An in vitro neurogenetics platform for precision disease modeling in the mouse

The power and scope of disease modeling can be markedly enhanced through the incorporation of broad genetic diversity. The introduction of pathogenic mutations into a single inbred mouse strain sometimes fails to mimic human disease. We describe a cross-species precision disease modeling platform that exploits mouse genetic diversity to bridge cell-based modeling with whole organism analysis. We developed a universal protocol that permitted robust and reproducible neural differentiation of genetically diverse human and mouse pluripotent stem cell lines and then carried out a proof-of-concept study of the neurodevelopmental gene DYRK1A. Results in vitro reliably predicted the effects of genetic background on Dyrk1a loss-of-function phenotypes in vivo. Transcriptomic comparison of responsive and unresponsive strains identified molecular pathways conferring sensitivity or resilience to Dyrk1a1A loss and highlighted differential messenger RNA isoform usage as an important determinant of response. This cross-species strategy provides a powerful tool in the functional analysis of candidate disease variants identified through human genetic studies.

Scalable Generation of Pre-Vascularized and Functional Human Beige Adipose Organoids

Obesity and type 2 diabetes are becoming a global sociobiomedical burden. Beige adipocytes are emerging as key inducible actors and putative relevant therapeutic targets for improving metabolic health. However, in vitro models of human beige adipose tissue are currently lacking and hinder research into this cell type and biotherapy development. Unlike traditional bottom-up engineering approaches that aim to generate building blocks, here a scalable system is proposed to generate pre-vascularized and functional human beige adipose tissue organoids using the human stromal vascular fraction of white adipose tissue as a source of adipose and endothelial progenitors. This engineered method uses a defined biomechanical and chemical environment using tumor growth factor β (TGFβ) pathway inhibition and specific gelatin methacryloyl (GelMA) embedding parameters to promote the self-organization of spheroids in GelMA hydrogel, facilitating beige adipogenesis and vascularization. The resulting vascularized organoids display key features of native beige adipose tissue including inducible Uncoupling Protein-1 (UCP1) expression, increased uncoupled mitochondrial respiration, and batokines secretion. The controlled assembly of spheroids allows to translate organoid morphogenesis to a macroscopic scale, generating vascularized centimeter-scale beige adipose micro-tissues. This approach represents a significant advancement in developing in vitro human beige adipose tissue models and facilitates broad applications ranging from basic research to biotherapies.

Effect of environmental and spatial factors on the phylogenetic and functional diversity of the Mediterranean tree communities of Europe

The tree flora of the Mediterranean Basin contains an outstanding taxonomic richness and a high proportion of endemic taxa. Contrary to other regions of the Mediterranean biome, a comprehensive phylogenetic analysis of the relationship between phylogenetic diversity, trait diversity and environmental factors in a spatial ecological context is lacking. We inferred the first calibrated phylogeny of 203 native tree species occurring in the European Mediterranean Basin based on 12 DNA regions. Using a set of four functional traits, we computed phylogenetic diversity for all 10,042 grid cells of 10 × 10 km spatial resolution to completely cover Mediterranean Europe. Then, we tested the spatial influence of environmental factors on tree diversity. Our results suggest that the nature of the relationship between traits and phylogeny varies among the different studied traits and according to the evolutionary distance considered. Phylogenetic diversity and functional diversity of European Mediterranean trees correlated strongly with species richness. High values of these diversity indices were located in the north of the study area, at high altitude, and minimum temperature of the coldest month. In contrast, the two phylogenetic indices that were not correlated with species richness (Mean Phylogenetic Distance, Phylogenetic Species Variability) were located in the south of the study area and were positively correlated with high altitude, soil organic carbon stock and sand soil texture. Our study provides support for the use of phylogenies in conservation biology to assess ecosystem functioning, and provides insights for the implementation of sustainable forest ecosystem management.

Unleashing the full power of LHCb to probe stealth new physics

In this paper, we describe the potential of the LHCb experiment to detect stealth physics. This refers to dynamics beyond the standard model that would elude searches that focus on energetic objects or precision measurements of known processes. Stealth signatures include long-lived particles and light resonances that are produced very rarely or together with overwhelming backgrounds. We will discuss why LHCb is equipped to discover this kind of physics at the Large Hadron Collider and provide examples of well-motivated theoretical models that can be probed with great detail at the experiment.

Understanding the local and remote source contributions to ambient O3 during a pollution episode using a combination of experimental approaches in the Guadalquivir valley, southern Spain

The Guadalquivir Valley is one of three major O₃ hotspots in Spain. An airborne and surface measurement campaign was carried out from July 9th to 11th, 2019 to quantify the local/regional O₃ contributions using experimental approaches. Air quality and meteorology data from surface measurements, a microlight aircraft, a helium balloon, and remote sensing data (TROPOMI-NO2-ESA) were used to obtain the 3D distribution of O₃ and various tracer pollutants. O₃ accumulation over 2.5 days started with inputs from oceanic air masses transported inland by sea breezes, which drew O₃ and its precursors from a local/regional origin to the northeastern end of the basin. The orographic-meteorological setting of the valley caused vertical recirculation of the air masses inside the valley that caused the accumulation by increasing regional background O₃ concentration by 25-30 ppb. Furthermore, possible Mediterranean O₃ contributions and additional vertical recirculation through the entrainment zone of the convective boundary layer also contributed. Using particulate matter finer than 2.5 μm (PM_2.5), ultrafine particles (UFP), and black carbon (BC) as tracers of local sources, we calculated that local contributions increased regional O₃ levels by 20 ppb inside specific pollution plumes transported by the breeze into the valley, and by 10 ppb during midday when flying over an area with abundant agricultural burning during the morning. Air masses that crossed the southern boundaries of the Betic system at mid-altitude (400-1850 m a.s.l.) on July 10th and 11th may have provided additional O₃. Meanwhile, a decreasing trend at high altitudes (3000-5000 m a.s.l.) was observed, signifying that the impact of stratospheric O₃ intrusion decreased during the campaign.

Heavy metal transport and evolution of atmospheric aerosols in the Antarctic region

Suspended particulate matter (SPM) measurements and backward air mass trajectory analysis using the HYSPLIT model were performed to better understand the main sources and transport pathways of heavy metals in atmospheric aerosols reaching the Antarctic region. Field campaigns were carried out during the austral summer 2016-2017 at the "Gabriel de Castilla" Spanish Antarctic Research Station, located on Deception Island. Aerosols were deposited in an air filter through a low-volume sampler and chemically analysed using Inductively Coupled Plasma-Mass Spectrometry (ICP-MS). The study of air masses and high enrichment factor values of several elements (Hf, Zr, As, Cu, Sn, Zn, Pb) together with their correlations (Hf/Zr, V/As, Ti/Mn and Cu/Sn) suggests a potentially significant role of three main sources in this area: remote maritime traffic, local petrol combustion (generators and/or tourist cruises), and remote/local crust. Additionally, the investigation of atmospheric flow patterns through backward trajectory analysis revealed that Hf/Zr correlation was related to a remote crustal origin, V/As to anthropogenic local pollution, Ti/Mn to terrestrial inputs on the island and Cu/Sn to remote anthropogenic sources. Overall, the present study demonstrates the existence of anthropogenic pollution at this remote site from distant as well as local sources following the Antarctic circumpolar wind pattern.

Tissue Quantification of CA 125 in Epithelial Ovarian Cancer

The objectives of this study were the determination of CA 125 in the cytosol of healthy and carcinomatous ovarian tissue by immunoanalysis, analysis of its correlation with the biological characteristics of ovarian carcinoma, determination of serum CA 125 levels, and study of the prognostic value of the marker in cytosol. The levels of the marker depend not only on the tumor's production rate, so its determination in tissue can indicate more accurately if the tumor is a producer of the marker and establish its value for the prognosis of the disease. Determination of CA 125 in tissue was performed by immunoanalysis in 50 ovarian epithelial cancer samples, 13 benign pathology samples and 32 healthy ovary samples. The presurgical serum level of the marker was also obtained. The correlation between the CA 125 level in the cytosol and the different biological characteristics of the ovarian carcinoma, the serum levels of the marker and survival were analyzed. The CA 125 level proved to be higher in malignant tissue (p<0.0001). There was a significant association between the tissue marker and histological type (high CA 125 was associated with serous and endometrioid tumors) and between the marker and survival. No relation with stage was found. There was a correlation between the CA 125 level in the cytosol and serum, both variables being dependent, with a correlation coefficient of 0.44. This good correlation speaks in favor of the usefulness of CA 125 determination in serum in the follow-up of ovarian cancer. Tumors having high tissue expression of CA 125 were found to have a double relative risk of death, independently of tumor stage.

Is the diversification of Mediterranean Basin plant lineages coupled to karyotypic changes?

The Mediterranean Basin region, home to 25,000 plant species, is included in the worldwide list of hotspots of biodiversity. Despite the indisputably important role of chromosome transitions in plant evolution and diversification, no reference study to date has dealt with the possible relationship between chromosome evolution and lineage diversification in the Mediterranean Basin. Here we study patterns of diversification, patterns of chromosome number transition (either polyploidy or dysploidy) and the relationship between the two for 14 Mediterranean Basin angiosperm lineages using previously published phylogenies. We found a mixed pattern, with half of the lineages displaying a change in chromosome transition rates after the onset of the Mediterranean climate (six increases, one decrease) and the other half (six) experiencing constant rates of chromosome transitions through time. We have also found a heterogeneous pattern regarding diversification rates, with lineages exhibiting moderate (five phylogenies) or low (six) initial diversification rates that either increased (six) or declined (five) through time. Our results reveal no clear link between diversification rates and chromosome number transition rates. By promoting the formation of new habitats and driving the extinction of many species, the Mediterranean onset and the posterior Quaternary climatic oscillations could have been key for the establishment of new chromosomal variants in some plant phylogenies but not in others. While the biodiversity of the Mediterranean Basin may be partly influenced by the chromosomal diversity of its lineages, this study concludes that lineage diversification in the region is largely decoupled from karyotypic evolution.

Style polymorphism in Linum (Linaceae): a case of Mediterranean parallel evolution?

Heterostyly is a sex polymorphism that has challenged evolutionary biologists ever since Darwin. One of the lineages where heterostyly and related stylar conditions appear more frequently is Linum (Linaceae). This group is particularly suitable for testing competing hypotheses about ancestral and transitional stages on the evolutionary building up of heterostyly. We generated a phylogeny of Linum based on extensive sampling and plastid and nuclear DNA sequences, and used it to trace the evolution of character states of style polymorphism. We also revised available data on pollination, breeding systems, and polyploidy to analyse their associations. Our results supported former phylogenetic hypotheses: the paraphyly of Linum and the non-monophyly of current taxonomic sections. Heterostyly was common in the genus, but appeared concentrated in the Mediterranean Basin and the South African Cape. Ancestral character state reconstruction failed to determine a unique state as the most probable condition for style polymorphism in the genus. In contrast, approach herkogamy was resolved as ancestral state in some clades, giving support to recent hypotheses. Some traits putatively related to heterostyly, such as life history and polyploidy, did show marginal or non-significant phylogenetic correlation, respectively. Although pollinator data are limited, we suggest that beeflies are associated with specific cases of heterostyly. The consistent association between style polymorphism and heteromorphic incompatibility points to ecological factors as drivers of the multiple evolution of style polymorphism in Linum. Albeit based on limited evidence, we hypothesised that specialised pollinators and lack of mating opportunities drive evolution of style polymorphism and loss of the polymorphism, respectively.

On the origin of the highest ozone episodes in Spain

The 2000-2015 occurrences of the highest ozone (O₃) pollution episodes in Spain were evaluated to investigate their origin. To this end, data series available for urban and regional background (UB and RB), traffic (TR) and industrial (IN) sites were analysed separately and intercompared. Results evidenced that during these 16years mean O₃ levels in the RB sites did not change significantly, and remained constantly high. However, there is a clear increase at the TR and UB sites. Although sensitivity analysis is needed to interpret the cause of this increasing trend, this might be caused probably by the lower O₃ titration intensity due to the preferential abatement of NO vs NO₂, as supported from the neutral trend of O_X (NO₂+O₃) at these sites. We found that the exceedances of the hourly information threshold for O₃ (>180μg/m³) are recorded mostly at UB and IN sites located in seven areas of Spain (specific hotspots or at the tail end of large urban plumes), and that these increased during summer heatwaves (i.e. 2003 and 2015). Although the external contribution of regional-to-subcontinental transported O₃ might be relevant during the highest O₃ episodes in the Western Mediterranean, our results evidenced that in the above specific areas, regional-local O₃ production decisively contributes to the exceedances of the information threshold. Also that the human protection threshold and the AOT40 are more frequently exceeded in the Central, Southern and Mediterranean sides of the Iberian Peninsula. The design of effective episode abatement measures is quite complex in those conditions, due to both the nonlinearity of the chemical processes of O₃ formation and destruction, and to the interplay with the complex meteorological setting, causing frequent recirculation and in situ aging of air masses. However, the combination of meteorological forecasting of the main recirculation processes and sensitivity analysis of NO_X/VOC emission abatement measures might be powerful tools to evaluate the effectiveness of potential O₃ mitigation strategies. Finally we would like to highlight that the current UB, RB, IN and TR classification (somewhat subjective) is not adequate to interpret the origin of O₃ exceedances in complex areas of Southern Europe. Thus, a UB station recording exceedances, and located in a small city in the tail end of an urban plume of a large city, receives not only the contribution from its own UB, but mainly from the specific high O₃ RB caused by the urban plume transport.

New classification scheme for ozone monitoring stations based on frequency distribution of hourly data

According to European Union (EU) legislation, ozone (O3) monitoring sites can be classified regarding their location (rural background, rural, suburban, urban) or based on the presence of emission sources (background, traffic, industrial). There have been attempts to improve these classifications aiming to reduce their ambiguity and subjectivity, but although scientifically sound, they lack the simplicity needed for operational purposes. We present a simple methodology for classifying O3 stations based on the characteristics of frequency distribution curves which are indicative of the actual impact of combustion sources emitting NO that consumes O3 via titration. Four classes are identified using 1998-2012 hourly data from 72 stations widely distributed in mainland Spain and the Balearic Islands. Types 1 and 2 present unimodal bell-shaped distribution with very low amount of data near zero reflecting a limited influence of combustion sources while Type 4 has a primary mode close to zero, showing the impact of combustion sources, and a minor mode for higher concentrations. Type 3 stations present bimodal distributions with the main mode in the higher levels. We propose a quantitative metric based on the Gini index with the objective of reproducing this classification and finding empirical ranges potentially useful for future classifications. The analysis of the correspondence with the EUROAIRNET classes for the 72 stations reveals that the proposed scheme is only dependent on the impact of combustion sources and not on climatic or orographic aspects. It is demonstrated that this classification is robust since in 87% of the occasions the classification obtained for individual years coincide with the global classification obtained for the 1998-2012 period. Finally, case studies showing the applicability of the new classification scheme for assessing the impact on O3 of a station relocation and performing a critical evaluation of an air quality monitoring network are also presented.

Industrial sources of primary and secondary organic aerosols in two urban environments in Spain

In urban areas, primary and secondary organic aerosols are typically considered to originate from vehicular traffic emissions. However, industrial emissions within or in the vicinity of urban areas may also be significant contributors to carbonaceous aerosol concentrations. This hypothesis was tested and validated in two urban areas in Spain. The observed unusual dominance of organic carbon (OC) over elemental carbon (EC), the analysis of the variability of OC, EC and OC/EC and their correlation with transport patterns suggested the presence of OC sources associated with industrial activities. A methodology based on chemical speciation of particulate matter (PM) followed by the application of receptor modelling techniques allowed for the identification of the specific industrial sources of OC, which were linked to primary OC emissions from a grain drying plant (cereal) and to secondary OC formation from paper production activities (paper mills), as well as from urban sources and biogenic emissions. This work presents an integrated approach to identifying and characterizing of industrial sources of carbonaceous aerosols in urban areas, aiming to improve the scarce body of literature currently available on this topic.

2001-2012 trends on air quality in Spain

This study aims at interpreting the 2001-2012 trends of major air pollutants in Spain, with a major focus on evaluating their relationship with those of the national emission inventories (NEI) and policy actions. Marked downward concentration trends were evidenced for PM10, PM2.5 and CO. Concentrations of NO2 and NOx also declined but in a lesser proportion at rural and traffic sites. At rural sites O3 has been kept constant, whereas it clearly increased at urban and industrial sites. Comparison of the air quality trends and major inflection points with those from NEIs, the National Energy Consumption and the calendar of the implementation of major policy actions allowed us to clearly identify major benefits of European directives on power generation and industrial sources (such as the Large Combustion Plants and the Integrated Pollution Prevention and Control Directives). This, together with a sharp 2007-2008 decrease of coal consumption has probably caused the marked parallel decline of SO2, NOx and for PM2.5 concentrations. Also the effect of the EURO 4 and 5 vehicle emission standards on decreasing emissions of PM and CO from vehicles is noticeable. The smooth decline in NO2-NOx levels is mostly attributed to the low efficiency of EURO 4 and 5 standards in reducing real life urban driving NO2 emissions. The low NOx decrease together with the complexity of the reactions of O3 formation is responsible for the constant O3 concentrations, or even the urban increase. The financial crisis has also contributed to the decrease of the ambient concentration of pollutants; however this caused a major reduction of the primary energy consumption from 2008 to 2009, and not from 2007 to 2008 when ambient air PM and SO2 sharply decreased. The meteorological influence was characterized by a 2008-2012 period favorable to the dispersion of pollutants when compared to the 2001-2007.

The east-west-north colonization history of the Mediterranean and Europe by the coastal plant Carex extensa (Cyperaceae)

Coastal plants are ideal models for studying the colonization routes of species because of the simple linear distributions of these species. Carex extensa occurs mainly in salt marshes along the Mediterranean and European coasts. Variation in cpDNA sequences, amplified fragment length polymorphisms (AFLPs) and simple sequence repeats (SSRs) of 24 populations were analysed to reconstruct its colonization history. Phylogenetic relationships indicate that C. extensa together with the South American Carex vixdentata and the southern African Carex ecklonii form a monophyletic group of halophilic species. Analyses of divergence times suggest that early lineage diversification may have occurred between the late Miocene and the late Pliocene (Messinian crisis). Phylogenetic and network analyses of cpDNA variation revealed the monophyly of the species and an ancestral haplotype contained in populations of the eastern Mediterranean. The AFLP and SSR analyses support a pattern of variation compatible with these two lineages. These analyses also show higher levels of genetic diversity and differentiation in the eastern population group, which underwent an east-to-west Mediterranean colonization. Quaternary climatic oscillations appear to have been responsible for the split between these two lineages. Secondary contacts may have taken place in areas near the Ligurian Sea in agreement with the gene flow detected in Corsican populations. The AFLP and SSR data accord with the 'tabula rasa' hypothesis in which a recent and rapid colonization of northern Europe took place from the western Mediterranean after the Last Glacial Maximum. The unbalanced west-east vs. west-north colonization may be as a result of 'high density blocking' effect.

Combination or sequential single agent for the treatment of metastatic breast cancer (MBC) patients (pts). Impact of further chemotherapy (CT) in overall survival (OS) in the Alamo registry

Abstract #2121

Introduction: Combinations can improve OS in MBC; however sequential single agent is sometimes preferred. In a recent report, pts receiving paclitaxel monotherapy in first line had a significantly worse OS if they were not receiving post study CT (PSC); no difference was seen in pts receiving paclitaxel+gemcitabine (Llombart, EBCC 2008). In this trial only 58% of pts received PSC.&#x2028; Purpose: To assess, outside the context of a clinical trial, the amount of MBC pts receiving CT beyond first line, as well as the impact of combination use and further CT lines in their OS.&#x2028; Methods: Alamo 1-2 is a breast cancer patient registry run by the GEICAM. 15482 pts diagnosed from 1990-1997 in 54 sites were included in the database. 4668 pts were stage IV; 778 (16.7%) metastatic at diagnosis and 3890 (83.3%) have had a recurrence.&#x2028; Results: 3045 (65%) pts received CT in first line, 83% were combinations (with anthracyclines 42%, CMF 16%, taxane+anthracyclines 9.4% or +other agents 8%) and 16% were monotherapy. Among other variables studied, only previous treatment (in early stage) was influencing the choice of a combination (pts without previous CT received more combinations than pts receiving CMF, than pts receiving anthracyclines). Median survival for pts receiving single agent was significantly shorter compared to pts receiving combination, 16.2 and 21.85 months (m) respectively, HR=1.37 (IC 95%: 1.21-1.55; p&lt;0.0001). Several covariates showed significant prognostic value in survival in the Cox multivariate model: monotherapy treatment in first line, anthracyclines pre-exposure, age &gt; 65, negative hormonal receptor status, hepatic disease, Grade 3 and ≥ 3 disease sites. Half of the pts never received further CT after first line treatment. Only age and number of disease sites were influencing this decision in the Cox multivariate model. Median survival was 24.9 m in pts receiving further CT and 14.5 m in the ones not receiving it. In pts not receiving further CT, median OS was significantly shorter if they were treated with single agent in first line in comparison to those receiving previous combination: HR= 1.59 (IC 95%: 1.33-1.89; p&lt; 0,00001). This difference was not significant in pts receiving further CT: HR= 1.15 (IC 95%: 0.97-1.37; p=0.101).&#x2028; Conclusion: Our data show that only half of the MBC pts receive further CT after first line; they have longer survival. We found significant evidence that further CT is impacting the OS in pts treated with single agent in first line, but not in those receiving previous combination. Those facts should be taken into consideration when selecting single agent or a combination in first line.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2121.

[Characterization of de novo malignancies in liver transplantation]

INTRODUCTION

The incidence of de novo malignancies after liver transplantation varies from 3-15%, and is greater than that in the general population. Immunosuppression may play a significant role in the development of most of these tumors.

OBJECTIVE

To evaluate the incidence and clinical features of de novo tumors in liver transplant recipients in our center as well as to assess survival.

PATIENTS AND METHODS

We retrospectively analyzed 437 liver transplantations (380 patients) performed from April 1990 to July 2001. The incidence of de novo malignancies was 7.4% (n = 28). Four patients presented two different tumors during their lifetime. The etiology of the underlying disease was alcoholic cirrhosis (45.8%), hepatitis C virus cirrhosis (20.8%), hepatitis B virus cirrhosis (12.5%), autoimmune disease (8.4%) and other causes (12.5%). The most frequent neoplasms were cutaneous and epidermoid tumors (21.4% of the malignancies both groups). All the patients with epidermoid tumors and adenocarcinomas were active smokers. The mean age at diagnosis was 58 9 years and this was a factor that influenced tumoral type (adenocarcinomas in older patients and epidermoid tumors in younger patients; p = 0.04).

RESULTS

Sarcomas and adenocarcinomas appeared sooner after transplantation than epidermoid and cutaneous tumors (p = 0.04). Fifty percent of the malignancies developed in the second and third year after transplantation. The type of immunosuppression did not influence tumoral type, although most patients received cyclosporin A in combination with azathioprine and/or corticoids. The mean duration of follow-up after diagnosis of the tumor was 23.1 28 months (range, 1-81). Mortality was 58.4% with a median survival of 9 16 months. The actuarial probability of survival at 1, 3 and 5 years was 46.1, 27.7 and 27.7%, respectively.

CONCLUSIONS

De novo malignancies are frequent after liver transplantation and their clinical course differs from that in the general population. Because their clinical course is more aggressive, regular follow-up of these patients is essential for early diagnosis.

P53 overexpression predicts endometrial carcinoma recurrence better than HER-2/neu overexpression

OBJECTIVE

to investigate the prognostic value of p53 and HER-2/neu overexpression in endometrial cancer.

STUDY DESIGN

p53 and HER-2/neu immunostaining was performed in 114 paraffin-embedded specimens of endometrial cancer diagnosed and treated between 1990 and 1997. Nuclear p53 and membrane HER-2/neu immunostaining were used.

RESULTS

p53 and HER-2/neu overexpression was observed in 17 cases (14.9%) and in 19 cases (16.7%), respectively. In univariate analysis p53 (P<0.001) and HER-2/neu (P=0.018) overexpression had a positive correlation with a high risk of recurrence. In multivariate analysis, age (P<0.001), FIGO stage (P<0.001), differentiation (P=0.013), non-endometrioid subtypes (P<0.001) and p53 overexpression (P<0.001), but not HER-2/neu overexpression, were independent prognostic indicators of recurrence. Simultaneous p53 and HER-2/neu overexpression made worse the prognostic (P<0.001).

CONCLUSIONS

p53 overexpression was an independent predictor of recurrent disease in endometrial cancer. HER-2/neu overexpression had a more limited effect but enhance the effect of p53.

A comparison of epithelial membrane antigen overexpression in benign and malignant endometrium

OBJECTIVE

The aim of this study was to analyze the value of epithelial membrane antigen (EMA) overexpression in benign and malignant endometrium and its prognostic significance.

METHODS

EMA immunostaining was performed in 178 paraffin-embedded specimens including 105 endometrial cancers, 40 endometrial hyperplasias, and 33 benign endometriums. EMA immunostaining was correlated with traditional prognostic factors and progression-free survival in endometrial cancer specimens.

RESULTS

EMA overexpression was observed more frequently in adenocarcinomas (60%) than in hyperplasias (15%) or benign endometrium (9.1%). EMA overexpression was observed in two patients with endometrial hyperplasia who progressed to carcinoma. In adenocarcinomas, EMA overexpression had a positive correlation with nonendometrioid subtypes (P = 0.012). In multivariate analysis, FIGO stage (P = 0.025) and EMA overexpression (P = 0.017) were independent prognostic factors for progression-free survival.

CONCLUSIONS

EMA overexpression appears to be a marker of malignant transformation in the endometrium and it is an independent predictor of recurrent disease in endometrial cancer.

Morphological identification of nitric oxide sources and targets in the cat oculomotor system

Nitric oxide (NO) production by specific neurons in the prepositus hypoglossi (PH) nucleus is necessary for the correct performance of eye movements in alert cats. In an attempt to characterize the morphological substrate of this NO function, the distribution of nitrergic neurons and NO-responding neurons has been investigated in different brainstem structures related to eye movements. Nitrergic neurons were stained by either immunohistochemistry for NO synthase I or histochemistry for reduced nicotinamide adenine dinucleotide phosphate (NADPH) diaphorase. The NO targets were identified by cyclic guanosine monophosphate (cGMP) immunohistochemistry in animals treated with a NO donor immediately before fixation of the brain. Connectivity between cells of the NO-cGMP pathway was analyzed by injections of the retrograde tracers horseradish peroxidase or fast blue in different structures. The motor nuclei commanding extraocular muscles did not contain elements of the NO-cGMP pathway, except for some scattered nitrergic neurons in the most caudal part of the abducens nucleus. The PH nucleus contained the largest number of nitrergic cell bodies and a rich neuropil, distributed in two groups in medial and lateral positions in the caudal part, and one central group in the rostral part of the nucleus. An abundant cGMP positive neuropil was the only NO-sensitive element in the PH nucleus, where no cGMP-producing neuronal cell bodies were observed. The opposite disposition was found in the marginal zone between the PH and the medial vestibular nuclei, with a large number of NO-sensitive cGMP-producing neurons and almost no nitrergic cells. Both nitrergic and NO-sensitive cell bodies were found in the medial and inferior vestibular nuclei and in the superior colliculus, whereas the lateral geniculate nucleus contained nitrergic neuropil and a large number of NO-sensitive cell bodies. Some of the cGMP-positive neurons in the marginal zone and medial vestibular nucleus projected to the PH nucleus, predominantly to the ipsilateral side. These morphological findings may help to explain the mechanism of action of NO in the oculomotor system.

The relevance of flow cytometry for biochemical analysis

Flow cytometry (FCM) allows the simultaneous measurement of multiple fluorescences and light scatter induced by illumination of single cells or microscopic particles in suspension, as they flow rapidly through a sensing area. In some systems, individual cells or particles may be sorted according to the properties exhibited. By using appropriate fluorescent markers, FCM is unique in that multiple structural and functional parameters can be quantified simultaneously on a single-particle basis, whereas up to thousands of biological particles per second may be examined. FCM is increasingly used for basic, clinical, biotechnological, and environmental studies of biochemical relevance. In this critical review, we summarize the main advantages and limitations of FCM for biochemical studies and discuss briefly the most relevant parameters and analytical strategies. Graphical examples of the biological information provided by multiparametric FCM are presented. Also, this review contains specific sections on flow cytoenzymology, FCM analysis of isolated subcellular organelles, and cell-free FCM.

[Esophageal fibrovascular polyp: report of 2 cases]

Fibrovascular esophageal polyps are benign intraluminal tumors that, although of slow growth, may become large. We describe the features of two cases, diagnosed in our department, and emphasize the endoscopic aspects of the lesion.

Prognostic factors in invasive lobular carcinoma of the breast: a multivariate analysis. A multicentre study after seventeen years of follow-up

BACKGROUND AND GOALS

The purpose of this study was to characterize the biologic determinants that affect the behavior of invasive lobular carcinoma of the breast.

MATERIAL AND METHODS

A prospectively accrued data base containing 9,619 breast cancer cases was queried for specific pathological features. From this data base, 390 patients with invasive lobular carcinoma of the breast treated and followed at any of these three centers: San Carlos Hospital, Doce de Octubre Hospital or The Jimenez Diaz Foundation in Madrid (Spain) were reviewed and results, in terms of overall survival and disease-free survival were recorded for a long-term follow-up of 206 months (17 years).

RESULTS

The parameters that showed an important statistical influence on survival were the stage at diagnosis, the tumor size and nodal status, as well as the tumor grade. Age showed a limited influence, and multicentricity, or the type of surgical procedure had no statistical impact on survival.

CONCLUSIONS

Our analysis specifies the clinico-pathological features that influence the prognosis of invasive lobular carcinoma of the breast, and confirms that conservative therapy may be an appropriate treatment for this type of cancer.

[The prolonged administration of intravenous immunoglobulins as a treatment for refractory fistulous Crohn's diseases]

Fistulating Crohn's disease is present in 17-35% of non-surgically treated patients and in up to 45% of surgically treated ones. Among the several therapeutic alternatives for this disease is intravenous immunoglobulin administration. We present a 28-year-old woman with refractory fistulating Crohn's disease who improved after prolonged immunoglobulin administration (32 months).

Mechanisms of action and targets of nitric oxide in the oculomotor system

Nitric oxide (NO) production by neurons in the prepositus hypoglossi (PH) nucleus is necessary for the normal performance of eye movements in alert animals. In this study, the mechanism(s) of action of NO in the oculomotor system has been investigated. Spontaneous and vestibularly induced eye movements were recorded in alert cats before and after microinjections in the PH nucleus of drugs affecting the NO-cGMP pathway. The cellular sources and targets of NO were also studied by immunohistochemical detection of neuronal NO synthase (NOS) and NO-sensitive guanylyl cyclase, respectively. Injections of NOS inhibitors produced alterations of eye velocity, but not of eye position, for both spontaneous and vestibularly induced eye movements, suggesting that NO produced by PH neurons is involved in the processing of velocity signals but not in the eye position generation. The effect of neuronal NO is probably exerted on a rich cGMP-producing neuropil dorsal to the nitrergic somas in the PH nucleus. On the other hand, local injections of NO donors or 8-Br-cGMP produced alterations of eye velocity during both spontaneous eye movements and vestibulo-ocular reflex (VOR), as well as changes in eye position generation exclusively during spontaneous eye movements. The target of this additional effect of exogenous NO is probably a well defined group of NO-sensitive cGMP-producing neurons located between the PH and the medial vestibular nuclei. These cells could be involved in the generation of eye position signals during spontaneous eye movements but not during the VOR.

Prognostic value of motor evoked potential obtained by transcranial magnetic brain stimulation in motor function recovery in patients with acute ischemic stroke

BACKGROUND AND PURPOSE

The early prognostic application of transcranial magnetic brain stimulation (TMS) for assessing motor and functional recovery in ischemic stroke patients has yielded contradictory results. We performed a prospective study of patients with acute ischemic stroke and motor deficit to evaluate the early prognostic value of TMS in motor and functional recovery.

METHODS

Fifty patients with different degrees of hemiparesis were studied in the first week after ischemic stroke and evaluated by clinical scales (Medical Research Council Scale, Canadian Neurological Scale, Barthel Index), with clinical follow-up over 6 months. TMS (Magstim 200) was performed at the same time, recording the motor evoked potential (MEP) in the thenar eminence muscles, with facilitation by voluntary contraction.

RESULTS

Of the total group of 50 patients, MEP was absent in 20 and present in 30 (17 with normal and 13 with delayed central conduction time [CCT]). The patients with MEP showed better motor and functional recovery than those without. The MEP provided information on patient recovery, regardless of the initial strength and/or Barthel values. The degree of recovery was better in those patients with normal CCT than in those with delayed CCT.

CONCLUSIONS

MEP obtained by TMS in patients with hemiparesis after acute ischemic stroke is useful as an early prognostic indicator of motor and functional recovery. This technique would allow the early identification of those patients who will have a good recovery, particularly among those with severe initial paresis.

Nitric oxide production by brain stem neurons is required for normal performance of eye movements in alert animals

Although nitric oxide (NO) is produced by discrete groups of neurons in the brain, participation of NO in premotor structures directly involved in reflexively evoked, sensory-motor functions has not been demonstrated so far. We now show that NO is a physiological mediator in the generation of a specific motor response in alert behaving animals. In the oculomotor system, numerous neurons expressing nitric oxide synthase (NOS) are located in the prepositus hypoglossi, a nucleus involved in the control of horizontal eye movements. Unilateral inhibition of NOS within this nucleus results in severe ocular nystagmus with slow phases directed to the contralateral side. Accordingly, local increases of NO or cyclic GMP produced a nystagmus in the opposite direction. It is concluded that a balanced production of NO by prepositus hypoglossi neurons is a necessary condition for the normal performance of eye movements in alert animals.

Discharge properties of brain stem neurons projecting to the flocculus in the alert cat. II. Prepositus hypoglossal nucleus

1. The aim of this study was to characterize the signals transmitted by the neurons of the nucleus prepositus hypoglossal (NPH) to the middle zone of the flocculus of the cat. The methods, the behavioral testing, and the animals used in this study were the same as those used in the accompanying paper on medial vestibular nucleus neurons. 2. The rostral two-thirds of the NPH was explored in alert animals with microelectrodes during stimulation of the middle zone of both flocculi. Discharges of neurons were analyzed during spontaneous eye movements (head fixed) and during horizontal vestibuloocular reflex (VOR) activity elicited by sinusoidal stimulation (10, 20, 30, or 40 degrees at 0.1 Hz). Forty neurons were found to be antidromically activated from only one or the other of the two flocculi (latency: 0.99 +/- 0.17 ms, mean +/- SD): 37 from the contralateral flocculus and 3 from the ipsilateral one. None of the neurons could be activated antidromically from both flocculi. Floccular stimulation never resulted in direct inhibition of these NPH neurons. 3. Of the 37 units antidromically activated from the contralateral flocculus, 26 were recorded sufficiently long to allow full quantitative analysis. Most of these (20 neurons) were classified as burst-tonic (BT) neurons. The BT neurons exhibited during each saccade made in one direction (the ON direction) a burst of spikes, and during postsaccadic fixation a tonic activity that increased with gaze displacement in the ON direction. The mean sensitivity of the neurons to eye velocity during the "ON" saccades was 3.3 +/- 1.6 spikes.s-1.deg-1.s-1. During intersaccadic fixation, the mean sensitivity to eye position was 3.6 +/- 2.5 spikes.s-1.deg-1. During the VOR, the majority showed modulation in relation to both eye position and eye velocity. The mean sensitivity to eye position during the VOR was 3.4 +/- 2.6 spikes.s-1.deg-1 (range: 0.2-8.1 spikes.s-1.deg-1). The mean sensitivity to eye velocity during the VOR was 2.1 +/- 1.3 spikes.s-1.deg-1.s-1. The mean phase lead of with respect to eye position was 16.4 +/- 6.8 degrees (range: 6.0-28.9 degrees). Eighty percent of the BT neurons behaved as type I neurons. Forty-seven percent of the BT neurons also presented some head velocity sensitivity (1.48 +/- 0.6 spikes.s-1.deg-1.s-1, mean +/- SD). 4. Other NPH cells antidromically activated from the contralateral flocculus were classified in two groups: bidirectional burst (BB) neurons (n = 4) and burst-driving (BD) neurons (n = 2). The BB neurons were characterized by a burst discharge during every horizontal saccade or VOR quick phase, irrespective of the direction. The mean sensitivity of the BB neurons to eye velocity during saccades was 3.3 +/- 7.8 (SD) spikes.s-1.deg-1.s-1. Both BD neurons increased their firing rate during the slow VOR phases induced by an ipsilateral rotation (type I neurons) and exhibited high-frequency bursts in association with ipsilaterally directed quick phases. 5. The results indicate that the main projection of the NPH onto the middle zone of the flocculus comes from contralaterally located type I BT neurons. Signals transmitted in this path associate a high sensitivity for eye velocity with a high sensitivity for eye position. This type of input is consistent with the suggestion that the main function of the flocculus is to control the gain of downstream reflexes and to perform a fine adjustment of the gaze holding command.

Discharge properties of brain stem neurons projecting to the flocculus in the alert cat. I. Medical vestibular nucleus

1. The aim of this study was to characterize the signals transmitted by neurons of the medial vestibular nucleus (MVN) to the middle zone of the flocculus in alert cats. 2. Bipolar stimulating electrodes were implanted into the middle zone of each flocculus, because this zone is known to be involved in the control of horizontal eye movements. Correct implantation of the stimulating electrodes was ensured by 1) recording of Purkinje cells whose activity was related to horizontal eye movements and 2) elicitation of slow abduction of the ipsilateral eye upon electrical stimulation. 3. The rostral two-thirds of the MVN were investigated by microelectrodes during stimulation of both flocculi. Antidromically activated neurons were found only in the central part of the explored area. Forty-four units were activated from the contralateral, eight from the ipsilateral flocculus. Neurons could never be activated from both flocculi. 4. Neurons included in this study were MVN neurons that had 1) to be antidromically activated from one flocculus and 2) to modulate their firing rate during the horizontal vestibuloocular reflex (VOR) elicited by sinusoidal stimulation (0.1 Hz; 10, 20, 30 or 40 degrees). The 39 neurons matching both criteria were classified in 2 groups: 22 neurons changed their firing rate during spontaneous horizontal eye movements (EM-neurons), 17 modulated their activity only during head rotation and were labeled vestibular-only neurons (VO-neurons). 5. Sufficient data were obtained from 13 EM-neurons to allow a quantitative analysis. Among those, 12 were activated from the contralateral and 1 from the ipsilateral flocculus. Their sensitivity to horizontal eye position during intersaccadic fixation was 3.54 +/- 2.75 (SD) spikes.s-1/deg. Eight EM-neurons behaved as type I neurons, five as type II neurons. During the slow phases of the VOR, all of these neurons combined some head-velocity sensitivity (1.50 +/- 0.43 spikes.s-1/deg.s-1) with some horizontal eye-position sensitivity (3.61 +/- 2.45 spikes.s-1/deg). Additionally, seven of these neurons presented a sensitivity to eye velocity (1.34 +/- 0.55 spikes.s-1/deg.s-1). The phase difference between the modulation of firing rate and eye position varied substantially between neurons. The observed phase lead with respect to eye position ranged from 2 to 110 degrees (41.9 +/- 31.8 degrees). 6. Sufficient data were obtained from 10 VO-neurons to allow a quantitative analysis. Among those, nine were activated from the contralateral and one from the ipsilateral flocculus. All of these neurons behaved as type I neurons. The sensitivity to head velocity was 1.64 +/- 1.07 spikes.s-1/deg.s-1. The phase lead of the modulation of spike activity with respect to head velocity ranged from 4.5 to 30.5 degrees (16.4 +/- 8.9 degrees). 7. We conclude that the MVN provides the horizontal zone of the flocculus (with a strong contralateral preference) with information about head velocity (through VO-neurons and EM-neurons) and about eye velocity and position (through EM-neurons).

Evaluation of flow injection sample to standard addition method for the inductively coupled plasma mass spectrometric determination of aluminium in biological tissues

An on-line flow injection sample to standard addition method was developed for the determination of aluminium in biological tissues by inductively coupled plasma mass spectrometry. The sample concentration is calculated from two transient signals obtained from the injection of the blank and the sample, using a standard solution as carrier. A flow injection manifold for the on-line injection of both solutions was used and a three-step flow injection programme allowing the two transient signals to be obtained in the same measurement process was applied. A microwave nitric acid digestion procedure in closed vessels was used for sample dissolution, and scandium was added as an internal standard to control plasma fluctuations and to correct for ion signal instability. Tissue samples from healthy rat brain, kidney, liver, lung and spleen were analysed to find their aluminium concentrations. Complete recoveries from rat liver tissue spiked with aluminium concentrations in the 0.5-10.0 micrograms g-1 level were achieved. The detection limit (3 sigma) referred to the solid sample was of 10 ng g-1 and the precision (RSD) was better than 1%. The accuracy of the proposed method was tested by determining the aluminium contents in two NIST Standard Reference Materials: SRM 1577b Bovine Liver and SRM 8414 Bovine Muscle Powder).

A quantitative study of electroencephalography, eye movements and neck electromyography characterizing the sleep-wake cycle of the guinea-pig

The qualitative and quantitative characteristics of cerebral cortex electrical activity, ocular motility and muscular activity were studied in six head-restrained guinea-pigs during wakefulness, slow-wave and paradoxical sleep. Animals were chronically implanted with bipolar electrodes in the obliquus capitis muscle for electromyographic recordings and epidurally through the parietal bones for electroencephalographic (EEG) recordings. Eye movements were recorded using the scleral search-coil technique. After postoperative recovery and a short period of habituation to immobilization, head-restrained animals exhibited a polyphasic sleep-wake cycle similar to what has already been described in the unrestrained guinea-pig. Paradoxical sleep periods of mean duration 110 +/- 42 s occurred at a mean interval of 32.2 +/- 7.2 min. Amplitude and frequency components of EEG activity were different for each state of vigilance. EEG amplitude was highest and frequency range lowest-with two well-defined peaks at 4 and 10 Hz-during slow-wave sleep. During paradoxical sleep, frequencies were higher and amplitudes lower than during wakefulness. Three types of eye movement intermingled with periods of ocular fixation were recorded: saccadic movements during wakefulness and paradoxical sleep, slow drifts during slow-wave sleep and paradoxical sleep, and a new type of eye movement-bursts of high-velocity eye oscillations during paradoxical sleep. Saccadic eye movements during paradoxical sleep were more frequent and showed higher velocities and amplitudes than during wakefulness. During paradoxical sleep the episodes of eye oscillation (8-14 Hz) occurred quite regularly every 1.6 s and had a mean duration of 1.4 s. During wakefulness, the obliquus muscle activity displayed a burst-tonic pattern. Bursting components were closely related to saccadic eye movements directed to the side of the recorded muscle. The muscle activity was predominantly tonic during slow-wave sleep and was completely absent during paradoxical sleep except for small bursts or twitches. These twitches were tightly synchronized with the occurrence of the rapid eye movements oriented towards the side of the recorded obliquus muscle, as during wakefulness. These results strongly suggest that paradoxical sleep is characterized by the oscillatory discharge of at least two neuronal populations: the brainstem saccadic generators and the tecto-reticular spinal network which underlies gaze-orienting behaviour during wakefulness. The occurrence of rhythmic discharges at approximately 11 Hz may explain the spinal motoneurons' inhibition during paradoxical sleep in order to avoid anarchic motor behavior. Whether these neuronal oscillations are simply an epiphenomenon or have functional implications remains to be determined.

Comparison of the effects of nerve growth factor and superoxide dismutase on vascular extravasation in experimental burns

Superoxide dismutase (SOD), a free-radical scavenger, inhibits the increase of vascular permeability in experimental burn lesions in rats. In this study the aim was to determine whether Nerve Growth Factor (NGF), which has been implicated in the modulation of some inflammatory reactions, behaves in an analogous way. The study compares the haematocrit (Ht) and haemoglobin (Hb) variations in three groups of rats treated respectively with saline solution, SOD and NGF, immediately after causing a 25 per cent dermal burn injury. Statistical comparison (Student's t test) of the Ht and Hb variations between the Control group (Ht and Hb increase) and the NGF group (Ht and Hb decrease), shows significant differences in the intervals between 15 and 60 min (P < 0.01) and between 60 and 120 min (P < 0.05). Although SOD is able to control extravasation in the immediate postburn period (basal-15 min), NGF has a comparable effect in subsequent periods. The overall action of NGF shows that this agent is able to maintain Ht and Hb values at basal levels even after 120 min postburn. These results seem to be the first evidence of an inhibitory effect of NGF on the vascular permeability in burn lesions.

Hypoglossal nerve conduction study by transcranial magnetic stimulation in normal subjects

The introduction of transcranial magnetic stimulation has allowed the study of conduction in the proximal portions and central pathways of the cranial nerves. A study is made of cranial nerve XII with transcranial magnetic stimulation at two levels, cortical and cisternal, registering the motor evoked potential by means of surface electrodes in contact with the upper face of the tongue. Motor evoked potentials were constantly observed on cortical stimulation, in a painless, easy, and reproducible way, with mean values of 10.84 +/- 1.14 milliseconds (latency) and 7.81 +/- 1.14 mV (amplitude). Motor evoked potentials were unconstant and showed reduced amplitudes on cisternal stimulation, with mean values of 4.72 +/- 0.62 milliseconds and 0.83 +/- 1.26 mV. The magnetic stimulation technique allows the study of the entire motor pathway of cranial nerve XII (motor cortex-medulla, motoneuron-muscle). The method is efficient, noninvasive, painless, and easily reproduced, and it comes close to being an ideal clinical conduction study technique for this cranial nerve.