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Biomedical subjects

M J Stone

Publications and source records attributed to M J Stone.

At least 109 records · Page 6Linked to original sources
PubMed1981

Trace metals in hematopoiesis.

The trace metals represent an extremely small part of the total mass of the organism. In spite of this, these elements appear to play major roles in metabolism. At the level of the hematopoietic system, specific roles can be identified for iron, copper, zinc, and cobalt. Other trace metals appear to play less clearly defined roles in hematopoiesis but clearly are involved by virtue of a number of interactions at the level of absorption, intermediary metabolism, or modulation of toxicity. Still other trace metals, such as lithium, appear to have a therapeutic role in altering production of granulocytes, by an as yet unidentified mechanism.

Animals↗
PubMed1980

Acute subendocardial myocardial infarction: its detection by Tc-99m stannous pyrophosphate myocardial scintigraphy.

Sixty-two patients hospitalized because of prolonged chest pain and initial electrocardiographic (ECG) changes of ST depression and T-wave inversion suggestive of acute subendocardial myocardial infarction were evaluated to determine the ability of Tc-99m-stannous pyrophosphate mycardial scintigraphy to detect the presence or absence of acute subendocardial myocardial necrosis. Three groups of patients were designated. Group A consisted of eight patients (13%) who developed reduction of R-waves of more than 25% or new Q-waves broader than 0.03 seconds; of these patients with acute transmural myocardial infarction, all had well-localized, abnormal scintigrams. Group B consisted of 30 patients with ECG changes and subsequent enzymatic documentation, including elevated serum creatine kinase-B levels as determined by radioimmunoassay, of the presence of acute subendocardial myocardial infarction. Of these, 27 had abnormal scintigrams, including 18 with well-localized patterns and nine with "poorly localized" patterns. Group C consisted of 24 patients (39%) with chest pain, but without enzymatic documentation of the presence of acute myocardial infarction (acute coronary insufficiency). Eight of these had abnormal scintigrams, including one with a well-localized pattern and seven with "poorly localized" patterns. In four of the latter, the scintigrams were "persistently positive" several weeks to months after a previous myocardial infarct. Serial myocardial imaging will be necessary to identify such patients.

Adult↗
PubMed1980

Immunopathology of periodontal disease. I. Immunologic profiles in periodontitis and juvenile periodontitis.

Eleven patients with periodontitis, ten patients with juvenile periodontitis and ten control subjects were studied to compare systemic and local immunologic responses and various other blood parameters. A more intensified immunologic response was seen in juvenile periodontitis as compared to periodontitis or controls as evidenced by: (1) greater number of plasma cells and lymphocytes in biopsy specimens of involved gingiva stained by Harris hematoxylin and eosin; (2) significant decrease in serum C4 levels and slightly elevated serum IgG levels as determined by radial immunodiffusion; (3) marked increase of positive fluorescing cells in biopsy specimens stained with antihuman immunoglobulin conjugate and an increase in complement deposition in the same tissues as determined by immunofluorescence. No significant differences among the two groups of patients and control subjects were observed with respect to complete blood counts, coagulation studies, or blood glucose levels. These findings suggest that the immunologic responses in periodontitis and juvenile periodontitis are qualitatively similar, but that the intensity of the response is greater in juvenile periodontitis.

Adolescent↗
PubMed1979

Detection of myocardial infarct extension by CK-B radioimmunoassay.

Myocardial infarct extension after the acute event was defined as a second reise in the myocardial isoenzyme of serum creatine kinase (CK-B) after the initial return of CK-B to normal values. In 43 patients with acute myocardial infarcts, CK-B was measured by radioimmunoassay every 12 hours for 14 days. Nineteen patients had anterior transmural myocardial infarcts AMI, 14 had inferior transmural myocardial infarcts (IMI) and 10 had subendocardial myocardial infarcts (SEMI). Infarct extension as detectd by a second rise in serum CK-B occurred in six patients (32%) with AMI, two (14%) with IMI and two (20%) with SEMI; these differences are not statistically significant. Infarct extension for all patients combined was 23%. Four patients with AMI also had infarct extension as determined by recurrent chest pain. ECG alterations and other enzyme changes. In the other six, the infarct extension was undetected clinically. Four patients with AMI and infarct extension died within 3 weeks after hospitalization. We did not note any additional morbidity or mortality in patients with infarct extension who had IMI or SEMI. There was no significant difference in the frequency of previous myocardial infarction, history of hypertension, diabetes mellitus or smoking history in patients with and without infarct extension shown by serum CK-B isoenzyme elevations. The measurement of serum CK-B values with a quantitative and sensitive assay suggests that myocardial infarct extension occurs more commonly than clinically recognized, but the frequency of extension may be less than that reported in patients in whom precordial mapping and total serum CK values were measured to identify this phenomenon.

Adult↗
PubMed1979

Reduction in exertional myoglobinemia after physical conditioning.

The development of a sensitive radioimmunoassay for the measurement of myoglobin now permits the accurate determination and detection of even small concentrations of serum myoglobin. To determine the effect of exercise and physical conditioning on serum myoglobin levels, 16 male Army recruits (ages 18 to 28 years) underwent treadmill exercise and strenuous physical evaluation tests (PETs) that consisted of sit-ups, push-ups, horizontal ladder, obstacle course, and 3.2-km run. These tests and exercise were performed before and after 12 weeks of physical conditioning performed in conjunction with basic military training. Serum myoglobin levels did not rise after treadmill exercise, but they were increased greatly six hours after PET. After physical conditioning, serum myoglobin concentrations measured after the treadmill exercise remained normal and values after PET showed a significant decrease (P less than 0.001) as compared with those measured before physical conditioning (mean +/- SD, 160 +/- 81 ng/mL after initial PET vs 76 +/- 60 ng/mL after physical conditioning). These results demonstrate that physical training reduces the degree of myoglobinemia occurring after strenuous exercise, possibly by modifying skeletal muscle alterations that allow myoglobin release in this setting.

Adolescent↗
PubMed1978

Creatine kinase BB isoenzyme levels by radioimmunoassay in patients with neurological disease.

Creatine kinase BB (CK-BB) isoenzyme was measured by radioimmunoassay in serum and in cerebrospinal fluid from 61 patients with various neurological disorders. Statistically significant elevations of CK-BB isoenzyme in the serum were observed in patients with acute cerebrovascular accidents and in those with seizures and a prolonged alteration in level of consciousness. Statistically significant elevations of CK-BB isoenzyme in the cerebrospinal fluid were also found in patients who had suffered acute cerebrovascular accidents. Some patients with central nervous system infections, acute demyelinating disease, certain drug overdoses, head trauma, and complex migraine also had elevations of serum and CSF CK-BB isoenzyme. In 2 patients with elevations of CK-BB isoenzyme, the elevations in serum occurred later than those detected in the cerebrospinal fluid. If CK-BB elevations determined by radioimmunoassay can be demonstrated to be quantitatively related to the extent of brain damage, then these determinations in conjunction with experimental animal models and newer radiological techniques should allow evaluation, in an objective and precise manner, of measures designed to decrease that damage.

Brain Damage, Chronic↗
PubMed1978

Detection of myoglobin by radioimmmunoassay in human sera: its usefulness and limitations as an emergency room screening test for acute myocardial infarction.

The results indicate that serum myoglobin determinations may be obtained by radioimmunoassay utilizing time periods for the testing which allow more useful clinical evaluation of patients. The data also demonstrate, however, that there are important temporal considerations in using serum myoglobin levels for the detection of acute myocardial infarcts and, if this test is used to determine in the Emergency Room whether patients have had acute myocardial infarcts, these limitations will have to be kept in mind. In addition, three other patient subgroups that might be expected to have elevated serum myoglobin levels by radioimmunoassay have been determined. These include patients with shock (irrespective of etiology), patients with severe renal insufficiency, i.e., those with serum creatinine levels equal to or greater than 8 mg. per cent, and possibly patients who have been on alcohol binges immediately prior to being seen in the Emergency Room.

Acute Disease↗
PubMed1977

Some observations concerning the demographic and geographic incidence of carcinoma of the lip and buccal cavity.

The geographic and demographic data obtained during the Third National Cancer Survey have provided a perspective on etiologic factors and incidence trends for cancers of low frequency. The incidence of cancer of the lip, oral cavity and skin from this survey was compared to similar studies in 1947 and intra-regional patterns in one area of the Third National Cancer Survey (Dallas-Fort Worth Metropolitan SMSA) were evaluated. The average age-adjusted annual incidence of cancer of the lip in white men in this latter area was 11.5 per 100,000 (based on 1950 population standard), 2-fold greater than that geographic area with the second highest incidence and approximately 3-fold greater than in all the other areas. The incidence in white women was only 8% that seen in white men. Intra-regional differences of similar populations were seen with the incidence in Fort Worth men being 50% greater than in a similar population in Dallas. Incidence trends over the past 2 decades reveal a significant decline in the incidence of oral cavity cancer and a slight decrease in lip cancer. Comparisons of the incidence of lip cancer did not correlate with the incidence of skin cancer nor with geographic latitude in the other survey areas. The studies fail to support the classical implication of actinic radiation as the primary etiologic factor in lip cancer incidence.

Age Factors↗
PubMed1977

Radioimmunoassay of creatine kinase-B isoenzyme in human sera: results in patients with acute myocardial infarction.

A radioimmunoassay was developed to measure serum levels of the B isoenzyme of creatine kinase(ATP: creatine N-phosphotransferase, EC 2.7.3.2) (CPK) in order to evaluate the time course and frequency of MB isoenzyme elevation in patients with acute myocardial infarction. The method can identify as little as 0.2 ng of the B portion of the CPK-MB isoenzyme, does not significantly crossreact with CPK-MM isoenzyme, and is not affected by storage of serum at --20 degrees CPK isoenzyme containing B subunits was detected in 48 out of 51 sera from normal adults; serum levels in these individuals ranged between 1.2 and 12.5 ng/ml [mean +/- SEM was 2.7 +/- 0.30 ng/ml]. The mean serum level of CPK-B isoenzyme in a pool of sera obtained from 100 normal subjects was 2.9 +/- 0.35 ng/ml; two patients with rhabdomyolysis that were studied had serum CPK-B isoenzyme levels of 2.5 and 3.5 ng/ml, respectively. In contrast, serum levels of the CPK-B isoenzyme were markedly elevated in sera from 18 patients with acute myocardial infarcts when obtained within 12 hr after hospital admission; the mean +/- SEM concentration was 56 +/- 7.8 ng/ml. We performed serial determinations on 14 patients with acute myocardial infarcts and demonstrated that maximal serum CPK-B levels occurred within the first 12 hr after admission and were lower thereafter. The serum concentration of B-containing CPK isoenzyme in 19 additional patients admitted with chest pain but without acute myocardial infarction was 3.4 +/- 0.50 ng/ml. Thus, radioimmunoassay measurement of CPK-B isoenzyme appears to be a useful and sensitive test for the detection of acute myocardial infarcts in patients.

Acute Disease↗
PubMed1977

Probable myeloblastic leukemoid reaction with disseminated sarcoidosis.

A 55-year-old woman had progressive weakness, weight loss, night sweats, fever, right-sided facial weakness, and hepatomegaly. Reticulonodular infiltrates were seen on chest x-ray film and a central filling defect was noted on liver scan. Study of the peripheral blood was noted on liver scan. Study of the peripheral blood revealed pancytopenia and myeloblasts. The bone marrow was not markedly hypercellular but contained noncaseating granulomas and myeloblasts. The patient's condition deteriorated and she died on the 22nd hospital day. Autopsy disclosed disseminated sarcoidosis but no evidence of leukemic infiltrates. Although concomitant "smoldering" acute leukemia cannot be ruled out, the findings in this patient can be best explained on the basis of a myeloblastic leukemoid reaction accompanying sarcoidosis.

Biopsy↗
PubMed1977

Serum myoglobin level as diagnostic test in patients with acute myocardial infarction.

Serum myoglobin levels were measured in normal subjects and patients by means of a newly developed radioimmunoassay. Myoglobin was identified in all of 135 sera from normal adults and ranged between 6 and 85 ng/ml (mean +/- SE 31 +/- 1.3). Raised myoglobin levels were present in 62 of 64 patients with documented acute myocardial infarction, the mean serum concentration being 528 +/- 76 ng/ml. Serial determinations in 46 patients with acute infarct showed that maximum values usually occurred within 4 hours after admission. In 19 of 42 cases, raised myoglobin levels preceded the rise in creatine kinase (CK) values; in the remaining patients, both serum myoglobin and creatine kinase were increased on admission. Only 2 of an additional 44 patients admitted with chest pain but without subsequent electrocardiographic, enzyme, or technetium-99m stannous pyrophosphate myocardial scintigraphic evidence of acute myocardial infarction had raised myoglobin levels; the mean value for this group was within the normal range (44 +/- 6 ng/ml). Serum myoglobin values also were normal in patients with congestive heart failure without acute myocardial infarction, and in patients after moderate exercise and cardiac catheterisation. Trasient myoglobinaemia appears to be one of the earliest laboratory abnormalities occurring in acute myocardial infarction and, therefore, should prove useful as a diagnostic aid in patients.

Acute Disease↗
PubMed1977

Comparison of different noninvasive methods of infarct sizing during experimental myocardial infarction.

This study evaluated the accuracy of several noninvasive infarct-sizing techniques in 12 awake, unsedated dogs with multivessel coronary obstructions and acute anterior myocardial infarcts. Estimations of infarct size by scintigraphy with technetium-99m Sn pyrophosphate (Tc-PP), serum creatine phosphokinase (CPK) release, peak serum myoglobin levels by radioimmunoassay, and precordial ECG mapping were compared and correlated with histologic measurements of infarct size. The comparisons indicate that precordial ST segments mapping, serum CPK release measurements and peak serum CPK, peak serum myoglobin, and Tc-PPi myocardial scintigraphy all provide approximate estimates of infarct size in this model. Each technique also has certain important limitations, however, including: (A) precordial mapping is relatively insensitive in the identification of small anterior infarcts, (B) serial serum CPK release measurements when obtained for only 24 hr after infarction tend to underestimate large anterior infarct size, and (C) Tc-PPi myocardial scintigrams may fail to recognize anterior infarcts less than 3 gm in size and may overestimate the size of small predominantly subendocardial infarcts. The findings also show that the closest estimate of histologic infarct size in this model was provided by combining two of the noninvasive techniques (precordial mapping to identify sites with 2 or more millimeters of ST segments elevation and Tc-PPi myocardial scintigrams) rather than by relying exclusively on any one technique alone.

Animals↗