血清PSA结合病理分级预测前列腺癌骨转移

探讨血清PSA结合前列腺癌病理分级预测前列腺癌骨转移价值.对202例新诊断的前列腺癌患者, 以同位素全身骨扫描为金标准分为骨转移和非骨转移组, 分析血清PSA水平、病理分级和同位素骨扫描结果的关系.PSA RIA检测结果: 血清PSA＜10μg/L和PSA＜20μg/L病理分级中、高度分化者骨转移的发生率为7%和6%, 两者无统计学差异; PSA＜20μg/L病理分级低度分化者和血清20μg/L＜PSA＜100μg/L者,骨转移的发生率为33%和39%, 两组无统计学差异; PSA＞100μg/L者骨转移发生率为80%.建议排除对没有骨痛、血清PSA＜10μg/L和PSA＜20μg/L病理分级中、高度分化者和PSA＞100μg/L者行同位素骨扫描.     

PSA、cPSA检测和骨显像对前列腺癌早期骨转移的诊断价值

目的:分析前列腺特异性抗原(PSA)、复合前列腺特异性抗原(cPSA)联检和核素全身骨显像对前列腺癌早期骨转移的诊断价值.方法:选择152例患者(其中74例为临床确诊的前列腺癌患者,78例为良性前列腺疾病患者),全部进行血清PSA、cPSA检测,并同时对74例临床确诊的前列腺癌患者进行核素全身骨显像.另选择正常健康查体男性90例检测血清PSA、cPSA结果作为对照组.并计算cPSA/PSA比值.结果:前列腺癌患者血清PSA、cPSA检测结果及cPSA/PSA比值显著高于良性前列腺疾病患者及正常健康男性.其中,骨转移阳性显像组血清PSA、cPSA水平及cPSA/PSA比值显著高于非骨转移显像组,检测存在显著性差异(P＜0.05).结论:当PSA＞20μg/L、cPSA＞10μg/L、cPSA/PSA＞0.80时,发生前列腺癌骨转移的可能性较大,应常规做核素全身骨显像,可早期、全面地发现前列腺癌骨转移.     

血清PSA、FPSA测定在前列腺癌骨转移诊断中的价值

目的 探讨检测前列腺特异性抗原(PSA)、游离PSA(FPSA)对前列腺癌骨转移的诊断价值.方法 对68例经临床确诊的前列腺癌患者的PSA和FPSA检测结果及全身骨显像进行回顾分析.结果 前列腺癌骨转移组和非骨转移组PSA和FPSA的均值差异均有显著性(P<0.01);PSA<10ug/L的7例患者中,发生骨转移者1例,诊断阳性率为14.3%;PSA在10ug/L～50ug/L的患者共18例.发生骨转移者7例,诊断阳性率为38.9%;PSA>50ug/L的患者43例,发生骨转移39例,诊断阳性率为90.7%.结论 PSA<10ug/L的前列腺癌患者发生骨转移的可能性小;PSA>50ug/L的患者发生骨转移的可能性大.     

SPECT全身骨显像、血清tPSA及fPSA/tPSA比值及病理分级与前列腺癌骨转移的关系探讨

目的：探讨SPECT全身骨显像、血清tPSA水平、fPSA/tPSA比值及前列腺癌病理分级与前列腺癌骨转移的关系,并研究其发生骨转移的规律和特点。方法：以核医学SPECT全身骨显像为金标准,回顾性分析了体外放免法测定的107例前列腺癌患者的血清PSA（前列腺特异抗原）水平、血清fPSA/tPSA比值及全身骨显像和病理分级。结果：107例前列腺癌患者：49例发生骨转移,占45.8%（49/107）,其中不同病理分组之间骨转移发生率比较差异有统计学意义,分化程度越低,骨转移发生率越高;随着tPSA水平的升高,骨转移的发生率明显增加;血清tPSA（4～40）ng/ml时,采用fPSA/tPSA比值,可明显提高前列腺癌诊断特异性。结论：前列腺癌患者骨转移发生率与前列腺癌的分化程度、血清PSA水平及fPSA/tPSA比值有一定的关系。分化程度越低,骨转移发生率越高。     

肿瘤标志物fPSA的临床应用及其初步评估

为对游离前列腺特异性抗原(fPSA)/总前列腺特异性抗原(tPSA)比值在临床应用中的价值进行评估, 本文应用电化学发光免疫测定法, 检测了38例Pca、68例BPH患者以及43名无前列腺疾病的正常男子血清tPSA和fPSA含量, 并计算fPSA/tPA的比值.结果表明单独以血清tPSA大于4.0μg/L作为诊断Pca的标准,其灵敏度和特异性分别为84.2%、75.0%.若以血清fPSA/tPSA小于0.13作为诊断Pca的限定值,当血清tPSA小于2.0μg/L时,fPSA/tPSA比值的灵敏度和特异性分别为100.0%、57.0%;当血清tPSA大于20.0μg/L时,fPSA/tPSA比值的灵敏度和特异性分别为62.1%、66.7%, 而当血清tPSA水平在2-20μg/L时, fPSA/tPSA比值的灵敏度和特异性分别为93.6%、89.9%.结果提示fPSA/tPSA比值对tPSA水平在2-20μg/L这组人群前列腺癌诊断的准确率可以大大提高,而对此以外的人群并无太大价值.     

电化学发光免疫分析F/T PSA比值对前列腺癌早期诊断的观察

目的:观察前列腺特异性抗原游离与总量比值(F/T PSA比值)对前列腺癌(PCa)早期诊断的价值.方法:采用电化学发光免疫分析技术检测136例正常健康男性、98例前列腺增生(BPH)患者和99例前列腺癌(PCa)患者血清的T-PSA和F-PSA,并求出F/T PSA比值,然后进行统计学分析.结果:正常对照组、BPH组PCa组的T-PSA、F-PSA及F/TPSA比值分别为:1.43±1.13、0.44±0.34、0.36±0.15;7.84±6.08、1.88±1.37、0.26±0.08;23.95±21.12、3.52±3.41、0.16±0.08,上述各组三项指标两两之间比较均有显著性差异(P＜0.001).PCa组根据T-PSA检测值＜4.0μg/L、4.0～10.0μg/L、＞10μg/L分为三组,显示T-PSA、F-PSA组间两两比较均有显著性差异(P＜0.001),但F/TPSA比值相比较无显著性差异(P＞0.05).正常对照组与PCa组T-PSA＜4μg/L三项检测指标比较示T-PSA和F/TPSA比值均有显著性差异(P＜0.001),而F-PSA之间比较无显著性差异(P＞0.05).将F/T PSA比值分为＜0.10、0.11～0.15、0.16～0.2、0.21～0.25、0.26～0.30以及＞0.31以上六个截点,显示在0.20截点以内PCa患者占有率为74.51%.结论:F/T PSA比值的检测对血清T-PSA＜4μg/L、4～10μg/L以及＞10μg/L的患者在诊断PCa中均有良好的临床价值,特别当T-PSA处于较低水平状态下做到早期诊断PCa显得尤为重要.     

前列腺增生及前列腺癌患者f-PSA/T-PSA的变化

目的:探讨诊断灰区内血清游离态前列腺特异性抗原与总前列腺特异性抗原的比值,在前列腺增生与前列腺癌的鉴别诊断中的应用价值.方法:选择血清总前列腺特异性抗原(4.0～10.0)μg/L的39例前列腺癌患者和36例前列腺增生患者,检测血清中总前列腺特异性抗原(T-PSA)和游离态前列腺特异性抗原(f-PSA),计算f/T比值.结果:T-PSA在(4.0～10.0)μg/L,组间T-PSA浓度无显著性差异(P＞0.05),而(f/T)PSA比值有显著性差异(P＜0.05),前列腺癌患者f/T比值明显低于前列腺增生患者(P＜0.01).结论:应用f/T比值＜0.16为鉴别点,提高了对前列腺癌诊断灵敏性和特异性,尤其T-PSA在(4.0～10.0)μg/L更有意义.     

动态观察PSA和F PSA/PSA对诊断前列腺癌的临床价值

为了评价游离前列腺抗原(F PSA)/前列腺抗原(PSA)比值和PSA动态变化(年变化率)在前列腺癌诊断中的应用价值.本文应用ELISA追踪检测PSA在4～10μg/L范围患者在不同时段内PSA水平,并与正常人进行对照,利用ROC曲线,评价F PSA/PSA比值和PSA年变化率两项指标在前列腺癌诊断时的预示价值.结果表明:前列腺癌患者的F PSA/PSA比值和PSA年变化率与非前列腺癌组之间具有显著性差异(P＜0.001),当F PSA/PSA比值的临床判断值为0.21时,诊断灵敏度为93.5%,特异性为91.4%;当PSA年变化率的临床判断值为0.85%.诊断灵敏度为82.6%,诊断特异性为97.9%.前列腺增生患者F PSA/PSA比值与正常人之间无显著性差异(P＞0.05),而PSA年变化率与正常人比较具有显著性差异(P＜0.001).提示F PSA/PSA比值和PSA年变化率有助于PSA在4～10μg/L范围的患者前列腺癌的诊断.     

血清PSA和BALP测定在前列腺癌骨显像诊断中的应用

目的：探讨血PSA和BALP的测定在前列腺癌骨显像诊断中的应用。方法：对96例前列腺癌患者的核素骨显像结果、血清PSA和BALP结果进行回顾性研究。结果：①血清PSA和BALP的值随着骨转移分期的增高而逐步升高,且差异显著（P〈0.01）;②血清PSA和BALP与骨转移的数目呈正相关,相关系数（r）分别为0.582（P〈0.01）和0.768（P〈0.01）;③血清PSA〉20ng/ml时,骨转移的阳性率为65.4%,血清PSA〈20ng/ml时,骨转移的阴性预测值为92.6%;血清BALP〉20u/L时,骨转移的阳性率为58.9%时,骨转移的阴性预测值为76.5%;当血清PSA〈20ng/ml同时BALP〈20u/L时,骨转移的阴性预测值为100%。结论：血清PSA和BALP测定在前列腺癌骨显像诊断中具有重要的应用价值。     

PSA、SPECT骨显像在前列腺癌诊断和治疗中的临床价值

目的:探讨PSA、SPECT骨显像在前列腺癌诊断及治疗中的临床应用.方法:对72例经临床确诊的前列腺癌患者全部行血清PSA测定及全身骨显像,并对部分患者治疗后进行了随访.结果:前列腺癌组PSA明显高于正常对照组、良性前列腺疾病组;前列腺癌骨转移组PSA明显高于非骨转移组;72例前列腺癌初诊患者骨显像发现24例骨转移瘤,阳性率33.3%.结论:血清PSA与骨显像联检对前列腺癌临床诊断、疗效观察及预后判定具有重要的指导意义.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

Hypo- und Hypermagnesämie aus kardiologischer Sicht

Zusammenfassung Eine Reihe pathologischer Zustände bedingen Magnesiummangel. Zustände mit Hypermagnesämie sind ebenfalls bekannt, doch wesentlich seltener. Für den Kardiologen beachtenswert ist, daß unter Therapie mit bestimmten Diuretica bei Herzinsuffizienz, bei Herzinfarkt, Kardiomyopathie, Digitalisintoxikation und bestimmten Herzrhythmusstörungen Hypomagnesämie beobachtet wurde. Leider kann in der klinischen Routine nur ein extracelluläres Magnesiumdefizit durch Serumbestimmungen gemessen werden; über Magnesiummangel einzelner Organe kann nichts ausgesagt werden. Hinweise für Magnesiummangel geben aber neben der Messung des Serumspiegels Anamnese, klinischer Befund, bestimmte EKG-Veränderungen wie auch evtl. Hypokalämie, ein Zustand, bei dem sich oft — besonders bei Aldosteronismus — parallele Veränderungen zeigten.Tierexperimente deuten darauf hin, daß infarktähnliche Läsionen unter Magnesiummangel entstehen, doch ob Herzinfarkt beim Menschen durch Magnesiummangel ausgelöst werden kann, ist noch ungeklärt. In Leichenherzen zeigte sich im Infarktgebiet neben Calciumakkumulation signifikanter Magnesiumverlust, wobei unklar blieb, ob sich Ursache oder Folge des Infarktes widerspiegelten. Falls ein ursächlicher Zusammenhang besteht, ist er im Myokardstoffwechsel selbst zu suchen, wie bei der Alkoholkardiomyopathie, wo myokardialer Magnesiummangel zumindest als pathogenetischer Teilfaktor anerkannt wird. Andererseits versucht man aber auch Beziehungen zwischen Atherosklerose, Blutgerinnung und Hypomagnesämie herzustellen, in der Meinung, daß Magnesiummangel auch über den coronaren Pathomechanismus des Herzinfarktes wirken könnte. Sicher scheint, daß gewisse EKG-Veränderungen und Herzrhythmusstörungen durch einen irritierten Magnesiumhaushalt bedingt sein können, da sie bei Gabe bzw. Entzug von Magnesium verschwinden. Daß Magnesiummangel die Glykosidtoleranz verringert, wird tierexperimentell bestätigt. Unter Hypomagnesämie bewirkt Acetylstrophanthidin eher und länger Rhythmusstörungen als ohne, außerdem lassen diese sich durch Magnesiumgaben eliminieren. Da in gewissen Fällen spontane und digitalisinduzierte Herzrythmusstörungen durch Magnesiuminjektionen beseitigt wurden, scheint Magnesium als Therapeuticum angebracht. Einsatz verschiedener Magnesiumsalze bei Angina pectoris, degenerativen Herzerkrankungen und Herzinsuffizienz ohne geprüften und offensichtlich gestörten Magnesiumhaushalt ist fragwürdig, weil keine eindeutigen klinischen Erfolgsbeweise vorliegen. Immerhin mag es aber larvierte, durch Serumbestimmungen nicht erfaßbare Mangelzustände geben. Allgemein erscheint es aus kardiologischer Sicht ratsam, den Magnesiumhaushalt zu überwachen und in entsprechenden Fällen auszugleichen, um möglichen Myokardläsionen oder fatalen Herzrhythmusstörungen entgegenzuwirken.     

Environmental risk factors and their role in the management of atopic dermatitis

Introduction: The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors.

Areas covered: We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD.

Expert commentary: The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

HLA genes in Amerindians from Mexico San Vicente Tancuayalab Teenek/Huastecos

Huastecos or Teenek Amerindians are presently living at North East Mexico (San Luis Potosi State). They have probably one of the most ancient culture of Mexico and Central America together with Mayas and Olmec groups with which also show close relationships. Proximity to Atlantic Ocean/Mexican Gulf originated that Spaniards had very early contact with them at about 1519 CE or before. In the present paper we have aimed to study HLA gene profile which may be useful for HLA and disease epidemiology and transplant programs in Teeneks. HLA-DRB1*04:07, -DRB1*14:06 and -DRB1*04:11 have been found in high frequency like in other Amerindian groups. High frequency typical Amerindians HLA extended haplotypes have been found, such as A*02-B*35-DRB1*04:07-DQB1*03:02; A*68-B*39-DRB1*04:07-DQB1*03:02 and A*02-B*39-DRB1*04:07-DQB1*03:02; also new haplotypes have been described, like A*02-B*52-DRB1*04:11-DQB1*03:02, A*68-B*35-DRB1*14:02-DQB1*03:01 and A*68-B*40-DRB1*16:02-DQB1*03:01. Genetic proximity is observed not only to linguistically close Mayans, but also to Mazatecans, Mixtecans and Zapotecans, who speak an altogether different languages; it shows once more that genes and languages do not correlate. This population was greatly diminished after European contact between 1500 and 1600 years CE; in fact, North and South America First Inhabitants population was brought from 80 down to 8 million people because of diseases (i.e.: measles, smallpox or influenza), slavery and war.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.