[Adenosine deaminase activity--an indicator of inflammation in liver disease]. / Die Adenosindesaminase-Aktivität--ein Entzündungsindikator bei Lebererkrankungen.

Inflammatory liver diseases display higher levels in serum ADA activity compared to non-inflammatory ones. The most pronounced increases in activity are found in acute virus-induced hepatitis, in active liver cirrhoses, extremely high levels in some liver tumours. Due to correlative relations, the ADA is mainly attributed to the mesenchymal parameters by factor analysis. This can be validated by assessment of histological criteria. The highest correlation coefficient could be demonstrated for ADA in relation to all parameters under investigation by means of the semi-quantitatively evaluated mesenchymal reaction within the histological section. The determination of the serum ADA is valuable in assessing the inflammatory reaction of the liver and for diagnosing active cirrhosis in particular. Increases in activity based on an elevated nucleic acid metabolism in tumours and regenerative processes have to be taken into consideration. This interpretation is evidenced by correlative relations between the activity of ADA in liver biopsy homogenate specimen and the hepatic inflammatory reaction.

[Aminoglycoside nephropathy]. / Aminoglykosidnephropathie.

Aminoglycosides lead to an increase of number and size of secondary lysosomiotics in the cells of the renal size of secondary lysosomes in the cells of the renal tubuli. Myeloid bodies appear in the lysosomes. As a sequel of the aminoglycoside antibiotics accumulated in the kidney a rhythmic change of the function of the cells of the tubuli with hyperenzymuria, decreased reabsorption of low molecular weight proteins, decreased concentration of urine and decreased glomerular filtration develops. Despite continued drug exposure these deviations are reversible. Simultaneous application of cephalotin, dextran or furosemid increase the toxic effect. A summarizing hypothesis concerning the aminoglycoside-induced nephropathy is presented which takes into consideration the specific receptor binding of the aminoglycosides at the membrane of the tubulus, their accumulation in the lysosomes and their ways in the cell of the tubulus. The lysosomes are regarded as primary working point of the aminoglycosides.

A low molecular weight alanine aminopeptidase in urine. Biochemical equivalent of tubular atrophy?

Using agarose gel electrophoresis, a faster moving alanine aminopeptidase (EC 3.4.11.2) has been demonstrated in the urine from cases of Fanconi syndrome, endemic (Balkan) nephropathy and advanced renal insufficiency. The enzyme was partially purified and its properties (isoelectric point, molecular weight, substrate specificity, influence of metal ions, Michaelis constant, antigenic behavior) were compared with those of normal kidney alanine aminopeptidase. Isoelectric points and antigenic properties are identical, but the molecular weights differ by a factor of about 2. Therefore, the greater electrophoretic mobility is due to the smaller size of the atypical enzyme.

[Hemofiltration of lysozyme in dialysis patients]. / Die Hämofiltration des Lysozyms bei Dialysepatienten.

With the help of the haemofiltration on the capillary dialysator CDAK 4 the behaviour of lysozyme (muramidase) was investigated in 20 dialysis patients. In 6 of 55 cases a measurable lysozyme concentration in the haemofiltrate was found. A relation to the size of the serum lysozyme level could not be established. The influence of defective capillaries is discussed. Despite the in most cases not measurable lysozyme concentrations in the haemofiltrate a decrease of the serum lysozyme level taking place parallel to creatinine could be proved during dialysis. Examinations of the influence of the renal rest function in dialysis patients with a rest diuresis resulted in a lower lysozyme concentration in the serum than in patients with complete anuria. These findings allow conclusions to the behaviour of low-molecular proteins in the kidney of dialysis patients and to their losses on the dialysis membrane.

[Urinary excretion kinetics of enzymes and proteins in the application of therapeutic doses of gentamycin]. / Ausscheidungskinetik von Enzymen und Protein mit dem Harn bei Applikation therapeutischer Gentamycindosen.

9 patients with chronic pyelonephritis were given gentamicin intramuscularly in an appropriate dosage for a period of 10 days. The urinary excretion of cells, protein, alanine aminopeptidase (EC 3.4.11.2),N-acetylglucosaminidase(EC 3.2.1.30) and alpha-galactosidase (EC 3.2.1.23) was determined daily. The most striking enzyme increase occurred in alanine aminopeptidase. The enzyme and protein output appears to be rhythmic and discontinuous. A 2--3-day rhythm is suggested. Rhythmic alterations of the digestion activity of the lysosomes are assumed to be the cause of these changes.

[Laboratory diagnosis of liver and biliary tract disease]. / Labordiagnostik der Leber- und Gallenwegersrkrankungen

Of a greater number of biochemical tests in hepatobiliary diseases by means of methematico-statistical methods (calculation of specificity and sensitiveness, variance analysis, discrimination analysis with following discrimination experiments) the parameters should be established which in a step programme with multivariate observation and non-discriminated approach give the best possible information. The recognition of patients with liver diseases (preliminary diagnostics) is at nearly 94% possible with a scale comprising GOT, AAP, some relevant clinical data (touch findings, jaundice, hepatic skin signs) and the hepatitis B-antigen. In non-discriminated approach according to our findings the following scale should not be trangressed: GPT, GOT (compare preliminary diagnostics), LAP, AP, AAP (compare preliminary diagnostics), cholesterol, TTT, bilirubin, beta-GC. As to aimed questionings the bromsulphalein test belongs to the enlarged basic scale.

[Aminopeptidases in the serum and urine of patients with hyperthyroidism]. / Aminopeptidasen im Serum und Harn bei Schiddrüsenüberfunktion

In patients with hyperthyroidism the serum activities of the leucine aminopeptidase (LAP) and the alanine aminopeptidase (AAP) as well as the alanine aminopeptidase excretion in the urine were determined. A significantly increased activity of the leucine aminopeptidase in the serum and an increased excretion of alanine aminopeptidase in the urine were found. The AAP in the serum did not show a significant increase of activity. On account of the changes in the serum and in the urine before and during therapy a low-grade participation of the hepatobiliary and renal systems which are clinically not uppermost is to be assumed. Increased excretion of AAP and hyperthyroidism coincide nearly without exception in out patients. Correlation-statistical investigations make it probable to regard the increased excretion of AAP in the urine as an indirect parameter of the peripheral metabolism in hyperthyroidism.