Three-dimensional ultrastructural and anatomical analysis of prostatic neuroendocrine cells in mice

BACKGROUND

A few studies have examined the ultrastructure of prostatic neuroendocrine cells (NECs), and no study has focused on their ultrastructure in three dimensions. In this study, three-dimensional ultrastructural analysis of mouse prostatic NECs was performed to clarify their anatomical characteristics.

METHODS

Three 13-week-old male C57BL/6 mice were deeply anesthetized, perfused with physiological saline and 2% paraformaldehyde, and then placed in 2.5% glutaraldehyde in 0.1 M cacodylate (pH 7.3) buffer for electron microscopy. After perfusion, the lower urinary tract, which included the bladder, prostate, coagulation gland, seminal vesicle, upper vas deferens, and urethra, was removed, and the specimen was cut into small cubes and subjected to postfixation and en bloc staining. Three-dimensional ultrastructural analysis was performed on NECs, the surrounding cells, tissues, and nerves using focused ion beam/scanning electron microscope tomography.

RESULTS

Twenty-seven serial sections were used in the present study, and 32 mouse prostatic NECs were analyzed. Morphologically, the NECs could be classified into three types: flask, flat, and closed. Closed-shaped NECs were always adjacent to flask-shaped cells. The flask-shaped and flat NECs were in direct contact with the ductal lumen and always had microvilli at their contact points. Many of the NECs had accompanying nerves, some of which terminated on the surface in contact with the NEC.

CONCLUSIONS

Three-dimensional ultrastructural analysis of mouse prostatic NECs was performed. These cells can be classified into three types based on shape. Novel findings include the presence of microvilli at their points of contact with the ductal lumen and the presence of accompanying nerves.

Molecular Analysis for Potential Hospital-Acquired Infection Caused by Aspergillus Tubingensis Through the Environment

The identification of Aspergillus species has been performed mainly by morphological classification. In recent years, however, the revelation of the existence of cryptic species has required genetic analysis for accurate identification. The purpose of this study was to investigate five Aspergillus section Nigri strains isolated from a patient and the environment in a university hospital. Species identification by matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry identified all five black Aspergillus strains as Aspergillus niger. However, calmodulin gene sequence analysis revealed that all five strains were cryptic species, four of which, including the clinical strain, were Aspergillus tubingensis. Hospital-acquired infection of the patient with the A. tubingensis strain introduced from the environment was suspected, but sequencing of six genes from four A. tubingensis strains revealed no environmental strain that completely matched the patient strain. The amount of in vitro biofilm formation of the four examples of the A. tubingensis strain was comparable to that of Aspergillus fumigatus. An extracellular matrix was observed by electron microscopy of the biofilm of the clinical strain. This study suggests that various types of biofilm-forming A. tubingensis exist in the hospital environment and that appropriate environmental management is required.

Sheet-like interstitial cells connect epithelial and smooth muscle cells in the mouse prostate

Epithelial-stromal relationship in the prostate gland is crucial for maintaining homeostasis, including functional differentiation, proliferation, and quiescence. Pathological stromal changes are believed to cause benign prostatic hyperplasia (BPH). The prostate stromal tissue is known to have several subtypes of interstitial cells that connect the epithelium and smooth muscle. However, the characteristics of their morphology and connection patterns are not fully understood. Therefore, we aimed to investigated the three-dimensional morphology and intercellular interactions of interstitial cells in the prostate ventral lobe of mature wild-type mice using immunohistochemistry and focused ion beam-scanning electron microscopy tomography (FIB-SEM tomography). The prostate interstitial cells exhibited immunohistochemical subtypes, including PDGFRα single-positive, CD34 single-positive, and CD34 and PDGFRα double-positive. PDGFRα single-positive cells were observed as elongated cells just below the epithelium, CD34 single-positive cells were observed as polygonal cells in the area away from the epithelium, and double-positive cells were observed as elongated cells situated slightly deeper than PDGFRα single-positive cells. Furthermore, connexin43-immunoreactive puncta were observed on interstitial cells just beneath the epithelium, suggestive of possible electrical connections among the PDGFRα single-positive interstitial cells. Three-dimensional structural analysis using FIB-SEM tomography revealed sheet-like multilayered interstitial cells that appear to separate the glandular terminal from the deeper interstitial tissue, which includes smooth muscle and capillaries. Further, epithelial cells might be indirectly connected to the smooth muscle and nerve fibers via these sheet-like multilayered interstitial cellular networks. These findings suggest that the cellular network that separates the glandular terminals from the deep interstitial tissue functionally bridges the epithelium and smooth muscle, possibly playing a pivotal role in prostate tissue homeostasis through the epithelial-smooth muscle or epithelial-stromal relationships.

Mesoscopic structural analysis via deep learning processing, with a special reference to in vitro alteration in collagen fibre induced by a gap junction inhibitor

Dense connective tissue, including the ligament, tendon, fascia and cornea, is formed by regularly arranged collagen fibres synthesized by fibroblasts (Fbs). The mechanism by which fibre orientation is determined remains unclear. Periodontal ligament Fbs consistently communicate with their surroundings via gap junctions (GJs), leading to the formation of a wide cellular network. A method to culture Fb-synthesized collagen fibres was previously reported by Schafer et al. ('Ascorbic acid deficiency in cultured human fibroblasts'. J. Cell Biol. 34: 83-95, 1967). This method has been applied to investigate the ability and activity of Fb collagen synthesis/phagocytosis using conventional electron microscopy (EM). However, the three-dimensional mesoscopic architecture of collagen fibres and the influence of GJ inhibitors on collagen fibre formation in vitro are poorly understood. In this study, three-dimensional mesoscopic analysis was used to elucidate the mechanism of directional fibre formation. We investigated the influence of GJ inhibitors on collagen formation driven by periodontal ligament Fbs in vitro, histomorphometrically, and the structural properties of in vitro collagen fibre on a mesoscale quantitatively, using correlative light and EM optimized for picrosirius red staining and focused ion beam-scanning EM tomography. Our results indicate that under culture conditions, in the presence of a GJ inhibitor, the orientation of collagen fibres becomes more disordered than that in the control group. This suggests that the GJ might be involved in determining fibre orientation during collagen fibre formation. Elucidation of this mechanism may help develop novel treatment strategies for connective tissue orientation disorders. Graphical Abstract.

Three-dimensional analysis of interstitial cells in the lamina propria of the murine vas deferens by confocal laser scanning microscopy and FIB/SEM

The present study aimed to explore the three-dimensional (3D) ultrastructure of interstitial cells (ICs) within the lamina propria of the murine vas deferens and the spatial relationships between epithelial cells and surrounding cells. Focused ion beam scanning electron microscopy and confocal laser scanning microscopy were performed. ICs within the lamina propria had a flat, sheet-like structure of cytoplasm with multiple cellular processes. In addition, two types of 3D structures that comprised cell processes of flat, sheet-like ICs were observed: one was an accordion fold-like structure and the other was a rod-shaped structure. ICs were located parallel to the epithelium and were connected to each other via gap junctions or adherens junctions. Moreover, multiple sphere-shaped extracellular vesicle-like structures were frequently observed around the ICs. The ICs formed a complex 3D network comprising sheet-like cytoplasm and multiple cell processes with different 3D structures. From this morphological study, we noted that ICs within the lamina propria of murine vas deferens may be involved in signal transmission between the epithelium and smooth muscle cells by physical interaction and by exchanging extracellular vesicles.

Correlative volume-imaging using combined array tomography and FIB-SEM tomography with beam deceleration for 3D architecture visualization in tissue

Focused ion beamed (FIB) SEM has a higher spatial resolution than other volume-imaging methods owing to the use of ion beams. However, in this method, it is challenging to analyse entire biological structures buried deep in the resin block. We developed a novel volume-imaging method by combining array tomography and FIB-SEM tomography and investigated the chondrocyte ultrastructure. Our method imparts certainty in determining the analysis area such that cracks or areas with poor staining within the block are avoided. The chondrocyte surface showed fine dendritic processes that were thinner than ultrathin sections. Upon combination with immunostaining, this method holds promise for analysing mesoscopic architectures.

Three-Dimensional Analysis of Interstitial Cells in the Smooth Muscle Layer of Murine Vas Deferens Using Confocal Laser Scanning Microscopy and FIB/SEM

The smooth muscle contraction of the vas deferens has the important function of transporting sperm. Interstitial cells (ICs) play a critical role in the pacing and modulation of various smooth muscle organs by interactions with nerves and smooth muscle. Elucidating the three-dimensional (3D) architecture of ICs is important for understanding their spatial relationship on the mesoscale between ICs, smooth muscle cells (SMCs), and nerves. In this study, the 3D ultrastructure of ICs in the smooth muscle layer of murine vas deferens and the spatial relationships between ICs, nerves, and smooth muscles were observed using confocal laser scanning microscopy and focused ion beam/scanning electron microscopy. ICs have sheet-like structures as demonstrated by 3D observation using modern analytical techniques. Sheet-like ICs have two types of 3D structures, one flattened and the other curled. Multiple extracellular vesicle (EV)-like structures were frequently observed in ICs. Various spatial relations were observed in areas between ICs, nerves, and SMCs, which formed a complex 3D network with each other. These results suggest that ICs in the smooth muscle layer of murine vas deferens may have two subtypes with different sheet-like structures and may be involved in neuromuscular signal transmission via physical interaction and EVs.

[Covid-19 And Surgical Pathologies In General Surgery Of CHU Gabriel Toure Of Bamako]

INTRODUCTION

The pure digestive form of COVID-19 is possible and initially considered rare. Our objectives were to determine the frequency of COVID-19 in patients treated in general surgery, identify the circumstances of COVID-19 discoveries in surgery, describe the post-operative complications in patients operated on COVID-1919 and describe the reorganization of post-operative COVID-19 diagnosis management.

MATERIALS AND METHODS

We conducted a prospective descriptive study from March 2020 to August 2021 (18 months). All patients who have been operated on, hospitalized or consulted in the department, the Emergency Department (ERS) or other CHU-GT departments for surgical pathology with COVID-19 or infected with COVID-19 while hospitalized were included in the study.

RESULTS

23 cases collected, representing 8.91% (23/258) of COVID-19 cases identified, a frequency of 1.27/month. The age group 66-75 was the most affected, the average age was 49.13 18.75 years, the predominance was male (sex ratio of 1.3). More than 34.78% were recruited at the SAU, 16 patients (69.56%) consulted in emergency, and digestive signs of COVID-19 were: Abdominal pain 20 cases (89.96%), anorexia 19 cases (82.61%), vomiting 8 cases (34.78%) and diarrhea 3 cases (13.04%). The pulmonary signs of COVID-19 were: Cough 18 cases (78.26%), chest pain 15 cases (65.22%), and dyspnea 9 cases (39.13%). Manifestations of COVID-19 were: pulmonary 9 cases, digestive 9 cases, associated 3 cases, incidental discovery 2 cases. The diagnostic mean was Thoracic CT (100%), Test-PCR 14 cases (60.86%) with a positive PCR test in 50% of cases. Surgical pathologies were surgical emergencies in 7 cases (30.43%), cancers in 6 cases (26.09%), COVID-19 digestive event (30.43%) and other 3 cases (13.04%). More than half of patients were operated on 12 cases (52.17%). The overall mortality was 60.87% and the mortality of surgical patients was 41.67%.

CONCLUSION

The infectious risk of COVID-19 during hospitalization, during or after digestive surgery is a real and potentially serious risk for the patient and caregivers.

3D Mesoscopic Architecture of a Heterogeneous Cellular Network in the Cementum-Periodontal Ligament-Alveolar Bone Complex

Cell-to-cell communication orchestrates various cell and tissue functions. This communication enables cells to form cellular networks with each other through direct contact via intercellular junctions. Because these cellular networks are closely related to tissue and organ functions, elucidating the morphological characteristics of cellular networks could lead to the development of novel therapeutic approaches. The tooth, periodontal ligament (PDL), and alveolar bone form a complex via collagen fibres. Teeth depend on the co-ordinated activity of this complex to maintain their function, with cellular networks in each of its three components. Imaging methods for three-dimensional (3D) mesoscopic architectural analysis include focused ion beam/scanning electron microscopy (FIB/SEM), which is characterised by its ability to select observation points and acquire data from complex tissue after extensive block-face imaging, without the need to prepare numerous ultrathin sections. Previously, we employed FIB/SEM to analyse the 3D mesoscopic architecture of hard tissue including the PDL, which exists between the bone and tooth root. The imaging results showed that the cementum, PDL, and alveolar bone networks are in contact and form a heterogeneous cellular network. This cellular network may orchestrate mechanical loading-induced remodelling of the cementum-PDL-alveolar bone complex as the remodelling of each complex component is coordinated, as exemplified by tooth movement due to orthodontic treatment and tooth dislocation due to occlusal loss. In this review, we summarise and discuss the 3D mesoscopic architecture of cellular networks in the cementum, PDL, and alveolar bone as observed in our recent mesoscopic and morphological studies.

[Therapeutic education in Mali: a training workshop for caregivers and young type 1 diabetic patients]

In March 2021, in the framework of a partnership between the Geneva University Hospitals (HUG), the Santé Diabète Organization and the Ministry of Health of Mali, a 4-day workshop training course was organized with the objective of strengthening the skills of caregivers in Therapeutic Patient Education (TPE) for children and young people with type 1 diabetes. To ensure interprofessionalism, physician-nurse pairs already working together in health structures in 7 regions of Mali participated in the training. Beyond complementarity between health professionals, the aim was to cope with the realities of the Malian health system. All activities were co-chaired by physician-nurse pairs, specialized in diabetes and in TPE. A total of 30 professionals took part in the training, which consisted of 2 days of classroom training and 2 days of hands-on training with type 1 diabetic children and their families. To build the caregivers capacity in TPE, we chose innovative approaches with activities allowing the immediate application of skills learned with various pedagogical tools. The beneficiaries are not only the professionals, but also the children, teenagers and their families, including the trainers.

Correlation of organelle dynamics between light microscopic live imaging and electron microscopic 3D architecture using FIB-SEM

Correlative light and electron microscopy (CLEM) methods combined with live imaging can be applied to understand the dynamics of organelles. Although recent advances in cell biology and light microscopy have helped in visualizing the details of organelle activities, observing their ultrastructure or organization of surrounding microenvironments is a challenging task. Therefore, CLEM, which allows us to observe the same area as an optical microscope with an electron microscope, has become a key technique in cell biology. Unfortunately, most CLEM methods have technical drawbacks, and many researchers face difficulties in applying CLEM methods. Here, we propose a live three-dimensional CLEM method, combined with a three-dimensional reconstruction technique using focused ion beam scanning electron microscopy tomography, as a solution to such technical barriers. We review our method, the associated technical limitations and the options considered to perform live CLEM.

[Management of patients with Covid 19: analysis of prescription drugs at Gabriel Touré University Hospital]

COVID-19 was declared a pandemic in March 2020. For case management, Mali has created several treatment sites including the site of the CHU Gabriel Touré.

AIMS

The objective of the study was to analyse drug prescriptions for the COVID-19 treatment at the CHU Gabriel Touré.

METHODS

We performed a retrospective and descriptive study from April to September 2020. Drug prescriptions and hospital records were used to collect data. Prescriptions and hospital records were used to collect data.

RESULTS

A total of 29 patients were hospitalized. The median age was 44 years, 75.90% of patients had at least one pathology associated with COVID-19. The number of prescriptions was 333 comprising 870 lines of prescriptions including 33.21% for standard treatments, and 66.79% for associated pathologies. with 86.23% available at the Hospital Pharmacy. Chloroquine, dosed at 250mg, was administered at 500mg twice a day. The national guidelines from the treatment of COVID-19 recommends 200mg of chloroquine in two doses. Vitamin C was prescribed for all patients although not included in the national guidelines. The class of drugs for the blood and blood-forming organs was the most prescribed (31.49%). The average cost of treatments was 65,602 ± 106,858 FCFA with a maximum of 567,860 FCFA. An evaluation of prescriptions in other treatment sites is necessary.

Cellular network across cementum and periodontal ligament elucidated by FIB/SEM tomography

Cementocytes in cementum form a lacuna-canalicular network. However, the 3D ultrastructure and range of the cementocyte network are unclear. Here, the 3D ultrastructure of the cementocyte network at the interface between cementum and periodontal ligament (PDL) was investigated on the mesoscale using FIB/SEM tomography. The results revealed a cellular network of cementocytes and PDL cells. A previous histomorphological study revealed the osteocyte-osteoblast-PDL cellular network. We extended this knowledge and revealed the cementum-PDL-bone cellular network, which may orchestrate the remodeling and modification of periodontal tissue, using a suitable method for imaging of complex tissue.

Correlative imaging of collagen fibers and fibroblasts using CLEM optimized for picrosirius red staining and FIB/SEM tomography

Conventional imaging for three-dimensional (3D) ultra-architectural analysis of collagen fibers and fibroblasts is time-consuming and requires numerous ultrathin sections to search the target area. Currently, no method allows 3D ultra-architectural analysis of predetermined areas including spatial relationships between collagen fibers and fibroblasts in vitro. Herein, we developed a new method for in vitro analysis of the 3D ultrastructure of fibroblasts and collagen fibers using CLEM optimized for picrosirius red staining and FIB/SEM tomography. Collagen fibers were observed between, rather than on top of, stacked cells. This method offers the advantage of mesoscopic and ultrastructural analysis, thus minimizing bias and ensuring accurate observation.

Age-dependent Alteration in Mitochondrial Dynamics and Autophagy in Hippocampal Neuron of Cannabinoid CB1 Receptor-deficient Mice

Endocannabinoid system activity contributes to the homeostatic defense against aging and thus may counteract the progression of brain aging. The cannabinoid type 1 (CB1) receptor activity declines with aging in the brain, which impairs neuronal network integrity and cognitive functions. However, the underlying mechanisms that link CB1 activity and memory decline remain unknown. Mitochondrial activity profoundly influences neuronal function, and age-dependent mitochondrial activity change is one of the known hallmarks of brain aging. As CB1 receptor is expressed on mitochondria and may regulate neuronal energy metabolism in hippocampus, we hypothesized that CB1 receptors might influence mitochondria in hippocampal neurons. Here, we found that CB1 receptor significantly affected mitochondrial autophagy (mitophagy) and morphology in an age-dependent manner. Serine 65-phosphorylated ubiquitin, a key marker for mitophagy, was reduced in adult CB1-deficient mice (CB1-KO) compared to those in wild type controls, particularly in CA1 pyramidal cell layer. Transmission electron microscopy (TEM) analysis showed reduced mitophagy-like events in hippocampus of adult CB1-KO. TEM analysis also showed that mitochondrial morphology in adult CB1-KO mice was altered shown by an increase in thin and elongated mitochondria in hippocampal neurons. 3D reconstruction of mitochondrial morphology after scanning electron microscopy additionally revealed an enhanced density of interconnected mitochondria. Altogether, these findings suggest that reduced CB1 signaling in CB1-KO mice leads to reduced mitophagy and abnormal mitochondrial morphology in hippocampal neurons during aging. These mitochondrial changes might be due to the impairments in mitochondrial quality control system, which links age-related decline in CB1 activity and impaired memory.

[Health care-associated infections in teaching hospital Gabriel TOURE]

OBJECTIVES

To study health care-associated infections (HCAI) in teaching hospital Gabriel TOURE.

METHODOLOGY

This was a prospective study of 6 months (from April to September 2016) which included patients admitted to the General Surgery Department, operated or not, except those who had undergone a necrosectomy. The criteria used for the diagnosis of the infection were those of the CDC of Atlanta.

RESULTS

A total of 200 patients were included in the study. Twenty one patients developed IAS that is a frequency of 10.5%. There were 11 men and 10 women with a mean age of 37.7 years with a standard deviation of 17.6 years. Surgical site infection was the most common HCAI (77.3%) followed by urinary tract infection (13.6%) and burn infection (9.1%). The influencing factors were those related to the patients (nutritional status p = 0.004, anemia RR = 3.1 IC p = 0.003 and diabetes), those related to the surgical intervention (the duration of the intervention ≥ 2H, p = 0,0001, the Altemeier class 3 and 4, RR = 4.24, IC p = 0.005, the number of interveners in the blocks ≥7, p = 0.000, the NNISS score 1 and 2 p = 0.0009), invasive procedures (bladder catheter ≥ 4 days p = 0.0000). Escherichia coli was the most isolated microorganism (31.2%) followed by Klebsiella pneumonia and A baumannii (18.7%). The treatment was local (twice-daily dressing with antiseptics), surgical (necrosectomy 16% and re-intervention 10%) and general (adapted to the antibiogram). The consequences of HCAI were an extension of total hospital stay (greater than 7 days) with p = 0.0000, morbidity 3% and mortality 5%.

CONCLUSION

HCAI remains a concern in our country and globally. They prolong the hospital stay. The implementation of a prevention, control and surveillance program will improve the quality of care by significantly reducing HCAI.

[Health-care related infections in pediatric surgery of the teaching hospital Gabriel Toure, Bamako, Mali]

OBJECTIVES

to identify the main causative agents of infection associated with care and their susceptibility to antibiotics used and to identify risk factors for care-associated infection.

MATERIAL AND METHODS

This was a cross-sectional study with prospective data collection, conducted from 1 November 2016 to 1 April 2017 among all children admitted to the pediatric surgery department. Non-consenting parents and cases of necrosectomy were included in this study.

RESULTS

Our study involved 200 patients, 30 of whom presented a care-associated infection (15% infection rate). The average age of patients with infection was 56.33 ± 48.66 months (1 and 180 months). The main pathogens responsible for infection of the operative site were: Escherischia coli (4 cases), Acinetobacterbaumanii (3 cases), Klebsiella pneumoniae (2 cases), Staphylococcus aureus (2 cases), Enterobacter cloacae (1case), Pseudomonas aeruginosa (1 case) and Enterobacter faecalis (1 case). In the burned patients, the organisms found were: Acinetobacter baumanii (7 cases), Klebsiella pneumoniae (6 cases), Staphylococcus aureus (6 cases), Escherischia coli (4 cases), Pseudomonas aeruginosa (2 cases) and Enterobacter faecalis (2 cases). Escherichia coli was noted in urinary tract infection. Antibiotics tested were amoxicillin, amoxicillin-clavulanic acid, ceftriaxone, imipenem, gentamicin and ciprofloxacin. The mode of recruitment and the duration of hospitalization were the risk factors noted.

CONCLUSION

The infection associated with care is a frequent occurrence in our practice. These infections mainly occur at the operating sites. The germs found were: Acinetobacter, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus. They are all sensitive to imipenem and resistant to amoxicillin. The infection remains formidable in health care. It is essential to give special attention to the prevention of infectious risk, especially in the surgical setting.

[Superior lumbar hernia or hernia of GRYNFELTT, a case study]

The superior lumbar hernia or hernia of GRYNFELTT is a rare pathology. It accounts for less than 1.5% of all hernias in the abdomen. An 84 year-old man with upper right lumbar swelling. The clinical examination revealed a right upper lumbar swelling of 5 cm in diameter, soft, gurgling, reducible, impulsive to cough and expansive to intra-abdominal hyperpressure. There was no history of trauma, surgery, tuberculosis or dysuria. The diagnosis of an uncomplicated upper lumbar hernia was retained. Intra-operatively, the sac was dissected up to the hernia opening, separated from the edges of the hernia orifice and discharged. The repair was performed by suturing the back of the hernia opening with a non absorbable thread. The patient was released on day 1 postoperatively. The suites were simple.

[Epidemiological, clinical profile and outcomes of chronic hemodialysis patients in the Nephrology and Hemodialysis Department of the CHU du Point "G"]

AIM

Hemodialysis is the only method of renal replacement in Mali. Purpose of this work: to study the evolution of chronic hemodialysis.

PATIENTS AND METHODS

In a retrospective study, we used the medical charts of 150 patients. The studied parameters were the epidemiology and clinic profile of patients, the risk factors, the quality and the impact of the benefits on the survival. The data were analyzed on SPSS 12.0 for Windows with p <0.05 as the significance value.

RESULTS

The mean age was 40.45 years (15 years and 77 years). Patients have a low income in 60%. The hemoglobin level was less than 9 g/l in 63.3%. Kidney vascular disease was the most frequent causes in 42%. Hyperphosphataemia was found in 38.6%. The lipid balance was disturbed in 73.9%. A central catheter was used directly in 78.7%. The mortality rate was of 37.3%. The death was due to hypertrophic cardiomyopathy in 35.5% (p = 0.002). Low hemoglobin (p = 0.0002), central catheterization (p=0.008), cardiovascular complications (p= 0.007) and hemodialysis duration (p = 0.00001) are the risk factors for high mortality.

CONCLUSION

The duration of life in hemodialysis remains linked to the complications of renal damage and early management.

[Dysthyroidism in children and adolescents at the Mali hospital]

INTRODUCTION

Dysthyroidism (hyperthyroidism or hypothyroidism) in children and adolescents is much rarer than in adults. The purpose of our study was to study the epidemiological, clinical, paraclinical, etiological and etiological aspects and to specify the therapeutic and evolutionary modalities of this condition.

METHOD

This was a five-year descriptive, retrospective and prospective study of children and adolescents under 18 years of age with dysthyroidism.

RESULTS

We collected 90 children and adolescents with dysthyroidism (hyperthyroidism 77.8% (n=70) and hypothyroidism 22.2% (n=20). For hyperthyroidism (n=70): the average age was 13.07 years and the sex ratio was 0.16. The family history of dysthyroidism was found in 24.3% (n=17). Clinical manifestations were dominated by tachycardia 88.57% (n=62), weight loss 87.14% (n=61), vibrating pulse 87.14% (n=61) and palpitation 81.42% (n=57). Bilateral exophthalmos was present in 70% of patients (n=49) with palpebral retraction in 51.42% (n=56). Goitre was present in 54 patients (77.1%). It was diffuse in 62.9% (n=44) and nodular in 12.9% (n=9). Basedow's disease represented the first etiology with 84.3% (n=59), followed by toxic multinodular goitre12, 9% (n=9). Sixty-eight patients (97.1%) received medical treatment with synthetic antithyroid drugs. Clinical remission was achieved in 64.3% (n=45) and 54.3% of patients were in biological euthyroidism at 6 months follow-up. For hypothyroidism (n=20): the average age was 10.70 years and the sex ratio was 0.53. Six family cases of hypothyroidism and three cases of family goitre were found. The clinical picture was dominated by signs of hypo metabolism at hypersomnia type 95% (n=19) and anorexia 75% (n=15). The skin was dry in 60% (n=12). A staturo-weight delay in 65% (n=13), behavioural disorders in 55% (n=11), weight gain in 40% (n=8) and puberty delay in 10% (n=2). Goitre was nodular in 25% (n=5) with cervical adenopathy present in 15% (n=3). Hashimoto's thyroiditis accounted for 45% (n=9) of etiologies followed by iodine deficiency disorders in 15% (n=3) and iatrogenic causes (2 cases of thyroidectomy). All patients were started on hormone replacement therapy for life. Five patients with large multinodular goiter received total thyroidectomy in addition to medical treatment. Euthyroidism was observed in 55% (n=11) of patients at 6 months follow-up.

CONCLUSION

Dysthyroidism in children and adolescents exists in our health facilities. Its management is deficient because of the technical and financial platform. Our public health decision-makers must help implement a screening strategy to facilitate faster diagnosis and treatment.

[Epidemio-clinicalappearances of care-associated infections in the resuscitation unit of Gabriel Touré teaching hospital (Bamako)]

An infection is said to be associated with care (IAS) when it occurs during or after a patient's management (PEC). A delay of at least 48 hours after admission is commonly accepted to distinguish a nosocomial infection from a community infection.in 2009, WHO estimated that 1.4 million people were sick in the world afterhospital-acquired infections. This prevalence remains largely underestimated in Sub - Saharan Africa, and particularly in Mali, which led us to initiatethiswork, whichaimed to describe the epidemiological and clinical aspects of nosocomial infections, determine their frequency and identify the germs responsible.

MATERIAL AND METHODS

This was a prospective study, over 12 months from January 1st to December 31st, 2016, in the resuscitation department of CHU Gabriel Touré. Including all patients with a temperature greater than or equal to 38 ° C occurring after at least 48 hours of admission. The data were collected through the surveycards and medical records. The input and analysis made respectivelyfrom Epi info software and the 2016 Office Pack (Word, Excel, Power Point).

RESULTS

Duringourstudy of 200 hospitalized patients we collected 35 IAS cases, aprevalence of 17.5%. The male sex was predominant with 60.5% and a sex ratio = 1.53. The average age was 34.28 ± 19.11 yearsold. The traumatized head with 10 cases (28.5%) were the most represented, followed by surgery postoperative 7 cases (20%) and burned 5 cases (14.2%). We carried out 51 samples (15 bronchial samples all positive, 13 ECBUs of which 11 positive, 7 blood cultures, one positive, 12 swabs all positive). The diagnoses retainedwere: ventilated lungdisease 12 cases (34.3%), urinary infection alone 8 cases (22.9%), 6 cases (17.1%) of surgical site infection, 6 cases (17.1%) ) of soft tissue infection and 3 cases (8.6%) of pneumopathy associated with urinary tract infection. The germs found were multidrug-resistant bacilli (BMR), for bronchial samples (Klebsialla pneumoniae, Acinetobacter baumanii, Echerichia coli). ECBU were found 08 cases of Echerichia coliand 01 case of enterococcusfaecalus, and 2 cases of association Echerichia coli and enterococcus faecalus; blood cultures: staphylococcus aureus. The swabsfound: Klebsialla pneumonia, Echerichia coli, Acinetobacter baumanii enterobacter, cloecae, Staphylococcus aureus, Providencia stuartii, Proteus mirabilis. The average duration of treatment of patients with IAS was 8 days with extremes of 2 to 15 days. The mortality was 57.1%.

CONCLUSION

This study allowed us to notice a resistance of different germs to antibiotics. It is therefore necessary to change the behavior of our health care facilities in order to meet this challenge.

[Epidemiological And Clinical Aspects Of Obesity In The Medicine And Endocrinology Service Of Mali Hospital]

INTRODUCTION

Lifestyle changes have played an important role in increasing the prevalence of obesity. The objectives were to describe the epidemiological, clinical and progressive aspects of obesity in patients of the Mali hospital.

PATIENTS AND METHOD

this is a descriptive study with retrospective collection of data from the medical records of patients hospitalized in the Medicine and Endocrinology department. Our patients benefited from weight gain, height, waist measurement and hip measurement with calculation of the body mass index.

RESULTS

the study concerned 90 obese patients out of 1515 hospitalized (5.94% of frequency). The mean age was 42 ± 5 with extremes 10 and 74. The sex ratio was 0.38. Obesity was mixed: 75.4% of men, 60% of woman; Android in 36% of men, 18% of women and the only child aged 10 had morbid obesity. The reason for hospitalization was complications of obesity in 13.30%. The psychological reactions collected were: anxiety 54.40%, indifference 40% and shame 5.60%. There were 68.90% complications including 37.80% cardio metabolic (hypertension associated in 51.10%). The lipid assessment carried out showed hyper LDLdemia: 70%; HDL hypoemia: 67.80%, hyper triglyceridaemia: 66.70%. Our patients received dietary and dietary advice. No drug or surgical treatment has been initiated despite the indication. We recorded 3.30% of deaths.

CONCLUSION

The epidemiological and clinical description, diagnosis and evaluation of the repercussions of obesity are easy in our daily practice. However, care remains insufficient due to the inadequacy of the technical platform, the lack of financial means and the prejudices of our patients (ignorance of obesity as a disease).

[Surgical site infections at Bocar Sidy Sall University Hospital Center of Kati]

INTRODUCTION

Surgical site infections (SSI) are frequent and dangerous in the surgical ward. They represent an obsession for the surgeon. The objectives were to determine the frequency of ISOs and risk factors, to identify the germs and to study their sensitivity to different antibiotics.

MATERIALS AND METHODS

This was a cross-sectional study with prospective data collection, performed at the general surgery department of the Bocar Sidy Sall University Hospital Center (Kati CHU) from January 2015 to December 2018.

RESULTS

During this period of study we recorded 55 cases of ISO out of 650 operated patients with a frequency of 8.46%. 450 patients were operated on the cold operating program (69.23%) and 200 patients on emergency (30.77%). The average age was 39, the sex ratio was 2.66. Among the 55 cases of ISO, 60% of these patients were operated in emergency and 40% in the operating program. The most common strains found were Escherichia coli (E. coli) in 38.3% of cases, Staphylococcus aureus in 23.4% and Klebsiella pneumonia in 13.3%. Hemoglobin levels were normal in 70% of cases. 4 of our patients or 7.27% were diabetic. We did not have any cases of obesity. Of the 55 cases of ISO, 66% were of class 3 and 4 of Altemeier, 59% were of ASA score 2 and ASA 3, 55% were of score 2 of NNISS (National Nosocomial Infection Surveillance System), 5.45% were NNISS score 3 or 3 cases and these 3 cases developed ISO. The ISOs were parietal in 49 cases, ie 89%. The recovered germs were 100% sensitive to imipenem. The most informative interventions of the ISOs were peritonitis 25 cases (45.45%), intestinal occlusions 12 cases (21.82%), appendicular abscess 8 cases (14.55%). We had 2 death cases, 3.64%, the average hospital stay was 13 days.

CONCLUSION

Escherichia coli was the common germ found in the ISO in general surgery at Kati BSS Hospital. The usual resistance to antibiotics must provoke effective preventive actions.

Three-dimensional ultrastructural and histomorphological analysis of the periodontal ligament with occlusal hypofunction via focused ion beam/scanning electron microscope tomography

The periodontal ligament (PDL) maintains the environment and function of the periodontium. The PDL has been remodelled in accordance with changes in mechanical loading. Three-dimensional (3D) structural data provide essential information regarding PDL function and dysfunction. However, changes in mechanical loading associated with structural changes in the PDL are poorly understood at the mesoscale. This study aimed to investigate 3D ultrastructural and histomorphometric changes in PDL cells and fibres associated with unloading condition (occlusal hypofunction), using focused ion beam/scanning electron microscope tomography, and to quantitatively analyse the structural properties of PDL cells and fibres. PDL cells formed cellular networks upon morphological changes induced via changes in mechanical loading condition. Drastic changes were observed in a horizontal array of cells, with a sparse and disorganised area of collagen bundles. Furthermore, collagen bundles tended to be thinner than those in the control group. FIB/SEM tomography enables easier acquisition of serial ultrastructural images and quantitative 3D data. This method is powerful for revealing 3D architecture in complex tissues. Our results may help elucidate architectural changes in the PDL microenvironment during changes in mechanical loading condition and regeneration, and advance a wide variety of treatments in dentistry.

[Torsion Of Meckel's Diverticulum, A Case Report At Paediatric Surgery Service Of CHU Gabriel Touré]

Twist is the rarest complication of Meckel's diverticulum (DM). We did not find a case published in African literature. We report a case of twisted "giant" diverticulum occurred in a 15-year-old boy who had consulted for abdominal pain. Operated in emergency, the diagnosis was intraoperative. The diverticulum was 14 cm long and 5 cm in diameter. It was twisted at its base, totally necrotic and perforated at the top. We performed a resection carrying the diverticulum followed by a terminoterminal ileal ileal anastomosis. The postoperative course was simple.

[Breast Cancer: Immunohistochemistry And Prognosis At Gabriel Touré Teaching Hospital In Bamako-Mali]

Breast cancer is the second cancer of women in Mali. Immunohistochemistry is poorly performed in our African countries.

OBJECTIVES

To describe the immunohistochemical aspect and determine the prognosis of breast cancer.

METHODOLOGY

This is a retrospective descriptive study (March 2006-July 2016) in the General Surgery Department of Gabriel Toure University Hospital in Bamako, Mali. Immunohistochemistry was performed in all patients through a collaboration of our German partners.

RESULTS

We collected 98 patients (95 women and 3 men) with an average age of 40.04 ± 13.07 years. Twenty-two patients (22.44%) had a personal history of benign breast disease. In 16 patients (16.33%), we found a family breast cancer. The most common histological types were intra ductal carcinoma with 84 (85.72%) and invasive lobular carcinoma in 9 cases (9.18%). Immunohistochemistry found a predominance of triple negative with forty nine patients (50%) followed by Luminal A subtype with 26 cases (26.23%). According to the TNM classification, 44 patients (44.90%) were received at stage III. The median survival was 60 months in the group of patients who received hormone therapy versus 28 months for the group without hormone therapy (p = 0.007).

CONCLUSION

Immunohistochemistry is essential for the adequate management of breast cancer. Its realization has allowed us to improve the prognosis of hormone-dependent cancers.

[Neonatal Gastric Perforation]

Neonatal gastric perforation (PGNN) is a rare and serious pathology when management is not early. We did not find a case published in African literature. . We report 2 cases of PGNN registered in pediatric surgery of C.H.U Gabriel TOURE. The clinical pictures were that of a neonatal occlusion. X-rays of the abdomen without preparation revealed pneumoperitoneum in both cases. Congenital origin was retained for both cases. Surgical treatment consisted of excision-suture of the perforation margins. The operative sequences were simple in both cases.

Three-dimensional ultrastructural analysis and histomorphometry of collagen bundles in the periodontal ligament using focused ion beam/scanning electron microscope tomography

BACKGROUND AND OBJECTIVE

The periodontal ligament (PDL) is an essential tissue for tooth function. However, the 3-dimensional ultrastructure of these PDL collagen bundles on a mesoscale is not clear. We investigated the 3-dimensional ultrastructure of these collagen bundles and quantitatively analyzed their histomorphometry using focused ion beam/scanning electron microscope (FIB/SEM) tomography.

MATERIAL AND METHODS

The PDLs of the first mandibular molar of male C57BL/6 mice were analyzed using FIB/SEM tomography. The serial images of the collagen bundles so obtained were reconstructed. The collagen bundles were analyzed quantitatively using 3-dimensional histomorphometry.

RESULTS

Collagen bundles of the PDL demonstrated multiple branched structures, rather than a single rope-like structure, and were wrapped in cytoplasm sheets. The structure of the horizontal fiber of the collagen bundle was an extensive meshwork. In contrast, the oblique and apical fibers of the collagen bundle showed a chain-like structure. The area and the minor and major axis lengths of cross-sections of the horizontal fiber, as determined from 3-dimensional images, were significantly different from those of the oblique and apical fibers.

CONCLUSION

These findings indicate that collagen bundles in horizontal fiber areas have high strength and that the tooth is firmly anchored to the alveolar bone by the horizontal fibers, but is not secured evenly to the alveolar bone. The tooth is firmly anchored around the cervical area, creating a "slingshot-like structure." This study has provided further insights into the structure of the PDL and forms the basis for the development of more effective therapies for periodontal tissue regeneration.

[Bilio-Digestives Derivative In The Palliative Surgery Of Pancreatic Head Cancer At The CHU Gabriel TOURE]

OBJECTIVES

Our objective was to determine the frequency of bilio-digestive bypass in palliative surgery in pancreatic head cancers, to determine the clinical and para-clinical aspects and to analyze the results of the treatment.

METHODS

This was a-15 year retrospective study from 1999 to 2014 including any patient with confirmed pancreatic cancer in the anatomo-pathology treated by palliative surgery in the department.

RESULTS

In 15 years, we operated152 cases of cancer of the head of the pancreas. The bilio-digestive derivation was performed in 78 patients, or 51.32%. The average age was 58.61 years ± 11.22 years with the extremes of 34 and 79 years old, the sex ratio was 1.44. The disease duration was 4.88 months on average with a standard deviation of 4.28 months and extremes of 1 and 24 months. Courvoisier-Terrier's disease was observed in 76 cases with lesions of the cases. The average pancreatic tumor size was 62.98 mm, and standard deviation = 8.68 with the extremes of45 and 121 mm. We performed a choledoco-duodenal anastomosis and a gastro-entero-anastomosis (GEA) in 85.90% of cases (n = 67), a choledocojejunal anastomosis and a GEA in 7 cases and a choledoco-duodenal anastomosis without GEA in 4 cases. The morbidity and the mortality rates were15.4% and 6.41%, respectively. At six (6) months postsurgery, a complete disappearance the majority of the functional signs was observed.

CONCLUSION

Pancreatic cancer is a slowly developing tumor. Therefore its diagnosis is late; the derivation makes it possible to improve the quality of life of the patients.

[Undesirable Events During Anesthesia For Programmed Digestive Surgery]

OBJECTIVES

to study the morbidity operative peri in digestive surgery.

PATIENT AND METHOD

It was about a prospective and descriptive survey in the services of digestive surgery and anesthesia resuscitation from February to August 2014. The population of survey was constituted of the whole patients having benefitted an anesthesia for programmed digestive surgery. The statistical test used for the comparison of the qualitative variables was CHI2 with p <0,05 considered meaningful.

RESULTS

during the period 125 files have been collected. The patients having presented at least an undesirable event were of 86 either 68,8%. These events had occurred in 77.9% of cases during the interview. The middle age was of 47.46±15, 68years with extremes of 18years. and 85 years. Sex ratio was of 1, 55. Patients were classified ASA I in 83.2%. The predominant operative indication was the gastric tumor in 26.4 % of the cases. General anesthesia was practiced in 82.4% of the cases. Anesthesia were achieved in 55.2% of the cases by male nurses' anesthetists and 44,8% by the students in diploma of studies specials(DES).Main recovered undesirable events were of cardiovascular, respiratory and digestive nature (nausea and vomiting). Intervening of the undesirable events was bound to the technique of anesthesia, Anesthetic time length of intervention, used narcotic and to the antecedents of the patients with p <0, 05.

CONCLUSION

Factors of avoidable operative morbidity peri are nearly present in all our acts for digestive surgery. The formation of the staff and the setting to disposition of products better tolerated will permit to reduce these factors.

Noncontiguous finished genome sequence and description of Enterococcus massiliensis sp. nov

Enterococcus massiliensis strain sp. nov. (= CSUR P1927 = DSM 100308) is a new species within the genus Enterococcus. This strain was first isolated from a fresh stool sample of a man during culturomics study of intestinal microflora. Enterococcus massiliensis is a Gram-positive cocci, facultative anaerobic and motile. E. massiliensis is negative for mannitol and positive for β-galactosidase, contrary to E. gallinarum. The complete genome sequence is 2 712 841 bp in length with a GC content of 39.6% and contains 2617 protein-coding genes and 70 RNA genes, including nine rRNA genes.

En bloc staining with hydroquinone treatment for block face imaging

IntroductionBecause recent three-dimensional (3D) ultrastructural reconstruction techniques such as serial block face scanning electron microscopy (SBFSEM), obtain their images directly from the flat surface of specimens via material contrast[1], specimens should be strongly stained with heavy metals prior to resin embedding in order to obtain higher material contrast using backscattered electrons (BSEs). To enhance membrane contrast for block face imaging (BFI), we usually stain specimens using the method published by Deerinck[2], and the images obtained show TEM-like contrast.However, recently, our research subjects have required reconstruction of a much larger volume, increasing the total image acquisition time. To reduce the total acquisition time, both high sensitivity detectors and a new specimen preparation method that provides much higher contrast are required. Takahashi et al.[3] have reported that hydroquinone (HQ) treatment during traditional electro-conductive staining increases specimen conductivity and drastically reduces the charge problem for SEM observation. They concluded that HQ treatment might increase the efficiency of secondary electron (SE) generation. Because BFI can be performed using SE as well as BSE, we examined whether addition of HQ treatment to en bloc staining protocols increased the contrast for BFI using SE. Materials & methodsMouse liver tissue was used. Mice were deeply anesthetized by diethyl ether and sodium pentobarbital, and tissues were fixed by transcardial perfusion of 2% paraformaldehyde and 2.5% glutaraldehyde in 0.1 M cacodylate buffer (pH 7.4) through the left ventricle, followed by heparin-containing saline. After perfusion, liver tissues were removed and cut into small cubes approximately 1 mm(3) in the fixative, and were further fixed in the same fixative for 2 h at 4°C. Subsequently, en blocstaining was performed as follows: the specimens were treated using a reduced-OTO staining method (1.5% potassium ferrocyanide-2% OsO4, 1% thiocarbohydrazide, and then 2% OsO4). Subsequently, specimens were treated with 1% HQ solution. Some specimens were exempted from this step and used as controls. Specimens were further stained with 4% uranyl acetate and Walton's lead aspartate solution.After staining, specimens were dehydrated using an ethanol series and embedded in epoxy resin (EPON812, TAAB). Surface of specimens block were cut with a diamond knife, and the newly created flat surfaces of the specimens were coated with evaporated carbon (50 Å) and observed using a SEM (Quanta 3D FEG, FEI).ResultsThe HQ-treated specimens generated a larger amount of SEs than control specimens when subjected to irradiation with the same beam, although BSE numbers were not evidently increased by the treatment. The present results suggest that HQ treatment increases SE generation efficiency, but does not enhance the recruitment of heavy metals into specimens. HQ treatment increased the contrast-to-noise ratio of BFI for images obtained using SEs, and may reduce the total image acquisition time of recently developed 3D reconstruction methods based on SEM.

Three-dimensional organization of the endoplasmic reticulum membrane around the mitochondrial constriction site in mammalian cells revealed by using focused-ion beam tomography

The endoplasmic reticulum (ER) and mitochondria associate at multiple contact sites to form specific domains known as mitochondria-ER associated membranes (MAMs) that play a role in the regulation of various cellular processes such as Ca2+ transfer, autophagy, and inflammation. Recently, it has been suggested that MAMs are also involved in mitochondrial dynamics, especially fission events. Cytological analysis showed that ER tubules were frequently located close to each other in mitochondrial fission sites that accumulate fission-related proteins. Three-dimensional (3D) imaging of ER-mitochondrial contacts in yeast mitochondria by using cryo-electron tomography also showed that ER tubules were attached near the constriction site, which is considered to be a fission site1). MAMs have been suggested to play a role in the initiation of mitochondrial fission, although the molecular relationships between MAMs and the mitochondrial fission process have not been established. Although an ER-mitochondrial membrane association has also been observed at the fission site in mammalian mitochondria, the detailed organization of MAMs around mammalian mitochondria remains to be established. To visualize the 3D distribution of the ER-mitochondrial contacts around the mitochondria, especially around the constriction site in mammalian cells, we attempted 3D structural analysis of the mammalian cytoplasm using high-resolution focused ion-beam scanning electron microscopy (FIB-SEM) tomography, and observed the distribution pattern of ER contacts around the mammalian mitochondrial constriction site.Rat hepatocytes and HeLa cells were used. Liver tissue was obtained from male rats (Wistar, 6W) fixed by transcardial perfusion of 2% paraformaldehyde and 2.5% glutaraldehyde in 0.1 M cacodylate buffer (pH 7.4) under deep anesthesia. HeLa cells were fixed with the same fixative. The specimens were then stained en bloc to enhance membrane contrast and embedded in epoxy resin2). The surface of the specimens was freshly exposed using an ultramicrotome and examined by FIB/SEM (Quanta 3D FEG, FEI, USA). Ion-beam milling and image acquisition cycles were performed under the following conditions. The milling was performed with a gallium ion beam at 30 kV with a current of 100 pA, with a milling pitch of 10 nm/step. Material contrast images using backscattered electrons (BSE) were acquired at a landing energy of 2 keV with a bias voltage of 1.5-2.5 kV using a vCD detector. The remaining acquisition parameters were as follows: beam current = 11 pA, dwell time = 6-30 µs/pixel, image size = 1024 × 883 pixel (5.9 × 5.1 µm), pixel size = 5.8 nm/pixel. The resultant image stack was processed using Avizo 6.3 and Amira 5.4(FEI, USA).Reconstructed volume showed the existence of several constriction sites on mitochondria in both chemically fixed normal hepatocytes and HeLa cells. Each material contrast image of specimen surfaces showed two types of membrane associations between the ER and mitochondria. The first was an osmiophilic bridge-like structure; these bridges were approximately 50 nm in length, and they connected the ER membrane and the mitochondrial outer membrane (OMM). The second was a close apposition (< 20 nm) of the ER membrane and the OMM. Membrane segmentation revealed the 3D distribution of the membrane contacts; 10 to 20% of the mitochondrial surface was occupied by ER contacts. No fundamental difference was observed between hepatocytes and HeLa cells in the distribution pattern of the contacts. Although ER-contacts and bridge-like structures were occasionally found to accumulate around the mitochondrial constriction area, we did not observe any ring-like ER tubules around the mammalian mitochondrial constriction site, as in yeast. These results suggest that the role of ER-membrane associations in the mitochondrial fission process may differ between mammals and yeast.

Chronic Fluoxetine Induces the Enlargement of Perforant Path-Granule Cell Synapses in the Mouse Dentate Gyrus

A selective serotonin reuptake inhibitor is the most commonly prescribed antidepressant for the treatment of major depression. However, the mechanisms underlying the actions of selective serotonin reuptake inhibitors are not fully understood. In the dentate gyrus, chronic fluoxetine treatment induces increased excitability of mature granule cells (GCs) as well as neurogenesis. The major input to the dentate gyrus is the perforant path axons (boutons) from the entorhinal cortex (layer II). Through voltage-sensitive dye imaging, we found that the excitatory neurotransmission of the perforant path synapse onto the GCs in the middle molecular layer of the mouse dentate gyrus (perforant path-GC synapse) is enhanced after chronic fluoxetine treatment (15 mg/kg/day, 14 days). Therefore, we further examined whether chronic fluoxetine treatment affects the morphology of the perforant path-GC synapse, using FIB/SEM (focused ion beam/scanning electron microscopy). A three-dimensional reconstruction of dendritic spines revealed the appearance of extremely large-sized spines after chronic fluoxetine treatment. The large-sized spines had a postsynaptic density with a large volume. However, chronic fluoxetine treatment did not affect spine density. The presynaptic boutons that were in contact with the large-sized spines were large in volume, and the volumes of the mitochondria and synaptic vesicles inside the boutons were correlated with the size of the boutons. Thus, the large-sized perforant path-GC synapse induced by chronic fluoxetine treatment contains synaptic components that correlate with the synapse size and that may be involved in enhanced glutamatergic neurotransmission.