Creatine kinase MB in cases of skeletal muscle trauma.

Fifty-eight patients admitted through our emergency room with severe skeletal muscle injury but no obvious cardiac contusions were evaluated for creatine kinase isoenzyme MB (CK-MB). When such patients show an above-normal value for total CK, it is a question of whether or not myocardial injury has been sustained along with skeletal muscle injury when (a) there are no obvious chest contusions or (b) the patient is unconscious and unable to complain of chest pain. Whenever there is doubt concerning the cardiac status of a patient, lactate dehydrogenase (LD) isoenzymes, serial electrocardiograms, and CK isoenzymes are ordered. Our study revealed that serum of 8.6% of the trauma victims had CK-MB values exceeding 5.0 EU/L (reflecting abnormal CK-MB concentrations) as part of their increased total CK. All patients had normal electrocardiographic patterns along with negative results for LD isoenzymes; none had sustained any demonstrable myocardial injury. The CK-MB value must be interpreted together with the total CK value for appropriate diagnosis in patients with skeletal muscle trauma.

Nifedipine aerosol attenuates airway constriction in dogs with hyperreactive airways.

We investigated the ability of a calcium channel blocker nifedipine, given as an aerosol, to attenuate bronchoconstriction induced by citric acid, Ascaris antigen, and methacholine in Basenji-Greyhound dogs. citric acid 10% increased pulmonary resistance (RL) 4.2-fold +/- 1.0 (mean +/- SEM) and 1.7-fold +/- 0.7 in untreated and nifedipine-pretreated dogs (P less than 0.05). Dynamic compliance (Cdyn) fell to 0.58 +/- 0.07 and 0.66 +/- 0.07 of control values in untreated and nifedipine-treated dogs, respectively (p greater than 0.05). Ascaris antigen increased RL 5.1-fold +/- 0.83 and 3-fold +/- 0.48 in untreated and nifedipine-treated dogs, respectively (p less than 0.05); Cdyn decreased to 0.33 +/- 0.04 and 0.48 +/- 0.03 in untreated and nifedipine-treated dogs, respectively (p less than 0.05). In 5 dogs challenged with 0.3 mg/ml methacholine, RL increased 6.1-fold +/- 0.7 and 4.4-fold +/- 1.0 in untreated and nifedipine-treated dogs, respectively (p less than 0.05); Cdyn fell to 0.41 +/- 0.-3 and 0.46 +/- 0.07 of control values in untreated and nifedipine-treated dogs (P greater than 0.05). Neither 40% ethanol nor nifedipine-ethanol altered resting RL and Cdyn. We conclude that nifedipine effectively attenuates bronchoconstriction induced by citric acid, Ascaris antigen, and methacholine in dogs with hyperreactive airways.