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We report an adult man presenting with sudden-onset epilepsy syndrome with evolution to refractory status epilepticus and an enhancing left frontal MRI lesion. The atypical nature of his presentation resulted in emergent epilepsy surgery. He was eventually diagnosed with NMDA receptor antibody (NMDAR AB) encephalitis based on positive CSF antibodies.

Analysis of the proteomic profile of pressure ulcers over time is a critical step in the identification of biomarkers of healing or nonhealing in pressure ulcers. The wound fluid from 32 subjects with 42 pressure ulcers was evaluated over 6 weeks at 15 time points. Samples specific to both the interior and the periphery of the wound bed were collected. Antibody screening arrays, isobaric tags for relative and absolute quantitation with mass spectrometry and multiplexed microarrays were used to characterize wound fluid and results were correlated with clinical outcome. Twenty-one proteins were found to distinguish between healed and chronic wounds and 19 proteins were differentially expressed between the interior and periphery of wounds. Four proteins, pyruvate kinase isozymes M1/M2, profilin-1, Ig lambda-1 chain C regions, and Ig gamma-1 chain C region, were present in lower levels for periphery samples when compared to interior samples and six proteins, keratin, type II cytoskeletal 6A (KRT6A), keratin, type I cytoskeletal 14, S100 calcium binding proteins A7, alpha-1-antitrypsin precursor, hemoglobin subunit alpha, and hemoglobin subunit beta, were present in higher levels in periphery samples when compared with interior samples. S100 calcium binding protein A6, S100 calcium binding protein A7, and soluble receptor for advanced glycation end-products had higher levels in the periphery of chronic wounds vs. the interior in planar arrays. A significant temporal trend was noted for monokine induced by gamma interferon (MIG), synonomous with chemokine (C-X-C motif) ligand 9 (CXCL9), which increased as wounds healed and remained nearly constant for ulcers that were not approaching closure.

I compared the sampling properties of two methods for collecting fish larvae over reefs: nighttime collecting with a light trap, and daytime collecting with a small plankton net that could be steered by a diver. Samples were collected in the Gulf of California during summer, 1989 and 1990. The 90 light-trap samples yielded 9406 larvae from 31 families, while the 75 plankton-net samples yielded 17852 larvae from 43 families plus unidentified anguilliforms. Four families were collected only in the light trap, and 16 families plus the anguilliforms were collected only with the plankton net. With one exception, the families that were collected by only one method were rare. Twenty-seven families were collected by both methods, but only 13 were collected at least five times by each. The average catch per sample differed significantly between methods for 9 of these 13 families. In each case, the plankton net yielded more larvae per sample. The distribution of larvae among families was less equitable in light-trap samples than in planktonnet collections, primarily because clupeids were so dominant in the former. However, the taxonomic composition of light-trap and plankton-net collections was broadly similar. Seven families were shared among the ten most abundant families for each method, and the relative abundances of taxa (47 families plus anguilliforms) were strongly correlated between methods. A comparison of larval size-distributions for 12 families indicated that the size structure of catches usually differed between collecting methods. In four families there was little overlap in the size classes collected, in five families the distributions overlapped broadly but had different shapes, and in three families the size distributions were similar. Although the light trap collected larger larvae on average, its catches were not limited to settlement-stage or transition larvae. Larvae of at least ten families were present over reefs in all size classes, but the combination of both sampling methods was usually required to detect this. Based on their abundance and wide size distribution over reefs, at least some larvae from these ten families may remain over reefs throughout development. However, additional data are required to determine the importance of water over reefs as a larval habitat.

Onychomycosis, most commonly caused by two species of dermatophyte fungi—Trichophyton rubrum and Trichophyton mentagrophytes—is primarily treated with regimens of topical and systemic antifungal medications. This study was undertaken to evaluate in vitro the efficacy of low-voltage direct current as an antifungal agent for treating onychomycosis. Agar plate cultures of T rubrum and T mentagrophytes were subjected to low-voltage direct current electrostimulation, and antifungal effects were observed as zones in the agar around the electrodes lacking fungal growth. Zones devoid of fungal growth were observed for T rubrum and T mentagrophytes around anodes and cathodes in a dose-dependent manner in the current range of 500 μA to 3 mA. Low-voltage direct current electrostimulation has great clinical potential for the treatment of onychomycosis and perhaps other superficial maladies of fungal etiology. (J Am Podiatr Med Assoc 94(6): 565–572, 2004)

Background and Purpose. Electrical stimulation (ES) is used in wound management. Concerns, however, have been raised about the possible role ES might play in promoting or exacerbating wound infections, especially bacterial infections. The purpose of this study was to address these concerns by evaluating the efficacy of a method for disinfecting ES electrodes used in wound treatment. Methods. Samples were taken from each wound treated in this study prior to and after ES and from sponges used with the ES electrodes prior to treatment, after treatment, and after 20 minutes of chemical disinfection. The presence and types of bacteria recovered were determined through standard microbiological techniques. Results. In this study of 25 patient samples, large numbers (ie, thousands) of bacteria were recovered from the pretreatment and posttreatment wound samples and from the posttreatment sponges. Following disinfection, however, bacteria were absent from the sponges in 23 of the 25 patient samples. In the remaining 2 samples, no more than two bacterial colonies were recovered after disinfection. Conclusion and Discussion. Immersion of the electrodes and sponges for 20 minutes in the disinfectant resulted in reduction of bacteria to safe, noninfective levels. Disinfection either completely eliminated all bacteria from the sponges (in 92% of the samples) or eliminated nearly all bacteria (in the remaining 8% of the samples), compared with predisinfection samples, which contained very large numbers of bacteria. These results demonstrate that the disinfection method used in this study is efficacious, and it appears to be cost-effective, practical, and safe for clinical use.

Live and prepared cells of the marine pennate diatom Navicula complanatoides Hust. were examined with light and electron microscopy. It has narrowly lanceolate valves (26–55 μm long, 4–5 μm wide) and girdles 10–24 μm in depth. Striae are parallel at the center of the valve (24–28 in 10 μm), becoming slightly convergent toward the apices. Electron microscopy revealed that the external valve surface presents a longitudinally ribbed appearance (20–28 parallel ribs at its maximum width), whereas internally, rectangular areolae are occluded by ricae. The raphe slit lies in a narrow axial area, and one side of the raphe sternum is deeper and folds over the other, obscuring the internal opening. Internally, the central virga on one side of the raphe and two virgae on the other are somewhat broader. A conspicuous pore (stigma) is present between the two broadened virgae. The girdle consists of valvocopulae, copulae, and pleurae. There are 16–20 bands per cingulum. The valvocopulae and copulae are hollow tube-like structures, with inner and outer portions contrsting in morphology. They decrease in diameter in an abvalvar direction. There are four pleurae. These are flat bands which facilitate overlap of the epicingulum and hypocingulum. Fundamental features of the valve and girdle reveal the distinctness of this species within Navicula. The areolae, external longitudinal ribs, and raphe structure suggest affinities with Pleurosigma, Gyrosigma, and Haslea. It is hypothesized that they share a derived state which indicates a recent common ancestor for these taxa. N. complanatoides and related species of the Naviculae microstigmatacae are distinctive enough to merit their own genus within the Naviculaceae.