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Biomedical subjects

A Urpegui García

Publications and source records attributed to A Urpegui García.

8 recordsLinked to original sources

[Study of bcl-2 oncogene in squamous-cell carcinoma of the larynx].

Apoptosis is a special type of programmed cell death that occurs in the embryonic period, in normal adult tissues, and in several pathological situations. The Bcl-2 gene (B-cell leukemia/lymphoma) is the first member of an oncogene family whose main function is to increase cell survival and inhibit apoptosis, thus participating in the carcinogenic process. This relationship motivated our study of antiapoptosis through the immunohistochemical expression of Bcl-2 oncogene in 72 patients with cancer of the larynx who underwent surgery in our department. The correlation between immunohistochemical expression and clinical factors was analyzed: age, sex, work, smoking and drinking history, marital status, etc., as well as other known biological and histopathological prognostic factors (tumoral stage, histological grade, neck metastases, and local invasion). Bcl-2 expression showed a statistically significant correlation with histological grade and regional lymph node involvement, but no correlation with the other parameters studied.

Adult↗

[Pharyngoesophageal foreign bodies].

A review was made of 77 rigid esophagoscopies to remove a foreign body from the upper digestive tract. Mean age of patients was 59 years. Meat bones were the most frequent impacted foreign body and the cervical esophagus was the most frequent site of impactation. No foreign body was found in 22% of esophagoscopies, a high rate that could have been due to our lack of confidence in radiographic studies, which yield false positive and false negative information. Esophagoscopy is performed whenever patient-referred symptoms are clear. The only complications were three cases of major esophageal erosions without perforation and one pneumothorax. A case of intramural esophageal pseudodiverticulosis was found.

Adolescent↗

[Malignant melanoma of the middle ear, a rare site].

Melanomas of upper airway tract constitute around 1% of the total melanomas of head and neck. It's for this reason we cannot forget their location in middle ear, although it is truly rare, and we have only found three cases published in literature. We report a patient of 75 years old, who went to our hospital with otorrhea of two months of evolution, with subjective sensation of deafness. In the exploration ENT a bleeding neoformation was observed by otoscopy, which occupied all external auditory canal. The biopsy of this neoformation was informed as malignant neoplasm. These cells show a little cytoplasmic melanotic pigment and were positive to the tinction with Masson Fontana, as well as to the immunohistochemical antibodies S-100 and HMB-45. These antibodies are specific of malignant melanoma. We had a low opinion of surgical treatment because the affectation of the temporal bone and the size of melanoma. Because of badly prognosis, our patient died six months after the diagnosis.

Aged↗

[Middle ear carcinoma].

Middle-ear cancer represents 5 to 10% of all ear neoplasms. Risk factors include chronic suppurative pathology of the middle ear and prior irradiation. Most malignant tumors are squamous-cell carcinomas. We report the case of a 51-year-old woman with this process. The ideal treatment is mastoidectomy or pterosectomy followed by radiotherapy. We made a bibliographic review of the clinical manifestations, diagnosis, treatment, and prognosis of middle-ear cancer. Five-year survival rates range from 25 to 50% in patients who undergo surgery and radiotherapy.

Carcinoma, Squamous Cell↗

[Invasive giant prolactinoma].

Large prolactin-secreting tumors are rare and their endocrinological and surgical management may be complex. We report the case of a patient with a prolonged history of unilateral tinnitus and sensation of a stopped-up ear who had a very large, invasive and aggressive tumor of the sphenoidal region with bone destruction, invasion of structures in every direction from the sellar region and extracranial extension to the ethmoid and nasopharynx. Serum prolactin level at the time of diagnosis was 16,860 ng/ml (normal: 3-17 ng/ml). Medical treatment with bromocriptine reduced the prolactin level to 31 ng/ml and reduced the size of the tumor, although less than expected. The literature is reviewed and the rarity of such large, invasive prolactinomas is highlighted, as well as the absence of symptoms and signs suggesting the presence of such a large tumor of the skull base.

Adult↗

[Olfactory esthesioneuroblastoma. Review of seven cases].

Esthesioneuroblastomas are fairly rare malignant tumors: only 20 cases have been reported in Spanish records. It is locally aggressive and produces late recurrences. There is no such thing as a universally accepted treatment model. We describe our experience with 7 cases seen in our hospital from 1980 to 1996. A or B stages can be treated with irradiation, surgery or a combination of both. C stages with the most aggressive tendencies may require the combined use of preoperative irradiation, surgery and chemotherapy. We analyzed the forms of presentation, diagnosis, differential diagnosis, treatment, prognosis, and survival. The 5-year survival rate was 75, 60 and 41% for stages A, B and C, respectively.

Aged↗

[ENT outpatient surgery].

The number of patients who undergo outpatient surgery is constantly growing in Spain. Outpatient surgery is interesting not only because of its economy, but also the social benefits that derive from patients returning home sooner and the rapid reduction of the waiting list. We discuss our experience in the last year with 40 patients who underwent surgery. We made a comparative study of patients with the same pathology and anesthetic risk who were treated by outpatient surgery and those treated by inpatient surgery with a traditional technique who were admitted 24 hours before surgery. Our rate of complications (19%) was close to the traditional rate. However, 3, 927, 000 pesetas were saved and the patients were very satisfied, which encouraged us to continue. Indications and complications are discussed.

Adolescent↗

[Selective therapeutic embolization in intractable epistaxis].

Epistaxis is a common otolaryngologic emergency that is controlled frequently with conservative measures. On the other hand, more aggressive treatments are required in refractory or severe epistaxis, which may have systematical impact. About intractable posterior epistaxis, selective embolization of external carotid territory is an effective option for managing. Three patients with severe epistaxis successfully treated with selective embolization and a review of literature are exposed.

Aged↗