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M Sánchez Chapado

Publications and source records attributed to M Sánchez Chapado.

At least 19 recordsLinked to original sources
PubMed2002

[Apoptosis in renal adenocarcinoma. Expression of bcl-2 in locally confined tumors].

INTRODUCTION AND OBJECTIVE: Bcl-2 is a proto-oncogene known to be a negative regulator of apoptosis, whose expression conferring prolonged cell survival and contributing to tumorigenesis. Inconsistent results concerning bcl-2 expression and the frequency of apoptosis were noted in renal cell carcinoma. To investigate a possible role of bcl-2 protein in renal cell carcinomas, we analyzed its expression and relationship with clinical and pathological parameters, including prognostic impact. METHODS: 58 patients diagnosed of renal cell carcinoma stage pT1, pT2 and pT3a N0 M0 (TNM 1997) were treated by radical or partial nephrectomy. We analyzed clinical and pathological parameters including bcl-2 expression in paraffin-embedded tumor samples using immunohistochemical technique. RESULTS: Bcl-2 immunopositivity was detected in 44/58 of the samples in different grades of intensity. There was no correlation of nuclear grade, tumoral size, stage or recurrency with bcl-2 immunopositivity. Bcl-2 expression was not related to prognosis if we divided all cases into subgroups according of stain intensity. CONCLUSIONS: Bcl-2 expression was not related with any pathological parameters; size, nuclear grade and stage or prognostic.

Apoptosis↗
PubMed2002

[Expression of p21ras in locally confined renal adenocarcinoma and its prognostic implications].

OBJECTIVE: The p21ras protein is encoded by the three ras genes (H-, K- and N-ras) and participate in the regulation of normal cell growth and cell differentiation. The objective of this study is to determine the expression of this protein in locally confined renal cell carcinoma, as well as its relations with different histopathological variables and their prognostic implications. METHOD: 58 renal cell carcinomas, in pT1-T3a N0 M0 (TNM 1997) stages, treated by radical or partial nephrectomy with curative intention. We analysed different clinical and anatomopathological variables, as well as expression of p21ras in paraffinated tissue, using immunohistochemical techniques. RESULTS: The mean percentage of stained nuclei was 6.1%, with a range lying between 0 and 45%. We did not obtain statistically significant association between expression of p21ras and the tumour size (p = 0.698), the nuclear grade (p = 0.676) or the histopathological stage (p = 0.095). The survival analysis also did not show significant differences when we stratified the patients using the mean value of the sample as reference point (p = 0.134). CONCLUSIONS: Expression of p21ras was not demonstrated to be related to any of the histopathological variables analysed: size, grade and stage, or with survival. Therefore, this protein does not appear to be related to the evolution of renal cell carcinoma.

Carcinoma, Renal Cell↗
PubMed2001

[Prevalence of prostatic intraepithelial neoplasia in Spain].

OBJECTIVE: To study the prevalence of high grade prostatic intraepithelial neoplasia in a Spanish population and to compare it with the prevalence in Caucasians of other countries and Afro-Americans. METHODS: 162 prostates obtained at autopsy from Spanish men aged 20-80 years, were fixed in 10% formalin and slices perpendicular to the posterior margin were made every 3-4 mm along its entire length. All blocks were embedded in paraffin and examined microscopically. Mapping of focality and site of the high grade prostatic intraepithelial neoplasia was done for each case. The Wayne University autopsy study was used for comparison of the prevalence in other countries and races. RESULTS: 146 prostates from men with a mean age of 48.5 years were considered valid for histological analysis. There were 42 high grade prostatic intraepithelial neoplasia; 20 were focal and 22 multifocal. By age group, the prevalence of high grade prostatic intraepithelial neoplasia were 7.1%, 14.7%, 28.5%, 33.3%, 45.4% and 51.8% for the 3rd, 4th, 5th, 6th, 7th, and 8th decades. CONCLUSIONS: High grade prostatic intraepithelial neoplasia begins to manifest in the Spanish population after the 3rd decade. It is usually focal and peripheral, and significantly increases with age and becomes multifocal. Its prevalence in the Spanish population is moderately lower than in American Caucasians and significantly lower than in Afro-Americans.

Adult↗
PubMed2000

[Clinical trial to evaluate trospium chloride (Uraplex) effectiveness and tolerance in patients with detrusor instability incontinence and its impact on quality of life].

OBJECTIVE: To determine the efficacy, tolerance and quality-of-life effects of trospium chloride in women with overactive bladder. METHODS: An open, prospective multicenter trial was conducted on 75 women with urinary incontinence from overactive bladder (ICS criteria, urodynamic evaluation). Trospium chloride was administered at a dose of 20 mg twice daily for 8 weeks. Neurological examination and cystometry were performed at the start of the trial. Quality of life was evaluated by analogue visual scales (faces scale) and EUROQOL (health status scale). At the 4th week, urodynamic, clinical, quality-of-life and tolerance evaluations were performed. Clinical and tolerance data and quality of life index were assessed at the 8th week. RESULTS: 8 of the 75 patients did not complete the study. Thus, analysis of the therapeutic efficacy was performed in 67 patients, while description and tolerance analyses were performed for the overall group of patients. Urodynamic parameters significantly improved at 4 weeks: maximum bladder capacity (232.09 ml pre-treatment vs 315.83 ml post-treatment) and first desire to void (100.9 ml pre-treatment vs 156.7 ml post-treatment). Incontinence clinical items also improved. All quality-of-life indixes significantly increased at the 4 and 8 weeks control evaluation. Excellent or very good tolerance was observed in 89.5% of the patients. CONCLUSIONS: The results of the study corroborate the efficacy and tolerance of trospium chloride in the management of overactive bladder in women. Improvement in patient quality of life was also observed.

Benzilates↗
PubMed1998

[Postoperative vesicourethral neurogenic dysfunction: the conceptual and clinical aspects based on the analysis of a series of 152 patients].

OBJECTIVE: To analyze the terminological and conceptual aspects of post-surgical vesicourethral neurogenic dysfunction, as well as the etiological, clinical and urodynamic data. METHODS: We conducted a clinical and urodynamic study on 152 patients, 103 males (67.8%) and 49 females (32.2%), mean age 52.04 years, who presented with neurogenic bladder dysfunction after surgery or exploratory maneuvers. The preoperative urodynamic study was available in 123 cases (80.9%). The study protocol included patient clinical history, neurological physical examination to determine the level of the lesion and a complete urodynamic study (Wiest 8000), including selective sphincteric electromyography. RESULTS: The study group comprised 59 patients (38.8%) who had undergone a neurosurgical procedure (25 patients had a disc hernia), 45 (29.6%) had undergone digestive surgery (abdominoperineal resection of the rectum was performed in 37 patients), 24 (15.7%) had undergone surgery for trauma (11 patients had a vertebral fracture), 12 (7.8%) had a urological procedure, 4 (2.6%) were referred from Gynecology and Obstetrics, 4 (2.6%) had received anesthesia or had undergone neurological explorations, 3 (1.9%) had undergone vascular surgery and 1 patient (0.6%) had received radiotherapy. The neurological lesions were supramesencephalic in 4 patients (2.6%), cervical in 14 (9.2%), dorsal in 6 (3.9%), lumbar in 6 (3.9%), conus medullaris in 17 (11.1%), cauda equina in 44 (28.9%) and peripheral in 61 (40.1%). Urinary incontinence (55 patients, 36.1%) was the most frequent cause for consultation. Other symptoms were difficulty in voiding (45 patients, 29.6%) acute urinary retention (33 patients, 21.7%), involvement of urge to void (33 patients, 8.5%) and daytime and/or nighttime frequency (6 patients, 3.9%). Acute urinary retention was statistically significant in the males (p < 0.05) and urinary incontinence in the females (p < 0.01). Incontinence was the most common symptom in patients submitted to radical prostatectomy. The correlation between conus medullaris lesion and acute urinary incontinence was significant (p < 0.001). Patients had referred symptoms for a mean of 8.5 +/- 30.7 months. Bladder reflex on cystomanometry was absent in 100 patients (65.8%) and present in 52 (34.2%). Thirty (57.6%) had voluntary and 22 (42.3%) had involuntary reflex (hyperreflexia). On electromyographic evaluation, baseline activity was normal in 84 patients (65.2%), diminished in 34 (26.3%) and absent in 11 (8.5%). The types of potentials were: normal in 35 cases (28.6%), positive waves 16 (13.1%), fibrillation in 24 (19.6%), polyphasic in 38 (31.1%), potentials with increased duration and/or amplitude in 8 cases (6.5%) and repetitive discharges in 1 case (0.8%). The following types of neurogenic vesicourethral dysfunctions were found: neurogenic shock in 10 patients (6.5%), lower motor neuron dysfunction in 109 (71.7%), upper motor neuron dysfunction in 22 (14.4%) and mixed motor neuron dysfunction in 11 (7.2%). CONCLUSIONS: The term 'postsurgical vesicourethral neurogenic dysfunction' overcomes the limitations of previous terminology (e.g., iatrogenic neurogenic bladder) since it refers to the neurogenic dysfunction that presents after surgery regardless of the previous study. It is possible to obtain a clinical and urodynamic map of this condition whose etiology can be found fundamentally in disc hernia surgery (neurosurgery) and abdomino-perineal resection of the rectum (digestive surgery).

Adolescent↗
PubMed1998

[The Leydig-cell testicular tumor. A case report with magnetic resonance images].

OBJECTIVE: An additional case of testicular Leydig cell tumor in a young man is reported. The clinical presentation included gynecomastia and a testicular mass. METHODS/RESULTS: Hormonal studies, testicular US and high resolution MRI were performed before orchidectomy. The histopathological findings were consistent with Leydig cell tumor. A CT scan revealed no metastasis. The patient is clinically disease-free 18 months after orchidectomy. CONCLUSION: High resolution MRI must be performed only when clinic and US findings are discordant.

Adult↗
PubMed1996

[Prognosis prediction in patients with transitional cell carcinoma of the urinary bladder].

OBJECTIVES: Many attempts have been made during decades to identify factors predictive of prognosis in patients with transitional cell carcinoma (TCC) of the bladder. The present study attempts to determine the predictive factors in a large series of patients with long follow-up homogeneously treated at three institutions from 1983 to 1992. METHODS: The clinical and histological factors with presumed prognostic value were retrospectively evaluated in a series of 331 patients with a mean follow-up of 7.2 years, and a study of survival was performed. RESULTS: Univariate analysis showed tumor stage, growth pattern, grade, size, coexisting dysplasia, histologic type, topography of the lesion and patient age are useful parameters for the prediction of prognosis. The Cox analysis revealed tumor stage is the most important prognostic variable (Beta = 1.23, p < .001), followed by growth pattern as determined by the presence or absence of a papillary phenotype (Beta = 1.18, p < .001), tumor size (Beta = .98, p < .001), WHO modified histologic grading considering persistence or loss of cell polarity (Beta = .73, p < .01), tumor location (Beta = .48, p < .05), and histology (presence or absence of phenotypes other than pure TCC, Beta = .45, p < .05). Coexisting dysplasia, tumor multiplicity, age and sex did not independently influence survival. CONCLUSION: Despite the advancements in the field of molecular biology relative to prognostic markers in bladder cancer, the conventional morphological parameters and tumor stage continue to be the main source of prognostic information in clinical practice.

Adult↗
PubMed1995

[Obstruction of the lower urinary tract: contractile capacity of the detrusor and obstruction degree. Analysis of pressure/flow curves].

OBJECTIVES: This study attempts to optimize information from pressure/flow curves of patients with obstructive symptoms. METHODS: We performed a computerized analysis of the pressure/flow ratio of 50 consecutive patients with benign prostatic hyperplasia and irritative and obstructive symptoms. All patients were evaluated urodynamically. This model (pressure/flow diagram) will allow application of this test (expressed as flow and pressure measurements) to urethral outflow resistance and detrusor power or energy. Outflow obstruction is classified into seven categories (O-VI) and detrusor contractility in four (very weak, weak, normal and strong). RESULTS: The suitability of urodynamic analysis was demonstrated. Those cases considered as indeterminate by the conventional method can be obviated by computerized analysis. The degree of obstruction and the contractile capacity were determined in these cases. CONCLUSIONS: This method provides more accurate information on pathophysiology of voiding, allowing for better diagnosis of outflow obstruction or poor detrusor contractility and avoids the diagnosis of "undetermined".

Aged↗
PubMed1995

[Malacoplakia of the prostate and seminal vesicle. Ultrastructural study and review of the literature].

OBJECTIVES: The present study describes a case of malacoplakia of the genitourinary tract arising in the seminal vesicle and prostate and reviews similar cases previously reported in the literature. METHOD: A 67-year-old male consulted for hemospermia and voiding symptoms. Prostatic neoplasm was suspected on the basis of the clinical and radiological findings. RESULTS: The diagnosis was made only after biopsy and histological analysis. Electron microscopy is a very useful tool. Long-term antibiotic therapy may achieve optimal results. Treatment with fluoroquinolones was successful. CONCLUSION: To avoid unwarranted radical approaches, we underscore the possibility that prostatic pseudotumors may be misinterpreted as neoplasia. Malacoplakia is diagnosed only by histology and requires medical treatment.

Aged↗
PubMed1995

[Surgical treatment of male hypospadias with pediculated transversal preputial flap technique: a 10-year follow-up].

OBJECTIVES: The study was conducted to evaluate the long-term follow-up micturition data, sexual function and cosmetic results of hypospadias surgical repair. METHODS: 14 males (mean age 19.6 yrs) submitted to hypospadias surgical repair with the pedicled preputial tubulized flap technique 10 years ago were evaluated. RESULTS: The most frequent site of the anomaly was the distal third of penis (85.6%). The micturition data were excellent and urinary flow rates were normal in 92.8%. Erection and ejaculation were normal in all patients. Penile curvature persisted in 14.2%; 64.2% of the patients had sexual intercourse (completely satisfactory in 66.6%), penis size was normal in 78.6% and 66.6% of the patients were married and had children. No longterm follow-up complications were observed. CONCLUSIONS: The technique achieved excellent cosmetic and functional results.

Adolescent↗
PubMed1995

[Conceptual review of simple renal ectopy and suggestion of a unifying embryogenetic hypothesis].

Proposal for a conceptual review of the theories currently used to explain the pathogenesis of single kidney ectopia. The inner mechanisms which generate this frequent anomaly in the positioning and rotation of the kidneys are far from being understood. Based on a critical review of the literature and our own observational findings, we believe the single kidney ectopia is a time-dependent embryo-development change model which can be used as a ¿chronopathy¿ paradigm.

Humans↗
PubMed1994

[Radical prostatectomy: usefulness of selective electromyography of the periurethral sphincter in the assessment of urinary continence].

The exact mechanisms of urinary continence in patients submitted to radical prostatectomy remain unknown. The aim of our study was to evaluate these mechanisms of continence through a complete urodynamic study, with a special emphasis on selective electromyography of the periurethral aphincter. Of a total of 10 consecutive patients who underwent radical prostatectomy between 1990-1993, a complete clinical control of urinary continence was demonstrated in 7 patients. The complete urodynamic work-up and particularly selective electromyography of the periurethral sphincter permitted evaluating the distal sphincteric mechanism and the degree of functional capacity. All of the cases showed loss of motor units, diminished electromyographic sphincter activity and incomplete lesion of the inferior motor neuron. The present study analyzed the pathophysiological, clinical and urodynamic aspects of these patients.

Aged↗
PubMedDate not supplied

[Metastatic renal carcinoma of the breast. Presentation of 2 cases diagnosed by fine-needle aspiration puncture].

Two cases of breast metastases from renal carcinoma are described herein. One patient underwent nephrectomy two years earlier and the other patient presented with bilateral involvement. The cytological features gleaned from fine needle aspiration biopsy are described. The diagnostic value of fine needle aspiration is underscored. This procedure makes surgery unnecessary and, furthermore, permits instituting a more adequate therapy.

Adenocarcinoma↗