Rectal leiomyosarcoma in a young male with a history of Wilms' tumor.
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Adult↗
Biomedical subjects
J Vicente
Publications and source records attributed to J Vicente.
Primary bladder carcinoma in situ: assessment of early BCG response as a prognostic factor.
OBJECTIVES: To evaluate the prognosis of primary bladder carcinoma in situ (CIS) according to the response to bacillus Calmette-Guerin (BCG). PATIENTS AND METHODS: Twenty-six cases of primary CIS were treated with BCG. Mean, median and minimum follow-up periods were 47, 56 and 24 months. At 6 months, the patients were evaluated endoscopically and the response was classified as complete, partial or failure. RESULTS: Twenty-one patients (80.8%) showed complete response to BCG, 3 did so after a second course; 28.5% relapsed or progressed at a mean of 44 months. Five patients (19.2%) did not respond initially and all progressed in a period of 6 months. Early response to BCG was the only significant prognostic factor (p < 0.005). CONCLUSIONS: A high- and a low-risk group of bladder CIS can be differentiated according to the response to BCG. CIS of the bladder has a poor prognosis, and the number of patients who developed progressive disease is significantly higher among the nonresponders.
Administration, Intravesical↗
Balloon dilatation in the treatment of ureteral stenosis in kidney transplant recipients.
OBJECTIVE: To assess the usefulness of balloon percutaneous dilatation as a starting treatment technique of ureteral stenosis in kidney transplant recipients. PATIENTS AND METHODS: A total of 472 kidney transplants have been performed at our center between August 1981 and January 1997. The coexistence of high creatinine values and urinary tract dilatation in the postoperative period, after discarding concomitant causes, was managed with a percutaneous nephrostomy. Once renal function had recovered, antegrade pyelography was performed to confirm ureteral stenosis and to determine its location. The dilatations are performed by means of 5-french balloon-fitted angioplasty catheters. RESULTS: Thirty patients were diagnosed with ureteral stenosis during follow-up, i.e. an incidence of 6.3%. Transluminal balloon dilatation was made as a first therapeutic option in 18 cases. No immediate complications were observed following dilatation. Disappearance of the stenosis as well as maintenance of the improvement in creatinine levels were verified in 39% of cases (7 patients). CONCLUSIONS: Ureteral stenosis in kidney transplant recipients should be included as part of the differential diagnosis when there is a deterioration in renal function. Balloon dilatation is the technique chosen as initial treatment of juxtavesical ureteral stenosis because of its good reproducibility and its low morbidity.
Adult↗
Comparative effects of nonsedating histamine H1 receptor antagonists, ebastine and terfenadine, on human Kv1.5 channels.
The effects of ebastine and terfenadine, long-acting nonsedating histamine H1 receptor antagonists, were studied on hKv1.5 channels using the whole-cell voltage-clamp configuration of the patch-clamp technique in Ltk- cells transfected with the gene encoding the hKv1.5 channel. Upon depolarization to +60 mV, terfenadine, 1 microM and 3 microM, inhibited the hKv1.5 current by 42.4 +/- 6.4% and 69.3 +/- 4.2% (P < 0.01). In contrast, at the same range of concentrations, ebastine-induced inhibition of this K+ current averaged 6.5 +/- 2.0% and 13.0 +/- 2.0 (P < 0.05). At the highest concentration tested (3 microM) neither terfenadine carboxylate nor carebastine significantly modified hKv1.5 current. All these results suggest that ebastine could represent a safer alternative to terfenadine in the clinical practice.
Animals↗
Visceral leishmaniasis diagnosed by colonoscopy.
Zoonotic visceral leishmaniasis is common in western Mediterranean countries. A strong link between visceral leishmaniasis and human immunodeficiency virus (coinfection) has been proved, especially in Spain, which is an endemic area. This suggests that Leishmania may behave opportunistically. We report a case of colonic leishmaniasis in a 23-year-old Spanish woman infected with the human immunodeficiency virus.
AIDS-Related Opportunistic Infections↗
Comel-Netherton syndrome. A diagnostic challenge.
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Diagnosis, Differential↗
Palpebral oedema associated with sensitization to cobalt in a dental prosthesis.
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Cobalt↗
Hypersensitivity pneumonitis related to a covered and heated swimming pool environment.
Hypersensitivity pneumonitis (HP) or extrinsic allergic alveolitis is a lung disease caused by a large group of inhaled antigens of various sources. The most common HP occurring in the farm environment is classically caused by exposure to various thermophilic actinomycetes and fungi that can grow in the farm environment. Pullularia species and thermophilic actinomycetes have been involved in HP related to humidifier water and saunas. Our case illustrates the value of a site visit in the diagnosis of HP. During a visit to the covered and heated swimming-pool where our patient used to swim we could see that favourable conditions to fungal growth existed. To determine the possible aetiological agents of a suspected HP, cultures from several parts of the swimming-pool were taken. These cultures showed an intense growth of thermophilic actinomycetes, Neurospora and Aspergillus species. Precipitating antibodies against Neurospora species and Mycropolyspora faeni were detected. A case of HP related to a covered and heated swimming-pool environment is reported. Thermophilic actinomycetes and Neurospora species may be the causing agents.
Actinomycetales↗
Molecular determinants of stereoselective bupivacaine block of hKv1.5 channels.
Enantiomers of local anesthetics are useful probes of ion channel structure that can reveal three-dimensional relations for drug binding in the channel pore and may have important clinical consequences. Bupivacaine block of open hKv1.5 channels is stereoselective, with the R(+)-enantiomer being 7-fold more potent than the S(-)-enantiomer (Kd = 4.1 mumol/L versus 27.3 mumol/L). Using whole-cell voltage clamp of hKv1.5 channels and site-directed mutants stably expressed in Ltk- cells, we have identified a set of amino acids that determine the stereoselectivity of bupivacaine block. Replacement of threonine 505 by hydrophobic amino acids (isoleucine, valine, or alanine) abolished stereoselective block, whereas a serine substitution preserved it [Kd = 60 mumol/L and 7.4 mumol/L for S(-)- and R(+)-bupivacaine, respectively]. A similar substitution at the internal tetraethylammonium binding site (T477S) reduced the affinity for both enantiomers similarly, thus preserving the stereoselectivity [Kd = 45.5 mumol/L and 7.8 mumol/L for S(-)- and R(+)-bupivacaine, respectively]. Replacement of L508 or V512 by a methionine (L508M and V512M) abolished stereoselective block, whereas substitution of V512 by an alanine (V512A) preserved it. Block of Kv2.1 channels, which carry valine, leucine, and isoleucine residues at T505, L508, and V512 equivalent sites, respectively, was not stereoselective [Kd = 8.3 mumol/L and 13 mumol/L for S(-)- and R(+)-bupivacaine, respectively]. These results suggest that (1) the bupivacaine binding site is located in the inner mouth of the pore, (2) stereoselective block displays subfamily selectivity, and (3) a polar interaction with T505 combined with hydrophobic interactions with L508 and V512 are required for stereoselective block.
Amino Acid Sequence↗
It's like a pain in the ... perineum: a surgical clip protruding into the urethra through the urethrovesical anastomosis after radical prostatectomy.
A 69-year-old male underwent a radical retropubic prostatectomy for prostate cancer. He presented severe perineal pain that prevented him from sitting normally after removal of the urethral catheter. Cystography and echography disclosed a possible aetiology that was later confirmed by cystoscopy: a metal clip protruding into the urethra through the urethrovesical anastomosis.
Aged↗
Duodenal obstruction secondary to a metastasis from an adenocarcinoma of the cecum: a case report.
Metastatic tumors to the gastrointestinal tract are rare; the stomach and small bowel are the most common organs involved. Lung cancer, renal cell carcinoma, breast carcinoma, and malignant melanoma are the most common primary tumors metastatic to the duodenum. We report a metastasis to the duodenum from an adenocarcinoma of the cecum presenting as a duodenal obstruction 4.5 yr after the surgical resection of the primary tumor. The condition of the patient was temporarily controlled with the implantation of an endoduodenal metallic prosthesis as a palliative measure.
Adenocarcinoma↗
[Protocol for the endoscopic sinus surgery: comparative analysis of 200 cases].
A preliminary analysis was published in 1993 of 100 cases of endoscopic sinus surgery (ESS) carried out in our service following a protocol that included sinusitis, nasal polyps, and other endoscopic nasal procedures. Another 100 cases of ESS were analyzed for the present study and compared with the 1993 group. Comparative analysis showed improved results in the second series, with fewer minor complications and no major complications. These findings confirm the general opinion that endoscopic sinus surgery requires an adequate training period before optimal results are obtained.
Adolescent↗
[Squamous cell carcinoma of the penis: treatment protocol according to our 14 years of experience].
OBJECTIVE: The management of lymph nodes and the determination of prognostic factors are matters of controversy in the treatment of squamous cell carcinoma of the penis. We attempted to establish an approach based on the different types of lymphadenectomies and biopsies we have performed and to evaluate local stage and grade of cellular differentiation as prognostic factors. METHODS: 81 cases treated at our institution between 1980 and 1994 were reviewed. The results of the different lymphadenectomies and biopsies performed were analyzed. Tumors were staged according to the Jackson and TNM classifications; in 62 cases the pathological samples were reexamined by the same pathologist to determine the grade of cellular differentiation according to the Broders classification. A p value of < 0.05 was considered significant. RESULTS: We did not obtain reliable results with the biopsies done and variable results in the lymphadenectomies performed. The grade of cellular differentiation and local stage were both statistically significant with respect to the presence of positive lymph nodes. We found statistically significant differences for survival according to the stage of the positive lymph nodes. CONCLUSION: We have established three approaches in management of squamous cell carcinoma of the penis according to the local stage and grade of cellular differentiation.
Adult↗
[Should one perform supravesical urinary diversions with excluded bladder in patients with cancer?].
OBJECTIVE: To review our experience in 37 patients who had undergone supravesical urinary diversion with defunctionalized bladder left in situ. METHODS: The pathological conditions that indicated surgery were advanced infiltrating bladder carcinoma and bladder irradiation due to other pelvic organ malignancies. RESULTS: The analysis showed 70.25% of the patients had complications, the most common being hemorrhage (27.07%), followed by pyocyst (13.51%). Four patients (10.81%) required rehospitalization for treatment of complications. The patients were treated with a combination of parenteral antibiotics and continuous bladder irrigations using a variety of antiseptic solutions. One patient required a permanent cystostomy. CONCLUSION: There is a need to evaluate the benefit of the supravesical urinary diversion with defunctionalized bladder left in situ in patients with advanced infiltrating bladder carcinoma and bladder irradiation due to other pelvic organ malignancies. The type of diversion is unrelated to the complications that develop in the defunctionalized bladder. Patients with positive urine cultures and/or urethral stricture preoperatively have an increased risk of developing pyocyst.
Adult↗
[Invagination of the sigmoid colon caused by a giant lipoma].
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Colonic Neoplasms↗
[Treatment protocol for sudden deafness].
There are two types of rapidly progressive sensorineural hearing loss: sudden hearing loss, which is generally unilateral and develops in less than 72 hours, and rapidly progressive sensorineural hearing loss, which develops over days or months. The origin of sudden deafness is difficult to establish. Several etiopathogenic factors have been postulated, such as viral infection, autoimmune origin, vascular and metabolic disease, rupture of the labyrinthine membrane, and, recently, immune-mediated inner ear disease. We made a retrospective study of 40 patients seen in our department. Patients were given a combined treatment with steroids, nimodipine, heparin, and oxygen. Patients were divided into two groups by intravenous or oral treatment.
Adolescent↗
Distribution of the trehalase activation response and the regulatory trehalase gene among yeast species.
In Saccharomyces cerevisiae and other yeasts the activity of regulatory trehalases increases in response to the addition of glucose and to thermal changes in the extracellular medium. We have performed an screening on the extent of this response among different representative yeast species and the results show that this ability is displayed only by a few members of the Saccharomycetaceae family. However, all yeasts examined contain a gene related to that coding for regulatory trehalase in S. cerevisiae. This finding reveals that the operational distinction between regulatory and nonregulatory trehalase in yeasts is not a property of the enzyme by itself but relays on the expression of accompanying mechanisms able to modulate trehalase activity.
Amino Acid Sequence↗
Temporal and geographic variations in the characteristics of heroin seized in Spain and their relation with the route of administration. Spanish Group for the Study of the Purity of Seized Drugs.
We studied the evolution of the purity and other characteristics of heroin seized in 17 Spanish provinces (especially seizures presumed to be street drugs) and explored their relation with the prevalence and recent changes in intravenous use. We found great variability in purity within and between provinces: in provinces with large cities the purity is similar to or greater than that detected elsewhere in Europe, in others it is less than 30 percent, and on the island of Mallorca it is over 60 percent. Purity has increased in recent years. The heroin in circulation is predominantly brown in all of Spain except on the Mediterranean coast. The principal adulterants detected are caffeine, paracetamol and piracetam; phenobarbital and procaine have disappeared. In provinces where white heroin is in circulation, most heroin users in treatment use the intravenous route; in provinces where brown heroin predominates, the proportion of chasers increases with increasing purity of heroin (correlation coefficient = 0.6). The disappearance of white heroin has paralleled the spread of the phenomenon of chasing.
Cross-Sectional Studies↗