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Liver function in asymptomatic adult individuals with severe alpha1-antitrypsin deficiency (Pi Z).

Eleven adult individuals (aged 24 to 66 years) with severe alpha1-antitrypsin deficiency, Pi Z, and with no clinical signs of liver disease, were investigated with a broad spectrum of liver function tests. Except for low alpha1-antitrypsin levels, no evidence of abnormal hepatic protein synthesis was found. Neither could any biochemical signs of liver cell necrosis or increased liver cell regeneration be disclosed. In spite of the well-known pronounced distension of hepatic endoplasmic reticulum (E.R.) by aggregated asialo-alpha1-antitrypsin in this disease, the function of the E.R. tested with the aminopyrine breath test was not found to be impaired.

Adult↗

Nuclear medicine liver function tests for pregnant women and children. 1. Breath tests with 14C-methacetin and 13C-methacetin.

Stable isotopes, such as 13C, should be substituted for the long-lived radionuclide 14C in the 14C breath test when doing liver function tests in children and pregnant women. For comparison 13C, 15N-methacetin and 14C-methacetin were synthesized as suitable diagnostic agents. Methods are described for the measurement of 14C and 13C in the breath. After oral administration of labelled methacetin to healthy subjects and patients with liver diseases a good correspondence between 13C- and 14C-measurements in the same subject on the one hand, and a good discrimination between controls and patients on the other hand were shown. Findings with regard to 14C measurements in urine are discussed supporting the supposed advantage of 13C-methacetin over 14C-methacetin application.

Acetamides↗

Effects of sevoflurane and isoflurane anesthesia on arterial ketone body ratio and liver function.

BACKGROUND: The purpose of this study was to compare the effect on arterial ketone body ratio (AKBR), which indicates hepatic mitochondrial energy charge in relation to hepatic blood flow, and liver function test (serum levels of liver enzymes) between sevoflurane and isoflurane anesthesia. METHODS: Serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBil), alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GTP), and lactate dehydrogenase (LDH) were measured before and 1,2,3,7, and 14 days after anesthesia in each of 60 patients receiving either sevoflurane or isoflurane anesthesia for neurosurgery (tumor resection). In 13 patients of both groups, arterial concentrations of acetoacetate and 3-hydroxybutyrate were also measured before, during and after (up to 12 h) anesthesia and the AKBR was calculated. RESULTS: AST, ALT and GTP increased, peaking 7 days after anesthesia, especially in the isoflurane group. There was a significantly greater number of patients with abnormal AST and ALT values in the isoflurane group than in the sevoflurane group. The increase of TBil had its peak 1 day after anesthesia in both groups. AKBR decreased after anesthesia induction and recovered to the control value 12 h after anesthesia in both groups. There was no difference between the two anesthetic groups in AKBR. CONCLUSION: Isoflurane induced an elevation of serum levels of liver enzymes more frequently than did sevoflurane 3 to 14 days after anesthesia, while AKBR until 12 h after anesthesia did not show any significant difference between sevoflurane and isoflurane anesthesia.

3-Hydroxybutyric Acid↗

[The effect of endogenous intoxication on liver function in patients with phlegmons of the face and neck].

The function of the liver is assessed in patients with maxillofacial phlegmons suffering from endogenic intoxication of different severity. The most marked changes of the enzymatic activity of the liver were observed in patients with progressive phlegmons and complications thereof (mediastinitis or sepsis) involving endotoxicosis of the second or third degree. The authors come to a conclusion on the functional hepatic failure in patients with phlegmons of the face and neck, which fact should be borne in mind when planning combined therapy of this patient population.

Acute Disease↗

Deranged liver function tests in type 1 diabetes mellitus: an unusual presentation of Treponema pallidum infection.

Deranged liver function tests are common in the diabetic population. Acute derangements are less common, however, and are usually secondary to viral or drug-related causes. A case of syphilitic hepatitis associated with positive anti-mitochondrial antibodies is described, where diagnostic confusion was present until characteristic features of the secondary phase of syphilis infection occurred.

Journal Article↗

[15N liver function test in underweight infants, hypotrophic at birth].

Fifty-two infants were enrolled in the study: 23 hypotrophically born infants (birth weight < 5th percentile according to Kyank) with present body weights < 3rd percentile according to Prader (group 1), 15 patients suffering from severe liver diseases (group 2), 14 patients without liver diseases (group 3). Usual serum parameters were estimated. Additionally, the hepatic detoxification capacities were measured using the non-invasive, non-radioactive [15N]methacetin urine test. 17 of the 23 infants of group 1 showed 15N elimination rates as low as in severe liver-diseased patients (group 2) whereas their serum parameters were in the normal range, as were those of group 3. The question remains whether intra-uterine malnutrition or postnatal effects, e.g., environmental conditions, caused the functional liver damage.

Acetamides↗

Safety aspects of a coumarin-troxerutin combination regarding liver function in a double-blind placebo-controlled study.

OBJECTIVE: Coumarin is reported to elevate liver function tests (LFT) values. In a prospective, placebo-controlled, clinical trial, efficacy and safety of a coumarin-containing combination (SB-LOT) were evaluated in the treatment of chronic venous insufficiency. Here, we report on the drug safety of coumarin with special respect to liver reaction. METHODS: 114 patients were treated with SB-LOT (30 mg coumarin and 180 mg troxerutin t.i.d.) and 117 with placebo during a period of 16 weeks. LFT values (ALT, AST, AP and gamma-GT) were monitored at baseline, 4, 6, 8, 12 and 16 weeks of therapy. Adverse drug reactions were assessed regarding causality. Additionally, lymphocyte proliferation test was used to identify allergic reactions. Logistic regression analysis was performed to identify possible risk factors. RESULTS: No serious adverse drug reactions occurred. Elevations of LFT were assessed as biochemical abnormality. Specific clinical symptoms such as jaundice did not occur. Only 1 patient reported fatigue and exhaustion. Logistic regression estimated a basic risk for elevation of LFT of 4.9% under SB-LOT and 2.1% under placebo. Hepatitis in the history and diseases of the liver were identified as risk factors. CONCLUSION: This evaluation contributes to safety data of SB-LOT in man. LFT elevation is transient and the low risk of the SB-LOT therapy to increase LFT value can be limited when risk factors are considered.

Aged↗

Effect of estrogen replacement on liver function in ovariectomized rats.

The effect of estrogen (17 beta-estradiol; E2) replacement on the liver function was examined in ovariectomized rats. Ovariectomy decreased serum transaminase activity and physiological dosage levels of E2 replacement returned the activity up to or above non-ovariectomized levels. Under the conditions of this experiment the elevated serum transaminase levels in the E2 replacement were not coincident with histological changes suggestive of liver dysfunction. The elevations of both serum glutamic oxaloacetic transaminase (GOT) and serum mitochondrial GOT were accompanied by increased hepatic tissue activity, suggesting that the elevated serum levels can be attributed to the accelerated synthesis of the enzymes. On the other hand, the elevation of serum glutamic pyruvic transaminase was not accompanied by increased tissue activity in the original organs, namely liver, kidney, heart and skeletal muscle. Ovariectomy decreased serum albumin and inhibited development of rough endoplasmic reticulum in the liver, and E2 replacement returned them up to or above the non-ovariectomized levels.

Alanine Transaminase↗

Symptoms, lung and liver function, blood counts, and genotoxic effects in coastal tanker crews.

OBJECTIVE: The deck crew on tankers can be exposed to high concentrations of benzene and other chemicals during loading, unloading and tank-cleaning operations. The objective of this study was to investigate whether genotoxic or other early health effects of cargo vapour exposure could be detected in coastal tanker crews. METHODS: The association between exposure to cargo vapours and clinical symptoms and signs, spirometry, blood cell count, blood test for liver function, and the frequency of micronuclei and sister chromatid exchanges in peripheral lymphocytes was studied in a cross-sectional investigation of 107 male crew members (66 deck crew and 41 others) on ten coastal tankers. RESULTS: Seven of the tankers had automatic cargo level gauging systems but some of the ships still had open hatches during loading and unloading operations. Acute symptoms such as headache, nausea, vertigo, fatigue and dizziness after loading or tank-cleaning operations were reported by 56 of the 66 deck crew members (85%). Irritation of the mucous membrane in eyes and upper respiratory tract by cargo vapours were also common in this group. Obstructive symptoms were more common in the group with the highest exposure to cargo vapours but persistent effects on lung function (vital capacity and forced expiratory volume in 1 s), nervous system, liver enzymes or blood counts were not found. The frequency of micronuclei after mitotic stimulation with phytohaemagglutinin was higher among the deck crew (mean 4.2 SEM 0.40) than in other crew members (mean 3.6, SEM 0.35). although the difference was not statistically significant. We found no association between exposure and the frequency of sister chromatid exchanges or micronuclei after stimulation with pokeweed mitogen. CONCLUSION: This study indicates that exposure to cargo vapours in coastal tanker crews may cause symptoms in the respiratory and nervous systems.

Adolescent↗

Quantitative liver function and morphology after paracetamol administration to rats.

The functional status of the liver after paracetamol administration to rats was dissociated with regard to cytosolic and microsomal functions. The cytosolic function, measured as galactose elimination capacity, was unchanged even after high doses of paracetamol. The microsomal function, measured as the prothrombin time, was reversibly decreased to a minimum 12 h after paracetamol administration and showed dose dependence. The structural changes of the liver cells were centrilobular necroses and dilatation of the endoplasmic reticulum. They were most marked 36 h after paracetamol and were not correlated to the functional impairment. We conclude that during acute paracetamol induced liver damage to rats different functions of the liver are unequally influenced and that the structural changes occur later than the functional ones. The paracetamol intoxicated rat is a promising model for further investigation of dissociation of subcellular functions during acute liver damage.

Acetaminophen↗

Similar liver function abnormalities occur in patients receiving glucose-based and lipid-based parenteral nutrition.

Biochemical and histopathological evidence of hepatic dysfunction has been associated with the use of glucose-based total parenteral nutrition (TPN). In the present study liver indices, SGOT, SGPT, alkaline phosphatase, and bilirubin, were analyzed retrospectively during the course of total parenteral nutrition in 40 patients; 15 patients received a glucose-based system and 25 received a lipid-based system. Transient elevations in at least one of the measured parameters were found in a majority of patients receiving either system. These data confirm previous reports of liver function test abnormalities in patients receiving glucose-based total parentual nutrition. However, in contrast to results from prior studies, these derangements also were observed during the administration of a nutritional support system using lipids as the primary source of calories.

Adolescent↗

Abnormalities of urine urobilinogen and urine bilirubin assays and their relation to abnormal results of serum liver function tests.

A prospective observational study of 324 cases was conducted in a busy ambulatory care setting to evaluate the sensitivity, specificity, predictive values, and accuracy of spot urine urobilinogen and urine bilirubin assays as screening tests for serum liver function test (LFT) abnormalities. High positive predictive values (88% for at least one abnormal LFT) make the evaluation of positive urine screens detected during routine health care maintenance examinations imperative. Because extraneous factors may influence both urine and serum test results, however, urine assays obtained as a screening parameter in clinical presentations (abdominal pain, jaundice, constitutional symptoms, etc) have only limited clinical utility. The high proportion of false-negative results for both urine assays renders their statistical properties unacceptable as screens in these clinical situations.

Adolescent↗