Foreign Body Giant Cell Reaction Research Articles

Efficacy of polyglycolic acid (Dexon) microsutures in peripheral nerve anastomoses in the rat: 2. Perineural suture.

In 48 rats, bilateral sciatic nerves were severed and perineuriums were resutured with Dexon 10-0 sutures. Animals were sacrificed at days 7, 14, 21, and months 2, 3, and 6. The nerve segments exhibited an acute inflammatory cellular reaction to the sutures during the early period. The inflammation gradually subsided. However, the inflammatory foreign body giant cells still remained around the sutures for as long as 68 days, after which they were not present. In the additional eight rats with nylon suture anastomoses of the perineurium of the sciatic nerves, a foreign body giant cell reaction was present combined with a lymphocytic cellular infiltrate surrounding the suture for 6 months postoperatively. It is concluded that Dexon microsuture is less reactive than nylon in perineural anastomosis of severed nerve.

Reaction of the Human Tibia to Bone Wax

In 12 patients treated by elevation of the tibial tubercle, bone wax was used to prevent bleeding from the cut surface. Biopsy specimens of the tissues obtained at the time of removal of the screws, five to 13 months after the operation, showed a definite foreign body giant cell reaction. Giant cells endocytosed bone wax from the site. The giant cell response culminated in a marked fibrous reaction.

A Complication of Silastic Hemiarthroplasty in Bunion Surgery

Seven cases of painful reactive synovitis following great toe Silastic hemiarthroplasty have been observed. All cases were treated successfully with synovectomy and removal of the implant. Microscopic examination of the synovium uniformly demonstrated a chronic foreign-body giant-cell reaction with intracellular and extracellular silicone elastomer particles. Gross examination of the implants showed varying degrees of erosion of the articulating surface. Abrasion of a Silastic implant creates free-floating silicone elastomer particles that can precipitate a reactive synovitis. The authors believe an irregular, degenerated first metatarsal head is a contraindication to an interpositional Silastic hemiarthroplasty.

Knee Joint Injury by Mercury From a Broken Thermometer

An 11-year-old boy injured the inner side of his left knee when accidentally breaking a mercury thermometer. He immediately developed an acute synovitis. Soft tissues and synovium containing metallic mercury droplets were completely removed at operation. The patient recovered within five weeks. Symptoms and signs of acute or chronic mercury poisoning were not observed. However, because injury by a mercury thermometer may become very serious if the metal is absorbed by the tissues and disseminated through the circulatory system, immediate local excision of tissue is necessary. Interestingly, the histologic appearance of the synovial membrane was remarkable by the lack of any foreign body giant cell reaction.

Laser photovaporization of endometrium for the treatment of menorrhagia

As an alternative to hysterectomy in patients with excessive bleeding, the endometrium was destroyed by means of the neodymium-YAG laser. The photovaporization was done under direct vision through a hysteroscope. Twenty-two patients have been treated, all but one successfully, i.e., little or no menstrual flow. The human uterus having a thick myometrium was found to be ideal for this modality. To suppress endometrial regeneration further, each patient was placed on a regimen of danazol for 2 to 3 weeks prior to and after the procedure. Hysterograms after laser photovaporization showed variable degrees of uterine contraction, scarring, and adhesion formation. Biopsies of the endometrial surface up to 20 months following the procedure showed no evidence of inflammation other than foreign body giant cell reaction around carbon particles. Minimal endometrial regeneration occurred.

Limitations of Gullino-type chambers for collection of interstitial proteins from human tumour xenografts: a histological and theoretical study

GULLINO-type diffusion chambers, made entirely from polytetrafluoroethylene (P.T.F.E.) were implanted subcutaneously into athymic nude mice either alone or with tumour mince from a human colonic tumour xenograft. Those implanted with mince became incorporated into the resulting tumours. Chambers were removed at various times following implantation and histological sections prepared from surrounding tissues. A consistent histological picture was seen adjacent to all parts of the implants comprised of a foreign body giant cell reaction with fibrosis, irrespective of the presence of tumour. We argue that in the absence of any reaction, such chambers may collect specific proteins and allow estimation of total interstitial protein content, but are unsuitable for determining the effective in vivo concentration of any particular interstitial protein. It is further suggested that the presence of reactive tissue around the chambers could introduce further sources of error, adequate controls for which are essential for interpretation of data relating of interstitial proteins collected in this manner.

Biological effects of residual glutaraldehyde in glutaraldehyde‐tanned collagen biomaterials

Glutaraldehyde is commonly used to control physical and biological properties of collagen structure by means of intramolecular and/or intermolecular crosslinking of collagen molecules. Solubility, antigenicity, and biodegradation of naturally occurring or reconstituted collagenous matrices are effectively reduced by glutaraldehyde treatment. Adverse biological reactions to glutaraldehyde have been limited to infrequent contact dermatitis and to biocidal effects which are exploited in chemical sterilization media. In the present study of glutaraldehyde-tanned collagen sponge, the presence of glutaraldehyde was correlated with cytotoxic effects upon fibroblasts in tissue culture and foreign body giant cell reaction to bioimplants of the sponge. Fibroblast growth in tissue culture is 99% inhibited at media concentrations of 3.0 ppm glutaraldehyde. Extracts of glutaraldehyde collagen sponge in aqueous media at pH 7 and 4.5 yielded 6 micrograms and 65 micrograms glutaraldehyde per gram of collagen sponge, respectively. The yield increased tenfold at pH 4.5. Observations indicate that leaching of the glutaraldehyde from glutaraldehyde-tanned collagen sponge is sufficient to produce potentially adverse cellular effects both in vivo and in vitro.

Long-Term Radiographic-Pathologic Follow-Up of Patients Treated with Visceral Transcatheter Occlusion Using Isobutyl 2-Cyanoacrylate (Bucrylate)

Visceral transcatheter occlusive therapy was performed with isobutyl 2-cyanoacrylate (Bucrylate) in 14 patients. Of 10 patients who subsequently died, postmortem examination in 6, performed 2--196 days post-embolization, showed only a mild histiocytic foreign body giant cell reaction to Bucrylate. The reaction was confined to the vessel lumina and did not involve the vessel walls or contiguous parenchymal tissues. Clinical and radiographic follow-up in the other 4 patients (range = 30--180 days) showed no evidence of untoward reaction to Bucrylate. No ischemic or inflammatory complications were observed in any of the peripheral organs.

Epidermal cyst in sternomastoid muscle simulating a malignant growth

Epidermal Cysts are slow growing, elevated, round, firm, intracutaneous or subcutaneous tumours varying from 0.2 to 5 cm in diameter. They are usually located in the exposed surfaces of the body, but may be located anywhere. Histologically, they have a wall composed of true epidermis. In young cysts several layers of squamous and granular cells can be recognised but in older cysts the wall is atrophic and usually contains one to three layers of flattened cells. The Cyst is filled with keratin which is frequently arranged in laminated layers. Rarely foci of calcification are found. If the Cyst ruptures and the contents reach the dermis a considerable foreign body giant cell reaction results, (Lever, 1967). In the present communication, we are going to report an unusual case of epidermal cyst in sternomastoid muscle in a male aged 43 years which clinically resembled a malignant growth. To the best of our knowledge, a similar case has not been reported in the past.

Granulomas caused by starch powder from surgeons' gloves

Implantation of 1 to 1.2 mg. of starch powder in rats produced foreign-body giant-cell reactions. The reaction was dose-dependent, but one granule incited a reaction. The starch granules did not appear to decrease in size during this experiment. Starch granules varied in size from 1 micron or less to 27 microns. All gloves dusted with starch powder should be thoroughly cleansed prior to any surgical procedure. Migration of granules occurred over short distances in the periodontal membrane and along facial planes.

Follicular choristoma of the gingiva: A peculiar lesion

In a 9-year-old girl a tumorlike nodular projection lingual to the lower permanent incisors contained sebaceous cells, hair follicles with hairs, a small keratocyst, melanocytes, and lymphocytes and plasmocytes, and, associated with disintegrated sebaceous cells, a foreign-body giant-cell reaction. The “tumor” is termed a follicular choristoma.

Adherence of prosthetic skin.

AbstractRecently, a new successful prosthetic skin was reported from this laboratory. Utilizing the burned rat model, this prosthesis, controlled burn wound sepsis, prevented insensible water vapor loss and remained indefinitely. A prime factor necessary for the success of this prosthesis is its ability to adhere early to the recipient site. Thus, in order to investigate the underlying mechanisms of adherence and to be able to evaluate more closely different types of prosthetic skin, materials, and designs, a quantitative technique was developed using a modified Keil tester. The force (dynes/cm2) necessary to tear the prosthesis free was recorded on a direct writing apparatus. Tensile strength measurements of the prosthetic skin revealed a gradully increasing adherence of the tissue to the prosthesis. Initial values, days 2 through 5 post‐application, were low as recorded in dynes/cm2. The graft when removed on these days showed little or no gross fascial adherence, however, edge adherence steadily increased. After a few days the successful prosthesis could not be peeled without removing some tissue. Histologic studies show that by day 9 the prosthesis is an integral part of the subcutaneous tissue with foreign body giant cell reaction, ingrowth of of fibroblasts and collagen, and few inflammatory cells or bacteria. The adhesion values reveal that as the day post‐application increased the mean value in dynes/cm2 increased from an initial 2.137 on day 2 to 8.019 on day 50.

Cholesterol in dental cysts

Two hundred dental cysts were examined histologically in an effort to determine the incidence of cholesterol within these cysts. It was found that, contrary to the generally accepted opinion, cholesterol is not an invariable finding within dental cysts and is present in 28.5 per cent of the cases. A theory was postulated to explain the presence of cholesterol in some cyst walls and not in others. It was suggested that local tissue damage appears to be a requisite for cholesterol accumulation. The cholesterol crystals are deposited in the cyst cavity by means of a foreign-body giant-cell reaction within the fibrous cyst wall.

EMPHYSEMATOUS ANORECTAL FISTULAS.

Summary Two patients with air-containing anorectal fistulas and extension of air subcutaneously into the adjacent tissues are presented. Both had air pockets in the subcutaneous tissue, deep perirectal pockets and tissue crepitus caused by diffuse subcutaneous emphysema, sphincter spasm and large primary internal fistulous stomas. Pain was conspicuous by its absence. The pathologic findings were identical in both patients, showing thick fibrous fistulous tracts, characterized by marked foreign body giant cell reaction. Air pocketing and diffuse emphysema were due to rupture and leakage of the fistulous tract. Since anorectal fistulas with large primary internal openings are usually accompanied by thick fibrous tracts, flatus-borne infection may play a part in their pathogenesis.

EFFECT OF TALC IN OCULAR SURGERY

Since rubber gloves have become popular in the operating rooms of many ophthalmic institutions, one is prompted to study the effect on the ocular tissues of the talc powder on these gloves. There has been a great deal of investigation along these lines, starting in 1933, when Antopol1reported the formation of tubercles by spores of Lycopodium. At that time the spores of Lycopodium were used on surgical gloves, as talc is used today. However, even as far back as 1912, Lambert2reported a foreign body giant cell reaction to spores of Lycopodium. He used the substance as a nonspecific foreign body and stated that he could just as well have used cotton fibers, or even glass. In later years, when talc had largely replaced spores of Lycopodium, similar investigations were conducted by various workers with the express purpose of determining the effect that accidental introduction of talc