كيفية تحضير كوب الشاي الاخضر: طريقة عمل كوب الشاي الاخضر

Cardiac enzymes (Creatine phosphokinase, CPK, CK)

Introduction

Myocardial infarction leads to myocardial cell death which can be diagnosed by appearance of blood different proteins released into the circulation due to damaged myocytes e.g. myoglobin, cardiac troponin (Troponin T and I), CK and LDH.

Creatine kinase (CK)

The CK also called creatine phosphokinase catalyzes the interconversion of phosphocreatine (or creatine phosphate) to creatine.

Tissue Source

CK with highest activities found in skeletal muscle, heart muscle, and brain tissue.

CK with smaller quantities in other tissue sources, including the bladder, placenta, gastrointestinal tract, thyroid, uterus, kidney, lung, prostate, spleen, liver, and pancreas.

CK isoenzymes

CK is an enzyme generally associated with ATP regeneration in contractile or transport systems where it is involved in the storage of high-energy creatine phosphate.

CK occurs as a dimer consisting of two subunits (protein subunits M and B). These two subunits combine to form three isoenzymes CK-BB (brain type), CK-MB (hybrid type), and CK-MM (muscle type). On electrophoretic separation, CK-BB will migrate fastest toward the anode and is therefore called CK-1. CK-BB is followed by CK-MB (CK-2) and, finally, by CK-MM (CK-3). The CK is the first enzyme released into circulation within 6-18 hours after the infarction. Therefore, CK estimation is highly useful for early diagnosis of myocardial infarction (MI). This enzyme reaches a peak value within 24-48 hrs. and returns to normal level by the second or third day.

Normal range:

In male CK < 190 U/L ,  while in female , while in male CK< 170 U/L

Interpretation of raised plasma CK activities:

Serum total CK levels are elevated in

1. Acute myocardial infarction (AMI).           2.   Disorders of skeletal muscle and muscular dystrophy       3. Central nervous system disorders: Ø  Cerebrovascular accident Ø  Seizures Ø  Nerve degeneration Ø  Central nervous system shock. 4.      Hypothyroidism. 5. Surgery 6. Circulatory failure with shock and hypoxia. 7.   Intramuscular injection 8.   Alcoholism.