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PubMed1994

Early infiltration of renal allografts with 27E10-positive macrophages and graft outcome.

Recently, we have demonstrated that acute cellular rejection is correlated with a massive infiltration of 27E10-positive macrophages. To examine the distribution of macrophage differentiation markers in the infiltrate in the very early post-transplantation period, two biopsies were taken intraoperatively, approximately 1 h following reperfusion, in each of 16 renal transplant recipients. One biopsy was taken for conventional histology and the other biopsy was snap-frozen. The sections were stained using an ABC indirect immunoperoxidase technique. A panel of monoclonal antibodies against three macrophage differentiation markers (27E10, 25F9 and RM3/1) was used to stain the sections. Using the early inflammation macrophage marker 27E10, there was an unexpected strong staining in 3 out of 16 biopsies. This severe infiltration of 27E10-positive macrophages with 10-20 macrophages per high power field (compared to 0-2 in others) was correlated in all cases with a poor outcome of the graft. All seven kidneys with no 27E10-positive infiltration showed a good function 6 weeks post-transplantation. The other macrophage markers, 25F9 and RM3/1, showed a less marked correlation with graft outcome. In conclusion, a massive infiltration of renal allografts with 27E10-positive macrophages 1 h post-transplantation may be a very early predictor of poor graft outcome.

Antigens, Surface↗

PubMed1997

Leukocyte infiltration and collagenolysis in cervical tissue from intrapartum sheep.

Sheep uterine cervices and cervical mucus were heavily infiltrated by neutrophils during labour, whereas samples of cervices obtained from non-pregnant controls had no infiltrate. The neutrophilic infiltrate of the sheep uterine cervix at term was not homogeneously distributed throughout the organ: luminal mucus contained more neutrophils than tissues which, in turn, displayed a differential distribution, the superficial subepithelial layer being more heavily infiltrated than the deeper submucous layers. A widespread collagenolysis was observed in the sheep uterine cervix at term. The homogeneous morphological aspect of degradation of collagen fibres throughout the whole cervical stroma contrasted with the above-mentioned differential distribution of neutrophils. On the basis of previous reports showing that collagenolysis follows the leukocytic invasion of human and rat cervices at term, a possible role for the neutrophilic infiltrate of the sheep uterine cervix is discussed.

Animals↗

PubMed2004

Vaginal and cervical dilatation intrapartum is associated with eosinophilic infiltration in the cow but not in the sheep.

During parturition maximal dilatation of the vagina and cervix is necessary for expulsion of the neonate. The aim of the present study was to characterize the cell infiltration of the vagina and cervix that is associated with this event in cows and sheep. For this purpose, vaginal and cervical tissue were removed from four pluriparous cows and four sheep immediately after delivery of the neonate by biopsy under visual control (group 1), and the eosinophilic granulocytes were stained selectively. Four cows that were in interoestrus were used for control (group 2). In a third group of cows (n=10), blood samples were taken to determine the concentration of eosinophilic granulocytes from the fifth day antepartum up to the sixth day postpartum (group 3). A high degree of infiltration with eosinophilic granulocytes was detected in the bovine vagina and cervix intrapartum but not during interoestrus and in the ovine tissue intrapartum (p <0.001). In the bovine tissue, the cell density was higher in the vagina than in the cervix (p <0.05). The intrapartal tissue infiltration was associated with a short-term blood eosinopenia. In conclusion, this investigation demonstrates eosinophilic infiltration in the bovine vagina and cervix intrapartum, which differs from the situation in sheep. We suggest that this difference can be explained by the fact that cows deliver at high oestrogen and low progesterone values, but sheep show relatively high intrapartal P4 levels, which might suppress tissue infiltration with eosinophilic granulocytes.

Animals↗

PubMed2004

Sub-Tenon infiltration or classical analgesic drugs to relieve postoperative pain.

BACKGROUND: In a prospective randomized double-blind study, the analgesic effect produced by sub-Tenon infiltration was compared with classic analgesic drugs in patients scheduled for posterior segment surgery under general anaesthesia. METHODS: One hundred patients were randomized into two groups of 50. One group received sub-Tenon infiltration (group 1) with 3 mL of bupivacaine 0.50% by the surgeon before the end of the surgery and the other (group 2) received only classical analgesic drugs postoperatively. A visual analogue scale (VAS) (graded from 1 to 10) was used to assess pain. For both groups, when VAS was between 1 and 3 paracetamol (3 g/24 h) associated with ketoprofen (200 mg/24 h) was given; between 3 and 6 nalbuphine (0.2 mg/kg slowly intravenously repeated every 4 h if necessary) was given; and over 6 morphine was given. Morphine 1 mg was injected every 2 min until VAS below 3 was obtained. RESULTS: All patients in group 2 (control) experienced pain in the recovery room period; however, no patient in group 1 required analgesic drugs in the first 6 h after the sub-Tenon infiltration. In the recovery room period, the VAS pain score in patients who received sub-Tenon infiltration (group 1) was 0.6 +/- 1.3 (mean +/- SD) compared to 3.4 +/- 2.2 in group 2. The difference was statistically significant (P = 0.000001). All patients in group 2 asked for analgesic drugs in the recovery room, some of whom required morphine. Despite the administration of drugs the pain score was statistically higher in group 2. Between the end of the recovery room period and the 6th hour, the VAS pain score in group 1 was statistically lower. From the 6th until the 24th hour, the pain score was not statistically significantly different between the groups. Regarding consumption of analgesic drugs from the recovery room until the 24th hour, the consumption of level 1 analgesic drugs (paracetamol, ketoprofen) and level 3 (morphine) was statistically lower in group 1 (P = 0.0009). The difference was not significant for level 2, probably because the number of patients was not sufficient. CONCLUSION: Sub-Tenon infiltration with 3 mL of bupivacaine 0.50% offers excellent postoperative analgesia for about 6 h and is an excellent alternative to classical drugs. Furthermore, it is highly reliable and safe.

Adult↗

PubMed2001

Does deep endometriosis infiltrating the uterosacral ligaments present an asymmetric lateral distribution?

OBJECTIVE: To investigate whether deeply infiltrating endometriosis occurs with equal frequency between left and right uterosacral ligaments. DESIGN: Retrospective analysis of consecutive cases. SETTING: Department of gynaecological surgery in a tertiary care university hospital in Paris, France. POPULATION: One hundred and thirty consecutive women with laparoscopic resection of histologically proven deep endometriosis infiltrating the uterosacral ligaments. METHODS: Laterality, intraoperative aspect of the uterosacral ligaments, and associated endometriosis were recorded during laparoscopy. Deep endometriosis infiltrating the uterosacral ligaments was considered as histologically proven in the presence of endometrial glands and stroma. MAIN OUTCOME MEASURE: Frequency of left- and right-sided deep endometriosis infiltrating the uterosacral ligaments. RESULTS: The left uterosacral ligament alone was involved in 69 cases; the right uterosacral ligament alone was involved in 38 cases; both were involved in 23 cases. For patients with unilateral deep endometriosis infiltrating the uterosacral ligaments the observed proportion of endometriosis involving the left uterosacral ligament (69/107, 64.5%) was significantly different from the expected proportion of 50% (chi2 = 8.98; P < 0.01). CONCLUSION: Anatomical differences between left and right hemipelvis and differences in the frequency of ovulation between right and left ovary could explain these results.

Adult↗

PubMed1988

Leucocyte infiltration and cartilage proteoglycan loss in immune arthritis in the rabbit.

1. The relationship between phagocytic leucocyte infiltration and cartilage degradation in immune arthritis has been investigated in groups of normal and neutropenic rabbits. 2. Injection of antigen into the knee joints of sensitized control animals induced joint swelling, prostaglandin E2 (PGE2) synthesis, leucocyte accumulation and proteoglycan loss from articular cartilage. 3. Intravenous injection of nitrogen mustard caused a selective depletion of circulating neutrophils and monocytes with little or no effect on platelets or lymphocytes. In neutropenic animals challenged with antigen, there was virtually no joint swelling, PGE2 synthesis or leucocyte infiltration but cartilage proteoglycan loss was unchanged after 1 day and increased by day 4 compared to control animals. 4. The numbers of circulating leucocytes returned to normal 3-4 days after nitrogen mustard treatment and leucocyte infiltration occurred in antigen-challenged joints but this was not accompanied by joint swelling. Subsequent intra-articular injection of PGE2 did, however, cause swelling. 5. Lysosomal enzyme levels in arthritic joint fluids were measured. The levels of beta-glucuronidase, which is released by activated phagocytes, were decreased in neutropenic animals but the levels of N-acetyl-beta-glucosaminidase, which is a marker of tissue damage, were not changed by neutrophil depletion. 6. Intra-articular injections of the cytokine interleukin-1 (IL-1) induced a pattern of leucocyte infiltration and cartilage proteoglycan loss similar to that seen in immune arthritis. In neutropenic animals, IL-1 did not cause significant accumulation of leucocytes in the joint but the loss of proteoglycan from cartilage was unimpaired. 7. These results indicate that both leucocyte infiltration and prostaglandin synthesis are required for joint swelling but that tissue degradation is mediated by resident cells. It is likely that release of IL-1 by synovial cells stimulates the synthesis and activation of metalloproteinases which initiate the process of tissue degradation.

Animals↗

PubMed1997

Bilevel tumescent anesthetic infiltration for hair transplantation.

BACKGROUND: A dual level of tumescent anesthetic infiltration has been found to expedite hair graft or strip harvesting for hair transplantation, reducing bleeding, and increasing the exit angle of the hairs, thereby promoting increased survivorship of hair shafts and bulbs. OBJECTIVE: To acquaint the readership with this variation of anesthetic tumescent technique in hair transplantation. METHODS: Patients were utilized for this study during international teaching exchanges. Larger multiport infiltrators were used for the deep infiltration; smaller and more narrow infiltrators were used for the more superficial anesthetic administration. RESULTS: Subcutaneous compression and a bilevel vasoconstriction in both donor and recipient sites resulted in an increased upwardly angled exit angle of the hairs to be harvested, an increased separation of individual hair shafts, and reduced bleeding. Placement of the correct incisional angle of instruments inserted into the donor site was facilitated. CONCLUSION: Utilization of a bilevel tumescent anesthetic infiltration technique is a superior method of anesthesia for hair transplant harvesting and transplanting. Bleeding at both occipital donor and frontal recipient sites was negligible.

Anesthesia, Local↗

PubMedDate not supplied

Urine cytology as a screening test for bladder infiltration in cervical cancer.

Ultrasound is currently used as a screening test for bladder infiltration in patients with advanced-stage cervical cancer at our institution. Cystoscopy is reserved for patients with abnormal bladder ultrasound findings. This study was undertaken to reevaluate this policy and to compare the results of different screening tests. The study was carried out in Pretoria academic complex. All newly diagnosed cervical carcinoma patients stage II and above were included in this study. The standard staging investigations were done on all patients. In addition, urine midstream and catheter specimens were sent for cytology. Cystoscopy and biopsy were performed on all patients. Two hundred twenty-eight patients were enrolled into this study. At cystoscopy, 47 patients had bladder mucosa suspicious of malignant infiltration, of which 17 had bladder mucosa infiltration diagnosed on histology. Urine catheter cytology has a sensitivity of 94% and specificity of 82% for bladder mucosa infiltration. The predictive value of a positive test is 31% and for a negative test is 99%. Catheter urine cytology is a very useful screening test for bladder infiltration in patients with cervical cancer. Cystoscopy should be reserved for patients with abnormal urine cytology in resource-poor settings with a large burden of disease.

Biopsy↗

PubMed2000

Focal fatty infiltration in the posterior aspect of hepatic segment IV: relationship to pancreaticoduodenal venous drainage.

OBJECTIVE: We aimed to investigate the relationship between fatty infiltration in the posterior aspect of hepatic segment IV and pancreaticoduodenal venous drainage. METHODS: Pancreaticoduodenal arteriography was performed in 21 patients who had nontumorous portal perfusion defects in the posterior aspect of hepatic segment IV, as demonstrated on CT during arterial portography (CTAP). RESULTS: In 10 patients, pancreaticoduodenal arteriography showed an aberrant nonportal vessel with flow toward the hepatic hilum in the venous phase. Four of the 10 patients with nonportal vessels from the pancreaticoduodenal arterial system had fatty infiltration in segment IV. In three of these four patients, the fatty infiltration was focal and localized to that area. On the other hand, none of the 11 patients without nonportal vessels from the pancreaticoduodenal arterial system had fatty infiltration in the regions corresponding to the nontumorous portal perfusion defects on CTAP. Moreover, three patients with diffuse fatty liver had a focal nonfatty area in segment IV. CONCLUSIONS: Focal fatty infiltration in the posterior aspect of hepatic segment IV seems to be related to pancreaticoduodenal venous drainage.

Aged↗

PubMed1990

Variation in the composition of gingival inflammatory cell infiltrates.

Biopsy specimens were taken at gingivectomy from 18 adult patients undergoing treatment for chronic marginal periodontitis. They were embedded so that the cut surface of the gingiva was parallel to the top of the block to obtain a comprehensive view in a transversal plane of the inflammatory cell infiltrate near the bottom of the pocket. Sections were stained with HES or with toluidine blue for histological description, and acid alpha-naphthyl acetate esterase (ANAE) was used to differentially stain T lymphocytes, plasma cells and monocytes/macrophages. Sections stained with HES showed that the density and size of the cell infiltrates varied along the circumference of a tooth over very short distances and on various surfaces on neighbouring teeth. Differential counts of cells stained for ANAE demonstrated great variation in the composition of the cell infiltrates, particularly along the pocket epithelium. The predominating ANAE positive cell type in this area was T lymphocytes, while in the central connective tissue, plasma cells predominated. There was no systematic covariation between the localization of the gingiva (i.e. mesial, facial, etc.) and the composition of the cell infiltrates. The local variation in the composition of the cellular infiltrate most likely reflects local variability in the noxious substances (i.e. plaque composition) within the periodontal pocket, and in the resulting local inflammatory response.

Adult↗

PubMed1993

Iatrogenic benign lymphoplasia induced by allergic contact dermatitis from squaric acid dibutylester: immunohistologic study of cellular infiltrates.

We report of a 62-year-old male patient with a dull red itchy nodule on the induction area of allergic contact dermatitis to squaric acid dibutylester, which had been used for the therapy of alopecia universalis. The excised biopsy specimen showed dense infiltration of lymphoid cells in the dermis and subcutaneous tissue, associated with the formation of lymphoid follicles. Immunohistologic analysis of the infiltrates indicated mixed proliferation of T- and B-cells. A biopsy specimen from the challenge area showed spongiosis in the epidermis and lymphoid cell infiltration in the upper dermis, while the infiltrates consisted mainly of T-cells. The following points are discussed: (i) the lesion had an iatrogenic origin and the causative agent was quite evident; (ii) the route of allergen application was only through the epidermis and not directly in the dermis; (iii) lymphoid cell infiltrates of the induction and challenge areas were different.

Allergens↗

PubMed1995

Erythema-multiforme-like eruption due to topical contactants: expression of adhesion molecules and their ligands and characterization of the infiltrate.

Erythema-multiforme-like reactions are a rare manifestation of allergic contact sensitivity, the pathomechanisms of which and their possible relationship to erythema multiforme remain unclear. We present our histopathological and immunohistochemical findings regarding the expression of several adhesion molecules and immunophenotypic markers of the infiltrate in skin biopsy specimens from 2 cases of erythema-multiforme-like reactions due to contact sensitizers and 3 cases of typical post-herpetic erythema multiforme. The histopathological pattern of erythema-multiforme-like reactions was characterized by an upper-dermal perivascular lymphoid infiltrate with exocytosis and keratinocyte necrosis; in 1 of the cases, there were foci of spongiosis and an admixture of eosinophils in the infiltrate. In comparison with biopsy specimens from cases of typical erythema multiforme, in both cases of erythema-multiforme-like reactions, the epidermal expression of ICAM-1 was more prominent, the % of CD4+ cells in the infiltrate was higher and the % of CD69+ cells was lower. There were no other significant differences in the cell phenotype of the infiltrate or in adhesion molecule expression in biopsy samples from both disorders.

Adult↗

PubMed1978

Inflammatory seborrheic keratoses with mononuclear cell infiltration.

Inflammation in inflammatory seborrheic keratoses was found to be composed of mononuclear cells, particularly lymphocytes. Accumulations of mononuclear cells in the papillary and subpapillary dermis frequently showed no tendency to infiltrate the epithelium. However, dramatic interaction of the seborrheic keratosis and the inflammatory process also was common. The lymphocytic exocytosis into the epithelium followed two basic patterns: eczematous, characterized by intercellular and intracellular edema, microvesicle formation, and epithelial necrosis; and lichenoid, in which a bandlike infiltrate attacked the dermoepidermal junction and hyaline bodies occurred in the infiltrated epithelium and in the dermis. Epithelial changes consisted of necrosis of epithelial cells and related parakeratosis; squamous eddies were occasionally found. Inflammatory cell infiltration in seborrheic keratoses possibly represents a process other than irritation, and we propose that mononuclear cell infiltration in seborrheic keratoses may be related to an involutionary process.

Dermatitis, Seborrheic↗

PubMed1996

Histological changes of the liver in experimental graft-versus-host disease across minor histocompatibility barriers. VIII. Role of eosinophil infiltration.

Although eosinophil infiltrate has been recognized in hepatic graft-versus-host disease, its significance in relation to hepatic graft-versus-host disease lesions is unknown. In the present study, we analyzed hepatic eosinophil infiltration in relation to bile duct damage in experimental mouse graft-versus-host disease across minor histocompatibility barriers up to 14 months after transplantation. Portal eosinophil infiltration was found from 1 week after transplantation throughout the entire 14-month observation period. It was most striking during the early chronic stage of hepatic graft-versus-host disease between 2 to 7 months, with a peak at 5 months after transplantation. Microscopic and electron microscopic study revealed eosinophils infiltrated around the bile duct as well as in the bile duct epithelial layer. They were commonly found together with lymphocytes but were also occasionally found singly around the bile duct and in the bile duct epithelial layer. Bile duct epithelial cells in contact with and in the vicinity of eosinophils showed a variety of generative changes, occasionally associated with the presence of extracellular eosinophil granules. Bile duct epithelial cells with eosinophil infiltration just beneath the basement membrane frequently showed further characteristic severe degenerative changes with shedding or dropping-off into the lumen, which features were quite similar to those seen in the bronchial epithelium in asthma patients. These results indicate that not only lymphocytes but also eosinophils may be involved in the production of the bile duct injury in hepatic graft-versus-host disease, especially in its early chronic stage.

Animals↗

PubMedDate not supplied

Computed tomographic imaging of infiltrative lipoma in 22 dogs.

Twenty two dogs with an infiltrative lipoma had computed tomographic (CT) images acquired to evaluate the extent of local disease. Ten dogs had undergone at least one cytoreductive surgical procedure (range = 1-3; median = 2) prior to imaging. Twenty dogs had measurable disease on CT images; 2 dogs had diffuse disease at a previous surgical site that could not be measured. Tumor volume (n = 20) ranged from 20 to 5,632 cm3 (median = 345 cm3; mean = 996 cm3). None of the dogs had evidence of bone involvement on the CT images; 2 of the 22 dogs had tumors that did not come into direct contact with osseous structures. All dogs with measurable disease had evidence of a fat opacity mass with variable degrees of muscle infiltration. Eleven of 22 dogs were given intravenous contrast medium prior to image acquisition and there was not evidence of enhancement of the infiltrative lipoma in any dog. Based on CT images, tumors were classified as well-defined in 9 dogs, moderately well-defined in 4, not well-defined in 3 and a mix of well-defined and not well-defined in 6 dogs. Tumors tended to be less well-defined in regions where the infiltrative lipoma interdigitated with normal body fat. It appears CT imaging allows adequate discrimination of tumor with the caveat that differentiation of normal fat from infiltrative lipoma can be problematic.

Animals↗

PubMed2006

Epidermal growth factor intralesional infiltrations can prevent amputation in patients with advanced diabetic foot wounds.

This study examined if a series of epidermal growth factor (EGF) local infiltrations can enhance the healing process of complicated diabetic wounds. Twenty-nine in-hospital patients with diabetic neuropathic or ischaemic lesions with high risk of amputation were treated in a non controlled pilot study conducted at the National Institute of Angiology, Havana. Lesions, classified as Wagner's grade 3 or 4, included ulcers > or = 20 cm2 for > or = 25 days or amputation residual bases > or = 30 cm2 for > or = 15 days, healing refractory despite comprehensive wound care. EGF (25 microg) intralesional infiltrations (approximately 250 microl of a 25 microg/ml solution/injection point) were performed thrice weekly up to the eighth week. Wound closure was monitored during the treatment and recurrence examined for a year following discharge from hospital. Eighty-six per cent of the patients treated showed a productive granulation at infiltration session 8. Histological examination at this point indicated a substantial wound matrix transformation, granulation tissue cell repopulation and angiogenesis. Of the 29 patients treated, amputation was prevented in 17 (58.6%) of them who completed 24 infiltration sessions. They averaged 71.1 +/- 18.3% of reepithelisation during a mean in-hospital period of 66.5 +/- 4.9 days. Wound recurrence after 1 year of follow-up appeared in only one patient. Preliminary evidences suggest that EGF intralesional infiltrations may be effective in reducing diabetic lower limb amputation.

Aged↗

PubMedDate not supplied

Migration of induced-infiltrated stream water into nearby aquifers due to seasonal ground water withdrawal.

Analysis of stream-aquifer interaction due to ground water extraction has traditionally focused on the determination of the amount of water depleted in the stream. Less attention has been paid to the movement of infiltrated stream water inside aquifer, particularly for agricultural areas. This paper presents a method of using particle-tracking techniques to evaluate the transport of the leaked stream water in the nearby aquifers. Simple stream-aquifer conditions are used to demonstrate the usefulness of the analysis. Travel times, pathlines, and influence zones of stream water were determined between a stream and nearby pumping wells for seasonal ground water extraction areas. When water quantity is a concern, the analyses provide additional information about stream depletion; when water quality is an issue, they offer information for wellhead protection. Analyses were conducted for transient conditions, and both pumping and nonpumping periods were considered. According to the results from the simulation examples, migration of infiltrated stream water into the nearby aquifers is generally slow and most infiltrated stream water does not arrive at the pumping well at the end of a 90-day irrigation season. Infiltrated stream water may remain in the aquifer for several years before arriving at the pumping well. For aquifers with a regional hydraulic gradient toward streams, part of the infiltrated stream water may discharge back to streams during a recovery period.

Agriculture↗

PubMed1994

Deeply infiltrating endometriosis is a disease whereas mild endometriosis could be considered a non-disease.

Deeply infiltrating endometriosis can be defined as endometriosis infiltrating deeper than 5 mm under the peritoneal surface. Type I is a conical lesion suggested to be caused by infiltration; type II is mainly caused by retraction of the bowel over the lesion; type III is the most severe lesion suggested to be caused by adenomyosis externa. Severe cases are clinically apparent by nodularities in the pouch of Douglas, whereas mild and subtle forms of deep endometriosis are easily missed. Clinical examination during menstruation and scrutiny at laparoscopy for indurations, followed, preferably, by CO2-laser-excision are the key features for diagnosis and treatment. It is important to realize that depth of infiltration and lateral spread cannot be evaluated by laparoscopic inspection but only during excision, that CA125 concentration but not ultrasound or nuclear magnetic resonance can be helpful in the diagnosis, and that in the most severe cases medical pretreatment is advocated. Results of excision, as evaluated by disappearance of pain in some 80% of women, by a cumulative pregnancy of some 70% and a low recurrence rate, are excellent. The peritoneal fluid is thought to play a key role in the physiopathology of deep endometriosis which is considered to be endometriosis which has escaped from the influence of the peritoneal fluid. This concept is clinically important for the medical treatment of endometriosis, which is suggested to shrink deep lesions and to bring them back under peritoneal fluid control. A model of endometriosis is proposed and discussed. Subtle lesions are considered a natural condition occurring intermittently in all women, whereas we question whether mild endometriosis is a disease. In some women endometriosis has an aggressive behavior and develops into cystic ovarian endometriosis or into deeply infiltrating endometriosis. In this model subtle and mild forms would be called "endometriosis," whereas deep and cystic ovarian forms could be called "endometriotic disease." It is stressed that deep and cystic ovarian endometriosis are two distinct entities, which is important for our understanding of endometriosis, for classification and for treatment of endometriosis.

Endometriosis↗