Interstellar

Earth is constantly bombarded with extraterrestrial dust containing invaluable information about extraterrestrial processes, such as structure formation by stellar explosions or nucleosynthesis, which could be traced back by long-lived radionuclides. Here, we report the very first detection of a recent ^{60}Fe influx onto Earth by analyzing 500 kg of snow from Antarctica by accelerator mass spectrometry. By the measurement of the cosmogenically produced radionuclide ^{53}Mn, an atomic ratio of ^{60}Fe/^{53}Mn=0.017 was found, significantly above cosmogenic production. After elimination of possible terrestrial sources, such as global fallout, the excess of ^{60}Fe could only be attributed to interstellar ^{60}Fe which might originate from the solar neighborhood.

Interstellar

A dying massive star ends in a supernova explosion ejecting a large fraction of its mass into the interstellar medium. If this happens nearby, part of the ejecta might end on Solar System bodies and, in fact, radioactive ^{60}Fe has been detected on the Pacific ocean floor in about 2 Ma old layers. Here, we report on the detection of this isotope also in lunar samples, originating presumably from the same event. The concentration of the cosmic ray produced isotope ^{53}Mn, measured in the same samples, proves the supernova origin of the ^{60}Fe. From the ^{60}Fe concentrations found we deduce a reliable value for the local interstellar fluence in the range of 1×10^{8} at/cm^{2}. Thus, we obtain constraints on the recent and nearby supernova(e).

Collateral urethral duplication in an adult.

OBJECTIVE: Congenital anomalies or malformations of the urethra that involve number are extremely rare and only 7 cases of trifurcation of the urethra and under 500 cases of urethral duplication have been described. METHODS: In the case we present, urethral duplication was diagnosed in adulthood, even though glans malformation with 2 urethral orifices was clearly evident and only 1 was functional. RESULTS: The condition is usually diagnosed in childhood due to the presence of 2 urethral meatus or from double stream if both are functional; at other times, the condition is diagnosed from complications that trigger infections or obstruction or if it is associated with more extensive malformations. CONCLUSIONS: Urethral duplication is an extremely rare birth defect, and diagnosis in adulthood is even more uncommon. No single embryologic argument explains all the anatomic variants of urethral duplication. The treatment of the urethral duplication should be individualized according to the type of duplication and the clinical symtoms.

Comparative gene expression of gonadotropins (FSH and LH) and peptide levels of gonadotropin-releasing hormones (GnRHs) in the pituitary of wild and cultured Senegalese sole (Solea senegalensis) broodstocks.

The Senegalese sole (Solea senegalensis) is a valuable flatfish for aquaculture, but it presents important reproductive problems in captivity. Spawning is achieved by wild-caught breeders but cultured broodstocks fail to spawn spontaneously and, when they do, eggs are unfertilized. To gain knowledge on the physiological basis underlying this reproductive dysfunction, this study aimed at analyzing comparative hormone levels between wild and cultured broodstocks at the spawning season. The Senegalese sole gonadotropin (GTH) subunits, FSHbeta, LHbeta and GPalpha, were cloned and qualitative (in situ hybridization) and quantitative (real-time PCR) assays developed to analyze pituitary GTH gene expression. In females, FSHbeta and GPalpha mRNA levels were higher in wild than in cultured broodstocks, whereas in males all three subunits were highest in cultured. By ELISA, three GnRH forms were detected in the pituitary, displaying a relative abundance of GnRH2>GnRH1>GnRH3. All GnRHs were slightly more abundant in wild than cultured females, whereas no differences were observed in males. Plasma levels of vitellogenin and sex steroids were also analyzed. Results showed endocrine differences between wild and cultured broodstocks at the spawning period, which could be related to the endocrine failure of the reproductive axis in cultured breeders.

Penile foreign bodies.

OBJECTIVE: To describe 8 cases of penile foreign bodies. METHODS/RESULTS: We provide an essentially visual overview of various objects or foreign bodies affecting the penis. CONCLUSIONS: The presence of penile foreign bodies is rarely due to an accident. These objects are placed for a wide variety of reasons, but primarily for erotic or self-arousal purposes. The consequences of penile foreign bodies can be mild or very severe, resulting in penile amputation.

[Femoral neuropathy in urological surgery]. / Neuropatía femoral en cirugía urológica.

We present four cases of femoral neuropathy due to urological surgery, first case happened after right lumbotomy twenty years ago and the other three cases in the last four years after iliac incision. We review lesion production mecanism, evolution, treatment and prevention of this rare neurological complication. We do a literature review about this pathology related with urological activity.

[Hemoperitoneum and death due to hepatoesplenic metastasis rupture in a testicular tumor]. / Hemoperitoneo y muerte por rotura de metástasis hepatoesplénicas de tumor testicular.

We present a case of a mix germinal testicular tumor, in III-C (AJCC-UICC) stage, at a terminal phase due to massive methastasis rupture at hepatic and splenic methastasis locations.

Estimating the impact from Fukushima in Southern Spain by 131I and Accelerator Mass Spectrometry detection of 129I.

After the Fukushima accident, large amounts of radionuclides were discharged to the atmosphere. Some of them travelled long distances and were detected in places as far from Japan as Spain a few days after the accident. One of these radionuclides was 131I. Its isotope 129I (T1/2 = 15.7 × 106 years) was also expected to follow the same pathway. In this work, we present the results for the 129I concentration in the same atmospheric samples from Seville (Spain) where 131I activity was measured in 2011 by Baeza et al. (2012). 129I concentrations in aerosol and gaseous samples showed concentrations in the order of 104 and 105 atoms/m3, typically higher in the gaseous form with respect to the aerosol form. Also 129I in rainwater was measured, showing concentrations in the order of 108 atoms/L. The results show a very good agreement with the 131I profile, showing that, if background from other sources is not relevant, it is possible to estimate the impact of similar events years after them thanks to the sensitivity of techniques like Accelerator Mass Spectrometry.

[Entero-neobladder ileal fistula: two cases report]. / Fístula entero-neovejiga ileal: a propósito de dos casos.

Fistulas between the orthotopic reservoir and the gastrointestinal tract have low incidence (1.5-2%). Simptomatology is variable, but it's frecuent to find fecaluria. Among 90 new intestinal bladders we show two fistule of new bladder to ileo, with nest postoperatory diagnosis, using retrograde cystografy; one was resolved with next postoperative treatment and the other with open surgery.

[Problem-based learning in urology training. The Faculty of Medicine of the Universidad de Castilla-La Mancha model]. / El aprendizaje basado en problemas en la enseñanza de la urologia. Modelo de la Facultad de Medicina de la Universidad de Castilla-La Mancha.

Ongoing changes in the social, economic, technological and scientific realms have generated new needs and led various organizations to suggest that educational institutions should reorient their educational strategies toward developing effective professionals with the skills to meet these needs. These "modern" strategies include problem-based learning, in which the student seeks and selects information, analyzes the data obtained, integrates both prior and newly acquired knowledge, and, finally, offers diagnostic and therapeutic options to resolve the problem posed, as would occur in professional practice. With this approach, prior skills and practical experience form the foundation of learning. Problem-based learning incorporates some aspects of cognitive psychology, a model that mainly centers on the nature of the knowledge structures found in active memory, the processes involved in information storage and retrieval and the various factors that activate these processes. At the Faculty of Medicine of the Universidad de Castilla-La Mancha, urology is part of a core subject (Medical and Surgical Pathology II) taught in the fifth year of coursework together with nephrology. Each course includes approximately 75 students, divided into five groups. The rotation lasts six weeks, with students spending a mean of two hours a day on theory (nephrology and/or urology) and the remaining time on rotations in the various activities: three weeks in nephrology and three weeks in urology. Upon completion of the rotation, the students write a combined theoretical examination with 100 multiple-choice questions (50 on urology) and take a practical skills examination. At the end of the course, another practical test consisting of an objective, structured clinical examination is taken, in which standard patients are used and the professor directly assesses the level of skills acquired with a "real" case.

Parenteral nutrition and immature neonates. Comparative study of neonates weighing under 1000 and 1000-1250 g at birth.

UNLABELLED: We studied the nutritional requirements of 53 neonates with a birth-weight of 1250 g or less and analysed the parenteral and enteral nutrition provided, the weight-gain curves, the incidence of prior pathology and complications. We compared those weighing under 1000 g at birth (n=25) with those weighing 1001-1250 g (n=28). All neonates received central parenteral nutrition at an average age of 42.3 h. The liquid requirements of the lower birth-weight group were significantly greater. No differences were found in the supply of glucose, proteins, lipids and calories until after the first 15 days of life, when the <1000 g group required a greater liquid and caloric intake. Parenteral nutrition was suspended earlier for the >1000 g group (32.6 vs. 48.1 days). Maximum weight loss (12.56%) for the two groups occurred at 5.23 days. No differences in weight gain (g/kg/day) between the groups were observed. The >1000 g group began enteral nutrition significantly earlier and presented greater tolerance. The incidence of complications (bronchopulmonary dysplasia, enterocolitis, nosocomial sepsis, Candidas A sepsis, osteopenia) was greater in the lower birth-weight group, as was that of hyaline membrane disease and mechanically assisted respiration. There were no differences in the incidence of intracraneal haemorrhage, ductus arteriosus, early sepsis, delayed intrauterine growth or hypoglucemia. CONCLUSIONS: The severity of the initial pathology and the greater incidence of complications among the lower birth-weight neonates (<1000 g) influenced both the need for parenteral nutrition and the reduced tolerance to enteral nutrition. Although the rate of weight gain was similar for the two groups, the <1000 g group required a longer period of parenteral nutrition.

[Profiles of the duration of temporary work incapacity in a health district and its comparison with some proposed standards]. / Perfiles de duración de incapacidad laboral transitoria en un distrito sanitario y su comparación con algunos estándares propuestos.

OBJECTIVE: To describe the Work Disability (WD) Profiles Lengths issued according to diagnostic in Usera's Sanitary District of Madrid, and compare them with recommended standards obtained with different methodology (consensual-practical experience) by several authors. METHOD: A descriptive study of 3555 WD informed by 31 general practitioners during 1992. Variables were achieved from P-14 registers, using by Medical Inspection. Diagnoses were processed according to CIPSAP-2-Def. The results were compared with recommended standards lengths proposed by INSALUD Experts Commission, (consensus) and with another obtained by practical experience by others. RESULTS: Grate variability in day's lengths of WD were observed (mean average = 45.1 +/- 79.7 days; medium = 16 days; mode = 4 days). Respiratory diseases score for the highest frequency (20.6%) while Muscle skeletics accounts for more days out of work (23.1% of working days lost). Applying to our study the intervals of lengths days proposed by the INSALUD (consensus), up to 75% of potential long-lasting and only 25% of short-lasting processes could be included. Nevertheless, a higher concordance is observed when they are compared with other authors with a similar methodology. CONCLUSIONS: The recommended lengths standards of work disability established by the INSALUD are difficult to be achieved in actual practice.

[Transitional cell tumor of the bladder in childhood]. / Tumor transicional de vejiga en la infancia.

Presentation of one case of transitional cells tumour of the urinary bladder in a 10-year old patient. We emphasize the rarity of such tumours during the first decade of life as well as their good prognosis, the only management required being just an endoscopic resection.

[Chyluria of non-parasitic origin. Presentation of a case and review of the literature]. / Quiluria de origen no parasitario. Presentación de un caso y revisión de la literatura.

Chyluria is defined as the lymph reflux to the urinary collecting system through fistulous communications secondary to lymphatic stasis caused by obstruction of the lymphatic flow. Filariasis is the most frequent cause of chyluria, which is endemic in some areas, mainly in the Asian continent. In our environment chyluria is extremely rare, most cases being due to non-parasitical causes: tumours, abscesses, trauma, tuberculosis, congenital, etc. A patient case of chyluria in a 39 year-old male with background of chest trauma in which the source of chyluria was discovered to be an obstruction of the chest duct due to post-traumatic aneurysm of the aortic notch. The picture of chyluria ceased immediately after surgery, an aneurysmal resection with replacement with an aortic prosthesis. Considering the infrequency of chyluria in our environment, a literature review is made, explaining the most frequent etiological data, as well as accompanying clinical signs, diagnostic means and conservative and surgical procedures in the treatment of this process.

[Retroperitoneal cystic mesothelioma and lymphangioma]. / Mesotelioma y linfangioma quísticos retroperitoneales.

Retroperitoneal cysts are uncommon entities of difficult diagnosis because of their insidious symptomatology. Urinary apparatus involvement is quite often the mode of presentation and the reason for calling on the urologist. The origin of many of these retroperitoneal cysts remains practically unknown. Surgery with exeresis is the choice management method. Follow-up is necessary for cystic mesothelioma because of the highly frequent relapses. The outlook of hormonal conservative therapy for relapses appears as a future alternative to treatment.

[Primary abscess of the psoas. Report of 3 cases and review of the literature]. / Abcesos primarios del psoas. Aportación de tres casos y revisión de la literatura.

Three cases of abscesses rated as primary of the psoas, after dismissing any likely cause that can be involved in the genesis of secondary abscesses of the psoas, are presented. A review of the literature is made, emphasizing the etiological change in the psoas' abscesses as well as the possible causes involved in the etiopathology of this picture which appears to be caused by distant dissemination from a septic nucleus. This theory is also supported by over 80% cases where Staphylococcus aureus is the causative organism. Reference is made to which clinical data is most relevant and to the value of the traditional diagnostic procedures: simplex x-ray, u.i.v., ultrasound techniques, radionuclides and CAT, the latter being the ideal diagnostic procedure in these processes. Finally, different therapy approaches are presented. Percutaneous draining (supported by ultrasound scanning and CAT) appears to have greater acceptance by most authors, relegating the surgical drainage for selected cases.

[Keratinizing squamous metaplasia (cholesteatoma) of the upper urinary tract]. / Metaplasia escamosa queratinizante (colesteatoma) del tracto urinario superior.

Presentation of four cases of keratinizing squamous metaplasia (KSM), two of the renal pelvis, one pyelocaliceal and one ureteral. Nephrouretetectomy was performed in all cases. All our patients showed good evolution. A review of the literature is made discussing all the etiological, diagnostic and therapeutical aspects of the condition. Its benign evolution is highlighted as well as the current need, once a better knowledge of the condition's natural history is available, of using a conservative approach.

[Wunderlich syndrome. Report of 3 cases]. / Síndrome de Wunderlich. Aportación de tres casos.

Contribution of three cases of Wunderlich Syndrome, two of which caused by an angiomyolipoma, and the third one encountered in an anticoagulated patient. We reflect on the obscure pathoetiogenesis of this uncommon disease and on the need to establish the appropriate diagnosis through different radiological examinations (ultrasound, CAT, arteriography) in order to apply the correct therapeutic approach, which in most cases will have an emergency nature, trying to adopt the most conservative attitude possible.

[Immunoprophylaxis of recurrence of T1 G2 bladder tumors with interferon alpha-2b]. / Inmunoprofilaxis de recidivas de tumores vesicales T1 G2 con interferón alpha-2b.

Assessment of results with -2b Interferon used as prophylaxis in 20 patients who underwent surgery for T1,G2 urothelial vesical tumours. Dosage was weekly intravesical instillation of 50 x 10(6) IU for three months and then monthly up to one year treatment. Mean follow-up was 17.20 months (4-41 months). Relapse rate over this time was 50%, all before 15 months, a relapsing ratio of 2.82% patients/month and a disease-free interval of 27.5 months. Chances of being disease-free at 30 months is 48.21%. Progression of disease, whether in grade or stage, was observed in 25% cases. No patient showed relevant changes or side effects during treatment, except for 5 patients who reported mictional symptoms mainly during the first 3 months, none of which required discontinuation of treatment. From the data obtained, it can be deduced that for the time being no reason justifies the use of -2b Interferon versus other conventional chemotherapeutical or immunotherapeutical (BCG) agents in the prophylaxis of this type of tumours.