264 TESTOSTERONE IN THE OOCYTE CULTURE DOES NOT ALTER SEX-RATIO OF IN VITRO PRODUCED BOVINE EMBRYOS

The production of sex-known offspring is a main objective in reproductive biotechnology. It has been reported that bovine ova developed in follicles with high concentrations of testosterone in vivo yielded significantly more male embryos in vitro (Grant V et al. 2008 Biol. Reprod. 78, 812–815). In this work we aimed to test the effects of testosterone on sex ratio of bovine embryos produced in fully in vitro conditions. Immature bovine cumulus–oocyte complexes (COCs; n = 750) from slaughterhouse ovaries were cultured in 199 HNaCO3 with polyvinyl alcohol (PVA) 0.1 mg mL–1 as a basic medium. Culture was made in two steps, a 24 h meiotic arrest (roscovitine 25 μm), and a subsequent in vitro maturation period with FSH-LH for 24 h. Testosterone (T-86500, Sigma-Aldrich, St. Louis, MO, USA) was added throughout the entire oocyte culture at 0, 30, 300, and 1500 nm. After in vitro fertilization (Day 0), zygotes were freed of cumulus cells by pipetting, and subsequently cultured in SOF + 6 g L–1 BSA up to Day 3. At this time, embryo development was recorded, and all embryos having 3 or more cells were treated with pronase to remove the zona pellucida. Zona-free embryos were washed in PBS containing PVA 0.1 mg mL–1 and individually frozen at –80°C until sex analysis by PCR (Bermejo-Alvarez P et al. 2008 Biol. Reprod. doi:10.1095/biolreprod.108.070169). A total of 252 embryos from 5 replicates were sexed. Data for development and sex-ratio are presented as % LSM ± SD. There were no interactions between testosterone treatment, embryonic sex, and embryonic stage analyzed. Testosterone did not affect development rates (P > 0.05) at any stage: cleavage (47.8 ± 6.8, 56.5 ± 6.8; 50.9 ± 6.8; 62.2 ± 6.8), 3 to 4 cells (40.6 ± 5.2, 45.8 ± 5.2; 37.8 ± 5.2; 47.7 ± 5.2) and >5 cells rates (24.5 ± 4; 27.3 ± 4; 21.3 ± 4; 25.3 ± 4) for 0, 30, 300, and 1500 nm testosterone, respectively. Cumulative percentages of male embryos were as follows: 53 ± 8 (n = 56), 42.6 ± 8 (n = 52), 53.6 ± 6 (n = 81) and 57.6 ± 8 (n = 63) for 0, 30, 300, and 1500 nm groups respectively (P > 0.05). These results show that the testosterone effects on oocyte ability to select Y-chromosome bearing spermatozoa are not reproducible in vitro under the present experimental conditions. Grant support: MEC, project AGL2008-01530; RTA2008-0082; M. Muoz is supported by FICYT.

242 DETECTION OF MICROTUBULES BY POLARIZED LIGHT MICROSCOPY IN BOVINE OOCYTES

Polarized light microscopy (PLM) is being used as a tool in assisted reproductive technologies in humans and, more recently, in farm animals. Polarized light microscopy may allow for a quick localization or removal of nuclear structures, or both in the oocyte without fluorochrome staining and ultraviolet exposure, and may reduce nuclear damage when performing intra-cytoplasmic sperm injection. The aim of this study was to assess the efficiency of PLM to detect microtubule-polymerized protein within in vitro-matured bovine oocytes. Cumulus–oocyte complexes from slaughterhouse ovaries were matured in vitro for 23 h in bicarbonate-buffered TCM-199, FSHp (1 μg mL–1), LH (5 μg mL–1), 17β-estradiol (1 μg mL–1), and 10% fetal calf serum at 38.7°C in 5% CO2 in air with high humidity. After in vitro maturation, oocytes (n = 98) were denuded with 0.5% hyaluronidase and were placed individually in 10-μL drops of TCM-199-HEPES-BSA in a glass Petri dish. Polarized light microscopy was used to detect the presence of polymerized protein that could be forming a meiotic spindle. To confirm the presence of the polymerized protein and the meiotic spindle, each individual oocyte was subjected to immunostaining and chromatin detection as described by Morató et al. 2008 Mol. Reprod. Dev. 75, 191–201. The experiment was replicated 6 times. There was an absolute positive correlation (r = 1; P < 0.0001) between the signal obtained by PLM and the presence of microtubule-polymerized protein as confirmed by immunostaining. A barrel-shaped spindle was observed in 40% of the individual samples, whereas disorganized microtubule structures were obtained in 55% of the samples. The biological implication of these findings needs to be explored. However, PLM seems to be an efficient system to detect polymerized protein in in vitro-matured bovine oocytes.

Study of the burden on patients with chronic obstructive pulmonary disease

BACKGROUND

Health-related quality of life measures are widely used in patients with chronic obstructive pulmonary disease (COPD). However, they are extremely limited when used to evaluate patients outside the clinical trials. The aim of this study was to analyse the burden of the disease using a simple, validated, self-administered questionnaire specifically developed for patients in daily clinical practice.

METHODS

A total of 3935 patients (74.5% men; mean age, 67 years) participated in a cross-sectional study. The burden of COPD on patients was measured using the Clinical COPD Questionnaire (CCQ). COPD was rated at four levels by the forced expiratory volume in one second (FEV(1)) according to The Global Initiative for Chronic Obstructive Lung Disease (GOLD) scale.

RESULTS

The disease mainly affects old men (more than 50% were over 65 years of age) and non-employed men (23% were employed). Of the patients studied, 22.7% continued smoking, especially men (24.4% of men vs. 18.1% of women). Most patients (54%) were diagnosed with moderate stage II COPD. Severity of COPD was lower in women: 29.6% of men had severe COPD compared with 13.7% of women. During the last year, 65.1% had at least one acute exacerbation and 36.6% were admitted to hospital because of COPD exacerbation. No association was found between the body mass index and COPD stage. The variable that most influenced the disease burden was dyspnoea, as progression from grade 0 to grade 4 increased the disease burden by 1.78 points for symptoms, 2.43 for functional state and 1.53 for mental state. The functional classification of COPD also had a significant influence on the disease burden.

CONCLUSIONS

The present findings show that dyspnoea and the degree of airflow limitation are the clinical variables that most affect the burden of COPD from the patient's point of view.

A role for the substance P/NK-1 receptor complex in cell proliferation and apoptosis in oral lichen planus

OBJECTIVES

To determine whether substance P (SP) and NK-1 receptor (NK-1R) are expressed in oral lichen planus (OLP) and are related to cell proliferation and apoptosis in this disease.

MATERIAL AND METHODS

Tissue samples from 50 OLP patients and 26 healthy controls were studied. Immunohistochemistry was performed with anti-SP, anti-NK-1R, anti-ki-67 and anti-caspase-3 monoclonal antibodies and the clinical and pathological data of the OLP patients were evaluated.

RESULTS

With the exception of NK-1R expression in epithelial cell membrane and cytoplasm, all markers were more frequently present in OLP patients than in controls (P < 0.05). Higher cytoplasmatic expression of NK-1R was associated with higher epithelial expression of caspase-3 (P < 0.05). Higher epithelial expression of NK-1R and SP was associated with higher suprabasal and basal epithelial expression of ki-67 (P < 0.05 and P < 0.005, respectively).

CONCLUSIONS

Actions of the SP/NK-1R complex may contribute to the immune disorder underlying OLP and trigger stimuli to induce cell proliferation. These results indicate that this complex might play a role in the malignant transformation of OLP.

[Study of frequency, distribution and diagnostic performance in synchronic neoplastic lesions of colorectal carcinoma]

AIM

To analyse the frequency, characteristics and diagnosis of synchronic neoplastic lesions in colorectal cancer.

METHODS

A review was carried out of 384 colorectal cancers, diagnosed through complete colonoscopy and resected. The synchronic cancers and the characteristics of the adenomas were determined: number, size, histological type, dysplasia, as well as their localisation in the colon and with respect to the carcinoma.

RESULTS

Twenty-eight synchronic cancers were found (7.3% of the total); 8 developed tumours and 20 malignant polyps. In 54.4% of the cases there was a synchronic adenoma. In patients with synchronic lesions, 43% showed an advanced adenoma. Twenty percent of the synchronic polyps found were proximal to the splenic flexure; 41% were distal and 38% had both localisations. Fifty-nine point one percent of the patients had some adenoma proximal to the cancer, with criteria of advanced adenoma in 13.9%. The distribution of the adenomas was more uniformly spread in the cancers with a proximal localisation (p = 0.038). Seventeen percent of the distal cancers presented synchronic lesions with a proximal colon localisation exclusively. Partial endoscopies would diagnose the distal cancers, but would omit a synchronic adenoma in 42.3% of the sigmoidoscopies and 40% of the short colonoscopies.

CONCLUSIONS

High rates of carcinoma and synchronic adenomas were registered. We underline the high index of advanced adenomas and the frequency of synchronic lesions proximal to the cancer, which is why incomplete colonoscopies, although allowing the diagnosis of the distal cancer, omit a high percentage of synchronic adenomas, including advanced lesions. All of this confirms the need to perform a complete pre-, intra- and post operational colonoscopy in resectable colorectal cancer.

Cell proliferation associated with actions of the substance P/NK-1 receptor complex in keratocystic odontogenic tumours

The expression of substance P (SP) and its NK-1 receptor (NK-1R) in keratocystic odontogenic tumours (KOTs) was studied to determine whether the intrinsic growth potential of these lesions is related to a cell proliferation stimulus mediated by the SP/NK-1R complex. A total of 65 tissue samples of solitary non-recurrent KOTs, solitary recurrent KOTs, KOTs associated with nevoid basal cell carcinoma syndrome (NBCCS) and KOTs with chondroid wall were studied by immunohistochemistry, using anti-SP, anti-NK-1R and anti-Ki-67 monoclonal antibodies. Expression of these markers was analysed in infiltrating lymphocytes, in fibrous capsule, and in membrane, cytoplasm and nucleus of epithelial cells. SP expression in infiltrating lymphocytes was significantly associated with SP in fibrous capsule and epithelial cells. KOTs associated with NBCCS showed a significantly higher SP expression in all tissues and cell compartments compared with other KOT types. Finally, SP expression in epithelial cells was associated with positive Ki-67 expression in dysplastic epithelium. This first published report on SP and NK-1R expressions in KOTs demonstrates that actions of the SP/NK-1R complex may constitute a mechanism to stimulate epithelial cell proliferation in KOT. This pathway may be of special relevance in the multiple KOTs associated with NBCCS.

Efficacy and safety of intravenous iron therapy as an alternative/adjunct to allogeneic blood transfusion

Anaemia is a common condition among patients admitted to hospital medicosurgical departments, as well as in critically ill patients. Anaemia is more frequently due to absolute iron deficiency (e.g. chronic blood loss) or functional iron deficiency (e.g. chronic inflammatory states), with other causes being less frequent. In addition, preoperative anaemia is one of the major predictive factors for perioperative blood transfusion. In surgical patients, postoperative anaemia is mainly caused by perioperative blood loss, and it might be aggravated by inflammation-induced inhibition of erythropoietin and functional iron deficiency (a condition that cannot be corrected by the administration of oral iron). All these mechanisms may be involved in the anaemia of the critically ill. Intravenous iron administration seems to be safe, as very few severe side-effects were observed, and may result in hastened recovery from anaemia and lower transfusion requirements. However, it is noteworthy that many of the recommendations given for intravenous iron treatment are not supported by a high level of evidence and this must be borne in mind when making decisions regarding its application to a particular patient. Nonetheless, this also indicates the need for further large, randomized controlled trials on the safety and efficacy of intravenous iron for the treatment of anaemia in different clinical settings.

Flow cytometric cell cycle analysis of cultured brown bear fibroblast cells

The aim of this study was to assess by flow cytometry the cell cycle of brown bear fibroblast cells cultured under different growth conditions. Skin biopsies were taken in Cantabria (Spain) from a live, anaesthetized brown bear. DNA analysis was performed by flow cytometry following cell DNA staining with propidium iodide. Serum starvation increased (P<0.01) the percentage of G0/G1 phase cells (92.7+/-0.86) as compared to cycling cells (39.7+/-0.86) or cells cultured to confluency (87.3+/-0.86). DMSO included for 48h in the culture significantly increased (P<0.01) the percentage of G0/G1 phase of the cell cycle at all concentrations used and decreased percentages of S phase in a dose-dependent fashion. Roscovitine increased the G0/G1 phase of the cell cycle (P<0.01) at 15microM concentration. Interestingly, the G2/M stage significantly increased at 30 and 50microM compared to the control and 15microM (P<0.02). The cell cycle of brown bear adult fibroblast cells can be successfully synchronized under a variety of culture conditions.

The oncology acute toxicity unit (OATU): an outpatient facility for improving the management of chemotherapy toxicity

OBJECTIVE

To provide an outpatient facility to improve the management of chemotherapy toxicity in cancer patients.

PATIENTS AND METHODS

We set up an oncology acute toxicity unit (OATU) to improve toxicity management. A telephone helpline was the initial contact which filters out inappropriate non-toxicity-related events. Patients were provided an information booklet describing the possible side effects of the chemotherapy and the helpline telephone number. A specialist nurse received the calls and consulted the doctor if necessary. Depending on requirements, the patient's problem was resolved by telephone, or a consultation visit at the OATU was arranged.

RESULTS

Between February 1999 and August 2001, 1126 patients made 2007 contacts with the OATU. The most common tumours were breast (26%), colorectal (20%) and lung (20%). The telephone helpline was used in 87% of contacts and 37% were considered inappropriate. Of the 1263 appropriate contacts, the most frequent chemotherapy schedules that had been administered were 5FU-leucovorin (11.2%) and CMF (10.4%). The most frequent side effects were fever (35.5%), diarrhoea (18.5%), mucositis (16.2%) and emesis (13%). The problem was resolved by telephone in 48% of cases and 52% required attendance in the OATU, of which 40% required hospital admission, i.e., 21.1% of the initial appropriate helpline contacts. The most frequent reason was Grade 3-4 neutropenic fever (56.5%).

CONCLUSIONS

The OATU enables prompt and efficient access of patients to medical oncology facilities in the event of toxicity due to chemotherapy. Unnecessary emergency room use is avoided while oncology outpatient and hospitalisation facilities are optimised.

[Prevalence and treatment of anemia in critically ill patients]

Anemia is a common condition among medical and surgical patients admitted to the intensive care unit (ICU) and generally has a multifactorial origin. In order to avoid the deleterious effects of anemia, 40% of ICU patients receive allogenic blood transfusion (ABT). This figure increases up to 70% if the ICU stay is longer than 7 days. However, ABT is associated with a dose-dependent increase in morbidity and mortality. In contrast, the administration of exogenous erythropoietin plus iron supplements, especially iv iron, improves anemia and reduces ABT requirements, although it does not reduce mortality. To ascertain whether treatment of anemia in the critically ill with exogenous erythropoietin and iron might improve outcomes and to optimize drug administration schedules and dosage, further studies with sufficient statistical power and adequate follow-up are warranted.

240 DEVELOPMENT, DIFFERENTIATION, AND Trk EXPRESSION IN PARTHENOGENETIC BOVINE BLASTOCYSTS

Parthenogenetic embryos allow study of the roles of paternal and maternal genomes in early mammalian development. Nevertheless, pregnancies established with parthenotes arrest around 48 days. Genomic imprinting alterations, fewer cells, and apoptotic index are higher in parthenotes than in IVF embryos and are likely to contribute to the failure to reach full-term development. Neurotrophins are a family of anti-apoptotic cytokines that mediate survival, growth, and differentiation by binding to two types of cell surface receptors, tyrosine kinase (Trk) and the low affinity p75 neurotrophin receptor (p75). Trk and p75 receptors have been localized in early bovine in vitro-produced embryos. At present there are no available data on expression of Trk and numbers of cells in the inner cell mass (ICM) and the trophectoderm (TE) of parthenogenetic embryos. The aim of this study was to evaluate the quality of bovine parthenotes in terms of cell allocation and blastocyst development, and to analyze TrkA, TrkB, and TrKC expression in the ICM and TE. Starting from in vitro-matured slaughterhouse oocytes, embryos were produced by conventional IVF, while parthenotes resulted from ionomycin activation followed by 6-dimethylaminopurine. Zygotes were cultured in SOF + 6 gL– 1 BSA. In vitro development was assessed for IVF embryos on (and referred to on) Days 3, 6, 7, and 8 after fertilization, and 24 h before these time points for parthenotes. Data were analyzed by the GLM procedure of SAS SAS Institute, Inc., Cary, NC, USA). Parthenotes cleaved at rates similar to IVF embryos (80.8 � 3.9 v. 85.8 � 3.9, respectively), but percentages of 5–8 and 8–16 cell stages were lower in parthenotes (40.4 � 4.3 v. 67.9 � 4.3, P < 0.005, and 9.7 � 3.5 v. 25.3 � 3.5, P < 0.01, respectively). However, parthenogenetic blastocyst rates were higher than those in IVF embryos (Day 6: 33.6 � 2.6 v. 11.0 � 2.6, P < 0.005; Day 7: 49.2 � 4.1 v. 30.0 � 4.1, P < 0.02). Double staining showed fewer TE cells in parthenotes (78.7 � 8.5) than in IVF embryos (111.0 � 8.6, P < 0.02). This reduction accounted for a reduced number of total cells in parthenotes (105.3 � 9.9) v. controls (144.0 � 9.8, P < 0.01), while numbers of cells in the ICM were comparable (27.9 � 3.5 v. 31.1 � 3.5, in parthenotes and controls, respectively). As in the case of IVF embryos, immunocytochemical analysis showed positive staining for Trk receptors in parthenotes. Although parthenotes showed blastocyst development rates higher than in IVF embryos, the reduced amount of TE cells in parthenotes could negatively affect implantation. Interestingly, parthenotes do not contain abnormally reduced cell numbers in their ICM, and they express Trks. Therefore, specific stimulation of these receptors with appropriate cytokines could improve blastocyst development and embryonic stem cell derivation. This work was supported by the Spanish Ministry of Science and Education (AGL2005-04479). Dr. Muñoz was supported by FICYT.

127 DEVELOPMENT AND QUALITY OF BOVINE MORULAE CULTURED IN SERUM-FREE MEDIUM WITH RETINOIC RECEPTOR SPECIFIC AGONISTS

In the cell, all-trans retinoic acid (ATRA), a vitamin A metabolite, binds to retinoic acid-receptor (RAR), whereas the ATRA isomere 9-cis-retinoic acid (9-cis-RA) binds to both RAR and the retinoid X receptor (RXR). Synthetic compounds such as LG100268 (LG; Ligand Laboratories) are highly specific to bind RXR, which allows to differentially study the RAR and RXR pathways. In previous work morulae treated with LG for 48 h showed to improve blastocyst development and to activate pro-apoptotic genes (in press), whereas ATRA for 24 h increased cell numbers in the inner cell mass (ICM) and the trophectoderm (TE) (Rodr�guez et al. 2006 Hum. Reprod. 21, 2149–2157). However, LG and ATRA were never both compared for 24 in medium with BSA, which is thought to be more appropriate to produce embryos for cryopreservation than serum-containing medium. In this work we analyze development, quality, and viability of morulae cultured with RAR and RXR agonists. Cumulus–oocyte complexes from slaughterhouse ovaries were matured and fertilized in vitro. Presumptive zygotes were cultured in synthetic oviduct fluid (SOF) +3 gL–1 BSA. On day 6, morulae were treated for 24 h with ATRA 0.7 µm, LG 0.1 µm, or no additives. Blastocyst development was monitored up to day 8. Differential cell counts were made on hatched blastocysts on days 7 and 8. Apoptosis and necrosis (TUNEL + nuclear histology) were made on day 8 expanded and hatched blastocysts. Data were analyzed by GLM and Duncan's test, expressed as LSM � SE, and development rates were expressed as percentages of cultured morulae (replicates [R] = 14 for development; R = 9 for cell counts; R = 4 for apoptosis; n = 1647 morulae). ATRA yielded more blastocysts on day 8 than LG and controls (72.2 � 2.2 v. 60.0 � 2.3 and 65.6 � 2.4, respectively; P < 0.02), and more expanded blastocysts than LG (48.6 � 2.3 v. 36.6 � 2.4; P < 0.02), but no more than controls (43.5 � 2.5). Day-7 and day-8 hatched blastocysts cultured with ATRA showed more total cells than day-7 controls (163.5 � 8.0 and 161.5 � 5.4 v. 137.7 � 8.9, respectively; P < 0.05). However, in the presence of ATRA, day-8 blastocysts showed a strong cell reduction in the inner cell mass (ICM), whereas their day-7 counterparts conserved ICM/total cells proportions comparable to day-7 controls (11.0 � 1.2 v. 19.7 � 1.7 and 20.6 � 1.9, respectively; P < 0.03). The LG increased apoptotic index (AI) and necrotic index (NI) in the ICM (AI: 14.5 � 2.4 v. 6.4 � 1.5 and 6.4 � 1.4; NI: 5.0 � 1.2 v. 0.9 � 0.8 and 1.6 � 0.7; for LG, ATRA, and controls, respectively; P < 0.02). Embryos produced with ATRA showed improved development and cell distribution without increasing apoptosis and necrosis. Vitrification of excellent day-7 and day-8 blastocysts is in course to evaluate cryosurvival and further embryo transfer to determine full developmental competence. Grant Support: MEC, project AGL2005-04479. M. Muñoz is sponsored by FICYT.