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1.
Toxins (Basel) ; 8(9)2016 09 13.
Artículo en Inglés | MEDLINE | ID: mdl-27649244

RESUMEN

The aim of this work was to organize the first proficiency test (PT) dedicated to staphylococcal enterotoxin B (SEB) detection in milk and buffer solutions. This paper describes the organization of the PT trial according to EN ISO 17043 requirements. Characterization of the SEB stock solution was performed using SDS-PAGE and SE-specific ELISA, and amino acid analysis was used to assign its protein concentration. The solution was then used to prepare six PT materials (four milk and two buffer batches) at a ng/g toxin level, which included one blank and one SEA-containing milk as specificity control. Suitable material homogeneity and stability were assessed using screening and quantitative ELISAs. Among the methods used by the participants, ELISA-based methods demonstrated their efficiency for the detection of SEB in both simple and complex matrices. The results serve as a basis for further improving the detection capabilities in expert laboratories and can therefore be considered as a contribution to biopreparedness.


Asunto(s)
Tampones (Química) , Técnicas de Laboratorio Clínico/normas , Enterotoxinas/análisis , Ensayo de Inmunoadsorción Enzimática/normas , Microbiología de Alimentos/normas , Ensayos de Aptitud de Laboratorios , Leche/microbiología , Animales , Calibración , Unión Europea , Estándares de Referencia , Reproducibilidad de los Resultados
2.
Anal Bioanal Chem ; 408(20): 5457-65, 2016 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-27220526

RESUMEN

Staphylococcal enterotoxins (SEs) account for a substantial number of food-poisoning outbreaks. European legislation (Commission Regulation 1441/2007) stipulates the reference procedure for SE analysis in milk and dairy products, which is based on extraction, dialysis concentration and immunochemical detection using one of two approved assays (VIDAS(®) SET2, Ridascreen(®) SET Total). However, certified reference materials (CRMs) are lacking to support laboratories in performing reliable detection of Staphylococcus aureus enterotoxin A (SEA) in relevant matrices at sub-nanogram per gram levels. The certification of a set of three reference materials (blank and two SEA-containing materials) for testing of the presence/absence of SEA in cheese is described. The reference procedure was applied in an intercomparison with 15 laboratories, and results were reported in a qualitative manner (presence or absence of SEA in the sample). No false-negative or false-positive results were obtained. The certified values were stated as diagnostic specificity (blank material) or diagnostic sensitivity (SEA-containing materials) and were 100 % in all cases. Stability studies demonstrated suitable material stability when stored cooled or frozen. An in-house study on the recovery of SEA in the cheese materials using a double-sandwich enzyme-linked immunosorbent assay (ELISA) revealed comparable recovery values of around 45 % at the two spiking levels and in both the SEA-containing CRMs as well as blank CRM freshly spiked prior to analysis. The values were also comparable over time and among different analysts. The materials provide valuable support to laboratories for method validation and method performance verification and will increase the reliability of measuring SEA in cheese.


Asunto(s)
Queso/microbiología , Enterotoxinas/análisis , Enterotoxinas/normas , Análisis de los Alimentos/normas , Contaminación de Alimentos/análisis , Staphylococcus aureus/metabolismo , Certificación , Europa (Continente) , Valores de Referencia , Reproducibilidad de los Resultados , Sensibilidad y Especificidad
3.
Toxins (Basel) ; 7(12): 4935-66, 2015 Nov 26.
Artículo en Inglés | MEDLINE | ID: mdl-26703724

RESUMEN

In the framework of the EU project EQuATox, a first international proficiency test (PT) on the detection and quantification of botulinum neurotoxins (BoNT) was conducted. Sample materials included BoNT serotypes A, B and E spiked into buffer, milk, meat extract and serum. Different methods were applied by the participants combining different principles of detection, identification and quantification. Based on qualitative assays, 95% of all results reported were correct. Successful strategies for BoNT detection were based on a combination of complementary immunological, MS-based and functional methods or on suitable functional in vivo/in vitro approaches (mouse bioassay, hemidiaphragm assay and Endopep-MS assay). Quantification of BoNT/A, BoNT/B and BoNT/E was performed by 48% of participating laboratories. It turned out that precise quantification of BoNT was difficult, resulting in a substantial scatter of quantitative data. This was especially true for results obtained by the mouse bioassay which is currently considered as "gold standard" for BoNT detection. The results clearly demonstrate the urgent need for certified BoNT reference materials and the development of methods replacing animal testing. In this context, the BoNT PT provided the valuable information that both the Endopep-MS assay and the hemidiaphragm assay delivered quantitative results superior to the mouse bioassay.


Asunto(s)
Toxinas Botulínicas Tipo A/análisis , Toxinas Botulínicas/análisis , Neurotoxinas/análisis , Animales , Toxinas Botulínicas/toxicidad , Toxinas Botulínicas Tipo A/toxicidad , Tampones (Química) , Contaminación de Alimentos/análisis , Humanos , Ensayos de Aptitud de Laboratorios , Dosificación Letal Mediana , Carne/análisis , Ratones , Leche/química , Neurotoxinas/toxicidad , Suero/química , Albúmina Sérica Bovina/química
4.
Toxins (Basel) ; 7(12): 4987-5010, 2015 Nov 26.
Artículo en Inglés | MEDLINE | ID: mdl-26703726

RESUMEN

While natural intoxications with seeds of Ricinus communis (R. communis) have long been known, the toxic protein ricin contained in the seeds is of major concern since it attracts attention of those intending criminal, terroristic and military misuse. In order to harmonize detection capabilities in expert laboratories, an international proficiency test was organized that aimed at identifying good analytical practices (qualitative measurements) and determining a consensus concentration on a highly pure ricin reference material (quantitative measurements). Sample materials included highly pure ricin as well as the related R. communis agglutinin (RCA120) spiked into buffer, milk and meat extract; additionally, an organic fertilizer naturally contaminated with R. communis shred was investigated in the proficiency test. The qualitative results showed that either a suitable combination of immunological, mass spectrometry (MS)-based and functional approaches or sophisticated MS-based approaches alone successfully allowed the detection and identification of ricin in all samples. In terms of quantification, it was possible to determine a consensus concentration of the highly pure ricin reference material. The results provide a basis for further steps in quality assurance and improve biopreparedness in expert laboratories worldwide.


Asunto(s)
Lectinas de Plantas/análisis , Ricina/análisis , Animales , Tampones (Química) , Ensayo de Inmunoadsorción Enzimática , Fertilizantes/análisis , Ensayos de Aptitud de Laboratorios , Carne/análisis , Leche/química , Lectinas de Plantas/inmunología , Lectinas de Plantas/toxicidad , Ricina/inmunología , Ricina/toxicidad , Albúmina Sérica Bovina/química
5.
Toxins (Basel) ; 7(12): 4906-34, 2015 Nov 26.
Artículo en Inglés | MEDLINE | ID: mdl-26703723

RESUMEN

Ricinus communis intoxications have been known for centuries and were attributed to the toxic protein ricin. Due to its toxicity, availability, ease of preparation, and the lack of medical countermeasures, ricin attracted interest as a potential biological warfare agent. While different technologies for ricin analysis have been established, hardly any universally agreed-upon "gold standards" are available. Expert laboratories currently use differently purified in-house materials, making any comparison of accuracy and sensitivity of different methods nearly impossible. Technically challenging is the discrimination of ricin from R. communis agglutinin (RCA120), a less toxic but highly homologous protein also contained in R. communis. Here, we established both highly pure ricin and RCA120 reference materials which were extensively characterized by gel electrophoresis, liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI MS/MS), and matrix-assisted laser desorption ionization-time of flight approaches as well as immunological and functional techniques. Purity reached >97% for ricin and >99% for RCA120. Different isoforms of ricin and RCA120 were identified unambiguously and distinguished by LC-ESI MS/MS. In terms of function, a real-time cytotoxicity assay showed that ricin is approximately 300-fold more toxic than RCA120. The highly pure ricin and RCA120 reference materials were used to conduct an international proficiency test.


Asunto(s)
Lectinas de Plantas/análisis , Ricina/análisis , Secuencia de Aminoácidos , Animales , Anticuerpos/inmunología , Ricinus communis , Supervivencia Celular/efectos de los fármacos , Chlorocebus aethiops , Cromatografía Liquida , Ensayo de Inmunoadsorción Enzimática , Ensayos de Aptitud de Laboratorios/normas , Lectinas de Plantas/química , Lectinas de Plantas/inmunología , Lectinas de Plantas/toxicidad , Estándares de Referencia , Ricina/química , Ricina/inmunología , Ricina/toxicidad , Semillas/química , Espectrometría de Masa por Ionización de Electrospray , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción , Espectrometría de Masas en Tándem , Células Vero
6.
Toxins (Basel) ; 7(12): 5035-54, 2015 Nov 26.
Artículo en Inglés | MEDLINE | ID: mdl-26703728

RESUMEN

The detection and identification of botulinum neurotoxins (BoNT) is complex due to the existence of seven serotypes, derived mosaic toxins and more than 40 subtypes. Expert laboratories currently use different technical approaches to detect, identify and quantify BoNT, but due to the lack of (certified) reference materials, analytical results can hardly be compared. In this study, the six BoNT/A1-F1 prototypes were successfully produced by recombinant techniques, facilitating handling, as well as improving purity, yield, reproducibility and biosafety. All six BoNTs were quantitatively nicked into active di-chain toxins linked by a disulfide bridge. The materials were thoroughly characterized with respect to purity, identity, protein concentration, catalytic and biological activities. For BoNT/A1, B1 and E1, serotypes pathogenic to humans, the catalytic activity and the precise protein concentration were determined by Endopep-mass spectrometry and validated amino acid analysis, respectively. In addition, BoNT/A1, B1, E1 and F1 were successfully detected by immunological assays, unambiguously identified by mass spectrometric-based methods, and their specific activities were assigned by the mouse LD50 bioassay. The potencies of all six BoNT/A1-F1 were quantified by the ex vivo mouse phrenic nerve hemidiaphragm assay, allowing a direct comparison. In conclusion, highly pure recombinant BoNT reference materials were produced, thoroughly characterized and employed as spiking material in a worldwide BoNT proficiency test organized by the EQuATox consortium.


Asunto(s)
Toxinas Botulínicas/análisis , Neurotoxinas/análisis , Animales , Toxinas Botulínicas/química , Toxinas Botulínicas/toxicidad , Femenino , Ensayos de Aptitud de Laboratorios/normas , Dosificación Letal Mediana , Ratones , Neurotoxinas/química , Neurotoxinas/toxicidad , Nervio Frénico/efectos de los fármacos , Nervio Frénico/fisiología , Proteínas Recombinantes/análisis , Proteínas Recombinantes/química , Proteínas Recombinantes/toxicidad , Estándares de Referencia , Proteínas SNARE/química
7.
J Pharm Sci ; 103(7): 2088-2097, 2014 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-24902839

RESUMEN

Coupling an infrared (IR) camera to a freeze dryer for on-line monitoring of freeze-drying cycles is described for the first time. Normally, product temperature is measured using a few invasive Pt-100 probes, resulting in poor spatial resolution. To overcome this, an IR camera was placed on a process-scale freeze dryer. Imaging took place every 120 s through a Germanium window comprising 30,000 measurement points obtained contact-free from -40 °C to 25 °C. Results are presented for an empty system, bulk drying of cheese slurry, and drying of 1 mL human serum in 150 vials. During freezing of the empty system, differences of more than 5 °C were measured on the shelf. Adding a tray to the empty system, a difference of more than 8 °C was observed. These temperature differences probably cause different ice structures affecting the drying speed during sublimation. A temperature difference of maximum 13 °C was observed in bulk mode during sublimation. When drying in vials, differences of more than 10 °C were observed. Gradually, the large temperature differences disappeared during secondary drying and products were transformed into uniformly dry cakes. The experimental data show that the IR camera is a highly versatile on-line monitoring tool for different kinds of freeze-drying processes.


Asunto(s)
Diseño de Equipo , Liofilización , Rayos Infrarrojos , Termografía , Queso/análisis , Pruebas de Química Clínica/instrumentación , Pruebas de Química Clínica/métodos , Industria de Alimentos/instrumentación , Industria de Alimentos/métodos , Liofilización/instrumentación , Liofilización/métodos , Humanos , Suero/química , Termografía/instrumentación , Termografía/métodos
8.
Food Chem ; 132(1): 567-73, 2012 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-26434333

RESUMEN

The feasibility for producing a matrix reference material for selected pesticides in a carrot/potato matrix was investigated. A commercially available baby food (carrot/potato-based mash) was spiked with 11 pesticides at the respective EU maximum residue limits (MRLs), and further processed by either freezing or freeze-drying. Batches of some 150 units were produced per material type. First, the materials were assessed for the relative amount of pesticide recovered after processing (ratio of pesticide concentration in the processed material to the initially spiked pesticide concentration). In addition, the materials' homogeneity (bottle-to-bottle variation), and the short-term (1 month) and mid-term (5 months) stability at different temperatures were assessed. For this, an in-house validated GC-EI-MS method operated in the SIM mode with a sample preparation procedure based on the QuEChERS ("quick, easy, cheap, effective, rugged, and safe") principle was applied. Measurements on the frozen material provided the most promising results (smallest analyte losses during production), and also freeze-drying proved to be a suitable alternative processing technique for most of the investigated pesticides. Both the frozen and the freeze-dried material showed to be sufficiently homogeneous for the intended use, and storage at -20°C for 5 months did not reveal any detectable material degradation. The results constitute an important step towards the development of a pesticide matrix reference material.


Asunto(s)
Daucus carota/química , Plaguicidas/química , Solanum tuberosum/química , Estudios de Factibilidad , Cromatografía de Gases y Espectrometría de Masas/métodos , Plaguicidas/análisis
9.
Anal Bioanal Chem ; 398(3): 1457-65, 2010 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-20665007

RESUMEN

Chloramphenicol (CAP), an effective antibiotic against many microorganisms, is meanwhile banned in the EU for treatment of food-producing animals due to adverse health effects. The Institute for Reference Materials and Measurements (IRMM) is currently developing a certified reference material (CRM) for CAP in pork, intended for validation and method performance verifications of analytical methods. The material will be certified using liquid chromatography-tandem mass spectrometry (LC-MS/MS) and gas chromatography-mass spectrometry (GC-MS) methods and has a target CAP level around the minimum required performance limit (MRPL) of 0.3 microg/kg. To prove that the material can be applied as a quality control tool for screening methods, a commutability study was conducted, involving five commercially available enzyme-linked immunosorbent assay kits and one biosensor assay (BiaCore kit). Meat homogenates (cryo-milled wet tissue) with CAP concentrations around the MRPL and the candidate CRM (lyophilised powder) were measured by LC-MS/MS and GC-MS as well as the six screening methods. Pairwise method comparisons of results obtained for the two sample types showed that the CRM can successfully be applied as quality control (QC) sample to all six screening methods. The study suggests that ERM-BB130 is sufficiently commutable with the investigated assays and that laboratories applying one of the investigated kits therefore benefit from using ERM-BB130 to demonstrate the correctness of their results. However, differences among the assays were observed, either in the abundance of bias between screening and confirmatory LC and GC methods, the repeatability of test results, or goodness of fit between the methods.


Asunto(s)
Cloranfenicol/análisis , Productos de la Carne/análisis , Animales , Técnicas Biosensibles , Cromatografía Liquida , Ensayo de Inmunoadsorción Enzimática , Cromatografía de Gases y Espectrometría de Masas , Límite de Detección , Estándares de Referencia , Porcinos , Espectrometría de Masas en Tándem
10.
J Chromatogr A ; 1216(2): 249-56, 2009 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-19084841

RESUMEN

A liquid chromatography-electrospray ionisation tandem mass spectrometry method for the simultaneous detection and quantitation of 5-nitroimidazole veterinary drugs in lyophilised pork meat, the chosen format of a candidate certified reference material, has been developed and validated. Six analytes have been included in the scope of validation, i.e. dimetridazole (DMZ), metronidazole (MNZ), ronidazole (RNZ), hydroxymetronidazole (MNZOH), hydroxyipronidazole (IPZOH), and 2-hydroxymethyl-1-methyl-5-nitroimidazole (HMMNI). The analytes were extracted from the sample with ethyl acetate, chromatographically separated on a C(18) column, and finally identified and quantified by tandem mass spectrometry in the multiple reaction monitoring mode (MRM) using matrix-matched calibration and (2)H(3)-labelled analogues of the analytes (except for MNZOH, where [(2)H(3)]MNZ was used). The method was validated in accordance with Commission Decision 2002/657/EC, by determining selectivity, linearity, matrix effect, apparent recovery, repeatability and intermediate precision, decision limits and detection capabilities, robustness of sample preparation method, and stability of extracts. Recovery at 1 microg/kg level was at 100% (estimates in the range of 101-107%) for all analytes, repeatabilities and intermediate precisions at this level were in the range of 4-12% and 2-9%, respectively. Linearity of calibration curves in the working range 0.5-10 microg/kg was confirmed, with r values typically >0.99. Decision limits (CCalpha) and detection capabilities (CCbeta) according to ISO 11843-2 (calibration curve approach) were 0.29-0.44 and 0.36-0.54 microg/kg, respectively. The method reliably identifies and quantifies the selected nitroimidazoles in the reconstituted pork meat in the low and sub-microg/kg range and will be applied in an interlaboratory comparison for determining the mass fraction of the selected nitroimidazoles in the candidate reference material currently developed at IRMM.


Asunto(s)
Cromatografía Liquida/métodos , Carne/análisis , Nitroimidazoles/análisis , Espectrometría de Masas en Tándem/métodos , Drogas Veterinarias/análisis , Animales , Estabilidad de Medicamentos , Análisis de los Alimentos , Liofilización , Modelos Lineales , Modelos Químicos , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Porcinos
11.
Rapid Commun Mass Spectrom ; 21(10): 1555-60, 2007.
Artículo en Inglés | MEDLINE | ID: mdl-17428013

RESUMEN

Tetramethylurea (TMU) with a certified D/H ratio is the internal standard for Site-specific Natural Isotope Fractionation measured by Nuclear Magnetic Resonance (SNIF-NMR) analysis of wine ethanol for detection of possible adulterations (Commission Regulation 2676/90). A new batch of a TMU certified reference material (CRM) is currently being prepared. Whereas SNIF-NMR has been employed up to now, Elemental Analysis/Isotope Ratio Mass Spectrometry ((2)H-EA-IRMS) was envisaged as the method of choice for value assignment of the new CRM, as more precise (better repeatable) data might be obtained, resulting in lower uncertainty of the certified value. In order to evaluate the accuracy and intra- and inter-laboratory reproducibility of (2)H-EA-IRMS methods, a laboratory inter-comparison was carried out by analysing TMU and other organic compounds, as well as some waters. The results revealed that experienced laboratories are capable of generating robust and well comparable data, which highlights the emerging potential of IRMS in food authenticity testing. However, a systematic bias between IRMS and SNIF-NMR reference data was observed for TMU; this lack of data consistency rules out the (2)H-IRMS technique for the characterisation measurement of the new TMU CRM.


Asunto(s)
Deuterio/análisis , Hidrógeno/análisis , Compuestos de Metilurea/análisis , Calibración , Cápsulas , Etanol , Espectroscopía de Resonancia Magnética , Isótopos de Oxígeno , Radioisótopos de Oxígeno , Reproducibilidad de los Resultados , Solventes , Agua/análisis
12.
Phytochemistry ; 67(7): 641-8, 2006 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-16516937

RESUMEN

Our work with almond peptide N-glycosidase A made us interested also in the alpha1,3/4-fucosidase which is used as a specific reagent for glycoconjugate analysis. The enzyme was purified to presumed homogeneity by a series of chromatographic steps including dye affinity and fast-performance anion exchange chromatography. The 63 kDa band was analyzed by tandem mass spectrometry which yielded several partial sequences. A homology search retrieved the hypothetical protein Q8GW72 from Arabidopsis thaliana. This protein has recently been described as being specific for alpha1,2-linkages. However, cDNA cloning and expression in Pichia pastoris of the A. thaliana fucosidase showed that it hydrolyzed fucose in 3- and 4-linkage to GlcNAc in Lewis determinants whereas neither 2-linked fucose nor fucose in 3-linkage to the innermost GlcNAc residue were attacked. This first cloning of a plant alpha1,3/4-fucosidase also confirmed the identity of the purified almond enzyme and thus settles the notorious uncertainty about its molecular mass. The alpha1,3/4-fucosidase from Arabidopsis exhibited striking sequence similarity with an enzyme of similar substrate specificity from Streptomyces sp. (Q9Z4I9) and with putative proteins from rice.


Asunto(s)
Prunus/enzimología , alfa-L-Fucosidasa/genética , alfa-L-Fucosidasa/metabolismo , Acetilglucosamina/metabolismo , Arabidopsis/enzimología , Secuencia de Carbohidratos , Clonación Molecular , ADN Complementario/análisis , Fucosa/metabolismo , Hidrólisis , Antígenos del Grupo Sanguíneo de Lewis/metabolismo , Datos de Secuencia Molecular , Peso Molecular , Oryza/enzimología , Pichia/enzimología , Alineación de Secuencia , Espectrometría de Masa por Ionización de Electrospray , Streptomyces/enzimología , Especificidad por Sustrato , alfa-L-Fucosidasa/aislamiento & purificación
13.
Planta ; 224(1): 222-7, 2006 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-16395581

RESUMEN

The long held but challenged view that plants do not synthesize sialic acids was re-evaluated using two different procedures to isolate putative sialic acid containing material from plant tissues and cells. The extracts were reacted with 1,2-diamino-4,5-methylene dioxybenzene and the fluorescently labelled 2-keto sugar acids analysed by reversed phase and normal phase HPLC and by HPLC-electrospray tandem mass spectrometry. No N-glycolylneuraminic acid was found in the protein fraction from Arabidopsis thaliana MM2d cells. However, we did detect 3-deoxy-D: -manno-octulosonic acid and trace amounts (3-18 pmol/g fresh weight) of a compound indistinguishable from N-acetylneuraminic acid by its retention time and its mass spectral fragmentation pattern. Thus, plant cells and tissues contain five orders of magnitude less sialic acid than mammalian tissues such as porcine liver. Similar or lower amounts of N-acetylneuraminic acid were detected in tobacco cells, mung bean sprouts, apple and banana. Yet even yeast and buffer blanks, when subjected to the same isolation procedures, apparently contained the equivalent of 5 pmol of sialic acid per gram of material. Thus, we conclude that it is not possible to demonstrate unequivocally that plants synthesize sialic acids because the amounts of these sugars detected in plant cells and tissues are so small that they may originate from extraneous contaminants.


Asunto(s)
Arabidopsis/metabolismo , Ácido N-Acetilneuramínico/análisis , Ácidos Neuramínicos/análisis , Azúcares Ácidos/análisis , Animales , Bovinos , Cromatografía Líquida de Alta Presión , Hígado/química , Espectrometría de Masas , Ácido N-Acetilneuramínico/aislamiento & purificación , Fenilendiaminas/análisis , Extractos Vegetales/química , Azúcares Ácidos/aislamiento & purificación , Porcinos/metabolismo
14.
J Agric Food Chem ; 50(15): 4169-75, 2002 Jul 17.
Artículo en Inglés | MEDLINE | ID: mdl-12105941

RESUMEN

Analysis of the sex of beef meat by fast and reliable molecular methods is an important measure to ensure correct allocation of export refunds, which are considerably higher for male beef meat. Two PCR-based beef sexing methods have been optimized and evaluated. The amelogenin-type method revealed excellent accuracy and robustness, whereas the bovine satellite/Y-chromosome duplex PCR procedure showed more ambiguous results. In addition, an interlaboratory comparison was organized to evaluate currently applied PCR-based sexing methods in European customs laboratories. From a total of 375 samples sent out, only 1 false result was reported (female identified as male). However, differences in the performances of the applied methods became apparent. The collected data contribute to specify technical requirements for a common European beef sexing methodology based on PCR.


Asunto(s)
Bovinos , Carne , Análisis para Determinación del Sexo , Amelogenina , Animales , ADN/análisis , Proteínas del Esmalte Dental , Electroforesis Capilar , Femenino , Masculino , Reacción en Cadena de la Polimerasa , Sensibilidad y Especificidad , Cromosoma Y
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