Nosocomial nasal myiasis.

Sixty-five fly maggots were retrieved from the nasal cavity of an unconscious 64-year-old man who had been admitted 18 days earlier with diabetic hyperosmolar coma. The larvae were identified as Cochliomyia macellaria, an organism commonly associated with myiasis in the United States. The clinical time sequence indicates that this infection was acquired in the hospital. This incident provides further evidence that immobile and debilitated patients are at risk to acquire myiasis.

Paragordius varius.

We describe a 30-year-old man who presented with a tangled knot of worms that he "passed per rectum." The worms were identified as Paragordius varius. This is an uncommon pseudoparasite that is ingested from contaminated food or water. Identifying characteristics and the life cycle of Gordian worms are briefly discussed. Identification of this worm is important to distinguish it from true parasitic worms.

Introduction to microsurgery: an emerging discipline in biomedical research.

Using microsurgical techniques, biomedical researchers are able to perform procedures that would otherwise be impossible on small laboratory animals. The authors provide a primer on learning microsurgical technique, from correct posture and hand position, to understanding lenses and proper handling of surgical needles and suture material.

Microsurgical instrumentation and suture material.

Microsurgery requires specialized instruments and very fine suture material. The authors describe microsurgical instruments and suturing materials available for small animal microsurgery.

Manometric changes during retrograde biliary infusion in mice.

The manometric, ultrastructural, radiographic, and physiological consequences of retrograde biliary infusion were determined in normostatic and cholestatic mice. Intraluminal biliary pressure changed as a function of infusion volume, rate, and viscosity. Higher rates of constant infusion resulted in higher peak intraluminal biliary pressures. The pattern of pressure changes observed was consistent with biliary ductular and/or canalicular filling followed by leakage at a threshold pressure. Retrograde infusion with significant elevations in pressure led to paracellular leakage of lanthanum chloride, radiopaque dye, and [(14)C]sucrose with rapid systemic redistribution via sinusoidal and subsequent hepatic venous drainage. Chronic extrahepatic bile duct obstruction resulted in significantly smaller peak intrabiliary pressures and lower levels of paracellular leakage. These findings indicate that under both normostatic and cholestatic conditions elevated intrabiliary volumes/pressures result in an acute pressure-dependent physical opening of tight junctions, permitting the movement of infusate from the intrabiliary space into the subepithelial tissue compartment. Control of intraluminal pressure may potentially permit the selective delivery of macromolecules >18-20 A in diameter to specific histological compartments.