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The liver is as an organ in the body and its duty is to destroy toxin, store and produce bile and responsible for thousands of biochemical reaction. The liver is located in the upper right part of the abdomen, the colour of the liver is a dark brown tinted with red. Also known as the largest gland and the largest solid organ in the body, whose weight differs from both sex, in human the liver approximately weighs 1.4-1.6 kg (3.1-3.5 lb)
Live function test as known it carries out a thousands of function, the true function liver test is not the blood it is just the standard test used to detect cell damage in the liver and biliary obstruction (the sign and symptoms of biliary obstruction occurs when the bile fails to reach its proper destination). Serum bilirubin is considered as the true or real test of the liver function because it shows the ability to process and secret bilirubin into bile. There is most common test carried out when looking at the liver function test, which is going to be discussed in a brief note they are as follow, bilirubin, Albumin, Globulin, Ck (creatinine kinase), Gamma GT (gamma glutamyl transpeptidase), Total protein, Alanine Transferase, Aspartate Transferase and Alkaline Phosphatase.
Bilirumbin is produced by the liver, it is found in bile and has a yellowish pigment. Bilirubin is the chemical and physical process of conversion of the breakdown of heme (the deep red, nonprotein ferrous component of hemoglobin (C34H32FeN4O4)), bilirubin as a cellular antioxidant serves as its physiological role , which enables haemoglobin in the red blood cell(Erythrocyte) to be broken into haem and back to unconjugated bilirubin It is in a lipid soluble form which is not soluble in water and in that case it has to be made soluble in the reticuloendothelial cell of the liver. The new produced bilibrubin is tightly bounded to albumin, this unconjugated bilibrubin formed is also called free bilirubin.
Bilibrubin that has not been conjugated by the liver is called an unconjugated bilibrubin. It produces an indirect reaction to the van den bergh test. When there is a high level of unconjugated bilibrubin in the blood it shows a lack of bilibrubin clearance by the liver. Unconjugated bilirubin is released from the carrier molecule of albumin in the process of moving some to the liver where it is converted to conjugated (water soluble) by an enzyme called glucurnosyltranseferase. During this process, the testing laboratory may be able to identify conjugate unconjugated when they react to certain dyes. And that’s when you get to understand why so-called direct (conjugated) and indirect (conjugated).
Conjugated bilirubin is bilirubin, which were picked up by liver cells and conjugated to form water soluble (conjugated) can be excreted into the bile through the bile into the small intestine and then share combined with bacterial urobilinogen, some of these fabric is excrected in stool, and some absorbed and excreted in bile or urine. Several of urobilinogen absorbed is returned to the liver to be re-excreted in bile and eliminated some amountof urobilinogen excrete in the urine, lack of human urinary urobilinogen in the system causing obstructive jaundice.
Jaundice is not a disease but a symptom that shows high accumulation of bile pigment (bilirubin) in the body, the yellow color of the skin and whites of the eyes. Jaundice becomes evident in a patient when the serum bilirubin exceeds the normal range. There are three main things that cause jaundice, which is pre-hepatic or hemolytic, hepatic and post hepatic or extrahepatic. Pre-hepatic jaundice is used when too many red blood cells break down and the liver is incapable of removing the excess
Albumin is a protein produced by the liver, serum albumin binding activity, and many include drugs such as bilirubin binding. Serum test the amount of protein in the clear liquid blood test to determine if the body is not absorbing enough protein. It also keeps the fluid leakage of blood, tissue, difficult piece of that injury, and blood capillaries, increasing capillary permeability caused by burns may be the loss of serum proteins. low albumin level may reflect disease, the kidneys can not prevent the leakage of albumin from the blood in the urine and is lost, the loss of albumin in the urine due to renal failure (nephotic syndrome) can cause human albumin. Protein in urine is a sign of kidney disease, and pre-eclampsia. Albumin indicate liver problems, the most common cause of liver failure caused by low albumin chronic liver cirrhosis (cirrhosis of the liver does not function properly as a result of chronic liver disease). Albumin concentration usually depends on the rate of synthesis, the volume and distribution and the rate of catabolism, so that the concentration is normal in chronic disease to cirrhosis and other serious damage occurs.
Aspartate transferase AST is also known as SGOT (serum glutamic oxolacetic), an enzyme that is often present in liver cells are damaged, this enzyme is mainly caused by the cell in the liver. High levels of this enzyme implicates the liver is damage, AST is released into the blood the amount of protein is proportional to the amount of damaged cells. The height of AST relies on how long the blood is tested after the accident, the results of correction of circulatory disorders often shows a very rapid decrease in levels of AST.
SERUM ALANINE AMINOTRANSFERASE
Serum alanine aminotransferase is also known as ALT, which measures the amount of the enzyme ALT in the blood. ALT is found in liver and muscle, ALT does not necessarily indicate the severity of liver damage. ALT tends to be slightly higher than the level of AST and this may be important in the detection of necroinflammatory activity in patients with chronic diseases hepatisis.
Alkaline phosphatase (ALP) is an enzyme located throughout the body, like all enzymes, it is necessary and required in a small amount to trigger specific chemical reactions. ALP is measured by combining the individual serum with a specific substance in which alkaline phosphatase is known to react. ALP produce different from liver, bone and placenta are called isoenzymes, liver isoenzyme is found in the surface region of the bile canalicular membrane hepatkovyte. ALP accumulate and escape into the bloodstream, in the presence of the disease of bile from the liver obstructive nature (cholestatic) differnciate ALP is used to identify what type of disease is present in the liver , cholestatic or hepato Cell. However, the leak of a pregnant woman during pregnancy is normal and ALP is produced in the placenta of a pregnant woman.
Antitrypsin is a glycoprotein synthesized in the liver and prevents the serine proteases, especially elastase. The normal concentration of 1 to 1.6 g / L. It is an acute phase protein that increases in serum inflammatory diseases, pregnancy and after oral contraceptives (OCP). The liver disease is generally seen as a deficiency of antitrypsin, an inherited disease. Depletion should confirmed by quantitative measurement.
Glutamyl transpeptidase (GGT) is a membrane glycoprotein that catalyzes the transfer of γ-glutamyl group to other peptides, amino acids and water. Large amounts can be found in kidney cancer, pancreas, liver, intestine and prostate. Glutamyl transpeptidase gene is on chromosome 22 glutamyl transpeptidase levels are high in infants and children up to 1 year and can increase after 60 years of life. Men have higher values. Children over 4 years are the values â€‹â€‹of the serum in normal adults. The normal range is 0-30IU/L1. Glutamyl transpeptidase levels of acute viral hepatitis may reach its peak in the second or third week of illness, and in some patients remain elevated for 6 weeks. From a diagnostic test the primary purpose of glutamyl transpeptidase is narrowed to just the exclusion of bone diseases such as γ-glutamyl transpeptidase is not in the bone.
A test of liver function alone is of little value in detecting liver disease that many serious liver disease may be associated with normal and abnormal levels are found in asymptomatic healthy patients. Using the battery of tests of liver function, however, is a very sensitive procedure. The number of false negatives should be reduced by this technique. Using the battery of tests of the liver is also associated with high specificity, especially when more than one test is abnormal. The pattern of enzyme abnormality, interpreted in the context of patient characteristics, can help direct the diagnostic work up. Knowledge of the prevalence of certain liver disease in specific populations and possible liver damage in systemic diseases or drug treatments can help the doctor identify the cause of the deterioration effectively
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