Advanced aspects of radiation protection in the use of particle accelerators in the medical field

In this work, the well-known MC code FLUKA was used to simulate the GE PETrace cyclotron (16.5 MeV) installed at “S. Orsola-Malpighi” University Hospital (Bologna, IT) and routinely used in the production of positron emitting radionuclides. Simulations yielded estimates of various quantities of interest, including: the effective dose distribution around the equipment; the effective number of neutron produced per incident proton and their spectral distribution; the activation of the structure of the cyclotron and the vault walls; the activation of the ambient air, in particular the production of 41Ar, the assessment of the saturation yield of radionuclides used in nuclear medicine. The simulations were validated against experimental measurements in terms of physical and transport parameters to be used at the energy range of interest in the medical field. The validated model was also extensively used in several practical applications uncluding the direct cyclotron production of non-standard radionuclides such as 99mTc, the production of medical radionuclides at TRIUMF (Vancouver, CA) TR13 cyclotron (13 MeV), the complete design of the new PET facility of “Sacro Cuore – Don Calabria” Hospital (Negrar, IT), including the ACSI TR19 (19 MeV) cyclotron, the dose field around the energy selection system (degrader) of a proton therapy cyclotron, the design of plug-doors for a new cyclotron facility, in which a 70 MeV cyclotron will be installed, and the partial decommissioning of a PET facility, including the replacement of a Scanditronix MC17 cyclotron with a new TR19 cyclotron.

Conoscenza e consapevolezza sugli effetti biologici degli ultrasuoni nella pratica clinica in Italia: risultati di una inchiesta con questionario tra ecografisti della socetà italiana di ultrasonologia in medicina e biologia (S.I.U.M.B.)

Background New potential hazards in the use of ultrasound (US) are implied in new diagnostic applications of US, such as contrast enhanced US. Aim To assess the level of awareness and knowledge on safety issues of clinical use of US among physicians who are members of the Italian National Society for Ultrasound (SIUMB) Materials and methods A questionnaire including 11 multiple choice quiz was sent by e-mail to members of SIUMB, who preliminarly agreed to participate in this initiative. The answers were received anonimously and statistically analyzed. Results The number of returned valid questionnaires was 97 (8 were considered not valid for less than 10 answers filled). Mean age of the responders was 44 years old, and the average time the physician has been performing ultrasound examinations was 13 years. The principal workplace (70%) was a public Hospital. Physicians seemed to know the general definitions of principal safety-parameters, but few of them knew the definition of specific indexes. There was a general knowledge about the safe use of ultrasound in obstetrics, but there was a poor knowledge of biological effects of US: only about 37% answered correctly to questions about damage of vasculature of lung by high Mechanical Index US investigation and about the increase of temperature under the probe, according to the thermal indexes. Conclusion In conclusion the present findings indicate that greater efforts of National Ultrasound Societies are warranted in disseminating knowledge about the bio-effects of diagnostic ultrasound modalities among their members to prevent possible hazards.

Studio della trasduzione del Segnale Nucleare Inositide-Dipendente: identificazione di eEF1A2 come nuovo Fosfosubstrato di PKC βI

Introduction Phospholipase Cb1 (PLC-β1) is a key player in the regulation of nuclear inositol lipid signaling and of a wide range of cellular functions, such as proliferation and differentiation (1,2,3). PLCb1 signaling depends on the cleavage of phosphatidylinositol 4,5-bisphosphate and the formation of the second messengers diacylglycerol and Inositol tris-phosphate which activate canonical protein kinase C (cPKC) isoforms. Here we describe a proteomic approach to find out a potential effector of nuclear PLC-b1 dependent signaling during insulin stimulated myogenic differentiation. Methods Nuclear lysates obtained from insulin induced C2C12 myoblasts were immunoprecipitated with anti-phospho-substrate cPKC antibody. Proteins, stained with Comassie blue, were excised, digested and subsequently analysed in LC-MS/MS. For peptide sequence searching, the mass spectra were processed and analyzed using the Mascot MS/MS ion search program with the NCBI database. Western blotting, GST-pull down and co-immunoprecipitation were performed to study the interaction between eEF1A2 and cPKCs. Site direct mutagenesis was performed to confirm the phosphorylated motif recognized by the antibody. Immunofluorescence analysis, GFP-tagged eEF1A2 vector and subcellular fractionation were performed to study nuclear localization and relative distribution of eEF1A2. Results We have previously shown that PLC-β1 is greatly increased at the nuclear level during insulin-induced myoblasts differentiation and that this nuclear localization is essential for induction of differentiation. Thus, nuclear proteins of insulin stimulated C2C12 myoblasts, were immunoprecipitated with an anti-phospho-substrate cPKC antibody. After Electrophoretic gel separation of proteins immunoprecipitated, several molecules were identified by LC-MS/MS. Among these most relevant and unexpected was eukaryotic elongation factor 1 alpha 2 (eEF1A2). We found that eEF1A2 is phosphorylated by PKCb1 and that these two molecules coimmunolocalized at the nucleolar level. eEF1A2 could be phosphorylated in many sites among which both threonine and serine residues. By site direct mutagenesis we demonstrated that it is the serine residue of the motif recognized by the antibody that is specifically phosphorylated by PKCb1. The silencing of PLCb1 gives rise to a reduction of expression and phosphorylation levels of eEF1A2 indicating this molecule as a target of nuclear PLCb1 regulatory network during myoblasts differentiation.

Imaging di risonanza magnetica nucleare nello studio del tumore della prostata

Aim of the present study was to evaluate the accuracy of transrectal ultrasound biopsy (TRUS-biopsy) directed to regions with abnormal MRI and/or MRSI (magnetic resonance spectroscopic imaging ) for both the transition (TZ) and the peripheral (PZ) zones in patients who presented with persistent suspect for prostate cancer and with prior negative biopsy. We also evaluated relationship between MRSI results and histopathological findings of biopsy. 54 patients with the aforementioned characteristics underwent MRI/MRSI at least 6 months after prior negative biopsy; interval between MRI/3D-MRSI and the further TRUS-biopsy was less than 3 months. The prostate was divided in 12 regions both for imaging interpretation and biopsy. Moreover one to three cores more were taken from each region with abnormal MRI and/or 3D-MRSI. Twenty-two out of 54 patients presented cancer at MRI/MRSI-directed-TRUS-biopsy. On a patient basis the highest accuracy was obtained by assigning malignancy on a positive finding with MRSI and MRI even though it was not significantly greater than that obtained using MRI alone (area under the ROC curve, AUC: 0.723 vs. 0.676). On a region (n=648) basis the best accuracy was also obtained by considering positive both MRSI and MRI for PZ (0.768) and TZ (0.822). Twenty-eight per cent of cores with prostatitis were false positive findings on MRSI, whereas only 2.7% of benign prostatic hyperplasia was false positive. In conclusion the accuracy of MRI/MRSI-directed biopsies in localization of prostate cancer is good in patient and region analyses. The combination of both MRI and MRSI results makes TRUS-biopsy more accurate particularly in the TZ (0.822) for patients with prior negative biopsies. Histopathological analysis showed that the main limitation of MRSI is the percentage of false positive findings due to prostatitis.

Metodi biochimici e biomolecolari applicati alla medicina clinica: rendimento della real-time TaqMan PCR per la valutazione della resistenza alla claritromicina in H.pylori e tests fecali nella diagnorstica del carcinoma colo-rettale: M2PK, calprotectina e FOBT

1) Background: The most common methods to evaluate clarithromycin resistance is the E-Test, but is time consuming. Resistance of Hp to clarithromycin is due to point mutations in the 23S rRNA. Eight different point mutations have been related to CH resistance, but the large majority of the clarithromycin resistance depends on three point mutations (A2142C, A2142G and A2143G). A novel PCR-based clarithromycin resistance assays, even on paraffin-embedded biopsy specimens, have been proposed. Aims: to assess clarithromycin resistance detecting these point mutation (E-Test as a reference method);secondly, to investigate relation with MIC values. Methods: Paraffin-embedded biopsies of patients Hp-positive were retrieved. The A2142C, A2142G and A2143G point mutations were detected by molecular analysis after DNA extraction by using a TaqMan real-time PCR. Results: The study enrolled 86 patients: 46 resistant and 40 sensible to CH. The Hp status was evaluated at endoscopy, by rapid urease test (RUT), histology and hp culture. According to real-time PCR, 37 specimens were susceptible to clarithromycin (wild type dna) whilst the remaining 49 specimens (57%) were resistant. A2143G is the most frequent mutation. A2142C always express a resistant phenotype and A2142G leads to a resitant phenotype only if homozigous. 2) Background: Colonoscopy work-load for endoscopy services is increasing due to colorectal cancer prevention. We tested a combination of faecal tests to improve accuracy and prioritize the access to colonoscopy. Methods: we tested a combination of fecal tests (FOBT, M2-PK and calprotectin) in a group of 280 patients requiring colonoscopy. Results: 47 patients had CRC and 85 had advanced adenoma/s at colonoscopy/histology. In case of single test, for CRC detection FOBT was the test with the highest specificity and PPV, M2-PK had the highest sensitivity and higher NPV. Combination was more interesting in term of PPV. And the best combination of tests was i-FOBT + M2-PK.

Studio degli aplogruppi mitocondriali nei pazienti con narcocataplessia

La narcolessia è un disturbo del sonno disabilitante caratterizzato da eccessiva sonnolenza diurna associata a disturbi del sonno REM che si manifestano con cataplessia (improvvisa perdita del tono muscolare scatenata da forti emozioni), paralisi del sonno (all’addormentamento o al risveglio) e allucinazioni ipnagogiche. Al momento attuale sono in corso studi di genome-wide solo sul genoma nucleare, l'unico ulteriore materiale genetico non indagato finora per una eventuale predisposizione genetica multifattoriale alla narcolessia è il genoma mitocondriale, che, a causa della sua variabilità, possiede un potenziale ruolo protettivo/predisponente nell’ambito di diverse malattie neurodegenerative, metaboliche ed infettive. Come obiettivo della tesi si propone la ricerca di eventuali polimorfismi sul DNA mitocondriale in grado di agire come fattori di suscettibilità/protezione nei confronti della narcolessia e di confermare quindi l’importante legame tra metabolismo bioenergetico, beta ossidazione e narcolessia. In particolare, vista la già nota capacità degli aplogruppi mitocondriali di modulare l’espressione di diverse malattie neurodegenerative, sono stati identificati i principali aplogruppi mitocondriali in un campione di pazienti con narcolessia successivamente confrontati con una popolazione di controllo per cercare eventuali differenze di distribuzione statisticamente significative tra le due popolazioni. I risultati presentati in questo studio completano con l’analisi del DNA mitocondriale i precedenti studi “genome wide”. L’assenza di associazione statisticamente significativa tra aplogruppi mitocondriali e narcolessia non esclude ancora il ruolo che la variabilità genetica del DNA mitocondriale può giocare nella patogenesi della narcolessia. La definitiva esclusione può essere conclusa solo espandendo la coorte dei pazienti studiati e considerando possibilmente origini etnico-geografiche diverse.

Studio di espressione e funzione della PLCβ1 nucleare in modelli murini ed umani di cellule ematopoietiche mieloidi e linfoidi

The aims of this work were to investigate the role of nuclear Phospholipase C beta 1 (PI-PLCβ1) in human and mouse cell lines and to identify new binding partners of nuclear PI-PLCβ1 to further understand the functional network in which the enzyme acts. The intracellular distribution of PI-PLCβ1 was further investigated in human leukaemia cell lines (NB4, HL60, THP1, CEM, Jurkat, K562). With the exception of HL60, a high endogenous level of PI-PLCβ1 was detected in purified nuclei in each of the cell lines. We found that also in Ba/F3 pro-B cells overexpressing PI-PLCβ1b the protein localize within the nucleus. Although our data demonstrated that PI-PLCβ1b was not involved in cell proliferation and IGF-1 response as shown in other cell lines (FELC and Swiss 3T3), there was an effect on apoptosis. Activation of early apoptotic markers caspase-3 and PARP was delayed in PI-PLCβ1b overexpressing Ba/F3 cells treated with 5 gr/ml mitomycin C for 24h. We performed an antibody-specific immunoprecipitation on nuclear lysates from FELC-PLCβ1b cells. Mass spectrometry analysis (nano-ESI-Q-TOF) of co-immunoprecipitated proteins allowed for identification of 92 potential nuclear PI-PLCβ1b interactors. Among these, several already documented PI-PLCβ1b interacting partners (Srp20, LaminB, EF1α2) were identified, further validating our data. All the identified proteins were nuclear, mostly localized within the nuclear speckles. This evidence is particularly relevant as PI-PLCβ1 is known to localize in the same domains. Many of the identified proteins are involved in cell cycle, proliferation and transcriptional control. In particular, many of the proteins are components of the spliceosome multi-complex, strengthening the idea that PI-PLCβ1b is involved in mRNA processing and maturation. Future work will aim to better characterize the regulatory role of PI-PLCβ1b in mRNA splicing.

Sulle tracce di Michel Leiris: possessione e medicina tradizionale nell’Etiopia settentrionale. Dimensione teatrale, religiosa, terapeutica, socio-politica.

La tesi si divide in due parti: nella prima si esamina l'esperienza etnografica condotta da M. Leiris durante la missione Dakar-Gibuti (1931-33) con riferimento alla studio della possessione a Gondar. Nella seconda parte si dà conto del lavoro sul terreno condotto dalla dottoranda nel Wollo a contatto con guaritori. Seguono appendici documentarie e iconografiche.