Changes in serum zinc and serum albumin after operation for bronchogenic carcinoma

Serum zinc and serum albumin were measured in 11 patients operated on for bronchogenic carcinoma and in six who underwent thoracotomy for nonmalignant disease. The postoperative changes in serum zinc values were identical in the two groups of patients, and could to some extent be explained by the changes in serum albumin. Earlier reports suggesting a prognostic value of serum zinc measurements in surgically treated bronchogenic cancer thus were not confirmed.     

Human serum monoamine oxidase

A study on serum monoamine oxidase (MAO) levels in fibrotic disease processes led us to investigate patients with moderate to severe burns. Strikingly low serum MAO activity was found in patients with relatively recent, severe injuries. So far, we have no explanation to offer for the phenomena observed.     

Clinical evaluation of serum basic fetoprotein--comparative study of serum immunosuppressive acid protein

The clinical significance of serum basic fetoprotein (BFP) in renal cell carcinoma was investigated in comparison with serum immunosuppressive acid protein (IAP). Investigated in this study were 46 patients with renal cell carcinoma, 31 males and 15 females ranging in age from 40 to 85 years (mean age: 56 years). According to Robson's system of staging, 10 cases (22%) had a stage I disease, 14 cases (30%) a stage II disease, and 18 (39%) a stage IV disease. The positivity rate for and levels of serum BFP were found higher as disease stage advanced, with 54% of the entire cases and 72% of stage IV cases being positive for serum BFP. On the other hand, 76% of 34 cases for whom assay of serum IAP was feasible and 79% of stage IV cases were positive for serum IAP, thus here again the positivity rate for and serum levels of the marker became increasingly higher with advancing disease stage. Simultaneous assay of serum BFP and IAP demonstrated that 85% of stage IV renal cell carcinoma cases were positive for at least one of the two markers. A study of changes in these tumor markers before and after curative resection of the tumor showed that BFP decreased below the preoperative level within 1 week postoperatively in 92% and even returned to normal in 75% of cases who were positive for the tumor markers preoperatively, while serum IAP reduced below the preoperative level in 82% and returned to normal in 27% of the cases preoperatively.     

Changes in serum glucose and serum growth hormone levels during pituitary surgery

During transsphenoidal surgery, serum growth hormone (GH) and serum glucose levels were measured in five acromegalic patients with diabetes or glucose intolerance, three acromegalic patients without diabetes or glucose intolerance, and six patients with prolactinoma. Preoperative steroid administration produced a significant increase in serum glucose level in acromegalic patients with diabetes or glucose intolerance, whereas in the other two groups no significant change in serum glucose level was found. After surgery started, there was a statistically significant increase in serum glucose level above baseline levels in all three groups. Serum GH levels decreased after commencement of surgery in acromegalic patients, and tumor manipulation did not produce a statistically significant increase in serum GH levels. Simultaneous increases in serum glucose and serum GH levels upon tumor manipulation did not occur in any group. We conclude that preoperative steroid administration in patients with high serum levels of GH in association with diabetes or glucose intolerance increases serum glucose levels, and that, after commencement of surgery, GH has only a minor role in the changes of serum glucose levels.     

血清CEA阴性结直肠癌患者血清差异蛋白质的初步筛选

目的分析血清CEA阴性结直肠癌患者、血清CEA阳性结直肠癌患者与正常人血清中差异表达蛋白,筛选潜在的与血清CEA阴性结直肠癌患者诊断及预后密切相关的血清蛋白质。方法血清CEA阴性结直肠癌患者、血清CEA阳性结直肠癌患者与正常人空腹血清标本各11例分别等量混合成3组样本,利用双向凝胶电泳（2-DE）及基质辅助激光解吸电离飞行时间质谱（MALDI_TOF-MS／MS）技术筛选及鉴定差异表达的蛋白点,并对其部分蛋白进行生物学分析。结果筛选出3组间表达量差异2倍以上差异蛋白点共13个,进行MALDI-TOF-MS／MS分析,鉴定出：①血清CEA阴性结直肠癌患者与正常人血清比较,表达下调的蛋白有纤维胶凝蛋白2前体,纤维胶凝蛋白3,载脂蛋白L1,间a胰蛋白酶抑制剂轻链H4,转甲状腺素蛋白,表达上调的蛋白为免疫球蛋白lambda轻链。②血清CEA阳性结直肠癌患者与正常人血清比较,表达下调的蛋白有纤维胶凝蛋白2前体,纤维胶凝蛋白3,载脂蛋白L1,间a胰蛋白酶抑制剂轻链H4,转甲状腺素蛋白,表达上调的蛋白为：载脂蛋白E,结合珠蛋白。③血清CEA阴性结直肠癌患者与血清CEA阳性结直肠癌患者的1个差异点,经鉴定为免疫球蛋白lambda轻链。结论血清CEA阴性结直肠癌患者与血清CEA阳性结直肠癌患者、正常人血清的蛋白质表达谱表现出一定差异,这些差异蛋白有可能成为血清CEA阴性结直肠癌患者诊断与判定预后的血清标志物。     

Propofol and serum potassium

The aim of this study was to examine the effect of propofol and propofol with suxamethonium on serum potassium concentration during induction of general anaesthesia. Forty patients were studied during elective surgery and serum electrolytes were measured before and after the induction of anaesthesia. Patients were allocated at random into two groups to receive either propofol alone or with suxamethonium. The serum potassium fell by 0.04 mmol.l-1 by 5 min after induction with propofol alone but had recovered to the pre-induction level by 10 min. The serum potassium rose by 0.23 mmol.l-1 when a combination of propofol and suxamethonium was used for the induction of anaesthesia.     

Thrombocytosis elevates serum potassium

Spurious elevation of the serum potassium can be seen if the platelet count exceeds 1,000 x 10(9)/L in patients with myeloproliferative disease. To see if serum potassium is increased at more modest elevations of the platelet count we studied these parameters in 283 controls and 161 patients with reactive thrombocytosis. The incidence of hyperkalemia was 34% in patients with over 500 x 10(9) platelets/L compared with 9% if the platelet count was below 250 x 10(9)/L. Over this range there was a significant correlation of potassium increasing with the platelet count. The higher potassium values could not be explained on the basis of leukocytosis, renal insufficiency, or acidosis, suggesting that the elevated serum levels were often spurious. In support of this conclusion, the serum potassium exceeded plasma potassium by a larger amount in patients with thrombocytosis. We conclude that serum potassium rises in direct proportion to the platelet count in normal patients and in those with thrombocytosis, and that this increment is an artifact.     

Estimation of glomerular filtration rate by serum creatinine and serum beta 2-microglobulin

51Cr-EDTA clearance, serum beta 2-microglobulin and serum creatinine were measured simultaneously on 271 occasions in 114 patients. Serum beta 2-microglobulin was more sensitive than serum creatinine for detection of changes of glomerular filtration rate (GFR) and for detection of a moderately reduced GFR. However, serum beta 2-microglobulin also had severe limitations when used to estimate GFR. The serum levels of the protein varied considerably in patients with similar GFR, probably due to different rates of synthesis of beta 2-microglobulin.     

Pituitary-testicular reserve in men with low serum testosterone and normal serum luteinizing hormone

Men with low serum testosterone levels who do not have elevated serum LH levels are generally thought to have hypothalamic-pituitary dysfunction. To evaluate this concept, seven men with a combination of low serum testosterone and normal serum LH underwent standard tests of hypothalamic-pituitary-testicular reserve. Pituitary reserve, tested with LHRH, showed exaggerated responses in two subjects, low-normal responses in one subject, and normal responses in the remaining four. Testing of hypothalamic-pituitary reserve with clomiphene showed normal gonadotropin responses in six subjects and blunted response in one (the same subject with the low LHRH response). Direct stimulation with hCG showed normal percentage increases in testosterone but low absolute levels, comparable to responses in patients with Klinefelter's syndrome. However, 17-OH-progresterone responses to hCG were lower in these subjects than in either controls or subjects with Klinefelter's syndrome. During follow-up, one subject developed frank primary testicular failure. It was concluded that men with low serum testosterone but normal serum LH are a heterogeneous group, and this pattern occasionally reflects early primary testicular failure rather than hypothalamic-pituitary dysfunction. Standard tests of pituitary-testicular reserve are generally not useful in defining abnormal hormonal output, although measurement of the 17-OH-progesterone response to hCG may improve their diagnostic utility.