Performance enhancement of an ultrafast all-fiber laser based on an InN saturable absorber using GRIN coupling.

Indium nitride (InN)-based semiconductor saturable absorbers have previously shown advantages for application in near-IR fiber lasers due to their broad modulation depth, ultrafast nonlinear response and thermal stability. However, up to now all demonstrated saturable absorber elements based on InN (either transmissive or reflective) have shown limited performance due to poor coupling and insertion losses. We present here a simple mode-locking device based on a GRIN-rod lens in conjunction with an InN semiconductor saturable absorber mirror (SESAM) for its use in a passively mode-locked all-fiber laser system operating at telecom wavelengths. Our results demonstrate that this coupling element ensures not only a compact, turnkey and alignment-free design but also a highly-stable optical femtosecond pulse train. The reduction of insertion losses (3.5 dB) enables the generation of 90-fs ultrafast pulses with an average power of 40 mW and up to 7 nJ of pulse energy without the need for additional amplification.

Leukoencephalopathy due to oral methotrexate.

Methotrexate (MTX) is considered the main agent for the treatment of rheumatoid arthritis (RA). Neurotoxicity is often mild, but severe encephalopathy can develop, especially with intrathecal or intravenous administration. In rare cases, this syndrome has been observed in patients on long-term low-dose oral administration. A 68-year-old male was diagnosed with RA and on treatment with oral MTX 25 mg weekly for 4 years. The patient started with progressive dysarthria, ataxia and cognitive dysfunction. Complementary tests were normal. Magnetic resonance imaging (MRI) showed hyperintense lesions in both cerebellar hemispheres on T2-weighted and FLAIR images with a diffusion restriction on diffusion-weighted imaging (DWI) and on the apparent diffusion coefficient map (ADC). On postgadolinium T1-weighted images, there were mild enhancements. Spectroscopy showed a demyelinating pattern. A pharmacogenetics determination was made, showing a heterozygous genotype in the MTHFR and ABCB1 genes. Medication with antirheumatic drug was stopped immediately on admission, and the patient gradually improved. MTX-induced leukoencephalopathy can occur even with low-dose administration. The exact pathogenic mechanism is still unknown, but it is hypothesised that it could be the result of a cumulative toxic effect on the blood-brain barrier. The nature of the relationship between the polymorphism and CNS toxicity is still unclear, and thus, further studies are warranted. Often located in the occipital lobes, the involvement of the cerebellum is quite rare. Early recognition of the condition and withdrawal of the drug lead to a better prognosis.

Gastrointestinal parasites in Chinstrap Penguins from Deception Island, South Shetlands, Antarctica.

Knowledge about parasites of Antarctic birds is fragmented and scarce. The aim of this work is to contribute to the knowledge of gastrointestinal parasites of the Chinstrap Penguin (Pygoscelis antarctica) from Deception Island (South Shetlands, Antarctica). Gastrointestinal tracts of 64 fresh dead individuals (61 chicks and three adults) were collected from December 2006 to February 2009 and examined for macroparasites. Three adult parasite species were found: two Cestoda species (Parorchites zederi and Tetrabothrius pauliani) and one Nematoda species (Stegophorus macronectes). Also, immature acanthocephalans (Corynosoma sp.) were found in one penguin. The low parasite richness observed could be related to the stenophagic and pelagic diet of the host species. False negatives were found in coprological studies.

Laparoscopic latero-abdominal colposuspension: Description of the technique, advantages and preliminary results. / Colposuspensión latero-abdominal laparoscópica: descripción, ventajas y resultados preliminares.

INTRODUCTION: There are currently various fixation or suspension techniques for pelvic organ prolapse (POP) surgery. Laparoscopic colposacropexy is considered the gold standard. We present the surgical steps of the laparoscopic latero-abdominal colposuspension (LACS) technique and the preliminary results obtained. MATERIAL AND METHODS: Patients with anterior and/or apical compartment symptomatic POP undergoing LACS are included. The Baden-Walker scale, the Overactive Bladder Questionnaire-Short Form (OAB-q SF), the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) and the Patient Global Impression of Improvement (PGI-I) scale were used to assess the degree of prolapse, urinary filling and sexual symptoms and the level of satisfaction before and after surgery, respectively. Conventional laparoscopic material and a polyvinylidene fluoride (PVDF) mesh were used. RESULTS: Eighteen patients were included with a minimum follow-up time of 6months. The mean surgical time was 70.3±23.8min. Anatomic correction of prolapse was seen in all cases. Only one recurrence was detected. High levels of patient satisfaction were achieved. CONCLUSION: LACS allowed the anatomical reconstruction of the pelvic floor and proved to be a minimally invasive, fast, effective, safe and reproducible technique. More series are needed to evaluate its role against laparoscopic colposacropexy.

Pharmacological blockade of CCR1 ameliorates murine arthritis and alters cytokine networks in vivo.

BACKGROUND AND PURPOSE: The chemokine receptor CCR1 is a potential target for the treatment of rheumatoid arthritis. To explore the impact of CCR1 blockade in experimental arthritis and the underlying mechanisms, we used J-113863, a non-peptide antagonist of the mouse receptor. EXPERIMENTAL APPROACH: Compound J-113863 was tested in collagen-induced arthritis (CIA) and three models of acute inflammation; Staphylococcus enterotoxin B (SEB)-induced interleukin-2 (IL-2), delayed-type hypersensitivity (DTH) response, and lipopolysaccharide (LPS)-induced tumour necrosis factoralpha (TNFalpha) production. In the LPS model, CCR1 knockout, adrenalectomised, or IL-10-depleted mice were also used. Production of TNFalpha by mouse macrophages and human synovial membrane samples in vitro were also studied. KEY RESULTS: Treatment of arthritic mice with J-113863 improved paw inflammation and joint damage, and dramatically decreased cell infiltration into joints. The compound did not inhibit IL-2 or DTH, but reduced plasma TNFalpha levels in LPS-treated mice. Surprisingly, CCR1 knockout mice produced more TNFalpha than controls in response to LPS, and J-113863 decreased TNFalpha also in CCR1 null mice, indicating that its effect was unrelated to CCR1. Adrenalectomy or neutralisation of IL-10 did not prevent inhibition of TNFalpha production by J-113863. The compound did not inhibit mouse TNFalpha in vitro, but did induce a trend towards increased TNFalpha release in cells from synovial membranes of rheumatoid arthritis patients. CONCLUSIONS AND IMPLICATIONS: CCR1 blockade improves the development of CIA, probably via inhibition of inflammatory cell recruitment. However, results from both CCR1-deficient mice and human synovial membranes suggest that, in some experimental settings, blocking CCR1 could enhance TNF production.

Obliteration of femoral pseudoaneurysm complicating coronary intervention by direct puncture and permanent or removable coil insertion.

We report on percutaneous obliteration of femoral pseudoaneurysm complicating percutaneous coronary interventions in 6 patients. Our findings suggest that permanent or transient direct coil insertion may be an useful alternative in the treatment of pseudoaneurysm in patients who do not respond to mechanical compression.

In-laboratory removal of femoral sheath following protamine administration in patients having intracoronary stent implantation.

Two hundred twenty-eight patients with successful coronary stent implantation were randomized either to protamine administration and femoral sheath removal (group I, n = 117) or no heparin neutralization and delayed sheath removal (group II, n = 111). The hospital stay after treatment was shorter in patients receiving protamine; therefore, protamine use for neutralizing circulating heparin may be safely administered immediately after stent implantation.

Conjugate addition of organocuprates to chiral bicyclic delta-lactams. Enantioselective synthesis of cis-3,4-disubstituted and 3,4,5-trisubstituted piperidines.

[reaction: see text] Chiral nonracemic bicyclic lactam 3, easily accessible by cyclodehydration of (R)-phenylglycinol and racemic methyl 4-formylhexanoate, was converted to the unsaturated lactams 5, which undergo the stereoselective conjugate addition of lower order cyanocuprates to ultimately lead to enantiopure cis-3,4-disubstituted and 3,4,5-trisubstituted piperidines.

Unprecedented oxidation of a phenylglycinol-derived 2-pyridone: enantioselective synthesis of polyhydroxypiperidines.

[reaction: see text]. The phenylglycinol-derived 2-pyridone 1 undergoes m-CPBA oxidation steroselectively leading to the chiral nonracemic unsaturated bicyclic hydroxylactam 2, from which the enantioselective synthesis of (3R,5R)-3,4,5-trihydroxypiperidine (16) and the formal synthesis of the azasugar epiisofagomine are described. The enantioselective synthesis of (S)-N-Boc-3-hydroxypiperidine and (3R,4S)-3,4-dihydroxypiperidine is also reported.

[Long-term clinical course of acute myocarditis. Prospective study of a series of 99 patients (1987-1995)]. / Evolución a largo plazo de la miocarditis aguda. Estudio prospectivo de una serie de 99 pacientes (1987-1995).

BACKGROUND: The natural history of acute myocarditis is not well known. The aim of our study was to assess the spontaneous outcome of patients with this disease and its possible relation with progression to chronic dilated cardiomyopathy. METHODS: With this aim, we have carried out a prospective study of 99 patients consecutively diagnosed with acute myocarditis in our hospital from 1987 to April 1995, with a mean follow-up of 34 +/- 25 months. Acute myocarditis was diagnosed by clinical, echocardiographic and isotopic (detection of myocite damage) data, in absence of any other cardiac lesion. RESULTS: Mean age was 26 +/- 17 years; 70% of the patients were male. Initial symptoms were dyspnea in 58% of the patients, chest pain in 33% and arrhythmias in 9%. Severe heart failure was present in 62% of the patients, ventricular arrhythmias in 16% and supraventricular arrhythmias in 16%. Cardiothoracic index was 0.50 +/- 0.07. Left ventricular ejection fraction was 0.40 +/- 0.18, although in 44% of the patients it was lower than 0.30. Immunosuppressive therapy was not used in any case. Outcome was favorable in 70% of the patients, who had a normal ejection fraction, while 13% died or needed heart transplantation during follow-up and 17% progressed to stable chronic dilated cardiomyopathy. Final ejection fraction was 0.53 +/- 0.17, significantly higher than the initial, 0.40 +/- 0.18 (p < 0.05); this improvement in ejection fraction was mainly observed during the first month after diagnosis (0.49 +/- 0.18). The proportion of patients with an ejection fraction of less than 0.30 decreased from 44% to 21% at the end of follow-up. CONCLUSIONS: Spontaneous outcome of acute myocarditis is good in the majority of patients, although an unfavourable evolution was observed in almost 30% of the patients (death, need of heart transplantation or chronic dilated cardiomyopathy). Improvement in ventricular function mainly occurs at short-term, during the first month of evolution in our study.

[Prognostic factors of thyroid function following surgical therapy in Graves-Basedow's disease]. / Factores pronósticos en el resultado funcional del tratamiento quirúrgico de la enfermedad de Graves-Basedow.

BACKGROUND: The goals of this work are to describe late thyroid function and to determine predictive factors of permanent hypothyroidism following surgery in Graves-Basedow's disease. PATIENTS AND METHOD: From 1979 to 1999, 107 patients with hyperthyroidism due to Graves-Basedow's disease underwent subtotal thyroidectomy. We performed life-table analysis and calculated the cumulative incidence of hypothyroidism by means of the Kaplan-Meier's method. Survival (euthyroidism)within patients groups was compared using the Mantel-Cox method. Variables influencing long-term thyroid function were determined by estimating the Odds ratio with a logistic regression model. RESULTS: The probability of euthyroidism among all 107 patients at 240 months was 51.4%.Age, gender, duration of both hyperthyroidism and antithyroid therapy and weight of resected thyroid tissue did not influence the eventual outcome. The weight of thyroid remnant was 5.4 (1.5)g and the conditional logistic regression analysis showed that weight of thyroid remnant was the only variable influencing long-term thyroid function. Hyperthyroidism relapsed in 5 patients. CONCLUSIONS: In our experience,surgery represents a definitive alternative treatment with a risk of hypothyroidism within the first 2 years of 43.9%. The weight of thyroid remnant is the only variable influencing long-term thyroid function.

[Chorioangioma of the placenta. Echographic, radiologic and anatomo-pathologic correlations]. / Le chorioangiome placentaire. Corrélations échographiques, radiologiques et anatomo-pathologiques.

Chorangioma, one of the most frequent placental tumors, is associated with an important perinatal morbidity and mortality. We describe the case of a pregnant woman in whom this tumor was diagnosed during a routine obstetric investigation. The originality of our report is a strong and clear correlation between echographic, radiologic and histopathological findings. To avoid its obstetric and perinatal dramatic complications, we review the main echographic patterns allowing an early diagnosis of chorangioma.

Hypothyroidism after iodine-131 or surgical therapy for Graves' disease hyperthyroidism.

BACKGROUND: The aim of this work was to describe late permanent hypothyroidism after iodine-131 or surgery, and to seek predictive factors of hypothyroidism for the two treatments. MATERIAL: From 1979 to 1994, 462 patients with Graves' disease hyperthyroidism underwent definitive treatment. Three hundred and fifty-five patients were treated with low calculated doses of iodine-131, and 107 patients with subtotal thyroidectomy. Life-table analysis was performed and the cumulative incidence of hypothyroidism was calculated by Kaplan-Meier's method, and survival (euthyroidism) within the groups was compared by the Mantel-Cox method. RESULTS: Of the 355 patients treated with one dose of 6.6 1.9 mCi of iodine-131, 246 became euthyroid after one dose, and 109 needed 2 or more doses. Twenty-two patients received one or more doses higher than 10 mCi. The probability of euthyroidism at 145 months after low-dose was 10. 19% and age, sex, pretreatment with antithyroid drugs, previous subtotal surgery did not influence the final outcome. Of the 107 surgically treated patients the probability of euthyroidism at 144 months was 56.1%. Age, sex, duration of hyperthyroidism, duration of antithyroid treatment, weight of thyroid resected, did not influence the final outcome. The weight of the thyroid remnant was 5.4 1.5 g and the multivariate statistical model by conditional logistic regression showed that the weight of thyroid remnant was the only variable that influenced long-term thyroid function. CONCLUSIONS: There is no ideal dose of iodine-131 that would correct hyperthyroidism in Graves disease without risk of hypothyroidism. Surgery is an alternative definitive treatment with a risk of hypothyroidism within the 2 first years, and a cumulative risk of hypothyroidism lower than with iodine-131.

Serum PCB levels in a representative sample of the Spanish adult population: the BIOAMBIENT.ES project.

This manuscript presents the levels of six indicator polychlorinated biphenyl (PCB) congeners (IUPAC nos. 28, 52, 101, 138, 153 and 180) in the serum of 1880 individuals from a representative sample of the Spanish working population recruited between March 2009 and July 2010. Three out of the six PCBs studied (180, 153 and 138) were quantified in more than 99% of participants. PCB 180 was the highest contributor, followed by PCBs 153 and 138, with relative abundances of 42.6%, 33.2% and 24.2%, respectively. In contrast, PCBs 28 and 52 were detected in only 1% of samples, whereas PCB 101 was detectable in 6% of samples. The geometric mean (GM) for ΣPCBs138/153/180 was 135.4 ng/g lipid (95% CI: 121.3-151.2 ng/g lipid) and the 95th percentile was 482.2 ng/g lipid. Men had higher PCB blood concentrations than women (GMs 138.9 and 129.9 ng/g lipid respectively). As expected, serum PCB levels increased with age and frequency of fish consumption, particularly in those participants younger than 30 years of age. The highest levels we found were for participants from the Basque Country, whereas the lowest concentrations were found for those from the Canary Islands. The Spanish population studied herein had similar levels to those found previously in Greece and southern Italy, lower levels than those in France and central Europe, and higher PCB levels than those in the USA, Canada and New Zealand. This paper provides the first baseline information regarding PCB exposure in the Spanish adult population on a national scale. The results will allow us to establish reference levels, follow temporal trends and identify high-exposure groups, as well as monitor implementation of the Stockholm Convention in Spain.

Association of dopamine- and serotonin-related genes with canine aggression.

Human-directed canine aggression was studied using 50 aggressive and 81 non-aggressive dogs. We examined 62 single nucleotide polymorphisms (SNPs) occurring in or in the close vicinity of 16 neurotransmitter-related genes. Allelic associations with aggression were identified for DRD1, HTR1D, HTR2C and SLC6A1. Risk or protective haplotypes for aggressive behaviour based on 2-5 SNPs were identified. The frequency of aggressive dogs varied significantly between the haplotypes within loci and the odds ratios of aggression in dogs with risk haplotypes compared with protective haplotypes varied from 4.4 (HTR2C) to 9.0 (SLC6A1). A risk haplotype across the neurotransmitter receptor gene HTR1D harboured a non-synonymous SNP with a potential effect on protein function. We identified no haplotypes in complete association with the recorded phenotypes, supporting a complex inheritance of aggression.

[I was born a woman, the life of Mame: the dramatization of intergenerational inclusion]. / Nací mujer, la vida de Mame: una puesta en escena sobre la inclusión intergeneracional.

I was born a woman, the life of Mame is the dramatization a fictitious intergenerational story. However, the story is based on true events and the feelings of real immigrant women. The dramatization narrates the life of a woman, from the time her parents-who had recently emigrated from Senegal-settled in Andalusia, up to the adolescence of Mame's own daughter. The story is told with one person on stage who, through the use of three costume changes, plays three different generations of women: mother, daughter and granddaughter, with the video-recorded testimonies of other characters (a teacher and a midwife), who express their views of the host society against a background of African music and pictures of their native country. The present article describes their goals, such as communication in conferences, and includes a concise summary of the script, reflections on the process of integrating, and the evaluation made after a performance.

Successful treatment of intranasal papillomata with imiquimod cream in a human immunodeficiency virus positive patient.

OBJECTIVES: To report a new, alternative treatment for nasal papillomata in human immunodeficiency virus positive patients with multiple recurrences after surgical removal. CASE REPORT: A human immunodeficiency virus positive patient presented with multiple, recurrent nasal papillomata which developed after repeated surgical removal procedures. In this patient, complete and persistent resolution of the lesions was achieved after topical treatment with imiquimod cream. CONCLUSION: Imiquimod is a class of non-nucleoside imidazoquinolinamines which promotes local cytokine release from antigen-presenting cells inducing a T-h1 dominant cell-mediated response against virus-infected cells. Topical imiquimod 5 per cent cream, applied for four to 16 weeks, may offer some benefit in the management of recurrent nasal papillomata in human immunodeficiency virus positive patients. Such treatment may be preferable to surgery or destructive therapeutic options when patients are unwilling or are poor surgical candidates, and also avoids potential surgical sequelae such as scar formation and stenosis.