No abstract

SUMMARY Rates and mechanisms of myoglobin removal from plasma were examined in closed-chest dogs, using disappearance patterns of immunoreactivity and radioactivity after i.v. canine myoglobin radiolabeled with '"I. Arterial immunoreactive myoglobin concentration decreased monoexponentially over a 2-decade range, with rate constants of disappearance averaging 0.080 i 0.014 min-' (i SD) (corresponding to half-times of disappearance of 8.9 ± 1.5 mmn). Renal SERUM MYOGLOBIN concentration is elevated abnormally in the early phase of myocardial infarction in almost all patients seen within 12-14 hours of the onset of chest pain.14 Elevations in myoglobin frequently precede elevations of creatine kinase (CK); Stone et al.5 reported that 45% of infarct patients show increased myoglobin levels with normal CK levels at the time of admission. Elevated myoglobin levels peak earlier and return toward normal more rapidly than elevated CK levels. Myoglobin concentration-time curves sometimes show multiple peaks during the first several hours of apparently uncomplicated infarction.9Although the basis for these differing patterns of myoglobin and CK elevation has not been defined, a difference in a rate of removal from serum is an important possibility. CK disappearance from the intravascular space has been characterized.10 Although similar information for myoglobin is not available, myoglobin disappearance rates may be faster than those for CK; the kidney may play an important role."1'-4 If it does, sequential measurements of serum myoglobin may be useful for defining patterns of protein entry into the intravascular space during ischemic syndromes. Patients in the early states of myocardial injury -who may be the ideal candidates for interventions intended to minimize myocardial injury -might be identified as those with a normal serum myoglobin level on admission or a rapidly rising serum myoglobin over an interval of a few hours.The present study was designed to define rates and mechanisms of clearance from the circulation of a bolus of radiolabeled myoglobin administered intravenously. The studies capitalized on the sensitivity of recently developed radioimmunoassay techniques for quantifying plasma myoglobin concentration. The immunoassay also offered the opportunity to contrast changing patterns of plasma immunoreactivity and radioactivity, the former presumably reflecting disposition of the native molecule and the latter catabolic byproducts circulating within the vascular space as well as the native molecule. MethodsCanine myoglobin for exogenous administration and preparation of anti-dog myoglobin antibody was purified in a fashion similar to that for human myoglobin.6 Sequential steps included homogenization of canine myocardium in buffered saline, centrifugation and isolation of the supernatant, precipitation of protein with 50% ammonium sulfate, repeat centrifugation with dialysis of the supernatant against saturated ammonium sulfate, dissolution of the precipitate with subsequent dialysis against 0.02 M phosphate ...

Forty-eight white women from the lower socioeconomic class were interviewed. They were attending clinics at a county hospital because of problems other than obesity or psychiatric illness. Their weights ranged from normal to hyperobese. A semistructured interview, Spitzer's Mental Status Schedule, was held and a specialized medical history elicited information on eating habits. Three groups were formed: normal weight (mean 121 Ib), obese (mean 182 Ib) and hyperobese (mean 235 Ib). On the Mental Status Schedule scores no significant mean differences were found among the groups, despite a wide range of scores in all groups. The specialized medical history noted that obese and hyperobese, compared to normal weight subjects, eat when not hungry, and when anxious and depressed. Obese and hyperobese subjects said they preferred to weigh more and more often reported a child with birth weight of over 9 Ib. These women are more often the head of a household, and report husbands who weigh less than those of the normal weight group. Half the obese and hyperobese reported that onset of obesity occurred in adult life. Gross psychiatric disturbance was found with equal frequency in all 3 weight groups. These data suggest that it is hazardous to assume a uniform psychodynamic formulation for obesity, applicable to all irrespective of their social or ethnic backgrounds.Heredity, hypothalamic, metabolic and nature of which are not at all clear. Specuendocrine factors cannot satisfactorily ac-lation regarding psychologic factors in obecount for all instances of obesity (1). sity varies from the orthodox psychoanalytWhile it is difficult to tell what future ic approach, which views obesity as an research will contribute, at present it is example of regression to the oral stage of impossible to demonstrate specific somatic development (2), to the more recent work factors in most obese patients. Obesity of Bruch (3) who maintains that the obese seems to be attributable primarily to emo-patient has no appreciation of his own tional or psychologic factors, the exact visceral hunger signals due to early disrupFrom the Department of Psychiatry, State Uni-t i o n of the mother-child relationship. versity of New York at Buffalo School of Medicine. Shachter (4) has demonstrated that envifS^s^^xrxzsR-ronmentai and situationai fact°.rs c°"si u der " 02.ably influence the eating behavior of obese Received for publication Dec 11, 1969; revision subjects, received Feb 16. 1970. T h e v a r i o u s t h e o r i e s concerning psychoAddress for reprint requests: Dr. J. Holland, , ° r ' E. J. Meyer Memorial Hospital, Buffalo, NY 14215. logic causes of obesity are based on the

A rapid radioimmunoassay for serum myoglobin concentration has been developed, capitalizing on a technique for rapid separation of antibody-bound antigen from free antigen using Sepharose-bound sheep anti-rabbit gamma-globulin. Total time required for the assay is 2.75 h, making it suitable for clinical approaches employing myoglobin for rapid identification of patients in the active phase of myocardial injury.