No abstract available.
Adenocarcinoma* ; Neurofibromatoses* ; Pancreas*

PURPOSE: To improve low sensitivity of urinary cytology in diagnosis and surveillance of bladder cancer, we performed a study using the Lewis X immunocytology with the murine BG-7 monoclonal anti-Lewis X immunoglobulin M antibody while comparing it with conventional urinary cytology. MATERIALS AND METHODS: Barbotage bladder washings were performed in 36 patients who were diagnosed as having bladder tumor after cystoscopy. The specimens were divided into conventional urinary cytology and immunocytochemical examinations. The cytologic examination was done according to Papanicolau. Indirect immunoperoxidase staining of urine samples was done using the murine BG-7 monoclonal antibody against the Lewis X antigen. Biopsies were obtained in all cases via transurethral resection. The results were analysed according to the tumor stage and grade. RESULTS: Of the 36 patients, 33 patients were diagnosed with transitional cell carcinoma, 1 with inverted papilloma, and 2 with chronic inflammation. Immunocytology showed positive results in 25 of the 33 patients, corresponding to a sensitivity of 75.8% while conventional cytology showed a sensitivity of 45.5%. This discrepancy was vivid in the cases of low grade transitional cell carcinoma. The sensitivities of conventional cytology were 23% in grade I and 50% in grade II, while those of immunocytology were 50% in grade I and 100% in grade II. CONCLUSIONS: Our data show that Lewis X immunocytology using the murine BG-7 monoclonal anti-Lewis X antibody can improve the sensitivity of noninvasive detection of transitional cell carcinoma of the bladder, especially in low grade tumor.
Antigens, CD15* ; Biopsy ; Carcinoma, Transitional Cell ; Cystoscopy ; Diagnosis ; Humans ; Immunoglobulin M ; Inflammation ; Papilloma, Inverted ; Urinary Bladder Neoplasms* ; Urinary Bladder*

BACKGROUND/AIMS: Colonoscopic perforation can be treated by both operative or non-operative methods. Non-operative management, and especially conservative management, may be appropriate for selected individuals. We wanted to verify the usefulness of performing conservative management for treating colonoscopic perforations. METHODS: We reviewed the medical records of the colonoscopic perforation cases that occurred in the recent 5 yrs. 11 cases of perforation occurred from among 8,536 colonoscopic procedures. RESULTS: Ten cases occurred from a therapeutic procedure (five from polypectomy and another five occurred from an endoscopic (submucosal dissection) and one case occurred from a diagnostic procedure. The perforation sites were the ascending colon (three cases), transverse colon (two cases), descending colon (one case), sigmoid colon (two cases), and rectum (three cases). There were five intraperitoneal perforations and five retroperitoneal perforations. All the cases were detected within 12 hours and all the cases had received good bowel preparation. 10 cases were managed conservatively (nothing by mouth, broad spectrum antibiotics and, Levin tube suction). One case was managed by an operative procedure due to the large size of the defect and the patient's wish. All the patients recovered without complications. The mean hospital stay was 9.5 days. CONCLUSIONS: Colonoscopic perforation can managed conservatively in selected cases, such as for those cases that will undergo post-therapeutic colonoscopy and those cases that have undergone good bowel preparation.
Anti-Bacterial Agents ; Colon, Ascending ; Colon, Descending ; Colon, Sigmoid ; Colon, Transverse ; Colonoscopy ; Humans ; Length of Stay ; Medical Records ; Mouth ; Rectum ; Surgical Procedures, Operative

OBJECTIVES: We studied the circadian rhythm of nonlinear heart rate dynamics in healthy subjects. BACKGROUND: The frequency of sudden cardiac death increases in the morning. The relationship between decreased complexity of heart rate dynamics and sudden cardiac death has been documented. An understanding of the circadian variation in the complexity of cardiac dynamics may be important and to predict and prevent this sudden cardiac death. METHODS: Dynamic 24-hour electrocardiographic recordings were obtained from 30 healthy ambulant subjects aged 41 to 50 years and the digitized data was partitioned into sections of 30 minutes' duration. For each section, four indexes obtained from separate algorithms of nonlinear dynamics of RR interval - correlation dimension, Lyapunov exponent, approximate entropy, and fractal dimension - were calculated. Normalized low- (0.04-0.1 hertz) and high-frequency (>0.15 hertz) components were also calculated. RESULTS: All the four indexes of nonlinear dynamics showed a remarkably similar circadian rhythm: a prominent morning dip preceded by a steep decline during the late night, a recovery during the evening and a peak around midnight. In the morning, the low frequency component rose rapidly with concomitant withdrawal of the high frequency component. CONCLUSION: The complexity of cardiac dynamics decreases significantly in the morning, and this may contribute to the ominously increased rate of cardiac death in the morning hours.
Circadian Rhythm* ; Death ; Death, Sudden, Cardiac ; Electrocardiography ; Entropy ; Fractals ; Heart Rate ; Nonlinear Dynamics

OBJECTIVES: The degree of hyperkalemia and effects of potassium removal by hemodialysis on the plasma potassium concentration to see the influence of nonselective beta-adrenergic blockade(carteolol) and ACE inhibitor(captopril) on patients in maintenance hemodialysis were evaluated. METHODS: This study was done on 16 patients with end-stage renal disease undergoing maintenance hemodialysis. These patients were classified two groups; group 1-patients with carteolol or captopril(9 patients) and group 2-patients without medication(7 patients). Measurement of plasma potassium and arterial blood gas analyses were performed at pre-dialysis and during hemodialysis(4 hours). To analysis the distribution of potassium kinetics during hemodialysis, dialysis potassium clearance rate was introduced in this study. RESULTS: 1) Among 16 patients studied, the mean age was 43 years old and the ratio of male to female was 2: 1 and the mean duration of hemodialysis was 17.9 months. The underlying cause of end-stage renal disease was chronic glomerulonephritis in the most patients. 2) The mean predialysis plasma potassium concentration of all patients, group 1 on medication, and group 2 without medication was 5.13 +/- 1.04mEq/L, 5.67 +/- 1.01mEq/L and 4.410.55mEq/L, with high significance(p<0.001) between groups 1 and 2. 3) The mean postdialysis plasma potassium concentration of group 1 on medication and group 2 without medication was 348 +/- 0.40mEq/L and 3.39 +/- 0.56mEq/L with insignificance between groups 1 and 2. 4) The pre- and post-dialysis concentration of plasma sodium, pH and bicarbonate between group 1 and group 2 was similar except glucose. 5) Despite the fall in absolute plasma concentration in group 1 more than twice than in group 2, the difference in dialysis potassium clearance rate measured at 1 hour of hemodialysis in group 1 compared to that of group 2 was only 12M. CONCLUSION: These data are consistent with at least a two-compartment distribution of plasma potassium rather than single pool in addition to frequent hyperkalemia on maintenance hemodialysis on nonselective beta-adrenergic blocker or ACE inhibitor contributed to partial impairment of extrarenal transcellular shifts of potassium during inter- and intra-dialytic phase.
Adult ; Blood Gas Analysis ; Carteolol ; Dialysis ; Female ; Glomerulonephritis ; Glucose ; Humans ; Hydrogen-Ion Concentration ; Hyperkalemia ; Kidney Failure, Chronic ; Kinetics ; Male ; Plasma* ; Potassium* ; Renal Dialysis* ; Sodium