Prostate-specific antigen, testosterone, sex-hormone binding globulin and androgen receptor CAG repeat polymorphisms in subfertile and normal men.

The aim of this study was to understand the androgen-related factors which may regulate concentrations of the tumour marker, prostate-specific antigen (PSA). We therefore measured the serum concentrations of total and free testosterone and of sex hormone-binding globulin (SHBG) and determined the androgen receptor (AR) gene CAG repeat length, then compared these values to total and free PSA concentrations in 91 subjects with proven fertility, and 112 subfertile men with defective spermatogenesis. Concentrations of free testosterone and total testosterone, adjusted for SHBG, were 17-20% lower in subfertile men compared with those in their fertile counterparts. This subtle, but highly significant (P < 0.001), difference in testosterone between fertile and subfertile men was accentuated by the positive correlation between testosterone and AR gene CAG repeat length in fertile, but not subfertile, subjects. In subfertile subjects, testosterone strongly correlated (r = 0.354, P < 0.001) with PSA concentrations, and independent of testosterone, total PSA negatively correlated (r = -0.229, P = 0.011) with AR CAG length. Overall our data suggest that, firstly, PSA correlates with testosterone only in an environment of relatively low androgenicity, such as in subfertile men. Secondly, in such a low androgenic environment, short CAG tracts (associated with high AR activity) correlate positively with PSA concentrations. These results suggest that interpretation of PSA is best made in conjunction with testosterone concentrations and AR CAG length.

Retroperitoneal cold abscess with tuberculosis of sacro-iliac joint and pubic bone: a case report of unusual presentation of osteo-articular tuberculosis.

Tuberculosis involving sacro-iliac joint and pubic bone presenting with massive retroperitoneal abscess is a rare entity. A 29-year-old female presented with history of discharging sinus in the sacrococcygeal region of 2 months duration. Plain x-ray revealed osteolytic lesion in right pubic bone and left sacro-iliac joint. Computed tomography scan revealed massive pus collection in the retroperitoneal region. Pus was drained extraperitoneally. Biopsy of the scraping of the abscess wall showed granulation tissue with foreign body type of giant cell. On follow-up the patient was doing well.

Prevalence of antibodies to hepatitis C virus in relation to surrogate markers in a blood donor population of Singapore.

Prevalence of antibodies to HCV is studied among a blood donor population in Singapore and its relationship to surrogate markers was examined. Sequential serum samples from 4,091 blood donors were tested for the presence of anti-HCV using the second generation immunoassay (Abbott). 275 random serum samples were tested for anti-HBc and ALT. All the samples positive for anti-HCV were also tested for anti-HBc and ALT. Only 22 of the 4,091 donor samples (0.54%) were repeatedly reactive for anti-HCV. Of the 275 random samples tested, 43 samples (15.6%) were positive for anti-HBc and 24 (8.7%) had ALT levels more than 45 IU/l. None of these 67 samples were positive for anti-HCV. Only 3 of the 22 anti-HCV positive samples (13.6%) were positive for anti-HBc and only 6 samples (27.2%) had ALT level more than 45 IU/l. The prevalence of anti-HCV among the donors is only 0.54% which is much lower than the prevalence of HBV. An important finding is that about 60% of the donors positive for anti-HCV had no detectable surrogate markers. Exclusion of blood donors positive for anti-HBc, if implemented in an area where the prevalence of HBV infection is relatively high will result in the loss of blood donors estimated to be 15.6% and the use of raised ALT will result in a further loss of 6.1% of the blood donors.