[en] Objective: To investigate the correlationship between the plasma homocysteine (Hcy) levels and development of hepatic cirrhosis as well as the diagnostic value of plasma Hcy determination. Method: Plasma Hcy levels were measured with ELISA in: (1) 64 patients with post-hepatitis cirrhosis (2) 42 patients with various types of hepatitis but no cirrhosis and (3) 60 controls. Results: The plasma levels of Hcy in patients with cirrhosis were significantly higher than those in the other two groups (P<0.01). The plasma Hcy levels in cirrhotic patients were well correlated with the levels of other hepatic fibrosis markers such as hyaluronic acid and laminin (r=0.87 and r=0.88 respectively, P<0.01), but were not correlated with cholesterol, triglyceride and HDL levels. Conclusion: Plasma Hcy levels was markedly elevated in cirrhotic patients and might be taken as a diagnostic marker. (authors)

[en] Objective: To investigate the changes of serum IL-6, IL-8 and TNF contents after surgery in patients with lung cancer. Methods: Serum IL-6, IL-8 (with ELISA) and TNF (with RIA) contents were determined both before and after surgery in 40 patients with lung cancer as well as in 35 controls. Results: Serum IL-6, IL-8 and TNF levels were significantly higher in patients with lung cancer before surgery than those in the controls (P<0.01). After surgery, those levels dropped markedly, approaching normal. Conclusion; Changes of serum IL-6, IL-8 and TNF levels after surgery might reflect improvement of cellular immuno-function after decrease of tumor burden. (authors)

[en] Objective: To investigate the clinical significance of changes of plasma ET and serum TNF levels after operation in patients with cataracts. Methods: Plasma ET and serum TNF levels were detected with RIA in 32 patients with cataracts both before and after operation as well as in 30 controls. Results: Before operation, the plasma ET and serum TNF levels in patients with cataract were significantly higher than those in controls (P<0.01). One month after operation the plasma ET and serum TNF levels dropped to within normal ranges (P>0.05). Conclusion: Plasma ET and serum TNF levels were closely related to the disease process of cataract and were of prognostic value. (authors)

[en] Objective: To study the relationship between serum thrombopoietin (TPO) levels and thrombocytopenia in patients with various kinds of liver diseases. Methods: Serum TPO levels were determined with ELISA in 102 patients with various kinds of liver diseases (acute hepatitis n=9, chronic hepatitis n=80, hepatic cirrhosis n=13, etiology, HBV infection n=73, HBV + HEV n=13, HEV n=8, HCV n=6, autoimmune hepatitis n=2) and 30 controls. Results: The serum TPO levels in patients with various kinds of liver diseases were not significantly different from those in the controls (P>0.05). However, the blood platelet counts were significantly lower in all the patients (with the exception of the nine patients with acute hepatitis) than those in the controls (P < 0. 05). If we split the patients with liver diseases into two groups: those with normal platelet count (n=37) and those with thrombocytopenia (n=40), then their TPO levels (136.38±93.49 μg/L and 98.65±65.20 μg/L) were significantly different from each other (P<0.05). Yet, as a whole, the serum TPO levels were not correlated with the blood platelet count (r=0.1572, P>0.05). Conclusion: The lower TPO levels in patients with liver diseases could be only one of the many factors leading to thrombocytopenia. (authors)

[en] Purpose: A technique for whole-body electron therapy with the patient in a lying position has been developed. This technique allows Total Skin Electron Therapy (TSET) for those patients who were previously unable to be treated in a conventional standing position. Methods and Materials: This study was carried out on a Varian 2100C linear accelerator with a 6 MeV high dose rate electron beam. The collimator was open to a width of 36 x 36 cm. There were two main procedures, with six dual-field techniques: 1) two static AP/PA vertical dual fields (VDF): the patient laid on the floor transversely under the collimator when the gantry was in a vertical position. A 0.6 cm acrylic board was placed 15 cm away from the patient, then the gantry was rotated 25 deg. clockwise and counterclockwise to treat the patient in the supine and prone positions, respectively. 2) Four oblique junction fields (OJF): the patient laid on the floor in a prone and supine position parallel to the wave guide at (227 - body thickness x tan 60 deg. ) cm away from the vertical axis of the gantry, then the gantry was rotated 60 deg. toward the patient. A 0.6 cm acrylic board was placed 15 cm away from the patient perpendicular to the beam. The patient was move along the field central axis. It allowed the patient's body to be within the 160 cm effective treatment profile. When the patient's body axis move 5 deg. toward the lateral side of the field central axis, we could obtain a better dose distribution in the vertex of the scalp and the soles of the feet. The angle of the VDF was measured by chamber detectors to obtain the effective treatment profile. Likewise, the optimal profile for the OJF was determined by the same procedures. The Rando phantom was used to measure the superficial dose of the body. Results: The dimension of effective treatment profile for the VDF was 188 x 72 cm at 87% dose level. For the OJF, we had to move the patient along the field central axis to obtain the effective treatment profile in a 180 x 85 cm dimension at a 87% dose level. The vertex and sole dose measured in this setup was in the range of 80-88%. Conclusions: The empirical data showed that the lying-on position for TSET was technically feasible. The dose distribution in the body surface was also compatible with the Stanford standing technique. The nonambulatory skin malignancy patient can be treated in a comfortable and reproducible position

[en] Objective: To investigate the diagnostic value of combined detection of four tumor markers in patients with possible malignant change in liver disorders. Methods: Serum AFP, CEA, CA199 and SF levels were determined with chemiluminescence immunoassay (CLIA) in 49 patients with primary liver carcinoma, 7 patients with metastatic liver carcinoma, 40 patients with hepatic cirrhosis, 47 patients with HBV hepatitis and 30 controls. Results: The serum levels of AFP, CEA, SF in patients with primary hepatic cancer and serum levels of AFP, SF in patients with hepatic cirrhosis were all significantly higher than those in controls (P<0.01 or 0.05). However, serum levels of the four markers in patients with hepatitis were not much different from those in controls (P>0.05). Moreover, positive rate of combined determination of AFP, CEA, CA199, SF in patients with primary hepatic cancer was significantly higher than that in patients with metastatic liver cancer. Conclusion: With combined determination of these four tumor markers, the detection rate of primary hepatic carcinoma could be enhanced to above 95%. Also, differential diagnosis between primary and metastatic hepatic cancers could be facilitated. (authors)

[en] Objective: To explore the clinical application of FQ-PCR in detection of cytokeratin 19 (CK19) expression in peripheral blood for diagnosis of breast carcinoma. Methods: Expression of CK19 mRNA in peripheral blood was detected with FQ-PCR [with glycerine aldehyde phosphate dehydrogenase (GAPDH) as internal control ] in 30 female controls, 30 patients with benign breast diseases and 76 patients with breast carcinoma. Results: Detected CK19 and CK19/GAPDH values were about the same in the controls and patients with benign breast diseases, but were significantly higher in patients with breast carcinoma. GAPDH values were about the same in all these groups. Taking CK19 and CK19/GAPDH readings higher than x-tilde±2s of the controls as positive, the positive rate in breast cancer patients was 41/76 or 53.9% (vs 0 in patients with benign breast diseases). In 27 of the 76 patients, CK19/GAPDH was serially tested (every four weeks) since before operation; the values dropped progressively after treatment and became significantly lower at the last determination. Conclusion: The technique of FQ-PCR is a highly sensitive and specific one for rapid quantification of CK-19 mRNA expression in peripheral blood. It is useful for diagnosis and therapeutic effect monitoring in patients with breast carcinoma. (authors)

[en] Objective: To investigate the possible diagnostic value of combined determination of serum and chest fluid contents of ADA, IL-2, IL-6, IL-10 in patients with tuberculous and malignant pleural effusion. Methods: Serum and chest fluid ADA (with biochemical method), IL-2, IL-6, IL-10 (with ELISA) contents were measured in 56 patients with tuberculosis pleural effusion, 53 patients with malignant effusion and 30 controls (in serum only). The receiving operative characteristic (ROC) curve for each parameter was analyzed for study of respective area under curse (Auc). Results: The serum IL-6 levels in both groups of patients were significantly higher than those in the controls (P<0.05). The chest fluid contents of ADA, IL-2, IL-6 and IL-10 in patients with tuberculous effusion were all significantly higher than those in patients with malignancies (P<0.05). The Auc in the ROC was largest in the case of ADA, followed by IL-10, IL-6 with IL-2 the least. Conclusion: Determination of chest fluid ADA, IL-2, IL-6, IL-10 contents was helpful in the differentiation of tuberculous from malignant pleural effusion. Combined determination of chest fluid ADA and IL-10 provided the highest accuracy rate for differentional diagnosis. (authors)

[en] Objective: To investigate the clinical significance of the changes of plasma ET and serum TNF levels after treatment in patients with diabetes millitus. Methods: Plasma ET and serum TNF contents were determined with RIA in 54 patients with diabetes mellitus both before and after treatment as well as in 35 controls. Results: Before treatment, the plasma ET and serum TNF levels were significantly in the diabetics higher than those in the controls (P<0.01). After 3 months treatment, the levels remained significantly higher (P<0.05). Conclusion: Development and progression of diabetes millitus were closely related to the plasma ET and serum TNF levels. (authors)

[en] Purpose: To report the treatment results and rectal/bladder complications of cervical carcinoma radically treated with high-dose-rate intracavitary brachytherapy (HDR-IC). The current policy of using three-fraction scheme was examined. Methods and Materials: Between November 1987 and August 1990, 173 patients with cervical carcinoma were treated with curative-intent radiation therapy. Whole pelvic irradiation was administered with 10-MV X ray. Dose to the central cervix was 40-44 Gy in 20-22 fractions, following by pelvic wall boost 6-14 Gy in three to seven fractions with central shielding. ⁶⁰Co sources were used for HDR-IC, and 7.2 Gy was given to Point A for three applications, 1-2 weeks apart. Duration of follow-up was 5-7.8 years. Results: Twenty-eight patients (16%) developed central-regional recurrences. Overall 5-year actuarial pelvic control rate was 83%. By stage, 5-year actuarial pelvic control rates were 94%, 87%, and 72% for Stages IB + IIA, IIB + IIIA, and IIIB + IVA, respectively. Thirty-one patients (18%) developed distant metastasis. Overall 5-year actuarial survival rate was 58%. By stage, 5-year actuarial survival rates were 79%, 59%, and 41% for Stages IB + IIA, IIB + IIIA, and IIIB + IVA, respectively. Sixty-six (38%) and 19 patients (11%) developed rectal and bladder complications, respectively. For rectal complication, the overall actuarial rate was 38% at 5 years. By grade, 5-year actuarial rectal complication rates were 24%, 15%, 4%, and 3% for Grades 1-4, respectively. Overall prevalence of rectal complications was 37% and 14% at 2 and 5 years, respectively. Prevalence of low-grade rectal complication (Grades 1 and 2) was dominant at 2 years (30%), but declined to 8% at 5 years. Prevalence of high-grade, severe rectal complication (Grades 3 and 4) remained steady at 2 and 5 years (7% and 6%, respectively). Five-year actuarial bladder complication was 9%. Five-year prevalence of bladder complication was 2%. Conclusion: Using a three-fraction scheme, survival rate appeared comparable with the existing results of the low-dose-rate technique. The incidence of rectal complication with this scheme remained relatively high. The increased part of rectal complication was predominately low grade. This result suggested that therapeutic gain with this scheme may not be good enough to circumvent its biologic disadvantage. Numbers of fractions >3 must be considered in future trials