Estimation Of Serum Alkaline Phosphatase Research Articles

Estimation of Serum Alkaline Phosphatase, Total Calcium and Urinary Hydroxyproline as Bone turn over marker in Post-Menopausal women in Tertiary care Hospital

Background: Osteoporosis is one of the prevalent diseases of post-Menopausal women. Hence to evaluate the severity of osteoporosis serum calcium, serum ALP and urinary hydroxyproline used as bone resorption marker.Method: 30 post-menopausal women with osteoporosis were compared with healthy pre-menopausal 25-40 years of women. Random Blood sample collected from venipuncture and centrifuged to get serum. Fasting Urine sample was collected and 1.2 drops 6 N HCI was added as preservative. The parameter compared between preand post menopausal were, serum calcium, alkaline phosphatase, total protein, Albumin, Urine test included Hydroxyproline,creatinine and results were noted.Results: Comparison of S. calcium, S.alkalinePhosphatase, S. Protein,S. Albumin and Urinary hydroxyproline. Urinary creatinine were compared and every parameters had highly significant p value (p<0.001).Conclusion: These results demonstrate that biochemical markers of bone turn over like serum total ALP total calcium provide dynamic measure of bone remodelling and helps to predict the changes in bone mass and fracture of risk in post-menopausal women.

Serum Osteocalcin Concentrations in Paget's Disease of Bone

Total body scintiscans, serum alkaline phosphatase estimations, and serum osteocalcin radioimmunoassays were performed in 49 consecutive patients with Paget's disease of bone. Eleven were receiving calcitonin (salmon synthetic) at the time of the study. The serum alkaline phosphatase activities were elevated in all but one patient, with the highest value almost 50 times the upper limit of the reference range. Serum osteocalcin concentrations were elevated in 53% of patients and normal in the rest. The highest serum osteocalcin value was 4.2 times the upper limit of the reference range. The correlation coefficient between the extent of skeletal involvement and serum osteocalcin level was .70, while that between skeletal involvement and serum alkaline phosphatase level was .55. In spite of the better correlation between bone scintiscans and serum osteocalcin level, osteocalcin measurements are diagnostically less useful than serum alkaline phosphatase estimations in patients with Paget's disease of bone.

LIVER SCANNING IN PATIENTS WITH COLORECTAL CARCINOMA

Three hundred liver scans were performed on a routine basis in patients with colorectal carcinoma, before and after operation, to detect hepatic metastases. In 98 of 106 pre-operative and 28 of 194 postoperative scans, confirmation of the pathological condition was obtained at operation or post-mortem examination. The overall diagnostic accuracy of the scan was 77.4%, but the false-positive rate was high. The presence of focal defects in liver scans before operation did not influence our decision regarding abdominal exploration. After operation on patients who did not have disseminated disease and whose liver scans showed localized focal defects, selective hepatic arteriography and abdominal exploration did not reveal resectable metastatic disease. In one-third of patients with abnormal liver scans after operation, subsequent scans returned to normal. Of the patients with true positive liver scans, three-quarters had clinically evident hepatic metastases. Serum alkaline phosphatase estimations were as accurate in detecting liver metastases as the liver scan, and returned fewer false-positive results. Routine liver scanning before or after operation is not recommended for patients with colorectal carcinoma and should be reserved for patients with clinical features or biochemical abnormalities suggestive of liver metastases.

The Application of Certain Liver Function Tests Including Serum Alkaline Phosphatase Estimations to Domesticated Animals in the Sudan

The activities of alkaline phosphatase, arginase, glutamic dehydrogenase, and the concentration of bilirubin have been measured on sera of normal and diseased Sudanese livestock and correlated with liver pathology. Alkaline phosphatase was estimated by three known methods, with and without two inhibitors—phenylalanine and urea, and the Michaelis constant (K m ) also determined. The results demonstrate that the wide normal range of alkaline phosphatase strictly limits its use as a diagnostic aid. This is in general agreement with the findings of other investigators. The one possible exception is that determination of K m appears to have some diagnostic value in the camel. Arginase determination appears to be the test of choice for active liver cell damage in the species investigated; glutamic dehydrogenase is also useful particularly in cases of active and diffuse liver cell damage, but less so when chronic lesions are present. Bilirubin estimations appear to be too insensitive for most purposes. Les activités de la phosphatase alcaline, de l’arginase, de la déshydrogénase glutamique, et la concentration de la bilirubine ont été mesurées au niveau des sérums de bétail Soudanais normal et malade et rapportéesà la pathologie hépatique. On évalua la phosphatase alcaline par trois méthodes connues, avec et sans deux inhibiteurs—phénylalanine et urée, et l’on détermina également la constante de Michelis (K m ). Les résultats démontrent que le rayon d’action normal et étendu des phosphatases alcalines limite strictement son utilisation comme aide diagnostique. Ceci est en général en accord avec les découvertes des autres chercheurs. La seule exception possible est que la détermination de K m paraisse avoir quelque valeur diagnostique chez le chameau. L’évaluation de l’arginase semble être l’examen de choix pour l’exploration de l’altération active de la cellule hépatique chez les espèces étudiées; l’hydrogénase glutamique est aussi utile en particulier dans les cas d’altération cellulaire hépatique active et diffuse, mais l’est moins que lorsque des lésions chroniques sont présentes. Les évaluations de la bilirubine paraissent être trop peu sensibles dans la pluprat des cas. In den Seren von normalen und erkrankten Haustieren im Sudan wurde die Aktion von alkalischer Phosphatase, Arginase, Glutamindehydrogenasce und die Konzentration von Bilirubin bestimmt unt mit pathologischen Vorgängen in der Leber in Beziehung gebracht. Alkalische Phosphatase wurde mit Hilfe von drei bekannten Methoden, mit und ohne Verwendung von zwei hemmenden Ingredienzien (Phenylalanin und Urea) bestimmt; die Michaeliskonstante (K m ) wurde ebenfalls bestimmt. Die Resultate zeigten, dass die ausgedehnte normale Reichweite der alkalischen Phosphatase der Verwendung für diagnostische Zwecke stark einschränkt. Im allgemeinen stimmt dies mit den Ergebnissen anderer Autoren überein. Die einzige mögliche Ausnahme ist, dass beim Kamel die Bestimmung von K m einen gewissen diagnostischen Wert zu haben scheint. Bei den untersuchten Tierarten schien die Bestimmung von Arginase die beste Untersuchungsmethode für die Festellung einer aktiven Leberzellenschädigung zu sein ; die Untersuchung auf Glutaminhydrogenase ist ebenfalls von Nutzen besonders in Fällen aktiver und diffuser Schädigung von Leberzellen jedoch weniger, wenn chronische Erkrankungen vorliegen. Bilirubinbestimmung scheint für die meisten diagnostischen Zwecke nicht empfindlich genug zu sein. Se ha realizado un estudio sobre la actividad de la fosfatasa alcalina, arginasa, dehidrogenasa glutámica y la concentración de bilirrubina en el suero del ganado normal, y enfermo del Sudán, procediéndose también a su correlación con enfermedades hepáticas. La fosfatasa alcalina se estimó por los tres métodos conocidos, con y sin los dos inhibidores—fenilalanina y urea, determinándose también la constante de Michaelis (K m ). Los resultados demuestran que el ámplio margen normal de la fosfatasa alcalina limita estrictamente su uso como medio diagnóstico. Esto va de acuerdo en general con los hallazgos de otros autores. La única excepción posible es que la determinación del K m parece tener un cierto valor diagnóstico en el camello. La determinación de la arginasa parece ser la prueba de elección para las lesiones activas de la célula hepática en las especies investigadas; la dehidrogenasa glutámica también es útil especialmente en casos de lesiones hepáticas difusas y activas, aunque lo es menos cuando existen lesiones crónicas. La determinación de bilirrubina parece ser demasiado insensible para la mayoría de los casos.

Some Properties of Alkaline Phosphatase in Dog Tissues and Serum

Some general properties of alkaline phosphatase (AP) isoenzymes from dog tissues have been investigated. These included the action of chemical inhibitors, variations in temperature, pH, composition of buffer/substrate mixtures, K m values, and some limited experiments on the application of selected chemical inhibitors on the estimation of serum alkaline phosphatase in normal and diseased dogs. The chemical inhibitors studied included urea, thiourea, phenylalanine and halogenated phenylalanines, various amino acids, mixtures of amino acids and some inorganic salts. Comparison of the present results with other investigations has revealed many similarities between the dog and other species. One new observation appears to be that p -chlorophenylalanine is more inhibitory towards the AP isoenzymes from muscle than towards those from other tissues. Some marked reversals in the quantitative inhibitory effects of phenylalanine and urea to APs from kidney and intestine were noted when activities were assessed on extracts and by histochemical techniques. Bearing in mind the preliminary nature of the experiments on normal and diseased animals there is some promise of possible application of selected inhibitors, particularly the phenylalanines, and glycine, in clinical biochemical procedures. Quelques propriétés générales des isoenzymes de la phosphatase alcaline des tissus du chien, ont été étudiées. Celles-ci comprennent l’action des inhibiteurs chimiques, des variations de la température, du pH, de la composition tampon/mélanges de substrat, des valeurs de Km, et de quelques expériences concernant l’application d’inhibiteurs chimiques sélectionnés dans l’évaluation de la phosphatase alcaline sérique chez les chiens normaux et malades. Les inhibiteurs chimiques étudiés comprennent l’urée, la thiourée, la phénylalanine et des phénylalanines halogènes, des acides aminés variés, des mélanges d’acides aminés et de quelques sels inorganiques. La comparaison des présents résultats avec d’autres études a révélé de multiples similitudes entre le chien et d’autres espèces. Une nouvelle constatation apparait être que la p -chlorophénylalanine est plus inhibitrice envers les isoenzymes de la phosphatase alcaline (PA) du muscle qu’envers ceux des autres tissus. Quelques importantes inversions des effets inhibiteurs quantitatifs de la phénylalanine et de l’urée vis à vis de la PAs du rein et de l’intestin furent observées lorsque l’on estimait les activités sur des extraits et par des techniques histochimiques. En gardant en mémoire la nature préparatoire des expériences pratiquées sur des animaux normaux et malades, il existe quelque espoir dans l’application possible des inhibiteurs sélectionnés, en particulier la phénylalanine, et la glycine, au cours de procédés biochimiques cliniques. Untersuchungen gewisser Eigenschaften alkaliner Phosphatase (AP) Isoenzyme in Geweben von Hunden. Hierzu gehörten die Wirkung chemischer Hemmer, Variationen der Temperatur, pH, Zusammensetzung von Puffer/Substrat-Mischungen, K m -Werte, und einige begrenzte Versuche mit der Applikation gewisser chemischer Hemmer auf die Bestimmung der alkalinen Serumphosphatase beim gesunden und kranken Hund. Die untersuchten chemischen Hemmer waren unter anderen Urea, Thiourea, Phenylalanin und halogenide Phenylalanine, verschiedene Aminosäuren, Mischung von Aminosäuren und anorganischen Salzen. Der Vergleich dieser Resultate mit denen anderer Untersuchungen hat viele Ähnlichkeiten zwischen Hunden und anderen Tierarten geziegt. Eine neue Beobachtung scheint zu sein, dass p -Chlorophenylalanin stärker hemmend auf die AP-Isoenzyme der Muskeln wirkt als auf die von anderen Geweben. Wenn Wirkungen mit Extrakten und durch histochemische Methoden bestimmt wurden, wurden deutliche Umkehrungen im quantitativen hemmenden Effekt von Phenylalanin und Urea auf AP von Niere und Darm bemerkt. Zwar waren dies nur vorläufige Experimente mit normalen und kranken Tieren, aber hier besteht eine gewisse Aussicht auf die mögliche Verwendung ausgewählter Hemmer, besonders der Phenylalanine und von Glycin bei klinischen biochemischen Untersuchungen. Se han investigado propriedades generales de las isoenzimas de fosfatasa alcalina (FA) de los tejidos del perro. Incluyeron la acción de inhibidores químicos, variaciones en temperatura, pH, composición de mezclas de neutralizador/substrato, valores Km, y algunos experimentos limitados sobre la aplicación de inhibidores químicos seleccionados en la estimación de la fosfatasa alcalina del suero de perros normales y enfermos. Los inhibidores químicos estudiados incluyeron la urea, tiourea, fenilalanit y fenilalaninas halogenadas, varios aminócidos, mezclas de aminoácidos y algunas sales inorgánicas. La comparación de los resultados presentes con otras investigaciones, ha revelado muchas similaridades entre el perro y otras especies. Una nueva observación parece ser que la p -chlorofenilalanina es más inhibidora para con las isoenzimas de FA del músculo que para con las de otros tejidos. Se observaron algunas inversiones notables de los efectos inhibidores cuantitativos de la fenilalanina y la urea en las FAs del riñón e intestino cuando sus actividades se estimaron en extractos y mediante técnicas histoquímicas. Teniendo en cuenta la naturaleza preliminar de los experimentos en animales normales y enfermos, existe la promesa de la posible aplicación de inhibidores selectos, particularmente las fenilalaminas y glicina, en los procedimientos bioquímicos clínicos.

An improved autoanalyzer technique for the determination of serum alkaline phosphatase

The use of dialysis in the present AutoAnalyzer technique for the estimation of serum alkaline phosphatase has been shown to result in a sufficient decrease in substrate concentration to significantly lower the apparent enzyme activity. A modification of the method is presented which overcomes this difficulty and also allows an accurate definition of the incubation period. Results by this technique are compared with existing methods.

A search for sub-clinical rickets in Glasgow children.

Two random samples of Glasgow children aged 12 to 24 months were examined for clinical, biochemical and radiological evidence of subclinical rickets. No cases of florid rickets were discovered. One-third of the first sample studied (202 children) were estimated to be receiving less than 100 i.u. of vitamin D daily from all sources except sunshine. A poor dietary intake was most prevalent in the higher birth ranks and in social classes II and III (non-manual). The mean serum alkaline phosphatase level was 20 K.A. units per 100 ml. (S.D. 8 units) and 11 per cent had levels of 25 K.A. units per 100 ml. or above. No reason, either dietary or clinical, was found which would account for these high levels. Bone changes were observed in the wrist X-rays of about 9 per cent of children. They disappeared gradually with vitamin D therapy and there is some correlation with a raised alkaline phosphatase level and with tallness. They may be due to a relative insufficiency of vitamin D. Serum alkaline phosphatase estimations and wrist radiography do not appear to be useful methods for estimating the prevalence of hypovitaminosis D in the community or as screening procedures in the detection of individual cases of subclinical rickets.

A Modified AutoAnalyzer Technique for the Estimation of Alkaline Phosphatase Using Phenolphthalein Monophosphate

A manual method for the estimation of serum alkaline phosphatase using phenolphthalein monophosphate has been described by Babson et al. (1966) and reagents for an AutoAnalyzer technique, based on this method, have been marketed by WarnerChilcott Laboratories as Phosphastrate Alkaline (Automation Set). The procedure, as published, was considered to be uneconomic in the use of reagents and Versatol control serum. It was also observed that serum alkaline phosphatase values greater than 40 KA units/100 ml. could not be estimated without dilution. These deficiencies were overcome by the introduction of modifications to the original procedure. The sampling rate in the original method was 40 tests per hour and two double mixing coils were used for the enzyme hydrolysis. When the sampling rate was increased to 60 tests per hour and one double mixing coil was used, it was possible to estimate alkaline phosphatase concentrations as high as 60 KA units without prior dilution. The substrate was prepared by diluting the concentrated substrate with water in a ratio of one drop of concentrated substrate to 4 ml. of water. As this is double the dilution recommended in the published procedure the total AutoAnalyzer running time was increased from 250 to 500 minutes for one reagent kit. An abnormal Versatol serum with a high alkaline phosphatase was serially diluted with water and analysed by the modified technique. Linear results were obtained as shown in Fig. 1 indicating that it was not necessary to use mixtures of normal and abnormal Versatol sera for the preparation of a standard curve. A standard curve can be prepared by estimating a single abnormal Versatol serum. The optical density obtained from this standard serum is used to calculate the respective optical densities for a range of alkaline phosphatase values. These readings can be marked on the transmission chart paper 0.3