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)

To ascertain modifications in the activation products derived from oxygen free radicals in patients with chronic pancreatic and extra-pancreatic diseases, lipid peroxide activity was measured in the sera of 40 control subjects, 28 patients with pancreatic cancer, 49 with chronic pancreatitis, and 53 with extra-pancreatic diseases. In 142 of the subjects, elastase 1, amylase, and pancreatic isoamylase activities were also determined. Increased lipid peroxide activities were found in some patients with both chronic pancreatic and extra-pancreatic diseases. Patients with chronic pancreatitis studied during relapse had higher activities of lipid peroxides than those without active disease. No difference was found between the values in patients with pancreatic cancer with liver metastases and those without. Correlations were found between lipid peroxides and both amylase and pancreatic isoamylase activities; no correlation was detected between lipid peroxides and elastase 1. In benign biliary tract disease a correlation was detected between lipid peroxides and alanine aminotransferase and alkaline phosphatase activities. In all patients, however, a correlation was found between alkaline phosphatase and lipid peroxide activities. It is concluded that activation of oxygen derived free radicals occurs in chronic pancreatic as well as in extra-pancreatic disease; it seems to reflect the degree of inflammation.
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PMID:Oxygen derived free radicals in patients with chronic pancreatic and other digestive diseases. 169 29

The clinical diagnostic utility of CA-50 (time-resolved fluoroimmunoassay) and Span-1 was compared with that of CA19-9 by measuring their levels in sera from patients with pancreatic cancer and other diseases. In pancreatic cancer CA-50, Span-1, and CA19-9 showed similar positive rates (84%, 82%, and 81%, respectively). With regard to the ability to distinguish pancreatic cancer from chronic pancreatitis, however, the specificity of CA-50 and Span-1 was higher than that of CA19-9 (85%, 85%, and 79%, respectively). Despite the similar positive rates of CA-50 and Span-1 in pancreatic cancer, the correlation between these two markers was low. Thus, used in combination, they compensated for each other in the diagnosis of pancreatic cancer. In chronic liver diseases, serum levels of both CA-50 and Span-1 were correlated with that of biliary tract enzymes, alkaline phosphatase, and r-glutamyl transpeptidase. And these two markers were more affected by the biliary system than CA19-9, resulting in the significantly higher positive rates. In these diseases immunohistochemical study showed that all three markers were localized in the epithelial cells of the bile duct, with CA-50 and Span-1 showing a similar tissue distribution.
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PMID:Comparative study of CA-50 (time-resolved fluoroimmunoassay), Span-1, and CA19-9 in the diagnosis of pancreatic cancer. 189 21

The probability that routine hematological laboratory tests of liver and pancreatic function can discriminate between malignant and benign pancreatic tumours, incidentally detected during operation, was investigated. The records of 53 patients with a verified diagnosis of pancreatic carcinoma and 19 patients with chronic pancreatitis were reviewed with regard to preoperative total bilirubin, direct reacting bilirubin, alkaline phosphatase, glutamyltranspeptidase, aminotransferases, lactic dehydrogenase and amylase. Multivariate and discriminant analysis were performed to calculate the predictive value for cancer, using SYSTAT statistical package in a Macintosh II computer. Total and direct reacting bilirubin and glutamyltranspeptidase were significantly higher in patients with pancreatic carcinoma. However, only considerably increased levels of direct reating bilirubin were predictive of pancreatic carcinoma.
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PMID:The value of routine biochemical tests in discriminating between malignant and benign pancreatic tumours. 193 81

A new tumour marker, CAR-3, was isolated using the monoclonal antibody technique and measured in the sera of 27 patients with pancreatic cancer, 25 chronic pancreatitis, 30 extra-pancreatic diseases and in that of 18 healthy controls in order (1) to evaluate the diagnostic role of CAR-3 in patients with pancreatic cancer and (2) to ascertain whether liver dysfunction influences CAR-3 serum levels. The increased levels were found in 12/27 patients with pancreatic cancer (sensitivity 44.4%). No increase was found in patients with chronic pancreatitis, whereas abnormal levels were found in patients with other gastrointestinal diseases, especially those of the liver and biliary tract. Correlations were found between serum CAR-3 and (1) total bilirubin and (2) alkaline phosphatase. In conclusion, CAR-3, an antigen structurally related to CA 19-9, does not appear to be accurate enough to be considered a tumour marker. Cholestasis seems to increase CAR-3 levels as well as those of other glycoproteic tumour markers, probably by interfering with the hepatic clearance of these substances.
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PMID:Does serum CAR-3 play a role in pancreatic cancer diagnosis? 198 95

The usefulness of serum DU-PAN-2 in diagnosing pancreatic cancer and in distinguishing between this cancer and other benign and malignant diseases, and to assess the role of liver dysfunction in altering the serum levels of this marker were investigated. DU-PAN-2 was measured in the sera of 31 patients with pancreatic cancer, 32 with chronic pancreatitis, 20 with benign and 21 with malignant extra-pancreatic diseases. DU-PAN-2 was found to be above 300 U ml-1 in 21/31 patients with pancreatic cancer (sensitivity 68%). Only 3/32 patients with chronic pancreatitis had abnormal values. A substantial number of patients with both benign and malignant extra-pancreatic diseases had an elevated serum DU-PAN-2 (9/20 and 15/21, respectively). Correlations were found between DU-PAN-2 and (1) total bilirubin, (2) alanine-amino-transferase and (3) alkaline phosphatase. Of the patients with high DU-PAN-2 values, jaundice was found in: 2/3 with chronic pancreatitis, 9/10 with benign and 12/14 with malignant extra-pancreatic diseases. In conclusion, the serum DU-PAN-2 test for pancreatic malignancy is not completely satisfactory, because it is not sensitive enough. While the test for chronic pancreatitis has an acceptable specificity, the assay cannot distinguish between pancreatic cancer and other extra-pancreatic diseases, mainly of the liver and biliary tract. Liver dysfunction as well as jaundice seem to considerable affect the levels of this marker, as reported elsewhere for CA 19-9.
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PMID:Serum DU-PAN-2 in the differential diagnosis of pancreatic cancer: influence of jaundice and liver dysfunction. 200 87

Serum ferritin, prealbumin, pseudocholinesterase, alpha-1-antitrypsin and caeruloplasmin were determined in control subjects and patients with pancreatic cancer, chronic pancreatitis or extra-pancreatic disease mainly of gastrointestinal origin, in order to investigate the different hepatic changes which influence serum ferritin in chronic pancreatic and other digestive diseases. Increased circulating ferritin was found in pancreatic cancer and extra-pancreatic disease when compared to controls. Correlations were detected between ferritin and the other proteins investigated and between ferritin and total bilirubin, alkaline phosphatase and alanine aminotransferase. Multiple regression analysis demonstrated that cholestasis accounts for 45% of circulating ferritin, the acute-phase response accounted for 18% and decreased liver function accounted for 11%. We conclude that the increase in serum ferritin in chronic pancreatic and other gastrointestinal diseases largely depends on liver changes, with cholestasis probably playing a primary role.
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PMID:Hepatic changes and serum ferritin in pancreatic cancer and other gastrointestinal diseases: the role of cholestasis. 202 31

For a group of 368 cases of chronic pancreatitis (CP) operated on since 1975, the authors have performed 85 biliary intestinal anastomoses using the gallbladder, for treatment of biliary obstruction. (These were cases not needing resection of the head of the pancreas). This original biliary-intestinal by-pass comprises resection of the cystic duct then bridging the gallbladder between the common bile duct and the duodenum (in 2 cases the jejunum). This anastomosis of common bile duct to infundibulum was termino-terminal except in 15 where portal vein dilatation necessitated a latero-terminal anastomosis. The gallbladder-intestinal anastomoses were termino-lateral. One patient with multi-system disease died on the 20th post-op day from cardio-respiratory problems not directly related to the procedure. No fistulae, biliary or intestinal occurred. The average hospitalization was 13.6 days. The average follow-up period is now 46 months (2 patients only have been lost to follow-up). One patient (not abstaining from alcohol) has presented with recurrent febrile episodes and transient alkaline phosphatase elevations. Two patients only have been re-operated (9th and 72nd months) for cholangiocholitis necessitating a re-do of the anastomosis infundibulum to bile duct. These 2 patients are well at 20 and 45 months respectively. No biliary calculi have been observed, with 22% of patients now being more than 5 years post-op. The authors have progressively left aside the anastomosis to a jejunal loop in favour of the gallbladder interposition described. This appears a better procedure for treating biliary obstruction in chronic pancreatitis even when complicated by portal vein dilatation. This procedure enables drainage of bile into its natural site at the 2nd part of the duodenum, so reducing the risk of ulceration. It also saves extending the operating field below the mesocolon and importantly in the already poorly nourished patient, it does not remove from function a segment of jejunum.
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PMID:[Bilio-digestive bypass using gallbladder in chronic pancreatitis. 85 cases of cholecystoplasty ]. 212 91

In patients with chronic pancreatitis, common bile duct obstruction is reported in 3.2-45.6% of patients; however, only 5-10% of all patients with chronic pancreatitis require operative decompression of the bile duct. The cause of the intrapancreatic stricture of the common bile duct may be either a fibrotic inflammatory restriction, or compression by a pseudocyst. Obstruction of the duodenum is much less common than common bile duct obstruction in chronic pancreatitis occurring in less than 1-2% of patients with chronic pancreatitis. Colonic obstruction secondary to pancreatitis is very infrequent. The intrapancreatic strictures of chronic pancreatitis are characteristically smooth and tapering on endoscopic retrograde cholangiopancreatography (ERCP), but in some patients, they may have a sharp cut-off and closely resemble the appearance of carcinoma of the pancreas invading the bile duct. The natural history of these intrapancreatic strictures is variable. They may progress and be associated with cholangitis, biliary cirrhosis, common duct stones, or may remain stable for years or regress. Prior pancreaticojejunostomy is not protective against the development of intrapancreatic biliary strictures which may follow in 5-30% of patients, with most authors reporting an incidence of less than 10%. Evaluation of alkaline phosphatase, bilirubin, the presence of jaundice, or the appearance of an intrapancreatic stricture on ERCP is not predictive of whether cholangitis or biliary cirrhosis may or may not develop. The incidence of cholangitis and biliary cirrhosis in patients with intrapancreatic stricture is 9.4% and 7.3%, respectively. Laennec's cirrhosis occurs in a similar number of patients. Operation is indicated in patients with intrapancreatic strictures of the common bile duct in association with chronic pancreatitis in patients developing cholangitis, biliary cirrhosis, common duct stones, progression of the stricture, persistent high elevations of alkaline phosphatase and/or bilirubin for over a month or inability to rule out cancer of the pancreas or periampullary region. The operation of choice is choledochoduodenostomy or Roux-en-Y choledochojejunostomy to bypass the obstructed intrapancreatic portion of the common bile duct. Persistent duodenal obstruction for over 3 or 4 weeks is an indication for gastrojejunostomy. Pain is not a feature of common bile duct obstruction in the absence of cholangitis. In the presence of pain associated with chronic pancreatitis, longitudinal pancreaticojejunostomy is the operation of choice combined with Roux-en-Y choledochojejunostomy. Some of the newer operations, e.g., the Beger and Frey procedures, may make the necessity of a separate operation for biliary decompression superfluous.
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PMID:Treatment of chronic pancreatitis complicated by obstruction of the common bile duct or duodenum. 240 39

Mononuclear leucocyte zinc was determined together with serum zinc, albumin and serum alkaline phosphatase activity before and after zinc supplementation (2 x 50 mg of zinc-gluconate daily during 3 months) in patients with alcoholic liver cirrhosis (n = 10), alcoholic chronic pancreatitis (n = 10) and Crohn's disease (n = 10). Initial mononuclear leucocyte zinc concentrations did not differ between the patient groups and the reference group (n = 10), whereas initial serum zinc values were lower in the patients with alcoholic liver cirrhosis and Crohn's disease. This difference disappeared, however, when serum zinc concentrations were corrected for albumin levels, which were lower in all the patient groups. Higher initial activity of serum alkaline phosphatase was found in the alcoholic patients. In all the patient groups serum zinc concentrations increased significantly after zinc supplementation. Only in patients with Crohn's disease was there also an increase in serum alkaline phosphatase and albumin. Mononuclear leucocyte zinc did not respond to zinc supplementation in any of the patient groups. The results of our study indicate that mononuclear leucocyte zinc is not a sensitive indicator of marginal zinc deficiency.
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PMID:Zinc in mononuclear leucocytes in alcoholics with liver cirrhosis or chronic pancreatitis and in patients with Crohn's disease before and after zinc supplementation. 253 48

The authors retrospectively evaluated 44 patients with chronic pancreatitis to determine (a) what features on computed tomographic and sonographic scans were associated with biliary tract dilatation, (b) how these findings and biliary tract dilatation changed at follow-up, and (c) the correlation between the degree of biliary tract dilatation and the laboratory and histologic findings when available. Twenty-four patients had biliary tract dilatation; of this group 88% had pancreatic calcifications and 75% had a focal mass in the pancreatic head. Sixteen of the 24 patients underwent follow-up studies; in 12 there was no change in the degree of biliary tract dilatation or appearance of the pancreas. The levels of serum alkaline phosphatase and bilirubin were elevated in most of the 24 patients; at follow-up, however, there was no consistent relationship between these values and radiologic findings. Biopsy is recommended for those patients in whom the serum alkaline phosphatase level remains persistently elevated. Four of seven such patients in this study underwent biliary-enteric bypass procedures due to pathologic evidence of cholestasis.
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PMID:Biliary tract dilatation in chronic pancreatitis: CT and sonographic findings. 266 56


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