Myoglobin has been shown to be elevated in the serum after myocardial infarction. Myoglobin is one of the first to appear in the serum and its quantification may thus be used in the diagnosis of the early phase of acute myocardial infarction. The purpose of this study was to clarify the time course of myoglobin elevation in the early phase of acute myocardial infarction. We compared this with the time course of serum CPK and obtained following results: 1) Serum myoglobin becomes significantly elevated at 4 hours following onset of chest pain and apears earlier than CPK. 2) Serum myoglobin time curve peaks at 8 hours, whereas the CPK time surve peaks at 16 hours following onset of chest pain. 3) Mearsurement of serum myoglobin in the early phase of acute myocardial infarction can serve as valuable aid in diagnosis of myocardial infarction with other findings.
Chest Pain ; Diagnosis ; Myocardial Infarction* ; Myoglobin*

The STRATUS CS200 (Siemens Healthcare Diagnostics Inc., USA) has recently been developed as an on-site diagnostic instrument for assaying several kinds of cardiac markers within a short duration. The precision, linearity, comparison, limit of quantification, and turnaround time (TAT) were evaluated for troponin I, creatine kinase-MB (CK-MB), N-terminal pro-brain natriuretic peptide (NT-proBNP), and myoglobin assays according to guidelines provided by the Clinical and Laboratory Standards Institute. The total coefficients of variation of the four items were between 1.90% and 4.25%. All markers showed a linearity that was ≥0.99, and the values were within the manufacturer's range. All items showed a close correlation with E170 (Roche Diagnostics, Germany). The limits of quantification for troponin I, CK-MB, myoglobin, and NT-proBNP were 0.03 ng/mL, 0.3 ng/mL, 1 ng/mL, and 15 pg/mL, respectively. The TAT was 14 minutes. The performance of the STRATUS CS200 for assaying cardiac markers was highly satisfactory in terms of the precision, linearity, limit of quantification, and TAT, and it showed a good correlation with the comparative method.
Creatine ; Delivery of Health Care ; Methods ; Myoglobin ; Troponin I

Serum myoglobin concentrations were studied in 46 patients during orthopedic and plastic operations that required the application of a pneumatic limb tourniquet. Serum myoglobin was measured at preoperation, during tourniquet and after touriquet release. In the general anesthesia patients, serum myoglobin was after tourniquet release(172.72+/-29.49 ng/ml) significantly increased(p<0.01) than at preoperation(103.06+/-24.03 ng/ml). In the regional block patients, serum myoglobin after tourniquet release(117.69+/-10.08ng/ml) also increased(p<0.05) than at preoperation(67.08+/-14.99ng/ml). In the male patients, serum myoglobin was significantly increased(p<0.05) during tourniquet and after tourniquet release(123.36+/-15.42ng/ml & 158.86+/-21.10ng/ml) than at preoperation (93.58+/-17.11ng/ml). In the female patients, there was no significant difference to regardless of tourniquet application. In the patients that tourniquet application time was within one hour, serum myoglohin was significantly increased(p<0.01) during tourniquet and after tourniquet release(125.66+/-18.86 & 126.20+/-14.99ng/ml) than at preoperation(86.12+/-15.29ng/ml). In the patients that tourniquet application time was over one hour, serum myoglobin was sig- nificantly increased(p<0.01) during tourniquet(l05.92+/-21.84ng/ml) than at preoperation(91.16+/-31.17ng/ml) and in the after tourniquet release(183.88+/-40.96ng/ml), serum myoglobin was more significantly(p<0.05) increased than during tourniquet.
Anesthesia, General ; Extremities ; Female ; Humans ; Male ; Myoglobin* ; Orthopedics ; Plastics ; Tourniquets*

Uterine rhabdomyosarcoma (RMS) typically presents as a mixed epithelial and mesenchymal tumors. Pure RMSs of the female genital tract are uncommon. Spindle cell variant of RMS is a rare morphologic subtype of embryonal RMS and mostly occurs in the paratesticular region of children. Here, we present a case of uterine spindle cell RMS in a 76-year-old woman. The tumor, 20x15x7 cm in size, was highly necrotic and adherent to the colon and rectum. Tumor cells were mostly spindle-shaped, and isolated rhabdomyoblasts were scattered. Immunohistochemical stains for myoglobin and myo-D1 showed diffuse positivity for tumor cells. The patient died only of disease three months after diagnosis.
Child ; Colon ; Coloring Agents ; Female ; Humans ; Myoglobin ; Rectum ; Rhabdomyosarcoma ; Uterus

BACKGROUND: More than 90% of acute stroke patients have measurable cardiovascular sequelae, but we have been often overlooked in formal discussions of treatment. If we estimate the incidence of myocardial injury in patient with spontaneous SAH, we may figure the possibility of cardiac dysfunction in such patients. This study was designed to investigate the incidence of myocardial injury in patients with spontaneous SAH using cardiac troponin I(cTnI). METHODS: A prospective single emergency center study was performed to determined preoperative incidence of unrecognized cardiac injury in patients suffering spontaneous SAH. We include the spontaneous SAH patients who underwent serum measurements of the cardic troponin I immediately upon admission last six month period. ECG, CK, CK-MB and myoglobin were also performed at admission. We excluded the spontaneous SAH patients who had past history of myocardial ischemia and ECG abnormality. RESULTS: Fifty-two patients(34 females, 18 males) with spontaneous SAH were studied prospectively. 18 patients(34.6% of the total study population) had cTnI level above 0.5ng/ml. ECG was performed in 52 patients and was abnormal in 15 of the 52 patients(28.8%). CONCLUSION: The measurement of cTnI has provided physicians with a myocardial marker that has a cardiac sensitivity for cardiac injury equal to that of CK-MB yet with greater specificity. So, cardiac troponin I is useful to estimate the incidence of myocardial injury in patients with spontaneous SAH. And we may estimate the possibility of cardiac dysfunction in such patients. This knowledge will hopefully aid in the care and improve the outcome.
Electrocardiography ; Emergencies ; Female ; Humans ; Incidence* ; Myocardial Ischemia ; Myoglobin ; Prospective Studies ; Sensitivity and Specificity ; Stroke ; Troponin I* ; Troponin*

The evaluation of renal damage in patients with renal stone after extracorporeal shock wave lithotripsy(ESWL) were analyzed by measuring chemical substances including cell-escaped enzymes in the blood and urine. We measured several chemical substances before ESWL, 1st, 3rd, and 4th day after ESWL. All patients had renal stones which were located in the renal pelvis and renal calices. Glutamic oxalate transaminase(GOT) and glutamic pyruvic transaminase(GPT) reached a peak on the 1st day after ESWL and decreased to pre-ESWL day values by the 4th day. Lactate dehydrogenase(LDH), creatine kinase(CK), and myoglobin also significantly increased on the 1st day after ESWL and decreased but did not return to pretreatment values by the 4th day. Urinary ratio of N-acetyl-beta-d-glucosaminidase(NAG) to creatinine(Cr) increased after ESWL and was still high on the 4th day. These results suggested that hemolysis and myolysis might be developed owing to shock wave exposure, and that the kidney was damagedto some extent. Therefore, we must be taken into account in renal damage during ESWL. Determination of urinary NAG and NAG/Cr ratio may be superior to GOT, GPT, LDH, CK and myoglobin in serum, after shock wave lithotripsy for renal stones.
Creatine ; Hemolysis ; Humans ; Kidney ; Kidney Pelvis ; Lactic Acid ; Lithotripsy ; Myoglobin ; Shock

Rhabdomyolysis is a syndrome involving the breakdown of skeletal muscle causing myoglobin and other intracellular proteins and electrolytes to leak into the circulation. There are various causes of acute rhabdomyolysis in childhood, such as direct trauma to muscle, muscle necrosis from ischemia, inflammation in muscle, or exposure to drugs and toxins. The most-important complication of this disorder is acute renal failure (ARF). However, the contributing factors to the development of ARF in children with rhabdomyolysis remain obscure. We report two cases of rhabdomyolysis after excessive exercise.
Acute Kidney Injury ; Child ; Electrolytes ; Humans ; Inflammation ; Ischemia ; Muscle, Skeletal ; Muscles ; Myoglobin ; Necrosis ; Proteins ; Rhabdomyolysis

MHS is a myopathic disorder transmitted by a dominant autosomal gene. The seriousness of the problem is underscored by the fact that the mortality rate, until recently, has ranked the highest among the complications of modern anesthesia. During halothane anesthesia we experienced a case of MHS with high temperature and rigidity after succinylcholine, observed change of serum electrolytes, and noted CPK and myoglobin in the urine. The patient was managed with surface cooling, bicarbonate, diurectics, mechanical ventilator and corticosteroids. The patient survived without any sequelae and was discharged after 10 days.
Adrenal Cortex Hormones ; Anesthesia ; Electrolytes ; Halothane ; Humans ; Malignant Hyperthermia* ; Mortality ; Myoglobin ; Succinylcholine ; Ventilators, Mechanical

The classic signs and symptoms of rhabdomyolysis are non-specific and not present in all cases, and mild cases might go unrecognized. We present a case of rhabdomyolysis recognized in a 68-year-old man after elevation of liver enzymes following prolonged urologic surgery. The patient's postoperative course was concerned with elevated serum aspartate aminotransferase and alanine aminotransferase without any clinical manifestations on the first postoperative day. After examining the serum creatine kinase and myoglobin levels, the patient was diagnosed with rhabdomyolysis. After 16 days, he was discharged with fully recovered liver enzymes and creatine kinase. We suggest that sufficient perioperative attentions should be given to patients at a higher risk of rhabdomyolysis.
Aged ; Alanine Transaminase ; Aspartate Aminotransferases ; Attention ; Creatine Kinase ; Humans ; Liver ; Myoglobin ; Rhabdomyolysis

OBJECTIVES: In coronary arterial disease, quantitative assessment of the extent of myocardial damage is important both in management of the patient and prediction of prognosis. Measurement of serum Troponin-T is a new method for detecting myocardial cellular injury, used as more specific marker of tissue damage and reperfusion status in acute myocardial infarction, This study was performed to evaluate the significance of serum Troponin-T measurement in various acute chest pain syndrome. METHODS: 37 patients who presented anterior ischemic chest pain enrolled from April, 1994 to September, 1995, From the initial period of admission, serial measurements of serum level of cardiac enzymes (CK, CK MB, Myoglobin, Troponin-T) were made. Then release time, peak time and normalization time of each enzyme were derived and compared each other. To evaluate whether Troponin-T level can reflect the extent of ischemic injury, correlation between peak Troponin-T level and peak CK MB level was analysed by regression method. RESULTS: 1) Acute myocardial infarction was confirmed in 15 cases; Q-wave myocardial infarction was 10 cases(anterior wall-5 cases, inferior wall-4 cases, lateral wall-1 cases), and non Q-wave myocardial infarction was 5 cases. Unstable angina was 22 cases. All cases had significant stenosis in coronary angiography. 2) The appearance in the serum level of 4 cardiac enzymes was as follows. The release time(hours) of 4 cardiac enzymes(Troponin-T, CK, CK MB, Myoglobin) were 7.1(1-30), 9.3(1-30), 9.9(1-30), 6.2(1-30). The peak time(hours) of 4 cardiac enzymes were 23.0(1.5-96), 21.6(2-66), 16.9(2-42), 12.7(3-40). The normalization time(hours) of the enzymes were over 72, 53.7(11-86), 52.3(11-94), 32.3(10-82). 3) Elevation pattern of cardiac enzymes showed concordance of all 3 enzymes(Troponin-T, CK MB, Myoglobin) in 29 of 43 cases(67.4%), There was concordance of 2 enzymes in 10 cases; 5 cases of CK MB and Myoglobin, 5 cases of Troponin-T and Myoglobin. In 4 cases, only Myoglobin level was increased. 4) There was significant correlation between peak Troponin-T level and peak CK level(r=0.66, p=0.0178), significant correlation was also observed between peak Troponin-T level and peak CK MR level(r=0.90, p=0.0001). CONCLUSION: In acute myocardial infarction serum Troponin-T was detectable as early as CK MB, and lasted longer after other enzyme level was normalized. There was significant correlation between peak Troponin-T level and peak CK, CK MB level, suggesting Troponin-T as useful marker for assessing the extent of myocardial damage.
Angina, Unstable ; Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Humans ; Myocardial Infarction ; Myoglobin ; Prognosis ; Reperfusion ; Troponin T*