Alfredo Pérez Viondi (1871-1938) teniente coronel médico. Carrera militar, sanitaria, social y política / Alfredo Pérez Viondi (1871-1938) medical lieutenant colonel. Military, health, social and political career

Revisión de la biografía militar y civil del doctor Alfredo Pérez Viondi (1871-1938), desde su nacimiento, en La Habana, hasta su fallecimiento, en Vigo. Estudios, carrera militar, participación en la Guerra de Cuba y Marruecos, pasó por Santiago, La Coruña, Madrid, Huesca, Pontevedra y Vigo. Describimos su activa participación en la sociedad de las ciudades en las que residió y citamos a personajes destacados que le influyeron. Cumplió un importante papel en la defensa de la salud pública municipal en Vigo, donde fue alcalde (1929-1930). Ocupó el cargo de gobernador civil en Huesca (1931) y el de director del Hospital Militar de Vigo (1917-1931). Sin descendencia, sus escasas cargas familiares le permitieron volcarse en una brillante carrera profesional, militar y política. (AU)

Review of the military and civil biography of Dr. Alfredo Pérez Viondi (1871-1938), from his birth in Havana to his death in Vigo. Studies, military career, participation in the wars of Cuba and Morocco, passing through Santiago, La Coruña, Madrid, Huesca, Pontevedra and Vigo. We describe his active participation in the society of the cities he lived and we quote prominent figures who influenced him. In Vigo, where he was mayor (1929-1930), he played a very important role in defending municipal public health. He was civil governor of Huesca (1931) and director of the Military Hospital of Vigo (1917-1931). Without children, his few family responsibilities allowed him to concentrate on a brilliant professional, military and political career. (AU)

Alfredo Pérez Viondi (1871-1938) teniente coronel médico. Carrera militar, sanitaria, social y política / Alfredo Pérez Viondi (1871-1938) medical lieutenant colonel. Military, health, social and political career

Revisión de la biografía militar y civil del doctor Alfredo Pérez Viondi (1871-1938), desde su nacimiento, en La Habana, hasta su fallecimiento, en Vigo. Estudios, carrera militar, participación en la Guerra de Cuba y Marruecos, pasó por Santiago, La Coruña, Madrid, Huesca, Pontevedra y Vigo. Describimos su activa participación en la sociedad de las ciudades en las que residió y citamos a personajes destacados que le influyeron. Cumplió un importante papel en la defensa de la salud pública municipal en Vigo, donde fue alcalde (1929-1930). Ocupó el cargo de gobernador civil en Huesca (1931) y el de director del Hospital Militar de Vigo (1917-1931). Sin descendencia, sus escasas cargas familiares le permitieron volcarse en una brillante carrera profesional, militar y política. (AU)

Review of the military and civil biography of Dr. Alfredo Pérez Viondi (1871-1938), from his birth in Havana to his death in Vigo. Studies, military career, participation in the wars of Cuba and Morocco, passing through Santiago, La Coruña, Madrid, Huesca, Pontevedra and Vigo. We describe his active participation in the society of the cities he lived and we quote prominent figures who influenced him. In Vigo, where he was mayor (1929-1930), he played a very important role in defending municipal public health. He was civil governor of Huesca (1931) and director of the Military Hospital of Vigo (1917-1931). Without children, his few family responsibilities allowed him to concentrate on a brilliant professional, military and political career. (AU)

Marcelino Ramírez García (1864-1940) veterinario militar y médico, precursor del concepto: "Un mundo, una salud" / Marcelino Ramírez García (1864-1940) veterinarian of the Military Veterinary Corps, and medical doctor, forerunner of: "One world, one health"

Marcelino Ramírez García [Bergasa (La Rioja) 1864 - Logroño 1940] fue un veterinario militar y médico español de destacado nivel científico, que dedicó la mayor parte de su trabajo a la tuberculosis, tanto en el aspecto de la patología animal como humana; y a la relación entre ambas. Fue un trabajador integral en la lucha contra ese azote de la Humanidad, a la que históricamente se denominó «La peste blanca». Su inaudito equilibrio en el ejercicio de ambas profesiones le convierte, de pleno, en un precursor eminente del concepto: «Un mundo, una salud»

Marcelino Ramirez Garcia [Bergasa (La Rioja) 1864 - Logroño 1940] was a military vet and Spanish doctor leading scientific level, which devoted most of his work to tuberculosis, both in terms of animal pathology and human, and the relationship between both. It was an integral worker in the fight against this scourge of humanity to which historically was called «The White Plague». His unusual balance in the exercise of both professions, makes him fully an eminent precursor of the concept: «One world, one health»

El martirio de San Zoilo, una cuestión urológica. Historia y desarrollo de su tradición / The martyrdom of St. Zoilus, a urological issue. History and development of the tradition

Objetivos: Poner de manifiesto, por su interés urológico, el martirio de San Zoilo. Desarrollar la tradición sobre la advocación y culto al Santo y sentar la base histórica de la misma. Material y métodos: Estudio de la iconografía encontrada sobre el martirio de San Zoilo, repaso pormenorizado de la historia y tradición del mismo y estudio comparativo de los distintos santos reconocidos como abogados del dolor o males de los riñones. Resultado: Encontramos 3 cuadros en distintas iglesias y localidades en los que se representa la extracción de los riñones a San Zoilo. Además el hallazgo de 3 piezas, una arqueta conservada en el Museo Arqueológico Nacional y 2 telares conservados en la sacristía de la Iglesia del Monasterio de San Zoilo, en la localidad palentina de Carrión de los Condes, proporcionan abundante información sobre las circunstancias en que fueron realizadas. De su análisis estilístico podemos deducir su filiación a un ambiente artístico concreto y proponer, en consecuencia, un marco cronológico. Conclusión: Sin intención de destronar a San Liborio como patrón de los urólogos, cargo reivindicado con anterioridad por compañeros desde distintos países europeos, el martirio de San Zoilo es a la luz de la tradición e iconografía aportada indudablemente una cuestión urológica. Reivindicada queda la tradición desde un nuevo punto de vista 1.712 años después

Objectives: To highlight, for its urological importance, the martyrdom of St. Zoilus. To elaborate on the tradition of invocation and worship of the saint and to establish their historical bases. Material and methods: We conducted a study of the images of the martyrdom of St. Zoilus, with a detailed review of the history and tradition of the saint and performed a comparative study of the various saints known as patrons of kidney pain and disease. Result: We found three paintings in different churches and locations depicting the kidney extraction of St. Zoilus. In addition to the three pieces, a preserved chest at the National Archaeological Museum and 2 tapestries in the sacristy of the church of the monastery of St. Zoilus in the Palencian town of Carrion de los Condes provided abundant information on the circumstances in which they were made. By analysing the style, we can deduce its affiliation to a specific artistic milieu and thereby propose a timeframe. Conclusion: Without meaning to dethrone St. Liborius as the patron saint of urologists, an office claimed earlier by colleagues from various European countries, the martyrdom of St. Zoilus is, in light of the tradition and images provided, an unquestionable urological issue. The tradition is vindicated from a new viewpoint 1,712 years later

The martyrdom of St. Zoilus, a urological issue. History and development of the tradition. / El martirio de San Zoilo, una cuestión urológica. Historia y desarrollo de su tradición.

OBJECTIVES: To highlight, for its urological importance, the martyrdom of St. Zoilus. To elaborate on the tradition of invocation and worship of the saint and to establish their historical bases. MATERIAL AND METHODS: We conducted a study of the images of the martyrdom of St. Zoilus, with a detailed review of the history and tradition of the saint and performed a comparative study of the various saints known as patrons of kidney pain and disease. RESULT: We found three paintings in different churches and locations depicting the kidney extraction of St. Zoilus. In addition to the three pieces, a preserved chest at the National Archaeological Museum and 2 tapestries in the sacristy of the church of the monastery of St. Zoilus in the Palencian town of Carrion de los Condes provided abundant information on the circumstances in which they were made. By analysing the style, we can deduce its affiliation to a specific artistic milieu and thereby propose a timeframe. CONCLUSION: Without meaning to dethrone St. Liborius as the patron saint of urologists, an office claimed earlier by colleagues from various European countries, the martyrdom of St. Zoilus is, in light of the tradition and images provided, an unquestionable urological issue. The tradition is vindicated from a new viewpoint 1,712 years later.

[Prognostic implications of positive margins in radical prostatectomy specimens]. / Implicaciones pronósticas de los márgenes positivos de las piezas de prostatectomía radical.

UNLABELLED: To evaluate the histopathologic implication of positive margins of prostatectomy specimens in the biochemical recurrence. MATERIAL AND METHODS: The study group consisted of 290 patients with clinically localized prostate cancer who were treated by radical retropubic prostatectomy. Patients with neoadjuvant hormonal therapy and positive lymph nodes were excluded. The mean age at the time of surgery was 63 years (range 47-73); 166 (57.2%) patients were T1c and 124 (42.8%) T2; the average time of folow-up was of 4 years (range 1-12). Positive surgical margins were defined as the presence of cancer cells at the surface inked of prostatectomy specimens. They were classified as: Margin for capsular incision (without extraprostatic extension evidence)/ margin for extraprostatic extension, margin with smooth rounded surface/margin with irregular surface, margin < or = 4 mm/margin > 4 mm, unifocal margin/multifocal margin. We define biochemical recurrence if the PSA exceeds 0.20 ng/ml in two consecutive determinations. RESULTS: The overall rate of positive margins was 65/290 (22.4%). The 5-year survival free of biochemical recurrence was as follows: Negative margins 71% vs positive margins 44% (p < 0.001); positive margins for capsular incision 84% vs positive margins for extraprostatic extension 33% (p < 0.01); positive margins with smooth rounded surface 58% vs positive margins with irregular surface 26% (p < 0.01); positive margins < or = 4 mm 57% vs positive margins > 4 mm 32% (p < 0.05); unifocal margins 53% vs multifocal margins 0% (p < 0.01). The multivariate analysis revealed that preoperative PSA, Gleason score and pathological classification were the best predictors of biochemical recurrence. CONCLUSIONS: Two groups are established of positive margin. The first group with high probability of biochemical recurrence: margin for extraprostatic. The second group with less probability of biochemical recurrence: margin for capsular incision, margin with smooth rounded surface, margin < or = 4 mm and unifocal margin.

Implicaciones pronósticas de los márgenes positivos de las piezas de prostatectomía radical / Prognostic implications of positive margins in radical prostatectomy specimens

Evaluar las implicaciones de los hallazgos histopatológicas de los márgenes positivos de las piezas de prostatectomía en la recidiva bioquímica. Material y métodos: Se analiza un grupo de 290 pacientes con cáncer de próstata clínicamente localizado que fueron tratados con prostatectomía radical retropúbica. Se desecharon todos los pacientes con tratamiento hormonal neoadyuvante y ganglios positivos. La media de edad en el momento de la cirugía era de 63 años (rango 47-73). 166 (57,2%) eran T1c y 129 (42,8%) T2. El tiempo medio de seguimiento fue de 4 años (rango 1-12). Se definió margen positivo como la presencia de células tumorales en contacto con la superficie tintada de la pieza quirúrgica. Fueron valorados desde diferentes puntos de vista: Margen por incisión capsular (sin evidencia de extensión extraprostática)/margen por extensión extraprostática, margen romo/margen espiculado, margen ≤4 mm/margen >4 mm, margen único/margen multifocal. Definimos recidiva bioquímica si el PSA supera 0,20 ng/ml en 2 determinaciones consecutivas. Resultados: El porcentaje global de márgenes positivos fue de 65/290 (22,4%). Las posibilidades de estar libres de recidiva a los 5 años son las siguientes: Márgenes negativos 71% vs márgenes positivos 44% (p4 mm 32% (p<0,05); márgenes únicos 53% vs márgenes multifocales 0% (p<0,01). El análisis multivariante demuestra que el PSA preoperatorio, el Gleason y el estadio anatomopatológico son los mejores predictores de recidivabioquímica. Conclusiones: Se establecen dos grupos de márgenes positivos. Un primer grupo con alta probabilidad de recidiva bioquímica: márgenes por extensión extraprostática, márgenes espiculados, márgenes de más de 4 mm y márgenes múltiples. Un segundo grupo con pronóstico más esperanzador en cuanto a la recidiva bioquímica: márgenes por incisión capsular, márgenes romos, márgenes ≤4 mm y márgenes únicos (AU)

To evaluate the histopathologic implication of positive margins of prostatectomy specimens in the biochemical recurrence. Matherial and methods: The study group consisted of 290 patients with clinically localized prostate cancer who were treated by radical retropubic prostatectomy. Patients with neoadjuvant hormonal therapy and positive lymph nodes were excluded. The mean age at the time of surgery was 63 years (range 47-73); 166 (57.2%) patients were T1c and 124 (42.8%) T2; the average time of folow-up was of 4 years (range 1-12). Positive surgical margins were defined as the presence of cancer cells at the surface inked of prostatectomy specimens. They were classified as: Margin for capsular incision (without extraprostatic extension evidence)/ margin for extraprostatic extension, margin with smooth rounded surface/margin with irregular surface, margin ≤4 mm/margin >4 mm, unifocal margin/multifocal margin. We define biochemical recurrence if the PSA exceeds 0.20 ng/ml in two consecutive determinations. Results: The overall rate of positive margins was 65/290 (22.4%). The 5-year survival free of biochemical recurrence was as follows: Negative margins 71% vs positive margins 44% (p4 mm 32% (p<0.05); unifocal margins 53% vs multifocal margins 0% (p<0.01). The multivariate analysis revealed that preoperative PSA, Gleason score and pathological classification were the best predictors of biochemical recurrence. Conclusions: Two groups are established of positive margin. The first group with high probability of biochemical recurrence: margin for extraprostatic. The second group with less probability of biochemical recurrence: margin for capsular incision, margin with smooth rounded surface, margin ≤4 mm and unifocal margin (AU)

Recidiva del cáncer de próstata después de la prostatectomía radical y radioterapia de rescate / Prostate cancer recurrence after radical prostatectomy and salvage radiotherapy

OBJETIVO: Evaluar la eficacia de la radioterapia en el lecho prostático en pacientes con cáncer de próstata y fracaso bioquímico después de la prostatectomía radical. MATERIAL Y MÉTODOS: Analizamos los resultados de 292 pacientes a los que se le practicó prostatectomía radical por cáncer de próstata localizado T1-T2, entre enero de 1992 y junio de 2003, con un seguimiento medio de 36 meses (rango 6 meses a 12 años). Se detecta fracaso bioquímico (PSA > 0,20 ng/ml) en 75 (26%) pacientes. De los 75 pacientes con fracaso bioquímico, 9 (12%) se diagnosticó de recidiva local siguiendo los siguientes criterios: a) Primer PSA obtenido a las 6 semanas de la intervención 6 meses. c) Tiempo de duplicación del PSA > 6 meses. d) Velocidad de PSA después de la prostatectomía radical <0,75/ng/ml/año. e) Nivel de PSA después de la prostatectomía radical <2,5 ng/ml. Los 9 pacientes diagnosticados de recidiva local reciben una dosis media de 56,42 Gy en el lecho prostático. RESULTADOS: De los 9 pacientes diagnosticados de recidiva local, en 7 (77,7%) se obtuvo una respuesta completa durante un tiempo medio de seguimiento de 25 meses (6-30 meses). El tiempo entre la radioterapia y la respuesta, en los pacientes con respuesta completa, siempre fue inferior a los 3 meses. No se observaron efectos adversos importantes secundarios a la radioterapia. CONCLUSIONES: La radioterapia de rescate puede ser beneficiosa en un seleccionado grupo de pacientes con recidiva local. La cinética del PSA después de la prostatectomía radical es útil para distinguir las recidivas locales de las metástasis a distancia

OBJETIVE: To evaluate the efficacy of the radiotherapy to prostatic bed in patients with biochemical recurrence for prostate cancer after radical prostatectomy. MATERIAL AND METHODS: We analyse the results of 292 patients underwent radical prostatectomy for localized prostate cancer T1-T2 between January 1992 and June 2003, with an average folow-up of 36 months (range 6 months to 12 years). We detect biochemical recurrence (PSA >0.20 ng/ml) in 75 (26%) patients. Of 75 patients with biochemical recurrence, 9 (12 %) was diagnosed of local recurrence by the following criteria: a) The first PSA obtained 6 weeks after radical prostatectomy 6 months. c) The prostate specific antigen doubling time >6 months. d) The prostate specific antigen velocity after radical prostatectomy <0.75 ng/ml/year. e) The prostate specific antigen level after radical prostatectomy <2.5 ng/ml. The 9 patients diagnosed of local recurrence received an average dose of 56.42 Gy in the prostate bed. RESULTS: Of all 9 patients with local recurrence, 7 (77.7%) has complete response with an average time of followup of 25 months (6-30 months). The time between the radiotherapy and the response, in patients with complete response, was lower than 3 months. Were not observed significant adverse effects associated to radiotherapy. CONCLUSIONS: The salvage radiotherapy may be beneficial in select patients with local recurrence. The characteristics of prostate specific antigen elevation are useful in distinguishing men with local recurrence from those with distant metastases

Utilidad de la expresión de Ki67 en las biopsias preoperatorias para predecir la recidiva bioquímica del cáncer de próstata después de la prostatectomía radical / The usefulness of Ki67 expression in the biopsy specimens, to predict the biochemical progresion of the prostate cancer after radical prostatectomy

OBJETIVO: Evaluar la utilidad de la expresión de Ki67 de las biopsias diagnósticas preoperatorias, para predecir la recidiva bioquímica del cáncer de próstata después de la prostatectomía radical. MATERIAL Y MÉTODOS: Analizamos la expresión de Ki67 en las biopsias ecodirigidas de 103 pacientes a los que se les practicó prostatectomía radical. El tiempo medio de seguimiento es de 3,4 años (1,3-8,8 años). Correlacionamos la recidiva bioquímica con los factores pronósticos clásicos como el PSA (>10/=7/3%/3%/3%/10/=7/<7) y clasificación pT (pT3/pT0-2), para predecir la progresión bioquímica del cáncer de próstata después de la prostatectomía radical

OBJETIVE: To evaluate the usefulness of Ki67 expression in the biopsy specimens, to predict the biochemical progression of the prostate cancer after radical prostatectomy. MATERIAL AND METHODS: We analyse the Ki67 expression in the biopsy specimens of 103 patients treated with radical prostatectomy. The mean follow up is 3.4 years (1.3-8.8 years). We correlate the biochemical progression with traditional prognostic factors as the PSA (>10/=7/3%/3%/3%/10/=7/<7) and pT ification (pT3/pT0-2), to predict the biochemical progression of the prostate cancer after radical prostatectomy

[Prostate cancer recurrence after radical prostatectomy and salvage radiotherapy]. / Recidiva del cáncer de próstata después de la prostatectomía radical y radioterapia de rescate.

OBJECTIVE: To evaluate the efficacy of the radiotherapy to prostatic bed in patients with biochemical recurrence for prostate cancer after radical prostatectomy. MATERIAL AND METHODS: We analyse the results of 292 patients underwent radical prostatectomy for localized prostate cancer T1-T2 between January 1992 and June 2003, with an average folow-up of 36 months (range 6 months to 12 years). We detect biochemical recurrence (PSA >0.20 ng/ml) in 75 (26%) patients. Of 75 patients with biochemical recurrence, 9 (12%) was diagnosed of local recurrence by the following criteria: a) The first PSA obtained 6 weeks after radical prostatectomy <0.20 ng/ml. b) The time to biochemical recurrence >6 months. c) The prostate specific antigen doubling time >6 months. d) The prostate specific antigen velocity after radical prostatectomy <0.75 ng/ml/year. e) The prostate specific antigen level after radical prostatectomy <2.5 ng/ml. The 9 patients diagnosed of local recurrence received an average dose of 56.42 Gy in the prostate bed. RESULTS: Of all 9 patients with local recurrence, 7 (77.7%) has complete response with an average time of follow-up of 25 months (6-30 months). The time between the radiotherapy and the response, in patients with complete response, was lower than 3 months. Were not observed significant adverse effects associated to radiotherapy. CONCLUSIONS: The salvage radiotherapy may be beneficial in select patients with local recurrence. The characteristics of prostate specific antigen elevation are useful in distinguishing men with local recurrence from those with distant metastases.

[The usefulness of Ki67 expression in the biopsy specimens, to predict the biochemical progresion of the prostate cancer after radical prostatectomy]. / Utilidad de la expresión de Ki67 en las biopsias preoperatorias para predecir la recidiva bioquímica del cáncer de próstata después de la prostatectomía radical.

OBJECTIVE: To evaluate the usefulness of Ki67 expression in the biopsy specimens, to predict the biochemical progression of the prostate cancer after radical prostatectomy. MATERIAL AND METHODS: We analyse the Ki67 expression in the biopsy specimens of 103 patients treated with radical prostatectomy. The mean follow up is 3.4 years (1.3-8.8 years). We correlate the biochemical progression with traditional prognostic factors as the PSA (> 10/< or = 10), Gleason (> or = 7/< 7), pT classification (pT3/pTO-2) and immunohistochemical factor Ki67 (> 3%/< or = 3%). RESULTS: Of all 103 patients, in 71 (69%) biochemical progression was not detected and in 32 (31%) biochemical progression was detected. The mean of preoperative PSA is 10.07 ng/ml in the patients without progression and 20.90 ng/ml in the patients with biochemical progression (p=0.0001). The mean of Gleason score in 6.03 in the patients without progression and 6.75 in the patients with biochemical progression (p=0.0001). The percentage of Ki67 expression is 3.95% in the patients without progression and 5.05% in the patients with biochemical progression (p=0.030). The tumors pT0-2 progressed 12/67 (17.9%) and the tumors pT3 progressed 20/36 (55.6%) (p=0.0001). Multivariant regression analysis indicate that it does not exist a statistically significant relation between Ki67 (> 3%/< or = 3%) expression in the biopsy specimens and the biochemical progression of the prostate cancer after radical prostatectomy (p=0.204). CONCLUSIONS: The immunohistochemical factor Ki67 (> 3%/< or = 3%) in the biopsy specimens, is less effective than the classic factors, PSA (> 10/< or = 10), Gleason (> or = 7/< 7) and pT classification (pT3/pT0-2), to predict the biochemical progression of the prostate cancer after radical prostatectomy.

[Correlation of the anatomo-pathological staging of radical prostatectomy specimens with the amount of cancer in the preoperative sextant biopsy]. / Correlación del estadio anatomopatológico de la pieza de prostatectomía radical con la cantidad de cáncer en la biopsia sextante preoperatoria.

OBJECTIVE: We assess the value of the percent of cancer in needle cores of sextant biopsy for predicting the risk of extraprostatic extension at radical retropublic prostatectomy. MATERIAL AND METHODS: We reviewed prostate needle biopsy findings in 97 patients with prostate cancer T1c-T2, who subsequently underwent radical retropubic prostatectomy. In each needle biopsy were assessed, number of cores positive, percent of cores positive, percent cancer in all cores, Gleason score, intraepithelial neoplasia, perineural invasion and vascular invasion. Initial PSA and preoperative clinical stage were incorporated with biopsy results into a univariate and multivariate model to determine the parameters most predictive of pathological stage. RESULTS: Of the 97 patients, 72 (74%) had organ confined cancer and 25 (26%) had extraprostatic extension. The average of cores positive for organ confined cancer was 4.2 (median 4) vs. 6.9 (median 6) for extraprostatic extension (p = 0.001), the percent of cores positive for organ confined cancer was 34.9% (median 28) vs. 53.8% (median 46) for extraprostatic extension (p = 0.013). The average of cancer in all cores in organ confined cancer was 13.6% (median 6) vs. 30.5% (median 30) for extraprostatic extension (p = 0.002). The mean Gleason score in needle cores was 5.9 (median 6) in organ confined cancer vs. 6.6 (median 7) in extraprostatic extension (p = 0.007). The average of intraepithelial neoplasia in needle cores was 3 (4%) in organ confined cancer vs. 1 (4%) in extraprostatic extension (p = 0.972). The perineural invasion of needle cores was 6 (8.3%) in confined cancer vs. 4 (16%) in extraprostatic extension (p = 0.355). Univariate analysis demonstrated that the risk of extraprostatic extension is predicted by the number of cores positive (p = 0.003), the percent of cores positive (p = 0.006), the percent of cancer in all cores (p = 0.001), the Gleason score (p = 0.002), the clinical stage (p = 0.019) and initial PSA (p = 0.032). Extraprostatic extension is not predicted by the intraepithelial neoplasia (p = 0.971), vascular invasion and perineural invasion (p = 0.285). Multivariate analysis showed that the percent of cancer in all cores is the strongest predictor of extraprostatic extension (p = 0.035). With a percent of cancer less than 3% in the biopsy specimen, the risk of extraprostatic extension is 11.5%. CONCLUSIONS: The amount of cancer on preoperative needle sextant biopsy is the strongest predictor of prostate stage, but it is slightly practical at the moment of admitting or to reject a patient for radical prostatectomy.

[Cystitis folicular. A case report and review of the literature]. / Cistitis folicular. Aportación de un caso y revisión de la literatura.

OBJECT: We report a patient with cystitis follicularis and review the literature about it. CLINICAL CASE: A man 78 years old with prostate cancer, who need a permanent bladder catheter. We make a desobstructive TUR, prostate resection and many nodular lesions in the lateral walls and bladder down. The diagnostic was cystitis follicularis. CONCLUSIONS: The cystitis follycularis is a cystitis inespecific and chronic kind with a important inflammation made of lymphocytes and plasmatic cells. Its makes lymphocytes foliculos in the bladder subepithelial wall. The indefination its alive about cystitis follicularis etiopageny, treatment and prognostic. The histopathology study is neccessary.

[Clinical and biological progression of incidental prostatic cancer ( Stage T 1a)]. / Progresión biológica y clínica del cáncer de próstata incidental (estadío T1a).

OBJECTIVES: To analyze the biological and clinical progression of the prostate cancer stage T1a. MATERIAL AND METHODS: Retrospective study of 44 patients diagnosed of T1a prostate carcinoma between 1985 and 2001. We value biological and clinical progression, time up to the progression, mortality for tumour reason and survival, with the following stratification: patients without initial treatment and patients treated by means of external radiotherapy or radical prostatectomía. RESULTS: Of all 44 patients biological progression was observed in 5 (11.36%) and clinical progression in 4 (9.09%). The mortality to 5 years for tumour reason was of 2 (4.54%). Of all 38 patients without initial treatment biological progression was observed in 5 (13.15%), in an average time of 25.8 months and clinical progression in 4 (10.52%), in an average time of 34.5 months. The mortality to 5 years was of 2 (5.26%). In all 6 patients to whom radical treatment carried out them progression was not observed and they all live. There are no statistically significant differences between both groups of patients (p = NS). CONCLUSIONS: The biological and clinical progression of the T1a prostate cancer is low, 11.36% and 9.09%, respectively. The mortality to 5 years is of 4.54%. Differences of survival do not exist, statistically significant, between treated and not treated.

Cistitis folicular. Aportación de un caso y revisión de la literatura / Cystitis folicular. A case report and review of the literature

OBJETIVO: Aportar un caso clínico con el diagnóstico de cistitis folicular y revisar la literatura sobre el tema. CASO CLÍNICO: Paciente de 78 años de edad, diagnosticado de cáncer de próstata, portador de sonda de forma permanente por retención urinaria. Se indica resección transuretral desobstructiva de próstata, realizándose al mismo tiempo resección y estudio anatomopatológico de múltiples formaciones con aspecto nodular, situadas en el trígono y caras laterales de la vejiga. El diagnóstico fue cistitis folicular. CONCLUSIONES: La cistitis folicular es un tipo de cistitis crónica inespecífica que se caracteriza por un intenso infiltrado inflamatorio a expensas de linfocitos y células plasmáticas que se agrupan formando folículos en la submucosa vesical. Continúa vigente la indefinición en la etiopatogenia, tratamiento y pronóstico de esta patología. Tan sólo la certeza del diagnóstico histológico confirma su entidad (AU)

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Correlación del estadio anatomopatológico de la pieza de prostatectomía radical con la cantidad de cáncer en la biopsia sextante preoperatoria / The pathological correlation of radical prostatectomy specimen with the quantification of the amount of cancer on preoperative needle sextant biopsy

OBJETIVO: Analizamos la utilidad que tiene la estimación del porcentaje de cáncer en la biopsia sextante para predecir el riesgo de extensión extraprostática en la pieza de prostatectomía radical retropúbica. MATERIAL Y MÉTODOS: Revisamos los hallazgos en las biopsias preoperatorias de 97 pacientes con cáncer de próstata T1c-T2c a los que se le practicó prostatectomía radical retropúbica. En cada biopsia se evalúa el número de cilindros positivos, el porcentaje de cilindros positivos, el porcentaje de cáncer en todos los cilindros, el Gleason, la presencia de neoplasia intraepitelial, la invasión perineural y la invasión vascular. A los resultados de la biopsia se añade el PSA preoperatorio y el estadio clínico, para determinar que parámetros pueden determinar mejor el estadio anatomopatológico, con un análisis univariante y multivariante. RESULTADOS: De los 97 pacientes, 72 (74 por ciento) tenían cáncer organoconfinado y 25 (26 por ciento) presentaban extensión extraprostática del cáncer. El número medio de cilindros positivos en los cánceres organoconfinados fue de 4,2 (mediana 4) vs. 6,8 (mediana 6) para los cánceres con extensión extraprostática (p=0,001). El porcentaje medio de cilindros positivos en los cánceres organoconfinados fue de 34,9 por ciento (mediana 28) vs. 53,8 por ciento (mediana 46) para los cánceres con extensión extraprostática (p=0,013). El porcentaje medio de cáncer en todo el material de la biopsia del cáncer organoconfinado fue de 13,6 por ciento (mediana 6) vs. 30,5 por ciento (mediana 30) para los cánceres con extensión extraprostática (p=0,002). Los valores medios de la puntuación de Gleason eran de 5,9 (mediana 6) en las biopsias de los cánceres organoconfinados vs. 6,6 (mediana 7) en los que presentaban extensión extraprostática (p=0,007). Se observó neoplasia intraepitelial en 3 (4 por ciento) de los cánceres organoconfinados vs. 1 (4 por ciento) de los cánceres con extensión extraprostática (p=0,972). Se encontró invasión perineural en 6 (8,3 por ciento) de las biopsias de los cánceres organoconfinados vs. 4 (16 por ciento) de los cánceres con invasión extraprostática (p=0,355). El análisis univariante demuestra que el riesgo de extensión extraprostática está en relación con el número de cilindros positivos (p=0,003), porcentaje de cilindros positivos (p=0,006), el porcentaje de cáncer en toda la biopsia (p=0,001), el Gleason (p=0,002), el estadio clínico (p=0,019) y el PSA preoperatorio (p=0,032). La presencia de neoplasia intraepitelial (p=0,971), infiltración vascular o infiltración perineural (p=0,285), no predice la extensión extraprostática. En el análisis multivariante se demuestra que el porcentaje de cáncer en el material de la biopsia es la variable que mejor predice la extensión extraprostática del cáncer (p=0,035). Con un porcentaje de cáncer inferior al 3 por ciento en la biopsia, la probabilidad de extensión extraprostática es solamente del 11,5 por ciento. CONCLUSIONES: El porcentaje de cáncer en la biopsia sextante preoperatoria es la variable que mejor predice el estadio del cáncer de próstata, pero es poco práctica a la hora de admitir o desechar un paciente para prostatectomía radical (AU)

OBJETIVE: We assess the value of the percent of cancer in needle cores of sextant biopsy for predicting the risk of extraprostatic extension at radical retropubic prostatectomy. MATERIAL AND METHODS: We reviewed prostate needle biopsy findings in 97 patients with prostate cancer T1c-T2, who subsequently underwent radical retropubic prostatectomy. In each needle biopsy were assessed, number of cores positive, percent of cores positive, percent cancer in all cores, Gleason score, intraepithelial neoplasia, perineural invasion and vascular invasion. Initial PSA and preoperative clinical stage were incorporated with biopsy results into a univariate and multivariate model to determine the parameters most predictive of pathological stage. RESULTS: Of the 97 patients, 72 (74%) had organ confined cancer and 25 (26%) had extraprostatic extension. The average of cores positive for organ confined cancer was 4.2 (median 4) vs. 6.9 (median 6) for extraprostatic extension (p=0.001), the percent of cores positive for organ confined cancer was 34.9% (median 28) vs. 53.8% (median 46) for extraprostatic extension (p=0.013). The average of cancer in all cores in organ confined cancer was 13.6% (median 6) vs. 30.5% (median 30) for extraprostatic extension (p=0.002). The mean Gleason score in needle cores was 5.9 (median 6) in organ confined cancer vs. 6.6 (median 7) in extraprostatic extension (p=0.007). The average of intraepithelial neoplasia in needle cores was 3 (4%) in organ confined cancer vs. 1 (4%) in extraprostatic extension (p=0,972). The perineural invasion of needle cores was 6 (8.3%) in confined cancer vs. 4 (16%) in extraprostatic extension (p=0.355). Univariate analysis demostrated that the risk of extraprostatic extension is predicted by the number of cores positive (p=0.003), the percent of cores positive (p=0.006), the percent of cancer in all cores (p=0.001), the Gleason score (p=0.002), the clinical stage (p=0.019) and initial PSA (p=0.032). Extraprostatic extension is not predicted by the intraepithelial neoplasia (p=0.971), vascular invasion and perineural invasion (p=0.285). Multivariate analysis showed that the percent of cancer in all cores is the strongest predictor of extraprostatic extension (p=0.035). With a percent of cancer less than 3% in the biopsy specimen, the risk of extraprostatic extension is 11.5%. CONCLUSIONS: The amount of cancer on preoperative needle sextant biopsy is the strongest predictor of prostate stage, but it is slightly practical at the moment of admitting or to reject a patient for radical prostatectomy (AU)

[Mucinous adenocarcinoma of the urachus]. / Adenocarcinoma mucinoso de uraco.

OBJECTIVE: The Adenocarcinoma of the Urachus is very rare tumor, with an incidence of 1/5,000,000 inhabitants, represents less than 0.001 of all types of bladder cancer. CASE REPORT: A 51 year old man with a chronic history of suprapubic pain and hematuria. Physical examination and excretory urography were normal. The cystoscopy demonstrated a oedematosa area in cupola of bladder wall. The transuretral biopsy was moderately differentiated adenocarcinoma, with positive antibody to CK7 and CK20, the carcinoembryonic antigen was 6.6 ng/ml. Extended partial cystectomy was done, followed for chemotherapy and radiotherapy. CONCLUSIONS: The treatment of adenocarcinoma of the urachus with a combination of extended partial cystectomy, chemotherapy and radiation, is a effective treatment.

Progresión biológica y clínica del cáncer de próstata incidental (Estadío T1a) / Clinical and biological progresion of incidental prostatic cancer (Stage T1a)

OBJETIVO: Analizar el comportamiento biológico y clínico del cáncer de próstata estadío T1a. MATERIAL Y MÉTODOS: Estudio retrospectivo de 44 pacientes diagnosticados de adenocarcinoma de próstata T1a entre 1985 y 2001. Valoramos progresión biológica y clínica, tiempo hasta la progresión, mortalidad por causa tumoral y supervivencia, con la siguiente estratificación: pacientes sin tratamiento inicial y pacientes tratados mediante radioterapia externa o prostatectomía radical. RESULTADOS: De los 44 pacientes se observó progresión biológica en 5 (11,36 por ciento) y progresión clínica en 4 (9,09 por ciento). La mortalidad a 5 años por causa tumoral fue de 2 (4,54 por ciento). De los 38 pacientes sin tratamiento inicial se observó progresión biológica en 5 (13,15 por ciento), en un tiempo medio de 25,8 meses y progresión clínica en 4 (10,52 por ciento), en un tiempo medio de 34,5 meses. La mortalidad a 5 años fue de 2 (5,26 por ciento). En los 6 pacientes a los que se les realizó tratamiento radical no se observó progresión y viven todos. No hay diferencias estadísticamente significativas entre los dos grupos de pacientes (p = NS). CONCLUSIONES: La progresión biológica y clínica del cáncer de próstata T1a es baja, 11,36 por ciento y 9,09 por ciento, respectivamente. La mortalidad a 5 años es del 4,54 por ciento. No existen diferencias de supervivencia, estadísticamente significativas, entre tratados y no tratados (AU)

Adenocarcinoma mucinoso de uraco / Mucinous adenocarcinoma of the urachus

OBJETIVO: El adenocarcinoma de uraco es un tumor extremadamente raro, con una incidencia de 1/5.000.000 de habitantes, lo que representa menos del 0,001 de todos los tumores de vejiga. CASO CLÍNICO: Varón de 51 años con historia de dolor suprapúbico y hematuria. La exploración física y la urografía intravenosa eran normales. La cistoscopia demostraba un área edematosa en la cúpula de la vejiga. La biopsia transuretral confirmó un adenocarcinoma moderadamente diferenciado, con anticuerpos positivos CK7 y CK20. El antígeno carcinoembrionario era de 6,6. Se practicó cistectomía parcial extensa, seguida de quimioterapia y radioterapia. CONCLUSIONES: El tratamiento del adenocarcinoma de uraco con una combinación de cistectomía parcial extensa, quimioterapia y radioterapia es eficaz. (AU)