Clinicopathological Features of 19 Eyelid Pilomatrixomas

Introduction: Pilomatrixoma is a relatively rare, benign tumor arising from the hair root matrix. It is found frequently on the head and neck, with most involving the eyebrow in the periocular region. In contrast, eyelid pilomatrixoma is less common, and often clinically misdiagnosed. Here, we present clinical and histological data from 19 pilomatrixomas arising in the eyelid. Methods: The study represents a retrospective study of eyelid pilomatrixoma diagnosed at our institution since 1981. All slides were reviewed, and demographic as well as clinical data obtained. Results: Patient ages ranged from 2 to 63 years (mean 24 years), including 12 (63%) females and 7(37%) males. Eight (42%) and 4 (21%) cases arose in the first and second decades of life, respectively. Upper eyelid involvement was found in 14 (74 %) of cases. Microscopically, the tumors were characterize by basaloid and shadow cells accompanied by calcification and foreign body giant cells. Conclusions: Eyelid pilomatrixoma is rarely suspected clinically, and can be mistaken for cyst, chalazion, sebaceous carcinoma and other tumors. Physicians should consider the possibility of pilomatrixoma in the eyelid area, especially in children or young female patients. Complete excision is curative, and diagnosis can generally be established by histopathological examination.

First Case Report of Cholesterol Granuloma of Femur

Introduction: Cholesterol granuloma (CG) is a special type of granulation tissue reaction. It is a very rare benign lesion with swelling growth, in which there are a large number of cholesterol crystals and foreign body giant cells. A small amount of literature reports that it occurred in the middle ear or mastoid area. There has been no report of CG of the femur.Methods: A 74-year-old woman suffered from pain and discomfort in the upper right knee for 10 years, which aggravated for 10 days. He was diagnosed with CG of the right femur in our hospital, and was treated with surgery. Results: During the operation, a large amount of yellow-brown oily crystal structure was found, and the pathology after the operation was confirmed as CG. The postoperative follow-up was 3 months, and the treatment effect was satisfactory.Conclusion: CG of the femur is an extremely rare benign lesion, and there is no relevant report. Surgical treatment can remove the diseased tissue and provide effective treatment results.

Immunological and functional features of decellularized xenogeneic heart valves after transplantation into GGTA1-KO pigs

Decellularization of xenogeneic heart valves might lead to excellent regenerative implants, from which many patients could benefit. However, this material carries various xenogeneic epitopes and thus bears a considerable inherent immunological risk. Here, we investigated the regenerative and immunogenic potential of xenogeneic decellularized heart valve implants using pigs deficient for the galactosyltransferase gene (GGTA1-KO) as novel large animal model. Decellularized aortic and pulmonary heart valves obtained from sheep, wild-type pigs or GGTA1-KO pigs were implanted into GGTA1-KO pigs for 3, or 6 months, respectively. Explants were analyzed histologically, immunhistologically (CD3, CD21 and CD172a) and anti-αGal antibody serum titers were determined by ELISA. Xenogeneic sheep derived implants exhibited a strong immune reaction upon implantation into GGTA1-KO pigs, characterized by massive inflammatory cells infiltrates, presence of foreign body giant cells, a dramatic increase of anti-αGal antibody titers and ultimately destruction of the graft, whereas wild-type porcine grafts induced only a mild reaction in GGTA1-KO pigs. Allogeneic implants, wild-type/wild-type and GGTA1-KO/GGTA1-KO valves did not induce a measurable immune reaction. Thus, GGTA1-KO pigs developed a ‘human-like’ immune response toward decellularized xenogeneic implants showing that immunogenicity of xenogeneic implants is not sufficiently reduced by decellularization, which detracts from their regenerative potential.

Morphological Features of Foreign Body Giant Cells in Experimental Conditions

Background: The purpose of our work was determined by the accumulation of a significant amount of experimental material under the conditions of implantation of a foreign body, a mesh implant, into the region of the anterior abdominal wall in order to obtain experimental inflammation, in which foreign body giant cells (FBGCs) were constantly visualized as reactive formations. This research aimed to study the dynamics of morphological changes in FBGCs under conditions of experimental implantation of a foreign body, a mesh implant, and the possible mechanism of their formation Methods and Results: This study was carried out on male Wistar rats, in which a foreign body was implanted—a mesh endoprosthesis made of polypropylene—in the region of the anterior abdominal wall under the aponeurosis of the rectus abdominis muscles. A section of the anterior abdominal wall with the implanted endoprosthesis was excised on Days 10, 21, 30, and 60 after surgery, fixed in 10% buffered formalin solution. The obtained samples were embedded in paraffin according to standard prescriptions; histological sections with a thickness of 5-7µm were made and stained with H&E, according to the methods of Van Gieson and Mallory, and an immunohistochemical study was performed using the marker of cell proliferation (Ki-67). The revealed structural features of multinucleated cells were recorded by microphotography using a photo attachment and a Levenhuk video camera (USA). During the study, it was revealed that the amount, functional activity and morphological diversity of FBGCs gradually increased, reaching a maximum by Day 30 of the experiment. At a later date, some of them died, while the remaining part was differentiated, splitting into small multinucleated cells and mononuclear elements, morphologically identical to macrophages and fibroblasts. The formation of FBGCs continued as long as the mesh implant was in the body. Conclusion: FBGCs are reactive formations that arise in response to various endo- and exogenous irritation.

Experimental Study Comparing Structural Changes Induced by Biologic Versus Synthetic Mesh Implants in Nephropexy

Background: The study suggests that the use of the extracellular bovine-derived peritoneum matrix as a new biological implant opens up new prospects for nephropexy. Materials and Methods: Experimental nephropexy was performed in 64 white shorthaired adult rats, divided for 2 groups: extracellular bovine-derived peritoneum matrix, UltraPro mesh. Implants were 1,5*1,5cm per one animal. Observation periods were 7, 21, 30 and 180 days. The tissue was stain with H&E, Van Gieson’s with pikro-fuchin. Cellular infiltrate was evaluated by counting granulocytes, mononuclear cells, and foreign-body giant cells on five high-magnification images for each stained section (×400). Results: The use of the extracellular bovine-derived peritoneum matrix induced less intense and less prolonged chronic inflammatory response, as well as intense production of new collagen fibers more similar to the native connective tissue in terms of their histologic structure. The UltraPro mesh induced moderately persistent chronic inflammatory response throughout the 6- month study period. Conclusion: Histologic evaluation demonstrates high biocompatibility of both the extracellular bovine-derived peritoneum matrix, and the UltraPro mesh implants.The results of using new biological material are not worse than synthetic mesh. The data obtained justify further research of the extracellular bovine-derived peritoneum matrix as a plastic material for nephropexy.

Fibrin Polymer on the Surface of Biomaterial Implants Drives the Foreign Body Reaction

ABSTRACTImplantation of biomaterials and medical devices in the body triggers the foreign body reaction (FBR) which is characterized by macrophage fusion at the implant surface leading to the formation of foreign body giant cells and the development of the fibrous capsule enveloping the implant. While adhesion of macrophages to the surface is an essential step in macrophage fusion and implanted biomaterials are known to rapidly acquire a layer of host proteins, a biological substrate that is responsible for this process in vivo is unknown. Here we show that mice with genetically-imposed fibrinogen deficiency display a dramatic reduction of macrophage fusion on implanted biomaterials and are protected from the formation of fibrin-containing granulation tissue, a precursor of the fibrous capsule. Furthermore, macrophage fusion on biomaterials implanted in FibAEK mice that express a mutated form of fibrinogen incapable of thrombin-mediated polymerization was strongly reduced. Surprisingly, despite the lack of fibrin, the capsule was formed in FibAEK mice, although it had a different composition and distinct mechanical properties than that in wild-type mice. Specifically, while mononuclear α-SMA-expressing macrophages embedded in the capsule of both strains of mice secreted collagen, the amount of collagen and its density in the tissue of FibAEK mice was reduced. These data identify fibrin polymer as a key biological substrate driving the development of the FBR.

Comparison of bone wax and chitosan usage on post-sternotomy bone healing

Background Sternotomy is a standard approach performed in almost every surgical procedure on the heart and mediastinum. Effective hemostasis of the sternum is required to keep the operative field dry, avoid excessive blood transfusions during surgery, and prevent reoperation due to massive postoperative bleeding, which can further increase morbidity and mortality in patients. Bone wax is a mechanical hemostat commonly used after sternotomy and has been known to affect bone healing, trigger chronic inflammatory reactions, and increase the rate of infection. The application of chitosan, which has intrinsic hemostat ability, as hemostatic material is believed to improve bone healing following sternotomy. This study aimed to compare the effectiveness of bone wax and chitosan on bone healing after sternotomy. Methods Median sternotomies were performed on 2 groups of New Zealand White rabbits. Each group of 16 animals received either bone wax or chitosan powder as hemostatic material. The degree of bone healing, the number of foreign-body giant cells, and the number of osteoblasts were evaluated after 6 weeks. Results Radiographs showed that significantly more animals in the chitosan group had total sternal healing ( p = 0.033). Histopathology revealed that the number of foreign-body giant cells was significantly less ( p = 0.036) and the number of osteoblasts was significantly greater ( p < 0.0001) in the group of animals that received chitosan. Conclusion The use of chitosan as hemostatic material can promote better bone healing compared to bone wax.

Pulmonary hair embolism in a rescued free-ranging Eurasian otter Lutra lutra in Kinmen, Taiwan

Eurasian otters Lutra lutra are listed as Near Threatened on the IUCN Red List and are imperiled by habitat loss, water pollution, and poaching. Harassment and attacks by stray animals are also recognized threats to the health of wild Eurasian otters. Pulmonary hair embolism is a possible complication in animals with deep traumatic injury, but to date no cases have been reported in wildlife. A free-ranging, adult male Eurasian otter was rescued due to severe emaciation and multiple bite wounds. The otter died 3 d after rescue and was necropsied. Grossly, a 1.5 × 1.5 × 1.5 cm firm nodule was observed in the left cranial lung lobe. Histologically, a fragment of hair shaft surrounded by multinucleated foreign body giant cells was observed in a medium-sized vein, and extensive eosinophilic infiltration was noted in the adjacent vascular wall and lung parenchyma. Based on the gross and histological findings, the pulmonary lesion was consistent with eosinophilic pneumonia and vasculitis induced by hair embolism. The presence of well-formed multinucleated foreign body giant cells and eosinophils may imply a late stage of foreign body reaction, and thus the presumptive source of hair embolism is an animal bite. This is the first report of pulmonary hair embolism associated with animal bite in a rescued free-ranging Eurasian otter.

Giant cells lepromatous leprosy. Diffuse dermatitis with exuberant foreign body giant cells in treated lepromatous leprosy

Patients with lepromatous leprosy that have received treatment for many years usually get follow up biopsies for persistent skin lesions or positive bacilloscopy even if the values are lower than in the initial bacilloscopy.We report the case of a 48-year old woman with long-standing lepromatous leprosy of 15 years of evolution, with a bacterial index of 4 in the direct smear and the initial skin biopsy.The patient was treated with multidrug therapy for 32 months although the treatment recommended by the World Health Organization (WHO) is only for 12 months.A skin biopsy was taken to determine if there was an active disease. We observed a diffuse dermal inflammation with numerous foreign body giant cells and vacuolated macrophages (Virchow´s cells). These cells contained granular acid-fast material that was also positive with immunohistochemistry for BCG. There were fragmented bacilli and the BI was 2.These cells were also strongly positive for CD68. The biopsy was interpreted as a residual form of lepromatous leprosy that did not require further multidrug therapy.We have observed similar histological profiles in several cases. The lack of clinical data makes it a histological challenge. The accumulation of lipids in these giant cells is due to bacillary destruction and fusion of vacuolated macrophages. We discuss here the role of bacillary and host lipids in the pathogenesis of lepromatous leprosy. We concluded that there was no need to extend the 12-month multidrug therapy recommended by WHO.

Additive effect of pulp pequi oil (Caryocar brasiliense Camb.) on the biocompatibility of collagen and gelatin membranes in subcutaneous implants

ABSTRACT Trauma or disease inflicted by tissue injuries may cause tissue degeneration. The use of biomaterials for direct or indirect repair has emerged as a promising alternative, and has become an important research topic. The pequi fruit (Caryocar brasiliense Camb.) has shown antifungal, antibacterial, anti-inflammatory, healing, antitumor, and antioxidant properties. The objective of this study was to develop a new biomaterial using a combination of collagen, gelatin, and pulp pequi oil, and to evaluate its biocompatibility in comparison with that of biomaterials produced without pulp pequi oil. Membranes were prepared from a mixture of bovine tendon collagen, commercial gelatin, and pulp pequi oil. The inflammatory and cicatricial processes were assessed via histopathology of the tissue interface/implants in the subcutaneous tissues and quantitative evaluation of leukocyte and collagen production in Wistar rats. It was observed that the presence of pequi oil reduced the amount of foreign-body giant cells and favored the recruitment of fibroblasts (P< 0.01), thereby promoting greater production of collagen membrane than that in the membranes of control samples. Therefore, it can be concluded that the addition of pequi oil improved the biocompatibility of collagen and accelerated the healing process.