Spinal transient receptor potential ankyrin 1 channel induces mechanical hypersensitivity, increases cutaneous blood flow, and mediates the pronociceptive action of dynorphin A.

We characterized pain behavior and cutaneous blood flow response induced by activation of the spinal transient receptor potential ankyrin 1 (TRPA1) channel using intrathecal drug administrations in the rat. Additionally, we assessed whether the pronociceptive actions induced by intrathecally administered dynorphin A, cholecystokinin or prostaglandin F(2α) are mediated by the spinal TRPA1 channel. Cinnamaldehyde, a TRPA1 agonist, produced a dose-related (3-10 µg) cutaneous blood flow increase and mechanical hypersensitivity effect. These effects at the currently used doses were of short duration and attenuated, although not completely, by pretreatment with A-967079, a TRPA1 antagonist. The cinnamaldehyde-induced hypersensitivity was also reduced by pretreatment with minocycline (an inhibitor of microglial activation), but not by carbenoxolone (a gap junction decoupler). In vitro study, however, indicated that minocycline only poorly blocks the TRPA1 channel. The mechanical hypersensitivity effect induced by dynorphin A, but not that by cholecystokinin or prostaglandin F(2α), was attenuated by a TRPA1 antagonist Chembridge-5861528 as well as A-967079. The cinnamaldehyde-induced cutaneous blood flow increase was not suppressed by MK-801, an NMDA receptor antagonist, or bicuculline, a GABA(A) receptor antagonist. The results indicate that spinal TRPA1 channels promote mechanical pain hypersensitivity and due to antidromic activation of nociceptive nerve fibers increase cutaneous blood flow. The attenuation of the cinnamaldehyde-induced hypersensitivity effect by minocycline may be explained by action other than block of the TRPA1 channel. Moreover, the spinal TRPA1 channel is involved in mediating the pronociceptive action of dynorphin A, but not that of the spinal cholecystokinin or prostaglandin F(2α).

[Cavernous hemangioma of the penis]. / Hemangioma cavernoso de pene.

We report one case of cavernous hemangioma of penis shaft appeared in a 35 years old man like a painful mass. The blood analysis and radiologics examinations hadn't any important contribution to the diagnostic that, finally, was confirmed during the surgical extirpation and the posterior histological study. We make a brief description about the mentioned pathology.

Uretrocistopexia con anclajes óseos: modificación técnica / Urethrocystopexy with bone anchors: a technical modification

OBJETIVO: Comunicar una modificación técnica de uretrocistopexia, consistente en la suspensión de los ligamentos uretropélvicos a la cara posterior del hueso púbico mediante la utilización de anclajes óseos insertados con el sistema In-Fast. MATERIAL Y METODOS: Entre Agosto de 2000 y Enero de 2001, trece pacientes con una edad media de 56,1 años fueron sometidas a dicha técnica. Usando una vía transvaginal y tras amplia apertura de la fascia endopélvica, colocamos un tornillo de anclaje a cada lado de la sínfisis púbica, dando posteriormente 2 ó 3 pasadas al ligamento uretropélvico con la sutura de polipropileno del nº 1 que cada uno de ellos lleva unido a su extremo. RESULTADOS: La estancia media ha sido de 5,1 días. La cistostomía se ha mantenido durante una media de 10,1 días. No se observaron complicaciones intra ni postoperatorias. Con un seguimiento medio de 5,3 meses todas las pacientes presentan desaparición de su incontinencia de esfuerzo. CONCLUSIONES: A falta de confirmar con un mayor seguimiento y casuística, la suspensión de los ligamentos uretropélvicos mediante anclajes directamente colocados en el hueso púbico por vía vaginal, se ha mostrado como un método sencillo, seguro y altamente confortable para las pacientes (AU)

Hemangioma cavernoso de pene / Cavernous hemangioma of penis

Presentamos un caso de hemangioma cavernoso de raíz de pene, aparecido en un varón de 35 años en forma de una masa dolorosa. Los estudios analíticos y radiológicos no tuvieron una aportación importante al diagnóstico que, finalmente, se confirmó durante la exéresis quirúrgica y el posterior estudio histológico (AU)

[Urethrocystopexy with bone anchors: technical modification]. / Uretrocistopexia con anclajes óseos: modificación técnica.

OBJECTIVE: To communicate a technical modification of urethrocystopexy which consist in the suspension of the urethropelvic ligaments to the posterior pubic bone with using bone fixations inserted with the In-Fast system. MATERIAL AND METHODS: Between August 2000 and January 2001, thirteen patients with an mean age of 56.1 years were operated with this technic. Using a transvaginal approach and after great opening of the endopelvic fascia we insert one fixation screw in each side of the symphisis pubic bone, later we give two or three stitches to the urethropelvic ligament with the polypropylene no. 1 suture that each screw have joined to their end. RESULTS: The mean stay has been 5.1 days. The cystostomy has been remained for a mean of the 10.1 days. We didn't observe any complication neither intra nor postoperatives. With a mean follow-up of 5.3 months all the patients present a disappearance of their stress incontinence. CONCLUSIONS: Lack of confirm with a larger following and more cases, the suspension of the urethropelvisc ligaments with screw fixations directly situated into the pubic bone per vaginal approach, has been a simple method, safe and highly comfortable for the patients.

[Self-administered questionnaire for assessing the Raz technique in stress urinary incontinence: analysis of results]. / Un cuestionario de diseño propio para la evaluación de la técnica de Raz en la incontinencia urinaria de esfuerzo: análisis de resultados.

OBJECTIVES: Knowing our results in the treatment of the stress incontinence by means of the use of the Raz technique evaluated by sending a questionnaire. MATERIAL AND METHODS: From July 1995 until the 31st of December 1998, 137 patients were operated by the Raz technique. The 102 people who were monitored for over 12 months were sent a questionnaire asking them about the postoperative evolution and the degree of the satisfaction obtained. From the 78 (76.47%) people who answered, 75 were included in this study with an average age of 53.96 and an average follow-up of 27.12 months. RESULTS: Thirty patients (40%) showed the disappearance of their stress incontinence, seventeen patients (22.7%), an important improvement and ten (13.3%) a slight improvement, but only 58.20% of the patients were very or quite pleased with the results. None of the preoperatives variables analysed showed any meaningful influence in the outcome, while the longest time of persistence of postmiccional residue was shown as a factor of prediction in a better result. CONCLUSIONS: The mediocre results and the low rate of satisfaction got with this technique justifies the research of other therapeutic and more effective options.

Un cuestionario de diseño propio para la evaluación de la técnica de Raz en la incontinencia urinaria de esfuerzo: análisis de resultados / An own design questionnaire for the evaluation of the Raz technique in the urinary stress incontinence: analysis of results

OBJETIVO: Conocer nuestros resultados en el tratamiento de la incontinencia urinaria de esfuerzo mediante el uso de la técnica de Raz, evaluados a través del envío de un cuestionario. MATERIAL Y MÉTODOS: Desde Julio de 1995 hasta el 31 de Diciembre de 1998, 137 pacientes fueron intervenidas mediante la técnica de Raz. A las 102 cuyo seguimiento superó los 12 meses les fue remitido un cuestiona-rio interrogándoles tanto sobre la evolución post-operatoria de su incontinencia como sobre el grado de satisfacción obtenida. De las 78 (76,47 por ciento) que respondieron, 75 quedaron incluidas en el estudio, con una edad media de 53,96 años y un seguimiento medio de 27,12 meses. RESULTADOS: Treinta pacientes (40 por ciento) mostraron desaparición de su incontinencia de esfuerzo, 17 (22,7 por ciento) una mejoría importante y 10 (13,3 por ciento) una mejoría leve; sin embargo sólo un 58,20 por ciento se mostraron muy o bastante satisfechas con el resultado. Ninguna de las variables preoperatorias analizadas mostró influencia significativa en el resultado, mientras que el mayor tiempo de persistencia de residuos post-miccionales post-operatorios, se mostró como factor predictivo de un mejor resultado. CONCLUSIONES: Los mediocres resultados y la baja tasa de satisfacción obtenida con esta técnica justifica la búsqueda de otras opciones terapéuticas más eficaces (AU)

Lymphocyte T subset counts in children with hypercholesterolemia receiving dietary therapy.

BACKGROUND: In children with hypercholesterolemia, dietary therapy is indicated; however, we do not know if a low-fat diet can modify some organic functions, i.e. immune function. METHODS: 42 children with hypercholesterolemia received a low-fat, low-cholesterol diet during 6 months. At baseline and after the treatment period, we determined a lipoprotein profile and some immune characteristics: immunoglobulins G, A and M; complement components (C3, C4 and factor B), and blood lymphocyte subsets (CD3, CD4 and CD8). RESULTS: Total cholesterol serum concentrations showed a significant reduction after 6 months of dietary therapy (p = 0.008). After 6 months on a low-fat diet, lymphocyte T subset counts (CD3, CD4 and CD8) showed significant decreases (p < 0.01 to p < 0.003), but lymphocyte counts were always within normal ranges. There was also a significant correlation between changes in some lymphocyte T subset counts (CD3 and CD8) and changes in triglyceride serum concentrations (p < 0.05). CONCLUSIONS: A low-fat, low-cholesterol diet diminished CD3, CD4 and CD8 lymphocyte subset counts that are elevated in children with hypercholesterolemia. Dietary therapy, with emphasis on the intake of n-3 fatty acids, could be useful in the modulation of the immune response at the atheromatous plaque level.

Intravesical immunoprophylaxis in recurrent superficial bladder cancer (Stage T1): multicenter trial comparing bacille Calmette-Guérin and interferon-alpha.

OBJECTIVES: To estimate and compare recurrence rates, index of recurrence, and disease-free interval in patients with superficial recurrent bladder cancer receiving bacille Calmette-Guérin (BCG) or interferon (IFN) for immunoprophylaxis. METHODS: One hundred twenty-two patients with recurrent superficial Stage pT1, grade 1 to 3 tumors were enrolled in a randomized, prospective, multicenter trial with two treatment arms of endovesical immunoprophylaxis: 150 mg of BCG versus 54 MU of recombinant IFN-alpha-2a. Administration was weekly during the first month, biweekly for 2 months, and monthly for 9 months. Both groups were similar with regard to tumor stage, grade, size, and number. RESULTS: Sixty-one patients were evaluable in the BCG group and 49 in the IFN group. Tumors recurred in 34 (69.4%) of 49 patients in the IFN group (890 months of follow-up) and in 24 (39.3%) of 61 in the BCG group (1272 months of follow-up). The total number of recurrences (28 for BCG, 47 for IFN), disease-free interval (mean 19.3 months for BCG, 15.3 months for IFN), and index of recurrence (2.2 for BCG, 5.5 for IFN) were statistically significant (P = 0.001) in favor of BCG. Progression to invasive carcinoma was similar in both study arms. Neither systemic nor local side effects were seen in the IFN group. However, the previously reported toxicity of BCG was confirmed. CONCLUSIONS: According to our trial, BCG remains the most efficacious agent for immunoprophylaxis of recurrent superficial bladder tumors.

Relationship between immunoinflammatory proteins containing sialic acid and low-density lipoprotein serum concentrations.

The aim of this study was to investigate the relationship between sialoglycoproteins and the lipoprotein profile in a group of children with different levels of low-density lipoprotein cholesterol. We have studied 177 children of 132 families who were sent to our Pediatric Lipid Research Clinic because of serum cholesterol concentrations higher than 5.17 mmol/l. At the time of diagnosis, we analyzed the serum lipoprotein profile and the sialoglycoproteins: alpha 1-antitrypsin, acid alpha 1-glycoprotein, haptoglobin, alpha 2-macroglobulin, transferrin, IgA, IgG, IgM, complement C3 component and ceruloplasmin. At 7.0 to 10.9 years, alpha 1-glycoprotein serum concentrations were higher in the high risk group than in the moderate risk group (P < 0.05). At 2.0 to 6.9 years, IgA and IgM serum concentrations were higher in the moderate risk group than in the low risk group (P < 0.05 and P < 0.01, respectively), and IgG and IgM serum concentrations were also higher in the high risk group than in the low risk group (P < 0.05). Our results seems to reflect a general reaction to injury or inflammation which could be associated with the atherosclerotic process.

Lymphocyte T subset counts in children with elevated low-density lipoprotein cholesterol levels.

The aim of this study was to determine blood lymphocyte T subset counts in children with elevated levels of low-density lipoprotein cholesterol. We studied 107 children, ages 2.0 to 15.9 years, from 79 families who were referred to our Lipid Research Clinic because total cholesterol serum levels higher than 200 mg/dl had been detected in at least one child. At the time of diagnosis we analyzed serum lipoprotein profile and blood lymphocyte T subsets (CD3, CD4 and CD8). Children were classified according to LDL-C levels into three groups: (1) normal, if levels were between the 5th and 75th percentiles (50 and 125 mg/dl, respectively); (2) at moderate risk, if levels were between the 75th and 95th percentiles (125 and 150 mg/dl, respectively); and (3) at high risk, if levels were above the 95th percentile (150 mg/dl). In children aged 2.0 to 6.9 years, all lymphocyte T subset counts were higher in the high risk group than in the normal group (P < 0.05 and P < 0.01). In children aged 11.0 to 15.9 years, the CD4 subset count was also significantly higher in the high risk group in the other two groups (P < 0.05 and P < 0.01). These results are in agreement with pathologic findings in the atheromatous plaque.

[Open adenomectomy: review of 223 cases]. / Adenomectomía abierta: revisión de 223 casos.

A retrospective study was undertaken to determine the results achieved in 223 patients with prostatic hypertrophy who underwent open surgery during a period spanning 5 years. Good results were achieved in 88.34% of the cases, the mortality rate was 0.44%, and the post-operative morbidity rate was 31.3%. Urinary infection was the most common complication during this period (21.01%). Late post-operatively, we observed the following low incidence of urethral stenosis and lodge sclerosis, 1.79% and 2.24%, respectively. Six patients (2.69%) were permanently incontinent and one required surgery for recurrent obstruction of prostatic origin.

[Transureteral resection of the prostate. Review of 20 consecutive operations (5 yr)]. / RTU de próstata. Revisión de 210 intervenciones consecutivas (cinco años).

In the present study we reviewed our results in the treatment of prostatic obstruction of adenomatous origin over a period of 5 years and with a follow-up of 1 to 6 years. Of the 210 patients considered evaluable, good results were achieved in 84.28%, with mortality and morbidity rates of 0.45% and 22.82%, respectively. Infections were the most commonly observed complications in the early post-operative period. Urethral stenosis, the most common cause for reoperation, was observed in 9.04% in the late post-operative period.

[Malignant fibrous histiocytoma of the scrotal wall. Presentation of a case and review of the literature]. / Histiocitoma fibroso maligno de la pared escrotal. Aportación de un caso y revisión de la literatura.

A case of Malignant Fibrous Histiocytoma in a 64 years old man, its rarity consisting in the location, the scrotal wall, is presented. An exposition on this pathological form of presentation, symptomatology, A.P., diagnostic, natural history, prognosis and treatment is made. Also, we review the literature on Malignant Fibrous Histiocytomas on the scrotal wall.

[The effect of preoperative parenteral nutrition on the capacity of the immune response in malnourished patients (preoperative parenteral nutrition and immunity)]. / Efecto de la nutrición parenteral preoperatoria en la capacidad de respuesta inmune en pacientes desnutridos. (Nutrición parenteral preoperatoria e inmunidad).

The objective of this study is to evaluate the response of the subpopulations of lymphocytes and IGs to the administration of total parenteral nutrition for 7 days in 26 patients suffering from malnutrition, 12 of whom had digestive neoplasia and 14 non-neoplastic gastrointestinal disorders. Following the total parenteral nutrition, a significant increase in the percentage of T-helper lymphocytes was noted, and an improvement in the OKT4/OKT8 quotient, as well as in the IgA and the C4 fraction of the complement. The existence of neoplastic conditions did not have a significant effect on the variations in the parameters studied. The presence of lipids in the parenteral nutrition diet did not affect the subpopulations of lymphocytes.

[Emphysematous cystitis]. / Cistitis enfisematosa.

We present a new case of emphysematous cystitis, commenting on some of the more interesting aspects of the etiopatogeny diagnosis and treatment of this entity. We underline the importance of early diagnosis and effective treatment of the disease as well as of the coadjuvant factors.