UB

1Unbound bilirubin

1323216 1UB1990.112

31945 - 2010 50.653.745754History of the UB Analyzer1964 - 2010Sephadex Column methodMPeroxidase methodFDAUB5198019802008, GDP3.5%6.3%-1.5%1571096,0008,3001,5003,3004.91.225%2.1%58%7.5%UB6UB1980UB Analyzer GOD-PODUBABRUBVLBW

7Kernicterus and Bilirubin Encephalopathy

8** Basal ganglia, globus pallidus, subthalamic nucleus, hippocampus, substantia nigra, cranial nerve nuclei, reticular formation. by Volpe9Kernicterus

10Kernicterus

11van Praagh, 1961Stage I2 3Stage II3 - 2

Stage III2 - 2Stage IV12

13 = UB14The Mode of Entry of Bilirubin-C14 into the Central Nervous System20151050Brain bilirubin, ug / dl

Serum bilirubin, mg / dlDiamond I & Schmid R, 1966Bilirubin with albuminBilirubin with saline25303515Bilirubin binding test 161966PorterDye binding method (HBABA) 1970OdellSaturation index (Salicylate)1970Bratlid Bilirubin binding by RBC1971ChungaSephadexG25 method1974JacobsenPeroxidase method1977NakamuraGOD-POD method1978HsiaElectron spin resonanceNakamura Automated GOD-POD method (UB Analyzer)1982WellsFront-face fluorometry1982BrodersenSelective trace ligands (MADDS)2006AhlforsComputer-directed Zone fluidicsUB Analyzer GOD-PODUBABRUBVLBW

17UB Analyzer (UA-2)(Arrows, Osaka, Japan)

18GOD-POD19XH2O2 + GluconateGlucose H2OGODGlucose oxidase

PODPeroxidasePODGODXBilAlbCalculation of unbound bilirubin in the presence of peroxidase2095% 76% B%%t1t2K: peroxidase rate constant

[peroxidase]st: used peroxidase conc.

[B]: initial bilirubin conc.Vo = B/tst = K [peroxidase] st [B]

Calcualte k by albumin-free bilirubin solution.Fixed B as 0.2[B], then count tst (seconds). [B] = 1/ K B/t 1/[peroxidase] [B] = 1/ K B/[B] t/tst [peroxidase]st /[peroxidase]

B/[B]0.2, then

[B] = 1/ K 0.2 t/tst [peroxidase]st /[peroxidase]

Law of mass action in bilirubin-albumin binding21Ka =[BA][UB] [A]

[BA] : biliribin[UB] : biliribin[A] : albuminKa : Association constant[UB][BA]/[TA] 1[TA] : albumin[A] = [TA] - [BA] [UB] =1[BA] [TA] - [BA]Ka[UB] =1[BA]/[TA] 1 - [BA]/[TA]Ka Bilirubin Titration Curves22

1986B/A1.0BILALB34mg/dL4g/dL25mg/dL3g/dL17mg/dL2g/dLNakamura H and Lee Y: Clinica Chimica Acta, 1977

Scatchard plot of bilirubin-albumin binding23Nakamura H and Lee Y: Clinica Chimica Acta, 1977Effects of hemolysis on the TB and UB levels by the addition of different conc. of hemolysate24

A575Shimabuku R: Acta Pediatr Jpn, 1983SulfisoxazoleBilirubin tritration Curve25

Gunn rat100mgkg3060UB Analyzer GOD-PODUBABRUBVLBW

26

UB (UA-2)()27279UB10/06/1911.2.14UB1027301m3(300.1TB 0~30 mg/dLUB 0.08~3.00 g/dLTB 30 mg/dL22UB 3.00 g/dL22

28289UB10/06/1911.2.14UBperoxidaseUB2mg/dL)

29299UB10/06/1911.2.14UBUB

30309UB10/06/1911.2.14UBUB/TB

.Neonatal Care 7 :104-108,199431319UB10/06/1911.2.14UB Analyzer GOD-PODUBABRUBVLBW

32

PEDIATRICS Vol. 75 No.4 April 198533ABR recording in infant treated with exchange transfusion34

Male, Day 3, RhE incompatibilitiesPEDIATRICS , 1985

35PEDIATRICS , 1985PEDIATRICS , 1985

3644: 2224-2250, 1991Nakamura H, Yonetani M, Uetani U, Funato M, Lee Y. Acta Paediatr Jpn 34:642-647, 1992 UB2261937379UB10/06/1911.2.1419871663270 At risk No risk At riskTBUB38389UB10/06/1911.2.14VLBW, LBWTB,UB

Nakamura H, Yonetani M, Uetani U, Funato M, Lee Y.: Acta Paediatr Jpn 34:642-647, 1992 At risk VLBWNo risk VLBW At risk LBWNo risk LBW39399UB10/06/1911.2.14ROCTBUB

UBLBW: 1.0 g/dL VLBW: 0.8 g/dL

TB LBW: 16 mg/dL VLBW: 11 mg/dLNakamura H, Yonetani M, Uetani U, Funato M, Lee Y.: Acta Paediatr Jpn 34:642-647, 1992 = 1-specificity= sensitivity40409UB10/06/1911.2.14UBTB

Nakamura H, Yonetani M, Uetani U, Funato M, Lee Y.: Acta Paediatr Jpn 34:642-647, 1992 41419UB10/06/1911.2.141991.4.42

Ontogeny of Bilirubin-Binding Capacity and the Effect of Clinical Status in Premature Infants Born at Less Than 1300 GramsGeorge Jesse Bender, William James Cashore, William OhPEDIATRICS Vol. 120 No. 5 November 2007, pp. 1067-107343439UB10/06/1911.2.14

From: Ontogeny of Bilirubin-Binding Capacity and the Effect of Clinical Status in Premature Infants Born at Less Than 1300 Grams G J Bender, W J Cashore and W Oh: Pediatrics 2007;120;1067-1073The relationship between UB and TSB was significant overall and in each of the risk groups (low, moderate, and high).44

From: Ontogeny of Bilirubin-Binding Capacity and the Effect of Clinical Status in Premature Infants Born at Less Than 1300 Grams G J Bender, W J Cashore and W Oh: Pediatrics 2007;120;1067-107345UB Analyzer GOD-PODUBABRUBVLBW

46ELBW, 25w, 705g1/415(TB:12.6mg/dL, UB:1.45g/dL)5ABR791512MMRI (T2-W)

Courtesy of Dr Arai H4747

Progress of ABRA VLBW Infant with High UB Level (BW:1468g, 30 GW)-Day 4Day 36TB 15.3mg/dlUB 1.51mg/dlET(Lee Y-K, et al. Pediatrics International, 51:795-799, 2009)48A Boy, 25w0d, 667g, abnormal ABR

40w (PCA) 8m (CA) 2y8m (CA)

49Number of VLBW athetotic CP(Arai, H:Bobath Memorial Hospital & Morinomiya Hospital)50Analysis of 26 cases (> 3y.) born pretermGA (w) 26.22.0 (2330)BW (g) 834187 (5441247)(Provided by the coputesy of Dr. Arai, HBobath Memorial Hospital and Morinomiya Hospital)Dystonic Cerebral PalsyKernicterus or not?51AffirmativeDystonic cerebral palsyT2 hyperintensity of internal globus pallidus88% (14/16) had pallidal hyperintensity (10mg/dl: 5/10 UB=&>1.0ug/dl: 3/10Prolonged Jaundice noted, but no ET during the courseAthetotic CP and Kernicterus in VLBW infants Cohort Surveillance by the JSPNM by Arai H, Funato M53

ABR, MRI54549UB10/06/1911.2.14

VLBW

55559UB10/06/1911.2.1456TB,UBABRMRI,MRSUB57579UB10/06/1911.2.14