Does impedance measure a functional state of the body fat?

The aim was to compare methods of body fat measurement in different BMI groups. An additional aim was to discuss differences reflecting the structural and functional changes of fat tissue. The study group included 130 adult Caucasian women stratified by body mass index (BMI): 18-24.99 (n=30), 25-29.99 (n=26), 30-34.99 (n=33), 35-39.99 (n=30), and BMI>/=40 (n=11). Bioelectrical impedance was performed using Tanita TBF 410 GS, Bodystat 1500, and Omron BF 300. A caliper type Best was also applied. Correspondence of four methods with DEXA was assessed using the Bland-Altman and ANOVA analyses. Measurements by BIA were not significantly different from DEXA up to BMI of 30, but DEXA significantly overestimated in the higher BMI subgroup by all three methods. Caliper measurement significantly underestimated DEXA in all BMI subgroups. BIA methods overestimated DEXA for the obese subjects. Tanita did statistically the best. The Caliper test appeared less preferable than the BIA methods, especially in the higher BMI subgroup. DEXA and Caliper measurements seem to be the best estimate of structural (anatomical) fat quantity. We hypothesize that BIA methods could also measure some other physiopathological conditions like inflammation, hydration or cell infiltration of fat.

Post-exercise changes of beta hydroxybutyrate as a predictor of weight changes.

The aim was to find the differences in ketogenesis initiation in the early period after the exercise in obese patients and to find if these changes may predict the weight loss during the physical activity program. 96 females were enrolled. A clamped heart rate test (CHR) was performed to establish comparable exercise intensity. Blood samples for beta hydroxybutyrate (BOHB) assessment were collected prior, immediately after and 60 min after the test. Patients underwent a three month fitness program. Anthropometric measurements (fat mass and biochemical parameters) were measured. An energy intake was monitored and comparable in all subjects. A significant increase of BOHB was found in 60(th) minute after the test, when compared with initiation levels (BOHB1 vs. BOHB3; p=0.03). This increase correlates with % fat mass (R=0.196; p=0.02) and negatively with age (R= -0.147; p=0.05) and with weight reduction during the three-month program (R= -0.299; p=0.03). Serum BOHB increase after the single exercise may detect individuals with an ability to induce lipolysis in three-month program of physical activity for obese patients.

The effect of three different miniaturized blood purification devices on plasma cytokine concentration in an ex vivo model of endotoxinemia.

PURPOSE: A novel type of adsorptive plasma filtering device (ETX-A) capable of removing endotoxin from blood in a single step has recently been developed using nanotechnology. METHODS: In a miniaturized, ex vivo model of extracorporeal circuits, we tested the capacity to reduce plasma cytokine concentration of ETX-A filters in comparison to standard high-flux (HF) filters, high cut-off (HCO) filters and a control. Blood from six healthy volunteers was spiked with endotoxin and then circulated through closed (ETX-A, control) or open (HF, HCO) circuits. Blood flow was set at 16 ml/min and filtration flow at 1 ml/min. Samples for measurement of IL-1ra and IL-6 were taken at baseline and at 4 hours. RESULTS: Compared to control (703.3 [850.6] pg/mL), in HCO (383.5 [1144.1] pg/mL) and ETX-A (490.1 [683.2] pg/mL) filters, plasma IL-1ra pooled pre- and postfilter concentrations were lower at the end of the experiment (P=0.002; P=0.050, respectively) whereas, in standard HF filters, IL-1ra concentration was higher than control. HCO showed a trend toward a reduced relative increase in IL-6 concentration from commencement to end of experiment compared to control (P=0.07). After pooling end-of-experiment plasma cytokine values of novel blood purification devices, we found HCO + ETX-A superior to H with regard to reduction of IL-1ra (-27.0 [-20.5]% vs. 8.1 [18.9]%; p<0.001) and IL-6 (-18.0 [38.3]% vs. -1.1 [24.3]%; P=0.050) compared to control. CONCLUSIONS: HCO and ETX-A appeared to significantly reduce plasma IL-1ra and, when combined, plasma IL-6 concentration as well. It appears desirable to manufacture full-size blood purification devices using this technology and to explore their effect on cytokine removal.

Dynamic monitoring of cardio-specific markers and markers of thyroid gland function in cancer patients--a pilot study.

BACKGROUND: With the increased effectiveness of anticancer therapy, much more attention is being paid to the monitoring of the side-effects of chemotherapy, which often constitute a limiting factor in anticancer therapy. In this pilot study, the results of our monitoring of changes in cardio-specific markers and thyroid gland parameters in patients with colorectal carcinoma in the course of adjuvant and palliative chemotherapy are presented. PATIENTS AND METHODS: A total of 42 patients with colorectal carcinoma were monitored (median age 52 years, range 34-82 years); in these patients a post-operative adjuvant or palliative chemotherapy was applied (de Gramont's or FOLFIRI regimen). In all of these patients, the cardio-specific markers brain natriuretic peptide (BNP) and troponin I were assessed, as well as markers of thyroid gland function, TSH and FT4. RESULTS: In the course of chemotherapy, more than half of the patients showed laboratory signs of coronary ischemia; in 6 of these (14%) coronary ischemia was manifested with troponin I levels above 0.3 microg/L. Twenty patients (48%) had laboratory signs of heart failure in the course of adjuvant or palliative chemotherapy. A more frequent incidence of elevated cardio-specific enzymes was observed in continual regimens than in bolus application of fluorouracil. Reduced TSH values were observed in the course of chemotherapy in 9 patients (21%), without changes in FT4 values. An increase in TSH values was observed in 4 patients (10%), again without changes in FT4 values. CONCLUSION: The pilot study demonstrated that in patients undergoing treatment for colorectal carcinoma by adjuvant or palliative chemotherapy on the basis of 5-fluorouracil, it is advisable to check for possible cardiotoxicity and simultaneously to monitor thyroid gland functions. This systematic monitoring may improve the quality of life in cancer patients.

Prognostic importance of thymidine kinase in colorectal and breast cancer.

BACKGROUND: Thymidine kinase (TK) plays an essential role in the processing of thymidine within the cell and therefore it is an important marker of proliferation, particularly in tumor cells. The aim of our study was to determine the diagnostic, prognostic and predictive importance of TK measurement in cancer. PATIENTS AND METHODS: TK was measured using radioreceptor analysis (RRA) with Immunotech assay kits. The serum level of TK was measured in 1087 patients with malignant disease (355 patients with hematology malignancies and 732 patients with solid tumors). RESULTS: Serum levels of TK were significantly elevated in inflammatory and immunological diseases in comparison with healthy individuals. Malignant diseases were associated with elevated serum levels of TK only in particular cases (e.g. hematological malignancies, cervical cancer). This marker has a high sensitivity for use as a primary diagnostic tool. It also has a high sensitivity during the follow-up period in breast and colorectal cancer for the prediction of relapse at the time of primary diagnosis and 3 months earlier than the diagnosis of relapse by imaging methods. CONCLUSION: TK represents a secondary tumor marker which is particularly useful for cancer disease monitoring. Interpretation of this marker must be performed only in association with evaluation of clinical status since all other possible non-specific causes (inflammatory or immunological diseases) of elevated serum levels must be excluded.

Tumor markers in pleural effusions.

AIM: The aim of this study was to determine the diagnostic capabilities of tumor markers in pleural effusion and their importance for assessment of the etiology of pleural effusions. PATIENTS AND METHODS: In pleural effusions from 166 patients hospitalized during the period 2003-2005 at the Department of Oncology and Radiotherapy, Faculty Hospital in Pilsen, the following tumor markers were determined: thymidine kinase (TK), neuron-specific enolase (NSE), cytokeratins [tissue polypeptide antigen (TPA), tissue polypeptide-specific antigen (TPS) and cytokeratin fragment 19 (CYFRA 21-1)], carcinoembryonic antigen (CEA) and mucinous markers (CA 15-3, CA 19-9, CA 125). The inflammatory marker procalcitonin-PCT was also assessed. RESULTS: Tumor markers CA 125, TPA, TPS were significantly elevated in exudates, irrespective of the etiology, as a non-specific reaction in mesothelial cells. TK had a sensitivity of over 80% for all the types of cancer examined, while CA 15-3 had a sensitivity of over 90%. CONCLUSION: Significant positivity of PCT and CA 15-3 in pleural effusions indicate a suspicion of inflammatory disease. Positivity of TK and CA 15-3 indicate a strong suspicion of malignant exudates.

Clinical relevance of tumor markers for the control of chemotherapy.

This presentation is based on our experience with tumor marker monitoring of surgery therapy and chemotherapy effects. The control of chemotherapy is one of the most important problems in oncological practice. The correlation between the clinical status of the patient and tumor size changes, based on the results of different imaging methods, has been the most important and most frequently used method. However, the therapy effect has been recently assessed by markers of the biological activity of the tumor. Using tumor markers for the assessment of the effect of surgery therapy is already part of routine practice in many different types of cancer. Pre-operative and post-operative values of tumor markers are essential for a proper evaluation. However, tumor marker monitoring of the effect of radiotherapy and chemotherapy has been used very rarely, mostly only for research purposes. Besides monitoring by classical tumor markers, monitoring by markers of angiogenesis and apoptosis seem to be promising for the assessment of chemotherapy effect. Measurement of circulating cancer cells by means of mRNA also seems to be intriguing for therapy effect control and monitoring of the course of disease. Unfortunately, the routine use of these methods has been applied in only a few institutes worldwide. A completely different situation has been observed in palliative treatment. In most cases, changes of serum levels of tumor markers correlate with therapy effect. Thus, the effect of treatment on tumor proliferation can be successfully estimated by decreasing tumor marker levels.

Markers of cellular adhesion in diagnosis and therapy control of colorectal carcinoma.

AIM: Early diagnosis of the progressive tumor disease and control of the effect of therapy in colorectal carcinoma are most frequently performed by monitoring CEA or CA 19-9 tumor markers. Their clinical application is, however, limited. The aim of our study was to demonstrate the contribution of adhesive molecule assessment to the early diagnosis of progression. We also wanted to find out if changes in the levels of cellular adhesion parameters correlate with the effect of antitumor therapy. MATERIALS AND METHODS: Intercellular cell adhesive molecule-1 (ICAM-1) and Vascular cell adhesive molecule-1 (VCAM-1) were assessed using the ELISA method, and the results were correlated with CEA and CA 19-9 tumor markers. Three hundred and sixty-four patients with colorectal carcinoma in Dukes' stages B-D were monitored. The results were processed with the SAS 6.2. statistical program and Statistica. RESULTS: In 92 patients with first clinical progression (occurrence of distant metastases irrespective of localization), significantly increased ICAM-1 and VCAM-1 values were demonstrated. In ROC evaluation of curves, we also demonstrated high sensitivity of adhesive molecules against both the control healthy group (n =89) and the no evidence of disease group (NED) (n=183). Adhesive molecule levels were closely connected with the type and course of therapy and are presented in the form of case reports. CONCLUSION: Soluble adhesive molecules are a prospective parameter both for the early diagnosis of progression and for control of the effect of therapy. There is a need for a large-scale study, preferably multicentric, which would verify the suitability of introducing cellular adhesion parameter assessment into routine practice.

Changes of thymidine kinase (TK) during adjuvant and palliative chemotherapy.

UNLABELLED: Thymidine kinase is involved in nucleic acid synthesis and is, therefore, considered to be an important proliferation tumor marker. For this reason, we monitored this marker in the course of colorectal cancer chemotherapy. MATERIALS AND METHODS: We examined thymidine kinase (TK) levels in 30 patients with colorectal cancer who underwent adjuvant or palliative chemotherapy (CHT schemes). The condition for being included in the study was a minimum of 3 cycles of chemotherapy. TK was always assessed with radio-receptor analysis, before and after every chemotherapy cycle, together with other tumor markers. RESULTS: From the monitored tumor markers, only TK changed typically in the course of chemotherapy. In adjuvant chemotherapy, it was mostly low at the beginning of the cycle and its values usually increased considerably at the end. On the other hand, in palliative chemotherapy the dynamics of TK varied mainly depending on the effect of the therapy. Other tumor markers showed nonstandard behavior and minimal correlation with TK changes. CONCLUSION: Thymidine kinase seems to be a suitable parameter for monitoring the effect of adjuvant and palliative chemotherapy in colorectal cancer.

[Serum tumor markers at exocrine adenocarcinoma of pancreas]. / Sérové nádorové markery u exokrinních adenokarcinomu pankreatu.

Pancreatic cancer represents a group of cancers with the worst prognosis. There exists only one method of successful therapy--radical surgery, i.e. the complete resection of the tumor. However, only 5% of cases are diagnosed in the early stage. More than 60% are recognised in the period of advanced disease. For those patients only palliative treatment can be used. Only early diagnosis can ensure better therapy results. Possibility of early diagnosis based on imaging and endoscope methods is at present very limited due to the anatomical location of pancreas. Serum tumor markers assessment might represent one of the possibilities of early detection of the pancreatic cancer. Review summarizes current knowledge on the use of tumor markers for diagnosis, prognosis and therapy monitoring of pancreatic exocrine adenocarcinomas with respect to the clinical use at the daily routine practice.

[Gastrointestinal tract cancer and diabetes mellitus]. / Nádory trávicího traktu a diabetes mellitus.

Risk of development of some gastrointestinal tract cancers (colorectal cancer, pancreas cancer and liver cancer) is higher in type II diabetics. Another important risk factor is obesity (for gall bladder cancer in women and in men also for stomach and esophageal cancer). Pathogenetic factors have been explored especially in colorectal cancer (diet, hyperinsulinaemia, metabolic receptors activation, absence of physical activity). Our Czech study also proved up to 4 times increased risk of colorectal cancer in diabetics and, in accordance with literature, probable influence of persistent diabetes on tumour development. Type II diabetes mellitus should be considered as a risk factor especially for colorectal cancer, liver cancer, and pancreas cancer. In type I diabetics no risk of gastrointestinal tract cancers was proved.

Seasonal distribution of borreliae in Ixodes ricinus ticks.

Ixodes ricinus ticks were collected by flagging vegetation of a mixed oak forest in South Moravia (Czech Republic) at regular two-month intervals from March 1991 to March 1992 and examined for borreliae by darkfield microscopy. Mean annual proportions of infected ticks were 17.2% (15.4% to 21.2% monthly) in females (F), 18.6% (11.8% to 25.9%) in males (M), and 16.3% (12.4% to 20.9%) in nymphs (N); the differences among monthly values were insignificant. However, monthly proportions of intensively infected ticks containing more than 100 borreliae fluctuated widely, from 0.0% to 7.7% (annual mean 3.3%) in F, from 0.0% to 5.6% (mean 2.4%) in M, and from 0.0% to 5.7% (mean 1.9%) in N; the differences among months were significant, and the peak prevalence values were found in July (F, M) or November (N). Mean numbers of borreliae per infected tick reached their peak in September for both adult and nymphal ticks while they were generally low in spring. The highest risk of infection with tick-borne borreliae for vertebrates (including man) occurred in the study area during the month of July; in that month, one either female or nymphal I. ricinus containing more than 100 borreliae was encountered, on the average, every 92 minutes of flagging.

A serologic survey for some bacterial and viral zoonoses in game animals in the Czech Republic.

Between 1986 and 1991, sera were collected from 33 roe deer (Capreolus capreolus), 24 red deer (Cervus elaphus), four fallow deer (Dama dama), two mouflon (Ovis musimon), 34 wild boars (Sus scrofa), and 48 hares (Lepus europaeus) shot in two areas of the Czech Republic. Collectively, the sera contained antibodies to Coxiella burnetii (prevalence of 12%), Francisella tularensis (4%), Brucella spp. (2%), Central European tick-borne encephalitis virus (8%), Tahyna (California serogroup) virus (36%), and Calovo (= Batai) virus (23%). We propose that these mammals may play a role in maintaining natural foci of Q-fever, Tahyna fever and Calovo virus infection.