Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: 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)

FACS analysis together with PIPLC treatment was applied to PI-anchoring antigens such as DAF (decay-accerelating factor, CD55), 1F5 antigen (CD59), CD14 and CD16 on the cell surfaces of blood cells from a normal adult and a male patient with paroxysmal nocturnal hemoglubinuria (PNH). Through the extensive analysis, this patient proved to be completely defective in 1F5 antigen, a newly found complement-regulatory protein, on all the blood cells tested. In normal blood cells such as lymphocytes, monocytes and granulocytes, 1F5 antigen was expressed as one of PI-anchoring proteins. In contrast to most of PNH patients, this patient reserved DAF, CD14 and CD16 at normal levels in his erythrocytes, monocytes and granulocytes. Also, there were no significant differences between the normal adult and the patient in the activities of erythrocyte acetylcholinesterase and granulocyte alkaline phosphatase which were also known to be PI-anchoring enzymes. Thus, deficiency of 1F5 antigen must be deeply related to the clinical symptoms of PNH in this patient.
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PMID:Analysis of PI (phosphatidylinositol)-anchoring antigens in a patient of paroxysmal nocturnal hemoglobinuria (PNH) reveals deficiency of 1F5 antigen (CD59), a new complement-regulatory factor. 168 70

Since February 1987, we have been using extracorporeal lithotripsy for certain cases of chronic biliary lithiasis, using an EDAP lithotripter. The technique is reserved for patients with less than four radiotransparent, or partially calcified calculi, less than 25 mm in size, within the context of a functioning gall bladder with no evidence of lithiasis in the C.B.D. Dissolution of the fragments after lithotripsy is ensured by bile salts, this treatment being continued for at least 3 months after the gall bladder has been completely cleared. 160 patients were treated using a total of 181 treatment sessions. Hospitalisation lasted on average 3 days, 1/5th of the patients suffered right hypochondrial pain and nausea for 24 hours. 17% of patients showed a transient elevation in alkaline phosphatase and 12% an elevation in amylase after the procedure. The rate of gall bladder clearance was 24% at 1 month, 40.7% at 3 months ans 50% at 1 year. 11 cholecystectomies were carried out (6.8%), 8 of which were essential. Bile duct migration occurred in 2 cases and produced oedematous pancreatitis in one case. Recurrent lithiasis was noted in 4 cases between 6 and 18 months after gall bladder clearance. 75% of cured patients had a single, radiotransparent stone less than 20 mm in diameter.
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PMID:[Extracorporeal lithotripsy of biliary lithiasis. 160 patients treated with an EDAP apparatus]. 261 78

The use of imaging procedures for breast cancer staging and follow-up should be based on the natural history of the disease as well as the accuracy, cost, and availability of the studies themselves. Early detection of metastases may provide palliation but probably does not affect survival. For staging, chest X-ray and mammogram are both recommended on all patients; radionuclide bone scan is advised in the presence of either an elevated alkaline phosphatase, axillary metastases, or a primary tumor measuring more than 2 cm; abdominal CT should be performed if liver chemistries are abnormal; CT brain scan is the procedure of choice for neurological symptoms. Chest CT should be reserved for selected patients with an abnormal chest X-ray. Follow-up recommendations include annual chest X-rays and mammogram, bone scans every 5 years when a staging scan was indicated, and CT of the liver and/or brain in the presence of appropriate symptoms or laboratory values.
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PMID:Imaging techniques and guidelines for evaluation and follow-up of breast cancer patients. 355 14

To determine the optimal management of posttransplant hypercalcemia, a chart analysis of 100 stable renal allograft recipients (longer than one year) was accomplished. The incidence of hypercalcemia ranged from 12% to 20% up to 30 months after transplantation. The mean serum alkaline phosphatase level, phosphate level, and duration of dialysis in hypercalcemic patients did not differ significantly from normocalcemic patients; however, serum creatinine levels were significantly lower at 12 and 24 months in patients with hypercalcemia. In patients with hypercalcemia at three and six months, greater than 50% underwent spontaneous resolution, whereas this occurred in 25% of the patients with hypercalcemia at 12 months. Seven patients underwent parathyroidectomy with prompt resolution of their hypercalcemia and ten patients with persistent hypercalcemia have been followed up from 14 to 66 months without sequelae of hyperparathyroidism. In conclusion, hypercalcemic hyperparathyroidism is a frequent occurrence after renal transplantation. Sequelae of this condition are rare, however, and parathyroidectomy should be reserved for progressive clinical and/or roentgenographic findings.
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PMID:Management of hypercalcemic hyperparathyroidism after renal transplantation. 388 17

A retrospective analysis of 151 patients with breast cancer over 2 years was performed to assess laboratory values as predictors of metastatic disease demonstrated by technetium-99 bone scan. In 105 patients with normal alkaline phosphatase (AP) and lactate dehydrogenase (LDH) values, only one positive bone scan (0.95%) was obtained. If either the AP or LDH value was abnormal, 15 of 29 scans (51.7%) were positive. If both values were abnormal, six of nine patients (66.7%) had positive bone scans. Of 41 patients with either an elevated AP or LDH, 26 (63.4%) were shown to have metastatic breast disease. In our subgroup of 120 consecutive admissions for primary evaluation and treatment of breast cancer, the 95 patients with normal AP and LDH values had 41 negative bone scans and no evidence of distant metastases in any patient. According to these results, we recommend that breast cancer metastatic screening be done by alkaline phosphatase and LDH determinations, and that isotope scans should be reserved for those patients having normal values or symptoms that suggest metastases.
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PMID:A reevaluation of bone scans in breast cancer. 391 16

The role of modern techniques of 99mTc methylene diphosphonate bone imaging in the management of lymphoma patients was assessed by comparing results of 107 bone scans in 16 patients with Hodgkin's disease, and 45 patients with non-Hodgkin's lymphoma to simultaneous radiologic, clinical, and histopathologic features as well as to subsequent disease course. The sensitivity and specificity were both greater than or equal to 0.96 in both Hodgkin's disease and non-Hodgkin's lymphoma and the overall accuracy by site was 98%. The scan proved to be useful in the definition and follow-up of skeletal lymphomatous disease in both symptomatic and asymptomatic patients, and defined abnormalities which were not predicted by either serum alkaline phosphatase activity or the presence of bone marrow involvement. In no patient, however, did the bone scan result by itself alter either initial staging or estimates of extent of disease at the time of relapse. Bone scanning, therefore, cannot be recommended as a screening procedure in patients with lymphoma; rather, this test is best reserved for the definition and follow-up of skeletal metastases in patients with active, concomitant, extraosseous disease.
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PMID:Role of 99mTc methylene diphosphonate bone imaging in the management of lymphoma. 407 10

The presentation of Paget's disease varies from a painful or deforming skeletal affliction to an asymptomatic disorder diagnosed on routine biochemical or radiological assessment. When involvement of the peripheral skeleton by Paget's disease is extensive, the clinical diagnosis is usually clear. Affected bones are thickened and deformed and the overlying skin is warm. Bone pain is sometimes severe and malignant change rarely occurs. The new bone formed is structurally abnormal and is consequently liable to deformity and fractures. Serum alkaline phosphatase concentrations and urinary hydroxyproline excretion are raised. Characteristic X-ray changes are seen. Paget's disease should be treated when it causes skeletal pain and tenderness, or when there are neurological symptoms, fractures, marked deformities, or other complications. New therapeutic agents offer both symptomatic relief and some control of the basic disease process. Simple analgesics should be tried before proceeding to the anti-osteoclastic agents, calcitonin, diphosphonates and mithramycin. All are effective in relieving bone pain and improving biochemical indices. The major advantage of the diphosphonates lies in their oral usage and thus, the number of patients who nowadays require calcitonin is small. The majority of patients should be commenced on a course of diphosphonate therapy (EHDP in most instances), but if clinical response is unsatisfactory calcitonin should be tried. Mithramycin should be reserved for special indications e.g. an elderly patient with severe disabling pain.
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PMID:Therapeutic progress--review VII. The medical treatment of Paget's disease. 622 Oct 33

Sixty-seven cases of eclampsia were managed between August 1977 and July 1980. Routinely acquired laboratory tests of these cases have been analyzed. In addition, the group of patients with eclampsia was compared with a group of 24 healthy pregnant women. There was no significant difference in platelet count, serum fibrinogen, and bilirubin values. The activated partial thromboplastin time was abnormal in 42% of patients with eclampsia. There was no clinical evidence of disseminated intravascular coagulation in any patient. Patients with eclampsia had abnormalities of lactic dehydrogenase, alkaline phosphatase, SGOT, uric acid, BUN, and creatinine. However, in any individual patients there was no single test of great clinical usefulness and no test predictive of maternal or fetal outcome. At present the authors recommend complete blood count (including blood smear and platelet count), clot observation, and serum creatinine tests. Liver function tests are reserved for the patient with upper abdominal pain. Additional tests are recommended if the diagnosis of eclampsia is questionable or if an additional disease process is suspected.
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PMID:Eclampsia II. Clinical significance of laboratory findings. 707 59

A retrospective review of 341 patients with bladder cancer revealed 58 candidates for cystectomy. These patients were evaluated preoperatively by radionuclide bone and/or liver scans in an attempt to increase the accuracy of clinical staging. In the face of a normal history, physical examination, liver function tests or serum alkaline phosphatase routine preoperative bone and liver scans in cystectomy candidates did not contribute significantly to clinical staging or choice of treatment. Since liver and bone scans add significantly to the cost of the illness their use should not be routine but reserved only for those special cases when they are indicated.
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PMID:Lack of value of routine preoperative bone and liver scans in cystectomy candidates. 723 Mar 33

Sodium Fluoride (NaF) is the only medication so far clinically available with a bone formation stimulating property, through its peculiar mitogenic dose-dependent action on the osteoblast cell line. Bone strength is commensurate to bone mass, and in a condition with fragility fractures, like osteoporosis, it seems logical to restore bone mass without weakening bone strength. However, as with any active drug. NaF therapy requires adhesion to elementary rules if drawbacks are to be prevented. A first mandatory rule is not to prescribe NaF without calcium supplementation, if bone loss at the appendicular skeleton is to be avoided; to prevent this, the availability of monofluorophosphate (MFP), containing the fluoride and calcium salts in the same preparation has enhanced the compliance to calcium supplementation. A second rule is not to give supraphysiological doses of vitamin D, for the same reason. Third, if one wants to avoid a calcium shift from cortical to trabecular bone and osteomalacia, one should use small doses of NaF, of the order of 50 mg/day. With this in mind, the bioavailability of the drug has to be taken into account, particularly its gastrointestinal absorption which is dramatically enhanced if a plain non entericoated (EC) capsule is used, as compared to that of an EC tablet with the same face value. Too much NaF is deleterious to bone, a fact known for years. Already in 1972, it was noted that in all patients receiving 60 mg or more of NEC NaF, daily, morphologically abnormal bone developed and which appeared irregular and contained areas of incompletely mineralized bone. The bone was histologically and microradiographically normal in patients receiving 45 mg or less of NEC NaF/day. Fourth, NaF therapy is contraindicated in renal insufficiency owing to an enhanced retention in the skeleton. NaF is, however, by no means the ideal medication, because its therapeutic window is narrow. It has many bothersome drawbacks, and notably it is irritating for the gastric mucosa, a hazard which may be partly circumvented by the use of an Ec or slow release tablet. Furthermore, peripheral stress fractures may occur, and, in our experience, they were seen in 17% of patients, almost exclusively in females with a low lumbar BMD. Their occurrence should be curtailed by not allowing an increase in alkaline phosphatase activity of more than 50%. This is a relatively benign complication, because no stress fracture degenerated into a complete fracture. In all cases, the stress fractures healed after a transitory drug discontinuation. If there is some concern about cortical bone, NaF therapy may be associated with an antiresorber like estrogens which will prevent any further bone loss, and does not impair the response to NaF. NaF therapy should be reserved for patients suffering chiefly from trabecular osteoporosis and should be avoided in senile osteoporosis, because of a frequently impaired renal function. Currently, we would recommend in clinical practice a daily dose of 50 mg EC-NaF or 150 mg Ca-MFP as the therapy of involutional osteoporosis in women, reserving the dose of 75 mg EC-NAF or 200 mg MFP for males or female patients resistant to lower dose. The therapy should be maintained for 2 to 3 years, or more, according to the bone response, taking into account that patients with the vertebral crush fracture syndrome have lost on average 30%, as compard to the young adult mean.
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PMID:Fluoride therapy of type I osteoporosis. 884 58


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