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At least 163 records · Page 9Linked to original sources

PubMed1989

DISIDA kinetics measure liver function in dogs.

We have investigated the ability of 99Tcm-disofenin (DISIDA) kinetics to measure liver function. Two approaches have been used: first, quantitative analysis of serial liver images, and second, clearance estimation from whole blood concentration-time data. Graded liver dysfunction was produced in 11 dogs over three months by common bile duct ligation and surgical relief of biliary obstruction one month later. The kinetic analysis of serial liver images showed clear abnormalities during biliary obstruction, with calculated rates of liver uptake falling in stages from 11.09 to 5.15 cts s-1 (p less than 0.001), and rates of elimination from the liver from 8.8 to 1.6 x 10(-4) cts s-1 (p less than 0.0001). These parameters paralleled the deterioration and recovery of liver function through the experimental period, and had not fully recovered 7 weeks after relief of biliary obstruction (10.5 and 6.2 x 10(-4) cts s-1 respectively). Serial blood sampling after injection of DISIDA permitted calculation of whole blood disposition rates (for hepatic clearance). Mean values fell from 256 to 67 ml min-1 with chronic biliary obstruction (p less than 0.001), and returned to almost normal (206 ml min-1) 10 days after surgical relief of biliary obstruction. It is clear that the gradual nature of recovering liver function was more sensitively identified by image analysis than serial blood data. Serial liver biopsies showed marked changes following biliary obstruction. These improved over a period of 7 weeks following its relief, when there was still considerable residual abnormality. This work supports the view that hepatic abnormalities caused by biliary obstruction do not recover quickly following its relief. DISIDA kinetics can quantitate both major and minor degrees of hepatic dysfunction, and may prove to be a valuable method to quantitative liver function.

Animals↗

PubMed1986

Evaluation of liver volume and liver function following hepatic resection in man.

In a longitudinal study liver volume and liver function were measured in a series of 12 patients undergoing partial liver resection for focal hepatic lesions. Ultrasonography revealed that liver volume, reduced by about 50% by the resection, progressively increased, and 6 months after surgery it returned to nearly normal values. A variable reduction in routine liver function tests was observed, possibly reflecting the influence of the different reserve synthetic capacity of the liver and, in the early postoperative phase, plasma half-life of liver products and blood loss or changes in plasma volume. The galactose elimination capacity was only marginally reduced in the early period (from a pre-surgery value of 2.49 +/- SE 0.21 mmol/min to 2.31 +/- 0.14 after 7 days; p = ns) and reached a nadir at 14 days (1.97 +/- 0.16; p less than 0.001). When expressed per unit of liver volume, the galactose elimination (22 +/- 2 mumol/min per unit before resection) progressively decreased during the regeneration phase from 36 +/- 4 at 14 days to 26 +/- 3 at 6 months (P vs 14-day: less than 0.01). At 6 months both galactose elimination and galactose elimination per unit of liver volume were no longer different from baseline values. Our data show that, following hepatic resection, both liver volume and liver function increase and progressively return to nearly normal values. In agreement with data obtained in animal studies, it appears that the metabolic activity of the remaining parenchyma is increased in the early postoperative phase, and it slows down in the course of regeneration.

Adult↗

PubMed1985

Total serum bile acids and the bile acid profile as tests of liver function.

Total serum bile acid assay for the evaluation of liver function has been available for many years but its application has been limited primarily by factors such as methodology, equipment and cost. New and improved methods for bile acid assay such as the radioimmunoassay or the hydroxysteroid dehydrogenase techniques have brought the assay for bile acids into the realm of the clinical laboratory. The efficacy of bile acids for clinical diagnostic use in the evaluation of liver function has not been firmly established. Newer methods using high pressure liquid chromatography to develop a profile of the different bile acids may clarify its usefulness and define its role among the many available tests of liver function in animals.

Bile Acids and Salts↗

PubMed1978

Effect of ATP on liver function tests in experimental diabetes.

Liver function tests were performed in severe and mild diabetic rats and under the influence of ATP. In mild diabetics the serum cholesterol was significantly increased, while in severe diabetes the serum cholesterol was significantly lower than in mild diabetes. The decreased serum cholesterol in severe diabetes may be an indication for the development of fatty liver. The serum alkaline phosphatase and serum bilirubin were significantly increased in both the severe and mild diabetic states, while the thymol turbidity test was insignificantly changed in both states of diabetes. Serum albumin was significantly decreased in 10 days mild diabetes, while it was insignificantly changed in 48 hrs severe diabetic animals. The effect of ATP was investigated in mild diabetes. ATP resulted in a significant increase in serum albumin and a decrease in total globulins with the resultant increase in A/G ratio. The serum alkaline phosphatase exhibited a significant reduction under the influence of ATP. The elevated cholesterol of mild diabetic rats remained significantly elevated and was not reduced by ATP, though the fat content of the liver showed a significant reduction. This may be due to more rapid mobilisation of fat from the liver under the influence of ATP. ATP showed no significant effect on serum bilirubin and thymol turbidity test. the histopathological examination of the liver revealed that administration of ATP to alloxan diabetic rats had a beneficial effect. It resulted in disappearrance of the fat globules from the liver cells.

Adenosine Triphosphate↗

PubMed1978

Biochemical evaluation of liver function.

Several chemistry tests for liver function are examined. Included are the transaminases, alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), and bromsulphalein (BSP), as well as combinations of these and the ALP isoenzymes.

Alkaline Phosphatase↗

PubMedDate not supplied

Effect of total parenteral nutrition on liver function.

A high incidence of liver dysfunction has recently been reported in adults receiving total parenteral nutrition (TPN) for prolonged periods. Liver function tests were followed in 36 patients undergoing TPN for more than two weeks (during the period January 1979 - March 1980). The calorie intake of the patients was limited to 125% of the energy expenditure and fat accounted for half of the non-protein calories. Increases in serum alkaline phosphatase and SGPT values were observed in respectively 14% and 11% of the patients. One patient also showed increases in SGOT value and serum bilirubin concentration. These results suggest that the incidence in liver dysfunction during TPN can be reduced by adapting the calorie intake to the patient's needs and by including fat in the TPN formula. The etiology of hepatic alterations induced by TPN is discussed.

Energy Intake↗

PubMed1976

Liver function in porstatic carcinoma patients.

Liver function tests were carried out for serum zinc turbidity test, icterus index, alkaline phosphatase, bilirubin and transaminases in a series of 222 patients, of whom 119 had prostatic carcinoma, 63 benign hyperplasia of the prostate and 40 congenital abnormality without prostatic trouble. Patients having prostatic carcinoma often displayed abnormally high levels of zinc turbidity test, alkaline phosphatase, bilirubin and transaminases.

Aged↗

PubMed1987

Evaluation of subjective assessment of liver function from radionuclide images.

The appearance of non-hepatic uptake in 99Tcm-colloid images is an important indicator of poor liver function. We undertook this study to evaluate the ability of experienced observers to assess liver function from radionuclide images. A simple model was used to simulate the changing distribution of 99Tcm-colloid in the liver, spleen and bone marrow as the liver function and mass were varied. Suitable images of these three organs were isolated from real studies and used as "templates" to create realistic simulated 99Tcm-colloid images, with the count densities of liver, spleen and bone marrow determined by the model. These images were presented in random order to several observers, who were asked to assess liver function. Comparison of the estimated with the true function shows that visual assessment is systematically inaccurate, with underestimation of poor function and overestimation of good function. It is also imprecise, especially for livers with only midly impaired function. Observers were also affected by changing liver mass and were more likely to judge small livers to be abnormal. We suggest that objective assessment using a quantitative technique should be used as an adjunct to visual inspection for the evaluation of liver function.

Humans↗

PubMed1990

Intravenous tryptophan tolerance test for liver function.

An intravenous tryptophan tolerance test (ITrpTT) was designed for liver function since 95% Trp is metabolized by the liver. After an intravenous loading dose of 4 mg/kg body weight, serum levels of both free (F) and total (T) Trp were determined at 45 and 60 minutes. In normal controls and nonhepatic-disease patients, F45 (60) and T45 (60) did not exceed 7 mumol/L and 80 mumol/L, respectively, and F/T ratio not greater than 0.14. These were set up as cutoffs of upper normal limits. The test was abnormal in 87.5% of chronic persistent hepatitis (CPH) characterized by elevation of T45 (60), 100% of chronic active hepatitis (CAH) by elevation of F45 (60) and/or T45 (60), and 100% of hepatic cirrhosis by increase in F45 (60) and F/T ratio but not in T45 (60). The test seems to be more sensitive than the conventional tests for liver function. However, one should be cautious in interpretation of the test as there are some factors which might influence the Trp metabolism like exercise, alcoholism, corticosteroids and enzyme-inducers. It merits as an indication of liver dysfunction only when these factors are considered and excluded.

Adult↗

PubMed1991

[Elective-selective Warren splenorenal shunt operation. Prognosis of liver function and esophageal varices hemorrhage after repeat sclerotherapy in liver cirrhosis].

From March 1st, 1982 to March 1st 1990 399 patients were admitted to the Heinz-Kalk-Hospital with recurrent bleeding from esophageal varices. Therapy of first choice was acute or elective endoscopic sclerotherapy. Early recurrences and uncontrollable hemorrhage were treated by Linton-Nachlas tube or if unsuccessful by devascularisation procedure. Two early or late bleeding recurrences were defined as sclerotherapy failures and choosen after passing a selection analysis (liver volume 1000 to 2500 ml, portal perfusion more than 30%, liver biopsy without activity or progression, exclusion of stenosis in the arterial supply of the liver and Child-Pugh classification A and B) for a selective-elective splenorenal Warren shunt (SRS). In 10 of 44 selected patients (11%) with an underlying disease of intrahepatic block in 95%, mostly alcoholic origin (65%) intraoperatively the performance of an SRS was technically problematic or impossible. Therefore, a mesocaval interposition shunt was carried out. Early mortality of 34 SRS was 5.9% (2 patients) and late mortality 17.6% (6 patients). No encephalopathy and shunt thrombosis were recorded. Postoperative angio- and sequential scintigraphies proved that portal perfusion was preserved during the first two years, but diminished. Liver function remained stable, too. One case of early rebleeding could be successfully managed by emergency endoscopic sclerotherapy. Five- and eight-years survival rate, according to the method of Kaplan-Meier is about 70%. We conclude that the SRS is the treatment of choice for elective management of recurrent bleeding of esophageal varices refractory to sclerotherapy. Its performance should be not enforced; in case of technical difficulties narrow-lumen mesocaval interposition shunt is an excellent alternative.

Adolescent↗

PubMed1989

Role of the standard 'liver function tests' in current clinical practice.

A prerequisite of current therapy in liver disease is precise diagnosis. The rapid increase in the number of tests available--immunological, virological, histological and radiological--testifies to this, and reflects the inadequacy of the 'standard' liver function tests (LFTs). The LFTs are, however, in contrast to these more sophisticated tests, observer independent and despite their lack of specificity, several characteristic patterns of abnormality can be recognised which direct the physician to the most appropriate definitive investigation. The cheapness and non-invasive nature of the LFTs makes them particularly appropriate for monitoring the course of liver diseases once the diagnosis has been established and this, together with screening for hepatotoxicity of newly developed drugs, is now their main role. A second generation of liver function tests based on the capacity of the liver to eliminate various test compounds may come closer to offering a true estimate of liver function. More accurate methods of measuring the various bilirubin fractions, particularly bilirubin conjugates may also become available in the near future and provide more sensitive tests of liver dysfunction.

Humans↗

PubMed1985

A possible beneficial effect of metronidazole in reducing TPN-associated liver function derangements.

Cholestasis and fatty infiltration of the liver are common complications of total parenteral nutrition (TPN). Following a recent suggestion that TPN-associated liver function derangements may be related to intestinal overgrowth of anaerobic bacteria, the effect of metronidazole on hepatic dysfunction during TPN in rats was investigated. After 5 days of TPN with either amino acids and glucose or amino acids with glucose and fat, all groups exhibited a mild weight gain, positive nitrogen balance, increased liver weight, increased liver:body weight ratio, increased levels of liver enzymes, and increased hepatic lipid content. The administration of metronidazole at 15 mg/kg/day significantly decreased the hepatic lipid content from 0.077 g fat/g liver for controls to 0.053 g fat/g liver. The efficacy of metronidazole in reducing hepatic fat accumulation during nutritionally effective and adequate TPN in rats suggests the possible involvement of anaerobic bacterial flora of the intestinal tract, at least in part, in the pathogenesis of TPN-associated liver function derangements. However, the various biochemical and morphological expressions of these changes and the discrepancy between unchanged liver weight, liver:body weight ratio, liver enzymes, and the improved hepatic fat content suggest multifactorial mechanisms for TPN-related liver damage.

Amino Acids↗

PubMed1983

Assessment of liver function by the aminopyrine breath test.

The aminopyrine breath-test (ABT) has been proposed as a non-invasive quantitative test of liver function and reserve. To evaluate its usefulness, we compared the ABT with standard liver function tests, Child's classification of liver disease and ICG clearance, as means of assessing liver function in 30 patients with cirrhosis. The cumulative output of 14CO2 in breath during the 6 h following [14C]aminopyrine administration was significantly decreased in the cirrhotic group as compared with control subjects. The severity of liver dysfunction, as assessed by Child's classification, was associated with a progressive and statistically significant impairment of the ABT. There was a good correlation between the ABT and ICG systemic clearance (r = 0.770, P less than 0.001) and also between the ABT and ICG intrinsic clearance (r = 0.885, P less than 0.001), a measure which is independent of hepatic blood flow variations. These results further strengthen the concept that the ABT is a simple non-invasive method to assess quantitatively liver function and reserve, and could be useful in following the evolution of patients with liver disease.

Adult↗

PubMed1976

[Liver function in hormonal contraception].

Numerous interactions between hormonal contraceptives and liver function have been described. Changed laboratory results do not represent obligatory pathologic conditions or hepatotoxi effects. Some of these changed results are transient, suggesting that liver cells are capable of adaptation. The use of oral contraceptives is contraindicated in the following liver diseases: - recurrent intrahepatic cholestasis (recurrent jaundice of pregnancy, Dubin-Johnson syndrome, Rotor syndrome); - acute disturbances of liver function. In general it is recommended that hormonal contraceptives should not be used by patients with biliary cirrhosis although some authors have stated that chronic disturbances of liver function did not appear to be aggravated by these agents. Impairment of carbohydrate and lipid metabolism needs careful control of the laboratory tests concerned. Due to its low frequency the increased risk of gallstones does not necessitate the withdrawal of the medication. Up to now the interrelationship between the use of contraceptive steroids and the induction of hepatic tumours has not been proven.

5-Aminolevulinate Synthetase↗

PubMed1978

14C-D-galactose breath test for evaluation of liver function in patients with chronic liver disease.

D-Galactose metabolism and demethylation of aminopyrine by healthy controls and patients with chronic active hepatitis (CAH) and cirrhosis (Ci), were assessed by a breath analysis technique measuring 14CO2 exhalation after oral ingestion of 14C-D-galactose or 14C-aminopyrine. Patients with CAH and Ci exhibited decreased 14CO2-exhalation rates following 14C-D-galactose or 14C-aminopyrine. D-Galactose oxidation capacity of the liver can be assessed by a breath analysis technique in analogy to the demethylating function for aminopyrine. The ordinary oral D-galactose tolerance test seems, however, superior in comparison to the 14C-D-galactose tolerance test, in discriminating between healthy controls and patients with chronic liver disease.

Administration, Oral↗

PubMed1984

Acute doxorubicin toxicity. Relationship to pretreatment liver function, response, and pharmacokinetics in patients with acute nonlymphocytic leukemia.

To determine if there is a relationship between development of acute doxorubicin toxicity, pretreatment liver function studies, and response, 64 acute nonlymphocytic leukemia patients undergoing induction chemotherapy with doxorubicin and cytosine arabinoside were evaluated. No statistically significant correlation could be found between the development of acute toxicity (mucositis) and the number or type of abnormal pretreatment liver functions. Patients receiving full doses of doxorubicin with mild hepatic dysfunction as determined by bromsulphalein (BSP) retention and serum liver function studies had the same incidence of toxicity and complete response rate as those with normal hepatic function. There was no significant difference between duration of response (P = 0.41) or survival (P = 0.17) between the two groups. Ten patients receiving a decreased dose of doxorubicin due to hepatic dysfunction had the same complete response rate but a lower incidence of toxicity as patients receiving full doxorubicin dose. Pharmacokinetic data from fluorescence plasma assays suggest no difference among patients with normal or mildly abnormal liver function studies receiving full doxorubicin doses. The results suggest that leukemia patients with mild hepatic dysfunction receiving a combination of full-dose doxorubicin and cytosine arabinoside for acute leukemia will have the same plasma pharmacokinetics, incidence of toxicity, and complete response rate as those with normal hepatic function. Reduction of doxorubicin dose in patients with abnormal liver function tests results in lower plasma concentrations, less toxicity, and the same response rate, but may also yield a shorter duration of response and survival.

Adolescent↗

PubMed1987

Liver function abnormalities in chronic heart failure. Influence of systemic hemodynamics.

To characterize the incidence and severity of liver function abnormalities in patients with congestive heart failure, we analyzed systemic hemodynamics and biochemical profiles in 133 patients with stable chronic congestive heart failure, secondary to a dilated cardiomyopathy. The patients were divided into three groups, based on the severity of the reduction in cardiac index (CI). The mean values of all liver function tests in groups 1 (n = 43; CI greater than or equal to 2.0 L/min/m2) and 2 (n = 48; CI greater than 1.5 and less than 2.0 L/min/m2) were essentially normal, except for minimally elevated alkaline phosphatase levels and slightly decreased albumin levels in both groups, and slight increases in levels of gamma-glutamyl transpeptidase and total bilirubin in group 2. In contrast, group 3 patients (n = 42; CI less than or equal to 1.5 L/min/m2) had the most severe heart failure, as assessed by the lowest CI and highest cardiac filling pressures, and significantly higher levels of aspartate aminotransferase (65 +/- 82 U/L), alanine aminotransferase (77 +/- 102 U/L), lactate dehydrogenase (282 +/- 91 U/L), and total bilirubin (29 +/- 14 mumol/L [1.7 +/- 0.8 mg/dL]). The percentage of patients in group 3 with these abnormalities ranged between 27% and 80%. Although linear regression analysis showed that the elevations in right atrial and pulmonary wedge pressures, and the decreases in CI, were significantly correlated with liver function abnormalities, the correlation coefficients were small. Thus, liver function abnormalities remain common in patients with congestive heart failure but are generally small in magnitude and not associated with clinically apparent hepatic disease. It is likely that reduced forward flow and passive backward congestion are both contributing factors in the pathogenesis of these biochemical abnormalities, although nonhemodynamic factors may also be important.

Adult↗

PubMed1990

Liver function assessment by drug metabolism.

Liver function can be assessed by administering an exogenous substance to quantify changes in hepatic blood flow, uptake, biotransformation, and excretion. Characterization of drug half-life, clearance, and product formation rates are possible methods for measuring hepatic efficiency. Allopurinol and caffeine have been used to measure metabolite formation followed by renal elimination of both parent substance and metabolite. Sorbitol, a substance with high intrinsic clearance, can reflect liver blood flow, while trimethadione, a low-extraction drug, has been used to measure liver enzyme capacity. Metabolites from lidocaine, methacetin, and aminopyrine have been measured in serum, urine, and breath tests. Salivary clearance measurements of caffeine and antipyrine are reported as suitable for routine use. Genetic diversity of isoenzymes and the many metabolic processes used by hepatocytes make it extremely difficult to quantify functional changes with one substance. Combinations of model substrates have been suggested to assess the many hepatic processes.

Acetamides↗