King-Armstrong unit, serum phosphatase

A circadian variation in serum acid phosphatase has been reported in patients with prostatic carcinoma and phosphatase activity determined with phenyl phosphatase as substrate (DIO). The nocturnal values decreased 25-50% of the highest day time activity. The highest values were observed from 9 am to 3 pm and the lowest between 9 pm and 3 am. In one patient observations were made at hourly intervals. The peak of 14.2 King-Armstrong units was observed at 11 am and the lowest activity, 6.4 units, at midnight. Orchiectomy did not eliminate the variation. 

Fig. 9. Means and standard errors of serum alkaline phosphatase values (King Armstrong units/deciliter) in 63 patients with fractures of the femoral neck. Note the significant but relatively minor rise during the first week. The upper limit of normal by the method employed was 14 King-Armstrong units/deciliter. From Nilsson and Westlin (N5) with permission.

Fig. 10. Serum alkaline phosphatase values (King-Armstrong units/deciliter) in 49 patients with documented bile duct obstruction (solid circles) and in 49 patients with hepatic cirrhosis or hepatitis (open circles). Note the si ficant overlap between the groups. Note also that the highest value in biliary obstruction was Iras than ten times the upper limit of normal. From Hill and Zieve (H14) with permission.

Patients with this disorder characteristically have high serum alkaline phosphatase activities. Only 2 of 100 patients with primary biliary cirrhosis studied by Sherlock and Scheuer (S33) had serum alkaline phosphatase values below 20 King-Armstrong units/dl, whereas 71 had values exceeding 50 King-Armstrong units/dl (Fig. 12). A reduction in serum alkaline phosphatase follows treatment with azathioprine (R30). 

The method of Gutman and Gutman (GIO, G14), an application of the King-Armstrong (K5) method for alkaline phosphatase to acid phosphatase, was described earlier in this paper. The activity by this method was defined in units, as the number of milligrams of phenol liberated in 1 hour at 37°C by 100 ml of serum. These have been fre-... 

Fig. 5. Relation between serum alkaline phosphatase determined in the Auto-Analyzer and by the manual method. AutoAnalyzer units are King-Armstrong, and manual units are Bodansky-Shinowara (F14).

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