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Tumor markers in the evaluation of ultrasonically detected focal liver masses using a computer decision support software system
TU!CR :!LrlXiRS ULTRASOiIICALLY
III THE
Eb!sLUATI03
'JF
ATRIAL NATRIDRKTIC FACTOR (ANF) IN LIVER CIRRHOSIS - RELATIONSHIP TO HAEMODYNAMIC PARAMETERS
FOUL LIVE8 GETECTEO i.iASSESUSIi!C k CO:(PUTEHOECISIO:I SUPPCKT SiX=TV:‘A2E SYSTEI.!.
V.Tesai-, K.HorkSr, J.JedliEka, J.Petrtql, Z.MareEek, 1st and 3rd Department of Medicine, Charles University, Prague, Czechoslovakia
A. Szcbeni. S.Schunann, J.Izsd, K.Kristd, . G .Stotz. Korvin Ottd t.Rinanoczk Hospital, 3uCapest, Hungary.
We performed right heart and hepatic vein catheterization in 12 patients with liver cirrhosis (LC), 6 of them with ascites and 6 controls. ANF was measured using RIA method after previous extraction in samples from pulmonary artery (AP) and wriuheral and heDatic veins. Patients with-a&tic cirrhosis (AC) had higher portohepatic gradient and lower mean arterial and central venous pressures (CVP) than controls. AC patients had higher ANF in PA (15.89_12.26VS. 8.04+0.97, ~~0.01) and hapatic vein (7.4420.44 VS. 3.9120.63, pcO.05) than controls, but they did not differ from controls in splanchnic ANF extraction (0.46+_0.1~5. 0.51+0.06, n.s.1. We found tight correlation between ANF in AP and CVP (r=0.677,p=0.016) and pulmonary capillary wedged pressure (r= 0.639,p=O.O25) in patients with LC. In conclusion, higher ANF concentrations in AP with no change of splanchnic extraction in patients with AC suggest increased cardiac production of ANP in AC which may be mediated by atria1 volumoreceptors.
Focal liver diseases are often detected SY ultrasound but the fialicnitv or benignity of the lesion can noi be.judged from ultrasound morphology. Sometimes other noninvasive diagnostic modalities or even ultrasonically guided fine-needle aspiration biopsy can not solve this proSlem, thus complementary data are necessary. Recently, a number of tumor marker Ceterninations were elaborated vet their sensitivity and specificity are _ different in thcnselves. Therefore hre tested a :ocplcx system in more then 50 patients with clinically sugGested naligYe performed ultrasoncgnant diseases. raphy and several tumor marker detereinations simultaneously. Data proccssing was made 3~ a newly
developed
own conputer
decisitn support software system. It uas verified. that evaluation of ultrasound eata an&tumor marker determinations in a complex eyzten gives better results than evaluatinz them individuallv. makinc clinical decisions more reliable. -
Fractional disappearancerates of caffeine and ladocyanlnegreen in subjectswhit constitlttioaal uaconju&ated lq-f.srbilirubine!ala. R. Testa.E. Bardellini, P. Bindl,F. Da~ino, P. Montani. L. Fontaaa, G. Celle. Cattedra di Castroenterolo6la ISNI. Universita' dl CeDOM. osp. s. Ksrtino.Geneva.Italy. Div. Med. Lavoro, Ia subjects vith constitutional unconju@ed hwerbillrubinemia (Gilbert'ssvldrow. 0s) it is p&ibls rind p+xt~bed _ fractioaal disappcuanctaorate (K) o"iindocranlne~eea (ICG). Th!r vork vas plannedto evaluate the kinetics n* both ICG and caffeine(OAF)In 0s subjects.In 16 man (age: 16-29 years) with hyperbilirubinemla (wan *SD 1.750.6"zyz n&mal fastlnmgserumbile &de Imean& 3.2zt.l.0 laud/l). were evaluatedin seauenceKICG (0.25an/Ku -iv). and KCAP (250me 06). c "arc calculatedby a ccaputerizlng curve strippingmethod: all plamra dlsappzaranca curvesof ICC, but not of OAF. shoved a biexponentialkinetic& Normal valuer (7 men rpatchsd for age) verc (mean?%I) KICG 0.43iO.l5/m and KOAF 0.27=0.06/h. In CS subject.8 KICG resulted noti (0.38tO.O4/m')la nine and perturbed (O.lotO.08 18')In seven.No differencela KCAF was found ktvcc~ subjectsvith (0.3Oztll.19) aad without abrmal KICG (O.3O+,o.18~). These resulta suggest thatperturbedtranspxtof ICClnC.5 syndromedoes not depend on anzymathic liver cell systems metabollzlng caffeine, and therefore normal K of caffeine could substantiate diagnosis of GS a.yndrome subjects unconjugatad byparbilirub:~emia sod altered% kinetics. s115
C-HA - RAS POLYMORPHISM IN HEPATOCELLULAR CARCINAWA. JM.SEIGNEURIN.CllfflquO d’HEPATOGASTROENTEROLOGIE, CHRU 6a LA WIOMCHE, BP 217 X 39043 GRENOBLE CEDEX. Laborstoke de VIROLOGIE. ifhasteen repmiedfhalfhefreqmcyr8a~~g~ Ha-msbcusinmeasedfnffmcancefpwulaWn
mamr IO d&u
ln5@mdenm~lltylfasscdateth5
ResfMonF~Len@lb~ (RFLP)al fhs c-Ha-fa-ras 9.3”s locuswifhft-3 Sporwronof &ffemnf#nd of fumors@led us fo invesfiie INS QestO locus in 40 kmalocellulafcarcinoma (HCC) patcenfs3nd in 42 unaffecfedindMduals. All studied ir&i&alswemc4wuc&ano&in. DNA was exb’acfedfrom pet+pberalblood leukocytes. hydrolyzedby fwo resfrkfffn enzymes Ek%nHl and Ava II, transferredon to a nylon nmmbfam by fbe afcalinelransfer mefhod.Hybd&affonp&onnsdwilha29KbB&fragmenfolcHa-ms19eneanda2.SKb5acl foBaWlfragmenl(pmbefoc VlR).ThemembmmS for24hand3days. slatislfcalcompzafmnol all&s fmqwm%s fnbofhproupswas canfedoufby lhe~lesLTbebydmly&wifbA~IIafbwedfo idenlify4 commonaUebsbfbolblwlfhyandcanwpqWalion: lhslrms&fc&nftqmsnfs skes wem al (I.55 W). a2 (20Kb). a3
(2.65 Kb).a4 (3.2 Kb). aad3 nn atlabs +s(l.ffi ~~~),aS&e.6$
Kb),a7(1.9Kb)wereakodskwf.tJosfawwkg thepwafemxwasobwvedbebwenbeaflbyandf-lCCgmup(P >O.Ol).nowevsr~Pddftionorme~~rr)aRe~shawsa pcevafenceaboutwiceklHCC(35%)tbaninthemmmlgtDup (16.5%) (P ( 0.01). 7hesa resullssug2esfMa Ihe sfgnh%enf changein the refafiveakndanwofffmmmnmnaifekscanau withothersfecfofslo inlluenceksmQ&c@.
III THE
Eb!sLUATI03
'JF
ATRIAL NATRIDRKTIC FACTOR (ANF) IN LIVER CIRRHOSIS - RELATIONSHIP TO HAEMODYNAMIC PARAMETERS
FOUL LIVE8 GETECTEO i.iASSESUSIi!C k CO:(PUTEHOECISIO:I SUPPCKT SiX=TV:‘A2E SYSTEI.!.
V.Tesai-, K.HorkSr, J.JedliEka, J.Petrtql, Z.MareEek, 1st and 3rd Department of Medicine, Charles University, Prague, Czechoslovakia
A. Szcbeni. S.Schunann, J.Izsd, K.Kristd, . G .Stotz. Korvin Ottd t.Rinanoczk Hospital, 3uCapest, Hungary.
We performed right heart and hepatic vein catheterization in 12 patients with liver cirrhosis (LC), 6 of them with ascites and 6 controls. ANF was measured using RIA method after previous extraction in samples from pulmonary artery (AP) and wriuheral and heDatic veins. Patients with-a&tic cirrhosis (AC) had higher portohepatic gradient and lower mean arterial and central venous pressures (CVP) than controls. AC patients had higher ANF in PA (15.89_12.26VS. 8.04+0.97, ~~0.01) and hapatic vein (7.4420.44 VS. 3.9120.63, pcO.05) than controls, but they did not differ from controls in splanchnic ANF extraction (0.46+_0.1~5. 0.51+0.06, n.s.1. We found tight correlation between ANF in AP and CVP (r=0.677,p=0.016) and pulmonary capillary wedged pressure (r= 0.639,p=O.O25) in patients with LC. In conclusion, higher ANF concentrations in AP with no change of splanchnic extraction in patients with AC suggest increased cardiac production of ANP in AC which may be mediated by atria1 volumoreceptors.
Focal liver diseases are often detected SY ultrasound but the fialicnitv or benignity of the lesion can noi be.judged from ultrasound morphology. Sometimes other noninvasive diagnostic modalities or even ultrasonically guided fine-needle aspiration biopsy can not solve this proSlem, thus complementary data are necessary. Recently, a number of tumor marker Ceterninations were elaborated vet their sensitivity and specificity are _ different in thcnselves. Therefore hre tested a :ocplcx system in more then 50 patients with clinically sugGested naligYe performed ultrasoncgnant diseases. raphy and several tumor marker detereinations simultaneously. Data proccssing was made 3~ a newly
developed
own conputer
decisitn support software system. It uas verified. that evaluation of ultrasound eata an&tumor marker determinations in a complex eyzten gives better results than evaluatinz them individuallv. makinc clinical decisions more reliable. -
Fractional disappearancerates of caffeine and ladocyanlnegreen in subjectswhit constitlttioaal uaconju&ated lq-f.srbilirubine!ala. R. Testa.E. Bardellini, P. Bindl,F. Da~ino, P. Montani. L. Fontaaa, G. Celle. Cattedra di Castroenterolo6la ISNI. Universita' dl CeDOM. osp. s. Ksrtino.Geneva.Italy. Div. Med. Lavoro, Ia subjects vith constitutional unconju@ed hwerbillrubinemia (Gilbert'ssvldrow. 0s) it is p&ibls rind p+xt~bed _ fractioaal disappcuanctaorate (K) o"iindocranlne~eea (ICG). Th!r vork vas plannedto evaluate the kinetics n* both ICG and caffeine(OAF)In 0s subjects.In 16 man (age: 16-29 years) with hyperbilirubinemla (wan *SD 1.750.6"zyz n&mal fastlnmgserumbile &de Imean& 3.2zt.l.0 laud/l). were evaluatedin seauenceKICG (0.25an/Ku -iv). and KCAP (250me 06). c "arc calculatedby a ccaputerizlng curve strippingmethod: all plamra dlsappzaranca curvesof ICC, but not of OAF. shoved a biexponentialkinetic& Normal valuer (7 men rpatchsd for age) verc (mean?%I) KICG 0.43iO.l5/m and KOAF 0.27=0.06/h. In CS subject.8 KICG resulted noti (0.38tO.O4/m')la nine and perturbed (O.lotO.08 18')In seven.No differencela KCAF was found ktvcc~ subjectsvith (0.3Oztll.19) aad without abrmal KICG (O.3O+,o.18~). These resulta suggest thatperturbedtranspxtof ICClnC.5 syndromedoes not depend on anzymathic liver cell systems metabollzlng caffeine, and therefore normal K of caffeine could substantiate diagnosis of GS a.yndrome subjects unconjugatad byparbilirub:~emia sod altered% kinetics. s115
C-HA - RAS POLYMORPHISM IN HEPATOCELLULAR CARCINAWA. JM.SEIGNEURIN.CllfflquO d’HEPATOGASTROENTEROLOGIE, CHRU 6a LA WIOMCHE, BP 217 X 39043 GRENOBLE CEDEX. Laborstoke de VIROLOGIE. ifhasteen repmiedfhalfhefreqmcyr8a~~g~ Ha-msbcusinmeasedfnffmcancefpwulaWn
mamr IO d&u
ln5@mdenm~lltylfasscdateth5
ResfMonF~Len@lb~ (RFLP)al fhs c-Ha-fa-ras 9.3”s locuswifhft-3 Sporwronof &ffemnf#nd of fumors@led us fo invesfiie INS QestO locus in 40 kmalocellulafcarcinoma (HCC) patcenfs3nd in 42 unaffecfedindMduals. All studied ir&i&alswemc4wuc&ano&in. DNA was exb’acfedfrom pet+pberalblood leukocytes. hydrolyzedby fwo resfrkfffn enzymes Ek%nHl and Ava II, transferredon to a nylon nmmbfam by fbe afcalinelransfer mefhod.Hybd&affonp&onnsdwilha29KbB&fragmenfolcHa-ms19eneanda2.SKb5acl foBaWlfragmenl(pmbefoc VlR).ThemembmmS for24hand3days. slatislfcalcompzafmnol all&s fmqwm%s fnbofhproupswas canfedoufby lhe~lesLTbebydmly&wifbA~IIafbwedfo idenlify4 commonaUebsbfbolblwlfhyandcanwpqWalion: lhslrms&fc&nftqmsnfs skes wem al (I.55 W). a2 (20Kb). a3
(2.65 Kb).a4 (3.2 Kb). aad3 nn atlabs +s(l.ffi ~~~),aS&e.6$
Kb),a7(1.9Kb)wereakodskwf.tJosfawwkg thepwafemxwasobwvedbebwenbeaflbyandf-lCCgmup(P >O.Ol).nowevsr~Pddftionorme~~rr)aRe~shawsa pcevafenceaboutwiceklHCC(35%)tbaninthemmmlgtDup (16.5%) (P ( 0.01). 7hesa resullssug2esfMa Ihe sfgnh%enf changein the refafiveakndanwofffmmmnmnaifekscanau withothersfecfofslo inlluenceksmQ&c@.