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PubMed2004

Liver volume in thalassaemia major: relationship with body weight, serum ferritin, and liver function.

BACKGROUND: It is not known whether body weight alone can adjust for the volume of liver in the calculation of the chelating dose in beta-thalassaemia major patients, who frequently have iron overload and hepatitis. OBJECTIVE: The hypothesis is that liver volume in children and adolescents suffering from beta-thalassaemia major is affected by ferritin level and liver function. MATERIALS AND METHODS: Thirty-five beta-thalassaemia major patients aged 7-18 years and 35 age- and sex-matched controls had liver volume measured by MRI. Serum alanine aminotransferase (ALT) and ferritin levels were obtained in the thalassaemia major patients. RESULTS: Body weight explained 65 and 86% of the change in liver volume in beta-thalassaemia major patients and age-matched control subjects, respectively. Liver volume/kilogram body weight was significantly higher (P < 0.001) in thalassaemia major patients than in control subjects. There was a significant correlation between ALT level and liver volume/kilogram body weight (r = 0.55, P = 0.001). Patients with elevated ALT had significantly higher liver volume/kilogram body weight (mean 42.9 +/- 12 cm3/kg) than control subjects (mean 23.4 +/- 3.6 cm3/kg) and patients with normal ALT levels (mean 27.4 +/- 3.6 cm3/kg). CONCLUSIONS: Body weight is the most important single factor for liver-volume changes in thalassaemia major patients, but elevated ALT also has a significant role. Direct liver volume measurement for chelation dose adjustment may be advantageous in patients with elevated ALT.

Adolescent↗

PubMed2003

Long-term culture of functional liver tissue: three-dimensional coculture of primary hepatocytes and stellate cells.

One of the greatest challenges in the attempt to create functional liver tissue in vitro is the maintenance of hepatocyte-specific functions. The pharmaceutical industry has long awaited the development of engineered liver tissue, which could represent a long-term, inducible, high-fidelity model for high-throughput screening of new drug compounds. It is also anticipated that such engineered models could one day be used in liver transplants, where replacement is limited by chronic donor shortages. As isolated hepatocytes dedifferentiate rapidly in culture the use of hepatocytes in long-term studies has proved to be a difficult challenge. Here we report a system of rat hepatocytes cocultured with primary rat hepatic stellate cells on a biodegradable poly(DL-lactic acid) substratum. These coculture conditions were found to encourage the rapid self-organization of three-dimensional spheroids. The spheroids formed exhibit hepatocyte-specific functionality (CYP-450 activity and albumin secretion) after almost 2 months in static culture.

Animals↗

PubMed1990

Automated volume determination of the liver and spleen from Tc-99m colloid SPECT imaging. Quantification of the liver functional and nonfunctional tissue in disease.

An automated volume determination program using SPECT imaging with Tc-99m has been validated by both phantom and patient studies. Its use for monitoring change of function of the liver and change in tumor mass during different therapy regimes has been assessed. The technique is not restricted to the estimation of the hepatic functioning tissues; it therefore has many potential clinical implementations for volume determination in other organs.

Humans↗

PubMed1987

Altered liver function in diabetes: model experiments with aminopyrine in the rat.

The aminopyrine breath test is a valuable quantitative liver function test. However, it may be influenced by factors not related primarily to liver disease. For instance, it has been published that diabetes affects microsomal demethylation of aminopyrine in vitro. The relevance of these findings for the in vivo situation, however, is ill defined. Aminopyrine disposition was evaluated, therefore, by performing an in vivo-in vitro comparison of its kinetics in control, diabetic and insulin-treated diabetic rats. Diabetes was induced by streptozotocin (75 mg/kg i.v.). A tracer dose of [14C]aminopyrine was injected i.p. (40 mu Ci/kg, 0.7 mg/kg) and the kinetics of 14CO2 in breath as well as disappearance of aminopyrine in blood were followed simultaneously for 2 hr. Diabetes increased the 14CO2 elimination rate constant in breath by 90%, whereas total recovery of 14CO2 in breath was decreased by 30% (P less than .001). Aminopyrine clearance in blood was doubled in diabetic rats compared to control (48.9 +/- 11.3 vs. 21.4 +/- 3.3 ml/min X kg, P less than .001). This was due to an increased volume of distribution (1.99 +/- 0.31 in diabetic rats vs. 0.96 +/- 0.11 liters/kg in control). In vitro aminopyrine kinetics in hepatic microsomal preparations showed a 52% higher Vmax of aminopyrine demethylase in D (P less than .001), whereas Km remained unchanged. The diabetes-induced changes were reversible by insulin. It is concluded that diabetes alters the aminopyrine breath test by interfering with demethylation rate and distribution of aminopyrine, and by changing the fate of the cleaved C1-fragments.

Aminopyrine↗

PubMed1991

[Liver function in diabetics with secondary sulfanilamide resistance (based on the data from dynamic hepatobiliary scintigraphy)].

Dynamic hepato-bilio-scintigraphy was performed in 43 patients with diabetes mellitus. An analysis of results showed that characteristic of patients with diabetes mellitus is a reduction of the detoxicating and bile excretory function of the liver which was most pronounced in patients with insulin-dependent type in the condition of secondary sulfanylamide resistance. Typical of diabetes mellitus disorder of the gallbladder function was its hypotonia and dyskinesia.

Biliary Tract↗

PubMed2004

Elevated circulating adiponectin levels in liver cirrhosis are associated with reduced liver function and altered hepatic hemodynamics.

Adiponectin is a novel adipocytokine negatively correlated with parameters of the metabolic syndrome, such as body mass index (BMI), body fat mass (BFM), and circulating insulin levels. Furthermore, metabolic actions directly on the liver have been described. The aim of the present study was to characterize circulating adiponectin levels, hepatic turnover, and the association of adiponectin with key parameters of hepatic as well as systemic metabolism in cirrhosis, a catabolic disease. Circulating adiponectin levels and hepatic turnover were investigated in 20 patients with advanced cirrhosis. Hepatic hemodynamics [portal pressure, liver blood flow, hepatic vascular resistance, indocyanine green (ICG) half-life], body composition, resting energy expenditure, hepatic free fatty acids (FFA) and glucose turnover, and circulating levels of hormones (catecholamines, insulin, glucagon) and proinflammatory cytokines (IL-1beta, TNF-alpha, IL-6) were also assessed. Circulating adiponectin increased dependently on the clinical stage in cirrhosis compared with controls (15.2 +/- 1.7 vs. 8.2 +/- 1.1 microg/ml, respectively, P < 0.01), whereas hepatic extraction decreased. Adiponectin was negatively correlated with parameters of hepatic protein synthesis (prothrombin time: r = -0.62, P = 0.003; albumin: r = -0.72, P < 0.001) but not with transaminases or parameters of lipid metabolism. In addition, circulating adiponectin increased with portal pressure (r = 0.67, P = 0.003), hepatic vascular resistance (r = 0.60, P = 0.008), and effective hepatic blood flow (ICG half-life: r = 0.69, P = 0.001). Adiponectin in cirrhosis was not correlated with BMI, BFM, parameters of energy metabolism, insulin levels, hepatic FFA and glucose turnover, and circulating proinflammatory cytokines. These results demonstrate that 1) adiponectin plasma levels in cirrhosis are significantly elevated, 2) the liver is a major source of adiponectin extraction, and 3) adiponectin levels in cirrhosis do not correlate with parameters of body composition or metabolism but exclusively with reduced liver function and altered hepatic hemodynamics.

Adiponectin↗

PubMed1981

Concomitant hepatic radiation and intraarterial fluorinated pyrimidine therapy: correlation of liver scan, liver function tests, and plasma CEA with tumor response.

Sixteen patients with metastatic disease to the liver (12 colorectal and four unknown primary tumors) were treated in a pilot study of hepatic irradiation (2500-3000 rads in 10-12 fractions) delivered concomitantly with continuous short-term intraarterial infusion of 5-fluorouracil (1 g/d) or FUDR (0.5 mg/kg/d) via a percutaneously placed hepatic artery catheter. Abnormal liver function tests, including SGOT, LDH, and alkaline phosphatase, decreased in all patients by day 7-10 of treatment, and other metabolic factors, including serum cholesterol, calcium, albumin, phosphorous, and uric acid, also decreased, often to subnormal levels by termination of treatment (day 15-20). These chemical alterations did not correlate with tumor response in that the identical pattern was observed in responders (ten patients) as well as nonresponders (six patients). Objective determinants of response were assessed by serial monitoring of the plasma carcinoembryonic antigen (CEA) and liver scan. In 14 patients with elevated CEA levels, tumor response (nine patients), nonresponse (four patients), and relapse (five patients) was predicted and confirmed by sequential monitoring of CEA. In one patient, a paradoxical decrease in plasma CEA was associated with progressive disease. The liver scan identified all responding patients but was difficult to quantitate and was delayed for months following subjective clinical response and changes in plasma CEA levels.

Alkaline Phosphatase↗

PubMed1977

Liver function in leprosy.

Thirty eight patients of leprosy were classified on the basis of clinical and biopsy findings into 10 lepromatous (all reactional), 20 tuberculoid (7 in reaction) and 8 dimorphic (5 in reaction). The liver function tests--serum proteins, albumin/globulin ratio, fractions in paper electrophoresis, serum glutamic pyruvic transaminase (SGPT) and thymol turbidity tests--and the serum cholesterol was estimated in each patient. The abnormalities were a reversal of the albumin/globulin ratio in all the three groups and an increase in beta/globulin fraction in the lepromatous group, but total proteins were within normal limits. The thymol turbidity test showed moderately elevated levels in all three groups. SGPT was slightly raised in a few cases. Only a single patient with tuberculoid leprosy showed serum cholesterol to be over 250 mg per 100 ml.

Alanine Transaminase↗

PubMed1984

Liver function studies on rhesus monkeys (Macaca mulatta) following the administration of hydrazine sulfate.

Hydrazine sulfate (Hs), a known occupational toxin and putative cancer therapeutic agent, was administered iv at various doses to rhesus monkeys in an effort to measure its effects upon the liver. Function tests included indocyanine clearance (ICG Vmax and Km), serum bile acid levels and serum enzyme activities, including alanine aminotransferase, gamma glutamyl transferase, and a panel of 19 other blood chemical constituents. Hepatic function and other biochemical tests were generally within the normal range following single-dose Hs administration (10-40 mg/kg) and did not suggest the presence of significant liver injury. Two monkeys receiving 80 mg/kg Hs exhibited extensive hepatic lipidosis without biochemical or histologic signs of necrosis. Hs, administered iv, appears to produce little or no hepatic toxicity.

Alanine Transaminase↗

PubMed1986

[Serum bile acids in cirrhosis: correlation with liver function parameters and with the severity of the disease].

The aim of this paper is to evaluate the relationships among the increase of serum bile acids (SBA) and other common liver function tests in subjects with liver cirrhosis. Our results show that SBA levels are well-correlated with the seriousness of the disease (classified according to Child's criteria), and with the presence of ascites, of oesophageal varices, of hepatic encephalopathy and with the gamma-globulin level. SBA also appear to be well-correlated with total bilirubinemia, and, at a lower extent, with cholesterolemia and albuminemia; no significant linear correlation was found among SBA and cholestasis (alkaline phosphatase, gamma-glutamyl-transpeptidase) or cytolysis (transaminases) indexes. In conclusion, the SBA increase in liver cirrhosis without evidence of cholestasis (as in our patients) seems to be related to liver cell reuptake disturbances and to the presence of porto-systemic shunts, with consequent alterations in entero-hepatic bile salt recirculation.

Adult↗

PubMed1951