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Metabolic Brain Disease

, Volume 12, Issue 2, pp 161–169 | Cite as

Measurement of the expiratory ammonia concentration and its clinical significance

  • Hiroyuki Wakabayashi
  • Yoshihiro Kuwabara
  • Hiroyuki Murata
  • Kyoich Kobashi
  • Akiharu Watanabe
Original Contributions

Abstract

Alghough gaseous ammonia (NH3) can freely enter cells through the plasma membrane where NH3 is cyto(neuro)toxic, NH3 and ionic ammonia (NH4 +) contents have not been studied in biological materials. We developed a new method for measurement of expiratory NH3 concentration, which may reflect blood NH3 concentrations. The method is a sensor tube type-gas assay system. Expiratory NH3 concentrations in patients with chronic liver diseases increased when their blood ammonia (NH4 ++NH3) concentrations increased above 90 μg/dl (normal range; 12–66 μg/dl). However, cirrhotic patients, who had relatively higher expiratory NH3 concentration compared to blood NH3 concentrations (calculated from Henderson-Hasselbalch formula), were found to have subclinical encephalopathy. Measurement of experatory NH3 concentration may be of clinical significance for the diagnosis of encephalopathy associated with hyperammonemia.

Key words

Ammonia NH4+ gaseous ammonia expiratory air hepatic encephalopathy liver cirrhosis 

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Copyright information

© Plenum Publishing Corporation 1997

Authors and Affiliations

  • Hiroyuki Wakabayashi
    • 2
  • Yoshihiro Kuwabara
    • 2
  • Hiroyuki Murata
    • 2
  • Kyoich Kobashi
    • 1
  • Akiharu Watanabe
    • 2
  1. 1.Department of Biological Chemistry, Faculty of Pharmaceutical ScienceToyama Medical and Pharmaceutical UniversityToyamaJapan
  2. 2.The Third Department of Internal Medicine, Faculty of MedicineToyama Medical and Pharmaceutical UniversityToyamaJapan

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