Usefulness of galactose oxidase-Schiff test in rectal mucus for screening of colorectal malignancy.

Based on a "field-effect" theory in colon carcinogenesis, and the expression of the disaccharide tumor marker D galactose-beta-[1-->3]-N-acetyl-D-galactosamine (Gal-GalNAc) in the rectal mucus of patients with cancer and precancer of the colon, Shamsuddin developed a simple, accurate, inexpensive, easy to perform and rapid (< or = 15 min) screening test for colonic cancer and precancerous lesions. In this study we examined 137 rectal mucus samples of randomly selected patients with colorectal malignancy or other colorectal diseases to confirm the sensitivity and specificity of this test in Croatia. Additionally, to test the validity of the "field-effect" theory, that the mucosa away from the obvious cancer will show abnormalities as a result of the generalized effect of the carcinogen throughout the entire field of the target tissue, we also monitored a subset of 53 patients post-operatively. Individuals free of colonic or any other malignancies served as control (n = 31). The rectal mucin was smeared on membrane filter and developed by a sequential reaction of galactose oxidase (GO) and Schiff's reagent. The test results were correlated to the findings from colonoscopy/surgery and histopathology. The sensitivity of the test was shown to be 100% and the specificity was 96.8% (p < 0.001). Interestingly, the test was positive in 60% (32 of 53) of the samples collected from patients after tumor resection, showing the persistence of the biochemical changes even though malignant tumors were removed, hence supporting the field-effect phenomenon of carcinogenic stimuli. Five patients out of these 32 (16%) postoperative cases with positive GO test had a tumor recurrence within a year (0.05 < p < 0.10), suggesting that a persistently positive GO test in this population may serve as a predictor of tumor recurrence. We conclude that Gal-GalNAc is an early and intermediate biomarker, suitable not only for the detection of malignancy in its inception, but also for monitoring of people at high risk for cancer, and the efficacy of the cancer therapy as well as secondary prevention by this technology.

Croatian experience in the treatment of 629 urogenital war injuries.

During the war in Croatia, from April 1991 until November 1993, 33,468 wounded persons were reported, and 24,865 of them were hospitalized. Out of the total number of the hospitalized persons 588 wounded suffered 629 injuries of the urogenital system. This study reports on the experience in the treatment of such injuries at 17 urological and surgical institutions.

Extracorporeal shockwave lithotripsy (ESWL)--a report on the first 500 patients.

This paper presents the results of the treatment of the first 500 patients treated with the second generation lithotriptor SIEMENS "LITHOSTAR". In 500 patients with 607 stones 521 treatments were performed in 799 sessions. Six months after the ESWL treatment 522 out of 607 stones (86%) were desintegrated completely, i.e. 87.2% of the patients were stone-free. The best results were obtained with solitary pelvic (95.51%) and ureteral stones (95.8%). In 52 patients (10.4%) complications due to obstruction were successfully solved by endoscopic procedures. These results clearly present ESWL as the best method in the treatment of urolithiasis patients.

[Adrenal gland cyst]. / Cista nadbubrezne zlijezde.

The authors present a case with a large pseudocyst (20 x 10 x 10 cm.) of the suprarenal gland containing tho liters of clear yellow liquid. It had pushed the right kidney entirely to the left retroperitoneum. On IVU there can be observed a crossed ectopia of the right kidney as well as the shadow of the tumorous formation in the right half of the abdomen. On angiography the right renal artery origins from its normal place, from the right side of aorta, but later it bands medially, crosses aorta over its front side and enters the right kidney, which is now placed under the left kidney. The left renal artery has a normal course. The branches of both arteries inside the kidneys are normal. The right suprarenal artery comes out together with the phrenical artery; it is pushed back in an arc-like form and ramifies over the avascular formation - the cyst. The operation confirmed the diagnosis. The suprarenal gland cyst was removed by a partial resection of the right suprarenal gland and nephropexy of the right kidney to the twelfth rib was done. IVU following the operation demonstrated a normal situation. There are also mentioned the difficulties in classification, pathohistology and pathogenesis of this illness.

[Regeneration of defects in a small portion of the urinary bladder mucosa in experiments with guinea pigs]. / Regeneracija defecta sluznice mokracnog mjehura manjeg areola u eksperimentu na zamorcima.

Regeneration of the vesical mucosa begins from the remains of the bladder at the trigonum and urethra, and the author studied this regeneration in 30 rats. Epithelial regeneration began on the third day after formation of the defect. On the fifth day the entire defect was covered with transitional epithelium whose thickness did not exceed 1--2 cell layers. During the fifth week regeneration was complete. This experiment confirms the claim of Baker et al. the regeneration of the mucossa of the urinary bladder (except for the remaining mucosa of the trigonum and urethra) occurs via differentiation of pluripotential mesenchyme cells into transitional epithelium. During the experiment, the rats were given garamycin prophylactically. The very short regeneration time was probably due to the absence of any inflammatory process.