Oral myiasis in humans.

Myiasis is a parasitic infestation resulting from flies laying eggs in the host tissues. It is common in animals, but can also occur in humans, including in the oral cavity. The diagnosis is usually quite clear in endemic regions such as Brazil, but it can be challenging to clinicians in nonendemic counties when faced with a patient who has acquired the infection elsewhere. We report two clinical cases of human intraoral myiasis and discuss the diagnosis and treatment of this condition. Two men, both of whom were in situations of vulnerability presented with myiasis: the first patient had larvae infesting the alveolar ridge region after tooth extraction, while the second was diagnosed with inflammatory fibrous hyperplasia associated with larvae along the edges of the lesion. Both were treated with ivermectin and antibiotics, and given guidance on preventative care. Such infestations are often a clear sign of neglect, and clinicians need to pay attention to the general health of patients affected by oral myiasis.

Fast fluid-attenuated inversion-recovery MR of intracranial infections.

PURPOSE: To assess the usefulness of fast fluid-attenuated inversion-recovery (FLAIR) MR sequences in the diagnosis of intracranial infectious diseases. METHODS: We compared fast FLAIR images with conventional spin-echo images (T1- and T2-weighted) obtained in 20 patients with infectious diseases (six with encephalitis, five with brain abscesses, three with meningitis, two with meningoencephalitis, two with Creutzfeldt-Jakob disease, one with epidural empyema, and one with cysticercosis). Two neuroradiologists independently reviewed the FLAIR images and compared them with the conventional spin-echo images, obtaining agreement in all patients. RESULTS: FLAIR images of diagnostic quality were obtained in 18 patients. In two patients, FLAIR images were degraded by motion. Lesions in the patients with encephalitis and meningoencephalitis were better delineated on FLAIR images than on spin-echo images. FLAIR images clearly depicted lesions in the basal ganglia in both patients with Creutzfeldt-Jakob disease. In patients with brain abscess, meningitis, cysticercosis, and epidural empyema, FLAIR images provided no more information than conventional spin-echo images, and the lesions were seen better on postcontrast T1-weighted spin-echo images. CONCLUSION: Fast FLAIR images showed pathologic changes in intracranial infectious diseases better than or as well as conventional T2- and proton density-weighted spin-echo sequences. However, postcontrast T1-weighted spin-echo sequences resulted in better visibility of abscess, meningitis, cysticercosis, and epidural empyema than did FLAIR images.

Echo-planar perfusion MR of moyamoya disease.

PURPOSE: Our goal was to assess the value of perfusion MR imaging by using a single-shot echo-planar technique to evaluate the hemodynamics of moyamoya disease. METHODS: We performed echo-planar perfusion studies in 19 patients with a 1.5-T unit, using a free-induction-decay echo-planar sequence for 14 examinations and a turbo-gradient-spin-echo echo-planar sequence for five examinations. After a bolus injection of contrast material, 30 consecutive scans were done in 10 sections every 2 seconds. The data were analyzed to yield time-intensity curves for a region of interest set in the territory of the bilateral middle and/or anterior cerebral arteries in all examinations and to produce semiquantitative flow maps of each section, representing the signal decrease due to passage of contrast material in 17 examinations. The semiquantitative flow maps were compared with single-photon emission CT (SPECT) findings in 11 cases. RESULTS: We detected differences between the cerebral hemispheres and/or focal perfusion abnormalities by the time-intensity curves and semiquantitative flow maps in 15 of the 19 examinations and in 11 of the 17 examinations, respectively. Results of one or both these examinations corresponded with the SPECT findings in nine of the 11 examinations. CONCLUSION: Our results indicate that single-shot echo-planar perfusion MR imaging can sensitively depict hemodynamic abnormalities in moyamoya disease.

Non-contrast enhanced MR venography using 3D fresh blood imaging (FBI): initial experience.

OBJECTIVE: This study examined the efficacy of 3D-fresh blood imaging (FBI) in patients with venous disease in the iliac region to lower extremity. MATERIALS AND METHODS: Fourteen patients with venous disease were examined [8 deep venous thrombosis (DVT) and 6 varix] by 3D-FBI and 2D-TOF MRA. All FBI images and 2D-TOF images were evaluated in terms of visualization of the disease and compared with conventional X-ray venography (CV). RESULTS: The total scan time of 3D-FBI ranged from 3 min 24 sec to 4 min 52 sec. 3D-FBI was positive in all 23 anatomical levels in which DVT was diagnosed by CV (100% sensitivity) as well as 2D-TOF. The delineation of collateral veins was superior or equal to that of 2D-TOF. 3D-FBI allowed depiction of varices in five of six cases; however, in one case, the evaluation was limited because the separation of arteries from veins was difficult. CONCLUSION: The 3D-FBI technique, which allows iliac to peripheral MR venography without contrast medium within a short acquisition time, is considered clinically useful.

Detection of specific bacterial cells with 2-hydroxy-3-naphthoic acid-2'-phenylanilide phosphate and fast red TR in situ hybridization.

An in situ hybridization technique with HNPP (2-hydroxy-3-naphthoic acid-2'-phenylanilide phosphate) and Fast Red TR was used to detect specific bacterial cells at the single-cell level. By this technique, the fluorescent signals of target bacterial cells were up to eight times more intense than those of standard fluorescence in situ hybridization with mono-fluorescein isothiocyanate-labeled oligonucleotide probes. This novel HNPP-Fast Red TR whole-cell hybridization technique is available for the identification of small or low-rRNA-content bacterial cells in the natural environment.

[Clinical application of magnetic resonance angiography for coronary arteries: correlation with conventional angiography and evaluation of imaging time].

Magnetic resonance angiography (MRA) of the coronary arteries is a particularly difficult task because of the small size of the vessels and cardio-respiratory motion. The authors describe a method of performing of ultrafast MRA of the coronary arteries with a standard MR system and body coil. Each image was obtained within a single breath hold by "segmented Turbo FLASH" sequences using an electrocardiography gate. Clinical application was performed in 20 patients with ischemic heart disease, and a comparison was made with conventional coronary angiography. The imaging time was shortened significantly by our methods. The diagnosis was made by at least two different images to avoid false positives. The results indicated a good correlation between MRA and conventional angiography.