A case of anaerobic abscessed hydroxyapatite orbital implants.
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The purpose of this report is to document an unusual case of implant infection in a patient who had undergone enucleation and hydroxyapatite orbital implant surgery. A 32-year-old woman presented with chronic orbital discomfort and discharge following a history of hydroxyapatite orbital implant surgery at another hospital 4 years previous. She exhibited profuse discharge with a yellow, creamy color and marked conjunctival chemosis. Granulation tissue was noted on the central conjunctival surface. Following the removal of the conjunctival granulation tissue, a central 3x5 mm conjunctival dehiscence was present with exposure of the hydroxyapatite implant. A culture of purulent drainage emanating from the exposed implant showed a growth of Clostridium acetobutylicum. Removal of the orbital implant was done. The implant was noted to be filled with pus. This case suggests that anaerobic infection may be suspected when the granulation tissue is observed and a discharge with a foul odor is found. (+info)
TGF-beta and IL-10 regulation of IFN-gamma produced in Th2-type schistosome granulomas requires IL-12.
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Interleukin-10 (IL-10) and transforming growth factor-beta (TGF-beta) regulate CD4+ T cell interferon-gamma (IFN-gamma) secretion in schistosome granulomas. The role of IL-12 was determined using C57BL/6 and CBA mice. C57BL/6 IL-4-/- granuloma cells were stimulated to produce IFN-gamma when cultured with IL-10 or TGF-beta neutralizing monoclonal antibody. In comparison, C57BL/6 wild-type (WT) control granuloma cells produced less IFN-gamma. IL-12, IL-18, and soluble egg antigen stimulated IFN-gamma release from C57BL/6 IL-4-/- and WT mice. IFN-gamma production in C57 IL-4-/- and WT granulomas was IL-12 dependent, because IL-12 blockade partly abrogated IFN-gamma secretion after stimulation. All granuloma cells released IL-12 (p70 and p40), and IL-12 production remained constant after anti-TGF-beta, anti-IL-10, recombinant IL-18, or antigen stimulation. C57 WT and IL-4-/- mouse granuloma cells expressed IL-12 receptor (IL-12R) beta1-subunit mRNA but little beta2 mRNA. TGF-beta or IL-10 blockade did not influence beta1 or beta2 mRNA expression. CBA mouse dispersed granuloma cells released no measurable IFN-gamma, produced IL-12 p70 and little p40, and expressed IL-12R beta2 and little beta1 mRNA. In T helper 2 (Th2) granulomas of C57BL/6 WT and IL-4-/- mice, cells produce IL-12 (for IFN-gamma production) and IL-10 and TGF-beta modulate IFN-gamma secretion via mechanisms independent of IL-12 and IL-12R mRNA regulation. We found substantial differences in control of granuloma IFN-gamma production and IL-12 circuitry in C57BL/6 and CBA mice. (+info)
Modulation of in vivo granuloma formation related to regulation of in vitro IFN-gamma and IL-4 expressions in experimental schistosomiasis japonica.
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OBJECTIVE: To find out relationship between the in vitro schistosome egg antigen (SEA) stimulated IFN-gamma and IL-4 mRNA expressions and the in vivo SEA elicited granulomatous responses, the transcriptions of IFN-gamma and IL-4 gene were investigated in the spleen of BALB/c mice infected with Schistosoma japonicum (S. japonicum). METHODS: Spleens were removed at 0, 3, 5, 8, and 10 and 12 weeks after infection and the spleen cells were incubated in the presence of SEA. The extracted RNA was analyzed for IFN-gamma and IL-4 mRNA by reverse transcription PCR (RT-PCR). Newly-formed liver granulomas were measured. RESULTS: The study revealed that no detectable IFN-gamma and IL-4 mRNA RT-PCR products were found in SEA treated spleen cells from uninfected, or 3-week infected mice, whereas IL-4 mRNA was found to be expressed in 5- and 8-week infected mice, and an appreciable enhanced expression of IL-4 mRNA was observed in SEA stimulated spleen cells at 8-week infection than at 5-week infections. However, SEA could not induce IFN-gamma and IL-4 mRNA transcription in 10- and 12-week infected mice, indicating the modulated expression of IFN-gamma and IL-4 mRNA. CONCLUSION: The significant changes of IL-4 mRNA expression in SEA stimulated spleen cells during S. japonicum infection were coincident with SEA elicited granuloma formation and modulation in vivo. (+info)
Short-term evaluation of non-absorbable microgranular hydroxyapatite infiltration in the guinea pig subepidermal abdominal region.
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Non-absorbable microgranular hydroxyapatite was infiltrated into the subepidermal abdominal region of guinea pigs in order to assess the possibility of using this material to correct deficiencies in orbital volume. Microgranular hydroxyapatite (2.0 ml) was subepidermally infiltrated into the abdominal region of 20 guinea pigs. The animals were divided into four experimental groups of 5 animals each, which were killed 7 (G1), 15 (G2), 30 (G3) and 60 (G4) days after infiltration. The area and the largest and smallest diameters of the nodules formed by infiltration were evaluated at the site of infiltration and histological examination was performed. The mean granuloma area was similar in all groups. Histopathological examination showed that the material remained isolated from surrounding tissues by a pseudocapsule that became denser throughout the experiment. A host reaction started with young fibroblastic tissue that evolved to dense tissue until cartilaginous tissue was formed in G4, progressively advancing towards the center of the granuloma from G1 to G4. Non-absorbable microgranular hydroxyapatite is an inert material that was well tolerated by the animals studied, with maintenance of the infiltrated volume, and may perhaps be useful to fill anophthalmic cavities. (+info)
Foreign body granulomas of the breast presenting as bilateral spiculated masses.
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In Asia, mammography following the injection of foreign materials into the breasts for cosmetic augmentation is frequently seen and diagnosis based on the typical radiologic findings is straightforward. We report the unusual radiologic findings in two patients with foreign body granulomas caused by injected foreign materials and discovered incidentally during screening work up. The mammographic findings were bilateral, hyperdense, spiculated masses, with occasional microcalcification, and at sonography, markedly hypoechoic, spiculated solid masses, located near the pectoralis muscle and partly extending into it, were observed. These radiologic findings mimicked malignancy. (+info)
Contribution to differential diagnostics of granulomatous lesions in lung tissue.
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Etiopathogenesis of pulmonary granulomatous lesions can be very varied. Pathologists find pulmonary granulomatous lesions in autopsies frequently. Diagnostics of pulmonary granulomatous lesions is based on anamnesis data, clinical examinations and morphological changes. In some cases, especially in long-term ill patients, morphological finding remains the only way to explain the case. We provide a description of an incidental autoptic finding of chronic granulomatous lesion in lung tissue in a man aged 81. Histopathological examination proved aspired granules of maize starch. Aspired granules triggered lesion of granulomatous character. At microscopic examination vegetable particles were defined to be maize starch. Granules of maize starch, which are a part of artificial nutrition labelled Caglusal, may have caused granulomatous lesion in our case. (+info)
Pulmonary granuloma possibly caused by staples after video-assisted thoracoscopic surgery.
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A 74-year-old man, with a history of colon cancer resection and video-assisted thoracoscopic surgery (VATS) resection of pulmonary metastases, was found to have a left pulmonary nodule near the previous staple-line. The size of this nodule increased during follow-up. Because of this clinical course, this nodule was considered to be a tumor recurrence at the staple-line, and pulmonary re-resection was performed. The pathologic diagnosis of this nodule was foreign body granuloma (FBG) possibly due to previous surgical staples. FBG induced by staples may be a rare complication in VATS. (+info)
Teflon-induced granuloma: a false-positive finding with PET resolved with combined PET and CT.
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Patients who have undergone thyroidectomy may have recurrent laryngeal nerve injury; until recently, Teflon injection was commonly used for vocal cord medialization. We present a case of a patient who underwent thyroidectomy who had significantly increased and unilateral (18)F-fluorodeoxyglucose uptake in the neck, which was found to be localized to the left vocal cord by use of combined positron emission tomography (PET) and CT, presumably because of a Teflon-induced granuloma. Knowledge of this potential source of false-positive PET interpretation because of its inability to precisely localize neoplastic lesions, and the use of combined PET and CT imaging, may allow precise diagnosis and prevention of unnecessary interventions. (+info)