Comparison of serum CA 19.9, CA 125 and CEA levels with severity of chronic obstructive pulmonary disease.

OBJECTIVE: To investigate serum levels of CA 19.9, CA 125 and carcinoembryonic antigen (CEA) in patients with different stages of chronic obstructive pulmonary disease (COPD). PATIENTS AND METHODS: Fifty-three consecutive patients (50 males, 3 females, mean age 67.6 +/- 10.1 years) with COPD were included in this study. Serum levels of CA 19.9, CA 25 and CEA were determined by the chemiluminescent immunometric method. Based on values obtained from pulmonary function tests, the patients were divided into 3 groups: moderate (21), severe (18) and very severe (14). Data were analyzed with a Kruskal-Wallis one-way analysis of variance test and Mann-Whitney U test. RESULTS: The mean serum levels of CA 125 and CA 19.9 were significantly higher in patients with very severe COPD (p = 0.013 and p = 0.017, respectively) than in patients with severe and moderate COPD (p < 0.05). Patients with cor pulmonale had significantly high mean serum levels of CEA, CA 19.9 and CA 125 (p < 0.05). Patients using a long-acting beta-agonist and theophylline showed significantly higher mean serum levels of CA 125 than patients who were not (p < 0.05). CONCLUSION: Data showed that the increased serum tumor markers in patients with COPD might be due to the severity of COPD, medication and cor pulmonale.

Alterations in semen parameters of toll collectors working at motorways: does diesel exposure induce detrimental effects on semen?

Air pollution is contemporarily considered to be a significant cause in impairing semen parameters. The aim of this study was to investigate possible effects of traffic pollutants, mainly the diesel exposure, on semen analysis. A total of 38 men working as toll collectors at motorways formed the study group. Simultaneously, 35 men working as office personnel constituted the control group. Factors including varicocele, chronic diseases that can affect sperm production were the exclusion criteria. No difference regarding smoking was present between the groups. Usual semen analysis according to WHO guidelines was performed. The results of semen analysis revealed decreased motility and low sperm counts in eight and seven men from the study group respectively. Besides, a man from the same group had combined abnormality of decreased motility and low sperm count. However, two men from the control group had slight motility defect and one had low sperm count. The differences regarding the abnormal sperm count and motility were significant between the groups (P = 0.002 and P = 0.003, respectively). Similarly, the ratio of sperm cells with normal morphology was significantly lower in the study group than that in the control group (P = 0.001). This observation proposes that air pollution particularly diesel exposure may have detrimental effects on sperm parameters.

Can sarcoidosis cause autoamputation of a finger phalanx?

Sarcoidosis is a multisystemic granulomatous disease. In the case presented, autoamputation of the distal phalanx of a little finger of the left hand was observed. The possibility of autodigital amputation as a result of sarcoidosis is discussed.

Tuberculous orchitis in chronic renal failure.

Tuberculosis confined to the testes with no epididymal involvement is uncommon. Chronic renal failure patients requiring hemodialysis have increased risk for developing tuberculosis. We report a 47-year old chronic renal failure man presenting with right testicular tuberculous orchitis. A high index of suspicion is required to recognize the unusual presentation of tuberculosis in this group of patients, and routine screening for tuberculosis may be recommended in patients undergoing hemodialysis.