Reactive astrocytes adjacent to a forebrain stab injury were selectively ablated in adult mice expressing HSV-TK from the Gfap promoter by treatment with ganciclovir. Injured tissue that was depleted of GFAP-positive astrocytes exhibited (1) a prolonged 25-fold increase in infiltration of CD45-positive leukocytes, including ultrastructurally identified monocytes, macrophages, neutrophils, and lymphocytes, (2) failure of blood-brain barrier (BBB) repair, (3) substantial neuronal degeneration that could be attenuated by chronic glutamate receptor blockade, and (4) a pronounced increase in local neurite outgrowth. These findings show that genetic targeting can be used to ablate scar-forming astrocytes and demonstrate roles for astrocytes in regulating leukocyte trafficking, repairing the BBB, protecting neurons, and restricting nerve fiber growth after injury in the adult central nervous system.

An 81-year-old woman had uneventful bilateral sequential phacoemulsification using a separate sterile technique for each eye. Despite this, early culture-positive postoperative endophthalmitis developed. Management included bilateral intravitreal antibiotic agents, and the patient achieved an excellent visual outcome. To our knowledge, this is the third reported case of bilateral endophthalmitis after bilateral sequential phacoemulsification and the first reported case in which a separate sterile technique was used in each eye.

No abstract