Intestinal ischemic shock and the protective role of the liver

1959 ◽  
Vol 197 (2) ◽  
pp. 281-285 ◽  
Author(s):  
Ewald E. Selkurt
Keyword(s):  
Liver Function ◽  
Survival Time ◽  
Mode Of Action ◽  
Intestinal Ischemia ◽  
Normal Liver ◽  
Systemic Circulation ◽  
Protective Role ◽  
Circulatory Collapse ◽  
Normal Liver Function

A study has been made of the effects of intestinal ischemia of 2 hours' duration on hemodynamics and survival time of mongrel dogs. When the arterial supply to the liver was kept intact during ischemia of the remainder of the splanchnic bed, circulatory collapse ensued at an average time of 7 hours after release of the ischemic compression. When the blood supply to the liver was virtually eliminated, survival was reduced to an average of less than 3 hours ( P = <0.02). The view is favored that the anoxic intestine elaborates a vasotoxic substance, which in the absence of normal liver function invades the systemic circulation with deleterious consequences on the cardiovascular system. The nature of this substance or substances is unknown, as is its specific mode of action.

scholarly journals The Mechanisms and Physiological Consequences of Diurnal Hepatic Cell Size Fluctuations: A Brief Review.

2022 ◽  
Vol 56 (S2) ◽  
pp. 1-11
Keyword(s):  
Liver Function ◽  
Molecular Mechanisms ◽  
Normal Liver ◽  
Hepatic Cell ◽  
Future Research ◽  
Normal Liver Function ◽  
Liver Size ◽  
Daily Changes ◽  
Diurnal Regulation

Liver size in mammals fluctuates throughout the day and correlates with changes in hepatocyte size. However, the role of these daily changes in liver and hepatocyte size and the underlying molecular mechanisms remain largely unknown. In this review, we highlight the view that hepatocyte size, and thus, overall organ size, is subject to regulation by the circadian clock and feeding/fasting cycles. To that end, we provide an overview of the current literature dealing with this phenomenon and elaborate the role of feeding and nutrients in this process. We will discuss the role of hepatic protein content and synthesis, which are both subject to diurnal regulation, in daily hepatocyte and liver size fluctuations. Although there is evidence that changes in hepatocyte and liver size are associated with daily variations in macromolecule content, there is also evidence that these changes in size may be actively regulated by modifications of the cells' osmotic environment. Future research will need to examine the intriguing possibility that hepatocyte and liver size fluctuations may be required for normal liver function and to reveal the underlying molecular mechanisms behind this process.

scholarly journals Unexpected encephalopathy in chronic renal failure: hyperammonemia complicating acute peritonitis.

1994 ◽  
Vol 5 (4) ◽  
pp. 1066-1073
Author(s):  
J L Pimentel ◽  
S W Brusilow ◽  
W E Mitch
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Liver Function ◽  
Normal Liver ◽  
Liver Function Tests ◽  
Systemic Circulation ◽  
Pelvic Abscess ◽  
Chronic Inflammatory Disease ◽  
Normal Liver Function ◽  
Acute Peritonitis

A woman with mild chronic renal insufficiency was being treated with glucocorticoids for a presumed chronic inflammatory disease. She developed peritonitis arising from a pelvic abscess, which was drained without complications. Unexpectedly, she became obtunded, and eventually, the neurologic dysfunction was linked to hyperammonemia in spite of normal liver function tests. Hyperammonemia was only transiently controlled in spite of protein restriction, repeated hemodialysis, and the use of biochemical means to reduce ammonia. A recurrent pelvic abscess was drained, and hyperammonemia disappeared. A review of ammonia and nitrogen metabolism indicates that bypassing the liver with shunting of ammonia into the systemic circulation should be added to the causes of symptomatic hyperammonemia. Treatment requires the elimination of the bacteria.

Management of Obscurely Dilated Common Bile Duct with Normal Liver Function Tests: A Pragmatic Approach

2021 ◽  
Author(s):  
Sundeep Singh Saluja ◽  
Vaibhav Kumar Varshney ◽  
Vidya Sharada Bhat ◽  
Phani Kumar Nekarakanti ◽  
Asit Arora ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Liver Function ◽  
Normal Liver ◽  
Liver Function Tests ◽  
Pragmatic Approach ◽  
Normal Liver Function ◽  
Function Tests

Persistently raised aspartate aminotransferase (AST) due to macro-AST in a rheumatology clinic

Diagnosis ◽  
2015 ◽  
Vol 2 (2) ◽  
pp. 137-140 ◽  
Author(s):  
Wycliffe Mbagaya ◽  
Joanne Foo ◽  
Ahai Luvai ◽  
Claire King ◽  
Sarah Mapplebeck ◽  
...  
Keyword(s):  
Liver Function ◽  
Aspartate Aminotransferase ◽  
Normal Liver ◽  
Abdominal Ultrasound ◽  
Liver Function Tests ◽  
Analytical Investigation ◽  
Normal Liver Function ◽  
Rheumatology Clinic ◽  
History Of ◽  
Liver Biopsies

AbstractMacrocomplexes between immunoglobins and aspartate aminotransferase (macro-AST) may result in persistently increased AST concentration. The presence of macro-AST in patients has been implicated in unnecessary investigations of abnormal liver function tests. We report the case of a 44-year-old female who presented to the rheumatology clinic with a 12-months’ history of constant widespread pain affecting her limbs and was found to have an elevated AST concentration. Further information from her GP revealed a 14-years’ history of elevated AST with otherwise normal liver function. Previous abdominal ultrasound and two liver biopsies carried out 2 years apart were normal. This prompted further analytical investigation by the biochemistry department which identified macro-AST as the cause. This case illustrates that persistently raised isolated AST concentration with no other abnormal indices may warrant macroenzyme analysis potentially avoiding unnecessary invasive investigations.

The gut does not contribute to systemic ammonia release in humans without portosystemic shunting

2008 ◽  
Vol 295 (4) ◽  
pp. G760-G765 ◽  
Author(s):  
Marcel C. G. van de Poll ◽  
Gerdien C. Ligthart-Melis ◽  
Steven W. M. Olde Damink ◽  
Paul A. M. van Leeuwen ◽  
Regina G. H. Beets-Tan ◽  
...  
Keyword(s):  
Major Hepatectomy ◽  
Normal Liver ◽  
Systemic Circulation ◽  
Ammonia Production ◽  
Concentration Gradients ◽  
Ammonia Metabolism ◽  
Ammonia Uptake ◽  
Ammonia Release ◽  
Baseline Values

The gut is classically seen as the main source of circulating ammonia. However, the contribution of the intestines to systemic ammonia production may be limited by hepatic extraction of portal-derived ammonia. Recent data suggest that the kidney may be more important than the gut for systemic ammonia production. The aim of this study was to quantify the role of the kidney, intestines, and liver in interorgan ammonia trafficking in humans with normal liver function. In addition, we studied changes in interorgan nitrogen metabolism caused by major hepatectomy. From 21 patients undergoing surgery, blood was sampled from the portal, hepatic, and renal veins to assess intestinal, hepatic, and renal ammonia metabolism. In seven cases, blood sampling was repeated after major hepatectomy. At steady state during surgery, intestinal ammonia release was equaled by hepatic ammonia uptake, precluding significant systemic release of intestinal-derived ammonia. In contrast, the kidneys released ammonia to the systemic circulation. Major hepatectomy led to increased concentrations of ammonia and amino acids in the systemic circulation. However, transsplanchnic concentration gradients after major hepatectomy were similar to baseline values, indicating the rapid institution of a new metabolic equilibrium. In conclusion, since hepatic ammonia uptake exactly equals intestinal ammonia release, the splanchnic area, and hence the gut, probably does not contribute significantly to systemic ammonia release. After major hepatectomy, hepatic ammonia clearance is well preserved, probably related to higher circulating ammonia concentrations.

scholarly journals Mildly elevated succinylacetone and normal liver function in compound heterozygotes with pathogenic and pseudodeficient FAH alleles

2018 ◽  
Vol 14 ◽  
pp. 55-58 ◽  
Author(s):  
Hao Yang ◽  
Francis Rossignol ◽  
Denis Cyr ◽  
Rachel Laframboise ◽  
Shu Pei Wang ◽  
...  
Keyword(s):  
Liver Function ◽  
Normal Liver ◽  
Normal Liver Function ◽  
Compound Heterozygotes
Sign in / Sign up

Export Citation Format

Share Document