PURPOSE: Cholestylamine has been shown to release chloride ion and absorbs bile acid in the intestine, forming a nonabsorbable complex preventing enterohepatic circulation. The purpose of this study is to clarify the value of cholestylamine and the adequate dosage, in combination with phototherapy, as well as to confirm whether it shorten the duration of hospitalization. METHODS: Total 80 full-term neonates with a total bilirubin level greater than 12mg/dL were studied. The neonates were randomly divided into four groups : (1) Only phototherapy group (A)(2) 250mg/kg/day cholestylamine with phototherapy group (B)(3) 500mg/kg/day cholestylamine with phototherapy group (C)(4) 1000mg/kg/day cholestylamine with phototherapy group (D). RESULTS: Forty-eight hours, 72 hours and 96 hours after the beginning of the study, the mean bilirubin level among the B, C, D groups significantly diminished than A group (P<0.05). The duration of phototherapy and hospitalization significantly diminished in the D group. After phototherapy, finished mean bilirubin level was markedly diminished in the D group. CONCLUSION: The data revealed that oral administration of cholestylamine (especially 1000mg/kg/ day cholestylamine with phototherapy group : D) not only increased the efficacy of phototherapy, but also shortened the duration of phototherapy.
Administration, Oral* ; Bile ; Bilirubin ; Enterohepatic Circulation ; Hospitalization ; Humans ; Hyperbilirubinemia, Neonatal* ; Infant, Newborn ; Intestines ; Jaundice, Neonatal ; Phototherapy*

The effects of halothane anesthesia on the liver function were investigated in 78 male Sprague-Dawley rats pretreated with ethyl alcohol. Blood sampling was done before intravenous administration of ethyl alcohol(400 mg/kg, 5 ml/kg, 9.99 vol %) or saline(5 ml/kg)through tail vein of the rat. Twentyfour hours later, all rats were randomly assigned to receive one of two anesthetic managements for two hours; 1) halothane -N2O-O2 2)N2O-O2 Bood sample and hepatic tissue were obtained 24 or 96 hours after anestheia Measurements of hepatic function(protein, albumin, cholesterol, bilirubin, blood urea nitro- gen, creatinine) were made and hepatic tissue was examined with light microscopy. The results are as follows; 1) There was no siginificant difference in the laboratory findings between the alcohol and saline groups. 2) There was no significant difference in the laboratory findings between the halothane and nitrous oxide anesthesia. 3) No difference in histologic injury was found between alcohol and saline groups. 4) No difference in histologic injury was found between halothane-nitrous oxide-oxygen and nitrous oxide-oxygen ansthesia groups.
Administration, Intravenous ; Anesthesia* ; Animals ; Bilirubin ; Cholesterol ; Ethanol* ; Halothane* ; Humans ; Liver ; Male ; Microscopy ; Nitrous Oxide ; Rats* ; Rats, Sprague-Dawley ; Urea ; Veins

OBJECTIVETo explore the clinical effects of colonic dripping with Taihuang liquid (THL) in treating neonatal hyperbilirubinemia (HBE).

METHODSOne hundred and thirty-eight neonates with HBE were randomly assigned to two groups. Conventional treatment and nursing were given to both groups, and THL was given additionally to the observation group by colonic dripping.

RESULTSSignificant differences between the observation group and the control group were shown in frequency of defecation (4.6 +/- 1.3 times/d vs 2.0 +/- 1.1 times/d), daily serum bilirubin reduction (31.5 +/- 10.1 micromol/L vs 23.3 +/- 8.3 micromol/L), and days for normalizing serum bilirubin level (5.6 +/- 3.5 d vs 7.8 +/- 4.1 d, all P < 0.01).

CONCLUSIONColonic dripping of THL could promote the excretion of bilirubin, so as to decrease the level of serum bilirubin in neonates with HBE.

Bilirubin ; blood ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Hyperbilirubinemia, Neonatal ; blood ; drug therapy ; Infant ; Infant, Newborn ; Male

Omega (omega)-3 polyunsaturated fatty acids appear to be effective in preventing and treating parenteral nutrition-associated liver disease, and several mechanisms were proposed for this observation. An 8-week-old male infant with cholestasis and acholic stool was diagnosed non-syndromic intrahepatic interlobular bile duct paucity by open-wedge liver biopsy. Initially he was treated with usual supportive medical therapy, including ursodeoxycholic acid. However, the clinical status and laboratory tests did not improve. Omega (omega)-3 polyunsaturated fatty acids (initially intravenous administration and oral administration later), were started and his liver function, including aminotransferase level and bilirubin levels normalized, and the ivory stool color turned green. We report the possible effectiveness of omega-3 polyunsaturated fatty acids as a potent choleretic agent for non-syndromic intrahepatic interlobular bile duct paucity, a very rare structural pediatric hepatic disease.
Administration, Intravenous ; Administration, Oral ; Bile Ducts* ; Bilirubin ; Biopsy ; Cholestasis* ; Fatty Acids, Omega-3 ; Fatty Acids, Unsaturated ; Humans ; Infant ; Liver ; Liver Diseases ; Male ; Ursodeoxycholic Acid

PURPOSE: The aims of this study are to measure the serum levels of fat soluble vitamins (vitamin A and D) from bile duct ligated rats, and to evaluate the effect of oral bile acids administration to facilitate absorption of fat soluble vitamins. METHOD: We measured serum ALT, total bilirubin, vitamin A, and vitamin D of Sprague-Dawley rats 1 week before and 4 weeks after experimental bile duct ligation. Rats were consisted with 3 groups. Group 2 had been find bile acids and group 3 ursodeoxycholic acid after operation for 4 weeks. Multi-vitamin was given to all groups. RESULTS: 1) Base line (mean value before duct ligation): ALT 74.2 IU, total bilirubin 0.26 mg/dL; vitamin D 13.01 ng/mL vitamin A 0.87 microgram/mL, total bile acids 25.16 micron mol/L. 2) Four weeks after ligation: ALT 100.7 IU, total bilirubin 2.58 mg/dL; vitamin D 7.89 ng/mL vitamin A 1.37 microgram/mL, total bile acids 278.22 micron mol/L. 3) 4 weeks after ligation, each group (group 1, group 2 and group 3) showed vitamin D (7.62, 8.10 and 7.99) ng/mL, vitamin A (1.68, 1.06 and 1.33) microgram/mL, total bile acids (233.17, 345.80 and 268.57) micron mol/L, which were statistically not significant. CONCLUSION: Serum level of vitamin A is increased after bile duct ligation although vitamin D is decreased. Oral administration of bile acids does not affect the serum levels of vitamin A and D in bile duct ligated rats.
Absorption ; Administration, Oral ; Animals ; Bile Acids and Salts ; Bile Ducts* ; Bile* ; Bilirubin ; Cholestasis ; Ligation ; Rats* ; Rats, Sprague-Dawley ; Ursodeoxycholic Acid ; Vitamin A ; Vitamin D ; Vitamins*

BACKGROUND: Ischemia reperfusion (IR) injury is a complex phenomenon that leads to organ dysfunction and causes primary liver failure following liver transplantation. We investigated whether an intravenous administration of magnesium before reperfusion can prevent or reduce IR injury. METHODS: Fifty-nine living donor liver transplant recipients were randomly assigned to an MG group (n = 31) or an NS group (n = 28). Each group was also divided in two groups based on the preoperative magnesium levels (normal: > or = 0.70 mmol/L, low: < 0.70 mmol/L). The MG groups received 25 mg/kg of MgSO4 mixed in 100 ml normal saline intravenously before reperfusion and the NS groups received an equal volume of normal saline. The levels of lactate, pH, arterial oxygen tension, and base excess were measured to assess reperfusion injury at five specific times, which were 10 min after the beginning of anhepatic phase, and 10, 30, 60 and 120 min after reperfusion. To evaluate postoperative organ function, the serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin and creatinine levels were measured at preoperative day 1, postoperative day 1 and 5. RESULTS: The blood lactate levels were significantly lower at 10, 30, 60 and 120 min after reperfusion in the MG groups compared to the NS groups. In addition, significantly higher blood lactate levels were observed in the NS group with preoperative hypomagnesemia than in MG groups. CONCLUSIONS: Magnesium administration before reperfusion of liver transplantation significantly reduces blood lactate levels. These findings suggest that magnesium treatment may have protective effects on IR injury during living donor liver transplantation.
Administration, Intravenous ; Alanine Transaminase ; Aspartate Aminotransferases ; Bilirubin ; Creatinine ; Humans ; Hydrogen-Ion Concentration ; Ischemia ; Lactic Acid ; Liver ; Liver Failure ; Liver Transplantation ; Living Donors ; Magnesium ; Oxygen ; Reperfusion ; Reperfusion Injury

PURPOSE: Dioctahedral smectite is an alumina silicate of phyllitic structure and absorbs bile acid in the intestine, forming a non-absorbable complex preventing enterohepatic circulation. The purpose of this study is to clarify the value of dioctahedral smectite and the adequate dosage, in combination with phototherapy, as well as to confirm whether it shortens the duration of hospitalization and to compare dioctahedral smectite with cholestyramine. METHODS: Total 45 full-term neonate with a total bilirubin level greater than 12 mg/dl were studied. The neonate were randomly divided into three groups : 1) Only phototherapy group (A) 2) 3.0 g/day dioctahedral smectite with phototherapy group (B) 3) 1.0 g/kg/day cholestyramine with phototherapy group (C). RESULTS: The mean serum bilirubin level of group B and C decreased significantly compared to group A at 48, 72 and 96 hours after the beginning of the study. The duration of phototherapy and hospitalization significantly decreased in group B and C. CONCLUSION: The data revealed that oral administration of dioctahedral smectite not only increased the efficacy of phototherapy, but also shortened the duration of phototherapy and can substitute for cholestyramine.
Administration, Oral* ; Aluminum Oxide ; Bile ; Bilirubin ; Cholestyramine Resin* ; Enterohepatic Circulation ; Hospitalization ; Humans ; Hyperbilirubinemia, Neonatal* ; Infant, Newborn ; Intestines ; Jaundice, Neonatal ; Phototherapy* ; Silicates

OBJECTIVETo explore the clinical efficacy of early application of sequential gastrointestinal lavage in patients with acute paraquat poisoning by analyzing the clinical data of 97 patients.

METHODSA total of 97 eligible patients with acute paraquat poisoning were divided into conventional treatment group (n = 48) and sequential treatment group (n = 49). The conventional treatment group received routine gastric lavage with water. Then 30 g of montmorillonite powder, 30 g of activated charcoal, and mannitol were given to remove intestinal toxins once a day for five days. The sequential treatment group received 60 g of montmorillonite powder for oral administration, followed by small-volume low-pressure manual gastric lavage with 2.5%bicarbonate liquid. Then 30 g of activated charcoal, 30 g of montmorillonite powder, and polyethylene glycol electrolyte lavage solution were given one after another for gastrointestinal lavage once a day for five days. Both groups received large doses of corticosteroids, blood perfusion, and anti-oxidation treatment. The levels of serum potassium, serum amylase (AMY) alanine aminotransferase (ALT), total bilirubin (TBIL), blood urea nitrogen (BUN), creatinine (Cr), lactate (Lac), and PaO₂of patients were determined at 1, 3, 5, 7, and 10 days. Laxative time, mortality, and survival time of dead cases were evaluated in the two groups.

RESULTSThe incidence rates of hypokalemia (<3.5 mmol/L) and AMY (>110 U/L) were significantly lower in the sequential treatment group than in the conventional treatment group (P < 0.05). There were no significant differences in the incidence of ALT (>80 U/L), TBIL (>34.2 µmol/L), BUN (>7.2 mmol/L), and Cr (>177 µmol/L) between the two groups (P>0.05). However, the highest levels of ALT, TBIL, BUN, Cr, and Lac were significantly lower in the sequential treatment group than in the conventional treatment group (P < 0.05). Moreover, the sequential treatment group had significantly lower incidence of PaO₂(<60 mmHg), shorter average laxative time, lower mortality, and longer survival time of dead cases than the conventional treatment group (P < 0.05).

CONCLUSIONThe early application of sequential gastrointestinal lavage can shorten laxative time, alleviate organ damage in the liver, kidney, lung, and pancreas, reduce mortality, and prolong the survival time of dead cases in patients with acute paraquat poisoning.

Acute Disease ; Bentonite ; administration & dosage ; Bilirubin ; Blood Urea Nitrogen ; Charcoal ; Combined Modality Therapy ; Creatinine ; Gastric Lavage ; methods ; Humans ; Liver ; Paraquat ; poisoning ; Poisoning ; therapy ; Treatment Outcome

This study was designed to investigate the effect of cholestyramine on the formation of pigment gallstones in high carbohydrate diet-fed hamsters and whether that effect occurred because of cholecystokinin action. Forty seven hamsters were divided into three groups: group I(n = 16) was fed on normal rodent chow(43% carbohydrate), group II(n = 14) was fed on a high CHO diet(65% carbohydrate), group III(n = 17) was fed on a high CHO diet containing 4% cholestyramine. Gallstones developed in 0% of group I, 42.9% of group II and 5.9% of group III(P< 0.05, group II vs III). To evaluate the chronic status of cholecystokinin level, the wet weight of pancreas and the average area of pancreatic acinar in microscopic high power field were measured. There was no significant difference between group II and group III in pancreatic weight and average area of pancreatic acinar(P> 0.05). In gallbladder bile analysis, there was also no significant difference between group II and group III in cholesterol, phospholipid, total calcium, total bilirubin and bile acid levels. In conclusion, cholestyramine decreases the frequency of pigment gallstone formation in high CHO diet-fed hamsters, but it is not clear whether the mechanism of cholestyramine decreasing the gallstone formation is due to the action of cholecystokinin.
Animal ; Bilirubin/metabolism ; Cholecystokinin/*analysis ; Cholelithiasis/*pathology ; Cholesterol/metabolism ; Cholestyramine/*administration & dosage ; Dietary Carbohydrates/*administration & dosage ; Female ; Gallbladder/*metabolism/pathology ; Hamsters ; Male ; Mesocricetus ; Organ Weight ; Pancreas/physiopathology ; Phospholipids/metabolism ; Pigmentation ; Support, Non-U.S. Gov't

OBJECTIVETo investigate therapeutic effect of high-dose intravenous immunoglobulin (IVIG) for early management of ABO hemolytic disease of the newborn (ABO-HDN).

METHODSA total of 121 cases with ABO-HDN were randomly divided into treatment group (n=61) and control group (n=60). In addition to the routine treatment of the control group, IVIG were given at a daily dose of 400 mg/kg to the cases in the treatment group for 2-3 times, and therapeutic effects were evaluated and compared between the two groups.

RESULTSThe serum total billirubin concentration on the third day after treatment (153.42-/+45.21 micromol/L) and mean daily serum total billirubin concentration reduction (56.49-/+24.05 micromol/L) in treatment group were lower than those in the control group (P<0.01). The jaundice resolution time (23.51-/+11.19 h) and the phototherapy time (3.01-/+0.89 h) for billirubinemia treatment in treatment group were shorter than those in the control group (P<0.01). The patients in the the treatment group had higher hemoglobin level after treatment (15.59-/+2.01 g/L) than those of the control group (P<0.01).

CONCLUSIONHigh-dose IVIG can effectively arrest the progression of hemolytic disease, quickly reduce serum total billirubin concentration and shorten phototherapy time for early treatment of ABO-HDN.

ABO Blood-Group System ; Bilirubin ; blood ; Erythroblastosis, Fetal ; blood ; drug therapy ; immunology ; Female ; Humans ; Immunoglobulins, Intravenous ; administration & dosage ; therapeutic use ; Immunologic Factors ; administration & dosage ; therapeutic use ; Infant, Newborn ; Jaundice, Neonatal ; drug therapy ; Male ; Time Factors ; Treatment Outcome