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)

We have selected for this study a well-defined group of patients with moderately advanced but compensated alcoholic cirrhosis. They were well-nourished and had no ascites, varices, azotemia, or encephalopathy. Liver biopsy showed little or no necrosis and inflammation despite wide-spread fibrosis. Serum bilirubin, transaminase, alkaline phosphatase, albumin and globulins were essentially normal. Biochemical evidence for liver disease was restricted to modest elevation of BSP retention, gamma GTP, serum bile acid concentrations, and urinary bile acid excretion. Except for changes in the interrelationships among the three biliary lipids, they were generally spared the abnormalities of sterol metabolism described in other patients with more advanced, more active liver disease. Thus, striking abnormalities in the metabolism of cholesterol and bile acids probably require severe reductions in functioning hepatocellular mass, major portal-systemic shunting, high disease activity, or all three to become manifest.
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PMID:Cholesterol and bile acid metabolism in moderately advanced, stable cirrhosis of the liver. 49 6

Cytological, histochemical and neurohistological methods were used to study the human retina (27 corpses of people from 60 to 80 years of age). Two retinas from people of 32 and 27 years served as controls. The activity of alkaline phosphatase in neurons was established to increases with age. There were also enlargement of cysts and an increase of the square surface of their distribution in the retina, numerous aneurysmatic swelling along the course of the retinal capillaries. The nerve elements of the retina degenerated more often with age and partly died. Varicosities and excessively growing enlarged terminals were found along the course of dendritic and axonic processes. In the macular zone there were hypertrophicsynapses and circularly running sinuous fine fibres. Solitary ganglionic cells in this region had dendrites directed toward on side-they ere asymmetrical. The astrocytigglia was not changed. The fovea bottom contained may Muller's cells. Possible interpretation of the mechanism of appearance of vaicosities and excrescences in the nerve fibres with age age is presented.
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PMID:[Age characteristics of the structure of the human retina]. 109 21

Portal hypertension with varices developed in 18/675 patients with chronic myeloid leukaemia (CML) in a randomized trial comparing busulphan with busulphan and thioguanine. All 18 had received the drug combination and none busulphan alone (P less than 0.0001). Ascites was also seen significantly more often in the combination arm (P less than 0.05). These results strongly suggest that the addition of thioguanine was responsible for the development of portal hypertension. The histological features were predominantly those of non-cirrhotic portal hypertension--either idiopathic portal hypertension with minimal morphological abnormalities, nodular regenerative hyperplasia or in two cases leukaemic infiltration only was noted. Cirrhosis was present in 3/16 cases studied. Both treatment groups developed abnormal liver function tests during the chronic phase, but particularly with progression of the disease. During chronic phase abnormalities were significantly more frequent in those receiving busulphan and thioguanine-alkaline phosphatase (P less than 0.02), transaminases (P less than 0.04), bilirubin (P less than 0.05), multiple abnormalities (P less than 0.01). The development of portal hypertension was often associated with abnormalities of these tests; however, lack of specificity precludes their use as a predictor of subsequent clinical problems. Thioguanine confers no survival advantage in this disease. In view of its hepatotoxicity it should not be used routinely for maintenance of control in chronic phase CML.
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PMID:Thioguanine used in maintenance therapy of chronic myeloid leukaemia causes non-cirrhotic portal hypertension. Results from MRC CML. II. Trial comparing busulphan with busulphan and thioguanine. 195 75

In patients undergoing aortic-coronary bypass operations, essentially similar ultrastructural changes are found both in the fragments removed from the coronary arteries and in veins from the saphenous system that are about to be used as autografts. The most important changes involve the intima and media, and include an increase in the number of 'm' smooth muscle cells and degenerating or dying cells, together with enlargement of the total intercellular space of the media and an increase in the proportion of dysplastic collagen fibrils found there. Furthermore, both the venous grafts and the varicose veins of heavy smokers who inhale show an increase in the calcium content that is independent of age. On the other hand, varicose veins which have been stripped show no alteration in either beta-NAG or alkaline phosphatase activity as a result of smoking; although, in parts of the saphenous veins mobilised for transplantation, an increase in the activity of both enzymes is found which is dependent upon the number of cigarettes daily consumed by the patient.
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PMID:[Calcium determination, enzyme biochemical and electron microscopy studies of saphenous veins in patients with coronary sclerosis or varicose veins]. 236 Mar 65

A retrospective study was made of the clinical features, especially oesophageal varices, of 93 patients with PBC. The 5 year survival rate of asymptomatic PBC patients was 88.7% and that of symptomatic PBC was 43.7%. The 5 year survival rate of the group with oesophageal varices was 44.0% and that of the group without varices was 68.8%. The 5 year survival rate of the patients with high-risk varices was 39.1% and of those without high-risk varices was 67.9%. Management of variceal bleeding in PBC patients was considered very difficult. In prognostic study, the patients with the prophylactic therapy were better than the patients with emergency or elective therapy. The antiM8 (a subtype of antimitochondrial antibody) positive patients had poor prognosis compared with antiM8 negative patients. Therefore, it was concluded from these data that some kind of treatment was necessary for patients with high-risk varices. In particular, it was considered necessary to monitor closely the patients whose serum alkaline phosphatase levels had remained high.
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PMID:Immunological response and oesophageal varices in PBC. 251 87

A case report is presented of a 43-year-old woman with generalized peliosis hepatitis that developed during longterm use of oral contraceptives (OCs). The patient had been in good health until the last 2 years when she began to experience vague epigastric pains and a feeling of abdominal distension. Several months prior to admission, she had started to complain of itching and fatigue. There was no history of dark urine, white stools, or hepatitis. On physical examination, no jaundice or cutaneous stigmata of chronic liver disease were observed. Laboratory studies showed a normal erythrocyte sedimentation rate and hematological blood count. A radionuclide study of the liver showed hepatomegaly; especially the left lobe was enlarged. A computerized tomographic scan of the liver showed multiple areas of decreased density in both of the enlarged lobes. There was no evidence of a tumor. Selective transfemoral angiography of the celiac artery also showed hepatic enlargement but no signs of a space-occupying lesion. At laparoscopy, the liver was grossly enlarged and had a lumpy appearance, but again there were no signs of a tumor. No evidence of veno-occlusive disease or hepatocellular adenoma was found. The diagnosis was peliosis hepatitis. The OCs were withdrawn, and the patient was discharged. Regular follow-up in the outpatient department showed no decrease in the size of the liver. The alkaline phosphatase level rose. The fatigue became worse, and cholestyramine was prescribed for progressive itching. In September 1980, the patient was admitted for reevaluation. A repeated CT scan and angiography of the liver again yielded no evidence of a tumor. Esophagoscopy showed the presence of varices grade 2. The liver at laparoscopy had the same appearance as it had in 1976. Histological examination of a biopsy specimen showed occasional dilated sinusoids and locally marked periportal and intralobular fibrosis. No regeneration nodules were found. The diagnosis was liver fibrosis. The patient's condition deteriorated gradually in the following years. She experienced increasing fatigue. Steatorrhea developed, and the patient lost weight. She needed increasing doses of cholestyramine and oral supplementation of vitamins A, D, and K. She was admitted for a 3rd time in February 1985. Esophagoscopy revealed varices grade 4. A CT scan of the liver showed no change. The patient successfully underwent an orthotopic liver transplantation in January 1987. The diagnosis of peliosis hepatis was well documented in this patient.
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PMID:Generalized peliosis hepatis and cirrhosis after long-term use of oral contraceptives. 312 33

Retained or recurrent stones in the common bile duct remain a clinical problem in 2% to 5% of patients undergoing cholecystectomy. Nonoperative extraction via the T tube tract or endoscopic sphincterotomy is successful in 85% to 95% of patients; however, the remainder require reoperation. This study evaluates the efficacy of electrohydraulic shock wave lithotripsy therapy of common duct stones too large to be extracted endoscopically or by T tube. Six patients were entered into the study. Ages ranged from 62 to 93 years. All patients either had severe preexisting systemic disorders or were of an advanced age. Stones ranged in size from 10 to 41 mm, with a mean largest dimension of 22 mm. In all patients either extraction by traditional nonoperative means failed or there was a stone that was considered to be too large to be extracted successfully. Patients were treated with 1200 to 2400 shocks at 16 to 20 kV. Five of six patients were treated with local anesthesia and sedation. Stones were successfully fragmented in all but one patient. Five patients required extraction of the remaining fragments either through the T tube tract (one patient) or via endoscopic sphincterotomy. All patients were free of stones at discharge, with the exception of one patient with severe cirrhosis who had an intrahepatic stone behind a right hepatic duct stricture. This stone had been successfully fragmented but an endoscopic retrograde cholangio-pancreatogram revealed some residual fragments despite normal alkaline phosphatase and bilirubin values. There were no hospital deaths, although the patient with the intrahepatic stone died of bleeding varices several months later. Electrohydraulic shock wave lithotripsy seems to be an effective adjuvant treatment in clearing the bile duct of stones that would otherwise require reoperation.
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PMID:Electrohydraulic shock wave lithotripsy (ESWL) fragmentation of retained common duct stones. 317 59

In the context of studies bearing on the enzymatic activity in healthy veins and varicose veins, sample sections of veins were excised in eight patients with primary varices of the long saphenous vein. The veins were subjected to histochemical methods for identifying enzymes. The histochemical dosage related to lactate-dehydrogenase, alkaline phosphatase, adenosine triphosphoric acid enzymes, as well as lysosomal beta-glucuronidase, non-specific esterase and phosphatase acid enzymes. The authors deal with the specific problems involved in the different enzymatic methods, and their relevance to prognosis. In conformity with the results of our histochemical studies, the comparison between the enzymatic profiles of healthy and varicose veins showed an increase in lysosmal enzyme activity in the vein walls leading to varicose degeneration. The increase in activity was more pronounced in the media than in the intima. A reverse pattern was observed in the behaviour of enzymes involved in energetic metabolism. The enzymatic activity in the venous wall leading to varicose degeneration proved to have decreased. This reduction in the enzymatic activity was more marked in the intima than in the media and was particularly pronounced in the case of the histochemical identification of adenosine triphosphoric acid Ca++.
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PMID:[Histochemical comparison of the enzyme profiles of healthy veins and varicose veins]. 356 64

Hepatic metabolism is the primary process of elimination of propafenone. It therefore is important to understand the effect of altered liver function on the disposition and elimination kinetics of this drug. Patients with abnormal liver function probably will require treatment with propafenone for cardiac arrhythmias; an understanding of the relationship between liver function and the pharmacokinetics of propafenone will provide a rational basis for optimal dosage adjustments in these individuals. Our results demonstrate that both systemic clearance and bioavailability of propafenone are sensitive to variability in liver function. The bioavailability of propafenone is inversely related to the clearance of indocyanine green (ICG), whereas a direct relationship exists between systemic clearance of propafenone and ICG clearance. Comparisons of clinical parameters with the propafenone data yielded interesting results. An overall clinical grading of severity of liver disease based on the presence or absence of portal hypertension (i.e., varices and/or splenomegaly), prior encephalopathy, and ascites did not correlate well with propafenone results. However, albumin, total bilirubin, serum glutamic oxaloacetic transaminase (SGOT) concentrations and prothrombin time values correlated strongly with the overall results. No definite relationships with subjects' age; weight; and hemoglobin, alkaline phosphatase, lactic acid dehydrogenose, cholesterol, blood urea nitrogen, or creatinine levels were detected. These results demonstrate that moderate to severe liver disease significantly affects the absorption and disposition of propafenone. In patients with cirrhosis, and presumably other forms of hepatic dysfunction, careful adjustments of propafenone doses are needed to optimize therapy.
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PMID:Influence of hepatic dysfunction on the pharmacokinetics of propafenone. 369 82

Mild abnormalities of liver function tests are frequently seen in pregnancy but return to normal after delivery. A raised serum alkaline phosphatase is common, along with a decline in the serum albumin, but the aminotransferases remain within normal limits. The physician must interpret abnormal liver function tests in pregnancy with these changes in mind, but most liver diseases in pregnancy result in more marked alterations. Viral hepatitis is the most common cause of jaundice in pregnancy, and the maternal prognosis is generally good. Perinatal transmission of hepatitis B virus is likely when the mother is positive for HBsAg. Concurrent administration of hepatitis B vaccine and HBIG to the infant has an efficacy of 90 per cent in preventing transmission to the infant. ICP is the second most common cause of jaundice in pregnancy. The condition is generally benign, although maternal and fetal mortality occasionally result, probably due to premature delivery and the bleeding tendency of cholestatic patients. Vitamin K administration may correct the coagulopathy, and cholestyramine is effective in controlling pruritus. AFLP is rare but carries a high mortality rate for both the mother and the fetus. Early diagnosis, correction of the coagulopathy, and prompt delivery may improve the outcome significantly. Patients with cirrhosis have reduced fertility, and in those who become pregnant, fetal loss is high. The effect of pregnancy or hepatocellular function is variable, but, when evidence of liver failure is present in the first trimester, termination should be considered. Variceal size and the risk of bleeding may be assessed by endoscopy. Pregnant cirrhotic patients with large esophageal varices and a history of bleeding can undergo shunt surgery. Conservative management may be appropriate for patients with small varices and no history of bleeding.
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PMID:Liver diseases in pregnancy. 405 85


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