A radioimmunoassay was developed to determine serum myoglobin (SMb). 50 healthy persons showed values between 0 and 90 ng/ml. Serial tests of 10 patients following acute myocardial infarction or during angina pectoris (AP) indicated that SMb reached pathological values before CK and CK-MB (average 250 +/- 95 ng/ml at the time of hospitalisation which corresponds to 3.3 +/- 1.4 h after beginning of angina pectoris). At hospitalisation the simultaneously determined CK was within normal limits and reached pathological values only 6.2 +/- 1.9 h after the onset of angina. Maximum of SMb was 506 +/- 194 ng/ml occurring 8.8 +/- 2.8 h after beginning of AP, maximum of CK was 905 +/- 475 mU/ml occurring 20.0 +/- 7.8 h after AP. CK-MB and CK differed only slightly in their time course. One patient with severe AP had pathologically increased SMb values whilst all other enzymes were completely normal. Methodical and clinical results are discussed.
Summary: We determined representative enzyme activities of glycogenolysis (glycogen phosphorylase) glycolysis (d-glyceraldehyde-3-phosphate dehydrogenase, GAPDH), /3 oxidation of free fatty acids (1-3-hydroxyacyl CoA dehydrogenase, HADH), citric acid cycle (citrate synthase, CS), lactate fermentation (lactate dehydrogenase LDH), and creatine phosphate metabolism (creatine kinase, CK) in left ventricular samples of 36 patients to investigate if the metabolic capacities of the energysupplying pathways are differently affected in different heart diseases. There were 17 patients with mitral valve diseases (MVD), 8 patients with aortic valve diseases (AVD), and 1 1 patients who suffered from dilative cardiomyopathies (DCM). The main metabolic characteristic on the level of enzymatic organization in patients with DCM was an increased ratio of GAPDH/HADH activities and a decreased ratio of HADH/CS activities compared to the valve-diseased patients. This result indicates that the capacity of glucose oxidation is enhanced at the expense of fatty acid metabolism in patients with DCM. Furthermore, we determined significantly lower myocardial CK activities in this group of patients, most probably reflecting a diminished content of myofibrils. Citrate synthase activity was lowest in patients with AVD. Although we cannot rule out that the impaired left ventricular function is in part responsible for the shift of the capacities of the energy-supplying metabolism in patients with DCM, we favor the assumption that it is a specific feature of this myocardial disease.
Chordomas of the clivus are frequently denoted as malignant, mainly because of their propensity to recur, their crucial location and the fatal clinical course. Although microscopical examination commonly reveals pleomorphism, particularly of cells and nuclei, the histological assessment of malignancy is not always appropriate. The measurement of DNA could provide important information for a classification of their biological behavior (grading). Our examination of a chondroid chordoma revealed a typical diploid DNA curve within a "benign" 4C range concordant to the favorable course of this variant. Our second examination of a "typical" chordoma showed a wide pleomorphism of cell nuclei and moderate proliferation activity within a "low grade" scale. This pointed to a coming (fatal) recurrence 3.5 years after the first surgery. The third chordoma we examined presented an extraordinary 4C aneuploidy with hypertetraploid subpopulations and an increased number of bi- or poly-nucleated tumor cells with prominent nucleoli and some more mitotic figures. In 5 recurrences the DNA pattern remained principally unchanged.
The Flow-Fluorescence Cytometric Method (FCM) was applied to investigate the DNA content and the ploidy outlines of each of 96 glioblastomas. No specific DNA pattern was detected, possibly because of the tangle morphology of these variable tumors. Due to their capricious growth the DNA distribution proved to fluctuate greatly. Thus, the series, arranged according to increased PI (proliferation index) values, exhibited a wide spread within a total range from 7.1-97.15% (mean 39.3%) PI. A threefold subdivision of main types (I-III) appears to be of practical use for clinical prognostic assessment: "diploid" tumors with a PI range up to 10% (N = 7) are followed by "abnormal" chiefly tetra- and hyper-tetraploid tumors up to PI values about 30% (N = 21). The third category includes cases showing excessive "aneuploidy" combined more and more with polyploidy and valid stemlines, up to the PI maximum of about 97 rel.% (N = 68). Thus, in 89 tumors clear pathological changes of DNA content can be decoded; of these 68 (76.4%) express a considerable aneuploidy and polyploidy respectively.
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