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Serum Glutamic Oxalacetic Transaminase (Sgo-T) Determinations in Prostatic Surgery: Report of Cases
THE JOURNAL OF UROLOGY
Vol. 85, No. 3 March, 1961 Copyright © 1961 by The Williams & Wilkins Co. Printed in U.S.A.
SERUM GLUTAMIC OXALACETIC TRANSAMINASE (SGO-T) DETERMINATIONS IN PROSTATIC SURGERY: REPORT OF CASES J.R.REAGAN,F. W. TAYLOR,R. E. HIGGS, C.B.DAYDEN, E. W. IRVINE, JR. AND E. S. IRVINE
It has been repeatedly demonstrated that elevations most commonly occur in the serum level of glutamic oxalacetic transaminase (SGOT) following damage to the myocardium, liver and skeletal muscle1• Some surgical procedures will elevate the transaminase levels, particularly those involving the liver, lungs and skeletal muscle. 2 Studies have also revealed that in the normal person, surgical procedures will not cause sufficient elevations to mask the characteristic curve caused by a myocardial infarction.a Literature includes relatively few reports of SGO-T determinations in prostatic surgery.a, 4 One of us (J.R.) was faced with the problem of an elevated SGO-T in a patient following transurethral resection. This patient had a negative electrocardiogram and no evidence of liver disease. The current study was then undertaken to determine if this elevation could possibly be a result of the operative procedure.
DISCUSSION
Weisberg and Sampsona reported SGO-T levels in 21 surgical cases, 17 of which were major surgical procedures, and 4 were minor. Included in this report was 1 case of suprapubic prostatectomy. No marked elevation in transaminase TABLE
SGO-T (K. Units) Case
MATERIALS AND METHODS
Blood samples were drawn on 20 patients, 8, 12, and 24 hours postoperatively (table 1). Transaminase levels were determined by the Reitman and Frankel colorimetric method, 5 and the results were expressed in Karmen units. By this method, the normal range is from O to 40 units, with 40 to 50 considered borderline. 1 Merrill, J.M., Lemley-Stone, J., Grace, J. T., Jr. and Meneely, G. R.: Recent clinical experiences with serum aminopherase (transaminase) determinations. J.A.M.A., 160: 1454-1456, 1956. 2 Fisk, A. A., Thomas, R. G. and Maurukas, J.: S.G.0.-T. values after cholecystectomy, hysterectomy and operations on fractured hip. Am. J. Med. Sc., 235-236: 133-138, 1958. 3 Weisberg, R. and Sampson, J.: Determination of serum enzymes in surgical patients. Am. Heart J., 57:240-246, 1959. 4 Person, D. A. and Judge, R. D.: Effect of operation on serum transaminase levels. Arch. Surg., 77:892-897, 1958. 5 Reitman, S. and Frankel, S.: A colorimetric method for determination of serum glutamic oxalacetic and glutamic pyruvic transaminases. Am. J. Olin. Path., 28: 56-62, 1957.
1. SG0-'1' levels
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20.
L. C. J.B. M. S. R. L. R.M. R. w. B. N. L. W. W.W. E. S. G. B. P. J.E. E. A. T. K. J.B. G. P. N. E. J.M. G. C. A. L.
Age
75 57 70 53 53 56 64 82 79 56 63 64 68 63 53 63
72
Operation
Tissue Resected -Gms.
Postoperative 12 8 Hrs. Hrs.
24
Hrs.
--- - - -- -- -TUR 28 28 36 17 TUR 12 17 14 14 TUR 20 16 20 23 TUR 18 11 17 14 14 11 TUR 10 26 TUR 12 11 11 11 TUR 48 35 46 59 28 TUR 17 29 TUR 52 30 6 TUR 10 40 36 36 18 TUR 33 33 36 23 23 TUR 23 26 SPP 125 44 44 SPP 80 23 23 23 TUR 55 23 23 23 TUR 30 17 23 17 TUR 18 44 23 67 12 TUR 7 8.5 14 43 TUR 10 10 10 TUR 23 9 9 10
levels was noted. Elevations were exhibited in 3 patients undergoing major surgery. Only one of these was related to surgery; this case was a thoracotomy. Of the remaining 2 patients, one had a myocardial infarction, and the other, biliary obstruction due to carcinoma of the head of the pancreas. Person and Judge4 reported 7 cases of prostatic surgery, in which the highest elevation recorded
334
SERUM LEVELS OF SGO-T IN PROSTATIC SURGERY
at the end of 24 hours was 43, certainly not a significant rise. In the current study, 3 cases exhibited borderline elevations of no clinical significance. These elevations were not correlated with any evident pathology. It must be concluded that significant elevations in SGO-T levels, following prostatectomy, cannot be attributed to the operative procedure.
SGO-T levels will remain within normal range following prostatecto1ny. Significant elevations exhibited in postoperative patients are indications of one of the pathologic states known to produce such elevations.
SUMMARY AND CONCLUSIONS
1511 Tenth St., Wichita Falls, Texas (J.R.R., F.W.T., R.E.H.) 1505 Tenth St., Wichita Falls, Texas (E. E.S.I.)
Twenty cases of prostatic surgery are reported, in which no significant postoperative elevation in SGO-T levels occurred. In normal individuals,
Appreciation is expressed to JVIrs. Vera J. Brown and Mrs. Dorothy ff Edwards for technical assistance.
Vol. 85, No. 3 March, 1961 Copyright © 1961 by The Williams & Wilkins Co. Printed in U.S.A.
SERUM GLUTAMIC OXALACETIC TRANSAMINASE (SGO-T) DETERMINATIONS IN PROSTATIC SURGERY: REPORT OF CASES J.R.REAGAN,F. W. TAYLOR,R. E. HIGGS, C.B.DAYDEN, E. W. IRVINE, JR. AND E. S. IRVINE
It has been repeatedly demonstrated that elevations most commonly occur in the serum level of glutamic oxalacetic transaminase (SGOT) following damage to the myocardium, liver and skeletal muscle1• Some surgical procedures will elevate the transaminase levels, particularly those involving the liver, lungs and skeletal muscle. 2 Studies have also revealed that in the normal person, surgical procedures will not cause sufficient elevations to mask the characteristic curve caused by a myocardial infarction.a Literature includes relatively few reports of SGO-T determinations in prostatic surgery.a, 4 One of us (J.R.) was faced with the problem of an elevated SGO-T in a patient following transurethral resection. This patient had a negative electrocardiogram and no evidence of liver disease. The current study was then undertaken to determine if this elevation could possibly be a result of the operative procedure.
DISCUSSION
Weisberg and Sampsona reported SGO-T levels in 21 surgical cases, 17 of which were major surgical procedures, and 4 were minor. Included in this report was 1 case of suprapubic prostatectomy. No marked elevation in transaminase TABLE
SGO-T (K. Units) Case
MATERIALS AND METHODS
Blood samples were drawn on 20 patients, 8, 12, and 24 hours postoperatively (table 1). Transaminase levels were determined by the Reitman and Frankel colorimetric method, 5 and the results were expressed in Karmen units. By this method, the normal range is from O to 40 units, with 40 to 50 considered borderline. 1 Merrill, J.M., Lemley-Stone, J., Grace, J. T., Jr. and Meneely, G. R.: Recent clinical experiences with serum aminopherase (transaminase) determinations. J.A.M.A., 160: 1454-1456, 1956. 2 Fisk, A. A., Thomas, R. G. and Maurukas, J.: S.G.0.-T. values after cholecystectomy, hysterectomy and operations on fractured hip. Am. J. Med. Sc., 235-236: 133-138, 1958. 3 Weisberg, R. and Sampson, J.: Determination of serum enzymes in surgical patients. Am. Heart J., 57:240-246, 1959. 4 Person, D. A. and Judge, R. D.: Effect of operation on serum transaminase levels. Arch. Surg., 77:892-897, 1958. 5 Reitman, S. and Frankel, S.: A colorimetric method for determination of serum glutamic oxalacetic and glutamic pyruvic transaminases. Am. J. Olin. Path., 28: 56-62, 1957.
1. SG0-'1' levels
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20.
L. C. J.B. M. S. R. L. R.M. R. w. B. N. L. W. W.W. E. S. G. B. P. J.E. E. A. T. K. J.B. G. P. N. E. J.M. G. C. A. L.
Age
75 57 70 53 53 56 64 82 79 56 63 64 68 63 53 63
72
Operation
Tissue Resected -Gms.
Postoperative 12 8 Hrs. Hrs.
24
Hrs.
--- - - -- -- -TUR 28 28 36 17 TUR 12 17 14 14 TUR 20 16 20 23 TUR 18 11 17 14 14 11 TUR 10 26 TUR 12 11 11 11 TUR 48 35 46 59 28 TUR 17 29 TUR 52 30 6 TUR 10 40 36 36 18 TUR 33 33 36 23 23 TUR 23 26 SPP 125 44 44 SPP 80 23 23 23 TUR 55 23 23 23 TUR 30 17 23 17 TUR 18 44 23 67 12 TUR 7 8.5 14 43 TUR 10 10 10 TUR 23 9 9 10
levels was noted. Elevations were exhibited in 3 patients undergoing major surgery. Only one of these was related to surgery; this case was a thoracotomy. Of the remaining 2 patients, one had a myocardial infarction, and the other, biliary obstruction due to carcinoma of the head of the pancreas. Person and Judge4 reported 7 cases of prostatic surgery, in which the highest elevation recorded
334
SERUM LEVELS OF SGO-T IN PROSTATIC SURGERY
at the end of 24 hours was 43, certainly not a significant rise. In the current study, 3 cases exhibited borderline elevations of no clinical significance. These elevations were not correlated with any evident pathology. It must be concluded that significant elevations in SGO-T levels, following prostatectomy, cannot be attributed to the operative procedure.
SGO-T levels will remain within normal range following prostatecto1ny. Significant elevations exhibited in postoperative patients are indications of one of the pathologic states known to produce such elevations.
SUMMARY AND CONCLUSIONS
1511 Tenth St., Wichita Falls, Texas (J.R.R., F.W.T., R.E.H.) 1505 Tenth St., Wichita Falls, Texas (E. E.S.I.)
Twenty cases of prostatic surgery are reported, in which no significant postoperative elevation in SGO-T levels occurred. In normal individuals,
Appreciation is expressed to JVIrs. Vera J. Brown and Mrs. Dorothy ff Edwards for technical assistance.