Blood glucose levels in children with Type 1 diabetes attending a residential diabetes camp: a 2-year review.

AIMS: The objective of this retrospective analysis of blood glucose values at a week-long residential summer camp for children with Type 1 diabetes was to provide experiential data to reinforce current summer camp guidelines and to determine if specific interventions implemented between 2009 and 2010 were effective in lowering average blood glucose among our campers without increasing risk of hypoglycaemia. METHODS: Blood glucose records were obtained from a random selection of children who attended six 1-week camp sessions, three each in 2009 and 2010. Five values per day: pre-meal breakfast, lunch and dinner, pre-evening snack and midnight values were analysed. RESULTS: A total of 13,267 blood glucose values were included. There were no severe hypoglycaemic episodes, seizures or need for full-dose glucagon or intravenous glucose in either year. Mean blood glucose was significantly lower in 2010 compared with 2009 (9.22 vs. 10.06 mmol/l, P < 0.001). Older age and camp year were associated with lower mean blood glucose, even when controlling for gender and duration of diabetes. CONCLUSIONS: This analysis is the largest so far conducted at a residential diabetes camp. Mean blood glucose levels were lower than other published studies. Although we cannot attribute a cause-and-effect relationship between our interventions and the improvement in blood glucose between 2009 and 2010, the use of pre-meal insulin bolus doses, low glycaemic meals and highlighting blood glucose levels in logs before being reviewed by endocrinologists are strongly encouraged. From this study we hope to establish benchmarks for comparison among camps and begin to identify best practices.

Photoabsorption studies of neutral green fluorescent protein model chromophores in vacuo.

We report on gas-phase experimental and theoretical studies on the neutral form of the green-fluorescent protein (GFP) chromophore using six different models, each carrying a spectator positive charge. Theoretical studies were carried out to quantify the effect of the spectator charge on the absorption maximum of the true neutral. The study also includes models having the possibility of forming intra-molecular hydrogen bonds, and their effect on the absorption profile is analyzed. The charge redistribution caused by a strong intra-molecular hydrogen bond was found to give rise to a red shift in going from non-hydrogen bonded to hydrogen bonded models. For the non-hydrogen bonded models, the length of the side chain as well as the group carrying the spectator charge, was varied to explore the possibility of shifts in absorption maximum due to these variations. No shifts were observed. The implications of these results in tuning the absorption maximum of the neutral form of the GFP chromophores are discussed.

Different isoforms of fasciclin II are expressed by a subset of developing olfactory receptor neurons and by olfactory-nerve glial cells during formation of glomeruli in the moth Manduca sexta.

During development of the primary olfactory projection, olfactory receptor axons must sort by odor specificity and seek particular sites in the brain in which to create odor-specific glomeruli. In the moth Manduca sexta, we showed previously that fasciclin II, a cell adhesion molecule in the immunoglobulin superfamily, is expressed by the axons of a subset of olfactory receptor neurons during development and that, in a specialized glia-rich "sorting zone," these axons segregate from nonfasciclin II-expressing axons before entering the neuropil of the glomerular layer. The segregation into fasciclin II-positive fascicles is dependent on the presence of the glial cells in the sorting zone. Here, we explore the expression patterns for different isoforms of Manduca fasciclin II in the developing olfactory system. We find that olfactory receptor axons express transmembrane fasciclin II during the period of axonal ingrowth and glomerulus development. Fascicles of TM-fasciclin II+ axons target certain glomeruli and avoid others, such as the sexually dimorphic glomeruli. These results suggest that TM-fasciclin II may play a role in the sorting and guidance of the axons. GPI-linked forms of fasciclin II are expressed weakly by glial cells associated with the receptor axons before they reach the sorting zone, but not by sorting-zone glia. GPI-fasciclin II may, therefore, be involved in axon-glia interactions related to stabilization of axons in the nerve, but probably not related to sorting.

Immunolocalization of synaptotagmin for the study of synapses in the developing antennal lobe of Manduca sexta.

In the mature olfactory systems of most organisms that possess a sense of smell, synapses between olfactory receptor neurons and central neurons occur in specialized neuropil structures called glomeruli. The development of olfactory glomeruli has been studied particularly heavily in the antennal lobe of the moth Manduca sexta. In the current study, we address the development of synapses within the antennal lobe of M. sexta by reporting on the localization of synaptotagmin, a ubiquitous synaptic vesicle protein, throughout development. A cDNA clone coding for M. sexta synaptotagmin was characterized and found to encode a protein that shares 67% amino acid identity with Drosophila synaptotagmin and 56% amino acid identity with human synaptotagmin I. Conservation was especially high in the C2 domains near the C-terminus and very low near the N-terminus. A polyclonal antiserum (MSYT) was raised against the unique N-terminus of M. sexta synaptotagmin, and a monoclonal antibody (DSYT) was raised against the highly conserved C-terminus of D. melanogaster synaptotagmin. In Western blot analyses, both antibodies labeled a 60 kD protein, which very likely corresponds to synaptotagmin. On sections, both antibodies labeled known synaptic neuropils in M. sexta and yielded similar labeling patterns in the developing antennal lobe. In addition, DSYT detected synaptotagmin-like protein in three other insect species examined. Analysis of synaptotagmin labeling at the light microscopic level during development of the antennal lobe of M. sexta confirmed and extended previous electron microscopic studies. Additional synapses in the coarse neuropil and a refinement of synaptic densities in the glomeruli during the last one-third of metamorphic development were revealed.

Olfactory receptor axons influence the development of glial potassium currents in the antennal lobe of the moth Manduca sexta.

In the olfactory (antennal) lobe of the moth Manduca sexta, olfactory receptor axons strongly influence the distribution and morphology of glial cells. In the present study, we asked whether the development of the electrophysiological properties of the glial cells is influenced by the receptor axons. Whole-cell currents were measured in antennal lobe glial cells in acute brain slices prepared from animals at different stages of metamorphic development (stages 3, 6, and 12). Outward currents were induced by depolarizing voltage steps from a holding potential of -70 mV. At all developmental stages investigated, the outward currents were partly blocked by bath application of the potassium channel blocker 4-aminopyridine (4AP, 10 mM) or by including tetraethylammonium (TEA, 30 mM) in the pipette solution. The relative contribution of the 4AP-sensitive current to the outward current increased from 18% at stages 3 and 6 to 42% at stage 12, while the TEA-sensitive current increased from 18% at stage 3 to 81% at stage 6, and then declined again to 40% at stage 12. In contrast, in the absence of receptor axons, these changes in the contribution of the TEA- and 4AP-sensitive currents to the total outward current did not occur; rather, the current profile remained in the most immature state (stage 3). The results suggest that olfactory receptor axons are essential for development of the mature pattern of glial potassium currents.

Brief report: Lack of correlation between age of symptom onset and contemporaneous presentation.

The parents/guardians of 50 individuals were surveyed using a semistructured interview to determine the feasibility of this method and to establish ages of symptom onset. Thirty-eight informants were able to recall sufficient detail to allow categorization of the age of symptom onset. Chi-square analysis confirmed a significant association between investigators' categorization and informants' categorization. Contemporaneous presentation was indexed using Childhood Autism Rating Scale, the Autism Behavior Checklist, the Conners Hyperactivity Index, and the Ritvo-Freeman Real Life Rating Scale for Autism. No significant correlations were determined between any of these indices of symptom severity and age of symptom onset.

Fenvalerate treatment affects development of olfactory glomeruli in Manduca sexta.

Low doses of fenvalerate, a widely used type-II pyrethroid insecticide, have been shown previously to produce abnormal olfactory centers in the brain and abnormal olfactory-mediated behavior in beetles (Wegerhoff et al. [1998] Neuroreport 9:3241-3245). Here, we use the experimental advantages of the moth Manduca sexta to explore the cellular changes that lead to these abnormalities. Our results indicate that treatment with fenvalerate may affect multiple aspects of the development of the primary olfactory centers, the antennal lobes, in Manduca, including ingrowth of olfactory receptor axons, axon fasciculation, and targeting within the antennal lobe, and intercellular signaling between the receptor axons and the glial cells that ordinarily surround and stabilize the developing olfactory glomeruli.

Neuron-glia communication via nitric oxide is essential in establishing antennal-lobe structure in Manduca sexta.

Nitric oxide synthase recently has been shown to be present in olfactory receptor cells throughout development of the adult antennal (olfactory) lobe of the brain of the moth Manduca sexta. Here, we investigate the possible involvement of nitric oxide (NO) in antennal-lobe morphogenesis. Inhibition of NO signaling with a NO synthase inhibitor or a NO scavenger early in development results in abnormal antennal lobes in which neuropil-associated glia fail to migrate. A more subtle effect is seen in the arborization of dendrites of a serotonin-immunoreactive neuron, which grow beyond their normal range. The effects of NO signaling in these types of cells do not appear to be mediated by activation of soluble guanylyl cyclase to produce cGMP, as these cells do not exhibit cGMP immunoreactivity following NO stimulation and are not affected by infusion of a soluble guanylyl cyclase inhibitor. Treatment with Novobiocin, which blocks ADP-ribosylation of proteins, results in a phenotype similar to those seen with blockade of NO signaling. Thus, axons of olfactory receptor cells appear to trigger glial cell migration and limit arborization of serotonin-immunoreactive neurons via NO signaling. The NO effect may be mediated in part by ADP-ribosylation of target cell proteins.

Importance of timing of olfactory receptor-axon outgrowth for glomerulus development in Manduca sexta.

In the moth Manduca sexta, development of glomeruli in the antennal (olfactory) lobes (ALs) follows a precise timetable and involves interactions of olfactory receptor cell (ORC) axons with AL glial cells and neurons. To study the importance of timing for these intercellular interactions, we experimentally desynchronized the development of the ALs and the ORCs by altering the temperature of the developing antenna and brain for defined periods of time during development. Selective cooling of the antenna relative to the body resulted in a delay of ORC-axon outgrowth, and slightly warming the antenna while cooling the body caused precocious ingrowth of axons into the AL. Whereas cooling of the antenna for 24 hours caused only a delay in the formation of glomeruli, cooling for 48 hours led to significant disruption of glomerular development. Glial cells did not form normal glomerular borders, and glomeruli were shaped abnormally. Axons of pheromone-specific ORCs projected to their correct target, but terminal branches within the macroglomerular complex (MGC) were not clearly segregated. The results suggest that proper formation of glial glomerular borders requires interaction of ORC axons and glial cells within a sensitive period, whereas targeting of ORC axons appears to be effective over extended periods in development. Precocious ingrowth of ORC axons after warming the antenna and cooling the body for 48 hours resulted in enlarged protoglomeruli. Glial borders formed normally, but a subpopulation of MGC-specific ORC axons grew past the MGC. The decreased accuracy of targeting in these cases suggests that targeting mechanisms are not fully developed before the time when ORC axons normally would enter the brain.

Platelet activation in depression and effects of sertraline treatment: An open-label study.

OBJECTIVE: The authors' goal was to determine whether sertraline attenuates the increased platelet activation seen among depressed patients. METHOD: They tested 21 otherwise healthy patients with untreated major depressive episode who were 25-52 years old and 21 age- and sex-matched comparison subjects. Patients received 6 weeks of sertraline treatment, and 17 returned for retesting. RESULTS: At baseline, the depressed patients had greater platelet secretion than the comparison subjects in response to collagen. Depressed patients with a family history of coronary disease had nonsignificantly greater wound-induced fibrinogen receptor binding than the other subjects. Platelet secretion in response to collagen was significantly reduced after treatment with sertraline. CONCLUSIONS: Sertraline diminished the increased platelet secretion found among depressed patients, although the findings are limited by a lack of a placebo control group.

Nuclear Ca2+/calmodulin translocation activated by mu-opioid (OP3) receptor.

Previous evidence has suggested a role for calmodulin (CaM) in opioid receptor signaling. We demonstrate here that morphine stimulation of the mu-opioid (OP3) receptor causes rapid CaM translocation to the nucleus in OP3-transfected human embryonic kidney (HEK)-293 cells and in SH-SY5Y human neuroblastoma cells. Ca2+ influx into the cells resulting from OP3 receptor activation was required for nuclear CaM translocation. Moreover, in HEK-OP3 and SH-SY5Y cells, increased nuclear CaM content was associated with enhanced phosphorylation of the nuclear transcription factor cyclic AMP-responsive element-binding protein. This appeared to be mediated by Ca2+/CaM kinases and also by a pathway involving protein kinase C. CaM was previously shown to bind directly to the OP3 receptor and to be released from the plasma membrane on agonist stimulation. To test whether OP3-mediated CaM release contributes to nuclear CaM signaling, we used a mutant OP3 receptor (K273A) with reduced affinity for CaM that fails to release CaM from the plasma membrane. K273A-OP3 activated Ca2+ influx to a similar extent as wild-type OP3; however, CaM translocation to the nucleus was attenuated. These results indicate that OP3-stimulated Ca2+ influx results in nuclear CaM translocation, which appears to be enhanced by simultaneous CaM release by OP3 wild-type receptor from plasma membranes. These results suggest a novel Ca2+/CaM signaling pathway of opioid receptors in the regulation of transcriptional activity.

Basal signaling activity of human dopamine D2L receptor demonstrated with an ecdysone-inducible mammalian expression system.

Basal signaling activity of the dopamine D2L (long isoform) receptor was investigated using an ecdysone-inducible mammalian expression system. Whereas basal signaling activity had been demonstrated for the D1, D2S (short isoform), D3, and D5 receptor subtypes, this issue has yet to be clearly resolved for the D2L receptors. An ecdysone-inducible mammalian expression system was used to express the dopamine D2L receptor in human embryonic kidney cells (HEK293). The two ecdysone analogs, muristerone A and ponasterone A, induced D2L receptor expression dose-dependently from 120 (non-induced) to 2000 fmol/mg protein which is similar to physiological D2 receptor density in dopaminergic brain regions. With this approach, we demonstrate significant basal D2L receptor activity. Basal and agonist-stimulated signaling activity, determined with assays of cAMP levels and [35S]GTPgammaS binding to assess G protein coupling, correlated with the level of receptor expression. Furthermore, among several antagonists tested, only fluphenazine and trifluoperazine exhibited clearly detectable inverse agonist activity. This differs from the D2S receptors, where most antagonists were reported to display full inverse agonism. Differences between inverse agonist effects of D2L and D2S antagonists may be relevant to the treatment of diseases involving dopamine D2 receptors.

Development of a glia-rich axon-sorting zone in the olfactory pathway of the moth Manduca sexta.

Olfactory receptor cells (ORCs) of a particular odor tuning are dispersed in the olfactory epithelium, but their axons converge on distinct glomeruli in primary olfactory centers. As a consequence, axon associations must change to bring axons of ORCs with the same odor specificity together. Studies in Manduca sexta have indicated that just before they enter the antennal lobe (AL), ORC axons undergo extreme reorganization, finally entering the AL in fascicles destined for subsets of glomeruli. This axon-sorting zone is heavily populated by glial cells, and ORC axon growth cones often are in close physical contact with the glia. In moths rendered glia deficient, ORC axons fail to fasciculate in this region. Using propidium iodide to label nuclei and 5-bromo-2'-deoxyuridine to monitor proliferation, we found that the glia in the sorting zone arise from the AL, appearing shortly after the first ORC axons arrive. Experimental removal of some or all of the sensory innervation revealed that proliferation of sorting-zone glia is triggered by ORC axons. A second set of glia arises in the antenna and migrates along the antennal nerve toward the brain, populating the nerve after the establishment of the sorting zone. Development of this type of glial cell is independent of contact of the ORC axons with their central targets. We conclude that the sorting zone arises from CNS glia in response to ingrowth of ORC axons, and a critical number of glia must be present in the sorting zone for axons to correctly establish new neighbor-neighbor associations.

Identification and functional analysis of novel cAMP response element binding protein splice variants lacking the basic/leucine zipper domain.

Two novel cAMP response element binding protein (CREB) splice variants were found by reverse transcription-polymerase chain reaction cloning by using mouse brain RNA as a template. One splice variant, named Delta-14, lacks 14 nucleotides at the beginning of exon 9 of the CREBDelta isoform. The other, named Delta-35, lacks 35 nucleotides at the beginning of exon 8 of CREBDelta. These nucleotide deletions cause frame shifts for codon usage, producing proteins which conserve the major phosphorylation site (Ser(133)) but lack the basic/leucine zipper domain, which is essential for binding to DNA and to other transcription factors. Both variants are widely expressed in peripheral tissues, but are enriched in brain, thymus, and testis. CREBDelta-14 and Delta-35 variant proteins were expressed by using an in vitro translation system and by transfecting into human embryonic kidney 293 cells. Both variants were detected by a CREB antibody that recognizes the CREBDelta amino terminus, but not by an antibody which recognizes the CREBDelta carboxy terminus, as would be predicted based on the frame shift. Activation of the cAMP pathway increased phospho-CREB immunoreactivity, indicating that these variants are substrates of cAMP-dependent protein kinase. In addition, immunocytochemical analysis demonstrated that CREBDelta-14 and Delta-35 are primarily cytosolic, whereas CREBalpha is predominantly in the nucleus. Finally, expression of CREBDelta-14 or Delta-35 decreased cAMP responsive element-chloramphenicol acetyltransferase reporter activity, demonstrating that both can function as repressors of endogenous CREB.

Differential regulation of muscarinic M1 and M3 receptors by a putative phosphorylation domain.

A motif consisting of several serine residues flanked N-terminally by acidic residues occurs in the third intracellular loop of both muscarinic M1 and M3 receptors (287SerLeuThrSerSer291 and 349SerAlaSerSer352, respectively). We examined the role of these domains in modulating agonist-induced desensitization and receptor trafficking, and for the muscarinic M3 receptor, we assessed the contribution of phosphorylation to receptor regulation. Mutation of the above residues did not affect desensitization of phosphoinositide hydrolysis signaling for either the muscarinic M1 or M3 receptor and did not alter the agonist-induced phosphorylation state of the muscarinic M3 receptor. Mutation of this domain (349SerAlaSerSer352/349AlaAlaAlaAla352) in the muscarinic M3 receptor completely abrogated receptor internalization and subsequently, down-regulation. Mutation of the analogous domain (287SerLeuThrSerSer291/287AlaLeuAlaAlaAla291) in the muscarinic M1 receptor had no obvious effect on internalization, but led to a more rapid down-regulation. Thus, these serine-rich regions are not required for receptor desensitization, but are differentially involved in receptor trafficking for the muscarinic M1 and M3 receptors.

Axons of olfactory receptor cells of transsexually grafted antennae induce development of sexually dimorphic glomeruli in Manduca sexta.

The influence of olfactory receptor cell (ORC) axons from transsexually grafted antennae on the development of glomeruli in the antennal lobes (ALs), the primary olfactory centers, was studied in the moth Manduca sexta. Normally during metamorphic adult development, the pheromone-specific macroglomerular complex (MGC) forms only in the ALs of males, whereas two lateral female-specific glomeruli (LFGs) develop exclusively in females. A female AL innervated by ORC axons from a grafted male antenna developed an MGC with three glomeruli, like the MGC of a normal male AL. Conversely, a male AL innervated by ORC axons from a grafted female antenna lacked the MGC but exhibited LFGs. ORC axons from grafted male antenna terminated in the MGC-specific target area, even in cases when the antennal nerve (AN) entered the AL via an abnormal route. Within ectopic neuromas formed by ANs that had become misrouted and failed to enter the brain, male-specific axons were not organized and formed terminal branches in many areas. The results suggest the presence of guidance cues within the AL for male-specific ORC axons. Depending on the sex of the antennal innervation, glial borders formed in a pattern characteristic of the MGC or LFGs. The sex-specific number of projection neurons (PNs) in the medial group of AL neurons remained unaffected by the antennal graft, but significant changes occurred in the organization of PN arborizations. In gynandromorphic females, LFG-specific PNs extended processes into the induced MGC, whereas in gynandromorphic males, PNs became restricted to the LFGs. The results indicate that male-and female-specific ORC axons play important roles in determining the position, anatomical features, and innervation of sexually dimorphic glomeruli.

Increased serotonin receptor density and platelet GPIIb/IIIa activation among smokers.

This study sought to determine whether depressive symptoms and/or platelet serotonin receptor (5HT2A) density are associated with increased platelet activation (PA) found among smokers. Flow cytometric detection of PA was used to study 36 smokers and 16 nonsmokers, aged 18 to 48 years. Subjects were tested at baseline and after either smoking 2 cigarettes (smokers) or a similar resting interval (nonsmokers). Assessment of PA included both platelet secretion and fibrinogen receptor (GPIIb/IIIa) binding. Platelet 5HT2A receptor binding and saturation were tested using [3H]LSD, and depressive symptoms were measured using the Beck Depression Inventory. Platelet 5HT2A receptor density was increased among smokers versus nonsmokers (82.7+/-67.7 versus 40.0+/-20.2 fmol/mg protein; P<0.005), and there was a dose-dependent relationship between receptor density and packs/d among smokers. Baseline wound-induced GPIIb/IIIa binding at 1 minute and GPIIb/IIIa binding in response to collagen stimulation in vitro was increased among smokers (P<0.05); there were no changes in PA among smokers after smoking, and platelet secretion was not elevated among smokers. Depressive symptoms were associated with 5HT2A receptor density among nonsmokers (P<0.005), but no such relationship was evident among smokers; PA was unrelated to 5HT2A receptor density in either group. The findings indicate that smoking is associated with increased platelet serotonin receptor density and with increased GPIIb/IIIa receptor binding, although these 2 factors are not related to each other or to depressive symptoms among smokers. Serotonergic dysfunction may be an important factor in the development of cardiovascular disease among smokers.

Vancomycin-resistant enterococcal colonization in nonhospitalized HIV-infected patients.

We studied fecal colonization with vancomycin-resistant enterococci (VRE) in 89 HIV-infected nonhospitalized patients ages 24 to 62 years, including 70 (79%) men (including 41 homosexual and 5 bisexual men) and 19 (21%) women. Of the 89 patients, 61 (69%) were black, 25 (28%) Hispanic, and 3 (3%) white; 53 (60%) had history of ongoing or recent antibacterial therapy with trimethoprim/sulfamethoxazole (29), clarithromycin (18), amoxicillin (7), ofloxacin (3), and metronidazole, doxycycline, dicloxacillin, and cephalexin (1 each). VRE were not isolated from any of the patients studied.

Partner notification and focused intervention as a means of identifying HIV-positive patients.

Partner notification as a means of contact tracing human immunodeficiency virus (HIV)-infected persons remains controversial. It is argued against by many gay activists, while primary public health officials and leaders in ethnic communities continue to support this as a means of identifying unknown cases. Human immunodeficiency virus-positive patients were interviewed to determine if partner notification could be a useful instrument. Based on interviews, patients at risk of infection through heterosexual contact were able to identify most of their sexual partners; the majority of these patients were women. Twenty-two of 22 women infected heterosexually were able to identify all of their sexual partners. Five of 8 heterosexual men were able to identify all of their sexual partners, but these men were infected through intravenous drug use. Six of 44 homosexual men interviewed were able to make these identifications. Two focus groups of homosexual men who were HIV-positive patients were organized; each was asked one question. Men in group B were asked if they could identify HIV-positive persons whom they suspected were not in a treatment program. Men in group A were asked if they they thought they knew HIV-positive persons still practicing unsafe sex. Thirteen of the 14 patients in group A were able to identify 30 persons they felt were still practicing unsafe sex; 17 of 30 tested HIV-positive and 9 were unaware of their status. The 14 patients in group B identified 15 persons they felt were HIV-positive; 11 were found to be HIV-positive and 8 were unaware of their status. These findings suggest that partner notification definitely has a role in heterosexual contact tracing, and focused intervention is a more cost-effective approach to early intervention.