Confocal Laser Scanning Microscopy, a New In Vivo Diagnostic Tool for Schistosomiasis

BACKGROUND: The gold standard for the diagnosis of schistosomiasis is the detection of the parasite's characteristic eggs in urine, stool, or rectal and bladder biopsy specimens. Direct detection of eggs is difficult and not always possible in patients with low egg-shedding rates. Confocal laser scanning microscopy (CLSM) permits non-invasive cell imaging in vivo and is an established way of obtaining high-resolution images and 3-dimensional reconstructions. Recently, CLSM was shown to be a suitable method to visualize Schistosoma mansoni eggs within the mucosa of dissected mouse gut. In this case, we evaluated the suitability of CLSM to detect eggs of Schistosoma haematobium in a patient with urinary schistosomiasis and low egg-shedding rates. METHODOLOGY/PRINCIPAL FINDINGS: The confocal laser scanning microscope used in this study was based on a scanning laser system for imaging the retina of a living eye, the Heidelberg Retina Tomograph II, in combination with a lens system (image modality). Standard light cystoscopy was performed using a rigid cystoscope under general anaesthesia. The CLSM endoscope was then passed through the working channel of the rigid cystoscope. The mucosal tissue of the bladder was scanned using CLSM. Schistoma haematobium eggs appeared as bright structures, with the characteristic egg shape and typical terminal spine. CONCLUSION/SIGNIFICANCE: We were able to detect schistosomal eggs in the urothelium of a patient with urinary schistosomiasis. Thus, CLSM may be a suitable tool for the diagnosis of schistosomiasis in humans, especially in cases where standard diagnostic tools are not suitable

Confocal Laser Scanning Microscopy for Detection of Schistosoma mansoni Eggs in the Gut of Mice

Background: The gold standard for diagnosing Schistosoma mansoni infections is the detection of eggs from stool or biopsy specimens. The viability of collected eggs can be tested by the miracidium hatching procedure. Direct detection methods are often limited in patients with light or early infections, whereas serological tests and PCR methods fail to differentiate between an inactive and persistent infection and between schistosomal species. Recently, confocal laser scanning microscopy (CLSM) has been introduced as a diagnostic tool in several fields of medicine. In this study we evaluated CLSM for the detection of viable eggs of S. mansoni directly within the gut of infected mice. Methodology/Principal Findings: The confocal laser scanning microscope used in this study is based on the Heidelberg Retina Tomograph II scanning laser system in combination with the Rostock Cornea Module (image modality 1) or a rigid endoscope (image modality 2). Colon sections of five infected mice were examined with image modalities 1 and 2 for schistosomal eggs. Afterwards a biopsy specimen was taken from each colon section and examined by bright-field microscopy. Visualised eggs were counted and classified in terms of viability status. Conclusions/Significance: We were able to show that CLSM visualises eggs directly within the gut and permits discrimination of schistosomal species and determination of egg viability. Thus, CLSM may be a suitable non-invasive too

Pediatric differentiated thyroid carcinoma in stage I: risk factor analysis for disease free survival

<p>Abstract</p> <p>Background</p> <p>To examine the outcomes and risk factors in pediatric differentiated thyroid carcinoma (DTC) patients who were defined as TNM stage I because some patients develop disease recurrence but treatment strategy for such stage I pediatric patients is still controversial.</p> <p>Methods</p> <p>We reviewed 57 consecutive TNM stage I patients (15 years or less) with DTC (46 papillary and 11 follicular) who underwent initial treatment at Ito Hospital between 1962 and 2004 (7 males and 50 females; mean age: 13.1 years; mean follow-up: 17.4 years). Clinicopathological results were evaluated in all patients. Multivariate analysis was performed to reveal the risk factors for disease-free survival (DFS) in these 57 patients.</p> <p>Results</p> <p>Extrathyroid extension and clinical lymphadenopathy at diagnosis were found in 7 and 12 patients, respectively. Subtotal/total thyroidectomy was performed in 23 patients, modified neck dissection in 38, and radioactive iodine therapy in 10. Pathological node metastasis was confirmed in 37 patients (64.9%). Fifteen patients (26.3%) exhibited local recurrence and 3 of them also developed metachronous lung metastasis. Ten of these 15 achieved disease-free after further treatments and no patients died of disease. In multivariate analysis, male gender (p = 0.017), advanced tumor (T3, 4a) stage (p = 0.029), and clinical lymphadenopathy (p = 0.006) were risk factors for DFS in stage I pediatric patients.</p> <p>Conclusion</p> <p>Male gender, tumor stage, and lymphadenopathy are risk factors for DFS in stage I pediatric DTC patients. Aggressive treatment (total thyroidectomy, node dissection, and RI therapy) is considered appropriate for patients with risk factors, whereas conservative or stepwise approach may be acceptable for other patients.</p

Chemical Additives for Corrosion Control in Desalination Plants

The addition of chemical additives has been considered as a standard operation in water treatment systems. This chapter discusses the chemical additives used for the control of corrosion in desalination systems. Specifically, corrosion inhibitors for various metallurgies, biocides, and oxygen scavengers are covered. The pros and cons of the additive chemicals have been highlighted. The need to utilize green corrosion inhibitors based on plants and ionic liquids materials have been emphasized. This class of materials are environmentally friendly, cheap, and readily available

Starre konfokale Laser Scanning Endoskopie zur Frühdiagnostik des Oropharynxkarzinoms - eine tierexperimentelle Studie

Einleitung: Ziel der tierexperimentellen Untersuchungen ist es, die für die HNO-Heilkunde neue Technologie, die starre konfokale Endoskopie (SKE), auf einen möglichen Einsatz zur Diagnostik von präneoplastischen Schleimhautveränderungen zu prüfen. Methoden: Die Tumorinduktion im Tiermodell wurde mit einem wasserlöslichen Quinolin-Derivat vorgenommen (4-NQO). Insgesamt 50 Mäuse (C57Bl/6) erhielten das chemische Kanzerogen 4-NQO über das Trinkwasser über einem Zeitraum von 8 bis 18 Wochen (5 Gruppen). Der Kontrollgruppe (n=10) wurde nichtkontaminertes Wasser verabreicht. Nach definierten Zeitintervallen (8, 10, 12, 14 und 18 Wochen) wurden post mortem die konfokalen Untersuchungen der Zungen durchgeführt. Es wurde ein Prototyp eines SKE (Fa. Storz), angekoppelt an den Heidelberg Retina Tomographen (HRTII/RCM), verwendet. Ergebnisse: Mit der LSM lassen sich Parameter, wie Zellkernmorphologie und Kern-Plasma-Relation, erfassen. Dysplastische und kanzeröse Läsionen weisen konfokalmikroskopisch Unterschiede bezüglich dieser Parameter im Vergleich zu gesundem Epithel des Oropharynx auf. Für die Differenzierung benigner Veränderungen und leichter Dysplasien von Dysplasiegraden II, III und CIS ergaben sich Werte für die Sensitivität und Spezifität sowie für den positiven und negativen prädiktiven Vorhersagewert von 73%, 93%, 91% bzw. 54%. Schlussfolgerungen: Mit der SKE konnten konsistente Unterschiede zwischen gesundem und keratotisch sowie dysplastisch verändertem Zungenepithel aufgezeigt werden. Weitere Entwicklungen am Endoskop, insbesondere ein automatischer Tiefenscan, sind erforderlich, um Aussagen über die potentielle Eignung dieser Technologie zur Frühdiagnostik des Oropharynxkarzinoms treffen zu können