HBsAg 양성자에 있어서의 HBe 항원 및 간기능검사에 대한 고찰

배기택,김병성,최원충 인제대학교 1990 仁濟醫學 Vol.11 No.2

건강관리과 신체 검사에서 발견된 473명의 HBsAg 양성자를 대상으로 HBeAg 및 transaminase치를 추적 조사하여 HBeAg 양성률이 45.1%, transaminase 상승률이 28.5%이고 HBsAg 보균자가 지속될 확률은 98% 이상임을 밝혀냈다. Among those who received regular health examination at health center, 473 HBsAg carriers were followed for 5 years with serial measurements of transaminase levels, hepatitis B surface antigen (HBsAg), hepatitis Be Ag(HBeAg). Male to female ratio was 4.7:1 and the average age was 32 in male, 26 in female. Persistent HBsAg positive rate was 98.7% and HBsAg was seroconverted to negative in 6.4%. The HBeAg positivity rate among HBsAg carriers was 45.1%, and seroconversion late of HBeAg was 4.3%. Transaminase levels were elevated in 28.5% of the HBsAg carriers. The proportion of abnormal transaminase levels in HBeAg positive carriers (42.9%) were significantly higher than that of HBeAg negative carriers (20.2%)(P<0.005) and the Odds ratio was 2.96. The 24 clients out of 135 carriers (17.8%) who had elevatd transaminase levels were normalized and the average duration was 7.1±7.0 months.

활력증후가 안정적인 복부둔상 환자에서 증가된 liver transaminase치가 가지는 간손상 진단의 임상적 의의

김주현,김영식,김상철,김호중,김선만,이부수 대한응급의학회 2003 대한응급의학회지 Vol.14 No.3

Purpose: A patient at the emergency department (ED) with blunt abdominal trauma may still have the possibility of liver injury, even though they are hemodynamically stable. Computed tomography (CT) scanning or ultrasonography (US) is available if they are hemodynamically stable. However ultrasonography (US) has technical differences between physicians depending on their skill and computed tomography (CT) is expensive and time consuming, while liver transaminase is widely available, relatively inexpensive. Therefore, we studied diagnostic value of liver transaminase as a screening test for liver injury in hemodynamically stable patients with blunt abdominal trauma. Methods: From March 2000 to February 2001, we treated 44 hemodynamically stable patients with suspected blunt abdominal trauma who were patients with elevated liver transaminase. An evaluation protocol including patient' s age, sex, injury mechanism, history, physical examination, Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), Injury Severity Scale (ISS), liver transaminase, abdominal US and abdominal CT was prospectively performed on all patients by residents and the staff of the emergency department. Based on the confirmed diagnosis of abdominal CT, patients were divided into two groups: groupⅠwith liver injury and group Ⅱ without liver injury. We analysed the two groups by using the t-test and the chi-square test, and calculated the sensitivity, the specificity and the predictive value of serum aspartate aminotransferase (AST) and serum alanine aminotransferase (ALT) by using multiple cutoff values. Results: There were 34 male patients (76.3%) and 10 female patients (23.70/o) and the average age of all patients was 37 years. Triage RTS and GCS were, respectively, 11.7±0.7 and 13.9±2.1 in group Ⅰ, and 11.4±1.2 and 13.2±3.5 in group Ⅱ, the differences between the two groups were statistically insignificant. The ISS was 26.8±9.4 in group Ⅰ and 21.1±8.0 in group Ⅱ, and the differences was statistically significant. AST and ALT were, respectively, 288.0±113.7 IU/L and 177.9±95.8 IU/L in group I and 148.1±84.8 IU/L and 95.1+59.8 IU/L in group Ⅱ. The maximum value of the highest sensitivity and minimal specificity of AST and ALT, calculated using the receiver operator curve, were AST > 256.3 IU/L and/or ALT > 122.0 IU/L, for which the sensitivity and the specificity were 61.1% and 84.6%, and the positive and the negative predictive values were 73.3% and 75.8%, respectively. Conclusion: We recommend that all patient with suspected blunt abdominal trauma be evaluated using serum liver transaminase as a screening test for liver injury even though they are hemodynamically stable. If AST > 256.3 IU/L and/or ALT 122.0 >IU/L, they should be evaluated with abdominal CT to confirm liver injury.

De Ritis Ratio (Aspartate Transaminase/Alanine Transaminase) as a Significant Prognostic Factor With Upper Urinary Tract Carcinoma Who Underwent Radical Nephroureterectomy and Adjuvant Chemotherapy

윤지환(Yoon Jee Hwan),정창욱,곽철,김현회,구자현,유지형,육형동 대한비뇨기종양학회 2022 대한비뇨기종양학회지 Vol.20 No.1

Purpose: To investigate the correlation between preoperative De Ritis ratio (aspartate transaminase [AST]/alanine transaminase [ALT]) and postoperative clinical outcome in patients with upper urinary tract carcinoma (UTUC) who underwent radical nephroureterectomy (RNU) and adjuvant chemotherapy (ACH).Materials and Methods: We respectively analyzed the clinical and pathological data of 102 patients who underwent RNU and ACH for UTUC. Patients were divided into 2 groups, according to the optimal value of AST/ALT ratio. The effect of the AST/ALT ratio was analyzed by the Kaplan-Meier method and Cox regression hazard models for patients’ cancer-specific survival (CSS) and overall survival (OS).Results: Mean survival time was 50.5±41.2 months. Mean age was 61.4±9.7years. Forty-one of the patients (46.5%) were in the high AST/ALT group. According to receiver operating characteristic analysis, the optimal AST/ALT ratio was 1.2. In Kaplan-Meier analyses, the high AST/ALT group showed worse outcomes in OS (p=0.007) and CSS (p=0.011). Using Cox regression models of clinical and pathological parameters to predict OS, high AST/ALT ratio (hazard ratio [HR], 5.428; 95% confidence interval [CI]; 1.803–16.334; p=0.002), pathological T3 (pT3) or higher (HR, 1.464; 95% CI; 1.156-1.857; p=0.002), and to predict CSS, high AST/ALT ratio (HR, 4.417; 95% CI; 1.545–12.632; p=0.005), and pT3 or higher (HR, 1.475; 95% CI; 1.172–1.904; p=0.002) were determined as independent prognostic factors.Conclusions: Pretreatment AST/ALT ratio is a significant independent predictor of CSS and OS in advanced UTUC patients receiving systemic ACH after RNU.

초음파로 진단된 지방간의 혈중 transaminase, 비만도와의 상관 관계

이현경,김지용,이성우 東國大學校醫學硏究所 1995 東國醫學 Vol.3 No.-

초음파 검사에서 지방간을 시사하는 주요한 소견은 간실질 에코의 증가, 음향 감쇄의 증가, 간내 혈관의 경계와 횡격막이 잘 보이지 않는 것 등이 있으나, 이와같은 소견이 어느 정도 환자의 임상적 상태를 반영하는가 평가하기 어렵다. 본 연구에서는 일반 건강 검진을 실시한 남자 근로자 602명을 대상으로 복부 초음파를 시행하여 정상인 군과 지방간인 군을 grade 1, 2, 3으로 분류하고 초음파로 분류된 지방간의 정도가 임상적 간 기능 장애의 지표인 혈중 transaminase의 치와, 비만도의 지표인 체용적 지수(BMI)와의 상관관계를 분석하였다. 지방간을 가진 군에서 정상인 군에 비해 통계적으로 유의하게 transaminase 치와 체용적 지수(BMI)가 높았을 뿐 지방간 각 군 사이에는 grade가 높아짐에 따라 통계적으로 유의한 증가가 보이지 않았다. 결론적으로 초음파상 지방간의 중증도가 임상적 간 기능 장애의 정도를 반영하지 않는 것으로 사료된다. The important sonographic findings of the fatty liver are echogenecity of liver, acoustic attenuation, and visualization of the portal vein and the diaphragm, but it is difficult assessing these findings are representing the clinical status of the fatty liver. The screening abdominal ultrasonogram has performed in 602 males and we divided normal group and fatty liver group 1, 2, 3, which is based on sonographic examination. We analyzed the relation between severity of the fatty liver and serum transaminase, body mass index. The fatty liver groups are higher percentage of supranormal value in serum transaminase and body mass index than normal group, but there was no supranormal value between interfatty liver groups. Conclusively, the severity of the fatty liver on sonographic examination do not representing the status of clinical impairment of hepatic function.

한국인 산부혈청 Transaminase에 대하여

박성관(SK Park) 대한산부인과학회 1965 Obstetrics & Gynecology Science Vol.8 No.11

The serum transaminase determinations were taken by Sigma-Frankel method in 20 healthy non-pregnant women, 22 normal full-term paturients and 22 acute toxemia patients. Following are the results. 1. Non-Pregnant healthy women. (1) SGO-T. Mean 17.07 +/- 9.37 U/ml. Range 3-35 U/ml. (2) SGP-T. Mean 16.15 +/- 13.11 U/ml. Range 4-33 U/ml. Over 30 U/ml in the 2 cases (Table 2). 2. Normal full-term paturients. (1) SGO-T. Mean 20.65 +/- 9.05 U/ml. Range 6.5-43 U/ml. Over 40 U/ml in the one case. (2) SGP-T. Mean 19.06 +/- 6.77 U/ml. Range 11-40 U/ml. Over 30 U/ml in the one case(Table 4). 3. Acute toxemias. (1) SGO-T. Mean 36.09 +/- 16.11 U/ml. Range 15.5-90 U/ml. Over 40 U/ml in the 7 cases(32%). (2) SGP-T. Mean 24.43 +/- 10.23 U/ml. Range 6-43 U/ml. Over 30 U/ml in the 5 cases(23%)(Table 6). According to the results of present investigation, it is considered that determination of the serum transaminase activity is significant to study the degree of liver damage in toxemias, Otherwise, I am not sure but it may be little contributive to diagnose acute toxemias.

Genome-Wide Association Study of Liver Enzymes in Korean Children

박태준,황주연,고민진,이혜자,장한별,최영심,강재헌,박경희,최민규,송지현,김봉조,이종영 한국유전체학회 2013 Genomics & informatics Vol.11 No.3

Liver enzyme elevations, as an indicator of liver function, are widely associated with metabolic diseases. Genome-wide population-based association studies have identified a genetic susceptibility to liver enzyme elevations and their related traits; however, the genetic architecture in childhood remains largely unknown. We performed a genome-wide association study to identify new genetic loci for liver enzyme levels in a Korean childhood cohort (n = 484). We observed three novel loci (rs4949718, rs80311637, and rs596406) that were multiply associated with elevated levels of alanine transaminase and aspartate transaminase. Although there are some limitations, including genetic power, additional replication and functional characterization will support the clarity on the genetic contribution that the ST6GALNAC3, ADAMTS9, and CELF2 genes have in childhood liver function.

Genome-Wide Association Study of Liver Enzymes in Korean Children

Park, Tae-Joon,Hwang, Joo-Yeon,Go, Min Jin,Lee, Hye-Ja,Jang, Han Byul,Choi, Youngshim,Kang, Jae Heon,Park, Kyung Hee,Choi, Min-Gyu,Song, Jihyun,Kim, Bong-Jo,Lee, Jong-Young Korea Genome Organization 2013 Genomics & informatics Vol.11 No.3

Liver enzyme elevations, as an indicator of liver function, are widely associated with metabolic diseases. Genome-wide population-based association studies have identified a genetic susceptibility to liver enzyme elevations and their related traits; however, the genetic architecture in childhood remains largely unknown. We performed a genome-wide association study to identify new genetic loci for liver enzyme levels in a Korean childhood cohort (n = 484). We observed three novel loci (rs4949718, rs80311637, and rs596406) that were multiply associated with elevated levels of alanine transaminase and aspartate transaminase. Although there are some limitations, including genetic power, additional replication and functional characterization will support the clarity on the genetic contribution that the ST6GALNAC3, ADAMTS9, and CELF2 genes have in childhood liver function.

복부 둔상 환자에게 간 손상 예측을 위한 Liver Transaminase의 유용성

이종석 ( Jong Seok Lee ),오성찬 ( Sung Chan Oh ),김혜진 ( Hye Jin Kim ),조석진 ( Suk Jin Cho ),이상래 ( Sang Lae Lee ),류석용 ( Seok Yong Ryu ) 대한외상학회 2010 大韓外傷學會誌 Vol.23 No.2

Purpose: The liver is the second most common organ injured by blunt abdominal trauma. The purpose of this study was to determine the utility of liver transaminase in screening blunt abdominal trauma patients for traumatic liver injury. Methods: We retrospectively reviewed the medical records of 231 patients who sustained blunt trauma and were at risk for traumatic liver injury between June 2009 and August 2010. All of them underwent a focused assessment with sonography for trauma (FAST) and abdominal computed tomography (CT). Based on the diagnosis of abdominal CT, patients were divided into two groups: group I with liver injury and group II without liver injury. We compared the two groups and calculated the sensitivity, the specificity and the predictive values of serum aspartate aminotransferase (AST) and serum alanine aminotransferase (ALT) by using multiple cutoff values. Results: Of 231 patients with no abdominal free fluid in the FAST, 33 had traumatic liver injury on abdominal CT. The mean AST and ALT levels in group I (311.6 IU/L and 228.1 IU/L, respectively) were significantly higher than the values in group II (48.4 IU/L and 35.6 IU/L, respectively). The cutoff to distinguish liver injury is 60 IU/L for AST and 58 IU/L for ALT, with 93.8% sensitivity and 79.8% specificity for AST, and 90.6% sensitivity and 87.4% specificity for ALT. Conclusion: We recommend that all patient with suspected blunt abdominal trauma be evaluated using serum liver transaminase as a screening test for liver injury even though no abdominal free fluid is shown on the FAST. If AST > 60 IU/L and/or ALT > 58 IU/L, abdominal CT was useful to confirm liver injury in this study (J Korean Soc Traumatol 2010;23:151-156).

Association between De Ritis ratio and intraoperative blood transfusion in patients undergoing surgical clipping of unruptured intracranial aneurysms: a single center, retrospective, propensity score-matched study

Sim Ji-Hoon,Kim Chan-Sik,Ha Seungil,Kim Hyunkook,박용석,Kim Joung Uk 대한마취통증의학회 2024 Korean Journal of Anesthesiology Vol.77 No.2

Background: Although elective surgery for unruptured intracranial aneurysms (UIA) has increased, few studies have evaluated the risk factors for transfusion during UIA surgery. We evaluated the association between the preoperative De Ritis ratio (aspartate transaminase/alanine transaminase) and the incidence of intraoperative transfusion in patients who had undergone surgical UIA clipping. Methods: Patients who underwent surgical clipping of UIA were stratified into two groups according to the preoperative De Ritis ratio cutoff levels (< 1.54 and ≥ 1.54), and the propensity score (PS)-matching analysis was performed to compare the incidence of intraoperative transfusion. Logistic regression analyses were performed to determine the risk factors for intraoperative transfusion. Net reclassification improvement (NRI) and integrated discrimination improvement (IDI) analyses were performed to verify the improvement in the intraoperative transfusion predictive model upon addition of the De Ritis ratio. Results: Intraoperative transfusion incidence was 15.4% (77/502). We observed significant differences in the incidence of intraoperative transfusion (16.2% vs. 39.7%, P = 0.004) between the groups after matching. In the logistic regression analyses, the De Ritis ratio ≥ 1.54 was an independent risk factor for transfusion (odds ratio [OR]: 3.04, 95% CI [1.53, 6.03], P = 0.002). Preoperative hemoglobin (Hb) value was a risk factor for transfusion (OR: 0.33, 95% CI [0.24, 0.47], P < 0.001). NRI and IDI analyses showed that the De Ritis ratio improved the intraoperative blood transfusion predictive models (P = 0.031 and P = 0.049, respectively).Conclusions: De Ritis ratio maybe a significant risk factor for intraoperative transfusion in UIA surgery.

Quantitative Analysis of γ-aminobutyric Acid by Complementary Cell-free Protein Synthesis Wired with a Transamination Reaction

You jin LEE,Hye jin LIM,So jung LEE,Dong-Myung KIM 한국생물공학회 2021 한국생물공학회 학술대회 Vol.2021 No.10

Complementary cell-free protein synthesis (CCFPS) assay is a method to analyze amino acids by the activity of cell-free synthesized reporter proteins. For example, a reaction mixture for cell-free protein synthesis is prepared in the absence of alanine. Due to the lack of an amino acid, this reaction mixture is not capable of producing synthesis of a reporter protein. Upon the addition of an assay sample containing alanine, however, the set of 20 amino acids is completed to produce functional reporter protein. γ-aminobutyric acid (GABA) is major inhibitory neurotransmitter in the central nervous systems of mammals. Besides blocking impulses between nerve cells, numerous functions of GABA have been reported including antihypertension, anti-diabetes, anti-cancer, anti-inflammation, and intestinal protection [1-4]. In this study, we designed a versatile method that enables facile and accurate measurement of GABA by the CCFPS assay combined with transaminase-mediated synthesis of alanine from GABA. After conversion of GABA into alanine by a transaminase, the concentration of generated alanine was measured based on the activity of cell-free synthesized reporter protein. The modular nature of this method enables the use of a variety of measuring instrument by programming the assay solution with the genes of appropriate reporter proteins. Depending on the experimental settings and demanded sensitivity, for example, the assay can be customized to measure GABA concentration by fluorescence, luminescence, and electric signals. Our results demonstrate that the translational machinery can be harnessed to convert a metabolic analyte to readily measurable reporter proteins.