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

In 47 patients there was applied the hemosorption (HS) in complex of treatment of obstructive jaundice (OJ) after cholecystectomy. The jaundice duration was 4-6 weeks at average. Choledocholithiasis, the papilla magna duodeni stenosis, choledochal cicatricial stricture were the most frequent causes of OJ. There were conducted 73 HS procedures. In 2 h the level of general bilirubin, cholesterol, urea, creatinine, biliary acids, phenols, middle molecular weight peptides, the alkaline phosphatase activity had lowered significantly. Positive changes of the indices were noted. One-two day term after the HS conduction is optimal one for the radical operation performance.
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PMID:[The application of hemosorption in the treatment of patients with obturative jaundice after cholecystectomy]. 1103 1

We report a case of intrahepatic cholangiocarcinoma treated by extended right lobectomy and resection of the inferior vena cava (IVC) and portal vein. A 53-year-old man was referred with elevated serum alkaline phosphatase (ALP) and gamma-glutamyl transpeptidase (gamma-GTP) levels on April 23, 1999. He was not jaundiced and did not have any symptoms. Endoscopic retrograde cholangiopancreatography (ERCP) revealed irregular strictures in both the anterior and posterior segmental ducts. Contrast-enhanced computed tomography (CT) scan demonstrated a low-density tumor with an unclear margin in the right lobe of the liver. The patient underwent extended right hepatic lobectomy and total caudate lobectomy. Partial resection of the IVC (6 cm) was performed under total hepatic vascular exclusion. The main portal trunk and left portal vein were resected and reconstructed with an end-to-end anastomosis. Macroscopically, a 5.0 x 5.0 x 4.5-cm periductal infiltrating-type tumor occupied the right hepatic parenchyma along the posterior and anterior segmental ducts. Histological examination revealed moderately differentiated tubular adenocarcinoma with marked perineural invasion. Lymph node metastasis was observed in the hepatoduodenal ligament and posterior surface of the pancreatic head. The resected margins of the common bile duct and left hepatic duct were free of tumor. The patient's postoperative course was uneventful, and he was discharged from hospital on the 28th postoperative day. Nine months after the operation, he suddenly developed obstructive jaundice, and died with recurrent disease. This is the first reported case of intrahepatic cholangiocarcinoma treated with major hepatectomy and resection of the IVC and portal vein except ex situ procedure. This aggressive surgical approach may offer hope for patients with intrahepatic cholangiocarcinoma involving the IVC.
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PMID:Extended right hepatic lobectomy with resection of inferior vena cava and portal vein for intrahepatic cholangiocarcinoma. 1118 Aug 93

In patients with portal hypertension, particularly with extrahepatic portal vein obstruction, portal biliopathy producing biliary ductal and gallbladder wall abnormalities are common. Portal cavernoma formation, choledochal varices and ischemic injury of the bile duct have been implicated as causes of these morphological alterations. While a majority of the patients are asymptomatic, some present with a raised alkaline phosphatase level, abdominal pain, fever and cholangitis. Choledocholithiasis may develop as a complication and manifest as obstructive jaundice with or without cholangitis. Endoscopic sphincterotomy and stone extraction can effectively treat cholangitis when jaundice is associated with common bile duct stone(s). Definitive decompressive shunt surgery is sometimes required when biliary obstruction is recurrent and progressive.
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PMID:Portal biliopathy. 1168 33

Biliary obstruction is rarely caused by a foreign body. This report describes the case of a 60-year-old Japanese man with jaundice caused by an impacted shrapnel splinter in the common bile duct (CBD) that had migrated from the right thoracic cavity 36 years after initial injury. Biochemical data showed a total bilirubin level of 4.2 mg/dl with a direct bilirubin level of 3.1mg/dl, an alanine aminotransferase level of 24IU/l, and an alkaline phosphatase level of 18.5KA units. It was serially documented that the shrapnel had migrated toward the diaphragm, then burrowed into the liver, settling in the CBD, and causing obstructive jaundice. Choledochotomy and T-tube drainage was performed and the postoperative course was uneventful. To our knowledge, this is the first case report of this type of occurrence in the Japanese literature. Although there are few reports of combat injury in Japan, this diagnosis should be considered in the evaluation of any patient with jaundice who has suffered a previous chest wound involving a foreign body.
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PMID:Impaction of a shrapnel splinter in the common bile duct after migrating from the right thoracic cavity: report of a case. 1202 9

Jirgl's serum flocculation reaction was examined in a series of 121 patients with varying types of liver disease. Positive results were found in 90% of patients with proven extrahepatic obstructive jaundice. Strongly positive reactions were also obtained in primary biliary cirrhosis and chlorpromazine jaundice. One out of three cases of ;cholestatic' hepatitis gave a weakly positive reaction and the test may be of value in the diagnosis of this condition and in the rare recurrent conjugated hyperbilirubinaemia in which it is also negative.Eighty-four per cent of cases of portal cirrhosis were negative and the finding of a positive result in this condition may indicate the presence of a hepatoma.No correlation could be found either in intra- or extrahepatic obstructive jaundice between the degree of flocculation present and the severity of the obstruction as judged by serum bilirubin and alkaline phosphatase levels.
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PMID:THE VALUE OF JIRGL'S FLOCCULATION TEST IN THE DIAGNOSIS OF JAUNDICE. 1410 2

The differential diagnosis between viral hepatitis and other liver diseases (particularly obstructive jaundice) is often difficult on purely clinical grounds. Damage to the liver causes changes in the pattern of the serum enzymes and this has led to the development in recent years of a number of enzyme tests. The authors have amassed evidence to show that the most useful of these is determination of the levels of serum glutamic oxalacetic and serum glutamic pyruvic transaminase (SGOT and SGPT), coupled with calculation of the SGOT/SGPT ratio. It is characteristic of viral hepatitis that both levels are greatly increased, but the SGOT/SGPT ratio, normally greater than one, falls considerably below his figure. In a few cases of obstructive jaundice, the serum transaminase picture may initially resemble that in viral hepatitis, but the differential diagnosis can be established by repeating the determinations at intervals. Other enzyme tests, such as determination of alkaline phosphatase and leucylaminopeptidase, may be used to confirm the biliary obstruction. Flocculation tests and electrophoretic determination of the plasma protein picture, while of limited value in the diagnosis of acute viral hepatitis, are useful in conjunction with the serum transaminase test for assessing the activity of the disease and any tendency to progress towards "active" chronic hepatitis or post-hepatic cirrhosis.
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PMID:BIOCHEMICAL LABORATORY TESTS IN VIRAL HEPATITIS AND OTHER HEPATIC DISEASES. EVALUATION AND FOLLOW-UP. 1429 63

A technique for measuring the alkaline phosphatase activity of serum protein fractions separated by electrophoresis on cellulose acetate strips is described. Alkaline phosphatase activity in alpha 2, alpha 1, and beta globulins and in albumin is present in varying proportions in normal and pathological sera. In normal sera peak activity is in the alpha 2 globulins and beta globulins have a little more than half the alpha 2 activity. Albumin activity is often more than 10% of the total, but alpha 1 and gamma globulin activity is less than this. In bone disorders with a high serum alkaline phosphatase a large, and sometimes predominant, part of the increase is due to raised beta globulin phosphatase activity, and alpha 2 activity is also raised. Alpha 1 activity, though usually low, may be increased. In hepatobiliary disorders with a high phosphatase concentration the increase is due mainly to raised alpha 2 phosphatase activity, and there is also an increase in alpha 1 phosphatase. Beta activity is usually, but not always, low, and albumin activity may be somewhat increased in obstructive jaundice and liver metastases. There is some overlap between these two patterns of alkaline phosphatase distribution. The findings are consistent with the possibility that alkaline phosphatases in different protein fractions are derived from different tissues.
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PMID:Distribution of alkaline phosphatase in serum protein fractions. 1445 63

Complications of the hydatid cyst of the liver on bile ducts appear in 5-25% representing almost two third of all complications of the hydatid liver cysts. Fortunately a damage to the bile ducts causes only an infection of the cyst usually without major consequences. More serious complications such as cholangitis and deep obstructive jaundice are much rarer. The defect of the bile duct usually is a periferal one. Damage to the major ducts are rarer and those on the confluence of hepatic ducts itself are the rarity. In that case biliary reconstruction may be a serious challenge. The authors present a 23 year-old man in whom a centrally localised hydatid cyst made a major damage of the confluence of all three hepatic ducts causing deep obstructive jaundice. After standard procedure for hydatid cyst an intracavital mucosa to mucosa hepaticojejunostomy was carried out with excellent success. More then six years after surgery the patient stayed symptom-free with bilirubin and alkaline phosphatase within normal limits.
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PMID:[Echinococcosis damaging the junction of the hepatic duct and causing severe obstructive icterus]. 1469 49

An experimental model of microsurgical cholestasis is studied as an alternative to the most frequently used surgical techniques, based on the section of the common bile duct. This microsurgical technique consists of the resection of the extrahepatic biliary tract, that is, of the common bile duct in continuity with the bile ducts that drain the four lobes of the rat liver. At 30 days of evolution, rats with microsurgical cholestasis do not develop biliary pseudocysts or intraperitoneal hilar hepatopulmonary abscesses and show an increase (p < 0.001) in total bilirubin (9.50 +/- 1.50 mg/dL vs. 1.60 +/- 0.35 mg/dL), bile acids (225 +/- 87 micromol/L vs. 12.5 +/- 14.50 micromol/L), gamma-glutamyltranspeptidase (375 +/- 143 U/L vs. 8 +/- 11 U/L), and alkaline phosphatase (73 +/- 25 U/L vs. 23 +/- 4 U/L) levels. The histological study shows fibrosis with biliary proliferation. The microsurgical cholestasis technique is a valid alternative to other techniques and can be an adequate experimental model for the study of etiopathogenic mechanisms of obstructive jaundice and especially to study extrahepatic biliary atresia.
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PMID:Microsurgical extrahepatic cholestasis in the rat: a long-term study. 1520 16

We investigated the effect of dehydroepiandrosterone (DHEA) on oxidative injury in obstructive jaundice using three groups of rats: sham-operated group; common bile duct (CBD) group--the CBD was ligated; and DHEA group--DHEA administration followed CBD ligation. Liver function tests were performed using blood samples, and malondialdehyde concentration (MDA), superoxide dismutase activities (SOD), glutathione peroxidase (GPx), and total glutathione (tGSH) concentrations were measured in liver tissue. Serum alkaline phosphatase, gamma-glutamyltransferase and alanine aminotransferase activity were significantly elevated in the CBD group compared with the other groups. Serum aspartate aminotransferase and total bilirubin were highest in the CBD group; the MDA concentration was higher in the CBD group than the sham group. There were no significant differences in GPx activity among the groups. SOD activity and tGSH concentration were significantly lower in the CBD group than the other groups. DHEA may protect hepatic tissue against oxidative injury in obstructive jaundice by decreasing MDA concentration and increasing SOD activity and tGSH concentration.
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PMID:Dehydroepiandrosterone prevents oxidative injury in obstructive jaundice in rats. 1530 71


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