Intravesical Bacillus Calmette-Guerin (BCG) had been shown to be effective therapy and prophylaxis against recurrent tumor in patients with superficial bladder cancer, including carcinoma in situ. A study was performed to determine the prophylactic efficacy of intravesical Tice-Chicago strain BCG instillation in 47 patients with high risk superficial bladder cancers (stage Ta or T1). Group I consisted of 17 patients with a history of at least 1 tumor recurrence before BCG therapy. Most had received various forms of intravesical chemotherapy as prophylaxis following previous TUR of the bladder tumor. The tumor recurrence rate of patients was compared with the rate during the 2 years prior to BCG therapy as a personal historical control. The simple recurrence rate of group I was 41.2% before and 5.9% after intravesical BCG therapy. According to the person-years method. the number of recurrent tumors per patient-months was 0.0149 before and 0.0021 after BCG therapy(p>0.05). Group R consisted of 30 consecutive new patients. The tumor recurrence rate after BCG therapy was compared with that of historical controls in our hospital. There were lI6 other patients who had previously been treated by transurethral resection and most had also received intravesical chemotherapy. The simple recurrence rate was 20% in BCG patients and 44.8% in the historical controls. According to the person-years method, the number of recurrences per patient-months in this group was 0.0081 and 0.0576 in the historical group. The results show that intravesical BCG instillation is effective and safe as a prophylaxis against the recurrence of the superficial bladder tumors. The granulomatous response in the bladder and PPD responsiveness have their statistical correlation with status free of tumor.
Bacillus ; Carcinoma in Situ ; Drug Therapy ; Humans ; Mycobacterium bovis* ; Recurrence ; Urinary Bladder Neoplasms* ; Urinary Bladder*

We present a case of portal and superior mesenteric venous gas in a 31-year-old diabetic woman with a left-sided retroperitoneal abscess. Five years prior to admission, patient was diagnosed with diabetes mellitus and developed emphysematous pyelonephritis, requiring nephrectomy on the left side. A CT examination showed air distributed throughout the portal venous system and superior mesenteric vein.
Abscess/blood/*radiography ; Adult ; Female ; Gases/blood ; Humans ; Mesenteric Veins/metabolism/*radiography ; Portal Vein/metabolism/*radiography ; Retroperitoneal Space ; Tomography, X-Ray Computed

BACKGROUND: This study was designed to evaluate the clinical efficasy of lovastatin, HMG-CoA reductase inhibitor, in patients with hypercholesterolemia. METHODS AND RESULTS: Lovastatin 20 to 80 mg were administered once daily for 12 weeks in twenty five patients(11 male, 14 famale ; nine patients with familial hypercholesterolemia) with hypercholesterolemia(>240mg/dl). Compared with pretreatment levels, lovastatin significantly decreased levels of total cholesterol(309+/-46mg/dl versus 201+/-37mg/dl) by 35%, LDL-cholesterol(230+/-48mg/dl versus 125+/-40mg/dl) by 46% and triglyceride(170+/-76 versus 142+/-66mg/dl) by 11% (p<0.05) with significantly decreased levels of total-cholesterol/HDL-cholesterol ratio(7.4+/-2.1 versue 4.6+/-1.5) and LDL-cholesterol/HDL-cholesterol ratio(5.6+/-1.9 versue 2.9+/-1.4) (p<0.005 except triglyceride, respectively). The level of Apo B(183+/-32mg/dl versus 114+/-26mg/dl) was decreased significantly by 37%(p<0.005) with significantly decreased level of Apo A-1(115+/-22 to 122+/-26mg/dl) was increased significantly by 6%(p<0.05). No serious side effects were found. CONCLUSIONS: Results from the present study show that lovastatin is an effective and well-tolerated cholesterol-lowering agent.
Humans ; Hypercholesterolemia* ; Lovastatin* ; Male ; Oxidoreductases ; Triglycerides

We report a case of a 65-year-old man with Behcet's disease who presented with massive hemoptysis caused by bronchial varices. A computed tomography (CT) scan and bronchoscopy were performed to identify the bleeding site. The CT scan revealed pneumonia and a combined hemorrhage in the right-middle and lower lobes. Massive bleeding was detected during the bronchoscopy and emergency embolization was attempted but angiographic findings were normal. An anteriojugulo-right femoral bypass operation was performed to relieve the tortuous and hypertrophied jugular venous obstruction. However, thrombectomy and thrombolysis followed because of graft thrombosis six days post-surgery. The patient was treated with steroid and high-dose cyclophosphamide therapy for his Behçet's disease, which caused the venous obstructions; the saccular bronchial varices in the right-middle and right lower lobes on bronchoscopy regressed slightly after four cycles of cyclophosphamide therapy
Aged ; Bronchoscopy ; Cyclophosphamide ; Emergencies ; Hemoptysis ; Hemorrhage ; Humans ; Pneumonia ; Superior Vena Cava Syndrome ; Thrombectomy ; Thrombosis ; Tomography, X-Ray Computed ; Transplants ; Varicose Veins*

Human papillomavirus E7 (HPV E7) is a viral oncoprotein that plays an important role in cervical carcinogenesis through binding with retinoblastoma protein (Rb). Inactivation of Rb by E7 is necessary but not sufficient for cellular transformation, suggesting other protein-protein interactions are required for E7-mediated cellular transformation aside from the interaction with Rb. However, studies on the oncogenic function of HPV E7 have been limited by its poor immunoreactivity. In this report, we show that the fixation of purified recombinant HPV E7 on blotted nitrocellulose membrane with glutaldehyde markedly enhanced the immunoreactivity of HPV E7 protein. Using HeLa and Caski cell line which are infected with HPV 18 and HPV 16, respectively, we demonstrated that native HPV E7 proteins also could be detected by this method. These results therefore can provide the experimental conditions for detection of HPV E7 proteins with greater sensitivity and may help to analyze E7 functions.
Cell Extracts/chemistry/immunology ; Cell Line ; Human ; Immunochemistry/*methods ; Oncogene Proteins, Viral/*analysis/immunology ; Papillomavirus, Human/chemistry/*immunology

BACKGROUND: It is well known that sevoflurane anesthesia is associated with emergence agitation (EA) in children, and that fentanyl may reduce its incidence. However, in case of midazolam, there have been conflicting reports. Therefore, we measured the effect of midazolam on EA after sevoflurane anesthesia and compared it with that of fentanyl. METHODS: Sixty pediatric patients receiving sevoflurane anesthesia for tonsillectomy was assigned to 3 groups. Saline 0.1 ml/kg (group P), midazolam 0.1 mg/kg (group M), or fentanyl 1 microgram/kg (group F) was administered intravenously 10 minutes before the end of surgery. The incidences of over-sedation (OS) and EA were checked three times at the postanesthesia care unit. RESULTS: Group M had a tendency to show a high incidence of OS, but its incidence of EA was not different from the other groups. In group F, OS and EA were less frequent than in groups P and M. CONCLUSIONS: After sevoflurane anesthesia for tonsillectomy, fentanyl effectively prevented EA, but midazolam elicited OS and was ineffective at preventing EA.
Anesthesia* ; Child* ; Dihydroergotamine* ; Fentanyl ; Humans ; Incidence* ; Midazolam* ; Tonsillectomy*

BACKGROUND: Losartan potassium, an orally active, highly selective AT (1) angiotensin II receptor inhibitor, effectively reduces blood pressure by directly blocking receptors. The purpose of this study is to compare the antihypertensive efficacy, safety and tolerability of losartan potassium and fosinopril in patients with stage 1 to 3 hypertnesion. METHODS: In this comparative, open labelled, randomized, parallel study, the efficacy, safety and tolerability of once-daily losartan (50mg) versus once-daily fosinopril (10mg) were evaluated over twelve weeks in 96 patients with stage 1-3 hypertension. If trough sitting diastolic blood pressure was equal to or greater than 90mmHg after a 6 week treatment period, the dosage for both study drugs was doubled until the end of the study (week 12). RESULTS: After 6 weeks of treatment, mean reductions in trough sitting diastolic blood pressure were 7.4mmHg (95% confidence interval 5.0-9.9) with 50mg losartan and 6.7mmHg (95% confidence interval 4.4-9.2)with 10mg fosinopril. After 12 weeks of treatment (after dose titration), mean reductions in trough sitting diastolic blood pressure were 9.4mmHg (95% confidence interval 6.7-12.1) with losartan and 10.3mmHg (95% confidence interval 7.6-12.9) with fosinopril. At weeks 6 and 12, there were no dignificant difference in the mean reduction of through ditting diastolic blood pressure between the losartan group and the fosinopril group. Losartan and fosinopril were well tolerated without significant clinical and laboratory adverse reactions. The incidence of dry cough was lower in the losartan group than in the fosinopril group but not statistically significant. CONCLUSIONS: The antihypertensive effect of once-daily administration of losartan is similar to that of once-daily administration of fosinopril in patients with hypertension. Both losartan and fosinopril are well tolerated without significant adverse reaction.
Blood Pressure ; Cough ; Fosinopril* ; Humans ; Hypertension* ; Incidence ; Losartan* ; Receptors, Angiotensin

BACKGROUND: Aldosterone antagonists are reported to have beneficial effects on diabetic nephropathy by effective blocking of the renin-angiotensin-aldosterone system. We investigated the renoprotective effect of the selective aldosterone receptor blocker eplerenone, the angiotensin converting enzyme inhibitor lisinopril, and combined eplerenone and lisinopril treatment in type 2 diabetic rats. METHODS: Animals were divided into six groups as follows: Otsuka Long-Evans Tokushima Fatty (OLETF) rat control, OLETF rats treated with a low dose of eplerenone (50 mg/kg/day), OLETF rats treated with a high dose of eplerenone (200 mg/kg/day), OLETF rats treated with lisinopril (10 mg/kg/day), OLETF rats treated with a combination of both drugs (eplerenone 200 mg/kg/day and lisinopril 10 mg/kg/day), and obese non-diabetic Long-Evans Tokushima Otsuka rats for 26 weeks. RESULTS: Urinary albumin excretion was significantly lower in the lisinopril group, but not in the eplerenone group. Urinary albumin excretion was decreased in the combination group than in the lisinopril group. Glomerulosclerosis and renal expression of type I and type IV collagen, plasminogen activator inhibitor-1, transforming growth factor-beta1, connective tissue growth factor, and fibronectin mRNA were markedly decreased in the lisinopril, eplerenone, and combination groups. CONCLUSION: Eplerenone and lisinopril combination showed additional benefits on type 2 diabetic nephropathy compared to monotherapy of each drug.
Aldosterone ; Animals ; Collagen Type IV ; Connective Tissue Growth Factor ; Diabetic Nephropathies ; Fibronectins ; Lisinopril ; Mineralocorticoid Receptor Antagonists ; Peptidyl-Dipeptidase A ; Plasminogen Activators ; Rats ; Rats, Inbred OLETF ; Receptors, Mineralocorticoid ; Renin-Angiotensin System ; RNA, Messenger ; Spironolactone

BACKGROUND/AIMS: We compared the efficacy and safety of the second-generation everolimus-eluting stent (EES) and the third generation biolimus-eluting stent (BES) in patients with acute myocardial infarction (AMI). METHODS: We analyzed 629 consecutive patients (mean age 65.1 +/- 11.2 years, 426 males) with AMI undergoing percutaneous coronary intervention from February 2008 to April 2012. They were divided into two groups according to stent type (EES group, n = 426; BES group, n = 203). The primary end-point was 2-year major adverse cardiac events (MACEs), defined as the composite of all-cause death, myocardial infarction, target vessel revascularization, non-target vessel revascularization and target lesion revascularization. The secondary end-point was 2-year target lesion failure (TLF). RESULTS: There were no significant differences in baseline characteristics, except that the patients with EES had a significantly higher prevalence of diabetes mellitus (34.7 vs. 22.7%, p = 0.002) and were older (67.1 +/- 11.3 vs. 64 +/- 12.9 years, p = 0.039) compared with the patients with BES. After propensity score matching, 2-year clinical outcomes showed no differences in composite MACEs or TLF between the two groups. Multivariate Cox regression analysis showed that stent type was not a predictor of 2-year mortality or MACEs. However, older age (hazard ratio [HR] 1.037, 95% confidence interval [CI] 1.014-1.060, p = 0.001), diabetes mellitus (HR 2.247, 95% CI 1.426-3.539, p = 0.001) and a left ventricular ejection fraction < or = 45% (HR 3.007, 95% CI 1.978-4.573, p = 0.001) were independent predictors for 2-year MACEs in patients undergoing EES or BES. CONCLUSIONS: Patients with BES had similar clinical 2-year outcomes compared with EES patients with AMI.
Diabetes Mellitus ; Humans ; Mortality ; Myocardial Infarction* ; Percutaneous Coronary Intervention ; Prevalence ; Prognosis ; Propensity Score ; Stents* ; Stroke Volume