Removal of microfiber in vertical flow constructed wetlands treating greywater

Nature-based solutions such as constructed wetlands (CW) are considered as a sustainable, green technology for greywater treatment. However, their efficiency to remove microplastics is not well-known even though greywater is considered as a significant source of microfiber pollution. In this study, the removal of fiber microplastics from greywater using a vertical flow constructed wetland (VFCW) was investigated. For the purposes of this study, an experimental wetland was constructed, planted with the flowering plant Zantedeschia aethiopica and filled with a substrate made of sand/gravel of several sizes. The system's performance was monitored for five months during which it received real laundry wastewater. Promising results were obtained showing the significant removal of microfibers from the influent (> 95 %). Moreover, the ability of the system to remove microfibers from laundry wastewater was not significantly affected from the hydraulic loading rate (HLR) applied. The average microfibers concentration decreased from 71 ± 25 microparticles/L in the influent to 1 ± 1 microparticles/L in the effluent of VFCW when an HLR of 63.7 mm/d was applied. High removal efficiencies were also observed for COD and turbidity (93 % and 94 %, respectively). Thus, the results indicate a significant improvement in the overall quality of laundry wastewater due to the use of the VFCW.

Abstract P4-08-13: Prognostic significance of CD8+ tumor-infiltrating lymphocytes (TILs) in patients with early breast cancer (EBC) treated with dose-dense sequential adjuvant chemotherapy (dds-CT). An observational study (ACTRN12616001043426)

Background - aim: Information on the prognostic role of cytotoxic CD8+ T cells in the era of modern adjuvant CT is limited. The primary objective of the present report is to assess the prognostic impact of CD8+ cells in patients with intermediate or high-risk EBC (T1-3N1-2M0) treated with dds-CT. Secondary endpoints are safety, disease-free survival (DFS) and overall survival (OS).

Patients and Methods: Patients (N=1,000) were treated with 4 cycles of Epirubicin, 75mg/m2, and Cyclophophamide, 600mg/m2 every 2 weeks followed by 4 cycles of Docetaxel (D), 100mg/m2 every 3 weeks with G-CSF support in all cycles. Trastuzumab was initiated concurrently with D and continued for a total of 1 year. Hormonal and radiation therapy were given post CT, as indicated. Formalin-fixed paraffin-embedded tumors were available for 642 patients (64.2%) and were centrally assessed for immunohistochemical subtypes (IHC4; N=526), stromal TILs density by morphology (N=636), as well as stromal and intratumoral cytotoxic CD8+ T cell numbers (N=554). TILs and CD8+ were assessed as continuous variables for associations and as 10% increments for outcome.

Results: In total, 901/1,000 pts (90.1%) completed 8 cycles of CT. Severe (gradeIII-IV) toxicitiesincludedneutropenia (5.6%), leucopenia (3.6%), lymphopenia (2.1%), hand-footsyndrome (2.1%), and hepatotoxicity (1.8%). Febrileneutropenia occurred in 1.6% of the patients. The 5-year DFS and OS rates were 89.5% and 93.1%, respectively. Luminal A tumors were classified in 26.2%, Luminal B in 35.2%, luminal HER2 in 9.5%; HER2-enriched in 7.2%; and, triple-negative (TNBC) in 21.9% of informative patients. Among subtypes, stromal TILs density was higher in HER2-enriched and TNBC (p<0.001); intratumoral CD8+ values were higher in TNBC (p<0.001); and, stromal CD8+ were higher in HER2-enriched (p=0.034). In all patients, TILs density and intratumoral CD8+ cell numbers were not associated with DFS and OS, while increased stromal CD8+ were marginally associated with prolonged DFS (HR=0.98, 95%CI 0.96-1.00, p=0.066).Adjusted for histological grade, menopausal, ER/PgR and nodal status, higher stromal CD8+ were associated with prolonged DFS (HR=0.98, 95% CI 0.96-1.00, p=0.043). In TNBC, higher stromal TILs density conferred prolonged DFS (HR=0.97, 95%CI 0.94-0.99, p=0.029), which retained its prognostic significance in multivariate analysis (HR=0.97, 95% CI 0.94-1.00, p=0.049).

Conclusions: In this study, dds-CT was well tolerated and active in patients with EBC. We confirm the presence of morphologically assessed higher TILs density, and of higher cytotoxic CD8+ T cell numbers in hormone receptor negative EBC, as well as the favorable prognostic impact of higher stromal TILs density in TNBC. In comparison to stromal TILs density, higher stromal CD8+ may confer favorable prognosis irrespectively of EBC subtype. Stromal CD8+ seems to be a marker worth further standardizing for reporting on immune cell infiltrates in EBC.

Citation Format: Kourea HP, Koletsa T, Kotoula V, Koliou G-A, Batistatou A, Pentheroudakis G, Arapantoni-Dadioti P, Zagouri F, Bobos M, Sotiropoulou M, Papoudou-Bai A, Chrisafi S, Efstratiou I, Aravantinos G, Nicolaou I, Gogas H, Visvikis A, Christodoulou C, Petraki C, Koutras A, Psyrri A, Pectasides D, Fountzilas G. Prognostic significance of CD8+ tumor-infiltrating lymphocytes (TILs) in patients with early breast cancer (EBC) treated with dose-dense sequential adjuvant chemotherapy (dds-CT). An observational study (ACTRN12616001043426) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-08-13.

Abstract P5-08-50: Associations of MYC protein expression and gene status with breast cancer subtypes and outcome in patients treated with anthracycline-based adjuvant chemotherapy

Background-Aim: Breast cancer is a heterogeneous disease and despite recent scientific progress there is still need for the identification of biomarkers associated with risk for relapse, as well as for markers identifying patients who will benefit from specific treatments. The aim of the present study was to investigate the role of MYC, as a clinically meaningful biomarker, in the outcome of breast cancer subtypes.

Patients and Methods: We have pooled the patients and the respective breast carcinomas from two randomized anthracycline-based adjuvant phase III trials, consecutively conducted by the Hellenic Cooperative Oncology Group (HE10/97 and HE10/00). The HE10/97 trial included a non-paclitaxel arm. Tissue microarrays were constructed from 1,060 formalin-fixed paraffin-embedded tumor tissue samples that were collected retrospectively in the first and prospectively in the second trial. MYC was evaluated by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) in 986 cases.

Results: In total 61.0% of the cases showed positive cytoplasmic MYC immunostaining, while 26.5% showed positive nuclear staining. 65-80% of the patients were characterized as non-amplified or loss/normal-low gain in all FISH cut-offs examined. A weak association was observed between FISH and nuclear protein expression of MYC. High histological grade was associated with MYC protein overexpression and gene amplification. In terms of disease-free survival (DFS), low (2.5-5 copies) and high (≥5 copies) gain of MYC was of adverse prognostic value compared to loss/normal (<2.5 copies) MYC (HR=1.50, 95% CI 1.13-1.98, Wald's p=0.004 and HR=1.45, 95% CI 1.07-1.97, p=0.016, respectively). Comparable results were observed for overall survival (OS) (HR=1.51, 95% CI 1.09-2.08, p=0.013 and HR=1.65, 95% CI 1.17-2.33, p=0.005, respectively). The comparison of neoplasms with CEP8 ratio ≥1.3 and polysomy 8 for MYC versus all others resulted in worse survival prognosis (HR=1.44, 95% CI 1.13-1.83, p=0.004), while tumors with nuclear protein overexpression were associated with better DFS (HR=0.77, 95% CI 0.60-0.99, p=0.039) and OS (HR=0.73, 95% CI 0.55-0.98, p=0.034). In HER2-enriched patients, MYC amplification was found to be an adverse prognostic factor for DFS (HR=2.11, 95% CI 1.09-4.07, p=0.026) and OS (HR=2.41, 95% CI 1.12-5.15, p=0.024).

Treatment with paclitaxel was found to differentiate the effect of MYC: CEP8 ratio ≥1.3 and polysomy 8 in terms of DFS and OS in our total cohort. Among patients with CEP8 ratio ≥1.3 and polysomy 8, those treated with paclitaxel performed significantly better than those not treated, while among patients not treated with paclitaxel, those with CEP8 ratio ≥1.3 and polysomy 8 performed much worse than those with CEP8 ratio <1.3 or no polysomy 8.

Conclusions: Our data suggest that MYC has prognostic and predictive value in patients with breast cancer. MYC amplification and MYC protein overexpression are detected in breast cancer patients and are of adverse prognostic value for DFS and OS. Polysomy 8 is also associated with worse prognosis. Treatment with paclitaxel in the adjuvant setting benefits breast cancer patients with MYC:CEP8 ratio ≥1.3 and polysomy 8.

Citation Format: Batistatou A, Razis E, Bobos M, Tsolaki E, Timotheadou E, Alexopoulou Z, Goussia A, Gogas H, Koutras A, Karina M, Pentheroudakis G, Efstratiou I, Petraki K, Sotiropoulou M, Pavlakis K, Koletsa T, Kotoula V, Fountzilas G. Associations of MYC protein expression and gene status with breast cancer subtypes and outcome in patients treated with anthracycline-based adjuvant chemotherapy. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-08-50.

Radioactive pollution in Athens, Greece due to the Fukushima nuclear accident

As a result of the nuclear accident in Fukushima Dai-ichi power plant, which started on March 11, 2011, radioactive pollutants were transferred by air masses to various regions of the Northern hemisphere, including Europe. Very low concentrations of (131)I, (137)Cs and (134)Cs in airborne particulate matter were measured in Athens, Greece during the period of March 24 to April 28, 2011. The maximum air concentration of (131)I was measured on April 6, 2011 and equaled 490 ± 35 μBq m(-3). The maximum values of the two cesium isotopes were measured on the same day and equaled 180 ± 40 μBq m(-3) for (137)Cs and 160 ± 30 μBq m(-3) for (134)Cs. The average activity ratio of (131)I/(137)Cs in air was 3.0 ± 0.5, while the corresponding ratio of (137)Cs/(134)Cs equaled 1.1 ± 0.3. No artificial radionuclides could be detected in air after April 28, 2011. Traces of (131)I as a result of radioactive deposition were measured in grass, soil, sheep milk and meat. The total deposition of (131)I (dry + wet) was 34 ± 4 Bq m(-2), and of (137)Cs was less than 10 Bq m(-2). The maximum concentration of (131)I in grass was 2.1 ± 0.4 Bg kg(-1), while (134)Cs was not detected. The maximum concentrations of (131)I and (137)Cs in sheep milk were 1.7 ± 0.16 Bq kg(-1) and 0.6 ± 0.12 Bq kg(-1) respectively. Concentrations of (131)I up to 1.3 ± 0.2 Bq kg(-1) were measured in sheep meat. Traces of (131)I were found in a number of soil samples. The radiological impact of the Fukushima nuclear accident in Athens region was practically negligible, especially as compared to that of the Chernobyl accident and also to that of natural radioactivity.

Distribution of natural radioactivity in sediment cores from Amvrakikos Gulf (Western Greece) as a part of IAEA's campaign in the Adriatic and Ionian Seas

The vertical distribution of natural radionuclides ((232)Th decay, (238)U decay, (40)K and (210)Pb) was assessed in sediment cores collected from the Amvrakikos Gulf, (Ionian Sea, Western Greece). Two collection stations were selected, the first at the western part of the Gulf near Preveza Strait (13A station) and the other near the centre of the Gulf (13B station). Activity concentrations were measured by means of gamma-ray spectrometry using high-purity germanium (HPGe) detectors installed at two national laboratories. The activity concentration of (226)Ra was found in a range from 10 to 20 Bq kg(-1), while the activity concentration of (222)Rn daughters ((214)Pb, (214)Bi) ranged from 6 to 20 Bq kg(-1). The activity concentration of (228)Ac varied from 20 to 28 Bq kg(-1), while (220)Rn daughters ((212)Pb, (208)Tl) from 7 to 35 Bq kg(-1). As concerns (40)K and (210)Pb, their activities varied from 400 to 830 Bq kg(-1) and from 11 to 360 Bq kg(-1), respectively. Also, the data of (210)Pb were utilised in the calculations of the sedimentation rate along the sediment cores. Both locations were characterised by a consistent pattern with the average rates of 0.55 ± 0.02 and 0.32 ± 0.02 cm y(-1), corresponding to 13A and 13B stations, respectively. Finally, the measurements constituted the basis of the first reported database concerning the radiological condition of the Gulf and which can be reclaimed as reference values in future monitoring studies.

Prognostic evaluation of tumour type and other histopathological characteristics in advanced epithelial ovarian cancer, treated with surgery and paclitaxel/carboplatin chemotherapy: cell type is the most useful prognostic factor

AIM

Ovarian carcinomas have been classified into types I and II according to the hypothesised mode of carcinogenesis and molecular characteristics. The prognostic significance of this classification has not been studied.

PATIENTS AND METHODS

Five hundred and sixty-eight patients with histologically confirmed, ovarian, fallopian tube or peritoneal carcinomas, international federation of gynecology and obstetrics (FIGO) stages IIC-IV, treated with paclitaxel/platinum following cytoreductive surgery, were included in this analysis. Type I included low-grade serous, mucinous, endometrioid and clear-cell and type II high-grade serous, unspecified adenocarcinomas and undifferentiated carcinomas.

RESULTS

Median overall survival (OS) was 49 months for type I versus 45 for type II (p=0.576). In contrast to type II, there was considerable prognostic heterogeneity among the subtypes included in type I. Cox regression analysis showed that cell-type classification: low-grade serous, mucinous, endometrioid, clear-cell, type II (high-grade serous, unspecified adenocarcinomas, undifferentiated carcinoma) was an independent predictor of survival (respective median OS 121 versus 15 versus 64 versus 29 versus 45 months, p=0.003). On the contrary, histopathological subtype or tumour type (I versus II) did not offer additional prognostic information.

CONCLUSION

The proposed model of ovarian tumourigenesis does not reflect tumour behaviour in advanced disease. Tumour-cell type is the most relevant histopathological prognostic factor in advanced ovarian cancer treated with platinum/paclitaxel.

Metastatic medullary carcinoma of the vulva in a patient with MEN IIb syndrome

BACKGROUND

Multiple endocrine neoplasia (MEN) IIb is a rare genetic syndrome characterized by the occurrence of medullary thyroid carcinoma (MTC), pheochromocytoma and mucosal neuromas.

CASE REPORT

A 43-year-old woman with MEN IIb syndrome presented to our department with a painful enlargement of the left side of her vulva, which was initially presumed to be an inflammatory Bartholin's gland process. Upon admission, the patient was on antibiotics with no response and surgery was decided. A wide local excision was performed and histology revealed a metastatic medullary carcinoma of the vulva.

CONCLUSION

MEN IIb syndrome is a clinical entity that may present multiple metastatic sites. To our knowledge, this is the first case of vulvar metastasis as part of the syndrome.