Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:2.6.1.2 (alanine aminotransferase)
 26,722 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Bile and serum were analysed in 45 cases of cholelithiasis and 25 control subjects for cholesterol, phospholipids, bilirubin, alkaline phosphatase and LCAT activity. Serum phospholipids were found to be elevated in sixty percent of cases, whereas phospholipids in bile were found to be decreased. Serum alkaline phosphatase and alanine aminotransferase were normal. Serum and bile LCAT activity was found to be significantly depressed.
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PMID:Biochemical assessment of cholelithiasis. 130 23

The introduction of laparoscopic cholecystectomy as method of choice for gall stone treatment reopened the question whether to continue with routine intraoperative cholangiography or to switch over to a selective indication. In order to set an accurate indication for selective intraoperative cholangiography it was our goal to develop a tool for preoperative identification of patients with a high risk of common bile duct stones. A preoperative score, indicating the risk of common bile duct stones, was designed. A history of jaundice, elevated levels of bilirubin, alkaline phosphatase, amylase (serum), ALAT (GPT) or ASAT (GOT), a common bile duct wider than 10 mm or containing concrements and multiple gallstones smaller than 10 mm were valued as risk indicators, whereas normal wide bile duct, large or solitary gallstones were valued as decreasing the risk of common bile duct stones. The retrospective screening of 289 consecutive conventional cholecystectomies (1986-1990) for these risk indicators demonstrated a good correlation of the risk score with the occurrence of common bile duct stones. A prospective application of the score, with improved ultrasound examination and routine preoperative intravenous cholangiography, mandatory for laparoscopic cholecystectomy at our institution, will define the high risk group definitely and allow an accurate selective use of intraoperative cholangiography.
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PMID:[Is routine intra-operative cholangiography in laparoscopic cholecystectomy truly unnecessary?]. 138 97

The serum cholylglycine (CG), alanine aminotransferase (ALT) and total bilirubin levels were studied in 210 patients with hepatobiliary disease and in 70 healthy subjects. Serum CG concentrations in all the hepatobiliary diseases were found to be significantly higher than those of their controls. Patients with abnormal increases in ALT and bilirubin levels also showed raised CG concentrations; however, some patients with normal ALT and bilirubin levels, still had markedly elevated CG values. Patients with hepatic cirrhosis had high serum CG levels, followed, in descending order, by chronic active hepatitis and chronic persistent hepatitis. In the cholecystitis and cholelithiasis cases, their CG levels were significantly higher than those of the controls but lower than the values in hepatic disease patients; however, more cholecystitis cases had abnormally high serum bilirubin levels than CG. The results also show that serum CG concentrations vary in the different hepatobiliary diseases, and that serial CG measurements are more sensitive than measuring ALT and bilirubin levels in the diagnosis of hepatic diseases. Serum CG can be used as an index for evaluating the activity of chronic hepatitis; it can also be employed as a diagnostic tool in cholecystitis and cholelithiasis.
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PMID:A correlative study on serum cholylglycine levels in hepatobiliary disease. 142 17

The sera from 144 patients (27 males and 117 females) with documented gallstones were assayed for eight different biochemical quantities, in order to study the pattern of specific biochemical changes in the blood of such patients and to establish any aetiologic relationship with gallstones. These quantities included: fasting glucose, alkaline phosphatase, alanine aminotransferase, total protein, albumin, total bilirubin, fasting total cholesterol, and fasting triacylglycerol. The same analysis was performed on sera obtained from 50 (9 males and 41 females) age- and sex-matched healthy controls. The statistical analysis showed that female patients had significantly higher values for fasting plasma glucose; alkaline phosphatase, total protein and albumin; and significantly lower values for bilirubin and total cholesterol than female controls. No overall differences in the levels of alanine aminotransferase and triacylglycerol were observed between the two female groups. Male patients on the other hand showed significantly higher values for fasting glucose and alkaline phosphatase than male controls. All other quantities, however, were not significantly different between the two male groups. When chemical analysis of the gallstones was performed, no consistent relationship was observed between the level of any of the above mentioned quantities and the chemical subtype of the gallstone (for both male and female patients). These data suggest that no specific serum biochemical pattern characterizes gallstone disease, and that there is no relationship between the stone type and the serum level of the studied quantities.
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PMID:The pattern of serum biochemical abnormalities in patients with gallstones. 157 35

The role of clinical (biliary pain and/or jaundice), laboratory (discriminant function (DF) calculated using AST, ALT, AlkPh and GGT serum values) and ultrasonographic (US)(dilation and/or stone of common bile duct (CBD)) findings in identification of the biliary etiology of acute pancreatitis (AP) was studied in 60 patients. AP biliary etiology was defined by ERCP executed in the early phase of the disease (lithiasis and/or stenosis of CBD; endoscopic features of forced papilla in patients with gallstone). US showed the best values of sensitivity (84.6%) and diagnostic efficacy (76.7%); DF showed the best results of specificity (62.5%) and of test positive predictive value (92.8%). The statistical evaluation (McNemar test) showed a significant increase of sensitivity for US vs clinical findings and of specificity for DS vs clinical findings (p less than 0.05). The sensitivity, specificity, accuracy, test negative and positive predictive value were improved to 96.1, 87.5, 96.6, 77.1 and 92% by the combination of US and DF. Therefore the association of US and DF can provide the best non invasive method in rapidly detecting CBD pathology as an etiological factor in AP and then the enough accurate indication to early operative ERCP.
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PMID:[The role of clinical, biochemical and echographic data in identifying the biliary pathogenesis of acute pancreatitis]. 162 15

Early identification of severe gallstone-associated acute pancreatitis (GAAP) is a prerequisite for treatment with urgent endoscopic sphincterotomy. This study assesses the value of two clinicobiochemical scoring systems to this end. Over the 7-year period from 1983 to 1989, 100 consecutive patients with acute pancreatitis (45 related to gallstones, 36 to alcohol, and 19 of undetermined etiologies) had clinicobiochemical analysis within 48 hours of admission. The final diagnosis and outcome were retrospectively compared with the prediction achieved by the scoring systems. With regard to Blamey's criteria for early identification of gallstones, significant differences were found between the biliary and nonbiliary groups with respect to female sex, serum amylase concentration greater than or equal to 4,000 IU/L, alkaline phosphatase level greater than or equal to 300 IU/L, and alanine aminotransferase level greater than or equal to 100 IU/L (all p values less than 0.001). Age greater than or equal to 50 years was found to be significant (p less than 0.02) only in differentiating gallstone- versus alcohol-associated acute pancreatitis. When three or more positive factors were present, the sensitivity and specificity for predicting gallstones were 60% and 87%, respectively; the predictive value of a positive result was 79%, of a negative result 74%, and the overall accuracy was 75%. At a cutoff level of five, rather than three or more prognostic factors, the modified Ranson's criteria for patients known as having GAAP allowed a suitable discrimination of patients with an expected high risk of complications and mortality. When the two scoring systems (Blamey greater than or equal to 3 and Ranson greater than or equal to 3) were combined, 17 patients were predicted as having severe GAAP: 6 of these 17 patients were misdiagnosed as having biliary pancreatitis, whereas 9 patients with definite severe GAAP were not selected because of a Blamey score less than 3. More specific diagnostic tools are needed, and higher cutoff levels for prognostic scores are required for the prediction of severe GAAP, particularly in view of selecting patients for potentially dangerous approaches such as urgent endoscopic sphincterotomy.
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PMID:Predictability of clinicobiochemical scoring systems for early identification of severe gallstone-associated pancreatitis. 162 3

In an ecographic survey for gallstones, executed on a systematic sample from the municipal electoral roll of a town in Southern Italy, 164 subjects were found with ALT more than twice the upper normal limit (unl). Five years later 138 of these were re-examined; 76 still had ALT greater than 2 unl (group A), 41 still abnormal (group B) and 21 normal (group C). Anti-HCV antibodies were found in 52 subjects of group A (68%). 18 of group B (44%) and 2 of group C (9.5%). The odds ratio of ALT greater than 2 unl (A vs C) in anti-HCV+ was 20.6 and of a still elevated ALT (A + B vs C) was 14.1. Logistic regression was used to eliminate the effect of possible confounding factors (sex, age, alcohol, drugs, HBV markers) on the relationship chronic ALT increase and anti-HCV positivity but the odds ratio was still 18.9 (A vs C) and 11 (A + B vs C). These findings suggest that anti-HCV antibodies are strongly associated with chronic hypertransaminasemia at the population level in Southern Italy.
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PMID:Antibodies to hepatitis C virus and chronic hypertransaminasemia in southern Italy. 166 Mar 28

Previously we have reported on the pigmentary lithogenic action of vitamin A in the form of retinol acetate. In the present work the possible lithogenic action of retinoic acid was tested, since this differs from retinol in several metabolic aspects, which can contribute to the understanding of the pathogenesis of the pigment cholelithiasis produced by vitamin A. Two experiments were performed in which the lithogenicity of retinol acetate added to a colony chow at the level of 25,000 IU%, was compared with that of 3 dietetic levels of all-trans retinoic acid. In the first experiment seric triglycerides were determined in order to establish whether there is a relation between the hypertriglyceridemic effect of retinoids and their lithogenicity; in the second experiment GPT and GOT were determined as indicators of hepatotoxicity. The results showed that the retinoic acid at levels of 24,000 and 35,000 IU% of diet, produced a cholelithiasis incidence similar to that of 25,000 IU% of retinol acetate, whereas the retinoic acid level of 12,000 IU% was not lithogenic. The dietetic retinoic acid produced a reduction of hepatic vitamin A, that was directly proportional to the level supplied. There was no relation between the hypertriglyceridemic effect of retinoids and its lithogenicity. The retinoids produced a light increase in GPT, which was higher with retinol acetate, whereas GOT had not significative changes. It is concluded that all-trans retinoic acid produces pigment gallstones in the hamster, with an incidence similar to that produced by retinol acetate.
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PMID:Gallstones in the golden hamster. XXXVI. Pigment cholelithiasis produced by retinoic acid. 181 96

The aim of this study was to investigate the usefulness of serum bilirubin, aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (APh) and real time ultrasonography (US) in distinguishing between gallstone and non gallstone related acute pancreatitis (A.P.). The second aim was to evaluate whether or nor there was biliary tract hypertension. Both aims were designed in order to evaluate them in the early stage of A.P. Two Groups of patients were studied. Group 1--gallstone related A.P., 63 pts. Group 2--Non gallstone related A.P. 21 pts. Fifty nine (93.6%) of Group 1 and 11 (52.3%) of Group 2 had surgical confirmation. In the other, the diagnosis was based on US and C.T. Blood samples were taken during the three days after admission for biochemical test and US was performed within the same period. Statistical evaluation and Student's t test were used. Biochemical test: when the cut off level was expressed by the upper limit of normal (ULN), the highest diagnostic sensibility was (table 1): ALT 85.7%, APH 80.9%. AST 71%, bilirubin 65%. When the cut off level was chosen at twice the ULN (Table 1), the sensibility was: ALT 61.9%, bilirubin and AST 47%, APh 30%, Group 2 (Table 2) values higher than the ULN were: AST 42.8%, bilirubin 33%, ALT 19%, APh 14.2%. The differences between the two Groups were statistically significant: APh and bilirubin P less than 0.001, ALT less than 0.05 m AST, NS. Ultrasonography: Group 1: gallstones were detected in 96.6% (58/60). Biliary tree was not visualized in 10 (15.8%), diagnosed as normal in 38 (60.3%) and pathologic (dilatation and/or lithiasis) in 15 (23.8%).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Value of laboratory tests and echography in the diagnosis of biliary disease in the initial phase of acute pancreatitis]. 209 97

Among 30 consecutive patients diagnosed with primary biliary cirrhosis (PBC) in Taiwan, 27 were females and the median age of symptom onset was 54.5 years. Most had similar clinical manifestations to those reported in the Western countries, but ascites and oesophageal varices as commonly found at the late stages of cirrhosis of liver were noted in nine patients (30%) and 13 patients (43%) respectively. Only one patient was asymptomatic. Hyperbilirubinaemia was noted in 21 patients (70%) and hypoalbuminaemia in 8 patients (27%). All patients had elevated serum alkaline phosphatase and alanine aminotransferase and 28 (93%) had antimitochondrial antibodies. Ten out of 21 patients (48%) were positive in antinuclear antibodies, of which most were of speckled type. Sixteen out of 18 patients (89%) had elevated serum IgM levels. Interestingly, only one of 26 patients (3.8%) was positive for hepatitis B surface antigen, in contrast to its high prevalence (15%) in the Taiwan population. Special associated diseases, including systemic lupus erythematosus, scleroderma, malignant lymphoma and hepatocellular carcinoma, were each noted in one patient respectively. Eight patients had a history of gallstones before the diagnosis of PBC. The mean follow-up period was 23.6 +/- 19.8 months, and nine patients died during that period. In conclusion, the clinical manifestations of PBC in Taiwan are similar to those in Western countries, but most of our cases were at later stages.
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PMID:Primary biliary cirrhosis in Taiwan. 212 28


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