Subcutaneous granuloma annulare

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Dhar Sandipan

1994-01-01

Full Text Available Two cases of subcutaneos granuloma annulare are reported. Clinical presentation was in the form of hard subcutaneous nodules; histopathology confirmed the clinical diagnosis. The cases were unique because of onset in adult hood, occurrence over unusual sites and absence of classical lesions of granuloma annulare elsewhere.

Subcutaneous granuloma annulare

Directory of Open Access Journals (Sweden)

Dhar Sandipan

1993-01-01

Full Text Available Two cases of subcutaneous granuloma annulare are reported. Clinical presentation was in the form of hard subcutaneous nodules, histopathology confirmed the clinical diagnosis. The cases were unique because of onset in adult age, occurrence over unusual sites and absence of classical lesions of granuloma annulare elsewhere.

Total hip reconstruction in acetabular dysplasia : a finite element study

NARCIS (Netherlands)

Schüller, H.M.; Dalstra, M.; Huiskes, H.W.J.; Marti, R.K.

1993-01-01

In acetabular dysplasia, fixation of the acetabular component of a cemented total hip prosthesis may be insecure and superolateral bone grafts are often used to augment the acetabular roof. We used finite element analysis to study the mechanical importance of the lateral acetabular roof and found

CUSTOMIZED ACETABULAR COMPONENTS IN REVISION HIP ARTHROPLASTY

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G. M. Kavalersky

2016-01-01

Full Text Available In recent years, there is a trend of increasing demand for revision hip arthroplasty. Among these patients there are many with complex acetabular defects, including patients with pelvic discontinuity. To ensure stability for revised acetabular components in such cases becomes a challenging or unachievable task. Such defects give indications for printing customized tri-flange acetabular component. The authors analysed own experience of creating and applying custom made acetabular components in 3 patients with complex acetabular defects. Material and methods. Among the patients there were 2 women and 1 man. Average age was 60,3±19,4 years (38 to 78 years. Two patients had III B defects with pelvic discontinuity and one patient had III A defect by Paprosky classification. As the first step, the authors in collaboration with engineers printed a plaster full size pelvic 3D model, as the second step a customized tri-flange acetabular component was designed and printed. Harris Hip Score was evaluated preoperatively and 3 months postoperatively. Results. Average follow-up period was 5,3±2,5 months (3 to 8 months. The authors observed no cases of implant loosening, dislocation or deep periprosthetic infection. Average Harris Hip Score before surgery was 27,13 and after surgery – 74,1 indicating a significant improvement in 3 months postoperatively. Conclusion. Indications for use of individual acetabular components in reported patients correspond to indications formulated by Berasi et al. The authors obtained encouraging early follow-up outcomes that correspond to data of other authors. In one patient certain difficulties were reported due to insufficient pelvic distraction. Component’s flanges prevented achieving adequate pelvic distraction. Nevertheless, good primary stability was achieved. Modern software and 3D metal printers can significantly reduce the production cost of customized acetabular components. Application of this technology can be

Mathematical Modeling of Tuberculosis Granuloma Activation

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Steve M. Ruggiero

2017-12-01

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.

Dentin dysplasia type I with pyogenic granuloma in a 12-year-old girl

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Nirmala SVSG

2009-06-01

Full Text Available This paper presents a case of dentin dysplasia, a rarely reported disorder that is also associated with pyogenic granuloma in a 12-year-old girl. The case presented as excessively mobile teeth that appeared radiographically as rootless teeth and also as a soft tissue lesion in the right maxillary anterior region.

Sea urchin granuloma Granulomas por ouriços-do-mar

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André Luiz Rossetto

2006-10-01

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.

Extensive FDG uptake and its modification with corticosteroid in a granuloma rat model: an experimental study for differentiating granuloma from tumors

International Nuclear Information System (INIS)

Zhao, Songji; Takei, Toshiki; Zhao, Yan; Tamaki, Nagara; Kuge, Yuji; Kohanawa, Masashi; Takahashi, Toshiyuki; Kawashima, Hidekazu; Temma, Takashi; Seki, Koh-ichi

2007-01-01

Increased 18 F-fluorodeoxyglucose (FDG) uptake in inflammatory lesions, particularly in granulomatous inflammation (e.g., sarcoidosis), makes it difficult to differentiate malignant tumors from benign lesions and is the main source of false-positive FDG-PET findings in oncology. Here, we developed a rat granuloma model and examined FDG uptake in the granuloma. The effects of corticosteroid on FDG uptake in the granuloma were compared with those in a malignant tumor. Rats were inoculated with Mycobacterium bovis bacillus Calmette-Guerin (BCG) or allogenic hepatoma cells, and subdivided into control and pretreated (methylprednisolone acetate, 8 mg/kg i.m.) groups. Radioactivity in tissues was determined 1 h after the FDG injection. FDG-PET was performed in rats bearing BCG granulomas or tumors before and after prednisolone treatment. Mature epithelioid cell granuloma-formation and massive lymphocyte-infiltration were observed in the control group of granuloma, histologically similar to sarcoidosis. The mean FDG uptake in the granuloma was comparable to that in the hepatoma. Prednisolone reduced epithelioid cell granuloma-formation and lymphocyte-infiltration. Prednisolone significantly decreased the level of FDG uptake in the granuloma (52% of control), but not in the hepatoma. The FDG uptake levels in the granulomas and tumors were clearly imaged with PET. We developed an intramuscular granuloma rat model that showed a high FDG uptake comparable to that of the tumor. The effect of prednisolone pretreatment on FDG uptake was greater in the granuloma than in the tumor. These results suggest that BCG-induced granuloma may be a valuable model and may provide a biological basis for FDG studies. (orig.)

Acetabular Dysplasia and Surgical Approaches Other Than Direct Anterior Increases Risk for Malpositioning of the Acetabular Component in Total Hip Arthroplasty

DEFF Research Database (Denmark)

Gromov, Kirill; Greene, Meridith E; Huddleston, James I

2016-01-01

BACKGROUND: Persistent acetabular dysplasia (AD) after periacetabular osteotomy has been hypothesized to increase the risk for malpositioning of the acetabular component. In this study, we investigate whether AD is an independent risk factor for cup malpositioning during primary total hip...... arthroplasty (THA). METHODS: Patient demographics, surgical approach, presence of AD assessed using the lateral center-edge angle, and acetabular cup positioning determined using Martell Hip Analysis Suite were investigated in 836 primary THA patients enrolled in a prospective multicenter study. RESULTS: We...

Granuloma central de células gigantes Giant cells central granuloma

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Ayelén María Portelles Massó

2011-03-01

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.

Gingival plasma cell granuloma

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Amitkumar B Pandav

2012-01-01

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.

[Quantification of acetabular coverage in normal adult].

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Lin, R M; Yang, C Y; Yu, C Y; Yang, C R; Chang, G L; Chou, Y L

1991-03-01

Quantification of acetabular coverage is important and can be expressed by superimposition of cartilage tracings on the maximum cross-sectional area of the femoral head. A practical Autolisp program on PC AutoCAD has been developed by us to quantify the acetabular coverage through numerical expression of the images of computed tomography. Thirty adults (60 hips) with normal center-edge angle and acetabular index in plain X ray were randomly selected for serial drops. These slices were prepared with a fixed coordination and in continuous sections of 5 mm in thickness. The contours of the cartilage of each section were digitized into a PC computer and processed by AutoCAD programs to quantify and characterize the acetabular coverage of normal and dysplastic adult hips. We found that a total coverage ratio of greater than 80%, an anterior coverage ratio of greater than 75% and a posterior coverage ratio of greater than 80% can be categorized in a normal group. Polar edge distance is a good indicator for the evaluation of preoperative and postoperative coverage conditions. For standardization and evaluation of acetabular coverage, the most suitable parameters are the total coverage ratio, anterior coverage ratio, posterior coverage ratio and polar edge distance. However, medial coverage and lateral coverage ratios are indispensable in cases of dysplastic hip because variations between them are so great that acetabuloplasty may be impossible. This program can also be used to classify precisely the type of dysplastic hip.

[Contact characteristics research of acetabular weight-bearing area with different internal fixation methods after compression fracture of acetabular dome].

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Xu, Bowen; Zhang, Qingsong; An, Siqi; Pei, Baorui; Wu, Xiaobo

2017-08-01

To establish the model of compression fracture of acetabular dome, and to measure the contact characteristics of acetabular weight-bearing area of acetabulum after 3 kinds of internal fixation. Sixteen fresh adult half pelvis specimens were randomly divided into 4 groups, 4 specimens each group. Group D was the complete acetabulum (control group), and the remaining 3 groups were prepared acetabular dome compression fracture model. The fractures were fixed with reconstruction plate in group A, antegrade raft screws in group B, and retrograde raft screws in group C. The pressure sensitive films were attached to the femoral head, and the axial compression test was carried out on the inverted single leg standing position. The weight-bearing area, average stress, and peak stress were measured in each group. Under the loading of 500 N, the acetabular weight-bearing area was significantly higher in group D than in other 3 groups ( P area were significantly higher in group B and group C than in group A, and the average stress and peak stress were significantly lower than in group A ( P 0.05). For the compression fracture of the acetabular dome, the contact characteristics of the weight-bearing area can not restore to the normal level, even if the anatomical reduction and rigid internal fixation were performed; compared with the reconstruction plate fixation, antegrade and retrograde raft screws fixations can increase the weight-bearing area, reduce the average stress and peak stress, and reduce the incidence of traumatic arthritis.

Granuloma periapical: tratamiento convencional. Reporte de un caso

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Natalia Patricia Harris Ortega

2014-03-01

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.

Modified Harrington Procedure for Acetabular Insuficiency Due to Metastatic Malignant Disease

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WI Faisham

2009-05-01

Full Text Available Extensive peri-acetabular osteolysis caused by malignant disease process is a major surgical challenge as conventional hip arthroplasty is not adequate. We describe a modified use of the Harrington procedure for acetabular insufficiency secondary to metastatic disease in twelve patients. The procedures include application of multiple threaded pins to bridge the acetabular columns, anti-protrusio cage and cemented acetabular cup. Eleven patients were able to walk pain free and achieved a mean Musculoskeletal Tumour Society Functional Score of 80 (range, 68 to 86.

MR imaging findings of acetabular dysplasia in adults

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James, Steven; Connell, David [The Royal National Orthopaedic Hospital, Radiology Department, London, Middlesex (United Kingdom); Miocevic, Miranda; Malara, Frank; Pike, Jonathan [Victoria House Hospital, Radiology Department, Melbourne (Australia); Young, David [Melbourne Orthopaedic Group, Orthopaedic Surgery, Melbourne (Australia)

2006-06-15

To evaluate the diagnostic accuracy of MR imaging in the identification of labral and articular cartilage lesions in patients with acetabular dysplasia. Pre-operative MR imaging was performed on 27 hips in 25 consecutive patients (16 males, 9 females, age range 19-52 years, mean age 31.2 years) with radiographic evidence of acetabular dysplasia (centre-edge angle of Wiberg <20 degrees). The average duration of symptoms was 16.2 months. Two musculoskeletal radiologists assessed MR images in consensus for the presence of abnormality involving the acetabular labrum and adjacent acetabular articular cartilage. A high resolution, non-arthrographic technique was used to assess the labrum and labral chondral transitional zone. Surgical correlation was obtained in all cases by a single surgeon experienced in hip arthroscopy and ten patients with normal hip MRI were included to provide a control group. The acetabular labra in the dysplastic hips demonstrated abnormal signal intensity, and had an elongated appearance when compared with the control group (mean length 10.9 mm vs 6.4 mm). Morphological appearances in the labra included surface irregularity, fissures and cleft formation. MR imaging correctly identified the severity of chondral abnormality in 24 of 27 hips (89%) when compared with arthroscopic findings. MR imaging demonstrates an elongated labrum, focal intra-substance signal change and irregularity and fissuring of the margins in patients with acetabular dysplasia. Abnormality is also identified at the labral chondral transitional zone, where fissuring, focal clefts, chondral deficiency and subchondral cyst formation may be apparent. A high-resolution, non-arthrographic technique can provide an accurate preoperative assessment and evaluate the presence of premature osteoarthritis. (orig.)

MR imaging findings of acetabular dysplasia in adults

International Nuclear Information System (INIS)

James, Steven; Connell, David; Miocevic, Miranda; Malara, Frank; Pike, Jonathan; Young, David

2006-01-01

To evaluate the diagnostic accuracy of MR imaging in the identification of labral and articular cartilage lesions in patients with acetabular dysplasia. Pre-operative MR imaging was performed on 27 hips in 25 consecutive patients (16 males, 9 females, age range 19-52 years, mean age 31.2 years) with radiographic evidence of acetabular dysplasia (centre-edge angle of Wiberg <20 degrees). The average duration of symptoms was 16.2 months. Two musculoskeletal radiologists assessed MR images in consensus for the presence of abnormality involving the acetabular labrum and adjacent acetabular articular cartilage. A high resolution, non-arthrographic technique was used to assess the labrum and labral chondral transitional zone. Surgical correlation was obtained in all cases by a single surgeon experienced in hip arthroscopy and ten patients with normal hip MRI were included to provide a control group. The acetabular labra in the dysplastic hips demonstrated abnormal signal intensity, and had an elongated appearance when compared with the control group (mean length 10.9 mm vs 6.4 mm). Morphological appearances in the labra included surface irregularity, fissures and cleft formation. MR imaging correctly identified the severity of chondral abnormality in 24 of 27 hips (89%) when compared with arthroscopic findings. MR imaging demonstrates an elongated labrum, focal intra-substance signal change and irregularity and fissuring of the margins in patients with acetabular dysplasia. Abnormality is also identified at the labral chondral transitional zone, where fissuring, focal clefts, chondral deficiency and subchondral cyst formation may be apparent. A high-resolution, non-arthrographic technique can provide an accurate preoperative assessment and evaluate the presence of premature osteoarthritis. (orig.)

Image research on acetabular teardrop shadow by X-ray plain-film and CT

International Nuclear Information System (INIS)

Wang Xiaoxuan; Zhai Yuejie; Yu Hongguang; Yang Yijun; Zhang Daiwei; Chen Aili; Song Quanjun

2001-01-01

Objective: To evaluate the anatomical structure of bone in the formation of acetabular teardrop shadow. Methods: The acetabular teardrop shadow of the X-ray plain-film in 100 children and 300 adults, and of CT in 43 cases were analysed, measured and compared. Results: In children, teardrop shadow appeared 'U' in 80.00%, 14.00% in teardrop, 6.00% in line. In adult teardrop shadow appeared 'U' in 41.33%, 53.33% in teardrop, 5.34% in line. There were significant differences between children and adult in the frequency of 'U' and teardrop (x 2 = 43.34, P 2 = 45.62, P < 0.01). In children, inpeduncle of teardrop shadow was formed of middle 1/3 substantia-line of acetabular concavity inside of pelvis; outpeduncle was formed of middle 1/3 substantia-line of bottom of acetabular. In adult, inpeduncle was formed of middle 1/3 or back 1/3 substantia line of acetabular concavity inside of pelvis; outpeduncle was formed of middle 1/3 or back 1/3 substantia-line of bottom of acetabular. Conclusion: In children, acetabular teardrop shadow was mainly formed of middle 1/3 bone of acetabular concavity. In adult, middle 1/3 or back 1/3 bone of acetabular concavity contribute to the shadow. The ahead 1/3 bone of acetabular concavity is not involved

The use of an Ossis custom 3D-printed tri-flanged acetabular implant for major bone loss: minimum 2-year follow-up: Short title: Ossis custom 3D-Printed tri-flanged acetabular implant.

Science.gov (United States)

Kieser, David C; Ailabouni, Ramez; Kieser, Sandra C J; Wyatt, Michael C; Armour, Paul C; Coates, Mark H; Hooper, Gary J

2018-05-01

Custom 3D-printed acetabular implants are a new technology used in hip surgery with ever-increasing frequency. They offer patient-specific implants to optimise filling of bone defects and implant-bone contact, without the need for excessive bone resection. This is a retrospective cohort study of 46 consecutive patients who underwent an Ossis unilateral custom 3D-printed acetabular implant. Clinical (Oxford Hip Score OHS-60), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Harris Hip Score (HHS) and radiological (restoration of biomechanical hip centre, osteointegration, wear, heterotrophic ossification) results were assessed. Patient mean age was 68 years and follow-up was 38 months (minimum 24 months). 10 patients were excluded from the outcome analysis; 2 patients died, 1 required revision for deep infection and 7 were lost to follow-up. Of the 36 patients included, 21 had severe osteolysis. 7 were revised for infection, 3 for tumoural defects, 3 for metallosis, 1 for dysplasia and 1 for trauma (Paprosky 2a [n=6], 2b [n=2], 2c [n=5], 3a [n=6], 3b [n=11], pelvic dissociation [n=6]). OHS significantly improved postoperatively (16-8-48.4 p=0.027). Postoperative functional scores were good (WOMAC 98; HHS 79). The biomechanical hip centre was restored in all patients. 1 patient had early implant migration with subsequent stabilisation. 2 patients had radiographs concerning for failure of osteointegration. 1 patient had recurrent dislocations. The mid-term results of the Ossis custom 3D-printed tri-flanged acetabular implant for the management of severe acetabular defects are encouraging. The improvement in functional scores and radiographic outcomes are comparable to similar designs. In addition, no cases have required revision for aseptic loosening.

Superior dislocation hip with anterior column acetabular fracture ...

African Journals Online (AJOL)

Superior variety of anterior dislocation of the hip is a rare injury. Its occurrence with acetabular fractures has been documented infrequently. We report a case of superior dislocation of the hip with anterior column acetabular fracture. Open reduction of the hip and internal fixation of the fracture was carried out using a twin ...

Pyogenic granuloma associated with bone loss in an eight year old child: A case report

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Shenoy S

2006-01-01

Full Text Available Soft tissue enlargements of the oral cavity often present a diagnostic challenge because a diverse group of pathologic processes can produce such lesions. An enlargement may represent a variation of normal anatomic structures, inflammation, cysts, developmental anomalies and neoplasm. Within these lesions is a group of reactive hyperplasias, which develop in response to a chronic, recurring tissue injury that stimulates an exuberant or excessive tissue repair response. The pyogenic granuloma is a reactive enlargement that is an inflammatory response to local irritation such as calculus, a fractured tooth, rough dental restoration and foreign materials. This article aims to present a case of pyogenic granuloma in 8 year old child patient associated with resorption of bone in relation to the tooth.

Immunostimulatory mouse granuloma protein.

Science.gov (United States)

Fontan, E; Fauve, R M; Hevin, B; Jusforgues, H

1983-10-01

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.

21 CFR 888.3370 - Hip joint (hemi-hip) acetabular metal cemented prosthesis.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint (hemi-hip) acetabular metal cemented... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3370 Hip joint (hemi-hip) acetabular metal cemented prosthesis. (a) Identification. A hip joint (hemi-hip) acetabular...

Acetabular labral tears in patients with sports injury.

Science.gov (United States)

Kang, Chan; Hwang, Deuk-Soo; Cha, Soo-Min

2009-12-01

We wanted to investigate acetabular labral tears and their correlation with femoroacetabular impingement in patients with sports injury. Among 111 patients who were diagnosed with the acetabular labral tears after arthroscopic treatment from January 2004 to December 2007, we selected 41 patients with sports injury. There were 12 cases of Taekwondo injury, 5 of golf injury, 4 of soccer injury, 3 of gymnastics injury, 2 of Hapkido injury, 2 of aerobics injury, 2 of rock-climbing injury, 2 of fitness training injury and 9 of other sports injuries. We checked the subtypes of acetabular labral tears and the accompanying femoroacetabular impingement. For the cases with accompanying femoroacetabular impingement, we investigated the subtypes according to the types of sports, gender and age. At last follow-up, we checked the Harris Hip Score (HHS), the Hip Outcome Score (HOS) sports scale and the percentage of patients who returned to their sports activity. The average age of symptomatic onset was 26 years (range, 12 to 65 years). The ratio of males to females was 29 : 12. An average duration of the hip pain was 17 months (range, 1 to 60 months). The degenerative type of acetabular labral tears was the most prevalent with 32 cases (78%), and there were 9 cases (22%) of the partial tear type. Thirty cases (73%) were accompanied by femoroacetabular impingement. The average age of the 23 cases (56%) of the cam-type was 23 years (range, 12 to 48 years), and it was more likely to occur in men (87%) and for people practicing martial arts such as Taekwondo or Hapkido. An average age of the 5 cases (12%) of the pincer-type was 26 (range, 16 to 43 years), it usually occurred in women (60%) and for non-martial arts such as golf and gymnastics. There were 2 cases of the mixed type (cam + pincer-type). At 27 months follow-up, the HHS was 61 to 92 points, the HOS sports scale increased 43 to 75%, and the rate of returning to sports was 71%. In spite of the early expression of symptoms

Plain film analysis of acetabular fracture

Energy Technology Data Exchange (ETDEWEB)

Kim, Chang Soo; Han, Sang Suk; Yoon, Eu Giene; Cha, Seong Sook; Eun, Tchoong Kie; Chung, Duck Hwan [Inje Medical College Paik Hospital, Pusan (Korea, Republic of)

1986-02-15

Acetabular fracture can result in severe limitation of the motion of the hip joint, which supports total weight of human body. Because of different methods of surgical approach according to fracture type, precise interpretation of X-ray films of acetabular fracture is required. We reviewed 38 cases of simple X-ray films showing acetabular fracture. The results were as follows: 1. Almost 60% of the cases-were in their 2nd and 3rd decades. 2. Twenty cases were male, and 18 cases were female. 3. The most common cause of the injury was traffic accident (33 cases, 86.8%), followed by fall down (4 cases, 10.5%), and slip down (1 case, 2.7%). 4. Elementary fractures were 21 cases (55.3%), and associated fractures were 17 cases (44.7%). 5. Among elementary fractures, posterior wall fractures were 9 cases (23.7%), followed by anterior column fractures (8 cases, 21.1%), anterior wall fractures (4 cases, 10.5%). 6. Among associated fractures, T-shaped fractures were 8 cases (21.1%), followed by both column fractures (6 cases, 15.8%), anterior and hemitransverse fractures (3 cases, 7.8%). 7. Other pelvic bone fractures associated with the acetabular fracture were as follows: fractures of contralateral pubic rami (6 cases, 15.8%) contralateral iliac bone (1 case, 2.6%) and ipsilateral iliac bone (1 case, 2.6%). 8. Injuries of other organs adjacent to the acetabulum were as follows: rupture of the bladder (3 cases, 7.9%), urethra (2 cases, 5.3%) and uterus (1 cases, 2.6%)

Plain film analysis of acetabular fracture

International Nuclear Information System (INIS)

Kim, Chang Soo; Han, Sang Suk; Yoon, Eu Giene; Cha, Seong Sook; Eun, Tchoong Kie; Chung, Duck Hwan

1986-01-01

Acetabular fracture can result in severe limitation of the motion of the hip joint, which supports total weight of human body. Because of different methods of surgical approach according to fracture type, precise interpretation of X-ray films of acetabular fracture is required. We reviewed 38 cases of simple X-ray films showing acetabular fracture. The results were as follows: 1. Almost 60% of the cases-were in their 2nd and 3rd decades. 2. Twenty cases were male, and 18 cases were female. 3. The most common cause of the injury was traffic accident (33 cases, 86.8%), followed by fall down (4 cases, 10.5%), and slip down (1 case, 2.7%). 4. Elementary fractures were 21 cases (55.3%), and associated fractures were 17 cases (44.7%). 5. Among elementary fractures, posterior wall fractures were 9 cases (23.7%), followed by anterior column fractures (8 cases, 21.1%), anterior wall fractures (4 cases, 10.5%). 6. Among associated fractures, T-shaped fractures were 8 cases (21.1%), followed by both column fractures (6 cases, 15.8%), anterior and hemitransverse fractures (3 cases, 7.8%). 7. Other pelvic bone fractures associated with the acetabular fracture were as follows: fractures of contralateral pubic rami (6 cases, 15.8%) contralateral iliac bone (1 case, 2.6%) and ipsilateral iliac bone (1 case, 2.6%). 8. Injuries of other organs adjacent to the acetabulum were as follows: rupture of the bladder (3 cases, 7.9%), urethra (2 cases, 5.3%) and uterus (1 cases, 2.6%).

Actinic Granuloma with Focal Segmental Glomerulosclerosis

Directory of Open Access Journals (Sweden)

Ruedee Phasukthaworn

2016-02-01

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.

Pyogenic granuloma associated with periodontal abscess and bone loss - A rare case report

OpenAIRE

Bhrugesh J Panseriya; Shital Hungund

2011-01-01

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 enl...

Post thyroidectomy suture granuloma: a cytological diagnosis.

Science.gov (United States)

Javalgi, Anita P; Arakeri, Surekha U

2013-04-01

There are known post thyroidectomized complications, a suture granuloma being less frequent, with its late complication mimicking recurrent thyroid cancer. A suture granuloma is a benign, granulomatous inflammatory reaction that occurs due to the use of non absorbable suture. It constitutes one of the late complications which altogether make up less than 2% of its incidence. A suture granuloma is similar to a foreign body reaction and it usually develops slowly as a painless, palpable asymptomatic mass over the years. It mimics a cancer recurrence or a lymph node metastasis. Here, we are reporting a case of a post thyroidectomy suture granuloma in a 46 years old lady who presented with a painless swelling in the lateral neck, with a past history of thyroidectomy 5 years back.

Cholesterol granuloma of the petrous apex: CT diagnosis

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Lo, W.W.M.; Solti-Bohman, L.G.; Brackmann, D.E.; Gruskin, P.

1984-12-01

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.

Cholesterol granuloma of the petrous apex: CT diagnosis

International Nuclear Information System (INIS)

Lo, W.W.M.; Solti-Bohman, L.G.; Brackmann, D.E.; Gruskin, P.

1984-01-01

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

The nerve endings of the acetabular labrum.

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Kim, Y T; Azuma, H

1995-11-01

The nerve endings of the human acetabular labrum were investigated. Twenty-three acetabular labra were obtained from 24 fresh human cadavers, stained with Suzuki's silver impregnation and an immunohistochemical technique for neurogenic specific protein S-100, and examined by light and electron microscopy. Ramified free nerve endings were seen in all specimens by silver staining, and also were observed by the immunohistochemical technique for S-100 protein. Sensory nerve end organs, such as a Vater-Pacini corpuscle, Golgi-Mazzoni corpuscle, Ruffini corpuscle, and articular corpuscle (Krause corpuscle), were observed by silver staining. Collagen fibers were scattered sparsely in the superficial layer of the labrum, and nerve endings were observed mostly in this region. Collagen fibers were sparse, and nerve endings also were observed in some regions among the collagen fiber bundles in the inner layer. Innervation of the acetabular labrum was confirmed in this study, suggesting that nerve endings in the labrum may be involved in nociceptive and proprioceptive mechanisms.

Experiences in therapy for lethal midline granuloma

International Nuclear Information System (INIS)

Tosaka, Kaoru; Ishikawa, Takeru

1982-01-01

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. (author)

Barium granuloma of the rectum: case report

International Nuclear Information System (INIS)

Kim, Dae Jin; Kim, Se Hyung; Jeoung, Ah Young; Lee, Kyoung Ho; Choi, Byung Ihn; Han, Joon Koo

2003-01-01

Barium granulomas usually occur after barium enema within 8 cm of the anal verge probably due to minute laceration of rectal wall by enema tip and extravasation of barium during barium enema. We report a case of barium granuloma of rectum in a 47-year-old man, who did not have history of barium enema. In rare instance, barium granuloma can occur without a history of barium enema and careful interpretation of radiologic image is essential to make a correct diagnosis

Subcutaneous granuloma annulare: radiologic appearance

International Nuclear Information System (INIS)

Kransdorf, M.J.; Murphey, M.D.; Temple, H.T.

1998-01-01

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.)

Plasma cell granuloma of lip

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B Sabarinath

2012-01-01

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.

An in vitro model of Mycobacterium leprae induced granuloma formation.

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Wang, Hongsheng; Maeda, Yumi; Fukutomi, Yasuo; Makino, Masahiko

2013-06-20

Leprosy is a contagious and chronic systemic granulomatous disease caused by Mycobacterium leprae. In the pathogenesis of leprosy, granulomas play a key role, however, the mechanisms of the formation and maintenance of M. leprae granulomas are still not clearly understood. To better understand the molecular physiology of M. leprae granulomas and the interaction between the bacilli and human host cells, we developed an in vitro model of human granulomas, which mimicked the in vivo granulomas of leprosy. Macrophages were differentiated from human monocytes, and infected with M. leprae, and then cultured with autologous human peripheral blood mononuclear cells (PBMCs). Robust granuloma-like aggregates were obtained only when the M. leprae infected macrophages were co-cultured with PBMCs. Histological examination showed M. leprae within the cytoplasmic center of the multinucleated giant cells, and these bacilli were metabolically active. Macrophages of both M1 and M2 types co-existed in the granuloma like aggregates. There was a strong relationship between the formation of granulomas and changes in the expression levels of cell surface antigens on macrophages, cytokine production and the macrophage polarization. The viability of M. leprae isolated from granulomas indicated that the formation of host cell aggregates benefited the host, but the bacilli also remained metabolically active. A simple in vitro model of human M. leprae granulomas was established using human monocyte-derived macrophages and PBMCs. This system may be useful to unravel the mechanisms of disease progression, and subsequently develop methods to control leprosy.

Acetabular paralabral cyst causing compression of the sciatic nerve

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Caoimhe Byrne, MB BCh BAO

2017-12-01

Full Text Available Acetabular paralabral cysts are common. They vary in their clinical presentation and may be asymptomatic or cause pain and restriction at the hip joint. In rare instances they may cause symptoms by compressing local neurovascular structures. We report a case of symptomatic compression of the sciatic nerve by a posteriorly displaced acetabular paralabral cyst.

Pyogenic granuloma associated with mandibular odontoma.

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Karla Ocampo

2014-08-01

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.

Three-dimensional finite analysis of acetabular contact pressure and contact area during normal walking.

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Wang, Guangye; Huang, Wenjun; Song, Qi; Liang, Jinfeng

2017-11-01

This study aims to analyze the contact areas and pressure distributions between the femoral head and mortar during normal walking using a three-dimensional finite element model (3D-FEM). Computed tomography (CT) scanning technology and a computer image processing system were used to establish the 3D-FEM. The acetabular mortar model was used to simulate the pressures during 32 consecutive normal walking phases and the contact areas at different phases were calculated. The distribution of the pressure peak values during the 32 consecutive normal walking phases was bimodal, which reached the peak (4.2 Mpa) at the initial phase where the contact area was significantly higher than that at the stepping phase. The sites that always kept contact were concentrated on the acetabular top and leaned inwards, while the anterior and posterior acetabular horns had no pressure concentration. The pressure distributions of acetabular cartilage at different phases were significantly different, the zone of increased pressure at the support phase distributed at the acetabular top area, while that at the stepping phase distributed in the inside of acetabular cartilage. The zones of increased contact pressure and the distributions of acetabular contact areas had important significance towards clinical researches, and could indicate the inductive factors of acetabular osteoarthritis. Copyright © 2016. Published by Elsevier Taiwan.

The role of trochanteric flip osteotomy in fixation of certain acetabular fractures.

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Gupta, Sandeep; Singh, Jagdeep; Virk, Jagandeep Singh

2017-06-01

Complete visualization of certain acetabular fractures of posterior wall or column with cranial extension involving superior dome from standard surgical exposures is a challenge. Osteotomy of the greater trochanter has been used to enhance fracture visualization, especially the dome, in posterior and lateral exposures of the acetabulum. It also decreases the need for excessive muscle retraction. The purpose of the study was to investigate the outcome associated with trochanteric flip osteotomy in the management of certain acetabulum fractures. From January 2011 to December 2013, 25 displaced acetabular fractures were treated by open reduction and internal fixation. The fractures were managed using a Kocher-Langenbeck approach along with trochanteric flip osteotomy. At 3rd, 6th and 24th month follow-up, all patients had radiographic examination and underwent a final clinical evaluation based on the modified Merle d'Aubigne and Postel score. The strength of the abductors was assessed according to the Medical Research Council (MRC) grading system. Congruent reduction was achieved in all patients and all osteotomies healed within an average period of 3.8 months. All our patients were allowed full weight bearing at the end of 3 months and with no abductor lurch at the end of 6 months follow-up. There were no cases of avascular necrosis of femoral head. None of the patients had any neurovascular complication or infection by the end of the follow-up period. Trochanteric flip osteotomy is a very effective technique to fix certain acetabular fractures especially those with dome involvement. It is more accurate and associated with no significant complications compared with conventional way. Copyright © 2017 Daping Hospital and the Research Institute of Surgery of the Third Military Medical University. Production and hosting by Elsevier B.V. All rights reserved.

Acetabular paralabral cyst: an uncommon cause of sciatica

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Sherman, P.M.; Sanders, T.G. [Department of Radiology, Wilford Hall Medical Center, 2200 Bergquist Drive, Ste. 1, Lackland AFB, TX 78236 (United States); Matchette, M.W. [University of Texas Medical School, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900 (United States); Parsons, T.W. [Department of Orthopedic Surgery, Wilford Hall Medical Center, 2200 Bergquist Drive, Ste. 1, Lackland AFB, TX 78236 (United States)

2003-02-01

The association between tears of the acetabular labrum and paralabral cysts has been well documented, and magnetic resonance imaging (MRI) has been shown to be the most accurate noninvasive method of depicting not only the normal anatomic structures of the hip, but also the common pathologic processes such as labral tears and paralabral cysts. We present the case of an acetabular paralabral cyst that resulted in clinically symptomatic compression of the sciatic nerve. (orig.)

Acetabular paralabral cyst: an uncommon cause of sciatica

International Nuclear Information System (INIS)

Sherman, P.M.; Sanders, T.G.; Matchette, M.W.; Parsons, T.W.

2003-01-01

The association between tears of the acetabular labrum and paralabral cysts has been well documented, and magnetic resonance imaging (MRI) has been shown to be the most accurate noninvasive method of depicting not only the normal anatomic structures of the hip, but also the common pathologic processes such as labral tears and paralabral cysts. We present the case of an acetabular paralabral cyst that resulted in clinically symptomatic compression of the sciatic nerve. (orig.)

Granuloma annulare localized to the shaft of the penis

DEFF Research Database (Denmark)

Trap, R; Wiebe, B

1993-01-01

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....

Laryngeal granuloma: a complication of prolonged endotracheal intubation.

OpenAIRE

Keiser, G. J.; Bozentka, N. E.; Gold, B. D.

1991-01-01

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...

CUSTOM TRIFLANGE ACETABULAR COMPONENTS IN REVISION HIP REPLACEMENT (EXPERIENCE REVIEW

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A. A. Korytkin

2017-01-01

Full Text Available Extensive defects of acetabulum especially accompanied by pelvis discontinuity at the level of acetabulum pose a serious challenge in revision hip replacement and create additional complexity in fixing the acetabular component. One of the perspective options to solve the above issue is the use of custom triflange acetabular components (CTAC designed based on preoperative computer tomography given the specifics of bone defects of the patient. Purpose of the study — to evaluate the outcomes of CTAC use in revision hip replacement.Materials and methods. The authors analyzed treatment outcomes of 12 patients after revision hip replacement using additive techniques of computer simulation and 3D printing CTAC. Follow up period after the surgery averaged 7±3 months (from one to ten months. 7 out of 12 patients had acetabular defects of Paprosky 3B type, 4 patients had defects of Paprosky 3A and in one patient — of Paprosky 2C.Results. Two out of twelve patients had prosthesis dislocations that required revision hip surgery, one of those patients underwent open reduction of dislocation with wound debridement, another patient underwent replacement of articulating couple of acetabular component. Total scores under Harris Hip Score and paint VAS score prior to treatment was 28±7 and 7±1 points respectively, postoperative scores were 76±9 and 3±1 respectively.Conclusion. The application of additive techniques for revision hip replacement in patients with extensive acetabular and pelvic defects allows to make a precise preoperative planning, to restore joint rotation center, to reconstruct bone defects and to securely fix triflange acetabular component that altogether significantly improve treatment outcomes and patients satisfaction with the surgery.

Three-dimensional computed tomography analysis of non-osteoarthritic adult acetabular dysplasia

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Ito, Hiroshi; Matsuno, Takeo; Hirayama, Teruhisa; Tanino, Hiromasa; Yamanaka, Yasuhiro [Asahikawa Medical College, Department of Orthopaedic Surgery, Asahikawa (Japan); Minami, Akio [Hokkaido University School of Medicine, Department of Orthopaedic Surgery, Sapporo (Japan)

2009-02-15

Little data exists on the original morphology of acetabular dysplasia obtained from patients without radiographic advanced osteoarthritic changes. The aim of this study was to investigate the distribution and degree of acetabular dysplasia in a large number of patients showing no advanced degenerative changes using three-dimensional computed tomography (3DCT). Eighty-four dysplastic hips in 55 consecutive patients were studied. All 84 hips were in pre- or early osteoarthritis without radiographic evidence of joint space narrowing, formation of osteophytes or cysts, or deformity of femoral heads. The mean age at the time of CT scan was 35 years (range 15-64 years). 3D images were reconstructed and analyzed using recent computer imaging software (INTAGE Realia and Volume Player). Deficiency types and degrees of acetabular dysplasia were precisely evaluated using these computer software. The average Harris hip score at CT scans was 82 points. Twenty-two hips (26%) were classified as anterior deficiency, 17 hips (20%) as posterior deficiency, and 45 hips (54%) as lateral deficiency. No significant difference was found in the Harris hip score among these groups. The analysis of various measurements indicated wide variations. There was a significant correlation between the Harris hip score and the acetabular coverage (p < 0.001). Our results indicated wide variety of deficiency type and degree of acetabular dysplasia. Hips with greater acetabular coverage tended to have a higher Harris hip score. (orig.)

Three-dimensional computed tomography analysis of non-osteoarthritic adult acetabular dysplasia

International Nuclear Information System (INIS)

Ito, Hiroshi; Matsuno, Takeo; Hirayama, Teruhisa; Tanino, Hiromasa; Yamanaka, Yasuhiro; Minami, Akio

2009-01-01

Little data exists on the original morphology of acetabular dysplasia obtained from patients without radiographic advanced osteoarthritic changes. The aim of this study was to investigate the distribution and degree of acetabular dysplasia in a large number of patients showing no advanced degenerative changes using three-dimensional computed tomography (3DCT). Eighty-four dysplastic hips in 55 consecutive patients were studied. All 84 hips were in pre- or early osteoarthritis without radiographic evidence of joint space narrowing, formation of osteophytes or cysts, or deformity of femoral heads. The mean age at the time of CT scan was 35 years (range 15-64 years). 3D images were reconstructed and analyzed using recent computer imaging software (INTAGE Realia and Volume Player). Deficiency types and degrees of acetabular dysplasia were precisely evaluated using these computer software. The average Harris hip score at CT scans was 82 points. Twenty-two hips (26%) were classified as anterior deficiency, 17 hips (20%) as posterior deficiency, and 45 hips (54%) as lateral deficiency. No significant difference was found in the Harris hip score among these groups. The analysis of various measurements indicated wide variations. There was a significant correlation between the Harris hip score and the acetabular coverage (p < 0.001). Our results indicated wide variety of deficiency type and degree of acetabular dysplasia. Hips with greater acetabular coverage tended to have a higher Harris hip score. (orig.)

Granuloma Faciale Treatment: A Systematic Review

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Claudia Lindhaus

2017-10-01

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.

Prevotella intermedia and Porphyromonas gingivalis in dental caries with periapical granuloma

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Risya Cilmiaty

2013-12-01

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

Granuloma periapical: tratamiento convencional. Reporte de un caso

OpenAIRE

Natalia Patricia Harris Ortega; Fernando Javier Guzman Lopez; Antonio Díaz Caballero

2014-01-01

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...

Tympanomastoid cholesterol granulomas: Immunohistochemical evaluation of angiogenesis.

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Iannella, Giannicola; Di Gioia, Cira; Carletti, Raffaella; Magliulo, Giuseppe

2017-08-01

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.

High matrix metalloproteinase activity is a hallmark of periapical granulomas.

Science.gov (United States)

de Paula-Silva, Francisco Wanderley Garcia; D'Silva, Nisha J; da Silva, Léa Assed Bezerra; Kapila, Yvonne Lorraine

2009-09-01

The inability to distinguish periapical cysts from granulomas before performing root canal treatment leads to uncertainty in treatment outcomes because cysts have lower healing rates. Searching for differential expression of molecules within cysts or granulomas could provide information with regard to the identity of the lesion or suggest mechanistic differences that may form the basis for future therapeutic intervention. Thus, we investigated whether granulomas and cysts exhibit differential expression of extracellular matrix (ECM) molecules. Human periapical granulomas, periapical cysts, and healthy periodontal ligament tissues were used to investigate the differential expression of ECM molecules by microarray analysis. Because matrix metalloproteinases (MMP) showed the highest differential expression in the microarray analysis, MMPs were further examined by in situ zymography and immunohistochemistry. Data were analyzed by using one-way analysis of variance followed by the Tukey test. We observed that cysts and granulomas differentially expressed several ECM molecules, especially those from the MMP family. Compared with cysts, granulomas exhibited higher MMP enzymatic activity in areas stained for MMP-9. These areas were composed of polymorphonuclear cells (PMNs) in contrast to cysts. Similarly, MMP-13 was expressed by a greater number of cells in granulomas compared with cysts. Our findings indicate that high enzymatic MMP activity in PMNs together with MMP-9 and MMP-13 stained cells could be a molecular signature of granulomas unlike periapical cysts.

Acetabular fractures: what radiologists should know and how 3D CT can aid classification.

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Scheinfeld, Meir H; Dym, Akiva A; Spektor, Michael; Avery, Laura L; Dym, R Joshua; Amanatullah, Derek F

2015-01-01

Correct recognition, description, and classification of acetabular fractures is essential for efficient patient triage and treatment. Acetabular fractures may result from high-energy trauma or low-energy trauma in the elderly. The most widely used acetabular fracture classification system among radiologists and orthopedic surgeons is the system of Judet and Letournel, which includes five elementary (or elemental) and five associated fractures. The elementary fractures are anterior wall, posterior wall, anterior column, posterior column, and transverse. The associated fractures are all combinations or partial combinations of the elementary fractures and include transverse with posterior wall, T-shaped, associated both column, anterior column or wall with posterior hemitransverse, and posterior column with posterior wall. The most unique fracture is the associated both column fracture, which completely dissociates the acetabular articular surface from the sciatic buttress. Accurate categorization of acetabular fractures is challenging because of the complex three-dimensional (3D) anatomy of the pelvis, the rarity of certain acetabular fracture variants, and confusing nomenclature. Comparing a 3D image of the fractured acetabulum with a standard diagram containing the 10 Judet and Letournel categories of acetabular fracture and using a flowchart algorithm are effective ways of arriving at the correct fracture classification. Online supplemental material is available for this article. (©)RSNA, 2015.

Sarcoid granuloma of the choroid.

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Marcus, D F; Bovino, J A; Burton, T C

1982-12-01

Two patients were found to have macular choroidal granulomas associated with systemic sarcoidosis. This unusual fundus picture was documented by serial fundus photography and fluorescein angiography. Both patients had a similar clinical picture of decreased vision, chorioretinal granulomas, and overlying neurosensory detachments. Staining of the inflammatory mass with fluorescein and leakage of dye into the neurosensory space was typical. Lymph node biopsies were performed to substantiate the diagnosis. Both patients responded promptly to systemic corticosteroid therapy with dramatic improvement in visual acuity and resolution of the choroidal lesions.

Annular elastolytic giant cell granuloma of conjunctiva: A case report

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Karabi Konar

2014-01-01

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.

Posterior column acetabular fracture fixation using a W-shaped angular plate: A biomechanical analysis.

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Ke Su

Full Text Available The purpose of this study was to compare the stability and feasibility of four fixation constructs in a posterior column acetabular fracture: one reconstruction plate, one reconstruction plate and lag screw, two reconstruction plates, and a W-shaped acetabular angular plate.Twenty embalmed cadaveric pelvises with a posterior column acetabular fractures were allocated to one of four groups: 1 a reconstruction plate, 2 a reconstruction plate with a posterior column lag screw, 3 double reconstruction plates, and 4 a W-shaped acetabular angular plate. These constructs were mechanically loaded on a testing machine, and construct stiffness values were measured. Strain gauges were utilized to measure the mechanical behavior in the condition of compressive force.Final stiffness was not different between the two reconstruction plates (445.81±98.30 N/mm and the W-shaped acetabular angular plate (447.43±98.45 N/mm, p = 0.524, both of which were superior to a single reconstruction plate (248.90±61.95 N/mm and a combined plate and lag screw (326.41±94.34 N/mm. Following the fixation of the W-shaped acetabular angular plate, the strain distribution was similar to the intact condition around the acetabulum. The parameters of the W-shaped acetabular angular plate that were observed at the superior region of the acetabulum were less than those of a single reconstruction plate (p<0.05, a single reconstruction plate with lag screw (p<0.05, and two reconstruction plates (p<0.05.The novel W-shaped acetabular angular plate fixation technique was able to provide the biomechanically stiffest construct for stabilization of a posterior column acetabular fracture; it also resulted in a partial restoration of joint loading parameters toward the intact state.

Optimization of technique for insertion of implants at the supra-acetabular corridor in pelvis and acetabular surgery.

Science.gov (United States)

Tosounidis, Theodoros H; Mauffrey, Cyril; Giannoudis, Peter V

2018-01-01

The technique for application of implants at the sciatic buttress has been well described in the pelvic and acetabular fracture reconstruction literature. We described a new use of the inlet-obturator oblique view for the identification of the anterior inferior iliac spine, which is the entry point of implants, and we provide a detailed fluoroscopic and radiographic description of this view. A small series of 15 patients who underwent an application of an anterior inferior pelvic external (supra-acetabular) fixator via this technique is presented. We consider the use of the obturator oblique for the identification of the entry point unnecessary, and we advocate for the use of only the inlet-obturator oblique and iliac oblique views when implants are applied to the sciatic buttress.

Computer assisted surgery in preoperative planning of acetabular fracture surgery: state of the art.

Science.gov (United States)

Boudissa, Mehdi; Courvoisier, Aurélien; Chabanas, Matthieu; Tonetti, Jérôme

2018-01-01

The development of imaging modalities and computer technology provides a new approach in acetabular surgery. Areas covered: This review describes the role of computer-assisted surgery (CAS) in understanding of the fracture patterns, in the virtual preoperative planning of the surgery and in the use of custom-made plates in acetabular fractures with or without 3D printing technologies. A Pubmed internet research of the English literature of the last 20 years was carried out about studies concerning computer-assisted surgery in acetabular fractures. The several steps for CAS in acetabular fracture surgery are presented and commented by the main author regarding to his personal experience. Expert commentary: Computer-assisted surgery in acetabular fractures is still initial experiences with promising results. Patient-specific biomechanical models considering soft tissues should be developed to allow a more realistic planning.

Endoscopic Transnasal Approach for Cholesterol Granuloma of the Petrous Apex

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Mohammad Samadian

2015-01-01

Full Text Available Cholesterol granulomas are rare round or ovoid cysts. They contain cholesterol crystals surrounded by foreign bodies of giant cells and are characterized by chronic inflammation. Large cholesterol granuloma can compress surrounding tissue especially cranial nerves. There are several types of surgery for the resection of cholesterol granuloma. We describe 4 cases of cholesterol granuloma operated on via transnasal endoscopic approach. In this report, we describe radiologic and pathologic features of this lesion and explain the advantages and disadvantages of transsphenoidal endoscopic approach for these rare lesions.

Decreased Lumbar Lordosis and Deficient Acetabular Coverage Are Risk Factors for Subchondral Insufficiency Fracture.

Science.gov (United States)

Jo, Woo Lam; Lee, Woo Suk; Chae, Dong Sik; Yang, Ick Hwan; Lee, Kyoung Min; Koo, Kyung Hoi

2016-10-01

Subchondral insufficiency fracture (SIF) of the femoral head occurs in the elderly and recipients of organ transplantation. Osteoporosis and deficient lateral coverage of the acetabulum are known risk factors for SIF. There has been no study about relation between spinopelvic alignment and anterior acetabular coverage with SIF. We therefore asked whether a decrease of lumbar lordosis and a deficiency in the anterior acetabular coverage are risk factors. We investigated 37 patients with SIF. There were 33 women and 4 men, and their mean age was 71.5 years (59-85 years). These 37 patients were matched with 37 controls for gender, age, height, weight, body mass index and bone mineral density. We compared the lumbar lordosis, pelvic incidence, pelvic tilt, sacral slope, acetabular index, acetabular roof angle, acetabular head index, anterior center-edge angle and lateral center-edge angle. Lumbar lordosis, pelvic tilt, sacral slope, lateral center edge angle, anterior center edge angle, acetabular index and acetabular head index were significantly different between SIF group and control group. Lumbar lordosis (OR = 1.11), lateral center edge angle (OR = 1.30) and anterior center edge angle (OR = 1.27) had significant associations in multivariate analysis. Decreased lumbar lordosis and deficient anterior coverage of the acetabulum are risk factors for SIF as well as decreased lateral coverage of the acetabulum.

Case Report: Corneal Pyogenic Granuloma: Rare Complication of ...

African Journals Online (AJOL)

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 ...

Intraoperative CT in the assessment of posterior wall acetabular fracture stability.

Science.gov (United States)

Cunningham, Brian; Jackson, Kelly; Ortega, Gil

2014-04-01

Posterior wall acetabular fractures that involve 10% to 40% of the posterior wall may or may not require an open reduction and internal fixation. Dynamic stress examination of the acetabular fracture under fluoroscopy has been used as an intraoperative method to assess joint stability. The aim of this study was to demonstrate the value of intraoperative ISO computed tomography (CT) examination using the Siemens ISO-C imaging system (Siemens Corp, Malvern, Pennsylvania) in the assessment of posterior wall acetabular fracture stability during stress examination under anesthesia. In 5 posterior wall acetabular fractures, standard fluoroscopic images (including anteroposterior pelvis and Judet radiographs) with dynamic stress examinations were compared with the ISO-C CT imaging system to assess posterior wall fracture stability during stress examination. After review of standard intraoperative fluoroscopic images under dynamic stress examination, all 5 cases appeared to demonstrate posterior wall stability; however, when the intraoperative images from the ISO-C CT imaging system demonstrated that 1 case showed fracture instability of the posterior wall segment during stress examination, open reduction and internal fixation was performed. The use of intraoperative ISO CT imaging has shown an initial improvement in the surgeon's ability to assess the intraoperative stability of posterior wall acetabular fractures during stress examination when compared with standard fluoroscopic images. Copyright 2014, SLACK Incorporated.

Vulvar Lobular Capillary Hemangioma (Pyogenic Granuloma

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Kian-Mei Chong

2005-03-01

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.

Eosinophilic granuloma of the mandibular condyle

International Nuclear Information System (INIS)

Huh, Kyung Hoe; Yi, Won Jin; Oh, Sung Won; Lee, Sam Sun; Choi, Mun Kyung

2008-01-01

The present study reports a case of eosinophilic granuloma of the mandibular condyle. Eosinophilic granulomas on the mandibular condyle are very rare, but there are several common clinical and radiographic presentations. The clinical presentations involve swelling on preauricular area, limitation of opening, TMJ pain, etc. The radiographic presentations involve radiolucent lytic condylar lesion with or without pathologic fracture. Sometimes new bone formations are observed. The purpose of the article is to add new cases to the literatures.

Eosinophilic granuloma of the mandibular condyle

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Huh, Kyung Hoe; Yi, Won Jin; Oh, Sung Won; Lee, Sam Sun [Department of Oral and Maxillofacial Radiology, and Dental Research Institute, School of Dentistry, Seoul National University, Seoul (Korea, Republic of); Choi, Mun Kyung [Department of Oral and Maxillofacial Surgery, College of Medicine, Inje University Sanggye Paik Hospital, Seoul (Korea, Republic of)

2008-03-15

The present study reports a case of eosinophilic granuloma of the mandibular condyle. Eosinophilic granulomas on the mandibular condyle are very rare, but there are several common clinical and radiographic presentations. The clinical presentations involve swelling on preauricular area, limitation of opening, TMJ pain, etc. The radiographic presentations involve radiolucent lytic condylar lesion with or without pathologic fracture. Sometimes new bone formations are observed. The purpose of the article is to add new cases to the literatures.

Cholesterol granuloma of the orbit: An atypical presentation

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Syed A R Rizvi

2014-01-01

Full Text Available Cholesterol granuloma is a rare, well-defined lesion of the orbit. In the orbit, diploe of the frontal bone is involved almost exclusively. We report an atypical case of cholesterol granuloma involving superomedial quadrant of orbit. A 42-year-old male presented with progressive, painless, proptosis with infero-temporal displacement of left eye. A large mass was felt beneath the bony orbital margin in the superomedial quadrant of the left orbit. Computerized tomography (CT scan revealed an extraconal superomedial, heterogeneous enhancing mass which was isodense with brain and pushing the globe inferolaterally and anteriorly. Excision biopsy of the tumor revealed the typical features of a cholesterol granuloma without any epithelial elements. Cholesterol granuloma of the orbit is a rare entity, but it can be diagnosed and differentiated from other lesions of the superior orbit by its characteristic clinical, radiological and histopathological features. An appropriate intervention in time carries a good prognosis with almost no recurrence.

Comparison of digital radiometric features between radicular cysts and periapical granulomas

International Nuclear Information System (INIS)

Jin, Yeon Hwa; Lee, Keon Il

1999-01-01

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.

Comparison of digital radiometric features between radicular cysts and periapical granulomas

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Jin, Yeon Hwa; Lee, Keon Il [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Wankwang University, Yongin (Korea, Republic of)

1999-02-15

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.

Iatrogenic granulomas of the prostate and the urinary bladder

DEFF Research Database (Denmark)

Sørensen, Flemming Brandt; Marcussen, N

1987-01-01

in the granulomatous lesions and the configurations and anatomical distribution of the granulomas suggest a common pathogenesis by electrocauterization. Immunohistochemically, histiocytic cells were stained by antibodies against lysozyme. In the prostate, no reaction by antibodies against prostate specific antigen......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...

Sacroiliac joint dysfunction as a reason for the development of acetabular retroversion: a new theory.

Science.gov (United States)

Cibulka, Michael T

2014-05-01

Acetabular retroversion has been recently implicated as an important factor in the development of femoral acetabular impingement and hip osteoarthritis. The proper function of the hip joint requires that the anatomic features of the acetabulum and femoral head complement one another. In acetabular retroversion, the alignment of the acetabulum is altered where it opens in a posterolaterally instead of anterior direction. Changes in acetabular orientation can occur with alterations in pelvic tilt (anterior/posterior), and pelvic rotation (left/right). An overlooked problem that alters pelvic tilt and rotation, often seen by physical therapists, is sacroiliac joint dysfunction. A unique feature that develops in patients with sacroiliac joint dysfunction (SIJD) is asymmetry between the left and right innominate bones that can alter pelvic tilt and rotation. This article puts forth a theory suggesting that acetabular retroversion may be produced by sacroiliac joint dysfunction.

MRI morphometric hip comparison analysis of anterior acetabular labral tears

International Nuclear Information System (INIS)

Aly, Abdel Rahman; Rajasekaran, Sathish; Obaid, Haron

2013-01-01

Anterior (3 o'clock) acetabular labral tears (AALTs) have been reported to be associated with iliopsoas impingement (IPI). However, no study has examined the association between anatomical bony variables of the hip joint and AALTs. The purpose of this study was to evaluate the association between AALTs, femoroacetabular impingement (FAI) and other bony variables of the hip. Seventy-six out of 274 hip MRI records met the inclusion criteria. Two independent blinded investigators evaluated the location of acetabular labral tears (ALTs), edema at the musculotendinous junction of the iliopsoas insertion, femoral neck anteversion angle, femoral neck shaft angle, acetabular anteversion angle, alpha angle, lateral central edge angle (LCEA), acetabular index, and acetabular depth. Comparison analyses between groups were performed. Twenty-two patients had no ALTs (controls), 19 patients had AALTs, and 35 patients had ALTs not isolated at the 3 o'clock position (25 with cam-bony deformities [FAI-cam] and 10 with pincer-bony deformities [FAI-pincer]). The alpha angle mean was significantly higher (p < 0.001) in the FAI-cam group (62.7 , 95 % confidence interval [CI]: 56.2-69.2 ) compared with the AALTs group (46.9 , 95 % CI: 40.1-53.7 ). The LCEA mean was significantly higher (p < 0.001) in FAI-pincer group (41.9 , 95 % CI: 39.3 -44.5 ) compared to AALTs group (29.4 , 95 % CI: 24.2 -34.6 ). There was no statistically significant difference in any of the bony variables between the controls and the AALTs group. Our study demonstrated that AALTs are pathologically distinct and not associated with FAI or other bony abnormalities. This supports the previous studies, which proposed that AALTs are associated with IPI. (orig.)

A case report of giant cell reparative granuloma

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Park, Chang Sik; Lee, Yoo Dong [College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

1974-11-15

The authors observed in the routine roentgenographic examination, a rare case of Giant cell Reparative Granuloma found in the mandible of woman 23 years of age who had visited Infirmary of Dental College, Seoul National University be cause of the traffic accident. In the serial roentgenograms, authors had obtained the results as follows; 1. Giant cell Reparative Granuloma occurred below the 20 years of age, and occurred in the mandible of female. 2. In roentgenograms, it figures the radiolucent lesion with multilocular appearance. 3. The growing process of Giant Cell Reparative Granuloma is not by the neoplastic reaction but by the local reparative reaction.

Tinea granulomatosa de Majocchi Majocchi's granuloma

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Aline Lopes Bressan

2011-08-01

Full Text Available Relata-se o caso de um homem de 45 anos com dermatofitose superficial de longa data, tratado, inadvertidamente, com corticoide e antibiótico, com progressão subsequente para a forma profunda, conhecida como granuloma de Majocchi. O tratamento com terbinafina VO foi curativoWe report the case of a man of 45 with superficial dermatophytosis longtime inadvertently treated with antibiotics and corticosteroids with subsequent progression to the deep form, known as granuloma Majocchi. Treatment with orally terbinafine was successful

CROHN’S GRANULOMA OF SKIN IN IBD COLITIS

OpenAIRE

Hardeep Singh; Vijay; Anumeet Singh

2015-01-01

Crohn’s granuloma is a sarcoid - like lesion, with collections of monocyte/macrophages cells (epitheloid histiocytes) and other inflammatory cells, including lymphocytes and eosinophils with occasional giant cells. They are seen rarely in extraintestinal sites. Crohn’s granuloma is highly characteristic of C rohn’s disease. It responds to treatment of ...

Eosinophilic granuloma in the anterior mandible mimicking radicular cyst

International Nuclear Information System (INIS)

Lee, Byung Do; Lee, Wan; Lee, Jun; Son, Hyun Jin

2013-01-01

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.

Eosinophilic granuloma in the anterior mandible mimicking radicular cyst

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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)

2013-06-15

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.

Autotransplantation of hepatic granulomas into the skin of mice with Schistosoma mansoni infection

International Nuclear Information System (INIS)

Nishimura, M.; Epstein, W.L.; Fukuyama, K.

1982-01-01

Hepatic egg granulomas of mice infected with Schistosoma mansoni were transplanted into the skin of the same animal and changes occurring to macrophages, eosinophils, and mast cells over time were studied by light and electron microscopy and by autoradiographic techniques. Disappearance of cellular components about the egg granulomas occurred within 1 week; the entire implant became encapsulated by inflammatory cells and stroma. By 3 weeks mononuclear cells and macrophages reorganized the granulomas around the eggs and neutrophils disappeared. Activated macrophages contained both secretory rough endoplasmic reticulum and lysosomal-dense bodies. Granuloma size increased up to 5 weeks after implantation and mast cells and eosinophils tended to migrate into the granulomas. The mast cell index always remained lower than in the original hepatic granulomas, while eosinophils were seen in large numbers. During 3 to 8 weeks after implantation mononuclear cells undergoing DNA synthesis in the granulomas ranged from 2.9-4.8%. Some 3-week-old autotransplants were injected with 3 H-thymidine and biopsied from 1 to 21 days later. Labeled mononuclear cells peaked in the granulomas by 10 days (24%) and the numbers fell off sharply after that. These findings indicate that autologously implanted schistosome egg granulomas can be maintained successfully in the skin for prolonged periods with marked ingress of macrophages and eosinophils. The autoradiographic data suggest the lesions are high turnover granulomas

Post-operative intracranial foreign body granuloma: A case report

International Nuclear Information System (INIS)

Djindjian, M.; Brugieres, P.; Razavi-Encha, F.; Allegret, C.; Poirier, J.; Paris-12 Univ., 94 - Creteil

1987-01-01

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. (orig.)

A Case of Angioleiomyoma with Epithelioid Granuloma

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Masazumi Onishi

2011-08-01

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.

Role of matrix metalloproteinases in radicular cysts and periapical granulomas.

Science.gov (United States)

D'addazio, G; Artese, L; Piccirilli, M; Perfetti, G

2014-01-01

The aim of the present study was to evaluate the expression and distribution of different classes of matrix metalloproteinases (MMPs) in radicular cysts and periapical granulomas. Twenty consecutive specimens of radicular cysts and 20 of periapical granulomas were selected. Expression of MMP-2, -9, -8, -13, -3 was immunohistochemically evaluated. The intensity of expression of the MMPs was evaluated using a semi-quantitative analysis: low = +; intermediate = ++; high = +++. Positive expression of MMPs was present with different distribution. MMP-9 expressed differently in the lesions. Indeed, in periapical granulomas low expression was found in endothelial cells and fibroblasts, whilst high intensities were only detected in inflammatory cells. On the contrary, in radicular cysts the high intensities were mainly present in keratinocytes and fibroblasts. MMP-8 was mainly expressed in inflammatory cells of periapical granulomas. MMP-2 and -3 presented a low intensity of expression in both groups. MMP-13 showed a variable pattern of distribution in the different cell types of the two different lesions. The present investigation supports the role of MMPs in the inflammatory process leading to the development of radicular cysts and periapical granulomas. The results of the present study suggested that the increased enlargement of radicular cysts, compared to periapical granulomas, might be related to a higher expression of MMP-9. On the other hands, the higher intensity of expression of MMP-8 in periapical granulomas could be related to an active inflammatory process. MMP-8 could play an important role in the inflammation processes during the development of periapical lesions.

MRI morphometric hip comparison analysis of anterior acetabular labral tears

Energy Technology Data Exchange (ETDEWEB)

Aly, Abdel Rahman [University of Saskatchewan, Department of Physical Medicine and Rehabilitation, Saskatoon, SK (Canada); Saskatoon City Hospital, Saskatoon, SK (Canada); Rajasekaran, Sathish [HealthPointe, Pain, Spine and Sport Medicine, Alberta (Canada); Obaid, Haron [Royal University Hospital, University of Saskatchewan, Department of Medical Imaging, Saskatoon, SK (Canada)

2013-09-15

Anterior (3 o'clock) acetabular labral tears (AALTs) have been reported to be associated with iliopsoas impingement (IPI). However, no study has examined the association between anatomical bony variables of the hip joint and AALTs. The purpose of this study was to evaluate the association between AALTs, femoroacetabular impingement (FAI) and other bony variables of the hip. Seventy-six out of 274 hip MRI records met the inclusion criteria. Two independent blinded investigators evaluated the location of acetabular labral tears (ALTs), edema at the musculotendinous junction of the iliopsoas insertion, femoral neck anteversion angle, femoral neck shaft angle, acetabular anteversion angle, alpha angle, lateral central edge angle (LCEA), acetabular index, and acetabular depth. Comparison analyses between groups were performed. Twenty-two patients had no ALTs (controls), 19 patients had AALTs, and 35 patients had ALTs not isolated at the 3 o'clock position (25 with cam-bony deformities [FAI-cam] and 10 with pincer-bony deformities [FAI-pincer]). The alpha angle mean was significantly higher (p < 0.001) in the FAI-cam group (62.7 , 95 % confidence interval [CI]: 56.2-69.2 ) compared with the AALTs group (46.9 , 95 % CI: 40.1-53.7 ). The LCEA mean was significantly higher (p < 0.001) in FAI-pincer group (41.9 , 95 % CI: 39.3 -44.5 ) compared to AALTs group (29.4 , 95 % CI: 24.2 -34.6 ). There was no statistically significant difference in any of the bony variables between the controls and the AALTs group. Our study demonstrated that AALTs are pathologically distinct and not associated with FAI or other bony abnormalities. This supports the previous studies, which proposed that AALTs are associated with IPI. (orig.)

Acetabular roof stress fracture: a rare cause of hip pain in children ...

African Journals Online (AJOL)

Stress fracture of acetabular roof is an unusual cause of hip pain. It is considered as an underdiagnosed entity. People who are more susceptible to experience this fracture are athletes, soldiers and dancers. We present the case of an 11 year old girl with a roof acetabular stress fracture for which the diagnosis and ...

Cement-in-cement acetabular revision with a constrained tripolar component.

Science.gov (United States)

Leonidou, Andreas; Pagkalos, Joseph; Luscombe, Jonathan

2012-02-17

Dislocation of a total hip replacement (THR) is common following total hip arthroplasty (THA). When nonoperative management fails to maintain reduction, revision surgery is considered. The use of constrained acetabular liners has been extensively described. Complete removal of the old cement mantle during revision THA can be challenging and is associated with significant complications. Cement-in-cement revision is an established technique. However, the available clinical and experimental studies focus on femoral stem revision. The purpose of this study was to present a case of cement-in-cement acetabular revision with a constrained component for recurrent dislocations and to investigate the current best evidence for this technique. This article describes the case of a 74-year-old woman who underwent revision of a Charnley THR for recurrent low-energy dislocations. A tripolar constrained acetabular component was cemented over the primary cement mantle following removal of the original liner by reaming, roughening the surface, and thoroughly irrigating and drying the primary cement. Clinical and radiological results were good, with the Oxford Hip Score improving from 11 preoperatively to 24 at 6 months postoperatively. The good short-term results of this case and the current clinical and biomechanical data encourage the use of the cement-in-cement technique for acetabular revision. Careful irrigation, drying, and roughening of the primary surface are necessary. Copyright 2012, SLACK Incorporated.

Pelvic Incidence: A Predictive Factor for Three-Dimensional Acetabular Orientation—A Preliminary Study

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Christophe Boulay

2014-01-01

Full Text Available Acetabular cup orientation (inclination and anteversion is a fundamental topic in orthopaedics and depends on pelvis tilt (positional parameter emphasising the notion of a safe range of pelvis tilt. The hypothesis was that pelvic incidence (morphologic parameter could yield a more accurate and reliable assessment than pelvis tilt. The aim was to find out a predictive equation of acetabular 3D orientation parameters which were determined by pelvic incidence to include in the model. The second aim was to consider the asymmetry between the right and left acetabulae. Twelve pelvic anatomic specimens were measured with an electromagnetic Fastrak system (Polhemus Society providing 3D position of anatomical landmarks to allow measurement of acetabular and pelvic parameters. Acetabulum and pelvis data were correlated by a Spearman matrix. A robust linear regression analysis provided prediction of acetabulum axes. The orientation of each acetabulum could be predicted by the incidence. The incidence is correlated with the morphology of acetabula. The asymmetry of the acetabular roof was correlated with pelvic incidence. This study allowed analysis of relationships of acetabular orientation and pelvic incidence. Pelvic incidence (morphologic parameter could determine the safe range of pelvis tilt (positional parameter for an individual and not a group.

Using Periapical Radiography to Differentiate Periapical Granuloma and Radicular Cysts

Directory of Open Access Journals (Sweden)

Farhadi

2016-06-01

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.

Granuloma actínico de O'Brien: apresentação clínica exuberante O'Brien's actinic granuloma: an unusually extensive presentation

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Rosana Lazzarini

2011-04-01

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.

Normal microscopic architecture of acetabular labrum of hip joint: a qualitative original study with clinical aspects.

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Kapetanakis, Stylianos; Gkantsinikoudis, Nikolaos; Dermon, Antonios; Kommata, Vassiliki; Papathanasiou, Jannis; Soukakos, Panagiotis; Dermon, Caterina

2017-01-01

Normal histologic architecture of acetabular labrum, regarding presence of Free Nerve Endings (FNEs) and Nerve End Organs (NEOs) has been four times described. Nevertheless, elderly cadaveric specimens and individuals were recruited, leading to considerably high unreliability probability due to microscopic degenerative alterations. Aim of this paper is to analyze distribution pattern of FNEs and NEOs in acetabular labra of healthy middle-aged individuals, configuring thus more reliably acetabular labrum microscopic profile. Six patients with middle age 52 ± 2.5 years were enrolled in this study. Injury of acetabular labrum and normal hip radiograph were present in all cases. Patients were all subjected to successful hip hemi-arthroplasty and derived acetabular labra were subsequently histologically processed and observed under a compound microscope. FNEs and NEOs were detected in all specimens. All types of NEOs were identified, including Paccini, Golgi-Mazzoni, Ruffini and Krause corpuscles. FNEs and NEOs were both in ventral part and in chondral side of labrum predominantly detected. FNEs and NEOs presence was greater in ventral side of labrum, being thus in partial agreement with previous studies results. Further study is required, in order to elucidate the exact acetabular labrum normal microscopic anatomy. IV.

Coblation of suprastomal granulomas in tracheostomy-dependent children.

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Brown, C Scott; Ryan, Marisa A; Ramprasad, Vaibhav H; Karas, Anatoli F; Raynor, Eileen M

2017-05-01

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.

[Inflammatory granulomas in the pathology of the nervous system. General remarks].

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Tommasi, M

1976-01-01

The "gliogenic" participation in the edification of granulomas may produce peculiar morphological features especially in the central nervous system, and perhaps more than elsewhere, pseudotumoral features. Moreover, the concept of "granuloma" is perhaps not as well defined as in the other tissues. There are also some still unsolved problems concerning the histogenesis of the cells of the "granuloma". Some examples taken among the different etiologies illustrate these notions.

Peripheral giant cell granuloma: A review of 123 cases

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Niloofar Shadman

2009-01-01

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.

MR findings of eosinophilic granuloma

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Choi, Jong O; Yee, Mi Kyeung; Cho, Kil Ho [Yeungnam Univ. College of Medicine, Kyongsan (Korea, Republic of); Lee, Sung Moon [Keimyung Univ. College of Medicine, Taegu (Korea, Republic of); Lee, Young Hwan [Hyosung Catholic Univ. College of Medicine, Taegu (Korea, Republic of); Suh, Kyung Jin [Suhjoo MR Clinic, Taegu (Korea, Republic of)

1999-06-01

To describe the MR findings for the three phases of eosinophilic granuloma, as defined by Mirra's conventional radiographic criteria. Eighteen lesions in 14 patients with proven eosinophilic granuloma were retrospectively analyzed. Among this total, three vertebral lesions were excluded, and the remaining is were classified as early, middle, or late phase on the basis of Mirra's radiographic criteria. For each phase, we compared MR findings with regard to signal intensity, homogeneity, contrast enhancement, perilesional marrow edema, and soft tissue change. For the three vertebral lesions excluded because the application of radiographic criteria was difficult, MR findings for paravertebral soft tissue reaction and degree of cord compression were compared. Of the fifteen cases classified, eight were early phase, five were mid phase, and two were late phase. During each phase, all lesions except one, as seen on T1-weighted images(T1WI), showed iso-signal intensity. On T2WI, all lesions showed high signal intensity. Contrast study demonstrated marked contrast enhancement. Thus, no remarkable differences were found in the signal intensity degree of contrast enhancement of each phase. With regard to heterogeneity, this was demonstrated in most early phase lesions, reflecting necrosis and hemorrhage of those lesions. Soft tissue swelling was more severe during the early phase than the mid or late phase, but marrow edema was similar in each of the three phase. One of three patients with vertebraplana showed para-vertebral soft tissue swelling and cord compression, but this was not seen in the two other cases. For evalvating the extent of eosinophilic granuloma and its relationship with surrounding structures, MRI was superior to conventional radiography. During the early phase of the disease, lesions showed greater inhomogeneity and more aggressive soft tissue reaction than during the mid and late phase.The use of MRI for the evalvation of eosinophilic granuloma

Postoperative Granulomas at Liposuction Incision Sites.

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Weniger, Frederick G; White, Peter F; Barrero Castedo, Carlos E

2016-02-01

Since most liposuction incisions heal uneventfully, difficult healing in such incisions must be investigated. In the cases of two gynecomastia liposuction patients in which a water-based lubricating gel was used on the liposuction incisions, the incisions failed to heal. For both patients, workup uncovered palisading granulomas at the lateral inframammary fold incision sites several months after otherwise successful surgeries. These two cases are presented and the previous literature is reviewed, with consideration given to the etiology and prevention of such granulomas. LEVEL OF EVIDENCE 5: Risk. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

Nasal granuloma gravidarum presenting with recurrent massive epistaxis.

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Tantinikorn, Weerachai; Uiprasertkul, Mongkol; Assanasen, Paraya

2003-05-01

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.

Computed tomography findings in patients with pulmonary hyalinizing granulomas: a case report

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Marchiori, Edson; Valiante, Paulo Marcos; Correia, Ana Helena Pereira; Carneiro, Leonardo Hoehl; Caldas, Carolina Rodrigues; Souza Junior, Arthur Soares

2003-01-01

Hyalinizing granulomas are benign fibrotic lesions that generally present multiple nodules seen on radiological examinations, which are frequently cavitary and/or calcified lesions. We report a case of a 28 year-old-woman with hyalinizing granulomas probably secondary to a previous tuberculosis infection. Hyalinizing granulomas should be included in the differential diagnosis of patients with multiple pulmonary nodules. (author)

Ultrasound versus Magnetic Resonance Arthrography in Acetabular Labral Tear Diagnostics: A Prospective Comparison in 20 Dysplastic Hips

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Troelsen, A.; Jacobsen, S.; Bolvig, L.; Gelineck, J.; Roemer, L.; Soeballe, K. [Orthopedic Research Unit and Dept. of Radiology, Univ. Hospital of Aarhus, A arhus (Denmark)

2007-11-15

Background: Acetabular labral tears are highly associated with hip dysplasia. Magnetic resonance arthrography (MR arthrography) is the expensive and time-consuming contemporary gold-standard method in the radiological assessment of acetabular labral tears. Purpose: To assess the diagnostic ability of noninvasive ultrasound (US) examination compared to MR arthrography in diagnosing acetabular labral tears in dysplastic hip joints. Material and Methods: The study compared US examination and MR arthrography diagnosis of labral tears in 20 consecutively referred dysplastic hip joints. Results: The ability to diagnose acetabular labral tears upon US examination was calculated: sensitivity 44%, specificity 75%, positive predictive value 88%, and negative predictive value 25%. Conclusion: The ability of US examination in diagnosing acetabular labral tears is not yet good enough. The technique is still to be developed, and more experience, especially with the interpretation of US examinations, is needed.

Arthroscopic treatment of femoral nerve paresthesia caused by an acetabular paralabral cyst.

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Kanauchi, Taira; Suganuma, Jun; Mochizuki, Ryuta; Uchikawa, Shinichi

2014-05-01

This report describes a rare case of femoral nerve paresthesia caused by an acetabular paralabral cyst of the hip joint. A 68-year-old woman presented with a 6-month history of right hip pain and paresthesia along the anterior thigh and radiating down to the anterior aspect of the knee. Radiography showed osteoarthritis with a narrowed joint space in the right hip joint. Magnetic resonance imaging showed a cyst with low T1- and high T2-weighted signal intensity arising from a labral tear at the anterior aspect of the acetabulum. The cyst was connected to the joint space and displaced the femoral nerve to the anteromedial side. The lesion was diagnosed as an acetabular paralabral cyst causing femoral neuropathy. Because the main symptom was femoral nerve paresthesia and the patient desired a less invasive procedure, arthroscopic labral repair was performed to stop synovial fluid flow to the paralabral cyst that was causing the femoral nerve paresthesia. After surgery, the cyst and femoral nerve paresthesia disappeared. At the 18-month follow-up, the patient had no recurrence. There have been several reports of neurovascular compression caused by the cyst around the hip joint. To the authors' knowledge, only 3 cases of acetabular paralabral cysts causing sciatica have been reported. The current patient appears to represent a rare case of an acetabular paralabral cyst causing femoral nerve paresthesia. The authors suggest that arthroscopic labral repair for an acetabular paralabral cyst causing neuropathy can be an option for patients who desire a less invasive procedure. Copyright 2014, SLACK Incorporated.

[Effects of Surgically Treated Pelvic Ring and Acetabular Fractures on Postural Control].

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Lang, P; Schnegelberger, A; Riesner, H-J; Stuby, F; Friemert, B; Palm, H-G

2016-04-01

The aim of surgical treatment of pelvic ring and acetabular fractures is to allow rapid mobilisation of patients in order to restore stance and gait stability (postural control), as this significantly correlates with a positive outcome. The regulation of postural stability is mainly controlled by transmission of proprioceptive stimuli. In addition, the pelvis serves as a connection between the legs and the spine and thus is also of great importance for mechanical stabilisation. It remains unclear whether surgical treatment of pelvic ring and acetabular fractures affects the regulation of postural control. Therefore, the aim of this study was to examine the impact of surgically treated pelvic ring and acetabular fractures on postural stability by means of computerised dynamic posturography (CDP) after a mean of 35 months and to compare the results with a healthy control group. A retrospective case control study of 38 patients with surgically treated pelvic ring and acetabular fractures and 38 healthy volunteers was carried out using CDP. The average time of follow-up was 35 (12-78) months. The most important outcome parameter in this investigation was the overall stability index (OSI). Hip joint mobility, the health-related quality of life (SF-12) and pain were supplementary outcome parameters. It was found that surgically treated pelvic ring and acetabular fractures had no influence on postural stability. The OSI was 2.1 ° in the patient group and 1.9 ° in the control group. There was no significant difference between the groups in hip joint mobility. A total of 52 % of patients showed no or only mild pain. Mean health-related quality of life was the same as in the total population. Surgically treated pelvic ring and acetabular fractures do not lead to deterioration in postural control in the mid term. This is of high prognostic importance for rapid mobilisation of the patients. Therefore no increase in the risk of falling is expected after successfully

Measurement of acetabular morphology under three-dimensional reconstruction of CT and significance

International Nuclear Information System (INIS)

Han Yingying; Yang Qiwei; Lai Ying; Hao Shuang; Ma Hecheng; Xiao Chengshuang; Li Youqiong

2011-01-01

Objective: To measure the acetabular morphology of Chinese on CT three-dimensional (3D) reconstruction image, and provide the evidence on the prevention and treatment of hip disease. Methods: 96 cases (192 sides) of adult hip CT scans were reconstructed, the acetabular index (AA), center-edge (CE), ACE angle, anteversion angle (AVA), abduction angle (ABA), and vertical diameter (SID) were measured. Results: The total acetabular index was (8.78±5.34)°, of which male was (7.84±5.55)° and female was (9.60±5.06)°. The total CE was (33.59±5.91)°, of which male was (34.55±6.03)° and female was (32.78±5.70)°. The total ACE angle was (29.01±5.65)°, of which male was (28.02±5.94)° and female was (29.80±5.30)°. The total AVA was (20.92±5.55)°, of which male was (20.48±5.08)° and female was (21.25±5.89)°. The total ABA was (51.27±4.16)°, of which male was (51.71±4.37)° and female was (50.89±3.96)°. The total SID was (53.79±3.92) mm, of which male was (56.55±2.64) mm and female was (51.46±3.25) mm. Of the above data, there were statistical differences in the acetabular index, CE angle, ACE angle and acetabular diameter between men and women (P<0.05), Chinese and foreigners (P<0.05). While there was no statistical difference between the left and right sides (P>0.05). Conclusion: There are differences in acetabular morphology between men and women, Chinese and foreigners. Compared with simply using overseas data, it is better to study morphological parameters of native acetabula to instruct the preoperative preparation and operation of national total hip arthroplasty surgery. And it is meaningful to design national parameters. (authors)

Oral pyogenic granuloma: a epidemiologic study of 191 cases

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Thiago de Santana SANTOS

2008-01-01

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

Normal microscopic architecture of acetabular labrum of hip joint: a qualitative original study with clinical aspects

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Kapetanakis, Stylianos; Gkantsinikoudis, Nikolaos; Dermon, Antonios; Kommata, Vassiliki; Papathanasiou, Jannis; Soukakos, Panagiotis; Dermon, Caterina

2017-01-01

Summary Background Normal histologic architecture of acetabular labrum, regarding presence of Free Nerve Endings (FNEs) and Nerve End Organs (NEOs) has been four times described. Nevertheless, elderly cadaveric specimens and individuals were recruited, leading to considerably high unreliability probability due to microscopic degenerative alterations. Aim of this paper is to analyze distribution pattern of FNEs and NEOs in acetabular labra of healthy middle-aged individuals, configuring thus more reliably acetabular labrum microscopic profile. Materials and methods Six patients with middle age 52 ± 2.5 years were enrolled in this study. Injury of acetabular labrum and normal hip radiograph were present in all cases. Patients were all subjected to successful hip hemi-arthroplasty and derived acetabular labra were subsequently histologically processed and observed under a compound microscope. Results FNEs and NEOs were detected in all specimens. All types of NEOs were identified, including Paccini, Golgi-Mazzoni, Ruffini and Krause corpuscles. FNEs and NEOs were both in ventral part and in chondral side of labrum predominantly detected. Conclusion FNEs and NEOs presence was greater in ventral side of labrum, being thus in partial agreement with previous studies results. Further study is required, in order to elucidate the exact acetabular labrum normal microscopic anatomy. Level of evidence IV. PMID:29264339

Digestive Fistula Due to Acetabular Protrusion: Case Report and Review of the Literature

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Carlos Marqués

2017-12-01

Full Text Available Intrapelvic migration of the acetabular component after primary or revision hip arthroplasty is a rare complication. We present a case of an intrapelvic migration of the acetabular component after a revision hip arthroplasty which led to an enteric fistula to the hip joint as well as to a sigmoid colon perforation.

Foreign Body Granulomas after the Use of Dermal Fillers: Pathophysiology, Clinical Appearance, Histologic Features, and Treatment

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Jeong Min Lee

2015-03-01

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.

Endoscopic transsphenoidal surgery for cholesterol granulomas involving the petrous apex

NARCIS (Netherlands)

Georgalas, C.; Kania, R.; Guichard, J.-P.; Sauvaget, E.; Tran Ba Huy, P.; Herman, P.

2008-01-01

Surgery for cholesterol granulomas involving the petrous apex has traditionally been performed via a lateral skull base approach. We present a case-series of four cholesterol granulomas treated through the endoscopic-transsphenoid approach over the last 10 years. Drainage was successful and

The imaging diagnosis of costal solitary eosinophilic granuloma

International Nuclear Information System (INIS)

Cui Fa; Feng Shiting

2007-01-01

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)

Surgical Site Infection Following Fixation of Acetabular Fractures.

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Iqbal, Faizan; Younus, Sajid; Asmatullah; Zia, Osama Bin; Khan, Naveed

2017-09-01

Acetabular fractures are mainly caused by high energy trauma. Surgical fixation of these fractures requires extensive surgical exposure which increases the length of operation and blood loss as well. This may increase the risk of surgical site infection. Our aim is to evaluate the prevalence of surgical site infections and the risk factors associated with it so as to minimize its chances. A total of 261 patients who underwent acetabular fracture surgery were retrospectively reviewed. Patients were divided into 2 groups, with or without surgical site infection. Factors examined include patients' gender, age, body mass index (BMI), time between injury and surgery, operative time, estimated blood loss, number of packed red blood cell transfused, length of total intensive care unit (ICU) stay, fracture type, surgical approach, smoking status, patients' comorbids and associated injuries. Fourteen patients (5.4%) developed surgical site infection. Out of 14 infections, 4 were superficial and 10 were deep. The factors that were found to be associated with surgical site infection following acetabular fracture fixation were prolonged operation time, increased BMI, prolonged ICU stay, larger amount of packed red blood cell transfused and associated genitourinary and abdominal trauma. In our study, we conclude that measures should be undertaken to attenuate the chances of surgical site infection in this major surgery by considering the risk factors significantly associated with it.

Macrophage and T cell dynamics during the development and disintegration of mycobacterial granulomas.

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Egen, Jackson G; Rothfuchs, Antonio Gigliotti; Feng, Carl G; Winter, Nathalie; Sher, Alan; Germain, Ronald N

2008-02-01

Granulomas play a key role in host protection against mycobacterial pathogens, with their breakdown contributing to exacerbated disease. To better understand the initiation and maintenance of these structures, we employed both high-resolution multiplex static imaging and intravital multiphoton microscopy of Mycobacterium bovis BCG-induced liver granulomas. We found that Kupffer cells directly capture blood-borne bacteria and subsequently nucleate formation of a nascent granuloma by recruiting both uninfected liver-resident macrophages and blood-derived monocytes. Within the mature granuloma, these myeloid cell populations formed a relatively immobile cellular matrix that interacted with a highly dynamic effector T cell population. The efficient recruitment of these T cells was highly dependent on TNF-alpha-derived signals, which also maintained the granuloma structure through preferential effects on uninfected macrophage populations. By characterizing the migration of both innate and adaptive immune cells throughout the process of granuloma development, these studies provide a new perspective on the cellular events involved in mycobacterial containment and escape.

Surgical Stabilization of Pelvic and Acetabular Fractures: A Review on the Determinants of Clinical Outcomes

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SS Sathappan

2010-03-01

Full Text Available AIM: Pelvic and acetabular fractures are associated with high-energy trauma. The aim of this study was to identify factors that are associated with specific clinical outcomes following treatment for these fractures. METHODS: A consecutive series of 30 patients who had surgical intervention for either pelvic or acetabular fractures formed the sample for this study. Clinical variables reviewed were: age, associated injuries, number of surgical procedures, time to surgery and post-operative complications. Clinical outcomes were assessed using Matta’s grading of post- operative fracture reduction alignment, and functional outcomes were graded using D'Aubigne & Postel’s Hip scoring system. RESULTS: Study subjects included twelve pelvic fractures and eighteen acetabular fractures. Patients older than 50 years of age had poorer hip scores despite surgery. Earlier fracture fixation (within five days was associated with better hip scores. Patients with acetabular fractures generally had better functional outcomes than patients with pelvic fractures (mean hip score 15.0 vs. 13.5. Closer anatomical reduction of acetabular fractures was associated with better functional outcome. CONCLUSION: Improved clinical outcomes are associated with younger age, fewer concomitant injuries, shorter time interval to surgery and more closely approximated anatomical fracture reduction.

A Case of Typhoid Fever with Hepatic Granulomas and Enteritis

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Shraddha Narechania

2015-01-01

Full Text Available The common histopathologic hepatic manifestations in patients infected with Salmonella include cloudy swelling and balloon degeneration with vacuolation of the hepatocytes and steatosis. Hepatic granulomas are a very rare finding, so far reported in very few cases. We report a 64-year-old patient with Salmonella enteritis who was found to have multiple 1.4 to 1.6 cm hypoechoic liver masses on ultrasound of the abdomen which on biopsy revealed hepatic granulomas. This case highlights the importance of keeping the differential diagnosis of Salmonella typhi (S. typhi in mind in a patient with hepatic granulomas.

Coexistence of morphea and granuloma annulare: a rare case report

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Şenay Ağırgöl

2017-11-01

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.

Risk factors for granuloma formation in children induced by tracheobronchial foreign bodies.

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Huang, Zhenghua; Zhou, Ai; Zhang, Jianya; Xie, Lisheng; Li, Qi

2015-12-01

The aim of this study was to analyze the risk factors for granuloma formation caused by plant-based tracheobronchial foreign bodies in children, and investigate the underlying pathogenesis. In this retrospective analysis of 153 cases with tracheobronchial foreign bodies (peanuts and watermelon seeds), 35 cases of granuloma formation as granulation group (G), and 118 cases of no granuloma formation as non-granulation group (NG) were studied. Clinical data pertaining to sex (S), age (A), foreign body surface smoothness (SF), foreign body shape (SH), foreign body oil release state (O), the location of foreign bodies (L), and foreign body retention time (T) were collected for statistical analysis. Univariate analysis showed no significant difference between the two groups (G and NG) with respect to S, A, SH and L. Significant factors based on univariate analysis included SF, O and T. Multivariate logistic regression analysis revealed that SF and T were independent risk factors associated with development of granuloma. SF, O and T had relationship with the granuloma formation. Local trauma caused by an irregular and sharp foreign body, and extended period of time represent the main factors causing granuloma formation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Assessment of trochanteric osteotomy fragment union after acetabular fracture surgery.

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Dubina, Andrew G; Wickramaratne, Niluka; O'Toole, Robert V; Manson, Theodore T

2017-02-01

Trochanteric osteotomies are performed in conjunction with standard approaches to improve surgical exposure during open reduction and internal fixation (ORIF) of acetabular fractures. The literature on total hip arthroplasty reports nonunion rates as high as 30% associated with trochanteric osteotomies; however, few data exist regarding the outcomes of trochanteric osteotomies for acetabular fracture surgery. Our hypotheses were 1) patients receiving trochanteric osteotomies during ORIF of acetabular fractures have a low rate of nonunion of the osteotomy fragment, and 2) hip abduction precautions are not necessary with digastric type osteotomies. A retrospective review was conducted to identify patients with acetabular fractures between July 2002 and June 2010 (n=734 fractures) who required trochanteric osteotomies (n=64, 9% of fractures). Forty-seven met inclusion criteria of adequate follow-up (>56days). No excluded patient experienced a complication. Fractures were classified using the Letournel-Judet classification system. Only seven (20%) of 35 patients who received digastric osteotomies had hip abduction precautions applied during the postoperative period. All study patients were shown to have radiographic union at the trochanteric osteotomy site (100% union rate, n=47). Hip abduction precautions intended to protect the osteotomy site and reduce the risk of nonunion and fixation failure were infrequently applied to patients with digastric osteotomies (20%) in this cohort. Multiple protective factors against nonunion were present in this study population compared with previous arthroplasty studies from other institutions. Trochanteric osteotomies are not associated with a significant nonunion rate, and digastric osteotomies might be safely managed without hip abduction precautions. Copyright © 2016. Published by Elsevier Ltd.

3.0 T conventional hip MR and hip MR arthrography for the acetabular labral tears confirmed by arthroscopy

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Tian, Chun-Yan [Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191 (China); Wang, Jian-Quan [Department of Sports Medicine, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191,PR China (China); Zheng, Zhuo-Zhao, E-mail: zzhuozhao@aliyun.com [Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191 (China); Ren, A.-Hong [Department of Radiology, Beijing Daxing Hospital, 26 West Huangcun Road, Daxing District, Beijing 102600 (China)

2014-10-15

Highlights: • MR is the preferred imaging modality for diagnosing acetabular labral tears. • The diagnostic performance of MR arthrography are superior than conventional hip MR. • The hip MR arthrography is recommended for diagnosing acetabular labral lesions. - Abstract: Objective: To evaluate the value of hip MR for diagnosing acetabular labrum tears, and to further compare the diagnostic performances of conventional MR with MR arthrography in acetabular labrum tears. Methods: 90 patients undergoing both hip MR examination and subsequent hip arthroscopy were retrospectively evaluated. Of these patients, 34 accepted both conventional MR and MR arthrography; while the other 56 only underwent conventional MR examination. All hip MR images were independently reviewed by two radiologists, and further compared with the results of hip arthroscopy. Results: 59 of 90 patients were confirmed with acetabular labral tears by hip arthroscopy and 31 without tears. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of conventional MR for evaluating the acetabular labral tears were 61.0%, 77.4%, 83.7% and 51.1% (radiologist A), and 66.1%, 74.2%, 82.9% and 53.4% (radiologist B), respectively, with good consistency between the two observers (K = 0.645). The sensitivity, specificity, PPV and NPV of MR arthrography for assessing the acetabular labral tears were 90.5%, 84.6%, 90.5% and 84.6% (radiologist A), and 95.2%, 84.6%, 90.9% and 91.7% (radiologist B), respectively, with excellent good consistency between the two observers (K = 0.810). The sensitivity and NPV of MR arthrography for diagnosing the acetabular labral tears were significantly higher than those of conventional MR (both P < 0.05). Conclusion: Hip MR arthrography is a reliable evaluation modality for diagnosing the acetabular labral tears, and its diagnostic performance is superior to that of conventional MR at 3.0 T.

Congestive cardiomyopathy and endobronchial granulomas as manifestations of Churg-Strauss syndrome.

Science.gov (United States)

Alvarez-Sala, R.; Prados, C.; Armada, E.; Del Arco, A.; Villamor, J.

1995-01-01

Churg-Strauss syndrome is a systemic vasculitis. Its most frequent complications are heart diseases and asthma. Usually, cardiological manifestations are pericarditis, cardiac failure and myocardial infarction. Endobronchial granulomas identified by bronchoscopy are unusual. We present the case of a man with congestive cardiomyopathy and endobronchial granulomas macroscopically visible at bronchoscopy. After a review of medical literature, we found one case of congestive cardiomyopathy and no cases of endobronchial granulomas observed by bronchoscopy associated with Churg-Strauss syndrome. Images Figure PMID:7644400

Epulis and pyogenic granuloma with occlusal interference

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Widowati Witjaksono

2005-06-01

Full Text Available In dental clinic of Hospital University Science Malaysia (HUSM, there were cases with Localized Gingival Enlargement (LGE in the oral cavity with occlusal interference. In this study, three cases were observed. They were a 13 - year- old female with fibrous lge around 31 and 32 with occlusal interference in protrusive movement due to X bite, a 15 - year – old female with pyogenic granuloma near 11 & 21 with occlusal interference due to deep bite; and a 24 – year – old female who was eight months in pregnancy with pyogenic granuloma on the 34-35 and severe generalized pregnancy gingivitis with occlusal interference in centric occlusion and lateral movement. Clinical and histopathological diagnosis of the first case showed fibrous epulis, whereas the second and third cases disclosed pyogenic granuloma. Chronic trauma of the gingiva due to occlusal interference was assumed to be the cause of those LGE in case 1 and 2, while in case 3 poor oral hygiene and chronic trauma were assumed to be the etiologic factors.

Aluminium allergy and granulomas induced by vaccinations for children

DEFF Research Database (Denmark)

Andersen, Rosa Marie O; Zachariae, Claus; Johansen, Jeanne Duus

2014-01-01

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....

MR findings of calvarial eosinophilic granuloma

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Choi, Gi Bok; Son, Seok Hyun; Eun, Choong Ki; Park, Sung Kun; Han, Sang Suk [Pusan Paik Hospital, Inje Univ., Pusan (Korea, Republic of); Choi, Sun Seob [Donga Univ. College of Medicine, Pusan (Korea, Republic of); Kim, Seong Min [Kosin Univ. College of Medicine, Pusan (Korea, Republic of); Kim, Chang Soo [Maryknoll Hospital, Pusan (Korea, Republic of)

2001-03-01

The purpose of this study was to evaluate the MR findings of calvarial eosinophilic granuloma. We reviewed the MR imaging studies of nine patients [M:F=3:6, aged 6-35 (mean, 20.5) years] with pathologically proven eosinophilic granuloma in the calvaria. The findings were evaluated for involvement of the diploic space, changes in adjacent bone marrow, distinction of the transitional zone, pattern of bone destruction, signal intensity and contrast enhancement of the tumor, and contrast enhancement of the adjacent dura. All lesions involved the diploic space, showed no change in adjacent bone marrow, and had a distinct transitional zone. In most (8/9) cases there was asymmetric bony destruction. On T1-weighted images, signal intensities of the tumors varied, while on T2-weighted images, hyperintensity was observed in seven cases, isointensity in one, and hypointensity in one. After the administration of contrast material, enhancement was homogeneous in four cases and inhomogeneous in five. Enhancement of the adjacent dura was demonstrated in all nine cases. The characteristic MR findings of calvarial eosinophilic granuloma are variable signal intensity on T1WI, high signal intensity on T2WI, and marked contrast enhancement; in addition, there is a distinct transitional zone, asymmetrical bony destruction, and associated dural enhancement.

Cemented total hip replacement cable debris and acetabular construct durability.

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Altenburg, Aaron J; Callaghan, John J; Yehyawi, Tameem M; Pedersen, Douglas R; Liu, Steve S; Leinen, Jessica A; Dahl, Kevin A; Goetz, Devon D; Brown, Thomas D; Johnston, Richard C

2009-07-01

Third-body wear can adversely affect the outcome of total hip arthroplasty by causing increased polyethylene wear, osteolysis, and component loosening. We hypothesized that there would be greater generation and migration of metal debris to the bearing surfaces in hips in which cobalt-chromium cables were used to reattach the osteotomized greater trochanter when compared with hips in which stainless steel wires were used. Between June 1981 and December 1983, 196 consecutive total hip arthroplasties were performed with use of an Iowa stem and a titanium-backed cemented acetabular component, with cobalt-chromium cable trochanteric reattachment. After nineteen to twenty years of follow-up, the patients were evaluated with regard to the depth of head penetration into the polyethylene (as a surrogate for wear), osteolysis, loosening, and the need for revision. The results were compared with those for a series of 304 total hip arthroplasties that were performed by the same surgeon from January 1984 to December 1985 with use of the same components and the same surgical technique, but with stainless steel wire trochanteric reattachment. The two groups had a comparable nineteen to twenty-year follow-up. All living patients (fifty-nine hips in the cable group and ninety-two hips in the wire group) had minimum ten-year follow-up radiographs. The polyethylene wear rate was 0.101 mm/yr for the cable group and 0.082 mm/yr for the wire group (p = 0.039). For the living patients, the rate of revision of the acetabular component because of aseptic loosening was 37.3% (twenty-two hips) for the cable group and 20.7% (nineteen hips) for the wire group (p = 0.025). The rate of acetabular osteolysis was 44% (twenty-six hips) for the cable group and 26% (twenty-four hips) for the wire group (p = 0.022). Kaplan-Meier analysis with revision of the acetabular component because of aseptic loosening as the end point demonstrated survival rates of 73.7% +/- 9% and 83% +/- 7% for the cable and

Digital radiography density measurements in differentiation between periapical granulomas and radicular cysts.

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Rózyło-Kalinowska, Ingrid

2007-05-01

The distinction between radicular cysts and apical granulomas is a matter of considerable importance in making a treatment decision. Because there are no clearly defined radiographic criteria, the distinction is made on the grounds of size. However, it has been suggested that cysts can be distinguished from granulomas on the basis of their radiometric density. The results of previous studies have proved conflicting. To determine possibilities of application of digital radiography density measurements in differentiation of periapical granulomas and radicular cysts of inflammatory origin. The material consisted of 355 digital periapical radiograms obtained using Digora, RVG and Dixi 2 digital radiography systems in patients aged 20 to 84, divided into two groups: 259 granulomas and 102 radicular cysts. By means of Digora 2.0 software there were measured maximum and minimum densities along a line, then there was calculated the difference between maximum and minimum density. The largest dimensions of the lesions were measured - perpendicular and parallel to the root canal axis. It was proved that to some extent it was possible to differentiate cystic granulomas and radicular cysts on the basis of the difference between maximum and minimum density in linear measurement - when the difference exceeded 85.6 the lesion was a cyst and when it was below 45.9 a granuloma was diagnosed. Combination of two criteria - the calculated difference between densities and the largest dimension of a lesion, increased diagnostic possibilities of radiological differentiation of granulomas and radicular cysts.

Radiological landmarks for the safe extra-capsular placement of supra-acetabular half pins for external fixation.

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Lidder, Surjit; Heidari, Nima; Gänsslen, Axel; Grechenig, Wolfgang

2013-03-01

Low anterior external fixators are constructed by placing half pins in the dense bone tunnel of the supra-acetabular region in an anterior to posterior direction. Although the placement of these pins is extra-articular, they may still breach the hip capsule on the anterior inferior iliac spine and thus be intra-capsular. We aim to provide radiological markers for the most superior fibres of the capsule to allow safe extra-capsular pin placement within the supra-acetabular bone tunnel. Thirteen cadaveric pelves were used for this study. The supra-acetabular bone tunnel was visualised with an image intensifier. The proximal most fibres of the hip joint capsule were marked with a K-wire so that their relation to the bone tunnel could be clearly seen on the images. Once all images were acquired they were calibrated and analysed to estimate the dimensions of the supra-acetabular bone tunnel and the reflection of the hip capsule. The median height of the bone tunnel was 23.6 mm (18.9-33.2) and maximum width was 11.4 mm (7.6-16.3). The inferior margin of the bone tunnel was 6.7 mm (1.1-14.5) superior to the acetabular dome, and the most proximal fibres of the capsule were 9.3 mm (4.7-6.1) superior to the acetabular dome. The inferior portion of the tunnel was 3.7 mm (0.3-8.9) within the joint. Half pins for the construction of a pelvic external fixator should be placed in the upper half of the supra-acetabular bone corridor to minimise the risk of intra-capsular placement.

Endoscopic resection of acetabular screw tip to decompress sciatic nerve following total hip arthroplasty.

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Yoon, Sun-Jung; Park, Myung-Sik; Matsuda, Dean K; Choi, Yun Ho

2018-06-04

Sciatic nerve injuries following total hip arthroplasty are disabling complications. Although degrees of injury are variable from neuropraxia to neurotmesis, mechanical irritation of sciatic nerve might be occurred by protruding hardware. This case shows endoscopic decompression for protruded acetabular screw irritating sciatic nerve, the techniques described herein may permit broader arthroscopic/endoscopic applications for management of complications after reconstructive hip surgery. An 80-year-old man complained of severe pain and paresthesias following acetabular component revision surgery. Physical findings included right buttock pain with radiating pain to lower extremity. Radiographs and computed tomography imaging showed that the sharp end of protruded screw invaded greater sciatic foramen anterior to posterior and distal to proximal direction at sciatic notch level. A protruding tip of the acetabular screw at the sciatic notch was decompressed by use of techniques gained from experience performing endoscopic sciatic nerve decompression. The pre-operative pain and paresthesias resolved post-operatively after recovering from anesthesia. This case report describes the first documented endoscopic resection of the tip of the acetabular screw irritating sciatic nerve after total hip arthroplasty. If endoscopic resection of an offending acetabular screw can be performed in a safe and minimally invasive manner, one can envision a future expansion of the role of hip arthroscopic surgery in several complications management after total hip arthroplasty.

Granuloma telangiectásico asociado a alteración hormonal

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Estephannia Mora Solano

2013-10-01

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.

Minimum ten-year follow-up of acetabular fracture fixation from the Irish tertiary referral centre.

LENUS (Irish Health Repository)

Magill, Paul

2012-04-01

Successful outcome from acetabular fracture fixation is multi-factorial. Long-term results are not frequently reported. Pooling such data from high output centres will help progress acetabular fixation. This paper presents the first ten-year data from the Irish tertiary referral centre.

Functional complexity of the Leishmania granuloma and the potential of in silico modelling

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John eMoore

2013-02-01

Full Text Available AbstractIn human and canine visceral leishmaniasis and in various experimental models of this disease, host resistance is strongly linked to efficient granuloma development. However, it is unknown exactly how the granuloma microenvironment executes an effective antileishmanial response. Recent studies, including using advanced imaging techniques have improved our understanding of granuloma biology, at the cellular level, highlighting heterogeneity in granuloma development and function, and hinting at complex cellular, temporal and spatial dynamics. In this mini-review, we discuss the factors involved in the formation and function of L.donovani-induced hepatic granulomas, as well as their importance in protecting against inflammation-associated tissue damage and the generation of immunity to rechallenge. Finally, we discuss the role that computational, agent-based models may play to answer outstanding questions within the field.

Cutaneous mercury granuloma

OpenAIRE

Kalpana A Bothale; Sadhana D Mahore; Sushil Pande; Trupti Dongre

2013-01-01

Cutaneous mercury granuloma is rarely encountered. Clinically it may pose difficulty in diagnosis. Here, we report a 23-year-old male presented with erythematous, nodular lesions over the forearm and anterior aspect of chest wall. Metallic mercury in tissue sections appear as dark black, opaque, spherical globules of varying size and number. They are surrounded by granulomatous foreign-body reaction. It is composed of foreign body giant cells and mixed inflammatory infiltrate composed of hist...

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

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Maura R. F. Souza Vidal

1993-10-01

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

Induction of ER stress in macrophages of tuberculosis granulomas.

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Tracie A Seimon

2010-09-01

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

Acetabular labrum of hip joint in osteoarthritis: A qualitative original study and short review of the literature.

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Kapetanakis, S; Dermon, A; Gkantsinikoudis, N; Kommata, V; Soukakos, P; Dermon, C R

2017-01-01

Histological architecture of normal acetabular labrum regarding free nerve endings (FNEs) and mechanoreceptors (MRs) has been satisfactorily described in the literature. However, the presence of FNEs and MRs in acetabular labrum of hip joint has been analyzed only once in patients with osteoarthritis (OA). Aim of this article is to report histological distribution pattern of FNEs and MRs in acetabular labrum of patients with severe OA, at the same time conducting a comparison with normal acetabular labrum described in the literature. Seven patients with severe hip OA were enrolled in this study. Patient selection was assisted by the utilization of specific clinical scales delineated by the American College of Rheumatology. After successful total hip arthroplasty, tissue samples of acetabular labra of seven patients were histologically processed and stained with the gold standard chloride method, which was subsequently examined under a compound microscope. FNEs and MRs constituted the major histological structures. Identified MRs included Pacini corpuscles, Ruffini corpuscles, and Golgi-Mazzoni corpuscles. The presence of FNEs was predominant in the middle part of the acetabular labrum, featuring a remarkable decrease in peripheral parts. In contrast, MRs were detected basically in peripheral parts and less in the middle part. Differentiation of the distribution pattern of MRs and FNEs in acetabular labrum of hip joint is remarkable between normal patients and patients with severe OA. The abundance of FNEs in the middle part of the pathologic labrum is mainly responsible for the observed discrimination. A "conversion" of MRs to FNEs may occur during OA progression, modulating therefore this pattern as well as the upcoming clinical manifestations.

Pulmonary Hyalinizing Granuloma Associated with Idiopathic Thrombocytopenic Purpura

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Christopher Coleman

2014-01-01

Full Text Available Pulmonary hyalinizing granuloma (PHG is a rare, benign lung disease of unknown etiology. It manifests as discrete, rounded nodules within the lung parenchyma. A 39-year-old woman presented for investigation after pulmonary nodules were found incidentally. Chest computed tomography showed multiple, discrete, non-enhancing pulmonary nodules bilaterally. Positron emission tomography (PET was negative. Biopsy demonstrated a non-specific lymphoplasmacytic infiltrate. Open resection yielded two nodules consistent with hyalinizing granulomas. The differential for multiple pulmonary nodules is broad. PET scan can help rule out metastatic disease, although some cancers are not hypermetabolic on PET. Furthermore, some non-malignant conditions, including hyalinizing granuloma, can show increased activity on PET. PHG should be included in the differential of multiple pulmonary nodules, especially if nodule stability can be demonstrated and/or needle biopsies are non-diagnostic. Associated immune-mediated conditions, such as idiopathic thrombocytopenic purpura (ITP in our patient, may also favor HG. In this case report we find an association between PHG and ITP.

Tenon's capsule granuloma at the donor site after conjunctival grafting: short report Granuloma da cápsula de Tenon em área doadora de retalho conjuntival: relato curto

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Patrícia Ioschpe Gus

2003-06-01

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.

Biochemical and Cellular Assessment of Acetabular Chondral Flaps Identified During Hip Arthroscopy.

Science.gov (United States)

Hariri, Sanaz; Truntzer, Jeremy; Smith, Robert Lane; Safran, Marc R

2015-06-01

To analyze chondral flaps debrided during hip arthroscopy to determine their biochemical and cellular composition. Thirty-one full-thickness acetabular chondral flaps were collected during hip arthroscopy. Biochemical analysis was undertaken in 21 flaps from 20 patients, and cellular viability was determined in 10 flaps from 10 patients. Biochemical analysis included concentrations of (1) DNA (an indicator of chondrocyte content), (2) hydroxyproline (an indicator of collagen content), and (3) glycosaminoglycan (an indicator of chondrocyte biosynthesis). Higher values for these parameters indicated more healthy tissue. The flaps were examined to determine the percentage of viable chondrocytes. The percentage of acetabular chondral flap specimens that had concentrations within 1 SD of the mean values reported in previous normal cartilage studies was 38% for DNA, 0% for glycosaminoglycan, and 43% for hydroxyproline. The average cellular viability of our acetabular chondral flap specimens was 39% (SD, 14%). Only 2 of the 10 specimens had more than half the cells still viable. There was no correlation between (1) the gross examination of the joint or knowledge of the patient's demographic characteristics and symptoms and (2) biochemical properties and cell viability of the flap, with one exception: a degenerative appearance of the surrounding cartilage correlated with a higher hydroxyproline concentration. Although full-thickness acetabular chondral flaps can appear normal grossly, the biochemical properties and percentage of live chondrocytes in full-thickness chondral flaps encountered in hip arthroscopy show that this tissue is not normal. There has been recent interest in repairing chondral flaps encountered during hip arthroscopy. These data suggest that acetabular chondral flaps are not biochemically and cellularly normal. Although these flaps may still be valuable mechanically and/or as a scaffold in some conductive or inductive capacity, further study is

Acetabular prosthesis: Proff of migration with ruler and pencil?

International Nuclear Information System (INIS)

Diederichs, C.G.; Fischer, U.; Vosshenrich, R.

1993-01-01

Conventional X-ray films were made with varying degrees of tilt of a pelvic phantom containing an acetabular prosthesis. The position of the prosthesis was then reconstructed graphically. The measurement errors were calculated and an estimate was made for the tilt. There is a linear correlation between the measurement error and the tilt of the prosthesis. Therefore a tilt dependent maximum error can be calculated. This error is very small for small degrees of tilt, so that acetabular migration can in this instance be evaluated with greater confidence than with other graphical methods. The error also correlates with the determination of the selected region of the acetabulum, but not with the position of the central focus spot or image magnification. (orig.) [de

Immunoglobulins and C3 in the P. brasiliensis granuloma

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Lilian M. V. Biagioni

1987-04-01

Full Text Available The experimental model of paracoccidioidomycosis induced in mice by the intravenous injection of yeast-forms of P. brasiliensis (Bt2 strain; 1 x 10(6 viable fungi/animal was used to evaluate sequentially 2, 4, 8, 16 and 20 weeks after inoculation: 1. The presence of immunoglobulins and C3 in the pulmonary granuloma-ta, by direct immunofluorescence; 2. The humoral (immunodiffusion test and the cellular (footpad sweeling test immune response; 3. The histopathology of lesions. The cell-immune response was positive since week 2, showing a transitory depression at week 16. Specific antibodies were first detected at week 4 and peaked at week 16. At histology, epithelioid granulomas with numerous fungi and polymorphonuclear agreggates were seen. The lungs showed progressive involvement up to week 16, with little decrease at week 20. From week 2 on, there were deposits of IgG and C3 around fungal walls within the granulomas and IgG stained cells among the mononuclear cell peripheral halo. Interstitital immunoglobulins and C3 deposits in the granulomas were not letected. IgG and C3 seen to play an early an important role in. the host defenses against P. brasiliensis by possibly cooperating in the killing of parasites and blocking the antigenic diffusion.

Radiotherapy of the solitary and multiple eosinophilic granuloma of the bone (stage I)

International Nuclear Information System (INIS)

Wiegel, T.; Sommer, K.; Baumann, M.; Kruell, A.; Huebener, K.H.; Knop, J.; Reuter, M.

1991-01-01

Between 1957 and 1990 15 patients with solitary (stage Ia by Greenberger) and 2 patients with mulitple (stage Ib) eosinophilic granuloma of the bone were treated by radiotherapy in 18 locations after previous surgery. The doses applied varied from 6 Gy to 42 Gy (median for patients under 18 years: 8 Gy, for patients over 18 years: 30 Gy). Median follow-up was 9 years (range, 0,3-33 years). Local control rate and survival were 100%. Three patients with granuloma developed a second granuloma within 13 years after primary diagnosis (two bone manifestations, one cutaneous manifestation). Long term follow-up of patients with solitary eosinophilic granuloma is neccessary. (orig.) [de

X-ray and CT findings of costal eosinophilic granuloma

International Nuclear Information System (INIS)

Tu Zhanhai; Lin Zhengyu; Chen Yiguang

2010-01-01

Objective: To study the X-ray and CT features of costal eosinophilic granuloma for a better understanding. Methods: Eight patients with costal eosinophilic granuloma proved by surgery or biopsy were analyzed retrospectively. All patients had X-ray plain film, 6 patients had CT examination, including a case of enhanced CT scan. Results: All 8 lesions were solitary. Six lesions were in the anterior rib and 2 in the posterior rib. On X-ray, all case showed single cavity and oval lesion with clear boundary. On CT images, 5 lesions demonstrated expansile destruction of bone with cortical bone thinning, and 3 were osteolystic destruction with soft tissue mass around. On the patient with enhanced CT scan, the lesions showed a moderate and uniform enhancement. Conclusion: The X-ray and CT findings of costal eosinophilic granuloma are characteristic. (authors)

Improving the accuracy of acetabular cup implantation using a bulls-eye spirit level.

Science.gov (United States)

Macdonald, Duncan; Gupta, Sanjay; Ohly, Nicholas E; Patil, Sanjeev; Meek, R; Mohammed, Aslam

2011-01-01

Acetabular introducers have a built-in inclination of 45 degrees to the handle shaft. With patients in the lateral position, surgeons aim to align the introducer shaft vertical to the floor to implant the acetabulum at 45 degrees. We aimed to determine if a bulls-eye spirit level attached to an introducer improved the accuracy of implantation. A small circular bulls-eye spirit level was attached to the handle of an acetabular introducer. A saw bone hemipelvis was fixed to a horizontal, flat surface. A cement substitute was placed in the acetabulum and subjects were asked to implant a polyethylene cup, aiming to obtain an angle of inclination of 45 degrees. Two attempts were made with the spirit level masked and two with it unmasked. The distance of the air bubble from the spirit level's center was recorded by a single assessor. The angle of inclination of the acetabular component was then calculated. Subjects included both orthopedic consultants and trainees. Twenty-five subjects completed the study. Accuracy of acetabular implantation when using the unmasked spirit level improved significantly in all grades of surgeon. With the spirit level masked, 12 out of 50 attempts were accurate at 45 degrees inclination; 11 out of 50 attempts were "open," with greater than 45 degrees of inclination, and 27 were "closed," with less than 45 degrees. With the spirit level visible, all subjects achieved an inclination angle of exactly 45 degrees. A simple device attached to the handle of an acetabular introducer can significantly improve the accuracy of implantation of a cemented cup into a saw bone pelvis in the lateral position.

Tantalum acetabular augments in one-stage exchange of infected total hip arthroplasty: a case-control study.

Science.gov (United States)

Klatte, Till Orla; Kendoff, Daniel; Sabihi, Reza; Kamath, Atul F; Rueger, Johannes M; Gehrke, Thorsten

2014-07-01

During the one-stage exchange procedure for periprosthetic joint infection (PJI) after total hip arthroplasty (THA), acetabular defects challenge reconstructive options. Porous tantalum augments are an established tool for addressing acetabular destruction in aseptic cases, but their utility in septic exchange is unknown. This retrospective case-control study presents the initial results of tantalum augmentation during one-stage exchange for PJI. Primary endpoints were rates of re-infection and short-term complications associated with this technique. Study patients had no higher risk of re-infection with equivalent durability at early follow-up with a re-infection rate in both groups of 4%. In conclusion, tantalum augments are a viable option for addressing acetabular defects in one-stage exchange for septic THA. Further study is necessary to assess long-term durability when compared to traditional techniques for acetabular reconstruction. Copyright © 2014 Elsevier Inc. All rights reserved.

Posterior trochanteric osteotomy in acetabular fractures for 32 cases.

Science.gov (United States)

Niu, Yunfei; An, Xiaofei; Xu, Shuogui; Wu, Dajiang; Zhang, Chuncai; Li, Ming

2014-11-01

The aim of this study is to explore the method and clinical outcome of posterior trochanteric osteotomy in acetabular fractures. From January 2000 to January 2008, 32 cases of acetabular fractures involving the dome of acetabulum underwent posterior trochanteric osteotomy for a better exposure and internal fixation with acetabular tridimensional memory fixation system. 28 cases (16 men and 12 women, mean age 39.9 years, range 16-73 years) were followed up with an average of 48.9 months (range of 19-95 months) and four were lost during follow up. Of 28 cases, 19 were fresh fractures and 9 were old fractures. The reduction was evaluated with Matta criteria. Clinical evaluation was based on modified Merle d'Aubigne and Postel scoring. Motor strength of the abductors was evaluated according to the Medical Research Council grading system. Ectopic ossification was classified according to Brooker criteria. Anatomical reduction was achieved in 17 cases and satisfied reduction in 10 patients. Poor reduction happened in an old fracture. All acetabular fractures got a direct bone union and no displacement and deep infection occurred. All osteotomies healed within 3.5 months without any nonunion, proximal migration of the greater trochanter, loosing or broken of instrumentation, and deep infection. Two superficial infections were healed with a regular dressing. Two patients underwent removal of implants from greater trochanter because of irritation. The strength of the abductors was of Grade 3/5 in two patients, Grade 4/5 in five patients, and normal in the rest. Clinical scoring was excellent to good in 84 %. Ectopic ossification occurred in five patients, grade 1 in two patients, grade 2 in two, and grade 3 in one. But function of hip joint was not seriously affected. Posterior trochanteric osteotomy can provide an adequate exposure of the dome of acetabulum without the associated complications like nonunion, proximal replacement, and weak of the abductors which often occur

Conservative approach in the management of oral pyogenic granuloma by sclerotherapy

Directory of Open Access Journals (Sweden)

Tanya Khaitan

2018-01-01

Full Text Available Background: Pyogenic granuloma is a common, non-neoplastic reactive growth of the oral cavity. Treatment consists of conservative surgical excision, cryosurgery, or laser surgery. These are usually adequate but often result in scars and recurrence. Therefore, this study was undertaken to determine the effectiveness of sclerotherapy in the treatment of oral pyogenic granuloma. Materials and Methods: Forty clinically diagnosed cases of oral pyogenic granuloma were included in the study. After topical anesthesia application, 0.2–0.5 mL of sodium tetradecyl sulfate was delivered by insulin syringe into the base of lesions till the solution leaked out. Each patient was recalled after 1 week and evaluated. If the lesion did not resolve, second and third injections were given consecutively. Results: All the 40 patients showed complete regression of the lesion after one to four consecutive shots in weekly interval. Conclusion: Intralesional sclerotherapy can be considered as an effective non-surgical treatment procedure for oral pyogenic granuloma.

Does Increased Coefficient of Friction of Highly Porous Metal Increase Initial Stability at the Acetabular Interface?

Science.gov (United States)

Goldman, Ashton H; Armstrong, Lucas C; Owen, John R; Wayne, Jennifer S; Jiranek, William A

2016-03-01

Highly porous metal acetabular components illustrate a decreased rate of aseptic loosening in short-term follow-up compared with previous registry data. This study compared the effect of component surface roughness at the bone-implant interface and the quality of the bone on initial pressfit stability. The null hypothesis is that a standard porous coated acetabular cup would show no difference in initial stability as compared with a highly porous acetabular cup when subjected to a bending moment. Second, would bone mineral density (BMD) be a significant variable under these test conditions. In a cadaveric model, acetabular cup micromotion was measured during a 1-time cantilever bending moment applied to 2 generations of pressfit acetabular components. BMD data were also obtained from the femoral necks available for associated specimen. The mean bending moment at 150 μm was not found to be significantly different for Gription (24.6 ± 14.0 N m) cups vs Porocoat (25 ± 10.2 N m; P > .84). The peak bending moment tolerated by Gription cups (33.9 ± 20.3 N m) was not found to be significantly different from Porocoat (33.5 ± 12.2 N m; P > .92). No correlation between BMD and bending moment at 150 μm of displacement could be identified. The coefficient of friction provided by highly porous metal acetabular shells used in this study did not provide better resistance to migration under bending load when compared with a standard porous coated component. Copyright © 2016 Elsevier Inc. All rights reserved.

Generalized Granuloma Annulare in Infancy Following Bacillus Calmette-Guerin Vaccination

OpenAIRE

Lee, Sang Woo; Cheong, Seung Hyun; Byun, Ji Yeon; Choi, You Won; Choi, Hae Young; Myung, Ki Bum

2011-01-01

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.

Immunostimulatory mouse granuloma protein.

OpenAIRE

Fontan, E; Fauve, R M; Hevin, B; Jusforgues, H

1983-01-01

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...

Imaginal diagnosis of eosinophilic granuloma of long bones

International Nuclear Information System (INIS)

Cui Fa; Cui Minyi

2006-01-01

Objective: To analyze the clinical and imaging features of eosinophilic granuloma of long bones so as to improve diagnosis accuracy of the disease. Methods: The clinic materials and imaging findings of 24 patients with eosinophilic granuloma of long bones proved by surgery or histopathology were analyzed retrospectively. All the patients received radiography; CT scan was performed in 6 cases; and MRI was done in 4 cases. Results: Fifteen patients out of 24 were male and 9 were female, with the average age 14. 7 years old. Solitary lesion was found in 22 cases, and multiple bone destruction was noted in 2 cases. There were 14 lesions located in femur; 5 in tibia; 3 in humer; and 2 in fibula. In total 16 lesions involved diaphysis and in 8 cases the metaphysis was invaded. Bone destruction, the changes of the adjacent cortex, periosteal reaction and soft tissue mass or swelling were demonstrated in images obtained. Conclusion: The imaging features in eosinophilic granuloma of long bones are characteristic. Careful and integrative analysis of imaging findings improves diagnosis accuracy of the disease. (authors)

Giant pyogenic granuloma of the thigh: a case report

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Nthumba Peter M

2008-03-01

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.

Acetabular stress fractures in military endurance athletes and recruits: incidence and MRI and scintigraphic findings

International Nuclear Information System (INIS)

Williams, T.R.; Puckett, M.L.; Shin, A.Y.; Gorman, J.D.; Denison, G.

2002-01-01

Objective: To evaluate the incidence and the MRI and scintigraphic appearance of acetabular stress (fatigue) fractures in military endurance athletes and recruits. Design and patients: One hundred and seventy-eight active duty military endurance trainees with a history of activity-related hip pain were evaluated by both MRI and bone scan over a 2-year period. Patients in the study ranged in age from 17 to 45 years. They had hip pain related to activity and had plain radiographs of the hip and pelvis that were interpreted as normal or equivocal. The study was originally designed to evaluate the MRI and scintigraphic appearance of femoral neck stress fractures. Patients had scintigraphy and a limited MRI examination (coronal imaging only) within 48 h of the bone scan. Twelve patients demonstrated imaging findings compatible with acetabular stress fractures. Results: Stress fractures are common in endurance athletes and in military populations; however, stress fracture of the acetabulum is uncommon. Twelve of 178 patients (6.7%) in our study had imaging findings consistent with acetabular stress fractures. Two patterns were identified. Seven of the 12 (58%) patients had acetabular roof stress fractures. In this group, two cases of bilateral acetabular roof stress fractures were identified, one with a synchronous tensile sided femoral neck stress fracture. The remaining five of 12 (42%) patients had anterior column stress fractures, rarely occurring in isolation, and almost always occurring with inferior pubic ramus stress fracture (4 of 5, or 80%). One case of bilateral anterior column stress fractures was identified without additional sites of injury. Conclusions: Stress fractures are commonplace in military populations, especially endurance trainees. Acetabular stress fractures are rare and therefore unrecognized, but do occur and may be a cause for activity-related hip pain in a small percentage of military endurance athletes and recruits. (orig.)

Pyogenic granuloma associated with periodontal abscess and bone loss - A rare case report

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Bhrugesh J Panseriya

2011-01-01

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.

Pyogenic granuloma associated with periodontal abscess and bone loss - A rare case report.

Science.gov (United States)

Panseriya, Bhrugesh J; Hungund, Shital

2011-07-01

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.

Monthly rifampicin, ofloxacin, and minocycline therapy for generalized and localized granuloma annulare

Directory of Open Access Journals (Sweden)

Shilpa Garg

2015-01-01

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.

Vocal fold granulomas in six brachycephalic dogs: clinical, macroscopical and histological features.

Science.gov (United States)

Sarran, D; Caron, A; Billet, J P

2018-06-05

Vocal cord granulomas are rarely observed in brachycephalic breeds but often reported in humans as contact granulomas. Six French bulldogs were included in this retrospective descriptive study. Endoscopic laryngeal examinations were performed on all dogs under general anaesthesia. Vocal cord lesions were exclusively unilateral, exophytic, approximately 3-mm wide ulcerated mucosal nodules, arising from the vocal cord. Histopathological examination mainly revealed chronic inflammatory changes on the laryngeal epithelium which were consistent with laryngeal granulomas described in humans, except for the location: vocal cord in dogs versus vocal process in humans. In humans, granulomas result from chronic physical or chemical insult to laryngeal mucosa (chronic cough or throat clearing, vocal abuse, gastro-esophageal reflux). In brachycephalic breeds, chronic inspiratory efforts and air turbulences and gastro-esophageal reflux are suspected to result in chronic laryngeal inflammation. © 2018 British Small Animal Veterinary Association.

Increased Mortality in Elderly Patients with Sarcopenia and Acetabular Fractures.

Science.gov (United States)

Deren, Matthew E; Babu, Jacob; Cohen, Eric M; Machan, Jason; Born, Christopher T; Hayda, Roman

2017-02-01

Sarcopenia is a condition of clinically relevant loss of muscle mass and function. Acetabular fractures in elderly patients are common and difficult to treat. This study aimed to determine if sarcopenia is common in elderly patients with acetabular fractures and correlates with lower-energy mechanisms of injury, higher rates of complications, and higher mortality than patients with normal muscle mass. The Rhode Island Hospital Trauma Database was queried for patients who were ≥60 years of age from 2005 to 2014 using the International Classification of Diseases, Ninth Revision, code for closed acetabular fracture, 808.0. Charts were retrospectively reviewed for demographic data, operative intervention, mechanism of injury, mortality, comorbidities, and other factors. Computed tomography (CT) was used to determine the muscle cross-sectional area and to calculate the skeletal muscle index. The database revealed 192 patients coded for acetabular fracture; of these, 181 were correctly diagnosed. Ninety-nine patients had recorded body mass index (BMI) and adequate CT scans to measure the skeletal muscle index. Forty-two patients (42.4%) had sarcopenia, and 57 patients (57.6%) did not have sarcopenia. There were no significant differences in demographic characteristics between the groups with the exception of BMI and sex. BMI was higher in patients who did not have sarcopenia (31.7 kg/m) than it was in patients with sarcopenia (23.6 kg/m) (p sarcopenia at 76.2% (32 of 42 patients) than in patients without sarcopenia at 50.9% (29 of 57 patients). Fractures in patients without sarcopenia were associated with a higher-energy mechanism of injury in 78.9% of cases compared with 52.4% of cases of patients with sarcopenia (p = 0.005). Sarcopenia was significantly associated (p = 0.0419) with increased 1-year mortality (28.6%) compared with the absence of sarcopenia (12.3%). This association was even stronger if in-hospital mortality was excluded (p = 0.00074). Finally

The Histopathological Spectrum of Pyogenic Granuloma: A Case Series

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Vinay Marla

2016-01-01

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.

Localized foreign body granulomas of the breast : clinical and mammographic findings

International Nuclear Information System (INIS)

Choi, Dong Il; Han, Boo Kyung; Choe, Yeon Hyeon; Park, Jeong Mi; Yang, Jung Hyun; Nam, Seok Jin

1998-01-01

The purpose of this study is to evaluate the clinical and radiographic findings of localized foreign body (FB) granulomas on mammograms. This study involved 13 patients with localized FB granulomas on mammograms; their history of mammoplasty or other plastic procedures was obtained by telephone interviews. Two radiologists analyzed the location and morphology of FB granulomas and the presence of associated linear densities or parenchymal distortion on mammograms. Four patients underwent ultrasonography. No patient had a history of mammoplasty. All 13, however, had a history of plastic procedure, three to 22 (average, 12) years previously, as follows: foreign materials including silicone liquid and oil such as paraffin had been injected into the anterior neck area of nine patients, the representing FB granulomas were distributed bilaterally in nine patients; they were noted in the suggesting fibrosis. There was no calcification or parenchymal distortion. Though in three cases, the masses were palpable. Ultrasonography revealed several anechoic nodules with posterior enhancement in subcutaneous fatty layers, and in one, 0.2 cc of oil droplet had been aspirated under ultrasonographic guidance. Localized FB granulomas of the breast could be caused by the migration of FB from cervicofacial areas. Mammography showed characteristic distribution of upper inner portions, and the findings were similiar to those of mild interstitial mammoplasty. (author). 13 refs., 2 figs

Granuloma en la incisión tras el implante de un estimulador eléctrico medular Granuloma in the incisin after implants of an spinal cord device

OpenAIRE

P. Diéguez; V. Villanueva; S. López; J. De Andrés

2008-01-01

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...

Acetabular fractures following rugby tackles: a case series

LENUS (Irish Health Repository)

Good, Daniel W

2011-10-05

Abstract Introduction Rugby is the third most popular team contact sport in the world and is increasing in popularity. In 1995, rugby in Europe turned professional, and with this has come an increased rate of injury. Case presentation In a six-month period from July to December, two open reduction and internal fixations of acetabular fractures were performed in young Caucasian men (16 and 24 years old) who sustained their injuries after rugby tackles. Both of these cases are described as well as the biomechanical factors contributing to the fracture and the recovery. Acetabular fractures of the hip during sport are rare occurrences. Conclusion Our recent experience of two cases over a six-month period creates concern that these high-energy injuries may become more frequent as rugby continues to adopt advanced training regimens. Protective equipment is unlikely to reduce the forces imparted across the hip joint; however, limiting \\'the tackle\\' to only two players may well reduce the likelihood of this life-altering injury.

21 CFR 888.3320 - Hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint metal/metal semi-constrained, with a... Devices § 888.3320 Hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with a cemented acetabular...

21 CFR 888.3330 - Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint metal/metal semi-constrained, with an... Devices § 888.3330 Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with an uncemented acetabular...

Cranial acetabular retroversion is common in developmental dysplasia of the hip as assessed by the weight bearing position

DEFF Research Database (Denmark)

Troelsen, Anders; Mikkelsen, Lone Rømer; Jacobsen, Steffen

2010-01-01

The appearance of acetabular version differs between the supine and weight bearing positions in developmental dysplasia of the hip. Weight bearing radiographic evaluation has been recommended to ensure the best coherence between symptoms, functional appearance, and hip deformities. Previous...... prevalence estimates of acetabular retroversion in dysplastic hips have been established in radiographs recorded with the patient supine and with inclusion only if pelvic tilt met standardized criteria. We assessed the prevalence and the extent of acetabular retroversion in dysplastic hip joints in weight...

Macrophage polarization differs between apical granulomas, radicular cysts, and dentigerous cysts.

Science.gov (United States)

Weber, Manuel; Schlittenbauer, Tilo; Moebius, Patrick; Büttner-Herold, Maike; Ries, Jutta; Preidl, Raimund; Geppert, Carol-Immanuel; Neukam, Friedrich W; Wehrhan, Falk

2018-01-01

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

The role of Hsp0, CD-8 and IFN-γ in immunopathobiogenesis of periapical granuloma in dental caries

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Risya Cilmiaty

2014-03-01

Full Text Available Background: The incidence of dental caries with periapical granulomas in Indonesia is quite high. However, the mechanism of the formation of periapical granulomas in dental caries caused by bacterial infection in immunopathobiogenesis cannot be explained completely. Thus, this explanation is necessary in order to be used as a basis for diagnostic, preventive and therapeutic measures. Purpose: This research was aimed to determine the role of Hsp60, CD-8 and IFN-γ in immunopatobiogenesis of periapical granuloma in dental caries. Methods: This research was an analytic observational study with cross sectional approach. Samples of this research were 36 teeth of patients with dental caries, consisting of 18 caries teeth with periapical granulomas and 18 caries teeth without periapical granulomas. The variables observed in this research were Hsp60, CD-8 and IFN-γ. Measurements were conducted by using immunohistochemical methods on periapical tissue. Results: The mean of Hsp60, CD-8 and IFN-γ in granuloma group was significantly higher than those in non granuloma group (p<0.05. The positive role of IFN-γ on the incidence of granulomas appeared to be more prominent. Conclusion: The study suggested that in immunopathobiogenesis of periapical granuloma in dental caries, Hsp60, CD-8 and IFN-γ played important roles, but the role of IFN-γ was found to be more prominent.Latar belakang: Angka kejadian gigi karies dengan granuloma periapikal di Indonesia cukup tinggi, Namun mekanisme terbentuknya granuloma periapikal pada gigi karies yang disebabkan oleh infeksi bakteri secara imunopatobiogenesis belum dapat dijelaskan secara tuntas. Adanya penjelasan ini diperlukan agar dapat digunakan sebagai dasar pengembangan diagnosis, langkah preventif dan terapinya. Tujuan: Penelitian ini bertujuan untuk mengetahui peran Hsp60, CD-8 dan IFN-γ dalam immunopatobiogenesis dari granuloma periapikal karies gigi. Metode: Penelitian ini merupakan penelitian observasional

A Pilot Study of Augmented Reality Technology Applied to the Acetabular Cup Placement During Total Hip Arthroplasty.

Science.gov (United States)

Ogawa, Hiroyuki; Hasegawa, Seiichirou; Tsukada, Sachiyuki; Matsubara, Masaaki

2018-06-01

We developed an acetabular cup placement device, the AR-HIP system, using augmented reality (AR). The AR-HIP system allows the surgeon to view an acetabular cup image superimposed in the surgical field through a smartphone. The smartphone also shows the placement angle of the acetabular cup. This preliminary study was performed to assess the accuracy of the AR-HIP system for acetabular cup placement during total hip arthroplasty (THA). We prospectively measured the placement angles using both a goniometer and AR-HIP system in 56 hips of 54 patients undergoing primary THA. We randomly determined the order of intraoperative measurement using the 2 devices. At 3 months after THA, the placement angle of the acetabular cup was measured on computed tomography images. The primary outcome was the absolute value of the difference between intraoperative and postoperative computed tomography measurements. The measurement angle using AR-HIP was significantly more accurate in terms of radiographic anteversion than that using a goniometer (2.7° vs 6.8°, respectively; mean difference 4.1°; 95% confidence interval, 3.0-5.2; P < .0001). There was no statistically significant difference in terms of radiographic inclination (2.1° vs 2.6°; mean difference 0.5°; 95% confidence interval, -1.1 to 0.1; P = .13). In this pilot study, the AR-HIP system provided more accurate information regarding acetabular cup placement angle than the conventional method. Further studies are required to confirm the utility of the AR-HIP system as a navigation tool. Copyright © 2018 Elsevier Inc. All rights reserved.

The granuloma in tuberculosis: Dynamics of a host-pathogen collusion

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Stefan eEhlers

2013-01-01

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.

Pre-operative irradiation of eosinophilic granuloma in the parotid area

International Nuclear Information System (INIS)

Kitahara, Satoshi; Toda, Yukio; Nakajima, Hisami; Takeyama, Isamu; Sodemoto, Yukio; Endo, Masaru

1983-01-01

Eosinophilic granuloma is thought to originate in the reticuloendothelial system and cannot clearly be distinguished from the surrounding tissue during operation. An eosinophilic granuloma in the parotid area was removed after 25 days of irradiation at a dosage of 10.0 Gy per 3 days. A thin capsule of connective tissue was observed after the tumor was cut in half. Then, histopathological studies were performed on this connective tissue to determine the effect of the irradiation. Histopathologically, at the periphery of the tissue, atrophy of lymphocytes and destruction of the lymphoid tissue, which were thought to result in an increase in the connective tissue, were observed. It was concluded that a small dose of pre-operative radiation on eosinophilic granuloma in the parotid area made the tumor small and produced a capsule around the tumor. (author)

Case report 342: Eosinophilic granuloma of the right iliac wing

International Nuclear Information System (INIS)

Schlesinger, A.E.; Glass, R.B.J.; Fernbach, S.K.; Young, S.

1986-01-01

In summary, this case demonstrates that eosinophilic granuloma may present with findings on CT usually associated with aggressive malignant lesions, while plain films may show the same lesion to have the unequivocal appearance of a benign lesion. It is important, therefore, that eosinophilic granuloma be considered in the differential diagnosis of solitary bone lesions with extraosseous extension, extensive destruction of the cortex and associated periosteal reaction. A local biopsy, as opposed to wide excision, should be performed for diagnosis, prior to any therapy. Of at least equal significance, it is obvious from this case that plain films in many instances still maintain their importance and with few exceptions should be obtained prior to the CT study. In this instance the diagnosis of a benign disorder and even the specific diagnoses of eosinophilic, granuloma was suggested with confidence because of the plain films. (orig.)

Tolerance of brightness and contrast adjustments on chronic apical abscess and apical granuloma interpretation

Science.gov (United States)

Purnamasari, L.; Iskandar, H. H. B.; Makes, B. N.

2017-08-01

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.

A woman with juxta-articular nodules—An uncommon form of subcutaneous granuloma annulare

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Lili Wang

2014-06-01

Full Text Available Granuloma annulare is a benign inflammatory dermatosis that is most common in children and young adults. The subcutaneous form of granuloma annulare, which occurs mainly on the extremities in children, is rare. Lesions usually occur as painless subcutaneous nodules without inflammation of the cutaneous surface; the most frequent sites are the legs, buttocks, and scalp. Nevertheless, we present a case of subcutaneous granuloma annulare confined to the dorsa of the hand joints and right knee in a 51-year-old woman.

Change in Acetabular Cup Orientation From Supine to Standing Position and Its Effect on Wear of Highly Crosslinked Polyethylene.

Science.gov (United States)

Teeter, Matthew G; Goyal, Prateek; Yuan, Xunhua; Howard, James L; Lanting, Brent A

2018-01-01

The purpose of this study is to measure acetabular cup position and wear of the highly crosslinked polyethylene liner in the supine and standing position for patients at a minimum of 10 years after the operation. A total of 38 patients were recruited at a mean of 12.5 years after the operation. All patients received a single acetabular cup design with a highly crosslinked liner and a 28-mm cobalt-chromium femoral head. Patients underwent supine and standing radiostereometric examinations in which the X-ray sources and detectors were positioned to obtain an anterior-posterior and cross-table lateral radiograph. Acetabular cup position and the three-dimensional wear rate were measured from the radiographs, and outcome scores were recorded for each patient. Anteversion significantly increased (P cup orientation and wear rate in either position. Highly crosslinked polyethylene is a forgiving bearing material. Although adherence to the traditional acetabular position target zone is recommended, ensuring hip stability and consideration of the patient's functional position are also important objectives to consider for the acetabular position. Copyright © 2017 Elsevier Inc. All rights reserved.

Patch Type Granuloma Annulare Imitating Cutaneous T-Cell Lymphoma

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Şeval Doğruk Kaçar

2015-03-01

Full Text Available Granuloma annulare (GA is a benign inflammatory skin disease with distinct clinical and histopathological findings. Patch type GA is described with erythematous patches beyond the classical clinical appearance and an interstitial pattern is observed without histopathologically granulomas with disseminated histiocytes among collagen bundles and vessels. Here we report 46 year old woman diagnosed as patch type GA after a punch biopsy performed from the annular bordered patches in belly area, which is a classical area for mycosis fungoides (MF evolution, and lesions increasingly spreading out within a 2 year period.

Suture Granuloma Showing False-Positive Findings on FDG-PET

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Kohei Takahara

2013-01-01

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.

Ultrasound-guided supra-acetabular pin placement in pelvic external fixation: description of a surgical technique and results.

Science.gov (United States)

Chana-Rodríguez, Francisco; Cuervas-Mons, Manuel; Rojo-Manaute, José; Mora, Félix; Arnal, Juan; Vaquero-Martín, Javier

2017-11-01

Pelvic fracture in trauma patients can lead to hemodynamic instability. External fixation is a treatment capable of stabilizing these injuries in the context of damage control surgery. Supra-acetabular pin offers the greater biomechanical stability but requires the use of intraoperative fluoroscopy. The aim of this study was to analyze our results for an ultrasound-guided supra-acetabular pinning. Cross-sectional study with cadaveric specimens. Ultrasound-guided pin placement assessed by fluoroscopy and dissection. Fourteen ultrasound-guided supra-acetabular pins were placed in seven cadaveric specimens. Excellent placement in all cases, evaluated with radiological control. Good qualitative bone fixation after dissection. One femoral cutaneous nerve was not found during anatomic dissection and was assumed injured. Ultrasound-guided supra-acetabular pin placement is a feasible and effective technique. Our study indicates that pin placement without intraoperative fluoroscopy is feasible without compromising the reliability of its placement. © 2017 Elsevier Ltd. All rights reserved.

Acetabular retroversion as a rare cause of chronic hip pain: recognition of the ''figure-eight'' sign

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Banks, Kevin P. [Brooke Army Medical Center, Department of Radiology, Fort Sam Houston, TX (United States); Grayson, David E. [Wilford Hall Medical Center, Department of Radiology, Lackland Air Force Base, TX (United States)

2007-06-15

While well-recognized in the orthopedic literature as a cause of chronic hip pain, acetabular retroversion has not been specifically described in the radiologic literature. Acetabular retroversion represents a particular form of hip dysplasia characterized by abnormal posterolateral orientation of the acetabulum. This pathophysiology predisposes the individual to subsequent anterior impingement of the femoral neck upon the anterior acetabular margin and fibrous labrum. Without treatment, cases may progress to damage of the anterior labrum and cartilage, with eventual early onset of osteoarthritic disease. This impinging condition has been described as occurring in isolation or as part of a complex dysplasia. We describe two cases of acetabular retroversion diagnosed by conventional radiographic evaluation of the pelvis, one in isolation and one occurring in the setting of a larger congenital syndrome. These cases illustrate the utility of the ''figure-eight'' sign in identifying abnormalities of acetabular version and thus assisting clinicians in properly identifying these individuals so that appropriate therapy may be instituted. (orig.)

Granuloma telangiectásico en cavidad oral

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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.

Pacing Lead-Induced Granuloma in the Atrium: A Foreign Body Reaction to Polyurethane

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Shinagawa Yoko

2013-01-01

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.

Femoral anteversion is correlated with acetabular version and coverage in Asian women with anterior and global deficient subgroups of hip dysplasia: a CT study

International Nuclear Information System (INIS)

Akiyama, Mio; Nakashima, Yasuharu; Fujii, Masanori; Sato, Taishi; Yamamoto, Takuaki; Mawatari, Taro; Motomura, Goro; Matsuda, Shuichi; Iwamoto, Yukihide

2012-01-01

Morphological correlation between the acetabulum and femur at the hip joint is still controversial. We tested the hypothesis that femoral anteversion correlates with acetabular version and coverage in patients with developmental dysplasia of the hip (DDH). Using pelvic computed tomography (CT) images of 79 hips in 49 Asian women with DDH and 49 normal hips, we measured femoral anteversion, the axial and vertical acetabular version and the acetabular sector angle (ASA) to demarcate femoral head coverage. Depending on the location of the acetabular bone defect, dysplastic hips were divided into three subgroups: the anterior, global and posterior deficiency groups. We performed a comparative analysis between dysplastic and normal hips using the Wilcoxon rank sum test, and a relative analysis between femoral anteversion and acetabular measurements in dysplastic hips using Pearson's correlation coefficient. The amount of femoral anteversion in dysplastic hips was greater and more variable than in normal hips (p < 0.0001, p = 0.0277 respectively). Femoral anteversion in dysplastic hips correlated significantly with acetabular anteversion in the groups with anterior and global deficiency subgroups (p < 0.05, r = 0.2990, p < 0.05, r = 0.451 respectively), but not with the posterior deficiency subgroup. Femoral anteversion also correlated with vertical acetabular version. When acetabular coverage was examined, significant correlations were noted between femoral anteversion and anterior and superior coverage, but not with posterior coverage. These correlations were not observed in normal hips. Our results showed significantly greater and more variable femoral anteversion in DDH, and a significant correlation between femoral anteversion and acetabular version and coverage in DDH with anterior and global acetabular bone deficiency. (orig.)

Femoral anteversion is correlated with acetabular version and coverage in Asian women with anterior and global deficient subgroups of hip dysplasia: a CT study

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Akiyama, Mio; Nakashima, Yasuharu; Fujii, Masanori; Sato, Taishi; Yamamoto, Takuaki; Mawatari, Taro; Motomura, Goro; Matsuda, Shuichi; Iwamoto, Yukihide [Kyushu University, Department of Orthopaedic Surgery, Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka (Japan)

2012-11-15

Morphological correlation between the acetabulum and femur at the hip joint is still controversial. We tested the hypothesis that femoral anteversion correlates with acetabular version and coverage in patients with developmental dysplasia of the hip (DDH). Using pelvic computed tomography (CT) images of 79 hips in 49 Asian women with DDH and 49 normal hips, we measured femoral anteversion, the axial and vertical acetabular version and the acetabular sector angle (ASA) to demarcate femoral head coverage. Depending on the location of the acetabular bone defect, dysplastic hips were divided into three subgroups: the anterior, global and posterior deficiency groups. We performed a comparative analysis between dysplastic and normal hips using the Wilcoxon rank sum test, and a relative analysis between femoral anteversion and acetabular measurements in dysplastic hips using Pearson's correlation coefficient. The amount of femoral anteversion in dysplastic hips was greater and more variable than in normal hips (p < 0.0001, p = 0.0277 respectively). Femoral anteversion in dysplastic hips correlated significantly with acetabular anteversion in the groups with anterior and global deficiency subgroups (p < 0.05, r = 0.2990, p < 0.05, r = 0.451 respectively), but not with the posterior deficiency subgroup. Femoral anteversion also correlated with vertical acetabular version. When acetabular coverage was examined, significant correlations were noted between femoral anteversion and anterior and superior coverage, but not with posterior coverage. These correlations were not observed in normal hips. Our results showed significantly greater and more variable femoral anteversion in DDH, and a significant correlation between femoral anteversion and acetabular version and coverage in DDH with anterior and global acetabular bone deficiency. (orig.)

Determinación del desgaste del componente acetabular en prótesis totales de cadera. // Wear determination of acetabular component in total hip prosthesis.

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G. García del Pino

2002-01-01

Full Text Available En este trabajo se realiza un estudio a través del Método de los Elementos Finitos “MEF” sobre el desgaste del componenteacetabular durante el ciclo de marcha y considerando algunos casos extremos de cargas como subir y bajar escaleras,levantarse de una silla, etc. Utilizando el MEF fueron modelados independientemente los componentes acetabular yfemoral de la prótesis total de cadera y puestos en contacto posteriormente. Fueron estudiadas varias posiciones delacetábulo así como diferentes casos de carga simulando pacientes con diferente peso corporal y actividades físicas. Paraevaluar los resultados se crearon rutinas en lenguaje C que organizaron los mismos para un tratamiento estadísticoposterior.Palabras claves: biomecánica, ortopedia, elementos finitos, modelación, desgaste, prótesis de cadera.___________________________________________________________________________Abstract.A wear study of acetabular component during the marching cycle, considering some extreme loads cases as: ascend anddescend stairways, get up from a seat, etc , by means of Finite Elements Method ( FEM , is carried out. The acetabular andfemoral component of the total hip prosthesis were independently modeled and placed in contact lastly. Several acetabulpositions were studied as well as different load cases, simulating patients with different body weight and different physicalactivities. To evaluate the results routines in C language were created in order to organized the same ones for a laterstatistical treatment.Key words. biomechanics, ortophedy, finite elements, modelation, wear, hip bone prosthesis.

Prophylactic post-operative radiotherapy prevents heterotopic ossification following traumatic acetabular fracture

International Nuclear Information System (INIS)

Meyer, Joseph T.; Hixson, William C.; Jennelle, Richard L. S.; Alonso, Jorge E.; Raben, David; Spencer, Sharon S.; Kim, Robert Y.

1996-01-01

Purpose/Objective: To determine the effect of post-operative radiation on the incidence of heterotopic ossification following traumatic acetabular fracture. Materials and Methods: A retrospective analysis was performed of the medical records and radiographs of all patients who received prophylactic radiotherapy to prevent heterotopic ossification. These results were compared to a similar group of patients receiving no prophylactic radiotherapy following traumatic acetabular fracture. Between 1987 and 1994, sixty-six patients received prophylactic radiotherapy to prevent heterotopic ossification. Results: Thirty-six patients (55%) received radiotherapy following operative repair of a traumatic acetabular fracture (median follow-up: 210 days). Three dose schedules were utilized: (28(36)) (77.8%) received 700 cGy/1 fx, (2(36)) (5.5%) 800 cGy/1 fx, and (6(36)) (16.7%) 1000 cGy/5 fxs. These patients were retrospectively compared with thirty-four patients who received similar operative management of traumatic acetabular fractures without post-operative radiotherapy (median follow-up: 378 days). Of the patients with heterotopic ossification, 96% developed it within 180 days. Complications and delayed wound healing rates were not significantly different in patients treated with or without post-operative radiotherapy, 6.4% and 6.3% respectively (p=0.49). The incidence of heterotopic ossification at last follow-up in patients treated with and without post-operative radiotherapy was (5(36)) (13.9%) and (19(34)) (55.9%), respectively (p=0.000332). For all patients, type of surgical approach was associated with development of heterotopic ossification: posterior, (7(38)) (18.4%), ilio-inguinal (1(3)) (33.3%), tri-radiate (13(19)) (68.4%), p=.000511. In patients receiving post-operative radiotherapy, variables associated with heterotopic ossification included dose (p=.00962), injury-to-radiation interval (p=.0038), and surgery-to-radiation interval (p=.0238). Fifty percent ((3

MR-arthrography of the acetabular labrum - radiologic-pathologic correlation in 20 cadaveric hip joints; MR-Arthrographie des Labrum acetabulare - Radiologisch-anatomische Korrelation an 20 Leichenhueften

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Brossmann, J.; Steffens, J.C.; Heller, M. [Kiel Univ. (Germany). Klinik fuer Diagnostische Radiologie; Ploetz, G.M.J.; Hassenpflug, J. [Kiel Univ. (Germany). Klinik fuer Orthopadie

1999-08-01

Purpose: To investigate frequency of acetabular labral lesions in elderly hip joints, and to determine sensitivity and specificity of MR arthrography (MRa) for the detection of these abnormalities. Materials and Methods: Twenty cadaveric hip joints were examined by MRa. For MRa, 15 ml of a solution of iodinated contrast solution (Solutrast 300) and Gd-DTPA (100:1) were injected under fluoroscopic guidance. MR imaging was performed on a 1.5 TM scanner (Vision, Siemens; FOV 16 cm, matrix 256x256, fat-suppressed 3D-FLASH). Multiplanar image reconstructions were done perpendicular to the acetabulum in the oblique-coronal, oblique-axial, and radial planes. The labral specimens were examined macroscopically. Results: In 12/20 hips (60%), a labral lesion was found on pathologic examination. In 7 specimens, the labrum was partially or completely detached in the weight-bearing superior region. One flap-like variant of the labrum was seen; in 4 hip joints, the labrum was degenerated (one cystic degeneration). Pathologic findings were confirmed by MRa in 8/12 specimens (sensitivity 67%). All degenerated labra were correctly diagnosed on MRa. Three small labral detachments and the flap-like variant were misinterpreted as being normal. There were no false positive findings (specificity 100%). The accuracy was 80%. Labral lesions were seen in 6/8 and in 6/12 of hips with and without osteoarthritis, respectively. Conclusion: MRa is well suited to delineate the acetabular labrum and to diagnose labral abnormalities. Detection of small labral detachments and anatomic variants is difficult and requires some experience. Labral lesions are correlated to osteoarthritis of the hip, but may be frequently seen in the elderly without underlying osteoarthritis. (orig.) [German] Ziel: Feststellung der Haeufigkeit von Laesionen des Labrum acetabulare bei aelteren Hueftgelenkspraeparaten und Untersuchung der Sensitivitaet und Spezifitaet der MR-Arthrographie (MRa) fuer die Darstellung dieser

Acetabular fractures following rugby tackles: a case series

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Morris Seamus

2011-10-01

Full Text Available Abstract Introduction Rugby is the third most popular team contact sport in the world and is increasing in popularity. In 1995, rugby in Europe turned professional, and with this has come an increased rate of injury. Case presentation In a six-month period from July to December, two open reduction and internal fixations of acetabular fractures were performed in young Caucasian men (16 and 24 years old who sustained their injuries after rugby tackles. Both of these cases are described as well as the biomechanical factors contributing to the fracture and the recovery. Acetabular fractures of the hip during sport are rare occurrences. Conclusion Our recent experience of two cases over a six-month period creates concern that these high-energy injuries may become more frequent as rugby continues to adopt advanced training regimens. Protective equipment is unlikely to reduce the forces imparted across the hip joint; however, limiting 'the tackle' to only two players may well reduce the likelihood of this life-altering injury.

Evaluation of immunoglobulin G synthesizing plasma cells in periapical granuloma and cyst.

OpenAIRE

Grover N; Rao N; Kotian M

2001-01-01

Immunoglobulin synthesizing plasma cells for IgG were quantitated in 20 periapical granulomas and 20 periapical cysts, using unlabelled antibody peroxidase-antiperoxidase complex method. Result showed that immunoglobulin G producing plasma cells were predominant in periapical cyst as compared with periapical granuloma. A statistical significant relation was observed between these two lesions.

Evaluation of Medial Acetabular Wall Bone Stock in Patients with Developmental Dysplasia of the Hip Using a Helical Computed Tomography Multiplanar Reconstruction Technique

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Rui Yu Liu; Kun Zheng Wang; Chun Sheng Wang; Xiao Qian Dang; Zhi Qin Tong (Second Hospital Affiliated to the Medical College of Xi' an Jiaotong Univ., Xi' an Shaanxi (China))

2009-08-15

Background: The technique of medialization has been used to reconstruct acetabula at the level of true acetabula in total hip arthroplasty (THA) in patients with developmental dysplasia of the hip (DDH). Appreciation of the bone stock in the medial acetabular wall is significant for making an optimal acetabular reconstruction plan and avoiding complications. Purpose: To evaluate the bone stock of the medial acetabular wall and its relation to the degree of subluxation in patients with DDH using computed tomography (CT). Material and Methods: Helical CT scans of 27 hips were obtained from 21 patients with osteoarthritis secondary to DDH who were scheduled for total hip arthroplasty. Eleven hips belonged to Crowe class I, while 16 hips belonged to Crowe class II/III. The raw CT data were reprocessed in various planes by scrolling multiplanar reformation (MPR). Acetabular opening, depth, and medial bone stock, as indicated by the minimum thickness of the medial acetabular wall, were measured in the transverse reformed MPR plane. Results: The minimum thicknesses of the medial acetabular wall in Crowe-I and Crowe-II/III hips were 3.8+-2.1 mm and 7.1+-3.1 mm, respectively, with statistically significant differences between the groups (P<0.05). Furthermore, the bone stock in the medial acetabular wall correlated with the degree of subluxation (R=0.69) and the acetabular depth (R= ;- ;0.71). Conclusion: There was significantly more bone stock in the medial acetabular wall in patients with higher-degree subluxation than there was in the less-severe class. This difference should be taken into consideration when reconstructing acetabula in THA in patients with DDH using the technique of medialization

Evaluation of Medial Acetabular Wall Bone Stock in Patients with Developmental Dysplasia of the Hip Using a Helical Computed Tomography Multiplanar Reconstruction Technique

International Nuclear Information System (INIS)

Rui Yu Liu; Kun Zheng Wang; Chun Sheng Wang; Xiao Qian Dang; Zhi Qin Tong

2009-01-01

Background: The technique of medialization has been used to reconstruct acetabula at the level of true acetabula in total hip arthroplasty (THA) in patients with developmental dysplasia of the hip (DDH). Appreciation of the bone stock in the medial acetabular wall is significant for making an optimal acetabular reconstruction plan and avoiding complications. Purpose: To evaluate the bone stock of the medial acetabular wall and its relation to the degree of subluxation in patients with DDH using computed tomography (CT). Material and Methods: Helical CT scans of 27 hips were obtained from 21 patients with osteoarthritis secondary to DDH who were scheduled for total hip arthroplasty. Eleven hips belonged to Crowe class I, while 16 hips belonged to Crowe class II/III. The raw CT data were reprocessed in various planes by scrolling multiplanar reformation (MPR). Acetabular opening, depth, and medial bone stock, as indicated by the minimum thickness of the medial acetabular wall, were measured in the transverse reformed MPR plane. Results: The minimum thicknesses of the medial acetabular wall in Crowe-I and Crowe-II/III hips were 3.8±2.1 mm and 7.1±3.1 mm, respectively, with statistically significant differences between the groups (P<0.05). Furthermore, the bone stock in the medial acetabular wall correlated with the degree of subluxation (R=0.69) and the acetabular depth (R= ;- ;0.71). Conclusion: There was significantly more bone stock in the medial acetabular wall in patients with higher-degree subluxation than there was in the less-severe class. This difference should be taken into consideration when reconstructing acetabula in THA in patients with DDH using the technique of medialization

An enigmatic clinical presentation of plasma cell granuloma of the oral cavity

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Pravesh Kumar Jhingta

2018-01-01

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.

Nonunion of acetabular fractures: evaluation with interactive multiplanar CT

International Nuclear Information System (INIS)

Kuhlman, J.E.; Fishman, E.K.; Ney, D.R.; Brooker, A.F. Jr.; Magid, D.

1989-01-01

Nonunions involving fractures of the acetabulum are reportedly rare, with few citings and little discussion in the literature. It is possible that acetabular nonunions go undetected because imaging of the acetabulum is difficult by conventional radiography. We report two cases of fracture nonunion involving the weight-bearing surface of the acetabulum diagnosed with the aid of computed tomography (CT) and a newly developed interactive 2D/3D orthotool that uniquely processes and reformats routine CT data. The interactive 2D/3D orthotool is a sophisticated computer program that allows dynamic viewing of standard multiplanar reconstructions in the axial, coronal, and sagittal planes as well as multiple oblique projections. The 2D/3D orthotool provides on screen correlation of two-dimensional multiplanar images with three-dimensional reconstructions of the pelvis. The authors found this capability ideally suited for studying fractures with off-axis orientation such as those through the acetabular dome, greatly facilitating the diagnosis of nonunion

Early failure mechanisms of constrained tripolar acetabular sockets used in revision total hip arthroplasty.

Science.gov (United States)

Cooke, Christopher C; Hozack, William; Lavernia, Carlos; Sharkey, Peter; Shastri, Shani; Rothman, Richard H

2003-10-01

Fifty-eight patients received an Osteonics constrained acetabular implant for recurrent instability (46), girdlestone reimplant (8), correction of leg lengthening (3), and periprosthetic fracture (1). The constrained liner was inserted into a cementless shell (49), cemented into a pre-existing cementless shell (6), cemented into a cage (2), and cemented directly into the acetabular bone (1). Eight patients (13.8%) required reoperation for failure of the constrained implant. Type I failure (bone-prosthesis interface) occurred in 3 cases. Two cementless shells became loose, and in 1 patient, the constrained liner was cemented into an acetabular cage, which then failed by pivoting laterally about the superior fixation screws. Type II failure (liner locking mechanism) occurred in 2 cases. Type III failure (femoral head locking mechanism) occurred in 3 patients. Seven of the 8 failures occurred in patients with recurrent instability. Constrained liners are an effective method for treatment during revision total hip arthroplasty but should be used in select cases only.

Preliminary application of computer-assisted patient-specific acetabular navigational template for total hip arthroplasty in adult single development dysplasia of the hip.

Science.gov (United States)

Zhang, Yuan Z; Chen, Bin; Lu, Sheng; Yang, Yong; Zhao, Jian M; Liu, Rui; Li, Yan B; Pei, Guo X

2011-12-01

The considerable variation in anatomical abnormalities of hip joints associated with different types of developmental dysplasia of hip (DDH) makes reconstruction in total hip arthroplasty (THA) difficult. It is desirable to create patient-specific designs for THA procedures. In the cases of adult single DDH, an accuracy-improved method has been developed for acetabular cup prosthesis implantation of hip arthroplasty. From October 2007 to November 2008, 22 patients with single DDH (according to the Crowe standard, all dysplasia hips were classified as type I) were scanned with spiral CT pre-operatively. These patients scheduled for THA were randomly assigned to undergo either conventional THA (control group, n = 11) or navigation template implantation (NT group, n = 11). In the NT group, three-dimensional (3D) CT pelvis image data were transferred to a computer workstation and 3D models of the hip were reconstructed using the Mimics software. The 3D models were then processed by the Imageware software. In brief, a template that best fitted the location and shape of the acetabular cup was 'reversely' built from the 3D model, the rotation centre of the pathological hip determined by mirroring that of the healthy site, and a guiding hole in the template was then designed. The navigational templates were manufactured using a rapid prototyping machine. These navigation templates guide acetabular component placement. Based on the predetermined abduction angle 45° and anteversion angle 18°, after 1 year follow-up, the NT group showed significantly smaller differences (1.6° ± 0.4°, 1.9° ± 1.1°) from the predetermined angles than those in the control group (5.8° ± 2.9°, 3.9° ± 2.5°) (P < 0.05). The template designs facilitated accurate placement of acetabular components in dysplasia of acetabulum. The hip's center of rotation in DDH could be established using computer-aided design, which provides a useful method for the accurate

A new method for the measurement of anteversion of the acetabular cup after total hip arthroplasty.

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Aydogan, Mehmet; Burç, Halil; Saka, Gursel

2014-08-01

Many methods of determining the anteversion of the acetabular cup have been described in the literature. The advantages and disadvantages of each of these methods are discussed in this paper. We present a new method of measuring the acetabular anteversion at the anteroposterior hip. The formula designed by the authors was anteversion angle (α) = arc sin |PK|/√ |AK| × |BK|. The formula was tested using the AutoCAD software, and an experimental study was conducted to evaluate the accuracy. Three groups were created, and 16 X-ray images were taken and coded. Ten orthopaedic surgeons measured the acetabular anteversion from these X-rays using our formula. The results in Group 1 were closer to the actual value; in contrast, the results in Group 2 differed from the actual values. The results in Group 3 were as close to the actual anteversion values as were those in Group 1. Developments in technology often bring an increase in complications. Despite newly developed surgical methods and technology, the position of the acetabular cup is still used to determine the results of a total hip arthroplasty. Our method is simple, cost-effective and achieves almost 100 % accuracy.

The Evolution of the Cup-Cage Technique for Major Acetabular Defects: Full and Half Cup-Cage Reconstruction.

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Sculco, Peter K; Ledford, Cameron K; Hanssen, Arlen D; Abdel, Matthew P; Lewallen, David G

2017-07-05

Complex acetabular reconstruction for major bone loss can require advanced methods such as the use of a cup-cage construct. The purpose of this study was to review outcomes after the initial development of the cup-cage technique and the subsequent evolution to the use of a half cup-cage construct. We performed a retrospective, single-center review of 57 patients treated with cup-cage reconstruction for major acetabular bone loss. All patients had major acetabular defects graded as Paprosky Type 2B through 3B, with 34 (60%) having an associated pelvic discontinuity. Thirty patients received a full cup-cage construct and 27, a half cup-cage construct. The mean follow-up was 5 years. Both the full and half cup-cage cohorts demonstrated significantly improved Harris hip score (HHS) values, from 36 to 72 at a minimum of 2 years of follow-up (p cup-cage constructs and 6 (22%) of the half cup-cage constructs. One patient with a full cup-cage construct underwent re-revision of the acetabular component for progressive migration and aseptic loosening. Short-term survivorship free from re-revision for any cause or reoperation was 89% (83% and 96% for full and half cup-cage cohorts, respectively). Both full and half cup-cage constructs demonstrated successful clinical outcomes and survivorship in the treatment of major acetabular defects and pelvic discontinuity. Each method is utilized on the basis of individual intraoperative findings, including the extent and pattern of bone loss, the quality and location of host bone remaining after preparation, and the presence of pelvic discontinuity. Longer-term follow-up is required to understand the durability of these constructs in treating major acetabular defects and pelvic discontinuity. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Para-acetabular peritendinitis calcarea; its radiographic manifestations

International Nuclear Information System (INIS)

Kawashima, Akira; Murayama, Sadayuki; Ohuchida, Toshiyuki; Russell, W.J.

1987-02-01

Peritendinitis calcarea and os acetabuli have long been confused during interpretations of hip-joint radiographs. Such confusion is reflected in the medical literature. The present study differentiated these two entities according to their interval radiographic progression and regression. There were 137 instances of para-acetabular calcifications among 110 subjects (59 men and 51 women), whose mean age was 46.8 years at the time of their initial detection. Twenty-six of the subjects had lumbago, which was probably unrelated. Other abnormalities including narrowed intervertebral spaces, scoliosis, and spondylolysis were observed in 21 of the subjects. These could have been responsible for any symptoms they had had, but none of the subjects complained of local hip-joint pain when the radiographs in question were made. Ninety-three of these instances of calcification were reviewed by means of serial radiographs. Interval changes in the sizes and shapes of the calcifications occurred among 90 of them, indicative of the latent type of peritendinitis calcarea. No interval changes were noted in the remaining three cases, indicating they were secondary ossification centers; namely, os acetabuli. This study showed that in asymptomatic adults, most para-acetabular calcifications were really not os acetabuli, but actually peritendinitis calcarea. (author)

Morphometric analysis of acetabular dysplasia in cerebral palsy: three-dimensional CT study.

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Gose, Shinichi; Sakai, Takashi; Shibata, Toru; Murase, Tsuyoshi; Yoshikawa, Hideki; Sugamoto, Kazuomi

2009-12-01

Three-dimensional computed tomography (3D-CT) eliminates the positioning errors and allows the clinician to more accurately assess the radiographic parameters present. To elucidate the 3D geometry of the acetabulum and the extent of hip subluxation/dislocation in patients with cerebral palsy (CP), quantitative morphometric analysis was performed using 3D-CT data. We evaluated 150 hips in 75 patients with bilateral spastic CP. The mean age of the patients was 5.4 years (range: 2.7 to 6.9 y). The fitting plane of the ilium was projected onto the coronal plane and then onto the sagittal plane, and then the angle formed with a horizontal line was defined as CTalpha (the lateral opening angle) and CTbeta (the sagittal inclination angle), respectively. The center of the acetabulum and the femoral head were defined, and the distance between these centers was divided by the femoral head diameter, defined as CT migration percentage (CTMP, %). In 123 (82%) of the 150 hips, the femoral head center was located posteriorly, superiorly, and laterally relative to the acetabular center. Large CTalpha cases tended to show large CTMP. CTalpha and CTMP were significantly larger in the cases with Gross Motor Functional Classification System (GMFCS) level IV/V and spastic quadriplegia, than in the cases with GMFCS level II/III and spastic diplegia. CTbeta showed significant correlation with the acetabular defect on the lateral 3D reconstructed images. Three-dimensional acetabular geometry and migration percentage in CP patients can be analyzed quantitatively using 3D-CT regardless of the abnormal spastic posture. The extent of acetabular dysplasia and subluxation is more severe in patients with GMFCS level IV/V and spastic quadriplesia. Level 4.

Human schistosomiasis mansoni: studies on in vitro granuloma modulation

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Juçara C. Parra

1992-01-01

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.

The preliminary application of magnetic resonance arthrography in the diagnosis of acetabular labrale tears

International Nuclear Information System (INIS)

Hong Wen; Zhang Xuezhe; Wang Wu; Yue Debo; Wang Weiguo

2010-01-01

Objective: To investigate the application value of MR arthrography (MRA) in the diagnosis of acetabular lab ral tears. Methods: Fifteen patients with a high degree of suspected acetabular lab ral tears received fluoroscope-guided injection of the contrast media into the hip joint (hip arthrography) and fat-saturated spin-echo T 1 -weighted images were obtained in the coronal, sagittal, oblique-axial and radial planes. Hip arthroscopy was performed on 12 of them. Results: Lab ral tears which were diagnosed in 11 patients by hip MRA were confirmed at hip arthroscopy. One patient showed no MRA indication of lab ral tear, also showed normal on arthroscopy. Tear in the anterior-superior quadrant 10 cases of 12 joints (12/13), posterior-superior quadrant 1 case of a joint (1/13). In 11 patients who underwent arthroscopy, hip MRA diagnosed 3 (3/13) joints labrale tears in coronal planes, 10 (10/13) joints in sagittal planes and 13 (13/13) labrale tears in axial-oblique and radial planes. In 15 patients with 20 hip joints, 5 cases 6 joints (6/20) with normal acetabular sublabral sulcus were performed. Conclusions: MR arthrography of hip is a reliable method in the diagnosis of acetabular labrale tears. Scanning method should be included fat-saturated spin-echo T 1 -weighted images in sagittal and oblique-axial planes or sagittal plus radial planes. The diagnosis of torn posterior-inferior quadrant should pay attention to the existence of a normal variation. (authors)

early experience of operative treatment of pelvic and acetabular

African Journals Online (AJOL)

Objective: To review early post-operative results of pelvic and acetabular fracture intern al fixation. Design: ... 600 needing operative treatment annually. ... Infection was controlled with debridement and antibiotics. All the patients in the study returned to their work except one who has yet to do so 5 months after his injury.

Mitomicina C colírio como tratamento para granuloma piogênico em cavidade anoftámica Mitomicyn C eye drops as alternative treatment for pyogenic granuloma in anophthalmic socket

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Hérika Danielle de Miranda Santos

2006-10-01

Full Text Available OBJETIVO: Avaliar a eficácia do uso tópico de colírio de mitomicina C 0,02% (MMC 0,02% no tratamento de pacientes com granuloma piogênico em cavidade anoftálmica. MÉTODOS: Seis pacientes portadores de granuloma piogênico em cavidade anoftálmica foram submetidos ao tratamento com mitomicina C 0,02% instilada quatro vezes ao dia durante ciclos quinzenais e intervalo de 15 dias entre os ciclos. Os pacientes foram acompanhados semanalmente. RESULTADOS: Foram acompanhados seis pacientes dos quais um apresentou resolução do granuloma piogênico ao final do primeiro ciclo de uso da MMC 0,02%. Em dois pacientes a MMC 0,02% foi eficaz na resolução da lesão após a segunda semana de tratamento (primeiro ciclo. Dois pacientes apresentaram resolução completa do granuloma piogênico na quinta semana de uso da MMC 0,02% (início do segundo ciclo. Este fármaco foi ineficaz em apenas um paciente que persistiu com a lesão após dois ciclos de tratamento. Não foram observadas complicações decorrentes do uso de MMC 0,02% em nenhum dos pacientes. CONCLUSÃO: A MMC 0,02% tópica mostrou-se eficaz no tratamento de granuloma piogênico em cavidade anoftálmica, entretanto, diante de casuística pequena, torna-se necessário estudo mais amplo, comparando a eficácia da MMC 0,02% com drogas já utilizadas no tratamento desta lesão, tais como os esteróides e antimetabólicos.PURPOSE: To evaluate the efficacy of mitomycin C eye drops 0.02% concentration (0.02% MMC in pyogenic granuloma in anophthalmic socket. METHODS: Six patients who presented pyogenic granuloma were treated with 0.02% MMC four times a day in fifteen-day cycles with intervals of fifteen days between each cycle. The patients were observed every week. RESULTS: Among the six studied patients, one presented a complete resolution of the pyogenic granuloma after a ten-day treatment with 0.02% MMC that is, before the end of the first cycle. In two patients, the treatment was successful

Pulmonary hyalinizing granuloma presenting with dysphagia: a rare presentation.

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Khan, Fazal; Hamid, Arsalan; Fatima, Benish; Hashmi, Shiraz; Fatimi, Saulat

2017-01-01

A 25-year-old man presented with a 2-month history of dysphagia and past history of pulmonary and intestinal tuberculosis. A barium swallow showed a point of constriction 42 mm above the gastroesophageal junction. Computed tomography revealed large opacities in bilateral lung fields, encroaching more on the esophagus. The lesion progressively compressed the esophagus as it moved inferiorly. A right posterolateral thoracotomy was performed for sub-anatomical resection of the mass. A biopsy revealed homogenous whirling hyalinized collagen fibers, highly suggestive of pulmonary hyalinizing granuloma, with no evidence of malignancy. Pulmonary hyalinizing granuloma should be considered in the differential diagnosis of longstanding dysphagia.

Minimally Invasive Approach to Eliminate Pyogenic Granuloma: A Case Report

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B. Chandrashekar

2012-01-01

Full Text Available Pyogenic granuloma is one of the inflammatory hyperplasia seen in the oral cavity. The term is a misnomer because it is not related to infection and arises in response to various stimuli such as low-grade local irritation, traumatic injury, or hormonal factors. It is most commonly seen in females in their second decade of life due to vascular effects of hormones. Although excisional surgery is the treatment of choice for it, this paper presents the safest and most minimally invasive procedure for the regression of pyogenic granuloma.

A severe transmissible Majocchi's granuloma in an immunocompetent returned traveler

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James G. Gallo

2017-12-01

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 [1]. 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

Accuracy of templating the acetabular cup size in Total Hip Replacement using conventional acetate templates on digital radiographs.

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Krishnamoorthy, Vignesh P; Perumal, Rajamani; Daniel, Alfred J; Poonnoose, Pradeep M

2015-12-01

Templating of the acetabular cup size in Total Hip Replacement (THR) is normally done using conventional radiographs. As these are being replaced by digital radiographs, it has become essential to create a technique of templating using digital films. We describe a technique that involves templating the digital films using the universally available acetate templates for THR without the use of special software. Preoperative digital radiographs of the pelvis were taken with a 30 mm diameter spherical metal ball strapped over the greater trochanter. Using standard acetate templates provided by the implant company on magnified digital radiographs, the size of the metal ball (X mm) and acetabular cup (Y mm) were determined. The size of the acetabular cup to be implanted was estimated using the formula 30*Y/X. The estimated size was compared with the actual size of the cup used at surgery. Using this technique, it was possible to accurately predict the acetabular cup size in 28/40 (70%) of the hips. When the accuracy to within one size was considered, templating was correct in 90% (36/40). When assessed by two independent observers, there was good intra-observer and inter-observer reliability with intra-class correlation coefficient values greater than 0.8. It was possible to accurately and reliably predict the size of the acetabular cup, using acetate templates on digital films, without any digital templates.

Taurine drinking ameliorates hepatic granuloma and fibrosis in mice infected with Schistosoma japonicum

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Yan-Rong Yu

2016-04-01

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

Amlodipine induced plasma cell granuloma of the gingiva: A novel case report.

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Vishnudas, Bhandari; Sameer, Zope; Shriram, Bansode; Rekha, Kardile

2014-07-01

Drug-induced gingival overgrowth (DIGO) can be a serious concern for both patients and clinicians. DIGO is a well-documented side-effect of some pharmacologic agents, including, but not limited to, calcium channel blockers, phenytoin, and cyclosporine. Plasma cell granulomas (pseudotumors) are exceedingly rare, non-neoplastic, reactive tumor-like proliferation, primarily composed of plasma cells that manifest primarily in the lungs, but may occur in various anatomic locations. Intraoral plasma cell granulomas involving the lip, oral mucosa, tongue, and gingiva have been reported in the past. This is the first case report of amlodipine induced plasma cell granuloma of the gingiva in the medical literature presenting a 54 year-old female patient with hypertension, who received amlodipine (10 mg/day, single dose orally) for 2 years, sought medical attention because of developing maxillary anterior massive gingival overgrowth causing functional and esthetic problem, which was treated by excisional biopsy. Histologically, these lesions were composed of mature plasma cells, showing polyclonality for both lambda and kappa light chains and fibrovascular connective tissue stroma confirming a diagnosis of plasma cell granuloma. This case also highlights the need to biopsy for unusual lesions to rule out potential neoplasms.

Clinical and Radiological Results over the Medium Term of Isolated Acetabular Revision

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Nicola Piolanti

2014-01-01

Full Text Available Acetabular cup loosening is associated with pain, reduced function, and instability of the implant. If such event happens while the femoral implant is in a satisfactory position and is well fixed to the bone, isolated acetabular revision surgery is indicated. The aim of this single-center retrospective study was to evaluate the clinical and radiological results over the medium term (12-month follow-up mean 36, max 60 of isolated acetabular revisions surgery using a porous hemispheric revision shell matched with a cemented all-poly cup and large diameter femoral head (>32. 33 patients were enrolled. We collect any relevant data from the clinical board. Routine clinical and radiographic examinations were performed preoperatively; the postoperative follow-up was made at 1, 3, and 6 months and yearly thereafter. At the last available follow-up, we report satisfactory improvement of functional scores in all the patients; 2 patients (6.1% showed thigh pain and only 4 hips (12.11% presented mild groin pain; all the femoral components are well fixed and there were no potential or pending rerevisions. With bias due to the follow-up and to the retrospective design of the study, we report clinical, functional, and radiological satisfactory results.

Oral plasma cell granuloma: A case report of an ambiguous lesion

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Manveen Kaur Jawanda

2014-01-01

Full Text Available Plasma cell granuloma (PCG is a rare reactive tumor such as proliferation composed chiefly of plasmacytic infiltrate. Both clinically and histopathologically, it may be misinterpreted as various pathological entities thus necessitating the complete evaluation of patient and proper histopathological and immunohistochemical analysis of the tissue to rule out other lesions with poor prognosis. Here, we present a case of PCG of gingiva in a female patient masquerading as pyogenic granuloma clinically and plasma cell neoplasms histopathologically.

Primary cutaneous anaplastic large cell lymphoma masquerading as large pyogenic granuloma

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Anupama Bains

2016-01-01

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.

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)

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Chigi, Gino; Pastremoli, Alessandro; Pisi, Paolo; Pastremoli, Alfredo [Bologna Univ., Bologna (Italy). Dipartimento di scienze odontomastologiche; Bianchi, Giuseppe [Istituti Ortopedici Rizzoli, Bologna (Italy)

2005-04-01

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

Risk factors for laryngeal trauma and granuloma formation in pediatric intubations.

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Jang, Minyoung; Basa, Krystyne; Levi, Jessica

2018-04-01

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

[A rare form of granuloma annulare].

Science.gov (United States)

Bogdanowski, T; Wygledowska-Kania, M

1995-01-01

We present a four-year-old girl with a doubly rare form of granuloma annulare with non-typical localisation of superficial nodules on the palms and predisposition to ulceration which is very rare in this type of superficial nodules. The diagnosis was proved by histological examination. After the local cryotherapy (ethyl chloride) the lesions almost completely disappeared.

Three-dimensional printing model improves morphological understanding in acetabular fracture learning: A multicenter, randomized, controlled study.

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Zhenfei Huang

Full Text Available Conventional education results in unsatisfactory morphological understanding of acetabular fractures due to lack of three-dimensional (3D details and tactile feedback of real fractures. Virtual reality (VR and 3D printing (3DP techniques are widely applied in teaching. The purpose of this study was to identify the effect of physical model (PM, VR and 3DP models in education of morphological understanding of acetabular fractures. 141 students were invited to participate in this study. Participants were equally and randomly assigned to the PM, VR and 3DP learning groups. Three-level objective tests were conducted to evaluate learning, including identifying anatomical landmarks, describing fracture lines, identifying classification, and inferring fracture mechanism. Four subjective questions were asked to evaluate the usability and value of instructional materials. Generally, the 3DP group showed a clear advantage over the PM and VR groups in objective tests, while there was no significant difference between the PM and VR groups. 3DP was considered to be the most valuable learning tool for understanding acetabular fractures. The findings demonstrate that 3DP modelling of real fractures is an effective learning instrument that can be used to understand the morphology of acetabular fractures and promote subjective interest.

Revision of migrated pelvic acetabular components in THA with or without vascular involvement

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Ștefan Cristea

2016-05-01

Full Text Available Purpose. The literature describes a high rate of mortality in cases of intrapelvic acetabular component migration, which is a rare but serious complication. Our aim is to establish and propose a treatment protocol according to our results and experience. Material and Methods. We performed eight (8 total hip revisions with acetabular cup migration between 2006 and 2012. A vascular graft was needed in four (4 of these cases. Two (2 cases were revisions after a spacer for infected arthroplasties. The protocol included the following: X-Ray examination (frontal and lateral views, CT angiography, a biological evaluation, a suitable pre-operative plan, at least six (6 units of blood stock, an experienced anesthesiologist, an experienced surgical team that included a vascular surgeon and a versatile arsenal of revision prostheses, bone grafts and vascular grafts. The anterolateral approach was generally used for hip revisions and the retroperitoneal approach in the dorsal decubitus position was used when vascular risk was involved. Results: The acetabular defect was reconstructed using bone grafts and tantalum revision cups in 4 cases, Burch-Schneider cages in 2 cases, a Kerboull ring in 1 case and a cementless oblong cup (Cotyle Espace in 1 case. In 4 cases, an iliac vessel graft procedure was conducted by the vascular surgeon. All patients survived the revision procedures and returned regularly for subsequent check-ups, during which they did not show any septic complications. Conclusions: Intrapelvic acetabular cup migration is a rare but serious complication that can occur after total hip arthroplasty in either septic or aseptic cases. An experienced, multidisciplinary team of surgeons should be involved in planning and conducting such complicated revisions.

Early Versus Late Weight-Bearing Protocols for Surgically Managed Posterior Wall Acetabular Fractures.

Science.gov (United States)

Heare, Austin; Kramer, Nicholas; Salib, Christopher; Mauffrey, Cyril

2017-07-01

Despite overall improved outcomes with open reduction and internal fixation of acetabular fractures, posterior wall fractures show disproportionately poor results. The effect of weight bearing on outcomes of fracture management has been investigated in many lower extremity fractures, but evidence-based recommendations in posterior wall acetabular fractures are lacking. The authors systematically reviewed the current literature to determine if a difference in outcome exists between early and late postoperative weight-bearing protocols for surgically managed posterior wall acetabular fractures. PubMed and MEDLINE were searched for posterior wall acetabular fracture studies that included weight-bearing protocols and Merle d'Aubigné functional scores. Twelve studies were identified. Each study was classified as either early or late weight bearing. Early weight bearing was defined as full, unrestricted weight bearing at or before 12 weeks postoperatively. Late weight bearing was defined as restricted weight bearing for greater than 12 weeks postoperatively. The 2 categories were then compared by functional score using a 2-tailed t test and by complication rate using chi-square analysis. Six studies (152 fractures) were placed in the early weight-bearing category. Six studies (302 fractures) were placed in the late weight-bearing category. No significant difference in Merle d'Aubigné functional scores was found between the 2 groups. No difference was found regarding heterotopic ossification, avascular necrosis, superficial infections, total infections, or osteoarthritis. This systematic review found no difference in functional outcome scores or complication rates between early and late weight-bearing protocols for surgically treated posterior wall fractures. [Orthopedics. 2017: 40(4):e652-e657.]. Copyright 2017, SLACK Incorporated.

Extraoral tumor-like granuloma as a symptom of dental infection

DEFF Research Database (Denmark)

Werner Madsen, Sanne; Søgaard, Sara Taylor; Schmidt, Grethe

2016-01-01

A 26-year old woman with a cutaneous granuloma and fistula caused by a dental infection was initially mistaken for a tumor. She was under diagnostic examinations at several health care providers for 1.5 years before a final diagnosis and treatment was reached. The fistula originated from a periap...... always be suspected. Relevant imaging of the teeth and jaws will usually reveal the cause. The medical history, the oral and skin findings, biopsy, imaging results and treatment are presented in this article.......A 26-year old woman with a cutaneous granuloma and fistula caused by a dental infection was initially mistaken for a tumor. She was under diagnostic examinations at several health care providers for 1.5 years before a final diagnosis and treatment was reached. The fistula originated from...... a periapical lesion and extended to the facial skin. Differential diagnoses include malignant tumor, bacterial infection, furuncle and a granulomatous-like lesion. When a patient is presented with a fistula or granuloma-like lesion on the cheek, chin or the submandibular region, a dental infection should...

Methylation pattern of IFNG in periapical granulomas and radicular cysts.

Science.gov (United States)

Campos, Kelma; Gomes, Carolina Cavaliéri; de Fátima Correia-Silva, Jeane; Farias, Lucyana Conceição; Fonseca-Silva, Thiago; Bernardes, Vanessa Fátima; Pereira, Cláudia Maria; Gomez, Ricardo Santiago

2013-04-01

Interferon-γ plays an important role in the pathogenesis of periapical lesions, and the methylation of IFNG has been associated with transcriptional inactivation. The purpose of the present study was to investigate IFNG promoter methylation in association with gene transcription and protein levels in periapical granulomas and radicular cysts. Methylation-specific polymerase chain reaction was used to assess the DNA methylation pattern of the IFNG gene in 16 periapical granulomas and 13 radicular cyst samples. The transcription levels of IFNG mRNA were verified by quantitative real-time polymerase chain reaction, and protein expression was evaluated by immunohistochemistry. All the periapical lesion samples exhibited partial or total methylation of the IFNG gene. In addition, an increased methylation profile was found in radicular cysts compared with periapical granulomas. Increased IFNG mRNA expression was observed in the partially methylated periapical lesion samples relative to the samples that were completely methylated. The present study provides the first evidence of the possible impact of IFNG methylation on IFNG transcription in periapical lesions. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Acetabular bone density and metal ions after metal-on-metal versus metal-on-polyethylene total hip arthroplasty; short-term results

NARCIS (Netherlands)

Zijlstra, Wierd P.; van der Veen, Hugo C.; van den Akker-Scheek, Inge; Zee, Mark J. M.; Bulstra, Sjoerd K.; van Raay, Jos J. A. M.

Information on periprosthetic acetabular bone density is lacking for metal-on-metal total hip arthroplasties. These bearings use cobalt-chromium instead of titanium acetabular components, which could lead to stress shielding and hence periprosthetic bone loss. Cobalt and chromium ions have

A TNF-Regulated Recombinatorial Macrophage Immune Receptor Implicated in Granuloma Formation in Tuberculosis

Science.gov (United States)

Streich, Roswita; Breysach, Caroline; Raddatz, Dirk; Oniga, Septimia; Peccerella, Teresa; Findeisen, Peter; Kzhyshkowska, Julia; Gratchev, Alexei; Schweyer, Stefan; Saunders, Bernadette; Wessels, Johannes T.; Möbius, Wiebke; Keane, Joseph; Becker, Heinz; Ganser, Arnold; Neumaier, Michael; Kaminski, Wolfgang E.

2011-01-01

Macrophages play a central role in host defense against mycobacterial infection and anti- TNF therapy is associated with granuloma disorganization and reactivation of tuberculosis in humans. Here, we provide evidence for the presence of a T cell receptor (TCR) αβ based recombinatorial immune receptor in subpopulations of human and mouse monocytes and macrophages. In vitro, we find that the macrophage-TCRαβ induces the release of CCL2 and modulates phagocytosis. TNF blockade suppresses macrophage-TCRαβ expression. Infection of macrophages from healthy individuals with mycobacteria triggers formation of clusters that express restricted TCR Vβ repertoires. In vivo, TCRαβ bearing macrophages abundantly accumulate at the inner host-pathogen contact zone of caseous granulomas from patients with lung tuberculosis. In chimeric mouse models, deletion of the variable macrophage-TCRαβ or TNF is associated with structurally compromised granulomas of pulmonary tuberculosis even in the presence of intact T cells. These results uncover a TNF-regulated recombinatorial immune receptor in monocytes/macrophages and demonstrate its implication in granuloma formation in tuberculosis. PMID:22114556

A TNF-regulated recombinatorial macrophage immune receptor implicated in granuloma formation in tuberculosis.

Directory of Open Access Journals (Sweden)

Alexander W Beham

2011-11-01

Full Text Available Macrophages play a central role in host defense against mycobacterial infection and anti- TNF therapy is associated with granuloma disorganization and reactivation of tuberculosis in humans. Here, we provide evidence for the presence of a T cell receptor (TCR αβ based recombinatorial immune receptor in subpopulations of human and mouse monocytes and macrophages. In vitro, we find that the macrophage-TCRαβ induces the release of CCL2 and modulates phagocytosis. TNF blockade suppresses macrophage-TCRαβ expression. Infection of macrophages from healthy individuals with mycobacteria triggers formation of clusters that express restricted TCR Vβ repertoires. In vivo, TCRαβ bearing macrophages abundantly accumulate at the inner host-pathogen contact zone of caseous granulomas from patients with lung tuberculosis. In chimeric mouse models, deletion of the variable macrophage-TCRαβ or TNF is associated with structurally compromised granulomas of pulmonary tuberculosis even in the presence of intact T cells. These results uncover a TNF-regulated recombinatorial immune receptor in monocytes/macrophages and demonstrate its implication in granuloma formation in tuberculosis.

Radiologic Findings of Foreign Body Granuloma by the Bee Sting: A Case Report

International Nuclear Information System (INIS)

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

2010-01-01

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

Radiologic Findings of Foreign Body Granuloma by the Bee Sting: A Case Report

Energy Technology Data Exchange (ETDEWEB)

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)

2010-03-15

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.

Canine Oral Eosinophilic Granuloma Treated with Electrochemotherapy

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Matías Nicolás Tellado

2014-01-01

Full Text Available A case of a canine oral eosinophilic granuloma in a 14-year-old female crossbred is described. The dog was presented with a history of ptyalism, halitosis, local pain, decreased appetite, and blood staining noted on food and water bowls. Clinical, hematologic, and biochemical examinations, abdominal ultrasonography, and 3-view chest radiographs were performed, and no metastases were found. Histopathologic examination of two 6 mm punch biopsies from the oral lesion revealed the presence of eosinophilic granulomatous lesions in the submucosa. After treatment with corticosteroids and wide spectrum antibiotics no significant changes in clinical signs and lesion size were observed. Electrochemotherapy (ECT, a novel tumor treatment routinely used for cutaneous and subcutaneous tumors in human patients in the European Union since 2006, was used to treat the eosinophilic granuloma. The procedure was performed under general anesthesia, followed by intravenous administration of bleomycin. Six weeks after treatment a complete response with disappearance of the mass and improvement of clinical signs were observed.

Connective matrix organization in chronic granulomas of experimental paracoccidioidomycosis.

Science.gov (United States)

Kerr, I B; de Oliveira, P C; Lenzi, H L

1988-07-01

The histological and ultrastructural aspects of chronic granulomas from rats infected intraperitoneally with Paracoccidioides brasiliensis are described with special emphasis on the composition of the extracellular matrix. The granulomas were structurally arranged in two zones, one central containing fungi, and the other peripheral. The extracellular matrix was composed of collagen types I and III, proteoglycans, glycoprotein, and an undefined amorphous substance. The main cellular population was represented by macrophages, epithelioid cells, and giant cells in the central zone, and fibroblasts in the peripheral zone. The fibrotic process was a critical event in this stage of the infection, and showed a centrifugal direction. This might be provoked by direct stimulus from the fungi or by macrophage-fibroblastic interaction.

Variability in tuberculosis granuloma T cell responses exists, but a balance of pro- and anti-inflammatory cytokines is associated with sterilization.

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Hannah Priyadarshini Gideon

2015-01-01

Full Text Available 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

Granuloma hialinizante de pulmão recidivante Recurrent pulmonary hyalinizing granuloma

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Guilherme D'Andréa Saba Arruda

2010-10-01

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.

Granuloma Inguinale Simulating Squamous Cell Carcinoma

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M Z Mani

1981-01-01

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.

Entrapment of the acetabular labrum following reduction of traumatic hip dislocation in a child

Energy Technology Data Exchange (ETDEWEB)

Chun, K.A. [The Catholic University of Korea Uijongbu St. Mary' s Hospital, Department of Radiology, Uijongbu, Kyunggi-Do 480-130 (Korea); University of Iowa Hospitals and Clinics, Department of Radiology, Iowa City (United States); Morcuende, J. [University of Iowa Hospitals and Clinics, Department of Orthopaedic Surgery, Iowa City (United States); El-Khoury, G.Y. [University of Iowa Hospitals and Clinics, Department of Radiology, Iowa City (United States)

2004-12-01

In traumatic hip dislocation, concentric reduction can be prevented by various causes. Soft-tissue interposition, such as entrapment of the acetabular labrum, is a rare but important cause of failed reduction of a hip. Early diagnosis of incomplete reduction due to interposition of soft tissue is important, because delayed treatment is associated with a greater incidence of avascular necrosis of the femoral head and early onset of osteoarthritis. This report describes a case of acetabular labral entrapment following reduction of traumatic hip dislocation in a child. The importance of CT and MRI in arriving at an early diagnosis is emphasized. (orig.)

Entrapment of the acetabular labrum following reduction of traumatic hip dislocation in a child

International Nuclear Information System (INIS)

Chun, K.A.; Morcuende, J.; El-Khoury, G.Y.

2004-01-01

In traumatic hip dislocation, concentric reduction can be prevented by various causes. Soft-tissue interposition, such as entrapment of the acetabular labrum, is a rare but important cause of failed reduction of a hip. Early diagnosis of incomplete reduction due to interposition of soft tissue is important, because delayed treatment is associated with a greater incidence of avascular necrosis of the femoral head and early onset of osteoarthritis. This report describes a case of acetabular labral entrapment following reduction of traumatic hip dislocation in a child. The importance of CT and MRI in arriving at an early diagnosis is emphasized. (orig.)

Differential cytokine gene expression in granulomas from lungs and lymph nodes of cattle experimentally infected with aerosolized Mycobacterium bovis

Science.gov (United States)

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...

Receptor activator NFkappaB-ligand and osteoprotegerin protein expression in human periapical cysts and granulomas.

Science.gov (United States)

Menezes, Renato; Bramante, Clóvis Monteiro; da Silva Paiva, Katiúcia Batista; Letra, Ariadne; Carneiro, Everdan; Fernando Zambuzzi, Willian; Granjeiro, José Mauro

2006-09-01

The purpose of this study was to determine the expression of receptor activator of NFkappaB ligand (RANKL) and osteoprotegerin (OPG) associated with bone destruction in periapical cysts and granulomas. Forty human dental chronic periapical lesions were collected after periapical surgery. The lesions collected were fixed in 10% buffered formalin and histologically processed. At least 2 sections of each specimen were stained with hematoxylin and eosin for microscopic diagnosis. After that, 10 human periapical granulomas and 10 cysts were selected for immunohistochemical analysis for RANKL, OPG, and CD68+. Polymorphonuclear neutrophils, macrophages, endothelial cells, and lymphocytes were stained for RANKL and OPG in both lesions. Epithelial cells were also stained for RANKL and OPG in periapical cysts. Quantitative analysis was conducted and the results were expressed as a ratio of the number of immunostained cells over the total number of cells in the field (n = 100). The ratio of RANKL+/total cells was higher than OPG+/total cells in periapical granulomas (0.553 +/- 0.153 and 0.483 +/- 0.189, respectively; P cysts (0.519 +/- 0.09 and 0.339 +/- 0.117, respectively; P cysts. However, the ratio RANKL+/OPG+ in granulomas (1.336 +/- 0.723) and cysts (1.404 +/- 0.385) was not significantly different. The ratio of CD68+/total cells was significantly higher in granulomas (0.381 +/- 0.040) than in cysts (0.307 +/- 0.068) (P cysts and granulomas, strongly suggesting the involvement of these gene products in the development of periapical lesions.

Multinucleated giant cell cytokine expression in pulmonary granulomas of cattle experimentally infected with Mycobacterium bovis

Science.gov (United States)

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...

A Case of Unifocal Eosinophilic Granuloma of the Mandible in an Adult Female: A Case Report

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Anshita Agarwal

2012-01-01

Full Text Available Eosinophilic granuloma of bone is a disease with an incidence of one new case per 350,000 to 2 million per year, which is an uncommon disease of maxillofacial region, and presents in more than 90% in children under the age of ten with predominance for males. As a result, eosinophilic granuloma of the jaw is always unconsidered in the differential diagnosis of similar lesions by many clinicians. It is difficult to make a correct diagnosis on it without proof of a pathological diagnosis, which correlates with the diverse clinical and radiographic presentations of eosinophilic granuloma in the jaws. In the present paper we report a rare case of unifocal eosinophilic granuloma of mandible occurring in an adult female.

[Posterior partial trochanteric osteotomy for the treatment of the roof involved acetabular fractures].

Science.gov (United States)

Wang, Pan-Feng; Xu, Shuo-Gui; Zhang, Chun-Cai; Fu, Qing-Ge; Zhang, Yun-Tong; Liu, Xin-Wei; Niu, Yun-Fei; Tang, Yang

2013-11-01

To introduce a new trochanteric osteotomy,and evaluate the outcome of the procedure combined a posterior lateral approach in treating acetabular fractures which involving the roof. Between March 2007 and Novmber 2010,30 patients with displaced acetabular fractures involving the dome need trochanteric osteotomy were retrospectively reviewed. There were 21 males and 9 females,ranging in age from 18 to 70 years with an average of 35.2 years at the time of injury. According to Letournel-Judet classification, there were 10 posterior wall fractures,7 posterior column fractures,5 transverse fractures, 2 T-shape fractures, 1 transverse associated with posterior wall fracture, 3 posterior column and wall fractures and 2 bicolumn fractures. The standards of Matta,the modified Merle d'Aubigne-Postel, Medical Research Council were respectively used to evaluate the reduction result, function of hip joint and the strength of hip abduction. All patients were followed up with an average time of 25 months (18 to 40) and all osteotomy sites obtained bone union with an average time of 8.4 weeks (6 to 12). No bone non-union, bone block displaceing, internal fixation looseing and breaking,infection of deep part were found. Seventeen patients got anatomic reduction, 12 got satisfied reduction, and 1 got unsatisfied result according to the criteria of Matta. At final follow-up, function of hip joint obtained excellent results in 11 cases, good in 15, fair in 3 and poor in 1. The strength of the abductors of 3 patients were grade 4 and 27 patients were grade 5. Posterior partial great trochanteric osteotomy can enhance the exposure and provide a more accurate reduction and degrade the difficulty of acetabular fracture fixation without increasing the risk of complications. The method provide a new way for the treatment of the roof involved acetabular fractures.

Larval nematodes in stomach wall granulomas of smelt Osmerus eperlanus from the German North Sea coast

OpenAIRE

Obiekezie, A. I.; Lick, Roland R.; Kerstan, Susanne L.; Möller, Heino

1992-01-01

Occurrence of stomach wall granulomas in European smelt was studled at 6 locations along the German North Sea coast. Identification of larval nematodes inhabiting these granulomas is provided for the first time. Three species, isolated by pepsin-HC1 digestion, are involved: Hysterothylacium cf. cornutum, Cosmocephalus obvelatus and Paracuaria tridentata. 72% of all stomachs examined were affected. The ratio of number of granulomas to number of the 3 larval species free in the mesentery was 1:...

The role of trochanteric flip osteotomy in fixation of certain acetabular fractures

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Sandeep Gupta

2017-06-01

Conclusion: Trochanteric flip osteotomy is a very effective technique to fix certain acetabular fractures especially those with dome involvement. It is more accurate and associated with no significant complications compared with conventional way.

Contribution to the radiological study of the eosinophilic granuloma of the mandible (Unifocal granuloma due to Langherans' cell histiocytosis)

International Nuclear Information System (INIS)

Chigi, Gino; Pastremoli, Alessandro; Pisi, Paolo; Pastremoli, Alfredo

2005-01-01

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 [it

CT-guided corticosteroid injection for solitary eosinophilic granuloma of the spine

Energy Technology Data Exchange (ETDEWEB)

Rimondi, Eugenio; Rossi, Giuseppe [Istituto Ortopedico Rizzoli, University of Bologna, Department of Radiology and Interventional Angiographic Radiology, Bologna (Italy); Mavrogenis, Andreas F. [Istituto Ortopedico Rizzoli, University of Bologna, Department of Orthopedics, Bologna (Italy); Istituto Ortopedico Rizzoli, University of Bologna, Department of Orthopaedics, Orthopaedic Oncology Service, Bologna (Italy); Ussia, Giuseppe; Angelini, Andrea [Istituto Ortopedico Rizzoli, University of Bologna, Department of Orthopedics, Bologna (Italy); Ruggieri, Pietro [Istituto Ortopedico Rizzoli, University of Bologna, Department of Orthopedics, Bologna (Italy); Istituto Ortopedico Rizzoli, University of Bologna, Department of Orthopaedics, Bologna (Italy)

2011-06-15

To evaluate the clinical and imaging outcome of patients with symptomatic eosinophilic granuloma of the spine treated with CT-guided intralesional methylprednisolone injection after biopsy. Patients (n =19) with symptomatic solitary eosinophilic granuloma of the spine treated by CT-guided intralesional methylprednisolone injection were retrospectively studied. There were 12 males and seven females with a mean age of 17 years (range, 3-43 years). The mean follow-up was 6 years (median, 4 years; range, 0.5-19 years). Spinal location included the cervical (two patients), thoracic (seven patients), lumbar spine (eight patients), and the sacrum (two patients). Vertebra plana was observed in two patients. All patients had biopsies before treatment. Complete resolution of pain and healing of the lesion was observed in 17 patients (89.5%); none of these patients had recurrence at the latest examination. Reconstitution of the T1 and L1 vertebra plana was observed in both patients. Two patients initially diagnosed and treated for a solitary eosinophilic granuloma had constant pain after the procedure; in these patients, 6 and 12 months after the procedure, respectively, imaging showed multifocal disease and systemic therapy was administered. Complications related to the procedure were not observed. General anesthesia was administered in two patients because of intolerable pain during the procedure. In view of the benign clinical course of eosinophilic granuloma, in patients with symptomatic lesions, CT-guided intralesional corticosteroid injection is a safe and effective outpatient treatment with a low complication rate. (orig.)

Four whole-istic aspects of schistosome granuloma biology: fractal arrangement, internal regulation, autopoietic component and closure

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HL Lenzi

2006-10-01

Full Text Available This paper centers on some whole-istic organizational and functional aspects of hepatic Schistosoma mansoni granuloma, which is an extremely complex system. First, it structurally develops a collagenic topology, originated bidirectionally from an inward and outward assembly of growth units. Inward growth appears to be originated from myofibroblasts derived from small portal vessel around intravascular entrapped eggs, while outward growth arises from hepatic stellate cells. The auto-assembly of the growth units defines the three-dimensional scaffold of the schistosome granulomas. The granuloma surface irregularity and its border presented fractal dimension equal to 1.58. Second, it is internally regulated by intricate networks of immuneneuroendocrine stimuli orchestrated by leptin and leptin receptors, substance P and Vasoactive intestinal peptide. Third, it can reach the population of ± 40,000 cells and presents an autopoietic component evidenced by internal proliferation (Ki-67+ Cells, and by expression of c-Kit+ Cells, leptin and leptin receptor (Ob-R, granulocyte-colony stimulating factor (G-CSF-R, and erythropoietin (Epo-R receptors. Fourth, the granulomas cells are intimately connected by pan-cadherins, occludin and connexin-43, building a state of closing (granuloma closure. In conclusion, the granuloma is characterized by transitory stages in such a way that its organized structure emerges as a global property which is greater than the sum of actions of its individual cells and extracellular matrix components.

Reliability of ultrasonographic measurements in suspected patients of developmental dysplasia of the hip and correlation with the acetabular index

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Cem Copuroglu

2011-01-01

Full Text Available Background: Ultrasonography is accepted as a useful imaging modality in the early detection of developmental dysplasia of the hip (DDH. Early detection and early treatment of DDH prevents hip dislocation and related physical, social, economic, and psychological problems. The purpose of this study was to evaluate the reliability of ultrasonographic and roentgenographic measurements measured by seven different observers. Materials and Methods: The alpha angles of 66 hips in 33 patients were measured using the Graf method by seven different observers. Acetabular index degrees on plane roentgenograms were measured in order to assess the correlation between the ultrasonographic alpha angle and the radiographic acetabular index, which both show the bony acetabular depth, retrospectively. Results: The interclass correlation coefficient, measuring the interobserver reliability, was high and statistically significant for the ultrasonographic measurements. There was a negative correlation between the alpha angle and the acetabular index. Conclusions: Ultrasonography, when applied properly, is a reliable technique between different observers, in the diagnosis and follow up of DDH. When assessed concomitantly with the roentgenographic measurements, the results are reliable and statistically meaningful.

Deep Granuloma Annulare Mimicking Inflamed Cysts in a Teenager.

Science.gov (United States)

Guo, Emily L; Degesys, Catherine A; Jahan-Tigh, Richard; Chan, Audrey

2017-07-01

We describe deep granuloma annulare (DGA) of the forehead mimicking inflamed cysts. Reactive inflammation and sterile purulent drainage may be an underrecognized feature of DGA. © 2017 Wiley Periodicals, Inc.

Chololesterol granuloma in the middle cranial fossa: report of two cases

International Nuclear Information System (INIS)

Morioka, T.; Fujii, K.; Nishio, S.; Hasuo, K.; Hisashi, K.; Miyagi, Y.; Nagata, S.; Fukui, M.

1995-01-01

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.)

Acetabular cup position and risk of dislocation in primary total hip arthroplasty

DEFF Research Database (Denmark)

Seagrave, Kurt G; Troelsen, Anders; Malchau, Henrik

2017-01-01

Background and purpose - Hip dislocation is one of the most common complications following total hip arthroplasty (THA). Several factors that affect dislocation have been identified, including acetabular cup positioning. Optimal values for cup inclination and anteversion are debatable. We performed...... a systematic review to describe the different methods for measuring cup placement, target zones for cup positioning, and the association between cup positioning and dislocation following primary THA. Methods - A systematic search of literature in the PubMed database was performed (January and February 2016......) to identify articles that compared acetabular cup positioning and the risk of dislocation. Surgical approach and methods for measurement of cup angles were also considered. Results - 28 articles were determined to be relevant to our research question. Some articles demonstrated that cup positioning influenced...

Cam deformity and acetabular dysplasia as risk factors for hip osteoarthritis

NARCIS (Netherlands)

Hosnijeh, Fatemeh Saberi; Zuiderwijk, Maria E; Versteeg, Mathijs; Smeele, Hieronymus T W; Hofman, Albert; Uitterlinden, André G; Agricola, Rintje; Oei, Edwin H G; Waarsing, Jan H; Bierma-Zeinstra, Sita M; van Meurs, Joyce B J

2017-01-01

Objective: Cam deformity and acetabular dysplasia have been recognized as relevant risk factors for hip osteoarthritis (OA) in a few prospective studies with limited sample sizes. To date, however, no evidence is available from prospective studies regarding whether the magnitude of these

A Gray-purple Mass on the Floor of the Mouth: Gigantic Mucogingival Pyogenic Granuloma in a Teenage Patient.

Science.gov (United States)

Brunet-LLobet, Lluís; Miranda-Rius, Jaume; Lahor-Soler, Eduard; Mrina, Ombeni; Nadal, Alfons

2014-01-01

Pyogenic granuloma is defined as a benign neoplasm of vascular phenotype. This case describes the clinical and histopathological features of a gigantic mucogingival pyogenic granuloma, in a 14-year-old healthy black boy. This exophytic gray-purple mass, related to a toothpick injury, had more than twelve-month evolution on the anterior mandible involving lingual area besides to the floor of the mouth pressing the right salivary duct. Conservative excision was performed, followed by uncomplicated healing with no recurrence in two years. The histopathological examination reported a pyogenic granuloma (lobular capillary haemangioma). The authors provide a discussion of the presurgical differential diagnosis of the lesion. This case report presents an extremely uncommon location of a gigantic pyogenic granuloma, involving mucogingival complex and affecting the salivary outflow. This clinical manuscript may shed light on the controversies about possible mechanisms inducing oral pyogenic granuloma.

Femoro-acetabular impingement and hip pain with conventionally normal x-rays.

LENUS (Irish Health Repository)

Baker, J F

2010-06-01

There has in recent years been a fundamental change in the understanding of hip pain in the young adult and hip pain without plain radiographic findings of arthritis. Pain in these groups has long represented a diagnostic and therapeutic challenge. With new appreciation of hip biomechanics, pathological processes and the arrival of modern imaging modalities we now have a greater understanding of non-arthritic hip pathology. One of the commonest yet least well recognized \\'new\\' diagnoses around the hip is femoro-acetabular impingement (FAI). FAI is a developmental condition of the hip joint that is associated with abnormal anatomical configuration and thus joint mechanics on either the femoral or acetabular sides or both. It is hypothesized to have a variety of precipitants and may ultimately lead to labral and chondral injury and what has previously been referred to as \\'primary\\' or \\'idiopathic\\' hip osteoarthritis.

Interleukin-17 limits hypoxia-inducible factor 1α and development of hypoxic granulomas during tuberculosis.

Science.gov (United States)

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

2017-10-05

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.

Localized granuloma annulare and autoimmune thyroiditis in a ...

African Journals Online (AJOL)

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, ...

Concurrent pyogenic granuloma and bullous impetigo of a pregnant woman's finger.

Science.gov (United States)

Qin, Rosie; Cohen, Philip R

2017-03-15

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.

The analysis of imaging diagnosis and misdiagnosis of vertebral eosinophilic granuloma

International Nuclear Information System (INIS)

Liang Weiqiang; Li Sheng

2007-01-01

Objective: To analyze the imaging features of vertebral eosinophilic granuloma and the reasons of misdiagnosis, so as to improve the diagnosis accuracy of the disease. Methods: The clinical materials and images findings of 10 patients with vertebral eosinophilic granuloma proved by surgery and histopathology were analyzed retrospectively. Results: Of all the cases, 3 of them were located in cervical vertebra, 5 in thoracic vertebra and 2 in lumbar vertebra. 8 lesions were single and 2 involved the adjacent 2 vertebrae. 4 lesions showed obvious sinking and flattening of the vertebra body, with widening anteroposterior and transverse diameters, 4 cases showed wedge-shaped appearance, 2 cases showed well-defined oval deossification. The appendix of vertebrae in 3 lesions were destroyed with surrounding mass. The intervertebral spaces were normal in 7 cases, slightly widened in 2 cases and slightly narrowed in 1 case. 6 cases showed paravertebra soft tissue swelling or soft tissue mass formation. Conclusion: Though there are some imaging features of vertebral eosinophilic granuloma, close combination with clinical dates and careful analysis of imaging findings can effectively improved the diagnosis accuracy. (authors)

Giant Cell Reparative Granuloma Mimicking Aneurysmal Bone Cyst in Proximal Phalanx of Toe

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Huan CM

2016-03-01

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.

Bilateral non-traumatic acetabular and femoral neck fractures due to pregnancy-associated osteoporosis.

Science.gov (United States)

Aynaci, Osman; Kerimoglu, Servet; Ozturk, Cagatay; Saracoglu, Metehan

2008-03-01

Pregnancy-associated osteoporosis is a rare disorder and its pathophysiology remains unknown. We report a case of pregnancy-associated osteoporosis in a 27-year-old primiparous patient who revealed bilateral hip pain during early postnatal period. The plain radiographs and computerized tomography showed bilateral femoral neck and acetabular fractures. The diagnosis of osteoporosis was established by bone mineral density. Diagnostic work-up excluded a secondary osteoporosis. The case was treated successfully by bilateral cementless total hip arthroplasty. Bone mineral density increased after 2 years of treatment with calcium-vitamin D, calcitriol and alendronate. Diagnosis of pregnancy-associated osteoporosis should be suspected when hip pain occurs during pregnancy or in the post-partum period as it can lead to acetabular and femoral neck fractures.

Ipsilateral Traumatic Posterior Hip Dislocation, Posterior Wall and Transverse Acetabular Fracture with Trochanteric Fracture in an adult: Report of First Case

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Skand Sinha

2013-10-01

Full Text Available Introduction: Posterior dislocation of the hip joint with associated acetabular and intertrochanteric fracture is a complex injury. Early recognition, prompt and stable reduction is needed of successful outcome. Case Report: 45 year old male patient presented with posterior dislocation of the hip with transverse fracture with posterior wall fracture of acetabulam and intertrochanteric fracture on the ipsilateral side. The complex fracture geometry was confirmed by CT scan. The patient was successfully managed by open reduction and internal fixation of intertrochanteric fracture was achieved with dynamic hip screw (DHS plate fixation followed by fixation of acetabular fracture with reconstruction plate. Conclusion: Hip dislocation combined with acetabular fracture is an uncommon injury; this article presents a unique case of posterior wall and transverse fractures of ipsilateral acetabulum with intertrochanteric fracture in a patient who sustained traumatic posterior hip dislocation. Early surgical intervention is important for satisfactory outcomes of such complex fracture-dislocation injuries. Keywords: Hip dislocation; acetabular fractures; intertrochanteric fracture; operative treatment.

Positive staining for cellulose in oral pulse granuloma

DEFF Research Database (Denmark)

Virkkunen, Sirke; Wolff, Henrik; Haglund, Caj

2017-01-01

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...

Taurine drinking ameliorates hepatic granuloma and fibrosis in mice infected with Schistosoma japonicum.

Science.gov (United States)

Yu, Yan-Rong; Ni, Xian-Qiang; Huang, Jie; Zhu, Yong-Hong; Qi, Yong-Fen

2016-04-01

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.

[Evaluation of the results of surgical treatment of granuloma teleangiectodes].

Science.gov (United States)

Bogdanowski, T; Rubisz-Brzezińska, J; Macura-Gina, M; Misiewicz, D

1990-01-01

In the clinic of dermatological surgery, I Department of Dermatology Silesian Medical Academy in Katowice 328 patients were treated surgically for granuloma teleangiectodes in the years 1973-1988. Two methods were used: excision of the lesion and curettage with electrocoagulation of the base of the lesion. After excision the wound was closed by approximation of its margins or local plastic procedure (285 cases) and by covering it with a free full-thickness skin graft (3 cases). Curettage and electrocoagulation was used in 43 cases, mainly due to the location of the lesion (in 90% on fingers). After granuloma excision no recurrences were observed, while after curettage and electrocoagulation recurrences developed in 20% of cases.

Thorium-dioxide granuloma

International Nuclear Information System (INIS)

Terao, Akira; Kobayashi, Takeo; Ushijima, Tatsujiro; Yoshioka, Hirohide; Kogure, Takashi

1979-01-01

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)

Florid cemento-osseous dysplasia and peripheral giant cell granuloma in a patient with neurofibromatosis 1.

Science.gov (United States)

Sarmento, Dmitry José de Santana; Carvalho, Sérgio Henrique Gonçalves de; Araújo, José Cadmo Wanderley Peregrino de; Carvalho, Marianne de Vasconcelos; Silveira, Éricka Janine Dantas da

2017-01-01

We report a 35-year-old mulatto female patient with neurofibromatosis Type 1 who presented with facial asymmetry. The patient had two lesions: florid cemento-osseous dysplasia associated with peripheral giant cell granuloma. She was referred for surgical treatment of the peripheral giant cell granuloma and the florid cemento-osseous dysplasia was treated conservatively by a multidisciplinary team. So far, no changes have been observed in the patient's clinical status. We observed no recurrence of peripheral giant cell granuloma. To the best of our knowledge, the present case is the first report of a patient with neurofibromatosis Type 1 associated with a giant cell lesion and florid cemento-osseous dysplasia.

The diagnostic accuracy of acetabular labral tears using magnetic resonance imaging and magnetic resonance arthrography: a meta-analysis

Energy Technology Data Exchange (ETDEWEB)

Smith, Toby O. [University of East Anglia, Faculty of Health, Queen' s Building, Norwich (United Kingdom); Hilton, Gemma [Norfolk and Norwich University Hospital, Norwich (United Kingdom); Toms, Andoni P.; Donell, Simon T. [Norfolk and Norwich University Hospital, University of East Anglia, Norwich (United Kingdom); Hing, Caroline B. [St. George' s Hospital, London (United Kingdom)

2011-04-15

Magnetic resonance imaging (MRI) and magnetic resonance arthrography (MRA) have been advocated for the diagnosis of acetabular labral tears. The purpose of this study was to determine the sensitivity and specificity of MRI and MRA in diagnosing acetabular labral tears using meta-analysis. Pertinent published and unpublished literature databases were reviewed. A two-by-two table was constructed to calculate the sensitivity and specificity of MRI or MRA investigations against surgical outcomes. Pooled sensitivity and specificity and Receiver Operating Characteristic curve (ROC) evaluations were performed. Methodological quality of each study was assessed using the QUADAS (Quality Assessment of Diagnostic Accuracy Studies) tool. Nineteen papers assessing 881 hips were reviewed. Conventional MRI was assessed in 13 studies and MRA was assessed in 16 studies. Whilst both MRI (0.5-3T) and MRA (0.5-3T) presented with a moderate sensitivity and specificity (sensitivity 66%, 87%; specificity 79%, 64%), diagnostic accuracy of MRA appeared to be superior to MRI in detecting acetabular labral tears on ROC curve interpretation. The literature poorly described population characteristics, assessor blinding, with limited sample sizes. MRI and MRA may be useful adjuncts in the diagnosis of acetabular labral tears in adults. MRA appears to be superior to conventional MRI. (orig.)

Cholestrol granuloma of the breast incidentally detected on dynamic abdominal CT: A case report

Energy Technology Data Exchange (ETDEWEB)

Jeong, Sun Hye; Lee, Eun Hye; Hong, Hyun Sook; Kwak, Jeong Ja [Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon (Korea, Republic of)

2016-01-15

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.

CENTRAL GIANT CELL GRANULOMA OF THE MANDIBLE: A RARE PRESENTATION

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Virendra SINGH

2012-06-01

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.

[Venereal granuloma (donovaniasis) in France].

Science.gov (United States)

Duperrat, B; Labouche, F

1975-01-01

The study of six cases of MacLeod-Donovan chancre, 2 in Paris, 4 in Brest, in young men coming from the West Indies, showed after 15 days incubation, a balano-preputial lesion consisting of an oval-shaped granuloma, 1 to 4 cm diameter, raised, indurated, ulcerated, reddish-yellow, spontaneously painful, bleeding easily, accompanied in 50 p. 100 of cases by inguinal adenitis, due to secondary infection. Swabs, which should be repeated, showed Donovan bodies within numerous histiocytes. The inactivity of penicillin may be contrasted with the rapidly favourable effect of streptomycin, chloramphenicol or aureomycin.

Osseous eosinophilic granuloma in children

International Nuclear Information System (INIS)

Leblan, I.; Gaucher, H.; Marinard, L.; Galloy, M.A.; Phi, I.N.; Hoeffel, J.C.

2001-01-01

Eosinophilic granuloma of bone or Langerhans cell histiocytosis is mostly uni-focal. It appears on plain X Ray as a solitary destructive lesion of long bones or flat bones. CT is useful to define the extension to the cortical bone and also to precisely localize the lesion when the anatomy is complex (hip, spine, base of the skull). MR is very useful in case of more aggressive lesions when there is extension to soft tissues. Differential diagnosis includes circumscribed osteitis and tumors prognosis is more serious in case of multiple lesions. (authors)

Preservation of the Acetabular Cup During Revision Total Hip Arthroplasty Using a Novel Mini-navigation Tool: A Case Report.

Science.gov (United States)

Vincent, John; Alshaygy, Ibrahim; Muir, Jeffrey M; Kuzyk, Paul

2018-01-01

While intraoperative navigation systems have been shown to improve outcomes in primary total hip arthroplasty (THA), their use in the context of revision has been largely overlooked. This case report presents the first documented use of an imageless navigation tool in the context of revision THA, and an unexpected benefit to the surgical procedure as a result. An 84-year-old female patient presented following five episodes of dislocation of the left hip and with pain in the left buttock, groin, and posterior aspect of her hip. Relevant surgical history included primary hip arthroplasty in 1999 and the first revision in 2014. Preoperative analysis revealed a constrained liner that had become disengaged and migrated inferiorly, lodging at the distal aspect of the femoral neck. Acetabular protrusion was also noted. The pre-operative plan included the replacement of the fragmented liner and likely of the acetabular cup due to hardware failure. Intraoperative assessment, however, revealed that the cup was in good condition and would be difficult to remove due to substantial bony ingrowth. With the assistance of imageless navigation, the orientation of the acetabular cup was determined and a new constrained liner was cemented into the preexisting acetabular component at an altered orientation, correcting anteversion by 7°. In revision hip arthroplasty cases, image-based navigation is limited by the presence of existing implants and corresponding metal artefact. This case demonstrates the successful use of an imageless navigation tool for revision surgery. Use of navigation led to the unexpected intraoperative discovery that the acetabular cup was in an acceptable state, and allowed the surgical team to correct the position of the cup using a constrained liner, thus preserving the cup. This significantly benefitted patient outcome, due to the risks associated with the removal of a firmly fixated acetabular cup. While more extensive research is required, this case

Efficient radiologic diagnosis of pelvic and acetabular trauma

International Nuclear Information System (INIS)

Kreitner, K.F.; Mildenberger, P.; Thelen, M.; Rommens, P.M.

2000-01-01

In spite of the widespread availability of CT scanners, conventional X-ray radiographs remain the basic imaging modality in patients with pelvic and/or acetabular trauma. However, the extent of their use will depend on local utilities (e.g., availability of CT scanners) and on the patient's clinical condition. Regarding the inaccuracy of conventional radiography in the diagnosis of injuries of the dorsal pelvic ring and of the acetabulum, computed tomography represents the most important imaging modality in the clinically stable patient. CT provides an exact staging of the extent of trauma and allows for differentiation of pelvic instabilities. CT clearly demonstrates the severity of acetabular trauma and is superior in the detection of local complicating factors, i.e., impressions fractures and (sub-)luxations of the femoral head as well as free intraarticular fragments. CT findings provide the basis for definite treatment regimens of the injured patient. By extension of the examination, all relevant organs and systems (craniospinal, cardiovascular, gastrointestinal, respiratory, genitourinary) can be imaged during one session. The speed of spiral CT scanners and their diagnostic accuracy will play a major role in the management of, especially, polytraumatized patients. The indication for angiography with the option of therapeutic embolization exists if a pelvic bleeding persists even after reposition and operative fixation of the injury. (orig.) [de

Reduced survival for uncemented compared to cemented total hip arthroplasty after operatively treated acetabular fractures.

Science.gov (United States)

Clarke-Jenssen, John; Westberg, Marianne; Røise, Olav; Storeggen, Stein Arne Øvre; Bere, Tone; Silberg, Ingunn; Madsen, Jan Erik

2017-11-01

Post traumatic arthritis and avascular necrosis of the femoral head are common complications after operatively treated acetabular fractures. This may cause severe disabilities for the patient, necessitating a total hip arthroplasty. Even though an arthroplasty may provide good symptomatic relief, the long-term results are more uncertain and no consensus exists according to preferred prosthetic designs. With this cohort study, we aimed to investigate the medium to long term arthroplasty survival and clinical results of total hip arthroplasty after operatively treated acetabular fractures. We included 52 patients treated with a secondary total hip arthroplasty at a median of 2.4 (0.1-14.1) years after an operatively treated acetabular fracture. The median age was 54 (11-82) years. Cemented arthroplasty was used for 33 patients, 10 patients had an uncemented arthroplasty and 9 patients received a hybrid arthroplasty. Average follow up was 8.0 (SD 5.0) years. Ten-year revision free arthroplasty survival was 79%. Uncemented arthroplasties had a significantly worse 10-year survival of 57%. Arthroplasties performed at a centre without a pelvic fracture service also had a significantly worse 10-years survival of 51%. Cox regression showed similar results with an 8-fold increase in risk of revision for both uncemented arthroplasties and operations performed at a non-pelvic trauma centre. Total hip arthroplasty secondary to an operatively treated acetabular fracture provides good symptomatic relief. These patients are, however, complex cases and are probably best treated at specialist centres with both pelvic trauma surgeons and arthroplasty surgeons proficient in complex revisions present. Copyright © 2017 Elsevier Ltd. All rights reserved.

Absence or interruption of the supra-acetabular line: a subtle plain film indicator of hip pathology

International Nuclear Information System (INIS)

Major, N.M.; Helms, C.A.

1996-01-01

Objective. To show that absence or interruption of the supraacetabular line is a subtle plain film indicator of pathology in the acetabulum. Design. Nineteen hips from 17 patients with known disease processes involving the acetabulum as demonstrated by subsequent magnetic resonance imaging, bone scan or plain film follow-up were evaluated with antero-posterior (AP) plain films of the pelvis. Three additional cases were diagnosed prospectively using interruption of the supra-acetabular line as the criterion for inclusion. Fifty AP plain films of the pelvis in patients without hip pain were examined prospectively to determine normal imaging criteria. Results and conclusions. The normal supra-acetabular line measures 2-3 mm in thickness superiorly and is a thin sclerotic line in the medial aspect. In all 22 hips (with pathology) in this series, the line was interrupted or absent. Loss or interruption of the supra-acetabular line may thus be a subtle pain film indicator of a disease process involving the acetabulum. This plain film sign has not previously been reported. (orig.). With 8 figs., 1 tab

Rapid Hip Osteoarthritis Development in a Patient with Anterior Acetabular Cyst with Sagittal Alignment Change

Directory of Open Access Journals (Sweden)

Yasuhiro Homma

2014-01-01

Full Text Available Rapidly destructive coxarthrosis (RDC is rare and develops unusual clinical course. Recent studies suggest multiple possible mechanisms of the development of RDC. However the exact mechanism of RDC is still not clear. The difficulty of the study on RDC is attributed to its rareness and the fact that the data before the onset of RDC is normally unavailable. In this report, we presented the patient having the radiographic data before the onset who had rapid osteoarthritis (OA development after contralateral THA, which meets the current criteria of RDC. We thought that the increased posterior tilt of the pelvis after THA reinforced the stress concentration at pre-existed anterior acetabular cyst, thereby the destruction of the cyst was occurred. As a result the rapid OA was developed. We think that there is the case of rapid osteoarthritis developing due to alternating load concentration by posterior pelvic tilt on preexisting anterior acetabular cyst such as our patient among the cases diagnosed as RDC without any identifiable etiology. The recognition of sagittal alignment changes and anterior acetabular cyst may play important role in prediction and prevention of the rapid hip osteoarthritis development similar to RDC.

Insights into the pathogenesis and clinicopathological spectrum of oral vegetable granuloma. Case series with literature review

Directory of Open Access Journals (Sweden)

Shankargouda Patil

2017-10-01

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.

Giant cell granuloma of the maxilla - a case report and review of the literature

International Nuclear Information System (INIS)

Setubal, Roger; Menezes, Benedito; Carvalho, Marcos Brasilino de; Soares, Aldemir Humberto; Souza, Ricardo Pires de

1997-01-01

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)

Hacking into the granuloma: could antibody antibiotic conjugates be developed for TB?

Science.gov (United States)

Ekins, Sean

2014-12-01

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.

Histological assessment of granulomas in natural and experimental Schistosoma mansoni infections using whole slide imaging.

Directory of Open Access Journals (Sweden)

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

Acetabular osteotomy for double boarding in lateral decubitus. Anatomical bases and surgical technique

International Nuclear Information System (INIS)

Lazennec, J Y; Del Vecchio, R; Saillant, G

2001-01-01

The periacetabular osteotomies of reorientation of the eotilo have a reputation of being difficult from the technical point of view. The authors present a technique of juxta acetabular osteotomy that respects the posterior column of the acetabulo the same as the GANZ technique. The osteotomy is of simpler realization thanks to an installation that allows carrying out two simultaneous boarding. The osteotomy lines, their rectilinear and controllable in permanency through of images intensificator and they don't constitute any risk for the essential vascular contribution of the obturatriz artery and their branches. Their other interest comes represented by the possibility of correcting easily the parasitic retroversion associated to the descent of the whole eotilo, that it allows to avoid the bad positions that they affect the center of the articulation and the widths acetabular

Florid cemento-osseous dysplasia and peripheral giant cell granuloma in a patient with neurofibromatosis 1*

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Sarmento, Dmitry José de Santana; de Carvalho, Sérgio Henrique Gonçalves; de Araújo Filho, José Cadmo Wanderley Peregrino; Carvalho, Marianne de Vasconcelos; da Silveira, Éricka Janine Dantas

2017-01-01

We report a 35-year-old mulatto female patient with neurofibromatosis Type 1 who presented with facial asymmetry. The patient had two lesions: florid cemento-osseous dysplasia associated with peripheral giant cell granuloma. She was referred for surgical treatment of the peripheral giant cell granuloma and the florid cemento-osseous dysplasia was treated conservatively by a multidisciplinary team. So far, no changes have been observed in the patient's clinical status. We observed no recurrence of peripheral giant cell granuloma. To the best of our knowledge, the present case is the first report of a patient with neurofibromatosis Type 1 associated with a giant cell lesion and florid cemento-osseous dysplasia. PMID:28538890

Sarcoid-like lung granulomas in a hemodialysis patient treated with a dipeptidyl peptidase-4 inhibitor.

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Sada, Ken-Ei; Wada, Jun; Morinaga, Hiroshi; Tuchimochi, Shigeyuki; Uka, Mayu; Makino, Hirofumi

2014-04-01

It has been reported that the inhibition of dipeptidyl peptidase-4 (DPP-4)/CD26 on T-cells by DPP-4 enzymatic inhibitors suppresses lymphocyte proliferation and reduces the production of various cytokines, including tumor necrosis factor (TNF)-α. A 72-year-old female with diabetic nephropathy on hemodialysis developed multiple lung nodules following the administration of vildagliptin. A biopsy demonstrated the histology of granulomas without caseous necrosis. The discontinuation of vildagliptin resulted in the disappearance of the granulomas within 4 months. As granulomatosis often develops in patients under anti-TNF-α therapy, the accumulation of DPP-4 inhibitors or its metabolites is possibly linked to unrecognized complications, such as sarcoid-like lung granulomas.

Aluminium allergy and granulomas induced by vaccinations for children

DEFF Research Database (Denmark)

Andersen, Rosa Marie O; Zachariae, Claus; Johansen, Jeanne Duus

2014-01-01

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...

Should total hip arthroplasty be performed acutely in the treatment of acetabular fractures in elderly or used as a salvage procedure only?

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Katharine Hamlin

2017-01-01

Full Text Available Background: Total hip arthroplasty (THA is now an increasingly common procedure for people sustaining acetabular fractures. The incidence of acetabular fractures among the elderly population is increasing, and contemporary treatment aims to avoid the risks of prolonged incumbency associated with poor bone stock for fixation or inability to comply with limited weightbearing in this patient group. The concept of acute hip arthroplasty as a treatment for acetabular fracture is, therefore, becoming more topical and relevant. Our systematic review investigates whether THAs for acetabular fractures should be performed acutely, with a short delay, or as a late procedure for posttraumatic osteoarthritis (PTOA if it develops. Materials and Methods: Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed when undertaking this systematic review. Detailed searches were performed on three different databases, using keywords, such as “acetabular fracture,” “acetabular trauma,” “total hip arthroplasty,” “hip arthroplasty,” and “hip prosthesis.” Studies from 1975 to September 2016 were included in the study. All studies included in the review were independently critically appraised by two of the authors. Results: Forty three studies were included in this review. Only two of them actually compared acute and delayed THAs for acetabular fractures with the rest focusing on one or the other. Results were comparable between acute and late THAs in terms of aseptic loosening, operative time, blood loss, Harris Hip Score, and ability to mobilize postoperatively without aid. Complication rates, however, were much higher in the acute group. Conclusion: Evidence based on this topic is scarce and therefore we have to be cautious about drawing a definitive conclusion. The findings of this systematic review do suggest, however, that acute THAs should be considered in elderly patients, where fixation is not possible, or

Primary stability of a cementless acetabular cup in a cohort of patient-specific finite element models.

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O'Rourke, Dermot; Al-Dirini, Rami Ma; Taylor, Mark

2018-03-01

The primary stability achieved during total hip arthroplasty determines the long-term success of cementless acetabular cups. Pre-clinical finite element testing of cups typically use a model of a single patient and assume the results can be extrapolated to the general population. This study explored the variability in predicted primary stability of a Pinnacle ® cementless acetabular cup in 103 patient-specific finite element models of the hemipelvis and examined the association between patient-related factors and the observed variability. Cups were inserted by displacement-control into the FE models and then a loading configuration simulating a complete level gait cycle was applied. The cohort showed a range of polar gap of 284-1112 μm and 95th percentile composite peak micromotion (CPM) of 18-624 μm. Regression analysis was not conclusive on the relationship between patient-related factors and primary stability. No relationship was found between polar gap and micromotion. However, when the patient-related factors were categorised into quartile groups, trends suggested higher polar gaps occurred in subjects with small and shallow acetabular geometries and cup motion during gait was affected most by low elastic modulus and high bodyweight. The variation in primary stability in the cohort for an acetabular cup with a proven clinical track record may provide benchmark data when evaluating new cup designs. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1012-1023, 2018. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Revisión acetabular con conservación del componente metálico osteointegrado y cementado de un componente de poliestireno. Reporte de una serie de 40 casos. [Acetabular revision cementing a liner into a stable acetabular shell

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Fernando Manuel Bidolegui

2013-12-01

Full Text Available In­tro­duc­ción: Un escenario cada vez más frecuente en la cirugía de revisión protésica de la cadera es hallar un cotilo no cementado fijo con una falla del componente modular de polietileno. Una completa revisión acetabular se presenta como demasiado agresiva cuando el componente metálico es salvable. Cementar un nuevo inserto de polietileno dentro del componente acetabular metálico os-teointegrado es una alternativa. Comunicamos los resultados con esta técnica, y sus indicaciones, el modo de realización y las posibles limitaciones. Materiales­y­Métodos: Entre 2001 y 2011, se cementaron 40 componentes de polietileno dentro de copas no cementadas. Se evaluó radiológicamente y clínicamente a todos los pacientes. El motivo por el que se cementó un inserto fue falla o rotura de mecanismo de captura (11 casos; 27,5%, ganar estabilidad (18 casos; 45% y falta de disponibilidad del inserto correspondiente (11 casos, 27,5%. Resultados:­ La tasa de duración del implante sin reoperación a 46 meses de seguimiento fue del 92%. Un paciente (2,4% sufrió una infección, y dos presentaron inestabilidad (4,8%. No se presentaron aflojamientos hasta el último seguimiento. El puntaje preoperatorio y posoperatorio en la escala de Harris fue de 59 y 80, respectivamente. Conclusiones: Los datos técnicos por considerar para tener éxito son: utilizar un inserto de menor tamaño que el de la copa, cementar insertos texturizados y dejar siempre como mínimo un manto de cemento uniforme de 2 mm. Nuestros resultados preliminares cementando un inserto de polietileno dentro de una copa acetabular osteointegrada parecerían justificar esta técnica de revisión en pos de prevenir la pérdida de capital óseo asociada a la necesidad de recambio de copas osteointegradas.

Strict Anatomical Colocalization of Vitiligo and Elastolytic Granulomas

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N. Merino de Paz

2010-02-01

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.

Copas de metal trabecular y aloinjertos óseos impactados en defectos acetabulares graves. Resultados a los 2-4 años. [Impacted bone allografts and trabecular metal cups in severe acetabular bone defects: 2 to 4-year results.

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Martín Buttaro

2014-06-01

Full Text Available In­tro­duc­ción: El objetivo principal es presentar la supervivencia del componente acetabular en pacientes con defectos graves reconstruidos con copas de metal trabecular combinadas con aloinjertos óseos impactados. Como objetivo secundario, se compararon estos resultados con los previamente obtenidos por los autores en defectos de similar gravedad utilizando anillos de reconstrucción y aloinjertos óseos. Materiales­ y­ Métodos:­ Se realizaron 20 cirugías de revisión en 19 pacientes (edad promedio 65 años, controlados, de forma prospectiva, con defectos acetabulares graves tipos 3A o 3B de Paprosky, por falla mecánica o infecciosa. El puntaje funcional promedio preoperatorio fue de 6,2 puntos, según la escala de Merle D ́Aubigne. Siempre se utilizaron copas de metal trabecular y aloinjertos óseos impactados. Resultados:­ A los 30 meses de seguimiento promedio (rango 24-48 meses, la supervivencia del componente acetabular fue del 95% (IC = 75%-98%. Un paciente presentó un aflojamiento acetabular por infección profunda a las 16 semanas de la revisión y fue tratado con una artroplastia de resección. El puntaje funcional promedio, excluido el caso con aflojamiento posoperatorio, fue de 16,2 puntos. Se observó la incorporación de los aloinjertos óseos en todos los pacientes, salvo el caso con infección profunda. La comparación con nuestras series históricas reconstruidas con anillos de Kerboull o con anillos GAP arrojó resultados altamente favorables a favor de las copas de metal trabecular.  Conclusiones: Las copas de metal trabecular asociadas a aloinjertos óseos impactados ofrecen una alternativa válida en cirugía de revisión acetabular con defectos graves del capital óseo. Este método se asocia a resultados más favorables que los obtenidos antes con anillos de reconstrucción.

Human bone ingrowth into a porous tantalum acetabular cup

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Gregory N. Haidemenopoulos

2017-11-01

Full Text Available Porous Tantalum is increasingly used as a structural scaffold in orthopaedic applications. Information on the mechanisms of human bone ingrowth into trabecular metal implants is rather limited. In this work we have studied, qualitatively, human bone ingrowth into a retrieved porous tantalum monoblock acetabular cup using optical microscopy, scanning electron microscopy and energy dispersive X-ray analysis. According to the results and taking into account the short operational life (4 years of the implant, bone ingrowth on the acetabular cup took place in the first two-rows of porous tantalum cells to an estimated depth of 1.5 to 2 mm. The bone material, grown inside the first raw of cells, had almost identical composition with the attached bone on the cup surface, as verified by the same Ca:P ratio. Bone ingrowth has been a gradual process starting with Ca deposition on the tantalum struts, followed by bone formation into the tantalum cells, with gradual densification of the bone tissue into hydroxyapatite. A critical step in this process has been the attachment of bone material to the tantalum struts following the topology of the porous tantalum scaffold. These results provide insight to the human bone ingrowth process into porous tantalum implants.

The crescent sign: dissociation of the polyethylene liner from a modular acetabular component in total hip arthroplasty

International Nuclear Information System (INIS)

White, S.P.; Blom, A.W.; Lee, M.; Smith, E.J.

2005-01-01

To study whether there was a common pattern of clinical symptoms, signs and radiographic features for the dissociation of the polyethylene liner from an acetabular component and to postulate reasons for these features. Retrospective study of notes and radiographs of cases of revision hip arthroplasty for polyethylene liner dissociation of the cementless Harris-Galante I porous-coated acetabular component (Zimmer Inc, Warsaw, IN) at the Avon Orthopaedic Centre, Bristol, UK and St. Mary's Hospital, Bristol, UK between 1995 and 2004. Patients were contacted to confirm preoperative symptoms. Nine cases of late polyethylene liner dissociation of this prosthesis have been revised in these institutions. All patients presented with a reduction in mobility, groin pain and limp. Eight patients reported an audible noise on hip movement. In all cases, radiographs showed radiolucency medial to the femoral neck in association with an eccentrically placed femoral head showing contact with the acetabular metal shell, which we have termed the ''crescent sign.'' There is a typical clinical presentation in this study. The diagnosis can be made from a single anteroposterior pelvic radiograph without the need for previous films for comparison, or the need for arthrography. Clinicians should look specifically for the crescent sign when an eccentrically placed femoral head has been noted, in order to differentiate the more unusual diagnosis of dissociation from that of polyethylene wear. Early revision surgery can prevent damage to the femoral head and metal acetabular shell, thus reducing the complexity of revision surgery. (orig.)

Difficult acetabular revision. A preliminary report.

Science.gov (United States)

Newport, M L; Stuchin, S A; Frankel, V H; Zuckerman, J

1986-01-01

Thirteen patients (14 hips) underwent revision from conventional cemented total hip arthroplasty to uncemented acetabular threaded screw-in components and cementless femoral press-fit stems by means of the Autophor, Biofit, and Ti-Thread designs. The patients suffered from all forms of primary hip disease except rheumatoid arthritis; their average age was 34 years. The average preoperative Harris hip score was 39.4; the average postoperative score was 71.2 at six months, 90.6 at one year, and 91.6 at two years. Complications included two femoral shaft fractures, one femoral nerve palsy, and one dislocation. No signs have been observed of loosening or migration as of an early (6-24 months) follow-up.

Lethal midline granuloma syndrome: a diagnostic dilemma

International Nuclear Information System (INIS)

Ribeiro, Bruno Niemeyer de Freitas; Bahia, Paulo Roberto Valle; Oliveira, Ana Luiza Vianna Sobral de Magalhaes; Marchon Junior, Joao Luiz

2012-01-01

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)

Lethal midline granuloma syndrome: a diagnostic dilemma

Energy Technology Data Exchange (ETDEWEB)

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)

2012-11-15

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)

Systemic Lupus Erythematosus with Hepatosplenic Granuloma: A Rare Case

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Anju Bharti

2014-01-01

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.

Morphological experimental study of bone stress at the interface acetabular bone/prosthetic cup in the bipolar hip prosthesis.

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Anuşca, D; Pleşea, I E; Iliescu, N; Tomescu, P; Poenaru, F; Dascălu, V; Pop, O T

2006-01-01

By calculating the tension and distortion of the elements composing the bipolar prosthesis under extreme conditions encountered in real life using a special post-processing program, we established the variation curves of the contact pressure at the hip bone-cup, armor-cup and cup-femoral head interface. By comparing the data obtained from all the examined cases, important conclusions were drawn regarding the influence of tension and pressure distribution on the structural integrity and biomechanics of the prosthesis, as well as the acetabular wear and tear, in order to assess its reliability. The experimentally determined tension and distortion status at the acetabular bone-metal armour interface, lead to the wear and tear phenomenon, which can be explained by three mechanisms and theories incompletely reflecting the overall process. The histopathologic study of the acetabular bone tissue using FEM (finite elements method) on surgically removed specimens will probably lead to the identification of a series of factors that could reduce the rate of the wear and tear process.

[The expression and significance of receptor activator of nuclear factor kappaB ligand and osteoprotegerin in periapical cyst and periapical granuloma].

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Zhang, Meihua; Yu, Yunzhi; Miao, Yu

2012-08-01

To investigate the expression of receptor activator of nuclear factor kappaB ligand (RANKL) and osteoprotegerin (OPG) in periapical cyst and periapical granuloma by comparison with the expression in the normal periodontal tissue as control, and to identify their functional mechanism in the bone destruction of periapical cyst and granuloma. 20 periapical cyst tissues (cyst group), 20 periapical granuloma tissues (granuloma group), and 20 normal periodontal tissues (control group) were collected respectively. Immunohistochemical technology was performed to detect the expression of RANKL and OPG in above three groups. In cyst group, granuloma group and control group, the expression of RANKL were 75.00 +/- 7.54, 68.40 +/- 6.74 and 29.40 +/- 2.46, respectively. The expression of OPG were 38.10 +/- 7.09, 47.65 +/- 13.85 and 58.60 +/- 5.88, respectively. The differences among the three groups were statistically significant (Pcysts group were negatively correlated (r=-0.56, P=0.01) and were not correlated with granuloma and control group (P>0.05). RANKL and OPG play roles in the bone absorption of periapical disease. In periapical disease, abnormal expression of RANKL and OPG are detected, RANKL significantly increase, OPG decrease, bone absorption accelerate and osteolytic lesion are observed. In periapical cyst, the bone absorption is more active compared with periapical granuloma.

Acetabular QCT in Total Hip Arthroplasty - a reliability study using porcine hips

DEFF Research Database (Denmark)

Mussmann, Bo Redder; Overgaard, Soren; Torfing, Trine

and reliability of bone mineral density measurements (BMD) in close proximity of the acetabular cup using SECT and DECT images and 3D segmentation software. Materials and methods 22 acetabular cups (12 cemented, 10 un-cemented) were inserted in porcine hip specimens ex vivo. A femoral stem was attached to each...... difference between the double measurements in SECT was 8 mg/cm3 (p=0.64) and 2 mg/cm3 in DECT (p=0.6). In the cemented concept the differences were 33 mg/cm3 (p=0.054) and 11 mg/cm3 (p=0.014), respectively. ICC was >0.90 regardless of scan mode and cup type. In both cup types the Bland-Altman limits...... of agreement were wider in SECT (uncemented: -95 to 111; cemented: -86 to 153) compared with DECT (uncemented: -28 to 23; cemented: -21 to 44). Conclusion There were no statistically significant reliability differences between SECT and DECT, but results suggest that the agreement of DECT is better than...

Wear analysis by applying a pin-disc configuration to phemoral head and acetabular cup

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Guillermo Urriolagoitia-Calderón

2008-01-01

Full Text Available This work determines a prosthetic hip system’s life-span, focusing on a Mexican phenotype. The total sliding equivalent distance for the system was determined, as well as the loading regime under which the femoral component and the acetabular cup were subjected in normal operating conditions. An experimental tribology essay was then performed to simulate the wearing of the components in a Pin over Disc machine. This assay (for which the test specimens were manufactured in medical grade stainless steel AISI-ASTM 316L for the femoral component and high density polyethylene for the acetabular cup was aimed at simulating wear conditions involved in 10 years of continuous operation. A numerical simulation of operational conditions (using the finite element method was performedIn for establishing assay loading conditions to accurately determine where the loads should be applied. The tribology assay led to quantifying the volumetric loss of materials for the system being analysed. It can be concluded that the methodology proposed in this work for estimating the life-span of a prosthetic hip system was valid and accurate by comparing the results with those found in the literature. A statistical validation of the proposed method is plaaned for the future. Key words: Design life; femoral component; acetabular cup; Mexican phenotype; pin-disc configuration.

Sperm cell granuloma in a gobbler ( Meleagris Gallopavo ) | Ajayi ...

African Journals Online (AJOL)

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 ...

T2* Mapping Provides Information That Is Statistically Comparable to an Arthroscopic Evaluation of Acetabular Cartilage.

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Morgan, Patrick; Nissi, Mikko J; Hughes, John; Mortazavi, Shabnam; Ellerman, Jutta

2017-07-01

Objectives The purpose of this study was to validate T2* mapping as an objective, noninvasive method for the prediction of acetabular cartilage damage. Methods This is the second step in the validation of T2*. In a previous study, we established a quantitative predictive model for identifying and grading acetabular cartilage damage. In this study, the model was applied to a second cohort of 27 consecutive hips to validate the model. A clinical 3.0-T imaging protocol with T2* mapping was used. Acetabular regions of interest (ROI) were identified on magnetic resonance and graded using the previously established model. Each ROI was then graded in a blinded fashion by arthroscopy. Accurate surgical location of ROIs was facilitated with a 2-dimensional map projection of the acetabulum. A total of 459 ROIs were studied. Results When T2* mapping and arthroscopic assessment were compared, 82% of ROIs were within 1 Beck group (of a total 6 possible) and 32% of ROIs were classified identically. Disease prediction based on receiver operating characteristic curve analysis demonstrated a sensitivity of 0.713 and a specificity of 0.804. Model stability evaluation required no significant changes to the predictive model produced in the initial study. Conclusions These results validate that T2* mapping provides statistically comparable information regarding acetabular cartilage when compared to arthroscopy. In contrast to arthroscopy, T2* mapping is quantitative, noninvasive, and can be used in follow-up. Unlike research quantitative magnetic resonance protocols, T2* takes little time and does not require a contrast agent. This may facilitate its use in the clinical sphere.

High complication rate in reconstruction of Paprosky type IIIa acetabular defects using an oblong implant with modular side plates and a hook.

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Babis, G C; Sakellariou, V I; Chatziantoniou, A N; Soucacos, P N; Megas, P

2011-12-01

We report the results of 62 hips in 62 patients (17 males, 45 females) with mean age of 62.4 years (37 to 81), who underwent revision of the acetabular component of a total hip replacement due to aseptic loosening between May 2003 and November 2007. All hips had a Paprosky type IIIa acetabular defect. Acetabular revision was undertaken using a Procotyl E cementless oblong implant with modular side plates and a hook combined with impaction allografting. At a mean follow-up of 60.5 months (36 to 94) with no patients lost to follow-up and one died due to unrelated illness, the complication rate was 38.7%. Complications included aseptic loosening (19 hips), deep infection (3 hips), broken hook and side plate (one hip) and a femoral nerve palsy (one hip). Further revision of the acetabular component was required in 18 hips (29.0%) and a further four hips (6.4%) are currently loose and awaiting revision. We observed unacceptably high rates of complication and failure in our group of patients and cannot recommend this implant or technique.

In-Office Excision En Masse of a Vocal Process Granuloma Using the Potassium-Titanyl-Phosphate Laser.

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Mascarella, Marco A; Young, Jonathan

2016-01-01

In-office laryngeal surgery is taking on a more commonplace role in the treatment of laryngeal disorders. The potassium-titanyl-phosphate (KTP) laser has been a resourceful adjunct to the management of patients with mucosal lesions of the vocal cords. However, a paucity of data exists for its use in postintubation granulomas treated in-office. A 43-year-old female presented with voice hoarseness and found to have a large obstructing postintubation granuloma which was treated by in-office KTP laser and en masse excision. We report the successful case of a patient receiving in-office treatment for a large vocal process granuloma using the KTP laser with en masse excision. The combined use of the KTP laser and forceps in-office can be valuable to the surgical management of vocal process granulomas, given their numerous recurrences. New avenues in office-based surgical management of laryngeal disorders can offer accessibility and decreased morbidity to patients. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Development of spermatic granuloma in albino rats following administration of water extract of Heliotropium bacciferum Forssk.

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Alanazi, Khalid; Alahmadi, Bassam A; Alhimaidi, Ahmed; Abou-Tarboush, Faisal M; Farah, Mohammad Abul; Mahmoud, Ahmed; Alfaifi, Mohamed

2016-01-01

A spermatic granuloma is a chronic inflammatory reaction produced in response to extravasated sperm within the intertubular connective tissue. The present study investigates the possible toxic effects of water extract of Heliotropium bacciferum on the reproductive system of male albino rats and the associated potential for the development of spermatic granulomas. H. bacciferum is a herbal plant used in traditional medicine and reported to have cytotoxic effects due to pyrrolizidine alkaloids. Histological examinations revealed no changes in the tissues of the testes, although, some changes were detected in the cauda epididymis, the most important of which was the development of small lesions of spermatic granulomas. Clear gaps were observed between the epithelial linings of the epididymal tubules.

Use of iPhone technology in improving acetabular component position in total hip arthroplasty

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Xiau Wei Tay, MBBS

2017-09-01

Full Text Available Improper acetabular cup positioning is associated with high risk of complications after total hip arthroplasty. The aim of our study is to objectively compare 3 methods, namely (1 free hand, (2 alignment jig (Sputnik, and (3 iPhone application to identify an easy, reproducible, and accurate method in improving acetabular cup placement. We designed a simple setup and carried out a simple experiment (see Method section. Using statistical analysis, the difference in inclination angles using iPhone application compared with the freehand method was found to be statistically significant (F[2,51] = 4.17, P = .02 in the “untrained group”. There is no statistical significance detected for the other groups. This suggests a potential role for iPhone applications in junior surgeons in overcoming the steep learning curve.

Lumbosacral plexopathies associated with acetabular fracture

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Patpiya Sirasaporn

2017-01-01

Full Text Available Lumbosacral plexopathies are of considerably less epidemiologic common prevalence than brachial plexus. The most common form of trauma resulting in lesions affecting the lumbosacral plexus is injuries to sacroiliac region. The symptoms which are caused by compressing lumbosacral plexus are sensory disturbance and weakness in an affected leg. The author reports a case of a 65-year-old male with a history of right acetabular fracture status post open reduction and internal fixation by plate and screw who complained weakness and numbness in the right leg. Four months later, he still had difficulty in walking and felt paresthesia at the right lateral thigh and entire of the right foot. His further investigation which was electrodiagnostic study was diagnosed as right lumbosacral plexopathies.

Diabetes insipidus secondary to sarcoidosis presenting with caseating granuloma

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Alam, Taimour; Thomas, Steven

2011-01-01

Diabetes insipidus is a rare complication of sarcoid infiltration of the hypothalamic-pituitary region. Non-caseating granuloma formation is typical of sarcoidosis. Anterior and posterior pituitary function may be affected. MRI coupled with endocrinology assessment is the usual method of investigation. A 25-year-old Caucasian male with no significant medical history presented with polyuria and polydipsia. Water deprivation test confirmed diabetes insipidus. CT scanning of the chest confirmed lymphadenopathy. Lymph node biopsy revealed caseating granuloma. Extensive investigation for tuberculosis was negative. The patient was started on intranasal desmopressin and steroids with marked improvement in symptoms. This is the first reported case of neurosarcoidosis with diabetes insipidus and caseation on histology that we are aware of. Differentiating between caseation due to sarcoidosis and tuberculosis on histology is possible by the use of special stains. Return of normal endocrine function is unusual and the patient is likely to require desmopressin therapy for life. PMID:22707619

Examination and treatment of a professional ballet dancer with a suspected acetabular labral tear: A case report.

Science.gov (United States)

Khoo-Summers, Lynnette; Bloom, Nancy J

2015-08-01

Dancers are at risk for developing groin pain that is due to acetabular labral tears. Although surgical management of labral tears has been reported extensively, conservative management has been poorly described. This case report describes the examination, diagnosis, and treatment of groin pain in a professional ballet dancer with a suspected acetabular labral tear. Treatment focused on decreasing anterior hip joint stresses and improving the precision of hip motion through correction of alignment and movement impairments noted during functional activities and dance. Successful outcomes included a reduction in pain and return to professional ballet dancing. Copyright © 2015 Elsevier Ltd. All rights reserved.

Acetabular labral tears with underlying chondromalacia: a possible association with high-level running.

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Guanche, Carlos A; Sikka, Robby S

2005-05-01

The use of hip arthroscopy has helped delineate intra-articular pathology and has enabled clinicians to further elucidate the factors responsible for injuries, such as running. The subtle development of degenerative changes may be a result of repetitive impact loading associated with this sport. This study presents a population of runners with common pathologic acetabular changes. Case series. Eight high-level runners with an average age of 36 years (range, 19 to 45 years) were seen for complaints of increasing hip pain with running without any history of macrotrauma. All of the patients had either run several marathons (4), were triathletes (1), Olympic middle distance runners (1), or had run more than 10 miles per week for longer than 5 years (2). Plain radiographic analysis revealed no degenerative changes and an average center-edge (CE) angle of 36.7 degrees (range, 28 degrees to 44 degrees). All patients underwent hip arthroscopy with labral debridement. In 6 patients (75%), a chondral injury of the acetabular cartilage underlying the labral tear was noted. In addition, 3 patients had ligamentum teres disruptions. It is possible that the development of these tears is the result of subtle instability, which may be exacerbated by running, eventually leading to labral tearing and possible ligamentum teres disruption. While perhaps concurrently, subtle acetabular dysplasia may play a role. Although this study does not confirm an association between running and the development of labral tears or chondral lesions in the hip, it certainly questions whether there is an injury pattern common to this population, a "runner's hip." Level IV.

Combination acetabular radiofrequency ablation and cementoplasty using a navigational radiofrequency ablation device and ultrahigh viscosity cement: technical note.

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Wallace, Adam N; Huang, Ambrose J; Vaswani, Devin; Chang, Randy O; Jennings, Jack W

2016-03-01

Percutaneous radiofrequency ablation and cementoplasty is an alternative palliative therapy for painful metastases involving axial load-bearing bones. This technical report describes the use of a navigational radiofrequency probe to ablate acetabular metastases from an anterior approach followed by instillation of ultrahigh viscosity cement under CT-fluoroscopic guidance. The tumor ablation databases of two institutions were retrospectively reviewed to identify patients who underwent combination acetabular radiofrequency ablation and cementoplasty using the STAR Tumor Ablation and StabiliT Vertebral Augmentation Systems (DFINE; San Jose, CA). Pre-procedure acetabular tumor volume was measured on cross-sectional imaging. Pre- and post-procedure pain scores were measured using the Numeric Rating Scale (10-point scale) and compared. Partial pain improvement was categorically defined as ≥ 2-point pain score reduction. Patients were evaluated for evidence of immediate complications. Electronic medical records were reviewed for evidence of delayed complications. During the study period, 12 patients with acetabular metastases were treated. The median tumor volume was 54.3 mL (range, 28.3-109.8 mL). Pre- and post-procedure pain scores were obtained from 92% (11/12) of the cohort. The median pre-procedure pain score was 8 (range, 3-10). Post-procedure pain scores were obtained 7 days (82%; 9/11), 11 days (9.1%; 1/11) or 21 days (9.1%; 1/11) after treatment. The median post-treatment pain score was 3 (range, 1-8), a statistically significant difference compared with pre-treatment (P = 0.002). Categorically, 73% (8/11) of patients reported partial pain relief after treatment. No immediate symptomatic complications occurred. Three patients (25%; 3/12) were discharged to hospice within 1 week of treatment. No delayed complications occurred in the remaining 75% (9/12) of patients during median clinical follow-up of 62 days (range, 14-178 days). Palliative percutaneous

High-resolution CT in eosinophilic granuloma (histiocytosis X) of the lung

International Nuclear Information System (INIS)

Godwin, J.D.; Buschman, D.L.; Moore, A.D.A.; Muller, N.L.; Naidich, D.P.; Carvalho, C.R.R.; Takasugi, J.E.; Schmidt, R.A.

1988-01-01

Eosinophilic granuloma of the lung is fascinating but poorly understood. Computed tomographic (CT) scans in 18 cases (11 high resolution) showed a variety of striking patterns: cysts up to 4 cm with thin or indiscernible walls, ranging from a few lesions to confluent honeycombing; retriculonodular infiltrate; and nodules 2 mm-2cm, sometimes cavitated. CT showed that the ill-defined lucencies barely visible on radiographs are indeed cysts, rather than preserved normal lung surrounded by infiltrate. High-resolution CT showed that some of the early, small nodules were concentrated along terminal bronchioles within the secondary lobules. The differential diagnosis includes sarcoidosis and idiopathic fibrosis, but the prominent cystic abnormality and the lack of peripheral concentration help to distinguish eosinophilic granuloma

Radiographic features of periapical cysts and granulomas

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Zain, R. B.; Roswati, N.; Ismail, K.

1989-01-01

Many studies have been reported on radiographic lesion sizes of periapical lesions. However no studies have been reported on prevalences of subjective radiographic features in these lesions except for the early assumption that a periapical cyst usually exhibit a radiopaque cortex. This study is conducted to evaluate the prevalences of several subjective radiographic features of periapical cysts and granulomas in the hope to identify features that maybe suggestive of either diagnosis. The resu...

Cellular Architecture of Spinal Granulomas and the Immunological Response in Tuberculosis Patients Coinfected with HIV.

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Bhattacharya, Debapriya; Danaviah, Siva; Muema, Daniel M; Akilimali, Ngomu Akeem; Moodley, Prashini; Ndung'u, Thumbi; Das, Gobardhan

2017-01-01

Mycobacterium tuberculosis ( M.tb ) and HIV are individually responsible for the most deaths worldwide among all infectious agents, and coinfection with M.tb and HIV is a significant public health challenge in the developing world. Although the lung is the primary target organ for tuberculosis (TB), M.tb can also cause extrapulmonary tuberculosis (EPTB) such as in the bones and joints. Treatment of EPTB is much more challenging than treatment of pulmonary TB. The hallmark of the host immune response against TB is the formation of organized structures called granulomas that are infiltrated with immune cells and are rich in cytokines and chemokines. Inside granulomas, the host confines the M.tb bacteria to a particular region of the organ and avoids dispersion. In this study, we analyzed immune cells in bone granulomas of patients with EPTB that are also coinfected with HIV. We found that HIV-infected TB patients have dispersed bone granulomas, with reduced T cell numbers and a concomitant increase in plasma cells. Additionally, HIV-infected patients exhibited dramatically increased serum levels of IgM and IgG1 antibodies, which is indicative of T-cell-independent B-cell activation and mucosal T-cell activation, respectively. Interestingly, we also observed that CD29 + stem cells are increased in HIV-TB coinfection, suggesting a link with HIV infection. Therefore, our work provides new insights into the architecture of spinal TB granulomas and the role of B-cells and humoral immunity against a highly infectious intracellular pathogen. We propose that our findings will inform biomarker identification for EPTB and possibly the development of related therapeutics and/or vaccines to protect HIV-infected patients against disseminated TB.

Interventional management of spine eosinophilic granuloma in children: preliminary investigation of its clinical value

International Nuclear Information System (INIS)

He Yu; Wu Chungen; Gu Yifeng; Cheng Yongde

2011-01-01

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)

Sequential Expression of the Neuropeptides Substance P and Somatostatin in Granulomas Associated with Murine Cysticercosis

OpenAIRE

Robinson, Prema; White, A. Clinton; Lewis, Dorothy E.; Thornby, John; David, Elliott; Weinstock, Joel

2002-01-01

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 thi...

Biomechanical analysis of the fixation systems for anterior column and posterior hemi-transverse acetabular fractures.

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Lei, Jianyin; Dong, Pengfei; Li, Zhiqiang; Zhu, Feng; Wang, Zhihua; Cai, Xianhua

2017-05-01

The aim of this study was to evaluate the biomechanical properties of common fixation systems for complex acetabular fractures. A finite element (FE) pelvic model with anterior column and posterior hemi-transverse acetabular fractures was created. Three common fixation systems were used to fix the posterior wall acetabular fractures: 1. Anterior column plate combined with posterior column screws (group I), 2. Anterior column plate combined with quadrilateral area screws (group II) and 3. Double-column plates (group III). And 600 N, representing the body weight, was loaded on the upper surface of the sacrum to simulate the double-limb stance. The amounts of total and relative displacements were compared between the groups. The total amount of displacement was 2.76 mm in group II, 2.81 mm in group III, and 2.83 mm in group I. The amount of relative displacement was 0.0078 mm in group II, 0.0093 mm in group III and 0.014 mm in group I. Our results suggested that all fixation systems enhance biomechanical stability significantly. Anterior column plate combined with quadrilateral area screws has quite comparable results to double column plates, they were superior to anterior column plate combined with posterior screws. Copyright © 2017 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.

Suture Granuloma Mimicking Renal Cell Carcinoma: Magnetic Resonance Imaging (MRI and Pathologic Correlation

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İbrahim İlker Öz

2014-11-01

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.

Importance of preoperative imaging in acetabular revision surgery - a case report.

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Schmitz, Hc; Egidy, Cc; Al-Khateeb, H; Cárdenas, G; Gehrke, T; Kendoff, D

2012-01-01

Acetabular defects, particularly as a result of protrusion of acetabular components into the hemipelvis, may cause serious complications during revision procedures as a result of iatrogenic injury to surrounding anatomical structures. In these challenging cases, we advocate the utilisation of preoperative three dimensional imaging. MRI and CT- imaging offer superior understanding of the three-dimensional quality of bony defects and the relationship of implants to important anatomical structures. Appropriate preoperative planning may also prevent major complications during the removal of the pre-existing hardware, prior to re-implantation of implants. Potential complications include injury of nerves, blood vessels and other intrapelvic structures.In our case, a major bony defect of the acetabulum was a result of the protrusion of an implanted reinforcement ring. A preoperative, contrast-enhanced CT scan showed that the urethra was in close proximity to the hook of the reinforcement ring.The preoperative imaging aided in identifying and understanding the potential complications that could occur intraoperatively. Additionally, it delineated the intact anatomic structures prior to surgery, which could have medico-legal implications.The importance of preoperative imaging and the existing literature is discussed within this case description.

The development and nature of femoral head cam lesions following acetabular fractures.

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Berber, Onur; Foote, Julian; Sabharwal, Sanjeeve; Datta, Gorav; Bircher, Martin D

2014-01-01

The aim of acetabular fracture fixation is to restore joint congruity with restoration of the articular surface. Poor outcomes are seen where this has not been achieved. Letournel reported a collarette osteophyte seen postoperatively in a proportion of patients, which he suggested was an early precursor to the development of osteoarthritis. This is a retrospective study of patients treated at a tertiary referral unit who developed this lesion. The triangular index was measured in 48 of these patients and then correlated with their clinical findings, Oxford Hip Score and the presence of osteoarthritis. Length of follow-up, fracture classification, and joint congruency were also recorded. Results showed a statistically significant relationship between cam lesion size and the development of osteoarthritis (P = 0.008), cam lesion size and length of follow-up (P = 0.01), and between groin pain and postoperative joint congruency (LR = 0.035). These findings suggest that the appearance of a cam lesion is a poor long-term prognostic marker for the development of osteoarthritis in patients with an acetabular fracture.

Bipolar hip arthroplasty as salvage treatment for loosening of the acetabular cup with significant bone defects

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Ghanem, Mohamed

2016-04-01

Full Text Available Introduction: Revision arthroplasty of the hip is becoming increasingly important in recent years. Early primary arthroplasty and longer life expectancy of the patients increases the number of revision surgery. Revision surgery of hip arthroplasty is major surgery for the patients, especially the elderly, with significant risks concerning the general condition of the patient. The aim of this work is to evaluate the outcome of bipolar hip arthroplasty as a salvage procedure for treatment of loosening of the acetabular cup with significant acetabular bone defects after total hip replacement (THR in multi-morbid patients.Patients and methods: During the period from January 1 2007 to December 31 2011 19 revision hip surgeries were performed in , in which the loosened acetabular cup was replaced by a bipolar head. The examined patient group consisted exclusively of female patients with an average of 75 years. The predominant diagnosis was “aseptic loosening” (84.2%. All patients in our study were multi-morbid. We decided to resort to bipolar hip arthroplasty due to the compromised general condition of patients and the major acetabular bone defects, which were confirmed intraoperatively. The postoperative follow-up ranged from 0.5 to 67 months (average 19.1 months. Results: Evaluation of the modified Harris Hip Score showed an overall improvement of the function of the hip joint after surgery of approximately 45%.Surgery was less time consuming and thus adequate for patients with significantly poor general health condition. We noticed different complications in a significant amount of patients (68.4%. The most common complication encountered was the proximal migration of the bipolar head.The rate of revision following the use of bipolar hip arthroplasty in revision surgery of the hip in our patients was high (21%. Despite the high number of complications reported in our study, we have noticed significant improvement of hip joint function as well

3D CT versus axial helical CT versus conventional tomography in the classification of acetabular fractures: A ROC analysis

International Nuclear Information System (INIS)

Kickuth, Ralph; Laufer, Ulf; Hartung, Guido; Gruening, Christian; Stueckle, Christoph; Kirchner, Johannes

2002-01-01

AIM: To assess the diagnostic power of three-dimensional computed tomography (3D CT), axial helical computed tomography (CT) and conventional tomography in the classification of acetabular fractures by interdisciplinary review. MATERIALS AND METHODS: Receiver operating characteristics (ROCs) were assessed for two radiologists and two surgeons blinded to the presence of acetabular fractures in an animal model (a total of 62 porcine hips, 40 of them with artificial acetabular fractures). Main target parameter was the diagnostic accuracy in the classification of the artificial fractures following Judet et al. RESULTS: ROC analysis for radiologists showed A z values of 0·83 for 3D CT, 0·81 for axial helical CT, and 0·78 for conventional tomography; differences between the three techniques were not significant (P = 0·46-0·73). A z values for the surgeons were 0·87 for 3D CT, 0·68 for axial helical CT, and 0·60 for conventional tomography; 3D CT was significantly better than axial helical CT (P = 0·01) and conventional tomography (P = 0·001). The differences between axial helical CT and conventional tomography were not significant (P = 0·37). CONCLUSION: Acetabular fractures are best classified by 3D CT, followed by axial helical CT and conventional tomography when assessed by surgeons. 3D CT did not provide any additional significant benefit in the classification performed by radiologists. Kickuth, R. et al. (2002)

Lesion-Specific Immune Response in Granulomas of Patients with Pulmonary Tuberculosis: A Pilot Study.

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Selvakumar Subbian

Full Text Available The formation and maintenance of granulomas is central to the host response to Mycobacterium tuberculosis (Mtb infection. It is widely accepted that the lungs of patients with tuberculosis (TB usually contain multiple infection foci, and that the granulomas evolve and differentiate independently, resulting in considerable heterogeneity. Although gene expression profiles of human blood cells have been proposed as biomarkers of Mtb infection and/or active disease, the immune profiles of discrete lesion types has not been studied extensively. Using histology, immunopathology and genome-wide transcriptome analysis, we explored the immunological profile of human lung TB granulomas. We show that although the different granulomas share core similarities in their immunological/inflammatory characteristics, they also exhibit significant divergence. Despite similar numbers of CD68+ macrophages in the different lesions, the extent of immune reactivity, as determined by the density of CD3+ T cells in the macrophage rich areas, and the extent of fibrosis, shows considerable variation. Both quantitative and qualitative differences among significantly differentially expressed genes (SDEG were noted in each of the lesion types studied. Further, network/pathway analysis of SDEG revealed differential regulation of inflammatory response, immune cell trafficking, and cell mediated immune response in the different lesions. Our data highlight the formidable challenges facing ongoing efforts to identify peripheral blood biomarkers due to the diversity of lesion types and complexity of local immune responses in the lung.

MR Spectroscopy and Perfusion MR Imaging Findings of Intracranial Foreign Body Granuloma: a Case Report

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Jang, Seung Won; Kim, Sang Joon; Kim, Sun Mi; Lee, Jeong Hyun; Choi, Choong Gon; Lee, Deok Hee; Lee, Jung Kyo [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Kim, Eun Ju [Philips Healthcare, Seoul (Korea, Republic of)

2010-06-15

We report a case of intracranial foreign body granuloma that showed features of a high grade tumor on magnetic resonance (MR) imaging. However, the relative cerebral blood volume was not increased in the enhancing mass on perfusion MRI and the choline/creatine ratio only slightly increased on MR spectroscopy. The results suggest that the lesion is benign in nature. Perfusion MRI and MR spectroscopy may be helpful to differentiate a foreign body granuloma from a neoplastic condition

Abordagem cirúrgica inédita para denervação acetabular em cães A new surgical approach to acetabular denervation in dogs

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Cássio R.A. Ferrigno

2007-02-01

Full Text Available Este artigo tem por objetivo demonstrar nova abordagem cirúrgica para denervação seletiva das fibras sensitivas do periósteo acetabular, para tratamento da displasia coxo femoral em cães, conduzidas em 189 articulações. Para tanto, é descrita abordagem da região cranial e dorso-lateral do acetábulo de cães por incisão em forma de meia lua de aproximadamente de três centímetros de extensão, iniciando trocânter maior do fêmur e em direção ao corpo do ílio. Após rebatimento dorsal do músculo glúteo médio, secciona-se parcialmente a inserção do m. glúteo profundo para acesso às regiões citadas. Com auxílio de cureta foi removido, em todos os pacientes, periósteo na margem acetabular cranial e dorso lateral, até a exposição da cortical óssea. Em todos os animais foi possível a abordagem, tanto da face cranial como também acesso para a curetagem da face dorsal do acetábulo, com a técnica descrita, com incisão de pele de aproximadamente 3,2cm. A curetagem da porção cranial do acetábulo foi, em todos os casos realizados, sem visualização do osso, mas de fácil confecção e sem intercorrências de lesão de nervos ou músculos. Em todas as abordagens foi possível visualizar a cápsula articular da articulação coxo femoral, e em nenhum dos animais esta estrutura foi incisada por erro de técnica. Conclui-se que a abordagem cirúrgica descrita no presente trabalho é factível para este tipo de procedimento cirúrgico em cães, promovendo acesso adequado, com mínima invasão e sem complicações de qualquer natureza.The purpose of this study is to demonstrate a new surgical approach for the selective denervation of the sensitive fibers of the acetabular periosteum, for the treatment of hip dysplasia in dogs, conducted in 189 joints.The surgical approach of the cranial and dorso-lateral regions of the acetabular joint in dogs, by moon-shaped incision of approximately 3cm in extension, starting from the

Single-stage Acetabular Revision During Two-stage THA Revision for Infection is Effective in Selected Patients.

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Fink, Bernd; Schlumberger, Michael; Oremek, Damian

2017-08-01

The treatment of periprosthetic infections of hip arthroplasties typically involves use of either a single- or two-stage (with implantation of a temporary spacer) revision surgery. In patients with severe acetabular bone deficiencies, either already present or after component removal, spacers cannot be safely implanted. In such hips where it is impossible to use spacers and yet a two-stage revision of the prosthetic stem is recommended, we have combined a two-stage revision of the stem with a single revision of the cup. To our knowledge, this approach has not been reported before. (1) What proportion of patients treated with single-stage acetabular reconstruction as part of a two-stage revision for an infected THA remain free from infection at 2 or more years? (2) What are the Harris hip scores after the first stage and at 2 years or more after the definitive reimplantation? Between June 2009 and June 2014, we treated all patients undergoing surgical treatment for an infected THA using a single-stage acetabular revision as part of a two-stage THA exchange if the acetabular defect classification was Paprosky Types 2B, 2C, 3A, 3B, or pelvic discontinuity and a two-stage procedure was preferred for the femur. The procedure included removal of all components, joint débridement, definitive acetabular reconstruction (with a cage to bridge the defect, and a cemented socket), and a temporary cemented femoral component at the first stage; the second stage consisted of repeat joint and femoral débridement and exchange of the femoral component to a cementless device. During the period noted, 35 patients met those definitions and were treated with this approach. No patients were lost to followup before 2 years; mean followup was 42 months (range, 24-84 months). The clinical evaluation was performed with the Harris hip scores and resolution of infection was assessed by the absence of clinical signs of infection and a C-reactive protein level less than 10 mg/L. All

Acetabular component positioning in total hip arthroplasty with and without a computer-assisted system: a prospective, randomized and controlled study.

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Gurgel, Henrique M C; Croci, Alberto T; Cabrita, Henrique A B A; Vicente, José Ricardo N; Leonhardt, Marcos C; Rodrigues, João Carlos

2014-01-01

In a study of the acetabular component in total hip arthroplasty, 20 hips were operated on using imageless navigation and 20 hips were operated on using the conventional method. The correct position of the acetabular component was evaluated with computed tomography, measuring the operative anteversion and the operative inclination and determining the cases inside Lewinnek's safe zone. The results were similar in all the analyses: a mean anteversion of 17.4° in the navigated group and 14.5° in the control group (P=.215); a mean inclination of 41.7° and 42.2° (P=.633); a mean deviation from the desired anteversion (15°) of 5.5° and 6.6° (P=.429); a mean deviation from the desired inclination of 3° and 3.2° (P=.783); and location inside the safe zone of 90% and 80% (P=.661). The acetabular component position's tomography analyses were similar whether using the imageless navigation or performing it conventionally. Published by Elsevier Inc.

Clinical outcome of pedestal cup endoprosthetic reconstruction after resection of a peri-acetabular tumour

NARCIS (Netherlands)

Bus, M. P. A.; Boerhout, E. J.; Bramer, J. A. M.; Dijkstra, P. D. S.

2014-01-01

Peri-acetabular tumour resections and their subsequent reconstruction are among the most challenging procedures in orthopaedic oncology. Despite the fact that a number of different pelvic endoprostheses have been introduced, rates of complication remain high and long-term results are mostly lacking.

What is the role of clinical tests and ultrasound in acetabular labral tear diagnostics?

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Troelsen, Anders; Mechlenburg, Inger; Gelineck, John

2009-01-01

BACKGROUND AND PURPOSE: An acetabular labral tear is a diagnostic challenge. Various clinical tests have been described, but little is known about their diagnostic sensitivity and specificity. We investigated the diagnostic validity of clinical tests and ultrasound as compared with MR arthrography...... no or only slight signs of osteoarthritis (Tönnis grade 0-1). RESULTS: MR arthrography identified labral tears in 17 of the 18 hips. Ultrasound had a sensitivity of 94%, a positive predictive value of 94%, and was false negative in only 1 case compared to MR arthrography. The impingement test had the best...... diagnostic ability of the clinical tests, with a sensitivity of 59% and a specificity of 100%. The positive predictive value was 100% while the negative predictive value was 13%. INTERPRETATION: The impingement test is helpful in identifying acetabular labral tears. If this test is negative and if a labral...

Skin granulomas due to Mycobacterium gordonae.

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Gengoux, P; Portaels, F; Lachapelle, J M; Minnikin, D E; Tennstedt, D; Tamigneau, P

1987-04-01

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.

Trabecular metal acetabular components in primary total hip arthroplasty

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Laaksonen, Inari; Lorimer, Michelle; Gromov, Kirill

2018-01-01

Background and purpose - Trabecular metal (TM) cups have demonstrated favorable results in acetabular revision and their use in primary total hip arthroplasty (THA) is increasing. Some evidence show that TM cups might decrease periprosthetic infection (PPI) incidence. We compared the survivorship...... of TM cups with that of other uncemented cups in primary THA, and evaluated whether the use of TM cups is associated with a lower risk of PPI. Patients and methods - 10,113 primary THAs with TM cup and 85,596 THAs with other uncemented cups from 2 high-quality national arthroplasty registries were...

Endodontic misdiagnosis of periapical central giant cell granuloma: Report of case with 2 years of follow-up

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Rahul Kumar

2012-01-01

Full Text Available Central giant cell granuloma is considered as reactive lesion of jaws possibly to intramedullary hemorrhage or trauma. It may manifest as radiolucencies anywhere in the mandible or maxilla. In rare cases, it can appear as a localized periapical area and mimic an endodontic lesion. This report presents a case where central giant cell granuloma was misdiagnosed as a periapical cyst in 20-year-old male and was treated by conventional endodontic treatment. However the lesion was refractory to endodontic treatment and proved to be central giant cell granuloma after surgical intervention and histopathological examination. The purpose of this case report is to emphasize on periodic follow-up of periapical lesions after endodontic treatment and surgical intervention if required.

Computer-aided designed, three dimensional-printed hemipelvic prosthesis for peri-acetabular malignant bone tumour.

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Wang, Baichuan; Hao, Yongqiang; Pu, Feifei; Jiang, Wenbo; Shao, Zengwu

2018-03-01

Prosthetic reconstruction may be a promising treatment for peri-acetabular malignant bone tumour; however, it is associated with a high complication rate. Therefore, prosthetic design and approach of prosthetic reconstruction after tumour resection warrant study. We retrospectively analyzed 11 patients with peri-acetabular malignant bone tumours treated by personalized 3D-printed hemipelvic prostheses after en bloc resection between 2015 and 2016. Pre-operative and post-operative pain at rest was assessed according to a 10-cm VAS score. The results of functional improvement were evaluated using the MSTS-93 score at the final follow-up. We also analyzed tumour recurrence, metastases, and complications associated with the reconstruction procedure. All patients were observed for six to 24 months with an average follow-up of 15.5 months. One patient had occasional pain of the involved hip at the final follow-up (VAS, pre vs. post 8 months: 3 vs. 2). The mean MSTS-93 score was 19.2 (range, 13-25). Hip dislocation was detected in two patients, while delayed wound healing occurred in one patient. One patient with mesenchymal chondrosarcoma had a left iliac bone metastasis. Local tumour recurrence was not observed. Reconstruction of bony defect after tumour resection using personalized 3D-printed hemipelvic prostheses can obtain acceptable functional results without severe complications. Based on previous reports and our results, we believe that reconstruction arthroplasty using 3D-printed hemipelvic prostheses will provide a promising alternative for those patients with peri-acetabular malignant bone tumours. Level IV, therapeutic study.

Th1 and Th2-like protein balance in human inflammatory radicular cysts and periapical granulomas.

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de Carvalho Fraga, Carlos Alberto; Alves, Lucas Rodrigues; de Sousa, Adriana Alkmim; de Jesus, Sabrina Ferreira; Vilela, Daniel Nogueira; Pereira, Camila Santos; Batista Domingos, Patrícia Luciana; Viana, Agostinho Gonçalves; Jham, Bruno Correia; Batista de Paula, Alfredo Maurício; Sena Guimarães, André Luiz

2013-04-01

Chronic dental periapical lesions result from chronic inflammation of periapical tissues caused by continuous antigenic stimulation from infected root canals. Recent findings have suggested that T helper (Th) 1 and Th2-like cytokines are important in the pathogenesis of chronic periapical inflammatory diseases. However, the mechanisms regulating these immunoinflammatory pathways have not been fully elucidated. Thus, the aim of this study was to evaluate interleukin (IL)-4, IL-12, and interferon γ (IFN-γ) protein levels in human radicular cysts and periapical granulomas. Archived samples of cysts (n = 52) and granulomas (n = 27) were sectioned and submitted to immunohistochemistry to evaluate the tissue expression of IL-4, IL-12, and IFN-γ. The data were analyzed using the Mann-Whitney U test (P cysts. IL-4 expression was stronger in periapical granulomas than in radicular cysts. IL-12 was not detected in any of the samples. Our study showed that IFN-γ protein levels are increased in radicular cysts, whereas IL-4 expression is stronger in samples of periapical granulomas. Further studies are necessary to elucidate the signaling pathways mediated by these cytokines and to facilitate the development of more effective periapical disease management strategies. Copyright © 2013 American Association of Endodontists. All rights reserved.

Histochemical and polarization microscopic study of two cases of vegetable/pulse granuloma

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Manjunatha B

2008-01-01

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.

Does the optimal position of the acetabular fragment should be within the radiological normal range for all developmental dysplasia of the hip? A patient-specific finite element analysis.

Science.gov (United States)

Wang, Xuyi; Peng, Jianping; Li, De; Zhang, Linlin; Wang, Hui; Jiang, Leisheng; Chen, Xiaodong

2016-10-04

The success of Bernese periacetabular osteotomy depends significantly on how extent the acetabular fragment can be corrected to its optimal position. This study was undertaken to investigate whether correcting the acetabular fragment into the so-called radiological "normal" range is the best choice for all developmental dysplasia of the hip with different severities of dysplasia from the biomechanical view? If not, is there any correlation between the biomechanically optimal position of the acetabular fragment and the severity of dysplasia? Four finite element models with different severities of dysplasia were developed. The virtual periacetabular osteotomy was performed with the acetabular fragment rotated anterolaterally to incremental center-edge angles; then, the contact area and pressure and von Mises stress in the cartilage were calculated at different correction angles. The optimal position of the acetabular fragment for patients 1, 2, and 3 was when the acetabular fragment rotated 17° laterally (with the lateral center-edge angle of 36° and anterior center-edge angle of 58°; both were slightly larger than the "normal" range), 25° laterally following further 5° anterior rotation (with the lateral center-edge angle of 31° and anterior center-edge angle of 51°; both were within the "normal" range), and 30° laterally following further 10° anterior rotation (with the lateral center-edge angle of 25° and anterior center-edge angle of 40°; both were less than the "normal" range), respectively. The optimal corrective position of the acetabular fragment is severity dependent rather than within the radiological "normal" range for developmental dysplasia of the hip. We prudently proposed that the optimal correction center-edge angle of mild, moderate, and severe developmental dysplasia of the hip is slightly larger than the "normal" range, within the "normal" range, and less than the lower limit of the "normal" range, respectively.

Intra- and inter-observer agreement and reliability of bone mineral density measurements around acetabular cup

DEFF Research Database (Denmark)

Mussmann, Bo Redder; Overgaard, Soren; Torfing, Trine

2017-01-01

in measuring bone density (BMD) in complex anatomic structures which might be overcome using dual-energy computed tomography (DECT).PurposeTo test inter- and intra-observer agreement and reliability of in-house segmentation software measuring BMD adjacent to acetabular cup and to compare measurements performed...... with single-energy CT (SECT) and DECT in cemented and cementless cups.Material and Methods: Twenty-four acetabular cups inserted in porcine hip specimens were scanned with SECT and DECT. Bone density was measured in a three-dimensional volume adjacent to the cup. Double measurements were performed.......Results: BMD derived from SECT was approximately four times higher than that of DECT. In both scan modes, intraclass correlation coefficient (ICC) was >0.90 with no differences between repeated measurements, except for uncemented cups where a statistically significant difference of 11 mg/cm3 was found...

Role of lifestyle modifications for patients with laryngeal granuloma caused by gastro-esophageal reflux: comparison between conservative treatment and the surgical approach.

Science.gov (United States)

Kobayashi, Rika; Tsunoda, Koichi; Ueha, Rumi; Fujimaki, Yoko; Nito, Takaharu; Yamasoba, Tatsuya

2017-03-01

It is considered that a regimen combining pharmacologic management and lifestyle modifications is the most effective treatment for laryngeal granulomas caused by GER. This study compared the results of the combination therapy and surgery to determine the best treatment of laryngeal granuloma caused by gastro-esophageal reflux in 51 patients. Prospective study. In the conservative treatment group, the CR rate was 89.7% and recurrence rate was 2.6%, while the lesions remained in patients (7.7%). This study compared the CR and recurrence rates between conservative treatment and surgery for granuloma. The results showed that the laryngeal granuloma recurrence rate was significantly lower with the conservative treatment regimen compared with surgery (p = .0016).

Does surface roughness influence the primary stability of acetabular cups? A numerical and experimental biomechanical evaluation.

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Le Cann, Sophie; Galland, Alexandre; Rosa, Benoît; Le Corroller, Thomas; Pithioux, Martine; Argenson, Jean-Noël; Chabrand, Patrick; Parratte, Sébastien

2014-09-01

Most acetabular cups implanted today are press-fit impacted cementless. Anchorage begins with the primary stability given by insertion of a slightly oversized cup. This primary stability is key to obtaining bone ingrowth and secondary stability. We tested the hypothesis that primary stability of the cup is related to surface roughness of the implant, using both an experimental and a numerical models to analyze how three levels of surface roughness (micro, macro and combined) affect the primary stability of the cup. We also investigated the effect of differences in diameter between the cup and its substrate, and of insertion force, on the cups' primary stability. The results of our study show that primary stability depends on the surface roughness of the cup. The presence of macro-roughness on the peripheral ring is found to decrease primary stability; there was excessive abrasion of the substrate, damaging it and leading to poor primary stability. Numerical modeling indicates that oversizing the cup compared to its substrate has an impact on primary stability, as has insertion force. Copyright © 2014 IPEM. Published by Elsevier Ltd. All rights reserved.

3D Printing Aids Acetabular Reconstruction in Complex Revision Hip Arthroplasty

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Andrew J. Hughes

2017-01-01

Full Text Available Revision hip arthroplasty requires comprehensive appreciation of abnormal bony anatomy. Advances in radiology and manufacturing technology have made three-dimensional (3D representation of osseous anatomy obtainable, which provide visual and tactile feedback. Such life-size 3D models were manufactured from computed tomography scans of three hip joints in two patients. The first patient had undergone multiple previous hip arthroplasties for bilateral hip infections, resulting in right-sided pelvic discontinuity and a severe left-sided posterosuperior acetabular deficiency. The second patient had a first-stage revision for infection and recurrent dislocations. Specific metal reduction protocols were used to reduce artefact. The images were imported into Materialise MIMICS 14.12®. The models were manufactured using selective laser sintering. Accurate templating was performed preoperatively. Acetabular cup, augment, buttress, and cage sizes were trialled using the models, before being adjusted, and resterilised, enhancing the preoperative decision-making process. Screw trajectory simulation was carried out, reducing the risk of neurovascular injury. With 3D printing technology, complex pelvic deformities were better evaluated and treated with improved precision. Life-size models allowed accurate surgical simulation, thus improving anatomical appreciation and preoperative planning. The accuracy and cost-effectiveness of the technique should prove invaluable as a tool to aid clinical practice.

Migration measurement of acetabular components in cementless total hip arthroplasty; Messung der Pfannenwanderung bei zementfreien Hueftimplantaten

Energy Technology Data Exchange (ETDEWEB)

Eckardt, A.; Karbowski, A.; Schwitalle, M.; Vogel, J.; Boden, F.; Seeleitner, C. [Mainz Univ. (Germany). Orthopaedische Klinik und Poliklinik; Schunk, K. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Radiologie; Mayrhofer, P. [Innsbruck Univ. (Austria). Inst. fuer Mathematik und Geometrie

1998-08-01

Migration measurements of acetabular components using a special computer aided method (EBRA = abbrevation for the German term ``Ein-Bild-Roentgenanalyse``) were performed to evaluate early results of the implants and predict aseptic loosening. Methods: Standard ap-radiographs of the pelvis were marked, specific points were digitised. Simulating the spatial situation the programme computes lengitudinal and vertical migration of the cup. 74 acetabular components in 71 patients could be studied by migration measurements. Results: 14 patients showed migration of more than 1 mm, which is the confidence limit of this method. Each of these patients showed diverse reasons for the migration, i.e. osteoporosis of the acetabular bone stock or problems concerning the surgical technique which means malposition of the cup or insufficient reaming of the bone. There were some patients with severe congenital dysplasia of the hip and in some cases the inclination angle of the cup was too great. Conclusion: The technique applied for measuring migration of acetabular components can be useful for evaluating early instability of the implant and can be helpful in detecting problems concerning the surgical technique. (orig.) [Deutsch] Mittels der Ein-Bild-Roentgenanalyse wurden Pfannenwanderungen nach Implantation von zementfreien, sphaerischen Hueftgelenkspfannen erfasst, um Praediktoren fuer die langfristige Prognose der Implantate zu evaluieren. Methoden: Nach Markierung von Referenzpunkten in den Beckenuebersichtsaufnahmen wurden diese digitalisiert, vom Programm verrechnet und die Wanderung des Implantats im Verlauf angegeben. Bei 71 Patienten wurden von 74 Pfannen ueber einen Mindestnachuntersuchungszeitraum von 12 Monaten Migrationsmessungen durchgefuehrt. Das Konfidenzintervall der Methode liegt bei <1 mm. Bei jedem dieser Patienten fanden sich Hinweise entweder auf ein schlechtes Knochenlager, auf operationsbedingte Probleme, wenn keine ausreichende Primaerstabilitaet der Pfanne

TOTAL EYELID RECONSTRUCTION IN A PRIMARY IMMUN O DEFICIENT WI TH G I A NT PYOGENIC GRANULOMA

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Vijay Kumar

2015-06-01

Full Text Available Total upper and lower eyelid defect is usually secondary to the excision of malignant or benign tumours, trauma and burns. Reconstruction of this type of defect is important not only for the cosmetic result, but also for coverage of the cornea an d prevent injury to eyeball. Pyogenic granuloma is usually preceded by the history of trauma to the eyelid. But reports of giant pyogenic granuloma of both upper and lower eyelid are rare. We present here a ten year old boy diagnosed primary immune deficient with a large fungating mass over both upper and lower eyelid, which was excised and total upper and lower eyelid defect was reconstructed with paramedian forehead flap. Histopathology revealed pyogenic granuloma. Post operatively c hild had good lid movements.

Internal granuloma with perforation – 2 case report

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Ioana Suciu

2015-11-01

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.

Eosinophilic granuloma in jaw bone: a pare pediatric case report ...

African Journals Online (AJOL)

Background: Eosinophilic granuloma (EG), one of the three clinical forms of Langerhans cell histiocytosis (LCH), is a benign inflammatory reaction to an unknown etiologic agent. It most commonly occurs in children and young adults. The most frequently involved bones are the skull, the ribs and the femurs. Alongside the ...

Inguinal Abnormalities in Male Patients with Acetabular Fractures Treated Using an Ilioinguinal Exposure

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Reza Firoozabadi

2015-09-01

Full Text Available Purpose: Surgeons performing an ilioinguinal exposure for acetabular fracture surgery need to be aware of aberrant findings such as inguinal hernias and spermatic cord lesions. The purpose of this study is to report these occurrences in a clinical series of adult males undergoing acetabular fracture fixation and a series of adult male cadavers. The secondary aim is to characterize these abnormalities to aid surgeons in detecting these abnormalities preoperatively and coordinating a surgical plan with a general surgeon.Methods: Clinical study- Retrospective review of treated acetabular fractures through an ilioinguinal approach. Incidence of inguinal canal and spermatic cord abnormalities requiring general surgery consultation were identified. Corresponding CT scans were reviewed and radiographic characteristics of the spermatic cord abnormalities and/or hernias were noted.Cadaveric study- 18 male cadavers dissected bilaterally using an ilioinguinal exposure. The inguinal canal and the contents of the spermatic cord were identified and characterized.Results: Clinical Study- 5.7% (5/87 of patients had spermatic cord lesion and/or inguinal hernia requiring general surgical intervention. Preoperative pelvic CT scan review identified abnormalities noted intraoperatively in four of the five patients. Cord lipomas visualized as enlargements of the spermatic cord with homogeneous density. Hernias visualized as enlarged spermatic cords with heterogeneous density. Cadaver Study- 31% (11/36 of cadavers studied had spermatic cord and/or inguinal canal abnormalities. Average cord diameter in those with abnormalities was 24.9 mm (15-28 compared to 16 mm (11-22 in normal cords, which was statistically significant.Conclusion: The clinical and cadaveric findings emphasize the importance of understanding inguinal abnormalities and the value of detecting them preoperatively. The preoperative pelvic CT scans were highly sensitive in detecting inguinal abnormalities.

[Stress analysis on the acetabular side of bipolar hemiarthroplasty by the two-dimensional finite element method incorporating the boundary friction layer].

Science.gov (United States)

Ichihashi, K; Imura, S; Oomori, H; Gesso, H

1994-11-01

We compared the biomechanical characteristics of bipolar and unipolar hemiarthroplasty on the proximal migration of the outer head by determining the von Mises stress distribution and acetabular (outer head) displacement with clinical assessment of hemiarthroplasty in 75 patients. This analysis used the two-dimensional finite element method, which incorporated boundary friction layers on both the inner and outer bearings of the prosthesis. Acetabular reaming increased stress within the pelvic bone and migration of the outer head. A combination of the acetabular reaming and bone transplantation increased the stress within the pelvic bone and grafted bone, and caused outer head migration. These findings were supported by clinical results. Although the bipolar endoprosthesis was biomechanically superior to the unipolar endoprosthesis, migration of the outer head still occurred. The bipolar endoprosthesis appeared to be indicated in cases of a femoral neck fracture or of avascular necrosis in the femoral head, but its use in cases of osteoarthritis in the hip required caution.

Anti-inflammatory and anti-granuloma activity of Berberis aristata DC. in experimental models of inflammation

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Kumar, Rohit; Gupta, Yogendra Kumar; Singh, Surender

2016-01-01

Objective: Berberis aristata (Berberidaceae) is an important medicinal plant used in traditional system of medicine for the treatment of rheumatoid arthritis and other inflammatory disorders. The aim of the present study is to scientifically validate the traditional use of BA in the treatment of inflammatory disorders. Materials and Methods: Anti-inflammatory and anti-granuloma activity of BA hydroalcoholic extract (BAHE) were evaluated in experimental models, viz., carrageenan-induced paw edema, cotton pellet-induced granuloma formation, and complete Freund's adjuvant-induced stimulation of peritoneal macrophages in rats. Expression of inflammatory mediators, viz., tumor necrosis factor-alpha (TNF-α), interleukin-1β (IL-1β), IL-6, IL-10, TNF-R1, and cyclooxygenase-2 (COX-2) was carried out in serum and peritoneal macrophages to derive the plausible mechanism of BAHE in activated peritoneal macrophages. Results: Pretreatment with BAHE produced a dose-dependent reduction (P < 0.01) in carrageenan-induced paw edema and cotton pellet-induced granuloma model. BAHE treatment produced significant (P < 0.01) reduction in serum inflammatory cytokine levels as compared to control. Protein expression of pro-inflammatory markers, IL-1β, IL-6, TNF-R1, and COX-2, was found to be reduced in stimulated macrophages whereas anti-inflammatory cytokine, IL-10, was upregulated in peritoneal macrophages. Conclusion: The result of the present study thus demonstrates the anti-inflammatory and anti-granuloma activity of BAHE which may be attributed to its inhibitory activity on macrophage-derived cytokine and mediators. PMID:27114638

High-precision measurements of cementless acetabular components using model-based RSA: an experimental study

DEFF Research Database (Denmark)

Baad-Hansen, Thomas; Kold, Søren; Kaptein, Bart L

2007-01-01

BACKGROUND: In RSA, tantalum markers attached to metal-backed acetabular cups are often difficult to detect on stereo radiographs due to the high density of the metal shell. This results in occlusion of the prosthesis markers and may lead to inconclusive migration results. Within the last few years...

A 3-dimensional in vitro model of epithelioid granulomas induced by high aspect ratio nanomaterials

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Hurt Robert H

2011-05-01

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

Cutaneous Silicone Granuloma Mimicking Breast Cancer after Ruptured Breast Implant

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Waseem Asim Ghulam El-Charnoubi

2011-01-01

Full Text Available Cutaneous manifestations due to migration of silicone from ruptured implants are rare. Migrated silicone with cutaneous involvement has been found in the chest wall, abdominal wall, and lower extremities. We describe a case of cutaneous silicone granuloma in the breast exhibiting unusual growth mimicking breast cancer after a ruptured implant.

Surgical treatment of acetabular fractures: clinical and radiological results and its complications

International Nuclear Information System (INIS)

Martinez, C; Rey, R.

2011-01-01

The objective of this work is to analyse a serie of consecutive cases of surigically treated acetabular fractures, evaluating middle-term clinical and radiological results. A retrospective analysis of clinical histories, surgical forms and X-rays was performed for 42 patients who underwent surgery in two centers (Instituto Nacional de Ortopedia y Traumatologia [INOT] and Banco de Protesis), from July 2001 through August 2007

Is radiation superior to indomethacin to prevent heterotopic ossification in acetabular fractures?: a systematic review.

NARCIS (Netherlands)

Blokhuis, T.J.; Frolke, J.P.M.

2009-01-01

Heterotopic ossification is a well-known complication after fixation of an acetabular fracture. Indomethacin and radiation therapy are used as prophylaxis to prevent heterotopic ossification. It is unclear, however, whether either is superior, although this may relate to lack of power in individual

T-helper cell type 17/regulatory T-cell immunoregulatory balance in human radicular cysts and periapical granulomas.

Science.gov (United States)

Marçal, Juliana R B; Samuel, Renata O; Fernandes, Danielle; de Araujo, Marcelo S; Napimoga, Marcelo H; Pereira, Sanivia A L; Clemente-Napimoga, Juliana T; Alves, Polyanna M; Mattar, Rinaldo; Rodrigues, Virmondes; Rodrigues, Denise B R

2010-06-01

Cysts and granulomas are chronic periapical lesions mediated by a set of inflammatory mediators that develop to contain a periapical infection. This study analyzed the nature of the inflammatory infiltrate, presence of mast cells, and in situ expression of cytokines (interleukin [IL]-17 and transforming growth factor [TGF]-beta), chemokines (macrophage inflammatory protein [MIP]-1beta and monocyte chemotactic protein [MCP]-1), and nuclear transcription factor (FoxP3) in human periapical granulomas and cysts compared with a control group. Fifty-five lesions (25 periapical cysts, 25 periapical granulomas, and 5 controls) were analyzed. The type of inflammatory infiltrate was evaluated by hematoxylin-eosin staining, and the presence of mast cells was analyzed by toluidine blue staining. Indirect immunohistochemistry was used to evaluate the expression of cytokines, chemokines, and FoxP3. The inflammatory infiltrate mainly consisted of mononuclear cells. In cysts, mononuclear infiltrates were significantly more frequent than mixed (polymorphonuclear/mononuclear) infiltrates (P = .04). Mixed inflammatory infiltrates were significantly more frequent in patients with sinus tract (P = .0001). The number of mast cells was significantly higher in granulomas than in cystic lesions (P = .02). A significant difference in the expression of IL-17 (P = .001) and TGF-beta (P = .003) was observed between cysts and granulomas and the control group. Significantly higher IL-17 levels were also observed in cases of patients with sinus tract (P = .03). We observed that chronic periapical lesions might experience a reagudization process that is correlated with an increased leukocyte infiltration, with the predominance of neutrophils attracted by a chemokine milieu, as well as the increased presence of IL-17. Copyright 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

[Acetabular anteversion angle of the hip in the Mexican adult population measured with computed tomography].

Science.gov (United States)

Rubalcava, J; Gómez-García, F; Ríos-Reina, J L

2012-01-01

Knowledge of the radiogrametric characteristics of a specific skeletal segment in a healthy population is of the utmost clinical importance. The main justification for this study is that there is no published description of the radiogrametric parameter of acetabular anteversion in a healthy Mexican adult population. A prospective, descriptive and cross-sectional study was conducted. Individuals of both genders older than 18 years and orthopedically healthy were included. They underwent a two-dimensional axial tomographic study of both hips to measure the acetabular anteversion angles. The statistical analysis consisted of obtaining central trend and scatter measurements. A multivariate analysis of variance (ANOVA) and statistical significance were performed. 118 individuals were studied, 60 males and 58 females, with a mean age of 47.7 +/- 16.7, and a range of 18-85 years. The anteversion of the entire group was 18.6 degrees + 4.1 degrees. Anteversion in males was 17.3 degrees +/- 3.5 degrees (10 degrees - 25 degrees) and in females 19.8 degrees +/- 4.7 degrees (10 degrees - 31 degrees). There were no statistically significant differences (p right and left anteversion in the entire group. However, there were statistically significant differences (p > or = 0.005) both in the right and left sides when males and females were compared. Our study showed that there are great variations in the anteversion ranges of a healthy population. When our results are compared with those published by other authors the mean of most measurements exceeds 15 degrees. This should be useful to make therapeutic decisions that involve acetabular anteversion.

Characterization of tuberculous granulomas in different stages of progression and associated tertiary lymphoid tissue in goats experimentally infected with Mycobacterium avium subsp. hominissuis.

Science.gov (United States)

Schinköthe, Jan; Köhler, Heike; Liebler-Tenorio, Elisabeth M

2016-08-01

Oral infection of goats with Mycobacterium avium subsp. hominissuis (MAH) resulted in a large variety of granulomas in organized gut-associated lymphatic tissues and intestinal lymph nodes. To characterize the cellular composition of granulomas, CD4(+), CD8(+), γδ, B lymphocytes and plasma, CD25(+), CD68(+), MHC-II(+), Ki67(+) and endothelial cells were labeled in consecutive frozen sections by immunohistochemistry and acid fast bacilli (AFB) by Kinyoun stain. Granulomas with extensive necrosis, little mineralization and variable numbers of AFB surrounded by many CD4(+) T cells, but only few epitheloid macrophages were observed in severely sick goats at 2-3mpi. They were interpreted as exuberant immune reaction. Organized granulomas with very few AFB were seen in clinically healthy goats at 13mpi. The necrotic cores were surrounded by a zone of granulomatous infiltrate with many epitheloid macrophages and few lymphocytes. This zone was initially wide and highly vascularized and became progressively smaller. It was enclosed by an increasing layer of connective tissue. All organized granulomas were surrounded by compartimentalized tertiary lymphoid tissue. The granulomas in experimental infection of goats with MAH reflect the heterogeneity of lesions seen in mycobacterial infections of humans and ruminants and are therefore valuable for comparative research. Copyright © 2016 Elsevier Ltd. All rights reserved.

Acetabular Reconstruction with the Burch-Schneider Antiprotrusio Cage and Bulk Allografts: Minimum 10-Year Follow-Up Results

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Dario Regis

2014-01-01

Full Text Available Reconstruction of severe pelvic bone loss is a challenging problem in hip revision surgery. Between January 1992 and December 2000, 97 hips with periprosthetic osteolysis underwent acetabular revision using bulk allografts and the Burch-Schneider antiprotrusio cage (APC. Twenty-nine patients (32 implants died for unrelated causes without additional surgery. Sixty-five hips were available for clinical and radiographic assessment at an average follow-up of 14.6 years (range, 10.0 to 18.9 years. There were 16 male and 49 female patients, aged from 29 to 83 (median, 60 years, with Paprosky IIIA (27 cases and IIIB (38 cases acetabular bone defects. Nine cages required rerevision because of infection (3, aseptic loosening (5, and flange breakage (1. The average Harris hip score improved from 33.1 points preoperatively to 75.6 points at follow-up (P<0.001. Radiographically, graft incorporation and cage stability were detected in 48 and 52 hips, respectively. The cumulative survival rates at 18.9 years with removal for any reason or X-ray migration of the cage and aseptic or radiographic loosening as the end points were 80.0% and 84.6%, respectively. The use of the Burch-Schneider APC and massive allografts is an effective technique for the reconstructive treatment of extensive acetabular bone loss with long-lasting survival.

[One-stage operation for pelvis and acetabular fractures combined with Morel-Lavallée injury by internal fixation associated with vacuum sealing drainage].

Science.gov (United States)

Wei, Dan; Wang, Yue; Yuan, Jiabin; Tang, Xiaoming; Zhang, Bin; Lu, Bing; Tan, Bo

2014-01-01

To investigate the methods and effectiveness of one-stage operation for pelvis and acetabular fractures combined with Morel-Lavallée injury by internal fixation associated with vacuum sealing drainage (VSD). Between June 2008 and October 2012, 15 cases of pelvis and acetabular fractures combined with Morel-Lavallée injury were treated. There were 5 males and 10 females, aged from 18 to 67 years (mean, 36.8 years). Fractures were caused by traffic accident in 11 cases and crashing injury of heavy object in 4 cases. The time from injury to hospitalization was 3 hours to 9 days (mean, 5.4 days). Morel-Lavallée injury located in the above posterior superior iliac spine in 4 cases, greater trochanter in 7 cases, and anterior proximal thigh in 4 cases. In 10 cases complicated by pelvic fracture, there were 1 case of anteroposterior compression type, 3 cases of lateral compression type, 5 cases of vertical shear type, and 1 case of compound injury type; in 5 cases complicated by acetabular fracture, there were 1 case of transverse fracture, 1 case of posterior wall and posterior column fracture, 1 case of transverse acetabulum plus posterior wall fracture, and 2 cases of both columns fracture. Open reduction and internal fixation were used to treat pelvic and acetabular fractures, and VSD to treat Morel-Lavallée injury. When the drainage volume was less than 20 mL/d, interrupted wound suture or free skin grafting was performed. The hospitalization time was 16-31 days (mean, 20.8 days). Thirteen cases were followed up 4-16 months (mean, 7.8 months). The healing time of Morel-Lavallée injury was 16-36 days after operation (mean, 21.3 days). All the wounds had primary healing, and no infection occurred. The X-ray films showed that all fractures healed, with a mean healing time of 13.6 weeks (range, 11-18 weeks). At 6.5 months after operation, according to Majeed function scoring system in 8 cases of pelvic fracture, the results were excellent in 5 cases, good in 2 cases

Preshipment testing success: resolution of a nasal sinus granuloma in a captive koala (Phascolarctos cinereus) caused by Cryptococcus gattii.

Science.gov (United States)

Wynne, Janna; Klause, Stephen; Stadler, Cynthia K; Pye, Geoffrey W; Meyer, Wieland; Sykes, Jane E

2012-12-01

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.

Tolosa-Hunt syndrome: is it really necessary to show granuloma? - The report of eight cases

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Podgorac Ana

2017-01-01

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.

Contribution of magnetic resonance imaging to the diagnosis of eosinophilic granuloma in children

International Nuclear Information System (INIS)

Gaucher, H.; Arnould, V.; Leblan, I.; Mainard, L.; Chastagner, P.; Galloy, M.A.; Hoeffel, J.C.

1995-01-01

Magnetic resonance imaging (MRI) findings in 12 patients with biopsy-proven eosinophilic granuloma were studied retrospectively. Signal intensity was variable on T1 images and increased on T2 images and after gadolinium injection. Magnetic resonance imaging identified all the granulomas, as well as accompanying bone marrow and soft tissue changes. In all 12 cases, the lesion appeared larger on MRI displays than on plain roentgenograms. MRI findings had low specificity and consistently tended to overestimate tumor spread, especially when a long limb bone was affected. Chemotherapy was followed by changes in the size and shape of MRI lesions (loss of the high-intensity signal on T2 images and after gadolinium) suggestive of a favorable response to treatment. (authors). 12 refs., 16 figs

Detection and quantification of mast cell, vascular endothelial growth factor, and microvessel density in human inflammatory periapical cysts and granulomas.

Science.gov (United States)

Fonseca-Silva, T; Santos, C C O; Alves, L R; Dias, L C; Brito, M; De Paula, A M B; Guimarães, A L S

2012-09-01

To identify and quantify mast cell (MC), vascular endothelial growth factor (VEGF) expression and microvessel density (MVD) in human periapical cysts and granulomas. Archived samples of cysts (n = 40) and granulomas (n = 28) were sectioned and stained with toluidine blue. MCs were identified and counted. Immunohistochemical reactions were employed to evaluate the tissue expression of VEGF and vessels. MVD was estimated by determining the areas of tissue labelled with CD31 antibody. The data were analysed using the Mann-Whitney test (P cysts than in granulomas (P cysts. Moreover, the identification of VEGF and MVD was consistent with the immune mechanisms involved in the lesions. © 2012 International Endodontic Journal.

A Foreign Body Granuloma of the Buccal Mucosa Induced by Honeybee Sting

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Kazuhiko Yamamoto

2017-01-01

Full Text Available A foreign body granuloma of the buccal mucosa induced by honeybee sting was reported. The patient was an 82-year-old female who presented with a submucous mass at the right buccal mucosa. The mass was 20 mm in diameter, elastically firm, partly mobile without pain or tenderness, and covered with almost normal mucosa. MR image did not delineate the lesion clearly. Under clinical diagnosis of a benign tumor, the lesion was excised under local anesthesia. The excised lesion was 14×11×9 mm in size and solid and yellowish in cut surface. Histologically, the lesion consisted of granulomatous tissue with a few narrow, curved, eosinophilic structures compatible with decomposed fragments of a honeybee sting and was diagnosed as a foreign body granuloma, although the patient did not recall being stung.

Alopecia with foreign body granulomas induced by Radiesse injection: A case report.

Science.gov (United States)

Liu, Ren-Feng; Kuo, Tseng-Tong; Chao, Yen-Yu; Huang, Yu-Huei

2018-02-26

Radiesse is a soft tissue filler which has been widely used for cosmetic enhancement. The safety of Radiesse has been thoroughly investigated via numerous studies. A late-onset complication of Radiesse injection consists of foreign body granulomas, with only three case reports in over 10 years of clinical use. Herein, we describe the case of a patient who experienced alopecia with foreign body granulomas at the injection region one month after receiving a Radiesse injection. To our knowledge, this is the first report in the English literature of alopecia as an adverse event associated with Radiesse injection. The present case reminded physicians to evaluate more cautiously the necessity of injecting filler into hair-bearing area for lifting purpose. This procedure may cause foreign body granulomatous reaction, which may result in hair loss at the injection region.

Immunoexpression of tryptase-positive mast cells in periapical granulomas and radicular cysts.

Science.gov (United States)

Costa Neto, H; de Andrade, A L D L; Gordón-Núñez, M A; Freitas, R de A; Galvão, H C

2015-08-01

To evaluate and compare the immunoexpression of tryptase in samples of periapical granulomas (PGs) and radicular cysts (RCs) correlating it with the type of lesion, localization, intensity of the inflammatory infiltrate and thickness of the cystic epithelial lining, in order to gain insight into the phlogistic role of these cells in the lesions studied. Twenty-five PGs and twenty-five RCs obtained from human teeth without endodontic treatment were submitted to morphological and immunohistochemical analysis using anti-tryptase antibody. Mast cells were identified and counted in three regions: intra-epithelial, central/superficial and deep portions. The data were analysed using the Mann-Whitney U-test (P periapical lesions in a larger number in periapical granulomas than in radicular cysts, in both central/superficial and deep regions. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Effect of acetabular cup abduction angle on wear of ultrahigh-molecular-weight polyethylene in hip simulator testing.

Science.gov (United States)

Korduba, Laryssa A; Essner, Aaron; Pivec, Robert; Lancin, Perry; Mont, Michael A; Wang, Aiguo; Delanois, Ronald E

2014-10-01

The effect of acetabular component positioning on the wear rates of metal-on-polyethylene articulations has not been extensively studied. Placement of acetabular cups at abduction angles of more than 40° has been noted as a possible reason for early failure caused by increased wear. We conducted a study to evaluate the effects of different acetabular cup abduction angles on polyethylene wear rate, wear area, contact pressure, and contact area. Our in vitro study used a hip joint simulator and finite element analysis to assess the effects of cup orientation at 4 angles (0°, 40°, 50°, 70°) on wear and contact properties. Polyethylene bearings with 28-mm cobalt-chrome femoral heads were cycled in an environment mimicking in vivo joint fluid to determine the volumetric wear rate after 10 million cycles. Contact pressure and contact area for each cup abduction angle were assessed using finite element analysis. Results were correlated with cup abduction angles to determine if there were any differences among the 4 groups. The inverse relationship between volumetric wear rate and acetabular cup inclination angle demonstrated less wear with steeper cup angles. The largest abduction angle (70°) had the lowest contact area, largest contact pressure, and smallest head coverage. Conversely, the smallest abduction angle (0°) had the most wear and most head coverage. Polyethylene wear after total hip arthroplasty is a major cause of osteolysis and aseptic loosening, which may lead to premature implant failure. Several studies have found that high wear rates for cups oriented at steep angles contributed to their failure. Our data demonstrated that larger cup abduction angles were associated with lower, not higher, wear. However, this potentially "protective" effect is likely counteracted by other complications of steep cup angles, including impingement, instability, and edge loading. These factors may be more relevant in explaining why implants fail at a higher rate if

A case of recurrence-mimicking charcoal granuloma in a breast cancer patient: Ultrasound,CT, PET/CT and breast-specific gamma imaging findings

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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)

2016-07-15

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.

Acetabular labral tears: contrast-enhanced MR imaging under continuous leg traction

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Nishii, T. [Div. of Functional Diagnostic Imaging, Biomedical Research Center, Osaka Univ. Medical School, Suita (Japan); Nakanishi, K. [Dept. of Radiology, Osaka Univ. Medical School, Suita (Japan); Sugano, N. [Dept. of Orthopaedic Surgery, Osaka Univ. Medical School, Suita (Japan); Naito, H. [Div. of Functional Diagnostic Imaging, Biomedical Research Center, Osaka Univ. Medical School, Suita (Japan); Tamura, S. [Div. of Functional Diagnostic Imaging, Biomedical Research Center, Osaka Univ. Medical School, Suita (Japan); Ochi, T. [Dept. of Orthopaedic Surgery, Osaka Univ. Medical School, Suita (Japan)

1996-05-01

The objective of this study was to evaluate the effects of continuous leg traction on contrast-enhanced MR imaging of the hip joint and to determine whether MR imaging under these conditions is useful for demonstrating acetabular labral tears. Nineteen hips underwent MR imaging with a T1-weighted spin-echo sequence, followed by MR imaging under continuous leg traction after intravenous injection of gadolinium-DTPA. Joint fluid enhancement and labral contour detection were evaluated. Eleven hips had labral tears shown by conventional arthrography, arthroscopy and macroscopic surgical findings. Assessment of labral tears by MR imaging was correlated with the diagnosis based on these standard techniques. Joint fluid enhancement was obtained in all hips at 30 min after injection. Superior and inferior labral surfaces were completely delineated in 1 hip on the unenhanced MR images, and in 7 and 13 hips, respectively, on the enhanced images under traction. The enhanced images under traction depicted 9 of the 11 labral tears. Comparison between the unenhanced image and the enhanced image under traction avoided mistaking undercutting of the labrum for a tear in 4 hips. Contrast-enhanced MR imaging under traction was valuable for detecting labral tears non-invasively and without radiation. Follow-up examinations using this method in patients with acetabular dysplasia can help to clarify the natural course of labral disorders and enable better treatment planning. (orig./MG)

Surgical treatment of isolated aseptic acetabular loosening of the hip joint

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Zvereva К.Р.

2017-09-01

Full Text Available Aseptic acetabular loosening is one of the most common complications of primary hip arthroplasty Its treatment is possible in the volume of replacement of only the endoprosthesis cup with the preservation of a stable correctly oriented femoral component. The sequence of actions consists of provision of access to the acetabulum component and its replacement, after which the necessary offset is selected by changing the size of the head and installing a new pair of friction. Currently, the vast majority of the installed heads during the primary and revision hip replacement have a standard size forthe cone of the femoral component 12/14mm. According to the observations, in 3% of cases, there are femoral components with non-standard cone sizes 11/13 mm, usually established 7-8 years ago. The absence of heads forthe necessary cone leads to the need to replace the stable correctly oriented femoral component, which is accompanied by an increase in the time of intervention, the volume of intraoperative blood loss and the risk of intraopera-tive peri-prosthetic fracture. We represent the clinical case of a 75-year-old patient with a dislocation of the acetabular component and a stable correctly oriented femoral component, which during the audit intervention due to the lack of heads for an irregular cone size, total replacement of the components was made.

Hyalinizing Granuloma: An Unusual Case of a Pulmonary Mass

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Viviane Brandão

2010-01-01

Full Text Available We describe the case of pulmonary hyalinizing granuloma in a 34-year-old asymptomatic man who presented with a pulmonary nodule apparent by chest radiography and computed tomography (CT. He had a history of previous treatment for tuberculosis. His laboratory data were normal. Bronchoscopy and CT-guided percutaneous transthoracic fine needle aspiration cytology were inconclusive. The diagnosis was revealed after the histopathological examination of an open lung biopsy.

Eosinophilic granuloma of bone in children

International Nuclear Information System (INIS)

Leblan, I.; Gaucher, H.; Hoeffel, J.C.; Arnould, V.; Galloy, M.A.; Mainard, L.

1995-01-01

Eosinophilic granuloma of bone or Langerhans cell histiocytosis is mostly unifocal. It appears on plain X Ray as a solitary destructive lesion of long bones or flat bones. Computerized tomography (CT) is useful to define the extension to the cortical bone and also to precisely localize the lesion when the anatomy is complex (hip, spine, base of the skull). Magnetic resonance (MR) is very useful in case of more aggressive lesions when there is extension to soft tissues. Differential diagnosis includes circumscribed osteitis and tumors in the case of extensive destruction. The natural course of solitary lesions is favorable, spontaneously or with therapy. The prognosis is more serious in the case of multiple lesions. (authors)

Role of radiotherapy in the treatment of granuloma gangraenescens (lethal midline granuloma)

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Sack, H; Horch, H H; Schaefer, H E; Wustrow, F

1984-02-01

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.

The effect of variable size posterior wall acetabular fractures on contact characteristics of the hip joint.

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Olson, S A; Bay, B K; Pollak, A N; Sharkey, N A; Lee, T

1996-01-01

The indications for open reduction and internal fixation of posterior wall acetabular fractures associated with a clinically stable hip joint are unclear. In previous work a large posterior wall defect (27% articular surface area) resulted in significant alteration of load transmission across the hip; specifically, there was a transition from evenly distributed loading along the acetabular articular surface to loading concentrated mainly in the superior portion of the articular surface during simulated single leg stance. However, the majority of posterior wall fractures involve a smaller amount of the articular surface. Posterior wall acetabular fractures not associated with instability of the hip are commonly treated nonoperatively. This practice does not account for the size of the posterior wall fracture. To study the biomechanical consequences of variably sized articular defects, a laboratory experiment was conducted evaluating three progressively larger posterior wall defects of the acetabulum during simulated single leg stance using superlow Fuji prescale film (Itochu International, New York): (a) 1/3 articular surface width through a 50 degrees arc along the posterior wall of the acetabulum, (b) 2/3, and (c) 3/3 articular width defects through the same 50 degrees arc along the posterior wall of the acetabulum. In the intact acetabulum, 48% of the total articular contact was located in the superior acetabulum. Twenty-eight percent of articular contact was in the anterior wall region of the acetabulum and 24% in the posterior wall region. After the 1/3 width posterior wall defect, 64% of the articular contact was located in the superior acetabulum (p = 0.0011). The 2/3 width posterior wall defect resulted in 71% of articular contact area being located in the superior acetabulum (p = 0.0006). After the 3/3 width posterior wall defect, 77% of articular contact was located in the superior acetabulum, significantly greater than the intact condition (p < 0

Percutaneous Fixation of Anterior Column Acetabular Fracture in a Renal Transplant Recipient

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Halil Ceylan

2013-01-01

Full Text Available Renal transplantation, performed per million population, ranges from 30 to 60 in developed countries. The transplanted kidney is generally placed in iliac fossa; therefore the treatment procedure of the pelvic trauma in these patients should be selected carefully. The gold standard technique for the treatment of displaced acetabulum fractures is open reduction and internal fixation. Our patient had received a living-related-donor renal transplant due to chronic renal failure. In the second year of transplantation, she had been injured in a motor-vehicle accident, and radiographs showed a right acetabular anterior column fracture and left pubic rami fractures. The patient was treated with percutaneous fixation techniques and at one year of postoperative period there was no evidence of degenerative signs and the clinical outcome was good. Beside having the advantage of avoiding dissection through the iliac fossa by the standard ilioinguinal approach, percutaneous techniques, with shorter surgical time, decreasing soft tissue disruption, and the potential for early discharge from hospital might be ideal for a renal transplant recipient carrying a higher risk of infection. Percutaneous fixation of selected acetabular fractures in a renal transplant recipient would presumably have the potential to decrease the morbidity associated with traditional open surgical procedures.

Acetabular reconstruction with human and bovine freeze-dried bone grafts and a reinforcement device

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Ricardo Rosito

2008-01-01

Full Text Available BACKGROUND: This is a cohort trial (1997-2005 of 49 patients submitted to an acetabular component revision of a total hip arthroplasty, using impacted human and bovine freeze-dried cancellous bone grafts (H&FDBG and a reinforcement device. OBJECTIVE: To compare clinical/radiographic graft incorporation capability between cancellous bone grafts. PATIENTS/METHODS: There were two groups: I (n=26 receiving human grafts and II (n=25 receiving bovine grafts. The average follow-up times were 55 and 49 months, respectively. Clinical analysis was based on the Merle d'Aubigné and Postel score, and the radiographic analysis involved an established score based on Conn's et al. criteria for radiographic bone incorporation. RESULTS: No clinical/radiographic differences were found between the groups and both showed an overall rate of 88.5% and 76% of graft incorporation (p=0.424. CONCLUSION: The results presented here are comparable to those in the literature with the use of deep-FG. Therefore, cancellous bone grafts can be safely and adequately used in acetabular component revision in total hip arthroplasty.

Dynamic 11C-methionine PET analysis has an additional value for differentiating malignant tumors from granulomas: an experimental study using small animal PET

International Nuclear Information System (INIS)

Zhao, Songji; Zhao, Yan; Kuge, Yuji; Hatano, Toshiyuki; Yi, Min; Kohanawa, Masashi; Magota, Keiichi; Tamaki, Nagara; Nishijima, Ken-ichi

2011-01-01

We evaluated whether the dynamic profile of L- 11 C-methionine ( 11 C-MET) may have an additional value in differentiating malignant tumors from granulomas in experimental rat models by small animal positron emission tomography (PET). Rhodococcus aurantiacus and allogenic rat C6 glioma cells were inoculated, respectively, into the right and left calf muscles to generate a rat model bearing both granulomas and tumors (n = 6). Ten days after the inoculations, dynamic 11 C-MET PET was performed by small animal PET up to 120 min after injection of 11 C-MET. The next day, after overnight fasting, the rats were injected with 18 F-2-deoxy-2-fluoro-D-glucose ( 18 F-FDG), and dynamic 18 F-FDG PET was performed up to 180 min. The time-activity curves, static images, and mean standardized uptake value (SUV) in the lesions were calculated. 11 C-MET uptake in the granuloma showed a slow exponential clearance after an initial distribution, while the uptake in the tumor gradually increased with time. The dynamic pattern of 11 C-MET uptake in the granuloma was significantly different from that in the tumor (p 11 C-MET, visual assessment and SUV analysis could not differentiate the tumor from the granuloma in all cases, although the mean SUV in the granuloma (1.48 ± 0.09) was significantly lower than that in the tumor (1.72 ± 0.18, p 18 F-FDG in the granuloma were similar to those in the tumor (p = NS). Dynamic 11 C-MET PET has an additional value for differentiating malignant tumors from granulomatous lesions, which deserves further elucidation in clinical settings. (orig.)

Differentiation of periapical granulomas and cysts by using dental MRI: a pilot study.

Science.gov (United States)

Juerchott, Alexander; Pfefferle, Thorsten; Flechtenmacher, Christa; Mente, Johannes; Bendszus, Martin; Heiland, Sabine; Hilgenfeld, Tim

2018-05-17

The purpose of this pilot study was to evaluate whether periapical granulomas can be differentiated from periapical cysts in vivo by using dental magnetic resonance imaging (MRI). Prior to apicoectomy, 11 patients with radiographically confirmed periapical lesions underwent dental MRI, including fat-saturated T2-weighted (T2wFS) images, non-contrast-enhanced T1-weighted images with and without fat saturation (T1w/T1wFS), and contrast-enhanced fat-saturated T1-weighted (T1wFS+C) images. Two independent observers performed structured image analysis of MRI datasets twice. A total of 15 diagnostic MRI criteria were evaluated, and histopathological results (6 granulomas and 5 cysts) were compared with MRI characteristics. Statistical analysis was performed using intraclass correlation coefficient (ICC), Cohen's kappa (κ), Mann-Whitney U-test and Fisher's exact test. Lesion identification and consecutive structured image analysis was possible on T2wFS and T1wFS+C MRI images. A high reproducibility was shown for MRI measurements of the maximum lesion diameter (intraobserver ICC = 0.996/0.998; interobserver ICC = 0.997), for the "peripheral rim" thickness (intraobserver ICC = 0.988/0.984; interobserver ICC = 0.970), and for all non-quantitative MRI criteria (intraobserver-κ = 0.990/0.995; interobserver-κ = 0.988). In accordance with histopathological results, six MRI criteria allowed for a clear differentiation between cysts and granulomas: (1) outer margin of lesion, (2) texture of "peripheral rim" in T1wFS+C, (3) texture of "lesion center" in T2wFS, (4) surrounding tissue involvement in T2wFS, (5) surrounding tissue involvement in T1wFS+C and (6) maximum "peripheral rim" thickness (all: P periapical cysts and granulomas in vivo. Thus, MRI may substantially improve treatment strategies and help to avoid unnecessary surgery in apical periodontitis.

Quantitave and qualitative interferences of pentoxifillyne on hepatic Schistosoma mansoni granulomas: effects on extracellular matrix and eosinophil population

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Luis Felipe Reis

2001-09-01

Full Text Available Mast cells and eosinophils actively participate in tissue repair and are prominent components of Schistosoma mansoni granulomas. Since pentoxifillyne (PTX is an immunomodulatory and antifibrotic substance, we aimed to characterize, by morphological techniques, the effect of this drug on fibrosis developed inside murine hepatic schistosomal granulomatous reaction, beyond the quantification of eosinophil and mast cell populations. The drug (1 mg/100 g animal weight was administrated from 35 to 90 days post-infection, when the animals were killed. The intragranulomatous interstitial collagen network was analyzed by confocal laser scanning microscopy, the number of eosinophils and mast cells was quantified and the results were validated by t-student test. Treatment did not interfere on the granuloma evolution but caused a significant decrease in the total and involutive number of hepatic granulomas (p = 0.01 and 0.001, respectivelly, and in the intragranulomatous accumulation of eosinophils (p = 0.0001. Otherwise, the number of mast cells was not significantly altered (p = 0.9; however, it was positively correlated with the number of granulomatous structures (r = 0.955. In conclusion, PTX does not affect development and collagen deposition in S. mansoni murine granuloma, but decreases the intragranulomatous eosinophil accumulation possibly due to its immunomodulatory capability, interfering in cellular recruitment and/or differentiation.

Use of a constrained tripolar acetabular liner to treat intraoperative instability and postoperative dislocation after total hip arthroplasty: a review of our experience.

Science.gov (United States)

Callaghan, John J; O'Rourke, Michael R; Goetz, Devon D; Lewallen, David G; Johnston, Richard C; Capello, William N

2004-12-01

Constrained acetabular components have been used to treat certain cases of intraoperative instability and postoperative dislocation after total hip arthroplasty. We report our experience with a tripolar constrained component used in these situations since 1988. The outcomes of the cases where this component was used were analyzed for component failure, component loosening, and osteolysis. At average 10-year followup, for cases treated for intraoperative instability (2 cases) or postoperative dislocation (4 cases), the component failure rate was 6% (6 of 101 hips in 5 patients). For cases where the constrained liner was cemented into a fixed cementless acetabular shell, the failure rate was 7% (2 of 31 hips in 2 patients) at 3.9-year average followup. Use of a constrained liner was not associated with an increased osteolysis or aseptic loosening rate. This tripolar constrained acetabular liner provided total hip arthroplasty construct stability in most cases in which it was used for intraoperative instability or postoperative dislocation.

Radiographic features of central giant cell granuloma of the jaws in children

International Nuclear Information System (INIS)

Bodner, L.; Bar-Ziv, J.

1996-01-01

The radiographic features of ten pediatric cases of central giant cell granuloma of the jaws were studied, using plain film radiography (PFR), computed tomography (CT), and a dental CT software program (DS). The radiologic features varied from ill-defined destructive lesions to a well-defined, multilocular appearance. Teeth or root displacement was found as the most consistent feature. Root resorption was rare. The features seen on CT were clearer than those seen on PFR. DS, by its visualization of the jaw in three plans - axial, panoramic, and buccolingual - provided useful information for determining the topography of the lesion in its structure (uni- or multilocular) and proximity to adjacent anatomic structures, such as teeth, nerves, or maxillary sinus. CT and, ideally, CT with DS should be used for diagnosis and surgical management of central giant cell granuloma of the jaws in children. (orig.). With 3 figs., 1 tab

Radiographic features of central giant cell granuloma of the jaws in children

Energy Technology Data Exchange (ETDEWEB)

Bodner, L. [Department of Oral and Maxillofacial Surgery, Soroka Medical Center, P. O. Box 151, Beer-Sheva 84101 (Israel); Bar-Ziv, J. [Department of Radiology, Hebrew University and Hadassah School of Medicine, Jerusalem (Israel)

1996-02-01

The radiographic features of ten pediatric cases of central giant cell granuloma of the jaws were studied, using plain film radiography (PFR), computed tomography (CT), and a dental CT software program (DS). The radiologic features varied from ill-defined destructive lesions to a well-defined, multilocular appearance. Teeth or root displacement was found as the most consistent feature. Root resorption was rare. The features seen on CT were clearer than those seen on PFR. DS, by its visualization of the jaw in three plans - axial, panoramic, and buccolingual - provided useful information for determining the topography of the lesion in its structure (uni- or multilocular) and proximity to adjacent anatomic structures, such as teeth, nerves, or maxillary sinus. CT and, ideally, CT with DS should be used for diagnosis and surgical management of central giant cell granuloma of the jaws in children. (orig.). With 3 figs., 1 tab.

SURGICAL TREATMENT AND RECONSTRUCTION FOR CENTRAL GIANT CELL GRANULOMA OF MANDIBLE - case report and literature review.

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Elitsa G. Deliverska

2013-11-01

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.

Usefulness of Arthroscopic Treatment of Painful Hip after Acetabular Fracture or Hip Dislocation.

Science.gov (United States)

Hwang, Jung-Taek; Lee, Woo-Yong; Kang, Chan; Hwang, Deuk-Soo; Kim, Dong-Yeol; Zheng, Long

2015-12-01

Painful hip following hip dislocation or acetabular fracture can be an important signal for early degeneration and progression to osteoarthritis due to intraarticular pathology. However, there is limited literature discussing the use of arthroscopy for the treatment of painful hip. The purpose of this retrospective study was to analyze the effectiveness and benefit of arthroscopic treatment for patients with a painful hip after major trauma. From July 2003 to February 2013, we reviewed 13 patients who underwent arthroscopic treatment after acetabular fracture or hip dislocation and were followed up for a minimum of 2 postoperative years. The degree of osteoarthritis based on the Tonnis classification pre- and postoperatively at final follow-up was determined. Clinical outcomes were evaluated using visual analogue scale for pain (VAS) and modified Harris hip score (MHHS), and range of motion (ROM) of the hip pre- and postoperatively at final follow-up. There were nine male and four female patients with a mean age at surgery of 28 years (range, 20 to 50 years). The mean follow-up period of the patients was 59.8 months (range, 24 to 115 months), and the mean interval between initial trauma and arthroscopic treatment was 40.8 months (range, 1 to 144 months). At the final follow-up, VAS and MHHS improved significantly from 6.3 and 53.4 to 3.0 and 88.3, respectively (p = 0.002 and p hip flexion, abduction, adduction, external rotation, and internal rotation as minor improvements from 113.1°, 38.5°, 28.5°, 36.5°, and 22.7° to 118.5°, 39.0°, 29.2°, 38.9°, and 26.5° were observed, respectively (p = 0.070, p = 0.414, p = 0.317, p = 0.084, and p = 0.136, respectively). None of the patients exhibited progression of osteoarthritis of the hip at the final follow-up. Arthroscopic treatment after acetabular fracture or hip dislocation is effective and delays the progression of traumatic osteoarthritis.

[Correlation analysis between residual displacement and hip function after reconstruction of acetabular fractures].

Science.gov (United States)

Ma, Kunlong; Fang, Yue; Luan, Fujun; Tu, Chongqi; Yang, Tianfu

2012-03-01

To investigate the relationships between residual displacement of weight-bearing and non weight-bearing zones (gap displacement and step displacement) and hip function by analyzing the CT images after reconstruction of acetabular fractures. The CT measures and clinical outcome were retrospectively analyzed from 48 patients with displaced acetabular fracture between June 2004 and June 2009. All patients were treated by open reduction and internal fixation, and were followed up 24 to 72 months (mean, 36 months); all fractures healed after operation. The residual displacement involved the weight-bearing zone in 30 cases (weight-bearing group), and involved the non weight-bearing zone in 18 cases (non weight-bearing group). The clinical outcomes were evaluated by Merle d'Aubigné-Postel criteria, and the reduction of articular surface by CT images, including the maximums of two indexes (gap displacement and step displacement). All the data were analyzed in accordance with the Spearman rank correlation coefficient analysis. There was strong negative correlation between the hip function and the residual displacement values in weight-bearing group (r(s) = -0.722, P = 0.001). But there was no correlation between the hip function and the residual displacement values in non weight-bearing group (r(s) = 0.481, P = 0.059). The results of clinical follow-up were similar to the correlation analysis results. In weight-bearing group, the hip function had strong negative correlation with step displacement (r(s) = 0.825, P = 0.002), but it had no correlation with gap displacement (r(s) = 0.577, P = 0.134). In patients with acetabular fracture, the hip function has correlation not only with the extent of the residual displacement but also with the location of the residual displacement, so the residual displacement of weight-bearing zone is a key factor to affect the hip function. In patients with residual displacement in weight-bearing zone, the bigger the step displacement is, the

Should money follow the patient: Financial implication for being the National Centre for the Treatment and Management of Pelvic and Acetabular Fractures in Ireland.

LENUS (Irish Health Repository)

Kelly, M E

2013-03-13

BACKGROUND: Pelvic and acetabular fractures are complex injuries requiring specialist treatment. Our institution is the National Centre for Treatment and Management of these injuries. AIM: To audit all referrals to our institution over a 6-month period and calculate the cost incurred by being the national referral centre. METHODS: Retrospective review of database, and subsequent allocation of Casemix points to assess total cost of treatment for each patient referred to our institution. RESULTS: 103 patients referred with pelvic or acetabular fracture for operative management. The furthest referral distance was 181miles. Over-all, the length of stay was 15.4 days. The average inclusive cost for a referral to our unit for operative management was €16,302. CONCLUSION: Pelvic and acetabular fractures are complex injuries that require specialist referral unit management. However for these units to remain sustainable money needs to "follow the patient".

Effects of Titanium Mesh Surfaces-Coated with Hydroxyapatite/β-Tricalcium Phosphate Nanotubes on Acetabular Bone Defects in Rabbits

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Thuy-Duong Thi Nguyen

2017-07-01

Full Text Available The management of severe acetabular bone defects in revision reconstructive orthopedic surgery is challenging. In this study, cyclic precalcification (CP treatment was used on both nanotube-surface Ti-mesh and a bone graft substitute for the acetabular defect model, and its effects were assessed in vitro and in vivo. Nanotube-Ti mesh coated with hydroxyapatite/β-tricalcium phosphate (HA/β-TCP was manufactured by an anodizing and a sintering method, respectively. An 8 mm diameter defect was created on each acetabulum of eight rabbits, then treated by grafting materials and covered by Ti meshes. At four and eight weeks, postoperatively, biopsies were performed for histomorphometric analyses. The newly-formed bone layers under cyclic precalcified anodized Ti (CP-AT meshes were superior with regard to the mineralized area at both four and eight weeks, as compared with that under untreated Ti meshes. Active bone regeneration at 2–4 weeks was stronger than at 6–8 weeks, particularly with treated biphasic ceramic (p < 0.05. CP improved the bioactivity of Ti meshes and biphasic grafting materials. Moreover, the precalcified nanotubular Ti meshes could enhance early contact bone formation on the mesh and, therefore, may reduce the collapse of Ti meshes into the defect, increasing the sufficiency of acetabular reconstruction. Finally, cyclic precalcification did not affect bone regeneration by biphasic grafting materials in vivo.

Profundization of acetabular cup uncemented in total substitution of hip in-patient with acetabular dysplasia - Experience university hospital - Clinica San Rafael

International Nuclear Information System (INIS)

Dimian Mayorga, Omar David; Sandoval Daza, Alejandro; Vargas Turriago, Marcela; Perez Torres, Javier

2005-01-01

14 patients with acetabular dysplasia were treated at Hospital Universitario Clinica San Rafael with total hip arthroplasty with uncemented cup internization. According to Crowe classification, one was type 1, eight were type 2 and five were type 3. The average follow up was twenty-four months. The Harris hip score was used for the clinical evaluation with a pre operative average of 35 points and 37 points post operative. The average cup internization was four millimeters, with an average cup protrutio of 47% and an average of cup coverage of 81%. The average internization of the femoral head's center was 26mm. screws for cup fixation were used in 3 patients. We did not have complications nor implant revision at the time of follow up

The Extracellular Matrix Regulates Granuloma Necrosis in Tuberculosis.

Science.gov (United States)

Al Shammari, Basim; Shiomi, Takayuki; Tezera, Liku; Bielecka, Magdalena K; Workman, Victoria; Sathyamoorthy, Tarangini; Mauri, Francesco; Jayasinghe, Suwan N; Robertson, Brian D; D'Armiento, Jeanine; Friedland, Jon S; Elkington, Paul T

2015-08-01

A central tenet of tuberculosis pathogenesis is that caseous necrosis leads to extracellular matrix destruction and bacterial transmission. We reconsider the underlying mechanism of tuberculosis pathology and demonstrate that collagen destruction may be a critical initial event, causing caseous necrosis as opposed to resulting from it. In human tuberculosis granulomas, regions of extracellular matrix destruction map to areas of caseous necrosis. In mice, transgenic expression of human matrix metalloproteinase 1 causes caseous necrosis, the pathological hallmark of human tuberculosis. Collagen destruction is the principal pathological difference between humanised mice and wild-type mice with tuberculosis, whereas the release of proinflammatory cytokines does not differ, demonstrating that collagen breakdown may lead to cell death and caseation. To investigate this hypothesis, we developed a 3-dimensional cell culture model of tuberculosis granuloma formation, using bioelectrospray technology. Collagen improved survival of Mycobacterium tuberculosis-infected cells analyzed on the basis of a lactate dehydrogenase release assay, propidium iodide staining, and measurement of the total number of viable cells. Taken together, these findings suggest that collagen destruction is an initial event in tuberculosis immunopathology, leading to caseous necrosis and compromising the immune response, revealing a previously unappreciated role for the extracellular matrix in regulating the host-pathogen interaction. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Granuloma macular por tuberculose sem manifestação pulmonar

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Albert Costa Rebello

2015-08-01

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.

Circumscribed cicatricial alopecia due to localized sarcoidal granulomas and single-organ granulomatous arteritis: a case report and systematic review of sarcoidal vasculitis.

Science.gov (United States)

Yazdani Abyaneh, Mohammad-Ali; Raghu, Preethi; Kircher, Kenneth; Kutzner, Heinz; Kortz, Alison; Carlson, John Andrew

2015-10-01

Vasculitis associated with sarcoid granulomas is an uncommon phenomenon. A 72-year-old female presented with an expanding region of circumscribed alopecia and scalp atrophy of 2 months duration. Biopsy showed non-caseating granulomas, dermal thinning, loss of follicles, fibrosis and muscular vessels disrupted by mixed lymphocyte, macrophage and giant-cell infiltrates. Affected vessels had loss and fragmentation of the elastic lamina, fibrous replacement of their walls and luminal stenosis (endarteritis obliterans). Dermal and vascular advential intralymphatic granulomas and lymphangiectases were found by D2-40 expression, suggesting lymphatic obstruction and poor antigen clearance. No evidence of a post-zoster eruption, systemic sarcoidosis or systemic giant-cell arteritis was found. Two years later, prednisone had halted - but not reversed - progression of her alopecia. Review of the literature showed two types of vasculitis associated with sarcoid granulomas: (i) acute, self-limited leukocytoclastic vasculitis and (ii) chronic granulomatous vasculitis (GV). Persistence of non-degradable material or antigen contributes to the pathogenesis of granulomatous inflammation. In this case, lymphatic obstruction probably impeded clearance of nonimmunologic and/or immunologic stimuli permitting and sustaining the development of sarcoid granulomas and sarcoid GV, ultimately causing scarring alopecia and cutaneous atrophy. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Computed tomography of lethal medline granuloma

International Nuclear Information System (INIS)

Lee, Ho Suk; Kim, Tae Ho; Suh, Kyung Jin; Kim, Tae Hun; Kim, Yong Joo; Kang, Duk Sik

1991-01-01

In order to clarify the CT findings of lethal midline granuloma (LMG) diagnosed clinically or histopathologically, the authors retrospectively analyzed 12 patients who were seen at Kyungpook National University Hospital from February 1985 to August 1989. CT showed nasal mucosal thickening and / or soft tissue mass (9 case), spreading of the lesions along the facial subcutaneous fat plane (8 cases), invasion into the paranasal sinuses (5 cases), bone destruction (5 cases), nasopharyngeal mass lesion (2 cases), and extension of the lesion into the infratemporal fossa (1 case). In spite of the fact that CT does not make definitive diagnosis of LMG, it permits evaluation of the extent of the lesion, detection of the combined lesion, differential diagnosis, and close monitoring of its evolution under treatment

Keloidal granuloma faciale with extrafacial lesions

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Verma Rajesh

2005-01-01

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.

Porous metal revision shells for management of contained acetabular bone defects at a mean follow-up of six years: a comparison between up to 50% bleeding host bone contact and more than 50% contact.

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Sternheim, A; Backstein, D; Kuzyk, P R T; Goshua, G; Berkovich, Y; Safir, O; Gross, A E

2012-02-01

We report the use of porous metal acetabular revision shells in the treatment of contained bone loss. The outcomes of 53 patients with ≤ 50% acetabular bleeding host bone contact were compared with a control group of 49 patients with > 50% to 85% bleeding host bone contact. All patients were treated with the same type of trabecular metal acetabular revision shell. The mean age at revision was 62.4 years (42 to 80) and the mean follow-up of both groups was 72.4 months (60 to 102). Clinical, radiological and functional outcomes were assessed. There were four (7.5%) mechanical failures in the ≤ 50% host bone contact group and no failures in the > 50% host bone contact group (p = 0.068). Out of both groups combined there were four infections (3.9%) and five recurrent dislocations (4.9%) with a stable acetabular component construct that were revised to a constrained liner. Given the complexity of the reconstructive challenge, porous metal revision acetabular shells show acceptable failure rates at five to ten years' follow-up in the setting of significant contained bone defects. This favourable outcome might be due to the improved initial stability achieved by a high coefficient of friction between the acetabular implant and the host bone, and the high porosity, which affords good bone ingrowth.

Pulmonary hyalinizing granuloma and retroperitoneal fibrosis in an adolescent

International Nuclear Information System (INIS)

Young, Adam S.; Binkovitz, Larry A.; Adler, Brent H.; Nicol, Kathleen K.; Rennebohm, Robert M.

2007-01-01

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.)

Pulmonary hyalinizing granuloma and retroperitoneal fibrosis in an adolescent

Energy Technology Data Exchange (ETDEWEB)

Young, Adam S.; Binkovitz, Larry A.; Adler, Brent H. [Columbus Children' s Hospital, Children' s Radiological Institute, Columbus, OH (United States); Nicol, Kathleen K. [Columbus Children' s Hospital, Department of Pathology, Columbus, OH (United States); Rennebohm, Robert M. [Columbus Children' s Hospital, Department of Rheumatology, Columbus, OH (United States)

2007-01-15

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.)

Granuloma gigantocelular central del maxilar inferior: Presentación de un caso pediátrico Giant cell granuloma of the lower jaw: Description of a pediatric case

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S A Grees

2006-12-01

Full Text Available El granuloma gigantocelular central (GGCC, es una lesión tumoral o seudotumoral, infrecuente de los huesos de la cabeza y cuello, que afecta más frecuentemente los maxilares. Su etiología y patogenia son poco conocidas, sus características histológicas son benignas y su comportamiento biológico puede ser agresivo localmente. Presentamos el caso de un niño de 6 años con esta afección y realizamos una revisión de la entidad y sus diagnósticos diferenciales con otras lesiones de los maxilares.Giant Cell Granuloma (GCG is an uncommon condition affecting the bones of the head and neck. The ethiology and pathophysiology are not completely understood. The histlogic characteristics of GCG are benign, but its biologic behavior could locally aggressive. We describe the case of a 6 year-old boy with GCG and performed a review of the entity ant their differential diagnosis with other lesions of the maxillary bones.

The role of radiotherapy in the treatment of granuloma gangraenescens (lethal midline granuloma)

International Nuclear Information System (INIS)

Sack, H.; Horch, H.H.; Schaefer, H.E.; Wustrow, F.

1984-01-01

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 socalled 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. (orig.) [de

Validation of an optical system to measure acetabular shell deformation in cadavers.

Science.gov (United States)

Dold, Philipp; Bone, Martin C; Flohr, Markus; Preuss, Roman; Joyce, Tom J; Deehan, David; Holland, James

2014-08-01

Deformation of the acetabular shell at the time of surgery can result in poor performance and early failure of the hip replacement. The study aim was to validate an ATOS III Triple Scan optical measurement system against a co-ordinate measuring machine using in vitro testing and to check repeatability under cadaver laboratory conditions. Two sizes of custom-made acetabular shells were deformed using a uniaxial/two-point loading frame and measured at different loads. Roundness measurements were performed using both the ATOS III Triple Scan optical system and a co-ordinate measuring machine and then compared. The repeatability was also tested by measuring shells pre- and post-insertion in a cadaver laboratory multiple times. The in vitro comparison with the co-ordinate measuring machine demonstrated a maximum difference of 5 µm at the rim and 9 µm at the measurement closest to the pole of the shell. Maximum repeatability was below 1 µm for the co-ordinate measuring machine and 3 µm for the ATOS III Triple Scan optical system. Repeatability was comparable between the pre-insertion (below 2 µm) and post-insertion (below 3 µm) measurements in the cadaver laboratory. This study supports the view that the ATOS III Triple Scan optical system fulfils the necessary requirements to accurately measure shell deformation in cadavers. © IMechE 2014.

Biocompatibility of Bespoke 3D-Printed Titanium Alloy Plates for Treating Acetabular Fractures

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Xuezhi Lin

2018-01-01

Full Text Available Treatment of acetabular fractures is challenging, not only because of its complicated anatomy but also because of the lack of fitting plates. Personalized titanium alloy plates can be fabricated by selective laser melting (SLM but the biocompatibility of these three-dimensional printing (3D-printed plates remains unknown. Plates were manufactured by SLM and their cytocompatibility was assessed by observing the metabolism of L929 fibroblasts incubated with culture medium extracts using a CCK-8 assay and their morphology by light microscopy. Allergenicity was tested using a guinea pig maximization test. In addition, acute systemic toxicity of the 3D-printed plates was determined by injecting extracts from the implants into the tail veins of mice. Finally, the histocompatibility of the plates was investigated by implanting them into the dorsal muscles of rabbits. The in vitro results suggested that cytocompatibility of the 3D-printed plates was similar to that of conventional plates. The in vivo data also demonstrated histocompatibility that was comparable between the two manufacturing techniques. In conclusion, both in vivo and in vitro experiments suggested favorable biocompatibility of 3D-printed titanium alloy plates, indicating that it is a promising option for treatment of acetabular fractures.

Bacillus calmette-guerin infection in NADPH oxidase deficiency: defective mycobacterial sequestration and granuloma formation.

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Christine Deffert

2014-09-01

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

Dynamic {sup 11}C-methionine PET analysis has an additional value for differentiating malignant tumors from granulomas: an experimental study using small animal PET

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Zhao, Songji; Zhao, Yan [Hokkaido University, Department of Nuclear Medicine, Graduate School of Medicine, Sapporo (Japan); Hokkaido University, Department of Tracer Kinetics and Bioanalysis, Graduate School of Medicine, Sapporo (Japan); Kuge, Yuji; Hatano, Toshiyuki [Hokkaido University, Central Institute of Isotope Science, Sapporo (Japan); Yi, Min; Kohanawa, Masashi [Hokkaido University, Department of Advanced Medicine, Graduate School of Medicine, Sapporo (Japan); Magota, Keiichi; Tamaki, Nagara [Hokkaido University, Department of Nuclear Medicine, Graduate School of Medicine, Sapporo (Japan); Nishijima, Ken-ichi [Hokkaido University, Department of Molecular Imaging, Graduate School of Medicine, Sapporo (Japan)

2011-10-15

We evaluated whether the dynamic profile of L-{sup 11}C-methionine ({sup 11}C-MET) may have an additional value in differentiating malignant tumors from granulomas in experimental rat models by small animal positron emission tomography (PET). Rhodococcus aurantiacus and allogenic rat C6 glioma cells were inoculated, respectively, into the right and left calf muscles to generate a rat model bearing both granulomas and tumors (n = 6). Ten days after the inoculations, dynamic {sup 11}C-MET PET was performed by small animal PET up to 120 min after injection of {sup 11}C-MET. The next day, after overnight fasting, the rats were injected with {sup 18}F-2-deoxy-2-fluoro-D-glucose ({sup 18}F-FDG), and dynamic {sup 18}F-FDG PET was performed up to 180 min. The time-activity curves, static images, and mean standardized uptake value (SUV) in the lesions were calculated. {sup 11}C-MET uptake in the granuloma showed a slow exponential clearance after an initial distribution, while the uptake in the tumor gradually increased with time. The dynamic pattern of {sup 11}C-MET uptake in the granuloma was significantly different from that in the tumor (p < 0.001). In the static analysis of {sup 11}C-MET, visual assessment and SUV analysis could not differentiate the tumor from the granuloma in all cases, although the mean SUV in the granuloma (1.48 {+-} 0.09) was significantly lower than that in the tumor (1.72 {+-} 0.18, p < 0.01). The dynamic patterns, static images, and mean SUVs of {sup 18}F-FDG in the granuloma were similar to those in the tumor (p = NS). Dynamic {sup 11}C-MET PET has an additional value for differentiating malignant tumors from granulomatous lesions, which deserves further elucidation in clinical settings. (orig.)

Recognition of the mycobacterial cord factor by Mincle: relevance for granuloma formation and resistance to tuberculosis

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Roland eLang

2013-01-01

Full Text Available The world’s most successful intracellular bacterial pathogen, Mycobacterium tuberculosis (MTB, survives inside macrophages by blocking phagosome maturation and establishes chronic infection characterized by the formation of granulomas. Trehalose-6,6-dimycolate (TDM, the mycobacterial cord factor, is the most abundant cell wall lipid of virulent mycobacteria, is sufficient to cause granuloma formation, and has long been known to be a major virulence factor of MTB. Recently, TDM has been shown to activate the Syk-Card9 signaling pathway in macrophages through binding to the C-type lectin receptor Mincle. The Mincle-Card9 pathway is required for activation of macrophages by TDM in vitro and for granuloma formation in vivo following injection of TDM. Whether this pathway is also exploited by MTB to reprogram the macrophage into a comfortable niche has not been explored yet. Several recent studies have investigated the phenotype of Mincle-deficient mice in mycobacterial infection, yielding divergent results in terms of a role for Mincle in host resistance. Here, we review these studies, discuss possible reasons for discrepant results and highlight open questions in the role of Mincle and other C-type lectin receptors in the infection biology of MTB.

Florid Granuloma Annulare-Like Reaction in Regional Lymph Nodes After "Regression" of Red Pigment in Tattoos.

Science.gov (United States)

Carter, Michael D; Trites, Jonathan; McNeil, Shelly A; Walsh, Noreen N M; Bullock, Martin J

2018-05-01

A healthy 50-year-old woman had a tattoo performed on the posterior aspect of her neck and another on the dorsum of her left foot. Several weeks later, she noted redness, tenderness, and intense pruritis at both tattoo sites. Treatment with cephalexin and hydrocortisone cream was instituted, without success. Within a few months, the red, but not black, pigment had disappeared from both tattoos and was replaced by pale areas of scarring. Persistently enlarged left supraclavicular and suboccipital lymph nodes were excised 7 and 10 months after receipt of the tattoos, respectively. The nodes were pigmented on gross examination, and on microscopy, a granuloma annulare-like reaction was observed. Normal lymphoid tissue was seen to be replaced by large palisading granulomas with central degenerative change, abundant stromal mucin, and scattered deposits of tattoo pigment. Histochemical stains, tissue culture, and serological studies revealed no evidence of infection. There are rare reports of granuloma annulare-like reactions in tattoos, and these are believed to represent delayed-type hypersensitivity reactions. Our case is unique in the observation of this reaction pattern in regional lymph nodes, and it expands the spectrum of complications known to be associated with tattoos.

Distinct Th1, Th2 and Treg cytokines balance in chronic periapical granulomas and radicular cysts.

Science.gov (United States)

Teixeira-Salum, Tatiana Beber; Rodrigues, Denise Bertulucci Rocha; Gervásio, Aurélia M; Souza, Cássio J A; Rodrigues, Virmondes; Loyola, Adriano Motta

2010-03-01

Periapical lesions are a host response that involves immune reaction to prevent dissemination of bacteria from an infected root canal. The purpose of this study was to evaluate the levels of nitric oxide (NO), IL-4, TGF-beta, tumor necrosis factor-alpha (TNF-alpha), and interferon-gamma (IFN-gamma) in chronic periapical lesions and to determine their possible association with clinical and radiographic parameters. Seventeen human radicular cysts and 30 periapical granulomas were used in this study. Cytokines and NO were assessed by enzyme-linked immunosorbent assay and by the Griess reaction respectively confirmed by immunohistochemical. TNF-alpha and IFN-gamma were detected in 10% of granulomas and in 41.2% and 70% of radicular cysts. IL-4 was reactive in 24% of cysts, and TGF-beta was positive in all samples. Patients with tenderness showed significantly higher levels of IFN-gamma and IL-4 (P Periapical granulomas display a regulatory environment characterized by high TGF-beta and low inflammatory cytokine levels, while radicular cysts has mist Th1 and Th2 inflammatory reaction with the presence of IFN-gamma, TNF-alpha, and IL-4.

Wear analysis by applying a pin-disc configuration to phemoral head and acetabular cup Análisis del desgaste de la articulación cabeza femoral–copa acetabular mediante simulación experimental con máquina perno-disco

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Beltrán-Fernandez Juan Alfonso

2008-07-01

Full Text Available This work determines a prosthetic hip system’s life-span, focusing on a Mexican phenotype. The total sliding equivalent distance for the system was determined, as well as the loading regime under which the femoral component and the acetabular cup were subjected in normal operating conditions. An experimental tribology essay was then performed to simulate the wearing of the components in a Pin over Disc machine. This assay (for which the test specimens were manufactured in medical grade stainless steel AISI-ASTM 316L for the femoral component and high density polyethylene for the acetabular cup was aimed at simulating wear conditions involved in 10 years of continuous operation. A numerical simulation of operational conditions (using the finite element method was performedIn for establishing assay loading conditions to accurately determine where the loads should be applied. The tribology assay led to quantifying the volumetric loss of materials for the system being analysed. It can be concluded that the methodology proposed in this work for estimating the life-span of a prosthetic hip system was valid and accurate by comparing the results with those found in the literature. A statistical validation of the proposed method is plaaned for the future. Key words: Design life; femoral component; acetabular cup; Mexican phenotype; pin-disc configuration.Este trabajo presenta un estudio que permite establecer la vida útil esperada de un sistema prostético de cadera para el caso del fenotipo mexicano. En primera instancia se determinó la distancia total equivalente de deslizamiento y las condiciones de carga entre el componente femoral y la copa acetabular bajo condiciones normales de carga. Posteriormente, se desarrolló una simulación experimental para la realización de un ensayo tribológico en una máquina de desgaste del tipo Perno sobre Disco (Pin on Disk, POD. Este ensayo sometió al conjunto fabricado en acero inoxidable AISI

Peri-acetabular radiolucent lines: inter- and intra-observer agreement on post-operative radiographs

OpenAIRE

Kneif, D.; Downing, M.; Ashcroft, G. P.; Gibson, P.; Knight, D.; Ledingham, W.; Hutchison, J.

2005-01-01

Peri-acetabular radiolucent lines (RLLs) seen on “early” post-operative radiographs have been identified as a potential predictor of long-term implant performance. This study examines the inter- and intra-observer variation encountered when assessing such radiographs. Four consultant orthopaedic surgeons assessed the presence, extent and width of RLLs in 220 radiographs performed on 50 patients taken one to two weeks, six weeks, six months and one year following surgery. Inter-observer agreem...

[Biomechanical significance of the acetabular roof and its reaction to mechanical injury].

Science.gov (United States)

Domazet, N; Starović, D; Nedeljković, R

1999-01-01

The introduction of morphometry into the quantitative analysis of the bone system and functional adaptation of acetabulum to mechanical damages and injuries enabled a relatively simple and acceptable examination of morphological acetabular changes in patients with damaged hip joints. Measurements of the depth and form of acetabulum can be done by radiological methods, computerized tomography and ultrasound (1-9). The aim of the study was to obtain data on the behaviour of acetabular roof, the so-called "eyebrow", by morphometric analyses during different mechanical injuries. Clinical studies of the effect of different loads on acetabular roof were carried out in 741 patients. Radiographic findings of 400 men and 341 women were analysed. The control group was composed of 148 patients with normal hip joints. Average age of the patients was 54.7 years and that of control subjects 52.0 years. Data processing was done for all examined patients. On the basis of our measurements the average size of female "eyebrow" ranged from 24.8 mm to 31.5 mm with standard deviation of 0.93 and in men from 29.4 mm to 40.3 mm with standard deviation of 1.54. The average size in the whole population was 32.1 mm with standard deviation of 15.61. Statistical analyses revealed high correlation coefficients between the age and "eyebrow" size in men (r = 0.124; p 0.05). The examination of the size of collodiaphysial angle and length of "eyebrow" revealed that "eyebrow" length was in inverse proportion to the size of collodiaphysial angle (r = 0.113; p 0.05) and female (r = 0.005; p > 0.05) patients. The "eyebrow" length was proportionally dependent on the size of the shortened extremity in all examined subjects. This dependence was statistically significant both in female (r = 0.208; p < 0.05) and male (r = 0.193; p < 0.05) patients. The study revealed that fossa acetabuli was forward and downward laterally directed. The size, form and cross-section of acetabulum changed during different

Does using a polyethylene RM press-fit cup modify the preparation of the acetabulum and acetabular offset in primary hip arthroplasty?

Science.gov (United States)

Erivan, R; Aubret, S; Villatte, G; Mulliez, A; Descamps, S; Boisgard, S

2017-09-01

When performing total hip arthroplasty (THA), it is important to maintain the femoral and acetabular offsets to ensure good joint stability and to restore the function of the hip abductor muscles. In our practice, we mainly use a lateralized stem and hollow out the acetabulum to the quadrilateral plate to accommodate a press-fit polyethylene cup. However, the repercussions of this preparation method, which is driven by the cup's design, are not known. We carried out a retrospective study to assess: (1) the changes in the femoral and acetabular offset; (2) the height of the center of rotation; and (3) the repercussions on wear. We hypothesized there would be no significant differences between the preoperative and postoperative femoral and acetabular offsets. We reviewed 88 primary THA cases performed with the RM Pressfit™ cup that had a minimum of 5 years' follow-up. A lateralized self-locking Muller-type cemented femoral stem was used in 92.0% of cases and a standard stem in 8.0%. Measurements were done on plain radiographs with MHP™ and Mesurim Pro™ software. The average follow-up was 6.5 years (5-8). On average, the acetabular offset was reduced by 2.75mm±5.9 mm (range: -17.5 to +10.6 mm) (Pcup in subchondral bone without contacting the quadrilateral plate. This preserves bone stock, which may be useful later on if the cup is revised, particularly in younger patients. Conversely, the femoral offset did not change significantly, despite the use of lateralized stems in 92.0% of cases. We measured an annual wear rate of 0.068mm per year, which is lower than in other published studies, possibly because our patient population was older. IV, retrospective study. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Cholesterol granuloma of temporal bone: CT and MR findings

International Nuclear Information System (INIS)

Ruiz Jauriguizuria, J.C.; Ferrero Collado, A.; Ereno Ealo, M.J.; Grande Icaran, D.

1994-01-01

Three cases of cholesterol granuloma of the left temporal bone are presented, two located in the petrous apex and the other at the otomastoid level. One of the patients had a history of mastoid surgery and the other surgery of the bone ridge. The three cases were confirmed histologically following surgical resection. The etiopathogenesis of the lesion is discussed, as are the clinical, histological and radiological features, with a broad description of the computed tomography and magnetic resonance findings. The differential diagnosis is also dealt with. (Author)

Hızma Induced Papul of Nose Mimicking Pyogenic Granuloma

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Mualla Polat

2014-09-01

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.

A Man with Pancreatic Head Mass Lesion on Endoscopic Ultrasound and Granuloma on Cytopathology

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Neda Rad

2016-12-01

Full Text Available Primary pancreatic lymphoma is an unlikely malignancy accounting for less than 0.5% of pancreatic tumors. Clinical presentation is often nonspecific and may be clinically misdiagnosed as pancreatic adenocarcinoma. Here we present an Iranian case of primary pancreatic lymphoma in a 47-year-old male suffering from jaundice and 20% weight loss. Endoscopic ultrasound revealed a mixed echoic mass lesion at the head of pancreas. The patient underwent endoscopic ultrasound-guided fine needle aspiration of solid pancreatic mass and histopathologic diagnosis revealed granuloma. Computed tomography-guided core needle biopsy was performed and eventually histological examination showed granuloma that was coherent with the diagnosis of primary pancreatic lymphoma. Primary pancreatic lymphoma is a rare entity presenting with nonspecific symptoms, laboratory and radiological findings. Computed tomography results in combination with clinical and radiological studies generally provide guidance for appropriate investigation.

A Man with Pancreatic Head Mass Lesion on Endoscopic Ultrasound and Granuloma on Cytopathology.

Science.gov (United States)

Rad, Neda; Heidarnezhad, Arash; Soheili, Setareh; Mohammad-Alizadeh, Amir Houshang; Nikmanesh, Arash

2016-01-01

Primary pancreatic lymphoma is an unlikely malignancy accounting for less than 0.5% of pancreatic tumors. Clinical presentation is often nonspecific and may be clinically misdiagnosed as pancreatic adenocarcinoma. Here we present an Iranian case of primary pancreatic lymphoma in a 47-year-old male suffering from jaundice and 20% weight loss. Endoscopic ultrasound revealed a mixed echoic mass lesion at the head of pancreas. The patient underwent endoscopic ultrasound-guided fine needle aspiration of solid pancreatic mass and histopathologic diagnosis revealed granuloma. Computed tomography-guided core needle biopsy was performed and eventually histological examination showed granuloma that was coherent with the diagnosis of primary pancreatic lymphoma. Primary pancreatic lymphoma is a rare entity presenting with nonspecific symptoms, laboratory and radiological findings. Computed tomography results in combination with clinical and radiological studies generally provide guidance for appropriate investigation.

Central Nervous System Brucellosis Granuloma and White Matter Disease in Immunocompromised Patient.

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Alqwaifly, Mohammed; Al-Ajlan, Fahad S; Al-Hindi, Hindi; Al Semari, Abdulaziz

2017-06-01

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.

Pelvic and acetabular trauma care in Ireland: the past, present and future

LENUS (Irish Health Repository)

Queally, JM

2017-08-01

Pelvic injuries involve injury to the osseo-ligamentous ring structure of the pelvis or the acetabulum of either hip joint. They are typically caused by high-energy trauma and may be associated with significant morbidity or mortality at the time of injury due to excessive haemorrhage and associated abdominal, chest or head injuries with mortality rates of 8.6% to 19.1% reported for closed injuries and rates of up to 50% reported for open injuries1. Despite the severity of these injuries and the potential for poor long term outcomes, these injuries were managed with non-surgical treatment until the middle of the 20th century. Treatment typically involved prolonged bed rest, traction or compression devices, pelvic slings and spica casts with poor outcomes due to persistent pelvic deformity in pelvic injures and early osteoarthritis in acetabular fractures2,3. In the 1930’s, with the advent of radiography, significant progress was made in terms of understanding injury patterns, subsequent displacement and the significance of pelvic instability and deformity post injury. Along with the improved definitive management of pelvic injuries, similar progress was made with the immediate management of life-threatening haemodynamic instability and resuscitation with a significant improvement in mortality rate achieved over the past 50 years3,4. In contemporary trauma care, to ensure optimal outcomes, pelvic trauma is now considered a subspecialty practised in tertiary centres by fellowship trained specialists. Herein we describe the evolution of pelvic trauma care in Ireland over the past 30 years in an overall context of improved international paradigms of care and discuss potential future developments

Regulatory T cells with reduced repressor capacities are extensively amplified in pulmonary sarcoid lesions and sustain granuloma formation.

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Rappl, Gunter; Pabst, Stefan; Riemann, Dagmar; Schmidt, Annette; Wickenhauser, Claudia; Schütte, Wolfgang; Hombach, Andreas A; Seliger, Barbara; Grohé, Christian; Abken, Hinrich

2011-07-01

Sarcoidosis can evolve into a chronic disease with persistent granulomas accompanied by progressive fibrosis. While an unlimited inflammatory response suggests an impaired immune control in sarcoid lesions, it stands in contrast to the massive infiltration with CD4(+)CD25(high)FoxP3(+) regulatory T cells. We here revealed that those Treg cells in affected lung lesions were mainly derived from activated natural Treg cells with GARP (LRRC32)-positive phenotype but exhibited reduced repressor capacities despite high IL-10 and TGF-beta 1 levels. The repressive capacity of blood Treg cells, in contrast, was not impaired compared to age-matched healthy donors. Treg derived cells in granuloma lesions have undergone extensive rounds of amplifications indicated by shortened telomeres compared to blood Treg cells of the same patient. Lesional Treg derived cells moreover secreted pro-inflammatory cytokines including IL-4 which sustains granuloma formation through fibroblast amplification and the activation of mast cells, the latter indicated by the expression of membrane-bound oncostatin M. Copyright © 2011 Elsevier Inc. All rights reserved.

Initial stability of a highly porous titanium cup in an acetabular bone defect model.

Science.gov (United States)

Yoshimoto, Kensei; Nakashima, Yasuharu; Wakiyama, Miyo; Hara, Daisuke; Nakamura, Akihiro; Iwamoto, Mikio

2018-04-12

The purpose of this study was to quantify the initial stability of a highly porous titanium cup using an acetabular bone defect model. The maximum torque of a highly porous titanium cup, with a pore size of 640 μm and porosity of 60%, was measured using rotational and lever-out torque testing and compared to that of a titanium-sprayed cup. The bone models were prepared using a polyurethane foam block and had three levels of bone coverage: 100, 70, and 50%. The highly porous titanium cup demonstrated significantly higher maximum torque than the titanium-sprayed cups in the three levels of bone defects. On rotational torque testing, it was found to be 1.5, 1.3, and 1.3 times stronger than the titanium-sprayed cups with 100, 70 and 50% bone coverage, respectively. Furthermore, it was found to be 2.2, 2.3, and 1.5 times stronger on lever-out testing than the titanium-sprayed cup. No breakage in the porous layers was noted during the testing. This study provides additional evidence of the initial stability of highly porous titanium cup, even in the presence of acetabular bone defects. Copyright © 2018. Published by Elsevier B.V.

Giant cells reparative granuloma of the spine

International Nuclear Information System (INIS)

Toro, Nancy; Jorge Andres Delgado; Walter Leon

1998-01-01

The giant cell reparative granuloma (GCRG), was first described by Jaffe in 1953, which found it to be clinically and histopathologically different from the giant cell tumor. The GCRG accounts for 1.0 % of the osseous tumoral lesions, is more frequently found in females (68%) and in patients less than 30 years old (74%). It was believed that it only affected the jaw; it has been reported compromising other locations including the spine (7 cases). We report a case affecting the vertebral bodies of C2-C3 in a 10 years old, female patient, who was studied by plain film and MRI. The histological diagnosis was established at surgery, this report is the first one described in a cervical location and the second studied by MRI

Cholesterol Granuloma in Odontogenic Cyst: An Enigmatic Lesion

Directory of Open Access Journals (Sweden)

Mala Kamboj

2016-01-01

Full Text Available Cholesterol granuloma (CG is the outcome of the foreign body type of response to the accumulation of cholesterol crystals and is frequently present in conjunction with chronic middle ear diseases. Recently, cases of CG in jaws have been reported, but still, very few cases have been found of CG in dental literature. This article presents three rare cases of CG in the wall of odontogenic cysts emphasizing on its possible role in expansion of the associated lesion and bone erosion. It also lays stress on the fact that more cases of CG should be reported so that its nature and pathogenesis in the oral cavity become more perceivable.

A case of pulmonary Serratia marcescens granuloma radiologically mimicking metastatic malignancy and tuberculosis infection.

Science.gov (United States)

Das, Joyutpal; Layton, Benjamin; Lamb, Harriet; Sinnott, Nicola; Leahy, Bernard C

2015-11-01

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.

Aluminium hydroxide-induced granulomas in pigs

DEFF Research Database (Denmark)

Valtulini, S; Macchi, C; Ballanti, P

2005-01-01

The effect of intramuscular injection of 40 mg/2 ml aluminium hydroxide in the neck of pigs was examined in a number of ways. The investigation followed repeated slaughterhouse reports, according to which 64.8% of pigs from one particular farm were found at slaughter to have one or more nodules...... in the muscles of the neck (group slaughtered). The pigs had been injected with a vaccine containing 40 mg/2 ml dose of aluminium hydroxide as adjuvant. Research consisted of two phases: first, an epidemiological study was carried out, aimed at determining the risk factors for the granulomas. The results...... and adjuvant) to pigs inoculated twice with apyrogenic bi-distilled water (group water) and to pigs inoculated once with the adjuvant and once with apyrogenic bi-distilled water (group adjuvant/water). Both studies agreed in their conclusions, which indicate that the high amount of aluminium hydroxide...

A pilot trial comparing the tear-out behavior in screw-sockets and cemented polyethylene acetabular components - a cadaveric study.

Science.gov (United States)

Möbius, R; Schleifenbaum, S; Grunert, R; Löffler, S; Werner, M; Prietzel, T; Hammer, N

2016-10-01

The removal of well-fixed acetabular components following THA (total hip arthroplasty) is a difficult operation and could be accompanied by the loss of acetabular bone stock. The optimal method for fixation is still under debate. The aim of this pilot study was to compare the tear-out resistance and failure behavior between osseo-integrated and non-integrated screw cups. Furthermore, we examined whether there are differences in the properties mentioned between screw sockets and cemented polyethylene cups. Tear-out resistance and related mechanical work required for the tear-out of osseo-integrated screw sockets are higher than in non-integrated screw sockets. Ten human coxal bones from six cadavers with osseo-integrated screw sockets (n=4), non-integrated (implanted post-mortem, n=3) screw sockets and cemented polyethylene cups (n=3) were used for tear-out testing. The parameters axial failure load and mechanical work for tear-out were introduced as measures for determining the stability of acetabular components following THA. The osseo-integrated screw sockets yielded slightly higher tear-out resistance (1.61±0.26kN) and related mechanical work compared to the non-integrated screw sockets (1.23±0.39kN, P=0.4). The cemented polyethylene cups yielded the lowest tear-out resistance with a failure load of 1.18±0.24kN. Compared to the screw cups implanted while alive, they also differ on a non-significant level (P=0.1). Osseous failure patterns differed especially for the screw sockets compared to the cemented polyethylene cups. Osseo-integration did not greatly influence the tear-out stability in cementless screw sockets following axial loading. Furthermore, the strength of the bone-implant-interface of cementless screw sockets appears to be similar to cemented polyethylene cups. However, given the high failure load, high mechanical load and because of the related bone failure patterns, removal should not be performed by means of tear-out but rather by osteotomes

Teflon granulomas mimicking cerebellopontine angle tumors following microvascular decompression.

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Deep, Nicholas L; Graffeo, Christopher S; Copeland, William R; Link, Michael J; Atkinson, John L; Neff, Brian A; Raghunathan, Aditya; Carlson, Matthew L

2017-03-01

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.

The acetabular fossa hot spot on {sup 18}F-FDG PET/CT: epidemiology, natural history, and proposed etiology

Energy Technology Data Exchange (ETDEWEB)

Kubicki, Shelby L. [Trinity University, San Antonio, TX (United States); Richardson, Michael L. [University of Washington, Department of Radiology, Seattle, WA (United States); Martin, Thomas [X-Ray Associates of New Mexico, Department of Radiology, Albuquerque, NM (United States); Rohren, Eric [The University of Texas M.D. Anderson Cancer Center, Department of Diagnostic Radiology, Division of Nuclear Medicine, Houston, TX (United States); Wei, Wei [The University of Texas M.D. Anderson Cancer Center, Department of Biostatistics, Houston, TX (United States); Amini, Behrang [The University of Texas M.D. Anderson Cancer Center, Department of Diagnostic Radiology, Division of Musculoskeletal Radiology, Houston, TX (United States)

2015-01-15

To describe a benign focus of increased activity in the acetabular fossa (the acetabular fossa hot spot, AFHS) on {sup 18}F-FDG PET/CT that can mimic a neoplasm. {sup 18}F-FDG PET/CT images from four patient populations were examined. Group 1 (n = 13) was collected from a search of radiology reports and used to define the AFHS and for hypothesis generation. Group 2 (n = 1,150) was used for prevalence of AFHS. Group 3 (n = 1,213) had PET/CT and MRI pelvis within a week of each other and was used to correlate metabolic and anatomic findings. Group 4 (n = 100) was used to generate the control group. Data were collected on demographics, common comorbidities, underlying cancer diagnosis and status, and hip symptoms. Prevalence of AFHS was 0.36 % (95 % CI 0.10-0.91 %). None progressed to malignancy or was associated with cancer status. The majority (71 %) were on the left, and 6 % were bilateral. Mean SUV{sub max} of the AFHS was 4.8 (range, 2.7-7.8). Male patients were more likely to have the AFHS (OR = 8.69, 95 % CI 1.88-40.13). There was no difference with respect to other collected data, including hip symptoms. Average minimum duration of AFHS was 346 days (range, 50-1,010 days). Readers did not detect corresponding hip abnormalities on MRIs. AFHS is a benign finding that may be caused by subclinical ligamentum teres injury, focal synovitis, or degeneration of acetabular fossa fat. Despite uncertainty regarding its etiology, recognition of AFHS as a benign finding can prevent morbidity associated with unnecessary biopsy or initiation of therapy. (orig.)

[Persistence of the omphalomesenteric duct. Childhood differential diagnosis of umbilical granuloma].

Science.gov (United States)

Sánchez-Castellanos, M E; Sandoval-Tress, C; Hernández-Torres, M

2006-01-01

The omphalomesenteric duct is an embryonic structure which communicates the vitelline duct with the midgut. It normally disappears between the fifth and ninth weeks of intrauterine life. Anomalies related with the total or partial absence of this involution are show in 2 % of the population. We report a case of persistence of the omphalomesenteric duct and review the bibliography to establish the differences between this anomaly and umbilical granuloma, which is the main differential diagnosis.

Case clusters of leproid granulomas in foxhounds in New Zealand and Australia.

Science.gov (United States)

Smits, Bronwyn; Willis, Richard; Malik, Richard; Studdert, Virginia; Collins, Desmond M; Kawakami, Pamela; Graham, Duncan; Fyfe, Janet A

2012-12-01

Canine leproid granuloma (CLG) characteristically presents as single to multiple circumscribed dermal to subcutaneous nodules in haired skin. An unidentified mycobacterium is considered be the aetiological agent of this entity. Several cases of canine leproid granulomas occurred in dogs in New Zealand during 2010 and 2011. Cases appeared in clusters, affecting multiple closely related foxhounds domiciled in the same kennels. All affected hounds recovered after topical and/or systemic antimicrobial therapy. Two similar outbreaks that occurred in foxhounds near Melbourne, Australia are also reported. Cases were investigated using cytological, histological, microbiological and several molecular techniques. An environmental epidemiological study was also performed. A diagnosis of CLG was established in 11 dogs. Molecular identification of the causative agent confirmed that it was a mycobacterial species with 100% sequence homology within the amplified regions of the 16S rRNA gene and internal transcribed spacer (ITS1) with that found in association with similar infections from the USA, Brazil and Australia. This report details the first occurrence of multiple cases of CLG occurring in in-contact dogs and the first proven case of CLG in dogs in New Zealand. © 2012 The Authors. Veterinary Dermatology © 2012 ESVD and ACVD.

Symptomatic Granuloma Secondary to Embolic Agent: A Case Report.

Science.gov (United States)

Gunawat, Prashant; Shaikh, Salman Tehran; Karmarkar, Vikram; Deopujari, Chandrashekhar

2016-11-01

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.

Eosinophilic granuloma of spine in adults: a report of 30 cases and outcome.

Science.gov (United States)

Huang, Wending; Yang, Xinghai; Cao, Dong; Xiao, Jianru; Yang, Mosong; Feng, Dapeng; Huang, Quan; Wu, Zhipeng; Zheng, Wei; Jia, Lianshun; Wu, Shujia

2010-07-01

Eosinophilic granuloma (EG) of the spine is rare, especially in adults. There had been few large and long-term studies reported in the literature. The management goals of this disease in adults are preservation of neurologic function, relief of pain and reconstruction of spinal stability. However, there are still controversies over appropriate management modality of eosinophilic granuloma. Clinical manifestations, radiographic presentations, therapeutic outcomes and follow-up findings of 30 adults who were histiologically diagnosed with spinal eosinophilic granuloma, including 28 patients who received surgical treatment at our institutions from 1985 to 2008 were reviewed retrospectively. There were 25 males and five females with a mean age of 34.5 years (range, 18-71 years). The post-operative follow-up period ranged from 2 to 22.4 years (mean, 8.3 years). Neurologic deficits developed in 21 patients, apparent kyphosis developed in four cases. In contrast to the classic feature of vertebra plana in children, we found that more severe lesions often led to asymmetric collapse in adult patients and only three patients presented with vertebra plana. Thirty-three vertebral lesions distributed throughout the spine column. Twenty-one lesions were in cervical spine, seven in the thoracic spine and five in the lumbar spine. Twenty-eight adult patients underwent surgical resection with or without chemotherapy or radiotherapy, and four (13.3%) patients had recurrence after surgery. No patient in our series died. The onset of spinal EG is insidious and mainly presents as osteolytic destruction. There is a particular high prevalence of lesions in the cervical spine and more severe lesions often led to asymmetric collapse. As the skeleton of adults is well-developed and the epiphysis has stopped growing, individualized management including surgical intervention should be considered in adult patients with spinal EG who present with neurological damage and spinal instability.

Pyogenic granuloma: a rare side complication from an orthodontic appliance.

Science.gov (United States)

Acharya, Priti N; Gill, Daljit; Lloyd, Tim

2011-12-01

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.

Case report 424: Eosinophilic granuloma of the acromion

International Nuclear Information System (INIS)

Moyer, R.A.; Betz, R.R.; Bonakdarpour, A.

1987-01-01

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)

Radiologic analysis of femoral acetabular impingement: from radiography to MRI

Energy Technology Data Exchange (ETDEWEB)

Dwek, Jerry R. [University of California at San Diego, Department of Radiology, Rady Children' s Hospital and Health Center, San Diego, CA (United States); San Diego Imaging, San Diego, CA (United States); Monazzam, Shafagh [Rady Children' s Hospital and Health Center, Department of Orthopedics, San Diego, CA (United States); Chung, Christine B. [University of California at San Diego, Department of Radiology, San Diego, CA (United States)

2013-03-15

Femoral acetabular impingement is a set of morphologic abnormalities that are considered to be a major cause of degenerative disease in the hip joint. Early changes are already present in adolescence when it is the pediatric radiologist who must assess current damage with the aim of averting progression to more severe and debilitating osteoarthritis. A multimodality approach is used for diagnosis, that includes conventional radiography and CT to assess the osseous structures. MR arthrography is the primary advanced imaging modality for assessment of morphologic changes as well as injuries of the labrum and articular cartilage. Details of radiologic imaging are offered to guide the radiologist and provide an avenue for the accurate description of the osseous and articular alterations and injury. (orig.)

A new technique for radiographic measurement of acetabular cup orientation.

Science.gov (United States)

Derbyshire, Brian; Diggle, Peter J; Ingham, Christopher J; Macnair, Rory; Wimhurst, James; Jones, Henry Wynn

2014-02-01

Accurate radiographic measurement of acetabular cup orientation is required in order to assess susceptibility to impingement, dislocation, and edge loading wear. In this study, the accuracy and precision of a new radiographic cup orientation measurement system were assessed and compared to those of two commercially available systems. Two types of resurfacing hip prostheses and an uncemented prosthesis were assessed. Radiographic images of each prosthesis were created with the cup set at different, known angles of version and inclination in a measurement jig. The new system was the most accurate and precise and could repeatedly measure version and inclination to within a fraction of a degree. In addition it has a facility to distinguish cup retroversion from anteversion on anteroposterior radiographs. © 2013.

Long-term results of uncemented alumina acetabular implants.

Science.gov (United States)

Boehler, M; Knahr, K; Plenk, H; Walter, A; Salzer, M; Schreiber, V

1994-01-01

We report the clinical and tribological performance of 67 ceramic acetabular prostheses implanted between 1976 and 1979 without bone cement. They articulated with ceramic femoral heads mounted on mental femoral stems. After a mean elapsed period of 144 months, 59 sockets were radiographically stable but two showed early signs and six showed late signs of loosening. Four of the loose sockets have been revised. Histological analysis of the retrieved tissue showed a fibrous membrane around all the implants, with fibrocartilage in some. There was no bone ingrowth, and the fibrous membrane was up to 6 mm thick and infiltrated with lymphocytes, plasma cells, and macrophages. Intra- and extracellular birefringent wear particles were seen. Tribological analysis showed total wear rates in two retrieved alumina-on-alumina joints of 2.6 microns per year in a stable implant and 68 microns in a loose implant. Survival analysis showed a revision rate of 12.4% at 136 months.

Delayed cementless total hip arthroplasty for neglected dislocation of hip combined with complex acetabular fracture and deficient bone stock

Directory of Open Access Journals (Sweden)

Gavaskar Ashok S

2012-12-01

Full Text Available 【Abstract】Total hip arthroplasty (THA for an un-treated acetabular fracture is technically challenging and the long-term result is not so favorable. A 45-year-old fe-male patient with untreated column and comminuted poste-rior wall fracture of the acetabulum was treated in our insti-tution by reconstruction of the posterior wall using iliac strut autograft and plate stabilization of the posterior col-umn with cancellous grafting and cementless THA in a single stage. At 3 years’ follow-up, the patient was independently mobile without limb length discrepancy. Radiological evalu-ation showed well integrated components and bone grafts. No evidence of aseptic loosening or osteolysis was found. This report aims to emphasize that bony acetabular recon-struction allows the use of primary hip components, which improves prosthesis longevity and preserves bone stock for a future revision. Key words: Acetabulum; Fractures, bone; Hip dislocation; Arthroplasty, replacement, hip

Influence of soft tissue in the assessment of the primary fixation of acetabular cup implants using impact analyses.

Science.gov (United States)

Bosc, Romain; Tijou, Antoine; Rosi, Giuseppe; Nguyen, Vu-Hieu; Meningaud, Jean-Paul; Hernigou, Philippe; Flouzat-Lachaniette, Charles-Henri; Haiat, Guillaume

2018-06-01

The acetabular cup (AC) implant primary stability is an important determinant for the success of cementless hip surgery but it remains difficult to assess the AC implant fixation in the clinic. A method based on the analysis of the impact produced by an instrumented hammer on the ancillary has been developed by our group (Michel et al., 2016a). However, the soft tissue thickness present around the acetabulum may affect the impact response, which may hamper the robustness of the method. The aim of this study is to evaluate the influence of the soft tissue thickness (STT) on the acetabular cup implant primary fixation evaluation using impact analyses. To do so, different AC implants were inserted in five bovine bone samples. For each sample, different stability conditions were obtained by changing the cavity diameter. For each configuration, the AC implant was impacted 25 times with 10 and 30 mm of soft tissues positioned underneath the sample. The averaged indicator I m was determined based on the amplitude of the signal for each configuration and each STT and the pull-out force was measured. The results show that the resonance frequency of the system increases when the value of the soft tissue thickness decreases. Moreover, an ANOVA analysis shows that there was no significant effect of the value of soft tissue thickness on the values of the indicator I m (F = 2.33; p-value = 0.13). This study shows that soft tissue thickness does not appear to alter the prediction of the acetabular cup implant primary fixation obtained using the impact analysis approach, opening the path towards future clinical trials. Copyright © 2018 Elsevier Ltd. All rights reserved.

Pelvic reconstructions following peri-acetabular bone tumour resections using a cementless ice-cream cone prosthesis with dual mobility cup.

Science.gov (United States)

Issa, Samir-Pierre; Biau, David; Babinet, Antoine; Dumaine, Valérie; Le Hanneur, Malo; Anract, Philippe

2018-01-27

Despite numerous reconstructive techniques and prosthetic devices, pelvic reconstructions following peri-acetabular malignant tumours resections are highly challenging. In the present study, we describe our experience with the Integra® (Lépine, Genay, France) ice-cream cone prosthesis in such indications. The objective was to assess the mid-term outcomes of this device. Twenty-four patients' chart with peri-acetabular malignant tumours, who underwent types II or II + III peri-acetabular resections according to Enneking and Dunham with subsequent reconstruction using the Integra® prosthesis between February 2009 and February 2015, were reviewed. Seventeen cases were primary surgeries and seven cases were revisions (i.e., failures of previous reconstructions for pelvic tumours). All living patients with the prosthesis implanted were functionally assessed, using the musculoskeletal tumour society (MSTS) and Postel-Merle d'Aubigné (PMA) scores. After a mean follow-up of 49 ± 26 months (range, 8 to 94 months), 21 patients were alive (88%), including 15 patients continuously disease-free (63%). MSTS and PMA scores averaged 72 ± 13% (range, 43 to 87%) and 14.6 ± 2.6 (range, 9 to 18), respectively. Fourteen patients (58%) presented at least one complication during follow-up, including four cases of deep infection (17%), four cases of dislocation (17%), and two mechanical failures (8%). At 5 years, the implant survival rate was 75%. In comparison to previous reconstructive techniques that we used in similar indications, functional and oncologic outcomes were improved with the Integra® implant. However, as commonly observed in pelvic bone tumour surgery, complication rates remain significant. Therapeutic, Level IV-Retrospective Cases Series.

Giant cell reparative granuloma of the occipital bone

International Nuclear Information System (INIS)

Santos-Briz, A.; Ricoy, J.R.; Martinez-Tello, F.J.; Lobato, R.D.; Ramos, A.; Millan, J.M.

2003-01-01

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.)

Long-term retrospective study on the placement of the cementless acetabular cup and clinical outcomes in patients undergoing femoral head autografting for hip dysplasia and total hip arthroplasty.

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Ozden, Vahit Emre; Dikmen, Goksel; Beksac, Burak; Tozun, Ismail Remzi

2018-05-01

Placement of acetabular cup in the dysplastic hip is a challenging procedure. Using bulk femoral head autograft to increase the bony coverage of the cup is one of the techniques, which have been described. The impact of cup position on cup and autograft survival is a controversial issue. We aimed to determine whether the position of cementless acetabular cup used in conjunction with femoral head autograft in dysplastic hips affected the autograft-host incorporation with its final radiographic appearance and the cup survivorship into the second decade. Thirty-eight dysplastic hips with varying Crowe types in 31 patients (30 women and one man) were included. The mean age was 47 years (range, 29-64 years) and the mean follow-up was 20.3 years (range, 14.8-25.9 years). The initial postoperative and final radiographs were evaluated. The survival rate of the cups was analysed using Kaplan-Meier statistics and the log-rank test. Multivariate analysis was used to evaluate the effect of variables (Crowe type, radiographic initial host bone coverage over the cup and position of the cup) on survivorship. The acetabular cups were positioned anatomical in 27/38 hips according to Ranawat measurement technique. Trabecular bridging at graft-host interface was seen in all cases at an average 22.1 months. Neither acetabular cup position nor initial host bone coverage over acetabular cup less than 50% had any significant effect on either cup survival or final radiographic appearance of the graft. The 20-year cup survival rate without aseptic revision was 66% (95 CI, 52%-84%). No revision was performed due to graft resorption. Twenty-year survival rate of the cementless cup combination with femoral head autograft showed no significant differences whether it was placed at high or anatomic hip centre. The final radiographic appearance of the autograft was not affected from either the cup location or the initial radiographic horizontal host bone coverage. Copyright © 2018 The Japanese

Ultrasound in Total Hip Replacement: Value of Anterior Acetabular Cup Visibility and Contact With the Iliopsoas Tendon.

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Guillin, Raphaël; Bertaud, Valérie; Garetier, Marc; Fantino, Olivier; Polard, Jean-Louis; Lambotte, Jean-Christophe

2018-06-01

To assess visibility of the acetabular cup in total hip replacement and to determine the value of direct and indirect signs of iliopsoas impingement syndrome with ultrasound. Ultrasound examinations were performed by a single operator in 17 patients with iliopsoas impingement syndrome and 48 control patients. Cup visibility, contact between the cup and psoas tendon, and the presence of indirect signs of iliopsoas impingement syndrome were investigated in all patients. When the acetabular cup was visible, its size and position in relation to the psoas tendon were recorded. Anterior cup visibility (P = .03), contact with the psoas tendon (P cup shift of 3 mm or greater yielded respective sensitivities of 82% and 59% and specificities of 81% and 100%. When iliopsoas impingement syndrome is clinically suspected, the presence of iliopsoas bursitis or a posteroanterior cup shift of greater than 3 mm under the psoas tendon serve to confirm the diagnosis. In the absence of these conditions, a therapeutic test may be necessary because of the incomplete, albeit high, specificity of other signs. © 2017 by the American Institute of Ultrasound in Medicine.

Vulvar Pyogenic Granuloma in a Postmenopausal Woman: Case Report and Review of the Literature

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Deniz Cemgil Arikan

2011-01-01

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.

Vulvar Pyogenic Granuloma in a Postmenopausal Woman: Case Report and Review of the Literature

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Arikan, Deniz Cemgil; Kiran, Gurkan; Sayar, Hamide; Kostu, Bulent; Coskun, Ayhan; Kiran, Hakan

2011-01-01

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. PMID:21912553

Precision of radiostereometric analysis (RSA) of acetabular cup stability and polyethylene wear improved by adding tantalum beads to the liner

DEFF Research Database (Denmark)

Nebergall, Audrey K; Rader, Kevin; Palm, Henrik

2015-01-01

segment to measure wear and acetabular cup stability. The standard deviation multiplied by the critical value (from a t distribution) established the precision of each method. Results - Due to the imprecision of the automated edge detection, the shell-only method was least desirable. The shell + liner...

Percutaneous vertebroplasty for eosinophilic granuloma of the cervical spine in a child

International Nuclear Information System (INIS)

Tan, Hua-Qiao; Li, Ming-Hua; Wu, Chun-Gen; Gu, Yi-Feng; Zhang, He; Fang, Chun

2007-01-01

We report a case of eosinophilic granuloma at the fourth cervical vertebra in a 10-year-old girl presenting with a 1-month history of cervical pain and stiffness. This lesion was histologically diagnosed by needle biopsy and then treated by percutaneous vertebroplasty. After the procedure, the cervical pain and stiffness resolved rapidly. The height of the vertebral body remained stable without further collapse over a 6-month follow-up period. (orig.)

[Total hip arthroplasty in post-dysplastic hip arthritis. Can type and position of the acetabular component influence longevity of the prosthesis?].

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Fousek, J; Indráková, P

2007-02-01

The aim of the study was a retrospective evaluation of our patients with post-dysplastic hips treated by cemented or non-cemented total hip arthroplasty (THA) in order to ascertain which type and position of the acetabular component was most effective. In the years 1999-2002, 111 THA procedures were performed in 93 patients, 76 women and 17 men, with post-dysplastic hip arthritis. The average age of the patients at the time of implantation was 52.6 years. On the basis of pre-operative radiographic findings, the patients' conditions were evaluated using the Hartofilakidis classification into three disease categories: dysplasia, low dislocation and high dislocation, and the patients were placed in two groups. Group 1 included 78 patients, and group 2 comprised 26 patients. None of our patients was classified as having high dislocation. Thirty-nine of these patients had previously undergone surgery for dysplastic hips. A total of 104 THAs were evaluated, because radiographic data was incomplete in seven cases. In addition to X-ray findings, the prosthesis type (cemented, hybrid, non-cemented), post-operative complications and signs of loosening were included in the evaluation. Clinical outcomes were assessed by the Harris score. The follow-up terminating on 31st December 2005 was 67 months on the average. In group 1 patients, the average Harris score increased from 38.6 to 80.3 points and in group 2 patients from 35.5 to 84.9 points, mostly with excellent and good results. In 72.1 % of the hips, a press-fit acetabular component was implanted. In 55.8 % of the cases, the acetabular component was implanted off the anatomical center of rotation, into the high hip center, with the range from 9 to 20 mm and an average of 15 mm. The average limb lengthening was 2.5 cm, ranging from 1.0 to 3.5 cm. Our results show that it is more effective to use non-cemented THA for post-dysplastic hips. The implantation of a noncemented acetabular component into the high center provides

Ultrasonographic study of subcutaneous penile granuloma secondary to silicone injection

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Lucio Dell'Atti

2016-10-01

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.

Failure mechanisms and closed reduction of a constrained tripolar acetabular liner.

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Robertson, William J; Mattern, Christopher J; Hur, John; Su, Edwin P; Pellicci, Paul M

2009-02-01

Unlike traditional bipolar constrained liners, the Osteonics Omnifit constrained acetabular insert is a tripolar device, consisting of an inner bipolar bearing articulating within an outer, true liner. Every reported failure of the Omnifit tripolar implant has been by failure at the shell-bone interface (Type I failure), failure at the shell-liner interface (Type II failure), or failure of the locking mechanism resulting in dislocation of the bipolar-liner interface (Type III failure). In this report we present two cases of failure of the Omnifit tripolar at the bipolar-femoral head interface. To our knowledge, these are the first reported cases of failure at the bipolar-femoral head interface (Type IV failure). In addition, we described the first successful closed reduction of a Type IV failure.

High proximal migration in cemented acetabular revisions operated with bone impaction grafting; 47 revision cups followed with RSA for 17 years.

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Mohaddes, Maziar; Herberts, Peter; Malchau, Henrik; Johanson, Per-Erik; Kärrholm, Johan

2017-05-12

Bone impaction grafting is a biologically and mechanically appealing option in acetabular revision surgery, allowing restitution of the bone stock and restoration of the biomechanics. We analysed differences in proximal migration of the revision acetabular components when bone impaction grafting is used together with a cemented or an uncemented cup. 43 patients (47 hips), revised due to acetabular loosening and judged to have less than 50% host bone-implant contact were included. The hips were randomised to either an uncemented (n = 20) or a cemented (n = 27) revision cup. Radiostereometry and radiography was performed postoperatively, at 3 and 6 months, 1, 2, 3, 5, 7, 10 and 13 and 17 years postoperatively. Clinical follow-up was performed at 1, 2 and 5 years postoperatively and thereafter at the same interval as in the radiographic follow-up. There were no differences in the base line demographic data between the 2 groups. At the last follow-up (17 years) 14 hips (10 cemented, 4 uncemented) had been re-revised due to loosening. 3 additional cups (1 uncemented and 2 cemented) were radiographically loose. There was a higher early proximal migration in the cemented cups. Cups operated on with cement showed a higher early migration measured with RSA and also a higher number of late revisions. The reason for this is not known, but factors such as inclusion of cases with severe bone defects, use of smaller bone chips and issues related to the impaction technique might have had various degrees of influence.

First report of a spermatic granuloma and varicocele in a marsupial: A Koala (Phascolarctos cinereus) Case Study.

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Schultz, B K; Palmieri, C; Nicolson, V; Larkin, R; Keeley, T; McGowan, M; Johnston, S D

2016-08-01

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.

Clinical applications for multiplanar- and three-dimensional-reconstructions by helical-CT for the diagnosis of acetabular fractures

International Nuclear Information System (INIS)

Stroszczynski, C.; Schedel, H.; Stoeckle, U.; Wellmann, A.; Beier, J.; Wicht, L.; Hoffmann, R.; Felix, R.

1996-01-01

This review describes recent visualizations of computed tomography for the diagnosis of acetabular fractures. The techniques of conventional and helical-CT for the imaging of the acetabulum are compared. Furthermore, the different methods of multiplaner and three-dimensional reconstructions e.g. shaded surface display, maximum intensity projection, and volume rendering are presented. Figures of multiplanar and three-dimensional imaging for fractures of the pelvis is discussed. (orig.) [de

Cutaneous foreign body granulomas associated with lipolytic cocktail: Who is the enemy, mesotherapy or drugs injected?

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Kutlubay, Zekayi; Gokalp, Hilal; Ince, Umit; Engin, Burhan

2017-10-01

Mesotherapy is widely used for its lipolytic effect as an alternative procedure to surgical methods. Although many benefits of lipolytic mesotherapy have been observed, numerous side effects have also been reported. Here, we report a case of cutaneous foreign body granulomas that occurred after lipolytic mesotherapy.

Recurrence of sarcoid granulomas in lung transplant recipients is common and does not affect overall survival

DEFF Research Database (Denmark)

Schultz, Hans Henrik Lawaetz; Andersen, Claus Bøgelund; Steinbrüchel, D

2014-01-01

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...

Supra-Acetabular Brown Tumor due to Primary Hyperparathyroidism Associated with Chronic Renal Failure

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Rosaria M. Ruggeri

2010-01-01

Full Text Available A 63-year-old woman presented to the Orthopedic Unit of our hospital complaining of right hip pain of 6 months'duration associated with a worsening limp. Her past medical history included chronic renal insufficiency. Physical examination revealed deep pain in the iliac region and severe restriction of the right hip's articular function in the maximum degrees of range of motion. X-rays and CT scan detected an osteolytic and expansive lesion of the right supra-acetabular region with structural reabsorption of the right iliac wing. 99mTc-MDP whole-body bone scan showed an abnormal uptake in the right iliac region. Bone biopsy revealed an osteolytic lesion with multinucleated giant cells, indicating a brown tumor. Serum intact PTH was elevated (1020 pg/ml; normal values, 12 62 pg/ml, but her serum calcium was normal (total = 9.4 mg/dl, nv 8.5–10.5; ionized = 5.0 mg/dl, nv 4.2–5.4 due to the coexistence of chronic renal failure. 99mTc-MIBI scintigraphy revealed a single focus of sestamibi accumulation in the left retrosternal location, which turned out to be an intrathoracic parathyroid adenoma at surgical exploration. After surgical removal of the parathyroid adenoma, PTH levels decreased to 212 pg/ml. Three months after parathyroidectomy, the imaging studies showed complete recovery of the osteolytic lesion, thus avoiding any orthopedic surgery. This case is noteworthy because (1 primary hyperparathyroidism was not suspected due to the normocalcemia, likely attributable to the coexistence of chronic renal failure; and (2 it was associated with a brown tumor of unusual location (right supra-acetabular region.

Posterosuperior Placement of a Standard-Sized Cup at the True Acetabulum in Acetabular Reconstruction of Developmental Dysplasia of the Hip With High Dislocation.

Science.gov (United States)

Xu, Jiawei; Xu, Chen; Mao, Yuanqing; Zhang, Jincheng; Li, Huiwu; Zhu, Zhenan

2016-06-01

We sought to evaluate posterosuperior placement of the acetabular component at the true acetabulum during acetabular reconstruction in patients with Crowe type-IV developmental dysplasia of the hip. Using pelvic computed tomography and image processing, we developed a two-dimensional mapping technique to demonstrate the distribution of preoperative three-dimensional cup coverage at the true acetabulum, determined the postoperative location of the acetabular cup, and calculated postoperative three-dimensional coverage for 16 Crowe type-IV dysplastic hips in 14 patients with a mean age of 52 years (33-78 years) who underwent total hip arthroplasty. Mean follow-up was 6.3 years (5.5-7.3 years). On preoperative mapping, the maximum three-dimensional coverage using a 44-mm cup was 87.31% (77.36%-98.14%). Mapping enabled the successful replacement of 16 hips using a mean cup size of 44.13 mm (42-46 mm) with posterosuperior placement of the cup. Early weight-bearing and no prosthesis revision or loosening during follow-up were achieved in all patients. The postoperative two-dimensional coverage on anteroposterior radiographs and three-dimensional coverage were 96.15% (89.49%-100%) and 83.42% (71.81%-98.50%), respectively. This technique may improve long-term implant survival in patients with Crowe-IV developmental dysplasia of the hip undergoing total hip arthroplasty by allowing the use of durable bearings, increasing host bone coverage, ensuring initial stability, and restoring the normal hip center. Copyright © 2015 Elsevier Inc. All rights reserved.

Expression of interleukin-33 and its receptor ST2 in periapical granulomas and radicular cysts.

Science.gov (United States)

Velickovic, Milena; Pejnovic, Nada; Petrovic, Renata; Mitrovic, Slobodanka; Jeftic, Ilija; Kanjevac, Tatjana; Lukic, Aleksandra

2016-01-01

Interleukin-33 (IL-33) is a recently identified cytokine belonging to the IL-1 family and ligand for the IL-1 receptor-related protein ST2. IL-33/ST2 signaling plays a critical role in allergy, autoimmunity, and chronic inflammatory disorders, but its role in the pathogenesis of periapical lesions is unknown. We aimed to investigate the expression patterns of IL-33 and ST2 in human periapical lesions. Periapical lesions (n = 36) and healthy periapical tissues (n = 10) were evaluated by immunohistochemistry using antibodies specific for human IL-33 and ST2. Lesion samples were further analyzed by double immunofluorescence to assess IL-33/ST2 co-expression. The numbers of IL-33- and ST2-positive fibroblasts were significantly higher in periapical lesions compared to healthy periapical tissues (both P 0.05). There were no significant differences in the numbers of IL-33- and ST2-positive fibroblasts and endothelial cells between periapical granulomas and radicular cysts (all P > 0.05). Similarly, numbers of ST2-positive mononuclear cells did not differ between periapical granulomas and radicular cysts (P > 0.05). The majority of epithelial cells in radicular cysts were IL-33 positive, while the small proportion of epithelial cells was ST2 positive. Double immunofluorescence analysis revealed IL-33/ST2 co-expression in fibroblasts and endothelial cells. IL-33 and ST2 are expressed in periapical granulomas and radicular cysts. Increased numbers of IL-33- and ST2-positive fibroblasts in periapical lesions when compared to healthy periapical tissues suggest that IL-33/ST2 signaling may be involved in periapical inflammation and tissue fibrosis. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Accessing 3D Location of Standing Pelvis: Relative Position of Sacral Plateau and Acetabular Cavities versus Pelvis

International Nuclear Information System (INIS)

Berthonnaud, E.; Hilmi, R.; Berthonnaud, E.; Berthonnaud, E.; Dimnet, J.

2012-01-01

The goal of this paper is to access to pelvis position and morphology in standing posture and to determine the relative locations of their articular surfaces. This is obtained from coupling bi planar radiography and bone modeling. The technique involves different successive steps. Punctual landmarks are first reconstructed, in space, from their projected images, identified on two orthogonal standing X-rays. Geometric models, of global pelvis and articular surfaces, are determined from punctual landmarks. The global pelvis is represented as a triangle of summits: the two femoral head centers and the sacral plateau center. The two acetabular cavities are modeled as hemispheres. The anterior sacral plateau edge is represented by an hemi-ellipsis. The modeled articular surfaces are projected on each X-ray. Their optimal location is obtained when the projected contours of their models best fit real outlines identified from landmark images. Linear and angular parameters characterizing the position of global pelvis and articular surfaces are calculated from the corresponding sets of axis. Relative positions of sacral plateau, and acetabular cavities, are then calculated. Two hundred standing pelvis, of subjects and scoliotic patients, have been studied. Examples are presented. They focus upon pelvis orientations, relative positions of articular surfaces, and pelvis asymmetries.

A foreign body granuloma of the stomach: a case report

International Nuclear Information System (INIS)

Rhee, Gwang Woo; Kim, Inn; Sohn, Hyung Kook; Koh, Byung Hee; Joo, Kyung Bin; Kim, Soon Yong; Park, Kyung NAm

1987-01-01

Granulomatous inflammation of the stomach similar to gastric neoplasm may occur in disseminated sarcoidosis, allergic granulomatosis. Crohn's disease, a variety of infectious disease, as a reaction to foreign material, and in the absence of any of the above as isolated granulomatous gastritis. In the foreign body induced granulomatous inflammation of the stomach, beryllium, kaolin, talcum, suture material and food can be causative materials. It is the intent of this case report to add to the list of more commonly occurring intramural gastric masses, the remote possibility of a foreign body granuloma. So radiologist should be aware of this entity and include it in their differential diagnosis of intramural gastric masses.

Three-dimensional magnetic resonance imaging analysis of hip morphology in the assessment of femoral acetabular impingement

International Nuclear Information System (INIS)

Kavanagh, E.C.; Read, P.; Carty, F.; Zoga, A.C.; Parvizi, J.; Morrison, W.B.

2011-01-01

Aim: To determine a possible association between femoral-acetabular impingement (FAI) volume and the development of labral tear using a three-dimensional (3D) model reconstruction of the acetabulum and the femoral head. Materials and methods: Magnetic resonance arthrography images of the hip in 42 patients with pain and suspected labral tear were acquired using a 1.5 T MRI machine. Using 3D analysis software, outlines of the acetabular cup and femoral head were drawn and 3D reconstruction obtained. To control for differences in patient size, ratios of acetabulum : femoral head volume (AFV) and acetabulum : femoral head surface area (AFA) were used for analysis. The association between volume of acetabulum : femoral head and FAI was investigated using ANOVA analysis. Results: There were 19 men and 23 women with a mean age of 39 years (range 18-78 years). The average AFV was 0.64 (range 0.37-1.05, SD 0.16) and AFA was 0.73 (range 0.36-1.26, SD 0.23). Herniation pit was significantly associated with a small AFV. Conclusion: Femoral neck herniation pits are associated with a low AFV. Gross volume and surface area ratios do not appear to correlate with labral tears or cartilage loss. This technique will enable more advanced analysis of morphological variations associated with FAI.

Accelerated aging, natural aging, and small punch testing of gamma-air sterilized polycarbonate urethane acetabular components.

Science.gov (United States)

Kurtz, S M; Siskey, R; Reitman, M

2010-05-01

The objectives of this study were three-fold: (1) to determine the applicability of the small punch test to characterize Bionate 80A polycarbonate urethane (PCU) acetabular implants; (2) to evaluate the susceptibility of PCU acetabular implants to exhibit degradation of mechanical behavior following gamma irradiation in air and accelerated aging; and (3) to compare the oxidation of gamma-air sterilized PCU following accelerated aging and 5 years of natural shelf aging. In addition to attenuated total reflectance-Fourier transform infrared spectroscopy, we also adapted a miniature specimen mechanical test, the small punch test, for the deformable PCU cups. Accelerated aging was performed using ASTM F2003, a standard test that represents a severe oxidative challenge. The results of this study suggest that the small punch test is sufficiently sensitive and reproducible to discriminate slight differences in the large-deformation mechanical behavior of Bionate 80A following accelerated aging. The gamma-air sterilized PCU had a reduction of 9% in ultimate load after aging. Five years of shelf aging had little effect on the mechanical properties of the PCU. Overall, our findings suggest that the Bionate 80A material has greater oxidative stability than ultra-high molecular weight polyethylene following gamma irradiation in air and exposure to a severe oxidative challenge. (c) 2010 Wiley Periodicals, Inc.

Utility of radiation in the prevention of heterotopic ossification following repair of traumatic acetabular fracture

International Nuclear Information System (INIS)

Haas, Michael L.; Kennedy, Andrew S.; Copeland, Carol C.; Ames, John W.; Scarboro, Mark; Slawson, Robert G.

1999-01-01

Purpose: Heterotopic ossification (HO) is a common problem following surgical repair of traumatic acetabular fracture (TAF), potentially causing severe pain and decreased range of motion. This report analyzes the role of radiation therapy for prevention of HO in TAF. Methods and Materials: The charts of all patients who received RT to the hip following TAF repair between July 1988 and January 1998 were reviewed. Sixty-six patients were identified. RT was given in 5 fractions of 2 Gy in 45 patients, 1 fraction of 8 Gy in 17 patients, and other doses in 4 patients. Treatment fields encompassed peri acetabular tissues at highest risk for HO. Time to RT was ≤ 24 hours for 46 patients. Results: Radiographic follow-up at least 6 months following RT was available in 47/66 (71%) patients to permit Brooker classification, revealing 6 cases (13%) of Grade III HO, compared to historical incidence in this population of 50%. No Grade IV HO was found. Mean follow-up was 18 months. Four of the Grade III patients had received 10 Gy/5 fractions, and 2 received 8 Gy/1 fraction. Postoperative wound infection occurred in 6 patients, and osteonecrosis of the femoral head was found in 13. Conclusions: RT following surgical repair of TAF provides effective prophylaxis against formation of clinically significant HO. We recommend a single fraction of 7-8 Gy within 24 hours of surgery to prevent HO formation and minimize patient discomfort

The interaction of inflammatory cells in granuloma faciale

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Takeshi Nakahara

2010-11-01

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.

Lethal midline granuloma histologically. Management with radiation therapy

International Nuclear Information System (INIS)

Barriga T, L.; Misad, O.; Moscol, A.; Pinillos G, L.; Barriga T, O.; Heredia, A.; Pinillos A, L.; Mayer Z, T.

1995-01-01

From 1973 through 1990, 24 patients with lethal midline granuloma histologically demonstrated were treated with radiation therapy at the Radiation Oncology Department of the National Institute of Neoplasmic Diseases from Peru. The authors reports the results of their experience, reviewed the literature and present a clinic and pathologic discussion of this rare entity. All the patients received radiotherapy as the main treatment and 12 of them received chemotherapy. The male to female ratio was 5:3 with a mean age of 29.33 years (range 6 to 84 years old). Symptoms of nasal obstruction were presented 45.83%, nasal enlargement in 33.33%, nasal discharge in 29.16% and fever in 29.16%, principally. We believe that radiotherapy is the treatment of choice in this report we can not demonstrate it because of the small number of patients. (authors). 28 refs., 10 tabs

MR imaging of eosinophilic granuloma: report of 11 cases

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Schepper, A M.A. de [Department of Medical Imaging, Univ. Hospital, Antwerp, (Belgium)1; Ramon, F [Department of Medical Imaging, Univ. Hospital, Antwerp, (Belgium)1; Marck, E van [Department of Pathology, University Hospital, Antwerp (Belgium)2

1993-04-01

The findings in 11 patients with histologically proven eosinophilic granuloma (EG) examined by magnetic resonance imaging (MRI) are described. In contrast with the variable appearance of EG on conventional radiography and computed tomography (CT), relatively constant features - intermediate to high signal intensity on T1-weighting, high signal intensity of T2-weighting, marked enhancement - were found on MRI. MRI was superior to other imaging methods in demonstrating bone marrow involvement and any accompanying soft tissue mass or inflammation. Intermediate to high signal intensity on T1-weighting and marked contrast enhancement could not be 'explained' by histological findings. Prediction of the evolutionary phase of EG by MRI remains questionable because of the phase I (proliferative) histology of all 11 lesions. (orig.)

Higher expression of galectin-3 and galectin-9 in periapical granulomas than in radicular cysts and an increased toll-like receptor-2 and toll-like receptor-4 expression are associated with reactivation of periapical inflammation.

Science.gov (United States)

de Oliveira, Rita de Cássia Medeiros; Beghini, Marcela; Borges, Cláudia Renata Bibiano; Alves, Polyanna Miranda; de Araújo, Marcelo Sivieri; Pereira, Sanívia Aparecida de Lima; Rodrigues, Virmondes; Rodrigues, Denise Bertulucci Rocha

2014-02-01

Cysts and periapical granulomas are inflammatory reactions that develop in response to periapical infection by microbial species in dental root canal. It is known that toll-like receptors (TLRs) are pathogen recognition molecules and that galectins are lectins that can be associated with the inflammatory process, stimulating or inhibiting the immune system. The objective of this study was to evaluate the in situ expression of TLRs and galectins in radicular cysts and periapical granulomas. We analyzed 62 cases (30 radicular cysts, 27 periapical granulomas, and 5 control cases). Indirect immunohistochemistry was used to evaluate the expression of TLRs (TRL-2 and TLR-4) and galectins (Gal-3 and Gal-9). The expression of Gal-3 and Gal-9 was significantly higher in periapical granulomas and radicular cysts than in the control group. Similarly, both Gal-3 and Gal-9 were expressed significantly more in periapical granulomas than in radicular cysts. The expression of TLR-2 was significantly higher in periapical granulomas and radicular cysts than in the control group, and it was also significantly higher in radicular cysts with sinus tract than in the cases without sinus tract. Furthermore, the expression of TLR-4 was significantly higher in the cases of periapical granulomas with sinus tract than in the cases without sinus tract. Gal-3/Gal-9 and TLR-2/TLR-4 expression in the periapical granulomas and radicular cysts is associated with reactive periapical inflammation. Pathobiology of periapical disease is a very complex interplay of many bioactive molecules involved in immunoinflammatory responses. Up-regulation of these bioactive molecules might be an important modulator of inflammatory periapical lesions. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Evaluation of Felis domesticus allergen I as a possible autoallergen in cats with eosinophilic granuloma complex

NARCIS (Netherlands)

Wisselink, Marinus A.; van Ree, Ronald; Willemse, Ton

2002-01-01

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,

Multiscale computational modeling reveals a critical role for TNF-a receptor 1 dynamics in tuberculosis granuloma formation

NARCIS (Netherlands)

Fallahi-Sichani, M.; El-Kebir, M.; Marino, S.; Kirschner, D.; Linderman, J.J.

2011-01-01

Multiple immune factors control host responses to Mycobacterium tuberculosis infection, including the formation of granulomas, which are aggregates of immune cells whose function may reflect success or failure of the host to contain infection. One such factor is TNF-α. TNF-α has been experimentally

Management of acetabular fractures with modified posterior approach to spare external hip rotators.

Science.gov (United States)

Sarlak, Ahmet Y; Selek, Ozgur; Inanir, Murat; Musaoglu, Resul; Baran, Tuncay

2014-04-01

In the present study the quality of reduction and incidence of complications in hip external rotator sparing modified posterior approach was assessed in both simple and complex acetabular fractures. This retrospective study includes 37 patients (38 hips) with a mean age of 42.1 years (range 21-60), that had been treated for displaced acetabular fractures from June 2007 through May 2011. They were reviewed at a mean of 3 years (20-67 months). The fractures were classified according to the Letournel-Judet classification. Anatomic reduction and stable fixation of the fracture with less than 2mm residual displacement was achieved in 28 of 38 hips. At the final follow up the patients were evaluated clinically according to Merle d'Aubigne and Postel scoring system which had been modified by Matta and radiologically based on the criteria described by Matta. The clinical results were excellent in 20, good in 8, fair in 8, and poor 2 hips. Complications included two superficial local wound infection and 10 heterotopic ossification with 7 of the cases having grade I heterotopic ossification. Avascular necrosis of the femoral head was not seen in any of the 38 hips. One patient with preoperative sciatic nerve palsy had complete recovery of neurologic function. There were no cases of deep vein thrombosis or pulmonary embolism. The functional outcome was satisfactory in most of the cases and comparable with other larger series. Using the limited part of Henry's sciatic nerve exposure skin incision - working in the plane between gluteus maximus and the tensor fascia lata as in the classical Gibson approach and two portal external rotator hip sparing approach resulted in good fracture reduction without approach related complications. Copyright © 2013 Elsevier Ltd. All rights reserved.

Foamy macrophages and the progression of the human TB granuloma

Science.gov (United States)

Russell, David G.; Cardona, Pere-Joan; Kim, Mi-Jeong; Allain, Sophie; Altare, Frédéric

2009-01-01

The progression of tuberculosis from a latent, sub-clinical infection to active disease that culminates in transmission of infectious bacilli is determined locally at the level of the granuloma. This progression takes place even in the face of a robust immune response that, while it contains infection, is unable to eliminate the bacterium. The factors or environmental conditions that influence this progression remain to be determined. Recent advances have indicated that pathogen-induced dysregulation of host lipid synthesis and sequestration plays a critical role in this transition. The foamy macrophage appears to be a key player in both sustaining persistent bacteria and contributing to the tissue pathology that leads to cavitation and release of infectious bacilli. PMID:19692995

A foreign body granuloma of the stomach: a case report

Energy Technology Data Exchange (ETDEWEB)

Rhee, Gwang Woo; Kim, Inn; Sohn, Hyung Kook; Koh, Byung Hee; Joo, Kyung Bin; Kim, Soon Yong; Park, Kyung NAm [Hanyang University School of Medicine, Seoul (Korea, Republic of)

1987-02-15

Granulomatous inflammation of the stomach similar to gastric neoplasm may occur in disseminated sarcoidosis, allergic granulomatosis. Crohn's disease, a variety of infectious disease, as a reaction to foreign material, and in the absence of any of the above as isolated granulomatous gastritis. In the foreign body induced granulomatous inflammation of the stomach, beryllium, kaolin, talcum, suture material and food can be causative materials. It is the intent of this case report to add to the list of more commonly occurring intramural gastric masses, the remote possibility of a foreign body granuloma. So radiologist should be aware of this entity and include it in their differential diagnosis of intramural gastric masses.

Quantification of Wear and Deformation in Different Configurations of Polyethylene Acetabular Cups Using Micro X-ray Computed Tomography

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Saverio Affatato

2017-03-01

Full Text Available Wear is currently quantified as mass loss of the bearing materials measured using gravimetric methods. However, this method does not provide other information, such as volumetric loss or surface deviation. In this work, we validated a technique to quantify polyethylene wear in three different batches of ultrahigh-molecular-polyethylene acetabular cups used for hip implants using nondestructive microcomputed tomography. Three different configurations of polyethylene acetabular cups, previously tested under the ISO 14242 parameters, were tested on a hip simulator for an additional 2 million cycles using a modified ISO 14242 load waveform. In this context, a new approach was proposed in order to simulate, on a hip joint simulator, high-demand activities. In addition, the effects of these activities were analyzed in terms of wear and deformations of those polyethylenes by means of gravimetric method and micro X-ray computed tomography. In particular, while the gravimetric method was used for weight loss assessment, microcomputed tomography allowed for acquisition of additional quantitative information about the evolution of local wear and deformation through three-dimensional surface deviation maps for the entire cups’ surface. Experimental results showed that the wear and deformation behavior of these materials change according to different mechanical simulations.

Laser: A powerful tool for treatment of pyogenic granuloma

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Shalu Rai

2011-01-01

Full Text Available Lasers have opened a new door for the treatment of various disorders. Treatment of soft tissue intraoral mucosal growth by laser has profound effect on the patient acceptability taking the functional and aesthetic factor into consideration. The patient is able to get the outdoor treatment without the phobia of local anaesthetic and is out of the clinic in few minutes in contrast to the traditional method of surgical excision. Very few cases have been reported in literature regarding treatment of mucosal growth by soft tissue lasers. We present a case of recurrent pyogenic granuloma in a patient treated with an alternative approach, that is, diode laser, without the use of anaesthesia, sutures, anti-inflammatory drugs, or analgesics. The diagnosis of this lesion is equally important for correct treatment planning.

Computerized tomography in evaluation of decreased acetabular and femoral anteversion

International Nuclear Information System (INIS)

Toennis, D.; Skamel, H.J.

2003-01-01

Computerized tomography has received a new importance. It has been shown that decreased anteversion of femur and acetabulum, when both have decreased angles, are causing pain and osteoarthritis of the hip joint. Operative treatment should be performed before osteoarthritis develops. Exact measurements therefore are necessary. The investigation should be performed in prone position to have the pelvis lying in a defined and normal position. Femoral torsion is measured between the transverse axis of the knee and the femoral neck. The transverse axis for measurement of the femoral anteversion is defined by a rectangular line to the sagittal plane. For evaluation of the femoral anteversion in total the angle of the condyles has to be added to the femoral neck angle when the knee is found in internal rotation. Acetabular anteversion should be measured at the level where the femoral head is still in full contact and congruence with the anterior margin of the acetabulum. (orig.) [de

A case of eosinophilic granuloma of the calvarium and the diagnostic value of the bone scintigraphy

International Nuclear Information System (INIS)

Sugiyama, Hirotaka; Nakashima, Yasutaka; Takahashi, Shozo; Oyama, Teruo; Nishimura, Kenichi.

1981-01-01

An operative case of eosinophilic granuloma in a 2 year and 3 month old boy was presented. The authors found that bone scintigraphy using sup(99m)Tc-diphosphonate is valuable in determining the spread of eosinophilic granulomatous lesion in the skull. We recommend this procedure before and after operation on this disease. (author)

[Mucoceles of the minor salivary glands. Extravasation mucoceles (mucus granulomas) and retention mucoceles (mucus retention cysts) (author's transl)].

Science.gov (United States)

Seifert, G; Donath, K; von Gumberz, C

1981-06-01

360 cases of salivary glands cysts (= 6%) were collected in the Salivary Glands Register (Institute of Pathology, University of Hamburg) from 1965 until 1979 among a total of 5739 register cases. 273 cases of the cystic lesions (= 76%) were mucoceles of the minor salivary glands. The analysis of these 273 cases revealed the following results: 1. Two types of mucoceles can be morphologically distinguished: extravasation mucoceles and retention mucoceles. 2. The extravasation mucocele is in our material (240 cases = 88.7%) the most frequent type of mucocele. The term "extravasation mucocele" of the anglo-american literature is identical with the term "mucus granuloma" ("Schleimgranulom") introduced by Hamperl (1932). 3. The main signs of the mucus granulomas are: predominant location (79%) at the lower lip, age peak in the 2nd decade and more frequent occurrence (in 60%) in the male sex. 4. Three stages of development can be distinguished in the pathogenesis of the mucus granulomas: an initial stage (interstitial mucus lakes), a resorption stage (mucus granulomas with macrophages, foam cells and foreign bodies giant cells) and a terminal stage with the development of a pseudocyst (capsule of collagen tissue, no epithelial demarcation). 5. The retention mucocele (synonym: mucus retention cyst) is a rare type of mucocele (33 cases = 11.3%). The main signs are: nearly equal occurrence in all oral regions, age peak in the 8th decade, moderate predominance of the female sex. 6. The retention mucoceles contain viscous mucous material, possess always an epithelial demarcation of the cysts differentiated analogous to the different segments of the salivary duct system and show as a rule no inflammatory reaction compared with the extravasation mucoceles. 7. Microtraumas and mucus congestions play the important role in the development of the extravasation mucocele. The final formation depends on the amount of the overflowed mucus and the intensity of the mucus phagocytosis. 8

Systemic granuloma observed in Atlantic salmon Salmo salar raised to market size in a freshwater recirculation aquaculture system

Science.gov (United States)

Systemic granuloma was observed in sampled adult Atlantic salmon Salmo salar raised to harvest size in a freshwater recirculation aquaculture system. The prevalence of this condition was estimated at 10-20% of the population, with affected individuals grossly demonstrating pathology in varying degre...

The Use of a Supra-Acetabular Antibiotic-Loaded Cement Shelf to Improve Hip Stability in First-Stage Infected Total Hip Arthroplasty.

Science.gov (United States)

Drexler, Michael; Kuzyk, Paul R T; Koo, Kevin; Gross, Allan E; Kosashvili, Yona; Reischl, Nickola; Rutenberg, Tal Frenkel; Safir, Oleg

2016-11-01

Antibiotic-loaded cement spacers in first-stage revision total hip arthroplasty (THA) for managing infection are associated with high dislocation and fracture rates. The aim of this study was to report the use of an antibiotic-loaded cemented supra-acetabular roof augmentation to reinforce hip stability after cement spacer insertion for first-stage total hip revision in the treatment of infected THA. We retrospectively reviewed a consecutive series of 50 THAs involving 47 patients with an infected hip requiring staged revisions of THA. We documented dislocation, reinfection, and time for revision and outcome. There were no cases of hip dislocation, cement fractures, or any other technical complications associated with the use of the roof augmentation lip. Thirteen cases (26%) had a cemented spacer for longer than 120 days. Seven (14%) cases had recurrent infection after staged revision THA. The antibiotic-loaded cemented supra-acetabular roof augment improved femoral head spacer coverage for patients requiring a staged revision THA for infection. Copyright © 2016 Elsevier Inc. All rights reserved.

Multiple Synchronous Central Giant Cell Granulomas of the Maxillofacial Region: A Case Report

International Nuclear Information System (INIS)

Kang, Min Seok; Kim, Hak Jin

2010-01-01

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

Multiple Synchronous Central Giant Cell Granulomas of the Maxillofacial Region: A Case Report

Energy Technology Data Exchange (ETDEWEB)

Kang, Min Seok; Kim, Hak Jin [Pusan National University Hospital, Busan (Korea, Republic of)

2010-01-15

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

[Prostatic granulomas revealing a peripheral T-cell lymphoma].

Science.gov (United States)

Foguem, C; Curlier, E; Rouamba, M-M; Regent, A; Philippe, P

2009-02-01

The presence of granulomas on tissue biopsie has been reported in a wide range of disorders. The clinical presentation and the diagnostic work-up of granulomatosis can be difficult as it is illustrated in the following report. A 59-year-old patient was referred in 2002 for a granulomatous prostatitis. Physical examination was normal. Except for the increase of prostate-specific antigen (which motivated a biopsy), the laboratory results were normal. Thoracic CT-scan disclosed mediastinal lymph nodes. A minor salivary gland biopsy was consistent with the diagnosis of sarcoidosis. In 2004, the patient presented an epidermal necrolysis, and in 2005 the deterioration of general status raised suspicion of a lymphoproliferative disorder. Liver and bone marrow biopsies revealed a granulomatous process. Despite steroid therapy, the patient died. Autopsy discloses a anaplasic T cell lymphoma. This report illustrates the relationship between sarcoidosis and lymphoma as a mode of presentation, a complication, or an accidental but misleading association? The association between anaplastic lymphoma and sarcoidosis is exceptional.

Delayed-Onset Edematous Foreign Body Granulomas 40 Years After Augmentation Rhinoplasty by Silicone Implant Combined with Liquid Silicone Injection.

Science.gov (United States)

Hu, Hao-Chun; Fang, Hsu-Wei; Chiu, Yu-Hsun

2017-06-01

Despite the widespread application of augmentation rhinoplasty in Asia, reports on the interaction between alloplastic implants and injectable filler are scarce. This paper reports on a patient with delayed-onset edematous foreign body granuloma that had been caused by augmentation rhinoplasty performed using a silicone implant in conjunction with a liquid silicone injection 40 years earlier. This is the longest reported duration between initial rhinoplasty and the exacerbation of foreign body granuloma. This case report also presents intraoperative findings pertaining to the interlocking structures between silicone implants and injected liquid silicone. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The Use of a 3D Printer in Pre-operative Planning for a Patient Requiring Acetabular Reconstructive Surgery.

Science.gov (United States)

Duncan, James M; Nahas, Samuel; Akhtar, Kashif; Daurka, Jasvinder

2015-01-01

Surgical management of acetabular fractures is often highly complex, and a successful outcome depends upon an appreciation of the fracture pattern and the most appropriate approach to reduce and hold it. Currently, computed tomography (CT) images are used in conjunction with plain x-rays to identify the main fracture components and their spatial relationship to one another, and as such surgeons still have to make decisions based upon their ability to visualise the fracture from the images available. 3D printers have now become widely available and inexpensive, and can be used to rapidly produce life-size models based on CT scans of an individual patient. The availability of patient specific, accurate and detailed models of complex acetabular fractures can aid planning of surgical management on a patient specific basis. This report describes the use of a 3D printer to create a life-size model reconstruction of the pelvis of a 48 year old male patient who sustained a left sided associated both column acetabular fracture following a motorbike accident in the Sahara Desert. The model allowed visualisation of the multiple fracture fragments and their relative displacements. The tactile feedback allowed assessment of the different fracture fragments. The relative displacement of the quadrilateral plate and posterior column fragments could be assessed and the surgeon felt that these would be amenable to reduction from an ilioinguinal approach. An anatomic reduction was achieved and was held with the application of a pelvic brim plate with 2 screws lagging the posterior column/quadrilateral plate fragment. There are previous examples of 3D models being used in orthopaedic surgery through the use of rapid prototyping, however this method is usually expensive and time consuming. Advances in 3D printer technology offer surgeons a number of advantages when treating these complex fractures. With the ever-increasing economy, ease of use and speed of additive processing, the

Giant cell reparative granuloma of the base of the skull in a 4-month-old infant - CT findings

International Nuclear Information System (INIS)

Cohen, D.; Granda-Ricart, M.C.

1993-01-01

An unusual case of giant cell reparative granuloma of the base of the skull of a 4-month-old infant is described. Computerized tomography was useful in defining extent of the lesion and soft tissue abnormalities. Differential diagnosis with other giant cell lesions is discussed. (orig.)

Early experience with dual mobility acetabular systems featuring highly cross-linked polyethylene liners for primary hip arthroplasty in patients under fifty five years of age: an international multi-centre preliminary study.

Science.gov (United States)

Epinette, Jean-Alain; Harwin, Steven F; Rowan, Fiachra E; Tracol, Philippe; Mont, Michael A; Chughtai, Morad; Westrich, Geoffrey H

2017-03-01

To evaluate early performance of contemporary dual mobility acetabular systems with second generation annealed highly cross-linked polyethylene for primary hip arthroplasty of patients under 55 years of age. A prospective observational five years study across five centers in Europe and the USA of 321 patients with a mean age of 48.1 years was performed. Patients were assessed for causes of revision, hip instability, intra-prosthetic dissociation, Harris hip score and radiological signs of osteolysis. There were no dislocations and no intra-prosthetic dissociations. Kaplan Meier analysis demonstrated 97.51% survivorship for all cause revision and 99.68% survivorship for acetabular component revision at five years. Mean Harris hip score was 93.6. Two acetabular shells were revised for neck-rim implant impingement without dislocation and ten femoral stems were revised for causes unrelated to dual mobility implants. Contemporary highly cross-linked polyethylene dual mobility systems demonstrate excellent early clinical, radiological, and survivorship results in a cohort of patients that demand high performance from their implants. It is envisaged that DM and second generation annealed HXLPE may reduce THA instability and wear, the two most common causes of THA revision in hip arthroplasty.

COMPARATIVE ANALYSIS OF THE TREATMENT OF THE EOSINOPHILIC GRANULOMA WITH VERTEBRAL INVOLVEMENT USING ORTHOPEDIC CORSET AND SURGICAL OPERATION

Directory of Open Access Journals (Sweden)

A. I. Snetkov

2010-01-01

Full Text Available The results of treatment of 72 patients with pathological fracture of vertebra bodies against eosinophilic granuloma a spine are analysed. Orthopedic corset technologies are used in treatment of 42 patients, surgical treatment was applied. Orthopedic corset may be used in patients with eosinophilic granuloma of backbone. This method of treatment was used in a case of the absence of spine secondary deformations and neurologic semiology. Orthopedic corset treatment is associated with long immobilization on the average within 1,5-2 years and never leads to a complete recovery of the damaged spine. Surgical treatment consists in use only at loss of height of a body to 30-40%, when destruction of spine more severe it is necessary to use operative treatment in two stages. Absolute indications to surgical treatment are the neurologic deficit and secondary deformations of a spine. Surgical treatment allows to reduce terms of treatment till 3-4 months and quickly to return the patient to an active life.

Traumatic ulcerative granuloma with stromal eosinophilia of the palate showing an angiocentric/angiodestructive growth pattern

OpenAIRE

Brasileiro, Bernardo Ferreira; Alves, Daniel Berretta; Andrade, Bruno Augusto Benevenuto; Vargas, Pablo Agustin; León, Jorge Esquiche; Almeida, Oslei Paes De

2012-01-01

Traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) is a benign, self-limiting lesion of the oral mucosa with unknown pathogenesis. A 65-year-old male patient presented with an ulcerative palate lesion, which on microscopic examination exhibited an exuberant polymorphic lymphoid proliferation, numerous eosinophils, and extensive vascular destruction. The atypical lymphoid cells infiltrating the medium-sized vessels showed positivity for CD3, CD30, and granzyme B, implicating an a...

Treatment with silver nitrate versus topical steroid treatment for umbilical granuloma: A non-inferiority randomized control trial.

Directory of Open Access Journals (Sweden)

Chikako Ogawa

Full Text Available The aim of this prospective multicenter randomized controlled trial was to compare the efficacy of silver nitrate cauterization against that of topical steroid ointment in the treatment of neonatal umbilical granuloma.An open-label, non-inferiority randomized controlled trial was conducted from January 2013 to January 2016. The primary endpoint for the silver nitrate cauterization and topical steroid ointment groups was the healing rate after 2 weeks of treatment, applying a non-inferiority margin of 10%. The healing rate was evaluated until completion of 3 weeks of treatment.Participants comprised 207 neonates with newly diagnosed umbilical granuloma, randomized to receive silver nitrate cauterization (n = 104 or topical steroid ointment (n = 103. Healing rates after 2 weeks of treatment were 87.5% (91/104 in the silver nitrate cauterization and 82% (82/100 in the topical steroid ointment group group. The difference between groups was -5.5% (95% confidence interval, -19.1%, 8.4%, indicating that the non-inferiority criterion was not met. After 3 weeks of treatment, the healing rate with topical steroid ointment treatment was almost identical to that of silver nitrate cauterization (94/104 [90.4%] vs. 91/100 [91.0%]; 0.6% [-13.2 to 14.3]. No major complications occurred in either group.This study did not establish non-inferiority of topical steroid ointment treatment relative to silver nitrate cauterization, presumably due to lower healing rates than expected leading to an underpowered trial. However, considering that silver nitrate cauterization carries a distinct risk of chemical burns and that the overall efficacy of topical steroid ointment treatment is similar to that of silver nitrate cauterization, topical steroid ointment might be considered as a good alternative in the treatment of neonatal umbilical granuloma due to its safety and simplicity. To clarify non-inferiority, a larger study is needed.

Specific Human and Candida Cellular Interactions Lead to Controlled or Persistent Infection Outcomes during Granuloma-Like Formation.

Science.gov (United States)

Misme-Aucouturier, Barbara; Albassier, Marjorie; Alvarez-Rueda, Nidia; Le Pape, Patrice

2017-01-01

A delayed type of multicellular process could be crucial during chronic candidiasis in determining the course of infection. This reaction, consisting of organized immune cells surrounding the pathogen, initiates an inflammatory response to avoid fungal dissemination. The goal of the present study was to examine, at an in vitro cellular scale, Candida and human immune cell interaction dynamics during a long-term period. By challenging human peripheral blood immune cells from 10 healthy donors with 32 Candida albicans and non-albicans (C. glabrata, C. tropicalis, C. parapsilosis, C. dubliniensis, C. lusitaniae, C. krusei, and C. kefyr) clinical isolates, we showed that Candida spp. induced the formation of granuloma-like structures within 6 days after challenge, but their sizes and the respective fungal burdens differed according to the Candida species. These two parameters are positively correlated. Phenotypic characteristics, such as hypha formation and higher axenic growth rate, seem to contribute to yeast persistence within granuloma-like structures. We showed an interindividual variability of the human response against Candida spp. Higher proportions of neutrophils and elevated CD4 + /CD8 + T cell ratios during the first days after challenge were correlated with early production of gamma interferon (IFN-γ) and associated with controlled infection. In contrast, the persistence of Candida could result from upregulation of proinflammatory cytokines such as interleukin-6 (IL-6), IFN-γ, and tumor necrosis factor alpha (TNF-α) and a poor anti-inflammatory negative feedback (IL-10). Importantly, regulatory subsets of NK cells and CD4 lo CD8 hi doubly positive (DP) lymphocytes at late stage infiltrate granuloma-like structures and could correlate with the IL-10 and TNF-α production. These data offer a base frame to explain cellular events that guide infection control or fungal persistence. Copyright © 2016 Misme-Aucouturier et al.

Outcome of periacetabular osteotomy for the management of acetabular dysplasia: experience in an academic centre.

LENUS (Irish Health Repository)

Burke, Neil G

2011-02-01

Periacetabular osteotomy (PAO) is a very effective reconstructive procedure for treatment of acetabular dysplasia. An orthopaedic paediatric surgeon and a reconstructive hip arthroplasty surgeon performed this procedure together in the early phase of their learning curve and then performed it individually. The early clinical and radiographic results of 85 consecutive PAOs performed in this academic orthopaedic unit were reviewed. The mean Merle-d\\'Aubigné score increased from 12.4 preoperatively to 16 at follow-up. Pre-operatively 73 hips were anteverted and 12 were neutral or retroverted. The mean angle of Wiberg improved from 5 degrees to 21 degrees (p < 0.0001) in anteverted hips, and from 9 degrees to 30 degrees in neutral or retroverted hips. The mean angle of Lequesne and de Sèze improved from 6 degrees to 35 degrees (p < 0.0001) in anteverted hips, and in neutral or retroverted hips from 9 degrees to 30 degrees (p < 0.0001). The acetabular index improved from 26 degrees to 8 degrees (p < 0.0001) in anteverted hips, and from 21 degrees to 7 degrees (p < 0.0001) in neutral or retroverted hips. Over the 7 year period the blood loss and operative time improved from 2000 ml to 900 ml and 4 hours to 2 hours respectively. Four hips (four patients) required conversion to total hip replacement. The radiographic correction and improved clinical scores are similar to those in previous studies. This study shows a survival rate of 94% at 58 months following periacetabular osteotomy. The learning curve and the early results of this procedure performed in our academic unit are encouraging.

Internal Fixation of Complicated Acetabular Fractures Directed by Preoperative Surgery with 3D Printing Models.

Science.gov (United States)

Liu, Zhao-Jie; Jia, Jian; Zhang, Yin-Guang; Tian, Wei; Jin, Xin; Hu, Yong-Cheng

2017-05-01

The purpose of this article is to evaluate the efficacy and feasibility of preoperative surgery with 3D printing-assisted internal fixation of complicated acetabular fractures. A retrospective case review was performed for the above surgical procedure. A 23-year-old man was confirmed by radiological examination to have fractures of multiple ribs, with hemopneumothorax and communicated fractures of the left acetabulum. According to the Letounel and Judet classification, T-shaped fracture involving posterior wall was diagnosed. A 3D printing pelvic model was established using CT digital imaging and communications in medicine (DICOM) data preoperatively, with which surgical procedures were simulated in preoperative surgery to confirm the sequence of the reduction and fixation as well as the position and length of the implants. Open reduction with internal fixation (ORIF) of the acetabular fracture using modified ilioinguinal and Kocher-Langenbeck approaches was performed 25 days after injury. Plates that had been pre-bent in the preoperative surgery were positioned and screws were tightened in the directions determined in the preoperative planning following satisfactory reduction. The duration of the operation was 170 min and blood loss was 900 mL. Postoperative X-rays showed that anatomical reduction of the acetabulum was achieved and the hip joint was congruous. The position and length of the implants were not different when compared with those in preoperative surgery on 3D printing models. We believe that preoperative surgery using 3D printing models is beneficial for confirming the reduction and fixation sequence, determining the reduction quality, shortening the operative time, minimizing preoperative difficulties, and predicting the prognosis for complicated fractures of acetabulam. © 2017 Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

Eosinophilic granuloma of the skull base: patient with unique clinical moreover, radiographic presentation.

Directory of Open Access Journals (Sweden)

Hosein Dalili

2015-01-01

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.

Measuring Acetabular Cup Orientation on Antero-Posterior Radiographs of the Hip after Total Hip Arthroplasty with a Vector Arithmetic Radiological Method. Is It Valid and Verified for Daily Clinical Practice?

Science.gov (United States)

Craiovan, B; Weber, M; Worlicek, M; Schneider, M; Springorum, H R; Zeman, F; Grifka, J; Renkawitz, T

2016-06-01

The aim of this prospective study is to validate a vector arithmetic method for measuring acetabular cup orientation after total hip arthroplasty (THA) and to verify the clinical practice. We measured cup anteversion and inclination of 123 patients after cementless primary THA twice by two examiners on AP pelvic radiographs with a vector arithmetic method and compared with a 3D-CT based reconstruction model within the same radiographic coronal plane. The mean difference between the radiographic and the 3D-CT measurements was - 1.4° ± 3.9° for inclination and 0.8°± 7.9° for anteversion with excellent correlation for inclination (r = 0.81, p cup position after THA on pelvic radiographs by this vector arithmetic method, there is a need for a correct postoperative ap view, with special regards to the pelvic tilt for the future. • Measuring acetabular cup orientation on anteroposterior radiographs of the hip after THA is a helpful procedure in everyday clinical practice as a first-line imaging modality• CT remains the golden standard to accurately determine acetabular cup position.• Future measuring on radiographs for cup orientation after THA should account for integration of the pelvic tilt in order to maximize the measurement accuracy. Citation Format: • Craiovan B, Weber M, Worlicek M et al. Measuring Acetabular Cup Orientation on Antero-Posterior Radiographs of the Hip after Total Hip Arthroplasty with a Vector Arithmetic Radiological Method. Is It Valid and Verified for Daily Clinical Practice?. Fortschr Röntgenstr 2016; 188: 574 - 581. © Georg Thieme Verlag KG Stuttgart · New York.

Influence of pelvic position on radiographic measurements of the prosthetic acetabular component

International Nuclear Information System (INIS)

Thoren, B.; Sahlstedt, B.; Uppsala Univ.

1990-01-01

A change in the position of a prosthetic acetabular component between two different radiographic examinations indicates loosening, and may be observed as tilting or migration of the socket. To determine the apparent changes in socket position caused by improper positioning of the pelvis, a full-scale model of a pelvis with attached prosthetic sockets was examined radiographically in different positions. The projected alignment of the Charnley socket indicator wire against the inter-tuberosity line was markedly influenced by the positioning of the pelvis. An alternative way of measuring the alignment is to use the long axis of the projected ellipse of the outer circumferential groove in the socket polyethylene. The thus defined socket alignment was not influenced by the positioning of the pelvis within the investigated range. No apparent socket migration was recorded within the range of pelvic rotation and inclination studied. (orig.)

GIANT CELL GRANULOMAS OF THE JAWS (ANALYSIS OF 1,083 CASES

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Ismail Yazdi

1995-07-01

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.

Effect of centre-edge angle on clinical and quality of life outcomes after arthroscopic acetabular labral debridement.

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Wu, Ziying; Chen, Shiyi; Li, Yunxia; Li, Hong; Chen, Jiwu

2016-07-01

The aim of this study was to compare clinical and quality of life outcomes following arthroscopic acetabular labral debridement between patients with different centre-edge (CE) angle. A total of 79 patients who underwent hip labral debridement were enrolled in this study. Radiographic measurements of CE angle were collected, and patients were assigned into a normal group (25°  0.05). Additionally, there was a greater improvement in clinical scores post-operatively in the normal group compared with the dysplasia group (P 25° compared with patients with CE angle < 20°.

Mesenteric cryptococcal granuloma in a dog caused by Cryptococcus neoformans var. grubii

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Rodrigues-Hoffmann A

2012-09-01

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

Open reduction and internal fixation of osteoporotic acetabular fractures through the ilio-inguinal approach: use of buttress plates to control medial displacement of the quadrilateral surface.

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Peter, Robin E

2015-01-01

The number of acetabular fractures in the geriatric population requiring open reduction and internal fixation is increasing. Fractures with medial or anterior displacement are the most frequent types, and via the ilio-inguinal approach buttress plates have proved helpful to maintain the quadrilateral surface or medial acetabular wall. Seven to ten hole 3.5 mm reconstruction plates may be used as buttress plates, placed underneath the usual pelvic brim plate. This retrospective study presents our results with this technique in 13 patients at a minimum follow-up of 12 months (average, 31 months). 85% of the patients had a good result. The early onset of post-traumatic osteoarthritis necessitated total hip arthroplasty in two patients (15%) at 12 and 18 months follow-up, respectively. This treatment option should be considered in the surgeon's armamentarium when fixing these challenging cases. Copyright © 2015 Elsevier Ltd. All rights reserved.

Pulmonary hyalinizing granuloma: Bilateral pulmonary nodules associated with chronic idiopathic thrombocytopenic purpura

International Nuclear Information System (INIS)

Satti, Mohamed B.; Batouk, Abdelnasir; Ahmad, Mohamed F.; Abdelaal, Mohamed A.; Abdelaziz, Muntasir M.

2005-01-01

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)

Clinical and radiological analysis of a series of periapical cysts and periapical granulomas diagnosed in a Brazilian population.

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Tavares, Daniel-Petitet; Rodrigues, Janderson-Teixeira; Dos Santos, Teresa-Cristina-Ribeiro-Bartholomeu; Armada, Luciana; Pires, Fábio-Ramôa

2017-01-01

Periapical cysts (PC) and periapical granulomas (PG) are the two most common chronic inflammatory periapical diseases, but their clinicoradiological characteristics can vary depending on the methods employed in each study. The aim of the present work was to analyze the clinical and radiological profile of a series of PC and PG diagnosed in a Brazilian population. The files of two Oral Pathology laboratories were reviewed and all cases diagnosed as PG and PC were selected for the study. Clinical and radiological information were retrieved and data were tabulated and descriptively and comparatively analyzed. Final sample was composed by 647 inflammatory periapical lesions, including 244 PG (38%) and 403 PC (62%). The number of women affected by PG was significantly higher than the number of women affected by PC ( p =0.037). Anterior region of the maxilla was the most common affected area for both entities (39% of the cases), but the most common anatomical location of PG (anterior maxilla and posterior maxilla) was different from PC (anterior maxilla and posterior mandible) ( p Periapical granuloma, periapical cyst, radicular cyst, diagnosis, Oral Pathology.

Hip flexor muscle size, strength and recruitment pattern in patients with acetabular labral tears compared to healthy controls.

Science.gov (United States)

Mendis, M Dilani; Wilson, Stephen J; Hayes, David A; Watts, Mark C; Hides, Julie A

2014-10-01

Acetabular labral tears are a source of hip pain and are considered to be a precursor to hip osteoarthritis. Hip flexor muscles contribute to hip joint stability and function but it is unknown if their size and function is altered in the presence of labral pathology. This study aimed to investigate hip flexor muscle size, strength and recruitment pattern in patients with hip labral pathology compared to control subjects. 12 subjects diagnosed with an unilateral acetabular labral tear were compared to 12 control subjects matched for age and gender. All subjects underwent magnetic resonance imaging (MRI) of their lumbo-pelvic region. Average muscle cross-sectional area (CSA) of the iliacus, psoas, iliopsoas, sartorius, tensor fascia latae and rectus femoris muscles were measured. Hip flexion strength was measured by an externally fixed dynamometer. Individual muscle recruitment pattern during a resisted hip flexion exercise task was measured by muscle functional MRI. Hip flexor muscle strength was found to be decreased in patients with labral pathology compared to control subjects (p muscle size (all p > 0.17) and recruitment pattern (all p > 0.53). Decreased hip flexor muscle strength may affect physical function in patients with hip labral pathology by contributing to altered gait patterns and functional tasks. Clinical rehabilitation of these patients may need to include strengthening exercises for the hip flexor muscles. Copyright © 2014 Elsevier Ltd. All rights reserved.