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The course of liver involvement during the first three weeks of typhoid fever was studied in 20 patients. Previous studies of liver involvement in typhoid fever have not considered the time course of changes. In this study, hepatomegaly was found during the 2nd or 3rd wk more often than in the 1st wk (36% vs. 11%), whereas jaundice was detectable in 9% of patients after the 1st wk, but never before. Alkaline phosphatase, AST, and ALT were raised in 100%, 100%, and 91% of cases, respectively, during the 2nd and 3rd wk but during the 1st wk, only 11%, 89%, and 56% had mild increases. This study shows that, although the clinical picture of hepatitis is unusual, liver involvement is invariably present after the 1st wk, and should not be considered as a complication, but as a feature of the disease.
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PMID:The liver in typhoid fever: always affected, not just a complication. 188 3

A prospective study was performed in clinically malnourished patients in which liver function was tested during a 4-week period of total parenteral nutrition (TPN). The purpose was to determine if concomitant intravenous lipid administration would reduce liver function abnormalities noted to occur frequently in patients receiving TPN. Twenty-five patients were randomly assigned to receive either daily infusions of 200 cc of a 20% lipid emulsion with TPN or TPN without lipid for the first week. In the subsequent 3 weeks all patients received daily intravenous lipid. The early lipid treatment group received 0.7 g lipid/kg BW/day and approximately 280 mg of choline/day from the lecithin emulsifier throughout the entire study period. Liver function tests were performed twice in the first week, then weekly thereafter. There were significant (p less than 0.05) elevations in liver function tests in the early lipid treatment group (for aspartate aminotransferase in weeks 1, 2, and 3, and lactic acid dehydrogenase in weeks 2 and 3). Alkaline phosphatase activity was elevated at weeks 2, 3, and 4 for the lipid-treatment group and at week 1 for the lipid-restricted group. The two groups had a similar elevation in gamma-glutamyltransferase activity. Analysis of covariance demonstrated that the overall duration of TPN, and not the presence or absence of intravenous lipid, was significantly related to the elevations in both alkaline phosphatase and gamma-glutamyltransferase (GGT) levels. In contrast, the early intravenous administration of lipid was significantly related to the increase in aspartate aminotransferase levels. The peak increase in AST was noted at day 7 in the lipid-administration group.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Abnormal liver function in malnourished patients receiving total parenteral nutrition: a prospective randomized study. 210 45

The purpose of these present experiences was to evaluate some metabolic parameters, which can show liver damage after end-to-side porto-caval shunt, comparing the data with "sham operated" rats. At 180th day in each group the following parameters were controlled: ALT, AST, Alkaline phosphatase, gamma GT, bilirubin, Cholesterol, albumin and ammonia blood level. The results showed a significant increase of gamma GT, APh, bilirubin and ammonia blood level in porto-caval shunt operated rats.
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PMID:[Metabolic changes following termino-lateral portacaval anastomosis in the rat]. 614 21

There is no one test of liver function. Routine laboratory tests that are useful in screening for liver disease and following its course include serum AST, ALT, alkaline phosphatase, protein electrophoresis, prothrombin time, and bilirubin levels. The transaminase levels give a day-by-day account of the amount of hepatocellular injury and death that occurs. Alkaline phosphatase levels estimate the amount of impedance of bile flow. The prothrombin time and serum albumin level are excellent gauges of hepatic protein synthetic ability, whereas the bilirubin level is probably the best test of overall liver function. Many tests are now available that permit one to diagnose specific diseases of the liver.
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PMID:Evaluation of tests used to screen patients with liver disorders. 888 44

1. Female broiler breeders were fed ad libitum or a restricted quantity of food to achieve either a recommended body weight curve or a modified (linear) growth curve that allowed more generous feeding between 6 and 15 weeks of age. The birds were fed a ration containing either a normal or low concentration of crude protein. The welfare of the birds was assessed using a profile of indices of welfare at 6, 12, 18 and 24 weeks of age. 2. The low-protein ration decreased the body weight of birds fed ad libitum and restricted birds were fed substantially more of the low-protein ration to meet target body weights from 3 to 14 weeks of age. 3. The modified restricted rearing programme did not have an effect on indices of welfare. 4. Water intakes and plasma corticosterone concentrations were lower in restricted birds fed the low-protein ration and they spent more time resting, and less time spot-pecking, than birds fed the high-protein ration. 5. Birds fed ad libitum on both rations spent more time resting and less time foraging, drinking and spot-pecking than food restricted birds and were more fearful than restricted birds at 6, 12 and 18 weeks of age. 6. The heterophil:lymphocyte ratio in restricted birds was higher at 6 weeks and lower at 24 weeks compared with birds fed ad libitum. Humoral immunity was lower at 6 weeks of age in birds fed ad libitum and was similar at other ages. Cell-mediated immunity was similar among all treatments. 7. Plasma corticosterone concentrations were higher in restricted birds compared with birds fed ad libitum. Plasma creatine kinase activity was higher in birds fed ad libitum at 6, 12 and 18 weeks of age. Alkaline phosphatase and lactate dehydrogenase activity were higher whereas AST was lower in restricted birds compared with those fed ad libitum. 8. There was no evidence to support the use of low protein rations or linear growth curves to improve welfare in restricted broiler breeder females.
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PMID:Welfare assessment of modified rearing programmes for broiler breeders. 1157 16

Protein-energy malnutrition is one of the major public health problems in developing countries of the world due to prevailing socio-economic problems. This study aimed to observe the effect of formulated complementary blends on biochemical parameters of rats. Extruded complementary blends from maize fortified with cowpea or soybean at a level of 35% and 25% respectively were fed to 4 groups of rats for 28 days. Similarly, 3 other groups of rats were placed on casein, non-protein or rat pellet diet. Biochemical analysis was done on blood samples of the rats. Results from previous studies show the protein content of the formulated diets to range from 15.75% in UMC to 17.24% in MMS. Significantly (p < 0.05) lower WBC, Hb, MCHC, total protein, albumin and globulin values were recorded for the rats fed a non-protein diet (NP). The serum AST level was 75.5, 71.2, 63.2, 51.0, 60.5 and 55.7, respectively, for rats on casein, rat pellet, MMS, UMS, MMC and UMC (list of abbreviations is shown in the appendix) diets. Alkaline phosphatase was significantly (p < 0.05) higher in soybean-based diets while cholesterol was lowest in rats fed the non-protein diet (NP). The value obtained for serum electrolyte concentration in the rats fed NP compared well with rats on other diets but, however, had a significantly (p < 0.05) higher serum sodium value. These results confirm that the experimental diets supported growth, as shown in a previous study, and had no harmful consequence.
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PMID:Effect of feeding maize/legume mixtures on biochemical indices in rats. 1274 70

The prevalence of alterations of liver function tests in patients treated with a wide range of antypsychotics is unknown. The aim of this study was to analyze the effects of antipsychotics on liver function tests in a population of schizophrenic outpatients. Concentrations of AST, ALT, GGT, alkaline phosphatase, albumin, and bilirubin were determined in 54 patients fitting DSM-IV criteria of schizophrenia, and the same number of sex- and age-matched healthy subjects. Assessments included the Clinical Global Impression (CGI) and the Positive and Negative Syndrome Scale (PANSS) in addition to treatment related variables. Transaminases concentrations were slightly elevated in study patients compared to healthy controls, but without statistical significance. Alkaline phosphatase showed higher values in schizophrenic patients. Albumin and bilirubin were lower in study patients. Liver function tests abnormalities were found in about 10% of schizophrenic patients treated with antipsychotics. Treatment with depot phenotiazines induces alteration in these tests more frequently than treatment with other antipsychotics. PANSS negative subscale scores directly correlated with alkaline phosphatase and inversely correlated with albumin. A substantial number of patients in treatment with antipsychotic drugs present alterations of liver function tests. Both pharmacological and clinical factors could be related with these alterations.
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PMID:Alterations of liver function test in patients treated with antipsychotics. 1461 43

Liver function tests include biochemical parameters (AST, ALT, GGT or Alkaline phosphatase), bilirubin and albumin levels and coagulation tests as prothrombin activity. These tests are commonly used in the routine screening even in symptomatic as in asymptomatic patients, and the right evaluation of the results is of vital importance. Cytolytic elevation in serum aminotransferases: In mild chronic elevation pharmacological toxicity, viral hepatitis, alcoholic and non-alcoholic fatty liver disease and hemochromatosis, should be excluded. Cholestatic elevation os serum enzymes: The first option should be to establish the origin of the alkaline phosphatase elevation, with the evaluation of the GGT levels to confirm the hepatic origin. The next step should be to distinguish the presence of an extrahepatic (biliary obstruction) or intrahepatic (PBC, PSC, drugs, etc) cholestasis, in these cases the most important test should be the abdominal ultrasound, in order to evaluate the biliary system. Hyperbilirubinemia: Non conjugated hyperbilirubinemia (hemolysis, ineffective erythropoiesis, Gilbert or Criggler-Najjar syndromes) and conjugated hyperbilirubinemia, an unusual situation in which Rotor and Dubin-Johnson Syndromes should be considered. The evaluation of albumin and prothrombin levels evaluates the hepatic function per se, allowing to differentiate between acute and chronic diseases. At present, there are not prospective studies to evaluate the efficacy of the liver function tests. To carry out a complete medical history, an appropriate physical examination and the appropriate application of non-invasive diagnostic tests (serology, iron levels, autoimmunity or abdominal ultrasound) allow to perform a right diagnosis in most patients, making more complex tests, including liver biopsy, secondary.
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PMID:[Utility of analytical parameters in the diagnosis of liver disease]. 1737 60

An attempt has been made to study the influence of taurine on mercury intoxicated rats. The animals were treated with sublethal dose of mercuric chloride (2 mg/kg body wt.) for 30 days. During the mercury treatment, the level ofAspartate transaminase(AST), Alanine transaminase (ALT) and Alkaline phosphatase(ALP) in serum and lipid peroxidation (LPO) in liver tissue significantly increased whereas Glutathione (GSH), Glutathione peroxidase(GPx), Catalase (CAT) and Superoxide dismutase (SOD) were simultaneously decreased in the liver tissue. Present results indicate that the liver tissue was completely damaged, after mercury treatment. In another group of animals, taurine (5 mg/kg body wt.) was administrated for another 15 days. Taurine administration was observed to improve the liver function in mercury intoxicated animal as indicated by the decline in increased levels of AST, ALT and ALP in serum and LPO content in liver tissue. The decreased level of antioxidant system (GSH, GPx, CATand SOD) has been promoted Results suggested that taurine played a vital role in reducing the mercury toxicity in intoxicated animals.
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PMID:Hepatoprotective effects of taurine against mercury induced toxicity in rats. 1840 8

Sarcoidosis is a granulomatous disease of unknown origin, with pulmonary findings in more than 90% of patients. Extrapulmonary involvement is common and all organs can be involved (especially lymph nodes, eyes, joints, central nervous system) but it is rare to find an isolated extrapulmonary disease (less than 10% of patients). Granulomatous inflammation of the spleen and the liver is common in patients with systemic sarcoidosis, while hepatosplenic enlargement is unusual and splenic involvement rare. We report two cases of systemic sarcoidosis, that onset with splenic and hepatosplenic disease, and one case with splenic sarcoidosis without pulmonary involvement. In the first case a 53-year-old woman with mild abdominal pain underwent sonography and CT, which revealed one hypoechoic/hypodense splenic lesion. Laboratory tests were normal. In order to exclude a lymphoma, splenectomy was performed: histology revealed a sarcoid granuloma. After surgery the patient was asymptomatic and now, after two years, disease is silent. The second case is a 66-year-old woman with a recent weight loss (8 kg in two months) and alterated liver function tests (AST 61 U/l, ALT 72 U/l, Alkaline phosphatase 748 U/l, g-GT 381 U/l). Since she had a familiar history of colon cancer, abdominal US scan, abdominal CT scan and MRI were performed and showed inter-aorto-caval lymphadenopathies and discreet multiple bilobar hepatic and splenic substitutive lesions, with no signs of primary tumor. Upper and lower GI endoscopy, full gynecological workup, complete set of tumor markers, bone marrow biopsy were performed. All resulted negative for neoplasia. Small pulmonary infiltrations were observed on chest-CT scan but cytology on BAL was normal. Infections were also excluded. An exploratory laparotomy showed whitish peritoneal, hepatic and splenic nodules. The histological exam revealed chronic granulomatous lesions typical for sarcoidosis. During a two-year follow-up after the splenectomy the patient feels well without any treatment. The third patient is a 32-year-old woman with mild epigastric pain after meals. Neck-thoracic CT, bone scintigraphy and upper GI endoscopy were negative. Abdominal US and MR showed splenomegaly with multiple splenic lesions. Splenectomy was performed and histological exam showed chronic granulomatous lesions typical for sarcoidosis. Further laboratory tests were normal, except for ACE (66 UI/l). After the surgery ACE became normal and now, three years later, the patient is still asymptomatic. We conclude that hepatosplenic involvement is less rare than it is thought. It is often oligosymptomatic or accompanied with unspecific manifestations and laboratory abnormalities. The diagnosis could be difficult; in fact typical laboratory findings of sarcoidosis such as ACE, lysozyme, calcium, were not diagnostic. Ultrasonography and CT were important but the diagnosis was established only with the histological examination of suspected lesions. This latter required to differentiate liver and/or spleen sarcoidosis from tuberculosis and other infections, primary biliary cirrhosis, metastasis or malignant lymphoma.
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PMID:Atypical sarcoidosis: case reports and review of the literature. 2138 7


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