Aarne Konttinen

Determination of serum creatine kinase isoenzymes in myocardial infarction

Abstract Serum creatine kinase (CK) isoenzymes were measured in patients with acute myocardial infarction by an improved method which allows quantitation of CK isoenzymes in the serum. Since there are no previous reports of the serum CK isoenzyme pattern in myocardial infarction, the study was focused on uncomplicated myocardial infarction. This was done in order to obtain information of the “heart pattern” of serum CK isoenzyme activity. The principal increase was found to depend on increases in skeletal muscle (MM) isoenzymes and, to a lesser degree, on augmentation of myocardial (MB) isoenzymes.

Value of quinidine in maintenance of sinus rhythm after electric conversion of atrial fibrillation.

Onehundred andseventy-five patients withatrial fibrillation treated forthefirst timewithDC shock weredivided into twogroupsaccording toyearofbirth. GroupIreceived a long-acting quinidine bisulphate preparation, thedosage ofwhich was adjusted togive serumlevels of1-3mg./l. Side-effects wererarewiththis dosage. Group 2received noquinidine. Ofthe88patients ofgroup I,sinus rhythm was restored in75(85%). Whenleaving thehospital 64(73%) still hadsinus rhythm, andafter 3 months 52(59%). Thecorresponding figures forthe87patients ofGroup2 were 73(84%), 54(62%), and30(34%). Thedifference at3 months isstatistically highly significant. Because ofthese results itisconcluded thatelectric conversion ofatrial fibrillation should beperformed forthefirst timewithout quinidine prophylaxis. Ifthere isfailure orearly recurrence,however, a second electric conversion withsubsequent quinidine treatmentshould be considered.

Demonstration of serum creatine kinase isoenzymes by fluorescence technique

Abstract Serum creatine kinase (CK) isoenzymes can be sensitively and specifically demonstrated by the fluorescence of NADPH2. The method allows demonstration over the whole normal range. The technique is more specific than the tetrazolium staining methods because the “nothing dehydrogenase reaction” does not cause disturbing artefacts as in the staining methods.

Heart type creatine kinase isoenzyme (CK MB) in acute cerebral disorders.

Heart type creatine kinase isoenzyme (CK MB) was detected in the serum in 23 out of 53 patients (43%) with acute cerebrovascular, traumatic, or infectious brain damage. Electrocardiogram disclosed abnormalities suggestive of acute myocardial injury in 15 of these 23 patients. Eleven of them also showed increased LD1 activity. Subendocardial haemorrhage was detected in 3 out of 8 necropsied patients with serum CK MB activity. Among those 30 patients in whom no CK MB activity was found electrocardiographic abnormalities suggestive of acute myocardial injury were observed in 2 and increased LD1 was seen in 4 cases. The mortality was higher if either CK MB isoenzyme or electrocardiographic abnormalities suggestive of acute myocardial injury were present, compared with the patients lacking these signs (P less than 0.01). Present findings suggest that acute brain damage may secondarily cause myocardial damage more often than has been believed before. Results also indicate that a combination of acute brain damage and acute myocardial injury often indicated a poor prognosis.

Brain creatine kinase in blood after acute brain injury.

Severe cold injury of the brain increased significantly both total creatine kinase and the corresponding brain isoenzyme (CKBB) activity in confluens sinuum samples. CKBB could be detected also in peripheral blood a few hours after severe brain injury in eight of 12 patients. Finding of CKBB in human plasma may prove a useful indicator of severe brain injury.

A new cause of increased serum aspartate aminotransferase activity.

Two healthy young women had an unexplained persistent elevation of aspartate aminotransferase (ASAT) activity. In both cases electrophoresis of serum ASAT isoenzymes displayed an abnormally moving fraction that comprised the whole serum activity, while liver and muscle revealed the normal cytoplasmic and mitochondrial isoenzymes. In the first case serum ASAT was found to be bound by serum IgG, in the second case the binding protein remained unidentified.

Effects of physical training on circulation at rest and during exercise

Abstract Fourteen young men with sedentary habits were studied before and after a two-month hard training period to obtain data on the changes in hemodynamics, explored both at rest and during supine leg exercise. The physical working capacity of the subjects was markedly improved, paralleled by an increase in the heart volume. The cardiac output at rest was slightly higher after training, due to a significant increase in the stroke volume. The change in the total peripheral resistance was inversely commensurate to that of the cardiac output. The heart rate was reduced at rest in eleven of the subjects. Left heart work was unchanged, but this work was performed with a smaller oxygen cost after training, as assumed from the changes in the tension-time index. This sequence of events was even more evident in the circulatory adjustment during exercise, characterized by a larger stroke volume and a significantly lower heart rate than before training.

Origin of Elevated Serum Enzyme Activities after Direct-Current Countershock

Abstract Serum creatine kinase (CPK) activity was abnormally elevated on eight of 37 occasions in patients treated with direct-current electroshock. Serum total LDH rose on five and GOT on three oc...

A method allowing the quantitation of serum creatine kinase isoenzymes

Abstract The methods available for creatine kinase (CK) isoenzyme separation are too insensitive for the quantitation of serum CK isoenzymes. The method presented here is sensitive enough for the quantitation even in normal sera. Agarose was observed to give sharper bands and in this way to increase the sensitivity of the measurement. NBT was observed superior to other tetrazolium salts in the staining capacity.

A further simplified method of ornithine carbamoyltransferase measurement

Abstract A further simplification of ornithine carbamoyltransferase measurement is presented. In this form the method consists of two steps: (a) incubation of serum with the substrate, and (b) measurement of ammonia formed in the reaction as indophenol. This method is suitable for use in routine clinical work.