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dark field microscopy uk

dark field microscopy uk for point-of-care syphilis diagnosis

syphilis is a sexually transmitted disease caused by the spirochetal bacterium Treponema pallidum subspecies pallidum. Globally, an estimated 12 million cases of syphilis occur annually. In the United States, 13,997 cases of primary and secondary (infectious) syphilis were reported to the Centers for Disease Control and Prevention (CDC) in 2009, a 3.7% increase from 2008 and a 134% increase from 2000, when a post-war low of 5,979 primary and secondary syphilis cases was reported. Men who have sex with men (MSM) — especially those who are HIV infected — and blacks are disproportionately affected by syphilis. Geographically, urban areas and the Southeastern region of the United States have the highest rates.

Syphilis is most commonly transmitted by skin-to-skin (or mucous membrane) contact. Following exposure, the infection passes through the following stages:

Primary syphilis, characterized by a painless ulcer, called a chancre, usually develops three weeks after exposure (range 10 days to 90 days) at the site of inoculation. The chancre heals spontaneously after several weeks.

Secondary syphilis is most often characterized by a generalized rash that also resolves without treatment. Rash on the palms and soles can also occur, as can systemic manifestations such as fever, malaise, and lymphadenopathy. Given the widely variable nature of the rash and other manifestations of the disease, syphilis has acquired the moniker “The Great Imitator.”

Early (one year) latent syphilis, defined by the absence of signs or symptoms of disease and diagnosed by serologic evidence of infection.

Tertiary syphilis, which affects about a third of untreated patients and manifests with cutaneous, cardiovascular, or neurologic disease.

Syphilis can also be acquired in utero at any stage of pregnancy and lead to congenital syphilis. Routine syphilis screening and treatment in pregnant women has made congenital syphilis rare in the United States.

Approaches to syphilis diagnosis

Because T pallidum is too fragile an organism to be cultured in the clinical setting, diagnostic testing relies on two approaches: direct detection of the organism and indirect evidence of infection.
Syphilis – Treponema pallidum on darkfield.

Direct methods include darkfield microscopy, molecular assays to detect T pallidum DNA, and histopathologic examination of biopsies of skin or mucous membranes (which can also provide indirect evidence of infection, on the basis of patterns of inflammation in the tissue). Direct methods have the advantage, in some cases, of detecting infection before a patient has mounted a measurable antibody response that results in a reactive serologic test result.

dark field microscopy uk allows visualization of live treponemes obtained from a variety of cutaneous or mucous membrane lesions, as follows.

In primary syphilis, the chancre teems with treponemes that can be seen with darkfield microscopy. The sensitivity of darkfield microscopy for the diagnosis of primary syphilis is approximately 80%. Darkfield sensitivity declines over time and can also decrease if the patient has applied topical antibiotics to the lesion(s). Of note, the mouth harbors normal non-pathogenic treponemes that are indistinguishable microscopically from T pallidum. Therefore, oral specimens cannot be used for darkfield microscopy because of the possibility of false-positive test results.

In secondary syphilis, mucous patches (as long as not oral) and condyloma lata (found in moist areas between body folds) are appropriate specimens for darkfield microscopy. Dry skin lesions usually do not contain sufficient organisms for darkfield testing.

In congenital syphilis, moist discharge from the nose (snuffles) and vesiculobullous lesions of the skin are high-yield specimen sources for darkfield testing.

Indirect methods of diagnosis include serologic testing of blood or cerebrospinal fluid (CSF) and detection of CSF abnormalities (elevated white blood cell count or protein) consistent with neurosyphilis. Serologic testing of blood involves demonstration of host antibody to either endogenous antigens (non-treponemal tests) or to antigens of T pallidum (treponemal tests). Non-treponemal tests, including the rapid plasma reagin test and the venereal disease research laboratory test, have historically been used as the initial screening tests for the serologic diagnosis of syphilis. If a patient’s non-treponemal test is reactive, confirmatory testing with a treponemal test is performed, using either the T pallidum particle agglutination test, the fluorescent treponemal antibody-absorbed test, or another treponemal test. A reactive treponemal test confirms the diagnosis of a new or previously treated case of syphilis. If the treponemal test is non-reactive, the positive non-treponemal test result is considered a biologic false-positive that is not diagnostic of syphilis. A newer algorithm that is gaini

dark field microscopy uk

dark field microscopy uk Options

dark field microscopy uk Options

Metallurigcal reflected light brightfield/darkfield microscope.
Metallurgical reflected and transmitted light brightfield/darkfield microscope.
Stereo microscope 420 with darkfield attachment.
Stereo Zoom SMZ-168 microscope with darkfield attachment.
Biological laboratory phase contrast microscope with darkfield for up to 40x.
Biological laboratory microscope BA210 with darkfield slider.
Biological student microscope 162 with darkfield attachment.

dark field microscopy uk

When to Use a dark field microscopy uke

When to Use a dark field microscopy uke

Dark field microscopes are used in a number of different ways to view a variety of specimens that are hard to see in a light field unit. Live bacteria, for example, are best viewed with this type of microscope, as these organisms are very transparent when unstained.

There are multitudes of other ways to use dark field illumination, often when the specimen is clear or translucent. Some examples:

Dark field illumination of caffeine crystalsLiving or lightly stained transparent specimens

Single-celled organisms

Live blood samples

Aquatic environment samples (from seawater to pond water)

Living bacteria

Hay or soil samples

Pollen samples

Certain molecules such as caffeine crystals (right)

Dark field microscopy makes many invisible specimens appear visible. Most of the time the specimens invisible to bright field illumination are living, so you can see how important it is to bring them into view!

dark field microscopy uk

What is dark field microscopy uk?

What is dark field microscopy uk?

Darkfield microscopy is a specialized illumination technique that capitalizes on oblique illumination to enhance contrast in specimens that are not imaged well under normal brightfield illumination conditions. After the zeroth order (direct) light has been blocked by an opaque stop in the substage condenser, light passing through the specimen from oblique angles at all azimuths is diffracted, refracted, and reflected into the microscope objective to form a bright image of the specimen superimposed onto a dark background.

Transmitted Darkfield Illumination – Transmitted darkfield illumination can be used to increase the visibility of specimens lacking sufficient contrast for satisfactory observation and imaging by ordinary brightfield microscopy techniques. This section discusses various aspects of darkfield illumination, including theory of the technique, condenser design for transmitted darkfield illumination (at both low and high magnifications), microscope configuration parameters, and suggestions for choosing suitable candidates for observation.

Reflected Darkfield Illumination – Darkfield illumination with reflected light enables visualization of grain boundaries, surface defects, and other features that are difficult or impossible to detect with brightfield illumination. The technique relies on an opaque occluding disk, which is placed in the path of the light traveling through the vertical illuminator so that only the peripheral rays of light reach the deflecting mirror. These rays are reflected by the mirror and pass through a hollow collar surrounding the objective to illuminate the specimen at highly oblique angles.

Darkfield Illumination for Stereomicroscopy – Darkfield observation in stereomicroscopy requires a specialized stand containing a reflection mirror and light-shielding plate to direct an inverted hollow cone of illumination towards the specimen at oblique angles. A number of aftermarket products are currently available for retrofitting stereomicroscopes with transmitted darkfield illumination. In addition, many of the microscope manufacturers offer illumination accessories that can be conveniently utilized to achieve darkfield conditions for their stereo systems. The principal elements of darkfield illumination are the same for both stereomicroscopes and more conventional compound microscopes.

Darkfield Microscope Configuration – A step-by-step guide to configuration of transmitted light microscopes for use with both low and high magnification darkfield condensers is provided in this review. Careful attention should always be given to microscope alignment and configuration, irrespective of whether the illumination mode is brightfield, darkfield, phase contrast or some other contrast enhancement technique. Time spent in this endeavor will be repaid in excellent performance of the microscope both for routine observation and critical digital imaging or photomicrography.

Troubleshooting dark field microscopy uk – There are numerous common problems associated with darkfield microscopy and photomicrography or digital imaging. These range from insufficient illumination and condenser mis-alignment to using a field stop of incorrect size. Most darkfield illumination problems are associated with the substage condenser, and this should be the first suspect when things do not work properly. This section addresses some of the more common problems encountered with darkfield microscopy, along with suggested remedies.

Darkfield Photomicrograph Gallery – The Molecular Expressions gallery of darkfield illumination photomicrography and digital imaging contains a wide spectrum of images captured under a variety of conditions and utilizing many different specimens. Included in this unique gallery are specimens ranging from simple diatoms to fossilized dinosaur bones, insects, Moon rocks, and integrated circuits.

dark field microscopy uk Interactive Tutorials – Explore various aspects of darkfield microscopy theory and practice using these tutorials, which are designed to complement text pages by enabling visitors to use a web browser to simulate configuration and operation of a microscope under darkfield illumination. Both the theory and practice of darkfield microscopy are addressed by the tutorials.

dark field microscopy uk

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