hynek; Rimpelová, S.; Ruml, T.; Wong, R.J.; Vítek, L.

    2014-01-01

    Roč. 13, č. 2 (2014), s. 273-283. ISSN 1665-2681 Institutional support: RVO:67985823 ; RVO:68378050 Keywords : bilirubin * chlorophyll * heme oxygenase * phycocyanin * phycocyanobilin * Spirulina platensis * tetrapyrroles Subject RIV: FD - Oncology ; Hematology Impact factor: 2.065, year: 2014

  13. Transcutaneous bilirubin--comparing the accuracy of BiliChek(R) and JM 103(R) in a regional postnatal unit.

    LENUS (Irish Health Repository)

    Qualter, Yvonne M

    2012-01-31

    OBJECTIVE: Transcutaneous bilirubin (TcB) has the potential to reduce serum bilirubin sampling. During a recent survey on the use of TcB in postnatal units in the Republic of Ireland, we identified that only 58% of the 19 units were using TcB and that only two devices were in use, the BiliChek(R) and JM 103(R). We aimed to evaluate and compare these two devices in a regional postnatal unit. METHODS: To evaluate and compare the accuracy of the BiliChek(R) and JM 103(R), we studied simultaneous TcB and total serum bilirubin (TSB) measurements from a population of jaundiced term and near term infants. We evaluated each device with regard to correlation with TSB and potential to safely reduce serum bilirubin testing. RESULTS: Both TcB devices strongly correlated with TSB (r = 0.88 for BiliChek(R) and r = 0.70 for JM 103(R). The BiliChek(R) and JM 103(R) were accurate up to cut-off values of 200 mumol\\/L and 180 mumol\\/L, respectively. Using Bhutani\\'s nomogram, 100% sensitivity was achieved using the 75th percentile for BiliChek(R) and the 40th percentile for JM 103(R). CONCLUSION: Both TcB devices correlated closely with moderately increased TSB levels and are suitable screening tools to identify jaundiced infants that require a serum bilirubin, with upper limit cut-off values. Both devices reduced the need for TSB levels. We found the BiliChek(R) slightly more accurate than the JM 103(R) for our study population. TcB however, is not in widespread use.

  14. Effects of Bilirubin on Alveolar Macrophages in Rats with Emphysema and Expression of iNOS and NO in Them

    Institute of Scientific and Technical Information of China (English)

    李建强; 赵卉; 宋满景; 徐永健; 张珍祥

    2004-01-01

    To explore the effects of bilirubin on alveolar macrophages (AM) and expression of iNOS and NO in them in emphysema model, the rats were pretreated with bilirubin before exposed to smoke. AM were isolated from bronchoalveolar lavage fluid (BALF) and cultured. Pathological microscopic examination of AM and immunohistochemical analysis of iNOS were performed. Nitric oxide (NO) content in the samples was determined by nitrate reductase technique. The results showed both alveoli and alveolar septum appeared normal in size and shape in normal group. AM showed kidney-shaped nucleus and were rich in Golgi complexes and primary lysosomes in the cytoplasm. The inner membrane of mitochondrion was continuous. Most cristae of the mitochondria were intact. In model group, the alveoli were expanded, ruptured and bullaes were formed. Both the population and sizes of AM increased significantly. Secondary lysosomes were rich in the cytoplasm. Deformation and pyknosis of the nucleus, swelling of the mitochondrions and rupture of the inner mitochondrial membrane could also be seen. At high magnification, most of the mitochondrial cristae were broken, or completely lost at certain points. In bilirubin group, alveoli partly expanded and the population of AM also increased, with morphological changes being slighter than that in model group. Both NO contents and expression of iNOS in model group were higher than those in normal group (P<0.05). In bilirubin group the two indice were lower than those in model group (P<0.05). Our findings suggested that high expression of iNOS and high NO content in AM accelerate the development of emphysema associated with smoking in rats. Bilirubin may exert protective effects on AM and retards the development of emphysema in rats.

  15. Research on prevention of bilirubin-induced brain injury and kernicterus: National Institute of Child Health and Human Development conference executive summary. 2003.

    Science.gov (United States)

    Blackmon, Lillian R; Fanaroff, Avroy A; Raju, Tonse N K

    2004-07-01

    In July 2003, the National Institute of Child Health and Human Development convened a conference, "Research on Prevention of Bilirubin-Induced Brain Injury and Kernicterus: Bench-to-Bedside." This article will provide a summary of presentations and discussions from this conference. The summary will focus on the identified knowledge gaps in 5 areas related to bilirubin-induced brain injury and kernicterus: 1) neurobiology and neuroimaging; 2) epidemiology and issues of clinical management; 3) methodologies for assessing clinical jaundice and direct and noninvasive measurement of serum bilirubin and hemolysis; 4) therapies for management of neonatal hyperbilirubinemia; and 5) public health surveillance and systems-based approaches to prevention. PMID:15231933

  16. Characterization of erythrosine B binding to bovine serum albumin and bilirubin displacement.

    Science.gov (United States)

    Mathavan, Vinodaran M K; Boh, Boon Kim; Tayyab, Saad

    2009-08-01

    The interaction of crythrosine B (ErB), a commonly used dye for coloring foods and drinks, with bovine scrum albumin (BSA) was investigated both in the absence and presence of bilirubin (BR) using absorption and absorption difference spectroscopy. ErB binding to BSA was reflected from a significant red shift of 11 nm in the absorption maximum of ErB (527 nm) with the change in absorbance at lamdamax. Analysis of absorption difference spectroscopic titration results of BSA with increasing concentrations of ErB3 using Benesi-Hildebrand equation gave the association constant, K as 6.9 x 10(4) M(-1). BR displacing action of ErB was revealed by a significant blue shift in the absorption maximum, accompanied by a decrease in absorbance difference at lamdamax in the difference spectrum of BR-BSA complex upon addition of increasing concentrations of ErB. This was further substantiated by fluorescence spectroscopy, as addition of increasing concentrations of ErB to BR-BSA complex caused a significant decrease in fluoresccnce at 510 nm. The results suggest that ErB binds to a site in the vicinity of BR binding site on BSA. Therefore, intake of ErB may increase the risk of hyperbilirubinemia in the healthy subjects. PMID:19788065

  17. Theory of the variable quantum yield of Bilirubin-IX Photoisomers: the end of a chapter

    International Nuclear Information System (INIS)

    Full text: Bilirubin-IX (BR-IX), responsible for neonatal jaundice, has two slightly different chromophores which undergo the Davidoff (exciton) interaction. Because of this, BR-IX in certain solvents, e.g. human serum albumin (but not Me/OH) exhibits magnetic circular dichroism (MCD), due to the exciton lines only. The absoption spectrum of BR-IX in the exciton line region is best fitted by two gaussian lines of equal width, but the MCD spectrum best fit requires two gaussian of unequal width: the gaussian assumption is made for ease of calculation. The difference between the fitted spectra shows up as a single broad line of maximum smaller than that of the gaussian lines, and in the region of the central portion of the gaussians overlap. The origin of this line is as yet unknown, so that much further work needs to be done on the structure of the excited state of BR-IX giving rise to the exciton interaction. This is currently being undertaken. However, the variation of the exciton interaction energy with wavelength as deduced from present theory seems reasonably certain though its origin may not be

  18. Bilirubin oxidase based enzymatic air-breathing cathode: Operation under pristine and contaminated conditions.

    Science.gov (United States)

    Santoro, Carlo; Babanova, Sofia; Erable, Benjamin; Schuler, Andrew; Atanassov, Plamen

    2016-04-01

    The performance of bilirubin oxidase (BOx) based air breathing cathode was constantly monitored over 45 days. The effect of electrolyte composition on the cathode oxygen reduction reaction (ORR) output was investigated. Particularly, deactivation of the electrocatalytic activity of the enzyme in phosphate buffer saline (PBS) solution and in activated sludge (AS) was evaluated. The greatest drop in current density was observed during the first 3 days of constant operation with a decrease of ~60 μA cm(-2) day(-1). The rate of decrease slowed to ~10 μA cm(-2) day(-1) (day 3 to 9) and then to ~1.5 μA cm(-2)day(-1) thereafter (day 9 to 45). Despite the constant decrease in output, the BOx cathode generated residual current after 45 days operations with an open circuit potential (OCP) of 475 mV vs. Ag/AgCl. Enzyme deactivation was also studied in AS to simulate an environment close to the real waste operation with pollutants, solid particles and bacteria. The presence of low-molecular weight soluble contaminants was identified as the main reason for an immediate enzymatic deactivation within few hours of cathode operation. The presence of solid particles and bacteria does not affect the natural degradation of the enzyme. PMID:26544631

  19. Analysis of binding ability of two tetramethylpyridylporphyrins to albumin and its complex with bilirubin.

    Science.gov (United States)

    Solomonov, Alexey V; Shipitsyna, Maria K; Vashurin, Arthur S; Rumyantsev, Evgeniy V; Timin, Alexander S; Ivanov, Sergey P

    2016-11-01

    An interaction between 5,10,15,20-tetrakis-(N-methyl-x-pyridyl)porphyrins, x=2; 4 (TMPyPs) with bovine serum albumin (BSA) and its bilirubin (BR) complex was investigated by UV-Viz and fluorescence spectroscopy under imitated physiological conditions involving molecular docking studies. The parameters of forming intermolecular complexes (binding constants, quenching rate constants, quenching sphere radius etc.) were determined. It was showed that the interaction between proteins and TMPyPs occurs via static quenching of protein fluorescence and has predominantly hydrophobic and electrostatic character. It was revealed that obtained complexes are relatively stable, but in the case of TMPyP4 binding with proteins occurs better than TMPyP2. Nevertheless, both TMPyPs have better binding ability with free protein compared to BRBSA at the same time. The influence of TMPyPs on the conformational changes in protein molecules was studied using synchronous fluorescence spectroscopy. It was found that there is no competition of BR with TMPyPs for binging sites on protein molecule and BR displacement does not occur. Molecular docking calculations have showed that TMPyPs can bind with albumin via tryptophan residue in the hydrophilic binding site of protein molecule but it is not one possible interaction way. PMID:27267279

  20. Effect of bilirubin on expression and localization of PGP and Mrp1 in the central nervous system

    OpenAIRE

    Gazzin, Silvia

    2008-01-01

    INTRODUZIONE A basse concentrazioni la bilirubina non coniugata (unconjugated bilirubin, UCB) prodotta dalla degradazione dell’emoglobina, sembra essere un potente anti-ossidante, mentre è estremamente dannosa ad alte concentrazioni, causando encefalopatia nei neonati con severo ittero. Il 70% dei bambini che presentano kernittero muoiono entro sette giorni di vita, mentre il 30% dei sopravvissuti manifesta irreversibili conseguenze come sordità, ritardo mentale e danni cerebrali perman...

  1. X-ray analysis of bilirubin oxidase from Myrothecium verrucaria at 2.3 Å resolution using a twinned crystal

    International Nuclear Information System (INIS)

    The crystal structure of bilirubin oxidase (BOD) from M. verrucaria has been determined at 2.3 Å resolution using a merohedrally twinned crystal. BOD has four copper-coordination sites that are almost identical to those of other multicopper oxidases and is also very similar to them in overall structure. Bilirubin oxidase (BOD), a multicopper oxidase found in Myrothecium verrucaria, catalyzes the oxidation of bilirubin to biliverdin. Oxygen is the electron acceptor and is reduced to water. BOD is used for diagnostic analysis of bilirubin in serum and has attracted considerable attention as an enzymatic catalyst for the cathode of biofuel cells that work under neutral conditions. Here, the crystal structure of BOD is reported for the first time. Blue bipyramid-shaped crystals of BOD obtained in 2-methyl-2,4-pentanediol (MPD) and ammonium sulfate solution were merohedrally twinned in space group P63. Structure determination was achieved by the single anomalous diffraction (SAD) method using the anomalous diffraction of Cu atoms and synchrotron radiation and twin refinement was performed in the resolution range 33–2.3 Å. The overall organization of BOD is almost the same as that of other multicopper oxidases: the protein is folded into three domains and a total of four copper-binding sites are found in domains 1 and 3. Although the four copper-binding sites were almost identical to those of other multicopper oxidases, the hydrophilic Asn residue (at the same position as a hydrophobic residue such as Leu in other multicopper oxidases) very close to the type I copper might contribute to the characteristically high redox potential of BOD

  2. Bilirubin Oxidase from Bacillus pumilus: A promising enzyme for the elaboration of efficient cathodes in Biofuel cells

    OpenAIRE

    Durand, Fabien; Kjaergaard, Christian Hauge; Suraniti, Emmanuel; Gounel, Sébastien; Hadt, Ryan G.; Solomon, Edward I.; Mano, Nicolas

    2012-01-01

    A CotA Multicopper Oxidase (MCO) from Bacillus pumilus, previously identified as a laccase, has been studied and characterized as a new bacterial Bilirubin Oxidase (BOD). The 59kDa protein containing four coppers, was successfully over-expressed in Escherichia coli and purified to homogeneity in one step. This 509 amino-acid enzyme, having 67% and 26% sequence identity with CotA from Bacillus subtilis and BOD from Myrothecium verrucaria, respectively, shows higher turnover activity towards bi...

  3. On the Possibility of Uphill Intramolecular Electron Transfer in Multicopper Oxidases: Electrochemical and Quantum Chemical Study of Bilirubin Oxidase

    Czech Academy of Sciences Publication Activity Database

    Shleev, S.; Andoralov, V.; Falk, M.; Reimann, C. T.; Ruzgas, T.; Srnec, Martin; Ryde, U.; Rulíšek, Lubomír

    2012-01-01

    Roč. 24, č. 7 (2012), s. 1524-1540. ISSN 1040-0397 Grant ostatní: 7th Framework Program(XE) NMP4-SL-2009-229255 Institutional research plan: CEZ:AV0Z40550506 Keywords : bilirubin oxidase * intramolecular electron transfer * rate-limiting catalytic step * reorganization energy * QM/MM calculations Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 2.817, year: 2012

  4. Dimethyl ester of bilirubin exhibits anti-inflammatory activity through inhibition of secretory phospholipase A2, lipoxygenase and cyclooxygenase.

    Science.gov (United States)

    Joshi, Vikram; Umashankara, M; Ramakrishnan, Chandrasekaran; Nanjaraj Urs, Ankanahalli N; Suvilesh, Kanve Nagaraj; Velmurugan, Devadasan; Rangappa, Kanchugarakoppal S; Vishwanath, Bannikuppe Sannanaik

    2016-05-15

    Overproduction of arachidonic acid (AA) mediated by secretory phospholipase A2 group IIA (sPLA2IIA) is a hallmark of many inflammatory disorders. AA is subsequently converted into pro-inflammatory eicosanoids through 5-lipoxygenase (5-LOX) and cyclooxygenase-1/2 (COX-1/2) activities. Hence, inhibition of sPLA2IIA, 5-LOX and COX-1/2 activities is critical in regulating inflammation. We have previously reported unconjugated bilirubin (UCB), an endogenous antioxidant, as sPLA2IIA inhibitor. However, lipophilic UCB gets conjugated in liver with glucuronic acid into hydrophilic conjugated bilirubin (CB). Since hydrophobicity is pre-requisite for sPLA2IIA inhibition, conjugation reduces the efficacy of UCB. In this regard, UCB was chemically modified and derivatives were evaluated for sPLA2IIA, 5-LOX and COX-1/2 inhibition. Among the derivatives, BD1 (dimethyl ester of bilirubin) exhibited ∼ 3 fold greater inhibitory potency towards sPLA2IIA compared to UCB. Both UCB and BD1 inhibited human 5-LOX and COX-2 activities; however only BD1 inhibited AA induced platelet aggregation. Molecular docking studies demonstrated BD1 as better inhibitor of aforesaid enzymes than UCB and other endogenous antioxidants. These data suggest that BD1 exhibits strong anti-inflammatory activity through inhibition of AA cascade enzymes which is of great therapeutic importance. PMID:27060751

  5. Application of high-performance liquid chromatography combined with ultra-sensitive thermal lens spectrometric detection for simultaneous biliverdin and bilirubin assessment at trace levels in human serum.

    Science.gov (United States)

    Martelanc, Mitja; Žiberna, Lovro; Passamonti, Sabina; Franko, Mladen

    2016-07-01

    We present the applicability of a new ultra-sensitive analytical method for the simultaneous determination of biliverdin and bilirubin in human serum. The method comprises isocratic reversed-phase (RP) C18 high-performance liquid chromatography (HPLC) and thermal lens spectrometric detection (TLS) based on excitation by a krypton laser emission line at 407nm. This method enables the separation of IX-α biliverdin and IX-α bilirubin in 11min with limit of detection (LOD) and limit of quantitation (LOQ) for biliverdin of 1.2nM and 3nM, and 1nM and 2.8nM for bilirubin, respectively. In addition, a step-gradient elution was set up, by changing the mobile phase composition, in order to further enhance the sensitivity for bilirubin determination with LOD and LOQ of 0.5nM and 1.5nM, respectively. In parallel, an isocratic HPLC-DAD method was developed for benchmarking against HPLC-TLS methods. The LOD and LOQ for biliverdin were 6nM and 18nM, and 2.5nM and 8nM for bilirubin, respectively. Additionally, both isocratic methods were applied for measuring biliverdin and free bilirubin in human serum samples (from 2 male and 2 female healthy donors). Combining isocratic HPLC method with TLS detector was crucial for first ever biliverdin determination in serum together with simultaneous free bilirubin determination. We showed for the first time the concentration ratio of free bilirubin versus unbound biliverdin in human serum samples. PMID:27154653

  6. Human serum albumin-stabilized gold nanoclusters act as an electron transfer bridge supporting specific electrocatalysis of bilirubin useful for biosensing applications.

    Science.gov (United States)

    Santhosh, Mallesh; Chinnadayyala, Somasekhar R; Singh, Naveen K; Goswami, Pranab

    2016-10-01

    Human serum albumin (HSA)-stabilized Au18 nanoclusters (AuNCs) were synthesized and chemically immobilized on an Indium tin oxide (ITO) plate. The assembly process was characterized by advanced electrochemical and spectroscopic techniques. The bare ITO electrode generated three irreversible oxidation peaks, whereas the HSA-AuNC-modified electrode produced a pair of redox peaks for bilirubin at a formal potential of 0.27V (vs. Ag/AgCl). However, the native HSA protein immobilized on the ITO electrode failed to produce any redox peak for bilirubin. The results indicate that the AuNCs present in HSA act as electron transfer bridge between bilirubin and the ITO plate. Docking studies of AuNC with HSA revealed that the best docked structure of the nanocluster is located around the vicinity of the bilirubin binding site, with an orientation that allows specific oxidation. When the HSA-AuNC-modified electrode was employed for the detection of bilirubin using chronoamperometry at 0.3V (vs. Ag/AgCl), a steady-state current response against bilirubin in the range of 0.2μM to 7μM, with a sensitivity of 0.34μAμM(-1) and limit of detection of 86.32nM at S/N 3, was obtained. The bioelectrode was successfully applied to measure the bilirubin content in spiked serum samples. The results indicate the feasibility of using HSA-AuNC as a biorecognition element for the detection of serum bilirubin levels using an electrochemical technique. PMID:27126550

  7. Apoptosis in murine hepatoma hepa 1c1c7 wild-type, C12, and C4 cells mediated by bilirubin.

    Science.gov (United States)

    Seubert, John M; Darmon, Alison J; El-Kadi, Ayman O S; D'Souza, Sudhir J A; Bend, John R

    2002-08-01

    Elevated serum and tissue bilirubin concentrations that occur in pathological conditions such as cholestasis, jaundice, and other liver diseases are known to stimulate cytotoxic responses. In preliminary studies, we noted that bilirubin seemed to cause apoptosis in murine hepatoma Hepa 1c1c7 wild-type (WT) cells. Consequently, we investigated apoptosis caused by bilirubin in WT, mutant C12 [aryl hydrocarbon receptor (AHR)-deficient], and C4 (AHR nuclear translocator-deficient) Hepa 1c1c7 cells. Three independent measures of apoptosis were used to quantify the effects of exogenous bilirubin (0, 1, 10, 25, 50, or 100 microM). Caspase-3 activity and cytochrome c release from mitochondria increased at 3 h post-treatment, before increased caspase-8 activity at 6 h, and nuclear condensation by 24 h after treatment with bilirubin. No differences in whole-cell lipid peroxidation were observed between the cell types; however, intracellular reactive oxygen species (ROS) production was greater in WT cells than C12 or C4 cells 3 h after bilirubin exposure. Pretreatment of cells for 1 h with 1 or 10 microM alpha-naphthoflavone, an AHR antagonist, before bilirubin exposure resulted in decreased caspase-3 activity at 6 h and nuclear condensation at 24 h in WT cells. These results indicate that bilirubin, a potential AHR ligand, causes apoptosis in murine Hepa 1c1c7 WT cells by a mechanism(s) partially involving the AHR, disruption of membrane integrity, and increased intracellular ROS production. PMID:12130676

  8. Biliverdin reductase/bilirubin mediates the anti-apoptotic effect of hypoxia in pulmonary arterial smooth muscle cells through ERK1/2 pathway

    Energy Technology Data Exchange (ETDEWEB)

    Song, Shasha [Department of Biopharmaceutical Sciences, College of Pharmacy, Harbin Medical, University (Daqing), Daqing 163319 (China); Wang, Shuang [Department of Biopharmaceutical Sciences, College of Pharmacy, Harbin Medical, University (Daqing), Daqing 163319 (China); Biopharmaceutical Key Laboratory of Heilongjiang Province, Harbin 150081 (China); Ma, Jun; Yao, Lan; Xing, Hao; Zhang, Lei; Liao, Lin [Department of Biopharmaceutical Sciences, College of Pharmacy, Harbin Medical, University (Daqing), Daqing 163319 (China); Zhu, Daling, E-mail: dalingz@yahoo.com [Department of Biopharmaceutical Sciences, College of Pharmacy, Harbin Medical, University (Daqing), Daqing 163319 (China); Biopharmaceutical Key Laboratory of Heilongjiang Province, Harbin 150081 (China)

    2013-08-01

    Inhibition of pulmonary arterial smooth muscle cell (PASMC) apoptosis induced by hypoxia plays an important role in pulmonary arterial remodeling leading to aggravate hypoxic pulmonary arterial hypertension. However, the mechanisms of hypoxia acting on PASMC apoptosis remain exclusive. Biliverdin reductase (BVR) has many essential biologic roles in physiological and pathological processes. Nevertheless, it is unclear whether the hypoxia-induced inhibition on PASMC apoptosis is mediated by BVR. In the present work, we found BVR majorly localized in PASMCs and was up-regulated in levels of protein and mRNA by hypoxia. Then we studied the contribution of BVR to anti-apoptotic response of hypoxia in PASMCs. Our results showed that siBVR, blocking generation of bilirubin, reversed the effect of hypoxia on enhancing cell survival and apoptotic protein (Bcl-2, procasepase-9, procasepase-3) expression, preventing nuclear shrinkage, DNA fragmentation and mitochondrial depolarization in starved PASMCs, which were recovered by exogenous bilirubin. Moreover, the inhibitory effect of bilirubin on PASMC apoptosis under hypoxic condition was blocked by the inhibitor of ERK1/2 pathway. Taken together, our data indicate that BVR contributes to the inhibitory process of hypoxia on PASMC apoptosis, which is mediated by bilirubin through ERK1/2 pathway. Highlights: • BVR expresses in PASMC and is up-regulated by hypoxia in protein and mRNA levels. • BVR/bilirubin contribute to the inhibitive process of hypoxia on PASMC apoptosis. • Bilirubin protects PASMC from apoptosis under hypoxia via ERK1/2 pathway.

  9. Biliverdin reductase/bilirubin mediates the anti-apoptotic effect of hypoxia in pulmonary arterial smooth muscle cells through ERK1/2 pathway

    International Nuclear Information System (INIS)

    Inhibition of pulmonary arterial smooth muscle cell (PASMC) apoptosis induced by hypoxia plays an important role in pulmonary arterial remodeling leading to aggravate hypoxic pulmonary arterial hypertension. However, the mechanisms of hypoxia acting on PASMC apoptosis remain exclusive. Biliverdin reductase (BVR) has many essential biologic roles in physiological and pathological processes. Nevertheless, it is unclear whether the hypoxia-induced inhibition on PASMC apoptosis is mediated by BVR. In the present work, we found BVR majorly localized in PASMCs and was up-regulated in levels of protein and mRNA by hypoxia. Then we studied the contribution of BVR to anti-apoptotic response of hypoxia in PASMCs. Our results showed that siBVR, blocking generation of bilirubin, reversed the effect of hypoxia on enhancing cell survival and apoptotic protein (Bcl-2, procasepase-9, procasepase-3) expression, preventing nuclear shrinkage, DNA fragmentation and mitochondrial depolarization in starved PASMCs, which were recovered by exogenous bilirubin. Moreover, the inhibitory effect of bilirubin on PASMC apoptosis under hypoxic condition was blocked by the inhibitor of ERK1/2 pathway. Taken together, our data indicate that BVR contributes to the inhibitory process of hypoxia on PASMC apoptosis, which is mediated by bilirubin through ERK1/2 pathway. Highlights: • BVR expresses in PASMC and is up-regulated by hypoxia in protein and mRNA levels. • BVR/bilirubin contribute to the inhibitive process of hypoxia on PASMC apoptosis. • Bilirubin protects PASMC from apoptosis under hypoxia via ERK1/2 pathway

  10. Heme oxygenase-1 induction prevents neuronal damage triggered during mitochondrial inhibition: role of CO and bilirubin.

    Science.gov (United States)

    Orozco-Ibarra, Marisol; Estrada-Sánchez, Ana María; Massieu, Lourdes; Pedraza-Chaverrí, José

    2009-06-01

    Heme oxygenase (HO) catalyzes the breakdown of heme to iron, carbon monoxide (CO), and biliverdin, the latter being further reduced to bilirubin (BR). A protective role of the inducible isoform, HO-1, has been described in pathological conditions associated with reactive oxygen species (ROS) and oxidative damage. The aim of this study was to investigate the role of HO-1 in the neurotoxicity induced by the mitochondrial toxin 3-nitropropionic acid (3-NP) in primary cultures of cerebellar granule neurons (CGNs). Toxicity of 3-NP is associated with ROS production, and this metabolic toxin has been used to mimic pathological conditions such as Huntington's disease. We found that cell death caused by 3-NP exposure was exacerbated by inhibition of HO with tin mesoporphyrin (SnMP). In addition, HO-1 up-regulation induced by the exposure to cobalt protoporphyrin (CoPP) before the incubation with 3-NP, prevented the cell death and the increase in ROS induced by 3-NP. Interestingly, addition of SnMP to CoPP-pretreated CGNs exposed to 3-NP, abolished the protective effect of CoPP suggesting that HO activity was responsible for this protective effect. This was additionally supported by the fact that CORM-2, a CO-releasing molecule, and BR, were able to protect against cell death and the increase in ROS induced by 3-NP. Our data clearly show that HO-1 elicits in CGNs a neuroprotective action against the neurotoxicity of 3-NP and that CO and BR may be involved, at least in part, in this protective effect. The present results increase our knowledge about the role of HO-1 in neuropathological conditions. PMID:19063990

  11. Total bilirubin in nasogastric aspirates: A potential new indicator of postoperative gastrointestinal recovery

    Directory of Open Access Journals (Sweden)

    Go Miyano

    2013-01-01

    Full Text Available Background: The aim of our study was to investigate if total bilirubin (T-bil, amylase (Amy, and sodium (Na in nasogastric (NG aspirates can reflect gastrointestinal motility reliably. Materials and Methods: NG aspirates from all laparotomies lasting more than 150 min in children less than 12 months old were studied for 3 months. Color of aspirates and intensity of bowel sounds were graded every 3 h by nursing staff and aspirate samples for measuring T-bil, Amy, and Na were collected independently every 12 h until an oral fluid challenge was tolerated. Results: There were 26 subjects. Mean age at surgery was 5.6 months; mean body weight at surgery was 5.8 kg. No postoperative complications occurred. While there was no reduction in average volume of NG aspirates, color change was subjective, and bowel sounds could not be standardized, T-bil decreased over time (0d: 4.4 mg/dL; 0.5d: 2.7 mg/dL; 1.0d: 1.6 mg/dL; 1.5d: 1.3 mg/dL; 2.0d: 0.4 mg/dL; 2.5d: 0.33 mg/dL; 3.0d: 0.21 mg/dL; 3.5d: 0.15 mg/dL; 4.0d: 0.06 mg/dL; 4.5d: 0.05 mg/dL; 5.0d: 0.02 mg/dL; 5.5d: 0.02 mg/dL; 6.0d: 0.01 mg/dL. Amy and Na were inconclusive. Conclusion: T-bil levels in NG aspirates may be useful as a reliable objective quantitative marker of gastrointestinal motility postoperatively.

  12. Cytochrome P450 2A5 and bilirubin: Mechanisms of gene regulation and cytoprotection

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sangsoo Daniel; Antenos, Monica [Department of Biomedical Sciences, University of Guelph, Guelph, Ontario, N1G 2W1 (Canada); Squires, E. James [Department of Animal and Poultry Sciences, University of Guelph, Guelph, Ontario, N1G 2W1 (Canada); Kirby, Gordon M., E-mail: gkirby@uoguelph.ca [Department of Biomedical Sciences, University of Guelph, Guelph, Ontario, N1G 2W1 (Canada)

    2013-07-15

    Bilirubin (BR) has recently been identified as the first endogenous substrate for cytochrome P450 2A5 (CYP2A5) and it has been suggested that CYP2A5 plays a major role in BR clearance as an alternative mechanism to BR conjugation by uridine-diphosphate glucuronyltransferase 1A1. This study investigated the mechanisms of Cyp2a5 gene regulation by BR and the cytoprotective role of CYP2A5 in BR hepatotoxicity. BR induced CYP2A5 expression at the mRNA and protein levels in a dose-dependent manner in primary mouse hepatocytes. BR treatment also caused nuclear translocation of Nuclear factor-E2 p45-related factor 2 (Nrf2) in hepatocytes. In reporter assays, BR treatment of primary hepatocytes transfected with a Cyp2a5 promoter-luciferase reporter construct resulted in a 2-fold induction of Cyp2a5 reporter activity. Furthermore, cotransfection of the hepatocytes with a Nrf2 expression vector without BR treatment resulted in an increase in Cyp2a5 reporter activity of approximately 2-fold and BR treatment of Nrf2 cotransfectants further increased reporter activity by 4-fold. In addition, site-directed mutation of the ARE in the reporter construct completely abolished both the BR- and Nrf2-mediated increases in reporter activity. The cytoprotective role of CYP2A5 against BR-mediated apoptosis was also examined in Hepa 1–6 cells that lack endogenous CYP2A5. Transient overexpression of CYP2A5 partially blocked BR-induced caspase-3 cleavage in Hepa 1–6 cells. Furthermore, in vitro degradation of BR was increased by microsomes from Hepa 1–6 cells overexpressing CYP2A5 compared to control cells transfected with an empty vector. Collectively, these results suggest that Nrf2-mediated CYP2A5 transactivation in response to BR may provide an additional mechanism for adaptive cytoprotection against BR hepatotoxicity. - Highlights: • The mechanism of Cyp2a5 gene regulation by BR was investigated. • The cytoprotective role of CYP2A5 in BR hepatotoxicity was determined. • BR

  13. PREDICTION OF SIGNIFICANT NEONATAL HYPERBILIRUBINAEMIA IN HEALTHY TERM NEW BORNS USING 22-26 HOURS’ SPECIFIC SERUM BILIRUBIN – A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Reddy

    2016-03-01

    Full Text Available INTRODUCTION Hyperbilirubinemia invariably occurs in the newborns and is discerned as clinical jaundice in nearly 50% of infants. It is a cause of concern not only for the parents but also for the paediatricians. Bilirubin production is 2-3 times higher in normal term newborns compared with adults. The colour in jaundice usually results from accumulation of unconjugated, non-polar, lipid soluble, bilirubin pigment in the skin which is formed from haemoglobin by the action of heme oxygenase, biliverdin reductase and non-enzymatic reducing agents in the reticulo-endothelial cells. AIMS & OBJECTIVE To determine hour specific serum bilirubin (22-26 hrs which will predict, subsequent significant hyperbilirubinemia in healthy term newborns. MATERIALS & METHODS A total of 250 healthy full term newborns were enrolled into the study. First bilirubin estimation (TSB 1 was estimated at 22- 26 hrs. The neonates were followed up clinically every 12 hrs for 72 hrs (till discharge. Second bilirubin estimation (TSB S was done whenever clinical suspicion of jaundice was present (usually at 72 hours. Depending upon the TSB 1 value, the infants were evaluated by using two available protocols (Arbitrary cut off value of 5 mg/dl and average value of 4.06 mg%. Sensitivity, specificity, negative and positive predictive values and likelihood ratio of the test were calculated. P-value was used to determine the level of significance. RESULTS Of 250 neonates included in the study, 13 neonates developed hyperbilirubinemia and were subjected to phototherapy. No infants with average bilirubin value of ≤4.06 mg% developed subsequent hyperbilirubinemia. However, 2 infants with arbitrary cut off value of ≤5 mg/dl developed hyperbilirubinemia. There was significant difference in TSB I value of neonates who subsequently did and those who did not developed significant hyperbilirubinemia (P-value-<0.01. The negative predictive value to these two applied protocol is very high

  14. The Relationship between the Behavioral Hearing Thresholds and Maximum Bilirubin Levels at Birth in Children with a History of Neonatal Hyperbilirubinemia

    Directory of Open Access Journals (Sweden)

    Rasool Panahi

    2013-06-01

    Full Text Available Introduction: Neonatal hyperbilirubinemia is one of the most important factors affecting the auditory system and can cause sensorineural hearing loss. This study investigated the relationship between behavioral hearing thresholds in children with a history of jaundice and the maximum level of bilirubin concentration in the blood.   Materials and Methods: This study was performed on 18 children with a mean age of 5.6 years and with a history of neonatal hyperbilirubinemia. Behavioral hearing thresholds, transient evoked emissions and brainstem evoked responses were evaluated in all children.   Results: Six children (33.3 % had normal hearing thresholds and the remaining (66.7 % had some degree of hearing loss. There was no significant relationship (r= -0.28, P= 0.09 between the mean total bilirubin levels and behavioral hearing thresholds in all samples. A transient evoked emission was seen only in children with normal hearing thresholds however in eight cases brainstem evoked responses had not detected.   Conclusion:  Increased blood levels of bilirubin at the neonatal period were potentially one of the causes of hearing loss. There was a lack of a direct relationship between neonatal bilirubin levels and the average hearing thresholds which emphasizes on the necessity of monitoring the various amounts of bilirubin levels.

  15. Evaluating the role of indirect bilirubin, urobilinogen and Shine AND Lal index as an alternative screening tool for beta thalassemia minor

    Directory of Open Access Journals (Sweden)

    Ridham A. Khanderia

    2015-06-01

    Methods: The present study was conducted on 100 (n=100 subjects in blood bank, department of pathology, government medical college Rajkot, Gujarat, India. In first group 50 subjects (Thalassemia minor were selected while in second group 50 (n2=50 normal individuals from hospital staff were selected. Complete-haemogram, serum-direct, indirect and total bilirubin, urine urobilinogen and their sensitivity and specificity were calculated. Results: Of the 50 cases in test group, 41 had higher Indirect Bilirubin level (>0.7 mg/dl, 35 had high urobilinogen level (>1 mg/dl. In control group out of 50 cases, 3 had high indirect bilirubin levels, 4 had high urobilinogen levels. Indirect-bilirubin had sensitivity of 82%, specificity of 94%. Urobilinogen showed sensitivity of 70% and specificity of 92%. Conclusion: Indirect bilirubin and urine-urobilinogen is a valuable, cost-effective screening test for beta-thalassemia-trait with sensitivity and specificity comparable to RBC indices. [Int J Res Med Sci 2015; 3(3.000: 730-737

  16. A COMPARISON STUDY: CORD SERUM ALBUMIN IS COMPARED WITH CORD SERUM BILIRUBIN AS A RISK INDICATOR IN PREDICTING NEONATAL JAUNDICE

    Directory of Open Access Journals (Sweden)

    Venkatamurthy

    2014-04-01

    Full Text Available : OBJECTIVE: 1. Comparing Cord Serum Albumin level (CSA with Cord Serum Bilirubin (CSB in predicting neonatal hyperbilirubinemia. 2. To know the sensitivity, specificity, Positive predictive value and negative predictive value of CSA and CSB in predicting neonatal jaundice in term neonates. METHOD: Prospective study was performed on 174 healthy term neonates. Relevant maternal history is collected. Cord blood was collected from the healthy term neonates at birth, CSA and CSB measured. Neonate was assessed clinically every day. Total Serum Bilirubin (TSB and blood group were assessed in neonate during 72-96 hours of life. TSB value ≥17mg/dl is considered Neonatal Hyperbilirubinemia (NH which requires intervention like phototherapy (PT or Exchange transfusion (ExT. RESULT: Study cohort is grouped in Group 1, Group 2 and Group 3 based on Cord Serum Albumin level ≤2.8g/dl, 2.9-3.3g/dl and ≥3.4g/dl, respectively. Based on CSB, study cohort divided into neonates with CSB ≤ 2mg/dl and CSB ≥ 2.1mg/dl. Statistical analysis done for correlation of CSA and CSB with NH. Statistical significance is seen for both CSA and CSB. CONCLUSION: Both CSA and CSB are equally effective in predicting NH at birth. These study variables can be considered as neonatal screening tool for NH for term neonates.

  17. A transcriptome analysis identifies molecular effectors of unconjugated bilirubin in human neuroblastoma SH-SY5Y cells

    Directory of Open Access Journals (Sweden)

    Giraudi Pablo

    2009-11-01

    Full Text Available Abstract Background The deposition of unconjugated bilirubin (UCB in selected regions of the brain results in irreversible neuronal damage, or Bilirubin Encephalopathy (BE. Although UCB impairs a large number of cellular functions in other tissues, the basic mechanisms of neurotoxicity have not yet been fully clarified. While cells can accumulate UCB by passive diffusion, cell protection may involve multiple mechanisms including the extrusion of the pigment as well as pro-survival homeostatic responses that are still unknown. Results Transcriptome changes induced by UCB exposure in SH-SY5Y neuroblastoma cell line were examined by high density oligonucleotide microarrays. Two-hundred and thirty genes were induced after 24 hours. A Gene Ontology (GO analysis showed that at least 50 genes were directly involved in the endoplasmic reticulum (ER stress response. Validation of selected ER stress genes is shown by quantitative RT-PCR. Analysis of XBP1 splicing and DDIT3/CHOP subcellular localization is presented. Conclusion These results show for the first time that UCB exposure induces ER stress response as major intracellular homeostasis in surviving neuroblastoma cells in vitro.

  18. Thymoquinone, an active constituent of Nigella sativa seeds, binds with bilirubin and protects mice from hyperbilirubinemia and cyclophosphamide-induced hepatotoxicity.

    Science.gov (United States)

    Laskar, Amaj A; Khan, Masood A; Rahmani, Arshad H; Fatima, Sana; Younus, Hina

    2016-08-01

    Some reports indicate that thymoquinone (TQ), the main constituent of Nigella sativa seeds, is hepatoprotective. The aim of this study was to determine whether TQ is able to bind directly to bilirubin, and whether TQ or liposomal formulation of TQ (Lip-TQ) can reduce cyclophosphamide (CYP)-induced liver toxicity, serum bilirubin level in mice. The binding of TQ with bilirubin was studied by UV-VIS, fluorescence and Near-UV CD spectroscopy. Inhibition of binding of bilirubin to erythrocytes by TQ was also examined. To increase the in vivo efficacy, Lip-TQ was prepared and used against CYP-induced toxicity. The protective role of TQ or Lip-TQ against CYP-induced toxicity was assessed by determining the liver function parameters, the levels of superoxide dismutase (SOD) and catalase (CAT), and histological studies. It was found that TQ binds to bilirubin and significantly inhibits the binding of bilirubin to erythrocytes. Lip-TQ (10 mg/kg) significantly reduced the levels of aspartate transaminase (AST) from 254 ± 48 to 66 ± 18 IU/L (P < 0.001), alanine transaminase (ALT) from 142 ± 28 to 47.8 ± 16 IU/L (P < 0.05) and serum bilirubin from 2.8 ± 0.50 to 1.24 ± 0.30 mg/dl (P < 0.05). Treatment with Lip-TQ reduced the CYP-induced inflammation and hemorrhage in liver tissues. Moreover, treatment with free or Lip-TQ protected the activity of SOD and CAT in CYP-injected mice. Therefore, TQ can reduce the level of bilirubin in systemic circulation in disease conditions that lead to hyperbilirubinemia and liver toxicity and hence may be used as a supplement in the treatment of liver ailments. PMID:27265787

  19. Low solubility of unconjugated bilirubin in dimethylsulfoxide – water systems: implications for pKa determinations

    OpenAIRE

    Ostrow J Donald; Mukerjee Pasupati; Tiribelli Claudio

    2002-01-01

    Abstract Background Aqueous pKa values of unconjugated bilirubin are important determinants of its solubility and transport. Published pKa data on an analog, mesobilirubin-XIIIα, studied by 13C-NMR in buffered solutions containing 27 and 64 vol% (C2H3)2SO because of low aqueous solubility of mesobilirubin, were extrapolated to obtain pKa values in water of 4.2 and 4.9. Previous chloroform-water partition data on bilirubin diacid led to higher estimates of its pKa, 8.12 and 8.44, and its aqueo...

  20. Adjusting CA19-9 values to predict malignancy in obstructive jaundice: Influence of bilirubin and C-reactive protein

    Institute of Scientific and Technical Information of China (English)

    Gaetano La Greca; Maria Sofia; Rosario Lombardo; Saverio Latteri; Agostino Ricotta; Stefano Puleo; Domenico Russello

    2012-01-01

    AIM:To find a possible relationship between inflammation and CA19-9 tumor marker by analyzing data from patients with benign jaundice (BJ) and malignant jaundice (MJ).METHODS:All patients admitted for obstructive jaundice,in the period 2005-2009,were prospectively enrolled in the study,obtaining a total of 102 patients.On admission,all patients underwent complete standard blood test examinations including C-reactive protein (CRP),bilirubin,CA19-9.Patients were considered eligible for the study when they presented obstructive jaundice confirmed by instrumental examinations and increased serum bilirubin levels (total bilirubin > 2.0 mg/dL).The standard cut-off level for CA19-9 was 32 U/mL,whereas for CRP this was 1.5 mg/L.The CA19-9 level was adjusted by dividing it by the value of serum bilirubin or by the CRP value.The patients were divided into 2 groups,MJ and BJ,and after the adjustment a comparison between the 2 groups of patients was performed.Sensitivity,specificity and positive predictive values were calculated before and after the adjustment.RESULTS:Of the 102 patients,51 were affected by BJ and 51 by MJ.Pathologic CA19-9 levels were found in 71.7% of the patients.In the group of 51 BJ patients there were 29 (56.9%) males and 22 (43.1%) females with a median age of 66 years (range 24-96 years),whereas in the MJ group there were 24 (47%) males and 27 (53%) females,with a mean age of 70 years (range 30-92 years).Pathologic CA19-9 serum level was found in 82.3% of MJ.CRP levels were pathologic in 66.6% of the patients with BJ and in 49% with MJ.Bilirubin and CA19-9 average levels were significantly higher in MJ compared with BJ (P =0.000 and P =0.02),while the CRP level was significantly higher in BJ (P =0.000).Considering a CA19-9 cut-off level of 32 U/mL,82.3% in the MJ group and 54.9% in the BJ group were positive for CA19-9 (P =0.002).A CA19-9 cut-off of 100 U/mL increases the difference between the two groups:35.3% in BJ and 68.6

  1. Acute effect of weight loss on levels of total bilirubin in obese, cardiovascular high-risk patients: an analysis from the lead-in period of the Sibutramine Cardiovascular Outcome trial

    DEFF Research Database (Denmark)

    Andersson, Charlotte; Weeke, Peter; Fosbøl, Emil Loldrup;

    2009-01-01

    Low levels of bilirubin are associated with an increased risk of cardiovascular adverse events. Weight reduction is known to reduce several cardiovascular risk factors, but effects on bilirubin levels have not been reported. We studied the response of weight loss therapy with sibutramine and life...

  2. A meaningful appraisal of cholestasis in serum total bilirubin, cholyglyine, alpha-fetoprotein and carbohydrate antigen19-9

    International Nuclear Information System (INIS)

    Objective: Appraise the clinical significant how the serum total bilirubin (TB), cholylglycine (CG), α-fetoprotein (AFP), carbohydrate antigen 19-9 (CA 19-9) have their concentration changes in the pathological changes of intrahepatic cholestasis through a combined detection to them. Methods: The serum samples from 96 cases of chronic virus hepatitis, 26 cases of liver cirrhosis and 50 cases of normal people were detected by biochemistry for TB, by radioimmunoassay for CG, by electro chemiluminescence for AFP and CA19-9. Results: There is no obvious deference of serum TB in the group without intrahepatic cholestasis, the group of cholestasis without clinical symptoms and the control groups. There is also a marked deference (P<0.01) in the group of cholestasis with clinical symptoms, the group of liver cirrhosis, the group without intrahepatic cholestasis, the control group and the group of cholestasis without clinical symptoms. the serum CG from the groups of intrahepatic cholestasis, the group without intrahepatic cholestasis, and the control group all show a very obvious deference (P<0.01). The serum CA19-9 from the groups of intrahepatic cholestasis and the group without intrahepatic cholestasis show an obvious deference. The serum AFP, CA19-9 from the group of liver cancer show a very obvious deference (P<0.01). Conclusions: In clinc bilirubin is a rough index to reflect cholestasis. It has its own limit in deciding patterns of deferent bile obstruction. In the early stage of intrahepatic cholestasis, that the index of CG is high obviously points out existence of intrahepatic cholestasis. CG and the liver impairment are well interrelated and they are comparatively sensitive indexes of liver function. AFP reflects the regeneration of the liver cell necrosis and it means alarm to the seriousness of intrahepatic cholestasis. CA19-9 is a marker of tumor of biliary tract. The index increase through an initial observation is interrelated to the seriousness of

  3. Higher plasma bilirubin predicts veno-occlusive disease in early childhood undergoing hematopoietic stem cell transplantation with cyclosporine

    Science.gov (United States)

    Kim, Kwi Suk; Moon, Aree; Kang, Hyoung Jin; Shin, Hee Young; Choi, Young Hee; Kim, Hyang Sook; Kim, Sang Geon

    2016-01-01

    AIM: To analyze the association between plasma bilirubin levels and veno-occlusive disease (VOD) in non-adult patients undergoing hematopoietic stem cell transplantation (HSCT) during cyclosporine therapy. METHODS: A total of 123 patients taking cyclosporine were evaluated using an electronic medical system at the Seoul National University Children’s Hospital from the years 2004 through 2011. Patients were grouped by age and analyzed for incidence and type of adverse drug reactions (ADRs) including VOD. RESULTS: The HSCT patients were divided into three age groups: G#1 ≥ 18; 9 ≤ G#2 ≤ 17; and G#3 ≤ 8 years of age). The majority of transplant donor types were cord blood transplantations. Most prevalent ADRs represented acute graft-vs-host disease (aGVHD) and VOD. Although the incidences of aGVHD did not vary among the groups, the higher frequency ratios of VOD in G#3 suggested that an age of 8 or younger is a risk factor for developing VOD in HSCT patients. After cyclosporine therapy, the trough plasma concentrations of cyclosporine were lower in G#3 than in G#1, indicative of its increased clearance. Moreover, in G#3 only, a maximal total bilirubin level (BILmax) of ≥ 1.4 mg/dL correlated with VOD incidence after cyclosporine therapy. CONCLUSION: HSCT patients 8 years of age or younger are more at risk for developing VOD, diagnosed as hyperbilirubinemia, tender hepatomegaly, and ascites/weight gain after cyclosporine therapy, which may be represented by a criterion of plasma BILmax being ≥ 1.4 mg/dL, suggestive of more sensitive VOD indication in this age group. PMID:27358786

  4. 用于清除胆红素的磁性亲和分离方法%Study on Removal of Bilirubin with Magnetic Affinity Separation Technique

    Institute of Scientific and Technical Information of China (English)

    徐辉; 张国亮; 张凤宝; 王淑兰

    2003-01-01

    An affinity adsorbent, Cibacron Blue 3GA immobilized magnetic polyvinyl alcohol (PVA) microsphereswas used for bilirubin removal taking the advantage of easy separation of magnetic sorbent from the biosystem.Fe3 O4 superparamagnetic particles was synthesized with hydrothermal reaction of ferrous chloride (FeCl2) and ferricchloride (FeCl3). Such magnetic particles are then encapsulated in biocompatible PVA to form magnetic polymermicrospheres sized from 2 to 15 nm with hydroxyl groups on its surface. Cibacron Blue 3GA, a dye-ligand, wascovalently coupled with the polyvinyl alcohol through the nucleophilic reaction between the chloride of its triazinering and the hydroxyl groups of PVA molecules under alkaline condition. The affinity adsorbent carried 21.1 μmolCibacron Blue 3GA per gram magnetic polymer microspheres was used to remove unconjugated and conjugatedbilirubin from the solution which was composed of bilirubin or bilirubin and protein. After the adsorption, theadsorbent loaded with bilirubin was removed easily in the magnetic field.

  5. Indicators of inflammation and cellular damage in chronic asymptomatic or oligosymptomatic alcoholics: correlation with alteration of bilirubin and hepatic and pancreatic enzymes

    Directory of Open Access Journals (Sweden)

    Borini Paulo

    1999-01-01

    Full Text Available Biochemical and hematimetric indicators of inflammation and cell damage were correlated with bilirubin and hepatic and pancreatic enzymes in 30 chronic male alcoholics admitted into psychiatric hospital for detoxification and treatment of alcoholism. Aspartate aminotransferase, alanine aminotransferase, gamma-glutamyltransferase, alkaline phosphatase, and total bilirubin were altered, respectively, in 90%, 63%, 87%, 23% and 23% of the cases. None of the indicators of inflammation (lactic dehydrogenase, altered in 16% of the cases; alpha-1 globulin, 24%; alpha-2 globulin, 88%; leucocyte counts, 28% was correlated with alterations of bilirubin or liver enzymes. Lactic dehydrogenase was poorly sensitive for detection of hepatocytic or muscular damage. Alterations of alpha-globulins seemed to have been due more to alcohol metabolism-induced increase of lipoproteins than to inflammation. Among indicators of cell damage, serum iron, increased in 40% of the cases, seemed to be related to liver damage while creatine phosphokinase, increased in 84% of the cases, related to muscle damage. Hyperamylasemia was found in 20% of the cases and significantly correlated with levels of bilirubin, alkaline phosphatase and gamma-glutamyltransferase. It was indicated that injuries of liver, pancreas, salivary glands, and muscle occurred in asymptomatic or oligosymptomatic chronic alcoholics.

  6. Bilirubin isomer distribution in jaundiced neonates during phototherapy with LED light centered at 497 nm (turquoise) vs. 459 nm (blue)

    DEFF Research Database (Denmark)

    Ebbesen, Finn; Madsen, Poul H; Vandborg, Pernille K;

    2016-01-01

    of jaundiced neonates after 24 h of therapy with narrow-band (LED) light centered at 497 nm (turquoise) vs. 459 nm (blue), of essentially equal irradiance. MATERIALS: Eighty-three neonates (≥33 wk gestational age) with uncomplicated hyperbilirubinemia were included in the study. Forty neonates were...... difference was found between concentrations of E,Z-lumirubin. CONCLUSION: Therapy with LED light centered at 497 nm vs. 459 nm, applied with equal irradiance on the infants, resulted in a different distribution of bilirubin isomers in serum.Pediatric Research (2016); doi:10.1038/pr.2016.115.......BACKGROUND: Phototherapy using blue light is the treatment of choice worldwide for neonatal hyperbilirubinemia. However, treatment with turquoise light may be a desirable alternative. Therefore, the aim of this randomized, controlled study was to compare the bilirubin isomer distribution in serum...

  7. Modulation of defect-mediated energy transfer from ZnO nanoparticles for the photocatalytic degradation of bilirubin

    Directory of Open Access Journals (Sweden)

    Tanujjal Bora

    2013-11-01

    Full Text Available In recent years, nanotechnology has gained significant interest for applications in the medical field. In this regard, a utilization of the ZnO nanoparticles for the efficient degradation of bilirubin (BR through photocatalysis was explored. BR is a water insoluble byproduct of the heme catabolism that can cause jaundice when its excretion is impaired. The photocatalytic degradation of BR activated by ZnO nanoparticles through a non-radiative energy transfer pathway can be influenced by the surface defect-states (mainly the oxygen vacancies of the catalyst nanoparticles. These were modulated by applying a simple annealing in an oxygen-rich atmosphere. The mechanism of the energy transfer process between the ZnO nanoparticles and the BR molecules adsorbed at the surface was studied by using steady-state and picosecond-resolved fluorescence spectroscopy. A correlation of photocatalytic degradation and time-correlated single photon counting studies revealed that the defect-engineered ZnO nanoparticles that were obtained through post-annealing treatments led to an efficient decomposition of BR molecules that was enabled by Förster resonance energy transfer.

  8. Evaluation of treatment thresholds for unconjugated hyperbilirubinemia in preterm infants: effects on serum bilirubin and on hearing loss?

    Directory of Open Access Journals (Sweden)

    Christian V Hulzebos

    Full Text Available BACKGROUND: Severe unconjugated hyperbilirubinemia may cause deafness. In the Netherlands, 25% lower total serum bilirubin (TSB treatment thresholds were recently implemented for preterm infants. OBJECTIVE: To determine the rate of hearing loss in jaundiced preterms treated at high or at low TSB thresholds. DESIGN/METHODS: In this retrospective study conducted at two neonatal intensive care units in the Netherlands, we included preterms (gestational age 35 dB. RESULTS: There were 479 patients in the high and 144 in the low threshold group. Both groups had similar gestational ages (29.5 weeks and birth weights (1300 g. Mean and mean peak TSB levels were significantly lower after the implementation of the novel thresholds: 152 ± 43 µmol/L and 212 ± 52 µmol/L versus 131 ± 37 µmol/L and 188 ± 46 µmol/L for the high versus low thresholds, respectively (P<0.001. The incidence of hearing loss was 2.7% (13/479 in the high and 0.7% (1/144 in the low TSB threshold group (NNT = 50, 95% CI, 25-3302. CONCLUSIONS: Implementation of lower treatment thresholds resulted in reduced mean and peak TSB levels. The incidence of hearing impairment in preterms with a gestational age <32 weeks treated at low TSB thresholds was substantially lower compared to preterms treated at high TSB thresholds. Further research with larger sample sizes and power is needed to determine if this effect is statistically significant.

  9. Oxygen reduction reactions of the thermostable bilirubin oxidase from Bacillus pumilus on mesoporous carbon-cryogel electrodes

    International Nuclear Information System (INIS)

    This study demonstrates the bioelectrocatalytic reactions of a new bilirubin oxidase (BOD) from Bacillus pumilus on a mesoporous carbon cryogel (CCG) electrode, in the presence and absence of a mediator. BOD, physically adsorbed on the mesoporous matrix of a CCG electrode, allowed a direct electron transfer (DET) from the carbon electrode to the type I copper site of the enzyme. The current from the dioxygen reduction reaction (ORR), catalyzed by BOD, depended on the temperature and pH of the electrolyte. The mediated ORR catalyzed by BOD on CCG electrode was also investigated using osmium based redox polymers. The catalytic current on the CCG electrode modified with 0.2 mg cm−2 of hydrogel consisting of an enzyme, a redox polymer and a cross linker, was 1.8 mA cm−2, which was almost five times higher than that on a flat glassy carbon electrode for the same hydrogel composition and loading. The catalytic current linearly increased with the total amount of hydrogel on the porous carbon electrode while the catalytic current on the flat electrode was indifferent to the loading

  10. Phenobarbital and Phototherapy Combination Enhances Decline of Total Serum Bilirubin and May Decrease the Need for Blood Exchange Transfusion in Newborns with Isoimmune Hemolytic Disease

    OpenAIRE

    Mahmoud A.F. Kaabneh; Ghassan S. A. Salama; Ayoub G.A Shakkoury; Ibrahim M. H. Al-abdallah; Afrah Alshamari; Ruba A.A. Halaseh

    2015-01-01

    OBJECTIVE The objective of this study was to evaluate the effect of phenobarbital and phototherapy combination on the total serum bilirubin of the newborn infants with isoimmune hemolytic disease (IHD) and its impact on blood exchange transfusion rates. PATIENTS AND METHOD This single-blinded, prospective, randomized, controlled trial was conducted between March 2013 and December 2014 at the pediatric ward of two Military Hospitals in Jordan. A total of 200 full-term neonates with IHD were di...

  11. 新生儿胆红素脑病43例临床分析%Clinical Analysis of 43 Cases With Neonatal Bilirubin Encephalopathy

    Institute of Scientific and Technical Information of China (English)

    刘向红; 郎玉洁

    2015-01-01

    目的:了解胆红素脑病的病因及后遗症的发生情况,重视胆红素脑病的早期诊断、早期干预。方法43例胆红素脑病患儿进行病因、辅助检查、治疗、转归及随访结果进行分析研究。结果胆红素脑病的病因主要为感染占46.5%(23/43),出血占34.9%(15/43)和溶血占18.6%(8/43),后遗症的发生率为40.6%。结论应早期就诊,针对病因综合积极治疗,可减少智力落后、脑瘫等后遗症的发生。%Objective To investigate the etiology and the sequelae of bilirubin encephalopathy,pay attention to early diagnosis and early intervention of neonatal bilirubin encephalopathy.Methods 43 cases of bilirubin encephalopathy etiology,auxiliary examination,treatment,prognosis and folow-up results were analyzed.ResultsThe causes of bilirubin encephalopathy were mainly infection accounted for 46.5%(23/43),hemorrhage accounted for 34.9%(15/43)and hemolysis accounted for 18.6%(8/43),the incidence of sequelae rate was 40.6%.Conclusion Early treatment,comprehensive treatment for the cause,and can reduce mental retardation,cerebral palsy sequela.

  12. Correlations between periparturient serum concentrations of non-esterified fatty acids, beta-hydroxybutyric acid, bilirubin, and urea and the occurrence of clinical and subclinical postpartum bovine endometritis

    OpenAIRE

    Tenhagen Bernd-Alois; Drillich Marc; Kaufmann Toschi B; Heuwieser Wolfgang

    2010-01-01

    Abstract Background Postpartum endometritis in cattle is a multifactorial disease with high economic impact. Both, clinical endometritis (CE) and subclinical endometritis (SCE) result in decreased reproductive performance. Results from in vitro studies led to the implication that non-esterified fatty acids (NEFA), beta-hydroxybutyric acid (BHBA), bilirubin, and urea could be used as predictors for endometritis in veterinary practice. In this field study, we set out to establish optimal predic...

  13. Development and validation of serum bilirubin nomogram to predict the absence of risk for severe hyperbilirubinaemia before discharge: a prospective, multicenter study

    OpenAIRE

    Romagnoli Costantino; Tiberi Eloisa; Barone Giovanni; De Curtis Mario; Regoli Daniela; Paolillo Piermichele; Picone Simonetta; Anania Stefano; Finocchi Maurizio; Cardiello Valentina; Giordano Lucia; Paolucci Valentina; Zecca Enrico

    2012-01-01

    Abstract Background Early discharge of healthy late preterm and full term newborn infants has become common practice because of the current social and economic necessities. Severe jaundice, and even kernicterus, has developed in some term infants discharged early. This study was designed to elaborate a percentile-based hour specific total serum bilirubin (TSB) nomogram and to assess its ability to predict the absence of risk for subsequent non physiologic severe hyperbilirubinaemia before dis...

  14. Validation of transcutaneous bilirubin nomogram for identifying neonatal hyperbilirubinemia in healthy Chinese term and late-preterm infants: a multicenter study

    OpenAIRE

    Zhangbin Yu; Shuping Han; Jinxia Wu; Mingxia Li; Huaiyan Wang; Jimei Wang; Jiebo Liu; Xinnian Pan; Jie Yang; Chao Chen

    2014-01-01

    OBJECTIVE: to prospectively validate a previously constructed transcutaneous bilirubin (TcB) nomogram for identifying severe hyperbilirubinemia in healthy Chinese term and late-preterm infants. METHODS: this was a multicenter study that included 9,174 healthy term and late-preterm infants in eight hospitals of China. TcB measurements were performed using a JM-103 bilirubinometer. TcB values were plotted on a previously developed TcB nomogram, to identify the predictive ability for subseq...

  15. Metastable and equilibrium phase diagrams of unconjugated bilirubin IXα as functions of pH in model bile systems: Implications for pigment gallstone formation

    OpenAIRE

    Berman, Marvin D.; Carey, Martin C.

    2014-01-01

    Metastable and equilibrium phase diagrams for unconjugated bilirubin IXα (UCB) in bile are yet to be determined for understanding the physical chemistry of pigment gallstone formation. Also, UCB is a molecule of considerable biomedical importance because it is a potent antioxidant and an inhibitor of atherogenesis. We employed principally a titrimetric approach to obtain metastable and equilibrium UCB solubilities in model bile systems composed of taurine-conjugated bile salts, egg yolk lecit...

  16. Influence of Phosphatidylcholine and Calcium on Self-Association and Bile Salt Mixed Micellar Binding of the Natural Bile Pigment, Bilirubin Ditaurate.

    Science.gov (United States)

    Neubrand, Michael W; Carey, Martin C; Laue, Thomas M

    2015-11-17

    Recently [Neubrand, M. W., et al. (2015) Biochemistry 54, 1542-1557], we determined a concentration-dependent monomer-dimer-tetramer equilibrium in aqueous bilirubin ditaurate (BDT) solutions and explored the nature of high-affinity binding of BDT monomers with monomers and micelles of the common taurine-conjugated bile salts (BS). We now investigate, employing complementary physicochemical methods, including fluorescence emission spectrophotometry and quasi-elastic light scattering spectroscopy, the influence of phosphatidylcholine (PC), the predominant phospholipid of bile and calcium, the major divalent biliary cation, on these self-interactions and heterointeractions. We have used short-chain, lyso and long-chain PC species as models and contrasted our results with those of parallel studies employing unconjugated bilirubin (UCB) as the fully charged dianion. Both bile pigments interacted with the zwitterionic headgroup of short-chain lecithins, forming water-soluble (BDT) and insoluble ion-pair complexes (UCB), respectively. Upon micelle formation, BDT monomers apparently remained at the headgroup mantle of short-chain PCs, but the ion pairs with UCB became internalized within the micelle's hydrophobic core. BDT interacted with the headgroups of unilamellar egg yolk (EY) PC vesicles; however, with the simultaneous addition of CaCl2, a reversible aggregation took place, but not vesicle fusion. With mixed EYPC/BS micelles, BDT became bound to the hydrophilic surface (as with simple BS micelles), and in turn, both BDT and BS bound calcium, but not other divalent cations. The calcium complexation of BDT and BS was enhanced strongly with increases in micellar EYPC, suggesting calcium-mediated cross-bridging of hydrophilic headgroups at the micelle's surface. Therefore, the physicochemical binding of BDT to BS in an artificial bile medium is influenced not only by BS species and concentration but also by long-chain PCs and calcium ions that exert a specific rather

  17. Bilirubin UDP-Glucuronosyltransferase 1A1 (UGT1A1) Gene Promoter Polymorphisms and HPRT, Glycophorin A, and Micronuclei Mutant Frequencies in Human Blood

    Energy Technology Data Exchange (ETDEWEB)

    Grant, D; Hall, I J; Eastmond, D; Jones, I M; Bell, D A

    2004-10-06

    A dinucleotide repeat polymorphism (5-, 6-, 7-, or 8-TA units) has been identified within the promoter region of UDP-glucuronosyltransferase 1A1 gene (UGT1A1). The 7-TA repeat allele has been associated with elevated serum bilirubin levels that cause a mild hyperbilirubinemia (Gilbert's syndrome). Studies suggest that promoter transcriptional activity of UGT1A1 is inversely related to the number of TA repeats and that unconjugated bilirubin concentration increases directly with the number of TA repeat elements. Because bilirubin is a known antioxidant, we hypothesized that UGT1A1 repeats associated with higher bilirubin may be protective against oxidative damage. We examined the effect of UGT1A1 genotype on somatic mutant frequency in the hypoxanthine-guanine phosphoribosyl-transferase (HPRT) gene in human lymphocytes and the glycophorin A (GPA) gene of red blood cells (both N0, NN mutants), and the frequency of lymphocyte micronuclei (both kinetochore (K) positive or micronuclei K negative) in 101 healthy smoking and nonsmoking individuals. As hypothesized, genotypes containing 7-TA and 8-TA displayed marginally lower GPA{_}NN mutant frequency relative to 5/5, 5/6, 6/6 genotypes (p<0.05). In contrast, our analysis showed that lower expressing UGT1A1 alleles (7-TA and 8-TA) were associated with modestly increased HPRT mutation frequency (p<0.05) while the same low expression genotypes were not significantly associated with micronuclei frequencies (K-positive or K-negative) when compared to high expression genotypes (5-TA and 6-TA). We found weak evidence that UGT1A1 genotypes containing 7-TA and 8-TA were associated with increased GPA{_}N0 mutant frequency relative to 5/5, 5/6, 6/6 genotypes (p<0.05). These data suggest that UGT1A1 genotype may modulate somatic mutation of some types, in some cell lineages, by a mechanism not involving bilirubin antioxidant activity. More detailed studies examining UGT1A1 promoter variation, oxidant/antioxidant balance and

  18. Correlations between periparturient serum concentrations of non-esterified fatty acids, beta-hydroxybutyric acid, bilirubin, and urea and the occurrence of clinical and subclinical postpartum bovine endometritis

    Directory of Open Access Journals (Sweden)

    Tenhagen Bernd-Alois

    2010-10-01

    Full Text Available Abstract Background Postpartum endometritis in cattle is a multifactorial disease with high economic impact. Both, clinical endometritis (CE and subclinical endometritis (SCE result in decreased reproductive performance. Results from in vitro studies led to the implication that non-esterified fatty acids (NEFA, beta-hydroxybutyric acid (BHBA, bilirubin, and urea could be used as predictors for endometritis in veterinary practice. In this field study, we set out to establish optimal predictor cut points of these metabolic parameters for the detection of CE and SCE. Serum samples were collected one week prior to parturition (wk -1, in the first week postpartum (wk +1 and between 28 and 35 days postpartum (wk +5 from 209 Holstein-Friesian cows. At wk +5, all cows were examined for signs of CE and SCE. Results Higher concentrations of urea at wk +1 were associated with increased odds of CE (OR = 1.7, P = 0.04 in primiparous (PP cows. A predictor cut point of 3.9 mmol/L (sensitivity: 61%, specificity: 70% was determined. In multiparous (MP cows, the logistic regression model revealed that higher concentrations of NEFA at wk -1 were associated with increased odds of CE and SCE (healthy vs. CE: OR = 9.1, P = 0.05; healthy vs. SCE: OR = 12.1, P = 0.04. A predictor cut point of 0.3 mmol/L (sensitivity: 38%, specificity: 87% and sensitivity: 35%, specificity: 89%, respectively was determined. Increasing concentrations of urea at wk +5 were associated with decreased odds of CE (healthy vs. CE: OR = 0.6, P = 0.01; SCE vs. CE: OR = 0.5, P = 0.03. A predictor cut point of 3.8 mmol/L (sensitivity: 52%, specificity: 81% was determined. For BHBA and bilirubin relationships with CE or SCE were not detected. Conclusions The corresponding combinations of sensitivity and specificity of the determined predictor cut points were not satisfactory for practical use. Thus, the analysed parameters, i.e. NEFA, BHBA, bilirubin, and urea, at the chosen time points, i.e. at wk

  19. Bilirubin nomograms for identification of neonatal hyperbilirubinemia in healthy term and late-preterm infants:a systematic review and meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Zhang-Bin Yu; Shu-Ping Han; Chao Chen

    2014-01-01

    Background: Hyperbilirubinemia occurs in most healthy term and late-preterm infants, and must be monitored to identify those who might develop severe hyperbilirubinemia. Total serum bilirubin (TSB) or transcutaneous bilirubin (TcB) nomograms have been developed and validated to identify neonatal hyperbilirubinemia. This study aimed to review previously published studies and compare the TcB nomograms with the TSB nomogram, and to determine if the former has the same predictive value for signifi cant hyperbilirubinemia as TSB nomogram does. Methods: A predefined search strategy and inclusion criteria were set up. We selected studies assessing the predictive ability of TSB/TcB nomograms to identify significant hyperbilirubinemia in healthy term and latepreterm infants. Two independent reviewers assessed the quality and extracted the data from the included studies. Meta-Disc 1.4 analysis software was used to calculate the pooled sensitivity, specificity, and positive likelihood ratio of TcB/TSB nomograms. A pooled summary of the receiver operating characteristic of the TcB/TSB nomograms was created. Results: After screening 187 publications from electronic database searches and reference lists of eligible articles, we included 14 studies in the systematic review and meta-analysis. Eleven studies were of medium methodological quality. The remaining three studies were of low methodological quality. Seven studies evaluated the TcB nomograms, and seven studies assessed TSB nomograms. There were no differences between the predictive abilities of the TSB and TcB nomograms (the pooled area under curve was 0.819 vs. 0.817). Conclusions: This study showed that TcB nomograms had the same predictive value as TSB nomograms, both of which could be used to identify subsequent signifi cant hyperbilirubinemia. But this result should be interpreted cautiously because some methodological limitations of these included studies were identifi ed in this review.

  20. 新生儿小时胆红素百分位曲线图预测高胆红素血症的研究进展%Prediction of neonatal hyperbilirubinemia by the hour-specific bilirubin nomogram

    Institute of Scientific and Technical Information of China (English)

    孙小凡

    2015-01-01

    Neonatal hyperbilirubinemia,a common disease in the newborn period,account for about 8% ~ 11% in all newborns.Without getting proper controlling or being treated on time,severe hyperbilirubinemia may develop bilirubin encephalopathy leading to nerve damage and functional disability,which causes society and family problems.The hour-specific bilirubin nomogram is used to evaluate neonatal bilirubin discharge risks,intervention and follow-up.All pediatricians all over the world are focus on reducing the occurrence of bilirubin encephalopathy.In this study,we reviewed all researches about predicting the occurrence of neonatal hyperbilirubinemia after discharge using the hour-specific bilirubin nomogram which will better guide clinical diagnosis and treatment.%新生儿高胆红素血症是新生儿期的常见病,约8%~11%的新生儿发生严重的高胆红素血症.严重高胆红素血症如果没有得到及时控制和治疗,可发展为胆红素脑病,导致神经损害和功能残疾.利用小时胆红素百分位曲线图对新生儿进行出院的风险预测、干预及随访,降低胆红素脑病的发生,是国内外儿科医生关注的焦点.该文就各国制备的小时胆红素百分位曲线预测出院后高胆红素血症发生风险的研究进展作一综述,以便于小时胆红素百分位曲线更好地指导临床诊疗.

  1. Optimal time of phototherapy for newborns whose total bilirubin ranges from 75 th to 95th percentile in the hour - specific serum bilirubin nomogram%对总胆红素位于小时胆红素第75-95百分位的新生儿光疗时机的研究

    Institute of Scientific and Technical Information of China (English)

    韩金粉; 彭艳松; 刘学工

    2012-01-01

    Objective To study the optimal time of phototherapy for newborns (gestational age≥36 weeks and birth weight≥2500 g) whose total bilirubin ranges from 75th to 95th percentile in the hour - specific serum bilirubin nomogram.Methods The hour - specific serum bilirubin nomogram recommended by America in 2004 was used in this study.Newborns total serum bilirubin (TSB) values from 75th to 95th percentile were divided into 2 groups based on high -risk factors of jaundice inside 72 hours after birth:the observed group with high - risk factors of jaundice and the CK group without them.The number of TSB of the newborns TSB beyond 95th percentile outside 72 h after birth was researched in the two groups.Results Before discharge,total serum bilirubin (TSB) values of 12.8% (5/39) infants were in the high risk zone ( >95th percentile) in the CK group and of 32.2% (10/31) were in that zone in the observed group.The difference was significant ( x2 =3.876,P < 0.05 ).Conclusions Phototherapy should begin inside 72 hours after birth for the newborns with high - risk factors of jaundice and (TSB) values from 75 th to 95 th percentile,and the primary diseases should be treated actively.%目的 探讨胎龄≥36周、体质量≥2500 g、总胆红素值位于小时胆红素百分位值列线图第75~95百分位的新生儿合理光疗时机.方法 利用美国2004年推荐使用的小时胆红素百分位值列线图,将生后72 h内总胆红素值位于第75 ~95百分位的新生儿,分为有黄疸高危因素的研究组及无黄疸高危因素的对照组,比较两组新生儿生后72 h后胆红素上升至第95百分位病例数的统计学差异.结果 对照组39倒,生后72 h后总胆红素上升至第95百分位5倒,发生率为12.8% (5/39);研究组31例,生后72 h后总胆红素上升至第95百分位10例,发生率为32.2%( 10/31),差异有统计学意义(x2=3.876,P< 0.05).结论 对生后72 h内总胆红素值位于小时胆

  2. Determination of Effect of Low Dose Vs Moderate Dose of Clofibrate on the Decreasing in Serum Bilirubin Level in the Term Healthy Neonate

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    Mohammad Ashkan Moslehi

    2007-05-01

    Full Text Available Objective: This study was performed to determine the effect of low doses (25 mg/Kg vs. moderate doses (50 mg/Kg of clofibrate in treatment of non-hemolytic hyperbilirubin¬emia in healthy term neonates. Material & Methods: A clinical randomized controlled trial was performed in three groups of healthy term neonates. One group was treated with a single low dose of clofibrate (25 mg/Kg while another group received a single moderate dose (50mg/kg both orally plus phototherapy; the results were compared with those of a control group that received only phototherapy. Findings: The mean total serum bilirubin (TSB levels of 12th and 24th hours were significantly lower in the two clofibrate-treated groups as compared with the control group (P=0.002 and P=0.003, respectively. There was no statistically significant difference between the mean of TSB levels in the two clofibrate-treated groups. Treatment with clofibrate also resulted in a shorter duration of jaundice and a decreased use of phototherapy (P=0.01. No side effects were observed. Conclusion: The present study demonstrated that there was no significant difference between a low (25mg/Kg and moderate (50mg/Kg doses of clofibrate in reducing TSB levels and also decreased need of phototherapy in healthy breastfed term newborns with marked hyperbilirubin¬emia (TSB>16 mg/dL.

  3. Electrochemistry of bilirubin oxidase and its use in preparation of a low cost enzymatic biofuel cell based on a renewable composite binder chitosan

    International Nuclear Information System (INIS)

    Graphical abstract: - Abstract: Spherical carbon nanoparticles KetjenBlack (KB) with a high sorption capacity together with conductivity increasing single walled carbon nanotubes (CNTs) were “glued” together by chitosan for the preparation of a composite. A biocathode with bilirubin oxidase (BOD) adsorbed within the composite was characterised and its composition optimised. A renewable biopolymer chitosan present in the composite offered (1) pre-concentration of BOD within the matrix via electrostatic interactions, (2) favourable orientation of BOD for a direct electron transfer (DET) between BOD and the composite, (3) electrochemical visibility of 3 redox sites present in BOD, (4) low charge transfer resistance, (5) high proton conductivity and (6) low overpotential for oxygen reduction. Electrochemical investigation of BOD revealed interesting internal redox communication within the enzyme with some novel insights provided. At least one of tyrosines present in BOD seems to be involved in electron transfer route, as well. The composite used for the biocathode was directly applied for the preparation of a bioanode with fructose dehydrogenase immobilised, working in a DET mode of operation. Finally, integration of the biocathode and the bioanode into a biofuel cell operated in a reagentless and membraneless mode offered a power density of 50 μW cm−2 at 300 mV.

  4. Validation of transcutaneous bilirubin nomogram for identifying neonatal hyperbilirubinemia in healthy Chinese term and late-preterm infants: a multicenter study

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    Zhangbin Yu

    2014-06-01

    Full Text Available OBJECTIVE: to prospectively validate a previously constructed transcutaneous bilirubin (TcB nomogram for identifying severe hyperbilirubinemia in healthy Chinese term and late-preterm infants. METHODS: this was a multicenter study that included 9,174 healthy term and late-preterm infants in eight hospitals of China. TcB measurements were performed using a JM-103 bilirubinometer. TcB values were plotted on a previously developed TcB nomogram, to identify the predictive ability for subsequent significant hyperbilirubinemia. RESULTS: in the present study, 972 neonates (10.6% developed significant hyperbilirubinemia. The 40th percentile of the nomogram could identify all neonates who were at risk of significant hyperbilirubinemia, but with a low positive predictive value (PPV (18.9%. Of the 453 neonates above the 95th percentile, 275 subsequently developed significant hyperbilirubinemia, with a high PPV (60.7%, but with low sensitivity (28.3%. The 75th percentile was highly specific (81.9% and moderately sensitive (79.8%. The area under the curve (AUC for the TcB nomogram was 0.875. CONCLUSIONS: this study validated the previously developed TcB nomogram, which could be used to predict subsequent significant hyperbilirubinemia in healthy Chinese term and late-preterm infants. However, combining TcB nomogram and clinical risk factors could improve the predictive accuracy for severe hyperbilirubinemia, which was not assessed in the study. Further studies are necessary to confirm this combination.

  5. Development and validation of serum bilirubin nomogram to predict the absence of risk for severe hyperbilirubinaemia before discharge: a prospective, multicenter study

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    Romagnoli Costantino

    2012-02-01

    Full Text Available Abstract Background Early discharge of healthy late preterm and full term newborn infants has become common practice because of the current social and economic necessities. Severe jaundice, and even kernicterus, has developed in some term infants discharged early. This study was designed to elaborate a percentile-based hour specific total serum bilirubin (TSB nomogram and to assess its ability to predict the absence of risk for subsequent non physiologic severe hyperbilirubinaemia before discharge. Methods A percentile-based hour-specific nomogram for TSB values was performed using TSB data of 1708 healthy full term neonates. The nomogram's predictive ability was then prospectively assessed in five different first level neonatal units, using a single TSB value determined before discharge. Results The 75 th percentile of hour specific TSB nomogram allows to predict newborn babies without significant hyperbilirubinemia only after the first 72 hours of life. In the first 48 hours of life the observation of false negative results did not permit a safe discharge from the hospital. Conclusion The hour-specific TSB nomogram is able to predict all neonates without risk of non physiologic hyperbilirubinemia only after 48 to 72 hours of life. The combination of TSB determination and risk factors for hyperbilirubinemia could facilitate a safe discharge from the hospital and a targeted intervention and follow-up.

  6. 吸附于银胶颗粒表面的胆红素及胆绿素分子吸附取向研究%The Study of Orientations of Bilirubin and Biliverdin by Surface-enhanced Raman Spectroscopy

    Institute of Scientific and Technical Information of China (English)

    胡军; 方清; 盛蓉生; 徐知三; 曾云鹗

    2001-01-01

    胆红素、胆绿素作为重要的生物小分子被广泛研究。本文采用表面增强拉曼光谱技术获得了胆红素和胆绿素分子吸附于银胶颗粒表面的拉曼光谱。通过对其谱带的指认分析,表明胆红素形成了三对内氢键,并以其两个吡咯亚甲基酮环沿银胶颗粒表面切向方向镶嵌在银胶颗粒上,而胆绿素则以顺式-顺式-顺式构型平躺吸附于银胶颗粒表面。%The surface-enhanced Raman spectra of bilirubin and biliverdin were obtained.By the bands analysis of the spectra,the orientation of bilirubin and biliverdin on the surface of silver colloid was discussed.In such case,the bilirubin was adsorbed on the silver colloid particle with the two planar pyrromethenone groups intercalated into the globe silver colloid particle,however,the biliverdin might lie flat on the surface of silver colloid with syn-synsyn conformation.

  7. SERUM TOTAL BILIRUBIN, NOT CHOLELITHIASIS, IS INFLUENCED BY UGT1A1 POLYMORPHISM, ALPHA THALASSEMIA AND S GENOTYPE: FIRST REPORT ON COMPARISON BETWEEN ARAB-INDIAN AND AFRICAN S GENES

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    Said Y ALkindi

    2015-10-01

    Full Text Available Background: We explored the potential relationship between steady state serum bilirubin levels and the incidence of cholelithiasis in the context of UGT1A1 gene A(TAnTAA promoter polymorphism in Omani sickle cell anemia (SCA patients, homozygotes for African (Benin and Bantu and Arab-Indian bS haplotypes, but sharing the same microgeographical environment and comparable life style factors.   Methods: 136 SCA patients were retrospectively studied in whom imaging data including abdominal CT scan, MRI or Ultrasonography was routinely available. Available data on the mean steady state hematological/biochemical parameters (n=136,  bs haplotypes(n=136, a globin gene status (n=105 and UGT1A1 genotypes(n=133 were reviewed from the respective medical records.   Results: The mean serum total bilirubin level was significantly higher in the homozygous UGT1A1(AT7 group as compared to  UGT1A1(AT6 group. Strikingly, cholelithiasis was not influenced by age, gender, alpha globin genotype or bS haplotypes in this SCA cohort.   Conclusion: As observed in other population groups, the UGT1A1 (AT7 homozygosity was significantly associated with raised serum total bilirubin level, but the prevalence of gallstones in the Omani SCA patients was not associated with a thalassaemia, UGT1A1 polymorphism, or bs haplotypes.

  8. Membraneless enzymatic ethanol/O2 fuel cell: Transitioning from an air-breathing Pt-based cathode to a bilirubin oxidase-based biocathode

    Science.gov (United States)

    Aquino Neto, Sidney; Milton, Ross D.; Hickey, David P.; De Andrade, Adalgisa R.; Minteer, Shelley D.

    2016-08-01

    The bioelectrooxidation of ethanol was investigated in a fully enzymatic membraneless ethanol/O2 biofuel cell assembly using hybrid bioanodes containing multi-walled carbon nanotube (MWCNT)-decorated gold metallic nanoparticles with either a pyrroloquinoline quinone (PQQ)-dependent alcohol dehydrogenase (ADH) enzyme or a nicotinamide adenine dinucleotide (NAD+)-dependent ADH enzyme. The biofuel cell anode was prepared with the PQQ-dependent enzyme and designed using either a direct electron transfer (DET) architecture or via a mediated electron transfer (MET) configuration through a redox polymer, 1,1‧-dimethylferrocene-modified linear polyethyleneimine (FcMe2-C3-LPEI). In the case of the bioanode containing the NAD+-dependent enzyme, only the mediated electron transfer mechanism was employed using an electropolymerized methylene green film to regenerate the NAD+ cofactor. Regardless of the enzyme being employed at the anode, a bilirubin oxidase-based biocathode prepared within a DET architecture afforded efficient electrocatalytic oxygen reduction in an ethanol/O2 biofuel cell. The power curves showed that DET-based bioanodes via the PQQ-dependent ADH still lack high current densities, whereas the MET architecture furnished maximum power density values as high as 226 ± 21 μW cm-2. Considering the complete membraneless enzymatic biofuel cell with the NAD+-dependent ADH-based bioanode, power densities as high as 111 ± 14 μW cm-2 were obtained. This shows the advantage of PQQ-dependent ADH for membraneless ethanol/O2 biofuel cell applications.

  9. High baseline bilirubin and low albumin predict liver decompensation and serious adverse events in HCV-infected patients treated with sofosbuvir-containing regimens.

    Science.gov (United States)

    Perumalswami, P V; Patel, N; Bichoupan, K; Ku, L; Yalamanchili, R; Harty, A; Motamed, D; Khaitova, V; Chang, C; Grewal, P; Liu, L; Schiano, T D; Woodward, M; Dieterich, D T; Branch, A D

    2016-09-01

    To conduct surveillance and determine the safety profile of new hepatitis C virus treatments in real-world clinical practice. Hepatic decompensation and other serious adverse events were investigated in an observational cohort study of 511 patients treated with regimens containing sofosbuvir, December 2013-June 2014. Among 499 previously stable patients (no history of hepatic decompensation during the previous 12 months), a nested case-control study was performed to identify predictors of decompensation/serious adverse event. Cases and controls were matched 1:5 based on treatment regimen and duration. Matched conditional logistic regression was used for analysis. Providers scored the likelihood that events were treatment-related (scale = 0-4). The cumulative incidence of decompensation/events was 6.4% for the total cohort. Among 499 previously stable patients, the incidence of decompensation/events was 4.5%; the mortality rate was 0.6%. Sixteen of the 499 experienced one or more serious complications considered to be at least potentially treatment-related, and the sustained virological response rate was 7/16 (44%). Two cases, both on sofosbuvir/simeprevir (without interferon or ribavirin), had complications consistent with autoimmune events (score 3, 'likely treatment-related'), and one experienced a flare of autoimmune hepatitis. Compared to controls, cases had higher baseline median model for end-stage liver disease scores (14 vs 8, P < 0.01). Decompensation/events was independently associated with lower baseline albumin (OR = 0.12/g/dL, P = 0.01) and higher total bilirubin (OR = 4.31/mg/dL, P = 0.01). Reduced hepatic function at baseline increased the risk of liver decompensation/events. PMID:26989855

  10. Metastable and equilibrium phase diagrams of unconjugated bilirubin IXα as functions of pH in model bile systems: Implications for pigment gallstone formation.

    Science.gov (United States)

    Berman, Marvin D; Carey, Martin C

    2015-01-01

    Metastable and equilibrium phase diagrams for unconjugated bilirubin IXα (UCB) in bile are yet to be determined for understanding the physical chemistry of pigment gallstone formation. Also, UCB is a molecule of considerable biomedical importance because it is a potent antioxidant and an inhibitor of atherogenesis. We employed principally a titrimetric approach to obtain metastable and equilibrium UCB solubilities in model bile systems composed of taurine-conjugated bile salts, egg yolk lecithin (mixed long-chain phosphatidylcholines), and cholesterol as functions of total lipid concentration, biliary pH values, and CaCl2 plus NaCl concentrations. Metastable and equilibrium precipitation pH values were obtained, and average pKa values of the two carboxyl groups of UCB were calculated. Added lecithin and increased temperature decreased UCB solubility markedly, whereas increases in bile salt concentrations and molar levels of urea augmented solubility. A wide range of NaCl and cholesterol concentrations resulted in no specific effects, whereas added CaCl2 produced large decreases in UCB solubilities at alkaline pH values only. UV-visible absorption spectra were consistent with both hydrophobic and hydrophilic interactions between UCB and bile salts that were strongly influenced by pH. Reliable literature values for UCB compositions of native gallbladder biles revealed that biles from hemolytic mice and humans with black pigment gallstones are markedly supersaturated with UCB and exhibit more acidic pH values, whereas biles from nonstone control animals and patients with cholesterol gallstone are unsaturated with UCB. PMID:25359538

  11. Review: Bilirubin pKa studies; new models and theories indicate high pKa values in water, dimethylformamide and DMSO

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    Ostrow J

    2010-03-01

    Full Text Available Abstract Background Correct aqueous pKa values of unconjugated bilirubin (UCB, a poorly-soluble, unstable substance, are essential for understanding its functions. Our prior solvent partition studies, of unlabeled and [14C] UCB, indicated pKa values above 8.0. These high values were attributed to effects of internal H-bonding in UCB. Many earlier and subsequent studies have reported lower pKa values, some even below 5.0, which are often used to describe the behavior of UCB. We here review 18 published studies that assessed aqueous pKa values of UCB, critically evaluating their methodologies in relation to essential preconditions for valid pKa measurements (short-duration experiments with purified UCB below saturation and accounting for self-association of UCB. Results These re-assessments identified major deficiencies that invalidate the results of all but our partition studies. New theoretical modeling of UCB titrations shows remarkable, unexpected effects of self-association, yielding falsely low pKa estimates, and provides some rationalization of the titration anomalies. The titration behavior reported for a soluble thioether conjugate of UCB at high aqueous concentrations is shown to be highly anomalous. Theoretical re-interpretations of data in DMSO and dimethylformamide show that those indirectly-derived aqueous pKa values are unacceptable, and indicate new, high average pKa values for UCB in non-aqueous media (>11 in DMSO and, probably, >10 in dimethylformamide. Conclusions No reliable aqueous pKa values of UCB are available for comparison with our partition-derived results. A companion paper shows that only the high pKa values can explain the pH-dependence of UCB binding to phospholipids, cyclodextrins, and alkyl-glycoside and bile salt micelles.

  12. The relationship between transcutaneous bilirubin changes after surgery and the prognosis in biliary atresia%测定胆道闭锁术后皮肤胆红素动态变化与预后的关系

    Institute of Scientific and Technical Information of China (English)

    王文晓; 李龙; 张金山; 刘树立; 谢华伟; 明安晓; 崔龙; 周峻

    2011-01-01

    Objective To study the relationship between the post-op transcutaneous bilirubin changes after Surgery and the prognosis in children with biliary atresia. Methods Between July 2009to December 2009,52 children( 19 males and 33 female, age: 36 d~304 d, the mean age 83d, including 5cholestasis and 47 biliary atresia)with jaundice and 59 non-jaundiced children's (28 males and 31 females,aged 26 d~200 d and the mean age 119 d) were recruited for the study. The transcutaneous bilirubin and total serum bilirubin of children with jaundice and non-jaundice were measured at the same time. Twenty-three children with biliary atresia (8 males and 15 females, aged 36 d~ 127 d and the mean age 63 d) underwent Kasai operation. The children were divided into good or poor prognosis groups according to the serum bilirubin levels of 20 μmol/L three months after operation. Measurements were compared between the two groups during hospital stay. Results Linear regression oftranscutaneous bilirubin (x) correlated with that of serum bilirubin (y) (y = 0. 945x - 46. 273, P<0. 05). The 95% confidence interval of transcutaneous bilirubin in normal children was 33. 14~96. 14μmol/L. The transcutaneous bilirubin of children with good prognosis was significantly lower than that of children with poor prognosis on postoperative day 11 ( 159 μmol/L vs 205 μmol/L,P<0. 05) and 12(151 μmol/L vs 210μmol/L,P<0. 05). Postoperative average daily decline of transcutaneous bilirubin in children with good prognosis was faster (5. 04 μmol/L vs 2. 33 μmol/L, P<0. 05). Conclusions Transcutaneous bilirubin measurement is a safe and reliable method of monitoring the decline of jaundice of children with biliary atresia.%目的 初步探讨胆道闭锁患儿术后测定皮肤胆红素动态变化与黄疸消退及预后的关系.方法 2009年7月至12月,收治黄疸患儿52例,男19例,女33例,年龄36 d~304 d,平均年龄83 d,包括胆汁淤积5例,胆道闭锁47例,采血测血清胆

  13. Analysis and Treatment of Related Risk Factors of Neonatal Bilirubin Encephalopathy%新生儿胆红素脑病相关危险因素的分析与处理

    Institute of Scientific and Technical Information of China (English)

    张超雁

    2016-01-01

    目的:进一步探索新生儿胆红素脑病的相关危险因素及处理方法。方法对我院新生儿科自2008年6月~2015年8月收治的76例新生儿胆红素脑病患儿病历进行回顾性分析。结果患儿自身因素造成的新生儿胆红素性脑病前3位的危险因素包括感染因素、围产期因素和G-6-PD缺乏症,所占比率分别达到了48.68%、32.89%和10.53%。患儿自身以外因素造成新生儿胆红素性脑病最主要的因素是产妇产后住院时间不足3 d、在家自行用药和未按医生要求进行及时随访,所占比率分别为47.36%、38.16%、51.32%。结论临床上造成新生儿胆红素性脑病的危险因素是多方面的,加强围产期保健工作、做好患儿生后护理、及时发现并治疗新生儿黄疸是防止新生儿胆红素性脑病发生的关键。%Objective To explore the related risk factors and treatment methods of neonatal bilirubin encephalopathy.Methods In our new pediatric since June 2008 to August 2015 treated 76 cases of neonatal bilirubin encephalopathy patients medical records were retrospectively analyzed.ResultsIts own factors of neonatal bilirubin encephalopathy in children with risk factors for the three factors including infection,perinatal factors and G-6-PD deficiency,proportion reached 48.68%,32.89% and 48.68% respectively. The outside factors of the patients is the most important factors of neonatal bilirubin encephalopathy maternal postpartum hospitalization time less than 3 days,take medicines at home and not timely folow-up required by doctors,proportion of 47.36%,38.16% and 51.32% respectively.Conclusion Clinical risk factors of the neonatal bilirubin encephalopathy is various, strengthening perinatal health care work,completes the child postpartum nursing,timely detection and timely treatment of neonatal jaundice is the key to prevention of neonatal bilirubin encephalopathy.

  14. Endothelial cells derived from the blood-brain barrier and islets of Langerhans differ in their response to the effects of bilirubin on oxidative stress under hyperglycemic conditions

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    JaimeKapitulnik

    2012-07-01

    Full Text Available Unconjugated bilirubin (UCB is a neurotoxic degradation product of heme. Its toxic effects include induction of apoptosis, and ultimately neuronal cell death. However, at low concentrations, UCB is a potent antioxidant that may protect cells and tissues against oxidative stress by neutralizing toxic metabolites such as reactive oxygen species (ROS. High glucose levels (hyperglycemia generate reactive metabolites. Endothelial cell dysfunction, an early vascular complication in diabetes, has been associated with hyperglycemia-induced oxidative stress. Both glucose and UCB are substrates for transport proteins in microvascular endothelial cells of the blood-brain barrier (BBB. In the current study we show that UCB (1-40 M induces apoptosis and reduces survival of bEnd3 cells, a mouse brain endothelial cell line which serves as an in vitro model of the BBB. These deleterious effects of UCB were enhanced in the presence of high glucose (25 mM levels. Interestingly, the bEnd3 cells exhibited an increased sensitivity to the apoptotic effects of UCB when compared to the MS1 microcapillary endothelial cell line. MS1 cells originate from murine pancreatic islets of Langherans, and are devoid of the barrier characteristics of BBB-derived endothelial cells. ROS production was increased in both bEnd3 and MS1 cells exposed to high glucose, as compared with cells exposed to normal (5.5 mM glucose levels. While UCB (0.1-40 M did not alter ROS production in cells exposed to normal glucose, relatively low ('physiological' UCB concentrations (0.1-5 M attenuated ROS generation in both cell lines exposed to high glucose levels. Most strikingly, higher UCB concentrations (20-40 M increased ROS generation in bEnd3 cells exposed to high glucose, but not in similarly treated MS1 cells. These results may be of critical importance for understanding the vulnerability of the BBB endothelium upon exposure to increasing UCB levels under hyperglycemic conditions.

  15. Study on extraction of chenodeoxycholic acid and bilirubin fromgoose gallbladder%鹅胆汁中鹅脱氧胆酸和胆红素提取工艺研究

    Institute of Scientific and Technical Information of China (English)

    贾霖; 黄国清; 王宝维; 肖军霞

    2012-01-01

    Both chenodeoxycholic acid and bilirubin are the main active components of goose gallbladder.The chenodeoxycholic acid and bilirubin were isolated and extracted from the goose gallbladder in the same time through the steps of saponification,neutralization,delamination and so on.The effect of saponification temperature,time and sodium hydroxide concentration were determined through the single factor and orthogonal tests.The results showed that the optimum conditions were as follows:saponification temperature 90℃,1h,sodium hydroxide concentration 8%.Under these conditions,the yield of chenodeoxycholic acid reached 0.9mg/g,the yield of bilirubin reached 0.46mg/g.%鹅脱氧胆酸(CDCA)和胆红素均是鹅胆中的主要活性成分。将鹅胆通过皂化、中和、分层等步骤,同时从中分离提取出鹅脱氧胆酸和胆红素。通过单因素实验和正交实验确定了皂化温度、皂化时间和NaOH浓度的最佳条件。实验结果表明,当皂化温度为90℃,皂化时间为1h,NaOH浓度为8%时,CDCA的提取量为0.9mg/g,胆红素的提取量为0.46mg/g。

  16. Self-assembly of aqueous bilirubin ditaurate, a natural conjugated bile pigment, to contraposing enantiomeric dimers and M(-) and P(+) tetramers and their selective hydrophilic disaggregation by monomers and micelles of bile salts.

    Science.gov (United States)

    Neubrand, Michael W; Carey, Martin C; Laue, Thomas M

    2015-02-24

    The solution behavior of bilirubin ditaurate (BDT), the first naturally occurring conjugated bile pigment to be physically and chemically characterized, was assessed in aqueous solution and in monomeric and micellar solutions of common taurine-conjugated bile salts (BS). Analytical ultracentrifugation revealed that BDT self-associates in monomer-dimer equilibria between 1 and 500 μM, forming limiting tetramers at low millimolar concentrations. Self-association was enthalpically driven with ΔG values of ≈5 kcal/mol, suggesting strong hydrophobic interactions. Added NaCl and decreases in temperature shifted the oligomerization to lower BDT concentrations. On the basis of circular dichroism spectra and the limiting size of the self-aggregates, we infer that the tetramers are composed of 2P(+) and 2M(-) enantiomeric BDT pairs in "ridge-tile" conformations interacting in a "double-bookend" structure. With added monomeric BS, blue shifts in the UV-vis spectra and tight isosbestic points revealed that BDT/BS heterodimers form, followed by BDT "decorating" BS micelles mostly via hydrophilic interactions. Conformational enantiomerism, fluorescence intensities, and anisotropy, as well as resistance of the hybrid particles to disaggregation in 6 M urea, suggested that two or three hydrogen-bonding sites bound BDT monomers to the hydroxyl groups of BS, possibly via pyrrole-π-orbital-OH interactions. BDT stabilized these interactions by enveloping the BS in its "ridge-tile" pincers with variable strain that maximized van der Waals interactions. Possibly because the BDT molecule becomes highly strained with BS subtending a 7β-hydroxyl group, BDT became totally resistant to oxidation in air. This work predicts that, because of BS dissolution of the BDT self-aggregates, BS/bilirubin hybrid particles, which are stabilized hydrophilically, are likely to be the dominant mode of transport for all conjugated bilirubins in bile. PMID:25671490

  17. Analysis the Risk Factor of Bilirubin Encephalopathy of Neonatal Hyperbilirubinemia%新生儿高胆红素血症胆红素脑病的危险性因素分析

    Institute of Scientific and Technical Information of China (English)

    陈思远; 覃睿; 黄国坚; 叶军; 陈媚; 周江; 周转智

    2015-01-01

    Objective Analysis the risk factor of bilirubin encephalopathy of Neonatal .And provides the measurement to decrease hy-perbilirubinemia bilirubin encephalopathy incidence.Methods Retrospective analysis 209 neonatal hyperbilirubinemia patients′clinical data.Definite bind the score 7-9 points as acute bilirubin encephalopathy (ABE).the children ABE as the observation group (n=40 pa-tients), the rest patients as the control group (n=169 patients).Related factors that may affect the incidence of hyperbilirubinemia ABE were univariate and multivariate Logistic regression analysis, the Related factors include gender, neonatal gestational age, birth weight, mode of delivery, fetal membranes early break, feeding patterns, gestational diabetes, gestational hypertension, asphyxia or fetal distress,the peak total bilirubin, jaundice family history, RH hemolytic disease and ABO hemolytic disease.Results It was found that birth weight (OR=3.739,95%CI:1.240 -11.880), total bilirubin peak (OR=6.475,95%CI:1.724 -17.419), RH hemolytic disease(OR=11.473,95%CI:2.708-33.697)and ABO hemolytic disease (OR=9.143,95%CI:2.492-28.513)were the risk factors for neonatal hy-perbilirubinemia bilirubin encephalopathy after multivariate Logistic regression analysis, P<0.05.Conclusion Birth weight, total biliru-bin peak, RH hemolytic disease and ABO hemolytic disease are related to bilirubin encephalopathy, clinicians should strengthen Screening and treat the very low birth weight, high total bilirubin peak, accompanied by RH hemolytic disease and ABO hemolytic patients.%目的:分析新生儿高胆红素血症胆红素脑病的危险性因素,为预防高胆红素血症胆红素脑病提供思路。方法回顾性分析我院收治的209例新生儿高胆红素血症患儿临床资料,将胆红素脑病致使神经功能系统障碍( bilirubin-induced neurologic dysfunction,Bind)评分为7~9分的患儿定义为急性胆红素脑病(ABE)患儿

  18. Composição do liquido cefalorrraqueano do recem-nascido normal: citometria, proteinorraquia e bilirrubinorraquia em 79 casos Cerebrospinal fluid composition of normal newborn children: cytology, proteins, and bilirubin

    Directory of Open Access Journals (Sweden)

    Berta R. Luz

    1975-09-01

    Full Text Available Estudo do LCR de recém-nascidos a termo e de parto normal, sem intercorrências perinatais, para verificar o quanto a xantocromia é devida à bilirrubinorraquia. Foi verificado que a bilirrubinorraquia é constante na primeira semana de vida e que sua concentração: não guarda relação com a concentração proteica total do LCR e/ou com os níveis de bilirrubina no soro; não sofre influência do número de hemácias e/ou de leucócitos presente na amostra. Os valores encontrados no LCR quanto ao número de leucócitos e de hemácias e às concentrações de proteínas totais e de bilirrubina são analisados na caracterização do LCR do recém-nascido normal na primeira semana de vida.The study was made in order to verify if the bilirubin content of the cerebrospinal fluid (CSF is constant during the first week of life, and their relations to: the concentrations of total proteins in the CSF and bilirubin in the blood serum; the red blood cells and leucocytes present in the CSF sample. The study was made in 79 normal newborns without perinatal problems or obstetrical abnormalities. The gestational ages were stablished through maternal anamnesis and the clinical evaluation of the newborn was made according to the patterns established by Usher & col., Lubchenko & col. and Lubchenko. All the pregnancies were over 37 weeks. The vital conditions of the newborn immediately after the delivery were calculated according to the patterns proposed by Apgar and Apgar & James. The first complete clinical examination was made in the first twelve hours of life. The cranial sizes were situated within the limits accepted as normal. The deliveries were head-first (only two were breech presentation. The cry was immediate after birth, the breathing well established in the first minute of life and the cut of the umbelical cord was made after the first respiratory movement. The deliveries were made in delivery rooms or surgical rooms always assisted by an

  19. Relationship between serum bilirubin and diabetic retinopathy in patients with type 2 diabetes%2型糖尿病增殖期视网膜病变与血清胆红素水平关系的研究

    Institute of Scientific and Technical Information of China (English)

    冯伟; 杨金奎

    2012-01-01

    Objective To investigate the difference of serum bilirubin between non-diabetic retinopathy( NDR) in long-standing type-2 diabetes mellitus and proliferative diabetic retinopathy( PDR) . Methods Type-2 diabetic patients who were out-patient or who attended the department of endocrinology at Capital Medical University affiliated Tongren Hospital between March 2010 and December 2011 were recruited. Of all the patients, 253 had diabetic duration longer than 10 years and non-diabetic retinopathy( NDR) (male female ratio: 136/117) , and 218 had proliferative diabetic retinopathy( PDR) and diabetic duration was not restricted( male female ratio: 98/120). Comparing the level of serum bilibubin between the two groups and the significant parameters were taken to the logistic regression formula. Results Both total bilirubin and indirect bilirubin were not significantly different between the two groups(P>0. 05) , however, patients with NDR had higher direct bilirubin than those with PDR(P<0. 05). Concerning sex, male patients in NDR group had higher direct bilirubin than those with PDR. But in female patients, no significant diffenence was found. In the logistic regression analysis about diabetic retinopathy risk factors, age and direct bilirubin were protective factors; and systolic blood pressure, HbAlc were risk factors. Conclusion The level of direct bilirubin between the NDR group with diabetic duration longer than 10 years and PDR was different. Bilirubin is a natural anti-oxidant, and can play a protective role in the onset and development of diabetic retinopathy.%目的 研究2型糖尿病长病程的无糖尿病视网膜病变患者(病程≥10年)与增殖期糖尿病视网膜病变患者之间胆红素水平的差异.方法 2010年3月至2011年12月于首都医科大学附属北京同仁医院内分泌科门诊或住院治疗的2型糖尿病患者.其中病程≥10年且无糖尿病视网膜病变(non-diabetic retinopathy,NDR)的患者253例(男女比例为136

  20. 阴道分娩的断脐方法对胆红素及血红蛋白的影响%The effect of umbilical cord clamping on serum bilirubin and hemoglobin during vaginal delivery

    Institute of Scientific and Technical Information of China (English)

    王忠轩; 黄惠娟; 刘凤萍

    2011-01-01

    [ Objective ] To improve hemoglobin level but not increase serum bilirubin when the method of umbilical cord clamping is used during vaginal delivery. [Methods] Full term babys (n =120) were randomly assigned to experimental group (n =68) and control group (n =54). The umbilical cords of both groups were clamped within 30 seconds after birth. But the experimental group was clamped near the placenta and put up the distal remaining the cord untorsion in order to make the residual blood completely flow into the infants, while the control group was clamped by conventional method. The total serum bilirubin, peak-time of bilirubin, hemoglobin, hematocrit of the two groups were compared. [ Results ] The difference of serum bilirubin between two groups was not significant (P > 0.05). Hemoglobin and hematocrit of infants when birth and at 3-days of experimental group were higher than that of control group. The difference between two groups was significant (P <0.01). Hemoglobin and hematocrit of infants of experimental group at 3-days were higher than that of birth. The difference was significant (P <0.01); Hemoglobin and hematocrit of infants of control group at 3-days were also higher than that of birth, the difference was significant (P <0.05). [ Conclusion ] The method of umbilical cord clamping near the placenta within 30 seconds after birth during vaginal dehvery can not increase the incidence of jaundice induced by hyperbilirubinemia, but can improve hemoglobin level and reduce the incidence of anemia in infants.%目的 探讨断脐方法 以提高新生儿血红蛋白值但不增加胆红素值的研究.方法 对正常足月阴道分娩的新生儿120例,随机分为研究组58例和对照组62例.两组新生儿均于娩出后30 s内断脐,研究组断脐部位靠近胎盘端,并将远端抬高保持脐带不扭转,以便脐带内残余血迅速完全流入新生儿体内,再结扎处理脐部;对照组常规断脐处理残端.对两组新生儿的胆

  1. 足月显性黄疸新生儿 TcB 与血清 TSB 测定的比较%A comparison between transcutaneous bilirubin and total serum bilirubin measurement in full-term neonates with visible jaundice

    Institute of Scientific and Technical Information of China (English)

    孙立平; 王助衡; 底建辉; 张铮; 洪翠翠

    2016-01-01

    Objective To evaluate the accuracy of BiliCheck device used for measuring the levels of transcutaneous bilirubin ( TcB) in full-term neonates with visible jaundice .Methods The levels of total serum bilirubin ( TSB ) and TcB were measured by using direct spectrophotometric device and BiliCheck device , respectively .TSB was set as the reference standard .The data was analyzed by using Stata/SE 12.0 (StataCorp LP, U.S.A.) statistical programme so as to evaluate the accuracy of TcB measurement in full-term neonates with visible jaundice and to re-evaluate the guideline for jaundice in neonates .Results A total of 368 pairs of TSB/TcB samples were collected from 222 cases of neonates.The mean value of TSB and TcB was 225.4 ±25.4μmol/L and 237.9 ±21.0μmol/L, respectively. The correlation between them was poor [Pearson’s correlation coefficient was 0.439; Lin’s concordance coefficient was 0.377 (95%confidence interval ranged from 0.301 to 0.453,P<0.001].The Bland-Altman analysis demonstrated that TcB measurements tended to overestimate the value of TSB (mean difference was 12.5 ±24.9 μmol/L).The 95% limits of agreement were relatively wide (-36.2-61.3 μmol/L).Conclusion When using BiliCheck device to measure the levels of TcB and TSB in full-term neonates with visible jaundice, the correlation between TcB and TSB is poor .Thus, imprecise results are often obtained when using BiliCheck device to predict the actual level of TSB .To some extent , it has increased the possibility of requiring phototherapy during treatment .%目的:评估应用BiliCheck 设备新生儿经皮胆红素( TcB)测定的准确度。方法分别使用直接分光设备和Bili-Check设备进行测定,获得血清总胆红素(TSB)值和TcB值,以TSB为参考标准,使用Stata/SE 12.0(StataCorp LP,美国)统计方案对数据进行分析,考察健康足月显性黄疸新生儿TcB测定的准确度,并重新评估新生儿黄疸指南。结果获得222

  2. Research in the mathematical model of transcutaneous bilirubin and total serum bilirubin after phototherapy in neonates%光疗后新生儿经皮胆红素测定值与血清胆红素值数学模型研究

    Institute of Scientific and Technical Information of China (English)

    毛旭洁; 林振浪; 赵益伟; 王晓

    2015-01-01

    目的:通过建立光疗结束时遮光材料覆盖区域新生儿经皮胆红素测定值(TcB)与血清胆红素值(TSB)关系的数学模型,为临床用新生儿经皮胆红素测定值来推算实际血清胆红素值提供理论依据。方法2013年10月—2014年6月期间随机选择温州医科大学附属乐清医院新生儿科住院的病理性黄疸患儿,根据胎龄分为:足月儿组(胎龄≥37周)、晚期早产儿组(胎龄34~36+6周)和早中期早产儿组(28~33+6周)。给予单面或双面光疗,光疗时在额部、前胸部经皮胆红素检测区域用遮光材料覆盖,光疗前后测定额部、前胸部、会阴部TcB各3次,同时抽血检测TSB。结果共261例患儿纳入研究,足月儿组169例、晚期早产儿组63例、早中期早产儿组29例。光疗前,所有病例额部、前胸部、会阴部TcB值与TSB值均有显著相关性(r=0.813、0.827、0.754,P均<0.001),其中前胸部TcB值与TSB值相关性最好,因此光疗前采用新生儿前胸部TcB值与TSB值建立直线回归方程:TSB=1.35 TcB –5.50。光疗结束时,所有病例额部、前胸部、会阴部TcB值与TSB值也均有显著相关性(r=0.751、0.807、0.683,P均<0.001),其中前胸部TcB值与TSB值相关性最好,因此光疗后采用前胸部TcB值与TSB值建立直线回归方程:TSB=1.01×TcB –0.62。三组中,足月儿组较其他组相关性更佳。结论光疗结束后前胸部黑色卡纸遮盖区域的TcB值与TSB值相关性好,可以建立直线回归模型。%ObjectiveTo establish the mathematical model of transcutaneous bilirubin (TcB) and total serum bilirubin (TSB) after phototherapy in neonates.MethodsNeonates with pathological jaundice were enrolled from October 2013 to June 2014. The neonates were divided into three groups by gestational age: full-term neonates (gestation age of 37-42 weeks), late preterm neonates (gestation age of 34-36+6 weeks), early and mid-preterm neonates (gestation

  3. Clinical analysis on transcutaneous bilirubin value of normal neonates at 7 days after birth%正常新生儿生后7天经皮胆红素值的临床分析

    Institute of Scientific and Technical Information of China (English)

    王金秀; 王瑛; 江华; 张琳; 刘滢; 丁雪晶

    2011-01-01

    Objective: To provide the transcutaneous bilirubin (TcB) value of normal neonates at 7 days after birth in Changzhou region, obtain the average peak value of TcB, provide a basis for clinical diagnosis, draft an hour - specific TcB percentile nomogram suitable for the neonates in the region. Methods: 7 482 TcB values were obtained from 679 healthy full term neonates and near full term neonates by JH20 - 1B percutaneous jaundice apparatus from January to March in 2010, the detection time was from 12 hours after birth until 152 hours after birth. Every TcB percentile for each designated time was calculated and used for drafting an hour - specific nomogram. Results: TcB values varied at different time points among the normal neonates at 12 ~ 152 hours after birth, peaked at 116 hours after birth, the proportion of neonatal hyperbilirubinemia (TcB>12.9 mg/dL) was 8.4% (57/679) , no bilirubin encephalopathy occurred during follow - up after leaving the hospital TcB nomogram reflected the natural history of TcB among the normal neonates at 7 days after birth. The average peak value of bilirubin was (10.0 ±2. 2) mg/dL, the P40, P75 and P95 of bilirubin were 8. 3 mg/dL, 10. 8mg/dL and 12.6 mg/dL, respectively. Among the perinatal factors, TcB level was significantly associated with gestational age, premature rupture of membrane and cephalhematoma (P < 0. 05) . Conclusion: The appearance time and peak time of neonatal jaundice in Changzhou region are similar to the published reports at home and abroad; the diagnostic criterion of neonatal hyperbilirubinemia in China should be higher than current criterion, thus, the interventional standard of hyperbilirubinemia should be improved correspondingly.%目的:提供常州地区正常新生儿生后7天经皮胆红素(TcB)值,得出胆红素的平均峰值,为临床诊断奠定基础并制定一份适合本地区新生儿小时TcB百分位列线图.方法:2010年1~3月679例健康足月和近足月新生儿采用JH20 - 1B

  4. Cerebral palsy associated with bilirubin-encephalopathy and its precipitating factors%胆红素脑病引起的脑性瘫痪及其促发因素分析

    Institute of Scientific and Technical Information of China (English)

    侯梅; 王海桥; 孙殿荣; 王珂; 赵建慧

    2009-01-01

    目的 探讨新生儿胆红素脑病后遗脑性瘫痪的促发因素.方法 回顾分析1999年1月至2008年6月青岛市残疾儿童医疗康复中心住院治疗的脑性瘫痪患儿资料,以面谈方式填写父母调查问卷,详细询问并记录新生儿期疾病情况尤其是黄疸情况.由专科医师进行全面的神经科体格检查、常规进行脑干听觉诱发电位(ABR)检剐、格塞尔(Gesell)发育测查、脑CT或MRI检查.结果 满足诊断条件者共35例,其中男25例,女10例.年龄5个月至9岁2个月,中位值23个月.其中足月儿25例,早产儿10例.除脑性瘫痪外,16例患儿合并牙齿发育不良,6例患儿合并听觉障碍.ABR测得的听力阈值75~105 dB,均为双侧性损伤,1例合并West综合征.35例患儿中21例因"核黄疸"、"胆红素脑病"住院治疗,主要病因为ABO溶血症和感染;就诊时间以及高胆红素血症干预时问为生后2 d至生后1个月,中位值7 d;血清总胆红素(TSB)范围400.0~889.9μmol/L,中位值580.0μmol/L,其中10例进行了换血治疗,其他给予蓝光照射、输注白蛋白等.14例患儿有严重黄疸史但未曾诊治,其中7例为早产儿.结论 家长和基层医务人员对新生儿尤其早产儿黄疸重视不够,严重黄疸就诊和治疗过晚是胆红素脑病引起脑性瘫痪的促发因素.如何加强一级和二级预防是临床首要问题.%Objective To investigate the precipitating factors, clinical features and brain magnetic resonance imaging (MRI) of cerebral palsy in children with neonatal bilirubin-encephalopathy. Methods The children with cerebral palsy associated with bilirubin-encephalopathy, who had been treated between January 1999 and June 2008 in Qingdao Rehabilitation Center for Disabled Children, were retrospectively studied. Their parents were interviewed for their high risk factors, neonatal jaundice status and development history. Two neuro-pediatricians performed together a comprehensive neurologic assessment for

  5. Gilbert's syndrome: High frequency of the (TA)7 TAA allele in India and its interaction with a novel CAT insertion in promoter of the gene for bilirubin UDP-glucuronosyltransferase 1 gene

    Institute of Scientific and Technical Information of China (English)

    Shabana Farheen; Sanghamitra Sengupta; Amal Santra; Suparna Pal; Gopal Krishna Dhali; Meenakshi Chakravorty; Partha P Majumder; Abhijit Chowdhury

    2006-01-01

    AIM: To identify the variants in UDP-glucuronosyltransferase 1 (UGT1A1) gene in Gilbert's syndrome (GS) and to estimate the association between homozygosity for TA insertion and GS in India, as well as the frequency of TA insertion and its impact among normal controls in India.METHODS: Ninety-five GS cases and 95 normal controls were selected. Liver function and other tests were done. The promoter and all 5 exons of UGT1A1 gene were resequenced. Functional assessment of a novel trinucleotide insertion was done byin silico analysis and by estimating UGT1A1 promoter activity carried out by luciferase reporter assay of appropriate constructs in Hep G2 cell line.RESULTS: Among the GS patients, 80% were homozygous for the TA insertion, which was several-fold higher than reports from other ethnic groups. The mean UCB level was elevated among individuals with only one copy of this insertion, which was not significantly different from those with two copies. Many new DNA variants in UGT1A1 gene were discovered, including a trinucleotide (CAT) insertion in the promoter found in a subset (10%) of GS patients, but not among normal controls. In-silico analysis showed marked changes in the DNA-folding of the promoter and functional analysis showed a 20-fold reduction in transcription efficiency of UGT1A1 gene resulting from this insertion, thereby significantly elevating the UCB level.CONCLUSION: The genetic epidemiology of GS is variable across ethnic groups and the epistatic interactions among UGT1A1 promoter variants modulate bilirubin glucuronidation.

  6. [Maltodextrin in a 13% solution as a supplement in the first 4 days of life in breast-fed mature newborn infants. Effect on drinking behavior, weight curve, blood picture, blood glucose and bilirubin].

    Science.gov (United States)

    Rosegger, H

    1986-05-16

    200 mature healthy newborn infants (birthweight 3382 +/- 377 g) were randomly divided into 2 groups of 100 each: all were breast fed according to the guidelines recommended by 'La Leche League'. If possible breast feeding was commenced in the delivery room. When breast feeds did not suffice infants of group A were supplemented ad libitum with a fully adapted formula (67 kcal/dl), those of group B with a 13% maltodextrine solution (52 kcal, 160 mOsm/l). Total fluid intake was similar in both groups. Group A took less supplementary feeds on day 2, the caloric uptake, however, was not different from that of group B. On day 4 group A had a somewhat higher caloric uptake due to supplementation, whereas group B needed less supplementation but had a higher intake of breast milk. On day 5 all babies were entirely breast fed. No supplementation was handed over to the mothers for at home use. The frequency of breast meals and supplementary meals was almost equal for both groups, as were sucking activity, appetite and degree of saturation. 18.6% of the infants in both groups had no need for any supplementary feeding at all. Temperature, stools, weight loss, blood glucose and bilirubin (taken on day 4 simultaneously with the Guthrie test) were almost identical. The red blood cell count showed slightly higher values in group A. Supplementation with fully adapted formula was not advantageous over supplementation with 13% maltodextrine solution. The latter was, indeed, tolerated well in all cases and satisfied all infants who remained hungry after being breast fed; additional early exposure to cow-milk protein was, thus, avoided in all these cases. PMID:3727591

  7. Early steps in bilirubin-mediated apoptosis in murine hepatoma (Hepa 1c1c7) cells are characterized by aryl hydrocarbon receptor-independent oxidative stress and activation of the mitochondrial pathway.

    Science.gov (United States)

    Oakes, Garth H; Bend, John R

    2005-01-01

    Unconjugated bilirubin (UCB), the end product of heme catabolism, causes apoptosis in cells of the central nervous system, endothelial cells, and hepatotoma cells. However, the molecular mechanisms that contribute to UCB cytotoxicity remain unclear. The purpose of this study was to characterize the sequence of early events leading to UCB-mediated cytotoxicity in murine hepatoma Hepa 1c1c7 cells. In the present study, UCB (5-50 microM) was found to markedly increase the intracellular generation of reactive oxygen species (ROS) in a concentration-dependent manner, which is significantly elevated by 30 min post-treatment. This generation of ROS by UCB is not dependent on aryl hydrocarbon receptor (Ahr) signaling, as cells deficient in the Ahr (C12 cells) or the Ahr nuclear translocator protein (Arnt; C4 cells) were as efficient at generating ROS as wild type (WT) Hepa 1c1c7 cells. Mitochondrial membrane depolarization, evaluated with the lipophilic cationic dye, JC-1, occurred at least by 2 h after treatment with 50 muM UCB. Analysis of the caspase cascade demonstrated that activation of caspase-9 preceded activation of caspase-3. No conversion of procaspase-2 to active caspase-2 was detected in this study. These results demonstrate that UCB-mediated apoptosis in Hepa 1c1c7 cells is associated with increased oxidative stress and that caspase-9, and definitely not caspase-2, is the initiator caspase for apoptosis in UCB-treated Hepa 1c1c7 cells. PMID:16173058

  8. Bilirubin dysregulates myelination in early neonatal life

    OpenAIRE

    Barateiro, Andreia Pereira, 1982-

    2012-01-01

    Tese de doutoramento, Farmácia (Biologia Celular e Molecular), Universidade de Lisboa, Faculdade de Farmácia, 2012 Oligodendrocytes (OL) are neuroglial cells present in the central nervous system responsible for myelin sheath formation, that provide an electric insulation of axons fastening the transmission of electrical signals. During the neonatal period, the brain is particularly vulnerable to toxic insults, like the one induced by hyperbilirubinemia. It has been demonstrated that in th...

  9. 胆红素对成人肝移植术后急性呼吸窘迫综合征的影响%The impact of bilirubin for acute respiratory distress syndrome in post-liver transplantation adults

    Institute of Scientific and Technical Information of China (English)

    赵蔚; Victor W.Xia

    2014-01-01

    目的:回顾性分析成人肝移植患者术后急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)的发生和临床危险因素,探讨胆红素对ARDS发病和预后的影响。方法经医学伦理委员会同意,选择2004年1月1日至2011年12月31日的成人(年龄≥18岁)肝移植患者,所有数据来自加州大学洛杉矶分校(UCLA)的移植数据中心。诊断标准采用2011年ARDS柏林新定义,将患者分为ARDS组和非ARDS(No-ARDS)组两组,均采用全身麻醉。分析数据包括一般情况,实验室检查如总胆红素、肌酐、电解质(K+、Na+)及预后情况。数据分析软件采用IBM SPSS 20.0软件。结果1335例肝移植患者中有57例术后出现ARDS,发生率为4.3%;终末期肝病模型(MELD)评分和术前是否已经气管内插管两组之间差异均有统计学意义(均P<0.05)。电解质和肌酐两组间无明显差异(P>0.05)。总胆红素在术前〔(411.01±322.16)μmol/L比(250.17±271.04)μmol/L〕和术后第7天〔(164.84±146.55)μmol/L比(84.13±91.83)μmol/L〕ARDS组明显高于No-ARDS组(均P<0.05);经logistic分析,术前总胆红素≥324.9μmol/L(P=0.013,95%CI=1.164~3.578)和术后第7天总胆红素≥188.1μmol/L(P=0.001,95%CI=1.488~5.331)是ARDS发生的独立危险因素。ARDS组1年病死率明显高于No-ARDS组(6.10%比3.30%,P=0.033)。结论①肝移植术后ARDS发生率为4.3%,是多个因素作用的结果;②胆红素对ARDS的作用与剂量有关,术前总胆红素≥324.9μmol/L、术后第7天总胆红素≥188.1μmol/L是术后ARDS发生的危险因素。%Objective To retrospectively analyze the incidence and risk factors of acute respiratory distress syndrome(ARDS)in post-liver transplant adult patients, and to approach the effect of bilirubin on morbidity and prognosis of ARDS. Methods After winning institutional review board approval

  10. 健康新生儿出生后120h内经皮胆红素水平的研究%Transcutaneous measurement of bilirubin in postnatal 120 hours in healthy neonates

    Institute of Scientific and Technical Information of China (English)

    王立; 吴光声; 周芳

    2013-01-01

    目的绘制健康黄种新生儿出生后120h内经皮胆红素(TCB)水平随时间变化的TCB-时间百分位曲线图,为新生儿黄疸的评价提供依据。方法3118例健康新生儿,根据不同产式、不同胎龄及是否需要光疗分别分为顺产和剖宫产组;足月儿、早产儿和过期产儿组;非光疗组和光疗组。所有新生儿均在出生后12~120h内定时测定TCB数据。并针对不同组别的TCB改变情况作相关分析,同时绘制TCB-时间百分位曲线图。结果(1)TCB-时间百分位曲线图反映了健康黄种新生儿出生后120h内TCB水平的自然演变过程。(2)不同分娩方式对健康新生儿TCB水平的影响无统计学差异(P>0.05)。(3)足月儿与过期产儿组各个时间点TCB均值均无统计学差异(均P>0.05)。但早产儿组TCB均值于出生96h后明显大于足月儿及过期产儿组(均P<0.05)。(4)光疗组TCB增长速率虽明显大于非光疗组(P<0.05),但在出生后24h内两者百分位曲线也有潜在重叠的部分。结论TCB-时间百分位曲线反映了健康黄种新生儿生后120h内的TCB水平自然演变过程,此变化过程与血清胆红素(TSB)改变相互吻合。接近足月的健康早产儿在出院后应进行TCB定期随访,以预防高胆红素血症的发生。%Objective To develop hour- specific transcutaneous bilirubin (TCB) nomogram for healthy Chinese neonates. Methods TCB levles were measured with BiliCheck bilirubinometer from 12 to 120 postnatal hours in 3118 neonates. The neonates were divided into vaginal and cesarean groups according to delivery mode;term infants, premature infants and post-term infants groups according to gestational age;phototherapy and non- phototherapy groups according to requirement of pho-totherapy. The dynamic changes of TCB levels were analyzed, the TCB percentiles for each time points were calculated and the hour- specific nomogram was developed

  11. 参考测量程序测定血清总胆红素浓度的不确定度评定%Evaluation on measurement uncertainty of serum total bilirubin concentration by reference procedure

    Institute of Scientific and Technical Information of China (English)

    戴绘芬; 王惠民; 王建新; 季伙燕; 孟舒婷

    2016-01-01

    目的:探讨参考实验室测定血清总胆红素(TBil)的不确定度评定方法。方法应用国际检验医学溯源联合委员会(JCTLM)推荐的Doumas血清TBil参考测量程序测定国际临床化学和检验医学联合会(IFCC)参考实验室外部质量评价计划(RELA)样本,分析各不确定度分量的来源,并对各不确定度分量分别进行评定,计算合成标准不确定度,进而计算出扩展不确定度。结果2013年RELA-A样本TBil平均浓度为52.30μmol/L,合成标准不确定度为0.67μmol/L,取包含因子(k)=2、95%置信区间,则扩展不确定度为1.34μmol/L;2013年RELA-B样本TBil平均浓度为81.60μmol/L,合成标准不确定度为0.70μmol/L,取k=2、95%置信区间,则扩展不确定度为1.40μmol/L。结论依据JCTLM推荐的Doumas血清TBil参考测量程序建立的测量不确定度评定方法可满足临床实验室对血清TBil参考测量系统的要求。%ObjectiveTo investigate the evaluation method for measurement uncertainty of serum total bilirubin (TBil) concentration in clinical reference laboratories.MethodsThe International Federation of Clinical Chemistry and Laboratory Medicine(IFCC) external quality assessment scheme for reference laboratories in laboratory medicine(RELA)sample was measured by Doumas serum TBil reference procedure of the Joint Committee for Traceability in Laboratory Medicine(JCTLM),and the sources of uncertainty components were identified. The evaluation of uncertainty components was processed,and then a combined standard uncertainty was calculated. Finally,an expanded uncertainty was obtained.ResultsThe TBil average concentration of 2013 RELA-A sample was 52.30μmol/L,the combined standard uncertainty was 0.67μmol/L,the 95% confidence interval was taken,and the coverage factor(k)was 2. The expanded uncertainty was 1.34μmol/L. The TBil average concentration of 2013 RELA-B sample was 81.60μmol/L,the combined standard

  12. 不同光谱的发光二极管阵列光源照射对体外游离胆红素光化学降解效应的影响%Effect of Various Light-emitting Diode Arrays on the Efficacy of Unconjugated Bilirubin Photochemical Reaction: a Randomized Trial in Vitro

    Institute of Scientific and Technical Information of China (English)

    胡江; 李晓原; 赖兴强; 刘建中; 吴俊超; 唐琳

    2011-01-01

    Objective: To probe into effect of light-emitting diodes (LED) irradiation with differ light spectrum on the unconjugated bilirubin degradation in vitro. Methods: 500 (xL bilirubin solution of 205.2μmol/L was put into 5 mL Pyrex tube to be one sample, and 54 samples were divided into 3 groups, and then irradiated with blue, blue-green and green LEDs of identical irradiance intensity for time intervals: 0 h,0.5 h,l h,2 h,4 h,8 h separately. At last, the absorbency of each sample was determined by modified J-G assay. Results: Under the irradiation of blue, blue-green and green LEDs, the bilirubin degradation increased significantly in the irradiated groups compared to that of the control (P < 0.05), and the most effective was blue LEDs. Conclusions: Light spectrum is a key factor to influence the efficacy of LED phototherapy, and the optimal is blue (465±20) nm.%目的:探讨三种不同光谱范围的发光二极管(LED)阵列光源对体外游离胆红素降解效应的影响.方法:将500μL浓度为205.2 μmol/L的胆红素标准液封入5 mL的耐热玻璃管制成一个样本管.将所有共54个样本管分为三组,分别经相同光照强度的蓝光、蓝绿混合光和绿光LED阵列照射0h、0.5 h、1 h、2 h、4h和8h,然后通过咖啡因法检测胆红素溶液的吸光度值.结果:与空白对照组比较,蓝光、蓝绿混合光和绿光LED光照均对胆红素有明显的降解作用(P<0.05);其中又以蓝光LED的光化学降解效应最强.结论:光谱是影响新生儿黄疸LED光疗疗效的重要参数,并且蓝光(465±20)nm为LED光疗较适宜光谱范围.

  13. 新生儿小时经皮胆红素百分位曲线图预测高胆红素血症价值的多中心临床研究%Predictive value of hour-specific transcutaneous bilirubin nomogram for neonatal hyperbilirubinemia: a national multicenter study

    Institute of Scientific and Technical Information of China (English)

    新生儿高胆红素血症临床研究协作组

    2015-01-01

    Objective To assess the predictive value of hour-specific transcutaneous bilirubin (TcB) nomogram for subsequent neonatal hyperbilirubinemia.Method Thirteen tertiary class-A hospitals (including two hospitals respectively in the northeastern, northern, eastern, south, northwest, southwestern regions of China, and one in central region) participated in this multicenter study between January 1 and December 31, 2013.All TcB measurements were obtained from healthy term and near-term newborns (gestational age ≥35 weeks, birth weight ≥ 2 000 g) by the JM-103 bilirubinometer between 0 and 168 postnatal hours.Developed an hour-specific TcB bilirubin nomogram with these data.Newborns were divided into 4 groups based on the predischarge bilirubin "risk zone" (≤ P40, > P40-P75 , > P75-P95 , and > P95 as low, low-intermediate, high-intermediate and high risk zones on the hour-specific bilirubin nomogram) to predict subsequent hyperbilirubinemia.Selected bilirubin measurements of three time quantums (25-48 h,49-72 h, 73-96 h) as a predictor for the respective danger zone, and adopted ROC curve to assess the predictive ability of the TcB nomogram.Result Data from 19 601 healthy term and near-term newborns,and 2 673 cases with neonatal hyperbilirubinemia were collected.The prevalence was 13.6%.The P40, P75,and P95 peak percentile value of the hour-specific TcB nomogram was 167, 206, 253 μmol/L,respectively.The rate of rise in TcB was highest during the first 24 h of age, and the 95th percentile curve was faster than the P40 and P75 percentile curves.The areas under the ROC curves of 25-48 h, 49-72 h and 73 -96 h were respectively 0.752 0, 0.834 4, 0.856 1.During 25-48 h, 49-72 h and 73-96 h after birth, the TcB before discharge were in the high-risk zone, its prevalence was 49.4%, 67.3% , 80.4%, its likelihood ratio was 6.20, 13.0, and 27.8, respectively.Conclusion The constructed TcB nomogram shows a good predictivity for hyperbilirubinemia.%目的 评价

  14. Transcutaneous Bilirubin Levels in the First 120 Hours in Term and Near-Term Neonates%足月儿和近足月儿出生后120小时内经皮胆红素变化趋势

    Institute of Scientific and Technical Information of China (English)

    李新萍; 吴峰; 常丽; 陈卫平

    2013-01-01

    目的:提供足月和近足月新生儿出生后120h内的经皮胆红素(TcB)数据,并绘制新生儿TcB水平评估曲线图.方法:2009年8月至2012年1月在湖北省襄阳市妇幼保健院出生的2 373例新生儿中获得10 136个TcB值,所选新生儿胎龄≥35周,出生体重≥2 000 g,采用经皮胆红素仪(JH20-1C型)测量出生后6~120 h的TcB值,出生后24h内每6h测量1次,之后每12 h测量1次,每例新生儿至少有4次测量值,计算每一时段的TcB百分位数并绘制曲线图.结果:TcB百分位曲线图反映了新生儿自出生后至120 h内TcB水平,本研究经皮胆红素峰值出现时间为日龄3~5d,与国内部分研究资料相似,但百分位曲线值较高.结论:经皮小时胆红素水平用于评估新生儿高胆红素血症具有一定的价值,TcB百分位曲线图可用于对新生儿高胆红素血症进行有效的评估.%Objective: To provide the data on transcutaneous bilirubin (TcB) levels in the first 120 postnatal hours, and to develop an hour-specific bilirubin nomogram for term and near-term neonales. Methods: Ten thousand one hundred and thirty-six TcB values were collected from 2,373 neonates (gestational age≥35 weeks and birth weight ≥2,000 g) who were bom in our hospital from August 2009 to January 2012. All measurements were performed with the JH20-1C bilirubinometer at designated times from 6 to 120 postnatal hours. From the first postnatal day, TcB determinations were performed every 6 hours and thereafter every 12 hours up to the age of 120 hours. At least 4 measurements were obtained from each neonate. TcB percentiles for each designated time were calculated and used for the development of an hour-specific nomogram. Results: The TcB nomogram reflected the TcB levels in healthy neonales up to the 120 postnatal hours. In this study, transcutaneous bilirubin peak appeared in the third to fifth postnatal day. Conclusions: The hour-specific transcutaneous bilimbin nomogram was valuable in

  15. 母乳性黄疸患儿血清总胆红素和胆汁酸测定的临床意义%Clinical Significance of Detecting the Total Bilirubin and Total Bile Acid of Breast-Feeding Jaundice Infants

    Institute of Scientific and Technical Information of China (English)

    付纳新; 徐建英; 刘俊芬

    2013-01-01

    Objective To explore clinical significance of detecting the total bilirubin (TBil) and total bile acid(TBA)of breast-feeding jaundice infants. Methods From January 2011 to April 2012,a total of 66 infants with breast-feeding jaundice were included in the study(research group,n = 66) ,meanwhile,30 health infants were also accepted as control group(n = 30). Ankle saphenous vein blood sampling(2 mL) was taken from each infants. Serum TBil,TBA and cholesterol (CHO) were detected respectively in two groups. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Baotou Third Affiliated Hospital. Informed consent was obtained from the parents of each participating neonate. Results Serum TBil,TBA and CHO of neonates were significant higher in research group than those of control group (P0.05)(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准,得到该委员会批准,分组征得受试对象监护人的知情同意,并与之签署临床研究知情同意书).结果 两组新生儿血清TBil,TBA和CHO水平比较,差异均有统计学意义(P<0.001).研究组新生儿血清TBil与TBA水平呈显著正相关关系(r=0.412,P<0.05).结论 母乳性黄疸新生儿可能自身存在胆汁淤积.

  16. Correlation of blood lipids,bilirubin,uric acid and leukocyte subtypes with coronary heart disease%血脂、胆红素、尿酸及不同炎性细胞与冠心病的相关性分析

    Institute of Scientific and Technical Information of China (English)

    张灿; 丁晓梅

    2011-01-01

    Objective To explore the relationship between blood lipids, bilirubin, uric acid and leukocyte subtypes and coronary heart disease. Methods 142 patients who underwent coronary angiography were allocated into three groups:one-vessel desease group( 58 cases) ,two-vessel desease group(46 cases)and multi-vessel desease group (38 cases) ,60 patients who had normal coronary artery were chosen as control group. And the SYNTAX score was calculated,the blood lipids,bilirubin,uric acid and leukocyte subtypes were tested on admission. Results TG,LDLC and UA increased with the coronary artery lesions( P < 0.05 ) while TBiL, IBiL decreased ( P < 0.05 ). The leukocytes, monocytes and the ratio of neutrophils and lymphocyte (NLR)increased with the coronary artery lesions (P< 0.05 ) while lymphocytes decreased ( P<0.05 ). Multiple linear regression analysis showed that TG, HDL-C and UA had independent association with SYNTAX score ( the partial correlation coefficient were 0.264,-0.275,0.205, respectively, P < 0.05 ), leukocytes and NLR had indenpent association with SYNTAX score ( the partial correlation coefficient were 0.587,0.342 respectively ,P<0.05 ). Conclusion Serum TG, UA and blood leukocytes and NLR had some relationship with coronary actery lesions and its degree.%目的 探讨血脂、胆红素、尿酸及不同炎性细胞变化在冠状动脉粥样硬化性心脏病患者中的临床意义.方法 选择142例经冠脉造影证实为冠状动脉粥样硬化性心脏病的患者,按造影结果分为单支病变组(58例),双支病变组(46例)和多支病变组(38例),并设60例冠脉造影正常患者为对照组,按照SYNTAX评分系统衡量冠脉造影结果.入院时测其白细胞计数、白细胞亚型计数及比例、中性粒细胞计数/淋巴细胞计数比值(NLR)及血脂、胆红素和尿酸,分析患者血脂、胆红素、尿酸及不同炎性细胞变化的临床意义及其与SYNTAX评分的相关性.结果 随着冠脉病变支数

  17. UNCONJUGATED BILIRUBIN MEDIATED OXIDATIVE STRESS, ER STRESS, AND ACTIVATION OF NRF2 PATHWAY

    OpenAIRE

    Qaisiya, Mohammed Ali Hassan

    2014-01-01

    Elevati livelli plasmatici di bilirubina non coniugata (UCB) sono responsabili dell’ittero neontale che è fisiologico nella maggior parte dei casi. L’iperbilirubinemia severa e prolungata nel tempo può causare encefalopatia da bilirubina e Kernicterus che, se non trattati, possono lasciare pesanti sequele neurologiche e nei casi più gravi condurre a morte. La neurotossicità da bilirubina è ancora una delle principali cause di malattie neurologiche nei paesi via di sviluppo ed è un problema ri...

  18. Clinical Significance of Serum Bilirubin Detection of Patient with Coronary Heart Disease

    Institute of Scientific and Technical Information of China (English)

    TAOLi; LUORui; ZHUANGDiankui

    2004-01-01

    To explore the relation between serum bilinabin and eoronary heart disease Methods Compare the level of serum bilinabin among patients with eoronary heart disease, patients with other disease and normal persons. Results The level of serum bilinabin of patients with coronary heart disease is higher than that of normal persons. Conclusion The reduction of density of serum bihrubin is one of the independent risk factors of coronary heart disease.

  19. Molecular mechanisms of microglia reactivity to bilirubin : evaluation of potential neurological effects

    OpenAIRE

    Silva, Sandra Isabel Leitão da, 1984-

    2010-01-01

    As células da micróglia são sensores activos de dano no cérebro e rapidamente adquirem estados funcionais de activação adequados à restauração da homeostase. Durante o período neonatal o cérebro está mais vulnerável a certas lesões tais como as induzidas pela hiperbilirrubinémia, uma condição comum no recém-nascido, na qual níveis excessivos de bilirrubina não conjugada (BNC) podem atingir e lesar o cérebro. A toxicidade desencadeada pela BNC em neurónios e astrócitos já foi al...

  20. Impairment of Bilirubin Clearance and Intestinal Interleukin-6 Expression in Bile Duct-Ligated Vitamin D Receptor Null Mice

    OpenAIRE

    Ishizawa, Michiyasu; Ogura, Michitaka; Kato, Shigeaki; Makishima, Makoto

    2012-01-01

    The vitamin D receptor (VDR) mediates the physiological and pharmacological actions of 1α,25-dihydroxyvitamin D3 in bone and calcium metabolism, cellular growth and differentiation, and immunity. VDR also responds to secondary bile acids and belongs to the NR1I subfamily of the nuclear receptor superfamily, which regulates expression of xenobiotic metabolism genes. When compared to knockout mouse investigations of the other NR1I nuclear receptors, pregnane X receptor and constitutive androsta...

  1. Evaluating the Effect of Mother’s Diet in the Third Trimester of Pregnancy on the Level of Total Bilirubin in Newborns

    OpenAIRE

    A Erjaee; Habibi, A.; Z Mazloum; M Niknam; E Ghashghaie

    2016-01-01

    Introduction: Neonatal jaundice is regarded as a common problem in newborns observed in 60% of term and80% of preterm neonates. Maternal nutrition before and during pregnancy may directly influence the mothers’ health, incidence of pregnancy-related complaints, fetal development as well as risks during pregnancy. Maternal nutrition has been traditionally held to produce an effect on neonatal jaundice and it is a deep-rooted belief that hot natured  food can increase the rise of bil...

  2. Determination of Effect of Low Dose Vs Moderate Dose of Clofibrate on the Decreasing in Serum Bilirubin Level in the Term Healthy Neonate

    OpenAIRE

    Mohammad Ashkan Moslehi; Narges Pishva

    2007-01-01

    Objective: This study was performed to determine the effect of low doses (25 mg/Kg) vs. moderate doses (50 mg/Kg) of clofibrate in treatment of non-hemolytic hyperbilirubin¬emia in healthy term neonates. Material & Methods: A clinical randomized controlled trial was performed in three groups of healthy term neonates. One group was treated with a single low dose of clofibrate (25 mg/Kg) while another group received a single moderate dose (50mg/kg) both orally plus phototherapy; the results wer...

  3. Voltammetry and single-molecule in situ scanning tunneling microscopy of laccases and bilirubin oxidase in electrocatalytic dioxygen reduction on Au(111) single-crystal electrodes

    DEFF Research Database (Denmark)

    Climent, Victor; Zhang, Jingdong; Friis, Esben Peter;

    2012-01-01

    Laccases (E.C. 1.10.3.2) are multicopper oxidases catalytically active in the oxidation of diphenolics and related compounds by molecular dioxygen. The laccases contain a single-copper type I center and a trinuclear cluster of a single-copper type II and a dinuclear type III center. The oxidation...... of four equivalents of substrate near the type I copper and the sequential transfer of electrons to the trinuclear cluster are coupled with four-electron reduction of O2 to H2O at the latter site. Extensive efforts have been given to kinetic and structural characterization of numerous laccases to......)-electrode surfaces or surfaces modified by thiol-based self-assembled molecular monolayers. These well-defined surfaces enable introducing electrochemical scanning tunneling microscopy directly in aqueous biological media in which the enzymes are operative (in situ STM), to the level of resolution of the...

  4. 冠心病患者检测血清胆红素的意义%Significance of serum bilirubin detection in patients with coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    李淑翠; 李淑芬

    2004-01-01

    [目的]探讨冠心病患者检测胆红素的意义.[方法]用奥林巴斯640全自动生化分析仪钒酸盐法检测血清胆红素,用酶法检测TC、TCG,用直接法检测HDLC、LDLC,用免疫比浊法检测APOAI、APOB.[结果]冠心病组患者血清胆红素低于对照组,而TCG、LDLG、APOB均高于对照组.[结论]血清胆红素是潜在的防止冠心病的有效物质,故冠心病患者检测胆红素有重要的意义.

  5. THE ANATAGONISM OF BILIRUBIN ON DNA DAMAGE OF ICR MICE DUE TO TCE%胆红素对TCE致ICR小鼠DNA损伤的拮抗作用

    Institute of Scientific and Technical Information of China (English)

    涂程; 邰昌松; 杨青; 黎燕; 王绵珍

    2005-01-01

    目的:研究胆红素对三氯乙烯(TCE)致ICR小鼠肝、肾、外周血DNA损伤的影响.方法:应用单细胞凝胶电泳(SCGE)技术,检测TCE对ICR小鼠肝、肾、外周血细胞DNA损伤作用,同时观察20~200 μmol/L胆红素对TCE所致DNA损伤的保护作用.结果:TCE染毒组肝、肾、血细胞彗星率较对照组增加;胆红素各剂量组SCGE各指标在20~200μmol/L范围内先减小后增大,100μmol/L处最小.结论:100μmol/L左右的胆红素能较好的拮抗TCE对小鼠肾脏细胞DNA损伤.

  6. Evaluating the role of indirect bilirubin, urobilinogen and Shine AND Lal index as an alternative screening tool for beta thalassemia minor

    OpenAIRE

    Ridham A. Khanderia; Amit H Agravat

    2015-01-01

    Background: Beta thalassemia continues to be a significant burden to Western India particularly Saurashtra region of Gujarat. Since cost of treatment is high emphasis must be shifted from treatment to prevention that includes mass screening as most effective tool including RBC indices and peripheral blood smear. These tests have limited availability, re quire sophisticated equipments and are expensive. Thus, there is need for simple, low cost and reliable test which can be used in absence o...

  7. 术前减黄改善阻塞性黄疸大鼠肝功能的机制研究%The Mechanism of Preoperative Reduce Bilirubin on Improvement of Liver Function of Obstructive Jaundice in Rats

    Institute of Scientific and Technical Information of China (English)

    张清华; 胡章林; 胡景元

    2010-01-01

    目的 探讨术前减黄改善阻塞性黄疸大鼠肝功能的机制.方法 检测阻塞性黄疸大鼠(阻塞10 d)-胆管外引流组(ED组)及对照组(SO组)引流的0、1、4、7、10、14 d的肝功能,并通过反转录-聚合酶链反应法检测两组肝组织胆盐输出泵(BSEP)、多药耐药蛋白2(MRP2)、Na+信赖性的牛磺酸/钠共转运蛋白(NTCP)基因的表达.结果 阻塞10 d后ED组MRP2、NTCP基因表达减弱,与SO组相比差异有统计学意义(P<0.05),但BSEP基因表达略增强,开放引流后ED组肝功能各项指标均明显改善,引流后MBP2、NTCP基因表达明显增强,引流14 d与SO组相比差异无统计学意义(P>0.05).结论 术前减黄改善阻塞性黄疸大鼠肝功能的机制可能是增加单位体积膜转运蛋白表达.

  8. Therapeutic effect of turquoise versus blue light with equal irradiance in preterm infants with jaundice

    DEFF Research Database (Denmark)

    Ebbesen, Finn; Madsen, Poul; Støvring, Søren;

    2007-01-01

    (OSRAM L18W/860 fluorescent lamps) or blue light (Philips TL20W/52 fluorescent lamps). The concentrations of serum total bilirubin and bilirubin isomers were measured by the Vitros routine method and by HPLC, respectively. RESULTS: The decrease in serum concentrations of total bilirubin, total bilirubin...... irradiance, expressed both by serum total bilirubin, total bilirubin isomers and Z,Z-bilirubin, i.e. the turquoise spectral range is more efficient than the blue. This is in accordance with deeper penetration into the skin, lower production of the Z,E-bilirubin and greater production of E,Z-bilirubin and......AIM: To compare the efficiency of turquoise light with that of TL52 blue in treatment of preterm infants with jaundice at the same level of body irradiance. METHODS: Infants with gestational age 28-37 weeks and non-haemolytic hyperbilirubinemia were treated for 24 h with either turquoise light...

  9. Bile duct obstruction

    Science.gov (United States)

    ... the liver. It contains cholesterol, bile salts, and waste products such as bilirubin . Bile salts help your ... can lead to life-threatening infection and a dangerous buildup of bilirubin. If the blockage lasts a ...

  10. Genetic disorders associated with neonatal jaundice

    OpenAIRE

    Morioka, Ichiro; Morikawa, Satoru; Yusoff, Surini; Harahap, Indra Sari Kusuma; Nishimura, Noriyuki; Yokoyama, Naoki; Matsuo, Masafumi; Rostenberghe, Hans Van; Nishio, Hisahide

    2013-01-01

    Abstract. Neonatal jaundice is very common in newborn infants. Although it is often a natural and transitional condition, some infants develop severe hyperbilirubinemia, in which unconjugated bilirubin in the serum may cross the blood-brain-barrier and cause bilirubin encephalopathy (acute bilirubin intoxication) or kernicterus (chronic bilirubin intoxication). To avoid these hazardous conditions, it is important to identify the infants at risk for developing severe hyperbilirubinemia. There ...

  11. Phototherapy in the newborn: what’s new?

    OpenAIRE

    Murat Yurdakök

    2015-01-01

    When exposed to light, bilirubin undergoes photoisomerization which are water-soluble and can be excreted in bile and urine. Photoisomerization starts as soon as the lights turned on, and risk of bilirubin encephalopathy is lower in infants who receive phototherapy even in the same serum bilirubin levels. Blue light is absorbed most readily if bilirubin is in a tube, but skin penetration and albumin binding shift of the most effective light to blue-green region. However, there is no consensus...

  12. External Validation of the Bilirubin–Atazanavir Nomogram for Assessment of Atazanavir Plasma Exposure in HIV-1-Infected Patients

    OpenAIRE

    Rekić, Dinko; Röshammar, Daniel; Bergstrand, Martin; Tarning, Joel; Calcagno, Andrea; D’Avolio, Antonio; Ormaasen, Vidar; Vigan, Marie; Barrail-Tran, Aurélie; Ashton, Michael; Gisslén, Magnus; Äbelö, Angela

    2012-01-01

    Atazanavir increases plasma bilirubin levels in a concentration-dependent manner. Due to less costly and readily available assays, bilirubin has been proposed as a marker of atazanavir exposure. In this work, a previously developed nomogram for detection of suboptimal atazanavir exposure is validated against external patient populations. The bilirubin nomogram was validated against 311 matching bilirubin and atazanavir samples from 166 HIV-1-infected Norwegian, French, and Italian patients on...

  13. 健康新生儿经皮小时胆红素百分位列线图预测高胆红素血症的价值%Value of hour-specific transcutaneous bilirubin nomogram for prediction of hyperbilirubinemia in healthy neonates

    Institute of Scientific and Technical Information of China (English)

    石碧珍; 陈兰; 韩树萍; 陈超; 刘玲

    2016-01-01

    目的 绘制健康新生儿小时经皮胆红素(TCB)百分位列线图,评价其在预测高胆红素血症发生风险中的价值.方法 选取5250名足月儿或晚期早产儿(胎龄≥35周,出生体重≥2000 g),连续记录生后168 h TCB值.将生后24~48 h、49~72 h和73~96 h内对应最高危区TCB值作为预测指标,采用小时TCB列线图结合受试者工作特征曲线(ROC曲线)评价小时TCB列线图对高胆红素血症的预测价值.结果 小时TCB百分位列线图显示,生后16~72 h TCB快速上升明显,72 h后至144h上升逐渐减缓,144h后维持一个平稳高值,其中第95百分位(P95)小时胆红素在96 h已趋于稳定.P40、P75、P95小时TCB高峰值分别为173、217、248 μmol/L.生后24~48h、49~72 h和73~96h内TCB水平预测高胆红素血症ROC曲线下面积(AUC)分别为0.77、0.85和0.87.24~48 h、49~72 h和73~96h内高危区预测新生儿高胆红素血症患病率分别为35.03%、43.35%和79.95%,阳性似然比分别为3.35、4.75和22.70.结论 小时TCB百分位列线图结合TCB值危险区的划分可较好预测新生儿高胆红素血症的发生.73~96 h内小时胆红素若处于高危区,73~96 h后有较大可能发生高胆红索血症.

  14. Investigation of Surface-Enhanced Raman Spectra of Human Gallstones on Colloidal Silver

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    The surface-enhanced Raman scatterihg (SERS) spectra of human gallstones is investigated. Complicated Raman bands were due to multiple components that include bilirubin, bilirubinate salts, cholesterol, fatty salts and proteins. The results suggest that besides bilirubin and cholesterol, fatty salts and proteins may play an important role in the formation of gallstone. The experimental data supply an useful information for the research of the formation mechanism of gallstones.

  15. Diagnosing Jaundice by Eye-Outpatient Assessment of Conjunctival Icterus in the Newborn.

    Science.gov (United States)

    Maisels, M Jeffrey; Coffey, Mary P; Gendelman, Brian; Smyth, Mary; Kendall, Ada; Clune, Sarah; Coleman, Kimberlee; McManus, Sharon

    2016-05-01

    In pediatric office practices, we compared transcutaneous bilirubin levels in 689 newborns, age 3-10 days, with and without conjunctival icterus. In this age range, and in the absence of other clinical or laboratory indications, the presence of conjunctival icterus does not imply the need to measure the transcutaneous bilirubin or serum bilirubin level, but the absence of conjunctival icterus helps to rule out significant hyperbilirubinemia. PMID:26898809

  16. A product of heme catabolism modulates bacterial function and survival.

    Directory of Open Access Journals (Sweden)

    Christopher L Nobles

    Full Text Available Bilirubin is the terminal metabolite in heme catabolism in mammals. After deposition into bile, bilirubin is released in large quantities into the mammalian gastrointestinal (GI tract. We hypothesized that intestinal bilirubin may modulate the function of enteric bacteria. To test this hypothesis, we investigated the effect of bilirubin on two enteric pathogens; enterohemorrhagic E. coli (EHEC, a Gram-negative that causes life-threatening intestinal infections, and E. faecalis, a Gram-positive human commensal bacterium known to be an opportunistic pathogen with broad-spectrum antibiotic resistance. We demonstrate that bilirubin can protect EHEC from exogenous and host-generated reactive oxygen species (ROS through the absorption of free radicals. In contrast, E. faecalis was highly susceptible to bilirubin, which causes significant membrane disruption and uncoupling of respiratory metabolism in this bacterium. Interestingly, similar results were observed for other Gram-positive bacteria, including B. cereus and S. aureus. A model is proposed whereby bilirubin places distinct selective pressure on enteric bacteria, with Gram-negative bacteria being protected from ROS (positive outcome and Gram-positive bacteria being susceptible to membrane disruption (negative outcome. This work suggests bilirubin has differential but biologically relevant effects on bacteria and justifies additional efforts to determine the role of this neglected waste catabolite in disease processes, including animal models.

  17. Effects of thyroid status and thyrostatic drugs on hepatic glucuronidation of lodothyronines and other substrates in rats - Induction of phenol UDP-glucuronyltransferase by methimazole

    NARCIS (Netherlands)

    T.J. Visser (Ton); E. Kaptein (Ellen); A.L. Gijzel (Anthonie); W.W. de Herder (Wouter); M.L. Cannon (Mark); F. Bonthuis (Fred); W.J. de Greef (W.)

    1996-01-01

    textabstractGlucuronidation of iodothyronines in rat liver is catalyzed by at least three UDP-glucuronyltransferases (UGTs): bilirubin UGT, phenol UGT, and androsterone UGT. Bilirubin and phenol UGT activities are regulated by thyroid hormone, but the effect of thyroid status on hepatic glucuronidat

  18. REGULATION OF RAT HEPATIC DELTA-AMINOLEVULINIC ACID SYNTHETASE AND HEME OXYGENASE ACTIVITIES: EVIDENCE FOR CONTROL BY HEME AND AGAINST MEDIATION BY PROSTHETIC IRON

    Science.gov (United States)

    The effects of in vivo administration of 6 compounds on the activity of delta-aminolevulinic acid (ALA) synthetase and heme oxygenase were determined. The order of decreasing potency in reducing ALA synthetase activity was heme, bilirubin, protoporphyrin IX, bilirubin dimethyl es...

  19. [Simultaneous long-term measurement of duodenogastric reflux and gastroduodenal motility].

    Science.gov (United States)

    Thomas, H; Wilhelm, L; Petermann, J; Rosenbaum, K D; Lorenz, D

    1997-06-01

    We combined a newly developed ambulatory fiberoptic system for detecting intragastric bilirubin (Bilitec 2000, Synectics Medical Inc., Sweden) with prolonged measurement of gastroduodenal motility in 10 healthy volunteers and 10 patients followed BI resection. Circadian intragastric bilirubin exposure and the total number of tremendous changes of bilirubin absorption (more than 20%, over a period of at least 5 min) were significantly increased in the BI-resected patients (P < 0.05). In patients the interdigestive motility cycle (IMC) was characterized by the appearance of several types of abnormally propagated phase III activity fronts. Of the tremendous increases of bilirubin absorption in the patient group, 90.1% were associated with abnormally propagated phase III activity fronts. In cases of increased duodenogastric reflux, the combination of ambulatory intragastric bilirubin measurement and long-term manometry seems to be feasible to assess motility and reflux simultaneously. PMID:9324442

  20. Composition of common bile duct stones in Chinese patients during and after endoscopic sphincterotomy

    Institute of Scientific and Technical Information of China (English)

    Wei-Lun Tsai; Kwok-Hung Lai; Chiun-Ku Lin; Hoi-Hung Chan; Ching-Chu Lo; Ping-I Hsu; Wen-Chi Chen; Jin-Shiung Cheng; Gin-Ho Lo

    2005-01-01

    AIM: Endoscopic sphincterotomy (ES) is a well-established therapeutic modality for the removal of common bile duct (CBD) stones. After ES there are still around 10% of patients that experience recurrent CBD stones. The aim of this study is to investigate the composition of CBD stones before and after ES and its clinical significance in Chinese patients.METHODS: From January 1996 to December 2003, 735Veterans General Hospital and stone specimens from 266patients were sent for analysis. Seventy-five patients had recurrent CBD stones and stone specimens from 44patients were sent for analysis. The composition of the stones was analyzed by infrared (IR) spectrometry and they were classified as cholesterol or bilirubinate stones according to the predominant composition. Clinical data were analyzed.RESULTS: In the initial 266 stone samples, 217 (82%)were bilirubinate stones, 42 (16%) were cholesterol stones,3 were calcium carbonate stones, 4 were mixed cholesterol and bilirubinate stones. Patients with bilirubinate stones were significantly older than patients with cholesterol stones (66±13 years vs 56±17 years, P= 0.001). In the 44 recurrent stone samples, 38 (86%) were bilirubinate stones, 3 (7%) were cholesterol stones, and 3 were mixed cholesterol and bilirubinate stones. In 27 patients, bothinitial and recurrent stone specimens can be obtained,23 patients had bilirubinate stones initially and 2 became cholesterol stones in the recurrent attack. In the four patients with initial cholesterol stones, three patients had bilirubinate stones and one patient had a cholesterol stone in the recurrent attack.CONCLUSION: Bilirubinate stone is the predominant composition of initial or recurrent CBD stone in Chinese patients. The composition of CBD stones may be different from initial stones after ES.

  1. Synthesis of 8-(ω-Chloroalkyl)-dipyrrinones

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    @@ Dipyrrinones,typically bright yellow compounds with a long axis-polarized π-π* excitation in the 14π-electron-conjugated chromophore,such as xanthobilirubic acid methyl ester(XBRMe),are useful building blocks for the syntheses of biologically important tetrapyrrole pigments such as bilirubin(the yellow pigment of jaundice)[1],and they have been extensively used as model dipyrrole pigments for the spectroscopic and the photochemical studies of liner tetrapyrroles such as bilirubin and biliverdin.They have also served as useful adjuncts in the studies of jaundice phototherapy and in bilirubin structure-biological function relationships[2].

  2. Uniform treatment thresholds for hyperbilirubinemia in preterm infants : Background and synopsis of a national guideline

    NARCIS (Netherlands)

    van Imhoff, Deirdre Elisabeth; Dijk, Peter Hendrik; Hulzebos, Christian Victor

    2011-01-01

    Background: To prevent severe hyperbilirubinemia and bilirubin neurotoxicity, the American Academy of Pediatrics' management guideline for hyperbilirubinemia in near term infants is used worldwide. A leading guideline for jaundiced preterm infants is lacking whereas the risk on severe hyperbilirubin

  3. Uniform treatment thresholds for hyperbilirubinemia in preterm infants: background and synopsis of a national guideline

    NARCIS (Netherlands)

    Imhoff, D.E. van; Dijk, P.H.; Hulzebos, C.V.; Liem, K.D.

    2011-01-01

    BACKGROUND: To prevent severe hyperbilirubinemia and bilirubin neurotoxicity, the American Academy of Pediatrics' management guideline for hyperbilirubinemia in near term infants is used worldwide. A leading guideline for jaundiced preterm infants is lacking whereas the risk on severe hyperbilirubin

  4. ALP (Alkaline Phosphatase) Test

    Science.gov (United States)

    ... Also known as: ALK PHOS; Alkp Formal name: Alkaline Phosphatase Related tests: AST ; ALT ; GGT ; Bilirubin ; Liver Panel ; Bone Markers ; Alkaline Phosphatase Isoenzymes; Bone Specific ALP All content on ...

  5. Jaundice

    Science.gov (United States)

    ... Autoimmune hepatitis Bile Biliary atresia Biliary stricture Bilirubin blood test Cholestasis Delta agent (Hepatitis D) Dubin-Johnson syndrome Gallstones Gilbert disease Hemolytic anemia Hepatitis A Hepatitis B Hepatitis C Malaria Newborn jaundice Pancreatic cancer Primary ...

  6. Neonatal Hyperbilirubinemia in infants with G6PD c.563C > T Variant

    OpenAIRE

    Moiz Bushra; Nasir Amna; Khan Sarosh; Kherani Salima; Qadir Maqbool

    2012-01-01

    Abstract Background There is a strong correlation between glucose-6-phosphate dehydrogenase (G6PD) deficiency and neonatal hyperbilirubinemia with a rare but potential threat of devastating acute bilirubin encephalopathy. G6PD deficiency was observed in 4–14% of hospitalized icteric neonates in Pakistan. G6PD c.563C > T is the most frequently reported variant in this population. The present study was aimed at evaluating the time to onset of hyperbilirubinemia and the postnatal bilirubin traje...

  7. Montelukast induced acute hepatocellular liver injury

    OpenAIRE

    Harugeri A; Parthasarathi G; Sharma J; D′Souza G; Ramesh M

    2009-01-01

    A 46-year-old male with uncontrolled asthma on inhaled albuterol and formoterol with budesonide was commenced on montelukast. He developed abdominal pain and jaundice 48 days after initiating montelukast therapy. His liver tests showed an increase in serum total bilirubin, conjugated bilirubin, aspartate aminotranferase, alanine aminotranferase, and alkaline phosphatase. The patient was evaluated for possible non-drug related liver injury. Montelukast was discontinued suspecting montelukast i...

  8. Facility-based constraints to exchange transfusions for neonatal hyperbilirubinemia in resource-limited settings

    OpenAIRE

    Mabogunje, Cecilia A.; Olaifa, Sarah M; Olusanya, Bolajoko O

    2016-01-01

    Several clinical guidelines for the management of infants with severe neonatal hyperbilirubinemia recommend immediate exchange transfusion (ET) when the risk or presence of acute bilirubin encephalopathy is established in order to prevent chronic bilirubin encephalopathy or kernicterus. However, the literature is sparse concerning the interval between the time the decision for ET is made and the actual initiation of ET, especially in low- and middle-income countries (LMICs) with significant r...

  9. Effect of phototherapy with alumunium foil reflectors on neonatal hyperbilirubinemia

    OpenAIRE

    Tony Ijong Dachlan; Tetty Yuniati; Abdurachman Sukadi

    2015-01-01

    Background Neonatal hyperbilirubinemia (NH) is one of the most common problems in neonates, but it can be treated with blue light phototherapy. Developing countries with limited medical equipment and funds have difficulty providing effective phototherapy to treat NH, leading to increased risk of bilirubin encephalopathy. Phototherapy with white reflecting curtains can decrease the duration of phototherapy needed to reduce bilirubin levels. Objective To compare the duration of phototherapy...

  10. Effect of phototherapy with alumunium foil reflectors on neonatal hyperbilirubinemia

    OpenAIRE

    Tony Ijong Dachlan; Tetty Yuniati; Abdurachman Sukadi

    2016-01-01

    Background Neonatal hyperbilirubinemia (NH) is one of the most common problems in neonates, but it can be treated with blue light phototherapy. Developing countries with limited medical equipment and funds have difficulty providing effective phototherapy to treat NH, leading to increased risk of bilirubin encephalopathy. Phototherapy with white reflecting curtains can decrease the duration of phototherapy needed to reduce bilirubin levels. Objective To compare the duration of phototherapy nee...

  11. Comparison of Two Phototherapy Methods (Prophylactic vs Therapeutic) for Management of Hyperbilirubinemia in Very Low Birth Weight Newborns

    OpenAIRE

    Seyedeh-Sarah Nazem-Sadati; Majid Mohammadizadeh; Ramin Iranpour

    2011-01-01

    Objective: Preterm and low birth weight (LBW) infants are at greater risk of developing bilirubin-associated brain damage compared with term infants. Certainly, phototherapy, if used appropriately, is capable of controlling the bilirubin levels in LBW infants; but there is not a unique phototherapy treatment strategy in LBW infants. This study was designed to compare the prophylactic phototherapy and late treatment of jaundiced newborns weighing 1000-1500 grams.Methods: Sixty newborns with bi...

  12. The effect of clofibrate with phototherapy in late pre-term newborns with non-hemolytic jaundice

    OpenAIRE

    Sakha Sedigheh Hossein; Gharehbaghi Manizheh; Rahbani Mohammad

    2009-01-01

    Background : Despite an understanding of the enzymatic pathways leading to bilirubin production and degradation, very few pharmacologic interventions are utilized and the mainstay of treatment remains phototherapy. Aims : To evaluate the efficacy of clofibrate in reducing total serum bilirubin levels in late pre-term neonates with non-hemolytic jaundice. Design and Setting : Double-blind, placebo-controlled, randomized trial; tertiary level neonatal unit. Materials and Methods : A randomized...

  13. Newborn's light treatment: Phototherapy

    OpenAIRE

    Canbulat, Nejla; DEMİRGÖZ, Meltem

    2009-01-01

    Neonatal jaundice results from some changes in bilirubin metabolism and increase in bilirubin production. Hyperbilirubinemia occurs in 80% of preterm neonatals and 40-60% of term neonatals. Hyperbilirubinemia is treated by using the phototherapy and in severe cases via blood transfusions. The history of phototherapy dates back to the summer of 1956 by Miss J. Ward who worked as a charge nurse at Rochford General Hospital Premature Service in Essex, England. Although the phototherapy has been ...

  14. Efektivitas Fototerapi Tunggal Dibandingkan Fototerapi Ganda Pada Neonatus Dengan Hiperbilirubinemia Indirek

    OpenAIRE

    Milyana, Nanda Susanti

    2011-01-01

    Background: Hyperbilirubinemia is one of the most common problems in term newborns and the phototherapy is the most widespread treatment for lowering bilirubin concentration in neonates. The double phototherapy unit could increase effectiveness of phototherapy. Objective: To compare the effectiveness of single phototherapy and double phototherapy in decreasing serum bilirubin and increasing spectral irradiance Methods: An open, randomized controlled trial was conducted at both H. Ada...

  15. Comparison of light emitting diode phototherapy and double standard conventional phototherapy for nonhemolytic neonatal hyperbilirubinemia

    OpenAIRE

    Uraş, Nurdan

    2009-01-01

    Aim: To compare the efficacies and the rebound bilirubin levels of infants who received light emitting diode phototherapy and double standard conventional phototherapy. Materials and Methods: One hundred twenty-three healthy term and near term (>=35 weeks) infants requiring phototherapy for non-hemolytic hyperbilirubinemia were enrolled in the study. All infants' gestational age, type of feeding, age at phototherapy, total serum bilirubin level at initiation and termination of phot...

  16. Single and Double Versus Intensive Phototherapy in Term Newborns with Severe Hyperbilirubinemia

    OpenAIRE

    A Mazlomi; R. Alizadeh; M Fuladinejat; M Ahmadpour; Y Zahedpasha

    2006-01-01

    Background: Hyperbilirubinemia is one of the most common problems in term newborns and the phototherapy is the most widespread treatment for lowering bilirubin concentration in neonates. The purpose of this study is to compare the effectiveness of conventional phototherapy, double phototherapy and intensive phototherapy in decreasing serum bilirubin. Methods: This interventional study was done on 60 neonates divided randomly in three groups. Infants in group 1 received conventional photothera...

  17. Jaundice: a basic review

    OpenAIRE

    Muhammad Waseem Abbas; Talha Shamshad; Muhammad Aizaz Ashraf; Rukhsar Javaid

    2016-01-01

    Jaundice is a complex disease. Jaundice is actually the high bilirubin level in the body. Yellowing of skin, mucous membranes and skin are common presentations of jaundice. Jaundice has various variants including pre-hepatic jaundice (due to hemolysis of red blood cells), hepatic jaundice (due to defect in capture, conjugation and excretion of bilirubin by liver) and post hepatic jaundice (due to the obstruction of extra hepatobiliary system). The causes of various variants of Jaundice is eit...

  18. HEPATOTOXICITY OF EUGENOL

    OpenAIRE

    Soundran, Vijaya; Namagiri, Tara; Manonayaki, S.; Vanithakumari, G.

    1994-01-01

    EUGENOL a widely used pharmaceutical agent proceeds toxicity on inhalation in rats. Two different doses 20 & 30 μg/100g body weight/ day of eugenol were given intramuscularly to male albino rats for 10 days and the liver function was assessed by measuring the specific enzyme activities, and total and differential bilirubin concentration. There was an appreciable increase in total as well as differential bilirubin fractions and a dose dependent increase was noticed in the activities of alkalin...

  19. Evaluation of the hepatotoxic potential of minocycline.

    OpenAIRE

    Böcker, R.; Estler, C J; Ludewig-Sandig, D

    1991-01-01

    Minocycline (25 to 100 micrograms/g) dose dependently increased serum glutamic oxalacetic transaminase, urea, and bilirubin levels, and the hepatic triglyceride content in mice. In animals pretreated with phenobarbital to enhance minocycline metabolism, the effects on liver triglycerides were attenuated, while the changes in serum glutamic oxalacetic transaminase, urea, and bilirubin were enhanced. It is concluded that part of the toxic effects of minocycline may be produced by a metabolite o...

  20. Treatment of neonatal jaundice - more than phototherapy and exchange transfusions

    OpenAIRE

    Erlandsen, Marie Andersen; Hansen, Thor Willy Ruud

    2013-01-01

    Abstract. Jaundice is the most common reason for doing blood tests and starting therapy in newborn infants. In some neonates serum bilirubin levels may become excessively high, and in rare instances this may lead to brain damage (kernicterus). In such cases it is important to start treatment quickly. Herein we will discuss various approaches through which serum bilirubin levels may be reduced, thus potentially preventing brain damage. This paper is based on relevant publications found through...

  1. The jaundiced newborn: which early monitoring for a safe discharge?

    OpenAIRE

    S. Pratesi; Dani, C

    2013-01-01

    Neonatal jaundice is one of the most common causes of prolonged hospital stay or readmission of a near-term or term baby. Reason of concern at early discharge of a jaundiced newborn is that of bilirubin neurotoxicity, even if a serum bilirubin concentration surely toxic for the brain is still unknown. Kernicterus and severe neonatal hyperbilirubinemia are still problems in the third millennium and the American Academy of Pediatrics claimed the pediatric community to increase vigilance in orde...

  2. Therapeutic Effect of Agaricus brasiliensis on Phenylhydrazine-Induced Neonatal Jaundice in Rats

    OpenAIRE

    Lan Zhang; Bo Yuan; HuiPing Wang; Ya Gao

    2015-01-01

    The present study was designed to investigate the effect of Agaricus brasiliensis extract (ABE) on phenylhydrazine-induced neonatal jaundice in rats. Administration of ABE dose-dependently reduced the elevated bilirubin level induced by phenylhydrazine. It can be somewhat supported from the results of in vitro bilirubin degradation experiment. ABE treatment also reduced the total antioxidant status (TAOS), cascade O2 −/SOD, level of NF-κB protein, and adrenomedullin (AM). Overall, the results...

  3. Spectrophotometry for cerebrospinal fluid pigment analysis

    OpenAIRE

    Petzold, A.; Sharpe, L. T.; Keir, G

    2006-01-01

    The use of spectrophotometry for the analysis of the cerebrospinal fluid (CSF) is reviewed. The clinically relevant CSF pigments--oxyhemoglobin and bilirubin--are introduced and discussed with regard to clinical differential diagnosis and potentially confounding variables (the four T's: traumatic tap, timing, total protein, and total bilirubin). The practical laboratory aspects of spectrophotometry and automated techniques are presented in the context of analytical and clinical specificity an...

  4. Jaundice and wound healing: a tissue-culture study.

    OpenAIRE

    Taube, M.; Elliot, P.; Ellis, H.

    1981-01-01

    The effects of jaundice on wound healing have been studied by growing fibroblasts, in vitro, in normal culture media, in culture media to which bilirubin has been added, and in culture media containing sera from jaundiced patients. It has been found that the addition of bilirubin to the culture media causes morphological changes in the fibroblasts, and impairs the growth of cells. The addition of jaundiced human sera to the culture also causes similar changes.

  5. Measurements of intracellular calcium

    International Nuclear Information System (INIS)

    Intracellular calcium concentration ([Ca2+]i) has been measured in cultured cells by using Fura-2 load cells and a computer-controlled Perkin Elmer LS-5B spectrofluorometer. Increased [Ca2+]i in cells exposed to extracellular bilirubin was observed both with and without extracellular calcium. However, the increase was considerable larger with extracellular calcium. The enhancement of [Ca2+]i became smaller with decreasing bilirubin/BSA (bovine serum albumine) ratio. 5 refs., 5 figs

  6. Fetal fluid and protein dynamics

    OpenAIRE

    Pasman, Suzanne

    2010-01-01

    In this thesis fetal fluid and protein dynamics are investigated to gain insight in fetal (patho-)physiology. Studies were performed in fetuses with severe anemia and/or hydrops fetalis. Measurements were performed in fetal blood or amniotic fluid, obtained before or during intrauterine transfusion. The severity of anemia can be predicted by measurement of bilirubin in amniotic fluid. We showed that this concentration is based on bilirubin in fetal blood and on albumin concentrations. Albumin...

  7. Preparation of Chitosan-coated Nylon Membranes and their Application as Affinity Membranes

    Institute of Scientific and Technical Information of China (English)

    Wei SHI; Feng Bao ZHANG; Guo Liang ZHANG

    2005-01-01

    Chitosan-coated nylon membranes which possess a large number of reactive groups of-CH2OH and -NH2 were prepared by coupling chitosan onto the nylon membrane. Then polylysine as ligand was also immobilized onto the composite membranes by 1, l′-carbonyldiimidazole activation to prepare affinity membranes for bilirubin adsorption. The results showed that these membranes exhibited high binding affinity capacities for bilirubin and the adsorption isotherm fitted the Freundlich model well.

  8. Identification of cellular targets for specific therapies in neurodevelopmental disorders

    OpenAIRE

    Vaz, Ana Rita Mendonça, 1984-

    2010-01-01

    Tese de doutoramento, Farmácia (Biologia Celular e Molecular), Universidade de Lisboa, Faculdade de Farmácia, 2010 The present dissertation is focused in neonatal hyperbilirubinemia, a very common condition in the neonatal period, characterized by increased concentrations of unconjugated bilirubin (UCB). High levels of UCB may lead to bilirubin-induced neurologic dysfunction (BIND), particularly in premature infants, which may be a starting point to the appearance of long-term ...

  9. OXYTOCIN INDUCED NEONATAL HYPERBILIRUBINEMIA

    Directory of Open Access Journals (Sweden)

    Smita S.

    2015-05-01

    Full Text Available INTRODUCTION: Hyperbilirubinemia is one of the most common causes of health problems, observed in 60% of term and 80% of preterm infants in the first week of life . Hyperbilirubinemia leads to neurotoxicity in severe condition. Some studies suggests that liberal use of oxytocin for inducing labour is one of the factor which lead to neonatal hyperbilirubinemia. OBJECTIVE: To compare the effect of oxytocin and neonatal bilirubin levels with spontaneous vaginal delivery . MATERIALS AND METHOD S : 100 full term parturients were selected for this study. The subjects were divided into two groups. 50 healthy babies of women who had oxytocin induced labour and 50 healthy babies of women with normal vaginal delivery following spontaneous onset of labour formed the control group. Neon atal serum bilirubin was measured on day 1, 3 and 5 after delivery. Bilirubin was measured by spectrophotometry. Data was analysed in ms excel sheet using spss 19.0v. Statistical analysis was done by using unpaired‘t’ test. RESULTS: There was significant i ncrease in bilirubin level in oxytocin induced group compared to control group on day 1 and 3. There was insignificant increase in bilirubin level in oxytocin induced group on day 5. However the level of serum bilirubin is within normal limits as bilirubin level normally rises on till 4 th day and decreases thereafter. CONCLUSION: Neonatal hyperbilirubinemia may be due to oxytocin administration by continues IV infusion which results in erythrocyte swell and rupture. Increase in bilirubin level in oxytocin i nduced group is within physiological limits

  10. Marked Direct Hyperbilirubinemia due to Ceftriaxone in an Adult with Sickle Cell Disease

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    Daniyeh Khurram

    2015-01-01

    Full Text Available Drugs are a significant cause of liver injury. Drug-induced liver injury (DILI can cause acute hepatitis, cholestasis, or a mixed pattern. Ceftriaxone is a commonly used antibiotic and has been associated with reversible biliary sludge, pseudolithiasis, and cholestasis. A 32-year-old male with sickle cell disease was admitted to the hospital for acute sickle cell crisis. On the second day of hospitalization, he developed cough and rhonchi with chest X-ray revealing right middle lobe infiltrates. Ceftriaxone and azithromycin were initiated. Subsequently, he developed conjugated hyperbilirubinemia and mild transaminitis. His total bilirubin trended upwards from 3.3 mg/dL on admission to 17 mg/dL. It was predominantly conjugated bilirubin, with preadmission bilirubin levels of 3-4 mg/dL. His transaminases were mildly elevated as well compared to previous levels. Extensive workup for bilirubin elevation was unremarkable. Ceftriaxone was switched to levofloxacin and the hyperbilirubinemia improved. On ambulatory follow-up, his bilirubin remained below 4 mg/dL. Ceftriaxone may be associated with marked direct hyperbilirubinemia particularly in sickle cell patients with chronic liver chemistry abnormalities. In the case of elevated bilirubin with concomitant ceftriaxone use, elimination of the offending agent should be considered.

  11. ESTIMATION OF MALONDIALDEHYDE AND VITAMIN-E LEVELS IN NEONATAL HYPERBILIRUBINEMIA BEFORE AND AFTER PHOTOTHERAPY

    Directory of Open Access Journals (Sweden)

    Sidrah, Tandrapad Priyanka, Asiya Naaz, Lakshmi Chaitanya G, Sridevi D

    2015-07-01

    Full Text Available Background: Hyperbilirubinemia is a common and benign problem in neonates worldwide. It is observed during the 1st week of life in approximately 60% of term neonates and 80% of preterm neonates. Phototherapy is most widely used as therapy for unconjugated hyperbilirubinemia. Phototherapy is related to oxidative stress and lipid peroxidation. The present study is undertaken to establish the relation between anti-oxidant status and the marker of lipid peroxidation in neonatal hyperbilirubinemia before and after phototherapy. Objectives: To estimate the levels of MDA (malondialdehyde and vit-E levels in neonatal hyperbilirubinemia before and after phototherapy. Material and Methods: A total of 30 patients were eligible for the study who met the inclusion and exclusion criteria. Blood sample was collected from neonates of preterm/full term age 1 to 10 days with hyperbilirubinemia undergoing phototherapy. Total Bilirubin, Direct Bilirubin, MDA and vit-E levels were estimated in serum by thiobarbituric acid (TBA method and Backer and Frank’s Method respectively. Results: The present study showed increase in Total bilirubin, Direct bilirubin, MDA and decrease in vit-E levels before phototherapy when compared to control group and same subjects after phototherapy showed decrease in Total bilirubin and Direct bilirubin, MDA and a further decrease in vit-E levels. Conclusion: From these results it is concluded though phototherapy had a beneficial effect in treatment of neonatal hyperbilirubinemia, supplementation of vit-E is necessary in addition to phototherapy.

  12. A Comparison of Y-Type and T-Type Metallic Bilateral Biliary Stents in Patients with Malignant Hilar Biliary Obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Koh, Esther; Jin, Gong Yong; Hwang, Seung Bae; Choi, Eun Jung; Song, Ji Soo; Han, Young Min; Kwon, Keun Sang [Dept. of Chonbuk National University Hospital and Medical School, Jeonju (Korea, Republic of)

    2013-04-15

    To compare the Y type (side-by-side) and T type (stent-in-stent) bilateral biliary metal stenting in malignant hilar obstruction in terms of treatment outcomes, including post-stenting serum bilirubin level and stent patency. 41 consecutive patients with advanced hilar malignancies who underwent percutaneous placement of bilateral metallic stents - Y (n = 23) and T types (n = 18) - were retrospectively reviewed. We evaluated stent patency after the procedure by cholangiogram and abdominal CT. Pre- and post-stenting serum bilirubin level (total, direct bilirubin) at 1 week and at 1 month were compared. Student t-test and Kaplan-Meier method were used in the statistical analysis. After comparing the median stent patency according to both types, they did not differ significantly (Y: 38 days, T: 61 days; p 0.141). There was a more decrease in the total and direct bilirubin of the T type compared to the Y type after 1 week (p = 0.013, 0.025). However, no significant difference existed between the decreasing bilirubin rates of both types after 1 month (p = 0.923, 0.742). In patients with malignant hilar obstruction, both Y and T type bilateral metallic biliary stents are effective methods. Stent patency and bilirubin decrease rates were not significantly different.

  13. A Comparison of Y-Type and T-Type Metallic Bilateral Biliary Stents in Patients with Malignant Hilar Biliary Obstruction

    International Nuclear Information System (INIS)

    To compare the Y type (side-by-side) and T type (stent-in-stent) bilateral biliary metal stenting in malignant hilar obstruction in terms of treatment outcomes, including post-stenting serum bilirubin level and stent patency. 41 consecutive patients with advanced hilar malignancies who underwent percutaneous placement of bilateral metallic stents - Y (n = 23) and T types (n = 18) - were retrospectively reviewed. We evaluated stent patency after the procedure by cholangiogram and abdominal CT. Pre- and post-stenting serum bilirubin level (total, direct bilirubin) at 1 week and at 1 month were compared. Student t-test and Kaplan-Meier method were used in the statistical analysis. After comparing the median stent patency according to both types, they did not differ significantly (Y: 38 days, T: 61 days; p 0.141). There was a more decrease in the total and direct bilirubin of the T type compared to the Y type after 1 week (p = 0.013, 0.025). However, no significant difference existed between the decreasing bilirubin rates of both types after 1 month (p = 0.923, 0.742). In patients with malignant hilar obstruction, both Y and T type bilateral metallic biliary stents are effective methods. Stent patency and bilirubin decrease rates were not significantly different.

  14. Effect of poly (2-methoxyethyl acrylate)-coated oxygenators on haemolysis.

    Science.gov (United States)

    Kocakulak, M; Ozgürtaş, T; Ayhan, H

    2006-01-01

    Blood contact with artificial device surfaces and mechanical trauma are two major factors for haemolysis. Poly(2-methoxyethyl acrylate) (PMEA) is an amphiphilic polymer with a polyethylene chain that is hydrophobic and a mildly hydrophilic tail. PMEA coating has showed positive effects on protein adsorption, platelet loss, platelet aggregation and post-operative bleeding in previous studies. In this study, effects of poly(2-metoxyethyl acrylate) (PMEA)-coated oxygenators on haemolysis was investigated. PMEA-coated (SX18-Capiox) oxygenators were used. Desorbed erythrocyte, free haemoglobin indirect bilirubin and total bilirubin quantities from fibre samples of oxygenators were studied. Erythrocyte, total bilirubin and direct bilirubin values were measured from blood aliquots taken in five different times during cardiopulmonary by-pass (CPB); baseline (T1), during CPB (T2), at the end of CPB (T3), after protamine injection (T4) and in intensive care (T5). In both coated and non-coated oxygenators haemolysis rate was in clinically acceptable safety range. Average desorbed free haemoglobin was 6663 mg/dl from coated and 29.405 mg/dl from non-coated fibres. Average desorbed total bilirubin was 0.0068 mg/dl from coated and 0.023 mg/dl from noncoated fibres. We observed less haemolysis, as reflected by lower desorbed free haemoglobin and indirect bilirubin from coated oxygenators and less decrease in blood erythrocyte number. Blood bilirubin concentration was low in the coated group when compared to the control group. This study describes the relationship between PMEA coating and haemolysis at the blood contacting surface. PMEA coating reduces red blood cell damage during extracorporeal circulation. PMID:16768295

  15. Screening for neonatal hyperbilirubinaemia and ABO alloimmunization at the time of testing for phenylketonuria and congenital hypothyreosis.

    Science.gov (United States)

    Meberg, A; Johansen, K B

    1998-12-01

    In a population-based study including 2463 infants, serum bilirubin measurements were added to the neonatal screening programme for phenylketonuria and congenital hypothyreosis. This screening programme detected 11/17 (65%) of infants with serum bilirubin levels >350 micromol 1(-1), of whom 7 (3 per 1000) were readmitted from home (6 treated with phototherapy). A total of 139 infants (5.6%) received phototherapy. Maternal blood type O occurred significantly more often in term infants treated (30/54; 55.6%) compared with preterm infants treated (32/85; 37.6%) and with blood type O occurrence in the total population of mothers (906/2426; 37.3%) (p constellations mother O/infant A or B showed a sensitivity of 64%, specificity 65%, positive predictive value 12% and a negative predictive value of 96% for the requirement of phototherapy for the whole material. Exchange transfusion was not required in any of the infants. No infant developed bilirubin encephalopathy (kemicterus). Adding bilirubin to a neonatal screening programme detects some cases with unexpectedly high bilirubin levels in need of intervention. Routine ABO blood typing of pregnant women, ABO cord blood typing and Coombs' test in infants of mothers with blood type O cannot be recommended because of low positive predictive value for the requirement of intervention (phototherapy) by these tests. PMID:9894828

  16. Evaluation of Serum Zinc Levels in Hyperbilirubinemic Neonates Before and After Phototherapy

    Directory of Open Access Journals (Sweden)

    Ziba Mosayebi

    2016-03-01

    Full Text Available Background The existing therapeutic methods for neonatal jaundice are costly, time-consuming and potentially risky. Zinc salts can reduce phototherapy duration by precipitating unconjugated bilirubin in the intestine (bilirubin and zinc can form a complex in physiologic pH; however, zinc toxicity is an issue that must be considered since theoretically bilirubin reduction by phototherapy may increase serum zinc levels, making additional zinc supplementation the potential cause of zinc toxicity. Objectives So, our purpose was evaluating the serum zinc level alterations before and after phototherapy, in hyperbilirubinemic newborns. Materials and Methods A prospective cohort study was performed at the children’s medical center of Tehran University of Medical Sciences from 2012 to 2014. Healthy, full-term exclusively breast fed newborns with non-hemolytic jaundice were enrolled in the study. Participants were divided into two groups based on serum bilirubin levels (TSB 200 in only neonates with severe hyperbilirubinemia. Conclusions Phototherapy increases serum zinc level by reducing bilirubin level so that additional supplementation of this element can lead potentially to zinc toxicity.

  17. Jaundice: a basic review

    Directory of Open Access Journals (Sweden)

    Muhammad Waseem Abbas

    2016-05-01

    Full Text Available Jaundice is a complex disease. Jaundice is actually the high bilirubin level in the body. Yellowing of skin, mucous membranes and skin are common presentations of jaundice. Jaundice has various variants including pre-hepatic jaundice (due to hemolysis of red blood cells, hepatic jaundice (due to defect in capture, conjugation and excretion of bilirubin by liver and post hepatic jaundice (due to the obstruction of extra hepatobiliary system. The causes of various variants of Jaundice is either acquired or congenital. High plasma bilirubin level can cause various manifestations involving satiety, gastrointestinal bleeding, diarrhea, anemia, edema, weight-loss and can be fatal because it can cause psychosis, lethargy, seizures, coma or even death. High bilirubin level can help in the diagnosis of Jaundice. Differential diagnosis of various variants of Jaundice can be carried out on the basis of bilirubin level (conjugated and unconjugated, ultrasonography and other radiological techniques. The proper management of Jaundice is high water intake and low fat diet. The primary effective treatment for pre-hepatic jaundice and neonatal physiological jaundice is phototherapy. Infusion of immunoglobulins is also used for treatment of pre-hepatic jaundice. Proper nutrition, steroids and immunosuppressant are used for treatment of hepatic jaundice. The treatment for post hepatic jaundice is decompression and surgery. [Int J Res Med Sci 2016; 4(5.000: 1313-1319

  18. Pancreatic islet regeneration and some liver biochemical parameters of leaf extracts of Vitex doniana in normal and streptozotocin-induced diabetic albino rats

    Science.gov (United States)

    Oche, Okpe; Sani, Ibrahim; Chilaka, Njoku Godwin; Samuel, Ndidi Uche; Samuel, Atabo

    2014-01-01

    Objective To test two water soluble extracts (aqueous and ethanolic) obtained from the leaves of Vitex doniana in normal and streptozotocin-induced diabetic rats for their effects on pancreatic endocrine tissues and serum marker enzymes for a period of 21 d. Methods A total of 55 rats divided into 11 groups of 5 rats each were assigned into diabetic and non-diabetic groups and followed by a daily administration of ethanolic and aqueous extracts for 21 d. Group 1 was the normal control while group 7 was treated with standard drug. Results The histopathological studies of the diabetic rats indicated increase in the volume density of islets, percent of β-cells and size of islet in the groups that received the plant extracts, which suggested regeneration of β-cells along with β-cells repairs, as compared with the non-treated diabetic control which showed complete degeneration of the islet cells. There was significant reduction (P0.01) in the serum activities of marker enzymes was observed for non-diabetic treated rats. Results of total bilirubin, direct bilirubin and unconjugated bilirubin showed that diabetic control group was significantly higher (P0.01) in total bilirubin and direct bilirubin compared with the normal control. Conclusion This herbal therapy appears to bring about repair/regeneration of the endocrine pancreas and hepatic cells protection in the diabetic rat. PMID:25182283

  19. [How reliable are assays with the ictometer? Comparative studies with direct measurement of billirubin and a diazo technique (author's transl)].

    Science.gov (United States)

    Schulz, D; Gerstheimer, A

    1976-01-01

    Comparison of measurements of a diazo technique with those of a direct assessment of bilirubin with the photo-ictometer type II (Hirtz & Co., Cologne). Comparative analysis of total bilirubin-concentration in 172 non-hemolytic sera of neonates and in dilution series with and without contamination by hemoglobin and/or lipid-suspension gave the following results and conclusions drawn from them: 1. In non-contaminated sera the relation between the two techniques is linear, well correlated, parallel and with little divergence. 2. In contrast to the ictometer the diazo technique used underrates the bilirubin content in hemolytic sera. 3. In contrast to the diazo technique the ictometer underrates the bilirubin content in strongly turbid sera. 4. The precision of the ictometer is superior in series and from day to day to the already good precision of the diazo technique. 5. The standard built- in after calibration has to be checked daily and adjusted during the first working hour of the ictometer on several occasions. 6. In order to aboid major systematic faults each apparatus should be compared with a safely calibrated technique. 7. The very simple and rapidly serviced apparatus is suitable for the assay of total bilirubin in sera of the newborn. For older neonates and after exchanges transfusions the results should not be trusted. PMID:943668

  20. Clinical Observation of Treatment of Hyperbilirubinemia in the Newborn by Integrated Traditional Chinese and Western Medicine

    Institute of Scientific and Technical Information of China (English)

    孟浦; 周东风; 赵萍; 夏传雄

    2002-01-01

    Objective: To find a method of treatment for correcting hyperbilirubinemia timely and effectively to prevent bilirubin induced cerebral damage in the newborn. Methods: The newborns with hyperbilirubinemia in the treated group were treated with conventional treatment plus Butyribacterial preparation (BBP) and Simo Decoction (SMD, 四磨饮) taken orally, and the effect was compared with that in control group A treated with conventional treatment only and that in control group B treated with conventional treatment plus BBP. Results: The mean daily decreasing rate of bilirubin in the treated group was 51.11±25.03 μmol/L, which was higher than that in control groups A (39.36±22.44 μmol/L) and B (43.24±24.18 μmol/L), respectively (P<0.01 and P<0.05). The bilirubin decreasing value on the first day and the speed of bilirubin decreasing (to 102.6 μmol/L) in the treated group were both higher than those in the control groups, P<0.01. Conclusion: The combined therapy of conventional treatment plus BBP and SMD could rapidly reduce the blood bilirubin level in the newborn with hyperbilirubinemia, and shorten the therapeutic course markedly, and the therapeutic effect is superior to that of the conventional treatment alone or that of the conventional treatment plus BBP only.

  1. Pancreatic islet regeneration and some liver biochemical parameters of leaf extracts of Vitex doniana in normal and streptozotocin-induced diabetic albino rats

    Institute of Scientific and Technical Information of China (English)

    Okpe Oche; Ibrahim Sani; Njoku Godwin Chilaka; Ndidi Uche Samuel; Atabo Samuel

    2014-01-01

    Objective: To test two water soluble extracts (aqueous and ethanolic) obtained from the leaves ofVitex doniana in normal and streptozotocin-induced diabetic rats for their effects on pancreatic endocrine tissues and serum marker enzymes for a period of 21 d. Methods: A total of 55 rats divided into 11 groups of 5 rats each were assigned into diabetic and non-diabetic groups and followed by a daily administration of ethanolic and aqueous extracts for 21 d. Group 1 was the normal control while group 7 was treated with standard drug.Results:The histopathological studies of the diabetic rats indicated increase in the volume density of islets, percent of β-cells and size of islet in the groups that received the plant extracts, which suggested regeneration of β-cells along with β-cells repairs, as compared with the non-treated diabetic control which showed complete degeneration of the islet cells. There was significant reduction (P0.01) in the serum activities of marker enzymes was observed for non-diabetic treated rats. Results of total bilirubin, direct bilirubin and unconjugated bilirubin showed that diabetic control group was significantly higher (P0.01) in total bilirubin and direct bilirubin compared with the normal control.Conclusion:This herbal therapy appears to bring about repair/regeneration of the endocrine pancreas and hepatic cells protection in the diabetic rat.

  2. TRIPLE TEST – NEWBORN SCREENING REDEFINED

    Directory of Open Access Journals (Sweden)

    Fysal

    2014-02-01

    Full Text Available Hyperbilirubinemia is one of the common causes of admission in newborns. There is concern about an increasing incidence of hyperbilirubinemia and possibility of kernicterus even in healthy term newborns. Thus , early prediction of newborns at risk for developing significant hyperbilirubinemia may be helpful in early intervention . This study was done to find out the association between cord blood bilirubin and hyperbilirubinemia at 72 hours of life and also the association between cord Hb and Hb at sixth month of life along with screening babies for congenital hypothyroidism by TSH assay at birth. MATERIALS AND METHODS : 120 term healthy newborn babies delivered in a tertiary care centre (MES Medical College, Perinthalmanna , were included in this study. They were screened at birth for cord blood Hb, bilirubin and TSH values. Thes e values were compared with bilirubin values at 72 hours of life and Hb at sixth month. Chi - square and correlation tests were used and data analyzed using Epi Info software. RESULTS : Our study showed a strong association between cord blood bilirubin ( >2 mg /dL and significant hyperbilirubinemia ( >14 mg/dL at 72 hours of life with a p value of 0.009. No association was found between cord Hb and Hb at sixth month. CONCLUSION : A cord blood bilirubin value above 2 mg/dL is a useful predictor of significant hyp erbilirubinemia ( >14 mg/dL in healthy term newborns

  3. Light treatment of infants with hyperbilirubinaemia - optimalization and dosimetry

    International Nuclear Information System (INIS)

    This report deals with certain aspects of phototherapy of infants with hyperbilirubinaemia. The first part of the report concerns light measurement at different distances from a phototherapy unit equipped with eight fluorescent tubes. At the actual distance of treatment, there was a considerable lack of homogeneity with the largest irradiance below the center of the unit. The second part of the report is a study of the formation of different isomers of bilirubin detected by use of HPLC. The research was mainly done in vitro by irradiation of bilirubin solutions. Three different fluorescent tubes were used which emitted white, blue and green light. The green light was most efficient in producing Z-lumirubin, which is considered as the main isomer responsible for excretion of bilirubin from infants. Green light may be safer to use than blue light and may in the future be the wavelength of choice in phototherapy. 43 refs., 50 figs

  4. Measurements and monitoring of phototherapy in newborn jaundice

    Energy Technology Data Exchange (ETDEWEB)

    Sisson, T.R.

    Hyperbilirubinemia in the newborn (neonatal jaundice) may cause irreversible brain damage if plasma concentrations of bilirubin exceed the number of binding sites on albumin and other blood components. Phototherapy or exchange transfusions to prevent the excessive rise in concentration of the pigment should be instituted in appropriate clinical situations. In phototherapy, the jaundiced infant is exposed to visible light containing the wavelength (about 450 nm) bilirubin will absorb. Because bilirubin is quite photolabile and will readily isomerize in vivo, it is rapidly converted to excretable forms. The effectiveness of this therapy, however, depends upon the maintenance of adequate radiant flux in the required wavelength. Energy output and spectral distributions of phototherapy lamps must be measured. The long-term effects of irradiation of newborn infants over several days are not yet known.

  5. Effect of different pectin on bile acid biosynthesis

    International Nuclear Information System (INIS)

    The objective of the study was to examine the effects of consumption of different pectins from peach, quince, and apricot on bile flow and bile secretion of bile acids, cholesterol, phospholipids and bilirubin in rats. Six groups of nine rats were fed diets containing pectin 20 mg/kg once a day for two weeks. These groups of rats were compared with the group fed on physiological solution as a control and two groups fed on flamenol. Results of our study indicate that pectins, by decreasing cholesterol levels and enhancing bile acid secretion may cause increased hepatic synthesis of bile acids, phospholipids and reduced bilirubin synthesis. Among the studied pectins the apricot pectin shows in a very consistent lowering of cholesterol and bilirubin levels

  6. Efficacy of zinc sulfate in reducing unconjugated hyperbilirubinemia in neonates

    Directory of Open Access Journals (Sweden)

    Somayyeh Hashemian

    2014-09-01

    Full Text Available Hyperbilirubinemia is a common disease and unconjugated hyperbilirubinemia has been seen mainly in neonates. Severe form of unconjugated hyperbilirubinemia may cause kernicterus and even death. Conventional treatment for severe unconjugated hyperbilirubinemia consists of phototherapy and exchange transfusion that have several known disadvantages; specially exchange transfusion is associated with a significant morbidity and even mortality. These harmful effects indicate the need to develop alternative pharmacological treatment strategies for unconjugated hyperbilirubinemia. One of these pharmacological agents is zinc salts. Zinc has been shown to lower the bilirubin levels by inhibition of the enterohepatic cycling of unconjugated bilirubin. Oral zinc has been shown to reduce serum unconjugated bilirubin in animals, adolescents and low birth weight neonates. However, studies in healthy term neonates given oral zinc showed no reduction in hyperbilirubinemia based on daily measurement. In order to improve the accuracy, hyperbilirubinemia may be determined based on measurements every hour. More studies are needed to know the effect of zinc in neonatal jaundice.

  7. Changes of plasma VEGF levels and liver function in patients with liver cancer before and after interventional treatment

    International Nuclear Information System (INIS)

    To explore the effect of the interventional treatment for the angiogenesis and liver function in patients with liver cancer within short time, enzyme linked immunosorbent assay was used to determine the level of VEGF in plasma. The level of liver function was measured through automatic biochemistry analyzer. The results indicated that the level of VEGF in patients with liver cancer decreased after interventional treatment than that of before treatment (P<0.05). The level of total protein, albumin, alkaline phosphatase and total bile acid decreased after interventional treatment (P<0.05). The level of alanine aminotransferase, aspartate aminotransferase, total bilirubin, direct bilirubin and indirect bilirubin were increased than before (P<0.05). The interventional treatment inhibit the expression of the VEGF in the tumor tissue and limited the angiogenesis within short time, but to some extent may caused the injury of the hepatocytes and the synthetic and excremental function in patients with liver cancer. (authors)

  8. Evaluation of the potential Toxicity and Interaction of Methomyl and Diazinon Insecticides in Male Rats

    International Nuclear Information System (INIS)

    The toxic effect of methomyl and/or diazinon given orally to male rats for 4 consecutive days at the level of 20% of their LD50, was investigated. Methomyl did not affect plasma choline esterase (Ch E) after four days of treatment. Serum testosterone, lactate dehydrogenase (LDH), gamma glutamyl transferase (gamma G T) were decreased, while bilirubin alkaline phosphatase (ALP) and uric acid were increased. Serum creatinine phosphokinase (CPK) was increased significantly while creatinine was not affected. Diazinon caused substantial decline in plasma Ch E activity after four days of treatment. Serum creatinine phosphokinase and testosterone were altered significantly while lactate dehydrogenase and creatinine levels were comparable to controls. Serum bilirubin, ALP and uric acid were increased while gamma G T was decreased. Co administration of the two insecticides lowered plasma Ch E activity more than diazinon did. The combined effect on CPK, ALP, testosterone, bilirubin and uric acid was greater than that produced from each insecticide acting independently

  9. Association of laboratory parameters with viral factors in patients with hepatitis C

    Directory of Open Access Journals (Sweden)

    Khaliq Saba

    2011-07-01

    Full Text Available Abstract Background and Aims HCV infection may lead to hepatic fibrosis. In this study, we tried to determine whether there is any correlation of HCV genotypes and viral load to the clinical parameters such as ALT, AST, ALP, bilirubin, Hb level, patient's age and gender; and then correlated this association with disease progression in liver biopsy samples. Methods In cross-sectional and observational study, 6048 serum HCV RNA positive patients were chosen. The study consists of 53 months from March 2006 to September 2010. Patients were divided into three cohorts to validate our data. Statistical analysis and correlation of lab parameters with viral factors was determined by using SPSS version 16. Results The most prevalent genotype was 3 (70.9% followed by 1 (13.3% and 4 (7.4%, collectively. During Univariate analysis, in all cohorts; serum bilirubin, ALP, ALT and AAR showed significant correlation with genotypes, however multivariate analysis showed that all genotypes except 4a have no association with host biochemical markers. Disease progression was also independent of all genotypes. Serum ALP, ALT, bilirubin and viremea levels were significantly elevated in patients with genotype 4a. Viral load showed negative association with serum bilirubin (r = -0.112, P = 0.000 and ALP levels (r = -0.098, P = 0.000. We observed positive correlation of ALP and bilirubin levels, while negative associations of viral load with HCV liver disease progression. Conclusion Disease progression seems independent of the genotypes. Relationship between ALP and bilirubin with viral load may be an attractive marker to guess disease progression in patients with hepatitis C.

  10. Three-dimensional drip infusion CT cholangiography in patients with suspected obstructive biliary disease: a retrospective analysis of feasibility and adverse reaction to contrast material.

    Directory of Open Access Journals (Sweden)

    Smedby Ö

    2006-04-01

    Full Text Available Abstract Background Computed Tomography Cholangiography (CTC is a fast and widely available alternative technique to visualise hepatobiliary disease in patients with an inconclusive ultrasound when MRI cannot be performed. The method has previously been relatively unknown and sparsely used, due to concerns about adverse reactions and about image quality in patients with impaired hepatic function and thus reduced contrast excretion. In this retrospective study, the feasibility and the frequency of adverse reactions of CTC when using a drip infusion scheme based on bilirubin levels were evaluated. Methods The medical records of patients who had undergone upper abdominal spiral CT with subsequent three-dimensional rendering of the biliary tract by means of CTC during seven years were retrospectively reviewed regarding serum bilirubin concentration, adverse reaction and presence of visible contrast media in the bile ducts at CT examination. In total, 153 consecutive examinations in 142 patients were reviewed. Results Contrast media was observed in the bile ducts at 144 examinations. In 110 examinations, the infusion time had been recorded in the medical records. Among these, 42 examinations had an elevated bilirubin value (>19 umol/L. There were nine patients without contrast excretion; 3 of which had a normal bilirubin value and 6 had an elevated value (25–133 umol/L. Two of the 153 examinations were inconclusive. One subject (0.7% experienced a minor adverse reaction – a pricking sensation in the face. No other adverse effects were noted. Conclusion We conclude that drip infusion CTC with an infusion rate of the biliary contrast agent iotroxate governed by the serum bilirubin value is a feasible and safe alternative to MRC in patients with and without impaired biliary excretion. In this retrospective study the feasibility and the frequency of adverse reactions when using a drip infusion scheme based on bilirubin levels has been evaluated.

  11. Three-dimensional drip infusion CT cholangiography in patients with suspected obstructive biliary disease: a retrospective analysis of feasibility and adverse reaction to contrast material

    International Nuclear Information System (INIS)

    Computed Tomography Cholangiography (CTC) is a fast and widely available alternative technique to visualise hepatobiliary disease in patients with an inconclusive ultrasound when MRI cannot be performed. The method has previously been relatively unknown and sparsely used, due to concerns about adverse reactions and about image quality in patients with impaired hepatic function and thus reduced contrast excretion. In this retrospective study, the feasibility and the frequency of adverse reactions of CTC when using a drip infusion scheme based on bilirubin levels were evaluated. The medical records of patients who had undergone upper abdominal spiral CT with subsequent three-dimensional rendering of the biliary tract by means of CTC during seven years were retrospectively reviewed regarding serum bilirubin concentration, adverse reaction and presence of visible contrast media in the bile ducts at CT examination. In total, 153 consecutive examinations in 142 patients were reviewed. Contrast media was observed in the bile ducts at 144 examinations. In 110 examinations, the infusion time had been recorded in the medical records. Among these, 42 examinations had an elevated bilirubin value (>19 umol/L). There were nine patients without contrast excretion; 3 of which had a normal bilirubin value and 6 had an elevated value (25–133 umol/L). Two of the 153 examinations were inconclusive. One subject (0.7%) experienced a minor adverse reaction – a pricking sensation in the face. No other adverse effects were noted. We conclude that drip infusion CTC with an infusion rate of the biliary contrast agent iotroxate governed by the serum bilirubin value is a feasible and safe alternative to MRC in patients with and without impaired biliary excretion. In this retrospective study the feasibility and the frequency of adverse reactions when using a drip infusion scheme based on bilirubin levels has been evaluated

  12. UGT1A1 promoter polymorphisms and the development of hyperbilirubinemia and gallbladder disease in children with sickle cell anemia.

    Science.gov (United States)

    Carpenter, Shannon L; Lieff, Susan; Howard, Thad A; Eggleston, Barry; Ware, Russell E

    2008-10-01

    Genetic modifiers contribute to phenotypic variability in patients with sickle cell anemia (SCA). The influence of the bilirubin UDP-glucuronosyltransferase (UGT) 1A1 (TA)(n)TAA promoter polymorphism on bilirubin levels and gallbladder disease in SCA was examined using prospectively collected data from the Cooperative Study of Sickle Cell Disease. A total of 324 children with HbSS (median age 6.9 years) had UGT1A1 genotyping; 243 (75%) had common (TA)(6) or (TA)(7) alleles, whereas 81 (25.0%) had variant (TA)(5) or (TA)(8) alleles. The UGT1A1 genotype significantly influenced average bilirubin levels for the common alleles: 6/6 genotype = 2.36 +/- 1.13 mg/dL, 6/7 genotype = 2.90 +/- 1.54 mg/dL, and 7/7 genotype = 4.24 +/- 2.11 mg/dL (P < 0.0001). Thirty-nine percent of children with the 7/7 genotype had documented gallbladder disease, compared with 18.2% with the 6/7 genotype and only 9.9% with the wildtype 6/6 UGT1A1 genotype (P = 0.001). To analyze the (TA)(5) and (TA)(8) variant alleles, three groups were generated, showing increasing bilirubin levels with increasing TA repeats and age. Group 3 (genotypes 6/8, 7/7, and 7/8) had a significantly greater rate of bilirubin change than Groups 1 (genotypes 5/6, 5/7, and 6/6) or 2 (genotype 6/7). These results validate previous smaller studies and confirm that the UGT1A1 promoter polymorphism exerts a powerful influence on bilirubin levels and the development of gallbladder disease in children with SCA. UGT1A1 genotyping should be considered as a screening tool for predicting children most likely to develop gallbladder disease at a young age. PMID:18756540

  13. The Preterm Infant: A High-Risk Situation for Neonatal Hyperbilirubinemia Due to Glucose-6-Phosphate Dehydrogenase Deficiency.

    Science.gov (United States)

    Kaplan, Michael; Hammerman, Cathy; Bhutani, Vinod K

    2016-06-01

    Prematurity and glucose-6-phosphate dehydrogenase (G6PD) deficiency are risk factors for neonatal hyperbilirubinemia. The 2 conditions may interact additively or synergistically, contributing to extreme hyperbilirubinemia, with the potential for bilirubin neurotoxicity. This hyperbilirubinemia is the result of sudden, unpredictable, and acute episodes of hemolysis in combination with immaturity of bilirubin elimination, primarily of conjugation. Avoidance of contact with known triggers of hemolysis in G6PD-deficient individuals will prevent some, but not all, episodes of hemolysis. All preterm infants with G6PD deficiency should be vigilantly observed for the development of jaundice both in hospital and after discharge home. PMID:27235211

  14. Glucose-6-Phosphate Dehydrogenase Deficiency and the Need for a Novel Treatment to Prevent Kernicterus.

    Science.gov (United States)

    Cunningham, Anna D; Hwang, Sunhee; Mochly-Rosen, Daria

    2016-06-01

    Hyperbilirubinemia occurs frequently in newborns, and in severe cases can progress to kernicterus and permanent developmental disorders. Glucose-6-phosphate dehydrogenase (G6PD) deficiency, one of the most common human enzymopathies, is a major risk factor for hyperbilirubinemia and greatly increases the risk of kernicterus even in the developed world. Therefore, a novel treatment for kernicterus is needed, especially for G6PD-deficient newborns. Oxidative stress is a hallmark of bilirubin toxicity in the brain. We propose that the activation of G6PD via a small molecule chaperone is a potential strategy to increase endogenous defense against bilirubin-induced oxidative stress and prevent kernicterus. PMID:27235212

  15. Hemolysis in Preterm Neonates.

    Science.gov (United States)

    Christensen, Robert D; Yaish, Hassan M

    2016-06-01

    Hemolysis can be an important cause of hyperbilirubinemia in premature and term neonates. It can result from genetic abnormalities intrinsic to or factors exogenous to normal to red blood cells (RBCs). Hemolysis can lead to a relatively rapid increase in total serum/plasma bilirubin, hyperbilirubinemia that is somewhat slow to fall with phototherapy, or hyperbilirubinemia that is likely to rebound after phototherapy. Laboratory methods for diagnosing hemolysis are more difficult to apply, or less conclusive, in preterm infants. Transfusion of donor RBCs can present a bilirubin load that must be metabolized. Genetic causes can be identified by next-generation sequencing panels. PMID:27235204

  16. A decision-making tool for exchange transfusions in infants with severe hyperbilirubinemia in resource-limited settings.

    Science.gov (United States)

    Olusanya, B O; Iskander, I F; Slusher, T M; Wennberg, R P

    2016-05-01

    Late presentation and ineffective phototherapy account for excessive rates of avoidable exchange transfusions (ETs) in many low- and middle-income countries. Several system-based constraints sometimes limit the ability to provide timely ETs for all infants at risk of kernicterus, thus necessitating a treatment triage to optimize available resources. This article proposes a practical priority-setting model for term and near-term infants requiring ET after the first 48 h of life. The proposed model combines plasma/serum bilirubin estimation, clinical signs of acute bilirubin encephalopathy and neurotoxicity risk factors for predicting the risk of kernicterus based on available evidence in the literature. PMID:26938921

  17. Metalloporphyrins – an update

    Directory of Open Access Journals (Sweden)

    Stephanie eSchulz

    2012-04-01

    Full Text Available Metalloporphyrins are structural analogues of heme and their potential use in the management of neonatal hyperbilirubinemia has been the subject of considerable research for more than three decades. The pharmacological basis for using this class of compounds to control bilirubin levels is the targeted blockade of bilirubin production through the competitive inhibition of heme oxygenase (HO, the rate-limiting enzyme in the heme degradative pathway. Ongoing research continues in the pursuit of identifying ideal metalloporphyrins, which are safe and effective, by defining therapeutic windows and targeted interventions for the treatment of neonatal hyperbilirubinemia.

  18. Artificial liver support for postoperative hepatic failure with anion exchange resin (BR-601).

    OpenAIRE

    Sakagami,Kenichi; MIYAZAKI, MASASHI; Matsuoka, Junji; Shiozaki,Shigehiro; Saito, Shinya; Orita,Kunzo

    1986-01-01

    An artificial liver support system for plasma exchange and plasma perfusion through BR-601 resin using a membrane separator was applied to 5 patients with postoperative liver failure. Percent absorption of total and direct bilirubin, and of bile acids were 77.1 +/- 6.4, 78.4 +/- 6.1, and 93.4 +/- 3.6%, respectively, when 250 ml of plasma was treated. Percent reductions in total and direct bilirubin, and in bile acids were 24.5 +/- 5.8, 25.5 +/- 5.8 and 30.9 +/- 8.5%, respectively. In contrast...

  19. Prevalence of hepatobiliary dysfunction in a regional group of patients with chronic inflammatory bowel disease

    DEFF Research Database (Denmark)

    Wewer, V; Gluud, C; Schlichting, P; Burcharth, F; Binder, V

    1991-01-01

    -22%) had at least 1 abnormal laboratory value. Serum bilirubin was elevated in 5%, alkaline phosphatases in 8%, aspartate aminotransferases in 4%, and alanine aminotransferases in 8% of the patients. Two per cent had decreased plasma coagulation factors (2.7 and 10) and serum albumin. Further diagnositc...... laboratory value. Serum bilirubin was elevated in 2%, alkaline phosphatases in 18%, asparetate aminotransferases in 3%, and alanine aminotransferases in 10% of the patients. One per cent had decreased plasma coagulation factors (2.7 and 10) and serum albumin concentrations. Three patients (2%) fulfilled the...

  20. An Unusual Case of Rapidly Progressive Hyperbilirubinemia

    Directory of Open Access Journals (Sweden)

    Kimberly M. Thornton

    2013-01-01

    Full Text Available We present an unusual case of hyperbilirubinemia with rapid early progression leading to bilirubin encephalopathy in a term neonate. Despite early recognition and intervention, the total serum bilirubin reached a maximum level of 39 mg/dL at 32 hours of life. Prior to an emergent exchange transfusion, the patient’s diagnostic evaluation was significant for Coombs-negative microangiopathic hemolytic anemia and thrombocytopenia. Further testing revealed a deficiency of ADAMTS13 protein, or von Willebrand factor-cleaving protease, a finding diagnostic of congenital thrombotic thrombocytopenic purpura, or Upshaw-Schulman syndrome. This rare disease is often misdiagnosed, especially in the newborn period.

  1. LEVELS OF SELECTED INDICATORS IN THE BLOOD SERUM OF HORSES AND THEIR CORRELATION DEPENDENCY

    OpenAIRE

    Peter Čupka; Marek Halo; Peter Massányi; Anton Kováčik; Robert Stawarz; Formicki Grzegorz

    2013-01-01

    In this study 26 sport horses (14 mares and 12 stallions) were included in the trial. The content of urea, total proteins (TP), glucose (GLU), cholesterol (CHOL), triglycerides (TG), bilirubin (BILI), AST, ALT, GGT and ALP was determined in the blood serum. Levels of monitoring indicators in stallions and mares were balanced. Significant difference (P

  2. The effect of long-term danazol prophylaxis on liver function in hereditary angioedema?a longitudinal study

    OpenAIRE

    Farkas, Henriette; Czaller, Ibolya; Csuka, Dorottya; Vas, Anikó; Valentin, Szilvia; Varga, Lilian; Széplaki, Gábor; Jakab, László; Füst, George; Prohászka, Zoltán; Harmat, George; Visy, Beata; Karádi, István

    2009-01-01

    Abstract Background Danazol is a drug most widely used for the prophylaxis of hereditary angioedema resulting from the deficiency of the C1-inhibitor. Potential hepatotoxic or liver tumor-inducing side effects of long-term danazol prophylaxis have been investigated during the follow-up of hereditary angioedema patients. Methods Characteristic parameters of liver function (including bilirubin, GOT, GPT, ?GT...

  3. Impaired CD163-mediated hemoglobin-scavenging and severe toxic symptoms in patients treated with gemtuzumab ozogamicin

    DEFF Research Database (Denmark)

    Maniecki, M.B.; Hasle, H.; Friis-Hansen, L.; Lausen, B.; Nielsen, O.J.; Bendix, K.; Moestrup, S.K.; Moller, H.J.

    2008-01-01

    , and low bilirubin after septicemia-induced intravascular hemolysis indicated abrogated clearance of haptoglobin-hemoglobin complexes. This was further supported by low levels of plasma soluble CD163 and a concordant low number of CD163-expressing monocytes. We show that CD163 positive monocytes and...

  4. Impaired CD163 Mediated Hemoglobin-Scavenging and Hemolytic Crisis in Patients Treated with CD33 Targeted Chemotherapy (Gemtuzumab Ozogamicin, MylotargTM)

    DEFF Research Database (Denmark)

    Maniecki, Maciej Bogdan; Hasle, Henrik; Friis-Hansen, Lennart; Lausen, Birgitte; Nielsen, Ove Juul; Bendix, Knud; Moestrup, Søren Kragh; Møller, Holger Jon

    , MylotargTM). A synchronous high free hemoglobin, haptoglobin, and low bilirubin after septicemia-induced intravascular hemolysis indicated abrogated clearance of haptoglobin-hemoglobin complexes. This was further supported by low levels of plasma soluble CD163 and a concordant low number of CD163...

  5. Hyperbilirubinemia as a predictor for appendiceal perforation

    DEFF Research Database (Denmark)

    Burcharth, J; Pommergaard, H C; Rosenberg, J; Gögenur, I

    2013-01-01

    Delayed or wrong diagnosis in patients with appendicitis can result in perforation and consequently increased morbidity and mortality. Serum bilirubin may be a useful marker for appendiceal perforation. The purpose of this systematic review was to evaluate studies investigating elevated serum...

  6. Development and optimization of a noncontact optical device for online monitoring of jaundice in human subjects

    Science.gov (United States)

    Polley, Nabarun; Saha, Srimoyee; Singh, Soumendra; Adhikari, Aniruddha; Das, Sukhen; Choudhury, Bhaskar Roy; Pal, Samir Kumar

    2015-06-01

    Jaundice is one of the notable markers of liver malfunction in our body, revealing a significant rise in the concentration of an endogenous yellow pigment bilirubin. We have described a method for measuring the optical spectrum of our conjunctiva and derived pigment concentration by using diffused reflection measurement. The method uses no prior model and is expected to work across the races (skin color) encompassing a wide range of age groups. An optical fiber-based setup capable of measuring the conjunctival absorption spectrum from 400 to 800 nm is used to monitor the level of bilirubin and is calibrated with the value measured from blood serum of the same human subject. We have also developed software in the LabVIEW platform for use in online monitoring of bilirubin levels in human subjects by nonexperts. The results demonstrate that relative absorption at 460 and 600 nm has a distinct correlation with that of the bilirubin concentration measured from blood serum. Statistical analysis revealed that our proposed method is in agreement with the conventional biochemical method. The innovative noncontact, low-cost technique is expected to have importance in monitoring jaundice in developing/underdeveloped countries, where the inexpensive diagnosis of jaundice with minimally trained manpower is obligatory.

  7. Effects of Hyperbilirubinemia on Auditory Brainstem Response of Neonates Treated with Phototherapy

    Directory of Open Access Journals (Sweden)

    Negin Salehi

    2016-01-01

    Conclusion:  The results of this study underline the importance of the Auditory Brainstem Response Test as an efficient tool for monitoring the auditory brainstem pathway in neonates who are at risk of neurotoxicity and for diagnosing the earliest stages of auditory damage caused by high levels of bilirubin.

  8. The effect of clofibrate and phototherapy on physiological jaundice in term newborns

    Directory of Open Access Journals (Sweden)

    Amir Hosein Hashemian

    2011-09-01

    Full Text Available Background: Clofibrate is an effective anti lipid agent that induces glucuronyltransferase could increase bilirubin conjugation. The aim of this study was to evaluate effect of clofibrate on neonatal physiologic jaundice.Methods: Randomized clinical trial sampling method used and 60 healthy term neonates which were admitted in Imam Reza Hospital of Kermanshah-Iran because of indirect hyperbilirubinemia enrolled into the study. 30 neonates (case group were treated with single oral dose of clofibrate (100/mg plus phototherapy and 30 neonates (control group received only phototherapy. Serum total and direct bilirubin levels were measured at admission, 12 hours later, and then every 24 hours until 96 hours. Results: There were no significant difference between two groups regarding to gender, age, weight and total serum bilirubin level at the admission. Mean values for total bilirubin of serum in case group 12, 24 and 48 hours after admission were significantly lower than control group (P<0.001. The mean of needed time for phototherapy in case group was significantly less than the control group (P<0.00l.Conclusion: It seems that clofibrate plus phototherapy is effective for treatment of neonatal physiologic jaundice in healthy term newborns, although further studies are necessary for evaluation of clofibrate safety as a routine treatments.

  9. Effects of water supplementation on physiological jaundice in breast-fed babies.

    OpenAIRE

    Carvalho, M.; Hall, M.; Harvey, D

    1981-01-01

    The effect of water supplementation in normal, term, breast-fed babies with physiological jaundice was studied. Water supplementation was given to 120 babies and 55 received no extra fluids. There was no significant difference between the two groups when peak serum bilirubin levels and incidence of phototherapy were compared.

  10. Neonatal physiological correlates of near-term brain development on MRI and DTI in very-low-birth-weight preterm infants

    Directory of Open Access Journals (Sweden)

    Jessica Rose, PhD

    2014-01-01

    Results suggest that at near-term age, thalamus WM microstructure may be particularly vulnerable to certain neonatal risk factors. Interactions between albumin, bilirubin, phototherapy, and brain development warrant further investigation. Identification of physiological risk factors associated with selective vulnerability of certain brain regions at near-term age may clarify the etiology of neurodevelopmental impairment and inform neuroprotective treatment for VLBW preterm infants.

  11. The liver in consecutive patients with morbid obesity

    DEFF Research Database (Denmark)

    Andersen, T; Christoffersen, Pernille Yde; Gluud, C

    1984-01-01

    an elevated serum alkaline phosphatase activity (P less than 0.0001) compared with non-obese controls. Serum lactate dehydrogenase and aspartate aminotransferase were significantly raised only in patients with fatty change. With respect to serum bilirubin and plasma cholesterol concentrations no...

  12. Liver synthesis function in chronic asymptomatic or oligosymptomatic alcoholics: correlation with other liver tests A função de síntese hepática em alcoolistas crônicos assintomáticos ou oligossintomáticos. Correlações com outros testes hepáticos

    OpenAIRE

    Paulo Borini; Romeu Cardoso Guimarães

    1999-01-01

    Liver function and its correlation with bilirubin and hepatic enzymes were evaluated in 30 male chronic asymptomatic or oligosymptomatic alcoholics admitted into the psychiatric hospital for detoxification and treatment of alcoholism. Hypoalbuminemia, lowered prothrombin activity, hypotransferrinemia and hypofibrinogenemia were detected in 32 %, 32 %, 28 %, and 24 % of patients, respectively. Transferrin was elevated in 8 %. Greater prevalence of hyperbilirubinemia was found in patients with ...

  13. Hepatic clearance mechanism of /sup 99m/Tc-HIDA and its effect on quantitation of hepatobiliary function concise communication

    International Nuclear Information System (INIS)

    Parameters affecting the hepatobiliary clearance of /sup 99m/Tc N(2,6-dimethylphenylcarbamoylmethyl) iminodiacetic acid (Tc-HIDA) were evaluated in dogs. Competitive clearance studies were performed with Tc-HIDA after infusion to plasma saturation levels of an anion, sodium sulfobromophthalein (BSP), and a cation, oxyphenonium. The results demonstrated that Tc-HIDA is transported through hepatocytes by a carrier-mediated organic-anion pathway. The data are consistent with an alteration of the elimination kinetics of Tc-HIDA induced by elevations in the serum bilirubin level, and it is predicted that serum bilirubin at some increased concentration will dominate the distribution and elimination kinetics of Tc-HIDA independently of hepatobiliary status. A quantitative description of liver function in terms of regional distribution and elimination rate constants will require either a pharmacokinetic model that expressly includes the effects of bilirubin from transport binding sites, or the development of new hepatobiliary agents that use a different clearance mechanism from that used by bilirubin

  14. Short-term rat-feeding studies of irradiated bananas and mangoes

    International Nuclear Information System (INIS)

    Bananas and mangoes irradiated at 30 and 50 Krad were fed to albino rats for 12 weeks. Parameter used included food consumption, weight gain, haemoglobin, hematocrit, white and red blood cell counts, differential count, protein, albumin, blood sugar, blood urea nitrogen and bilirubin. Irradiation at the 2 dose levels did not show ill effects. (author)

  15. Toxicological evaluation of the hydro-alcohol extract of the dry leaves of Peumus boldus and boldine in rats.

    Science.gov (United States)

    Almeida, E R; Melo, A M; Xavier, H

    2000-03-01

    The hydro-alcohol extract of the dry leaves of Peumus boldus and boldine, showed abortive and teratogenic action and changes in the blood levels of bilirubin, cholesterol, glucose, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and urea in rats. The long term administration of the extract and boldine did not cause histological modification during a period of 90 days. PMID:10685105

  16. Prognostic factors in patients with advanced cholangiocarcinoma:Role of surgery,chemotherapy and body mass index

    Institute of Scientific and Technical Information of China (English)

    Mirna H Farhat; Ali I Shamseddine; Ayman N Tawil; Ghina Berjawi; Charif Sidani; Wael Shamseddeen; Kassem A Barada

    2008-01-01

    AIM:To study the factors that may affect survival of cholangiocarcinoma in Lebanon.METHODS:A retrospective review of the medical records of 55 patients diagnosed with cholangiocarcinoma at the American University of Beirut between 1990 and 2005 was conducted.Univariate and multivariate analyses were performed to determine the impact of surgery,chemotherapy,body mass index,bilirubin level and other factors on survival.RESULTS:The median survival of all patients was 8.57 mo (0.03-105.2).Univariate analysis showed that low bilirubin level (<10 mg/dL),radical surgery and chemotherapy administration were significantly associated with better survival (P = 0.012,0.038 and 0.038,respectively).In subgroup analysis on patients who had no surgery,chemotherapy administration prolonged median survival significantly (17.0 mo vs 3.5 too,P = 0.001).Multivariate analysis identified only low bilirubin level < 10 mg/dL and chemotherapy administration as independent predictors associated with better survival (P < 0.05).CONCLUSION:Our data show that palliative and postoperative chemotherapy as well as a bilirubin level < 10 mg/dL are independent predictors of a significant increase in survival in patients with cholangiocarcinoma.

  17. Incidence of Thrombocytopenia in Idiopathic Hyperbilirubinemic Newborns

    Directory of Open Access Journals (Sweden)

    Hassan Boskabadi

    2014-06-01

    Conclusion: This study determines higher rate of thrombocytopenia among idiopathic hyperbilirubinemic neonates (36% and helps the practitioner to be aware of this association and avoid unnecessary investigations.We did not find a significant correlation between serum bilirubin values and thrombocytopenia.

  18. A phase I trial of intravenous catumaxomab

    DEFF Research Database (Denmark)

    Mau-Sørensen, Morten; Dittrich, Christian; Dienstmann, Rodrigo;

    2015-01-01

    care; ≥grade 3 increase in liver enzymes and/or bilirubin not resolving to grade 2. RESULTS: Sixteen patients were enrolled receiving doses of 2 (n = 5), 4 (n = 3), 7 (n = 7) and 10 µg catumaxomab (n = 1). The most common treatment-emergent adverse events (TEAEs) were chills (93.8 %) and pyrexia (87...

  19. [The jaundiced newborn: which early monitoring for a safe discharge?].

    Science.gov (United States)

    Pratesi, S; Dani, C

    2013-01-01

    Neonatal jaundice is one of the most common causes of prolonged hospital stay or readmission of a near-term or term baby. Reason of concern at early discharge of a jaundiced newborn is that of bilirubin neurotoxicity, even if a serum bilirubin concentration surely toxic for the brain is still unknown. Kernicterus and severe neonatal hyperbilirubinemia are still problems in the third millennium and the American Academy of Pediatrics claimed the pediatric community to increase vigilance in order to reduce the occurrence of these dramatic events. The only existing kernicterus registry is the pilot USA kernicterus registry whose data on 125 kernicteric term and near term babies from 1992 to 2004 have been recently published. Nobody of the kenicteric babies into the USA register had a serum bilirubin levels below 20 mg/dL. All the babies who suffered from kernicteric sequelae were discharged as healthy from hospital and then, 86% of them, readmitted in the first ten days of life. In the majority of babies (69%) a cause of the severe hyperbilirubinemia was not found. Current knowledge on mechanism of neurological damage induced by bilirubin, unfortunately, does not allow to have a universal evidenced based guideline on how to manage neonatal jaundice. Thus, the existing national guidelines contain inevitable differences in the recommended procedure. Waiting for the future italian guidelines the paper illustrates a proposal of management of neonatal jaundice in term or near term newborns based on available scientific evidence and national guidelines published in english language. PMID:24245097

  20. The jaundiced newborn: which early monitoring for a safe discharge?

    Directory of Open Access Journals (Sweden)

    S. Pratesi

    2013-08-01

    Full Text Available Neonatal jaundice is one of the most common causes of prolonged hospital stay or readmission of a near-term or term baby. Reason of concern at early discharge of a jaundiced newborn is that of bilirubin neurotoxicity, even if a serum bilirubin concentration surely toxic for the brain is still unknown. Kernicterus and severe neonatal hyperbilirubinemia are still problems in the third millennium and the American Academy of Pediatrics claimed the pediatric community to increase vigilance in order to reduce the occurrence of these dramatic events. The only existing kernicterus registry is the pilot USA kernicterus registry whose data on 125 kernicteric term and near term babies from 1992 to 2004 have been recently published. Nobody of the kenicteric babies into the USA register had a serum bilirubin levels below 20 mg/dL. All the babies who suffered from kernicteric sequelae were discharged as healthy from hospital and then, 86% of them, readmitted in the first ten days of life. In the majority of babies (69% a cause of the severe hyperbilirubinemia was not found. Current knowledge on mechanism of neurological damage induced by bilirubin, unfortunately, does not allow to have a universal evidenced based guideline on how to manage neonatal jaundice. Thus, the existing national guidelines contain inevitable differences in the recommended procedure. Waiting for the future italian guidelines the paper illustrates a proposal of management of neonatal jaundice in term or near term newborns based on available scientific evidence and national guidelines published in english language.

  1. Artificial liver support for postoperative hepatic failure with anion exchange resin (BR-601.

    Directory of Open Access Journals (Sweden)

    Sakagami,Kenichi

    1986-10-01

    Full Text Available An artificial liver support system for plasma exchange and plasma perfusion through BR-601 resin using a membrane separator was applied to 5 patients with postoperative liver failure. Percent absorption of total and direct bilirubin, and of bile acids were 77.1 +/- 6.4, 78.4 +/- 6.1, and 93.4 +/- 3.6%, respectively, when 250 ml of plasma was treated. Percent reductions in total and direct bilirubin, and in bile acids were 24.5 +/- 5.8, 25.5 +/- 5.8 and 30.9 +/- 8.5%, respectively. In contrast, percent reductions in total and direct bilirubin, and in bile acids by plasma exchange were 30.9 +/- 13.3, 34.5 +/- 12.5 and 24.2 +/- 8.5%, respectively. The coma grade was improved in 4 out of 5 cases, but unfortunately the patients did not recover. In conclusion, plasma perfusion through BR-601 resin is expected to play a promising role in artificial liver support systems because of its capacity to absorb bilirubin and bile acids.

  2. Refractory obstructive jaundice in a child affected with thalassodrepanocytosis: a new endoscopic approach

    Directory of Open Access Journals (Sweden)

    Barresi Luca

    2010-10-01

    Full Text Available Abstract Background Liver involvement, including elevated direct-reacting bilirubin levels, is common in patients with sickle cell disease. Fifty to seventy percent of sickle cell patients have pigmented gallstones due to precipitation of unconjugated bilirubin, and cholelithiasis or choledocholithiasis are common complications. The highest prevalence of these complications occurs in patients with Gilbert's syndrome because of the combined effect of increased bilirubin production and reduced bilirubin-diphosphate-glucuronosyltransferase enzyme activity. Cholelithiasis is also a common complication in patients with thalassemia. Endoscopic removal of choledochal stones does not always resolve the clinical picture, as in cases of dysfunction of the Vater's papilla, increased bile density due to persistently impaired bile flow or distortion of the choledocus due to dilatation, or inflammation secondary to gallstone. Case presentation We report here a case of severe and persistent obstructive jaundice in a child affected with thalassodrepanocytosis and Gilbert's syndrome, previously, and unsuccessfully, treated with endoscopic removal of choledochal stones. Deep and thorough biliary washing, and stenting with a new removable polytetrafluoroethylene (PTFE-covered flared-type stent led to complete resolution of the obstructive jaundice. Conclusions This report shows that an aggressive endoscopic approach in this select category of patients can help resolve the severe complication of hemolytic anemia, thus avoiding surgery.

  3. The value of hyperbilirubinaemia in the diagnosis of acute appendicitis.

    LENUS (Irish Health Repository)

    Emmanuel, Andrew

    2011-04-01

    No reliably specific marker for acute appendicitis has been identified. Although recent studies have shown hyperbilirubinaemia to be a useful predictor of appendiceal perforation, they did not focus on the value of bilirubin as a marker for acute appendicitis. The aim of this study was to determine the value of hyperbilirubinaemia as a marker for acute appendicitis.

  4. Gallbladder bile composition in patients with Crohn's disease

    Institute of Scientific and Technical Information of China (English)

    Annika Lapidus; Jan-Erik (A)kerlund; Curt Einarsson

    2006-01-01

    AIM: To further elucidate the pathogenesis and mechanisms of the high risk of gallstone formation in Crohn's disease.METHODS: Gallbladder bile was obtained from patients with Crohn's disease who were admitted for elective surgery (17 with ileallileocolonic disease and 7 with Crohn's colitis). Fourteen gallstone patients served as controls. Duodenal bile was obtained from ten healthy subjects before and after the treatment with ursodeoxycholic acid. Bile was analyzed for biliary lipids,bile acids, bilirubin, crystals, and crystal detection time (CDT). Cholesterol saturation index was calculated.RESULTS: The biliary concentration of bilirubin was about 50% higher in patients with Crohn's disease than in patients with cholesterol gallstones. Ten of the patients with Crohn's disease involving ileum and three of those with Crohn's colitis had cholesterol saturated bile. Four patients with ileal disease and one of those with colonic disease displayed cholesterol crystals in their bile. About 1/3 of the patients with Crohn's disease had a short CDT. Treatment of healthy subjects with ursodeoxycholic acid did not increase the concentration of bilirubin in duodenal bile. Several patients with Crohn's disease,with or without ileal resection/disease had gallbladder bile supersaturated with cholesterol and short CDT and contained cholesterol crystals. The biliary concentration of bilirubin was also increased in patients with Crohn's colitis probably not due to bile acid malabsorption.CONCLUSION: Several factors may be of importance for the high risk of developing gallstones of both cholesterol and pigment types in patients with Crohn's disease.

  5. Safety and pharmacology of paclitaxel in patients with impaired liver function : a population pharmacokinetic-pharmacodynamic study

    NARCIS (Netherlands)

    Joerger, M.; Huitema, A. D. R.; Huizing, M. T.; Willemse, P. H. B.; Rosing, H.; Schellens, J. H. M.; Beijnen, J. H.; Vermorken, J. B.

    2007-01-01

    Aims To assess quantitatively the safety and pharmacology of paclitaxel in patients with moderate to severe hepatic impairment. Methods Solid tumour patients were enrolled into five liver function cohorts as defined by liver transaminase and total bilirubin concentrations. Paclitaxel was administere

  6. Common Diagnoses in the NICU

    Science.gov (United States)

    ... a surgeon to place a tube in the brain (called a shunt) that drains the fluid from the brain. Sometimes the fluid is drained to the scalp ... treated? Extremely high levels of bilirubin can cause brain damage, so infants ... abdomen to allow the infected fluid to drain. How long will my baby be in the ...

  7. REVERSIBILITY OF CHOLESTATIC CHANGES FOLLOWING EXPERIMENTAL COMMON BILE-DUCT OBSTRUCTION - FACT OR FANTASY

    NARCIS (Netherlands)

    ARONSON, DC; CHAMULEAU, RAFM; FREDERIKS, WM; GOOSZEN, HG; HEIJMANS, HSA; JAMES, J

    1993-01-01

    In 36 male Wistar rats extrahepatic cholestasis was induced by ligation and transsection of the common bile duct. After 1, 2 and 3 weeks of cholestasis the bile flow was restored by means of a Roux-en-Y choledochojejunostomy. Plasma levels of bilirubin, alkaline phosphatase, GOT and clotting factor

  8. Assessment of Requirement of Routine Intraoperative Cholaniography at Cholecystectomy

    Directory of Open Access Journals (Sweden)

    M Shiryazdi

    2013-12-01

    Conclusion: According to above statistically significant relation, we recommend that in patients who are candidate for cholecystectomy, if elevated preoperative serum alkaline phosphatase or elevated preoperative serum bilirubin or abnormal ultrasound findings were observed, more diagnostic evaluation should be done for them including MRC and ERC.

  9. Conformational changes in human serum albumin studied by fluorescence and absorption spectroscopy. Distance measurements as a function of pH and fatty acids

    DEFF Research Database (Denmark)

    Honoré, B; Pedersen, A O

    1989-01-01

    pH- and fatty acid-induced conformational changes in human serum albumin were investigated by fluorescence-energy transfer, determining the distance between Trp-214 and bound bilirubin at 25 degrees C. This distance changes significantly with the pH, being 2.52 +/- 0.01 nm at pH 6, 2.31 +/- 0.04 ...

  10. INTER-RELAÇÕES ENTRE A FUNÇÃO HEPÁTICA, LIPIDOGRAMA E OS DISTÚRBIOS INFLAMATÓRIOS DO ENDOMÉTRIO (ENDOMETRITES PUERPERAIS AGUDAS, RETENÇÃO DOS ANEXOS FETAIS E CATARROS GENITAIS) DE FÊMEAS BOVINAS DA RAÇA HOLANDESA

    OpenAIRE

    Regiane Machado de Souza; Melina Marie Yasuoka; Diego Antonio Leão; Eduardo Harry Birgel Junior

    2010-01-01

    Aiming to assess the relationship among hepatic function,lipid profile and endometrium inflammatory disorders (acutepostpartum endometritis, placental retention and genital catarrhaldischarges), 126 blood samples were collected from Holsteincows. Hepatic function was assessed by total serum protein,albumin, globulins, aspartate aminotransferase (AST), gammaglutamyltranspeptidase (GGT) and bilirubin measurement. Lipidprofile assessment was measured by serum levels of cholesterol,triglycerides,...

  11. Non-invasive physiological measurements

    International Nuclear Information System (INIS)

    This book discusses the diagnostic techniques of nondestructive type for monitoring the physiology of various organ systems. The topics covered are: non-invasive assessment of gastric activity; uterine activity, intestinal activity; monitoring of fetal cardiovascular system and bilirubin physiology of infants. Respiratory system of infants is monitored and ultrasonography of heart is discussed

  12. Neonatal jaundice.

    Science.gov (United States)

    Allen, Daniel

    2016-07-01

    Essential facts The National Institute for Health and Care Excellence (NICE) first published guidelines on jaundice in newborn babies in 2010 and updated them in May. Jaundice is caused by raised bilirubin levels when red blood cells are broken down. PMID:27387624

  13. Percutaneous Transhepatic Cholangiography and Biliary Drainage After Liver Transplantation: A Five-Year Experience

    OpenAIRE

    Zajko, Albert B.; Bron, Klaus M.; Campbell, William L.; Behal, Rajan; VAN THIEL, DAVID H.; Starzl, Thomas E.

    1987-01-01

    Evaluation of the biliary tract by percutaneous transhepatic cholangiography (PTC) is often required in liver transplant patients with an abnormal postoperative course. Indications for PTC include failure of liver enzyme levels to return to normal postoperatively, an elevation of serum bilirubin or liver enzyme levels, suspected bile leak, biliary obstructive symptoms, cholangitis, and sepsis.

  14. The results of percutaneous transhepatic biliary drainage

    International Nuclear Information System (INIS)

    Significant reduction in serum bilirubin levels was obtained in 90.7% of 75 patients on whom percutaneous transhepatic biliary drainage had been carried out, either immediately before operation or as a prolonged palliative procedure. The technical requirements, complications, mortality rate and length of stay in hospital are less than following palliative surgery. (orig.)

  15. Results of percutaneous transhepatic biliary drainage

    Energy Technology Data Exchange (ETDEWEB)

    Lackner, K.; Steudel, A.; Baeuerle, R.; Engel, C.; Schneider, B.

    1985-06-01

    Significant reduction in serum bilirubin levels was obtained in 90.7% of 75 patients on whom percutaneous transhepatic biliary drainage had been carried out, either immediately before operation or as a prolonged palliative procedure. The technical requirements, complications, mortality rate and length of stay in hospital are less than following palliative surgery.

  16. Carbon monoxide production in ventilated premature infants weighing less than 1500 g.

    OpenAIRE

    Fischer, A F; Ochikubo, C G; Vreman, H. J.; Stevenson, D. K.

    1987-01-01

    Mean pulmonary excretion rate of carbon monoxide in 13 premature babies on ventilators was significantly higher (p less than 0.001) than that of 19 healthy infants born at full term. This correlated with carboxyhaemoglobin concentrations in blood, indicating that the premature infants on ventilators produced abnormally large amounts of bilirubin.

  17. A comparative study of gallstones from children and adults using FTIR spectroscopy and fluorescence microscopy

    Directory of Open Access Journals (Sweden)

    Marks Robert S

    2002-02-01

    Full Text Available Abstract Background Cholelithiasis is the gallstone disease (GSD where stones are formed in the gallbladder. The main function of the gallbladder is to concentrate bile by the absorption of water and sodium. GSD has high prevalence among elderly adults. There are three major types of gallstones found in patients, White, Black and Brown. The major chemical component of white stones is cholesterol. Black and brown stones contain different proportions of cholesterol and bilirubin. The pathogenesis of gallstones is not clearly understood. Analysis of the chemical composition of gallstones using various spectroscopic techniques offers clues to the pathogenesis of gallstones. Recent years has seen an increasing trend in the number of cases involving children. The focus of this study is on the analysis of the chemical composition of gallstones from child and adult patients using spectroscopic methods. Methods In this report, we present FTIR spectroscopic studies and fluorescence microscopic analysis of gallstones obtained from 67 adult and 21 child patients. The gallstones were removed during surgical operations at Soroka University Medical Center. Results Our results show that black stones from adults and children are rich in bilirubin. Brown stones are composed of varying amounts of bilirubin and cholesterol. Green stones removed from an adult, which is rare, was found to be composed mainly of cholesterol. Our results also indicated that cholesterol and bilirubin could be the risk factors for gallstone formation in adults and children respectively. Fluorescence micrographs showed that the Ca-bilirubinate was present in all stones in different quantities and however, Cu-bilirubinate was present only in the mixed and black stones. Conclusions Analysis based on FTIR suggest that the composition of black and brown stones from both children and adults are similar. Various layers of the brown stone from adults differ by having varying quantities of

  18. Prophylactic effect of zinc sulphate on hyperbilirubinemia in premature very low birth weight neonates: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Ashraf Mohammadzadeh

    2015-02-01

    Full Text Available Introduction: One of the common problems in neonatal period is jaundice that occurs in the first week of birth in 60% of term and 80% of preterm neonates. In preterm newborn hyperbilirubinaemia is higher, persistent, longer, and more likely to be associated with neurological injury than term neonates. The purpose of this study was to determine Prophylactic effect of zinc sulphate on hyperbilirubinemia in premature very low birth weight neonates. Method and Material: Sixty Newborns who admitted in our NICU which had inclusion criteria were eligible in this trial. Included neonates were randomly placed in two groups (case and control and before intervention the total serum bilirubin (TSB was measured at second day. The participant received either 20 mg of zinc sulfate or placebo through NG-tube divided in two doses till day seven of age. Then total and indirect bilirubin was measured at 3ed, 5th and 7th day of life. If any of newborns in duration of hospitalization develop clinical jaundice, after assessment of bilirubin, need for phototherapy was evaluated based on phototherapy and exchange schedule as described by the American Academy of Pediatrics guidelines. The termination point of phototherapy was defined as a bilirubin level less than 50 percent of starting point. After gathering Data, they were analyzed using SPSS software (version 11.5 and T-test, Chi-square and repeated measurement tests. Results: Seventy eight patients enrolled in this trial that 18 cases were excluded and the remaining cases divided into two equal groups (N=30 in each group. Demographic condition was similar in two groups. There were no different between two groups in decreasing total serum bilirubin and duration of phototherapy. Conclusion: This study showed that zinc sulfate has no preventing effective in hyperbilirubinemia in preterm very low birth weight neonates. It has also no effect on duration of phototherapy.

  19. The Effect of Clofibrate on Hyperbilirubinemia of Term Neonates

    Directory of Open Access Journals (Sweden)

    Parviz Ayazi

    2012-01-01

    Full Text Available Clofibrate is a glucuronosyl transferase inducer that has been proposed to increase the elimination of bilirubin in neonates with hyperbilirubinemia. This study was conducted to determine the therapeutic effect of clofibrate in term neonates with non-hemolytic jaundice. This study was conducted on 52 newborns with pathologic unconjugated jaundice in Qazvin children hospital. Newborns divided randomly in two groups. Case group treated with clofibrate and intensive phototherapy, while control group treated only with intensive phototherapy. Serum bilirubin level was measured before and 6, 12, 24 and 48 hours after treatment. Results were compared and analyzed. The mean serum level of bilirubin before treatment in the case and control groups were 20.78±2.38 and 20.52 ±2.44 mg/dl, respectively (P=0.69. The mean serum level of bilirubin in 6, 12, 24 and 48 hours after treatment in the case group were 18.20±2.20, 14.70±2.06, 10.72±2.40 and 8.90±0.83 mg/dl , respectively. These values in control group were 18.26±2.42, 15.36±2.59, 12.29±2.28 and 10.23±1.50 mg/dl, respectively. There was significant difference between two groups regarding mean serum level of bilirubin 24 hours (P=0.019 and 48 hours after treatment (P=0.005. In conclusion, clofibrate was effective in reducing neonatal jaundice and its effect appeared 24 hours after treatment.

  20. Progress in the study on the composition and formation mechanism of gallstone

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Our serial studies from 1970s on chemical composition, structure determination and formation mechanism of gallstones were reviewed. The chemical component investigation of brown-pigment gallstone demonstrated that it consists of macromolecules such as proteins, glycoproteins, polysaccharides, bilirubin polymers and pigment polymers, and biomolecules such as cholesterol, bile salts, calcium salts of carbonate, phosphate, fatty acids and bilirubinate as well as various metal ions. The binding of metal ions with bile salts and bilirubin plays important roles in gallstone formation, i.e., calcium bilirubinate complex is the major constitute of brown-pigment gallstones, and copper bilirubinate complex is critical in the black color appearance of black-pigment gallstone. The cross section of many gallstones exhibits a concentric ring structure composed of various small particles with a fractal character. This is nonlinear phenomenon in gallstone formation. A typical model system of metal ions-deoxycholate (or cholate)-gel was chosen to mimic an in vitro pattern formation system. The experimental results suggested that a nonlinear scientific concept should be considered in understanding gallstone formation. Minor changes in the chemical composition and/or the microenvironment may lead to very different precipitate patterns with a variety of shapes, colors, appearances, and structures. A new model was suggested that periodical templets of periodical and fractal patterns were formed in the initial stage, then the spatio-temporal patterns grew gradually on it. Furthermore, the interaction between divalent metal ions and bile salts in vitro was investigated, and the results indicated that non-stoichiometric M(DC)2-NaDC mixed complexes with mixed micelles structure can be formed in physiological condition.

  1. Systemic effects of orally-administered zinc and tin (IV) metalloporphyrins on heme oxygenase expression in mice.

    Science.gov (United States)

    Morioka, Ichiro; Wong, Ronald J; Abate, Aida; Vreman, Hendrik J; Contag, Christopher H; Stevenson, David K

    2006-05-01

    Some metalloporphyrins (Mps) inhibit heme oxygenase (HO), the rate-limiting enzyme in the production of bilirubin, and are potential compounds for the treatment of neonatal jaundice. We studied the safety and efficacy of Mps following oral administration. Adult HO-1-luc reporter mice were administered 30 micromol/kg body weight of tin mesoporphyrin (SnMP), zinc bis glycol deuteroporphyrin (ZnBG), or zinc protoporphyrin (ZnPP), or vehicle by oral gavage. Bilirubin production was measured as total body carbon monoxide (CO) excretion (VeCO). HO activity was quantitated via CO measurements by gas chromatography. HO-1 protein was determined by Western blot. HO-1 transcription levels were assessed by in vivo bioluminescence imaging. A significant 28% decrease in bilirubin production occurred within 3 h of SnMP treatment and persisted beyond 48 h. Bilirubin production decreased 15% and 9% by 3 h after administration of ZnBG and ZnPP, respectively, but returned to baseline within 48 h. Maximal inhibition of liver, spleen, and intestine HO activity was seen at 3 h with inhibitory effects decreasing in the order: SnMP > or = ZnBG > or = ZnPP. After SnMP treatment, HO-1 transcription increased 5.7-fold after 24 h. Furthermore, liver and spleen HO-1 protein significantly increased 3.7- and 2.0-fold, respectively, after 24 h. HO-1 transcription and protein were not affected in ZnBG- or ZnPP-treated mice. We conclude that the three Mps are absorbed at different rates in the mouse and affect bilirubin production and HO-1 expression in a tissue- and time-dependent manner. PMID:16627879

  2. Antioxidant status in neonatal jaundice before and after phototherapy

    Directory of Open Access Journals (Sweden)

    S Ayyappan

    2015-01-01

    Full Text Available Background: Neonatal jaundice refers to yellow coloration of the skin and the sclera (whites of the eyes of newborn babies that result from the accumulation of bilirubin in the skin and mucous membranes. Because bilirubin is potentially toxic to the central nervous system. Genetic disorders of bilirubin conjugation, particularly the common Gilbert′s syndrome, can also contribute to neonatal hyperbilirubinemia. Objective: The aim of this study was to evaluate the lipid per-oxidation and antioxidant enzyme activities in patients with neonatal jaundice before and after phototherapy. Materials and Methods: The study includes 50 neonatal jaundice patients with average age 2-15 days. All patients of neonatal jaundice receiving phototherapy except feeding, cleaning. Subjects selected were from the patients attending Pediatrics Department. Plasma malondialdehyde (MDA, erythrocyte glutathione peroxidase (GPX, superoxide dismutase and catalase (CAT to monitor the bilirubin level. Results: The results show increased levels of bilirubin compared with controls (P < 0.001 shows the level of plasma MDA in control, before and after phototherapy. Represents the level of GPX was significantly increased in after the phototherapy group when compared with before phototherapy and control SPSS soft ware: (P < 0.001. Shows the reduced glutathione (GSH level in plasma was significantly decreased in the after phototherapy group when compared with before phototherapy and control (P < 0.001. And finally with ascorbic acid and CAT. Conclusion: It is evident from the study that increased oxidative stress in neonatal jaundice babies leads to decrease in the levels of antioxidants like GSH and ascorbic acid and disturb their metabolism, that weaken their ability to fight the growing stress. Intense oxidative stress and decreased antioxidants may contribute to neural cell death and alter the erythrocytomembrane structure processing in neonatal jaundice.

  3. Characteristics of brainstem auditory evoked potential of neonates with mild or moderate hyperbilirubinemia

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: Brainstem auditory evoked potential (BAEP) has been widely used to evaluate the functional integrity and development of injured auditory system and brain, especially to objectively evaluate the function of auditory system and brain stem of very young babies, such as neonates and sick babies.OBJECTIVE: To observe the changes of BAEP of neonates with hyperbilirubinemia, and to investigate the relationship of bilirubin concentration and BAEP.DESIGN: An observation experiment.SETTING: Department of Pediatrics, the 309 Clinical Division, General Hospital of Chinese PLA.PARTICIPANTS: Fifty-eight neonates with mild or moderate hyperbilirubinemia exhibiting jaundice within 24 hours after born, who received the treatment in the Department of Pediatrics, the 309 Clinical Division, General Hospital of Chinese PLA between January 2004 and May 2007, were recruited in this study. The involved neonates, 31 boys and 27 girls, had gestational age of 37 to 46 weeks. They had no history of birth asphyxia, and were scored 8 to 10 points when born. Written informed consents of examination and treatment were obtained from the guardians of the neonates. This study was approved by the Hospital Ethics Committee. According to serum total bilirubin value, the neonates were assigned into 3 groups: low-concentration bilirubin group (n =16), moderate-concentration bilirubin group (n =27) and high-concentration bilirubin group (n =15). According to mean daily bilirubin increase, the subjects were sub-assigned into bilirubin rapid increase group (n =39) and bilirubin slow increase group (n =19).METHODS: After admission, all the neonates received drug treatment. Meanwhile, their 116 ears were examined with a myoelectricity evoked potential equipment (KEYPOINT) in latency, wave duration,amplitude and wave shape differentiation of each wave of BAEP. BAEP abnormal type was observed and abnormal rate of BAEP was calculated.MAIN OUTCOME MEASURES: ① Abnormal rate and abnormal type of BAEP

  4. Relation Between Interleukin-1-β And Interleukin-8 Levels In Breast Milk (Colostrum) And Neonatal Physiological Jaundice

    International Nuclear Information System (INIS)

    The immune system of neonates is influenced by maternal immunity during pregnancy and lactation. Breast-fed neonates have higher incidence of neonatal jaundice and higher level of total serum bilirubin than formula-fed infants. The aim of this study was to find a relationship between neonatal physiological jaundice and interleukin-1-beta (IL-1-β) and interleukin-8 (IL-8) in the colostrum of nursing mothers. Breast milk (colostrum) was collected from 45 nursing mothers of healthy full term neonates. The sharing mothers and their neonates were divided into two groups according to the presence of neonatal jaundice and the level of total serum bilirubin. All jaundiced neonates had total serum bilirubin level more than 12 mg/dl which appeared on the third postpartum day, all of them were breast-fed only. They were subjected to full history through clinical examination and laboratory investigations including determination of colostral levels of IL-1-β and IL-8, by ELISA, and determination of neonatal total serum bilirubin levels. This study revealed that mothers of neonates with physiological jaundice had higher concentrations of IL-1-β and IL-8 in their colostrums as compared with control group. Moreover, it displayed that total serum bilirubin level of jaundiced neonates was higher than its level in non-jaundiced neonates. There were significant correlations between IL- 1-β and IL-8 with mother's age in all groups, while there were inverse correlations between IL-1- , IL-8 and gestational age of non- jaundiced neonates. Additionally, there was significant correlation between IL-1-β and IL-8 in the colostrum of all mothers enrolled in this study. On the other hand, no correlation was determined between cytokines IL-1-β, IL-8 and total serum bilirubin in all neonates sharing in this study. This study clearly demonstrated that the levels of immunomodulating agents such as cytokines IL-1-β and IL-8 were elevated in the colostrum of mothers with jaundiced neonates

  5. Comparison of Two Phototherapy Methods (Prophylactic vs Therapeutic for Management of Hyperbilirubinemia in Very Low Birth Weight Newborns

    Directory of Open Access Journals (Sweden)

    Seyedeh-Sarah Nazem-Sadati

    2011-12-01

    Full Text Available Objective: Preterm and low birth weight (LBW infants are at greater risk of developing bilirubin-associated brain damage compared with term infants. Certainly, phototherapy, if used appropriately, is capable of controlling the bilirubin levels in LBW infants; but there is not a unique phototherapy treatment strategy in LBW infants. This study was designed to compare the prophylactic phototherapy and late treatment of jaundiced newborns weighing 1000-1500 grams.Methods: Sixty newborns with birth weight 1000-1500 g were studied. They were divided into two groups: the "Prophylactic" group, in which phototherapy started within six hours after birth and continued for at least 96 hours, and the "Treatment" group, which received phototherapy when indicated according to birth weight and suspended when bilirubin level fell below 50% of bilirubin level for blood exchange. Mean value of daily transcutaneous bilirubin (TCB, duration of phototherapy, the need for blood exchange, and the highest TCB value in both groups were analyzed."nFindings: In the prophylactic group, the highest daily mean rate of TCB was 7.71±1.84 mg/dl, which happened on the third day. In the treatment group, it was 8.74±1.72 mg/dl on the fourth day after birth. The TCB values in prophylactic group were significantly less than those of the treatment group only on the fourth and fifth days after birth (P<0.001. Although the median duration of phototherapy in the treatment group was shorter than that of the prophylactic group (137.60±57.39 vs 168.71±88.01 hours, respectively, this difference was not statistically significant. Only one neonate needed blood exchange in the treatment group."nConclusion: The prophylactic phototherapy treatment for babies weighing 1000-1500 g significantly decreases bilirubin levels on the fourth and fifth days after birth but the clinical course of hyperbilirubinemia does not alter in LBW infant, as indicated by the non-significant change in the duration

  6. Phototherapy in the newborn: what’s new?

    Directory of Open Access Journals (Sweden)

    Murat Yurdakök

    2015-10-01

    Full Text Available When exposed to light, bilirubin undergoes photoisomerization which are water-soluble and can be excreted in bile and urine. Photoisomerization starts as soon as the lights turned on, and risk of bilirubin encephalopathy is lower in infants who receive phototherapy even in the same serum bilirubin levels. Blue light is absorbed most readily if bilirubin is in a tube, but skin penetration and albumin binding shift of the most effective light to blue-green region. However, there is no consensus on the most effective wavelength for phototherapy. The light sources used in conventional phototherapy are fluorescent bulbs, halogen lamps or light-emitting diodes (LED with equally effective in reducing serum bilirubin levels. Fiberoptic devices are less effective. Despite higher irradiance in double or triple phototherapy, there is no superiority in clinical settings. Hyperthermia and skin rashes are higher when used super (high-intensity LED devices. Watery loose stools may cause dehydration in preterm infants. Riboflavin loss and lipid peroxidation are prevented with using dark tubing or covering the line with aluminum foil. The consequences of light penetration into deep brain in newborn infants because of open wide fontanel and thin skull is unknown. Non-ocular light exposure and suppressed melatonin secretion may affect autonomic and behavioral disturbances. Phototherapy-induced hypocalcemia may be prevented by covering the head. Phototherapy does not effect ductal patency or reopening, its effect on the incidence of retinopathy of prematurity have yielded conflicting results. Neonatal phototherapy increases the risk of asthma and allergic disorders in older age groups. Aggressive (low-threshold phototherapy increase mortality risk in small preterm infants less than 750 g at birth, which may be related to the reduced bilirubin with its antioxidant effects. In conclusion, phototherapy is not a treatment without side effects and overtreatment should

  7. Hemolysis test of emulsified isoflurane in vitro and in vivo%乳化异氟烷的体内和体外溶血性实验研究

    Institute of Scientific and Technical Information of China (English)

    饶艳; 王焱林; 张文胜; 杨小霖; 马汉祥; 杨经文; 杨宗斌; 刘爱杰; 刘进

    2011-01-01

    Objective Emulsified isoflurane (8% ,vol/vol) is a kind of lipid based formation for intravenous administration. The purpose of this study is to evaluate whether emulsified isoflurane induces hemolysis or not in vitro and in vivo. Methods In hemolysis test in vitro, a male rabbit was used to prepare 2% (vol/vol) erythrocyte suspensions for measuring degree of hemolysis of emulsified isoflurane at the doses from 12 to 0. 3 g/L. In hemolysis test in vivo,4 male Beagle dogs were intravenously adminstrated emulsified isoflurane 225.6 mg/kg in 3-5 min. 5 ml samples of venous blood were collected from each dog at 0 min (start of injection) ,5 min,30 min,1 h,2 h,4 h,8 h,1 d,2 d,3 d and 6 d after the adminstration of emulsified isoflurance for measuring erythrocyte morphology,reticulocyte counts, the concentrations of free hemoglobin,haptoglobin,and bilirubin. At the same time, urinary blood, urinary bilirubin and urobilinogen were also measured before and after adminstration. Results In vitro experiment,emulsified isoflurane led to hemolysis at the concentrations from 12 to 1.2 g/L. However,no hemolysis was found at the concentrations from 0. 6 to 0. 3 g/L. In vivo experiment,with the exception of a slight reduction in indirect bilirubin and a mild increase in direct bilirubin at 5 min (P < 0.05 ) , others such as total bilirubin, retculocyte counts, haptoglobin, free hemoglobin,urinary bilirubin,urinary blood, and urinary urobinogen were not significantly different compared with their corresponding values before injection. There was also no significant difference in erythrocyte fragmentations at 0 min,5 min,30 min,1 h,2 h,4 h,8 h,1 d,2 d,3 d and 6 d after injection of emusified isoflurane, and none of macrocytes and nucleated red cells was noted on all blood films. Conclusions Emulsified isoflurane at concentrations recommended for clinical trials did not cause hemolysis in vitro and in vivo.

  8. IMPORTANCE OF LIVER FUNCTION TESTS IN DIFFERENTIAL DIAGNOSIS OF JAUNDICE

    Directory of Open Access Journals (Sweden)

    Sandeep

    2015-11-01

    Full Text Available BACKGROUND: Liver function tests (LFT still play a pivotal role in investigating a case of jaundice and hence helps in the diagnosis of a liver disease. In a developing country like India, doctors come across multiple cases of jaundice in day to day practice. Liver functions tests continue to be one of the oldest and basic investigations which a clinician trusts upon to reach the diagnosis of underlying etiology. Liver function tests include liver enzyme studies – SGPT, SGOT, Alkaline phosphatase, GGTP along with S. Bilirubin and S. Protein levels. With the help of liver function tests we can easily assess the cause of jaundice, whether it is due to prehepatic causes, hepatic causes or posthepatic causes. MATERIAL AND METHODS: A study carried out at Parul Institute of Medical Sciences, Vadodara, Gujarat, included 200 patients with jaundice among which were men, women and children of age group – 1 day to 80 years. The study was carried out over a span of 6 months. Liver function tests were performed by collecting samples in plain vacutainer and tests were carried out on Fully Automated Biochemistry Analyzer – SELECTRA BY Merck diagnostics. All the patients had minimum serum total bilirubin levels of greater than 1.5 mg%. RESULTS: Our study included total 200 patients of jaundice with serum bilirubin >1.5 mg%. Among them 55 were females and 145 were males. Patients were of age group 1 day to 80 years. Data revealed that approximately 30% of patients had prehepatic jaundice, 60 % had hepatic type, whereas 10 % had post hepatic type. In pre-hepatic jaundice, liver function tests show increase in indirect bilirubin with minimal or slight increase in the liver enzymes. In hepatic jaundice there is marked elevation in serum enzyme levels principally SGPT and SGOT while slight elevation in alkaline phosphatase and GGTP, elevated serum bilirubin levels is mainly of direct type and serum protein levels were altered. In post hepatic jaundice there is

  9. AB161. High resolution melting analysis of buccal DNA revealed a significant association between UGT1A1 c.211G>A and neonatal hyperbilirubinemia development in Malay population

    Science.gov (United States)

    Cheung, Tian Pei; Van Rostenberghe, Hans; Ismail, Rosliza; Nawawi, Noor Namirah; Abdullah, Nurul Amierah; Ramli, Noraida; Ibrahim, Nor Rosidah; Hj Abd Majid, Noorizan; Mohd Yusoff, Narazah; Nishio, Hisahide; Yusoff, Surini

    2015-01-01

    Background Severe neonatal hyperbilirubinemia or neonatal jaundice (NNJ) characterised by an elevated total serum bilirubin (TSB) level may result in kernicterus or even death. Uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1) is the key enzyme which conjugates bilirubin with glucuronic acid for the subsequent bilirubin excretion. Conversely, constitutive androstane receptor (CAR), encoded by nuclear receptor subfamily 1, group I, member 3 (NR1I3) gene, regulates bilirubin excretion by activating the components of the bilirubin clearance pathway. Thus, genetic variants in UGT1A1 and NR1I3 genes may modulate bilirubin excretion and lead to NNJ. This study aimed to determine the association between UGT1A1 and NR1I3 genetic variants and NNJ development in Malay population by genotyping the DNA isolated from buccal swabs. The accuracy and reliability of the genotyping results produced by buccal DNA was also compared with that of the whole blood DNA. Methods Buccal swabs were collected from 232 hyperbilirubinemia and 232 non-hyperbilirubinemia newborns admitted to and/or born in Hospital Universiti Sains Malaysia (HUSM). Hyperbilirubinemia subjects were those with TSB levels ≥250 µmol/L within the first week after birth while non-hyperbilirubinemia subjects were newborns without significant hyperbilirubinemia. The UGT1A1 (c.211G>A) and NR1I3 [MPJ6_1I3008 (G>A), IVS8+116T>G and 540A>G] variants were genotyped by using high resolution melting (HRM) analysis. Binary logistic regression was used to assess the association between variant genotypes and risk of NNJ. Whole blood samples were also collected from 60 subjects and genotyped to compare the HRM genotyping results with that of the buccal swabs. Results When compared with wild-type genotype, both heterozygous and homozygous variant genotypes of MPJ6_1I3008 (G>A), IVS8+116T>G and 540A>G were not significantly associated with NNJ. However, the heterozygous genotype (GA) of c.211G>A was found to increase the

  10. Effectiveness of ultrasound, computed tomography, hepatobiliary scintigraphy and nuclear magnetic resonance in diseases of the gallbladder and bile ducts

    Energy Technology Data Exchange (ETDEWEB)

    Fiegler, W.; Schoerner, W.; Felix, R.

    1984-09-01

    The effectiveness of ultrasound, computed tomography, hepatobiliary scintigraphy and nuclear magnetic resonance in diseases of the biliary tract is described. Ultrasound should be the first examination in clinical suspicion of cholelithiasis and has a higher accuracy than oral cholecystography. Computed tomography is very expensive and should be carried out in suspected gallbladder carcinoma, cholecystitis with abscess formation, tumour in the porta hepatis and pancreatic head and in sonographically unclear cases. Nuclear magnetic resonance can determine the ability of the gallbladder to concentrate bile. Ultrasound can distinguish with high accuracy between obstructive and inflammatory jaundice. In clinical suspicion of bile duct lesions an infusion cholangiogram must be carried out, if bilirubin is lower than 5 mg%; if bilirubin is higher, an ERC or PTC should be performed. If in biliary obstruction a suspicion of tumour in porta hepatis or head of the pancreas is present, computed tomography should be effected.

  11. PROTECTIVE ABILITY OF MOMORDICA CHARANTIA L AGAINST CCL4 INDUCED HEPATIC DAMAGE IN RATS

    Directory of Open Access Journals (Sweden)

    Pingale Shirish S

    2010-12-01

    Full Text Available The aim of this study is to evaluate the efficacy of Momordica charantia on the experimental hepatotoxicity induced by carbon tetrachloride (CCl4. Carbon tetrachloride was administered once and simultaneously suspension of dry fruit powder was prepared in aqueous medium and was daily administered at a dose level of 1mg/kg body weight for 4 days. Silymarin was used as a standard drug for this study. Administration of carbon tetrachloride showed significant changes in the levels of serum aminotransferase, alkaline phosphatase, bilirubin and total proteins levels, however necrosis, collagen deposition and altered hepatic architecture were also observed. Markers of liver injury, altered aminotransferase, alkaline phosphatase, bilirubin etc. and morphological changes such as necrosis and collagen deposition were significantly decreased in the rats treated with Momordica charantia fruit powder. These results suggest that the Momordica charantia showed hepatoprotective effect on carbon tetrachloride induced hepatic damage and may be a potential clinical application for treatment of liver diseases.

  12. Development of a membraneless ethanol/oxygen biofuel cell

    International Nuclear Information System (INIS)

    Biofuel cells are similar to traditional fuel cells, except the metallic electrocatalyst is replaced with a biological electrocatalyst. This paper details the development of an enzymatic biofuel cell, which employs alcohol dehydrogenase to oxidize ethanol at the anode and bilirubin oxidase to reduce oxygen at the cathode. This ethanol/oxygen biofuel cell has an active lifetime of about 30 days and shows power densities of up to 0.46 mW/cm2. The biocathode described in this paper is unique in that bilirubin oxidase is immobilized within a modified Nafion polymer that acts both to entrap and stabilize the enzyme, while also containing the redox mediator in concentrations large enough for self-exchange based conduction of electrons between the enzyme and the electrode. This biocathode is fuel tolerant, which leads to a unique fuel cell that employs both renewable catalysts and fuel, but does not require a separator membrane to separate anolyte from catholyte

  13. ADH1B and ADH1C Genotype, Alcohol Consumption and Biomarkers of Liver Function

    DEFF Research Database (Denmark)

    Lawlor, Debbie A; Benn, Marianne; Zuccolo, Luisa; De Silva, N Maneka G; Tybjaerg-Hansen, Anne; Smith, George Davey; Nordestgaard, Børge G

    2014-01-01

    BACKGROUND: The effect of alcohol consumption on liver function is difficult to determine because of reporting bias and potential residual confounding. Our aim was to determine this effect using genetic variants to proxy for the unbiased effect of alcohol. METHODS: We used variants in ADH1B and ADH......1C genes as instrumental variables (IV) to estimate the causal effect of long-term alcohol consumption on alanine aminotransferase (ALT), γ-glutamyl-transferase (γ-GT), alkaline phosphatase (ALP), bilirubin and prothrombin action. Analyses were undertaken on 58,313 Danes (mean age 56). RESULTS: In...... inverse association of alcohol with ALP [-1.5% (-1 .7, -1.3)], which differed from the strong positive effect found in genetic-IV analyses [11.6% (6.8, 16.4)] (p diff<0.0001). In both multivariable and genetic-IV analyses associations with bilirubin and protrombin action were weak and close to the null...

  14. Descriptive urological record of chimpanzees (Pan troglodytes) in the wild and limitations associated with using multi-reagent dipstick test strips.

    Science.gov (United States)

    Kaur, Taranjit; Huffman, Michael A

    2004-08-01

    Ten urine chemistry parameters were measured on 74 voided urine samples from 34 wild chimpanzees (Pan troglodytes). Multi-reagent urine dipstick tests were performed and results determined using colorimetric scales. Urine pH measured between 8 and 9 units in 91% of the chimpanzees. Test pads detected protein, erythrocytes, leukocyte esterase activity, and nitrites, ketones and bilirubin in 47, 32, 29, and chimpanzees, respectively. No apparent association between positive test results for blood in adult females and reproductive status was found. Overall, 17 of the 34 chimpanzees had positive urine test results for protein, hemoglobin, erythrocytes, leukocytes, nitrites, ketones, and/or bilirubin. Dipstick urinalysis alone is an unreliable method for assessing health and physiological status of wild chimpanzees. However, if combined with other diagnostics it could prove to be a valuable health-monitoring tool. Limitations associated with this methodology need to be considered when interpreting urinary dipstick test results. PMID:15271068

  15. Acute acalculous cholecystitis (AAC in the pediatric population associated with Epstein–Barr Virus (EBV infection. Case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Fuad Alkhoury

    2015-01-01

    PRESENTATION OF CASE: A 15-year-old female who came to the JDCH ER complaining of 3 days history of mild diffuse abdominal pain associated with two episodes of emesis. She also reports headache as well as a mild cough and low grade subjective fever. Blood test results showed mild leukocytosis with significant elevation in the lymphocytes (59%, High alkaline phosphatase (221 U/I, AST (191 U/I, ALT(221 U/I and bilirubin (Total 1.8 and direct 1.5. Abdominal US showed a contracted gallbladder with wall thickness and pericholecystic fluid. During hospital stay number 2–3 laboratory work up show a trending up in the bilirubin levels. MRCP was ordered and no abdnormalities were found. At this point Hospital stay number 3 EBV acute infection was suspected. Serum serological studies were subsequently diagnostic for this viral disease. Management was conservative and the patient was discharged asymptomatic on hospital day number six.

  16. Hepatoprotective activity of Vitex trifolia against carbon tetrachloride-induced hepatic damage

    Directory of Open Access Journals (Sweden)

    Manjunatha B

    2008-01-01

    Full Text Available Aqueous and ethanol extracts of leaf of Vitex trifolia was investigated for hepatoprotective activity against carbon tetrachloride induced liver damage. To assess the hepatoprotective activity of the extracts, various biochemical parameters viz., total bilirubin, total protein, alanine transaminase, aspartate transaminase and alkaline phosphatase activities were determined. Results of the serum biochemical estimations revealed significant reduction in total bilirubin and serum marker enzymes and increase in total protein in the animals treated with ethanol and aqueous extracts. However significant rise in these serum enzymes and decrease in total protein level was noticed in CCl4 treated group indicating the hepatic damage. The hepatoprotective activity is also supported by histological studies of liver tissue. Histology of the liver tissue treated with ethanol and aqueous extracts showed normal hepatic architecture with few fatty lobules. Hence the present study revealed that Vitex trifolia could afford significant protection against CCl 4 induced hepatocellular injury.

  17. [Treatment of neonatal hyperbilirubinemia

    Science.gov (United States)

    Carvalho, M D

    2001-07-01

    OBJECTIVE: To review the recent medical literature on the treatment of neonatal jaundice, focusing on practical aspects that are relevant to pediatricians and neonatologists. SOURCES: An extensive review of the related literature was performed, also including the authors clinical experience in this field of investigation. SUMMARY OF THE FINDINGS: Jaundice is very common among infants during the first days of life. Several factors such as maternal and neonatal history have to be considered before implementing treatment. Significant advances have been made in the past few years concerning the treatment of jaundiced newborn infants. This review focuses on three forms of treatment of neonatal hyperbilirubinemia: phototherapy, exchange transfusion and the use of drugs to reduce serum bilirubin concentration. CONCLUSIONS: Nowadays, the in-depth knowledge about the mechanism of action of phototherapy, the development of intensified phototherapy units and the use of drugs to reduce bilirubin formation, have contributed to significantly decrease the need for exchange transfusion. PMID:14676895

  18. Hyperbilirubinemia: new approaches to an old problem.

    Science.gov (United States)

    Schwoebel, A; Sakraida, S

    1997-12-01

    Hyperbilirubinemia continues to be a common problem of the term and near-term neonate. Each year more than 60% of infants born in the United States develop jaundice, making it difficult at times to differentiate jaundice due to pathologic reasons from jaundice due to physiologic ones. Now, the knowledge that bilirubin may even have a beneficial role as an antioxidant has caused a great deal of renewed interest in the management of jaundice. The American Academy of Pediatrics has published revised guidelines for management of neonatal jaundice that have resulted in much discussion. The article reviews current theories of bilirubin production and clearance, noninvasive and nonintrusive techniques to assess and care for jaundice, and newer concepts of preventive and treatment modalities from a nursing perspective. PMID:9451194

  19. Kernicterus in sick and preterm infants (1999-2002): a need for an effective preventive approach.

    Science.gov (United States)

    Bhutani, Vinod K; Johnson, Lois H; Shapiro, Steven M

    2004-10-01

    Kernicterus in sick and preterm infants is a rarity. Universal availability of phototherapy and concerted clinical efforts to identify, effectively manage and establish clinical guidelines have been instrumental in preventing kernicterus in US intensive care nurseries. However, in sick and preterm infants the absence of precise data on prevalence of bilirubin induced neurologic injury, the lack of proven predictive indices and the absence of evidence-based studies that clearly demonstrate the actual risk of kernicterus. These leave questions regarding the basis for clinical strategies and recommendations for the management of neonatal jaundice in this select population. This article reviews 6 preterm infants selected from the Pilot Kernicterus Registry who had recovered from life-threatening neonatal illnesses, briefly discusses current indices used to ascertain risk, and offers an initial bilirubin level based identification of infants while future directions and studies are conducted to supplement our presently incomplete knowledge for safer clinical practice. PMID:15686262

  20. 90 days bioassay in sprague-dawley rats exposed to 20KHz magnetic field

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sung-Ho [College of Veterinary Medicine, Chonnam National Univ. Kwangju (Korea, Republic of); Song, Ji-Eun; Lee, Yun-Sil [Korea Cancer Center Hospital, Seoul (Korea, Republic of); Pack, Jeong-Ki [ETRI, Daejon (Korea, Republic of); Yoo, Done-SIk [College of Engineering, Daejon (Korea, Republic of)

    2002-07-01

    Sprague Dawley rats (20 rats/group [10 males, 10 females] in sham and magnetic field exposed groups) were exposed in carrousel irradiator to an 20 KHz magnetic field for 8 hrs/day, 5 days/week, for 90 days. Urine analysis (pH, SG, protein, ketone body, RBC, WBC, glucose, bilirubin, and urobilinogen), blood analysis (WBC, RBC, HGB; henoglubin concentration, HCT; hematocrit, MCV; mean corpuscular volume, MCH; mean corpuscular hemoglobin, MCHC; mean corpuscular hemoglobin concentration, and PLT; platelet or thrombocyte count), blood biochemistry (total protein, blood urea nitrogen, creatinine, glucose, total bilirubin, total cholesterol, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and lactate dehydrogenase), histopathological analysis for organs such as liver, kidney, testis, ovary, spleen, brain, heart, and lung were performed. When compared to the sham control rats, there were no significant differences in above analysis of magnetic field exposed rats. From the results, there were no significant differences between control and exposed fetus.

  1. Montelukast induced acute hepatocellular liver injury

    Directory of Open Access Journals (Sweden)

    Harugeri A

    2009-01-01

    Full Text Available A 46-year-old male with uncontrolled asthma on inhaled albuterol and formoterol with budesonide was commenced on montelukast. He developed abdominal pain and jaundice 48 days after initiating montelukast therapy. His liver tests showed an increase in serum total bilirubin, conjugated bilirubin, aspartate aminotranferase, alanine aminotranferase, and alkaline phosphatase. The patient was evaluated for possible non-drug related liver injury. Montelukast was discontinued suspecting montelukast induced hepatocellular liver injury. Liver tests began to improve and returned to normal 55 days after drug cessation. Causality of this adverse drug reaction by the Council for International Organizations of Medical Sciences or Roussel Uclaf Causality Assessment Method (CIOMS or RUCAM and Naranjo′s algorithm was ′probable′. Liver tests should be monitored in patients receiving montelukast and any early signs of liver injury should be investigated with a high index of suspicion for drug induced liver injury.

  2. Plasma catecholamine level and portal venous pressure as guides to prognosis in patients with cirrhosis

    DEFF Research Database (Denmark)

    Tage-Jensen, U; Henriksen, Jens Henrik Sahl; Christensen, E;

    1988-01-01

    clinical and biochemical variables and survival. Forty-seven (58%) of the patients died during the follow-up period. Univariate analysis showed that plasma noradrenaline and adrenaline concentrations, portal pressure, indocyanine green clearance, serum sodium, bilirubin, and albumin concentrations, and the......Circulating noradrenaline is increased in patients with cirrhosis, especially in decompensated patients with ascites. Eighty-one patients with alcoholic cirrhosis were followed for up to 8 years in order to establish a possible relationship between plasma catecholamines, haemodynamics, and routine...... presence of ascites or cardiovascular disease were of significant prognostic value. In a multivariate analysis (Cox regression model), plasma noradrenaline concentration, portal pressure, serum bilirubin concentration, and the presence of ascites and cardiovascular disease remained significant independent...

  3. Hepatoprotective effect of Vernonia cinerea and Cumin seeds on Carbon Tetrachloride Induced Hepatic Oxidative Stress

    Directory of Open Access Journals (Sweden)

    A. Nishadh

    2013-09-01

    Full Text Available In this study, we have examined the protective effect of Vernonia cinerea against carbon tetrachloride (1.0ml / kg b.wt / day administered intraperitoneally for 2 days in male albino Wistar rats. The levels of aspartate transaminase, alanine transaminase, lactate dehydrogenase, alkaline phosphatase, bilirubin, creatinine, and urea were determined. The activities of glutathione, Vitamin C and the levels of lipid peroxides in 10% w/v liver homogenate were also determined. The CCl4 induction resulted a significant elevation in the levels of serum marker enzymes, bilirubin and creatinine with decreased urea. The activities of hepatic glutathione and vitamin C were also significantly depleted with increased lipid peroxides in CCl4 intoxicated rats. The oral administration of herbal drug alone did not show any toxicity in the liver tissue. These results suggest that the herbal drug may probably act as a natural antioxidant against CCl4 induced hepatic oxidative stress.

  4. Operational use of neem oil as an alternative anopheline larvicide. Part B: Environmental impact and toxicological potential.

    Science.gov (United States)

    Awad, O M

    2003-07-01

    This study was conducted to investigate the preliminary environmental and mammalian toxicology of neem oil, temephos and chlorpyriphos-methyl/fenitrothion. Culex pipiens, Daphnia magna and Gambusia affinis were used to study environmental impact. A high level of toxicity was observed, with slight differences between organisms. The emulsifiers individually also displayed toxicity towards the tested organisms. Up to 90 days daily oral crude neem oil treatment (5 g/kg body weight) of laboratory mice did not cause any significant changes in weekly body weight gain, nor in serum liver damage indicators, direct bilirubin or total bilirubin. Blood parameters of treated mice up to 90 days were not statistically different from those of control mice. Neem oil could be used as an environmentally friendly alternative to the traditional chemical anopheline larvicides. PMID:15748062

  5. The Possible Efficacy of Artichoke in Fluconazole Related Hepatotoxicity

    Directory of Open Access Journals (Sweden)

    Hüseyin Kurt

    2014-01-01

    Full Text Available Although fluconazole related hepatotoxicity (FRH is rare, mortal acute hepatic necrosis and jaundice were reported in immunocompromised states such as acquired immunodeficiency syndrome (AIDS and bone marrow transplant (BMT. We present a case of a patient with multiple sclerosis who developed hepatotoxicity with the use of a single 150 mg fluconazole tablet for fungal vaginitis, 10 days after methylprednisolone pulse treatment. Our patient’s alanine aminotransferase (ALT and aspartate aminotransferase (AST levels were decreased, 1200 U/L and 800 U/L, respectively, and bilirubin levels were consistent at 37 mg/dL. Artichoke which has anticholestatic and antioxidant properties was used by our patient. She consumed a 30 mg artichoke leaf extract tea 3 times a day. The bilirubin levels significantly declined at the end of the first week and all liver function tests were normalized within 2 months.

  6. Follow-up of extreme neonatal hyperbilirubinaemia in 5- to 10-year-old children

    DEFF Research Database (Denmark)

    Vandborg, Pernille Kure; Hansen, Bo Moelholm; Greisen, Gorm;

    2015-01-01

    AIM: To investigate whether infants with neonatal hyperbilirubinaemia but without intermediate or advanced bilirubin encephalopathy develop long-term sequelae, with impairment of motor development, executive function, or hearing. METHOD: This nested double-cohort study included 167 exposed children...... Movement Assessment Battery for Children-Second Edition (MABC-2), pure tone audiometry, and the Behavioural Regulation Inventory of Executive Function (BRIEF) questionnaire. RESULTS: The follow-up rate was 70% of the eligible infants in the exposed group and 45% in the unexposed group. Mean difference was...... spectrum disorder recorded in national registries. INTERPRETATION: No evidence was found of an increased risk of deficits in motor development, executive function, or hearing in children with extreme hyperbilirubinaemia who did not have intermediate or advanced bilirubin encephalopathy....

  7. Study on the relationship between the serum levels of several cytokines (L-selectin, sICAM-1, IL-6, IL-10 and IL-18) and the severity of liver function impairment in patients with virus C type hepatitis

    International Nuclear Information System (INIS)

    Objective: To study the role of several cytokines (L-selectin, soluble intercellular adhesion molecule-l i.e. sICAM-1, IL-6, IL-10 and IL-18) in the pathogenesis of liver function injury in patients with C type hepatitis. Method: Serum L-selectin, sICAM-1, IL-6, IL-10 and IL-18 levels were measured with ELISA in 62 patients with hepatitis C and 36 controls. The serum ALT and total bilirubin levels were also examined. Results: The serum level of L-selectin, sICAM-1, IL-6, IL-10 and IL-18 levels in the hepatitis C patients were significantly higher than those in the controls (P<0.01). The levels of these cytokines were significantly positively correlated with those of ALT and total bilirubin. Conclusion: Detection of the levels of these cytokines might reflect the immune status and severity of liver cell injury in patients with hepatitis C. (authors)

  8. Actinomyces naeslundii and Eikenella corrodens as rare causes of liver abscesses.

    Science.gov (United States)

    Jaqua, Nathan Thomas; Smith, Adam J; Shin, Terry T; Jahanmir, Jay

    2013-01-01

    A 48-year-old man with an unremarkable medical history was admitted with vague conditions of fever, chills, myalgias and malaise. Physical examination was remarkable for only scleral icterus. Laboratory evaluation revealed elevated aminotransferases, alkaline phosphatase and bilirubin. Imaging demonstrated two masses in the right lobe of his liver, which were ultimately drained and cultures demonstrated Actinomyces and Eikenella. He continued to have fever on broad-spectrum antibiotics until catheter drainage of the abscesses was performed. He was eventually discharged in improved condition on amoxicillin-clavulanate. His aminotransferases, alkaline phosphatase and bilirubin continued to improve and he remained afebrile and asymptomatic. A repeat CT 2 months after discharge demonstrated resolution of the abscesses. Actinomyces and Eikenella are rare causes of liver abscesses and treatment requires drainage and an extended course of antibiotics. The polymicrobial character typical of liver abscesses makes antibiotic therapy challenging when cultures reveal rare organisms such as Actinomyces and Eikenella. PMID:23867879

  9. Study on the relationship between serum erythropoietin (EPO), folic acid (FA), VitB12 levels and degree of liver function impairment in patients with virus C hepatitis

    International Nuclear Information System (INIS)

    Objective: To investigate the relationship between the levels of serum EPO, FA, VitB12 and degree of liver injury in patients with hepatitis C virus infection. Methods: Levels of serum EPO, FA, VitB12 were detected with RIA and related liver function indicators (ALT total bilirubin) were also determined in 62 cases of virus C hepatitis and 36 controls. Results: Serum levels of EPO in the patients were significantly higher than those in controls (P<0.01), while levels of FA and VitB12 were significantly lower (P<0.01). The ALT and total bilirubin levels in the patients were positively correlated with those of EPO and negatively correlated with those of FA, VitB12. Conclusion: Changes of serum levels of EPO, FA and VitB12 in patients with virus C hepatitis might reflect the degree of hepatic injury and determination of these changes was of clinical usefulness. (authors)

  10. Follow-up controls after percutaneous transhepatic choledochus drainage by means of hepatobiliary sequential scintiscanning

    International Nuclear Information System (INIS)

    For follow-up controls using hepatobiliary sequential scintiscanning with 99mTc-Iodida have proven to be very satisfactory in patients with high bilirubin levels of up to 40 ng/dl. Other than with former IDA agents, this new one has the advantage of absence of renal elimination, so that there will be no overshadowing in the liver parenchyma scan, and biliary excretion can be clearly distinguished from the intestinal activities. Hepatobiliary sequential scintiscanning with 99mTc-Iodida yields information that allows to distinguish in case of rising bilirubin level between a parenchymatous jaundice and an obstruction and thus gives significant criteria for decision about further diagnostics or treatment. As patients may stay in bed during examination, even long scanning periods of up to 24 hours p.i. are not too cumbersome. (orig./MG)

  11. Interaction of indomethacin with adult human albumin and neonatal serum

    DEFF Research Database (Denmark)

    Honoré, B; Brodersen, R; Robertson, A

    1983-01-01

    The binding of indomethacin to albumin was investigated at 37 degrees C, pH 7.4. The first stoichiometric binding constant is 2.5 X 10(5) M-1. Indomethacin utilizes both the bilirubin and diazepam binding functions equally. The effect on bilirubin binding to albumin is negligible at therapeutic...... indomethacin blood levels. Oleic acid does not affect indomethacin binding until the oleate/albumin molar ratio exceeds 2. A method for measuring the reserve albumin equivalent for binding indomethacin is described. Measurement of this reserve binding equivalent in 33 neonatal serum samples shows no...... significant correlation of the reserve binding to the albumin level. This methodology may be useful in studying the variable response of infants with patent ductus arteriosus to indomethacin. Udgivelsesdato: 1983-null...

  12. Evaluation of Antioxidant and Hepatoprotective Activities of Moringa oleifera Lam. Leaves in Carbon Tetrachloride-Intoxicated Rats

    OpenAIRE

    Dharmendra Singh; Priya Vrat Arya; Ved Prakash Aggarwal; Radhey Shyam Gupta

    2014-01-01

    The antioxidant and hepatoprotective activities of the extract of Moringa oleifera leaves were investigated against CCl4-induced hepatotoxicity in rats. Hepatotoxic rats were treated with ethanol extract of Moringa oleifera for a period of 60 days at the following three dose levels; 100, 200 and 400 mg/kg body weight/day, orally. The activities were studied by assaying the serum marker enzymes like SGOT, SGPT, GGT, LDH, ALP, ACP, as well as total bilirubin, total protein and albumin in serum ...

  13. Genetic determinants of haemolysis in sickle cell anaemia

    OpenAIRE

    Milton, Jacqueline N.; Rooks, Helen; Drasar, Emma; McCabe, Elizabeth L.; Baldwin, Clinton T.; Melista, Efi; Gordeuk, Victor R; Nouraie, Mehdi; Kato, Gregory R.; Minniti, Caterina; Taylor, James; Campbell, Andrew; Luchtman-Jones, Lori; Rana, Sohail; Castro, Oswaldo

    2013-01-01

    Haemolytic anaemia is variable among patients with sickle cell anaemia and can be estimated by reticulocyte count, lactate dehydrogenase, aspartate aminotransferase and bilirubin levels. Using principal component analysis of these measurements we computed a haemolytic score that we used as a subphenotype in a genome-wide association study. We identified in one cohort and replicated in two additional cohorts the association of a single nucleotide polymorphism in NPRL3 (rs7203560; chr16p13·3) (...

  14. Early modification of sickle cell disease clinical course by UDP-glucuronosyltransferase 1A1 gene promoter polymorphism

    OpenAIRE

    Martins, R.; Morais, A.; Dias, A; Soares, I; Rolão, C; Ducla-Soares, J; Braga, L.; Seixas, T.; Nunes, B.; Olim, G; Romão, L; Lavinha, J; Faustino, P

    2008-01-01

    Elevated erythrocyte destruction in sickle cell disease (SCD) results in chronic hyperbilirubinaemia and, in a subset of patients, cholelithiasis occurs. We investigated whether the (TA)n promoter polymorphism in the UDP-glucuronosyltransferase 1A1 gene (UGT1A1) may modify bilirubin metabolism, influencing bilirubinaemia, predisposition to cholelithiasis and subsequent cholecystectomy, in a group of 153 young SCD patients (mean age 12.0 +/- 9.0 years) predominantly of Bantu beta S haplotype. ...

  15. Liver Function Parameters in Hip Fracture Patients: Relations to Age, Adipokines, Comorbidities and Outcomes

    OpenAIRE

    Fisher, Leon; Srikusalanukul, Wichat; Fisher, Alexander; Smith, Paul

    2015-01-01

    Aim: To asses liver markers in older patients with hip fracture (HF) in relation to age, comorbidities, metabolic characteristics and short-term outcomes. Methods: In 294 patients with HF (mean age 82.0±7.9 years, 72.1% women) serum alanine aminotransferase (ALT), gammaglutamyltransferase (GGT), alkaline phosphatase (ALP), albumin, bilirubin, 25(OH)vitaminD, PTH, calcium, phosphate, magnesium, adiponectin, leptin, resistin, thyroid function and cardiac troponin I were measured. Results: Eleva...

  16. Evaluation of Glucose-6-Phosphate Dehydrogenase Deficiency without Hemolysis in Icteric Newborns

    OpenAIRE

    Farzaneh Eghbalian; Ali Reza Monsef

    2007-01-01

    Objective: Glucose-6- phosphate dehydrogenase (G6PD) deficiency is an inherited deficiency that may be the cause of neonatal jaundice. Our aim was to study the prevalence of G6PD deficiency without hemolysis in relation to neonatal jaundice. Material & Methods: This prospective descriptive study has been conducted on 272 icteric newborns admitted to the Ekbatan Hospital from October 2002 to September 2004. The dataset included: age, sex, total and direct bilirubin, hemoglobin, reticulocyte co...

  17. Prevalence of glucose-6- phosphate dehydrogenase (G6PD) deficency in neonates in Bunda Women's and Childre's Hospital, Jakarta, Indonesia

    OpenAIRE

    Risma Kerina Kaban; Veronica Wijaya

    2011-01-01

    Background Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common ennme deficiency in the world. It is a risk factor for hyperbilirubinemia in neonates, which can cause serious complica¬tions such as bilirubin-induced encephalopathy or kernicterus. WHO recommends universal neonatal screening for G6PD deficiency when the frequency exceeds 3-5% of male newborns. Objective To assess the prevalence of G6PD deficiency among neonates in Bunda Women and Children Hospital (Bunda WC...

  18. Acute viral hepatitis E presenting with haemolytic anaemia and acute renal failure in a patient with glucose-6-phosphate dehydrogenase deficiency.

    Science.gov (United States)

    Tomar, Laxmikant Ramkumarsingh; Aggarwal, Amitesh; Jain, Piyush; Rajpal, Surender; Agarwal, Mukul P

    2015-10-01

    The association of acute hepatitis E viral (HEV) infection with glucose-6-phosphate dehydrogenase (G6PD) deficiency leading to extensive intravascular haemolysis is a very rare clinical entity. Here we discuss such a patient, who presented with acute HEV illness, developed severe intravascular haemolysis and unusually high levels of bilirubin, complicated by acute renal failure (ARF), and was later on found to have a deficiency of G6PD. The patient recovered completely with haemodialysis and supportive management. PMID:25500531

  19. Dengue haemorrhagic fever presenting with cholestatic hepatitis: two case reports and a review of literature

    OpenAIRE

    Yudhishdran, Jevon; Navinan, Rayno; Ratnatilaka, Asoka; Jeyalakshmy, Sivakumar

    2014-01-01

    Background Dengue fever is a common mosquito borne viral fever in South Asia, which causes significant morbidity and mortality. Dengue fever is well known to involve the liver, especially in dengue hemorrhagic fever. The hepatic involvement is usually that of a mild hepatitis with transaminase derangement without jaundice. In cases of dengue hemorrhagic fever where shock has ensued, a severe hepatitis with gross derangements of transaminases and bilirubin may occur. These are two rare cases o...

  20. A new automated method for the determination of the Total Antioxidant Capacity (TAC) of human plasma, based on the crocin bleaching assay

    OpenAIRE

    Notas George; Maliaraki Niki; Tsaousis Vassilios; Nistikaki Anastasia; Kampa Marilena; Castanas Elias

    2002-01-01

    Abstract Background Antioxidant molecules, which scavenge free radical species to prevent or delay oxidative damage of important macromolecules, membrane lipids and lipoproteins, are prevalent in plasma and other biological fluids. Among them, bilirubin, uric acid and protein thiols are the major endogenous antioxidants, while vitamins C and E, as well as a number of food-derived (poly)aromatic substances, belonging to stilbens, flavonoids and phenolic acids, are the main classes of nutrition...

  1. Blackcurrant Suppresses Metabolic Syndrome Induced by High-Fructose Diet in Rats

    OpenAIRE

    Ji Hun Park; Min Chul Kho; Hye Yoom Kim; You Mee Ahn; Yun Jung Lee; Dae Gill Kang; Ho Sub Lee

    2015-01-01

    Increased fructose ingestion has been linked to obesity, hyperglycemia, dyslipidemia, and hypertension associated with metabolic syndrome. Blackcurrant (Ribes nigrum; BC) is a horticultural crop in Europe. To induce metabolic syndrome, Sprague-Dawley rats were fed 60% high-fructose diet. Treatment with BC (100 or 300 mg/kg/day for 8 weeks) significantly suppressed increased liver weight, epididymal fat weight, C-reactive protein (CRP), total bilirubin, leptin, and insulin in rats with induced...

  2. The dynamics of biochemical parameters in blood of clinically healthy holstein cows from day 5 before to day 60 after calving

    OpenAIRE

    Irena Celeska; Aleksandar Janevski; Igor Dzadzovski; Igor Ulchar; Danijela Kirovski

    2015-01-01

    The peripartal period in Holstein dairy cows is critical, due to the transition from pregnancy to lactation. We have studied the dynamics of biochemical parameters from day 5 before to day 60 after calving. The study included 10 multiparous Holstein cows, examined at days -5, 5, 10, 30 and 60 relative to calving. Blood samples were taken from vena jugularis. Analyzed biochemical parameters were glucose, triglycerides, total cholesterol, total bilirubin, albumin, total protein, urea, NEFA and ...

  3. PENGARUH PEMBERIAN KARBON TETRAKLORIDA TERHADAP FUNGSI HATI DAN GINJAL TIKUS

    OpenAIRE

    Zulfa Zakiah; Masriani; Chairul; Ekowati Handharyani; Ruqiah Ganda Putri Panjaitan; Wasmen Manalu

    2007-01-01

    The Effects of Carbon Tetrachloride Administration on Liver and Renal Function. Carbon tetrachloride (CCl4) that induces liver damage is widely used in hepatoprotector experiments. Carbon tetrachloride at a single dose 0,1; 1,0; and 10 ml/kg body weight was administrated intraperitoneally in male rats to investigate liver and renal damage. Liver damage was monitored by increased alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), total bilirubin, and serum to...

  4. Evaluation of the changes in serum iron levels in pre-eclampsia

    OpenAIRE

    Gupta, Shalini; Nanda, Smiti; Singh, Uma; Bansal, Sadhna; Lal, Harbans

    1997-01-01

    Serum iron levels were studied in 50 patients with pre-eclampsia and the results were compared with 50 control cases. Their serum iron levels were found to be higher than the controls. Increase in serum iron was directly proportional to the increased levels of uric acid, urea and creatinine. Mean reticulocyte counts, plasma free haemoglobin and unconjugated bilirubin levels were also higher in these patients. It is suggested that haemolysis may be a major contributory factor for the increased...

  5. Recent advances in the development of farnesoid X receptor agonists

    OpenAIRE

    Ali, Ahmad H; Carey, Elizabeth J.; Lindor, Keith D

    2015-01-01

    Farnesoid X receptors (FXRs) are nuclear hormone receptors expressed in high amounts in body tissues that participate in bilirubin metabolism including the liver, intestines, and kidneys. Bile acids (BAs) are the natural ligands of the FXRs. FXRs regulate the expression of the gene encoding for cholesterol 7 alpha-hydroxylase, which is the rate-limiting enzyme in BA synthesis. In addition, FXRs play a critical role in carbohydrate and lipid metabolism and regulation of insulin sensitivity. FX...

  6. The Effect of Clofibrate on Hyperbilirubinemia of Term Neonates

    OpenAIRE

    Parviz Ayazi; Abolfazl Mahyar; Morteza Habibi; Farzad Ahmadabadi; Amir Javadi

    2012-01-01

    Clofibrate is a glucuronosyl transferase inducer that has been proposed to increase the elimination of bilirubin in neonates with hyperbilirubinemia. This study was conducted to determine the therapeutic effect of clofibrate in term neonates with non-hemolytic jaundice. This study was conducted on 52 newborns with pathologic unconjugated jaundice in Qazvin children hospital. Newborns divided randomly in two groups. Case group treated with clofibrate and intensive phototherapy, while control g...

  7. Assessment of Effect of Mirror Room in Management of Neonatal Hyperbilirubinemia

    OpenAIRE

    SH Nabavizade; SH Yazdanpanah

    2006-01-01

    ABSTRACT: Introduction & Objective: Jundice is the most common problem that can occur in the newborn. Although most jaundiced infants are otherwise perfectly healthy, jundice makes us anxious because bilirubin is potentially toxic to the central nervous system. Phototherapy is a highly effective method for prevention of exchange transfusion. The evaluation of the effect of mirror room on the decrease of hyperbilirubinemia is the purpose of this study. Materials & Metods: In this clini...

  8. EFFECT OF PHOTOTHERAPY ON HYPOCALCEMIA

    OpenAIRE

    Srinivasa; Renukananda; Srividya

    2015-01-01

    Jaundice is the most common and important abnormal physical problem in the first week of life. Due to immaturity of the bilirubin metabolism approximately 60% of term new borns and 80% of preterms (1) develop jaundice in the first week of life which may require phototherapy. The commonly known side effects of phototherapy are loose stools, hyperthermia , dehydration fluid loss, skin burn, photoretinitis, low platelet count, increased red cell osmotic fragility, bron...

  9. INCIDENCE OF NEONATAL HYPERBILIRUBINEMEA IN TERM NEW BORNS AT KBNTGH

    Directory of Open Access Journals (Sweden)

    Mujumdar

    2015-11-01

    Full Text Available AIM AND SCOPE: We conducted this study to estimate the incidence of hyperbilirubinemia in term new born with birth weight >2.5 kgs born at neonatal care unit of KBNTGH, and to determine the underlying causes, which would be of value in identifying and implementing strategies to prevent morbidity from this condition. BACKGROUND: Management of hyperbilirubinemia remains a challenge for neonatal medicine because of the risk for serious neurological complications related to the toxicity of bilirubin. MATERIALS AND METHODS: From January 2014 to January 2015, we screened 525 newborns born at KBNTGH (Khaja Bandanawaz Teaching & General Hospital attached to Khaja Bandanawaz Institute of Medical Scienceswith complaints of yellowish discoloration of skin were screened for jaundice. Infants aged 3–5 days and with unconjugated hyperbilirubinemia were included for assessment if they had a peak serum total bilirubin level exceeding 10 mg/dl. Sex, birth weight, gestational age, breast feeding, type of birth, presence of facial bruising (Including cephalohematoma and ABO group were noted. Patients with Toxoplasma or Cytomegalovirus infection, hepatic insufficiency, or suspected drug-induced hyperbilirubinemia were excluded from more detailed analysis. RESULTS: Our year-long nursery sample examined otherwise healthy-appearing term infants with birth weigth>2.5kgs for the prevalence of hyperbilirubinemia (Defined as bilirubin levels exceeding 6 mg/dL [11mol/L]. We found hyperbilirubinemia in 19% (100/525. Among the patients with hyperbilirubinemia, 1.2% had peak levels of bilirubin 20 mg/dL, levels which are generally considered to be potentially neurotoxic. CONCLUSIONS: In our clinic experience, hyperbilirubinemia was generally a serious medical issue and one whose etiology can usually be well defined.

  10. Evaluation of risk factors for development of severe hyperbilirubinemia in term and near term infants in Turkey

    OpenAIRE

    Bulbul, Ali; Cayonu, Nihal; Sanli, Merve Emecen; Uslu, Sinan

    2014-01-01

    Objective: To determine clinical features, etiology and risk factors in term and near term newborns with severe hyperbilirubinemia. Methods: During ten years period (2000 - 2009), infants of ≥ 35 gestational weeks who received phototherapy were evaluated retrospectively. The study population was divided into two groups and clinical features, etiology and risk factors were compared. Group 1 defined by those who had bilirubin level ≥25 mg/dl (severe hyperbilirubinemia) and group 2 defined by bi...

  11. Effect of induction of meconium evacuation using per rectal laxatives on neonatal hyperbilirubinemia in term infants: A systematic review of randomized controlled trials

    OpenAIRE

    Ravisha Srinivasjois; Ajay Sharma; Prakesh Shah; Maina Kava

    2011-01-01

    Objective: To study the efficacy of early meconium evacuation using per rectal laxatives on the level of serum bilirubin and the need for phototherapy in healthy term infants. Materials and Methods: Systematic review of randomized controlled trials comparing per rectal laxatives versus no intervention was conducted using English language articles identified from the Cochrane Central Register of Controlled Trials, Medline, Ovid, and CINAHL databases and bibliographies of selected articles. Eli...

  12. The Effect of Clofibrate on Neonatal Hyperbilirubinemia in Uncomplicated Jaundice

    OpenAIRE

    Seyed Aidin Sajedi; Reza Sharafi; Hamid R. Badeli

    2008-01-01

    Objective: Clofibrate has been used for several years as a hypolipidemic drug. Our aim was to study the effect of Clofibrate on neonatal hyperbilirubinemia in uncomplicated jaundice.Material & Methods: This clinical trial study has been conducted on 90 normal term neonates who were admitted for uncomplicated jaundice in 17th-Shahrivar Childrens Hospital of Guilan University of Medical Sciences from September 2005 to January 2006. The data included: age, sex, total and direct serum bilirubin, ...

  13. The effect of clofibrate and phototherapy on physiological jaundice in term newborns

    OpenAIRE

    Amir Hosein Hashemian; Sayed amir Masoud Borghaee; Homa Babaee; Ali Asghar Alipour; Mahba Azizi

    2011-01-01

    Background: Clofibrate is an effective anti lipid agent that induces glucuronyltransferase could increase bilirubin conjugation. The aim of this study was to evaluate effect of clofibrate on neonatal physiologic jaundice.Methods: Randomized clinical trial sampling method used and 60 healthy term neonates which were admitted in Imam Reza Hospital of Kermanshah-Iran because of indirect hyperbilirubinemia enrolled into the study. 30 neonates (case group) were treated with single oral dose of clo...

  14. Effects of Hyperbilirubinemia on Auditory Brainstem Response of Neonates Treated with Phototherapy

    OpenAIRE

    Salehi, Negin; Bagheri, Fereshte; Ramezani Farkhani, Hamid

    2016-01-01

    Introduction: One of the most common pathologies in neonates is hyperbilirubinemia, which is a good marker for damage to the central nervous system. The sensitivity of the auditory system to bilirubin has been previously documented, with much discrepancy in its effects on Auditory Brainstem Response results. Thus the objective of this study was to evaluate the effects of hyperbilirubinemia on Auditory Brainstem Response of neonates treated with phototherapy. Materials and Methods: Forty-two t...

  15. Glutathione-S-transferase subtypes α and π as a tool to predict and monitor graft failure or regeneration in a pilot study of living donor liver transplantation

    OpenAIRE

    Jochum C; Beste M; Sowa J-P; Farahani MS; Penndorf V; Nadalin S; Saner F; Canbay A; Gerken G

    2011-01-01

    Abstract Objective Glutathione-S-Transferase (GST) subtype α and π are differentially expressed in adult liver tissue. Objective of the study was if GST α and p may serve as predictive markers for liver surgery, especially transplantations. Methods 13 patients receiving living donor liver transplantation (LDLT) and their corresponding donors were analyzed for standard serum parameters (ALT, AST, gGT, bilirubin) as well as GST-α and -π before LDLT and daily for 10 days after LDLT. Patients (R)...

  16. Morphological features of microglial cells in the hippocampal dentate gyrus of Gunn rat: a possible schizophrenia animal model

    OpenAIRE

    Liaury Kristian; Miyaoka Tsuyoshi; Tsumori Toshiko; Furuya Motohide; Wake Rei; Ieda Masa; Tsuchie Keiko; Taki Michiyo; Ishihara Kotomi; Tanra Andi; Horiguchi Jun

    2012-01-01

    Abstract Background Schizophrenia is a debilitating and complex mental disorder whose exact etiology remains unknown. There is growing amount of evidence of a relationship between neuroinflammation, as demonstrated by microglial activation, and schizophrenia. Our previous studies have proposed that hyperbilirubinemia plays a role in the pathophysiology of schizophrenia. Furthermore, we suggested the Gunn rat, an animal model of bilirubin encephalopathy, as a possible animal model of schizophr...

  17. Modulation of Tinospora rumphii and Zinc Salt on DNA Damage in Quinoline-Induced Genotoxicity and Hepatotoxicity in Male Albino Mice

    OpenAIRE

    Roger Salvacion Tan; Bajo, Lydia M.

    2014-01-01

    Tinospora rumphii (T. rumphii) is a folkloric medicinal plant that is widely distributed in Asia and Africa. It has been widely used by locals to treat many diseases including jaundice, which is a manifestation of liver damage. We investigated the action of T. rumphii crude extract together with zinc sulphate, a known tumor modulator, on hepatic injuries induced by intraperitoneal (i.p) injections of quinoline on albino mice. The hepatotoxic effect was assessed by bilirubin concentration in t...

  18. Biochemical and histopathological effects of administration various levels of Pomposia (Syzygium cumini) fruit juice as natural antioxidant on rat health

    OpenAIRE

    El-Anany, Ayman M.; Rehab F. M. Ali

    2011-01-01

    The aim of the current investigation was to evaluate the effects of administration various levels (400, 800 and 1,200 ppm) of pomposia extracts as natural antioxidant in comparison with BHT as synthetic antioxidant on some biochemical activities and histopathological examination of rats. Some of biochemical tests i.e. Alkaline phosphatase, transaminases]Aspartate transferase (AST) and alanine transferase (ALT) [,bilirubin, urea and uric acid were conducted. Histopathological examinations were...

  19. Role of mitogen-activated protein kinases and nuclear factor-kappa B in 1,3-dichloro-2-propanol-induced hepatic injury

    OpenAIRE

    Lee, In-Chul; Lee, Sang-Min; Ko, Je-Won; Park, Sung-Hyeuk; Shin, In-Sik; Moon, Changjong; Kim, Sung-Ho; Kim, Jong-Choon

    2016-01-01

    In this study, the potential hepatotoxicity of 1,3-dichloro-2-propanol and its hepatotoxic mechanisms in rats was investigated. The test chemical was administered orally to male rats at 0, 27.5, 55, and 110 mg/kg body weight. 1,3-Dichloro-2-propanol administration caused acute hepatotoxicity, as evidenced by an increase in serum aminotransferases, total cholesterol, and total bilirubin levels and a decrease in serum glucose concentration in a dose-dependent manner with corresponding histopath...

  20. Solution Structure and Backbone Dynamics of Human Liver Fatty Acid Binding Protein: Fatty Acid Binding Revisited

    OpenAIRE

    Cai, Jun; Lücke, Christian; Chen, Zhongjing; Qiao, Ye; Klimtchuk, Elena; Hamilton, James A.

    2012-01-01

    Liver fatty acid binding protein (L-FABP), a cytosolic protein most abundant in liver, is associated with intracellular transport of fatty acids, nuclear signaling, and regulation of intracellular lipolysis. Among the members of the intracellular lipid binding protein family, L-FABP is of particular interest as it can i), bind two fatty acid molecules simultaneously and ii), accommodate a variety of bulkier physiological ligands such as bilirubin and fatty acyl CoA. To better understand the p...

  1. EFFECT OF DARUHARIDRA AND PUNARNAVA IN HEPATOCELLULAR JAUNDICE: A CLINICAL STUDY

    OpenAIRE

    Ram Bhuwal; Pandey Hari Shankar; Dwivedi Kamal Nayan

    2011-01-01

    A clinical study was done on twenty patients of hepatocellular Jaundice. Ghanasatva (water soluble solid) of Daruharidra (Berberis aristata DC.)(Root and Stem) and leave juice of Punarnava (Boerhavia diffusa Linn.) was given to patients after their enrollment in study. Signs and symptoms of hepatocellular jaundice as yellow colour of eyes, nails, urine and loss of appetite, weakness, nausea, vomiting, fever, epigastric discomfort as well as biochemical assessment was done as GBP, S. bilirubin...

  2. Isolation and characterization of serum albumin from Camelus dromedarius

    OpenAIRE

    Malik, Ajamaluddin; Al-Senaidy, Abdulrahman; SKRZYPCZAK-JANKUN, EWA; JANKUN, JERZY

    2013-01-01

    Serum albumin constitutes 35–50 mg/ml of plasma proteins and performs various physiological activities including the regulation of osmotic pressure on blood, maintaining buffering of the blood pH, carrying different fatty acids and other small molecules, such as bilirubin, hormones, drugs and metal ions, as well as participating in immunological responses. Serum albumin is an extensively used protein in biotechnological and pharmaceutical industries. The camel (Camelus dromedarius) is well ta...

  3. Usefulness of Kelly clamp crushing technique during hepatic resection

    OpenAIRE

    Kim, K. H.; Lee, S G

    2008-01-01

    Introduction. Recently, there are various kinds of parenchymal transection methods. The aim of this study is to evaluate the usefulness of the Kelly clamp crushing technique compared to ultrasonic dissector during hepatic resection. Materials and methods. Comparisons between 10 ultrasonic dissector group and 10 Kelly clamp crushing technique group were performed by using nine items (transaction time, right lobe volume, perioperative transfusion, total bilirubin (TB), aspartate aminotransferas...

  4. KNOWLEDGE, ATTITUDE AND PERCEPTION TOWARDS JAUNDICE AMONG AYDER REFERAL HOSPITAL HEALTH WORKERS

    OpenAIRE

    Selahudin Alemu; Derbew Fikadu Berhe; S.Palani; Nisha Mary Joseph

    2011-01-01

    The objective of the study was to determine knowledge, practice and attitude towards jaundice among hospital health workers in Ayder Referral Hospital. Jaundice is a condition in which a person's skin and the whites of the eyes are discolored yellow due to an increased level of bilirubin in blood it is associated with many myth and Misconception. A study, using self administered questionnaire, was conducted from March 2009 to early May 2009.The result of the study showed that 79% respondent...

  5. A new animal model in the study of UCB metabolism and neurotoxicity

    OpenAIRE

    Bortolussi, Giulia

    2009-01-01

    Hyperbilirubinemia is the most common clinical situation during neonatal life and it is observed in 60% of full−term and 80% of pre−term infants. A combination of factors still not well defined such as: prematurity, infections, genetic disorders, brest-feed under-nourishing, may cause hazardous, toxic levels of UnConjugated Bilirubin (UCB) during neonatal period (neonatal jaundice) that pose a direct threat of brain bamage (kernicterus). The deposition of UCB in the Central Nervous System (CN...

  6. Assessment of knowledge on causes and care of neonatal jaundice at the Nigerian primary and secondary health institutions

    OpenAIRE

    Olusegun Joseph Adebami

    2015-01-01

    Background: Neonatal jaundice is the most common condition that requires medical attention in new-borns. However, missed diagnosis of jaundice, poor monitoring, and prescriptions of wrong and ineffective medications by the health workers for jaundice are known to be responsible for the persistence of acute bilirubin encephalopathy in the sub region. Therefore, the aim of the present study was therefore to assess the knowledge in the care of neonatal jaundice at the primary and secondary heal...

  7. Physiological antioxidant system and oxidative stress in stomach cancer patients with normal renal and hepatic function

    OpenAIRE

    E Prabhakar Reddy; V Seshadri Reddy; K. CHANDRA MOULI; PVLN Srinivasa Rao

    2010-01-01

    Role of free radicals has been proposed in the pathogenesis of many diseases. Gastric cancer is a common disease worldwide, and leading cause of cancer death in India. Severe oxidative stress produces reactive oxygen species (ROS) and induces uncontrolled lipid peroxidation. Albumin, uric acid (UA) and Bilirubin are important physiological antioxidants. We aimed to evaluate and assess the role of oxidative stress (OS) and physiological antioxidant system in stomach cancer patients. Lipid pero...

  8. In vitro and in vivo Efficacy of New Blue Light Emitting Diode Phototherapy Compared to Conventional Halogen Quartz Phototherapy for Neonatal Jaundice

    OpenAIRE

    Chang, Yun Sil; Hwang, Jong Hee; Kwon, Hyuk Nam; Choi, Chang Won; Ko, Sun Young; Park, Won Soon; Shin, Son Moon; Lee, Munhyang

    2005-01-01

    High intensity light emitting diodes (LEDs) are being studied as possible light sources for the phototherapy of neonatal jaundice, as they can emit high intensity light of narrow wavelength band in the blue region of the visible light spectrum corresponding to the spectrum of maximal bilirubin absorption. We developed a prototype blue gallium nitride LED phototherapy unit with high intensity, and compared its efficacy to commercially used halogen quartz phototherapy device by measuring both i...

  9. Maternal anti-D prophylaxis during pregnancy does not cause neonatal haemolysis

    OpenAIRE

    Maayan-Metzger, A; Schwartz, T; Sulkes, J; Merlob, P

    2001-01-01

    OBJECTIVE—To evaluate signs of haemolysis in babies of Rh-D negative mothers who underwent prophylaxis with anti-D immunoglobulin during pregnancy.
DESIGN—The following were evaluated in all babies of Rh-D negative mothers born within a three month period in our department: haemoglobin level, packed cell volume, mean corpuscular volume, reticulocytes, bilirubin level, and direct Coombs' test (direct anti-globulin test). The babies were divided into two groups according to...

  10. PATHOPHYSIOLOGIC BASIS OF LIVER DISEASE IN CYSTIC FIBROSIS EMPLOYING A ΔF508 MOUSE MODEL

    OpenAIRE

    Freudenberg, Folke; BRODERICK, ANNEMARIE L.; Yu, Bian B.; Leonard, Monika R.; Glickman, Jonathan N.; CAREY, MARTIN C.

    2008-01-01

    The molecular pathogenesis of cystic fibrosis (CF) liver disease is unknown. This study investigates its earliest pathophysiologic manifestations employing a mouse model carrying ΔF508, the commonest human CF mutation. We hypothesized that, if increased bile salt spillage into the colon occurs as in the human disease, this should lead to a hydrophobic bile salt profile and to “hyperbilirubinbilia” because of induced enterohepatic cycling of unconjugated bilirubin. Hyperbilirubinbilia may then...

  11. Reversal of Intestinal Failure-Associated Liver Disease by Switching From a Combination Lipid Emulsion Containing Fish Oil to Fish Oil Monotherapy.

    Science.gov (United States)

    Lee, Sanghoon; Park, Hyo Jung; Yoon, Jihye; Hong, Seul Hee; Oh, Chae-Youn; Lee, Suk-Koo; Seo, Jeong-Meen

    2016-03-01

    Intestinal failure-associated liver disease (IFALD) is a serious complication of parenteral nutrition (PN). Studies have shown that the amount and content of intravenous lipid emulsions (LEs) used is closely related to the development of IFALD. We report 2 cases of IFALD reversed by switching from a combination lipid emulsion containing fish oil to fish oil monotherapy (Omegaven; Fresenius Kabi Austria Gmbh, Graz, Austria). Patients initially received PN containing SMOFlipid 20% (SMOF; Fresenius Kabi Austria Gmbh, Graz, Austria), 2.0-3.0 g/kg/d, over 24 hours. When IFALD developed, LE was switched from SMOF to Omegaven starting at 1.0 g/kg/d over 12 hours. Case 1 was an 11-month-old girl with a diagnosis of extensive Hirschsprung disease up to the proximal jejunum. She developed direct bilirubinemia at 3 months, and the patient's LE was switched to Omegaven. A decrease in direct bilirubin was observed after 60 days on Omegaven, and IFALD was completely resolved after 90 days. Case 2 was a 1-month-old boy with a history of gastroschisis diagnosed with megacystis microcolon intestinal hypoperistalsis syndrome. He could not tolerate any oral feeds and was kept on full PN. He had elevated direct bilirubin and developed IFALD since 5 weeks. Omegaven treatment was initiated at 5 months. Direct bilirubin rose to 8 mg/dL during the first month on Omegaven. Then a gradual decrease in direct bilirubin was observed, and after 5 months on Omegaven, IFALD was completely resolved. In conclusion, 2 infants with advanced IFALD showed reversal of cholestasis by switching from SMOF to Omegaven monotherapy. PMID:25560679

  12. Equipment review: The molecular adsorbents recirculating system (MARS®)

    OpenAIRE

    Boyle, Martin; Kurtovic, Jelica; Bihari, David; Riordan, Stephen; Steiner, Christian

    2004-01-01

    The molecular adsorbents recirculating system (MARS®) is a form of artificial liver support that has the potential to remove substantial quantities of albumin-bound toxins that have been postulated to contribute to the pathogenesis of liver cell damage, haemodynamic instability and multi-organ failure in patients with acute liver failure (ALF) and acute-on-chronic liver failure (AoCLF). These toxins include fatty acids, bile acids, tryptophan, bilirubin, aromatic amino acids and nitric oxide....

  13. Tin-mesoporphyrin in the treatment of refractory hyperbilirubinemia due to Rh incompatibility.

    Science.gov (United States)

    Maisels, M J; Yang, H

    2012-11-01

    We describe the use of tin-mesoporphyrin (SnMP) in the treatment of an infant with Rh hemolytic disease. The infant's hyperbilirubinemia responded to phototherapy but every time the phototherapy was discontinued, the serum bilirubin rebounded and repeat phototherapy was necessary. A single intramuscular dose of SnMP on day 18 eliminated the need for further phototherapy and allowed us to discharge this infant. PMID:23128060

  14. biliverdin. Is there a role for biliverdin reductase?

    Directory of Open Access Journals (Sweden)

    AndreasDaiber

    2012-03-01

    Full Text Available Reactive oxygen species (ROS and signaling events are involved in the pathogenesis of endothelial dysfunction and represent a major contribution to vascular regulation. Molecular signaling is highly dependent on reactive oxygen species. But depending on the amount of ROS production it might have toxic or protective effects. Despite a large number of negative outcomes in large clinical trials (e.g. HOPE, HOPE-TOO, antioxidant molecules and agents are important players to influence the critical balance between production and elimination of RONS. However, chronic systemic antioxidant therapy lacks clinical efficacy, probably by interfering with important physiological redox signaling pathways. Therefore, it may be a much more promising attempt to induce intrinsic antioxidant pathways in order to increase the antioxidants not systemically but at the place of oxidative stress and complications. Among others, heme oxygenase (HO has been shown to be important for attenuating the overall production of ROS in a broad range of disease states through its ability to degrade heme and to produce carbon monoxide (CO, biliverdin/bilirubin, and the release of free iron with subsequent ferritin induction. With the present review we would like to highlight the important antioxidant role of the heme oxygenase system and especially discuss the contribution of the biliverdin, bilirubin and biliverdin reductase to these beneficial effects. The bilierdin reductase was reported to confer an antioxidant redox amplification cycle by which low, physiological bilirubin concentrations confer potent antioxidant protection via recycling of biliverdin from oxidized bilirubin by the biliverdin reductase, linking this sink for oxidants to the NADPH pool. To date the existence and role of this antioxidant redox cycle is still under debate and we present and discuss the pros and cons as well as our own findings on this topic.

  15. Protective Effect of Acacia nilotica (L.) against Acetaminophen-Induced Hepatocellular Damage in Wistar Rats

    OpenAIRE

    Kannan, Narayanan; Sakthivel, Kunnathur Murugesan; Guruvayoorappan, Chandrasekaran

    2013-01-01

    The potential biological functions of A. nilotica have long been described in traditional system of medicine. However, the protective effect of A. nilotica on acetaminophen-induced hepatotoxicity is still unknown. The present study attempted to investigate the protective effect of A. nilotica against acetaminophen-induced hepatic damage in Wistar rats. The biochemical liver functional tests Alanine transaminase (ALT), Aspartate transaminase (AST), Alkaline phosphatase (ALP), total bilirubin, ...

  16. Role of Subgroup Incompatibility in Newborn Jaundice Requiring Exchange Transfusion

    OpenAIRE

    Annagür, Ali; Altunhan, Hüseyin; Konak, Murat; Koç, Hasan; Örs, Rahmi

    2014-01-01

    We aimed to determine the role of exchange transfusion related complications, treatment, and etiology as well as subgroup incompatibility in patients subject to ET (exchange transfusion) due to newborn jaundice. 82 patients hospitalized due to newborn jaundice and exposed to exchange transfusion between August 2007 and August 2011 were retrospectively studied. Before ET mean total serum bilirubin was 29,2±9,83. The most frequent cause of ET was ABO incompatibility (31%) followed by...

  17. The Yeast Homolog of Heme Oxygenase-1 Affords Cellular Antioxidant Protection via the Transcriptional Regulation of Known Antioxidant Genes*

    OpenAIRE

    Collinson, Emma J.; Wimmer-Kleikamp, Sabine; Gerega, Sebastien K.; Yang, Yee Hwa; Parish, Christopher R.; Dawes, Ian W.; Stocker, Roland

    2010-01-01

    Heme oxygenase-1 (HO-1) degrades heme and protects cells from oxidative challenge. This antioxidant activity is thought to result from the HO-1 enzymatic activity, manifested by a decrease in the concentration of the pro-oxidant substrate heme, and an increase in the antioxidant product bilirubin. Using a global transcriptional approach, and yeast as a model, we show that HO-1 affords cellular protection via up-regulation of transcripts encoding enzymes involved in cellular antioxidant defens...

  18. Senior Resident Research Abstracts

    OpenAIRE

    Dean, K; Gorchynski, J.; Bey, T; Henderson, J. L.; Boysen, M.M.; Langdorf, M I; Lulloff, L.; Quinn, M; Scruggs, W; Fox, J. C.; Solley, M.; Zlidenny, A.; Lahham, S.; Maasumi, K.; Waters, M.

    2006-01-01

    Objective In this retrospective consecutive cohort study, we attempted to determine the point prevalence of urine bilirubin and urobilinogen in blunt abdominal trauma patients and its utility as a predictor of intraabdominal injury. Research Design and Methods A total of 986 consecutive trauma patients were screened, of which 698 (71%) were adult blunt trauma patients. 516 (52%) of these patients underwent a urinalysis and CT scan of the abdomen and pelvis or operative exploration of the abdo...

  19. Acute liver failure caused by concurrent autoimmune hepatitis and hepatitis B in a 16-year old girl

    OpenAIRE

    Pawłowska, Małgorzata; Halota, Waldemar

    2010-01-01

    A 16 year-old girl was admitted to hospital because of fatigue and somnolence, nausea, epistaxis and jaundice. Physical examination revealed jaundice, an enlarged liver and tenderness of upper right abdomen. Laboratory tests revealed an increased level of acute liver failure, bilirubin, bile acids, GGTP and a decreased prothrombin ratio, with elevated gamma-globulin and IgG levels, and the presence of anti-mitochondrial M2 antibodies and HBV infection markers. The patient was diagnosed with l...

  20. Morphometric Variables Related to Metabolic Profile in Captive Chimpanzees (Pan troglodytes)

    OpenAIRE

    Andrade, Marcia CR; Higgins, Paul B.; Mattern, Vicki L; Garza, Melissa A De La; Brasky, Kathleen M.; Voruganti, V. Saroja; Comuzzie, Anthony G.

    2011-01-01

    Obesity is a risk factor for several diseases including type 2 diabetes and cardiovascular disease. The aim of this study was to compare the relationships of waist circumference and body weight with circulating markers of metabolic, cardiovascular, and hepatic function in chimpanzees (Pan troglodytes). After a 12-h fast, blood was collected from 39 adult captive chimpanzees for measurement of serum glucose, BUN, creatinine, albumin, cholesterol, ALT, AST, ALP, total and direct bilirubin, trig...

  1. Oxidants and antioxidants in cardiovascular disease

    OpenAIRE

    Ekblom, Kim

    2010-01-01

    Background Cardiovascular diseases, including myocardial infarction and stroke, are the main reason of death in Sweden and Western Europe. High iron stores are believed to produce oxygen radicals, which is the presumed putative mechanism behind lipid peroxidation, atherosclerosis and subsequent cardiovascular disease. Iron levels are associated with the hemochromatosis associated HFE single nucleotide polymorphisms C282Y and H63D. Bilirubin is an antioxidant present in relatively high levels ...

  2. Intrahepatic cholestasis in subclinical and overt hyperthyroidism: two case reports

    OpenAIRE

    Soylu Aliye; Taskale Mustafa; Ciltas Aydin; Kalayci Mustafa; Kumbasar A Baki

    2008-01-01

    Abstract Introduction Non-specific abnormalities in liver function tests might accompany the clinical course of hyperthyroidism. Hyperthyroidism can cause the elevation of hepatic enzymes and bilirubin. Jaundice is rare in overt hyperthyroidism, especially in subclinical hyperthyroidism. On the other hand, the use of anti-thyroid drugs has rarely been associated with toxic hepatitis and cholestatic jaundice. Case presentation Here we present two cases of cholestasis that accompanied two disti...

  3. Accuracy of computed tomography-intravenous cholangiography (CT-IVC) in detection of choledocholithiasis)

    International Nuclear Information System (INIS)

    Full text: The aim of the study was to determine the accuracy of computed tomography-intravenous cholangiography (CT-IVC) in the detection of choledocholithiasis, compared with endoscopic retrograde cholangiography (ERC). 65 patients undergoing ERC had CT-IVC within 24 hours prior to ERC. Helical CT-IVC was performed following intravenous infusion of 100ml Biliscopin (Schering, Berlin). 2mm beam collimation was used with axial reformats at 1.5mm intervals used for image interpretation. Patients with serum bilirubin levels>3 times normal were excluded. CT-IVC and ERC studies were interpreted independently, and studies were graded as positive, negative or indeterminate for the presence of ductal calculi. 65 patients had a median age of 56 years. Median serum bilirubin at the time of CT-IVC was 13 mmol/L (range 5-47). ERC was indeterminate in 3 patients (4.7%) and CT-IVC in 4 (6.3%). 23 patients had ductal calculi on ERC and CT-IVC was positive in 22 (sensitivity 96%). False positive rate for CT-IVC was 8.3% with positive and negative predictive values of 92% and 97% respectively. Stones' size range was 4-16mm. Of the 14 solitary stones, 10 were pound 5mm and 8 pound 4mm.The bilirubin level in the positive cases was within the normal range in 20, with a range of 7-37 mmol/L. CT-IVC is highly accurate for detection of ductal calculi, including single small calculi, in patients with a serum bilirubin of <3 times normal. Copyright (2002) Blackwell Science Pty Ltd

  4. Systemic inflammatory response syndrome (SIRS) induced by carbon tetrachloride in rats

    OpenAIRE

    Gergely, J.; Sipka, S; Csípo, J.; Udvardy, M.; Gy. Szegedi; Kulcsár, A.

    1997-01-01

    We have observed the symptoms of systemic inflammatory response syndrome (SIRS) in male rats intoxicated by carbon tetrachloride (CCl4). Severe hypothermia, tachypnoea and increase in the heart beat min were diagnosed. These symptoms developed in the first hour of intoxication. The hepatic dysfunction was characterized by elevated bilirubin levels. In the sera we have measured increases in the activity of secretable (group II) phospholipase A2 sPLA2 (2,8x) and 6-ketoprostaglandin F1α (KPGF) (...

  5. The effect of UGT1A1 promoter polymorphism in the development of hyperbilirubinemia and cholelithiasis in hemoglobinopathy patients.

    Directory of Open Access Journals (Sweden)

    Suad AlFadhli

    Full Text Available Present study was aimed to explore the effect of (TAn UGT1A1 gene promoter polymorphism on bilirubin metabolism, bilirubinaemia, predisposition to cholelithiasis and subsequent cholecystectomy, in Sickle-Cell Anemia (SCA and beta-Thalasemia major (bTH in Kuwaiti subjects compared to other population. This polymorphism was analyzed and correlated to total bilirubin and cholelithiasis in 270 age, gender, ethnically matched subjects (92 bTH, 116 SCA and 62 Controls using PCR, dHPLC, fragment analysis and direct sequencing. Four genotypes of UGT1A1 were detected in this study (TA6/6, TA6/7, TA6/8 and TA7/7. (TA6/8 was found only in four individuals; hence it was not included in the analysis. There was a statistically significant association of genotypes with serum total bilirubin levels in both bTH and SCA groups (p<0.001. Subjects with (TA7/7 had the highest total serum bilirubin level (178.7 ± 3.5 µmole/l. A significant association was observed between allele (TA7 and cholelithiasis development (p = 0.0001. The 40%, 67.5% and 100% of SCA with (TA6/6, (TA6/7 and (TA7/7 respectively developed cholelithiasis and were subsequently cholecystectomized. Our results confirm UGT1A1 (TA7 allele as one of the factors accounting for the hyperbilirubinemia and cholelithiasis observed in SCA and bTH.

  6. ESPGHAN Committee on Nutrition Position Paper. Intravenous Lipid Emulsions and Risk of Hepatotoxicity in Infants and Children: a Systematic Review and Meta-analysis.

    Science.gov (United States)

    Hojsak, Iva; Colomb, Virginie; Braegger, Christian; Bronsky, Jiri; Campoy, Cristina; Domellöf, Magnus; Embleton, Nicholas; Fidler Mis, Nataša; Hulst, Jessie M; Indrio, Flavia; Lapillonne, Alexandre; Mihatsch, Walter; Molgaard, Christian; van Goudoever, Johannes; Fewtrell, Mary

    2016-05-01

    The aim of the present article was to perform a systematic review with meta-analysis of available scientific evidence regarding the role of different intravenous lipid emulsions (ILE) in the pathogenesis of cholestasis and parenteral nutrition-associated liver disease. A systematic review of the literature (up to March 2015) identified 23 randomized controlled trials (RCTs). Of these, 17 were performed in preterm infants or critically ill neonates with a short duration of intervention, 2 in older children with short-term use (following surgery or bone marrow transplantation), 1 in neonates with long-term use, and 3 in infants and children receiving long-term parenteral nutrition (PN). Meta-analysis showed no differences in the rate of cholestasis or bilirubin levels associated with short-term use of different ILEs. Because of high heterogeneity of the long-term studies no meta-analysis could be performed. Available studies found that the use of multicomponent fish oil (FO)-containing ILE compared with pure soya bean oil (SO), ILE-reduced liver enzymes, and bilirubin levels in noncholestatic children on long-term PN and one other RCT found that FO-based ILE-reversed cholestasis in a proportion of patients. The ESPGHAN Committee on Nutrition concludes that there is no evidence of a difference in rates of cholestasis or bilirubin levels between different ILE for short-term use in neonates. The use of multicomponent FO-containing ILE may contribute to a decrease in total bilirubin levels in children with IF on prolonged PN. Well-designed RCTs are, however, lacking and long-term effects have not been determined. PMID:26825766

  7. Simeprevir and Sofosbuvir Combination Treatment in a Patient with HCV Cirrhosis and HbS Beta 0-Thalassemia: Efficacy and Safety despite Baseline Hyperbilirubinemia

    OpenAIRE

    Nikolaos Papadopoulos; Melanie Deutsch; Athanasios Georgalas; Helias Poulakidas; Lazaros Karnesis

    2016-01-01

    Hyperbilirubinemia is an adverse reaction of simeprevir (SMV). The majority of these patients were taking concurrent ribavirin presenting elevated unconjugated hyperbilirubinemia due to hemolysis. However, cases of hepatic failure with elevated bilirubin level have also been reported in patients with decompensated cirrhosis. We describe a 51-year-old female patient with HbS beta 0-thalassemia and recently diagnosed compensated cirrhosis due to chronic hepatitis C infection. Laboratory evaluat...

  8. Comparison of ELF, FibroTest and FibroScan for the non-invasive assessment of liver fibrosis

    OpenAIRE

    Friedrich-Rust Mireen; Rosenberg William; Parkes Julie; Herrmann Eva; Zeuzem Stefan; Sarrazin Christoph

    2010-01-01

    Abstract Background FibroTest (FT) is the most frequently used serum fibrosis marker and consists of an algorithm of five fibrosis markers (alfa2-macroglobulin, apolipoproteinA1, haptoglobin, GGT, bilirubin). The Enhanced Liver Fibrosis (ELF) test consists of an algorithm of three fibrosis markers (hyaluronic acid, amino-terminal propeptide-of-type-III-collagen, tissue-inhibitor of matrix-metaloproteinase-1). While a systematic review has shown comparable results for both individual markers, ...

  9. Inaugural-Dissertation

    OpenAIRE

    Kastner, Annett

    2004-01-01

    Mit vorliegender Arbeit wurde geprüft, ob an Dislocatio abomasi (DA) erkrankte Rinder vor dem Auftreten klinischer Symptome Veränderungen im Fettstoffwechsel aufweisen und ob Beziehungen zum Endotoxin-Metabolismus bestehen. Dazu wurde ein breites Untersuchungsspektrum zum Fett- und Leberstoffwechsel [b-Hydroxy-Butyrat (BHB), Freie Fettsäuren (FFS), Cholesterol, Tria-cylglycerol (TG), Phospholipide (PL), a-, b-, prä-b-Lipoproteine (LP), Bilirubin, Aspartat-Amino-Transferase (ASAT), Gamma-Gluta...

  10. Expression and regulation of transmembrane transporters in healthy intestine and gastrointestinal diseases

    OpenAIRE

    Hruz, Petr

    2006-01-01

    Transmembrane transporters mediate energy dependent or independent translocation of drugs, potentially toxic compounds, and of various endogenous substrates such as bile acids and bilirubin across membranes. In this thesis the focus is on two classes of transporters, the ATPbinding cassette (ABC) transporters, which mediate ATP dependent transport and the solute carriers (SLC) which use electrochemical gradients for their transport. The transporters are expressed on membranes o...

  11. A Case of Biliary Pancreatitis Which Subsided after Endoscopic Sphincterotomy during Pregnancy

    OpenAIRE

    Gulbanu Erkan; Ibrahim Dogan; Seren Ozenirler; Candan Tuncer

    2011-01-01

    A 24-year-old pregnant patient was referred to us because of pain and tenderness in the right upper quadrant. Her liver enzymes and bilirubin levels were elevated; an abdominal ultrasound examination revealed gallstones within the gallbladder. Diagnosis of biliary pancreatitis was established based on elevated amylase levels. Oral intake was withheld; intravenous antibiotic therapy and total parenteral nutrition were administered. An endoscopic sphincterotomy without the use of fluoroscopy wa...

  12. Gemcitabine-Induced Hepatitis in a Pancreatic Cancer Patient Receiving Adjuvant Therapy following Metastasectomy

    OpenAIRE

    Hamid Saadati; Jennifer Peccerillo; Kristin Kaley; Schilsky, Michael L.; Muhammad Wasif Saif

    2009-01-01

    Dear Sir: Gemcitabine is the only FDA-approved cytotoxic agent for the treatment of pancreatic cancer. Although a relatively safe drug, the major side effects of gemcitabine include bone marrow suppression and flulike symptoms. Transient abnormalities of liver transaminase enzymes are seen in two-third of patients; elevations of alkaline phosphatase and bilirubin are less common, but severe hepatic toxicity is uncommon. We describe a case of patient with metastatic pancreatic cancer who de...

  13. Vergleich von stoffwechselrelevanten Parametern bei Kühen mit und ohne Puerperalerkrankungen zur Erkennung eines erhöhten Erkrankungsrisikos

    OpenAIRE

    Stock, Corina

    2009-01-01

    Aim of the present study was, to show relations between various metabolic parameters and the occurrence of inflammatory diseases of the uterus in dairy cows. Additionally, we wanted to find limiting values that show an increased risk of disease if they were exceeded or fallen short of. In eight dairy herds 124 cows and heifers were examined weekly from week 2 before calving to week 5 postpartum. Metabolic parameters in blood as total protein, albumin, total bilirubin, aspartate aminotrans...

  14. Management of a patient with colon cancer and rotor syndrome: A case report

    OpenAIRE

    Arslan, Deniz; Avci, Fatma; Merdin, Alparslan; GUNDUZ, SEYDA; Coskun, Hasan Senol

    2013-01-01

    Rotor Syndrome (RS) is a rare disease that is autosomal recessive and characterized by asymptomatic jaundice, conjugated hyperbilirubinemia and coproporphyria. RS occurs as a result of a complete lack or partial defect of organic anion transporter polypeptides (OATPs) on the basolateral surface of hepatocytes. OATPs facilitate the excretion of bilirubin and organic anions from the liver to the bile. To the best of our knowledge, there is no information in the literature relating to the treatm...

  15. Liver dysfunction associated with artificial nutrition in critically ill patients

    OpenAIRE

    Grau, Teodoro; Bonet, Alfonso; Rubio, Mercedes; Mateo, Dolores; Farré, Mercé; Acosta, José Antonio; Blesa, Antonio; Montejo, Juan Carlos; de Lorenzo, Abelardo García; Mesejo, Alfonso; ,

    2007-01-01

    Introduction Liver dysfunction associated with artificial nutrition in critically ill patients is a complication that seems to be frequent, but it has not been assessed previously in a large cohort of critically ill patients. Methods We conducted a prospective cohort study of incidence in 40 intensive care units. Different liver dysfunction patterns were defined: (a) cholestasis: alkaline phosphatase of more than 280 IU/l, gamma-glutamyl-transferase of more than 50 IU/l, or bilirubin of more ...

  16. Exploration of oxidative stress and inflammatory markers in relation to urinary phthalate metabolites: NHANES 1999–2006

    OpenAIRE

    Ferguson, Kelly K.; Loch-Caruso, Rita; John D. Meeker

    2011-01-01

    Phthalate exposure has been associated with a wide range of adverse health outcomes in limited epidemiologic studies, and inflammation and oxidative stress have been hypothesized as potential mechanisms involved. In the present study we investigated associations between urinary concentrations of phthalate metabolites and potential blood markers of oxidative stress (bilirubin) and inflammation (alkaline phosphatase [ALP], absolute neutrophil count [ANC], ferritin [adjusted for iron status] and...

  17. Examination of the relationships between environmental exposures to volatile organic compounds and biochemical liver tests: application of canonical correlation analysis

    OpenAIRE

    Jing LIU; Drane, Wanzer; Liu, Xuefeng; Wu, Tiejian

    2008-01-01

    This study was to explore the relationships between personal exposure to ten volatile organic compounds (VOCs) and biochemical liver tests with the application of canonical correlation analysis. Data from a subsample of the 1999–2000 National Health and Nutrition Examination Survey were used. Serum albumin, total bilirubin (TB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), alkaline phosphatase (ALP), and γ-glutamyl transferase (GGT) served as ...

  18. Structure of the Murine Constitutive Androstane Receptor Complexed to Androstenol: A Molecular Basis for Inverse Agonism

    OpenAIRE

    Shan, Li; Vincent, Jeremy; Brunzelle, Joseph S.; Dussault, Isabelle; Lin, Min; Ianculescu, Irina; Sherman, Mark A.; Forman, Barry M.; Fernandez, Elias J.

    2004-01-01

    The nuclear receptor CAR is a xenobiotic responsive transcription factor that plays a central role in the clearance of drugs and bilirubin while promoting cocaine and acetaminophen toxicity. In addition, CAR has established a “reverse” paradigm of nuclear receptor action where the receptor is active in the absence of ligand and inactive when bound to inverse agonists. We now report the crystal structure of murine CAR bound to the inverse agonist androstenol. Androstenol binds within the ligan...

  19. Actinomyces naeslundii and Eikenella corrodens as rare causes of liver abscesses

    OpenAIRE

    Jaqua, Nathan Thomas; Smith, Adam J.; Shin, Terry T; Jahanmir, Jay

    2013-01-01

    A 48-year-old man with an unremarkable medical history was admitted with vague conditions of fever, chills, myalgias and malaise. Physical examination was remarkable for only scleral icterus. Laboratory evaluation revealed elevated aminotransferases, alkaline phosphatase and bilirubin. Imaging demonstrated two masses in the right lobe of his liver, which were ultimately drained and cultures demonstrated Actinomyces and Eikenella. He continued to have fever on broad-spectrum antibiotics until ...

  20. Fatal disseminated paracoccidioidomycosis in a two-year-old child

    OpenAIRE

    Pereira Ricardo M.; Tresoldi Antonia Terezinha; Silva Marcus T.N. da; Bucaretchi Fábio

    2004-01-01

    A two year-old female child was admitted at the Pediatric Intensive Care Unit in a septic shock associated with a lymphoproliferative syndrome, with history of fever, adynamia and weight loss during the last two months. On admission, the main clinical and laboratory manifestations were: pallor, jaundice, disseminated enlarged lymph nodes, hepatosplenomegaly, crusted warts on face, anemia, eosinophilia, thrombocytopenia, increased direct and indirect bilirubin, alkaline phosphatase, and gammag...

  1. Effect of hyperbilirubunemia on coagulation system of blood in patients with obstructive jaundice

    OpenAIRE

    Sarkisian Z.O.; Tolstokorov A.S.

    2012-01-01

    Objective of the study: determination of the degree of influence of bilirubin in the blood during obstructive jaundice, on blood clotting. Methods. A retrospective study of case histories of patients with obstructive jaundice who have been treated at the Regional Hospital of Saratov in the period from 2000 to 2010. Results. The results confirm the assumption that the causes of bleeding in obstructive jaundice is hepatic failure. Conclusion. Absence of bile in the small intestine in obstructiv...

  2. Effects of phospholipid hepatoprotectors on apoptosis during experimental liver pathology induced by isoniazid and paracetamol.

    Science.gov (United States)

    Udut, V V; Vengerovsky, A I; Dygai, A M

    2013-03-01

    Phospholipid hepatoprotectors essentiale, eplir, and their combinations with succinic acid decreased the relative content of apoptotic lymphocytes and granulocytes in the blood, content of TNF-α, total and indirect bilirubin, and activities of transaminases and alkaline phosphatase and increase the content of IL-10 in rats with experimental intoxication induced by isoniazid and paracetamol. A combination of eplir and succinic acid was most effective in preventing the development of leukocyte apoptosis. PMID:23658881

  3. Effect of Momordica charantia (bitter melon) on serum glucose level and various protein parameters in acetaminophen intoxicated rabbits

    OpenAIRE

    Kanwal Zahra; Muhammad Imran Sohail; Muhammad Anwar Malik

    2012-01-01

    Aim: Liver function tests, including total plasma proteins, albumin, bilirubin and glucose were analyzed to find out the hepatocurative and hepatoprotective effects of Momordica charantia. Method: The study was divided into two categories. In first category, the livers of rabbits were intoxicated with acetaminophen, and then Momordica fruit extract was given to observe its hepatocurative effects. Results: The results indicated significant changes in concentrations of the parameters in...

  4. Transhepatic cholangiography in the jaundiced patient. Extracorporeal drainage and endoprosthesis

    Energy Technology Data Exchange (ETDEWEB)

    Olbert, F.; Schlegl, A.; Muzika, N. (Krankenhaus der Stadt Wien-Lainz (Austria). 1. Chirurgische Abt.)

    1984-01-01

    Percutaneous transhepatic cholangiographpy, as well as the therapeutic possibility of extracorporeal biliary tract drainage and insertion of an endoprosthesis are discussed in this paper. The results are presented of 19 patients treated by extracorporeal drainage and of 12 patients treated by insertion of an endoprosthesis, with a successful outcome in each group. The clinical parameters, the reduction in bilirubin values after treatment and improvement in the patient's condition and general well-being are discussed.

  5. Palliative percutaneous transhepatic drainage for inoperable obstructive jaundice.

    OpenAIRE

    Baxter-Smith, D. C.; Temple, J G; Howarth, F.

    1982-01-01

    A technique of percutaneous transhepatic drainage under local anaesthesia is described for the relief of intractable pruritus in patients with obstructive jaundice due to inoperable carcinoma. After standard percutaneous transhepatic cholangiography a polyethylene catheter is introduced into one of the large dilated bile ducts and left in situ, thereby establishing external retrograde biliary drainage. The technique has been used successfully in 6 cases with reduction in serum bilirubin level...

  6. Clinical outcomes and prediction of survival following percutaneous biliary drainage for malignant obstructive jaundice

    OpenAIRE

    Zhang, Guang Yuan; LI, WEN TAO; PENG, WEI JUN; LI, GUO DONG; HE, XIN HONG; XU, LI CHAO

    2014-01-01

    The present study aimed to investigate the clinical outcomes of percutaneous transhepatic biliary drainage in patients with obstructive jaundice and identify potential predictors of patient survival. Clinical data from 102 patients (66 males and 36 females; median age, 63.50 years; range, 29–84 years) with a mean (± standard deviation) pre-drainage serum bilirubin level of 285.4 (±136.7 μmol/l), were retrospectively studied. Technical and clinical success, complications and survival time were...

  7. Histological changes at an endosonography-guided biliary drainage site: A case report

    OpenAIRE

    Fujita, Naotaka; Noda, Yutaka; Kobayashi, Go; Ito, Kei; Obana, Takashi; Horaguchi, Jun; Takasawa, Osamu; Nakahara, Kazunari

    2007-01-01

    Endosonography-guided biliary drainage (ESBD) is a new method enabling internal drainage of an obstructed bile duct. However, the histological conditions associated with fistula development via the duodenum to the bile duct have not been reported. We performed ESBD 14 d preoperatively in a patient with an ampullary carcinoma and histologically confirmed changes in and around the fistula. The female patient developed no complications relevant to ESBD. Levels of serum bilirubin and hepatobiliar...

  8. Guidelines on routine cerebrospinal fluid analysis. Report from an EFNS task force

    DEFF Research Database (Denmark)

    Deisenhammer, F; Bartos, A; Egg, R;

    2006-01-01

    protein measurement and normal upper limits should be related to patients' age. Elevated Qalb is a non-specific finding but occurs mainly in bacterial, cryptococcal, and tuberculous meningitis, leptomingeal metastases as well as acute and chronic demyelinating polyneuropathies. Pathological decrease of...... evaluated whenever pleocytosis is found or leptomeningeal metastases or pathological bleeding is suspected. Computed tomography-negative intrathecal bleeding should be investigated by bilirubin detection....

  9. Antioxidant vitamins and glucose-6-phosphate dehydrogenase deficiency in full-term neonates

    Directory of Open Access Journals (Sweden)

    Obediat, Ahmad D.

    2008-09-01

    Full Text Available Objective: The mechanism by which glucose-6-phosphate dehydrogenase (G6PD deficiency causes neonatal hyperbilirubinemia is not completely understood. However, the genetic disorder G6PD deficiency predisposes red blood cells to oxidative stress. The aim of this study was to establish the relationship between plasma antioxidant vitamin (E and C levels and the development of hyperbilirubinemia in full-term neonates with deficient G6PD. Methods: A total of 196 live birth neonates of healthy mothers were included in this study. Twelve of them were deficient in G6PD. In addition to demographic data, serum total bilirubin, hemoglobin, hematocrit, and vitamin E and C levels were measured on the first day after birth.Results: Neonates with G6PD deficiency (n=7 who did not develop hyperbilirubinemia (mean serum bilirubin level of 70.8±23 µmol/l, median 71.8 and neonates with G6PD deficiency (n=4 who developed hyperbilirubinemia (mean serum bilirubin level of 226.7±79 µmol/l, median 233.4 on the first day of life had similar gestational weights and age. The second group, however, had lower hemoglobin and hematocrit as well as plasma vitamin C and E levels. None of these results showed significant difference. Conclusion: The results of the present study indicate that red blood cell hemolysis as a result of inadequate antioxidants system in G6PD-deficient neonates is not the only contributing factor for hyperbilirubinemia.

  10. The Effects of Air Pollution and Smoking on Cadmium Concentration in Human Blood and Correlation with Biochemical Parameters

    Directory of Open Access Journals (Sweden)

    L. Zeneli

    2009-01-01

    Full Text Available Problem statement: The study described the research of the effects that the environment pollution and smoking have in cadmium concentration in human blood, as well as in the correlation between cadmium and the biochemical parameters. Approach: In a comparative study of cadmium concentration in blood of human population of two different environments in Kosovo, one nearby Kosovo Thermo Power Plants (Obiliq, a highly polluted environments (Investigated Group and the other that was considered as relatively clean rural environment Dragash (control group. Results: The results showed that there exists a significant difference in the average concentration of cadmium in human blood between the Investigated Group (IG and the Control Group (CG (t = -3.34, p = 0.0006. The series of determination of cadmium concentration in blood of population that lives in this environment had shown direct effects in biochemical parameters (direct bilirubine, total bilirubine. Conclusion: Air pollution (from coal burning in power plant and smoking were very important factors for the level of cadmium concentration in blood, which had an inhibitory effect in the syntheses of bilirubine.

  11. Facility-based constraints to exchange transfusions for neonatal hyperbilirubinemia in resource-limited settings.

    Science.gov (United States)

    Mabogunje, Cecilia A; Olaifa, Sarah M; Olusanya, Bolajoko O

    2016-05-01

    Several clinical guidelines for the management of infants with severe neonatal hyperbilirubinemia recommend immediate exchange transfusion (ET) when the risk or presence of acute bilirubin encephalopathy is established in order to prevent chronic bilirubin encephalopathy or kernicterus. However, the literature is sparse concerning the interval between the time the decision for ET is made and the actual initiation of ET, especially in low- and middle-income countries (LMICs) with significant resource constraints but high rates of ET. This paper explores the various stages and potential delays during this interval in complying with the requirement for immediate ET for the affected infants, based on the available evidence from LMICs. The vital role of intensive phototherapy, efficient laboratory and logistical support, and clinical expertise for ET are highlighted. The challenges in securing informed parental consent, especially on religious grounds, and meeting the financial burden of this emergency procedure to facilitate timely ET are examined. Secondary delays arising from post-treatment bilirubin rebound with intensive phototherapy or ET are also discussed. These potential delays can compromise the effectiveness of ET and should provide additional impetus to curtail avoidable ET in LMICs. PMID:27170928

  12. Intermittent Versus Continuous Phototherapy for Reducing Neonatal Hyperbilirubinemia

    Directory of Open Access Journals (Sweden)

    Nikoo Niknafs

    2008-09-01

    Full Text Available Objective: Clinical studies comparing intermittent versus continuous phototherapy for reducing neonatal hyperbilirubinemia have produced conflicting results. This study was conducted to compare the efficacy of intermittent with continuous phototherapy. Methods: This study was performed on 114 neonates with indirect hyperbilirubinemia. Inclusion criteria were body weight above 2000 grams, absence of other concomitant diseases, and hyperbilirubinemia neither requiring intensive phototherapy nor exceeding the range of exchange transfusion. The neonates were randomly divided into two groups. Continuous phototherapy group received phototherapy on and off for 2 hours and half an hour respectively and the intermittent phototherapy group on and off for one hour. The phototherapy units were identical and serum total bilirubin levels were measured every 12 hours after starting phototherapy. Findings: Two groups were matched regarding weight and risk factors such as ABO and Rh incompatibility. The difference of total serum bilirubin levels between two groups was insignificant at the start of phototherapy and also after 12, 24, 36 and 48 hours (P>0.2.Conclusion: Intermittent phototherapy defined as one hour on and one hour off is as effective as continuous phototherapy defined as 2 hours on and half an hour off, in reducing total serum bilirubin level in full term babies.

  13. A Multicenter, Prospective Study of a New Fully Covered Expandable Metal Biliary Stent for the Palliative Treatment of Malignant Bile Duct Obstruction

    Directory of Open Access Journals (Sweden)

    Bret T. Petersen

    2013-01-01

    Full Text Available Background and Study Aims. Endoscopic placement of self-expanding metal stents (SEMSs is indicated for palliation of inoperable malignant biliary obstruction. A fully covered biliary SEMS (WallFlex Biliary RX Boston Scientific, Natick, USA was assessed for palliation of extrahepatic malignant biliary obstruction. Patients and Methods. 58 patients were included in this prospective, multicenter series conducted under an FDA-approved IDE. Main outcome measurements included (1 absence of stent occlusion within six months or until death, whichever occurred first and (2 technical success, need for reintervention, bilirubin levels, stent patency, time to stent occlusion, and adverse events. Results. Technical success was achieved in 98% (57/58, with demonstrated acute removability in two patients. Adequate clinical palliation until completion of followup was achievedin 98% (54/55 of evaluable patients, with 1 reintervention due to stent obstruction after 142 days. Mean total bilirubin decreased from 8.9 mg/dL to 1.2 mg/dL at 1 month. Device-related adverse events were limited and included 2 cases of cholecystitis. One stent migrated following radiation therapy. Conclusions. The WallFlex Biliary fully covered stent yielded technically successful placement with uncomplicated acute removal where required, appropriate reduction in bilirubin levels, and low rates of stent migration and occlusion. This SEMS allows successful palliation of malignant extrahepatic biliary obstruction.

  14. Metallic stents in malignant biliary obstruction

    International Nuclear Information System (INIS)

    Purpose. Retrospective analysis of our results with metallic stent placement for malignant biliary strictures. We sought to determine parameters that influence stent patency. Methods. A total of 95 Wallstents were implanted in 65 patients (38 men, 27 women; mean age, 65.1 years) with malignant biliary obstruction. Serum bilirubin levels were assessed in 48 patients; the mean value prior to intervention was 15.0 mg/dl. Results. In 12 patients (21%) complications occurred as a result of percutaneous transhepatic drainage. Stent implantation was complicated in 13 patients, but was possible in all patients. A significant decrease in bilirubin level was seen in 83.3% of patients following stent implantation. Approximately 30% of patients developed recurrent jaundice after a mean 97.1 days. In 9 patients (15%) the recurrent jaundice was caused by stent occlusion due to tumor growth. The mean follow-up was 141.8 days, the mean survival 118.7 days. Patients with cholangiocarcinomas and gallbladder carcinomas had the best results. Worse results were seen in patients with pancreatic tumors and with lymph node metastases of colon and gastric cancers. Conclusions. The main predictive factors for occlusion rate and survival are the type of primary tumor, tumor stage, the decrease in bilirubin level, and the general condition of the patient

  15. Effect of α-naphthylisothiocyanate on blood clearance of 99mTc-phytate in dogs

    International Nuclear Information System (INIS)

    The effect of α-naphthylisothiocyanate (ANIT) on blood clearance of 99mTc-phytate (99mTc-P) in dogs was examined, and blood clearance test of 99mTc-P was compared with the cases of serum transaminase test or serum bilirubin test. Serum transaminase and bilirubin levels in dogs increased after ANIT administration, however, the degree of increase in these parameters was much lower than the cases in rats. The disappearance rate of 99mTc-P from blood in dogs decreased with the increase in dose of ANIT and with the passage of time after the ANIT administration. Changes of the blood clearance of 99mTc-P after ANIT treatment in dogs may be influenced by the disorder in the hepatocytes rather than in the bile ductule cells. The blood clearance test of 99mTc-P in dogs showed a sensitive reaction for the acute hepatic dysfunction induced by ANIT equally to the serum transaminase test or the serum bilirubin test. (author)

  16. Effect of D-galactosamine on blood clearance of 99mTc-phytate in dogs

    International Nuclear Information System (INIS)

    The effect of D-galactosamine (GalN) on the blood clearance of 99mTc-phytate (99mTc-P) in dogs was examined, and the blood clearance test of 99mTc-P was compared with the cases of the serum transaminase and bilirubin test. Serum transaminase and bilirubin levels in dogs increased dose-dependently after GalN administration, and the degree of increase in these parameters was much higher than the cases in rats. The disapearance rate of 99mTc-P from blood in dogs decreased with the increase in dose of GalN and with the passage of time after the GalN administration. Changes of the blood clearance of 99mTc-P after GalN treatment in dogs may be influenced by the disorder in the hepatocytes. The blood clearance test of 99mTc-P in dogs showed a sensitive reaction for the acute hepatic dysfunction induced by GalN equally to the serum transaminase and bilirubin test. (author)

  17. ABHRAK BHASMA MEDIATED ALTERATIONS IN LIVER AND KIDNEY FUNCTIONS IN MALE ALBINO RATS DURING CARBON TETRACHLORIDE INDUCED TOXICITY

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    Teli Parashuram

    2013-10-01

    Full Text Available Abhrak bhasma, an Ayurvedic drug used against many diseases including hepatitis. In present study various doses of abhrak bhasma (10, 20, 30 and 40 mg/kg body wt were tested for hepatoprotective efficacy against carbon tetrachloride (CCl4 intoxicated liver and kidney functions in male albino rat. Administration of CCl4 to the normal rat increased serum levels of AST, ALT, ALP and bilirubin indicated acute damage. Abhrak bhasma treatment counteracted the action of CCl4 on liver and kidney functions. With the administration of increasing doses of abhrak bhasma all activities were dropped progressively and significantly at 40 mg dose as compared with silicate control. Conjugation metabolism and excretion of bilirubin were improved with increasing doses of abhrak bhasma suggesting dose dependent protection of all metabolic steps in bilirubin metabolism. Also CCl4 induced acute toxicity increased serum urea and creatinine content, which was progressively controlled by increasing abhrak bhasma doses. The findings of this study indicated that abhrak bhasma exert dose dependent protective effects in liver and kidneys functions against CCl4 induced toxicity in albino rat.

  18. Acute hepatitis due to brucellosis: case report

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    Nevil AYKIN

    2009-06-01

    Full Text Available Brucella infection is a systemic disease. It rarely causes local infections like hepatitis in gastrointestinal system. In this article we would like to present an acute hepatitis case related to brucella infection that followed up in our clinic. A male, 30 year-old patient hospitalized due to common muscle pain, high fever and vomiting. During the physical examination the patient’s skin, scleras and mucosal membranes were icteric, the liver was 2-3 cm palpable and tender. Laboratory findings were as follows: AST:1190 U/L; ALT:715 U/L; GGT:961 U/L; ALP:369 U/L; total bilirubin:4.6 mg/dL; direct bilirubin:2.1 mg/dL. Viral markers were found to be negative. We started treatment with streptomicine and doxicycline since, the patient’s standard brucella tube agglutination test was positive (1/60 and brucella spp produced in his blood culture. From the second day of the treatment, we started to get clinical response. On the 17th day of the treatment, he discharged from the hospital because ALT, AST and bilirubine level were found normal and his treatment was completed to the 8 weeks. Brucella is continuing to be an important health problem especially who live in surrounding countryside and have to keep in mind in the differential diagnosis of the acute hepatitis.

  19. Photodegradation of riboflavin in neonates

    International Nuclear Information System (INIS)

    The biologically most important flavins are riboflavin and its related nucleotides, all highly sensitive to light. It is because of its photoreactivity and its presence in almost all body fluids and tissues that riboflavin assumes importance in phototherapy of neonatal jaundice. The absorption maxima of both bilirubin and riboflavin in the body are nearly identical: 445-450 (447) nm. In consequence, blue visible light will cause photoisomerization of bilirubin accompanied by photodegradation of riboflavin. This results in diminished erythrocyte glutathione reductase, which indicates generalized tissue riboflavin deficiency and red cell lysis. Single- and double-strand breaks in intracellular DNA have occurred with phototherapy. This light exposure of neonates may result also in alterations of bilirubin-albumin binding in the presence of both riboflavin and theophylline (the latter frequently given to prevent neonatal apnea). Many newborns, especially if premature, have low stores of riboflavin at birth. The absorptive capacity of premature infants for enteral riboflavin is likewise reduced. Consequently, inherently low stores and low intake of riboflavin plus phototherapy for neonatal jaundice will cause a deficiency of riboflavin at a critical period for the newborn. Supplementation to those infants most likely to develop riboflavin deficiency is useful, but dosage, time, and mode of administration to infants undergoing phototherapy must be carefully adjusted to avoid unwanted side effects

  20. Influence of Fasciola Hepatica on Serum Biochemical Parameters and Vascular and Biliary System of Sheep Liver

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    A Hodžić

    2013-03-01

    Full Text Available Background: The aim of this study was to evaluate the functional capacity of the liver based on the activity of specific enzymes and bilirubin in serum and also to investigate the influence of mechanical and toxic effects of Fasciola hepatica on the structures of the blood vessels and biliary tract in the sheep liver.Methods: Blood samples and liver of 63 indigenous sheep of Pramenka breed, slaughtered in the period from March to December 2009 were used. Based on parasitological findings in the liver, all animals were divided into two groups: control (n=34 and infected group (n=29. For investigation and description of pathological changes in sheep liver, naturally infected with F. hepatica, corrosion cast technique was used.Results: Biochemical analysis of tested parameters showed a significant elevation (P≤0.05 of serum gamma-glutamyl transferase (GGT, total bilirubin (TBIL and direct bilirubin (DBIL in infected sheep group comparing with the control group. No significant differences were observed for activity of aspartate aminotranferase (AST between groups. Vascular and biliary systems of the liver were found to be affected.Conclusion: Results of biochemical analysis are consistent with pathological findings and measuring of tested parameters could be used in early diagnosis of sheep fasciolosis and to test the effectiveness of anthelmintic therapy. Corrosion cast technique is very useful for investigation of pathological changes and neoangiogenesis of vascular and biliary system in sheep liver, caused by mechanical and toxic effects of F. hepatica.

  1. Efficacy of preoperative biliary tract decompression in patients with obstructive jaundice.

    Science.gov (United States)

    Gundry, S R; Strodel, W E; Knol, J A; Eckhauser, F E; Thompson, N W

    1984-06-01

    Fifty consecutive matched patients with benign or malignant biliary tract obstruction were compared to determine the efficacy of preoperative percutaneous biliary drainage (PBD). Twenty-five patients underwent PBD for an average of nine days before operation; 25 patients underwent percutaneous transhepatic cholangiography ( PTHC ) followed immediately by operation. Serum bilirubin levels before PTHC were 16.5 +/- 7.6 mg/dL and 14.9 +/- 7.6 mg/dL in PBD and non-PBD groups, respectively. Serum bilirubin levels decreased to 6.5 +/- 6.2 mg/dL preoperatively in patients having PBD. One week after operation, bilirubin levels were 4.2 +/- 4.3 mg/dL and 9.0 +/- 5.2 mg/dL in the PBD and non-PBD groups, respectively. Major morbidity (sepsis, abscess, renal failure, or bleeding) occurred in two patients (8%) having PBD and in 13 patients (52%) without PBD. One patient (4%) with PBD, and five patients (20%) without PBD, died. The mean hospital stay was shorter for the PBD group. Preoperative PBD reduces operative mortality and morbidity and results in a more rapid resolution of hyperbilirubinemia during the postoperative period. PMID:6428380

  2. Effect of Mallotus Philippensis Muell.-Arg leaves against hepatotoxicity of Carbon tetrachloride in rats

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    Ramakrishna.S,

    2011-02-01

    Full Text Available Liver Toxicity is a major health problem of worldwide proportions. Herbal medicines derived from plant extracts are being increasingly utilized to treat a wide variety of clinical diseases. In the present study MEMP leaves is used to screen the hepatoprotective activity. Hepatotoxicity was induced in experimental animals by administration of carbon tetra chloride (CCl4 (25ml/kg, i.p.. Silymarin (25 mg/kg, p.o. was used as the standard. Functional parameters like onset of sleep and duration of sleep, Biochemical Parameters like serum glutamic oxaloacetic transaminase (SGOT, serum glutamic pyruvic transaminase (SGPT, serum alkaline phosphatase (SALP, total bilirubin and direct bilirubin were measured. Cytotoxicity of CCl4 was estimated by quantitating the release of malondialdehyde (MDA. The activity of tissue antioxidant enzymes namely super oxide dismutase (SOD, catalase (CAT, and the level of total protein (TP were also measured. Histopathological evaluation of liver sections was also done. CCl4 administration in rats elevated the levels of SGPT, SGOT, SALP and bilirubin. Administration of MEMP significantly (P<0.001 prevented this increase. The activity of anti-oxidant enzymes in carbon tetrachloride (CCl4 group was decreased and these enzyme levels were significantly (p<0.001 increased in Mallotus philippensis leaves groups. Histopathological studies revealed that the concurrent administration of MEMP with CCl4 exhibited protection of liver tissue, which further evidenced the above results. Thestudy confirmed the hepatoprotective activity of MEMP, which may be attributed to its antioxidant property.

  3. The Distribution of Etiology in Newborns with Prolonged Jaundice

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    Merih Çetinkaya

    2008-01-01

    Full Text Available Aim: The aim of this study is to determine the etiology in neonates admitted with prolonged jaundice.Materials and Method: Neonates with prolonged jaundice were included to this prospective study designed between January 2007 and December 2007. Prolonged jaundice was defined as total bilirubin level >5 mg/dL in newborns older than 14 days of age. After detailed history and physical examination, blood tests including blood groups of baby and mother, total, direct and indirect bilirubin, complete blood count (CBC, blood smear, reticulocyte count, Coombs test, serum aspartat transaminase (AST level, serum alanin transaminase (ALT level, viral markers, thyroid function tests, and glucose-6 phosphate dehydrogenase (G-6 PD level and routine urine analysis with urine culture were performed in all newborns. Results: A total of 154 neonates were enrolled to the study. The most frequent cause of prolonged jaundice was breast milk jaundice (53%. It was followed by urinary tract infections and clinical sepsis (29%, hemolytic causes due to blood group incompetency (10% and congenital hypothyroidism (8%. However,there were no significant differences between etiology and mean bilirubin levels.Conclusion: It is important to determine the etiology and to plan therapy according to etiology is important in newborns with prolonged jaundice. Breast milk jaundice, urinary tract infection and sepsis, hypothyroidism and hemolytic causes must be considered as the main etiology in newborns with prolonged jaundice. (Journal of Current Pediatrics 2008; 6: 99-103

  4. Clinical results of a new high-phototherapeutic-efficiency blue-green lamp for the management of hyperbilirubinemia

    Science.gov (United States)

    Donzelli, Gian Paolo; Pratesi, Simone; Agati, Giovanni; Fusi, Franco; Pratesi, Riccardo

    1996-01-01

    We report a preliminary study on the introduction of a new, blue-green fluorescent lamp with high phototherapeutic efficiency in the treatment of neonatal hyperbilirubinemia. The lamp (New Lamp) has an emission spectrum, peaked at 490 nm and about 40 nm wide, that was not previously investigated in clinical trials. Our study demonstrates the significantly greater efficacy of the New Lamp in decreasing the bilirubin serum level, in comparison with the most commonly used blue fluorescent lamp. The rate of decline of bilirubin concentration with the New Lamp was twice that with Philips/BB light. The success of the blue-green PT is mainly due to the combined effects of the (1) increase from blue to green of the quantum yield for lumirubin, that is the bilirubin photoproduct rapidly excreted from the organism; (2) corresponding decrease of the configurational photoisomer, formed with high concentration but not excreted from the organism; (3) filtering effect of the skin, which attenuates more blue than green light. Our results represent the first significant improvement of phototherapy efficiency following the development and introduction of the special-blue lamp by Sisson in 1970. The phototherapy exposure time has now been reduced to less than 1-day in preterm infants, ensuring less stress to the infant and less interference with nursing care.

  5. Changes in urinary response in the soccer practice

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    M.A. López-Mata

    2012-02-01

    Full Text Available The objective of this study was to evaluate the chemical parameters and urinary sediment changes before and after a soccer game. Seventeen players were selected from a selective universitary men's soccer team (age 21,8 ± 1,38 years, weight 73,2 ± 11,8 kg, height 1,71 ± 0,07 m and BMI 24,7 ± 2.3 kg/m2. Chemical parameters of the urine (specific gravity, pH, leukocytes, nitrite, proteins, glucose, bodies ketones, urobilinogene, bilirubin and erythrocytes and sediment (leukocytes, erythrocytes, crystals, epithelial cells, bacteria, casts, and mucine filaments were determined. We found a significant increase of specific gravity before and after of competition (1,019 ± 0.005 vs 1,025 ± 0.004; p= 0,0001, pH (6,0 ± 0,91 vs 5,35 ± 0,60; p= 0,008 urinary and in presence of bilirubin (0% vs 41,2%; p= 0,01. In urinary sediment was found a significant rise in the presence of casts (0% vs 29,4%; p= 0,04 and mucin filaments (11,7% vs 64,7% p= 0,004. Although some changes were found in urinary parameters, these chances may have been influenced by an increase in renal reabsortion of water.Key words: Soccer, urinary parameters, bilirubin, mucin, casts

  6. Tc-99m-BrIDA hepatobiliary (HIDA) scan has a low sensitivity for detecting biliary complications after orthotopic liver transplantation in patients with hyperbilirubinemia

    International Nuclear Information System (INIS)

    Tc-99m-BrIDA hepatobiliary scans are noninvasive tests for detecting biliary leaks and obstructions. However, there is low sensitivity and specificity in patients with hyperbilirubinemia. Biliary complications (BC) are the Achilles heel of orthotopic liver transplantation (OLT). We questioned whether hyperbilirubinemia in liver transplant recipients rendered HIDA scanning less dependable. HIDA findings were compared to endoscopic retrograde cholangiopancreatography, laparotomy, and clinical course. Results were categorized as follows: true positive (TP), true negative (TN), false positive (FP), false negative (FN), or nondiagnostic/inconclusive. We searched for variables associated with erroneous or nondiagnostic tests which we defined as all examinations determined to be FP, FN and/or nondiagnostic/inconclusive. Thirty-four patients underwent a HIDA scan. The sensitivity and specificity were 70 and 100%. The sensitivity of HIDA improved to 100% in patients with a total bilirubin (TB) 5 mg/dl. One FN had a TB <5 mg/dl, but was determined inconclusive due to the roux-en-Y. HIDA scans performed when the total bilirubin was <5 mg/dl had a high sensitivity and specificity for detecting biliary complications after OLT. However, when the total bilirubin exceeded 5 mg/dl, the specificity was still 100% but the numbers of nondiagnostic/inconclusive and FN exams were increased. (author)

  7. An unusual case of prolonged post-endoscopic retrograde cholangiopancreatography jaundice

    Institute of Scientific and Technical Information of China (English)

    Georgios Tziatzios; Paraskevas Gkolfakis; Ioannis S Papanikolaou; George Dimitriadis; Konstantinos Triantafyllou

    2016-01-01

    ABSTRACT:Despite the effectiveness of endoscopic retro-grade cholangiopancreatography (ERCP) for the treatment of choledocholithiasis, various complications have been described. We herein report the ifrst case of prolonged post-ERCP jaundice due to toxicity of the contrast agent Iobitridol (®XENETIX, Guerbet, Roissy CdG Cedex, France) in a patient who underwent ERCP with sphincterectomy and common bile duct stone removal. While clinical improvement and nor-malization of aminotransferases and cholestatic enzymes after the procedure, an unexplained increase of direct bilirubin was noticed. A second ERCP was performed one week later, exclud-ing possible remaining choledocholithiasis. Nevertheless, se-rum direct bilirubin increased further up to 15 mg/dL. Other potential causes of direct hyperbilirubinemia were ruled out and patient’s liver biopsy was compatible with drug-induced liver toxicity. Additionally, the cause-result time connection between the use of Iobitridol and bilirubin increase indicated the possibility of a toxic effect related to the repeated use of the particular contrast agent. Iobitridol, a contrast agent, can induce prolonged direct hyperbilirubinemia.

  8. «Evaluation of the anti-icterus effect of crude powdered leaf of Argemone mexicana L. (Papaveraceae against CCl4-induced liver injury in rats».

    Directory of Open Access Journals (Sweden)

    T.S. SOURABIE

    2012-10-01

    Full Text Available Leaves of Argemone mexicana L. (Papaveraceae are used in the folk medicine of Burkina Faso (West Africa to treat a variety of illness. Aqueous decoction of the drug is indicated in the treatment of malaria fever, abdominal pains, and jaundice. A preliminary study led by the authors showed a good anti-icterus (hepatoprotective activity of leaves extracts on intoxicated Wistar rats. The aim of the present investigation was to evaluate the anti-icterus activity of crude leaf powder against CCl4 induced hepatotoxicity in rats. Liver functions were assessed by the activities of liver marker enzymes, ASAT/GOT, ALAT/GPT, ALP, Total Bilirubin (TBIL and Direct Bilirubin (DBIL.A crude powdered leaf suspended in acacia gum solution (2% p/w was administered orally to the animal at doses of 125, 250 and 500 mg/kg attenuated significantly (p<0,05 the elevation of serum enzymes level and bilirubin (total and direct if compared to the CCl4 treated groups. Silymarin (100 mg/kg, p.o., a known antihepatoprotective drug was used as reference. The results showed a dose-dependent anti-hepatotoxic effect against liver injury induced by CCl4 in rats. These findings give an opportunity for a future elaboration of galenic formulation as phytomedicament.

  9. [Blood biochemical indices of female red-crowned crane (Grus japonensis) in Zhalong Nature Reserve of Heilongjiang Province, Northeast China].

    Science.gov (United States)

    Wang, Hong-Wei; Sun, Zhong-Wu; Zou, Hong-Fei; Jin, Guang-Yao

    2009-10-01

    From November 2004 to October 2005, twenty blood biochemical indices, i. e., total protein, serum albumin, serum globulin, total bilirubin, direct bilirubin, indirect bilirubin, blood glucose, serum urea nitrogen, serum creatine, total cholesterol, triglyceride, aspartate amino transferase, alanine amino transferase, alkaline phosphatase, serum creatine kinase, hydroxybutyrate dehydrogenase, lactic dehydrogenase, serum calcium ion, inorganic phosphate, and magnesium ion, of 10 female Grus japonensis adults in their wintering, reproduction, and migration periods in Zhalong Nature Reserve were analyzed by automatic biochemical analyzer. Significant differences (P < 0.05 or P < 0.01) were observed in the test indices except serum total protein, serum globulin, and blood glucose among the three life periods, which suggested that the serum total protein, serum globulin, and blood glucose could be used as the reliable references of blood biochemical indices of female G. japonensis, while the year-round dynamics of the other 17 indices reflected the physiological characteristics and ecological adaptability of female G. japonensis in its different periods in one year. When using these 17 indices as the references of the blood biochemical indices of female G. japonensis, the physiological period should be considered. PMID:20077721

  10. Opisthorchiasis-associated biliary stones:Light and scanning electron microscopic study

    Institute of Scientific and Technical Information of China (English)

    Banchob Sripa; Pipatphong Kanla; Poonsiri Sinawat; Melissa R. Haswell-Elkins

    2004-01-01

    AIM: Biliary stones are frequentty encountered in areas endemic for opisthorchiasis in Thailand. The present study was to describe the prevalence and pathogenesis of these stones.METHODS: Gallstones and/or common bile duct stones and bile specimens from 113 consecutive cholecystectomies were included. Bile samples, including sludge and/or microcalculi, were examined for Opisthorchis viverrini eggs,calcium and bilirubin. The stones were also processed for scanning electron microscopic (SEM) study.RESULTS: Of the 113 cases, 82 had pigment stones, while one had cholesterol stones. The other 30 cases had no stones. Most of the stone cases (76%, 63/83) had multiple stones, while the remainder had a single stone. Stones were more frequently observed in females. Bile examination was positive for O. viverrini eggs in 50% of the cases studied. Aggregates of calcium bilirubinate precipitates were observed in all cases with sludge. Deposition of calcium bilirubinate on the eggshell was visualized by special staining. A SEM study demonstrated the presence of the parasite eggs in the stones. Numerous crystals,morphologically consistent with calcium derivatives and cholesterol precipitates, were seen.CONCLUSION: Northeast Thailand has a high prevalence of pigment stones, as observed at the cholecystectomy, and liver fluke infestation seems involved in the pathogenesis of stone formation.

  11. Study on the changes of serum leptin level, peripheral B cell number, T cell subsets distribution type in patients with hepatitis C and the relationship between the changes and liver dysfunction

    International Nuclear Information System (INIS)

    Objective: To investigate the changes of serum leptin level, B cell number, T-cell subsets in patients with hepatitis C and the relationship between the changes and liver function alterations. Methods: Serum leptin levels (with RIA), peripheral B cell number, T cell subsets distribution type (with monoclonal antibody technique), ALT and total bilirubin (with biochemistry) were measured in 65 patients with hepatitis C and 35 controls. Results: The serum leptin level and B cell percentage in the patients were significantly higher than those in controls (P<0.01), while the CD3, CD4 percentage and CD4/CD8 ratio were significantly lower (P<0.Ol). The serum leptin levels were significantly positively correlated with those of ALT and total bilirubin (P <0.01). Conclusion: Serum leptin levels correlated well with those of two major liver function indicators (ALT and total bilirubin), thus, leptin might be used as a part of liver function test battery. Changes in B and T cell subsets demonstrated immuno-disturbances in patients with hepatitis C. (authors)

  12. Clinical evaluation of the measurement of hepatosplenic volume ratio by computed tomography

    International Nuclear Information System (INIS)

    The liver and spleen ratio (S/L ratio) was estimated with X-ray computed tomography. Clinical usefulness of S/L ratio was evaluated by comparison with other liver functions (retention rate of ICG, total bilirubin, serum albumin, and cholinesterase activity) in 42 hepatocellular carcinoma patients with liver cirrhosis. The correlation between S/L ratio and retention rate of ICG, total bilirubin, serum albumin or cholinesterase activity was good (r=0.870, r=0.719, r=-0.691, or r=0.606, respectively p<0.001). Positive correlation was observed between S/L ratio and retention rate of ICG or total bilirubin. Negative correlation was observed between S/L ratio and serum albumin or cholinesterase activity. In conclusion, the measurement of S/L ratio on computed tomography was considered to be useful as an evaluation for the degree of severity in liver cirrhosis by considering both effective hepatic blood flow and portal hypertension. (author)

  13. [Relationships between biomarkers of oxidative stress and nutritional status in adults, Ecuador].

    Science.gov (United States)

    Salazar-Lugo, Raquel; Barahona, Amparito; Santamaria, Manuel; Salas, Hilda; Oleas, Mariana; Bermeo, Bélgica

    2014-12-01

    In this work it was evaluated the relationship between oxidative stress biomarkers (uric acid, bilirubin and C-reactive protein) with nutritional status in 321 adults of Ecuador, belonging to administrative staff of of the Universidad Tècnica del Norte, aged 43 ± 10 years old (46 30% female and 53.61% male). Socio demographic and epidemiological information and lifestyle were obtained through a survey; The Body Mass Index (BMI) and body fat and body water percentages were calculated; waist circumference (WC) and blood pressure was measured. Determinations of uric acid, bilirubin, and serum C-reactive protein (PCR) were performed. 17.9% of the populations were obese and 51.72% overweight. The highest values of uric acid were found in obese, hypertensive and physical activity groups. The total direct and indirect bilirubin were found in upper limits in abdominal obesity and physical activity groups. The CRP level was influenced by % fat and % water in the low body fat group and in females. In male, BMI and WC were associated with CRP. Uric acid showed relationship with % fat and WC in overweight, high body fat and PHT groups, uric acid was associated with the % water and BMI in obese. Finally, uric acid was associated with % water and the WC in the abdominal obesity, and HT groups'. The body water percentage is an important indicator to development of oxidative stress in this population. PMID:26336722

  14. Danshen (Salvia miltiorrhiza) Compounds Improve the Biochemical Indices of the Patients with Coronary Heart Disease

    Science.gov (United States)

    Liu, Boyan; Du, Yanhui; Cong, Lixin; Jia, Xiaoying; Yang, Ge

    2016-01-01

    Danshen was able to reduce the risk of the patients with coronary heart disease (CHD), but the mechanism is still widely unknown. Biochemical indices (lipid profile, markers of renal and liver function, and homocysteine (Hcy)) are closely associated with CHD risk. We aimed to investigate whether the medicine reduces CHD risk by improving these biochemical indices. The patients received 10 Danshen pills (27 mg/pill) in Dashen group, while the control patients received placebo pills, three times daily. The duration of follow-up was three months. The serum biochemical indices were measured, including lipid profiles (LDL cholesterol (LDL-C), HDL-C, total cholesterol (TC), triglycerides (TG), apolipoprotein (Apo) A, ApoB, ApoE, and lipoprotein (a) (Lp(a))); markers of liver function (gamma-glutamyl transpeptidase (GGT), total bilirubin (TBil), indirect bilirubin (IBil), and direct bilirubin (DBil)); marker of renal function (uric acid (UA)) and Hcy. After three-month follow-up, Danshen treatment reduced the levels of TG, TC, LDL-C, Lp(a), GGT, DBil, UA, and Hcy (P < 0.05). In contrast, the treatment increased the levels of HDL-C, ApoA, ApoB, ApoE, TBil, and IBil (P < 0.05). Conclusion. Danshen can reduce the CHD risk by improving the biochemical indices of CHD patients. PMID:27366196

  15. Radiation sensitivity of microorganisms adhering to the crude drug ''Bezoar Bovis'' and stability of its main components for γ-ray irradiation

    International Nuclear Information System (INIS)

    The sterilization dose (SD) of γ rays required for the microbial-contaminated crude drug ''Bezoar Bovis'' and the residual rates of its characteristic and effective components, bilirubin and some kinds of cholic acid, were studied experimentally. Samples of Bezoar Bovis made in America were used. The contamination level of the samples was 2.2 x 108 cells of bacteria and 6.0 x 105 spores of fungi per g specimen. The survival rate of these microorganisms showed nearly an exponential dependence on radiation dose. The decimal reduction doses (D10) for the bacteria and fungi were found to be 1.5 kGy and 1.1 kGy respectively. From these values, the dose required for attaining the contamination level provided by the administrative guidance (Bacteria, 3 cells/g; Fungi, 2 spores/g) were estimated to be 7.5 kGy and 4.3 kGy, respectively. The G-values for bilirubin, cholic acid and deoxycholic acid were calculated to be 13, 6 and 8, respectively. If the sterilization treatment is carried out with a dose less than 10 kGy on the specimen in a dry powder state, the reduction of the main components such as bilirubin and cholic acids by γ-ray irradiation is considered to be negligible. (author)

  16. The role of biliverdin reductase in colorectal cancer

    International Nuclear Information System (INIS)

    In recent years, the effects of biliverdin and bilirubin have been studied extensively, and an inhibitory effect of bile pigments in cancer progression has been proposed. In this study we focused on the effects of biliverdin reductase, the enzyme that converts biliverdin to bilirubin, in colorectal cancer. For in vitro experiments we used a human colorectal carcinoma cell line and transfected it with an expression construct of shRNA specific for biliverdin reductase, to create cells with stable knock-down of enzyme expression. Cell proliferation was analyzed using the CASY model TT cell counting device. Western blot protein analysis was performed to study intracellular signaling cascades. Samples of human colorectal cancer were analyzed using immunohistochemistry. We were able to confirm the antiproliferative effects of bile pigments on cancer cells in vitro. However, this effect was attenuated in biliverdin reductase knock down cells. ERK and Akt activation seen under biliverdin and bilirubin treatment was also reduced in biliverdin reductase deficient cells. Immunohistochemical analysis of tumor samples from patients with colorectal cancer showed elevated biliverdin reductase levels. High enzyme expression was associated with lower overall and disease free patient survival. We conclude that BVR is required for bile pigment mediated effects regarding cancer cell proliferation and modulation of intracellular signaling cascades. The role of BVR overexpression in vivo and its exact influence on cancer progression and patient survival need to be further investigated. (author)

  17. Effect Of L-Cysteine On Blood Picture And Some Serum Parameters In Rats Exposed To 2 Gauss Electro-Magnetic Field

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    Mervat Abdel-Rahman

    2004-12-01

    Full Text Available Objective: investigation of the bio-effects of exposure to 2 gauss electromagnetic field (EMF on blood elements, blood glucose, hepatocellular enzymes and bilirubin of mice and their possible modification by L-cysteine. Methods: the following groups were studied; (1 normal rats treated with saline; (2 normal rats treated with L-cysteine (18 mg/kg; (3 rats exposed to EMF for 21 days and treated with the vehicle (saline during the exposure period; (4 rats exposed to EMF for 21 days and treated with L-cysteine (18 mg/kg orally, 3 times per week during the exposure period; (5 rats exposed to EMF for 21 days and treated with the vehicle (saline during the exposure period and for 45 days after exposure; (6 rats exposed to EMF for 21 days and treated with L-cysteine (18 mg/kg orally, 3 times per week during the exposure period and for 45 days after exposure; Results: in rats exposed to low frequency EMF for 21 days (group2, marked increase in aspartate aminotransferase (AST and alanine aminotransferase (ALT activities in serum was observed. Plasma bilirubin level was raised. Meanwhile, significant decrease in plasma glucose levels occured after exposure to EMF. No significant changes were observed in haemoglobin level, red blood cells or total leucocytic count noted in rats exposed to EMF. The elevations in serum bilirubin, AST and ALT levels were reduced to near normal values in rats given L-cysteine druing the 21 days of exposure (group3. On the other hand, in rats examined 45 days after the end of the exposure period (group 3, no significant alterations were noted as regards bilirubin, AST, ALT and glucose levels in serum. Conclusions: these results suggest that (1 exposure to low frequency EMF of 50 Hz is associated with some degree of liver injury reflected in increased leakage of hepatoceular enzymes into plasma as well as an increase in serum bilirubin; (2 these alterations can be ameliorated by the administration of L-cysteine, as well as; (3

  18. A Survival Analysis of Patients with Malignant Biliary Strictures Treated by Percutaneous Metallic Stenting

    International Nuclear Information System (INIS)

    Background. Percutaneous metal stenting is an accepted palliative treatment for malignant biliary obstruction. Nevertheless, factors predicting survival are not known. Methods. Seventy-six patients with inoperable malignant biliary obstruction were treated with percutaneous placement of metallic stents. Twenty patients had non-hilar lesions. Fifty-six patients had hilar lesions classified as Bismuth type I (n = 15 patients), type II (n = 26), type III (n = 12), or type IV (n = 3 patients). Technical and clinical success rates, complications, and long-term outcome were recorded. Clinical success rates, patency, and survival rates were compared in patients treated with complete (n = 41) versus partial (n = 35) liver parenchyma drainage. Survival was calculated and analyzed for potential predictors such as the tumor type, the extent of the disease, the level of obstruction, and the post-intervention bilirubin levels. Results. Stenting was technically successful in all patients (unilateral drainage in 70 patients, bilateral drainage in 6 patients) with an overall significant reduction of the post-intervention bilirubin levels (p < 0.001), resulting in a clinical success rate of 97.3%. Clinical success rates were similar in patients treated with whole-liver drainage versus partial liver drainage. Minor and major complications occurred in 8% and 15% of patients, respectively. Mean overall primary stent patency was 120 days, while the restenosis rate was 12%. Mean overall secondary stent patency was 242.2 days. Patency rates were similar in patients with complete versus partial liver drainage. Mean overall survival was 142.3 days. Survival was similar in the complete and partial drainage groups. The post-intervention serum bilirubin level was an independent predictor of survival (p < 0.001). A cut-off point in post-stenting bilirubin levels of 4 mg/dl dichotomized patients with good versus poor prognosis. Patient age and Bismuth IV lesions were also independent predictors

  19. Correlation of Apgar Score with Asphyxial Hepatic Injury and Mortality in Newborns: A Prospective Observational Study From India

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    Sharma, Deepak; Choudhary, Mukesh; Lamba, Mamta; Shastri, Sweta

    2016-01-01

    OBJECTIVE The objective of this study is to determine the correlation of Apgar score with asphyxial hepatic injury and neonatal mortality in moderately and severely asphyxiated newborns. MATERIAL AND METHODS This is a secondary analysis of our prospective observational case-controlled study. Sixteen neonates with severe birth asphyxia (five-minute Apgar ≤3) were compared with either 54 moderate asphyxia neonates (five-minute Apgar >3) or 30 normal neonates. Liver function tests were measured on postnatal days 1, 3, and 10 in the study and control groups. Neonatal mortality was observed in the study and control population. RESULTS Correlation of Apgar score in severely asphyxiated neonates compared with normal Apgar score neonates and moderately asphyxiated neonates for deranged hepatic function showed significant correlation (odds ratio [OR] 4.88, 95% CI 3.26–5.84, P = 0.01 and OR 2.46, 95% CI 1.94–3.32, P = 0.02, respectively). There was a significant increase in serum lactate dehydrogenase (LDH) and total bilirubin on day 1 and serum LDH at age of 10th postnatal life in severely asphyxiated neonates when compared to moderately asphyxiated neonates, whereas there was a significant decrease in total bilirubin and serum albumin on day 3 in severely asphyxiated neonates. There was a significant increase in serum alanine transaminase, serum LDH, and total bilirubin on day 1, serum aspartate transaminase, serum LDH, and total bilirubin on day 3, and International Normalized Ratio on day 10 of postnatal life when severely asphyxiated neonates were compared with normal neonates. There was a significant reduction in total protein and serum albumin on day 1 and direct bilirubin on day 3 in severely asphyxiated neonates when compared with normal neonates. There was a significant increase in neonatal mortality in severely asphyxiated neonates when compared to the other two groups. Correlation of Apgar score in severely asphyxiated neonates compared with normal Apgar

  20. Acute Brucella Hepatitis in an Urban Patient

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    Seyed Moayed Alavian

    2009-11-01

    Full Text Available A 35-year-old man was referred to our center because of low grade fever, vomiting, yellow sclera, and tenderness in the upper-right quadrant of his abdomen. Laboratory tests showed a white blood cell (WBC of 7100/µL, a platelet of 184,000/µL, an erythrocyte sedimentation rate (ESR of 4 mm/h, an alanine aminotransferase (ALT of 525 U/L, an aspartate aminotransferase AST of 142 U/L, a total bilirubin level of 4.23 mg/dL, and a direct bilirubin level of 3.16 mg/dL. Viral hepatitis markers, immunoglobuline M antibody to cytomegalovirus (anti-CMV IgM, Ebstein-Barr virus (EBV IgM, and immunologic markers of autoimmune hepatitis were negative. The patient was diagnosed with acute hepatitis. Alkaline phosphatase was in the normal range throughout the course of the disease. Because of the patient's occupation as a butcher and his history of eating semi-cooked sheep testes, serologic tests of brucellosis were conducted; the tests came out positive. We were concerned about the hepatotoxicity of standard regimens; therefore, we started treatment with streptomycin and ciprofloxacin regimens. Although liver enzyme had fallen and fever discontinued, the total and direct bilirubin concentrations in the patient's serum both increased in spite of using 2 weeks of the abovementioned drug regimen. The elevation of bilirubin could have been due to drug hepatotoxicity. Alternatively, a regimen containing ciprofloxacin may have not have been efficient enough and may have had effects on the direct bilirubin concentration. Fortunately, within 8 weeks, progressive recovery was noticed. Brucellosis should be considered in the differential diagnosis of fever and hepatitis for those who live in endemic areas, especially if his/her job was at high risk for acquiring brucellosis. We recommend taking a careful occupational and behavioral history for patients with acute hepatitis syndrome. We assumed that ciprofloxacin was not suitable for brucella hepatitis treatment and

  1. Ursodeoxycholic acid in neonatal sepsis-associated cholestasis

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    Rita Mey Rina

    2014-07-01

    Full Text Available Background Sepsis-associated cholestasis (SAC is an intrahe-intrahepatic cholestasis caused by inflammatory cytokines. Patients with this condition have poor prognoses. Antibiotics are the mainstay of therapy, however, other adjuvant therapies, such as ursodeoxycholic acid (UDCA, have not been well established. Objective To assess the effect of UDCA for treatment of neonatal sepsis-associated cholestasis. Methods We performed a randomized, double-blind, controlled trial in 37 neonates who were diagnosed with sepsis-associated cholestasis in the Neonatal Care Unit of Cipto Mangunkusumo Hospital. Subjects were divided into two groups, with 19 neonates randomly allocated to the intervention group (received UDCA at 30 mg/kg/day divided into 3 doses for 7 days and 18 neonates to the control group (received placebo. After 7 days of treatment, we evaluated the subjects’ liver function parameters and performed a survival analysis. Results Liver function parameter improvements at day 7 were not significantly different between the UDCA group and the control group, including for mean decrease of total bilirubin (TB levels [2.2 (SD 2.9 mg/dL vs 1.7 (SD 4.6 mg/dL; P=0.080, mean decrease of direct bilirubin (DB levels [1.1 (SD 2.3 mg/dL vs 0.6 (SD 3.6 mg/dL; P=0.080, median indirect bilirubin (IB levels [0.4 (range 0.1- 5.6 mg/dL vs 0.9 (range 0.1-4.1 mg/dL; P=0.358, mean decrease of alanine aminotransferase (ALT levels [0.5 (-80.0 - 21.0 U/L vs -2.0 (ranged -167.0 - 85.0 U/L; P= 0.730, median aspartate aminotransferase (AST levels [43.0 (range 14.0-297.0 U/L vs 150.0 (range 24.0-840.0 U/L; P=0.081, and median gamma-glutamyl transpeptidase (GGT levels [125.0 (48.0-481.0 U/L vs 235.0 (56.0-456.0 U/L; P=0.108]. Five neonates in control group died compared to two in the UDCA group (P=0.232. In addition, UDCA did not significantly lengthen the survival time (hazard ratio/HR 3.62; 95%CI 0.69 to 18.77. Conclusion Ursodeoxycholic acid tends to improve total

  2. Neuronal quantity and ultrastructure in extracorticospinal tract of newborn rabbits with cerebral palsy

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    Xiaojie Li; Ying Yang; Zhimei Jiang; Lanrnin Guo; Jing Gao

    2006-01-01

    BACKGROUND: The liver enzyme system and blood brain barrier function of newborn rabbits are incomplete.High level of bilirubin can lead to cerebral palsy (CP) of newborn rabbits. The pathological and ultrastructural changes of brains of immature rabbits may differ from those of mature rabbits.OBJECTIVE: To observe the changes in dopaminergic neuron amount and ultrastructure in the extracorticospinal tract of animal models of CP induced by hyperbilirubinemia.DESIGN: A randomized controlled observation.SETTING: Rehabilitation Medical College of Jiamusi University; Laboratory for Pediatric Neurology Rehabilitation of Jiamusi University.MATERIALS: Thirty newborn 2- to 5- day inbred Japanese rabbits, weighing about 50 g, of either gender, were provided by Experimental Animal Center, Jilin University. Bilirubin and tyrosine hydroxylase (TH) antibody were purchased from Sigma Corporation, USA.METHODS: This experiment was carried out in the laboratory for children neuro-rehabilitation, Jiamusi University between September 2002 and December 2005. ①Thirty rabbits were randomly divided into 2groups: control group (n =10) and model group (n =20). ②Bilirubin of 100 mg/kg was given to the rabbits of model group through intraperitoneal injection, once every other day, 3 times totally; The same amount of normal saline was given to the rabbits of control group. After injection, the newborn rabbits had been fed by maternal milk for 45 days. ③TH-positive neurons in substantia nigra and corpora striatum in each area of0.15 mm ×0.15 mm were counted. Uitrastructures of substantia nigra and corpora striatum were observed under the electron miscroscope. The concentration of bilirubin in brain tissue of CP rabbits of model group was measured with high performance liquid chromatogram.MAIN OUTCOME MEASURES: Quantitative analysis results and ultrastructure of TH-positive neurons in substantia nigra and corpora striatum in two groups.RESULTS: Thirty newborn rabbits were involved, 6

  3. A GWAS Study on Liver Function Test Using eMERGE Network Participants

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    Namjou, Bahram; Marsolo, Keith; Lingren, Todd; Ritchie, Marylyn D.; Verma, Shefali S.; Cobb, Beth L.; Perry, Cassandra; Kitchner, Terrie E.; Brilliant, Murray H.; Peissig, Peggy L.; Borthwick, Kenneth M.; Williams, Marc S.; Grafton, Jane; Jarvik, Gail P.; Holm, Ingrid A.; Harley, John B.

    2015-01-01

    Introduction Liver enzyme levels and total serum bilirubin are under genetic control and in recent years genome-wide population-based association studies have identified different susceptibility loci for these traits. We conducted a genome-wide association study in European ancestry participants from the Electronic Medical Records and Genomics (eMERGE) Network dataset of patient medical records with available genotyping data in order to identify genetic contributors to variability in serum bilirubin levels and other liver function tests and to compare the effects between adult and pediatric populations. Methods The process of whole genome imputation of eMERGE samples with standard quality control measures have been described previously. After removing missing data and outliers based on principal components (PC) analyses, 3294 samples from European ancestry were used for the GWAS study. The association between each single nucleotide polymorphism (SNP) and total serum bilirubin and other liver function tests was tested using linear regression, adjusting for age, gender, site, platform and ancestry principal components (PC). Results Consistent with previous results, a strong association signal has been detected for UGT1A gene cluster (best SNP rs887829, beta = 0.15, p = 1.30x10-118) for total serum bilirubin level. Indeed, in this region more than 176 SNPs (or indels) had p<10−8 spanning 150Kb on the long arm of chromosome 2q37.1. In addition, we found a similar level of magnitude in a pediatric group (p = 8.26x10-47, beta = 0.17). Further imputation using sequencing data as a reference panel revealed association of other markers including known TA7 repeat indels (rs8175347) (p = 9.78x10-117) and rs111741722 (p = 5.41x10-119) which were in proxy (r2 = 0.99) with rs887829. Among rare variants, two Asian subjects homozygous for coding SNP rs4148323 (G71R) were identified. Additional known effects for total serum bilirubin were also confirmed including organic anion

  4. CT examination, clinical situation and experimental characteristics of infants with intracranial hemorrhage induced by delayed vitamin K deficiency

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    Zhiqing Lin; Feng Fang; Min Chen; Guoxiang Cai

    2006-01-01

    alkaline phosphatase, total bilirubin, direct bilirubin and indirect bilirubin,were detected with Roche Modular PPI automatic biochemistry analyzer. ③ After hospitalization, infants were given 5-10 mg vitamin K1 for 3-5 days, and then, they were transfused with 10-15 mL/kg fresh plasma or whole blood for 1-3 times and received other relative therapies. Therapeutic effects were evaluated based on clinical diagnosis and criteria.MAIN OUTCOME MEASURES: ① Clinical situation, physical sign and CT examination; ② results of experimental examination; ③ treatment and termination.RESULTS: A total of 17 infants with intracranial hemorrhage were involved in the final analysis. ① Clinical situation, physical sign and CT examination: All infants had pale facial expression and full or bossing anterior fontanelle. Among them, 13 infants had drowsiness or dysphoria, 12 rejective milk or emesis, 11 tic, 13 injection site hemorrhage, 2 gastrointestinal hemorrhage, 3 cerebral hernia, 11 high muscular tension and 6 cervical rigidity. CT examination demonstrated that most infants (88%, 15/17) had subarachnoid hemorrhage;10 (59%, 10/17) had subdural hematoma; 8 (47%, 8/17) had cerebral parenchyma hemorrhage; few had intraventricular hemorrhage. In addition, results of CT examination also indicated that 17 infants had intracranial hemorrhage. Hemorrhage sites of 12 infants were equal to or more than 2, which was accounted for 70%(12/17); meanwhile, partial cases accompanied with a large area of focus of cerebral infarction or cerebral hypoxia-ischemia lesion. ② Results of experimental examination: There were 6 infants with elongation of prothrombin time, 5 with partial elongation of prothrombin time, 4 with decrease of serum calcium (1.69-2.25 mmol/L), 3 with increase of serum alkaline phosphatase, 3 with increase of total bilirubin, 3 with increase of direct bilirubin, and 3 with increase of indirect bilirubin. ③ Treatment and termination: After treatment, 12 infants were cured

  5. Hyperglycaemic Environment: Contribution to the Anaemia Associated with Diabetes Mellitus in Rats Experimentally Induced with Alloxan

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    Oseni Bashiru Shola

    2015-01-01

    Full Text Available Background. Diabetes mellitus characterized by hyperglycaemia presents with various complications amongst which anaemia is common particularly in those with overt nephropathy or renal impairment. The present study has examined the contribution of the hyperglycaemic environment in diabetic rats to the anaemia associated with diabetes mellitus. Method. Sixty male albino rats weighing 175–250 g were selected for this study and divided equally into control and test groups. Hyperglycaemia was induced with 170 kgbwt−1 alloxan intraperitoneally in the test group while control group received sterile normal saline. Blood samples obtained from the control and test rats were assayed for packed cell volume (PCV, haemoglobin (Hb, red blood cell count (RBC, reticulocyte count, glucose, plasma haemoglobin, potassium, and bilirubin. Result. Significant reduction (P<0.01 in PCV (24.40±3.87 versus 40.45±3.93 and haemoglobin (7.81±1.45 versus 13.39±0.40 with significant increase (P<0.01 in reticulocyte count (12.4±1.87 versus 3.69±0.47, plasma haemoglobin (67.50±10.85 versus 34.20±3.83, and potassium (7.04±0.75 versus 4.52±0.63 was obtained in the test while plasma bilirubin showed nonsignificant increase (0.41±0.04 versus 0.24±0.06. Conclusion. The increased plasma haemoglobin and potassium levels indicate an intravascular haemolytic event while the nonsignificant increased bilirubin showed extravascular haemolysis. These play contributory roles in the anaemia associated with diabetes mellitus.

  6. Effect of phototherapy with alumunium foil reflectors on neonatal hyperbilirubinemia

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    Tony Ijong Dachlan

    2016-07-01

    Full Text Available Background Neonatal hyperbilirubinemia (NH is one of the most common problems in neonates, but it can be treated with blue light phototherapy. Developing countries with limited medical equipment and funds have difficulty providing effective phototherapy to treat NH, leading to increased risk of bilirubin encephalopathy. Phototherapy with white reflecting curtains can decrease the duration of phototherapy needed to reduce bilirubin levels. Objective To compare the duration of phototherapy needed in neonates with NH who underwent phototherapy with and without aluminum foil reflectors. Methods This open clinical trial was conducted from July to August 2013 at Dr. Hasan Sadikin Hospital, Bandung, Indonesia. The inclusion criteria were term neonates with uncomplicated NH presenting in their first week of life. Subjects were randomized into two groups, those who received phototherapy with or without aluminum foil reflectors. Serum bilirubin is taken at 12th, 24th, 48th hours, then every 24 hours if needed until phototherapy can be stopped according to American Academy of Pediatrics guidelines. The outcome measured was the duration of phototherapy using survival analysis. The difference between the two groups was tested by Gehan method. Results Seventy newborns who fulfilled the inclusion criteria and had similar characteristics were randomized into two groups. The duration of phototherapy needed was significantly less in the group with aluminum foil reflectors than in the group without reflectors [72 vs. 96 hours, respectively, (P<0.01]. Conclusion The required duration of phototherapy with aluminum foil reflectors is significantly less than that of phototherapy without reflectors, in neonates with NH.

  7. A multicenter randomized controlled study on the efficacy and safety of Yinzhihuang oral solution for the treatment of neonatal indirect hyperbilirubinemia in term newborn infants%茵栀黄口服液治疗足月新生儿高间接胆红素血症的多中心随机对照研究

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    茵栀黄口服液临床研究协作组

    2011-01-01

    Objective Alarge-scale prospective multicenter randomized controlled tial was conducted to evaluate the efficacy and safety of Yinzhihuang oral solution for the treatment of neonatal indirect hyperbilirubinemia in term newborn infants. Yinzhihuang oral solution is a herbal extract with the main components of Herba Artemisiae Scopariae, Scutellaria, Lonicera Japonica and Gardenia jasminoides. Methods A total of 16 hospitals participated in this study. From March to September 2010, the term infants whose bilirubin level ≥ 40 th percentile for age in hours were enrolled, except for those who received exchange transfusion or had signs of bilirubin encephalopathy. All the 1177 cases were divided randomly into three groups: phototherapy group (409 cases ), phenobarbital combined with phototherapy group (373 cases) and Yinzhihuang oral liquid combined with phototherapy group (395 cases). Phenobarbital and Yinzhihuang oral liquid was started once the infants participated the study, and persisted for 5 days. Phototherapy was added as soon as the bilirubin level reached the lowest threshold ( the threshold for infants at higher risk). The demographic data of infants in each group were recorded, the serum bilirubin level before treatment, after treatment for 72 hours and after the treatment completion were checked. The reduction rate of serum bilirubin and the phototherapy rate in different groups were compared. The adverse events were assessed as well. Results Of the total of 1177 cases, 707 (60. 1% ) were male, 1119 cases (95. 1% ) were of Han ethnicity. The average total bilirubin level before treatment was ( 282. 0 ± 70. 9) μmol/L and the highest level was 626 μmol/L The severe hyperbilirubinemia (total bilirubin level at 342 μmoL/L to 427 μmol/L) accounted for 15.8% (186 cases), and the extremely severe hyperbilirubinemia (total bilirubin >427 μmol / L) accounted for 2. 5% (30 cases). After treatment for 72 hours, the reduction of bilirubin was not

  8. Results of exchange transfusions in newborns without blood group incompatibility

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    Servet Yel

    2013-01-01

    Full Text Available Objective: Hyperbilirubinemia is a common problem ofneonatal period that has high morbidity and mortality.Blood exchange is the most effective and urgent treatmentmodality for very high bilirubin levels that can lead toneurotoxicity called as kernicterus. The aim of this studywas to compare 90 minutes exchange transfusion withthat of 120 minutes.Methods: This study was performed at Dicle UniversityMedical Faculty, Neonatal Unit between July 2007 andJune 2008. A total of 36 term newborn (38 - 42 gestationalweek without blood group incompatibility and withtotal serum bilirubin levels over 25 mg/dl were included.Newborns were randomly assigned in two groups eachof them comprise 18 babies as Group 1 underwent 90minute-exchange and Group 2 120 minute. Effectivenessand complications of exchange transfusion were recorded.Newborns with Rh, ABO or subgroup incompatibilities,prematurity or small for gestational age, septicemia,hypothyroidism, G6PD enzyme deficiency, intrauterineinfections, diabetic mother’s baby, hemolytic disease ormetabolic diseases were excluded.Results: There were no significant differences in thebody weight, gestational age, postnatal age, age of mother,total bilirubin and albumin levels, the number of bloodexchange, hospital stay days and complications betweentwo groups (p>0.05. However, mean phototherapy durationwas significantly shorter in 120 minutes transfusiongroup compared with 90 minutes group (p<0.001.Conclusion: Our results indicated that 90 minutes wassufficient for an effective exchange transfusion in severehyperbilirubinemic newborn infants. However longer exchangetransfusion durations may shorten the duration ofphototherapy.Key words: Indirect hyperbilirubinemia, exchange transfusion,newborns, outcome

  9. The Effect of Clofibrate on Neonatal Hyperbilirubinemia in Uncomplicated Jaundice

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    Seyed Aidin Sajedi

    2008-04-01

    Full Text Available Objective: Clofibrate has been used for several years as a hypolipidemic drug. Our aim was to study the effect of Clofibrate on neonatal hyperbilirubinemia in uncomplicated jaundice.Material & Methods: This clinical trial study has been conducted on 90 normal term neonates who were admitted for uncomplicated jaundice in 17th-Shahrivar Childrens Hospital of Guilan University of Medical Sciences from September 2005 to January 2006. The data included: age, sex, total and direct serum bilirubin, weight and duration of hospitalization. All data were analyzed by using statistical methods.Findings: All 90 infants enrolled in our study had received phototherapy. The infants were divided into Clofibrate group (G1 consisting of 26 boys (57.8% and 19 girls (42.2% and Control group with 24 boys (53.3% and 21 girls (46.7% (G2. There were no statistically overt differences between the two groups regarding sex distribution, age, weight and total serum bilirubin level at admission. Mean values for total bilirubin of serum in Clofibrate group 12, 24, 36, and 48  hours after admission were significantly lower than those for Control group (P<0.00l. The mean time needed for phototherapy in Clofibrate group (38.8 (20-48h was significantly shorter than that in control group (68.7 (36-96h (P<0.00l. Conclusion: Clofibrate is effective and probably a safe drug for neonatal hyperbilirubinemia that can decrease the time needed for phototherapy and hospitalization, although further studies with a more precise and longer follow up is needed for proving its safety to be used routinely in the treatment of neonatal hyperbilirubinemia.

  10. Assessment of Effect of Mirror Room in Management of Neonatal Hyperbilirubinemia

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    SH Nabavizade

    2006-10-01

    Full Text Available ABSTRACT: Introduction & Objective: Jundice is the most common problem that can occur in the newborn. Although most jaundiced infants are otherwise perfectly healthy, jundice makes us anxious because bilirubin is potentially toxic to the central nervous system. Phototherapy is a highly effective method for prevention of exchange transfusion. The evaluation of the effect of mirror room on the decrease of hyperbilirubinemia is the purpose of this study. Materials & Metods: In this clinical trial 60 term infants with the weight of more than 2500gr and the age of 72 hours who were admitted in Emam Sajad hospital (1384 for phototherapy were randiomized into two equal groups of phototherapy. The first group undertook the traditional method of phototherapy and the second group was placed in mirror room (creative method. Then the results of the 2 groups, including bilirubin on admission, after 12, 24 and 48 hours after admission, and duration of admission were analyzed using the statistical test of chi-square. Results: In term infants the first 24 hour decline rate of bilirubin for traditional and mirror incubator phototherapy was 2.1± 1.1 and 3.6± 2.2 respectively (p< 0.01. The decline rate during the second day was 2.6± 1.3 in group one versus 3.8±2.4 in the second group (p<0.01. Duration of admission in the first group was 62.3±25 hours compared to 40.5± 28.6 hours in the second group (p<0.05. Conclusion: The creative method mirror incubator had a better effect compared with traditional methods. It is comparable with double phototherapy and fibrobtic blanket methos. It could be an alternative model for double phototherapy as it produces reasonable cost effectiveness and is easy to apply.

  11. ABO incompatibility hemolytic disease following exchange transfusion 96 newborn

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    Khatami S.F

    2007-09-01

    Full Text Available Background: ABO incompatibility hemolytic disease of the newborn is a common cause of clinical jaundice and causes two-thirds of the hemolytic disease in newborns. This study was undertaken to determine the frequency of ABO incompatibility hemolytic disease and its complications in newborns undergoing exchange transfusion.Methods: This prospective and descriptive study was performed in jaundiced newborn infants during a three-year period. Inclusion criteria were: maternal blood type O, newborn blood type A or B, rising indirect hyperbilirubinemia in the first two days of life, positive immunohematologic test for newborns and exchange transfusion. Exclusion criteria were: incomplete information, other accompanying diseases that induce hyperbilirubinemia. All newborn infants received phototherapy before and after exchange transfusion. We did not use intravenous immunoglobulin, hemoxygenase inhibitor drugs and blood products before exchange transfusion.Results: Double-volume exchange transfusion via umbilical cord catheter was performed in 96 patients, 19 (20% of whom suffered from ABO incompatibility. Of these 19 newborns, two-thirds (13 were preterm infants. The minimum level of serum bilirubin was 10 mg/dl and the maximum serum bilirubin level was 35 mg/dl. In six patients (32% serum bilirubin levels were >25mg/dl. The most common blood group was type A for newborns. Immunohematologic tests were positive in 84% of the mothers. ABO incompatibility hemolytic disease was the fourth and second most common reasons for blood exchange transfusion in preterm and term infants, respectively. Laboratory complications were more common than clinical complications. The etiology of 48% of the alloimmunization and 42% of the hemolytic disease in these newborns was ABO incompatibility.Conclusions: Mothers with blood group O and newborns with blood group A or B with positive immunohematologic tests in first hours of life are at high risk for hemolytic disease

  12. Effect of phototherapy with alumunium foil reflectors on neonatal hyperbilirubinemia

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    Tony Ijong Dachlan

    2015-01-01

    Full Text Available Background Neonatal hyperbilirubinemia (NH is one of the most common problems in neonates, but it can be treated with blue light phototherapy. Developing countries with limited medical equipment and funds have difficulty providing effective phototherapy to treat NH, leading to increased risk of bilirubin encephalopathy. Phototherapy with white reflecting curtains can decrease the duration of phototherapy needed to reduce bilirubin levels. Objective To compare the duration of phototherapy needed in neonates with NH who underwent phototherapy with and without aluminum foil reflectors. Methods This open clinical trial was conducted from July to August 2013 at Dr. Hasan Sadikin Hospital, Bandung, Indonesia. The inclusion criteria were term neonates with uncomplicated NH presenting in their first week of life. Subjects were randomized into two groups, those who received phototherapy with or without aluminum foil reflectors. Serum bilirubin is taken at 12th, 24th, 48th hours, then every 24 hours if needed until phototherapy can be stopped according to American Academy of Pediatrics guidelines. The outcome measured was the duration of phototherapy using survival analysis. The difference between the two groups was tested by Gehan method. Results Seventy newborns who fulfilled the inclusion criteria and had similar characteristics were randomized into two groups. The duration of phototherapy needed was significantly less in the group with aluminum foil reflectors than in the group without reflectors [72 vs. 96 hours, respectively, (P<0.01]. Conclusion The required duration of phototherapy with aluminum foil reflectors is significantly less than that of phototherapy without reflectors, in neonates with NH. [Paediatr Indones. 2015;55:18-22.].

  13. A study of impact of stent implantation in distal common bile duct on duodenal-biliary reflux

    International Nuclear Information System (INIS)

    Objective: This study aimed to investigate the incidence and the cause for duodenal- biliary reflux and reflux cholangitis after metallic stent placement in distal common bile duct. Methods: After percutaneous transhepatic bile duct puncture and biliary outside drainage was performed, 16 cases with malignant distal biliary stricture underwent metallic stent placement in distal common bile duct. Before stent placement, the routine laboratory studies including leukocyte, neutrophil percentage and the levels of total bilimbin and direct bilirubin in blood were performed for all patients. Two to five days [an average of (3.3±0.9) days] after stent implantation, the above indexes were tested again, and 1 ml of water containing 185 MBq of 99Tcm-DTPA was given orally before extubation, then 99Tcm radioactivity in the bile was detected 2 hours later. For the measurement data obtained from the experiment, t test or Wilcoxon signed rank test was adopted to compare them, and P9/L, and the median of neutrophil percentage was 0.74. Compared with those before stent implantation, the difference did not reach statistical significance (t=0.423, Z=1.036, P>0.05). After stent implantation, the median of total bilirubin and direct bilirubin were significantly lower, which were 92.2 and 74.3 μmol/L. Compared with those before stenting, the difference was statistically significant (Z=-3.170, -3.170, P<0.05). Conclusions: There is a high incidence of duodenal-biliary reflux after stent implantation in distal common bile duct in the early stage. However, there is no simultaneous cholangitis caused by duodenal-biliary reflux. (authors)

  14. 新生儿高胆红素血症的治疗进展%Advances in treatment of neonatal hyperbilirubinemia

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    赵冬莹

    2012-01-01

    Hyperbiiirubinemia, one of the common problems in neormtes, is due io a combination of increased bilirahm load and decreased bilirubin elimination. In order to reduce the risk of developing neurologic sequelae, active interventions have been used clinically in the treatment of neonatal hyperbilimbinaemia. Various approaches of treatment including phototherapy, exchange transfusion, pharmacology and massage are reviewed. Phototherapy and exchange transfusion have fewer side effects while the pharmacological agents such as clofibrate, Yinzhilmarig and probiotics have been proven safe arid effective. Therefore, it will be more efficient to use a variety of treatments to reduce serum bilirubin and thus prevent bilirubin encephalopathy.%新生儿高胆红素血症是新生儿期常见问题之一,是由于胆红素生产和消除不平衡,而导致的血浆胆红素升高.为避免高胆红素血症所造成的中枢神经系统后遗症,必须积极治疗.高胆红素血症的治疗方法包括光疗、换血、药物和抚触等.随着研究进展,高胆红素血症治疗有新的突破,如光疗和换血的安全性得到进一步加强,安妥明、茵栀黄、益生菌等药物治疗也安全有效.临床上利用多种方式综合治疗更能有效地降低血清胆红素,防止胆红素脑病的产生.

  15. Effect of seasonal variation on adult clinical laboratory parameters in Rwanda, Zambia, and Uganda: implications for HIV biomedical prevention trials.

    Directory of Open Access Journals (Sweden)

    Eugene Ruzagira

    Full Text Available To investigate the effect of seasonal variation on adult clinical laboratory parameters in Rwanda, Zambia, and Uganda and determine its implications for HIV prevention and other clinical trials.Volunteers in a cross-sectional study to establish laboratory reference intervals were asked to return for a seasonal visit after the local season had changed from dry to rainy or vice versa. Volunteers had to be clinically healthy, not pregnant and negative for HIV, Hepatitis B and C, and syphilis infection at both visits. At each visit, blood was taken for measurement of hemoglobin, haematocrit, mean corpuscular volume, red blood cells, platelets, total white blood cells (WBC, neutrophils, lymphocytes, monocytes, eosinophils, basophils, CD4/CD8 T cells, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, direct bilirubin, total bilirubin, total immunoglobulin gamma, total protein, creatinine, total amylase, creatine phosphokinase and lactate dehydrogenase (LDH. Consensus dry season reference intervals were applied to rainy season values (and vice versa and the proportion of 'out-of-range' values determined. Percentage differences between dry and rainy season parameter mean values were estimated.In this cohort of 903 volunteers, less than 10.0% of consensus parameter (except LDH values in one season were "out-of-range" in the other. Twenty-two (22 percent of rainy season LDH values fell outside of the consensus dry season interval with the higher values observed in the rainy season. Variability between consensus seasonal means ranged from 0.0% (total WBC, neutrophils, monocytes, basophils, and direct bilirubin to 40.0% (eosinophils. Within sites, the largest seasonal variations were observed for monocytes (Masaka, 11.5%, LDH (Lusaka, 21.7%, and basophils (Kigali, 22.2%.Seasonality had minimal impact on adult clinical laboratory parameter values in Rwanda, Zambia, and Uganda. Seasonal variation may not be an important factor in the

  16. Hepatocellular carcinoma with chronic B-type hepatitis complicated by autoimmune hemolytic anemia: A case report

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    A 57-year-old man consulted a local hospital because of a persistent slight fever. At the age of 37 years he was diagnosed having B-type hepatitis, but left the liver dysfunction untreated. Twenty years later, he was diagnosed having chronic hepatitis B, hepatocellular carcinoma (HCC) and macrocytic anemia, and referred to our hospital for further investigation. A HCC with a maximum diameter of 5.2 cm was detected in segment 8. Results of blood tests included 1.8 mg/dL serum total bilirubin, 0.9 mg/dL bilirubin, less than 10 mg/dL haptoglobin, 7.9 g/dL hemoglobin, 130 fL MCV, and 14.5% reticulocytes. A bone marrow sample showed erythroid hyperplasia. The direct Coombs test gave a positive result. We diagnosed the anemia as autoimmmune hemolytic anemia (AIHA), for which prednisolone could not be administered due to positivity for HBsAg and HBeAg. After preparation of washed blood cells for later transfusion, the patient underwent systematic resection of segment 8. The cut surface of the resected specimen demonstrated an encapsulated yellow-brownish tumor measuring 52 mm × 40 mmwhich was diagnosed pathologicaly as moderately differentiated HCC. On the 9th postoperative day, the patient's temperature rose to 38℃, and exacerbated hemolysis was observed. The maximum total bilirubin value was 5.8 mg/dL and minimum hemoglobin level was 4.6 g/dL. He tolerated this period without blood transfusion. Currently he is being followed up as an outpatient, and shows no signs of HCC recurrence or symptoms of anemia. AIHA associated with HBV infection has been described in only three previous cases, and the present case is the first in which surgery was performed for accompanying HCC.

  17. The Role of Hemolysis in Inducing Jaundice in the Newborns with G6PD Deficiency

    Directory of Open Access Journals (Sweden)

    M Mirzadeh

    2006-08-01

    Full Text Available Background: Jaundice is a common disorder in neonates and G6PD deficiency is one of its known etiologic factors that could result in kernicterus. This study was done to determine (1 incidence of this enzyme deficiency in icteric newborns and (2 the role of hemolysis in inducing jaundice in G6PD deficient neonates. Methods: This is a 3-year cross-sectional study performed on 505 icteric newborn infants admitted to 22e Bahman hospital in Mashad. G6PD activity was measured qualitatively in the patients. The case group consisted of 34 newborns with G6PD deficiency and the control group included also 34 neonates without this enzyme-defect. In addition to routine laboratory tests, hemolysis indicators were also evaluated in both groups and data were analyzed statistically with SPSS. Findings: The incidence of G6PD deficiency was 6.7% (85% male and 15% female. Mean level of total bilirubin was significantly higher in case group (22.73mg/dl vs 19.25mg/dl in control group with pv<0.05. In each group hemolysis was proved to exist in only 2 neonates and Coombs test was negative in all of the patients. There were no significant differences in the mean level of hematocrit and reticulocyte counts between the two groups (pv<0.05. Conclusions: With respect to the high incidence of G6PD deficiency in this study (6.7% and significant incidence in females, measurement of G6PD activity should be recommended in all newborns with jaundice regardless of sex. Hemolysis plays a minor role in inducing jaundice in these newborns and most of them have nonhemolytic jaundice, so that exchange transfusion should be done according to the same indications of other nonhemolytic icterus cases. Because of higher level of serum bilirubin in G6PD deficient neonates, phototherapy must be started early and with lower levels of serum bilirubin.

  18. Fusing Data Mining, Machine Learning and Traditional Statistics to Detect Biomarkers Associated with Depression.

    Directory of Open Access Journals (Sweden)

    Joanna F Dipnall

    Full Text Available Atheoretical large-scale data mining techniques using machine learning algorithms have promise in the analysis of large epidemiological datasets. This study illustrates the use of a hybrid methodology for variable selection that took account of missing data and complex survey design to identify key biomarkers associated with depression from a large epidemiological study.The study used a three-step methodology amalgamating multiple imputation, a machine learning boosted regression algorithm and logistic regression, to identify key biomarkers associated with depression in the National Health and Nutrition Examination Study (2009-2010. Depression was measured using the Patient Health Questionnaire-9 and 67 biomarkers were analysed. Covariates in this study included gender, age, race, smoking, food security, Poverty Income Ratio, Body Mass Index, physical activity, alcohol use, medical conditions and medications. The final imputed weighted multiple logistic regression model included possible confounders and moderators.After the creation of 20 imputation data sets from multiple chained regression sequences, machine learning boosted regression initially identified 21 biomarkers associated with depression. Using traditional logistic regression methods, including controlling for possible confounders and moderators, a final set of three biomarkers were selected. The final three biomarkers from the novel hybrid variable selection methodology were red cell distribution width (OR 1.15; 95% CI 1.01, 1.30, serum glucose (OR 1.01; 95% CI 1.00, 1.01 and total bilirubin (OR 0.12; 95% CI 0.05, 0.28. Significant interactions were found between total bilirubin with Mexican American/Hispanic group (p = 0.016, and current smokers (p<0.001.The systematic use of a hybrid methodology for variable selection, fusing data mining techniques using a machine learning algorithm with traditional statistical modelling, accounted for missing data and complex survey sampling

  19. Neonatal Jaundice Detection System.

    Science.gov (United States)

    Aydın, Mustafa; Hardalaç, Fırat; Ural, Berkan; Karap, Serhat

    2016-07-01

    Neonatal jaundice is a common condition that occurs in newborn infants in the first week of life. Today, techniques used for detection are required blood samples and other clinical testing with special equipment. The aim of this study is creating a non-invasive system to control and to detect the jaundice periodically and helping doctors for early diagnosis. In this work, first, a patient group which is consisted from jaundiced babies and a control group which is consisted from healthy babies are prepared, then between 24 and 48 h after birth, 40 jaundiced and 40 healthy newborns are chosen. Second, advanced image processing techniques are used on the images which are taken with a standard smartphone and the color calibration card. Segmentation, pixel similarity and white balancing methods are used as image processing techniques and RGB values and pixels' important information are obtained exactly. Third, during feature extraction stage, with using colormap transformations and feature calculation, comparisons are done in RGB plane between color change values and the 8-color calibration card which is specially designed. Finally, in the bilirubin level estimation stage, kNN and SVR machine learning regressions are used on the dataset which are obtained from feature extraction. At the end of the process, when the control group is based on for comparisons, jaundice is succesfully detected for 40 jaundiced infants and the success rate is 85 %. Obtained bilirubin estimation results are consisted with bilirubin results which are obtained from the standard blood test and the compliance rate is 85 %. PMID:27229489

  20. Hepatoprotective and immunomodulatory properties of aqueous extract of Curcuma longa in carbon tetra chloride intoxicated Swiss albino mice

    Institute of Scientific and Technical Information of China (English)

    Mahuya Sengupta; Gauri Dutta Sharma; Biswajit Chakraborty

    2011-01-01

    Objective: To evaluate the hepatoprotective and immunotherapeutic effects of aqueous extract of turmeric rhizome in CCl4 intoxicated Swiss albino mice. Methods: First group of mice (n=5) received CCl4 treatment at a dose of 0.5 mL/kg bw (i.p.) for 7 days. Second group was fed orally the aqueous extract of turmeric at a dose of 50 mg/kg bw for 15 days. The third group was given both the turmeric extract (for 15 days, orally) and CCl4 (for last 7 days, i.p.). The fourth group was kept as a control. To study the liver function, the transaminase enzymes (SGOT and SGPT) and bilirubin level were measured in the serum of respective groups. For assaying the immunotherapeutic action of Curcuma longa (C. longa), non specific host response parameters like morphological alteration, phagocytosis, nitric oxide release, myeloperoxidase release and intracellular killing capacity of peritoneal macrophages were studied from the respective groups. Results: The result of present study suggested that CCl4 administration increased the level of SGOT and SGPT and bilirubin level in serum. However, the aqueous extract of turmeric reduced the level of SGOT, SGPT and bilirubin in CCl4 intoxicated mice. Apart from damaging the liver system, CCl4 also reduced non specific host response parameters like morphological alteration, phagocytosis, nitric oxide release, myeloperoxidase release and intracellular killing capacity of peritoneal macrophages. Administration of aqueous extract of C. longa offered significant protection from these damaging actions of CCl4 on the non specific host response in the peritoneal macrophages of CCl4 intoxicated mice. Conclusions: In conclusion, the present study suggests that C. longa has immunotherapeutic properties along with its ability to ameliorate hepatotoxicity.