Hyperinfection with Strongyloides stercoralis is rare in acquired immunodeficiency syndrome (AIDS), despite endemicity in areas where infection with human immunodeficiency virus is highly prevalent. We autopsied two patients with AIDS and disseminated Strongyloides and describe their central nervous system findings. The microscopic patterns of brain infection were dissimilar in the two patients, and reflected histology in systemic viscera. In one patient, a granulomatous response accompanied filariform larvae in all locations, including granulomatous ependymitis in brain. Additionally in the brain, larvae without tissue reaction were seen. In the second patient, the absence of tissue response to larvae was body wide, and isolated parasites were found in centrum semiovale. The occurrence of these patients in a region where Strongyloides is not endemic suggests that this infection may be more prevalent in AIDS than formerly suspected.

\s=b\ Melanocytes are present in the lamina propria of the middle ear mucosa of young children to elderly adults in both whites and blacks. Melanin pigment also is seen in the epithelial cells, so-called melanogenic metaplasia. The melanocytes in the middle ear mucosa are of neural crest origin and their presence explains melanocytic tumors at this anatomic site. (Arch Otolaryngol 1982;108:489-490) This is one of a series of studies on extracutaneous melanocytes in the head and neck regions covering a wide range of ages and encompassing material from whites and blacks.15 MATERIALS AND METHODSAfter removal of the brain at autopsy, a wedge-shaped block was resected from both petrous bones of 50 human bodies.The ages ranged from 25 weeks' gestation (premature) to 95 years (Table). The speci¬ mens were fixed in 4% neutral buffered formaldehyde solution for one week and then decalcified in 5% hydrochloric acid solution for three days to one week. Multi¬ ple slices were taken for paraffin embed¬ ding. The paraffin blocks were cut at 5 pm and the sections were stained with hema¬ toxylin-eosin and the Masson-Fontana sil¬ ver procedure for melanin. A segment of skin was cut and stained as a normal control. In the cases positive for melanin, additional sections were stained with Perls' method for hemosiderin or bleached with potassium permanganate to confirm the nature of the pigment. RESULTSDendritic, elongated, ovoid, or round melanocytes were scattered in the lamina propria of the middle ear mucosa (Fig 1) in ten of 50 cases of both sexes (Table). Occasionally, the melanocytes were seen very close to capillaries (Fig 2).The ages ranged from 21 months to 85 years in whites and blacks. Melano¬ cytes were not seen in the middle ear mucosa specimens from the prema¬ ture infant and the full-term new¬ born, yet melanin pigment was seen in the epithelial cells (Fig 3), so-called melanogenic metaplasia, in two instances: a 4-year-old black boy and a 75-year-old white man. Melanocytes were present in the inner ear specimen from the prema¬ ture infant of 25 weeks' gestation to the specimens from elderly adults. They were seen in the wall of the scala vestibuli, Reissner's membrane, inter¬ stices of modiolus, maculae utriculi and sacculi, and interstices of inner ear bone. Melanin pigment was also seen in the epithelial cells of the sacculus. COMMENTEmbryologically, the middle ear mucosa is derived from pharyngeal pouches that also develop into naso¬ pharyngeal and oral mucosa. Melano¬ cytes have been demonstrated in the oral and nasopharyngeal mucosa of children and adults. From an embryological point of view, melanocytes may be expected to be seen in the middle ear mucosa. The present study proves their presence.Melanocytes were recognized in the inner ear by Alphonse Corti 150 years ago and were reported in the loose connective tissue of the middle ear by Wolff6 50 years ago. The melanocytes are widely distributed in the inner ear and are frequently associated with ganglions and nerves.In this study, the melanocytes are not ...

A newborn with severely shortened ribs, short limbs, and postaxial polydactyly died shortly after birth. Postmortem roentgenograms established the diagnosis of type 3 short rib-polydactyly (SRP) syndrome as described by Naumoff and associates. Histopathologic study showed the chondrocytes to contain previously undescribed cytoplasmic inclusion bodies that were PAS-positive and diastase-resistant. The material appeared by staining reactions to be a glycoprotein that was seen electron microscopically to accumulate within dilated cisterns of rough endoplasmic reticulum. Similar cytoplasmic inclusions have not been seen in other short rib-polydactyly syndromes, including SRP types 1 and 2, Jeune syndrome, and Ellis-van Creveld syndrome. It is often difficult to differentiate cases of type 3 and type 1 (Saldino-Noonan) syndrome, and in the past the diagnosis has sometimes been confused. A review of previously reported cases showed that type 3 syndrome rarely (1 in 13) had cloacal developmental abnormalities, which are invariably present in patients with type 1 syndrome. Type 3 is also associated with a lower incidence of congenital heart disease, and cardiac malformations, when present, differ from those associated with type 1 syndrome. Both type 3 and type type 1 SRP syndromes are transmitted in autosomal recessive fashion. Type 3 SRP syndrome has had an equal sex distribution, although type 1 has so far been reported to occur only in girls. Further investigation with additional patients is necessary to verify the above preliminary findings.