Biomedical subjects
Publications and source records attributed to G Server Pastor.
A 48-year-old woman was diagnosed with right renal vein thrombosis (RVT) 2 weeks after a laparoscopic cholecystectomy. The patient had none of the major risk factors for RVT or deep vein thrombosis. She was treated with long-term anticoagulation. Complete dissolution of the thrombi was reached 1 month after diagnosis.
OBJECTIVE: Bladder stones have been observed more frequently in patients undergoing bladder augmentation or substitution than in the normal population. We analyzed the etiological factors influencing bladder stone formation in patients submitted to the foregoing procedures. METHODS: Between December 1986 and October 1994, 12 augmentation cystoplasties with detubularized ileum or colon (group I) and 24 substitution ileocystoplasties (group II) were performed. None of the patients were known to have urinary stone formation. The possible causes of bladder stone formation were analyzed in both patients groups. The patients were evaluated for urinary infection, post micturition bladder residue, urinary pH, and stone forming metabolic alterations in blood or urine. The latter consisted in determining the blood levels of creatinine, calcium, uric acid and phosphorus and the 24-hr urine levels of calcium uric acid, phosphorus, creatinine, urea, oxalic acidi citric acid and magnesium. The statistical analysis consisted of an unweighted logistic regression test and a chi square test between each of the above variables and the existence of bladder stones. RESULTS: In group I, 10 patients revealed recurrent urinary infections, 0 showed a significant post-micturition bladder residue, a pathologically alkaline pH was observed in 2 and the metabolic study of blood and urine revealed alterations in 9 patients. In group II, 18 patients revealed recurrent urinary infection, 13 patients had post-micturition bladder residue, a pathologically alkaline pH was observed in 1, and the metabolic study of blood and urine revealed alterations in 13 patients. The statistical analysis using the unweighted logistic regression test showed no significant relation between any of the parameters and the presence of stones, for the substitution group pr augmentation group. However, the chi-square test to determine the relation between the different varikables and the existence of stones, showed a statistically significant relation between an elevated urinary pH, recurrent urinary infection, post-micturition bladder residue and bladder stone formation for groups I. Concerning the type of suture employed, some degree of relation between the use of non-resorbable suture and stone formation was found, although it was not statistically significant. CONCLUSION: We can therefore conclude that urinary pH, recurrent urinary infection annd post-micturition bladder residue, and probably use of nonreabsorbable suture, are among the etiological factors that we should avoid and treat in order to prevent the formation of bladder stones in patients undergoing augmentation or substitution cystoplasty.
Traditionally, right varicoceles have been considered a rare entity nearly always secondary to a neoplastic or retroperitoneal disease. There are other possible etiologies for right varicoceles such as the venous disease of the large veins and visceral malposition syndromes. This paper presents one case report of right varicocele as the only clinical sign of situs inversus. Revision of the literature and nomenclature of these syndromes.
OBJECTIVE: To analyze the sensitivity of renal ultrasonography and intravenous urography in renal trauma. METHODS: An extensive analysis on the sensitivity of IVP and US in the assessment of renal trauma was conducted using CT, renal selective arteriography or surgical exploration as the gold standard tests of reference to validate the initial diagnosis. RESULTS: IVP and US are useful techniques because of their high sensitivity in the diagnosis of renal trauma. The sensitivity of US decreases as the severity of the trauma increases (75% for grade I, 88.9% for grade II, 73.3% for grade III and 0% for grade IV), while that of IVP remains high for all degrees of severity (100% for grade I, 92% for grade II, 100% for grade III and 100% for grade IV). CONCLUSIONS: IVP and US were found to be useful techniques because of their high sensitivity in the diagnosis of blunt renal trauma. The sensitivity of US decreases as the severity of the trauma increases, while that of IVP remains high for all degrees of severity.
OBJECTIVE: A case of erectile dysfunction in a patient with prolactinoma is described herein. METHODS/RESULTS: The literature on the incidence, diagnosis and therapeutic management of this condition is reviewed. Impotence may arise from several causes. It is widely accepted that 30-50% have an organic etiology, with vascular involvement being more prevalent than other causes (neurological, endocrinological, urological, iatrogenic, pharmacological, systemic diseases). Hyperprolactinemia, arising from a prolactinoma, is one of the endocrinological conditions causing impotence. In men, this endocrinological disorder is rarely accompanied by other clinical anomalies, such as gynecomastia, galactorrhea or signs of a pituitary tumor. The patient described herein presented with erectile dysfunction. During evaluation, he was found to be hyperprolactinemic. Subsequent assessment disclosed a pituitary adenoma. The patient was successfully treated with bromocriptine. CONCLUSION: Erectile dysfunction arising from hyperprolactinemia is uncommon. Serum prolactin levels, a lateral skull x-ray and CT/MRI are essential in the diagnosis and treatment of this condition. Treatment must be directed at the underlying cause. Bromocriptine has proved to be effective and carries a low risk of undesired effects.
The present work was intended to be a revision of our series of Eosinophilic Cystitis and we have found that, from one single anatomicopathological picture three different clinical pictures emerge with different treatments and prognosis. Group I is constituted by young people and children with a profuse background of atopy and parasitosis, which develop mictional syndrome and haematuria and show good response to steroids. Group II includes middle-aged women, with development of chronic recurrent cystopaty and a poor response to treatment. Group III comprises elderly patients with a history of vesical injury or chronic vesical irritation, with no separate clinical signs and symptoms and requiring no treatment.
An "in vitro" experimental line was designed to study the dependence of the canine detrussor's contractile activity on extracellular calcium, or whether on the contrary there are intracellular sources of this element. If dependence from extracellular calcium could be demonstrated, the capacity of calcium channel blockers to block the input the this ion would be studied. The conclusions arrived at were: 1. Ach- and KCl-induced activity is dependent from extracellular calcium. 2. This activity is also sensitive to the action of calcium channel blockers. 3. Calcium channel blockers block Ach-activated calcium channels completely, but only partially dose activated by KCl. 4. While the activity induced by Ach and resistant to action from calcium channel blockers is probably due to calcium released from the intracellular reservoirs, the activity induced by KCl and resistant to the calcium channel blockers action can be better explained by the activation of the transmembrane channels which cannot be blocked by this agents.
Paratesticular vascular lesions are very uncommon. One of them, the epithelioid hemangioendothelioma, is a vascular tumour which grows around a vessel and in characterized for presenting epithelioid endothelial cells. Is very rare and it has good prognosis. This paper reports one case of paratesticular epithelioid hemangioendothelioma.
Presentation of the case of one patient with a leiomyosarcoma of the spermatic cord with presence of numerous giant cells, a remarkably unusual finding. Presence of this type of cells, as well as their positivity for histiocytic markers in immunohistochemical staining, raise considerable problems for the differential diagnosis of this neoplasia with malignant fibrous histiocytomas, which probably requires a different, more aggressive therapeutical approach.
Leydig's cells tumours are a variant of testicular tumours. Its has a low incidence, accounting for just 1-3% of all testicular tumours. This tumour is characterized by its endocrine manifestations, and it is an element in the differential diagnosis of many endocrine sexual dysfunctions both in adults and children, due to the tumour's capacity to secrete hormones. This paper contributes 5 cases of Leydig's cells tumours diagnosed in our hospital between 1977 and 1993.
Vesical hernias are, in general, a rare condition, except when they have an inguinal location. These are common, although their diagnosis is not so, and it is not infrequent that they are a chance finding of an inguinal herniorrhaphy procedure, during which relevant, but rare, complications have been described when the bladder has not been suitably identified. We present four cases of inguino-vesical hernia (three, massive hernia), and include a literature review.
Presentation of one case of soft lithiasis in a child which was treated by pyelolithectomy with good results and which has not relapsed after a 20-year follow-up. A commented revision is made of related literature.
Contribution of one case of spontaneous bilateral perirenal haematoma (SBPH) in a patient infected with the human immunodeficiency virus (HIV). The haematoma etiology was a nodose panarteritis (NPA). Etiological diagnosis was established by arteriography, but abdominal computerized tomography (CT) and renal ultrasound scans were useful diagnostic tools. A relationship between human immunodeficiency virus and NPA pathoetiology is suggested and commented upon.
The ultimate mechanism of action for all substances with the ability of modifying the activity of smooth muscle is an increased or decreased intracellular concentration of Ca2+. This report presents an "in vitro" study where the dependency on extracellular Ca2+ for the spontaneous activity of the detrusor muscle was investigated, and also the changes that calcium channel blockers can exert on it. The study concludes that the tonic component of the spontaneous activity depends on the Ca2+ intracellular deposits while the physical activity depends on Ca2+ entry from extracellular space. This entry of Ca2+ from the outside is not inhibited by the action of Ca2+ channel blocking agents.
Presentation of one case of a 40 year-old, homosexual, AIDS diagnosed male with extrapulmonary tuberculosis (lymphatic nodes) and prior history of gonococcal urethritis, brain toxoplasmosis, molluscum contagiosum and pneumonia by Pneumocystis carinii. A purpura-type lesion with inflammatory features appeared in the foreskin which was diagnosed as primary Kaposi's sarcoma of the penis. The article explains the clinical signs and symptoms, laboratory data, histological findings, and it reviews the literature.
Four cases with high flow priapism are described herein. Patient evaluation included intracavernal blood-gasmetry, echo Doppler, selective arteriography of the pudendal artery. Three patients had a previous history of trauma and one patient was on psychotropics. The alpha-agonist drugs and the different shunt techniques did not achieve detumescence. Two embolization procedures of the internal pudendal artery were performed with good long-term results. The other two cases achieved spontaneous detumescence. No complications or secondary erectile dysfunction were observed.
Among 322 cases of primary malignant renal tumours reviewed between 1969 and 1991, six were renal sarcoma (1.85%). They all presented earlier symptomatology which was not different from other renal tumours, and nephrectomy was performed in all cases, 5 of which died before 14 months. The histopathological diagnose showed two liposarcoma, two carcinosarcomas, all the others being fibrosarcomas.
The evaluation of erectile dysfunction by popliteal and pudendal evoked potentials is not widely utilized in our country, although the foregoing has proved to be a useful technique in the evaluation of a possible neurological etiology. This study describes this simple, fast and low cost method of evaluation and reports the normal ranges. The study comprised 40 subjects; 15 were healthy volunteers and the remaining had consulted for impotence and referred antecedents suggesting a neurological etiology. The results show that a latency of 40.9 +/- 2.1 msec in P1 for the pudendal evoked potentials is normal. Concerning the popliteal evoked potentials, the normal latency for P1 is 38.07 +/- 2.8 msec.