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At least 217 records · Page 12Linked to original sources
PubMed1993

Hepatic functional scintigraphic imaging with 99mtechnetium galactosyl serum albumin.

99mTc-galactosyl serum albumin (GSA), a specific radiolabeled synthetic ligand for asialoglycoprotein receptors on hepatocytes, was used for functional liver imaging in 18 patients. Six patients had chronic hepatitis, and 12 had liver cirrhosis. Serial scintigraphic images were obtained for 60 minutes after intravenous administration of 1 mg of the ligand. High-quality images of the liver was obtained in all the patients. Dispersed accumulation in the liver in association with delayed clearance of the ligand from the heart was noted in cirrhotic patients. The activity of the entire liver (L) and that of the heart (H) were measured. The capacity of the liver in terms of elimination of the ligand was estimated by calculating [L/H+L] 15 and 30 minutes after the administration. [L/H+L] showed significant differences between patients with chronic hepatitis and those with liver cirrhosis, and also showed significant correlations with laboratory values such as indocyanine green clearance, prothrombin time, hepaplastin test, serum albumin level, and the Child-Turcotte classification score. 99mTc-GSA might be a useful radiopharmaceutical for obtaining hepatic functional images.

Adult↗
PubMed1994

[Two-stage multivariant analyses for prediction of hepatic function reserve].

Eleven liver function tests were used for preoperative estimations of the hepatic function reserve in 103 patients with primary hepatocellular carcinoma (HCC) and underlying liver cirrhosis. Postoperatively, the patients' liver function could be classified as good recovering (Grade A, n = 38), functional damage (Grade B, n = 37) and liver failure (Grade C, n = 28). Single factor analyses showed 6 of those tests were significant indicators, including the ratio of blood glucose level at 120 minutes and 60 minutes by oral glucose tolerance test, total bilirubin, the ratio of albumin and globulin, prealbumin, prothrombin time and indocyanine green retention at 15 minutes. The correlations between 11 preoperative parameters (xi) and postoperative course scored (Y) were analysed by Fisher's discriminant test. The multiple regression equation Y1 was obtained by comparing from groups of Grade A with B and formula Y2 from groups of Grade B with C. The predictive accuracy of both equations were 88.0%, 83.1%, respectively. To select adequate surgical procedures with the best therapeutic effect and minimal liver damage for the patients with HCC, we proposed a method of "two-stage predications" combining use of Y1 and Y2 for evaluation of liver function reserve.

Adult↗
PubMed2006

Relationship of hepatic functional imaging to irinotecan pharmacokinetics and genetic parameters of drug elimination.

PURPOSE: The marked variability of irinotecan (Ir) clearance warrants individualized dosing based on hepatic drug handling. The aims of this trial were to identify parameters from functional hepatic nuclear imaging (HNI) that correlate with (1) Ir pharmacology, and (2) single-nucleotide polymorphisms (SNPs) for the ABCB1 (P-glycoprotein) and UGT-1A1 genes, known to influence Ir handling. METHODS: Patients underwent genotyping for ABCB1 SNPs and UTUGT-1A1*28 carriage and HNI with 99mTc-DIDA (acetanilidoiminodiacetic acid)/99mTc-DISIDA (disofenin) and MIBI (99mTc-sestamibi) scans, probes for biliary transport proteins ABCC1 and -2, and ABCB1 function. HNI data were analyzed by noncompartmental and deconvolutional analysis to provide hepatic extraction and biliary excretion parameters. Patients received Ir, fluorouracil, and folinic acid using a weekly x2, every-3-weeks schedule. Plasma was taken for Ir and SN-38 analysis on day 1, cycle 1. RESULTS: Of the 21 patients accrued, Ir pharmacokinetics data were obtained from 16 patients. 99mTc-DIDA/DISIDA percent retention at 1 hour (1-hour RET) correlated to baseline serum bilirubin (P = .008). Both 99mTc-DIDA/DISIDA and MIBI 1-hour RET correlated with SN-38 area under the curve (AUC; P < .01). On multiple regression analysis, SN-38 AUC = -215 + 18.68 x bilirubin + 4.27 x MIBI 1-hour RET (P = .009, R2 = 44.2%). HNI parameters did not correlate with Ir toxicity or UGT1A1*28 carriage. MIBI excretion was prolonged in patients with the ABCB1 exon 26 TT variant allele relative to wild-type (P = .015). CONCLUSION: Functional imaging of hepatic uptake and excretory pathways may have potential to predict Ir pharmacokinetics. Evaluation of a larger cohort as well as polymorphisms in other biliary transporters and UGT1A1 alleles is warranted.

ATP Binding Cassette Transporter, Subfamily B↗
PubMed1989

[Pharmacological effects of reiousan on experimental hepatic injuries and hepatic functions].

Pharmacological effects of Reiousan, a crude drug preparation consisting of bezoar and ginseng, on experimental hepatic injuries and hepatic functions were studied. After administration of Reiousan, carbon tetrachloride, d-galactosamine and alpha-naphthylisothiocyanate-induced experimental hepatic injuries in rats were inhibited. Facilitation of recovery from increased retention rate of sulfobromophthalein in hepatectomized rats, increase in hepatic blood flow, inhibition of superoxide anions, and decrease in blood ethanol concentration in rats administered ethanol were observed after application of Reiousan. Inhibitory effects of Reiousan on experimental hepatic injuries may result from the increase in hepatic blood flow and inhibition of superoxide anions.

1-Naphthylisothiocyanate↗
PubMedDate not supplied

Quantitative assessment of hepatic function by means of 99mTc-mebrofenin in healthy horses.

99mTc-mebrofenin is used in humans and small animals to assess hepatic function. This study was undertaken to measure hepatic clearance of 99mTc-mebrofenin in healthy horses and to determine whether feed deprivation and increased serum total bilirubin (TBIL) concentration alter 99mTc-mebrofenin clearance. Plasma clearance of 99mTc-mebrofenin was determirned in 7 healthy horses at 0, 48, and 96 hours of feed withholding. Serum TBIL and nonesterified fatty acid (NEFA) concentrations were measured every 24 hours. 99mTc-mebrofenin (4.16 +/- 0.62 mCi, mean +/- SD) was injected into a jugular vein, and blood samples were retrieved from the contralateral jugular vein. A plasma time-activity curve of 99mTc-mebrofenin was generated, from which the area under the curve (AUC) and the T1/2 of the fast-phase (T1/2) and slow-phase (T1/2f) were calculated. Mean +/- SD AUC was 17,700 +/- 4,257, 18,616 +/- 8,078, and 16,168 +/- 6,031 counts per minute (cpm) at 0, 48, and 96 hours, respectively; mean +/- SD T1/2f was 2.80 +/- 0.38 minutes, 3.52 +/- 1.46 minutes, and 3.82 +/- 1.29 minutes at 0, 48, and 96 hours, respectively; median T1/2s was 63.9, 49.2, and 45.8 minutes at 0, 48, and 96 hours, respectively. No difference was detected between the values of AUC, T1/2f, and T1/2s at 0, 48, and 96 hours. There was a significant increase in TBIL with fasting, with a mean +/- SD of 6.3 +/- 1.3 mg/dL at 26 hours. NEFAs increased, reaching a plateau at 48 hours (650 +/- 152 micromol/L). Plasma TBIL concentrations did not correlate with AUC or T1/2s but correlated weakly with T1/2f (r = 0.50). Plasma NEFA concentrations did not correlate with AUC, T1/2s, or T1/2f values. This study suggests that 99mTc-mebrofenin plasma clearance is not affected by feed withholding and that hyperbilirubinemia associated with feed withholding does not affect the hepatic extraction efficiency of this radiopharmaceutical.

Aniline Compounds↗
PubMed1997

[Influence of renal and hepatic function in the serum concentration of prostate specific antigen].

The influence of renal and hepatic functioning on serum levels of prostate specific antigen has been studied by examining its behaviour in a control group (CG) of 178 healthy male, a group of 48 patients with end-stage renal failure (ESRF) 22 of which had pre- and post-dialysis PSA measurements and a group of 48 patients with chronic liver failure (CLF). Mean PSA level in CHF, 0.64 ng/ml, was lower (p < 0.001) than the level seen either in CG, 1.37 ng/ml, and ESRF, 1.33 ng/ml, the last two exhibiting no statistical difference. Also, no significant differences were seen between pre- and post-dialysis PSA levels, 1.52 and 1.33 ng/ml respectively. The authors conclude that renal functioning has little relevance in the regulation of PSA serum levels and that, in spite of levels being lower in liver failure, this does not seem to be meaningful in the clinical practice.

Adult↗
PubMedDate not supplied

[Geomagnetic effects on hepatic function in different phases of the annual cycle].

Investigations on 496 Wistar rats have revealed that in winter geomagnetic deviations (GMD) have no effect on hepatic function of the intact animals. GMD in spring and summer provoked functional impairment of the liver while in autumn intact and CCl4 hepatitis rats exhibited GMD-related normalization of liver function. Thus, efficacy of physiotherapeutic correction of the liver depends on the phase of the annual cycle and geomagnetic situation.

Animals↗
PubMed1994

Effects of growth hormone (GH) administration on functional hepatic nitrogen clearance: studies in normal subjects and GH-deficient patients.

A decline in serum urea levels and urinary urea excretion is usually seen after GH administration in humans, indicating overall protein anabolism. Whether this reflects the diminished supply of alpha-amino acids for urea synthesis or a substrate-independent hepatic mechanism is unknown. To pursue this we measured the urea nitrogen synthesis rate (UNSR) and blood alanine levels before, during, and after a 4-h constant iv infusion of alanine (2 mmol/kg BW.h). UNSR was estimated hourly as urinary excretion corrected for gut hydrolysis and accumulation in total body water. The slope of the linear relationship between UNSR and circulating alanine levels represents the hepatic components of conversion of amino nitrogen and is denoted the functional hepatic nitrogen clearance (FHNC). Eight male volunteers were randomly investigated on three occasions: 1) after 12-h iv saline infusion, 2) after 12-h iv GH infusion (1 IU/h), and 3) after 2-day sc GH treatment (8 IU/day), followed by 12-h iv infusion of GH (1 IU/h). The UNSR (millimoles per h) during alanine infusion was significantly lower when the subjects were receiving GH therapy [maximum +/- SE, 133.0 +/- 6.9 (saline) vs. 96.7 +/- 11.1 (12-h GH; P < 0.01) vs. 106.5 +/- 7.5 (2-day GH; P < 0.05)]. FHNC (liters per h) was similar in all three studies [30.3 +/- 1.2 (saline) vs. 26.6 +/- 3.4 (12-h GH) vs. 27.0 +/- 2.6 (2-day GH)]. Six GH-deficient adult patients were randomly studied twice: 1) on regular daily (at 2000 h) sc GH therapy (3 IU/m2.day), and 2) after discontinuation of GH for 2 days. The UNSR during alanine infusion was likewise significantly lower when the patients were receiving GH therapy [147.7 +/- 11.7 mmol/h (no GH) vs. 123.9 +/- 9.1 mmol/h; P < 0.01]. FHNC (liters per h) values were similar in the two studies [29.2 +/- 3.8 (GH) vs. 27.5 +/- 4.5 (no GH)]. Our data confirm the anabolic action of GH and show that short term GH deprivation is associated with catabolism in terms of increased UNSR. The finding of unaltered FHNC suggests a GH-induced extrahepatic regulation of amino nitrogen conversion, rather than a substrate-independent hepatic mechanism.

Adult↗
PubMed2001

Technetium Tc 99m DTPA galactosyl human serum albumin to measure changes in hepatic functional reserve after transcatheter arterial embolization of the liver.

OBJECTIVE: To describe the acute and subacute changes in hepatic functional reserve using technetium Tc 99m diethylenetriaminepentaacetic acid galactosyl human serum albumin (Tc-99m DTPA GSA) in patients with hepatocellular carcinoma and liver cirrhosis who had undergone transcatheter arterial embolization (TAE). METHODS: Sequential Tc-99m DTPA GSA hepatic scintigraphies were performed prospectively in 26 consecutive patients with hepatocellular carcinoma and liver cirrhosis approximately 1 week before, 2 days after and 1 month after TAE. Counts per 10 seconds of the heart region of interest on 3- and 15-min images and the liver region of interest on a 15-min image were calculated. RESULTS: Clearance index decreased (p < 0.001) and receptor index and modified receptor index increased 2 days after TAE (p < 0.001 and p = 0.004, respectively), but these changes did not persist 1 month later. CONCLUSION: This study has established an expected pattern of behaviour of the liver after TAE, which could be used to monitor progress of patients who undergo the procedure.

Aged↗
PubMed2004

Splanchnic oxygen transport, hepatic function and gastrointestinal barrier after normothermic cardiopulmonary bypass.

BACKGROUND: The effect of non-pulsatile, normothermic cardiopulmonary-bypass (CPB) on the splanchnic blood-flow and oxygen-transport, the hepatic function and the gastrointestinal barrier were observed in a prospective observational study in 31 adults undergoing cardiac valve replacement surgery. METHODS: The splanchnic (i.e. hepatic) blood-flow (HBF) was measured by the constant infusion of indocyanine-green (ICG) using a hepatic-venous catheter. Liver function was examined by calculation of lactate uptake, ICG extraction and the monoethylglycinexylidide (MEGX) test. A day before and after surgery the gastrioduodenal and intestinal permeability was measured by determination of sucrose and lactulose/mannitol excretion. RESULTS: Splanchnic blood flow and oxygen delivery did not decrease during and after surgery while splanchnic oxygen consumption (P < 0.0125) and arterial lactate concentrations increased. The splanchnic lactate uptake paralleled the lactate concentration. After but not during CPB an increase of systemic oxygen consumption was observed. The MEGX test values decreased on the first day after surgery. The ICG extraction was attenuated during the operation. The gastroduodenal and the intestinal permeability increased significantly postoperatively (P < 0.002, respectively, P < 0.001). There was no correlation between these findings and the duration of CPB. There was a significant correlation of the intestinal permeability but not of the gastroduodenal permeability between the prior and after surgery values (P < 0.001). CONCLUSION: Increased oxygen consumption during CPB may indicate an inflammatory reaction due to the pump beginning in the splanchnic area or a redistribution of the splanchinc blood flow during the CPB. Normothermic CPB does not lead to a significant or prolonged reduction of liver function. Normothermic CPB causes an increase of gastrointestinal permeability. The intestinal barrier function prior to surgery was accountable for the degree of loss of intestinal barrier function following surgery.

Adult↗
PubMed1989

Change in hepatic function, hemodynamics, and morphology after liver transplant. Physiological effect of therapy.

Orthotopic liver transplantation (OLT) has become standard therapy for patients with acute hepatic necrosis and end-stage liver disease. This study measured change in hepatic function (galactose elimination capacity [GEC]), liver blood flow (low dose galactose clearance: flow), hepatic volume (CT scan; volume) and morphology after OLT. The aim was to measure the physiologic response after OLT and compare this response with that after selective shunt (SS) and sclerotherapy (ES) to determine which patients should receive specific therapy. Between January 1987 and November 1988, 37 patients underwent OLT. Operative mortality was 18%, which was similar to that of SS in Child's C cirrhotics. GEC and volume were less in transplant patients than in cirrhotics treated with SS or ES. GEC, flow, and volume normalized after OLT; GEC was preserved after ES and SS, but volume decreased. Three preoperative patterns were observed that can aid in selection of OLT candidates. Patients with chronic cirrhosis (chronic active hepatitis; cryptogenic) need OLT when GEC is less than or equal to 225 mg/min and volume is less than or equal to 50% normal. Patients with Budd-Chiari Syndrome require OLT if cirrhosis has evolved. Patients with sclerosing cholangitis and primary biliary cirrhosis qualify for transplants when complications of the portal hypertensive syndrome develop. The studies can also direct therapy for ES failures. Selective shunt is indicated in those patients with stable disease whose GEC is greater than or equal to 300 mg/min and liver volume is greater than 75% normal; OLT is indicated for cirrhotics with GEC that is less than 225 mg/min and liver volume that is less than 50% predicted normal.

Adult↗