Ischemia-modified albumin increases after skeletal muscle ischemia during arthroscopic knee surgery
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Ischemia-modified albumin
Diagnosis on myocardial ischemia is often difficult. The ischemia-modified albumin (IMA) assay presents a quantitative accurate laboratory determination of the occurrence of an iscbemic myocardial event. Unlike previous serum items that identify myocardial damage after the event, this test allows doctors to determine which patient has potential coronary artery lesions before occlusion occurs. Albumin cobalt binding (ACB) test is the assay that measures IMA in human serum, and may be used as an early marker of myocardial iscbemia that occurs prior to myocardial necrosis.
Key words:
ischemia-modified albumin; albumin cobalt binding test; myocardial ischemia
Ischemia-modified albumin
Serum Albumin
Human albumin
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Ischemia-modified albumin
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Objective To investigate the value of early diagnosis of Ischemic modified albumin in patients with acute Ischemic Cerebral stroke.Methods Albumin cobalt binding(albumin cobalt binding,ACB) test was used with the Hitachi7600-110 full automatic biochemical analyzer to detect modified albumin concentration in serum among 86 cases of patients with acute ischemic stroke,52 cases of ischemic cerebral apoplexy convalescent patients and 30 normal controls of ischemia,its positive rate was calculated,comparative analysis was conducted.Results Patients with acute ischemic stroke of serum ischemia modified albumin in the positive rate was 57.0%,and the recovery period(3.8%) and normal controls(0),the positive rates increased significantly,the difference was statistically significant(P0.01),and the recovery period of ischemia modified albumin in serum of patients with positive rate of 3.8% and normal controls(0) comparison of positive rate,the closer,the difference was not statistically significant(P0.01),serum ischemia-modified albumin levels were positively correlated with ischemia.Conclusion The detection of serum levels of IMA had important value in early diagnosis of ischemic cerebral stroke.
Ischemia-modified albumin
Stroke
Serum Albumin
Cerebral stroke
Brain ischemia
Ischaemic stroke
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Ischemic preconditioning (IP) refers to a phenomenon whereby short periods of ischemia reduce tissue damage after a subsequent sustained ischemia. The effect of IP before tourniquet ischemia of the extremities has not yet been evaluated. We developed a rat model of skeletal muscle ischemia and measured the effect of IP on postischemic function and high-energy phosphate levels. IP consisted in three cycles of 10 min ischemia and 10 min reperfusion each. IP improved significantly skeletal muscle function after 3 hours of ischemia and 2 hours of reperfusion. High-energy phosphate levels, however, remained unchanged. This study is the first that shows a protective effect of IP in skeletal muscles. These results furthermore suggest that the protection of energy metabolism is not a mechanism of IP in this model. IP could be easily performed before surgery of the extremities under tourniquet ischemia. The protective effect on postischemic skeletal muscle has therefore to be further investigated.
Ischemic Preconditioning
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AIM To explore the changes of endogenous H2S during myocardial injury caused by ischemia/reperfusion(I/R)of rat skeletal muscle. METHODS We established the model of bilateral hindlimb I/R in rats by using a tourniquet and 62 Wistar rats were divided into 9 groups at random: group normal (C), group 2 h ischemia (I2), group 4 h ischemia (I4) and groups 4 h ischemia with 0.5 h(R0.5), 2 h(R2), 4 h(R4), 6 h(R6), 12 h(R12), 24 h(R24) reperfusion. The pathologic changes in the myocardium were observed. The levels of plasma H2S, CKMB and TnT in each group were measured and the CSE activity in myocardium was detected. RESULTS Histopathologic results indicated that myocardial injury was relatively mild after skeletal muscle ischemia but it became much more serious following reperfusion. Compared with that in group normal, the level of plasma CKMB significantly increased in group I2, and the level of plasma TnT markedly increased in group I4(P0.05). There were no significant changes in H2S and CSE in ischemia groups. Compared with that in group I4, the level of plasma CKMB markedly increased in group R0.5(P0.05), reached peak in group R4 and significantly decreased in group R24. The level of plasma TnT markedly increased in group R4, reached peak in group R6 and still remained at high level in group R4. The level of plasma H2S and the level of myocardial CSE decreased obviously in group R2, R4, R6, R12 (P0.05) and reached the lowest level in group R4. The level of plasma H2S was negatively correlated with the level of plasma CKMB (r=-0.78, P0.05) and TnT (r=-0.89, P0.05). CONCLUSION Skeletal muscle ischemia and reperfusion induce myocardial injury. The injury is the most serious in 4-6 hours after reperfusion. The downregulation of endogenous H2S/CSE system may play an important role in myocardial injury during skeletal muscle IR.
Hindlimb
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Changes in permeability following ischemia-reperfusion injury were assessed in the intact rabbit hindlimb by measuring the transvascular clearance of 125I-labeled rabbit serum albumin. Ischemia was induced for periods of 1 or 2 hours by use of a pneumatic tourniquet inflated to 300 mmHg. Following ischemia, the limb was reperfused for 1, 2, or 3 hours. The albumin clearance in the gastrocnemius muscle of control rabbits was 5.1 +/- 0.7 (mean +/- SEM) microliters/hr/g dry weight. Following 1 hour of ischemia and reperfusion, muscle albumin clearance rose to 71.4 +/- 26 microliters/hr/g dry weight which was not significantly different from those animals that underwent 2 hours of ischemia. Muscle albumin clearance continued to be elevated following 2 hours of reperfusion; however, it returned toward control levels after 3 hours of reperfusion. These data suggest there is a transient increase in albumin permeability following ischemia-reperfusion injury in skeletal muscle.
Hindlimb
Gastrocnemius muscle
Ischemia-modified albumin
Lagomorpha
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Objective To understand the diagnostic significance of ischemia modified albumin(IMA) in the diagnosis of acute myocardial ischemia(AMI).Methods 48 patients with myocardial ischemia, 134 non-myocardial ischemia patients, and 30 healthy people were selected to detect serum ischemia modified albumin(IMA) by albumin cobalt binding assay(ACB).SPSS 13.0 software was used to analyze test results.Results ACB value of myocardial ischemia group was significantly lower than that of the non-myocardial ischemia group or the control group.IMA positive rate and number were higher than those of LDH, CK, CK-MB, MB in this patient group.Conclusions Ischemia modified albumin is a early, sensitive and specific biochemical indicator for the judgment of acute myocardial ischemia.
Ischemia-modified albumin
Serum Albumin
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To improve prognosis in acute coronary syndrome, new clinical applications in terms of diagnosis, risk stratification, and treatment strategies are still under investigation. Ischemia-modified albumin was one of the novel markers of myocardial ischemia. In our study, we aimed to determine the prognostic significance of the albumin cobalt binding capacity test in patients with acute coronary syndromes. We compared the ischemia-modified albumin levels of patients with acute coronary syndrome with those of patients with stable coronary artery disease and those of normal individuals and found them to be significantly higher in the first group (P<0.05). A cutoff value of ischemia-modified albumin of 477 U/ml was found by using receiver operating characteristic curve analysis. Mortality in groups of patients whose ischemia-modified albumin levels were above 477 U (50%) was found to be significantly higher than in those whose levels were below 477 U (8.3%) (P<0.05). The sensitivity and specificity of the cutoff value, 477 U/ml, for the 1-year mortality were found to be 70 and 82%, respectively. Using the Cox regression model the relation of albumin cobalt binding capacity test results with mortality was statistically significant (beta=1.013, confidence interval 95%, P=0.01) and independent of the existence of hypertension, diabetes, and advanced age. In conclusion, ischemia-modified albumin was found to be significantly related to 1-year mortality. Prognostic significance of ischemia-modified albumin should be evaluated in large populated and randomized study groups. Afterwards, ischemia-modified albumin could be used in risk stratification modality in patients with acute coronary syndrome.
Ischemia-modified albumin
Serum Albumin
Cut-off
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The concentration of myoglobin in plasma was assessed before and up to 68 hours after tourniquet release in 27 patients who underwent elective operations with no incision into skeletal muscle. The duration of ischemia was 1-3 hours. A control group underwent the same kind of surgery without the use of tourniquet. There was a minimal elevation in myoglobin values after 65 and 90 minutes of ischemia, and a marked elevation after more than 150 minutes of ischemia. Maximum values were reached 8 to 10 hours after tourniquet release, and preoperative values after 50 to 60 hours.
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Ischemic preconditioning (IP) refers to a phenomenon whereby short periods of ischemia reduce tissue damage after a subsequent sustained ischemia. The effect of IP before tourniquet ischemia of the extremities has not yet been evaluated. We developed a rat model of skeletal muscle ischemia and measured the effect of IP on postischemic function and high-energy phosphate levels. IP consisted in three cycles of 10 min ischemia and 10 min reperfusion each. IP improved significantly skeletal muscle function after 3 hours of ischemia and 2 hours of reperfusion. High-energy phosphate levels, however, remained unchanged. This study shows a protective effect of IP in skeletal muscles. These results furthermore suggest that the protection of energy metabolism is not a mechanism of IP in this model. IP could be easily performed before surgery of the extremities under tourniquet ischemia. The protective effect on postischemic skeletal muscle has therefore to be further investigated.
Ischemic Preconditioning
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