Liver function

About: Liver function is a research topic. Over the lifetime, 32949 publications have been published within this topic receiving 770929 citations.

Transection of the oesophagus for bleeding oesophageal varices

Abstract: Emergency ligation of bleeding oesophageal varices using the Milnes Walker technique was performed in 38 patients. Haemorrhage continued or recurred in hospital in 11 patients, all of whom subsequently died. A further 10 patients died in hospital following operation from hepatic failure and a variety of other causes. Five patients were finally considered suitable for elective shunt surgery, but of 12 patients who were discharged without a further operation, only 2 have re-bled. Although the overall 6-month survival was 32 per cent, in patients with good preoperative liver function this rose to 71 per cent, and the simple scoring system for grading the severity of disturbance of liver function was found to be of value in predicting the outcome of surgery. Since the results of emergency ligation of bleeding oesophageal varices in our hands have been so disappointing we are currently using it less and are trying the mesenteric caval jump graft as an emergency operation for the control of bleeding varices.

Efficacy and safety of sorafenib in patients in the Asia-Pacific region with advanced hepatocellular carcinoma: a phase III randomised, double-blind, placebo-controlled trial.

Abstract: Summary Background Most cases of hepatocellular carcinoma occur in the Asia-Pacific region, where chronic hepatitis B infection is an important aetiological factor. Assessing the efficacy and safety of new therapeutic options in an Asia-Pacific population is thus important. We did a multinational phase III, randomised, double-blind, placebo-controlled trial to assess the efficacy and safety of sorafenib in patients from the Asia-Pacific region with advanced (unresectable or metastatic) hepatocellular carcinoma. Methods Between Sept 20, 2005, and Jan 31, 2007, patients with hepatocellular carcinoma who had not received previous systemic therapy and had Child-Pugh liver function class A, were randomly assigned to receive either oral sorafenib (400 mg) or placebo twice daily in 6-week cycles, with efficacy measured at the end of each 6-week period. Eligible patients were stratified by the presence or absence of macroscopic vascular invasion or extrahepatic spread (or both), Eastern Cooperative Oncology Group performance status, and geographical region. Randomisation was done centrally and in a 2:1 ratio by means of an interactive voice-response system. There was no predefined primary endpoint; overall survival, time to progression (TTP), time to symptomatic progression (TTSP), disease control rate (DCR), and safety were assessed. Efficacy analyses were done by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00492752. Findings 271 patients from 23 centres in China, South Korea, and Taiwan were enrolled in the study. Of these, 226 patients were randomly assigned to the experimental group (n=150) or to the placebo group (n=76). Median overall survival was 6·5 months (95% CI 5·56–7·56) in patients treated with sorafenib, compared with 4·2 months (3·75–5·46) in those who received placebo (hazard ratio [HR] 0·68 [95% CI 0·50–0·93]; p=0·014). Median TTP was 2·8 months (2·63–3·58) in the sorafenib group compared with 1·4 months (1·35–1·55) in the placebo group (HR 0·57 [0·42–0·79]; p=0·0005). The most frequently reported grade 3/4 drug-related adverse events in the 149 assessable patients treated with sorafenib were hand-foot skin reaction (HFSR; 16 patients [10·7%]), diarrhoea (nine patients [6·0%]), and fatigue (five patients [3·4%]). The most common adverse events resulting in dose reductions were HFSR (17 patients [11·4%]) and diarrhoea (11 patients [7·4%]); these adverse events rarely led to discontinuation. Interpretation Sorafenib is effective for the treatment of advanced hepatocellular carcinoma in patients from the Asia-Pacific region, and is well tolerated. Taken together with data from the Sorafenib Hepatocellular Carcinoma Assessment Randomised Protocol (SHARP) trial, sorafenib seems to be an appropriate option for the treatment of advanced hepatocellular carcinoma. Funding Bayer HealthCare Pharmaceuticals and Onyx Pharmaceuticals, Inc.

Clinical biochemistry of domestic animals

Abstract: T.B. Farver, Concepts of Normality in Clinical Biochemistry. J.G. Hauge, DNA Technology in Diagnosis, Breeding, and Therapy. J.J. Kaneko, Carbohydrate Metabolism and Its Diseases. M.L. Bruss, Lipids and Ketones. J.J. Kaneko, Serum Proteins and the Dysproteinemias. L.J. Gershwin, Clinical Immunology. J.W. Harvey, The Erythrocyte: Physiology, Metabolism, and Biochemical Disorders. J.J. Kaneko, Porphyrins and the Porhyrias. J.E. Smith, Iron Metabolism and Its Disorders. W.J. Dodds, Hemostasis. J.G. Zinkl and M.B. Kabbur, Neutrophil Function. J.W. Kramer and W.E. Hoffmann, Clinical Enzymology. B.C. Tennant, Hepatic Function. D.F. Brobst, Pancreatic Function. W.E. Hornbuckle and B.C. Tennant, Gastrointestinal Function. G.H. Cardinet III, Skeletal Muscle Function. D.R. Finco, Kidney Function. G.P. Carlson, Fluid, Electrolyte, and Acid-Base Balance. J.A. Mol and A. Rijnberk, Pituitary Function. A. Rijnberk and J.A. Mol, Adrenocortical Function. J.J. Kaneko, Thyroid Function. L-E. Edqvist and M. Forsberg, Clinical Reproductive Endocrinology. T.J. Rosol and C.C. Capen, Calcium-Regulating Hormones and Diseases of Abnormal Mineral (Calcium, Phosphorus, Magnesium) Metabolism. R.B. Rucker and J.G. Morris, The Vitamins. M. Haskins and U. Giger, Lysosomal Storage Diseases. B.R. Madewell, Tumor Markers. C.S. Bailey and W. Vernau, Cerebrospinal Fluid. J.R. Turk and S.W. Casteel, Clinical Biochemistry in Toxicology. W.F. Loeb, Clinical Biochemistry of Laboratory Rodents and Rabbits. J.T. Lumeij, Avian Clinical Biochemistry. Appendixes. Index.