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The author studied changes in glutamic-pyruvic transaminase activity of liver homogenates under the effect of various compounds capable and incapable of forming Schiff bases with phosphopyridoxal.

Dane particles were observed electron microscopically in sera of all 10 patients with Australia (Au) antigen-positive chronic aggressive hepatitis. Massive Dane particles were demonstrated in sera of a patient at the early phase of the elevation of serum glutamic pyruvic transaminase. The inner body of a Dane particle was shown as a typical icosahedral symmetry by rotation technique.

(1958). A Fluorimetric Method for Measuring the Activity in Serum of the Enzyme Glutamic Pyruvic Transaminase. Scandinavian Journal of Clinical and Laboratory Investigation: Vol. 10, No. 1, pp. 53-58.

Summary In an attempt to discover a laboratory test by means of which female carriers of the gene For the Duchenne type muscular dystrophy could be identified, creatine and creatinine excretion has been studied in forty-eight female relatives of patients suffering from this variety of muscular iystrophy. The activity in the serum of aldolase, of serum glutamic oxalacetic transaminase (SGOT) and of serum glutamic pyruvic transaminase (SGPT) has also been determined in thirty-six female relatives. The females tested were divided into three groups: (a) known carriers, (b) possible carriers, and (c) probable non-carriers. No significant differences were discovered between the results obtained in each of these three groups. No method of identifying female carriers has yet been discovered. We are grateful to Dr A. L. Latner for his advice and for providing facilities in the Department of Chemical Pathology of the Royal Victoria Infirmary for biochemical estimations to be carried out in the Newcastle upon Tyne series. Creatine and creatinine estimations on the female relatives of patients living in the London area were carried out in the Department of Chemical Pathology, the Institute of Neurology, the National Hospital, Queen Square, by kind permission of Prof. J. N. Cumings. The pedigree was prepared by Miss M. Mustart of the Department of Photography, King's College, Newcastle upon Tyne, and statistical analyses were performed by Mrs D. Weightman of the Department of Industrial Health, King's College.

1. (1) The SGOT and SGPT values were determined in venous blood withdrawn 1–4 h post-prandially from 200 unselected patients having treated diabetes. 2. (2) In 194 patients (97%) both transaminase activities were within normal range. 3. (3) In 4 patients both SGOT and SGPT levels were higher than normal and in 2 the SGOT activity alone was elevated. The high transaminase activity in these 6 was considered to be due to known or demonstrated hepatic disease. 4. (4) The presence of reasonably controlled diabetes need not modify the diagnostic interpretation of high SGOT or SGPT activities. 5. (5) Further studies of the SGOT and SGPT levels in metabolically uncontrolled and newly-diagnosed diabetics are required.

The report by Redeker et al 1 stated that 12 cases of serum hepatitis developed among 120 recipients of commercially prepared pooled plasma. Four of these were clinically icteric and eight were not, giving an attack rate for icteric hepatitis of 3%, and for nonicteric hepatitis, 7%—a total of 10%. There were elevations of transaminase values (serum glutamic oxaloacetic transaminase [SGOT], serum glutamic pyruvic transaminase [SGPT]) in all 12 patients, occurring within proper periods of incubation for serum hepatitis. Needle biopsies were performed upon the 12, and the diagnosis was confirmed pathologically. On the basis of this report, the National Research Council's Committee on Plasma and Plasma Substitutes 2 concluded that heat treatment of plasma was ineffective in preventing serum hepatitis. Thereupon, they hastily recommended the discontinuance of the commercial production of plasma and by legal implication, the private production as well. This experience however, appears to be unique

Among the enzymes normally found in the body are the transaminases which catalyze the interconversion of an amino acid with a keto acid. The two most widely studied transaminases are glutamic oxaloacetic transminase and glutamic pyruvic transaminase, the former being the subject of the current study. Since skeletal muscle contains a high concentration of glutamic oxaloacetic transaminase, the present investigation, and extension of previous work with Fleisher, was carried out to ascertain whether the serum levels of this enzyme are altered in patients with muscular dystrophy. Historical Review Cohen studied these enzymes and, with Hekhuis, noted their wide distribution in the body. Another tissue enzyme, aldolase, was soon discovered by Warburg and Christian who found it to be elevated in the serum of rats with tumors. Sibley and Lehninger, in a survey of a large number of patients with various diseases, found that aldolase did not constitute a good test for cancer

Forty-one persons, mostly children, were followed up with serial serum glutamic pyruvic transaminase (SGPT) determinations for 6 to 12 months after onset of acute infectious hepatitis. An abnormal level was observed in the postconvalescent period in 12 (29%) of these. Most children with SGPT abnormality were asymptomatic; among the few with mild residual complaints, there appeared to be no necessary correlation with SGPT level. Observations made approximately one year after onset did not suggest that chronic hepatitis had developed within that interval in any of the children. It does not appear that SGPT abnormality is a reason by itself for reinstituting bed rest or restricting activity.

In a population sample from Southwestern Germany GPT-phenotypes have been determined. The allele GPT1 is more frequent in this sample than in the USA.

The effects of halothane anesthesia on liver function, as reflected by postanesthetic changes in serum glutamic pyruvic transaminase (SGPT) levels, were evaluated in 2 groups of 40 patients. All patients had 2 halothane anesthetics. In 1 group, both anesthetics were administered at 1 atmosphere pressure with 30% O2 in the inspired air. In the 2nd group, both anesthetics were administered at 2 to 3 atmospheres (absolute) of pressure with 97 to 98% O2 in the inspired air. While the SGPT levels remained within the normal range in all cases, there was a significant rise in SGPT levels in patients undergoing surgery under 1 atmospheric pressure. Patients undergoing surgery at 2 to 3 atmospheres pressure (absolute) had SGPT levels which remained at low normal values. The difference in response of SGPT in the 2 groups was statistically significant. We conclude that increased O2 tensions alter the normal response of SGPT to halothane anesthesia and that increased O2 tensions appear to protect the liver from possible adverse responses to halothane or its metabolites.

A Study on glutamic pyruvic and oxaloacetic transaminase of different organs(e.g intestine, seminal vesicle, reticular tissue, uterus, ovary, testes) in Ascaris lumbricoides suis have been investigated. The activity of transaminase were determined on the whole homogenates and subcellular fractions separated by differential centrifugation. The activity of glutamic pyruvic and oxaloacetic were assayed by colorimetric method of Reitman-Frankel. The results were obtained as follows: 1. About ninty percent of the glutamic pyruvic and oxaloacetic transaminase in different organs was found to be localized in the supernatant fraction with the separation of differential centrifugation. And it was found that ten percent of glutamic pyruvic and oxaloacetic transaminase exists in the mitochondrial fraction. 2. The specific activity of glutamic oxaloacetic transnaminase in different organs was relatively higher than the glutamic pyruvic transaminase activity.

SEVERAL workers1–4 have shown that there are two electrophoretically and chromatographically separable forms of GOT*. These two forms are found at different sites in the cell and have different properties, and it has been shown that they are both isoenzymes of GOT. While one isoenzyme is localized in mitochondria the other is localized in the cytoplasm, and moreover, unlike the latter, the mitochondrial enzyme is markedly inhibited by its reaction product OAA.

In a period of nine weeks, four private duty nurses at a municipal hospital developed viral hepatitis. As a result of the deaths of the first two of these, a state of near-panic developed among the employee population. A program of inoculation of personnel was instituted during which 1,900 employees received γ-globulin. A survey of 1,300 employees by means of serum glutamic pyruvic transaminase screening together with more intensive evaluation of those with abnormal levels proved useless in disclosing subclinical cases. Concepts of transmission of this disease are reviewed, including more recent studies which suggest the existence of a fecal-oral route in the spread of serum hepatitis.

To the Editor:— The editorial entitled "The Shrinking Specificity of the Transaminase Determination" (JAMA191:179 [March 29] 1965) is wrongly named. A better title would have been "Further Evidence Substantiating Congestive Hepatomegaly" as an etiology of elevated serum glutamic pyruvic transaminase (SGOT) level. These determinations are of value in myocardial infarction and diseases of the liver. Less informed persons might draw erroneous conclusions from the title used.I, as well as, I am sure, many others, have diagnosed subclinical congestive heart failure on the basis of a SGOT level of significant degree.As is true with many other laboratory procedures in clinical medicine, a test for one organ system becomes more and more specific as more diseases that cause pathophysiology of this particular organ system are studied and fewer exceptions are found.

The frequency of Australia antigen is high in patients with Down's syndrome in large institutions (27.7%) and is low in patients without this syndrome in the same institutions (3.2%). It is rare in patients with Down's syndrome in small institutions (1.5%) and absent in newborn patients and those who are not institutionalized. Serum glutamic pyruvic transaminase levels were studied in age- and sex-matched groups of 16 patients with Down's syndrome and Australia antigen [phenotype Au (1)], 16 with Down's syndrome but without Australia antigen [Au(0)] and 16 Au(0) mental defectives without Down's syndrome. The findings indicated active liver cell breakdown in Au(1) patients, and were confirmed in an extensive study including 581 individuals. The findings are best explained by the operation of an environmental factor, probably infectious, present in the large institutions, and a host susceptibility factor present in association with Down's syndrome.

Carbenicillin disodium was effective in the treatment of 91% (54) of 59 infections caused by Pseudomonas organisms. However, 7% (4) of the infections responded only partially, and 10% (6) relapsed when therapy was discontinued. The response rate and relapse rate did not correlate very closely with the results of in vitro sensitivity testing. Only 7% (4) of the strains of pseudomonas became resistant during carbenicillin therapy, and there has been no major increases in carbenicillin-resistant isolates at the University of Texas M. D. Anderson Hospital and Tumor Institute since the widespread usage of this antibiotic was begun. The frequency of pseudomonas as a cause of fatal infection in adults with leukemia has decreased from 31% to 8% (8 deaths) since carbenicillin has been introduced. Superinfection occurred in 17% (10) of the patients receiving this drug. Toxic effects were minimal and consisted mainly of transient elevations in serum glutamic oxaloacetic transaminase and serum glutamic pyruvic transaminase levels.

M\ EASUREMENTS of activity levels of enzymes in the blood have proven to be valuable diagnostic aids in human medicine. Elevated levels of glutamic oxalacetic transaminase (GOT), glutamic pyruvic transaminase (GPT), lactic dehydrogenase (LDH), and malic dehydrogenase (MDH) have been associated with certain pathological conditions. The pos'sible significance of determinations of the levels of these enzymes as aids in the diagnosis of avian diseases has not been investigated. Cornelius, et al., however, did observe elevated plasma GOT levels in chickens with inherited muscular dystrophy.2

To the Editor:— Within the past five months, we have cared for five patients with acute hepatic coma occurring as a result of massive hepatic necrosis. This letter is written to relate our experiences because of considerable current interest in the treatment of this problem. Exchange transfusions were performed in four of the patients, of whom one survived. He is a 48-year-old white man who ingested a pint of carbon tetrachloride in a suicide attempt and became comatose four days later. His peak serum glutamic pyruvic transaminase (SGOT) was > 6,500 units and peak prothrombin time 30 seconds ( 12 second control). He received an exchange transfusion of 6 liters of whole blood and awoke 27 hours later at a time when his prothrombin time was 26 seconds and bilirubin level was climbing. Additional therapy included neomycin but no steroids. The other three patients who did not survive had the following