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

1. Cefmetazole was administered to 10 patients; 5 acute cholecystitis, 4 acute peritonitis and 1 periproctitis. 2. Cefmetazole was given by drip infusion at a daily dose of 2 to 4 g. 3. Clinical response was excellent in 3 patients, and good in other 7 patients. 4. No clinical adverse effect was recognized except the increase of GOT and GPT in 1 patient.
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PMID:[Clinical studies of cefmetazole (author's transl)]. 43 2

Southern Taiwan experienced a dengue (type 1) outbreak in the autumn of 1988. One hundred and thirteen febrile patients suspected as having dengue infection were seen in the emergency room of the Kaohsiung Medical College Hospital. These patients were recruited for this study. Two hundred and eighty-six sequential serum aspartate transaminase (AST) and alanine transaminase (ALT) data from these patients were analyzed. Data analysis showed serum AST had increased daily and all data were out of normal range from day 6 of the illness. Compared to the AST level on the first day of the illness, the AST level was noted to elevate to an average of 9.25 folds on day 6. The sequential changes of AST were as follows: AST had elevated since the third ill-day in most cases and reached a peak on the 7th or 8th ill-day. It then declined gradually from the 8th ill-day and became normal about 3 weeks later. The changes of ALT level were about the same as AST but had later onset and lower peak. Abdominal sonographic examinations showed thickening of the gall bladder wall, splenomegaly and ascites in some patients during acute stage of the illness and recovered completely after patients recovered from the dengue attack. The sequential change of serum transaminase levels and sonographic findings were compatible. These findings may be used as a reference for the differential diagnosis among dengue fever, acute hepatitis and acute cholecystitis.
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PMID:Sequential changes of serum transaminase and abdominal sonography in patients with suspected dengue fever. 221 70

Lomefloxacin (NY-198), a new antimicrobial quinolone, was examined for its antimicrobial activities against clinical isolates and clinical efficacies to biliary tract infections. The following results were obtained. 1. The MICs of NY-198 against Escherichia coli (20 strains) and Klebsiella pneumoniae (20 strains) were good and similar to those of ofloxacin (OFLX) or norfloxacin (NFLX). The MICs of NY-198 against Pseudomonas aeruginosa (20 strains) were inferior by 1 dilution factor to OFLX or NFLX, and against Enterococcus faecalis (10 strains), they were similar to NFLX and slightly inferior to OFLX. 2. NY-198 was administered to 8 patients with biliary tract infections (acute cholecystitis 7 cases, chronic cholangitis 1 case). The results were good in 7 and unevaluable in 1 case because the duration of the therapy was too short. 3. As for side effects, mild urticaria was observed in 1 case and epigastralgia with nausea in another. As for abnormal laboratory test values slight elevations of GOT and GPT were recognized in 1 case. 4. In conclusion, we consider NY-198 is a useful oral drug for the treatment of biliary tract infections.
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PMID:[Studies of lomefloxacin in biliary tract infections]. 276 34

Two hundred and forty-three patients aged under 75 years with acute calculous cholecystitis treated by early surgery were studied with a view to investigating the frequency of choledocholithiasis and the predictive value of routine liver function tests (bilirubin, alkaline phosphatase, alanine aminotransferase). 7% had stones in the common duct, but 33% had hyperbilirubinaemia. In less than 10% of the latter could be hyperbilirubinaemia be attributed to common bile duct stones. It was concluded that the frequency of common bile duct stones in acute cholecystitis was low, and that patients often had signs of impaired liver function which was of no help in diagnosing the presence of stones in the common duct.
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PMID:Acute cholecystitis. Frequency of stones in the common duct and predictive value of liver function tests. 401 23

Aztreonam (AZT), a new synthetic monocyclic beta-lactam antibiotic, which is resistant to beta-lactamase and has a strong and specific activity against aerobic Gram-negative bacteria including Pseudomonas aeruginosa. The patients of 13 cases with localized peritonitis due to acute appendicitis, 3 cases with panperitonitis (1 case with perforative appendicitis, 1 with acute cholecystitis and 1 with pancreatic necrosis) and 4 cases with skin and soft tissue infection (anal fistula and abdominal abscess etc.) were treated by AZT. AZT was administered in a dose of 1 g twice a day by intravenous drip infusion using 100 ml-volume bottle preparation with saline for 4 to 10 days. Clinical efficacy was rated excellent in 2 cases, good in 16 cases, fair in 1 case and poor in 1 case (efficacy rate 90.0%). Adverse effects were small skin rash in 1 case, and increased GOT and GPT in 1 case. No adverse effect was recognized in other cases. Therefore, AZT appears to be very useful drug when used for chemotherapy of infectious diseases in surgery.
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PMID:[Clinical studies on aztreonam following intravenous drip infusion]. 407 96

The incidence of acute cholecystitis complicating standard abdominal aortic aneurysm (AAA) repair has been reported between 0.3 and 18 per cent. This has prompted considerable debate regarding the management of cholelithiasis discovered incidentally during open aortic reconstruction. This study seeks to determine the incidence of cholelithiasis and acute cholecystitis after endovascular AAA repair and evaluate options for management. Between February 1996 and October 2001 492 patients underwent endovascular AAA repair. All the procedures were performed in the operating room under fluoroscopic guidance. Epidural (98.9%), local (0.5%), or general (1.7%) anesthesia was used during these cases. The incidence of cholelithiasis and acute cholecystitis was evaluated by CT scan and abdominal ultrasound. Serum measurements of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, total and direct bilirubin, and amylase were performed and clinical assessment was conducted at 1, 6, and 12 months postoperatively and annually thereafter. The mean age of these patients was 76.6 years; 84% were male. Comorbid medical conditions were present in all patients (average 3.5 conditions/patient). Follow-up ranged from 2 to 35 months (mean 12.8 months). Endovascular stent graft deployment was successful in 486 of the 492 patients (98.8%). Six patients were converted to standard open repair because of inability to achieve successful endovascular aneurysm repair. The perioperative major morbidity rate was 14.9 per cent. Minor morbidity rate was 8.5 per cent. The perioperative mortality rate was 1.9 per cent. No deaths were related to biliary disease. Cholelithiasis was identified in 64 (13%) patients preoperatively. One of 64 patients with a prior Billroth II reconstruction for peptic ulcer disease developed jaundice 8 days after AAA repair as a result of choledocholithiasis that required surgical repair. One patient without gallstones developed acute acalculous cholecystitis on postoperative day 16 as determined on pathologic analysis of the gallbladder. A third patient who had gallstones identified on preoperative CT scan developed calculous cholecystitis 16 months after endovascular AAA repair. These two patients underwent uncomplicated laparoscopic cholecystectomy and recovered uneventfully. The incidence of postoperative symptomatic cholelithiasis is 1.6 per cent (one of 64). The incidence of postoperative acute cholecystitis was 0.2 per cent (one of 486) and was unrelated to the presence of gallstones. The incidence of delayed symptomatic cholelithiasis was 1.6 per cent (one of 64). Endovascular repair of AAA does not appear to predispose the patient to the development of symptomatic cholelithiasis during the perioperative period. Therefore a preoperative or intraoperative diagnosis of cholelithiasis does not necessitate cholecystectomy in the setting of planned endovascular AAA repair. Patients who develop cholecystitis after endovascular AAA repair may be effectively treated by standard laparoscopic techniques.
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PMID:Abdominal aortic aneurysmorrhaphy and cholelithiasis in the era of endovascular surgery. 1241 7

Acute cholecystitis associated with gallbladder carcinoma is very rare in young patients (younger than 30 years of age). Moreover, a definitive preoperative diagnosis is difficult. A 26-year-old man was referred to our hospital with a 5-day history of right upper quadrant pain. Computed tomography and ultrasonography demonstrated an enlarged gallbladder with a diffuse thick wall and a 2-cm gallstone obstructing the cystic duct. Magnetic resonance cholangiopancreatography showed no evidence of an anomalous pancreaticobiliary junction. The patient showed an elevation in the white blood cell count, serum C-reactive protein, and alkaline phosphate; however, total bilirubin, alanine aminotransferase, and tumor markers including carcinoembryonic antigen and carbohydrate antigen 19-9 were all within the normal ranges. The preoperative diagnosis of gallstone-induced acute cholecystitis was made and an open cholecystectomy was thus performed 2 days after admission. The macroscopic findings showed a necrotic enlarged gallbladder with a thick wall and a gallstone, but no intraluminal nodular lesion. Histologic examinations revealed well-differentiated focal adenocarcinoma in the gallbladder mucosa, but no venous, lymphatic, or perineural invasion. The postoperative course has been uneventful with no recurrence 18 months postoperatively.
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PMID:Latent gallbladder carcinoma in a young adult patient with acute cholecystitis: report of a case. 1764 22

Pyogenic abscesses of the liver represent a serious nosologic unit with high morbidity and mortality rates. Their diagnostics is based on ultrasonography, computer tomography or MRI, or positrone emission tomography. The principal treatment procedure includes percutaneous draining of the abscess cavity under the ultrasound or CT control. The authors present a group of 83 subjects hospitalized from 2000 to 2006 for pyogenic abscesses of the liver. Obstruction of the bile ducts, acute cholecystitis and resections of the liver or pancreas for malignancies were recorded as the commonest causes of the abscesses. Percutaneous drainage was the treatment method of choice in 67.5% of the subjects and it included management of the causative factors and administration of antibiotics. The hospitalization period was affected by the following factors: septic conditions (p < 0.04), ALT levels (p < 0.003) - cut off 3.0 mkat/l, the abscess diameter, which may have required reoperation, (p < 0,05), diabetes mellitus (p < 0.05) and septic conditions (p < 0.001). The need for re-hospitalization due to a relaps of the pyogenic abscess of the liver correlated significantly with the following: a number (> 2) of abscesses (p < 0.04), C-reactive protein levels (p < 0.005) - cut off> 100 mg/l and septic conditions (p < 0.007). Furthermore, significat correlation was detected between the mortality rates and sepsis (p < 0.05).
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PMID:[Pyogenic abscesses of the liver]. 1769 33

Among various expert systems (ES), Artificial Neural Network (ANN) has shown to be suitable for the diagnosis of concurrent common bile duct stones (CBDS) in patients undergoing elective cholecystectomy. However, their application in practice remains limited since the development of ANNs represents a slow process that requires additional expertize from potential users. The aim of this study was to propose an ES for automated development of ANNs and validate its performances on the problem of prediction of CBDS. Automated development of the ANN was achieved by applying the evolutionary assembling approach, which assumes optimal configuring of the ANN parameters by using Genetic algorithm. Automated selection of optimal features for the ANN training was performed using a Backward sequential feature selection algorithm. The assessment of the developed ANN included the evaluation of predictive ability and clinical utility. For these purposes, we collected data from 303 patients who underwent surgery in the period from 2008 to 2014. The results showed that the total bilirubin, alanine aminotransferase, common bile duct diameter, number of stones, size of the smallest calculus, biliary colic, acute cholecystitis and pancreatitis had the best prognostic value of CBDS. Compared to the alternative approaches, the ANN obtained by the proposed ES had better sensitivity and clinical utility, which are considered to be the most important for the particular problem. Besides the fact that it enabled the development of ANNs with better performances, the proposed ES significantly reduced the complexity of ANNs' development compared to previous studies that required manual selection of optimal features and/or ANN configuration. Therefore, it is concluded that the proposed ES represents a robust and user-friendly framework that, apart from the prediction of CBDS, could advance and simplify the application of ANNs for solving a wider range of problems.
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PMID:Automated development of artificial neural networks for clinical purposes: Application for predicting the outcome of choledocholithiasis surgery. 2726 65

The present paper describes a case of hemorrhagic cholecystitis in a patient on maintenance dialysis. The patient presented with right upper quadrant abdominal pain. Computed tomography revealed swelling of the gallbladder, high- and isodensity contents of the gallbladder, and high-density stone in the gallbladder neck. He was hospitalized for suspected acute cholecystitis. After hospitalization, his levels of total bilirubin, aspartate aminotransferase, and alanine aminotransferase increased. T2-weighted magnetic resonance imaging showed low-intensity contents expanded to include a wide area from the common bile duct to the cystic duct and gallbladder neck. Endoscopic retrograde cholangiopancreatography revealed clotting from the duodenal papilla. After cannulation of the bile duct, old blood and pus began to flow from the mammary papilla, and an endoscopic nasobiliary drainage tube was placed. After his liver function had improved, the patient underwent laparoscopic cholecystectomy. His sample revealed that the gallbladder was filled with blood clots and stones. His postoperative course was uneventful and he was discharged on day 19 after the procedure. Although hemorrhagic cholecystitis is rare, it should be considered as a differential diagnosis for patients on dialysis who have acute abdominal symptoms.
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PMID:Hemorrhagic Cholecystitis in a Patient on Maintenance Dialysis. 2903 67


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