Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:3.1.3.1 (alkaline phosphatase)
 47,916 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The medical records of 277 consecutive patients who underwent cholecystectomy for benign gall stone disease, were reviewed to determine the incidence and cause of biliary tract obstruction. Obstructive jaundice (icteric obstructive biliopathy) was present in 38 cases. This was due to choledocholithiasis in 22. Mirizzi's Syndrome in two, biliobiliary fistula in eight and biliary stricture in five patients. Preoperative direct cholangiography (ERCP/PIC) was helpful. Anicteric patients were classified on the basis of a history of jaundice serum alkaline phosphatase, sonography and operative findings. Anicteric patients with evidence of biliary tract pathology (anicteric obstructive biliopathy) had a significant incidence of choledocholithiasis (33.3%). Biliary complications were uncommon in this group (4.3%). Peroperative cholangiography was carried out and was valuable in these patients but was normal in all 83 patients who had no evidence of biliary obstruction.
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PMID:Gall bladder and common bile duct stones--when is direct cholangiography indicated. 248 86

Fifty-nine colorectal cancer patients with metastatic liver cancer who underwent intra-arterial infusion chemotherapy (IAIC) at the National Cancer Center Hospital from May 1986 to February 1989 were reviewed. Excisions of metastatic liver cancer were performed in 36 patients and 23 had nonresectable metastatic liver cancer. Catheter troubles, including severe infections (8), extravasations (3), obstruction (1) and other (1) occurred in 13 (22.0%) patients, and 6 patients (10.2%) were unable to receive IAIC. Three patients did not undergo IAIC because of hepatitis or other reasons. Serious complications following IAIC, including sclerosing cholangitis (SC) (6), extravasations (6) and obstructions (3) were observed in 15 patients (30.0%). 5-Flourouracil (5-FU) (700 mg/m2) and mitomycin C (MMC) (7 mg/m2) were infused through implantable pumps weekly or every two weeks. Total infused doses of 5-FU ranged from 7,000 to 26,250 mg (mean: 11,800 + 7,700 mg) and those of MMC from 24 to 84 mg (mean: 45.3 + 25.8 mg) in 6 patients (12%) with SC, 4 resectable and 2 non-resectable cases. All six patients with SC had cholangiographic abnormalities of the biliary tract by endoscopic retrograde cholangiography (ERCP) or percutaneous transhepatic cholangiography (PTC), but serial CT examination of the liver did not show any progression of the tumor at the hilum in these patients. Segmental stricture at the common hepatic duct and bifurcation appeared specific to IA-5-FU induced SC. Obstructive jaundice occurred in 3 patients. Four patients had epigastralgia and 3 exhibited elevated alkaline phosphatase level prior to the cholangiographic examination. The elevated level of alkaline phosphatase was reversible in one patient without obstructive jaundice. Although the relation of the sclerosing process to IA-5-FU dose is not yet clear as well as IA-FUDR, it should be important to make an early detection of SC by ERCP and also to discontinue IAIC as soon as possible. In our opinion, SC may relate to the arterial delivery of 5-FU. In order to prevent SC, devascularization of the right hepatic artery via surgical procedures may well be effective, because retrograde flow from the right hepatic artery was confirmed by several clinical and anatomical studies.
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PMID:[Complications of intra-arterial infusion chemotherapy in patients with colorectal cancer with liver metastasis, with special reference to IA-5-FU induced sclerosing cholangitis]. 250 36

In the past, before the development of biochemical tests for serum enzymes, differentiation between obstructive (surgical) and parenchymal (medical) jaundice was difficult. It was based mainly on patient history, physical examination and the experience of the physician, and the definitive diagnosis depended on surgical exploration. Even with known serum aminotransferase and alkaline phosphatase levels, a distinction between the two types of jaundice was not always certain. Then came the era of new imaging techniques. With the development of direct cholangiography followed by x-ray CT and real-time ultrasonography (US), differential diagnosis of surgical and medical jaundice is no longer a problem. In the clinical setting, the current issue is how quickly and how less invasively the diagnosis could be made. In this chapter, current imaging diagnosis in patients with obstructive jaundice will be discussed, along with its differentiation from medical jaundice.
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PMID:Imaging diagnosis of obstructive jaundice. 269 52

Of 58 cases of obstructive jaundice treated in a three year period, six were due to the intrabiliary rupture of hydatid cysts of the liver. Eosinophilia of more than 10%, raised alkaline phosphatase, positive indirect haemagglutination test were noted in all six cases. Plain X-ray of the abdomen, ultrasound, endoscopic retrograde cholangio-pancreatography and CT scan were useful modalities for definite pre-operative diagnosis. All patients had operative treatment which consisted of cyst drainage, partial pericystectomy, curettage of the remaining cavity which was stitched with tube drain, cholecystectomies, choledochotomy and T-tube drainage. They all recovered satisfactorily and without complications in a follow-up period of two years.
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PMID:Obstructive jaundice secondary to intra-biliary rupture of hepatic hydatid cyst. 270 97

Enzymological examination of 113 patients with A and B viral hepatitis (VH) and 41 with obstructive jaundice of tumor origin and 32 with chronic cholecystitis during exacerbation showed an increase of activity of blood serum lactate dehydrogenase (LDG), gamma-glutamyltranspeptidase (GGTP), alkaline phosphatase. The GGTP/LDG ratio is of differential-diagnostic value. Ratio values of 0.8 and less indicate VH while values of 1 and more indicate obstructive jaundice.
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PMID:[A clinical evaluation of enzymologic methods for the differential diagnosis of viral hepatitis and subhepatic jaundice]. 275 Jan 6

We have measured the amounts of different molecular forms of gamma-glutamyltransferase (EC 2.3.2.2), leucine aminopeptidase (EC 3.4.11.2), and alkaline phosphatase (EC 3.1.3.1) in serum of patients with different types of liver disease. A high-molecular-mass (greater than 1 000 000 Da) form of gamma-glutamyltransferase and of each of the other enzymes is present in greatest amounts in patients with jaundice from extrahepatic obstruction. A gamma-glutamyltransferase form of intermediate molecular mass (250 000 to 500 000 Da) is present in the serum from most patients with liver disease and can be separated by electrophoresis into several bands. We found that one of these bands predominated in patients with extrahepatic obstructive jaundice, whereas the others predominated in patients with other liver diseases. Electrophoresis of serum gamma-glutamyltransferase may be of clinical value in distinguishing extrahepatic from intrahepatic causes of jaundice.
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PMID:Multiple forms of gamma-glutamyltransferase: a clinical study. 285 75

Obstructive jaundice due to benign, nonparasitic hepatic cysts is rare, with only 11 previously reported cases. We report a case in which relief of jaundice was obtained by percutaneous cyst aspiration. For the elderly, infirm, or high-risk patient, percutaneous aspiration is recommended to relieve obstructive jaundice. Immense size and porta hepatis proximity are major risk factors for developing jaundice from simple hepatic cysts. Abdominal pain of recent onset and rising alkaline phosphatase are warning signs that this complication is developing. In these situations, treatment prior to developing jaundice is recommended.
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PMID:Obstructive jaundice from benign, nonparasitic hepatic cysts: identification of risk factors and percutaneous aspiration for diagnosis and treatment. 327 52

Serum bile acid (SBA) concentration was determined weekly for 4 weeks in dogs with experimentally induced hyperbilirubinemic liver disease. Obstructive jaundice was created in 6 dogs by surgical ligation of the common bile duct, and hepatocellular jaundice was created in 6 sham-operated dogs by administration of dimethylnitrosamine; 6 other sham-operated dogs served as controls. Serum bile acid concentration increased rapidly after bile duct ligation (from 0.6 +/- 0.1 to 69.2 +/- 15.3 mumol/L at 3 days), peaked at 14 days (247.8 +/- 54.1 mumol/L), and then gradually decreased (179.9 +/- 27.1 mumol/L at 28 days). Serum bile acid concentration in dimethylnitrosamine-treated dogs increased more gradually to 38.9 +/- 10.7 mumol/L at 28 days, at which time the serum bilirubin concentration was comparable with that of bile duct-ligated dogs. Mean total SBA values in bile duct-ligated dogs were significantly (P less than 0.01) higher than those in control and dimethylnitrosamine-treated dogs at days 3 through 28, with no overlap of individual values. Serum bile acid concentration at day 28 correlated positively (P less than 0.01) with cholestasis and bile duct proliferation observed in liver biopsy specimens, but did not correlate with necrosis or inflammation. Serum bile acid concentration also correlated positively (P less than 0.01) with serum bilirubin and cholesterol concentrations and with serum alkaline phosphatase and alanine transaminase activities. Results of the study reported here indicated a relationship between SBA concentration and cholestasis in dogs; extrahepatic bile duct obstruction resulted in the highest SBA values.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Serum bile acid analysis in dogs with experimentally induced cholestatic jaundice. 335 42

Patients with jaundice and hyperbilirubinemia over 34 mumol/l have been examined by different methods in order to assess the diagnostic value of the methods. 340 patients were examined clinically and by laparoscopy, 168 patients and 92 healthy persons were examined by 10 laboratory indices, 639 patients--by ultrasonography, 95 patients--by scintigraphy, 116 patients--by computer tomography, 83 patients--by endoscopic retrograde cholangio-pancreatography (ERCPG), 17 patients--by percutaneous transhepatic cholangiography (PTC), 70 patients--by directed liver biopsy. In the patients with cholestasis the 5'-nucleotidase, alkaline phosphatase, glutamyl transpeptidase (lipoprotein X is positive in 92% of the patients) and cholesterol are increased most. The extrahepatic obstructions are diagnosed by ultrasonography in 94.8% of the patients (the biliary ducts are dilated), in 88.7% of the patients the localization of the obstruction and in 74.7% of the patients the cause of the obstruction are found. In parenchymal jaundice the sonography reveals the disease which has caused jaundice in 62.1% of the patients. The scintigraphy gives correct diagnosis in 50% of the patients with hepatitis and jaundice, in 78% of the patients with cirrhosis and jaundice and in 87.5% of the patients with liver cancer. The computer tomography reveals the obstructive jaundice in 94.7% of the patients and the focal processes in the liver in 96.7% of the patients. The ERCPG gives a clear picture of the biliary ducts in 72.28% and of the pancreatic duct in 83.13% of the patients with jaundice, simultaneously the biliary and the pancreatic ducts--in 45.78% of the patients and correct diagnosis in 83.1% of the patients examined.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Differential diagnosis of jaundice]. 343 27

Using OST6 and OST7 monoclonal antibodies against human osteosarcoma cells, a solid-phase radioimmunosandwich assay was developed to quantitate a human osterosarcoma-associated antigen in a total of 242 sera from healthy adults and patients with various diseases. The levels of the antigen in sera were high in patients with osteosarcoma and in children without tumorous diseases compared with healthy adults; however, the highest level of the antigen was found in patients with obstructive jaundice. The quantity of the antigen correlated with serum alkaline phosphatase (EC 3.1.3.1.) activity, and showed a strong correlation (correlation coefficient, 0.94) in 50 sera. Immunolocalization of enzyme activity assay using monoclonal antibodies was performed to ascertain whether the antigen had alkaline phosphatase activity. This assay proved that OST6, OST7, and OST15 monoclonal antibodies recognized serum alkaline phosphatase; furthermore, these monoclonal antibodies seemed to react with not only the bone isoenzyme but also the liver isoenzyme.
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PMID:Recognition of serum alkaline phosphatase by murine monoclonal antibodies against human osteosarcoma cells. 352 20


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