[Clinical application of negative pressure dressing in the full-thickness skin grafting]

Objective: To investigate the effect of different negative pressure of wound negative pressure dressing (NPD) on the survival of full-thickness skin grafts of patients. Methods: One hundred and eleven patients who need skin grafting, conforming to the inclusion criteria were hospitalized in our unit from August 2012 to March 2017, and their clinical data were retrospectively analyzed. Forty-seven patients hospitalized from August 2012 to October 2015 were assigned into traditional treatment group. Sixty-four patients hospitalized from November 2015 to March 2017 were divided into -9.975 kPa negative pressure treatment group (n=34) and -13.300 kPa negative pressure treatment group (n=30). Patients in traditional treatment group received conventional dressing after full-thickness skin grafting. Patients in -9.975 kPa and -13.300 kPa negative pressure treatment groups received -9.975 kPa and -13.300 kPa NPD based on traditional treatment after vacuum sealing, respectively. Dot necrosis area of skin grafts and erosion and escharosis of graft edges of patients in the three groups on post operation day 10 were observed. The percentage of dot necrosis area of skin grafts and occurrence rate of erosion and escharosis of skin graft edges were calculated, respectively. Data were processed with chi-square test, Fisher's exact test, and Kruskal-Wallis H test. Results: Percentages of dot necrosis area of skin grafts of patients in traditional treatment group and -9.975 kPa and -13.300 kPa negative pressure treatment groups were 17.81%, 3.20%, and 3.00%, respectively. Percentage of dot necrosis area of skin grafts of patients in traditional treatment group was significantly higher than that in -9.975 kPa and -13.300 kPa negative pressure treatment groups (Z=-5.770, -4.690, P<0.001). Percentages of dot necrosis area of skin grafts of patients in -9.975 kPa and-13.300 kPa groups were close (Z=-0.619, P>0.05). The occurrence rates of erosion and escharosis of skin graft edges of patients in traditional treatment group and -9.975 kPa and -13.300 kPa negative pressure treatment groups were 78.7% (37/47), 32.4 (11/34), and 36.7% (11/30), respectively. Erosion and escharosis of skin graft edges of patients in -9.975 kPa and -13.300 kPa negative pressure treatment groups were better than those in traditional treatment group (P<0.001). Erosion and escharosis of skin graft edges of patients in -9.975 kPa and -13.300 kPa negative pressure treatment groups were close (P>0.05). Conclusions: The use of -9.975 kPa and -13.300 kPa NPD in skin grafts after full-thickness skin grafting significantly diminishes the occurrence rates of dot necrosis area of skin grafts and erosion and escharosis of graft edges.

Exploiting coumarin-6 as ancillary ligands in 1,10-phenanthroline Ir(iii) complexes: generating triplet photosensitisers with high upconversion capabilities

A series of new Ir(iii) complexes incorporating 3-(2-benzothiazolyl)-7-(diethylamino)coumarin (coumarin 6) and ethynylpyrene (EP) functionalised 1,10-phenanthroline (phen) were developed. [Ir(iii)(coumarin 6)₂(3-EP-phen)](PF₆) (Ir-3) proved to be the most promising material in triplet photosensitising applications. Highly absorbing at λ = 485 nm (ε = 1.31 × 10⁵ M^-1 cm^-1), it exhibits high upconversion and singlet oxygen quantum yields (Φ_UC = 27.5%, Φ_Δ = 81.5%) and an exemplary upconversion capability (η = 3.60 × 10⁶ M^-1 cm^-1).

Mechanisms of sphingosine-1-phosphate-mediated vasoconstriction of rat afferent arterioles

AIM

Sphingosine-1-phosphate (S1P) influences resistance vessel function and is implicated in renal pathological processes. Previous studies revealed that S1P evoked potent vasoconstriction of the pre-glomerular microvasculature, but the underlying mechanisms remain incompletely defined. We postulated that S1P-mediated pre-glomerular microvascular vasoconstriction involves activation of voltage-dependent L-type calcium channels (L-VDCC) and the rho/rho kinase pathway.

METHODS

Afferent arteriolar reactivity was assessed in vitro using the blood-perfused rat juxtamedullary nephron preparation, and diameter was measured during exposure to physiological and pharmacological agents.

RESULTS

Exogenous S1P (10^-9 -10^-5 mol L^-1 ) evoked concentration-dependent vasoconstriction of afferent arterioles. Superfusion with nifedipine, a L-VDCC blocker, increased arteriolar diameter by 39 ± 18% of baseline and significantly attenuated the S1P-induced vasoconstriction. Superfusion with the rho kinase inhibitor, Y-27632, increased diameter by 60 ± 12% of baseline and also significantly blunted vasoconstriction by S1P. Combined nifedipine and Y-27632 treatment significantly inhibited S1P-induced vasoconstriction over the entire concentration range tested. In contrast, depletion of intracellular Ca²⁺ stores with the Ca²⁺ -ATPase inhibitors, thapsigargin or cyclopiazonic acid, did not alter the S1P-mediated vasoconstrictor profile. Scavenging reactive oxygen species (ROS) or inhibition of nicotinamide adenine dinucleotide phosphate oxidase activity significantly attenuated S1P-mediated vasoconstriction.

CONCLUSION

Exogenous S1P elicits potent vasoconstriction of rat afferent arterioles. These data also demonstrate that S1P-mediated pre-glomerular vasoconstriction involves activation of L-VDCC, the rho/rho kinase pathway and ROS. Mobilization of Ca²⁺ from intracellular stores is not required for S1P-mediated vasoconstriction. These studies reveal a potential role for S1P in the modulation of renal microvascular tone.

Electrochemical Production of Glycolic Acid from Oxalic Acid Using a Polymer Electrolyte Alcohol Electrosynthesis Cell Containing a Porous TiO2 Catalyst

A liquid flow-type electrolyser that continuously produces an alcohol from a carboxylic acid was constructed by employing a polymer electrolyte, named a polymer electrolyte alcohol electrosynthesis cell (PEAEC). Glycolic acid (GC, an alcoholic compound) is generated on anatase TiO₂ catalysts via four-electron reduction of oxalic acid (OX, a divalent carboxylic acid), accompanied with water oxidation, which achieves continuous electric power storage in easily stored GC. Porous anatase TiO₂ directly grown on Ti mesh (TiO₂/Ti-M) or Ti felt (TiO₂/Ti-F) was newly fabricated as a cathode having favourable substrate diffusivity. A membrane-electrode assembly composed of the TiO₂/Ti-M, Nafion 117, and an IrO₂ supported on a gas-diffusion carbon electrode (IrO₂/C) was applied to the PEAEC. We achieved a maximum energy conversion efficiency of 49.6% and a continuous 99.8% conversion of 1 M OX, which is an almost saturated aqueous solution at room temperature.

Effects of caponization and ovariectomy on objective indices related to meat quality in chickens

Capons and ovariectomized chickens are birds that have been gonadectomized to improve the meat quality. This study investigated the effects of caponization and ovariectomy on physical, chemical, and fatty acid and amino acid profiles of meat from Beijing-You chickens (a Chinese local breed) at market age (17 wk). All birds (20 capons, 20 ovariectomized, and 40 controls) were reared under the same conditions. Breast muscle fiber diameter and area were significantly smaller and the fiber density was higher in capons and ovariectomized chickens than in controls (P < 0.05). Compared with controls, caponization and ovariectomy significantly decreased breast muscle shear values and redness (a*), as well as increased yellowness (b*), hue (H*), and chroma (C*) (P < 0.05). There was significantly more intramuscular fat (IMF) in capons than in controls (P < 0.05), and there was a tendency for more inosine-5΄-monophosphate (IMP) in capons than in controls (P = 0.10). The levels of IMF and IMP in ovariectomized chickens were significantly higher than those in controls (P < 0.05). Capons and ovariectomized chickens exhibited a significantly higher content of palmitic acid (C16:0), palmitoleic acid (C16:1) and oleic acid (C18:1), together with a lower content of stearic acid (C18:0), arachidonic acid (C20:4), and lignoceric acid (C24:0) compared to controls (P < 0.05). The total saturated, monounsaturated, and polyunsaturated fatty acids as well as amino acid composition were not affected by gonadectomy (P > 0.05). Overall, this study indicates that both caponization and ovariectomy likely improve the meat quality of the breast muscle based on the objective indices of IMF, appearance (color), texture, and minor change of the fatty acid profile; ovariectomy improves flavor-related indices.

Analysis of the safety and efficacy of combined extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy for the treatment of complex renal calculus

OBJECTIVE

To investigate the safety and efficacy of extracorporeal shock wave lithotripsy (ESWL) combined with percutaneous nephrolithotomy (PCNL) for treatment of complex renal calculus.

PATIENTS AND METHODS

Seventy-eight patients diagnosed with complex renal calculus and who accepted treatment in our hospital were consecutively selected. Patients were divided randomly into the observation group (n=40) treated by combined ESWL and PCNL and the control group (n=38) treated by PCNL. The effect of treatment between the two groups was compared.

RESULTS

The stone-free rate at 3 months after surgery was higher in the observation group than in the control group. There were no differences in the rates of complications (including infection, hemorrhage, collection system perforation and laceration, peripheral organ impairment, and urination extravasation). There were gradual decreases of serum creatinine in the observation group at 4 weeks after extubation of the double J catheter and at 3 months after surgery, while there were no apparent decreases in the control group. The levels of cysteine protease inhibitor and neutrophil gelatinase-associated lipocalin in both groups increased at 4 weeks after extubation of the double J catheter, and decreased at 3 months after surgery. The decreases were more apparent in the observation group compared with the control group, and the differences were statistically significant (p<0.05).

CONCLUSIONS

Combined use of ESWL and PCNL to treat complex renal calculus can improve the stone-free rate and renal function, and does not increase the complication rate. It is, therefore, safe and effective.

FOXC1: an emerging marker and therapeutic target for cancer

The Forkhead box C1 (FOXC1) transcription factor is involved in normal embryonic development and regulates the development and function of many organs. Most recently, a large body of literature has shown that FOXC1 plays a critical role in tumor development and metastasis. Clinical studies have demonstrated that elevated FOXC1 expression is associated with poor prognosis in many cancer subtypes, such as basal-like breast cancer (BLBC). FOXC1 is highly and specifically expressed in BLBC as opposed to other breast cancer subtypes. Its functions in breast cancer have been extensively explored. This review will summarize current knowledge on the function and regulation of FOXC1 in tumor development and progression with a focus on BLBC as well as the implications of these new findings in cancer diagnosis and treatment.

Abstract P6-09-55: “Quality, not quantity”: 10X hot-spot (HS) analysis of lymphocyte markers (CD3, CD8, CD4, CD20) in tumor-infiltrating lymphocytes (TILs) is superior to whole tumor (WT) analysis in triple-negative breast cancer (TNBC)

This abstract was withdrawn by the authors.

Abstract P4-12-14: Folate receptor alpha (FOLR1) expression in triple-negative breast cancer (TNBC)

Background Folate receptor alpha (FOLR1) has been identified as a potential prognostic and therapeutic target in breast cancer. The limited studies evaluating the role of FOLR1 in breast cancer have shown that FOLR1 protein expression is enriched in triple-negative breast cancer (TNBC). Newly developed anti-FOLR1 therapy could potentially be used for patients with TNBC for whom few therapeutic options exist. We sought to evaluate FOLR1 protein expression in a cohort of patients with TNBC to determine its prevalence and prognostic value. Design Immunohistochemistry was performed for FOLR1 (26B3.F2, Biocare, RTU) on tissue microarray (TMA) slides consisting of 62 primary TNBC. Membranous staining in ≥5% of cells was deemed positive in a given case. Statistical analyses correlating FOLR1 protein expression with clinicopathologic parameters and clinical outcome [disease-free survival (DSF) and overall survival (OS) (range: 16 to 196 months, mean: 111 months)] were performed. Results 62 cases of primary TNBC from 61 patients were studied. All patients were female and the mean age was 55 years (range 30 to 91 years). Histologically, almost all tumors were invasive ductal carcinoma (94%; 58/62) and grade 3 (89%; 55/62). Most were pT1 tumors (71%; 44/62) or pT2 (27%; 17/62). For the majority of patients, the nodal status was N0 (61%; 38/62) or N1 (24%; 15/62) and the stage was 1 (53%; 33/62) or 2 (32%; 20/62). Most cases were negative for FOLR1 (84%; 52/62). FOLR1 expression did not correlate with any clinicopathologic parameters, DFS or OS (P&gt;0.05). Conclusion Similar to other studies, we found no correlation with FOLR1 expression and common clinicopathologic parameters and clinical outcome in TNBC. While FOLR1 expression has been previously reported to confer poor prognosis in breast cancer (all types), our findings suggest that in TNBC specifically, FOLR1 expression is not prognostically significant.

Citation Format: Cui X, McIntire PJ, Ginter PS, Irshaid L, Chen Z, Shin SJ. Folate receptor alpha (FOLR1) expression in triple-negative breast cancer (TNBC) [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-12-14.

Abstract P4-12-15: Triple-negative breast cancers (TNBCs) rich in infiltrating stromal plasma cells have improved disease-free survival and overall survival

Background Tumor-infiltrating lymphocytes (TILs) have emerged as a prognostic indicator in patients with TNBC. Furthermore, lymphocyte-predominant breast cancer (LPBC), defined as those containing ≥50% stromal TILs has been shown to be associated with better prognosis. While cell-mediated immunity has received much of the credit for anti-tumor responses, the International TILs Working Group recommends that the assessment of stromal density of TILs should incorporate all mononuclear cells including plasma cells. Very little is known about the role of humoral immunity, particularly the role of plasma cells in the anti-tumoral response in breast cancer. We sought to evaluate the prognostic value of plasma cells in the setting of stromal TIL assessment of TNBC. Design Morphologic assessment of TILs was performed on a representative H&E slide of 76 cases of primary TNBC. For each case, the stromal density of TILs was estimated and then classified as LPBC or non-LPBC using a cutoff of ≥50% for the former. Also, the plasma cell intensity defined as the mean percentage of stromal plasma cells of five 40x high power microscopic fields of TILs was recorded at 5% increments. Statistical analyses were performed using disease-free survival (DFS) and overall survival (OS) (range: 16 to 196 months, mean: 110 months) as primary endpoints. Results Plasma cell intensity was dichotomized at 12.5% and predictive of OS [.21, 95% confidence interval (CI) .05-.93, P = 0.0401)]. A positive dose related response trended toward significance for each 5% increase in plasma cell intensity (.97, 95% CI .93-1.01, P = 0.1168). Disease-free survival also trended positively towards significance (.39, 95% CI .13-1.20, P = 0.0991). When comparing LPBC, tumors rich in plasma cells (&gt;12.5% of TILs) trended towards longer DFS (.17, 95% CI .02-1.62, P = 0.1226) when compared to plasma cell poor LPBC. Conclusion In addition to the cell-mediated immune response in TNBC, our findings suggest that humoral immunity may also play a role in predicting recurrence and survival in these patients. Our findings suggest that inclusion of an additional parameter of plasma cell intensity may be prognostically valuable in TIL assessment of TNBC.

Citation Format: McIntire PJ, Cui X, Ginter PS, Irshaid L, Chen Z, Shin SJ. Triple-negative breast cancers (TNBCs) rich in infiltrating stromal plasma cells have improved disease-free survival and overall survival [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-12-15.

Abstract P6-09-56: Tissue microarray (TMA) based immunohistochemical studies of lymphocyte-specific markers yield inaccurate results

This abstract was withdrawn by the authors.

Advances in multicellular spheroids formation

Three-dimensional multicellular spheroids (MCSs) have a complex architectural structure, dynamic cell-cell/cell-matrix interactions and bio-mimicking in vivo microenvironment. As a fundamental building block for tissue reconstruction, MCSs have emerged as a powerful tool to narrow down the gap between the in vitro and in vivo model. In this review paper, we discussed the structure and biology of MCSs and detailed fabricating methods. Among these methods, the approach in microfluidics with hydrogel support for MCS formation is promising because it allows essential cell-cell/cell-matrix interactions in a confined space.

Stretchable and compressible strain sensors based on carbon nanotube meshes

Flexible strain sensors have promising applications in healthcare and human movement detection. Herein, we report stretchable and compressible strain sensors based on carbon nanotube meshes (CNTMs) with unique structures consisting of macroscopic grids and microscopic spider-web networks. The stretchable strain sensor shows good reliability for long cyclic tests and can be used for weak stimuli and large motion detection. The compressible strain sensor also shows good reliability after long cyclic tests and can be used to detect large strains induced by walking or running motion. Both the stretchable and compressible CNTM strain sensors are reliable and stable at detecting large stretching and compressing deformation.

Hepatic fibrosis and supersonic shear imaging in patients with different etiological chronic hepatic diseases

The objective of the present study was to investigate whether hepatic fibrosis difference of supersonic shear imaging (SSI) value existed in patients with different etiological chronic hepatic diseases. Retrospective analysis was used to study chronic hepatitis. All the subjects were diagnosed by shear wave elastography and percutaneous liver biopsy. The shear moduli were analyzed to check whether any difference existed between groups. For the chronic hepatitis B, autoimmune hepatitis and fatty hepatitis, the shear moduli in S0 stage were (8.50±3.1)kPa, (9.41±2.5)kPa, (8.97±3.8)kPa; the shear moduli in S1 stage were (9.54±3.0)kPa, (10.42±5.1)kPa, (9.51±4.6)kPa; the shear moduli in S2 stage were (11.77±4.8) kPa, (13.25±5.6)kPa, (11.03±6.0)kPa; the shear moduli in S3 stage were (14.96±6.1)kPa, (19.03±7.8) kPa, (15.38±7.8)kPa; the shear moduli in S4 stage were (20.36±7.5)kPa, (24.99±9.5)kPa, (19.53±5.6)kPa. Shear wave elastography could measure the different etiological chronic hepatic diseases.

Training in metabolomics research. I. Designing the experiment, collecting and extracting samples and generating metabolomics data

Metabolomics is perhaps the most challenging of the -omics fields, given the complexity of an organism's metabolome and the rapid rate at which it changes. When one sets out to study metabolism there are numerous dynamic variables that can influence metabolism that must be considered. Recognizing the experimental challenges confronting researchers who undertake metabolism studies, workshops like the one at University of Alabama at Birmingham have been established to offer instructional guidance. A summary of the UAB course training materials is being published as a two-part Special Feature Tutorial. In this month's Part I the authors discuss details of good experimental design and sample collection and handling. In an upcoming Part II, the authors discuss in detail the various aspects of data analysis.

Positive feedback regulation between microRNA-132 and CREB in spinal cord contributes to bone cancer pain in mice

BACKGROUND

cAMP response element-binding protein (CREB)-dependent gene expression plays an important role in central sensitization. CREB-regulated transcription coactivator 1 (CRTC1) dramatically increase CREB-mediated transcriptional activity. microRNA-132 (miR-132), which is highly CREB-responsive, functions downstream from CREB/CRTC1 to mediate activity-dependent synaptic plasticity and in turn loops back to amplify CREB/CRTC1 signalling. This study aimed to investigate the positive feedback regulation between miR-132 and CREB in spinal cord in the maintenance of bone cancer pain.

METHODS

Osteosarcoma cells were implanted into the intramedullary space of the right femurs of C3H/HeNCrlVr mice to induce bone cancer pain. We further investigated effects of repeated intrathecal administration with Adenoviruses expressing CREB-siRNA or miR-132 antisense locked nucleic acid (LNA), respectively, on nociceptive behaviours and on the activity of CREB/CRTC1 signalling.

RESULTS

Intramedullary inoculation of osteosarcoma cells resulted in up-regulation of spinal p-CREB, CRTC1 and CREB-target genes (NR2B and miR-132). Repeated intrathecal administration with Adenoviruses expressing CREB-siRNA or miR-132 LNA-AS, respectively, attenuated bone cancer-evoked pain behaviours, reduced the activity of CREB/CRTC1 signalling and down-regulated CREB-target gene NR2B expression in spinal cord.

CONCLUSIONS

These findings suggest that activation of spinal CREB/CRTC1 signalling may play an important role in bone cancer pain. Interruption to the positive feedback regulation between CREB/CRTC1 and its target gene miR-132 can effectively relieved the bone cancer-induced mechanical allodynia and spontaneous pain. WHAT DOES THIS STUDY ADD?: The positive feedback regulation between CREB/CRTC1 and its target gene miR-132 in spinal cord plays an important role in bone cancer pain.

Abstract P5-01-03: Stratifying triple-negative breast cancer prognosis using 18F-FDG-PET/CT imaging

Introduction: Triple-negative breast cancer (TNBC) is a highly diverse group of cancers, and may benefit from molecular-targeted therapies. This study aims to stratify prognosis of TNBC patients using pre-treatment 18F-FDG PET/CT, alone and with correlation to immunohistochemistry biomarkers.

Method: 200 consecutive TNBC breast cancer patients treated between 2008 and 2012 who received lumpectomy or mastectomy as primary treatment were retrieved. Among the full cohort, 79 patients had pre-treatment 18F FDG PET/CT scans. Immunostaining status (percentage and intensity) of basal biomarkers (EGFR, CK5/6), Ki-67, P53, and other clinicopathological variables (age, tumor size, pathological T/N stage, nuclear grade, and lymph node metastasis) were obtained. Three PET image features were evaluated: maximum uptake values (SUVmax), mean uptake (SUVmean) and target volume (SUVvol) defined by SUV&gt;2.5. The relationships among tumor metabolic activities and clinicopathological factors were evaluated. All variables were analyzed versus disease-free survival (DFS) using univariate and multivariate Cox analysis, Kaplan-Meier curves and log-rank tests. The optimal cutoff points of variables were estimated using time-dependent survival receiver operating characteristic (ROC) analysis.

Results: All PET features significantly correlated with proliferation marker Ki-67 (all p&lt;0.010). SUVmax stratified the prognosis of TNBC patients with optimal cutoff derived by ROC analysis (≤3.5 vs &gt;3.5, AUC=0.654, p=0.006). Basal biomarkers EGFR and CK5/6 and image features SUVmax, SUVmean, SUVvol were significant associated with DFS in univariate Cox analysis, whereas SUVmax (p=0.001) and EGFR (p=0.001) were also significant in multivariate Cox analysis. To integrate prognosis of biological and imaging markers, patients were first stratified by EGFR into low (≤15%) and high (&gt;15%) risk groups. Further, SUVmax was used as a variable to stratify the two EGFR groups. In the high EGFR group, patients with high FDG uptake (SUVmax&gt;3.5) had worse survival outcome (median DFS=7.6 months) than those patients with low FDG uptake (SUVmax≤3.5, median DFS=11.6 months). In the low EGFR group, high SUVmax also indicated worse survival outcome (17.2 months) than low SUVmax (22.8 months). The risk stratification with integrative EGFR and PET was statistically significant with log-rank p&lt;&lt;0.001.

Multivariate Cox analysis for disease-free survivalVariablesHR (95% CI)p-valuePathology, T stage, ≤ 3 vs &gt;32.337(0.428-7.384)0.148EGFR, ≤15% vs &gt; 15%9.109(1.997-41.55)0.004CK5/6, ≤ 50% vs &gt; 50%1.471(0.598-3.614)0.401SUVmax, ≤3.5 vs &gt; 3.53.883(1.13-13.32)0.031

TNBC patient risk groups stratified by EGFR and SUVmax (with the median values of variables)Risk groups (EGFR&gt;15, SUVmax&gt;3.5)patient#DFS monthsEGFR %SUVmaxSUVmeanSUVvolKi-67%1 (-, -)1222.852.00.60.2342 (-, +)1517.258.94.37.2673 (+, -)1311.6502.72.60.9354 (+, +)377.66011.35.210.960

Conclusions: Pre-treatment 18F-FDG PET/CT imaging has significant prognostic value for predicting survival outcome of TNBC patients. Integrated with basal-biomarker EGFR, PET imaging can further stratify patient risks in the pre-treatment stage, and help select appropriate treatment strategies for individual patients.

Citation Format: Yue Y, Cui X, Bose S, Audeh W, Zhang X, Fraass B. Stratifying triple-negative breast cancer prognosis using 18F-FDG-PET/CT imaging. [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 P5-01-03.