Grading of minor salivary gland immuno-histopathology post-allogenic hematopoietic cell transplantation.

The oral cavity commonly displays mucosal lichenoid lesions and salivary gland dysfunction, which are considered different chronic Graft-versus-Host Disease (cGVHD) pathophysiology's. However, diagnostics of salivary gland (sg-)cGVHD are limited. The objectives of the current study are to evaluate the minor salivary gland (MSG) histo-immunopathological profiles post allogenic hematopoietic cell transplantation based on sg-cGVHD criteria. Design: Histopathology was characterized according to two published grading strategies. Firstly, the National Institute of Health (NIH) assessed peri-ductal/acinar infiltration, exocytosis, damage, and fibrosis, and a points-based grading scheme was established (0-16 points, Grade (G) 0 to IV). Second, a modified Sjögren's Syndrome focus-score with parenchymal damage was also adapted, (0-10 points, Score 0 to 2). 146 MSG biopsies from 79 patients were compared, using the histopathological specific criteria for sg-cGVHD pathology. Quantitative immunohistochemistry for T-cells (CD4, CD8), B-cells (CD19, CD20), monocytic cells (CD68) and dendritic cells (CD1a) were also assessed. Results: The large-scale cohort validated the use of both grading schemes. GIII-GIV and score 2 signified a histopathological diagnosis of "likely" sg-cGVHD. Immunopathological severity was associated with increased T-cells (CD4 and CD8) and monocytic (CD68) infiltrate, with minimal involvement of B-cells (CD19 and CD20), and Langerhans cells (CD1a). Conclusions: Both schemes were verified as being suitable for histological grading to improve assessment and diagnosis of sg-cGVHD. The NIH cGVHD grading appears to be more beneficial for research purposes, including final diagnostics of "no/inactive", "possible" or "likely" cGVHD. The study highlights the intricacies of sg-cGVHD pathology; and the need for standardized assessment to improve patient management associated to sg-cGVHD.

Impact of modern systemic therapies and clinical markers on treatment outcome for metastatic melanoma in a real-world setting.

BACKGROUND: The survival in metastatic melanoma has dramatically improved after the introduction of immune checkpoint- (ICIs) and MAPKinase inhibitors (MAPKis). OBJECTIVE: Our aim was to describe therapy response and survival in a real-world population as well as to assess the associations between clinical variables and therapy outcome for patients with metastatic melanoma receiving first-line ICIs or MAPKis. METHODS: A total of 252 patients with metastatic (stage IV) melanoma were prospectively followed between 1 January 2010 and 3 December 2017 with follow-up until 31 March 2019, at the Karolinska University Hospital, Sweden. Hazard ratios (HRs) for progression-free survival (PFS) and overall survival (OS) were analysed with Cox regression, and logistic regression was used to estimate odds ratios (ORs) for therapy response. RESULTS: Patients receiving ICIs (n = 138) experienced longer PFS compared to patients that received MAPKis (n = 114; median PFS for ICIs was 6.8 months, and median PFS for MAPKis was 5.3 months). In the multivariable analyses of clinical markers, increasing M-stage (OR 0.65; 95% CI 0.45-0.94; P = 0.022) and male sex (OR 0.41; 95% CI 0.19-0.90; P = 0.027) were significantly associated with lower response to ICIs. Lower baseline albumin levels (OR 0.90; 95% CI 0.83-0.98; P = 0.019) and male sex (OR 0.33; 95% CI 0.12-0.93; P = 0.036) were related with lower response to MAPKis. For ICIs, increasing M-stage (HR 1.34; 95% CI 1.07-1.68; P = 0.010), increasing LDH (HR 1.73; 95% CI 1.19-2.50; P = 0.004) and decreasing albumin (HR 1.06; 95% CI 1.01-1.10; P = 0.011) were significantly associated lower PFS in the adjusted model. The corresponding markers for MAPKis were increasing LDH (HR 1.44; 95% CI 1.08-1.92; P = 0.013) and decreasing albumin (HR 1.05; 95% CI 1.02-1.09; P = 0.005) for PFS. CONCLUSION: ICIs and MAPKis were effective in this real-world population, and we could confirm the importance of previously reported clinical prognostic markers. Albumin values may be associated with therapy outcome but need further validation.

From static micrographs to particle aggregation dynamics in three dimensions.

Studies on colloidal aggregation have brought forth theories on stability of colloidal gels and models for aggregation dynamics. Still, a complete link between developed frameworks and obtained laboratory observations has to be found. In this work, aggregates of silica nanoparticles (20 nm) are studied using diffusion limited cluster aggregation (DLCA) and reaction limited cluster aggregation (RLCA) models. These processes are driven by the probability of particles to aggregate upon collision. This probability of aggregation is one in the DLCA and close to zero in the RLCA process. We show how to study the probability of aggregation from static micrographs on the example of a silica nanoparticle gel at 9 wt%. The analysis includes common summary functions from spatial statistics, namely the empty space function and Ripley's K-function, as well as two newly developed summary functions for cluster analysis based on graph theory. One of the new cluster analysis functions is related to the clustering coefficient in communication networks and the other to the size of a cluster. All four topological summary statistics are used to quantitatively compare in plots and in a least-square approach experimental data to cluster aggregation simulations with decreasing probabilities of aggregation. We study scanning transmission electron micrographs and utilize the intensity-mass thickness relation present in such images to create comparable micrographs from three-dimensional simulations. Finally, a characterization of colloidal silica aggregates and simulated structures is obtained, which allows for an evaluation of the cluster aggregation process for different aggregation scenarios. As a result, we find that the RLCA process fits the experimental data better than the DLCA process.

Estimation of mass thickness response of embedded aggregated silica nanospheres from high angle annular dark-field scanning transmission electron micrographs.

In this study, we investigate the functional behaviour of the intensity in high-angle annular dark field scanning transmission electron micrograph images. The model material is a silica particle (20 nm) gel at 5 wt%. By assuming that the intensity response is monotonically increasing with increasing mass thickness of silica, an estimate of the functional form is calculated using a maximum likelihood approach. We conclude that a linear functional form of the intensity provides a fair estimate but that a power function is significantly better for estimating the amount of silica in the z-direction. The work adds to the development of quantifying material properties from electron micrographs, especially in the field of tomography methods and three-dimensional quantitative structural characterization from a scanning transmission electron micrograph. It also provides means for direct three-dimensional quantitative structural characterization from a scanning transmission electron micrograph.

Block bootstrap methods for the estimation of the intensity of a spatial point process with confidence bounds.

This paper deals with the estimation of the intensity of a planar point process on the basis of a single point pattern, observed in a rectangular window. If the model assumptions of stationarity and isotropy hold, the method of block bootstrapping can be used to estimate the intensity of the process with confidence bounds. The results of two variants of block bootstrapping are compared with a parametric approximation based on the assumption of a Gaussian distribution of the numbers of points in deterministic subwindows of the original pattern. The studies were performed on patterns obtained by simulation of well-known point process models (Poisson process, two Matérn cluster processes, Matérn hardcore process, Strauss hardcore process). They were also performed on real histopathological data (point patterns of capillary profiles of 12 cases of prostatic cancer). The methods are presented as worked examples on two cases, where we illustrate their use as a check on stationarity (homogeneity) of a point process with respect to different fields of vision. The paper concludes with various methodological discussions and suggests possible extensions of the block bootstrap approach to other fields of spatial statistics.

[The effect of Federal Public Health Service guidelines on air, surface and floor germ count in a general surgery and an orthopedic operating room]. / Der Einfluss der Richtlinien des Bundesgesundheitsamtes auf die Luft-, Flächen- und Bodenkeimzahl in einer allgemeinchirurgischen und einer orthopädischen Operationsabteilung.

In a prospective study the environmental contamination in an old and a new operating theatre was investigated. The old operating rooms were constructed in 1936 whereas the new rooms were built in 1986. The study was conducted in surgical and orthopedic surgical operating rooms. There was a slight increase in floor as well as in surface contamination in the new operating rooms. On the other hand there was a slight decrease in the airborne microorganisms in the orthopedic surgery and nearly identical colony counts in the general surgery operating rooms. All the differences were statistically not significant. The spectrum of microorganisms and the occurrence of Staphylococcus aureus in the old and the new operating rooms showed no difference.

Specific anti-Bordetella pertussis activities in human blood examined by enzyme-linked immunoassay and biological assay.

Enzyme-linked immunoassays have been employed in this work to measure antibodies against either pertussigen or filamentous hemagglutinin, using a urease-conjugated second antibody system. Pertussigen and filamentous hemagglutinin were obtained from the supernatants of Bordetella pertussis cultures by chromatographic procedures, and were shown to be essentially free of other proteins. Further checks have established the specificity of the enzyme-linked immunoassay-systems. Anti-pertussigen and anti-filamentous hemagglutinin antibody titers, in a pilot study of sera from normal adults, showed little correlation with the donors' pertussis contact, infection or vaccination histories. Nevertheless, the titers did correlate with the ability of the sera to neutralize the biological actions of pertussigen in mice and the haemagglutinating activity of filamentous haemagglutinin, respectively. Antibody titers of sera from patients with suspected or confirmed pertussis infection fell within the range covered by sera from normal adults. Sera from unvaccinated children (less than two months old) also showed some anti-pertussis activity that was probably maternal in origin. Further selected adult plasma samples have been compared for anti-pertussis activity by enzyme-linked immunoassays and agglutination. These samples also have been evaluated for their abilities to protect mice passively against intra-nasal and intra-cerebral challenge with Bordetella pertussis.