Umbilical Level Research Articles

Muscle Steatosis is an Independent Predictor of Postoperative Complications in Patients with Hepatocellular Carcinoma.

Skeletal muscle depletion, referred to as sarcopenia, has been shown to be an independent predictor of lower disease-free and overall survivals in various kinds of diseases. The quality of skeletal muscle has recently attracted much attention as a new parameter of sarcopenia, but its impact on surgical complications is still unknown. A retrospective analysis of 492 patients undergoing hepatectomy for hepatocellular carcinoma (HCC) in our institution between April 2005 and December 2014 was performed. The quality of skeletal muscle was evaluated by intramuscular adipose tissue content (IMAC) using preoperative CT imaging at the umbilical level. The impact of sarcopenia on postoperative complications and the predictors of surgical complications after hepatectomy for HCC were analyzed. Patients with high IMAC were older and had higher body mass index, higher indocyanine green retention test at 15min, and more operative blood loss. Among 492 patients, 108 (22%) patients had major postoperative complications (Clavien grade≥III), and infectious complications were found in 74 (15%) patients. Twelve (2%) patients died from postoperative complications. On multivariate analysis, preoperative high IMAC was an independent risk factor for increased major postoperative complications [odds ratio (OR) 1.580; P=0.049] and infectious complications (OR 1.903; P=0.021). Preoperative muscle steatosis evaluated with IMAC was closely correlated with increased postoperative complications, especially infectious complications. The preoperative nutritional intervention and rehabilitation might lead to the improvement of postoperative outcomes after hepatectomy for HCC.

MP78-01 ECTOPIC LIPID ACCUMULATION IN LIVER IS ASSOCIATED WITH TUMOR AGGRESSIVENESS AND POOR PROGNOSIS IN RENAL CELL CARCINOMA

You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging II1 Apr 2016MP78-01 ECTOPIC LIPID ACCUMULATION IN LIVER IS ASSOCIATED WITH TUMOR AGGRESSIVENESS AND POOR PROGNOSIS IN RENAL CELL CARCINOMA Daisuke Watanabe, Akio Horiguchi, Shinsuke Tasaki, Kenji Kuroda, Akinori Satoh, Junichi Asakuma, Keiichi Ito, Tomohiko Asano, and Hiroshi Shinmoto Daisuke WatanabeDaisuke Watanabe More articles by this author , Akio HoriguchiAkio Horiguchi More articles by this author , Shinsuke TasakiShinsuke Tasaki More articles by this author , Kenji KurodaKenji Kuroda More articles by this author , Akinori SatohAkinori Satoh More articles by this author , Junichi AsakumaJunichi Asakuma More articles by this author , Keiichi ItoKeiichi Ito More articles by this author , Tomohiko AsanoTomohiko Asano More articles by this author , and Hiroshi ShinmotoHiroshi Shinmoto More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1957AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Obesity is a well-known risk factor for the development of renal cell carcinoma (RCC). However, the impact of BMI-indicated visceral fat distribution on tumor aggressiveness and prognosis in RCC remains controversial. Because free fatty acids are transported from excess visceral adipose tissue directly to the liver via the portal vein, the ectopic lipid accumulation in liver could be more informative as a prognostic factor for RCC. In the present study, we examined the ectopic lipid accumulation in liver in patients with RCC and investigated its associations with clinicopathological parameters and survival. METHODS A total of 230 patients who underwent surgery for RCC at a single institute were retrospectively reviewed. The mean CT values of liver regions of S3 and S6 and S8 were estimated in the preoperative planar CT images, and a fatty liver was defined as one with a mean CT value < 50 Hounsfield units. The visceral fat area (VFA) was also estimated in the preoperative planar CT images at the umbilical level, and the visceral obesity was defined as VFA ≥ 100 cm2. Kaplan-Meier curves were generated to determine overall survival (OS) rates and cancer specific survival (CSS) rates for patients, and the log rank test was used to compare the survival rates of patients with and without fatty liver. Cox proportional hazard models were used to identify the independent predictors of OS and CSS. RESULTS Visceral fat area was not associated with any pathological parameters or survival. The mean liver CT values of patients with high-grade tumors (G3), patients with T3-4 tumors, and patients with visceral obesity were significantly lower than those of patients with low-grade tumors (G1-2), patients with T1-2 tumors, and patients without visceral obesity (p = 0.0116, p = 0.0336, p < 0.0001, respectively). Overall patients with fatty liver had significantly shorter OS and CSS than those without fatty liver (p = 0.0095, p = 0.0145). In patients without visceral obesity, the mean liver CT values of patients with T3-4 tumors and patients with lymph node metastasis and/or distant metastasis at the time of operation were significantly lower than those of patients with T1-2 tumors and patients without any metastasis (p = 0.0401, p = 0.026), and presence of fatty liver was significantly associated with shorter OS and CSS (p = 0.0009, p = 0.0015). CONCLUSIONS Our results suggest that ectopic lipid accumulation in liver could be a novel predictor of tumor aggressiveness and poor prognosis in renal cell carcinoma regardless of the presence or absence of visceral obesity. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1024 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Daisuke Watanabe More articles by this author Akio Horiguchi More articles by this author Shinsuke Tasaki More articles by this author Kenji Kuroda More articles by this author Akinori Satoh More articles by this author Junichi Asakuma More articles by this author Keiichi Ito More articles by this author Tomohiko Asano More articles by this author Hiroshi Shinmoto More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Evaluation of the Predictive Value of Umbilical Cord Serum Bilirubin Level for the Development of Subsequent Hyperbilirubinemia in Term and Late-Preterm Neonates

Background: Considering the increasing rates of early hospital discharge and kernicterus in healthy full term newborns, timely identification of neonates at risk of severe hyperbilirubinemia is of great significance. The aim of this study was to investigate the predictive value of umbilical cord serum (UCS) bilirubin level for subsequent hyperbilirubinemia. Moreover, we compared the predictive value of UCS bilirubin with that of risk factor assessment and predischarge bilirubin level. Methods: In this prospective, cohort study, 450 healthy neonates born at the gestational age of ³ 35 weeks were included. UCS bilirubin concentration, direct Coombs test results, and blood group were determined in the newborns. Total serum bilirubin level was re-assessed before hospital discharge. The subjects were followed-up for 1-4 days after discharge and the total serum bilirubin level was measured in neonates with clinical jaundice. Results of the assessment of risk factors for hyperbilirubinemia were recorded. Results: In total, 319 newborns were followed-up within the study period. The mean UCS bilirubin level in non-icteric and icteric neonates was 2.35 and 2.49 mg/dl, respectively. No significant relationship was found between UCS bilirubin level and development of hyperbilirubinemia (P=0.30), whereas a significant correlation was detected between predischarge bilirubin level and development of jaundice (P=0.009). Gestational age, birth weight, history of jaundice in siblings, and mode of delivery were the clinical risk factors which showed a significant correlation with postnatal hyperbilirubinemia. Conclusion: Based on the findings, UCS bilirubin level could not predict subsequent hyperbilirubinemia. Therefore, the best predictive marker for neonatal jaundice is the assessment of clinical risk factors and predischarge bilirubin level.

Pharmacokinetics and placental transfer of magnesium sulfate in pregnant women

Magnesium sulfate is one of the most commonly prescribed intravenous medications in obstetrics. Despite its widespread use, there are limited data about magnesium pharmacokinetics, and magnesium is prescribed empirically without dose adjustment for different indications. The aim of this study was to characterize the pharmacokinetics and placental transfer of magnesium sulfate in pregnant women and to determine key covariates that impact the pharmacokinetics. This is a prospective pharmacokinetic cohort study ofpregnant women who were prescribed magnesium sulfate for preeclampsia, preterm labor, or extreme prematurity. Women received a 4-g loading dose and 2 g/h maintenance dose as clinically indicated. Maternal blood samples were obtained before and at multiple time points during and after magnesium administration. Cord blood also was sampled at delivery. A population pharmacokinetic approach that used a nonlinear mixed-effects modeling was used to characterize magnesium disposition. Pharmacokinetic profiles of 111 pregnant women were analyzed. Magnesium clearance was 3.98 L/h in preeclamptic women and5.88 L/h non-preeclamptic women. Steady-state concentration ofmagnesium was 7.2 mg/dL in preeclamptic women compared with 5.1mg/dL in non-preeclamptic women. Maternal weight significantly impacted time to steady state. The ratio of the mean umbilical vein magnesium level to the mean maternal serum magnesium level at the time of delivery was 0.94 ± 0.15. The study accurately characterizes the pharmacokinetics of magnesium administered to pregnant women. Preeclamptic status and maternal weight significantly impact serum magnesium levels. This pharmacokinetic model could be applied to larger cohorts to help tailor magnesium treatment and account for these covariates.

Correlations between quantitative fat-water magnetic resonance imaging and computed tomography in human subcutaneous white adipose tissue.

Beyond estimation of depot volumes, quantitative analysis of adipose tissue properties could improve understanding of how adipose tissue correlates with metabolic risk factors. We investigated whether the fat signal fraction (FSF) derived from quantitative fat-water magnetic resonance imaging (MRI) scans at 3.0 T correlates to CT Hounsfield units (HU) of the same tissue. These measures were acquired in the subcutaneous white adipose tissue (WAT) at the umbilical level of 21 healthy adult subjects. A moderate correlation exists between MRI- and CT-derived WAT values for all subjects, [Formula: see text], [Formula: see text], with a slope of [Formula: see text], (95% CI [Formula: see text]), indicating that a decrease of 1HU equals a mean increase of 0.38% FSF. We demonstrate that FSF estimates obtained using quantitative fat-water MRI techniques correlate with CT HU values in subcutaneous WAT, and therefore, MRI-based FSF could be used as an alternative to CT HU for assessing metabolic risk factors.

Impact of postoperative changes in sarcopenic factors on outcomes after hepatectomy for hepatocellular carcinoma.

We have reported that preoperative low skeletal muscle quality was an independent risk factor for poor outcomes after hepatectomy for hepatocellular carcinoma (HCC). However, postoperative changes of quality as well as quantity of skeletal muscle after hepatectomy for HCC and their impact on postoperative outcomes have not been fully investigated. We retrospectively analyzed 241 patients undergoing primary hepatectomy for HCC between January 2007 and September 2012. The quality and quantity of skeletal muscle were evaluated by intramuscular adipose tissue content (IMAC) and the psoas muscle mass index (PMI) using computed tomography imaging at the umbilical level, respectively. We evaluated postoperative changes in IMAC and PMI in patients according to preoperative sarcopenia, sex, and surgical procedure. We also investigated the impact of ΔIMAC and ΔPMI on HCC recurrence in patients with preoperative normal IMAC. On multivariate analysis, indocyanine green retention test at 15 min ≥ 15% (odds ratio [OR] = 3.156; P = 0.041) and high ΔIMAC at 6 months after hepatectomy (OR = 3.713; P = 0.024) were the risk factors for HCC recurrence in patients with preoperative normal IMAC. Postoperative depletion of skeletal muscle quality is closely involved with HCC recurrence after hepatectomy for HCC.

Laparoscopic herniorrhaphy in children.

The authors report their experience in laparoscopic repair of inguinal hernias in children. From May 2010 to November 2013, 122 patients with inguinal hernia underwent laparoscopic herniorrhaphy (92 males and 30 females). Telescope used was 5 mm, while trocars for the operative instruments were 3 or 2 mm. After introducing the camera at the umbilical level and trocars in triangulation, a 4-0 nonabsorbable monofilament suture was inserted directly through the abdominal wall. The internal inguinal ring was then closed by N or double N suture. All operations were performed in one-day surgery setting. In the case of association of inguinal and umbilical hernia an original technique was performed for positioning and fixing the umbilical trocar and for the primary closure of the abdominal wall defect. The postoperative follow-up consisted of outpatient visits at 1 week and 1, 3, and 6 months. The mean age of patients was 38.5 months. Of all patients, 26 were also suffering from umbilical hernia (19 males and 7 females). A total of 160 herniorrhaphies were performed; 84 were unilateral (66 inguinal hernia, 18 inguinal hernia associated with umbilical hernia), 38 bilateral (30 inguinal hernia, 8 inguinal hernia associated with umbilical hernia). Nine of 122 patients (6 males and 3 females) were operated in emergency for incarcerated hernia. A pre-operative diagnosis of unilateral inguinal hernia was performed in 106 cases. Of these patients, laparoscopy revealed a controlateral open internal inguinal ring in 22 cases (20.7%). The mean operative time was 29.9±15.9 min for the monolateral herniorrhaphies, while in case of bilateral repair the mean operative time was 41.5±10.4 min. The mean operative time for the repair of unilateral inguinal hernia associated with umbilical hernia was 30.1±7.4 while for the correction of bilateral inguinal hernia associated with umbilical hernia 39.5±10.6 min. There were 3 recurrences (1.8%): 2 cases in unilateral repair and 1 case a unilateral recurrence in a bilateral repair. No other complications were seen. Laparoscopic repair of inguinal hernia in children performed in this experience resulted a safe and effective procedure.

Evaluation of Obesity in School-Age Children.

To prevent obesity in middle age, early precautions and interventions are required during childhood. Therefore, it is very important to accurately evaluate the degree of overweight in children. Body mass index (BMI) is widely used worldwide in adults, but not in children. Because standard BMI, which is calculated using the average height and weight for age, changes widely during growth, a constant cut-off point cannot be set for children. An international unified method defining childhood obesity has not been established. In many countries, BMI-for-age percentile (BMI%) value or Z (standard deviation) score is used, whereas in Japan, the percentage of overweight (POW), which is the modified weight-for-height method, is used. We compared BMI% values with POW values obtained using the anthropometric data of elementary and junior high school students based on the Japanese school survey conducted in 2000 and found that the values for the degree of overweight were significantly different between the two methods. It became clear that tall students were easily defined as being overweight, whereas short students tended to be evaluated as being underweight when using BMI%. POW method seemed to be more appropriate than BMI% for school-age children. Abdominal obesity, excess visceral adipose tissue (VAT), is highly associated with obesity-related complications. Waist circumference (WC) is now accepted as an appropriate guide to VAT accumulation. The cut-off value of WC defining excess VAT is 80 cm at the umbilical level in Japanese school-age children. It is not easy to decide the obesity criteria and optimum WC in school-age children. Childhood obesity should be discussed more internationally.

Slow Growing Abdominal Mass Over 10 Years

Gastroenterolo Question: A 79year-old man was admitted for evaluation of jaundice and abdominal pain that began 2 weeks before admission. The patient had received right pneumonectomy for lung cancer 30 years ago and had undergone endoscopic retrograde cholangiopancreatography to remove common bile duct stones 10 years ago. Physical examination at admission revealed icteric sclera and mild right upper quadrant tenderness. Initial laboratory test result showed liver function enzyme elevation in a cholestatic pattern, and computed tomography (CT) scan demonstrated multiple gallbladder stones and common bile duct stones. Therefore, endoscopic retrograde cholangiopancreatography was performed to resolve the biliary obstruction. However, in addition to the bile duct stones noted on CT, there was a 8.3-cm, heterogeneously enhancing mass lesion abutting jejunum and involving many jejunal branches of superior mesenteric artery (Figure A). On retrospective review of the CT scan taken 10 years ago at the time of the initial common bile duct stone removal, a 3 2-cm mass lesion abutting jejunum at the umbilical level of mesenteric root was found to have been present (Figure B). Percutaneous biopsy had been performed 10 years ago and proliferation of spindle cells was reported to have been observed. Although surgical resection had been recommended to remove the mass, the patient was lost to follow-up. A follow-up percutaneous biopsy showed severe cellular atypia. Because the mass increased by nearly 3-fold, albeit over the period of 10 years, surgical resection was performed. What is the diagnosis of this slow growing abdominal mass? Look on page 1696 for the answer and see the Gastroenterology web site (www.gastrojournal.org) for more information on submitting your favorite image to Clinical Challenges and Images in GI.

Aging, Smoking, Dyslipidemia, and Obesity Are Independently Associated With the Prevalence of Colorectal Neoplasia in Japan: Analyses of Comprehensive Health Checkup Data

Introduction: Colorectal cancer (CRC) is the third leading cause of cancer death in Japan. For the past decades, the incidence and mortality rate of CRC has been increased in Japan which corresponds with the economic development and concomitant shifts from traditional lifestyle towards a westernized lifestyle. We investigated the risk factors such as metabolic and lifestyle factors for the occurrence of colorectal neoplasia (CRN) by using comprehensive health checkup data. Methods: We conducted a retrospective analysis in clinical practice at a single center. Among 6698 subjects who took comprehensive health checkup at our hospital between in August 2012 and March 2015, 1511 subjects who also underwent screening colonoscopy were enrolled. In the present study, CRN was defined as adenomatous polyp ≥ 5 mm in size and adenocarcinoma. A diagnosis of metabolic syndrome (MetS) was made by Metabolic Syndrome Diagnostic Criteria Exploratory Committee in Japan. Demographic characteristics, anthropometric measurements, visceral fat area (VFA) measured at the umbilical level by computed tomography, hematological metabolic parameters, degree of liver fat evaluated by ultrasonography, and current smoking and drinking habits were assessed. Association between variables and CRN was evaluated by univariate analysis using t-test, χ2 test, Mann-Whitney test, and then by multivariate analysis using multiple logistic regression model. A p value < 0.05 was considered statistically significant. Results: One hundred and seventy subjects had CRN (11.3%) and 5 had invasive colorectal cancer (0.3%). Three hundred and fifty-eight subjects were diagnosed as MetS (24.9%) and presence of MetS was significantly associated with CRN (MetS (+): 16.2% vs MetS (-): 9.6%, p < 0.001). Univariate analysis identified significant association of age, body mass index (BMI), VFA, systolic blood pressure, lowdensity lipoprotein (LDL)-cholesterol, triglycerides (TG), fasting plasma glucose, hemoglobin A1c (HbA1c), fatty liver, current smoking habits, current drinking habits and ≥ 10 kg weight gain compared with the body weight at the age of twenty with prevalence of CRN. Logistic regression analysis revealed that age (odds ratio (OR): 1.048), BMI (OR: 1.061), LDL-cholesterol (OR: 1.008), and current smoking (OR: 2.335) were independent factors associated with CRN prevalence. Conclusion: The present study demonstrated that aging, smoking, dyslipidemia and obesity (high BMI) might be risk factors for CRN in Japan.Table 1: Multivariate analysis of risk factors for colorectal neoplasia prevalence

Advances in prediction of neonatal hyperbilirubinemia

Neonatal jaundice is one of the most commonly diseases in newborns.Severe indirect hyperbilirubinemia may lead to neurotoxicity, or death.Hence, predicting the neonates especially high risk neonates for subsequent bilirubin level is required.This paper gives an account of the predictive value of umbilical cord blood bilirubin level, umbilical cord alpha-fetoprotein level, cord blood hydrogen peroxide and end-tidal CO for neonatal hyperbilirubinemia. Key words: Hyperbilirubinemia; Neonate; Prediction

Umbilical Cord Bilirubin Level as a Predictive Indicator of Neonatal Jaundice

BACKGROUND AND OBJECTIVE: Neonatal jaundice is a major problem among infants in the first weeks of life. Research on several indicators of severe neonatal jaundice including alpha-fetoprotein and umbilical cord bilirubin level has indicated contradictory results. Therefore, the aim of the present study was to evaluate the significance of umbilical cord bilirubin level as a predictive indicator of severe neonatal jaundice. METHODS: This prospective, cross-sectional study was performed on 102 healthy infants, born to healthy mothers at Babol Clinic Hospital, Babol, Iran. After birth, 2 cc blood samples were obtained from the umbilical cord and the bilirubin level was measured in the hospital laboratory. The infants were followed-up after hospital discharge in terms of jaundice presentations. In case jaundice was diagnosed in infants, they were compared in treated and untreated groups. FINDINGS: Clinical jaundice was not detected in 54 cases (52.94%). Overall, 48 neonates (47.05%) suffered from clinical jaundice and 10 cases (8.9%) presented with severe jaundice, requiring treatment based on the criteria proposed by the American Academy of Pediatrics (AAP). The mean umbilical cord bilirubin level was 1.82±0.42 mg/dl in the untreated group and 2.36±0.56 mg/dl in the treated group (P=0.000). The area under the ROC curve for umbilical cord bilirubin level was 0.722 in the treated group, based on the AAP criteria. The cut-off point of 2 mg/dl showed 80% sensitivity and 73% specificity in predicting severe jaundice (requiring treatment), based on the AAP criteria. CONCLUSION: As the results indicated, measurement of umbilical cord bilirubin level and determination of a suitable cut-off point could be valuable in predicting severe jaundice in newborns.

Role of Fetal Serum Prolactin in Pregnancy

&lt;p&gt;In our study we have tried to to study the comparison of fetal cord serum prolactin level in normal and abnormal pregnancies and correlate the cord serum prolactin level with occurrence of HMD and to establish the fact that If cord serum prolactin is less, then there might be the chances of neonate developing HMD .study was conducted in Department of Obstetrics and Gynaecology, Datta Meghe Institute Of Medical Sciences, Sawangi (Meghe), Wardha (1st September 2005 to 31st August 2007: on 160 randomly selected booked and unbooked women GROUP A 80 women with normal pregnancies GROUP B 80 women with abnormal pregnancies.&lt;/p&gt;&lt;p&gt;&lt;br /&gt;In a prospective study umbilical cord serum prolactin level was found to be lower in women with abnormal pregnancy.&lt;/p&gt;

Correlation of abdominal fat ratio with hepatic CT enhancement.

The objective of the study was to evaluate the effect of abdominal fat proportion on hepatic computed tomography (CT) enhancement. CT data for 87 patients (47 men, mean age 55.09±13.27 years; 40 women, mean age 60.43±11.29 years) were analyzed by linear regression to assess the association of patient age and abdominal fat proportion with adjusted maximal hepatic enhancement (aMHE), calculated by dividing the maximal hepatic enhancement by the dose of iodine injected per kilogram of patient body weight, for each gender. The abdominal fat ratio (AFR) at the umbilical level, calculated as the volume of abdominal fat divided by the total abdominal volume, was used as a marker of abdominal fat proportion. It was found that aMHE was positively correlated with AFR for men (r=0.48, P<0.01) and women (r=0.46, P<0.01) but not with patient age (r=-0.09 and -0.14, respectively, both P>0.05). Therefore, it was concluded that determining an iodine dose on the basis of AFR might be an optimal way to maintain constant hepatic enhancement.

Five-Element Acupuncture: Blocks to Healing, Causative Factors, and Diagnostic Correspondences

Abstract Classical Five-Element Acupuncture was brought to the Western world by the late J.R. Worsley, MAc, DrAc(China), ND(UK) (1923–2003 ad). There is a growing tendency to dilute this system of acupuncture. The purpose of this article is to clarify and inform readers about the purity of this style. The opinions expressed herein are those of the author. The seven energetic blocks and impediments to treatment efficacy, the concept of Causative Factor (“CF”)—the one primary elemental imbalance at the root of a patient's symptoms—and the diagnostic correspondences used to diagnose the CF accurately, are discussed. The seven energetic blocks include Possession, Aggressive Energy, Husband/Wife Imbalance, the Umbilical Pulse, Akabani Imbalances, Entry/Exit blocks, and Spirit Level blocks. The Five Element diagnostic indicators include assessment of the patient's odor, facial color, vocal quality, and emotion. Each element has a specific odor, color, sound, and emotion, which will manifest when that particular...

Glyburide transport across the human placenta.

To estimate the magnitude of transplacental transfer of glyburide in women with gestational diabetes mellitus (GDM). A prospective, observational study was conducted on women with GDM on glyburide therapy. On delivery admission, the glyburide dose and time of last dose were recorded. Immediately postdelivery, maternal and umbilical venous blood samples were obtained and the concentrations of glyburide were determined by high-performance liquid chromatography-mass spectrometry with a limit of detection of 0.25 ng/mL. Nineteen patient dyads were analyzed. The mean total daily maternal glyburide dose was 6.6±6.3 mg per day and the mean time between last dose and sampling was 13.3±6.5 hours. The mean maternal serum glyburide level at birth was 15.4±20.8 ng/mL, whereas the mean umbilical glyburide level was 7.5±8.2 ng/mL, which showed a statistical correlation (r=0.72, P<.01). There were statistically significant relationships between total maternal glyburide dose (1.25-20 mg per day) and maternal glyburide levels (0.93-70.71 ng/mL; r=0.46, P≤.01) and between total maternal glyburide dose and umbilical glyburide levels (0.95-32.41 ng/mL; r=0.43, P≤.01) However, we observed wide variability in maternal and umbilical glyburide levels at both extremes of the total glyburide dose. Seventy-nine percent of cord samples (15/19) had glyburide levels less than 10 ng/mL (the limit of detection reported in earlier studies) and 37% (7/19) were higher than the corresponding maternal samples. Transplacental transfer of glyburide is highly variable among patients, corroborating ex vivo placental perfusion studies showing a transport-mediated glyburide efflux from the fetal to the maternal circulation. In most neonates (79%), glyburide levels were below 10 ng/mL. III.

Maternal and Umbilical Cord Blood Level of Leptin and C-Reactive Protein in Preeclamptic Sudanese Women

Maternal and Umbilical Cord Blood Level of Leptin and C-Reactive Protein in Preeclamptic Sudanese Women Objective: To determine maternal and umbilical cord blood levels of leptin and C-reactive protein in healthy pregnant women and preeclamptic patients. Material and methods: Thirty eight healthy pregnant controls, 68 mild and 25 with severe preeclampsia women were involved in this case-control study. Levels of leptin and CRP in maternal and cord blood were determined by ELISA and a sandwich-format immunometric method, respectively.

Umbilical neutrophil gelatinase-associated lipocalin level as an early predictor of acute kidney injury in neonates with hypoplastic left heart syndrome.

Acute kidney injury (AKI) is a primarily described complication after unbalanced systemic perfusion in neonates with congenital heart defects, including hypoplastic left heart syndrome (HLHS). The aim of the study was to compare the umbilical NGAL concentrations between neonates born with HLHS and healthy infants, as well as to analyze whether the determination of NGAL level could predict AKI in neonates with prenatally diagnosed HLHS. Twenty-one neonates with prenatally diagnosed HLHS were enrolled as study group and 30 healthy neonates served as controls. Perinatal characteristics and postnatal parameters were extracted from the hospital neonatal database. In umbilical cord blood, we determined plasma NGAL concentrations, acid base balance, and lactate and creatinine levels. In neonates with HLHS, complications (respiratory insufficiency, circulatory failure, NEC, IVH, and AKI) were recorded until the day of cardiosurgery. We observed in neonates with HLHS higher umbilical NGAL levels compared to controls. Among 8 neonates with HLHS and diagnosed AKI stage 1, we observed elevated NGAL levels in comparison to those newborns without AKI. Umbilical NGAL could predict, with high sensitivity and specificity, AKI development in study neonates. We suggest that the umbilical blood NGAL concentration may be an early marker to predict AKI in neonates with HLHS.

Increased levels of FFA during heat stress after a 2-week repeated heat stress

Event Abstract Back to Event Increased levels of FFA during heat stress after a 2-week repeated heat stress Jeong-Beom Lee1*, Tae-Wook Kim2, Young-Ki Min1 and Hun-Mo Yang1 1 Soonchunhyang University, Physiology, Republic of Korea 2 Soonchunhyang University, Health care, Republic of Korea The purpose of this study was to determine whether repeated heat stress is closely related to circulating levels of free fatty acids (FFA) during repeated heat stress, defined as immersion of the lower body up to an umbilical level in hot water, 42±0.5 °C (three times/ week, 30 min/day) for 2 weeks. There were significant correlations between mean body temperature and FFA before and after repeated heat stress (p<0.001, respectively), and the level of FFA was significantly higher after repeated heat stress during heat stress (p<0.01). The threshold of mean body temperature for lipolysis was lowered by repeated heat load and enhanced lipolysis during heat stress. However, caution is needed for diabetic individuals. Acknowledgements None of the authors have any conflicts of financial interest to declare. References Bae, J.S., Lee, J.B., Matsumoto, T., Othman, T., Min, Y.K., and Yang, H.M. (2006). Prolonged residence of temperate natives in the tropics produces a suppression of sweating. Pflugers. Arch. 453, 67-72. Kim, T.W., and Lee, J.B. (2013). The effects of caffeine ingestion before passive heat loading on serum leptin levels in humans. Appl. Biochem. Biotechnol. 171,1253-1251. Lee, J.B., Bae, J.S., Matsumoto, T., Yang, H.M., and Min, Y.K. (2009). Tropical Malaysians and temperate koreans exhibit significant differences in sweating sensitivity in response to iontophoretically administered acetylcholine. Int. J. Biometeorol. 53,149-157. Lee, J.B. (2008). Heat acclimatization in hot summer for ten weeks suppress the sensitivity of sweating in response to iontophoretically-administered acetylcholin. Korean. J. Physiol. Pharmacol. 12, 349-355. Lee, J.B., Bae, J.S., Shin, Y.O., Kang, J.C., Matsumoto, T., Toktasynovna, A.A., Kaimovich, A.G., Kim, W.J., Min, Y.K., and Yang, H.M. (2007). Long-term tropical residency diminishes central sudomotor sensitivities in male subjects. Korean. J. Physiol. Pharmacol. 11, 233-237. Ramanathan, N.L. (1964). New weighing system for mean surface temperature of human body. J. Appl. Physiol. 19, 531-533. Rowell, L.B., Brengelmann, G.L., Blackmon, J.R., Murray, J.A. (1970). Redistribution of blood flow during sustained high skin temperature in resting man. J. Appl. Physiol. 28, 415-420. Tobin, L., Simonsen, L., Galbo, H., Bülow, J. (2012). Vascular and metabolic effects of adrenaline in adipose tissue in type 2 diabetes. Nutr. Diabetes. 2:e46. Keywords: Repeated heat stress, free fatty acids, Lipolysis, mean body temperature, diabetic individual Conference: Neuroinformatics 2015, Cairns, Australia, 20 Aug - 22 Aug, 2015. Presentation Type: Poster, not to be considered for oral presentation Topic: Clinical neuroscience Citation: Lee J, Kim T, Min Y and Yang H (2015). Increased levels of FFA during heat stress after a 2-week repeated heat stress. Front. Neurosci. Conference Abstract: Neuroinformatics 2015. doi: 10.3389/conf.fnins.2015.91.00014 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 01 Mar 2015; Published Online: 05 Aug 2015. * Correspondence: Prof. Jeong-Beom Lee, Soonchunhyang University, Physiology, Cheonan, ChungNam, Cheonan, Republic of Korea, leejb@sch.ac.kr Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Jeong-Beom Lee Tae-Wook Kim Young-Ki Min Hun-Mo Yang Google Jeong-Beom Lee Tae-Wook Kim Young-Ki Min Hun-Mo Yang Google Scholar Jeong-Beom Lee Tae-Wook Kim Young-Ki Min Hun-Mo Yang PubMed Jeong-Beom Lee Tae-Wook Kim Young-Ki Min Hun-Mo Yang Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

5ICCN_010: Umbilical NGAL level as predictior of acute kidney injury in infants with hypoplastic left heart syndrome

Acute kidney injury (AKI) is a primarily described complication after unbalanced systemic perfusion during fetal and neonatal periods in children with congenital heart defects. Among termborn children, hypoplastic left heart syndrome (HLHS) may be an important predisposing factor for this condition. The study focused on evaluation of umbilical neutrophil gelatinaseassociated lipocalin (NGAL) levels, as an early biomarker predicting AKI in neonates with HLHS. Among 1,271 neonates born from January 2013 to January 2014 in Department of Neonatology in Katowice, we enrolled 21 neonates with HLHS as the study group, and 60 healthy newborns as controls. Umbilical cord blood morphology with total counts of white blood cells and neutrophils, acidbase balance, NGAL, lactate, creatinine concentrations were performed in all study and control neonates. We also investigated the risk of AKI, diagnosed before cardiac surgery based on creatinine and umbilical NGAL concentrations in neonates born with HLHS. Among neonates with HLHS, 8 children were diagnosed with AKI on average on the 3rd day of life. We observed higher umbilical NGAL concentrations in neonates with HLHS compared with controls. NGAL concentration was significantly higher in the group of neonates with HLHS and AKI, compared to those without AKI. ROC curve analysis demonstrated a critical level of NGAL in the umbilical cord blood >66.6 ng/mL, and this allows with 80% sensitivity and 94% specificity to predict AKI in newborns with HLHS. We suggest that the umbilical blood NGAL concentration may be an early marker to predict AKI in neonates with HLHS.