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)

We have experienced a case of fulminant malignant hyperthermia who was a 63-year-old female weighing 44 kg. There was no particular past history nor family history. She underwent right mastoidectomy because of chronic otitis media. Her preoperative physical status was ASA I. She was premedicated with diazepam 10 mg and loxatigine 75 mg P.O. The induction was done with thiamylal 200 mg IV and fentanyl 0.1 mg IV followed by vecuronium 6 mg IV for endotracheal intubation. Intubation was easy and uneventful. Anesthesia was maintained with nitrous oxide 3 l.min-1, oxygen 3 l.min-1 and enflurane 2.0%. Seventy min after the induction of anesthesia, arterial blood gas analysis showed severe respiratory acidosis (PCO2: 63.2 mmHg, pH: 7.27) and it was improved with manual hyperventilation at that time. Pulse rate increased from 80 to 115 b.p.m. 20 minutes later. Then, the patient was ventilated with 100% oxygen, and anesthetic circuits and machine were exchanged for new units. Surgery was postponed. Muscle stiffness of upper extremities was observed and her temperature increased to a maximum of 38.9 degrees C. Surface cooling was started and dantrolene sodium 60 mg and furosemide 20 mg were given intravenously. The patient was transferred to the intensive care unit, and clinical signs improved gradually within one hour. Serum enzymes; CPK, LDH, GOT and GPT increased on the first postoperative day. On the 11 th postoperative day skeletal muscle biopsy was done under local anesthesia with 1% procaine and Ca-induced Ca-release rate test revealed positive for enflurane. This is the oldest patient of malignant hyperthermia reported in Japan.
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PMID:[A case report of a 63-year-old patient with malignant hyperthermia]. 161 62

We investigated the factors which may influence post-operative liver and renal function using a multiple regression analysis after isoflurane or sevoflurane anesthesia in 844 patients (ASA I or II, age 20-90 yr). Hepatic and renal surgeries were excluded from this study. The parameters examined were sex, age, degree of obesity, preoperative liver function, preoperative renal function, infection with hepatitis B or hepatitis C virus, inhalation anesthetics used, MAC.h of anesthesia, the duration of operation, blood loss, amount of blood transfusion, urine volume during operation, and surgical site. Serum GOT, GPT, total bilirubin, BUN and serum creatinine were examined on the 3rd and 7th day after surgery. An increase in serum GOT, GPT or bilirubin was observed for each of the following parameters; male, infection with hepatitis C virus, long operation, and upper abdominal surgery. Postoperative BUN and serum creatinine increased in patients with preoperative renal dysfunction, in elderly patients, and in hepatitis C carriers.
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PMID:[Multiple regression analysis of pre- and intra-operative factors in relation to post-operative liver and renal functions]. 854 85

Patients with epilepsy on long term antiepileptic drug (AED) therapy deserve special consideration not only concerning seizure control but also the effect on anaesthetic metabolism and hepatorenal functions. In the present study, we examined the effects of sevoflurane anaesthesia on plasma inorganic fluoride (F-) level and hepatorenal function in patients with and without AED therapy. Twenty-two patients (12 with AEDs = AED group, and ten without AEDs = control group = C group), ASA I, who were free of hepatorenal disease, received approximately 2-3 h sevoflurane anaesthesia. Plasma F- analysis was performed at the stages of: 1) induction of anaesthesia, 2) conclusion of anaesthesia, 3) 15 h after the conclusion of anaesthesia, using an ion-selective electrode calibrated with a standard solution of sodium fluoride. Pre- and postoperative hepatic (aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total bilirubin) and renal (blood urea nitrogen, creatinine) function was tested. There were no significant differences between the two groups in the average age (AED group = 9.4 and control group = 10.1 y.o.), body weight, duration of anesthesia, and MAC hours (2.6 and 2.4). The mean peak F- levels were 15.5 and 13.6 microM, in AED and C groups (not significant), respectively. No patient exhibited F- values greater than 50 microM, the hypothetical nephrotoxic threshold. The patients showed no abnormal values either in hepatic or renal function tests postoperatively. These results suggest approximately 2-3 h sevoflurane anaesthesia to be safe in patients taking AEDs.
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PMID:Clinical characteristics and biotransformation of sevoflurane in paediatric patients during antiepileptic drug therapy. 888 Aug 18

Propofol in emulsion formulation is widely used for anesthesia during operation and sedation in ICU. We investigated the effect of propofol used as a main anesthetic on post-operative serum lipid concentration. Nineteen patients with ASA physical status I or II scheduled for elective operations were enrolled in this study. We measured triglycerides and total cholesterol (pre-operatively, post-operatively and on post-operative day 1) along with AST, ALT and T-Bil (pre-operatively and on post-operative day 1). Intraoperative infusion rate of propofol was 6.9 +/- 2.64 mg.kg-1.hr-1. Serum triglyceride concentration increased significantly post-operatively (P < 0.05). Serum total cholesterol concentration decreased significantly post-operatively and on post-operative day 1 (P < 0.05). Serum AST concentration increased significantly on post-operative day 1. But there were no significant changes in ALT and T-Bil concentration. Additionally, no significant correlation was found between intraoperative infusion rate of propofol and difference in pre- and post-operative triglyceride concentrations (r = 0.44). The soya bean oil content of propofol solution is equivalent to that of 10% fat solution. With 10% fat infusion rates of below 0.1 mg.kg-1.hr-1 (equall to propofol 10 mg.kg-1.hr-1), serum lipid concentration did not increase. But our results suggested that serum triglyceride concentration may increase significantly post-operatively after intra-operative propofol infusion at a rate of 4-9 mg.kg-1.hr-1.
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PMID:[Effect of intra-operative propofol administration on post-operative serum lipid concentrations]. 1159 11

Propofol in emulsion formulation is widely used for operation and sedation in ICU. We retrospectively investigated the effect of dopamine on post-operative serum lipid concentrations after propofol administration. Twenty three patients with ASA physical status I or II scheduled for elective operations were enrolled in this study; 15 patients in the non-dopamine administration group (Group P) and 8 patients in the dopamine administration group (Group Dopa-P). We measured triglyceride (TG), total cholesterol (T-chol) pre-operatively, post-operatively and on post-operative day 1 and AST, ALT preoperatively and on post-operative day 1. Serum TG concentration increased significantly in post-operative measurements in Group-P (P < 0.05). But there was no significant change in TG in Group Dopa-P. Serum T-chol concentration decreased significantly post-operatively and on post-operative day 1 in both groups (P < 0.05). Serum AST and ALT concentrations increased significantly on post-operative day 1 (P < 0.05). With 10% fat infusion rates below 0.1 mg.kg-1.hr-1 (equal to propofol 10 mg.kg-1.hr-1), serum lipid concentration did not increase. But our results suggest that the serum TG concentration may increase significantly post-operatively after intra-operative propofol administration and dopamine may decrease serum TG level.
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PMID:[The effect of dopamine on serum lipid concentration after propofol administration]. 1192 96

The article contains results of mass-spectrometric control of sevoflurane and compound A concentrations during inhalation anesthesia with minimal flow (< or = 0.5 l/min) and its influence on liver and kidney function. 40 patients (ASA I-II) were included in the study. Transsphenoidal pituitary adenomectomy was performed in all cases. Patients didn't have any signs of liver or kidneys disfunctions preoperatively. We used quadrupole mass spectrometer "Prisma Plus" (Pfeiffer vacuum, Germany) to determine the real time concentration of sevoflurane and compound A. Intensity of m/z = 131 peak sevoflurane and m/z = 128 peak compound A were registered. Laboratory blood tests to assess liver and kidney function were carried out before anesthesia, after anesthesia, and on the 1st day after anesthesia. They included: AST, ALT, total bilirubin, total protein, urea, creatinine. Quantitative analysis of the compound A and blood test before and after anesthesia showed only a tendency to increase biochemical markers levels within normal range, except small, but significant, AST elevation and total protein reduction in postoperative period. We concluded that maximal registered level of compound A (275 ppm/h) during minimal flow anesthesia didn't associate with significant liver and kidneys injury in healthy patients.
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PMID:[Mass-spectrometric control of compound A during minimal flow anesthesia and its influence on liver and kidneys functions]. 2434 Oct 36