Cumulative incidence and risk factors for cutaneous squamous cell carcinoma metastases in organ transplant recipients: The Skin Care in Organ Transplant Patients in Europe-International Transplant Skin Cancer Collaborative metastases study, a prospective multicenter study

INTRODUCTION

Solid organ transplant recipients (SOTRs) are believed to have an increased risk of metastatic cutaneous squamous cell carcinoma (cSCC), but reliable data are lacking regarding the precise incidence and associated risk factors.

METHODS

In a prospective cohort study, including 19 specialist dermatology outpatient clinics in 15 countries, patient and tumor characteristics were collected using standardized questionnaires when SOTRs presented with a new cSCC. After a minimum of 2 years of follow-up, relevant data for all SOTRs were collected. Cumulative incidence of metastases was calculated by the Aalen-Johansen estimator. Fine and Gray models were used to assess multiple risk factors for metastases.

RESULTS

Of 514 SOTRs who presented with 623 primary cSCCs, metastases developed in 37 with a 2-year patient-based cumulative incidence of 6.2%. Risk factors for metastases included location in the head and neck area, local recurrence, size > 2 cm, clinical ulceration, poor differentiation grade, perineural invasion, and deep invasion. A high-stage tumor that is also ulcerated showed the highest risk of metastasis, with a 2-year cumulative incidence of 46.2% (31.9%-68.4%).

CONCLUSIONS

SOTRs have a high risk of cSCC metastases and well-established clinical and histologic risk factors have been confirmed. High-stage, ulcerated cSCCs have the highest risk of metastasis.

[Primary cutaneous lymphoma-a case series of 163 patients]

BACKGROUND

In addition to a broad and clinically diverse spectrum of known primary cutaneous lymphomas, for which an incidence of 1-3:100,000 is postulated, each year further entities are specified and defined. The goal is the presentation of a case series from daily clinical routine.

METHODS

Over a period of 6 years and 2 months, patients consulting the Department of Dermatology, Medical Center University of Freiburg, were registered. Subsequently, collectives of mycosis fungoides (MF), Sezary syndrome (SS), CD30+ lymphoproliferative diseases, single cases with rare primary cutaneous lymphomas, and subcollectives of B‑cell lymphomas were examined. The high number of MF cases allowed the additional quantitative analyses of the types of therapies used in this group.

RESULTS

Yearly 16-25 new diagnoses of primary cutaneous lymphoma are made. The evaluation of 163 primary cutaneous lymphoma revealed 111 cases with MF (68.1%), including 9 particular variants, 15 primary cutaneous CD30+ lymphoproliferative diseases (9.2%) dominated by 10 lymphomatoid papulosis (LyP), in addition to 5 primary cutaneous anaplastic large cell lymphoma (PCALCL), 6 SS (3.68%), and 24 cutaneous B‑cell lymphomas (14-72%). Three cases with rare primary cutaneous T/NK cell lymphomas are addressed in detail. In all, 82% of MF cases were stage IA and IB. The descending use of therapies for stage I-III included steroids and diverse UV therapies followed by bexarotene, interferon-α, methotrexate, and extracorporal photophoresis.

CONCLUSIONS

Diagnoses of cutaneous lymphomas belong to a vast spectrum of differential diagnoses. This registry describes frequent findings and shows rare variants. You can only diagnose what you know; accordingly, a collection of case reports, which we wish to encourage, can help in processing and specification of entities.

Minimum Information about T Regulatory Cells: A Step toward Reproducibility and Standardization

Cellular therapies with CD4+ T regulatory cells (Tregs) hold promise of efficacious treatment for the variety of autoimmune and allergic diseases as well as posttransplant complications. Nevertheless, current manufacturing of Tregs as a cellular medicinal product varies between different laboratories, which in turn hampers precise comparisons of the results between the studies performed. While the number of clinical trials testing Tregs is already substantial, it seems to be crucial to provide some standardized characteristics of Treg products in order to minimize the problem. We have previously developed reporting guidelines called minimum information about tolerogenic antigen-presenting cells, which allows the comparison between different preparations of tolerance-inducing antigen-presenting cells. Having this experience, here we describe another minimum information about Tregs (MITREG). It is important to note that MITREG does not dictate how investigators should generate or characterize Tregs, but it does require investigators to report their Treg data in a consistent and transparent manner. We hope this will, therefore, be a useful tool facilitating standardized reporting on the manufacturing of Tregs, either for research purposes or for clinical application. This way MITREG might also be an important step toward more standardized and reproducible testing of the Tregs preparations in clinical applications.

Static and dynamic behaviour of responsive graphene oxide-poly(N-isopropyl acrylamide) composite gels

Thermoresponsive hydrogels have enormous potential e.g., as sensors, actuators, and pollution control remedies or in drug delivery systems. Nevertheless, their application is often restricted by physical limitations (poor mechanical strength and uncontrolled thermal response). Composite systems may offer a means of overcoming these limitations. This paper presents a systematic study of the structure and dynamics of graphene oxide-poly-(N-isopropylacrylamide) composite systems, and investigates the effect of the nanoparticle filler content on the mechanical and swelling properties of the systems. A combination of macroscopic (swelling and elastic modulus) and microscopic (differential scanning microcalorimetry, small angle neutron scattering and neutron spin-echo spectroscopy) investigations reveals that the architecture of the polymer network is modified by chain nucleation at the surface of the GO platelets, and these form a percolating network inside the gel. Our results show that the elastic modulus of the gels is reinforced by the filler, but the mobility of the polymer chains in the swollen state is practically unaffected. The macroscopic deswelling of the composites, however, is slowed by the kinetics of ordering in the GO network.

Age and gender leucocytes variances and references values generated using the standardized ONE-Study protocol

Flow cytometry is now accepted as an ideal technology to reveal changes in immune cell composition and function. However, it is also an error-prone and variable technology, which makes it difficult to reproduce findings across laboratories. We have recently developed a strategy to standardize whole blood flow cytometry. The performance of our protocols was challenged here by profiling samples from healthy volunteers to reveal age- and gender-dependent differences and to establish a standardized reference cohort for use in clinical trials. Whole blood samples from two different cohorts were analyzed (first cohort: n = 52, second cohort: n = 46, both 20-84 years with equal gender distribution). The second cohort was run as a validation cohort by a different operator. The "ONE Study" panels were applied to analyze expression of >30 different surface markers to enumerate proportional and absolute numbers of >50 leucocyte subsets. Indeed, analysis of the first cohort revealed significant age-dependent changes in subsets e.g. increased activated and differentiated CD4(+) and CD8(+) T cell subsets, acquisition of a memory phenotype for Tregs as well as decreased MDC2 and Marginal Zone B cells. Males and females showed different dynamics in age-dependent T cell activation and differentiation, indicating faster immunosenescence in males. Importantly, although both cohorts consisted of a small sample size, our standardized approach enabled validation of age-dependent changes with the second cohort. Thus, we have proven the utility of our strategy and generated reproducible reference ranges accounting for age- and gender-dependent differences, which are crucial for a better patient monitoring and individualized therapy. © 2016 International Society for Advancement of Cytometry.

I. Die Inaktivierung von Escherichia coli K-12 durch den Phosphonsäureester Trichlorphon

Trichlorphone is bacteriocidal for Escherichia coli K-12. The bacterial inactivation depends on the concentration and the reaction time of trichlorphone and on the growth phase of the bacteria. DDVP formed by hydrolysis of trichlorphone had a higher bacteriocidal effect than trichlorphone itself; pH-changes may modify the effectiveness. The processes that take place in the bacterial cultures containing trichlorphone are discussed.

Scaling behaviour of hyaluronic acid in solution with mono- and divalent ions

The effect of the simultaneous presence of mono- and divalent cations on the thermodynamics of polyelectrolyte solutions is not fully understood. In physiological conditions, combinations of these ions affect structure formation in biopolymer systems. It is known that divalent counterions form a tight sheath around the polymer backbone, while monovalent ions are distributed in a diffuse cloud. Dynamic light scattering measurements of the collective diffusion coefficient D and the osmotic compressibility of semi-dilute hyaluronan solutions containing different ratios of sodium and calcium ions are compared with simple polyelectrolyte models. Scaling relationships are derived in terms of polymer concentration and ionic strength J of the added salt. Differences in the effects of sodium and calcium ions are expressed only through J.

Dynamic scaling of polymer gels comprising nanoparticles

We present dynamic light scattering (DLS) measurements of soft poly(methyl-methacrylate) (PMMA) and polyacrylamide (PA) polymer gels prepared with trapped bodies (latex spheres or magnetic nanoparticles). We show that the anomalous diffusivity of the trapped particles can be analyzed in terms of a fractal Gaussian network gel model for the entire time range probed by DLS technique. This model is a generalization of the Rouse model for linear chains extended for structures with power law network connectivity scaling, which includes both percolating and uniform bulk gel limits. For a dilute dispersion of strongly scattering particles trapped in a gel, the scattered electric field correlation function at small wavevector ideally probes self-diffusion of gel portions imprisoning the particles. Our results show that the time-dependent diffusion coefficients calculated from the correlation functions change from a free diffusion regime at short times to an anomalous subdiffusive regime at long times (increasingly arrested displacement). The characteristic time of transition between these regimes depends on scattering vector as approximately q(-2), while the time decay power exponent tends to the value expected for a bulk network at small q. The diffusion curves for all scattering vectors and all samples were scaled to a single master curve.

X-ray intensity fluctuation spectroscopy by heterodyne detection

A straightforward way of measuring X-ray intensity fluctuation spectroscopy in a small-angle X-ray scattering configuration is demonstrated using heterodyne techniques. Two examples are presented: the Brownian motion of latex spheres in glycerol, and a Doppler velocity experiment demonstrating the motion and the relaxation of carbon-black-filled elastomers after uniaxial stretching. In the latter case the effects of mechanical relaxation can be separated from those of aggregate diffusion. The results suggest that the dynamics of these filled elastomers are similar to the universal features observed in disordered jammed systems.

Thermoablation of colorectal liver metastases promotes proliferation of residual intrahepatic neoplastic cells

BACKGROUND

Resection of liver neoplasms is believed to promote growth of residual intrahepatic neoplastic cells. As the effects of radiofrequency thermoablation (RFA) are still unknown, we aimed to compare the influence of RFA versus liver resection on residual intrahepatic neoplastic cells.

METHODS

A primary metastasis was established by injection of syngenic CT-26 coloncarcinoma cells into the right liver lobe of Balb/C mice. Five days later, 3 x 10(5) GFP-transfected CT-26 tumor cells were injected intraportally, and the primary metastasis was treated by resection (group I, n = 7) or RFA (group II, n = 7). The effect of resection/RFA on the growth of single intrahepatic GFP neoplastic cells was evaluated by intravital microscopy 7 days later.

RESULTS

Resection of a primary metastasis enhanced the proliferation of residual intrahepatic neoplastic cells, compared with the control group. RFA led to an increased survival of residual neoplastic cells (5% +/- 2% vs 1% +/- 1% single cells) and significantly promoted the proliferation of neoplastic cells, compared with resection (13% +/- 4% vs 2% +/- 2% micrometastases).

CONCLUSIONS

RFA strongly promotes intrahepatic growth of residual neoplastic cells. On the basis of our findings, RFA should not be recommended as an alternative curative treatment to resection. Furthermore, if RFA is performed as palliative therapy, postinterventional chemotherapy may be advisable to overcome the stimulation of residual neoplastic cells by RFA.

Benefit of Kupffer cell modulation with glycine versus Kupffer cell depletion after liver transplantation in the rat: effects on postischemic reperfusion injury, apoptotic cell death graft regeneration and survival

Inhibition or destruction of Kupffer cells (KC) may protect against ischemia-reperfusion (IR) induced primary graft nonfunction (PNF) in liver transplantation. Besides KC activation, PNF is characterized by microvascular perfusion failure, intrahepatic leukocyte accumulation, cell death and hepatocellular dysfunction. KCs can be inactivated by different agents including gadolinium chloride (GdCl3), methyl palmitate (MP) and glycine. The effects of three KC inactivators on IR-injury after rat liver transplantation were compared in the present study. Lewis liver donors were treated with GdCl3, MP, glycine or saline (control). Liver grafts were transplanted following 24 h storage (UW solution). KC populations and IR damage were assessed by histologic analysis, quantitative real-time polymerase chain reaction (RT-PCR) and intravital microscopy. The number of hepatic ED-1 positive macrophages was diminished after GdCl3 (114.8+/-4.4/mm2 liver tissue) and MP treatment (176.0+/-5.0), versus the glycine (263.9+/-5.5) and control (272.1+/-5.6) groups. All three treatment modalities downregulated phagocytic activity for latex particles, paralleled by reduced microvascular injury (acinar perfusion index, GdCl3: 0.75+/-0.03; MP: 0.83+/-.03; glycine: 0.84+/-0.03; 0.63+/-0.03). Quantitative RT-PCR revealed elevated myeloperoxidase mRNA after glycine versus GdCl3 and MP pretreatment (3.2- and 3.4-fold, P=0.011, respectively), without difference to controls (2.9-fold of glycine). TNFalpha-mRNA was reduced after glycine- (5.2-fold), GdCl3- (19.7-fold), MP-treatment (39.5-fold) compared with controls. However, profound prevention of intrahepatic cell death and liver graft failure was solely achieved with glycine preconditioning. Different than GdCl3 and MP, glycine modulates rather than destroys KCs. Glycine appears to preserve cell viability and to TNFalpha/leukocyte dependent organ regeneration capacity, which is related to increase graft survival following liver transplantation.

Konsensusempfehlung zum Einsatz von Sirolimus in der Lebertransplantation

Sirolimus is an m-TOR inhibitor without renal side effects and potentially protects against the development of malignancy. Due to a higher incidence of complications in two trials and an official warning in the drug information, the use of Sirolimus in liver transplantation is limited. The participants of this consensus meeting had to analyse and evaluate the literature with respect to the potential role of Sirolimus in liver transplantation. This consensus statement follows the scheme normally employed for the presentation of guidelines including the grading of evidence (1a-5) and the extent of recommendation (A-C). Moreover, the consensus included the experience of the authors with respect to the handling of Sirolimus after liver transplantation.

Structure of polymer solutions containing fumed silica

Small angle neutron scattering is employed to estimate the interactions in complex multicomponent systems. The method is applied to describe a ternary system, poly(dimethyl siloxane) toluene with silica filler particles. Contrast variation by solvent deuteration is used to distinguish the three different partial structure factors of filled polymer samples, S(pp)(q), S(pf)(q), and S(ff)(q), where the subscripts p and f refer to polymer and filler. This procedure allows changes to be detected in the distribution of the polymer close to the solid surface. Independent dynamic light scattering measurements are used to validate the method. A comparison is made between the behavior of different filled poly(dimethyl siloxane) PDMS samples. It is found that the polymer distribution is perturbed in the vicinity of the solid surfaces. In the case of weak interactions, the solvent removes the polymer almost completely from the filler particles, while, when the interaction is strong, the surface remains covered.

Kinetic evolution of unmixing in an AlLi alloy using x-ray intensity fluctuation spectroscopy

Irreversible decomposition of an AlLi single crystal has been studied by x-ray photon correlation spectroscopy. The precipitate coarsening follows a universal behavior, as measured by the time-resolved average scattering. Using coherent scattering, two-time correlation functions have been measured. The time evolution of the speckle pattern gives new insight into the process of unmixing; at least two regimes govern this evaporation-condensation coarsening process. One is related to the overall arrangement of precipitates, and the characteristic time is linear with annealing time. The other is related to the motion of interfaces and is related to Porod's law.

Aging in a filled polymer: coherent small angle x-ray and light scattering

Measurements are described using small angle coherent x-ray scattering and small angle dynamic light scattering of motion in fumed silica aggregates suspended in a poly(dimethyl siloxane) melt. At rest, this system develops weakly bound superstructures that are disrupted by mechanical stirring or thermal treatment. The observed relaxation rates correspond to a combination of liquidlike diffusion and a structural relaxation (flocculation) whereby the diffusing silica aggregates recombine into larger agglomerates at long times. Both processes are diffusion controlled. Two samples are investigated. The first, in which the silica is hydrophilic, is a highly viscous liquid for which the respective rate coefficients are about 5x10(-14) cm(2) s(-1) and 2x10(-15) cm(2) s(-1). The second sample, in which the silica surface is hydrophobic, is a thixotropic paste. The same aging mechanism in the diffusion is also observed, but with much slower rate constants, 2x10(-15) cm(2) s(-1) and 9x10(-16) cm(2) s(-1), respectively.

A transfecting peptide derived from adenovirus fiber protein

New strategies to improve the outcome of gene therapy often employ a nonviral gene delivery, which is most likely to fulfil microbiological safety criteria and be retained in the clinical setting. Here we show that efficient gene transfer can be achieved in vitro using as a vector a polyvalent peptide derived from the N-terminal sequence of the human adenovirus fiber protein. The level of transfection is better than that obtained with the two liposomes, DOTAP and DOSPER. Internalization was studied by confocal microscopy using fluorescently marked peptide and DNA. The peptide alone is targeted to the nucleus and concentrated within the nucleolus. Similarly, DNA complexed with peptide also enters the nucleolus, where it is retained for at least 48 h. Peptide I appears to attach to cells by a saturable process, as preincubation of cells with peptide blocks transfection and there is no transfection at 4 degrees C. The peptide contains three domains: a nuclear localization signal of adenovirus fiber protein; a domain containing hydrophobic and polar residues harboring an internalization signal for receptor-mediated endocytosis; and a stretch of lysines. Each of these domains is required for optimum gene transfer. Peptide I may be an interesting alternative to known vectors for gene transfer, for local administration and for ex vivo applications.

Speckle Structure in Small-Angle Coherent X-ray Scattering

Small-angle coherent X-ray scattering measurements on a polymer gel and on a single crystal of Al–9at.% Li are reported. Speckle structures were recorded using a direct-illumination CCD camera. A speckle intensity fluctuation of ~20% was observed. Time and space statistics for the signal provided estimates of the coherence effects and the measurements demonstrate the wavevector dependence of the coherence effects. Preliminary intensity-fluctuation spectroscopy was performed for Al–Li.

Clustering of cytokine genes on mouse chromosome 11

The presence of positionally conserved amino acid residues suggests that the mouse proteins TCA3, P500, MIP1-alpha, MIP1-beta, and JE are members of a single gene family. These proteins are activation specific and can be expressed by both myeloid and lymphoid cells. MIP1-alpha/MIP1-beta and MCAF (the putative human homologue of JE) act as chemotactic and activating agents for neutrophils and macrophages, respectively. The functions of TCA3 and P500 are unknown. We have used interspecies somatic cell hybrids and recombinant inbred mouse strains to show that the genes encoding TCA3, MIP1-alpha, MIP1-beta, and JE (provisionally termed Tca3, Mip-1a, Mip-1b, and Sigje, respectively) map as a cluster on the distal portion of mouse chromosome 11 near the Hox-2 gene complex. DNA sequence analysis indicates that the P500 and TCA3 proteins are encoded by alternative splicing products of one genomic gene. Additionally, the genes encoding TCA3 and JE are found to be strikingly similar with respect to the positions of intron-exon boundaries. Together, these data support the model that the cytokines TCA3, P500, MIP1-alpha, MIP1-beta, and JE are encoded by a single cluster of related genes. The gene encoding IL-5 (Il-5), which acts as a T cell-replacing factor, a B cell growth factor, and an eosinophil differentiation factor, is also mapped to mouse chromosome 11.Il-5 maps approximately 25 cM proximal to the Tca-3 gene and appears tightly linked to a previously described gene cluster that includes Il-3, Il-4, and Csfgm. We discuss the potential relevance of the two cytokine gene clusters described here with particular attention to specific human hematologic malignancies associated with chromosomal aberrations at corresponding locations on human chromosomes 5 and 17.

Genes encoding alpha and beta subunits of Na,K-ATPase are located on three different chromosomes in the mouse

We have made use of a panel of mouse-hamster somatic cell hybrids and restriction fragment length polymorphisms between two mouse species (Mus musculus and Mus spretus) to determine the chromosomal localization of genes encoding the alpha and beta subunits of the Na,K-ATPase (Na+,K+-activated ATP phosphohydrolase, EC 3.6.1.3). DNA probes for three distinct isoforms of the Na,K-ATPase alpha subunit mapped to three different mouse chromosomes: the alpha 1 gene (Atpa-1) cosegregated with the Egf gene on chromosome 3; alpha 2 (Atpa-2) with the cytochrome P-450PB gene family/coumarin hydroxylase locus on chromosome 7; alpha 3 (Atpa-3) with the alpha-spectrin gene on chromosome 1. The Na,K-ATPase beta-subunit gene (Atpb) mapped to the same region of chromosome 1, but it was not tightly linked to the Atpa-3 gene. These results indicate that three isoforms of the Na,K-ATPase alpha subunit are encoded by three distinct genes. The dispersion of Na,K-ATPase genes suggests that their expression is not likely to be controlled by a common cis-acting regulatory element.

Simian virus 40-induced mutagenesis: action of the early viral region

Earlier results have demonstrated a mutagenic activity of simian virus 40 (SV40) in mammalian cells. To analyse this ability further, the effect of SV40 DNA fragments, introduced into Chinese hamster cells, on the frequency of mutations at the hypoxanthine phosphoribosyltransferase locus and other loci was studied. It was found that the mutagenic effect was substantially maintained when the viral genome had been replaced by a fragment comprising the T antigen-coding region and the early promoter-enhancer region; was strongly reduced or abolished when the promoter region including upstream sequences in this fragment had been replaced by the chicken lysozyme gene promoter or both enhancer elements were deleted, and was abolished in an SV40 replication origin-defective mutant in which the structure of the T antigen-binding site II was affected. It may be concluded that SV40-induced mutagenesis depends on the expression of the early region of the genome and on a function involved in specific binding of large T antigen to viral DNA. Since origin-defective mutants of SV40 were reported as being able to transform cells, the functions of transformation and mutation do not seem to correlate.

Rescue of a tk-plasmid from transgenic mice reveals its episomal transmission

This communication demonstrates the usefulness of the plasmid rescue procedure for recovery of plasmids from transgenic mice. We have microinjected the plasmid pSK1 harbouring the Herpes simplex virus thymidine kinase gene into fertilized mouse oocytes and succeeded in recovering plasmids from newborns by transformation of E. coli either with HindIII cut cellular DNA or with uncut DNA. The majority of the rescued plasmids were indistinguishable from pSK1 by restriction analysis. The rescued plasmids proved to be functionally active in a transient expression assay in mouse Ltk- cells. The pSK1 DNA sequences were inherited by up to 90% of the second generation progeny mice, which is not in agreement with a Mendelian transmission of heterozygous markers integrated into a single site of the chromosome. These data support the assumption that germ line transmission of non-integrated episomal plasmids can occur.

Studies on the SV40-like papovavirus SV40-GBM. III. Propagation at low multiplicities of infection in various human cell lines

At low multiplicity several human cell lines supported the lytic infection with SV40-GBM better than that with the wild type SV40. The efficiency of viral DNA replication differed in the cell lines used suggesting that specific host cell factors may determine the rate of viral DNA synthesis. Furthermore, the emergence of different DNA defects during propagation of the virus indicates that host cell factors in question might also influence the composition of the viral DNA population.