Prostate-specific antigen levels among cirrhotic patients.

PURPOSE: The aim of this study was to determine serum prostate-specific antigen (PSA) levels in patients with liver cirrhosis. PATIENTS AND METHODS: Between January 1995 and August 2001, 216 men with cirrhosis were evaluated. The extent of their liver disease was classified according to the Child-Pugh classification. Serum PSA levels were measured with the Hybritech Tandem-R RIA method and matched with age-related reference PSA levels. Digital rectal examination (DRE) was performed in all patients. Patients with elevated PSA levels and/or abnormal DRE were recommended to undergo further assessment including transrectal ultrasonography (TRUS) and biopsy performed by an urologist. RESULTS: Two hundred and sixteen men (mean age 54.09 +/- 9.09 years, range 25-76) with cirrhosis were examined. Their mean PSA value was 0.57 +/- 0.84 ng/mL and tended to be lower than in the normal population. The degree of PSA decrease was found to parallel the severity of the liver disease (p=0.002). The mean serum PSA level increased with each age decade in a statistically significant manner (p<0.001). Four patients (three with elevated PSA values) underwent prostate biopsy. Three biopsies were positive for prostate cancer, the other showed evidence of benign prostatic hyperplasia (BPH). CONCLUSION: Serum PSA is influenced by the severity of liver disease and its levels tend to be lower in cirrhotic patients than in the normal population. However, serum PSA can still be considered a reliable marker in the clinical management of prostatic disease in patients with cirrhosis.

Selenium detoxification by methylation.

The major detoxification process for selenium is methylation. The major pathway for the formation of methylated compounds in biological systems is transmethylation catalyzed by methyltransferases. In this study methyltransferase activity was assayed in the liver cytosol prepared from different strains of rats using HPLC method by measuring the formation of epinephrine from norepinephrine. The methyltransferase activity in Fischer, Wistar, and Sprague-Dawley rats were 1.65 x 10(-12), 0.74 x 10(-12), and 1.2 x 10(-12) moles epinephrine formed/mg protein/hr respectively. Volatilization of injected Se (2.5 mg/kg, i.p.) was found to be higher in Wistar rats compared to Fischer rats. LD50 for Wistar and Fischer rats were 2.58 and 3.15 mg Se/kg respectively. Our results suggest that the methylation of dimethyl selenide to trimethhyl selenide appears to be an important step in the detoxification of selenium.