Urinary lumirubin excretion in jaundiced preterm neonates during phototherapy with blue light-emitting diode vs. green fluorescent lamp.

Phototherapy converts lipophilic unconjugated bilirubin to hydrophilic bilirubin photoisomers, such as lumirubin. We comparatively used a blue light-emitting diode (LED) and a green fluorescent lamp (FL) as light sources for phototherapy of hyperbilirubinemic preterm neonates with the aim of examining potential differences in urinary lumirubin excretion between these two wavelengths. Urinary lumirubin levels were measured using a fluorescence assay with blue light exposure in the presence of the unconjugated bilirubin-inducible fluorescent protein UnaG, and denoted as urinary UnaG-bound bilirubin (UUB)/creatinine (Cr) (µg/mg Cr). Preterm neonates born at ≤ 33 weeks gestational age and treated with phototherapy were subjected to this study. The maximum UUB/Cr level during phototherapy per device intensity was compared between neonates treated with the blue LED and the green FL. A total of 61 neonates were examined to determine the maximum UUB/Cr levels. The median of maximum UUB/Cr excretion per light intensity of each device (µg/mg Cr/µW/cm2/nm) was 0.83 for the blue LED and 1.29 for the green FL (p = 0.01). Green light was found to be more effective than blue one for bilirubin excretion via urinary lumirubin excretion. This is the first spectroscopic study to compare the efficacy of phototherapy at different wavelengths using fluorescence assay.

Importance Of Laboratory Detection Of Macro-Aspartate Aminotransferase.

The macroenzyme form of aspartate aminotransferase (macro-AST) is formed by the binding of AST with immunoglobulins. Macro-AST excretion from serum is prolonged because of its high molecular weight, leading to increased AST activities. Because of the difficulty in detecting macro-AST through routine laboratory tests, affected patients often undergo repeated examinations, with associated anxiety. We report a case in which macro-AST was detected by assaying the patient's serum after refrigeration at 4ºC for 3 days. The sample showed progressive loss of AST activity compared with that frozen in the refrigerator, indicating the presence of macro-AST, which was confirmed as a complex with IgG-κ. The cold storage method was validated using many samples obtained from several patients. Use of this simple method to detect macro-AST may avoid unnecessary examinations and patient anxiety even at primary care facilities.

Determination of the components in erythrocytes using an automated analyzer.

Determination of the biochemical components in erythrocytes should provide unique pathophysiological information. We optimized a simple alcohol binding method for the selective removal of hemoglobins from hemolysates, and enabled simultaneous determination of several components in erythrocytes using commercially available assay kits in an automated analyzer. Venous blood was collected in a vacutainer containing lithium heparin. The washed cells were hemolyzed with distilled water, frozen, and then thawed. Nine volumes of the hemolysates were mixed with one volume of Tris-HCl buffer. One volume of n-butanol was then added to nine volumes of the buffered hemolysates. After vigorous mixing, the mixture of n-butanol and hemolysates was left to stand. The butanol-bound hemoglobins were precipitated by centrifugation, and the clear supernatant below the butanol layer was applied directly to an automated analyzer. Using sera, we determined the effects of the hemoglobin removal procedures on the chemical analytes. Sufficient recovery was noted in most analytes, except for several enzyme activities and lipids. Accordingly, we determined five components present in erythrocytes: creatine, potassium, magnesium, and aspartate aminotransferase as well as superoxide dismutase activities in healthy subjects. We suggest that our simple method is applicable to the simultaneous determination of erythrocyte components in routine laboratory tests.