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Results for “Infiltrative”

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PubMed1996

Prognostic value of tumor infiltrating lymphocytes in the vertical growth phase of primary cutaneous melanoma.

BACKGROUND: Primary cutaneous melanoma is often infiltrated lymphocytes that provide the opportunity to study what may be the local immunologic reaction to the tumor and to correlate the presence of these lymphocytes with overall survival. In an attempt to delineate the histologic diagnostic criteria, to classify different categories of lymphocytic infiltrates, previously described by Elder et al. at brisk, nonbrisk, and absent, and to verify their prognostic significance, we reviewed 285 consecutive cases of primary cutaneous melanomas (American Joint Committee on Cancer Stage I and II). METHODS: In addition to clinical variables (age, sex, and location of tumor) and the presence of tumor infiltrating lymphocytes in the vertical growth phase, the histopathologic attributes reviewed included mitotic rate, thickness, and regression. The results were derived from independent histopathologic review by two pathologists (C.G.C., M.C.M., Jr.) on separate occasions. A multivariate analysis of survival was performed with the Cox's regression model. RESULTS: The 5- and 10-year rates for melanoma with a vertical growth phase and a brisk infiltrate were 77% and 55%, respectively. For tumors with a nonbrisk infiltrate, the 5- and 10-year survival rates were 53% and 45%, respectively, and for tumors with absent tumor infiltrating lymphocytes, the 5- and 10-year survival rates were 37% and 27%, respectively. Mitotic index, thickness, and tumor infiltrating lymphocytes were statistically (univariate analysis) significant prognostic factors (P = 0.003, 0.000001, 0.0003, respectively), whereas the presence or absence of regression is not. In the univariate statistical analysis, the sex of patients and site of melanoma also were statistically significant (P = 0.00001 and 0.002 respectively), whereas age (P = 0.98) was not statistically significant. The multivariate analysis of thickness, mitotic rate, and tumor infiltrating lymphocytes showed that thickness and presence tumor infiltrating lymphocytes were significant and independent histologic prognostic factors. With regard to the clinical factors, sex retained its independent prognostic significance. The histologic characteristics of melanoma with vertical growth phase (brisk, nonbrisk, and absent) are exemplified. CONCLUSIONS: We demonstrated that when categories of tumor infiltrating lymphocytes are strictly defined, they indeed have very strong predictive value for primary cutaneous melanomas with a vertical growth phase. This work confirms the work of Clark et al. and fully illustrates the brisk, nonbrisk, and absent categories of infiltration. Finally, a multivariate analysis comparing thickness, mitotic rate and presence of tumor infiltrating lymphocytes showed that only thickness and presence of tumor infiltrating lymphocytes are significant and independent positive histologic prognostic factors.

Adult↗

PubMed1999

Infiltrative capacity of T leukemia cell lines: a distinct functional property coupled to expression of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinases-1 (TIMP-1).

Infiltrative capacity was found to distinguish separate T leukemia cell lines. Of seven T-cell lines four exhibited capacity to infiltrate Matrigel. Analysis of infiltration was performed at the single-cell level throughout the Matrigel using a depth meter. Further, we examined differences in migration capacity and metalloproteinase production between infiltrating and non-infiltrating T-cell lines. The capacity to infiltrate was not directly correlated to the capacity to adhere to the Matrigel or to migrate on/to extracellular matrix components. It is concluded that infiltration capacity does not simply reflect capacity to migrate but represents a distinct functional property. The production of metalloproteinases and their inhibitors by the separate T-cell lines was analyzed using rt PCR, biosynthetic labelling, zymography, immunoprecipitation and ELISA. All T-cell lines with capacity to infiltrate produced matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) while non-infiltrating cell lines did not express MMP-9. Expression of MMP-1, 2, 3, 10, 14 and 17 showed no correlation to capacity to infiltrate. Analysis of infiltration in the presence of a metalloprotease inhibitor showed an increased number of cells within the gel. This enhancement of infiltration suggests that the function of MMPs and/or their inhibitors in lymphocyte infiltration is more complex than previously thought.

Cell Adhesion↗

PubMedDate not supplied

Prognostic significance of CD8+ T cell and macrophage peritumoral infiltration in colorectal cancer.

The purpose of this study was to evaluate the prognostic significance of CD8+ T cell and macrophage peritumoral infiltration in patients with colorectal cancer. A total of 97 adenocarcinomas of the colon and rectum were examined. Immunohistochemical staining was performed by the standard avidin-biotin-peroxidase complex method using antibodies to CD8 and CD68. Peritumoral infiltration by CD8+ T cells or macrophages was evaluated along the invasive margin of the cancer in each specimen. The area with the most abundant infiltration was selected, and the number of immunoreactive positive cells counted at x400 magnification. Patients were divided into two groups based on the degree of infiltration by each cell type: namely those with a high level of infiltration (more than the mean number of positive cells) and those with a low level of infiltration (less than the mean number of positive cells). Patients with a low level of macrophage infiltration had a significantly deeper depth of invasion than patients with a high level of macrophage infiltration (P=0.027). The percentage of patients with a high level of macrophage infiltration was significantly higher in vascular invasion-negative cases (46.7%) than in vascular invasion-positive cases (22.7%; P=0.045), and in lymph node metastasis-negative cases (52.9%) than in lymph node metastasis-positive cases (28.3%; P=0.014). Overall survival was significantly shorter for patients with a low level of CD8+ T cell infiltration than those with a high level of CD8+ T cell infiltration (P=0.01). The survival rate for patients with a high level of both CD8+ T cell and macrophage infiltration was 100%. In conclusion, both CD8+ T cell and macrophage peritumoral infiltration indicates anti-tumoral action in patients with colorectal cancer.

Adenocarcinoma↗

PubMed2006

The Alabama Preterm Birth study: polymorphonuclear and mononuclear cell placental infiltrations, other markers of inflammation, and outcomes in 23- to 32-week preterm newborn infants.

OBJECTIVE: The purpose of this study was to better understand the relationship between placental polymorphonuclear and mononuclear cell infiltrations with bacterial cultures, markers of inflammation, and preterm outcomes. STUDY DESIGN: This was a prospective study in 446 women who were delivered of a singleton infant at <32 weeks of gestational age. Five placental sites were categorized as having polymorphonuclear or mononuclear infiltrations. Results were compared with placental and cord cultures, umbilical cord interleukin-6 levels, and neonatal outcomes. RESULTS: Polymorphonuclear, but not mononuclear, cell infiltrations were more common at the earliest gestational ages and in black women (56.0% vs 39.3%; P < .01). Polymorphonuclear infiltration was associated with spontaneous preterm birth (73.9% vs 8.0%; P < .0001), but not with preeclampsia (9.9% vs 34%; P < .0001). Women with positive cultures, high interleukin-6 levels, and clinical chorioamnionitis all had significantly more polymorphonuclear infiltrations than did women without those conditions (all probability values, <.0001). In all sites, polymorphonuclear infiltration was associated with neonatal systemic inflammatory response syndrome (P < .0001) and in the cord with necrotizing enterocolitis (22.4% vs 13.5%; P = .02). Intraventricular hemorrhage and neonatal death were not associated with polymorphonuclear infiltration. Polymorphonuclear infiltration at all sites was associated with less respiratory distress syndrome (P < .01). Mononuclear cell infiltration, when present in the decidua basalis, was associated with an increase in neonatal intraventricular hemorrhage (23.8% vs 7.4%; P < .0004). Plasmacytic infiltrates were associated with increased intraventricular hemorrhage (29.4% vs 8.3%; P = .01) and neonatal death (27.8% vs 9.2%; P = .02). CONCLUSION: Polymorphonuclear infiltrations of the free membranes, chorionic plate, and umbilical cord were associated with positive intrauterine cultures and elevated cord blood interleukin-6. There was also an association with systemic inflammatory response syndrome and necrotizing enterocolitis, but not with intraventricular hemorrhage or death, and with decreased respiratory distress syndrome. Decidual mononuclear cell infiltration was associated with an increased risk of intraventricular hemorrhage and decidual plasma cell infiltration with increased intraventricular hemorrhage and neonatal death.

Black or African American↗

PubMed2002

Pulpal anaesthesia for mandibular central incisor teeth: a comparison of infiltration and intraligamentary injections.

AIM: This study compared the anaesthetic efficacy of infiltration and intraligamentary injections in the permanent mandibular central incisor. METHODOLOGY: Twelve healthy volunteers received each of the following methods of anaesthesia for one of their mandibular central incisors over four visits. 1 Labial infiltration of 1.0 mL. 2 Lingual infiltration of 1.0 mL. 3 Labial infiltration of 0.5 mL plus lingual infiltration of 0.5 mL. 4 Intraligamentary injection of (118 mL. Two percent lidocaine with 1: 80 000 adrenaline and 30 gauge needles were used throughout. Electrical pulp testing was performed before injection and every 2 min up to 30 min after the injection. Injection discomfort was recorded on a 100-mm visual analogue scale. Data were compared with ANOVA, Student's t-test and chi2 tests. RESULTS: Anaesthesia varied between techniques(F = 9.3, P < 0.001). The incidence of anaesthesia at any time was as follows: 50% success for labial infiltration; 50% success for lingual infiltration: 92% success for combined labial and lingual infiltration; 0% success for intraligamentary injections (chi2 = 20; P < 0.001). The mean (+/-SD) VAS score for intraligamentary injection discomfort was 28 +/- 12 mm, for buccal infiltrations 17 +/- 8 mm and for lingual infiltrations 16 +16 mm. Intraligamentary injections were more uncomfortable than buccal (t = 3.7: P < 0.01) and lingual infiltrations (t = 2.67: P < 0.05). CONCLUSIONS: The most reliable method of the techniques investigated for obtaining pulpal anaesthesia in mandibular permanent central incisors was a combination of labial and lingual infiltration. Intraligamentary injections were unreliable and were more uncomfortable than infiltrations in the mandibular central incisor region.

Adult↗

PubMedDate not supplied

New pulmonary infiltrates in granulocytopenic cancer patients being treated with antibiotics.

During a 5 1/2-year period, 34 of 829 episodes of granulocytopenia during which broad spectrum antibiotics were being administered for fever and/or infections were complicated by the development of new pulmonary infiltrates. In 12 patients the infiltrates were due to fungal pneumonia, while in 6 patients the infiltrates were due to a variety of other causes. In the remaining 16 cases the etiology of the infiltrates was not determined. Time to development of infiltrate, radiographic appearance of the infiltrate, patient temperature and absolute granulocyte count failed to predict the etiology of the infiltrate. Conversely, development of the infiltrate or its radiographic progression in the absence of bone marrow recovery correlated significantly with the diagnosis of fungal pneumonia. While empiric alterations of antibiotics at the time that the infiltrate appeared were not associated with improved survival, the early use of amphotericin B was associated with a significant decrease in fatal fungal pneumonia. We suggest that the diagnostic and therapeutic approach to the febrile, granulocytopenic patient who develops a new pulmonary infiltrate while receiving broad spectrum antibiotic therapy may be guided by the state of marrow recovery at the time of infiltrate appearance. Patients developing an infiltrate coincident with granulocyte recovery may be managed conservatively while patients whose infiltrate develops or progresses in the absence of granulocyte recovery should be considered to be at high risk for fungal pneumonia and if possible undergo a diagnostic lung biopsy and/or empiric antifungal therapy.

Adolescent↗

PubMed2005

Correlation between CD4, CD8 cell infiltration in gastric mucosa, Helicobacter pylori infection and symptoms in patients with chronic gastritis.

AIM: To evaluate the correlation between CD4, CD8 cell infiltration in gastric mucosa, Helicobacter pylori (H pylori) infection and symptoms or the assemblage of symptoms in cases with chronic gastritis. METHODS: Biopsy samples at the gastric antrum were obtained from 62 patients with chronic gastritis. CD4 and CD8 cell infiltration was evaluated by immunohistochemical assays on frozen sections of the biopsy samples. Fifteen symptoms referring to digestion-related activity and non-digestion related activity were observed. The correlation between lymphocyte infiltration and each symptom or symptom assemblage was analyzed by logistic regression and K-mean cluster methods. RESULTS: CD4 cell infiltrations in gastric mucosa were much more in patients with H. pylori infection, while CD8 cell infiltrations were similar in patients with or without H. pylori infection. Logistic regression analysis showed that the symptoms including heavy feeling in head or body (t = 2.563), and thirst (t = 2.478) were significantly related with CD4 cell infiltration in gastric mucosa (P<0.05), and cool limbs with aversion to cold were related with CD8 cell infiltration (t = 2.872, P<0.05). Further analysis showed that non-digestive related symptom assemblage could increase the predicted percentage of CD4 and CD8 cell infiltration in gastric mucosa, including lower CD4 infiltration by 12.5%, higher CD8 infiltration by 33.3%, and also non-H. pylori infection by 23.6%. K-means cluster analysis of all symptoms and CD4 and CD8 cell infiltration in gastric mucosa showed a similar tendency to increase the predicted percentage of CD4, CD8 cell infiltration and H. pylori infection. CONCLUSION: Based on correlation between the gastric mucosa lymphocyte infiltration, H. pylori infection and clinical symptoms, symptoms or symptomatic assemblages play an important role in making further classification of chronic gastritis, which might help find a more specific therapy for chronic gastritis.

Adolescent↗

PubMed2002

[Influencing factors of local immunocyte infiltration in hepatocellular carcinoma tissues pre- and post-percutaneous microwave coagulation therapy].

OBJECTIVE: To investigate the influencing factors of the local immunity in tissues of hepatocellular carcinoma (HCC) before and after percutaneous microwave coagulation therapy (PMCT). METHODS: Seventy-eight patients with HCC diagnosed by needle biopsy of liver underwent PMCT. Before the treatment and three and 17 days after the treatment specimens of carcinoma tissues were obtained by ultrasound-guided liver biopsy. The extents of infiltration of CD3(+) cell, natural killer cells (CD56(+)), and macrophages (CD68(+)), and the expression rate of proliferating cell nuclear antigen (PCNA) were evaluated by immunohistochemistry. The relation between the extents of immunocyte infiltration and the clinical parameters was analyzed with multiple regression. RESULTS: Before PMCT infiltration of the three kinds of immunocytes was found in the carcinoma tissues to different degrees with a great variation among individuals. A remarkable increase in the extent of infiltration of the three kinds of immunocytes was found three days after the treatment and continued or remained till the 17th post-PMCT day (P < 0.01). The post-PMCT extent of immunocyte infiltration was positively correlated with the pre-PMCT extent (CD3(+): r = 0.256, P = 0.005; CD56(+): r = 0.257, P = 0.002; CD68(+): r = 0.275, P = 0.001). A negative correlation was found between the extent of immunocyte infiltration and serum alpha-fetal protein (AFP) and between the extent of immunocyte infiltration and tumor size (for serum AFP, CD3(+): r = -0.075, P = 0.049; CD56(+): r = -0.062, P = 0.041; CD68(+): r = -0.007, P = 0.035; for tumor size, CD3(+): r = -0.074, P = 0.051; CD56(+): r = -0.100, P = 0.012; CD68(+): r = -0.109, P = 0.038). No correlation was found between the extent of immunocyte infiltration and age of patient, Child-Pugh class of tumor, grade of tumor differentiation, and number of tumor. The extent of immunocyte infiltration was lesser in the carcinoma tissues with higher expression rate of PCNA. The extent of immunocyte infiltration was greater in the carcinoma tissues where PCNA expression was negative and carcinoma cells had necrotized but with their structure recognizable. No immunocyte infiltration was found in the necrotic and structureless tumor tissues. CONCLUSION: The local immunocyte infiltration in patients with HCC was influenced by serum AFP and the grade of tumor cell necrosis pre- and post-PMCT. Destruction of tumor tissue in situs by PMCT is the premise of increase of immunocyte infiltration. Before PMCT improving the immune status of the patients helps enhance the local immune response.

Adult↗

PubMed1996

Peripheral corneal infiltrates associated with contact lens wear.

PURPOSE: We describe the epidemiological and clinical characteristics of peripheral corneal infiltrates associated with contact lens wear. METHODS: We conducted a retrospective study of 52 patients with contact lens associated peripheral corneal infiltrates. Demographic data, clinical characteristics of the infiltrates, contact lens parameters, treatment modality, and the time to resolution for the infiltrates were analyzed. RESULTS: Forty-four of the 52 patients in this study presented with a single infiltrate, while the remaining 8 patients had multiple infiltrates. Types of contact lenses worn were as follows: 40% of the patients wore disposable extended wear contact lenses; 21% wore conventional extended wear lenses; 19% wore conventional daily wear lenses; 12% used frequent replacement daily wear lenses; 6% wore rigid gas permeable (RGP) contact lenses; and 2% used disposable lenses as daily wear. Although there was no predilection for a specific quadrant of the cornea, when a subgroup of extended wear contact lens patients was analyzed, 19 of their 40 infiltrates were located in the superior quadrant. The epithelium was intact in 42% of the infiltrates, while 58% of the infiltrates had epithelial involvement, either punctate staining or frank defect. Eight of the 16 patients who had corneal cultures performed had positive cultures. All patients who had positive cultures used extended wear contact lenses. Smoking did not appear to have an effect on the associated inflammatory reaction, positive cultures, or time to resolution. Seventy-five percent of patients were treated with topical antibiotics. Antibiotic steroids were prescribed for 23% of patients, and 2% of patients were treated with topical steroids. The mean time to resolution for all infiltrates was 1.74 weeks. CONCLUSIONS: Focal peripheral infiltrates with or without epithelial disturbance represent a distinct clinical complication associated with contact lens wear. All patients in this study had resolution of their infiltrates without complications. We recommend that after resolution of corneal infiltrates, patients should be refit with daily wear soft or RGP contact lenses.

Adolescent↗

PubMed1998

[Tumor invasion in gallbladder cancer. Importance of blood vascular tumor infiltration diagnosis].

BACKGROUND: The infiltration of venous blood vessels in gallbladder carcinoma and its importance as a prognostic factor has not been well studied. Victoria blue stain has been used to identify vascular involvement in gastric and thyroidal carcinomas. AIM: To assess blood vessel infiltration using Victoria blue stain in gallbladder carcinomas. MATERIAL AND METHODS: One hundred forty eight samples of gallbladder carcinomas, coming from 24 men and 123 women aged 60.4 +/- 12.2 years old, were studied. They were stained with Victoria blue stain to quantify blood vessel invasion. RESULTS: Twenty nine percent of tumors had blood vessel infiltration, 61% had lymph vessel and 20% had perineural infiltration. Lymph vessel or perineural involvement was found in 81% and 31% of those tumors with blood vessel infiltration, respectively. Perineural infiltration was associated with lymph or vascular involvement in 93 and 40% of tumors, respectively. None of the early carcinomas had blood vessel infiltration, whereas 33% of advanced tumors had this type of infiltration (p < 0.001). No differences in vascular infiltration were observed according to the differentiation of the tumor. CONCLUSIONS: Blood vessel infiltration was observed only in advanced gallbladder carcinomas and was tightly related to the degree of gallbladder wall infiltration. The presence of perineural infiltration was the best marker of lymph or blood vessel infiltration.

Adenocarcinoma↗

PubMed2000

Lymphocytic infiltration in undifferentiated nasopharyngeal cancer.

BACKGROUND: Undifferentiated nasopharyngeal carcinoma (NPC) is characterized by prominent lymphocytic infiltration. Although the lymphoid infiltrate in NPC has been examined extensively in morphologic and immunocytochemical studies, the significance of this lymphoid infiltrate and its correlation with prognosis has been a subject of controversy for years. OBJECTIVE: To elucidate the significance of lymphoid infiltration in undifferentiated NPC. DESIGN: Evaluation of the relationship between lymphocytic infiltration in NPC and cervical lymph node status, ultrastructural examination of the lymphoid infiltrate, and assessment of lymphocytic infiltration as an independent prognosticator of regional node metastasis. MATERIALS AND METHODS: Lymphocytic infiltration was evaluated quantitatively in 20 cases of undifferentiated NPC using light microscopy. Four cases of undifferentiated NPC were processed for conventional electron microscopy. The effects of degree of lymphocytic infiltration, age, and tumor stage on cervical nodal metastasis were analysed using the logistic regression model. RESULTS: The degree of lymphoid infiltration correlated with cervical nodal metastasis (P<.001). Ultrastructural evidence of lymphocytes destroying cancer cells was seen. Lymphocytic infiltration was found to be an independent factor affecting cervical nodal metastasis (P =.02, univariate analysis; P =.03, multivariate analysis). CONCLUSIONS: The lymphoid infiltrate is beneficial in undifferentiated NPC, and its presence may deter regional metastasis of cancer cells to the cervical nodes.

Adult↗

PubMed2006

Bone marrow infiltration pattern in B-cell chronic lymphocytic leukemia is related to immunoglobulin heavy-chain variable region mutation status and expression of 70-kd zeta-associated protein (ZAP-70).

B-cell chronic lymphocytic leukemia (B-CLL) consists of at least 2 subtypes with either somatically mutated or unmutated immunoglobulin heavy-chain variable region (IgVH) genes. A prognostic significance of the infiltration pattern in bone marrow trephine biopsy has been described before. The combined pattern analysis and detection of 70-kd zeta-associated protein (ZAP-70) expression in formalin-fixed, paraffin-embedded bone marrow trephines has not been investigated so far. To evaluate the relationship between ZAP-70 expression, mutation status, and the infiltration pattern in B-CLL, we analyzed bone marrow trephine biopsies from B-CLL patients (n = 35). The expression of ZAP-70 was related to the infiltration type: in all samples with diffuse infiltration pattern, the leukemic cells showed ZAP-70 staining, whereas leukemic cells in a nodular infiltration pattern were negative. By contrast, the mixed-pattern type showed a variable ZAP-70 expression. Besides definitely negative or positive ZAP-70 expression, a few samples showed a faint ZAP-70 staining, and the classification into the positive or negative group was difficult. In addition, the infiltration type was related to the mutation status in a subset of samples: mutation of the IgVH gene was restricted to the nondiffuse infiltration pattern and was not found in cases with diffuse infiltration of bone marrow. The expression of ZAP-70, detected by an immunohistochemical assay and also by real-time quantitative reverse transcriptase-polymerase chain reaction assigned 83% of the chronic lymphocytic leukemia cases to the suspected immunoglobulin mutation subtype. In 2 patients with ZAP-70 expression, a mutated IgVH status was found. These cases exhibited a mixed pattern of infiltration. We conclude that the pure nodular type of marrow infiltration in B-CLL is associated with IgH hypermutation and ZAP-70 negativity, whereas the predominantly diffuse type of infiltration reveals unmutated IgH genes with ZAP-70 overexpression. The mixed type of infiltration is displayed by mutated as well as unmutated cases with a varying pattern of ZAP-70 expression.

Adult↗

PubMed1989

The effects of peritonsillar infiltration on the reduction of intraoperative blood loss and post-tonsillectomy pain in children.

Improved hemostasis and reduction of postoperative pain are desired goals when performing tonsillectomy. This is especially true in children, who may be reluctant to receive intramuscular injections for pain relief and who may lose a higher percentage of total blood volume during surgery than adults. This study evaluated the effects of peritonsillar infiltration upon operative blood loss and postoperative pain in 42 children. For the purpose of infiltration, patients were randomly assigned to one of four groups. Children in groups I, II, and III had their peritonsillar infiltrations performed with the contents of a coded vial which contained bupivacaine 0.25% with epinephrine (1:200,000), normal saline with epinephrine (1:200,000), and normal saline, respectively. Group IV children (controls) received no infiltration. All solutions were prepared in the hospital pharmacy to assure binding of the operator and observer. All infiltrations were performed following the induction of general anesthesia and 5 minutes prior to the onset of surgery. Anesthetic agents, end-tidal carbon dioxide levels, and the administration of intravenous fluids were carefully regulated. Surgery was performed by one of two attending otolaryngologists or a senior otolaryngology fellow using the same dissection and snare technique. Hemostasis was managed by suction-electrocautery and packs. Patients in group IV, the control group, lost twice as much blood as did those who had infiltrations performed with normal saline, group III (p less than 0.001). However, patients in group III lost 1.5 times more blood than did those children in either of the two groups whose infiltrations were performed with an epinephrine solution, groups I and II (p less than 0.001). No postoperative bleeding was noted in any patient. Infiltration of the peritonsillar space with epinephrine (1:200,000) was shown to be more effective in reducing blood loss than infiltration with normal saline. Because of the small sample size we were unable to evaluate the beneficial effects of peritonsillar infiltration performed with bupivacaine upon the reduction of the severity of pain and the requirement for narcotic analgesics following tonsillectomy. Therefore, until further studies demonstrate such efficacy, all peritonsillar infiltrations should be performed solely for the purpose of reducing operative blood loss. As such, infiltrations should be performed with either normal saline containing epinephrine (1:200,000) or lidocaine containing epinephrine (1:200,000).

Bupivacaine↗

PubMed2002

Anesthetic efficacy of an infiltration in mandibular anterior teeth following an inferior alveolar nerve block.

The purpose of this prospective, randomized, blinded study was to measure the degree of pulpal anesthesia obtained with an inferior alveolar nerve (IAN) block followed by an infiltration in mandibular anterior teeth. Through use of a repeated-measures design, 40 patients randomly received 3 injection combinations at 3 separate appointments: an IAN block followed by a mock lingual infiltration and a mock labial infiltration, an IAN block followed by a mock lingual infiltration and a labial infiltration, and an IAN block followed by a mock labial infiltration and a lingual infiltration. Each IAN block used 3.6 mL of 2% lidocaine with 1:100,000 epinephrine, and each infiltration used 1.8 mL of 2% lidocaine with 1:100,000 epinephrine administered over the lateral incisor apex. Mandibular anterior teeth were blindly pulp tested at 2-minute cycles for 60 minutes following the IAN-infiltration injections. No response from the patient to the maximum output (80 reading) of the pulp tester was used as the criterion for pulpal anesthesia. Anesthesia was considered successful when 2 consecutive 80 readings were obtained within 15 minutes and the 80 reading was sustained for 60 minutes. Anesthesia was considered a failure if 2 consecutive 80 readings were not obtained during the 60 minutes. The results of this study showed that 100% of the patients had lip numbness with all IAN blocks. For the lateral incisor, the success rate of the IAN block alone was 40% and the failure rate was 30%. For the IAN block plus labial infiltration, the success rate was 62% and the failure rate was 12% for the lateral incisor. There was a significant difference (P < .05) between the IAN block alone and the IAN block plus labial infiltration. In conclusion, a labial infiltration, over the lateral incisor apex, of 1.8 mL of 2% lidocaine with 1:100,000 epinephrine following an IAN block significantly improved pulpal anesthesia for the lateral incisor compared with the IAN block alone.

Adult↗

PubMed2005

[Prognostic significances of natural killer cells and dendritic cells infiltrations in esophageal squamous cell carcinoma].

BACKGROUND & OBJECTIVE: Natural killer (NK) cell and dendritic cell (DC) play important roles in anti-tumor immunity. Heat shock protein (HSP) is also involved in anti-tumor immune mechanisms. This study was to explore prognostic significances of NK cells and DCs infiltrations in esophageal squamous cell carcinoma (ESCC), and their relationships with expressions of HSP27 and HSP70. METHODS: NK cells, and DCs infiltrations were detected by SP immunohistochemistry in 101 specimens of ESCC. Among the relevant 101 patients, 38 were classified into long-term survival group (>/=5 years), and 63 into short-term survival group (</=1 year) according to follow-up data. The 2 groups were matched in all pathologic and clinical features but post-esophagectomy survival time. Infiltrations of NK cells and DCs in ESCC were compared between the 2 groups. Relationships of NK cells and DCs infiltrations to expressions of HSP27 and HSP70 were statistically analyzed. RESULTS: Immunohistochemical results showed that the mean number of NK cells in the 101 specimens of ESCC was 31.4+/-19.7 per high-power field (x400, HPF), that in long-term survival group was much higher than that in short-term survival group [(41.9+/-21.7)/HPF vs. (25.0+/-15.4)/HPF, P < 0.001]. The mean number of DCs in the 101 specimens of ESCC was (14.8+/-21.7)/HPF; there was no significant difference between long-term and short-term survival groups [(15.2+/-8.6)/HPF vs. (14.5+/-7.4)/HPF, P > 0.05, t test]. NK cells and DCs infiltrations in ESCC had no significant correlation with clinicopathologic features, such as length of tumor, depth of invasion, histological grade, and lymph node metastasis, etc. (P > 0.05). Binary logistic regression analysis indicated that infiltration of NK cells was of prognostic significance for ESCC (P=0.001), while DCs was not (P=0.842). Infiltration of NK cells was positively correlated with infiltration of DCs (r=0.266, P=0.007). Both infiltrations of NK cells and DCs were positively correlated with expression of HSP27 (P=0.017, P=0.018), while no such correlation with expression of HSP70 was found (P > 0.05). CONCLUSIONS: Infiltration of NK cells is an independent prognostic factor of ESCC, and might be a prognostic biomarker of ESCC. Infiltration of DCs has no correlation with prognosis of ESCC. Infiltrations of NK cells and DCs may have internal correlation with the expression of HSP27.

Adult↗

PubMed2006

[Infiltrative pulmonary tuberculosis: course and efficiency of treatment].

The purpose of the investigation was to study the course of and the efficiency of treatment for new-onset infiltrative pulmonary tuberculosis. Two hundred and two patients with this condition were examined. Among the 202 patients, 15 (7.4%), 49 (24.3%), and 46 (22.8%) patients had lobular, rounded, and cloud-like infiltrates, respectively. 31 (15.3%) patients had periscissuritis and 61 (30.2%) had lobitis. The extent of infiltrative pulmonary tuberculosis within 1 segment was encountered in 19.3% and more frequently in the presence of rounded and lobular infiltrates; the specific process in 2 segments was detected in 24.3% of cases and more frequently when rounded and cloud-like infiltrates were observed. In periscissuritis and lobitis, the process occupied 1 lobe in 87.1 and 44.3% of cases, respectively, and 2 lobes or more in 34 (55.7%) patients. Infiltrates were located in the upper lobe in 167 (82.7%) patients, in Segment IV in 21 (10.4%), Segment IX in 6 (3%), Segment X in 5 (2.5%). The signs of lung tissue decay were detected in 140 (69.3%) persons. Decay cavities of less than 2 cm, 2-4 cm, and more than 4 cm in diameter were found in 56 (40%), 62 (44.3%), and 22 (15.7%) patients, respectively. Mycobacterium tuberculosis (MTB) was detected in 13.3, 46.9, 54.4, 70.9, and 83.6% of the patients who had lobular, rounded, and cloud-like infiltrates, periscissuritis, and lobitis, respectively. The drug-sensitive MBT population was seen in 58.4% of the patients; the drug-resistant MBT population was detected in 18.1% of the patients: in 14.3% with a lobular infiltrate, in 10% with a rounded infiltrate, in 28.6% with a cloud-like one, in 21.4% with perscissuritis, and in 15.7% with lobitis. Multi-drug MBT resistance was ascertained in 3.5% of the patients. Bacterial isolation ceased in 100% of the patients with a lobular infiltrate after 1-month therapy, in 47.8 and 52.2% of those with a rounded infiltrate after 1- and 2-month therapy, respectively, in two thirds and one third of the patients with a cloud-like infiltrate after 1- and 2-month therapy, respectively, in 45.4 and 31.8% of those with periscissuritis after 1- and 2-month therapy, respectively, and in 45.1 and 11.8% of cases of lobitis after 1- and 4-month therapy, respectively.

Adult↗

PubMed1989

Immunohistologic features predict clinical behavior of orbital and conjunctival lymphoid infiltrates.

The natural history of lymphoid infiltrates of the orbit and conjunctiva is poorly understood. To determine if immunohistologic features could predict clinical outcome, these features were evaluated in 61 patients with orbital and conjunctival lymphoid infiltrates, including 44 patients with lesions localized to one or both orbits or conjunctivae. Using histologic criteria, 20 infiltrates were classified as malignant lymphoma (cytologically atypical), 14 cases were classified as benign (follicular hyperplasia or inflammatory pseudotumor), and 27 infiltrates (44%) were dense infiltrates of small lymphocytes without cytologic atypia, which could not be confidently classified as benign or malignant (histologically indeterminate). Based on expression of monotypic immunoglobulin, 20 of these cases were reclassified as small lymphocytic lymphoma. For all cases, monotypic immunoglobulin expression correlated with reduced survival (P less than .05) and increased likelihood of dissemination (P less than .001). Monotypic immunoglobulin expression also correlated with increased risk of dissemination for all histologically indeterminate (small lymphocytic) infiltrates (P less than .05). Separate analysis of the localized infiltrates showed that monotypic immunoglobulin expression significantly correlated with an increased likelihood of dissemination for all 44 cases (P less than .005) and for the 22 histologically indeterminate lesions (P = .06). For the localized small lymphocytic infiltrates, monotypic immunoglobulin expression conferred a 50% risk of dissemination. In contrast, no patients with polytypic small lymphocytic infiltrates have disseminated, although one lesion locally recurred 30 months later as lymphoma. Thus, monotypic immunoglobulin expression significantly correlates with reduced patient survival and increased risk of dissemination by orbital and conjunctival lymphoid infiltrates. Monotypic small lymphocytic infiltrates without cytologic atypia behave as do low grade B-cell malignant lymphomas with a significant risk of dissemination and an indolent clinical course. The relationship of polytypic small lymphocytic infiltrates to lymphoma remains to be determined.

Adult↗

PubMedDate not supplied

Endocardial infiltrates in the transplanted heart: clinical significance emerging from the analysis of 5026 endomyocardial biopsy specimens.

UNLABELLED: To further elucidate the significance of endocardial infiltrates in heart transplant patients, the presence, frequency, and type of endocardial infiltrates were evaluated in 5026 endomyocardial biopsy specimens obtained from 200 heart transplant patients 0 to 75 months after heart transplantation. The relationship of endocardial infiltrates to immunologic, clinical, and demographic variables was then explored. Endocardial infiltrates were detected in 557 endomyocardial biopsy specimens (11%) from 117 heart transplant patients (58%) at 6.3 +/- 9.4 months (mean +/- SD; range, 0 to 49 months) after heart transplantation. Heart transplant patients with endocardial infiltrates were younger (p = 0.03), had a greater incidence of idiopathic dilated cardiomyopathy before heart transplantation (p = 0.05), and included a greater percentage of females (p < 0.05). Both total and treated rejection rates were significantly higher in patients with endocardial infiltrates versus those without endocardial infiltrates (p = 0.0001). Rejection on the subsequent endomyocardial biopsies was more often present in endocardial biopsy specimens with endocardial infiltrates than in those without endocardial infiltrates, both in the presence (37% versus 24%; p < 0.001) and absence (33% versus 19%; p < 0.0001) of concomitant findings of rejection. No association was identified between endocardial infiltrates and posttransplantation lymphoproliferative disorder, cytomegalovirus infection, Epstein-Barr virus infection, or cardiac allograft vasculopathy. Multivariate regression analysis confirmed that the occurrence of endocardial infiltrates is associated with rejection when adjustment is made for patient's age, gender, heart disease before transplantation, follow-up time, and number of endomyocardial biopsies after heart transplantation (p = 0.0001). CONCLUSIONS: (1) Endocardial infiltrates may occur with or without associated endomyocardial biopsy findings of rejection.(ABSTRACT TRUNCATED AT 250 WORDS)

Biopsy↗