Study of liver biochemical profiles in congestive heart failure patients in Government Dharmapuri Medical College, Dharmapuri

Introduction: Heart failure causes a number of pathophysiological affects which, alone or in combination result in liver cell damage. As a consequence, liver function abnormalities are so common in heart failure. Liver dysfunction in heart failure is usually mild and asymptomatic and often detected incidentally on routine liver biochemical investigations. Aim of The Study: To study the influence of congestive heart failure on liver biochemical profiles. Materials and methods: Among cases admitted with heart failure in the medical wards, government general hospital, sixty patients who had met the inclusion and exclusion criteria were taken up for study. Results: Among the total heart failure cases, 40% were due to rheumatic heart disease. Dilated cardiomyopathies represent about 23% of cases. Heart failure secondary to coronary artery heart disease is seen in about 13% of cases. We have found five cases with acute heart failure and three cases with hypotension. Present study revealed a strong correlation between liver function derangements and the above cases. Conclusion: The study observed 20% of cases with jaundice. Among sixty cases liver enlargement was seen in 63% of cases. Increased liver size is strongly correlated with hyperbilirubinemia. Though the conjugated fraction of bilirubin is also elevated, the levels of unconjugated fraction were higher. Serum aminotransferases were elevated in 78% of cases unlike serum alkaline phosphatase which is increased only in 25% of cases. There found to be a significant correlation between rise in unconjugated bilirubin and elevation of serum aminotransferases.

Interactions of Unconjugated Bilirubin with Bile Acid by Rapid Solvent Partition / 대한간학회지

BACKGROUND/AIMS: Our previous studies of ionization and solubility of unconjugated bilirubin (UCB) yielded inappropriately large differences between the two carboxylic pK'a values of UCB. These data, however, were not ideal due to crystal effects, matastability, impurities of the bilirubin, and imprecision of analyses at low UCB. METHODS: The sodium salt of taurocholate (TC) was purified and dissolved in water to 100 mM. Chloroform (CHCl3) was purified by vacuum distillation. Buffers used were: citrate from pH 4 to 6, phosphate from pH 6 to 8, and borate above pH 8. All had an ionic strength of 0.10. The problems were minimized by rapid solvent partition of UCB from CHCl3 into buffered aqueous NaCl, and a new, accurate assay of low UCB in the aqueous phase which was achieved by concentrating the UCB through back extraction into small volumes of CHCl3. RESULTS: In contrast with the crystal dissolution studies, the two pK'a value were similar. H2B0, not HB-, was the dominant UCB species in the pH range of bile (6.0 to 8.0). The aqueous solubilities of UCB were 90 to 98% less. Less than 0.01% of the bile salt partitioned into the CHCl3 phase and self-association of B= was negligible. UCB solubilities in 50 mM TC were 2 to 10% of those obtained by crystal dissolution, and, up to pH 7.9, were below the maximum UCB concentration in normal human bile. CONCLUSIONS: We suggest that the markedly increased binding of UCB with each ionization step is due to the disruption of the internal hydrogen bonds of the ionized carboxyl groups on interaction with the bile salt. We propose to extend the study of partition to determine the activity and the degradation products of calcium salts of unbound bilirubin fractions.

Contents change and clinical significance of serum heme oxygenase-1 and unconjugated bilirubin in patient with acute cerebral infarction / 临床神经病学杂志

Objective To speculate the contents changes and clinical significance of heme oxygenase-1(HO-1) and unconjugated bilirubin (UCB) in the patients with acute cerebral infarction.Methods HO-1 and UCB in blood serum were measured in these patients with acute cerebral infarction(ACI) and control group at one day, third day,and sixth day after the onset by ELISA and oxidation of vanadate. Results The content of HO-1 and UCB in serum decreased step by step at the first day, third day, and sixth day after the onset. The level of HO-1 displayed a positive correlation with the UCB in serum in the first day after the onset (r=0.645, P