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PubMed1982

Studies on recovery of liver function of operated biliary atresia.

Serial liver function studies were analyzed in 42 biliary atresia patients who had undergone portoenterostomy. Values for serum bilirubin, ZTT, TTT, and gamma globulin returned to normal levels three months after operation in patients with good bile excretion. These tests remained abnormal in those with poor bile output. Alkaline phosphatase and serum transaminase values remained high during the early postoperative period, requiring a much longer duration to return to normal. The biological activity of sulfobenzyl penicillin (SBPC) in the serum and bile was determined by serial broth dilution in 15 children with biliary atresia. Eleven patients were studied 10 days to 2 weeks after an apparent successful portoenterosotomy while four others were clinically well and anicteric three to four years postoperatively. The biliary concentration of SBPC was very low despite good bile output during the early postoperative period. The SBPC levels increased three time during the remote postoperative period. The bile concentration of SBPC is lower than normal, however, and it seems that the ability of the liver to excrete this material may never reach normal levels despite apparent good clinical hepatic function.

Alanine Transaminase↗

PubMed1994

The usefulness of biliary drainage for restoring liver function in obstructive jaundice.

In eighty patients with obstructive jaundice treated with percutaneous or endoscopic drainage, the results of biochemical liver-function tests (serum bilirubin, transaminase, gamma-glutamyl transferase, alkaline phosphatase, and albumin) were analyzed to evaluate the return of liver function after biliary decompression. Before decompression all the patients had increased serum concentrations of all the liver-function indicators measured. Conjugated bilirubin normalized within 7 days in 67.5% of the patients and within 14 days in 94.5%. The other serum responses normalized as follows: glutamic oxaloacetic transaminase (7 days in 45%, 14 days in 100%); glutamic pyruvic transaminase (7 days in 46.2%, 14 days in 100%); gamma-glutamyl transferase (7 days in 56.2%, 14 days in 89.1%); alkaline phosphatase (7 days in 52.5%, 14 days in 90.4%); and albumin (7 days in 100%, 14 days in 90.4%). The low mortality and morbidity rates in this series of patients with obstructive jaundice: 0% and 7% after endoscopic and 2.1% and 10.4% after percutaneous drainage suggest that biliary drainage has a valuable place in the preparation of jaundiced patients for surgery and in some cases provides a definitive intervention.

Adult↗

PubMed2005

Effect of anti-tuberculosis therapy on liver function of pulmonary tuberculosis patients infected with hepatitis B virus.

AIM: To observe the effect of anti-tuberculosis therapy on liver function of pulmonary tuberculosis patients with hepatitis B virus (HBV) infection, and to compare the differences of liver function by two treatments of anti-tuberculosis. METHODS: Forty-seven TB patients with HBV infection and 170 TB patients without HBV infection were divided into HPBE(S) and HLAMKO treatment groups. Liver function tests before and after the treatments were performed once in 2 wk or monthly, and their clinical manifestations were recorded. RESULTS: The rate of hepatotoxicity occurred in 26 (59%) TB patients with HBV during anti-TB treatment, higher than that in 40 (24%) TB patients without HBV. Hepatotoxicity occurred in 66 out of 217 patients, and the incidence of liver dysfunction was 46.1% in HPBE(S) group, significantly higher than that in HLAMKO group (12.7%) (P<0.01). CONCLUSION: TB patients with HBV should choose HLAMKO treatment because of fewer hepatotoxicity.

Adult↗

PubMed1985

[Liver function disorders and damage in critically ill intensive care patients].

The course of the disease of critically ill patients is complicated and prognosis worsened by failure of one or more organs. During intensive care monitoring and treatment of vital functions most attention usually is paid to the cardio-pulmonary and renal system; liver function is neglected rather often. In a retrospective study 100 critically ill patients were evaluated, who had serum bilirubin levels above 3,0 mg/dl, but no primary liver disease. Excluded were patients who had liver destruction caused for instance by liver abscess or metastases, and patients with acute hemolysis and extrahepatic cholestasis. Severe infection was the primary cause of disease in 64% of these critically ill patients without primary liver dysfunction; 52% patients had septicemia, 37% patients were in a post-operative or post-traumatic status, 28% patients had severe gastrointestinal complications, 23% had myocardial pump failure, 32% had protracted shock, 29% had hematological disease, 59% had lung failure, and 58% renal failure. It was tried to find a correlation between the different liver function parameters in this group of patients. In spite of rather pronounced pathological findings a statistically significant correlation could only be found between SGPT and SLDH. This study demonstrates the importance of liver involvement in critically ill patients on the one side and the necessity of comprehensive and repeatedly performed investigations of liver function in such patients on the other side.

Adolescent↗

PubMed1987

Effects of inducer pretreatment on liver function and morphology in the mountain vole Microtus montanus.

Liver function and morphology of the mountain vole, Microtus montanus, were examined after i.p. injections of phenobarbital, beta-naphthoflavone, or Aroclor 1254 at three dose levels. The results of the liver function tests showed serum glutamic pyruvic transaminase and serum malathion carboxylesterase activities were normal in all the treatment groups. The histological results showed no necrotic tissue but did reveal two different morphological stages related to the level of monooxygenase activity; a low induction state was represented by foamy vacuolated hepatocytes while high induction states were related to enlarged, swollen, hypertrophied cells.

Alanine Transaminase↗

PubMed1990

[Transient fever with abnormal liver function in patients underwent bone marrow transplantation--clinical symptom of cytomegalovirus infection].

In seventeen (38.6%) out of forty-four children underwent bone marrow transplantation, transient fever with abnormal liver function tests occurred between 30 and 70 days following bone marrow transplantation. More than half of cases suffered from nausea, anorexia and general malaise. C reactive protein was negative in all but one case, and thrombocytopenia occurred in five cases. Transient fever with abnormal liver function tests occurred more frequently in patients with cytomegalovirus (CMV) infection (63.4%) than in patients without CMV infection (16.0%) (P less than 0.01). Therefore, CMV infection was considered to be the cause of transient fever with abnormal liver function tests. The incidence of transient fever with abnormal liver function tests was not significantly different between the patients with pretransplant positive anti-CMV titer and the patients with pretransplant negative anti-CMV titer. Clinical symptoms improved in 16 patients (93.4%), but fatal CMV interstitial pneumonia followed in one case.

Adolescent↗

PubMed2004

[Studies on the relationship between the level of cytokine and liver function in patients with clonorchiasis sinensis].

OBJECTIVE: To explore the relationship between cytokine level and liver function among patients infected with Clonorchis sinensis. METHODS: 47 patients were divided into three groups according to the degree of Child-Pugh liver function grade: 20 in group A (3-4 scores), 15 in group B (5-6 scores) and 12 in group C (7-9 scores). Interleukin 2 (IL-2), soluble IL-2 receptor (sIL-2R), interleukin 8 (IL-8) and tumor necrosis factor (TNF-alpha) were examined by radioimmunoassay (RIA) and enzyme-linked immunosorbent assay (ELISA). Automatic biochemical analyzer was employed for the determination of serum level of total bilirubin (TBL), albumin (ALB) and alanine aminotransferase (ALT). Data were analyzed with SAS statistic software. RESULTS: Serum levels of sIL-2R, IL-8 and TNF-alpha from patients were significantly higher than those obtained from healthy people (P<0.05, P<0.05, P<0.01), whereas the IL-2 level was significantly lower than the former (P<0.01). With the affected degree of the liver, serum levels of sIL-2R, IL-8 and TNF-alpha increased, in contrast to the decrease of IL-2 level. The differences were significant between groups A and C (P<0.05). The level of sIL-2R and TNF-alpha directly correlated with that of TBL (r=0.331 P<0.05, r=0.518 P<0.01) and ALT (r=0.475 P<0.01, r=0.285 P<0.05) respectively, but inversely correlated with the level of ALB (r=-0.319 P<0.05, r=-0.665 P<0.01). CONCLUSION: The infection of Clonorchis sinensis results in the reduction of cellular immune function of the patients. Certain relationship exists between serum cytokine level and liver function. Two cytokines, sIL-2R and TNF-alpha, are involved in the process of pathology.

Adult↗

PubMed1999

Utility of liver function tests for screening "alcohol abusers" who are not severely dependent on alcohol.

This study evaluated the utility of using liver function tests to identify low dependence outpatient "alcohol abusers" (N = 253) and for evaluating changes in their drinking over the course of treatment. Despite drinking at levels considered to pose a health risk (i.e., drinking on 72% of all days in the year prior to treatment and averaging 6.3 drinks per drinking day), nearly two-thirds had normal liver function tests at treatment entry. It is concluded that for problem drinkers the cost of using liver function tests outweighs the benefits.

Adult↗

PubMed1994

High-dose methotrexate treatment and liver function in patients with osteosarcoma.

OBJECTIVES: To study the effects of short-term high-dose methotrexate therapy on liver function in patients with osteosarcoma. DESIGN: Open prospective study. SETTING: Department of Internal Medicine and Oncology, Istituto Ortopedico Rizzoli, Bologna, Italy. SUBJECTS: Fourteen patients with osteosarcoma, with no evidence of previous or actual liver disease at the time of diagnosis. INTERVENTIONS: All patients received a cumulative dose of 30-57 gm-2 of methotrexate within 6 months as neo-adjuvant chemotherapy (pre- and post-surgery). Each course of chemotherapy included methotrexate at a dose of 8-12 gm-2 and, in addition, adriamycin and cisplatinum. MAIN OUTCOME MEASURES: Galactose elimination capacity and antipyrine clearance were measured at baseline, after the first course of chemotherapy, at the end of the pre-operative period and at the end of chemotherapy. In each case they were carried out after transaminase levels had returned to normal. RESULTS: Galactose elimination capacity decreased from 2.45 (+/- 0.48) mM min-1 to 2.04 (+/- 0.60) mM min-1 after the five planned courses of chemotherapy (P = 0.013, Wilcoxon signed-rank test), without any change in routine liver function tests. No differences in antipyrine clearance and half-life were demonstrated (n = 8). CONCLUSIONS: The data are consistent with a decreased reserve capacity of the liver after short-term, high-dose methotrexate. Long-term survivors deserve monitoring of liver function for safer methotrexate use, in the light of progressive dosage increments to improve prognosis in neoplastic diseases.

Adolescent↗

PubMed1983

Environmental determinants, liver function, and high density lipoprotein cholesterol levels.

High density lipoprotein cholesterol (HDL-chol) is negatively associated with coronary heart disease. Environmental heart disease risk factors may partially be related to coronary heart disease through alterations in HDL-chol concentrations. Little is known about the underlying mechanisms by which environmental factors are related to HDL-chol. The authors investigated a possible mechanism: changes in liver function as a mediating link between risk factors and HDL-chol concentrations in marathon runners, alcoholics, and participants in the Multiple Risk Factor Intervention Trial. Liver function, as measured by liver enzymes, was related to both coronary heart disease risk factors and alcohol consumption, suggesting that the increased levels of HDL-chol associated with alcohol were primarily the result of changes in liver function. The relationship of obesity to HDL-chol could not be explained by the alterations in liver function.

Adult↗

PubMed2001

Treatment of hepatocellular carcinoma and the exacerbation of liver function.

We performed interventional treatments on 50 patients with hepatocellular carcinoma (HCC) and analyzed the relationship between these treatments and the exacerbation of liver function after treatment. The different treatments included transcatheter arterial embolization (TAE), percutaneous ethanol injection therapy (PEIT), selective segmental sclerotherapy (SSS), combined TAE and PEIT, or transcatheter arterial chemo-injection (TAI). Thirteen patients showed an exacerbation of liver function after treatment. The laboratory data on admission, showed the lower levels of serum albumin and cholinesterase in this group. In comparison to patients who did not show any exacerbation of liver function, these 13 patients had undergone combined TAE and PEIT. An analysis of cases after TAE and PEIT treatment revealed that the time from TAE to PEIT was shorter in the exacerbation group than in the non-exacerbation group, however, there was no significant difference in the amount of injected ethanol between the two groups. It is assumed that the values of albumin and cholinesterase before treatment, or the period from TAE to PEIT are related to liver failure after treatment. Combining TAE and PEIT treatment may be effective for HCC, however, we should pay special attention to liver failure after treatment.

Administration, Cutaneous↗

PubMed1999

Pharmacokinetics and pharmacodynamics of lobaplatin (D-19466) in patients with advanced solid tumors, including patients with impaired renal of liver function.

The purpose of this study was to determine the influence of impaired renal and liver function on the pharmacokinetics and pharmacodynamics of lobaplatin in cancer patients. A total of 25 patients with advanced solid tumors not amenable for standard treatment entered the study. Patients had normal organ function or an impaired liver or renal function (two levels). The starting dose of lobaplatin was 50 mg/m2 i.v. given every 3 weeks. The blood and urine of all patients were sampled for the determination of (ultrafilterable) platinum, intact lobaplatin, creatinine, and blood cell counts. No objective responses were recorded. Five patients experienced no change and received 4-10 cycles (median, 6 cycles) of lobaplatin. The extent and duration of hematological toxicity were worse in patients with impaired renal function. Thrombocytopenia was most prominent; grade 4 toxicity was observed in 15 patients in the first two cycles of treatment. The concentration-time curves of ultrafilterable platinum and intact lobaplatin revealed almost identical patterns. The elimination of ultrafilterable platinum [final half-life (t1/2 final) = 131+/-15 min; clearance (Cl) = 125+/-14 ml/min/1.73 m2] was much faster than that of total platinum (t1/2 final = 6.8+/-4.3 days, CI = 34+/-11 ml/min/1.73 m2). No pharmacokinetic differences were observed between patients with normal organ function and those with an impaired liver function within the investigated range. An impaired renal function resulted in an increase of the t1/2 final due to a decrease of the total body Cl that resulted in a higher exposure of the body to the drug. The calculated creatinine Cl was linearly correlated with the total body clearance of ultrafilterable platinum (r = 0.91), which resulted in the dosage formula D = AUCinfinity (1.1 Cl(CrU) + 16), in which D represents dose, AUC represents area concentration-time curve, and Cl(CrU) represents creatinine Cl. The thrombocyte surviving fraction correlated well with the AUC value of ultrafilterable platinum (r = 0.72). It can be concluded that the hematological toxicity and the pharmacokinetics of lobaplatin are strongly affected by renal function. The total body Cl of ultrafilterable platinum correlated well with the creatinine Cl and the thrombocyte surviving fraction. In patients with renal function, represented by a creatinine clearance > or =30 ml/min/1.73 m2, the derived dosage formula will enable us to calculate the dose that is expected to lead to an acceptable extent of thrombocytopenia in a patient with a given renal function. Prospective studies with larger groups of patients are needed to prove the value of this dosage formula.

Adult↗

PubMed1989

[Effect of li dan ling in decreasing jaundice and improving liver function in patients with obstructive jaundice].

A total of 89 cases with extrahepatic jaundice were studied clinically. All patients were divided into two groups at random: control group and Li Dan Ling treatment group. It was found that: (1) liver functions in the patients with obstructive jaundice were injured severely; bilirubin, R15ICG, m-GOT, and gamma-GT were increased significantly; (2) in patients with incomplete biliary obstruction or after the relief of obstruction, liver functions could be improved gradually. They were improved more quickly in patients of the Li Dan Ling treatment group; (3) for the patients suffering from complete biliary tract obstruction, until the obstruction was relieved liver function could not be improved. After the herbal medicine, all the indicators would be further worsened before the relief of the obstruction, and the value of "b" would be positive. The increase in m-GOT and gamma-GT was higher than in the control group, indicating the liver functions were further injured. Therefore, the herbal cholegogue was not suitable for the patients before the obstruction was relieved. The further investigations showed that excretion of bilirubin from the bile could be accelerated by Li Dan Ling, and after herbal administration, the cholesterol level in bile was lowered significantly; the liver blood flow in normal and jaundiced rats would be increased 30 to 90 min. after administering the herbs.

Adult↗

PubMed2002

Serum thrombopoietin levels are linked to liver function in untreated patients with hepatitis C virus-related chronic hepatitis.

BACKGROUND: Thrombocytopenia can be found in patients with chronic hepatitis related to hepatitis C virus (HCV). Both hypersplenism and decreased liver production of thrombopoietin (TPO) have been hypothesized as mechanisms responsible for thrombocytopenia. AIMS: To assess the presence of relationships among platelet count, spleen size, TPO serum levels, liver histology, and liver function in a group of patients with HCV-related chronic hepatitis. METHODS: Platelet count, TPO serum levels, and spleen size were assessed in 25 untreated HCV positive chronic hepatitis patients undergoing liver biopsy. These parameters were correlated to liver histology and liver function as evaluated by means of [(13)C]aminopyrine breath test (ABT). RESULTS: Both platelet counts (146 +/- 48 vs. 202 +/- 56 x 10(9)/1, P < 0.03) and TPO serum levels (103 +/- 24 vs. 158 +/- 7 1 pg/ml, P < 0.02) were lower among patients with high fibrosis scores as compared to patients with low fibrosis scores. Patients with thrombocytopenia as well as patients with high fibrosis scores had lower ABT results as compared to patients with normal platelet counts and patients with no or mild fibrosis, respectively. TPO serum levels were correlated to platelet count (r(s) = 0.493, P = 0.016), and negatively correlated to fibrosis stage (r(s) = -0.545, P = 0.008). Lastly, low TPO serum levels were associated to a decrease in liver function. CONCLUSIONS: Our study showed that in patients with chronic hepatitis related to HCV infection serum TPO levels are correlated to liver functional impairment and to the degree of liver fibrosis.

Adult↗

PubMed1991

Liver function in early congenital syphilis: does penicillin cause a deterioration?

In this prospective study, neonates with clinical congenital syphilis were investigated to determine if penicillin therapy caused a deterioration in liver function. The relationship between circulating immune complexes and liver involvement was monitored, and the efficacy of steroid therapy as an adjunct in the treatment of congenital syphilis was investigated. Thirty neonates with clinical congenital syphilis were randomly assigned into two groups: one group received penicillin therapy only, and the other group penicillin and prednisone as an adjunct. Twenty-one infants who did not have clinical or serological syphilis, born to seropositive mothers, served as a "control" group. Liver function tests, full blood counts, and immunological studies were performed at various intervals up to 3 months of age. Although the symptomatic groups differed significantly from the asymptomatic group in most of the parameters measured, there were no significant differences noted between the two symptomatic groups at any time point. No direct relationship between penicillin therapy and either deteriorating liver function or the presence of circulating immune complexes could be demonstrated. Also, prednisone therapy did not modify any of the parameters studied.

Antigen-Antibody Complex↗

PubMed2004

Isolated idiopathic bile ductular hyperplasia in patients with persistently abnormal liver function tests.

BACKGROUND/AIMS: In routine examination of liver biopsies isolated ductular hyperplasia (IDH) may be the only histopathological change. Here we describe the clinical and immunophenotypic features of a number of cases retrospectively identified reviewing consecutive liver biopsies from five Italian centers over 4 years. METHODS: We reviewed 1235 cases biopsied for chronic liver disease (1078 for viral hepatitis). Records of cases fulfilling the inclusion criteria for IDH were reviewed to identify possible aetiologies. Biopsies showing IDH and control biopsies were studied by immunohistochemistry for cytokeratin-7, epithelial-membrane-antigen (EMA), neural-cell-adhesion-molecule (NCAM), Ki-67. RESULTS: Out of 70 biopsies fulfilling IDH criteria, 16 (22.8%) were of unknown aetiology. Patients with idiopathic IDH (age 38.2+/-11 years) were asymptomatic with mild, long-lasting ALT and/or gammaGT increases. A significant increase of well-differentiated (EMA-positive; NCAM-negative) bile ductules localized at the portal interface and inside the lobule was found in idiopathic IDH. CONCLUSIONS: Idiopathic IDH was present in 10% of adults biopsied for persistent mild liver function test abnormalities unrelated to viral hepatitis. In contrast with the ductular reaction seen in many forms of liver disease, it is characterized by well-differentiated hyperplastic ductules in absence of significant inflammation, and may represent a non-specific pattern of reaction to mild liver damages.

Adolescent↗

PubMed1986

Effect of abnormal liver function on vitamin E status and supplementation in adults with cystic fibrosis.

Patients with cystic fibrosis tend to have reduced serum concentrations of vitamin E and are therefore at risk of developing the neurological complications associated with vitamin E deficiency. Improved survival in cystic fibrosis has resulted in an increasing number of older patients who may develop hepatobiliary complications which may further impair the absorption of vitamin E. In this study the vitamin E status and results of supplementation with oral vitamin E were compared in adult patients with and without evidence of liver involvement as assessed by routine liver function tests. The serum vitamin E concentrations were reduced below normal in 24 of 25 patients. The mean serum vitamin E concentration was significantly lower (p less than 0.05) in those patients with abnormal liver function. When vitamin E status was assessed as the serum vitamin E/cholesterol ratio, however, there was no significant difference between those patients with normal and abnormal liver function. After supplementation with oral vitamin E, either 10 mg/kg/day for one month or 200 mg/day (equivalent to 3.4 to 4.4 mg/kg/day) for up to three months, there was no significant difference in the vitamin E status between the two groups. The results of this study indicate that in general, patients with cystic fibrosis and abnormal liver function do not require increased supplements of vitamin E compared with those with normal liver function.

Adolescent↗

PubMed1992

Oral administration of clonidine in patients with alcoholic cirrhosis. Hemodynamic and liver function effects.

The effects of long-term oral clonidine treatment on hepatic and systemic hemodynamics and on quantitative liver function tests were investigated in 15 patients with alcoholic cirrhosis. Clonidine was administered at a mean dose of 0.33 +/- 0.1 mg/day (mean +/- SD) for a mean period of 64 +/- 10 days. Oral clonidine induced a significant reduction in the hepatic venous pressure gradient from 18.8 +/- 3.0 mm Hg to 15.9 +/- 3.4 mm Hg (P less than 0.001), which was the result of an increase in the free hepatic venous pressure from 5.1 +/- 4.2 mm Hg to 8.7 +/- 3.8 mm Hg (P less than 0.05). In 10 of the 15 patients (67%), the reduction in the hepatic venous pressure gradient was greater than 10% of baseline values. Hepatic blood flow did not change significantly after clonidine treatment. Additionally, treatment with clonidine decreased mean arterial pressure by 15.5% +/- 6% (P less than 0.001), heart rate by 17.7% +/- 7% (P less than 0.001), and cardiac output by 14.6% +/- 7% (P less than 0.001). However, systemic vascular resistance did not change significantly. There were no adverse effects on liver function, as shown by the nonsignificant changes in galactose-elimination capacity (149 +/- 59 vs. 170 +/- 58 mg/min), hepatic clearance of indocyanine green (0.19 +/- 0.10 vs. 0.17 +/- 0.07 L/min), and hepatic intrinsic clearance of indocyanine green (0.23 +/- 0.14 vs. 0.21 +/- 0.1 L/min) before and after clonidine treatment, respectively. In none of the patients was the drug withdrawn because of side effects, although 12 subjects complained of dry mouths. This study suggests that in patients with alcoholic cirrhosis, long-term oral clonidine administration achieves a reduction in the hepatic venous pressure gradient without adverse effects on hepatic blood flow and liver function.

Administration, Oral↗