Scedosporium apiospermum otomycosis.

We present a case of Scedosporium apiospermum otomycosis in an immunocompetent 62-year-old woman presumably inoculated as a child in Vietnam. She had life-long recurrent symptoms of chronic otomastoiditis and otorrhea. The organism was identified in an unexpected wound infection after a modified radical mastoidectomy done for chronic otitis media. Treatment consisted of local debridement of necrotic tissue, topical wound care, and long-term systemic antifungals.

Low-grade adenocarcinoma of the nasal cavity--an unusual presentation: case report and review of the literature.

Low-grade nasal cavity adenocarcinoma is an unusual neoplasm. When it does occur, it often appears in conjunction with a history of epistaxis and nasal obstruction that spans a period of a few weeks to several months. Most of these tumors arise in patients who are middle-aged or older. We report a case of low-grade nasal cavity adenocarcinoma that was unusual in that it occurred in an adolescent boy and that the presenting symptoms of chronic nasal obstruction and recurrent epistaxis had persisted for 7 years. The occurrence of this uncommon but recognized entity in such a young patient widens the age range of possible patients with this tumor, and a finding of such an extended duration of symptoms should raise clinical suspicion and encourage a thorough investigation in order to make the diagnosis.

Neurotrophin-3 expressed in situ induces axonal plasticity in the adult injured spinal cord.

The mammalian CNS lacks the ability to effectively compensate for injury by the regeneration of damaged axons or axonal plasticity of intact axons. However, reports suggest that molecular or cellular manipulations can induce compensatory processes that could support regeneration or plasticity after trauma. We tested whether local, sustained release of the neurotrophic factor neurotrophin-3 (NT-3) would support axonal plasticity in the spinal cord distal to the site of injury in rats. The corticospinal tract (CST) was cut unilaterally at the level of the medulla. This avoided excessive inflammation, secondary cell death, vascular disruption, and the release of inhibitory molecules in the lumbar spinal cord. A replication-defective adenoviral vector (Adv) carrying the NT-3 gene (Adv.EFalpha-NT3) was delivered to the spinal motoneurons by retrograde transport through the sciatic nerve. Retrograde transport of the adenoviral vectors avoided the inflammatory response that would be associated with direct injection into the spinal cord. Transduction of spinal motoneurons with Adv.EFalpha-NT3 resulted in a significant increase in the concentration of NT-3 in the L3-L6 region of the spinal cord for up to 3 weeks. In animals with a CST lesion, this local expression of NT-3 induced growth of axons from the intact CST across the midline to the denervated side. If the CST remained intact, overexpression of NT-3 did not lead to an increase in the number of axons crossing the midline. These data demonstrate that local, sustained expression of NT-3 will support axonal plasticity of intact CST axons after trauma-induced denervation.

Kikuchi's disease: a case report and review of the literature.

Kikuchi's disease is a necrotizing lymphadenitis that is prevalent in Asia and is being increasingly recognized in other areas of the world. It usually occurs in women in their late 20s or early 30s and manifests as a posterior cervical adenopathy. It resolves spontaneously, usually over a period of several weeks to 6 months. Its initial clinical appearance is commonly similar to that of a lymphoma, and it can be pathologically misdiagnosed as such. Kikuchi's disease might be associated with systemic lupus erythematosus. We report a case of Kikuchi's disease that occurred in a 36-year-old Asian woman. We discuss the clinical features, differential diagnosis, radiographic evaluation, and pathology of this case, and we review the literature in an effort to assist otolaryngologists in diagnosing this benign and uncommon entity.