In vivo two-photon microscopy of the hippocampus using glass plugs

Two-photon microscopy has been used in conjunction with micro-optics, such as GRIN lenses, to access subcortical structures in the intact mouse brain. In this study, we demonstrate the use of thick glass windows, or plugs, for high-resolution, large field-of-view two-photon imaging of the hippocampus in a live mouse. These plugs are less expensive, yield larger fields-of-view and are simpler to use than GRIN lenses while requiring less tissue removal compared to previous methods based on cortical ablation. To demonstrate the capabilities of our system, we show fluorescence images of dendritic spines in the CA1 region of the hippocampus in THY1-YFP transgenic mice.OCIS codes: (180.0180) Microscopy, (180.2520) Fluorescence microscopy, (180.4315) Nonlinear microscopy     

Genetic diversity of Ascaris in southwestern Uganda

Despite the common occurrence of ascariasis in southwestern Uganda, helminth control in the region has been limited. To gain further insights into the genetic diversity of Ascaris in this area, a parasitological survey in mothers (n=41) and children (n=74) living in two villages, Habutobere and Musezero, was carried out. Adult Ascaris worms were collected from infected individuals by chemo-expulsion using pyrantel pamoate treatment. Genetic diversity within these worms was assessed by inspection of DNA sequence variation in a mitochondrial marker and length polymorphism at microsatellite loci. Overall prevalence of ascariasis was 42.5% in mothers and 30.4% in their children and a total of 98 worms was examined from 18 hosts. Sequence analysis of a portion of the mitochondrial cytochrome c oxidase subunit 1 gene revealed 19 different haplotypes, 13 of which had not been previously encountered. Microsatellite analysis using eight loci provided evidence for high gene flow between worm populations from the two villages but comparing these worms with others obtained in a prior study on Unguja, Zanzibar, confirmed little genetic exchange and mixing of worm populations between the two areas. By adding to our understanding of the genetic diversity of Ascaris in Africa, this study provides useful information for monitoring changes in parasite population structure in the face of ongoing and future control.     

Fine specificity and cross-reactions of monoclonal antibodies to group B streptococcal capsular polysaccharide type III

Group B streptococcus (GBS) is a major cause of neonatal sepsis and meningitis. Despite aggressive campaigns using antenatal prophylactic antibiotic therapy, infections continue. Developing an effective maternal vaccine is a public health priority. Antibody (Ab) to the capsular polysaccharide (CPS) is considered the dominant "protective" immune mediator. Here we study the fine specificity and potential host reactivity of a panel of well-characterized murine monoclonal Abs against the type III CPS by examining the binding of the Abs to intact and neuraminidase-digested GBS, purified CPS, synthetic carbohydrate structures, and cells. The results showed marked differences in the fine specificity among these mAbs to a single carbohydrate structure. Cross-reactions with synthetic GD3 and GT3 carbohydrates, representing structures found on surfaces of neural and developing cells, were demonstrated using carbohydrate array technology. The anti-CPS(III) mAbs did not react with cells expressing GD3 and GT3, nor did mAbs specific for the host carbohydrates cross-react with GBS, raising questions about the physiological relevance of this cross-reaction. But in the process of these investigations, we serendipitously demonstrated cross-reactions of some anti-CPS(III) mAbs with antigens, likely carbohydrates, found on human leukocytes. These studies suggest caution in the development of a maternal vaccine to prevent infection by this important human pathogen.     

Evaluation of the Efficacy and Safety of an eGlycemic Management System in a Community Hospital Setting

Background:Glucommander is an eGlycemic management system (eGMS) for intravenous (IV) and subcutaneous (SQ) insulin therapy in hospitalized patients. The purpose of this study was to evaluate the efficacy and safety of Glucommander compared to previously utilized nomograms in the community hospital setting.Methods:This study was a retrospective, single-center cohort study comparing measures of efficacy and safety of IV and SQ insulin therapy via eGMS versus nomogram-driven IV insulin therapy followed by provider-ordered basal-bolus SQ insulin. The primary efficacy endpoint was percent of blood glucose (BG) readings per patient in target glycemic range. Safety objectives were percent of hyperglycemic events, hypoglycemic events, and severe hypoglycemic events after achieving target blood glucose range, and mean number of each event per patient.Results:The percentage of BG readings in range was significantly higher for eGMS patients (n = 110) than comparison cohort patients (n = 108, 84.6% vs 76.8%, P < .001). Hyperglycemic events occurred for significantly fewer patients in the eGMS cohort relative to the comparison cohort (81.8% vs 92.6%, P = .03). Overall, there was no significant difference between cohorts in rate of hypoglycemic events, but hypoglycemic events while on IV insulin occurred in a significantly higher percentage of eGMS cohort patients than comparison cohort patients (30.9% vs 15.7%, P < .01). There were no significant differences in incidence of severe hypoglycemic events.Conclusions:Our study found that Glucommander maintained a higher percentage of BG readings in target BG range per patient compared to previously utilized nomograms. This result was driven by an improvement in hyperglycemia, but not hypoglycemia.     

A Submucosal Antral Mass Caused by Cytomegalovirus Infection in a Patient with Acquired Immunodeficiency Syndrome

A 29-yr-old homosexual man with acquired immunodeficiency syndrome presented with watery diarrhea and fever. Upper gastrointestinal endoscopy was performed to obtain duodenal aspirates and biopsies. A 4-cm submucosal mass in the gastric antrum was identified. Subsequent abdominal CT scan confirmed the presence of this antral mass. An attempt at CT guided needle biopsy was nondiagnostic. Because the mass possibly represented a Kaposi's sarcoma or lymphoma, exploratory laparotomy and open biopsy was performed. Examination of the biopsy specimen showed inflammatory debris with multiple intranuclear cytomegalovirus inclusions. This report describes a case of a submucosal antral mass caused by localized cytomegalovirus infection in a patient with acquired immunodeficiency syndrome.     

Techniques and uses of nosocomial infection surveillance in U.S. hospitals, 1976–1977

From personal interviews in a representative sample of hospitals, we found that 97 per cent of them had some type of infection surveillance system; most involved continuous, hospital-wide surveillance, written definitions of infections, active case-finding methods and basic analytic techniques. Infection control nurses spent an average of about half of their time on surveillance. In larger hospitals (≥ 200 beds), the heads of the infection surveillance and control programs reported a greater awareness of most nosocomial infections if they were in hospitals with more intensive surveillance systems, and most indicated that surveillance data were used for a variety of specific purposes. Although 81 percent of persons who described surveillance reported using surveillance data in inservice education, only 31 percent of U.S. staff nurses recalled its having been presented. “Clean” wound, surgeon-specific rates of surgical wound infection were reported back to surgeons in only 16 percent of the hospitals. Ninety-seven percent of the hospital administrators believed that surveillance data are not a hindrance in defending the hospital against litigation for alleged malpractice, and 65 percent considered the information more often a help.     

Age adjustment corrects for apparent differences in erythrocyte sedimentation rate and C-reactive protein values at the onset of seropositive rheumatoid arthritis in younger and older patients

OBJECTIVE: To evaluate the effect of age adjustment on baseline erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) in patients with late-onset rheumatoid arthritis (LORA, age > or = 55 yrs) and younger-onset RA (YORA, age < 55 yrs) in a cohort with early, rheumatoid factor (RF) positive RA that has not received disease modifying antirheumatic drugs (DMARD). METHODS: In an ongoing prospective cohort study of 263 patients with seropositive RA who were enrolled within 14 months of symptom onset, baseline assessments included ESR, CRP, tender and swollen joint counts, and functional status. Westergren ESR determinations were performed in the rheumatologist's office or in a local laboratory using appropriate methods. CRP were performed at the Specialty Laboratories in Santa Monica, CA, using Behring nephelometry. Percentages of patients with greater than the upper limit of normal (ULN) laboratory values using both age-unadjusted and age-adjusted ESR and CRP values were determined. The late-onset and younger-onset RA patients were compared using Wilcoxon rank-sum and chi-square tests. RESULTS: At study entry, both the YORA and LORA patients had comparable symptom duration, disease activity scores, tender and swollen joint counts, and Health Assessment Questionnaire values. RF, CRP, and ESR were significantly higher (p < 0.05) in LORA patients. Although the percentages of patients with age-unadjusted ESR and CRP above ULN were higher in LORA patients, the percentages exceeding the age-adjusted ULN did not differ significantly between the YORA and LORA groups. CONCLUSION: In patients with late-onset and younger-onset RA with similar disease duration and severity, the apparent discrepancy in elevation of both the baseline ESR and CRP disappears after age-adjustment.     

Search for enteric microbial pathogens in patients with ulcerative colitis.

Microbial pathogens were sought in faeces of patients with active ulcerative colitis and again after 3 months treatment. 64 patients were examined during their first episode of ulcerative colitis and 30 with relapse of chronic disease. At presentation, bacterial pathogens were not found; 1 patient had cryptosporidiosis. In 10 patients treatment appeared to result in some loss of colonisation resistance as evidenced by colonisation with beta-haemolytic streptococci, Staphylococcus aureus, candida and Clostridium difficile. Unidentified cytotoxic activity was present in the faeces of 4 patients at presentation and 2 patients during or after treatment. We conclude that enteric infection is an uncommon finding in patients with active ulcerative colitis.