Biomedical subjects

L Llanes González

Publications and source records attributed to L Llanes González.

At least 19 recordsLinked to original sources

PubMed2004

[Genitourinary cancer incidence in a health geographic area of 300,000 people].

OBJECTIVE: To provide descriptive information on site-specific urological cancer occurrence we computed 10-year cancer incidence rates in the geographic area of Getafe (Madrid, Spain, 300,000 people). MATERIALS AND METHODS: Only histologically confirmed genitourinary cancer (bladder, prostate, kidney, testicle and penis) throughout 1992-2001 was considered. Cancers were classified according to the international rules. 10 years age-standardized population-adjusted incidence rates per 100,000 people (or per 100,000 men when appropriate) were calculated. Overall and cancer-specific yearly increments were also evaluated. The most recent release of National Statistics (2001) was used for population adjusting. RESULTS: Prostate cancer (PC) accounted for the majority of diagnostics. A strong correlation was detected between the total number of new cancer diagnostics and the overall population. While the correlation was frail between the number of new cancer diagnostics in females and the female population, the association remained significant in males. Nevertheless, only the number of new prostate cancer diagnostics was firmly and significantly associated with the population. CONCLUSIONS: Incidence rates of every cancer type increased throughout the last decade. Nevertheless, this increases didn't parallel the population increment perhaps translating environmental factors.

Female↗

PubMed2003

[Epidemiologic analysis of clear cell and chromophilic carcinoma of the kidney].

OBJECTIVE: Finding differences in the characteristics of the two most frequent variants of renal cancers: the clear-cell renal carcinoma, and the chromophilic one. MATERIAL AND METHODS: Retrospective analysis of epidemiological characteristics of patients diagnosed of renal carcinoma in our hospital between 1991 and 2001. Statistical differences were searched between patients' characteristics (age, sex, smoking habitus) and tumors' characteristics (size, focality, stage, side and grade). RESULTS: Sixty six renal tumors were diagnosed, of which 41 (62.1%) were clear-cell tumors and 9 (13%) were chromophilic. We only found statistical differences between both subpopulations' tumor size (p < 0.05), being greater for clear-cell tumors (7 +/- 3.92 cm) than for chromophilic ones (4.89 +/- 1.96 cm). We could also appreciate a bias towards a less advanced stage of the chromophilic type, although not statistically significant. CONCLUSIONS: Clear-cell renal carcinoma and chromophilic renal carcinoma are the two more frequent variants of renal tumors. The chromophilic type is smaller and is usually found in a less advanced stage, although this bias could not be demonstrated in our series.

Adenocarcinoma, Clear Cell↗

PubMed2001

[Selective bladder sparing with transrectal resection of muscle-infiltrating tumors].

OBJECTIVE: To disclose te ability of TUR as monotherapy in muscle invasive bladder cancer. MATERIAL AND METHODS: 27 patients with muscle-invasive bladder cancer recruited throughout 1991-1999 were allocated into a protocol based on TUR. 30-45 days after the first TUR a second procedure was performed. The number of recurrences and progressions was registered. Progression-free survival and survival were analyzed using Kaplan-Meier estimates. RESULTS: Two patients were excluded due to persistence of muscle-invasive disease after the second resection. 8 subjects (32%) were lost in follow-up. 17 were eventually evaluable. 12 patients (70.5%) had recurrences. Eventually, 4 more cystectomies were undertaken for invasive recurrences (4/17, 23.5%). During the study period, 3 deaths were recorder (3/17, 17.6%). The actuarial probability of progression at 93 months was estimated on 60%. CONCLUSIONS: 75% of patients retained their bladders. The proportion of patients lost in follow-up was very high. Patients must commit to a close surveillance.

Aged↗

PubMed2000

[Conditions for the development of a program of reverse transcriptase-polymerase chain reaction for molecular staging of prostatic cancer].

OBJECTIVE: To determine accurately the conditions for the development of tests using RT-PCR for PSA in patients with prostate cancer. METHOD: Gen amplification of PSA in cultures of the human prostate tumoral cell line LNCaP with RT-PCR under hot-start conditions, and verification through enzyme restriction digestion of the PCR product. Also, calculation of the PCR test limit of detection through serial dilutions of LNCaP cells in peripheral blood mononucleate cells. RESULTS: A highly specific, easy to perform, reproducible RT-PCR protocol has been developed. The lowest limit of detection reached was 1 PSA synthesising cell per 10(6) peripheral blood mononucleate cells. CONCLUSIONS: RT-PCR is a highly sensitive technique that allows detection of small numbers of PSA producing cells in peripheral blood. This experience allows to establish with precision the conditions for the development of RT-PCR tests for PSA.

Humans↗

PubMed2000

[Differential traits of prostatic cancer detected through an early screening program versus the one detected during urologic consultation].

OBJECTIVE: To compare some features of prostate cancers (PCa) detected in a screening program, versus cancers diagnosed in an outpatient clinic. MATERIAL AND METHODS: Retrospective study of 393 patients with biopsy evidence of PCa: 93 (23.7%) from a screening campaign, and 300 (76.3%) detected in an outpatient Urology clinic. Features studied at the moment of diagnosis were age, PSA, digital rectal examination (DRE), transrectal ultrasound (TRUS) characteristics and volume stimation, PSA density (PSAD), clinical stage and Gleason score. A comparison was established between the two groups of patients taking into account the mentioned parameters. RESULTS: A higher age, PSA and DPSA values were found among cancers detected out of the screening program. A greater probability of abnormal DRE and a more advanced clinical stage was also noted. In the screening group, 78.5% of the cancers were localized and 8.6% metastatic. In the outpatient clinic group, the proportions were 50.7% and 26%, respectively. No differences were found with respect to TRUS findings, prostate volume, or Gleason score. CONCLUSIONS: Cancers detected in screening programs are found in earlier stages. Nevertheless, results from long term randomized studies are necessary to verify if these data really mean that a disease-specific mortality reduction can be achieved.

Aged↗

PubMed2000

[Characteristics of prostatic cancer undetected in the first assessment of a screening program. Quality control].

OBJECTIVE: To study the results of the second round in the subjects with negative tests in the first round of a prostate cancer screening program and to analyze the characteristics of the tumors that were not detected in the first round. METHODS: Of 5188 males evaluated in a prostate cancer screening program, 976 with negative tests in the first round (804 with PSA < or = 4 ng/ml; 172 with PSA > 4 ng/ml and a negative biopsy) accepted to undergo subsequent tests. During the second round, 163 biopsies were indicated. The biopsy results and the characteristics of the tumors detected were analyzed. RESULTS: The biopsy yield was higher (but not significantly) in the first round (80 cancers/481 biopsies; 16.6%) than in the second round (13 cancers/115 biopsies; 11.3%). Of the 163 biopsies indicated in the second round, 115 were performed and 13 cancers were detected (10 of these patients had a high PSA in the first round). The univariate analysis showed no differences for age, PSA, PSA density, prostate volume, transrectal US findings, or Gleason score in the cases diagnosed in the first round and those detected in the second round. However, there was a higher proportion of tumors with abnormal DRE in the cancers detected in the first round than in the second round, (31.3% vs 7.7%, respectively; p = 0.02). There was a higher proportion of tumors clinically detected in the second round than in the first round (100% vs 75%, respectively; p = 0.043). The multivariate analysis only showed differences for the DRE findings (p = 0.045). CONCLUSION: A significant number of tumors are undetected in prostate cancer screening programs. Although the biopsy yield may be slightly lower in subsequent rounds, there is a strong trend of detecting more localized tumors (and therefore potentially curable). We have found no correlation between a greater prostate volume and tumors that were undetected in the first round.

Aged↗

PubMed1999

[Some details on the updating of an animal vesical tumor model].

OBJECTIVES: To describe the problems found by the authors with a murine vesical tumour model. METHODOLOGY: Review of the primary aspects of the choice of animal and challenge of murine vesical tumours. Also, analysis of the relationship between bladder size, estimated by palpation, and volume obtained after death of animals and measurement of bladder dimensions. Finally, establishment of specificity and positive predictive value (PPV) of the abdominal examination in bladders with size > or = 4 mm. RESULTS: Vesical tumours challenging in small-sized experimental animals is simple and requires minimum logistics. With regard to estimate of vesical dimensions, the r coefficient between the methods used by the authors to assess vesical volume reached 0.97 (r2 = 0.95). Specificity and PPV of abdominal digital examination in bladders > or = 4 mm reached 100%. CONCLUSIONS: Handling of C57BL/6 mice requires very short training periods. Abdominal digital examination allows to extrapolate size of the bladder and to select tumour-bearing animals when the estimated vesical size is equal to or greater than 4 mm.

Animals↗

PubMed1999

[A reliability analysis of transrectal echographic estimation of prostatic volume].

OBJECTIVE: To establish the reliability of transrectal ultrasound to estimate prostatic volume. MATERIAL AND METHODS: Study of 27 patients diagnosed with prostate cancer who were managed with radical prostatectomy. Transrectal ultrasound assessment of prostatic volume was performed using the revolution ellipsoid equation V = (pi/6) x L x T x AP. The values obtained were compared to those from radical prostatectomy specimens calculated by the same method and with the weights of the specimens. RESULTS: Mean prostatic volume estimated through transrectal ultrasound was 38.77 cc vs. 38.46 cc in the pathoanatomical specimens. Mean difference between both was 0.31 cc (not significant). The coefficient of correlation that related both values was 0.80 and the coefficient of correlation between transrectal ultrasound volume and weight was 0.86. CONCLUSIONS: Prostatic transrectal ultrasound is an accurate tool to calculate total prostatic volume.

Aged↗

PubMed1999

[Mid-term results of a program for the monitoring of superficial bladder tumors].

OBJECTIVE: To identify the medium-term clinical prognostic factors for recurrence and progression in superficial bladder tumors and to analyze the efficacy and safety of the surveillance program. METHODS: 135 patients with primary superficial bladder tumor (Ta: 57, T1: 76, Tx: 2, grade I: 51, grade II: 70, grade III: 12, unknown grade: 2) were evaluated by cystoscopy/cytology alternately with ultrasound/cytology during the first two years, and by ultrasound and cytology yearly after the third year. The influence of tumor characteristics (stage, grade, size and number) and patient age and sex on tumor recurrence and progression were analyzed. The disease-free interval was expressed through an actuarial curve. The relationships between the annual recurrence rate and disease-free interval, and tumor and patient characteristics were analyzed. The influence of each variable in the presence of the other covariables was determined by multivariative analysis using a logistic regression model. RESULTS: The recurrence rate was 51.3% and the progression rate was 2.75%. The mean recurrence rate was 0.59 and the mean disease-free interval was 16.2 months. Tumor grade, size and number significantly influenced recurrence. Tumor size and number influenced the annual recurrence rate. Similarly, tumor number and size were associated with a shorter disease-free interval. Logistic regression analysis showed a relationship between tumor number and recurrence (relative risk = 2.7), and identified tumor size as a characteristic of a high recurrence rate (relative risk = 3.3). None of the factors could predict a higher risk for tumor progression. CONCLUSIONS: The estimation of the risk factors shows a wide intra and interindividual variability. It might therefore be necessary to establish them for each institution. In the medium-term, surveillance can be considered effective in terms of the recurrence rate and safe in terms of the progression rate.

Disease Progression↗

PubMed1998

[Kinetics of in vitro clonal growth of the murine MB-49 bladder tumor cell line].

OBJECTIVE: To analyze the in vitro growth kinetics of the MB-49 murine bladder tumor cell line. METHODS: Cell proliferation and duplication time (DT) were determined by 595 nm absorbance analysis and hemocytometry with and without fetal calf serum (FCS). RESULTS: The 595 nm absorbance and the hemocytometer cell count correlated according to the linear equation of cell number = 595 nm absorbance x 334.110-8.795 (r = 0.98). Cell proliferation was significantly higher in cultures with FCS (p < 0.001). However, a significant increase in the cell count (p < 0.01) was observed after 24 hours in cultures with and without FCS. DT was 21 and 50 hours for cultures with and without FCS, respectively. CONCLUSION: This experiment confirms the nature of the tumor cells and permits establishing the precise growth conditions of the MB-49 cells in this laboratory.

Animals↗

PubMed1998

[Predictive factors on postoperative quality of life in transurethral resection of prostatic adenoma].

OBJECTIVE: To identify the traits of patients undergoing transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH) that best predict the outcome of the procedure; i.e., quality of life (QOL) changes. METHODS: The prostatic symptoms and the pre- and postoperative QOL of 151 patients submitted to TURP for BPH were evaluated by the IPSS AUA-7 questionnaire. The available preoperative variables (age, symptoms, US prostate size and DRE findings) were correlated with the QOL changes. Thereafter, the relationship between the available postoperative variables and the QOL changes were analyzed. RESULTS: Of the available preoperative variables, symptoms and prostate size were the only factors that significantly influenced the variability of the QOL changes. Multivariate analysis permitted anticipating only 14% of that variability (r2 = 0.14). Analysis of all of the available post-TURP variables showed postoperative symptoms to be the only variable with a statistically significant relationship with the QOL changes. This model provides an explanation for the 60% interindividual variability of the QOL changes (r2 = 0.77, r2 = 0.603; p < 0.001). CONCLUSIONS: We found no mathematical relationship between the preoperative factors and the QOL changes. These changes depended largely upon the postoperative symptoms. The remaining parameters analyzed in this study--including the weight of resected prostatic tissue--showed a weak influence, which suggests that the prostates react differently to TURP.

Adenoma↗

PubMed1998

[Initial aspects of a program for in vitro transfection of cytokine genes into LNCap tumor cells].

OBJECTIVES: To characterize the conditions and kinetics for in vitro growth of tumoral cells LNCaP. METHODS: Determination of proliferation curves and time to cell duplication through spectrophotometry and manual cell counts in haemocytometer with and without foetal calf serum (FCS) challenge. RESULTS: Data from the spectrophotometry and manual cell counts were correlated by mean of the equation through the number of cells = absorbance at 595 nm x 227,530-14,160. The correlation coefficient r was 0.99. Cell proliferation was higher in the presence of FCS (p > 0.001), the final culture density being 5.4 times higher than the baseline. Similarly, time to duplication in the presence of FCS was 36.4 hours. CONCLUSIONS: This experiment allowed to establish the local conditions for growth of LNCaP cells. In contrast to the behaviour exhibited by other malignant cells in culture, LNCaP cells grow slowly and require the stimulus provided by FCS. Both aspect are of the highest significance when adopting the pre-established timetables and logistic to the actual laboratory operation.

Cell Count↗

PubMed1998

[Prostatic adenocarcinoma associated with incidental intestinal carcinoid].

The association of a carcinoid tumour with non-endocrine urologic neoplasms is an infrequent finding. This paper contributes one case of multiple primary neoplasm where a prostatic adenocarcinoma coexists with an intestinal carcinoid tumour in a 63-year old asymptomatic patient. Diagnosis of prostate cancer was achieved during a screening for this conditions whereas the intestinal carcinoid tumour was found in the extension study.

Adenocarcinoma↗

PubMed1998

[Does some relation exist in the size and histological composition of the prostate?].

OBJECTIVE: To determine if the histological composition of the prostate-the proportion of glands and stroma-depends on its size. METHODS: Prostate volume was determined by abdominal US; transurethral biopsy of the prostate was performed in 22 patients (mean age 64.8 years) with BPH or bladder tumor. Morphometric analysis of a fragment of the prostate was performed using light and electron microscopy. The stroma-epithelial ratio (SER) and the density of prostatic vascularization (DPV), and the nuclear and cellular areas of 5 epithelial cells in each case, were determined. The ratio of the sum of granular to cellular areas (secreto-cellular ratio), and the nuclear-cytoplasmic ratio (NCR) were determined. The pearson coefficient and linear regression equation that best correlated the prostate volume and the rest of the variables. RESULTS: The mean SER was 4:1 and the DPV was 15.18 vessels/mm2. The cellular and nuclear areas were 79.6 and 21.2 mu2, respectively. The secreto-cellular ratio was 0.083 and the NCR was 0.28. The prostate volume showed no mathematical relationship with SER (r = 0.016, p = 0.9) or DPV (r = 0.026, p = 0.9). Only a random association between the US prostate volume and the cellular and nuclear areas, and the secreto-cellular and NCR could be observed. CONCLUSION: The histological composition of the prostate cannot be determined by the US prostate volume.

Aged↗

PubMed1998

[A bladder nephrogenic adenoma. A case report].

OBJECTIVE: To report an additional case of nephrogenic adenoma of the bladder. METHODS/RESULTS: A case of nephrogenic adenoma of the urinary bladder in a 28-year-old female is described. Patient clinical history and diagnostic imaging findings are presented. CONCLUSIONS: Nephrogenic adenoma of the bladder is a rare benign tumor with specific histological features that has been associated with previous surgery, trauma, infections and lithiasis. Although it is currently not considered to be a premalignant lesion, its rate of recurrence is high (37%-49%). The treatment of choice is by transurethral resection and yearly cytological, ultrasound and cystoscopic follow-up evaluation to detect recurrence.

Adenoma↗

PubMed1997

[Antimicrobial prophylaxis in urology].

UNLABELLED: Antimicrobial prophylaxis in surgery has proven to be effective in controlled randomized trials. Usage in Urology is known at least since the '30s although its effectiveness has only become known since 1979. METHODS: Review of literature related to surgical antibiotic prophylaxis, more specifically urological surgery, basically from 1991 to 1995, but without overlooking those papers that have become classics due to their impact. RESULTS AND CONCLUSIONS: Efficacy of antimicrobial prophylaxis in urological surgery is nowadays beyond all doubt. Usage is indicated in the presence of sterile urine and dosage must be short, in single dosis in the immediate pre-operative or within 24 hours after the procedure. However, there is a number of issues that deserve to be treated in more detail for better understanding. Those are the establishment of adequate prophylactic regimes in renal transplantation and the use of antimicrobials based on their pharmacokinetic characteristics to optimize the prophylactic purpose.

Anti-Bacterial Agents↗

PubMed1997

[The validity of the IPSS questionnaire in a sample of 262 patients with benign prostatic hyperplasia].

OBJECTIVE: The IPSS is a well-known method for symptom evaluation in patients with prostate disease. The present study analyzes the validity of this self-administered questionnaire in a group of patients from an industrial area in Spain. METHODS: 513 questionnaires (test 1) were sent out to patients with benign prostatic hyperplasia (BPH) who had undergone TUR or adenomectomy. After an interval of 30-60 days, the same questionnaire (test 2) was sent out to all those patients who had correctly answered test 1. The feasibility and reliability of this test in our hands, as well as its ability to discriminate, were determined. Moreover, the relationship between symptoms (S) and quality of life (L) was analyzed. RESULTS: Patient ages ranged from 50 to 86 years (mean 67.6). A) Feasibility (percentage of patients who answered the questionnaire correctly) was 71%. B) Reliability: internal consistency (Cronbach's alpha) was 0.74 and the retest reliability (correlation between the scores of tests 1 and 2) was 0.76 (Pearson's r) and 0.5 (Kendall's T). C) Correlation between symptoms (S) and quality of life (L) was 0.53 (Pearson) and 0.33 (Kendall). D) Discriminating validity (ability of the test alone to diagnose patients with BPH correctly). The patients in the study were compared with a group of 420 "healthy" males from a prostate cancer screening program; the area below the ROC curve was 0.98 (scantily evaluable: healthy patients vs surgical BPH cases). CONCLUSIONS: In our setting, the self-administered IPSS questionnaire had a moderate feasibility (29% of the patients were unable to understand the questionnaire). Our results, in terms of internal consistency and retest reliability, are similar to those of other validation studies conducted in our country (and appreciably worse than those of the original validation studies in the English language). Nevertheless, some items of the questionnaire have an unacceptable retest reliability, particularly those relating to frequency or urgency. Finally, the total symptom (S) score showed a scanty correlation with quality of life (L). We can conclude that although the IPSS questionnaire is a useful method in the assessment of patients with prostate disease, its reliability remains far from optimal.

Aged↗

PubMedDate not supplied

[Effect of sacral roots block in the prostatic structure of the rat].

OBJECTIVE: To validate a simplified model of neural manipulation of the lower urinary tract of the rat, by means of alcoholic blockade of sacral roots. MATERIAL AND METHODS: Twenty Sprague-Dawle rats (aged 3 months) underwent alcohol sacral root blockade under total anesthesia with previous needle placement monitoring (electrostimulation). After 28-30 days, ipsilateral ventral prostatic lobe (VL) was obtained. Macroscopic and light microscopy (LM) studies were performed (computerized image analysis). Results were compared with 20 LV from non manipulated rats. RESULTS: A slight non significant decrease of LV weight in the blockade group was notice. LM study showed a reduced epithelial height after manipulation. Gland compartment mean proportions were: control group: 28.1% (epithelial), 29.8% (stromal), y 70.2% (glandular -lumen plus epithelium-); study group: 30.5% (not significant), 37.4% y 62.3% (both p < 0.05) respectively. Epithelium area did not suffer any variation. A reduced vascular overall count was noted in the study group. Ipsilateral diffusion of blockade solution was shown in 9 rats (45%), and bilateral in 11 (55%). CONCLUSIONS: Alcoholic sacral root blockade produces an atrophy of the glandular component (due to luminal shrinkage, without epithelial change). No differences were found after the macroscopic study. This study could not reproduce the changes produced after standard surgical denervation, therefore we cannot recommend this method to be used in future models.

Animals↗