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[Various blood-foreign body reactions in the heart-lung machine in heart valve replacement and aortocoronary bypass operations].

Blood-foreign material interaction in the pump oxygenator was studied by means of scanning electron microscopy in 3 patients undergoing heart valve replacement (HVR) and 3 patients undergoing coronary bypass operation (CBO). While polyvinyl tubes show an average deposit of 60 thrombi/mm2 with 20--40 microns in size in CBO, bloodgas interface during HVR causes increasing thrombotic deposits (375 Mcthr/nm2, 25--50 microns in size). Distal to the pump the volume of particles may rise up 250 micrometer in HVR and up to 80 micrometer in CBO. In a 35 micrometer pore arterial-line-filter (Pall-Corporation) platelet clumps up to 1 mm in size are removed from circulating blood in HVR, and up to 300 micrometer thrombi in CBO. According to different platelet deposit proximal to the filter, more and larger thrombi can pass through the filter in HVR. Distal to the pump thromboemboli of 30--60 (maximum 90) micrometer in size can be observed in HVR. Particles of 20--35 (maximum 60) micrometer in size may pass through the filter and enter into the patient's circulation in CBO. As the results suggest, extracorporal circulation is more harmful for patients undergoing HVR than for those undergoing CBO.

Blood Cells↗

[Animal studies on the construction of continent ileostomies and colostomies with the use of BioCarbon implants].

Ring-shaped implants of BioCarbon, a recently developed vitreous carbon polymer, were used for construction of continent ileostomies and colostomies in dogs. The stoma was fashioned by suture fixation of the intestine inside the ring, which was then placed subfascially in the abdominal wall. The exterior of the implant could be hermetically sealed with a screw cap. Implantation in 19 dogs performed so far showed a high rate of incorporation of BioCarbon devices.

Animals↗

Wood fiber contamination of reusable cotton laparotomy pads.

If the thesis that disposable fabrics are responsible for granulomatous peritonitis is correct, surgeons who operate within the abdominal cavity and use these products would be reporting instances of granulomatous peritonitis in epidemic proportions. Such is not so. Consequently, there can be valid concern expressed as to implied medicolegal problems. While the observations and conclusions were made in obvious good faith, nevertheless, there appears to be sufficient grounds for questioning this apparent cause and effect conclusion and for focusing interest on a more important consideration, the indiscriminate collection, sorting and laundering of the reusable cotton laparotomy pad. Certainly, attention should be directed to the more rigidly controlled use and disposition of these pads by the individual hospital.

Equipment and Supplies, Hospital↗

Comparative studies of cellular reactions to injuries between the inner medulla and the cortex of rat kidneys.

The inner medulla and the cortex of the rat kidney were surgically traumatized or threaded with a silk suture, and the sequence of morphologic events occurring in these two topographic locations were studied by light microscopy on Days 7, 14, and 28. On Days 7, 14, and 28 following the infliction of the surgical trauma, such cellular reactions as mononuclear cell infiltration and fibroblastic proliferation were less intense in the injured site of the inner medulla than in the cortex. Numerous foreign body type giant cells appeared about the suture material in the cortex as early as Day 7 and were persistently present on Days 14 and 28. A similar type of foreign body giant cells did not appear about the suture material within the inner medulla throughout the experiment. Our results suggest that there is a difference in cellular reaction to injury or to a foreign body between the inner medulla and the cortex of rat kidneys.

Animals↗

[Retinal detachment surgery: Incidence and causes of silicone sponge implant rejection].

In 51 patients with retinal detachments silicone sponge implants have been applicated. In 9 of these cases (17,6%) the implants had to be removed 3 weeks to 16 months postoperatively because of inflammatory reactions. The influence of these complications on the healing of the retinal detachment is considered as relatively unimportant. In light- and electron-microscopic examinations we could establish that the reactions are mainly caused by infections (which primarily spread within the caves of the sponge implants). Chronic infections caused by so-called apathogenic bacteria are more frequent than acute infections by so-called pathogenic micro-organisms. A foreign body reaction could be proved only in one case, in which the sponge was loosened and displaced. Defence reactions against the foreign body material probably develop only if mechanical irritation of the tissue is caused by the sponge material.

Adult↗

Schistosomiasis--cancer: etiological considerations. A review.

Evidence for a causal connection between Schistosoma haematobium-infection and carcinoma of the urinary bladder is discussed. A group relationship of schistosomiasis cancer to cancers as+sociated with asbestosis, foreign body implants, and cicatrization is suggested on the basis of several criteria. Results of experimental foreign body tmuorigenesis in mice are presented and elaborated in relationship to schistosomiasis cancer. Carcinogenic development at the cellular level is discussed with emphasis on the essential role of tissue-environmental conditions, especially fibrotic changes and macrophage quiescence.

Adult↗

Polyvinylchloride (PVC) particles implantation in mouse liver. A technique for experimental study of schistosome eggs-induced liver pathology.

An injection of suspended PVC particles in the caecal vein of mice induces a foreign-body portal granuloma reaction in the liver. Plastic casts of the portal system, after PVC particles implantation, show modifications in the portal bed and are compared with plastic casts obtained in mice infested by Schistosoma mansoni. This technique can be useful to study the cellular dynamics of the portal granuloma and can be a model for schistosomal eggs induced liver pathology.

Animals↗

The osteoninductive property of decalcified bone matrix. An experimental study,.

Demineralised homologous bone-matrix implant was used to bridge a large circumferential osteoperiosteal gap in the diaphysis of the ulna of rabbits. Periodic observations of the graft were made clinically, radiologically, histologically and by tetracycline fluorescence up to forty-two weeks. By the twelfth week after operation 81 per cent of the animals revealed bone formation in the implant and complete bridging of the gap. The new bone was laid on the surface and in the substance of the matrix, suggesting that the inductive principle was acting locally. The bone, once formed, remodelled to the texture of a mature tubular bone and did not undergo absorption during a long follow-up period. Demineralise bone-matrix proved to be a highly osteoinductive and readily osteoconductive material. The graft did not evoke any appreciable local foreign-body or immunogenic reaction. The high degree of success in bridging massive bone defects justifies further serious studies and hopes for a useful substitute for massive autologous bone grafts.

Animals↗

Fc-receptor-bearing macrophages isolated from hypersensitivity and foreign-body granulomas. Delineation of macrophage dynamics, fc receptor density/avidity and specificity.

Foreign-body and delayed hypersensitivity granulomas were induced in mice; and the dynamics of macrophages isolated from dispersed, 1--4-week-old lesions was delineated. The size and histologic complexity of the lesions increased as shown: adjuvant greater than schistosome egg greater than methylated bovine serum albumin greater than bead. Esterase staining, spreading on glass, and the percentage of Fc-receptor--bearing macrophages present in the various granulomas reflected the same gradient. The Fc receptors were examined by rosetting with rabbit-antibody--SRBC complex (EA). Whereas more than 90% of the population of macrophages of the dermal adjuvant granuloma contained undiminished numbers of receptor-bearing macrophages throughout the 4 weeks, the percentage of macrophages that displayed receptors in pulmonary foreign-body (40%) and delayed hypersensitivity granulomas (70%) peaked at 1 week and subsequently declined. The EA rosetting of the foreign-body and delayed hypersensitivity granuloma macrophages was strongly inhibited by monomeric IgG2a-specific and weakly by aggregated IgG2b-specific mouse myeloma proteins. Also, macrophages of the delayed hypersensitivity granulomas rosetted in higher percentages with SRBCs coupled with monomeric IgC2a than with those coupled with aggregated IgG2b myeloma proteins. Macrophages of the foreign-body lesion did not react with aggregated IgG2b--SRBC. Rosetting with monomeric IgG2a--SRBC or aggregated IgG2b--SRBC could not be cross-inhibited by the myeloma proteins. Both the monomeric IgG2a--SRBC and aggregated IgG2b--SRBC complexes were readily phagocytized. Trypsin treatment of the macrophages inhibited rosetting with EA or myeloma-protein--coupled SRBCs. The display of Fc receptors on the granuloma macrophages seems to be related to the etiology of the lesion and the intensity and duration of the inflammatory reaction.

Animals↗

On skeletal muscle pathology in trichinosis.

A study was carried out on the pathology of trichinosis in human muscle biopsy sample and comparatively in experimental trichinosis in the rat, by current microscopic techniques and Troitsky's method of block silver impregnation of the nerve endings. Stress is laid upon the incipient changes in the parasitized muscle fibers, the sarcolemmic origin of the parasite capsule, the myogenic nature of certain periparasitary but intracapsular clear cells of precocious appearance and other associated, non-specific lesions, such as common myositis changes or giant myogenic foreign-body cells. The intimate relationships between parasitized muscle fibres, cellular interstitial reactions, local new-growth vessels and proliferation of the nerve endings are also described. The morpho-functional significance of such morphological synergic manifestations is discussed as an adaptation to the new local conditions brought about by the appearance of the peculiar muscle fibre-parasite unit in trichinosis.

Animals↗

Development of a model for transepidermal elimination.

Transepidermal elimination is a phenomenon which occurs spontaneously in certain skin disorders in which effete connective tissue or foreign materials is expelled via the epidermis to the exterior. In order to learn how this phenomenon is effected and what factors control it, we have attempted to produce an animal model for the process. When charcoal particles are deposited subepidermally in guinea-pig flank skin transepidermal elimination occurs within 4 days and we believe that this mimics the disorder seen in man. The hair follicles became hyperplastic and were intimately involved in the reaction, some of the particles actually being expelled via the follicular lumina. The reaction has some similarities to the wound healing response.

Animals↗