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PubMed2001

Effects of exposure to tobacco smoke in pregnancies complicted by oligohydramnios and premature rupture of the membranes. II. Activity of brush border enzymes in human amniotic fluid.

The aim of the present study was to assess the activity of membrane enzymes: alanine aminopeptidase (AAP), gamma-glutamyltransferase (GGT) and trehalase in amniotic fluid of women who smoke cigarettes during pregnancy complicated by idiopathic oligohydramnios or premature rupture of the membranes (PROM). The enzyme activity was measured between 22 and 31 (group A) and between 32 and 39 (group B) weeks of gestation. In the women of group A with idiopathic oligohydramnios, AAP activity was five times higher than in PROM women. AAP activity was declining with the progression of gestation, and in the B group women with oligohydramnios, it was over eight times lower than in group A. A threefold increase in GGT activity was found in women of group A with oligohydramnios as compared to women of group A with PROM. No statistically significant differences in trehalase activity were found in amniotic fluid of women with oligohydramnios and PROM, AAP, GGT and trehalase activity in women with idiopathic oligohydramnios correlated with the cadmium ion concentration, and AAP and GGT activity with the lead ion concentration in amniotic fluid which confirms toxical properties of these heavy metals present in cigarette smoke. It has already been confirmed that measurements of the brush border enzyme activity in amniotic fluid are very useful in prenatal diagnosis and detection of the placenta disorders.

Adult↗
PubMed2002

[Preparation of hard dental tissues by aeroabrasive method].

The efficiency of aeroabrasive preparation (AAP) of teeth was evaluated by clinical methods and scanning electron microscopy. The authors conclude that the use of AAP should be confined to the treatment of surface and medium caries. Analgesia before AAP is obligatory, except cases with preparation of fissures for preventive hermetization. The use of AAP is absolutely contraindicated in cases of allergic reactions in the patient, dentist, or assistant. Methods for protection of the dentist, assistant, and patient during the use of AAP are discussed.

Adult↗
PubMed1992

[The effect of monoclonal and polyclonal antibodies to peroxidase on combined peroxidase oxidation of 4-iodophenol with luminol and 4-aminoantipyrine].

The kinetics of peroxidase-dependent cooxidation for two substrate pairs [p-iodophenol + 4-aminoantipyrine (AAP) and p-iodophenol + luminol was studied both in the absence and presence of polyclonal antibodies (polyAB), three types of peroxidase-specific monoclonal antibodies (monoAB) and their double or triple mixtures in a wide range of H2O2 concentrations (0.01-10.0 mM). MonoAB 2C, 3E and 9D at concentrations of 0.05-500 nM inhibited the cooxidation of p-iodophenol + AAP at H2O2 concentration above 1.0 mM but activated the cooxidation of p-iodophenol + luminol. The double and triple mixtures of monoAB activated the cooxidation of p-iodophenol + AAP at the same H2O2 concentrations without any effect on the p-iodophenol + luminol cooxidation. PolyAB activated the cooxidation of p-iodophenol + AAP more effectively and only slightly activated (or inhibited) that of p-iodophenol + luminol. PolyAB diminished the values of rate constants for the interaction of the peroxidase active intermediates, E1 and E2, with p-iodophenol, AAP or luminol. Possible modes of monoAB and polyAB effects on the two substrate pair cooxidation are discussed.

Ampyrone↗
PubMed1977

beta-Adrenergic receptors in rat kidney: direct localization by a fluorescent beta-blocker.

A new fluorescent beta-adrenergic blocker, 9-amino-acridin propranolol (9-AAP), was administered intravenously to albino rats. Fluorescent aggregates of 9-AAP binding sites were concentrated in the vascular poles of the glomeruli in association with the preglomerular afferent arterioles. 9-AAP fluorescence was reduced following pretreatment with (+/-)- and (-)-propranolol and was less affected in rats pretreated by the (+)-racemic isomer. 9-AAP binding sites were also observed on the lining epithelium of the renal collecting system. Our data suggest that 9-AAP may label beta-adrenergic receptors in rat kidney.

Adrenergic beta-Antagonists↗
PubMed1986

[Enzymuria and kidney diseases in childhood].

Urinary enzyme excretion and proteinuria were studied in 316 children with different underlying diseases. Activities on N-acetyl-beta-D-glucosaminidase and alanine aminopeptidase decreased progressively with age in the urine of 66 healthy prematures, newborns, infants or children. In 51 children with nephrotic syndrome, tubulopathies or chronic renal failure, excretion of NAG and AAP rose 3 to 30 fold. Contrary to molecular weight dependent protein analysis, determination of enzymuria did not allow to differentiate between glomerular and tubular disorders. After renal transplantation, 31 out of 52 children had a pathological enzymuria. NAG and AAP were more frequently elevated during treatment with cyclosporine A (21/29), than with azathioprine (10/23). The influence of nephrotoxic drugs upon enzymuria was documented in 14 children with cystic fibrosis or septicaemia treated with tobramycin. Activities of NAG and AAP rose transiently, whereas proteinuria remained almost unchanged. Only three out of 45 children receiving nonsteroidal antiinflammatory drug therapy for juvenile rheumatoid arthritis or spondylarthritis showed a pathological increase in enzymuria. Mean urinary NAG and AAP excretion in 154 children with insulin dependent diabetes mellitus were not different from controls and were unrelated to either duration of disease or HbA1 concentration. The determinations of urinary enzymes as non-invasive tests of renal integrity in medicine and toxicology provide a very sensitive indicator of renal damage. The assays of NAG and AAP have proven to be most valuable; however, due to a lack of specificity for the type and origin of renal dysfunction, these urinary enzyme assays are most useful when carried out in conjunction with electrophoretic analyses of proteinuria.

Acetylglucosaminidase↗
PubMed1981

Quantitative enzymatic, immunologic and histochemical studies of clinically relevant human kidney alterations using image analysis.

Tissue sections of kidneys from 172 patients with various pathologic conditions, such as hydronephrosis, interstitial nephropathies, ischemia, chronic graft rejection and renal cancer, were evaluated by an image analysis technique. Structurally defined kidney alterations were monitored for enzymatic, immunologic and other histochemical changes. Indicator enzymes of the proximal tubule, alanine-aminopeptidase (AAP), alkaline phosphatase (AP), beta-glucoronidase (beta-Gl) and gamma-glutamyltranspeptidase (GGTP), were used as parameters for screening. Enzyme concentrations were found to be significantly decreased in kidney sections of patients with various renal diseases (AP less than 15%, AAP less than 55% and beta-Gl less than 60%) as compared to normal kidney tissues (100%). AAP concentration was measured quantitatively by specific immunofluorescence using an antienzyme antibody. Immunofluorescence of AAP was comparable to that of AAP calculated by the colorimetric technique (substrate: DL-alanine-beta-naphthylamide-HCl) and decreased to less than 50% in altered kidney tissues. Furthermore, kidney cancer (less than 20%) and kidney tissue adjacent to tumours (less than 65%) displayed significantly decreased levels of kidney marker enzyme activity. This study suggests that (1) the diseased kidney is characterized by a defined change in key enzymes of the cell surface and (2) renal cancer exhibits partial depletion of these constituents. Image analysis of the pattern of enzyme activity appears to be a useful tool in the analysis of renal pathology.

Alkaline Phosphatase↗
PubMed1981

[Determination of p-aminoacetophenone and changes in its levels in a levorin producer depending on culture conditions].

A method for spectrophotometric determination of p-aminoacetophenone (p-AAP) in the mycelium and fermentation broth filtrates of organisms producing polyenic macrolide antibiotics is described. The level of p-AAP accumulation was studied as applicable to the biosynthesis of levorin, a polyenic antibiotic of the heptaen series. The levels of p-AAP under usual conditions of the levorin-producing organism cultivation and under conditions of its stimulation with the products of the vital activity of yeast-like fungi were compared. Higher levels of p-AAP in the cultures grown with stimulation of the antibiotic biosynthesis were noted. Inadequacy of the correlation between production of levorin and p-AAP is discussed.

Acetophenones↗
PubMed1993

[The role of substance P and somatostatin in acupuncture and moxibustion-induced postsynaptic inhibition].

AIM OF INVESTIGATION: Our previous work indicated that acupuncture and moxibustion (heating acupoints with a special lamp) could produce inhibitory effects on the tail flick reflex and the nociceptive response of dorsal horn neurons. In the present study the role of somatostatin (SS) and substance P (SP) in acupuncture and moxibustion-induced postsynaptic inhibition was further investigated. METHODS: The experiments were performed on male adult Wistar rats. The antidromic action potential (AAP) induced by cervical cord stimulation was extracellulary recorded at lumbar cord (L3-4). The latency of AAP was used to represent the excitability of postsynaptic projecting neurons. The effects of acupuncture (0.5 ms, 3.3 Hz, 2 mA) for five minutes or moxibustion (the temperature up to 45-46 degrees C) for six minutes at Huantiao points on the latency of AAP were observed. And then the effects of topical administration of SS or SP antiserum on either acupuncture or moxibustion-induced postsynaptic inhibition were observed. RESULTS: The latency of AAP was markedly prolonged by acupuncture and moxibustion. The maximal prolongation was 0.196 +/- 0.071 ms (n = 12, P < 0.02) and 0.176 +/- 0.062 ms (n = 11, P < 0.02) respectively. After topical administration of SS antiserum (1:40, 10 microliters), the latency of AAP was slightly prolonged by either acupuncture or moxibustion. The maximal prolongation (0.041 +/- 0.029 ms and 0.016 +/- 0.020 ms) was significantly reduced by SS antiserum (P < 0.05). While pretreated with SP antiserum, the latency was still prolonged by moxibustion (0.142 +/- 0.067 ms), but not by acupuncture (-0.003 +/- 0.046 ms). CONCLUSION: It is referred that postsynaptic inhibition may be involved in both acupuncture analgesia and moxibustion analgesia. The former is predominately mediated by SP and partially by SS, while the latter mainly by SS but not by SP.

Action Potentials↗
PubMed1995

Ribavirin therapy: implementation of hospital guidelines and effect on usage and cost of therapy.

OBJECTIVE: The American Academy of Pediatrics (AAP) recommends that ribavirin be reserved for infants who are severely ill and who are at high risk of morbidity and mortality, based on underlying clinical conditions. The purpose of this study was to evaluate current ribavirin use in our institution, implement hospital-specific guidelines for use, develop a prospective surveillance system to monitor ribavirin therapy, and evaluate the impact of these guidelines on subsequent use and cost of therapy. METHODS: Ribavirin use was compared with the recommendations of the AAP. Results were presented to the professional staff, and hospital guidelines were implemented. Ribavirin therapy was reevaluated in a 2-year period after hospital guidelines were implemented. RESULTS: In the initial evaluation period, only 67% of the ribavirin recipients met the AAP guidelines for use, and 19% received an inappropriate treatment regimen. The total cost and billed patient charges for ribavirin recipients who did not meet the guidelines for use in period 1 was $60,638 and $127,940, respectively. Over the next 2 years (period 2) after the implementation of hospital guidelines, the percentage of patients who received ribavirin decreased 35%, and approximately 96% of ribavirin recipients met the established criteria. Based on the decrease in the percentage of patients who received ribavirin in period 2 (41% versus 63%), the estimated cost avoidance and reduction in billed patient charges in period 2 was $55,540 and $117,334, respectively. This represents an estimated reduction in hospital costs and billed patient charges of $46,283 and $97,778 per 100 admissions for acute bronchiolitis. CONCLUSIONS: Before the implementation of hospital guidelines for use, a substantial percent of patients received ribavirin not consistent with the recommendations of the AAP. Following the adoption of a modified version of the AAP guidelines for our institution and the use of a multidisciplinary surveillance system for monitoring ribavirin therapy, we observed a substantial decrease in the overall ribavirin use. This has resulted in a significant savings in terms of cost avoidance and reduced billed patient charges.

Drug Costs↗
PubMed1994

Universal hepatitis B immunization of infants: reactions of pediatricians and family physicians over time.

OBJECTIVE: In November 1991 the Advisory Committee on Immunization Practice (ACIP) recommended universal hepatitis B immunization of infants. In February 1992 the American Academy of Pediatrics (AAP) and in August 1992 the American Academy of Family Physicians (AAFP) issued similar recommendations. The purpose of this study was to assess over time the effectiveness and impact of the dissemination efforts of the ACIP, AAP, and AAFP regarding this new recommendation and to determine the factors affecting its adoption. DESIGN: Cohort survey over time. SETTING: North Carolina. PARTICIPANTS: All 778 pediatricians and a random sample of 300 family physicians in North Carolina were surveyed by mail 3 months after publication of the ACIP recommendation (January/February 1992), but before the AAP and AAFP recommendations. Response rate was 78%. Of these, 83% responded to a follow-up survey 8 months later (October 1992). MAIN OUTCOME MEASURES: Rates of agreement and adoption of the recommendation for universal infant immunization with hepatitis B vaccine; factors affecting agreement and adoption of the recommendation. RESULTS: In the first survey (3 months after the ACIP recommendation) more pediatricians than family physicians were aware of the new recommendation (82% vs 48%), yet only 37% of pediatricians and 23% of family physicians agreed that immunization of all newborns in their practice was warranted. Eight months later, after the AAP and AAFP recommendation, 66% of pediatricians and 32% of family physicians agreed universal immunization was warranted, but still only 53% of pediatricians and 23% of family physicians had adopted it into practice. Factors associated with these low rates of adoption include physician and practice characteristics, cost, perceived need for the vaccine, and aversion to multiple injections. CONCLUSIONS: Federal, AAP, and AAFP efforts have not been effective thus far in fostering widespread agreement and adoption of this recommendation. If this and future vaccine programs are to succeed, research is needed to determine influences on implementation of new recommendations and to address the economic and noneconomic concerns of physicians and parents.

Attitude of Health Personnel↗
PubMed1977

Influence of the aryl group on the reaction of glucuronides of N-arylacethydroxamic acids with polynucleotides.

The reactions of the glucuronide conjugates of the carcinogens N-hydroxy-2-acetylaminofluorene (N-hydroxy-AAF), N-hydroxy-4-acetylaminostilbene (N-hydroxy-AAS), N-hydroxy-4-acetylaminobiphenyl (N-hydroxy-AABP), and N-hydroxy-2-acetylaminophenanthrene (N-hydroxy-AAP) with transfer RNA, ribosomal RNA, DNA, polyadenylate, polyguanylate, polyuridylate, polycytidylate, poly(adenylate, guanylate), and poly(guanylate, uridylate) were studied. The relative order of reactivity of these glucuronides with nucleic acids, measured by the covalent binding of the aryl group labeled with 3H or 14C, was glucuronide of N-hydroxy-AAF greater than glucuronide of N-hydroxy-AAS greater than glucuronide of N-hydroxy-AABP greater than glucuronide of N-hydroxy-AAP. The glucuronide of N-hydroxy-AAP showed only marginal or negligible reactivity. The glucuronide of N-hydroxy-AAF showed greater reactivity with polyguanylate than with polyadenylate, but the reverse was true for the glucuronide of N-hydroxy-AAS. Both of these glucuronides had much lower extents of reaction with polyuridylate and polycytidylate. Except for the reaction of the glucuronide of N-hydroxy-AABP with polyadenylate, there was no detectable reaction of this glucuronide or the glucuronide of N-hydroxy-AAP with the homopolynucleotides. Under comparable conditions the glucuronide conjugates of N-hydroxy-AAF, N-hydroxy-AAS, and N-hydroxy-AABP demonstrated greater reactivity with poly(adenylate, guanylate) and poly(guanylate, uridylate) than with the homopolynucleotides. Furthermore, the synthesis of two new glucuronide conjugates, those of N-hydroxy-AAS and N-hydroxy-AAP, is described.

Animals↗
PubMed1996

Dose effect of nitrendipine on urinary enzymes and microproteins following non-ionic radiocontrast administration.

BACKGROUND: Although calcium-channel antagonists have been proposed as prophylaxis to prevent radiocontrast-induced nephropathy, the dose and dose interval to achieve a protective effect have not been quantified in humans. METHODS: In a randomized, double-blind protocol we studied urinary enzyme and microprotein excretion in 121 outpatients (mean age 65.3 +/- 9.3 years, 62% male) with normal renal function who were to undergo digital subtraction arteriography with iohexol or iopentol. The subjects were treated with a single dose of placebo (group 1) or nitrendipine 10 mg (group 2) or 20 mg (group 3) p.o. 1 h before the procedure. Blood and urine samples were collected 1 h before, 1 h after, and 24 h after contrast administration. Study variables included contrast volume and serum creatinine, and urinary creatinine, osmolality, albumin, alanylamino-peptidase (AAP, a brush border enzyme), N-acetyl-beta-glucosaminidase (NAG, a lysosomal enzyme), and alpha-1-microglobulin (alpha-1-micro, a filtered microprotein). RESULTS: Serum values of creatinine remained unchanged during the study period. Albuminuria was not affected by contrast administration, whereas AAP, NAG, and alpha-1-micro increased significantly, all except AAP returning to baseline at 24 h. Pretreatment with nitrendipine did not reduce enzyme excretion, although AAP levels were lower in general in the group assigned to the 20-mg dose. Acute renal failure, defined as a 50% increase of serum creatinine 24 h after radiocontrast administration, was found in eight patients: four from group 1 (8.3%), three from group 2 (6.5%), and one from group 3 (3.7%). CONCLUSIONS: Neither the course of enzyme excretion nor the incidence of acute renal failure following radiocontrast administration were affected by single doses of calcium antagonists. AAP levels were lower in general in subjects taking the 20-mg dose of nitrendipine. This study also indicates that a single low or normal dose of nitrendipine per os is not effective prophylaxis before radiocontrast administration. The designs of future studies investigating the "nephroprotective' effect of calcium-channel antagonists per os should incorporate (1) the use of repeated doses to saturate hepatic metabolic pathways, and (2) the control of confounding variables in the measurement of urinary enzymes.

Acetylglucosaminidase↗
PubMed1997

Now I lay me down to sleep: SIDS and infant sleep positions.

Sudden infant death syndrome (SIDS) is the primary cause of infant death outside the neonatal period. The etiology of SIDS has been studied extensively but remains unclear. In 1992, the American Academy of Pediatrics (AAP) responded to international research that suggested an association between SIDS and prone sleeping patterns. Controversial guidelines on infant sleep position were issued at this time, advocating supine or sidelying positions. The AAP modified their initial guidelines in 1996, recommending supine as the preferred sleep position during infancy. The AAP stressed that both sidelying and supine positions place an infant at less risk for SIDS than the prone position, but that supine offered the lowest risk of SIDS. The AAP reaffirmed that these guidelines were intended for healthy newborns only, and also modified some of the original recommendations to reflect the latest research on SIDS. This article provides a brief overview of SIDS and the events leading to the current AAP stance on infant positioning. Parent education is addressed, with specific recommendations for discharge teaching.

Humans↗
PubMed1982

Factors affecting the practice of circumcision.

In 1975, the American Academy of Pediatrics (AAP) stated that there is "no medical indication for routine circumcision of the newborn." A survey was conducted among Chicago-area pediatricians, obstetricians, and family practitioners to determine what impact this statement had on their approach to circumcision. Hospitals were also surveyed to determine whether the AAP's statement had caused a change in the frequency of circumcision in area hospitals. Only 49% of the physicians were aware of the AAP's position. Forty-one percent recommended routine circumcision; 15% recommended against the practice. Age, medical specialty, religious customs, and concerns about hygiene and cancer all appeared to influence the physicians' approach to circumcision. The frequency of routine circumcision. The frequency of routine circumcision was 70% to 90% and remained unchanged in the three years following the AAP's statement.

Adult↗
PubMed1993

Missed opportunities in preventive pediatric health care. Immunizations or well-child care visits?

OBJECTIVE: To determine the percentage of patients in a large pediatric practice in compliance with national recommendations regarding immunizations and well-child care visits. RESEARCH DESIGN: Chart review. Point estimates with 95% confidence intervals were determined for reviewed charts in compliance with recommendations of the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention and schedule of well-child care visits, screening, and anticipatory guidance recommended by the American Academy of Pediatrics (AAP). SETTING: A large, multisite urban public pediatric practice. PATIENTS: Three hundred eighty-six infants and children (aged 0 to 60 months) who had a total of 7595 patient visits. SELECTION PROCEDURE: A random sample of charts. RESULTS: There was a large discrepancy in compliance for patients aged 0 to 23 months in ACIP-recommended immunizations (90.5% +/- 3.9%) vs AAP-recommended well-child care visits (37.6% +/- 6.4%) and for patients aged 24 to 60 months in ACIP-recommended immunizations (87.8% +/- 5.1%) vs AAP-recommended well-child care visits (31.0% +/- 7.1%). CONCLUSIONS: The data suggest that immunization alone does not ensure that children will receive all aspects of preventive care, raising questions about the practicality of the current AAP recommendations for preventive pediatric health care.

Child Health Services↗
PubMed1995

Actin, its associated proteins and metastasis.

In this short article we have overviewed the effect of transformation on AAPs. We have not dealt with molecules indirectly associated with actin which are modified by transformation, such as the catenins, cadherins, vinculin, and integrins [Tsukita et al., 1993], although their relationship with and importance to the transformed phenotype cannot be overemphasised. Similarly, alterations in polyphosphoinositide metabolism that occur in transformed cells may also promote or induce alterations in the microfilament cytoskeleton via interactions with proteins such as gelsolin, alpha-actinin, and MARCKS [Bretscher, 1993]. At present, there are no clear-cut rules regarding the effect that oncogenesis has on AAPs, since the expression level of one oncogenically modified AAP can vary from one tumour to another, even within the same type of tumour [Yamamoto et al., 1993]. This apparent inconsistency may well be because we are "playing with an incomplete pack of cards" [Pollard, 1993], or it may reflect this highly complex control mechanism in which any perturbation of the normal expression levels of actin/AAPs unbalances the delicate equilibrium which controls normal cell behaviour [Bray and Vasiliev, 1989]. For example, it is possible that oncogenically induced alterations to actin isoform expression [Lin et al., 1985] exert a downstream effect on actin-associated protein expression. Oncogenically induced actin based cell movements may be activated by alterations to either a single AAP or a synergistic functional unit of these molecules [Shapland et al., 1993; Vandekerckhove et al., 1990].(ABSTRACT TRUNCATED AT 250 WORDS)

Actins↗
PubMed1994

Antioxidant potential of anaerobic human plasma: role of serum albumin and thiols as scavengers of carbon radicals.

Extracellular fluids contain low-molecular-weight antioxidants that are actively involved in the defense against reactive oxygen species. The antioxidant activity of these compounds is largely due to their ability to trap oxygen radicals. Less known is the ability of extracellular antioxidants to scavenge carbon-centered free radicals (C-radicals). These radicals can be involved in the damage under hypoxic/anoxic conditions as well as in ischemia/reperfusion injury. We studied the reactivity of some plasma antioxidants toward a water-soluble C-radical generated by the azocompound 2,2'-azobis(2-amidinopropane) hydrochloride (AAP) under anaerobic conditions. The AAP C-radical in plasma was trapped by the spin trap 3,5-dibromo-4-nitrosobenzene-sulfonic acid (DBNBS) and produced a DBNBS radical. The scavenging properties of urate, cysteine, glutathione, natural amino acids, and serum albumin were assessed by the inhibition of the intensity of DBNBS radical. The antioxidant activity of ascorbate and that of vitamin E was measured directly by the formation of their free radicals. Urate, vitamin E and non-SH amino acids were ineffective and ascorbate was a poor scavenger of AAP C-radical. At variance, cysteine and glutathione (0.1-1.0 mM) were effective scavengers of AAP C-radicals and, importantly, protected plasma ascorbate from oxidation under both aerobic or anaerobic conditions. Our data show that ascorbate in aerobic plasma can reduce vitamin E radical and the oxidized ascorbate may be recycled by a thiol antioxidant cycle. Low-molecular-weight antioxidants accounted only partially for plasma scavenging activity of C-radicals. Plasma strongly reduced the intensity of DBNBS radical and, after dialysis, its activity was reduced by approximately 10%. Serum albumin showed an antioxidant activity comparable to dialyzed plasma. Also the cysteine residue of serum albumin was an efficient scavenger of C-radicals as shown by approximately 20% decrease in the protein scavenging activity after thiol alkylation. These results suggest that elevation in the concentration of total reduced thiols in plasma may improve its antioxidant activity under hypoxic/anoxic conditions. This may be particularly useful since other important antioxidant mechanisms such as urate, ascorbate, and vitamin E appear to be inefficient.

Aerobiosis↗
PubMed1982

Assessment of renal function during high-dose cis-platinum therapy in patients with ovarian carcinoma.

Five courses of cis-dichlorodiammine platinum (II) (100 mg/m2) were given to 22 patients with advanced stage III and IV ovarian cancer. Renal function was assessed by measurement of creatinine clearance, urinary osmolality and urinary B2-microglobulin (B2MG) in all patients, and by urinary alanine aminopeptidase (AAP) and N-acetyl-B-glucosaminidase (NAG) excretion in seven patients. Serum creatinine, creatinine clearance, urinary osmolality, and urinary B2-microglobulin were within the reference ranges and did not change significantly after five courses of cis-platinum in any patient. There was a significant increase in the urinary excretion of both enzymes (AAP and NAG) within 2 days of cis-platinum administration (NAG P less than 0.05 and AAP P less than 0.07). There was evidence of a cumulative effect during treatment for AAP (P less than 0.025).

Acetylglucosaminidase↗