Antioxidant enzyme activities in hepatic tissue from children with chronic cholestatic liver disease

To study the oxidative stress status in children with cholestatic chronic liver disease by determining activities of glutathione peroxidase [GPx], superoxide dismutase [SOD] and catalase [CAT] in liver tissue. A total of 34 children suffering from cholestatic chronic liver disease were studied. They were selected from the Hepatology Clinic, Cairo University, and compared with seven children who happened to have incidental normal liver biopsy. The patients were divided into three groups: extrahepatic biliary atresia [n=13], neonatal hepatitis [n=15] and paucity of intrahepatic bile ducts [n=6]; GPx, SOD and CAT levels were measured in fresh liver tissue using ELISA. In the cholestatic patients, a significant increase was found in mean levels of SOD, GPx and CAT in hepatic tissue compared to control children. The three enzymes significantly increased in the extrahepatic biliary atresia group, whereas in the groups of neonatal hepatitis and paucity of intrahepatic bile ducts, only GPx and CAT enzymes were significantly increased. Oxidative stress could play a role in the pathogenesis of cholestatic chronic liver diseases. These preliminary results are encouraging to conduct more extensive clinical studies using adjuvant antioxidant therapy

Leptin and insulin levels in umbilical cord blood of infants of diabetic mothers-relation to fetal birth weight

Diabetes mellitus is a common medical condition complicating pregnancy. The present study is planned to estimate the level of insulin and leptin in cord blood of infants of diabetic mothers to find if there is a relation between circulating levels of leptin as well as insulin in umbilical cord of these infants and their birth weight and length. Twenty four controlled and 32 uncontrolled diabetic women, beside 20 healthy nondiabetic women and their full term infants constituted the subjects of the present work. Patients and controls were selected from attendants of the Obstetric and Gynecology Outpatient Clinic of EI-Galaa Hospital, Ministry of Health, Cairo. Assessment of the glycemic state [controlled or uncontrolled] was performed by estimation of glycosylated hemoglobin [HbA1c]. Thorough clinical examination of the infants including birth weight, BMI and height was done. Cord blood was collected from the neonates delivered to those mothers immediately after clamping the cord and serum levels of insulin and leptin were measured. Results demonstrated that cord blood insulin and leptin levels are increased in infants of uncontrolled diabetics more than infants of controlled diabetics and infants of nondiabetic controls. Also, significant increase in body weight and body mass index in infants of uncontrolled diabetics more than infants of controlled diabetic and infants of nondiabetic controls was found. A significant positive correlation was found between umbilical cord plasma insulin and leptin levels and body weight, length, body mass index and maternal HbA1c in all groups. No significant difference of umbilical cord plasma leptin and insulin levels was found between male and female infants of all groups

Pulmonary function testing in children with chronic liver disease

Hepatopulmonary syndrome [HPS] is a rare but severe complication in children with chronic liver disease [CLD] that may necessitate "urgent" liver transplantation. This study aimed at studying the feasibility and usefulness of pulmonary function testing [PFT] in the diagnosis of lung affections in a group of Egyptian children with chronic liver disease [CLD] in order to diagnose HPS in them. Twenty five Egyptian children [aged 10-16 years with a mean of 12.4 +/- 1.8 years] with different causes of CLD and 8 age-matched, healthy controls were subjected to arterial blood gas analysis, PFT and measurement of mean pulmonary artery pressure [MPAP]. Arterial oxygen pressure [Pa0[2]] less than 80 mmHg was present in 10 patients, forced expiratory volume in I second [FEV[1]] less than 80% predicted in 15, forced vital capacity [FVC] less than 80% predicted in 15 and the ratio FEV[1]:FVC less than 65% predicted in 20. Carbon monoxide diffusion capacity [DL[CO]] was less than 80% predicted in 15 patients and 4 controls. Hypoxemia occurred in 60% of patients with decreased DL[co] but none of controls. MPAP was significantly lower in patients than controls, it increased with exercise but not significantly. Neither portal hypertension nor sclerotherapy showed a significant relation to hypoxemia, or low MPAP. Also the duration of CLD, its histological severity and grading of fibrosis were not related to any of the pulmonary function tests. Arterial hypoxemia is present in CLD. PFT was rather "tedious" but non-invasive investigation in children with CLD. It did demonstrate obstructive airway as well as diffusion defects in these children. Therefore we may recommend PFT in the work-up of children with CLD, particularly if liver transplantation is contemplated