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PubMed1995

[Predictors of hepatic functional reserve in cirrhotic patients].

We have determined the interstitial ratio, hepatocyte numerical density on area (NA) by the method of Luzex-F Image Analyser, and the level of serum prealbumin (PA), choline esterase activity (ChE) by agarose immunodiffusion and ratemetry in control group (14 cases) and 25 cirrhotic patients undergoing pericardial devascularization. The results were compared with traditional hepatic function grade (Child's Grade). We found that NA, PA, and ChE are independently useful in evaluating the hepatic functional reserve in cirrhotic patients.

Adult↗
PubMedDate not supplied

Predetermining postoperative hepatic function for hepatectomies.

To perform major resections safely in liver cancer operations, we have developed a reliable preoperative method to estimate postoperative liver function. We first conducted a series of studies using dogs to determine the various correlations between the volume of the remaining liver and postresectional hepatic function. We calculated Indocyaningreen (ICG) plasma disappearance and retention rates 15 minutes after intravenous injection of ICG at 0.5 mg/kg and found a 1:1 ratio, thus: ICG(K) postop. = ICG(K) preop. x functional remaining rate. This was applicable in our study of dogs with normal livers; in clinical cases complicated by liver cirrhosis and cancer, however, the functional rate of the remaining liver cannot be calculated only by the volumetric ratio of the whole liver and the remaining part. In clinical cases it must also be calculated by using hepatic vein catheterization and by measuring the ICG extraction rate of each segment of the part to be resected and the part to remain. By using this segmental liver function test, the postoperative hepatic function can be estimated accurately before the operation, thus enabling the surgeon to perform major hepatectomies safely and efficiently.

Animals↗
PubMed1987

Short-term and long-term changes in hepatic function in 60 patients with blunt liver injury.

We treated 60 patients with blunt liver injury over 14 years. According to Makiya's scale of severity, 22 of these lesions (37%) were of Type I, 23 (38%) of Type II, and 15 (25%) of Type III. The overall mortality rate was 23% (14 patients). Changes in hepatic function were studied in these patients. Transaminase levels showed abnormal elevations immediately after the injury but rapidly decreased to normal levels within about 40 days in both the patients who survived the injury and those who died. The alkaline phosphatase activity showed moderate gradual elevations with time, exceeding 20 K.A. units 10 days after the injury in those who died. The total bilirubin level increased to only about 4 mg/dl in those who survived but exceeded 8 mg/dl 10 days after the injury in about 80% of those who died. The total cholesterol level decreased below 100 mg/dl in those who died. In chloric cobalt reaction, the R-value shifted to the left in those who survived but to the right in those who died. Total plasma protein, which decreased to about 6.0 gm/dl immediately after the injury, gradually recovered in those who survived but further declined in those who died. Percentage of gamma-globulin increased but remained below 20% in those who survived but exceeded 20% within 10 days of injury in many of those who died. Hepatic functions 5 years after the injury were generally within the normal range.

Adolescent↗
PubMed1984

Effect of taurine supplementation on hepatic function during short-term parenteral nutrition in the premature infant.

To evaluate the potential role of taurine deficiency in the pathogenesis of parenteral nutrition-induced cholestasis, 20 premature (less than 34 weeks AGA) infants were randomized to receive parenteral nutrition with and without taurine (10.8 mg/kg/day) during the first 10 days of life. Birth weight, gestational age, and protein and caloric intake were similar in both groups. Plasma taurine levels and hepatic function were assessed before the study began (3 +/- 1 days of age), at 5 +/- 1 days of age, and at 9 +/- 1 days of age. Although plasma taurine levels were significantly greater at 5 +/- 1 and 9 +/- 1 days of age (p = 0.009) in the group receiving supplementation, no differential effect on hepatocellular function could be detected during this short period of time. A decrease in plasma ammonia (p = 0.001), alanine aminotransferase (ALT) (p = 0.036), gamma-glutamyltranspeptidase (GGTP) (p = 0.05), 5'-nucleotidase (5'N) (p = 0.001), and bile salt concentrations was noted in both groups, indicating the rapid maturation of hepatic function even in the presence of parenteral nutrition during the first 10 days of life.

Animals↗
PubMedDate not supplied

Effects of Fructus gardeniae extract on hepatic function.

This article discusses the effects of Fructus Gardeniae extract on hepatic function. Fructus Gardeniae extract manifested no hepatotoxic effects on rats, as shown by alkaline phosphatase, aspartate aminotransferase, and lactate dehydrogenase studies. Fructus Gardeniae extract failed to activate the UDP-glucuronyltransferase system; whereas in hyperbilirubinemic state the enzyme was activated, presumably by substrate induction. Fructus Gardeniae extract increased the activity of UDP-glucose dehydrogenase, which would result in an increase in availability of UDP-glucuronic acid intracellularly, BSP clearance study showed an unexpected impairment of hepatic uptake of the dye after extract treatment. The action mechanism involved in lowering of serum bilirubin level by Fructus Gardeniae extract may well be complex; it is probably acting on a locus other than glucuronyl transferase.

Alkaline Phosphatase↗
PubMed1986

[Effects of enflurane and halothane on hepatic function in biliary surgery].

The effects of two volatile anaesthetics on hepatic function are compared in 80 patients in hepato-biliary surgery. 40 patients were anaesthetized either with enflurane or halothane. This study is based on the variations of blood levels of gamma GT, bilirubin, SGOT SGPT, alkaline phosphatase, L.D.H. Samples were taken the day prior to the operation, one, two and five days afterwards. The results show an increase in the levels of BD, SGPT, LDH no 5, less important with enflurane than with halothane, and mainly in patients with preoperative hepatic abnormalities. Enflurane appears to be preferable in such cases.

Adult↗
PubMed1992

No effect of dose, hepatic function, or nutritional status on 5-FU clearance following continuous (5-day), 5-FU infusion.

One hundred and eighty seven patients (155 males, 32 females) with histologically proven and previously untreated head and neck cancer were entered in the study. A total of 222 cycles of therapy were analyzed (cisplatin 100 mg m-2 on day 1 and 5-day continuous intravenous infusion of 5-FU 550-1069 mg m-2 day-1, mean 875.5 mg m-2 day-1). Significant interpatient variability for various 5-FU pharmacokinetic parameters was observed including an almost ten-fold range in 5-FU clearance (5-FU Cl, ml min-1 m-2 = 791-7769, mean 2820.7). Log 5-FU Cl was not modified by 5-FU dose (r = -0.1034, P = 0.124, n = 222). Poor linear correlations between log 5-FU Cl and hepatic function tests were observed (respective r and P values for 222 cycles, log AST:0.0526, 0.4365; Log ALT: -0.1167, 0.0842; Log A1K. Phos.:0.154, 0.0214; Log GGT: 0.0652, 0.3436; Log LDH: -0.0984, 0.1563; Log bilirubin: 0.1278, 0.0601). The log 5-FU Cl was also poorly correlated with the serum concentration of various nutritional proteins (respective r and P values for 222 cycles, Albumin: 0.0110, 0.8714; prealbumin: -0.1067, 0.1129; transferrin: 0.0439, 0.5226). Laboratory data including indices of hepatic function and nutritional status cannot account for the interpatient variability in 5-FU disposition.

Blood Proteins↗
PubMedDate not supplied

Serum biochemical and histopathological changes related to the hepatic function in pigs following atrazine treatment.

Biochemical and histopathological parameters of the hepatic function were used to quantify the hepatotoxic effects of atrazine in female pigs (gilts) undergoing intensive breeding. Female pigs (cross-bred Swedish and German landrace) received 2 mg atrazine kg-1 body wt. in feed daily during 19 days of the oestrous cycle. The last treatment day corresponded to day -3 of the onset of the next expected oestrus. Blood samples were collected three times daily at 3-h intervals on the first four post-treatment days. Serum activities of gamma-glutamyltransferase (GGT), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (AP) were determined. Serum activity of GGT was significantly increased throughout the four post-treatment days. In comparison with the control values, a slight but not significant decrease was observed in the serum activities of ALT, AST and AP. Histopathological examination of the liver of exposed pigs showed mild centrolobular parenchymatous degeneration. Interstitial connective tissue proliferation resulted in narrow and irregular bile canaliculi.

Alanine Transaminase↗
PubMed1994

[Two-stage multivariant analyses for prediction of hepatic function reserve].

Eleven liver function tests were used for preoperative estimations of the hepatic function reserve in 103 patients with primary hepatocellular carcinoma (HCC) and underlying liver cirrhosis. Postoperatively, the patients' liver function could be classified as good recovering (Grade A, n = 38), functional damage (Grade B, n = 37) and liver failure (Grade C, n = 28). Single factor analyses showed 6 of those tests were significant indicators, including the ratio of blood glucose level at 120 minutes and 60 minutes by oral glucose tolerance test, total bilirubin, the ratio of albumin and globulin, prealbumin, prothrombin time and indocyanine green retention at 15 minutes. The correlations between 11 preoperative parameters (xi) and postoperative course scored (Y) were analysed by Fisher's discriminant test. The multiple regression equation Y1 was obtained by comparing from groups of Grade A with B and formula Y2 from groups of Grade B with C. The predictive accuracy of both equations were 88.0%, 83.1%, respectively. To select adequate surgical procedures with the best therapeutic effect and minimal liver damage for the patients with HCC, we proposed a method of "two-stage predications" combining use of Y1 and Y2 for evaluation of liver function reserve.

Adult↗
PubMed1989

[Pharmacological effects of reiousan on experimental hepatic injuries and hepatic functions].

Pharmacological effects of Reiousan, a crude drug preparation consisting of bezoar and ginseng, on experimental hepatic injuries and hepatic functions were studied. After administration of Reiousan, carbon tetrachloride, d-galactosamine and alpha-naphthylisothiocyanate-induced experimental hepatic injuries in rats were inhibited. Facilitation of recovery from increased retention rate of sulfobromophthalein in hepatectomized rats, increase in hepatic blood flow, inhibition of superoxide anions, and decrease in blood ethanol concentration in rats administered ethanol were observed after application of Reiousan. Inhibitory effects of Reiousan on experimental hepatic injuries may result from the increase in hepatic blood flow and inhibition of superoxide anions.

1-Naphthylisothiocyanate↗
PubMed1994

Effects of growth hormone (GH) administration on functional hepatic nitrogen clearance: studies in normal subjects and GH-deficient patients.

A decline in serum urea levels and urinary urea excretion is usually seen after GH administration in humans, indicating overall protein anabolism. Whether this reflects the diminished supply of alpha-amino acids for urea synthesis or a substrate-independent hepatic mechanism is unknown. To pursue this we measured the urea nitrogen synthesis rate (UNSR) and blood alanine levels before, during, and after a 4-h constant iv infusion of alanine (2 mmol/kg BW.h). UNSR was estimated hourly as urinary excretion corrected for gut hydrolysis and accumulation in total body water. The slope of the linear relationship between UNSR and circulating alanine levels represents the hepatic components of conversion of amino nitrogen and is denoted the functional hepatic nitrogen clearance (FHNC). Eight male volunteers were randomly investigated on three occasions: 1) after 12-h iv saline infusion, 2) after 12-h iv GH infusion (1 IU/h), and 3) after 2-day sc GH treatment (8 IU/day), followed by 12-h iv infusion of GH (1 IU/h). The UNSR (millimoles per h) during alanine infusion was significantly lower when the subjects were receiving GH therapy [maximum +/- SE, 133.0 +/- 6.9 (saline) vs. 96.7 +/- 11.1 (12-h GH; P < 0.01) vs. 106.5 +/- 7.5 (2-day GH; P < 0.05)]. FHNC (liters per h) was similar in all three studies [30.3 +/- 1.2 (saline) vs. 26.6 +/- 3.4 (12-h GH) vs. 27.0 +/- 2.6 (2-day GH)]. Six GH-deficient adult patients were randomly studied twice: 1) on regular daily (at 2000 h) sc GH therapy (3 IU/m2.day), and 2) after discontinuation of GH for 2 days. The UNSR during alanine infusion was likewise significantly lower when the patients were receiving GH therapy [147.7 +/- 11.7 mmol/h (no GH) vs. 123.9 +/- 9.1 mmol/h; P < 0.01]. FHNC (liters per h) values were similar in the two studies [29.2 +/- 3.8 (GH) vs. 27.5 +/- 4.5 (no GH)]. Our data confirm the anabolic action of GH and show that short term GH deprivation is associated with catabolism in terms of increased UNSR. The finding of unaltered FHNC suggests a GH-induced extrahepatic regulation of amino nitrogen conversion, rather than a substrate-independent hepatic mechanism.

Adult↗
PubMed1989

Change in hepatic function, hemodynamics, and morphology after liver transplant. Physiological effect of therapy.

Orthotopic liver transplantation (OLT) has become standard therapy for patients with acute hepatic necrosis and end-stage liver disease. This study measured change in hepatic function (galactose elimination capacity [GEC]), liver blood flow (low dose galactose clearance: flow), hepatic volume (CT scan; volume) and morphology after OLT. The aim was to measure the physiologic response after OLT and compare this response with that after selective shunt (SS) and sclerotherapy (ES) to determine which patients should receive specific therapy. Between January 1987 and November 1988, 37 patients underwent OLT. Operative mortality was 18%, which was similar to that of SS in Child's C cirrhotics. GEC and volume were less in transplant patients than in cirrhotics treated with SS or ES. GEC, flow, and volume normalized after OLT; GEC was preserved after ES and SS, but volume decreased. Three preoperative patterns were observed that can aid in selection of OLT candidates. Patients with chronic cirrhosis (chronic active hepatitis; cryptogenic) need OLT when GEC is less than or equal to 225 mg/min and volume is less than or equal to 50% normal. Patients with Budd-Chiari Syndrome require OLT if cirrhosis has evolved. Patients with sclerosing cholangitis and primary biliary cirrhosis qualify for transplants when complications of the portal hypertensive syndrome develop. The studies can also direct therapy for ES failures. Selective shunt is indicated in those patients with stable disease whose GEC is greater than or equal to 300 mg/min and liver volume is greater than 75% normal; OLT is indicated for cirrhotics with GEC that is less than 225 mg/min and liver volume that is less than 50% predicted normal.

Adult↗
PubMed1990

[Effects of drinking Tettuccio di Montecatini mineral waters on gallbladder emptying and functioning hepatic mass].

Real time echography and galactose loading test were used to evaluate changes in gallbladder emptying and functioning hepatic mass in dyspeptic patients after drinking Tettuccio mineral water. The above tests showed that Tettuccio mineral water is apt to provoke a rapid, intense gallbladder contraction which appeared to be slightly more protracted when the tests were repeated after two weeks of treatment with the mineral water. This action appears to be due to the composition of the alkaline sulfate saline water rather than to its osmolar concentration since the water is more effective in bringing about gallbladder emptying than saline solutions of higher osmolarity.

Adult↗
PubMed1981

A comparative study of renal and hepatic function in Sprague-Dawley rats following systemic injection of purified carrageenans (kappa, lambda and iota).

Renal and hepatic function was investigated in groups of 7 rats for 14 days after a single i.p. injection of 125 mg/kg purified kappa (kappa), lambda (lambda) or iota (iota) carrageenan. Kappa carrageenan was clearly nephrotoxic, as evidenced by a progressive, marked increase in serum creatinine and urea levels and in urinary N-acetyl-beta-D-glucosaminidase (NAG) activity. It also caused significant elevation in serum aspartate aminotransferase (AAT) activity from Day 2 to Day 7, and a progressive decrease in circulating albumin concentrations. Lambda carrageenan had no significant effect on serum creatinine or urea levels and caused only a transient increase in urinary NAG which was maximal on Day 2. Serum AAT levels were also significantly raised on Day 2. Iota carrageenan injection resulted in the deaths of 2/7 animals. Significant increases in serum creatinine levels were observed on Day 4: in 2 rats these increase were very pronounced as were those in urea levels, but no significant alterations in serum urea or urinary NAG levels were observed. No significant elevation in serum AAT was found, except for minor changes on Days 7 and 14. Whereas lambda carrageenan decreased serum albumin throughout the 14-day course of the experiment, albumin levels in lambda carrageenan-injected rats, whilst depressed during the first week, returned to normal by Day 14.

Acetylglucosaminidase↗