[Practical data on liver function tests in current use].
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This paper records biochemical and follow-up observations on 153 patients with cirrhosis who have had a shunt operation. The experience confirms that no shunt operation should be undertaken on a patient whose serum albumin level is less than 3.2g.%. Low pseudocholinesterase levels are of help diagnostically but the main value of this test is in indicating whether or not liver function will deteriorate after a shunt operation in any given patient.
The investigations were performed on 6 Friesian-Holstein heifers, weighing 410-504 kg, in which acid indigestion was induced by intraruminal administration of saccharose in a dose of 12 g/kg body weight. The animals were observed for 9 days after the treatment. Functional state of the liver was evaluated on the basis of bromosulphthalein clearance, total bilirubin level and aspartate amino-transferase (AspAT) activity in serum, concentration of blood glucose, total serum protein and protein fractions. Within the first 24 hours, all heifers developed acute symptoms of rumen acidosis which persisted for 3 days after saccharose administration. Afterwards, a phase of gradual spontaneous recovery was observed. In the course of rumen acidosis a reduction in bromosulphthalein clearance, an increase in bilirubin level and AspAT activity, a decrease and then an increase in glucose concentration and a reduction in albumin content and, as a consequence, in albumin/globulin ratio were found. The results indicate that experimental rumen acidosis produced disturbances in excretory and metabolic functions of the liver in the examined heifers. Changes in biochemical parameters were preceded by an increase in AspAT activity and were most remarkable between 48 and 144 hours after saccharose administration. Liver dysfunction was of a various degree in individual animals and recovered within a relatively short period following the disappearance of rumen acidosis symptoms.
Earlier work has shown that penicillamine reduces the acute toxicity of antimonyl potassium tartrate (APT) as well as the abnormal ECG changes it induces. In the present study, the possible protective effect of penicillamine on the hepatic toxicity of APT was investigated. Tests of liver function showed changes in the level of serum aspartate and alanine aminotransferase and of alkaline phosphatase, and in the beta-/alpha-lipoprotein ratio, in response to antimony treatment. The changes were significantly reduced by penicillamine, though the effect depended on the dose. Penicillamine was found to give the best overall protection without affecting the antischistosomal efficacy of the antimonial when a 1:2 APT/penicillamine ratio was used. The findings provide further evidence of the potential usefulness of penicillamine in the antimonial treatment of schistosomiasis.
Over the last few years, lipoprotein(a) [Lp(a)] levels have been investigated because clinical studies have related it to increased cardiovascular and cerebrovascular risk. Although it is known that serum Lp(a) concentrations are controlled genetically, little is known about its metabolism. We studied changes in the lipid profile and Lp(a) values in 57 patients (34 males and 23 females) affected by cirrhosis of the liver subdivided into Child's classes in order to assess whether this lipoprotein is sensitive to reduced liver protein synthesis. The patients presented with low total cholesterol, normal HDL-cholesterol (HDL-c), LDL-cholesterol (LDL-c), triglycerides, apoprotein A1 (Apo-A1) and apoprotein B100 (Apo-B100) concentrations, while Lp(a) concentrations seemed elevated. Grouping the patients into Child's classes revealed that all the lipid parameters investigated reduced as the disease progressed. Lp(a) reduced significantly between Child's Classes I and II and seems to be correlated with the severity of cirrhosis and the clinical worsening of the patients' conditions. These findings suggest that Lp(a) is not only an index of atherosclerosis risk, but also plays a role in monitoring liver functions.
The effect of secretin on bile flow, biliary clearance of 14C-erythritol and bile composition was studied in fasting, chloralose anesthetized cats. Secretin (2 U.kg-1 . h-1) increased from values below the values above the erythritol clearance, which did not change significantly. It is therefore concluded that secretin altered ductular transfer of fluid from a net reabsorption to a net secretion of a bicarbonate rich fluid. Secretin did not affect the sphlanchno-hepatic hemodynamics or the overall function of the liver and Indomethacin did not significantly alter the response to secretin.