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[The possibility of inducing subcutaneous granulomas using plant foreign bodies. Experimental research].

Experimental research designed to provoke subcutaneous granulomas by means of vegetable foreign bodies in animals is reported. The possibility of influencing the ongoing picture by means of anti-inflammatory drugs was also investigated. The findings were similar to those observed in a patient with a similar foreign body responsible for a perineal granuloma. The anti-inflammatory substances employed, however, had no effect on the aspecific granulomatous reaction.

Animals↗

Biomicroscopy of surface deposits resembling foreign-body giant cells on implanted intraocular lenses.

Deposits resembling foreign-body giant cells, which can be seen on specular reflex slit-lamp examination, were studied in vivo with a wide-field specular microscope using a low-power dipping cone lens in three cases of posterior chamber lens implantation. The deposits seen as iris pigment on routine examination showed two types of cell-like figures: round, bipolar or ameboid small figures with long branching processes and round, oval, or bizarre large figures. The large cell type had the pigment particles at the central or paracentral area and vacuole-like structures adjacent to the pigment particles. The specular photomicrographic characteristics were similar to those of fibroblast-like cells and foreign-body giant cells, which had been shown on the surfaces of extracted implanted intraocular lenses by the lens implant cytology technique.

Aged↗

Needle-wire localization of an infratemporal fossa foreign body using computed tomography.

We report a case involving the localization and surgical removal of a traumatically introduced foreign body deep within the infratemporal fossa. Needle-hookwire placement with computed tomographic guidance allowed the precise localization and marking of the foreign body. Surgical removal under local anesthesia and without extensive exploration was, therefore, possible. The details of the localization and marking techniques are described. Needle-hookwire localization under computed tomographic guidance should be considered for deeply located foreign bodies in the head and neck area.

Adult↗

Angiographic retrieval of foreign bodies in pulmonary artery: a report of three cases.

Three cases of percutaneous retrieval of foreign bodies that migrated into the pulmonary artery are described in this paper. All of the intravascular foreign bodies were attributed to SVC catheters for intravenous hyperalimentation (IVH) therapy, an accidentally cut strip of indwelling SVC catheter in two patients and a fragment of guide wire used for the insertion of the SVC catheter in one patient. They were all successfully removed by fluoroscopic angiographic procedures using a snare loop retriever and grasping forceps. The technical aspects of the procedures are discussed here.

Adolescent↗

[Pharyngeal foreign bodies in infants persisting for two months: two case reports].

In general, patients who suffer from pharyngeal foreign bodies can explain the time and nature of the object which had been swallowed, resulting in easy diagnosis. However, in infants, difficulty in communication makes diagnosis troublesome. Two cases of long-standing pharyngeal foreign bodies were treated at our hospital. Case 1 was a 16-month-old girl complaining of stridor and fever. She had fallen with a toothbrush in her mouth two months before, and was hospitalized in the pediatrics department for one week with upper airway inflammation and dehydration. A toothbrush head was embedded in the back wall of the mesopharynx and hypopharynx. Case 2 was a 10-month-old boy complaining of dysphagia and failure in weight gain. He was hospitalized in the pediatrics department with pneumonia two months before. A PTP (press through pack for medicine) was embedded in the back wall of the hypopharynx. We removed both foreign bodies under general anesthesia.

Deglutition Disorders↗

[Misdiagnosis of intracranial foreign body: report of one case].

This case of misdiagnosis of intracranial foreign body arose from undetailed history inquiry at hospitalization of the patient and poor image of wood foreign body by CT examination, suggesting that a detailed knowledge of the cause of injury and close examination of the wounds are crucial to avoid misdiagnosis.

Craniocerebral Trauma↗

The interrupted bronchus: a fluoroscopic sign of bronchial foreign body in infants and children.

OBJECTIVE: The objective is to describe the characteristic features of the interrupted bronchus sign and to determine the value of this sign in detection of bronchial foreign bodies. The interrupted bronchus sign refers to disruption of the air column in the main bronchi seen by fluoroscopy. CONCLUSION: The interrupted bronchus sign has a sensitivity of 100% for detection of foreign bodies in the main bronchi. This sign is particularly helpful when chest radiography shows atelectasis or pneumonia. The specificity of this sign for foreign bodies is only 71% because other endobronchial lesions can disrupt the air column. Nevertheless, the interrupted bronchus sign indicates the presence of bronchial occlusion and signifies the need for bronchoscopy. This sign is not sensitive for detection of foreign bodies in lobar or segmental bronchi.

Bronchi↗

Vaginal foreign body in childhood: A multidisciplinary approach.

A 5-year-old girl referred to our division for evaluation of persisting foul-smelling brown vaginal discharge with pruritus for over 2 years, not corresponding to antibiotic therapy. Transabdominal ultrasound identified a heterogeneous mass intensely fixed in the upper third of vaginal wall. Vaginography revealed a filling defect in the upper part of vagina, confirming the diagnosis of an intravaginal foreign body. The foreign body was grasped and removed by traction; it turned out to be a thin double-wrapped piece of sponge. Psychological assessment of the girl was undertaken, in order to illuminate the potential of an underlying emotional and behavioural problem and revealed the existence of psychological disturbances mostly affecting social competence and adaptiveness.

Child, Preschool↗

Unusual foreign body causing quadriparesis: case report.

OBJECTIVE AND IMPORTANCE: An unusual foreign body traversing the spinal canal at the foramen magnum level is described. Interesting radiological findings and a review of nonmissile penetrating injuries are presented. This case demonstrates the importance of a thorough physical examination and the use of neurodiagnostic imaging in an inebriated, uncooperative patient with neurological dysfunction. CLINICAL PRESENTATION: The patient presented with quadriparesis confounded by cocaine intoxication. A physical examination revealed only a small punctate lesion in the posterior occipital region. INTERVENTION: After detection of the foreign body, the patient underwent immediate surgical exploration and removal of the object. The dura was repaired primarily, and the patient was maintained on intravenous antibiotics for 7 days. CONCLUSION: With physical therapy, the patient was walking with assistance at 2 weeks postsurgery. Upper extremity strength, especially intrinsic hand movement, was most severely affected. At 10 months' follow-up, the patient's only deficits were mild intrinsic hand weakness and incoordination with fine finger movements. Immediate surgical exploration is indicated for patients with retained fragments and progressive neurological dysfunction.

Adult↗

Developmental morphology of calcium oxalate foreign body stones in rats.

Calcium oxalate bladder stones were induced in male rats by implanting plastic foreign bodies and by adding ethylene glycol to their drinking water. The foreign body surface was first coated with cellular debris and some amorphous material. Encrustation with crystals of calcium oxalate started on the third day of implantation. Within 2 weeks the entire surface of a foreign body was covered with crystals and some noncrystalline material. Calcium oxalate monohydrate crystals consisted of platelike crystallites arranged in hemispherulitic or spherulitic habit. Calcium oxalate dihydrate crystals wee basically dipyramidal, a majority of them showing interpenetrant twinning. The stone grew by confluent crystal growth and crystal aggregation. A transformation of calcium oxalate monohydrate crystals to calcium oxalate dihydrate also occurred. The matrix consisting of cellular debris and urinary macromolecules was universally distributed in the stone including the inside of crystal bodies.

Animals↗

A new approach using intraoperative ultrasound imaging for the localization and removal of multiple foreign bodies in the neck.

An innovative method of using ultrasound imaging intraoperatively is reported. Multiple radiopaque and radiolucent foreign bodies within soft tissues were localized in theatre using high resolution ultrasonography. Depth of injury and vessel status were also ultrasonically assessed. Surgical removal of all foreign bodies was aided by intraoperative ultrasound guidance. In addition, this new approach of using intraoperative ultrasonography was pivotal in confirming the removal of all foreign bodies from the wound at the time of the operation.

Accidents, Occupational↗

Caustic ingestions and foreign body aspirations: an overlooked form of child abuse.

Caustic ingestions and foreign body aspirations are common occurrences in the pediatric population. The high association between caustic ingestions and foreign body aspirations and family stress with social problems may result in significant morbidity and mortality. It is the purpose of this article to increase physician awareness concerning the possibility that these events may be a form of child abuse. It is hoped that by recognizing the risk of child abuse in these cases the physician can make the appropriate referrals in order to avoid serious injury to the child.

Child↗

[On secondary endoepithelial dystrophy of the cornea due to non-magnetic anterior chamber foreign body (author's transl)].

Secondary endoepithelial dystrophy of the cornea can be uncharacteristic and lead to misdiagnoses. A foreign body in the anterior chamber producing an endothelial dystrophy is often recognized late, or not at all. Clearing the cornea with glycerin facilitates the gonioscopic examination. Foreign bodies found in the anterior chamber following war wounds of traffic accidents were most commonly glass, quartz or stone. After removal of the foreign body, the endothelial dystrophy can heal spontaneously. A perforating keratoplasty of large diameter is indicated if the dystrophy persists or increases. The results are reported.

Adult↗

Results and prognostic factors in penetrating ocular injuries with retained intraocular foreign bodies.

Of 105 eyes with ocular injuries involving retained intraocular foreign bodies, 63 (60%) had a final visual acuity of 20/40 or better; 20 (19%) were 20/50 to 5/200; and 15 (14%) were worse than 5/200. Six eyes (6%) were enucleated. The extent of visual recovery was limited in selected cases by the characteristics of the initial injury. Multivariate analysis was used to identify prognostic factors. Predictive of a good visual outcome (greater than or equal to 20/40) were: (1) initial visual acuity better than 20/40 and (2) the need for only one or two operations in the treatment of the injury. Predictive of a poor visual outcome (less than 5/200) were: (1) initial visual acuity worse than 5/200 and (2) a wound 4 mm or longer in length, independent of wound location. The visual outcome in this series of patients was compared with other large series of intraocular foreign bodies reported before the development of vitreous microsurgical techniques. The percentage of patients with a visual outcome of 20/40 or better has remained the same, whereas the incidence of enucleation has diminished.

Adolescent↗

Vaginal foreign bodies and child sexual abuse.

OBJECTIVE: To determine whether vaginal foreign bodies (VFBs) in prepubertal girls are associated with sexual abuse and whether evidence exists in earlier reports for such an association. DESIGN: Retrospective case review. SETTING: General pediatric clinic at Duke University Medical Center, Durham, NC. PARTICIPANTS: All 12 girls 10 years of age and under who, between 1985 and 1988, were seen in the general clinic and subsequently found to have VFBs. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Clinic protocol required referral of all children with vaginal bleeding, unusual discharge, or VFBs to the Child Protection Team at the medical center, which also served as a pediatric gynecology consultation service. Records for the 12 girls, whose mean age was 6.3 years, showed 19 visits for single, multiple, or recurrent VFBs. Two girls had concurrent sexually transmitted diseases. Eight met diagnostic criteria for confirmed sexual abuse; three, for suspected abuse; and in one, abuse status was unknown. CONCLUSIONS: Vaginal foreign bodies in young girls may be a previously unrecognized indicator of sexual abuse. Girls with VFBs should be evaluated for possible sexual abuse. Prospective studies on the suggested association between VFBs and sexual abuse need to be conducted.

Child↗

[Removal of foreign bodies from the trachea. Indications for tracheobronchoscopy with a rigid instrument].

Intrathoracic disease is nowadays better investigated by fibreoptic endoscopy than by the use of rigid endoscopes. Nevertheless the use of rigid systems is still indicated for the removal of foreign bodies, especially in children. In this paper diagnostic procedures and techniques are reviewed. Seventy per cent of all inhaled or ingested foreign bodies present in children, 55% of them under 4 years of age. The foreign bodies should be extracted with the patient under general anaesthesia. Since many physicians now perform endoscopy, the foreign body cases should be concentrated in one institution in each region to ensure that one group has sufficient experience with rigid systems.

Adult↗