Extracellular vesicle DNA from human melanoma tissues contains cancer-specific mutations

Liquid biopsies are promising tools for early diagnosis and residual disease monitoring in patients with cancer, and circulating tumor DNA isolated from plasma has been extensively studied as it has been shown to contain tumor-specific mutations. Extracellular vesicles (EVs) present in tumor tissues carry tumor-derived molecules such as proteins and nucleic acids, and thus EVs can potentially represent a source of cancer-specific DNA. Here we identified the presence of tumor-specific DNA mutations in EVs isolated from six human melanoma metastatic tissues and compared the results with tumor tissue DNA and plasma DNA. Tumor tissue EVs were isolated using enzymatic treatment followed by ultracentrifugation and iodixanol density cushion isolation. A panel of 34 melanoma-related genes was investigated using ultra-sensitive sequencing (SiMSen-seq). We detected mutations in six genes in the EVs (BRAF, NRAS, CDKN2A, STK19, PPP6C, and RAC), and at least one mutation was detected in all melanoma EV samples. Interestingly, the mutant allele frequency was higher in DNA isolated from tumor-derived EVs compared to total DNA extracted directly from plasma DNA, supporting the potential role of tumor EVs as future biomarkers in melanoma.

Tetraspanins distinguish separate extracellular vesicle subpopulations in human serum and plasma - Contributions of platelet extracellular vesicles in plasma samples

Background: The ability to isolate extracellular vesicles (EVs) from blood is vital in the development of EVs as disease biomarkers. Both serum and plasma can be used, but few studies have compared these sources in terms of the type of EVs that are obtained. The aim of this study was to determine the presence of different subpopulations of EVs in plasma and serum.

Method: Blood was collected from healthy subjects, and plasma and serum were isolated in parallel. ACD or EDTA tubes were used for the collection of plasma, while serum was obtained in clot activator tubes. EVs were isolated utilising a combination of density cushion and SEC, a combination of density cushion and gradient or by a bead antibody capturing system (anti‐CD63, anti‐CD9 and anti‐CD81 beads). The subpopulations of EVs were analysed by NTA, Western blot, SP‐IRIS, conventional and nano flow cytometry, magnetic bead ELISA and mass spectrometry. Additionally, different isolation protocols for plasma were compared to determine the contribution of residual platelets in the analysis.

Results: This study shows that a higher number of CD9⁺ EVs were present in EDTA‐plasma compared to ACD‐plasma and to serum, and the presence of CD41a on these EVs suggests that they were released from platelets. Furthermore, only a very small number of EVs in blood were double‐positive for CD63 and CD81. The CD63⁺ EVs were enriched in serum, while CD81⁺ vesicles were the rarest subpopulation in both plasma and serum. Additionally, EDTA‐plasma contained more residual platelets than ACD‐plasma and serum, and two centrifugation steps were crucial to reduce the number of platelets in plasma prior to EV isolation.

Conclusion: These results show that human blood contains multiple subpopulations of EVs that carry different tetraspanins. Blood sampling methods, including the use of anti‐coagulants and choice of centrifugation protocols, can affect EV analyses and should always be reported in detail.

A170 A NOVEL DECISION AID IMPROVES KNOWLEDGE AND QUALITY OF PREGNANCY-RELATED DECISION-MAKING IN IBD

Background

Women with inflammatory bowel disease (IBD) with poor IBD-specific reproductive knowledge experience more voluntary childlessness. Poor knowledge is associated with fear of IBD medications in pregnancy; this must be addressed as active IBD at preconception (PC) correlates with worse intrapartum disease and poor fetal outcomes. The Pregnancy IBD Decision Aid (PIDA), developed by an international multidisciplinary team following International Patient Decision Aids Standards, is an interactive online tool that offers personalised decision support on fertility, pregnancy, and medications in IBD (Fig).

Aims

To assess PIDA’s impact on knowledge and quality of decision-making among PC and pregnant patients with IBD, and to evaluate its feasibility as a tool for patients and clinicians.

Methods

PC and pregnant women aged 18–45 with IBD, recruited in Canada and Australia, completed questionnaires pre and post PIDA to assess quality of decision-making (Decisional Conflict Scale, DCS; Self-Efficacy Score, SES) and IBD in pregnancy knowledge (Crohn’s and Colitis Pregnancy Knowledge Score, CCPKnow). DCS assesses if a decision is informed, aligned with personal values, and would be implemented. SES measures belief in one’s ability to make informed decisions. Patients and clinicians (gastroenterology, obstetrics, primary care) also completed feasibility surveys. Paired t-test assessed for differences pre and post PIDA.

Results

DCS and SES were completed by 74 patients (42 Crohn’s disease, 32 ulcerative colitis); 41 PC and 33 pregnant. DCS improved significantly post PIDA (effect size 0.44, p<0.0001); this was observed in PC patients regarding pregnancy planning with IBD, and in pregnant patients regarding peripartum IBD medication management. SES of PC but not pregnant patients improved significantly post PIDA (effect size 0.32 vs 0.24, p=0.0001 vs 0.0525). In both cohorts, CCPKnow improved significantly post PIDA (n=76, effect size 0.66, p<0.0001).

Patients (n=73) assessed PIDA feasibility. Mean scores for length (3.05±0.44), readability (3.09±0.5), and content amount (2.91±0.81) were perceived as appropriate (1=limited, 5=excessive). Perceived usefulness of PIDA was high among all patients (4.09±0.93; 5=most useful). Clinicians (n=14) believed PIDA had appropriate length, readability, and content amount, and deemed PIDA useful to patients (4.6±0.8) and themselves (4.8±0.8) for clinical practice.

Conclusions

PIDA improved knowledge and quality of decision-making in PC and pregnant patients with IBD. Patients developed a strengthened belief in their ability to make informed, effective decisions, and both patients and clinicians found PIDA feasible. PIDA is an accessible tool that can empower women with IBD to make evidence-based decisions about pregnancy and may ultimately reduce voluntary childlessness.

Funding Agencies

Mount Sinai Hospital Resident Research Grant; Gastroenterological Society of Australia Rose Amarant Grant; Women and Children’s Health Research Institute (WCHRI); Clinical/Community Research Integration Support Program (CRISP); Merck Better Care, Healthy Communities Funding Program

Haplotype analysis of the CFTR gene on normal and mutant CFTR genes

BACKGROUND

Mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene are responsible for Cystic Fibrosis (CF) disease. Since the distribution of polymorphisms varies among populations, a comparison between the frequency of CFTR polymorphisms in patients and healthy population may further identify their role in CF disease. The results obtained from this research may facilitate the prediction of disease phenotype in prenatal diagnosis or newborn screening program as well as determine the possible associations between haplotypes and specific mutations.

METHODS

Blood samples collected from 27 unrelated West Iranian families contain at least one CF patient and 55 control families with no history of CF. Samples were analyzed for c.1210-12 T [5-9], c.1242-35-1242-12GT [8-10], c.744-33GATT [6-8] and c.869 + 11C > T polymorphisms by automated direct DNA sequencing following DNA extraction.

RESULTS

Our results showed that the T7 allele is the most common allele in normal and non-ΔF508 CF chromosomes with the frequencies of 93.6% and 100%, respectively. Conversely, T9 was the only allele detected in ΔF508 chromosomes. Moreover, the c.1242-35-1242-12GT analysis showed that (TG)11 repeat was the most common dinucleotide repeat in both, non-ΔF508 and normal chromosomes with the frequencies of 91% and 71%, respectively. The c.744-33GATT and c.869 + 11C > T polymorphism analyses indicated that (GATT)6 and T allele are only found in ΔF508 CF chromosomes. Besides, the [T7-TG11-GATT7-C] haplotype was the most common haplotype in both, normal and non-ΔF508 CF subjects while the [T9-TG10- GATT6-T] haplotype was only detected in CF patients carrying ΔF508 mutation.

CONCLUSIONS

Our findings identified an informative haplotype that could be used in genetic counseling, prenatal diagnosis and future screening of CF in Iran.

COVID-19 and intracerebral haemorrhage: causative or coincidental?

Pneumonia appears to be the most common manifestation of coronavirus disease 2019 (COVID-19), but some extrapulmonary involvement, such as gastrointestinal, cardiac and renal, has been reported. The limited clinical data about the virus's behavior to date, especially extrapulmonary symptoms, suggest that we should be aware of the possibility of initial cerebrovascular manifestations of COVID-19.

Effect of 6% hydroxyethyl starch 130/0.4 on kidney and haemostatic function in cardiac surgical patients: a randomised controlled trial

Whether third‐generation hydroxyethyl starch solutions provoke kidney injury or haemostatic abnormalities in patients having cardiac surgery remains unclear. We tested the hypotheses that intra‐operative administration of a third‐generation starch does not worsen postoperative kidney function or haemostasis in cardiac surgical patients compared with human albumin 5%. This triple‐blind, non‐inferiority, clinical trial randomly allocated patients aged 40–85 who underwent elective aortic valve replacement, with or without coronary artery bypass grafting, to plasma volume replacement with 6% starch 130/0.4 vs. 5% human albumin. Our primary outcome was postoperative urinary neutrophil gelatinase‐associated lipocalin concentrations, a sensitive and early marker of postoperative kidney injury. Secondarily, we evaluated urinary interleukin‐18; acute kidney injury using creatinine RIFLE criteria, coagulation measures, platelet count and function. Non‐inferiority (delta 15%) was assessed with correction for multiple comparisons. We enrolled 141 patients (69 starch, 72 albumin) as planned. Results of the primary analysis demonstrated that postoperative urine neutrophil gelatinase‐associated lipocalin (median (IQR [range])) was slightly lower with hydroxyethyl starch (5 (1–68 [0–996]) ng.ml⁻¹) vs. albumin (5 (2–74 [0–1604]) ng.ml⁻¹), although not non‐inferior [ratio of geometric means (95%CI) 0.91 (0.57, 1.44); p = 0.15] due to higher than expected variability. Urine interleukin‐18 concentrations were reduced, but interleukin‐18 and kidney injury were again not non‐inferior. Of 11 individual coagulation measures, platelet count and function, nine were non‐inferior to albumin. Two remaining measures, thromboelastographic R value and arachidonic acid‐induced platelet aggregation, were clinically similar but with wide confidence intervals. Starch administration during cardiac surgery produced similar observed effects on postoperative kidney function, coagulation, platelet count and platelet function compared with albumin, though greater than expected variability and wide confidence intervals precluded the conclusion of non‐inferiority. Long‐term mortality and kidney function appeared similar between starch and albumin.

Subpopulations of extracellular vesicles from human metastatic melanoma tissue identified by quantitative proteomics after optimized isolation

The majority of extracellular vesicle (EV) studies conducted to date have been performed on cell lines with little knowledge on how well these represent the characteristics of EVs in vivo. The aim of this study was to establish a method to isolate and categorize subpopulations of EVs isolated directly from tumour tissue. First we established an isolation protocol for subpopulations of EVs from metastatic melanoma tissue, which included enzymatic treatment (collagenase D and DNase). Small and large EVs were isolated with differential ultracentrifugation, and these were further separated into high and low-density (HD and LD) fractions. All EV subpopulations were then analysed in depth using electron microscopy, Bioanalyzer®, nanoparticle tracking analysis, and quantitative mass spectrometry analysis. Subpopulations of EVs with distinct size, morphology, and RNA and protein cargo could be isolated from the metastatic melanoma tissue. LD EVs showed an RNA profile with the presence of 18S and 28S ribosomal subunits. In contrast, HD EVs had RNA profiles with small or no peaks for ribosomal RNA subunits. Quantitative proteomics showed that several proteins such as flotillin-1 were enriched in both large and small LD EVs, while ADAM10 were exclusively enriched in small LD EVs. In contrast, mitofilin was enriched only in the large EVs. We conclude that enzymatic treatments improve EV isolation from dense fibrotic tissue without any apparent effect on molecular or morphological characteristics. By providing a detailed categorization of several subpopulations of EVs isolated directly from tumour tissues, we might better understand the function of EVs in tumour biology and their possible use in biomarker discovery.

Serum overexpression of miR-301a and miR-23a in patients with colorectal cancer

BACKGROUND

Extracellular vesicles (EVs) are a heterogeneous group of membrane-bound vesicles with complex cargoes including proteins, lipids, and nucleic acids. EVs have received significant attention due to their specific features including stability under harsh conditions and involvement in cell-to-cell communication. Circulating EVs and the molecules associated with them are important in the diagnosis and prognosis of cancers. MicroRNAs (miRNAs) are a group of small noncoding RNAs that have a role in regulating gene expression. Current literature shows that circulating miRNAs can be used as noninvasive biomarkers for early detection of cancers. The present study was set to investigate the potential role of serum exosomal miRNA expression levels in colorectal cancer (CRC) patients and evaluate their correlation with clinicopathologic features.

METHODS

Exosome-enriched fractions were isolated from the serum of 25 CRC patients and 13 age- and sex-matched healthy controls using a polymer-based precipitation method. During the pilot phase, real-time polymerase chain reaction (RT-PCR) was carried out on 12 CRC patients and eight healthy participants to evaluate the expression difference of 11 candidate miRNAs between CRC patients and tumor free subjects. Finally, the results were validated in a separate group, which was similar in size to the pilot group. The clinicopathologic data were also collected and the relationship between aberrant miRNA expression and clinicopathological parameters were investigated.

RESULTS

There were high expressions of exosomal miR-23a and miR-301a in serum samples of CRC patients compared to normal controls in training and validation phases; these differences were not significantly correlated with clinicopathologic features. Receiver operating characteristic curve analysis showed that miR-301a and miR-23a were able to discriminate CRC patients from normal subjects.

CONCLUSION

The findings provide evidence on the roles of miR-301a and miR-23a in CRC development and their potential roles as noninvasive biomarkers for early detection of CRC.

Electrophoretic deposition of chitosan reinforced graphene oxide-hydroxyapatite on the anodized titanium to improve biological and electrochemical characteristics

Chitosan reinforced hydroxyapatite-graphene oxide (CS-GO-HA) nanocomposite coatings were developed using electrophoretic deposition process in order to improve the biological and electrochemical properties of Ti surface. Moreover, the role of anodized layer on the physical and electrochemical properties of the CS-GO-HA nanocomposite coating was evaluated. After synthesize of HA-GO nanopowder using a sol-gel process, nanocomposite coatings with various concentrations of chitosan (0.5, 1 and 1.5 mg/ml) were produced. Increasing the chitosan content lowered the deposition rate of HA-GO nanoparticles, reduced the coating thickness and diminished apatite-formation ability and biocompatibility. Noticeably, MG63 cell viability significantly reduced form 119.3 ± 5.1 (% control) to 51.9 ± 14.8 (% control), when the chitosan concentration increased from 0.5 to 1.5 mg/ml. In addition, the CS-GO-HA coating containing 0.5 mg/ml chitosan revealed the best barrier property owing to the less crack formation. Furthermore, anodizing of titanium substrate and formation of TiO₂ nanotube (TiNT) resulted in the formation of crack-free and homogeneous CS-GO-HA coatings without any observable defect. Moreover, the TiNT formation noticeably improved barrier resistance of the coating (6.7 times) due to better adhesion governed between coating and substrate. Our results confirmed that the surface modification using both anodizing of Ti substrate and electrophoretic deposition of ternary CS-GO-HA nanocomposite coating with 0.5 mg/ml chitosan successfully improves electrochemical properties, bioactivity and cell function, which makes it promising for bone implant applications.

Detailed analysis of the plasma extracellular vesicle proteome after separation from lipoproteins

The isolation of extracellular vesicles (EVs) from blood is of great importance to understand the biological role of circulating EVs and to develop EVs as biomarkers of disease. Due to the concurrent presence of lipoprotein particles, however, blood is one of the most difficult body fluids to isolate EVs from. The aim of this study was to develop a robust method to isolate and characterise EVs from blood with minimal contamination by plasma proteins and lipoprotein particles. Plasma and serum were collected from healthy subjects, and EVs were isolated by size-exclusion chromatography (SEC), with most particles being present in fractions 8-12, while the bulk of the plasma proteins was present in fractions 11-28. Vesicle markers peaked in fractions 7-11; however, the same fractions also contained lipoprotein particles. The purity of EVs was improved by combining a density cushion with SEC to further separate lipoprotein particles from the vesicles, which reduced the contamination of lipoprotein particles by 100-fold. Using this novel isolation procedure, a total of 1187 proteins were identified in plasma EVs by mass spectrometry, of which several proteins are known as EV-associated proteins but have hitherto not been identified in the previous proteomic studies of plasma EVs. This study shows that SEC alone is unable to completely separate plasma EVs from lipoprotein particles. However, combining SEC with a density cushion significantly improved the separation of EVs from lipoproteins and allowed for a detailed analysis of the proteome of plasma EVs, thus making blood a viable source for EV biomarker discovery.

CFTR Mutation Analysis in Western Iran: Identification of Two Novel Mutations

BACKGROUND

Cystic fibrosis (CF) is one of the most common autosomal recessive disorders in Caucasian population. The incidence of disorder varies among different religious, ethnic and geographical isolates. The aim of this study was to identify the spectrum and the frequency of known and unknown disease-causing mutations in Iranian CF patients.

METHODS

Genomic DNA was extracted from peripheral whole blood with a QIAamp DNA Mini-Kit. Mutation analysis was done in the CFTR gene including complete coding region and intron/exon boundaries using a direct sequencing method.

RESULTS

In general, ten mutations were identified in 27 CF cases. Two out of 10 mutations, 754delT and GGTGGCdel/TTGins, were reported as novel mutations. The most common observed mutations in patients were R334W (40.74%), ΔF508 (18.5%), K710X (12.96%) and D110H (5.5%), 1897C>G (1.85%), R1162X (1.85%), S466X (1.85%) and T1036I (1.85%).

CONCLUSION

The finding indicated a unique mutation panel which can be used in genetic counseling, prenatal diagnosis and future screening of CF in Iran. Although ΔF508 is the most common mutation in other populations including Caucasian, this mutation seem not to have an important role in Iranian CF patients. Findings suggest that a different approach in molecular genetics diagnostic strategies in Middle Eastern countries including Iran should be considered.

Hardware image assessment for wireless endoscopy capsules

Wireless capsule endoscopy is a new technology in the realm of telemedicine that has many advantages over the traditional endoscopy systems. Transmitted images should help diagnosis of diseases of the gastrointestinal tract. Two important technical challenges for the manufacturers of these capsules are power consumption and size of the circuitry. Also, the system must be fast enough for real-time processing of image or video data. To solve this problem, many hardware designs have been proposed for implementation of the image processing unit. In this paper we propose an architecture that could be used for the assessment of endoscopy images. The assessment allows avoidance of transmission of medically useless images. Hence, volume of data is reduced for more efficient transmission of images by the endoscopy capsule. This is done by color space conversion and moment calculation of images captured by the capsule. The inputs of the proposed architecture are RGB image frames and the outputs are images with converted colors and calculated image moments. Experimental results indicate that the proposed architecture has low complexity and is appropriate for a real-time application.

Vessel extraction in X-ray angiograms using deep learning

Coronary artery disease (CAD) is the most common type of heart disease which is the leading cause of death all over the world. X-ray angiography is currently the gold standard imaging technique for CAD diagnosis. These images usually suffer from low quality and presence of noise. Therefore, vessel enhancement and vessel segmentation play important roles in CAD diagnosis. In this paper a deep learning approach using convolutional neural networks (CNN) is proposed for detecting vessel regions in angiography images. Initially, an input angiogram is preprocessed to enhance its contrast. Afterward, the image is evaluated using patches of pixels and the network determines the vessel and background regions. A set of 1,040,000 patches is used in order to train the deep CNN. Experimental results on angiography images of a dataset show that our proposed method has a superior performance in extraction of vessel regions.

Robust watermarking in non-ROI of medical images based on DCT-DWT

Increasing demand and utilization of telemedicine require transmission of medical information and images over internet. Since authenticity of received images is crucial and patient's information should be included with minimum changes in images, robust watermarking schemes are needed. In this paper, we propose a robust watermark method that embeds patient's information outside the region of interest (ROI) in medical image. In order to find appropriate regions for embedding, we use saliency as a means of measuring importance of regions and find blocks having minimum overlap with the ROI. The algorithm employs wavelet transform and also discrete cosine transform (DCT) domains in the embedding stage and redundantly embeds watermark to increase robustness against possible alterations. Moreover, voting is utilized in the extraction phase. Experimental results show the efficiency of the proposed method and better results are obtained as compared to comparable methods with same size of the watermarked data.

Robust catheter identification and tracking in X-ray angiographic sequences

Coronary artery disease (CAD) is one of the major causes of death worldwide. Today X-ray angiography is a standard method for CAD diagnosis. Usually, the quality of these images is not good enough. Noise, camera and heart motions, non-uniform illumination and even the presence of catheter are sources of quality degradation. The existence of catheter can produce difficulties in vessel extraction methods because catheter is structurally similar to arteries. In this paper we propose a fully automatic method for catheter detection and tracking during the whole angiography sequence. In this method with a vesselness map, we smooth each frame using guided filter. The catheter is detected in the first frame using Hough transform. We then fit a second order polynomial on the catheter and accurately track it throughout the sequence. Our method is tested on 25 X-ray angiography sequences where a precision of 0.9597 is achieved.

Automatic segmentation of multimodal brain tumor images based on classification of super-voxels

Despite the rapid growth in brain tumor segmentation approaches, there are still many challenges in this field. Automatic segmentation of brain images has a critical role in decreasing the burden of manual labeling and increasing robustness of brain tumor diagnosis. We consider segmentation of glioma tumors, which have a wide variation in size, shape and appearance properties. In this paper images are enhanced and normalized to same scale in a preprocessing step. The enhanced images are then segmented based on their intensities using 3D super-voxels. Usually in images a tumor region can be regarded as a salient object. Inspired by this observation, we propose a new feature which uses a saliency detection algorithm. An edge-aware filtering technique is employed to align edges of the original image to the saliency map which enhances the boundaries of the tumor. Then, for classification of tumors in brain images, a set of robust texture features are extracted from super-voxels. Experimental results indicate that our proposed method outperforms a comparable state-of-the-art algorithm in term of dice score.

Automatic detection of melanoma using broad extraction of features from digital images

Automatic and reliable diagnosis of skin cancer, as a smartphone application, is of great interest. Among different types of skin cancers, melanoma is the most dangerous one which causes most deaths. Meanwhile, melanoma is curable if it were diagnosed in its early stages. In this paper we propose an efficient system for prescreening of pigmented skin lesions for malignancy using general-purpose digital cameras. These images can be captured by a smartphone or a digital camera. This could be beneficial in different applications, such as computer aided diagnosis and telemedicine applications. It could assist dermatologists, or smartphone users, evaluate risk of suspicious moles. The proposed method enhances borders and extracts a broad set of dermatologically important features. These discriminative features allow classification of lesions into two groups of melanoma and benign. This method is computationally appropriate as a smartphone application. Experimental results show that our proposed method is superior in diagnosis accuracy compared to state-of-the-art methods.

Melanoma detection by analysis of clinical images using convolutional neural network

Melanoma, most threatening type of skin cancer, is on the rise. In this paper an implementation of a deep-learning system on a computer server, equipped with graphic processing unit (GPU), is proposed for detection of melanoma lesions. Clinical (non-dermoscopic) images are used in the proposed system, which could assist a dermatologist in early diagnosis of this type of skin cancer. In the proposed system, input clinical images, which could contain illumination and noise effects, are preprocessed in order to reduce such artifacts. Afterward, the enhanced images are fed to a pre-trained convolutional neural network (CNN) which is a member of deep learning models. The CNN classifier, which is trained by large number of training samples, distinguishes between melanoma and benign cases. Experimental results show that the proposed method is superior in terms of diagnostic accuracy in comparison with the state-of-the-art methods.

The Value of miR-299-5p in Diagnosis and Prognosis of Intestinal-Type Gastric Adenocarcinoma

MicroRNAs (miRNAs) are a class of non-coding RNAs, containing about 22 nucleotides and having a pivotal function in various cellular processes. The oncogenic and tumor suppressor roles of miRNAs have been identified in cancers especially in gastric cancer, which is one of the most prevalent cancers. MiR-299-5p is located in the imprinted Dlk1-Dio3 region in chromosome 14q32. Aberrant expression of miR-299-5p was determined in solid and blood cancers. The current study was performed to assess the expression pattern of miR-299-5p in intestinal-type gastric adenocarcinoma and compare it with the normal adjacent counterparts. The expression level of miR-299-5p was investigated in forty fresh specimens which were obtained from gastric cancer patients during endoscopy. Moreover, the association of aberrant expression of miR-299-5p and clinicopathological features, as well as the susceptibility of miR-299-5p as a tumor marker, was determined. The result of qRT-PCR revealed the downregulation of miR-299-5p in intestinal-type gastric adenocarcinoma compared with adjacent tumor-free tissues (P < 0.001); this misregulation can be used as a tumor marker. Analysis of miR-299-5p misregulation did not reveal a significant correlation with clinical features. The result obtained from the present study revealed the significant downregulation of miR-299-5p in intestinal-type gastric adenocarcinoma which is consistent with previous studies showing miR-299-5p downregulation in other types of cancers. The data obtained from the current study suggest basic information which can be very helpful for future research in the field of diagnosis and treatment of gastric cancer.

Region of interest extraction for lossless compression of bone X-ray images

For few decades digital X-ray imaging has been one of the most important tools for medical diagnosis. With the advent of distance medicine and the use of big data in this respect, the need for efficient storage and online transmission of these images is becoming an essential feature. Limited storage space and limited transmission bandwidth are the main challenges. Efficient image compression methods are lossy while the information of medical images should be preserved with no change. Hence, lossless compression methods are necessary for this purpose. In this paper, a novel method has been proposed to eliminate the non-ROI data from bone X-ray images. Background pixels do not contain any valuable medical information. The proposed method is based on the histogram dispersion method. ROI is separated from the background and it is compressed with a lossless compression method to preserve medical information of the image. Compression ratios of the implemented results show that the proposed algorithm is capable of effective reduction of the statistical and spatial redundancies.

Adaptive stereo medical image watermarking using non-corresponding blocks

Today with the advent of technology in different medical imaging fields, the use of stereoscopic images has increased. Furthermore, with the rapid growth in telemedicine for remote diagnosis, treatment, and surgery, there is a need for watermarking. This is for copyright protection and tracking of digital media. Also, the efficient use of bandwidth for transmission of such data is another concern. In this paper an adaptive watermarking scheme is proposed that considers human visual system in depth perception. Our proposed scheme modifies maximum singular values of wavelet coefficients of stereo pair for embedding watermark bits. Experimental results show high 3D visual quality of watermarked video frames. Moreover, comparison with a compatible state of the art method shows that the proposed method is highly robust against attacks such as AWGN, salt and pepper noise, and JPEG compression.

Mutation analysis of the CYP21A2 gene in congenital adrenal hyperplasia

Congenital adrenal hyperplasia (CAH) is an inherited autosomal recessive enzymatic disorder involving the synthesis of adrenal corticosteroids. 21-Hydroxylase deficiency (21-OHD) is the most common form of the disease which is observed in more than 90% of patients with CAH. Early identification of mutations in the genes involved in this disease is critical. A marker of the disease, errors in the CYP21A2 gene, is thought to be part of the pathophysiology of CAH. Therefore, the identification of gene mutations would be very beneficial in the early detection of CAH. This research was a descriptive epidemiological study conducted on individuals elected by the inclusion criteria whom were referred to the Genetic Diagnosis Center of Tabriz during 2012 to 2013. After sampling and DNA extraction, PCR for the detection of mutations in the CYP21A2 gene was performed followed by sequencing. For data analysis, the results of sequencing were compared with the reference gene by blast, Gene Runner and MEGA-5 software. Obtained changes were compared with NCBI databases. The analysis of the sequencing determined the mutations located in Exons 6, 7, 8 and 10. The most frequent findings were Q318X (53%) and R356W (28%). Exon 6 cluster (7%), E431k (4%), V237E (2%), V281L (2%), E351K (2%), R426C (2%) were also frequent in our patients. The most frequent genotype was compound heterozygote, Q318X/R356W. Three rare mutations in our study were E431K, E351K and R426C. Observed mutation frequencies in this study were much higher than those reported in previous studies in Iranian populations. Thus, it seems that it is necessary to follow-up screening programs and use sequencing methods to better identify mutations in the development of the disease.

Effects of hydrostatic pressure on mouse sperm

OBJECTIVES

The objective of this study was to investigate the abnormalities in sperm after exposure to hydrostatic pressure.

BACKGROUND

Hydrostatic pressure acting on the cells is one of the fundamental environmental mechanical forces. Disorders of relationship between the cells and this mechanical force, such as when pressure varies beyond physiological limits, can lead to disease or pathological states. Sperm exposed to different range of hydrostatic pressure within male reproductive system and after entering the female reproductive system.

METHODS

Sexually mature male NMRI mice, 8-12 weeks-old were sperm donors. Sperms were separated from the caudal epididymis and maintained in Ham's F-10 culture medium supplemented with 10 % FBS and divided into control and treatments. Sperm suspensions in the treatments were placed within pressure chamber and were subjected to increased hydrostatic pressure of 25, 50 and 100 mmHg (treatment I, II and III) above atmospheric pressure for 2 and 4 h. Sperm viability, motility, morphology, DNA integrity and fertilizing ability were assessed and compared with control.

RESULTS

Results showed that hydrostatic pressure dependent on ranges and time manner reduced sperm quality due to adverse effect on viability, motility , morphology, DNA integrity and fertilizing ability in all of treatments, especially after 4h (p<0.05).

CONCLUSION

Our data revealed hydrostatic pressure reduces sperm quality as a consequence of adverse effects on sperm parameters and may cause male infertility or subfertility (Tab. 5, Ref. 5).

Talking about STD/HIV prevention: a look at communication online

Little is known about the quality and usability of online health information. This analysis evaluated STD prevention websites' content quality and usability. Thirty-six sites were analyzed to determine their adherence to established sexual health guidelines and their accessibility, usability, credibility and currency. The objective of this study was to determine what communication skills are available to teenagers through STD prevention websites. Only two (6%) addressed safe sex negotiation; seven (19%) addressed basic communication skills; and slightly more than half (53%) addressed at least one sexual decision-making message. Most sites displayed consistent template design and two-thirds had working hyperlinks. But few (19%) of the sites offered a site map, while only one-third (36%) provided an internal search engine. These results indicate that health educators need to include tips on how to negotiate safe sex and improve interactive design features when creating STD websites for teenagers.

Abnormal cervical cytology leading to the diagnosis of gastric cancer

There have been nine cases reported in the English literature in which the finding of malignant cells on cervical/vaginal cytology led to the diagnosis of primary gastric cancer. We report on a patient with gastric carcinoma, metastatic to the cervix, in which the diagnosis was suspected by the finding of signet ring cells on a Papanicolaou smear of the cervix. Prior to treatment of this patient, concordance of signet ring carcinoma on cervical and ascitic fluid cytology and on cervical and gastric biopsies was documented; this has not been reported previously. Thirty-four additional cases of gastric carcinoma metastatic to the cervix are reviewed. This paper is presented to remind the clinician that, however rare, metastases from the gastrointestinal tract to the uterine cervix do occur.