Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound

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Query: EC:2.6.1.1 (aspartate aminotransferase)
21,665 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Spontaneous renal artery embolism is not rare, but a correct diagnosis and appropriate treatment are often delayed. Clinical features and follow-up of 17 cases are reported. Cardiac disease or arrhythmias pre-existed in 16 patients. Initial symptoms included flank pain (seven cases), abdominal or chest pain alone (seven), and nausea and vomiting (eight). Fever (greater than or equal to 37.5 degree C) occurred in 10 cases and flank tenderness in only eight. Laboratory findings included leukocytosis, proteinuria, hematuria, and elevated levels of lactic dehydrogenase, serum glutamic-oxalacetic transaminase, serum glutamic-pyruvic transaminase, and alkaline phosphatase. Serum creatinine level exceeded 1.3 mg/dl in 88% and 4.0 mg/dl in 65%; four patients required dialysis. The diagnosis, made by scintiscan, arteriography, or both was often delayed. Renal embolization was bilateral in seven patients and unilateral in 10, with serum creatinine level above 4.0 mg/dl in five of the latter. Emboli to other organs caused early death; cardiovascular disease led to later death. With anticoagulants, renal function returned in patients surviving more than 1 month, even those with bilateral emboli. Thus, renal embolism is recognizable if the disease is considered, and a favorable outcome is common with long-term anticoagulants.
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PMID:Renal artery embolism: clinical features and long-term follow-up of 17 cases. 69 26

Exclusion of acute myocardial infarction preoperatively, particularly in patients undergoing cardiac catheterization, is an important requirement for optimal results following coronary revascularization. Unfortunately, activity of conventionally measured serum enzymes (AST, LDH, total CPK) is frequently raised because of enzyme released from non-cardiac sources during the catheterization procedure. however, serum activity of the MB CPK isoenzyme, an isoenzyme found primarily in heart muscle, appears to be more specific. Accordingly, in the present study, total CPK and MB CPK activities were determined in serum samples from 53 patients undergoing diagnostic catheterization, immediately before study and serially for 24 hours afterwards. A comprehensive range of catheterization procedures included selective coronary arteriography in 39 patients by brachial (17) or femoral (22) artery approaches. Myocardial infarction was excluded by clinical and electrocardiographic criteria in all patients before and after the procedure. MB CPK isoenzyme activity was also measured in serum samples from 50 patients with actue myocardial infarction documented electrocardiographically, and in 20 controls admitted to hospital but without cardiovascular disease. In patients with acute myocardial infarction, both total CPK and MB CPK isoenzyme levels were significantly raised (0.78 +/- 0.087 and 0.086 +/- 0.037 IU/ml, respectively), exceeding the upper limit of normal in all cases. MB CPK activity remained within normal limits (less than 0.004 IU/ml) in all 20 subjects without cardiovascular disease. Peak total serum CPK activity exceeded control levels in all patients undergoing catheterization (0.260 +/- 0.033). However, in each case, MB CPK isoenzyme activity remained within normal limits (less than .004). Thus, in contrast to an increase of activity of conventionally used serum enzymes, increased MB CPK isoenzyme activity is a reliable indicator of myocardial infarction, even in patients undergoing cardiac catheterization.
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PMID:Serum CPK isoenzymes after cardiac catheterization. 119 29

The objective of this study was to determine the probabilities of specific morbid events or death among patients with end-stage renal disease (ESRD) treated by hemodialysis. A prospective cohort study was performed between March 1988 and September 1989 in 18 hemodialysis centers in 13 Canadian cities, representing about one third of the hemodialysis population in Canada. The inception cohort consisted of 496 patients entering hemodialysis who had survived 1 month. The few new hemodialysis patients who received erythropoietin (EPO) in the last 3 months of the study were excluded. Survival curves were compared using the Cox proportional hazards regression model. Older age and history of cardiovascular disease were independently associated with a greater probability of death. Age and history of cardiovascular disease were also associated with a greater probability of nonfatal circulatory events (myocardial infarction, angina requiring hospitalization, or stroke), while a serum albumin level less than or equal to 30 g/L (3.0 g dL) was associated with an increased probability of pulmonary edema. The probability of surviving 12 months without receiving a blood transfusion was 47.2% for males and 27.5% for females. The incidence of non-A, non-B hepatitis, as estimated by unexplained elevations in serum aspartate aminotransferase (AST) values, was not different between patients receiving and not receiving blood transfusions. The probability of hospitalization for any cause was greater for patients with grafts for vascular access than for those with fistulae, for those with a history of cardiovascular disease, for those with a serum albumin level less than or equal to 30 g/L, and for those with renal disease due to diabetes or vascular disease. Hospitalization due to circulatory disease was more likely among those with a history of cardiovascular disease and among those with a lower serum albumin level. Hospitalization for infectious disease was more likely among those with a lower serum albumin level and less likely among those with a fistula for vascular access. Among all patients receiving hemodialysis treatment for more than 6 months, there were 14.8 hospital days per year.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Canadian Hemodialysis Morbidity Study. 155 66

PAP of harvested livers is routinely used to minimize parenchymal anoxia during storage. PP is compared with PAP to evaluate the relative reliability of PAP. Sixty female Landrace pigs were used for 30 OLTs. Group 1 livers underwent PP, whereas group 2 livers were treated with PAP. The cold ischemic time was less than 120 minutes for both groups, with no warm ischemia. Intraoperative and 24-hour postoperative biochemical, coagulation, and histocytological data were analyzed. Morphological studies of cellular damage were based on the percentage of CVD and KP and classified as light, moderate, and severe damage. Data, at closing, were compared by using Fisher's test (group 1 v group 2,P = 0.003 for light damage and P = .04 for severe damage; first postoperative day for group 1 v group 2, P = .133 for light damage and P = .25 for severe damage. Blood samples at closing and 24 hours postoperatively showed significant differences between groups 1 and 2: At closing for groups 1 and 2, respectively: AST, 968.9 +/- 742.7 and 327.4 +/- 174.7 IU/L (P less than .001); ALT, 63.1 +/- 40.3 and 20.3 +/- 5.3 IU/L (P less than .001); AP, 292.2 +/- 107.1 and 139.5 +/- 45.3 IU/L (P less than .001); and 24 hours postoperatively for groups 1 and 2, respectively: AST, 1,664.9 +/- 917.8 and 419.3 +/- 230.9 IU/L (P less than .001): ALT. 180.4 +/- 28.9 and 66.4 +/- 17.5 IU/L (P less than .001); AP, 602.1 +/- 153.3 and 255.7 +/- 116.3 IU/L (P less than .01). Comprehensively, the results reflect a better perfusate distribution of the PAP livers compared with PP ones: uniform organ preservation, faster metabolic recovery, and reduced postoperative mortality.
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PMID:Comparison of combined portal-arterial versus portal perfusion during liver procurement. 327 50

Heritability analyses were performed with clinical chemistry data collected on 360 twin pairs of white, middle-aged male veterans during the second examination of the NHLBI Twin Study, a multicenter study of cardiovascular disease risk factors. Significant genetic variability was present for albumin, alkaline phosphatase, blood urea nitrogen, 1-hr postload glucose, phosphorus, total protein, and uric acid. Calcium and aspartate aminotransferase had significantly different means by zygosity, which precluded further analysis. Total bilirubin and lactate dehydrogenase did not show evidence for genetic variation at this examination. Comparisons are made to results from similar twin studies and the first examination of the NHLBI Twin Study. Heritability estimates for phosphorus and blood urea nitrogen exhibited marked stability across studies, while heritability estimates for total bilirubin, total protein, and uric acid decreased in older study populations. The heritability of 1-hr postload blood glucose decreased from 0.88 at the first NHLBI examination to 0.52 at the second one. Interpretation of these results requires consideration of possible selection biases, methodologic and demographic issues, and the view that for some clinical chemistries, biological aging along with prolonged environmental exposures may alter the amount of phenotypic variation explained by the additive effect of genes alone.
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PMID:Heritability of clinical chemistries in an older twin cohort: the NHLBI Twin Study. 356 74

Macroenzymes are serum enzymes that have a higher molecular mass than the corresponding enzyme normally found in serum under physiologic or pathophysiologic conditions. Although no evidence convincingly indicates that macroenzymes cause disease or necessitate treatment, some patients with immunoglobulin-complexed enzyme disorders have previously been reported to have associated autoimmune diseases or malignant lesions. To address this issue, we reviewed the medical records of 42 patients in whom a macroenzyme had been detected during assessment at the Mayo Clinic between 1986 and 1990. Of these 42 patients, 21 had macro-creatine kinase, 10 had macro-lactate dehydrogenase, 6 had macro-aspartate aminotransferase, and 5 had macroamylase in the serum. Although the study group did not include all Mayo patients with this phenomenon, it represented a sufficient sample size to determine retrospectively whether specific dismissal diagnoses were present concurrently. The most common findings in this group of patients with macroenzymes were (1) advanced age (except for those with macro-aspartate aminotransferase), (2) cardiovascular disease (probably due to sampling bias), (3) malignant lesions (particularly in those with macro-creatine kinase), and (4) rheumatologic disease (in those with macro-lactate dehydrogenase). The immunoglobulin-complexed enzyme disorders are characterized by increased total serum enzyme levels that are often isolated and persistent. Physicians should be aware of the presence of macroenzymes so that invasive or costly procedures are not undertaken unnecessarily to determine the cause of increased serum enzyme levels.
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PMID:The macroenzymes: a clinical review. 768 Nov 33

Shortage of donor livers has led several liver transplant centres to widen their definition of liver donor suitability. We have assessed the function of liver grafts from "marginal" donors and attitudes to use of such organs. Over an 18-month period, livers used in 30 of 213 consecutive liver transplantations in Birmingham, UK, came from marginal donors (history of alcoholism, abnormal liver function test results, drug overdose that included paracetamol, advanced cardiovascular disease, sepsis, lengthy hypotension [systolic blood pressure < 80 mm Hg for > 1 h], high-dose inotropic drug use). 16 of these donors had been refused by other UK liver transplant centres, 11 on medical grounds. The controls were grafts retrieved from "good" donors (n = 183) during the same period. All 30 grafts showed satisfactory early function but had greater day 1 (p = 0.004) and peak serum aspartate aminotransferase (p = 0.0008) values than control grafts. Graft and patient survival at 1 year in the two groups was similar (72% vs 73% and 80% vs 82%, respectively). To assess attitudes to marginal donor livers, a questionnaire outlining the details of these 30 donors was sent to the 80 centres in the European Liver Transplant Group, and 60 replied. Median immediate refusal rate of the marginal donors was 7/30 (range 0-18) and median outright acceptance rate was only 11/30 (1-26). Larger centres were less selective, with a significantly lower refusal rate (p = 0.03). These results indicate that, because of existing liver donor criteria within Europe, usable donor livers are being unnecessarily refused on medical grounds.
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PMID:Policies in Europe on "marginal quality" donor livers. 796 24

Immediate-release niacin manifests beneficial effects in cardiovascular disease with respect to dyslipidemic states. It lowers low-density lipoprotein (LDL) cholesterol, triglycerides, lipoprotein(a), and apoprotein B; at the same time, it increases high-density lipoprotein (HDL) cholesterol, HDL2, and apoprotein A-I. However, use of crystalline niacin has drawbacks: therapy requires multidose regimens, and side effects include flushing and pruritus. Slowing absorption with sustained-release formulations succeeds in decreasing flushing and increasing tolerance, but increases in hepatic enzyme levels have raised safety concerns. A new extended-release, once-daily formulation of niacin (Niaspan) shows promise in minimizing flushing while avoiding hepatotoxicity. A multicenter, randomized, double-blind clinical trial of Niaspan enrolled 122 patients with confirmed diagnosis of primary dyslipidemia (LDL cholesterol >4.14 mmol/L [160 mg/dL] and triglycerides <9 mmol/L [800 mg/dL]) into 3 treatment groups: (1) Niaspan 1,000 mg/day; (2) Niaspan 2,000 mg/day; and (3) placebo. The primary treatment endpoint was LDL-cholesterol level. This endpoint was not significantly affected by placebo (0.2% increase), but Niaspan decreased LDL cholesterol by 5.8% (1,000 mg/day) and 14.6% (2,000 mg/day) (p <0.001). Likewise, with placebo there were significant changes in total cholesterol, triglycerides, lipoprotein(a), and apoprotein B, whereas both Niaspan 1,000 and 2,000 mg/day significantly (p <0.001) decreased these parameters. In addition, both Niaspan groups showed significant (p <0.001) increases in HDL cholesterol (17% and 23%, respectively), including HDL subfractions. With respect to flushing, 20% of the placebo group reported at least 1 episode, whereas 88% and 83% of the Niaspon 1,000- and 2,000-mg/day groups, respectively, reported episodes. There was no hepatotoxicity as liver enzyme levels remained within clinically accepted limits in all treatment groups. However, Niaspan 2,000 mg/day showed a significant increase in aspartate aminotransferase compared with baseline and placebo. This trial demonstrated a cholesterol-modifying effect of Niaspan consistent with those reported for niacin, but demonstrated a better tolerance for flushing. Moreover, in contrast to sustained-release formulations, Niaspan showed relatively mild hepatic effects.
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PMID:A new extended-release niacin (Niaspan): efficacy, tolerability, and safety in hypercholesterolemic patients. 991 60

1. The welfare of male and female male-line turkeys fed ad libitum or food-restricted was determined at 4, 8, 12, 16, 20, 24, 28, 36(38) and 46(48) weeks of age using behavioural and physiological indices of well-being. Traditional turkeys fed ad libitum were kept as a control treatment. Restricted male and female male-line turkeys were fed to 0-5 during rearing and subsequently to 0-8 of sex-specific ad libitum-fed body weight. In another treatment, male-line males were fed ad libitum to 18 weeks and 0.8 of ad libitum thereafter. 2. Traditional turkeys and restricted male-line turkeys were more active than ad libitum-fed birds of both sexes. Restricted turkeys showed a high incidence of wall pecking. In the breeding period, about 0.4 of the observations of male-line males were of strutting behaviour whereas traditional male turkeys showed no strutting behaviour at the end of the breeding period. 3. The heterophil lymphocyte ratio (HLR) and the proportion of basophils were not increased in food-restricted turkeys. The HLR was relatively low in traditional birds, compared with male-line turkeys during the rearing period. 4. Plasma corticosterone concentrations were increased by food restriction during the rearing period. Corticosterone concentrations were relatively high in traditional turkeys at 4 and 8 weeks of age only. 5. Plasma lactate dehydrogenase (LIDH) activity was higher from 12 to 24 weeks of age in ad libitum-fed male-line turkeys and was consistent with mortality from cardiovascular disease in this group of turkeys. The pattern of activity of aspartate transaminase was similar, and alkaline phosphatase was inversely related to that of LDH. 6. It was concluded that turkeys may be better able to adjust physiologically to the demands of food restriction than broiler breeders and that there were few deleterious consequences of restricting male turkeys after 18 weeks of age. Male-line turkeys were less active than traditional turkeys.
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PMID:Welfare of food restricted male and female turkeys. 1040 31

Renal transplant recipients now have an increased life expectancy, and this has highlighted the need for increased concern about the long-term complications associated with transplantation. To better manage renal transplant recipients over the long term, it is essential to schedule periodic clinic visits to detect problems and intervene in a timely fashion. Besides enabling early detection and possible treatment, periodic visits permit continuing patient education. Unfortunately, there is no scientifically based consensus that indicates what the optimal frequency and timing of such visits should be, although the AST has recently issued some guidelines. At the MINT, an Annual Review Clinic has been implemented to provide better service to renal transplant recipients over the long term. The clinic offers a comprehensive medical assessment, identifies and quantifies risk factors for CVD, and initiates referrals to appropriate specialists. The Annual Review Clinic increases patient awareness in a number of areas specific to transplantation, promotes a positive approach to healthcare, enables collection of structured data for analysis, and, with hope, engenders a significant degree of patient well-being and satisfaction. The medical community needs to continue long-term patient evaluation and clinical audit as means to improve long-term patient and graft survival, as well as patient quality of life.
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PMID:Clinical audit and long-term evaluation of renal transplant recipients. 1183 48


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