Neoadjuvant use of Imiquimod Before Surgery in Extramammary Paget’s Disease

A doença de Paget extramamária (DPEM) é uma neoplasia maligna cutânea, rara, observada principalmente em mulheres caucasianas pós-menopausa. A cirurgia é o tratamento mais comum. No entanto, no que diz respeito à DPEM vulvar, o seu tratamento cirúrgico passa frequentemente por cirurgia radical, que pode ser mutilante e levar à perda de feminilidade. Recentes avanços terapêuticos têm incluído abordagem médica e multimodal médico-cirúrgico, permitindo uma maior preservação da anatomia genital e subsequente diminuição da morbilidade. Neste sentido, imiquimod tem sido utilizado, off-label, como monoterapia ou terapêutica adjuvante na DPEM.Relatamos o caso de uma mulher com DPEM extenso na área anogenital submetida a resseção cirúrgica complementada com reconstrução plástica e precedida de tratamento médico com imiquimod. O imiquimod neoadjuvante permitiu uma citorredução significativa da área tumoral, minimizando a radicalidade cirúrgica, mantendo a função local e a morfologia.Extramammary Paget's disease (EMPD) is a distinct form of a rare malignant skin neoplasm, primarily seen in postmenopausal Caucasian women. Surgery is the most common treatment. However, concerning vulvar EMPD, radical surgery can be mutilating and leads to loss of femininity. Recent therapeutic development has included medical and medical-surgical approaches, allowing better preservation of genital anatomy with subsequent reduced morbidity. Accordingly, off-label use of imiquimod has been reported as a monotherapy or adjuvant therapy in EMPD.We report the case of a woman with extensive EMPD in the anogenital area, submitted to surgical resection complemented with plastic reconstruction and preceded by imiquimod medical treatment. Neoadjuvant imiquimod induced a significant cytoreduction of the tumor area, minimizing surgical radicality and maintaining local function and morpholog

Response of key stress-related genes of the seagrass Posidonia oceanica in the vicinity of submarine volcanic vents

Submarine volcanic vents are being used as natural laboratories to assess the effects of increased ocean acidity and carbon dioxide (CO2) concentration on marine organisms and communities. However, in the vicinity of volcanic vents other factors in addition to CO2, which is the main gaseous component of the emissions, may directly or indirectly confound the biota responses to high CO2. Here we used for the first time the expression of antioxidant and stress-related genes of the seagrass Posidonia oceanica to assess the stress levels of the species. Our hypothesis is that unknown factors are causing metabolic stress that may confound the putative effects attributed to CO2 enrichment only. We analyzed the expression of 35 antioxidant and stress-related genes of P. oceanica in the vicinity of submerged volcanic vents located in the islands of Ischia and Panarea, Italy, and compared them with those from control sites away from the influence of vents. Reverse-transcription quantitative polymerase chain reaction (RT-qPCR) was used to characterize gene expression patterns. Fifty-one percent of genes analyzed showed significant expression changes. Metal detoxification genes were mostly down-regulated in relation to controls at both Ischia and Panarea, indicating that P. oceanica does not increase the synthesis of heavy metal detoxification proteins in response to the environmental conditions present at the two vents. The up-regulation of genes involved in the free radical detoxification response (e.g., CAPX, SODCP and GR) indicates that, in contrast with Ischia, P. oceanica at the Panarea site faces stressors that result in the production of reactive oxygen species, triggering antioxidant responses. In addition, heat shock proteins were also activated at Panarea and not at Ischia. These proteins are activated to adjust stress-accumulated misfolded proteins and prevent their aggregation as a response to some stressors, not necessarily high temperature. This is the first study analyzing the expression of target genes in marine plants living near natural CO2 vents. Our results call for contention to the general claim of seagrasses as "winners" in a high-CO2 world, based on observations near volcanic vents. Careful consideration of factors that are at play in natural vents sites other than CO2 and acidification is required. This study also constitutes a first step for using stress-related genes as indicators of environmental pressures in a changing ocean.project HighGrass "High-CO2 effects on seagrass photosynthetic ecophysiology" [PTDC/MAREST/3687/2012]; MIUR Italian flagship project RITMARE; ESF COST Action "Seagrass Productivity: from genes to ecosystem management

Quantum Topology Change in (2 + 1)d

The topology of orientable (2 + 1)d spacetimes can be captured by certain lumps of non-trivial topology called topological geons. They are the topological analogues of conventional solitons. We give a description of topological geons where the degrees of freedom related to topology are separated from the complete theory that contains metric (dynamical) degrees of freedom. The formalism also allows us to investigate processes of quantum topology change. They correspond to creation and annihilation of quantum geons. Selection rules for such processes are derived.Comment: LaTeX file, 33 pages, 10 postscript figures, some typos corrected, references updated, and other minor change

Nonlinear optimization for human-like movements of a high degree of freedom robotics arm-hand system

The design of autonomous robots, able to closely cooperate with human users in shared tasks, provides many new challenges for robotics research. Compared to industrial applications, robots working in human environments will need to have human-like abilities in their cognitive and motor behaviors. Here we present a model for generating trajectories of a high degree of freedom robotics arm-hand system that reflects optimality principles of human motor control. The process of finding a human-like trajectory among all possible solutions is formalized as a large-scale nonlinear optimization problem. We compare numerically three existing solvers, IPOPT, KNITRO and SNOPT, in terms of their real-time performance in different reach-to-grasp problems that are part of a human-robot interaction task. The results show that the SQP methods obtain better results than the IP methods. SNOPT finds optimal solutions for all tested problems in competitive computational times, thus being the one that best serves our purpose.Eliana Costa e Silva was supported by FCT (grant: SFRH/BD/23821/2005). The resources and equipment were financed by FCT and UM through project "Anthropomorphic robotic systems: control based on the processing principles of the human and other primates motor system and potential applications in service robotics and biomedical engineering" (Ref. CONC-REEQ/17/2001) and by EC through project "JAST: Joint-Action Science and Technology" (Ref. IST- 2-003747-IP).We thank the Mobile and Anthropomorphic Robotics Laboratory at University of Minho for constant good work environment. Finally, we would like to thank Carl Laird and Andreas Wachter for making available IPOPT, and AMPL for making available an unrestricted 30 days trial version of AMPL, KNITRO and SNOPT executables