An unusual case of galactorrhea in a postmenopausal woman complicating breast reduction

Galactorrhea is a relatively common condition, but has rarely been seen following breast reduction surgery. To date there are only seven cases reported in the literature, all in premenopausal women. Postsurgical galactorrhea is a diagnosis of exclusion and differential diagnosis is extensive. Common causes should be excluded first. We present the case of a 56-year-old postmenopausal woman who underwent bilateral breast reduction and developed galactorrhea 2 months postoperatively. MRI scan of the skull as well as Thyroid-Stimulating Hormone (TSH), prolactin levels were normal. She was on long-term hormonal replacement therapy. Because of suspected nerve-related pain in her right breast she was commenced on amitriptyline. We hypothesise that galactorrhea may have been caused by underlying neuroma or irritation of the anterior branch of the T4 intercostal nerve or hormonal replacement therapy or a combination of both.

A High-Resolution Record of Atmospheric Dust Composition and Variability Since Ad 1650 from a Mount Everest Ice Core

A Mount Everest ice core analyzed at high resolution for major and trace elements (Sr, Cs, Ba, La, Ce, Pr, Nd, Sm, Eu, Tb, Dy, Ho, Er, Tm, Yb, Lu, Bi, U, Tl, Al, S, Ca, Ti, V, Cr, Mn, Fe, Co) and spanning the period A. D. 1650- 2002 is used to investigate the sources of and variations in atmospheric dust through time. The chemical composition of dust varies seasonally, and peak dust concentrations occur during the winter-spring months. Significant correlations between the Everest dust record and dust observations at stations suggest that the Everest record is representative of regional variations in atmospheric dust loading. Back-trajectory analysis in addition to a significant correlation of Everest dust concentrations and the Total Ozone Mapping Spectrometer (TOMS) aerosol index indicates that the dominant winter sources of dust are the Arabian Peninsula, Thar Desert, and northern Sahara. Factors that contribute to dust generation at the surface include soil moisture and temperature, and the long-range transport of dust aerosols appears to be sensitive to the strength of 500-mb zonal winds. There are periods of high dust concentration throughout the 350-yr Mount Everest dust record; however, there is an increase in these periods since the early 1800s. The record was examined for recent increases in dust emissions associated with anthropogenic activities, but no recent dust variations can be conclusively attributed to anthropogenic inputs of dust.

Signal Processing for the Measurement of the Deuterium/Hydrogen Ratio in the Local Interstellar Medium

We report on a comprehensive signal processing procedure for very low signal levels for the measurement of neutral deuterium in the local interstellar medium from a spacecraft in Earth orbit. The deuterium measurements were performed with the IBEX-Lo camera on NASA���s Interstellar Boundary Explorer (IBEX) satellite. Our analysis technique for these data consists of creating a mass relation in three-dimensional time of flight space to accurately determine the position of the predicted D events, to precisely model the tail of the H events in the region where the H tail events are near the expected D events, and then to separate the H tail from the observations to extract the very faint D signal. This interstellar D signal, which is expected to be a few counts per year, is extracted from a strong terrestrial background signal, consisting of sputter products from the sensor���s conversion surface. As reference we accurately measure the terrestrial D/H ratio in these sputtered products and then discriminate this terrestrial background source. During the three years of the mission time when the deuterium signal was visible to IBEX, the observation geometry and orbit allowed for a total observation time of 115.3 days. Because of the spinning of the spacecraft and the stepping through eight energy channels the actual observing time of the interstellar wind was only 1.44 days. With the optimised data analysis we found three counts that could be attributed to interstellar deuterium. These results update our earlier work.

Time Variable Gravity: Contributions of GOCE Satellite Data to Monthly and Bi-monthly GRACE Gravity Estimates

A feasibility study by Pail et al. (Can GOCE help to improve temporal gravity field estimates? In: Ouwehand L (ed) Proceedings of the 4th International GOCE User Workshop, ESA Publication SP-696, 2011b) shows that GOCE (���Gravity field and steady-state Ocean Circulation Explorer���) satellite gravity gradiometer (SGG) data in combination with GPS derived orbit data (satellite-to-satellite tracking: SST-hl) can be used to stabilize and reduce the striping pattern of a bi-monthly GRACE (���Gravity Recovery and Climate Experiment���) gravity field estimate. In this study several monthly (and bi-monthly) combinations of GRACE with GOCE SGG and GOCE SST-hl data on the basis of normal equations are investigated. Our aim is to assess the role of the gradients (solely) in the combination and whether already one month of GOCE observations provides sufficient data for having an impact in the combination. The estimation of clean and stable monthly GOCE SGG normal equations at high resolution (���>��� d/o 150) is found to be difficult, and the SGG component, solely, does not show significant added value to monthly and bi-monthly GRACE gravity fields. Comparisons of GRACE-only and combined monthly and bi-monthly solutions show that the striping pattern can only be reduced when using both GOCE observation types (SGG, SST-hl), and mainly between d/o 45 and 60.

Outbreak of severe foot rot associated with benign Dichelobacter nodosus in an Alpine ibex colony in the Swiss Prealps.

An outbreak of foot rot occurred in the ibex colony "Vanil Noir" in Switzerland from May to December 2014. This article describes field observations and the analyses carried out on the limbs of 3 animals submitted for postmortem examination. Disease signs observed in the field included lameness, poor body condition and overgrown hooves. Macroscopic examination of selected limbs revealed severe lesions in all of them, including interdigital inflammation with ulceration and malodorous exudation. Histological changes were consistent with chronic laminitis with bone resorption, which was not detected at radiographical examination. Grocott-positive organisms compatible with Dichelobacternodosus were detected in the lesions. Samples collected from the lesions were positive by polymerase chain reaction for benign D. nodosus, which is typically associated with only mild lesions in domestic sheep. Whether D. nodosus is endemic in the colony or had previously been transmitted from sympatric domestic livestock is unclear. The unusual warm and humid weather conditions in 2014 may well have contributed to the outbreak.

Autoregulation of TRA-2 pre -mRNA splicing

One of the most elegant and tightly regulated mechanisms for control of gene expression is alternative pre-mRNA splicing. Despite the importance of regulated splicing in a variety of biological processes relatively little is understood about the mechanisms by which specific alternative splice choices are made and regulated. The transformer-2 (tra-2) gene encodes a splicing regulator that controls the use of alternative splicing pathways in the sex determination cascade of D. melanogaster and is particularly interesting because it directs the splicing of several distinct pre-mRNAs in different manners. The tra-2 protein positively regulates the splicing of both doublesex (dsx) and fruitless (fru) pre-mRNAs. Additionally tra-2 controls exuperantia (exu) by directing the choices between splicing and cleavage/polyadenylation and autoregulates the tra-2 pre-mRNA processing by repressing the removal of a specific intron (called M1). The goal of this study is to identify the molecular mechanisms by which TRA-2 protein affects the alternative splicing of pre-mRNA deriving from the tra-2 gene itself.^ The autoregulation of M1 splicing plays a key role in regulation of the relative levels of two functionally distinct TRA-2 protein isoforms expressed in the male germline. We have examined whether the structure, function, and regulation of tra-2 are conserved in Drosophila virilis, a species diverged from D. melanogaster by over 60 million years. We find that the D. virilis homolog of tra-2 produces alternatively spliced RNAs encoding a set of protein isoforms analogous to those found in D. melanogaster. When introduced into the genome of D. melanogaster, this homolog can functionally replace the endogenous tra-2 gene for both normal female sexual differentiation and spermatogenesis. Examination of alternative pre-mRNAs produced in D. virilis testes suggests that the germline-specific autoregulation of tra-2 function is accomplished by a strategy similar to that used in D. melanogaster.^ To identify elements necessary for regulation of tra-2 M1 splicing, we mutagenized evolutionarily conserved sequences within the tra-2 M1 intron and flanking exons. Constructs containing these mutations were used to generate transgenic fly lines that have been tested for their ability to carry out autoregulation. These transgenic fly experiments elucidated several elements that are necessary for setting up a context under which tissue-specific regulation of M1 splicing can occur. These elements include a suboptimal 3$\sp\prime$ splice site, an element that has been conserved between D. virilis and D. melanogaster, and an element that resembles the 3$\sp\prime$ portion of a dsx repeat and other splicing enhancers.^ Although important contextual features of the tra-2 M1 intron have been delineated in the transgenic fly experiments, the specific RNA sequences that interact directly with the TRA-2 protein were not identified. Using Drosophila nuclear extracts from Schneider cells, we have shown that recombinant TRA-2 protein represses M1 splicing in vitro. UV crosslinking analysis suggests that the TRA-2 protein binds to several different sites within and near the M1 intron. ^

(Table 1) Organic geochemistry of ODP Hole 134-832B and Site 134-833

Ocean Drilling Program (ODP) Leg 134 was located in the central part of the New Hebrides Island Arc, in the Southwest Pacific. Here the d'Entrecasteaux Zone of ridges, the North d'Entrecasteaux Ridge and South d'Entrecasteaux Chain, is colliding with the arc. The region has a Neogene history of subduction polarity reversal, ridge-arc collision, and back-arc spreading. The reasons for drilling in this region included the following: (1) to determine the differences in the style and time scale of deformation associated with the two ridge-like features (a fairly continuous ridge and an irregularly topographic seamount chain) that are colliding with the central New Hebrides Island Arc; (2) to document the evolution of the magmatic arc in relation to the collision process and possible Neogene reversal of subduction; and (3) to understand the process of dewatering of a small accretionary wedge associated with ridge collision and subduction. Seven sites were occupied during the leg, five (Sites 827-831) were located in the d'Entrecasteaux Zone where collision is active. Three sites (Sites 827, 828, and 829) were located where the North d'Entrecasteaux Ridge is colliding, whereas two sites (Sites 830 and 831) were located in the South d'Entrecasteaux Chain collision zone. Sites 828 (on North d'Entrecasteaux Ridge) and 831 (on Bougainville Guyot) were located on the Pacific Plate, whereas all other sites were located on a microplate of the North Fiji Basin. Two sites (Sites 832 and 831) were located in the intra-arc North Aoba Basin. Results of Leg 134 drilling showed that forearc deformation associated with the North d'Entrecasteaux Ridge and South d'Entrecasteaux Chain collision is distinct and different. The d'Entrecasteaux Zone is an Eocene subduction/obduction complex with a distinct submerged island arc. Collision and subduction of the North d'Entrecasteaux Ridge results in off scraping of ridge material and plating of the forearc with thrust sheets (flakes) as well as distinct forearc uplift. Some offscraped sedimentary rocks and surficial volcanic basement rocks of the North d'Entrecasteaux Ridge are being underplated to the New Hebrides Island forearc. In contrast, the South d'Entrecasteaux Chain is a serrated feature resulting in intermittent collision and subduction of seamounts. The collision of the Bougainville Guyot has indented the forearc and appears to be causing shortening through thrust faulting. In addition, we found that the Quaternary relative convergence rate between the New Hebrides Island Arc at the latitude of Espiritu Santo Island is as high as 14 to 16 cm/yr. The northward migration rate of the d'Entrecasteaux Zone was found the be ~2 to 4 cm/yr based on the newly determined Quaternary relative convergence rate. Using these rates we established the timing of initial d'Entrecasteaux Zone collision with the arc at ~3 Ma at the latitude of Epi Island and fixed the impact of the North d'Entrecasteaux Ridge upon Espiritu Santo Island at early Pleistocene (between 1.89 and 1.58 Ma). Dewatering is occurring in the North d'Entrecasteaux Ridge accretionary wedge, and the wedge is dryer than other previously studied accretionary wedges, such as Barbados. This could be the result of less sediment being subducted at the New Hebrides compared to the Barbados.

La Argentina rent��stico - financiera : el papel decisivo del Estado en su conformaci��n

A partir del golpe de estado de 1976 se impone en la Argentina, sobre las ruinas del proceso de industrializaci��n, una nueva forma de acumulaci��n del capital que subsiste hasta hoy: el modelo "aperturista", "neoliberal" o "rent��stico-financiero". Contra la idea de la desaparici��n del poder del Estado a favor del poder econ��mico, ��ste art��culo analiza el importante papel de este Aparato en la emergencia y consolidaci��n del nuevo patr��n y en la reproducci��n del capital monopolista, as�� como las transformaciones que las pol��ticas estatales, fundamentalmente econ��micas, producen en la estructura social, tanto en los sectores dominantes como en los dominados.

El Banquete Indigesto. Una cr��tica luci��nica al paradigma idealista del convivio cultural en El Banquete de los Lopitas

A mediados del siglo II, cuando se supone que se encontraba en la mitad de su producci��n literaria y ya dominaba los muy variados recursos de su cr��tica cultural, Luciano de Sam��sata escribe su propia versi��n de El Banquete, que significativamente lleva por t��tulo completo El Banquete o los Lapitas. La finalidad del art��culo es analizar la est��tica luci��nica para desarrollar un pastiche de los clich��s de banquete, a trav��s de la cual critica a todas las formas de la intelectualidad de su tiempo: a fil��sofos de todos los linajes, r��tores, gram��ticos, poetas. Los resultados deparan algunas sorpresas: como todo texto luci��nico, su Banquete tambi��n interpela a su futuro, es decir, a nuestro presente.

El Banquete Indigesto. Una cr��tica luci��nica al paradigma idealista del convivio cultural en El Banquete de los Lopitas

A mediados del siglo II, cuando se supone que se encontraba en la mitad de su producci��n literaria y ya dominaba los muy variados recursos de su cr��tica cultural, Luciano de Sam��sata escribe su propia versi��n de El Banquete, que significativamente lleva por t��tulo completo El Banquete o los Lapitas. La finalidad del art��culo es analizar la est��tica luci��nica para desarrollar un pastiche de los clich��s de banquete, a trav��s de la cual critica a todas las formas de la intelectualidad de su tiempo: a fil��sofos de todos los linajes, r��tores, gram��ticos, poetas. Los resultados deparan algunas sorpresas: como todo texto luci��nico, su Banquete tambi��n interpela a su futuro, es decir, a nuestro presente.

El Banquete Indigesto. Una cr��tica luci��nica al paradigma idealista del convivio cultural en El Banquete de los Lopitas

A mediados del siglo II, cuando se supone que se encontraba en la mitad de su producci��n literaria y ya dominaba los muy variados recursos de su cr��tica cultural, Luciano de Sam��sata escribe su propia versi��n de El Banquete, que significativamente lleva por t��tulo completo El Banquete o los Lapitas. La finalidad del art��culo es analizar la est��tica luci��nica para desarrollar un pastiche de los clich��s de banquete, a trav��s de la cual critica a todas las formas de la intelectualidad de su tiempo: a fil��sofos de todos los linajes, r��tores, gram��ticos, poetas. Los resultados deparan algunas sorpresas: como todo texto luci��nico, su Banquete tambi��n interpela a su futuro, es decir, a nuestro presente.

Age models of upper Pliocene samples of the North Atlantic

Abundance variations of six Pliocene species of discoasters have been analyzed over the time interval from 1.89 to 2.95 Ma at five contrasting sites in the North Atlantic: Deep Sea Drilling Project Sites 552 (56��N) and 607 (41��N) and Ocean Drilling Program 658 (20��N), 659 (18��N), and 662 (1��S). A sampling interval equivalent to approximately 3 k.y. was used. Total Discoaster abundance showed a reduction with increasing latitude and from the effects of upwelling. This phenomenon is most obvious in Discoaster brouweri, the only species that survived over the entire time interval studied. Prior to 2.38 Ma, Discoaster pentaradiatus and Discoaster surculus are important components of the Discoaster assemblage: Discoaster pentaradiatus increases slightly with latitude up to 41��N, and its abundance relative to D. brouweri increases up to 56��N; D. surculus increases in abundance with latitude and with upwelling conditions relative to both D. brouweri and D. pentaradiatus and is dominant to the latter species at upwelling Site 658 and at the highest latitude sites. Discoaster asymmetricus and Discoaster tamalis appear to increase in abundance with latitude relative to D. brouweri. Many of the abundance changes observed appear to be connected with the initiation of glaciation in the North Atlantic at 2.4 Ma. The long-term trend of decreasing Discoaster abundance probably reflects the fall of sea-surface temperatures. This trend of cooling is overprinted by short-term variations that are probably associated with orbital forcing. Evidence for the astronomical elements of eccentricity and obliquity periodicities were found at all sites; however, only at Sites 607, 659, and 662 were precessional periodicities detected. Furthermore, only at Site 659 was precession found to be dominant to obliquity. Abundance peaks of individual species were found to cross-correlate between sites. The distinct abundance fluctuations observed especially in the tropics suggest that temperature is not the only factor responsible for this variation. This study reveals for the first time the importance of productivity pressure on the suppression of Discoaster abundance.

Accumulation rates of dinoflagellate cysts at trap sites CB2, CB3, CB4, and CB9 off Cape Blanc

A 5-year sediment trap survey in the upwelling area off Cape Blanc (NW Africa) provides information on the seasonal and annual resting cyst production of dinoflagellates, their sinking characteristics and preservation potential. Strong annual variation in cyst production characterizes the region. Cyst production of generally all investigated species, including Alexandrium pseudogonyaulax (Biecheler) T. Horig. ex T. Kita et Fukuyo (cyst genus Impagidinium) and Gonyaulax spinifera (Clap. et J. Lachm.) Diesing (cyst genus Nematosphaeropsis) was enhanced with increasing upper water nutrient and trace-element concentrations. Cyst production of Lingulodinium polyedrum (F. Stein) J. D. Dodge was the highest at the transition between upwelling and upwelling-relaxation. Cyst production of Protoperidinium americanum (Gran et Braarud) Balech, Protoperidinium monospinum (Paulsen) K. A. F. Zonn. et B. Dale, and Protoperidinium stellatum (D. Wall) Balech, and heterotrophic dinoflagellates forming Brigantedinium spp. and Echinidinium aculeatum Zonn., increased most pronouncedly during upwelling episodes. Production of Protoperidinium conicum (Gran) Balech and Protoperidinium pentagonum (Gran) Balech cysts and total diatom valves were related, providing evidence of a predator-prey relationship. The export cyst-flux of E. aculeatum, P. americanum, P. monospinum, and P. stellatum was strongly linked to the flux of total diatom valves and CaCO3, whereas the export production of Echinidinium granulatum Zonn. and Protoperidinium subinerme (Paulsen) A. R. Loebl. correlated with total organic carbon, suggesting potential consumption of diatoms, prymnesiophytes, and organic matter, respectively. Sinking velocities were at least 274 m �� d**-1, which is in range of the diatom- and coccolith-based phytoplankton aggregates and "slower" fecal pellets. Species-selective degradation did not occur in the water column, but on the ocean floor.

Mejora del autocuidado de pacientes diab��ticos en zonas rurales de Panam�� a trav��s de tecnolog��as tic

Durante a��os, los pa��ses de Am��rica Latina y en especial Panam�� han sufrido grandes cambios sociales, demogr��ficos y epidemiol��gicos que han provocado un crecimiento de la incidencia y prevalencia de varias enfermedades cr��nicas no transmisibles como: las cardiopat��as, el c��ncer y la diabetes. Actualmente, la suma de estas afecciones causa la mayor��a de las muertes y discapacidades en la regi��n. Las necesidades de salud var��an de un pa��s a otro, inclusive en el interior de un mismo pa��s o de una misma regi��n debido a factores demogr��ficos, socioculturales, econ��micos y pol��ticos propios de la regi��n, lo cual favorece la desigualdad en el acceso a los servicios de salud. Este hecho pone de manifiesto un aspecto importante de esta tesis de doctorado, que es facilitar el autocuidado de los pacientes diab��ticos en tres zonas rurales de Panam��, contribuyendo de esta manera a la planeaci��n e implantaci��n de nuevos servicios TIC en salud para los pacientes diab��ticos de tres zonas rurales de Panam��. El objetivo principal de esta tesis doctoral es desarrollar una contextualizaci��n del paciente diab��tico en zonas rurales de Panam�� y modelar su autocuidado mediante el uso de las TIC. A trav��s del modelo se busca mejorar la calidad de vida de los pacientes y propiciar estados de equidad en salud. Se contin��a con la implementaci��n del modelo en tres zonas rurales diferentes de Panam��. Se concluye con una fase de validaci��n en la que se demuestra que el enfermo de diabetes aumenta la conciencia de la importancia de su tratamiento mejorando su estado de salud y su calidad de vida. La demostraci��n cl��nica de este resultado est�� fuera del ��mbito de la tesis doctoral. Abstract Through the years, countries of Latin America, Panama in particular have endured great social, demographic and epidemiologic changes, which in turn caused an increase in the occurrence and prevalence of chronic non transmissible diseases, such as: cardiopathy, cancer and diabetes. The sum of these afflictions causes most of the deaths and disabilities in the region nowadays. The healthcare needs vary from one country to another, furthermore the healthcare needs are different from one rural area to another in a given country or region, due demographic, sociocultural, economic and political factors, this favors the inequality in access to health care services. This facts shows one important aspect of this Ph. D. thesis, which is to facilitate the self-care of diabetic patients in three rural areas of Panama, contributing to the planning and implementation of new ICT services in healthcare for diabetic patients in rural areas of Panama. The primary goal of this Ph.D thesis is to develop a contextualization of the diabetic patient in country side of Panama and to model its self-care by means of the use of the ICT. Through model one looks for to improve the quality of life of the patients and to cause states of fairness in health. It continues with the implementation of ICT through a conceptualized model in three different rural areas of Panama. It concludes with a validation phase which shows how the awareness of the diabetes patient increases, about the importance of his/her treatment for the improvement of health and quality of life. The clinic demonstration of this result is not part of this thesis.

Edge Detection by Adaptive Splitting II. The Three-Dimensional Case

In Llanas and Lantar��n, J. Sci. Comput. 46, 485���518 (2011) we proposed an algorithm (EDAS-d) to approximate the jump discontinuity set of functions defined on subsets of ��� d . This procedure is based on adaptive splitting of the domain of the function guided by the value of an average integral. The above study was limited to the 1D and 2D versions of the algorithm. In this paper we address the three-dimensional problem. We prove an integral inequality (in the case d=3) which constitutes the basis of EDAS-3. We have performed detailed computational experiments demonstrating effective edge detection in 3D function models with different interface topologies. EDAS-1 and EDAS-2 appealing properties are extensible to the 3D case