LUMBAR syndrome-OEIS complex overlap: A case series and review

We present three new and six published infants with overlapping features of LUMBAR syndrome (lower body hemangioma, urogenital anomalies, spinal cord malformations, bony deformities, anorectal/arterial anomalies and renal anomalies) and OEIS complex (omphalocele, exstrophy, imperforate anus, and spinal defects), also known as cloacal exstrophy. OEIS is included under the recently proposed umbrella coined recurrent constellations of embryonic malformations (RCEMs). The RCEMs represent a phenotypically overlapping spectrum of rare disorders of caudal dysgenesis with unknown cause but likely shared pathogenesis. It has recently been proposed that LUMBAR be considered an RCEM. This report of infants with combined features of OEIS and LUMBAR is the first to demonstrate an overlap between LUMBAR and another RCEM, which supports LUMBAR's inclusion within the RCEM spectrum.

Liquid-Based Cytology in the Detection of Premalignant Lesions in Patients with "Atypia in Squamous Cells" in Conventional Cytology

Background

The management of patients with "Atypical Squamous Cells" (ASC) in conventional papanicolaou smears (CPS) is based on the risk of high-grade squamous intraepithelial lesion (HSIL). The efficacy of liquid-based cytology (LBC) to detect this premalignant lesion is variable, with little evidence of its performance in Colombian patients.

Aims

The aim of this study is to determine the performance of LBC in the detection of premalignant lesions, in patients with ASC in CPS.

Materials and Methods

Were obtained patients who attended colposcopy clinic due the result of ASC in CPS. An LBC was taken, which was interpreted by two pathologists without access to other results. The performance of LBC to detect HSIL, was determined, considering as a gold standard: histopathological study/negative-satisfactory colposcopy.

Results

Were included 114 patients, with a mean age of 38.4 years (SD ± 13.3). LBC had abnormal results in 40.36% (n = 46), with a slightly higher proportion of low-grade squamous intraepithelial lesion (LSIL) than HSIL. The total of abnormal diagnoses by colposcopy and/or biopsy was 51.75% (n = 59), with a predominance of LSIL (36.84%). The sensitivity of the liquid-based cytology to detect premalignant lesions was 76.5%, specificity: 66.0%, positive predictive value: 28.3% and negative predictive value: 94.1%; The Cohen's kappa index of LBC for detecting HSIL was 0.2492 for the total population and 0.2907 for ≥30 years.

Discussion

Although LBC decreases abnormal cytology and increases the detection of HSIL, which improves diagnostic accuracy; sensitivity and predictive values for detecting HSIL are not significantly different between CPS and LBC.

Duct-like Recess in the Infundibular Portion of Third Ventricle Craniopharyngiomas: An MRI Sign Identifying the Papillary Type

BACKGROUND AND PURPOSE

Papillary craniopharyngiomas (PCPs) are particularly challenging lesions requiring accurate diagnosis to plan the best therapy. Our aim was to define a narrow duct-like recess identified on MR imaging at the base of papillary craniopharyngiomas with a strict third ventricle location.

MATERIALS AND METHODS

A duct-like recess at the infundibular portion of craniopharyngiomas was observed on conventional T1WI and T2WI in 3 strict third ventricle papillary craniopharyngiomas in our craniopharyngioma series (n = 125). We systematically investigated this finding on the MR imaging of 2582 craniopharyngiomas and 10 other categories of third ventricle tumors (n = 690) published in the modern era (1986-2020). The diagnostic value and significance of this finding are addressed.

RESULTS

The duct-like recess was recognized in 52 papillary craniopharyngiomas, including 3 of our own cases, as a narrow canal-shaped cavity invaginated at the tumor undersurface, just behind the optic chiasm. This structure largely involves papillary craniopharyngiomas with a strict third ventricle topography (96%), follows the same diagonal trajectory as the pituitary stalk, and finishes at a closed end. The duct-like recess sign identifies the papillary craniopharyngioma type with a specificity of 100% and a sensitivity of 38% in the overall craniopharyngioma population. This finding can also establish the strictly intra-third ventricle location of the lesion with a 90% specificity and 33% sensitivity. These recesses appear as hypointense circular spots on axial/coronal T1WI and T2WI. Their content apparently corresponds to CSF freely flowing within the suprasellar cistern.

CONCLUSIONS

The presence of a duct-like recess at the infundibular portion of a third ventricle tumor represents a distinctive hallmark of papillary craniopharyngiomas that can be used as a simple MR imaging sign to reliably diagnose these lesions.

Abstract 5718: Rab34 is downregulated in human prostate cancer tissue

Background: Rab34 encodes a protein belonging to the Rab family of proteins, which are small GTPases important in regulating signal transduction and cellular processes. A potential role of Rab34 in cancer has been suggested, but few studies have reported its function in human epithelial cancers. It was reported that prostate cancer (PCa) patients were more prone to biochemical recurrence when Rab34 was downregulated in PCa tissue compared with benign prostate tissue (BPT), being negatively associated with miR-148, a miRNA that increased the growth in cell lines and was up-regulated in PCa samples. Rab34 is a putative target gene for miR-9. We aimed to explore the Rab34 and miR-9 expression in PCa using a bioinformatic analysis, however, the mere presence of miRNA-binding sites is insufficient for predicting target regulation, and therefore, we also analyzed Rab34 expression in BPT and PCa tissues.

Design: The expression of miR9-5p and Rab34 mRNA was explored in the tumor tissues of the Cancer Genome Atlas (TCGA) through the bioinformatics tools of the dbDEMC2 and GEPIA2 web servers, and additional evidence of miR-9/Rab34 interaction was sought in the miRTarBase of experimentally validated microRNA-target interactions. Two pathologists evaluated Rab34 immunohistochemical expression in localized PCa and BPT in a prostate tissue microarray. For each spot an H-score was obtained by microscopic assessment of epithelial cells with positive staining. Differences in Rab34 expression were found by comparing H-Scores between BPT and PCa tissues using Mann-Whitney test, a p value less than 0.05 was considered statistically significant.

Results: The analysis of miR-9 and Rab34 expression in the TCGA showed that Rab34 has a diverse expression in tumor tissues, being downregulated in colon, rectum and PCa, and upregulated in lymphoma, leukemia and pancreatic adenocarcinoma. On the other hand, miR-9 was upregulated in PCa and downregulated in pancreatic adenocarcinoma. There were no experimental evidence supporting the miR-9/Rab34 interaction in PCa tissues from the miRTarBase. However, most of the breast cancer datasets showed a negative correlation in the expression of both genes. Rab34 expression at protein level was assessed in 123 tissue cores representing PCa, and 86 tissue cores representing BPT. In cores with PCa mean Rab34 expression was significantly lower than the mean Rab34 expression in cores with BPT (p less than 0.0001). There was a lower mean staining score in PCa (87.3, 95% CI: 73.78 - 100.9), compared to BPT (156.3, 95% CI: 144 - 168.5).

Conclusions: Our study shows that Rab34 is downregulated in PCa tissue. These findings are in accordance to a previous report that associated its lower expression to worse prognosis and tumor recurrence. The downregulation of Rab34 in PCa tissue might be related to overexpression of its putative microRNA, miR-9. Additional studies to detect the in situ expression of miR-9 in PCa are in progress to validate these results.

Citation Format: Ines Benedetti, Lia Barrios, Juan Rebollo. Rab34 is downregulated in human prostate cancer tissue [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5718.

Abstract 5856: Differential expresion of miR-9 and their putative targets in prostate cancer

Background: Deregulation of microRNA (miRNA) plays an important role in the growth, invasion and migration of prostate cancer cells. miR-9 has been found overexpressed in prostate cancer (Pca) compared to benign prostate tissue (BPT) and proposed as an oncomiR with a potential as a therapeutic target. Little is known about the regulatory mechanisms of miR-9 in PCa and opposing roles in supporting or suppressing tumor development and metastasis has been reported in different tumor tissues. We aimed to explore the miR-9 expression and their putative targets in BPT and PCa tissue through in situ Hybridization (ISH) and bioinformatics analysis of miRNA and gene expression databases.

Design: A prostate tissue microarray was constructed with representative areas of BPT and PCa. The expression of miR-9-5p was evaluated through a miRNAscope 2.5 LS Red ISH, it was scored using a semiquantitative analysis of the average number of dots per cell; mean score values were compared between BPT and PCa tissues using Mann-Whitney test, a p value less than 0.05 was considered statistically significant. We look for possible mir-9 targets in the database of experimentally validated microRNA-target (miRTarBase), and we use the AACR Project GENIE data base to analyze the behavior of the putative miR-9 targets in PCa vs BPT and explored their expression in the tumor tissues of the Cancer Genome Atlas (TCGA) through the bioinformatics tools of the GEPIA2 web server.

Results: The analysis of miR-9 expression in 294 prostate tissue cores (145 BPT and 149 PCa) showed an overexpression of this miRNA in PCa (1.60, 95% CI:1.51-1.69) compared to BPT (0.86, 95% CI: 0.77-0.94), (p less than 0.0001). We identified 526 mir-9 target genes in the miRTarBase validated with at least one experimental assay, and selected the 24 genes with the strongest evidence of interaction with miR-9. The gene targets with higher expression level in PCa were CDH1, RAB34, AP3B1, CCNG1, SRF, TGFB1, ID2, FOXO3 y CCND1 (Log2 (TPM+1) > 4). Only 4 genes showed a statistically significant difference in their expression when BPT and PCa tissue data from the TCGA were compared. CDH1 was overexpressed in the PCa datasets and BCL6, RAB34 and NTRK3 were downregulated in cancer compared to normal tissues. Most of the miR-9 gene targets did not show alterations at the DNA sequence level according to the analysis of the AACR Project GENIE data using the cBioPortal, except for CDH1, BCL6, CCND1 and PRDM1, which showed truncating mutations, amplifications, deep deletion and splice mutations in some of the cancer datasets. These results suggest that mir-9 may be regulating tumor initiation, progression, and metastasis processes through the Neurotrophic Receptor Tyrosine Kinase 3 (NTRK3), which has been found altered in breast carcinomas and other cancers, or the downregulation of Cadherin 1 (CDH1), whose loss of function is thought to contribute to cancer progression by increasing proliferation, invasion, and metastasis.

Citation Format: Ines Benedetti, Lia Barrios, Juan Rebollo. Differential expresion of miR-9 and their putative targets in prostate cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5856.

Seasonal Dynamics of Fleas (Siphonaptera: Pulicidae, Ceratophyllidae and Leptopsyllidae) on Oryctolagus cuniculus in a Meso-Mediterranean Area of Central Spain

Flea infestations of wild rabbits were examined monthly in central Spain in a meso-Mediterranean area for 5 yr. A total of 1,180 wild rabbits were trapped and 7,022 fleas were collected from them. Overall, the prevalence was 74.1% with a mean flea index of 5.95 fleas per rabbit. Four flea species were identified: Spilopsyllus cuniculi (Dale, 1878) was the most abundant species (accounting for 74.3% of fleas collected) followed by Xenopsylla cunicularis (Smit, 1957), Odontopsyllus quirosi (Gil Collado, 1934), and Nosopsyllus fasciatus (Bosc, 1800) (18.9, 6.7, and 0.1%, respectively). The highest prevalence was observed in S. cuniculi (48.6%) followed by X. cunicularis, O. quirosi, and N. fasciatus (34.3, 20.0, and 0.6%, respectively). Odontopsyllus quirosi and S. cuniculi were mainly collected from autumn to spring with the peak of infestation in winter, while X. cunicularis was mainly found from spring to autumn with maximum levels of infestation during the summer months. The relevance of these findings is discussed.

Abstract 2153: KRT16 and E6-E7 HR-HPV mRNA in situ expression in normal cervical tissue, and low-grade and high-grade squamous intraepithelial lesions

Background: KRT16 codifies for acidic-intermedium cytokeratin constitutively expressed in squamous epithelia. Its role in carcinogenesis may be related to its expression in the hyperproliferative phase on epidermal cultures, but yet need to be clarified. In a previous cDNA microarray analysis, the KRT16 gene was differentially expressed between healthy cervical tissue and a high grade squamous intraepithelial lesion (HSIL) with confirmed HPV-18 transforming infection. Gene expression profile differences between uterine cervix healthy tissue, low grade, and high grade squamous intraepithelial lesion (LSIL, HSIL) could contribute to identify potential biomarkers for cervical premalignant lesions progression.

Design: A chromogenic in situ hybridization (CISH) assay, (RNAscope), was performed to evaluate the KRT16 mRNA in situ expression in a tissue microarray (TMA) constructed from excision specimens (conization and hysterotomy) from 169 patients, with a mean age of 35.37 years (SD ±10.4), with representative areas from normal cervix tissue, LSIL and HSIL. The RNAscope 2.5HD Red KRT16 assay, and the RNAscope 2.5HD Red E6/E7 HPV-HR18 assay, designed to detect E6/E7 mRNA for eighteen different high-risk (HR) HPV genotypes, were performed. Stainings were visually scored from 0 to 4 by two pathologist based on the average number of dots per cell according to a semi-quantitative analysis; score values were compared using GraphPad Prism 7.0 software. A p< 0.05 was considered statistically significant.

Results: The KRT16 mRNA in situ expression in healthy cervical tissue, LSIL and HSIL was determined by CISH in a cervical TMA including, normal cervix: 84, LSIL: 77, and HSIL: 157, tissue cores. The mean KRT16 mRNA expression scores in squamous epithelium lining normal cervix (0.95, 95% CI: 0.70-1.20), LSIL (0.88, 95% CI:0.60-1.15), and HSIL (1.11, 95% CI:0.89-1.33), were not significantly different (p=0.573). Mean HPV E6/E7 mRNA expression score in HSIL was significantly higher than mean HPV E6/E7 mRNA expression in LSIL (p<0.0001). There was a positive-low correlation between KRT16 mRNA expression and E6/E7 HR-HPV mRNA expression (Spearman r =0.27).

Conclusions: Although previous cDNA microarray analysis identified differential expression of KRT16 between healthy cervical tissue and a HSIL with confirmed HPV-18 transforming infection, this was not confirmed when comparing its in situ mRNA expression between squamous epithelium lining normal cervix, LSIL and HSIL. Also, there is not a strong correlation with the expression of E6/E7 mRNA for eighteen different HR-HPV. The fact that KRT16 is constitutively expressed in basal cells may help to elucidate this phenomenon. The role of KRT16 in proliferative phase of basal cells and cervical carcinogenesis remains unclear, further studies are required to define it.

Citation Format: Ines Benedetti, Reinhard Rodríguez, Lia Barrios. KRT16 and E6-E7 HR-HPV mRNA in situ expression in normal cervical tissue, and low-grade and high-grade squamous intraepithelial lesions [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 2153.

Abstract 2530: Differences in mRNA expression of a candidate gene, between normal cervical tissue and cervical premalignant lesions

Background: Cervical cancer is the fourth most common cancer in women worldwide, with around 85% of cases occurring in underdeveloped countries. The diagnosis of premalignant lesions is ​​the objective of cervical cancer prevention programs, aimed at increasing the chances of cure and survival time. In a previous study of our group cDNA of TMEM45A gene was detected as differentially expressed between healthy cervical tissue and a high grade squamous intraepithelial lesion (HSIL) with confirmed HPV-18 transforming infection. TMEM45A gene family is highly expressed in squamous epithelium, playing roles in differentiation, senescence and chemoresistance in some sort of epithelial carcinomas. The overexpression of this product may confer antiapoptotic pathways, contributing to the development of cervical squamous cell carcinoma. We compared the TMEM45A in situ mRNA expression in healthy cervical tissue, low grade squamous intraepithelial lesion (LSIL) and HSIL, using RNAscope chromogenic in situ hybridization (CISH). Design: TMEM45A expression was evaluated by CISH using a tissue microarray (TMA) constructed from cervical excision samples (conization and histerectomy) from 169 patients, with a mean age of 35.37 years (SD ±10.4), from a reference center for cervical pathology in the Colombian Caribbean. Stained sections from the donor blocks were reviewed by two pathologist, verifying the original sign-out diagnosis, and representative areas from normal cervix, LSIL and HSIL were selected. RNAscope 2.5HD Red TMEM45A assay was performed as a technical service in Advanced Cell Diagnostics´s laboratories (Newark, CA). The staining was visually scored by two pathologist from 0 to 4 based on the average number of dots per cell, according to a semi-quantitative analysis. The mean score values for each lesion group were compared using GraphPad Prism 7.0 software. A p< 0.05 was considered statistically significant. Results: The TMEM45A mRNA in situ expression was determined in a cervical TMA including, normal cervix: 76, LSIL: 69, and HSIL: 138, tissue cores. There was a higher mean staining score for TMEM45A mRNA in HSIL (1.51, 95% CI:1.26-1.76), compared to normal cervix (1.10, 95% CI:0.80-1.40). Mean score of TMEM45A in situ mRNA expression in HSIL was significantly higher than mean TMEM45A in situ mRNA expression in the normal cervix lining squamous epithelium (p=0.046). Conclusions: TMEM45A expression analysis identified differential expression between normal cervix lining squamous epithelium and HSIL. This finding supports the possible role of TMEM45A in carcinogenesis of well differentiated epithelial lesions. Additional studies to detect the TMEM45A expression at protein with samples of women from the Colombian Caribbean are in progress to validate these results.

Citation Format: Ines Benedetti, Reinhard Rodríguez, Lia Barrios. Differences in mRNA expression of a candidate gene, between normal cervical tissue and cervical premalignant lesions [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 2530.

Abstract 2538: Retinol binding protein-1 and E6-E7 HR-HPV mRNA expression in normal cervical tissue and high grade squamous intraepithelial lesions

Background: Gene expression differences between cervical healthy tissue and premalignant lesions could contribute to identify potential biomarkers for each step of this tumor progression. In a previous cDNA microarray analysis, we identified the gene Retinol Binding Protein 1 (RBP1), differentially expressed between normal cervix and a high grade squamous intraepithelial lesion (HSIL) with HPV-18 transforming infection. RBP1 codifies a retinol-binding protein implied in differentiation of epithelia and may play a role on inhibition of E2F-dependent gene expression and suppress cell growth.

Design: The expression of RBP1 mRNA was evaluated using RNAscope chromogenic in situ hybridization (CISH) in a tissue microarray constructed from specimens (conization and hysterotomy) obtained from 169 patients, with mean age of 35.37 years (SD ±10.4). Stained sections from donor blocks were reviewed by two pathologist, who chose representative areas of normal cervix, low grade squamous intraepithelial lesion (LSIL), and HSIL. RNAscope 2.5HD Red RBP1 assay, and RNAscope 2.5HD Red HPV-HR18 , that detect E6/E7 mRNA for eighteen different high-risk (HR) HPV genotypes, were performed, the stainings were visually scored by two pathologist from 0 to 4 in a semi-quantitative analysis, based on the average number of red dots per cell. The mean score values for each tissue group were compared using GraphPad Prism® 7.0. A p< 0.05 was considered statistically significant.

Results: The in situ expression of RBP1 mRNA was determined in a cervical TMA including, normal cervix: 66, LSIL: 74, and HSIL: 130, tissue cores. There was not a statistically significant difference (p=0.965) between the RBP1 mRNA expression score in the squamous epithelium from normal cervix (0.42, 95% CI:0.23-0.61), and LSIL (0.51, 95% CI:0.28-0.74). But, its expression was higher in HSIL (1.30, 95% CI:1.09-1.50), with a very significant difference compared to squamous epithelium from normal cervix (p<0.0001). Mean HPV E6/E7 mRNA expression in HSIL was significantly higher than mean HPV E6/E7 mRNA expression in LSIL (p<0.0001). There was positive-moderate correlation between RBP1 mRNA expression and E6/E7 HR-HPV mRNA expression (Spearman r =0.55).

Conclusions: The in situ mRNA expression of RBP1 is similar in LSIL and squamous epithelium lining normal cervix, but the significantly different expression between healthy cervical tissue and HSIL, considered as the real premalignant cervical lesion, confirms our previous findings. There is a moderate correlation with the expression of E6/E7 mRNA for eighteen different HR-HPV. We could hypothesized that this overexpression represent a failed mechanism of regulation induced by the HR-HPV infection in cervical carcinogenesis.

Citation Format: Ines Benedetti, Reinhard Rodríguez, Lia Barrios. Retinol binding protein-1 and E6-E7 HR-HPV mRNA expression in normal cervical tissue and high grade squamous intraepithelial lesions [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 2538.

Abstract 1123: Simultaneous p16/ki-67 expression in detection of high-grade squamous intraepithelial lesions, in women with ASC in cervical smears

Background Immunocytochemical staining for overexpression of the cell-cycle regulatory protein p16INK4a has been shown to be an efficient approach to triage to colposcopy women with cervical smears categorized as Atypical Squamous Cells (ASC). Overexpression of p16 is associated with the transforming activity of the HR-HPV-E7 oncoprotein in cervical dysplasia. Ki-67 is a marker of cell proliferation of dysplastic epithelium. The efficiency of p16 and Ki-67 separately has been widely described. In high-grade squamous intraepithelial lesion (H-SIL) and cancer they can be co-expressed and the identification of cells with double staining reactivity (p16/Ki-67) can be used as an indicator of H-SIL. We aim to evaluate the diagnostic performance of double p16/Ki-67 staining in the detection of underlying H-SIL in cytological smears of women referred to colposcopy due to an ASC cervical smear result.

Design Prospective diagnostic test study. It took 18 months to complete the representative number of cases considering the prevalence of ASC in the colposcopy consultation. Samples were included from patients referred to colposcopy with a cytological diagnosis of ASC. Liquid based cytology was taken and processed to obtain a blank cytological preparation. The p16/Ki-67 staining was performed using CINtec Plus™. The immunoreactivity for both markers evidenced by one or more cervical epithelial cells with brown cytoplasmic immunostaining for p16, and nuclear red for Ki-67, was evaluated by two pathologists blind to colposcopy or biopsy results. Biopsies and/or endocervical curettage were obtained when the colposcopist considered necessary and they were considered as gold standard. In cases where there was no visible lesion and no biopsy was taken, colposcopy was considered gold standard and it was classified as: satisfactory/unsatisfactory, negative/normal or positive/abnormal. A high-grade biopsy lesion (≥ CIN2) with H&E was considered as a final diagnosis.

Results There were 120 cases included of ASC (114 ASCUS and 6 ASC-H), from women between 18 and 82 years (mean=38.6). 90 (75.0%) cases had histological study: 62 (68.9%) biopsies and 28 (31.1%) endocervical curettages, of which 17 (14.28%) cases had ≥CIN2, and none were cases of invasive cancer. p16/Ki-67 staining was positive in 21 (17.5%) cases, (64.7% sensitivity for ≥CIN2). All the ASC-H cases (3, 100%), and 57.1% of ASCUS cases with ≥CIN2 as final diagnosis were positive to p16/Ki-67. The specificity of p16/Ki-67 dual staining was greater than 90%.

Conclusions There was a p16/Ki-67 specificity that exceeded the values ​​published in other studies on this double staining, but, the positivity and sensitivity estimates were lower than reported previously. The variability of p16/Ki-67 staining in HSILs would reflect the heterogeneity of these lesions.

Citation Format: Lia Barrios, Luis Alvis, Ines Benedetti. Simultaneous p16/ki-67 expression in detection of high-grade squamous intraepithelial lesions, in women with ASC in cervical smears [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 1123.

Abstract 5771: Performance of uterine cervix liquid based cytology, in patients with ASCUS by conventional pap smear

Background: The diagnosis of uterine cervix premalignant lesions is ​​the goal of cervical cancer prevention programs; Conventional Pap smear (CPS) with its limitations remains the screening method used in these programs in many Latin-American countries. In Colombia, after the implementation of CPS as a primary screening test, a less than expected decrease in mortality from cervical cancer has been observed. Actions aimed to improving cytological diagnosis could reduce the number of patients followed and treated unnecessarily. The demonstration of high specificity for liquid-based cytology (LBC) to adequately categorize cases with ASCUS in CPS, will serve as support for public health authorities, in their decisions about the best method to the screening programs.

Design: Were included all patients with ASCUS results in CPS, referred to a Cervical Pathology Unit in Cartagena, Colombia. Material for LBC was obtained and LBCs were interpreted by two pathologists, blind to previous CPS or colposcopy diagnosis. Colposcopy were classified as negative/normal and positive/abnormal, colposcopic abnormalities were biopsied. Histological analyzes were performed by two pathologists blind to CBL outcome. Pathology diagnosis used were: CIN1/HPV infection: low-grade squamous intraepithelial lesion (LSIL), CIN2/CIN3: high-grade squamous intraepithelial lesion (HSIL). Diagnostic gold standards used to calculate LBC performance were: normal/negative for SIL: if colposcopy did not reveal lesion or colposcopy was abnormal but biopsy revealed no lesion; abnormal/positive: biopsy diagnosis ≥CIN2. Sensitivity, specificity, positive (PPV), negative predictive values (NPV), ​​ and Kappa concordance and correlation test were performed.

Results: A total of 114 cases taken from patients with ASCUS in CPS were included, 77 of them corresponded to patients ≥30 years old. LBC sensitivity and specificity to detect HSIL/≥CIN2 were 76.5% and 66.0% respectively; PPV and NPV were 28.3% and 94.1%, when the cut-off point was a cytological result of HSIL. The concordance with the histological study was k = 0.2492 (p= 0.01). LBC is possible to reduce doubtful results and colposcopy remissions. Using LBC there were fewer results of ASCUS which is the most common cytological abnormality in screening populations that imposes heavy burden for follow-up. Concordance in HSIL cases with histological study was 100%, but in general the accuracy measured by the kappa statistic is low.

Conclusions: These results support the evidence that LBC is no more sensitive than CPS for detection of HSIL/≥CIN2. The sensitivity and predictive values for HSIL/≥CIN2 were not significantly different between CPS and LBC, but, taking into account the benefits of unsatisfactory minors, and material availability for molecular biomarkers and HPV detection in the same sample, it could be used in cervical cancer program management guidelines.

Citation Format: Ines Benedetti, Yoled Vizcaino, Lia Barrios. Performance of uterine cervix liquid based cytology, in patients with ASCUS by conventional pap smear [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 5771.

Efectos de un programa de ejercicio intradiálisis en pacientes con enfermedad renal crónica

El objetivo de este estudio fue comprobar el grado de cumplimiento y analizar el efecto de un programa intradiálisis de ejercicio físico sobre la condición física y salud del paciente con enfermedad renal crónica (ERC) que recibe hemodiálisis. Estudio de intervención con dos periodos de 14 semanas, uno sin intervención de ejercicio y otro con intervención, combinando trabajo de resistencia aeróbica y fuerza, en sesiones de 60 minutos, 3 días/semana. La condición física se evaluó a través de la capacidad de fuerza máxima de prensión manual, fuerza resistencia en extremidades inferiores y capacidad cardiorrespiratoria. El 62% de los pacientes cumplieron el 75% del programa. Durante el periodo sin ejercicio intradiálisis se observó una disminución significativa de la condición física, que se frenó durante el periodo con intervención de ejercicio. El programa de ejercicio intradiálisis es importante para frenar la pérdida de condición física ocasionada por la ERC.

P13.08 1H-MRS metabolomics as a predictor of overall survival in glioma patients

BACKGROUND

We assess the efficacy of the metabolomic profile from glioma biopsies, in providing estimates of postsurgical Overall Survival in glioma patients.

MATERIAL AND METHODS

Tumor biopsies from 46 patients bearing gliomas, obtained neurosurgically in the period 1992–1998, were analyzed by high resolution 1H magnetic resonance spectroscopy (HR- 1H MRS), following retrospectively individual postsurgical Overall Survival up to 720 weeks.

RESULTS

The Overall Survival profile could be resolved in three groups; Short (shorter than 52 weeks, n=19), Intermediate (between 53 and 364 weeks, n=19) or Long (longer than 365 weeks, n=8), respectively. Classical histopathological analysis assigned WHO grades II-IV to every biopsy but notably, some patients with low grade glioma depicted unexpectedly Short Overall Survival, while some patients with high grade glioma, presented unpredictably Long Overall Survival. To explore reasons underlying this behavior, we analyzed HR- 1H MRS spectra from acid extracts of these biopsies, to identify the metabolite patterns underlying OS predictions. Poor prognosis was found in biopsies with higher contents of alanine, acetate, glutamate, total choline, phosphorylcholine and glycine, while more favorable prognosis was achieved in biopsies with larger contents of total creatine, glycerol-phosphorylcholine and myo-inositol. We implemented then a multivariate analysis approach to identify hierarchically the influence of these metabolomic biomarkers on OS predictions, using Classification Regression Trees (CRTs). Metabolomic CRTs grew up to 3 branches and split into 8 nodes, predicting correctly the outcome of 94.7% of the patients in the Short Overall Survival group, 78.9 % of the patients in the Intermediate Overall Survival group, and 75% of the patients in the Long Overall Survival group, respectively.

CONCLUSION

Present results suggest that metabolic profiling by HR-1H MRS provides more accurate Overall Survival estimates of glioma patients than classical histopathological grading, thus allowing to implement more accurate therapeutic decisions.

Abstract 1489: Differential gene expression profiles between normal cervical tissue and high-grade squamous intraepithelial lesion expressing p16 and high-risk HPV E6/E7 mRNA

Background:

HPV is necessary but not sufficient for development of uterine cervix carcinoma. There are genetic factors that influence the progression of premalignant lesions. Gene expression profile differences between healthy and premalignant lesion could contribute to identify potential biomarkers for each step of cervical tumor progression.

Design:

A female patient with an initial diagnosis of low grade squamous intraepithelial lesion (SIL) was invited to participate in the study. During follow-up a high grade SIL was observed by colposcopy, and two samples were obtained from the lesion: one sample was processed for histopathologic diagnosis, and additionally stained by IHC with p16 antibody; the other sample, along with a matched sample of healthy tissue taken distantly from the lesion were stored in a nucleic acids preservation reagent for subsequent analysis of gene expression. Differences in gene expression between healthy tissue and high grade SIL tissue were assessed in triplicate using the cDNA gene expression Illumina microarray Human-HT-12-V4. A statistical p value was computed comparing expression levels from the tissue lesion and healthy tissue. Genes with a fold-change ≥ 2 and a p value <0.05 were regarded as differentially expressed. Additionally, two cervix swabs were obtained for detection of HPV DNA by PCR, and for assessment of high risk HPV E6/E7 mRNA expression by RT-PCR.

Results:

Histopathological evaluation of the lesion confirmed a high grade squamous intraepithelial lesion, with positive p16 staining. HPV-18 DNA was detected and E6/E7 HPV 18 mRNA expression was confirmed. Gene expression analysis detected 33 overexpressed genes, including TMEM45A, SPRR2B, KRT16 and RBP1, and 30 underexpressed genes, including SPARCL1, GCNT3, TMPRSS11b

and ESR1, in high grade SIL compared to healthy uterine cervical tissue. Overexpressed genes belonged to important cellular pathways, such as queratinization, defensins, cytoskeletal signaling, cellular adhesion and extracellular matrix remodeling. Underexpressed genes belonged to metabolic pathways, cell trafficking, and chemokine signaling, among others.

Conclusions:

Microarray analysis identified differential expression between healthy cervical tissue and high grade SIL with confirmed HPV-18 transforming infection. Differentially expressed genes belonged to important cellular pathways. Further studies are required to evaluate the usefulness of these genes as risk markers for progression.

Citation Format: Ines Benedetti, Lia Barrios, Niradiz Reyes. Differential gene expression profiles between normal cervical tissue and high-grade squamous intraepithelial lesion expressing p16 and high-risk HPV E6/E7 mRNA [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 1489.

Topographic Diagnosis of Craniopharyngiomas: The Accuracy of MRI Findings Observed on Conventional T1 and T2 Images

BACKGROUND AND PURPOSE

The topography of craniopharyngiomas has proved fundamental in predicting the involvement of vital brain structures and the possibility of achieving a safe radical resection. Beyond the imprecise term "suprasellar," indiscriminately used for craniopharyngiomas, an accurate definition of craniopharyngioma topography should be assessed by preoperative MR imaging. The objective of this study was to investigate the MRI findings that help define craniopharyngioma topography.

MATERIALS AND METHODS

This study retrospectively investigated a cohort of 200 surgically treated craniopharyngiomas with their corresponding preoperative midsagittal and coronal conventional T1- and T2-weighted MR images, along with detailed descriptions of the surgical findings. Radiologic variables related to the occupation of the tumor of intracranial compartments and the distortions of anatomic structures along the sella turcica-third ventricle axis were analyzed and correlated with the definitive craniopharyngioma topography observed during the surgical procedures. A predictive model for craniopharyngioma topography was generated by multivariate analysis.

RESULTS

Five major craniopharyngioma topographies can be defined according to the degree of hypothalamic distortion caused by the tumor: sellar-suprasellar, pseudointraventricular, secondary intraventricular, not strictly intraventricular, and strictly intraventricular. Seven key radiologic variables identified on preoperative MRI allowed a correct overall prediction of craniopharyngioma topography in 86% of cases: 1) third ventricle occupation, 2) pituitary stalk distortion, 3) relative level of the hypothalamus in relation to the tumor, 4) chiasmatic cistern occupation, 5) mammillary body angle, 6) type of chiasm distortion, and 7) tumor shape.

CONCLUSIONS

Systematic assessment of these 7 variables on conventional preoperative T1 and T2 MRI is a useful and reliable method to ascertain individual craniopharyngioma topography.

A recombinant cystatin from Ascaris lumbricoides attenuates inflammation of DSS-induced colitis

Helminthiasis may ameliorate inflammatory diseases, such as inflammatory bowel disease and asthma. Information about immunomodulators from Ascaris lumbricoides is scarce, but could be important considering the co-evolutionary relationships between helminths and humans. We evaluated the immunomodulatory effects of a recombinant cystatin from A. lumbricoides on an acute model of dextran sodium sulphate (DSS)-induced colitis in mice. From an A. lumbricoides cDNA library, we obtained a recombinant cystatin (rAl-CPI). Protease activity inhibition was demonstrated on cathepsin B and papain. Immunomodulatory effects were evaluated at two intraperitoneal doses (0.5 and 0.25 μg/G) on mice with DSS-induced colitis. Body weight, colon length, Disease Activity Index (DAI), histological inflammation score, myeloperoxidase (MPO) activity, gene expression of cytokines and cytokines levels in colon tissue were analysed. Treatment with rAl-CPI significantly reduced DAI, MPO activity and inflammation score without toxic effects. Also, IL-10 and TGF-B gene overexpression was observed in rAl-CPI-treated group compared to DSS-exposed control and healthy mice. Furthermore, a reduction in IL-6 and TNF-A expression was found, and this was confirmed by the levels of these cytokines in colonic tissue. In conclusion, rAl-CPI reduces inflammation in a mouse model of DSS-induced colitis, probably by increasing the expression of anti-inflammatory cytokines and reducing pro-inflammatory ones.

Cell Death Mechanisms in Tumoral and Non-Tumoral Human Cell Lines Triggered by Photodynamic Treatments: Apoptosis, Necrosis and Parthanatos

Cell death triggered by photodynamic therapy can occur through different mechanisms: apoptosis, necrosis or autophagy. However, recent studies have demonstrated the existence of other mechanisms with characteristics of both necrosis and apoptosis. These new cell death pathways, collectively termed regulated necrosis, include a variety of processes triggered by different stimuli. In this study, we evaluated the cell death mechanism induced by photodynamic treatments with two photosensitizers, meso-tetrakis (4-carboxyphenyl) porphyrin sodium salt (Na-H₂TCPP) and its zinc derivative Na-ZnTCPP, in two human breast epithelial cell lines, a non-tumoral (MCF-10A) and a tumoral one (SKBR-3). Viability assays showed that photodynamic treatments with both photosensitizers induced a reduction in cell viability in a concentration-dependent manner and no dark toxicity was observed. The cell death mechanisms triggered were evaluated by several assays and cell line-dependent results were found. Most SKBR-3 cells died by either necrosis or apoptosis. By contrast, in MCF-10A cells, necrotic cells and another cell population with characteristics of both necrosis and apoptosis were predominant. In this latter population, cell death was PARP-dependent and translocation of AIF to the nucleus was observed in some cells. These characteristics are related with parthanatos, being the first evidence of this type of regulated necrosis in the field of photodynamic therapy.

Realising the European network of biodosimetry: RENEB-status quo

Creating a sustainable network in biological and retrospective dosimetry that involves a large number of experienced laboratories throughout the European Union (EU) will significantly improve the accident and emergency response capabilities in case of a large-scale radiological emergency. A well-organised cooperative action involving EU laboratories will offer the best chance for fast and trustworthy dose assessments that are urgently needed in an emergency situation. To this end, the EC supports the establishment of a European network in biological dosimetry (RENEB). The RENEB project started in January 2012 involving cooperation of 23 organisations from 16 European countries. The purpose of RENEB is to increase the biodosimetry capacities in case of large-scale radiological emergency scenarios. The progress of the project since its inception is presented, comprising the consolidation process of the network with its operational platform, intercomparison exercises, training activities, proceedings in quality assurance and horizon scanning for new methods and partners. Additionally, the benefit of the network for the radiation research community as a whole is addressed.

Nanostructured Ti-Zr-Pd-Si-(Nb) bulk metallic composites: Novel biocompatible materials with superior mechanical strength and elastic recovery

The microstructure, mechanical behaviour, and biocompatibility (cell culture, morphology, and cell adhesion) of nanostructured Ti45 Zr15 Pd35- x Si5 Nbx with x = 0, 5 (at. %) alloys, synthesized by arc melting and subsequent Cu mould suction casting, in the form of rods with 3 mm in diameter, are investigated. Both Ti-Zr-Pd-Si-(Nb) materials show a multi-phase (composite-like) microstructure. The main phase is cubic β-Ti phase (Im3m) but hexagonal α-Ti (P63/mmc), cubic TiPd (Pm3m), cubic PdZr (Fm3m), and hexagonal (Ti, Zr)5 Si3 (P63/mmc) phases are also present. Nanoindentation experiments show that the Ti45 Zr15 Pd30 Si5 Nb5 sample exhibits lower Young's modulus than Ti45 Zr15 Pd35 Si5 . Conversely, Ti45 Zr15 Pd35 Si5 is mechanically harder. Actually, both alloys exhibit larger values of hardness when compared with commercial Ti-40Nb, (HTi-Zr-Pd-Si ≈ 14 GPa, HTi-Zr-Pd-Si-Nb ≈ 10 GPa and HTi-40Nb ≈ 2.7 GPa). Concerning the biological behaviour, preliminary results of cell viability performed on several Ti-Zr-Pd-Si-(Nb) discs indicate that the number of live cells is superior to 94% in both cases. The studied Ti-Zr-Pd-Si-(Nb) bulk metallic system is thus interesting for biomedical applications because of the outstanding mechanical properties (relatively low Young's modulus combined with large hardness), together with the excellent biocompatibility.

DES daughters in France: experts' points of view on the various genital, uterine and obstetric pathologies, and in utero DES exposure

BACKGROUND

Compensation of diethylstilbestrol exposure depends on the judicial system. In France, girls having been exposed to diethylstilbestrol are currently being compensated, and each exposure victim is being evaluated. Fifty-nine expert evaluations were studied to determine the causal relation between exposure to diethylstilbestrol and the pathologies attributable to diethylstilbestrol.

METHODS

The following were taken into consideration: age at the first signs of the pathology; age of the sufferer at the time of evaluation; the pathologies grouped into five categories: fertility disorders - cancers - mishaps during pregnancy - psychosomatic complaints - pathologies of "3rd generation DES victims"; submission of proof of DES exposure; the degree of causality determined (direct, indirect, ruled out).

RESULTS

61% of the cases related to fertility disorders, 28.8% to cancer pathologies (clear-cell adenocarcinoma), 18.6% to mishaps during pregnancy, 8.5% to disorders resulting from preterm delivery, and 3.4% to psychosomatic disorders. Some cases involved a combination of two types of complaints. Indirect causality was determined in 47.1% of the cases involving primary sterility, in 66.7% involving secondary sterility, and in 5 out of 6 cases of total sterility. There is direct causality between in utero diethylstilbestrol exposure and vaginal or cervical clear cell adenocarcinoma. Causality is indirect in the case of disorders linked to prematurity in third generation victims.

CONCLUSION

Causality was determined by the experts on the basis of scientific criteria which attribute the presenting pathologies to diethylstilbestrol exposure. When other risk factors come into play, or when exposure is indirect (third generation), this causality is diminished.

Validation of semi-automatic scoring of dicentric chromosomes after simulation of three different irradiation scenarios

Large scale radiological emergencies require high throughput techniques of biological dosimetry for population triage in order to identify individuals indicated for medical treatment. The dicentric assay is the "gold standard" technique for the performance of biological dosimetry, but it is very time consuming and needs well trained scorers. To increase the throughput of blood samples, semi-automation of dicentric scoring was investigated in the framework of the MULTIBIODOSE EU FP7 project, and dose effect curves were established in six biodosimetry laboratories. To validate these dose effect curves, blood samples from 33 healthy donors (>10 donors/scenario) were irradiated in vitro with ⁶⁰Co gamma rays simulating three different exposure scenarios: acute whole body, partial body, and protracted exposure, with three different doses for each scenario. All the blood samples were irradiated at Ghent University, Belgium, and then shipped blind coded to the participating laboratories. The blood samples were set up by each lab using their own standard protocols, and metaphase slides were prepared to validate the calibration curves established by semi-automatic dicentric scoring. In order to achieve this, 300 metaphases per sample were captured, and the doses were estimated using the newly formed dose effect curves. After acute uniform exposure, all laboratories were able to distinguish between 0 Gy, 0.5 Gy, 2.0, and 4.0 Gy (p < 0.001), and, in most cases, the dose estimates were within a range of ± 0.5 Gy of the given dose. After protracted exposure, all laboratories were able to distinguish between 1.0 Gy, 2.0 Gy, and 4.0 Gy (p < 0.001), and here also a large number of the dose estimates were within ± 0.5 Gy of the irradiation dose. After simulated partial body exposure, all laboratories were able to distinguish between 2.0 Gy, 4.0 Gy, and 6.0 Gy (p < 0.001). Overdispersion of the dicentric distribution enabled the detection of the partial body samples; however, this result was clearly dose-dependent. For partial body exposures, only a few dose estimates were in the range of ± 0.5 Gy of the given dose, but an improvement could be achieved with higher cell numbers. The new method of semi-automation of the dicentric assay was introduced successfully in a network of six laboratories. It is therefore concluded that this method can be used as a high-throughput screening tool in a large-scale radiation accident.

Web-based scoring of the dicentric assay, a collaborative biodosimetric scoring strategy for population triage in large scale radiation accidents

In the case of a large scale radiation accident high throughput methods of biological dosimetry for population triage are needed to identify individuals requiring clinical treatment. The dicentric assay performed in web-based scoring mode may be a very suitable technique. Within the MULTIBIODOSE EU FP7 project a network is being established of 8 laboratories with expertise in dose estimations based on the dicentric assay. Here, the manual dicentric assay was tested in a web-based scoring mode. More than 23,000 high resolution images of metaphase spreads (only first mitosis) were captured by four laboratories and established as image galleries on the internet (cloud). The galleries included images of a complete dose effect curve (0-5.0 Gy) and three types of irradiation scenarios simulating acute whole body, partial body and protracted exposure. The blood samples had been irradiated in vitro with gamma rays at the University of Ghent, Belgium. Two laboratories provided image galleries from Fluorescence plus Giemsa stained slides (3 h colcemid) and the image galleries from the other two laboratories contained images from Giemsa stained preparations (24 h colcemid). Each of the 8 participating laboratories analysed 3 dose points of the dose effect curve (scoring 100 cells for each point) and 3 unknown dose points (50 cells) for each of the 3 simulated irradiation scenarios. At first all analyses were performed in a QuickScan Mode without scoring individual chromosomes, followed by conventional scoring (only complete cells, 46 centromeres). The calibration curves obtained using these two scoring methods were very similar, with no significant difference in the linear-quadratic curve coefficients. Analysis of variance showed a significant effect of dose on the yield of dicentrics, but no significant effect of the laboratories, different methods of slide preparation or different incubation times used for colcemid. The results obtained to date within the MULTIBIODOSE project by a network of 8 collaborating laboratories throughout Europe are very promising. The dicentric assay in the web based scoring mode as a high throughput scoring strategy is a useful application for biodosimetry in the case of a large scale radiation accident.

In vitro biocompatibility assessment of Ti40Cu38Zr10Pd12 bulk metallic glass

The use of biocompatible materials has attained an increasing importance for tissue regeneration and transplantation. The excellent mechanical and corrosion properties of Ti40Cu38Zr10Pd12 bulk metallic glass (BMG) turn it into a potential candidate for its use in orthopaedic implants. Before being considered as a biomaterial, some biological parameters must be taken into account. In this study,mouse preosteoblasts were cultured in the presence or absence of the alloy at different times (24 h, 7 and 21 days) and no differences in cell viability were detected.Moreover, cells were able to adhere to the alloy surface by establishing focal contacts, and displayed a flattened polygonal morphology. After 14 days in culture, differentiation into osteoblasts was observed. Besides, the amount of Cu ions released and their potential toxic effects were analyzed, showing that the amount of Cu released did not increase cell death. Finally, the low levels of inflammatory cytokines secreted by THP-1 differentiated macrophages exposed to the alloy suggest the absence of an immunogenic response to the alloy. In conclusion, in vitro studies indicate that the Ti40Cu38Zr10Pd12 BMG could be considered as a biomaterial to be used in orthopaedic implants.

142 ZONA PELLUCIDA TAGGING WITH BARCODES ALLOWS THE TRACEABILITY OF BOVINE EMBRYOS CULTURED IN GROUP

The low number of oocytes collected from unstimulated donors by ovum pick-up means that embryos produced from each female have to be cultured in very small groups. Because embryo quality and development rates are reduced in individual and small group culture, several methods to culture embryos individually but sharing the same medium have been designed. However, these systems prevent embryo movements, interfering with paracrine factors transmission and gradient changes. Here, we present an alternative in vitro culture method to allow the co-culture of embryos from different origins, without movement restriction and preserving their pedigree, by labelling the zygotes with polysilicon barcodes attached to the outer surface of the zona pellucida (ZP). Barcodes (10 × 6 × 1 µm) with 8 rectangular bits of binary codification (256 possible combinations), which can be read under a standard inverted microscope, were fabricated using silicon microtechnologies. To provide the barcodes with a ZP-binding capacity, they were biofunctionalized by self-assembled monolayers with the wheat germ agglutinin (WGA) lectin, which recognizes specific saccharides highly abundant in the ZP of most mammalian species. As a proof of concept, the culture method was tested on bovine zygotes produced from slaughterhouse-derived cow oocytes matured and fertilized in vitro. Using a mouth-controlled pipette, presumptive zygotes were individually rolled over WGA-biofunctionalized barcodes (8 barcodes/embryo) previously placed at the bottom of a drop of manipulation media. Four different barcodes, each one with a different codification, were used to encode 25 embryos (6–7 embryos/barcode codification), which were then cultured together in the same drop of medium. Day 7 (D7) and Day 8 (D8) blastocyst, and barcode retention rates were assessed. In addition, D7 expanded blastocysts were vitrified by the cryotop method and post-warming survival was determined as re-expansion rate at 24 h in culture. Finally, the quality of D8 blastocysts was assessed by differential staining and counting of inner cell mass (ICM) and trophectoderm (TE) cells. In all the experiments, a control group without barcodes was cultured and vitrified-warmed. Data were analyzed by chi-square and Mann–Whitney tests. The presence of barcodes attached to the ZP did not affect in vitro embryo development (D8 blastocysts: 29.7% control n = 309, 36.2% encoded n = 315), post-warming survival (86.4% control n = 66, 80.5% encoded n = 82), or blastocyst quality (IMC/TE: 22.1 ± 1.4/64.5 ± 5.7 control n = 18, 22.2 ± 1.7/64.1 ± 6.1 encoded n = 23). The labelling system was effective until D8 of culture, as all the embryos maintained barcodes attached (4 ± 1.8 barcodes/embryo) and could be identified, even after undergoing vitrification and warming. In conclusion, identification of co-cultured embryos by biofunctionalized barcodes attached to the ZP is feasible and will allow to culture embryos from different donors in the same drop, keeping the benefits of collective culture. Support was provided by Spanish MEC (TEC2011-29140-C03; RZ2010-00015-0-00; AGL2010-19069), Generalitat Catalunya (2009 SGR 282 and 621), and PIF-UAB Fellowship.

Realising the European Network of Biodosimetry (RENEB)

In Europe, a network for biological dosimetry has been created to strengthen the emergency preparedness and response capabilities in case of a large-scale nuclear accident or radiological emergency. Through the RENEB (Realising the European Network of Biodosimetry) project, 23 experienced laboratories from 16 European countries will establish a sustainable network for rapid, comprehensive and standardised biodosimetry provision that would be urgently required in an emergency situation on European ground. The foundation of the network is formed by five main pillars: (1) the ad hoc operational basis, (2) a basis of future developments, (3) an effective quality-management system, (4) arrangements to guarantee long-term sustainability and (5) awareness of the existence of RENEB. RENEB will thus provide a mechanism for quick, efficient and reliable support within the European radiation emergency management. The scientific basis of RENEB will concurrently contribute to increased safety in the field of radiation protection.

Interplant movement and spatial distribution of alate and apterous morphs of Nasonovia ribisnigri (Homoptera: Aphididae) on lettuce

Knowledge on colonization modes and interplant movement of Nasonovia ribisnigri can contribute to the development of optimal control of this pest. The aim of this study was to determine the spatio-temporal distribution and the mode of spread between adult morphs of Nasonovia ribisnigri, comparing spring and autumn lettuce protected crops. The spatial and temporal pattern was analyzed using the spatial analysis by distance indices (SADIE) methodology and other related displacement indices. The population size of N. ribisnigri was greater in the autumn than in the spring growing seasons due to milder temperatures. The percentage of plants colonized by aphids was higher in spring than in autumn, showing the great dispersal potential of this aphid species independent of their population size. Differential propensity for initial displacement from the central plant was observed between adult morphs in spring, resulting in a greater ability of apterous than alate aphids to spread far away from the source plant. In autumn, both adult morphs showed an initial reduced displacement; however, the number of plants infested (≈20%) with at least one aphid at this initial time (seven days) was similar for both adult morphs and both growing seasons. Analysis of the spatial pattern of both adult morphs revealed a predominantly random distribution for both spring and autumn trials. This pattern was achieved by a prevalent random movement over the area (γ≈0.5). These results highlight the ability of the apterous N. ribisnigri to spread within greenhouse lettuce crops early in the spring, suggesting that detection of the pest by deep visual inspection is required after lettuce emergence.

Chemical functionalization of polysilicon microparticles for single-cell studies

In this work, two types of polycrystalline silicon (polysilicon) microparticles were modified with specific ligands in order to be selectively attached to chemical residues located at the plasma membrane and thus to be applied to study individual cells in culture. Two different functionalization approaches based on adsorption and covalent attachment were assayed. A comparative study of the efficiency of the ligand immobilization and stability of the modified particle in the culture medium was carried out using the selected ligands labeled with a fluorophore. Cylindrical microparticles (nonencoded microparticles) and shape-encoded microparticles (bar codes) were used with the aim of demonstrating the nondependence of the particle size and shape on the efficiency of the immobilization protocol. Fluorescence imaging and statistical analysis of the recorded fluorescence intensity showed that the covalent attachment of the ligand to the surface of the microparticle, previously modified with an aldehyde-terminated silane, gave the best results. As a proof of concept, Vero cells in culture were labeled with the covalently modified bar codes and successfully tracked for up to 1 week without observing any alteration in the viability of the cells. Bar code numbers could be easily read by eye using a bright-field optical microscope. It is anticipated that such modified microparticles could be feasible platforms for the introduction of other analytical functions of interest in single-cell monitoring and cell sorting in automatic analysis systems.

Multimodal BCI-mediated FES suppression of pathological tremor

Tremor constitutes the most common movement disorder; in fact 14.5% of population between 50 to 89 years old suffers from it. Moreover, 65% of patients with upper limb tremor report disability when performing their activities of daily living (ADL). Unfortunately, 25% of patients do not respond to drugs or neurosurgery. In this regard, TREMOR project proposes functional compensation of upper limb tremors with a soft wearable robot that applies biomechanical loads through functional electrical stimulation (FES) of muscles. This wearable robot is driven by a Brain Neural Computer Interface (BNCI). This paper presents a multimodal BCI to assess generation, transmission and execution of both volitional and tremorous movements based on electroencephalography (EEG), electromyography (EMG) and inertial sensors (IMUs). These signals are combined to obtain: 1) the intention to perform a voluntary movement from cortical activity (EEG), 2) tremor onset, and an estimation of tremor frequency from muscle activation (EMG), and 3) instantaneous tremor amplitude and frequency from kinematic measurements (IMUs). Integration of this information will provide control signals to drive the FES-based wearable robot.

[The concept of characterized malpractice in wrongful birth]

OBJECTIVES

The law of March2002 was introducing a new concept of liability in the field of prenatal diagnosis, survey and investigations. For wrongful birth, medical physicians are responsible for newborn infants with congenital or hereditary disorder only in a case of characterized malpractices.

MATERIALS AND METHODS

We performed a study about decisions that awarded or refused monetary damages specifically to the parents in the light of this new law. This research was performed by using official court rulings website, crossed in the search engine two expression-keys that were characterized: fault and antenatal diagnosis. Fifteen rulings were reviewed and studied. The matter of our research is to understand how the judges characterize the medical malpractice and insist upon the qualification "Blatant" in the field of prenatal medical liability?

RESULTS

In fact, judicial decisions explicit more what it is not a characterized fault than what it is. Such judicial rejections stated that the medical practices were based on to established medical references and so couldn't be characterized. The taking care, the survey and the biological and radiological investigations of the pregnancy were evaluated in accordance to the knowledge of science although they didn't diagnose fetal malformations. Only four rulings accepted this kind of medical fault, focused the notion of medical neglect accompanied with hurriedness for some judges when physicians performed in particular antenatal echography. In these circumstances, the physician performed quickly and without interest the medical investigations which missed to detect fetal malformations. Two rulings of them categorized the malpractice by the inversion of results, and by the no information about unusual margin of error for cellular culture. The judge argued that negligence of health-care-providers denied to the parents the psychological preparation of hosting disabilities newborn. In this point of view, the judges want to damage parent's injuries.

Analysis of γ-rays induced chromosome aberrations: A fingerprint evaluation with a combination of pan-centromeric and pan-telomeric probes

PURPOSE

To evaluate the types of induced chromosome aberrations after the exposure of peripheral blood to gamma-rays by the simultaneous detection of all centromeres and telomeres; and to analyse the suitability of different radiation fingerprints for the assessment of radiation quality in cases of recent exposures.

MATERIAL AND METHODS

Peripheral blood samples were irradiated at 2, 4 and 6 Gy of gamma-rays. Cytogenetic analysis was carried out by fluorescence in situ hybridization (FISH) technique with pan-centromeric and peptide nucleic acid (PNA)-telomeric DNA probes. Cells were analysed using a Cytovision FISH workstation, chromosome aberrations and the length of the acentric fragments were recorded.

RESULTS

The total number of the incomplete chromosome elements was 276. The ratio between incomplete elements and multicentrics was 0.38. The number of acentrics was 1096, 71% were complete acentrics, 15% incomplete acentrics, and 14% interstitial fragments. The relative length of complete, incomplete and interstitial acentrics fragments were 2.70 +/- 0.04, 1.91 +/- 0.07, and 1.42 +/- 0.04 respectively. The mean value of the F-ratio was 11.5 higher than the one, 5.5, previously obtained for alpha-particles. For the G-ratio there was no difference between gamma-rays and alpha-particles, 2.8 and 2.8 respectively. The mean value of the H-ratio for gamma-rays, 0.25, was lower than for alpha-particles 0.40.

CONCLUSION

The results support that the percentage of incomplete chromosome aberrations depends on radiation type; low-linear energy transfer (LET) radiation would produces less incomplete aberrations than high-LET radiation. The F- and H-ratios seem to be good indicators of radiation quality, although a real estimation of the H-ratio is only possible using pan-telomeric probes.

Analysis ofα‐particle induced chromosome aberrations in human lymphocytes, using pan‐centromeric and pan‐telomeric probes

PURPOSE

The aim of the present study has been the evaluation of the incomplete chromosome aberrations induced after alpha-particle irradiation by the simultaneous detection of all centromeres and telomeres present in human lymphocytes. Moreover, a study on the lengths of the different acentric fragments is presented.

MATERIALS AND METHODS

Attached lymphocytes were irradiated at doses of 0.2, 0.5, 0.7 and 1 Gy using a 241Am source. Flourescent in-situ hybridization (FISH) techniques were applied using pan-centromeric and pan-telomeric probes. All abnormal cells were digitalised and analysed using a Cytovision FISH workstation. The description of all abnormalities observed, and the length of the acentric fragments was recorded.

RESULTS

A total of 378 incomplete chromosomes plus incomplete acentrics was found. Cases with more than 92 telomeres were not detected. The ratio between total incomplete elements and multicentrics was 1.00. The total number of acentric (ace) fragments was 822; 57% of them were complete fragments ace (+,+), 26% incomplete fragments ace (+,-), and 17% interstitial fragments ace(-,-); the mean relative lengths were 2.91 +/- 0.06, 1.91 +/- 0.07 and 1.63 +/- 0.07, respectively. In all three cases a secondary peak in the length distribution was found, corresponding to a relative length between 3.5 and 4.

CONCLUSION

The percentage of incomplete rejoinings is higher after alpha-particle exposure than that described previously for low-linear energy transfer (LET) radiation exposures. The results seem to indicate that compared to low-LET radiation, after alpha-particle exposure centromere-containing elements are more likely to be repaired.Many interstitial fragments are large linear forms that cannot be considered as non-distinguishable acentric rings.

Design and implementation of the Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study

OBJECTIVE

To provide an overview of the Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study (HELENA-CSS) design, with particular attention to its quality control procedures. Other important methodological aspects are described in detail throughout this supplement.

DESIGN

Description of the HELENA-CSS sampling and recruitment approaches, standardization and harmonization processes, data collection and analysis strategies and quality control activities.

RESULTS

The HELENA-CSS is a multi-centre collaborative study conducted in European adolescents located in urban settings. The data management systems, quality assurance monitoring activities, standardized manuals of operating procedures and training and study management are addressed in this paper. Various quality controls to ensure collection of valid and reliable data will be discussed in this supplement, as well as quantitative estimates of measurement error.

CONCLUSION

The great advantage of the HELENA-CSS is the strict standardization of the fieldwork and the blood analyses, which precludes to a great extent the kind of immeasurable confounding bias that often interferes when comparing results from isolated studies.