Bacteria Patterns on Tonsillar Surface and Tonsillar Core Tissue among Patients Scheduled for Tonsillectomy at Bugando Medical Centre, Mwanza, Tanzania

Background: Tonsillitis is an inflammation of the tonsils due to either viruses or bacteria. Here, we report the bacteria patterns on the tonsillar surface and tonsillar core tissue among patients scheduled for tonsillectomy at Bugando Medical Centre (BMC), Mwanza Tanzania. Methods: The study included 120 patients planned for tonsillectomy between April and July 2019. Swab samples from tonsillar surface pre-tonsillectomy and core post-tonsillectomy were collected. Culture was performed following the microbiology laboratory standard operating procedures. Data analysis was completed using STATA version 13, as per the study objectives. Results: The slight majority of participants were males (73; 60.83%) with median age of 6 years (interquartile range 4–11). The proportion of positive culture growth was higher on the surface than in core swab samples: 65 (54.2%) vs. 42 (35.0%), p = 0.003. The commonest bacterial pathogen detected from the surface and core were S. aureus in 29 (40.3%) and 22 (51.2%) participants, followed by S. pyogenes in 17 (23.6%) and 11 (25.6%), respectively. Methicillin-resistant Staphylococcus aureus (MRSA) was observed in 20/51 (39%) of isolates. Streptococcus pyogenes resistance to macrolides ranged from 8.3% for core isolates to 35.3% for surface isolates. Features suggestive of tonsillitis on histology were reported in 83 (73.5%) samples. Conclusion: More than two-thirds of patients undergoing tonsillectomy had a positive culture for possible bacterial pathogens. Staphylococcus aureus and Streptococcus pyogenes were the predominant bacteria detected with more than one third of Staphylococcus aureus being MRSA. More studies to investigate the treatment outcome of these patients are highly recommended.

Bacteria Patterns on Tonsillar Surface and Tonsillar Core Tissue among Patients Scheduled for Tonsillectomy at Bugando Medical Centre

Background: Tonsillitis is an inflammation of tonsils due to either viruses or bacteria. Here we report the bacteria patterns on tonsillar surface and tonsillar core tissue among patients scheduled for tonsillectomy at Bugando Medical Centre (BMC), Mwanza Tanzania.Methods: The study included 120 patients planned for tonsillectomy between April and July 2019. Swab samples from tonsilar surface pre-tonsillectomy and core post-tonsillectomy were collected. Culture was performed following the microbiology laboratory standard operating procedures. Data analysis was done using STATA version 13 as per study objectives.Results: The slightly majority of participants were males 73 (60.83%) with median age of 6 [IQR 4-11] years. The proportion of culture positive growth was high on surface than in core swab samples 65(54.2%) vs 42(35.0%), p=0.003. The commonest bacterial pathogen detected from the surface and core were S. aureus 29(40.3%) and 22(51.2%), followed by S. pyogenes, 17(23.6%) and 11(25.6%), respectively. Features suggestive of tonsillitis on histology were reported in 83 (73.5%) of samples. Conclusion: More than two-third of patients undergoing tonsillectomy had positive culture of possible bacterial pathogens. Streptococcus pyogenes and Staphylococcus aureus were the predominant bacteria detected. More studies to investigate the treatment outcome of these patients are highly recommended.

Comparison of Two EUS-Guided Liver Biopsy Techniques (“Wet Heparin” and “Wet Saline”) For Benign Parenchymal Liver Disease

Background: Endoscopic ultrasound-guided liver biopsy (EUS-LB) has emerged as a viable mean to obtain core tissue. Different wet suction techniques using saline or heparin have been described. We aimed to compare tissue adequacy with the “wet saline” (WS) technique compared to the “wet heparin” (WH) technique.Methods: We conducted a retrospective review of patients who underwent EUS-LB and Percutaneous liver biopsy (PLB-LB) for benign parenchymal liver disease between May 2017 to October 2019. All procedures were performed at a single tertiary Veterans Affairs Medical Center (VAMC).Results: A total of 257 biopsies from 217 patients were included. Among the 102 EUS-LB specimens, 53 were obtained using WS technique and 49 were obtained using WH technique. Specimen adequacy was similar in the both groups. Median ASL and length of longest piece did not differ significantly between both groups. Clots were present more frequently in the WS group. Among patients who underwent EUS-LB of both right and left liver lobes, an adequate biopsy was obtained in 85% of patients in the WS group and 96% of patients in the WH group. EUS-LB showed lower risk of post procedural pain and complication rates when compared with percutaneous liver biopsy (PLB). To our knowledge, this is the first study to compare diagnostic accuracy between WH and WS EUS-LB techniques, and to compare post-procedure pain between EUS-LB and moderate sedation PLB. WH-EUS-LB may be preferable to WS because of fewer clots in the specimen. Prospective studies are needed to further verify these findings.

389 Combining transcriptomic- and tissue-based immune biomarkers to evaluate GB1275, a CD11b modulator, as a single agent or with pembrolizumab in patients with advanced solid tumors

BackgroundGB1275 is a first-in-class CD11b modulator in development as monotherapy and in combination with pembrolizumab or chemotherapy for the treatment of advanced solid tumors. Nonclinical data show that GB1275 reduced influx of tumor-associated myeloid-derived suppressor cells (MDSCs) and macrophages (TAMs), and repolarized M2 immuno-suppressive TAMs towards an M1 phenotype. We hypothesize that GB1275 administration can alleviate myeloid cell-mediated immunosuppressive effects and improve cancer treatment outcomes. A phase 1 trial evaluating GB1275 as monotherapy and in combination with pembrolizumab in specified advanced tumors in ongoing (NCT04060342).MethodsBlood gene expression variations as well as core tissue biopsies pre- and post-treatment were assessed following GB1275 monotherapy and combination with pembrolizumab. After obtaining informed consent, peripheral blood for MDSCs was collected from 21 patients pre- and two weeks post-treatment; core tissue biopsies were collected from 13 patients pre- and post-treatment. The frequency of MDSCs in whole blood was measured using the Serametrix MDSC FACS Assay. Gene expression transcriptome profiles were generated using NovaSeq platform. CD8 staining was performed at Neogenomics, and tumor infiltrating lymphocyte (TIL) quantification was performed by an independent pathologist.ResultsPreliminary statistical analysis of MDSC immunophenotyping pre- and post- treatment is consistent with the proposed mechanism of GB1275, showing modulation of peripheral blood MDSCs in some patients. Preliminary gene expression analysis in the blood showed dose-dependent clusters following treatment with GB1275 alone. Moreover, the transcriptomic analysis revealed two unique expression patterns for patients treated with GB1275 monotherapy or in combination with pembrolizumab. Gene Set Enrichment Analysis showed that the CD11b pathway is downregulated in patients treated with GB1275. Analyses of TIL count revealed an increase in lymphocyte trafficking into the tumor after treatment with GB1275 alone or in combination with pembrolizumab. CD8 expression and transcriptomic analysis are underway and will be presented.ConclusionsGB1275 alone or in combination with pembrolizumab demonstrates biological activity, which may be dose dependent. The observed increase in TILs after treatment is supportive of the mechanism of action of GB1275. Further biomarker analyses in blood and tissues are ongoing and will be correlated with clinical activity in a larger number of patients.Ethics ApprovalThis ongoing study is being conducted in accordance with the the Declaration of Helsinki and Council for International Organizations of Medical Sciences (CIOMS) International Ethical Guidelines. The study was approved by the Ethics Boards of University of Colorado Hospital, Washington University School of Medicine - Siteman Cancer Center, Memorial Sloan Kettering Cancer Center, The Sarah Cannon Research Institute/Tennessee Oncology, South Texas Accelerated Research Therapeutics, and The Royal Marsden NHS Foundation Trust.

Skeletal Muscle Extracellular Matrix: Composition, Structure and Function

The skeletal muscle provides movement and support to the skeleton, controls body temperature, and regulates the glucose level within the body. This is the core tissue of insulin-mediated glucose uptake via glucose transporter type 4 (GLUT4). The extracellular matrix (ECM) provides a scaffold for cells, controlling biological processes, and providing structural as well as mechanical support to surrounding cells. Disruption of ECM homeostasis results in several pathological conditions. Various ECM components are typically found to be augmented in the skeletal muscle of obese and/or diabetic humans. A better understanding of the importance of skeletal muscle ECM remodeling, integrin signaling, and other factors that regulate insulin activity may help in the development of novel therapeutics for managing diabetes and other metabolic disorders.

Storage regimes to allow softening in a processing apple treated with 1-methylcyclopropene

The objective of this study was to investigate the effects of storage regime and postharvest 1-methylcyclopropene (1-MCP) treatment timing on softening of ‘Northern Spy’ apples, to determine if ideal firmness for processing could be achieved after storage while at the same time maintaining fruit quality and extending storage life. Over 4 yr of study, ‘Northern Spy’ apples with or without 1-MCP (1 μL L−1) were held for up to 12.5 mo at 0 °C–1 °C in the following regimes: (1) controlled atmosphere (CA) with or without 2 wk post-storage ambient air; (2) ambient air or CA; (3) CA with up to 6 mo delayed 1-MCP treatment; (4) delayed CA establishment for up to 4 mo; (5) delayed 1-MCP treatment in combination with delayed CA establishment for 1 or 2 mo. 1-MCP treatment at harvest consistently enhanced firmness retention, which remained too high for processing. Delayed 1-MCP treatment allowed more firmness loss but fruit remained firmer than those not treated, and these apples would be acceptable for subsequent processing (∼67–72 N). 1-MCP-treated fruit developed higher incidence of core browning than those not treated, especially after 6 mo of storage. However, this is not a major problem for processing because core tissue is removed. Delayed CA within any regime did not result in apples with firmness values acceptable for processing, while additional air storage for 2 wk at 0 °C after CA had no significant effect. Overall, delayed 1-MCP treatment with no delay in CA provided the most acceptable apple firmness for processing.