Effects of lowered dialysate sodium on left ventricle function and brain natriuretic peptide in maintenance of hemodialysis patients.

INTRODUCTION: Impaired diastolic flow is characterized by decreased left ventricular (LV) filling diastole, abnormal LV distensibility, or delayed relaxation. B-Type natriuretic peptide (BNP) is an indicator of various cardiovascular diseases and body volume status. The aim of this study was to determine whether the lowering of dialysate sodium (Na) levels is effective on LV systolic and diastolic parameters and BNP in the maintenance of hemodialysis patients. MATERIALS AND METHODS: The study included 49 chronic hemodialysis patients. Left atrium (LA) diameter and LV ejection fraction, LV systolic and diastolic diameter, deceleration time (DT), pulmonary artery pressure (PAP), inferior vena cava diameter (IVCD), early diastolic transmitral flow ( E) and late diastolic transmitral flow ( A) velocities, E/ A ratio, isovolumic relaxation time, peak early diastolic velocity ( E'), late diastolic velocity ( A') of tissue Doppler mitral annulus, and flow propagation velocity of mitral inflow ( Vp) were measured before and 6 months after hemodialysis with low Na dialysate. RESULTS: Six months after low Na hemodialysis, a decrease was observed in echocardiographic parameters such as PAP and IVCD ( p < 0.05, p < 0.001, and p < 0.001, respectively). However, a significant difference was not observed in LA diameter. In LV diastolic measurement of E and A waves, E/ A ratio, DT, Vp, septal E' and A', and lateral E' and A' exhibited significant improvement by low Na HD. BNP level was significantly reduced ( p < 0.001). CONCLUSIONS: Lowered dialysate Na concentration improves PAP, IVCD, and LV diastolic properties assessed by mitral inflow filling, tissue Doppler velocity, and mitral inflow velocity propagation.

The association between serum Dickkopf-1 levels and esophageal squamous cell carcinoma.

Serum Dickkopf-1(DKK-1) is elevated in many malignancies and is an important indicator of malignant potential. However, its significance in esophageal squamous cell cancer (ESCC) has not yet been clarified. We hypothesized a role for DKK-1 in patients with ESCC. The study consisted of 90 ESCC patients and 85 healthy controls. After diagnosis, the level of DKK-1 was measured in the serum samples by enzyme-linked immunosorbent assay and the levels of DKK-1 were much higher in the ESCC patients than in the healthy control group (p < 0.0001). For serum DKK-1, the sensitivity and specificity of the assay were 70 and 80%, respectively. The preoperative serum DKK-1 level was elevated in the ESCC patients. Although serum DKK-1 is not a specific biomarker for ESCC, it might be a useful marker for the diagnosis and treatment of ESCC.

Human neutrophil peptides 1, 2 and 3 (HNP 1-3): elevated serum levels in colorectal cancer and novel marker of lymphatic and hepatic metastasis.

OBJECTIVE: Biological levels of localized colon tumors are needed for the diagnosis and prevention of colon cancer. Numerous biomarker studies are produced currently through research. We investigated some peptides with the aim of identifying biomarkers for colorectal cancer and lymphatic and hepatic metastasis. MATERIALS AND METHODS: A total of 100 patients with histologically proven colorectal cancer and 60 normal volunteers were included in this study. Preoperative serum was collected for analysis. Human neutrophil peptides levels (HNP) were assayed by solid phase RIA (Radio Immun Assay) based on monoclonal antibodies. RESULTS: The HNP-1, -2 and -3-also known as α-defensin-1, -2 and -3-are present in elevated concentrations in the plasma from colorectal cancer patients. CONCLUSION: Preoperative high plasma HNP 1-3 levels are associated with colorectal cancer. The HNP 1-3 levels may procure information on patients with lymph node or hepatic metastasis.

The relationship among acute-phase responce proteins, cytokines, and hormones in various gastrointestinal cancer types patients with cachectic.

BACKGROUND: Acute-phase response proteins (APRPs), cytokines, and hormones have been claimed to be an independent, important factor of cancers. We suggest that in gastrointestinal system cancers, changes in APRP, cytokines, and hormones are associated. METHODS: C-reactive protein (CRP), albumin, interleukin 1α (IL-1α), IL-1ß, IL-6, IL-8, IL-10, tumor necrosis factor α (TNF-α), midkine, vascular endothelial growth factor-A(VEGF-A), VEGF-C, VEGF receptor 1 (VEGFR1), leptin, adiponectin, and ghrelin serum levels are studied in 148 gastrointestinal system cancer types and 40 healthy controls. RESULTS: We found statistically significant differences and correlations between groups. We found significantly higher serum CRP, IL-1α, IL-1ß, IL-6, IL-8, IL-10, TNF-α, VEGF-A, VEGF-C, VEGFR1, and leptin concentrations in patients with esophageal, gastric, pancreas, colon, and rectum cancers than controls (p < 0.001, p < 0.0001). But, we found lower levels of the serum albumin, midkine, adiponectin, and ghrelin in patients with esophageal, gastric, pancreas, colon, and rectum cancers compared to control subjects (p < 0.05, p < 0.001). CONCLUSIONS: Cachexia in gastrointestinal system cancer types is associated with changes in APRP, cytokines, and hormone concentrations. This may be reflected between the outcomes in malignancies and the biomarkers.

Amlodipine-induced gingival hyperplasia in chronic renal failure: a case report.

Amlodipine is a dihydropyridine calcium channel blocker that is used in the management of both hypertension and angina. Amlodipine induced side effects are headache, dizziness, edema, flushing, palpitations, and rarely gingival hyperplasia. The exact reason of amlodipine-induced gingival hyperplasia is not known. We presented a case with chronic renal failure (CRF) that developed gingival hyperplasia due to amlodipine use, which improved after ceasing the drug.