Nontuberculous mycobacterial disease and Aspergillus-related lung disease in bronchiectasis.

The aim of the present study was to determine whether patients with bronchiectasis and nontuberculous mycobacteria (NTM) have a higher prevalence of Aspergillus-related lung disease. A series of 30 consecutive patients with bronchiectasis and NTM (cases) were compared with 61 patients with bronchiectasis and no evidence of NTM (controls). Aspergillus serology and computerised tomography of the thorax were used to identify Aspergillus-related lung diseases, including aspergilloma, allergic bronchopulmonary aspergillosis and chronic necrotising pulmonary aspergillosis. The rate of positive Aspergillus serology was higher in cases with NTM disease compared with controls (10 out of 30 versus six out of 61). The radiological features of Aspergillus-related lung disease were also more common among patients with NTM disease than controls (six out of 30 versus none out of 61). This association between NTM disease and Aspergillus-related lung disease remained significant after adjustment for confounding effects of age and lung function (adjusted odds ratio 5.1, 95% confidence interval 1.5-17.0). Patients with bronchiectasis and nontuberculous mycobacterial disease have a higher prevalence of coexisting Aspergillus-related lung disease than patients with bronchiectasis and without nontuberculous mycobacteria. Identification of Aspergillus-related lung disease is important as prognosis amongst undetected cases is invariably poor.     

Magnetic resonance imaging of nonmetallic orbital foreign bodies

We studied a cadaver head model in which we inserted three orbital foreign bodies. We chose these foreign bodies because of their similarity to substances found in orbital trauma. Teflon and Lucite were used to represent synthetic materials, and dry pine was chosen as a type of organic material. Lucite is similar in radiographic density to plastics used in interior trim for automobiles and spectacle frames. While both orbital ultrasound and plain skull films failed to detect the foreign bodies consistently, both computed tomography and magnetic resonance imaging detected and localized the foreign bodies relatively well. Computed tomography was better in delineating shape and characterizing composition.     

A simplified method for detecting cytomegalovirus by polymerase chain reaction from histologic sections of small biopsies.

Using a simplified procedure, we have extracted DNA from unstained paraffin sections of needle biopsies of kidney and liver transplants and identified the presence of CMV using the polymerase chain reaction. This method utilizes oligonucleotide primers for two genes shown to be specific for cytomegalovirus (CMV) as well as an internal control gene (hemoglobin) in a single reaction. Utilizing nested PCR amplification with agarose gel electrophoresis, CMV can be detected without radioisotopes to a level of sensitivity equivalent to one one-hundredth of a cytomegalic virocyte per cm2 of a 3-microM paraffin section. This method is applicable to situations where only scarce paraffin-embedded tissue is available.     

Cervical Anterior Spinal Cord Infarction

Spinal cord infarction or ischemia predominates in the thoracic region, less so in the cervical and lumbar regions. Different etiological factors have been implicated in anterior spinal artery syndrome. Magnetic resonance imaging (MRI) allows in vivo imaging of spinal cord disease, including infarction. A 31-yearold, previously healthy man had an acute onset of interscapular pain, followed by rapid development of quadriparesis associated with paresthesias and mild bladder dysfunction. Initial MRI of the cervicothoracic region demonstrated normal findings. A repeat study obtained 6 days later showed marked increase in the cervical cord size, especially at the C6-7 level. On the T2-weighted sagittal series and after gadolinium injection, increased signal in the anterior portions of the cord extending from C-4 to the T2-3 interspace was noted. This was most prominent at the C-6 and C-7 levels. The coronal views revealed abnormal high signal in the region of the anterior horns of the gray matter, a finding that is recognized as an “owl's eyes” pattern. Because the MRI changes of cerebral infarction may succeed a clinical event by hours or days, accurate diagnosis may require delayed or repeated studies. This report suggests that the diagnosis of spinal cord disease requires a similar evaluation.     

Ectoparasites of a population of urban gray squirrels in northern Florida

Ectoparasites infesting a population of urban gray squirrels (Sciurus carolinensis Gmelin) in northern Florida were collected monthly during 1974. Eleven species were identified: one flea (Orchopeas howardi (Baker], three suckling lice (Enderleinellus longiceps Kellogg & Ferris, Hoplopleura sciuricola Ferris, and Neohaematopinus sciuri Jancke), one tick (Dermacentor variabilis Say), two mesostigmatid (gamasid) mites (Androlaelaps casalis (Berlese) and A. fahrenholzi (Berlese], and four chiggers (Eutrombicula alfreddugesi (Oudemans), E. splendens (Ewing), Leptotrombidium peromysci Vercammen-Grandjean & Langston, and Parasecia gurneyi (Ewing]. The flea and three suckling lice represent core species of ectoparasites for the gray squirrel; the remainder are probably satellite species. Only E. longiceps varied significantly in prevalence or intensity of infestation among host age groups; subadult squirrels had higher intensities than adults. Peak prevalence of O. howardi occurred in January and attained maximum intensity in March, whereas both prevalance and intensity were minimum in August. Prevalence of H. sciuricola was maximum in November and remained at similar levels through June. It then declined significantly to its minimum in September-October. Intensity of infestation, however, was greatest in August, September, and January. Maximum prevalence of N. sciuri occurred from January to March and was minimum in September; intensity of infestation reached maxima in January, June, and August.