Evaluation of carcinoembryonic antigen (CEA) and brain-type creatine kinase (CK-BB) in serum from patients with carcinoma of the lung.

The levels of carcinoembryonic antigen (CEA) and the activities of creatine kinase isoenzyme BB (CK-BB) were assessed in 84 patients with primary lung carcinoma and in 20 patients with nonmalignant lung diseases. The level of CEA was measured by the immunoenzymatic method using monoclonal antibodies (Abbott). The activity of CK-BB was assayed using a commercial kit (Boehringer Manheim, Monotest CK-NAC aktiviert). Increased levels of CEA were observed in 62% of patients, mostly in patients with nonsmall cell lung carcinoma (NSCLC), while enhanced activities of CK-BB were found in 39%, first of all in patients with small cell lung carcinoma (SCLC). A relationship was found between enhanced levels of CEA or CK-BB and the degree of carcinoma advance. The increased values of studied markers seem to indicate the limited possibility of surgical treatment and they are also important in prognosis after the resection of lung tissue.

Carcinoembryonic antigen, neuron-specific enolase and creatine kinase-BB as tumor markers for carcinoma of the lung.

Carcinoembryonic antigen (CEA), neuron-specific enolase (NSE) and creatine kinase-BB (CK-BB) were estimated in blood serum of 75 patients with primary lung carcinoma and of 20 patients with nonmalignant lung diseases. CEA and NSE were determined by immunoenzymatic method using monoclonal antibodies (Abbott CEA-EIA and Roche NSE-EIA) and CK-BB was assayed using kits supplied by Boehringer-Mannheim (Monotest CK-NAC aktiviert). Enhanced levels of CEA were observed in 64% of patients with lung carcinoma, mainly with adenocarcinoma. Increased activities of NSE and CK-BB were obtained in 47% and 39% of patients, respectively, principally of those with small cell carcinoma. The CEA level was dependent on the stage of advanced NSCLC carcinoma and of NSE and CK-BB on the stage of advanced SCLC carcinoma. The complex analysis of the three markers has given 100% specificity of test.

Acid-base status of the newborn in relation to cord blood serum creatine kinase isoenzymes' activities.

Creatine kinase (CK) isoenzymes are considered to be specific tissue injury markers. The purpose of this study was to evaluate CK isoenzymes (CK-MM, CK-MB, and CK-BB) in umbilical cord blood sera of newborns in relation to their acid-base status. Investigations were performed in a group of 75 newborns delivered after 37 weeks of pregnancy. We estimated CK-isoenzymes with the use of DEAE-Sepharose C1-6B column chromatography. Total CK activity was measured using kits supplied by Boehringer-Mannheim (Monotest-R CK-NAC aktiviert). Newborns were considered hypoxic if umbilical artery blood pH was under 7.2 and/or base excess less than -10 mmol/L. Of 75 newly born infants 26 had features of perinatal hypoxia. We were unable to demonstrate significant differences in total CK, CK-MM and CK-MB activities in examined groups of newborns. We found a significant rise of CK-BB activity in cord sera of hypoxic infants. Our results show that the fetal brain is the most vulnerable to a hypoxic state.

Cord blood serum creatine kinase isoenzymes with placental dysfunction.

It has been suggested that perinatal asphyxia is not generally followed by neurological impairment unless there is preexisting chronic fetal distress. In cases of brain damage one can observe elevated levels of CK-BB. The purpose of our study was to evaluate CK isoenzymes in umbilical cord blood sera of newborns affected by chronic fetal distress. Fetal distress reflected by placental dysfunction was characterized by a diminished HPL level and decreased activity of CAP. We estimated CK isoenzymes with the use of DEAE-sepharose CL-6B column chromatography. Total CK activity was measured using kits supplied by Boehringer-Mannheim (Monotest CK-NAC aktiviert). The clinical state of examined newborns was estimated. Investigations were carried out in the group of 57 infants delivered after 37 weeks of gestation. Total CK activity in cord sera ranged from 40 to 400 U/l. Our results showed a significant rise of CK-BB activity in cord sera of newborns delivered from pregnancies with placental dysfunction (figure 2) as well as in cases of asphyxiated infants (figure 3). We were unable to demonstrate differences in total CK, CK-MM and CK-MB activities in all examined groups of newborns. Other authors have confirmed that severe asphyxia results in increase in CK-BB activity in cord blood. Infants with ominous fetal heart rate patterns have higher CK-BB activity. There are several possible sources for CK-BB activity in umbilical cord blood sera, i.e. fetal brain, lung, gastrointestinal tract, placenta and uterus. It appears that the brain is most likely the source of elevated CK-BB activity found in cord blood in cases of placental dysfunction.

Beneficial effects of intravenous nitroglycerin on haemodynamics and enzymatically estimated infarct size.

The effects of intravenous nitroglycerin (TNG) were evaluated in 39 patients with a first acute myocardial infarction, subdivided according to Killip into those with left ventricular failure (N = 24) and those without (N = 15). A group of 38 randomly selected patients treated in a conventional, but unstandardized manner, served as a control (C). TNG caused a statistically significant reduction in pulmonary artery diastolic pressure, regardless of its initial value, by about 30%. Neither cardiac index nor total peripheral resistance was significantly changed. Infarct size, measured in gEq of isoenzyme MB creatine kinase (CK-MB), was smaller by about 40% in both subgroups of patients treated with TNG, when compared with the controls. A significant difference was found in peak CK-MB blood levels only in the group of patients with left ventricular failure (Killip classes II and III) treated with TNG. The best results were obtained when TNG was given not later than 4 h after the onset of the symptoms of infarction.

Diagnostic importance of lipoprotein-X (LP-X) in the diagnosis of cholestasis.

In 317 patients with diseases of the liver and bile tract the authors determined LP-X in the serum and the obtained results were compared with the morphological findings in liver tissue or intraoperative examination of the extrahepatic bile ducts. Int he same patients serum bilirubin, total cholesterol, alkaline phosphatase activity, gamma-glutamyltranspeptidase and leucylaminopeptidase activity were determined. In the light of these results the authors believe that detection of LP-X in the serum is a sensitive and specific method in the diagnosis of cholestasis and that it is of greater usefulness than determination of alkaline phosphatase activity. Determinations of other biochemical parameters is of small diagnostic importance in these cases.

Significance of serum lipoproteid-X (LP-X) determination for the diagnosis of cholestasis in chronic liver diseases.

Among 179 patients with various chronic diseases of the liver the authors found in 20 cases histological evidence of intrahepatic cholestasis and in all these cases lipoproteid X (LP-X) was present in the serum. In the group of 159 patients without evidence of cholestasis in microscopic examination of liver tissue LP-X was demonstrated only in two cases (1.3%). The results of investigations confirm the view that detection of LP-X in the serum is a specific and sensitive index of cholestasis and its value in the diagnosis of this condition is greater than that of determinations of alkaline phosphatase, gamma-glutamyl-transpeptidase, leucinamino-peptidase activity or cholesterol in the serum.