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Seo SB, Kim S, Yi K. Delayed occurrence of foreign body reaction caused by poly-L-lactic acid with monitoring through ultrasonography. Skin Res Technol 2024; 30:e13683. [PMID: 38563152 PMCID: PMC10985543 DOI: 10.1111/srt.13683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 03/18/2024] [Indexed: 04/04/2024]
Affiliation(s)
- Suk Bae Seo
- SeoAhSong Dermatologic ClinicSeoulSouth Korea
| | - Soo‐Bin Kim
- Division in Anatomy and Developmental BiologyDepartment of Oral BiologyHuman Identification Research Institute, BK21 FOUR Project, Yonsei University College of DentistrySeodaemun‐guSeoulSouth Korea
| | - Kyu‐Ho Yi
- Division in Anatomy and Developmental BiologyDepartment of Oral BiologyHuman Identification Research Institute, BK21 FOUR Project, Yonsei University College of DentistrySeodaemun‐guSeoulSouth Korea
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Hsieh TC, Hsu CW. Foreign body reaction mimicking local recurrence from polyactide adhesion barrier film after laparoscopic colorectal cancer surgery: A retrospective cohort study. Medicine (Baltimore) 2022; 101:e28692. [PMID: 35119013 PMCID: PMC8812642 DOI: 10.1097/md.0000000000028692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 01/05/2022] [Indexed: 01/04/2023] Open
Abstract
Polyactide (PLA) barrier is one of the most commonly used materials to prevent the formation of postoperative adhesion. Even though previous studies supported the anti-adhesion efficacy of PLA barrier, there have been limited reports focusing on the associated foreign body reaction. We sought to investigate the potential complication of PLA barrier placement that could lead to unnecessary intervention.This is a retrospective study of colorectal cancer patients with laparoscopic surgery. Cases with stage IV unresectable disease, poor Eastern Cooperative Oncology Group Performance, death within 3 months after the surgery, and insufficient record were excluded. A total of 296 cases were identified in our study and 220 patients received PLA film placement. We compared the incidence of foreign body reaction between the patients with and without PLA film.Among PLA film group, 16 cases had signs of local recurrence on the follow-up image studies. The subsequent operation found 10 patients had no cancerous lesions but only foreign-body-associated granulomas. The incidence of foreign body reaction mimicking local recurrence on image study was 4.5% with high false positive rate of 62.5% on positron emission tomography scan in patients with PLA film. There were only 2 cases without the antiadhesive barrier developed signs of recurrence during active surveillance. Both cases were later confirmed to have malignant peritoneal seeding.The PLA film was associated with rare foreign body reaction that could interfere the accuracy of follow-up program and result in unnecessary surgical intervention. Hence, we recommend avoiding the use of the PLA barrier.
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Affiliation(s)
- Tien-Chan Hsieh
- Division of Colorectal Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, No. 386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City, Taiwan
- Department of Medicine, Danbury Hospital, 24 Hospital Avenue, Danbury, CT
- Department of Internal Medicine, Yale University, 333 Cedar St, New Haven, CT
| | - Chao-Wen Hsu
- Division of Colorectal Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, No. 386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City, Taiwan
- Faculty of Medicine, National Yang-Ming University, No. 155, Section 2, Linong St, Beitou District, Taipei City, Taiwan
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Koff MF, Gao MA, Neri JP, Chiu YF, Lin BQ, Burge AJ, Su E, Padgett DE, Potter HG. Adverse Local Tissue Reactions are Common in Asymptomatic Individuals After Hip Resurfacing Arthroplasty: Interim Report from a Prospective Longitudinal Study. Clin Orthop Relat Res 2021; 479:2633-2650. [PMID: 34232144 PMCID: PMC8726542 DOI: 10.1097/corr.0000000000001882] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 06/08/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND The evaluation of the natural history prevalence of adverse local tissue reactions (ALTRs) using MRI has focused only on metal-on-metal (MoM) bearing surfaces without comparison to nonMoM bearing surfaces. QUESTIONS/PURPOSES To determine (1) the longitudinal changes and differences in blood metal ion levels in patients with hip resurfacing arthroplasty (HRA), ceramic-on-ceramic (CoC) THA, and metal-on-polyethylene (MoP) THA compared with those undergoing ceramic-on-polyethylene (CoP) THA; (2) how the longitudinal change of synovial reaction classification in patients with HRA, CoC THA, and MoP THA compares with those undergoing CoP THA, and whether there is an association between the presence of an ALTR or metallosis on MRI with corresponding patient-reported outcomes, or the presence of capsular dehiscence; and (3) differences in blood metal ion levels between patients undergoing HRA with an ALTR or metallosis on MRI and those with HRA without these conditions. METHODS Between March 2014 and February 2019, 22,723 patients underwent primary HRA and THA at one center. Patients received an HRA based on their desired athletic level after surgery and the presence of normal acetabular and proximal femoral bone morphology without osteopenia or osteoporosis. Two percent (342 of 22,723) of patients were contacted to participate, and 71% (243 of 342 hips in 206 patients) were enrolled for analysis at baseline. The patients underwent arthroplasty for degenerative joint disease, and 25 patients withdrew over the course of the study. We included patients who were more than 1 year postarthroplasty. All participants had an MRI examination and blood serum ion testing and completed a Hip Disability and Osteoarthritis Outcome Score survey annually for four years (baseline, year 1, year 2, year 3). Morphologic and susceptibility-reduced MR images were evaluated by a single radiologist not involved in the care of patients for the presence and classification of synovitis (Gwet AC1: 0.65 to 0.97), synovial thickness, and volume (coefficient of repeatability: 1.8 cm3). Linear mixed-effects models were used to compare the mean synovial thickness, synovial volume, and Hip Disability and Osteoarthritis Outcome Score subscales between bearing surfaces at each timepoint and within each bearing surface over time. Marginal Cox proportional hazards models were used to compare the time to and the risk of developing ALTR only, metallosis only, and ALTR or metallosis between bearing surfaces. All models were adjusted for age, sex, BMI, and length of implantation based on known confounders for hip arthroplasty. Adjustment for multiple comparisons was performed using the Dunnett-Hsu method. RESULTS Patients with unilateral HRA had higher cobalt and chromium serum ion levels (baseline: 1.8 ± 0.8 ppb, year 1: 2.0 ± 1.5 ppb, year 2: 2.1 ± 1.2 ppb, year 3: 1.6 ± 0.7 ppb) than those with unilateral CoP bearings (baseline: 0.0 ± 0.1 ppb, year 1: 0.1 ± 0.3 ppb, year 2: 0.0 ± 0.2 ppb, year 3: 0.0 ± 0.0 ppb) at all timepoints (p < 0.001 for each time point). More patients who received an HRA developed ALTR or metallosis on MRI than did patients with CoP bearings (hazard ratio 4.8 [95% confidence interval 1.2 to 18.4]; p = 0.02). There was no association between the longitudinal change of synovial reaction to ALTR or metallosis on MRI with patient-reported outcomes. In addition, there was no association between the presence of dehiscence at baseline and the subsequent development of ALTR or metallosis, as seen on MRI. There were elevated cobalt (4.7 ± 3.5 ppb) and chromium (4.7 ± 2.6 ppb) serum levels in patients with unilateral HRA who had an ALTR or metallosis present on MRI at year 1 compared with patients without an ALTR or metallosis on MRI (cobalt: 1.8 ± 1.0 ppb, mean difference 4.7 ppb [95% CI 3.3 to 6.0]; p < 0.001; chromium: 2.3 ± 0.5 ppb, mean difference 3.6 ppb [95% CI 2.2 to 5.0]; p < 0.001) as well as for chromium at year 3 (3.9 ± 2.4 ppb versus 2.2 ± 1.1 ppb, mean difference 1.3 ppb [95% CI 0.3 to 2.4]; p = 0.01). CONCLUSION We found a higher proportion of ALTR or metallosis on MRI in patients with HRA compared with patients with CoP, even when patient self-assessed symptomatology of those with an ALTR or metallosis on MRI was not different than the absence of these features. MRI detected ALTRs in high-function patients, emphasizing that an annual clinical assessment dependent on survey or blood ion testing alone may not detect soft tissue complications. The results of this study are in line with prior consensus recommendations of using MRI as part of a routine follow-up protocol for this patient population. LEVEL OF EVIDENCE Level III, therapeutic study.
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Affiliation(s)
- Matthew F. Koff
- MRI Research Laboratory, Hospital for Special Surgery, New York, NY, USA
| | - Madeleine A. Gao
- MRI Research Laboratory, Hospital for Special Surgery, New York, NY, USA
| | - John P. Neri
- MRI Research Laboratory, Hospital for Special Surgery, New York, NY, USA
| | - Yu-fen Chiu
- Biostatistics Core, Hospital for Special Surgery, New York, NY, USA
| | - Bin Q. Lin
- Biostatistics Core, Hospital for Special Surgery, New York, NY, USA
| | - Alissa J. Burge
- MRI Research Laboratory, Hospital for Special Surgery, New York, NY, USA
| | - Edwin Su
- Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, New York, NY, USA
| | - Douglas E. Padgett
- Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, New York, NY, USA
| | - Hollis G. Potter
- MRI Research Laboratory, Hospital for Special Surgery, New York, NY, USA
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Kastelein AW, de Graaf BC, Latul YP, Verhorstert KWJ, Holthof J, Guler Z, Roovers JPWR. Ultra-high-frequency ultrasound: promising technique to visualize pelvic floor mesh in vivo. Ultrasound Obstet Gynecol 2021; 57:653-654. [PMID: 32621365 DOI: 10.1002/uog.22137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/20/2020] [Accepted: 06/26/2020] [Indexed: 06/11/2023]
Affiliation(s)
- A W Kastelein
- Department of Obstetrics and Gynaecology, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
| | - B C de Graaf
- Department of Obstetrics and Gynaecology, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
| | - Y P Latul
- Department of Obstetrics and Gynaecology, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
| | - K W J Verhorstert
- Department of Obstetrics and Gynaecology, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
| | - J Holthof
- Fujifilm Visualsonics, Amsterdam, The Netherlands
| | - Z Guler
- Department of Obstetrics and Gynaecology, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
| | - J P W R Roovers
- Department of Obstetrics and Gynaecology, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
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Abstract
Button batteries are the second most frequently-ingested foreign bodies and can lead to serious clinical complications within hours of ingestion. The purpose of this study was to analyze the outcomes of 14 children with button batteries lodged in the upper gastrointestinal tract.Totally 14 children with button batteries lodged in the upper gastrointestinal tract were included. The diagnosis was made primarily by the history of button battery ingestion, physical examination and chest-abdomen X-ray examination.The button batteries lodged in the esophagus were removed by esophagoscope, and those in the gastrointestinal tract were under observation. Among 10 children with batteries in the first esophageal stenosis, 9 were cured and 1 suffered from tracheoesophageal fistula. One case of battery in the second esophageal stenosis was dead due to intercurrent aortoesophageal fistula. Two cases of batteries in the third esophageal stenosis were cured after removal, and 1 case of the battery in the gastrointestinal tract discharged spontaneously.Ingested button batteries are mainly lodged in the esophageal stenoses and are easy to cause esophageal injury and severe complications. Early detection, prompt treatment, strengthening observation and regular follow-up after discharge may help to decrease the incidence of complications and improve the outcomes.
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Affiliation(s)
- Yan Gao
- Department of Otolaryngology Head and Neck Surgery, Kunming Children's Hospital
| | - Jin Wang
- Department of Otolaryngology Head and Neck Surgery, The Second People's Hospital of Yunnan Province
| | - Jing Ma
- Department of Otolaryngology Head and Neck Surgery, Kunming Children's Hospital
| | - Yingqin Gao
- Department of Otolaryngology Head and Neck Surgery, Kunming Children's Hospital
| | - Tiesong Zhang
- Department of Otolaryngology Head and Neck Surgery, Kunming Children's Hospital
| | - Puping Lei
- Faculty of Forensic Medicine, Kunming Medical University, Kunming, Yunnan, China
| | - Xin Xiong
- Faculty of Forensic Medicine, Kunming Medical University, Kunming, Yunnan, China
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Meng S, Liu G, Wang S, Yang F. Case report: inflammatory pseudotumor in the lung parenchyma caused by a medical suture originating from a cardiac surgery 35 years ago. J Cardiothorac Surg 2020; 15:151. [PMID: 32576201 PMCID: PMC7313219 DOI: 10.1186/s13019-020-01194-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 06/15/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The incidence of the iatrogenic foreign body retained after surgery is extremely low. Iatrogenic foreign body retained is surrounded by normal tissue, which responds to foreign matter to form inflammatory pseudotumors. Surgical sponge or swap is the most common type of foreign body. There were no reports of medical sutures remaining as foreign bodies in the lung parenchyma to form inflammatory pseudotumors. CASE PRESENTATION A CT scan of a 50-year-old female showed an irregular soft tissue mass in the left upper lobe with rough edge and spiculation. After 20 months, the size increased from 2.8 × 1.9 cm to 3.2 × 2.2 cm. The patient underwent a ventricular septal repair surgery for congenital Fallot tetralogy 35 years ago and a left breast surgery for breast cancer. She had a family history of lung cancer. Evaluation of this mass highly suggested a lung malignant lesion. The patient underwent video-assisted thoracoscopic surgery (VATS) lobectomy and her pathology revealed an intrapulmonary inflammatory pseudotumor caused by a medical prolene suture. Based on her medical history and other reports of iatrogenic foreign bodies, we believe that this suture retained from the heart surgery 35 years ago entered the pulmonary artery, moved to the distal branch, and eventually formed an inflammatory pseudotumor in the lung parenchyma. Here we reported and analyze this rare case. CONCLUSION We reported a rare case of inflammatory pseudotumor in the lung parenchyma caused by a medical suture, and determined it was a prolene suture retained in the body during a cardiac surgery 35 years ago. Diagnosis of this rare disease required sufficient imaging experience. Besides, appropriate surgical exploration can help with the diagnosis and treatment.
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Affiliation(s)
- Shushi Meng
- Department of Thoracic Surgery, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing, 100044, China
| | - Ganwei Liu
- Department of Thoracic Surgery, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing, 100044, China
| | - Shaodong Wang
- Department of Thoracic Surgery, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing, 100044, China.
| | - Fan Yang
- Department of Thoracic Surgery, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing, 100044, China
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Baciarello M, Maspero G, Maestroni U, Palumbo G, Bellini V, Bignami E. If it looks like a catheter and winds like a catheter . . . fibroblastic sheath mimicking a central venous catheter fragment: A case report. J Vasc Access 2019; 21:529-532. [PMID: 31526092 DOI: 10.1177/1129729819873488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Fibroblastic sheath formation is a well-known complication of long-term central venous catheters. When calcified, fibroblastic (formerly known as "fibrin") sheaths may be easily mistaken for retained catheter fragments. We describe one such case and how imaging was used to recognize the sheath and avoid unnecessary interventions. CASE DESCRIPTION A patient with systemic sclerosis was referred for port removal because of suspected infection. A later computed tomography scan showed a persistent tubular structure coursing behind the right clavicle, which was also seen in an anteroposterior chest radiograph. Three-dimensional reconstruction and analysis of the structure's lumen in comparison to previous imaging studies allowed us to confirm that it was, in fact, a calcified fibroblastic sheath. The patient's course was uneventful thereafter. CONCLUSION Three-dimensional computed tomography reconstruction, as well as the hollow appearance of a tubular structure after removal of a central catheter may help differentiate a fibroblastic sheath from a retained catheter fragment. Accurate surgical notes mentioning the length of the catheter at implant and explant are also of paramount importance.
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Affiliation(s)
- Marco Baciarello
- Anesthesiology, Critical Care and Pain Medicine Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Giada Maspero
- Second Unit of Anesthesia, Critical Care and Pain Medicine, University Hospital of Parma, Parma, Italy
| | - Umberto Maestroni
- Urology Unit, Department of Surgery, University Hospital of Parma, Parma, Italy
| | - Giuseppina Palumbo
- Anesthesiology, Critical Care and Pain Medicine Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Valentina Bellini
- Anesthesiology, Critical Care and Pain Medicine Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Elena Bignami
- Anesthesiology, Critical Care and Pain Medicine Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
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Abstract
RATIONALE Failure to pass though the gastrointestinal tract can result in inflammatory response, reactive fibrosis, and intestinal perforation. Fish bones, chicken bones, and toothpicks are the most common types of foreign substances that produce intestinal perforation during ingestion. PATIENT CONCERNS Case 1: A 49-year-old female was hospitalized with abdominal pain and a fever. The fever lasted for 5 days before hospitalization. Case 2: A 72-year-old male was hospitalized with abdominal pain and fever. The fever lasted for 4 days before hospitalization. DIAGNOSES Case 1: An abdominal pelvic computed tomography (APCT) scan revealed a large inflammatory mass formation and linear high-density material within the inflammatory mass. The presence of foreign bodies, including acupuncture needles or intrauterine devices was ruled out. Case 2: An APCT scan revealed that there was a small abscess formation measuring about 2.5 cm abutting the abdominal wall and a parasitic infestation was ruled out. INTERVENTIONS Case 1: An exploratory laparotomy was performed. After removal of the abscess pocket, the sigmoid colon was found to be perforated, and there was a firm, sharp foreign body in the abscess pocket that measured about 5 cm and resembled a toothpick. Case 2: Laparoscopic exploration was then performed. When the abscess was removed from the abdominal wall using a harmony scalpel, a 4 cm foreign body that resembled a toothpick appeared in the abscess pocket. OUTCOMES The patients recovered well after surgery and were discharged. LESSONS Two of the above case reports describe the cases in which the presence of toothpicks was suspected clinically, resulting in the surgery of intra-abdominal abscess caused by intestinal perforations.
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Chen J, Wang C, Zhuo J, Wen X, Ling Q, Liu Z, Guo H, Xu X, Zheng S. Laparoscopic management of enterohepatic migrated fish bone mimicking liver neoplasm: A case report and literature review. Medicine (Baltimore) 2019; 98:e14705. [PMID: 30882633 PMCID: PMC6426515 DOI: 10.1097/md.0000000000014705] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
RATIONALE Accidental ingestion of a foreign body is common in daily life. But the hepatic migration of perforated foreign body is rather rare. PATIENT CONCERNS A 37-year-old man presented with a history of vague epigastric discomfort for about 2 months. DIAGNOSIS A diagnosis of the foreign body induced hepatic inflammatory mass was made based on abdominal computed tomographic scan and upper gastrointestinal endoscopy. INTERVENTIONS The patient underwent laparoscopic laparotomy. During the operation, inflammatory signs were seen in the lesser omentum and segment 3 of liver. B- Ultrasound guided excision of the mass (in segment 3) was performed. Dissecting the specimen revealed a fish bone measuring 1.7 cm in length. OUTCOMES The patient recovered uneventfully and was discharged on day 5 after surgery. LESSONS This study shows the usefulness of endoscopy for final diagnosis and treatment in foreign body ingestion. Early diagnosis and decisive treatment in time are lifesaving for patients with this potentially lethal condition.
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Affiliation(s)
- Jun Chen
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Key Lab of Combined Multi-Organ Transplantation, Ministry of Public Health, First Affiliated Hospital, Zhejiang University School of Medicine, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
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Abstract
PURPOSE Foreign body reactions elicit granulomatous inflammation composed of reactive macrophages. We hypothesized that [125I]iodo-DPA-713 single-photon emission computed tomography (SPECT), a low-molecular-weight pyrazolopyrimidine ligand selectively trapped by phagocytes, could be used to detect foreign body reactions in a murine model. PROCEDURES C57BL/6 mice intratracheally inoculated with dextran beads, which developed foreign body lesions, were imaged after injection of [125I]iodo-DPA-713 or DPA-713-IRDye800CW using SPECT and optical imaging, respectively. RESULTS Foreign body lesions were clearly observed in the lungs of the dextran-treated mice on computer tomography imaging and demonstrated significantly higher [125I]iodo-DPA-713 uptake compared with control animals (p < 0.01). Ex vivo studies demonstrated granulomatous reactions in the lungs of dextran-treated mice and localization of DPA-713-IRDye800CW at the diseased sites confirming the imaging findings. CONCLUSION Radioiodinated DPA-713 may be used as a noninvasive biomarker for the detection of pulmonary foreign body reactions.
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Affiliation(s)
- Julian Sanchez-Bautista
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University, 1550 Orleans Street, CRB-II, Rm 1.09, Baltimore, MD, 21287, USA
- Center for Tuberculosis Research, Johns Hopkins University, Baltimore, MD, USA
- Department of Pediatrics, Johns Hopkins University, Baltimore, MD, USA
| | - Catherine A Foss
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University, 1550 Orleans Street, CRB-II, Rm 1.09, Baltimore, MD, 21287, USA
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Alvaro A Ordonez
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University, 1550 Orleans Street, CRB-II, Rm 1.09, Baltimore, MD, 21287, USA
- Center for Tuberculosis Research, Johns Hopkins University, Baltimore, MD, USA
- Department of Pediatrics, Johns Hopkins University, Baltimore, MD, USA
| | - Mariah H Klunk
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University, 1550 Orleans Street, CRB-II, Rm 1.09, Baltimore, MD, 21287, USA
- Center for Tuberculosis Research, Johns Hopkins University, Baltimore, MD, USA
- Department of Pediatrics, Johns Hopkins University, Baltimore, MD, USA
| | - Sanjay K Jain
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University, 1550 Orleans Street, CRB-II, Rm 1.09, Baltimore, MD, 21287, USA.
- Center for Tuberculosis Research, Johns Hopkins University, Baltimore, MD, USA.
- Department of Pediatrics, Johns Hopkins University, Baltimore, MD, USA.
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, MD, USA.
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Tetreault MW, Jacobs JJ, Mahmud W, Nam D. Adverse Local Tissue Reaction After a Metal-on-Metal Total Hip Prosthesis Without Elevated Serum Metal Ion Levels. Orthopedics 2018; 41:e438-e441. [PMID: 29257191 DOI: 10.3928/01477447-20171213-05] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 10/17/2017] [Indexed: 02/03/2023]
Abstract
In the 1990s, metal-on-metal (MoM) bearings were reintroduced in total hip arthroplasty (THA), having the proposed advantages of decreased wear and improved stability. However, catastrophic adverse local tissue reaction (ALTR) secondary to metal debris from both the bearing surface and the head-neck junction is a well-recognized complication. The measurement of metal ion levels in the serum is often a first-line test to identify failure of a MoM bearing. The authors describe a 70-year-old man who presented with a multiply revised MoM THA and a large periprosthetic fluid collection incidentally seen during computed tomography for renal nephrolithiasis. The patient reported painless, progressive swelling over the lateral aspect of the hip. An infectious workup including serum erythrocyte sedimentation rate, C-reactive protein, and intraarticular hip aspiration yielded negative results. Metal ion levels in the serum, including a minimally elevated cobalt level, were unremarkable, and metal-lymphocyte transformation testing yielded negative results. Radiographic imaging revealed progressive osteolysis around the proximal femur, and magnetic resonance imaging showed large fluid collections with irregular wall thickening surrounding the gluteal and iliopsoas musculature. At revision surgery, a large fluid collection and corrosion at the head-neck junction were present. Pathology specimens confirmed the presence of an ALTR. This report presents a previously undescribed case of an ALTR secondary to MoM THA in the absence of elevated serum metal ion levels. This indicates the necessity of considering all aspects of a patient's clinical presentation, imaging modalities, and laboratory testing in the evaluation and diagnosis of a symptomatic MoM THA. [Orthopedics. 2018; 41(3):e438-e441.].
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Slonimsky E, Kushnir T, Kadar A, Menahem A, Grundshtein A, Velekes S, Lidar M, Dekel S, Eshed I. Metal-on-Metal Hip Replacement: MRI Signal Intensities of Different Body Tissues and Their Relations to Blood Metal Ion Levels. Isr Med Assoc J 2017; 19:674-678. [PMID: 29185279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Metal-on-metal total hip prostheses (MoM-THR) have been shown to produce hypersensitivity reactions and fluid collection (pseudotumor) by the hip as well as high blood metal ions levels (BMILs). OBJECTIVES To evaluate the magnetic resonance imaging (MRI) signal-to-noise ratio (S/N) in selected body tissues around the hip of patients who underwent MoM hip replacement and to correlate to BMILs. METHODS Sixty-one MRI hip examinations in 54 post-MoM-THR patients (18 males, 36 females, mean age 65 years) were retrospectively evaluated independently by two readers. The mean S/N ratio in a region of interest was calculated for periprosthetic pseudotumor collection (PPC), the bladder, fat, and muscle on axial T1w, FSE-T2w, and short tau inversion recovery (STIR) sequences on the same location. BMILs were retrieved from patient files. RESULTS PPC was detected in 32 patients (52%) with an average volume of 82.48 mm3. BMIL did not correlate with the presence of PPCs but positively correlated with the PPC's volume. A trend for positive correlation was found between BMILs and S/N levels of STIR images for muscle and bladder as well as for PPC and cobalt levels. A trend for correlation was also seen between BMIL with PPC's T1 w S/N. CONCLUSIONS Alteration of MRI S/N for different hip tissues showed a tendency for correlation with BMILs, possibly suggesting that metal deposition occurs in the PPC as well as in the surrounding tissues and bladder.
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Affiliation(s)
- Einat Slonimsky
- Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv Israel
| | - Tammar Kushnir
- Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv Israel
| | - Assaf Kadar
- Department of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv Israel
| | - Aharon Menahem
- Department of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv Israel
| | - Alon Grundshtein
- Department of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv Israel
| | - Steven Velekes
- Department of Orthopedic Surgery, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel
| | - Merav Lidar
- Department of Orthopedic Surgery, Assuta Medical Center, Tel Aviv, Israel
| | - Shmuel Dekel
- Department of Orthopedic Surgery, Assuta Medical Center, Tel Aviv, Israel
| | - Iris Eshed
- Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv Israel
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Tasoulas J, Daskalopoulos A, Droukas C, Nonni A, Nikitakis NG. An unusual microscopic pattern of foreign body reaction as a complication of dry socket management. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 125:e118-e123. [PMID: 29104032 DOI: 10.1016/j.oooo.2017.08.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 08/06/2017] [Accepted: 08/09/2017] [Indexed: 10/19/2022]
Abstract
Foreign body reactions in the oral cavity are relatively common, frequently resulting from iatrogenic causes. Depending on the nature of the foreign material, various microscopic patterns may be observed, causing diagnostic difficulties. Recognition of the ensuing unusual microscopic pattern, especially for cases in which the possibility of a foreign body reaction is not entertained in the clinical differential diagnosis, necessitates sufficient degree of suspicion, familiarization with the spectrum of microscopic appearances, and careful clinicopathologic correlation. Medicated dressings of various compositions are commonly placed for prevention or management of dry socket (or alveolar osteitis, a common postoperative complication of tooth extraction) and may be a cause of foreign body reaction. Here, we report a foreign body reaction to a medical dressing material in a postextraction socket, with an unusual microscopic pattern bearing resemblance to parasitic infestation.
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Affiliation(s)
- Jason Tasoulas
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Argyrios Daskalopoulos
- Department of Oral Pathology and Medicine, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Afroditi Nonni
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos G Nikitakis
- Department of Oral Pathology and Medicine, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
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14
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Martinez-Lopez A, Pérez-Lopez I, Sánchez-Cano D, Ruiz-Villaverde R. Nódulos subcutáneos faciales de 3 meses de evolución. Dermatol Online J 2017; 23:13030/qt53p393n2. [PMID: 28329506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 02/16/2017] [Indexed: 06/06/2023] Open
Abstract
Siliconomas are subcutaneous nodules that usuallyappear as a consequence of the migration of freesilicon implanted in other locations. They are morefrequent in women with abnormal breast implants,such as poly implant prostheses (PIP), but they may alsoappear after illegal injection of free silicone. We reporta 57-year-old woman who attended our Dermatologyclinic complaining of relapsing facial panniculitis ofunknown origin. After a thorough work-up, thesenodules were determined to be the consequence ofdermal filler made with fluid silicone, which had beeninjected 20 years prior. High frequency skin ultrasoundof one of the nodules showed a hyperechoic image,also known as "snowstorm," which was located in thesubcutaneous tissue. The disposition of silicone in thisplane obscures the view of any sonographic structurein the underlying plane. Cutaneous sonographyhas become one of the most useful non-invasivetechniques in diagnosis of filler complications andother inflammatory diseases. Combined treatmentwith prednisone and allopurinol was successful, withno recurrence after 1 year of follow-up.
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15
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Arguto J, Manigot DA, Garzón D, Chaves DA. [Foreign body attached to the duodenal wall]. Medicina (B Aires) 2017; 77:129. [PMID: 28463220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Affiliation(s)
- Juan Arguto
- Hospital San Juan de Dios, Ramos Mejía, Argentina
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Abstract
Vacuum-assisted closure (VAC) system has become a widely used, efficacious, and overall safe method for managing many types of open wounds. The authors present a case of a rare but avoidable complication caused by a retained piece of sponge after VAC therapy™ (KCI Inc, San Antonio, TX). They emphasize the need for awareness and careful evaluation of the patient who receives VAC therapy to avoid diagnostic confusion and morbidity to the patient.
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Affiliation(s)
- Musab U Saeed
- Department of Infectious Diseases, Saint Louis University Hospital, St. Louis, MO, USA.
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17
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Willekens P, Verstraete K, Hollevoet N. Foreign body reaction after trapeziectomy and Dacron interposition. Hand Surg Rehabil 2016; 35:27-33. [PMID: 27117021 DOI: 10.1016/j.hansur.2015.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 11/04/2015] [Accepted: 11/06/2015] [Indexed: 11/19/2022]
Abstract
The purpose of this study was to evaluate patients who were treated with trapeziectomy and Dacron interposition in our hospital and to describe the incidence of foreign body reactions. Between 2004 and 2010, 10 women with trapeziometacarpal osteoarthritis underwent Dacron interpositional arthroplasty. One patient had surgery in both hands. Implants were removed in two patients, 5 and 8 years postoperatively. Histological analysis confirmed the presence of a foreign body reaction with giant cells in both cases. At a mean follow-up of 9 years, seven patients with the implant still in place were available for review and clinical examination. Mean DASH score was 32 and mean VAS for pain and satisfaction was 1.6 and 8.8, respectively. Mean grip strength was 11.4kg and mean key pinch strength was 1.5kg. Recent radiographs were available in nine hands. Seven out of nine hands had radiological signs of a foreign body reaction with bone erosion. A severe reaction occurred in three patients. We no longer use the Dacron implant and recommend careful monitoring of all patients in whom this implant has been used.
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Affiliation(s)
- Philippe Willekens
- Department of Orthopaedic Surgery and Traumatology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.
| | - Koenraad Verstraete
- Department of Radiology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.
| | - Nadine Hollevoet
- Department of Orthopaedic Surgery and Traumatology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.
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Kadouch JA, Tutein Nolthenius CJ, Kadouch DJ, van der Woude HJ, Karim RB, Hoekzema R. Complications After Facial Injections With Permanent Fillers: Important Limitations and Considerations of MRI Evaluation. Aesthet Surg J 2014; 34:913-23. [PMID: 24948821 DOI: 10.1177/1090820x14539504] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2014] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Soft-tissue fillers have become more prevalent for facial augmentation in the last 2 decades, even though complications of permanent fillers can be challenging to treat. An investigative imaging tool could aid in assessing the nature and extent of these complications when clinical findings are ambiguous. OBJECTIVES The authors analyzed the value of magnetic resonance imaging (MRI) in the assessment of delayed-onset complications after injection of patients with permanent fillers. METHODS Thirty-two patients with complications related to facial fillers were evaluated in this prospective cohort study. Their medical history was documented, and MRI was conducted before treatment of the complications. Radiologists were informed of the injection sites but were blinded to the results of other clinical evaluations. Levels of agreement between clinical and radiologic findings were calculated with the Jaccard similarity coefficient. RESULTS A total of 107 site-specific clinicoradiologic evaluations were analyzed. The level of agreement was assessed as strong for deposits without complications and noninflammatory nodules (combined 85%), moderate for abscesses (60%), fair for low-grade inflammations (32%), and slight for migrations (9%). Results from the MRI examinations aided in subsequent treatment decisions in 11% of cases. CONCLUSIONS Study results show that MRI may be useful for diagnosing complications associated with fillers that have migratory potential, for depiction of the extent of deposits before treatment, and for follow-up of low-grade inflammation and abscesses after surgery. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- Jonathan A Kadouch
- Dr J.A. Kadouch is a resident, Division of Dermatology, Free University Medical Center, Amsterdam, Netherlands
| | - Charlotte J Tutein Nolthenius
- Dr Tutein Nolthenius is a resident in a teaching hospital, Division of Radiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands
| | - Daniel J Kadouch
- Dr D.J. Kadouch is a resident, Division of Dermatology, Academic Medical Center, Amsterdam, Netherlands
| | - Henk-Jan van der Woude
- Dr van der Woude is a radiologist in a teaching hospital, Division of Radiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands
| | - Refaat B Karim
- Dr Karim is a plastic surgeon in private practice in Amstelveen, Netherlands
| | - Rick Hoekzema
- Dr Hoekzema is the Head of the Division of Dermatology, Free University Medical Center and Academic Medical Center, Amsterdam, Netherlands
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Waring TP, Hegde P, Foley RJ. Airbag lung: an unusual case of sarcoid-like granulomatous lung disease after a rollover motor vehicle accident. Conn Med 2014; 78:273-276. [PMID: 24974560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Sarcoid-like granulomatous lung disease (SLGLD) is a condition associated with the formation of noncaseating, nonnecrotizing granulomas. The final by-product of airbag deployment is alkaline silicates or glass. Silicates trapped and sequestered in the lung parenchyma are a potential mediator for immune system activation and development of sarcoid-like granulomatous lung disease.
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20
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Shafi M, Suhail Z, Ashrafi SKA, Sajjad SMQ. Frequency of tracheobronchial foreign bodies and their management in urban population of Sindh. J PAK MED ASSOC 2012; 62:896-899. [PMID: 23139971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To assess the common foreign bodies in urban areas of Sindh, and the presentation, problems and complications during their removal through rigid bronchoscopy. METHODS The descriptive study was conducted at the Ear, Nose and Throat Department and the Department of Head and Neck Surgery of Liaquat University Hospital, Hyderabad, and Abbasi Shaheed Hospital, Karachi, from April 2009 to October 2010. Fifty patients with strong suspicion of foreign body inhalation in whom rigid bronchoscopy was done were included in the study. A definitive diagnostic protocol was applied and rigid bronchoscopy was done to search and remove the foreign bodies. The data was fed into SPSS version 15 for descriptive analysis. RESULTS In our study,28(56%) cases were male and 22(44%) were female. The age range was 1-7 years. Most of the victims (n=21; 42%) were over 3 years of age. Commonest symptom of presentation was dyspnoea (n=34; 68%) and the commonest sign of presentation was decreased unilateral air entry (n=25; 50%). Most of the foreign bodies were impacted in the right main bronchus (n=26; 52%). The most retrieved foreign body was betel nut (n=23; 46%). The commonest complication of bronchoscopy was airway oedema which occurred in 13 (26%) patients. The successful removal of exogenous foreign body was achieved in 41 (82%), and the mortality rate was 3 (6%). CONCLUSION Delay in the diagnosis of foreign body inhalation translates into a higher risk of complications. Therefore, early bronchoscopy should be done on suspicion. Early recognition at both parental and clinical levels should be promoted through public awareness.
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Affiliation(s)
- Muhammad Shafi
- Department of ENT, Liaquat University of Medical & Health Sciences, Jamshoro, Hyderabad.
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21
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Huang CH, Chiang CC, Yan YH, Tsai TJ, Chen CY. Role of endoscopic sonography in the diagnosis of a fish bone perforation of the gastric wall resulting in a submucosal pseudotumor. J Clin Ultrasound 2011; 39:415-417. [PMID: 21739435 DOI: 10.1002/jcu.20817] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2010] [Accepted: 01/18/2011] [Indexed: 05/31/2023]
Abstract
We report the case of a 72-year-old woman with a fish bone-induced granulation tissue in the gastric wall that was initially diagnosed as a submucosal tumor by panendoscopy. High-frequency endoscopic ultrasonography identified the linear calcified fish bone embedded in a heterogeneous mass.
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Affiliation(s)
- Ching-Hsiu Huang
- Division of Gastroenterology, Department of Internal Medicine, Chia-Yi Christian Hospital, Chiayi, Taiwan
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22
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Ambartsumian AR. [Potential of ultrasound biomicroscopy in diagnosis of ocular trauma with intraocular metallic foreign bodies]. Vestn Oftalmol 2011; 127:29-33. [PMID: 21882637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A detailed analysis of ultrasound biomicroscopy (UBM) scanogramms of 4 patients with a history of trauma and signs of metallosis is performed. In all cases foreign body was found and its precise localization in relation to anterior segment structures was identified. The following changes were revealed and described: pathological changes of cornea, lens and its fibers, uveal tract in silent zone, zone of retinal periphery and secondary vitreous changes due to trauma itself and chemically active foreign body invasion and long persistence. UBM is recommended to be the part of examination algorithm in patients with penetrating ocular trauma and screening of latent metallosis.
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23
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Rajalingam R, Saluja SS, Sharma A, Mishra PK. Post cholecystectomy gossypiboma: a malignant masquerade. Am Surg 2011; 77:E94-E95. [PMID: 21679580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Rajesh Rajalingam
- Department of Gastrointestinal Surgery, GB Pant Hospital, New Delhi, India
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24
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Chen CY, Peng JP. Esophageal fish bone migration induced thyroid abscess: case report and review of the literature. Am J Otolaryngol 2011; 32:253-5. [PMID: 20434801 DOI: 10.1016/j.amjoto.2010.02.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2009] [Revised: 01/24/2010] [Accepted: 02/28/2010] [Indexed: 01/15/2023]
Abstract
A thyroid abscess is a rare condition, and it is so infrequently encountered. A migrated fish bone is a rare otolaryngologic emergency indicated when the foreign body penetrates through the esophageal mucosa into the thyroid gland space of the neck after several weeks of swallowing. We present the case of a 50-year-old woman who had fever and anterior neck painful mass. An intrathyroid abscess was diagnosed; and she underwent thyrotomy with transcervical approach. A foreign body, which proved to be a fish bone and which fortunately did not cause any adverse effects, was removed.
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Affiliation(s)
- Ching Yuan Chen
- Department of Otolaryngology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine,Kaohsiung, Taiwan
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25
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Tomaszewski A, Kutarski A, Tomaszewski M. [Fibrotic tissue reflecting lead course after percutaneous leads extraction]. Kardiol Pol 2011; 69:619-620. [PMID: 21678308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We present a case report of fibrotic tissue reflecting lead course after percutaneous pacemaker lead extraction.
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26
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Ghosh S, Akers S, Mittal A, Adrian D, Lipschik G, Grippi M. Images Dx. A case of "patchy" pneumonia. J Hosp Med 2010; 5:E14-5. [PMID: 20533588 DOI: 10.1002/jhm.662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Somnath Ghosh
- Pulmonary and Critical Care, Health Science Center, University of Texas, Houston, Texas, USA.
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27
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Huang BK, Hubeny CM, Dogra VS. Sonographic appearance of a retained tunneled catheter cuff causing a foreign body reaction. J Ultrasound Med 2009; 28:245-248. [PMID: 19168774 DOI: 10.7863/jum.2009.28.2.245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Affiliation(s)
- Brady K Huang
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA
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28
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Affiliation(s)
- Mousumi Bhaduri
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.
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29
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Hahn M, Kuner RP, Scheler P, Freidel K, Hoffmann G, Madjar H, Wallwiener D, Krainick-Strobel U. Sonographic criteria for the confirmation of implant rotation and the development of an implant-capsule-interaction ("interface") in anatomically formed textured breast implants with texturised Biocell-surface. Ultraschall Med 2008; 29:399-404. [PMID: 17610178 DOI: 10.1055/s-2007-963020] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
AIM In comparison to round breast implants, anatomically formed implants have a broader indication spectrum in augmentation surgery for the formation of a natural breast shape. In order to achieve a long-term result, it is necessary for anatomically formed breast implants to remain secured in the position desired and planned initially. In the case of textured implants of a certain pore size and depth, this can be aided by the development of a stabilising implant-capsule-interaction (interface). The aim of this study was to investigate whether there are sonographic criteria for verifying the position of anatomically formed breast implants and the development of a stable interface. MATERIAL AND METHODS 628 patients underwent breast implant surgery and were followed up clinically as well as sonographically at the Frauenklinik und Institut für Asthetische Chirugie am St. Josefs-Hospital, Wiesbaden. 228 implants (Style 410 Inamed McGhain) were evaluated after a mean of 27 months postoperatively. Only cosmetic augmentations were included in the results. Verification of the implant position was conducted by palpation as well as by sonography. Statistical analysis was performed using the McNemar-Test (Chi-squared test). RESULTS Two marker points on the anterior side of the implant capsule in the lower hemisphere, which are designed for intraoperative position monitoring by palpation, could be reproduced sonographically in all cases and the position of the breast implant could thereby by determined. Two cases of clinically apparent implant rotation of more than 90 degrees around the vertical axis were discovered in this way. The sonographical identification of the development of a stable interface between the implant and the periprosthetic capsule is possible when sonographic criteria of the "parasternal movement layer" are met. The sonographic outcome is significantly superior to palpation. CONCLUSION Breast sonography used for the clinical follow-up of patients with anatomically formed breast implants represents an efficient diagnostic supplement with clinical relevance.
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Affiliation(s)
- M Hahn
- Universitäts-Frauenklinik, Tübingen.
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30
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Meyer D, Schmid S, Müller J. [What is your diagnosis? Intra-abdominal abscess]. Praxis (Bern 1994) 2008; 97:826-828. [PMID: 18754334 DOI: 10.1024/1661-8157.97.15.826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- D Meyer
- Klinik für Urologie Kantonsspital, Gallen
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31
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Sarrabayrouse M, Mayer HF, Loustau HD. Gauzoma mimicking siliconoma after breast augmentation surgery. Aesthetic Plast Surg 2008; 32:692-4. [PMID: 18493819 DOI: 10.1007/s00266-008-9174-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2008] [Accepted: 04/21/2008] [Indexed: 11/30/2022]
Abstract
Gauzoma is a rare iatrogenic mass caused by the retention of gauze fibers during surgery. This intraoperative complication represents a diagnostic problem for radiologists besides being a medicolegal problem for surgeons. We present a patient in whom a retained surgical sponge after breast augmentation surgery mimicked a siliconoma and discuss imaging appearance and differential diagnosis.
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Affiliation(s)
- Manuel Sarrabayrouse
- Department of Plastic Surgery, Hospital Italiano de Buenos Aires, University of Buenos Aires, School of Medicine, Gascon 450, Buenos Aires, 1181, Argentina.
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32
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Park NH, Lee EJ, Kim MS, Park CS, Ryu JA. Sonographically guided excisional biopsy of small abdominal wall masses using vacuum-assisted biopsy device. J Clin Ultrasound 2008; 36:226-228. [PMID: 18088058 DOI: 10.1002/jcu.20436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
We report the case of a 37-year-old man who underwent excision of small benign abdominal wall masses using a vacuum-assisted biopsy device designed for breast biopsy (Mammotome). To our knowledge, this is the first application of such a device to remove a soft tissue mass other than a breast lesion.
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Affiliation(s)
- Noh Hyuck Park
- Department of Diagnostic Radiology, Kwandong University College of Medicine, Myongji Hospital, 697-24 Hwajung-dong, Koyang, Kyunggi-do 412-279, Korea
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Colak MC, Kocatürk H, Kiziltan F, Bayram E. Early detection of retained surgical sponge by the lateral chest radiography. Anadolu Kardiyol Derg 2008; 8:E6-E7. [PMID: 18258522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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34
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Kharrazi FD, Busfield BT, Khorshad DS, Hornicek FJ, Mankin HJ. Knee mass from severe metallosis after failure of a metal-backed patellar component total knee arthroplasty. Am J Orthop (Belle Mead NJ) 2008; 37:E38-E41. [PMID: 18401493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Abstract
We present foreign body granulomas induced by activated charcoal from intraperitoneal chemotherapy and mimicked peritoneal metastases in the patients with gastric cancer. On CT, they were manifested as a peritoneal mass or thickening with variable shapes, including oval, round, bizarre, linear and even a molded shape due to where they were lodged, such as the pelvis and paracolic gutter. All the lesions showed high attenuation relative to muscle on the precontrast CT and showed positive findings on PET/CT.
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Affiliation(s)
- Young Kon Kim
- Department of Diagnostic Radiology, Chonbuk National University Hospital and Medical School, Keum Am Dong, JeonJu, South Korea.
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36
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Abstract
Gossypiboma is composed of non-absorbable surgical material with a cotton matrix. Gossypiboma is usually under-reported and is a severe medicolegal issue. Thus, we describe the computed tomography (CT) findings of gossypiboma in our institution. From January 2003 to June 2006, gossypibomas diagnosed in our institution and their data regarding sex, age, previous operation, location, the interval between the operation and the diagnosis of gossypiboma, clinical presentation, indication of CT, CT findings and further management were collected. There were 6 cases of gossypiboma, 4 men and 2 women. Three of our cases had previous chest surgery and the other 3 cases had previous abdominal surgery. The locations of 3 (50%) cases were in the left anterior subphrenic space. The mean interval between original operation and diagnosis was 24.6 +/- 33.4 months (range, 17 days to 8 years). With regard to CT findings, 3 (50%) cases had an isodense mass and 3 (50%) had a typical mass containing curvilinear opaque structures. The mean size of the gossypibomas was 62 x 62 x 67 mm. Because gossypiboma is due solely to human factors and is a severe medicolegal issue, continuous education should be considered.
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Affiliation(s)
- Tzu-Chieh Cheng
- Department of Radiology, Cathay General Hospital, Taipei, Taiwan, R O C
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37
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Wedemeyer C, Xu J, Neuerburg C, Landgraeber S, Malyar NM, von Knoch F, Gosheger G, von Knoch M, Löer F, Saxler G. Particle-induced osteolysis in three-dimensional micro-computed tomography. Calcif Tissue Int 2007; 81:394-402. [PMID: 17952672 DOI: 10.1007/s00223-007-9077-2] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2007] [Accepted: 09/07/2007] [Indexed: 12/26/2022]
Abstract
Small-animal models are useful for the in vivo study of particle-induced osteolysis, the most frequent cause of aseptic loosening after total joint replacement. Microstructural changes associated with particle-induced osteolysis have been extensively explored using two-dimensional (2D) techniques. However, relatively little is known regarding the 3D dynamic microstructure of particle-induced osteolysis. Therefore, we tested micro-computed tomography (micro-CT) as a novel tool for 3D analysis of wear debris-mediated osteolysis in a small-animal model of particle-induced osteolysis. The murine calvarial model based on polyethylene particles was utilized in 14 C57BL/J6 mice randomly divided into two groups. Group 1 received sham surgery, and group 2 was treated with polyethylene particles. We performed 3D micro-CT analysis and histological assessment. Various bone morphometric parameters were assessed. Regression was used to examine the relation between the results achieved by the two methods. Micro-CT analysis provides a fully automated means to quantify bone destruction in a mouse model of particle-induced osteolysis. This method revealed that the osteolytic lesions in calvaria in the experimental group were affected irregularly compared to the rather even distribution of osteolysis in the control group. This is an observation which would have been missed if histomorphometric analysis only had been performed, leading to false assessment of the actual situation. These irregularities seen by micro-CT analysis provide new insight into individual bone changes which might otherwise be overlooked by histological analysis and can be used as baseline information on which future studies can be designed.
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Affiliation(s)
- Christian Wedemeyer
- Department of Orthopedics, University of Duisburg-Essen, Hufelandstr. 55, 45122 Essen, Germany.
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38
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Abstract
An 84-year-old gentleman developed an angiosarcoma in the lateral temporal fossa 60 years after a World War II injury. The tumour resection confirmed the close spatial relationship of the tumour and a shell splinter. Analysis of the metallic composition showed no clear carcinogenic potential of the ingredients; an inflammation-related carcinogenesis seems more probable. A review of the literature revealed two similar cases.
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Affiliation(s)
- T Teltzrow
- Abteilung für Mund-, Kiefer- und Gesichtschirurgie, Dorbaumstrasse 300, 48157 Münster, Germany.
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39
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Abstract
We report a case of a swallowed partial denture in a 51-year-old man who presented with progressive dysphagia, odynophagia, and fevers. Imaging studies were initially interpreted as supraglottitis with laryngeal inflammation, which was confirmed by direct visualization with flexible endoscopy. Despite appropriate therapy, the patient's symptoms persisted and rigid laryngoscopy was performed, which revealed a partial denture in the hypopharynx and upper esophagus. The subtle imaging appearance of a swallowed denture is discussed.
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Affiliation(s)
- A Haidary
- Department of Diagnostic Radiology, William Beaumont Hospital, Royal Oak, MI 48073, USA.
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40
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Nitsche T, Yousefpour A, Bainton R. Chronic orbital infection caused by migration of an orbital Silastic implant. Int J Oral Maxillofac Surg 2007; 37:90-2. [PMID: 17825528 DOI: 10.1016/j.ijom.2007.07.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2006] [Revised: 05/27/2007] [Accepted: 07/16/2007] [Indexed: 11/20/2022]
Abstract
A Silastic sheet was used for the repair of a lateral orbital wall defect in a 48-year-old man. Migration of this implant through the defect has caused recurrent episodes of orbital infection. Although migration of Silastic within the orbit has been reported previously, the absence of fixation together with further remodelling of the lateral orbital wall defect contributed to this phenomenon.
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Affiliation(s)
- T Nitsche
- Department of Oral/Maxillofacial and Head and Neck Surgery, University Hospital of North Staffordshire, Hartshill Road, Stoke-on-Trent ST4 7PA, United Kingdom.
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41
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Aydin H, Koçer B, Albayrak D, Dural K. Surgical removal of a migrated guidewire: a safe method. Anadolu Kardiyol Derg 2007; 7:327-8. [PMID: 17785230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Affiliation(s)
- Hakan Aydin
- Department of Thoracic and Cardiovascular Surgery, Ankara Numune Training and Research Hospital, Ankara, Turkey.
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42
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Koçyildirim E, Kanani M, Bonhoeffer P, Elliott MJ. Amplatzer device embolization: hazards of multiple attempts at catheter retrieval. Anadolu Kardiyol Derg 2007; 7:329-30. [PMID: 17785231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Affiliation(s)
- Ergin Koçyildirim
- Cardiothoracic Unit, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom.
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43
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Abstract
Retention of surgical sponges is rare. They cause either an aseptic reaction without significant symptoms or an exudative reaction which results in early but non-specific symptoms. Even if there are no studies which compare the diagnostic accuracy of the different imaging modalities, CT seems to be the most promising tool to diagnose foreign bodies. However, apart from radio-paque markers there are no specific signs for the existence of surgical sponges in CT. Therefore, an experienced radiologist is needed to differentiate foreign bodies from morphologically quite similar differential diagnoses such as abscess and haematoma.
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Affiliation(s)
- H A Wieder
- Institut für Röntgendiagnostik, Klinikum Rechts der Isar, Technische Universität, Ismaningerstrasse 22, 81675 Munich, Germany.
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44
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Walaszek I, Zyluk A. [Post-traumatic cyst of the scaphoid--a case report]. Chir Narzadow Ruchu Ortop Pol 2007; 72:215-217. [PMID: 17941586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Carpal bone cysts are very uncommon and they are usually occasionally diagnosed during radiological examination of the wrist after trauma. Some carpal bone cysts are symptomatic and then they are revealed on routine X-ray investigation. We present a case of 14 years old boy, in whom a scaphoid bone cyst developed around the foreign body (a splinter), stacked into the wrist when he fell on the wooden board. Because of pain, swelling and reduction of active range of motion of the wrist occurred at the load of the hand and lasted 3 months, patient was given radiological examination which was negative, and eventually CT scanning revealed a scaphoid bone cyst. Patient underwent operation: curettage of the lesion followed by filling of the bone defect with prepared allogenic bone. Histopathological examination of the contents of the cyst showed presence of wood piece, surrounded with granulomatic tissue and necrotic trabecular bone. This suggested a splinter stacked in the wrist at the primary injury to be a cause of cyst formation. Surgery resulted in complete recovery in 6 months.
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Affiliation(s)
- Ireneusz Walaszek
- Klinika Chirurgii Ogólnej i Chirurgii Reki, Pomorska Akademia Medyczna w Szczecinie
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45
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Başer M, Arslantürk H, Kisli E, Arslan M, Oztürk T, Uygan I, Kotan C. Primary aortoduodenal fistula due to a swallowed sewing needle: a rare cause of gastrointestinal bleeding. ULUS TRAVMA ACIL CER 2007; 13:154-7. [PMID: 17682960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
A primary fistula between the abdominal aorta and the duodenum is rare and usually fatal. Atherosclerosis remains the most common etiologic factor, accounting for more than two-thirds of the cases reported. Other etiologies include carcinoma, ulcers, radiation, aortitis and foreign bodies including sewing needle, cocktail stick, open safety pin and fishbone. We report a case of a 17 year-old girl who underwent surgical treatment because of severe upper gastrointestinal bleeding which was related to an aortoduodenal fistula caused by a swallowed sewing needle. At operation, a chronic aortoduodenal fistula that contained the sewing needle was found and repaired. This is the fourth case in the literature in which a needle was found to be associated with the development of an aortoenteric fistula.
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Affiliation(s)
- Murat Başer
- Department of General Surgery, Medicine Faculty of Yüzüncü Yil University, Van, Turkey
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46
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Pryde D. Re: the ongoing importance of plain film interpretation. Australas Radiol 2007; 51:201-2. [PMID: 17419872 DOI: 10.1111/j.1440-1673.2007.01710.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
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47
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Abstract
A 48-year-old patient reported pain in her face and neck. Within 10 years she had undergone three "golden thread lift" suspension procedures, the last one 2 years previously. Skull radiographs showed complete fragmentation of all the implants into small pieces, and a total loss of their vector orientation.
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Affiliation(s)
- G Björn Stark
- Department of Plastic Hand and Surgery and Erich-Lexer-Klinik, University of Freiburg Medical Centre, Hugstetterstrasse 55, D-79106 Freiburg, Germany.
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48
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Crundwell N, O'Donnell P, Saifuddin A. Non-neoplastic conditions presenting as soft-tissue tumours. Clin Radiol 2007; 62:18-27. [PMID: 17145259 DOI: 10.1016/j.crad.2006.08.007] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2006] [Revised: 07/28/2006] [Accepted: 08/02/2006] [Indexed: 12/27/2022]
Abstract
Review of referrals to our unit over the last 7 years showed that of approximately 750 cases referred as soft-tissue tumours, 132 were subsequently diagnosed as non-neoplastic lesions. The imaging characteristics of these lesions are presented to differentiate them from neoplasms. The most common diagnoses were myositis ossificans, ganglion cyst, abscess/infection, bursitis and synovitis. The imaging features of other rarer conditions will also be discussed.
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Affiliation(s)
- N Crundwell
- Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK
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49
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Tung CH, Chen YH, Lan HHC, Hsieh TY, Chen DY, Lan JL. Diagnosis of plant-thorn synovitis by high-resolution ultrasonography: a case report and literature review. Clin Rheumatol 2007; 26:849-51. [PMID: 17273812 DOI: 10.1007/s10067-006-0482-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2005] [Revised: 09/05/2005] [Accepted: 09/09/2005] [Indexed: 12/01/2022]
Abstract
Plant-thorn synovitis is an uncommon cause of arthritis and has not been reported in Asian countries. Zanthoxylum ailanthoides, an aromatic plant distributed in East Asia, is used as a spice in Taiwan. We reported a case of acute monoarthritis over the third metacarpo-phalangeal joint of the right hand after an injury by the thorn of the Zanthoxylum ailanthoides. A thorn foreign body of 2.7 mm in length was detected in the joint by high-resolution ultrasonography and led to a surgical synovectomy. The patient recovered completely after synovectomy. Plant-thorn synovitis is easily negligible. Early diagnosis is difficult and frequently delayed. The removal of thorn by synovectomy is the only curative treatment for plant-thorn synovitis. Compared to CT and MRI, ultrasonography is inexpensive, nonradioactive, repeatable, and easily accessible. It could detect foreign bodies that are smaller than 0.5 mm. High-resolution ultrasonography is a useful tool for detecting plant thorn and could promote early diagnosis.
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Affiliation(s)
- Chien-Hsueh Tung
- Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, N.160, Chung-Kang Road, Sec. 3, Taichung, 407, Taiwan
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50
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Kohn D, Pape D. Extensive intrapelvic granuloma formation caused by ceramic fragments after revision total hip arthroplasty. J Arthroplasty 2007; 22:293-6. [PMID: 17275651 DOI: 10.1016/j.arth.2006.01.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2004] [Revised: 04/14/2005] [Accepted: 01/09/2006] [Indexed: 02/01/2023] Open
Abstract
Ceramic debris embedded in a polyethylene liner was identified as the cause for rapid metal wear after revision total hip arthroplasty when a broken ceramic head was replaced by a metal head. Removal of an intrapelvic foreign body granuloma and rerevision hip arthroplasty had to be performed within 2 years after the first revision.
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Affiliation(s)
- Dieter Kohn
- Department of Orthopaedic Surgery, Saarland University Medical Center, Homburg, Germany
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