Does Creatine Phosphokinase MB Predict Long-Term Cardiac Death or Atrial Fibrillation?

Objectives: Exploring the long-term consequences of elevated postoperative creatine phosphokinase MB as a surrogate measure of cardiac tissue damage subsequent to coronary artery bypass graft surgery (CABG). Methods: Prospective cohort study including 414 patients subjected to solitary CABG at Odense University Hospital from September 30, 2007, and backwards in time. According to individual postoperative peak creatine phosphokinase MB, patients were assigned to five subgroups. Kaplan Meier survival analysis and Cox proportional-hazard regression evaluated the predictive value of creatine phosphokinase MB on late death from cardiac cause and diagnosis of paroxysmal or persistent atrial fibrillation within 10-years after CABG. Results: There was a general numeric decrease in time to cardiac death with increasing postoperative creatine phosphokinase MB (Log-Rank 0.285). Creatine phosphokinase MB p p p = 0.002) increase in paroxysmal or persistent atrial fibrillation in patients with postoperative atrial fibrillation compared to patients in postoperative sinus rhythm. Conclusions: Postoperative creatine phosphokinase MB was not found predictive of late cardiac death or diagnosis of paroxysmal or persistent atrial fibrillation within 10 years after CABG. However, patients with postoperative atrial fibrillation had increased risk of later developing paroxysmal or persistent atrial fibrillation compared to patients in postoperative sinus rhythm.

Effect of Yuxintong (愈心痛 ) Capsule on Serum Creatine Phosphokinase Activity and Plasma Endothelin Concentration in Acute Myocardial Ischemic Dogs

The protective effect of the traditional Chinese compound medicine Yuxingtong (YXT) in cap-sule form on the experimental acute myocardial ischemia formation has been studied in dogs. The plasma en-dotlielin concentration and serum creatine phosphokinase activity were measured after coronary occlusion indifferent medication groups and compared with the saline control group. Results showed that YXT could signifi-cantly lowered the plasma endothelin concentration and the serum creatine phosphokinase activity, it sug-gested that both YXT and diltiazem have the similar protective effect on acute myocardial ischemia and necro-sis in dogs.

Biochemical indicators and the Peradeniya Organophosphate Poisoning scale in prediction and prognosis of organophosphorus poisoning:An observational prospective study

Objective:To study the value of some biochemical indicators and Peradeniya Organophosphate Poisoning scale in prediction and prognosis of organophosphorus poisoning.Methods:This was a hospital-based prospective,observational study.Various biochemical tests viz.complete blood count,random blood sugar,liver and renal function tests,creatine phosphokinase,and electrolytes were performed.Patients were assessed based on the Peradeniya Organophosphate Poisoning scale.All the patients were followed till the end point like recovery/death.Results:Out of the 100 patients,72%were males and 28%were females.The majority of the patients were farmers and 21 to 30 years of age.Suicidal was the most common manner(92,92%).Based on the Peradeniya Organophosphate Poisoning scale,47%were mild,34%moderate,and 19%severe.Serum creatinine,creatine phosphokinase,serum glutamic-oxaloacetic transaminase,serum glutamic pyruvic transaminase,and alkaline phosphatase levels showed a significant correlation with severity.Conclusions:Some biochemical indicators such as creatine phosphokinase,alkaline phosphatase can be used as prognostic markers of organophosphorus poisoning.The Peradeniya Organophosphate Poisoning scale can be used for assessing severity of the poisoning.

Prosaposin ablation inactivates the MAPK and Akt signaling pathways and interferes with the development of the prostate gland

<abstract>The recent development of a prosaposin -/- mouse model has allowed the investigation of the role of prosaposin in the development of the male reproductive organs. A morphometric analysis of the male reproductive system of 37 days old mice revealed that prosaposin ablation produced a 30 % reduction in size and weight of the testes, 37 % of the epididymis, 75 % of the seminal vesicles and 60 % of the prostate glands. Light microscopy (LM) showed that smaller testis size from homozygous mutant mice was associated with reduced spermiogenesis. Both, dorsal and ventral lobules of the prostate glands were underdeveloped in the homozygous mutant. LM analysis also showed that prostatic alveoli were considerably smaller and lined by shorter epithelial cells in the homozygous mutant. Smaller tubular diameter and shorter undifferentiated epithelial cells were also observed in seminal vesicles and epididymis. In the efferent ducts of the homozygous mutant mice, the epithelium was composed exclusively of ciliated cells in contrast to the heterozygotes, which showed the presence of nonciliated cells. Radioimmunoassays demonstrated that testosterone levels were normal or higher in mice with the inactivated prosaposin gene. Immunostaining of prostate sections with an anti-androgen receptor antibody showed that the epithelial cells lining the alveoli express androgen receptor in both the heterozygous and homozygous tissue. Similarly, sections immunostained with antibodies to the phosphorylated MAPKs and Akts strongly reacted with tall prostatic secretory cells in prostate from heterozygous mouse. On the other hand, the epithelial cells in the homozygous prostate remained unstained or weakly stained. These findings demonstrate that inactivation of the prosaposin gene affected the development of the prostate gland and some components of the MAPK pathway. 63 )

Atypical Neuroleptic Malignant Syndrome: Pitfalls and Challenges in the Delirious Substance Abuser

Introduction: A rare and atypical form of Neuroleptic Malignant Syndrome (NMS) can be a deceptive and life threatening condition if not diagnosed properly in acute and critical care settings. Methods: The management of a patient presenting with atypical NMS without prominent rigidity, but with extensive rhabdomyolysis after the administration of haloperidol and ziprasidone is described in this report. Results: Prompt recognition of atypical features of NMS was managed by intensive care unit admission, supportive care and pharmacotherapy, leading to a complete resolution of the syndrome and a favorable outcome verified by laboratory findings. Conclusion: Early stages and atypical features of NMS may be variable in presentation and clinical course. The absence of muscle rigidity may not rule out NMS. A strong clinical suspicion based on clinical history is crucial for early diagnosis and treatment. Termination of dantrolene therapy may not be necessary during rhabdomyolysis and elevated aminotransferase levels.

CASE REPORT OF NEUROLEPTIC MALIGNANT SYNDROME WITH RISING BLOOD SUGAR

Objective To report one case of neuroleptic malignant syndrome （NMS） with raising blood sugar. Methods The patient was studied clinically with biochemistry, white blood cells, psychiatric symptoms, and creatine phosphokinase （CPK） observations. Results The male patient with a history of taking antipsychot- ics more 30 years and his age of onset was about 20 years. He had severe muscular rigidity, altered consciousness and autonomic disturbance associated with elevation of serum CPK levels （max 3755 U/ L ） and leucocytosis （max 13.3 × 10^9/L）, especially granular leukocytosis（ max 90% ） and lymphocytopenia （rain 8% ）. In addition, high blood sugar emerged along with the variation of white blood cells （ max 9. 0 mmol/L）. Conclusion The manifestations of the patient was in conformity with those of the NMS. The patient had catatonic signs such as mutism, drinking difficulty, etc. and excess of saliva. Developmental observation with CPK and white blood cells is able to reveal the severity level of NMS. Raising blood sugar should be also monitoring item.

Monitoring Training Load,Muscle Damage,and Body Composition Changes of Elite Indian Rowers During a Periodized Training Program

Purpose The purpose of this study was to monitor the Indian national rowing team’s training regime and the changes that occur in the rowers’body composition,muscle cell damage,and training load markers during the phases of preparation for an international competition.Methods Ten male and 9 female elite rowers from the national team underwent anthropometric assessment and blood tests during 17 weeks of training,at the end of general preparation(W4),preparation(W10),and pre-competition(W17)phase.Body fat%and somatotype were determined by Siri’s equation and Heath-Carter manual,respectively.Assessments of blood biomarkers included measures of creatine phosphokinase(CPK),lactate dehydrogenase(LDH),urea,uric acid,testosterone,and cortisol concentration.Results Changes in variables were estimated by repeated-measures ANOVA.Body fat%(P<0.001;male:d=−2.03;female:d=−2.89)and endomorph(P<0.05;male:d=−2.05;female:d=−0.68)decreased significantly at pre-competition,whereas weight,mesomorph,and ectomorph remained unchanged throughout training.Urea(male:d=−1.47;female:d=−1.46)and uric acid(male:d=−0.74;female:d=−1.71)showed a significant decrease at pre-competition phase in both groups.CPK concentration significantly(P<0.05)decreased at preparation(d=−1.05)and increased during pre-competition(d=−1.28)in male rowers.LDH showed significant increase(P<0.01)at preparation(male:d=1.17;female:d=2.02)and pre-competition(male:d=1.28;female:d=2.09)than base preparation.Whereas,no significant changes were observed in cortisol,testosterone,or T/C ratio in subsequent measurements.Significant correlation(P<0.05)was found between LDH and T/C ratio with rowing timing in male rowers.The 2000 m rowing timing also showed a significant improvement at W17 compared to W4(male:d=−1.25;female:d=−0.94).Conclusion In conclusion,our results showed that rowers encounter more muscle damage and less protein catabolism during training season.Additionally,it is evidenced that rowing performance improved and biochemical markers-particularly enzymes-altered largely with altered training load rather than anabolic or catabolic hormone concentration in rowers.

Clinical Study of Chronic Renal Failure Treated with Baoyuan Dahuang Decoction (保元大黄汤)

Chronic renal failure patients (as test group) under treatment by Baoyuan Dahuang De-coction, other 20 cases (as control group) by western medicine, mainly coated aldehyde oxystain, hadcommonly blood urea nitrogen and creatinine decreased. But among the test group, the hemoglobin in-creased obviously, the symptons of fatigue, lassitude in loin and legs, lack of appetite, sexual disorder,and mental depression improved markedly (P<0. 01) . and estradiol, progesterone, testosterone as wellas creatine phosphokinase were regulated notably compared with before treatment (P<0.01) . Whereasin the control group, the symptoms were not significantly improved, hemoglobin, levels of sex hormonesand creatine phosphokinase differed slightly. It is concluded that Baoyuan Dahuang Decoction possessesefficacy to improve chronic renal failure patients' vitality and ability, the mechanism of which is related toanemia rectification and membrane function.