Correlation between serum enzymes and serum unsaturated vitamin B12 binding proteins in primary liver carcinoma

The serum unsaturated vitamin B12-binding capacity (UBBC), unsaturated transcobalamin (UTC) I, UTC II, UTC III levels, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase activities and bilirubin concentration were estimated in 61 patients with liver diseases (31 with hepatoma, 30 with viral hepatitis). The levels of serum cobalamin, UTC I, UTC III, UBBC, alanine and aspartate aminotransferases, and bilirubin were raised in both hepatoma and viral hepatitis patients. Serum UTC II was reduced in both conditions. Alkaline phosphatase activity was significantly increased in hepatoma. Four significant correlations were observed among these parameters in the hepatoma patients while only one significant correlation was observed in viral hepatitis.

Low prevalence of particle-associated reverse transcriptase activity in serum from patients with non A - non B hepatitis

Sera from 367 patients presumed to have NANB hepatitis were screened for reverse transcriptase activity. In 29 cases significantly increased enzyme activities could be observed. In contrast, sera from 338 patients did not contain significant reverse transcriptase activities. 207 healthy individuals, 7 patients with hepatitis A and 6 patients with hepatitis B who served as controls were all negative for reverse transcriptase activity. The specificity of the enzyme assay was demonstrated by estimation of reverse transcriptase activity in sera from 10 "healthy" HIV-1-antibody positive individuals. In 3 out of 10 cases significant reverse transcriptase activity was observed associated with the human immunodeficiency virus. Our results indicate that the presence of particle-associated reverse transcriptase activity in serum from patients with NANB hepatitis is indicative of the presence of a retrovirus-like agent in these cases. However, the relatively low prevalence of reverse transcriptase positive cases associated with the NANB hepatitis makes it rather questionable whether this agent is a frequent and specific factor in the etiology of NANB hepatitis.

Activities of 2'-5'oligoadenylate synthetase in peripheral blood mononuclear cells of patients with viral hepatitis, and chronic type B hepatitis during interferon therapy

The activities of the interferon-induced enzyme 2'-5' oligoadenylate synthetase in peripheral blood mononuclear cells were determined in patients with viral hepatitis. Increased levels of the enzyme were found in patients with acute type B hepatitis at the early phase and also in those with chronic type B hepatitis at the active stage. The levels of this enzyme activity were not significantly increased in patients with acute type A hepatitis or in those with acute type non A non B hepatitis. However, in two patients with acute type A hepatitis the levels of this enzyme were elevated shortly at the onset. These results support the hypothesis that an endogenous interferon response in patients with acute type A hepatitis and in those with acute type B hepatitis may be instrumental in the modulation of these types of hepatitis virus infections. Whereas hepatitis non A non B virus replication in patients with acute type non A non B hepatitis may be associated with poor interferon response. The activities of the enzyme in peripheral blood mononuclear cells were determined in patients with chronic type B hepatitis during interferon therapy. Increased levels of the enzyme were found in all patients during interferon therapy. This increase correlated well with the decreased DNA-polymerase activities. The data also showed that assay of this enzyme activity is useful to determine the optimal dosage and means of interferon therapy for chronic type B hepatitis.

Lack of detectable reverse transcriptase activity in human and chimpanzee sera with a high infectivity for non-A, non-B hepatitis

A serum sample from a patient with hepatitis and samples from two experimentally infected chimpanzees, all with a high infectivity for non-A, non-B hepatitis, were tested for reverse transcriptase. Biopsy confirmed that the hepatocytes of the chimpanzees that received these sera contained the characteristic tubular structures associated with non-A, non-B hepatitis. None of these three sera revealed detectable enzyme activity. We have not been able to confirm the association of reverse transcriptase activity with non-A, non-B hepatitis reported recently.

Liver gamma-glutamyltransferase activity in viral liver disease

gamma-Glutamyltransferase (GGT) activity was determined in serum and liver tissue obtained by needle biopsy in 104 patients with viral hepatic disease. The liver GGT activity in these patients was significantly greater than that in the controls. The tissue GGT activity was also significantly greater in the patients with chronic persistent hepatitis than in the patients with acute viral hepatitis or posthepatitic cirrhosis. The serum and tissue GGTs in the patients with non-A, non-B chronic active hepatitis were significantly greater than those in the patients with B-related chronic active hepatitis. The increased serum GGT is due to the synthesis of the enzyme in liver tissue and its release in viral hepatic disease.

Serum beta-N-acetyl hexosaminidase (beta-NAH) as a discriminant between malignant and benign extrahepatic biliary obstruction: comparison with carcinoembryonic antigen (CEA)

Fifty-one patients (16 with malignant extrahepatic biliary obstruction, ten with benign extrahepatic biliary obstruction, eight with alcoholic liver disease, five with viral hepatitis and 12 with liver metastases) and 19 adult healthy controls were studied with determinations of beta-N-acetyl hexosaminidase (a lysosomal enzyme which is cleared from the circulation by the Kupffer cells), carcinoembryonic antigen (CEA), serum bilirubin, alkaline-phosphatase and aspartate aminotransferase (AST). Both CEA and beta-NAH were elevated in each disease group. Elevated beta-NAH levels distinguished between benign and malignant extrahepatic biliary obstruction better than CEA levels. Beta-NAH levels for the malignant and the benign groups were 47.6 +/- 14.7 U/l and 23.0 +/- 4.7 U/l (mean +/- S.D.) respectively. The groups differed significantly (P less than 0.001). Plasma CEA levels for both groups were 18.7 +/- 38.9 and 7.2 +/- 3.3 ng/ml (mean +/- S.D.) respectively. Beta-NAH levels for the 19 normal controls were 15.8 +/- 3.5 U/l (mean +/- S.D.). Beta-NAH also was significantly elevated in patients with hepatic metastases (36.9 +/- 20.1 U/l). In 25 cancer patients with metastases other than in the liver beta-NAH levels (18.3 +/- 5.2) were not significantly elevated over the control group. It has potential value as a marker for non-CEA-producing liver metastases.

Monophasic and polyphasic pattern of alanine aminotransferase in acute non-A, non-B hepatitis. Clinical and prognostic implications

One-hundred-and-two out of 788 consecutive patients (12.9%) hospitalized for an attack of acute hepatitis fulfilled criteria for non-A, non-B (NANB) hepatitis, and were followed prospectively for 8 to 70 months. Forty-one out of 97 patients showed a monophasic pattern of alanine aminotransferase (ALT), and all recovered completely. In contrast, 22 of 56 (39.2%) subjects with a polyphasic pattern of ALT exhibited persistent hypertransaminasemia for more than 14-18 months, and all of them developed chronic hepatitis. Thus, a polyphasic pattern of ALT seems to characterize one of two forms of NANB hepatitis, more frequently associated with parenteral exposure, absence of jaundice and a high tendency for the development of chronic hepatitis. This suggests distinct immunopathogenetic mechanisms from two unrelated NANB agents. Benign, non-progressive chronic persistent hepatitis is the prevalent form of chronic sequela of NANB hepatitis observed in our patients. Although many of these patients show a tendency to spontaneous remission of the disease, there is the possibility in some of a deterioration of inflammatory activity of the liver that has need of immunosuppressive therapy.

Semi-quantitative estimation of serum myoglobin by a rapid latex agglutination method: an emergency screening test for acute myocardial infarction

The present study reports the evaluation of a new latex agglutination test for serum myoglobin (SMb). The time of agglutination of the latex particles coated with antibodies to myoglobin was measured in 172 serum specimens with known concentration of myoglobin quantitated by a radioimmunoassay (RIA), collected from myocardial infarction (MI) patients, subjects suffering from various diseases, and normal controls. Myoglobin levels in the samples were found to decrease exponentially with time of agglutination. Agglutination occurring within 1 min (result coded as + + + +) corresponded to 761 +/- 366 micrograms/l of myoglobin; between 1 and 2 min (+ + +), to 285 +/- 101 micrograms/l; between 2 and 3 min (+ +), to 85 +/- 47 micrograms/l; between 3 and 4 min (+), to 51 +/- 38 micrograms/l; and after more than 4 min (-), to 31 +/- 16 micrograms/l. Blood samples were serially drawn from 24 MI patients with short hospitalization delays; the rapid agglutination which was obtained in the specimens taken upon admission (20 results coded as + + + + and four as + + +) actually corresponded to markedly increased SMb levels. In contrast, serum creatine kinase (CK) activities were still less than 150 U/l in four patients (16.6%); CK-MB was less than 5 U/l in five cases (20.8%). Positive agglutinations for SMb were also obtained 4 and 8 h following admission in all subjects, confirming that the latex test is an early and very sensitive indicator for MI.(ABSTRACT TRUNCATED AT 250 WORDS)

Detection of reverse transcriptase activity in association with the non-A, non-B hepatitis agent(s)

Particle-associated reverse transcriptase activity was detected in four human serum specimens and in two plasma-derived products, all of which had been shown to transmit non-A, non-B hepatitis (NANBH) to other human beings and/or chimpanzees. Reverse transcriptase activity was also detected in all twelve sera from patients with acute or chronic NANBH. In contrast, reverse transcriptase activity was found in only 2 of 49 serum specimens from healthy plasma donors and laboratory workers. Sucrose density gradient fractions of two of the infectious human sera (peak reverse transcriptase activity at 1.14 g/ml) transmitted NANBH to chimpanzees. Biochemical and enzymatic data indicate that the NANBH agent(s) is a retrovirus or is retrovirus-like.

Low serum creatine phosphokinase values in patients with acute viral hepatitis

Low values of serum creatine phosphokinase (CPK) were found in a group of 27 patients suffering from acute viral hepatitis. The values were significantly lower than CPK values in a group of 25 patients with extra hepatic obstructive jaundice (23.3 +/- 32.1 versus 163 +/- 43 U/L, p less than 0.001). CPK values in the hepatitis group when recovered (6 months after hospitalization) were much higher than the mean CPK levels in the same group during the acute illness (178 +/- 28 versus 23.3 +/- 32.1 U/L, p less than 0.001) and were the same as a control group of 26 healthy volunteers (179 +/- 28 versus 179 +/- 20.9 U/L). Similar results were found when the groups were divided into separate male and female groups. Serum CPK values, thus, were found to be a useful diagnostic tool to distinguish between patients with intrahepatic jaundice due to acute viral hepatitis and patients with extra hepatic obstructive jaundice.

Acute viral hepatitis: morphologic and functional correlations in human livers

The usual histologic pattern in acute viral hepatitis (AVH) includes cellular abnormalities predominantly in the perivenular (zone 3) hepatocytes and changes interpreted as representing regenerative activity in the periportal (zone 1) hepatocytes. Enzyme histochemical and ultrastructural studies of livers of 12 patients with AVH were undertaken to see whether these features support the concept of regeneration of hepatocytes in zone 1. The swollen hepatocytes in the perivenular areas were hydropic, with dilated or eccentric rough endoplasmic reticulum and decreased or vesicular smooth endoplasmic reticulum; correspondingly, the glucose-6-phosphatase activity (reflecting, when present, intact and functional endoplasmic reticulum) was markedly decreased. Succinic dehydrogenase and diphosphopyridine nucleotide diaphorase activities, representing mitochondrial enzymes, were limited to the perinuclear or pericanalicular cytoplasm of swollen hepatocytes. gamma-Glutamyl transpeptidase activity was increased. The periportal hydropic hepatocytes were small and arranged in clusters displacing sinusoids. Ultrastructurally, these hepatocytes had nearly normal organelles but scanty smooth endoplasmic reticulum. Activities of the enzymes glucose-6-phosphatase, succinic dehydrogenase, and diphosphopyridine nucleotide diaphorase were weak, although glycogen was abundant. gamma-Glutamyl transpeptidase activity was scanty in these hepatocytes. These findings from enzyme histochemical and electron microscopic studies could be interpreted as evidence of functional deterioration of perivenular swollen hepatocytes and relative functional immaturity of periportal hydropic clustered hepatocytes, suggesting regeneration of zone 1 hepatocytes.