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[The use of the Price-Jones curve as liver function test].
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Practical considerations of liver function tests.
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Clinical aspects of liver function.
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[Flocculation tests and liver function].
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[A simple, fast and reliable liver function test].
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[Physiopathology of the liver and liver function tests].
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Sclerotherapy vs. esophageal transection vs. distal splenorenal shunt for the clinical management of esophageal varices in patients with child class A and B liver function: a prospective randomized trial.
Ninety-six patients with good liver function (Child class A or B) and esophageal varices were randomly assigned to one of three groups given different treatments: endoscopic injection sclerotherapy (n = 32), esophageal transection (n = 32) or distal splenorenal shunt (n = 32). Five patients (5.2%) had to be excluded from this study because severe chronic pancreatitis made separation of the distal splenic vein from the pancreatic bed difficult. Esophageal transection was performed for these patients. No deaths occurred during the 30 days of treatment. The 5-yr cumulative bleeding rates were 0%, 5.9% and 12.9% in the endoscopic injection sclerotherapy, esophageal transection and distal splenorenal shunt groups, respectively (no statistical significance). In no case in the three groups did death occur because of variceal bleeding. Sixteen patients died, mainly because of underlying liver disease; four were in the endoscopic injection sclerotherapy group, five were in the esophageal transection group and seven were in the distal splenorenal shunt group. No statistically significant difference in survival rate among the three groups was found. These results show that endoscopic injection sclerotherapy is a satisfactory alternative to esophageal transection or distal splenorenal shunt for the clinical management of patients with esophageal varices.
Effects of homologous plasma cross-circulation on liver function in galactosamine-induced hepatic necrosis in rats.
Plasma cross-circulation that resembles clinical plasma exchange was carried out in rats with galactosamine (GalN)-treated hepatic failure to investigate its effect on the damaged liver function. Twenty-four hours after the injection of GalN, plasma cross-circulation was performed at a plasma flow rate of 0.1 ml/min for 6 h. At 48 h after the injection of GalN, survival was obtained in 6 of 8 GalN-injected rats treated with plasma cross-circulation as compared with 4 of 10 GalN-injected rats treated with sham circulation. State 3 oxygen consumption and ATP synthesis (mitochondrial respiratory function) and ATP, ADP, and total adenine nucleotide contents in the liver were significantly higher in the former group than in the latter group at that period, as determined by sacrificing the surviving animals. Although the survival rate was not significantly improved, evidence suggests that plasma cross-circulation enhanced mitochondrial phosphorylative activity and produced an augmented high-energy state of the liver, which had been markedly reduced by GalN administration. An efficient removal of toxic metabolites as well as an influx of a large amount of fresh plasma by plasma cross-circulation would be beneficial for the regenerative process of the necrosing liver tissues.
Effect of paraquat (methyl viologen) on liver function in mice.
Paraquat poisoning may result in pulmonary damage and hepatotoxicity. To examine the effect of paraquat on liver function, paraquat-treated mice were injected with sulfobromophthalein (BSP, 100 mg/kg) or indocyanine green (20 mg/kg) via the tail vein and plasma concentrations of these compounds were determined at various times. Hepatic concentrations of reduced glutathione were also determined following paraquat. Retention of BSP and indocyanine green in the plasma was observed 24 hours after paraquat. Body temperature of the poisoned mice was significantly depressed 24 hours after treatment and the paraquat-induced indocyanine green retention could be reversed by warming the paraquat-treated mice to normal body temperature. In contrast, paraquat-induced BSP retention was independent of body temperature. Inasmuch as hepatic glutathione concentrations were reduced 24 hours after paraquat treatment, the retention of BSP in the plasma may have been secondary to the reduction of hepatic glutathione concentrations.
[Liver functional test (LFT) and ultrasound (US) usefulness in the diagnostic of non-alcoholic steato-hepatitis (NASH)].
OBJECTIVE: To investigate the Liver Functional Test (LFT) and hepatic ultrasound (US) usefulness in the diagnostic of NASH. BACKGROUND: NASH is part of NAFLD (non-alcoholic fatty liver disease), this condition can lead to cirrhosis; it is associated with others frequents diseases in Mexico such as type 2 diabetes and obesity. Unfortunately the diagnosis of NASH is not easy, since it must be confirmed by an hepatic biopsy and this requisite can conditionate a subnormal register. Until now, we don't have programs oriented to detect this disease; even though several high risk populations have been identified. METHODS: We compared the results of LFT and hepatic US often patients with NASH and ten healthy volunteers. Both groups where matched; the sensibility (S), specificity (Sp) and predictive values (PV) of each test were established. Student t test was used in the statistic analysis. RESULTS: The tests with the most notable difference were aminotransferases (AST, ALT), indirect billirubin (IB) and the US; with S of 100% to IB and US; Sp 100% to aminotransferases; PV+ 100% to ALT and AST, and 71% to US; and PV- 100% to IB and US. CONCLUSIONS: LFT and US are useful to detect NASH, the periodic testing of subjects with type 2 diabetes and overweight in risk of NASH is proposed as an effective tool of detection for the cases that require a subsequent study by a gastroenterologist.
Liver function tests among Michigan and Wisconsin dairy farmers.
Serum activity of SGOT, SGPT, LDH, and alkaline phosphatase was measured in 614 Michigan adults exposed to PBB and 141 Wisconsin adults not so exposed. The Michigan group had higher prevalence of abnormal SGOT (p less than 0.005) and SGPT (p less than 0.005). A clear sex difference was observed. Michigan men had a higher prevalence of abnormal SGPT (p less than 0.005) and LDH (p less than 0.005) than Michigan women, and a higher prevalence than Wisconsin men of abnormal SGOT (p less than 0.005) and SGPT (p less than 0.01). These differences could not be ascribed to differing patterns of alcohol consumption, laboratory error, or choice of criteria for normality/abnormality. Seven Michigan subgroups were defined on the basis of the criteria by which they had been selected to participate. The two subgroups who were essentially self-invited did not differ from the remaining five randomly selected subgroups combined in prevalence of these abnormal liver function tests. Based on 364 serum PBB analyses thus far analyzed of the 614 Michigan participants, no obvious relationship between serum PBB values and liver function tests was observed. However, this is a tentative conclusion that will be further evaluated when remaining serum PBB analyses are completed. The greater prevalence of abnormal SGPT and SGOT among Michigan dairy farm residents compared to the Wisconsin dairy farm residents is tentatively ascribed to the former group's exposure to PBB.
The clearance of Xenon-133 following its parenchymal injection: a rapid method for estimating functional liver blood-flow.
Portal venous flow, total hepatic blood-flow and hepatic artery flow were measured in healthy dogs by electromagnetic flowmetry and a double indicator dilution technique. Functional liver blood-flow was measured by the double indicator dilution technique. Functional hepatic blood-flow did not correlate with portal venous flow, total hepatic blood-flow or hepatic artery flow, measured by either electromagnetic flowmetry or a double indicator dilution technique. There was a good correlation (r = 0.83, P less than 0.001) between functional hepatic blood-flow and liver blood-flow, measured by the clearance of Xenon-133 injected directly into the liver parenchyma. It is concluded that the clearance of Xenon-133, injected directly into the liver parenchyma, is a rapid and simple method for measuring functional hepatic blood-flow.
Effects of selenium supplementation on blood and urine selenium levels and liver function in patients with primary biliary cirrhosis.
To study the mechanism of the reduced serum selenium concentration in patients with liver damage we administered 200 micrograms (2.53 mumol) selenium daily as selenium-rich yeast to 8 patients with primary biliary cirrhosis and 8 healthy controls over 16 weeks. Initially selenium concentrations in serum were 24% lower (P less than 0.001) in patients than controls. During supplementation serum selenium levels increased in both groups but the difference between them persisted. Throughout the study whole blood selenium levels and glutathione peroxidase activities were also somewhat lower (P = NS) in patients than controls. Selenium supplementation had no effect on whole blood glutathione peroxidase activities in either group. The basal 24 h urinary excretion of selenium was similar in both groups but was increased more by supplementation in patients than controls. Selenium administration did not influence the liver function of the patients. We conclude that impaired hepatic production of selenium-containing serum compounds is the most likely explanation for the reduced serum selenium concentration in patients with primary biliary cirrhosis.