1.The effects of calcium aluminate cement according to particle sizes on calvarial bone defects in rats.
Jung A SHIN ; Jeong Ho YUN ; Seung Han OH ; Jeong Won PAIK ; Se Young CHOI ; Chong Kwan KIM ; Seong Ho CHOI
The Journal of the Korean Academy of Periodontology 2002;32(4):769-779
This present study was carried out to find the effects of calcium aluminate cement(CaO, Al2O3, CAC), which has been developed with bio-compatibility and mechanical properties, in biological environments. Two different particle sizes of CAC - 3.5micrometer vs. 212~250micrometer which is recommended in periodontal bone grafting procedures- were filled in 8mm calvarial defect in Sprague-Dawley rat. The specimens were examined histologically, especially the bone-cement interface and the response of surrounding tissues. The results are as follows; 1. In the control group, inflammatory cells were observed at 2 weeks. At 8 weeks, periosteum and dura mater were continuously joined together in the defect areas. But in the center of defect area were filled up with the loose connective tissues. 2. In the experimental group 1(212micrometer~250micrometer particle), immature bone was formed and outermost layer was surrounded by osteoid layer at 2 weeks. Osteoblasts were arranged between immature bone and osteoid layer. And, osteoid layer was remained until 8 weeks after surgery. 3. In the experimental group 2, periosteum and dura mater lost its continuity at 2 weeks. Scattering of CAC particles and infiltration of inflammatory cells were observed, which this findings deepened at 8 weeks. The result of this study shows that when calvarial defects in white rats are filled with calcium aluminate cement of 212~250micrometer, the materials are to be bio-compatible in growth and healing on surrounding tissues. When further researches are fulfilled, such as direct bone adhesion and bone regeneration ability, it's possible that CAC could be applied to various periodontology fields in the future.
Animals
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Bone Regeneration
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Bone Transplantation
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Calcium*
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Connective Tissue
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Dura Mater
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Osteoblasts
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Particle Size*
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Periosteum
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Rats*
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Rats, Sprague-Dawley
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Regeneration
2.Extensive duraplasty with autologous graft in decompressive craniectomy and subsequent early cranioplasty for severe head trauma.
Guo-liang ZHANG ; Wei-zhong YANG ; Yan-wei JIANG ; Tao ZENG
Chinese Journal of Traumatology 2010;13(5):259-264
OBJECTIVETo compare the effect of extensive duraplasty and subsequent early cranioplasty on the recovery of neurological function in management of patients with severe traumatic brain injuries received decompressive craniectomy.
METHODSThe computer-aided designation of titanium armor plate was used as a substitute for the repair of skull defect in all the patients. The patients were divided into three groups. Twenty-three patients were in early cranioplasty group who received extensive duraplasty in craniectomy and subsequent cranioplasty within 3 months after previous operation (Group I). Twenty-one patients whose cranioplasty was performed more than 3 months after the first operation were in the group without duraplasty (Group II); while the other 26 patients in the group with duraplasty in previous craniotomy (Group III). Both the Barthel index of activity of daily living (ADL) 3 months after craniotomy for brain injuries and 1 month after cranioplasty and Karnofsky Performance Score (KPS) at least 6 months after cranioplasty were assessed respectively.
RESULTSThe occurrence of adverse events commonly seen in cranioplasty, such as incision healing disturbance, fluid collection below skin flap, infection and onset of postoperative epilepsy was not significantly higher than other 2 groups. The ADL scores at 3 months after craniotomy in Groups I-III were 58.9 ± 26.7, 40.8 ± 20.2 and 49.2 ± 18.6. The ADL scores at 1 month after cranioplasty were 70.2 ± 25.2, 50.8 ± 24.8 and 61.2 ± 21.5. The forward KPS scores were 75.4 ± 19.0, 66.5 ± 24.7 and 57.6 ± 24.7 respectively. The ADL and KPS socres were significantly higher in group I than other 2 groups.
CONCLUSIONThe early cranioplasty in those with extensive duraplasty in previous craniotomy is feasible and helpful to improving ADL and long-term quality of life in patients with severe traumatic brain injuries.
Activities of Daily Living ; Adult ; Craniocerebral Trauma ; surgery ; Decompressive Craniectomy ; methods ; Dura Mater ; surgery ; Female ; Humans ; Male ; Middle Aged ; Skull ; surgery ; Transplantation, Autologous
3.Reparation and restitution of head tissue deletion with fascia lata and local flap.
Weiguang ZHA ; Minghuo XU ; Lizhi ZHANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2013;27(21):1191-1192
OBJECTIVE:
To explore the effect of reparation and restitution of head tissue deletion with autologous fascia lata and local flap.
METHOD:
The clinical data of 8 cases with scalp squamous celled carcinoma from 2003 to 2010 were summarized retrospectively. All patients carcinoma were removed almost, cerebral dura mater deletion and skin deletion from 5 cm to 15 cm, repaired cerebral dura mater with autologou fascia lata; and restitution scalp with local flap, the area of local flap were planted with free skin graft.
RESULT:
The outcomes of the treatment with fascia lata were very well, and the local flap of all cases were survival the free skin graft were survival from 85% to 100%. There was no leakage of cerebrospinal fluid or intracranial infection during follow-up.
CONCLUSION
The method of repairation and reconstruction of head tissue deletion with fascia lata and local flap is effective, the out comes are satisfying.
Carcinoma, Squamous Cell
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surgery
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Dura Mater
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surgery
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Fascia Lata
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transplantation
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Female
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Head and Neck Neoplasms
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surgery
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Humans
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Male
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Retrospective Studies
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Scalp
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surgery
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Skin Neoplasms
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surgery
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Skin Transplantation
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Surgical Flaps
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transplantation
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Treatment Outcome
4.Dura Mater Graft-Associated Creutzfeldt-Jakob Disease: The First Case in Korea.
Hye Lim KIM ; Ju Young DO ; Han Jeong CHO ; Yong Chul JEON ; Seok Joo PARK ; Hyeo Il MA ; Jun Ho SONG ; Yul LEE ; Hyun CHOI ; Kyung Chan CHOI ; Yong Sun KIM ; Inga ZERR ; Kai KALLENBERG ; Yun Joong KIM
Journal of Korean Medical Science 2011;26(11):1515-1517
Since 1987, dura mater graft-associated iatrogenic Creutzfeldt-Jakob disease (dCJD) has been reported in many countries. We report the first case of dCJD in Korea. A 54-yr-old woman, who underwent resection of the meningioma in the left frontal region and received a dura mater graft 23 yr ago presented with dysesthesia followed by psychiatric symptoms and ataxia. Her neurological symptoms rapidly progressed to such an extent that she exhibited myoclonus, dementia, and pyramidal and extrapyramidal signs within 8 weeks. The 14-3-3 protein was detected in her cerebrospinal fluid; however, an electroencephalogram did not reveal characteristic positive sharp wave complexes. Diffusion-weighted magnetic resonance images, obtained serially over 64 days, revealed the rapid progression of areas of high signal intensity in the caudate nucleus and cingulate gyrus to widespread areas of high signal intensity in the cortex and basal ganglia. Pathological examination of brain biopsy specimens confirmed the presence of spongiform changes and deposition of prion protein in the neurons and neuropils.
14-3-3 Proteins/cerebrospinal fluid
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Ataxia/diagnosis
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Brain/pathology
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Creutzfeldt-Jakob Syndrome/diagnosis/pathology/*transmission
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Dementia/diagnosis
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Dura Mater/*transplantation
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Female
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Humans
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Meningioma/surgery
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Middle Aged
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Paresthesia/diagnosis
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Prions/*analysis
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Republic of Korea
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Transplants