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J M Cozar

Publications and source records attributed to J M Cozar.

13 recordsLinked to original sources
PubMed2006

Analysis of the expression of HLA class I, proinflammatory cytokines and chemokines in primary tumors from patients with localized and metastatic renal cell carcinoma.

Changes in the human leukocyte antigen (HLA) class I expression and cytokine and chemokine production both by cancer cells and by normal surrounding tissue are believed to be responsible for immune escape and tumor progression. In this study, we compared the tumor expression levels of HLA heavy chain (HLAhc), beta-2-microglobulin (beta2m), chemokines (Interferon-gamma-inducible Protein-10 (IP-10), Interferon-inducible T-cell Alpha-Chemoattractant (I-TAC), Stromal cell-Derived Factor-1 (SDF-1), Macrophage Inflammatory Protein-1-alpha (MIP-1-alpha) and Regulated upon Activation, Normally T-Expressed, and presumably Secreted (RANTES)) and cytokines (Vascular Endothelial Growth Factor (VEGF), Interferon-gamma (IFN-gamma), Interleukin-10 (IL-10), Tumor Growth Factor-beta (TGB-beta)) in primary tumors and adjacent normal tissues from patients with localized and metastatic renal cell carcinoma (RCC) using a quantitative real-time polymerase chain reaction technique. We report that the expression of HLAhc, beta2m and the studied cytokines and chemokines (except for SDF-1) was significantly higher in the tumor (29 samples) than in the normal tissue (14 samples). When we compared the tumor expression levels between patients with localized RCC and patients with advanced metastatic stage, we found that the messenger RNA expression levels of HLAhc and beta2m were much lower in patients with metastatic RCC (6 cases) than in patients with localized cancer (23 cases), with levels similar to those in normal tissue. This was also confirmed on a protein level by immunohistological labeling of tumor tissues. Thirty-nine percent of the analyzed RCC tumors showed partial loss of HLA class I molecules, while 6% of the tumors showed HLA class I total loss. The expression of IP-10, SDF-1 and VEGF-c was also significantly lower in patients with advanced tumor, while the IFN-gamma expression in metastatic RCC was not detectable. Our findings show that primary RCC tumors are characterized by a high expression of HLAhc and a presence of proinflammatory mediators and chemokines. We also observed that disease progression and development of metastasis in RCC are associated with decreased expression of HLAhc, beta2m, IP-10, SDF-1 and IFN-gamma. This microenvironment may suppress the cytotoxic response, creating conditions that favor tumor escape and cancer progression.

Adult↗
PubMed2003

HLA class I expression in bladder carcinomas.

HLA class I molecules are frequently lost in a large variety of human carcinomas, possibly because of T-cell immune selection of major histocompatibility complex class I deficient tumor variants. We report that this phenomenon is also a frequent event in bladder carcinomas. Of a total of 72 bladder carcinomas, 72% of the tumors had at least one alteration in HLA class I expression. These altered HLA class I phenotypes were classified as total HLA class I loss (25%; phenotype I); HLA-A or/and HLA-B locus-specific loss (12%; phenotype III); and HLA class I allelic loss (35%; phenotype II or IV). Comparison of histopathological parameters with HLA class I expression showed a statistically significant relationship with the degree of differentiation and tumor recurrence.

Carcinoma↗
PubMed1996

[Ureteral obstruction caused by periureteral venous dilatation secondary to infrarenal caval obstruction].

Presentation of a case report of a female patient with single right kidney and background of left nephrectomy 21 years earlier due to hypertension who presented to the clinic after an episode of oliguria with lower limbs oedema and renal failure. Renal ultrasound evidenced moderate hydronephrosis, and backward pyelography showed medialization and lumbar ureter compression. CAT examination confirmed the ureteropyelocalycectasis as well as the reduction of the infrarenal lower cava vein to a fibrous cord with internal calcification. Axillary cavography and venography through both femorals demonstrated absence of the infrarenal cava vein segment and existence of a large replacement venous network. During surgery it became evident that the latter was displacing a retrovenous right lumbar ureter medially. Ureterolysis and ureter section with transposition, and termino-terminal anastomosis were performed. The morphological and functional results were excellent with recovery of the renal function (normal serum creatinine) which is still maintained after 7 years follow-up. As a consequence of this case, a review was made of different cava vein anomalies with repercussion in the urine excretory tract.

Aged↗
PubMed1994

[Clinical impact of idiopathic bladder instability].

Idiopathic vesical instability (I.V.I.), defined as the detrusor's spontaneous contraction during vesical filling or at its end, with a pressure higher than 15 cm H2O, is a urodynamic concept of unknown origin related to clinical disorders such as urinary incontinence, urgency-frequency syndrome, vesicoureteral reflux, repeat urinary infections, upper urological diseases due to pseudo-obstruction and morphological changes in vesicourethral X-rays. From January 1988 to January 1994, 2500 patients have been urodynamically examined. In 24% cases the diagnosis arrived at was vesical instability, 72% of them being I.V.I. I.V.I. was present as single diagnosis in 53% of prostate post-surgical incontinence, 71% of enuresis, 11% of clinically labelled stress incontinence, 46% of non-subsidiary incontinence, 16% of patients examined for prostatism, 55% of vesicoureteral reflux and 59% of repeat urinary infections.

Adult↗
PubMed1992

Value of testicular ultrasound in the evaluation of blunt scrotal trauma without haematocele.

The value of ultrasound in testicular trauma with haematocele has been questioned inasmuch as the injured testis should always be explored surgically. Ultrasonography, however, plays an important role in the diagnosis and follow-up of patients with blunt scrotal trauma without haematocele. We have evaluated 17 such patients with real-time ultrasound. In 9 cases the testis and epididymis were normal to palpation, although in 6 of them parenchymal lesions, mainly subcapsular haematomas and parenchymal contusions not amenable to surgical intervention, were detected with ultrasonography. Seven patients presented with changes in the testicular or epididymal morphology at palpation and in 1 case the testes were not palpable. Ultrasonography was of great value, indicating surgery in 6 of these patients where physical examination alone was not sufficient to establish the need for surgical exploration.

Adolescent↗
PubMed1991

[Primary bladder adenocarcinoma: retrospective study of 11 cases and general review].

Eleven cases of primary adenocarcinoma of the bladder are described herein. Eight had a glandular pattern, 1 was papillary and 2 were comprised of signet ring cells (one had areas of colloid carcinoma). One of the cases, originating from the urachus, also showed colloid areas and a glandular pattern. Forty-five percent of the cases were moderately differentiated and the remaining 55% were poorly differentiated. In all cases the tumor had areas of adenocarcinoma in more than 2/3 of its extent. All but two cases revealed muscle layer infiltration at the time of diagnosis. Two patients were submitted to radical cystectomy, lymphadenectomy and Wallace II cutaneous ureteroileostomy, 1 patient underwent partial cystectomy and lymphadenectomy, and 6 were submitted to transurethral resection. Excision of the urachal tumor was by en bloc partial cystectomy. The 5-year survival of patients with infiltrating tumors, excluding the urachal tumor, was 33%, 67% died within the first year of follow-up. The only evaluable case of superficial adenocarcinoma is alive and tumor-free at 94 months. Primary adenocarcinoma of the bladder is an aggressive tumor. Although it may be superficial at the time of diagnosis, it soon develops into an infiltrating tumor if untreated. Treatment and survival depend on tumor stage. Superficial or minimally infiltrating tumors warrant treatment by deep transurethral resection up to the pericystium.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1991

[Leydig cell tumor: presentation of 3 new cases with a benign course].

Three cases of Leydig cell tumor are described. Patient ages were 27, 44 and 55 years, respectively. The first two patients consulted for a testicular mass and the third patient presented with gynecomastia, an incidental finding during the ultrasound work up of a hydrocele. Hormonal evaluation revealed a marked serum testosterone level in one case, whereas in another case it fell within the lower limits of normal ranges. No evidence of dissemination was observed in all patients. Treatment was by radical inguinal orchiectomy in all patients. The pathological analysis of the surgical specimens revealed Leydig cell tumor with no histologic evidence of malignancy. A follow-up of 32, 14 and 10 months, respectively, revealed no evidence of tumor recurrence in all patients. The clinical and histologic features and treatment of this disease process are described.

Adult↗
PubMedDate not supplied

[Multilocular renal cyst: clinico-pathological considerations apropos of a case and review of the literature].

A case of multilocular renal cyst (MRC) is reported in a hypertensive patient in whom the IVP had disclosed a left renal mass. The ultrasound and CT workup revealed a well-defined, solid renal mass that was angiographically hypovascular. Cytologic examination of the specimen obtained by fine needle aspiration biopsy yielded no conclusive data. A left radical nephrectomy was performed. The histologic diagnosis was that of multilocular renal cyst. At 42 months the patient remains hypertensive with no evidence of tumor recurrence. We discuss the diagnostic criteria of MRC and the difficulty in making the differential diagnosis from renal carcinoma, and describe the histologic features of MRC that permit us to distinguish this disease entity from other renal tumors or dysplastic disease with different biologic significance.

Carcinoma, Renal Cell↗
PubMedDate not supplied

[Complications in kidney transplant: our experience in 107 cases].

We introduce our case material on urological complications occurred in 107 renal transplants, 102 of which were from corpse donors and 5 form live donors. The techniques used for the reconstruction of the urinary tract were: extravesical ureterocystoneostomy (91 = 85%), pyelo-pyelic anastomosis (15 = 14%) and uretero-ureteral anastomosis (1 = 0.9%). Sixteen cases presented urinary fistula (15%), emphasizing the high percentage of extravasations occurred in the pyelo-pyelic anastomosis (5/15). The resolution of the problem with graft preservation was achieved in 11 cases (68.75%). We encountered 6 ureteral obstructions that resolved favourably in 100% if the cases. Other important complications were: appearance of lymphocele in 8 cases, detection of post-grafting ureteral stenosis in 5 patients, finding asymptomatic vesicoureteral reflux in 16 grafts, and presence of urinary lithiasis in 2 cases. Similarly, we analyzed our series of 16 vascular complications, emphasizing that 15 out of 107 grafts had arterial or venous vascular abnormalities (14.1%), that forced to perform bench surgery in two occasions. Our statistical analysis showed that arterial thrombosis was more frequent than stenosis (8.49% versus 4.71%), and in nearly 80% of the cases (7/9) it happened in grafts concerning more than one arterial vessel, including in this series thrombosis of any of the ramus. The largest loss of grafting were due to this complication, since in 5 out of 9 cases of arterial thrombosis (55.5%) a transplantectomy had to be performed. With regard to venous complications thrombosis is a relatively rare complication, representing in our series less than 1%, usually associated to uncontrollable vascular acute rejection.

Adolescent↗
PubMedDate not supplied

[Xanthogranulomatous pyelonephritis in renal allograft. Report of a case and review of the literature].

Clinic report case of a kidney-transplanted female who, after one year of normal functioning, developed xantogranulomatous pyelonephritis in the renal allograft. Clinical presentation was mesorenal tumoration causing pyelocaliecstasis, which coincided with a progressive decline of renal function due to interstitial rejection. Diagnosis by eco-doppler imaging, CAT, arteriography, renogram and descending pyelography were non-specific in relation to the process benignant or malignant nature. Surgical examination with obtention of biopsy was not conclusive with regard to diagnosis and so, during a second surgery, transplanctectomy was chosen. The histological examination showed that the expansive process of the allograft corresponded to a case of xantogranulomatous pyelonephritis. After reviewing the existing literature, only 4 cases were found reporting this rare condition in a renal allograft.

Adult↗
PubMedDate not supplied

[Psychogenic urinary retention. Diagnostic-therapeutic approach].

OBJECTIVE: The influence of psychogenic factors on voiding generally manifests as an irritative syndrome and rarely in the form of acute or chronic urinary retention. The diagnosis and treatment of this uncommon urological pathology are reviewed and our experience is presented. METHODS: We conducted a retrospective study on 5 patients with psychogenic urinary retention (3 males and 2 females), aged 20 to 28 years (mean age 23.4), that had been treated at our urological services over the last 6 years. Three patients (2 males and 1 female) had a history of depression, one patient had a somatic form of disorder (mimicking) and one patient was diagnosed as having schizophrenia one year after he had presented with urinary retention. The physical and neurological examinations were normal in all 5 patients and the radiological evaluation was normal in all but one patient who had bilateral hydronephrosis. The pressure/flow test disclosed absence of detrusor muscle contraction in all 5 patients; 3 had incomplete voiding by abdominal pressure and had more than 500 ml residual urine. All patients received psychiatric therapy, and intermittent catheterization and urinary rehabilitation until residual urine less than 100 ml was achieved. CONCLUSIONS: The importance of the urodynamic study in the diagnosis of this condition is underscored. Definitive diagnosis can only be established after discarding other pathologies. The initial treatment must always be conservative; irreversible surgical procedures must not be performed. Treatment is by intermittent catheterization, urinary rehabilitation and supportive psychiatric therapy.

Adult↗