The influence of extreme thermal stress on the physiological and psychological characteristics of young women who sporadically use the sauna: practical implications for the safe use of the sauna

Background

Many individuals who use the sauna at a temperature of 120°C of higher are not aware of the negative consequences of extreme thermal stress. Despite extensive research into sauna use, the impact of extreme thermal stress on the physiological and psychological characteristics of sauna users have not been examined to date.

Aim

The aim was to determine the effect of 20 min sauna sessions with a temperature of 80°C and 120°C on the physiological and psychological characteristics of women who sporadically visit the sauna.

Methods

The study was conducted on 22 full-time female university students. Physical activity (PA) levels were evaluated with the Polish short version of the International Physical Activity Questionnaire (IPAQ). Anthropometric characteristics were measured before the first sauna session by the InBody270 body composition analyzer. Physiological parameters, including heart, energy expenditure, physical effort, and blood pressure (systolic blood pressure - SBP, and diastolic blood pressure - DBP), were assessed indirectly using Polar V800 heart rate monitors and the Omron M6 Comfort blood pressure monitor. The participants' wellbeing was assessed with the Profile of Mood States (POMS) questionnaire. The presence of significant correlations between heat exhaustion and heat stress variables and syncope during the second sauna session was examined with the use of classification and regression trees (CRT) and the cross-validation technique.

Results

Twenty-minute sauna sessions with a temperature of 80°C and 120°C induced a significant (p < 0.001) decrease in the values of SBP (excluding the temperature of 120°C), DBP, and body mass, as well as a significant increase in HR and forehead temperature. Exposure to a temperature of 80°C led to a significant (p < 0.001) increase in vigor with a simultaneous decrease in tension, depression, anger, fatigue, and confusion. In turn, sauna bathing at a temperature of 120°C had an opposite effect on the above mood parameters. Vomiting and confusion were the main predictors of syncope that occurred in some of the surveyed women.

Conclusion

Excessive air temperature can induce symptoms characteristic of heat exhaustion and heat stress nausea, heavy sweating, fast weak or strong HR, high body temperature, and confusion. Therefore, sauna bathing at a temperature of 80°C can be recommended to women who sporadically use the sauna, whereas exposure to a temperature of 120°C is not advised in this group of sauna users. The present findings provide highly valuable inputs for managing wellness and SPA centers.

The Effect of Neoglandin on the Activity of N-Acetyl-β-D-Hexosaminidase in the Serum and Urine of Alcohol-Dependent Men

Dietary supplementation of gamma-linolenic acid (GLA) in the form of a commercial drug neoglandin (containing GLA and vitamin E), in people following alcohol abuse allows bypassing of the ineffective delta-6-desaturase system involved in the transformation of linoleic acid into GLA. Determination of the activity of N-acetyl-β-D-hexosaminidase (HEX) in the serum and urine reflects neoglandin action on the catabolism of glycoconjugates and the functioning of liver and kidneys in people following alcohol abuse.

MATERIAL AND METHODS

The serum and urine were collected from men with alcohol dependence, treated (n = 31, age 33.16 ± 9.72 years) and not treated (n = 50, age 35.46 ± 11.37 years) with neoglandin. HEX activity were assayed in the supernatants by the colorimetric method, with the p-nitrophenyl derivative of sugar as substrate.

RESULTS

Our study on alcoholic men not treated with neoglandin indicates a significantly higher concentration of the serum and urinary HEX activity (nKat/L) on day 1 compared to days 7, 10, 14 and 30 (p < 0.001). For days 14 and 30 (p < 0.01), the urinary HEX activity was expressed in μKat/kgCr. No significant differences were observed in the activity of serum (nKat/L) and urinary (nKat/L and μKat/kgCr) HEX in alcoholics during treatment with neoglandin compared to day 1 of neoglandin treatment. We found significantly different (p < 0.05) concentration of HEX activity (nKat/L) in serum of alcohol-dependent men treated with neoglandin compared to those not taking neoglandin on days 7, 10, 14 and 30 of treatment. The urinary concentration of HEX activity (nKat/L) on days 1, 4, 10 and 30 and HEX activity in μKat/kgCr on days 1, 4 and 7 it was significantly higher (p < 0.05) during the treatment of alcohol-dependence without the use of neoglandin as compared to alcoholics treated with neoglandin. We found a positive correlation between the amount of alcohol consumed and the urinary activity of HEX in the early phase after alcohol withdrawal and a lack of correlation between the HEX activity in serum and urine of alcohol-dependent men not treated with neoglandin.

CONCLUSIONS

Neoglandin supplementation in alcoholic men significantly slows down the catabolism of glycoconjugates, thus reducing the effects of ethanol poisoning that are harmful to the kidneys. Neoglandin reduces the harmful effects of ethanol poisoning more on the kidneys than on the liver. The activity of HEX in the serum may be used in monitoring the treatment of alcoholism and whether alcohol reuse occurred during the therapy. In the early stages of alcohol withdrawal, urinary HEX activity can be used as a marker of the amount of alcohol consumed during previous alcohol abuse.

TPH1 gene polymorphism rs211105 is associated with serotonin and tryptophan hydroxylase 1 concentrations in acute pancreatitis patients

Background

The role of serotonin and its metabolic pathway in proper functioning of the pancreas has not been thoroughly investigated yet in acute pancreatitis (AP) patients. Tryptophan hydroxylase (TPH) as the rate-limiting enzyme of serotonin synthesis has been considered for possible associations in various diseases. Single-nucleotide polymorphisms (SNPs) in TPH genes have been already described in associations with psychiatric and digestive system disorders. This study aimed to explore the association of a rs211105 (T/G) polymorphism in TPH1 gene with tryptophan hydroxylase 1 concentrations in blood serum in a population of acute pancreatitis patients, and to investigate this association with acute pancreatitis susceptibility.

Results

Our data showed an association between the presence of the T allele at the position rs211105 (OR = 2.47, 95 % CI 0.94–6.50, p = 0.06) under conditions of a decreased AP incidence. For TT and GT genotypes in the control group, the lowest concentration of TPH was associated with higher serotonin levels (TT: Rs = − 0.415, p = 0.0018; GT: Rs = − 0.457, p = 0.0066), while for the AP group the highest levels of TPH among the TT genotype were associated with lower levels of serotonin (TT: Rs = − 0.749, p < 0.0001, and in the GG genotype higher levels of TPH were associated with higher levels of serotonin (GG: Rs = − 0.738, p = 0.037).

Conclusions

Here, a new insight in the potential role of a selected genetic factor in pancreatitis development was shown. Not only the metabolic pathway of serotonin, but also factors affecting serotonin synthesis may be interesting and important points in acute pancreatitis.

Vitamin D Receptor (VDR) Gene Polymorphism in Patients Diagnosed with Colorectal Cancer

Colorectal cancer (CRC) is one of the most commonly occurring neoplasias in humans. The prevalence of CRC rates is still rising. Although the exact background of the disease still remains unknown, it is believed that CRC may not only be a result of environmental factors, but also genetic ones. One of the mechanisms underlying CRC might be the vitamin D pathway, as CRC is the most closely linked neoplasia to vitamin D deficiency. This study shows a possible association of the vitamin D receptor (VDR) polymorphisms FokI, BsmI, ApaI, and TaqI with CRC susceptibility. A total of 103 patients diagnosed with CRC (61 men and 42 women, aged 57-82 years) and 109 healthy people (50 men and 59 women, aged 47-68 years) were genotyped using PCR-RFLP for FokI, BsmI, ApaI, and TaqI. None of the single nucleotide polymorphisms (SNPs) individually increased or decreased the risk of CRC. The evaluation of haplotypes revealed two that might enhance the likelihood of CRC development: taB (OR = 30.22; 95% CI 2.81-325.31; p = 0.01) and tAb (OR = 3.84; 95% CI 1.29-11.38; p = 0.01). In conclusion, genotyping is an easy and robust procedure that needs to be performed only once in a lifetime. A creation of a relevant SNP's panel might contribute to the identification of the groups that are at the greatest risk of CRC.

Single Nucleotide Polymorphisms in the Vitamin D Receptor Gene (VDR) May Have an Impact on Acute Pancreatitis (AP) Development: A Prospective Study in Populations of AP Patients and Alcohol-Abuse Controls

Vitamin D imbalance is suggested to be associated with the development of pancreatitis. Single nucleotide polymorphisms (SNPs), Apa-1, Bsm-1, Fok-1, and Taq-1, in the vitamin D receptor gene (VDR) are known in various diseases, but not yet in pancreatitis. The aim of this study was to explore possible associations of the four SNPs in the VDR receptor gene in a population of acute pancreatitis patients and alcohol-abuse controls, and to investigate the association with acute pancreatitis (AP) susceptibility. The study population (n = 239) included acute pancreatitis patients (n = 129) and an alcohol-abuse control group (n = 110). All patients met the Diagnostic and Statistical Manual of Mental Disorders (DSM IV) criteria for alcohol dependence. DNA was extracted from peripheral leukocytes and analyzed for VDR polymorphisms using a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Odd ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression analysis. To date, we have found allele T in Taq-1 (OR = 2.61; 95% CI: 1.68⁻4.03; p < 0.0001) to be almost three times more frequent in the AP group compared to the alcohol-abuse control patients. Polymorphism Taq-1 occurring in the vitamin D receptor may have an impact on the development of acute pancreatitis due to the lack of the protective role of vitamin D.

Septic Shock in the Course of Liver Absces Rescued with Percutaneous Drainage - A Literature Review and Case Report

This study presented a septic shock occurring with striking speed during the percutaneous drainage of a large abscess of the liver in an 18-year-old female patient after an appendectomy performed 3 months earlier using the laparoscopic method because of its phlegmonous and gangraenosus inflammation. The post-operative course was complicated by increased suppuration in places after removal of the trocars. After including the intravenous antibiotic therapy and under the USG control, the percutaneous drainage of the abscess was performed. While withdrawing the guide of the drainage catheter set, the symptoms of septic shock occurred. The pharmacological treatment was applied with continuation of the antibiotic therapy till a negative result of microbiological tests was obtained and the normalization of life parameters. The patient was not qualified for treatment in the ICU. She was discharged in a generally good condition after 24 days of hospitalization. In the case of this patient, the drain covered with the content of the abscess may have contact with the adjacent tiny blood vessels, which may have contributed to the systemic inflammatory response syndrome that was linked with fast-developing sceptic shock.

μ-Opioid receptor gene (OPRM1) polymorphism in patients with breast cancer

Structure-dependent μ-opioid receptor (MOR) activity is an important element in cancer opioid analgesic effectiveness. It is widely accepted that guanine (G) substitution for adenine (A) at OPRM1 gene sequence position 118 changes receptor glycosylation pattern. This is associated with decreased binding ability in both exogenous and endogenous opioids, resulting in increased human pain resistance. The endogenous opioid system's function in body homeostasis maintenance is considered mainly regulatory, so its participation in breast tumor formation and progression is identified herein. We examine the association of the most frequent MOR (A118G) gene polymorphism on breast cancer risk in a Northeastern Polish population by PCR-RFLP comparison of A and G allele frequency at OPRM1 gene A118G polymorphic site in breast cancer-diagnosed patients with healthy control group frequencies. Our results highlight a strong association between G allele presence at μ-opioid receptor A118G and increased breast cancer incidence (OR = 3.3, 95 % CI 2.2-5.0, p < 0.0001) and female gender (OR = 2.0, 95 % CI 1.4-2.9, p = 0.0004). Consequently, OPRM1 G allele presence at that site is a highly significant risk factor in breast cancer development.

[Isoforms A and B of lysosomal N-acetyl-beta-D-hexosaminidase in serum and urine of parenterally fed patients]

Parenteral nutrition entails numerous metabolic complications resulting from food bypass of the gastrointestinal tract. Up to now have not been established all complications of parenteral nutrition, despite intensive research and clinical observations. Knowledge of the biochemical changes resulting from parenteral nutrition is essential to effective prevention, early detection and effective treatment of the metabolic disorders induced by parenteral nutrition. The aim of the study was to evaluate the catabolism of glycoconjugates of parenterally fed patients, reflected by the activity of N-acetyl-beta-D-hexosaminidase (HEX): HEX A and HEX B isoenzymes in serum and urine.

MATERIAL AND METHODS

Samples of blood and urine were collected from 23 patients: before intravenous alimentation, at start, as well as of fifth and tenth day of parenteral nutrition. The activity of HEX A and HEX B in serum and urine was determined by the colorimetric method of Zwierz et al. as modified by Marciniak et al. The activity of urinary HEXA and HEX B has been calculated per 1 mg of creatinine.

RESULTS

The activity of serum HEXA significantly decreased at fifth day, in comparison to the activity before parenteral alimentation, and significantly increased at tenth day of parenteral nutrition. The activity of HEX B in serum increased significantly at fifth and tenth day of the parenteral nutrition.

CONCLUSIONS

Parenteral nutrition alter the catabolism of glycoconjugates, reflected by significant changes in serum HEX A and HEX B activities. Urine was the not appropriate material to evaluate the catabolism of glycoconjugates in view of HEX A and HEX B activities.

Activity of alpha-fucosidase and beta-glucuronidase in serum and urine of patients administered parenteral nutrition

BACKGROUND

In hospital patients suffering from adverse clinical and biochemical symptoms of malnutrition, it is often necessary to employ parenteral nutrition to avoid the body's tissue becoming broken down by being metabolised. Thus, the patient's welfare and survival can be supported throughout any periods of medical crisis. Two of the enzymes responsible for metabolising glycoconjugates are alpha-fucosidase (FUC) and beta-glucuronidase (GLU), present in lysosomes. They release fucose or glucuronic acid from the non-reducing end of oligosaccharide chains.

OBJECTIVE

To determine the effect of parenteral nutrition administered to ill patients, on glycoconjugate metabolism, by measuring serum and urinary activities of FUC and GLU. Material and methods. Blood samples and the daily urine collection were taken from 23 patients' who had been undergoing parenteral nutrition for either 5 or 10 days, as well as from a baseline sample. Enzyme activities in serum and urine were determined by the method of Zwierz et al.

RESULTS

Serum FUC activities were significantly lower after 10 days compared to 5, (p< 0.0172), whereas GLU activities were significantly lower after both 5 and 10 days, (p< 0.0007 and p< 0.0208 respectively), compared to levels before starting parenteral nutrition. GLU activities were however higher after 10 days than those after 5 days, (p< 0.0023). In urine, FUC activities were significantly decreased after 10 days compared to 5 days after starting parenteral nutrition, (p< 0.0245). Urine GLU activities were unaffected by parenteral nutrition nor was any effect seen on FUC or GLU activities when calculated per 1mg creatinine.

CONCLUSIONS

Serum FUC and GLU activities can be used for assessing the effect of parenteral nutrition on glycoconjugate metabolism. The significant decreases of serum GLU activity observed after 5 and 10 days, may serve to indicate that the components of parental nutrition are appropriate and that the body has become suitably adapted to this form of nutrition.

The outcomes of SILS cholecystectomy in comparison with classic four-trocar laparoscopic cholecystectomy

INTRODUCTION

General approval of laparoscopy as well as persistent urge to minimize operative trauma with still existing difficulties in putting natural orifice transluminal endoscopic surgery (NOTES) into practice have contributed to the introduction of laparoscopic operations through one incision in the umbilicus named single incision laparoscopic surgery (SILS).

AIM

The main aim of this study was to assess the benefits to patients of applying SILS cholecystectomy as a method of gallbladder removal based on the comparison with classic four-port laparoscopic cholecystectomy.

MATERIAL AND METHODS

Between 18.03.2009 and 09.12.2009, 100 patients were included in the study and they underwent elective gallbladder removal by applying the laparoscopic technique. All patients were divided into two equal groups: qualified for SILS cholecystectomy (group I) and qualified for classic four-trocar laparoscopic cholecystectomy (group II), whose ASA physical status was I and II. BMI was limited to 35 kg/m(2). Outcome measures included operative time, intensity of postoperative pain and consumption of painkillers, hospital stay, need for conversion, complications, and cosmetic effects.

RESULTS

Mean operating time in group I was 66 min and in group II 47.2 min. Intensity of pain evaluated by using the visual analogue scale (VAS) 6 h after the operation in group I was 3.49 and in group II 4.53, whereas 24 h after the operation in group I it was 1.18 and in group II 1.55. The painkiller requirement in group I was smaller than in group II. Mean hospital stay after the operation in group I was 1.33 days and in group II 1.96 days. There were 4 conversions in group I and one conversion in group II. Among the complications in group I there were noted 2 cases of right pneumothorax, 1 case of choleperitonitis and 4 complications connected with wound healing. There was one injury of the duodenum and one wound infection in group II.

CONCLUSIONS

Single-incision laparoscopic surgery cholecystectomy can be an alternative to classic laparoscopic cholecystectomy, especially with reference to young people with body mass index less than 35 kg/m(2), without serious systemic diseases, operated on electively due to benign gallbladder diseases.

Exceptionally rare cause of a total stomach resection

The first-ever case of a 54-year-old woman who overdosed on non-steroidal anti-inflammatory drugs in an attempt at suicide. Before that incident, she had not been treated for coexisting diseases such as rheumatoid arthritis or depression. At the time of admission to the General Surgery Department, the patient reported pains in the epigastric region with accompanying nausea and vomiting with mucous content as well as the inability to ingest food orally. Despite parenteral and enteral feeding, the patient exhibited a drop in body mass. The histopathologic examination of a sample taken from the stomach during gastroscopy showed some non-specific necrotic and inflammatory masses with granulation. Intraoperatively, a very small, infiltrated stomach with an initial section of duodenum was identified. A total stomach resection together with the reconstruction of digestive tract continuity was performed using the Roux-Y method. Histopathologic examination of the stomach revealed a deep, chronic and exacerbated inflammatory condition with an extensive ulceration over the entire length of the stomach, reaching up to the pylorus. Additionally, numerous lymphatic glands with inflammatory reaction changes were observed.

N-acetyl-beta-D-hexosaminidase and its isoenzymes A and B in blood serum and urine, as a potential colon cancer markers

BACKGROUND/AIMS

Evaluation of N-acetyl-beta-D-hexosaminidase (HEX), and its isoenzymes A (HEX A) and B (HEX B) activity in blood serum and urine as potential markers of colorectal cancer.

METHODOLOGY

The study was performed in blood serum and urine of 32 patients with adenocarcinoma, 6 with adenocarcinoma mucinosum of the colon, and 20 healthy people. The activity of HEX, HEX A and HEX B was determined in blood serum and urine by spectrophotometric method of Marciniak et al. The concentration of CEA was determined in blood serum by immunoenzymatic method (MEIA). The concentration of protein was assessed by the Lowry method, whereas the concentration of creatinine in urine by the Jaffe method (without deproteinization).

RESULTS

A significant increase in the concentration of HEX, HEX A and HEX B activity was proved in serum and urine of patients with colon adenocarcinoma. In patients with colon adenocarcinoma mucinosum, the higher activity of HEX was revealed in blood serum compared to healthy people, and the significantly higher activity of HEX and HEX B expressed as pKat/mg of creatinine, was found in urine. We observe a significant increase in the activity of HEX, HEX A and HEX B expressed in pKat/mg of creatinine was found in urine of patients bearing tumor of diameter 6.0-7.0 cm in comparison to patients with tumor of diameter 4.0-5.0 cm.

CONCLUSIONS

The present study results suggest that determination of HEX, HEX A and HEX B activity in blood serum and urine may be used to detect colon cancer in its early stages. However, the use of HEX, HEX A and HEX B activity in oncological diagnostics requires further studies on a larger group of patients.

Catabolism of salivary glycoconjugates in acute ethanol intoxication

BACKGROUND

The aim was to study the effects of a single large dose of ethanol (approximately 2.0 g/kg of body weight, as 40% vodka) on the specific activities of alpha-mannosidase, alpha-fucosidase, beta-glucuronidase, and beta-galactosidase as well as on the total protein concentration in saliva in eight healthy young volunteers.

MATERIAL/METHODS

Resting whole saliva samples were collected 12 hours prior to and 36 and 108 hours after alcohol consumption. Exoglycosidase activities were assayed in the supernatants by the colorimetric method. Protein content was determined by the Lowry method.

RESULTS

Thirty-six hours after alcohol consumption the specific activities of alpha-fucosidase and beta-glucuronidase were significantly higher than before drinking. The specific activity of beta-galactosidase showed a greater tendency to increase than alpha-mannosidase after the drinking session. The total protein concentration was significantly lower after alcohol consumption than at baseline, even at 108 hr. Significant inverse correlations between total protein content and the specific activities of the exoglycosidases in saliva were found after the drinking session.

CONCLUSIONS

Acute ingestion of a large dose of ethanol increased the activity of salivary exoglycosidases, which might be followed by subsequent degradation of proteins in saliva. The observed changes might contribute to salivary defense system malfunction as well as to oral malodor production.

Colon cancer releases alpha-tocopherol from its O-glycosides better than normal colon tissue

BACKGROUND/AIMS

Free radicals, in a colon, may damage DNA, make difficult DNA repair and change course of post-translational modifications of regulatory proteins, which promote tumor initiation and progression. Therefore risk of colon cancer is closely related to diet and other lifestyle factors. Dietary antioxidants, such as vitamin E, should reduce the levels of harmful oxidation products. However vitamin E is not soluble in water, which decreases its bioavailability. As O-glycosides of alpha-tocopherol are better soluble in water and penetrate to tissues easier than free alpha-tocopherol, the aim of our work was to investigate the rate of release the free tocopherol from its O-glycosides in colon cancer, in comparison to human healthy colon tissue.

METHODOLOGY

The activities of enzymes catalysing hydrolysis of alpha-tocopheryl glucoside (1a) and mannoside (1b) as well as p-nitrophenyl beta-glucoside (2a) and mannoside (2b) in cancer and healthy human colon tissues, were determined according to the modified method described by Zwierz et al.

RESULTS

The alpha-tocopherol and p-nitrophenol were significantly better released from the respective glucosides and mannosides in cancer tissue than in "healthy" human colon tissues, with p = 0.000947 for la, p = 0.033024 for 1b; p = 0.0028 for 2a, and p = 0.0033 for 2b, respectively.

CONCLUSION

Alpha-tocopherol and p-nitrophenol are released from the O-glycosides of glucose and mannose in significantly higher amount in colon cancer than in healthy tissues. The alpha-tocopherol O-glycosides can be considered as prodrugs in prevention and treatment of the colon cancer.

Evaluation of PDGF-AB and sP-selectin concentrations in relation to platelet count in patients with colorectal cancer before and after surgical treatment

INTRODUCTION

Platelet-derived growth factor (PDGF) and P-selectin, the low-molecular weight proteins located mainly in the platelet alpha-granules, are considered to be biologically active markers of platelet (PLT) activation.

OBJECTIVES

The study objective was to assess levels of PDGF-AB and sP-selectin in relation to PLT blood count in patients with colorectal cancer (CRC) who were examined before and after radical surgical treatment of the cancer.

PATIENTS AND METHODS

The study involved 38 CRC patients including B1 - 20 patients (T(2-3)N(1)M(0)), B2 -18 patients (T(2-3)N2M0) and 24 age and sex-matched healthy subjects (the control group). Blood samples were collected from the antecubital vein prior to and 3 months after the radical surgery. PDGF-AB and souble (s)P-selectin, the markers of PLT activation, were determined by the immunoenzymatic methods.

RESULTS

In CRC patients, the levels of PDGF-AB and sP-selectin were a few times higher, whereas the PLT count was lower as compared to the control group. Moreover, these levels were statistically much higher before, compared to those after the surgery, in patients with a higher grade of clinical and histological differentiation (p <0.05) as well. However, no positive correlation was found between the PLT count and the PDGF-AB and sP-selectin levels.

CONCLUSIONS

High levels of PDGF-AB and sP-selectin, the sensitive markers of PLT activation prior to surgical treatment seem to indicate cancer tissue as the source of both PDGF and sP-selectin. For this reason, PDGF-AB and sP-selectin determination may help in early non-invasive CRC evaluation in the future.

Lysosomal exoglycosidases in serum and urine of patients with colon adenocarcinoma

BACKGROUND/AIMS

The aim of this study is to evaluate the usefulness of determination the activity of lysosomal exoglycosidases: N-acetyl-beta-D-hexosaminidase (HEX - E.C. 3.2.1.30), beta-D-galactosidase (GAL - E.C. 3.2.1.23), alpha-L-fucosidase (FUC - E.C. 3.2.1.51) and alpha-D-mannosidase (MAN - E.C. 3.2.1.24) in blood serum and urine in diagnostics of colon adenocarcinoma.

METHODOLOGY

The activity of lysosomal exoglycosidases was determined by the method of Marciniak et al. adapted to serum and urine of patients with adenocarcinoma of the colon.

RESULTS

A significant increase in concentration of the activity of HEX, GAL and FUC was found in blood serum, as well as HEX and GAL in urine, of patients with colon adenocarcinoma, in comparison with healthy people. With the method of Marciniak et al. for determination the activity of HEX, GAL and FUC in blood serum as well as HEX and GAL in urine, the cases of colon adenocarcinoma were significantly differentiated from healthy people.

CONCLUSIONS

The high diagnostic value, sensitivity and specificity of the method of Marciniak et al., suggests the possibility of its use for determination of the activity of HEX, FUC and GAL in blood serum as well as HEX and GAL in urine, in the diagnostics of colon adenocarcinoma.

Cathepsin D and carcino-embryonic antigen in serum, urine and tissues of colon adenocarcinoma patients

BACKGROUND/AIMS

Application of neoplastic markers in early diagnosis of colorectal carcinoma has brought fresh hope to millions of sufferers. However such a marker, distinctive for this particular carcinoma and allowing its detection at a sufficiently early stage of development has not yet been found. Cathepsin D (CD) is lysosomal aspartyl proteinase. It is a component of a proteolytic cascade participating actively in neoplastic invasion as well as in metastasis formation. Carcino-embryonic antigen (CEA) is a useful marker in oncological diagnostics of colorectal cancer. CEA undergoes expression in all kinds of adenocarcinoma and is found both intercellularly and extracellularly. High concentrations of CEA in the blood serum confirm neoplastic changes in the digestive tract with high probability. The objective of this study has been to evaluate CD activity in the blood serum, urine and tumor tissues as well as in the colon biopsies which were not changed macroscopically and CEA concentration in the serum of colon adenocarcinoma, considering the extent of spread of cancer (TNM), the grade of the differentiation of cancer cell (G) as well as the tumor size. The possibility of application of CD along with CEA as markers of colon adenocarcinoma has also been examined.

METHODOLOGY

The examination included the serum and urine of 21 patients as well as 12 tissues biopsies with histopathologically confirmed colon adenocarcinoma. The reference group for the blood and urine comprised of 17 healthy controls, and for the colon adenocarcinoma tissues- samples collected from 14 people from the sites most distant from the resected tumor on the boundaries which were free of cancer cells. Activity of CD in the blood serum, urine as well as tissues was determined with a modified Greczaniuk et al. method and expressed by the amount of released tyrosine as the concentration of the activity in nmolTyr/mL/6h, whereas the specific activity was expressed in nmol Tyr/mg of protein /6h. The specific activity of CD in the urine was expressed in nmol Tyr/mg of creatinine/6h. CEA concentration in the blood serum was determined by the immunoenzymatic method (MEIA) on Axym Abbot Analyzer and was expressed in ng/mL. The protein concentration was determined by the Lowry method, and the results were expressed in mg/mL. The creatinine concentration in the urine was determined by the Jaffe method (without deproteinization) and was expressed in mg/100mL.

RESULTS

CD activity was increased in the blood serum (p < 0.0001) and tissues (p = 0.022) of colon adenocarcinoma patients in comparison to the reference group. CD specific activity (Tyr/mg of protein/6h) was significantly increased in serum but decreased in the urine (p < 0.0001) whereas the specific activity of CD (nmol Tyr/mg of creatinine/6h) was increased in the urine (p = 0.0001). CD specific activity has tendency to increase in colon adenocarcinoma tissues (p = 0.441) as compared to the reference group. By examining data in regard to TNM clinical-histopathological classification, G and the tumor size, it could be concluded that CD activity in serum and urine in colon adenocarcinoma patients depends on progress of cancer in which CD activity increases with TNM. A statistically significant increase in CEA concentration was found in the serum of colon adenocarcinoma patients, which was almost threefold higher than the in reference group. No significant differences in CEA concentration were found depending on TNM, G and tumor size.

CONCLUSIONS

The results of this study suggest that examination of CD activity and CEA concentration in serum, as well as CD activity in the urine, might be used in oncological diagnostics of colon adenocarcinoma.

Isoenzymes A and B of N-acetyl-beta-D-hexosaminidase in serum and urine of patients with pancreatic cancer

BACKGROUND/AIMS

Adenocarcinoma is the most frequent malignant tumor of the pancreas. Biochemical diagnostics of pancreatic adenocarcinoma is based on determination of carcinoma antigen (CA 19-9) in the blood. Determination of N-acetyl-beta-hexosaminidase (HEX) in the serum and urine was used in diagnosis of renal and gastric cancers. Therefore the aim of our research was to estimate N-acetyl-beta-hexosaminidase (HEX) and its isoenzymes (HEX A and HEX B) in the serum and urine as potential markers of pancreatic cancer.

METHODOLOGY

Serum and urine samples were collected from 15 patients with adenocarcinoma of the pancreas and 15 healthy persons. The activity of N-acetyl-beta-hexosaminidase and its isoenzymes (A and B) was determined by a colorimetric method of Zwierz et al. Absorbancy of the yellow product of the colorimetric reaction was determined on the microplate reader EL(x)800 produced by BIO-TEK. The concentration of HEX, HEX A and B was expressed in pKat/mL, and the specific activity in pKat/mg of protein. Protein concentration was determined in the serum by the biuret and in the urine by the Lowry method, respectively, and expressed in mg/mL.

RESULTS

The concentration and specific activity of HEX and its isoenzyme A were significantly higher in the serum and urine of pancreatic cancer patients in comparison with the concentration and specific activity in the serum and urine of healthy people.

CONCLUSIONS

The results suggest that the activity of HEX and its isoenzyme A determined in the serum and urine can be used as a potential marker of pancreatic adenocarcinoma.

[Carcinoma and acute pancreatitis--case reports]

The coexistence of pancreatic carcinoma with severe form of acute pancreatitis (AP) is not only an extremely rare phenomenon described in literature but also a real problem in the aspect of differential diagnostics of neoplastic and inflammatory morphological changes in this organ. The study objective was the analysis of clinical material obtained from patients with inflammatory and neoplastic lesions, treated surgically in I Department of General and Endocrinological Surgery, Medical University of Bialystok in the years 1980-2005. Of these patients, 7 had pancreatic carcinoma at various stages of advancement diagnosed in the late postoperative period after severe form of AP. Patients' history, physical examination as well as biochemical tests and imaging diagnostic procedures (ultrasonography, CT) of the abdominal cavity explicitly showed severe form of acute pancreatitis. In every case, CA19-9 antigen values were substantially elevated (mean 780 +/-325 IU/ml, norm 0-37 IU/ml). Histopathological analyses of samples collected during laparotomy revealed the presence of necrotic-purulent tissues. In the late postoperative period, i.e. 3-24 months, all these patients were reoperated on for pancreatic carcinoma or its metastases. Only in one case, radical Whipple surgery was performed. All the remaining patients underwent palliative procedures or samples for histopathological examinations were only collected. In all the seven cases, metastatic carcinoma was diagnosed, including pancreatic carcinoma in 6 patients. These observations seem to indicate that severe AP may be insidiously accompanied by pancreatic carcinoma and that this coexistence should always be taken into consideration.

[Activity of cathepsin D in the blood serum and urine of patients with cancer of the stomach, pancreas and liver]

Cathepsin D is a protease involved in invasion of the cancer and metastasis formation. The purpose of the study was to evaluate a prognostic value of cathepsin D activity in blood serum and urine of patients with cancer of the stomach, pancreas and liver. The study was carried out on the samples of blood serum and urine obtained from patients with cancer of the stomach, pancreas and liver treated surgically at the First Department of General Surgery and Endocrinology of the Medical University of Białystok. The control group consisted of healthy individuals. Activity of cathepsin D was determined in serum and urine by the Folin-Ciocaltau method with the cupric modification and was expressed in nmol Tyr/ml/6h. Specific activity of cathepsin D was determined in the urine, and was expressed in nmol Tyr/mg of protein/6h. Protein concentration in serum was assessed with Lowry et al. method and results were expressed in mg/ml. A significant increase in activity of cathepsin D in serum (p = 0.0169) and urine (p = 0.0008) and an enhanced specific activity in the urine (p = 0.0085) was found in patients with cancer of the pancreas as compared with the controls. A significantly increased activity of cathepsin was revealed in serum (p = 0.0233) of patients with cancer of the stomach. No significant differences of cathepsin D activity were found in urine of the patients with cancer of the stomach when compared to the controls. Additionally, an upward tendency (almost two-fold increase) of cathepsin D activity was shown in blood serum and an increase in the activity and in specific activity was observed in urine of both patients with cancer of the liver in comparison with the healthy individuals. There were no significant differences in the activity of cathepsin D in serum of the patients with cancer of the pancreas and stomach (p = 0.4156). A statistically significantly higher activity (p = 0.0004) and specific (0.0048) cathepsin D activity was demonstrated in urine of the patients with cancer of the pancreas in comparison with the patients with cancer of the stomach. Determination of protein level in urine proved a downward tendency in the patients with cancer of the stomach (p = 0.11109), as compared to the controls, and a statistically significant increase found in the patients with cancer of the pancreas (p = 0.0238), in comparison with the patients with cancer of the stomach. In conclusion, investigation of cathepsin D activity in the blood serum of patients with cancer of the stomach and pancreas and in the urine of the patients with cancer of the pancreas may be usefull in clinical oncological diagnostics. However, further studies of the enzyme are necessary to establish the clinical value of cathepsin D measurement.

[Concentration of thyroid stimulating hormone and activity of N-acetyl-beta-D-hexosaminidase and its isoenzymes, in serum of patients with thyroid cancer]

Thyroid cancer consists 1% of all malignant neoplasms. It is not known interrelationship between concentration of TSH in blood serum and condition of thyroid cancer. Thyroid cancer is difficult for diagnosis and differentiation. Therefore it is necessary to search for biochemical markers helpful in diagnostics of thyroid cancer. Significant increase in activity of N-acetyl-beta-D-hexosaminidase and its isoenzymes A and B in serum of patients with neoplasms of kidney and pancreas suggest approporiateness of evaluation of HEX and its isoenzymes in diagnostics of thyroid cancer.

THE AIM

of the study--evaluation of TSH concentration and activity of HEX and its isoenzymes A and B, in serum of patients with thyroid cancer.

MATERIALS AND METHODS

Blood was taken from 7 patients with thyroid cancer (6 men and 1 woman). Control consisted of 7 healthy men. In blood serum concentration of TSH was determined with immunoenzymatic method on analyzer Axsym of Abbott and expressed in microU/mL. The activity of HEX and its isoenzymes A and B was determined by method of Chatterjee et al., as modified by Zwierz et.al. Determination of HEX was performed on microplate reader ELX800 BIO-TEK. Activity of HEX, HEX A and B was expressed in pKat/mL, and specific activity in pKat/mg protein). Protein was determined by biuret method and results were expressed in mg/mL.

RESULTS

Concentration of HEX A activity in serum of thyroid cancer patients is significantly higherin comparison to healthymen (p = 0.0191). Also specific activity of HEX A in serum of thyroid cancer patients is significantly higher in comparison to healthy men (p = 0.0393).

CONCLUSIONS

1. Determination of TSH concentration in serum of thyroid cancer before the operation may confirm euthyreosis. 2. Determination of HEX A activity in serum may be helpful in diagnostics of thyroid cancer.

Usefulness of examination of some tumor markers in diagnostics of liver cancer

BACKGROUND/AIMS

Diagnostics of liver cancer is mainly based on imaging methods: which are ultrasound and computer tomography. Determination of tumor markers is an accessory investigation enabling us to detect cancer, to evaluate the effectiveness of its operative and postoperative treatment and to diagnose early cancer relapse or distant metastases. Alpha-fetoprotein (AFP) is a basic well-known marker in diagnostics of liver cancer. Carcinoembryonic antigen (CEA) and cancer procoagulant (CP) are also important in case of metastases to this organ, especially from the colon. The purpose of this study was to evaluate the usefulness of AFP, CEA and CP in detection of liver cancer.

METHODOLOGY

The material of the study was the blood serum from 25 patients with liver cancer diagnosed histopathologically and 12 healthy individuals as a control group. The concentrations of AFP and CEP were assessed by immunoenzymatic method (MEIA) in the Axsym analyzer of Abbott and expressed in ng/mL. CP activity was determined by coagulation method worked out by Gordon and Benson and expressed as coagulation time in seconds (s).

RESULTS

Based on the results obtained in our study, the concentrations of AFP and CEP were several fold higher in the serum of patients with liver cancer than the relevant values of these markers. CP activity was higher in the serum of patients with liver cancer than the mean values of patients in the control group. The differences found in the study between the groups examined and the control group were statistically significant atp<0.001.

CONCLUSIONS

The results confirmed a high diagnostic value of AFP and CEA testing and suggest the possibility of using CP activity to detect liver cancer.

[Usefulness of detecting cancer procoagulant activity and thyrotropic hormone concentration in the differentiation of tumor-like changes in the thyroid]

Epidemiological studies have shown the increased incidence of malignant cancer of the thyroid gland observed in the last decade. This increase is connected with the elevated number of benign tumor-like/tuberous changes in the thyroid gland. Since it is difficult to differentiate diagnostically this pathology, it would be justified to search for biochemical markers which can help to confirm this change. The aim of our study was to evaluate the usefulness of detecting cancer procoagulant activity (CP) and thyrotropic hormone concentration (TSH) in the differentiation of tumor-like changes in the thyroid gland. The study included 15 patients (12 women and 3 men) with adenoma glandulae thyreoideae or nodular changes in the character of struma nodosa hyperplastica and 12 patients (11 women and 1 man) with carcinoma glandulae thyreoideae. A control group consisted of 12 healthy people (5 women and 7 men). CP activity was determined in the serum by the coagulation method according to Gordon and Benson and it was expressed as the coagulation time in seconds (s). TSH concentration was measured by the immunoenzymatic method (MEIA) using an analyzer of Axsym (Abbott) and was expressed in microU/ml. The results of our study indicate that the determination of CP activity can be used in the differential diagnosis of tumor-like changes of the thyroid gland. The concentration ofTSH was within the normal values, despite statistically different mean values between particular groups that results from the fact that patients qualified to surgery were in the state of euthyreosis.

The role of a therapeutic team and The Pol-Ilko Association in readaptation of patients with a stoma to the life in a family and society in the 21st century

Patients who crossed operation where exteriorization stoma was integral her part the aside from of cause, location and far-gone of illness which hereinto brought require special care. In moment of entry we to European Union should advert on introduction by us the surgeons of new operating techniques not only, but to attach importance to quality of sick's life after operations also, particularly these which violate beauty of our body. They are of the patients' groups the nation from stoma, particularly if cause the exteriorization stoma the state the neoplasmic disease of alimentary canal or arrangement urinary. The stay in Clinic whether the surgical squad, perspective of operation which is final effect producing artificial accompanying urinary content tract intestinal or fecal it joins with high-level of phobia. The Information Bureau for Stoma in year 1993 at Medical University was created and on the basis of this the information bureau the therapeutic complex worked out own model of these patients' care over group. The model of care over sick from stomy hugs three periods: preoperative, early and late surgical period (ambulant). On the basis of The Information Bureau from Stoma in 1994 year The Department was created of Podlasie the Society of Care over Patients from Stoma in Bialystok--association of working on thing sick's good. Organization this assembles from stomy the men, their family and guardians, workers of medical service and different men of good will. Meetings are forms of working, which performance of bothering patient's problems connected with nurturing and supply stomy is aim, and also psychical and help support in readaptation to life in family, company and society. The volunteers' training is to help different form of working this sick's group. Volunteer in this case--then living from stomy over year happily, adopted to life in every respect, person which exemplifies for sick prepared to operation positive (exteriorization stoma) or beginning one's "path stoma". Both the analysis and opinion of work of therapeutic complex, as and the workings The Association be made by only patients, their family and guardians, and also the workers of medical service. The elaborate model of care over sick from stoma on the basis of Information Bureau is accepted universally and resoluteness improves quality of life of this patients' group. Patient in XXI age from stomia on Podlasie it can appropriately living in family, work professionally, grow sport and hobby not only thanks to work therapeutic complex, but also and men who earlier found oneself in similar situation, as he alone.

[Evaluation of diagnostic values of neoplastic procoagulant in pancreatic, hepatic and ovary cancers]

The cancer procoagulant (CP) activity has been evaluated in serum of patients with pancreas, liver and ovarian cancer and in homogenates of these cancer tissues. CP activity in examined cancer tissues as well as in blood serum was significantly higher than in the control. The obtained results indicate that estimation of CP activity may be useful in oncological diagnosis of pancreas, liver and ovarian cancer.

Antioxidant potential in esophageal, stomach and colorectal cancers

BACKGROUND/AIMS

The gastrointestinal tract is particularly susceptible to reactive oxygen species attack which lead to carcinogenesis. An important role in defense strategy against reactive oxygen species is played by antioxidants. The present study aims at examining antioxidant parameters and malondialdehyde--the product of lipid peroxidation as well as the marker of cancer progression--and cancer procoagulant in esophageal, gastric and colorectal cancer patients.

METHODOLOGY

The activity of superoxide dismutase, catalase, glutathione peroxidase and reductase and the level of glutathione, vitamin C, malondialdehyde and cancer procoagulant were determined in tumors and normal mucous from 18 patients with esophageal cancer, 18 patients with stomach tumor and 62 patients with colorectal cancer.

RESULTS

In esophageal tumor the activity of all enzymes has been increased compared with normal mucous. Stomach tumor has been also characterized by an increase in antioxidant enzymes activity except glutathione peroxidase and reductase whose activities have been decreased. However in colorectal tumor the activity of enzymes has been increased apart from catalase. In all cases the glutathione level has been increased while the vitamin C content has been significantly decreased. Tumor malondialdehyde level was significantly increased, too. The level of cancer procoagulant also increased in cancer tissues as well as in the serum.

CONCLUSIONS

Antioxidant potential in all cases of gastrointestinal tract cancer has been unbalanced which has lead to increase in reactive oxygen species action and enhancement of lipid peroxidation and cancer procoagulant generation.

Cancer procoagulant as a marker in monitoring the therapy in cases of oesophageal, stomach and colorectal cancer

Cancer procoagulant activity in the blood serum of patients with oesophagal, gastric and colorectal cancer was evaluated before and after the tumour removal. Cancer procoagulant activity was significantly higher before the operation in comparison to the control group and was reduced after a total operative procedure, whereas it was kept on a high level after a non-radical procedure or in cases of metastases. Examination results point to the possibility of using the evaluation of cancer procoagulant activity in monitoring the course of treatment of patients with oesophagal, gastric and colorectal cancer.

Malignant and benign tumours of liver--problems of diagnostics, treatment and complications

Non-invasive diagnostics development, and particularly introduction of ultrasound to everyday medical practice contributed to early detection of tumour lesions in the liver. The aim of the research was to analyse the patients with tumour lesions of livers in the north-eastern region of Poland. 325 patients with tumour lesions in livers underwent surgical treatment between year 1978 and 2000. In 197 patients metastatic malignant tumours were found in livers, while in 24 cases--primary malignant neoplasms of the organ. In the remaining cases benign tumours, mostly non-parasitic cysts were found. Out of 325 patients, who were surgically treated, 80 underwent resection procedures of liver parenchyma with tumour, 17--enucleation of tumour lesion with the enclosing capsula, 14--abscess drainage with necrotic mass evacuation. In 11 cases of non-parasitic as well as parasitic cysts fenestration was performed due to high risk of surgery, while in the remaining patients laparotomy was only performed and segments for histopathologic examination were taken due to the progression of the neoplasmatic disease. In the patients who had undergone resections of liver parenchyma in the postoperative course we noted complications such as: prolonged cholerrhagia from peritoneal cavity, stress duodenal ulcers complicated by bleeding, bleeding from liver parenchyma at the section line, jaundice as well as cisterns of fluid at the parenchyma section line. Mortality in the patients after the resection procedures of liver in our material was 7.5%. The development of diagnostics contributed to early detection and surgical treatment of tumour lesions of liver. The observation of our patients showed that resection procedures in benign tumours lead to complete recovery, while in malignant lesions--to clearly prolonged survival.

[Cancer procoagulant activity in cases of esophageal, stomach and colorectal cancer considering progression degree and histological type of cancer]

The cancer procoagulant activity has been evaluated in homogenates of esophagal, stomach and colorectal cancer tissues and in the blood serum of patients with these neoplasms's. Activity of CP was significantly higher in examined material than in control. The correlation between CP activity and progression degree as well as histological type was affirmed. The higher activity of CP in homogenates as well as in serum was observed in cases with higher degree of clinical progression and smaller activity of this enzyme corresponded with lower degree of the cancer progression. The highest activity of CP was observed in the cases of adenocarcinoma whereas the lowest in cases of squamous cell carcinoma. Higher activity of CP in homogenates of examined tissues correlated with higher activity of this enzyme in the serum. Activity of CP depended on the tissue localisation of the cancer and the highest was in the cases of stomach cancers whereas the lowest was in the cases of esophagal cancer.

[Diagnostic value of testing the procoagulant activity of neoplasms in cases of stomach and esophageal neoplasms]

The cancer procoagulant (CP) activity has been evaluated in homogenates of stomach and esophagus cancer tissues and in patients serum. Activity of CP in homogenates of stomach and esophagus cancer tissues as well as in serum of examined cancer patients were statistically higher than in the control group. The data indicate that estimation of CP activity in the neoplasmic tissues homogenates and in serum may be suggested as an new biochemical marker of cancer process useful in oncological diagnosis.

[Significance of medium molecular weight peptides in pathologic processes]

The literature concerning of prevalence and meaning of middle molecular peptids in experimental and clinical pathology has been reviewed. Middle molecular peptids have been extracted for the first time from plasma of the patients with renal insufficiency by Babb in 1970.

[Hydatoid cysts of liver--diagnostic and therapeutic problem]

In the Department of General Surgery of Medical University 11 patients with hydatid cysts of liver were operated. Ultrasonography and computer tomography allowed to define exact localization, size and contents of the cysts, what made possible planning of operating procedure. In 2 cases nonanatomic resection of liver parenchyma was performed, in 2 ones with coexisting stomach neoplasm just excision of the frontal wall of the cyst and emptying of the interior. In all the other cases the cysts were removed with surrounding liver tissue. Late results of surgical treatment with albendazol therapy are good. Diagnosis of echinococcic desease should be precised, considering with possibility of co-existing foci in other organs.

[The time of maintainance of positive serologic results among patients operated on echinococcal liver cysts]

The purpose of this work was to analyse results of serologie examinations and complaints reported by patients who were operated on echinococcal liver cysts. The analysis was conducted on patients who were qualified to surgical removal of echionococcal liver cysts. Persons who were analysed answered the questionaires and 11 of them send sera for serologie examination. The questionaires consisted of questions about time since operation, complaints before and after operation abdomen pains, distensions, vomits, exanthema, weakness, headaches). Results showed that patient were from 1 to 6 years after operation. Among 11 who send sera 18% results were negative (2 and 6 years after operation) and 82% was positive. Analysis of 15 questionnaires showed that majority of patients still had the complaints that were present before operation.

[Complications after surgical resection of liver parenchyma]

The number of liver resection in Poland has recently increased. Most frequent indications are benign tumors of the liver, metastatic changes and primary hepatic carcinoma. The aim of work is to discuss incidence of complications which appeared after liver resections at our Department. Among 56 patients aged 19-76, 32 anatomical and 24 nonanatomical resections of hepatic tissue were performed. In the early postoperation period, 8 patients had peritoneal fluid collections and 3 laparotomies with drainage were necessary, while in 5 cases fluid was aspirated under usg guidance. The outflow of bile and blood contents from subhepatic space was prolonged to 9 days in 3 patients, gastric or duodenal 3 stress ulcerations complicated with bleeding were observed as well as transitory hemobilia in 3 and jaundice in 6 cases. Early hemorrhage from excision line of hepatic tissue was observed in 2 patients which needed additional surgical intervention. Atelectasis and inflammatory changes of the right lung appeared in majority of patients operated on. The postoperative mortality of 16% (9 patients of total 56) was mainly dependent on hepatorenal or cardiorespiratory failure, however myocardial infarction and DIC syndrome were also noticed. In spite of progress of surgical technique and intensive perioperative care, resection procedures of the liver are still accompanied with large percentage of serious complications.

Cellular utilization of cytosolic NADPH in kidney and liver cells from rats fed a normal or a vitamin D-deficient diet

The amount of reducing equivalents from NADPH generated by glucose 6-phosphate dehydrogenase activity (G6PD) used in mixed function oxidation (pathway I) or in reductive biosynthesis (pathway II) has been determined by cytochemical methods and microdensitometry in cells from the pars recta (PR) and distal convoluted tubule (DCT) of the kidney and from centrilobular (CL) and periportal (PP) hepatocytes from rats fed a normal or a vitamin D-deficient diet. In the kidney, pathway I activity was similar to that of pathway II in PR, whereas in DCT pathway II was markedly predominant. Feeding a vitamin D-deficient diet resulted in an increase in the total amount of reducing equivalents in PR and DCT. This increase was due to a rise in pathway I activity in the PR, whereas in the DCT the increase resulted from a stimulation of pathway II activity. Pathway I activity in PR was inversely correlated with plasma calcium, and was significantly decreased when calcium (1 mM) was added in vitro. In the liver the total amount of reducing equivalents generated by G6PD and both hydrogen pathways, was higher in CL than in PP hepatocytes. In CL cells, a vitamin D-deficient diet induced a significant increase in both NADPH pathways. Furthermore, in these cells pathway I activity was inversely related to plasma calcium and was significantly lowered when 1 mM calcium was added in vitro. It is concluded that vitamin D status and calcium influence the production and utilization of cytosolic reducing equivalents both in kidney and liver.