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At least 991 records · Page 55Linked to original sources
PubMed2005

Role of liver function tests in predicting common bile duct stones in acute calculous cholecystitis.

BACKGROUND: The role of liver function tests (LFTs) in evaluating common bile duct (CBD) stones in patients with cholelithiasis has been studied widely. However, it is not clear whether these predictive models are useful in inflammatory gallstone disease. METHODS: A review was undertaken of 385 consecutive patients admitted as an emergency for acute calculous gallbladder disease. The diagnosis of calculous cholecystitis was confirmed by ultrasonography or histological confirmation of acute or chronic inflammation of the gallbladder. Patients with obvious jaundice, defined as a bilirubin level above 80 micromol/l, and gallstone pancreatitis were excluded. RESULTS: Some 216 patients met the inclusion criteria, of whom 28 (13.0 per cent) were found to have CBD stones. LFT results were not significantly different in patients with chronic, acute or complicated acute cholecystitis. Using several cut-off levels, gamma-glutamyl transpeptidase (GGT) had the highest specificity, positive predictive value and negative predictive value, comparable to a scoring system that combined all LFTs. Bilirubin was the least specific and predictive. A cut-off point for GGT at 90 units/l produced a sensitivity of 86 per cent (24 of 28), specificity of 74.5 per cent (140 of 188), and positive and negative predictive values of 33 per cent (24 of 72) and 97.2 per cent (140 of 144) respectively. This represented a one in three chance of CBD stones when the GGT level was above 90 units/l and a one in 30 chance when the level was less than 90 units/l. CONCLUSION: Selection criteria based on GGT can be used in acute calculous cholecystitis to identify high-risk patients who would benefit most from further imaging to exclude choledocholithiasis.

Adolescent↗
PubMed1992

[A compartment model of Tc-99m-DTPA-galactosyl-human serum albumin for evaluating liver function].

Technetium-99m-diethylenetriaminepentaacetic acid-galactosyl-human serum albumin (99mTc-GSA) is a new liver scintigraphy agent which binds to asialoglycoprotein receptor in hepatocyte. Studies were performed in three normal volunteers and 11 patients with liver cirrhosis. Time-activity curves for the heart and liver were obtained for 60 min following an i.v. injection of 99mTc-GSA (1 mg/185 MBq). We introduced five compartments to describe 99mTc-GSA: 1) extrahepatic blood, 2) hepatic blood, 3) receptor, 4) interstitial fluid and 5) urine. The %ID of 99mTc-GSA in blood and the hepatic blood volume were obtained from the extrapolation of the biexponential fitting for the heart and liver curves. Michaelis-Menten type saturation kinetics was applied to the process of receptor-ligand binding. Numerical analysis solved the simultaneous differential equations that were introduced from the compartment model. Hepatic blood flow was 1,651 +/- 131 ml/min, maximal removal rate for the ligand was 0.547 +/- 0.069 mg/min in normal controls. Both results were significantly decreased in patients with liver cirrhosis compared with normal controls. Present study may provide a novel method for the diagnosis of liver function that allows independent quantification of the hepatic blood flow and the receptor population.

Adult↗
PubMed2003

Occult hepatitis C virus infection in patients in whom the etiology of persistently abnormal results of liver-function tests is unknown.

BACKGROUND: There are patients in whom the etiology of long-standing abnormal results of liver-function tests is unknown (ALF-EU) after exclusion of all known causes of liver diseases. We analyzed the presence of hepatitis C virus (HCV) RNA in liver-biopsy specimens from 100 patients who were negative for anti-HCV antibodies and for serum HCV RNA and who had ALF-EU. METHODS: HCV RNA status was tested by reverse-transcription polymerase chain reaction (RT-PCR) and by in situ hybridization, in liver and peripheral-blood mononuclear cells (PBMCs). RESULTS: HCV RNA was detected in liver-biopsy specimens from 57 of 100 patients negative for anti-HCV antibodies and for serum HCV RNA (i.e., who had occult HCV infection). HCV RNA of negative polarity was found in the liver of 48 (84.2%) of these 57 patients with occult HCV infection. Nucleotide-sequence analysis confirmed the specificity of detection of HCV RNA and that patients were infected with the HCV 1b genotype. Of these 57 patients with intrahepatic HCV RNA, 40 (70%) had viral RNA in their PBMCs. With regard to liver histology, patients with occult HCV infection were more likely to have necroinflammatory activity (P=.017) and fibrosis (P=.022) than were patients without intrahepatic HCV RNA. CONCLUSIONS: Patients with ALF-EU may have intrahepatic HCV RNA in the absence of anti-HCV antibodies and of serum HCV RNA.

Adult↗
PubMed1983

Excess rumen product anions in cattle. I. Blood clearance rates and reduced liver function from sublethal doses of volatile fatty acids, lactate and succinate.

Blood clearance rates of volatile fatty acids, lactate and succinate were estimated in cattle following a single rapid intravenous injection of a Na-anion solution. Bromosulfophthalein was administered immediately before the anion to monitor the effects upon liver function, blood circulation, and dose equilibrium. Acetate, propionate, and valerate at doses up to 5 mmole/kg were cleared quickly from the blood by a first-order process without effects either upon the animal or bromosulfophthalein clearance. Injection of acetic acid solutions produced no effects. Butyrate was toxic at doses above 1 mmole/kg and progressively affected both the rate and progress of bromosulfophthalein clearance as the dose increased. Lactate and succinate were toxic and lethal at doses around 0.25 mmole/kg, and caused both reduced rates and altered progress of bromosulfophthalein clearance. The toxic reactions resulted in total collapse from loss of muscle tone. The butyrate and lactate effects were accentuated when the anion solutions were injected at low pH where a large portion of the anion would be unionized. Levels of butyrate, lactate and succinate in the rumens of feedlot cattle were high enough to provide toxic doses of these anions. The results are discussed in terms of the effects of excess rumen production of these anions upon the liver function and health of feedlot cattle.

Animals↗
PubMed2004

Accuracy of indocyanine green pulse spectrophotometry clearance test for liver function prediction in transplanted patients.

AIM: To investigate whether the non-invasive real-time Indocyanine green (ICG) clearance is a sensitive index of liver viability in patients before, during, and after liver transplantation. METHODS: Thirteen patients were studied, two before, three during, and eight following liver transplantation, with two patients suffering acute rejection. The conventional invasive ICG clearance test and ICG pulse spectrophotometry non-invasive real-time ICG clearance test were performed simultaneously. Using linear regression analysis we tested the correlation between these two methods. The transplantation condition of these patients and serum total bilirubin (T. Bil), alanine aminotransferase (ALT), and platelet count were also evaluated. RESULTS: The correlation between these two methods was excellent (r(2)=0.977). CONCLUSION: ICG pulse spectrophotometry clearance is a quick, non-invasive, and reliable liver function test in transplantation patients.

Coloring Agents↗
PubMed1995

Preliminary assessment of glycine conjugation of para-aminobenzoic acid as a quantitative test of liver function.

OBJECTIVES: Our hypothesis is that because of its hepatic metabolism paraaminobenzoic acid (PABA) could be a test of liver function. DESIGN AND METHODS: PABA is well absorbed by the gastrointestinal tract and acetylated and conjugated in the liver to glycine before being excreted. Its three major metabolites include para-acetoamidobenzoic acid (PAABA), paraaminohippuric acid (PAHA), and paraacetamidohippuric acid (PAAHA). In this study, we measured the metabolism of lidocaine to monoethylglycinexylidide (MEGX) and PABA to PAHA+PAAHA/PABA+PAABA+PAHA+PAAHA (hippurate ratio) in 14 patients with liver disease and 12 control subjects. RESULTS: Comparison of the total bilirubin with the hippurate ratio (at 30 min) and the conventional MEGX test (at 15 min) was assessed. The 30 min hippurate ratio correlated well with the 15 min MEGX results (r = 0.69). CONCLUSIONS: While these results are preliminary the PABA test appears to be equally sensitive to MEGX and has the distinct advantage over the MEGX test of being administered orally versus the intravenous administration of lidocaine which is often associated with unwanted side-effects such as hypotension, drowsiness and paresthesias.

4-Aminobenzoic Acid↗
PubMed1990

Clinical evaluation of serum N-acetyl-beta-D-glucosaminidase as a liver function test.

Serum N-acetyl-beta-D-glucosaminidase has been shown to be a sensitive indicator of liver function. The enzyme activity in serum from patients with different forms of hepatic disease was found to be elevated. A comparison is also made with routine liver parameters. The frequencies of pathological serum levels of the routine measurements made are in relatively good agreement with earlier reports.

Acetylglucosaminidase↗
PubMed1994

[Protective effects of prostaglandin E1 on postoperative liver function after cardiac surgery].

Effects of prostaglandin E1 (PGE1) on liver function were studied in 72 patients who underwent mitral valve replacement (MVR) and coronary artery bypass grafting (CABG). The patients were divided into three groups: (A) patients with preoperative hepatic dysfunction who underwent MVR; (B) patients without previous hepatic dysfunction who underwent MVR; (C) patients without hepatic dysfunction who underwent CABG. About half of the patients in each group received PGE1 during the operation and postoperative period in the ICU. Change of serum GOT, GPT, albumin, total bilirubin, and cholinesterase (ChE) showed no difference between the patients with and without PGE1 administration in groups B and C. But, in group A, PGE1 administration significantly ameliorated the decrease of ChE, a condition which is usually observed in the first and second postoperative weeks after MVR. None of the patients showed severe hepatic dysfunction in the PGE1 group. One patient in the control group A revealed severe hepatic failure with high bilirubinemia and decreased ChE. These results suggest that the administration of PGE1 to patients with hepatic dysfunction, scheduled for MVR, might protect the liver from deterioration.

Aged↗
PubMed1991

[Protective effects of PGE1 on postoperative liver function after gastric cancer surgery].

The effects of PGE1 on liver function tests in patients who underwent gastric cancer surgery were studied. PGE1 was administered in 13 patients at a rate of 20-100 ng.kg-1.min-1 (PGE1 group) during surgery. Fourteen patients served as the control group. On the first postoperative day, SGOT and SGPT increased in both groups. But on the first and the third postoperative days, SGPT of the PGE1 group was significantly lower (P less than 0.05) than that of the control group. Five patients in the control group showed transaminase above 100 IU.l-1 in the postoperative period. In contrast, no patient showed this increase in the PGE1 group. These findings indicate that continuous infusion of PGE1 during surgery is beneficial in attenuating hepatic injury.

Aged↗
PubMed2005

Chemotherapy dosing with elevated liver function test results in acute leukemia.

OBJECTIVE: To report a case of massive blast infiltration of the liver by acute lymphoblastic leukemia (ALL) manifested by worsening liver function test (LFT) results and concern over how to dose chemotherapy in this patient. CASE SUMMARY: A 36-year-old male presenting with productive cough, abdominal pain, and lower back pain was diagnosed with pre-B cell ALL. Of note, the patient developed worsening LFT results within the first few days of diagnosis. Because of concern over increasing liver dysfunction and the need to administer vincristine and daunorubicin with induction therapy, a transvenous liver biopsy was performed, revealing massive lymphoblast infiltration. DISCUSSION: A short course of prednisone was given to determine whether the LFT abnormalities would reverse with treatment. Once a downward trend in the abnormalities was noted, full-dose induction chemotherapy was administered. CONCLUSIONS: It is important to discern the cause of elevated LFT values in patients with acute leukemia who require induction chemotherapy, as this may affect treatment decisions and patient outcomes.

Acute Disease↗
PubMed1984

Effects of isoflurane anesthesia on equine liver function.

The acute 2-hour effects of isoflurane anesthesia on liver function and biliary excretion were examined in 2 ponies prepared surgically with chronic external biliary fistulas (T-tubes). Studies were conducted 2 to 8 months postoperatively with the enterohepatic circulation held intact between studies. Bile acid infusion IV (8.1 to 8.8 mumol/min) helped maintain bile flow and bile acid and bilirubin excretion during complete biliary diversion throughout each study. Following 3-hour control periods, anesthesia was induced and maintained at 1.3 to 1.5 minimal alveolar concentration plus O2 (spontaneous breathing) for 2 hours. Compared with the immediate 2-hour preanesthesia values, isoflurane caused significant increases in PCV (27%) and biliary bilirubin excretion (24%). However, no significant differences were detected in plasma or biliary bilirubin concentrations, biliary bile acid concentration or excretion, bile flow, or plasma aspartate aminotransferase concentrations between preanesthesia control and anesthesia periods. The results indicate that although isoflurane anesthesia enhanced hepatic bilirubin excretion, its effects on hepatic bilirubin formation and/or clearance are modest, compared with effects of halothane anesthesia which have previously been shown to enhance equine bilirubin excretion by 138% and reduce bile acid excretion by 27%. Isoflurane anesthesia in ponies does not appear to affect hepatic bile acid transport or bile formation significantly.

Anesthesia, Inhalation↗
PubMed1993

Effects of feeding aflatoxin-contaminated diets with and without clay to weanling and growing pigs on performance, liver function, and mineral metabolism.

Ninety-six crossbred weanling pigs (36 d of age, initial weight of 8.8 kg) were used in a three-phase study to determine the effects of feeding an aflatoxin-contaminated corn (AC) diet (922 ppb of aflatoxin B1) with and without sodium bentonite (clay) on performance, liver function, and mineral metabolism. In the nursery phase, control corn (NC) or AC was fed in corn-soybean meal diets with and without 1% clay for 6 wk. Compared with NC, AC decreased ADFI and ADG (P < .01) and increased serum activities of gamma-glutamyltransferase (P < .01) and alkaline phosphatase (P < .05). In the growing phase, 48 pigs from the nursery phase were fed NC but continued on their respective clay treatments for 5 wk. Pigs previously fed AC had higher (P < .01) ADFI and lower (P < .05) gain/feed, serum Ca, K, and glucose; ADG, other serum values, and liver minerals were not affected by treatments. In the metabolism phase, 24 barrows from the nursery phase were continued on the same corn and clay treatments for two 4-d total collections of urine and feces. Feeding AC increased (P < .05) P and Na absorption. The addition of clay lowered Mg and Na absorption (P < .01) for both AC and NC. Significant interactions for many minerals indicated that the effects on mineral metabolism were more pronounced when AC was fed. Serum and liver mineral concentrations were generally unaffected by the treatments in all phases. Feeding clay with AC results in partial restoration of performance and liver function without greatly influencing mineral metabolism.

Aflatoxin B1↗
PubMed1991

Liver function tests and neuropsychologic impairment in substance abusers.

The relationship between residual neuropsychologic dysfunction in alcoholics and subtle changes in liver function during acute phases of treatment was examined. Noncirrhotic alcoholics who exhibited extreme elevations in the liver enzyme gamma-glutamyl transferase (GGT) were found to have greater impairments in tasks of visuoperceptual and conceptual abilities when compared to alcoholics with normal or only mild elevations in GGT. The relationship between acute liver dysfunction and residual neuropsychologic impairment appeared to be independent of age and patterns of drinking. The implications of these findings in relation to treatment planning and prognosis of alcoholics are discussed.

Adult↗
PubMed1995

Evaluation of liver function tests in neonatal calves.

OBJECTIVE: To evaluate the efficacy of tests for hepatic disease in young calves. DESIGN: Prospective case-control study. ANIMALS: 28 clinically normal calves and 47 calves with histologically proven hepatic disease. PROCEDURE: Liver function tests and serum activity of liver-derived enzymes were determined on 28 clinically normal calves at birth and at 2 weeks of age. These values were compared with the results from 47 calves with hepatic disease verified by histologic examination. Upper limit of confidence interval was determined for the results on the clinically normal calves, and Student's t-test was used to identify significant differences in the data from calves of various age-groups. RESULTS: None of the results of the common tests for liver damage or function (measurement of bilirubin, gamma-glutamyltransferase, glutamate dehydrogenase [GMD], alkaline phosphatase, L-lactate dehydrogenase, aspartate transaminase, or alanine transaminase) were clinically useful when used alone for detection of hepatic disease in calves less than 6 weeks old. Sensitivity of gamma-glutamyltransferase, GMD, aspartate transaminase, and alkaline phosphatase as indicators of hepatic disease in this population of calves was 0, 59, 80, and 9%, respectively. Direct bilirubin (sensitivity, 87%) was more sensitive than total bilirubin (sensitivity, 66%). Serum enzyme activity of most enzymes (P < 0.01), total bilirubin concentration (P < 0.001), and sulfobromophthalein sodium clearance half-life were significantly higher (P < 0.001) in newborn calves than in 2-week-old calves. CLINICAL IMPLICATIONS: Clinical findings that indicate hepatic disease in calves that are less than 6 weeks old could be confirmed by measurement of serum activity of GMD or concentrations of total serum bile acids or direct bilirubin. Percutaneous liver biopsy may still be needed and may provide the most information.

Animals↗
PubMed1984

[Bacampicillin in urinary tract infections tolerance in patients with impaired kidney and liver function].

The evaluation of a 10-day 3 x 800 mg dosage regimen was equivalent for bacampicillin to oral ampicillin therapy (using 3 or 4 g respectively per day) in patients with primary UTI (n = 50) in clinical and bacteriological respect. The cure rate amounted to 69 and 68,4% respectively 2 days after therapy. No differences could be assessed after a 2-, 4- and 6-week period. Frequency of diarrhoea was 3 times as high in the ampicillin group as in the bacampicillin group. The rate of exanthema was also 2,5 times as high. No differences existed between eosinophilia and pain complaints in the upper gastrointestinal tract. 10 patients with liver function disturbances and renal impairment respectively tolerated well bacampicillin treatment. Only in the patients with impaired liver function rise of BUN and urea was found in 3 cases, not related to rise of creatinine.

Ampicillin↗
PubMed1999

Special considerations in interpreting liver function tests.

A number of pitfalls can be encountered in the interpretation of common blood liver function tests. These tests can be normal in patients with chronic hepatitis or cirrhosis. The normal range for aminotransferase levels is slightly higher in males, nonwhites and obese persons. Severe alcoholic hepatitis is sometimes confused with cholecystitis or cholangitis. Conversely, patients who present soon after passing common bile duct stones can be misdiagnosed with acute hepatitis because aminotransferase levels often rise immediately, but alkaline phosphatase and gamma-glutamyltransferase levels do not become elevated for several days. Asymptomatic patients with isolated, mild elevation of either the unconjugated bilirubin or the gamma-glutamyltransferase value usually do not have liver disease and generally do not require extensive evaluation. Overall hepatic function can be assessed by applying the values for albumin, bilirubin and prothrombin time in the modified Child-Turcotte grading system.

Alanine Transaminase↗
PubMed1991

[The lipid peroxidation characteristics in the liver function disorders of patients with vasorenal hypertension].

The authors investigated the functional state of the liver and lipid peroxidation in vasorenal hypertension. Results indicate that the functional state of the liver in vasorenal hypertension is disturbed as a result of the main renal disease and also under the effect of arterial hypertension as a destabilizing factor leading to disorders of the hemodynamics and furthering potentiation of lipid peroxidation processes in the body.

Adult↗