Libyan breast cancer: Health services and biology. Diagnosis delay and prognostic value of DNA pploidy, S-phase fraction, and Ki-67 and Bcl-2 immunohistochemistry

The aim of this study was to investigate the diagnosis delay and its impact on the stage of disease. The study also evaluated a nuclear DNA content, immunohistochemical expression of Ki-67 and bcl-2, and the correlation of these biological features with the clinicopathological features and patient outcome. 200 Libyan women, diagnosed during 2008–2009 were interviewed about the period from the first symptoms to the final histological diagnosis of breast cancer. Also retrospective preclinical and clinical data were collected from medical records on a form (questionnaire) in association with the interview. Tumor material of the patients was collected and nuclear DNA content analysed using DNA image cytometry. The expression of Ki-67 and bcl-2 were assessed using immunohistochemistry (IHC). The studies described in this thesis show that the median of diagnosis time for women with breast cancer was 7.5 months and 56% of patients were diagnosed within a period longer than 6 months. Inappropriate reassurance that the lump was benign was an important reason for prolongation of the diagnosis time. Diagnosis delay was also associated with initial breast symptom(s) that did not include a lump, old age, illiteracy, and history of benign fibrocystic disease. The patients who showed diagnosis delay had bigger tumour size (p<0.0001), positive lymph nodes (p<0.0001), and high incidence of late clinical stages (p<0.0001). Biologically, 82.7% of tumors were aneuploid and 17.3% were diploid. The median SPF of tumors was 11% while the median positivity of Ki-67 was 27.5%. High Ki-67 expression was found in 76% of patients, and high SPF values in 56% of patients. Positive bcl-2 expression was found in 62.4% of tumors. 72.2% of the bcl-2 positive samples were ER-positive. Patients who had tumor with DNA aneuploidy, high proliferative activity and negative bcl-2 expression were associated with a high grade of malignancy and short survival. The SPF value is useful cell proliferation marker in assessing prognosis, and the decision cut point of 11% for SPF in the Libyan material was clearly significant (p<0.0001). Bcl-2 is a powerful prognosticator and an independent predictor of breast cancer outcome in the Libyan material (p<0.0001). Libyan breast cancer was investigated in these studies from two different aspects: health services and biology. The results show that diagnosis delay is a very serious problem in Libya and is associated with complex interactions between many factors leading to advanced stages, and potentially to high mortality. Cytometric DNA variables, proliferative markers (Ki-67 and SPF), and oncoprotein bcl-2 negativity reflect the aggressive behavior of Libyan breast cancer and could be used with traditional factors to predict the outcome of individual patients, and to select appropriate therapy.

Macroalgae across environmental gradients : tools for managing rocky coastal areas of the northern Baltic Sea

Macroalgae are the main primary producers of the temperate rocky shores providing a three-dimensional habitat, food and nursery grounds for many other species. During the past decades, the state of the coastal waters has deteriorated due to increasing human pressures, resulting in dramatic changes in coastal ecosystems, including macroalgal communities. To reverse the deterioration of the European seas, the EU has adopted the Water Framework Directive (WFD) and the Marine Strategy Framework Directive (MSFD), aiming at improved status of the coastal waters and the marine environment. Further, the Habitats Directive (HD) calls for the protection of important habitats and species (many of which are marine) and the Maritime Spatial Planning Directive for sustainability in the use of resources and human activities at sea and by the coasts. To efficiently protect important marine habitats and communities, we need knowledge on their spatial distribution. Ecological knowledge is also needed to assess the status of the marine areas by involving biological indicators, as required by the WFD and the MSFD; knowledge on how biota changes with human-induced pressures is essential, but to reliably assess change, we need also to know how biotic communities vary over natural environmental gradients. This is especially important in sea areas such as the Baltic Sea, where the natural environmental gradients create substantial differences in biota between areas. In this thesis, I studied the variation occurring in macroalgal communities across the environmental gradients of the northern Baltic Sea, including eutrophication induced changes. The aim was to produce knowledge to support the reliable use of macroalgae as indicators of ecological status of the marine areas and to test practical metrics that could potentially be used in status assessments. Further, the aim was to develop a methodology for mapping the HD Annex I habitat reefs, using the best available data on geology and bathymetry. The results showed that the large-scale variation in the macroalgal community composition of the northern Baltic Sea is largely driven by salinity and exposure. Exposure is important also on smaller spatial scales, affecting species occurrence, community structure and depth penetration of algae. Consequently, the natural variability complicates the use of macroalgae as indicators of human-induced changes. Of the studied indicators, the number of perennial algal species, the perennial cover, the fraction of annual algae, and the lower limit of occurrence of red and brown perennial algae showed potential as usable indicators of ecological status. However, the cumulated cover of algae, commonly used as an indicator in the fully marine environments, showed low responses to eutrophication in the area. Although the mere occurrence of perennial algae did not show clear indicator potential, a distinct discrepancy in the occurrence of bladderwrack, Fucus vesiculosus, was found between two areas with differing eutrophication history, the Bothnian Sea and the Archipelago Sea. The absence of Fucus from many potential sites in the outer Archipelago Sea is likely due to its inability to recover from its disappearance from the area 30-40 years ago, highlighting the importance of past events in macroalgal occurrence. The methodology presented for mapping the potential distribution and the ecological value of reefs showed, that relatively high accuracy in mapping can be achieved by combining existing available data, and the maps produced serve as valuable background information for more detailed surveys. Taken together, the results of the theses contribute significantly to the knowledge on macroalgal communities of the northern Baltic Sea that can be directly applied in various management contexts.

Green diesel synthesis by hydrodeoxygenation of lipids extracted from Chlorella algae in supercritical hexane

Lipids were extracted from Chlorella algae with supercritical hexane. The high lipids yield of approximately 10% was obtained at optimum conditions of 300 rpm stirring speed and 2 h duration compared to the total contents of lipids being 12%. Furthermore, an easiness of hexane recovery may be considered as economically and ecologically attractive. For the first time, in the current work catalytic hydrodeoxygenation (HDO) of Chlorella algal lipids was studied over 5 wt% Ni/H-Y-80 and 5 wt% Ni/SiO2 at 300 C and under 30 bar total pressure in H2. A comparative HDO of stearic acid was carried out under similar conditions. The conversion of lipids was about 35% over 5 wt% Ni/H-Y-80 after 6h, whereas, 5 wt% Ni/SiO2 was totally deactivated after 60 min. The selectivity to hydrocarbons (C15-C18) is 6%. As a comparison, complete conversion of stearic acid over 5 wt% Ni/H-Y-80 was achieved in 6 h. The transformation of lipids proceeded mostly via hydrogenation and hydrolysis with formation of free fatty acid (FFA). The lower activity might be attributed to deactivation of catalysts caused by chlorophylls and carotenoids. Even though the conversion is low, future studies in HDO of lipids extracted from other algae species having higher lipid content could be proposed. Coke resistant catalyst might be considered to improve catalytic activity.