Biomedical subjects

J Hontoria

Publications and source records attributed to J Hontoria.

5 recordsLinked to original sources

PubMed1998

One-incision nephroureterectomy endoscopically assisted by transurethral ureteral stripping.

OBJECTIVES: Ureteral endoscopic surgery has been proposed as the first step of nephroureterectomy, either open or laparoscopic, to obviate the low abdominal incision. We present our experience with a technique of one-incision nephroureterectomy endoscopically assisted by transurethral ureteral stripping. METHODS: Standard nephrectomy is performed after placement of a Chevassu ureteral catheter. The lumbar ureter is sectioned and the catheter tip tied to the top of the distal portion of the ureter, which is later intussuscepted when the catheter is pulled out. Transurethral resection through the muscular wall and into the perivesical fat is performed around the everted ureteral orifice, and the bladder spontaneously closes with an indwelling Foley catheter. Since 1989, we have used this technique in 21 patients with urothelial malignancies of the renal pelvis or calyces (15 patients), renal cell carcinoma (2 patients), renal cholesteatoma (1 patient), or reflux nephropathy (3 patients). RESULTS: Two patients required a low abdominal incision for removal of retained ureter after unsuccessful stripping. The rest underwent this procedure without complications or adverse effects. Mean follow-up was 44.6 +/- 11.4 months (range 4 to 76). Three patients presented with bladder tumor but no recurrences were detected in the resected area of the bladder or the retroperitoneum. CONCLUSIONS: Endoscopically assisted nephroureterectomy allows removal of an adequate cuff of bladder with the distal ureter and generally obviates extending the incision or performing a second one. It can be an attractive option in selected cases, without apparent risk of neoplastic urine contamination in the retroperitoneum.

Endoscopy↗

PubMed1996

[Secondary neoplasm in patients with bladder carcinoma. A case-control study].

Presentation of a case-control study on 755 subjects with the purpose of defining whether the development of a neoplasia on any organ and of any histological type, either synchronous or metachronous, occurs more frequently in patients who already have vesical carcinoma (338 cases) versus other populations of similar epidemiological characteristics comprising subjects who do not present that condition (417 controls). The evaluation of the difference between both groups establishes a cause-effect relationship expressed in terms of an odds ratio of 2:11 which allows to claim that presence of a second neoplasia is more frequent in patients with vesical carcinoma (p < 0.001). The paper also includes a discussion on the distribution to organs and systems. Once the cases with urothelial site (renal pelvis, ureter or urethra) are excluded, prostate adenocarcinoma is the most frequent form associated to vesical carcinoma, followed at a distance by renal adenocarcinoma, epidermoid carcinoma of the larynx and bronchopulmonary carcinoma. Cumulative incidence of secondary neoplasias, including tumours diagnosed synchronically is 12% at 54 months.

Adult↗

PubMed1995

Defective functional response to membrane stimuli in lymphocytes from patients with benign prostatic hyperplasia.

Benign prostatic hyperplasia (BPH) is a local disturbance in the prostate that may involve an inflammatory infiltrate predominantly composed of activated lymphocytes and macrophages. The activation and proliferative response of T lymphocytes to different mitogenic signals has been analysed in peripheral blood mononuclear cells (PBMC) from 45 patients with BPH and 55 healthy controls. The PBMC obtained from the patients showed a significant specific impairment in proliferation, CD25 expression and IL-2 production in response to stimulation with lectins (phytohaemagglutinin (PHA), concanavalin A (Con A)), that was not corrected by the addition of IL-2 or of phorbol esters (phorbol myristate acetate (PMA)). Also, the CD28 response was defective in patient PBMC. Activation with anti-CD3 or anti-CD2 MoAbs was normal, but the addition of PMA to these stimuli provoked a significant defective response. Only the use of transmembrane stimuli (PMA and ionomycin) elicited responses similar to those found in the control group. The results indicate that peripheral T lymphocytes from BPH patients show a functional impairment that is mainly explained by an alteration of membrane signals (PHA, CD28) and is distal to protein kinase C (PKC) activation.

Aged↗

PubMedDate not supplied

[Study, treatment and follow-up of 379 patients with urinary tract lithiasis].

Between May 1988 and December 1989, 369 patients were seen at our lithiasis unit. During that time the Unit had neither "percutaneous nephroscope" nor "ureterorenoscope". Twenty-three percent of the patients were not susceptible to therapy either due to spontaneous extrusion of their lithiasis or because it was not considered indicated. Of the remaining 77% (296 cases) 94.5% were referred for extracorporeal lithotrity with shock waves, of which 89.8 were monotherapy and 4.7% a combination with other strategies (medico-lithic, surgical, endoscopic extrusion). At the time of collecting the results, 216 patients had undergone some treatment. In those receiving shock waves, an EDAP piezoelectric lithotripter was used in 19.9% and a HM3-Dornier in 80% of the cases. Taking into consideration the overall resulted from last examination of each patient, 67% were free from lithiasic residues, 25% had residues under 4 mm, and 7.7% residues over 4 mm. 19.4% of the patients developed some kind of complication and 9 patients had to be admitted to hospital.

Adolescent↗

PubMedDate not supplied

[Brucellar orchitis with abscess].

A clinical case of orchitis with brucellosis etiology is presented. Testicular symptomatology appeared from the beginning of the brucellosis's general clinical picture. It envolved painfully and increased the testicular size, with no mictional symptoms, expanding progressively in spite of specific brucellosis therapy given from the beginning, towards formation of an intratesticular abscess which required orchiectomy, a way of progression we have not found in the related literature. The main differential diagnosis must be done with tuberculosis orchitis. Since our country had the largest incidence of brucellosis in Europe, and it is possible that in many cases a orchiepididymarial condition can become apparent in the initial phases, this is an etiology that should be taken into account among specific orchiepididymitis.

Abscess↗