Retrograde intrarenal surgery and micro-percutaneous nephrolithotomy for renal lithiasis smaller than 2 CM. / Cirugía retrógrada intrarrenal y micro-nefrolitectomía percutánea en la litiasis renal menor de 2 cm.

INTRODUCTION: Microperc is the upgraded form of percutaneous nephrolithotomy miniaturization. The aim of this study is to compare prospectively microperc and retrograde intrarenal surgery for the treatment of renal stones smaller than 2 cm. MATERIAL AND METHODS: A comparative prospective study of both techniques was carried out between January 2014 and June 2015. Thirty-five patients were divided in two groups: Group A, 17 patients treated by retrograde intrarenal surgery and Group B, 18 patients treated by microperc. Stone clearance was assessed using CT scan 3 months after surgery. RESULTS: Both groups were statistically comparable as demographic variables and stone size was similar (16.76 mm Group A vs 15.72 mm Group B). Success rate, hospital stay and JJ stenting were similar for both groups. There was no statistically significant difference regarding post-operatory complications: 17.64% Group A vs 5.56% Group B (p=0,062), all of them Clavien I and II. Surgical time was statistically different (63.82 min Group A vs 103.24 min Group B) as well as hemoglobin drop (0.62 g/dl Group A and 1.89 g/dl Group B). CONCLUSION: Microperc is an effective and safe procedure for the treatment of renal lithiasis smaller than 2 cm, which makes it a good alternative to retrograde intrarenal surgery for this stone size. However, more prospective studies that include a larger cohort are necessary to confirm our results.

[Indications and morbidity associated with double J catheters.] / Indicaciones y morbilidad asociada a los catéteres doble J.

The use of double J catheters is usual in urologist's daily practice. The indication can be divided in prophylactic or therapeutic. Prophylactically, they prevent complications derived from endourological procedures, such as ureteral lesion or obstructive uropathy secondary to residual lithiasis or edema. Therapeutically, they treat obstructive uropathy of many different pathologies, either in an emergency setting or scheduled, such as lithiasis, stenosis, extrinsic compression of any nature or urinary tract tumors among others. Although they add clear benefits in both cases, they are not free from side effects. The most frequent symptoms they cause are: voiding urgency and increase in voiding frequency, macroscopic hematuria and suprapubic and lumbar pain. The physiopathological mechanism is explained by a mechanical and inflammatory effect or due to vesicoureteral reflux depending on the symptom. This causes patient's quality of life disturbance that may vary from mild degree to very severe. Thus, several strategies have emerged with the aim of diminishing or palliate the intensity of such symptoms: alpha-blocker drugs, design modifications or reduction of their use.

Influence of barbed suture in laparoscopic radical prostatectomy. / Influencia de la sutura barbada en la prostatectomía radical laparoscópica.

OBJECTIVES: To determine the influence of barbed suture in laparoscopic radical prostatectomy. METHODS: A retrospective study of 150 patients who underwent laparoscopic radical prostatectomy was carried out by our department. The patients were divided in two groups according to the kind of suture used during the vesicourethral anastomosis: conventional 3-0 absorbable multifilament running suture (group 1) and bidirectional barbed suture (Quill®) (group 2). Operating time, postoperatory urinary fistula, hospital stay and catheter duration were analyzed in both groups. RESULTS: After the analysis of all the preoperative variables, such as age, PSA, prostate volume, Gleason and stage on biopsy, no statistically significant differences were found in both groups. Operating time was significantly shorter in Group 2 (169±43 min vs 215±45 min, p=0.00). Statistically significant differences were found regarding postoperative urinary fistula rate, hospital stay and urethral catheterization duration, favourable to Group 2. CONCLUSIONS: The use of bidirectional barbed suture (Quill®) for vesicourethral anastomosis in laparoscopic radical prostatectomy, when compared with the conventional suture, shortens surgical time, reduces urinary fistula rate, catheter duration and hospital stay, as the anastomosis is easily performed and prevents leakage.

Heart Rate Variability: a Follow-up in Elite Soccer Players Throughout the Season.

Heart rate variability (HRV) can provide useful information on physiological adaptations to training, but its role is unknown in professional soccer. The aim of this study was to determine an HRV profile in professional soccer over a season. A total of 504 records were made of the heart beat signal throughout a season from 22 professional soccer players. HRV was recorded in a sitting position, early morning and fasting for a period of 10 min. Standard deviation 1 and 2 (SD1, SD2), standard deviation of normal to normal R-R intervals (SDNN), Root Mean Square of the Successive Differences (rMSSD), percentage of RR intervals > 50 ms (pNN50), Sample Entropy (SampEn), Stress Score (SS) and sympathetic/parasympathetic ratio (S/PS ratio) were calculated. SDNN, rMSSD, pNN50, SD1 and SD2 showed an identical behaviour throughout the season, with lower values in the pre-season and the end of the season. SS and S/PS ratio indicated a sympathetic stress alert in the same periods. A weekly recording of the HRV over a 10 min period that includes a Poincaré plot with SS and S/PS ratio and at least one variable of the time domain is a useful tool for the follow-up of the individual assimilation of weekly workloads, including the game.

Characterization of radioactive particles from the Palomares accident.

As a consequence of the nuclear accident that took place in Palomares (Almería, Spain) more than 40 years ago, actinides contamination is present in the area nowadays. Previous investigations performed with soil samples collected in different locations of Palomares indicate that the contamination in the area is highly inhomogeneous, suggesting the existence of radioactive particles, thus hindering the evaluation of the radiological situation. This work presents the methodology used for the location of the radioactive particles in the field and their isolation in the laboratory for further speciation and characterization studies. Colour pictures, electron microscopy images and EDX analyses show that most of the studied particles present a granular appearance with a variable grain size and a high fragmentation tendency, being plutonium and uranium the most abundant nuclear elements. Radiochemical determinations and activity isotopic ratios prove that the nuclear material is aged weapon grade plutonium arising from the Palomares accident.

Identification of sex using cranial base measurements.

It is well known that the skull provides elements for sex identification. Twenty-two bones form the cephalic cranium and they are divided into neurocranium and splancnocranium. This research aimed to study different characteristics between skulls from both sexes by evaluating the following measurements: mastoid notch to incisive foramen (right and left side); mastoid notch to mastoid notch; and incisive foramen to basion. In order to do so, two hundred skulls were selected (100 males and 100 females), with information about the age of the subjects (20-55 years old), sex and ethnic group known according to records at the Imaculada Conceicao Cemetery, located in the city of Campinas, Sao Paulo State, Brazil. Measurements were taken using a digital calliper. The results were subjected to a statistical analysis (logistic regression and discriminate function) and showed dimorphic characteristics within the measurements. A formula with 79.9% accuracy was established for sex identification (logito = 25.2772 - 0.1601 x incisive foramen to basion - 0.0934 x mastoid notch - mastoid notch). The authors have concluded that the method is efficient and suitable for anthropology and forensic purposes. The research also showed that the analysis may be carried out using a practical computer program.

La importancia del peritaje en el estudio comparativo histomorfológico del esmalte, dentina y cemento de dientes humanos y de otros animales

Los patólogos Médicos y Odontólogos reciben fragmentos mineralizados para que los mismos establezcan su origen, si se trata de dientes humanos o de animales. Estos materiales no permiten la clasificación de la especie cuando los caracteres anatómicos diferenciales se encuentran fragmentados o deteriorados por agentes físicos o químicos. Situación ésta donde se tornan necesarios exámenes histomorfológicos para tal clasificación. El objetivo del presente trabajo es proporcionar soporte científico al estudio de los fragmentos mineralizados, cuando es necesario establecer el origen e individualidad de los mismos. Para el siguiente estudio fueron utilizados cortes histológicos, longitudinales y transversales, por desgaste del esmalte, dentina y cemento dentario de cada mamífero estudiado, y analizados por medio de microscopía de luz. Los resultados demuestran con claridad y precisión que el análisis histomorfológico de las estructuras citadas posibilita la identificación y diferenciación de los géneros estudiados o excluyen la posibilidad de fragmentos dentarios examinados pertenecer al género Homo sapiens.

Pathologist and forensic odontologist receive mineralized fragments to identify their origin, if human or animal teeth. These structures don’t permit the classification of the species when the differential anatomical characters are fragmented or deteriorated by physical or chemical agents, where histomorphological studies are needed for such classification. The purpose of this study is to provide scientifical support to study the mineralized fragments, when it comes to the necessity of the establishment of the origin and individuality of them. For the present study longitudinal and transversal histological cuts by abrasion of the enamel, dentin and cement were utilized and analyzed by means of microscopy. The results have clearly and accurately shown that the histomorphologic analysis of the above-mentioned structures makes either possible to identify and differentiate the gender studied or to exclude the possibility that the dental fragment may belong to the gender Homo sapiens.

Modeling of geochemical processes related to uranium mobilization in the groundwater of a uranium mine.

This paper describes the processes leading to uranium distribution in the groundwater of five boreholes near a restored uranium mine (dug in granite), and the environmental impact of restoration work in the discharge area. The groundwater uranium content varied from <1 microg/L in reduced water far from the area of influence of the uranium ore-containing dyke, to 104 microg/L in a borehole hydraulically connected to the mine. These values, however, fail to reflect a chemical equilibrium between the water and the pure mineral phases. A model for the mobilization of uranium in this groundwater is therefore proposed. This involves the percolation of oxidized waters through the fractured granite, leading to the oxidation of pyrite and arsenopyrite and the precipitation of iron oxyhydroxides. This in turn leads to the dissolution of the primary pitchblende and, subsequently, the release of U(VI) species to the groundwater. These U(VI) species are retained by iron hydroxides. Secondary uranium species are eventually formed as reducing conditions are re-established due to water-rock interactions.

Hermafroditismo Verdadero

Objetivo: El hermafroditismo verdadero (HV) es una forma poco frecuente de ambigüedad genital, caracterizado por la presencia de tejido ovárico y testicular maduro en el mismo individuo. En el presente estudio se presentan y discuten los casos de HV atendidos en el Hospital de Niños J. M. de los Ríos. Caracas- Venezuela durante los años 2000-2004. Métodos: Se describen manejo y diagnóstico: clínica, cariotipo, exámenes hormonales, ecografía, evaluaciones endoscópicas y los resultados de anatomía patológica. Resultados: En el Hospital José Manuel de los Ríos, entre los años 2000 a 2004, acudieron 73 pacientes con diagnóstico de ambigüedad genital, de los cuales 4 (5,47%) resultaron ser HV. ` Conclusiones: El HV es una condición, que aun cuando rara, es muy importante, ya que puede influir de manera decisiva sobre la psiquis del individuo y sobre su entorno. Debe considerarse una emergencia relativa y es prioritario dar solución al problema, tan pronto éste sea diagnosticado. Su manejo debe estar a cargo de un equipo multidisciplinario integrado por un ginecólogo infantil, endocrinólogo, urólogo, psiquiatra, genetista y trabajador social.

Objective: The true hermaphroditism (HV) is a not very frequent form of genital ambiguity. It is characterized by the presence of ovarian and testicular tissue in the same individual. In the present study we report the clinical cases evaluated at the Hospital de Niños J. M. de los Ríos. Caracas- Venezuela. Methods: A set of tests were performed: history and physical examination, blood tests, hormonal determinations, cariotype, renal and pelvic ultrasound, laparoscopy, exploratory laparotomy, hystero-salpingo-oophorectomy, and gonadal biopsy. Results: Between 2000-2004 in the Hospital José Manuel de los Ríos, 73 patients with ambiguos genitalia were studied. Four of them with true hermaphroditism (5,47%) Conclusions: The birth of a child with ambiguous genitalia represents a very stressing situation for the family, and afterwards has great social and psychological repercussion for the patient itself. Severe cases of genital anomalies must be solved after a good psychological evaluation and proper surgical repair.A multidisciplinary approach is required to guarantee the patient a proper sexual identity.

Tumores germinales gonadales en niños: experiencia en el SA: Hospital de Niños JM de Los Ríos 1985-1998 / Tumor germinal gonadal in children: experience in the SA: Hospital de Niños JM de Los Ríos 1985-1998

Entre enero 1985 y agosto 1998, 68 pacientes 137 pacientes con diagnóstico de Tumores Germinales (TG) ingresaron al S.A. Hospital de Niños J.M. de Los Ríos. De ellos, 68 pacientes con Tumor Germinal Gonadal (TGG) fueron incluidos en el protocolo 0021/85, todos se consideraron evaluables. 22 pacientes eran varones, la relación sexo V:H 1:2,09. El promedio de edad fue de 6,6 a., con una mínima de 4 meses y máxima de 17 años. Los síntomas y signos más frecuentes fueron: Masa 73,5 por ciento, Dolor 45,6 por ciento. Marcadores se determinaron en 26 pacientes (38,23 por ciento), resultando positivos en 16 pacientes La variedad histológica más frecuente fue: Teratoma Maduro (TM) 33 casos (48,52 por ciento), Tumor del Seno Endodérmico (TSE) 15 casos (22,05 por ciento), Teratoma Inmaduro (TI) 11 casos (16,17 por ciento), Disgerminoma (DSG) 8 casos (11,76 por ciento) y 1 caso Germinal Mixto (GM). Se utilizó el sistema de Estadiaje propuesto por Brodeur: Estadio I 48 pacientes (70,58 por ciento), Estadio II 10 pacientes (14,70 por ciento), Estadio III 9 pacientes (13,23 por ciento), Estadio IV 1 paciente (1,47 por ciento). Cirugía fue empleada como terapia inicial en todos los casos. Quimioterapia se utilizó en 24: 15 pacientes recibieron esquema PVB, y 6 pacientes esquema VIP Radioterapia fue administrada en 3 pacientes (4,41 por ciento). Respuesta Completa se obtuvieron en 62 pacientes (91,14 por ciento), Respuesta Parcial en 3 pacientes (4,41 por ciento) y Progresión 3 pacientes (4,41 por ciento). Sólo 2 pacientes fallaron a la terapia. La SLE según Histología fue: TM 100 por ciento a 159 meses, TSE 90 por ciento a 147 meses, TI 90 por ciento a 161 meses, DSG 100 por ciento a 135 meses; según Estadio: Est. I 100 por ciento a 159 meses, Est. II 87,5 por ciento a 141 meses, Est. III 100 por ciento a 161 meses; según esquema: PVB 90 por ciento a 161 meses, VIP 80 por ciento a 47 meses. No se demostró diferencia estadística significativa. La SLE general fue de 9677 por ciento a 161 meses. 3 pacientes fallecieron, la Sobrevida Global por Histología fue TM 100 por ciento a 159 meses, TSE 86,66 por ciento a 147 meses, TI 100 por ciento a 161 meses, DSG 87,5 por ciento a 135 meses; según Estadio: Est. I 100 por ciento a 159 meses, Est. II 70 por ciento a 141 meses, Est. III 100 por ciento a 161 meses; según Esquema: PVB 80 por ciento a 161 meses, VIP 100 por ciento a 47 meses. No se demostró diferencia estadística significativa

Glucose-regulated turnover of mRNA and the influence of poly(A) tail length on half-life.

Glucose repression in Saccharomyces cerevisiae can now be seen to operate at two levels: regulation of transcription of certain genes and control of the half-life of the corresponding mRNAs (Scheffler, I. E., de la Cruz, B. J., and Prieto, S. (1998) Int. J. Biochem Cell Biol. 30, 1175-1193). For example, the steady state levels of SDH2 mRNA and SUC2 mRNA are significantly determined by their differential rates of turnover. A current model for the mechanism of mRNA turnover includes three distinct steps: a rate-limiting deadenylation, removal of the 5'-7-methyl-G (decapping), and 5'-3' exonuclease digestion. We have investigated the same three reactions during glucose-induced degradation of these transcripts. Our results indicate that while decapping (by Dcp1p) and 5'-3' exonuclease digestion (by Xrn1p) are obligatory steps for the rapid degradation of these mRNAs, the dependence on deadenylation is more complicated. At steady state in glycerol these transcripts have very short poly(A) tails but are nevertheless very stable; the addition of glucose causes immediate decapping and degradation without further deadenylation; in contrast, newly made SUC2 mRNA (after a shift from glucose to glycerol) has significantly longer poly(A) tails, and such transcripts are not rapidly degraded upon addition of glucose. A constitutive deadenylation reaction that is independent of the carbon source eventually makes the stability of these transcripts very sensitive to glucose. These results are interpreted in terms of a working hypothesis proposing a competition between translational initiation and decapping influenced by the carbon source. The presence of a long poly(A) tail may also affect this competition in favor of translational initiation and mRNA stabilization.

The use of Fe59 labelled plant foodstuffs in the study of iron-deficient anemia

Biologically labelled kamote tops (Ipomoea batatas Linn.) were prepared by growing the plants in a modified Hoagland Arnon nutrient solution containing 81.89 uCi of Fe59 of high specific activity and .05 ml. of a 0.5 non-radioactive ferric chloride solution. Iron absorption from these foodstuffs and its distribution in anemic and non-anemic rats were studied. The utility of using physiologically labelled plants foodstuffs in the study of the pathogenesis and management of iron-deficient anemia was discussed. (Author)

Trace elements in heart and other tissues of Filipinos determined by neutron activation analysis

Heart, brachial arteries and diaphragm specimens were obtained from 30 autopsy cases consisting of 18 apparently normal subjects who met accidental death and 12 patients who died of myocardial infarction were analyzed for their elemental contents by neutron activation analysis. The following trace elements were determined: Co, Cu Zn, Fe, Mn, Cr and Mo. The values of these elements in the heart tissue of normal subjects were found to be higher than those of the Swedes. The concentration of chromium among Filipinos was found to be thirty times higher than the Swedes. The importance of this finding was discussedIt is hoped that the data we obtained will add to the growing evidence that trace elements are related to diabetes and possibly to degenerative cardiovascular disease, such as hypertension, atherosclerosis and the sequela. If related, measures can be taken not only for the treatment but also for the prevention of the disease. The incidence of cardiovascular disease is increasing not only in our country but also in other parts of the world. The metals coming from the expanding environmental contamination as a result of the industrial pollution of air and water, and the use of soil fertilizers, may play a role in the increasing incidence of cardiovascular disease by producing mineral inbalance in man.(Summary)

The physiological labelling of schistosoma japonicum cercariae with carbon 14

The snails (Oncomelania quadrasi) fed with C labelled sugars, proteins and phospholipids shedded labelled cercariae after 72-96 hours. Autoradiographs of whole worms developing from labelled cercariae shedded from snails fed with C labelled sugars and phospholipids showed that the label was retained and the radioactivity was distributed uniformly throughout the whole fluke. The level of activity was high, especially with flukes developing from C labelled sugar cercariae, having an activity of 49 cpm per organism. The activity can be retained 37 days after their penetration of the body of the infected host. The value of our findings in the investigation of certain problems in schistosomiasis research have been discussed. (Summary)

The absorption of iron from native plant foodstuffs

A technique of preparing Fe labelled plant foodstuffs is described and utilized to investigate the absorption of iron from common iron-rich Philippine plant foostuffs by anemic and non-anemic rats. Anemic rats did not show significantly larger amounts of absorbed iron as compared to the normal rats. It is concluded that iron-deficient subjects do not absorb food iron more efficiently than do normal subjects.(Author)

Control of mRNA turnover as a mechanism of glucose repression in Saccharomyces cerevisiae.

The phenomenon of glucose repression in yeast is concerned with the repression of a large number of genes when glucose is an abundant carbon source and almost all of the energy requirements of the cell can be satisfied from glycolysis. Prominent among the repressed genes are those encoding mitochondrial proteins required for respiration and oxidative phosphorylation. Past studies have characterized a pathway by which a signal generated from extracellular glucose is transmitted to the nucleus. The ultimate outcome is the repression of transcription of numerous genes, but also the induction of a limited number of others. The emphasis has been almost exclusively on transcriptional control mechanisms. A discovery made originally with the transcript of the SDH2 gene prompted an investigation of post-transcriptional mechanisms, and more specifically a study of the turnover rate of this mRNA in the absence and presence of glucose. SDH2 mRNA has a very short half-life in medium with glucose (YPD) and a significantly longer half-life in medium with glycerol (YPG). Experimental evidence and recent progress in understanding of (1) mRNA turnover in yeast and (2) initiation of translation on the 5' untranslated region of mRNAs, lead to a working hypothesis with the following major features: the carbon source, via a signaling pathway involving kinase/phosphatase activities, controls the rate of initiation, and thus influences a competition between eukaryotic initiation factors (prominently eIF4E, eIF4G, eIF3) binding to the capped mRNA and a decapping activity (DCP1) which is one of the rate limiting activities in the turnover of such mRNAs.