Tumor markers in patients undergoing hemodialysis or kidney transplantation.

The following tumor markers, AFP, CEA, CA 19-9, CA-125 and CA 15-3 were studied in 50 healthy volunteers (group A), in 23 patients on chronic hemodialysis (group B) and in 30 successfully transplanted individuals (group C) who did not present any clinical symptoms or signs of neoplasia. The levels of AFP, CEA and CA 15-3 were significantly higher in group B when compared to groups A and C. The levels of CA 19-9 and CA-125 did not differ significantly among the three groups. Transplanted individuals (group C) presented significantly lower levels of CEA and AFP and higher levels of CA 15-3 when compared to group B patients. The levels of all markers were not influenced by sex or time on dialysis. It is concluded that: (1) CA 19-9 and CA-125 can be considered as reliable tumor markers in patients undergoing hemodialysis or kidney transplantation. (2) The elevation of CEA and AFP levels in hemodialysis and their decline to normal levels found in the group of successfully transplanted individuals, suggest a possible active role of functioning renal tissue in their clearance. (3) The etiology of CA 15.3 elevation following successful kidney transplantation remains obscure and requires further evaluation.

Cerebrospinal fluid cyclic adenosine 3',5'-monophosphate in cases of severe cerebral ischemia and meningitis.

The concentration of cyclic adenosine 3',5'-monophosphate (cAMP) in cerebrospinal fluid was measured in 45 samples from 45 subjects, one sample per subject. 12 of the studied persons were (control group) neurologically normal, 11 were suffering from acute cerebral ischemia with deep coma, and 22 from meningitis of different types. The mean value obtained in the control group was 21.4 +/- (SEM) 3.3 nmol/l, in the group of acute cerebral ischemic attack with deep coma it was 7.00 +/- 0.81 nmol/l and in the group of meningitis 5.5 +/- 0.4 nmol/l. These values are significantly lower than the control group (p less than 0.001). These low levels, observed in the two groups of patients, may be attributed to the altered cAMP metabolism in the central nervous system because of deep coma and bacterial infections.

Serum vitamin B12 and folic acid levels in hyperthyroidism.

Serum vitamin B12 and folic acid levels were measured in 48 hyperthyroid patients and in a group of euthyroid controls. The levels of vitamin B12 ranged from 120-900 pg/ml with a mean of 429.3 +/- 30.9 pg/ml (SE). The mean serum vitamin B12 level was lower in hyperthyroid patients than in normal controls, the difference being statistically significant (t = 2.584, p less than 0.025). Serum vitamin B12 levels showed a statistically significant negative correlation with the clinical index of Grooks et al. (r = 0.344, p less than 0.05). The findings, although not excluding the involvement of auto-immune gastritis in patients with low serum vitamin B12 levels, suggest a direct action of increased thyroid hormone concentrations. Serum folic acid levels ranged from 0.5-13.8 ng/ml with a mean of 6.8 +/- 0.46 ng/ml (SE). The mean serum folic acid levels were higher in the hyperthyroid patients than in normal controls but the difference was not statistically significant (t = 1.2, p greater than 0.2). The serum folic acid levels did not show any statistically significant correlation with the clinical index of Grooks et al. The fact that no statistically significant difference was found between the mean value in hyperthyroid patients and the mean value in normal controls is probably due to the high folic acid intake in Greece.