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Foreign bodies in the face are often not discovered at first sight. If there is reasonable suspicion caused by anamnesis or by clinical examination of a facial foreign body, a CT scan should be done. However, consideration should be given to wooden foreign bodies, which may appear different depending on the water content and are therefore often misinterpreted. Wooden foreign bodies should be extracted immediately to avoid severe complications. After surgery, regular controls of the wound should be carried out to immediately recognize and treat infection of the lesion.

We present the case of an orbital fracture and a wooden foreign body found during surgery. The patient had undergone a pre-operative computed tomography scan but the foreign body had not been seen on these images. We discuss the difficulties in demonstrating wooden objects on CT and describe indicators in patient history, examination findings and radiological signs that might suggest the presence of a wooden object. We emphasise the necessity to explore any orbital injury if there are clinical signs suggesting an intraorbital foreign body.

Facial perforation injuries are very rare. We describe a case of a 48-year-old man who sustained a perforation trauma from an 11 cm long wooden tree branch in the middle of the face in a skiing accident. He suffered from additional injuries, such as fractures of the ribs and hand, but was neurologically without pathologic findings and was cardiopulmonary stable.The branch penetrated the head from the sinus maxillaris through the maxilla just missing the internal and external carotid arteries and ending just short of the cervical vertebra. The patient was transported to a center for oral and maxillofacial surgery and underwent several operations.He could return to his normal social and professional life 8 months after the accident.

We report the case of a 46-year-old man who was admitted to the medical department of the hospital Reichenbach with a 2-day history of central and upper abdominal pain. The pain was displaced in the right lower abdominal quadrant, which is why the patient was transferred to our department. At laparoscopy a toothpick was found perforating the cecum. Laparoscopic management, therapeutic possibilities and problems of diagnosis are discussed. The patient does not recall having ingested a toothpick. The laparoscopic treatment of perforation of the cecum by a toothpick might be among the rarest operations ever conducted. In the literature no such publication could be found up to now.

Asbestos is a well known inhalant cancerogenic substance, causing not only mesothelioma but also cancer of the respiratory mucosa of the bronchi. Exposure can also cause non-malignant alterations of the pleura or lung, which can be assessed radiologically. Since asbestos can also induce malignant tumors of the nose and sinuses, we identified 50 patients from the files of the ENT Department Münster and tried to complete questionnaires concerning occupation and occupational hazards using informations from insurance companies as well as at least one chest x-ray. This material could be obtained in 19 patients. Nine of the 19 patients had x-ray findings that could be associated with asbestos exposure, but in none of these 9 cases was massive occupational exposure to asbestos probable. In only two of the nine cases was definite occupational exposure to asbestos not able to be excluded. A control group was not established, since statistical calculations of significance would have been problematic in a number of the 19 patients even if a control group did exist. From the questionnaires we have found an unexpected incidence of dusty workplaces (as seen with textile workers, wood-dust workers, cement workers, quarrymen and millers). A correlation between various types of sinonasal tumors and asbestos exposure could not be made.

We examined the possible vestibulotoxicity of 16 patients subject to chronic exposure to wood preservatives containing pentachlorophenol. A vestibular test battery showed no abnormal findings except in one patient with pre-existing Menière's disease. The discrepancy between a clear history of exposure contrasted with the normal vestibular finding, and illustrates the diagnostic problems in patients chronically exposed to wood preservative.

Since 1980, 2145 samples of raw milk from producers in the district of Freiburg have been analysed for polychlorinated biphenyls (PCB) during a monitoring programme. In 1983, we started to search for the source of PCB, whenever milk was contaminated above the average value (above 0.2 mg/kg fat, calculated as Clophen A60). In 7 cases, previous coats of paint in the silos proved to be the cause of the PCB contamination. Five samples of milk and 4 corresponding silages as well as 1 sample of wood (from a cowshed) were investigated for all of the individual PCB components included in the technical mixtures of Clophen A30 and A60. Two samples of silages contained both low and high chlorinated biphenyls, whereas low chlorinated biphenyls (di-, tri-, and tetrachlorinated biphenyls) were not detected in the corresponding milk samples. Pentachlorinated biphenyls were only detected in the range of 1%-2%. In the samples of wood and corresponding milk, a different PCB pattern appeared. There were remarkably high percentages of hepta- and octachlorinated biphenyls as well as a lower percentage of hexachlorinated biphenyls. The exact PCB content of the milk, determined by the addition of all single components, proved to be approximately half the value obtained by the usual calculation based on the evaluation of the three main peaks of the technical PCB mixture (Clophen A60). During 1984-1987, 607 samples of raw milk were analysed for six single PCB components, for which legal tolerance levels became valid in 1988.(ABSTRACT TRUNCATED AT 250 WORDS)

A case of adenocarcinoma in the maxilloethmoidal angle is reported. Progressive loss of differentiation following radiation and surgery was observed during the course of the disease. Professional etiology is discussed, the patient being woodworker for 18 years.

After perforating eye injury the retention of a foreign body in the orbits has to be excluded. Wooden foreign bodies mostly have negative density on CT, which increases later as a result of granulomatous changes. On MRI, pieces of wood appear with low signal intensity, and only in some cases is a collar-shaped structure recognizable, allowing differentiation from gas. Soon after orbital trauma with splinters of wood, therefore CT allows better differentiation of pieces of wood from intraorbital gas by measurement of their density, whereas MRI, makes it possible to demonstrate wooden foreign bodies in older injuries in spite of granulomatous changes.

The typical painted wooden Black Forest clock of the late eighteenth and early nineteenth century was the original famous Black Forest clock. The clocks changed from a useful article to an object in great demand by collectors; however, among them there are many fakes. Because of the use of colors containing lead and zinc at that time, the paint on these clocks can be evaluated radiologically and restaurations made later or even fakes can be detected easily. Important information can even be obtained about the wood used: its condition, the wooden axles, and abrasion of the gears.

In former experiments it could be shown, that new bone is formed around ashwood after implantation in the tibia of rabbits, in spite of a foreign-body tissue reaction. Equally prepared ashwood half-cylinders were now implanted in the soft tissue of rats and evaluated 2, 6, 12 and 30 weeks after implantation. Around the implants a foreign-body tissue reaction developed and demonstrates the hitherto insufficient preparation of the implants.

In recent years an increasing number of cases of primary irritant and allergic contact dermatitis has been observed after using the South-American timber Pao ferro (Machaerium scleroxylum). Since 1978 140 cases have come to our knowledge. The patients were mainly cabinet and furniture makers occupied in the sanding of veneer. Perioral dermatitis and cheilitis was also seen in persons playing the flute made of Pao ferro wood. Guinea pig sensitization experiments revealed a strong sensitizing capacity of the main wood constituent R-3,4-dimethoxydalbergione. Amounts of up to 2% were found in the heartwood. Mix-up of Brazilian rosewood (Dalbergia nigra) with its substitute (Machaerium scleroxylum) may occur accidently due to their similar appearance. However, a chemical differentiation is easily possible by determination of their constituents: while Pao ferro exclusively contains the strong sensitizer R-3,4-dimethoxydalbergione, the botanically related Brazilian rosewood (and also the East Indian rosewood--Dalbergia latifolia Roxb.) yields several other and weaker dalbergiones. In 41 of 55 patients tested epicutaneously with R-3,4-dimethoxydalbergione an acquired sensitivity could be demonstrated. The high amount of R-3,4-dimethoxydalbergione in Machaerium scleroxylum is primarily responsible for the outbreak of toxic dermatitis in veneer factories, half of which resulted in a sensitization. The risk of active sensitization is high if epicutaneous tests are carried out with the native wood dust. To avoid active sensitization it is better to test the pure constituent, if available, in a dilution of 0.1%.