Activities of aminotransferases after treatment with streptokinase for acute myocardial infarction.

reported cytologically as non-neoplastic the cyto-logical specimens were reviewed. In one case from the first year of the study a retrospective cytological diagnosis of papillary carcinoma was made, but in all other cases there were no cytological features suggesting neoplasia, although in two cases the specimens would now be classed as unsatisfactory. Aspiration cytology is an adjunct to the management of thyroid swellings but is not a definitive diagnostic test and, in particular, negative results do not exclude neoplastic disease. Definition of an optimum management policy depends on further study, which should include the financial and psychological implications of repeated clinic attendances and of repeated aspiration, which may culminate in delayed surgical treatment. The role of fine-necdle aspiratiots biopsy in the rapid diagnosis and management of thyroid neoplasm. 8 Schnurer L, Widstrom A. Fine-needle biopsy of the thyroid gland. A cytohistological comparison itt cases of goiter. Robins J. Fine-needle aspiration cytology in the preoperative diagnosis of thyroid nodules.needle aspiration biopsy of thyroid nodules impact on thyroid practice and cost of care. Treatment with streptokinase can increase the serum activities of aspartate aminotransferase and alanine aminotransferase. 2 We examined the activities of aminotransferases in patients who had been treated with streptokinase for acute myocardial infarction to determine the incidence and clinical relevance of this drug reaction. Subjects, methods, and results We examined the case records of 189 patients from Dumfries and Galloway Royal Infirmary who had been entered into the second international study of infarction (ISIS 2)-a placebo controlled trial of streptokinase and aspirin in patients who had had a suspected acute myocardial infarction.3 Of our patients, 95 (64 men, 31 women; mean age 58-9 (SD 8 38) years) had received streptokinase and 94 (71 men, 23 women; mean age 56 8 (8-52) years) had received placebo. Venous blood had been taken for assay of enzyme activity on admission to hospital and then once daily for 72 hours. The figure shows the distribution of the peak activities of aminotransferases as determined from the case records (normal range: aspartate aminotransferase 13-42 U/I, alanine aminotransferase 11-50 U/l). The geometric mean of the peak activity of aspartate aminotransferase was 157 U/l for patients who received streptokinase and 120 U/I for those who received placebo (p<005; ratio 1-31, 95% confidence interval 1-02 to 1-66). The corresponding values for alanine aminotransferase were 60 U/i and 43 U/i (p<0 05; 1 40, 1-15 to 1 76). There …