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Metabolic bone disease has long been recognized in chronic liver disease, especially cholestatic or alcoholic liver diseases. The aim of the present study was to investigate the prevalence and severity of osteodystrophy in cirrhotic men and the correlation of its incidence with the clinical severity of cirrhosis in an endemic area of post-necrotic hepatitis. We measured serum levels of osteocalcin, 25-hydroxyvitamin D, parathyroid hormone mid-molecule, calcium and testosterone in 74 cirrhotic men (Child-Pugh's classification grade A n = 30, B n = 21 and C n = 23) and 16 healthy controls. Standard X-rays and bone mineral densities of lumbar spine were performed in 30 patients with post-necrotic cirrhosis and 10 healthy controls. Serum levels of osteocalcin, parathyroid hormone and testosterone were significantly lower in patients with cirrhosis than in controls. Changes paralleling an increased severity of cirrhosis were found in serum levels of 25-hydroxyvitamin D and testosterone, but not in the serum levels of osteocalcin and parathyroid hormone. The lumbar bone mineral density was significantly lower in patients with post-necrotic cirrhosis than in controls (0.97 +/- 0.13) vs 1.07 +/- 0.12 g/cm2, P < 0.05) and was correlated with serum 25-hydroxyvitamin D levels (r = 0.467; P < 0.005). There was no correlation between the bone mineral density and serum osteocalcin or the clinical severity of cirrhosis. The prevalence of spinal osteoporosis, as defined by a lumbar bone mineral density greater than two standard deviations below the mean value of the controls, was 20% in cirrhotic patients compared with 10% in controls. Two (6.7%) patients (both grade C) had spinal compression fractures compared with none in the control group. In conclusion, serum osteocalcin and lumbar bone mineral density were significantly lower in cirrhotic men than in controls. However, they were not correlated with each other or the clinical severity of cirrhosis.

Procarboxypeptidase B (human pancreas-specific protein) has been reported to be a good serum marker for the diagnosis of acute pancreatitis. The current study was conducted in order to evaluate the frequency and degree of elevated serum levels of procarboxypeptidase B in chronic renal failure and their correlations with serum levels of amylase, lipase and renal function tests. Blood samples were taken from 84 asymptomatic patients with chronic renal failure, including 34 patients with periodical haemodialysis and 50 patients without haemodialysis. Serum levels of procarboxypeptidase B, amylase, lipase, creatinine and blood urea nitrogen were measured. Serum levels of procarboxypeptidase B in 84 patients were 63.4 +/- 5.5 micrograms/L significantly greater than the figure of 29.6 +/- 1.6 micrograms/L in healthy adults in our previous report (P < 0.0001). There was a significant difference in serum levels of PCPB between patients with and without haemodialysis (78.0 +/- 9.4 vs 53.6 +/- 6.3 micrograms/L; P < 0.01). The frequencies of elevated serum levels of procarboxypeptidase B, amylase and lipase greater than upper normal limits were 27.4, 35.7 and 26.2%, respectively. The frequencies of elevated PCPB in patients with and without haemodialysis were 38.2 and 20%, respectively. Only one patient had a serum procarboxypeptidase B level greater than three-fold the upper normal limit. A significant correlation was found between procarboxypeptidase B and lipase (r = 0.785; P < 0.0001). No significant correlation was noted between procarboxypeptidase B vs amylase or renal function tests. In conclusion, in patients with chronic renal failure, the elevation of serum procarboxypeptidase B is as common as the elevations of other pancreatic enzymes.

A population of 622 prostitutes in Taiwan was tested for antibodies to the hepatitis C virus (anti-HCV) using a synthetic peptide assay composed of representative determinants from capsid and nonstructural (NS) viral proteins. Seventy-four (12%) were positive and the remaining 548 (88%) were negative. Seventy-nine samples were retested by a second-generation anti-HCV assay composed of recombinant capsid and NS proteins of HCV. Both assays had a nearly perfect agreement (Kappa value = 0.91). Of the positive cases, 31% were positive for reactivity to capsid only. Most (60/74, 81%) of the cases positive for synthetic peptide assay were HCV RNA positive, indicating potential infectivity. On the basis of the results of synthetic peptide assay, univariate analysis showed that history of paid sex for longer than 6 months, blood transfusion, acupuncture, intravenous drug abuse, and age over 20 years were significant risk factors of HCV infection (P < 0.01). Elevated alanine aminotransferase levels (> 40 U/L) were positively associated with anti-HCV, while the presence of serum hepatitis B surface antigen was a negatively associated factor. Multivariate analysis revealed that history of paid sex for longer than 6 months and blood transfusion were positively associated with anti-HCV (P < 0.001). The latter only accounted for less than one fifth of the HCV-infected prostitutes. This study indicates strongly that sexual transmission is an important route for HCV infection in prostitutes. This risk group may spread HCV to other populations as a sexually transmitted disease.

Cervical cancer is a predomiannt gynecologic neoplasia in Taiwan. The associations of carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA) and squamous cell carcinoma antigen (SCC-Ag) for detection of cervical cancers with type of cancer, clinical stage and lymph node metastasis were studied. Serum samples were collected from 395 patients with cervical cancers (61 CIN3, 334 squamous cell carcinoma, 18 adenocarcinoma), 72 patients with benign gynecologic diseases and 115 healthy controls. The sensitivities of CEA, TPA, and SCC-Ag were 15.2%, 33.6%, and 49.3%. The specificities were 89.3%, 96.2%, and 95.1%, respectively. The positive rate of CEA was found significantly higher among patients with adenocarcinoma than those with squamous cell carcinoma. The positive rate of CEA and SCC-Ag increased with advance of the clinical stages. There was no significant difference in the rate of each tumor marker between patients with lymph node metastasis and those without metastasis. The positive rate obtained by SCC-Ag alone was comparable to those by the combinations of two or three antigens. The result of the present study indicates that SCC-Ag is the most useful tumor marker in the detection of cervical cancers.

In order to establish the normal values of bone mineral content (BMC) (g/cm2), the BMC of 140 healthy growing children including 49 girls (aged 5 to 16 years) and 91 boys (aged 7 to 17 years) was measured using Dual Photon absorptiometry (DPA) at L2-L4 level of the spine. The BMC increased significantly with age, after stratification by age. Both male and female children aged 7 to 10 years had similar BMC, but female children had significantly higher BMC at 12 to 13 years of age. We also established regression equations. Female: BMC = 0.38 + 0.021 x age. Male: BMC = 0.45 + 0.017 x age. They may be useful in estimating BMC in unknown individuals

The effects of thyroidectomy on both the secretion of rat prolactin (PRL) in vivo and the release of PRL from rat anterior pituitary glands (Aps) in vitro in the absence of ovarian steroids were studied. Rats were ovariectomized (Ovx) 42 days after thyroidectomy or sham-thyroidectomy. On day 15 following ovariectomy the rats were either decapitated for examining the in vitro release of PRL from AP or anesthetized for measuring the metabolic clearance rate (MCR) of rat PRL. After decapitation, blood samples were collected and APs were incubated with or without the extract of rat medial basal hypothalamus (rHE) at 37 degrees C for 4 h. The MCR of iodinated rat PRL was determined by a single injection method. Blood samples were collected by heart puncture at frequent intervals. Serum PRL concentrations of decapitated thyroidectomized-ovariectomized (TX-Ovx) rats were 56% lower than those found in Ovx rats. Thyroidectomy in Ovx rats resulted in a significant reduction of the spontaneous release of PRL from AP. The rHE decreased PRL levels in the medium after incubation with APs from sham Tx rats, but not those from Tx rats. MCR of PRL was reduced in Ovx rats by thyroidectomy. These results indicate that thyroidectomy reduces the spontaneous release of rat PRL by AP and secretion rate of rat PRL in the absence of ovarian steroids.

We evaluated a new monoclonal antibody defined antigen CA195 as a tumor marker in patients with colorectal adenocarcinoma and compared the results with CA19-9 and carcinoembryonic antigen (CEA). This study included 37 patients with colorectal adenocarcinoma, 118 healthy subjects, 20 hepatitis with or without jaundice, and 20 duodenal ulcer with or without smoking habits. The average concentration of CA195 in serum from 118 healthy subjects is 5.80 +/- 6.83 U/ml. In the 37 patients with colorectal adenocarcinoma, 13 had elevated levels (greater than 30 U/ml) of CA195 (35%), 10 had elevated levels (greater than 37 U/ml) of CA19-9 (27%), and 18 and elevated levels (greater than 5 ng/ml) of CEA (48%). The sensitivity of CA195 is correlated well with the extent of the malignancy, 9% in Duke's stage A and B, and 79% in advanced stage C and D. Although the sensitivity of CA195 is less than CEA (35% vs. 48%), this difference is not statistically significant scaled (P greater than 0.05). Combined use CA195 with CEA can increase detecting rate from 48% (CEA alone) to 59%. CA-195 level may be elevated in some patients with hepatocellular disease, but its level is not affected by smoking. Therefore CA-195 can be applied as complementary tumor marker in colorectal cancer.

Serum ovarian carcinoma antigen (CA 125) and carcinoembryonic antigen (CEA) were measured in 36 patients with ovarian cancer, to compare their effects and assess clinical applications. The positive rate of CA 125 was significantly higher than CEA, ie, 72.2% v.s. 33.3% in all types of ovarian cancer, 81.3% v.s. 31.3% in the 32 epithelial cancers, and even more of 100% v.s. 25% in the 16 serous cystadenocarcinoma. The positive rate of CA 125 was also higher than CEA in borderline malignancy and stage-I cancers, a possible indication of its greater usefulness in early diagnosis. CA 125 was also a better marker in monitoring of epithelial ovarian cancer than CEA. Combining use of these two markers achieved an even higher positive rate. Therefore it seems useful to utilize them concomitantly in the diagnosis of ovarian cancers.

Chinese J. Physiol. 31(2):105-112, 1988. The effect of calcitonin (CT) on the release of prolactin (PRL) and thyrotropin (TSH) in vitro from anterior pituitary glands (APs) of thuroidectomized (Tx) and intact male rats was investigated. Male rats were Tx or sham Tx, then sacrificed 47 days later. APs were removed, quartered and incubated with CT (0 or 32 microIU/ml) and/or thyroxine (0 or 0.1 microgram/ml) at 37 degrees C for 4 h. Thyroidectomy significantly decreased PRL release in vitro. CT inhibited the release of PRL in vitro from APs of intact rats but increased PRL release from APs of Tx animals. Neither CT nor T4 affected the release of TSH in vitro. These results suggest that the modulation of CT on the release of PRL from rat anterior pituitary glands is thyroxine-dependent.