Corneal (A-D) and conjunctival granuloma (E-F) caused by synthetic fibers from a toy teddy bear. A: A 4 × 5 mm oval corneal ulceration due to synthetic fibers in the 2-year-old girl (case 1). B-C: Haematoxylin-eosin (HE) staining of the inflamed corneal biopsy. The stroma contains multiple histiocytes and neutrophils and is embedded with bluish brown synthetic fibers (black arrows) exhibiting central black granular spots. Bars: 150 μm (B), 50 μm (C). D: Microscopy of synthetic fibers from the face of the 2-year-old girl's teddy bear causing the corneal ulceration. Bar: 50 μm. E-F: HE stained conjunctival biopsy from the 5-year-old girl (case 2) showing a normal differentiated epithelium (star = conjunctival surface). The connective tissue is infiltrated with inflammatory cells mostly eosinophils, and synthetic fibers (black arrows) surrounded by foreign body giant cell (white arrows). Bars: 200 μm (E), 50 μm (F).
Slit lamp examination showed a 7 × 5 mm granuloma in the left inferior conjunctival fornix embedded with hairs and synthetic fibers. The lesion prolapsed easily with gentle pressure on the left lower lid. The examination was otherwise normal.
To verify whether the synthetic fibers belonged to a toy teddy bear, we performed microscopical examination of two different types of synthetic fibers (whiskers and face hair) from the girl's toy teddy bear. Hairs from the face of the teddy bear were morphologically and microscopically identical with the fibers causing the severe corneal ulceration in the two-year-old girl.
The majority of patients with conjunctival granuloma (caused by synthetic foreign bodies) were referred to an eye department after the granuloma was visible . This may in children take weeks since children may neglect the symptoms until the granuloma has developed, or because the symptoms communicated to the parents are misunderstood [2,11]. However, in the present case of conjunctival granuloma signs were seen early and the child was referred after two days.
Even though the patient with the corneal lesion was examined with slit lamp, the examiner was unable to identify the corneal foreign body. A main reason might be that the synthetic fibers were bluish brown similar to the colour of the hypopyon and the iris. However, a slit lamp examination combined with negative bacterial and fungal staining and culturing should lead to a diagnosis of foreign body granuloma.
Cases with tarantula hairs and caterpillar setae penetrating the cornea and giving rise to serious conditions like chronic kerato-conjunctivitis, intracorneal hairs with granuloma formation and chronic iritis are well documented [6-9]. However, so far no similar consequences of synthetic fibers from a teddy bear's hair have been reported. The lesions are considered partly due to infiltration and to the inflammatory/toxic reactions, in the same way as hairs from the tarantula back are supposed to irritate the skin . Whether the same mechanisms are responsible for the severe case of keratitis in our patient is unclear. However, the synthetic fibers in case one were made of polyethylene. When used in joint arthroplasty, polyethylene may cause an osteolytic reaction when small particles are engulfed by macrophages in granulomatous reactions . A similar reaction could be the explanation in our patient. The azo dye applied in the fibers may also have had an influence, however, it has not been documented to have any adverse effect.
In a recent review of the literature, Schmack et al demonstrated the histopathological and ultrastructural features of conjunctival granuloma caused by synthetic fibers . The diagnosis is confirmed by the microscopic features of the conjunctival granuloma showing granulomatous inflammatory tissue with lymphocytes, plasma cells, eosinophils and usually foreign-body giant cells surrounding the synthetic fibers. The simplest method to confirm the diagnosis is excision of the conjunctival granuloma and microscopical examination demonstrating marked birefringence of the synthetic fibers when examined in polarized light [14,15]. The synthetic fibers are fairly uniform in diameter and generally round to oval in cross sections. The diameter of the synthetic fibers in the cases published by Schmack et al and Weinberg et al ranged from 17-29 μm and 21-27 μm like in our case [1,2]. The localization of the granuloma in the previously published 15 cases was unilateral and mainly in the inferior fornix, except in one case in the superior fornix .
PET polyethylene terephthalate (polyester), A acrylic (polyacrylonitrile), N nylon (polyamide), MF microfleece, FL fleece, Pt Polar Tech, T Tenson. Supplier of commercial fabrics are shown. SST Swedish School of Textiles. The specifications describing the textiles indicate the knitting gauge, density, and number of filaments in the fibers. Size of each fabric was 10 × 10 cm, n = 6
Total number of fibers released from 100 cm2 of fabric per wash. Results are presented in box plots showing median, 25th, and 75th percentiles, max and min. Different types of fabrics are divided into separate figures; note that y-axis scale is identical in all figures, to emphasize differences. a Five polyester (PET) fabrics of differing structure. b Acrylic (A1) and nylon (N1). c Three different polyester (PET) fleece (FL) or microfleece (MF) fabrics, commercially produced by Polar Tech (Pt) or Tenson (T). Statistically significant differences are indicated by letters (p
Total number of fibers released from 100 cm2 of fabric per wash, when fabrics were washed with water alone or with a commercially available detergent. Fabrics tested: acrylic (A1), and polyester (PET) fleece (FL) or microfleece (MF) fabrics, commercially produced by Polar Tech (Pt) or Tenson (T). Results are presented in box plots showing median, 25th and 75th percentiles, max and min. Statistically significant differences between washes (with or without detergent) for each fabric are indicated by *, (p
Number of fibers release after repeated washing from polyester fabrics knit with different gauges (PET-3, knit E28 100/36 and PET-4, knit E28 100/144). Results are presented as mean ± SEM. Statistically significant differences between number of fibers released from each fabric following the indicated number of washes are indicated by (**p
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Economic, social, and cultural circumstances drove the rapid adoption and acceptance of nylon and the subsequent embrace of the synthetic fibers that followed. For manufacturers a shortage of traditional raw materials driven by the postwar boom enhanced the appeal of synthetic alternatives derived from abundant gas and oil. For fashion designers the durability, washability, and ease of care of nylon and other man-made fibers opened up creative possibilities that ultimately meant more clothing and accessories for the garment industry to manufacture and sell. And for consumers the unique characteristics of nylon and other synthetics led many to embrace these fibers not just as artificial substitutes for natural substances but as new materials in their own right.
Once manufacturers and consumers embraced synthetics, there was no going back. The revolution that began with nylon gave rise to new silhouettes, textures, and colors impossible to create with natural fibers and continued to shape consumer tastes in the decades to come.
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The Synthetic Yarn and Fabric Association is a non-profit association comprised of over 265 individual and corporate members in the United States and across the globe who are affiliated with the synthetic yarn, fiber and fabrics industry. We have served as an advocate for our industry, the success of the distinguished companies we represent, and the professional education of the individuals who support us.
SYFA brings you the latest news and perspective on the synthetic yarn, fiber and fabrics industry in the United States and Canada, and around the world. Industry insider Alasdair Carmichael brings you the latest happenings and important developments in the synthetic fiber sector, sharing his unique insights on industry events, manufacturing, trade, business and innovation.
Certain fibers are better than others for specific applications. Some properties that distinguish these fibers include tensile strength, modulus, elongation, conductivity, and environmental compatibility. 781b155fdc