Diagnostic value of three tumor markers determined in pleural effusions.

In order to discriminate between malignant and benign effusions, the values of tissue polypeptide specific antigen,carcinoembryonic antigen and squamous cell carcinoma associated antigen were measured in the pleural fluid of 30 patients with neoplasm, 10 with tuberculous pleurisy, 10 with transudates due to congestive heart failure or cirrhosis, 29 with parapneumonic effusions and 23 with benign diseases other than tuberculosis and pneumonia. Carcinoembryonic antigen and tissue poly-peptide specific antigen levels in effusions due to neoplasms were significantly higher than those in effusions due to other diseases. The areas under Receiver Operating Characteristic curves for carcinoembryonic antigen and tissue polypeptide specific antigen determinations were 0.69 and 0.67, respectively. No significant differences were found in the pleural fluid squamous cell carcinoma associated antigen levels between neoplasms and other diseases. The ability of tissue polypeptide specific antigen and carcinoembryonic antigen to discriminate between benign and malignant effusions may be considered comparable. Although both carcinoembryonic antigen and tissue polypeptide specific antigen showed a low accuracy (the number of undiagnosed pleural effusions is considerably high), both tissue polypeptide specific antigen and carcinoembryonic antigen determinations may contribute to a correct diagnostic classification. Moreover, the combination of these markers provides a specificity of 97.2%. However, the low number of positivities obtained for tissue polypeptide specific antigen and carcinoembryonic antigen together (13 cases in our series) reveals the need for further investigations.

Isolated deficiency of follicle-stimulating hormone in man: a case report and literature review.

A 34-year-old male patient was studied because of primary infertility. He was a normally virilized man with normal potency, habitus, and sense of smell. The testes were of normal consistency and volume. Semen analysis showed azoospermia. The baseline serum concentrations of luteinizing hormone (LH) were normal, but those of follicle-stimulating hormone (FSH) were undetectable. After stimulation with gonadotrophin-releasing hormone (GnRH), 100 micrograms, iv, the response of LH was normal, whereas the rise in FSH levels was minimal. The administration of clomiphene citrate (100 mg/day for 21 days) increased LH levels, but FSH levels remained low. Serum concentrations of testosterone and estradiol were normal. Baseline serum levels of thyrotrophin, prolactin, growth hormone, corticotrophin and cortisol were also normal. The patient refused testicular biopsy and treatment with purified human FSH. Our results suggest a possible defect for FSH production at the pituitary level.

[Changes with age in adiposity and lean body mass in a healthy Spanish population]. / Modificaciones con la edad de la adiposidad y masa magra corporal, en una población española sana.

The reduction in muscular mass with age is well-known, and thus in order to obtain reference values, the behaviour of the LBM and corporal adiposity (FM) in a standard population was studied. Of a total of 217 patients considered a priori as healthy, 172 were selected following a strict application of criteria based on clinical examination, haematological analysis and biochemical parameters, as well as hormone concentrations, aimed showed urinary elimination of creatinine (Cro) of between (+ - DE) within the theoretical level for their weight and age. In this standard population, the behaviour of the LBM and FM was studied depending on age, using for this purpose creatinine at 24 hours, weight and size, and different calculation procedures. The reduction in LBM showed a better correlation with age when calculated based on Cro (r = 0.47; p < 0.01) than on height (r = -0.27; p < 0.01). The age correlation was similar for both sexes (women: r = -0.60; men: r = -0.65) and reduction in LBM started to be considerable from the fifth decade and could be calculated from the regression equation LBM = 64.6 - 0.00069. age (days). At the same time as this reduction in LBM, there was an increase in FM (p < 0.0001). Our results show that the reduction of LBM and increase in FM with age in a healthy Spanish population is similar to other foreign studies published. It is preferable to correct the LBM with age using Cro, which can be calculated using the above-mentioned linear regression equation, regardless of sex.