Basic Research
Copyright ©2008 The WJG Press and Baishideng.
World J Gastroenterol. Jul 14, 2008; 14(26): 4168-4178
Published online Jul 14, 2008. doi: 10.3748/wjg.14.4168
Table 1 Clinical profile of acute liver failure patients
CaseAge/SexEtiologyGrade of HEJaundice-HE interval (d)HE duration at presentation (d)Clinical features of raised ICP
DPHTBPCNH
124/MHepatitis E472++--+
214/MHepatitis B482++-++
324/FHepatitis B4232+++++
446/FHepatitis E422+++++
525/FHepatitis E321++---
Table 2 Biochemical profile of acute liver failure patients
CaseSerum bilirubin (mg/dL)ALT (U/L)AST (U/L)ALP (U/L)INRSerum sodium (mmol/L)Serum potassium (mmol/L)Serum creatinine (mg/dL)Blood sugar (mg/dL, range)Blood ammonia (&mgr;mol/dL)
113.32423491341.81423.81.2110-186
226.410209201208.21464.71.2130-194438
328.62061561406.81404.90.698-178150
415.316882762105.51454.30.6130-188265
521.52321421462.81433.60.488-176182
Table 3 Clinical profile of acute-on-chronic liver failure patients
CaseAge/SexEtiology
Grade of HEJaundice-HE interval (d)HE duration at presentation (d)Clinical features of raised ICP
AcuteChronicDPHTBPCNH
148/MHepatitis ECryptogenic3172++--+
248/MHepatitis EChronic Hepatitis B4153++-++
324/FHepatitis EAutoimmune3221+---+
445/FHepatitis EChronic Hepatitis C3132++-++
528/FHepatitis EChronic Hepatitis B372++--+
Table 4 Biochemical profile of acute-on-chronic liver failure patients
CaseSerum bilirubin (mg/dL)ALT (U/L)AST (U/L)SAP (U/L)INRSerum sodium (mmol/L)Serum potassium (mmol/L)Serum creatinine (mg/dL)Blood sugar (mg/dL, range)Blood ammonia (&mgr;mole/dL)Child scoreMELD score
118.83462741482.61433.71.2130-19418012/1530
217.22541421652.41444.90.998-21028013/1529
325.76365241643.71364.50.598-16626113/1533
425.1240320973.91453.90.9108-21031014/1534
510.2279151792.251374.30.889-18921013/1524
Table 5 Peak integrals relative to those of creatine (mean ± SD) in right parietal white and gray matter in healthy controls, acute liver failure (ALF) patients and acute-on-chronic liver failure (ACLF) patients before the intravenous infusion of mannitol (pre-mannitol study) and after receiving mannitol (post-mannitol study)
MetabolitesStudy
Control (n = 5)
ALF patient (n = 5)
ACLF patient (n = 5)
Pre-mannitolPost-mannitolPPre-mannitolPost-mannitolPPre-mannitolPost-mannitolP
NAA/Cr1.25 ± 0.161.23 ± 0.170.921.20 ± 0.131.27 ± 0.320.750.90 ± 0.350.58 ± 0.290.18
Cho/Cr0.24 ± 0.060.24 ± 0.080.750.18 ± 0.090.16 ± 0.070.470.20 ± 0.050.20 ± 0.030.75
Gln/Cr1.44 ± 1.061.18 ± 0.940.353.04 ± 1.322.52 ± 1.560.251.44 ± 0.302.42 ± 1.440.60
Glx/Cr2.84 ± 0.982.70 ± 1.210.604.46 ± 1.484.38 ± 1.610.922.85 ± 0.703.85 ± 2.130.35
mI/Cr0.57 ± 0.480.49 ± 0.340.920.56 ± 0.150.47 ± 0.160.180.41 ± 0.170.89 ± 1.140.81
Table 6 Summary of fractional anisotropy values (mean ± SD) from different white and gray matter regions in controls, patients with acute liver failure (ALF) and acute-on-chronic liver failure (ACLF) before the intravenous infusion of mannitol (pre-mannitol study) and after receiving mannitol (post-mannitol study)
RegionStudy
Control (n = 5)
ALF patient (n = 5)
ACLF patient (n = 5)
Pre-mannitolPost-mannitolPPre-mannitolPost-mannitolPPre-mannitolPost-mannitolP
ALIC0.36 ± 0.050.37 ± 0.040.600.30 ± 0.030.30 ± 0.020.470.32 ± 0.020.33 ± 0.020.56
PLIC0.49 ± 0.050.48 ± 0.050.600.33 ± 0.020.34 ± 0.010.120.45 ± 0.030.40 ± 0.030.08
CN0.11 ± 0.000.11 ± 0.000.470.09 ± 0.010.09 ± 0.010.600.08 ± 0.010.09 ± 0.010.56
P0.09 ± 0.010.09 ± 0.010.920.06 ± 0.010.07 ± 0.010.920.06 ± 0.020.08 ± 0.010.15
TH0.15 ± 0.010.14 ± 0.010.120.12 ± 0.000.12 ± 0.010.920.14 ± 0.010.15 ± 0.030.77
FWM0.31 ± 0.030.30 ± 0.030.920.30 ± 0.030.32 ± 0.070.920.32 ± 0.040.36 ± 0.070.56
OWM0.38 ± 0.060.38 ± 0.070.920.38 ± 0.040.37 ± 0.050.920.35 ± 0.040.31 ± 0.020.15
CC0.53 ± 0.040.54 ± 0.060.920.44 ± 0.060.45 ± 0.020.350.50 ± 0.040.51 ± 0.050.77
Cingulum0.36 ± 0.030.37 ± 0.040.750.44 ± 0.070.41 ± 0.030.250.38 ± 0.030.36 ± 0.030.56
Frontal cortex0.12 ± 0.010.11 ± 0.000.470.12 ± 0.040.12 ± 0.040.600.14 ± 0.020.11 ± 0.020.08
Parietal cortex0.12 ± 0.010.12 ± 0.010.750.11 ± 0.010.10 ± 0.010.750.14 ± 0.010.11 ± 0.030.39
Occipital cortex0.11 ± 0.020.12 ± 0.030.470.14 ± 0.050.10 ± 0.030.250.10 ± 0.050.13 ± 0.030.39
Table 7 Summary of mean diffusivity values (mean ± SD) in units of 10-3 mm2/s from different white and gray matter regions in controls, patients with acute liver failure (ALF) and acute-on-chronic liver failure (ACLF) before the intravenous infusion of mannitol (pre-mannitol study) and after receiving mannitol (post-mannitol study)
RegionStudy
Control (n = 5)
ALF patient (n = 5)
ACLF patient (n = 5)
Pre-mannitolPost-mannitolPPre-mannitolPost-mannitolPPre-mannitolPost-mannitolP
ALIC0.76 ± 0.070.76 ± 0.050.600.68 ± 0.020.68 ± 0.020.750.72 ± 0.020.71 ± 0.080.56
PLIC0.74 ± 0.060.75 ± 0.050.750.67 ± 0.030.67 ± 0.020.920.65 ± 0.030.65 ± 0.040.77
CN0.73 ± 0.020.74 ± 0.020.750.68 ± 0.010.69 ± 0.020.920.69 ± 0.020.69 ± 0.090.25
P0.69 ± 0.010.70 ± 0.060.250.64 ± 0.030.63 ± 0.010.470.69 ± 0.020.69 ± 0.060.39
TH0.72 ± 0.030.71 ± 0.030.920.66 ± 0.020.66 ± 0.040.920.71 ± 0.020.74 ± 0.050.56
FWM0.77 ± 0.060.76 ± 0.070.750.67 ± 0.010.66 ± 0.050.920.65 ± 0.020.66 ± 0.130.25
OWM0.76 ± 0.050.76 ± 0.070.920.66 ± 0.030.66 ± 0.050.750.76 ± 0.110.68 ± 0.050.56
CC0.74 ± 0.070.74 ± 0.070.920.74 ± 0.090.74 ± 0.080.920.77 ± 0.090.77 ± 0.090.77
Cingulum0.72 ± 0.050.72 ± 0.090.750.72 ± 0.100.72 ± 0.040.750.73 ± 0.030.70 ± 0.060.56
Frontal cortex0.69 ± 0.070.69 ± 0.040.920.68 ± 0.040.68 ± 0.050.920.65 ± 0.050.70 ± 0.030.08
Parietal cortex0.68 ± 0.060.68 ± 0.050.920.68 ± 0.010.68 ± 0.030.470.69 ± 0.040.63 ± 0.040.08
Occipital cortex0.67 ± 0.070.67 ± 0.060.920.66 ± 0.020.66 ± 0.050.920.69 ± 0.060.62 ± 0.030.15
Table 8 Change in brain volume and cerebrospinal fluid (CSF) volume values (mean ± SD) in units of cubic centimeter from different white and gray matter regions in controls, patients with acute liver failure (ALF) and acute-on-chronic liver failure (ACLF) before the intravenous infusion of mannitol (pre-mannitol study) and after receiving mannitol (post-mannitol study)
VolumeStudy
Control (n = 5)
ALF Patient (n = 5)
ACLF Patient (n = 5)
Pre-mannitolPost-mannitolPPre-mannitolPost-mannitolPPre-mannitolPost-mannitolP
Brain volume1303.47 ± 54.951308.88 ± 64.950.751130.76 ± 86.731162.39 ± 77.750.471096.85 ± 79.551076.90 ± 71.630.60
CSF volume84.05 ± 4.8885.10 ± 6.460.6073.77 ± 19.7273.27 ± 19.530.4776.77 ± 18.6883.84 ± 22.090.12