“Free-Floating Anus”: A Flap-Free Approach for Definitive Excision of Circumferential Giant Condyloma Acuminata

Giant condyloma acuminata (GCA), or Buschke-Löwenstein tumor, is a rare exophytic cauliflower-like growth in the anogenital region. The spectrum of treatment options is wide, ranging from the application of topical ointments to the performance of an abdominoperineal resection. Currently, wide local excision is the most common approach and may entail the creation of a protective loop ileostomy or implementation of flaps or grafts that facilitate closure. We describe a unique surgical approach for the management of circumferential GCA void of the use a protective loop ileostomy, flaps, or grafts. Our report highlights that the implementation of a radical, circumferential, wide excision resulting in “free-floating anus” and healing via secondary intention can ultimately lead to excellent functional and cosmetic results and therefore may be considered a minimally invasive surgical option for patients afflicted with a large, circumferential GCA

High-Resolution Observations in B1-IRS: ammonia, CCS and water masers

We present a study of the structure and dynamics of the star forming region B1-IRS (IRAS 03301+3057) using the properties of different molecules at high angular resolution (~4''). We have used VLA observations of NH3, CCS, and H2O masers at 1 cm. CCS emission shows three clumps around the central source, with a velocity gradient from red to blueshifted velocities towards the protostar, probably due to the interaction with outflowing material. Water maser emission is elongated in the same direction as a reflection nebula detected at 2micron by 2MASS, with the maser spots located in a structure of some hundreds of AU from the central source, possibly tracing a jet. We propose a new outflow model to explain all our observations, consisting of a molecular outflow near the plane of the sky. Ammonia emission is extended and anticorrelated with CCS. We have detected for the first time this anticorrelation at small scales (1400 AU) in a star forming region.Comment: 6 pages, 3 figures. To appear in the Proceedings of the 2004 European Workshop: "Dense Molecular Gas around Protostars and in Galactic Nuclei", Eds. Y.Hagiwara, W.A.Baan, H.J.van Langevelde, 2004, a special issue of ApSS, Kluwe

Stability of de Sitter spacetime under isotropic perturbations in semiclassical gravity

A spatially flat Robertson-Walker spacetime driven by a cosmological constant is non-conformally coupled to a massless scalar field. The equations of semiclassical gravity are explicitly solved for this case, and a self-consistent de Sitter solution associated with the Bunch-Davies vacuum state is found (the effect of the quantum field is to shift slightly the effective cosmological constant). Furthermore, it is shown that the corrected de Sitter spacetime is stable under spatially-isotropic perturbations of the metric and the quantum state. These results are independent of the free renormalization parameters.Comment: 19 pages, REVTeX

A survey for water maser emission towards planetary nebulae. New detection in IRAS 17347-3139

We report on a water maser survey towards a sample of 27 planetary nebulae (PNe) using the Robledo de Chavela and Medicina single-dish antennas, as well as the Very Large Array (VLA). Two detections have been obtained: the already known water maser emission in K 3-35, and a new cluster of masers in IRAS 17347-3139. This low rate of detections is compatible with the short life-time of water molecules in PNe (~100 yr). The water maser cluster at IRAS 17347-3139 are distributed on a ellipse of size ~ 0.2" x 0.1", spatially associated with compact 1.3 cm continuum emission (simultaneously observed with the VLA). From archive VLA continuum data at 4.9, 8.4, and 14.9 GHz, a spectral index alpha = 0.76 +- 0.03 is derived for this radio source, which is consistent with either a partially optically thick ionized region or with an ionized wind. However, the latter scenario can be ruled out on mass-loss considerations, thus indicating that this source is probably a young PN. The spatial distribution and the radial velocities of the water masers are suggestive of a rotating and expanding maser ring, tracing the innermost regions of a torus formed at the end of the AGB phase. Given that the 1.3 cm continuum emission peak is located near one of the tips of the major axis of the ellipse of masers, we speculate on a possible binary nature of IRAS 17347-3139, where the radio continuum emission could belong to one of the components and the water masers would be associated with a companion.Comment: Accepted by The Astrophysical Journal. 25 pages, 6 figure

Gelatin-based nanoparticles as DNA delivery systems: synthesis, physicochemical and biocompatible characterization

The rapidly rising demand for therapeutic grade DNA molecules requires associated improvements in encapsulation and delivery technologies. One of the challenges for the efficient intracellular delivery of therapeutic biomolecules after their cell internalization by endocytosis is to manipulate the non-productive trafficking from endosomes to lysosomes, where degradation may occur. The combination of the endosomal acidity with the endosomolytic capability of the nanocarrier can increase the intracellular delivery of many drugs, genes and proteins, which, therefore, might enhance their therapeutic efficacy. Among the suitable compounds, the gelification properties of gelatin as well as the strong dependence of gelatin ionization with pH makes this compound an interesting candidate to be used to the effective intracellular delivery of active biomacromolecules. In the present work, gelatin (either high or low gel strength) and protamine sulfate has been selected to form particles by interaction of oppositely charged compounds. Particles in the absence of DNA (binary system) and in the presence of DNA (ternary system) have been prepared. The physicochemical characterization (particle size, polydispersity index and degree of DNA entrapment) have been evaluated. Cytotoxicity experiments have shown that the isolated systems and the resulting gelatin-based nanoparticles are essentially non-toxic. The pH-dependent hemolysis assay and the response of the nanoparticles co-incubated in buffers at defined pHs that mimic extracellular, early endosomal and late endo-lysosomal environments demonstrated that the nanoparticles tend to destabilize and DNA can be successfully released. It was found that, in addition to the imposed compositions, the gel strength of gelatin is a controlling parameter of the final properties of these nanoparticles. The results indicate that these gelatin-based nanoparticles have excellent properties as highly potent and non-toxic intracellular delivery systems, rendering them promising DNA vehicles to be used as non-viral gene delivery system

Diagnosis of right bundle branch block: a concordance study

Bundle branch block; ConcordanceBloqueig de branca; ConcordançaBloqueo de rama; ConcordanciaBACKGROUND: Right bundle branch block is one of the most common electrocardiographic abnormalities. Most cases of right bundle branch block are detected in asymptomatic patients in primary care, so a correct interpretation of electrocardiograms (ECGs) at this level is necessary. The objective of this research is to determine the degree of concordance in the diagnosis of incomplete and complete right bundle branch block between four primary care researchers and a cardiologist. METHODS: The research design is a retrospective cohort study of patients over 18 years of ages of patients over 18 years of ages who underwent an ECG for any reason and were diagnosed with right bundle branch block by their physician. The physicians participating, 4 primary care researchers and a cardiologist were specialized in interpreting electrocardiographic records. The diagnosis of incomplete and complete right bundle branch block was recorded and other secondary variables were analysed. In case of diagnostic discordance between the researchers, the ECGs were reviewed by an expert cardiologist, who interpreted them, established the diagnosis and analysed the possible causes for the discrepancy. RESULTS: We studied 160 patients diagnosed with right bundle branch block by their general practise. The patients had a mean age of 64.8 years and 54% of them were men. The concordance in the diagnosis of incomplete right bundle branch block showed a Fleiss' kappa index (k) of 0.71 among the five researchers and of 0.85 among only the primary care researchers. The k for complete right bundle branch block was 0.93 among the five researchers and 0.96 among only the primary care researchers. CONCLUSION: The interobserver agreement in the diagnosis of right bundle branch block performed by physicians specialized in ECG interpretation (primary care physicians and a cardiologist) was very good. The variability was greater for the diagnosis of incomplete right bundle branch block

Early Detection of Corrosion-Induced Concrete Micro-cracking by Using Nonlinear Ultrasonic Techniques: Possible Influence of Mass Transport Processes

This work presents results allowing an unequivocal correlation of the observations of strong nonlinear elastic features of ultrasonic waves (values of the nonlinearity parameters exceeding the thresholds corresponding to undamaged states), with the critical events of the corrosion-induced surface cracking of reinforced cement-mortar specimens. These observations point to the possibility of the early detection of cracking using nonlinear ultrasonic (NLU) techniques. Experimental evidence is presented on the existence of active net mass transport processes, due to wick action, in the course of the corrosion tests, in the experimental conditions of this work. These phenomena might explain the observed abrupt shifting of the nonlinear parameter values (typically increasing and then decreasing post-peak, even reaching values typical of the undamaged state), and, partially, the high variability obtained for the values of the nonlinear parameters in damaged (cracked) states. Finally, some consequences are derived from the point of view of use of the NLU techniques in engineering practice, i.e., in surveys aimed at evaluating reinforced concrete structures affected by corrosion.This research was funded by the Spanish Agencia Estatal de Investigación (grant code BIA2016-80982-R) and by the European Regional Development Fund (grant code BIA2016-80982-R). M.M. acknowledges a pre-doctoral fellowship from the Spanish Ministerio de Educación, Cultura y Deporte (FPU16/04078)

Backreaction from non-conformal quantum fields in de Sitter spacetime

We study the backreaction on the mean field geometry due to a non-conformal quantum field in a Robertson-Walker background. In the regime of small mass and small deviation from conformal coupling, we compute perturbatively the expectation value of the stress tensor of the field for a variety of vacuum states, and use it to obtain explicitly the semiclassical gravity solutions for isotropic perturbations around de Sitter spacetime, which is found to be stable. Our results show clearly the crucial role of the non-local terms that appear in the effective action: they cancel the contribution from local terms proportional to the logarithm of the scale factor which would otherwise become dominant at late times and prevent the existence of a stable self-consistent de Sitter solution. Finally, the opposite regime of a strongly non-conformal field with a large mass is also considered.Comment: 31 page

Thalamic inputs to dorsomedial striatum are involved in inhibitory control: evidence from the five-choice serial reaction time task in rats

Rationale Corticostriatal circuits are widely implicated in the top-down control of attention including inhibitory control and behavioural flexibility. However, recent neurophysiological evidence also suggests a role for thalamic inputs to striatum in behaviours related to salient, reward-paired cues. Objectives Here, we used designer receptors exclusively activated by designer drugs (DREADDs) to investigate the role of parafascicular (Pf) thalamic inputs to the dorsomedial striatum (DMS) using the five-choice serial reaction time task (5CSRTT) in rats. Methods The 5CSRTT requires sustained attention in order to detect spatially and temporally distributed visual cues and provides measures of inhibitory control related to impulsivity (premature responses) and compulsivity (perseverative responses). Rats underwent bilateral Pf injections of the DREADD vector, AAV2-CaMKIIa-HA-hM4D(Gi)-IRES-mCitrine. The DREADD agonist, clozapine N-oxide (CNO; 1 μl bilateral; 3 μM) or vehicle, was injected into DMS 1 h before behavioural testing. Task parameters were manipulated to increase attention load or reduce stimulus predictability respectively. Results We found that inhibition of the Pf-DMS projection significantly increased perseverative responses when stimulus predictability was reduced but had no effect on premature responses or response accuracy, even under increased attentional load. Control experiments showed no effects on locomotor activity in an open field. Conclusions These results complement previous lesion work in which the DMS and orbitofrontal cortex were similarly implicated in perseverative responses and suggest a specific role for thalamostriatal inputs in inhibitory control