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Li Q, Tang B, Liu X, Chen B, Wang X, Xiao H, Zheng Z. Overcoming the Dilemma of In Vivo Stable Adhesion and Sustained Degradation by the Molecular Design of Polyurethane Adhesives for Bone Fracture Repair. Adv Healthc Mater 2024; 13:e2301870. [PMID: 38145973 DOI: 10.1002/adhm.202301870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 11/27/2023] [Indexed: 12/27/2023]
Abstract
Bone adhesive is a promising candidate to revolutionize the clinical treatment of bone repairs. However, several drawbacks have limited its further clinical application, such as unreliable wet adhesive performance leading to fixation failure and poor biodegradability inhibiting bone tissue growth. By incorporating catechol groups and disulfide bonds into polyurethane (PU) molecules, an injectable and porous PU adhesive is developed with both superior wet adhesion and biodegradability to facilitate the reduction and fixation of comminuted fractures and the subsequent regeneration of bone tissue. The bone adhesive can be cured within a reasonable time acceptable to a surgeon, and then the wet bone adhesive strength is near 1.30 MPa in 1 h. Finally, the wet adhesive strength to the cortical bone will achieve about 1.70 MPa, which is also five times more than nonresorbable poly(methyl methacrylate) bone cement. Besides, the cell culture experiments also indicate that the adhesives show excellent biocompatibility and osteogenic ability in vitro. Especially, it can degrade in vivo gradually and promote fracture healing in the rabbit iliac fracture model. These results demonstrate that this ingenious bone adhesive exhibits great potential in the treatment of comminuted fractures, providing fresh insights into the development of clinically applicable bone adhesives.
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Affiliation(s)
- Qiang Li
- School of Chemistry and Chemical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Bo Tang
- Department of Orthopedics, Central Hospital of Fengxian District, Sixth People's Hospital of Shanghai, Shanghai, 201400, China
- The Third Clinical Medical College of Southern Medical University, Guangzhou, 510630, China
| | - Xinchang Liu
- School of Chemistry and Chemical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Buyun Chen
- School of Chemistry and Chemical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Xinling Wang
- School of Chemistry and Chemical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Haijun Xiao
- Department of Orthopedics, Central Hospital of Fengxian District, Sixth People's Hospital of Shanghai, Shanghai, 201400, China
- The Third Clinical Medical College of Southern Medical University, Guangzhou, 510630, China
| | - Zhen Zheng
- School of Chemistry and Chemical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
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Mo ZX, Li W, Wang DF. Perforating and ophthalmic artery variants from the anterior cerebral artery: Two case reports. World J Clin Cases 2023; 11:4392-4396. [PMID: 37449223 PMCID: PMC10336983 DOI: 10.12998/wjcc.v11.i18.4392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/15/2023] [Accepted: 05/25/2023] [Indexed: 06/26/2023] Open
Abstract
BACKGROUND The diagnosis and therapy during surgery depend largely on a full account of anatomic characteristics. Apart from regular structures, the common, less common or even uncommon anatomic variations are critical for procedural planning. This is especially true during craniocerebral microsurgery, where small vascular variations can affect the final surgical results and patient prognosis.
CASE SUMMARY Herein, two rare variations concerning the A1 (horizontal) segment of anterior cerebral artery (ACA1) were introduced. One enabled the communication between perforating branch of ACA1 and dural artery of anterior skull base, which was discovered during autopsy. The other was ophthalmic artery (OA) originating from ACA1, shown on digital angiography.
CONCLUSION In this study, we found two rare anatomical variations. One was an abnormal OA originated from the anterior communicating artery. The other was a perforating branch of the A1 segment of the anterior cerebral artery, which communicated with meningeal vessels in the anterior skull base. This finding is of great significance for the treatment of anterior communicating artery aneurysm or in other anterior skull base surgery.
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Affiliation(s)
- Zhi-Xiao Mo
- Department of Neurosurgery, Qinghai Provincial People's Hospital, Xining 810007, Qinghai Province, China
| | - Wen Li
- Department of Neurosurgery, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
| | - De-Fa Wang
- Department of Neurosurgery, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou 215006, Jiangsu Province, China
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Kinaci A, Slot EMH, Kollen M, Germans MR, Amin-Hanjani S, Carlson AP, Majeed K, Depauw PRAM, Robe PA, Regli L, Charbel FT, van Doormaal TPC. Risk Factors and Management of Incisional Cerebrospinal Fluid Leakage After Craniotomy: A Retrospective International Multicenter Study. Neurosurgery 2023; 92:1177-1182. [PMID: 36688661 PMCID: PMC10158880 DOI: 10.1227/neu.0000000000002345] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 11/05/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Incisional cerebrospinal fluid (iCSF) leakage is a serious complication after intradural cranial surgery. OBJECTIVE To determine the incidence and risk factors of iCSF leakage after craniotomy. Secondarily, the complications after iCSF leakage and the success rate of iCSF leakage treatment was studied. METHODS All patients who underwent an intradural cranial surgery from 2017 to 2018 at 5 neurosurgical centers were retrospectively included. Data were retrieved from medical records with 2 months of follow-up. First, univariate regression analyses were performed. Subsequently, identified risk factors were evaluated in a multivariate regression analysis. RESULTS In total 2310 consecutive patients were included. Total iCSF leakage rate was 7.1% (n = 165). Younger age, male, higher body mass index, smoking, infratentorial surgery, and use of a dural substitute were associated with increased iCSF leakage risk, and use of a sealant reduced that risk. The odds for developing a wound infection and/or meningitis were 15 times higher in patients with iCSF leakage compared with patients without leakage. Initial conservative iCSF leakage treatment failed in 48% of patients. In 80% of cases, external cerebrospinal fluid drainage ceased the iCSF leakage. A total of 32% of patients with iCSF leakage required wound revision surgery. CONCLUSION iCSF leakage risk increases by younger age, higher body mass index, smoking, infratentorial craniotomy, and dural substitute use, whereas sealant use reduced the risk for iCSF leakage. The leak increases the risk of postoperative infections. When iCSF leakage occurs, immediate external cerebrospinal fluid drainage or wound revision should be considered.
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Affiliation(s)
- Ahmet Kinaci
- Department of Neurosurgery, Brain Center, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Emma M. H. Slot
- Department of Neurosurgery, Brain Center, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Mare Kollen
- Department of Neurosurgery, Brain Center, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Menno R. Germans
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sepideh Amin-Hanjani
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Andrew P. Carlson
- Department of Neurosurgery, University of New Mexico, Albuquerque, New Mexico, USA
| | - Kashif Majeed
- Department of Neurosurgery, University of New Mexico, Albuquerque, New Mexico, USA
| | - Paul R. A. M. Depauw
- Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands
| | - Pierre A. Robe
- Department of Neurosurgery, Brain Center, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Luca Regli
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Fady T. Charbel
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Tristan P. C. van Doormaal
- Department of Neurosurgery, Brain Center, University Medical Centre Utrecht, Utrecht, the Netherlands
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Dong RP, Zhang Q, Yang LL, Cheng XL, Zhao JW. Clinical management of dural defects: A review. World J Clin Cases 2023; 11:2903-2915. [PMID: 37215425 PMCID: PMC10198091 DOI: 10.12998/wjcc.v11.i13.2903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 03/03/2023] [Accepted: 04/04/2023] [Indexed: 04/25/2023] Open
Abstract
Dural defects are common in spinal and cranial neurosurgery. A series of complications, such as cerebrospinal fluid leakage, occur after rupture of the dura. Therefore, treatment strategies are necessary to reduce or avoid complications. This review comprehensively summarizes the common causes, risk factors, clinical complications, and repair methods of dural defects. The latest research progress on dural repair methods and materials is summarized, including direct sutures, grafts, biomaterials, non-biomaterial materials, and composites formed by different materials. The characteristics and efficacy of these dural substitutes are reviewed, and these materials and methods are systematically evaluated. Finally, the best methods for dural repair and the challenges and future prospects of new dural repair materials are discussed.
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Affiliation(s)
- Rong-Peng Dong
- Department of Spinal Surgery, The Second Hospital of Jilin University, Changchun 130000, Jilin Province, China
| | - Qi Zhang
- Department of Spinal Surgery, The Second Hospital of Jilin University, Changchun 130000, Jilin Province, China
| | - Li-Li Yang
- Department of Spinal Surgery, The Second Hospital of Jilin University, Changchun 130000, Jilin Province, China
| | - Xue-Liang Cheng
- Department of Spinal Surgery, The Second Hospital of Jilin University, Changchun 130000, Jilin Province, China
| | - Jian-Wu Zhao
- Department of Spinal Surgery, The Second Hospital of Jilin University, Changchun 130000, Jilin Province, China
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Achinger KG, Williams LN. Trends in CSF Leakage Associated with Duraplasty in Infratentorial Procedures over the Last 20 Years: A Systematic Review. Crit Rev Biomed Eng 2023; 51:33-44. [PMID: 37551907 DOI: 10.1615/critrevbiomedeng.v51.i2.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
Cerebrospinal fluid (CSF) leakage is a common postoperative complication of neurosurgical procedures, with iatrogenic causes accounting for 16% of CSF leakages. This complication increases healthcare costs and patient morbidity. The focus of this review is to analyze the rates of CSF leakage of some of the most commonly used xenogeneic and synthetic dural substitutes following surgeries in the infratentorial region of the brain where surgical repair can be most challenging. A systematic literature search was conducted using studies detailing duraplasty procedures performed with nonautologous grafts in the infratentorial region in PubMed. Studies were identified using the following search terms: "posterior fossa" or "infratentorial" were used in combination with "CSF leak," "CSF leakage," "cerebrospinal fluid leakage," "duraplasty" or "dura graft." The outcome of interest was a measure of the prevalence of CSF leakage rates following posterior fossa neurosurgery. Studies that contributed data to this review were published between 2006 and 2021. The dural graft materials utilized included: bovine collagen, acellular dermis, equine collagen, bovine pericardium, collagen matrix, and expanded polytetrafluoroethylene (ePTFE). The number of subjects in studies on each of these grafts ranged from 6 to 225. CSF leak rates ranged from 0% to 25% with the predominance of studies reporting between 3% and 15%. The studies that utilize bovine collagen, equine collagen, and acellular dermis reported higher CSF leakage rates; whereas studies that utilized ePTFE, bovine pericardium, and collagen matrix reported lower CSF leakage rates. Due to the heterogeneity of methodologies used across these studies, it is difficult to draw a direct correlation between the dural patch products used and CSF leaks. Larger prospective controlled studies that evaluate various products in a head-to-head fashion, using the same methods and animal models, are needed to conclude the relative efficacy of these dural patch products.
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Affiliation(s)
- Katherine G Achinger
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
| | - Lakiesha N Williams
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
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Uchino A, Ishihara S. Ophthalmic artery arising from the presumed meningohypophyseal trunk of the cavernous internal carotid artery diagnosed by magnetic resonance angiography. Surg Radiol Anat 2022. [PMID: 35780395 DOI: 10.1007/s00276-022-02975-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 06/18/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE The purpose of the study is to describe a case of ophthalmic artery (OA) arising from the presumed meningohypophyseal trunk (MHT) of the cavernous internal carotid artery (ICA). CASE REPORT A 63-year-old woman suspected of having cerebral infarctions underwent cranial magnetic resonance (MR) imaging and MR angiography. MR angiography showed a right OA that was found to arise from the superolateral aspect of the proximal cavernous ICA. This OA entered the orbit via the superior orbital fissure (SOF). DISCUSSION Rarely, an OA arises from the inferior aspect of the middle cavernous ICA at the level of the inferolateral trunk (ILT) and enters the orbit via the SOF. This OA variation was traditionally regarded as a persistent primitive dorsal OA but is now believed to be due to the persistence of the lateral branch of the primitive maxillary artery. The present case had an OA arising from the superolateral aspect of the more proximal cavernous ICA than the origin of the ILT, which was suggested to be the origin of the MHT. Persistence of the proximal segment of the trigeminal artery may play an important role in the formation of this extremely rare variation. CONCLUSION To identify this extremely rare OA variation, careful observation of source images and the creation of volume-rendering MR angiography images are important.
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Zhang ZD, Zhao LY, Liu YR, Zhang JY, Xie SH, Lin YQ, Tang ZN, Fang HY, Yang Y, Li SZ, Liu JX, Sheng HS. Absorbable Artificial Dura Versus Nonabsorbable Artificial Dura in Decompressive Craniectomy for Severe Traumatic Brain Injury: A Retrospective Cohort Study in Two Centers. Front Surg 2022; 9:877038. [PMID: 35865039 PMCID: PMC9295144 DOI: 10.3389/fsurg.2022.877038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/30/2022] [Indexed: 11/16/2022] Open
Abstract
Background Severe traumatic brain injury (TBI) patients usually need decompressive craniectomy (DC) to decrease intracranial pressure. Duraplasty is an important step in DC with various dura substitute choices. This study aims to compare absorbable dura with nonabsorbable dura in duraplasty for severe TBI patients. Methods One hundred and three severe TBI patients who underwent DC and dura repair were included in this study. Thirty-nine cases used absorbable artificial dura (DuraMax) and 64 cases used nonabsorbable artificial dura (NormalGEN). Postoperative complications, mortality and Karnofsky Performance Scale (KPS) score in one year were compared in both groups. Results Absorbable dura group had higher complication rates in transcalvarial cerebral herniation (TCH) (43.59% in absorbable dura group vs. 17.19% in nonabsorbable dura group, P = 0.003) and CSF leakage (15.38% in absorbable dura group vs. 1.56% in nonabsorbable dura group, P = 0.021). But severity of TCH described with hernial distance and herniation volume demonstrated no difference in both groups. There was no statistically significant difference in rates of postoperative intracranial infection, hematoma progression, secondary operation, hydrocephalus, subdural hygroma and seizure in both groups. KPS score in absorbable dura group (37.95 ± 28.58) was statistically higher than nonabsorbable dura group (49.05 ± 24.85) in one year after operation (P = 0.040), while no difference was found in the rate of functional independence (KPS ≥ 70). Besides, among all patients in this study, TCH patients had a higher mortality rate (P = 0.008), lower KPS scores (P < 0.001) and lower functionally independent rate (P = 0.049) in one year after surgery than patients without TCH. Conclusions In terms of artificial biological dura, nonabsorbable dura is superior to absorbable dura in treatment of severe TBI patients with DC. Suturable nonabsorbable dura has fewer complications of TCH and CFS leakage, and manifest lower mortality and better prognosis. Postoperative TCH is an important complication in severe TBI which usually leads to a poor prognosis.
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Affiliation(s)
- Zhong-Ding Zhang
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Li-Yan Zhao
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Yi-Ru Liu
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Jing-Yu Zhang
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Shang-Hui Xie
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Yan-Qi Lin
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Zhuo-Ning Tang
- West China School of Public Health, Sichuan University, Chengdu, China
| | - Huang-Yi Fang
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Yue Yang
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Shi-Ze Li
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Jian-Xi Liu
- Department of Neurosurgery, Yueqing Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Han-Song Sheng
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
- Correspondence: Han-Song Sheng
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Zhao Z, Wu T, Cui Y, Zhao R, Wan Q, Xu R. Design and Fabrication of Nanofibrous Dura Mater with Antifibrosis and Neuroprotection Effects on SH-SY5Y Cells. Polymers (Basel) 2022; 14:1882. [PMID: 35567051 PMCID: PMC9099771 DOI: 10.3390/polym14091882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/13/2022] [Accepted: 04/25/2022] [Indexed: 01/27/2023] Open
Abstract
The development and treatment of some diseases, such as large-area cerebral infarction, cerebral hemorrhage, brain tumor, and craniocerebral trauma, which may involve the injury of the dura mater, elicit the need to repair this membrane by dural grafts. However, common dural grafts tend to result in dural adhesions and scar tissue and have no further neuroprotective effects. In order to reduce or avoid the complications of dural repair, we used PLGA, tetramethylpyrazine, and chitosan as raw materials to prepare a nanofibrous dura mater (NDM) with excellent biocompatibility and adequate mechanical characteristics, which can play a neuroprotective role and have an antifibrotic effect. We fabricated PLGA NDM by electrospinning, and then chitosan was grafted on the nanofibrous dura mater by the EDC-NHS cross-linking method to obtain PLGA/CS NDM. Then, we also prepared PLGA/TMP/CS NDM by coaxial electrospinning. Our study shows that the PLGA/TMP/CS NDM can inhibit the excessive proliferation of fibroblasts, as well as provide a sustained protective effect on the SH-SY5Y cells treated with oxygen–glucose deprivation/reperfusion (OGD/R). In conclusion, our study may provide a new alternative to dural grafts in undesirable cases of dural injuries.
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Baz RA, Jurja S, Ciuluvica R, Scheau C, Baz R. Morphometric study regarding ophthalmic and internal carotid arteries utilizing computed tomography angiography. Exp Ther Med 2022; 23:112. [PMID: 34970335 PMCID: PMC8713174 DOI: 10.3892/etm.2021.11035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 08/20/2021] [Indexed: 11/06/2022] Open
Abstract
The aim of the present study was to accurately measure the diameter of the ophthalmic artery (OA) and investigate whether bilateral variations in diameter can be recorded in relation to patient age and sex. A retrospective study including 80 computed tomography angiographic (CTA) examinations and a total of 160 arteries was conducted to demonstrate the morphometric aspects of the OAs analyzed bilaterally by CTA examinations, while considering the references of the internal carotid artery (ICA) caliber. Precise measurements performed on the OA and the ICA below and above the ophthalmic emergence revealed an OA diameter of 1.38±0.24 mm and a narrowing of the ICA between the origin of the OA of 1.5±0.25 mm. Variations in the OA and the ICA calibers were studied in subjects with normal cervical vasculature on CTA. After a thorough statistical study, variations in OA and ICA caliber on each side were identified, between both sex and age-related groups, revealing morphometric parameters of the OA in relation to the ICA.
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Affiliation(s)
- Radu Andrei Baz
- Department of Radiology and Medical Imaging, Faculty of Medicine, 'Ovidius' University, 900630 Constanta, Romania.,Department of Radiology, 'Sf. Apostol Andrei' County Hospital, 900591 Constanta, Romania
| | - Sanda Jurja
- Department of Ophthalmology, Faculty of Medicine, 'Ovidius' University, 900470 Constanta, Romania.,Department of Ophthalmology, 'Sf. Apostol Andrei' County Hospital, 900591 Constanta, Romania
| | - Radu Ciuluvica
- Department of Anatomy, Faculty of Dental Medicine, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Cristian Scheau
- Department of Physiology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Radu Baz
- Department of Radiology and Medical Imaging, Faculty of Medicine, 'Ovidius' University, 900630 Constanta, Romania.,Department of Radiology, 'Sf. Apostol Andrei' County Hospital, 900591 Constanta, Romania
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Chitty JW, Miro AC, Kaczmarska A, Guevar J, Gutierrez‐Quintana R. Frontal sinus repair using polymethyl methacrylate after craniectomy for a resection of a fronto‐parietal osteoma in a dog. Vet Record Case Reports 2021. [DOI: 10.1002/vrc2.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | | | - Julien Guevar
- Vetsuisse Faculty Department of Clinical Veterinary Science, University of Bern Bern Switzerland
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Ma H, Sun Y, Tang Y, Shen Y, Kan Z, Li Q, Fang S, Lu Y, Zhou X, Li Z. Robust Electrospun Nanofibers from Chemosynthetic Poly(4-hydroxybutyrate) as Artificial Dural Substitute. Macromol Biosci 2021; 21:e2100134. [PMID: 33955128 DOI: 10.1002/mabi.202100134] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Indexed: 11/07/2022]
Abstract
Bioresorbable poly(4-hydroxybutyrate) (P4HB) may fulfill the specific requirements that are necessary for a dural substitute, including its high elasticity, long-term strength retention properties, and the biocompatibility without significant accumulation of acidic degradation products. However, commercial P4HB can only be produced by the bacterial fermentation, which limits its applications in the cerebrospinal system due to higher endotoxin restriction. Meanwhile, P4HB can be prepared via the ring-opening polymerization of γ-butyrolactone. In this contribution, high molecular weight P4HB from chemosynthesis is electrospun into fibrous membrane, showing good mechanical properties that match the natural dura mater. Such P4HB membrane induces fast cellular migration, adhesion, and proliferation of fibroblasts in vitro. Subcutaneous implantation in rats demonstrates excellent biocompatibility of the P4HB membrane with proper biodegradation behaviors. After implantation in the rabbit dural defect model as an onlay graft, the P4HB membranes prevent cerebrospinal fluid leakage and regenerate dura tissue without detecting any local or systematic infections or foreign body responses. Thus, the electrospun P4HB membranes may be particularly useful as artificial dural substitutes to induce wound closure and tissue regeneration, which will be of great benefit to neurosurgery in the future.
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Affiliation(s)
- Huihui Ma
- Key Lab of Biobased Polymer Materials of Shandong Provincial Education Department, College of Polymer Science and Engineering, Qingdao University of Science and Technology, 53 Zhengzhou Road, Qingdao, 266042, P. R. China
| | - Yilin Sun
- Key Lab of Biobased Polymer Materials of Shandong Provincial Education Department, College of Polymer Science and Engineering, Qingdao University of Science and Technology, 53 Zhengzhou Road, Qingdao, 266042, P. R. China
| | - Ying Tang
- Key Lab of Biobased Polymer Materials of Shandong Provincial Education Department, College of Polymer Science and Engineering, Qingdao University of Science and Technology, 53 Zhengzhou Road, Qingdao, 266042, P. R. China
| | - Yong Shen
- College of Chemical Engineering, Qingdao University of Science and Technology, Qingdao, 266042, P. R. China
| | - Ze Kan
- Key Lab of Biobased Polymer Materials of Shandong Provincial Education Department, College of Polymer Science and Engineering, Qingdao University of Science and Technology, 53 Zhengzhou Road, Qingdao, 266042, P. R. China
| | - Qing Li
- Qingdao Chunghao Tissue Engineering Co. Ltd., Qingdao, 266003, P. R. China
| | - Sha Fang
- Key Lab of Biobased Polymer Materials of Shandong Provincial Education Department, College of Polymer Science and Engineering, Qingdao University of Science and Technology, 53 Zhengzhou Road, Qingdao, 266042, P. R. China
| | - Yingxi Lu
- College of Material Science and engineering, Qingdao University of Science and Technology, Qingdao, 266042, P. R. China
| | - Xianfeng Zhou
- Key Lab of Biobased Polymer Materials of Shandong Provincial Education Department, College of Polymer Science and Engineering, Qingdao University of Science and Technology, 53 Zhengzhou Road, Qingdao, 266042, P. R. China
| | - Zhibo Li
- Key Lab of Biobased Polymer Materials of Shandong Provincial Education Department, College of Polymer Science and Engineering, Qingdao University of Science and Technology, 53 Zhengzhou Road, Qingdao, 266042, P. R. China.,College of Chemical Engineering, Qingdao University of Science and Technology, Qingdao, 266042, P. R. China
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Gallo N, Natali ML, Sannino A, Salvatore L. An Overview of the Use of Equine Collagen as Emerging Material for Biomedical Applications. J Funct Biomater 2020; 11:jfb11040079. [PMID: 33139660 PMCID: PMC7712325 DOI: 10.3390/jfb11040079] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 10/24/2020] [Accepted: 10/29/2020] [Indexed: 12/19/2022] Open
Abstract
Type I collagen has always aroused great interest in the field of life-science and bioengineering, thanks to its favorable structural properties and bioactivity. For this reason, in the last five decades it has been widely studied and employed as biomaterial for the manufacture of implantable medical devices. Commonly used sources of collagen are represented by bovine and swine but their applications are limited because of the zoonosis transmission risks, the immune response and the religious constrains. Thus, type-I collagen isolated from horse tendon has recently gained increasing interest as an attractive alternative, so that, although bovine and porcine derived collagens still remain the most common ones, more and more companies started to bring to market a various range of equine collagen-based products. In this context, this work aims to overview the properties of equine collagen making it particularly appealing in medicine, cosmetics and pharmaceuticals, as well as its main biomedical applications and the currently approved equine collagen-based medical devices, focusing on experimental studies and clinical trials of the last 15 years. To the best of our knowledge, this is the first review focusing on the use of equine collagen, as well as on equine collagen-based marketed products for healthcare.
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Bi X, Liu B, Mao Z, Wang C, Dunne N, Fan Y, Li X. Applications of materials for dural reconstruction in pre-clinical and clinical studies: Advantages and drawbacks, efficacy, and selections. Mater Sci Eng C Mater Biol Appl 2020; 117:111326. [PMID: 32919680 DOI: 10.1016/j.msec.2020.111326] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/26/2020] [Accepted: 07/30/2020] [Indexed: 12/29/2022]
Abstract
The dura mater provides a barrier to protect the tissue underneath and cerebrospinal fluid. However, dural defects normally cause cerebrospinal fluid leakage and other complications, such as wound infections, meningitis, etc. Therefore, the reconstruction of dura mater has important clinical significance. Current dural reconstruction materials include: homologous, acellular, natural, synthetic, and composite materials. This review comprehensively summarizes the characteristics and efficacy of these dural substitutes, especially in clinical applications, including the advantages and drawbacks of those from different sources, the host tissue response in pre-clinical studies and clinical practice, and the comparison of these materials across different surgical procedures. Furthermore, the selections of materials for different surgical procedures are highlighted. Finally, the challenges and future perspectives in the development of ideal dural repair materials are discussed.
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Affiliation(s)
- Xuewei Bi
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China; Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing 100083, China
| | - Bo Liu
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China; Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing 100083, China
| | - Zhinan Mao
- International Research Center for Advanced Structural and Biomaterials, School of Materials Science & Engineering, Beihang University, Beijing 100191, China
| | - Cunyang Wang
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China; Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing 100083, China
| | - Nicholas Dunne
- Centre for Medical Engineering Research, School of Mechanical and Manufacturing Engineering, Dublin City University, Stokes Building, Collins Avenue, Dublin 9, Ireland
| | - Yubo Fan
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China; Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing 100083, China.
| | - Xiaoming Li
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China; Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing 100083, China.
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Chumnanvej S, Luangwattanawilai T, Rawiwet V, Suwanprateeb J, Rattanapinyopituk K, Huaijantug S, Yinharnmingmongkol C, Hemstapat R. In vivo evaluation of bilayer ORC/PCL composites in a rabbit model for using as a dural substitute. Neurol Res 2020; 42:879-889. [PMID: 32657258 DOI: 10.1080/01616412.2020.1789383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE After a neurosurgical procedure, dural closure is commonly needed to prevent cerebrospinal fluids (CSF) leakage and to reduce the risk of complications, including infections and chronic inflammatory reactions. Although several dural substitutes have been developed, their manufacturing processes are complicated and costly and that many of them have been implicated in causing postoperative complications. This study aimed to assess the effectiveness and safety of new bilayer ORC/PCL composites in a rabbit model. METHODS Two formulations of bilayer oxidized regenerated cellulose (ORC)/poly ε-caprolactone (PCL) knitted fabric-reinforced composites and an autologous graft (pericranium) were employed for dural closure in forty-five male rabbits. Systemic reaction and the local reaction of the samples were assessed and compared at one-, three- and six-months post-implantation by blood chemistry and gross, and microscopic assessment using hematoxylin-eosin and Masson's trichrome stains. RESULTS No signs of CSF leakage or systemic infection were seen for all samples. All samples demonstrated minimal adhesion to adjacent tissues. The degree of host fibrous connective tissue ingrowth into both composites was comparable to that of the autologous group, but bone formation and osteoclast activities were significantly greater. Both composites progressively degraded over times and the residual thickness of the nonporous layer was 50% of the initial thickness at six months post-implantation. DISCUSSION Bilayer ORC/PCL composites were successfully employed for dural closure in the rabbit model. They were biocompatible and could support dural regeneration comparable to that of the autologous group, but induced greater osteogenesis.
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Affiliation(s)
- Sorayouth Chumnanvej
- Neurosurgery Unit, Surgery Department, Faculty of Medicine, Ramathibodi Hospital , Bangkok, Thailand
| | | | - Visut Rawiwet
- Central Animal Facility, Faculty of Science, Mahidol University (MUSC-CAF) , Bangkok, Thailand
| | - Jintamai Suwanprateeb
- Biofunctional Materials and Devices Research Group, National Metal and Materials Technology Center (MTEC) , Pathum Thani, Thailand
| | - Kasem Rattanapinyopituk
- Department of Pathology, Faculty of Veterinary Science, Chulalongkorn University , Bangkok, Thailand
| | - Somkiat Huaijantug
- Department of Clinical Sciences and Public Health, Faculty of Veterinary Science, Mahidol University , Nakhon Pathom, Thailand
| | - Chaowaphan Yinharnmingmongkol
- Department of Clinical Sciences and Public Health, Faculty of Veterinary Science, Mahidol University , Nakhon Pathom, Thailand
| | - Ruedee Hemstapat
- Department of Pharmacology, Faculty of Science, Mahidol University , Bangkok, Thailand
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Hemstapat R, Suvannapruk W, Thammarakcharoen F, Chumnanvej S, Suwanprateeb J. Performance evaluation of bilayer oxidized regenerated cellulose/poly ε-caprolactone knitted fabric-reinforced composites for dural substitution. Proc Inst Mech Eng H 2020; 234:854-863. [DOI: 10.1177/0954411920926071] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Ideally, alloplastic dural substitute should have functional properties resembling human dura mater and retain a watertight closure to prevent cerebrospinal leakage. Therefore, functional properties for successful dural closure application of newly developed bilayer oxidized regenerated cellulose knitted fabric/poly ε-caprolactone knitted fabric-reinforced composites were studied and compared with human cadaveric dura mater and three commercial dural substitutes including two collagen matrices and one synthetic poly-L-lactide patch. It was found that oxidized regenerated cellulose knitted fabric/poly ε-caprolactone knitted fabric-reinforced composites uniquely contained a bilayer structure consisting of micropores distributed within the relatively dense microstructure. Density, tensile properties and stitch tear strength of oxidized regenerated cellulose knitted fabric/poly ε-caprolactone knitted fabric-reinforced composites were found to be closed to human cadaveric dura mater than those of dense-type and porous-type dural substitutes. Water tightness performance in both sutured and non-sutured forms of oxidized regenerated cellulose knitted fabric/poly ε-caprolactone knitted fabric-reinforced composites was slightly inferior to human cadaveric dura mater, but still better than those of commercial dural substitutes. This study revealed that oxidized regenerated cellulose knitted fabric/poly ε-caprolactone knitted fabric-reinforced composite showed better functional properties than typical dural substitutes and was found to be a good candidate for being employed as a dural substitute. The role and relationship of both microstructure and the type of materials on the functional properties and water tightness of the dural substitutes were also elucidated.
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Affiliation(s)
- Ruedee Hemstapat
- Department of Pharmacology, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Waraporn Suvannapruk
- Biofunctional Materials and Devices Research Group, National Metal and Materials Technology Center (MTEC), Pathum Thani, Thailand
| | - Faungchat Thammarakcharoen
- Biofunctional Materials and Devices Research Group, National Metal and Materials Technology Center (MTEC), Pathum Thani, Thailand
| | - Sorayouth Chumnanvej
- Neurosurgery Unit, Surgery Department, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand
| | - Jintamai Suwanprateeb
- Biofunctional Materials and Devices Research Group, National Metal and Materials Technology Center (MTEC), Pathum Thani, Thailand
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Bonasia S, Bojanowski M, Robert T. Embryology and anatomical variations of the ophthalmic artery. Neuroradiology 2019; 62:139-152. [PMID: 31863143 DOI: 10.1007/s00234-019-02336-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 12/04/2019] [Indexed: 12/18/2022]
Abstract
PURPOSE The ophthalmic artery (OA) has one of the most complex anatomy and the most fascinating embryological development. METHODS The complexity of the embryologic development of the OA resides in the implication of three different embryological systems: the carotid system, the stapedial system, and the ventral pharyngeal system. RESULTS This explains very well the numerous variations in origin of the OA and the importance of vascular anastomoses developed with branches of the external carotid artery and with the middle meningeal artery. CONCLUSION In this review, authors propose a comprehensive description of different hypotheses on the embryologic development of the OA and, in a second part, explain all anatomical variations and clinical implications of this artery.
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Affiliation(s)
- Sara Bonasia
- Department of Neurosurgery, Regional Hospital of Lugano, Neurocenter of the Southern Switzerland, Via Tesserete 46, CH-6903, Lugano, Switzerland
| | - Michel Bojanowski
- Department of Neurosurgery, Notre-Dame Hospital, Montreal, Quebec, Canada
| | - Thomas Robert
- Department of Neurosurgery, Regional Hospital of Lugano, Neurocenter of the Southern Switzerland, Via Tesserete 46, CH-6903, Lugano, Switzerland.
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Abstract
Introduction: Dural closure preference has been a topic of debate in contemporary neurosurgery. This study aims to compare different closure techniques using an in vitro model.Methods: Human cadaveric dura mater was attached to a cylindrical metal glass filled with blue dyed saline. A 1 cm dural incision was made. Dural closure was performed using three different techniques. Each group had six samples: Group I - interrupted simple 4-0 polyglactin suture (S) only, Group II - S plus on lay collagen graft, Group III - S plus fibrin sealant. In Group NS, a 1 cm × 1 cm dural window was made. An onlay collagen graft was used with no suturing for this group to serve as an overtly weak reconstruction reference. Primary and secondary leak pressures were recorded (PLP and SLP, respectively).Results: All groups (I-III) had significantly higher PLP and SLP than Group NS. PLP was significantly higher in Group III as compared to groups I and II. Groups I and II had similar PLP values. SLP was similar in all three groups.Conclusion: In this study, the use of fibrin sealant has proven to be the best option in preventing dural leak. However, no technique was superior in the case of SLP.
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Affiliation(s)
- Ceren Kizmazoglu
- Department of Neurosurgery, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Safak Ozyoruk
- Department of Neurosurgery, Ardahan State Hospital, Ardahan, Turkey
| | - Resit Bugra Husemoglu
- Department of Biomechanics, Dokuz Eylul University School of Medicine Health Science Institute, Izmir, Turkey
| | - Orhan Kalemci
- Department of Neurosurgery, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Gulden Sozer
- Department of Pathology, Forensic Medicine Institution, Izmir, Turkey
| | - Burak Sade
- Department of Neurosurgery, Dokuz Eylul University School of Medicine, Izmir, Turkey
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Lei K, Zhu Q, Wang X, Xiao H, Zheng Z. In Vitro and in Vivo Characterization of a Foam-Like Polyurethane Bone Adhesive for Promoting Bone Tissue Growth. ACS Biomater Sci Eng 2019; 5:5489-5497. [PMID: 33464068 DOI: 10.1021/acsbiomaterials.9b00918] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Kun Lei
- School of Chemistry and Chemical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Qi Zhu
- School of Chemistry and Chemical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Xinling Wang
- School of Chemistry and Chemical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Haijun Xiao
- Department of Orthopedics, Central Hospital of Fengxian District, Sixth People’s Hospital of Shanghai, Shanghai 201400, China
| | - Zhen Zheng
- School of Chemistry and Chemical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
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Zanon E, Pasca S, Bertomoro A, Mardari R, Simioni P. Spontaneous recurrent intracranial haemorrhage in a woman with type 2B von Willebrand disease: A clinical case and a brief literature review. Haemophilia 2019; 25:e282-e285. [PMID: 30924991 DOI: 10.1111/hae.13742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 02/20/2019] [Accepted: 02/23/2019] [Indexed: 06/09/2023]
Affiliation(s)
- Ezio Zanon
- Department of Medicine, Haemophilia Centre, University Hospital of Padua, Padua, Italy
| | - Samantha Pasca
- Department of Medicine, Haemophilia Centre, University Hospital of Padua, Padua, Italy
| | | | - Rodica Mardari
- Department of Neuroradiology, University Hospital of Padua, Padua, Italy
| | - Paolo Simioni
- Department of Medicine, Haemophilia Centre, University Hospital of Padua, Padua, Italy
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Abstract
Acute subdural hemorrhage is typically associated with a history of head trauma, and as such it is a finding with significant potential medicolegal consequences. In this article, 37 adult and post-infantile pediatric sudden death autopsy cases with small volume ("thin film" or "smear") acute subdural hemorrhage are presented-in which there is either no further evidence of head trauma or only features of minor head injury. The possible underlying pathophysiological mechanisms are explored, and it is concluded that a common thread in many of these cases is likely to have been cranial venous hypertension at around the time of death. These findings may have implications in instances where small volume subdural hemorrhage is identified in the absence of other evidence of significant head injury.
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Affiliation(s)
- Matthew M. Orde
- Matthew M. Orde MBChB FRCPath FRCPA, 855 West 12th Avenue, Vancouver BC,
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van de Vijfeijken SE, Münker TJ, Spijker R, Karssemakers LH, Vandertop WP, Becking AG, Ubbink DT, Becking A, Dubois L, Karssemakers L, Milstein D, van de Vijfeijken S, Depauw P, Hoefnagels F, Vandertop W, Kleverlaan C, Münker T, Maal T, Nout E, Riool M, Zaat S. Autologous Bone Is Inferior to Alloplastic Cranioplasties: Safety of Autograft and Allograft Materials for Cranioplasties, a Systematic Review. World Neurosurg 2018; 117:443-452.e8. [DOI: 10.1016/j.wneu.2018.05.193] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 05/25/2018] [Accepted: 05/26/2018] [Indexed: 11/19/2022]
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Nagel SJ, Reddy CG, Frizon LA, Chardon MK, Holland M, Machado AG, Gillies GT, Howard MA, Wilson S. Spinal dura mater: biophysical characteristics relevant to medical device development. J Med Eng Technol 2018; 42:128-139. [PMID: 29569970 DOI: 10.1080/03091902.2018.1435745] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Understanding the relevant biophysical properties of the spinal dura mater is essential to the design of medical devices that will directly interact with this membrane or influence the contents of the intradural space. We searched the literature and reviewed the pertinent characteristics for the design, construction, testing, and imaging of novel devices intended to perforate, integrate, adhere or reside within or outside of the spinal dura mater. The spinal dura mater is a thin tubular membrane composed of collagen and elastin fibres that varies in circumference along its length. Its mechanical properties have been well-described, with the longitudinal tensile strength exceeding the transverse strength. Data on the bioelectric, biomagnetic, optical and thermal characteristics of the spinal dura are limited and sometimes taken to be similar to those of water. While various modalities are available to visualise the spinal dura, magnetic resonance remains the best modality to segment its structure. The reaction of the spinal dura to imposition of a foreign body or other manipulations of it may compromise its biomechanical and immune-protective benefits. Therefore, dural sealants and replacements are of particular clinical, research and commercial interest. In conclusion, existing devices that are in clinical use for spinal cord stimulation, intrathecal access or intradural implantation largely adhere to traditional designs and their attendant limitations. However, if future devices are built with an understanding of the dura's properties incorporated more fully into the designs, there is potential for improved performance.
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Affiliation(s)
- Sean J Nagel
- a Center for Neurological Restoration , Cleveland Clinic , Cleveland , OH , USA
| | - Chandan G Reddy
- b Department of Neurosurgery , University of Iowa Hospitals and Clinics , Iowa City , IA , USA
| | - Leonardo A Frizon
- a Center for Neurological Restoration , Cleveland Clinic , Cleveland , OH , USA
| | - Matthieu K Chardon
- c Department of Physiology , Northwestern University Feinberg School of Medicine , Chicago , IL , USA
| | - Marshall Holland
- b Department of Neurosurgery , University of Iowa Hospitals and Clinics , Iowa City , IA , USA
| | - Andre G Machado
- a Center for Neurological Restoration , Cleveland Clinic , Cleveland , OH , USA
| | - George T Gillies
- d Department of Mechanical and Aerospace Engineering , University of Virginia , Charlottesville , VA , USA
| | - Matthew A Howard
- b Department of Neurosurgery , University of Iowa Hospitals and Clinics , Iowa City , IA , USA
| | - Saul Wilson
- b Department of Neurosurgery , University of Iowa Hospitals and Clinics , Iowa City , IA , USA
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Lee CK, Mokhtari T, Connolly ID, Li G, Shuer LM, Chang SD, Steinberg GK, Hayden Gephart M. Comparison of Porcine and Bovine Collagen Dural Substitutes in Posterior Fossa Decompression for Chiari I Malformation in Adults. World Neurosurg 2017; 108:33-40. [DOI: 10.1016/j.wneu.2017.08.061] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 08/07/2017] [Accepted: 08/10/2017] [Indexed: 11/26/2022]
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Abstract
To evaluate effect of sellar reconstruction during pituitary adenoma resection surgery by the endoscopic endonasal transsphenoidal approach using artificial cerebral dura mater patch.This was a retrospective study of 1281 patients who underwent endoscopic transsphenoidal resection for the treatment of pituitary adenomas between December 2006 and May 2014 at the Neurosurgery Department of the People's Liberation Army General Hospital. The patients were classified into 4 grades according to intraoperative cerebrospinal fluid (CSF) leakage site. All patients were followed up for 3 months by telephone and outpatient visits.One thousand seventy three (83.7%) patients underwent sellar reconstruction using artificial dura matter patched outside the sellar region (method A), 106 (8.3%) using artificial dura matter patched inside the sellar region (method B), and 102 (8.0%) using artificial dura matter and a mucosal flap (method C). Method A was used for grade 0-1 leakage, method B for grade 1 to 2 leakage, and method C for grade 2 to 3 leakage. During the 3-month follow-up, postoperative CSF leakage was observed in 7 patients (0.6%): 2 among patients who underwent method B (1.9%) and 5 among those who underwent method C (4.9%). Meningitis was diagnosed in 13 patients (1.0%): 2 among patients who underwent method A (0.2%), 4 among those who underwent method B (3.8%), and 7 among those who underwent method C (6.7%).Compared with other reconstruction methods, sellar reconstruction surgery that only use artificial dura mater as repair material had a low rate of complications.
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Affiliation(s)
- Yuanliang Ye
- Department of Neurosurgery, The 3rd Affiliated Hospital of Guangxi Traditional Chinese Medical University, Liuzhou, Guangxi Autonomous Region
| | - Fuyu Wang
- Department of Neurosurgery, PLA 301 Hospital, Beijing, China
| | - Tao Zhou
- Department of Neurosurgery, PLA 301 Hospital, Beijing, China
| | - Yi Luo
- Department of Neurosurgery, The 3rd Affiliated Hospital of Guangxi Traditional Chinese Medical University, Liuzhou, Guangxi Autonomous Region
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Thacoor A, Murphy S, Sadr AH, Kang N. Method for Securing Methlymethacrylate Bone Cement Using Histoacryl Glue During Cranioplasty for Contour Deformities. J Craniofac Surg 2018; 29:202-3. [PMID: 29065050 DOI: 10.1097/SCS.0000000000004069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Methylmethacrylate bone cement (MM-BC) is one of the reconstructive methods: during cranioplasty to correct cranial defects following trauma or cranial surgery. Perfect intraoperative immobilization of the MM-BC is crucial to ensure correct subsequent shaping to best improve contour defects. Current immobilization techniques reported are time-consuming and involve complex metalwork. The authors hereby present a technique that may simplify the immobilization process by using histoacryl glue to secure the MM-BC. This provides a quick, inexpensive, and readily available option providing fixation strong enough to withstand final shaping of the MM-BC.
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Kobayashi K, Imagama S, Ito Z, Ando K, Yagi H, Hida T, Ito K, Ishikawa Y, Tsushima M, Ishiguro N. Is a Drain Tip Culture Required After Spinal Surgery? Clin Spine Surg 2017; 30:356-9. [PMID: 28937457 DOI: 10.1097/BSD.0000000000000326] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
STUDY DESIGN The efficacy of use of a drain tip culture for early detection of surgical-site infection (SSI) was investigated in 329 patients after spinal surgery. OBJECTIVE To examine the efficacy of a wound drain tip culture for detection of SSI in spinal surgery. SUMMARY OF BACKGROUND DATA A complication of SSI after spinal surgery has high associated morbidity and mortality, and is often difficult to treat. MATERIALS AND METHODS The subjects were patients who underwent spinal surgery at our institution between January 2010 and March 2013. All subjects were treated with antimicrobial prophylaxis based on evidence-based guidelines and were followed for at least 6 months after surgery. Data from culture studies using the distal tip of the wound drain were used for analysis. RESULTS Drain tip cultures were positive in 34 cases and there were 19 SSIs. Ten of the 34-tip culture-positive wounds developed SSI. Drain tip cultures had a sensitivity of 52%, specificity of 92%, positive predictive value (PPV) of 29%, and negative predictive value of 97% for predicting a wound infection. The association between a positive suction tip culture and wound infection was significant (P<0.05). The PPV for SSI was 60% in cases in which methicillin-resistant bacteria were detected in a drain tip, and the SSI rate in these cases differed significantly compared with those with non-methicillin-resistant bacteria (P=0.01). CONCLUSIONS A drain tip culture is useful for early detection of SSI caused by methicillin-resistant bacteria.
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Yilmaz S, Ozden B, Bas B, Altun G, Altunkaynak BZ. Could Calcified Triglyceride Bone Cement Be an Alternative Graft Material in Maxillary Sinus Augmentation? J Craniofac Surg 2017; 28:97-103. [PMID: 27977491 DOI: 10.1097/scs.0000000000003236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The ideal graft material for maxillary sinus augmentation is still a matter of controversy and the search for a more appropriate bone substitute for use continues. The aim of this study was to evaluate bone formation as a sign of the regeneration following maxillary sinus augmentation in rabbits using 3 different biomaterials, one of which is a newly developed graft material; calcified triglyceride bone cement (CTBC).Twenty-one New Zealand rabbits were used and randomly divided into 3 groups. Bilateral maxillary sinus augmentation was carried out and autogenous bone (AB), bovine hydroxyapatite (BHA), and CTBC were administered. Maxillary sinuses were dissected after fourth and eighth weeks of the operation. The bone formation was evaluated by stereological and histopathological analysis and the data were analyzed statistically.When the volume of primary bone is compared, statistically significant differences were found among all groups at both of the fourth and eighth weeks. The highest value was obtained from AB applied group. In BHA and CTBC applied groups, active bone formation, osseointegration of graft materials were observed at both fourth and eighth weeks. In CTBC applied group, primary bone formation was only seen as linked to the continuation of parent sinus bony wall.The efficiency of primary bone formation of CTBC was found less than AB and BHA. Of the 3 graft materials tested, BHA is the strongest alternative to AB graft for maxillary sinus augmentation.
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Affiliation(s)
- Seda Yilmaz
- *Department of Oral and Maxillofacial Surgery, Private Dental Clinic, Istanbul †Department of Oral and Maxillofacial Surgery, Faculty of Dentistry ‡Department of Histology and Embryology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
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Spooner AJ, Mewhort HEM, DiFrancesco LM, Fedak PWM. Adhesive-Enhanced Sternal Closure: Feasibility and Safety of Late Sternal Reentry. Case Rep Surg 2017; 2017:8605313. [PMID: 28634566 DOI: 10.1155/2017/8605313] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This clinical case report describes sternal reentry performed years after adhesive-enhanced sternal closure using Kryptonite bone cement. This report provides novel data on the late effects of this innovation. We observed that sternal reentry is feasible and safe. The adhesive did not weaken from biodegradation over a period of several years. There was no evidence of adherence to adjacent soft tissues or other nonbony deep mediastinal structures. Surgeons who receive patients who require redoing cardiac surgery after adhesive-enhanced closure with Kryptonite can be reassured that sternal reentry is safe and feasible.
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Biscola NP, Cartarozzi LP, Ulian-Benitez S, Barbizan R, Castro MV, Spejo AB, Ferreira RS, Barraviera B, Oliveira ALR. Multiple uses of fibrin sealant for nervous system treatment following injury and disease. J Venom Anim Toxins Incl Trop Dis 2017; 23:13. [PMID: 28293254 PMCID: PMC5348778 DOI: 10.1186/s40409-017-0103-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 02/23/2017] [Indexed: 12/14/2022] Open
Abstract
Lesions to the nervous system often produce hemorrhage and tissue loss that are difficult, if not impossible, to repair. Therefore, scar formation, inflammation and cavitation take place, expanding the lesion epicenter. This significantly worsens the patient conditions and impairment, increasing neuronal loss and glial reaction, which in turn further decreases the chances of a positive outcome. The possibility of using hemostatic substances that also function as a scaffold, such as the fibrin sealant, reduces surgical time and improve postoperative recovery. To date, several studies have demonstrated that human blood derived fibrin sealant produces positive effects in different interventions, becoming an efficient alternative to suturing. To provide an alternative to homologous fibrin sealants, the Center for the Study of Venoms and Venomous Animals (CEVAP, Brazil) has proposed a new bioproduct composed of certified animal components, including a thrombin-like enzyme obtained from snake venom and bubaline fibrinogen. Thus, the present review brings up to date literature assessment on the use of fibrin sealant for nervous system repair and positions the new heterologous bioproduct from CEVAP as an alternative to the commercial counterparts. In this way, clinical and pre-clinical data are discussed in different topics, ranging from central nervous system to peripheral nervous system applications, specifying positive results as well as future enhancements that are necessary for improving the use of fibrin sealant therapy.
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Affiliation(s)
- Natalia Perussi Biscola
- Graduate Program in Tropical Diseases, Botucatu Medical School, Univ Estadual Paulista (UNESP), Botucatu, SP Brazil.,Center for the Study of Venoms and Venomous Animals (CEVAP), Univ Estadual Paulista (UNESP), Botucatu, SP Brazil.,Department of Structural and Functional Biology, Institute of Biology, University of Campinas (UNICAMP), Laboratory of Nerve Regeneration, CEP 13083-970 Campinas, SP Brazil
| | - Luciana Politti Cartarozzi
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas (UNICAMP), Laboratory of Nerve Regeneration, CEP 13083-970 Campinas, SP Brazil
| | - Suzana Ulian-Benitez
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas (UNICAMP), Laboratory of Nerve Regeneration, CEP 13083-970 Campinas, SP Brazil.,Neuro Development Lab, School of Biosciences, University of Birmingham, Birmingham, England UK
| | - Roberta Barbizan
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas (UNICAMP), Laboratory of Nerve Regeneration, CEP 13083-970 Campinas, SP Brazil.,The School of Medicine at Mucuri (FAMMUC), Federal University of Jequitinhonha and Mucuri Valleys (UFVJM), 39803-371 Teófilo Otoni, MG Brazil
| | - Mateus Vidigal Castro
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas (UNICAMP), Laboratory of Nerve Regeneration, CEP 13083-970 Campinas, SP Brazil
| | - Aline Barroso Spejo
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas (UNICAMP), Laboratory of Nerve Regeneration, CEP 13083-970 Campinas, SP Brazil
| | - Rui Seabra Ferreira
- Graduate Program in Tropical Diseases, Botucatu Medical School, Univ Estadual Paulista (UNESP), Botucatu, SP Brazil.,Center for the Study of Venoms and Venomous Animals (CEVAP), Univ Estadual Paulista (UNESP), Botucatu, SP Brazil
| | - Benedito Barraviera
- Graduate Program in Tropical Diseases, Botucatu Medical School, Univ Estadual Paulista (UNESP), Botucatu, SP Brazil.,Center for the Study of Venoms and Venomous Animals (CEVAP), Univ Estadual Paulista (UNESP), Botucatu, SP Brazil
| | - Alexandre Leite Rodrigues Oliveira
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas (UNICAMP), Laboratory of Nerve Regeneration, CEP 13083-970 Campinas, SP Brazil
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Abstract
Purpose Several variations of the arterial blood supply of the orbit have been reported over the years. This review is aimed to provide an update focusing on three important issues: (a) variations of the ophthalmic artery origin; (b) contribution of the external carotid artery to the orbital blood supply; (c) orbital hemodynamic. Methods A PubMed and Google search was carried out with the following keywords: ophthalmic artery origin, ophthalmic artery anastomoses and ophthalmic artery anatomy. Results The site of origin of the ophthalmic artery displays a limited number of variations. However they are important as they are also associated with course variations. Anastomoses between the ophthalmic artery and the external carotid artery are numerous and many of them can acquire clinical relevance. Records on their anatomic frequency are limited. Orbital hemodynamic variations are a poorly studied subject. Recent investigations in children have unveiled unexpected variability and instability in the way the blood flows through the orbit. Conclusions The orbit shows several possible arterial variations. Some of them have a profound influence on its hemodynamic at least in children. More studies are required to ascertain if the hemodynamic variability observed in children can be pinpointed also in adults.
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Affiliation(s)
- Eugenio Bertelli
- Department of Molecular and Developmental Medicine, University of Siena, Via Aldo Moro 2, 53100, Siena, Italy.
| | - Marì Regoli
- Department of Molecular and Developmental Medicine, University of Siena, Via Aldo Moro 2, 53100, Siena, Italy
| | - Sandra Bracco
- Unit of Neuroimaging and Neurointervention (NINT), Department of Neurological and Sensorineural Sciences, Azienda Ospedaliera Universitaria Senese, Policlinico "Santa Maria alle Scotte", Siena, Italy
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Di Vitantonio H, De Paulis D, Del Maestro M, Ricci A, Dechordi SR, Marzi S, Millimaggi DF, Galzio RJ. Dural repair using autologous fat: Our experience and review of the literature. Surg Neurol Int 2016; 7:S463-8. [PMID: 27500007 PMCID: PMC4960926 DOI: 10.4103/2152-7806.185777] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 04/27/2016] [Indexed: 12/11/2022] Open
Abstract
Background: Various materials have been proposed to obliterate dead spaces and to reconstruct dural defects during a neurosurgical approach. This study describes our technique of using the abdominal autologous fat graft and evaluates the complications and characteristics related to the use of this tissue during cranial procedures. Methods: Autologous fat grafts were used in 296 patients with basicranial and convexity extraaxial tumors from April 2005 to January 2015. The adipose tissue was removed from the paraumbilical abdominal region and was transformed into a thin foil. When possible, a watertight suture was made between the dural or bone edge with a fat graft. We always used fibrin glue to reinforce the dural closure. Results: Complications occurred between 2 days and 1 year following procedure. Cerebrospinal fluid leaks were found in 11 cases. No case of mortality, pseudomeningoceles, fistula, infections, bacterial meningitides, or lipoid meningitides was reported. No patient required removal of the graft. No adhesion was observed between the brain and the autologous fat. Other fat-related complications observed were 2 cases of fat necrosis in the abdomen and 2 cases of abdominal hemorrhage. Conclusion: The technique of harvesting and applying fat grafts is fairly simple, although it must be performed meticulously to be effective. Our experience has led us to believe that the use of fat grafts presents low morbidity and mortality. However, a neurosurgeon should never forget the possible late or early complications related to the use of fat grafts.
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Affiliation(s)
- Hambra Di Vitantonio
- Department of Life, Health and Environmental Sciences (MESVA), University of L'Aquila, L'Aquila, Italy
| | - Danilo De Paulis
- Department of Neurosurgery, San Salvatore City Hospital, L'Aquila, Italy
| | - Mattia Del Maestro
- Department of Life, Health and Environmental Sciences (MESVA), University of L'Aquila, L'Aquila, Italy
| | - Alessandro Ricci
- Department of Neurosurgery, San Salvatore City Hospital, L'Aquila, Italy
| | - Soheila Raysi Dechordi
- Department of Life, Health and Environmental Sciences (MESVA), University of L'Aquila, L'Aquila, Italy
| | - Sara Marzi
- Department of Neurosurgery, San Salvatore City Hospital, L'Aquila, Italy
| | - Daniele F Millimaggi
- Department of Life, Health and Environmental Sciences (MESVA), University of L'Aquila, L'Aquila, Italy
| | - Renato J Galzio
- Department of Life, Health and Environmental Sciences (MESVA), University of L'Aquila, L'Aquila, Italy
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32
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Suwanprateeb J, Luangwattanawilai T, Theeranattapong T, Suvannapruk W, Chumnanvej S, Hemstapat W. Bilayer oxidized regenerated cellulose/poly ε-caprolactone knitted fabric-reinforced composite for use as an artificial dural substitute. J Mater Sci Mater Med 2016; 27:122. [PMID: 27278580 DOI: 10.1007/s10856-016-5736-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 06/06/2016] [Indexed: 06/06/2023]
Abstract
A novel bilayer knitted fabric-reinforced composite for potentially being used as a dural substitute was developed by solution infiltration of oxidized regenerated cellulose knitted fabric (ORC) with poly ε-caprolactone (PCL) solution at various concentrations ranging 10-40 g/100 mL. It was found that the density of all formulations did not differ significantly and was lower than that of the human dura. Microstructure of the samples typically comprised a bilayer structure having a nonporous PCL layer on one side and the ORC/PCL composite layer on another side. Tensile modulus and strength of the samples initially decreased with increasing PCL solution concentration for up to 20 g/100 mL and re-increased again with further increasing PCL solution concentration. Strain at break of all formulations were not significantly different. Watertight test revealed that all composites could prevent leakage at the pressure within the normal range of intracranial pressure. In vitro degradation study revealed that the weight loss percentage and change in tensile properties of all samples displayed biphasic profile comprising an initially rapid decrease and followed by a gradual decrease with incubation times afterward. Micro and macro porous channels were observed to be in situ generated in the composite layer by ORC dissolution and PCL resorption during degradation while nonporous layer remained relatively unchanged. The degradation rate was found to decrease with increasing PCL solution concentration. In vitro biocompatibility using alamar blue assay on selected samples showed that fibroblasts could attach and proliferate well at all incubation periods.
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Affiliation(s)
- Jintamai Suwanprateeb
- National Metal and Materials Technology Center (MTEC), Paholyothin Road, Klong 1, Klongluang, 12120, Pathumthani, Thailand
| | - Ticomporn Luangwattanawilai
- Department of Pharmacology, Faculty of Science, Mahidol University, Rama VI Road, Rajthevee, Bangkok, 10400, Thailand
| | - Thunyanun Theeranattapong
- Department of Pharmacology, Faculty of Science, Mahidol University, Rama VI Road, Rajthevee, Bangkok, 10400, Thailand
| | - Waraporn Suvannapruk
- National Metal and Materials Technology Center (MTEC), Paholyothin Road, Klong 1, Klongluang, 12120, Pathumthani, Thailand
| | - Sorayouth Chumnanvej
- Neurosurgery Unit, Surgery Department, Faculty of Medicine, Ramathibodi Hospital, Rama VI Road, Rajthevee, Bangkok, 10400, Thailand
| | - Warinkarn Hemstapat
- Department of Pharmacology, Faculty of Science, Mahidol University, Rama VI Road, Rajthevee, Bangkok, 10400, Thailand.
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Esposito F, Angileri FF, Kruse P, Cavallo LM, Solari D, Esposito V, Tomasello F, Cappabianca P. Fibrin Sealants in Dura Sealing: A Systematic Literature Review. PLoS One 2016; 11:e0151533. [PMID: 27119993 DOI: 10.1371/journal.pone.0151533] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 02/28/2016] [Indexed: 01/06/2023] Open
Abstract
Background Fibrin sealants are widely used in neurosurgery to seal the suture line, provide watertight closure, and prevent cerebrospinal fluid leaks. The aim of this systematic review is to summarize the current efficacy and safety literature of fibrin sealants in dura sealing and the prevention/treatment of cerebrospinal fluid leaks. Methods A comprehensive electronic literature search was run in the following databases: Cochrane Database of Systematic Reviews, Cochrane Central Resister of Controlled Trials, clinicaltrials.gov, MEDLINE/PubMed, and EMBASE. Titles and abstracts of potential articles of interest were reviewed independently by 3 of the authors. Results A total of 1006 database records and additional records were identified. After screening for duplicates and relevance, a total of 78 articles were assessed by the investigators for eligibility. Thirty-eight were excluded and the full-text of 40 articles were included in the qualitative synthesis. Seven of these included only safety data and were included in the safety assessment. The remaining 33 articles included findings from 32 studies that enrolled a total of 2935 patients who were exposed to fibrin sealant. Among these 33 studies there were only 3 randomized controlled trials, with the remaining being prospective cohort analysis, case controlled studies, prospective or retrospective case series. One randomized controlled trial, with 89 patients exposed to fibrin sealant, found a greater rate of intraoperative watertight dura closure in the fibrin sealant group than the control group (92.1% versus 38.0%, p<0.001); however, post-operative cerebrospinal fluid leakage occurred in more fibrin sealant than control patients (6.7% versus 2.0%, p>0.05). Other clinical trials evaluated the effect of fibrin sealant in the postoperative prevention of cerebrospinal fluid leaks. These were generally lower level evidence studies (ie, not prospective, randomized, controlled trials) that were not designed or powered to demonstrate a significant advantage to fibrin sealant use. Two small case series studies evaluated the effect of fibrin sealants in persistent cerebrospinal fluid leak treatment, but did not establish firm efficacy conclusions. Specific adverse reports where fibrin sealants were used for dura sealing were limited, with only 8 cases reported in neurosurgical procedures since 1987 and most reporting only a speculative relationship/association with fibrin sealant exposure. Conclusions A major finding of this systematic literature review is that there is a paucity of randomized studies that have evaluated the effectiveness and safety of fibrin sealants in providing intraoperative watertight dura closure and post-operative cerebrospinal fluid leakage. Among the limited studies available, evidence from a single randomized, controlled trial indicates that fibrin sealants provide a higher rate of intraoperative watertight closure of the dura suture line than control, albeit with a higher rate of postoperative cerebrospinal fluid leakage. Evidence from non-randomized, controlled trials suggests that fibrin sealants may be effective in preventing cerebrospinal fluid leaks with an acceptable safety profile. There is a substantial need for randomized, controlled clinical trials or well-designed prospective observational trials where the conduct of a randomized trial is not feasible to fully assess the impact of fibrin sealant utilization on the rates of intraoperative dura closure, postoperative cerebrospinal leakage, and safety.
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Belotti F, Ferrari M, Doglietto F, Cocchi MA, Lancini D, Buffoli B, Nicolai P, Fontanella MM, Maroldi R, Tschabitscher M, Rodella LF. Ophthalmic artery originating from the anterior cerebral artery: anatomo-radiological study, histological analysis, and literature review. Neurosurg Rev 2016; 39:483-93. [PMID: 27048359 DOI: 10.1007/s10143-016-0715-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 01/25/2016] [Indexed: 11/25/2022]
Abstract
The ophthalmic artery has an anomalous origin in 2-3 % of cases and rarely arises from the anterior cerebral artery. Herein, we provide the first anatomical, radiological, and histological description of such an anomalous origin, together with a literature review. During the anatomical dissection of an 81-year-old Caucasian male, the absence of the right ophthalmic artery in its usual location was evident from an endonasal transsphenoidal perspective. The specimen was then studied in detail, through multiple dissections, corrosion casting, high-resolution CT, and histological analysis. The English literature on anomalous origins of the ophthalmic artery was reviewed, together with reported associated pathologies. Anatomo-radiological analysis documented that the right ophthalmic artery arose from the inferior surface of A1 tract of the anterior cerebral artery (A1) and passed over the optic nerve in its subarachnoid tract. A meningo-ophthalmic artery was evident on the same side and reached the orbit through the superior orbital fissure. Histological examination of both internal carotid artery (ICA) walls documented a significantly decreased thickness of the tunica media and adventitia on the side of the anomalous ophthalmic artery, with a significantly different content of collagen types I and III. The literature review documented an association of aneurysms and anomalous ophthalmic arteries. To the best of our knowledge, this is the first anatomical report that includes a radiological and arterial wall analysis of a persistent ventral ophthalmic artery. The latter provides histological data that support the clinical evidence of a higher association of aneurysms with anomalous origins of the ophthalmic artery.
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Affiliation(s)
- Francesco Belotti
- Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Marco Ferrari
- Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Francesco Doglietto
- Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazzale Spedali Civili, 1, 25123, Brescia, Italy.
| | - Marco Angelo Cocchi
- Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Davide Lancini
- Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Barbara Buffoli
- Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Piero Nicolai
- ENT surgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Marco Maria Fontanella
- Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazzale Spedali Civili, 1, 25123, Brescia, Italy
| | - Roberto Maroldi
- Radiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Manfred Tschabitscher
- Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Luigi Fabrizio Rodella
- Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
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Abstract
Chronic subdural hematomas (CSHs) are generally regarded to be a traumatic lesion. It was regarded as a stroke in 17th century, an inflammatory disease in 19th century. From 20th century, it became a traumatic lesion. CSH frequently occur after a trauma, however, it cannot occur when there is no enough subdural space even after a severe head injury. CSH may occur without trauma, when there is sufficient subdural space. The author tried to investigate trends in the causation of CSH. By a review of literature, the author suggested a different view on the causation of CSH. CSH usually originated from either a subdural hygroma or an acute subdural hematoma. Development of CSH starts from the separation of the dural border cell (DBC) layer, which induces proliferation of DBCs with production of neomembrane. Capillaries will follow along the neomembrane. Hemorrhage would occur into the subdural fluid either by tearing of bridge veins or repeated microhemorrhage from the neomembrane. That is the mechanism of hematoma enlargement. Trauma or bleeding tendency may precipitate development of CSH, however, it cannot lead CSH, if there is no sufficient subdural space. The key determinant for development of CSH is a sufficient subdural space, in other words, brain atrophy. The most common and universal cause of brain atrophy is the aging. Modifying Virchow's description, CSH is sometimes traumatic, but most often caused by degeneration of the brain. Now, it is reasonable that degeneration of brain might play pivotal role in development of CSH in the aged persons.
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Affiliation(s)
- Kyeong-Seok Lee
- Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
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36
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Gelabert-González M, Arán-Echabe E, Bandín-Diéguez FJ, Santín-Amo JM, Serramito-García R, Prieto-González Á, García-Allut A. [Bilateral chronic subdural haematoma: Analysis of a series of 190 patients]. Neurocirugia (Astur) 2016; 27:103-11. [PMID: 26589663 DOI: 10.1016/j.neucir.2015.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 07/21/2015] [Accepted: 07/23/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of this study is to analyse the clinical findings and surgical results in a series of patients with bilateral chronic subdural haematoma (BCSDH), and compare the results with a series of patients treated for unilateral chronic subdural haematoma (UCSDH). PATIENTS AND METHODS A retrospective study was performed on 1523 patients diagnosed and surgically treated for chronic subdural haematoma over a period of 30 years. Patients were divided into 2 groups: The study group consisting of 190 patients operated on for a BCSDH and the control group consisting of patients operated on for an UCSDH (1333 cases). RESULTS The patient series included 126 males (66.3%) and 64 females (33.7%), with a mean age at diagnosis of 74.8±10.2. The control group consisted of 870 males (65.2%) and 463 women (34.8%), with a mean age of 73.2±12.1. The most common presenting symptoms was cognitive impairment in 63 patients (33.2%) with BCSDH and 416 (29.5%) with UCSDH. Recurrence rates were 9.4% (18 patients) and 5.7% (77 patients) in unilateral and bilateral haematomas, respectively. The mortality was 10 patients (5.2%) with BCSDH and 55(4%) with UCSDH. Factors significantly related to recurrence in the univariate analysis were being male (P=.040), anticoagulant/antiplatelet therapy (P=.032), and poor neurological status at admission (P=.039). CONCLUSIONS This study indicates that BCSDH is more frequent in males, and the most common presentation is headache. The most important factors influencing recurrences are being male, intake of anticoagulant-antiaggregant drugs, and worse clinical status at admission.
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Affiliation(s)
- K. Livesey
- Division Hematology/Oncology; Department of Medicine; University of Pittsburgh Medical Center; Pittsburgh PA USA
| | - D. M. Yealy
- Department of Emergency Medicine; University of Pittsburgh Medical Center; Pittsburgh PA USA
| | - J. Li
- Department of Healthy Policy and Management; Graduate School of Public Health Pittsburgh; Pittsburgh PA USA
| | - C. G. Moore
- Department of Biostatistics; Carolinas Healthcare System; Charlotte NC USA
| | - M. V. Ragni
- Division Hematology/Oncology; Department of Medicine; University of Pittsburgh Medical Center; Pittsburgh PA USA
- Hemophilia Center of Western PA; Pittsburgh PA USA
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Gregg L, San Millán D, Orru' E, Tamargo RJ, Gailloud P. Ventral and Dorsal Persistent Primitive Ophthalmic Arteries. Oper Neurosurg (Hagerstown) 2015; 12:141-152. [DOI: 10.1227/neu.0000000000001066] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 08/22/2015] [Indexed: 11/19/2022] Open
Abstract
Abstract
BACKGROUND
Before the development of the adult ophthalmic artery (OA), the primitive maxillary artery (MA), the primitive dorsal OA, and the primitive ventral OA contribute to the vascularization of early ocular structures, whereas the primitive olfactory artery (OlfA) forms in the vicinity of the optic vesicle. These vessels are involved in several OA origin variants.
OBJECTIVE
To clarify the developmental history of the OA, emphasizing in particular the criteria used to define persistent primitive OAs.
METHODS
Eight rare variants relevant to the discussion of aberrant OA origins are presented.
RESULTS
Five abnormal anatomic configurations are described including (1) OAs branching from the cavernous internal carotid artery (ICA) involving a persistent primitive MA, (2) OAs originating from the distal supraclinoid ICA involving persistent primitive ventral or dorsal OAs, (3) an OA originating from the anterior cerebral artery (ACA) involving a persistent primitive OlfA, (4) a persistent primitive OlfA, and (5) infraoptic ACAs involving the persistent primitive MA, OlfA, and OA.
CONCLUSION
Discrepancies regarding the identification of persistent primitive OAs appear to result from a misinterpretation of the literature. Notably, an OA arising from the cavernous segment of the ICA derives from a primitive MA, whereas an OA arising from the ACA represents the partial persistence of a primitive OlfA; neither corresponds to a persistent primitive OA. Two new observations of this latter variant, which is exceptional, are presented.
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Affiliation(s)
- Lydia Gregg
- Division of Interventional Neuroradiology, The Johns Hopkins Hospital, Baltimore, Maryland
- Department of Art as Applied to Medicine, The Johns Hopkins Hospital, Baltimore, Maryland
| | - Diego San Millán
- Division of Interventional Neuroradiology, The Johns Hopkins Hospital, Baltimore, Maryland
- Neuroradiology Unit, Diagnostic and Interventional Radiology Service, Hospital of Sion, Valais, Switzerland
| | - Emanuele Orru'
- Division of Interventional Neuroradiology, The Johns Hopkins Hospital, Baltimore, Maryland
| | - Rafael J Tamargo
- Department of Neurosurgery, The Johns Hopkins Hospital, Baltimore, Maryland
| | - Philippe Gailloud
- Division of Interventional Neuroradiology, The Johns Hopkins Hospital, Baltimore, Maryland
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Amirouche F, Solitro G, Broviak S, Goldstein W, Gonzalez M, Barmada R. Primary cup stability in THA with augmentation of acetabular defect. A comparison of healthy and osteoporotic bone. Orthop Traumatol Surg Res 2015; 101:667-73. [PMID: 26300456 DOI: 10.1016/j.otsr.2015.07.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 07/01/2015] [Accepted: 07/07/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND CONTEXT Reconstruction of acetabular defect has been advocated as standard procedure in total hip arthroplasty. The presence of bony defects at the acetabulum is viewed as a cause of instability and acetabular wall augmentation is often used without proper consideration of surrounding bone density. The initial cup-bone stability is, however, a challenge and a number of studies supported by clinical follow-ups of patients suggested that if the structural graft needs supporting more than 50% of the acetabular component, a reconstruction cage device spanning ilium to ischium should be preferred to protect the graft and provide structural stability. This study aims to (1) investigate the relationship between cup motion and bone density and (2) quantify the re-distribution of stress at the defect site after augmentation. HYPHOTESIS Paprosky type I or II, acetabular defects, when reconstructed with bone screws supported by bioabsorbable calcified triglyceride bone cement are significantly less effective for osteoporotic bone than healthy bone. MATERIALS AND METHODS Acetabular wall defects were reconstructed on six cadaveric subjects with bioabsorbable calcified triglyceride bone cement using a re-bar technique. Data of the specimen with higher bone density was used to validate a Finite Element Model. Values of bone apparent density ranging from healthy to osteoporotic were simulated to evaluate (1) the cup motion, through both displacement and rotation, (2) and the von Mises stress distribution. RESULTS Defect reconstruction with bone screws and bioabsorbable calcified triglyceride bone cement results in a re-distribution of stress at the defect site. For a reduction of 65% in bone density, the cup displacement was similar to a healthy bone for loads not exceeding 300 N, as load progressed up to 1500 N, the reconstructed defect showed increase of 99 μm (128%) in displacement and of 0.08° in rotation angle. CONCLUSIONS Based on the results, we suggest that an alternative solution to wall defect augmentation with bone screws supported by bioabsorbable calcified triglyceride bone cement, be used for osteoporotic bone. LEVEL OF EVIDENCE Level IV, experimental and cadaveric study.
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40
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Luongo M, Grassi M, Godano U. Bilateral Chronic Subdural Nontraumatic Hematoma in a Woman Affected by AL Amyloidosis. J Neurol Surg Rep 2015; 76:e164-6. [PMID: 26251797 PMCID: PMC4521006 DOI: 10.1055/s-0035-1554933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 03/28/2015] [Indexed: 11/25/2022] Open
Abstract
Chronic subdural hematoma (CSDH) is a condition frequently seen in neurosurgical practice, especially among the elderly. It is often preceded by head injury, even a trivial trauma. Light chain (AL) amyloidosis is a disorder involving extracellular tissue deposition of misfolded native proteins called amyloids. The several types of amyloidosis differ by source of proteins, organ involvement, treatment, and prognosis. We describe the case of a 59-year-old woman affected by AL amyloidosis, harboring surgically treated bilateral chronic nontraumatic subdural hematoma, and we suggest a possible correlation between the clinical entities of CSDH and AL amyloidosis.
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Affiliation(s)
- M Luongo
- Department of Neurosurgery, San Carlo Hospital, Potenza, Italy
| | - M Grassi
- Department of Neurosurgery, San Carlo Hospital, Potenza, Italy
| | - U Godano
- Department of Neurosurgery, San Carlo Hospital, Potenza, Italy
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Abstract
BACKGROUND AND PURPOSE Since 2009, a synthetic material known as kryptonite has become increasingly utilized during cranioplasty to repair bony defects. It provides bone-like strength and adhesive properties that make it a suitable replacement for bone. However, applications have been observed in the immediate postoperative period that demonstrates an increase in its original volume, giving rise to irregularities in the cranial surface. METHODS Ten kryptonite samples were reconstituted and allowed to polymerize according to the manufacturer's directions. The kryptonite samples were molded into a cylindrical shape, and they were immersed in 10 graduated cylinders filled with normal saline. Measurements of the rise in saline relative to baseline were taken at 0, 10, 20, 30, 40, 50, and 60 minutes, and then hourly through 5 hours, with the final measurement recorded at 24 hours. RESULTS The mean expansion of kryptonite was approximately 49% with an SD of 22%. The bulk of the expansion occurred within the first 2 hours, after which the rate tended to plateau for the remaining 22 hours. CONCLUSIONS Kryptonite has been touted as an excellent alternative for repairing contour abnormalities manifested in cranioplasty. Given the unpredictability of its expansile properties, the surgeon must take this variability into careful consideration when planning the desired surgical outcome. The results of the current study were communicated with the manufacture. Immediately thereafter, the manufacturer withdrew the product from the US market and is no longer Food and Drug Administration approved for cranioplasty.
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Li XL, Zhou XG, Jiang LB, Zheng GL, Cheng JA, Dong J. Modified resection technique for ventrally-located subdural thoracic extramedullary schwannoma. Orthop Surg 2015; 7:83-4. [PMID: 25708042 DOI: 10.1111/os.12154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Xi-lei Li
- Department of Orthopaedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
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Uchino A, Saito N, Ikeda S, Ishihara S. Ophthalmic artery arising from the anterior cerebral artery diagnosed by MR angiography. Surg Radiol Anat 2015; 37:1009-12. [DOI: 10.1007/s00276-015-1441-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Accepted: 01/28/2015] [Indexed: 10/24/2022]
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Guarnieri G, Tecame M, Izzo R, Vassallo P, Sardaro A, Iasiello F, Cavaliere C, Muto M. Vertebroplasty Using Calcium Triglyceride Bone Cement (Kryptonite™) for Vertebral Compression Fractures. A Single-Centre Preliminary Study of Outcomes at One-Year Follow-up. Interv Neuroradiol 2014; 20:576-82. [PMID: 25363260 DOI: 10.15274/inr-2014-10060] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Accepted: 04/12/2014] [Indexed: 11/12/2022] Open
Abstract
This study assessed the one-year clinical and radiographic outcomes, in terms of pain-relief, vertebral re-fracture and complications, after vertebroplasty (VP) using a new osteoconductive cement (calcium triglyceride bone cement - Kryptonite™ bone cement, Doctors Research Group Inc., Southbury, CT, USA) to treat osteoporotic vertebral compression fractures. Sixteen consecutive osteoporotic patients (12 women and four men, mean age 68+/-10.5) were treated with VP using Kryptonite™ bone cement for a total of 20 vertebral fractures. All the patients complained of a pain syndrome resistant to medical therapy and all procedures were performed under fluoroscopy control with neuroleptoanalgesia using a monopedicular approach in 12 patients and bipedicular approach in four patients. All patients were studied by MR and MDCT and were evaluated with the visual analogue scale (VAS) and the Oswestry disability index (ODI) before treatment and at one and 12 months after the procedure. A successful outcome was observed in 80% of patients, with a complete resolution of pain. Differences in pre and post treatment VAS and ODI at one-year follow-up were significant (P<0.0001). We observed a disk and venous leakage in 66% of patients but only in one case did an asymptomatic pulmonary embolism occur during cement injection. Two cases of vertebral re-fractures at distant metamers were observed during follow-up. VP using Kryptonite bone cement is a helpful procedure that allows complete and long-lasting resolution of painful vertebral symptoms. The cost of the material is very high and the rate of disk and venous leakage is too high compared to standard cement.
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Affiliation(s)
| | - Mario Tecame
- Radiology Service, Seconda Università degli Studi di Napoli SUN; Naples, Italy
| | - Roberto Izzo
- Neuroradiology Service, Cardarelli Hospital; Naples, Italy
| | | | - Angela Sardaro
- Radiology Service, Seconda Università degli Studi di Napoli SUN; Naples, Italy
| | - Francesca Iasiello
- Radiology Service, Seconda Università degli Studi di Napoli SUN; Naples, Italy
| | | | - Mario Muto
- Neuroradiology Service, Cardarelli Hospital; Naples, Italy
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Louw L. Different ophthalmic artery origins: Embryology and clinical significance. Clin Anat 2014; 28:576-83. [PMID: 25255996 DOI: 10.1002/ca.22470] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 08/29/2014] [Accepted: 08/30/2014] [Indexed: 11/10/2022]
Abstract
This retrospective study gives a summary of ophthalmic artery (OA) variations to serve as guidelines for surgical interventionists and trainees. Pubmed and Medline searches were conducted. The OA usually arises intradurally (superomedial, anteromedial, or rarely superolateral) from the internal carotid artery (ICA). Rare extradural origin (primitive dorsal OA) (PDOA) remnant and extremely rare interdural origin (primitive ventral OA) (PVOA) remnant are of significance when sectioning the dural ring. Rarely, a persistent PDOA with ICA origin, or a PDOA remnant with inferolateral trunk origin, enters the orbit via the superior orbital fissure (SOF) for sole or partial orbital supply. Extremely rare, the PDOA and PVOA persist and form double OAs that arise from the ICA and run via the SOF and optic foramen. Occasionally, the OA arises from the middle meningeal artery (MMA), when both the PDOA and VDOA regress and enter the orbit via the SOF. Sole orbital supply via the external carotid artery (ECA), i.e. meningo-ophthalmic artery and/or MMA branches, or dual OAs (ECA and ICA origins) may occur. Other rare OA origins include anterior or posterior communicating artery; anterior or middle cerebral artery; basilar artery; posterior inferior cerebellar artery; and the carotid bifurcation. Primitive arteries (persistent or remnant), and/or abnormal anastomoses play pivotal roles in manifestations of OA variations. Of clinical importance are orbital collateral routes and dangerous extracranial-intracranial anastomoses. Awareness of OA origins and collateral routes is imperative for transarterial embolizations or infusion chemotherapy in the ECA territory to prevent visual complications.
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Affiliation(s)
- Louise Louw
- Department of Otorhinolaryngology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
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Tsutsumi S, Nakamura M, Tabuchi T, Yasumoto Y. The superior ophthalmic vein: delineation with high-resolution magnetic resonance imaging. Surg Radiol Anat 2014; 37:75-80. [PMID: 24930005 DOI: 10.1007/s00276-014-1321-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Accepted: 06/02/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To delineate the superior ophthalmic vein (SOV) with high-resolution magnetic resonance (MR) imaging. METHODS This retrospective study enrolled 302 consecutive outpatients, 101 patients, 51 males and 50 females, who underwent coronal T2-weighted imaging and 201 patients, 99 males and 102 females, who underwent three-dimensional (3D) phase-contrast (PC) MR angiography. RESULTS Coronal T2-weighted imaging clearly delineated the intraorbital course of SOV on serial images in all 101 subjects. The SOV could be topographically divided into three segments in relation to the superior rectus muscle. The SOV crossed over the optic nerve at the level of the anterior ethmoidal foramina in 87% of right orbits and 71% of left orbits. The mean outer diameter of the SOV at the crossing point was 1.7 mm on both sides, but the SOVs were asymmetric in the same individual in 75% of the subjects. 3D PC MR angiography showed that the bilateral SOVs were symmetrical in 16% of subjects, larger in the right orbit in 18%, and larger in the left orbit in 13%, and were unidentified in 52%. The SOV showed a consistent lateral course to the ophthalmic artery. CONCLUSIONS The SOV consistently courses lateral to the ophthalmic artery, but tends to show bilateral asymmetry in the outer diameter. The superior rectus muscle, anterior ethmoidal foramen, and anterior ethmoidal artery are valuable landmarks to identify the SOV during transcranial orbital surgery. Combination of high-resolution MR imaging and 3D PC MR angiography is useful for delineating the SOV.
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Affiliation(s)
- Satoshi Tsutsumi
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan,
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Abstract
Injury to the CNS typically results in significant morbidity and endogenous repair mechanisms are limited in their ability to restore fully functional CNS tissue. Biologic scaffolds composed of individual purified components have been shown to facilitate functional tissue reconstruction following CNS injury. Extracellular matrix scaffolds derived from mammalian tissues retain a number of bioactive molecules and their ability for CNS repair has recently been recognized. In addition, novel biomaterials for dural mater repairs are of clinical interest as the dura provides barrier function and maintains homeostasis to CNS. The present article describes the application of regenerative medicine principles to the CNS tissues and dural mater repair. While many approaches have been exploring the use of cells and/or therapeutic molecules, the strategies described herein focus upon the use of extracellular matrix scaffolds derived from mammalian tissues that are free of cells and exogenous factors.
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Affiliation(s)
- Fanwei Meng
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15203, USA
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15203, USA
| | - Michel Modo
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15203, USA
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA 15203, USA
| | - Stephen F Badylak
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15203, USA
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15203, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15203, USA
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Alhalawani AM, Curran DJ, Pingguan-Murphy B, Boyd D, Towler MR. A Novel Glass Polyalkenoate Cement for Fixation and Stabilisation of the Ribcage, Post Sternotomy Surgery: An ex-Vivo Study. J Funct Biomater 2013; 4:329-57. [PMID: 24956193 PMCID: PMC4030933 DOI: 10.3390/jfb4040329] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 10/25/2013] [Accepted: 11/12/2013] [Indexed: 11/16/2022] Open
Abstract
This study investigates the use of gallium (Ga) based glass polyalkenoate cements (GPCs) as a possible alternative adhesive in sternal fixation, post sternotomy surgery. The glass series consists of a Control (CaO-ZnO-SiO2), and LGa-1 and LGa-2 which contain Ga at the expense of zinc (Zn) in 0.08 mol% increments. The additions of Ga resulted in increased working time (75 s to 137 s) and setting time (113 to 254 s). Fourier Transform Infrared (FTIR) analysis indicated that this was a direct result of increased unreacted poly(acrylic acid) (PAA) and the reduction of crosslink formation during cement maturation. LGa samples (0.16 wt % Ga) resulted in an altered ion release profile, particularly for 30 days analysis, with maximum Ca2+, Zn2+, Si4+ and Ga3+ ions released into the distilled water. The additions of Ga resulted in increased roughness and decreased contact angles during cement maturation. The presence of Ga has a positive effect on the compressive strength of the samples with strengths increasing over 10 MPa at 7 days analysis compared to the 1 day results. The additions of Ga had relatively no effect on the flexural strength. Tensile testing of bovine sterna proved that the LGa samples (0.16 wt % Ga) are comparable to the Control samples.
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Affiliation(s)
- Adel M.F. Alhalawani
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur 50603, Malaysia; E-Mails: (A.M.F.A.); (B.P.-M.)
| | - Declan J. Curran
- Department of Mechanical & Industrial Engineering, Ryerson University, Toronto M5B 2K3, ON, Canada; E-Mail:
| | - Belinda Pingguan-Murphy
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur 50603, Malaysia; E-Mails: (A.M.F.A.); (B.P.-M.)
| | - Daniel Boyd
- Department of Applied Oral Sciences, Faculty of Dentistry, Dalhousie University, Halifax B3H 4R2, NS, Canada; E-Mail:
| | - Mark R. Towler
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur 50603, Malaysia; E-Mails: (A.M.F.A.); (B.P.-M.)
- Department of Mechanical & Industrial Engineering, Ryerson University, Toronto M5B 2K3, ON, Canada; E-Mail:
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-416-979-5000 (ext. 4518)
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Liu W, Zhan J, Su Y, Wu T, Ramakrishna S, Liao S, Mo X. Injectable hydrogel incorporating with nanoyarn for bone regeneration. Journal of Biomaterials Science, Polymer Edition 2013; 25:168-80. [DOI: 10.1080/09205063.2013.848326] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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