Large-scale automated histology in the pursuit of connectomes

How does the brain compute? Answering this question necessitates neuronal connectomes, annotated graphs of all synaptic connections within defined brain areas. Further, understanding the energetics of the brain's computations requires vascular graphs. The assembly of a connectome requires sensitive hardware tools to measure neuronal and neurovascular features in all three dimensions, as well as software and machine learning for data analysis and visualization. We present the state of the art on the reconstruction of circuits and vasculature that link brain anatomy and function. Analysis at the scale of tens of nanometers yields connections between identified neurons, while analysis at the micrometer scale yields probabilistic rules of connection between neurons and exact vascular connectivity.     

Higher tobramycin concentration and vibrating mesh technology can shorten antibiotic treatment time in cystic fibrosis

Poor adherence to recommended therapy in cystic fibrosis (CF) is often because of the time demands of therapy. Tobramycin (TOBI®, 300 mg at 60 mg/ml) inhaled from the PARI LC PLUS® nebulizer requires about 20 min. This study determined if equivalent levels of pulmonary deposition could be achieved in shorter time using 1.5 ml of 100 mg/ml tobramycin solution delivered by an investigational eFlow® nebulizer. Sixteen males with stable CF, 8 children and 8 adults, and an FEV₁ > 45% predicted inhaled both preparations on two occasions with ^99mTc‐DTPA added to the tobramycin. Blood samples were taken for quantification of tobramycin in the serum. The PARI LC PLUS® delivered 45.4 (39.3–51.6), mean and 95% CI, mg to the lungs in 17.0 ± 2.5 min (mean ± SD) with serum levels of 1,089 ± 388 µg/L. The investigational eFlow® delivered 46.3(40.3–51.7) mg in 4.0 ± 1.0 min with blood levels of 909 ± 458 µg/L. Only the time of delivery was significantly different with P < 0.0001 (paired t‐test). Tolerability of the treatment was comparable for both inhalation regimes, but the shorter treatment was preferred by all patients. These results demonstrate the possibility of delivering equivalent levels of tobramycin much faster into the lungs of CF patients when using eFlow®, a very efficient electronic nebulizer. Pediatr Pulmonol. 2011; 46:401–408. © 2010 Wiley‐Liss, Inc.     

De novo fenestration of extra‐cardiac fontan goretex conduit assisted by inoue balloon

De novo fenestration of Goretex conduit of extra‐cardiac total cavopulmonary connection in the postoperative period is challenging, and is rarely reported. We report a 17‐year‐old boy with failing Fontan circuit in whom fenestration was created, aided by an Inoue balloon. © 2012 Wiley Periodicals, Inc.     

Cor triatriatum

The coexistence of cor triatriatum and tetralogy of Fallot (TOF) is rare. Preoperative identification of cor triatriatum may be difficult owing to reduced pulmonary blood flow in patients with TOF. However, it is imperative to identify this rare combination as failure to identify obstruction to pulmonary venous egress may result in persistent pulmonary venous hypertension postoperatively. The authors discuss hemodynamic aspects of this rare coexistence in a 14‐month‐old child in whom pulmonary capillary wedge pressure was elevated despite right ventricular outflow obstruction. © 2012 Wiley Periodicals, Inc.     

Endovascular revascularization of bald aortic arch for severe cerebral ischemia

Takayasu arteritis is a rare form of chronic, inflammatory arteriopathy affecting the aorta and its major branches. Obstructive lesions of all arch vessels lead to ischemic brain symptoms. There is very limited experience of endovascular revascularization in this situation. We report case of a female patient with potentially life threatening cerebral ischemic symptoms due to extra‐cranial occlusion of all arch arteries. Stent supported angioplasty of brachiocephalic, right common carotid and right subclavian artery was successfully performed. This improved her cerebral blood flow and relieved her severe, disabling neurologic symptoms. © 2013 Wiley Periodicals, Inc.     

Influence of oxygen,albumin and pH on copper dissolution in a simulated uterine fluid

Objectives?The aim of this paper is to study the influence of albumin content, from 5 to 45?g/L, on copper dissolution and compounds composition in a simulated uterine solution.

Methods?Experiments were performed in atmospheric pressure conditions and with an additional oxygen pressure of 0.2 atmospheres, at 6.3 and 8.0 pH values, and at a temperature of 37?±?0.1° C for 1, 3, 7, and 30 days experimentation time.

Results?The copper dissolution rate has been determined using absorbance measurements, finding the highest value for pH?8.0, 35?g/L albumin, and with an additional oxygen pressure of 0.2 atmospheres: 674?μg/day for 1 day, and 301?μg/day for 30 days. X-ray photoelectron spectroscopy (XPS) results show copper(II) as the main copper oxidation state at pH?8.0; and copper(I) and metallic copper at pH?6.3.

Conclusions?The presence of albumin up to 35?g/L, accelerates copper dissolution. For high albumin content a stabilisation on the copper dissolution takes place. Corrosion product layer morphology is poorly protective, showing paths through which copper ions can release.