Tratamiento de la litiasis con láser en condiciones especiales / Treatment of urinary stones with laser in special conditions

Durante la última década, se ha producido un rápido desarrollo en la nefroscopia y la ureterorrenoscopia flexible, litotricia láser y diferentes instrumentos para manejar las litiasis. Realizaremos una revisión del empleo del láser en distintas situaciones. Se deben hacer esfuerzos para minimizar el daño renal y el láser juega un papel importante en el tratamiento de pacientes con urolitiasis y riñones en herradura, insuficiencia renal crónica, pacientes neurológicos (AU)

During the last decade there has been a rapid development in flexible nephroscopy, flexible ureterorenoscopy, laser lithotripsy and instruments for stone manipulation. We are going to review the use of Laser in the management of lithiasis in different situations. Efforts should be made to minimize renal injury and lasers play a significant role in patients with urolithiasis and horseshoe kidneys, chronic renal failure, neurological patients (AU)

[Treatment of urinary stones with laser in special conditions]. / Tratamiento de la litiasis con láser en condiciones especiales.

During the last decade there has been a rapid development in flexible nephroscopy, flexible ureterorenoscopy, laser lithotripsy and instruments for stone manipulation. We are going to review the use of Laser in the management of lithiasis in different situations. Efforts should be made to minimize renal injury and lasers play a significant role in patients with urolithiasis and horseshoe kidneys, chronic renal failure, neurological patients.

[Anti-apoptotic potencial role of p38 in prostate cancer]. / Potencial anti-apoptótico de p38 en cáncer de próstata.

INTRODUCTION: TNF-alpha transduction pathway in prostate cancer seems to be diverted towards p38 activation. P38 may protect prostate tumoral cells from TNF-alpha apoptosis induced. The aim of this study was study the role of p38 in vivo (were evaluated some p38 downstream factors), as well as in vitro (in prostatic tumoral cell lines, LNCaP and PC3, pre-treated with TNF-alpha). MATERIAL AND METHODS: Two prostatic tumoral cell lines (LNCaP and PC3) were used in in vitro studies. Two different experiments were made: with TNF-alpha (several concentrations) and p38 specific inhibitor (SB203580). The apoptotic index were evaluated using DAPI staining and flow cytometry. P38 activation was measured by Western blot analysis. 15 normal samples (NP) and 27 prostate cancer samples (PC) were used in in vivo study, all of them were processed for immunohistochemistry and Western-blot. RESULTS: In vitro, TNF-alpha induced apoptosis in LnCap when we increased its concentration but not in PC3. TNF-alpha stimulation led to increase a time-dependent p38 phosphorylation in two intermediate doses whereas in PC3 not changes were found. In LNCaP after its preincubation with SB203580 and TNF-alpha treatment showed a significative increasing of apoptosis. In vivo, all NP samples were found positives to p-Elk-1 and p-ATF-2 (nuclei of epithelial cells). In PC the expression of p-Elk-1 or p-ATF-2 increased and was located in the nucleus and cytoplasm of epithelial cells. CONCLUSION: Our data in vitro and in vivo suggest that p38 plays a very important role in prostatic tumour progression. These data suggest that the control activation of p38 might be a possible target to cancer prostate treatment.

Potencial anti-apoptótico de p38 en cáncer de próstata / Anti-apoptotic potencial role of P38 in prostate cancer

Introducción: En cáncer de próstata, la vía de señalización intracelular de TNF-α parece estar desviada hacia la activación de p38. p38 podría proteger a las células tumorales de la muerte inducida por TNF-α. Nos propusimos estudiar el papel que desempeña p38 tanto in vivo (evaluando algunos factores activados por p38 en cáncer de próstata), como in vitro (en las líneas celulares tumorales de próstata LNCaP y PC3, tratadas previamente con TNF-α).Material y métodos: Para los estudios in vitro se utilizaron las líneas celulares LNCaP y PC3. Los tratamientos se realizaron con TNF-α (diferentes concentraciones) y el inhibidor específico de p38 (SB203580). El índice apoptótico se evaluó mediante DAPI y citometría de flujo. La activación de p38 se determinó mediante Western blot. Para los estudios in vivo se usaron 15 próstatas normales (PN) y 27 de cáncer (CP) procesadas para inmunohistoquímica y Western blot. Resultados: In vitro, el aumento de la concentración de TNF-α indujo apoptosis en LNCaP, pero no en PC3. El tratamiento con TNF-α produjo un aumento de la fosforilación de p38 en concentraciones intermedias, mientras que enPC3 no se observaron cambios en la activación. El pretratamiento con SB203580 y TNF-α produjo un aumento significativo de la apoptosis en LNCaP. In vivo todos los pacientes con PN resultaron positivos para p-Elk-1 y p-ATF-2 (núcleo de células epiteliales). En CP no sólo aumenta la expresión de estos factores, sino que se localizaron tanto en núcleo como en citoplasma. Conclusión: Nuestros datos in vitro e in vivo sugieren que p38 juega un importante papel en la progresión del cáncerde próstata. Estas observaciones sugieren que tratamientos centrados en el control de la activación de p38 podrían serefectivos en el tratamiento contra el cáncer de próstata (AU)

Introduction: TNF-α transduction pathway in prostate cancer seems to be diverted towards p38 activation. P38 may protect prostate tumoral cells from TNF-α apoptosis induced. The aim of this study was study the role of p38 in vivo (were evaluated some p38 downstream factors), as well as in vitro (in prostatic tumoral cell lines, LNCaP and PC3, pre-treated with TNF-α).Material and methods: Two prostatic tumoral cell lines (LNCaP and PC3) were used in in vitro studies. Two different experiments were made: with TNF-α (several concentrations) and p38 specific inhibitor (SB203580). The apoptotic index were evaluated using DAPI staining and flow cytometry. P38 activation was measured by Western blot analysis. 15 normal samples (NP) and 27 prostate cancer samples (PC) were used in vivo study, all of them were processed for immunohistochemistry and Western-blot. Results: In vitro, TNF-α induced apoptosis in LnCap when we increased its concentration but not in PC3. TNF-α stimulationled to increase a time-dependent p38 phosphorylation in two intermediate doses where as in PC3 not changes were found. In LNCaP after its preincubation with SB203580 and TNF-α treatment showed a significative increasing of apoptosis. In vivo, all NP samples were found positives to p-Elk-1 and p-ATF-2 (nuclei of epithelial cells). In PC the expression of p-Elk-1 or p-ATF-2 increased and was located in the nucleus and cytoplasm of epithelial cells. Conclusion: Our data in vitro and in vivo suggest that p38 plays a very important role in prostatic tumour progression. These data suggest that the control activation of p38 might be a possible target to cancer prostate treatment (AU)

[Simplified Ramírez urethropexy in the treatment of genuine stress urinary incontinence in women. Multicenter study of clinical and urodynamic results]. / Uretropexia simplificada de Ramírez en el tratamiento de la incontinencia urinaria de esfuerzo genuina en la mujer. Estudio multicéntrico sobre los resultados clínicos y urodinámicos.

OBJECTIVES: To evaluate the clinical and urodynamic data of a multicenter study on female urinary stress incontinence undergoing surgical repair with the Ramírez simplified urethropexy. METHODS: Clinical, urodynamic and videocystographic data were analyzed in a multicenter series of 340 female patients with urinary stress incontinence (mean age 51.7 +/- 9.7 years) before and after the Ramírez urethropexy technique (mean follow-up 21.7 months). RESULTS: Post surgical urinary continence was 78.4%. Cystocele repair was demonstrated in 57.7%. Urge incontinence decreased in 17.1%. Daytime frequency statistically significantly decreased in 19%. Urinary obstructive symptoms increased in 19.3%. Bladder instability significantly decreased posturethropexy. Peak urinary flow rate and mean urinary flow rate diminished in 65% and 59%, respectively. Postvoiding residual urine increased significantly. No statistical correlation between posturethropexy continence and videocystographic bladder neck morphology was observed. CONCLUSIONS: The clinical and urodynamic data obtained in our series indicate that the Ramírez urethropexy technique, a simple and fast procedure, may be considered an alternative treatment in female urinary stress incontinence.

[Synchronous bilateral renal oncocytoma]. / Oncocitoma renal bilateral sincrónico.

OBJECTIVES: The present study reports a case of bilateral synchronous renal oncocytoma and reviews similar cases described in the literature. METHODS: The present case was incidentally discovered in an 81-year-old female during evaluation for GI disease. The arteriogram was suggestive of oncocytoma and was confirmed by aspiration biopsy. The patient refused surgery. At 42 months' follow-up, the size and degree of invasion of both tumors remain unchanged. To our knowledge, only 20 cases of bilateral synchronous oncocytoma have been reported in the literature and only 6 of these were multifocal lesions. RESULTS: Renal oncocytoma, like salivary gland lesions, may spread as an advanced stage multifocal nodular oncocytic hyperplasia. Therefore it is not surprising to detect multiple synchronous or metachronous oncocytomas. CONCLUSIONS: Bilateral renal masses are a diagnostic and therapeutic difficulty, and even more so in the absence of systemic manifestations, hereditary disorders or a family history of renal tumor.