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Background: Congenital pseudocholinesterase (pChe) deficiency is a rare genetic abnormality which may lead to prolonged duration of action of muscle relaxants that are hydrolysed by pChe. We describe two cases in which mivacurium resulted in neuromuscular block lasting several hours., Case Reports: Two non-related male patients, aged 26 and 7 years, scheduled for elective ENT surgery, received propofol, desflurane, remifentanil and mivacurium. At the end of the surgery it was not possible to reverse the neuromuscular blockade, and there were no responses to TOF or post-tetanic stimulation. Neuromuscular transmission returned spontaneously after 7, and 4 h, respectively. Postoperative assay revealed severe pChe deficiency in both patients, with values of 3393 UL(-1)and 2558 UL(-1), respectively (normal range 5100-11700 UL(-1). Family screening confirmed the presence of pChe deficiency in both cases., Conclusion: In any case of unexpected prolonged muscle relaxation after mivacurium, pChe deficiency should be considered and its activity measured.When confirmed, careful family screening is mandatory.

Activities of aspirin esterase, EC 3.1.1.55 and cholinesterase, EC 3.1.1.8 were measured in sera of 106 healthy blood donors. Surprisingly high correlation of these two activities has been observed. Aspirin esterase exhibited about 10 times lower activity than cholinesterase, when expressed in mkat/L.

Paraneoplastic Lambert-Eaton myasthenia syndrome is presented in two cases with small cell lung cancer. An increase of serum cholinesterase activity was explained by induced release of biologically active proteins by neoplastic tissue.

Male white rats were given with drinking water detergents: sodium alkylbenzenosulphonate /ABSNa/S/ and Rokamid MRZ 17, Group I/control/received tap water. Groups II, III and IV were given ABSNa/S in doses of 2, 6 or 18 mg/l of water, and groups V, VI and VII were given Rokamid MRZ 17 in the same concentrations. After 10 months of exposure to these detergents haematological tests were done: haemoglobin level, haematocrit value and clotting time; biochemical investigations included blood cholinesterase activity, bilirubin and cholesterol levels in plasma. Then memory potential was tested by teaching the rats differentiation and memorizing of visual stimuli in a cage specially adapted for that purpose. On the ground of the obtained results it can be said that in the groups receiving Rokamid MRZ 17 in 18 mg/l concentration and ABSNa/S 6 and 18 mg/l the median survival was decreased by over ten per cent, and blood clotting time was prolonged in relation to the control group. The results of conditioning tests showed that the highest concentration of Rokamid MRZ 17 produced memory impairment in this group.

Organic insecticides used in agriculture and drugs often taken without medical control remain an important source of intoxication. The significance of the problem has been discussed in American medical literature, where toxic and posttoxic damage to the liver is rated second (25%), just after viral damage (40%), like in other highly developed countries. It can be assumed that the leading position of viral damage is the result of difficulties in ascertaining the diagnosis in each case of the disease. Clinical diagnosis of liver damage, in spite of many laboratory methods described and in use, leaves a margin of uncertainty and error. The diagnosis relies heavily on the activity of enzymes characteristic for morphologic and functional status of the liver. The determination of enzyme activities in plasma is also one of the basic diagnostic tools in the toxicology clinic in all cases of intoxication by hepatotoxic compounds. Toxicological recognition of acute intoxications relies on a wide range of biochemical tests and enzyme indices to evaluate the extent of damage by xenobiotics to organs. Usually the tests are selected in a clinical setting when the cause of intoxication is known. The present data were supplemented with activities of AspAT and AlAT determined during hospitalization of the patients. This choice acknowledged the wide-spread use of these tests and their organ specificity. All parameters in the control group were within normal limits described in the literature. For patients with phosphoroorganic or carbaminate intoxications (Ia) the activity of AECh and ECh proved to be a specific and sensitive parameter. In these cases both activities showed large, significant drops, confirming earlier reports advocating the use of these tests in insecticide intoxications. (Tab. 1-3). Among clinical symptoms frequently accompanying intoxication by ethylene glycol (Ib) one would mention metabolic acidosis, kidney damage and narcotic action of the glycol on the CNS. Little attention has been devoted to the hepatotoxic action of this compound. In the present study activities of the aminotransferases deviated slightly from normal. The DeRitis index was also within normal limits. However, the activity of AACo in this group of patients differed significantly from the control values. In the group of patients with Amanita phalloides poisoning (Id) the most sensitive indicator of liver damage proved to be AACo. The activity of this enzyme was significantly higher than in the remaining groups. The rise of activity of this enzyme was significantly higher than in the remaining groups. The rise of activity preceded by a few hours the appearance of increased aminotransferase activity which was observed near the end of the second day after intoxication. In the group of patients with chronic active hepatitis (II) the only parameter within normal limits was ECh. This finding supports earlier reports as to the relatively late decrease in the rate of synthesis of this enzyme in liver diseases. The use of toxogonine in vitro to discriminate between ECh and AECh in intoxications and liver diseases was decided upon basing on numerous reviews describing the clinical applications of this agent. The results of agent in the toxogonine test are in line with the disruptive action to toxogonine on the enzyme-insecticide complex in vitro, probably similar to the situation in the living organism. The observed elevation in AECh activity after the enzyme was inhibited by the phosphoro-organic pesticide, observed 30 minutes since the addition of toxogonin, averaged 86% +/- 25%. In the case of carbaminate insecticides the addition of toxogonine was followed by a further decrease in esterase activity and only a few samples showed an increase, but not exceeding 25%. No effect of toxogonine was seen in the case of serum cholinesterase and after 30 minutes the activity continued to fall.

The aim of the study was to evaluate the suitability of enzymatic tests for estimating the effects of organic solvents upon the organisms of daily exposed workers. The analysis was undertaken in 572 workers exposed to such solvents as toluene, xylene, cresols and benzine. Periodical examination was carried out for the purposes of the study. The level of excreting organic solvents' metabolites in urine and serum enzymes' activity were determined. Also, the activity of alanine and aspartate aminotransferases and of plasmatic cholinesterase was determined. The results of the study support the necessity of applying the enzymatic tests as a basic method of evaluating the toxic activity of organic solvents.

The experiments were carried out on male Wistar rats, weighing 200-250 g. The animals received oil or oily solutions of carbaryl, parathion-methyl and IPO62 in doses of 0.5, 0.1 or 0.02 LD50. 1, 2, 4 or 24 h after the administration of pesticides, the activities of ChE and blood glucose level, liver glycogen level, FFA and TG concentrations in serum and TG level in liver were estimated. Comparing the enzymatic changes in acute intoxications with carbaryl, parathion-methyl or IPO62, in the same doses, it was found that mechanisms of efficacy of those compounds had different trends. Changes in the activities of such parameters as ChE in serum, BGR, AspAT and AlAT in serum and liver and blood glucose level depend on the dose of pesticides and this effect is observed for IPO62, parathion-methyl and carbaryl.

The work has been aimed at investigating the effects of organic solvent-toluene-upon the painters of the Building Joinery Factory. Studies carried out during 1978-1980 showed an increased level of toluene metabolite (hippuric acid) in painters' urine, as compared to the environmental control group. The highest level of hippuric acid in painters' urine was found in the first period (first six months) of their job. This was not related to an increase in toluene vapours at the workplace. In painters' blood some irregular and rather small modifications of enzymatic activity were exhibited.

In experiments on toxicity, IWiOL-3-n aerosol as well as vapours and gases obtained by heating the oil up to 500 degrees C were administered by inhalation to experimental animals. No deaths of animals were recorded however, a significant decrease of cholinesterase activity was noted. The experiments were carried out in the specially constructed experimental chambers and the method of determination IWiOL-3-n in the air was developed. After intratracheal insufflation of IWiOL-3-n, rapid decrease of cholinesterase activity in blood serum was also observed. Tests on dermal toxicity showed very good absorption of the oils through the untouched skin.

In 30 workers being occupationally exposed to beryllium, examinations of biochemical indicators of liver efficiency were carried out: activity of alanine and asparagine aminotraspherase and basic phosphatases, cholinesterase, content of total protein and its fraction. Levels of electrolytes were determined: calcium, potassium, phosphorus, and magnesium. The above examinations were also carried out on 30 persons who have no contact with beryllium. The obtained results were subjected to statistical analysis. In 10 persons from the group exposed to beryllium one found lowering of the level of magnesium in blood serum, whereas in the control group the level of this electrolyte was correct in all persons. As to the results on the level of magnesium, in both groups high statistical significance was found (p less than 0,01). A dependence was found between the amount of workers and the lowered level of magnesium in blood serum and the duration of occupational exposure to beryllium. The comparison of the remaining results of examinations of both groups did not reveal any statistically significant differences or the differences were at the point of statistical significance.

In those chronically exposed to manganese the activity of alanine aminotransferase (ALAT), asparagine aminotransferase (AspAT), lactate dehydrogenase (LDH), cholinesterase (ChE) and ceruloplasmin (CPL) was determined. As compared with the control group, only enzymatic activity was statistically decreased. Thus, determination of the mentioned enzymes in blood serum is of little value for evaluation of an early stage of manganese toxic effects.

Serous activity of AspAT, A1AT, LDH, GLDH, AP, ChE was checked, and BSP retention and protein level as well as its electrophoretic division were determined in 42 DDD Plant workers. The subject group was divided into subgroups depending on the degree of exposure to various chemicals and length of occupational exposure. In a considerable percentage of subjects, changes in serous activity of the enzymes concerned and defective BSP retention were found. The biochemical parameters were analysed and a possibility was enhanced of the occurrence of subacute poisonings changing into chronic ones, including liver parenchyma lesion.