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J Rubio Briones

Publications and source records attributed to J Rubio Briones.

16 recordsLinked to original sources
PubMed2006

[Usefulness of bcl-2 expression as a new basal cell marker in prostatic pathology].

INTRODUCTION AND OBJECTIVES: The diagnosis of invasive adenocarcinoma of the prostate is often difficult in needle prostatic cores, where, additionally, the assessment of the presence of basal cells has demonstrated to be of paramount importance. Currently, the immunohistochemical expression of 34betaE12 antigen and p63 protein are the most utilized markers. In our study, we analyzed comparatively the expression of 34betaE12, p63, bcl-2 and alpha-methylacyl-CoA racemase in order to evaluate the usefulness of bcl-2 as a new marker of the basal cells in prostatic pathology. METHODS AND RESULTS: This study comprises radical prostatectomy specimens from 48 patients which were studied in order to determine the lack of staining of basal cells in invasive tumor areas together with the expression of racemase. Likewise, the presence of basal cells in areas of atrophy, hyperplasia, adenosis, and high-grade prostatic intraepithelial neoplasia (PIN) was also examined. Within the areas of adenosis and PIN a discontinuous pattern of basal cell expression was found in some cases. In 2 out of 48 cases (4,2%) of invasive carcinoma a weak bcl-2 expression without a basal cell distribution was found. Moreover, the expression of bcl-2 in the stromal lymphocytes appeared to be essential as an internal positive control of the technique. CONCLUSIONS: In addition to classical markers, we demonstrated the diagnostic value of bcl-2 as a new basal cell marker.

Adenocarcinoma↗
PubMed2006

[Radical laparoscopic nephrectomy].

In this article, we review the different surgical approaches to carry out radical laparoscopic nephrectomy: transperitoneal approach, retroperitoneal approach and hand-assisted approach. We describe the advantages and drawbacks of each alternative and summarize the most important references in the medical literature. In spite of this being a relatively new surgical approach, less than 15 years old, it has become a standard treatment and, today, is considered as the elective surgical treatment for T1 and T2 renal tumours in many centres.

Humans↗
PubMed2005

[Radiation-induced infiltrating transitional cell carcinoma].

INTRODUCTION: The increased risk of developing a transitional cell carcinoma (TCC) among patients irradiated for other pathologies in a known fact, but many times forgotten due to its low incidence. Our aim is to review the association between radiotherapy (RT) and muscle-infiltrating TCC among our patients. MATERIAL AND METHODS: Clinical survey among our muscle-infiltrating TCC data base since 1975. Descriptive analysis of found cases. RESULTS: We found 5 patients who developed muscle-infiltrating TCC with a mean time of 19.2 years since radiotherapy (three of them more than 20 years and the other two less than 10 years). Three patients also developed other tumours or pathologies related to radiotherapy. Two of them had an upper tract muscle-infiltrating TCC and required nephroureterectomy. All of them had high risk TCC of the bladder and one developed distant metastasis. CONCLUSIONS: Patients under abdomino-pelvic RT and a prolongued follow-up, can be considered a risk group for developing muscle-infiltrating TCC. Thus, either micro or macrohaematuria or irritative symptoms should lead us to think in this possibility, demanding complete and exhaustive study to rule out TCC in all the urothelium.

Aged↗
PubMed2004

[Usefulness of serum markers in renal cell carcinoma].

OBJECTIVES: To select a group of useful serum markers in renal cell carcinoma (RCC) with investigational purpose in future. MATERIAL AND METHODS: Periodic determination in serum of 21 RCC patients of the following markers: EGR, RPC, hemogram and leucocyte differential count (LDC), standard biochemist parameters, beta-2 microglobuline, CEA, CA 12.5, CA 50, CA 15.3, ferritin, interleukin-6, serum interleukin-2 receptor, TNF-alpha and TPSA. RESULTS: Different elements within the LDC had relations with the presence of symptoms/signs, tumour size, pathological stage and disease progression. There was a significant increase of beta-2 microglobuline and sIL-2 receptor when disease progressed, as well as a similar statistical trend with RPC and alkaline phosphatases. Beta-2 microglobuline and sIL-2 receptor also decreased after treatment of the disease progression. CONCLUSIONS: We will keep analysing hemogram, LDC and standard byochemics, RPC, ferritin, beta-2 microglobuline and sIL-2 receptor only with investigational purposes, obviating the determination of the rest of the tested markers.

Biomarkers, Tumor↗
PubMed2004

[Treatment of post radical prostatectomy erectile dysfunction with sildenafil in a non-selected group of patients].

OBJECTIVE: To evaluate erectile disfunction (ED) after radical prostatectomy in a non selected group of patients and their response to sildenafil. METHODS: We included our patients who were operated on between 1998 and 2001. The patients filled in a modification of IIEF (mIIEF) before the RP operation. We tried sildenafil with doses of 100 mg in 3 different periods: 3-6, 12 and 18-24 months after the RP operation. In the event of a complete response they filled in the mIIEF again. RESULTS: The mean age of the patients was 62.8 years old and the mean observation period was 31.7 months. Only 111 (62%) of the total number of patients operated on wanted treatment and only 90 took sildenafil in the proposed protocol; 27 (30%), 18 (20%) and 45 (50%) patients had a complete response, a partial response or no response to the sildenafil respectively. The mIIEF showed 6.5+/-5.7 points less than the mIIEF pre-treatment. In the univariate analysis, the preservation of bundles, the presence of a previous partial response and the presence of the previous tumescence were significantly related to the complete response; however, only tumescence kept its value in the multivariate study. CONCLUSIONS: Urologists must involve themselves in the early rehabilitation of the erectile function even in those patients where preservation of the NVB was not possible. One must always try to preserve, uni or bilaterally, whenever the patient desires preservation of EF. The response to sildenafil is better after the first year and in patients who have previous tumescence.

Aged↗
PubMed2002

[Assessment of the basal membrane status as prognostic factor in renal carcinoma].

OBJECTIVES: To know the basal membrane (BM) integrity in renal cell carcinoma (RC) and its importance as prognostic factor. MATERIAL AND METHODS: 73 patients with RC were selected. Immunohistochemistry with monoclonal antibodies against basal proteins laminin and collagen IV was performed. Percentage for BM fragmentation in the whole tumour was considered taking 75% as cut off. RESULTS: Follow-up was 6.3 +/- 4.3 years and 27 patients progressed. Correlation between laminin and collagen IV was significative (p = 0.000). A BM fragmentation expressed with laminin bigger than 75% was related to tumoural symptoms (p = 0.019), worse grade (p = 0.004) and necrosis in more than 10% of the tumour (p = 0.000). Fragmentation observed with collagen IV was associated to tumours greater than 7 cm (p = 0.014). Those patients whose tumours displayed more than 75% of BM fragmentation, measured with collagen IV, presented worse survival (p = 0.042). A similar trend was observed in the case of laminin, but it did not reach statistic significance (p = 0.119). In the unvariated analysis grade III-IV, more than 10% of necrosis within the tumour, tumoural symptoms and BM fragmentation bigger than 75% measured with collagen IV were prognostic, while only grade and necrosis did so in the multivariate analysis. CONCLUSIONS: Collagen IV and laminin represent nicely, with a similar expression pattern, the BM fragmentation in RC. Within a battery of immunohistochemical markers to study RC at least one of them should be included because their prognostic implication.

Basement Membrane↗
PubMed2001

[Color doppler ultrasonography in the diagnosis of a case of polyorchidism].

OBJECTIVE: To describe a case of polyorchidism, a rare anomaly of the genital tract, with special reference to the use of non-invasive imaging with color Doppler ultrasound for its diagnosis. METHODS/RESULTS: The patient presented with an asymptomatic mass in the left hemiscrotum. Color Doppler assessment revealed a supernumerary testis with the same ultrasound and perfusion patterns as the normal testes. CONCLUSION: Doppler ultrasound permits assessment of the echogenicity, perfusion and viability of the supernumerary testis, and to rule out associated anomalies. Surgical exploration to confirm the diagnosis is unnecessary.

Adolescent↗
PubMed1999

[BCG and radiotherapy: the compatibility of 2 conservative treatments for cancer of the urinary bladder].

OBJECTIVE: To review the efficacy of radiotherapy and BCG in the treatment of transitional cell carcinoma of the urinary bladder in its different forms of presentation, with special reference to patients with infiltrating bladder tumors receiving radiotherapy and those in whom the lesion recurs as a high grade superficial bladder tumor. METHODS/RESULTS: 10 patients who previously received radiotherapy for T2-4 infiltrating bladder tumor that recurred as a high grade superficial tumor were treated with BCG. Four patients are alive and disease-free with a preserved bladder at 2-8 years follow-up. Four other patients who required cystectomy for persistence or progression of the tumor to the bladder wall, are alive and disease free at 3-7 years follow-up. The remaining two patients who were not amenable to major surgery died from the disease more than two years after treatment with BCG. BCG was well-tolerated by 70% of the patients and the rest showed minor complications. CONCLUSIONS: 28.3% of recurrences after radiotherapy are superficial tumors and 7% are carcinoma in situ. The appearance of carcinoma in situ or T1 G3 lesions following radiotherapy of the bladder questions its efficacy against these superficial forms for which cystectomy is reserved. BCG has been found to be effective in high grade superficial bladder tumors that have not been previously irradiated, therefore it would be acceptable to extend its application to those patients in whom radiotherapy has achieved control of the infiltrating tumor but not the high grade superficial tumor. The 40-70% of patients who are alive with a preserved bladder appears to be sufficient to recommend BCG salvage for high grade superficial bladder tumors post-radiotherapy. BCG therapy does not entail major complications or compromise patient survival, including those cases that will require cystectomy.

BCG Vaccine↗
PubMed1998

Incidence of tumoural pathology in horseshoe kidneys.

OBJECTIVES: To know the incidence of tumoural pathology among our cases of horseshoe kidney (HK), a congenital anomaly occurring in 0.25% of the population, as well as their prognostic factors and follow-up. METHODS: A total of 82 patients admitted at our Centre between 1967 and 1996 with an HK diagnosis were retrospectively reviewed. We have collected a total of 10 cases of HK tumours. We analyse the clinical, diagnostic, surgical and evolutionary peculiarities of the different HK tumour aetiologies, as compared with those described in literature. RESULTS: Our experience is based on 10 patients-5 adenocarcinomas, 4 transitional cell carcinomas and a Wilms' tumour. CONCLUSIONS: We have observed that in the case of transitional cell carcinomas, the diagnosis is generally made at an advanced stage. The prognosis of the tumorous disease depends upon the same prognostic factors as in the case of normal kidneys. Renal adenocarcinoma is the kind of tumour most frequently associated with HKs. Its incidence among the HK cases is not greater than among the normal population. Conservative local treatment criteria for adenocarcinoma should be valid for HKs as well.

Adenocarcinoma↗
PubMed1997

[Urinary stress incontinence in women under 40 years of age].

OBJECTIVE: To analyze the therapeutic approach in young females with stress urinary incontinence. METHODS: A retrospective study was conducted on 35 females less than 40 years of age who had undergone surgery for stress urinary incontinence. These patients had a mean follow-up of 3.5 years (range one month to 18 years) and a previous history of 3.9 years mean duration. Retropubic urethral suspension according to the MMK or Burch procedure was performed in all patients. RESULTS: 65.7% became completely continent, 20% were continent for at least two months, and 1.43% continued to be incontinent after surgery. The postoperative complication rate was 31%; of these complications, 4 referred inguinal pain and there were 3 cases of wound infection. Those who had a failed procedure showed no changes with respect to their preoperative urodynamic status, although two patients presented clinical features of urgency. The best surgical results were achieved in the older patients, although the differences were not statistically significant. However, statistically significant differences were found for the time to surgery; i.e., the patients with a shorter history of urinary incontinence remained incontinent after surgery. CONCLUSION: Surgical treatment of stress urinary incontinence in females less than 40 years of age achieves satisfactory results, with a success rate similar to that of the general population regardless of the age, and appears to be closely related with the period of time the patient has been incontinent before undergoing surgery.

Adult↗
PubMed1996

[Surgical treatment of fracture of the corpus cavernosum and the urethra: review of the literature and report of 2 cases].

OBJECTIVES: Rupture of the corpora cavernosa, also known as fracture of the penis, is uncommon. To date, only 200 cases approximately have been reported. This lesion may be associated with rupture of the urethra in 25% of the cases. The diagnostic methods, management and the results achieved in these patients are discussed. METHODS: We describe two cases that had been treated at our institution and review the literature. RESULTS: Preservation of micturition and sexual function was achieved with early surgical management in these two patients with a follow-up of more than one year. CONCLUSIONS: An associated urethral lesion should be strongly suspected in the presence of urethrorrhagia. A negative urine sediment discards the presence of this lesion. If urethral injury associated with penile rupture is suspected, low pressure urethrography is the diagnostic method of choice following sonographic evaluation of the corpora cavernosa. Cavernosal integrity can only be established by cavernosography in equivocal cases and is not required when extravasation is demonstrated by urethrography. Conservative management carries a high risk of penile curvature and painful erection; therefore, whenever possible, surgery should be performed within a few hours following trauma and after careful evaluation. The cavernosal defect is repaired and end-to-end anastomosis of the urethra is performed. The patient should be informed of the risk of painful erection, penile curvature and urethral stenosis.

Humans↗
PubMed1996

[Polycystic kidney in the adult and kidney transplantation. Our experience].

OBJECTIVES: To determine the need for nephrectomy prior to renal transplantation in patients with adult polycystic renal disease. METHODS: We reviewed the records of 54 (31 females, 23 males) of 62 patients with polycystic renal disease that had been treated at our center from 1951 to 1994. Eight of the earlier cases, whose complete clinical data were unavailable, were excluded from the study. The patients were classified into three groups: nephrectomized transplanted, nephrectomized non-transplanted and non-nephrectomized transplanted patients. RESULTS: No patient had required nephrectomy due to a tumor. No surgical difficulty during transplantation had been reported in the non-nephrectomized patients. Nephrectomy had been performed in most of the cases for hematuria or preparatory to renal transplantation. The infections complications (11.76%) were resolved with antibiotic therapy. CONCLUSIONS: In the absence of renal tumor and given the low prevalence of complicated cysts, in our view it is unnecessary to perform nephrectomy routinely prior to renal transplantation in patients with adult polycystic renal disease. Nephrectomy should be reserved for cases with severe cystic complications, such as severe intracystic hemorrhage, hematuria causing anemia, pyonephrosis, or patients with grossly enlarged kidneys in whom we suspect that technical difficulties might arise at the time of transplantation.

Adult↗
PubMedDate not supplied

[Surgical treatment of stage I germ cell tumor of the testis].

OBJECTIVE: To analyze the current role of surgery in the treatment of stage I testicular germ cell tumors. METHODS: We reviewed the literature on stage I testicular germ cell tumors. The technique of orchidectomy, the arguments in favor of retroperitoneal lymphadenectomy, the evolution of this technique and the prognostic factors that might be useful in determining the therapeutic approach to stage I testicular germ cell tumors are analyzed. RESULTS/CONCLUSIONS: Treatment of testicular germ cell tumors should be performed in specialized centers that can offer all the therapeutic possibilities with a maximum guarantee so that the patient can decide on the treatment after receiving all the information on the advantages and disadvantages of each modality. Retroperitoneal lymphadenectomy with preservation of sympathetic innervation preserves ejaculation. Its cure rate is similar to that of other therapeutic options, it carries a minimum morbidity, follow-up is simplified, patient anxiety is reduced and there are long-term savings on costs.

Germinoma↗
PubMedDate not supplied

[Molecular biology in testicular cancer].

OBJECTIVE: To review the advancements in basic molecular biology and current insight into the pathogenesis of germ cell tumors of the testis, as well as the utility of the different genetic and molecular markers in the management of these tumors. METHODS: The literature on this subject was reviewed. The epidemiological data related to the pathogenesis of this tumor type, the cytogenetic and molecular alterations that could serve as a prognostic factor in these tumors were analyzed. RESULTS/CONCLUSIONS: The prenatal estrogenic effect together with the pubertal hypergonadotrophism could be responsible for the pathogenesis of germ cell testicular tumors. The cytogenetic changes of chromosome 12, although typical of the phenotype of these tumors, do not appear to be useful as a prognostic factor. However, cell proliferation, particularly of Ki-67, appears to be useful as a prognostic factor, although further studies are warranted.

Biomarkers, Tumor↗
PubMedDate not supplied

[Lithiasis in renal transplantation].

Lithiasis as a post-renal transplantation complication is rare and of delayed appearance. After having revised 320 transplantations performed at the Fundación Puigvert 8 cases were found, which implies a two-fold increased incidence over other series studied and greater than the prevalence in the normal population. We confirmed the existence of lithogenous factors in 7 of the 8 cases, and found that in 50% of them the calculus composition was urate, what explained the differences versus normal population in terms of treatment with cyclosporin and the personal background. Two therapeutic schemes may be outlined based on the chemical composition of the calculus, and thus ultrasound-guided ESWL is chosen as chronic therapy when calculi have a calcic origin whereas medical management is used when their nature is uric, even though we understand that treatment must be individualized in each case. We have obtained good results in all 8 cases without compromising neither the renal function nor the graft viability.

Adult↗