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Monoclonal antibody Proprotein Convertase Subtilisin/Kexin type 9 (PCSK9) inhibitors reduce total cholesterol (TC), low density lipoproteins (LDL), high density lipoproteins (HDL), and triglycerides (TG). We assessed the ability of berberine, a natural PCSK9 inhibitor, to reduce lipid concentrations either alone or combined with other nutraceuticals. We searched PubMed, Scopus and EMBASE from inception to September 30th, 2022 for randomized controlled trials (RCTs) assessing 8-18 wk of berberine therapy on. A total of 41 RCTs with 4,838 patients met our inclusion criteria. Berberine containing products significantly reduced TC (MD −17.42 mg/dL [95%CI: −22.91 to −11.93]), LDL (MD −14.98 mg/dL [95%CI: −20.67 to −9.28]), and TG (MD −18.67 mg/dL [95%CI: −25.82 to −11.51]) while raising HDL (MD 1.97 mg/dL [95%CI: 1.16 to 2.78]) versus control (I2 > 72% for all analyses). Products with berberine alone had less robust effects on TC (MD −12.08 mg/dL [95%CI: −21.79 to −2.37]), LDL (MD −9.26 mg/dL [95%CI: −20.31 to 1.78]), and HDL (MD 1.38 mg/dL [95%CI: −1.27 to 4.03]) but TG effects were similar (MD −17.40 mg/dL [95%CI: −32.57 to −2.23]). Berberine along with red yeast rice reduced TC (MD −19.62 mg/dL [95%CI: −28.56 to −10.68]) and LDL (MD −18.79 mg/dL [95%CI: −28.03 to −9.54]) as did combination therapy with Silybum maranium for TC (MD −31.81 mg/dL [95%CI: −59.88 to −3.73]) and LDL (MD −30.82 mg/dL [95%CI: −56.48 to −5.16]). Berberine, alone or with other nutraceuticals, can provide a modest positive impact on lipid concentrations. [ABSTRACT FROM AUTHOR]

Background and aimsCholangioscopy is useful in establishing a visual diagnosis of cholangiocarcinoma (CCA), but this is harder to achieve in primary sclerosing cholangitis (PSC) because of the stricture-forming nature of the disease. Furthermore, it can be harder to differentiate malignant from benign features of the underlying inflammation. This case series demonstrates the varied features of nonmalignant inflammatory findings in PSC.MethodsA single experienced endoscopist performed cholangioscopy for PSC cases referred for ERCP.ResultsCholangioscopy in these 5 cases without CCA demonstrated the features of acute and chronic inflammation, acute inflammatory mass, dominant stricture, acute cholangitis in a duct with features of chronic inflammation with a large pigmented stone, and fibrostenotic disease. Cholangioscopic maneuvers such as advancement across strictures after balloon dilation, targeted mucosal biopsy, and electrohydraulic lithotripsy (EHL) of impacted stones are demonstrated. The relevant radiographic and histopathologic features of the disease accompany each case description. Regarding long-term prognosis, 1 case of acute inflammatory mass and a case of worsening liver function required a liver transplant evaluation, whereas the other 3 cases remain stable.ConclusionsCholangioscopic features of benign disease in PSC are varied. Knowledge of these features is essential in differentiating between benign and malignant findings. These features, combined with biopsy and cytology evaluation, can help in tailoring management in patients with benign PSC.

Background and aimsPrompt and accurate differentiation of benign and malignant strictures in primary sclerosing cholangitis (PSC) is crucial. ERCP with brush cytology, the most common modality to achieve this, is hindered by a low diagnostic yield. Cholangioscopy can overcome this limitation by establishing a visual diagnosis based on the characteristic morphologic features of cholangiocarcinoma (CCA) and can aid in targeted biopsies of suspicious lesions. However, its role in PSC remains unclear. This case series demonstrates the performance of the latest generation of single-operator cholangioscope for this indication.MethodsA single experienced endoscopist performed cholangioscopy for PSC cases referred for ERCP.ResultsCholangioscopies of patients 1 to 3 demonstrate the features of extrahepatic duct dominant strictures (DS) and the cholangioscopic maneuvers undertaken in these cases, including advancement across the DS after balloon dilation, biopsy of the DS, and electrohydraulic lithotripsy of impacted stones. Cholangioscopies of patients 4 to 6 demonstrate the varied features of CCA ranging from focal stricture with tumor vessels, papillary frond-like projections, and features of an intraductal papillary biliary neoplasm. Also shown are the radiographic and histopathologic features of the disease.ConclusionsCholangioscopy allowed us to identify morphologic features of both malignancy and benign disease in PSC in the setting of extrahepatic duct strictures, and we were able to obtain adequate targeted tissue samples for histopathologic confirmation.

Abstract Background Gluten, a food allergen, is available in foods derived from wheat, rye and barley. It damages the small intestine and causes celiac disease. Herein, we designed a rapid immunochromatographic lateral flow test assay for detecting the gluten contents of raw materials. In this rapid test, the presence of gluten was screened through the capturing of gliadin (a toxic component of gluten) by two identical gliadin monoclonal antibodies. One of the antibodies was immobilized on the membrane in the test zone as a capture reagent. The other antibody was labeled with gold nanoparticles (AuNPs) as a detector reagent. Results Gold nanoparticles with a size of about 20 nm were synthesized and conjugated to the gliadin monoclonal antibodies. The detection limit of the experimental assay was 20 ppm and positive results were visualized after 15 min using only 40 μL of the extracted sample for each test. Analysis of different flour samples identified the best sensitivity and specificity of the lateral flow test strip (LFTS). Conclusion The experimental LFTS is an easy-to-use and rapid method for the screening of gluten level in raw materials. The LFTS may be employed to ensure the safety of foods.

Background: Gluten, a food allergen, is available in foods derived from wheat, rye and barley. It damages the small intestine and causes celiac disease. Herein, we designed a rapid immunochromatographic lateral flow test assay for detecting the gluten contents of raw materials. In this rapid test, the presence of gluten was screened through the capturing of gliadin (a toxic component of gluten) by two identical gliadin monoclonal antibodies. One of the antibodies was immobilized on the membrane in the test zone as a capture reagent. The other antibody was labeled with gold nanoparticles (AuNPs) as a detector reagent. Results: Gold nanoparticles with a size of about 20 nm were synthesized and conjugated to the gliadin monoclonal antibodies. The detection limit of the experimental assay was 20 ppm and positive results were visualized after 15 min using only 40 μL of the extracted sample for each test. Analysis of different flour samples identified the best sensitivity and specificity of the lateral flow test strip (LFTS). Conclusion: The experimental LFTS is an easy-to-use and rapid method for the screening of gluten level in raw materials. The LFTS may be employed to ensure the safety of foods. [ABSTRACT FROM AUTHOR]

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Objective: To determine the changes in liver function tests if any in patients of COVID-19. Study Design: Cross sectional study. Place and Duration of Study: Combined Military Hospital Lahore, from Apr 2020 to Jun 2020. Methodology: A total of 209 confirmed cases of COVID-19 positive by RT-PCR patients presenting to Combined Military Hospital, Lahore were included in the study. Their demographic details were recorded. Patients were grouped into mild- moderate and severe disease groups according to the symptoms, complications and oxygen or ventilation requirements. Liver function tests of all these patients were advised. Results: Amongst confirmed COVID-19 patients, 187 (89.5%) had mild to moderate disease whereas 22 patients (10.5%) had severe disease. Liver test abnormalities were defined as the elevation of the following liver enzymes in serum: ALT >42 U/L, AST >45 U/L, GGT >49 U/L, ALP >300 U/L, albumin17.1. In LFTs, Bilirubin was increased in 20 (9.6%) patients), ALT in 32 (15.3%) patients, of which 8 had severe disease, 38 patients having high AST levels (>45) 28 had mild-moderate disease and 10 had severe disease. ALP was raised in 24 (11.5%) patients with 8 being in severe disease and rest in mild moderate disease. Albumin was low in 35 (16.7%) patients of which 12 had severe disease and 23 had mild-moderate disease. Conclusion: About 15-20% of the confirmed cases of COVID-19 have deranged liver function tests and it correlates with severity of the disease.

Diethylamine nitrosamine (DEN), as an initiator of liver tumor, and carbon tetrachloride (CCl4), as a tumor promoter, have been used to study the molecular events of liver cancer in animal models. Recently, our in vitro study reported BLE (Berberis lycium Royle ethanol extract) as the most effective agent against liver cancer, thus we continued our study in vivo to assess the hepatoprotective effect of BLE and its most active alkaloid, berberine, in albino mice (70 male). Moreover, we investigated the biochemical/immunohistochemical effects of a single alkaloid versus the effect of Berberis extract in mice liver. Hepatic cancer was induced in mice by a single intraperitoneal injection with DEN (100 mg/kg b.wt), followed by biweekly injections of CCl4 (0.5 mL/kg) for 30 days. The development of liver cancer was assessed after 60 days of DEN injection by measuring the elevated level of the serum tumor marker alpha-fetoprotein (AFP) and liver function test (ALT, AST, ALP, and BUN) markers. After the confirmation of liver cancer development, the BLE extract and berberine were fed to mice for 90 days and the serum biomarkers for liver injury (LFTs and AFP) were measured again. Overall, berberine (120 mg/kg b.wt) proved to be a stronger agent in reducing the symptoms of HCC in mice, as compared with BLE. Histopathological analysis agreed well with the biochemical observations. Immunohistochemistry analysis suggested significant suppression of the quantitative expression of the key oncogene cyclin D1 at low (60 mg/kg) and high (120 mg/kg) doses of berberine. These findings implicate the amelioration of hepatocarcinoma by berberine more prominently in mice, by suppression of cyclin-dependent kinase activator (CD1) expression, reducing LFTs, as well as AFP, in the serum. Thus, our findings are novel, as berberine may help in controlling the perturbation in CD1 associated with aggressive forms of HCC. However, future studies should be directed at finding out whether berberine has any effect on inhibitors (p27 and CDKI) of cyclin-dependent kinase too. [ABSTRACT FROM AUTHOR]

Abstract Background Doxorubicin (DOX) is an anthracycline agent mostly prescribed for various cancers. However, its treatment is contiguous with toxic effects. Acacia hydaspica prevented drug-induced hepatic-toxicity in animals with anti-oxidative mechanisms. We intended to study the efficacy of A. hydaspica ethyl acetate extract (AHE) for inhibiting DOX- induced liver damage. Methods Normal control group received saline; Drug control group received 3 mg/kg b.w. dose of DOX for 6 weeks (single dose/week, intraperitoneal injection) to study the effect of chronic DOX treatment. In co-treatment groups, 200 and 400 mg/kg b.w AHE was given orally for 6 weeks in concomitant with DOX (3 mg/kg b.w, i.p. injection per week). The standard drug group received silyamrin 100 mg/kg b.w (2 doses/week: 12 doses/6 weeks) in conjunction with DOX (single dose/week). Lipid profile, liver function tests (LFTs), antioxidant enzymes, oxidative stress enzymes and morphological alterations were studied to evaluate the hepatoprotective potential of AHE. Results DOX treatment inhibits body weight gain and upturn liver index. DOX considerably upset serum cholesterol, triglycerides and LDL concentration. On the contrary, it reduced serum HDL amount. DOX induced marked depreciation in serum LFTs, diminish hepatic antioxidant enzymes; however, raised tissue oxidative stress markers accompanied by morphological damages. Co-treatment with AHE dose dependently adjusted DOX-prompted fluctuations in lipid profile, AST, ALP, ALT, total bilirubin, and direct bilirubin concentrations and hepatic weight. Likewise, AHE usage enhanced total protein and hepatic tissue antioxidant enzyme quantities whereas declined oxidative stress markers in hepatic tissue. Correspondingly histopathological examinations aid the biochemical results. The influence of AHE 400 mg/kg b.w dose is analogous to silymarin. Conclusion Acacia hydaspica possibly serve as adjuvant therapy that hampers DOX inveigled liver damage due to the underlying antioxidant mechanism of secondary metabolites.

Lilium is an important commercial flowering species, and there are many varieties and more than 100 species of wild Lilium. Lilium × formolongi is usually propagated from seedlings, and the flowering of these plants is driven mainly by the photoperiodic pathway. Most of the other lily plants are propagated via bulblets and need to be vernalized; these plants can be simply divided into pretransplantation types and posttransplantation types according to the time at which the floral transition occurs. We identified three Lilium FLOWERING LOCUS T (LFT) family members in 7 Lilium varieties, and for each gene, the coding sequence of the different varieties was identical. Among these genes, the LFT1 gene of Lilium was most homologous to the AtFT gene, which promotes flowering in Arabidopsis. We analyzed the expression patterns of LFT genes in Lilium × formolongi seedlings and in different Lilium varieties, and the results showed that LFT1 and LFT3 may promote floral induction. Compared with LFT3 , LFT1 may have a greater effect on floral induction in Lilium , which is photoperiod sensitive, while LFT 3 may play a more important role in the floral transition of lily plants, which have a high requirement for vernalization. LFT2 may be involved in the differentiation of bulblets, which was verified by tissue culture experiments, and LFT1 may have other functions involved in promoting bulblet growth. The functions of LFT genes were verified by the use of transgenic Arabidopsis thaliana plants, which showed that both the LFT1 and LFT3 genes can promote early flowering in Arabidopsis. Compared with LFT3 , LFT1 promoted flowering more obviously, and thus, this gene could be an important promoter of floral induction in Lilium. • Coding sequences of the LFT gene family members in different varieties were identical • During the floral transition of Lilium , LFT1 may have a greater effect on photoperiod sensitive Lilium, while LFT3 may be more important in Lilium which have higher requirements for vernalization • LFT2 may be involved in the differentiation and formation of bulblets • Both the LFT1 and LFT3 can promote early flowering in Arabidopsis [ABSTRACT FROM AUTHOR]

Objective: To determine the changes in liver function tests if any in patients of COVID-19. Study Design: Cross sectional study. Place and Duration of Study: Combined Military Hospital Lahore, from Apr 2020 to Jun 2020. Methodology: A total of 209 confirmed cases of COVID-19 positive by RT-PCR patients presenting to Combined Military Hospital, Lahore were included in the study. Their demographic details were recorded. Patients were grouped into mild- moderate and severe disease groups according to the symptoms, complications and oxygen or ventilation requirements. Liver function tests of all these patients were advised. Results: Amongst confirmed COVID-19 patients, 187 (89.5%) had mild to moderate disease whereas 22 patients (10.5%) had severe disease. Liver test abnormalities were defined as the elevation of the following liver enzymes in serum: ALT >42 U/L, AST >45 U/L, GGT >49 U/L, ALP >300 U/L, albumin<35g/L and total bilirubin (TBIL) >17.1. In LFTs, Bilirubin was increased in 20 (9.6%) patients), ALT in 32 (15.3%) patients, of which 8 had severe disease, 38 patients having high AST levels (>45) 28 had mild-moderate disease and 10 had severe disease. ALP was raised in 24 (11.5%) patients with 8 being in severe disease and rest in mild moderate disease. Albumin was low in 35 (16.7%) patients of which 12 had severe disease and 23 had mild-moderate disease. Conclusion: About 15-20% of the confirmed cases of COVID-19 have deranged liver function tests and it correlates with severity of the disease. [ABSTRACT FROM AUTHOR]

Diethylamine nitrosamine (DEN), as an initiator of liver tumor, and carbon tetrachloride (CCl4), as a tumor promoter, have been used to study the molecular events of liver cancer in animal models. Recently, our in vitro study reported BLE (Berberis lycium Royle ethanol extract) as the most effective agent against liver cancer, thus we continued our study in vivo to assess the hepatoprotective effect of BLE and its most active alkaloid, berberine, in albino mice (70 male). Moreover, we investigated the biochemical/immunohistochemical effects of a single alkaloid versus the effect of Berberis extract in mice liver. Hepatic cancer was induced in mice by a single intraperitoneal injection with DEN (100 mg/kg b.wt), followed by biweekly injections of CCl4 (0.5 mL/kg) for 30 days. The development of liver cancer was assessed after 60 days of DEN injection by measuring the elevated level of the serum tumor marker alpha-fetoprotein (AFP) and liver function test (ALT, AST, ALP, and BUN) markers. After the confirmation of liver cancer development, the BLE extract and berberine were fed to mice for 90 days and the serum biomarkers for liver injury (LFTs and AFP) were measured again. Overall, berberine (120 mg/kg b.wt) proved to be a stronger agent in reducing the symptoms of HCC in mice, as compared with BLE. Histopathological analysis agreed well with the biochemical observations. Immunohistochemistry analysis suggested significant suppression of the quantitative expression of the key oncogene cyclin D1 at low (60 mg/kg) and high (120 mg/kg) doses of berberine. These findings implicate the amelioration of hepatocarcinoma by berberine more prominently in mice, by suppression of cyclin-dependent kinase activator (CD1) expression, reducing LFTs, as well as AFP, in the serum. Thus, our findings are novel, as berberine may help in controlling the perturbation in CD1 associated with aggressive forms of HCC. However, future studies should be directed at finding out whether berberine has any effect on inhibitors (p27 and CDKI) of cyclin-dependent kinase too.

Pregnancy-induced hypertension (PIH) is responsible for significant maternal and prenatal morbidity, liver function affected by this disease. Liver function tests ( LFTs ), namely S.ALP, S.AST, S.ALT, Albumin, Bilirubin and prothrombin time were evaluated in forty hypertensive pregnant women, forty healthy pregnant women along with forty aged matched non pregnant women as a control who attended to Hospital, the results showed that: S.ALP, S.AST, S.ALT and Bilirubin were significantly higher (P

Laboratory testing plays an important part in Clinical decisions. 60-70% of the clinical decisions are based on laboratory tests. The volume of laboratory tests has increased in last few years that results inappropriate utilization for routine tests. The elimination of unnecessary tests will help to utilize time and resources more effectively. To study the utilization of Liver functions tests (LFTs) in hospitalized patients of Mayo Hospital in 10 days. Study Design: Observational Study. Setting: Central Diagnostic Laboratory, Mayo Hospital/King Edward Medical University, Lahore. Period: 1st to 10th December, 2017. Materials and Methods: All the samples from indoor patients referred to laboratory for LFTs were included. The results and other relevant information were recorded on Proforma. The collected data was analyzed by using Statistical package for social sciences (SPSS version 20). Results: Out of total 1800 samples referred for LFTs, 1500 (83.4%) were accepted and 300(16.6%) were rejected due to inappropriate sample (hemolysis, quantity not sufficient, empty vial, EDTA vial, labeling error). The results of LFTs of 59% samples were within reference range and 41% were out of range. 23.5% samples were repetitive and 8.6% reports were not collected by the wards either the patient was discharged from the hospital or due to repetitive sampling. Conclusion: There is overutilization of Liver function tests. The repetitive ordering and inappropriate samples are main reason of waste in our study. [ABSTRACT FROM AUTHOR]

Both innate and adaptive immune responses of host are regulated by fine balance between negative and positive signals to ensure their termination and onset on entry of pathogens. Suppressor of cytokine signaling (SOCS) genes inhibit cytokine signaling pathways and regulate innate and adaptive immunity. SOCS genes perform their function by positive and negative regulation of macrophages, development and differentiation of T cells, and activation of dendritic cells. Although the role of SOCS1 and SOCS3 genes in hepatitis C virus (HCV) patients has been well studied, the correlation of SOCS1 gene expression with complete blood count in HCV-positive patients has not been established yet. We observed a weak positive correlation of SOCS1 gene expression with hemoglobin (Hb) and platelet count, whereas leukocytes were negatively correlated with the expression. This study also provides a comparative analysis of complete blood count between healthy subjects and HCV-positive subjects. The findings suggest that Hb and platelet count were significantly lower (P < 0.0001) in HCV patients than in healthy subjects. [ABSTRACT FROM AUTHOR]

Hepatitis C virus (HCV) is the leading cause of chronic liver complications globally and suppressor of cytokine signaling‐1 (SOCS‐1) is a gene triggered by cytokines that activates transcription of the JAK/STAT signal transduction pathway and negatively regulates Janus kinase‐signal transducer. Several studies have shown that the expression of SOCS1 and SOCS3 genes negatively regulate the response of HCV infection to interferon therapy and interferon‐free regimens. It has been reported that liver function enzymes elevate in CHC patients but the association of SOCS1 gene expression with LFTs haven't been studied. This study recruited 114 CHC patients and 112 normal healthy participants and analyzed the correlation of SOCS1 gene expression and liver function enzymes (LFEs). Herein, we observed that the expression of SOCS1 gene had a positive correlation with LFEs. Highlight: Hepatitis C virus (HCV) infection is a global health threat associated with a significantly high rate of morbidity and mortality worldwide.Suppressor of cytokine signaling (SOCS) genes act as negative regulators of JAK‐STAT signaling and there are eight members (SOCS1 to SOCS7) that form the SOCS family.This study analyzed the correlation between liver function tests (LFTs) and SOCS1 gene expression in peripheral blood mononuclear cells (PBMCs).Herein, we observed that the expression of SOCS1 gene had a positive correlation with LFEs. [ABSTRACT FROM AUTHOR]

Objectives: Hepatotoxicity is the most complicated side effect of isoniazid (inh) in the patient treated for tuberculosis. In causes 8-30% hepatotoxicity in the developing world. Metabolism of INH produces a metabolite, called acetyl isoniazid. In this study hepatoprotective effect of honey, in isoniazid induced animal model was assessed. Study Design: Randomized control trial. Setting: Saidu Medical College, Saidu Sharif Swat, KP. Period: October To December 2017. Material and Methods: 40 healthy male rabbits were assigned randomly to the group i, ii, iii and iv by using lottery method. Ten animals were grouped each row. The isoniazid-induced hepatotoxic model was created by giving 50 mg inh/kg orally on daily basis for eleven days. Group i was taken as negative control group ii as a positive control. Group iii and iv were experimental groups treated with 50 mg/kg/day and 100 mg/kg/day buckwheat honey respectively for eleven days. SPSS Version 16 software was used, mean, s.d. were determined in all the groups. Values of serum bilirubin, sgpt, and alkaline phosphatase were compared with each other using pairt-test. Results: SGPT, Serum bilirubin, and alkaline phosphatase were obtained in all the animals. Comparing group 1 negative control with group 2, 3 and 4 shows statistical significance, (p=0.00). Comparing group 2 positive control with 3 and 4 shows statistical significance, (p=0.00). Further comparing group 3 with group 4 also shows statistical significance (p=0.00). Conclusion: From the above finding, it has been revealed that honey has got a protective effect in regressing hepatitis that has been induced in rabbit's model by high doses of isoniazid. Related studies performed in which different chemicals and drugs have been tried for their protective role in isoniazid induced hepatitis also shows a similar type of results. [ABSTRACT FROM AUTHOR]

Direct-acting antivirals (DAAs) have been proved as potent agents in the new era of Hepatitis C therapeutics. DAA has evolved to prove highly efficacious treatment rates and sustained virological response in hepatitis C virus (HCV)-treated patients and has shown minimal side effects, but in this study, we reported five cases that showed unusual response toward the use of DAA. The diagnosis was an unusual response of abruptly high viral titers and liver function tests (LFTs) in patients who received DAA combination therapy. The patients received sofosbuvir (400 mg) and ribavirin for 6 months. Although 6-month long recommended DAA combination therapy with ribavirin cleared HCV after 6 months, during the treatment period, five patients experienced unusually and unexpectedly high viral loads and LFTs level in the middle of therapy tenure and then sudden decline of viral titers after completion of treatment. This is the first study to describe the unusual response shown by patients treated with sofosbuvir-based combined therapy that experienced abrupt and marked rise in viral loads during the initial months of treatment followed by sudden elimination of virus during last 2 months of treatment. Although satisfactory response to DAA is well reported, clinicians and policy makers should deliberate upon the exceptions and ensure the proper implementation of International guidelines with modifications according to this population, if necessary. [ABSTRACT FROM AUTHOR]

Irreversible electroporation (IRE) is a relatively new ablation modality that uses electric currents to cause cell death. It is commonly used to treat primary and secondary liver tumors in patients with normal liver function and preexisting cirrhosis. Retrospective analysis of 205 procedures sought to evaluate changes in liver function after IRE. Liver function tests (LFTs) results before and after IRE were evaluated from 174 procedures in 124 patients. Aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase (ALKP), and total bilirubin levels were analyzed. The study was Health Insurance Portability and Accountability Act compliant and institutional review board approved. Informed consent was waived. Changes in LFT results after IRE were compared with baseline and were followed up over time to see if they resolved. Changes were compared with volume of ablation. The greatest perturbations were in transaminase levels. The levels increased sharply within 24 hours after IRE in 129 (74.1%) procedures to extreme levels (more than 20 times the upper limit of normal in one-third of cases). Resolution occurred in 95% and was demonstrated to have occurred by a mean of approximately 10 weeks, many documented as early as 7 days after procedure. ALKP levels elevated in 10% procedures, was slower to increase, and was less likely to resolve. Total bilirubin level demonstrated 2 different patterns of elevation--early and late--and similar to ALKP, it was more likely to remain elevated. There was no increased risk in patients with cirrhosis or cholangiocarcinoma. There was no correlation of levels with volume of ablation. IRE results in significant abnormalities in LFT results, but in most of the cases, these are self-limiting, do not preclude treatment, and are similar to the changes seen after radiofrequency and cryoablation in the liver. [ABSTRACT FROM AUTHOR]

Abstract: Al2O3/Ag/Al2O3 multilayer passivation prepared by plasma damage-free linear facing target sputtering (LFTS) was investigated as a function of inserted Ag thickness. Using antireflection effect of the Ag layer that is sandwiched between dielectric Al2O3 layers, we can obtain a transparent Al2O3/Ag/Al2O3 multilayer passivation for organic light emitting diodes (OLEDs). It was found that insertion of the Ag layer with optimized thickness between Al2O3 layers lead to improvement of the optical transparency and water vapor transmission rate of the Al2O3/Ag/Al2O3 multilayer. In addition, current density–voltage–luminescence of an OLED passivated with Al2O3/Ag (10nm)/Al2O3 multilayer was similar to that of an OLED with nonpassivated sample, indicating that the performance of an OLED is not affected by high-density plasma during the LFTS process. Moreover, the lifetime to half initial luminance of an OLED passivated with Al2O3/Ag (10nm)/Al2O3 multilayer was longer than that of a nonpassivated sample. [Copyright &y& Elsevier]

Abstract: We have investigated the characteristics of transparent and flexible PEDOT:PSS electrodes passivated by thin InZnSnO (IZTO) film for flexible organic solar cells (FOSCs). Using damage-free linear facing target sputtering (LFTS), an IZTO passivation layer was deposited on the gravure printed PEDOT:PSS electrode without causing plasma damage. The thickness of the IZTO passivation layer was found to critically affect electrical and optical properties of the IZTO/PEDOT multilayer because the continuity and morphology of the thin IZTO passivation layer were greatly influenced by thickness. At optimized IZTO passivation thickness of 20nm, the IZTO/PEDOT:PSS multilayer electrode exhibited decreased sheet resistance of 353.6Ω/sq and optical transmittance of 83.09% without flexibility degradation. The FOSC with an optimized IZTO/PEDOT:PSS electrode showed better performances than the FOSC with PEDOT:PSS electrodes due to the effect of a stable IZTO passivation layer. This indicates that IZTO passivation on the PEDOT:PSS electrode using a LFTS is one of the key solutions for improving the properties and stability of flexible PEDOT:PSS electrodes for high performance FOSCs. [Copyright &y& Elsevier]

The bacterium Listeria monocytogenes ubiquitously occurs in the environment but can cause severe invasive disease in susceptible individuals when ingested. We recently identified the L. monocytogenes genes lieAB and lftRS, encoding a multidrug resistance ABC transporter and a regulatory module, respectively. These genes jointly mediate resistance against aurantimycin, an antibiotic produced by the soil-dwelling species Streptomyces aurantiacus, and thus contribute to the survival of L. monocytogenes in its natural habitat, the soil. Repression of lieAB and lftRS is exceptionally tight but strongly induced in the presence of aurantimycin. Repression depends on LftR, which belongs to subfamily 2 of the PadR-like transcriptional repressors. To better understand this interesting class of transcriptional repressors, we here deduce the LftR operator sequence from a systematic truncation and mutation analysis of the PlieAB promoter. The sequence identified is also present in the PlftRS promoter but not found elsewhere in the chromosome. Mutational analysis of the putative operator in the PlftRS promoter confirmed its relevance for LftR-dependent repression. The proposed operator sequence was sufficient for DNA binding by LftR in vitro, and a mutation in this sequence affected aurantimycin resistance. Our results provide further insights into the transcriptional adaptation of an important human pathogen to survive the conditions in its natural reservoir. [ABSTRACT FROM AUTHOR]

Drug induced liver damage remains a prevalent concern in healthcare and may reduce the effectiveness of therapy by compromising therapeutic regimens. Many Commiphora species are known for their medicinal properties, and some of them are used traditionally for hepatoprotective effect. In the course of our drugs discovery from natural sources, phytosterols (lophenol (Lop) and lathosterol (Lat)), isolated from Commiphora kua were studied to evaluate their hepatoprotective effects in acetaminophen (APAP) induced hepatotoxicity in mice. To evaluate the hepatoprotective effects of phytosterols isolated from C. kua using in vivo experimental model. Mice of either sex were divided into 7 groups: Vehicle, silymarin (SLY), acetaminophen (APAP), Lop 25, Lop 50, Lat 25, Lat 50 (n = 5). Vehicle group received only vehicle (0.1% DMSO solution) for 7 days, APAP group received single dose of acetaminophen on day 7 and SLY group received silymarin for 7 days. Lop 25 and Lop 50 received low and high doses of Lop (25 μg/kg BW and 50 μg/kg BW), respectively, for 7 days, while Lat 25 and Lat 50 received low and high doses of Lat (25 μg/kg BW and 50 μg/kg BW) for 7 days. On day 7, all animals except Vehicle group kept fasted for 18 h and received APAP i. p. 400 mg/kg BW. After 20 h of APAP administration, the animals anesthetized with light chloroform and scarified by cervical decapitation. The blood serum and liver tissue samples were collected for biochemical and histopathological analysis. Liver function tests (LFTs) including lactate deydrogenase (LDH), alkaline phosphatase (ALP), alanine transaminase (ALT), aspartate transaminase (AST) and direct bilirubin) were used as biochemical parameters. While catalase (CAT), superoxide dismutase (SOD) and reduced glutathione (GSH) were taken as anti-oxidant enzymes. Significant increase in levels of ALT, AST, ALP, LDH and direct bilirubin, and significant decrease in concentration of anti-oxidant enzymes (SOD, CAT and GSH) was observed in APAP-treated group. Similarly, histological slides showed obvious signs of damage to liver cells, reflecting acetaminophen induced hepatotoxicity. Treatment of test animals with phytosterols resulted in significant recovery of LFTs profile and concentration of anti-oxidant enzymes. Similarly, significant improvement of liver tissues was noted in histological analysis. Both phytosterols possessed hepatoprotective potential and should be further evaluated for acute toxicity studies and pharmacokinetics/pharmacodynamics profile. Image 1 [ABSTRACT FROM AUTHOR]

Background The current pandemic of the novel coronavirus disease (COVID-19) is a global health challenge. Pulmonary dysfunction is the main outcome of COVID-19 infection. In critically ill patients, however, liver complications have also been reported. Thus, we conducted a systematic review and meta-analysis to draw generalized conclusions regarding impaired liver biochemistry and its potential relationship with COVID-19 disease severity. Materials and Methods We searched the PubMed, Scopus, and Web of Science databases for all the related literature published up to June 20, 2020. The data were analyzed using R statistical software. A random-effects model was employed for pooling the data. The risk of bias and quality of included studies was assessed using the modified Newcastle-Ottawa Scale (NOS) for cohort studies. Results The present meta-analysis comprises 10 retrospective and two prospective studies (6,976 COVID-19 patients). The serum analysis revealed significantly higher levels of alanine aminotransferases and aspartate aminotransferases and significantly lower albumin levels. Moreover, insignificant increases in serum levels of total bilirubin were observed. Upon subgroup analysis of six studies (severe cases, n=131; non-severe cases, n=334) stratified on the basis of disease severity, we found that these abnormalities were relatively higher in severe cases of COVID-19 (albumin [weighted mean difference (WMD), 34.03 g/L; 95% CI, 27.42 to 40.63; p<0.0001; I 2 =96.83%); alanine transaminase (ALT) [WMD, 31.66 U/L; 95% CI, 25.07 to 38.25; p<0.0001; I 2 =55.64%]; aspartate aminotransferase (AST) [WMD, 41.79 U/L; 95% CI, 32.85 to 50.72; p<0.0001; I 2 =51.43%]; total bilirubin [WMD, 9.97 μmol/L; 95% CI, 8.46 to 11.48; p<0.0001; I 2 =98%]) than in non-severe cases. Conclusion Deranged liver enzymes serve as prognostic factors to assess the severity of COVID-19. Liver markers should, therefore, be observed and monitored continuously., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Abdulla et al.)

Oral 5 aminolevulinic acid (5-ALA) is used to assist surgical resection of malignant tumours in the brain and other locations. Hypotension and alteration of liver functions have been reported as potential adverse effects. This study was designed to assess the incidence and contributing factors that cause 5-ALA induced side effects in a cohort of 90 patients. Hypotension occurred in 11% of patients irrespective of 5-ALA dose. The only contributing factor was the presence of cardiovascular disease and antihypertensive drug therapy with an odd ratio of 17.7. Liver function were disturbed in 2% in patients who received 20mg or less/kg body weight compared to 4% in those who received a dose of >20mg/kg 5-ALA. The liver dysfunction was minor and was not clinically significant. We concluded that 5-ALA induced side effects were minimal and hypotension more likely to occur in patients receiving antihypertensive drug therapy., (Copyright © 2013 Elsevier B.V. All rights reserved.)

Ibandronate is a widely used bisphosphonate with no previously well documented hepatotoxicity. We report the first case of ibandronate-related hepatotoxicity and, to our knowledge, the first case of immune-mediated drug-induced liver injury (DILI) related to bisphosphonates., (Copyright © 2013 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.)

Purpose: The purpose of this guideline is to provide a clinical framework for follow-up of clinically localized renal neoplasms undergoing active surveillance, or following definitive therapy., Materials and Methods: A systematic literature review identified published articles in the English literature between January 1999 and 2011 relevant to key questions specified by the Panel related to kidney neoplasms and their follow-up (imaging, renal function, markers, biopsy, prognosis). Study designs consisting of clinical trials (randomized or not), observational studies (cohort, case-control, case series) and systematic reviews were included., Results: Guideline statements provided guidance for ongoing evaluation of renal function, usefulness of renal biopsy, timing/type of radiographic imaging and formulation of future research initiatives. A lack of studies precluded risk stratification beyond tumor staging; therefore, for the purposes of postoperative surveillance guidelines, patients with localized renal cancers were grouped into strata of low- and moderate- to high-risk for disease recurrence based on pathological tumor stage., Conclusions: Evaluation for patients on active surveillance and following definitive therapy for renal neoplasms should include physical examination, renal function, serum studies and imaging and should be tailored according to recurrence risk, comorbidities and monitoring for treatment sequelae. Expert opinion determined a judicious course of monitoring/surveillance that may change in intensity as surgical/ablative therapies evolve, renal biopsy accuracy improves and more long-term follow-up data are collected. The beneficial impact of careful follow-up will also need critical evaluation as further study is completed., (Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.)