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PubMed1991

[The effect of partial splenic embolization (PSE) on liver function test in patients with liver cirrhosis].

Five patients with hypersplenism associated with liver cirrhosis were treated by PSE and the changes of peripheral blood cells and liver function tests were observed. After PSE, all patients had a high fever and abdominal pain continued for a few weeks without severe complications. Peripheral blood cell counts improved soon after PSE and liver function tests (hepaplastin test and ICGR15) grew transiently worse, but they also improved within two months. During 4.5 to 10 months, the levels of albumin and total cholesterol of three patients increased, although the changes of bilirubin level and HPT were not shown. For other two patients, it was difficult to estimate the effect of PSE, because one patient was treated at the same time with lipiodol chemoembolization for HCC and another patient had a progress of nephrotic syndrome. On the other hand, ICG levels were stable after PSE but RI-uptake on liver scintigram increased in the liver. These results suggest that PSE may be able to improve not only hypersplenism but also liver function in the patients with compensated liver cirrhosis without severe complication.

Blood Cell Count↗
PubMed1990

Differential regulation of liver P-450III cytochromes in choline-deficient rats: implications for the erythromycin breath test as a parameter of liver function.

Progressive liver fibrosis in rats develops when they are fed a diet deficient in choline. This diet also results in a pronounced and selective decrease in the liver microsomal content of a phase I drug-metabolizing enzyme belonging to the cytochrome P-450III gene family. Because P-450III cytochromes characteristically catalyze the N-demethylation of erythromycin, we believed that the production of breath CO2 from erythromycin would be dramatically reduced in choline-deficient rats. However, when 12 choline-deficient rats were compared with 9 control rats, the reduction in CO2 production from erythromycin (mean decrease 71%) was essentially identical to that from aminopyrine (mean decrease 69%), a substrate believed to be metabolized normally by the hepatocyte in fibrotic liver disease. Furthermore, we found that the relative erythromycin and aminopyrine demethylase activities were comparable when measured in vitro in liver microsomes prepared from the choline-deficient rats. To determine the molecular basis for the erythromycin demethylase activity in the choline-deficient rats, the liver microsomes were subjected to immunoblot analysis using a variety of polyclonal and monoclonal antibodies capable of distinguishing individual P-450III-related proteins. Our studies confirm that a major erythromycin demethylase belonging to the P-450III family, termed P-450p, was greatly reduced in the choline-deficient rat liver. However, the specific concentration of a second P-450p-related protein was essentially normal and that of a third P-450p-related protein was actually increased in the choline-deficient rat liver.(ABSTRACT TRUNCATED AT 250 WORDS)

Aminopyrine↗
PubMed1975

The effect of hepatic ischaemia on liver function and the restoration of liver mass after 70 per cent partial hepatectomy in the dog.

Partial hepatectomy was performed in dogs either as the only procedure or following a period of ischaemia of liver remnant produced by inflow occlusion for periods of 30-60 minutes before partial hepatectomy. Temporary portal decompression was maintained through the portion of liver subsequently excised. 1. Survival in dogs subjected to partial hepatectomy and ischaemia to the liver remnant was similar to that in animals after partial hepatectomy alone. 2. Metabolic changes were similar in both groups but dogs submitted to partial hepatectomy and ischaemia to the remnant had higher serum alkaline phosphatase and alanine amino-transferase levels with increased bromsulphthalein in the fourth to sixth post-operative weeks. 3. Replacement of liver mass proceeded rapidly in all groups of animals. It is concluded that ischaemia of the liver remnant for up to 60 minutes preceding partial hepatectomy in the dog is consistent with survival and produced little change in postoperative liver function or in the rate of restoration of liver mass.

Alanine Transaminase↗
PubMed1989

Lignocaine metabolite formation as a measure of pre-transplant liver function.

A method for rapid assessment of hepatic function in liver donors based on the formation of the lignocaine metabolite monoethylglycinexylidide (MEGX), was used in a prospective study of 69 donor-recipient pairs. The probability of graft survival over 120 days was significantly higher for livers from donors with MEGX test values above 90 micrograms/l than for those from donors with MEGX values of 90 micrograms/l or below. Other liver function tests (bilirubin, prothrombin time, activity of aminotransferases, glutamate dehydrogenase, and cholinesterase, indocyanine green clearance, and galactose elimination capacity) were inefficient at predicting early outcome of transplantation. For a 20-day graft survival, the MEGX test showed prognostic sensitivity of 73% and specificity of 78%. These findings suggest that the MEGX formation test could be valuable for selection of donor organs.

Adolescent↗
PubMed1989

Persistent impairment of liver function caused by a pendulated accessory liver lobe.

A large pendulated accessory liver lobe and complete absence of the left lobe were discovered by liver scintigraphy and ultrasound scanning in a patient suspected of having an ovarian tumor. The patient had a history of fluctuating impaired liver function tests for many years, probably caused by intermittent torsion of the peduncle. Pedunculated accessory liver lobes are extremely rare and seldom diagnosed in vivo. Our patient seems to be the 11th published case, and the only 1 in which longstanding fluctuating impaired liver function tests have been observed.

Adult↗
PubMed1989

Superiority of the Child-Pugh classification to quantitative liver function tests for assessing prognosis of liver cirrhosis.

To evaluate the prognostic value of quantitative liver function tests in comparison with established prognostic variables, the data of 47 patients with liver cirrhosis were analysed. A total of 16 variables, comprising the galactose elimination capacity and the indocyanine green clearance, the Child-Pugh classification, and several clinical and biochemical variables were subjected to Kaplan-Meier life-table analysis and Cox proportional hazards regression analysis. As independent variables, poor prognosis was associated significantly with increasing Child-Pugh score (p less than 0.00001), whereas the galactose elimination capacity (p = 0.03) and the indocyanine green clearance (p less than 0.001) were less sensitive indicators. The regression analysis showed prognostic value in decreasing sequence for Child-Pugh classification, age, sex, history of upper GI haemorrhage, and alkaline phosphatase activity. The quantitative liver function tests evaluated in the present work have less prognostic value than routinely accessible variables.

Adult↗
PubMed1976

Liver function tests following anaesthesia.

Liver function tests were performed in 41 patients who required repeated anaesthetics for genito-urinary surgery, and who had received multiple halothane anaesthetics in the past, first following anaesthesia using halothane and then following an anaesthetic without halothane. There was a smaller frequency of disturbance of liver function after halothane than after the non-halothane anaesthetic. There was no obvious relationship between the number of anaesthetics, or the total duration of anaesthesia, and the disturbance of liver function tests.

Aged↗
PubMed1976

Susceptibility of the liver and biliary tract to anaerobic infection in extrahepatic biliary tract obstruction. II. Liver function and morphology of the liver and biliary tract--an experimental study in rabbits.

Biliary tract infection with anaerobic bacteria (B. fragilis or Fusobacterium mortiferum) was produced in rabbits by common duct ligation (c.d.l.) 3 days prior to intravenous bacterial inoculation. Animals were investigated 1, 4 or 7 days after inoculation. Histopathological investigations included the liver, the common duct, and the gallbladder, while liver function was evaluated by bilirubin, alkaline phosphatase (AP), and L-alanine aminotransferase (GPT) in serum. Rabbits with c.d.l. and biliary tract infection were compared to rabbits with c.d.l. in which bacterial inoculation failed to produce infection, to inoculated rabbits without c.d.l., and to uninoculated rabbits with c.d.l. Anaerobic biliary tract infection in rabbits with c.d.l. caused a significant increase in liver abscesses, a significant increased infiltration with granulocytes in the gallbladder, and a significant increase in serum levels of bilirubin, AP, and GPT, but failed to produce signs of cholangitis in the liver and intramural abscesses in the gallbladder. A material is presented of normal values for bilirubin, AP, and GPT in serum in rabbits.

Alkaline Phosphatase↗
PubMed1990

Liver regeneration and restoration of liver function after partial hepatectomy in patients with liver tumors.

Liver regeneration and restoration of liver function were studied in six patients who underwent partial hepatectomy with removal of 30-70% of the liver. Liver volume and liver regeneration were studied by single-photon computed tomography (SPECT), using 99mTc-colloid as tracer. The method was assessed in 11 patients by comparing the pre- and post-operative volume measurements with the volume of the resected liver mass. The correlation coefficient between these methods was 0.899 (P less than 0.01). Liver function was determined by measuring the galactose elimination capacity and the caffeine clearance. After a postoperative follow-up period of 50 days the liver had regenerated maximally to a volume of 75 +/- 2% of the preoperative liver mass. Maximal restoration of liver function was achieved 120 days after operation and amounted to 75 +/- 10% for the caffeine clearance and to 100 +/- 25% for the galactose elimination capacity. This study shows that SPECT is a useful method for assessing liver regeneration in patients after partial hepatectomy. Our study furthermore shows that caffeine clearance correlates well with total liver volume, whereas the galactose elimination capacity overestimates total liver volume after partial hepatectomy.

Adult↗
PubMed1989

[The effects of exercise on liver function in patients with chronic liver disease].

This study examined the effect of exercise on liver function in patients with chronic liver disease (CLD). 1) Twenty-five patients with CLD (21 with chronic hepatitis (CH) and 4 with liver cirrhosis (LC] and 10 healthy subjects were administered an exercise test employing a treadmill. The load applied was 6.5 Mets and was administered for a period of 10 min. The serum levels of S-GOT, S-GPT, LDH, CPK, triglyceride, GOTm and GLDH were measured before exercise and 1 h, 24 h and 7 days after exercise in the patients with CLD, and before and 24 h after exercise in the healthy subjects. i. The patients with CLD showed an increase in GLDH 24 h after exercise (p less than 0.005), a decline in LDH 1 h (p less than 0.05) and 24 h (p less than 0.01) after exercise, and a decrease in triglyceride 24 h after exercise (p less than 0.005) as compared with pre-exercise values. No significant changes were observed in S-GOT, S-GPT, CPK or GOTm levels. ii. The mean values and standard deviations (SD) of S-GOT and S-GPT during the 3-month period immediately preceding the study were calculated for all 25 patients. Increases in S-GOT of more than 1 SD were observed after exercise in 5 patients (20%); another 5 patients (20%) showed similar increases in S-GPT. The number of overlapping cases in which increases in both S-GOT and S-GPT were observed was 2 (8%). iii. No significant differences were found in mean HR during exercise/predicted max HR, or mean BP during exercise between patients with increased S-GOT and those without, or between patients with increased S-GPT and those without. iv. In the healthy subjects, there was a significant increase in GOTm (p less than 0.05) following exercise, but no such increase in S-GOT, S-GPT, CPK or GLDH. 2) The number of steps taken per day measured by a pedometer was selected as a parameter of daily exercise and examined in 14 patients with CLD (9 with CH and 5 with LC). No significant correlation was found between mean number of walking steps and S-GOT and S-GPT levels for patients with either type of CLD. The results of this study indicate that moderate exercise was well tolerated in the majority of patients with CLD.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1975

Liver damage after paracetamol overdose. Comparison of liver-function tests, fasting serum bile acids, and liver histology.

54 patients have been studied after paracetamol (acetaminophen) overdose. Liver-function tests and fasting serum bile-acids were measured daily; liver biopsy was done in all cases, and slides were examined "blind" to assess liver damage. The plasma-paracetamol was measured on one occasion. A histological abnormality was present in the livers of 53 of the 54 patients, and was minor in 23, moderate in 16, and severe in 14. In 6 patients with moderate and 18 with mild histological abnormality liver-function tests were normal. A serum-aspartate-aminotransferase above 400 units/1 was always associated with severe histological liver damage. Fasting serum bile-acids were raised in 51 of the patients with abnormal liver histology; the serum-bile-acid seemed to be a more sensitive indicator of mild liver-cell damage than was the transaminase level. There was, however, little correlation between increase in bile-acid concentration and the degree of histological abnormality. As a result of these investigations empirically determined levels of plasma-paracetamol have been drawn which give a guide to the likelihood of liver damage after paracetamol overdose.

Acetaminophen↗
PubMed1990

Liver function in normal pregnancy.

Liver function tests were measured in a longitudinal study of 64 women throughout normal pregnancy. Standard liver function tests and postprandial levels of cholesterol, triglycerides, protein and albumin were measured at each visit. Serum alkaline phosphatase, cholesterol and triglyceride levels increased significantly throughout pregnancy (p less than 0.001) while serum transaminases and bilirubin remained within the normal range. Total protein and albumin levels decreased significantly (p less than 0.001).

Adult↗
PubMed1992

The effects of supra-therapeutic doses of rifampicin on liver function in the perfused rat liver.

The isolated liver perfusion model was used to study the effects of supra-therapeutic doses of rifampicin on hepatic gluconeogenesis and bromosulphthalein (BSP) clearance from the perfusate and biliary excretion of the dye in the rat. Three groups of rats randomly assigned to a control and two experimental groups were studied; those in the experimental groups were given 4 mg rifampicin per os daily for 90 days. The control group was untreated. The livers of the control and one experimental group were perfused with a medium containing pyruvate and subsequently these livers were perfused with a medium containing bromosulphthalein. The livers of the second experimental group were subjected to histological examination. The rate and the concentration of glucose was decreased, lactate levels and lactate: pyruvate ratios were increased in the experimental animals. The mean perfusate BSP and biliary excretion of the dye was decreased in the experimental group. Fatty change was present in the livers of rifampicin treated rats. This study demonstrates that the isolated liver model has proved to be both suitable and useful for the study of the effects of drugs and that chronic administration of supra-therapeutic doses of rifampicin to rats adversely affected liver function. It also produces histological evidence of hepatic damage in rats.

Animals↗