• 대한약리학회지
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• 제12권2호
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• pp.51-59
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• 1976

Methylene bis (3, 4, 6-trichlorophenoxy acetic acid) 'MTPA' has been developed for the purpose of treatment of clonorchiasis. It has been rpeorted that, in patients treated with MTPA, the flukes in the liver were killed, elevated serum bilirubin returned to normal and the patients´ general condition was improved. However it took $1{\sim}4 $ weeks to obtain sufficient therapeutic effects. In rabbits, excretion of bilirubin in the bile was increased by the MTPA, and this action was enhanced by a combination of deoxycholic acid with MTPA. This study was designed as a part of a series to increase the therapeutic effect of MTPA, by observing the relation of the blood level of MTPA with the excretion of MTPA in the bile, and the excretion of MTPA with bilirubin excretion in the bile caused by the injection of MTPA alone or in combination with deoxycholic acid. $^{14}C-labeled$ MTPA alone or with deoxycholic acid were injected into the ear veins of rabbits. The amout of bile, MTPA and bilirubin in the bile and the blood level of MTPA were measured. The results obtained were as follows: 1. The amount of excreted bile was decreased gradually as the time elapsed in both groups, that is groups injected with MTPA alone and with deoxycholic acid, without any significant difference between either group. 2. The largest amount of MTPA excretion in the early stage of the MTPA excretion in both groups, but deoxycholic acid caused an increase in blood level of MTPA whereas biliary excretion of MTPA decreased, especially in the early stage after drug injection. 3. The significant increment of bilirubin excretion began within an hour and it reached peak level in $2{\sim}2\frac{1}{2}$ hours after drug injection in both groups, but the amount of excreted bilirubin was larger in the combined group. The above results suggest that deoxycholic acid interferes with the biliary excretion of MTPA, and that there is no close relation between the increased excretion of MTPA and bilirubin excretion. But there is a close relation between blood level or tissue concentration of MTPA and bilirubin excretion. Concerning the influence of deoxycholic acid on the therapeutic effect of MTPA, deoxycholic acid would enhance the effect of MTPA, if the parasites take the drug from the blood, but diminish its effectiveness if they take the drug from the bile.

• 대한예방한의학회지
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• 제3권1호
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• pp.55-65
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• 1999

From January 1994 to April 1997, there was 15 survivals who was admitted to the department of internal medicine, Wonkwang Oriental Medicine Hospital in Cheun-ju, after ingestion of paraquat, and treated with Oriental and western medicine therapy. For the patients, I investigated clinical symptoms, gastroduodenoscopy, intake by oral and parenteral route, and output by urine and stool, serum ALP, AST. ALT, Bilirubin, BUN, Creatinine level and urine analysis. On admission day, the LFT level was as follows. The serum mean ALP, AST, ALT, Total Bilirubin and Direct Bilirubin was $10.05{\pm}2.75\;KAU$, $66.67{\pm}9.88\;IU／L$, $43.80{\pm}7.74\;IU／L$, $1.89{\pm}1.22\;mg／dl$ and $1.10{\pm}1.14\;mg／dl$ respectively. After that day, administered Gamdutang and checked the mean LFT level regullary. Until the 3rd day, the mean ALP, AST, ALT, Total Bilirubin and Direct Bilirubin level was $11.01{\pm}3.16\;KAU$, $56.47{\pm}7.19\;IU／L$, $59.00{\pm}7.57\;IU／L$, $2.54{\pm}1.78\;mg／dl$, $1.64{\pm}1.59\;mg／dl$ respectively. From 4th day to 7th day, the mean ALP; AST, ALT, Total Bilirubin and Direct Bilirubin level was $12.51{\pm}3.49\;KAU$, $77.85{\pm}7.17\;IU／L$, $58.00{\pm}9.09\;IU／L$, $2.54{\pm}1.97\;mg／dl$, and $1.80{\pm}1.81\;mg／dl$ respectively. From 8th day to 10th day, the mean ALP, AST, ALT, Total Bilirubin and Direct Bilirubin level was $12.43{\pm}3.14\;KAU$, $41.13{\pm}6.49\;IU／L$, $50.40{\pm}7.17\;IU／L$, $1.66{\pm}1.90\;mg／dl$ and $1.14{\pm}1.50\;mg／dl$ respectively. From 11th day to 14th day, the mean ALP, AST, ALT, Total Bilirubin and Direct Bilirubin level was $12.30{\pm}3.25\;KAU$, $31.07{\pm}3.85\;IU／L$, $43.33{\pm}5.49\;IU／L$, $1.62{\pm}1.95\;mg／dl$, $1.17{\pm}1.71\;mg／dl$ respectvely. On admission day, the mean RFT level as follows. Serum BUN and Creatinine level was $28.73{\pm}5.19\;mg／dl$ and $1.82{\pm}1.27\;mg／dl$ respectively. After that day, administered Gamdutang and checked the mean RFT level regullary. Until the 3rd day, the mean BUN and Creatinine level was $32.12{\pm}5.65\;mg／dl$ and $2.31{\pm}0.45\;mg／dl$ respectively. From 4th day to 7th day, the mean BUN and Creatinine level was $31.07{\pm}5.47\;mg／dl$ and $1.92{\pm}0.79\;mg／dl$ respectively. From 7th day to 10th day, the mean BUN and Creatinine level was $17.47{\pm}3.57\;mg／dl$ and $1.33{\pm}0.59\;mg／dl$ respectively. From 11th day to 14th day, the mean BUN and Creatinine level was $11.93{\pm}3.16\;mg／dl$, $1.27{\pm}0.38\;mg／dl$ respectively.

• Bulletin of the Korean Chemical Society
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• 제11권1호
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• pp.77-78
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• 1990

• Clinical and Experimental Pediatrics
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• 제48권6호
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• pp.649-654
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• 2005

목 적 : 본 연구는 고빌리루빈혈증이 유도된 신생자돈에서 비 침습적인 NIRS을 통한 뇌의 혈역학적 변화에 대해 알아보고자 하였다. 방 법 : 17 마리의 신생자돈을 대상으로 정상 대조군(CG, n=6), 고빌리루빈혈증군(BG, n=7마리), 7-NI를 투여한 고빌리루빈 혈증군(NG, n=4)으로 무작위 구분하였다. 고빌리루빈혈증의 유도는 40 mg/kg의 빌리루빈을 농축괴로 정주한 후 곧 이어 30mg/kg/hr로 4시간 동안 지속 정주하여 혈중 빌리루빈 농도를 20 mg/dL 이상으로 유지하였고 7-NI는 빌리루빈을 농축괴로 투여한 전과 후에 50 mg/kg을 복막투여 하였다. 모든 실험군은 실험 기간 동안 뇌의 혈역학적 변화를 위해 NIRS로 감시하였고 뇌 조직을 적출하여 생화학적인 변화를 관찰하였다. 결 과 : 동맥혈의 base excss, pH, 평균 동맥압은 BG군과 NG군에서 CG군에 비해 유의하게 감소하였다. BG군에서 유의하게 뇌 조직의 $Na^+$, $K^+$-ATPase activity, ATP, PCr은 유의하게 감소하고 conjugated dienes는 유의하게 증가하였으나 NG 군은 이런 이상소견이 유의하게 완화되었다(P<0.05). 뇌 혈역학적 검사상 [$HbO_2$], [HbT], 및 [HbD]는 BG군에서 CG군에 비해 유의하게 감소하였고(P<0.05) NG군은 CG군과 차이가 없었다. 실험 종료시 $ScO_2$는 세 군간에 유의한 차이가 없었다. 결 론 : 고빌리루빈혈증이 유도된 신생자돈에서 뇌의 혈역학적인 변화를 비침습적인 NIRS의 감시를 통해 유용하게 관찰할 수 있었다.

• 대한의생명과학회지
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• 제18권3호
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• pp.276-282
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• 2012

High-intensive endurance exercises induce cell changes in body, changes in structures and functions of the heart, the muscles, the cartilages, and the liver, as well as increase of inflammatory cytokine. The purpose of this study was to estimate the biochemical changes in the liver and muscles during ultra-marathon race (100 km) by sections. The blood of the subjects was collected before the marathon as a control in order to analyze serum creatine kinase (CK), lactic dehydrogenase (LDH), asprtate aminotransferase (AST), alanine aminotransferase (ALT), total(T)-bilirubin, direct(D)-bilirubin, total protein, albumin, uric acid, gamma-glutamyltranspeptidase (${\gamma}$-GTP), alkaline phosphatase (ALP), creatinine, blood urea nitrogen (BUN), and high sensitive C-reactive protein (hs-CRP) concentrations. The CK, LDH, D-bilirubin, AST and ALT concentrations at 50 km and 100 km were significantly increased compared to the control (P<0.05). The markers at 100 km were higher than those at 50 km (P<0.05). The T-bilirubin and hs-CRP concentrations showed no difference among the groups, whereas the markers at 100 km were higher than those of the control and at 50 km (P<0.05). In conclusion, this study shows that the ultra-marathon race (100 km) may induce the damage of the skeletal muscle, liver and kidney, intravascular hemolysis and inflammatory responses.

• Clinical and Experimental Pediatrics
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• 제56권2호
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• pp.75-79
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• 2013

Purpose: It has been reported that 10% to 20% of children with Kawasaki disease (KD) will not respond to intravenous immunoglobulin (IVIG) treatment. In this study, we aimed to identify useful predictors of therapeutic failure in children with KD. Methods: We examined 309 children diagnosed with KD at the Kyungpook National University Hospital and the Inje University Busan Paik Hospital between January 2005 and June 2011. We retrospectively reviewed their medical records and analyzed multiple parameters in responders and nonresponders to IVIG. Results: Among the 309 children, 30 (9.7%) did not respond to IVIG. They had significantly higher proportion of neutrophils, and higher levels of aspartate aminotransferase, alanine aminotransferase (ALT), total bilirubin, and N-terminal fragment of B-type natriuretic peptide than did responders. IVIG-nonresponders had a significantly longer duration of hospitalization, and more frequently experienced coronary artery lesion, and sterile pyuria. No differences in the duration of fever at initial treatment or, clinical features were noted. Conclusion: Two independent predictors (ALT${\geq}$84 IU/L, total bilirubin${\geq}$0.9 mg/dL) for nonresponse were confirmed through multivariate logistic regression analysis. Thus elevated ALT and total bilirubin levels might be useful in predicting nonresponse to IVIG therapy in children with KD.

• Clinical and Experimental Pediatrics
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• 제60권12호
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• pp.385-389
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• 2017

Purpose: This study aimed to assess whether different anesthetic techniques and oxytocin use applied during delivery affect transcutaneous bilirubin levels during the first 24 hours in neonates. Methods: A total of 1,044 neonates delivered by either caesarian section (C/S) or normal vaginal delivery (NVD) were included in the study. They were classified into 5 groups as follows: group 1: born by C/S using general anesthesia, group 2: C/S using spinal anaesthesia, group 3: C/S using general anesthesia after failed spinal block, group 4: by NVD without anesthesia, and group 5: oxytocin-induced vaginal delivery without anesthesia. Transcutaneous total bilirubin levels (TBLs) were measured during the first 24 hours and on the fifth and eighth days of life and the levels in different groups were compared. Results: The TBLs were significantly higher in neonates delivered by C/S using general anesthesia rather than spinal anesthesia (P<0.001), and both groups had higher levels than those born by NVD without anesthesia ($P{\leq}0.001$). However, the group receiving general anesthesia after failed spinal block was found to have the highest bilirubin level. Moreover, TBLs were significantly higher with the use of oxytocin ($P{\leq}0.001$). Conclusions: C/S and general anesthesia adversely affect the bilirubin levels in neonates, and the use of oxytocin during vaginal delivery also increases TBLs in neonates.

• Clinical and Experimental Pediatrics
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• 제60권4호
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• pp.106-111
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• 2017

Purpose: This study aimed to determine the prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency among infants with neonatal indirect hyperbilirubinemia (NIH); compare G6PD-deficient and G6PD-normal patients regarding hyperbilirubinemia and need for exchange transfusions (ET); and assess risk factors for ET and kernicterus. Methods: This is a case-control retrospective study. Medical records of NIH patients admitted to the Pediatric Department, Salmaniya Medical Complex, Bahrain, between January 2007 and June 2010 were reviewed. Data on sex, age at presentation, hospitalization duration, need for ET, hemoglobin (Hb) level, reticulocyte count, direct Coombs test, serum total and indirect bilirubin levels, thyroid function, blood and urine cultures, G6PD status, and blood groups were collected and compared between the G6PD-deficent and G6PD-normal patients. Results: Of 1,159 NIH patients admitted, 1,129 were included, of whom 646 (57%) were male. Among 1,046 patients tested, 442 (42%) were G6PD deficient, 49 (4%) needed ET, and 11 (1%) had suspected Kernicterus. The G6PD-deficient patients were mainly male (P<0.0001), and had lower Hb levels (P<0.0001) and higher maximum bilirubin levels (P=0.001). More G6PD-deficient patients needed ET (P<0.0001). G6PD deficiency (P=0.006), lower Hb level (P=0.002), lower hematocrit count (P=0.02), higher bilirubin level (P<0.0001), higher maximal bilirubin level (P<0.0001), and positive blood culture result (P<0.0001) were significant risk factors for ET. Maximal bilirubin level was a significant risk factor for kernicterus (P=0.021) and independently related to ET (P=0.03). Conclusion: G6PD deficiency is an important risk factor for severe NIH. In G6PD-deficent neonates, management of NIH should be hastened to avoid irreversible neurological complications.

• 대한화학회지
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• 제35권4호
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• pp.374-378
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• 1991

pH 7.8의 인산 완충용액에서 Bilirubin의 전기화학적인 환원거동을 직류 폴라로그래피, 시차 펄스폴라로그래피, 순환 전압전류법 및 정전위 전기량법으로 조사하였다. 직류 폴라로그램에서 반파전위가 -1.32V와 -1.51V vs. Ag/AgCl인 2개의 환원파를 확인하였고, 각 환원파의 전류유형은 제1환원파는 확산지배적인 전류였으며 제2환원파는 반응성전류가 약간 포함된 확산전류였다. 그리고 각 환원단계는 모두 비가역적이었다. 또한 Bilirubin의 농도가 3.4 ${\times}$ 10$^{-4}$M 이하일 때 나타나는 전방파가 흡착에 의한 전류임을 확인하였다. 환원반응에 관여하는 전자수는 제1단계에서는 2개였으며, 제2단계에서는 1개였다.

• Advances in pediatric surgery
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• 제18권1호
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• pp.12-17
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• 2012

The purpose of this study is to analyse clinical impact of specific MRI findings in liver in patients of long-term survivors after Kasai portoenterostomy (KPE). Twenty-eight patients who were underwent KPE were followed up more than 5 years. Macro-regenerative nodule (MRN) and beaded-duct dilatation (BDD) were considered as important findings in liver MRI. The association between these findings in MRI and clinical indicator, serum bilirubin level and history of cholangitis were evaluated. Sixteen patients (57.1%) were shown MRN in liver MRI. Therewere 14 patients(50%) whose MRI showed BDD. Serum total and direct bilirubin were 3.6 mg/dL and 1.8 mg/dL respectively in positive MRN group whereas 1.4 mg/dL and 0.7 mg/dL in negative MRN group (p = 0.427). Serum total and direct bilirubin level were 4.2 mg/dL and 2.1 mg/dL in patients with BDD negative group compare to 1.1 mg/dL and 0.5 mg/dL in BDD positive group (p = 0.281). The odds ratio to have cholangitis in the patient with MRN was 2.3 and 0.53 in patient with BDD in their MRI findings. MRN in liver MRI may suggest high bilirubin level and more chance to have cholangitis, but the findings of BDD may related to low bilirubin level and less change to have cholangitis.