Isomorphic red blood cells using automated urine flow cytometry is a reliable method in diagnosis of bladder cancer.

BACKGROUND: We aimed to identify patients with a chief complaint of hematuria who could safely avoid unnecessary radiation and instrumentation in the diagnosis of bladder cancer (BC), using automated urine flow cytometry to detect isomorphic red blood cells (RBCs) in urine. METHODS: We acquired urine samples from 134 patients over the age of 35 years with a chief complaint of hematuria and a positive urine occult blood test or microhematuria. The data were analyzed using the UF-1000i (®) (Sysmex Co., Ltd., Kobe, Japan) automated urine flow cytometer to determine RBC morphology, which was classified as isomorphic or dysmorphic. The patients were divided into two groups (BC versus non-BC) for statistical analysis. Multivariate logistic regression analysis was used to determine the predictive value of flow cytometry versus urine cytology, the bladder tumor antigen test, occult blood in urine test, and microhematuria test. RESULTS: BC was confirmed in 26 of 134 patients (19.4 %). The area under the curve for RBC count using the automated urine flow cytometer was 0.94, representing the highest reference value obtained in this study. Isomorphic RBCs were detected in all patients in the BC group. On multivariate logistic regression analysis, only isomorphic RBC morphology was significantly predictive for BC (p < 0.001). Analytical parameters such as sensitivity, specificity, positive predictive value, and negative predictive value of isomorphic RBCs in urine were 100.0, 91.7, 74.3, and 100.0 %, respectively. CONCLUSION: Detection of urinary isomorphic RBCs using automated urine flow cytometry is a reliable method in the diagnosis of BC with hematuria.

Early head penetration into cemented Hylamer Ogee socket.

The authors reviewed 18 consecutive cemented total hip arthroplasties with the Hylamer Ogee socket. The average follow-up period was 47 months. All Hylamer Ogee sockets were sterilized by gamma irradiation in air, and the average period from production to surgery was 12 months. Two-dimensional penetration of the femoral head into the Hylamer Ogee socket was determined from anteroposterior radiographs of the pelvis using a digitizer. The average head penetration rate of the present series was 0.36 mm/y. Osteolysis around both components was found in 6 cases (30%). Of 4 cases defined as aseptic loosening, 2 were revised during the follow-up period. To detect component loosening because of catastrophic high wear of the cemented Hylamer Ogee socket as early as possible, precise radiographic follow-up is essential.