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PubMed2004

[Study on the damage of liver in patients with SARS].

OBJECTIVE: To study the changes in liver function and histopathology, and investigate the underlying mechanism and clinical significance of damage of liver in patients with severe acute respiratory syndrome (SARS). METHODS: According the clinical diagnostic standard of atypical pneumonia of Ministry of Health P. R. China, liver function was assessed in 110 SARS patients admitted from February 2003 to June 2003. Of them 8 SARS patients died, and the livers were pathologically examined, and their liver function parameters were compared with that of the 35 healthy controls. RESULTS: Alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), total bilirubin (TBil) of patients with SARS were higher than those of controls, they were (91.61+/-50.53) U/L vs. (32.91+/-10.56) U/L, (78.68+/-33.32) U/L vs. (29.43+/-8.89) U/L, (429.95+/-188.94) U/L vs. (200.83+/-44.86) U/L, (11.67+/-4.26) micromol/L vs. (8.44+/-3.86) micromol/L, all P<0.001. Albumin (ALB) and pro-albumin (PAB) of patients with SARS were lower than those of controls, they were (34.40+/-5.13) g/L vs. (42.09+/-6.79) g/L, (0.20+/-0.06) g/L vs. (0.34+/-0.05) g/L, both P<0.001. Direct reaction bilirubin (DBil), total bile acid (TBA), gamma-glutamyltransferase (GGT) and alkaline phosphatase (ALP) showed no marked difference between SARS patients and controls, all P>0.05. Non-specific inflammation in the liver was observed in pathological examination in 4 cases. ALT, AST, GGT and LDH were always 4 to 9 times of normal. The ratio of abnormality of ALT, AST and PAB were more than 80.0 percent, the ratio of abnormality of ALB was 42.7 percent, and less than 30.0 percent for other indexes. The average of LDH, ALT, and AST of dead patients were higher than those of the survivors. Histopathology of liver was non-specific hepatitis. CONCLUSION: The patients with SARS are prone to have mild non-specific hepatitis. It seldom causes the typical symptoms of hepatitis and it is easy to be ignored in clinic.

Adult↗
PubMed2004

[Study on mouse pulmonary acute injury induced by air-borne PM2.5].

OBJECTIVE: In order to study the acute toxicity of PM2.5 and to explore the role of immunoreaction and oxidative stress in mouse pulmonary acute injury induced by PM2.5. METHODS: Kunming mice were randomly divided into five groups including blank control group, saline control group, three level PM2.5 (low, middle and high) groups. Three level PM2.5 groups were inoculated with suspensions of PM2.5 via trachea for 24 hours and saline control group were inoculated saline, Pulmonary pathological injury and bronchoalveolar lavage fluid (BALF) of all mice were later examined, including the level of LDH, AKP, ACP, ALB, NO, NOS, MDA, SOD, activities of TNF-alpha, IL-1 and phagocytosis of Alveolar macrophages (AM). RESULTS: The amount of LDH, AKP, ACP, ALB, NO, NOS, MDA and activities of TNF-alpha, IL-1 in exposed groups were significantly higher than those in control(P < 0.05), and at the same time the amount of SOD and phagocytosis of AM decreased significantly (P < 0.05). Dose-response relationships were observed in all indexes. CONCLUSION: Air-borne PM2.5 could have acute toxic effects on mouse pulmonary cells and membrane tissues via immunotoxicity and oxidative stress injury.

Air Pollutants↗
PubMed1992

[Comparative study on nephrotoxicity of ionic and non-ionic contrast agents for drip infused urography].

The effects on renal function of an ionic and hyperosmolaric contrast agent (diatrizoate) and a non-ionic and slightly hypertonic agent (iohexol) for drip infused urography were compared on 60 patients with normal renal function. Urine samples were collected before and 30 minutes after drip infusion of contrast agent, and analyzed for albumin (ALB), gamma-glutamyl transpeptidase (gamma-GTP), N-acetyl-beta-glucosaminidase (NAG), beta 2 microglobulin (beta 2MG) and creatinine (CRE). The urinary excretion of proteins and enzymes was compared with urinary CRE. gamma-GTP, NAG and beta 2MG increased significantly after infusion of diatrizoate. gamma-GTP and beta 2MG increased significantly after infusion of iohexol. Excretion of ALB, gamma-GTP, NAG and beta 2MG was significantly higher after infusion of diatrizoate than after iohexol. The urinary concentration of CRE was significantly lower after infusion of diatrizoate than after iohexol. The degree of renal damage after urography was no related to the appearance of allergy to the contrast agent or age of patient. Therefore, the non-ionic and slightly hyperosmolaric iohexol may be less toxic to the kidneys than the ionic and hypertonic diatrizoate. This nephrotoxicity after drip infused urography is thought to be related mainly to the osmolarity of contrast agent.

Adult↗
PubMed2004

Interaction of PACls with sulfate.

This article discusses the influential factors on Al13 separation considering the interaction of sulfate with various polyaluminum chloride (PACl). The experimental results showed that the basicity (B = [OH/[Al]), the concentration of PACl and Al/SO4 ratio exhibited significant roles in the PACl-sulfate reaction. It indicated that different species in various PACl underwent different reaction pathway with sulfate. The Alc, colloidal species, formed precipitation quickly with sulfate, while Alb, oligomers and polymers, underwent slow crystallization. And Ala, monomers, reacted with sulfate to form soluble complexes. The kinetic difference of reaction made it possible to realize the separation of Alb and further purification. The decrease of Ala resulted in the limit of ferron method was also mentioned.

Aluminum Hydroxide↗
PubMed2004

[Studies on the relationship between the level of cytokine and liver function in patients with clonorchiasis sinensis].

OBJECTIVE: To explore the relationship between cytokine level and liver function among patients infected with Clonorchis sinensis. METHODS: 47 patients were divided into three groups according to the degree of Child-Pugh liver function grade: 20 in group A (3-4 scores), 15 in group B (5-6 scores) and 12 in group C (7-9 scores). Interleukin 2 (IL-2), soluble IL-2 receptor (sIL-2R), interleukin 8 (IL-8) and tumor necrosis factor (TNF-alpha) were examined by radioimmunoassay (RIA) and enzyme-linked immunosorbent assay (ELISA). Automatic biochemical analyzer was employed for the determination of serum level of total bilirubin (TBL), albumin (ALB) and alanine aminotransferase (ALT). Data were analyzed with SAS statistic software. RESULTS: Serum levels of sIL-2R, IL-8 and TNF-alpha from patients were significantly higher than those obtained from healthy people (P<0.05, P<0.05, P<0.01), whereas the IL-2 level was significantly lower than the former (P<0.01). With the affected degree of the liver, serum levels of sIL-2R, IL-8 and TNF-alpha increased, in contrast to the decrease of IL-2 level. The differences were significant between groups A and C (P<0.05). The level of sIL-2R and TNF-alpha directly correlated with that of TBL (r=0.331 P<0.05, r=0.518 P<0.01) and ALT (r=0.475 P<0.01, r=0.285 P<0.05) respectively, but inversely correlated with the level of ALB (r=-0.319 P<0.05, r=-0.665 P<0.01). CONCLUSION: The infection of Clonorchis sinensis results in the reduction of cellular immune function of the patients. Certain relationship exists between serum cytokine level and liver function. Two cytokines, sIL-2R and TNF-alpha, are involved in the process of pathology.

Adult↗
PubMed2004

Promoting hepatic growth factor in the treatment of heavy type hepatitis and severe chronic hepatitis: a multicenter clinical study.

BACKGROUND: The mortality rate of heavy type hepatitis is high. No special treatment is available except general treatment. This multicenter clinical study was designed to observe the safety and efficacy of promoting hepatic growth factor (PHGF) in the treatment of heavy type hepatitis and severe chronic hepatitis. METHODS: 347 patients with heavy type hepatitis and 324 with severe chronic hepatitis were subjected to administration of 120 microg of PHGF per day for 4 weeks on the basis of general treatment. Those who were being effectively treated would last additional 2 to 4 weeks. Blood routine, urine routine, blood urea nitrogen (BUN), blood creatinine (Cr), blood ammonia, alpha fetoprotein (AFP), electrolyte, alanine transaminase (ALT), aspartate transaminase (AST), serum total bilirubin (TBIL), serum direct bilirubin (DBIL), prothrombin time activity (PTA), total protein (TP) and albumin (ALB) were detected in the patients before treatment, 2 weeks after treatment, and at the end of the treatment. Any side-effect would be recorded. RESULTS: In the patients with severe chronic hepatitis, the total effective rate of the treatment was 88.9%. The levels of ALT, AST and TBIL decreased significantly (P<0.001), whereas those of PTA and ALB increased significantly (P<0.001), and the level of AFP increased slightly. In patients with heavy type hepatitis, the total effective rate of this treatment was 78.4%, and patients at different stage showed different results. The total effective rates of patients with early, medium and terminal stage heavy type hepatitis were 89.9%, 84.8% and 27.5%, respectively. No severe side-effect was shown. CONCLUSION: PHGF is effective and safe in the treatment of patients with heavy type hepatitis and severe chronic hepatitis. But it should be administered early in patients with heavy type hepatitis so as to get better curative effects.

Acute Disease↗
PubMed2004

Study on enteric parasitosis and nutritional status of school children in remote hilly areas in Nepal.

We examined the effect of enteric parasitosis on nutritional status of school children in remote hilly areas in Nepal. A total of 325 school children aged 6 to 19 years (boys: 214; girls: 111) who provided both blood and stool samples were included. The height (Ht) (cm), weight (Wt) (kg), age, sex, ethnic of each child were recorded. Fecal samples were examined by direct smear method in duplicate. The blood hemoglobin (Hb) was estimated by Sahli's method in the field (Nepal) whereas the serum protein (Prot), albumin (Alb), Alb/globulin ratio (A/G), serum glutamate pyruvate transaminase (SGPT), cholesterol (Chol), triglycerides (Trig), and serum iron (SI) were measured in Japan. Of the total, 201 (61.8%) had enteric parasites, predominantly the soil transmitted helminths. Ascaris lumbricoides was the most common parasite detected (72.6%) followed by hookworm (16.2%) and others. Protozoan infections were very low (<6.0%). Of the total 201 parasite positive children, 15.4% had multiple infections. No significant differences in Ht and Wt in parasite positive and negative boys and girls of both age groups (< 11 and 11-19 years) were observed (P>0.05). Overall, no significant differences in levels of Hb, Prot, A/G, SGPT, Chol, Trig and SI in the parasite positive and negative children were observed (P>0. 05) but in Alb level (P<0.05). When, the levels of these parameters were compared in the age groups of <11 and 11-19 years, similar findings were observed in both the age groups. But, in the age group of 11-19 years, a significant difference was observed in Trig level (P<0.05). No differences were found in the levels of these parameters in the parasitic positive and negative children belonging to Dalits and different ethnic namely, Indo-Aryan and Tibeto-Burman, respectively.

Adolescent↗
PubMedDate not supplied

Preoperative hyaluronic acid measurement to assess the hepatic functional reserve.

BACKGROUND/AIMS: With liver surgery, preoperative assessment of the hepatic functional reserve is important for estimating the extent of hepatectomy. Hyaluronic acid (HA) is specifically cleared and metabolized by endothelial cells in the liver. Its half-life time is 2-5 min and HA might be a sensitive liver function marker. We obtained data from 44 patients with liver tumor undergoing liver resection. METHODOLOGY: We studied 44 liver resected patients. Blood samples were obtained before surgery and HA levels and other liver function markers [type IV collagen (IV), procollagen-III-peptide (PIIIP), lecithin-cholesterol acyltransferase (LCAT), cholinesterase (ChE), albumin (Alb), platelets (Plt), prothrombin time (PT%)] levels in the samples were measured. We also performed indocyanine green retention test and calculate R15% (ICG). RESULTS: HA showed strong positive correlation with ICG, IV and PIIIP, negative correlation with LCAT, ChE, Alb, Plt and PT%. ICG was not correlated with ChE, Plt and PT%. The HA levels and ICG of the patients who had more than 2 segments of the liver resected were below 100 ng/mL and 20%, respectively. In the patients with obstructive jaundice HA levels of the 3 patients with obstructive jaundice who underwent bisegmentectomy were below 100 ng/mL. CONCLUSIONS: Our findings suggest that HA is a useful preoperative liver function test as well as ICGR15%. Preoperative HA levels <100 ng/mL and ICGR15% <20% might be helpful indicators for major liver resection. We also recommend that HA measurement for evaluating liver function in the patients with obstructive jaundice ICG is not helpful.

Adult↗
PubMed2004

[Isolation and prelimary characterization of a kind of rat liver potential progenitor cells small round hepatic cells].

Liver undergoes profound regeneration usually after hepatic damage. It has been shown in recent study that two kinds of liver stem cells, which are mainly oval cells (OVCs) and small hepatocytes, are involved in the process of liver regeneration as they differentiated into premature liver cells. However, the origination of oval cells as well as its differentiation property is not quite understood. In this study, we isolated a novel potential liver progenitor cells, namely small round cells (SRCs). The cellular features of the cells such as morphological appearance, surface marker, growth curve, and differentiation induced by DMSO were analyzed. SRCs and OVCs were obtained by using discontinuous digestions and isopyknic centrifugation, respectively. With non-radioactive measurement of MTT, the cell growth was assayed. Meanwhile, SRCs were stained with antibodies against CK19, ALB and AFP antibody to characterize their tissue-specificities. The results showed that SRCs appeared in round-shaped, but irregular in size. The nuclei of SRCs were relative small with rich nucleolus visible. SRCs were semi-floated during primary culture. Even cultured in F12:DMEM (1:1) mixed-medium supplemented with 15% fetal calf serum, viability of the cells could merely be expanded over 7 days. SRCs were positively stained by CK19, ALB and AFP within initial 3 days. After DMSO stimulation, SRCs were not only morphologically changed into OVCs, but also expressed those markers identical to OVCs. It was suggested that SRCs could be considered as an potential candidate of liver progenitors which were related to OVCs.

Animals↗
PubMed1992

The clinical importance of routine measurement of liver enzymes, total protein and albumin in a general medicine outpatient clinic: a prospective study.

UNLABELLED: The objective was to study the usefulness of routine measurement of liver enzymes (ASAT, ALAT, alkaline phosphatase, gamma-GT), and total protein (TP) and albumin (Alb) in a general medicine outpatient clinic. A prospective study was made of consecutive patients who were classified according to whether or not an indication for the tests was present. All six tests were measured in all patients. Physicians were kept unaware of the results of tests in patients with no indication for ordering the test. The setting was a general internal medicine outpatient clinic in a 850-bed teaching hospital which serves as a referral clinic for general practitioners. There were 615 consecutive patients who were all new referrals to the outpatient clinic. The results of all patients with no indication for the test but who had abnormal results were presented to a panel of three experienced internists who decided whether the results had any clinical importance. Repeat measurements of the tests or follow-up results were obtained in all these patients. Seventy-eight of 320 patients in whom no indication for the test for liver enzymes existed had abnormal results. In only six of these (1.9%) were the abnormalities of clinical significance. In 56 of 449 patients in whom no indications were present for TP and Alb measurement the results were abnormal. In only 2 (0.4%) was this clinically important. CONCLUSION: the routine measurement of these six tests in general medicine outpatient clinics should be abandoned because of the low yield.

Adolescent↗
PubMed2005

[The value of coagulation factors in severity categorization of hepatitis B-related liver cirrhosis].

OBJECTIVE: To investigate the diagnostic value of coagulation factors in assessing the severity degree of liver cirrhosis caused by hepatitis B. METHODS: Fifty-eight patients with liver cirrhosis and twenty healthy persons as control were enrolled. Prothrombin time activity percentage (PTA), activated partial thromboplastin time, coagulation activity of factor II, V, VII, VIII, IX and X were detected with clotting assay. Antithrombin-III (AT-III) was detected with colorimetric assay. The biochemical markers were also detected. RESULTS: The differences of PTA, factor II, VII and AT-III among Child-Pugh A, B, C in patients with liver cirrhosis were statistically significant (P < 0.01). Through receiver operating characteristic curve analysis, when 64% and 50% were used as cut-off values for PTA and factor VII in diagnosing Child-Pugh B, the area under the curve (AUC) was 0.689 and 0.610, the sensitivity was 76.9% and 61.5%, the specificity was 62.2% and 55.6%; when 54% and 39% were used as cut-off values for PTA and factor VII in diagnosing Child-Pugh C, the AUC was 0.924 and 0.942, the sensitivity was 80.0% and 86.7%, the specificity was 88.4% and 90.7%. Stepwise linear regression was done between Child-Pugh grade and coagulation factors. PTA, cholinesterase (Che), total bilirubin (TBil), albumin (Alb), factor VII were included in regression equation, Y = 15.008 - 0.018 x PTA - 0.288 x Che + 0.264 x TBil - 0.988 x Alb - 0.034 x VII, R(2) = 0.871. Patients whose Y was less than 8 were classified as grade "a", between 8 - 10 as grade "b", more than 10 as grade "c", the diagnostic accuracy was 84.5%. CONCLUSION: Coagulation factor VII may serve as a helpful marker in diagnosing the severity degree of liver cirrhosis.

Adult↗
PubMed2005

[Clinical and experimental study of the therapeutic effect of umbilical cord blood stem cell transplantation on liver failure and heart damage in severe viral hepatitis patients].

OBJECTIVE: To investigate and compare the therapeutic effect of umbilical cord blood stem cell transplantation (UCBSCT) or adult fresh plasma in severe viral hepatitis liver failure with/without heart damage, and to study the effect of UCBSCT on liver lesions in rats. METHODS: 83 severe hepatitis patients with/without heart damage were included in the study between January 1994 and June 2003. The patients were treated with UCBSCT or given adult plasma transfusions. The therapeutic effect was evaluated by serial determination of liver function and myocardium enzymes in all patients before and after the treatment. The model of experimental hepatic failure was constructed in SD rats by injecting carbon tetrachloride. Then, the rats were given normal saline, neonate cord blood serum or neonate cord blood stem cells respectively. The expression of human AFP and Alb in SD rat livers was detected by immunohistochemistry; and human special DNA was detected by PCR. RESULTS: The UCBSCT group had much better effects in the improvement of liver function than the adult plasma group had, no matter whether the patients had heart damage or not. Moreover, UCBSCT can decrease heart impairment of the patients. The animal experiment demonstrated that AFP and Alb positive cells were present in the neonate cord blood stem cell group after 21 days and 1 month; human special DNA was detected by PCR in these SD rat livers. CONCLUSION: UCBSCT displayed good therapeutic effects on severe viral hepatitis and improvement of heart injury of the patients. The rat liver immunohistochemistry indicated that neonate cord blood stem cell application can decrease the liver damage and increase hepatocellular regeneration. Human umbilical cord blood stem cells can differentiate into liver cells in acute damaged SD rat livers.

Aged↗
PubMed2005

Effect of rofecoxib on the glomerular filtration rate, proteinuria and the renin-angiotensin-aldosterone system in elderly subjects with chronic renal impairment.

UNLABELLED: Considering the increasing popularity and prescribing of specific COX-2 inhibitors, a new class of NSAIDs lacking gastrointestinal side effects, the evaluation of their effects on renal function has become very important. OBJECTIVE: The aim of the study was to evaluate the effect of rofecoxib on GFR, proteinuria and the renin-angiotensin-aldosterone system (RAAS) in elderly patients with chronic renal impairment under controlled conditions of water and salt intake. SUBJECTS: There were ten patients (average age 67 years, range 53 - 80 years) with analgesic or vascular nephropathy (average GFR 54 ml/min/1.73 m2, range 30 - 79 ml/min/ 1.73 m2) given 25 mg rofecoxib daily for seven days under balanced conditions of water and sodium metabolism (salt intake 6 - 8 g/24 hours). METHODS: The effect of rofecoxib on GFR measured using inulin clearance (C(in)), creatinine clearance (C(Cr)) serum cystatin C concentration (S(cystatin)), tubular creatinine secretion (using the ratio C(Cr)/C(in)), 24-hour urinary excretion of albumin (U(alb)V) and prostaglandins (U(PGE2)V and U(PGF2alpha)V), basal and stimulated plasma renin activity (PRA) and serum aldosterone concentration S(aldosterone) was evaluated before and on Day 7 during rofecoxib treatment. RESULTS: Rofecoxib did not significantly change C(in), C(Cr), S(cystatin), C(Cr)/C(in) and U(alb)V. However, U(PGE2)V and U(PGF2alpha)V were decreased during rofecoxib administration (p = 0.059 and p = 0.024, respectively). Rofecoxib attenuated the stimulated rise of PRA and S(aldosterone) (p = 0.019 and p = 0.008, respectively). CONCLUSIONS: Short-term rofecoxib administration was not associated with significant change in GFR in elderly patients with moderate chronic renal impairment under conditions of balanced salt and water metabolism despite significant attenuation of RAAS activity. Since the C(Cr)/C(in) ratio did not change in our study, we assume rofecoxib to have no influence on creatinine tubular secretion.

Aged↗
PubMed2005

[Effects of aluminum speciation on wheat root growth and its enzyme activity].

Aluminum speciation is recognized to associate with environmental pH. In this paper, the effects of aluminum speciation (A1a, A1b) on the growth, protein content, acid phosphatase (AP) activity of wheat root were studied by changing the pH of aluminum solutions. Two concentrations of total aluminum, 25 micromol x L(-1) (T1) and 75 micromol x L(-1) (T2), were set up in the test solutions, and four levels of pH, 4.0, 4.5, 5.0 and 5.5, were regulated for each solution. The results indicated that the growth of wheat root in T1 and T2 was strongly inhibited by low doses of Ala and Alb, while the changing trend of protein content and AP activity varied when exposed to different composition of active A1. When the A1a concentration was above 90% of the active Al concentration, the protein content was reduced while the AP activity was enhanced by Al at pH 4.0, but it was reverse at pH 5.0 when the concentration of Ala and Alb was below 10 micromol x L(-1), respectively.

Acid Phosphatase↗
PubMed2005

[Practical application of nutritional assessment protein and inflammatory marker in the nutrition support team (NST)].

Recently nutrition support team (NST) has been established for the purpose of prevention of complications which are caused by nutrition disorders and reduction of the medical expenses. Although physical examinations and blood biochemical data had been used as the indexes evaluating nutritional of patients, they were not suitable for the evaluation for the short-term in-patient. On the contrary, serum albumin (ALB) has been wildly used as a nutritional marker. However, it is impossible to evaluate nutrition state for the short-term in-patient and acute phase disease patient accurately, because the plasma half-life is 21 days and it takes long time to detect the change in nutritional state by its value. Rapid turnover proteins (RTP), whose plasma half-life is shorter, has paid attention to evaluate nutritional state for the short-term in-patients and acute phase disease patients. Although, prognostic inflammatory and nutritional index (PINI) was considered as a useful maker for evaluating inflammatory and nutritional states using the concentrations of transthyretin (TTR), a RTP, alpha1-acid glycoprotein (alpha1-AG), a chronic inflammation marker, C reactive protein (CRP), a acute inflammation marker, and ALB, However, it has several pitfalls. We newly made serum amyloid A (SAA) index using SAA instead of CRP. When we compared SAA index with PINI in many diseases, it turned out that SAA index became a more effective index which reflected the patient condition than did PINI. As for this index, it is expected to be used by NST while further alternation may be needed.

C-Reactive Protein↗
PubMed2005

[Perioperative nutrition support of the patients with pancreatic head cancer].

OBJECTIVE: To explore the effect of perioperative nutrition support on nutritional condition and complications of the patients with postoperative pancreatic head cancer. METHODS: Thirty four patients received perioperative nutrition support, including enteral nutrition and parenteral nutrition (treatment group). Forty eight patients received routine postoperative parenteral nutrition (control group). According to the operative method, these two groups were further divided into two sub-groups: (1) pancreaticoduodenectomy (PD) subgroup, including 13 cases from treatment group, and 24 cases from control group; (2) palliative operation subgroup, including 21 cases from treatment group, and 24 cases from control group. Body weight, total protein (TP), serum albumin (ALB), and the complications after operation were compared. RESULTS: The concentrations of ALB and TP in the treatment group were significantly higher than those in the control group (P< 0.05). Body weight and TP of the patients received PD in the treatment group were significantly better than those of the control group (P < 0.05). CONCLUSION: Perioperative nutrition support can improve postoperative nutritional condition and reduce the postoperative complications in patients with pancreatic head cancer.

Adult↗
PubMed2005

Liver regeneration after split liver transplantation.

BACKGROUND: The number of split liver transplantations (SLT) has increased in the last 5 years. Regeneration after the loss of hepatic tissue is a fundamental response to liver injury. Because partial-liver grafts may not be an optimal size for recipients,the purpose of this study was to investigate the regeneration of graft liver after SLT. METHODS: Four recipients have undergone SLT at our hospital since 2002. The graft liver volume (GLV) in the postoperative day (POD) was measured by computed tomography (CT) and the serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TB), prealbumin (PA) and albumin (ALB) were monitored. The GLV at different postoperative times was compared to the recipient's standard liver volume (SLV) and the liver volume regeneration ratio (LVRR) was calculated. In order to compare SLV in recipient 2, we measured the total liver volume including the graft and the residual native liver as the GLV. RESULTS: The GLV/SLV at POD120 and POD360 of recipient 1 was measured 114% (1159.32 cm(3)/1016.95 cm(3)), 97% (986.44 cm(3)/1016.95 cm(3)) with the LVRR being -11.0%, -24.3%, respectively. For recipient 2, it was measured 96% (927.32 cm(3)/965.96 cm(3)) and 100% (968.98 cm(3)/965.96 cm(3)), with the LVRR being 24.4%, 30.0%, respectively. The initial graft volume of segment II, III was 265.36 cm(3) and increased to 335.24 cm(3) and 360.56 cm(3) at POD120 and POD360, respectively, with the LVRR being 26.3% and 35.9%, respectively. The GLV/SLV at POD60 of recipient 3 was 86% (893.04 cm(3)/1038.42 cm(3)) and the LVRR was 12.0%. For recipient 4, it was 90% (567.48 cm(3)/630.54 cm(3)) whereas the LVRR was 20.0%. The serum levels of ALT, AST and TB in all recipients declined gradually and returned to normal while the serum levels of PA and ALB increased to normal. The serum levels of ALT and AST peaked within 3 days after SLT. The neurological symptoms of Wilson's disease in recipient 2 were improved markedly. The levels of serum copper and copper-protein decreased to 30 mg/L, 120 mg/L at POD120 and the Kayser-Fleischer rings began to obliterate. CONCLUSIONS: The size of the transplanted liver after SLT tends to converge to the standard liver volume with time and it is adequate clinically for SLT to meet the need of the body's metabolic demands. The functional recovery of the graft liver occurs earlier than the morphological restoration.

Adult↗
PubMed2005

[Blood ionized calcium fraction in various serum albumin levels surveyed in non-dialysis patients].

Blood ionized calcium (iCa) fraction is affected by the serum albumin(Alb) level, even though this effect might not be appropriately estimated by the formulae proposed previously. To clarify a reasonable regimen for predicting iCa from serum total Ca (tCa), we investigated the relationship of blood iCa, tCa, and serum Alb levels through 124 samples from 116 non-dialysis patients requiring iCa measurement at the Nephrology Section of Toride Kyodo General Hospital. The patients comprised 61 males and 55 females with the mean age of 66.9 +/- 1.4 years, including 9 cases of hypercalcemia, 110 of normocalcemia, and 5 of hypocalcemia based on their iCa levels. Their background diseases were 25 cases of chronic glomerulonephritis, 17 of nephrotic syndrome, 40 of diabetes mellitus, 4 of collagen diseases, and 30 of others. Their mean serum Cr was 2.44 +/- 0.21 mg/dl, and 77 patients showed elevated Cr levels. Four adjustment formulae: one derived from Payne's, two from the proposal of K/DOQI Clinical Practice Guidelines, and a theoretical one based on the previous in vitro experiments, were compared with the non-adjusted value (tCa itself) with respect to their suitability for estimating iCa. The correlation coefficient of tCa with iCa was higher than the values adjusted by the above four formulae. The difference of iCa from tCa divided by eight, which concisely predicted iCa based on the assumption that half the serum Ca is bound to protein, was less than 1/8th of the other adjusted Ca levels. Hence none of the adjusted Ca by the above formulae was superior to nonadjusted tCa from the point of estimating the iCa level. Moreover, the sensitivity for predicting hypocalcemia was the highest in tCa, even though its specificity was lower than the other adjusted values. In conclusion, no adjustment formula is required to predict ionized Ca from tCa, and to screen hypo- or hypercalcemia.

Adolescent↗