The tumor markers CEA, TPA and CA 19-9 and ferritin and osteocalcin in follow-up studies in breast cancer

Radioimmunological determinations of the tumour markers CEA, TPA, CA 19-9, ferritin and also osteocalcin were carried out in 250 patients with ablatio mammae for breast cancer over a follow-up period of at least 1 year. Metastases were detected in 49 of the 250 patients. The normal control group comprised 193 healthy persons. CEA proved to be the most valuable tumour marker, but TPA and ferritin were also significantly elevated in metastatic breast cancer. Combined determination of all 3 parameters gave the best results. Additional measurement of CA 19-9 was helpful in only one of the 49 patients with metastases in whom the 3 other parameter were negative throughout. Hence, determination of CA 19-9 appears unnecessary in breast cancer. In progressive disease the markers generally increased and fell again following successful therapy. In a few cases the opposite was found or no changes were observed. Cases with small local recurrence or an additional carcinoma at an early stage did not exhibit increased marker values as compared to patients without metastases. Not infrequently the increase in markers preceded the manifestation of metastases by several months. Very high concentrations of tumour markers signify a poor prognosis. Osteocalcin was elevated in patients with bone metastases, but not soft tissue metastases. In general, however, it paralleled the serum alkaline phosphatase level.     

雷公藤三萜酸C的分离与结构鉴定

雷公藤总甙系雷公藤(Tripterygium wilfordii Hook.f)去皮根心经提取后得到的有效组分,它具有很强的抗炎免疫抑制作用。作者从雷公藤总甙中分离出5个三萜类化合物T_1,T_2,T_3,T_6,T_(28)。本文报道T_(28)化合物的分子结构,其他待另文发表。T_(28)是一个新的乌     

Dopamine agonists in the treatment of hyperprolactinemia. Comparison between bromocriptine and lisuride

27 patients (12 women and 15 men) with hyperprolactinemia were treated with the dopamine agonists lisuride (Dopergin) and bromocriptine on a cross-over basis for 3-6 months. By this treatment, plasma prolactin levels were reduced by 83 and 87%, and normalization was achieved in 13 patients in the lisuride group (average dosage 1 mg/d) and in 15 patients in the bromocriptine group (average dosage 10 mg/d). Side effects, consisting of orthostatic hypotension, vomiting and nausea, occurred in 11 patients treated with lisuride and 13 patients treated with bromocriptine, and 2 patients in the lisuride group and one in the bromocriptine group stopped the medication for this reason. There was a good correlation in the doses of both drugs used. There was a tendency for the prolactin-lowering effect of lisuride to last longer upon cessation of therapy which might be related to the higher receptor affinity of both drugs. In general, however, the present results indicate that bromocriptine and lisuride are comparable in efficacy and side effects, but that individual patients respond better to one or the other drug.     

Collagenous Colitis

A middle-aged female with chronic, watery diarrhea was diagnosed after extensive evaluation as having collagenous colitis. The clinical, histological, and pathological findings of our case and those previously reported are reviewed. The diagnostic importance of total colonoscopy with biopsy in a normal-appearing colon in a patient with chronic, undiagnosed, watery diarrhea is discussed.