Tantinikorn, Weerachai; Uiprasertkul, Mongkol; Assanasen, Paraya
Nasal granuloma gravidarum is a rare condition associated with pregnancy and minor trauma. This condition presents with a nasal mass with varying degree of bleeding and obstruction. We report a patient with nasal granuloma gravidarum in the third trimester of pregnancy. Surgical excision is the definite treatment for this condition in order to stop the vicious cycle of recurrent massive bleeding. Possible etiology, clinical features and management are discussed.
Wynne, Janna; Klause, Stephen; Stadler, Cynthia K; Pye, Geoffrey W; Meyer, Wieland; Sykes, Jane E
A 3-yr-old female koala (Phascolarctos cinereus) was diagnosed with a nasal sinus granuloma caused by Cryptococcus gattii after a pre-shipment examination revealed a latex cryptococcal agglutination titer of 1:512. Successful medical and surgical treatment of the granuloma was monitored using serial latex cryptococcal agglutination titers, serum levels of antifungal drugs, and advanced imaging.
Plattner, Brandon L; Doyle, Robert T; Hostetter, Jesse M
The characteristic lesion in bovine tuberculosis is well-organized respiratory granulomas. This is typically associated with a strong T-helper 1 biased cell-mediated immune response and eventual containment of the infection. In bovine paratuberculosis, the classic lesion is unorganized granulomatous intestinal inflammation. Clinical paratuberculosis is associated with a T-helper 2 biased humoral immune response and eventual death because of inability of the host to contain the infection. Recent reports have suggested that gamma-delta (gammadelta) T cells play a significant role in granuloma development and/or maintenance during initial stages of infection and may influence the subsequent adaptive immune response. The objective of this study was to use an in vivo bovine model to evaluate gammadelta T cells during the early host immune response to mycobacterial infection. We used immunofluorescent staining, hyperspectral microscopy, and computerized assisted morphometry to evaluate staining and distribution of gammadelta T cells during development of organized and unorganized granulomas. Our data suggest that bovine gammadelta T cell subsets are differentially recruited to early infection sites, and may be instrumental during the initial antimycobacterial host immune response as well as for granuloma organization.
Silim, A.; Elazhary, M.A.S.Y.
Nasal epithelial cells were collected by cotton swabs for the diagnosis in experimental and field cases of infectious bovine rhinotracheitis and field cases of bovine viral diarrhea in calves. A portion of the cells was washed twice in phosphate buffered saline and a 25 µL drop was placed on microscope slides. The cells were dried, fixed and stained according to the direct fluorescent antibody technique. Another portion of the same specimen was inoculated onto primary bovine skin cell cultures for virus isolation. In the experimental studies for infectious bovine rhinotracheitis, 29/35 specimens were positive by fluorescent antibody technique and 32/35 by cell culture and in the field cases, 22/119 were positive by fluorescent antibody technique and 19/119 by cell culture. In the field cases of bovine viral diarrhea, 28/69 samples were positive by fluorescent antibody technique and 14/69 by cell culture. When fluorescent antibody technique was performed on inoculated cell cultures a total of 24/69 specimens were positive for bovine viral diarrhea. The sensitivity of fluorescent antibody technique was thus comparable to that of cell culture method for infectious bovine rhinotracheitis and bovine viral diarrhea. ImagesFig. 1.Fig. 2.Fig. 3. PMID:6299484
Fabiana Q. Mayer
Full Text Available ABSTRACT: Bovine tuberculosis (bTB is a zoonosis causing economic losses and public health risks in many countries. The disease diagnosis in live animals is performed by intradermal tuberculin test, which is based on delayed hypersensitivity reactions. As tuberculosis has complex immune response, this test has limitations in sensitivity and specificity. This study sought to test an alternative approach for in vivo diagnosis of bovine tuberculosis, based on real-time polymerase chain reaction (PCR. DNA samples, extracted from nasal swabs of live cows, were used for SYBR® Green real-time PCR, which is able to differentiate between Mycobacterium tuberculosis and Mycobacterium avium complexes. Statistical analysis was performed to compare the results of tuberculin test, the in vivo gold standard bTB diagnosis method, with real-time PCR, thereby determining the specificity and sensitivity of molecular method. Cervical comparative test (CCT was performed in 238 animals, of which 193 had suitable DNA from nasal swabs for molecular analysis, as indicated by amplification of glyceraldehyde-3-phosphate dehydrogenase (GAPDH gene, and were included in the study. In total, 25 (10.5% of the animals were CCT reactive, of which none was positive in the molecular test. Of the 168 CCT negative animals, four were positive for M. tuberculosis complex at real time PCR from nasal swabs. The comparison of these results generated values of sensitivity and specificity of 0% and 97.6%, respectively; moreover, low coefficients of agreement and correlation (-0.029 and -0.049, respectively between the results obtained with both tests were also observed. This study showed that real-time PCR from nasal swabs is not suitable for in vivo diagnosis of bovine tuberculosis; thus tuberculin skin test is still the best option for this purpose.
Full Text Available Plasma cells are medium-sized round-to-oval cells with eccentrically placed nuclei, usually found in the red pulp of the spleen, tonsils, medulla of the lymph nodes, nasal mucosa, upper airway, lamina propria of the gastrointestinal tract, and sites of inflammation. Plasma cell granuloma is a rare reactive tumor-like proliferation composed chiefly of plasmacytic infiltrate. Here, we present a case of plasma cell granuloma of lip in a female patient.
Full Text Available For the generation of cell-based therapeutic products, it would be preferable to avoid the use of animal-derived components. Our study thus aimed at investigating the possibility to replace foetal bovine serum (FBS with autologous serum (AS for the engineering of cartilage grafts using expanded human nasal chondrocytes (HNC. HNC isolated from 7 donors were expanded in medium containing 10% FBS or AS at different concentrations (2%, 5% and 10% and cultured in pellets using serum-free medium or in Hyaff®-11 meshes using medium containing FBS or AS. Tissue forming capacity was assessed histologically (Safranin O, immunohistochemically (type II collagen and biochemically (glycosaminoglycans -GAG- and DNA. Differences among experimental groups were assessed by Mann Whitney tests. HNC expanded under the different serum conditions proliferated at comparable rates and generated cartilaginous pellets with similar histological appearance and amounts of GAG. Tissues generated by HNC from different donors cultured in Hyaff®-11 had variable quality, but the accumulated GAG amounts were comparable among the different serum conditions. Staining intensity for collagen type II was consistent with GAG deposition. Among the different serum conditions tested, the use of 2% AS resulted in the lowest variability in the GAG contents of generated tissues. In conclusion, a low percentage of AS can replace FBS both during the expansion and differentiation of HNC and reduce the variability in the quality of the resulting engineered cartilage tissues.
Oma, Veslemøy Sunniva; Klem, Thea; Tråvén, Madeleine; Alenius, Stefan; Gjerset, Britt; Myrmel, Mette; Stokstad, Maria
In order to prevent spread of the endemic pathogens bovine coronavirus (BCoV) and bovine respiratory syncytial virus (BRSV) between herds, knowledge of indirect transmission by personnel and fomites is fundamental. The aims of the study were to determine the duration of viral RNA carriage and the infectivity of viral particles on fomites and human nasal mucosa after exposure to BCoV and BRSV. During two animal infection experiments, swabs were collected from personnel (nasal mucosa) and their clothes, boots and equipment after contact with calves shedding either virus. Viral RNA was quantified by RT-qPCR or droplet digital RT-PCR (RT-ddPCR), and selected samples with high levels of viral RNA were tested by cell culture for infectivity. For BCoV, 46% (n = 80) of the swabs from human nasal mucosa collected 30 min after exposure were positive by RT-qPCR. After two, four and six hours, 15%, 5% and 0% of the swabs were positive, respectively. Infective virions were not detected in mucosal swabs (n = 2). A high viral RNA load was detected on 97% (n = 44) of the fomites 24 h after exposure, and infective virions were detected in two of three swabs. For BRSV, 35% (n = 26) of the human nasal mucosa swabs collected 30 min after exposure, were positive by RT-ddPCR, but none were positive for infective virions. Of the fomites, 89% (n = 38) were positive for BRSV RNA 24 h after exposure, but all were negative for infective viruses. The results indicate that human nasal mucosa can carry both BCoV and BRSV RNA after exposure to virus shedding calves, but the carriage seems short-lived and the transmission potential is likely limited. High viral loads on contaminates fomites 24 h after exposure to infected animals, and detection of infective BCoV, indicate that contaminated fomites represent a significant risk for indirect transmission between herds.
Moore, S Jo; O'Dea, Mark A; Perkins, Nigel; O'Hara, Amanda J
The prevalence of organisms known to be associated with bovine respiratory disease (BRD) was investigated in cattle prior to export. A quantitative reverse transcription polymerase chain reaction assay was used to detect nucleic acids from the following viruses and bacteria in nasal swab samples: Bovine coronavirus (BoCV; Betacoronavirus 1), Bovine herpesvirus 1 (BoHV-1), Bovine viral diarrhea virus 1 (BVDV-1), Bovine respiratory syncytial virus (BRSV), Bovine parainfluenza virus 3 (BPIV-3), Histophilus somni, Mycoplasma bovis, Mannheimia haemolytica, and Pasteurella multocida. Between 2010 and 2012, nasal swabs were collected from 1,484 apparently healthy cattle destined for export to the Middle East and Russian Federation. In addition, whole blood samples from 334 animals were tested for antibodies to BoHV-1, BRSV, BVDV-1, and BPIV-3 using enzyme-linked immunosorbent assay. The nasal prevalence of BoCV at the individual animal level was 40.1%. The nasal and seroprevalence of BoHV-1, BRSV, BVDV-1, and BPIV-3 was 1.0% and 39%, 1.2% and 46%, 3.0% and 56%, and 1.4% and 87%, respectively. The nasal prevalence of H. somni, M. bovis, M. haemolytica, and P. multocida was 42%, 4.8%, 13.4%, and 26%, respectively. Significant differences in nasal and seroprevalence were detected between groups of animals from different geographical locations. The results of the current study provide baseline data on the prevalence of organisms associated with BRD in Australian live export cattle in the preassembly period. This data could be used to develop strategies for BRD prevention and control prior to loading. © 2014 The Author(s).
Full Text Available Annular elastolytic giant cell granuloma is a condition characterized histologically by damaged elastic fibers associated with preponderance of giant cells along with absence of necrobiosis, lipid, mucin, and pallisading granuloma. It usually occurs on sun-damaged skin and hence the previous name actinic granuloma. A similar process occurs on the conjunctiva. Over the past three decades only four cases of conjunctival actinic granuloma have been documented. All the previous patients were females with lesions in nasal or temporal bulbar conjunctiva varying 2-3 mm in size. We report a male patient aged 70 years presenting with a 14 mm × 7 mm fleshy mass on right lower bulbar conjunctiva. Clinical differential diagnoses were lymphoma, squamous cell carcinoma in situ and amyloidosis. Surgical excision followed by histopathology confirmed it to be a case of actinic granuloma. This is the first case of isolated conjunctival actinic granuloma of such a large size reported from India.
Almada, Cinthya Bessa da Motta; Fonseca, Debora Rodrigues; Vanzillotta, Rachel Rego; Pires, Fábio Ramôa
Cholesterol granuloma (CG) is a foreign body reaction to the deposition of cholesterol crystals, usually found in association to chronic middle ear diseases, being highly uncommon in the paranasal sinuses. This article reports a case of CG in the maxillary sinus of a 22-year-old man, manifesting as a swelling on the right maxilla associated with pain and nasal obstruction. Computed tomography (CT) imaging showed complete opacification of the right maxillary sinus with cortical bone expansion ...
Full Text Available Granuloma annulare is a benign, asymptomatic, relatively common, often self-limited chronic granulomatos disorder of the skin that can affect both children and adults. The primary skin lesion usually is grouped papules in an enlarging annular shape, with color ranging from flesh-colored to erythematous. The two most common types of granuloma annulare are localized, which typically is found on the lateral or dorsal surfaces of the hands and feet; and disseminated, which is widespread. Rarely, familial cases of granuloma annulare has been reported. Herein, we report two sisters with annular papules and plaques diagnosed as granuloma annulare with the clinical and pathological findings. [J Contemp Med 2015; 5(3.000: 189-191
Fontan, E; Fauve, R M; Hevin, B; Jusforgues, H
Earlier studies have shown that from subcutaneous talc-induced granuloma in mice, a fraction could be extracted that fully protected mice against Listeria monocytogenes. Using standard biochemical procedures--i.e., ammonium sulfate fractionation, preparative electrophoresis, gel filtration chromatography, isoelectric focusing, and preparative polyacrylamide gel electrophoresis--we have now purified an active factor to homogeneity. A single band was obtained in NaDodSO4/polyacrylamide gel with an apparent Mr of 55,000. It migrated with alpha 1-globulins and the isoelectric point was 5 +/- 0.1. The biological activity was destroyed with Pronase but not with trypsin and a monospecific polyclonal rabbit antiserum was obtained. The intravenous injection of 5 micrograms of this "mouse granuloma protein" fully protects mice against a lethal inoculum of L. monocytogenes. Moreover, after their incubation with 10 nM mouse granuloma protein, mouse peritoneal cells became cytostatic against Lewis carcinoma cells.
Amitkumar B Pandav
Full Text Available Plasma cell granuloma, also known as inflammatory pseudotumor is a tumor-like lesion that manifests primarily in the lungs. But it may occur in various other anatomic locations like orbit, head and neck, liver and rarely in the oral cavity. We here report an exceedingly rare case of gingival plasma cell granuloma in a 58 year old woman who presented with upper gingival polypoidal growth. The histopathological examination revealed a mass composed of proliferation of benign spindle mesenchymal cells in a loose myxoid and fibrocollagenous stroma along with dense infiltrate of chronic inflammatory cells predominantly containing plasma cells. Immunohistochemistry for kappa and lambda light chains showed a polyclonal staining pattern confirming a diagnosis of plasma cell granuloma.
Kumar, Sandeep; Singh, G N
Midline Granuloma is a very uncommon disease characterised by localised inflamation, destruction and often mutilations of the tissues of the upper respiratory tract and face. This unique case is being reported for its rarity having the complete destruction of the external nose and part of the upper lip.
Full Text Available A 35-years-old female patient had generalized pruritic papular lesions, distributed like dermatitis herpetiformis for last 4 years. Histopathologic changes were typical of granuloma annulare with negative results of direct immunofluorescence. The patient did not have association of diabetes mellitus or any other systemic disease. She failed to respond to dapsone therapy and 13-cis-retinoic acid.
Full Text Available Aim: This study was conducted to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA in cattle and buffalo and to study their antibiotic resistance pattern. Materials and Methods: A total of 136 samples (skin and nasal swab from cattle and buffalo were collected. MRSA was identified by conventional bacterial culture techniques which were further confirmed by amplification of S. aureus-specific 16S rRNA by polymerase chain reaction (PCR. The isolates were further analyzed for the presence of mecA gene by PCR. The antimicrobial susceptibility profiling was performed by disc diffusion method. Results: The prevalence of MRSA in the current study was 28.57% and 34.28% in cattle nasal and skin swab, respectively, with an overall prevalence of 31.43% MRSA among cattle. Buffalo nasal and skin sample showed MRSA prevalence of 54.55% and 39.4%, respectively, with 46.9% overall prevalence. PCR could detect mecA gene in 36.4% and 58% MRSA isolates from cattle and buffalo, respectively. Antimicrobial susceptibility test found MRSA resistant to penicillin and oxytetracycline (88% each, cefoxitin (75%, cotrimoxazole (62%, and amoxyclav (50%. 100% sensitivity was observed against ciprofloxacin, amikacin, chloramphenicol, and gentamicin. Three (16.7% MRSA isolates from buffalo were found resistant to vancomycin. Conclusion: Cattle and buffalo were identified as a potential carrier of MRSA in Bihar (India. The isolation of vancomycinresistant S. aureus (VRSA in the current study indicates the emergence of VRSA in animal population which may be transmitted to the human beings working in close contact to the animals.
Bercier, Marjorie; Wynne, Janna; Klause, Stephen; Stadler, Cynthia K; Gorow, April; Pye, Geoffrey W
Nasal masses in the koala (Phascolarctos cinereus) are not uncommon and can be challenging to diagnose and treat. Differential diagnoses for nasal masses in the koala are cryptococcal granulomas, nasal polyps, nasal adenocarcinoma, and osteochondromatosis. This report describes successful surgical approaches for two adult koalas with nasal masses and includes photodocumentation and description of the anatomy of the koala nasal passages from the postmortem transverse sectioning of a normal koala head. Surgical removal of the nasal masses in these koalas resulted in a rapid resolution of clinical signs.
Fontan, E; Fauve, R M; Hevin, B; Jusforgues, H
Earlier studies have shown that from subcutaneous talc-induced granuloma in mice, a fraction could be extracted that fully protected mice against Listeria monocytogenes. Using standard biochemical procedures--i.e., ammonium sulfate fractionation, preparative electrophoresis, gel filtration chromatography, isoelectric focusing, and preparative polyacrylamide gel electrophoresis--we have now purified an active factor to homogeneity. A single band was obtained in NaDodSO4/polyacrylamide gel with...
Comparison of interferon and bovine herpesvirus-1-specific IgA levels in nasal secretions of dairy cattle administered an intranasal modified live viral vaccine prior to calving or on the day of calving.
Cortese, Victor S; Woolums, Amelia; Hurley, David J; Berghaus, Roy; Bernard, John K; Short, Thomas H
Thirty-two Holstein cows were allocated to receive intranasal vaccination with modified live bovine herpesvirus-1 (BHV-1), bovine respiratory syncytial virus (BRSV) and parainfluenza type 3 virus (PI3V) vaccine either two weeks prior to their projected calving date, or within 24h after calving. Nasal secretions were collected twice at a 12-h interval on the day prior to vaccination (day 0) and at 2, 4, 7, 10 and 14days post vaccination to measure interferon (IFN) alpha, IFN-beta, IFN-gamma, and BHV-1-specific IgA by ELISA. Serum neutralizing antibody titers to BHV-1 and BRSV were measured on days 0, 7, and 14. There was a significant treatment effect (p<0.0004) and interaction (p<0.05) on nasal BHV-1 IgA levels, with higher IgA levels in cows vaccinated within 24h after calving. There was a significant treatment effect on nasal IFN-gamma concentration (p<0.05) and on nasal total IFN concentration (p<0.05), with higher IFN-gamma and total IFN concentrations seen in cows vaccinated within 24h after calving. There was no significant treatment or interaction effect on nasal IFN-alpha or IFN-beta concentrations, or on serum neutralizing titers to BRSV. In spite of prior viral vaccination during the previous lactation, cows vaccinated on the day of calving responded to an intranasal viral vaccination with increased concentrations of IFN-gamma and increased titers of IgA following vaccination which was significantly higher than cows vaccinated precalving. This study is the first to examine respiratory mucosal responses in immunologically mature dairy cattle vaccinated intranasally before and after calving. Copyright © 2017. Published by Elsevier B.V.
Jul 15, 1989 ... Destructive and deforming lesions involving the external geni- talia may be caused by carcinoma, tuberculosis, lymphogranu- loma venereum, amoebiasis and granuloma inguinale. Such cases have become increasingly rare in the antibiotic era. Granuloma inguinale has been recognised in South Africa at.
Terao, Akira; Kobayashi, Takeo; Ushijima, Tatsujiro; Yoshioka, Hirohide; Kogure, Takashi
A case of Vernet's syndrome due to thoriumdioxide (Thorotrast) granuloma of the neck was presented. A patient, 65-year-old male, had a history of a machinegun wound in the head since 1939 during World War II. For the purpose of cerebral angiography, Thorotrast was injected into the carotid artery on the right side in 1940. In 1960, hoarseness, difficulty swallowing and hypersalivation appeared. Physical examination revealed diffuse firm atrophy of the right neck muscles, the paralyzed right vocal cord and hemiglossoplegia. The soft palate was immobilized on the same side. An x-ray film of the neck demonstrated an irregular density extending from the base of the skull to the right clavicle. These findings suggested the accidental extravasation of Thorotrast at the time of carotid angiography. (author)
Cholesterol granuloma is a chronic inflammatory reaction to cholesterol deposition. It may develop in variety of sites including middle ear, mastoid process, para nasal sinuses, mediastinum, breast, testis and kidney. But endometrial cholesterol granuloma is a rarely reported case and is usually presented clinically as pyometra. This article reports a case of cholesterol granuloma in the endometrium associated with prolapsed uterus. In this case the patient clinically presented with urinary retention and overflow incontinence of urine. The reason of acute urinary retention in this case was pelvic fibrosis and adhesion secondary to this chronic inflammatory reaction. This was supported by the presence of pus like yellowish material over the uterine surface and pelvic adhesion, noted during surgery. Endometrial biopsy revealed cholesterol granuloma that confirmed the source of chronic inflammatory reaction and pelvic fibrosis. PMID:27134881
Full Text Available Primary nasal tuberculosis is a rare disease with nearly 40 cases reported. Our patient was a young male presented with left sided nasal obstruction, anosmia and occasional epistaxis for last 7 weeks after 6 months of blunt trauma nose. Contrast enhanced computed tomography of the para nasal sinuses showed increased soft-tissue density with contrast enhancement in the left maxillary antrum with extension through left osteomeatal foramen to the left nasal cavity along with further extension through choana to nasopharynx resulting in partial obliteration of the nasopharyngeal airway. Nasal endoscopy revealed a sessile polypoidal pinkish mass arising from the left osteomeatal foramen. Histopathological examination of excisional biopsy of that area showed caseating granuloma. Our patient diagnosed as primary nasal tuberculosis following trauma and treated with anti-tubercular chemotherapy.
Babalola, Olubukola; Zhang, Jessica; Kristjansson, Arni; Whitaker-Worth, Diane; McCusker, Meagen
Granuloma faciale (GF) is an unusual, treatment-resistant skin disorder that commonly affects the face. Several medical and surgical interventions are available that offer varying degrees of benefit. Both the condition and the treatment modalities can lead to significant disfigurement. The use of oral dapsone in the treatment of GF has been described in the literature, but there are no reports, to our knowledge, of the use of topical dapsone 5% gel (Aczone; Allergan Inc, Irvine, CA). We present a case of a patient with GF on the nasal tip successfully treated with topical dapsone.
Fauci, A.S.; Johnson, R.E.; Wolff, S.M.
During a 15-year period, 10 patients with well-documented midline granuloma were treated with high-dose, deep local irradiation and followed for extended periods of time. Long-term remissions were achieved in 7 patients, with a mean (+- SEM) survival postirradiation of 7.4 (+-1.4) years in the 6 patients still alive. True midline granuloma, which is a localized, destructive, inflammatory process of the upper airways, can be distinguished from Wegener's granulomatosis and neoplasms of the upper respiratory tract by several clinicopathologic criteria. The cause of midline granuloma is unknown, but it most likely represents an abnormal accelerated hypersensitivity reaction to an unknown antigen(s). Although serious complications of high-dose local irradiation to the upper airways can occur, the risk is warranted because of the high, long-term remission rate in this previously uniformly fatal disease.
Jordan M. Virbalas
Full Text Available Background. LCH is a benign vascular growth of the skin and mucous membranes commonly affecting the head and neck. Since it was first described in the nineteenth century, this entity has been variously known as “human botryomycosis” and “pyogenic granuloma.” The shifting nomenclature reflects an evolving understanding of the underlying pathogenesis. We review the histopathology of and current epidemiological data pertaining to LCH which suggests that the development of these lesions may involve a hyperactive inflammatory response influenced by endocrine factors. We report two new cases of pediatric lobular capillary hemangioma (LCH of the nasal cavity and review current theories regarding the etiology, diagnosis, and treatment of nasal LCH. Methods. Retrospective case series. Case Series. Two adolescent females presented with symptoms of recurrent epistaxis, nasal obstruction, and epiphora. Both patients underwent computed tomography imaging and biopsy of their intranasal mass. The tumors were excised using image-guided transnasal endoscopic technique. Seven other cases of nasal LCH have been reported to date in the pediatric population. Conclusion. Nasal LCH is a rare cause of an intranasal mass and is associated with unilateral epistaxis, nasal obstruction, and epiphora. We advocate for image-guided endoscopic excision of LCH in the adolescent population.
alveolar bone. Involvement of other bones is ruled out by nucleotide imaging study. CONCLUSION: EG should be considered as a differential diagnosis whenever there is ... KEYWORDS: Eosinophilic granuloma, langerhans cell histiocytosis, oral manifestations, alveolar bone .... enough to initiate healing and spontaneous.
East African Medical Journal Vol. 80. No. 7 July 2003. MIDLINE LETHAL GRANULOMA COMPLICATING PREGNANCY: CASE REPORT. B.D.O. Saheeb, BDS, FWACS, FICS, FDS, RCS (Edin) Senior Lecturer/Consultant, and M.A. Ojo, BDS, MMed Sc, Dip Maxfac Rad, Associate Professor/Consultant. Department of oral ...
Apr 16, 1983 ... Packer H, Goldberg J. Studies of the antigenic ~~IationshipofD. granulomaris to members ofrhe tribe Escherichieae. Am] Syph 1950; 34: 342-350. 9. Hart G. Granuloma inguinale (donovanosis). In: Wehrle PF, Frankling HT, eds. Communicable Diseases. 9th ed. St Louis: CV Mosby, 1981: 295-299. 10. Lal S ...
Apr 16, 1983 ... Summary. Granuloma inguinale is a chronic specific infection ... These changes consisted of granulation tissue heavily infiltrated ... home. She has not been seen since. Case 3. A 19-vear-old Black woman, who was 32 weeks pregnant, had large ul~ers which had been present for 2 years on either side of.
... Anatomy Virtual Anatomy Disclosure Statement Printer Friendly Nasal Physiology Jeremiah A. Alt, MD, PhD Noam Cohen, MD, ... control the inflammation. CONCLUSION An understanding of the physiology of the nose is critical to understand nasal ...
... the way to your throat as you breathe. Cancer of the nasal cavity and paranasal sinuses is ... be like those of infections. Doctors diagnose nasal cancer with imaging tests, lighted tube-like instruments that ...
Kransdorf, M.J.; Murphey, M.D.; Temple, H.T.
Objective. Granuloma annulare is an uncommon benign inflammatory dermatosis characterized by the formation of dermal papules with a tendency to form rings. There are several clinically distinct forms. The subcutaneous form is the most frequently encountered by radiologists, with the lesion presenting as a superficial mass. There are only a few scattered reports of the imaging appearance of this entity in the literature. We report the radiologic appearance of five cases of subcutaneous granuloma annulare. Design and patients. The radiologic images of five patients (three male, two female) with subcutaneous granuloma annulare were retrospectively studied. Mean patient age was 6.4 years (range, 2-13 years). The lesions occurred in the lower leg (two), foot, forearm, and hand. MR images were available for all lesions, gadolinium-enhanced imaging in three cases, radiographs in four, and bone scintigraphy in one. Results. Radiographs showed unmineralized nodular masses localized to the subcutaneous adipose tissue. The size range, in greatest dimension on imaging studies, was 1-4 cm. MR images show a mass with relatively decreased signal intensity on all pulse sequences, with variable but generally relatively well defined margins. There was extensive diffuse enhancement following gadolinium administration. Conclusion. The radiologic appearance of subcutaneous granuloma annulare is characteristic, typically demonstrating a nodular soft-tissue mass involving the subcutaneous adipose tissue. MR images show a mass with relatively decreased signal intensity on all pulse sequences and variable but generally well defined margins. There is extensive diffuse enhancement following gadolinium administration. Radiographs show a soft-tissue mass or soft-tissue swelling without evidence of bone involvement or mineralization. This radiologic appearance in a young individual is highly suggestive of subcutaneous granuloma annulare. (orig.)
STAINES, N. A.; HARPER, N.; WARD, F. J.; MALMSTRÖM, V.; HOLMDAHL, R.; BANSAL, S.
The purpose of the study was to map the dominant T cell epitope of the CB11 sequence of CII in RT1u haplotype rats and to determine if, when used as a synthetic peptide, it would induce tolerance to protect against CIA. A dominant epitope corresponding to residues 184-198 included in the sequence of the CB11 fragment of bovine CII was identified in proliferation assay using peptides in an epitope scanning system using synthetic peptides of 15 amino acids, overlapping by 12 amino acids. This epitope is bovine-specific, but cross-reacts with the corresponding rat peptide. Minor epitopes in the bovine CB11 sequence were also autoantigenic. Use of independently synthesized and purified 184-198 peptide confirmed its dominance in the T cell responses of arthritic rats. The peptide itself was not arthritogenic. Cells from lymph nodes draining arthritic feet were particularly responsive to the dominant peptide sequence, and showed evidence of epitope spreading to include reactions to at least four subdominant epitopes. Mucosal tolerance was successfully induced by instilling CII into the nose of rats before induction of CIA; this was found to delay the onset of disease, reduce mean disease severity, shift the anti-CII antibody response to favour antibodies of the IgGl, rather than the IgG2b isiotype, and to reduce T cell reactivity to both CII and to the 184-198 peptide. The dominant 184-198 peptide itself had the same tolerogenic effects when given nasally to rats daily, on the 4 days immediately preceding the induction of CIA. Two forms of CIA with acute and delayed disease onset were each modified by pre-treatment with the peptide. This study demonstrates that mucosal tolerance to CII can be induced by delivering it nasally in a way similar to that achieved previously by oral delivery, and that the use of an immunodominant epitope contained in a synthetic peptide will also suppress the immunologic and arthritic responses to collagen. PMID:8608633
Tosaka, K.; Ishikawa, T. (Kumamoto Univ. (Japan). School of Medicine)
Four cases of the lethal midline granuloma or malignant granuloma of the nose were treated by irradiation and chemotherapy, which are generally prescribed for malignant lymphomas. Clinical, histological and laboratory examination indicated that they were the lethal midline granuloma and clearly differentiated from Wegener's granulomatosis or malignant lymphoma. All of the cases exhibited primary remission. The four cases were observed up to 38, 22, 14, and 10 months since the beginning of the therapy, showing no local or general recurrence.
Ellis, John A
Bovine parainfluenza-3 virus (bPI(3)V) is a long-recognized, currently underappreciated, endemic infection in cattle populations. Clinical disease is most common in calves with poor passive transfer or decayed maternal antibodies. It is usually mild, consisting of fever, nasal discharge, and dry cough. Caused at least partly by local immunosuppressive effects, bPI(3)V infection is often complicated by coinfection with other respiratory viruses and bacteria, and is therefore an important component of enzootic pneumonia in calves and bovine respiratory disease complex in feedlot cattle. Active infection can be diagnosed by virus isolation from nasal swabs, or IF testing on smears made from nasal swabs. Timing of sampling is critical in obtaining definitive diagnostic test results. Parenteral and intranasal modified live vaccine combination vaccines are available. Priming early in calfhood with intranasal vaccine, followed by boosting with parenteral vaccine, may be the best immunoprophylactic approach. Copyright © 2010 Elsevier Inc. All rights reserved.
Steve M. Ruggiero
Full Text Available Tuberculosis (TB is one of the most common infectious diseases worldwide. It is estimated that one-third of the world’s population is infected with TB. Most have the latent stage of the disease that can later transition to active TB disease. TB is spread by aerosol droplets containing Mycobacterium tuberculosis (Mtb. Mtb bacteria enter through the respiratory system and are attacked by the immune system in the lungs. The bacteria are clustered and contained by macrophages into cellular aggregates called granulomas. These granulomas can hold the bacteria dormant for long periods of time in latent TB. The bacteria can be perturbed from latency to active TB disease in a process called granuloma activation when the granulomas are compromised by other immune response events in a host, such as HIV, cancer, or aging. Dysregulation of matrix metalloproteinase 1 (MMP-1 has been recently implicated in granuloma activation through experimental studies, but the mechanism is not well understood. Animal and human studies currently cannot probe the dynamics of activation, so a computational model is developed to fill this gap. This dynamic mathematical model focuses specifically on the latent to active transition after the initial immune response has successfully formed a granuloma. Bacterial leakage from latent granulomas is successfully simulated in response to the MMP-1 dynamics under several scenarios for granuloma activation.
Multiple biopsies were taken. Histopathology revealed epithelioid granulomas with Langhans giant cells as well as areas of mild cryptitis, could be either tuberculosis or Crohns disease, Ultrasound guided liver biopsy from the focal lesions revealed epithelioid cells and poorly formed granulomas with areas of caseation and ...
Full Text Available Actinic granuloma is an uncommon granulomatous disease, characterized by annular erythematous plaque with central clearing predominately located on sun-damaged skin. The pathogenesis is not well understood, ultraviolet radiation is recognized as precipitating factor. We report a case of a 52-year-old woman who presented with asymptomatic annular erythematous plaques on the forehead and both cheeks persisting for 2 years. The clinical presentation and histopathologic findings support the diagnosis of actinic granuloma. During that period of time, she also developed focal segmental glomerulosclerosis. The association between actinic granuloma and focal segmental glomerulosclerosis needs to be clarified by further studies.
... at night. A saltwater nasal wash, or nasal irrigation, can help reduce this. A nasal wash: Cleans ... trouble cooperating with a nasal wash, and may need to be held and assisted. Ask your health ...
Conclusion: Pyogenic granuloma is considered a reactive hyperproliferative vascular response to trauma or other stimuli. The name “pyogenic granuloma” is a misnomer since the condition is not associated with pus and does not represent a granuloma histologically. There are a few cases of lobular capillary hemangioma of the glans penis but it is rare on the female genitalia. We present this case to help physicians become aware that lobular capillary hemangiomas may occur at this site.
Hoving, Eelco W.
Nasal encephaloceles can be divided into frontoethmoidal and basal encephaloceles. Both conditions are very rare, but frontoethmoidal encephaloceles show a relatively high incidence (1:5,000) in Southeast Asia. The pathogenesis of encephaloceles may be explained by a disturbance in separation of
... of the middle turbinate is oblique, connecting the vertical and horizontal parts, and is thus connected both the skull base in the front and the nasal sidewall in the back. The frontal sinus and anterior ethmoid sinus cells drain beneath the middle turbinate into the middle meatus. ...
Omoregie, F O; Ojo, M A; Saheeb, Bdo; Odukoya, O
This article aims to determine the incidence of periapical granuloma from extracted teeth and correlate the clinical diagnoses with the histopathological types of periapical granuloma. Over a period of eight months, a prospective study designed as a routine biopsy of recoverable periapical tissues obtained from patients who had single tooth extraction was carried out. One hundred and thirty-six patients participated in the study, with 75 (55.1%) histopathologically diagnosed periradicular lesions. There were 23 (16.9%) cases of periapical granuloma, with a male to female ratio of 2: 1. The lesion presented mostly between the third and fourth decades of life (n=9, 6.6%). Clinically diagnosed acute apical periodontitis was significantly associated with periapical granuloma, with predominantly foamy macrophages and lymphocytes (Pgranuloma appears to be a less common periapical lesion in this study compared to the previous reports. In contrast to reports that relate to an acute flare of the lesion with abundant neutrophilic infiltration, this study has shown marked foamy macrophages and lymphocytes at the acute phase, which are significantly associated with the clinical diagnosis of acute apical periodontitis. We recommend the classification of periapical granuloma into early, intermediate, and late stages of the lesion, based on the associated inflammatory cells.
Full Text Available Granuloma faciale is an uncommon benign chronic dermatosis characterized by reddish-brown to violaceous asymptomatic plaques appearing predominantly on the face. The pathogenesis of granuloma faciale remains unclear, and it is frequently unresponsive to therapy. This systematic review aims to summarize all recent publications on the management of granuloma faciale. The publications are mainly individual case reports, small case series and a few retrospective studies. Treatment options included topical, intralesional and systemic corticosteroids, topical pimecrolimus and tacrolimus, topical and systemic dapsone, systemic hydroxychloroquine, clofazimine, and tumour necrosis factor-alpha inhibitors. More invasive therapies using lasers as well as cryosurgery and surgery were also reported. Topical glucocorticosteroids and tacrolimus remain treatments of first choice, possibly supplemented by topical dapsone.
Full Text Available We describe a 61-year-old Japanese woman who had been aware of a lesion on her left thigh for 10 years. Pathological examination demonstrated a well-circumscribed encapsulated nodule at the dermal-subcutaneous boundary, composed of eosinophilic spindle cell bundles, connective tissue, and numerous small vessels. Immunohistochemically, these eosinophilic cells were positive for α-smooth muscle actin. The granulomatous areas in the tumor were composed focally of epithelioid cells and lymphocytes. The epithelioid cells were negative for α-smooth muscle actin. We diagnosed this case as an angioleiomyoma with epithelioid granuloma. Malignant tumors with granulomatous change have sometimes been reported in the literature, but benign tumors with epithelioid granuloma, such as the present one, are rare. We thought that epithelioid cell granuloma might transform to angioleiomyoma through the action of IL-1 released from vascular smooth muscle cells.
Full Text Available This work describes a malformation in one newborn female bovine, with two faces and two skull fused, showing one single head. Duplications of the nasal and oral structures, tetraofthalmy, two brains, one single cerebellum, and pons were observed. The right thyroid was hypertrophic and the other organs had normal morphology. Every change observed in this case was compatibles with diprosopus.
Iannella, Giannicola; Di Gioia, Cira; Carletti, Raffaella; Magliulo, Giuseppe
This study investigates the immunohistochemical expression of vascular endothelial growth factor (VEGF) and CD34 in patients treated for middle ear and mastoid cholesterol granulomas to evaluate the angiogenesis and vascularization of this type of lesion. A correlation between the immunohistochemical data and the radiological and intraoperative evidence of temporal bone marrow invasion and blood source connection was performed to validate this hypothesis. Retrospective study. Immunohistochemical expression of VEGF and CD34 in a group of 16 patients surgically treated for cholesterol granuloma was examined. Middle ear cholesteatomas with normal middle ear mucosa and external auditory canal skin were used as the control groups. The radiological and intraoperative features of cholesterol granulomas were also examined. In endothelial cells, there was an increased expression of angiogenetic growth factor receptors in all the cholesterol granulomas in this study. The quantitative analysis of VEGF showed a mean value of 37.5, whereas the CD34 quantitative analysis gave a mean value of 6.8. Seven patients presented radiological or intraoperative evidence of bone marrow invasion, hematopoietic potentialities, or blood source connections that might support the bleeding theory. In all of these cases there was computed tomography or intraoperative evidence of bone erosion of the middle ear and/or temporal bone structures. The mean values of VEGF and CD34 were 41.1 and 7.7, respectively. High values of VEGF and CD34 are present in patients with cholesterol granulomas. Upregulation of VEGF and CD34 is indicative of a remarkable angiogenesis and a widespread vascular concentration in cholesterol granulomas. 3b. Laryngoscope, 127:E283-E290, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.
Djindjian, M.; Brugieres, P.; Razavi-Encha, F.; Allegret, C.; Poirier, J.
The authors report and discuss some clinical, radiological, histological and ultrastructural aspects of an intracranial foreign body granuloma. This granuloma, which simulated a cavernoma, was due to a surgical swab forgotten during a previous neurosurgical evacuation of an intracerebral hematoma.
Nicotine nasal spray is used to help people stop smoking. Nicotine nasal spray should be used together with a ... support groups, counseling, or specific behavior change techniques. Nicotine nasal spray is in a class of medications ...
Oxymetazoline nasal spray is used to relieve nasal discomfort caused by colds, allergies, and hay fever. It ... also used to relieve sinus congestion and pressure. Oxymetazoline nasal spray should not be used to treat ...
M Z Mani
Full Text Available A case of extensive granuloma inguinale simulating squamous cell carcinoma is described. There was past history of urethritis leading to a urethral fistula. The ulcer healed almost completely within 19 days of receiving streptomycin injections. The patient had associated scabies and presumably also had latent syphillis (His VDRL was reactive in 1:8 dilution. The patient belonged to Madhya Pradesh.
Full Text Available Background: pyogenic granuloma is a kind of inflammatory hyperplasia of multifactorial origin, which is usually related to trauma or constant irritation, drug use, hormonal factors, among others. Meanwhile the odontoma is a benign tumor odontogenic composed of epithelial and mesenchymal cells, their development is usually associated with trauma, infections, inherited disorders or hyperactivity odontoblast. Objectives: The objective is to present the clinical case of a patient that presented a case of pyogenic granuloma related to the presence of a mandibular odontoma, and therapeutic management and postoperative results. Case report: The case shows a female patient of 32 years old with a history of multinodular goiter and hypothyroidism, developing a mandibular odontoma of the left side associated with pyogenic granuloma in the same area, which was treated with surgical excision and reconstructed affected tissues with lyophilized bone and collagen membrane. Favorable outcome after surgery without evidence of recurrence, with proper osseointegration of alloplastic materials and soft tissues. Conclusions: The irritant effect of the presence of a tumor (odontoma in developing confirmed pyogenic granuloma.
Shilpashree P Ravikiran
Full Text Available Granuloma faciale (GF is a benign, chronic inflammatory disorder, characterized by reddish brown plaques with prominent follicular orificesand telangeictasia, usually occurring over the face. The condition often presents a problem in differential diagnosis. Herein we describe a case of GF with an unusual diascopic finding of an apple jelly appearance on diascopy.
Fernandez-Flores, A; Ruzic-Sabljic, E
In 2003, pseudorosettes were described as highly suspicious of infection by Borrelia burgdorferi sensu lato in the appropriate clinical context. Nevertheless, such a pattern has been described in the literature in other non-infectious conditions. On the other hand, granuloma annulare (GA) has been recently closely associated with infection by Borrelia. We investigated how frequently pseudorosettes can be detected in common GA cases confirmed for Borrelia by PCR. We studied 13 biopsies of non-interstitial GA and 2 biopsies of interstitial GA from patients without clinical suspicion of borrelial infection. We also performed immunohistochemical studies in all the biopsies, using the CD-68 antibody. Molecular studies with PCR were performed with beta-globin PCR (human DNA). Borrelial DNA was confirmed by amplifying the OspA gene and intergenic rrf-rrl region. We found histiocytic pseudorosettes in 13 biopsies (86.66%). Human DNA was successfully amplified from 8 of 13 paraffin-embedded skin samples. From these we amplified borrelial DNA in 5 of 8 samples. Out of the 8 cases in which human DNA was amplified, a correlation between pseudorosettes and the molecular tests (Borrelia DNA) was confirmed in 5 instances. a) Pseudorosettes are not an unusual finding in common granuloma annulare; b) Borrelia is present in (most) cases of granuloma annulare; and c) Pseudorosettes seem to be a good morphological sign predictive of infection with Borrelia in granuloma annulare.
Byram, J E; von Lichtenberg, F
Schistosome egg-induced lesions in congenitally athymic mice differed from those found in normal heterozygous controls. Heterozygote liver granulomas were chareacterized by poorly phagocytic epithelioid macrophages, and were rich in eosinophils and fibroblasts, with peripheral lymphocytes and plasma cells. Hepatic lesions in nude mice were much smaller and lacked epithelioid macrophages, with lesions about mature eggs, typically consisting of monocytes and macrophages filled with pigment, occasional neutrophils, and rarely one or more eosinophils or giant cells. While heterozygote granulomas damaged liver cells mainly by encroachment or by their vascular effects, in the nudes hepatocytes bordering the lesions showed microvesicular cytoplasmic damage and either hydropic degeneration or focal acidophilic necrosis of individual liver cells. In heterozygotes, immunofluorescent-stainable schistosome egg antigen (SEA) was concentrated in the granuloma center. In nude mice, SEA, was distributed throughout the infiltrates and in and around hepatocytes adjacent to egg lesions corresponding to the observed pattern of hepatocyte necrosis. We conclude that, in contrast to heterozygotes, nude mice lack hypersensitivity granulomas and fail to sequester toxic egg products, this resulting in zonal hepatocellular damage. Alternative explanations include the possibility of a latent hepatitis virus being activated by the schistosome infection; however, several cogent arguments are presented against that alternative.
Granuloma inguinale is a chronic specific infection of the genitalia of both sexes. It is endemic in many parts of the world, including the Caribbean, the southern USA, India, New Guinea and tropical and sUbtropical Africa. Apart from a single patient diagnosed clinically, no cases of the disease have previously been reported ...
Shin, Jeong Won; Heo, Min Suk; Lee, Sam Sun; Choi, Soon Chul; Park, Tae Won [Dept. of Oral and Maxillofacial Radiology and Dental Research Institute College of Dentistry, Seoul National University, Seoul (Korea, Republic of)
Pyogenic granuloma is a overzealous proliferation of a vascular type connective tissue as a result of some minor trauma and is a well circumscribed elevated, pedunculated or sessile benign inflammatory lesion of skin and mucous membrane. The clinical features of pyogenic granuloma are indicative but not specific and nearly all cases of pyogenic granulomas are superficial in nature, and there is little if any mention in the literature of these lesions producing alveolar bone even jaw bone loss. This case is somewhat unique in that the lesion was an obvious histologic pyogenic granuloma; however, it appeared to invade the mandibular bone which resulted in the loss of the adjacent teeth. A 12-year-old boy came to Seoul National University Dental Hospital with chief complaints of left facial swelling. The features obtained were as follows ; Plain radiograms showed a large well-circumscribed radiolucent lesion on left mandibular ramus area, which made severe expansion of lingual cortex and displacement of lower left 3rd molar tooth germ. Computed tomograms showed large soft tissue mass involving left masticator space with destruction of left mandibular ramus. Histologically, sections revealed loose edematous stroma with intense infiltration of inflammatory cells and proliferation of vascular channels. Also, there were focal areas of extensive capillary proliferation, bone destruction and peripheral new bone formation.
Wood, John W; Casiano, Roy R
Benign lesions of the nasal cavity represent a diverse group of pathologies. Furthermore, each of these disorders may present differently in any given patient as pain and discomfort, epistaxis, headaches, vision changes, or nasal obstruction. Although these nasal masses are benign, many of them have a significant capacity for local tissue destruction and symptomatology secondary to this destruction. Advances in office-based endoscopic nasendoscopy have equipped the otolaryngologist with a safe, inexpensive, and rapid means of directly visualizing lesions within the nasal cavity and the initiation of appropriate treatment. The purpose of this study is to review the diagnosis, management, and controversies of many of the most common benign lesions of the nasal cavity encountered by the primary care physician or otolaryngologist. This includes discussion of inverted papilloma (IP), juvenile angiofibroma, squamous papilloma, pyogenic granuloma, hereditary hemorrhagic telangiectasia, schwannoma, benign fibro-osseous lesions, and other benign lesions of the nasal cavity, with particular emphasis on IP and juvenile angiofibroma. A diverse array of benign lesions occur within the nasal cavity and paranasal cavities. Despite their inability to metastasize, many of these lesions have significant capability for local tissue destruction and recurrence.
Nair, P N; Schmid-Meier, E
A chronic periapicalesion--apical granuloma--of the first left maxillary molar, which had rarefied the bony plate and grown into the maxillary sinus, was observed in a 64-year-old white male patient. Light microscopic study of the epon-embedded specimen showed a lesion that had been infiltrated predominantly by mononuclear cells and that had isolated neutrophil-dominated foci. The lesion contained extensive networks and arcades of proliferating epithelium. Unlike the classic granulomas of the periapex, which are generally delimited by a well-developed connective tissue capsule, this particular lesion was lined with epithelial tissue consisting of ciliated columnar and stratified squamous components. While the former seemed to be an extension of the sinus epithelium, the latter appeared to be an outgrowth of the proliferating epithelium encountered within the lesion.
Ribeiro, Bruno Niemeyer de Freitas; Bahia, Paulo Roberto Valle [Radiology, Hospital Universitario Clementino Fraga Filho - Universidade Federal do Rio de Janeiro (HUCFF-UFRJ), Rio de Janeiro, RJ (Brazil); Oliveira, Ana Luiza Vianna Sobral de Magalhaes [Resident of Medical Practice, Hospital Federal da Lagoa, Rio de Janeiro, RJ (Brazil); Marchon Junior, Joao Luiz [Unit of Computed Tomography, Hospital Federal da Lagoa, Rio de Janeiro, RJ (Brazil)
The rare lethal midline granuloma syndrome is difficult to diagnose because of the wide array of related diseases and lack of knowledge by the majority of physicians. In the present report, the authors describe the case of a patient with this disease, caused by squamous cell carcinoma, drawing attention to differential diagnoses and to clinical and radiological findings that may be useful to define the diagnosis. (author)
Full Text Available Pyogenic granuloma (PG is a rare side effect of isotretinoin therapy. Oral pyogenic granuloma developing during isotretinoin treatment has not been reported so far. A 22-old-male patient, who had been given oral isotretinoin treatment for severe nodular acne, was admitted with the complaint of a painless and red nodule in his lower gum at the end of the second month of the treatment. The patient did not report any history of trauma or dental treatment. Dermatologic examination revealed a hemorrhagic nodule measuring 1.5x1 cm in size in the lower gums of the cutting and canine teeth. The lesion was excised completely. Histopathological examination disclosed acanthosis and hyperkeratosis in epidermis, subepidermal vascular proliferation, edema, and sparsely scattered inflammatory cell groups. The mechanism by which isotretinoin causes pyogenic granulomas is not exactly known. It should be considered that this rare side effect can be gingival in patients taking isotretinoin and the regular oral examination should not be neglected.
Full Text Available Sarcoidosis is a multiorgan granulomatous disease, the most common head and neck manifestation of which is cervical lymphadenopathy. Only the presentation of sarcoidal granuloma in cervical lymph nodes without typical manifestations of systemic sarcoidosis poses a diagnostic difficulty. We describe the case of a 39-year-old male who had a 2-month history of a progressively increasing mass with soreness in his right neck. The biopsy from the neck mass demonstrated non-caseating epithelioid cell granuloma of the lymph nodes. The differential diagnoses of mycobacterial or fungal infections were excluded. Thoracic evaluations, including chest X-ray and high-resolution computed tomography, revealed no abnormal findings. Treatment with systemic corticosteroids resulted in improved clinical symptoms. No recurrence of the neck mass or other signs of systemic sarcoidosis were noted during 1.5 years of follow-up. Although our patient's definitive diagnosis could not be determined, the case highlights 2 important issues: sarcoidal granuloma in lymph nodes may be a precursor of sarcoidosis, even in the absence of pulmonary or other systemic involvement; and regular follow-up is recommended in such cases.
Sørensen, Flemming Brandt; Marcussen, N
In 1059 patients who had transurethral resections (TUR) of the prostate 8 cases (0.8%) with nonspecific granulomas were found. In another group of 280 patients treated by TUR for tumours of the urinary bladder 5 cases (1.8%) had granulomatous lesions in the resectates. The granulomas were observed...... only in patients with prior surgical trauma of the prostate and the bladder with an incidence of 14% and 6.5%, respectively. None of the patients had systemic diseases. Morphologically, two types of granulomas were observed, foreign-body-type and necrotizing. Carbonization rests were frequently noticed...... was observed in the granulomas. The findings are compared to previously reported cases of iatrogenic granulomas in the prostate, the urinary bladder and other organs. It is concluded that the granulomas arise as a local reaction to previous surgery, maybe involving hypersensitivity to locally altered collagen....
Patrícia Maria Fernandes Marback
Full Text Available Objetivo: Relatar caso de granuloma de conjuntiva por fibras sintéticas. Relato do Caso: Paciente de seis anos, sexo feminino com história de tumoração em conjuntiva tarsal inferior do olho direito há seis meses. Foi realizada exérese da lesão. O laudo anátomo-patológico mostrou reação inflamatória granulomatosa do tipo corpo estranho com células gigantes multinucleadas fagocitando material birrefringente, compatível com fibras sintéticas. Discussão: O granuloma de fibras sintéticas de conjuntiva é raro e descrito principalmente em crianças, com acometimento unilateral, em conjuntiva tarsal inferior ou fundo de saco inferior. O freqüente contato com material de pelúcia nesta faixa etária tem sido apontado como fator etiológico. Granuloma de fibras sintéticas de conjuntiva deve ser considerado no diagnóstico diferencial de lesões tumorais de conjuntiva em crianças.Purpose: To report a case of conjunctival synthetic fiber granuloma. Case Report: Six-year old female presented with an inferior conjunctival tumor in the right eye for six months. The lesion was excised and histopathological examination revealed granulomatous inflammation and multinucleated giant cells phagocy birefringent material, recognized as synthetic fibers. Discussion: Synthetic fiber granuloma of the conjunctiva is an uncommon lesion described mainly in children. Usually it occurs unilaterally and situated in the inferior conjunc-tival fornix. The contact of the eye with toys containing synthetic fibers in this age group could explain the origin of the lesion. Synthetic fiber conjunctival granuloma should be included in the differential diagnosis of conjunctival tumors in children.
Keiser, G. J.; Bozentka, N. E.; Gold, B. D.
Laryngeal granuloma is an uncommon complication arising from irritation of the laryngeal structures. We present a case where bilateral laryngeal granulomas became clinically evident 3 mo after orthognathic surgery. The patient, a 19-yr-old female, developed acute dyspnea after experiencing gradual voice loss. Excision of the lesions under endotracheal general anesthesia led to an uneventful outcome. The causes, predisposing factors, diagnostic features, and treatment of laryngeal granuloma ar...
Lo, W.W.M.; Solti-Bohman, L.G.; Brackmann, D.E.; Gruskin, P.
Cholesterol granuloma of the petrous apex is a readily recognizable and treatable entity that is more common than previously realized. Cholesterol granuloma grows slowly in the petrous apex as a mass lesion until it produces hearing loss, tinnitus, vertigo, and facial twitching. Twelve cases of cholesterol granuloma of the petrous apex are illustrated; ten of these analyzed in detail, especially with respect to CT findings. A sharply and smoothly marginated expansile lesion in the petrous apex, isodense with plain and nonenhancing on CT, is in all probability a cholesterol granuloma. Preoperative recognition by CT is important for planning proper treatment
Lo, W.W.M.; Solti-Bohman, L.G.; Brackmann, D.E.; Gruskin, P.
Cholesterol granuloma of the petrous apex is a readily recognizable and treatable entity that is more common than previously realized. Cholesterol granuloma grows slowly in the petrous apex as a mass lesion until it produces hearing loss, tinnitus, vertigo, and facial twitching. Twelve cases of cholesterol granuloma of the petrous apex are illustrated; ten of these analyzed in detail, especially with respect to CT findings. A sharply and smoothly marginated expansile lesion in the petrous apex, isodense with plain and nonenhancing on CT, is in all probability a cholesterol granuloma. Preoperative recognition by CT is important for planning proper treatment.
Trap, R; Wiebe, B
A case of granuloma annulare localized to the shaft of the penis is reported. The differential diagnoses are discussed. Penile granuloma annulare is a rare disorder and it is concluded that biopsies of penile lesions are recommended to verify the correct diagnosis.......A case of granuloma annulare localized to the shaft of the penis is reported. The differential diagnoses are discussed. Penile granuloma annulare is a rare disorder and it is concluded that biopsies of penile lesions are recommended to verify the correct diagnosis....
The authors present a case of nasal chondromesenchymal hamartoma (NCMH) in an 8-year-old boy with a 4-month history of frontal headache and no symptoms of nasal obstruction, rhinorrhoea or postnasal drip. An ENT examination as well as ophthalmology assessment presented normal results. CT scan showed a lesion involving the sphenoid and ethmoid sinuses. The patient had an endoscopic resection of the lesion that was confirmed histologically to be a NCMH. Though NCMH is known to present usually in infants with obstructing nasal mass, an unusual presentation of a patient with throbbing headache without any nasal symptoms is reported here.
André Luiz Rossetto
Full Text Available Injuries caused by venomous and poisonous aquatic animals may provoke important morbidity in humans. The phylum Echinoderma include more than 6000 species of starfish, sea urchins, sand dollars, and sea cucumbers some of which have been found responsible for injuries to humans. Initial injuries by sea urchins are associated with trauma and envenomation, but later effects can be observed. Sea urchin granuloma is a chronic granulomatous skin disease caused by frequent and successive penetration of sea urchin spines which have not been removed from wounds. The authors report a typical case of sea urchin granuloma in a fisherman and its therapeutic implications.Os acidentes por animais aquáticos traumatizantes e venenosos podem provocar morbidez importante em humanos. Equinodermos marinhos incluem mais de 6000 espécies de estrelas-do-mar, ouriços-do-mar, "bolachas-de-praia" e pepinos-do-mar. Vários equinodermos têm sido responsabilizados por acidentes em humanos. Granulomas por ouriço-do-mar são lesões de caráter granulomatoso, crônicas, causada por acidentes com espículas de ouriço-do-mar. Os autores relatam um caso típico de granulomas por ouriço-do-mar ocorrido em um pescador e enfatizam as implicações terapêuticas aplicadas.
Gengoux, P; Portaels, F; Lachapelle, J M; Minnikin, D E; Tennstedt, D; Tamigneau, P
A 38-year-old woman presented with small, ulcerated, red or bluish nodules on the right hand, clinically resembling mycobacterial granulomas; these appeared a few months after a bite by a rat, while the patient was collecting frogs in a pond in the Belgian Ardennes. The histopathologic picture was compatible with a diagnosis of mycobacterial infection and rare acid-fast bacilli could be found. Repeated bacteriologic investigations were performed and these led to the identification of a strain displaying characteristics of Mycobacterium gordonae. The skin condition responded well to rifampicin (300 mg/day) within 6 months.
Natalia Patricia Harris Ortega
Full Text Available Title: Periapical granuloma: conventional treatment. Case reportLos Granulomas radiculares son lesiones periapicales crónicas, consideradas secuelas directas de procesos infecciosos resultantes de la necrosis pulpar, extendiéndose hacia la región perirradicular. Los granulomas se pueden presentar por fallas en los tejidos duros, resultantes de caries, fracturas y procedimientos quirúrgicos. Se realizó tratamiento de endodoncia convencional con preparación invertida a paciente de 15 años con diagnóstico de Granuloma periapical (periodontitis apical asintomáticay su posterior recuperación de la lesión de órgano dentario 36. (DUAZARY 2013 No. 2, 141 - 144AbstractRoot granulomas are chronic periapical lesions, considered direct sequels of infectious processes resulting from pulp necrosis, extending into the periradicular region. The granulomas can occur due to failures in hard tissues, resulting from caries, fractures and surgical procedures. A conventional endodontic treatment was done with crown down technique in a patient of 15 years old with a diagnosis of periapical granuloma (chronic nonsuppurative apical periodontitis and subsequent recovery from injury in tooth 36.Keywords: periapical granuloma; periapical periodontitis (MESH Database.
Sørensen, Flemming Brandt; Marcussen, N
In 1059 patients who had transurethral resections (TUR) of the prostate 8 cases (0.8%) with nonspecific granulomas were found. In another group of 280 patients treated by TUR for tumours of the urinary bladder 5 cases (1.8%) had granulomatous lesions in the resectates. The granulomas were observe...
Farhadi; Mirinezhad; Zarandi
Background The distinction between radicular cysts and apical granulomas is important in treatment decision. Objectives The current study aimed to differentiate these two lesions based on radiography images. Patients and Methods The material consisted of 138 radiographs obtained using Kodak E -speed, in patients aged 29 to 47, divided into two groups: 109 granulomas and 29 radicula...
Full Text Available In response to Mtb infection, the host remodels the infection foci into a dense mass of cells known as the granuloma. The key objective of the granuloma is to contain the spread of Mtb into uninfected regions of the lung. However, it appears that Mtb has evolved mechanisms to resist killing in the granuloma. Profiling granuloma transcriptome will identify key immune signaling pathways active during TB infection. Such studies are not possible in human granulomas, due to various confounding factors. Nonhuman Primates (NHPs infected with Mtb accurately reflect human TB in clinical and pathological contexts.We studied transcriptomics of granuloma lesions in the lungs of NHPs exhibiting active TB, during early and late stages of infection. Early TB lesions were characterized by a highly pro-inflammatory environment, expressing high levels of immune signaling pathways involving IFNgamma, TNFalpha, JAK, STAT and C-C/C-X-C chemokines. Late TB lesions, while morphologically similar to the early ones, exhibited an overwhelming silencing of the inflammatory response. Reprogramming of the granuloma transcriptome was highly significant. The expression of approximately two-thirds of all genes induced in early lesions was later repressed.The transcriptional characteristics of TB granulomas undergo drastic changes during the course of infection. The overwhelming reprogramming of the initial pro-inflammatory surge in late lesions may be a host strategy to limit immunopathology. We propose that these host profiles can predict changes in bacterial replication and physiology, perhaps serving as markers for latency and reactivation.
Andersen, Rosa Marie O; Zachariae, Claus; Johansen, Jeanne Duus
Vaccination with aluminium-adsorbed vaccines can induce aluminium allergy with persistent itching subcutaneous nodules at the injection site - vaccination granulomas. In this article we give an overview of childhood aluminium-adsorbed vaccines available in Denmark. Through literature studies we...... examine the incidence, the symptoms and the prognosis for the vaccination granulomas and the allergy. Finally we discuss the status in Denmark....
Andersen, Rosa Marie Ø; Zachariae, Claus; Johansen, Jeanne Duus
Vaccination with aluminium-adsorbed vaccines can induce aluminium allergy with persistent itching subcutaneous nodules at the injection site – vaccination granulomas. In this article we give an overview of childhood aluminium-adsorbed vaccines available in Denmark. Through literature studies we examine the incidence, the symptoms and the prognosis for the vaccination granulomas and the allergy. Finally we discuss the status in Denmark.
Durmuş, Mustafa; Bardak, Yavuz; Özertürk, Yusuf
We are introducing a case with 3 times recurrence ofgranuloma formation in lower punctum. In the 3threcurrence, we removed the tube and appliedmitomycin C following excision. Granuloma was cured,epiphora disappeared for 15 months.Key Words: Canalicular granuloma, Silicone stent
Slit lamp examination showed vascularized central corneal mass with surrounding stromal infiltrates. The mass was excised, and histopathological examination confirmed pyogenic granuloma of the cornea. Conclusion: Corneal pyogenic granuloma could be a rare complication of infectious keratitis. Therefore, it should be ...
Akhtar, M.U.; Imtiaz, M.
Giant cell granuloma (GCG) is a non-neoplastic proliferative growth of unknown etiology. It mostly occurs in young adults and common site is mandible. This paper presents an-unusual case of 8 years old young boy with GCG in upper jaw. Clinically, radiologically and histopathologically the lesion behaves aggresively. The lesion presented with history of one year and two months of swelling in maxilla with right nasal obstruction. Required investigations including CT scan and incisional biopsy were performed and Weber Ferguson approach was used to remove the tumour in total. The suturing was performed and primary closure was done. After three months. of surgery, primary splint was replaced by definitive acrylic obturator and patient's functions and aesthetics were restored. (author)
Hamilton, Grant S
The external nasal valve is a complex entity comprised of multiple structures and tissue types. As such, there is no single operation that can address all problems of the external valve. This article reviews the relevant anatomy, pathologic conditions, and treatments for external nasal valve dysfunction, including a detailed review of the nasal muscles and their contribution to external nasal valve patency. Surgical and nonsurgical options for treatment and the evidence supporting the importance of proper external nasal valve function on quality-of-life measures are discussed. Copyright © 2016 Elsevier Inc. All rights reserved.
Full Text Available Peripheral T-cell lymphomas are a group of heterogeneous disorders and according to WHO classification, are categorized into nodal and extranodal forms. NK/T-cell lymphoma, nasal type, is a subtype of extranodal peripheral T-cell lymphoma and commonly presents as a midfacial destructive lesion. This disorder is more prevalent in Asia and South America and has a strong association with Epstein Barr Virus infection. Invasion of vessel walls by lymphoid cells, which is known as angiocentricity, is characteristic of nasal type NK/T-cell lymphoma. The tumor cells express CD2 and CD56 antigens; but not CD3. The nasal cavity is the mostly frequently affected site. Other commonly affected sites include palate and upper airways. On cross sectional imaging, the nasal involvement is seen as a diffuse sheet-like mucosal thickening along the nasal turbinates and septum or as a destructive midline mass (Figs 1,2. The latter form was previously described as a lethal midline granuloma or polymorphic reticulosis. The mass frequently extends into subcutaneous tissues of nasal ala and buccinator space (Fig.3. Regional lymphadenopathy is usually not seen. The radiological differential diagnoses for a midline nasal cavity mass include squamous cell carcinoma, minor salivary gland tumor, Wegener’s granulomatosis, and fungal infections. The imaging appearances of NK/T-cell lymphoma are often indistinguishable from the above mentioned conditions. However, predilection to involve both sides of the nasal cavity and tendency to spread as a diffuse thin sheet-like soft tissue along the walls of the nasal cavity enveloping the nasal turbinates and nasal septum favour the diagnosis of NK/T-cell lymphoma. Contiguous extension into the nasopharynx, palate, upper airways, and subcutaneous tissues can also suggest the possibility of NK/T-cell lymphoma, nasal type (Fig.4. T-cell lymphoma, compared to B-cell lymphoma, has an aggressive course and poor prognosis. The median
Full Text Available Granuloma faciale (GF is a rare cutaneous disorder characterized by one to several soft, erythematous to livid papules, plaques or nodules, usually occurring on the face. Extrafacial lesions are uncommon. A 52-year-old lady with multiple asymptomatic, variously sized brownish-black colored, firm, sharply circumscribed plaques resembling keloids on both cheeks and extrafacial lesions on the right arm and the right breast is presented for its unusual keloidal appearance and typical histopathological findings. She failed to respond to oral dapsone 100 mg daily administered for 3 months. Local infiltration of triamcinolone combined with cryotherapy led to only partial flattening of the lesions. All the skin lesions were excised surgically followed by flap transfer grafting on both cheeks. The cosmetic outcome was highly satisfactory.
Márton, I; Radics, T; Szakáll, S; Kiss, C
The ratio and in situ distribution of CD3+ T-lymphocytes, CD4+ and CD8+ subsets, CD14+ macrophages, CD56+ natural killer cells and CD25+ activated T-lymphocytes and CD68+ activated macrophages were determined in 20 chronic peripical granulomas by immunohistochemical method using monoclonal antibodies. CD3+ T-lymphocytes made up about 50% of the mononuclear cells. CD14+ macrophages were distributed all over the area but their proportion was much less that that of the T-lymphocytes. CD56+ natural killer cells made up a small proportion of the cells. The major proportion of the T-lymphocytes and macrophages were in activated stage within the lesion.
Muhle, C. [Kiel Univ. (Germany). Dept. of Diagnostic Radiology; Reinhold-Keller, E. [Rheumaklinik Bad Bramstedt (Germany). Dept. of Medicine]|[Medical Univ. Luebeck (Germany). Dept. of Rheumatology; Richter, C. [Rheumaklinik Bad Bramstedt (Germany). Dept. of Medicine]|[Medical Univ. Luebeck (Germany). Dept. of Rheumatology; Duncker, G. [Kiel Univ. (Germany). Dept. of Ophthalmology; Beigel, A. [Dr. Horst-Schmidt-Kliniken, Wiesbaden (Germany). ENT Clinic; Brinkmann, G. [Kiel Univ. (Germany). Dept. of Diagnostic Radiology; Gross, W.L. [Rheumaklinik Bad Bramstedt (Germany). Dept. of Medicine]|[Medical Univ. Luebeck (Germany). Dept. of Rheumatology; Heller, M. [Kiel Univ. (Germany). Dept. of Diagnostic Radiology
The purpose of this study was to evaluate diagnostic MRI criteria in Wegener`s granulomatosis of the nasal cavity, the paranasal sinuses and orbits. Between March 1991 and January 1996, 62 patients with biopsy-proven Wegener`s granulomatosis were studied with T1- and T2-weighted spin-echo (SE) sequences. In 32 patients coronal postcontrast T1-weighted images were obtained. Mucosal thickening of the nasal cavity and paranasal sinuses was demonstrated as high-intensity lesions on T2-weighted SE sequences in 57 patients (92%). Of this group, inflammatory granulomatous tissue was found on biopsy in 30 patients (48%) in the nasal cavity and in 4 patients (6%) in the paranasal sinuses. In 23 patients (37%) biopsy revealed unspecific inflammatory changes without evidence of granulomatous tissue. In 14 patients (23%) granulomas were depicted as low-signal intensity lesions on T1- and T2-weighted SE sequences in the paranasal sinuses and orbits. In 5 patients (8%) osseous destruction was found. After gadolinium injection, 12 of 14 granulomas showed inhomogeneous signal enhancement. In two granulomas no enhancement was found. The MRI technique is helpful in the diagnosis of patients with Wegener`s granulomatosis. In the initial inflammatory process of Wegener`s granulomatosis, it is not possible to differentiate between mucosal inflammation and granulomatous tissue in MRI. In the later stage of granulomatous transformation, granulomas can be depicted as low-signal-intensity lesions. Therefore, Wegener`s granulomatosis should be included in the differential diagnosis of patients with low-signal-intensity lesions on T1- and T2-weighted SE sequences of the nasal cavity, paranasal sinuses and orbits. (orig.)
Ghekiere, Olivier; Galant, Christine; Berg, Bruno Vande [Cliniques Universitaires St. Luc, Department of Radiology, Brussels (Belgium)
Lobular capillary hemangioma is a vascular neoplasm that commonly occurs as a cutaneous tumor. When it involves the skin and mucosal surfaces, ulceration and suppuration may occur, hence the classic term of pyogenic granuloma. Intravenous pyogenic granuloma is a rare solitary form of lobular capillary hemangioma that usually occurs in the veins of the neck and upper extremities. We report the ultrasonographic and magnetic resonance imaging findings of a pyogenic intravenous granuloma localized in the right cephalic vein. The imaging and pathological findings and the differential diagnoses are discussed. (orig.)
Natalia Patricia Harris Ortega; Fernando Javier Guzman Lopez; Antonio Díaz Caballero
Title: Periapical granuloma: conventional treatment. Case reportLos Granulomas radiculares son lesiones periapicales crónicas, consideradas secuelas directas de procesos infecciosos resultantes de la necrosis pulpar, extendiéndose hacia la región perirradicular. Los granulomas se pueden presentar por fallas en los tejidos duros, resultantes de caries, fracturas y procedimientos quirúrgicos. Se realizó tratamiento de endodoncia convencional con preparación invertida a paciente de 15 años con d...
Chirag A Desai
Full Text Available A patient presented with a an asymptomatic brown to erythematous, scaly indurated solitary plaque on his elbow. The lesion was diagnosed as lupus vulgaris on the basis of clinical features and biopsy findings. The histopathology further revealed a granuloma within the follicular infundibulum, which was possibly being expelled out. The phenomenon of transepidermal elimination has been described previously in many conditions, including cutaneous tuberculosis; however, transfollicular elimination of the granuloma has not been reported. We report this unusual phenomenon as a possible mode of elimination of the granuloma.
Full Text Available ABSTRACT CONTEXT: Localized scleroderma (morphea is characterized by fibrosis of skin and subcutaneous tissue. Granuloma annulare is a relatively common disease that is characterized by dermal papules and arciform plaques. CASE REPORT: Here, we present the case of a 42-year-old woman who developed granuloma annulare on the dorsum of her feet and abdominal region, and morphea on the anterior side of her lower limbs. We also discuss the etiological and pathogenetic processes that may cause the rare coexistence of these two diseases. CONCLUSION: Only a few cases in the literature have described coexistence of morphea and granuloma annulare.
Ayelén María Portelles Massó
Full Text Available El granuloma reparativo central de células gigantes es una lesión proliferativa no neoplásica de etiología desconocida. Se presenta un paciente masculino de 40 años de edad, portador de prótesis parcial superior. Fue remitido al Servicio de Cirugía Maxilofacial del Hospital "V. I. Lenin" por presentar aumento de volumen en reborde alveolar superior, de color rojo grisáceo y que provocaba expansión de corticales óseas. Una vez analizados los exámenes clínicos, radiográficos e histopatológicos se diagnosticó un granuloma reparativo central de células gigantes Se realizó exéresis quirúrgica de la lesión y extracción de dientes adyacentes con una evolución satisfactoria sin señales de recidivas luego de tres años del tratamiento. El granuloma reparativo central de células gigantes se presentó como respuesta a un trauma. La correcta interpretación de los datos clínicos, radiográficos e histopatológicos nos permitió llegar al correcto diagnóstico y plan de tratamiento.Giant-cell central reparative granuloma is non neoplastic proliferative lesion of unknown etiology. We report a 40 years old male patient who was admitted at the Maxillofacial Service of the "V. I. Lenin" Hospital. The patient had partial upper prosthesis and was complaining of red-grey volume increase lesion in upper alveolar ridge which led to the expansion of cortical bone. Having analyzed clinical, radiographic and histopathological findings the case was concluded as a giant-cell central reparative granuloma. Surgical exeresis and adjunct tooth extraction were done. After three years of treatment, satisfactory follow up without recurrence is reported.
Bohman, Anton; Oscarsson, Martin; Holmberg, Kenneth; Johansson, Leif; Millqvist, Eva; Nasic, Salmir; Torinsson-Naluai, Åsa; Bende, Mats
Nasal polyps is a common disease but little is known about its` pathogenesis. Our hypothesis was that there are genetic factors involved in the development of this disease. The aim of this study was to examine close relatives of patients with nasal polyps and comparing them with a general population with regard to prevalence of polyps. Patients with nasal polyps who attended the clinic were recruited to the study and were asked whether they had any close adult relatives (siblings, parents or children). We intended to recruit two relatives per patient, one of each gender, for nasal endoscopy. The prevalence of nasal polyps in these relatives was compared with the prevalence of nasal polyps in a general population. During a 4-year period, 368 patients and 410 relatives were recruited to the study. Although we were unable to recruit two close relatives for every patient, we were able to calculate nasal polyp prevalence within families as being 19.2%. Compared with the prevalence of nasal polyps among individuals in a general Swedish population from the same geographical area, the relative risk for polyps among relatives was almost five times higher. This study strongly indicates that heredity is a factor of importance for development of nasal polyps.
Tilak R Bedi
Full Text Available A case of perianal granuloma inguinale in a 8 year old child without any evidence of pederasty is reported. Nonvenereal transmission of the disease in some cases cannot be ruled out.
Lee, Byung Do; Lee, Wan; Lee, Jun [College of Dentistry, Wonkwang University, Iksan (Korea, Republic of); Son, Hyun Jin [Dept. of Pathology, School of Medicine, Eulji University, Daejeon (Korea, Republic of)
Eosinophilic granuloma is a common expression of Langerhans cell histiocytosis and corresponds with typical bone lesions. The radiographic appearance of eosinophilic granuloma in the jaw is variable and not specific. It may resemble periodontitis, radicular cyst, or malignancies. The purpose of this report is to describe the characteristic radiographic features of eosinophilic granuloma of a 39-year-old male. The lesion in the anterior mandible was first diagnosed as radicular cyst because the radiographic findings were ovoid radiolucent lesion with well-defined border. However, careful interpretation revealed a non-corticated border and floating tooth appearance that were the characteristic radiographic features for the differential diagnosis. Early clinical signs of eosinophilic granuloma can occur in the jaw and a bony destructive lesion might be mistaken for periodontitis or an odontogenic cystic lesion; therefore, careful interpretation of radiographs should be emphasized.
Loukides, S; Karameris, A; Lachanis, S; Panagou, P; Kalogeropoulos, N
A 19-yr-old male presented with left lung parahilar consolidation and clinical signs of pneumonia. These symptoms were secondary to an endobronchial mass in the apical segment of the lower lobe. At thoracotomy an apical segment bronchial sleeve resection successfully extirpated what later proved to be an endobronchial eosinophilic granuloma. To the authors' knowledge this is the first case report of an endobronchial eosinophilic granuloma in an adult.
Martín-González, Jénifer; Carmona-Fernández, Antonio; Pérez-Pérez, Antonio; Sánchez-Jiménez, Flora; Sánchez-Margalet, Víctor
Background Leptin, initially described as an adipocyte-derived hormone to regulate weight control, is expressed in normal and inflamed human dental pulp, being up-regulated during pulp experimental inflammation. Leptin receptor (LER) has been identified in human periapical granulomas. The aim of this study was to analyze and characterize the expression of leptin in human periapical granulomas. Material and Methods Fifteen periapical inflammatory lesions were obtained from extracted human teeth and teeth which underwent periapical surgery. After their morphological categorization as periapical granulomas and gradation of the inflammatory infiltrate, they were examined by immunohistochemistry using human leptin policlonal antibodies. Leptin mRNA expression was also determined by quantitative real-time PCR (qRT-PCR) and the amount of leptin protein was analyzed by immunoblot. Results All periapical lesions exhibited the characteristic of chronic granulomatous inflammatory process with inflammatory infiltrate grade III. Leptin+ cells were detected in 13 periapical granulomas (86.6%). The median number of Leptin+ cells in periapical granulomas was 1.70 (0.00-7.4). Amongst the inflammatory cells in the periapical granulomas, only macrophages were reactive to leptin antibodies. Western blot analysis revealed the presence in all samples of a protein with apparent molecular weight of approximately 16 kDa, corresponding to the estimated molecular weights of leptin. The expression of leptin mRNA was confirmed by qRT-PCR analysis and the size of the amplified fragment (296 bp for leptin and 194 bp for cyclophilin) was assessed by agarose gel electrophoresis. Conclusions For the first time, it has been demonstrated that human periapical granuloma expresses the adipokine leptin. Key words: Apical granuloma, dental pulp, endodontics, leptin, leptin receptor, immune system, immunohistochemistry, periapical inflammatory response. PMID:25662559
Cleverson Luciano Trento
Full Text Available Introduction: Pyogenic granuloma, known as gravidarum granuloma or pregnancy granuloma, is a benign non-neoplastic reactive oral lesion that may occur in pregnant women. It is usually a highly vascularized mass, which has exophytic characteristics, and it may be sessile or pedunculated. Its surface has usually a smooth or lobular aspect, with its coloration ranging from red to pink. The pain sensitivity will depend on the degree of injury involving the traumatic lesion, but it is frequently painless. Adjacent areas to dental implants are rare for the appearance of this type of granuloma. Objective: The aim of this case report was to present a clinic case of gravidarum granuloma in the region of lower lingual gingiva, adjacent to an osseointegrated implant in a 33-year-old woman, with 3 months of gestation, who had the lesion since the beginning of her pregnancy. Conclusion: Gravidarum granuloma was diagnosed in association to a dental implant, and it highlights the necessity for improvements of oral hygiene in the peri-implant regions. Surgical treatment with excisional biopsy plus hygiene control were enough to settle the case.
... to supply extra vitamin B12 to people who need unusually large amounts of this vitamin because they are pregnant or have certain diseases. ... Cyanocobalamin nasal gel will supply you with enough vitamin B12 only as ... it regularly. You may need to use cyanocobalamin nasal gel every week for ...
Feron, VJ; Arts, JHE; Kuper, CF; Slootweg, PJ; Woutersen, RA
Health risks of inhaled nasal toxicants were reviewed with emphasis on chemically induced nasal lesions in humans, sensory irritation, olfactory and trigeminal nerve toxicity, nasal immunopathology and carcinogenesis, nasal responses to chemical mixtures, in vitro models, and nasal dosimetry- and
Lawrence R. Menendez
Full Text Available Though rarely reported, neoplasms of the clavicle occur, and their symptoms can be mistaken for more common shoulder conditions. We present the case of a benign clavicular neoplasm, rarely seen in adults, presenting with pain, and eventual pathologic fracture in a 49 year-old. A 49 year-old male firefighter underwent arthroscopic rotator cuff repair for shoulder pain after magnetic resonance imaging revealed supraspinatus tendon tear. The patient’s pain persisted after surgery, and was described as routine until he developed severe pain after minor blunt trauma. A local Emergency Room performed the first x-rays, which revealed a pathologic fracture of the distal clavicle through a destructive lesion. The patient was referred to an orthopedic oncologist, who performed incisional biopsy, which initially diagnosed osteomyelitis. The patient was subsequently taken to surgery for debridement. Pathology then yielded the diagnosis of eosinophilic granuloma. The patient was taken back to surgery for formal curettage with open reduction and internal fixation. The patient’s pain resolved, the pathologic fracture fully healed, and the patient returned to full time work as a firefighter. Though workup for common shoulder conditions often identifies incidental benign lesions of bone, the converse can be true. Persistent pain despite intervention should raise concern for further investigation. An x-ray alone can reveal a destructive bone lesion as the source of shoulder pain.
Liu, J; Zhong, D; Liu, L; Sun, C; Han, D; Yang, W
To investigate the clinical course, histologic feature, diagnosis, differential diagnosis and treatment of giant cell reparative granuloma (GCRG). Three cases of GCRG, which arose in the skull, were collected from 1987 to 1999 and analyzed clinicopathologically. Two patients had the lesion in the temporal bone and one in the orbit. One patient with GCRG had a recurrence after incomplete surgical resection. Histologically, all of three cases were characterized by fibroblastic proliferation with osteoclast-like giant cell rich areas, hemorrage, and newly formed bone or osteoid trabeculae. GCRG appeared as a typical bony lytic lesion on computed tomography (CT) and as low signal intensity on both T1 and T2 weighted images on magnetic resonance imaging (MRI). GCRG is an uncommon nonneoplastic lesion that typically arises in mandible and maxilla and its involvement in skull is rare. Although behaves benignly, GCRG may be locally aggresive. It is usually misdiagnosed for a giant cell tumor (GCT). Diagnosis of GCRG is based on typical histologic features as well as clinical information. Complete surgical resection is believed to be the most suitable treatment for GCRG and long-term follow-up by CT scanning is essential.
Cler, Meredith J.; Lien, Yu-An, S.; Braden, Maia N.; Mittleman, Talia; Downing, Kerri; Stepp, Cara, E.
Purpose: This article describes the development and initial validation of an objective measure of nasal air emission (NAE) using nasal accelerometry. Method: Nasal acceleration and nasal airflow signals were simultaneously recorded while an expert speech language pathologist modeled NAEs at a variety of severity levels. In addition, microphone and…
Full Text Available Periapical granulomas are lesions around the apex of a tooth caused by a polymicrobial infection. Treatment with antibacterial agents is normally performed to eliminate bacteria from root canals; however, loss of the supporting alveolar bone is typically observed, and tooth extraction is often selected if root canal treatment does not work well. Therefore, bacteria and other microorganisms could be involved in this disease. To understand the pathogenesis of periapical granulomas more precisely, we focused on the association with Epstein-Barr virus (EBV using surgically removed periapical granulomas (n = 32. EBV DNA was detected in 25 of 32 periapical granulomas (78.1% by real-time PCR, and the median number of EBV DNA copies was approximately 8,688.01/μg total DNA. In contrast, EBV DNA was not detected in healthy gingival tissues (n = 10; the difference was statistically significant according to the Mann-Whitney U test (p = 0.0001. Paraffin sections were also analyzed by in situ hybridization to detect EBV-encoded small RNA (EBER-expressing cells. EBER was detected in the cytoplasm and nuclei of B cells and plasma cells in six of nine periapical granulomas, but not in healthy gingival tissues. In addition, immunohistochemical analysis for latent membrane protein 1 (LMP-1 of EBV using serial tissue sections showed that LMP-1-expressing cells were localized to the same areas as EBER-expressing cells. These data suggest that B cells and plasma cells in inflamed granulomas are a major source of EBV infection, and that EBV could play a pivotal role in controlling immune cell responses in periapical granulomas.
Full Text Available Tuberculosis (TB is responsible for death of nearly two million people in the world annually. Upon infection, Mycobacterium tuberculosis (Mtb causes formation of granuloma where the pathogen goes into dormant state and can live for decades before resuscitation to develop active disease when the immune system of the host is weakened and/or suppressed. In an attempt to better understand host-pathogen interactions, several groups have been developing in vitro models of human tuberculosis granuloma. However, to date, an in vitro granuloma model in which Mtb goes into dormancy and can subsequently resuscitate under conditions that mimic weakening of the immune system has not been reported. We describe the development of a biomimetic in vitro model of human tuberculosis granuloma using human primary leukocytes, in which the Mtb exhibited characteristics of dormant mycobacteria as demonstrated by (1 loss of acid-fastness, (2 accumulation of lipid bodies (3 development of rifampicin-tolerance and (4 gene expression changes. Further, when these micro granulomas were treated with immunosuppressant anti-tumor necrosis factor-alpha monoclonal antibodies (anti-TNFα mAbs, resuscitation of Mtb was observed as has been found in humans. In this human in vitro granuloma model triacylglycerol synthase 1deletion mutant (Δtgs1 with impaired ability to accumulate triacylglycerides (TG, but not the complemented mutant, could not go into dormancy. Deletion mutant of lipY, with compromised ability to mobilize the stored TG, but not the complemented mutant, was unable to come out of dormancy upon treatment with anti-TNFα mAbs. In conclusion, we have developed an in vitro human tuberculosis granuloma model that largely exhibits functional features of dormancy and resuscitation observed in human tuberculosis.
Full Text Available Anterior nasal spine fractures are a quite rare type of nasal bone fractures. Associated cervical spine injuries are more dangerous than the nasal bone fracture. A case of the anterior nasal spine fracture, in a 18-year-old male was presented. Fracture of the anterior nasal spine, should be considered in the differential diagnosis of the midface injuries and also accompanying cervical spine injury should not be ignored.
King, R.R.; Greiner, E.C.; Ackerman, N.; Woodard, J.C.
A five-year-old dog was evaluated for chronic nasal discharge. Nasal infection caused by Capillaria aerophila was diagnosed by identification of adult nematodes and eggs in the nasal flush sediment and by nasal biopsy samples and eggs in faecal flotations. Reinfection occurred following treatment with fenbendazole and ivermectin, probably because of a contaminated housing area
Full Text Available Jennifer R Cook, Karen E Russell, Kristin B Eden, Aline Rodrigues-HoffmannDepartment of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USAAbstract: Although cryptococcosis is usually associated with respiratory and neurologic signs in domestic species (such as sneeze, cough, nasal discharge, seizures, ataxia, clinical manifestations of the disease may be more subtle and nonspecific. A 3-year-old male castrated Boxer dog presented with a history of chronic vomiting, diarrhea, weight loss, and lethargy. At no time had respiratory or neurologic signs been noted by the owners or the primary care veterinarian. Palpation of an abdominal mass revealed an atypical lesion location: a large (16 × 9 × 7 cm mass at the root of the mesentery. Diagnosis was achieved through cytology of this mass and a positive serologic Cryptococcus capsular antigen titer; polymerase chain reaction was utilized for speciation of the abdominal isolate as Cryptococcus neoformans variety grubii. The animal was euthanized due to poor prognosis. After necropsy and histopathologic analysis, the mesenteric mass and associated lymph nodes were identified as large fungal granulomas. This is a rare manifestation of cryptococcosis, involving several visceral organs, with no remaining evidence of the route of entry of the organism. As prompt diagnosis of mycotic illness is paramount to successful management, this case indicates that cryptococcal infection should be considered as a differential diagnosis in dogs with gastrointestinal signs and lymphadenopathy. The protean nature of cryptococcosis is discussed within the context of a brief review of emerging and unresolved issues in pathogenesis.Keywords: Cryptococcus gattii, granuloma, lymphadenitis
Full Text Available Background: Peripheral giant cell granuloma is one of the reactive hyperplastic lesions of the oral cavity, which originates from the periosteum or periodontal membrane following local irritation or chronic trauma. The purpose of this study was to present the clinical characteristics of peripheral gi-ant cell granuloma in a group of Iranian population. Methods: A series of 123 consecutive confirmed cases of peripheral giant cell granuloma after biopsy were evaluated. Age, sex, anatomic location, consistency, etiologic factor, pain and bleeding history, color, surface texture, and pedicle situation were recorded and were analyzed by chi-square test and values were considered to be significant if P < 0.05. Results: Age ranged from 6 to 75 years (mean 33 years. Women affected more than men (M/F 1:1.1. Peripheral giant cell granuloma was seen in the mandible more than in the maxilla and in the anterior region more than in the posterior region. In most cases, lesions were pink, pedunculated and had non-ulcerated surface. In less than half of the cases, there was no history of bleeding and also pain was rarely reported. Calculus was the most common etiologic factor. Conclusion: The results confirmed that the clinical features of peripheral giant cell granuloma in a group of Iranian population are almost similar to those reported by other investigators.
Full Text Available Background The distinction between radicular cysts and apical granulomas is important in treatment decision. Objectives The current study aimed to differentiate these two lesions based on radiography images. Patients and Methods The material consisted of 138 radiographs obtained using Kodak E -speed, in patients aged 29 to 47, divided into two groups: 109 granulomas and 29 radicular cysts. Size of radiography images was measured; the tooth then was extracted and examined in pathologist lab. The results were analyzed by SPSS.15 and ROC curve was created to find cut-off point to differentiate periapical granuloma and radicular cysts. Results Average size of radiography in periapical granuloma was 7.4 mm and for a radicular cyst was 11.1 mm. Cut-off point was 8.2 mm and the area under curve (AUC was 0.63. Also, the tests were 83% sensitive and 79% specific. Conclusions Based on 8.2 mm cut-off point could differentiate 83% periapical granulomas and 79% radicular cysts from radiography images.
Yücebaş, Kadir; Taşkın, Ümit; Oktay, Mehmet Faruk; Tansuker, Hasan Deniz; Erdil, Mehmet; Altınay, Serdar; Kozanoğlu, Erol; Kuvat, Samet Vasfi
The aim of this study is to determine the effectiveness and biocompatibility of polypropylene mesh for the repair of nasal septal perforations in an animal model on rabbits. A full-thickness nasal septal perforation with a diameter of nearly 10 × 10 mm was created on 12 rabbits, and then the perforation was reconstructed with two different methods. We used mucosal flaps and polypropylene mesh as an interpositional graft in group 1. Only mucosal flaps were used for reconstruction and are identified as group 2. After 4 weeks, we removed the nasal septum of the rabbits and performed histopathological examinations for acute rejection, infection, inflammatory response, fibrosis, and granuloma formation. We found perforation closure rates of 75 and 25 % in groups 1 and 2, respectively. Inflammatory response was seen in all specimens of group 1 (100 %). The inflammatory response was +1 in five of the specimens (62.5 %), +2 in one specimen (12.5 %), and +3 in two specimens (25 %). Mild fibrosis around the mesh was detected in four specimens (50 %), medium-level fibrosis was detected in one (12.5 %), and no fibrosis was detected in three (37.5 %). Severe fibrosis was not seen in any specimens. The foreign-body reaction was limited to a few giant cells, and granuloma formation was seen in two specimens (25 %). The propylene mesh showed excellent biocompatibility with the septal mucosa, and it can, therefore, be used for the repair of septal perforation as an interpositional graft safely.
Robinson, Prema; White, A Clinton; Lewis, Dorothy E; Thornby, John; David, Elliott; Weinstock, Joel
Neurocysticercosis, a parasitic infection of the human central nervous system caused by Taenia solium, is a leading cause of seizures. Seizures associated with neurocysticercosis are caused mainly by the host inflammatory responses to dying parasites in the brain parenchyma. We previously demonstrated sequential expression of Th1 cytokines in early-stage granulomas, followed by expression of Th2 cytokines in later-stage granulomas in murine cysticercosis. However, the mechanism leading to this shift in cytokine response in the granulomas is unknown. Neuropeptides modulate cytokine responses and granuloma formation in murine schistosomiasis. Substance P (SP) induces Th1 cytokine expression and granuloma formation, whereas somatostatin inhibits the granulomatous response. We hypothesized that neuropeptides might play a role in regulation of the granulomatous response in cysticercosis. To test this hypothesis, we compared expression of SP and expression of somatostatin in murine cysticercal granulomas by using in situ hybridization and immunohistochemistry. We also compared expression with granuloma stage. Expression of SP mRNA was more frequent in the early-stage granulomas than in the late-stage granulomas (34 of 35 early-stage granulomas versus 1 of 13 late-stage granulomas). By contrast, somatostatin was expressed primarily in later-stage granulomas (13 of 14 late-stage granulomas versus 2 of 35 early-stage granulomas). The median light microscope grade of SP mRNA expression in the early-stage granulomas was significantly higher than that in the late-stage granulomas (P = 0.008, as determined by the Wilcoxon signed rank test). By contrast, somatostatin mRNA expression was higher at later stages (P = 0.008, as determined by the Wilcoxon signed rank test). SP and somatostatin are therefore temporally expressed in granulomas associated with murine cysticercosis, which may be related to differential expression of Th1 and Th2 cytokines.
Fentanyl nasal spray is used to treat breakthrough pain (sudden episodes of pain that occur despite round ... effects of the medication) to narcotic pain medications. Fentanyl is in a class of medications called narcotic ( ...
... Butorphanol is in a class of medications called opioid agonist-antagonists. It works by changing the way ... stop using butorphanol nasal spray, you may experience withdrawal symptoms such as nervousness, agitation, shakiness, diarrhea, chills, ...
Pepper, Amber N; Ledford, Dennis K
Nasal and ocular challenges facilitate the evaluation of subjective and objective responses to defined allergen or irritant exposure. Nasal and ocular allergen challenges are the gold standard to diagnose allergic rhinitis and conjunctivitis, respectively, and aid in the evaluation of novel therapies in clinical trials. Additionally, nasal and ocular allergen challenges might help identify medically relevant allergens in clinical practice. Nonspecific or irritant challenges evaluate mucosal hyperreactivity. Direct mucosal challenges, which can be performed in an office or research setting, expose the participant to higher allergen doses than common in the natural environment. Park studies and environmental chambers, which are most practical in clinical trials, more closely simulate natural allergen exposure. International consensus guidelines for nasal and ocular challenges do not exist. Therefore the positivity criteria, methodologies, and extract or allergen preparations used in challenges vary in the literature. Regardless of these limitations, nasal and ocular challenges are helpful clinical and research tools for nasal and ocular diseases. Copyright © 2018 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
VK, Varsha; Hallikeri, Kaveri; Girish, HC; Murgod, Sanjay
Background: Central and Peripheral giant cell granulomas of jaws are uncommon, benign, reactive disorders that are characterized by the presence of numerous multinucleated giant cells and mononuclear cells within a stroma. The origin of the multinucleated giant cells is controversial; probably originating from fusion of histiocytes, endothelial cells and fibroblasts. Objective: To assess the expression of CD34 and CD68 in central and peripheral giant cell granulomas to understand the origin of these multinucleated giant cells. Materials and Methods: Twenty cases of Central and Peripheral giant cell granulomas were evaluated immunohistochemically for CD34 and CD68 proteins expression. Results: Immunopositivity for CD34 was seen only in cytoplasm of endothelial cells of blood vessels; whereas, consistent cytoplasmic immunopositivity for CD68 was seen in few stromal cells. Statistical significance was seen in mean number of multinucleated giant cells, mean number of nuclei in multinucleated giant cells, CD68 expression and ratio of macrophages to multinucleated giant cells among two lesions. Conclusion: Although the central giant cell granulomas share some clinical and histopathological similarities with peripheral giant cell granulomas, differences in mean number of nuclei in multinucleated giant cells and CD68 immunoreactivity may underlie the distinct clinical behavior. PMID:25948986
Nthumba Peter M
Full Text Available Abstract Introduction Pyogenic granuloma or lobular capillary hemangioma remains an etiopathological enigma, with trauma, inflammatory and infectious agents being the commonest suspected causative agents. These lesions affect mucous membranes of the upper aero-digestive tract, and skin. HIV patients diagnosed with pyogenic granuloma present with multiple lesions, caused by Bartonella spp. Case presentation A 28-year-old woman presented with a solitary large tumor on a skin graft donor site on her left thigh. On excision and histological examination the tumor was found to be a lobular capillary hemangioma (pyogenic granuloma. Further investigation in search of a possible explanation for this unusual presentation revealed HIV infection as the underlying cause. Conclusion This report underscores the fact that the full spectrum of presentation of HIV infection is still unknown. Unusual or unexpected presentations should arouse suspicion of underlying immunosuppression, especially in HIV endemic areas.
Cui Fa; Feng Shiting
Objective: To study the imaging features of costal eosinophilic granuloma so as to improve diagnosis accuracy of the disease. Methods: The clinical and imaging materials of 6 patients with costal solitary eosinophilic granuloma which were proved by surgery or histopathology were analyzed retrospectively. X-ray plain films were performed in all the cases, CT in 3 cases, 2 cases were received CT plain scan and I case received both CT plain scan and enhanced CT scan. Results: 4 cases of them located in the anterior ribs. All the lesions were round-like and 5 were single cavity and 1 was multiple cavities. 3 of them were expansile destruction and 3 were cystic destruction. Soft tissue mass around the lesion was identified. Conclusion: X-ray plain films integrating CT play an important role in diagnosis and differential diagnosis of the costal eosinophilic granuloma. (authors)
Font, Ramon L; Blanco, Gonzalo; Soparkar, Charles N; Patrinely, James R; Ostrowski, Mary L
To report a case of cherubism with extensive, bilateral orbital involvement occurring in a 27-year-old woman who had the diagnosis established at the age of 4 years. Single interventional case report. Ophthalmologic examination and computed tomography were performed. The patient underwent multiple surgical excisions using a bicoronal and transorbital approach. The excised orbital tissues were studied histopathologically. Computed tomography showed bilateral inferior lateral masses involving the orbital floors and producing marked superior displacement of the orbital contents. The intrinsic expansile bone lesions involved the inferior and lateral orbital walls with apical compression of the optic nerves. Histopathologic examination of the masses revealed scattered giant cells in a fibroblastic stroma containing small vascular channels. The lesion was interpreted as giant cell reparative granuloma. Giant cell reparative granuloma is an uncommon bone lesion that might involve the orbit. Cherubism should be included in the differential diagnosis of lesions that show the histopathologic features of giant cell reparative granuloma.
Chopra, Ajay; Mitra, Debdeep; Sharma, Loknandini; Agarwal, Reetu
We report the case of a 32-year- old man with a short 3-week history of erythematous, annular, non scaly plaques on palmar and dorsal aspect of his hands, who was concurrently diagnosed as a case of sarcoidosis on the basis of findings of generalized lymphadenopathy and radiological and histological features of pulmonary sarcoidosis. His skin biopsy was consistent with the diagnosis of granuloma annulare. Sarcoidosis and granuloma annulare are two separate diseases, which involve the skin and have a mononuclear histiocytic cellular reaction, although their aetiology is still unknown. Granuloma annulare has been associated with the concomitant diagnosis of sarcoidosis in only two more case reports and this association can be evaluated further to study a common link in the aetipathogenesis of these two granulomatous skin diseases.
Pathogenic mycobacteria of the Mycobacterium tuberculosis complex such as Mycobacterium bovis, induce a characteristic lesion known as a granulomas. Granulomas represent a specific host response to chronic antigenic stimuli, such as foreign bodies, certain bacterial components, or persistent pathoge...
Jeong Min Lee
Full Text Available A foreign body granuloma is a non-allergic chronic inflammatory reaction that is mainly composed of multinucleated giant cells. Foreign body granulomas may occur after the administration of any dermal filler. Factors such as the volume of the injection, impurities present in the fillers, and the physical properties of fillers affect granuloma formation. The formation of granulomas involves five phases: protein adsorption, macrophage adhesion, macrophage fusion, and crosstalk. The clinical and pathologic features of granulomas vary depending on the type of filler that causes them. Foreign body granulomas can be treated effectively with intralesional corticosteroid injections. Surgical excisions of granulomas tend to be incomplete because granulomas have ill-defined borders and moreover, surgical excisions may leave scars and deformities.
Full Text Available Giant cell granuloma is a benign proliferative pathological lesion of the bone accounting for less than 7% of lesions of the jaw, predominant in females and most commonly seen in anterior segment of jaws. Mandible is more commonly affected. Radiographically, the lesion may present with diffuse or irregular borders, sometimes leading to expansion of cortex, displacement of teeth, or root resorption. We present a case of aggressive central giant cell granuloma in a 45-year-old female patient in the right mandibular alveolar ridge presenting as an irregular mass causing displacement of teeth.
James G. Gallo
Full Text Available Severe dermatophyte infection is rare in immunocompetent adults. Recently cases have been described in travelers returning from South East Asia (Luchsinger et al., 2015 . These may be sexually transmitted and can have permanent sequelae. We describe the first reported case of Majocchi's granuloma (MG in an Australian returned traveler and its subsequent transmission via sexual contact. Both patients were successfully treated with systemic antifungals. MG should be considered in patients with severe rash after travel to South East Asia. Keywords: Trichophyton interdigitale, Majocchi's granuloma, Dermatophyte infection, Tinea corporis
Young, E; Dabrowski, M; Brelsford, K
To present a case of, and to review the literature concerning, osteoblastoma of the nasal cavity, and to demonstrate the importance of considering this rare entity when assessing patients presenting with a nasal septum lesion. Benign osteoblastoma is a rare tumour, constituting 1 per cent of all bone tumours. Most cases occur in the long bones. Osteoblastoma involving the nasal cavity is rare, with only 10 reported cases in the English-language literature. Most nasal cavity cases originate from the ethmoid sinus and spread to involve the nasal cavity. There are only four reported cases of osteoblastoma originating from the bones of the nasal cavity. We report a case of osteoblastoma originating from the bony nasal septum in a 45-year-old man with a history of recurrent, right-sided epistaxis and nasal obstruction. This is the second report in the English-language literature of osteoblastoma originating from the bony nasal septum.
Full Text Available Introduction. Plasmacytomas are malignant tumors characterized by abnormal monoclonal proliferation of plasma cells. They originate in either bone - solitary osseous plasmacytoma, or in soft tissue - extramedullary plasmacytoma (EMP. EMP represents less than 1% of all head and neck malignancies. Case report. We presented a case of EMP of the nasal septum in a 44-year-old male who had progressive difficulty in breathing through the nose and frequent heavy epistaxis on the right side. Nasal endoscopy showed dark red, soft, polypoid tumor in the last third of the right nasal cavity arising from the nasal septum. The biopsy showed that it was plasmacytoma. Bence Jones protein in the urine, serum electrophoresis, bone marrow biopsy, skeletal survey and other screening tests failed to detect multiple myeloma. This confirmed the diagnosis of EMP. The mass was completely removed via an endoscopic approach, and then, 4 week later, radiotherapy was conducted with a radiation dose of 50 Gray. No recurrence was noted in a 3-year follow- up period. Conclusion. EMP of the nasal cavity, being rare and having long natural history, represents a diagnostic and therapeutic challenge for any ear, nose and throat surgeon. Depending on the resectability of the lesion, a combined therapy is the accepted treatment.
Full Text Available RESUMO: O granuloma leproide canino (GLC é uma doença micobacteriana que cursa com lesão nodular, cutânea ou subcutânea, tipicamente auto limitante, decorrente de infecção pelo Mycobacterium. É uma doença dermatológica rara, usualmente relatada em países de clima tropical. O objetivo deste trabalho é caracterizar as alterações microscópicas e epidemiológicas de casos de GLC. Além disso, utilizar exames complementares para demonstração do Mycobacterium sp. na lesão analisada utilizando coloração de Ziehl-Neelsen, imuno-histoquímica e PCR para classificação e sequenciamento da espécie de Mycobacterium. Foram analisados 27 casos de GLC diagnosticados no período compreendido de 2005 a 2014 (21 exames histológicos e seis citológicos. A raça mais acometida foi Boxer (33,3%, seguida da Dachshund (11,1%. Foi frequente o acometimento de caninos de grande porte (64% e de pelame curto (96%. Não foi possível estabelecer qualquer padrão de sazonalidade do GLC. As lesões se localizaram anatomicamente no pavilhão auricular na maioria dos casos (93%, constituindo-se de nódulos únicos ou múltiplos, ulcerados ou não. Em nenhum dos casos foi observado acometimento sistêmico. Lesões histológicas seguiram três padrões que variaram de nodulares a difusos, com infiltrado granulomatoso/piogranulomatoso com envolvimento de derme superficial e profunda. A observação de bacilos pela coloração de Ziehl-Neelsen confirmou o diagnóstico. Este teste demonstrou grande variação na quantidade de bacilos nas lesões, não relacionado estatisticamente ao tipo da lesão nem ao período evolutivo. A imuno-histoquímica foi positiva em 90% dos casos, e em alguns casos facilitou a identificação de bacilos, entretanto, em dois casos ocorreram resultados negativos mesmo havendo marcação pela coloração de Ziehl-Neelsen. Na técnica de PCR realizada em 18 amostras, 44% dos casos foram positivos, duas sequências inespecíficas, e
Thiago de Santana SANTOS
Full Text Available Objectives: To evaluate the prevalence of pyogenic granuloma and compare the data obtained with those of other reports in the worldliterature. Methods: The study material was surveyed from the records of patients with diagnosis of oral pyogenic granuloma, at the Oral Pathology Laboratory of the School of Dentistry of the University of Pernambuco, in the period from January 1992 to March 2007 (15 years. The following indicators were analyzed: gender, age group, race, anatomic location, diameter of lesions and presence of symptomatology.Results: Among the 5007 records in the laboratory, 3.81% corresponded to lesions diagnosed as oral pyogenic granuloma, in which 19.9% of the patients were in the second decade of life, 40.1% were white, the gingiva was the most affected location (77.9% and lesion of smaller diameter (0.1 to 2 cm were those most observed at the initial diagnosis. Conclusion: The clinical-pathological characteristics of oral pyogenic granuloma in the studied population are similar to those of other studies in the literature
Minguetti, G. (Parana Univ., Curitiba (Brazil). Dept. de Clinica Medica)
7 cases of paracoccidioidomycosis with CNS involvement studied by computerized tomography which showed granulomas in the superficial area of the temporal lobe (4), in the deep region of the temporal (2), frontal (1), parietal (2) and occipital lobes (1) and in the posterior fossa (3) are presented. In the experience of the Author paracoccidioidal granulomas of the CNS appear as single or multiple lesions which enhance contrast in a ring-like pattern with a small amount of peri-focal edema and insignificant mass effect, unless the lesion is located in the posterior fossa. The differential diagnosis has to be made mainly with metastases, abscesses, gliomas, neutrocistycercosis and other space occupying lesions which enhance contrast in a ring-like pattern. This report suggests that CT scanning may be used for early detection and monitoring of number and size of paracoccidioidal granulomas of the brain, thus allowing safer decision as to surgical or pharmacological treatment. This would decrease the high morbidity and mortality associated with surgical procedures in cases of paracoccidioidal granulomas of the brain.
Background: Pyogenic granulomas, when presented late, can sometimes pose diagnostic challenge due to their remarkably large sizes. There has been no known published data among Ghanaians on this subject. Aim: To determine the clinical, demographic, pathological features and management of oral pyogenic.
Microscopically, there was severe diffuse testicular degeneration and necrosis of the germinal epithelial cells, extravasation of spermatozoa into the epididymal interstitium, inciting a granulomatous reaction with arteritis. Based on these findings, sperm cell granuloma was diagnosed. This is probably the first reported case ...
Giant cell reparative granuloma (GCRG) is a rare, benign intra osseous lytic lesion occurring especially in gnathis bone but also seen in feet and hands. It has similar clinical and radiological presentations than giant cell tumor, chondroblastoma, aneurysmal bone cyst, and hyperparathyroidism brown tumors but with specific ...
Case Details: Herein, we report a case of eosinophilic granuloma in a ten years old boy involving posterior quadrants upper and lower jaws as a destructive lesion involving gingiva, periodontium and alveolar bone. Involvement of other bones is ruled out by nucleotide imaging study. Conclusion: EG should be considered ...
The association of granuloma annulare (GA) and autoimmune thyroiditis has been documented in the literature in 13 previous cases. However, the pathogenesis of GA remains obscure. Possible pathogenetic factors suggested include: humoral and delayed type hypersensitivity, vascular damage, metabolic disorder, or, ...
N. Merino de Paz
Full Text Available Vitiligo is the most common depigmenting disorder, with a worldwide occurrence of 0.1–2% in the general population. Multiple conditions have been described colocalized in vitiligo patches, like psoriasis or lichen planus. However, actinic granuloma has not been described in association with vitiligo lesions so far.
Data Resources: We reviewed liver biopsy specimens received in the pathology department of the University College Hospital, Ibadan, Nigeria over a 10-year period (1983-1992). Study Selection and Data Extraction: Cases classified as granulomas were retrieved and further studied with relevant data extracted from ...
Herrtwich, Laura; Nanda, Indrajit; Evangelou, Konstantinos
granuloma-resident macrophages formed via modified cell divisions and mitotic defects and not, as previously thought, by cell-to-cell fusion. TLR2 signaling promoted macrophage polyploidy and suppressed genomic instability by regulating Myc and ATR. We propose that, in the presence of persistent...
Pyogenic granuloma is an exophytic lesion which arises as a result of an exuberant connective tissue reaction to a known stimulus or injury. Common sites of presentation include oral mucosa, face and fingers. It may occour at any age but mostly in the second decade of life and more common in females. Surgical excision ...
Virkkunen, Sirke; Wolff, Henrik; Haglund, Caj
Objective: Oral pulse granuloma (OPG) is an oral inflammatory lesion characterized by the presence of hyaline rings with numerous multinucleated giant cells. The etiopathogenesis of this lesion is thus far unclear, as is the composition of the hyaline rings. Our aim was to investigate whether...
Full Text Available Background. Pyogenic granuloma is a reactive tumor-like lesion commonly affecting the oral cavity. These lesions usually appear as localized solitary nodule with a sessile or pedunculated base and colour varying from red, purplish, or pink, depending on the vascularity of the lesion. Pyogenic granuloma shows predilection for gingiva and is usually slow growing, but at times it shows rapid growth. The natural course of this lesion can be categorized into three distinct phases, namely, (i cellular phase, (ii capillary phase/vascular phase, and (iii involutionary phase. Histopathologically, pyogenic granuloma is classified into lobular capillary hemangioma (LCH and non-lobular capillary hemangioma (non-LCH. Case Presentation. In this series, four cases (varied age groups and both genders of pyogenic granuloma showing varying histopathological presentation in relation to its clinical course have been described. The lesion in its early phase reveals diffuse endothelial cells, with few budding into capillaries. Among the capillary phase, the LCH type shows numerous blood vessels organized into lobular aggregates whereas the non-LCH type does not show any such organization and resembles granulation tissue. The involutionary phase shows healing of the lesion and is characterized by extensive fibrosis in the connective tissue. Conclusion. In conclusion, knowledge of the various histopathological presentation of this lesion is necessary for proper identification.
Guilherme D'Andréa Saba Arruda
Full Text Available Relatamos o caso de um paciente de 61 anos, masculino, internado com objetivo de exérese de massa pulmonar para estudo anatomopatológico. O paciente apresentara anteriormente um quadro de febre, tosse seca e dor torácica, associado à presença de massas pulmonares detectadas por radiografia de tórax, tendo sido submetido em duas ocasiões (1976 e 1981 a toracotomia para a investigação diagnóstica, sem diagnóstico anatomopatológico conclusivo. A TC de tórax revelou volumosas massas com áreas de calcificação em ambos os campos pulmonares. O material do estudo anatomopatológico foi compatível com granuloma hialinizante de pulmão. No pós-operatório, o paciente apresentou vários episódios de broncoespasmo que foram revertidos com medicação sintomática. Foi mantido com prednisona na dose de 40 mg/dia com boa evolução clínica até o envio deste relato.We report the case of a 61-year-old male patient who underwent surgical excision of a lung mass for anatomopathological study. The patient had previously presented with fever, dry cough, and chest pain, together with lung masses detected by chest X-ray, and had undergone thoracotomy for diagnostic investigation on two occasions (1976 and 1981, although a conclusive diagnosis had not been made. A CT scan of the chest revealed large masses with areas of calcification in both lung fields. The anatomopathological study was consistent with pulmonary hyalinizing granuloma. In the postoperative period, the patient experienced several episodes of bronchospasm, which was reversible with the use of symptomatic medication. At this writing, the patient was receiving maintenance therapy with prednisone (40 mg/day and had shown clinical improvement.
Brown, C Scott; Ryan, Marisa A; Ramprasad, Vaibhav H; Karas, Anatoli F; Raynor, Eileen M
Suprastomal granulomas pose a persistent challenge for tracheostomy-dependent children. They can limit phonation, cause difficulty with tracheostomy tube changes and prevent decannulation. We describe the use of the coblator for radiofrequency plasma ablation of suprastomal granulomas in five consecutive children from September 2012 to January 2016. Retrospective case series at a tertiary medical center. The suprastomal granuloma could be removed with the coblator in all 5 cases. Three were removed entirely endoscopically and 2 required additional external approach through the tracheal stoma for complete removal. There were no intraoperative or postoperative complications. One patient was subsequently decannulated and 2 patients have improved tolerance of their speaking valves. Two patients remain ventilator dependent, but their bleeding and difficulty with tracheostomy tube changes resolved. Three of the patients have had subsequent re-evaluation with bronchoscopy, demonstrating resolution or markedly decreased size of the granuloma. This technique is time efficient, simple and minimizes risks associated with other techniques. The relatively low temperature and use of continuous saline irrigation with the coblator device minimizes the risk of airway fires. Additionally, the risk of hypoxia from keeping a low fractional inspiratory oxygen level (FIO 2 ) to prevent fire is avoided. The concurrent suction in the device decreases blood and tissue displacement into the distal airway. Coblation can be used safely and effectively with an endoscopic or external approach to remove suprastomal granulomas in tracheostomy-dependent children. More studies that are larger and have longer follow-up are needed to evaluate the use of this technique. Copyright © 2017 Elsevier B.V. All rights reserved.
Nair, Vinod; Singh, Surender; Gupta, Yogendra Kumar
Background: Coriandrum sativum has been used in the traditional systems of medicine for management of arthritis and other inflammatory disorders. Objectives: In this study, we have evaluated the anti-inflammatory and anti-granuloma activities of Coriandrum sativum hydroalcoholic extract (CSHE) in experimental models. Materials and Methods: The anti-inflammatory activity of CSHE was evaluated using carrageenan-induced paw edema model and the anti-granuloma activity of CSHE was evaluated using the subcutaneous cotton pellet implantation-induced granuloma formation and stimulation of peritoneal macrophages with complete Freund's adjuvant. Serum tumor necrosis factor-α (TNF-α), IL-6, IL-1 β levels, and peritoneal macrophage expression of TNF-R1 were evaluated as markers of global inflammation. Results: CSHE at the highest dose tested (32 mg/kg) produced a significant reduction (P < 0.05) in paw edema after carrageenan administration. CSHE treatment also reduced dry granuloma weight in all treated animals. Serum IL-6 and IL-1 β levels were significantly (P < 0.05) lower in the CSHE (32 mg/kg)-treated group as compared to control. Although there was an increase in serum TNF-α level in the CSHE-treated group as compared to control, TNF-R1 expression on peritoneal macrophages was found to be reduced. Conclusion: Thus, the result of this study demonstrates the anti-inflammatory and anti-granuloma activities of CSHE in experimental models, and validates its traditional use for the management of arthritis and other inflammatory disorders. PMID:23741156
Sack, H.; Horch, H.H.; Schaefer, H.E.; Wustrow, F.
The granuloma gangraenescens in the oral, maxillary and facial region is a rare disease. It is a destroying process in the region of palate, nose, paranasal sinuses, cheeks and orbit with characteristic signs of granulomatosis, infection and malignancy. The disease shows often a lethal development with cachexia or sepsis. Besides local inflammations and tumors, the granulomatosis of Wegener, and the so-called necrotizing sialometaplasia are above all to be excluded by differential diagnosis. Five cases are presented in order to describe the diagnostic and therapeutic problems. In literature, the greatest efficacy is attributed to radiotherapy, however, a detailed definition of the most efficient irradiation conditions cannot be given yet because of the small number of cases. Good long-term results or recoveries can be achieved in 75 to 80% of cases by a relatively high radiation dose of 40 to 50 Gy administered within four to five weeks. During the observation time of two to six years, no one of the five patients treated here only by megavoltage therapy showed a recurrence.
... nasal complaints. Nasal deformity can be categorized as “cosmetic” or “functional.” Cosmetic deformity of the nose results in a less ... taste , nose bleeds and/or recurrent sinusitis . A cosmetic or functional nasal deformity may occur secondary to ...
Cromolyn comes as a solution to use with a special nasal applicator. It usually is inhaled three to six times a day to prevent allergy ... first time, read the instructions provided with the solution. Ask your doctor, pharmacist, or respiratory therapist to ...
Tracie A Seimon
Full Text Available The endoplasmic reticulum (ER stress pathway known as the Unfolded Protein Response (UPR is an adaptive survival pathway that protects cells from the buildup of misfolded proteins, but under certain circumstances it can lead to apoptosis. ER stress has been causally associated with macrophage apoptosis in advanced atherosclerosis of mice and humans. Because atherosclerosis shares certain features with tuberculosis (TB with regard to lesional macrophage accumulation, foam cell formation, and apoptosis, we investigated if the ER stress pathway is activated during TB infection.Here we show that ER stress markers such as C/EBP homologous protein (CHOP; also known as GADD153, phosphorylated inositol-requiring enzyme 1 alpha (Ire1α and eukaryotic initiation factor 2 alpha (eIF2α, and activating transcription factor 3 (ATF3 are expressed in macrophage-rich areas of granulomas in lungs of mice infected with virulent Mycobacterium tuberculosis (Mtb. These areas were also positive for numerous apoptotic cells as assayed by TUNEL. Microarray analysis of human caseous TB granulomas isolated by laser capture microdissection reveal that 73% of genes involved in the UPR are upregulated at the mRNA transcript level. The expression of two ER stress markers, ATF3 and CHOP, were also increased in macrophages of human TB granulomas when assayed by immunohistochemistry. CHOP has been causally associated with ER stress-induced macrophage apoptosis. We found that apoptosis was more abundant in granulomas as compared to non-granulomatous tissue isolated from patients with pulmonary TB, and apoptosis correlated with CHOP expression in areas surrounding the centralized areas of caseation.In summary, ER stress is induced in macrophages of TB granulomas in areas where apoptotic cells accumulate in mice and humans. Although macrophage apoptosis is generally thought to be beneficial in initially protecting the host from Mtb infection, death of infected macrophages in
Okalidou, Areti; Karathanasi, Asimina; Grigoraki, Eleni
The purposes of this study were to derive nasalance norms for monolingual Greek speakers, to examine nasalance scores as a function of gender and to draw cross-linguistic comparisons based on normative data. Participants read aloud a corpus of linguistic material, consisting of (1) a nasal text, an oral text and a balanced text; (2) a set of nasal sentences and four sets of oral sentences and (3) repetitions of each of 12 syllable types (8 oral and 4 nasal). The last two sets of material corpus were based on an adaptation of the Simplified Nasometric Assessment Procedures Test (SNAP test) test ( MacKay and Kummer, 1994 ) in Greek, called the G-SNAP test. Eighty monolingual healthy young adult speakers of Greek, 40 males (mean age = 21 years) and 40 females (mean age = 20.5 years), with normal hearing and speech characteristics and unremarkable history were included in the study. The Nasometer (model 6200-3) was used to derive nasalance scores. Mean normative nasalance for spoken Greek was 25.50%, based on the G-oronasal text (with 8.6% nasals). Nasalance scores did not differ significantly with respect to gender. Finally, spoken Greek consistently yielded lower nasalance scores than other languages examined in past work. The aforementioned normative data on nasalance of young adult speakers of Greek are valid across gender and have direct clinical utility as they provide valuable reference information for the diagnosis and management of Greek adults with resonance disorders caused by velar dysfunction.
Salguero, F J; Gibson, S; Garcia-Jimenez, W; Gough, J; Strickland, T S; Vordermeier, H M; Villarreal-Ramos, B
Cattle vaccination against bovine tuberculosis (bTB) has been proposed as a supplementary method to help control the incidences of this disease. Bacillus Calmette-Guérin (BCG) is currently the only viable candidate vaccine for immunization of cattle against bTB, caused by Mycobacterium bovis (M. bovis). In an attempt to characterize the differences in the immune response following M. bovis infection between BCG-vaccinated and non-vaccinated animals, a combination of gross pathology, histopathology and immunohistochemical (IHC) analyses was used. BCG vaccination was found to significantly reduce the number of gross and microscopic lesions present within the lungs and lymph nodes. Additionally, the microscopically visible bacterial load of stages III and IV granulomas was reduced. IHC using cell surface markers revealed the number of CD68+ (macrophages), CD3+ (T lymphocytes) and WC1+ cells (γδ T cells) to be significantly reduced in lymph node granulomas of BCG-vaccinated animals, when compared to non-vaccinated animals. B lymphocytes (CD79a+) were significantly increased in BCG-vaccinated cattle for granulomas at stages II, III and IV. IHC staining for iNOS showed a higher expression in granulomas from BCG-vaccinated animals compared to non-vaccinated animals for all stages, being statistically significant in stages I and IV. TGFβ expression decreased alongside the granuloma development in non-vaccinated animals, whereas BCG-vaccinated animals showed a slight increase alongside lesion progression. IHC analysis of the cytokines IFN-γ and TNF-α demonstrated significantly increased expression within the lymph node granulomas of BCG-vaccinated cattle. This is suggestive of a protective role for IFN-γ and TNF-α in response to M. bovis infection. Findings shown in this study suggest that the use of BCG vaccine can reduce the number and severity of lesions, induce a different phenotypic response and increase the local expression of key cytokines related to
Pignatti, Patrizia; Pala, Gianni; Pisati, Marta; Perfetti, Luca; Banchieri, Gabriella; Moscato, Gianna
To investigate the usefulness of nasal blown secretion evaluation during specific nasal provocation test (sNPT) in diagnosing occupational rhinitis (OR). To validate the method, nasal blown secretions from 103 healthy subjects and 30 allergic rhinitis patients were analyzed. Furthermore, we analyzed nasal blown secretions, collected before and after sNPT, of 29 subjects with work-related rhinitis symptoms (WRRS) who underwent the diagnostic pathway for OR. Rhinoscopy and nasal symptom score were used to define a positive sNPT. A total of 89.6% WRRS subjects provided suitable nasal secretions. Eosinophils significantly increased after positive sNPTs compared to negative ones (P = 0.006). Four percent and/or 1 x 10(4) eosinophils/ml was the cut-off for a significant post-sNPT eosinophil increase. A total of 4/13 (33%) WRRS subjects with negative sNPT, assessed by rhinoscopy and nasal symptom score, presented a significant post-sNPT nasal eosinophil increase, and were identified as possible OR. Eosinophil evaluation in nasal blown secretions is an important tool in monitoring the response to occupational specific nasal challenges.
Sacadura, Rafaela Ribeiro
Dissertação para obtenção do grau de Mestre no Instituto Superior de Ciências da Saúde Egas Moniz A saúde oral é de extrema importância para a saúde e bem-estar geral. O granuloma piogénico oral, denominado de granuloma gravídico quando ocorre em mulheres grávidas, é uma lesão que se desenvolve na mucosa oral, com predileção pela gengiva, em resposta a irritantes crónicos de baixo grau e fatores hormonais. Devido à multiplicidade de apresentações clínicas e localizações anatómicas orais, o...
Full Text Available Background. Systemic lupus erythematosus (SLE is an autoimmune disease which is known to present with a wide variety of clinical manifestations. Case Report. A 15-year-old male presented with complaints of moderate grade fever and generalized body swelling. There was no history of cough, weight loss, joint pain, oral ulcerations, skin rash, photosensitivity, loss of hair, pain abdomen, jaundice, or any significant illness in the past. Contrast enhanced computerized tomography of the abdomen revealed hypodense lesions in both liver and spleen (without contrast enhancement, suggestive of granulomas along with few retroperitoneal and mesenteric lymph nodes. On the basis of immunological tests and renal biopsy report, SLE with hepatosplenic granulomatosis diagnosis was made. He was given pulse methylprednisolone 500 mg, for 3 days and he showed dramatic improvement clinically. Conclusion. Hepatic and splenic granulomas are not common in SLE, but this should be kept in differential diagnosis.
Bharti, Anju; Meena, Lalit Prashant
Background. Systemic lupus erythematosus (SLE) is an autoimmune disease which is known to present with a wide variety of clinical manifestations. Case Report. A 15-year-old male presented with complaints of moderate grade fever and generalized body swelling. There was no history of cough, weight loss, joint pain, oral ulcerations, skin rash, photosensitivity, loss of hair, pain abdomen, jaundice, or any significant illness in the past. Contrast enhanced computerized tomography of the abdomen revealed hypodense lesions in both liver and spleen (without contrast enhancement), suggestive of granulomas along with few retroperitoneal and mesenteric lymph nodes. On the basis of immunological tests and renal biopsy report, SLE with hepatosplenic granulomatosis diagnosis was made. He was given pulse methylprednisolone 500 mg, for 3 days and he showed dramatic improvement clinically. Conclusion. Hepatic and splenic granulomas are not common in SLE, but this should be kept in differential diagnosis.
Vilela, Raquel; Bossart, Gregory D; St Leger, Judy A; Dalton, Leslie M; Reif, John S; Schaefer, Adam M; McCarthy, Peter J; Fair, Patricia A; Mendoza, Leonel
Cutaneous granulomas in dolphins were believed to be caused by Lacazia loboi, which also causes a similar disease in humans. This hypothesis was recently challenged by reports that fungal DNA sequences from dolphins grouped this pathogen with Paracoccidioides brasiliensis. We conducted phylogenetic analysis of fungi from 6 bottlenose dolphins (Tursiops truncatus) with cutaneous granulomas and chains of yeast cells in infected tissues. Kex gene sequences of P. brasiliensis from dolphins showed 100% homology with sequences from cultivated P. brasiliensis, 73% with those of L. loboi, and 93% with those of P. lutzii. Parsimony analysis placed DNA sequences from dolphins within a cluster with human P. brasiliensis strains. This cluster was the sister taxon to P. lutzii and L. loboi. Our molecular data support previous findings and suggest that a novel uncultivated strain of P. brasiliensis restricted to cutaneous lesions in dolphins is probably the cause of lacaziosis/lobomycosis, herein referred to as paracoccidioidomycosis ceti.
Chiu, Yao-Kun; Huang, Chao-Cheng; Jeng, Jingyueh; Shiea, Jentaie; Chen, Wei-Jen
We describe a 7-month-old male infant with a foreign body granuloma caused by monosodium glutamate (MSG) after a Bacille Calmette-Guérin (BCG) immunization. A ridged, erythematous, indurated plaque developed over a BCG injection site on his left upper arm 1 month after the first BCG immunization. Biopsy showed multiple noncaseating foreign body granulomas without detectable mycobacteria by both Ziehl-Neelsen stain and polymerase chain reaction assay. Birefringent crystals were identified in the foreign body giant cells with polarized light microscopy. The crystals were further determined to be glutamic acid by the method of fast atom bombardment. Hence, MSG, the only composite of BCG vaccine except the bacillus, was believed to be responsible for the granulomatous foreign body reaction. On review of the literature, we could find no previous report of an adverse reaction of BCG immunization attributable to MSG (glutamic acid).
Müller, Silvia Ferreira Rodrigues; de Miranda, Mario Fernando Ribeiro
Paracoccidioidomycosis presenting as a sarcoid-like plaque may be misdiagnosed as leprosy, especially when shared endemic areas are concerned. We report the case of a Brazilian male patient presenting with an ulcerated plaque on his left ear and neighboring areas. The plaque simulated tuberculoid leprosy type 1 reaction, both clinically and histopathologically. A perineural granuloma with no organisms detected by routine and Fite-Faraco staining reinforced that diagnosis. Paracoccidioidomycos...
Full Text Available Internal resorption was associated with long-term chronic inflammation of the pulp (chronic granulomatous pulpitis. When internal resorption is radiographically confirmed, endodontic treatment becomes a necessity. Vital teeth internal resorption appears radiographically as an oval enlargement of the pulp chamber and root canal with smooth, symmetrical outline. Internal granuloma is assumed to be an effect of the trauma, or pulp inflammation, the ailment is rare, asymptomatic and might progress rapidly, causing perforation.
Juçara C. Parra
Full Text Available Infection with Schistosoma mansoni induces humoral and T cell mediated responses and leads to delayed hipersensitivity that results in granulomatous inflamatory disease around the parasite eggs. Regulation of these responses resulting in a reduction in this anti-egg inflamatory disease is appsrently determined by idiotypic repertoires of the patient, associated with genetic background and multiple external factors. We have previously reported on idiotype/anti-idiotype-receptor transactions in clinical human schistosomiasis. These findings support a hypothesis that anti-SEA cross-reactive idiotypes develop in some patients during the course of a chronic infection and participate in regulation of anti-SEA cellular immune responses. We repport here on experiments wich extend those observations to the regulation of granulomatous hypersensitivity measured by an in vitro granuloma model. T cells from chronic intestinal schistosomiasis patients were stimulated in vitro with anti-SEA idiotypes and assayed in an autologous in vitro granuloma assay for modulation of granuloma formation. These anti-SEA idiotype reactive T cells were capable of regulating autologous in vitro granuloma formation. This regulatory activity, initiated with stimulatory anti-SEA idiotypic antibodies, was antigenically specific and was dependent on the present of intact (F(ab'2 immunoglobulin molecules. The ability to elicit this regulatory activity appears to be dose dependent and is more easily demonstrated in chronically infected intestinal patients or SEA sensitized individuals. These data support the hypothesis that anti-SEA cross reactive idiotypes are important in regulating granulomatous hypersensitivy in chronic intestinal schistosomiasis patients and these cross-reactive idiotypes appear to play a major role in cell-cell interactions which result in the regulation of anti-SEA cellular immune responses.
This presentation is a further evidence that GA and autoimmune thyroiditis may be associated. Key Words: Granuloma annulare, Autoimmune thyroiditis. Résumé L'association d'un granulome annulaire (GA) et auto-immunité de la thyroidite a été documenté dans la litterature au cours des 13 cas précédents. Toutefois, la ...
Young, Adam S.; Binkovitz, Larry A.; Adler, Brent H.; Nicol, Kathleen K.; Rennebohm, Robert M.
We describe a 15-year-old boy who developed pulmonary hyalinizing granuloma (PHG) and retroperitoneal fibrosis (RPF). His PHG and RPF were not associated with histoplasmosis or tuberculosis and appeared to represent idiopathic autoimmune phenomena. This is the first reported case of PHG in a pediatric patient and the fourth reported co-occurrence of PHG and RPF. The use of F-18 fluorodeoxyglucose positron emission tomography in the diagnostic and follow-up evaluation of PHG is reported. (orig.)
Alam, J.; Siddiqui, M.W.; Abbas, A.; Sami, M.; Ayub, Z.
To compare the benefits of ventilated nasal packing with traditional vaseline guaze nasal packing. Study Design: Randomized controlled trial. Place and Duration of Study: This study was conducted at CMH Multan, from Jun 2014 to Dec 2014. Material and Methods: In this study, sample size of 80 patients was calculated using WHO calculator. Patients were divided in two groups using lottery method endotracheal tube and piece of surgical glove filled with ribbon guaze was utilized for fabricated ventilated nasal pack and compared with traditional nasal packs. Nasal obstruction and sleep disturbance were studied at eight hours and twenty-four hours following surgery using visual analog scale. Results: Mean nasal obstruction with ventilated nasal pack was 45.62 +- 6.17 and with Vaseline nasal pack was 77.67 +- 4.85 which was statistically significant (p=0.001) in both the groups. Mean sleep disturbance in both the groups was 46.32 +- 5.23 and 68.75 +- 2.70 respectively which was statistically significant (p=0.001) in both the groups. Conclusion: Patients with ventilated nasal packs were found to have better tolerance to nasal packs due to less nasal obstruction and sleep disturbance
Full Text Available Central giant cell granuloma (CGCG is an intra-osseous lesion consisting of cellular fibrosis tissue containing multiple foci of hemorrhage, multinucleated giant cells and trabecules of woven bone. This lesion accounts for less than 7% of all benign jaw tumours. Jaffe considered it as a locally reparative reaction of bone, which can be possibly due to either an inflammatory response, hemorrhage or local trauma. Females are affected more frequently than males. It occurs over a wide age range.It has been reported that this lesion is diagnosed during the first two decades of life in approximately 48% of cases, and 60% of cases are evident before the age of 30. It is considerably more common in the mandible than in the maxilla. Most lesions occur in the molar and premolar area, some of these extending up to the ascending ramus. The presence of giant cell granuloma in the mandibular body area, the entire ramus, condyle and coronoid represents a therapeutic challenge for the oral and maxillofacial surgeons. The aim of this report is to describe an unusual presentation of central giant cell granuloma involving the mandibular body, ramus, condylar and coronoid processes, and to discuss the differentiated diagnosis, the radiographic presentation and the management of this lesion.
Fulton, R W; Downing, M M; Cummins, J M
The antiviral effects of bovine interferons on the replication of bovine respiratory tract viruses were studied. Bovine turbinate monolayer cultures were treated with bovine interferons and challenged with several bovine herpesvirus 1 strains, bovine viral diarrhea virus, parainfluenza type 3 virus, goat respiratory syncytial virus, bovine respiratory syncytial virus, bovine adenovirus type 7, or vesicular stomatitis virus. Treatment with bovine interferons reduced viral yield for each of the...
Park, Gyeong Min; Lee, Jihae; Kang, Mijin; Lee, Han Bee; Bae, Kyung Eun; Kim, Jae Hyung; Kim, Hyun Jung [Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)
Giant cell reparative granuloma is a benign reactive process following intraosseous hemorrhage rather than a true tumor. This lesion most commonly affects the maxilla and mandible, followed by phalanges, hands, and feet. Local invasion of surrounding soft tissue is a typical feature of giant cell reparative granuloma in the bones of the upper and lower limbs. We present the rare case of giant cell reparative granuloma arising from soft tissue of the foot without erosion or engulfing of the adjacent bone.
Pons, S; Ortiz Medina, A
We presented a patient with a deforming and necrotizing syndrome of the nasal pyramid. The histopathology demonstrated a lymphoma. The original works of Weiss are related. The diseases is characterized by: ecotaxis of the nasal pyramid, localized persistency during a long time, malaise in advanced studies and sensibility to radiations. We proposed the name linfoma histiocitico maligno nasal de Weiss and consider it as a autonomous entity.
Kishimoto, Mai; Tsuchiaka, Shinobu; Rahpaya, Sayed Samim; Hasebe, Ayako; Otsu, Keiko; Sugimura, Satoshi; Kobayashi, Suguru; Komatsu, Natsumi; Nagai, Makoto; Omatsu, Tsutomu; Naoi, Yuki; Sano, Kaori; Okazaki-Terashima, Sachiko; Oba, Mami; Katayama, Yukie; Sato, Reiichiro; Asai, Tetsuo; Mizutani, Tetsuya
Bovine respiratory disease complex (BRDC) is frequently found in cattle worldwide. The etiology of BRDC is complicated by infections with multiple pathogens, making identification of the causal pathogen difficult. Here, we developed a detection system by applying TaqMan real-time PCR (Dembo respiratory-PCR) to screen a broad range of microbes associated with BRDC in a single run. We selected 16 bovine respiratory pathogens (bovine viral diarrhea virus, bovine coronavirus, bovine parainfluenza virus 3, bovine respiratory syncytial virus, influenza D virus, bovine rhinitis A virus, bovine rhinitis B virus, bovine herpesvirus 1, bovine adenovirus 3, bovine adenovirus 7, Mannheimia haemolytica, Pasteurella multocida, Histophilus somni, Trueperella pyogenes, Mycoplasma bovis and Ureaplasma diversum) as detection targets and designed novel specific primer-probe sets for nine of them. The assay performance was assessed using standard curves from synthesized DNA. In addition, the sensitivity of the assay was evaluated by spiking solutions extracted from nasal swabs that were negative by Dembo respiratory-PCR for nucleic acids of pathogens or synthesized DNA. All primer-probe sets showed high sensitivity. In this study, a total of 40 nasal swab samples from cattle on six farms were tested by Dembo respiratory-PCR. Dembo respiratory-PCR can be applied as a screening system with wide detection targets.
Hayes, M. J.; McGregor, F. B.; Roberts, D. N.; Schroter, R. C.; Pride, N. B.
BACKGROUND--Obstructive sleep apnoea is a common condition. Treatment with nasal continuous positive airway pressure (CPAP), while effective and safe, causes nasal congestion and stuffiness in some patients. The hypothesis that this study aimed to test was that nasal CPAP with a mouth leak and subsequent unidirectional airflow across the nasal mucosa causes an increase in nasal mucosal blood flux and a fall in both nasal volume and minimal cross sectional area. A secondary aim was to study if...
Fokkens, Wytske J.; Hellings, Peter W.
When we discuss nasal dysfunction, we think primarily of nasal obstruction. However, other clinical signs like rhinorrheoa, sneezing, itching, burning and loss of smell, as well as perception of the form and aesthetics of the nose should not be neglected. During the last decades, we have
Full Text Available Background: Dental caries with necrotic pulp is a multifactorial disease that attacks enamel involving tooth pulp. The anaerobic bacteria infection in the pulp chamber could induce the formation of periapical granuloma. However, the presence of the most frequently anaerobic bacteria identified in apical periodontitis, Porphyromonas gingivalis and Prevotella intermedia, in periapical granuloma have not been confirmed. Purpose: The aims of study were to determine the presence of Porphyromonas gingivalis and Prevotella intermedia in dental caries with necrotic pulp and to determine its relation to periapical granuloma. Methods: Thirty-six patients of dental caries with necrotic pulp in Dr. Moewardi General Hospital in Surakarta, Indonesia were involved and classified into two groups, the group of patients with periapical granuloma and the group of patients without periapical granuloma. The caries tooth was extracted, and the chronic periapical tissue was swabbed and cultured on blood agar medium in anaerobic condition. The bacterial DNA was extracted from the positive cultures and subjected for Polymerase Chain Reaction (PCR. Results: Periapical granuloma was more likely found in women (OR 5.5, 95% CI=1.277-23.693; RR 2.5, 95% CI= 1.025-6.100. Black colonies bacteria were associated with periapical granuloma (OR 2.2, 95% CI=0.517-9.594; RR 1.5, 95% CI=0.655-3.623. Porphyromonas gingivalis and Prevotella intermedia were detected in group with or without periapical granuloma, however, only Prevotella intermedia was associated with periapical granuloma (OR 1.6, 95% CI=0.418-5.903; RR 1.3, 95% CI=0.653-2.393. Conclusion: The presence of Porphyromonas gingivalis and Prevotella intermedia in periapical granuloma were confirmed, however, only Prevotella intermedia were associated with periapical granuloma.Latar belakang: Karies gigi dengan pulpa nekrosis adalah penyakit multifaktorial yang menyerang enamel hingga ruang pulpa gigi. Infeksi bakteri anaerob
Guilmette, R.A.; Wolff, R.K.
The size and configuration of the nasal airways of humans change with time as a result of the normal process of congestion/decongestion of the erectile tissue of the nasal mucosa. To determine the extent to which airway areas change in vivo, we used magnetic resonance imaging (MRI) to quantitate both the cross-sectional area and perimeter of coronal sections of the entire nasal airway of a human subject. Changes in airway size or patency were indexed to measured changes in unilateral nasal airway resistance determined by posterior rhino manometry. The results of this study in which two MRI scans were performed for presumed left-side patency and two for right-side patency, showed that changes in nasal airway resistance were difficult to ascribe to systematic changes In the sizes of the airways. (author)
Full Text Available Penile augmentation has been reported in the literature by injecting various materials. This study reports our experience in management of penile augmentation complications associated with selfpenile injection of silicone liquid. After a careful ultrasound study, the penile skin was excised through a circumferential sub-coronal incision and dissected with the silicon mass. Histology was well-compatible with silicone granulomas. The patient was discharged after 24 hours. Ultrasonography has permitted preoperatively to determine if the plane between the indurated inflammatory tissue and the Buck’s fascia was preserved for the complete surgical excision of affected tissue.
Müller, Silvia Ferreira Rodrigues; de Miranda, Mario Fernando Ribeiro
Paracoccidioidomycosis presenting as a sarcoid-like plaque may be misdiagnosed as leprosy, especially when shared endemic areas are concerned. We report the case of a Brazilian male patient presenting with an ulcerated plaque on his left ear and neighboring areas. The plaque simulated tuberculoid leprosy type 1 reaction, both clinically and histopathologically. A perineural granuloma with no organisms detected by routine and Fite-Faraco staining reinforced that diagnosis. Paracoccidioidomycosis was confirmed only after a second biopsy, taken from the ulcerated area. PMID:24474116
Full Text Available The application of body piercing is popular among young people, who consider it as a sign of marginality, beauty, or group identity. Piercing procedure is observed to cause a large number of complications such as infections, pain, inflammatory reactions, bleeding, dental fractures or fissures, and gingival damage, etc., mostly in young individuals. Hizma is a traditional body ornament worn by Anatolian women via a piercing procedure. Herein, we describe a papule of nose mimicking pyogenic granuloma as an uncommon complication of Hızma.
Acharya, Priti N; Gill, Daljit; Lloyd, Tim
This case report discusses a rare side effect associated with the use ofa fixed quad helix orthodontic appliance. A 14-year-old healthy girl presented with a painful enlarging mass on her tongue, which was causing distress to both her and her parents. Investigations confirmed that the mass was a pyogenic granuloma and management involved surgical excision of the mass and removal of the quad helix appliance. At least once previous case associated with an orthodontic quad helix appliance has been reported in the literature.
Roemer, Ségolène; Maeder, Philippe; Daniel, Roy Thomas; Kawasaki, Aki
Herein, we report a patient who had an isolated sixth nerve palsy due to a petrous apex cholesterol granuloma. The sixth nerve palsy appeared acutely and then spontaneously resolved over several months, initially suggesting a microvascular origin of the palsy. Subsequent recurrences of the palsy indicated a different pathophysiologic etiology and MRI revealed the lesion at the petrous apex. Surgical resection improved the compressive effect of the lesion at Dorello's canal and clinical improvement was observed. A relapsing-remitting sixth nerve palsy is an unusual presentation of this rare lesion.
Aguiló, Luz; Bagán, José V
The authors present two case reports of patients exhibiting pyogenic granulomas in the maxillary labial mucosa, which were related to an apical fenestration of a primary incisor. Several researchers have reported that the gingival wound and surrounding inflammatory tissue typically heal spontaneously after extraction of a fenestrated primary tooth. However, in the cases presented here, the gingival lesion did not heal after the fenestrated teeth were extracted. After extracting fenestrated teeth, clinicians need to examine the labial area at a follow-up appointment to ensure that the gingival hyperplasia heals properly. The authors suggest performing curettage of the surrounding abnormal tissue at the time of the tooth extraction.
Antonio José Díaz Caballero
Full Text Available El granuloma telangiectásico se considera como una lesión benigna no neoplásica de la mucosa gingival de tipo reactivo asociado a trauma. Durante varios años tuvo diferentes nombres dentro de los que destacan granuloma piógeno del embarazo o gravídico, hemangioma capilar lobular y épulis. Histológicamente se caracteriza por una proliferación vascular, infiltrado inflamatorio crónico y tejido de granulación. El objetivo del presente caso es describir las características clínicas e histológicas de un granuloma telangiectásico en cavidad oral y su plan de tratamiento. Llega a consulta paciente femenina de 50 años de edad, refiere presentar sangrado gingival en repetidas ocasiones en zona posterior de la arcada dentaria superior, durante el cepillado o con el consumo de algunos alimentos. Clínicamente se observa prótesis provisional desadaptada en órganos dentarios 11 al 15. Al retirar la prótesis es notorio un aumento de volumen en la encía interdental, con aspecto eritematoso, que sangra con facilidad. El reporte de anatomía patológica mostró una lesión con engrosamiento del epitelio escamoso, formación de nuevos vasos sanguíneos e infiltrado inflamatorio crónico. Diagnosticado como granuloma telangiectásico. La lesión fue eliminada quirúrgicamente por alargamiento coronal con reducción ósea. Ocho días después de la cirugía se evidencia proceso de cicatrización sin ninguna complicación. La lesión presentó recidiva transcurrido seis meses. Ello nos lleva a destacar la importancia del control de factores locales, como la presencia de prótesis desadaptadas y el acúmulo de placa bacteriana luego de la eliminación quirúrgica de este tipo de lesiones.
Gunawat, Prashant; Shaikh, Salman Tehran; Karmarkar, Vikram; Deopujari, Chandrashekhar
Onyx is a liquid embolic agent presently gaining wide acceptance for embolisation of multiple vascular cranial pathologies like Arteriovenous Malformation (AVM) and Arteriovenous Fistula (AVF). Onyx stays in the nidus of vascular pathology and initiates inflammatory response leading to thrombosis and subsequently resulting in occlusion of vascular nidus. However, if onyx spills into the surrounding brain tissue, reaction occurs in the form of foreign body inflammatory reaction. This is one of the very few cases in literature whereby embolisation of AVM with onyx lead to granuloma formation which needed surgical excision. It presented with limb weakness and seizure episodes.
Enzootic nasal adenocarcinoma (ENA), a contagious retroviral disease of sheep and goats, characterized by neoplastic growth of the ethmoidal mucosa in the nasal cavity is described in a West African Dwarf goat (WAD). A two-year old WAD goat, weighing approximately 20kg was observed in the Teaching and Research ...
Lee, Joonsik; Lee, Hwa; Lee, Hyun Kyu; Chang, Minwook; Park, Minsoo; Baek, Sehyun
To compare the effects of 2 nasal packing materials, synthetic polyurethane foam (absorbable) and expandable polyvinyl acetate (nonabsorbable), on the surgical success rate and postoperative complications after endoscopic endonasal dacryocystorhinostomy (EDCR). A retrospective medical review of 459 patients (580 eyes) who underwent EDCR for primary acquired nasolacrimal duct obstruction at Korea University Guro Hospitals from January 2009 to February 2014. Surgical success rate (anatomical, functional), postoperative complications (granuloma, synechia, bleeding, and infection) were compared between the 2 groups, absorbable (318 eyes) and nonabsorbable (262 eyes). The absorbable group showed better results in surgical success rate regarding anatomical (90.5% versus 76.3%, P = 0.00) and functional (89.3% versus 75.9%, P = 0.00). Granulomas developed less frequently in the absorbable group (24.5% versus 38.9%, P = 0.00). Also, bleeding and crust were less frequent in the absorbable group (P = 0.00). Infections were less frequent in the nonabsorbable group (1.52%) compared with the absorbable group (7.86%, P = 0.00). The rate of revision surgery was lower in the absorbable group (7.86% versus 20.9%, P = 0.00). As for the influence of secondary outcomes to the surgical success by multiple logistic regression, granulomas had the largest effect on surgical success either anatomical or functional (odds ratio = 82.393 to anatomical and 44.058 to functional). Synechia had the second largest effect on surgical success (odds ratio = 11.897 to anatomical and 9.605 to functional). The authors suggest that using a synthetic polyurethane foam as a nasal packing material is not only a surgical option, but also a crucial and essential procedure in EDCR.
Jin, Yeon Hwa; Lee, Keon Il
The purpose of this study was to investigate whether a radiometric analysis of radicular cysts and periapical granulomas is useful in the differential diagnosis. In this experiment, twenty-nine periapical radiographs of the radicular cyst and those periapical granuloma were used. The periapical radiography was taken by intraoral paralleling device. The X-ray film was digitized and digitally filtered to reduce film-grain noise. We estimated density difference of the inner/outer area, roundness or circularity, bone profile or scan line of the margin and cumulative percentage frequency curve of radicular cyst and periapical granuloma.The obtained results were as follows ; 1. The differences in density between ROIs of inner and outer area of radicular cysts were smaller than those of periapical granulomas.2. The equivalent circular diameter was over 6.3 mm, there was significant difference between periapical cyst and periapical granuloma.3. In differential diagnosis of radicular cyst and periapical granuloma using bone profile, sensitivity, spicificity and accuracy were considerably high (0.83, 0.86, 0.86) respectively.4. Cumulative percentage frequency curve of the radicular cyst was closer to the pseudo-pixel value of 50 than average curve, whereas periapical granuloma was closer to that of 0. Hence we conclude that digital radiometric features might be useful in the differential diagnosis between radicular cyst and periapical granuloma.
Jin, Yeon Hwa; Lee, Keon Il [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Wankwang University, Yongin (Korea, Republic of)
The purpose of this study was to investigate whether a radiometric analysis of radicular cysts and periapical granulomas is useful in the differential diagnosis. In this experiment, twenty-nine periapical radiographs of the radicular cyst and those periapical granuloma were used. The periapical radiography was taken by intraoral paralleling device. The X-ray film was digitized and digitally filtered to reduce film-grain noise. We estimated density difference of the inner/outer area, roundness or circularity, bone profile or scan line of the margin and cumulative percentage frequency curve of radicular cyst and periapical granuloma.The obtained results were as follows ; 1. The differences in density between ROIs of inner and outer area of radicular cysts were smaller than those of periapical granulomas.2. The equivalent circular diameter was over 6.3 mm, there was significant difference between periapical cyst and periapical granuloma.3. In differential diagnosis of radicular cyst and periapical granuloma using bone profile, sensitivity, spicificity and accuracy were considerably high (0.83, 0.86, 0.86) respectively.4. Cumulative percentage frequency curve of the radicular cyst was closer to the pseudo-pixel value of 50 than average curve, whereas periapical granuloma was closer to that of 0. Hence we conclude that digital radiometric features might be useful in the differential diagnosis between radicular cyst and periapical granuloma.
Al Aboud K
Full Text Available Khalid Al Aboud1, Daifullah Al Aboud21Department of Dermatology, King Faisal Hospital, Makkah; 2Department of Dermatology, Taif University, Taif, Kingdom of Saudi ArabiaAbstract: Granuloma annulare induced by scabies infection has been described previously in three patients. In this report, we share our observation of a fourth case.Keywords: granuloma annulare, scabies, skin
Jeong, Sun Hye; Lee, Eun Hye; Hong, Hyun Sook; Kwak, Jeong Ja [Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon (Korea, Republic of)
A breast cholesterol granuloma is an uncommon nodular breast lesion. We incidentally detected a persistently enhancing breast mass on the dynamic abdominal computed tomography (CT) of a 78-year-old woman. The mass decreased in diameter over 50 days following a core needle biopsy. This report is the first to describe the dynamic-enhanced CT features of a breast cholesterol granuloma.
Shamaei, Masoud; Mortaz, Esmaeil; Pourabdollah, Mihan; Garssen, Johan; Tabarsi, Payam; Velayati, Aliakbar; Adcock, Ian M
BACKGROUND: Sarcoidosis is a granulomatous disease of unknown etiology. Macrophages play a key role in granuloma formation with the T cells, having a significant impact on macrophage polarization (M1 and M2) and the cellular composition of the granuloma. This study evaluates macrophage polarization
Oei, A.; Mortele, K.; Kunnen, M. [Dept. of Radiology, University Hospital, Gent (Belgium); Lemmerling, M. [Dienst Radiologie, AZ St. Lucas, Gent (Belgium); Vandekerckhove, T. [Dept. of Neurosurgery, University Hospital, Gent (Belgium); Praet, M. [Dept. of Histopathology, University Hospital, Gent (Belgium)
A rare case of idiopathic midline destructive disease is presented, which is an entity of the so-called midline granuloma syndrome. Differentiation from other granulomas, especially from Wegener's granulomatosis, is important. This report shows the MR findings in a patient with atypical clinical presentation of histopathologically proven idiopathic midline destructive disease. (orig.)
Harris Ricardo, Jonathan; Corporación Universitaria Rafael Núñez, Cartagena, Colombia; Fortich Mesa, Natalia; Corporación Universitaria Rafael Núñez, Cartagena, Colombia; Cassiani Cassiani, Delenis; Corporación Universitaria Rafael Núñez, Cartagena, Colombia
El granuloma telangiectásico bucal es una hiperplasia reactiva inflamatoria que afecta la mucosa y el tejido gingival de la cavidad oral. Se presenta como una reacción del tejido conectivo a estímulos como traumas, irritación local por placa dental, procesos infecciosos y factores hormonales. Es una patología muy frecuente en la región suramericana, que se describe clínicamente como una lesión tumoral de color rojo, tamaño variable, superficie lisa o rugosa, de base pediculada con mayor frecu...
Contribution to the radiological study of the eosinophilic granuloma of the mandible (Unifocal granuloma due to Langherans' cell histiocytosis); Contributo allo studio radiologico del granuloma eosinofilo della mandibola (granuloma unifocale da istiocitosi delle cellule di Lagherhans)
Chigi, Gino; Pastremoli, Alessandro; Pisi, Paolo; Pastremoli, Alfredo [Bologna Univ., Bologna (Italy). Dipartimento di scienze odontomastologiche; Bianchi, Giuseppe [Istituti Ortopedici Rizzoli, Bologna (Italy)
Purpose: The radiological diagnosis of osteolytic lesions of the mandible still constitutes a challenge in some pathological conditions in which the clinical data and the case history are relatively uniform and the radiological picture is lacking in any characteristics. Materials and methods: We reviewed the conventional radiograms of six cases of Langherans' cell histiocytosis (LCH) of the mandible examined over the last ten years. The X-ray examinations were performed in the lateral-oblique projection to allow a view of the horizontal portion of the mandible almost completely free of overlapping images of other bone structures. Results: We identified a series of radiological patterns for these reticulo-endotheliopathies capable of causing granuloma formed by polinuclear eosinophils, plasma cells, lymphocytes, and large mononuclear macrophages with granulopexic and phagocytic activity that proliferate in the bone tissue and can be identified as the Langherans' cells of skin, mucosa, periodontal cavities and bone marrow. The granulomatous tissue penetrates the affected organ elements and, in its spread, it compresses, atrophies, and destroyed the damaged tissue, replacing it. The alterations produced by Langherans' cell histiocytic granuloma are most common in the skeletal system affecting, in order of frequency, the skull, the long bones of the limbs, the foot, the ribs and the spine. The oral mucosa is rarely involved. Conclusions: The radiological investigation of unifocal Langherans' cell histiocytic granuloma of the mandible is essential in the study of perimandibular swelling, although diagnosis is based on biopsy alone. In addition to digital or conventional radiography, other useful examinations are bone scintigraphy, Colour Doppler US, MR and CT, which enables a correct localisation necessary for planning the biopsy and treatment. [Italian] Scopo: La diagnosi radiologica delle lesioni osteolitiche della mandibola costituisce un problema
Datta, R.; Bandyopadhyaya, Amal K.
A new nasal drug delivery system of diazepam has been developed with a natural mucoadhesive agent from Tamarindus indica L. The mucoadhesive strength, viscosity and gelling property of this natural mucoadhesive agent was found to be higher in comparison to synthetic polymers, hydroxyl propyl methyl cellulose (HPMC) and carbopol 934 which are conventionally used for similar purpose. In vitro drug release characteristic through franz-diffusion cell using excised bovine nasal membrane was also found to be better in comparison to the above synthetic polymers. This patient friendly, needle free dosage form may replace the diazepam injections in future. (author)
Qin, You; Lu, Yanwei; Zheng, Liduan; Liu, Hong
Ghost cell odontogenic carcinoma (GCOC) is a rare malignant odontogenic tumor with aggressive growth characteristics. A 41-year-old Chinese male visited our hospital in 2013, with a 4-month history of bloody purulent rhinorrhea with a peculiar smell in the right nasal cavity. The patient suffered from recurrent GCOC with suspected cholesterol granuloma of the maxillary sinus. The patient was incorrectly diagnosed with a calcifying epithelial odontogenic tumor at his first recurrence. Physical examination, radiological examination, and histopathology were used to identify GCOC. Considering the recurrence of GCOC and poor effects of single surgery, postoperative adjuvant chemotherapy and concurrent chemoradiotherapy were performed after radical surgical excision. So far, no significant evidence has suggested recurrence or metastasis after a long-term follow-up. We advocate wide surgery with clean margins at the first accurate diagnosis. Combined modality therapy could be taken for the recurrent GCOC. We expect to provide a new treatment strategy to prevent the growth of this neoplasm.
The hallmark lesion of tuberculosis in humans and animals is the granuloma. The granuloma represents a distinct host cellular immune response composed of epithelioid macrophages, lymphocytes, and multinucleated giant cells, often surrounding a caseous necrotic core. Within the granuloma, host intera...
Yamamoto, Seiji; Motoori, Ken; Ueda, Takuya; Osaka, Iwao [Department of Radiology, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8677 (Japan); Takano, Hideyuki [Department of Radiology, Chiba Cancer Center, Chiba (Japan); Nagata, Hiroshi [Department of Otolaryngology, Chiba University Hospital, Chiba (Japan)
The nasal septum is a particularly rare site of origin of chondrosarcoma. Cranial base invasion may be at hand, with such lesions making complete tumor removal difficult. MRI techniques allow precise definition of tumor extent. In the described case, CT and Dynamic MR imaging were performed in a case of chondrosarcoma of the nasal septum. Imaging clearly illustrated size and extent of the mass with central regions of internal calcification. Dynamic MRI was additionally performed, which helped to define the presumed origin of the lesion from the nasal septum. (orig.)
Ninuk Dian Kurniawati
Full Text Available Introduction: The provision of oxygen therapy is traditionally use a humidifier to moisten the oxygen and prevent irritation of the nasal mucosa. Recent research proves that the use of a maximum of 4 lpm nasal oxygen without using a humidifier (non humidifier up to 8 hours does not cause irritation of the nasal mucosa and prevent colonization of bacteria in the humidifier. The purpose of this study was to determine the effectiveness of nasal oxygen administration using a non-humidifier more than 8 hours in the prevention of irritation of the nasal mucosa. Method: This study employed an analytic survey with cross-sectional study design. As many as 20 patients at inpatient wards of Port Health Center Hospital Surabaya were recruited as sample by means of consecutive sampling. Inclusion criteria was patients must not suffer from upper respiratory tract infection and do not suffer from impaired immunity. Independent variables were oxygen flow and long of oxygen therapy. Dependent variable was irritation of the nasal mucosa. Data were analyzed with descriptive statistics and tested with spearman rho correlation test. Result: The results showed that the use of oxygen up to 140 hours with 4 LPM had no effect on the nasal mucosa such as signs of irritation and complaints of discomfort in the nose area. Discussion: It can be concluded that the use of non-humidifier for a maximum of 140 hours with flow maximum of 4 lpm is effective in preventing irritation of the nasal mucosa. Further research on the effectiveness of non humidi fi ers in the elderly population and children under five years of age is needed.
Hwang, Kun; Yeom, Seung Han; Hwang, Suk Hyun
The aim of this study was to perform a systematic review of the treatment of nasal bone fractures. The search terms ("nasal bone fracture" AND complication) and ("nasal bone fracture" AND [anosmia OR olfaction OR olfactory nerve OR smell]) and (anosmia AND ["nasal preparation" OR "nasal antiseptics"]) were used to search PubMed and SCOPUS. Of the 500 titles, 40 full papers were reviewed. One paper was excluded, and 3 mined papers were added. Ultimately, 12 papers were analyzed. The overall deformity rate was 10.4% ± 4.8%. No significant differences were found between patients who underwent closed reduction (14.7% ± 7.3%) and those who underwent open reduction (9.4% ± 4.4%), between those who underwent local anesthesia (5.8% ± 4.5%), and those who underwent general anesthesia (8.8% ± 3.8%), or between those who received timely treatment (5.7%) and those whose treatment was delayed (9.0%). Septal deviation occurred in 10.0% of patients as a sequela of nasal bone fracture. The nasal obstruction rate was 10.5% ± 5.3%. Fewer patients of nasal obstruction occurred in the open reduction patients (6.9% ± 4.4%) than in the closed reduction patients (15.2%). One patient of epiphora and 1 patient of diplopia were reportedAmong the 77 patients with nasal bone fractures, 29 (37.7% ± 11.3%) complained of olfactory disturbances. No significant associations were found between the type of fracture and the presence of olfactory disturbances. It is recommended for providers to explain to patients that approximately one-tenth of nasal bone fractures exhibit deformity, septal deviation, or nasal obstruction after surgery. Surgeons should take considerable care to avoid the olfactory mucosa during reduction surgery.
Full Text Available Disseminated cryptococcosis usually occurs in immunocompromised individuals with defective cell-mediated immunity, most commonly seen with HIV infection. We present a case of disseminated cryptococcosis in an HIV-negative male patient who presented with headache, fever, altered sensorium of short duration and multiple cutaneous lesions. An emergency CT scan of the head showed multiple intracranial and intraventricular granulomas. Routine laboratory investigations were within the normal range. A CSF examination revealed capsulated yeasts on India ink and a culture yielded cryptococcus neoformans. A cryptococcal antigen test by latex agglutination kit was positive. A biopsy revealed multiple capsulated yeasts cells in the cutaneous lesions, which were consistent with cryptococcus neoformans. The patient was successfully treated with Amphotericin B and Fluconazole with regression of cranial and cutaneous lesions.
Full Text Available Pyogenic granulomas (PGs in the oral cavity present as an inflammatory hyperplasia usually caused by trauma, hormonal imbalance, chronic irritation, or as the response to a wide variety of drugs. PGs with atypical presentation and behavior may clinically mimic malignant tumors. Thus, histological examination is required to rule out cancer development. Lesions in the oral cavity have been described to be either an isolated entity or present in multiple forms and with multiple recurrences. Conservative surgical excision is the standard choice of treatment in almost every scenario. However, the severity of the lesions and the affected sites often challenge surgical treatment. In this report, we describe the clinical scenario of a recurrent PG, where surgical excision of the lesion was questioned. As an alternative, we describe a noninvasive approach with lesional steroid injections.
Full Text Available Central giant cell granuloma (CGCG is a benign intra-osseous lesion of unknown etiology, and occurs in jaws. Clinically and radiographically difference between its nature - aggressive and non-aggressive can be made. It is characterized histologically by cellular fibrous tissue containing multiple foci of hemorrhage, aggregations of multinucleated giant cells, and occasionally, trabeculae of woven bone. Histologically, identical lesions occur in patients with known genetic defects such as cherubism, Noonan syndrome, or neurofibromatosis type I. It has an increased predilection for mandible and females in younger age group. Surgical curettage or resection is the most common therapy in aggressive lesions. The drawback is undesirable damage to the jaw or teeth, tooth germs, and frequent recurrences. Non-aggressive tumors respond well to such treatments. We are presenting a case of an aggressive type of CGCG of mandible in a young patient, who presented with massive swelling associated with loss of teeth in just 6 months duration.
Regezi, J A; Zarbo, R J; Daniels, T E; Greenspan, J S
Oral traumatic granulomas are reactive mucosal lesions that are characterized by an intense mononuclear infiltrate (usually with eosinophils) that may mimic neoplasia. These pseudoneoplastic infiltrates were evaluated with the use of lineage-associated antibodies (CD3, OPD4, L26, KP1, XIIIa, S-100, HPCA-1, HHF-35). We determined that the large distinguishing mononuclear cells were either CD68-positive macrophages or factor XIIIa-positive dendrocytes (the oral counterparts to dermal dendrocytes). S-100-positive connective tissue cells occasionally contributed to this infiltrate. Also abundant in the infiltrate were smaller CD3-positive T-lymphocytes. Double-staining confirmed that there were separate populations of CD68-positive macrophages and XIIIa-positive dendrocytes. Because some XIIIa dendrocytes coexpressed CD68, phagocytosis may be one of the functions of dendrocytes.
Santos-Briz, A.; Ricoy, J.R.; Martinez-Tello, F.J.; Lobato, R.D.; Ramos, A.; Millan, J.M.
Giant cell reparative granuloma (GCRG) is a non-neoplastic fibrous lesion with unevenly distributed multinucleated giant cells, areas of osseous metaplasia and hemorrhage. The small bones of the hands and feet are the most common sites, followed by the vertebral bodies and craniofacial bones. In the craniofacial bones GCRG has been reported in the temporal bone, in the frontal bone and paranasal sinus. However, to the best of our knowledge no case has been reported in the occipital bone. We report on the imaging findings and pathological features of a GCRG of the occipital bone and discuss the differential diagnosis of this entity in this particular location, especially with giant cell tumor because of the therapeutic and prognostic implications. (orig.)
Full Text Available Granuloma faciale (GF is a rare, inflammatory, cutaneous disorder of unknown aetiology. It presents clinically as one or several well-circumscribed violaceous papules, plaques, and nodules almost exclusively confined to the facial region. Rarely, extrafacial lesions can occur, most often on sun-exposed sites. We report a case of extrafacial GF in a 63-year-old male with indolent lymphoma, who presented with plaques involving the right preauricular region and left posterior axilla. The clinical and histopathological findings were consistent with GF. Our case highlights the importance of performing skin biopsies in patients with persistent erythematous plaques and nodules, particularly to exclude important malignant and granulomatous differential diagnoses.
Full Text Available Granuloma faciale (GF is a rare chronic inflammatory skin disease characterized by single or multiple reddish-brown cutaneous plaques or nodules. Although this condition is benign, its clinical course is extremely chronic with poor response to therapy. The typical histopathological features of GF include vasculitis with mixed cellular infiltration; however, its etiopathogenesis remains unknown. Here, we describe the case of a 76-year-old man with GF resistant to topical steroids. Biopsy of the lesion revealed i dense mixed inflammatory cellular infiltrates of lymphocytes, histiocytes, neutrophils, and eosinophils, ii mild perivascular nuclear dust and swollen endothelium of blood vessels, and iii a narrow Grenz zone beneath the epidermis. Immunohistochemical staining demonstrated mixed cellular infiltrates intermixed with CD1a+ dendritic cells, CD68+ histiocytes, and CD4+ and CD8+ T cells.
Boulaich, M; Benbouzid, M A; Lazrak, A; Benchaqroun, L; Jazouli, N; Mahassini, N; Saidi, A; Kzadri, M
The authors report a series of 22 cases of central giant cells Granuloma of the jaws. There were 12 located in the maxilla, and 10 in the mandible. The majority of lesions were observed in patients under the age of 30 years, and occurs more often in females than in males, particularly in mandibular lesions. This lesion, which the pathogenesis still remains obscure, appears as radiolucency, well or ill-defined, uni or multilocular with trabeculations coursing through the lesion. Histologic study shows giant cells, fibroblastic cells, and foci of hemorrhage and osteoid tissue. The authors insist on the problem of differential diagnosis which can make a radiolucency with giant cells. It must be differentiated especially from giant cells tumor, which treatment and course are different. Finally, the authors underline a good prognosis of this lesion, which simple curettage is generally sufficient, and which recurrences remain rare.
McCracken, Michael S; Chavali, Ramakiran V; Al-Naief, Nasser Said; Eleazer, Paul D
At times, dental implants are placed into sites with a history of periapical pathology. Sometimes the infection is active, and other times the tooth may have been extracted years before implant placement. In either case, the possibility exists for long-term residual cysts or infections that can negatively impact the prognosis of the implant. In this case report, an implant is placed into a healed mandibular ridge several months after extraction of the tooth. A radiolucency was noted on routine radiographic examination 2 years later. Surgical inspection and histology revealed a periapical granuloma with acute and chronic inflammatory cells. After surgical curettage of the site, the patient healed without complication. Implants may develop apical pathology as a result of a preexisting long-term residual infection.
Russell, A F; Suggit, R I; Kazzi, J C
This is a case of a rare lung disease known as pulmonary hyalinising granuloma, which is usually discovered incidentally on chest radiographs and poses diagnostic difficulties but has an excellent prognosis. In this case a 75-year-old man had a 6-year history of undiagnosed, enlarging, bilateral dense apical infiltrates. The patient died from his tobacco smoke-related emphysema, which led to diagnosis of the lesion. At autopsy both lungs showed well-defined apical, hard, grey-white masses covered by a rind of thickened adherent pleura. Histologically, the lesion was composed of dense, haphazard lamellar, keloid-like collagen concentrically arranged around blood vessels with extension into the pleura and perivascular collections of lymphocytes and plasma cells.
Moyer, R.A.; Betz, R.R.; Bonakdarpour, A.
The case has been presented of a unifocal lesion of eosinophilic granuloma in the acromion of a 16-year-old young man. The use of a special technique radiologically in outlining lesions of the acromion was described. Of interest was the fact that the patient appeared at the Temple University Section for Sports Medicine and Science upon experiencing pain following a fishing expedition. In this connection, the frequency of injuries of the shoulder on various Temple University athletic teams was discussed. The value of an isotope scan in establishing a diagnosis was considered and the relationship of the lesion to Hand-Schueller-Christian disease and Letterer-Siwe disease was noted. Treatment also was considered. (orig./MG)
Tsokos, M.; Fauci, A.S.; Costa, J.
''Midline granuloma syndrome'' encompasses a number of specific clinicopathologic entities, such as ''Wegener's granulomatosis, midline malignant reticulosis, lymphoma, nasal carcinoma and a broad spectrum of infectious diseases. In the course of studying a number of patients presenting with destructive lesions of the upper respiratory tract, 11 cases emerged as having unique clinicopathologic features. These are: 1) presence of locally destructive lesions which are always restricted to the upper respiratory tract. 2) Absence of systemic disease during a follow-up period of six months to 18 years (mean 7.3 years). On examination of repeated biopsy specimens the histopathologic picture consisted of acute and chronic inflammation with variable amounts of necrosis. Granulomata were seen in one case. Malignant or atypical cells were invariably absent. Frank vasculitis was not seen, although in five of the patients inflammatory cells in the wall of small vessels were conspicuous 4) Inability to demonstrate an infectious origin by culture or special stains. Radiation therapy has proven effective in patients with this entity, for which the term ''Idiopathic Midline Destructive Disease'' (IMDD) is proposed.
Deep, Nicholas L; Graffeo, Christopher S; Copeland, William R; Link, Michael J; Atkinson, John L; Neff, Brian A; Raghunathan, Aditya; Carlson, Matthew L
To report two patients with a history of microvascular decompression (MVD) for hemifacial spasm who presented with Teflon granulomas (TG) mimicking cerebellopontine angle (CPA) tumors and to perform a systematic review of the English-language literature. Case series at a single tertiary academic referral center and systematic review. Retrospective chart review with analysis of clinical, radiological, and histopathological findings. Systematic review using PubMed, Embase, MEDLINE, and Web of Science databases. Two patients with large skull base TGs mimicking CPA tumors clinically and radiographically were managed at the authors' institution. The first presented 4 years after MVD with asymmetrical sensorineural hearing loss, multiple progressive cranial neuropathies, and brainstem edema due to a growing TG. Reoperation with resection of the granuloma confirmed a foreign-body reaction consisting of multinucleated giant cells containing intracytoplasmic Teflon particles. The second patient presented 11 years after MVD with asymmetrical sensorineural hearing loss and recurrent hemifacial spasm. No growth was noted over 2 years, and the patient has been managed expectantly. Only one prior case of TG after MVD for hemifacial spasm has been reported in the English literature. TG is a rare complication of MVD for hemifacial spasm. The diagnosis should be suspected in patients presenting with a new-onset enhancing mass of the CPA after MVD, even when performed decades earlier. A thorough clinical and surgical history is critical toward establishing an accurate diagnosis to guide management and prevent unnecessary morbidity. Surgical intervention is not required unless progressive neurologic complications ensue. 4 Laryngoscope, 127:715-719, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.
Abrahão, A C; Cabral, M G; Noce Dos Santos, C W; Janini, M E R; Pulcheri, W A
Eosinophilic granuloma is classified as a Langerhans cell histiocytosis. Although considered a rare pathology, up to 20% of all cases occur in the jaw bones, and radiographically may mimic odontogenic cysts or benign and malignant tumours. Different protocols have been suggested in the literature for treating eosinophilic granuloma. We report a case of polyostotic eosinophilic granuloma in a 34-year-old man showing ill defined mandibular and palatal radiolucencies. Due to the presence of multiple jaw lesions the treatment choice was chemotherapy. The clinical and radiographic feature are described, as well as treatment, complications and patient's follow-up.
Full Text Available Oral vegetable granuloma represents an inflammatory lesion of foreign body origin resulting from the implantation of vegetable matter. Controversy regarding its pathogenesis is reflected by the various terminologies used to describe the lesion. Its diverse clinical presentations are due to variations in the antigenic potential of the vegetable material and the host response. As the diagnosis is solely histopathological, it is critical to differentiate vegetable granuloma from other oral granulomatous lesions like tuberculosis, sarcoidosis and Wegner’s granulomatosis. Here, we report six cases with the varied clinicopathological presentation of hyaline ring granulomas in association with different pathological lesions.
Full Text Available We report the case of a 55-year-old Japanese patient with granuloma faciale (GF successfully treated with topical tacrolimus and describe the immunohistochemical study. Immunohistochemical staining revealed that the patient’s granuloma contained CD3+, CD4+, CD8+, CD68+ and CD163+ cells. Interestingly, these cells contained granulysin+ T cells and lacked Foxp3high+ regulatory T cells. In addition, the macrophages were mainly CD163+, which suggested that the alternatively activated macrophage is one of the main components of GF. In summary, the present data shed light on the granuloma-composing cells and possible mechanisms in the treatment of GF with topical tacrolimus.
Full Text Available We described a case of an 82-year-old male who presented with a granuloma entrapping the polyurethane-coated pacing lead at the site of contact on the atrium. He had been paced for 8 years without symptoms or signs suggestive of an allergic reaction to the pacemaker system and died from thrombosis of the superior mesenteric artery and heart failure. A histological examination of the nodule showed an incidental granuloma with multinucleated giant cells. No granuloma was found in the heart or the lung.
Robert Abraham Obeid
Full Text Available Cholesterol granulomas are composed of a distinct type of granulation tissue that contains lipids and cholesterol crystals. They are not believed to be a pathological entity, but rather an inflammatory tissue reaction to the presence of trapped blood secondary to localized hemorrhage.1 Cholesterol granulomas can be identified histologically by the presence of multi-nucleated giant cells, hemosiderin, and red blood cells along with their associated break-down products.1 Recognizing cholesterol granulomas can provide clinical utility as they demonstrate a tendency to mimic carcinoma both clinically and radiologically.
Zilton A. Andrade
Full Text Available São apresentados os dados clínico-patológicos de dois casos de entomoftorose nasal, nova doença humana causada por um ficomiceto - Entomophthora coronata. Os pacientes, uma menina e um homem, com 8 e 44 anos de idade respectivamente, apresentaram doença localizada, com nódulos no nariz e região paranasal, edema e deformação da face. O parasito foi isolado do primeiro caso, mas todas as tentativas para isolá-lo no segundo caso resultaram negativas. Histologicamente, havia reação granulomatosa, fibrose e edema, em torno de hifas não septadas, as quais exibiam envólucro eosinófilo amorfo em torno. Foram demonstrados anticorpos circulantes contra, as hifas do E. coronata no soro de um dos pacientes. O material eosinófilo em torno das hifas continha fibrina e material auto-fluorescente sob luz ultra-violeta, provavelmente lipofuscina, mas não foram demonstrados anticorpos ou antígenos nesta área. A apresentação destes casos, os primeiros a serem descritos no Brasil, é acompanhado, de uma revisão geral do assunto, pois tal poderá vir a ser de interesse para aqueles que estudam os problemas da patologia tropical em nosso meio.
Decaro, Nicola; Campolo, Marco; Desario, Costantina; Cirone, Francesco; D'Abramo, Maria; Lorusso, Eleonora; Greco, Grazia; Mari, Viviana; Colaianni, Maria Loredana; Elia, Gabriella; Martella, Vito; Buonavoglia, Canio
Four outbreaks of bovine respiratory disease (BRD) associated with bovine coronavirus (BCoV) infection in Italian cattle herds were reported. In 3 outbreaks, BRD was observed only in 2-3-month-old feedlot calves, whereas in the remaining outbreak, lactating cows, heifers, and calves were simultaneously affected. By using reverse transcription polymerase chain reaction (RT-PCR), BCoV RNA was detected in all outbreaks without evidence of concurrent viral pathogens (i.e., bovine respiratory syncytial virus, bovine herpesvirus type 1, bovine viral diarrhea virus, bovine parainfluenza virus). Common bacteria of cattle were recovered only from 2 outbreaks of BRD: Staphylococcus spp. and Proteus mirabilis (outbreak 1) and Mannheimia haemolytica (outbreak 4). A recently established real-time RT-PCR assay showed that viral RNA loads in nasal secretions ranged between 3.10 x 10(2) and 7.50 x 10(7) RNA copies/microl of template. Bovine coronavirus was isolated from respiratory specimens from all outbreaks except outbreak 1, in which real-time RT-PCR found very low viral titers in nasal swabs.
Hirota, Yoshiharu; Shimizu, Yayoi; Iinuma, Toshitaka.
Twenty cases of nasal bone fractures were evaluated as to the types of fractures based upon HRCT findings. Conventional X-Ray films for nasal bones were analyzed and compared with HRCT findings. Nasal bone fractures were classified into lateral and frontal fractures. HRCT images were evaluated in three planes including upper, middle and lower portions of the nasal bone. Fractures favored males of teens. Lateral fracture gave rise to the fractures of the nasal bone opposite to the external force, loosening of the ipsilateral nasomaxillary sutures and fractures of the frontal process of the maxilla. Conventional X-Ray films were reevaluated after HRCT evaluation and indications of nasal bone fractures were determined. In addition to the discontinuity of the nasal dorsum, fracture lines parallel to and beneath the nasal dorsum and indistinct fracture lines along the nasomaxillary sutures are the indication of nasal bone fractures by conventional X-Ray films. (author)
Full Text Available Bilateral cleft lip nose deformity is a multi-factorial and complex deformity which tends to aggravate with growth of the child, if not attended surgically. The goals of primary bilateral cleft lip nose surgery are, closure of the nasal floor and sill, lengthening of the columella, repositioning of the alar base, achieving nasal tip projection, repositioning of the lower lateral cartilages, and reorienting the nares from horizontal to oblique position. The multiplicity of procedures in the literature for correction of this deformity alludes to the fact that no single procedure is entirely effective. The timing for surgical intervention and its extent varies considerably. Early surgery on cartilage may adversely affect growth and development; at the same time, allowing the cartilage to grow in an abnormal position and contributing to aggravation of deformity. Some surgeons advocate correction of deformity at an early age. However, others like the cartilages to grow and mature before going in for surgery. With peer pressure also becoming an important consideration during the teens, the current trend is towards early intervention. There is no unanimity in the extent of nasal dissection to be done at the time of primary lip repair. While many perform limited nasal dissection for the fear of growth retardation, others opt for full cartilage correction at the time of primary surgery itself. The value of naso-alveolar moulding (NAM too is not universally accepted and has now more opponents than proponents. Also most centres in the developing world have neither the personnel nor the facilities for the same. The secondary cleft nasal deformity is variable and is affected by the extent of the original abnormality, any prior surgeries performed and alteration due to nasal growth. This article reviews the currently popular methods for correction of nasal deformity associated with bilateral cleft lip, it′s management both at the time of cleft lip repair
Rabago, David; Zgierska, Aleksandra
Saline nasal irrigation is an adjunctive therapy for upper respiratory conditions that bathes the nasal cavity with spray or liquid saline. Nasal irrigation with liquid saline is used to manage symptoms associated with chronic rhinosinusitis. Less conclusive evidence supports the use of spray and liquid saline nasal irrigation to manage symptoms of mild to moderate allergic rhinitis and acute upper respiratory tract infections. Consensus guidelines recommend saline nasal irrigation as a treatment for a variety of other conditions, including rhinitis of pregnancy and acute rhinosinusitis. Saline nasal irrigation appears safe, with no reported serious adverse events. Minor adverse effects can be avoided with technique modification and salinity adjustment.
Ebner, F.; Toelly, E.; Tritthart, H.
An intraspinal extradural foreign-body granuloma following surgical removal of herniated intervertebral disc is demonstrated by myelography, spinal computed tomography and transabdominal spinal sonography. The radiologic findings and differential diagnoses are discussed.
Purnamasari, L.; Iskandar, H. H. B.; Makes, B. N.
In digitized radiography techniques, adjusting the image enhancement can improve the subjective image quality by optimizing the brightness and contrast for diagnostic needs. To determine the value range of image enhancement (brightness and contrast) on chronic apical abscess and apical granuloma interpretation. 30 periapical radiographs that diagnosed chronic apical abscess and 30 that diagnosed apical granuloma were adjusted by changing brightness and contrast values. The value range of brightness and contrast adjustment that can be tolerated in radiographic interpretations of chronic apical abscess and apical granuloma spans from -10 to +10. Brightness and contrast adjustments on digital radiographs do not affect the radiographic interpretation of chronic apical abscess and apical granuloma if conducted within the value range.
Full Text Available O granuloma actínico de O'Brien é uma doença cutânea rara. Há muitas controvérsias na sua caracterização, podendo representar uma entidade nosológica distinta ou uma forma de granuloma anular em áreas expostas. A patogênese é desconhecida; no entanto, acredita-se que a radiação solar seja um fator desencadeante. Os autores relatam o caso de um paciente de 78 anos, branco, que apre sentava há 10 anos pápulas eritematosas e infiltradas na fronte e hemiface à esquerda. O diagnóstico de granuloma actínico de O'Brien foi estabelecido a partir do exame histopatológico, uma vez que o quadro clínico exuberante apresentado pelo paciente diferia do de casos anteriormente observados.O'Brien's actinic granuloma is a rare skin disease. Controversy continues over whether it should be considered a specific condition or a form of granuloma annulare located in sun-exposed areas. Its pathogenesis is unknown; however, the most widely accepted hypothesis suggests that solar radiation is the triggering factor. This paper describes the case of a 78-year old, fair-skinned male, who presented with a 10-year history of an infiltrate of annular erythematous papules on his forehead and left malar region. The diagnosis of O'Brien actinic granuloma was established from histopathology, since the clinical condition of the patient was extensive, unlike cases reported in the literature.
Setubal, Roger; Menezes, Benedito; Carvalho, Marcos Brasilino de; Soares, Aldemir Humberto; Souza, Ricardo Pires de
Giant cell granuloma is an uncommon lesion of the giant cell lesion's group, which includes brown tumor of hyperparathyroidism, true giant cell tumor, cherubism and aneurysmal bone cyst. their histologic features are very similar and make certain types indistinguishable from each other, remaining a considerable controversy on its classification. The authors report a case of giant cell maxillary granuloma and makes a review of the literature. (author)
Full Text Available Giant Cell Reparative Granuloma (GCRG of phalanx is uncommon. It is a benign osteolytic lesion but can be locally aggressive. GCRG has certain radiology and histological features that are similar to other giant cell lesions of the bone. We present a case report of a young patient with giant cell reparative granuloma of proximal phalanx of left third toe. The bone lesion was successfully treated surgically.
Lee, Sang Woo; Cheong, Seung Hyun; Byun, Ji Yeon; Choi, You Won; Choi, Hae Young; Myung, Ki Bum
Generalized granuloma annulare (GGA) is a rare benign granulomatous dermatosis characterized by disseminated necrobiotic dermal papules. Histologically, it presents as a lymphohistiocytic granuloma associated with varying degrees of connective tissue degeneration. It usually occurs in adults and rarely affects infants. Herein, we report an interesting case of GGA which occurred in a 3 month-old girl in association with Bacillus Calmette-Guerin vaccination.
Full Text Available Primary cutaneous anaplastic large cell lymphoma (pcALCL forms 9% of the cutaneous T-cell lymphomas. It usually presents as solitary reddish brown ulcerating nodule or indurated plaque. Sometimes, it mimics other dermatological diseases such as eczema, pyoderma gangrenosum, pyogenic granuloma, morphea, and squamous cell carcinoma. Our case presented with large pyogenic granuloma like lesion with regional lymphadenopathy. Since pcALCL is rare, one can misdiagnose such cases and therefore high index of suspicion is necessary.
Full Text Available Background: The localized form of granuloma annulare is usually self-limiting, resolving within 2 years. Generalized granuloma annulare, on the other hand, runs a protracted course, with spontaneous resolution being rare. It is also characterized by a later age of onset, an increased incidence of diabetes mellitus, poor response to therapy, and an increased prevalence of HLA Bw35. Objective: To assess the efficacy of monthly pulsed rifampicin, ofloxacin, and minocycline (ROM therapy in the management of granuloma annulare. Methods : Six biopsy proven patients of granuloma annulare were included in the study, five of the generalized variety, and one localized. Three of these patients were resistant to standard modalities of treatment. All six patients were treated with pulses of once monthly ROM till complete resolution of all lesions. Results were analyzed in terms of complete resolution of lesions and side effects. Presence of comorbid conditions was noted. Result: All six patients were successfully treated with 4-8 pulses of monthly ROM. None of the patients reported any adverse effects. Limitations: Small sample size and the lack of a control group are limitations. Conclusion: Treatment with pulses of once monthly ROM caused complete resolution of lesions in both localized and generalized granuloma annulare, even in cases recalcitrant to conventional therapy. There were no side effects in any of the patients. Larger trials are needed to substantiate the efficacy of monthly ROM in granuloma annulare.
ter Haar, G.; Buiks, S.C.; Kirpensteijn, J.
Abstract OBJECTIVE: To report reconstruction of a defect of the nasal plane and the rostral dorsum of the nose in a dog using a nasal rotation flap with Burow's triangles. STUDY DESIGN: Clinical report. ANIMALS: Mixed-breed dog (1.5 years, 8.6 kg). METHODS: A nasal defect caused by chronic
Doorly, D; Taylor, D J; Franke, P; Schroter, R C
The airway geometry of the nasal cavity is manifestly complex, and the manner in which it controls the airflow to accomplish its various physiological functions is not fully understood. Since the complex morphology and inaccessibility of the nasal passageways precludes detailed in-vivo measurements, either computational simulation or in-vitro experiments are needed to determine how anatomical form and function are related. The fabrication of a replica model of the nasal cavity, of a high optical clarity and derived from in-vivo scan data is described here, together with characteristics of the flow field investigated using particle image velocimetry (PIV) and flow visualization. Flow visualization is shown to be a capable and convenient technique for identifying key phenomena. Specifically the emergence of the jet from the internal nasal valve into the main cavity, how it impacts on the middle turbinate, and the large enhancement of dispersion that accompanies the initial appearance of flow instability are revealed as particularly significant features. The findings from the visualization experiments are complemented by PIV imaging, which provides quantitative detail on the variations in velocity in different regions of the nasal cavity. These results demonstrate the effectiveness of the cavity geometry in partitioning the flow into high shear zones, which facilitate rapid heat transfer and humidification from the nasal mucosa, and slower zones affording greater residence times to facilitate olfactory sensing. The experimental results not only provide a basis for comparison with other computational modelling but also demonstrate an alternative and flexible means to investigate complex flows, relevant to studies in different parts of the respiratory or cardiovascular systems.
Al-Qahtani, Khalid; Islam, Tahera; AlOulah, Mohammad; Bafaqeeh, Sameer; Faqeeh, Yasser
Myxoma is a benign tumor that arises from mesenchymal tissue, and found in the soft tissue and less commonly in the bone. The majority of bony myxomas of the head and neck occur in the jaws and maxilla. We report an extremely rare case of nasal bone myxoma in a 52-year-old man. The diagnosis was confirmed by biopsy. Due to the aggressive nature of the lesion the nasal bone was eroded by the disease. The patient underwent resection of the mass with reconstruction of the defect by septal cartilage. The patient remains tumor free after 5 years. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Weber, W.; Henkes, H.; Berg-Dammer, E.; Kuehne, D. [Alfred Krupp Krankenhaus, Essen (Germany). Klinik fuer Radiologie und Neuroradiologie; Metz, K.A. [Inst. fuer Pathologie, Universitaetsklinikum der Universitaets-Gesamthochschule Essen (Germany)
Haemangiopericytomas (HPC) are rare vascular tumours originating from a pericytes, a term coined by Zimmermann to refer to the main location of this cell line in the pericapillary connective tissue. HPC may arise in any part of the body. We report a 29-year-old man with a histologically proven nasal haemangiopericytoma-like tumour. The lesion was embolised through the ophthalmic artery before it was removed surgically. The main symptoms of nasal HPC are epistaxis and obstruction of the nose. Malignant and benign clinical courses have been described. Local recurrence and metastases may be observed years after initial diagnosis. (orig.)
Kang, Hyun Koo; Kim, Jae Kyun; Kim, Yoon Jung [Seoul Veterans Hospital, Seoul (Korea, Republic of)
Cholesterol granuloma (CG) is usually associated with chronic middle ear disease, and is not common in the paranasal sinuses. Additionally, it is very rare for cases of CG to be associated with a fungal infection. However, in this paper, we report a case of sphenoid sinus CG that is associated with aspergilloma in a 78- year-old male patient who presented with right hemifacial pain, headache and toothache. CT revealed the presence of an expansile cystic mass lesion in the sphenoid sinus that showed a high signal intensity on both the T1 and T2 weighted images. This mass was later determined to be CG. The suspected etiologic mechanisms of both CG and aspergilloma of the paranasal sinuses are similar, and impaired drainage and obstruction of the ventilation of the paranasal sinuses are considered to be the causative mechanism of both diseases. Overall, the results of this study indicate that the use of MRI findings could be helpful for differentiating CG from other paranasal sinus mass lesions
Sarangarajan, R; Vaishnavi Vedam, V K; Sivadas, G; Sarangarajan, Anuradha; Meera, S
Oral ulcers are a common symptom in clinical practice. Among various causative factors, different types of ulcers in oral cavity exist. Among this, traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) appears to be quite neglected by the clinicians due to the limited knowledge and awareness. On reviewing with a detailed approach to titles and abstracts of articles eliminating duplicates, 40 relevant articles were considered. Randomized studies, review articles, case reports and abstracts were included while conference papers and posters were excluded. Of importance, TUGSE cases been reported only to a minimal extent in the literature. Lack of its awareness tends to lead clinicians to a misconception of cancer. Thus, this particular lesion needs to be differentiated from other malignant lesions to provide a proper mode of treatment. The present article reviews various aspects of the TUGSE with emphasis on the clinical manifestation, pathogenesis, histological, and immunohistochemical study. This study provides the clinician contemporaries, a humble expansion to their knowledge of the disease, based on the searched literature, enabling a more comprehensive management of this rare occurrence.
Noleto, Jose Wilson [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Faculdade de Medicina. Dept. de Radiologia]. E-mail: firstname.lastname@example.org; Marchiori, Edson [Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil). Faculdade de Medicina. Dept. de Radiologia; Sampaio, Renato Kobler [Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ (Brazil). Faculdade de Medicina; Irion, Klaus L. [Liverpool NHS Trust, Liverpool (United Kingdom). Cardiothoracic Centre; Collares, Felipe Birchal [Harvard Medical School, Boston, MA (United States). Beth Israel Deaconess Medical Center (BIDMC)
Objective: The present study was aimed at evaluating main radiological and epidemiological aspects of giant cell lesions (central giant cell granuloma and brown tumors of hyperparathyroidism). Materials and methods: The sample consisted of 26 giant cell lesions diagnosed in 22 patients divided into two groups, one of them including 17 patients who were not affected by hyperparathyroidism (group A) and another including five patients with such a disorder (group B). Results: Prevalence was higher in female patients (72.7%). Most frequently, lesions occurred more in the second decade of life (mean age, 27 years). The mandible arc was most frequently involved (61.5%). Radiographically, 57.7% of lesions were multilocular and 42.3% were unilocular with defined limits. All of the 26 lesions caused expansion of bone, 15.4% radicular resorption, 50% dental displacement, and 11.5% produced pain. In the mandible 18.7% of the lesions crossed the midline. Group A showed 66.7% of lesions in the mandible and group B showed an even distribution of lesions between arches. In group A 66.7% of lesions were multilocular, and 33.3% unilocular; in group B 62.5% were unilocular, and 37.5% multilocular. Conclusion: Giant cells lesions may present themselves with a wide spectrum, from small, slow-growing unilocular lesions to extensive multilocular lesions. They present features of benignity, though some lesions may demonstrate a locally aggressive behavior. (author)
Kim, Young-Ji; Jo, Kwang Wook
The authors present a case of rapidly progressing eosinophilic granuloma (EG) of the skull without hemorrhage after minor trauma. A 6-year-old boy presented with a soft mass on the midline of his forehead. He had a surgery for EG 19 months ago. One month earlier, computed tomography (CT) and bone scans were performed to evaluate the possible recurrence of EG, and there was no evidence of recurrence in CT. However, a slightly increased uptake in the bone scan was noted on the midline of the forehead. A rapid growing mass developed in a new spot after a minor trauma 7 days before the patient arrived at the clinic. His physical examination was unremarkable, except for a non-tender, soft, and immobile mass. A plain skull X-ray and CT showed a lytic bony defect on the midline of the frontal bone. Magnetic resonance imaging showed a 1.4 cm sized enhancing mass. Surgical resection and cranioplasty were done. The role of trauma in the development of EG is unclear. However, our case suggests that minor trauma is an aggravating factor for EG formation. Careful observation with regular follow-up is necessary in patients with EG after minor trauma.
Kovác, J; Kovác, D
Periapical lesions are among the most frequently diagnosed apical odontogenic pathologies in human teeth. The condition is generally described as apical periodontitis. Apical periodontitis is a sequel to endodontic infection and manifests itself as the host defense response to microbial challenge emanating from the root canal system to the periapical tissue. It is viewed as a dynamic encounter between microbial factors and host defenses at the interface between infected radicular pulp and periodontal ligament that results in local inflammation, resorption of hard tissues, destruction of other periapical tissues, and eventual formation of various histopathological categories of apical periodontitis, commonly referred to as periapical lesions. There are also factors located within the inflamed periapical tissue that can interfere with post-treatment healing of the lesion. The purpose of this article is to provide a comprehensive overview of the etiopathogenesis of apical periodontitis and causes of failed endodontic treatment. This study presents a histopathological analysis through optical microscopy of periapical lesions, commonly referred to as solid dental or periapical granuloma.
Abdelmonem Awad Hegazy
Background: The nasal index determination is one of the most commonly used anthropometric parameters in classifying human races. There are few reports in medical literature concerning nasal index that specifically address particular Egyptian populations. The objective of this study was to determine the normal parameters of external nose (width, height and nasal index) in Egyptians. Methods: The study was conducted randomly on healthy Egyptian subjects of both sexes. Nasal height and width ...
Nishijima, Hironobu; Kondo, Kenji; Toma-Hirano, Makiko; Iwasaki, Shinichi; Kikuta, Shu; Fujimoto, Chisato; Ueha, Rumi; Kagoya, Ryoji; Yamasoba, Tatsuya
The posterior nasal nerve is the dominant source of the parasympathetic, sympathetic, and sensory fibers that innervate the nasal respiratory mucosa. Therefore, a posterior nasal neurectomy (PNN) is thought to induce denervation of the nasal mucosa and relieve the nasal symptoms of allergic rhinitis. However, the underlying mechanisms and therapeutic action of PNN remain unknown. To investigate the impact of PNN-induced denervation of the nasal mucosa on allergic rhinitis, we developed a rat model of PNN and examined the effects of PNN on allergic rhinitis in ovalbumin-sensitized rats. This rat model of PNN was characterized by the depletion of nerve fibers, choline acetyltransferase, and neuropeptides (eg, substance P, calcitonin gene-related peptide, vasoactive intestinal peptide, and neuropeptide Y) in the nasal respiratory mucosa. These animals exhibited nasal gland and goblet cell hypertrophy in the septal mucosa and atrophy of the submucosal gland in the lateral nasal wall, as well as reduced nasal secretion due to deficient acetylcholine synthesis. In an ovalbumin-sensitized model of allergic rhinitis, PNN also induced the depletion of nerve fibers, choline acetyltransferase, and neuropeptides in the nasal mucosa and suppressed nasal secretion. However, PNN did not affect mucosal thickening, eosinophil and mast cell infiltration, interleukin-4 and interferon-γ mRNA expression, and allergic symptoms (ie, sneezing and nasal scratching). These results suggest that the peripheral nerves and corresponding neuropeptides regulate nasal secretion, but not hypersensitivity, in allergic rhinitis, and that allergic rhinitis-related mucosal reactions occur in a highly denervated mucosa after PNN. Posterior nasal neurectomy may be a therapeutic option for the treatment of hyperrhinorrhea, but not allergic rhinitis hypersensitivity.
Full Text Available The main issues in nasal surgery are to stabilize the nose in the good position after surgery and preserve the cartilages and bones in the favorable situation and reduce the risk of deviation recurrence. Also it is necessary to avoid the synechia formation, nasal valve narrowing, hematoma and bleeding. Due to the above mentioned problems and in order to solve and minimize them nasal packing, nasal splint and nasal mold have been advised. Patients for whom the nasal packing used may faced to some problems like naso-pulmonary reflex, intractable pain, sleep disorder, post operation infection and very dangerous complication like toxic shock syndrome. We have two groups of patients and three surgeons (one of the surgeons used post operative nasal packing in his patients and the two others surgeons did not.Complications and morbidities were compared in these two groups. Comparing the two groups showed that the rate of complication and morbidities between these two groups were same and the differences were not valuable, except the pain and discomfort post operatively and at the time of its removal. Nasal packing has several risks for the patients while its effects are not studied. Septoplasty can be safely performed without postoperative nasal packing. Nasal packing had no main findings that compensated its usage. Septal suture is one of the procedures that can be used as alternative method to nasal packing. Therefore the nasal packing after septoplasty should be reserved for the patients with increased risk of bleeding.
Rosenberg, J; Pedersen, M H
Ten surgical patients were monitored with nasal and finger pulse oximetry (Nellcor N-200) for five study periods with alternating mouth and nasal breathing and switching of cables and sensors. Nasal pulse oximetry was found to overestimate arterial oxygen saturation by 4.7 (SD 1.4%) (bias...
Dubey, J P; Schares, G
The protozoan parasite Neospora caninum is a major cause of abortion in cattle. The diagnosis of neosporosis-associated mortality and abortion in cattle is difficult. In the present paper we review histologic, serologic, immunohistochemical, and molecular methods for dignosis of bovine neosporosis. Although not a routine method of diagnosis, methods to isolate viable N. caninum from bovine tissues are also reviewed.
Full Text Available Nasal NK/T-cell lymphoma (NKTCL frequently presents with necrotic, granulomatous lesions in the upper respiratory tract, and usually shows a highly aggressive clinical course. Thus, it was initially included in the clinical condition of lethal midline granuloma. Recently, the disease has been recognized as a neoplastic proliferation of NK/T cells. The disease is much more frequent in Asian and Latin American countries than in Western countries, and is universally associated with Epstein-Barr virus (EBV infection. Analyses of gene mutations, especially p53 and c-kit, revealed the different frequencies by district. Abnormalities of other genes have also been reported. Case-control studies showed that the exposure to pesticides and chemical solvents could be causative of NKTCL. Further studies including HLA antigen typing of patients is necessary to further clarify the disease mechanism.
Jensen, Jesper Langholm; Mølgaard, Anne; Poulsen, Jens-Christian Navarro
Bovine and camel chymosin are aspartic peptidases that are used industrially in cheese production. They cleave the Phe105-Met106 bond of the milk protein κ-casein, releasing its predominantly negatively charged C-terminus, which leads to the separation of the milk into curds and whey. Despite...... having 85% sequence identity, camel chymosin shows a 70% higher milk-clotting activity than bovine chymosin towards bovine milk. The activities, structures, thermal stabilities and glycosylation patterns of bovine and camel chymosin obtained by fermentation in Aspergillus niger have been examined...... interactions arising from variation in the surface charges and the greater malleability both in domain movements and substrate binding contribute to the better milk-clotting activity of camel chymosin towards bovine milk....
Luiz Carlos Severo
Full Text Available This report documents the first two Brazilian cases of mediastinal granuloma due to histoplasmosis, presenting selected aspects on the diagnosis. Tissue samples revealing histoplasmosis were obtained from each of the patients by mediastinoscopy and thoracotomy. In the second patient, a subcarinal calcified mass eroded into the bronchial tree, leading to secondary bilateral aspiration pneumonitis one week after thoracotomy. Although rare, histoplasmosis should be included in the differential diagnosis of mediastinal granuloma, specially if there are calcifications greater than 10 mm in dimension.São relatados os dois primeiros casos de granuloma mediastinal por histoplasmose no Brasil, apresentando aspectos selecionados sobre dignóstico. O diagnóstico tecidual de histoplasmose foi obtido por mediastinoscopia e toracotomia, respectivamente. Em um paciente a massa calcificada subcarinal erodiu na árvore brônquica com pneumonite de aspiração bilateral uma semana após a toracotomia. Embora rara, histoplasmose deve ser incluída no diagnóstico diferencial de granuloma mediastinal especialmente com calcificação maior do que 10 mm de diâmetro.
Full Text Available Nasal glomangiopericytoma is rare. The immunophenotype is heterogeneous, more frequently smooth-muscle-actin and CD34-positive. We report expression patterns for several vascular-related proteins such as CD99, CD146, Bcl2, and WT1 as well as for treatment-related proteins such as mTOR and EGFR in a nasal glomangiopericytoma. The patient (woman, 86 years presented with a left nasal tumefaction. The resected specimen (1.5-cm showed a glomangiopericytoma. Tumor cells expressed smooth-muscle-actin, CD31, CD34, and progesterone receptor. They also expressed the vascular-cell-related proteins Bcl2, CD99, CD146, and WT1, as well as mTOR and EGFR. Nasal glomangiopericytomas show immunohistochemical heterogeneity for vascular-related markers, suggesting a possible extensive pericytic differentiation. The expression of potential targets for drug treatments such as mTOR and EGFR may impact on the clinical follow-up of these tumors occurring at advanced ages, which may require complex surgery.
Daniel, M; Raghavan, U
Objectives: To find if the presence of epistaxis after nasal trauma can be used to predict post-traumatic external nasal deformity or a symptomatic deviated nasal septum. Methods: Retrospective analysis of all patients seen in the fractured nose clinic by the first author between 17 October 2003 and 27 February 2004. Presence of epistaxis, newly developed external nasal deformity, and the presence of a deviated nasal septum with new symptoms of nasal obstruction were noted. Results: A total of 139 patients were included in the study. Epistaxis following injury was noted in 106 (76%). Newly developed external nasal deformity was noted in 71 (51%), and 33 (24%) had a deviated nasal septum with new symptoms of nasal obstruction. Of the 106 patients with post-trauma epistaxis, 50 (67%) had newly developed external nasal deformity and of the 33 patients without post-traumatic epistaxis, 11 (33%) had nasal deformity (pepistaxis was not associated with the presence of a newly symptomatic deviated septum (25% in patients with epistaxis after injury versus 18% if there was no epistaxis). Conclusions: Presence of epistaxis after nasal trauma is associated with a statistically significant increase in external nasal deformity. However, one third of patients without epistaxis following nasal trauma also had external nasal deformity and hence all patients with a swollen nose after injury, irrespective of post-trauma epistaxis, still need to be referred to the fractured nose clinic. PMID:16244333
Perkins, Elizabeth L; Basu, Saikat; Garcia, Guilherme J M; Buckmire, Robert A; Shah, Rupali N; Kimbell, Julia S
Objectives Vocal fold granulomas are benign lesions of the larynx commonly caused by gastroesophageal reflux, intubation, and phonotrauma. Current medical therapy includes inhaled corticosteroids to target inflammation that leads to granuloma formation. Particle sizes of commonly prescribed inhalers range over 1 to 4 µm. The study objective was to use computational fluid dynamics to investigate deposition patterns over a range of particle sizes of inhaled corticosteroids targeting the larynx and vocal fold granulomas. Study Design Retrospective, case-specific computational study. Setting Tertiary academic center. Subjects/Methods A 3-dimensional anatomically realistic computational model of a normal adult airway from mouth to trachea was constructed from 3 computed tomography scans. Virtual granulomas of varying sizes and positions along the vocal fold were incorporated into the base model. Assuming steady-state, inspiratory, turbulent airflow at 30 L/min, computational fluid dynamics was used to simulate respiratory transport and deposition of inhaled corticosteroid particles ranging over 1 to 20 µm. Results Laryngeal deposition in the base model peaked for particle sizes 8 to 10 µm (2.8%-3.5%). Ideal sizes ranged over 6 to 10, 7 to 13, and 7 to 14 µm for small, medium, and large granuloma sizes, respectively. Glottic deposition was maximal at 10.8% for 9-µm-sized particles for the large posterior granuloma, 3 times the normal model (3.5%). Conclusion As the virtual granuloma size increased and the location became more posterior, glottic deposition and ideal particle size generally increased. This preliminary study suggests that inhalers with larger particle sizes, such as fluticasone propionate dry-powder inhaler, may improve laryngeal drug deposition. Most commercially available inhalers have smaller particles than suggested here.
Full Text Available Introduction: Spontaneous Perforation of the nasal septum is an uncommon condition. Nasal inhalation of substances such as cocaine has long been linked to this Perforation. Case Report: This report describes the case of a 46-year-old woman who was addicted to methamphetamine and who presented with perforation of the nasal septum.This is the first reported case of nasal septal necrosis linked to nasal inhalation of methamphetamine. Conclusions: Patient history and assurance regardingillegal drug consumption and abuse is a key point for fast and accurate diagnosis. The pathophysiology of drug-induced sinunasal disease and a review of the literature are also presented.
Kang, Haihong; Yan, Mengfei; Yu, Qinghua; Yang, Qian
As the main mucosal immune inductive site of nasal cavity, nasal-associated lymphoid tissue (NALT) plays an important role in both antigen recognition and immune activation after intranasal immunization. However, the efficiency of intranasal vaccines is commonly restricted by the insufficient intake of antigen by the nasal mucosa, resulting from the nasal mucosal barrier and the nasal mucociliary clearance. The distribution of NALT and the characteristic of nasal cavity have already been described in humans and many laboratory rodents, while data about poultry are scarce. For this purpose, histological sections of the chicken nasal cavities were used to examine the anatomical structure and histological characteristics of nasal cavity. Besides, the absorptive capacity of chicken nasal mucosa was also studied using the materials with different particle size. Results showed that the NALT of chicken was located on the bottom of nasal septum and both sides of choanal cleft, which mainly consisted of second lymphoid follicle. A large number of lymphocytes were distributed under the mucosal epithelium of inferior nasal meatus. In addition, there were also diffuse lymphoid tissues located under the epithelium of the concha nasalis media and the walls of nasal cavity. The results of absorption experiment showed that the chicken nasal mucosa was capable to absorb trypan blue, OVA, and fluorescent latex particles. Inactivated avian influenza virus (IAIV) could be taken up by chicken nasal mucosa except for the stratified squamous epithelium sites located on the forepart of nasal cavity. The intake of IAIV by NALT was greater than that of the nasal mucosa covering on non-lymphoid tissue, which could be further enhanced after intranasal inoculation combined with sodium cholate or CpG DNA. The study on NALT and nasal absorptive capacity will be benefit for further understanding of immune mechanisms after nasal vaccination and development of nasal vaccines for poultry.
Belagola D Sathyanarayana
Full Text Available Background: Transverse nasal groove is a condition of cosmetic concern which awaits due recognition and has been widely described as a shallow groove that extends transversely over the dorsum of nose. However, we observed variations in the clinical presentations of this entity, hitherto undescribed in literature. Aims: We conducted a clinicoepidemiological study of transverse nasal lesions in patients attending our outpatient department. Methods: We conducted a prospective observational study. We screened all patients attending our out-patient department for presence of transverse nasal lesions, signs of any dermatosis and associated other skin conditions. Results: One hundred patients were recruited in the study. Females (80% predominated over males. Most patients were of 15-45 years age group (70%. Majority of the transverse nasal lesions were classical transverse nasal groove (39% and others included transverse nasal line (28%, strip (28%, ridge (4% and loop (1%. Seborrhoeic diathesis was the most common condition associated with transverse nasal lesion. Conclusions: Occurrence of transverse nasal line, strip, ridge and loop, in addition to classical transverse nasal groove implies that latter is actually a subset of transverse nasal lesions. Common association of this entity with seborrheic dermatitis, seborrhea and dandruff raises a possibility of whether transverse nasal lesion is a manifestation of seborrheic diathesis.
Park, Si Hyun; Lee, Jun Ho; Tak, Min Sung; Lee, Hyun Ju; Choi, Hwan Jun
Pyogenic granuloma (PG) is a type of vascular tumor for which the growth mechanism is poorly understood. Estrogen and progesterone may influence vascular malformations by increasing neovascularization in the lesions. Pregnancy tumor is a term for PG that occurs on the gingival mucosa of pregnant women in response to local irritation or injury. The etiology and pathogenesis of this phenomenon are not fully understood. Hormonal imbalance has been hypothesized to be responsible for the development of gingival hyper-reactive inflammatory responses. Moreover, it has been shown in vitro that the female sex hormone is a potential regulator of the production of several growth factors, such as vascular endothelial growth factor (VEGF), basic fibroblast growth factor, and nerve growth factor, in various cell types. Epidermal growth factor receptor (EGFR) is also involved in a signaling cascade that influences proliferation and other tumor-promoting activities, as well as the responsiveness to chemotherapy. The aim of this study was to examine the relationship between PG pathogenesis and hormone imbalance in 21 patients. All specimens were analyzed by immunohistochemical staining with hematoxylin and eosin for the following hormones: estrogen receptor, progesterone receptor, VEGF, and EGFR. The analysis of the specimens showed that estrogen receptor and EGFR were not associated with PG, while VEGF was statistically related to PG. In addition, there was no significantly difference between sex, tumor location, or pregnancy. There are few studies about correlation between the pathogenesis of PG and sex hormones or growth factors demonstrated via immunohistochemical analysis. The results of this study indicate that estrogen and progesterone do not influence the pathogenesis of PG; however, VEGF may be associated with the pathogenesis of PG.
Bisgaard, H; Krogsgaard, O W; Mygind, N
1. The amount of admixture in nasal lavage fluids was determined by addition of 99mTc labelled albumin, providing a correction factor for measurements of cellular material and humoral substances in nasal lavage return as well as a quantitative measure of nasal secretions. 2. Albumin was chosen...... secretion to be carried out on the whole sample of lavage fluid, thereby avoiding the necessity of complete admixture between marker and lavage fluid which would be pertinent to marker molecules measured chemically. The radiation from a nasal lavage is minimal and the procedure is fully acceptable...... of the nose, yet not the oropharynx. 5. A dose related increase in nasal secretion harvested by the nasal lavage in 10 persons challenged with histamine chloride could be demonstrated by this technique. 6. It is concluded that the use of 99mTc-albumin in a nasal washing provides a safe, simple and quick...
Hutters, B; Brøndsted, K
There is a need for clinical methods which give more direct information about the behaviour of the velopharyngeal mechanism in natural speech than do the examination methods normally applied to patients suffering from velopharyngeal insufficiency. One possibility is the recording of nasal airflow in order to detect nasal emission of air. The purpose of the present study is to examine the qualities and the characteristics of a simple and cheap nasal anemometer. As this type of flowmeter is considered less reliable than most other flowmeters, its limitations must be clearly understood and accounted for in drawing conclusions. Therefore, nasal airflow in speech obtained with this flowmeter is discussed in relation to nasal airflow obtained by the more reliable pneumotachograph and in relation to nasal airflow data found in the literature. The tests made here suggest that, at least for the type of speech material and measurements used in the present study, reliable nasal airflow data can be obtained by the anemometer.
Li, H L; Liu, J Q; Bai, X F; vn der Meide, P H; Link, H
Nasal administration of soluble antigens is an exciting means of specifically down-regulating pathogenic T-cell reactivities in autoimmune diseases. The mechanisms by which nasal administration of soluble antigens suppresses autoimmunity are poorly understood. To define further the principles of nasal tolerance induction, we studied the effects of nasal administration of myelin basic protein (MBP) on experimental autoimmune encephalomyelitis (EAE) in the Lewis rat. EAE is a CD4+ T-cell-mediated animal model for human multiple sclerosis. Nasal administration of guinea-pig (gp)-MBP at a dose as low as 30 micrograms/rat can completely prevent gp-MBP-induced EAE, whereas nasal administration of bovine (b)-MBP is not effective even at a much higher dosage. Cellular immune responses, as reflected by T-cell proliferation and interferon-gamma (IFN-gamma)-ELISPOT, were suppressed in rats receiving the two different doses (30 and 600 micrograms/rat) of gp-MBP, but not after administration of b-MBP. Rats tolerized with both doses of gp-MBP had also abrogated MBP-induced IFN-gamma mRNA expression in popliteal and inguinal lymph node mononuclear cells compared with rats receiving phosphate-buffered saline nasally. However, adoptive transfer revealed that only spleen mononuclear cells from rats pretreated with a low dose, but not from those pretreated with a high dose, of gp-MBP transferred protection to actively induced EAE. Low-dose (30 micrograms/rat) gp-MBP-tolerized rats also had high numbers of interleukin-4 (IL-4) mRNA-expressing lymph node cells, while high-dose (600 micrograms/rat) gp-MBP-tolerized rats had low numbers of IL-4 mRNA-expressing lymph node cells. Our data suggest an exquisite specificity of nasal tolerance. Dose-dependent mechanisms also relate to nasal tolerance induction and protection against EAE in the Lewis rat.
Wellenberg, Gerardus Johannus
Mastitis is an often occurring disease in dairy cattle with an enormous economic impact for milk producers worldwide. Despite intensive research, which is historically based on the detection of bacterial udder pathogens, still around 20-35% of clinical cases of bovine mastitis have an unknown
Domingo-Gonzalez, Racquel; Das, Shibali; Griffiths, Kristin L; Ahmed, Mushtaq; Bambouskova, Monika; Gopal, Radha; Gondi, Suhas; Muñoz-Torrico, Marcela; Salazar-Lezama, Miguel A; Cruz-Lagunas, Alfredo; Jiménez-Álvarez, Luis; Ramirez-Martinez, Gustavo; Espinosa-Soto, Ramón; Sultana, Tamanna; Lyons-Weiler, James; Reinhart, Todd A; Arcos, Jesus; de la Luz Garcia-Hernandez, Maria; Mastrangelo, Michael A; Al-Hammadi, Noor; Townsend, Reid; Balada-Llasat, Joan-Miquel; Torrelles, Jordi B; Kaplan, Gilla; Horne, William; Kolls, Jay K; Artyomov, Maxim N; Rangel-Moreno, Javier; Zúñiga, Joaquín; Khader, Shabaana A
Mycobacterium tuberculosis (Mtb) is a global health threat, compounded by the emergence of drug-resistant strains. A hallmark of pulmonary tuberculosis (TB) is the formation of hypoxic necrotic granulomas, which upon disintegration, release infectious Mtb. Furthermore, hypoxic necrotic granulomas are associated with increased disease severity and provide a niche for drug-resistant Mtb. However, the host immune responses that promote the development of hypoxic TB granulomas are not well described. Using a necrotic Mtb mouse model, we show that loss of Mtb virulence factors, such as phenolic glycolipids, decreases the production of the proinflammatory cytokine IL-17 (also referred to as IL-17A). IL-17 production negatively regulates the development of hypoxic TB granulomas by limiting the expression of the transcription factor hypoxia-inducible factor 1α (HIF1α). In human TB patients, HIF1α mRNA expression is increased. Through genotyping and association analyses in human samples, we identified a link between the single nucleotide polymorphism rs2275913 in the IL-17 promoter (-197G/G), which is associated with decreased IL-17 production upon stimulation with Mtb cell wall. Together, our data highlight a potentially novel role for IL-17 in limiting the development of hypoxic necrotic granulomas and reducing disease severity in TB.
Geraldo Magela Azevedo
Full Text Available Parenteral injection of tolerated proteins into orally tolerant mice inhibits the initiation of immunological responses to unrelated proteins and blocks severe chronic inflammatory reactions of immunological origin, such as autoimmune reactions. This inhibitory effect which we have called “indirect effects of oral tolerance” is also known as “bystander suppression.” Herein, we show that i.p. injection of OVA + Al(OH3 minutes before i.v. injection of Schistosoma mansoni eggs into OVA tolerant mice blocked the increase of pulmonary granulomas. In addition, the expression of ICAM-1 in lung parenchyma in areas outside the granulomas of OVA-orally tolerant mice was significantly reduced. However, at day 18 after granuloma induction there was no difference in immunofluorescency intensity to CD3, CD4, F4/80, andα-SMA per granuloma area of tolerant and control groups. Reduction of granulomas by reexposure to orally tolerated proteins was not correlated with a shift in Th-1/Th-2 cytokines in serum or lung tissue extract.
Noa, M; de la Rosa, M C; Más, R
Policosanol is a new cholesterol-lowering drug isolated and purified from sugar-cane wax, which prevents the development of lipofundin-induced lesions and foam-cell formation in New Zealand rabbits and Wistar rats. This study was conducted to examine the effects of policosanol on foam-cell formation in carrageenan-induced granulomas in rats. Eighteen Wistar rats were randomly distributed in three experimental groups which received orally for 20 days Tween 20 H2O as vehicle (control group) or policosanol at 2.5 or 25 mg kg-1. At the 11th day, lipofundin was injected intraperitoneally for 8 days to induce formation of foam cells in the granuloma. At day 13, carrageenan was injected subcutaneously for granuloma induction and seven days later animals were killed. A significant reduction of the foam-cell formation in granulomas of policosanol-treated rats was observed. It is concluded that policosanol prevents the development of foam cells in carrageenan-induced granulomas (extravascular medium) in rats.
Askar, I; Kilinc, N; Yucetas, A
Pyogenic granuloma has been reported to be associated with hemangiomas and hamartomas, including port-wine stain. It has been suggested that the spontaneous development of pyogenic granuloma in port-wine stain might be associated with microscopic arteriovenous anastomoses in highly vascularized areas such as the fingers, hands, lips, tongue and face. A 25-year-old male patient presented with a history of a reddish, solitary nodule on the posterior cervical area for eight months. There had been an associated port-wine stain at the same localization since birth. Physical examination revealed a solitary, strawberry-like dome-shaped papule, 12 mm in diameter, within a well-demarcated reddish colored surrounding patch which had been present on the posterior cervical area. The lesion was excised, considering pyogenic granuloma arising in a port-wine stain. Histopathologic examination showed a mass of capillaries with variable luminal diameters, infiltration of inflammatory cells, and immature endothelial proliferation in the upper dermis. The capillaries were organized into lobules separated by fibrous stroma and were surrounded by an epithelial collarette. Immunohistochemical staining for factor VIII-related antigen supported all these findings of the port-wine stain. We present a pyogenic granuloma arising in port-wine stain on the posterior cervical area, since the posterior cervical area is not as highly vascular as the fingers, hands, lips, tongue and face. We believed that the collar of the patient's shirt continuously traumatized port-wine stain, and consequently led to the development of pyogenic granuloma.
Full Text Available In schistosomiasis, egg-induced hepatic granuloma formation is a cytokine-mediated, predominantly CD4+ Th2 immune response that can give rise to hepatic fibrosis. Hepatic fibrosis is the main cause of increased morbidity and mortality in humans with schistosome infection. Taurine has various physiological functions and hepatoprotective properties as well as anti-inflammatory and immunomodulatory activity. However, little is known about the role of taurine in schistosome egg-induced granuloma formation and fibrosis. We aimed to evaluate the therapeutic potential of taurine as preventative treatment for Schistosoma japonicum infection. Mice infected with S. japonicum cercariae were supplied with taurine drinking water (1% w/v for 4 weeks starting at 4 weeks post-infection. Taurine supplementation significantly improved the liver pathologic findings, reduced the serum levels of aminotransferases and area of hepatic granuloma, and prevented fibrosis progression. In addition, taurine decreased the expression of the granulomatous and fibrogenic mediators transforming growth factor β1, tumor necrosis factor α, monocyte chemotactic protein 1α and macrophage inflammatory protein 1α as well as the endoplasmic reticulum stress marker glucose-regulated protein 78. Thus, taurine can significantly attenuate S. japonicum egg-induced hepatic granuloma and fibrosis, which may depend in part on the downregulation of some relevant cytokine/chemokines and reducing the endoplasmic reticulum stress response. Keywords: Schistosomiasis, Schistosoma japonicum, Granuloma, Fibrosis, Taurine
Martín-González, J; Carmona-Fernández, A; Pérez-Pérez, A; Sánchez-Jiménez, F; Sánchez-Margalet, V; Segura-Egea, J J
To investigate the expression and immunohistochemical localization of leptin receptor (LEPR) in human periapical granulomas. Periapical inflammatory lesions were obtained from extracted human teeth and teeth which underwent periapical surgery. After their histopathological categorization as periapical granulomas (n = 20), they were examined by immunohistochemistry using human LEPR monoclonal antibodies. LEPR mRNA expression was also determined by quantitative real-time PCR (qRT-PCR), and the amount of LEPR protein was analysed by immunoblot. All granuloma samples expressed LEPR. Amongst inflammatory cells, only macrophages showed expression of LEPR. Western blot analysis revealed the presence in the samples of a protein with apparent molecular weight of ~120 kDa, corresponding to the estimated molecular weight of LEPR. The qRT-PCR analysis demonstrated the expression of LEPR mRNA, corresponding the size of the amplified fragment (338 bp), assessed by agarose gel electrophoresis, to that of LEPR mRNA. Human periapical granulomas express LEPR. In periapical granulomas, only macrophages showed expression of LEPR. This finding suggests that leptin can play a role in inflammatory and immune periapical responses. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.
Full Text Available The histopathological description of intralobular hepatic granulomas in animals with a defined clinical status (asymptomatic, oligosymptomatic and symptomatic animals was reported. Seventy-one mongrel dogs naturally infected with Leishmania chagasi were obtained from two Brazilian endemic areas: João Pessoa, PB and Belo Horizonte, MG. The hepatic parasite load was determined and compared to granuloma formation. Liver fragments from all infected animals showed remarkable leishmaniotic granulomatous inflammatory reaction. Granulomas with variable size were constituted by macrophages (parasitized or not with amastigotes of L. chagasi, some epithelioid cells, small numbers of lymphocytes, plasma cells, and rare neutrophils. Asymptomatic dogs had higher numbers of granulomas than oligosymptomatic and symptomatic animals from both geographical regions. However, the average diametric size of granulomas was very heterogeneous in all groups, independently of the geographic region (P>0.05. Parasite tissue load did not show any difference among liver fragments of all animals, especially when considering the defined clinical status and/or their geographic origin.Descreve-se a formação de granulomas hepáticos na leishmaniose canina em animais com classificação clínica definida - assintomáticos, oligossintomáticos e sintomáticos. Setenta e um animais, sem raça definida e naturalmente infectados com Leishmania chagasi, foram obtidos de duas regiões endêmicas brasileiras: João Pessoa, PB e Belo Horizonte, MG. A carga parasitária tecidual foi determinada mediante emprego do Leishmania Donovani Units (LDU e comparada com a formação de granulomas hepáticos. Fragmentos de fígado de todos os animais infectados mostraram reação granulomatosa notadamente leishmaniótica. Granulomas de variáveis tamanhos eram constituídos por macrófagos, parasitados ou não com formas amastigotas de L. chagasi, algumas células epitelióides, pequeno número de
Saulo Andrade Caldas
Full Text Available ABSTRACT. Caldas S.A., Nogueira V.A., Lima A.E.S., Aragão A.P., d’Avila M.S., Santos A.M., Miranda I.C., Costa S.Z.R. & Peixoto T.C. [Bilateral cheiloschisis in bovine - A case report.] Queilosquise bilateral em bovino - Relato de caso. Revista Brasileira de Medicina Veterinária, 36(1:55-59, 2014. Departamento de Medicina e Cirurgia Veterinária, Instituto de Veterinária, Universidade Federal Rural do Rio de Janeiro, BR 465 Km 7, Seropédica RJ 23890-000, Brasil. E-mail: email@example.com A case of bilateral queilosquise in a cattle two years old was reported. Clinically, there was cachexia, difficulty in grasping food and water intake. The clinical examination revealed that the nasal orifices were discontinuous with the upper lip, which allowed communication between the nostrils and mouth in its rostral portion, crowding of incisors (tweezers, as well as exposure of medium and the 2nd corner and of the tongue. In this case, the bilateral queilosquise was the result of flaws in fusion of the maxillary process and the medial nasal process and its surroundings, probably due to mineral deficiencies of pregnant cow. This pathogenesis was suggested by excluding other possible causes, the knowledge of the existence of mineral deficiencies in the region where the event occurred and bad nutritional status of pregnant female.
Rahwa A. Osman
Full Text Available Bovine natural killer (NK cells were originally defined by the NK activation receptor CD335 [natural killer cell p46-related protein (NKp46], but following the discovery of NKp46 expression on human T-cells, the definition of conventional bovine NK cells was modified to CD335+CD3− cells. Recently, a bovine T-cell population co-expressing CD335 was identified and these non-conventional T-cells were shown to produce interferon (IFN-γ and share functional properties with both conventional NK cells and T-cells. It is not known, however, if CD335+ bovine T-cells are recruited to mucosal surfaces and what chemokines play a role in recruiting this unique T-cell subpopulation. In this study, bovine herpesvirus-1 (BHV-1, which is closely related to herpes simplex virus-1, was used to investigate bovine lymphocyte cell populations recruited to the upper respiratory tract following a primary respiratory infection. Immunohistochemical staining with individual monoclonal antibodies revealed significant (P < 0.05 recruitment of CD335+, CD3+, and CD8+ lymphocyte populations to the nasal turbinates on day 5 following primary BHV-1 infection. Dual-color immunofluorescence revealed that cells recruited to nasal turbinates were primarily T-cells that co-expressed both CD335 and CD8. This non-conventional T-cell population represented 77.5% of CD355+ cells and 89.5% of CD8+ cells recruited to nasal turbinates on day 5 post-BHV-1 infection. However, due to diffuse IFN-γ staining of nasal turbinate tissue, it was not possible to directly link increased IFN-γ production following BHV-1 infection with the recruitment of non-conventional T-cells. Transcriptional analysis revealed CCL4, CCL5, and CXCL9 gene expression was significantly (P < 0.05 upregulated in nasal turbinate tissue following BHV-1 infection. Therefore, no single chemokine was associated with recruitment of non-conventional T-cells. In conclusion, the specific recruitment of CD335+ and CD8
do Prado Gomes Pedreira, Renato; de Carli, Marina Lara; Beijo, Luiz Alberto; Nonogaki, Suely; Pereira, Alessandro Antônio Costa; Junior, Noé Vital Ribeiro; Sperandio, Felipe Fornias; Hanemann, João Adolfo Costa
Multinucleated giant cells (MGC) are considered to be a hallmark of granulomatous inflammation; thus, they may play an essential role in the host response against pathogens, particularly Paracoccidioides brasiliensis. This study characterizes the MGC found in oral paracoccidioidomycosis and assesses the correlation of MGC with the amount of fungi within oral tissues. Twenty-six cases were included. They were classified as loose or dense granulomas, and the total MGC, including foreign-body and Langhans giant cells, besides the total and intracellular fungi, were taken into consideration. CD163 immunoexpression was performed, and CD163+ multinucleated giant cells were also quantified. Dense granulomas revealed more foreign-body type and total giant cells than loose granulomas (P paracoccidioidomycosis lesions contain MGC that mainly belong to a CD163+ phenotype, also showing both Langhans and foreign-body arrangements. Additionally, the higher the presence of MGC, the higher the amount of phagocytized fungi.
Full Text Available A 37 year old male was referred to our centre for management of episcleritis with peripheral keratitis in the right eye. He had a history of ocular discomfort in the right eye of 1 week duration. Slitlamp examination revealed marginal keratitis between 12′o clock to 2′o clock positions in the right eye. Lid eversion revealed an insect wing on the tarsal conjunctiva along with an adjacent conjunctival granuloma. The area of the marginal keratitis corresponded to the area of the foreign body and the conjunctival granuloma. The probable mechanism of the development of marginal keratitis and the conjunctiva granuloma is speculated in this case report.
Kim, Jae Won; Yang, Ik; Kim, Jeong Won; Jung, Ah Young; Chung, Soo Young; Kim, Hong Dae; Woo, Ji Young; Yoon, Sa Rah; Choi, Seon Hyeong
Bee sting therapy is a folk remedy used for arthralgia. An adverse reaction to bee sting therapy can be variable, ranging from a local inflammatory reaction to generalized anaphylaxis. There have been reports of dermatologic findings pertaining to bee sting granulomas, which results from a foreign body reaction to the persistence of venom and stinger at the sting site. However to the best of our knowledge, the radiologic findings of bee sting granulomas have not been reported on in Korea. We describe the ultrasound and MRI findings of bee sting granulomas at the lower extremity in a 36-year-old woman who underwent bee-sting therapy for osteoarthritis of the knee joints 3 months prior
Kim, Jae Won; Yang, Ik; Kim, Jeong Won; Jung, Ah Young; Chung, Soo Young; Kim, Hong Dae; Woo, Ji Young; Yoon, Sa Rah; Choi, Seon Hyeong [Kangnam Sacred Heart Hospital, Seoul (Korea, Republic of)
Bee sting therapy is a folk remedy used for arthralgia. An adverse reaction to bee sting therapy can be variable, ranging from a local inflammatory reaction to generalized anaphylaxis. There have been reports of dermatologic findings pertaining to bee sting granulomas, which results from a foreign body reaction to the persistence of venom and stinger at the sting site. However to the best of our knowledge, the radiologic findings of bee sting granulomas have not been reported on in Korea. We describe the ultrasound and MRI findings of bee sting granulomas at the lower extremity in a 36-year-old woman who underwent bee-sting therapy for osteoarthritis of the knee joints 3 months prior.
Full Text Available The aim of this study was to determine the nasal parameters in the population of central Serbia and to compare them with those determined in earlier studies in different populations. The research was conducted on 496 randomly selected persons (262 males and 234 females, aged 18-65 years. The measured parameters were nasal height and nasal breadth and the standard spreading caliper with scale was used for measurements. There were significant differences in the nasal parameters between male and female subjects. The nasal breadth was 34.72 mm in females, and in the male population it was 36.7 mm. The mean values of nasal height were 52.6 mm and 54.32 mm in females and males, respectively. The nasal index in females and males was 66.01 and 67.56, respectively, and the mean value of the nasal index of all respondents was 66.78. After conducting the research it was concluded that the dominant nasal type in the population of the central part of Serbia is leptorrhine. The present study showed the existence of sexual dimorphism in nasal morphology. The data obtained in our study may be useful in anthropological and forensic research, as well as in cosmetic planning and reconstructive surgery.
Experimental pulmonary schistosomiasis: lack of morphological evidence of modulation in schistosomal pulmonary granulomas Esquistossomose pulmonar experimental: falta de evidência morfológica de modulação nos granulomas esquistosomóticos pulmonares
Maura R. F. Souza Vidal
Full Text Available Numerous pulmonary schistosome egg granulomas were present in mice submitted to partial portal vein ligation (Warren's model. The granulomas were characterized by cellular aggregations formed within alveolar tissue. Main cellular types were macrophages (epithelioid cells, eosinophils, plasma cells and lymphocytes. These cells were supported by scanty fibrous stroma and exhibited close membrane contact points amongst themselves, but without forming specialized adhesion apparatus. When granulomas involved arterial structures, proliferation of cndothelial and smooth muscle cells occurred and fibrosis associated with angiogenesis became more evident. Granulomas formed around mature eggs in the pulmonary alveolar tissue presented approximately the same size and morphology regardless of the time of infection, the latter being 10, 18 and 25 weeks after cercarial exposure. This persistence of morphological appearance suggests that pulmonary granulomas do not undergo immunological modulation, as is the case with the granulomas in the liver and, to a lesser extent, in the intestines. Probably, besides general immunological factors, local (stromal factors play an important role in schistosomal granuloma modulation.Em camundongos submetidos à ligadura parcial da veia porta e infecção pelo Schistosoma mansoni, os granulomas periovulares apareceram em grande número nos pulmões, comprovando a validade do modelo de Warren. Histologicamente os granulomas eram representados por agregados celulares compactos no seio de escasso estroma. Os macrófagos (células epitelióides e eosinófilos eram os elementos celulares predominantes, vindo em seguida os linfóticos e plasmócitos. Ultraestruturalmenle, as células do granuloma exibiam íntimo contacto de suas membranas, com varios pontos de adesão, mas sem formar estruturas juncionais mais específicas. Os granulomas formados em torno a ovos maduros tinham tamanho, forma e composição celular similares ap
Kátia B Amaral
Full Text Available The pathology of schistosomiasis mansoni, a neglected tropical disease of great clinical and socioeconomic importance, results from the parasite eggs that become trapped in host tissues, particularly in the liver and intestines. Continuous antigenic stimulation from these eggs leads to recruitment of inflammatory cells to the sites of infection with formation of periovular granulomas. These complex structures have variable size and composition and are the most striking histopathological feature of schistosomiasis mansoni. However, evaluation of granulomas by conventional microscopy methods is time-consuming and limited, especially in large-scale studies. Here, we used high resolution Whole Slide Imaging (WSI, which allows fast scanning of entire histological slides, and multiple morphometric evaluations, to assess the granulomatous response elicited in target organs (liver, small and large intestines of two models of schistosomiasis mansoni. One of the advantages of WSI, also termed virtual microscopy, is that it generates images that simultaneously offer high resolution and a wide field of observation. By using a model of natural (Nectomys squamipes, a wild reservoir captured from endemic areas in Brazil and experimental (Swiss mouse infection with Schistosoma mansoni, we provided the first detailed WSI characterization of granulomas and other pathological aspects. WSI and quantitative analyses enabled a fast and reliable assessment of the number, evolutional types, frequency and areas of granulomas and inflammatory infiltrates and revealed that target organs are differentially impacted by inflammatory responses in the natural and experimental infections. Remarkably, high-resolution analysis of individual eosinophils, key cells elicited by this helminthic infection, showed a great difference in eosinophil numbers between the two infections. Moreover, features such as the intestinal egg path and confluent granulomas were uncovered. Thus, WSI may
Diedrich, Collin R; O'Hern, Jennifer; Gutierrez, Maximiliano G; Allie, Nafiesa; Papier, Patricia; Meintjes, Graeme; Coussens, Anna K; Wainwright, Helen; Wilkinson, Robert J
Human immunodeficiency virus type 1 (HIV)-infected persons are more susceptible to tuberculosis than HIV-uninfected persons. Low peripheral CD4 + T-cell count is not the sole cause of higher susceptibility, because HIV-infected persons with a high peripheral CD4 + T-cell count and those prescribed successful antiretroviral therapy (ART) remain more prone to active tuberculosis than HIV-uninfected persons. We hypothesized that the increase in susceptibility is caused by the ability of HIV to manipulate Mycobacterium tuberculosis-associated granulomas. We examined 71 excised cervical lymph nodes (LNs) from persons with HIV and M. tuberculosis coinfection, those with HIV monoinfection, and those with M. tuberculosis monoinfection with a spectrum of peripheral CD4 + T-cell counts and ART statuses. We quantified differences in M. tuberculosis levels, HIV p24 levels, cellular response, and cytokine presence within granulomas. HIV increased M. tuberculosis numbers and reduced CD4 + T-cell counts within granulomas. Peripheral CD4 + T-cell depletion correlated with granulomas that contained fewer CD4 + and CD8 + T cells, less interferon γ, more neutrophils, more interleukin 10 (IL-10), and increased M. tuberculosis numbers. M. tuberculosis numbers correlated positively with IL-10 and interferon α levels and fewer CD4 + and CD8 + T cells. ART reduced IL-10 production. Peripheral CD4 + T-cell depletion correlated with increased M. tuberculosis presence, increased IL-10 production, and other phenotypic changes within granulomas, demonstrating the HIV infection progressively changes these granulomas. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America.
Weber, Manuel; Schlittenbauer, Tilo; Moebius, Patrick; Büttner-Herold, Maike; Ries, Jutta; Preidl, Raimund; Geppert, Carol-Immanuel; Neukam, Friedrich W; Wehrhan, Falk
Apical periodontitis can appear clinically as apical granulomas or radicular cysts. There is evidence that immunologic factors are involved in the pathogenesis of both pathologies. In contrast to radicular cysts, the dentigerous cysts have a developmental origin. Macrophage polarization (M1 vs M2) is a main regulator of tissue homeostasis and differentiation. There are no studies comparing macrophage polarization in apical granulomas, radicular cysts, and dentigerous cysts. Forty-one apical granulomas, 23 radicular cysts, and 23 dentigerous cysts were analyzed in this study. A tissue microarray (TMA) of the 87 consecutive specimens was created, and CD68-, CD11c-, CD163-, and MRC1-positive macrophages were detected by immunohistochemical methods. TMAs were digitized, and the expression of macrophage markers was quantitatively assessed. Radicular cysts are characterized by M1 polarization of macrophages while apical granulomas show a significantly higher degree of M2 polarization. Dentigerous cysts have a significantly lower M1 polarization than both analyzed periapical lesions (apical granulomas and radicular cysts) and accordingly, a significantly higher M2 polarization than radicular cysts. Macrophage cell density in dentigerous cysts is significantly lower than in the periapical lesions. The development of apical periodontitis towards apical granulomas or radicular cysts might be directed by macrophage polarization. Radicular cyst formation is associated with an increased M1 polarization of infiltrating macrophages. In contrast to radicular cysts, dentigerous cysts are characterized by a low macrophage infiltration and a high degree of M2 polarization, possibly reflecting their developmental rather than inflammatory origin. As M1 polarization of macrophages is triggered by bacterial antigens, these results underline the need for sufficient bacterial clearance during endodontic treatment to prevent a possible M1 macrophage-derived stimulus for radicular cyst
Diedrich, C R; O'Hern, J; Wilkinson, R J
Infection with HIV-1 greatly increases the risk of active tuberculosis (TB). Although hypotheses suggest HIV-1 disrupts Mycobacterium tuberculosis (Mtb) granuloma function, few studies have examined this directly. The objective of this study was to determine what evidence exists about the effect HIV-1 co-infection has upon Mtb granulomas. A systematic search of PubMed, Web of Science, and Medline up to 20 March 2015 was conducted, to identify studies comparing Mtb-infected tissue from HIV-1 infected and uninfected persons, or HIV-1 infected persons with stratified peripheral CD4 T cell (pCD4) counts. We summarized findings that focused on how HIV-1 changes granuloma formation, bacterial presence, cellular composition, and cytokine production. Nineteen studies with a combined sample size of 899 persons were included. Although studies frequently were limited by variable or inadequately described definitions of outcomes and analytical methods, HIV-1 was found to be associated with increased bacillary load within Mtb-infected tissue. Reductions in pCD4 counts within co-infected persons associated with both poorer granuloma formation and higher bacterial load. The high degree of heterogeneity among studies combined with experimental limitations made it difficult to conclusively support previously published and prevalent hypotheses about HIV-1/Mtb co-infection granulomas. To elucidate the validity of these hypotheses we have described areas that can be improved in future studies in order to clarify the influence HIV-1 co-infection has upon the Mtb granuloma. Copyright © 2016 Elsevier Ltd. All rights reserved.
Estephannia Mora Solano
Full Text Available Title: Telangiecticum granuloma associated to hormonal alterations.ResumenEl granuloma telangiectásico es una lesión mucocutánea benigna no neoplásica, de origen epitelial, contenido vascular y crecimiento rápido, cuya etiología es atribuible a un trauma menor pero constante. Se asocia a alteraciones hormonales propias del embarazo y la pubertad. En la cavidad oral tiene predilección a nivel de la encía. A continuación se presenta caso clínico de una paciente de 25 años de edad, quien acude a consulta odontológica por presentar una lesión tumoral que se desarrolló mientras estaba en el tercer mes de embarazo, localizada en el sector anteroinferior, dificultando la fonación, masticación y deglución. Se realizó escisión quirúrgica y al efectuar estudio histopatológico se confirmó diagnóstico de granuloma telangiectásico. (DUAZARY 2012 No. 1, 65 - 67AbstractTelangiecticum granuloma is a nonneoplastic benign mucocutaneous lesion of epitelial origin, vascular content and fast growing, etiology is attributable to minor and constant trauma. In the oral cavity it has a predilection to the gum. We present a case of a female 25 years old patient who goes to dental consult for presenting a tumor lesion while she was in the third month of pregnancy, located in the jaw, making difficult the phonation, mastication and swallowing. We proceed to surgical excision and pathological studies confirmed the diagnosis of telangiectaticum granuloma.Key words: Pyogenic granuloma; pregnancy; hyperplasia; hormones. (Mesh Database.
Full Text Available Context: Pyogenic granuloma (PG is one of the most common reactive vascular lesions in the oral mucosa, which has been divided into the lobular capillary hemangioma (LCH and the non lobular type (non-LCH as two distinct entities, on the basis of some investigations. Aims: This study aims to compare the proliferative and angiogenic activity of two histological types of PG to determine whether they have two distinct types of biological behavior. Settings and Design: In this retrospective cross-sectional study, immunostaining was performed on 10 cases of each type of PG. Materials and Methods: About 4μm sections were cut from formalin-fixed paraffin-embedded blocks and each specimen was stained with both anti-CD31 and anti-Ki-67 antibodies simultaneously. Labeling index (LI was determined for both types by counting Ki-67 and CD31 positive cells separately and simultaneously in 1000 stromal and luminal cells. Micro vessel count (MVC, the mean number of micro vessels in five areas at Χ200 magnification, was also determined for both groups. Statistical Analysis: The results were statistically compared using the Mann-Whitney U-test. Results: Ki-67 LI in LCH (5.4 ± 2.4 was higher than non-LCH (3.9 ± 3.9. The percentage of CD31 positive cells in LCH (28.5 ± 22 was lower than non-LCH (37.1 ± 20.8 and simultaneously immunostaining for both markers in LCH type (2.4 ± 2.1 was higher than non-LCH (1.2 ± 1. The MVC was approximately 77.35 ± 34.6 and 82.6 ± 42.7 in the lobular areas of LCH and central areas of non-LCH PG, respectively. These differences were not statistically significant. Conclusions: These results demonstrate a higher proliferation activity in endothelial cells of LCH PG than in non-LCH.
Brancamp, Tami U; Lewis, Kerry E; Watterson, Thomas
To assess the nasalance/nasality relationship and Nasometer test sensitivity and specificity when nasality ratings are obtained with both equal appearing interval (EAI) and direct magnitude estimation (DME) scaling procedures. To test the linearity of the relationship between nasality ratings obtained from different perceptual scales. STIMULI: Audio recordings of the Turtle Passage. Participants' nasalance scores and audio recordings were obtained simultaneously. A single judge rated the samples for nasality using both EAI and DME scaling procedures. Thirty-nine participants 3 to 17 years of age. Across participants, resonance ranged from normal to severely hypernasal. Nasalance scores and two nasality ratings. The magnitude of the correlation between nasalance scores and EAI ratings of nasality (r = .63) and between nasalance and DME ratings of nasality (r = .59) was not significantly different. Nasometer test sensitivity and specificity for EAI-rated nasality were .71 and .73, respectively. For DME-rated nasality, sensitivity and specificity were .62 and .70, respectively. Regression of EAI nasality ratings on DME nasality ratings did not depart significantly from linearity. No difference was found in the relationship between nasalance and nasality when nasality was rated using EAI as opposed to DME procedures. Nasometer test sensitivity and specificity were similar for EAI- and DME-rated nasality. A linear model accounted for the greatest proportion of explained variance in EAI and DME ratings. Consequently, clinicians should be able to obtain valid and reliable estimates of nasality using EAI or DME.
Full Text Available Pulse or hyaline ring granulomas are rare but are well-defined oral and extraoral lesions due to implantation of the cellulose moiety of plant foods in contrast starch components. A unique form as reactive gingival growth showing histologic features of oral pulse or hyaline ring granuloma (OPHRG which had resulted from implantation of food particles of plant or vegetable origin into the periodontium has been illustrated. Such a presentation is attributable to compromised periodontal health and poor oral hygiene favoring the implantation of food particles has been described here along with a literature update on OPHRG.
Full Text Available As foreign body wounds of the eye are very common , many ocular injuries are caused by thorns, fragments of wood or husks of grains, which are retained in eye initiating granulomatous reaction , very commonly seen in rural places. Foreign body granuloma should be considered in differential diagnosis of conjunctival epibulbar lesions like episcleritis, scleritis and squamous dysplasia. Here we present a case of conjunctival foreign body granuloma developed after a thorn injury in a 19 years old young male, from rural area
Full Text Available We report a case of a 33-year-old male with a mixed germ-cell testicular tumor. Postoperative follow-up FDG-PET revealed concentration of FDG in the left inguinal area which is not tumor metastasis or local recurrence but suture reactivity granuloma. In this paper, we reviewed suture granulomas associated with false-positive findings on FDG-PET after surgery. If FDG-PET will be used more frequently in the future, it will be necessary to refrain from using silk thread in order to prevent any unnecessary surgery.
Lin, S K; Chiang, C P; Ou, S H; Wang, J T; Liu, B Y; Lan, W H
An unusual case of hyaline ring granuloma arising from the connective tissue wall of a residual apical periodontal cyst is reported. Hyaline rings with foreign-body type giant cell inclusions were a significant feature in the histopathologic diagnosis. Histochemical and polarized light microscopic studies suggested that the introduction of foreign material, possibly cellulose, through the postextraction socket into the cystic wall may have caused the granulomatous reaction and formation of the hyaline ring granuloma. The clinical features of this case and 66 previously reported cases, as well as the pathogenesis of the hyaline rings, are discussed.
İbrahim İlker Öz
Full Text Available Solid renal masses are generally distinguished with contrast enhancement and intratumoral fatty foci by radiological examinations. The present of enhancement is most important criteria for diagnosis of malignant lesions. Generally, a contrast enhanced solid mass in kidney is accepted as a neoplasm. Foreign body granuloma is an extraordinary cause of enhanced solid renal mass. This case of a renal suture granuloma demonstrated peripheral enhanced exophytic renal mass mimic renal cell carcinoma, and underwent surgery. At the solid renal mass with different radiological features, biopsy is an option to determining the necessity of surgery as well as the surgical approach.
Morioka, T.; Fujii, K.; Nishio, S.; Hasuo, K.; Hisashi, K.; Miyagi, Y.; Nagata, S.; Fukui, M.
We report two cases of cholesterol granuloma in the middle cranial fossa. On CT the lesions appeared as a nonspecific, nonenhancing soft-tissue mass with bone erosion. On MRI they were seen as areas of high signal intensity surrounded by a low-intensity peripheral zone on both T1- and T2-weighted images. Cholesterol granuloma is thought to occur when pneumatised cells in the temporal bone become obstructed. Although this lesion usually occurs in the petrous bone, it can extend to the middle cranial fossa. The diagnosis and surgical management are discussed. (orig.)
Alternatives to small molecule or vaccine approaches to treating tuberculosis are rarely discussed. Attacking Mycobacterium tuberculosis in the granuloma represents a challenge. It is proposed that the conjugation of small molecules onto a monoclonal antibody that recognizes macrophage or lymphocytes cell surface receptors, might be a way to target the bacteria in the granuloma. This antibody drug conjugate approach is currently being used in 2 FDA approved targeted cancer therapies. The pros and cons of this proposal for further research are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.
Jovanović J.; Jeremić D.; Jovanović B.; Vulović Maja; Sazdanović P.; Sazdanović Maja; Ognjanović Neda; Stojadinović D.; Jeremić Katarina; Marković N.; Živanović-Mačužić Ivana
The aim of this study was to determine the nasal parameters in the population of central Serbia and to compare them with those determined in earlier studies in different populations. The research was conducted on 496 randomly selected persons (262 males and 234 females), aged 18-65 years. The measured parameters were nasal height and nasal breadth and the standard spreading caliper with scale was used for measurements. There were significant differences in ...
Zargaran, Massoumeh; Moghimbeigi, Abbas; Afsharmoghadam, Noushin; Nasr Isfahani, Mohsen; Hashemi, Atefeh
Peripheral and central giant cell granuloma are two common benign lesions of the oral cavity. In spite of histopathological similarities, they have different clinical behaviors. Cathepsin D is a lysosomal enzyme which has different functions on the basis of protein and applied peptide cleavage. This research aimed to evaluate and compare the expression level of Cathepsin D in these two lesions to find the reasons for the differences in clinical and biologic characteristics. The expression of Cathepsin D was investigated by using the immunohistochemistry method in 20 samples of peripheral giant cell granuloma and 20 samples of central giant cell granuloma. The percentage of stained giant cells (labeling index), the intensity of staining of giant cells, and staining-intensity-distribution in both groups were calculated and compared. The labeling indices of Cathepsin D in peripheral giant cell granuloma and central giant cell granuloma were 95.9±4.03 and 95.6±2.34, respectively. There was no significant difference in the percentages of stained giant cells between the two groups (p= 0.586). The intensity of staining of giant cells in central giant cell granuloma was stronger than that of peripheral giant cell granuloma (p> 0.001). Staining- intensity- distribution of giant cells in central giant cell granuloma was significantly greater than that of the peripheral type of lesion (p= 0.001). The higher expression level of Cathepsin D in central giant cell granuloma compared to peripheral type of lesion can explain more aggressive behavior of central giant cell granuloma.
Bosmia, Anand N; Zimmermann, Terence M; Griessenauer, Christoph J; Shane Tubbs, R; Rosenthal, Eben L
Various case reports on nasal myiasis written during the 1990s and 2000s state that nasal myiasis, which is known as peenash among South Asian natives, is a form of divine punishment in Hindu mythology, but do not provide citations from Hindu scriptures that would suggest this interpretation. This paper aims to discuss the phenomenon of peenash in a historical context by examining medical literature written during the nineteenth and early twentieth centuries, to identify Hindu texts contributing to the belief of some Hindus that nasal myiasis is a form of divine punishment, and to provide an overview of contemporary treatment for and management of nasal myiasis.
Garcia, Guilherme; Sullivan, Corbin; Frank-Ito, Dennis; Kimbell, Julia; Rhee, John
Nasal airway obstruction (NAO) is a common health problem with 340,000 patients undergoing surgery annually in the United States. Traditionally, otolaryngologists have focused on airspace cross-sectional areas and nasal resistance to airflow as objective measures of nasal patency, but neither of these variables correlated consistently with patients' symptoms. Given that the sensation of nasal airflow is also associated with mucosal cooling (i.e., heat loss) during inspiration, we investigated the correlation between the sensation of nasal obstruction and mucosal cooling in 10 patients before and after NAO surgery. Three-dimensional models of the nasal anatomy were created based on pre- and post-surgery computed tomography scans. Computational fluid dynamics (CFD) simulations were conducted to quantify nasal resistance and mucosal cooling. Patient-reported symptoms were measured by a visual analog scale and the Nasal Obstruction Symptom Evaluation (NOSE), a disease-specific quality of life questionnaire. Our results revealed that the subjective sensation of nasal obstruction correlated with both nasal resistance and heat loss, but the strongest correlation was between the NOSE score and the nasal surface area where heat flux exceeds 50 W /m2 . In conclusion, a significant post-operative increase in mucosal cooling correlates well with patients' perception of better nasal patency after NAO surgery.
Lenzi Henrique L
Full Text Available The authors present morphogenetic and biomechanical approaches on the concept of the Schistosoma mansoni granulomas, considering them as organoid structures that depend on cellular adhesion and sorting, forming rearrangement into hierarchical concentric layers, creating tension-dependent structures, aiming to acquire round form, since this is the minimal energy form, in which opposing forces pull in equally from all directions and are in balance. From the morphogenetic point of view, the granulomas function as little organs, presenting maturative and involutional stages in their development with final disappearance (pre-granulomatous stages, subdivided in: weakly and/or initial reactive and exudative; granulomatous stages: exudative-productive, productive and involutional. A model for the development of granulomas was suggested, according to the following stages: encapsulating, focal histolysis, fiber production, orientation and compacting and involution and desintegration. The authors concluded that schistosomal granuloma is not a tangled web of individual cells and fibers, but an organized structure composed by host and parasite components, which is not formed to attack the miracidia, but functions as an hybrid interface between two different phylogenetic beings.
Full Text Available Tuberculosis (TB is characterized by a tight interplay between Mycobacterium tuberculosis and host cells within granulomas. These cellular aggregates restrict bacterial spreading, but do not kill all the bacilli, which can persist for years. In-depth investigation of M. tuberculosis interactions with granuloma-specific cell populations are needed to gain insight into mycobacterial persistence, and to better understand the physiopathology of the disease. We have analyzed the formation of foamy macrophages (FMs, a granuloma-specific cell population characterized by its high lipid content, and studied their interaction with the tubercle bacillus. Within our in vitro human granuloma model, M. tuberculosis long chain fatty acids, namely oxygenated mycolic acids (MA, triggered the differentiation of human monocyte-derived macrophages into FMs. In these cells, mycobacteria no longer replicated and switched to a dormant non-replicative state. Electron microscopy observation of M. tuberculosis-infected FMs showed that the mycobacteria-containing phagosomes migrate towards host cell lipid bodies (LB, a process which culminates with the engulfment of the bacillus into the lipid droplets and with the accumulation of lipids within the microbe. Altogether, our results suggest that oxygenated mycolic acids from M. tuberculosis play a crucial role in the differentiation of macrophages into FMs. These cells might constitute a reservoir used by the tubercle bacillus for long-term persistence within its human host, and could provide a relevant model for the screening of new antimicrobials against non-replicating persistent mycobacteria.
Peyron, Pascale; Vaubourgeix, Julien; Poquet, Yannick; Levillain, Florence; Botanch, Catherine; Bardou, Fabienne; Daffé, Mamadou; Emile, Jean-François; Marchou, Bruno; Cardona, Pere-Joan; de Chastellier, Chantal; Altare, Frédéric
Tuberculosis (TB) is characterized by a tight interplay between Mycobacterium tuberculosis and host cells within granulomas. These cellular aggregates restrict bacterial spreading, but do not kill all the bacilli, which can persist for years. In-depth investigation of M. tuberculosis interactions with granuloma-specific cell populations are needed to gain insight into mycobacterial persistence, and to better understand the physiopathology of the disease. We have analyzed the formation of foamy macrophages (FMs), a granuloma-specific cell population characterized by its high lipid content, and studied their interaction with the tubercle bacillus. Within our in vitro human granuloma model, M. tuberculosis long chain fatty acids, namely oxygenated mycolic acids (MA), triggered the differentiation of human monocyte-derived macrophages into FMs. In these cells, mycobacteria no longer replicated and switched to a dormant non-replicative state. Electron microscopy observation of M. tuberculosis-infected FMs showed that the mycobacteria-containing phagosomes migrate towards host cell lipid bodies (LB), a process which culminates with the engulfment of the bacillus into the lipid droplets and with the accumulation of lipids within the microbe. Altogether, our results suggest that oxygenated mycolic acids from M. tuberculosis play a crucial role in the differentiation of macrophages into FMs. These cells might constitute a reservoir used by the tubercle bacillus for long-term persistence within its human host, and could provide a relevant model for the screening of new antimicrobials against non-replicating persistent mycobacteria.
de Lange, Jan; van Rijn, Rick R.; van den Berg, Henk; van den Akker, Hans P.
Central giant cell granuloma is a benign lesion of the jaws which is sometimes aggressive locally. The most common treatment is curettage which has a high recurrence rate. particularly, in more aggressive lesions. Other treatments Such as interferon (IFN) and calcitonin have been described. We
Yadav, Suresh; Singh, Anurag; Kumar, Prince; Tyagi, Shallu
Central giant cell granuloma is a fairly common lesion in the jaws aetiology of which is still completely unknown but thought to be of a reactive process to some unknown stimuli. It usually arises either peripherally in periodontal ligament, mucoperiosteum, or centrally in the bone. The histological hallmark for both peripheral and central giant cell granuloma (CGCG) is the presence of distinctive multinucleated giant cells (MGCs) in a prominent fibrous stroma. Central giant cell granuloma is an uncommon benign proliferative lesion that almost exclusively occurs within the jaw. Eventually, it may become aggressive leading to the expansion and perforation of cortex resulting into mobility and displacement of teeth with root resorption. The present case focuses on the dilemma and perplexity in diagnosing aggressive CGCGs, due to its close proximity with respect to pathology, behavior and prognosis from giant cell tumors (GCT). Central giant cell granuloma persuaded extensive destruction to the hard and soft tissues with high rate of recurrence encourage us the need of exploring the possibilities of giant cell tumors having a definitive presence in the jaws. PMID:25298721
Danel, C.; Dewar, A.; Corrin, B.; Turner-Warwick, M.; Chretien, J.
The authors undertook this study to determine whether there were any morphologic changes in bronchoalveolar lavage lymphocytes and macrophages in sarcoidosis and, in particular, to determine whether changes described previously in the mononuclear phagocytes of sarcoid granulomas were also evident in such cells obtained by lavage. Lavage cells from 28 sarcoidosis patients were studied by transmission electron microscopy and compared with lavage cells from 17 control subjects and with lung tissue granulomas from 5 sarcoidosis patients. Interactions between mononuclear phagocytes, especially subplasmalemmal linear densities, and between these cells and lymphocytes were observed in both the tissue granulomas and lavage specimens from sarcoidosis patients. Subplasmalemmal linear densities were never observed in control lavage specimens. Fully developed epitheloid cells were not identified in lavage specimens, but differences were nevertheless found between the lavage cells from sarcoidosis patients and control subjects: in particular, alveolar macrophages in sarcoidosis were larger and showed better developed pseudopodia, more marked polarity, less nuclear heterochromatin, and lysosomes that were larger and more numerous but less electron-dense than normal. Lymphocytes were also enlarged and contained more lysosomes. It is concluded that although there are only a few similarities between the cells of the granuloma and those obtained by bronchoalveolar lavage in sarcoidosis, there are noticeable differences between the lavage cells of sarcoidosis patients and control subjects. In sarcoidosis, a variable proportion (10-70%) of the lavage cells show morphologic features of "activation." Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 10 Figure 11 PMID:6859231
Marino, S.; El-Kebir, M.; Kirschner, D.
Tuberculosis is a worldwide health problem with 2 billion people infected with Mycobacterium tuberculosis (Mtb, the bacteria causing TB). The hallmark of infection is the emergence of organized structures of immune cells forming primarily in the lung in response to infection. Granulomas physically
Yu, Yan-Rong; Ni, Xian-Qiang; Huang, Jie; Zhu, Yong-Hong; Qi, Yong-Fen
In schistosomiasis, egg-induced hepatic granuloma formation is a cytokine-mediated, predominantly CD4(+) Th2 immune response that can give rise to hepatic fibrosis. Hepatic fibrosis is the main cause of increased morbidity and mortality in humans with schistosome infection. Taurine has various physiological functions and hepatoprotective properties as well as anti-inflammatory and immunomodulatory activity. However, little is known about the role of taurine in schistosome egg-induced granuloma formation and fibrosis. We aimed to evaluate the therapeutic potential of taurine as preventative treatment for Schistosoma japonicum infection. Mice infected with S. japonicum cercariae were supplied with taurine drinking water (1% w/v) for 4 weeks starting at 4 weeks post-infection. Taurine supplementation significantly improved the liver pathologic findings, reduced the serum levels of aminotransferases and area of hepatic granuloma, and prevented fibrosis progression. In addition, taurine decreased the expression of the granulomatous and fibrogenic mediators transforming growth factor β1, tumor necrosis factor α, monocyte chemotactic protein 1α and macrophage inflammatory protein 1α as well as the endoplasmic reticulum stress marker glucose-regulated protein 78. Thus, taurine can significantly attenuate S. japonicum egg-induced hepatic granuloma and fibrosis, which may depend in part on the downregulation of some relevant cytokine/chemokines and reducing the endoplasmic reticulum stress response.
Schultz, Hans Henrik Lawaetz; Andersen, Claus Bøgelund; Steinbrüchel, D
Background: Sarcoidosis represents 2,5% of all indications for lung transplantation and criteria are generally assumed to be the same as for pulmonary fibrosis. Recurrence of granulomas in transplanted lungs has earlier been proved to derive from recipient immune cells, but its role in relation t...
Full Text Available A granuloma is defined as an inflammatory mononuclear cell infiltrate that, while capable of limiting growth of Mycobacterium tuberculosis, also provides a survival niche from which the bacteria may disseminate. The tuberculosis lesion is highly dynamic and shaped by both, immune response elements and the pathogen. In the granuloma, M. tuberculosis switches to a non-replicating but energy-generating life style whose detailed molecular characterization can identify novel targets for chemotherapy. To secure transmission to a new host, M. tuberculosis has evolved to drive T cell immunity to the point that necrotizing granulomas leak into bronchial cavities to facilitate expectoration of bacilli. From an evolutionary perspective it is therefore questionable whether vaccination and immunity enhancing strategies that merely mimic the natural immune response directed against M. tuberculosis infection can overcome pulmonary tuberculosis in the adult population. Juxtaposition of molecular pathology and immunology with microbial physiology and the use of novel imaging approaches afford an integrative view of the granuloma’s contribution to the life cycle of M. tuberculosis. This review revisits the different input of innate and adaptive immunity in granuloma biogenesis, with a focus on the co-evolutionary forces that redirect immune responses also to the benefit of the pathogen, i.e. its survival, propagation and transmission.
Full Text Available Objective(s: Peripheral giant cell granuloma (PGCG is a reactive, proliferative, exophytic lesion developing on the gingiva and alveolar ridge, originating from the periosteum or periodontal membrane. The lesion develops mostly in adults, commonly in the lower jaw, with slight female predilection although is uncommon in children.
Pravesh Kumar Jhingta
Full Text Available Plasma cell granuloma is a rare benign lesion characterized by the infiltration of plasma cells; primarily occurring in the lungs. It is also seen to occur in the brain, kidney stomach, heart, and so on but its intraoral occurrence is a rarity. This case report represents one of the uncommon locations in the oral cavity affected by plasma cell granuloma, its clinical and histological features, and establishes the differential diagnosis with other malignant or benign disease entities and planning the treatment accordingly. This report discusses the diagnostic enigma and the associated terminology of plasma cell granulomas and reinforces the need for performing biopsy and a histopathological or immune histochemical study, irrespective of the clinical features and clinical diagnosis of the lesion. In this case a 52-year-old female, presented with gingival enlargement in the mandibular anterior region, treated by excisional biopsy. Histological evaluation revealed plasma cell infiltrates in the connective tissue. The immune-histochemistry revealed kappa and lambda light chains with a polyclonal staining pattern, which confirmed the diagnosis of plasma cell granuloma.
Fernandez-Flores, Angel; Manjon, Jose A
Hair pigmentation is a complex phenomenon that involves many hormones, neurotransmitters, cytokines, growth factors, eicosanoids, cyclic nucleotides, nutrients, and a physicochemical milieu. We report a case of repigmentation of gray hairs in lesions of annular elastolytic giant cell granuloma (AEGCG) on the scalp of a 67-year-old man.
Kim, Hyo Rin; Hong, Hyun Sook; Lee, Eun Hye; Lee, Min Hee; Park, Jung Mi; Kwak, Jeong Ja; Lee, Seung Won [Soonchunhyang Univ. College of Medicine/Bucheon Hospital, Bucheon (Korea, Republic of)
To assess the ultrasonographic (US) findings of foreign body granulomas detected by endoscopic thyroidectomy. On positron emission tomography computed tomography of patients who had undergone endoscopic thyroidectomy, we encountered three fluorodeoxyglucose uptaken lesions in the surgical bed and those were pathologically confirmed to be foreign body granulomas. Additionally, 10 lesions demonstrating the same US findings were clinically diagnosed as foreign body granulomas. Echogenicity, shape, size, location, and vascularity were evaluated on US. Eleven lesions were subjected to follow up US. On US, seven lesions were found to be hyperechoic linear lesions with posterior acoustic shadowing while six other lesions were oval, iso to slightly hypoechoic lesions. No vascularity was observed on color Doppler US. The size of the lesions was inversely correlated with the time to lesion detection (Spearman's correlation r = -0.6528; p = 0.02). Oval iso to slightly hypoechoic lesions (mean, 672 days) had statistically longer times from the time of thyroidectomy to lesion detection on US than hyperechoic linear lesions (mean, 318 days; Mann Whitney test, p = 0.02). On follow up US, the lesions had decreased in size and hyperechoic linear lesions became oval iso to slightly hypoechoic lesions. In patients who underwent endoscopic thyroidectomy, characteristic US findings and evolutional changes are helpful for the diagnosis of foreign body granulomas and to distinguish from recurrent thyroid cancer, thus avoiding invasive procedures.
Tange, Rinze A.; Schimanski, Goesta; van Lange, Jeroen W. L.; Grolman, Wilko; Zuur, Lot C.
Objective: to determine the occurrence of the unusual side effect of a reparative granuloma after the implantation of a pure gold piston in cases of otosclerosis. Study design: a retrospective case review study of 475 stapes operations with a pure gold piston. Setting: Department of
Wisselink, Marinus A.; van Ree, Ronald; Willemse, Ton
OBJECTIVE: To investigate the role of Felis domesticus allergen I (Feld I) in the pathogenesis of eosinophilic granuloma complex (EGC) in cats. ANIMALS: 7 healthy cats and 6 cats with EGC. PROCEDURE: Epidermis was removed from 4 areas. Rubber stoppers filled with Feld I, saline (0.9% NaCl) solution,
Full Text Available Introduction. Tolosa–Hunt syndrome (THS is a rare entity, characterized by unilateral orbital pain associated with paresis of one or more of the oculomotor cranial nerves and caused by a granulomatous inflammation in the cavernous sinus, superior orbital fissure or orbit. The low prevalence of THS with a broad spectrum of other disorders that could cause painful ophtalmoplegia resulted in a stricter diagnostic criteria of THS in the latest edition of the International Classification of Headache Disorders. Current criteria require demonstration of granuloma by magnetic resonance imaging or biopsy. The diagnosis could be difficult and the initiation of treatment delayed due to a high variablity of clinical presentation of TSH. Reducing the number of patients that, based on clinical presentation, could be classified as having THS, but do not fullfil all diagnostic criteria further complicates establishing of correct diagnosis. Case report. Hereby we presented eight patients diagnosed with and treated for THS. Inspite the exclusion of other causes of painful ophtalmoplegia, granuloma could not be demonstrated in a half of patients. Clinical presentation of THS in patients with and without shown granuloma, did not significantly differ concerning headache characteristics (localization, intensity, quality, duration preceding cranial nerve palsy, response to steroids, the affected cranial nerve, disease course and response to the treatment, as well as types of diagnostic procedures that were performed in ruling out other diseases from the extensive differential diagnosis of painful ophthalmoplegia. Conclusion. There is no significant difference between the THS patients with and without demonstrated granuloma.
Alqwaifly, Mohammed; Al-Ajlan, Fahad S; Al-Hindi, Hindi; Al Semari, Abdulaziz
Brucellosis is a multisystem zoonotic disease. We report an unusual case of neurobrucellosis with seizures in an immunocompromised patient in Saudi Arabia who underwent renal transplantation. Magnetic resonance imaging of the brain showed diffuse white matter lesions. Serum and cerebrospinal fluid were positive for Brucella sp. Granuloma was detected in a brain biopsy specimen.
Kirtsreesakul, Virat; Khanuengkitkong, Thitiporn; Ruttanaphol, Suwalee
Although nasal steroids are the mainstay treatments in nasal polyposis, up to one-half of patients do not respond and need surgical treatment. This study aimed to evaluate whether oxymetazoline administration produces any additive effect on nasal steroid therapy and whether rebound congestion develops after oxymetazoline treatment. Sixty-eight patients with nasal polyposis were randomly assigned in a 1:1 ratio to receive either oxymetazoline plus mometasone furoate nasal spray (MFNS) or placebo plus MFNS, 2 sprays per nostril twice daily, with an interval of 5 minutes between each medication for 4 weeks. All the patients were then treated with MFNS, 2 sprays per nostril twice daily for 2 weeks. The nasal symptoms score, peak inspiratory flow index, nasal mucociliary clearance time (NMCCT), and total nasal polyps score were used to evaluate treatment outcomes. An intention-to-treat analysis was performed, and a worst case sensitivity analysis was applied to missing cases. Thirty-four patients were allocated to the oxymetazoline-MFNS group, and 34 to the placebo-MFNS group. One patient in each group was lost to last-visit follow-up. At 4 weeks after beginning treatment, the oxymetazoline-MFNS group showed significantly greater improvement in blocked nose, hyposmia, peak flow, NMCCT, and total nasal polyps score than the placebo-MFNS group. During the nasal steroid phase, both groups showed continuing improvement in all outcome variables. However, the oxymetazoline-MFNS group still showed significantly greater improvement in blocked nose, hyposmia, NMCCT, and total nasal polyps score, but not peak flow, than the placebo-MFNS group at the end of the study. The use of nasal steroids with oxymetazoline was more effective over 6 weeks than nasal steroids alone in improving blocked nose, hyposmia, nasal mucociliary clearance, and polyp size in treatment of nasal polyposis. There was no evidence of rebound congestion after 4 weeks of oxymetazoline treatment.
Popko, M; Verlinde-Schellekens, S A M W; Huizing, E H; Bleys, R L A W
The periosteum of the nasal bones, the periosteal-perichondrial nasal envelope, and the cartilaginous support of the bony vault were studied in serial coronal sections of four human cadaver noses. To differentiate between the various tissue components, the sections were stained according to Mallory-Cason and Verhoeff-Van Gieson stain. The results demonstrated: 1. the presence of clearly distinguishable layers of the periosteum covering the nasal bones; 2. the presence of a continuous periosteal-perichondrial covering of the bony and cartilaginous nasal vaults; 3. the way the cartilaginous support of the bony vault is constructed. The findings described in the present study may have clinical relevance in nasal surgery.
Jang, Minyoung; Basa, Krystyne; Levi, Jessica
Intubation has been associated with laryngeal injury that often resolves spontaneously without complication. We present a case of a child intubated for less than 48 hours, who presented with dysphonia and intermittent dyspnea two months after intubation due to epiglottic and vocal process granulomas. This is unusual in that multiple granulomas were found in the posterior glottis and supraglottis after short-term intubation. Our objective was to determine if there are risk factors for developing persistent post-intubation sequelae, including the delayed presentation and unusual location of post-intubation granulomas in our case. Case report and systematic literature review. Pubmed database, which is inclusive of MEDLINE, was used to perform a literature review with the search terms ((pediatric OR children OR neonatal OR infant) AND (laryngeal OR supraglottic) AND intubation AND (granuloma OR injury OR complication)). Only English language results were reviewed. Titles and abstracts from 379 results were reviewed. Full text was reviewed from all original studies which included human pediatric subjects and endoscopic examinations after endotracheal intubation. In our case, laryngeal granuloma size reduced significantly after starting anti-reflux medications. The remainder was removed with laryngeal microdebrider with no recurrence at 3 weeks and 2.5 years post-operatively. Overall, 28 of the 379 studies reviewed identified evidence of laryngeal trauma due to intubation, however only 6 studies documented any type of supraglottic injury. Risk factors identified for developing post-intubation sequelae included intubation duration greater than 24 h; trauma to the larynx via various mechanisms including traumatic intubation, need for reintubation and tube changes, and increased movement while intubated; and presence of respiratory tract infection during intubation. Trauma to the larynx during intubation should be avoided to minimize post-intubation injury in pediatric
Hurt Robert H
Full Text Available Abstract Background The most common causes of granulomatous inflammation are persistent pathogens and poorly-degradable irritating materials. A characteristic pathological reaction to intratracheal instillation, pharyngeal aspiration, or inhalation of carbon nanotubes is formation of epithelioid granulomas accompanied by interstitial fibrosis in the lungs. In the mesothelium, a similar response is induced by high aspect ratio nanomaterials, including asbestos fibers, following intraperitoneal injection. This asbestos-like behaviour of some engineered nanomaterials is a concern for their potential adverse health effects in the lungs and mesothelium. We hypothesize that high aspect ratio nanomaterials will induce epithelioid granulomas in nonadherent macrophages in 3D cultures. Results Carbon black particles (Printex 90 and crocidolite asbestos fibers were used as well-characterized reference materials and compared with three commercial samples of multiwalled carbon nanotubes (MWCNTs. Doses were identified in 2D and 3D cultures in order to minimize acute toxicity and to reflect realistic occupational exposures in humans and in previous inhalation studies in rodents. Under serum-free conditions, exposure of nonadherent primary murine bone marrow-derived macrophages to 0.5 μg/ml (0.38 μg/cm2 of crocidolite asbestos fibers or MWCNTs, but not carbon black, induced macrophage differentiation into epithelioid cells and formation of stable aggregates with the characteristic morphology of granulomas. Formation of multinucleated giant cells was also induced by asbestos fibers or MWCNTs in this 3D in vitro model. After 7-14 days, macrophages exposed to high aspect ratio nanomaterials co-expressed proinflammatory (M1 as well as profibrotic (M2 phenotypic markers. Conclusions Induction of epithelioid granulomas appears to correlate with high aspect ratio and complex 3D structure of carbon nanotubes, not with their iron content or surface area. This model
Poirier, Justin; George, Charles; Rotenberg, Brian
Nasal continuous positive airway pressure (CPAP) is the standard therapy for sleep apnea; however, compliance rates are historically poor. Among the most commonly cited reasons for nonadherence is nasal obstruction. Our study sought to examine if nasal surgery actually increases CPAP compliance. Prospective case series. Nasal CPAP-intolerant obstructive sleep apnea (OSA) patients, with documented nasal obstruction, underwent septoplasty plus inferior turbinoplasty. Preoperative and postoperative data were collected on CPAP usage per night and subjective nasal obstruction with the Nasal Obstruction Symptom Evaluation (NOSE) Scale questionnaire. Eighteen patients met inclusion criteria and underwent septoplasty. CPAP usage increased significantly from 0.5 hours per night preoperatively to 5 hours per night postoperatively (P nasal obstruction on the NOSE Scale decreased from 16.1 preoperatively to 5.4 following surgical intervention (P CPAP pressure decreased from 11.9 preoperatively to 9.2 after surgery, with a trend toward significance (P = .062). This study demonstrates improved CPAP compliance rates following septoplasty in OSA patients with nasal obstruction. Correction of nasal obstruction should be offered in nasal CPAP-intolerant individuals to improve CPAP compliance. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.
Millward, I R; Williams, M C
A 6-year-old, male, wild-born, free-ranging cheetah (Acinonyx jubatus) was evaluated for acute onset of progressive lameness in the right hind limb. Survey radiographs were unrewarding and myelography indicated an intramedullary compressive mass at the L3-L4 region. A fine needle aspirate of the lesion indicated the presence of Cryptococcus organisms. Necropsy confirmed the presence of granulomas (cryptococcoma) in the lung and the spinal cord (meningomyelitis) caused by Cryptococcus neoformans var. gattii. Cryptococcus neoformans is a yeast-like organism that is a potential pathogen to many species. Initial infection is thought to be of respiratory origin and then it commonly disseminates systemically from the nasal cavity or lungs to the skin, eyes and central nervous system in particular. The cheetah tested negative for both feline leukaemia virus (FeLV) and feline immunodeficiency virus (FIV), as have all the previously reported cheetah cases. C. neoformans is a non-contagious, opportunistic organism and is the most common systemic mycoses in domestic cats and the cheetah.
Full Text Available A 6-year-old, male, wild-born, free-ranging cheetah (Acinonyx jubatus was evaluated for acute onset of progressive lameness in the right hind limb. Survey radiographs were unrewarding and myelography indicated an intramedullary compressive mass at the L3-L4 region. A fine needle aspirate of the lesion indicated the presence of Cryptococcus organisms. Necropsy confirmed the presence of granulomas (cryptococcoma in the lung and the spinal cord (meningomyelitis caused by Cryptococcus neoformans var. gattii. Cryptococcus neoformans is a yeast-like organism that is a potential pathogen to many species. Initial infection is thought to be of respiratory origin and then it commonly disseminates systemically from the nasal cavity or lungs to the skin, eyes and central nervous system in particular. The cheetah tested negative for both feline leukaemia virus (FeLV and feline immunodeficiency virus (FIV, as have all the previously reported cheetah cases. C. neoformans is a non-contagious, opportunistic organism and is the most common systemic mycoses in domestic cats and the cheetah.
Venkatesha Belur Keshavamurthy
Full Text Available Introduction Nasal obstruction is implicated in the etiopathogenesis of Obstructive Sleep Apnea (OSA. OSA is associated with mean heart rate (HR variations in wakefulness and in sleep. Early intervention has proven to reduce cardiovascular morbidity in OSA patients. In spite of various confounding factors HR measurement has been utilised as an independent predictor of mortality. The influence of severity of nasal obstruction on HR has not been studied in the literature. This study aims to clarify the influence of severity of nasal obstruction on HR. Materials and Methods We examined 55 patients aged less than 50 years with no previous cardiac complaints, who underwent overnight oxygen saturation and HR monitoring. The patients were divided into Mild, Moderate and Severe Nasal Obstruction group depending on NOSE scale grading. Results There was no statistically significant difference in the Mean HR, Min HR, Max HR, and Max-Min HR in mild, moderate or severe nasal obstruction groups. Discussion The role of nasal obstruction in Obstructive Sleep Apnoea and the importance of HR as predictor of cardiovascular morbidity have been discussed. The studies on the heart rate in nasal obstruction and OSA were reviewed. Conclusion Nasal obstruction does not influence the heart rate.
Aly, Hany; Hammad, Tarek A; Ozen, Maide; Sandhu, Inderjeet; Taylor, Chita; Olaode, Adenike; Mohamed, Mohamed; Keiser, John
We examined the relationship between the use of nasal continuous positive airway pressure (CPAP) and nasal colonization among low-birth-weight (LBW) infants. We prospectively cultured the nares of LBW infants on admission and weekly until hospital discharge. The modality of respiratory support during each culture was recorded. Bivariate and multivariate analyses were conducted to test the relationship between CPAP and nasal colonization. Analyses were repeated after stratifying infants into three birth-weight categories: 1500 to 2499 g, 1000 to 1499 g, and nasal cultures were obtained from 167 infants. Nasal colonization with gram-negative bacilli was increased with the use of CPAP in all birth-weight categories ( P Nasal colonization with any potential pathogen increased with the use of CPAP in all birth-weight categories ( P Nasal CPAP is associated with increased colonization with gram-negative bacilli. © Thieme Medical Publishers.
Pavia, J.; Garcia, A.; Abello, R.; Herranz, R.; Franch, M.; Espana, R. de
A study has been carried out to assess the mucociliary function of nasal mucosa in 30 patients: 16 had undergone surgery due to larynx malignancy and the remaining 14 were divided in two groups. The first group was composed of seven patients suffering from larynx cancer but not operated, and the second group of seven had pathology not related to the airways (control group). The method used a sup(99m)technetium sulphur colloid drop deposited on the nasal mucosa of one nostril. To calculate the rate of transport, a new method of quantification has been introduced, based on the formation of a parametric image. The mean velocity in laryngectomees was 3.6 mm/min (range 1.1-6.4). It was compared with the group of 14 patients without tracheostomy (mean 5.3, range 3.3-8.2). An impaired student's-t-test gave a significant difference between both groups (P<0.005). The comparison between patients with nonoperated larynx cancer and normals have a nonsignificant difference. The 16 operated patients were arbitrarily divided into two groups as per the time elapsed from laryngectomy; seven were studied within the first 3 years of operation and seven other patients after this term. The comparison between them was not significant. (orig.)
Full Text Available The tuberculous granuloma is an elaborately organized structure and one of the main histological hallmarks of tuberculosis. Macrophages, which are important immunologic effector and antigen-presenting cells, are the main cell type found in the tuberculous granuloma and have high plasticity. Macrophage polarization during bacterial infection has been elucidated in numerous recent studies; however, macrophage polarization during tuberculous granuloma formation and development has rarely been reported. It remains to be clarified whether differences in the activation status of macrophages affect granuloma formation. In this study, the variation in macrophage polarization during the formation and development of tuberculous granulomas was investigated in both sections of lung tissues from tuberculosis patients and an in vitro tuberculous granuloma model. The roles of macrophage polarization in this process were also investigated. Mycobacterium tuberculosis (M. tuberculosis infection was found to induce monocyte-derived macrophage polarization. In the in vitro tuberculous granuloma model, macrophage transformation from M1 to M2 was observed over time following M. tuberculosis infection. M2 macrophages were found to predominate in both necrotic and non-necrotic granulomas from tuberculosis patients, while both M1 and M2 polarized macrophages were found in the non-granulomatous lung tissues. Furthermore, it was found that M1 macrophages promote granuloma formation and macrophage bactericidal activity in vitro, while M2 macrophages inhibit these effects. The findings of this study provide insights into the mechanism by which M. tuberculosis circumvents the host immune system as well as a theoretical foundation for the development of novel tuberculosis therapies based on reprogramming macrophage polarization.
Madhu, D N; Sudhakar, N R; Maurya, P S; Manjunathachar, H V; Sahu, Shivani; Pawde, A M
Oestrus ovis is a well-known parasite of the nasal cavities and adjoining sinuses in sheep and goats. A 3-year-old female Jamunapari goat was presented with a history of anorexia, weight loss, in-coordinated movements, nasal discharge since 10 days and two nasal bots expelled during sneezing 3 days back. Upon clinical examination the animal was dull, dysphonic, unsteady gait and having blocked nostrils with thick mucoid discharge along with an increased respiratory rate. Parasitiological examination revealed it as an O. ovis (nasal bots). The occurrence of nasal bots in a goat and its successful therapeutic management and public health significance have been reported and discussed in the present communication.
Surikov, E V; Ivanets, I V
A fracture of nasal bones is becoming a very common injury due to the increasingly greater number of car accidents and aggravated criminal situation. A total of 500 cases of nasal fracture associated with external deformities were included in the present study. The following kinds of deformities were identified: unilateral retraction, lateral displacement of the entire dorsum of the nose, and depressed comminuted fracture. Rhinoscopy revealed in addition such abnormalities associated with septal fracture as submucous hemorrhage, pathological mobility of the pyramid, deflection of the nasal septum at an acute angle. All in all, four types of nasal septum fractures were distinguished depending on the shape and localization of the fracture line. Two of them resulted in marked impairment of nasal breathing while two others required surgical intervention in the acute period after the injury.
Yuan, Yuan; Kitamura-Muramatsu, Yuri; Saito, Susumu; Ishizaki, Hiroshi; Nakano, Miwa; Haga, Satoshi; Matoba, Kazuhiro; Ohno, Ayumu; Murakami, Hironobu; Takeshima, Shin-Nosuke; Aida, Yoko
Bovine leukemia virus (BLV) induces enzootic bovine leukosis, which is the most common neoplastic disease in cattle. Sero-epidemiological studies show that BLV infection occurs worldwide. Direct contact between infected and uninfected cattle is thought to be one of the risk factors for BLV transmission. Contact transmission occurs via a mixture of natural sources, blood, and exudates. To confirm that BLV provirus is detectable in these samples, matched blood, nasal secretion, and saliva samples were collected from 50 cattle, and genomic DNA was extracted. BLV-CoCoMo-qPCR-2, an assay developed for the highly sensitive detection of BLV, was then used to measure the proviral load in blood (n=50), nasal secretions (n=48), and saliva (n=47) samples. The results showed that 35 blood samples, 14 nasal secretion samples, and 6 saliva samples were positive for the BLV provirus. Matched blood samples from cattle that were positive for the BLV provirus (either in nasal secretion or saliva samples) were also positive in their blood. The proviral load in the positive blood samples was >14,000 (copies/1×10(5) cells). Thus, even though the proviral load in the nasal secretion and saliva samples was much lower (blood, prolonged direct contact between infected and healthy cattle may be considered as a risk factor for BLV transmission. Copyright © 2015 Elsevier B.V. All rights reserved.
Howard, Lauren E; Holmes, William M; Ferrando, Sara; Maclaine, James S; Kelsh, Robert N; Ramsey, Andrew; Abel, Richard L; Cox, Jonathan P L
Holocephalans (chimaeras) are a group of marine fishes comprising three families: the Callorhinchidae (callorhinchid fishes), the Rhinochimaeridae (rhinochimaerid fishes) and the Chimaeridae (chimaerid fishes). We have used X-ray microcomputed tomography and magnetic resonance imaging to characterise in detail the nasal anatomy of three species of chimaerid fishes: Chimaera monstrosa, C. phantasma and Hydrolagus colliei. We have shown that the nasal chamber of these three species is linked to the external environment by an incurrent channel and to the oral cavity by an excurrent channel via an oral groove. A protrusion of variable morphology is present on the medial wall of the incurrent channel in all three species, but is absent in members of the two other holocephalan families that we inspected. A third nasal channel, the lateral channel, functionally connects the incurrent nostril to the oral cavity, by-passing the nasal chamber. From anatomical reconstructions, we have proposed a model for the circulation of water, and therefore the transport of odorant, in the chimaerid nasal region. In this model, water could flow through the nasal region via the nasal chamber or the lateral channel. In either case, the direction of flow could be reversed. Circulation through the entire nasal region is likely to be driven primarily by the respiratory pump. We have identified several anatomical features that may segregate, distribute, facilitate and regulate flow in the nasal region and have considered the consequences of flow reversal. The non-sensory cilia lining the olfactory sensory channels appear to be mucus-propelling, suggesting that these cilia have a common protective role in cartilaginous fishes (sharks, rays and chimaeras). The nasal region of chimaerid fishes shows at least two adaptations to a benthic lifestyle, and suggests good olfactory sensitivity, with secondary folding enhancing the hypothetical flat sensory surface area by up to 70%. Copyright © 2013
Gideon, Hannah Priyadarshini; Phuah, JiaYao; Myers, Amy J.; Bryson, Bryan D.; Rodgers, Mark A.; Coleman, M. Teresa; Maiello, Pauline; Rutledge, Tara; Marino, Simeone; Fortune, Sarah M.; Kirschner, Denise E.; Lin, Philana Ling; Flynn, JoAnne L.
Lung granulomas are the pathologic hallmark of tuberculosis (TB). T cells are a major cellular component of TB lung granulomas and are known to play an important role in containment of Mycobacterium tuberculosis (Mtb) infection. We used cynomolgus macaques, a non-human primate model that recapitulates human TB with clinically active disease, latent infection or early infection, to understand functional characteristics and dynamics of T cells in individual granulomas. We sought to correlate T cell cytokine response and bacterial burden of each granuloma, as well as granuloma and systemic responses in individual animals. Our results support that each granuloma within an individual host is independent with respect to total cell numbers, proportion of T cells, pattern of cytokine response, and bacterial burden. The spectrum of these components overlaps greatly amongst animals with different clinical status, indicating that a diversity of granulomas exists within an individual host. On average only about 8% of T cells from granulomas respond with cytokine production after stimulation with Mtb specific antigens, and few “multi-functional” T cells were observed. However, granulomas were found to be “multi-functional” with respect to the combinations of functional T cells that were identified among lesions from individual animals. Although the responses generally overlapped, sterile granulomas had modestly higher frequencies of T cells making IL-17, TNF and any of T-1 (IFN-γ, IL-2, or TNF) and/or T-17 (IL-17) cytokines than non-sterile granulomas. An inverse correlation was observed between bacterial burden with TNF and T-1/T-17 responses in individual granulomas, and a combinatorial analysis of pair-wise cytokine responses indicated that granulomas with T cells producing both pro- and anti-inflammatory cytokines (e.g. IL-10 and IL-17) were associated with clearance of Mtb. Preliminary evaluation suggests that systemic responses in the blood do not accurately
This result is infection and malnutrition (22). On the other hand, there also consistent with previous reports (16,18) which .... formulation of livestock breeding policy. In proc. 5th. Britton S. Bovine tuberculosis: A cross-sectional and ... Ankara: Turkish-German Health. 1996: 343-349. Information Project, General Directorate of.
Schetters, T.; Dubey, J.P.; Adrianarivo, A.; Frankena, K.; Romero, J.J.; Pérez, E.; Heuer, C.; Nicholson, C.; Russell, D.; Weston, J.
This article summarises the most relevant data of presentations delivered at the 19th International Conference of the World Association for the Advancement of Veterinary Parasitology (WAAVP) held in New Orleans, LA, USA, from 10 to 14 August 2003) in a symposium session on bovine neosporosis. The
Use of nasal continuous positive airway pressure (CPAP) is increasing as a means of respiratory support for respiratory distress syndrome in many premature neonates across the United States. Nasal CPAP is less invasive and may be as effective as mechanical ventilation in premature infants, and has been shown to cause less lung damage in premature neonates. Because of the increased use of nasal CPAP in neonates, especially younger and more fragile neonates, the presence of nare and nasal septum breakdown may be seen as a complication. Currently, all nasal CPAP systems use a hat and prong or mask type of delivery system. This appears to be effective for many neonates, but for some, it is difficult to appropriately fit the hat and prongs. The result of an inappropriately fitted device can be mild to severe nare and nasal septum damage. This article will discuss the need for nasal CPAP and the mechanics of nasal CPAP, but more importantly, serve to guide caregivers in the appropriate physical assessment and care of a neonate on nasal CPAP with the goal of preventing skin breakdown and nasal damage.
Braun, Thomas; Rich, Maria; Berghaus, Alexander; Kramer, Matthias F
Long-term rhinoflowmetry assesses bilateral nasal flow over 24 hours. In the present study, we evaluated the effects of a standard dose of oxymetazoline topical nasal spray, a widely used over-the-counter drug, on the nasal cycle, since the exact long-term effects, such as the duration of the decongestive effect, are not yet reported. Thirty healthy volunteers received a portable long-term rhinoflowmetry device and applied 22.5 μg oxymetazoline in each nostril. In 90 % of the probands, effects of the nasal spray application could be seen as changes in nasal flow. A decongestive effect could be seen after 18 minutes on average. We found a mean duration of the maximal decongestive effect of four hours. However, it took more than six hours on average until the nasal cycle resumed its normal condition. We did not find significant differences of the effect between probands with a 'classic,' 'in concert' or impaired nasal cycle. In contrast to a substantial interindividual variability, repeated measurements showed that intraindividual variability of the effect of decongestive nasal spray seems to be rather small. Long-term rhinoflowmetry, yielding reliable results, is a valuable tool in the assessment of the effects of nasal drugs on the nasal cycle.
Full Text Available It has recently been shown that vascular endothelial growth factor (VEGF enhances vascular permeability and that mast cells produce VEGF, suggesting the involvement of VEGF in allergic diseases. In the present study we quantitatively analyzed VEGF in the nasal lavage fluid of patients with nasal allergy. We performed nasal antigen challenge with Japanese cedar pollen antigen in 10 healthy adult volunteers and in 10 cedar pollen IgE-positive patients with nasal allergy. In all patients with nasal allergy, VEGF and histamine levels in the nasal lavage fluid reached a peak 30 min after antigen challenge, then returned to prechallenge values 2 h after antigen challenge. In these patients, the histamine level increased three-fold, while the VEGF level increased 10-fold. However, in all healthy adult volunteers, VEGF and histamine levels did not increase. A stronger correlation was noted between the ratio of decreased nasal cavity volume and the ratio of increased VEGF levels (R = 0.823; P < 0.001 than between the ratio of nasal cavity volume and the ratio of increased histamine levels (R = 0.660; P < 0.01. These results suggest that VEGF may contribute to the pathogenesis of nasal obstruction in the early phase of nasal allergy as a new factor involved in increasing vascular permeability.
Ernesto Sánchez Cabrales
Full Text Available El granuloma reparativo de células gigantes (GRCG es un proceso reactivo agresivo, que aparece con mayor frecuencia en los sectores anteriores de la mandíbula y el maxilar, en niños y adolecentes jóvenes. Constituye el 1 % de las lesiones óseas tumorales. Existe una considerable controversia acerca de si son lesiones benignas o reactivas; también desde el punto de vista de su origen, de sus características clínicas e histológicas, así como su terapéutica. En octubre de 2007 acudió un caso a consulta externa de Cirugía Maxilofacial del Hospital Pediátrico Universitario "Juan M. Márquez", con una lesión diagnosticada como GRCG agresivo, la cual provocó gran deformidad facial y osteólisis del cuerpo mandibular. Se realizaron exámenes físicos, complementarios e iconopatográfico. Se ejecutó tratamiento quirúrgico y análisis de la pieza. La paciente no tuvo alteraciones estéticas ni funcionales. Hubo ausencia de recidiva, luego de 30 meses de seguimiento. Se revisó la literatura más reciente en los sitios Med Line, Lilac, Google, con las palabras clave granuloma reparativo de células gigantes, en inglés y español, para comparar nuestros procederes y resultados con otros reportes.The giant cells reparative granulomas (GCRG is a reactive and aggressive process appearing more frequently in anterior sector of mandible and maxilla in children and young adolescents accounting for the 1 % of tumor bone lesions. There is a considerable controversy if they are benign or reactive lesions from the point of view of its origin, from its clinical and histological features as well as therapeutical. This is the case of a patient seen in external consultation of Maxillofacial Surgery of the "Juán Manuel Márquez" Children and University Hospital at October, 2007 in whom an extent lesion diagnosed as an aggressive GCRG provoked a facial deformity and osteolysis of mandibular body. Complementary, physical and iconopathographic examinations
Scholze, Alexandra; Lamwers, Stephanie; Tepel, Martin
Obstructive sleep apnoea (OSA) is linked to increased cardiovascular risk. This risk can be reduced by nasal continuous positive airway pressure (nCPAP) treatment. As OSA is associated with an increase of several vasoconstrictive factors, we investigated whether nCPAP influences the digital volume...... pulse wave. We performed digital photoplethysmography during sleep at night in 94 consecutive patients who underwent polysomnography and 29 patients treated with nCPAP. Digital volume pulse waves were obtained independently of an investigator and were quantified using an algorithm for continuous.......01; n = 94) and the arousal index (Spearman correlation, r = 0.21; p CPAP treatment, the AHI was significantly reduced from 27 ± 3 events · h(-1) to 4 ± 2 events · h(-1) (each n = 29; p
Segal, N; Gluk, O; Puterman, M
Chronic sinusitis with nasal polyps is an uncommon pathology in the pediatric population and may be associated with systemic disease. In this study we aimed to characterize children who underwent nasal surgery at our medical center due to nasal polyps and review the current literature related to pediatric nasal polyps. We retrospectively reviewed all medical records of patients younger than 18 years who had sinus surgery from 2000 to 2010. We collected demographic and clinical data including age, sex, laterality, revision operations, and comorbidities including asthma, allergy, and cystic fibrosis (CF). Thirty-one patients age 8.8 to 18 years (mean 13.7) were treated surgically in our hospital. Thirteen had antrochoanal polyp, 16 had chronic sinusitis with nasal polyps, and 2 had mucocele. Among patients treated for nasal polyps, there were 6 boys and 10 girls, mean age was 14.2 years, and 14 (87.5%) had bilateral disease. Mean Lund McKay score was 15.8. Five (31.2%) had asthma, 15 (93.7%) had sleep breathing disorder, and none had known allergy. Three patients (18.7%) had more than one surgery, including one patient with CF. Nine healthy children were tested for CF; one was positive. Nasal polyps in children are more common in teenagers, are usually bilateral, and are commonly associated with bronchial asthma. There was no association with allergy. Meticulous anamnesis and a high index of suspicion are recommended to manage other comorbidities.
Yoon, Han Young; Han, Dong Gil
Nasal bone fractures are managed by closed reduction within the 2-week period, and are managed by secondary correction after this time. There is little literature on the delayed reduction for nasal bone fractures beyond the 2-week duration. We report our experience with nasal fractures, which were reduced beyond this period. A retrospective review was performed for all patients who had undergone closed reduction of isolated nasal bone fracture. Patients were included for having undergone reduction of nasal bone fractures at or more than 2 weeks after the injury. Medical records were reviewed for demographic information, injury mechanism, fracture type, delay in treatment, and cause for delay. Postoperative outcomes were evaluated using computed tomography images. The review identified 10 patients. The average reduction time was 22.1 days. Five of patients underwent reduction between days 15 and 20, and the remaining five patients underwent reduction between days 21 and 41. The postoperative outcomes were excellent in 8 patients and good in 2 patients. Outcomes were superior for nasal fractures with displaced end plates and multiple fracture segments. Our study results appears to support delayed reduction of isolated nasal fractures in the presence of factors that delay bony reunion.
Full Text Available Introduction. During the past two decades, tuberculosis (TBC both pulmonary and extrapulmonary, has emerged to be a major health problem. Nasal tuberculosis is a specific inflammatory process which is, in most cases, joined by the inflammation of neck lymph nodes. Case report. Thirty-yearold man presented with shortness of breath through the nose and periodical headaches. Clinical examination showed signs of chronic rhinitis, with slight granular changes of nasal septal mucosa. Laboratory analyses were within the reference ranges. Nasal and throat swabs for bacteria and fungi were normal. Skin allergy testing to standard inhalatory allergens was positive. Computer rhinomanometry showed increased nasal resistance at medium difficulty level, on the right. Radiography of paranasal sinuses indicated chronic polysinusitis on the right. Anti-allergy therapy was prescribed. The patient came for checkup after a month with subjective deterioration and a neck tumefact on the right. Nasal endoscopy revealed the presence of dark red infiltrates with the 3 mm diameter on nasal septal mucosa, dominantly on the right, with small greyish nodules. This findings indicated a potential specific nasal inflammatory process. In the upper jugulodigastric area, on the left, painless tumefact 3 x 5 cm in size was palpated, it was mobile comparing to supra- and infrastructure, with unaltered skin above. The definite diagnosis was established on the basis of the results of nasal mucosa biopsy. After histopathological diagnosis was obtained, we started with antituberculosis therapy at once. Conclusion. Due to actual trends of TBC incidences, otolaryngologist should have in mind nasal TBC, when granulomatose lesions are found in nose.
Full Text Available In the article, the acoustic features of nasals in Standard Latvian are investigated. The aim of the study is to examine whether some of the spectral properties of nasal murmur (namely anti-formant frequency, as well as frequency and bandwidth of the first nasal formant can be considered as efficient cues for distinguishing between nasal places of articulation.Speech recordings from 10 native speakers of Standard Latvian, five male and five female, aged 19–39, without any disorders or dialectal traces in their pronunciation, were used for the analysis. Prevocalic nasals [m; n; ɲ] were analyzed in isolated CVC syllables, where C is one of the nasals and V is one of the vowels [i(ː; e(ː; æ(ː; ɑ(ː; ɔ(ː; u(ː]. The velar [ŋ] — the allophone of the phoneme /n/ — was recorded in postvocalic position in [k]V[ŋks] structure units. 1260 items were analyzed in total.According to the results, the nasals of Standard Latvian can be distinguished by anti-formant frequencies rather efficiently, and the results generally agree with those obtained in previous research of Latvian as well as data reported for other languages. The frequencies and the bandwidths of the first nasal formant are less informative regarding nasal place of articulation and can be used only for distinguishing between [ŋ] and [m; n; ɲ]. Conducting perception tests to assess the auditory relevance of these acoustic features is necessary.
Jagade, Mohan V; Langade, Deepak G; Pophale, Rupesh R; Prabhu, Arun
To compare the efficacy and tolerability of Oxymetazoline 0.05 % plus Dexpanthanol 5% versus Xylometazoline 0.1 % nasal drops in patients with nasal congestion due to allergic rhinitis and following nasal surgery. An investigator-blind, randomized, controlled, phase IV clinical trial conducted in 100 patients with acute allergic rhinitis or patients post-nasal surgery. Patients received either Oxymetazoline 0.05% with Dexpanthanol 5% (OD) or Xylometazoline 0.1% (XO) nasal drops. Relief from nasal congestion was significantly better in the OD group then in the XO group (mean nasal scores 1.24 vs 1.86). Significantly more improvement in sneezing and decrease in nasal discharge was seen in the OD group than the XO group. Nasal irritation in the OD group was significantly less as compared to XO group (0.38 v/s 1.12 on second day and 0.10 vs 0.36 on the fourth day). The recovery time for OD group was 1.08 hours, which was significantly (46 min) lesser than that of the XO group. Rebound congestion was significantly less in OD as compared to XO group (6.25% vs 82.98%). 93.75% of the physicians in the OD group and 51.28% in XO group reported response to therapy as good to excellent. 95.83% patients in the OD group and only 52.91% patients in the XO group rated tolerability to therapy as good to excellent. Oxymetazoline and dexpanthenol combination has a better efficacy, shorter recovery time, causes lesser rebound congestion and has better tolerability than xylometazoline.
Full Text Available Abstract Introduction Synchronous composite tumors are uncommon. Simultaneous, rather than metachronous or consecutive, occurrences of eosinophilic granuloma and Hodgkin's lymphoma in children are very rare. This is the first report of this kind in the medical literature. Case presentation We report the case of a 12-year-old Iranian boy with eosinophilic granuloma localized in his leg around the knee and Hodgkin's lymphoma in a cervical lymph node. The two tumours occurred synchronously before the patient had received any treatment. Conclusion Several cases of an association between eosinophilic granuloma and lymphoproliferative disorder have been reported. Some of these cases involve Hodgkin's lymphoma and Langerhans cell histiocytosis occurring in the same patient. Genetic or environmental etiologies have been postulated for eosinophilic granulomas which occur following Hodgkin's lymphomas, but have as yet not been proven. To our knowledge, synchronous occurrence of these two malignant processes in a patient who has not received any prior treatment is rare in children.
Patrícia Ioschpe Gus
Full Text Available PURPOSE: To describe a rare complication at the donor site of conjunctival transplantation. METHODS: The authors report the clinical, surgical, postoperative and histologic aspects of a Tenon's granuloma that followed an uneventful pterygium excision with conjunctival transplantation. RESULTS: Histology identified an hemangiomatous-like structure with some areas of foreign body granuloma overlying necrotic epithelial cels, easily excised surgically. CONCLUSIONS: Pyogenic granuloma is an inadequate term to describe an inflammatory nonsuppurative reaction that may follow uneventful conjunctival surgery in susceptible individuals.OBJETIVO: Descrever complicação rara em área doadora de retalho conjuntival. MÉTODOS: Os autores descrevem os aspectos clínico, cirúrgico, pós-operatório e histológico de granuloma da cápsula de Tenon em área doadora de conjuntiva que seguiu cirurgia não complicada de excisão de pterígio com transplante conjuntival. RESULTADOS: O exame histológico evidenciou estrutura tipo hemangiomatosa com áreas de granuloma de corpo estranho envolvendo células epiteliais necróticas. CONCLUSÃO: Granuloma piogênico é nomenclatura inadequada para descrever reação inflamatória não supurativa de fácil excisão cirúrgica que pode seguir a retirada de conjuntiva em pacientes suscetíveis.
Madhu, D. N.; Sudhakar, N. R.; Maurya, P. S.; Manjunathachar, H. V.; Sahu, Shivani; Pawde, A. M.
Oestrus ovis is a well-known parasite of the nasal cavities and adjoining sinuses in sheep and goats. A 3-year-old female Jamunapari goat was presented with a history of anorexia, weight loss, in-coordinated movements, nasal discharge since 10 days and two nasal bots expelled during sneezing 3 days back. Upon clinical examination the animal was dull, dysphonic, unsteady gait and having blocked nostrils with thick mucoid discharge along with an increased respiratory rate. Parasitiological exam...
Cavaliere, C; Begvarfaj, E; Frati, F; Masieri, S
Omalizumab, a monoclonal antibody against IgE, may be effective on nasal polyps, but its use is not currently authorized to treat that disease. We report the cases of three patients who were given omalizumab for asthma after undergoing nasal surgical polypectomy. Although such procedure is frequently followed by polyp recurrence, none of the three patients developed this complication, and in one subject the regression of initial polyp return was registered after starting omalizumab. Our data support the hypothesis that omalizumab may be useful to treat nasal polyposis.
Stoop, Esther J M; Schipper, Tim; Rosendahl Huber, Sietske K; Nezhinsky, Alexander E; Verbeek, Fons J; Gurcha, Sudagar S; Besra, Gurdyal S; Vandenbroucke-Grauls, Christina M J E; Bitter, Wilbert; van der Sar, Astrid M
The hallmark of tuberculosis (TB) is the formation of granulomas, which are clusters of infected macrophages surrounded by additional macrophages, neutrophils and lymphocytes. Although it has long been thought that granulomas are beneficial for the host, there is evidence that mycobacteria also promote the formation of these structures. In this study, we aimed to identify new mycobacterial factors involved in the initial stages of granuloma formation. We exploited the zebrafish embryo Mycobacterium marinum infection model to study initiation of granuloma formation and developed an in vivo screen to select for random M. marinum mutants that were unable to induce granuloma formation efficiently. Upon screening 200 mutants, three mutants repeatedly initiated reduced granuloma formation. One of the mutants was found to be defective in the espL gene, which is located in the ESX-1 cluster. The ESX-1 cluster is disrupted in the Mycobacterium bovis BCG vaccine strain and encodes a specialized secretion system known to be important for granuloma formation and virulence. Although espL has not been implicated in protein secretion before, we observed a strong effect on the secretion of the ESX-1 substrates ESAT-6 and EspE. We conclude that our zebrafish embryo M. marinum screen is a useful tool to identify mycobacterial genes involved in the initial stages of granuloma formation and that we have identified a new component of the ESX-1 secretion system. We are confident that our approach will contribute to the knowledge of mycobacterial virulence and could be helpful for the development of new TB vaccines.
Esther J. M. Stoop
The hallmark of tuberculosis (TB is the formation of granulomas, which are clusters of infected macrophages surrounded by additional macrophages, neutrophils and lymphocytes. Although it has long been thought that granulomas are beneficial for the host, there is evidence that mycobacteria also promote the formation of these structures. In this study, we aimed to identify new mycobacterial factors involved in the initial stages of granuloma formation. We exploited the zebrafish embryo Mycobacterium marinum infection model to study initiation of granuloma formation and developed an in vivo screen to select for random M. marinum mutants that were unable to induce granuloma formation efficiently. Upon screening 200 mutants, three mutants repeatedly initiated reduced granuloma formation. One of the mutants was found to be defective in the espL gene, which is located in the ESX-1 cluster. The ESX-1 cluster is disrupted in the Mycobacterium bovis BCG vaccine strain and encodes a specialized secretion system known to be important for granuloma formation and virulence. Although espL has not been implicated in protein secretion before, we observed a strong effect on the secretion of the ESX-1 substrates ESAT-6 and EspE. We conclude that our zebrafish embryo M. marinum screen is a useful tool to identify mycobacterial genes involved in the initial stages of granuloma formation and that we have identified a new component of the ESX-1 secretion system. We are confident that our approach will contribute to the knowledge of mycobacterial virulence and could be helpful for the development of new TB vaccines.
von Bubnoff, Dagmar; Scheler, Marina; Wilms, Helene; Wenzel, Jörg; von Bubnoff, Nikolas; Häcker, Georg; Schultze, Joachim; Popov, Alexey; Racz, Paul; Bieber, Thomas; Wickenhauser, Claudia
The enzyme indoleamine 2,3-dioxygenase (IDO) degrades the essential amino acid tryptophan, and this degradation is an immunosuppressive mechanism that is mainly used by antigen-presenting cells. IDO-expressing dendritic cells and macrophages have previously been identified as components of lymph node granulomas after Listeria monocytogenes infection. In this study we undertook an analysis of IDO expression in granulomas of infectious and noninfectious origin in the human skin. Lesional skin biopsy specimens (n = 22) from different granulomatous skin disorders (lupus vulgaris, sarcoidosis, granuloma annulare, leprosy) were analyzed. Immunohistochemistry was performed to identify and locate the enzyme IDO within the inflammatory granulomatous infiltrate (IDO, CD11c, CD68, S100, CD3, Foxp3). Two-color immunofluorescence of IDO in combination with multiple markers was applied to characterize the IDO-expressing cells. Cutaneous granulomas of different origin strongly express IDO, mainly in the center and in the ring wall of the granulomas. We demonstrate that in infectious, but also in noninfectious human cutaneous granulomas the large myeloid CD11c(+)S100(+)CD68(-) dendritic cells and the CD68(+) macrophages express IDO. This study was limited by the lack of details about the exact stage or maturity of granuloma formation in the specimens investigated. These findings reveal that IDO expression in myeloid dendritic cells and macrophages is part of an integrated response of granuloma formation, which may be a unifying feature of granulomatous reactions in the skin. Copyright © 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.
Hox, V; Bobic, S; Callebaux, I; Jorissen, M; Hellings, P W
Chronic rhinosinusitis with nasal polyposis (NP) represents an invalidating disorder that causes mainly nasal blockage and loss of smell. The aim of this study is to investigate correlations between individual subjective and objective parameters of stable NP disease. 65 NP patients scored their sinonasal symptoms on a visual analogue scale (VAS) and questionnaires (SNOT-22 and SF-36). Peak nasal inspiratory flow (PNIF) measurement, Sniffinatm Sticks (SS) smell test, blood analysis for eosinophilia, total IgE and culture for Staphylococcus aureus (SA) were performed. VAS scores for nasal blockage correlated with the SNOT-22 and SF-36 scores, which was not observed for VAS of other symptoms. VAS scores for nasal blockage correlated well with PNIF values as well as VAS scores for smell dysfunction and SS results (both psmell reduction (psmell reduction in NP disease. Nasal blockage is the only symptom that correlates well with NP size and SNOT-22 scores, whereas smell reduction correlates with blood eosinophilia.
Seppänen, Tiina M.; Alho, Olli-Pekka; Seppänen, Tapio
Allergic rhinitis is a major chronic respiratory disease and an immunoneuronal disorder. We aimed at providing further knowledge on the function of the neural system in nasal allergic reaction. Here, a method to assess simultaneously the nasal airflow resistance and the underlying function of autonomic nervous system (ANS) is presented and used during the nasal provocation of allergic and nonallergic subjects. Continuous nasal airflow resistance and spectral heart rate variability parameters show in detail the timing and intensity differences in subjects' reactions. After the provocation, the nasal airflow resistance of allergic subjects showed a positive trend, whereas LF/HF (Low Frequency/High Frequency) ratio and LF power showed a negative trend. This could imply a gradual sympathetic withdrawal in allergic subjects after the allergen provocation. The groups differed significantly by these physiological descriptors. The proposed method opens entirely new opportunities to research accurately concomitant changes in nasal breathing function and ANS. PMID:27196870
Tiina M. Seppänen
Full Text Available Allergic rhinitis is a major chronic respiratory disease and an immunoneuronal disorder. We aimed at providing further knowledge on the function of the neural system in nasal allergic reaction. Here, a method to assess simultaneously the nasal airflow resistance and the underlying function of autonomic nervous system (ANS is presented and used during the nasal provocation of allergic and nonallergic subjects. Continuous nasal airflow resistance and spectral heart rate variability parameters show in detail the timing and intensity differences in subjects’ reactions. After the provocation, the nasal airflow resistance of allergic subjects showed a positive trend, whereas LF/HF (Low Frequency/High Frequency ratio and LF power showed a negative trend. This could imply a gradual sympathetic withdrawal in allergic subjects after the allergen provocation. The groups differed significantly by these physiological descriptors. The proposed method opens entirely new opportunities to research accurately concomitant changes in nasal breathing function and ANS.
Sánchez Franco, Karina Milagros; Universidad Nacional Mayor de San Marcos
El granuloma telangiectásico también llamado Granuloma Piógeno, es una lesión tumoral benigna más común de todas las lesiones que afectan la mucosa y el tejido gingival de la cavidad oral. Se presenta como una reacción del tejido conectivo a estímulos, irritación local por placa dental, procesos infecciosos y factores hormonales; así como, por el inadecuado uso de elementos de higiene bucal que generan micro traumas. En el Perú es una patología muy frecuente entre los 30-60 años; que afecta e...
O IFN- apresenta importante função na patogênese das lesões periapicais e a metilação do gene IFNG tem sido associada à inativação da transcrição. O objetivo deste estudo foi investigar a metilação da região promotora do IFNG e a associação com a transcrição do gene e com os níveis de proteína no granuloma periapical e no cisto radicular. O PCR específico para metilação (MSP Methylation Specific PCR) foi usado para avaliar o padrão de metilação do DNA do gene IFNG em 16 amostras de granuloma...
Sykes, John M; Garner, Michael M; Greer, Leah L; Lung, Nancy P; Coke, Rob L; Ridgley, Frank; Bush, Mitch; Montali, Richard J; Okimoto, Ben; Schmidt, Robert; Allen, Jack L; Rideout, Bruce A; Pesavento, Patricia A; Ramsay, Edward C
Oral eosinophilic granulomas were diagnosed in 16 tigers (Panthera tigris). All lesions were located on the hard or soft palate and typically consisted of flat or slightly raised circular ulcers. Histologic features of these lesions were essentially identical to those seen in oral eosinophilic granulomas of domestic cats and dogs. No clinical signs were noted in eight cases, though various degrees of inappetence, excessive salivation, and dysphagia were noted in the other eight tigers. Six cases were not treated. Treatment for the remaining 10 cases centered on corticosteroids and additional treatments included surgical removal, cryotherapy, antibiotics, and chlorpheniramine. Treatment with corticosteroids did appear to be effective in some cases, though lesions would worsen after cessation of therapy and no cases were cured. In addition, three cases developed complications possibly related to this corticosteroid therapy. The etiology of these lesions remains unknown, though an underlying allergic condition is likely.
Full Text Available Abstract We present a 69-year-old woman with a chief complaint of postmenopausal bleeding. She was diagnosed as having an endometrioid adenocarcinoma by biopsy, and underwent a total abdominal hysterectomy. At the time of surgery, granulation tissue-like nodules were found on the peritoneal serosa of the uterus. In the intraoperative cytology of peritoneal washing, atypical cells were noted. The intraoperative frozen section of the peritoneal nodule revealed granulation tissue with proliferating mesothelial cells. Microscopic examination of the permanent section showed keratin granulomas without viable adenocarcinoma cells on the serosal surface of the ovaries, fallopian tubes and broad ligaments. Postoperative chemotherapy was administered. She has been alive with no evidence of recurrence for 6 months postoperatively. It should be noted that the prognosis of cases in peritoneal keratin granuloma without viable cancer cells is favorable, and that the histological examination is essential for its diagnosis.
Infante Cossío, Pedro; Martínez de Fuentes, Rafael; Carranza Carranza, Andrés; Torres-Lagares, Daniel; Gutiérrez Pérez, José Luis
El granuloma central de células gigantes es una rara lesión intraósea benigna de los maxilares. El tratamiento tradicional ha sido el curetaje local, aunque los sub-tipos agresivos tienen una alta tendencia a la recurrencia. Este caso clínico describe un granuloma central de células gigantes recurrente en el cuerpo mandibular de una mujer de 48 años. El tratamiento inicial de la lesión consistió en un curetaje con ostectomía periférica. Cuando se detectó la recurrencia un año más tarde, s...
Das, Joyutpal; Layton, Benjamin; Lamb, Harriet; Sinnott, Nicola; Leahy, Bernard C
Serratia marcescens is a saprophytic gram-negative bacillus capable of causing a wide range of infections. A 57-year-old female was admitted to our hospital for four weeks with community acquired pneumonia. A chest x-ray, six weeks after discharge, demonstrated multiple, bilateral 'cannon ball'-like opacities and mediastinal lymphadenopathy which were highly suspicious of disseminated malignancy or tuberculosis. The only symptom that this patient had was a productive cough. She had multiple commodities, but no specific immunodeficiency disorder. Interestingly, her sputum and bronchial washing samples grew S. marcescens. The computed tomography-guided lung biopsy demonstrated necrotic granulomatous changes. There was no pathological evidence of tuberculosis or fungal infection, malignancy or vasculitis. There are only a handful of reported cases of Serratia granulomas. Thus, we are reporting a rare instance of pulmonary Serratia marcescens granuloma radiologically mimicking metastatic malignancy and tuberculosis infection. © The Author(s) 2015.
Silas Antonio Juvencio de Freitas Filho
Full Text Available Cholesterol granuloma (CG is a tissue reaction in response to the accumulation of cholesterol crystals rarely found in the maxillary sinus. The etiopathogenesis of maxillary sinus CG remains unclear. We reviewed the literature and added two new reports of cholesterol granuloma in maxillary sinus related to endodontically treated maxillary posterior teeth. The first report refers to a 45-year-old woman diagnosed with rhinitis, who was submitted to endodontic retreatment of maxillary molar, and subsequently showed maxillary sinus opacity with cystic appearance. The second case describes a young adult woman, who presented a cystic mass in maxillary sinus after endodontic treatment, in close association with the apex of the maxillary right second premolar. Both patients were treated by a classic Caldwell-Luc surgery and the microscopic analyses revealed maxillary sinus CG. In the following, the authors discuss the probable involvement of endodontically treated maxillary posterior teeth in the etiopathogenesis of maxillary sinus CG.
Jung Hye Lee
Full Text Available A 30-year-old male, who underwent previous pars plana vitrectomy and silicone oil tamponade due to endogenous endophthalmitis originated from Klebsiella liver abscess, was referred for evisceration. At 2 months after vitrectomy with silicon oil tamponade, conjunctival chemosis and ocular pain were aggravated. Diffuse eyelid swelling and large subconjunctival mass with lipid droplets were noted. On MRI examination, subconjunctival mass and intra- and extraconal orbital mass around superior rectus muscle were observed. Excision of subconjunctival and orbital mass was performed. Histopathologic examination showed multiple silicone oil vacuoles surrounded by foreign body giant cells and fibrosis, which confirmed silicone oil granuloma. In a patient with suspicious melting sclera in diseases such as endophthalmitis, large silicone oil granuloma may be complicated in a rapid fashion after intravitreal silicone oil tamponade due to silicone oil leakage.
Full Text Available Vegetable granuloma (VG or pulse granuloma (PG results from the implantation of food particles of plant or vegetable origin. It is usually seen in the periapical or in the sulcus areas. These lesions have been described as a distinct entity and classified into central and peripheral lesions according to the location. Central lesions are asymptomatic, whereas peripheral lesions present as painless sub-mucosal swellings. Many authors have postulated that food particles in VG or PG get implanted and are rapidly digested, and sometimes partly get altered by host responses. The cellulose part of plant foods being indigestible persists in the form of hyaline material, whereas the starch matter gets digested. This cellulose moiety invokes chronic granulomatous response.
Tezuka, Yasuhiro; Endo, S; Yamamoto, S; Hasegawa, T; Murayama, F; Sohara, Y
A 45-year-old woman with no immunodeficiency or clinical symptoms presented to our hospital for treatment of an enlarging spherical lung tumor in 4.0-cm-diameter. Chest radiography 8 years ago had shown a 1.5-cm-diameter tumor. Chest computed tomography (CT) showed the solitary tumor, located in the right apical segment, to have an irregular margin without satellite lesions or cavitations. Mycobacterium avium complex (MAC) was cultured in tumor specimens incised during transbronchial biopsy. Right upper lobectomy was performed because of resistance to 6-month antituberculosis treatment. Pathological findings showed a MAC-infected granuloma with caseous necrosis. Postoperative course was uneventful and she had no recurrence 3 years after surgery. These findings suggest that nontuberculous mycobacterial granuloma can enlarge without clinical manifestations or any satellite lesions and cavitations, leading to a misdiagnosis of lung cancer.
Full Text Available Patients with chronic granulomatous disease (CGD lack generation of reactive oxygen species (ROS through the phagocyte NADPH oxidase NOX2. CGD is an immune deficiency that leads to frequent infections with certain pathogens; this is well documented for S. aureus and A. fumigatus, but less clear for mycobacteria. We therefore performed an extensive literature search which yielded 297 cases of CGD patients with mycobacterial infections; M. bovis BCG was most commonly described (74%. The relationship between NOX2 deficiency and BCG infection however has never been studied in a mouse model. We therefore investigated BCG infection in three different mouse models of CGD: Ncf1 mutants in two different genetic backgrounds and Cybb knock-out mice. In addition, we investigated a macrophage-specific rescue (transgenic expression of Ncf1 under the control of the CD68 promoter. Wild-type mice did not develop severe disease upon BCG injection. In contrast, all three types of CGD mice were highly susceptible to BCG, as witnessed by a severe weight loss, development of hemorrhagic pneumonia, and a high mortality (∼ 50%. Rescue of NOX2 activity in macrophages restored BCG resistance, similar as seen in wild-type mice. Granulomas from mycobacteria-infected wild-type mice generated ROS, while granulomas from CGD mice did not. Bacterial load in CGD mice was only moderately increased, suggesting that it was not crucial for the observed phenotype. CGD mice responded with massively enhanced cytokine release (TNF-α, IFN-γ, IL-17 and IL-12 early after BCG infection, which might account for severity of the disease. Finally, in wild-type mice, macrophages formed clusters and restricted mycobacteria to granulomas, while macrophages and mycobacteria were diffusely distributed in lung tissue from CGD mice. Our results demonstrate that lack of the NADPH oxidase leads to a markedly increased severity of BCG infection through mechanisms including increased cytokine
Tulebaev, R K; Mustafin, A A; Zholdybaeva, Z T
Serious disturbances of nasal aerodynamics contribute to the development of diseases of the broncho-pulmonary apparatus. The early recognition of ventilation problems in patients with the curved nasal septum is paramount for the efficacious prevention and treatment of respiratory complications. The authors describe principles of rhinosurgical correction of affected nasal aerodynamics in patients with the curved nasal septum.
Li, Qingwei; Sheng, Zunqi; Tang, Shengjian; Yang, Biaobing; Yu, Xiaohua
To evaluate the operative methods and therapeutic effects of nasal septum cartilage-silica gel complex for two-stage repair of nasal deformities of unilateral cleft lip. From June 2001 to June 2007, 38 cases of secondary nasal deformity and septum deviation of cleft lip were treated with transplanting nasal septum cartilage-silica gel complex. Among of them, there were 21 males and 17 females, aging 14-23 years with an average of 17.6 years. All cases were with nasal deformities of unilateral cleft lip, including 21 cases of complete cleft lip and 17 cases of incomplete cleft lip. The locations were left side in 26 cases and right side in 12 cases. Nasal deformities were columella nasi deflexion, flattened nasal tip, pteleorrhine and alanasi collapse. The patients received 1-4 times operations, and the interval of two operations was 3-10 years (mean 5.5 years). According to nasal deformity, the nasal septum cartilage of 1.8 cm x 1.2 cm was cut, and transplanted into the nose point phantom surface forming "the shield" to extend nose column and to raise the tip of the nose. At the same time the nasal tip fat-connective tissue flap graft with fat knot was given. After fixation, the nasal alar cartilage and soft tissues were reduced to normal position. Primary healing of the incisions was achieved in all cases. The nasal deformity was corrected. The postoperative follow-up period was 12-18 months with an average of 15.6 months. All the patients of regional cartilage scars had no complication. The figure of nose was slinky, the height of apex of nose and the shape of nose was natural, the apex of nose, nasal ala, nostrils and nasal columella were satisfactory [(the results were satisfactory in 30 cases (78.9%), general in 8 cases (21.1%)]. The nose department overall esthetics shape was improved in all the patients, no complications of the phantom sliding, shifting and exposure, hemorrhage and infection occurred. The nasal septum cartilage-silica gel complex to repair
Full Text Available Adequate perception of nasal airflow (i.e., nasal patency is an important consideration for patients with nasal sinus diseases. The perception of a lack of nasal patency becomes the primary symptom that drives these patients to seek medical treatment. However, clinical assessment of nasal patency remains a challenge because we lack objective measurements that correlate well with what patients perceive. The current study examined factors that may influence perceived patency, including air temperature, humidity, mucosal cooling, nasal resistance, and trigeminal sensitivity. Forty-four healthy subjects rated nasal patency while sampling air from three facial exposure boxes that were ventilated with untreated room air, cold air, and dry air, respectively. In all conditions, air temperature and relative humidity inside each box were recorded with sensors connected to a computer. Nasal resistance and minimum airway cross-sectional area (MCA were measured using rhinomanometry and acoustic rhinometry, respectively. General trigeminal sensitivity was assessed through lateralization thresholds to butanol. No significant correlation was found between perceived patency and nasal resistance or MCA. In contrast, air temperature, humidity, and butanol threshold combined significantly contributed to the ratings of patency, with mucosal cooling (heat loss being the most heavily weighted predictor. Air humidity significantly influences perceived patency, suggesting that mucosal cooling rather than air temperature alone provides the trigeminal sensation that results in perception of patency. The dynamic cooling between the airstream and the mucosal wall may be quantified experimentally or computationally and could potentially lead to a new clinical evaluation tool.
Günlemez, Ayla; Isken, Tonguç; Gökalp, Ayse S; Türker, Gülcan; Arisoy, Engin A
We conducted this study to investigate the efficacy of the silicon gel application on the nares in prevention of nasal injury in preterm infants ventilated with nasal continuous positive airway pressure (NCPAP). Patients (n=179) were randomized into two groups: Group 1 (n=87) had no silicon gel applied to nares, and in Group 2 (n=92), the silicon gel sheeting was used on the surface of nares during ventilation with NCPAP. Nasal injury developed in 13 (14.9%) neonates in Group 1 and 4 (4.3%) newborns in Group 2 (OR:3.43; 95% CI: 1.1-10.1; Pnasal injury in preterm infants on nasal CPAP.
Nakao, Takeshi; Xu, Jianjiang; Liu, Zuguo; Sun, Xinghuai; Chu, Yiwei; Hong, Jiaxu
Background Conjunctival pyogenic granulomas are commonly seen after ocular surgeries or at an ocular wound site. The aim of this study is to describe a novel histological classification for medically uncontrolled conjunctival pyogenic granulomas (MUCPG), and to explore whether the diversity in clinical features correlates to different histological subtypes of MUCPG. Methods This is an observational cross-section case series. We reviewed 46 consecutive patients with conjunctival pyogenic granulomas who did not respond to topical corticosteroids and underwent surgical excision from January 1, 2006 through December 31, 2015. Clinical features and histological findings were presented and analyzed. Results Ocular surgery, accidental injury, and chalazion were the main predisposing causes of MUCPG. The lesions tended to occur unilaterally on the bulbar conjunctiva. Forty patients (87%) presented an enrichment of inflammatory cells and proliferated capillaries in their pathological sections (inflammatory pattern). Six patients (13%) showed relatively few inflammatory cells and capillaries within fibrous stroma (fibrous pattern). Patients with the inflammatory pattern were older (p = 0.025) and tended to be located in bulbar conjunctiva (p = 0.002). The predisposing causes were also different between two histological subtypes (p = 0.007). Conclusions We found the correlation between clinical presentation and histological subtypes in patients with MUCPG, indicating this disease may need a new classification scheme. PMID:28008138
Qin, Rosie; Cohen, Philip R
Bullous impetigo is a superficial skininfection caused by Staphylococcus aureus (S.aureus). Pyogenic granuloma is a common benigntumor frequently associated with prior trauma.Bullous impetigo and pyogenic granuloma may occurin pregnant women. The features of a pregnant womanwith pyogenic granuloma and bullous impetigoconcurrently present in a lesion on her finger aredescribed. PubMed was used to search the followingterms: bullous impetigo, pregnancy, and pyogenicgranuloma. All papers were reviewed; relevantarticles, along with their references, were evaluatedResults: A red ulcerated nodule with a collaretteof epithelium around the tumor and surroundingbullae appeared on the fifth digit of the left hand of a31-year-old woman who was at 36 weeks gestation. Abacterial culture grew methicillin sensitive S. aureus.An excisional biopsy was performed. Histologicfindings revealed not only a benign vascular tumorwith an infiltrate of mixed inflammatory cells, butalso an intraepidermal blister. She received oralantibiotics and there was complete resolution of thefinger lesion and infection with preservation of digitfunction. Albeit uncommon, pyogenic granulomaand bullous impetigo may concurrently occur in thesame lesion. Therapeutic intervention should focuson treating both the benign skin tumor and theinfection.
Mayra Silva Miranda
Full Text Available One of the main features of the immune response to M. Tuberculosis is the formation of an organized structure called granuloma. It consists mainly in the recruitment at the infectious stage of macrophages, highly differentiated cells such as multinucleated giant cells, epithelioid cells and Foamy cells, all these cells being surrounded by a rim of lymphocytes. Although in the first instance the granuloma acts to constrain the infection, some bacilli can actually survive inside these structures for a long time in a dormant state. For some reasons, which are still unclear, the bacilli will reactivate in 10% of the latently infected individuals, escape the granuloma and spread throughout the body, thus giving rise to clinical disease, and are finally disseminated throughout the environment. In this review we examine the process leading to the formation of the granulomatous structures and the different cell types that have been shown to be part of this inflammatory reaction. We also discuss the different in vivo and in vitro models available to study this fascinating immune structure.
He Yu; Wu Chungen; Gu Yifeng; Cheng Yongde
Objective: To assess the clinical value of interventional management in treating spine eosinophilic granuloma in children. Methods: Interventional therapies, including per cutaneous biopsy and percutaneous vertebroplasty (PVP), were carried out in three child patients with five pathologically-proved eosinophilic granuloma lesions, which were localized in the vertebrae. The clinical data were retrospectively analyzed. Visual analogue pain scale (VAS) and Oswesty disability index (ODI) were assessed before and after operation. Results: A total of four operations were successfully carried out in all of three patients. The mean VAS score reduced from 7 before treatment of 1 after treatment. The mean ODI decreased from preoperative 52.5% to postoperative 10.5%. During procedures no significant complications occurred except for cement leakage in some cases. Pain relief and daily activity were remarkably improved after treatment. All patients were followed up for 3 months to 5 years. Conclusion: For the treatment of spine eosinophilic granuloma in children, interventional techniques are mini-invasive, safe and effective therapeutic methods. (authors)
Elitsa G. Deliverska
Full Text Available Introduction: Central giant cell granuloma (CGCG is a benign aggressive destructive osteolytic lesion of osteoclastic origin. The central giant cell granuloma is often found in the mandible, anterior to the first molars. It most commonly occurs in patients under the age of 30, with a clear female prevalencePurpose: To present a case of CGCG of the lower jaw in Department of Oral and maxillofacial surgery, University Hospital "St. Anna". Although en bloc resection provides the lowest recurrence rate, only a few single case reports describe the use of this technique followed by reconstruction with autogenous bone grafts.Material and methods: The medical history of a 28 years patient with a large central giant cell granuloma in the mandible. Biopsy specimen taken from the lesion showed CGCG followed by curettage with peripheral ostectomy with preservation of the continuity of the mandible.Result: At the 1-year clinical and radiological follow up there was no sign of recurrence. Conclusion: After complete healing of the graft, prosthetic rehabilitation with implants will be perfomed. This allows the best functional and aesthetic results.
Leach, Richard Jonathan
Infectious disease is an important issue for animal breeders, farmers and governments. Solutions to control infectious disease are needed and research focused on the genetic loci determining variation in immune-related traits has the potential to deliver solutions. The primary aim of this thesis is to discover regions of the bovine genome which influence the immune response post immunisation. To accomplish this two types of immunising agents, a Foot-and-Mouth Disease Virus (FMD...
Akinyemi Oluwole A
Full Text Available Abstract Background Teratoma is a rare developmental neoplasm that arises from totipotential tumor stem cells. Head and neck teratomas constitute about 10% of all cases. Only two cases of mature teratoma of the nasal septum have previously been documented in the world literature. Case presentation We present a case of histologically confirmed mature teratoma arising from the nasal septum in an eighteen month old Nigerian female who presented with a history of noisy breathing associated with recurrent rhinorrhea since birth. Physical examination revealed obstruction of the right nasal cavity by a pale fleshy mass. She underwent a total surgical excision and to date, after thirty one months follow-up, she is free from recurrence. Conclusion The prognosis for benign teratoma of the nasal septum is good following total surgical excision.
Cederlund, Anna; And Others
A study of nasal mucociliary transport in 11 healthy subjects before and after they jogged 8-10 kilometers indicated that the transport time was significantly longer after jogging than before jogging. (Author/CB)
... sprays the correct way can take some practice. Path to improved health Prescription nasal sprays come in ... thumb at the bottom and your index and middle fingers on top. Insert the canister tip in ...
The adaptation of cetaceans to aquatic life habits is reflected, in their nasal region, in three marked changes from the original relations found in land mammals. These changes include (1) the loss of the sense of smell, (2) translocation of the nostrils from the tip of the rostrum to the vertex of the head, and (3) elongation of the anterior head to form a rostrum protruding far towards anterior. The morphogenetic processes taking place during embryogenesis of the nasal skull play a decisive part in the development of all these changes. The lateral parts of the embryonic nasal capsule, encompassing the nasal passages, change their position from horizontal to vertical. At the same time, the structures of the original nasal floor (the solum nasi) are shifted in front of the nasal passages towards the rostrum. The structures of the original nasal roof (the tectum nasi) and of the nasal side wall (the paries nasi) are translocated behind the nasal passages towards the neurocranium. The medial nasal septum (the septum nasi) mostly loses its connection to the nasal passages and is produced into a point protruding far towards anterior. The transformed embryonic nasal skull of the Cetacea can be divided into three sections: 1. The median structures. These include the cartilaginous structures, viz., the rostrum nasi, the septum interorbitale and the spina mesethmoidalis, which are accompanied by the dermal bones, the vomer and the praemaxillare. In adult cetaceans the rostrum nasi is mostly preserved as a robust cartilage of the skull, which may possibly serve as a sound transmitting structure of the sonar system, or it may be responsible for the sensing of water streams and vibrations. 2. The posterior side wall structures. These include the following cartilaginous structures that are mostly heavily reduced or mutually fused: the cupula nasi anterior, the tectum nasi, the lamina cribrosa, the paries nasi, the commissura orbitonasalis, the cupula nasi posterior, the
Alvarez, Mónica; Montojo, Teresa; de la Casa, Beatriz; Vela, Lydia; Pareja, Juan A
Migraine attacks exclusively felt in the face are very rare, the pain involving the territories supplied by the second and third branches of the trigeminal nerve. Two patients suffering from heminasal pain attacks accompanied with typical migrainous features and responsive to oral or intranasal triptans - but not to intranasal lidocaine or oxymetazoline. In one patient, the attacks could be precipitated upon slight touching on the tip of the nose, in the other attacks were preceded by the nasal sensation typically heralding sneezing. Migraine pain mostly develops within the innervation territory of the first branch of the trigeminal nerve, which includes the nose. Therefore, episodes of unilateral nasal pain with migrainous features could be considered a migraine with unusual topography (nasal migraine). Painful nasal attacks occasionally preceded by stimulation of trigeminal afferents in the nose, could be conceived of as migraine-tic syndrome.
Full Text Available Abstract The possibility of producing local hyposensitization by administering allergens via mucosal routes was envisaged at the beginning of 1900, and local nasal immunotherapy has been extensively studied since the 1970s. Presently, there are 21 randomized controlled trials being conducted with the most common allergens, consistently showing the clinical efficacy of local nasal immunotherapy for rhinitis. Other advantages are that it has an optimal safety profile and can be self-administered at home by the patient. Moreover, there are several data from animal models and from humans that confirm the immunomodulatory effect of intranasally administered antigens. On the other hand, local nasal immunotherapy seems to be effective only on rhinitis symptoms and requires a particular technique of administration. For these reasons, its clinical use is progressively declining in favour of the sublingual route although nasal immunotherapy is validated in official documents and remains a viable alternative to injection.
Wellenberg, G J; van der Poel, W H M; Van Oirschot, J T
This review deals with the role of viruses in the aetiology of bovine mastitis. Bovine herpesvirus 1, bovine herpesvirus 4, foot-and-mouth disease virus, and parainfluenza 3 virus have been isolated from milk from cows with clinical mastitis. Intramammary inoculations of bovine herpesvirus 1 or parainfluenza 3 virus-induced clinical mastitis, while an intramammary inoculation of foot-and-mouth disease virus resulted in necrosis of the mammary gland. Subclinical mastitis has been induced after a simultaneous intramammary and intranasal inoculation of lactating cows with bovine herpesvirus 4. Bovine leukaemia virus has been detected in mammary tissue of cows with subclinical mastitis, but whether this virus was able to induce bovine mastitis has not been reported. Bovine herpesvirus 2, vaccinia, cowpox, pseudocowpox, vesicular stomatitis, foot-and-mouth disease viruses, and bovine papillomaviruses can play an indirect role in the aetiology of bovine mastitis. These viruses can induce teat lesions, for instance in the ductus papillaris, which result in a reduction of the natural defence mechanisms of the udder and indirectly in bovine mastitis due to bacterial pathogens. Bovine herpesvirus 1, bovine viral diarrhoea virus, bovine immunodeficiency virus, and bovine leukaemia virus infections may play an indirect role in bovine mastitis, due to their immunosuppressive properties. But, more research is warranted to underline their indirect role in bovine mastitis. We conclude that viral infections can play a direct or indirect role in the aetiology of bovine mastitis; therefore, their importance in the aetiology of bovine mastitis and their economical impact needs further attention.
Consuelo de Paiva Godinho COSTA
Full Text Available We propose to make a brief review on nasalization phenomena studies in Portuguese, aiming the phonological process of nasal harmonization that occurs in the variety of Brazilian Portuguese spoken in Vitória da Conquista-BA and region, a phenomenon hitherto not described for any Portuguese dialect. To do so, we consider as fundamental, D’Angelis (2002 analysis, which incorporates relevant concepts presented by Trubetzkoy, from the Prague School, and some points of Camara Jr. propose. We also propose to update the discussion with the approaches along the lines of auto segmental phonology, incorporating some insights of Piggott (1992, discussing with other analyzes for nasalization phenomena in other languages, especially Guarani (language of Tupi-Guarani Linguistic Family, as proposed by Costa (2010, which deals with the phonological processes involving nasality and nasal harmony in Brazilian indigenous languages , in order to verify if the researches on nasality phenomena in other languages can shed some light on the processes that occur in Portuguese.
Kofler, Johann; Geissbühler, Urs; Steiner, Adrian
Although a radiographic unit is not standard equipment for bovine practitioners in hospital or field situations, ultrasound machines with 7.5-MHz linear transducers have been used in bovine reproduction for many years, and are eminently suitable for evaluation of orthopedic disorders. The goal of this article is to encourage veterinarians to use radiology and ultrasonography for the evaluation of bovine orthopedic disorders. These diagnostic imaging techniques improve the likelihood of a definitive diagnosis in every bovine patient but especially in highly valuable cattle, whose owners demand increasingly more diagnostic and surgical interventions that require high-level specialized techniques. Copyright © 2014 Elsevier Inc. All rights reserved.
Beer, Helen; Southern, Kevin W; Swift, Andrew C
Nasal polyps frequently occur in people with cystic fibrosis. Sinus infections have been shown to be a factor in the development of serious chest complications in these people. Nasal polyps have been linked to a higher risk of lower respiratory tract infections with Pseudomonas aeruginosa . Topical nasal steroids are of proven efficacy for treating nasal polyposis in the non-cystic fibrosis population. There is no clear current evidence for the efficacy of topical steroids for nasal polyps in people with cystic fibrosis. This is an updated version of a previously published review. To assess the effectiveness of topical nasal steroids for treating symptomatic nasal polyps in people with cystic fibrosis. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register comprising references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings.Latest search: 10 June 2015. Randomised and quasi-randomised controlled comparing the effects of topical nasal steroids to placebo in people with nasal polyps with cystic fibrosis. Two authors independently assessed risk of bias in the included trial and extracted data. One single-centred trial (46 participants) was identified comparing a topical steroid (betamethasone) given as nasal drops to placebo. Treatment was given twice daily for six weeks; 22 participants received the active drug.Subjective symptom scores, change in polyp size, and side effects were assessed. There was no difference in nasal symptom scores between the treatment and placebo groups. Betamethasone was effective in reducing the size of polyps, but was associated with increased reports of mild side effects, nasal bleeding and discomfort.Risk of bias was high since over 50% of people enrolled did not complete the study. Follow-up of participants was short (six weeks) also reducing the significance of the results for clinical practice. This review
Park, Seong Kook; Heo, Kyung Wook; Hur, Dae Young; Yang, Young Il
Chitin is a recognition element for tissue infiltration by innate cells implicated in allergy and immunity. This process can be negatively regulated by vertebrate chitinases. Both acidic mammalian chitinase (AMCase) and chitotriosidase (ChT) have chitinolytic activity. This study aimed to determine the activities of AMCase and ChT in nasal polyps (NPs), as well as their in situ localization in NP tissue. AMCase and ChT activities in NPs were compared with those in inferior turbinate tissue samples. Tissue samples were measured for AMCase and ChT activities at a range of pHs using the fluorogenic substrate 4-methylumbelliferyl-beta-d-N,N',N''-triacetyl-chitotriose. Double immunofluorescent staining for the localization of both AMCase and ChT was performed using NP cryosections. Both AMCase and ChT displayed markedly increased chitinolytic activity in all NPs, compared with inferior turbinate tissues. Double immunofluorescent staining revealed that CD68 highlighted monocytes in the submucosa of NP and these cells disclosed coexpression of AMCase and ChT. CD31 detected capillary endothelial cells, but did not express any AMCase and ChT. The increased chitinolytic activities of AMCase and ChT in NPs may be important in NP pathogenesis, suggesting that inhibition of chitinolytic activity may be a novel therapeutic strategy for the treatment of NPs.
Hassan, Z.U.; Majeed, A.
To compare medical versus surgical treatment of nasal polyps in terms of frequency of success and recurrence. Study Design: Randomized controlled trial. Place and Duration of Study: This study was conducted at the department of ear nose throat (ENT), Combined Military Hospital (CMH) Peshawar over 2 years' period, from Jan 2000 to Dec 2002. Material and Methods: During this period, 80 patients were diagnosed of nasal polyps. These patients were randomly divided into two treatment groups. Patients in group-A received medical treatment in the form of intra-nasal steroids while patients in group-B received surgical treatment depending upon the extent of disease. Outcome variables were frequency of successful resolution of nasal polyps after 1 month of treatment and frequency of recurrence upon 1 year follow-up. Results: The age of the patients ranged from 15 years to 40 years with a mean of 26.13 +- 2.5 years. There were 49 (61.25%) male and 31 (38.75%) female patients in the study group giving a male to female ratio of 1.6:1. There was no significant difference between the two study groups in terms of gender (p=0.818) distribution. Bilateralintranasal polypectomy was the most frequently performed procedure (70.0%) followed by intranasal ethmoidectomy (12.5%), external ethmoidectomy (10.0%) and functional endoscopic sinus surgery (7.5%). The frequency of successful treatment was significantly higher with surgery (100% vs. 52.50%; p<0.001) as compared to intra-nasal steroids at 1 month follow-up. However, over the long-term follow-up, the frequency of recurrence was significantly lower with intra-nasal steroids (4.8% vs. 30.0%; p=0.022) as compared to surgery. There was no complication in the patients treated with intra-nasal steroids. While crusting (15.0%) followed by infection (10.0%) were among the few complications observed in the surgical group-B. Conclusion: Though associated with significantly lower frequency of successful treatment, intranasal steroids
Lorenz, Kai J.
Full Text Available Midfacial degloving is a proven method for easily accessing the midface, the nasal pyramid, the maxillary and ethmoidal sinuses, the orbits, as well as the anterior skull base. Indications for this method of access mainly include tumour resections in the area of the midface, the septum, the maxillary sinus, the paranasal to the sphenoidal sinus as well as the clivus. In addition, this method of access allows for the exposure of the bony structures of the midface in the event of extensive fractures.In general, this method of access combines an incision in the oral vestibule and circular incisions in the nasal vestibule area in order to release the nasal pyramid.After removing the facial wall of the maxillary sinus, extensive exposure of the surgical site is possible.One disadvantage of this method of access is the difficult reconstruction of the nasal valve area, which often leads to cicatricial stenoses and difficulties with breathing through the nose. Furthermore, wound healing problems and osteoradionecrosis in the area of the lateral margin of the anterior nasal aperture after replantation of the facial wall of the maxillary sinus have been described, because in this area sufficient soft tissue coverage cannot be ensured when a conventional technique is used.We describe a soft tissue flap pedicled in the cranial and caudal directions in the nasal valve area which makes both the reconstruction of the nasal vestibule and sufficient soft tissue coverage of the anterior nasal aperture possible.
Carlos Eduardo Nazareth Nigro
Full Text Available A porção anterior das cavidades nasais, da narina à válvula nasal (VN, é a região de maior resistência nasal ao fluxo aerífero, de suma importância para a fisiologia nasal. Na literatura existem terminologias diferentes para se referir às mesmas estruturas anatômicas e, ainda, o mesmo termo se referindo a estruturas anatômicas diferentes. OBJETIVO: Realizamos este trabalho com o objetivo de revisarmos o funcionamento da VN e definirmos com mais clareza estruturas anatômicas da porção anterior das cavidades nasais, principalmente a região da VN. CONCLUSÃO: Existe controvérsia na literatura quanto à nomenclatura das estruturas da VN. Neste trabalho definimos VN como uma estrutura tridimensional compreendida anteriormente pelo ostium internum e posteriormente pelo isthmus nasi.The anterior portion of the nasal cavities, from the nostril to the nasal valve (NV, is the place of highest nasal resistance to airflow, paramount to nasal physiology. There are different terminologies for the same anatomic structures in the literature. AIM: The aim of this paper was to study the NV function and define clearly the structures of the anterior portion of the nasal cavities, mainly the region of the NV. CONCLUSION: Internum ostium is the anterior segment and isthmus nasi is the posterior segment of the NV region.
Bannister, C M; Kashab, M; Dagestani, H; Placzek, M
After a difficult nasal intubation a premature infant leaked cerebrospinal fluid (CSF) from one nostril. After developing bacterial meningitis, the baby was referred for neurosurgical management of the CSF fistula. Transaxial computed tomograms demonstrated a nasal encephalocele, but coronal scans were needed to show the defect in the cribriform plate. Images PMID:8346963
Hox, V.; Bobic, S.; Callebaux, I.; Jorissen, M.; Hellings, P. W.
Chronic rhinosinusitis with nasal polyposis (NP) represents an invalidating disorder that causes mainly nasal blockage and loss of smell. The aim of this study is to investigate correlations between individual subjective and objective parameters of stable NP disease. 65 NP patients scored their
Cheryl L. Sershen
Full Text Available In several mammalian hosts, including non-human primates, Mycobacterium tuberculosis granulomas are often hypoxic, although this has not been observed in wild type murine infection models. Mtb associated granuloma formation can be viewed as a structural immune response that can contain and halt the spread of the pathogen. While a presumed consequence, the structural contribution of the granuloma to oxygen limitation and the concomitant impact on Mtb metabolic viability and persistence remains to be fully explored.We develop a multi-scale computational model to test to what extent in vivo Mtb granulomas become hypoxic, and investigate the effects of hypoxia on host immune response efficacy and mycobacterial persistence. Our study integrates a model of oxygen dynamics in the extracellular space of alveolar tissue, an agent-based model of cellular immune response, and a systems biology-based model of Mtb metabolic dynamics. Our theoretical studies suggest that the dynamics of granuloma organization mediates oxygen availability and illustrates the immunological contribution of this structural host response to infection outcome. Furthermore, our integrated model demonstrates the link between structural immune response and mechanistic drivers influencing Mtb's adaptation to its changing microenvironment and the qualitative infection outcome scenarios: clearance, containment, dissemination, and a newly observed theoretical outcome of transient containment. We observed hypoxic regions in the containment granuloma similar in size to granulomas found in mammalian in vivo models of Mtb infection. In the case of the containment outcome, our model uniquely demonstrates that immune response mediated hypoxic conditions help foster the shift down of bacteria through the two stages of adaptation similar to thein vitro non-replicating persistence (NRP observed in the Wayne model of Mtb dormancy. The adaptation in part contributes to the ability of Mtb to remain
Sershen, Cheryl L.; Plimpton, Steven J.; May, Elebeoba E.
Mycobacterium tuberculosis associated granuloma formation can be viewed as a structural immune response that can contain and halt the spread of the pathogen. In several mammalian hosts, including non-human primates, Mtb granulomas are often hypoxic, although this has not been observed in wild type murine infection models. While a presumed consequence, the structural contribution of the granuloma to oxygen limitation and the concomitant impact on Mtb metabolic viability and persistence remains to be fully explored. We develop a multiscale computational model to test to what extent in vivo Mtb granulomas become hypoxic, and investigate the effects of hypoxia on host immune response efficacy and mycobacterial persistence. Our study integrates a physiological model of oxygen dynamics in the extracellular space of alveolar tissue, an agent-based model of cellular immune response, and a systems biology-based model of Mtb metabolic dynamics. Our theoretical studies suggest that the dynamics of granuloma organization mediates oxygen availability and illustrates the immunological contribution of this structural host response to infection outcome. Furthermore, our integrated model demonstrates the link between structural immune response and mechanistic drivers influencing Mtbs adaptation to its changing microenvironment and the qualitative infection outcome scenarios of clearance, containment, dissemination, and a newly observed theoretical outcome of transient containment. We observed hypoxic regions in the containment granuloma similar in size to granulomas found in mammalian in vivo models of Mtb infection. In the case of the containment outcome, our model uniquely demonstrates that immune response mediated hypoxic conditions help foster the shift down of bacteria through two stages of adaptation similar to thein vitro non-replicating persistence (NRP) observed in the Wayne model of Mtb dormancy. The adaptation in part contributes to the ability of Mtb to remain dormant
Hoar, Bruce R.
Bovine virus diarrhea (BVD) is a complicated disease to discuss as it can result in a wide variety of disease problems from very mild to very severe. BVD can be one of the most devastating diseases cattle encounter and one of the hardest to get rid of when it attacks a herd. The viruses that cause BVD have been grouped into two genotypes, Type I and Type II. The disease syndrome caused by the two genotypes is basically the same, however disease caused by Type II infection is often more severe...
Virkkula, Paula; Maasilta, Paula; Hytönen, Maija; Salmi, Tapani; Malmberg, Henrik
Nasal obstruction is considered to be a potential etiological factor in sleep-disordered breathing. However, a significant correlation between nasal measurements and obstructive sleep apnea has not been demonstrated so far. The aim of this study was to investigate the relationships between nasal resistance, nasal volumes and selected sleep parameters using nasal measurements performed in both seated and supine positions. We also investigated whether snoring patients in our clinical sample showed increased positional or decongestive nasal mucosal changes. Forty-one snoring men on a waiting list for correction of nasal obstruction underwent polysomnography, anterior rhinomanometry and acoustic rhinometry. Nineteen non-snoring control subjects were also recruited. Nasal measurements were performed in a seated position, after lying down in a supine position and, after decongestion of nasal mucosa, in a seated position again. In the overall patient group, nasal volume at a distance 2-4 cm from the nares in the supine position correlated inversely with apnea-hypopnea index (AHI) (r = -0.32, p patients, total nasal resistance measured in a supine position correlated with AHI (r = 0.50, p position and sleep parameters. Postural or decongestive changes in nasal measurements were not increased in snoring patients compared with control subjects. The relationship found between nasal measurements and sleep parameters suggests that nasal obstruction does augment airway collapse.
Full Text Available Current methods for nasal spray formulations have been elementary evaluating the dripping characteristics of a formulation and have not assessed the behavior of the nasal formulation in the presence of varying types of mucus depending on the indication or diseased state. This research investigated the effects of nasal mucus on the dripping behavior of nasal formulations and focused on developing an improved in vitro analytical test method that is more physiologically relevant in characterizing nasal formulation dripping behavior. Method development was performed using simulated nasal mucus preparations for both healthy and diseased states as coatings for the dripping experiment representing a wide range of viscosity. Factors evaluated during development of this in vitro test method included amount of mucus, application of mucus, drying times, and compatibility of the mucus on a C18 Thin Layer Chromatography (TLC substrate. The dripping behavior of nasal formulations containing a range of 1% Avicel to 3.5% Avicel was assessed by actuating the nasal spray on a perpendicular TLC plate coated with either healthy or diseased simulated nasal mucus. After actuation of the nasal spray, the dripping of the formulation on the coated TLC plate was measured after the plate was repositioned vertically. The method that was developed generated reproducible results on the dripping behavior of nasal formulations and provided critical information about the compatibility of the formulation with the nasal mucus for different diseased states, aiding in nasal spray formulation development and physical characterization of the nasal spray.
Xiao, Shu-Hua; Zhang, Chao-Wei
To explore whether mefloquine possesses the effect on granuloma formation induced by Schistosoma japonicum eggs. Seventeen out of twenty-eight mice infected with 20 S. japonicum cercariae for 35 days were treated orally with mefloquine at a single dose of 200 mg/kg, and groups of 2-3 mice were sacrificed at various intervals post-treatment. The livers removed from each group of mice were fixed in 10% formaldehyde. While the remained 11 untreated mice divided into 6 groups (1-2 mice per group) were sacrificed at the same time periods as groups of mice treated with mefloquine, and their livers served as untreated corresponding controls. The granulomas with single egg in the center were counted and their diameters were measured using an ocular micrometer. The liver tissue sections were stained with hematoxylin and eosin (HE), Foot's or Mallory's methods for observation on histopathological alteration of egg granulomas, and on the appearance of reticular and collagen fibers within the granulomas. After infected mice were treated with mefloquine for 3, 7, 14, 21, 28 and 35 days, i.e., 38, 42, 49, 56, 63, and 70 days post-infection, the mean diameters of granuloma with single egg measured in the liver tissues section were (161 +/- 19), (175 +/- 13), (195 +/- 9), (171 +/- 40), (180 +/- 13), and (145 +/- 25) microm, respectively, and each of them was significantly lower than that of its corresponding control group of (189 +/- 18), (197 +/- 11), (211 +/- 12), (208 +/- 19), (203 +/- 16), and (207 +/- 36) microm (P mefloquine, the eosinophil-predominant inflammatory cells around the egg granuloma were sustained to 14-21 d post treatment (49-56 d post infection), which was significantly different from the corresponding control groups that all the eggs were surrounded by fibroblasts at 42 d post infection. Up to 28-35 d post treatment (63-70 d post infection), the boundary of egg granulomas distributed in the liver tissues of mefloquine treated groups was nearer in comparison
Michels, Daniel de Sousa; Rodrigues, Amanda da Mota Silveira; Nakanishi, Márcio; Sampaio, André Luiz Lopes; Venosa, Alessandra Ramos
Numerous studies have reported an association between nasal obstruction and obstructive sleep apnea syndrome (OSAS), but the precise nature of this relationship remains to be clarified. This paper aimed to summarize data and theories on the role of the nose in the pathophysiology of sleep apnea as well as to discuss the benefits of surgical and medical nasal treatments. A number of pathophysiological mechanisms can potentially explain the role of nasal pathology in OSAS. These include the Starling resistor model, the unstable oral airway, the nasal ventilatory reflex, and the role of nitric oxide (NO). Pharmacological treatment presents some beneficial effects on the frequency of respiratory events and sleep architecture. Nonetheless, objective data assessing snoring and daytime sleepiness are still necessary. Nasal surgery can improve the quality of life and snoring in a select group of patients with mild OSAS and septal deviation but is not an effective treatment for OSA as such. Despite the conflicting results in the literature, it is important that patients who are not perfectly adapted to CPAP are evaluated in detail, in order to identify whether there are obstructive factors that could be surgically corrected. PMID:25548569
Kim, Jisung; Jung, Hahn Jin; Shim, Woo Sub
Closed reduction is generally recommended for acute nasal bone fractures, and rhinoplasty is considered in cases with an unsatisfactory outcome. However, concomitant rhinoplasty with fracture reduction might achieve better surgical outcomes. This study investigated the surgical techniques and outcomes in patients who underwent rhinoplasty and fracture reduction concomitantly, during the acute stage of nasal bone fracture. Forty-five patients who underwent concomitant rhinoplasty and fracture reduction were enrolled. Nasal bone fractures were classified into three major types (type I, simple fracture; type II, fracture line that mimics nasal osteotomy; and type III, comminuted fracture) based on computed tomography images and preoperative facial images. Two independent otolaryngology-head and neck surgeons evaluated the surgical outcomes and telephone based survey were made to evaluate patients satisfaction. Among 45 patients, there were 39 males and 6 females. Type I was the commonest type of fracture with 18 patients (40%), while the most frequently used surgical technique for corrective surgery was dorsal augmentation with 44 patients (97.8%). The mean visual analogue scale satisfaction score of the surgeons and patients were 7.62 and 8, respectively, with no significant differences between fracture types. Concomitant rhinoplasty with fracture reduction can be performed for acute nasal bone fracture patients, and it might lead to better aesthetic outcomes.
Rosen, Evan B; Golden, Marjorie; Huryn, Joseph M
A technique for making a provisional nasal prosthesis for interim use after the ablation of a midface tumor is described. The technique is especially useful for the re-creation of a nasal form in an expedient and cost-effective manner. A preoperative definitive cast, or moulage, of the patient that includes a nasal form is used to fabricate a vacuum form of the midface. The vacuum form is evaluated on the patient, the extension is adjusted, and an external adhesive knit liner is applied to give the appearance of a contoured nasal bandage. The provisional nasal prosthesis is attached with medical adhesive tape and removed daily by the patient. The prosthesis is easily replaced during the course of treatment and has been found to be functional and esthetically acceptable to those patients receiving care from the Dental Service at Memorial Sloan Kettering Cancer Center. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.
Widdison, Stephanie; Watson, Michael; Coffey, Tracey J
Bovine tuberculosis is a disease of worldwide importance yet comparatively little is known about chemokine responses to infection. We report on the levels of chemokine expression within lymph nodes of cattle infected with Mycobacterium bovis when infection would be well established. Expression levels of a number of chemokines were increased in infected cattle and could be correlated to levels of respective chemokine receptors. Several chemokines were significantly correlated to pathology within the lymph node, indicating a direct relationship between chemokine expression and disease. Vaccinated animals challenged with M. bovis had lower levels of chemokine expression than unvaccinated, challenged animals, correlating with lower levels of disease in vaccinated animals. The chemokine expression profile correlated with previous evidence for a pro-inflammatory bias within the lymph node. At this stage of infection we suggest there is on-going chemokine expression by cells associated with the granuloma and continual recruitment of cells to control infection.
P. Diéguez; V. Villanueva; S. López; J. De Andrés
Presentamos el caso de un paciente que sufrió como complicación de la estimulación eléctrica medular, implantado a causa de su dolor neuropático, un granuloma en la incisión lumbar, a nivel de la conexión intermedia. Este granuloma evolucionó pese a su correcto diagnóstico y tratamiento precoz, a una infección de tejidos profundos con migración de los electrodos, por lo que precisó la retirada de éstos.It is showed you a patient who presented a granuloma in the lumbar incision at the level of...
Prause Jan U
Full Text Available Abstract Background To report a case of keratitis and a case of conjunctivitis caused by synthetic fibers from toy teddy bears. Case presentation Case stories with histopathological analysis. 1 A two-year-old girl developed a severe case of keratitis and corneal ulceration. The initial treatment with various antibiotics gave no improvement and eventually the patient developed spontaneous perforation of the cornea. The corneal swabs contained no bacteria or fungi. Corneal grafting was performed and the corneal button was sent for histopathological examination. 2 A five-year-old girl presented with ocular irritation in her left eye. Examination revealed a conjunctival granuloma in the inferior fornix. The lesion was excised and histopathologically examined. Results Microscopy revealed synthetic fibers embedded in the cornea and in the conjunctival granuloma. The diagnosis was confirmed by demonstration of marked birefringence of the synthetic fibers. Microscopical examination of synthetic fibers from two different types of fur (whiskers and face hairs from the two-year-old girl's teddy bear was performed. Hairs from the face of the teddy bear were morphologically and microscopically identical with the fibers causing the severe corneal ulceration in the two-year-old girl. Conclusions Doctors should especially in small children be aware of the risk of ocular consequences of close exposure of synthetic fibers from stuffed toy animals. Corneal ulceration, clinically presenting as corneal infection with negative culturing and staining, should lead to a different clinical strategy and treatment. The treatment of conjunctival synthetic fiber granuloma is excision and antibiotic eye drops.
Full Text Available An elderly female patient was referred to the author for the treatment of a large recurrent pyogenic granuloma in the sole of right foot for a period of 2 years. She underwent excisional surgeries at an outside facility twice in the past. This time, she was treated with wide excision biopsy and the surgical defect was closed with a new technique, the "adjustable suture technique". Histopathology report confirmed "desmoplastic melanoma" with complete marginal clearance. The wound had healed uneventfully. There were no recurrences at 4-year follow-up.
Satti, Mohamed B.; Batouk, Abdelnasir; Ahmad, Mohamed F.; Abdelaal, Mohamed A.; Abdelaziz, Muntasir M.
We report a case of a 30-year-old female who had been treated periodically with steroids for idiopathic thrombocytopenic purpura ICTP over the last 10 years. Recently, during the course of investigation, she was found to have incidental asymptomatic multiple pulmonary nodules on chest CT. Following a needle biopsy to exclude malignancy, 2 nodules were excised and were histologically confirmed as pulmonary hyalinizing granuloma PHG. The remaining 2 nodules regressed on increasing her dose of steroids. The case is discussed with emphasis on the histological and radiological differential diagnosis, in addition to including ITP among the spectrum of immunologic conditions associated with PHG. (author)
Full Text Available This case report presents an eight-year-old girl having periauricular swelling and severe pain during mouth opening on the right-side temporomandibular joint (TMJ. CBCT showed extensive destruction of the base of the skull and the roof of the glenoid fossa on the right side. The findings based on CT and MRI images with and without contrast are discussed herein. This report highlights a skull base eosinophilic granuloma that mimics TMJ disorder and the importance of proper evaluation of CBCT images to make an early diagnosis.
Crucitti, Antonio; Grossi, Ugo; Leccisotti, Lucia; Maggi, Fabio; Ricci, Riccardo; Mazzari, Andrea; Tomaiuolo, Pasquina M C; Giordano, Alessandro
A 31-year-old woman presenting with acute abdomen underwent an emergency Hartmann's procedure for fecal peritonitis due to perforated adenocarcinoma of the left colon. Shortly after a 7-month course of adjuvant chemotherapy, follow-up contrast-enhanced CT showed multiple peritoneal and hepatic nodules, showing focal intense and homogeneous FDG uptake on FDG-PET/CT, highly suspected for recurrence of disease. Excisional biopsy of the nodules revealed foreign body granulomas made up of alimentary materials surrounded by a fibrous wall. We report a unique case of a false-positive finding secondary to food residues mimicking metastatic disease on FDG-PET in a patient with colon cancer.
Kang, Min Seok; Kim, Hak Jin [Pusan National University Hospital, Busan (Korea, Republic of)
Multifocal central giant cell granulomas (CGCG) in the maxillofacial region are suggestive of systemic disease such as hyperparathyroidism or an inherited syndrome such as Noonan-like multiple giant cell lesion syndrome. Only 5 cases of multifocal CGCGs in the maxillofacial region without any concomitant systemic disease have currently been reported. We report here on an unusual case of 17-year-old man who presented with multifocal CGCGs of the bilateral posterior mandible and right maxilla and he was without any concomitant systemic disease
Askin Esen Hasturk
Full Text Available Gelatin sponge, oxidized cellulose and microfibrillar collagen are used to achieve hemostasis during neurosurgical procedures. Hemostatic agents may produce clinically symptomatic, radiologically apparent mass lesions. The differential diagnosis should include the foreign body along with recurrent tumor. We present a case of intracranial hemostatic agents found in a 56-year-old male patient seven years after undergoing a craniotomy for a left posterior parietal convexity meningioma. Preoperative magnetic resonance imaging (MRI suggested the presence of a recurrent tumor. We emphasize that although it is rare, a granuloma due to a foreign body reaction can result in a false image of tumor recurrence.
Miguel Parage Filho
Full Text Available Os autores apresentam um caso de blastomicose medular. O paciente apresentava síndrome de Brown-Séquard. Após a mielografia foi submetido à laminectomia cervical. Na operação foi encontrada lesão tumoral que a histologia mostrou tratar-se de um granuloma blastomicótico. O paciente foi medicado com Anfotericina B, associada à sulfametoxazol e trimetropim, assim como tratamento fisioterápico. A despeito do tratamento instituído o paciente não apresentou melhoras no que respeita à sintomatologia neurológica.
Begum, V.H.; Sadique, J.
The effect of W. somnifera on glycosaminoglycan synthesis in the granulation tissue of carrageenin-induced air pouch granuloma was studied. W. somnifera was shown to exert significant inhibitory effect on incorporation of /sup 35/S into the granulation tissue. The uncoupling effect on oxidative phosphorylation (ADP/O ratio reduction) was also observed in the mitochondria of granulation tissue. Further, Mg/sup 2 +/ dependent ATPase activity was found to be influenced by W. somnifera. W. somnifera also reduced the succinate dehydrogenase enzyme activity in the mitochondria of granulation tissue.
Müller, Maciej; Betlejewski, Stanisław
Diabetes mellitus is the most common endocrinologic disease all over the world. 150 million people suffer from this disease, in Poland about 2 million. The disease on the basis of the onset and pathophysiology may be divided into type I and type II. Pathophysiologic changes include diabetic microangiopathy, macroangiopathy and neuropathy. The most common presentations in head and neck are otitis externa, hypoacusis, vertigo, disequilibrium, xerostomia, dysphagia, fungal and recurrent infections. The changes in nasal mucosa are not very well known. Only few papers concerned the problem. The main complaints of patients regarding the nose are xeromycteria, hyposmia and various degree of decreased patency of the nose. Chronic atrophic rhinitis, septal perforation, ulceration of nasal mucosa, alar necrosis, symptoms of staphylococcal or fungal infection can be found during otolaryngologic examination. The treatment in this group of patients should consist of systemic therapy of diabetes mellitus and on the other hand focal therapy with the use of a solution to moisten the nasal mucosa.
Mohd Slim, Mohd Afiq; Dick, David; Trimble, Keith; McKee, Gary
Patients with cystic fibrosis (CF) are at increased risk of nasal polyps. We present the case of a 17-month-old Caucasian patient with CF who presented with hypertelorism causing cycloplegic astigmatism, right-sided mucoid discharge, snoring and noisy breathing. Imaging suggested bilateral mucoceles in the ethmoid sinuses. Intraoperatively, bilateral soft tissue masses were noted, and both posterior choanae were patent. Polypectomy and bilateral mega-antrostomies were performed. Histological examination revealed inflammatory nasal polyposis typical of CF. The role of early functional endoscopic sinus surgery (FESS) in children with CF nasal polyposis remains questionable as the recurrence rate is higher, and no improvement in pulmonary function has been shown. Our case, however, clearly demonstrates the beneficial upper airway symptom relief and normalisation of facial appearance following FESS in a child with this condition. 2016 BMJ Publishing Group Ltd.
Gaslin, Michael T; Rubin, Cory; Pribitkin, Edmund A
Long-term use of silver-containing products is associated with a permanent bluish-gray discoloration of the skin known as argyria, but they remain widely available despite several measures by the FDA to regulate them. Several recent case reports have described the occurrence of argyria as a result of using these "natural" products. We used the five most common Internet search engines to find Web sites providing information on silver-containing nasal sprays. Of 49 Web sites analyzed, only 2 (4%) mentioned argyria as a possible complication, although 30 (61%) did caution against long-term use. Eight sites (16%) made specific claims about the health benefits of the product. All 49 sites (100%) provided direct or indirect links to buy silver-containing nasal sprays. We conclude that information about silver-containing nasal sprays on the Internet is misleading and inaccurate. Therefore, otolaryngologists should be aware of the misinformation their patients may be receiving about these products.
Wellenberg, G.J.; Poel, van der W.H.M.; Oirschot, van J.T.
This review deals with the role of viruses in the aetiology of bovine mastitis. Bovine herpesvirus 1, bovine herpesvirus 4, foot-and-mouth disease virus, and parainfluenza 3 virus have been isolated from milk from cows with clinical mastitis. Intramammary inoculations of bovine herpesvirus 1 or
Full Text Available Aim: The present study was conducted to determine the zoonotic importance of methicillin resistant staphylococci associated with bovine mastitis and their potential role in transmission to animal handlers. Materials and Methods: A total of 158 milk samples from bovine mastitis cases and 126 nasal swabs from the animal handlers were sampled in and around Pondicherry (Southern India. The Presence of Staphylococcal organism was confirmed by PCR amplification using the genus specific primers and among the isolated Staphylococci; methicillin resistance was identified by genetic amplification of mec A methicillin resistant gene. Then the amplified gene from the bacteria expressing the mecA gene (PBP2a (~2kb fragment was further sequenced using four sets of primer pairs and aligned for determining their genetic relatedness between the sequences. Both phenotypic and genotypic analysis was carried out for the six MRS isolates (three bovine and three human in this study. Results: Out of 158 mastitis milk samples; 96 and 19 bovine isolates were found to be positive for Staphylococcal genus specific PCR and methicillin resistant (mecA gene PCR, respectively. Similarly, Out of 126 human nasal swabs, 64 and 13 human isolates were found to be positive for Staphylococcal genus specific PCR and mec A gene PCR, respectively. Among the 160 staphylococcal isolates (Bovine and Human origin; 51 were identified as coagulase-positive staphylococci (CPS and remaining as coagulase-negative staphylococci (CONS. The results obtained in this study revealed the presence of many species of Staphylococci but the predominant species were Staphylococcus aureus and S. epidermidis. The Sequence analysis of the mec A gene of human isolates obtained in this study had a maximum identity (99% -100% with the bovine isolates. Conclusion: The phenotypic and genotypic analysis carried out for the six MRS (Methicillin Resistant Staphylococci isolates in this study were indistinguishable
Jun Wook Lee
Full Text Available BackgroundPathogens in the nasal cavity during nasal surgery could lead to a systemic infectious condition, such as bacteremia, nosocomial infection, or toxic shock syndrome. However, there is no research about the prevalence of nasal carriage in patients with nasal bone fracture.MethodsThis was a prospective, double-blind, randomized study about the rate of nasal carriage in 200 patients with nasal bone fracture in Korea. Nasal secretions were taken from both the middle nasal meatus and colonized. All analyses were carried out using SPSS software.ResultsPathogens were identified in 178 of the 200 cases. Coagulase-negative staphylococci (CNS were the most cultured bacteria in 127 (66.84% of the 190 total patients after excluding 10 cases of contaminated samples, and methicillin-resistant coagulase-negative staphylococci (MRCNS were found in 48 (25.26%. Staphylococcus aureus was the second most identified pathogen, found in 36 (18.95%, followed by 7 cases (3.68% of methicillin-resistant Staphylococcus aureus (MRSA. The prevalence rate of MRSA in the females was higher than that in the males (RR=4.70; 95% CI, 1.09-20.18, but other demographic factors had no effect on the prevalence rate of MRSA and MRCNS.ConclusionsThe prevalence rate of these pathogens in patients with nasal bone fracture in Korea was similar to other reports. However, few studies have addressed the prevalence rate of CNS and MRCNS in accordance with risk factors or the change in prevalence according to specific prophylaxis against infectious complications. Additional research is needed on the potential connections between clinical factors and microbiological data.
At emergency tracheostomy, examination under anaesthesia, meticulous nasal and nasopharyngeal tumour clearance was done. Histopathological examination of the mass revealed osteogenic chondrosarcoma. CONCLUSION: Though rare, osteogenic chondrosarcoma affects nasal bones. Clinically the tumour mimicks ...
The continuous emergence of new pathogens and growing drug resistance of microorganisms asks for innovative vaccination strategies. An alternative to conventional multiple injection vaccines is the nasal route of vaccine delivery. The immune response induced following nasal antigen delivery depends
James H. Yang
Full Text Available This paper presented phonetic evidence to resolve the transcription disagreement concerning the syllable-final nasal shift in the variety of Mandarin spoken in Taiwan. Although three judges agreed that the rhyme /iŋ/ underwent a sound change, they perceived the nasal coda shift differently. Two of them transcribed it as a modification from /iŋ/ to /in/, whereas the other asserted that the velar nasal disappears with its preceding vowel nasalized. In order to resolve this transcription conflict, this study analyzed the acoustic attributes of the speculative sound alterations in question, including /in/, /iŋ/, /i/ and /ĩ/. The phonetic analysis indicated that the Taiwanese participants did not nasalize the preceding vowel deleting the nasal coda but tended to pronounce the post-vocalic velar nasal as its dental counterpart. This study concluded by discussing the implications of the synchronic variation for the theories of the nasal coda shift in Chinese dialects.
Cashman, E C
The aetiology of nasal deformity has frequently included birth trauma. There is no consensus in the literature as to whether nasal surgery, in the form of closed reduction, is indicated in neonates. The majority of studies in the literature that advocate intervention have inadequate followup periods and there is a paucity of evidence for the adverse effects of conservative management. This case highlights the therapeutic dilemma posed by such nasal injuries in the neonate and, to the best of the authors\\' knowledge, at the time of writing, represents the earliest reported case in the literature of nasal deformity in the neonate. The term nasal deformity is used to denote deformity of the nasal pyramid, soft tissue, and septum. Three main aspects of neonatal nasal deformity are addressed including, firstly, if nasal deformity at birth needs to be addressed, secondly, if left unaltered, what the long-term effects are and, finally, if intervention alters the normal course of midfacial development.
Schmidt, T; Kock, M M; Ehlers, M M
The objectives of this study were to examine the diversity of Staphylococcus spp. recovered from bovine intramammary infections and humans working in close contact with the animals and to evaluate the susceptibility of the staphylococcal isolates to different antimicrobials. A total of 3,387 milk samples and 79 human nasal swabs were collected from 13 sampling sites in the KwaZulu-Natal province of South Africa. In total, 146 Staph. aureus isolates and 102 coagulase-negative staphylococci (CNS) were recovered from clinical and subclinical milk samples. Staphylococcusaureus was isolated from 12 (15.2%) of the human nasal swabs and 95 representative CNS were recovered for further characterization. The CNS were identified using multiplex-PCR assays, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), and tuf gene sequencing. Seven Staphylococcus spp. were identified among the CNS of bovine origin, with Staph.chromogenes (78.4%) predominating. The predominant CNS species recovered from the human nasal swabs was Staph.epidermidis (80%) followed by Staph.chromogenes (6.3%). The antimicrobial susceptibility of all staphylococcal isolates was evaluated using disk diffusion and was supplemented by screening for specific antimicrobial resistance genes. Ninety-eight (67.1%) Staph.aureus isolates of bovine origin were pansusceptible; 39 (26.7%) isolates were resistant to a single class, and 7 (4.8%) isolates were resistant to 2 classes of antimicrobials. Two Staph. aureus (1.4%) isolates were multidrug-resistant. Resistance to penicillin was common, with 28.8% of the bovine and 75% of the human Staph. aureus isolates exhibiting resistance. A similar observation was made with the CNS, where 37.3% of the bovine and 89.5% of the human isolates were resistant to penicillin. Multidrug-resistance was common among the human CNS, with 39% of the isolates exhibiting resistance to 3 or more classes of antimicrobials. The antimicrobial
Full Text Available Nasoalveolar cysts, which originate from epithelial remnants of nasolacrimal duct, are nonodontogenic soft tissue lesions of the upper jaw. These cysts are thought to be developmental and are presented with fullness in the upper lip and nose, swelling on the palate, and sometimes nasal obstruction. Because of cosmetic problems, they are often diagnosed at an early stage. These lesions are mostly revealed unilaterally but also can be seen on both sides. In this case report, a patient who complained of nasal obstruction and then diagnosed with bilateral nasoalveolar cysts and treated by sublabial excision is presented and clinical features and treatment approaches are discussed with the review of literature.
Carlos Giraldo M.; Catalina López V.; Jorge U. Carmona
Se describe un caso de plasmocitoma nasal en un canino, macho entero, de raza Akita de 30 Kg de peso y veintiún meses de edad, con historia de epistaxis unilateral crónica. Se practicó examen clínico y biopsia de la neoplasia visible en la cavidad nasal izquierda. La ubicación y extensión del tumor fue determinada mediante tomografía computarizada de cabeza y cuello. Se realizaron análisis histopatológico e inmunohistoquímico (IHQ) del tejido tumoral. La tomografía computarizada evidenció una...
Giraldo M, Carlos; López V, Catalina
RESUMENSe describe un caso de plasmocitoma nasal en un canino, macho entero, de raza Akita de 30 Kg de peso y veintiún meses de edad, con historia de epistaxis unilateral crónica. Se practicó examen clínico y biopsia de la neoplasia visible en la cavidad nasal izquierda. La ubicación y extensión del tumor fue determinada mediante tomografía computarizada de cabeza y cuello. Se realizaron análisis histopatológico e inmunohistoquímico (IHQ) del tejido tumoral. La tomografía computarizada eviden...
Bykova, V P; Bakhtin, A A; Polyakov, D P; Yunusov, A S; Daikhes, N A
The paper describes a case of nasal glial heterotopia in a 10-month-old girl with a mixed (intranasal and subcutaneous) localization, which is accompanied by the divergence of the nasal bones. Histological examination supplemented by immunohistochemical reactions with antibodies to vimentin, S100 protein, neuron-specific enolase, as well as Ki-67 and smooth muscle actin confirmed the neural nature of the tumor. Fields of mature astrocytic glia including individual cells with neuronal differentiation were found among the fibrous and fibrovascular tissues. The paper provides a brief overview of the discussed pathology.
Full Text Available Glomangiopericytoma is a rare vascular neoplasm characterized by a pattern of prominent perivascular growth. A 72-year-old woman was admitted to our clinic complaining of nasal obstruction, frequent epistaxis, and facial pain. A reddish tumor filling the left nasal cavity was observed on endoscopy and treated with endoscopic excision. Microscopically, closely packed cells interspersed with numerous thin-walled, branching staghorn vessels were seen. Glomangiopericytoma is categorized as a borderline low malignancy tumor by WHO classification. Long-term follow-up with systemic examination is necessary due to high risk of recurrence.
J.H. Soria; J.C. Pintos; C.G. Conde; R.J. Losardo
Las líneas de tensión que comprometen la estructura del cartílago del tabique nasal contribuyen a la recidiva en las desviaciones nasales, particularmente las desviaciones anteriores o cartilaginosas. Utilizamos la técnica de desvinculación ántero-posterior resecando una porción de tabique en forma de L, logrando evitar la recidiva de la desviación nasal. Indicamos una disección acotada del cartílago que se limita a la porción a seccionar, con el fin de disminuir las posibilidad de complicaci...
Waddell, David D; Beyer, Alan; Thompson, Terry L; Morawiak, Jennifer; Elkins, Clare; Rosenberg, Andrew; Spitzer, Andrew
Osteoarthritic (OA) knee pain can be successfully treated with hylan G-F 20 (Synvisc, Sanofi Biosurgery, Cambridge, MA) with few local adverse events. However, a few studies have identified hyaluronate positive (HA+) granulomas in the synovial tissue of patients treated with hylan G-F 20 raising the question of their relationship and clinical significance. To understand the potential relationship of HA+ granulomas with the occurrence of acute local reactions (ALRs), we evaluated the synovial tissue of OA patients undergoing total knee replacement that had previously been treated with hylan G-F 20 (n = 101) or had not been treated (n = 20). Granulomas were observed in nine patients, of which eight were in the hylan G-F 20 group (7.9%); HA+ granulomas were identified in six of these eight patients (5.9%). Three of the six patients with HA+ granulomas experienced an ALR within 30 days of administering an injection. Overall, we found no consistent relationship between histologically found HA+ granulomas and the occurrence of an ALR following hylan G-F 20 treatment. These microscopic granulomas were not associated with any symptoms and likely have little clinical significance. The low occurrence of granulomas and/or ALRs should not preclude use of hylan G-F 20 for the treatment of knee pain associated with OA. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Fitzgerald, Liam E; Abendaño, Naiara; Juste, Ramon A; Alonso-Hearn, Marta
Mycobacterium tuberculosis, Mycobacterium leprae, Mycobacterium bovis, and Mycobacterium avium subsp. paratuberculosis can survive within host macrophages in a dormant state, encased within an organized aggregate of immune host cells called granuloma. Granulomas consist of uninfected macrophages, foamy macrophages, epithelioid cells, and T lymphocytes accumulated around infected macrophages. Within granulomas, activated macrophages can fuse to form multinucleated giant cells, also called giant Langhans cells. A rim of T lymphocytes surrounds the core, and a tight coat of fibroblast closes the structure. Several in vivo models have been used to study granuloma's structure and function, but recently developed in vitro models of granuloma show potential for closer observation of the early stages of host's responses to live mycobacteria. This paper reviews culture conditions that resulted in three-dimensional granulomas, formed by the adhesion of cell populations in peripheral blood mononuclear cells infected with mycobacteria. The similarities of these models to granulomas encountered in clinical specimens include cellular composition, granulomas' cytokine production, and cell surface antigens. A reliable in vitro dormancy model may serve as a useful platform to test whether drug candidates can kill dormant mycobacteria. Novel drugs that target dormancy-specific pathways may shorten the current long, difficult treatments necessary to cure mycobacterial diseases.
O'Donnell, Sinéad M
To determine if low-flow nasal prongs therapy with room air, compared with no treatment, facilitates weaning from nasal continuous positive airway pressure (NCPAP) in very low birth weight (VLBW, birth weight <1500 g) infants.
Ruijschop, R.; Boelrijk, A.E.M.; Ru, de J.A.; Graaf, de C.; Westerterp-Plantenga, M.
It is suggested that the brain response of a food odour sensed retro-nasally is related to satiation. The extent of retro-nasal aroma release during consumption depends on the physical structure of a food, i.e. solid foods generate a longer, more pronounced retro-nasal aroma release than liquid
Balsalobre, Leonardo; Pezato, Rogério; Gasparini, Hiran; Haddad, Fernanda; Gregório, Luis Carlos; Fujita, Reginaldo R
Continuous airflow in the upper airway can cause discomfort, leading to nasopharyngeal complaints. The aim of the present study is to evaluate the acute effects of continuous positive upper-airway pressure on nasal patency in awake normal subjects. Twenty-seven adults (17 men; 10 women; age range, 18 to 43 years) were exposed to continuous airway pressure (20 cmH 2 O) in the nasal cavity, delivered by a continuous positive airway pressure (CPAP) device through a nasal mask for 2 hours. Visual analogue scale (VAS) of nasal obstruction, Nasal Obstruction Symptom Evaluation (NOSE) modified scale, acoustic rhinometry (AR), and peak nasal inspiratory flow (PF) were measured before and after the use of CPAP. There was an increase in nasal obstruction scores both on the VAS (p nasal cavity volume on AR (p Nasal parameters were significantly worse in the rhinitis group, with higher nasal obstruction scores on the VAS (p = 0.001) and NOSE scale (p CPAP is associated with subjective and objective reductions in nasal patency. In individuals with allergic nasal symptoms, deterioration is even more severe than in patients without these symptoms. © 2017 ARS-AAOA, LLC.
Background: Nasal Staphylococcus aureus is a major source of community and hospital associated staphylococcal infections. This study determined the prevalence of nasal S. aureus isolates and investigated their antimicrobial resistance profile in healthy volunteers. Methods: Nasal specimens of healthy volunteers in ...
Objective: To investigate a possible contribution of Helicobacter pylori (H. Pylori) in the etiopathogenesis of simple nasal polyps. Study Design: Prospective clinical trial. Methods: Twenty five patients with simple nasal polyps underwent nasal polypectomy were studied. Helicobacter pylori DNA was investigated for ...
Patient presented with long standing history of nasal obstruction and intermittent epistaxis for three years. Diagnosis was confirmed by histopathological examination and he was successfully treated by complete surgical excision. This was a very unusual cause of nasal masses in our setting. Nasal rhinosporidioss lesions ...
Li, Pu; Bao, Huai-en; Rong, Ju-quan; Shen, Zhen-hua; Dang, Rong-min; He, Xiao-fei; Wu, Rong; Jiang, Shui
Immunohistochemical streptavidin biotin-peroxidase complex method was used to investigate the effect of gamma-interferon (IFN-gamma) on the hepatic granuloma formation and liver fibrosis in mice infected with Taenia saginata in Duyun area of Guizhou Province. The results reveal contrary relation between the level of IFN-gamma in the liver and the degree of liver fibrosis (p<0.01). The injection of IFN-gamma considerably decreased (p<0.01) the area and size of granuloma (p<0.01).
Dubey, J P; Buxton, D; Wouda, W
The protozoan parasite Neospora caninum is a major pathogen of cattle and dogs, being a significant cause of abortion in cattle in many countries. It is one of the most efficiently transmitted parasites, with up to 90% of cattle infected in some herds. The pathogenesis of abortion due to Neospora is complex and only partially understood. Losses occur after a primary infection during pregnancy but more commonly as the result of recrudescence of a persistent infection during pregnancy. Parasitaemia is followed by invasion of the placenta and fetus. It is suggested that abortion occurs when primary parasite-induced placental damage jeopardises fetal survival directly or causes release of maternal prostaglandins that in turn cause luteolysis and abortion. Fetal damage may also occur due to primary tissue damage caused by the multiplication of N. caninum in the fetus or due to insufficient oxygen/nutrition, secondary to placental damage. In addition, maternal immune expulsion of the fetus may occur associated with maternal placental inflammation and the release of maternal pro-inflammatory cytokines in the placenta. Thus N. caninum is a primary pathogen capable of causing abortion either through maternal placental inflammation, maternal and fetal placental necrosis, fetal damage, or a combination of all three. The question of how N. caninum kills the fetus exposes the complex and finely balanced biological processes that have evolved to permit bovine and other mammalian pregnancies to occur. Defining these immunological mechanisms will shed light on potential methods of control of bovine neosporosis and enrich our understanding of the continuity of mammalian and protozoal survival.
Sahin, Memduh; Yılmaz, Güldal; Arhan, Mehmet; Sen, Ilker
Granulomas are focal aggregates of modified macrophages that are surrounded by a rim of lymphocytes and fibroblasts. The present study aimed to evaluate the prevalence and etiology of hepatic granulomas (HGs) in the Department of Gastroenterology with a wider population. We performed a retrospective study on 2662 liver biopsy specimens analyzed between 2005 and 2011 at Gazi University Department of Gastroenterology to determine the presence of HGs. There were 16 cases with primary biliary cirrhosis, of whom 14 without any other causative etiology. There were 6 cases of sarcoidosis, 2 cases of Fasciola hepatica infection, 2 cases of hepatitis C, and 2 cases of hepatitis B. One case had both tuberculosis and rheumatoid arthritis and one case had both tuberculosis and brucellosis. There was also one case each of leishmaniasis and Hodgkin's lymphoma. The diagnosis of autoimmune hepatitis was found in two cases. One case had immune cholangiopathy. The leading causative etiology of HGs was primary biliary cirrhosis, followed by sarcoidosis. As a study performed in a center that accepts patient profiles throughout Turkey, tuberculosis took a minor part in HG etiology. A drug-affected or toxic case of HG was not observed.
Jean Luc Fobe
Full Text Available A criptococose do sistema nervoso central na sua forma granulomatosa ou criptococoma é rara, sendo mais freqüente a forma meningítica ou meningoencefalítica. Apresentamos o case de um paciente de 56 anos, não portador da síndrome de imunodeficiência adquirida, com manifestação clínica inicial de síndrome de hipertensão intracraniana em decorrência de criptococoma occípito-parietal que foi removido cirurgicamente, seguido do tratamento medicamentoso com anfotericina-B e 5-fIuorocitosina. A fisiopatologia, o diagnóstico por imagem e o tratamento são revistos.Cryptococcal granuloma or toruloma of the central nervous system is very rare, meningoencefalitis or meningitis being most common. The authors present the case of an immunocompetent male patient of 56 years old with initial clinical symptoms of intracranial hypertension due to an occípito-parietal crytococcal granuloma that was removed surgically. The patients was treated post operatively with anphotericin-B and 5-fluorcytosine. Pathophysiology, neuroimaging, diagnosis and treatment of this rare entity are discussed.
Vargas, Alex; Ramírez, Hernán; Ramírez, Pablo; Foncea, Camila; Venegas, Bernardo; Astorga, Paula
Langerhans cell histiocytosis (LCH), previously known as Histiocytosis X, is an infrequent disease that congregates a wide spectrum of clinical presentations with variable systemic involvement. Unification of these diseases under only one category is based on the almost identical histopathologic features of the lesions, but the etiology and proper approach for each presentation remains controversial. The localized alternative of Langerhans cell histiocytosis (LLCH), known as Eosinophilic Granuloma (EG) of bone, is the predominant clinical presentation of LCH. The maxilla is involved in 1 % of the head and neck region cases, representing an uncommon condition in this area. In this clinical case report, it is described a case of a 16-year-old male patient with an asymptomatic osteolytic lesion at first upper left molar apical level, a finding detected on control radiographic images was reported as "Monostotic Eosinophilic granuloma of the maxillary bone", which was later confirmed through an incisional biopsy. A surgical excision was initially planned, but finally it was not performed due to a spontaneous healing of the lesion after the incisional biopsy. The presented case supports a conservative approach in the management of solitary EG of maxillary and mandibular bone lesions and even supports an expectant attitude in the course of treatment given the possibility of a spontaneous regression after the biopsy, especially in small lesions.
Deniz Cemgil Arikan
Full Text Available Introduction. Although pyogenic granulomas (PG are common and benign vascular proliferations of the skin and mucous membranes, they are relatively rare on the vulva. Case Presentation. A 57-year-old G7P7 postmenopausal woman presented with a 3-year history of a foul smell and bleeding lesions in the genital region. A gynecologic examination revealed multiple large papillomatous, pedunculated, and lobulated lesions that were cherry-red and infective in appearance. There was a 2-cm lesion at the upper intersection of the labia majora, a 2-cm lesion on the right labium majus, and a 4-cm lesion on the clitoris. The patient complained of itching, and the lesions were asymptomatic, except for occasional bleeding. All lesions were excised and sent for histopathological examination, which revealed an ulcerated polypoidal structure with extensive proliferation of vascular channels lined by a single layer of endothelium. The histopathological features were consistent with PG. Conclusion. The present case is the first case of multiple pyogenic granulomas on the vulva in a postmenopausal woman.
Albert Costa Rebello
Full Text Available RESUMO Tuberculose é uma doença infecciosa causada pelo Mycobacterium tuberculosis, também conhecido como bacilo de Koch. O principal sítio de acometimento é o pulmonar, porém o bacilo pode disseminar-se por via linfo-hematogênica para outros órgãos, dentre eles o olho. A incidência de tuberculose ocular é de 1 a 2% dos casos extrapulmonares. Os autores apresentam um caso clínico de um paciente do sexo feminino de 28 anos que procura atendimento médico devido à redução da acuidade visual em olho esquerdo há 7 dias. Apresentava a melhor acuidade visual corrigida no olho acometido de 20/200 e no olho contralateral de 20/20. Na fundoscopia era evidenciado um granuloma em área macular do olho esquerdo, com edema e hemorragia intrarretiniana adjacente. Após investigação diagnóstica, a paciente foi tratada com esquema antibiótico para tuberculose durante 6 meses, obtendo regressão do granuloma e melhora da acuidade visual deste olho para 20/50.
Full Text Available Los granulomas a cuerpo extraño son inducidos por cuerpos relativamente inertes, es típico que se formen alrededor de material como talco o suturas. Algunos estudios describen que las suturas no absorbibles especialmente la seda tiene mayor índice de complicaciones como son la formación de granuloma a cuerpo extraño y dolor postoperatorio. Se reporta el caso de una paciente femenino de 40 años de edad, quién consulta por presentar dolor abdominal de moderada intensidad a nivel de epigástrio, de dos meses de evolución acompañado de náuseas y vómitos, presenta como antecedente quirúrgico una miomectomía realizada hace dos meses. Al examen físico de ingreso abdomen globoso a expensas de panículo adiposo, ruidos hidroaéreos presentes, blando, depresible, doloroso a la palpación en epigástrico donde se evidencia tumoración móvil de 10 x 10 cm aproximadamente, sin signos de irritación peritoneal. Se realizó laparotomía exploradora con los siguientes hallazgos: tumoración de 10 x 15 cm a nivel de epigastrio formado por epiplón mayor adherido a colon transverso y colon sigmoides formando plastrón alrededor de sutura no absorbible.
Full Text Available This is a case report of a rare clinical entity known as atypical histiocytic granuloma (AHG, which was previously grouped under a broad category known as pseudolymphoma or traumatic eosinophilic granuloma. Less than 15 cases of AHG have been reported until date. AHG poses diagnostic dilemma due to its clinical as well as histopathological appearance where it stimulates malignancy. A proper clinicopathological evaluation is necessary to establish the diagnosis and to avoid overtreatment. In this report, we review previously reported cases in literature and try to establish proper clinicopathological correlation, differential diagnosis and management. These will familiarize clinicians to include AHG in their differential diagnosis as well as for the pathologist to segregate pseudolymphomatous lesion in their proper categories. The role of immunohistochemistry (IHC has been given prime importance to establish the exact diagnosis. Further in this report, we review different status on lymphoproliferative disorders and advocate the use of IHC in categorizing these lesions upon cell lineage and to establish proper nomenclature for these lesions.
Sidhu, Harleen K; Chaffee, Barbara H; Tvetenstrand, Christian D; Sidhu, Jagmohan S
Enfuvirtide (ENF, T-20, or Fuzeon [Hoffman-La Roche Inc, Nutley, NJ, and Trimeris, Inc, Durham, NC]) is an HIV-1 fusion inhibitor and is the only injectable antiretroviral drug available. Injection site reactions (ISRs) are the most frequently reported adverse events, occurring in about 98% of patients. A granuloma annulare-like granulomatous ISR has been reported. We report a granulomatous ISR that is different from granuloma annulare and granuloma annulare-like reaction because it is rich in multinucleated giant cells engulfing altered collagen. We call this type of ISR a collagenophagic granuloma. Most previous reports-with the exception of 1 report-about ISRs with ENF treatment have used punch biopsies, which lack the depth to analyze the reticular dermis and subcutaneous tissue and, therefore, may have missed ISRs, which look like granuloma annulare, and the collagenophagic granulomatous reaction.
Ahmadi Moghadam, Mohamad; Ahmadi Moghadam, Shokofeh
Nose is one of the most important aesthetic unit of the face.Management of nasal trauma plays a significant role in the practices of the majority of facial and reconstructive surgeons. Replantation, although technically very challenging, is undoubtedly the procedure of choice following traumatic nasal amputation. Here we present an illustrative case report of the traumatic amputation of a nasal tip that was treated successfully with a paramedian forehead flap and further nasal reconstructive surgery. Use of the forehead flap was performed five hours after the occurrence of trauma and was followed by surgical repair about three weeks later. This case presents evidence that a forehead flap as a full-thickness composite graft can survive with an acceptable clinical outcome. In this particular case, the final result was satisfactory.
Full Text Available Congenital nasal pyriform aperture stenosis (CNPAS is a rare cause of nasal airway obstruction that clinically mimics choanal atresia in a neonate. The differentiation between the two is very important as the management of the two conditions is different. Timely recognition is important to prevent fatal outcome. CNPAS may present as an isolated condition or with associated craniofacial anomalies. Despite typical findings of CNPAS being present on cross-sectional imaging, this condition is commonly overlooked, probably because of a lack of familiarity with the normal morphological features of the nasal cavity in infants and also owing to a lack of awareness of this rare entity. Here we report a case of CNPAS with pre- and post-surgical CT images and the complication that occurred owing to nasal stenting.
Delhaes, L; Bourel, B; Pinatel, F; Cailliez, J C; Gosset, D; Camus, D; Dei-Cas, E
One case of human nasal myiasis caused by second and third instar larvae of Oestrus ovis was observed in Lille (North France). Oestrosis is a common myiasis of sheep and goats in Mediterranean and Tropical countries. The authors examine the oestrosis pathogenesis in the usual host (sheep) or in humans, and analyse the epidemiology, the symptomatology and the treatment of human oestrosis.
Horsmans, J D; Godballe, C; Jørgensen, K E
From 1978 to 1992, 66 patients (32 women and 34 men) were treated for carcinoma of the nasal vestibule at Odense University Hospital. The treatment was radiotherapy (41 patients), surgery (13 patients) or a combination of the two modalities (12 patients). Twenty-one patients (32%) developed...... prognosticator of both disease specific and crude survival (p treatment and close follow up....
The most worrying complications of sinusitis in- volve the orbit and intracranial cavity". Complications and local extension of paranasal sinus infections most often involve the orbit and periorbital”. In conclusion the nasal polyposis has been found in this study to cause the radiological changes mainly in the mxillary sinus and ...
BACKGROUND: Staphylococcus aureus is one of the major causes of community and hospital acquired infections. The emergence of methicillin resistant strains of. Staphylococcus aureus in the hospitals and the community is a serious health problem. The aim of this study was to determine the nasal carriage and ...
BACKGROUND: Staphylococcus aureus is one of the major causes of community and hospital acquired infections. The emergence of methicillin resistant strains of Staphylococcus aureus in the hospitals and the community is a serious health problem. The aim of this study was to determine the nasal carriage and ...
Fornazieri, Marco Aurélio
Full Text Available Introduction: One of the most common diseases in the otorhinolaryngology emergency room is the nasal bones fracture. The peak of incidence is between 15 and 25 years of age. Generally men are more affected. Objective: To analyze the age, gender and the most frequent causes of nasal fractures evaluated in the otorhinolaryngology service of a tertiary hospital. Method: Retrospective study of records of the patients with nasal fracture diagnosis treated between July 1st, 2003 and July 1st, 2007. Results: 167 patients with nasal bones fracture were included in the study, including 134 men and 33 women. Violence was the most frequent cause, with 55 cases (32.9%, followed by fall from their own height, with 33 cases (19.7%, and motorcycle accident, 14 cases (8.4%. The most common age was between 21 and 39 years (46.1%. Conclusion: Male, age between 21 and 39 years and violence are the most common characteristics found in our service. Motorcycle accidents also play an important role in this affection.
Lee, Hyo-Ki; Kim, Hojoong; Lee, Kyoung-Joung
This study presents a rule-based method for automated, real-time snoring detection using nasal pressure recordings during overnight sleep. Although nasal pressure recordings provide information regarding nocturnal breathing abnormalities in a polysomnography (PSG) study or continuous positive airway pressure (CPAP) system, an objective assessment of snoring detection using these nasal pressure recordings has not yet been reported in the literature. Nasal pressure recordings were obtained from 55 patients with obstructive sleep apnea. The PSG data were also recorded simultaneously to evaluate the proposed method. This rule-based method for automatic, real-time snoring detection employed preprocessing, short-time energy and the central difference method. Using this methodology, a sensitivity of 85.4% and a positive predictive value of 92.0% were achieved in all patients. Therefore, we concluded that the proposed method is a simple, portable and cost-effective tool for real-time snoring detection in PSG and CPAP systems that does not require acoustic analysis using a microphone.
hepatic first pass metabolism, and make possible the release of active ingredient in a controlled manner. In this review, the benefits, limitations ... With regard to absorption, good penetration of lipophilic molecules and low molecular ..... be a useful tool for in vitro screening of nasal drug candidates . Excised and cultured ...
Full Text Available Despite of improved survival of premature infants, the incidence of long term pulmonary complications, mostly associated with ventilation-induced lung injury, remains high. Non invasive ventilation (NIV is able to reduce the adverse effects of mechanical ventilation. Although nasal continuous positive airway pressure (NCPAP is an effective mode of NIV, traumatic nasal complications and intolerance of the nasal interface are common. Recently high flow nasal cannula (HFNC is emerging as an efficient, better tolerated form of NIV, allowing better access to the baby’s face, which may improve nursing, feeding and bonding. The aim of this review is to discuss the available evidence of effectiveness and safety of HFNC in preterm newborns with respiratory distress syndrome (RDS. It is known that distending pressure generated by HFNC increases with increasing flow rate and decreasing infant size and varies according to the amount of leaks by nose and mouth. The effects of HFNC on lung mechanics, its clinical efficacy and safety are still insufficiently investigated. In conclusion, there is a growing evidence of the feasibility of HFNC as an alternative mode of NIV. However, further larger randomized trials are required, before being able to recommend HFNC in the treatment of moderate respiratory distress of preterm infants.
Galvez Chavez, Julio Cesar; Sanchez Wals, Lenia; Monzon Fernandez, Abel Nicolas; Morales Tirado, Roxana
Tumor relapse is one of the more fearsome complications of the oncologic course and also to obscure the life prognosis, causing the loss of many reconstructions and of exhausting the repairing surgical possibilities. The aim of this study was to determine the relapse frequency, the repercussion on the repair and the subsequent medical course of patients operated on malign nasal tumors
Shoemake, B M; Vander Ley, B L; Newcomer, B W; Heller, M C
The prevention of bovine respiratory disease complex (BRD) in beef cattle is important to maintaining health and productivity of calves in feeding operations. Determine whether BRD bacterial and viral pathogens are susceptible to the lactoperoxidase/hydrogen peroxide/iodide (LPO/H 2 O 2 /I - ) system in vitro and to determine whether the oral administration of sodium iodide (NaI) could achieve sufficient concentrations of iodine (I) in the respiratory secretions of weaned beef calves to inactivate these pathogens in vivo. Sixteen weaned, apparently healthy, commercial beef calves from the University of Missouri, College of Veterinary Medicine teaching herd. In vitro viral and bacterial assays were performed to determine susceptibility to the LPO/H 2 O 2 /I - system at varying concentrations of NaI. Sixteen randomly selected, healthy crossbred beef weanlings were administered 70 mg/kg NaI, or water, orally in a blinded, placebo-controlled trial. Blood and nasal secretions were collected for 72 hours and analyzed for I - concentration. Bovine herpesvirus-1, parainfluenza-3, Mannheimia haemolytica and Bibersteinia trehalosi were all inactivated or inhibited in vitro by the LPO/H 2 O 2 /I - reaction. Oral administration of NaI caused a marked increase in nasal fluid I concentration with a C max = 181 (1,420 μM I), T 12 , a sufficient concentration to inactivate these pathogens in vitro. In vitro, the LPO/H 2 O 2 /I - system inactivates and inhibits common pathogens associated with BRD. The administration of oral NaI significantly increases the I concentration of nasal fluid indicating that this system might be useful in preventing bovine respiratory infections. Copyright © 2018 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.
Gelardi, Matteo; Carbonara, Giuseppe; Maffezzoni, Enrico; Marvisi, Maurizio; Quaranta, Nicola; Ferri, Raffaele
To analyze nasal inflammation in a group of patients with obstructive sleep apnea syndrome (OSAS) by means of nasal cytology and to describe the changes induced by continuous positive air pressure (CPAP) treatment. Thirty-two consecutive patients affected by OSAS (mean age 46.9 years) and 13 control subjects (mean age 49.1 years) were enrolled. Detailed clinical, laboratory, and polysomnographic studies were obtained in all participants and, in particular, nasal cytology was performed; inflammatory cells (neutrophils, eosinophils, mast cells, lymphocytes), bacteria, and spores were counted. A subgroup of 19 OSAS patients underwent regular nasal CPAP for eight weeks while the remaining 13 were noncompliant. Nasal cytology was repeated after eight weeks in all patients and controls. All patients with OSAS were affected by some form of rhinopathy, mostly subclinical, which was not found to influence compliance to CPAP. Regular CPAP treatment induced a significant reduction of cell infiltration (neutrophils, eosinophils, lymphocytes, and muciparous cells), which was not seen in nontreated patients. Nasal inflammation/infection is a very frequent finding in OSAS and can be reverted by the regular use of CPAP. Copyright © 2012 Elsevier B.V. All rights reserved.
Mitra, Namita; Cernicchiaro, Natalia; Torres, Siddartha; Li, Feng; Hause, Ben M
Bovine respiratory disease (BRD) is the most costly disease affecting the cattle industry. The pathogenesis of BRD is complex and includes contributions from microbial pathogens as well as host, environmental and animal management factors. In this study, we utilized viral metagenomic sequencing to explore the virome of nasal swab samples obtained from feedlot cattle with acute BRD and asymptomatic pen-mates at six and four feedlots in Mexico and the USA, respectively, in April-October 2015. Twenty-one viruses were detected, with bovine rhinitis A (52.7 %) and B (23.7 %) virus, and bovine coronavirus (24.7 %) being the most commonly identified. The emerging influenza D virus (IDV) tended to be significantly associated (P=0.134; odds ratio=2.94) with disease, whereas viruses commonly associated with BRD such as bovine viral diarrhea virus, bovine herpesvirus 1, bovine respiratory syncytial virus and bovine parainfluenza 3 virus were detected less frequently. The detection of IDV was further confirmed using a real-time PCR assay. Nasal swabs from symptomatic animals had significantly more IDV RNA than those collected from healthy animals (P=0.04). In addition to known viruses, new genotypes of bovine rhinitis B virus and enterovirus E were identified and a newly proposed species of bocaparvovirus, Ungulate bocaparvovirus 6, was characterized. Ungulate tetraparvovirus 1 was also detected for the first time in North America to our knowledge. These results illustrate the complexity of the virome associated with BRD and highlight the need for further research into the contribution of other viruses to BRD pathogenesis.
Liu, Cindy M; Price, Lance B; Hungate, Bruce A
The human microbiome can play a key role in host susceptibility to pathogens, including in the nasal cavity, a site favored by Staphylococcus aureus. However, what determines our resident nasal microbiota-the host or the environment-and can interactions among nasal bacteria determine S. aureus......, their negative interactions depend on thresholds of absolute abundance. These findings demonstrate that nasal microbiota is not fixed by host genetics and opens the possibility that nasal microbiota may be manipulated to prevent or eliminate S. aureus colonization....
Sakamoto, Kikuo; Gondo, Kyujiro; Tomita, Kazuhide; Kasuya, Takao
Neurinoma grows in the modulated nerve with Schwann cells, and is observed for all positions of the body. It is comparatively rare for neurinoma to grow in the nasal cavity and paranasal sinuses, however. We report a case of neurinoma of the nasal septum. A 24-year-old man seen for nasal obstruction was found in anterior rhinoscopy to have a tumor of the bilateral nasal cavity. Computed tomography (CT) showed a soft tissue density mass in the anterior part of the nasal cavity. Because we suspected neurinoma from biopsy, we resected the tumor by Denker's operation under general anesthesia. We found that it originated from the nasal septum. Histopathological findings of the tumor indicated an Antoni A type neurinoma. After surgery, cartilago costalis was transplanted the plastic surgery to correct the defect in the nasal septum. The post operative course was good and no signs of recurrence were seen. This is the 19th case found in the literature.
de Lange, J.; van den Akker, H.P.; van den Berg, H.; Richel, D.J.; Gortzak, R.A.T.
Central giant cell granuloma (CGCG) is a benign lesion of the jaws with a sometimes locally aggressive behaviour. The most common therapy is surgical curettage which has a high recurrence rate, especially in lesions with aggressive signs and symptoms (i.e. pain, paresthesia, root-resorption and
de Lange, Jan; van den Akker, Hans P.; van den Berg, Henk
Central giant cell granuloma (CGCG) is a benign lesion of the jaws with an unknown etiology. Clinically and radiologically, a differentiation between aggressive and non-aggressive lesions can be made. The incidence in the general population is very low and patients are generally younger than 30
Full Text Available Background and aims. The correlation between morphology of giant cells in peripheral granulomas of the jaws and the aggressive behavior of the lesion is unknown. This study investigated the correlation between the histopathologic features with demographic, gross and radiographic findings in giant cell granulomas. Materials and methods. In this analytical study, data from 23 cases of central giant cell granuloma (CGCG and 42 cases of peripheral giant cell granuloma (PGCG were analyzed, focusing on age, gender, location, and gross and radiographic features. For each patient, microscopic slides were assessed in terms of histologic features of giant cells and stroma. Results. No significant differences were found in the mean number of nuclei or the size of nuclei and giant cell distribution patterns between the jaws and genders in both lesions (P > 0.05. Correlation between the mean number of nuclei and age was positively significant and correlation between the size of nuclei and age was negatively significant (P 0.05. Conclusion. There were correlations between the mean number of nuclei per giant cell and the size of the lesion and age, and between the size of nuclei and size of the lesion. No relation was observed between histopathologic and radiographic features.
Awadhesh Kumar Singh
Full Text Available The pyogenic granuloma, one of the gingival lesions, has recurrence rate of 16%. To minimize the recurrence rate, it must be completely excised. Complete surgical excision can result in residual gingival defect. McCrea repaired residual gingival defect by subepithelial connective tissue graft with lateral mucogingival pedicle flap, and Choudhary et al. managed residual gingival defect by subepithelial connective tissue graft only. The aim of this case report was to use lateral pedicle graft for repair of residual gingival defect following complete surgical excision of a pyogenic granuloma. A patient with pyogenic granuloma on labial surface of maxillary central incisors was treated by complete surgical excision, and residual gingival defect was repaired by lateral pedicle graft. A lateral pedicle graft was raised as full-thickness up to mucogingival line and partial-thickness apical to mucogingival line from the left side of residual gingival defect. After 6 months, no recurrence was noticed. Thus, lateral pedicle graft can be potentially used for repair of residual gingival defect following complete surgical excision of a pyogenic granuloma.
Truschnegg, Astrid; Acham, Stephan; Kqiku, Lumnije; Beham, Alfred; Jakse, Norbert
This article reports the CO2 laser excision of a pyogenic granuloma related to dental implants and reviews the current literature on this pathology in association with dental implants. Five publications describe pyogenic granulomas related to dental implants, and a further one describes the removal of such a lesion with an Er:YAG laser; removal with a CO2 laser is not reported. A 67-year-old male patient presented with a hyperplastic gingival lesion around two implants in the left lower jaw. The hyperplastic tissue was removed with a CO2 laser (Lasram; model OPAL 25, 25 W continuous wave, 10.600 nm, gas laser), and a vestibuloplasty was performed. The excised tissue was examined histopathologically. The patient was followed up after 4 weeks, 6 weeks, 6 months, and 1 year, and a panoramic X-ray was also made. There were no complications during surgery or follow-up. The panoramic X-ray taken 1 year after excision showed neither vertical bone loss nor impaired osseointegration of the implant. Histopathology reported a pyogenic granuloma. After vestibuloplasty, the height of the fixed mucosa was satisfactory. The CO2 laser seems to be a safe and appropriate tool for removal of a pyogenic granuloma in close proximity to dental implants. The laser parameters must, however, be chosen carefully and any additional irritants should be excluded to prevent a recurrence.
Ghimire, Anand; Das, Balabhadra Prasad; Mishra, Subhash Chandra
This prospective randomized case controlled study was conducted to determine the efficacy of antihistamine (azelastine) nasal spray and compare it to steroid (beclomethasone) nasal spray on the symptoms of allergic rhinitis. Seventy five symptomatic patients of allergic rhinitis were included in this study. Diagnosis was made on the basis of history and physical examination. The patients were divided into three groups randomly. Group A was treated with Azelastine nasal spray, Group B was treated with Beclomethasone nasal spray and Group C was control group and only treated with steam inhalation. Efficacy of the treatment was assessed in the terms of Total Rhinitis Symptom Complex (TSC) scores and individual symptom score which was calculated on the basis of Okuda's grading system. Base line total symptom complex (TSC) scores were reduced in group A and group B by 84.0% after 4 week treatment whereas in group C it was reduced by only 38.0%. Decrease in mean score for sneezing was 95.0% in group A and group B whereas it was only 28.3% in group C. Similarly decrease in mean score for rhinorrhoea in azelastine group was 94.4% and in beclomethasone group was 95.3% in comparison to steam inhalation group where it was 25.0%. Only the beclomethasone reduced nasal stuffiness score significantly by 95.0%. No significant adverse effects of the drugs were observed. The present study establishes the relative efficacy and tolerability ofazelastine nasal spray as compared to beclomethasone nasal spray in symptomatic patients of allergic rhinitis.
Jun Wook Lee
Full Text Available Background Pathogens in the nasal cavity during nasal surgery could lead to a systemicinfectious condition, such as bacteremia, nosocomial infection, or toxic shock syndrome.However, there is no research about the prevalence of nasal carriage in patients with nasalbone fracture.Methods This was a prospective, double-blind, randomized study about the rate of nasalcarriage in 200 patients with nasal bone fracture in Korea. Nasal secretions were taken fromboth the middle nasal meatus and colonized. All analyses were carried out using SPSS software.Results Pathogens were identified in 178 of the 200 cases. Coagulase-negative staphylococci(CNS were the most cultured bacteria in 127 (66.84% of the 190 total patients after excluding10 cases of contaminated samples, and methicillin-resistant coagulase-negative staphylococci(MRCNS were found in 48 (25.26%. Staphylococcus aureus was the second mostidentified pathogen, found in 36 (18.95%, followed by 7 cases (3.68% of methicillin-resistantStaphylococcus aureus (MRSA. The prevalence rate of MRSA in the females was higher thanthat in the males (RR=4.70; 95% CI, 1.09-20.18, but other demographic factors had no effecton the prevalence rate of MRSA and MRCNS.Conclusions The prevalence rate of these pathogens in patients with nasal bone fracture inKorea was similar to other reports. However, few studies have addressed the prevalence rateof CNS and MRCNS in accordance with risk factors or the change in prevalence according tospecific prophylaxis against infectious complications. Additional research is needed on thepotential connections between clinical factors and microbiological data.
Mauren P. Rocha
Full Text Available As neoplasias nasais são bastante raras. Os tumores mais observados na cavidade nasal são papilomas epiteliais, angiomas, carcinoma de células transicionais, carcinoma pavimentoso e adenocarcinoma. O adenoma pleomórfico pertence ao grupo de tumores que aparecem com menor freqüência na fossa nasal, e é o tumor benigno glandular mais comum originado na cabeça e pescoço. A apresentação clínica típica dos pacientes com adenoma pleomórfico do septo nasal é de obstrução nasal unilateral, epistaxe e massa indolor na cavidade nasal. Em vista da raridade da apresentação clínica do adenoma pleomórfico nesta localização, os autores descrevem um caso de adenoma pleomórfico nasal em um paciente do sexo masculino, com 69 anos de idade, onde relatam os achados clínicos, critérios diagnósticos, tratamento, prognóstico e revisão da literatura.Nasal tumours are very rare. The neoplasms most frequently seen in the nasal cavity are epithelial papillomas, angiomas, transitional cells carcinoma, pavement carcinoma and adenocarcinoma. The pleomorphic adenoma belongs to the group of tumours less commonly observed in the nasal cavity, and is the most common head and neck benign glandular tumour. The typical clinical presentation of the nasal pleomorphic adenoma is of unilateral nasal obstruction, epistaxis and a painless mass in the nasal cavity. The authors reported an adenoma pleomorphic case that highlights itself by its unusual nasal presentation in the nasal septum of a 45-year-old male patient who was submitted to surgical treatment, and discuss the clinical findings, diagnostic criteria, treatment, prognosis and literature review.
Bergfors, Elisabet; Hermansson, Göran; Nyström Kronander, Ulla; Falk, Lars; Valter, Lars; Trollfors, Birger
The frequency of long-lasting, intensely itching subcutaneous nodules at the injection site for aluminium (Al)-adsorbed vaccines (vaccination granulomas) was investigated in a prospective cohort study comprising 4,758 children who received either a diphtheria-tetanus-pertussis-polio-Haemophilus influenzae type b vaccine (Infanrix®, Pentavac®) alone or concomitant with a pneumococcal conjugate (Prevenar). Both vaccines were adsorbed to an Al adjuvant. Altogether 38 children (0.83 %) with itching granulomas were identified, epicutaneously tested for Al sensitisation and followed yearly. Contact allergy to Al was verified in 85 %. The median duration of symptoms was 22 months in those hitherto recovered. The frequency of granulomas induced by Infanrix® was >0.66 % and by Prevenar >0.35 %. The risk for granulomas increased from 0.63 to 1.18 % when a second Al-adsorbed vaccine was added to the schedule. Long-lasting itching vaccination granulomas are poorly understood but more frequent than previously known after infant vaccination with commonly used diphtheria-tetanus-pertussis-polio-Haemophilus influenzae type b and pneumococcal conjugate vaccines. The risk increases with the number of vaccines given. Most children with itching granulomas become contact allergic to aluminium. Itching vaccination granulomas are benign but may be troublesome and should be recognised early in primary health care to avoid unnecessary investigations, anxiety and mistrust.
Balaji Babu Bangi
Full Text Available Lesions of non-endodontic origin may mimic periapical pathosis. Errors in one or more of the clinical reasoning steps of diagnosis of such lesions may ultimately lead to misdiagnosis and ensuing complications. Central giant cell granuloma (CGCG is one such lesion of non-endodontic origin which can present as periapical pathosis. Here, we present a case of CGCG in a 33-year-old female patient who visited our department with a complaint of growth from the extraction sockets of upper front teeth, which were extracted 1 month back after a misdiagnosis as periapical pathosis. Suspecting a non-endodontic lesion, radiographic examination and incisional biopsy were performed and a final diagnosis of CGCG was made. Biweekly intra-lesional steroids were given for 6 weeks and patient was followed up for 6 months.
Bhrugesh J Panseriya
Full Text Available A diverse group of the pathologic process can produce the enlargement of soft tissues in the oral cavity and often present a diagnostic challenge. This soft tissue enlargement may represent a variation of the normal anatomic structure, inflammatory reaction, cyst, neoplasm, and developmental anomalies. A group of reactive hyperplasias, which develop in response to chronic recurring tissue injury that stimulates an excessive tissue repair response. The pyogenic granuloma (PG is a reactive enlargement that is an inflammatory response to local irritation such as calculus, a fractured tooth, rough dental restoration, and foreign materials or hormonal (pregnancy tumor and rarely associated with bone loss. This paper presents a rare case of PG associated with periodontal abscess and bone loss in a 30-year-old male.
Full Text Available Skin is well recognized as an important somatic mirror of one′s emotion and a site for the discharge of one′s anxieties. We present a case of a 42-year-old female patient presenting with a vague history of generalized body pain and skin lesions in the form of cotton threads buried under the skin, crusted plaque, multiple keloids and rusted pin buried through the skin mostly in the easily accessible areas of the body. Histopathology from the crusted plaque revealed foreign body granuloma. To satisfy her psychological or emotional need, it is the deliberate and conscious production of self-inflicted skin lesions through overvalued ideation of acupuncture on her part.
Full Text Available Giant cell granulomas of the jaws are rather common in [rail, however, more reliable data need to be published In this retrospecti ve study 1,083 cases ojPGCO and CGCG (817 peripheral and 203 central were extracted from 6800 oral biopsy archives of the Oral Pathology Department and were analyzed: Age and sex ofthe patients and type and location distribution were obtained Our results show that most cases ofPGCG and CGCG occurred before"nthe fifth and during fourth decade, respectively. Slight predominance offemales was notedfor both types. Mandible wa~ often more affected (60.3%, especially in the premolarmolar region. The results obtained in this study were in agreement with other independent reports.
Wahl, R U; Wurpts, G; Merk, H F
Aluminium salts are common adjuvants in all established inactivated vaccines. They are necessary to activate the humoral immune system. In the 1990s a Swedish study on an acellular vaccination against pertussis was started. Until 2013, 745 of 760,000 children with pruritic subcutaneous nodules were identified. In 77 % of these children a contact allergy to aluminium could be proven. Contact allergy to aluminium induced by vaccines causes pruritic subcutaneous nodules at the vaccination site. During infections of the upper respiratory tract the pruritus often escalates with inflammatory, erythematous and urticarial plaques. The use of solutions containing aluminium salts for specific immunotherapy is contraindicated in the case of contact allergy to aluminium. Intramuscular injections of inactivated vaccines can be employed to avoid granuloma formation.
Full Text Available An influenza vaccination often causes local reactions, such as induration and erythema at the injection site, and occasionally systemic reactions. The association between these reactions and influenza vaccinations has not been fully recognized. By contrast, granuloma annulare (GA is an idiopathic, palisaded, granulomatous condition, and has some clinical variants, including localized, generalized, perforating, and subcutaneous types. We report a 76-year-old woman, who was suffering from a tender subcutaneous nodule on her left upper arm. One month before, she had just received influenza vaccination on the same area. Histological analysis demonstrated that subcutaneous tissue contained numerous large areas of necrosis, surrounded by palisaded epithelioid histiocytes. We diagnosed our case as a subcutaneous type of GA following influenza vaccination. To our knowledge, this is the first report of GA associated with influenza vaccination.
Marshall W. Meeks
Full Text Available Pyogenic granuloma (PG, more accurately known as lobular capillary hemangioma, is a benign vascular tumor that usually occurs in the skin or oral mucosa. This lesion is rarely reported in the gastrointestinal tract but is known to bleed if not resected. We herein describe a case series with the clinical, endoscopic, and histologic findings of four cases of gastrointestinal PG at our institution. In addition, we provide a review of the literature and summation of all reported cases of PG specific to the gastrointestinal tract. Based on our experience, we suggest that the actual incidence of gastrointestinal PG may in fact be higher than reported because PG can be unrecognized or improperly diagnosed. It is important for the clinician to properly recognize this lesion as a source of anemia and its propensity to bleed during biopsy or resection.
Ozyurek Seyfi C
Full Text Available Abstract Introduction Central nervous system involvement is a rare but serious manifestation of brucellosis. We present an unusual case of neurobrucellosis with transient ischemic attack, intracerebral vasculopathy granulomas, seizures, and paralysis of sixth and seventh cranial nerves. Case presentation A 17-year-old Caucasian man presented with nausea and vomiting, headache, double vision and he gave a history of weakness in the left arm, speech disturbance and imbalance. Physical examination revealed fever, doubtful neck stiffness and left abducens nerve paralysis. An analysis of his cerebrospinal fluid showed a pleocytosis (lymphocytes, 90%, high protein and low glucose levels. He developed generalized tonic-clonic seizures, facial paralysis and left hemiparesis. Cranial magnetic resonance imaging demonstrated intracerebral vasculitis, basal ganglia infarction and granulomas, mimicking the central nervous system involvement of tuberculosis. On the 31st day of his admission, neurobrucellosis was diagnosed with immunoglobulin M and immunoglobulin G positivity by standard tube agglutination test and enzyme-linked immunosorbent assay in both serum and cerebrospinal fluid samples (the tests had been negative until that day. He was treated successfully with trimethoprim and sulfamethoxazole, doxycyline and rifampicin for six months. Conclusions Our patient illustrates the importance of suspecting brucellosis as a cause of meningoencephalitis, even if cultures and serological tests are negative at the beginning of the disease. As a result, in patients who have a history of residence or travel to endemic areas, neurobrucellosis should be considered in the differential diagnosis of any neurologic symptoms. If initial tests fail, repetition of these tests at appropriate intervals along with complementary investigations are indicated.
P Mahesh Shanmugam
Full Text Available Wide field fundus imaging is needed to diagnose, treat, and follow-up patients with retinal pathology. This is more applicable for pediatric patients as repeated evaluation is a challenge. The presently available imaging machines though provide high definition images, but carry the obvious disadvantages of either being costly or bulky or sometimes both, which limits its usage only to large centers. We hereby report a technique of fundus imaging using a nasal endoscope coupled with viscoelastic. A regular nasal endoscope with viscoelastic coupling was placed on the cornea to image the fundus of infants under general anesthesia. Wide angle fundus images of various fundus pathologies in infants could be obtained easily with readily available instruments and without the much financial investment for the institutes.
Acute and chronic upper respiratory conditions are common and expensive disorders with enormous impact on patient quality of life and society at large. Saline nasal irrigation (SNI), a therapy with roots in Ayurvedic medicine that bathes the nasal mucosa with in spray or liquid saline, has been used as adjunctive care for upper respiratory conditions. In liquid form, SNI has been found to be effective adjunctive care by the Cochrane Collaboration for symptoms associated with chronic rhinosinusitis. Less conclusive clinical trial evidence supports its use in spray and liquid forms as adjunctive treatment for mild-to-moderate allergic rhinitis and acute upper respiratory infections. Consensus or expert opinion recommendations exist for SNI as a treatment for a variety of other conditions including rhinitis of pregnancy. SNI appears safe; side effects are minimal and transient. It can be recommended by clinicians to interested patients with a range of upper respiratory conditions in the context of patient education and printed instructional handouts. PMID:19904896
Kang, Haihong; Yan, Mengfei; Yu, Qinghua; Yang, Qian
The nasal mucosa is involved in immune defense, as it is the first barrier for pathogens entering the body through the respiratory tract. The nasal cavity-associated lymphoid tissue (NALT), which is found in the mucosa of the nasal cavity, is considered to be the main mucosal immune inductive site in the upper respiratory tract. NALT has been found in humans and many mammals, which contributes to local and systemic immune responses after intranasal vaccination. However, there are very few data on NALT in avian species, especially waterfowl. For this study, histological sections of the nasal cavities of Cherry Valley ducks were used to examine the anatomical location and histological characteristics of NALT. The results showed that several lymphoid aggregates are present in the ventral wall of the nasal cavity near the choanal cleft, whereas several more lymphoid aggregates were located on both sides of the nasal septum. In addition, randomly distributed intraepithelial lymphocytes and isolated lymphoid follicles were observed in the regio respiratoria of the nasal cavity. There were also a few lymphoid aggregates located in the lamina propria of the regio vestibularis, which was covered with a stratified squamous epithelium. This study focused on the anatomic and histological characteristics of the nasal cavity of the duck and performed a systemic overview of NALT. This will be beneficial for further understanding of immune mechanisms after nasal vaccination and the development of effective nasal vaccines for waterfowls. Copyright © 2014 Wiley Periodicals, Inc.
Full Text Available Ricardo Reis Dinardi, Cláudia Ribeiro de Andrade, Cássio da Cunha Ibiapina Department of Pediatrics, Pediatric Pulmonology Unit, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil Abstract: Our goal was to revise the literature about external nasal dilators (ENDs as to their definition, history, and current uses. We reviewed journals in the PubMed and MEDLINE databases. The current uses hereby presented and discussed are physical exercise, nasal congestion and sleep, snoring, pregnancy, cancer, and healthy individuals. Numerous studies have shown that ENDs increase the cross-sectional area of the nasal valve, reducing nasal resistance and transnasal inspiratory pressure and stabilizing the lateral nasal vestibule, avoiding its collapse during final inspiration. These effects also facilitate breathing and are beneficial to patients with nasal obstruction. Furthermore, END use is simple, noninvasive, painless, affordable, and bears minimum risk to the user. Most studies have limited sample size and are mainly focused on physical exercise. In conclusion, ENDs seem useful, so further studies involving potential effects on the performance of physical tests and improvements in sleep quality are necessary, especially in children and teenagers. Keywords: external nasal dilator, nasal valve, nasal congestion, nasal resistance
This present study intended to provide nasal adhesive formulations for the topical treatment of dry nasal syndrome. Mucoadhesive films were prepared according to solvent evaporation method consisting of well-known polymers such as gellan and carboxymethyl cellulose. Mucoadhesive films (A-E) were evaluated in respect to their physicochemical properties, stability, disintegration behavior and tensile strength. Moreover, uptake capacity of adhesive films was investigated according to three assays vapor uptake/ permeability and water uptake. Mucoadhesive assessment was carried out on porcine nasal mucosa in terms of adhesion time, wash off resistance and spreadability. Obtained finings indicated 4.2 (B) > 2.55 (A) > 1.8 (D) > 1.3 (C) > 1(E) fold vapor uptake ranking. The bioadhesive results indicated a 60-fold (B) > 8.58-fold (C) > 7.42-fold (E) > 1.3-fold (D) improvement in comparison to formulation A. A variety of humectants such as urea, Aloe vera, allantoin and hyaluronic acid was incorporated in the formulations. Taken together, nasal adhesive films convinced with their proficiency of mucoadhesiveness and stability to be suitable in the management of dry nasal syndrome. Copyright © 2018 Elsevier B.V. All rights reserved.
Nguyen, Van Thai; Lehes, Lagle; Truong, Thi Thuy Hang; Hoang, Thi Van Anh; Jagomägi, Triin
The Nasometer is increasingly being used to complement auditory perceptual assessment of nasality. Nasalance scores which are obtained from the Nasometer vary across languages. Normative nasalance scores have been established for many languages but not for the Vietnamese language. The objective of this study was to obtain the normative nasalance scores for Vietnamese-speaking children. In this study, 102 healthy Vietnamese children speaking in the central regional dialect aged from 7 to 9 years (45 boys, 57 girls; mean age = 7.5 years) at a primary school in Hue, Vietnam participated. Three speech stimuli, which were specific for the Vietnamese language, were designed: oral stimuli (19 words and 18 sentences), oro-nasal stimuli (eight sentences) and nasal stimuli (seven sentences). The children were asked to repeat these stimuli after the examiner. The Nasometer II (model 6450) was used to obtain the nasalance scores. The procedure took about 10 minutes for each child. The mean nasalance scores and the standard deviation of each stimulus were: 13.1 ± 5.8 (oral stimuli), 30.7 ± 6.6 (oro-nasal stimuli) and 56.9 ± 9.2 (nasal stimuli). No significant differences between the genders were found. The normative nasalance scores provide essential reference information for clinicians who deal with nasalance disorders, especially patients with cleft palate. The nasalance scores in this study were established for Vietnamese children speaking in the central regional dialect and can be applied to both genders.
Full Text Available Septoplasty is one of the most commonly performed surgeries in rhinology to relieve nasal obstruction of patients with distortion in the midline cartilage or septum of the nose to relieve nasal obstruction of patient and findings consistent with nasal endoscopy. The anterior nasal packing routinely done following septoplasty is usually conventional and not evidence based. The purpose of nasal packing is to obtain haemostasis, enhance opposition of septal flaps, avoid septal haematoma formation, close the dead space, avoid synechiae formation, provide support to septal cartilage and prevent its displacement. OBJECTIVE This study intends to evaluate the effects of nasal packing on surgical success and related complications in septoplasty. MATERIALS AND METHODS The present clinical prospective and randomised study was carried out on patients attending Otorhinolaryngology Department of Santhiram Medical College & General Hospital between March 2012 and March 2015. Patients undergoing septoplasty were randomised either to receive anterior nasal packing or to not receive nasal packing postoperatively. RESULTS Levels of pain experienced by patients with nasal packing postoperatively during the initial 24 hours postoperatively and during the removal of the pack were significantly more. Post-operative headache, epiphora, swallowing discomfort and sleep disturbance were more in patients with nasal packing and statistically (p.05. Septal haematoma, adhesions and local infections in both groups were statistically insignificant (p>.05. CONCLUSION Septoplasty enhances the standard of living of patients with septal deviation and nasal obstruction. Our study results suggest that nasal packing after septoplasty is not obligatory. Nasal packing causes considerably more pain and complications, and it should be reserved only for those who have bleeding predisposition.
José Wilson Noleto
Full Text Available OBJETIVO: Este estudo teve como objetivo avaliar os principais aspectos radiográficos e epidemiológicos das lesões de células gigantes (granulomas centrais de células gigantes e tumores marrons do hiperparatireoidismo. MATERIAIS E MÉTODOS: A amostra consistiu de 26 lesões de células gigantes diagnosticadas em 22 pacientes divididos em dois grupos, um deles composto por 17 pacientes que não tinham hiperparatireoidismo (grupo A e o outro formado por cinco pacientes portadores de tal distúrbio (grupo B. RESULTADOS: O sexo feminino (72,7% foi o mais acometido. As lesões ocorreram mais freqüentemente na segunda década de vida, com média de idade de 27 anos. A mandíbula (61,5% foi o arco mais envolvido. Radiograficamente, 57,7% das lesões eram multiloculares e 42,3% eram uniloculares com limites definidos. Todas as 26 lesões provocaram expansão óssea, 15,4% produziram reabsorção radicular, 50% causaram deslocamento dentário e 11,5% produziram dor. Na mandíbula, 18,7% das lesões cruzavam a linha média. O grupo A apresentou 66,7% das lesões na mandíbula e o grupo B mostrou igualdade na distribuição das lesões entre os arcos. O grupo A apresentou 66,7% das lesões multiloculares e 33,3%, uniloculares. O grupo B apresentou 62,5% das lesões uniloculares e 37,5%, multiloculares. CONCLUSÃO: As lesões de células gigantes podem manifestar-se, radiograficamente, com um amplo espectro, desde pequenas lesões uniloculares de crescimento lento até extensas lesões multiloculares. Elas apresentam características de benignidade, embora algumas lesões possam demonstrar um comportamento localmente agressivo.OBJECTIVE: The present study was aimed at evaluating main radiological and epidemiological aspects of giant cell lesions (central giant cell granuloma and brown tumors of hyperparathyroidism. MATERIALS AND METHODS: The sample consisted of 26 giant cell lesions diagnosed in 22 patients divided into two groups, one of them
Carlos Giraldo M.
Full Text Available Se describe un caso de plasmocitoma nasal en un canino, macho entero, de raza Akita de 30 Kg de peso y veintiún meses de edad, con historia de epistaxis unilateral crónica. Se practicó examen clínico y biopsia de la neoplasia visible en la cavidad nasal izquierda. La ubicación y extensión del tumor fue determinada mediante tomografía computarizada de cabeza y cuello. Se realizaron análisis histopatológico e inmunohistoquímico (IHQ del tejido tumoral. La tomografía computarizada evidenció una masa con densidad de tejido blando de 10 cm de longitud x 3.5 cm de diámetro y escasa captación de medio de contraste, que comprometía en su totalidad la cavidad nasal derecha y parte de la porción posterior de la coana izquierda. El análisis histopatológico reveló numerosas células redondas pleomórficas con poco citoplasma, rodeadas por trama escasa de tejido conectivo y bajo índice mitótico. En el examen IHQ la muestra fue negativa a los antígenos CD3 y CD20 para linfocitos T y B, respectivamente. Los hallazgos clínicos y de la tomografía computarizada, así como los resultados del análisis histopatológico del tejido tumoral, fueron compatibles con un plasmocitoma extramedular nasal de bajo grado de malignidad.
Faris, Callum; Vuyk, Hade D
Reconstruction of nasal tip and columella defects is demanding area with a range of reconstructive options, varying in complexity depending on requirements from simple skin grafting to multiple stage reconstruction with regional flaps. A framework is suggested to aid the reader in choice of reconstruction by classifying the defect based on size and the requirements of one to three layer (full thickness) reconstruction. Copyright © 2011 Elsevier Inc. All rights reserved.
Genther, Dane J; Papel, Ira D
Rhinoplasty often requires the use of grafting material, and the goal of the specific graft dictates the ideal characteristics of the material to be used. An ideal material would be biologically inert, resistant to infection, noncarcinogenic, nondegradable, widely available, cost-effective, readily modifiable, and easily removable, have compatible biomechanical characteristics, retain physical properties over time, and not migrate. Unfortunately, no material currently in existence meets all of these criteria. In modern rhinoplasty, autologous grafts are the gold standard against which all other nasal implants are measured and offer the safest long-term results for most patients. They are easily manipulated, have inherent stability and biomechanical characteristics similar to the native nasal framework, and confer minimal risk of complications. Modern homologous and alloplastic materials have gained considerable support in recent years because they are readily available in endless quantity, do not require a second surgical site for harvest, and are generally considered safe if most circumstances, but they confer additional risk and have biomechanical characteristics different from that of the native nasal framework. To address some of these issues, we provide a contemporary review of autologous, homologous, and alloplastic materials commonly used in rhinoplasty surgery. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Abdel-Aziz, Mosaad; El-Bosraty, Hussam; Qotb, Mohamed; El-Hamamsy, Mostafa; El-Sonbaty, Mohamed; Abdel-Badie, Hazem; Zynabdeen, Mustapha
Nasal encephalocele may presents as a nasal mass, its treatment is surgical and it should be done early in life. When removal is indicated, there are multiple surgical approaches; including lateral rhinotomy, a transnasal approach and a coronal flap approach. However, the treatment of a basal intranasal encephalocele using transnasal endoscopic approach could obviates the possible morbidity associated with other approaches. The aim of this study was to evaluate the efficacy of endoscopic removal of intranasal encephalocele, also to document the role of anesthetist in the operative and postoperative periods. Nine cases with nasal encephalocele were included in this study; CT and/or MRI were used in their examination. The lesions were removed via transnasal endoscopic approach. Preoperative evaluation, intervention and postoperative follow-up were presented with discussion of anesthesia used for those children. The lesions of all patients were removed successfully with no recurrence through the follow-up period of at least 21 months. No cases showed morbidity or mortality intra- or post-operatively. Endoscopic excision of intranasal encephalocele is an effective method with high success rate. Anesthetist plays an important role in the operative and postoperative period, even during the endoscopic follow up; sedation of the children is usually needed. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.
Park, Dae Woong; Park, Ji Yeon; Park, Noh Hyuck; Kim, Seon Jeong; Shin, Hyuck Jai; Lee, Jeong Ju [Myongji Hospital, Seonam University College of Medicine, Goyang (Korea, Republic of); Yi, Seong Yoon [Div. of Hematology-Oncology, Dept. of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang (Korea, Republic of)
Charcoal remains stable without causing a foreign body reaction and it may be used for preoperative localization of a non-palpable breast mass. However, cases of post-charcoal-marking granuloma have only rarely been reported in the breast, and a charcoal granuloma can be misdiagnosed as malignancy. Herein, we report the ultrasound, computed tomography (CT), 18F-fluorodeoxyglucose-positron emission tomography/CT, and breast-specific gamma imaging findings of recurrence-mimicking charcoal granuloma after breast conserving surgery, following localization with charcoal in a breast cancer patient.
Webb, S M; Grillo, V L
An 8-year-old desexed male Burmese cat, which lived on a sheep-grazing property in central New South Wales, Australia, was presented following the sudden onset of dyspnoea, moist coughing and violent sneezing. The respiratory distress started several hours after the cat had made an outdoor excursion. Anterior rhinoscopy demonstrated small, white objects moving across oedematous and moderately inflamed nasal mucosa. These were retrieved via a series of vigorous nasal flushes and subsequently identified as larvae of the nasal bot fly, Oestrus ovis. The cat was treated with ivermectin followed by selamectin 7 days later. It went on to make a complete recovery over 2-3 weeks. © 2010 The Authors. Australian Veterinary Journal © 2010 Australian Veterinary Association.
Kumar, Suman; Basu, Shriya; Sinha, Anisha; Chatterjee, Indranil
The purpose of this study was to analyze resonance characteristics (nasality and nasalance values) during the menstrual cycle. Previous studies indicate changes in voice quality and nasal mucosa due to temporary falling estrogen levels in human females during their menstrual cycle. The present study compared the nasality and "nasalance scores"…
Nasal congestion due to the common cold occurs because of dilation of the blood vessels, leading to swelling of the nasal mucosal epithelium. This narrows nasal passages, which are further blocked by increased mucus production. Nasal sprays and drops are often recommended for the treatment of rhinorrhoea and nasal ...
Fernandez-Alvarez, Jose Ramon; Gandhi, Rashmi Shreyans; Amess, Philip; Mahoney, Liam; Watkins, Ryan; Rabe, Heike
Despite the paucity of evidence, the practice of weaning nasal continuous positive airway pressure (NCPAP) is widespread. However, the most clinically effective non-invasive ventilatory support strategy remains to be determined. We compared the outcome of very premature infants with respiratory distress syndrome treated with a combination of NCPAP and heated humidified high-flow nasal cannula (HHFNC) versus NCPAP and low-flow nasal cannula (LFNC). Between 2004 and 2008, patients ≤28 weeks of gestation and nasal bridge lesions compared to none on HHFNC. Respiratory and non-respiratory outcome was not significantly different otherwise. Combination of NCPAP and HHFNC reduced costs by 33 %. HHFNC shortens NCPAP time without increasing overall length of non-invasive respiratory support in very preterm infants. Unlike NCPAP, HHFNC does not seem to increase the risk of nasal trauma and appears to improve cost-effectiveness whilst producing otherwise equal respiratory and non-respiratory outcomes.
Chur, Victor; Small, Catherine B; Stryszak, Paul; Teper, Ariel
Mometasone furoate nasal spray (MFNS) improves nasal symptoms and reduces polyp size in adults with nasal polyposis. This 4-month, multinational, randomized, double-blind study was conducted to assess the safety of MFNS in pediatric subjects aged 6-17 yr. Subjects aged 6-11 yr with bilateral nasal polyps received MFNS 100 μg once or twice daily or placebo; those aged 12-17 yr received MFNS 200 μg once or twice daily or placebo. End-points included change in 24-h urinary free cortisol (primary), change in 24-h urinary free cortisol corrected for creatinine (key secondary), and adverse events. Efficacy parameters included polyp size, nasal symptoms, and investigator-evaluated therapeutic response, although the study was not powered for statistical analysis of efficacy. Least squares baseline mean urinary free cortisol level (nmol/24 h) for both age groups combined (N = 127) was 49.5 in the MFNS once-daily group, 39.6 in the MFNS twice-daily group, and 49.8 in the placebo group. Change in 24-h urinary free cortisol did not significantly differ among MFNS- and placebo-treated subjects. Least squares mean 24-h urinary free cortisol levels corrected for creatinine also showed no significant differences among MFNS- and placebo-treated subjects. No safety issues emerged. Results of this study confirm the safety profile of MFNS in pediatric patients with bilateral nasal polyps over 4 months, even at double the recommended pediatric dosage for allergic rhinitis. © 2012 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.
Rasmussen, TT; Kirkeby Nielsen, LP; Poulsen, Knud
that of the pharynx, and that the nasal cavity is a primary habitat for several species of diphtheroids recognized as opportunistic pathogens. Under special circumstances, single species, including IgA1 protease-producing bacteria, may become predominant in a restricted area of the nasal mucosa.......Recent evidence strongly suggests that the microbiota of the nasal cavity plays a crucial role in determining the reaction patterns of the mucosal and systemic immune system. However, little is known about the normal microbiota of the nasal cavity. The purpose of this study was to determine...... the microbiota in different parts of the nasal cavity and to develop and evaluate methods for this purpose. Samples were collected from 10 healthy adults by nasal washes and by swabbing of the mucosa through a sterile introduction device. Both methods gave results that were quantitatively and qualitatively...
Full Text Available The nasal polyposis is a chronic inflammatory process of the nasal mucosa. Although it is rare in children, there may be also association with cystic fibrosis and primary ciliary dyskinesia. About 50% of primary ciliary dyskinesia patients develop situs inversus and it is known as Kartagener's syndrome. The Kartagener's sydrome is a rare autosomal recessive disorder characterized by sinusitis, bronchiectasis, situs inversus. Clinically, patients present to the otolaryngologist with nasal obstruction. We as pediatricians, should consider nasal polyposis as a rare cause of nasal obstruction in children. In the presence of recurrent upper and lower respiratory tract infections accompanying nasal polyposis, Kartagener's syndrome must be kept in mind as a rare reason. [Cukurova Med J 2014; 39(4.000: 942-945
Espefält Westin, Ulrika
Nasal administration of analgesics for achieving rapid pain relief is currently a topic of great interest. The blood-brain barrier (BBB) restricts access to the central nervous system (CNS) for several central-acting drugs, such as morphine and dihydroergotamine, which results in a substantial effect delay. Evidence for the olfactory transfer of drugs from the nasal cavity to the CNS after nasal administration, bypassing the BBB, is available for both animals and humans. The aims of this thes...
Soltan, Michelle; Kacker, Ashutosh
We describe the case of a 76-year-old man who presented with symptoms of chronic nasal obstruction and recurrent sinusitis of many years' duration. The patient's history and radiographic findings established a diagnosis of a complex odontoma of the nasal cavity. The mass was surgically excised, and the diagnosis was confirmed by histopathology. The occurrence of an odontoma in the nasal cavity is extremely rare.
Zhen, Hongtao; Gao, Qixue; Cui, Yonghua; Hua, Xiaoyang; Li, Huiqin; Feng, Jiane
To assess the value of oxymetazoline used in nasal endoscopic sinus surgery (ESS). The effect of oxymetazoline on 68 patients pulse, cilium mottom and rebound phenomenon during ESS were observed. Pulse and cilium motion are no significant difference after using oxymetazoline. Oxymetazoline reduces about 59% nasal mucosal blood flow and acts over 6 hours. Oxymetazoline used as nasal decongestant and anesthesia assistant is safe and effect in ESS as routine.
Maslow, Jed; Hutzler, Lorraine; Cuff, Germaine; Rosenberg, Andrew; Phillips, Michael; Bosco, Joseph
Led by the federal government, the payers of health care are enacting policies designed to base provider reimbursement on the quality of care they render. This study evaluated and compared patient experiences and satisfaction with nasal decolonization with either nasal povidone-iodine (PI) or nasal mupirocin ointment (MO). A total of 1903 patients were randomized to undergo preoperative nasal decolonization with either nasal MO or PI solution. All randomized patients were also given 2% chlorhexidine gluconate topical wipes. Patients were interviewed prior to discharge to assess adverse events and patient experience with their assigned preoperative antiseptic protocol. Of the 1903 randomized patients, 1679 (88.1%) were interviewed prior to discharge. Of patients receiving PI, 3.4% reported an unpleasant or very unpleasant experience, compared with 38.8% of those using nasal MO (P.05). Being recruited as an active participant in surgical site infection prevention was a positive experience for 87.2% of MO patients and 86.3% of PI patients (P=.652). Those assigned to receive PI solution preoperatively reported significantly fewer adverse events than the nasal MO group (P<.01). Preoperative nasal decolonization with either nasal PI or MO was considered somewhat or very helpful by more than two-thirds of patients. Copyright 2014, SLACK Incorporated.
Full Text Available Introduction: Nasal provocation testing involves an allergen-specific local reaction of the nasal mucosa to the administered allergen. Aim: To determine the most objective nasal occlusion assessment technique that could be used in nasal provocation testing. Material and methods : A total of 60 subjects, including 30 patients diagnosed with allergy to common environmental allergens and 30 healthy subjects were enrolled into the study. The method used in the study was a nasal provocation test with an allergen, with a standard dose of a control solution and an allergen (5,000 SBU/ml administered using a calibrated atomizer into both nostrils at room temperature. Early-phase nasal mucosa response in the early phase of the allergic reaction was assessed via acoustic rhinometry, optical rhinometry, nitric oxide in nasal air, and tryptase levels in the nasal lavage fluid. Results : In estimating the homogeneity of the average values, the Levene’s test was used and receiver operating characteristic curves were plotted for all the methods used for assessing the nasal provocation test with an allergen. Statistically significant results were defined for p < 0.05. Of all the objective assessment techniques, the most sensitive and characteristic ones were the optical rhinometry techniques (specificity = 1, sensitivity = 1, AUC = 1, PPV = 1, NPV = 1. Conclusions : The techniques used showed significant differences between the group of patients with allergic rhinitis and the control group. Of all the objective assessment techniques, those most sensitive and characteristic were the optical rhinometry.
A Research of nasal methicillin resistant/sensitive Staphylococcus aureus and pharyngeal beta-haemolytic Streptococcus carriage in midwifery students in Kahramanmaras, Eastern Mediterranean Region of Turkey.
Benitez, Hector Hugo Salas; Arvizu, Victor Manuel Almeida; Gutiérrez, Daniel Jijón; Fogelbach, Guillermo Arturo Guidos; Castellanos Olivares, Antonio; Vázquez Nava, Francisco; Velázquez, Héctor Chong; González Pérez, Maria del Carmen; Mora Nieto, Alejandra; Rodríguez, Eduardo Castro
To compare the efficacy of nasal budesonide plus oral zafirlukast against nasal budesonide plus oral loratadine/pseudoephedrine combination in the control of symptoms of rhinitis and asthma. A controlled, clinical, randomized, double blind and crossover study was made in 36 patients with allergic rhinitis and asthma following one of the next treatment regimes: group a) nasal budesonide plus oral zafirlukast twice a day or group b) nasal budesonide plus oral loratadine/pseudoephedrine twice a day, both of them during six weeks, and two weeks of washing and crossover of the treatments during six more weeks. Changes in the rhinitis and asthma symptoms, blood eosinophils, pulmonary function testing, and nasal cytology were evaluated before and after the treatment. 19 patients were assigned to group a, whereas 17 patients to group b. The age ranged between 16 to 45 years, and it predominated the female group, 70 and 89%, respectively (statistically no significant). During the first six weeks of the treatment, V0 to V3, both groups of patients got better nasal symptoms but group a was superior to group b. However, in bronchial symptoms, cough, wheezing and breathlessness, group a showed efficacy in comparison with group b, where no significant improvement was shown. Once the crossover was made, from V5 to V7, there was no difference between both groups. The other evaluated indicators, such as eosinophilia, VEF1 and nasal eosinophils, had a significant improvement before and at the end of the study. The association of a nasal steroid with a leukotriene modifier (zafirlukast) was more effective for controlling nasal symptoms and especially bronchial symptoms than the association of a nasal steroid with antihistamines (loratadine) with pseudoephedrine. Other inflammation indicators, such as eosinophilia and nasal eosinophilia, were diminished; the VEF1 increased significantly in both treatment groups. All the above may be due to the nasal steroid use associated to a
Kieran, Emily A
To determine whether nasal continuous positive airway pressure (NCPAP) given with nasal prongs compared with nasal mask reduces the rate of intubation and mechanical ventilation in preterm infants within 72 hours of starting therapy.
Full Text Available In this prospective study, a quantitative determination of histamine and tryptase in nasal secretions after nasal phosphate buffered saline (PBS and allergen challenge was performed in 18 atopic patients who were compared with ten non-allergic healthy volunteers. The aim of the study was to determine the normal and pathological concentrations of these important mediators in nasal secretions. The second objective was to test the relevance of these two mast cell secreted mediators after nasal challenge. Results showed that the concentrations of tryptase in almost all samples were under the minimal detection limit (< 0.5 μU/g and only a sigrtificant increase of tryptase (median, 28 μU/g occurred immediately after nasal allergen challenge in the patient group. Histamine concentration significantly increased after every nasal PBS challenge (median, 69 ng/g after first PBS challenge and 165 ng/g after second PBS challenge in the control group, as well as in the patient group after both PBS (median, 69 ng/g and allergen (median, 214 ng/g challenge. On the other hand, a rapid onset of sneezing and increase in nasal airway resistance was experienced only in the patient group after nasal allergen challenge, but did not occur after PBS challenge even though the histamine concentrations significantly increased in both groups. This study suggests that tryptase is a more preferable marker than histamine in quantitative monitoring of mast cell activation especially during the early phase nasal allergic reaction.
Oswald, N. T. A.; Cater, D. B.
Serratia marcescens polysaccharide (endotoxin) was injected i.v. into rats bearing carrageenin-induced granulomas and transplanted hepatomas, and the vascular-permeability changes were studied by injecting Pelikan ink i.v. at various times after the endotoxin (or saline in the controls). When the ink was given at 0 or 1 hr. there was little difference between the treated rats and the controls. But when the ink was given 2 or more hr. after the endotoxin there was a marked increase of the carbon-lined capillaries and venules, compared with controls, in tumour, granuloma, glomeruli, adrenal cortex, lung, lymph-nodes and sometimes heart. The significance of these changes is discussed in relation to the Shwartzman phenomenon, Arthus reaction, and adrenaline-induced vascular spasm producing anoxia. ImagesFigs. 2-5Figs. 6-9 PMID:4304259
Schultz, B K; Palmieri, C; Nicolson, V; Larkin, R; Keeley, T; McGowan, M; Johnston, S D
This study reports the first documented clinical case of a spermatic granuloma and varicocele in a marsupial. Initial clinical presentation included gross morphological changes in the left scrotal cord, epididymis and testis. Ultrasonography of the scrotum and spermatic cord, and gross and histopathological examination after hemicastration, confirmed the condition as a spermatic granuloma affecting the left caput epididymis, with a varicocele in the left proximal spermatic cord, which was causing azoospermia and infertility. Semen quality and serum testosterone secretion following a GnRH challenge was assessed prior to, and following surgery. After hemi-castration, an increase in androgen secretion to within normal reference ranges for the koala was observed with a subsequent increase in semen production and sperm quality resulting in the sire of a pouch young, 12months later. Copyright © 2016 Elsevier Ltd. All rights reserved.