INDEX liver function

Recently we have evaluated several exogenous and endogenous tests of liver function in rainbow trout following intoxication by the model hepatotoxicant CCl. The results of these studies indicate that elevated plasma activity of the enzyme glutamate-pyruvate transaminase (GPT) is the most sensitive endogenous index of... 

In humans, early symptoms of intoxication may include headache, dizziness, nausea, vomiting, malaise, and myoclonic jerks of the limbs clonic and tonic convulsions and sometimes coma follow and may occur without the premonitory symptoms. A suicidal person who ingested 25.6mg/kg developed convulsions within 20 minutes that persisted recurrently until large amounts of barbiturates had been administered. Hematuria and azotemia occurred the day after ingestion and continued for 18 days. Liver function studies were within normal limits except for an elevated icterus index an electroencephalogram revealed generalized cerebral dysrhythmia, which returned to normal after 5 months. ... 

Hartleb M, Romanczyk T, Becker A, et al. (1992) The theophylline disposition after caffeine administration in liver cirrhosis an index of liver function. 

If we consider the mode of action of digitalis, what would we expect the therapeutic index of the dmg to be Large or rather smaller Complete receptor saturation will completely knock out the NaVK -ATP ase and thereby terminate the life of the target cell. Thus, it is quite obvious that we will have to walk a fine line in determining the right dosage. Therefore, we will have to consider very carefully the pharmacokinetic properties of the dmgs, and the kidney and/or liver functions of the patient. 

Quick s value A drop in the coagulation factors II, V, Vn, IX and X is a reliable indicator of the still remaining liver function. Factor VIII increases. With massive liver cell destruction, a dangerous decrease in factors V and VII is witnessed within 1 or 2 days (corresponding to the half-life of the factors) together with a reduction in Quick s value and Colombi s index (<60 - 80%). (45, 47, 71) (s. p. 105)... 

Abdel Salam AR, Drummond GB, Bauld HW, Scott DB. Clearance of indocyanine green as an index of liver function during cyclopropane anaesthesia and induced hypotension. Br J Anaesth 1976 48(3) 231-8. 

Vitamin K can be used to diagnose liver function accurately. Intramuscular injection of 2 mg of 2-methyl-1,4-naphthoquinonc elicits a response in prothrombin index in patients with jaundice of extrahepatic origin but not in those with jaundice of intrahepatic origin (e.g.. cirrhosis). 

DNP for acute to intermediate durations. Tests for liver function, such as icteric index (a measure of serum bilirubin), the Van den Bergh test, and the bromsulphalein retention test, in other case reports and clinical studies of people exposed orally found no evidence of impaired damage (Anderson et al. 1933 Masserman and Goldsmith 1934 Simkins 1937a, 1937b). 

The term cholephil has been proposed (H4) for endogenous and exogenous substances which are removed from the circulation by the liver and concentrated in the bile. Among the cholephils are bromsulfophthalein (BSP) and other dyes which have been used in the study of liver function in patients and experimental animals for over half a century. The uptake of cholephilic dyes, indeed, is widely held to be the most sensitive index of hepatobiliary function. 

In health, BSP appears in bile 6-20 minutes after injection and continues to be excreted for 5-6 hours (C4). Measurement of the appearance time of BSP in the bile obtained by duodenal intubation (C7, C8, S14), or from a T-tube after choledochotomy (M30), has been suggested as a test of liver function. Normal persons and patients with hepatitis had appearance times which never exceeded 20 minutes whereas longer times were characteristic of patients with biliary obstruction (C7). Measurement of the amount of BSP in bile collected by duodenal intubation was found to be a more sensitive index of liver function in convalescent hepatitis patients than various other biochemical tests (W31). 

The use of rose bengal for the clinical evaluation of liver function was first proposed by Delprat (D4). Usually blood samples are collected at 2 minutes and 8 minutes. The amount of dye present at 8 minutes expressed as a percentage of the dye at 2 minutes is taken as an index of liver function. Normally not more than 50% of dye remains at 8 minutes (D5, K6, S31, S32). The use of multiple blood samples has been tested (S2), but this offers little advantage over collection of two samples. The FDR (a) of rose bengal has also been used as an index of dye uptake by the liver (S2). 

Effect on liver function liver somatic index, level of ascorbic add, together with enzyme levels, e.g., EROD noted above ... 

In 63 patients with liver disease, the levels of vitamin A, RBP, and TTR were all markedly decreased and were highly significantly correlated with each other over a wide range of concentrations (Smith and Goodman, 1971). Nineteen patients with acute hepatitis were studied with serial samples as the disease improved, the plasma levels of vitamin A, RBP, and TTR all increased. In these patients, the RBP concentrations correlated negatively with the values of standard tests of liver function (plasma bilirubin, glutamic-oxaloacetic transaminase, and alkaline phosphatase). It has been reported that the level of RBP is of value clinically in assessing the course of acute infectious hepatitis and, to a limited extent, in the differentiation of various forms of jaundice (Kindler, 1972). It seems clear that measurements of plasma RBP levels in patients with liver disease could, if available, be used as an index of hepatic parenchymal functional status and hence could serve as a useful clinical liver function test. 

A test that can be used to assess liver function when other liver function tests are normal. It is a test of the ability of the liver to conjugate and excrete the dye bromsulphthalein (BSP). It consists of an intravenous injection of the dye followed by the collection of blood specimens up to 45 minutes after the injection. Bromsulphthalein is then measured in the serum samples by adding alkali which renders the dye purple. In normal subjects less than 5% of the dose should remain in the circulation after 45 minutes. Increased retention of BSP is a sensitive index of hepatic dysfunction although false positives may occur if there is impaired circulation in the liver. 

From metabolic studies, an isotopic caffeine breath test has been developed that detects impaired liver function using the quantitative formation of labeled carbon dioxide as an index. From the urinary excretion of an acetylated uracil metabolite, human acet-ylator phenotype can be easily identified and the analysis of the ratio of the urinary concentrations of other metabolites represents a sensitive test to determine the hepatic enzymatic activities of xanthine oxidase and microsomal 3-methyl demethylation, 7-methyl demethylation, and 8-hydroxylation. Quantitative analyses of paraxanthine urinary metabolites may be used as a biomarker of caffeine intake. Fecal excretion is a minor elimination route, with recovery of only 2-5% of the ingested dose. 

The ability of the liver to act as a depot for vitamin Bi2 (B28, G13) enables us to use this vitamin as an index of proper hepatic function. Hepatic disorders lead to an increased Bi2-binding in the serum (J5, R3), suggesting that the blood assumes a greater role in the conservation of B12. We have reported that patients with liver disease excreted invariably less than 10 fig of Bi2> 8 hours after a 50-[ig intramuscular load dose of the vitamin. In contrast, normal subjects excreted 24-40 pg, i.e., 50-80% of the vitamin in the same test (B14). These results were correlated with various chemical determinations indicative of hepatic disorders (Bl). In Table 16 the clinical diagnosis and the various liver-... 

Newer and potentially better hepatic function index continues to captivate researchers. A recent report indicates that hippurate ratio is a good measure of functional hepatocyte capacity [13]. The procedure monitors the conjugation of glycine to p-aminobenzoic acid by liver enzymes and may provide unique information on functional hepatic reserve. 

The risk of post-transplant diabetes mellitus is greater with tacrolimus than with ciclosporin, but this was mostly true in black patients and during the initial months after transplantation (1084). In one study, insulin sensitivity, alpha and beta cell function, and beta cell reserve were studied in 14 hepatitis C-positive patients with liver transplants, who took tacrolimus or ciclosporin maintenance for 1 year (1085). The patients were matched for low prednisolone dosage (1.1 mg/day versus 1.3 mg/day), body mass index, lean body mass, and sex, and compared with eight controls. Insulin sensitivity and insulin secretory reserve were significantly different from controls, but there was no significant difference between ciclosporin and tacrolimus. 

W6. Weinbren, K., and Billing, B. H., Hepatic clearance of bilirubin as an index of cellular function in the regenerating rat liver. Brit. J. Exptl. Pathol. 37, 199-204 (1956). 

While low serum cholesterol levels have been observed in malnourished patients, largely as a result of decreased synthesis of lipoproteins in the liver, hypocholesterolemia occurs later in the course of malnutrition and is therefore not useful as a screening test. PEM usually results in low serum urea nitrogen (BUN), urinary urea, and total nitrogen. Estimation of 24-h urine creatinine excretion is also a valuable biochemical index of muscle mass (when there is no impairment in renal function). The urinary CHI is correlated to lean body mass and anthropometric measurements. In edematous patients, for whom the extracellular fluids contribute to body weight and spuriously high body mass index values, the decreased CHI values are especially useful in diagnosing malnutrition. 

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