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The present study was conducted to determine the concentration of amino acids in the cerebrospinal spinal fluid (CSF) and the activities of two tramsaminases: glutamic oxaloacetate transaminase (GOT) and glutamic pyruvate transaminase (GPT) in human Alzheimer disease (AD) and normal brain. L-glutamic acid, L-glutamine and L-alanine are the most abundant amino acids in the CSF (50-55% of total amino acids). L-glutamine occurs at much higher levels in Alzheimer CSF compared to the normal CSF (229+/-91.8 nmol/ml in AD versus 107+/-47.2 nmol/ml in normal; P=0.0041). In contrast, L-aspartate occurs at significantly lower concentrations in Alzheimer CSF than normal CSF (46.1+/-25.7 nmol/ml in Alzheimer versus 95.2+/-52.6 nmol/ml in normal; P=0.020). In Alzheimer brain (frontal, parietal and occipital cortices) GOT is present at significantly higher activities than in normal brain cortices (about 1.5 times higher; P<0.01). No significant differences for GPT activity occurred between normal and AD brain. Since CSF receives amino acids from brain tissues, and since GOT catalyzes the conversion of L-aspartate to L-glutamate, the higher concentrations of L-glutamine (which is derived from L-glutamate), and the lower concentrations of L-aspartate found in Alzheimer CSF could be considered as a consequence of the higher activity of GOT that occurs in Alzheimer brain.

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Postmortem biochemical indices may provide a useful adjunct to morphological studies in the identification of antemortem brain insult. We studied 34 routine medico-legal cases categorising them into one of four diagnostic groups. There were 11 cases of head trauma, 7 of 'hypoxia' (3 hangings and 4 carbon monoxide or drug poisonings), 7 sudden cardiac deaths and 9 miscellaneous cases. Survival time and postmortem interval was known for each case. The degree of cranio-cerebral trauma was graded. Cerebro-spinal fluid (CSF) and vitreous humour were analysed for calcium, glucose, total proteins, aldolase, aspartate transaminase (AST), alanine transaminase (ALT), gamma glutamyltransferase (GGT), lactate dehydrogenase (LDH), creatine kinase (CK) and creatine kinase BB isoenzyme (CK-BB). CK-BB was also measured in superior vena cava serum. In CSF there was a significant correlation between the severity of cranio-cerebral trauma and levels of aldolase, CK-BB, AST, ALT and total proteins. CSF CK-BB, median units/l (range), for the groupings of head trauma, hypoxia, sudden cardiac death and miscellaneous were respectively 823 (2-3431); 96 (2-187); 4 (2-25); 5 (1-69). Corresponding serum CK-BB levels were 240 (28-322); 390 (26-411); 180 (20-482); 79 (18-530).

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As far as the pathogenesis of poisonings with organophosphorus pesticides is concerned, in addition to irreversible inhibition of acetylcholinesterase (AGE) in tissues, of importance are changes in the other systems which essentially determine the outcome of intoxication. The purpose of the present study was to examine the nature of changes occurring in total protein and protein fractions, free amino acids (aspartic and glutamic acids, glycine, isoleucine, leucine) and in certain enzymes (AST, ALT, CP, GGTP, GDH) in the cerebrospinal fluid (CSF) of patients with acute Malathion insecticide poisoning. 137 patients aged 20 to 50 years were placed under observation. There were 77 men and 60 women. 40 persons had poisoning of medium gravity and 97 were severely poisoned. The intake of the CSF was performed on days 1, 3, 10, 14 and 21 since the disease onset. It has been established that in acute Malathion insecticide poisoning, the CSF content of the stimulating mediator amino acids, aspartic and glutamic, rises within the early periods, whereas the concentration of the inhibitory mediator glycine decreases. The changes in protein fractions of the CSF are characterized by a fall of the content of globulins and a rise of albumins, thus attesting to the predominance of pathological processes in the brain, especially in the initial period of intoxication, and to the impairment of the blood-brain barrier. The development of intoxication is associated with activation in the CSF of LDN, CP, GGTP and GDH as well as by activation of LDH isozymes which is viewed as the result of the membranotoxic effect of a Malathion insecticide.

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The study was performed to evaluate the levels of some enzymes (AST, ALT, HGTP, LDG) and free amino acids (aspartic, glutaminic, glycine, isoleucine, leucine) in liquor of 37 subjects who got poisoned with a Malathion insecticide. Their condition was diagnosed as moderate and severe. The liquor was obtained on poisoning day 1, 3, 10, 14 and 21. The liquor levels of enhancement mediatory amino acids, aspartic and glutaminic, rise early in poisoning, while concentration of inhibition mediator glycine tends to decline. Progress of intoxication brings about a rise in LDG and GGTP activity attributed to a membranotoxic effect of the insecticide.

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In the paper are presented the results of total enzyme activity investigation: GOT, GPT, LDH and CPK, and of the CPK isoenzymes in the cerebrospinal fluid of 148 examinees and in the serum of 67 examinees with an acute stroke, who were treated at the Intensive Care Unit of the Department of Neurology and Institute of Neuropathology, Clinical Medical center "Rebro". The aim was to determine the reliability of the applied methods in the diagnosis of cerebrovascular diseases, particularly in the differential diagnosis of cerebral hemorrhage, ischemia and subarachnoidal hemorrhage. The highest frequency of pathologic findings of the tested enzymes in the whole group of patients with CVA was obtained in the determination of the CPK total activity assessment, then followed the assessments of LDH activity, isoenzyme CPK profile, GOT and finally GPT activity. A larger number of pathologic findings of all mentioned enzymes and CPK isoenzymes was found in the group of patients with ICH. In the patients with ICH and ISI, who survived stroke a higher incidence of normal findings of the total enzymic activities was found, while in those who died from ICH a higher incidence of pathologic findings could not be established. The correlations between the total CPK activity in the serum and in the cerebrospinal fluid does not exist, as well as the correlation between the CPK isoenzyme profile in the serum and CSF.

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A study of the activity of alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, lactate and pyruvate in the CSF of patients with head injuries in the acute period revealed a high activity of the above enzymes and increased content of lactate as compared with a control group of patients. The activity of alanine aminotransferase and aspartate aminotransferase as well as the content of lactate showed a tendency to rise in patients with an unfavourable outcome of the disease.

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Gamma glutamyl transpeptidase (GGTP), glutamic oxaloacetic transaminase (GOT), and glutamic pyruvic transaminase (GPT) were measured serially in the serum and cerebrospinal fluid (CSF) of 22 patients with fresh stroke and an equal number of age- and sex-matched healthy control subjects. It was observed that levels of these enzymes in the CSF of control subjects were very low but were significantly elevated (p less than 0.001) in both serum and CSF in patients with stroke. The elevation was greater in the CSF than in the serum and was maximum during the first four days of stroke. Thereafter, the enzymatic activity declined. Of all these enzymes, GGTP in CSF correlated best with the clinical picture. It was possible to differentiate between the ischemic and hemorrhagic type of stroke on the basis of CSF levels of GGTP (greater than 60.0 units in hemorrhagic stroke). There was no correlation between GGTP levels in CSF and serum or among GOT, GPT, and GGTP in CSF. It can be concluded, therefore, that estimation of GGTP in CSF is helpful not only in predicting the degree of cerebral damage and functional outcome of the patient following stroke but also in differentiating the type of stroke.

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Having studied the clinical picture and changes in the activity of various enzymes in the cerebrospinal fluid (CSF) in 140 patients with cerebral strokes, the authors showed a diagnostic and prognostic value of determining the activity of LDH and GGTP in the CSF. The activity of these enzymes increased in hemorrhagic stroke and in cases of unfavourable outcome. Their activity was lower in ischemic stroke and in cases of a favourable course of the disease.

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Examination of 234 cases with cerebral stroke showed that the activity of enzymes in the cerebrospinal fluid (CSF) of these patients increased as compared to the control group. In hemorrhagic strokes their activity was considerably higher than in ischemic ones. In 92 cases the results of examination were compared to sectional findings. The activity of enzymes was affected by numerous factors including the speed of stroke development, its nature, the size of the focus, the distance of the latter from the CSF pathways, and the severity of brain oedema.

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The authors have examined the activities of the enzymes GOT, CPT, CK, LDH, gamma-GT, PCHE and ALP in the cerebrospinal fluid of 50 patients with various neurological diseases. The results obtained show that many activities constantly and remarkably increase in few diseases of the nervous system. Particularly, GOT, GPT, LDH and ALP demonstrated raised values in the meningitis; LDH, CK, GOT, GPT in the brain tumors; CK and LDH in the hydrocephalus. A comparison between the results of the protein and enzyme determinations in the cerebrospinal fluid of the same patients, revealed in the enzymologic reactions a more precocious and sensitive indicator of initial brain lesions.

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Under examination there were 420 children suffering from epilepsy. In 230 of them the convulsive seizures appeared during the first year of the life: in most of these children (71%) this was in the presence of perinatal pathology. A genealogical analysis of 112 families, from which 135 epileptic children descended, is presented. Various types of hereditary epilepsy were revealed. An examination of some enzymes contained in the cerebrospinal fluid of the epileptic patients revealed shifts in their metabolism in cases of both hereditary and sporadic epilepsy. This reflects common features of the pathogenesis of those forms.

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The CPK, aldolase, GOT, GPT, and LDH concentrations in the serum and lumbar CSF of 80 patients with neuromuscular diseases and 20 controls were measured. The value obtained in serum was essentially in agreement with the data in the literature. This is the first publications reporting on regular CSF enzyme examinations in different neuromuscular disorders, particularly the results obtained in neurogenic muscular atrophies, which have certain characteristic features. The LDH activity in CSF was decreased in peroneal muscular atrophy, the GPT concentration in CSF was elevated in spinal muscular atrophy, and the mean activity of CSF aldolase was increased in amyotrophic lateral sclerosis. The simultaneous determination of enzymes in serum and CSF can provide valuable information in the research of certain details of pathomechanisms and thus lead to further improvement of diagnosis.

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Glutamic oxalacetic and glutamic pyruvic transaminase levels in CSF and blood were estimated in 25 normal individuals and 50 patients with varying grades of head injury. CSF GOT, and to a lesser extent GPT, showed significant elevation proportionate to the degree of brain injury. Serum GOT was raised in more severe injuries. CSF GOT and GPT levels showed a significant correlation with the prognosis of the case.

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Antemortem and postmortem sera from 60 dogs were evaluated for lipase, amylase, alkaline phosphatase, gamma-glutamyltransferase, and alanine aminotransferase (AAT); cerebrospinal fluid was examined for AAT and alkaline phosphatase. The postmortem intervals were 3, 6, 12, 24, and 48 h at temperatures of 4, 20, and 37 degrees C. Amylase levels remained stable at 4 and 20 degrees C and may be beneficial for diagnosing pancreatitis. Lipase levels may be useful as an adjunct to amylase values. Serum alkaline phosphatase values increased with postmortem interval; values were higher at 37 degrees C than at 4 degrees C. Other enzymes were of little value for diagnosis.

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Cerebrospinal fluid was obtained from dogs with and without neurological conditions. Enzyme levels were raised in six out of 14 affected dogs but there was a lack of specificity to a particular disease entity.

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