[Other obstructive diseases: byssinosis, chronic bronchitis and occupational COPD and eosinophilic bronchitis]. / Otras enfermedades obstructivas: bisinosis, bronquitis crónica y EPOC de origen laboral y bronquitis eosinofílica.

Besides occupational asthma and diseases derived from acute inhalation, other obstructive diseases also have an occupational origin. Although at present byssinosis is a rare disease in Spain, we describe its characteristics because of its historical interest amongst occupational respiratory diseases and because it is still relevant in developing countries. Chronic bronchitis can also be related to exposure at work to dust and smoke, and is often referred to as "industrial bronchitis". Historically, the relation of CPOD to occupation has been subject to controversy, but nowadays this relationship is accepted; we describe the present evidence supporting this relationship. Finally, we describe eosinophilic bronchitis without asthma, an entity that was described for the first time in 1989 and that can sometimes have an occupational origin, sharing aetiological agents with occupational asthma.

[Genetic analysis results of patients with a retinoblastoma refractory to systemic chemotherapy]. / Resultados del analisis genético de los pacientes con retinoblastoma resistente a quimioterapia sistémica.

OBJECTIVE: To analyze the genetic alterations identified in the RB1 gene in retinoblastoma patients who do not respond to systemic chemotherapy. METHODS: A genetic analysis was performed on 115 patients with retinoblastoma, 40 of whom had received systemic chemotherapy, and 29 of them had bilateral disease. Descriptive and retrospective study. Non-responders were considered as patients who are finally enucleated. RESULTS: Patients with deletion type mutations are those with less preservation of the eyeball (Pearson Chi-square, P=.055). Patients with an impaired nonsense-frameshift type are more likely to preserve the eyeball. Of the 3 patients who had undergone bilateral enucleation, 2 of them had deletions and one missense alteration. Survival analysis (Kaplan-Meier curve) shows that patients with deletion type mutations are more resistance to chemotherapy, are suffering higher rates of enucleation, and for a shorter period of time (log rank [Mantel-Cox] with a significance level of P=.053), which are also associated with increased rate of being bilateral. CONCLUSIONS: Patients with a genotype show increased resistance to chemotherapy should be evaluated more closely and treated with various therapeutic weapons early. Patients that have deletions in the RB1 gene are at increased risk of chemoresistance. It is likely that other genetic alterations other than RB1 gene may be related to tumor aggressiveness and treatment resistance.

Linear shock wave therapy in the treatment of erectile dysfunction.

INTRODUCTION: Linear Shock Wave Therapy (LSWT) is a new noninvasive therapy that uses low-intensity shock waves to induce local angiogenesis promising modality in the treatment of erectile dysfunction (ED). OBJECTIVE: To evaluate the effectiveness of LSWT in men with vasculogenic erectile dysfunction (ED), in a Tertiary Care Center. MATERIAL AND METHODS: Included 15 men aged 45-70 years, sexually active with mild and moderate vascular ED evaluated with the International Index of Erectile Function (IIEF). The study was conducted in three stage: screening, treatment and results. Treatment stage: 4 weekly sessions LSWT (RENOVA ®) 5000 waves (.09mJ/mm(2)). Erectile function was assessed with IIEFF-EF, SEP (Sexual Encounter Profile) and GAQ (Global Assessment Questions) at one and six months after treatment. RESULTS: The rate of success was 80% (12/15). Patients with mild ED (6/15) 40% and moderate ED (9/15) 60%. We found a positive association between IIEF-Basal (average 14.23 pts) and IIEF at one month and six months after therapy (19.69 pts) a difference of 5.46 pts. (P<.013). CONCLUSIONS: The feasibility and tolerability of this treatment, and rehabilitation potential features, make it this an attractive new treatment option for patients with ED.

Genetic analysis in retinoblastoma and peripheral blood correlation.

OBJECTIVE: To determine the importance of intratumoral genetic analysis in the diagnosis of germ-line mutations in patients with retinoblastoma. To underline the importance of performing these genetic tests in every case of retinoblastoma. METHOD: Intratumoral genetic analysis of RB1 mutation was performed on 17 enucleated eyes that were non-responsive to conservative treatment. Patients had no family history of retinoblastoma, and lesions were always single. The identified mutations were then also studied in peripheral blood analysis. RESULTS: There were 12 (70.6%) cases with positive results in intratumoral analysis. In 8 cases (47.1%) mutation of both RB1 alelli were detected, and in 4 (23.5%) cases only one allele was found mutated. In 5 patients (29.4%) no mutation was identified. In the first hit, mutations comprised 7 frameshift or nonsense and 2 splice, whereas in the second hit, one splice mutation, 2 nonsense and 8 loss of heterozygosity were identified. Among 6 patients where intratumoral analysis detected a single mutation associated with a loss of heterozygosity, the peripheral blood analysis was able to detect the same mutation in 3 cases (50%). CONCLUSIONS: Intratumoral genetic analysis of sporadic retinoblastoma can detect germ-line mutations. These patients are at higher risk of bilateralization and development of second tumors or trilateral retinoblastoma. Genetic screening is recommended in every patient diagnosed with retinoblastoma.

Laser flash photolysis studies of electron transfer in complex III from yeast mitochondria.

The kinetics of reduction of cytochrome b and cytochrome c1 of yeast Complex III by 5-deazariboflavin semiquinone, generated by laser flash photolysis under anaerobic conditions, have been investigated. The reduction of cytochrome b occurs in two phases with first-order rate constants of 1300 and 670 s-1, whereas the reduction of cytochrome c1 appears as a unique exponential phase with an intermediate value of 800 s-1. Under these experimental conditions, about 50% of cytochrome b is reduced in comparison with cytochrome c1. After photoreduction, the re-oxidation of the cytochromes by internal re-equilibrium occurs in both cases, following pseudo-first-order kinetics at a rate constant of 43 s-1 for cytochrome b and 39 s-1 for cytochrome c1. These results, which agree with the data from the rapid mixing technique (A.-L. Tsai, J.S. Olson, G. Palmer, J. Biol. Chem. 262 (1987) 8677-8684), have implications for the mechanistic understanding of inner Complex III electron transfer. One of the goals of the investigation reported here is to provide direct evidence for the hypothesis of a proton-motive Q cycle for the mechanism of electron transfer in Complex III. Moreover, these results demonstrate the usefulness of laser flash photolysis in studying the redox kinetic properties of mitochondrial Complex III.

Derivatives of carbohydrazide, thiocarbohydrazide and diaminoguanidine as photometric analytical reagents-I 1,3-bis[(2-pyridyl)methyleneamino]thiourea and 1,3-bis[(2-pyridyl)methyleneamino]guanidine.

1,3-Bis[(2-pyridyl)methyleneamino]thiourea (PMAT) and 1,3-bis[(2-pyridyl)methyleneamino]-guanidine (PMAG) have been prepared. They have been examined and characterized by infrared and ultraviolet spectroscopy. A spectrophotometric method has been used for determination of the protonation constants of the reagents. Finally, a spectrophotometric survey has been made of the reactions of various cations with PMAT and PMAG.

Spectrophotometric determination of gallium in alloys and fly-ash with pyridoxal derivatives of thiocarbohydrazide and carbohydrazide.

The symmetric derivatives of pyridoxal with thiocarbohydrazide and carbohydrazide, and the asymmetric derivatives of pyridoxal and salicylaldehyde with the same hydrazides have been synthesized and their analytical potential for spectrophotometric and kinetic fluorimetric determination of metal ions was studied. Gallium(III) and PyMAU(1,3-bis{[4-(2-methyl-3-hydroxy-5-hydroxymethyl)pyridyl]methyleneaminourea at pH = 4.2 form a complex with a single absorption maximum at 425 nm, which can be extracted into cyclohexanone in the presence of a controlled amount of sodium perchlorate. The extract has maximum absorbance at 435 nm. Both systems can be used for determining gallium. The optimal range of gallium concentration for measurement in a 1-cm cell is 0.5-1.25 gmg/ml for the procedure in homogeneous medium ((425) = 3.76 x 10(4).mole(-1).cm(-1)) and 0.25-1.25 mug/ml for the extraction procedure ((435) = 5.30 x 10(4) 1.mole(-1).cm(-1). The latter procedure has been applied to the determination of gallium in alloys and fly-ash.

Simultaneous determination of cefepime and grepafloxacin in human urine by high-performance liquid chromatography.

A liquid chromatographic method with UV detection for simultaneous determination of cefepime and grepafloxacin has been developed. The method uses a C18 column, equipped with a pre-column of the same material, and acetonitrile-0.1 M phosphoric acid/sodium hydroxide buffer (pH 3.0)-0.01 M n-octylamine (pH 3.0) as mobile phase in gradient mode. Mobile flow rate and sample volume injected were 1.3 mL min(-1) and 20 microL, respectively. Detection wavelengths were 259 nm for cefepime and 278 nm for grepafloxacin. The retention times were 4.03 min for cefepime and 8.85 min for grepafloxacin, with detection limits of 1.0 and 1.1 microg mL(-1), respectively. The method was applied to the determination of both antibiotics in spiked samples of human urine.

[Anisakidosis of the colon as a cause of acute abdomen]. / Anisakidosis del colon como causa de abdomen agudo.

We report a case of acute abdomen caused by the invasion of the ascending colon by larvae of Anisakis simplex in a 57 year-old-woman whose initial symptoms were colic abdominal pain, diarrhea and fever. The diagnosis was done by the histological study of the surgical specimen in which two parasites were morphologically identified in the submucosa. Although a causal relationship of the disease with the ingestion of crude fish could not be established initially, there were antecedents of ingestion of anchovy in vinegar (Engraulis encrasicholus) and dyspeptic symptoms for several months.

[Vesicovaginal fistulas: correction using lyophilized dura mater]. / Fístulas vesicovaginales: corrección con duramadre liofilizada.

Thirty three cases of surgically corrected vesicovaginal fistulae, from a total of 73 patients with iatrogenic or pathological urinary tract conditions examined and treated in our service, are presented in this paper. Both the etiology and different surgical techniques that can be used are reviewed, contributing the novelty use of freeze dried dura mater as the material to interpose for the correction of the fistulae by means of abdominal surgical techniques. The material was used in 6 patients, with recovery being obtained in all cases and achieving the fistulae closure with a single surgical procedure.

[Cerebral metastasis as first manifestation++ of a bladder carcinoma]. / Metástasis cerebral como primera manifestación de un carcinoma vesical.

The infiltrant vesical carcinoma shows a tendency to become metastatic in a high percentage of cases, so that the preferred sites are usually the retroperitoneal lymph nodes, liver and bone. CNS metastasis is an uncommon fact, but it is even less common to find CNS affectation symptoms even before the appearance of any signs and symptoms related to the vesical affectation itself. Contribution of one case of infiltrant vesical carcinoma which presented with focal neurological symptomatology as its first manifestation.

[Giant urethral lithiasis]. / Litiasis uretral gigante.

We present a case of giant urethral lithiasis, housed in the penile urethra. Owing to the scant incidence of this pathology and its rarity, as well as the small number of bibliographic references found, we believe it of interest to offer this fresh case.

[Priapism caused by cauda equina compression. Report of a case and review of the literature]. / Priapismo por compresión de cauda equina. Aportación de un caso y revisión de la literatura.

As a result from the mechanical irritation provoked on the sacral roots, the cauda equina compression syndrome can involve, as part of its symptomatic state, involuntary erections and mictional disorders which arise when standing and stretching the spine. In the eight cases of priapism from this cause reported in the international literature, surgical decompression has solved the clinical picture. We now present a new case with the peculiarity that, following unsuccessful surgical therapy, the infiltration of the compromised spinal roots has rendered excellent results.

[Granulomatous prostatitis. An infrequent diagnosis. Review of our series]. / La prostatitis granulomatosa. Un diagnóstico infrecuente. Revisión de nuestra serie.

Granulomatous prostatitis is an inflammatory condition of the prostate which presents rarely in the urological practice. It is caused by several specific and unspecific infectious agents, and can also be secondary to prostate surgery or a local reflection of a systemic granulomatous disease. With regard to clinical manifestations and treatment, it is an unspecific entity which has a characteristic histopathology. Its major interest consists on the possibility of it being mistaken for a prostate cancer during physical examination. This paper reviews a series of 7 granulomatous prostatitis, with special emphasis on their histology and ultrasound findings.

[Ectopic gas as a complication of surgical kidney biopsy]. / Gas ectópico como complicaciones de la biopsia renal quirúrgica.

Since the complications herewith presented as a consequence of surgical renal biopsy are really exceptional and references found in the existing literature rare, we have considered that the contribution of these two cases which developed a pneumomediastinum-pneumoperitoneum and pneumocele prespectively during the immediate post-surgical period would be of interest. Evolution was favourable in both cases, with spontaneous resolution of the process.

[Purulent urethritis secondary to intraurethral foreign body]. / Uretritis purulenta secundaria a cuerpo extraño intrauretral.

Due to the rarity of the cases presented in this paper, the prolonged time of residence in the urethra and the limited functional repercussion produced by the foreign bodies lodged in the urethra, we consider convenient the exposition of the mentioned cases.

[Abdominal paragangliomas. The experience of the Hospital 12 de Octubre]. / Paragangliomas abdominales. Experiencia del Hospital 12 de Octubre.

This is a revision of our experience between 1975 and 1992 over a total of 35 patients who underwent surgery in 40 occasions for pheochromocytoma. If we dismiss one case of pheochromocytoma with early metastatic malignant presentation and which was not removed, a total of 6 patients with abdominal paraganglioma (17%) have undergone surgery in 10 occasions. Three of them (50%) were multiple and recurrent, an one (16%) become malignant after multiple recurrences. Average age was 34.6 years with balanced sex distribution. No patient had neurofibromatosis, Von Hippel Lindau disease, MEN syndromes or Carney's triad and only one case, which corresponded to the malignant pheochromocytoma, showed direct familial background. All patients were hypertensive. Four cases (66%) presented with catecholamine crisis, one case was an incidentaloma that at the 24-hour monitoring presented hypertensive crisis during the sleep, and the last one was diagnosed while investigating a case of sustained HTA in a young female. All patients had high urinary catecholamine excretion. To establish location of the tumour MIBG scanning (90% sensitivity) was used in first place followed by guided CT (80% sensitivity) since both techniques have a good correlation in order to design the surgical approach. Angiography was reserved for cases where the other two techniques were inconclusive or when it was necessary to obtain a better profile of the surgical anatomy. A total of 15 paraganglioma were removed, the most frequent location being renal parahilar (26%) followed by preaortic in Zuckerkandl's organ (20%) and vesical (20%). The most relevant intraoperative complications were HTA crisis related to anaesthetics manoeuvres and tumoral handling (90%), and hypotension following tumour exercises (10%). During the postoperative period, three patients required blood transfusion and one of them had to be re-intervened for bleeding caused by unnoticed damage to the right renal vein. Currently, three patients (50%) are disease free, one with residual mild HTA controlled with diuretics. Two patients (33%) are awaiting for re-intervention due to recurrence (one with multiple extra-abdominal recurrence) after one and two prior interventions respectively. The last one (16%) is the malignant pheochromocytoma, operated four times for recurrence which currently shows lung metastasis with adequate drug control of clinical manifestations, after polychemotherapy failure and 27-months follow-up since metastasis has been detected. Revision of existing literature and discussion of issues related to signs and symptoms, diagnosis, surgical preparation and approach, as well as prognostic implications related to paraganglioma as compared with adrenal-located pheochromocytoma.