Epidemiology, oncologic results and risk stratification model for metachronous peritoneal metastases after surgery for pT4 colon cancers: results from an observational retrospective multicentre long-term follow-up study.

PURPOSE: Metachronous peritoneal metastases (MPM) following a curative surgery procedure for pT4 colon cancer is a challenging condition. Current epidemiological studies on this topic are scarce. METHODS: A retrospective multicentre trial was designed. All consecutive patients who underwent operations to treat pT4 cancers between 2015 and 2017 were reviewed. Demographic, clinical, operative, pathological and oncological follow-up variables were included. MPM were described as any oncological disease at the peritoneum, clearly different from a local recurrence. Univariate and multivariate Cox regression models were constructed. A risk stratification model was created on a cumulative factor basis. According to the calculated hazard ratio (HR), a scoring system was designed (HR < 3, 1 point; HR > 3, 2 points) and a scale from 0 to 6 was calculated for peritoneal disease-free rate (PDF-R). A risk stratification model was also created on the basis of these calculations. RESULTS: Fifty different hospitals were involved, which included a total of 1356 patients. Incidence of MPM was 13.6% at 50 months median follow-up. The strongest independent risk factors for MPM were positive pN stage [HR 3.72 (95% CI 2.56-5.41; p < 0.01) for stage III disease], tumour perforation [HR 1.91 (95% CI 1.26-2.87; p < 0.01)], mucinous or signet ring cell histology [HR 1.68 (95% CI 1.1-2.58; p = 0.02)], poorly differentiated tumours [HR 1.54 (95% CI 1.1-2.2; p = 0.02)] and emergency surgery [HR 1.42 (95% CI 1.01-2.01; p = 0.049)]. In the absence of additional risk factors, pT4 tumours showed 98% and 96% PDF-R in 1-year and 5-year periods based on Kaplan-Meier curves. CONCLUSIONS: Cumulative MPM incidence was 13.6% at 5-year follow-up. The sole presence of a pT4 tumour resulted in high rates of PDF-R at 1-year and 5-year follow-up (98% and 96% respectively). Five additional risk factors different from pT4 status itself were identified as possible MPM indicators during follow-up.

Synchronization dynamics induced on pairs of neurons under applied weak alternating magnetic fields.

Pairs of Helix aspersa neurons show an alternating magnetic field dependent frequency synchronization (AMFS) when exposed to a weak (amplitude B0 between 0.2 and 150 Gauss (G)) alternating magnetic field (AMF) of extremely low frequency (ELF, fM = 50 Hz). We have compared the AMFS patterns of discharge with: i) the synaptic activity promoted by glutamate and acetylcholine; ii) the activity induced by caffeine; iii) the bioelectric activity induced on neurons interconnected by electric synapses. AMFS activity reveals several specific features: i) a tight coincidence in time of the pattern and frequency, f, of discharge; ii) it is induced in the time interval of field application; iii) it is dependent on the intensity of the sinusoidal applied magnetic field; iv) elicited biphasic responses (excitation followed by inhibition) run in parallel for the pair of neurons; and v) some neuron pairs either spontaneously or AMF synchronized can be desynchronized under applied higher AMF. Our electron microscopy studies reveal gap-like junctions confirming our immunocytochemistry results about expression of connexin 26 (Cx26) in 4.7% of Helix neurons. AMF and carbenoxolone did not induce any significant effect on spontaneous synchronization through electric synapses.

Vibron quasibound state in the noncentrosymmetric tetragonal heavy-fermion compound CeCuAl3.

We have investigated the noncentrosymmetric tetragonal heavy-fermion antiferromagnetic compound CeCuAl3 (T(N)=2.5 K) using inelastic neutron scattering (INS). Our INS results unequivocally reveal the presence of three magnetic excitations centered at 1.3, 9.8, and 20.5 meV. These spectral features cannot be explained within the framework of crystal-electric-field models and recourse to Kramers' theorem for a 4f(1) Ce(3+) ion. To overcome these interpretational difficulties, we have generalized the vibron model of Thalmeier and Fulde for cubic CeAl(2) to tetragonal point-group symmetry with the theoretically calculated vibron form-factor. This extension provides a satisfactory explanation for the position and intensity of the three observed magnetic excitations in CeCuAl3, as well as their dependence on momentum transfer and temperature. On the basis of our analysis, we attribute the observed series of magnetic excitations to the existence of a vibron quasibound state.

Usefulness of histological superstudy of sentinel lymph nodes detected with radioisotopes in colon cancer.

INTRODUCTION: Adjuvant chemotherapy (CT) significally reduces the rate of relapse in +pN (stage III) colon cancer (CC) and in some pN0 (stage II) with risk factors such as pT4, vascular invasion V1, perineural invasion Pn1, and complicated tumors. However, unexpectedly, 20%-30% of pN0 present a relapse in the follow-up, which may suggest that the lymph node involvement was not discovered in the conventional histological study (CS), and its finding with a superstudy (SS) could increase the number of patients who would benefit from neoadjuvant CT. It is not possible to perform this SS in every lymph node (LN) from the specimen, but it is possible in a small group of LN which are representative of the N status (definition of sentinel node SN). The aim of our work is to state the representativeness of the SN and to analyze de number of patients who are suprastaged after the SS of the SN. MATERIAL AND METHODS: Prospective study of a series of patients who have undergone curative surgery for CC, to whom we perform selective biopsy of sentinel node (SBDN). Identification of SN was carried out with in vivo injection of the radiotracer, with ex vivo isolation of SN. Once the specimen is out, we take pictures of the surgical bed to rule out the presence of aberrant drainage routes, out of the routine oncological resection area. We performed the histological CS (Hematoxilin-Eosin stain (H-E) in conventional sections) in the rest of the LN from the mesocolon. In the SN we performed the CS and a SS with H-E in serial sections, immunohistochemistry (IHC) and molecular study with OSNA® (One Step Nucleic Acid Amplification). Diagnostic validity study od SBSN was carried out, defining the false negative (FN) as the negativity of the SN while other LN are positive (N+), as well as a valuation of the suprastaging due to the SS of the SN. RESULTS: We performed lymphatic map in 72 patients, finding the SN in 62 of them (87.3%). The 9 identification failures happened in the first 17 cases. We have not found aberrant drainage routes. A total of 1.164 LN were studied in the 62 patients (18.8 LN/patient), from which 145 are SN (2,34 SN/patient), having found 103 positive LN with the CS and 112 positive with the SS of SN (9+ LN more in 8 patients than detected with the CS). Positivity after CS in the SN group is 17.24% (25/145), while it is 8.53% in the rest (87/1.019) (P < .001). With the CS, 50% of the patients (31/62) were pN+ (4 are N+ exclusively in the SN), and after the SS of the SN, only 1 of the 31 pN0 patients (3.2%) becomes pN1a, with a definitive 51.6% of N+ in the whole series (32 N+ in the 62 patients) (5 are N+ exclusively in the SN). Exclusively with the SS of the SN, FN rate ("-SN, +others", meaning patients who are N+ having -SN) is 54.8% (17/31). With the SS of the SN, 8 of the 62 patients (12.9%) increase their total number of +LN: apart from the patient who turns from pN0 to pN1a, suprastaging from IIA to IIIB (and therefore increasing the total number of pN+ to 32), 5 of the 17 FN in the CS turns into positive (2 change the pN subindex and one is suprastaged from IIIB to IIIC), decreasing FN to 37.5% (12/32 cases). Besides, 2 patients whose SN is already positive in the CS increase the number of +SN after the SS of the SN, therefore both changing their pN subindex and one of them suprastaging from IIIB to IIIC. In summary, 8 patients increase the total number of positive SN after the SS (8/62, 12.9%), 5 of them changing the pN subindex (5/62, 12.9%), even if only 3 of them get suprastaged (3/62, 4.8%), among them the one who turns from pN0 to pN1a. CONCLUSION: Technique is valid and reproducible, with a high detection rate even with a high learning curve. It globally increases the number of affected LN in 12.9% of patients, having prognostic implications in 4.8% (suprastaging rate). Only 3.2% of pN0 patients in the CS turn to be +pN after the SS of the SN, with its therapeutic implications (prescription of adjuvant CT), which could be relevant when extrapolated to a big number of patients. The high FN rate (37.5%) prevents us from accepting the representativeness of SN as the global N status, but it is not clinically relevant in CC, as its aim is not to avoid lymphadenectomy, which remains mandatory (opposite to breast cancer or melanoma in which SN detection decides upon whether to perform or not the lymphadenectomy), but to decide which patients would benefit from adjuvant CT.

Usefulness of histological superstudy of sentinel node detected with radioisotope in colon cancer. / Utilidad del superestudio anatomopatológico de ganglio centinela detectado con radioisótopos en el cáncer de colon.

INTRODUCTION: Adjuvant chemotherapy (CT) significally reduces the rate of relapse in +pN (stage III) colon cancer and in some pN0 (stage II) with risk factors such as pT4, vascular invasion V1, perineural invasion Pn1, and complicated tumors. However, unexpectedly, 20-30% of pN0 present a relapse in the follow-up, which may suggest that the lymph node involvement was not discovered in the conventional histological study (CS), and its finding with a superstudy (SS) could increase the number of patients who would benefit from neoadjuvant CT. It is not possible to perform this SS in every lymph node (LN) from the specimen, but it is possible in a small group of LN which are representative of the N status (definition of sentinel node SN). The aim of our work is to state the representativeness of the SN and to analyze de number of patients who are suprastaged after the SS of the SN. MATERIAL AND METHODS: Prospective study of a series of patients who have undergone curative surgery for colon cancer, to whom we perform selective biopsy of sentinel node. Identification of SN was carried out with in vivo injection of the radiotracer, with ex vivo isolation of SN. Once the specimen is out, we take pictures of the surgical bed to rule out the presence of aberrant drainage routes, out of the routine oncological resection area. We performed the histological CS (hematoxilin-eosin stain in conventional sections) in the rest of the LN from the mesocolon. In the SN we performed the CS and a SS with hematoxilin-eosin in serial sections, immunohistochemistry (IHC) and molecular study with One Step Nucleic Acid Amplification (OSNA®). Diagnostic validity study od selective biopsy of sentinel node was carried out, defining the false negative (FN) as the negativity of the SN while other LN are positive (N+), as well as a valuation of the suprastaging due to the SS of the SN. RESULTS: We performed lymphatic map in 72 patients, finding the SN in 62 of them (87.3%). The 9 identification failures happened in the first 17 cases. We have not found aberrant drainage routes. A total of 1.164 LN were studied in the 62 patients (18.8 LN/ patient), from which 145 are SN (2,34 SN/ patient), having found 103 positive LN with the CS and 112 positive with the SS of SN (9 +LN more in 8 patients than detected with the CS). Positivity after CS in the SN group is 17.24% (25/145), while it is 8.53% in the rest (87/1.019) (p<.001). With the CS, 50% of the patients (31/62) were pN+ (4 are N+ exclusively in the SN), and after the SS of the SN, only 1 of the 31 pN0 patients (3.2%) becomes pN1a, with a definitive 51.6% of N+ in the whole series (32 N+ in the 62 patients) (5 are N+ exclusively in the SN). Exclusively with the SS of the SN, FN rate ("-SN, +others", meaning patients who are N+ having -SN) is 54.8% (17/31). With the SS of the SN, 8 of the 62 patients (12.9%) increase their total number of +LN: apart from the patient who turns from pN0 to pN1a, suprastaging from IIA to IIIB (and therefore increasing the total number of pN+ to 32), 5 of the 17 FN in the CS turns into positive (2 change the pN subindex and one is suprastaged from IIIB to IIIC), decreasing FN to 37.5% (12/32 cases). Besides, 2 patients whose SN is already positive in the CS increase the number of +SN after the SS of the SN, therefore both changing their pN subindex and one of them suprastaging from IIIB to IIIC. In summary, 8 patients increase the total number of positive SN after the SS (8/62, 12.9%), 5 of them changing the pN subindex (5/62, 12.9%), even if only 3 of them get suprastaged (3/62, 4.8%), among them the one who turns from pN0 to pN1a. CONCLUSION: Technique is valid and reproducible, with a high detection rate even with a high learning curve. It globally increases the number of affected LN in 12.9% of patients, having prognostic implications in 4.8% (suprastaging rate). Only 3.2% of pN0 patients in the CS turn to be +pN after the SS of the SN, with its therapeutic implications (prescription of adjuvant CT), which could be relevant when extrapolated to a big number of patients. The high FN rate (37.5%) prevents us from accepting the representativeness of SN as the global N status, but it is not clinically relevant in colon cancer, as its aim is not to avoid lymphadenectomy, which remains mandatory (opposite to breast cancer or melanoma in which SN detection decides upon whether to perform or not the lymphadenectomy), but to decide which patients would benefit from adjuvant CT.

Thermoelectric stack sample cooling modification of a commercial atomic force microscopy.

Enabling temperature dependent experiments in Atomic Force Microscopy is of great interest to study materials and surface properties at the nanoscale. By studying Curie temperature of multiferroic materials, temperature dependent phase transitions on crystalline structures or resistive switching phenomena are only a few examples of applications. We present an equipment capable of cooling samples using a thermoelectric cooling stage down to -61.4 °C in a 15 × 15 mm2 sample plate. The equipment uses a four-unit thermoelectric stack to achieve maximum temperature range, with low electrical and mechanical noise. The equipment is installed into a Keysight 5500LS Atomic Force Microscopy maintaining its compatibility with all Electrical and Mechanical modes of operation. We study the contribution of the liquid cooling pump vibration into the cantilever static deflection noise and the temperature dependence of the cantilever deflection. A La0.7Sr0.3MnO3-y thin film sample is used to demonstrate the performance of the equipment and its usability by analyzing the resistive switching phenomena associated with this oxide perovskite.

Characterisation of spinophilin immunoreactivity in postmortem human brain homogenates.

Spinophilin is a multifunctional scaffold protein that regulates the formation and function of dendritic spines and plays a role in neuronal migration. The distinct roles of spinophilin depend on its localization and the direct interaction with other proteins, which may target spinophilin to specific locations within the cell. Several studies suggest a role of spinophilin in the pathophysiology of neurological or psychiatric diseases. However, the majority have been performed in animals or cultured cells. Thus, the aim of the present study was to characterise the regional and subcellular expression of spinophilin immunoreactivity by western blot in postmortem human brain. Two specific immunoreactive bands for spinophilin were observed: an intense band migrating at around 120kDa, which seems to correspond to the apparent molecular weight of spinophilin described by other authors, and a less intense band of around 95kDa. This second form seems to be a proteolysis or cleavage product of the ~120kDa spinophilin. Interestingly, the subcellular distribution of both bands was different. In membrane fraction, the ~120kDa spinophilin band was the most abundant, whereas in cytosol it was the ~95kDa form. Furthermore, a different regional distribution for ~120kDa spinophilin band was observed, with the highest expression in prefrontal cortex, followed by hippocampus and cerebellum, and the lowest in caudate nucleus. Altogether, these results constitute a useful reference for future studies of spinophilin in pathological and non-pathological human brain tissues.

Risk factors for cervical intraepithelial neoplasia grade III/carcinoma in situ in Spain and Colombia.

A case-control study of 525 histologically confirmed cases of cervical intraepithelial neoplasia grade III and 512 controls was done in Spain and Colombia to assess the role of various risk factors taking into account the effect of human papillomavirus (HPV). The presence of HPV DNA, assessed by a polymerase chain reaction-based method, was the strongest risk factor identified. In Spain the adjusted odds ratio (OR) and 95% confidence interval (CI) (numbers in parentheses) were 56.9 (24.8-130.6) and, in Colombia, were 15.5 (8.2-29.4). In addition to HPV, the multivariate analysis revealed independent effects of early age at first intercourse (in Spain ORa, 4.3; 95% CI, 2.0-9.3 for ages < 17 versus 20+ years and in Colombia ORa, 9.0; 95% CI, 2.6-30.9 for ages < 14 versus 20+ years), and antibodies to Chlamydia trachomatis (in Spain ORa, 2.3; 95% CI, 1.1-4.5; and in Colombia ORa, 1.7; 95% CI, 1.1-2.7). High parity showed a significant effect only in Colombia (ORa, 2.0; 95% CI, 1.0-5.0 for > or = 6 versus 1) while number of partners of the woman and specially of her husband showed a strong effect in Spain only (ORa, 6.9; 95% CI, 3.1-15.3 for partners of the husband > or = 21 versus 1-5). Smoking and use of oral contraceptives did not show significant or consistent associations. Among HPV-DNA positive women early age at first intercourse and high parity increased the risk of cervical intraepithelial neoplasia III but the effect was statistically significant only for the former.(ABSTRACT TRUNCATED AT 250 WORDS)

Transposon mutagenesis in Halomonas eurihalina.

We have established a transposon mutagenesis procedure for the moderate halophile Halomonas eurihalina, a bacteria that produces an exopolysaccharide (EPS) of considerable biotechnological interest. We used suicide plasmids pUT and pSUP102 to introduce the transposons mini-Tn5 and Tn1732 into H. eurihalina via Escherichia coli mediated conjugation. Southern hybridization analysis demonstrated that insertions of the transposon mini-Tn5 into H. eurihalina occurred randomly at single sites in the chromosome, whereas Tn1732 insertion also took place at random, but simultaneously, at several sites. Phenotypic analysis revealed that different mutants were generated by using mini-Tn5. The isolation of exopolysaccharide-defective strains is the first stage towards carrying out genetic studies on EPS production by this microorganism.

Effect of external salinity changes on cellular composition of some ions and amino acids in Deleya halophila.

Changes in total cellular composition of some ions and amino acids of the moderate halophile Deleya halophila were studied in response to external salinity changes. Among the 14 amino acids investigated, the cellular glycine and aspartic acid content increased with increasing salinity. D. halophila also accumulated Na+ at the highest external salt concentrations.

A comparative study of smoking, drinking and dietary habits in population samples in France, Italy, Spain and Switzerland. II. Tobacco smoking.

This paper describes the smoking habits of six populations in France, Switzerland, Italy and Spain. A total of 2,965 men and 2,369 women have been interviewed. The proportion of ever smoking men is almost the same (75 to 80%) everywhere but in Geneva and Calvados a higher proportion of smokers quitted the habit (over 30%). In females, on the contrary, the prevalences of ever smokers is higher in Torino (42%) and Geneva (36%) than in Spain (25%) and Calvados (19%). Young females, however, tend to smoke more and intercountry differences tend to disappear. In both sexes successive generations begin to smoke earlier. Exclusive use of black tobacco is still very high in Calvados (90%) and Navarra (80%) whilst it tends to disappear in Italy (30%). Plain cigarettes decrease everywhere, especially in Spain and Varese, but they are still smoked by the majority of men in Calvados. The results suggest that the tobacco epidemic is still increasing in those areas where it began more recently.

A comparative study of smoking, drinking and dietary habits in population samples in France, Italy, Spain and Switzerland. I. Study design and dietary habits.

Diet, tobacco and alcohol consumption, and occupational histories have been investigated in stratified random samples of the adult population in 6 areas in France (departement of Calvados), Italy (province of Varese and city of Torino), Spain (provinces of Navarra and Zaragoza) and Switzerland (canton of Geneva), to be used as a reference group in a case-control study on cancer of the larynx and hypopharynx. Out of a total of 8,074 sampled subjects, 5,564 could be interviewed. Sampling procedures are described, and reasons for non-response are analysed. Everywhere the intake of the 4 energy providing nutrients (particularly alcohol) was much greater in men than in women. In both sexes, total caloric intake was higher in Calvados and in Italy than elsewhere. There were wide inter-area variations in the consumption of butter + milk products and oils, resulting in a polyunsaturated/saturated fatty acid ratio ranging from 0.27 in Calvados to 0.54-0.65 in Spain. Among nutrients suggested to be involved in cancer aetiology, inter-area differences in daily intake were up to 3-fold for carotene and smaller for vitamin C and fibre. The proportion of lipids, fibres, vitamin C and carotene provided by different foods varied widely between areas, thus suggesting that in etiological cancer studies consideration should be given not only to nutrients but also to foods providing them.

[The effect of prebiotics on lipid metabolism]. / Efecto de los prebióticos sobre el metabolismo lipídico.

Prebiotics were defined in 1995 as non-digestible food ingredients beneficially affecting the host by stimulating the growth and/or activity of one or more bacteria in the colon, thus improving health. The proliferation of certain bacteria by fermentation of non-digestible carbohydrates has been shown to be able to inhibit the colonization of the intestine by pathogens, thus giving a protective effect vis-à-vis acute or chronic intestinal disorders. The fermentation of prebiotics may promote some specific physiological functions through the release of metabolites from the bacteria, especially short chain fatty acids (acetate, propionate, butyrate, lactate, etc.) into the lumen of the intestine. Short chain fatty acids may act directly or indirectly (by modifying the pH) on intestinal cells and may be involved in the control of various processes such as the proliferation of mucosa, inflammation, colorectal carcinogenesis, mineral absorption and the elimination of nitrogenated compounds. Curiously, numerous papers have hinted at the possibility that prebiotics may have systemic physiological effects that are related to beneficial effects on lipid metabolism and various cardiovascular risk factors.

Spinal anaesthesia in a patient with post-spine surgery dural ectasia.

Dural sac ectasia is a very infrequent anatomical abnormality, usually caused by connective tissue diseases, as Marfan syndrome. Very few cases have been described being a consequence of a previous spine surgical procedure. We describe the case of an elderly patient who should be operated on twice due to sub-occlusive colon disease. Surgery was performed under spinal anaesthesia. A dural sac ectasia was suspected after the first procedure and the abdominal X-ray was reviewed. The characteristics of the anatomical alteration and the course of both anaesthetic procedures were described. X-ray and CT images were provided.

Validation of an original incubator set-up for the exposure of human astrocyte cells to X-band microwaves in a GTEM-chamber.

A current concern about the biological effects of electromagnetic fields (EMF) is increasing with the wide spread use of X-band microwaves (MW, 8-10 GHz range). Gigahertz transverse electromagnetic (GTEM) field flat transmission lines are currently being used for experimental exposure of biological samples to high frequency EMF. Experiments carried out on human cells in culture require optimal growing temperature conditions, i.e. 37 °C, 5% CO2 in a humidified atmosphere. The aim of our work has been: i) to built up an original incubator set-up, the so called GTEM-incubator, for exposure of human cells in culture to MW inside a GTEM-chamber, under optimal growing physical conditions; ii) to make the validation of the GTEM-incubator by growing cell samples inside the non-energized GTEM-chamber (test sample) comparing the results with the ones obtained from cell samples grown inside a standard incubator (control samples). The features for comparison were: cell morphology, expression and distribution of cytoskeleton proteins, genotoxicity, viability and cell cycle progression. Any variation in any of the studied parameters would allow for detecting any possible failure or misconception in our GTEM-incubator working test. The results obtained in control and test incubators showed non-significant differences in the development of both cell populations for any of the studied parameters. Thereby our GTEM-incubator is considered valid for our purposes of human cell exposures to X-band MW.

Magnetic and magnetoelastic properties of epitaxial SmFe2 thin film.

We report on magnetic and magnetoelastic measurements for a 5000 Å (110) SmFe(2) thin film, which was successfully analyzed by means of a point charge model for describing the effect of the epitaxial growth in this kind of system. Some of the main conclusions of the Mössbauer and magnetoelastic results and the new magnetization results up to 5 T allow us to get a full description of the crystal electric field, exchange, and magnetoelastic behavior in this compound. So, new single-ion parameters are obtained for the crystal field interaction of samarium ions, A(4)(r(4)) = +755 K/ion and A(6)(r(6)) = -180 K/ion, and new single-ion magnetoelastic coupling B(γ,2) is approximately equal -200 MPa and B(ε,2) is approximately equal MPa, which represent the tetragonal and the in-plane shear deformations, respectively. Moreover, the new thermal behavior of the samarium magnetic moment, the exchange coupling parameter, and the magnetocrystalline anisotropy of the iron sublattice are obtained too. From these, the softening of the spin reorientation transition with respect to the bulk case could be accounted for.

Diagnóstico de sospecha de cáncer en los servicios de urgencias / Diagnosis of cancer in hospital emergency services

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