Use of alkaline phosphatase isoenzyme analysis in the evaluation of cholestatic liver disease

A useful laboratory test for the differentiation of liver, bone, and intestinal alkaline phosphatase (ALP) isoenzymes in serum is presented. Electrophoresis in polyacrylamide gel is performed with untreated serum as well as with serum incubated at 56 degrees C for 10 min. The heating step denatures bone isoenzyme which may obscure the liver ALP band when present in large amounts. Visualization of ALP activity is accomplished by the use of buffered p-toluidinium 5-bromo-4-chloro-indolyl phosphate and magnesium ions. In serum of patients with cholestatic liver disease, the occurrence of large molecular weight liver cell membrane fragments which contain ALP activity is postulated. These ALP-containing fragments occur at the origin of the electrophoretogram, unable to penetrate the small pore separation gel. Abnormalities involving ALP isoenzymes, such as bone isoenzyme arising from increased osteoblastic activity, may be detected. Intestinal isoenzyme, normally present in small amounts in some subjects of blood groups B or O, may be elevated in certain liver diseases, such as cirrhosis. By the use of this method the routine question of whether an ALP found to be increased in a screening procedure is due to liver or bone abnormality may be answered. In addition, the occurrence of abnormal ALP bands arising from cholestatic conditions and the occurrence of abnormal amounts of intestinal isoenzyme may also be detected.

Enzymic colorimetric determination of phosphatidylglycerol in amniotic fluid

We describe a procedure for the enzymic, colorimetric determination of phosphatidylglycerol in amniotic fluid. After extraction into chloroform:methanol (2:1 by vol) and evaporation, the phospholipid-containing residue is redissolved in a non-ionic detergent, which thus provides an aqueous sample. The subsequent enzymic reaction sequence involves phospholipase-catalyzed hydrolysis of glycerol from its phospholipid. Subsequent enzyme-catalyzed reactions phosphorylate this glycerol and oxidize the resulting glycerol phosphate to produce hydrogen peroxide, which is reacted to produce an intense red chromogen in the peroxidase-catalyzed coupling of 4-aminoantipyrine and 2-hydroxy-3,5-dichlorobenzenesulfonate. When used in conjunction with previously reported enzymic techniques for determination of lecithin and sphingomyelin, this procedure may provide an accurate and precise "lung profile" for assessment of fetal lung maturity.

Enzymic colorimetric determination of phosphatidylglycerol in amniotic fluid

We describe a procedure for the enzymic, colorimetric determination of phosphatidylglycerol in amniotic fluid. After extraction into chloroform:methanol (2:1 by vol) and evaporation, the phospholipid-containing residue is redissolved in a non-ionic detergent, which thus provides an aqueous sample. The subsequent enzymic reaction sequence involves phospholipase-catalyzed hydrolysis of glycerol from its phospholipid. Subsequent enzyme-catalyzed reactions phosphorylate this glycerol and oxidize the resulting glycerol phosphate to produce hydrogen peroxide, which is reacted to produce an intense red chromogen in the peroxidase-catalyzed coupling of 4-aminoantipyrine and 2-hydroxy-3,5-dichlorobenzenesulfonate. When used in conjunction with previously reported enzymic techniques for determination of lecithin and sphingomyelin, this procedure may provide an accurate and precise "lung profile" for assessment of fetal lung maturity.

Hand dermatitis: practical management and current concepts

hand dermatitis (HD) is a common clinical challenge, its management a clinical art. The vexing problem of etiologies is simplified by classifying causative factors as either exogenous or endogenous. Most patients respond to avoidance of irritants combined with appropriate topical corticoids and lubrication. While certain aspects of treatment must be individualized, many of the protective and lubricating measures are routine. Patient compliance with these routine, and necessarily involved, measures is greatly improved by using printed instruction forms. A minority of patients with HD will challenge the most skilled clinician. At present, technics for determining the role of endogenous versus exogenous factors are not satisfactory. Even repeated and involved patch testing combined with prolonged observation may leave a nagging uncertainty . . . is there an overlooked allergen responsible for this chronic dermatitis? The chronic, endogenous, palmar, vesicular dermatoses represent a stubborn therapeutic problem. Potent corticoids under occlusion, while often effective, tend to produce atrophy. Intralesional corticoids are practical only for small areas. Systemic corticoids, while producing dramatic relief, only postpone the problem, since their side effects preclude long-term usage. At times psoralens and ultraviolet A (PUVA) therapy provides effective control. With perceptive persistence, most chronic HD can be effectively controlled. It is worth the effort, for often it means restoring a social and economic outcast to a useful and happy life.

Physiological responses to salinity in selected lines of wheat

Two selections of bread wheat, Triticum aestivum L., differing in their relative salt resistance, were grown in salinized solution culture, and relative growth rates, osmotic adjustment, ion accumulation, and photosynthesis were monitored to study the responses of the plants to salinity.Differences in water relations were minimal and were only apparent for 3 days following salinization. The lines differed substantially in their relative growth rates and photosynthetic responses for several weeks following salinization, despite full osmotic adjustment. Concentrations of major cations and Cl(-) in the plant organs were remarkably similar in both lines, indicative of minimal differences in gross ion absorption and translocation.The authors interpret these results to suggest that the major difference between these two lines of wheat was their response to specific ion effects, at the level of the organ, tissue, cell, and subcellular entities. Superior compartmentation of toxic ions by the more salt-tolerant line, presumably in the vacuole, might have enabled it to maintain its cytoplasmic metabolic apparatus in a stabler and more nearly normal state than the sensitive line was able to do; a measure of true cytoplasmic toleration of salt may also be a factor.

Mucous membrane grafting for severe palpebral vernal conjunctivitis

Vernal conjunctivitis usually can be managed medically. In the rare cases that do not respond to medical treatment, surgical intervention has been considered. Four cases of vernal conjunctivitis and one case of probable contact lens-induced giant papillary conjunctivitis were treated with palpebral conjunctival excision and application of a mucous membrane graft. All patients improved symptomatically, with follow-up ranging from 1 1/2 to 14 years. The only complication encountered was recurrence of giant papillae at the conjunctiva-mucous membrane graft junction. Conjunctival excision and mucous membrane grafting is a useful procedure in rare cases of particularly severe vernal conjunctivitis.