Visible Foreign Body Research Articles

Qualitative Analysis of Visible Foreign Solids in Armillarisin A Injection Formulations Using Ultra-High Performance Liquid Chromatography-Tandem Mass Spectrometry.

During the trial production of Armillarisin A for injection (AA-I), unidentified needle-like yellow-brown crystals were occasionally observed. Here, we report an ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC-MS) method for determining the source of the visible foreign bodies in the formulations of Armillarisin A active pharmaceutical ingredient (AA-API). AA-API, photolyzed samples, the intermediate polymer, and the excipient analyzed determined after the separation on a Waters Symmetry C18 (3.5 μm, 4.6 × 75 mm) column with a mobile phase consisting of a methanol/acetic acid (0.1 mol/L) aqueous solution (50:50). Furthermore, the crystal type of the visible foreign bodies, the intermediate polymer and AA-API were investigated by X-ray powder diffraction (XRD). The results revealed that the characteristics of the visible foreign solids were the same as those of AA-API as regards UPLC peak position (368 nm) and MS spectrum in negative ion detection mode. The visible foreign solids were thus identified as unpolymerized crystals of AA-API and were attributed to AA-API itself. The results showed that the production process could be improved by changing the stirring method and frequency as well as by optimizing the polymerization temperature to ensure the safety, stability, and control of the product quality in the stage of batch production.

Features of medical care in patientswith elbow joint gunshot wounds

Gunshot wounds of the elbow joint are the third most common after knee and shoulder injuries. Features of the anatomical and functional structure of the elbow joint, the close location of the vascular and nervous formations, favorable conditions for the development of infection determine the severity of gunshot wounds and cause the complexity of its treatment. Objective. To evaluate the frequency and nature of the elbow joint gunshot wounds in the structure of the general combat injuries, as well as to determine the volume of medical care and direction of treatment of such injuries in the conditions of the regional hospital as a stage of care. Methods. A retrospective study included 1 809 patients (96.0 % of men, mean age (33.7 ± 0.2) years). Firearms limb injuries were detected in 1 013 (56.0 %) of all victims, of which the elbow joint — 25 (2.47 %). Mines and explosives injuries were in 22 (88 %) of the patients, bullet — in 3 (12 %). Results. Tactics of treatment of elbow joint gunshot wounds depended on the severity of the condition of the victims and the nature of concomitant traumatic injuries. In the structure of combat injury of the elbow joint the majority was combined (52 %) and multiple (40 %) injuries and was accompanied by gunshot fractures in 60 %. In patients who were in severe state, applied the tactics of Damage control in two stages. At the first stage the fractures were fixed with plaster splints or external fixation devices (EF), the wounds were not subjected to full surgical debridment (SD), but only washed with antiseptics and the visible foreign bodies were removed. In patients with soft tissue injuries wounds the primary SD was performed according to general principles, injured nerves were not restored. In the second stage, after patient is stabilized, the repeated SD of the wound was performed. After their uncomplicated healing the EF was removed and the method of fixation was changed to internal osteosyntesis. Conclusions. It is recommended to perform stabilization of intra-articular gunshot fractures of the elbow joint with EF and after uncomplicated wound healing go to the internal osteosynthesis. Key words. Elbow joint, gunshot wounds, treatment.

Research on Key Technologies of Robot for Visual Detection of Foreign Matter in Liquid Medicine Based on Machine Learning Algorithm

At present, in the pharmaceutical industry, people pay more and more attention to the quality of drugs, and therefore put forward higher requirements for the detection of drugs. In this paper, based on a large number of theories and experiments, an intelligent on-line detection system for visible foreign bodies in medicated liquor solution is designed based on machine learning algorithm. From the angle of mechanics and kinematics, the force analysis of moving objects in liquid after high-speed rotation and sudden stop is discussed, which provides an important reference standard for distinguishing visible foreign objects from random noise. The experimental results show that the algorithm can effectively eliminate the vibration interference of electromechanical system, and make the foreign body detection equipment of liquid medicine successfully migrate from single-station detection equipment to automatic online detection robot, which is of great significance to the research and development of the whole equipment.

Lenticular fungal infection caused by Aspergillus in a patient with traumatic corneal laceration: a case report

BackgroundTo report a case of lenticular infection caused by Aspergillus, which was diagnosed 13 weeks after traumatic corneal laceration.Case presentationA 60-year-old woman presented with traumatic corneal laceration including anterior lens capsule rupture and traumatic cataract after being hit with a chestnut in the right eye. There were multiple injuries due to tiny thorns of the chestnut, including the conjunctiva, sclera, cornea, and anterior lens capsule. But no visible foreign body was detected by slit-lamp examination. Topical corticosteroid was prescribed to resolve the conjunctival inflammation induced by the thorns of chestnut, which could have caused persistent irritation. As conjunctival injection and edema being decreased during outpatient clinical follow-up, embedded conjunctival foreign body was detected and surgically removed (1st surgery). Approximately 10 weeks after the trauma, severe inflammation of the anterior segment accompanied with hypopyon developed suddenly and at the same time embedded scleral foreign body was revealed. After removal of scleral foreign body (2nd surgery), unspecified mold species was cultured from the scleral foreign body in SDA (Sabouraud dextrose agar) plate. Suspicious corneal foreign body was removed as 3rd surgery and phacoemulsification of traumatic cataract was planned as 4th surgery. Aspergillus was finally detected from removed anterior capsule and fibrotic membrane during the operation. Fungal infection resolved successfully after administration of topical (1% voriconazole and 5% natamycin) and systemic (fluconazole) antifungal agents and phacoemulsification of traumatic cataract.ConclusionChestnut thorns can damage multiple ocular tissues simultaneously. Lens capsular rupture could result in fungal inoculation and lead to delayed lenticular fungal infection with complicated cataract formation. In cases of ocular trauma due to organic substances such as thorns and branches, the possibility of fungal infection should be considered.

Management of an Unusual Intranasal Foreign Body Abutting the Cribriform Plate: A Case Report and Review of Literature.

A 35-year-old man with history of schizophrenia presented 3 weeks after placing a screw in his right nostril. Initial imaging showed a screw in the right ethmoid sinus with the tip penetrating the right cribriform plate. On exam, the patient was hemodynamically stable with purulent drainage in the right nasal cavity but no visible foreign body. While most nasal foreign bodies occur in children and are generally removed at the bedside, intranasal foreign bodies in adults tend to require further assessment. The foreign body in this case was concerning for skull base involvement and the patient was brought to the operating room (OR) with neurosurgery for endoscopic sinus surgery (ESS) and removal of foreign body. The screw was removed and the patient recovered with no signs of cerebrospinal fluid (CSF) leak postoperatively. Any concern for skull base or intracranial involvement should call for a full evaluation of the mechanism of injury and intervention in a controlled environment.

Radiographic prediction of metallic foreign body penetration in the reticulum of cows and buffaloes.

AimThis study aimed to evaluate the role of radiography in the standing (right and left) and recumbent (right) lateral positions for the detection and prediction of metallic foreign body penetration in the reticular wall.Materials and MethodsA total of 41 bovines (23 cows and 18 buffaloes) having at least one sharp metallic foreign body (>1 cm) detected on reticular radiographs were investigated, and their extent of penetration in the reticular wall was confirmed on the left flank laparorumenotomy.ResultsOf total sharp metallic foreign bodies retrieved on rumenotomy, the maximum percent were detected on the right recumbent radiographic view (75.00% in cows and 57.14% in buffaloes) compared to the right standing (54.38% in cows and 40.42% in buffaloes) and left standing (51.06% in cows and 27.08% in buffaloes) radiographic views. The presence of gas pocket or nodule adjoining a foreign body, faintly visible foreign body, foreign body that appeared partially or completely out of the reticulum, and foreign body that appeared parallel, into, or directed toward the diaphragm indicated a high probability in the prediction of penetrating foreign body in the left standing (100%) followed by the right recumbent (85.71% in cattle and 90% in buffaloes) and right standing (94.74% in cattle and 55.56% in buffaloes) radiographic views.ConclusionThe right recumbent radiographic view is most reliable to detect sharp metallic foreign bodies in bovine. Buffaloes engulf more number of foreign bodies; however, comparatively, the number of completely or partially penetrating foreign bodies is high in cattle. The hypothesized radiographic parameters for the prediction of penetrability of the metallic foreign body were 100% reliable in the left standing radiographic view in both the species.

Comparison of accuracy between panoramic radiography, cone-beam computed tomography, and ultrasonography in detection of foreign bodies in the maxillofacial region: an in vitro study

ObjectivesForeign bodies (FBs) account for 3.8% of all pathologies of the head and neck region, and approximately one third of them are missed on initial examination. Thus, FBs represent diagnostic challenges to maxillofacial surgeons, rendering it necessary to employ an appropriate imaging modality in suspected cases.Materials and MethodsIn this cross-sectional study, five different materials, including wood, metal, glass, tooth and stone, were prepared in three sizes (0.5, 1, and 2 mm) and placed in three locations (soft tissue, air-filled space and bone surface) within a sheep's head (one day after death) and scanned by panoramic radiography, cone-beam computed tomography (CBCT), and ultrasonography (US) devices. The images were reviewed, and accuracy of the detection modalities was recorded. The data were analyzed statistically using the Kruskal-Wallis, Mann-Whitney U-test, Friedman, Wilcoxon signed-rank and kappa tests (P<0.05).ResultsCBCT was more accurate in detection of FBs than panoramic radiography and US (P<0.001). Metal was the most visible FB in all of modalities. US was the most accurate technique for detecting wooden materials, and CBCT was the best modality for detecting all other materials, regardless of size or location (P<0.05). The detection accuracy of US was greater in soft tissue, while both CBCT and panoramic radiography had minimal accuracy in detection of FBs in soft tissue.ConclusionCBCT was the most accurate detection modality for all the sizes, locations and compositions of FBs, except for the wooden materials. Therefore, we recommend CBCT as the gold standard of imaging for detecting FBs in the maxillofacial region.

Epileptik Bir Hastada Mentumda Olağandışı Yabancı Cisim

Cutaneous foreign body penetration is a rare condition usually occuring due to impalement or high speed strike leading to inoculation of foreign body. Most encountered foreign bodies in skin are sharp or high speed materials. Foreign body penetrates the epidermis with it’s high kinetic energy and indwells in the subcutaneous tissues. As a result of tissue reaction, a foreign body reaction (granulation tissue formation and giant cell reaction) or epithelisation may occur. Epilepsy is a chronic disease characterized by recurrent seizures in unpredictable times. Epileptic seizures are caused by abnormal electrical discharges in cortical neurons and may lead to loss of consciousness. Convulsions during the seizures may cause severe traumas. Generaly blunt traumas and lacerations especially oral and maxillofacial injuries are frequently encountered. In addition fractures, burns, drowning and even trauma-related deaths can be seen in these patients. In this report, a 23 years old female patient with a history of uncontrolled epilepsy presented to our outpatient clinic with a complaint of yellowish nonhealing infected mass on her chin. Due to her mental retardation history was taken from the parents. From the history we learned that about 20 days ago she had an epileptic seizure while she was alone at home, and her parents found her lying down on the floor in a semiconscious state with a yellowish mass in her chin. Antibiotic therapy (amoxicillin/clavulanic acid) had no effect on the lesion. In her physical examination, a yellowish, solid mass with a 0.7 cm diameter was observed on her mentum. Peripheral induration and semicircular epithelization on the mass were also noted (Figure 1). Extirpation was performed without using local anesthetics under loupe enhancement in the outpatient clinic (Figure 2). In vitro macroscopic examination of the mass revealed that it was an artificial pearl used for cosmetic purpose. Epithelization occured and contour returned to normal during the follow-up . A study on 159 epileptic and 68 healthy subjects reported by Nonato and Borges revealed that oromaxillary traumas had significantly higher incidence in the epileptic group. Most encountered skin penetrating foreign bodies are pellets, wood pieces, thorn, sharp plastic materials, fishhook and glass. Penetrated organic materials should be removed because of infection risk. If directly visible foreign bodies can be removed without any imaging technique. If necessary imaging techniques such as direct radiography, CT scan or ultrasound may be helpful. Inspection of skin penetrating foreign body should be done after Editore Mektup / Letter to the Editor

The visible foreign matter visual detecting algorithm research in oral liquid

Aiming at poor precision of the visible foreign body visual inspection in oral liquid, This paper adopt improved image processing algorithm to achieve the accurate detection of foreign body. Using joint difference way to separate the background at the same time improve the energy value of target. Using slope correlation determine whether filling possible fracture and hole in the target. Using self-adaption search algorithm independent choice expansion direction to realize the virtual Foreign body target accurate search. Through the change of form and movement direction difference to eliminate the interference of bubbles, eventually identify the real foreign body target. Experimental results show that the improved foreign body target visual detection steps enhance the detection accuracy of tiny hair and fiber target, the average error rate is less than 2%. It has important guiding significance for foreign body in oral liquid monitoring on the actual production and ensure the safety use of related products.

Deliberate Underexposure in Cases of Radiography of Suspected Ingested Highly Visible Foreign Bodies—A Preliminary Study

Introduction Because of the linear response of digital detectors, it was hypothesized that large radiopaque foreign bodies would remain visible even when the image is grossly underexposed, meaning that dose could be greatly reduced without compromising diagnostic usefulness of the image. Methods Several metallic objects were placed over the abdominal area of an adult anthropomorphic phantom and imaged at different exposure levels ranging from 16.8 milliampere-seconds (mAs) to 0.5 mAs at a film-focus distance of 170 cm. The resulting images were subjectively scored for ease of visualization of anatomical features and metallic objects. In addition, the detection performance of three observers was assessed for the images obtained at 0.5, 1.25, and 2.5 mAs. Results All foreign bodies could be detected, even at the lowest exposure level. One observer failed to detect a screw projected over the spine at the lowest exposure setting. Conclusion The findings suggest that in cases where radiography is used to detect a large radiopaque object, the normal exposure may be reduced by around 70%, although further research using patients should be conducted before firm conclusions can be reached.

Necrotizing Fasciitis in the Setting of Marine Injury

Dr. John Jesus:Today’s case is that of a 26-year-old righthand-dominant healthy patient who sustained a small puncture wound to the hand while disposing of a dead catfish at work. He presented to the Emergency Department (ED) approximately 12 h after his initial injury with significant malaise, chills, and rapidly increasing swelling in the affected hand. The patient reported puncturing the dorsal aspect of his right middle finger with one of the pectoral spines of a catfish at approximately 8:30 in the morning. He attempted to clean the wound by expressing blood from it and washing the wound with warm soapy water. He then went about his day, largely ignoring a seemingly innocuous wound. Shortly before presentation, the patient began to notice increasing pain, erythema, and swelling of the affected finger, quickly tracking up the finger to include the majority of the dorsum of his right hand (Figure 1). Dr. Richard Wolfe: Can you describe the initial appearance of the patient? Dr. Jesus: Upon arrival in the ED the patient was relatively comfortable, initially refusing pain medication. His right middle finger appeared edematous, with mild erythema that was subtle; the puncture wound itself was 3 mm in length, clean, closed, without drainage or visible foreign body. His initial vital signs were: temperature 38.6 C, heart rate 118 beats/min, blood pressure 179/ 93 mm Hg, respiratory rate 18 breaths/min, and an oxygen saturation of 99% on room air. Dr. Carrie Tibbles: Does the patient have any significant past medical history?

側頭部より副咽頭間隙まで刺入した箸異物例

We report a rare case of chopstick penetration of the parapharyngeal space. A 48-year-old man who fell down while holding chopsticks was injured in the left temporal region, after which he reported temporal and jaw pain and trismus. The first examination found a small laceration on the temporal skin but no visible foreign body. Computed tomography (CT) showed a slender low-density material in the infratemporal fossa extending to the parapharyngeal space. After general anesthesia was administered the laceration was opened and a fragment of broken chopstick was removed. His postoperative clinical course was uneventful and pain and trismus subsided completely. Given the potentially useful clinical and radiological features of wooden foreign body penetration of the head and neck, we review their ramifications bibliographically.

Oesophageal perforation with asymptomatic lung abscess formation

In November, 2005, a 58-year-old man presented to the emergency department with retrosternal chest pain, which he described as “cutting and stabbing”. The pain was accompanied by the development of dysphagia to solids. Clinical examination was unremarkable, with a normal oropharynx and neck. Chest radiography was normal with no visible foreign body. The patient was admitted overnight. The pain had settled and the dysphagia had improved by the next morning, and he was therefore discharged with an urgent outpatient appointment for oesophagogastroduodenoscopy (OGD).

Synovite granulomateuse après injection de hylane GF-20. À propos de deux cas

Intra-articular hyaluronan injections are used to treat osteo-arthritis of the knee. Acute painful swelling with a joint effusion develops locally after the injection in about 10% of cases but resolves spontaneously. Crystals are identifiable in some patients, but the mechanism in crystal-negative cases remains unknown. We report knee arthritis with inflammatory joint fluid free of organisms and crystals in two patients after Hylan GF-20 treatment for femorotibial osteo-arthritis. Synovial membrane histology disclosed granulomatous synovitis with epithelioid histiocytic and multinucleate giant cells but no visible foreign bodies. These two cases suggest that crystal-negative arthritis after Hylan GF-20 injection may be ascribable to granulomatous synovitis of the foreign-body giant-cell type.

Granulomatous synovitis after intraarticular Hylan GF-20. A report of two cases

Intraarticular hyaluronan injections are used to treat osteoarthritis of the knee. Acute painful swelling with a joint effusion develops locally after the injection in about 10% of cases but resolves spontaneously. Crystals are identifiable in some patients, but the mechanism in crystal-negative cases remains unknown. We report knee arthritis with inflammatory joint fluid free of organisms and crystals in two patients after Hylan GF-20 treatment for femorotibial osteoarthritis. Synovial membrane histology disclosed granulomatous synovitis with epithelioid histiocytic and multinucleate giant cells but no visible foreign bodies. These two cases suggest that crystal-negative arthritis after Hylan GF-20 injection may be ascribable to granulomatous synovitis of the foreign-body giant-cell type.

Growth of moulds inoculated into commercial mineral water.

The growth of mould spores of Penicillium sp. and Cladosporium sp. inoculated in a commercial mineral water product was studied. The strains had been isolated as fungal foreign bodies in commercial mineral waters. In product A, which was not originally sterilized and was contaminated with psychrophilic bacteria, the inoculated mould spores of the strains did not grow; no increases in viable colony counts or beta-glucans concentration in the samples were observed during storage. In a sterilized product A, inoculated spores of the strains grew into visible foreign bodies. The viable colony counts and the beta-glucans concentration in the samples increased during storage. These results showed that in a sterilized mineral water product, mould spores could grow into visible foreign bodies.

Ultrasound biomicroscopy as a tool for detecting and localizing occult foreign bodies after ocular trauma

Objective To show the utility of ultrasound biomicroscopy (UBM) in imaging small ocular foreign bodies of the anterior segment. Design Retrospective case series. Participants Twelve eyes of 12 consecutive patients evaluated in the emergency department or referred to specialty services at 1 institution between August 1994 and November 1997 were examined. Intervention Ocular ultrasound biomicroscopy was performed. Main outcome measures Detection and localization of an ocular foreign body were measured. Results An intraocular or superficial foreign body was detected by UBM in 9 (75%) of 12 eyes. The foreign body was classified as corneal in two eyes, subconjunctival in two, intrascleral in three, and intraocular in two eyes. The foreign body was not visible by ophthalmic physical examination in seven of the nine eyes with a confirmed ocular foreign body. In the remaining two eyes, UBM was used to determine the depth of a visible foreign body. In three of the eyes with a confirmed foreign body, computed tomography and/or contact B-scan ultrasonography was obtained and failed to show a foreign body. Six of the foreign bodies were nonmetallic. Conclusions Clinical detection of ocular foreign bodies after trauma can be hindered by small size, haziness of the optical media, poor patient cooperation, or hidden location. Ultrasound biomicroscopy is a valuable adjunct in the evaluation of suspected ocular foreign bodies, especially in cases involving small, nonmetallic objects.

Non-asphyxiating tracheobronchial foreign bodies in adults

The presentations of 47 adult patients with a non-asphyxiating tracheobronchial foreign body were reviewed. The duration of residence of the foreign body was 1 week or less in nine ("acute group"); 1 month or more in 29 ("chronic group"), uncertain in four ("uncertain group"); and the foreign body was a broncholith in five patients ("broncholith group"). In the chronic and uncertain groups, no precipitating factor was found and bone was the most common foreign body. In the chronic group, a choking history was obtained before bronchoscopy in only 15 patient. Clinical manifestations and roentgenograms were nonspecific in most cases, except in the acute group. In the chronic group, the mean duration of residence of the foreign body was 25.8 months. The diagnosis was delayed due to absence of a choking history and invisibility of the foreign body on chest films in 12, due to patient's ignorance in 14, due to physician's ignorance in 1, and due to previous unsuccessful retrieval attempts in 2 patients. The main indication for bronchoscopy in the acute group was a choking history or a visible foreign body on the chest film. In the chronic group, a choking history or conditions leading to "suspicion of an endobronchial lesion" were the main indications. The foreign body was removed with a fibreoptic bronchoscope in over 90% of patients. It is concluded that the most important diagnostic factor is a high clinical index of suspicion and that flexible fibreoptic bronchoscopy provides a valuable therapeutic option in selected conditions.

Functional middle ear reconstruction: experience with prostheses and tissue graft.

The transmission of sound to the internal ear passes across the tympanic membrane to vibrate the ossicle chain formed by the malleus, incus and stapes. Movements of the stapes footplate set up complex wave formation within the cochlear fluids to excite the sensory nerve endings of the organ of Corti. Microsurgery for the relief of middle ear deafness has been progressively developed since 1946 and is concerned with the restoration of this collection of sound by an intact flexible ear drum and transmission of oscillation across the middle ear by a free, mobile chain of ossicles. Otosclerosis is a deafness of genetic origin caused by bony overgrowth immobilizing the stapes footplate and is treated with a 95% success rate by selective stapedectomy and fenestration of the footplate. A prosthesis or one limb of the stapes is attached on to the incus and inserted into the fenestration, often with the use of using a tissue graft as a sealing membrane. Over twenty years' experience has originated many differing contours and materials for the stapes prosthesis--in scale some 4 mm or 5 mm in length and 0.3 mm to 0.8 mm in diameter--which will be illustrated and discussed. These prostheses lie deep within a healthy tympanic cavity, and it is most exceptional for a prosthesis to detach or extrude. In our large series subsequent reexploration usually reveals a prosthesis sheathed in mucosa without visible foreign body reaction.

Removal of a bullet from the right infratemporal fossa: Report of a case

C onverse,l in 1945, stated that the treatment of gunshot wounds of the jaw may be divided into three distinct periods : Phase I (period of emergency care), Phase II (period of prercconstruction), and Phase III (period of final reconstruction). Phase I, the most critical for the patient, extends from the time of injury to 1 or 2 days after injury. Signs and symptoms of shock, asphyxia, severe blood loss, pain, and mental depression arc often observed. It is imperative that the patient’s physiologic needs be evaluated thoroughly and that emergency care be administered promptly. The wound is cleansed b;v the removal of small devitalized tags of tissue, loose detached bone fragments, and visible foreign bodies. Immobilization of the remaining fragments of bone by simple means is of great importance for the patient’s comfort. During Phase II, treatment consists of extraction of teeth in the line of fracture, removal of deeply located foreign bodies, securing of a definitive means of immobilizing fractured bones, and control of wound infection with antibiotics and irrigation. Phase III is the final reconstructive period. Heconstructive surgical procedures are simplified by the provision of adequate treatment during the earlier phases. The objectives of Phase III are to correct t.he deformity produced by loss of tissue and to establish adequate function of the jaws. Such reconstruction