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beta-Hexosaminidase in the detection of alcoholism and heavy drinking.

The activities of beta-hexosaminidase (HEX), a lysosomal glycosidase, were studied in serum (sHEX) and urine (uHEX) among men with various drinking habits. Among 32 alcoholics, on the admission to the inpatient detoxification treatment, and among 25 drunkenness arrestees the average sHEX levels were twofold as compared with social drinkers (n = 16) or teetotallers (n = 27). The average urinary excretion of HEX was three times higher among alcoholics than teetotallers. In the detection of heavy drinking (over 60 g of 100% ethanol daily) sHEX and uHEX were more sensitive than serum gamma-glutamyltransferase (sGGT) both in alcoholics (sHEX = 69%, uHEX = 81%, sGGT = 48%) and in drunkenness arrestees (sHEX = 86%, sGGT = 66%). SHEX correlated positively with sASAT (r = 0.46 and 0.74; p < 0.01) and sALAT (r = 0.41 and 0.47; p < 0.01), but not with sGGT. The specificity of sHEX was 98% and that of uHEX 96%. The abstinence of 7-9 days had a significant decreasing effect on sHEX, but not on uHEX. Controlled moderate drinking (60 g of alcohol daily for ten days) was rapidly reflected on sHEX levels but not on uHEX levels. It is concluded that both sHEX and uHEX are sensitive laboratory markers of alcoholism and heavy drinking. As compared to each others sHEX may better reflect recent alcohol intake, whereas uHEX stays longer elevated after the cessation of drinking. HEX can be determined with a simple and inexpensive spectrophotometric method.

Alcohol Drinking↗

Clinical picture and diagnosis of acute pancreatitis.

Acute pancreatitis is characterized by clinical, morphological, and functional aspects. Severe abdominal pain with progression during the first hours after onset is the leading symptom. In the majority of patients acute pancreatitis had a "mild" clinical course, but 10 to 20% will develop severe local and systemic complications. Symptoms at the onset of disease are not specific and need consideration of several other diagnoses. Elevation of pancreatic serum enzymes is the main parameter in the diagnosis of acute pancreatitis. Besides the traditional parameter of total amylase, several specific pancreatic enzymes (e.g. pancreatic amylase, lipase, immunoreactive trypsin or elastase) are now widely used in clinical routine and guarantee a higher diagnostic specificity. The imaging procedures ultrasonography and computed tomography aid in identifying etiological factors in grading the severity of the disease and deciding therapeutic strategies. Endoscopic retrograde chol- angiopancreatography is most sensitive in detecting biliary lithiasis and can be successfully complemented by sphincterotomy if needed. Besides complex clinical and laboratory criteria, several biochemical markers (e.g. C-reactive protein, PMN-elastase, trypsinogen activation peptides) have been found to be valid for the detection of pancreatic necrosis and are of definite prognostic value. On the basis of such detailed information, the therapeutic strategy can be planned in a straight-forward manner.

Acute Disease↗

[Biological markers in the accurate diagnosis of chronic alcohol intoxication. The significance of gamma-glutamyl transpeptidase].

The late diagnosis of severe alcoholism--often after the onset of somatic complaints and the appearance of psychic disorders needs extensive research able to identify new objective clinical and paraclinical markers to allow early and accurate identification of alcoholism also after various periods of abstinence. The scores obtained are the consequence of alcohol abuse and not of nutritional deficiencies or some other associated visceral-humoral sufferings. The authors underline the significance of gamma-GTP in assessing early severe alcoholism state and the necessity and importance of finding certain specific biological markers--early and sensitive for etillic intoxication--that would considerably simplify the manner of diagnosis and an efficient therapy. The identification of certain significant and specific markers before the onset of visceral-humoral disorders would improve the psychoprotective measures before the onset of tolerance and withdrawal--determinant factors of severe etillic intoxication.

Adult↗

Application of DNA probes to hematology: an overview with selected examples.

Recent advances in molecular genetics have allowed development of short segments of desoxyribonucleic acid (DNA) which are complementary to active genetic sites. By pairing normal DNA with these "molecular probes", the presence of specific genetic sequences may be detected in patient samples. The majority of hematologic diseases arise from hereditary errors, neoplastic change or parasitic organisms. These types of disorders are particularly suited to diagnosis and management using detection of abnormal DNA sequences. Sensitive laboratory techniques employing these molecular probes are now available directly to detect target DNA sequences, assess abnormal short sequences of DNA, and evaluate the presence of abnormal DNA from its transcription products. Using DNA polymerase amplification, the sensitivity of these methods approaches its theoretical limitation of a single gene pair. In hematology, a prevalent application has been the detection of clonal molecular rearrangements which serves as a marker for lymphocytic neoplasia. Other applications of these techniques include the detection of abnormal chromosomal regions such as the Philadelphia chromosome and the detection of deletions of DNA which occur in such diseases as the myeloid dysplastic syndrome. As more human genetic sequences are known, it seems likely that these techniques will become prevalent among methods of laboratory testing.

Biomarkers, Tumor↗

[Determination of thymidine kinase in the cerebrospinal fluid as a marker of leukemic meningosis].

Levels of Thymidine Kinase (TK) in cerebrospinal fluid (CSF) were longitudinally evaluated in 68 patients with acute leukemia. Values significantly above the normal range were found in all cases with meningeal involvement (in two subjects before the cytological evidence of leukemic cells in CSF). Such high levels decreased until normal values after an effective treatment. Two patients with multiple cerebral neoplastic nodules without infiltration of meninges showed normal CSF-TK values. No false positive cases were observed. Both kinetic activity and mass of leukemic cells appeared to influence CSF-TK levels. Thus, CSF-TK appears to be a promising marker in diagnosing and monitoring meningeal disease in the course of acute leukemia.

Biomarkers↗

A computerized classification technique for screening for the presence of breath biomarkers in lung cancer.

A simple computer-based screening technique has been developed for classifying human expired air components into 16 chemical classes, based on empirical formulas. The sort procedure was developed to simplify the screening of the composition of expired air samples by sorting all components into chemical classes and classifying components at the greater than 75% and greater than 90% occurrence levels. Both occurrence-rate components are then evaluated as diagnostic markers in a discriminant function model for their ability to detect lung cancer. Of the 386 components detected in the gas chromatography/mass spectrometry (GC/MS) data files, 45 components were present at the greater than 75% occurrence level and 28 components at the greater than 90% occurrence level. Thus, this preliminary sort routine, performed by using a simple macro program installed into a standard personal-computer spread-sheet, greatly reduces the amount of data required for statistical treatment. Such a sort routine can also be applied as easily to other complex GC/MS data files for the purpose of data reduction.

Biomarkers, Tumor↗

Rapid diagnosis of acute myocardial infarction.

At present the ideal method for the very early and very rapid diagnosis of acute infarction is still elusive, making it difficult to implement strategies in large numbers of patients. With further research and conjoint biochemical and imaging approaches, however, it is likely that the early diagnosis of infarction and detection of ischemia will be possible.

Biomarkers↗

[Aspartate aminotransferase].

The characteristics and clinical usefulness for aspartate aminotransferase (AST) isoenzyme including apo- and holo-type enzymes were reviewed. The activation effect on mitochondrial- and cytosolic-AST (mAST and cAST) was compared in the presence of PALP, to sera of various diseases such non-alcoholic liver-, heart-, renal, and alcoholic liver diseases. A higher activation by PALP was described on both AST in the sera with ischemic heart disease than liver disease. Significantly higher apo and holo type of serum mAST were found even in patients with alcoholic fatty liver in the early stage of alcoholic liver injury than those in the normal. The mitochondrial injury relates to onset and progression of cellular necrosis so that differential measurement of apo and holo type activities of serum mAST might be useful for early prediction of necrotic diseases.

Aspartate Aminotransferases↗