Hyperbaric oxygen for radiation-induced cystitis: A long-term follow-up. / Oxígeno hiperbárico para la cistitis inducida por radioterapia: un seguimiento a largo plazo.

INTRODUCTION AND OBJECTIVES: Bladder complications may be seen in up to 12% of patients treated with pelvic irradiation. Hyperbaric oxygen therapy (HBOT) is an option for the management of radiation-induced hemorrhagic cystitis (RIHC). The aim of this study was to evaluate the efficacy of HBOT in radiation cystitis and to identify the predictive factors for a successful outcome. MATERIAL AND METHODS: We retrospectively reviewed 105 patients diagnosed with RIHC which were treated with HBOT between 2007 and 2016 in our institution. Patients received 100% oxygen in a multiplace hyperbaric chamber at 2.4atm for 80minutes. All patients fulfilled a questionnaire documenting symptom severity pre-HBOT and at the end of the follow-up period. RESULTS: After a median of 40 HBOT sessions, there was success rate of 92,4% in the control of hematuria. During our follow-up period (median of 63 months) 24,7% patients presented with recurrence of hematuria. The mean score of the questionnaire-assessed variables: dysuria, urinary frequency and hematuria, was significantly lower after the follow-up period (P<.05). Our data shows that the sooner HBOT is delivered after the first episode of hematuria, better response rates are achieved and lower recurrences concerning hematuria were registered (P<.05). No serious complications were observed. CONCLUSIONS: Our results support the safety and long-term benefits of HBOT on RIHC and other distressful bladder symptoms, which represents an expected improvement of quality of life in our patients.

EvoComposer: An Evolutionary Algorithm for 4-Voice Music Compositions.

Evolutionary algorithms mimic evolutionary behaviors in order to solve problems. They have been successfully applied in many areas and appear to have a special relationship with creative problems; such a relationship, over the last two decades, has resulted in a long list of applications, including several in the field of music. In this article, we provide an evolutionary algorithm able to compose music. More specifically we consider the following 4-voice harmonization problem: one of the 4 voices (which are bass, tenor, alto, and soprano) is given as input and the composer has to write the other 3 voices in order to have a complete 4-voice piece of music with a 4-note chord for each input note. Solving such a problem means finding appropriate chords to use for each input note and also finding a placement of the notes within each chord so that melodic concerns are addressed. Such a problem is known as the unfigured harmonization problem. The proposed algorithm for the unfigured harmonization problem, named EvoComposer, uses a novel representation of the solutions in terms of chromosomes (that allows to handle both harmonic and nonharmonic tones), specialized operators (that exploit musical information to improve the quality of the produced individuals), and a novel hybrid multiobjective evaluation function (based on an original statistical analysis of a large corpus of Bach's music). Moreover EvoComposer is the first evolutionary algorithm for this specific problem. EvoComposer is a multiobjective evolutionary algorithm, based on the well-known NSGA-II strategy, and takes into consideration two objectives: the harmonic objective, that is finding appropriate chords, and the melodic objective, that is finding appropriate melodic lines. The composing process is totally automatic, without any human intervention. We also provide an evaluation study showing that EvoComposer outperforms other metaheuristics by producing better solutions in terms of both well-known measures of performance, such as hypervolume, Δ index, coverage of two sets, and standard measures of music creativity. We conjecture that a similar approach can be useful also for similar musical problems.

Management of ischemic diabetic foot.

Diabetic foot pathology represent the more disabling complication of diabetes. More the 1 million of diabetes patients undergo a lower limb amputation per year; 85% of these amputation are preceded by un ulcer that can be avoided by a prevention program. Critical limb ischemia (CLI), the only independent cause of major amputation in diabetic population, can be correctly treated when an early diagnosis is made. Both endoluminal and surgical revascularization procedures can be applied in diabetes with high rate of success when performed by skilled operator. Infection of diabetic foot, in particular in patients suffering from peripheral artery disease (PVD), may rapidly evolves in severe local or systemic infection putting the patient at high risk of major amputation or death. Together with an early diagnosis of infection and ischemia it is mandatory to apply a correct medical and surgical treatment protocol with the aim to control infection and to improve blood perfusion to the foot. In case of infection surgical procedure should be applied first while revascularization procedure will follow soonest. Antibiotic therapy should be chosen considering different local biological pattern and different type of infection. Reconstructive surgery, the last step in treatment of any diabetic foot lesion, must obtain a functional residual foot or a stump that will allow the patient to go back walking soonest with residual good walking capacity.

Chemical composition and biotechnological properties of a polysaccharide from the peels and antioxidative content from the pulp of Passiflora liguralis fruits.

A new polysaccharide with a high molecular weight (greater than 1 x 106 Da) was extracted and characterized from the peels of Passiflora liguralis (granadilla) fruits. Chemical composition of the biopolymer, performed by using a high pressure anion exchange-pulsed amperometric detector (HPAE-PAD), showed the presence of six different sugar residues: xylose, glucose, galactose, galactosamine, an unknown component, and fucose in the relative ratio of 1:0.5:0.2:0.06:0.05:trace. The optical rotation of this xyloglucan was [alpha](D)(25) degrees C = -186.42 (concentration of 1.4 mg/mL of H(2)O), and the viscosity was dependent on the concentration and pH, showing a maximum value of 1.4 eta at a concentration of 3% in distilled water and a maximum value of 7.0 eta in citrate buffer solution. Thermogravimetric analysis indicated that this biopolymer was very stable at high temperatures, showing a degradation temperature at 280 degrees C. The characterization of the polysaccharide was also investigated by spectroscopic methods (1H NMR and IR) pointing out the complexity of this biopolymer and the presence of sugar residues in alpha-manno, alpha-gluco-galacto, and beta-gluco-galacto configurations. The formation of a biodegradable film using this novel xyloglucan was reported, and the anticytotoxic activity of the polysaccharide was studied in a brine shrimp bioassay. Considerable antioxidant activity (Trolox equivalent antioxidant capacity (TEAC) value of 0.32 microM/mg fresh product) was noted in the lipophilic extracts of Passiflora liguralis fruits, indicating, in this fruit, an alternative source of bioactive compounds.

[Acute renal ischemia--unusual cause of lumbar pain]. / Isquemia renal aguda--causa rara de lumbalgia.

Acute renal artery occlusion is rarely found in daily clinical practice. Its rarity and inespecific clinical presentation are responsible for late diagnosis or diagnostic errors, with symptoms frequently being erroneously attributed to other more common entities. There is no consensus in what concerns therapeutic options. Multiple treatment modalities are described in the available literature. Some defend anticoagulant therapy and support measures only while others recommend other more invasive alternatives reaching even open surgery. The authors present two additional case reports of acute embolic renal ischemia. A thorough literature review is also presented comprehending etiological, clinic, diagnostic and therapeutic aspects.

[Bulbourethral sling. The experience of our service]. / Sling bulbouretral. Experiencia del servicio.

OBJECTIVES: The authors present the clinic results obtained with the bulbourethral sling application with pubic bone anchorage (Invance) in patients with stress urinary incontinence. MATERIAL AND METHODS: From July to December 2003, 10 slings were implanted in men between the 60's and the 83 years old (average 72.6 years), whose incontinence appeared after prostatic surgery (retro pubic radical prostatectomy, perineal radical prostatectomy, radical cystoprostatectomy with Camey II neobladder, transurethral resection, transvesical prostate adenomectomy). RESULTS: After 9 months follow-up (3 to 7 months), 8 patients (80%) are continent (without need of using any pad) and 2 (20%) show minimum leakage with effort (need of 1 to 2 daily pads). All are satisfied with the surgery result. Two patients referred perineal pain, which was solved with Paracetamol. There was no case of perineal haematoma, infection, rejection or urethral erosion. CONCLUSION: The bulbourethral sling with bone anchorage is a rather invasive procedure, of easy technical execution, with high continence rates and associated to low morbidity. Although the presented results been an incentive to the technique prolongation, it would be necessary a higher tracking: and higher global experience in order that this sling affirm and transform itself in an alternative to the artificial sphincter in selected cases.

The vinification of partially dried grapes: a comparative fermentation study of Saccharomyces cerevisiae strains under high sugar stress.

AIMS: The study of the fermentation performance of Saccharomyces cerevisiae strains under high sugar stress during the vinification of partially dried grapes. METHODS AND RESULTS: Microvinification of partially dried grape must with sugar concentration of 35 degrees Brix was performed using four commercial strains to carry out alcoholic fermentation. A traditional red vinification without nutrients addition was applied. Yeasts displayed different efficiency to convert sugar in ethanol and varied in glycerol yield. Sugar consumption and ethanol level were attested at 80-87% and 143.5-158.0 g l(-1) respectively. High correlation between sugar and assimilable nitrogen consumption rate was observed. Statistical treatment of data by principal component analysis highlighted the different behaviours that strains exhibited in regard to the production of higher alcohols and other compounds important to wine quality. CONCLUSIONS: Saccharomyces cerevisiae strains displayed appreciable capability to overcome osmotic stress and to yield ethanol fermenting high sugar concentration grape must in winemaking condition. SIGNIFICANCE AND IMPACT OF THE STUDY: The results provided insights on the strain contribution to wine quality subordinate to stress condition. This investigation is of applicative interest for winemaking and processing industry that use high sugar concentration musts.

[Imperforate syringocele of the Cowper's glands laparoscopic treatment]. / Siringocele imperforado de las glándulas de Cowper. Tratamiento por vía laparoscópica.

OBJECTIVES: The authors present a clinical report of an imperforate syringocele diagnosed on a male patient and treated by laparoscopic surgery. MATERIAL AND METHODS: A forty-four year old patient attends the emergency room with acute urinary retention. With a former history of mild obstructive voiding symptoms, he presented, at rectal examination, a bump on the left rectal wall. This patient also underwent urethrocistoscopy, sonography and retrograde urethrography. To establish the diagnose, Computerized Tomography (CT) scan and MRI were used. RESULTS: The syringocele marsupialization by laparoscopic surgery, allowed the resolution of the clinical problem, with a good outcome. The patient was discharged 48 hours after surgery, with no need of a vesical catheter. A six month follow-up showed no recurrence. CONCLUSIONS: The syringocele is a rare deformity which usually is asymptomatic. Of acquired or congenital etiology, it can be classified in four different morphological types: simple, perforate, imperforate and ruptured. The most frequent treatment is the marsupialization of the syringocele by endoscopic surgery, leaving a broad opening of the cavity to the urethra. Some authors recommend an open surgery excision, specially in the presence of an abscess. The laparoscopic approach becomes a minimally invasive alternative with good therapeutically outcome. In the incidentally discovered asymptomatic patients, an expectant approach is the correct approach.

Lycopene in association with alpha-tocopherol or tomato lipophilic extracts enhances acyl-platelet-activating factor biosynthesis in endothelial cells during oxidative stress.

Lipophilic compounds contained in tomato can prevent cardiovascular diseases by modulating the atherogenic processes in vascular endothelium mediated by oxidized low-density lipoproteins (LDLs). We investigated the effects of lycopene on the metabolism of platelet-activating factor (PAF) and its much less biologically active acyl analog, acyl-PAF, known to prevent LDL oxidation. Lycopene, or lycopene in association with alpha-tocopherol, or whole tomato lipophilic extracts (containing more than 80% lycopene) were used in experiments in which endothelial cells (ECs) are known to synthesize PAF following H(2)O(2)-induced oxidative stress. The results indicated that in each case H(2)O(2)-stimulated PAF biosynthesis in ECs, which is catalyzed by acetyl-CoA acetyltransferase (AT), appeared strongly inhibited. However, acyl-PAF biosynthesis, which also occurs through the PAF-dependent transacetylase (TA), was significantly increased by lycopene only when it was in association with alpha-tocopherol or with the minor compounds present in the whole lipophilic tomato extract. These findings suggest that alpha-tocopherol or lipophilic compounds present in tomato juice potentiate the effects of lycopene on the modulation of PAF and acyl-PAF biosynthesis in ECs during oxidative stress.

[Inverted papillomas--cases at our service and review of the literature]. / Papilomas invertidos--casuística del servicio y revisión de la literatura.

Inverted papillomas are rare tumours representing about 2.2% of all urothelial tumours (benign or malignant). Inverted papillomas are predominantly seen in the bladder but these tumours have also been described in other locations, all over the urinary tract. The authors report six additional cases of such tumours describing the individual characteristics of each case, presenting symptoms, treatment employed and follow up available. A review of the literature relative to aetiology, clinical signs and symptoms, diagnostic criteria, treatment options and outcome has also been carried out.

[Solitary fibrous tumor. Two additional cases with urologic implications]. / Tumor fibroso solitario. Dos casos adicionales con implicaciones urológicas.

Solitary fibrous tumour is a well defined pathological entity originally described as a tumour of the pleura, but the occurrence of this neoplasm has increasingly been described at other sites. At present the development of these tumours is recognized as possible in virtually all anatomical sites. The rarity of this type of pathology has not allowed up to the present time clarification of the histogenesis, clinical behaviour, treatment and prognosis of these tumours. Differential diagnosis becomes important, especially in extra-thoracic sites so as not to mistake them for much more aggressive mesenquimal tumours. Two additional cases of this neoplasm are presented, one of them responsible for obstructive uropathy, accidentally found in a patient suffering renal trauma. The second tumour was located in the spermatic cord. A review of the theme is presented based on the available literature.

New abutment for a screw-retained, implant-supported crown.

The 1-piece, implant-supported abutment and crown, colloquially described as the UCLA abutment, commonly is used to fabricate single, screw-retained crowns. This abutment was designed to allow attachment of the crown directly to the implant and requires a waxing and casting procedure by a laboratory technician. A new prefabricated abutment has been developed that uses a similar approach but does not require the waxing and casting process. The PDQ abutment is made from a metal-ceramic alloy that is custom contoured by grinding to support a porcelain veneer. Porcelain then is fired to the contoured abutment to develop the 1-piece artificial crown. This article describes the use of the PDQ abutment.

[Hematuria]. / Hematúria.

Patients referred for hematuria work-up are frequently seen in the urologic practice. The initial evaluation does not require the participation of a urologist or nephrologist, due to the false sense of security in the evaluation of an asymptomatic and persistent hematuria. In fact, an adequate history and physical followed by urinalysis and radiologic tests, such as IVP and ultrasonography, must be made in the initial evaluation to exclude any serious urologic/nephrologic disease.

Purification of a 76-kDa iron-binding protein from human seminal plasma by affinity chromatography specific for ribonuclease: structural and functional identity with milk lactoferrin.

A pink-colored iron-binding protein has been found in large amount in human seminal plasma and identified as a lactoferrin isoform. Its purification, by a modification of a three-step chromatography procedure developed in an attempt to purify a ribonuclease from the same fluid, provided about 15-18 mg of pure protein from 100 ml of seminal plasma. Despite its ability to bind a ribonuclease ligand during the affinity step, the iron-binding protein did not display any detectable RNase activity in a standard assay with yeast RNA as substrate. It showed an apparent molecular weight of 76 kDa and resulted to be quite similar, if not identical, to human milk lactoferrin in many respects. Its N-terminal sequence (31 amino acid residues) starting with Arg-3 was identical to that of one of the N-terminally truncated lactoferrin variants isolated from human milk. Moreover, the amino acid sequence of a number of peptides, which represented about 23% of the entire sequence, has been also shown to be identical to that of the corresponding peptides of human milk lactoferrin. Double diffusion analysis revealed full recognition by antibodies anti-human milk lactoferrin of the human seminal plasma protein. Using immunoblotting analysis, both human milk lactoferrin and human seminal protein were recognized by antibodies anti-milk lactoferrin. When tested for its iron binding capacity, with Fe-NTA as iron donor, the protein purified was able to bind iron up to 100% saturation, as judged by absorbance at 465 nm.

[Pelvic lipomatosis]. / Lipomatosis pélvica.

Pelvian lipomatosis is a proliferative process of fatty tissue in the perivesical and perirectal pelvian space. The etiology is unknown and some authors consider that in reality is a localized form of obesity. Diagnosis can be incidental, or be part of a sequence within a study for unspecific symptoms such as pelvian complains or perineal problems. As part of the presentation of a clinical case report, the authors make a revision of this disease, focusing in several particular aspects, like diagnostic methods, treatment, etc.

Prognostic factors in childhood intracranial ependymomas: the role of age and tumor location.

Despite several clinical reports on intracranial ependymomas in children, the factors which affect prognosis, and the possibility that certain combinations of factors might limit survival, are still a matter of debate. Between 1976 and 1996 we operated on 35 children with intracranial ependymomas. Postoperative irradiation was given to 27 patients, with associated chemotherapy in 6 cases. Mean follow-up was 62 months. In 12 patients a 5-year follow-up was possible. In October 1996, 18 patients (51.4%) were still alive, the longest disease-free follow-up being 20 years, and the shortest 8 months. We analyzed the prognostic relevance of eight factors. For each factor, different subgroups were distinguished and compared as follows: age at diagnosis (<4 vs. >/=4 years), sex, tumor location (supratentorial vs. infratentorial), tumor size (<4 vs. 4-7 vs. >7 cm), surgical removal (total vs. subtotal), histology (low-grade vs. anaplastic), morphology (solid vs. cystic), adjuvant therapies (treatment vs. no treatment). Two-way contingency tables were made to identify associations between variables. The only significant association was between age and tumor location (p = 0.022): in children under 4, tumors were almost invariably located in the posterior fossa (9 out of 10 cases) with a clear preference for the lateral recess (8 cases). Other correlations were not significant. Kaplan-Meier survival curves were compared to assess the prognostic relevance of each factor. Survival was significantly lower for children under 4, for those with posterior fossa tumors, and for patients with residual tumor (p < 0.05). A multivariate analysis compared variables which significantly affected survival, revealing that age is the most important factor affecting prognosis (p < 0.05), while tumor location and surgical removal do not add any significance to the effect of age on survival. We conclude that age has the strongest prognostic relevance in childhood intracranial ependymomas, while the effect of tumor location on survival may be related to the high incidence of lateral recess ependymomas in younger children.

Single-strand-preferring RNases degrade double-stranded RNAs by destabilizing its secondary structure.

To establish the mechanism of dsRNA degradation by mammalian single-stranded-preferring ribonucleases, and, in particular, the influence of their positively charged non-catalytic amino acid residues, we have studied the kinetic parameters of the depolimerization of single- and double-stranded polyribonucleotides such as poly(U), poly(U).poly(A), poly(C) and poly(C).poly(I) by the action of human seminal RNase, bovine seminal RNase and ox pancreas RNase A. While the activities of these RNases on poly(I).poly(C) were definitely lower than those on poly(C), the activities of human seminal and bovine seminal RNases on poly(U).poly(A) and poly(U) were of the same order of magnitude under physiological salt conditions. The ratio of the RNase A degrading activities towards poly(U) and poly(U).poly(A) at I = 0.16 M is ten times higher than the corresponding ratios determined with bovine seminal and human seminal ribonucleases. The high activities of these two RNases towards poly(U).poly(A) are discussed on the basis of their efficient estabilishing action on this double-helical nucleic acid due to their high affinity for poly(A). The destabilizing action of human seminal RNase and bovine seminal RNase on the poly (U).poly(A) duplex is higher than that measurable with bovine RNase A because of the higher number of positive charges present on those enzyme molecules. This may therefore explain why human seminal and bovine seminal ribonucleases are more efficient than RNase A in the depolymerization of poly(U).poly(A) at physiological ionic strength.

[Vesico-scrotal hernia. Report of a clinical case]. / Hernia vésico-escrotal. A propósito de un caso clínico.

Incidental discovery of vesical hernias during herniorrhaphy is quite common. In such cases, patients are usually asymptomatic since the hernia portion is small and easily repairable. On the other hand, vesical solid protrusion to the scrotum is quite unusual, and is generally found associated to obstructive urinary symptoms. Management involves basically the correction of any associated obstructive conditions, correction of the vesical hernia and herniorrhaphy.

[Sealing of occlusal surfaces in preventodontics]. / La sigillatura delle superfici occlusali in preventodonzia.

The Authors, helped by S.E.M., examine the validity of the sigillature, as prophilactic measure against the formation of carious process. Tests effectuated on 100 patients' teeth show this therapy efficaciousness.