Microglia and complement mediate early corticostriatal synapse loss and cognitive dysfunction in Huntington's disease.

Huntington's disease (HD) is a devastating monogenic neurodegenerative disease characterized by early, selective pathology in the basal ganglia despite the ubiquitous expression of mutant huntingtin. The molecular mechanisms underlying this region-specific neuronal degeneration and how these relate to the development of early cognitive phenotypes are poorly understood. Here we show that there is selective loss of synaptic connections between the cortex and striatum in postmortem tissue from patients with HD that is associated with the increased activation and localization of complement proteins, innate immune molecules, to these synaptic elements.

BAC Transgenic Expression of Human TREM2-R47H Remodels Amyloid Plaques but Unable to Reprogram Plaque-associated Microglial Reactivity in 5xFAD Mice.

Background: Genetic study of late-onset Alzheimer's disease (AD) reveals that a rare Arginine-to-Histamine mutation at amino acid residue 47 (R47H) in Triggering Receptor Expressed on Myeloid Cells 2 (TREM2) results in increased disease risk. TREM2 plays critical roles in regulating microglial response to amyloid plaques in AD, leading to their clustering and activation surrounding the plaques. We previously showed that increasing human gene dosage exerts neuroprotective effects against AD-related deficits in amyloid depositing mouse models of AD.

The Effect of Language Concordance on Health Care Relationship Trust Score.

Introduction: Various barriers exist for Limited English Proficient (LEP) patients in the United States healthcare system, including language barriers. To address language access, interpreters have been used as well as physicians who speak the same language (language concordance), with unknown effect. By studying the strength of patient-physician relationships under different communication parameters, such as the use of a variety of language services, we can better understand healthcare interactions and move toward optimizing patient care and health outcomes.

A Rare Case of Salmonella Osteomyelitis in Immunocompetent Toddler Without Risk Factors.

Salmonella infections are common, though rarely cause disseminated or severe disease in immunocompetent children. We present a case of severe salmonella osteomyelitis and epidural abscess in a patient without significant risk factors. This patient presented over the course of multiple visits with nonspecific symptoms of fever, malaise, and eventual joint pain.

Improving Emergency Department Use of Safety-Net Antibiotic Prescriptions for Acute Otitis Media.

Objectives: Acute otitis media (AOM) is the most common reason for pediatric antibiotic prescriptions. The 2013 American Academy of Pediatrics' AOM guidelines recommend observation for nonsevere AOM. Our aim was to increase the percentage safety-net antibiotic prescription (SNAP) offered to patients 6 months of age or older diagnosed with AOM in 2 pediatric emergency departments (EDs) from a baseline of 0.

Computed tomography with Hounsfield unit assessment is useful in the diagnosis of liver lobe torsion in pet rabbits (Oryctolagus cuniculus).

Clinical signs of liver lobe torsion in rabbits are often nonspecific and mimic those that are also generally detected with gastrointestinal stasis. Nonspecific clinical signs may result in pursuit of full-body imaging such as computed tomography (CT). The aim of this multicenter, retrospective, case series study was to describe CT findings of liver lobe torsion in a group of rabbits.

Laser safety: the need for protocols.

Lasers are being used in ever-expanding roles in dermatology. As our understanding of laser energy grew, the need for safety guidelines became apparent. The US Food and Drug Administration (FDA) published the first safety guidelines in 1984, which are updated on a regular basis.

Elevated TREM2 Gene Dosage Reprograms Microglia Responsivity and Ameliorates Pathological Phenotypes in Alzheimer's Disease Models.

Variants of TREM2 are associated with Alzheimer's disease (AD). To study whether increasing TREM2 gene dosage could modify the disease pathogenesis, we developed BAC transgenic mice expressing human TREM2 (BAC-TREM2) in microglia. We found that elevated TREM2 expression reduced amyloid burden in the 5xFAD mouse model.

Mississippi Perspective: Dermatologic Manifestations of Arsenic Poisoning.

A Mississippi perspective on arsenic poisoning is largely related to thousands of asthma patients cared for by one physician, Elmer D. Gay, MD, in the 1950s. The general medical uses of arsenic and its specific use in intractable asthma are reviewed along with the dermatologic manifestations of arsenic poisoning.

Ultrasound-guided reoperative hysteroscopy for managing global endometrial ablation failures.

Study Objective: To determine whether ultrasound-guided reoperative hysteroscopy can reduce the need for hysterectomy in women experiencing delayed complications after global endometrial ablation (GEA) procedures.

Design: Retrospective review (Canadian Task Force classification III).

Setting: Private physician's office.

Operative hysteroscopy in an office-based surgical setting: review of patient safety and satisfaction in 414 cases.

Study Objective: To determine the safety and satisfaction among patients undergoing operative hysteroscopy in an office-based setting.

Design: Retrospective analysis (Canadian Task Force classification II-2).

Setting: Physician's private office.

Cadherin-9 regulates synapse-specific differentiation in the developing hippocampus.

Our understanding of mechanisms that regulate the differentiation of specific classes of synapses is limited. Here, we investigate the formation of synapses between hippocampal dentate gyrus (DG) neurons and their target CA3 neurons and find that DG neurons preferentially form synapses with CA3 rather than DG or CA1 neurons in culture, suggesting that specific interactions between DG and CA3 neurons drive synapse formation. Cadherin-9 is expressed selectively in DG and CA3 neurons, and downregulation of cadherin-9 in CA3 neurons leads to a selective decrease in the number and size of DG synapses onto CA3 neurons.

Laryngeal penetration during deglutition in normal subjects of various ages.

This study examined the frequency of penetration of liquid, paste, and masticated materials into the airway during videofluoroscopic studies of normal swallow in 98 normal subjects who were from 20 to 94 years of age. The purposes of the study were to define frequency and level of penetration using the penetration-aspiration scale as a result of age, bolus volume, viscosity, and gender, and to describe the body's sensorimotor response to the penetration based on audible coughs or throat clearing on the audio channel of each videotaped fluoroscopic study. Frequencies of penetration were defined in relation to bolus volume, age, gender, and bolus viscosity from swallows of 1, 3, 5, and 10 ml and cup-drinking of thin liquids; 3 ml of pudding; (1/4) of a Lorna Doone cookie; and a bite of an apple.

Reoperative hysteroscopic surgery in the management of patients who fail endometrial ablation and resection.

Study Objective: To determine the safety and efficacy of reoperative hysteroscopic surgery for women who fail endometrial ablation and resection.

Design: Retrospective chart review and follow-up (Canadian Task Force classification II-2).

Setting: Private office practice.

Hysteroscopic endomyometrial resection.

Objective: To determine the efficacy of hysteroscopic endomyometrial resection in treating women with intractable uterine bleeding.

Methods: A retrospective analysis was carried out on 304 women with intractable uterine bleeding treated between August 1, 1991, and December 31, 1997. The average patient was 41.

Hysteroscopic endocervical resection.

A new method was developed to access the uterine cavity in women in whom cervical stenosis precludes hysteroscopic surgery. Thirty-three women with intractable uterine bleeding were chosen to undergo either hysteroscopic myometrial resection or myomectomy. All of them had cervical stenosis that would, in the authors' opinion, not permit safe dilatation to 9 mm, the minimum diameter necessary to introduce a gynecologic resectoscope.

Association of conventional and exertional coronary heart disease risk factors in 5,000 apparently healthy men.

Background And Hypothesis: The aim of this study was to define the prevalence of previously undetected coronary heart disease among asymptomatic males, aged 30-65 years, by means of resting and exercise electrocardiography in conjunction with an analysis of conventional and exertional coronary risk factors.

Methods: Between January 1985 and December 1989 we examined 5,000 clinically asymptomatic subjects. A detailed case history was obtained for each individual, followed by a complete physical examination, comprehensive blood (including lipid) profile, lung function tests, chest x-ray, a resting 12-lead electrocardiogram (ECG), and a maximal treadmill exercise ECG.

Hysteroscopic endomyometrial resection: a new technique for the treatment of menorrhagia.

Thirty-five patients with menorrhagia and a normal uterine cavity underwent hysteroscopic endomyometrial resection. None underwent any form of medical or surgical preparation of the endometrium. A standard gynecologic resectoscope was used to excise a minimum of 3 mm of endomyometrium from the entire uterine cavity.

Hysteroscopic management of intractable uterine bleeding. A review of 103 cases.

One hundred three patients with intractable uterine bleeding were treated using the continuous flow resectoscope. All patients underwent diagnostic hysteroscopy and endometrial sampling prior to surgery. The patients were divided into three groups.

Inhibition of parathyroid hormone responsiveness in clonal osteoblastic cells expressing a mutant form of 3',5'-cyclic adenosine monophosphate-dependent protein kinase.

PTH activates multiple acute intracellular signals within responsive target cells, but the importance of cAMP vs. other second messenger signals in mediating different biological responses to PTH is not known. To address these questions, we developed a genetic approach to block activation of the cAMP-dependent protein kinase (PK-A) in PTH-responsive cell lines.