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Biomedical subjects

J L Ruiz Cerdá

Publications and source records attributed to J L Ruiz Cerdá.

At least 19 recordsLinked to original sources
PubMed2006

[Renal cancer in elderly: clinical and histopathological findings].

OBJECTIVE: to evaluate the clinical and pathological characteristics of the CCR in our series of tumors, analyzing its impact in the group of age greater than 65 years. MATERIAL AND METHODS: 300 patients with renal adenocarcinoma (CCR) were studied. In 252, ploidy pattern of DNA and pathologic characteristics of the surgical pieces were done. According to the criteria of the Spanish Society of Geriatrics, the patients were divided in two groups based on the age, greater and smaller of 65 years. The clinical and pathologic characteristics were compared between both groups. RESULTS: 103 of the 300 patients (33.3%) were included in the geriatric group. We did not found differences between both groups comparing stage, tumoral volume or treatment realized, but found differences in DNA ploidy pattern, recurrences and survey. CONCLUSIONS: The RCC in the elderly has a few clinical and pathological characteristics similar to the rest of patients in our series. Nevertheless differences exist in the average and actuarial survival, which is minor in the patient of more than 65 years, cause the percentage of detected aneuploidies and number of recurrences in not confined tumors in this group of age.

Adult↗
PubMed2006

[Traditional training devices for laparoscopy].

Laparoscopy is a new approach to urological surgery with a number of advantages. The learning of this technique is very important. In order to establish this technique as routine practice a considerable amount of training is needed. The learning curve is still very long and training methods are scarce. At the present time there are simple, low-cost simulators available that may be used in any place, thus facilitating training. We have reviewed recent literature on these models, which can be of great help in initial laparoscopic training.

Animals↗
PubMed2005

[Prognostic value for progression of the regulating proteins of the cellular cycle in PT1G3 bladder tumours].

INTRODUCTION AND OBJECTIVE: Bladder tumor T1G3 constitutes the group of superficial tumors more aggressive. New prognostic factors in the field of the cytogenetics and molecular biology have been analyzed, with often contradictory results, being little the specific works in tumors T1G3. Our objective is to determine if in this group of tumors the immunohistochemical markers present predictive value of clinically useful progression, and therefore with validity to indicate more suitable a precocious therapeutic attitude. MATERIAL AND METHODS: Retrospective study of a series of 83 patients affected of bladder tumor T1G3, on which we analyzed a total of 14 variables; between the new predictive factors: the immunohistochemical determination of regulating proteins of the cellular cycle: p53, p21 and bcl-2, as well as the Ki-67 protein like marker of cellular proliferation. By means of logistic regression analysis we establish the independent prognostic variables for tumorlike progression. RESULTS: The cut point established for Ki67 and p53 was 40% of inmmunomarked cells, 20% for p21 and 10% for Bcl-2. The univariant analysis showed different rates from progression and free times of progression based on the immunohistochemistry of Ki67 and p53: nevertheless, the logistic regression demonstrated that single the immunohistochemistry of p53 presented independent predictive value. CONCLUSIONS: The determination of p53 presents predictive value of clinically useful progression in bledder tumors T1G3, so that its determination can constitute a essential factor in the strategies of treatment of these tumors.

Cell Cycle Proteins↗
PubMed2005

[Predictive value of progression of muscularis mucosae and percentage G3 cells in vesical TIG3 tumours].

INTRODUCTION AND OBJECTIVE: Vesical tumor T1G3 constitutes the border between the superficial tumor and the infiltrante tumor. Some of these tumors do not respond to BCG and progress, with cystectomy that present poor results, patients who would benefit from a precocious and aggressive treatment if we could identify them in an preinvasive stage. New predictive factors try to select to these tumors, being little the works that consider anatomo-pathological meticulous study (substanding of the T1 in T1a and T1b and percentage of present G3 cells in the tumor). Our objective is to analyze the value of these anatomo-pathological considerations like predictive factors of progression. MATERIAL AND METHODS: Retrospective study of a series of 91 patient affection of vesical tumor T1G3 with initial treatment by means of RTU and BCG. We analyzed 12 variables. The new predictive factors: the level of invasion respect to muscularis mucosae and the percentage of G3 cells. By means of logistic regression analisys we establish the independent pronostic factors for tumoral progression. RESULTS: A total of 31 patients presented infiltration of detrusor, passing away 17 of tumoral cause, after an average time of pursuit of 57.8 +/- 28.2 months. In 8 cases (9%) the substanding could not be determined. The rate of progression for T1a tumors was of 20% (8/40) and for T1b 53% (23/43). Presented independent predictive value of progression the multiplicity (odds: 7.26), the size (odds: 2.14), the presence of Cis (odds: 1.42) and the subestanding (odds: 6.81). CONCLUSION: The substanding is a predictive factor of progression clinically useful in vesical tumors T1G3, reason why we considered habitual clinical introduction.

Aged↗
PubMed2004

[Prognostic value of DNA ploidy and nuclear morphometry in metastatic prostate cancer].

PURPOSE: To assess the prognostic value of DNA ploidy and nuclear morphometry in metastatic prostate cancer after androgenic deprivation treatment. METHODS: Fifty four patients with prostate cancer and bone metastases who had undergone androgenic suppression treatment were retrospectively studied. The deoxyribonucleic acid (DNA) content was analysed by flow cytometry. Nuclear morphometry characterized 14 nuclear descriptors. The study also included age, Gleason score, T classification, haematocrite, serum albumin, serum alkaline phosphatase, serum prostatic acid phosphatase and the amount of metastatic foci detected during radioisotope bone scan. Univariate survival analyses were performed and Cox's proportional hazards model was used to identify significant prognostic factors. To assess how the experimental factors improve the capacity of the classical factors for predicting the patients who reach median survival, logistic regression multivariate analysis was performed for the classical prognostic factors only and after added experimental variables (DNA content and Nuclear Area). RESULTS: The univariate survival analyses assigned a prognostic value to T category, level of albumin, alkaline phosphatase, Gleason score, bone scan, DNA ploidy and mean nuclear area. In the case of the Cox regression model only Gleason score, bone scan, mean nuclear area and DNA ploidy provided independent prognostic information. In logistic regression for classic prognostic factors only Gleason score is significant (sensibility 89.3%, specificity 64%). However, when the experimental factors are added, in addition to Gleason score, radioisotope bone scan and DNA ploidy are of prognostic value (sensibility 90% and specificity 72%). CONCLUSIONS: The study of DNA content and nuclear morphometry in the primitive tumor provides independent prognostic information in survival analysis for patients with metastatic prostate cancer. However, there is limited improvement with respect to the classical factors in predicting survival. This questions its utility in the daily clinical usage.

Adenocarcinoma↗
PubMed2004

[Study of the angiogenesis as prognostic factor of pT1G3 bladder tumours].

INTRODUCTION AND OBJECTIVES: Angiogenic activity has been considered like prognostic factor in several solid tumors. This activity can be analysed by two ways: immunohistochemical determination of molecules that activate/inhibit angiogenesis or quantitive measure of microvascular density (MD). Our objective is to determine the prognostic value of Vascular Endothelial Growth Factor (VEGF) and Microvascular Density (MD) in pT1G3 bladder tumours. MATERIAL AND METHODS: We have studied retrospectively 83 patients with pT1G3 tumors treated by TUR + endovesical instillations with a follow up of 3 years at least. We analysed VEGF expression monoclonal antibody No. 360P. To determine MD we have marked vessels with FVIII antibody and detected "hot spots" areas. The number of microvessels is quantited by a digital image analyser excluding those that have more than 50 micras of diameter. We established the correlation of these findings with recurrence, progression and survival by using Chi-square test and Kaplan-Meier curves (log-rank). RESULTS: Average follow up was 58 +/- 28 months. We have established like cut-off 50% of tumor cells (VEGF) and 30 microvessels/fields (MD). Chi-square test did not show correlation with survival neither recurrence but it was positive for progression p(VEGF) 0.048 and p(DM) 0.021. Kaplan Meier curves determined significative differences only for free of progression time respect to MD (p 0.038). CONCLUSIONS: We did not find statistically significant value for recurrence nor survival. Just MD reached prognostic value for progression. More studies and multivariant analysis are required to determine the clinical utility of MD, specially in order to make more aggressive therapeutic options in this kind of patients.

Follow-Up Studies↗
PubMed2001

[Prognostic value of DNA ploidy in prostatic cancer].

OBJECTIVE: To asses the prognostic value of deoxyribonucleic acid (DNA) ploidy in a group of patients with prostate cancer treated with adrogenic blockade. MATERIALS AND METHODS: A retrospective study on 136 patients with prostatic cancer having undergone androgenic blockade was carried out. The prognostic influence of age, T and M categories, Gleason score and flow cytometry-determined DNA ploidy from survival analyses. Univariate survival analysis was carried out following Kaplan-Meier's method, while for multivariate survival analysis Cox's proportional hazard model was used. RESULTS: The univariante analysis showed that T and M categories, Gleason score and DNA ploidy have prognostic value. The Cox's regression analysis identified DNA ploidy, metastasis and Gleason score as independent variables having prognostic potential. CONCLUSIONS: DNA ploidy has independent prognostic value in prostate cancer treated with androgenic blockade and improves the predictive potential of classical prognostic factors.

Adenocarcinoma↗
PubMed1997

[Study of DNA content and its association with staging, tumor size, architecture, cell type, and nuclear grade in renal adenocarcinoma].

OBJECTIVE: To present the results of the analysis of DNA content in renal adenocarcinoma and its correlation with histopathological findings as a first step to conduct predictive studies. MATERIAL AND METHOD: DNA analysis was carried out by flow cytometry in deparaffined and fresh samples (1-4 per tumour) from 192 tumours. Correlation to stage, size, growth pattern and grade was studied using the squared chi test. RESULTS: The percentage of non-diploid tumours increased with the number of samples analyzed. Use of multiple sampling allowed to classify as non-diploid an additional 19% tumours. 57% tumours were homogeneously diploid, while the rest were non-diploid showing a wide variety of patterns: homogeneous, heterogeneous, and even tumours with more than one different non-diploid population. A positive correlation was seen between DNA content pattern, pathological stage and grade. CONCLUSIONS: Multiple sampling is essential to obtain representative information on DNA content. Prior to conduct predictive studies, the correlation between DNA content, stage and grade should be studied to preclude addition of non-independent information.

Adenocarcinoma↗
PubMed1997

[Extracorporeal shock-wave lithotripsy in the treatment of calculi in horseshoe kidneys. Our experience].

Thirty-one (31 renal units (RU) were treated with extracorporeal shock wave lithotrity (ESWL) in 27 patients with lithiasis in horseshoe kidneys (HK). Treatment was done in an out-patients environment and in two thirds of cases the patient was placed in prone-decubitus. An average of 2.42 sessions per patient (range 1-8) were performed freeing 15 RU, 10 with removable residues, and failure in 6:3 with non-removable residues in all asymptomatic cases, 2 where fragmentation was insufficient and 1 renal annulment post-ESWL. Overall, results were "good" in 80.6% cases, with a significant relationship between size of lithiasis and therapeutical results. Thus, for < or = 2 cm calculi the result was good in 100% cases but a greater number of cleaning were required in those < 1 cm (62.5 vs 46.15%). On the contrary, "therapeutic failures" were limited to just > 2 cm calculi. It can therefore be concluded that most patients with lithiasis in HK, specifically when calculi are < 2 cm, can be treated primarily and in monotherapy with ESWL.

Adult↗
PubMed1996

[An in-vitro study of the sources of intracellular calcium in Ach-induced contractions and electrical depolarization and of the capacity of calcium antagonists to influence them in the canine detrusor].

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.

Acetylcholine↗
PubMed1996

[Sarcomatoid renal carcinoma].

Study of 250 pieces from nephrectomies performed in our service due to renal carcinoma, 10 (4%) of which where of the sarcomatoid histological variant. In 2 of the 10 cases, tumour was confined within the renal capsule at the time of surgery. These were the only cases where no disease progression was seen after treatment. A survival study using the Kaplan-Meter method was conducted. Median survival of patients with sarcomatoid pattern was 6 months, showing a significant difference with that obtained in other histological patterns. DNA content of tumoral cells was assessed by flow cytometry, which displayed a diploid pattern in 7 patients and aneuploid in 3. The 2 cases with no disease progression were diploid. We conducted nuclear cytomorphometry studies which showed significant differences in the mean nuclear perimeter between progressive and non-progressive tumours.

Adult↗
PubMed1995

[Extracorporeal shockwave lithotripsy in patients with urinary diversion].

Presentation of a review on nine patients (10 renal units) with urinary by-pass and renoureteral lithiasis who underwent shock wave extracorporeal lithotrity in our hospital. The justification for the by-pass was an infiltrant vesical tumour in 6 patients, myelomeningocele in 2, and vesicourethral trauma in the remaining one. All cases were being treated for a Bricker-type by-pass except the last one (bilateral ureterosigmoidostomy). Outcome of treatment was: absence of residual lithiasis in 6, minimal residues in 1 (2 renal units), failure in 1. The remaining patient suffered anaphylactic shock induced by the latex in the ureteral catheter placed prior to lithotrity which caused the patient's death.

Adolescent↗
PubMed1995

[The evolution over time (1960-1990) of mortality and the ratio of males in bladder cancer in Spain].

A time series on the evolution of mortality and the masculinity attribute in vesical cancer in Spain (1960-1990) was prepared. The specific rates by age and sex by 100,000 inhabitants were calculated. To attain standardization the same study population was taken as the reference population. Overall mortality rates due to vesical cancer have increased progressively in a linearly ascending trend, though the slope in men is sharper that in women. The females cohort approaches that of males, but with a difference between them of 30 years. By age groups, the higher increase has occurred in those over 75-year old (113% men, 77% women). The masculinity attribute presents variations depending on the age group and decade considered (1.4-10.9). It is possible to establish three groups by masculinity attribute: 20-44 years (average 1.91), 45-69 years (average 7.8) and over 70 years (average 6.3).

Adult↗
PubMed1994

Spontaneous rupture of a neobladder.

The spontaneous rupture of neobladder is an extremely rare entity of which there only exists one formerly reported case in the world literature. It is far more common after enterocystoplasty for augmentation (19 reported cases). We describe here the spontaneous rupture of a neobladder 8 months after performing cystectomy and bladder replacement by an enterocystoplasty in order to treat a bladder carcinoma. In this case the patient showed symptoms and signs of acute peritonitis. The diagnosis was carried out using a cystogram and the treatment consisted of a laparotomy with closure of the perforation and drainage of the peritoneal cavity.

Carcinoma, Transitional Cell↗
PubMed1994

[Risk of suffering from a second primary neoplasm in patients with bladder tumor].

An evaluation was made on the risk of having a second primary neoplasia following vesical tumor diagnosis. All patients attended the 'Hospital La Fe' and had been diagnosed between 1984 and 1993. A total of 238 vesical tumours were studied, 45 (15.9%) with associated second neoplasia; in 34 cases the vesical tumour was the first one to be diagnosed. The number of tumors seen was compared to expected figures, according to the appropriate incidence rates by age, sex and tumour type, taken out from the Spanish section of the 1987 edition of "Cancer Incidence in Five Continents". An increase over the expected values of second neoplasias for lung, prostate, kidney and bone cancer was found. Sixty percent developed concurrently (within 6 months from initial diagnosis). Most vesical tumours were infiltrant, thus conditioning both the prognosis and the second neoplasia. The likely factors implied in this phenomenon are discussed.

Aged↗
PubMed1993

[Vesicoprostatic echography versus transrectal planimetry in the determination of prostatic volume].

The intention of this paper is to analyze the correlation between two techniques used to measure prostatic volume: transrectal ultrasound with planimetry and transabdominal vesicoprostatic ultrasound. A total of 44 patients have been subjected to transrectal ultrasound, where prostatic volume was determined by planimetry. With this simultaneous technique, patients were performed a vesico-prostatic ultrasound with estimation of volume, achieved by measuring the prostatic diameters and then applying the ellipsoid formula. There were no statistically significant differences between mean values of prostatic volumes as calculated by either technique, both showing a strong correlation (r = 0.817). During transrectal planimetry, the three prostatic diameters were measured and, using a multiple regression study, the influence they have on the changes of prostate's volume was noted. It was observed that it is the transverse, but essentially the longitudinal diameter, the ones which explain those changes (Sig T = 0.0012 and 0.0000, respectively).

Aged↗