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PubMed2002

[A case of severe motor and intellectual disability with tracheal stenosis due to granulation caused by metal stents treated successfully by silicone stents].

A silicone stent (Dumon stent) was used in a severe motor and intellectual disability with severe tracheal stenosis due to granulation caused by an implanted the expanded metal stent (Ultraflex Nitinol Stent). To treat tracheobronchial malacia, diagnosed in infancy, expanded metalic stent was implanted at the ages of 30 and 32 years. However, a few months after the second implantation, progressive dyspnea appeared, and he had to use a respirator under intravenous anesthesia. Bronchoscopy showed re-stenosis of the trachea due to a granulation tissue within the stent. A Dumon stent was applied to control the re-stenosis. He was successfully weaned from a respirator. Since granulation tissue had recurred at the end of the Dumon stent after 3 months, a long term care of the airway and regular observation is necessary after implantation of stents.

Adult↗
PubMed1992

In vitro and in vivo evaluation of antibiotic diffusion from antibiotic-impregnated polymethylmethacrylate beads.

The elution of antibiotics from antibiotic-impregnated polymethylmethacrylate (PMMA) beads was measured in mongrel dogs. The antibiotics, used in mixture with Simplex cement, included cefazolin (Ancef; 4.5 g/40 g cement powder), ciprofloxacin (Cipro; 6 g/40 g powder), clindamycin (Cleocin; 6 g/40 g powder), ticarcillin (Ticar; 12 g/40 g powder), tobramycin (Nebcin; 9.8 g/40 g powder), and vancomycin (Vancocin; 4 g/40 g powder). After a pneumatic drill was used to dredge a trough in the tibia, five beads were implanted. During the next 28 days, seroma samples and serum samples were taken for antibiotic measurements. On Day 28, the dogs were killed, beads removed, and the seroma, serum, bone, and granulation tissue sampled. The results of the study showed that clindamycin, vancomycin, and tobramycin exhibited good elution characteristics and had consistently high levels in bone and granulation tissue.

Animals↗
PubMed1996

Wound healing effect of malotilate in rats.

The wound healing effect of malotilate (CAS 59937-28-9, NKK-105) was investigated by using an excisional skin-wound model produced on the back of normal and healing-impaired (induced by prednisolone pretreatment) rats. The rapid decrease in the square measure of wound areas and the improvement in the histological evaluation clarified that 0.3% and 1% cream preparations of malotilate were obviously effective in accelerating spontaneous healing in the normal rats. The accelerative effect of malotilate cream preparations was likely superior to that of an ointment containing 5% deproteinized calf blood extract used as a reference agent. The same effect was also observed in the healing-impaired rats. The histological findings revealed that a thicker and more cellular granulation tissue, which in turn created an adequate bed for rapid re-epithelization, was formed in the malotilate-treated animals. Acceleration of granulation tissue formation by malotilate was also supported by the cotton pellet implantation method. It is concluded from these results that malotilate seems to be a promising agent for topical wound therapy.

Administration, Topical↗
PubMed1987

Periodontal wound healing in the absence of periodontal ligament cells.

This experiment was designed to study the ability of mucoperiosteal flap connective tissue to form new attachment on partially demineralized roots as well as nondemineralized roots in a wound-model where periodontal ligament (PDL) cells are absent, and ingrowth of bone granulation tissue is controlled. After reflecting mucoperiosteal flaps, bone was removed circumferentially around the distal root of mandibular second premolars and the mesial root of mandibular third premolars in five beagle dogs. The roots were completely denuded from the cementoenamel junction to the apex and curetted to remove PDL and cementum. Following root canal filling, the denuded roots on one side were conditioned with citric acid while the contralateral roots served as controls. To prevent bone-derived granulation tissue from contacting denuded roots, sheets of Nuclepore membrane were placed over the exposed bone margins and secured in place with steel ligatures. The flaps were coronally positioned and sutured. Histologic examination was made after three months of healing accompanied by regular plaque control. Both the experimental (acid conditioned) and control roots showed epithelium extending into the apical third of denuded roots and root resorption confined to the root apices. Some experimental specimens showed connective tissue adhesion in the apical third of roots without any new cementum or oriented fibers. Inflammatory cell infiltrate was seen extending to the apical third of denuded roots in both groups. In this model, the flap connective tissue cells failed to form new cementum and inserting fibers. Whether this was the result of inflammation and epithelial downgrowth or the inability of flap connective tissues to form new attachment could not be concluded from the study.

Alveolar Process↗
PubMed1997

Juvenile keratin inoculation induces chronic ear pathology.

OBJECTIVE: Human neonatal temporal bones frequently show the formation of granulation tissue provoked by amniotic fluid keratin contents, desquamated keratinized epithelial cells and lanugo hair. Similar histopathologic findings have been produced previously in a short-term animal model. To test the hypothesis that those short-term pathologic observations could have theoretical relevance for ear disease in older patients, a longer term animal model study was necessary. METHODS: Into the right bulla of 10 chinchilla pups was placed an aliquot of autogenous, nonviable epidermal scrapings and hair. Into the left bulla was placed 1 mm2 viable autogenous epidermal tissue. Animals were killed at intervals up to 11 months and then studied by light microscopy. RESULTS: Chronic ear histopathologic changes such as granulation tissue, osteoneogenesis, adhesions, and cholesteatoma were present. Over time, these secondary pathologic changes became more obvious than the initial keratin implant. CONCLUSIONS: The authors conclude that chronic pathologic changes resembling human ear disorders persist and that this model further extends the hypothesis that prenatally acquired keratin eventually could account for some cases of human ear disease.

Animals↗
PubMed1997

Vacuum-assisted closure: a new method for wound control and treatment: clinical experience.

Despite numerous advances, chronic and other difficult-to-manage wounds continue to be a treatment challenge. Presented is a new subatmospheric pressure technique: vacuum-assisted closure (The V.A.C.). The V.A.C. technique entails placing an open-cell foam dressing into the wound cavity and applying a controlled subatmospheric pressure (125 mmHg below ambient pressure). Three hundred wounds were treated: 175 chronic wounds, 94 subacute wounds, and 31 acute wounds. Two hundred ninety-six wounds responded favorably to subatmospheric pressure treatment, with an increased rate of granulation tissue formation. Wounds were treated until completely closed, were covered with a split-thickness skin graft, or a flap was rotated into the health, granulating would bed. The technique removes chronic edema, leading to increased localized blood flow, and the applied forces result in the enhanced formation of granulation tissue. Vacuum-assisted closure is an extremely efficacious modality for treating chronic and difficult wounds.

Atmospheric Pressure↗
PubMed1986

[Immunomorphological study of fibronectin and collagen types I, III, IV and V in the myocardium in cardiosclerosis].

Fibronectin and collagen, types I, III, IV and V, in the granulation tissue replacing the myocardial infarction, in the focal and diffuse cardiosclerosis were studied by means of the immunofluorescent method. The extracellular matrix in the granulation tissue contained fibronectin and collagen of the above types. Intracellular fibronectin was also found in the necrotized cardiomyocytes. Fibronectin and collagen of type IV were not detected in the postinfarction scars. The extracellular matrix consisted mainly of collagen, types III and V. Fibronectin and collagen, types I, III and V, are observed in the connective tissue in diffuse cardiosclerosis in the presence of the coronary arteries stenosis. No prevalence of the collagen of any type was found.

Aged↗
PubMed1997

Biomechanical and biochemical study of a standardized wound healing model.

Standardized protocols were developed for use in a detailed investigation into the biomechanical and biochemical properties of a dermal wound healing model in the rat. The use of a rapid freezing method at -80 degrees C minimized the detrimental effects of freezing on the biomechanical properties of the tissue and also allowed for convenient inter-laboratory collaboration to be performed. The methodology described allowed for the simultaneous and reproducible measurement of tensile strength, collagen cross-linking and proteolytic enzyme activity. Increases in the tensile properties of the tissue with time were consistent with an active process of remodelling process as indicated by changes in the cross-link and enzyme profiles. Initially the granulation tissue was comparatively rich in the keto-imine cross-link hydroxylysino-keto-norleucine, which was later replaced by the aldimine cross-link dehydro-hydroxy-lysinonorleucine. The mature cross-link histidino-hydroxy-lysinonorleucine was not observed within the granulation tissue at any stage and was also absent in aged control skin. A peak of matrix metalloproteinase-9 activity was observed at early timepoints (48 hr) and then decreased rapidly to normal levels and is consistent with an acute inflammatory response. In contrast matrix metalloproteinase-2 activity peaked later (3 days) and then decreased gradually, consistent with its role as one of the predominant enzymes involved in the remodelling process. The results described validate the animal model used and emphasize its potential for use in combined biomechanical and biochemical studies of acute wound healing.

Animals↗
PubMed1997

Tumor cell implantation after colonoscopy with biopsies in a patient with rectal cancer: report of a case.

PURPOSE: Colonoscopy with biopsy(ies) is performed in patients with colorectal cancer for diagnosis and screening of synchronous lesions. There is some fear of spreading the disease related to implantation of tumor cells at sites of mucosal damage or to hematogenous or lymphatic spread as a result of tumor manipulation. METHODS: A total colonoscopy including biopsies, performed in a patient because of anal blood loss and tenesmus, revealed a circular, polypoid, ulcerated mass from 1.5 to 12 cm above the anal verge. After preoperative radiotherapy, the patient was subjected to surgical intervention. RESULTS: Histopathology revealed a poorly differentiated rectum adenocarcinoma, staged pT4N1Mx. At approximately 12 cm proximally from the tumor, a biopsy taken through a minute irregularity of the mucosa revealed some granulation tissue with adjacent normal colon mucosa. The basis of this granulation tissue, corresponding to submucosa, contained poorly differentiated tumor elements. CONCLUSIONS: This tiny lesion might have been caused by implantation of exfoliated cancer cells in a biopsy site. It may not be without risk to create excessive biopsy lesions in the presence of a manifestly malignant tumor because of the possibility of tumor cell implantation.

Adenocarcinoma↗
PubMed1998

Preclinical promise of becaplermin (rhPDGF-BB) in wound healing.

Advances in molecular biology have made possible the production of highly purified recombinant human proteins, and recombinant human growth factors have emerged as potential therapeutic wound healing agents. Becaplermin (recombinant human platelet-derived growth factor-BB [rhPDGF-BB]) quickly emerged as one of the leading candidates for clinical trials. Before the expected therapeutic potential of rhPDGF-BB and other growth factors could be realized, a number of concerns had to be addressed (eg, would growth factors show effects in normal animals, what parameters of wound healing would be affected, and would quality of healed wounds be normal?). In animal models, rhPDGF-BB demonstrated wound healing activity, predominantly by enhancing the formation of granulation tissue, but it was not known whether this effect on granulation tissue would translate into enhanced healing of chronic skin ulcers in humans. The objective of this article is to review how the study of rhPDGF-BB in animal wound healing models has assisted in addressing the potential clinical utility of rhPDGF-BB. Results of animal studies are summarized, and the advantages and limitations of the animal models are discussed.

Animals↗
PubMed1990

Skin grafts.

Skin grafting is a method to reconstruct the skin covering on areas of the body where there are defects and insufficient surrounding skin for advancement or for creation of flaps. Grafts are classified according to their host-donor relationship and by their thickness. Autogenous grafts, taken from one area of the body and applied to another area, are the type of graft used most often clinically. Pieces of skin are taken from one area of the body, prepared and applied over a defect that has also been properly prepared to accept the graft. The defect to which a graft is applied must be a healthy bed of granulation tissue or tissue that is vascular enough to produce a bed of granulation tissue. In its new location, the graft will develop a new blood supply and attachment to underlying tissues. This is accomplished as the graft undergoes the processes of fibrinous adherence, plasmatic imbibition, inoculation, and new vessel ingrowth. The types of grafts described in this chapter are split-thickness, full-thickness, seed, strip, and stamp grafts. Each of these graft types must be prepared using certain techniques, and each one has its inherent advantages and disadvantages. Split-thickness grafts may require considerable skill and/or expensive equipment to perform. Although they "take" better than full-thickness grafts, they are usually less cosmetically attractive. Full-thickness grafts require no special skill or expensive equipment, and their cosmetic appearance is better than that of split-thickness grafts, but they do not take as well as split-thickness grafts. Seed and strip grafts are easily accomplished and require no special instruments; however, their cosmetic appearance is not good. Stamp grafts have some of the properties associated with split-thickness grafts as well as those of seed and strip grafts, since they combine features of both.

Animals↗
PubMed2002

Biologic fixation of polyester- versus polyurethane-covered stents in a porcine model.

PURPOSE: Migration of endoprostheses remains a concern in endovascular aneurysm treatment. Biologic fixation is supposed to enhance anchorage, but the diseased atherosclerotic aorta in humans has demonstrated a limited capacity to incorporate an endoprosthesis by cellular proliferation. The biologic response of two different types of endoprostheses was evaluated in the porcine aorta. MATERIALS AND METHODS: Two types of endoprostheses--four polyurethane-covered (PUC) stents with a macroporous polyurethane covering and four polyester-covered (PEC) stents with a woven polyester covering--were implanted in eight infrarenal porcine aortas for 6 weeks. Electron microscopy and qualitative and quantitative microscopy were performed on serial cross sections. RESULTS: The PUC stents demonstrated an increase in diameter (from 8 mm +/- 1 to 10 mm +/- 1, 12.5%; P = .009), whereas the PEC stents persisted in their original dimensions (8 mm +/- 1, 0%). PUC and PEC stents were covered by continuous thrombus-free neointima (269 microm +/- 51 vs 575 microm +/- 113, respectively; P < .01). The PUC stents demonstrated firm attachment to the aorta as a consequence of a granulation tissue with ingrowth into the pores of the polyurethane covering. The PEC stents remained in loose contact with the aorta in the absence of tissue ingrowth. CONCLUSIONS: Enhanced biologic fixation was achieved by extensive granulation tissue invading the pores of PUC endoprostheses. This finding can modify the design of future devices.

Animals↗
PubMed1995

Case report: the first report of idiopathic hypereosinophilic syndrome involved with lung and middle ear.

It has been reported that various organs are involved in idiopathic hypereosinophilic syndrome. Frequently, the heart, lung, skin, and nervous system are involved. Involvement of the middle ear, however, has not yet been reported. In this article, the authors describe the first case of hypereosinophilic syndrome involving the lung and middle ear. A 39-year-old woman had a 4-month history of low grade fever, non-productive cough, and a feeling of fullness and hearing loss in both ears. Peripheral blood cell count showed eosinophilia. Bilateral tympanic cavities were obstructed with granulation tissue, and she was diagnosed as obliterative otitis media. The granulation tissue consisted of foamy histiocytes and eosinophils. Chest X-ray film and computed tomography showed patchy infiltrative shadow in the lung. Histologic examination of the open lung biopsied specimen showed alveolar spaces infiltrated by eosinophils. After treatment with 30 mg oral prednisolone daily, there was a rapid improvement in her clinical condition. Based on the clinical course and the histologic findings of this case, obliterative otitis media may be caused by eosinophilic infiltration and eosinophilic pneumonia.

Adult↗
PubMed2000

Effect of nitric oxide synthase inhibitor on experimentally induced burn wounds.

BACKGROUND: Nitric oxide (NO) may have an important role in the healing of burn wounds. This study investigated the effect of NO on experimentally induced burn wounds by preventing NO synthesis. METHODS: A total of 40 mice weighing 25 to 30 g were used in this study. The shaved skin on the back of the mice was immersed in 100 degrees C water for 10 seconds to achieve a partial-thickness scald burn. The mice were divided into two groups of 20. In group I (control group), 17.5 mg/kg of serum physiologic (placebo) was injected intraperitoneally two times a day for 15 days. In group II (study group), 17.5 mg/kg of aminoguanidine (NO synthase inhibitor) was injected intraperitoneally two times a day for 15 days. On day 15 of the burn, the animals were killed and the burn areas were investigated histologically. Histologic changes such as epithelial proliferation, abscess, collagen, and granulation tissue were evaluated. RESULTS: Epithelial proliferation, formation of collagen, and granulation tissue with rich capillaries observed in the control group were statically significantly higher than those observed in the study group (z = -2.022, p < 0.05; z = -2.02, p < 0.05; and z = -2.022, p < 0.05; respectively). CONCLUSION: We concluded that healing of the burn wound is delayed by preventing NO synthesis.

Animals↗
PubMed1992

Tracheobronchial obstruction due to silicosis.

Broncholithiasis can result in airway obstruction through the erosion of calcified lymph nodes into the bronchial lumen or by extrinsic compression of the tracheobronchial tree. We report an unusual case of broncholithiasis in a patient with silicosis who developed airway obstruction from endobronchial polypoid masses of granulation tissue adjacent to calcified mediastinal lymph nodes. The production of granulation tissue may have been the result of broncholiths in the early stages of erosion into the tracheobronchial tree. Efforts to ablate the endobronchial polyps using YAG laser phototherapy were only temporarily successful and surgical removal of the calcified mediastinal lymph nodes was required to halt further polyp growth. Surgical specimens grew Mycobacterium avium-intracellulare (MAI), a common pathogen in patients with silicosis. MAI may have contributed to the local inflammatory milieu provoking the exuberant tissue response.

Aged↗
PubMed1990

Squamous cell carcinoma originating from an epithelial scar in a horse.

A Quarter Horse stallion developed an abscess over the left gluteal region after an IM injection of antihistamine. The wound healed with considerable fibrous scarring and some persistent granulation tissue. The lesion was static for 2 years before the granulation tissue went through a 6-month period of progressive enlargement. At that time, histopathologic diagnosis of squamous cell carcinoma was made from excisional biopsy. Six months after diagnosis, the horse had lost body weight and the lesional diameter had further increased, so the horse was euthanatized.

Animals↗
PubMed1983

Respiratory mucosal damage after brush biopsy--an experimental study in rabbits.

Bronchial brushing is one of the main methods of obtaining bronchial mucosal material for cytologic examination. In 37 rabbits, the tracheal respiratory mucosa, brush biopsy damage and post-biopsy wound-healing were studied. In the majority of animals, the brush had penetrated the basement membrane but in animals with undamaged basement membrane there was, within one to two days, a covering cell layer, probably regenerated from the intact epithelium and from basal cells. Deep, wound areas were covered during the first two to three days after damage by granulation tissue protruding into the tracheal lumen. After rejection of the granulation tissue, ulceration was covered by epithelium within three days and a normal ciliated epithelium restored within three weeks.

Animals↗
PubMed1998

The 'penumbra sign' on T1-weighted MR imaging in subacute osteomyelitis: frequency, cause and significance.

OBJECTIVE: We studied the frequency and cause of a feature exhibited on T1-weighted (T1-W) magnetic resonance (MR) imaging termed the 'penumbra sign' in a series of patients presenting with osteomyelitis and correlated it with the double-line sign described as a T2-weighted (T2-W) or short tau inversion recovery (STIR) feature of both the Brodie's abscess and avascular necrosis. MATERIALS AND METHODS: The clinical, radiographic, MR imaging, microbiological and histological findings in 32 patients referred to an orthopaedic oncology service, but subsequently proven to have osteomyelitis, were reviewed. The presence or absence of a rim of tissue lining an abscess cavity typified by minor signal hyperintensity relative to the main abscess contents on T1-W MR imaging (the 'penumbra sign') was identified. The sign was correlated with the radiographic and other findings. RESULTS: The penumbra sign was identified in 24 cases (75%) and appears to be a more sensitive sign than the corresponding double-line sign which was evident in only 29% of these on T2-W or fast STIR images. The lesions were unilocular in 11 cases (46%) and multilocular in 13 (54%). The thickness of the penumbra ranged from 2 to 5mm. On histological examination the tissue comprising the penumbra sign was found to be highly vascularized granulation tissue containing thick walled arterioles. CONCLUSION: The penumbra sign is characteristically seen on T1-W MR images in subacute osteomyelitis and is due to a thick layer of highly vascularized granulation tissue which may not be visible as the double-line sign on T2-W or fast STIR sequences. This characteristic, but not pathognomonic, MR finding supports the diagnosis of bone infection and helps to exclude the presence of a tumour.

Abscess↗