The evaluation of the correlation between histomorphometric analysis and micro-computed tomography analysis in AdBMP-2 induced bone regeneration in rat calvarial defects

PURPOSE: Micro-computed tomography (micro-CT) has been widely used in the evaluation of regenerated bone tissue but the reliability of micro-CT has not yet been established. This study evaluated the correlation between histomorphometric analysis and micro-CT analysis in performing new bone formation measurement. METHODS: Critical-size calvarial defects were created using a 8 mm trephine bur in a total of 24 Sprague-Dawley rats, and collagen gel mixed with autogenous rat bone marrow stromal cells (BMSCs) or autogenous rat BMSCs transduced by adenovirus containing bone morphogenic protein-2 (BMP-2) genes was loaded into the defect site. In the control group, collagen gel alone was loaded into the defect. After 2 and 4 weeks, the animals were euthanized and calvaria containing defects were harvested. Micro-CT analysis and histomorphometric analysis of each sample were accomplished and the statistical evaluation about the correlation between both analyses was performed. RESULTS: New bone formation of the BMP-2 group was greater than that of the other groups at 2 and 4 weeks in both histomorphometric analysis and micro-CT analysis (P=0.026, P=0.034). Histomorphometric analysis of representative sections showed similar results to histomorphometric analysis with a mean value of 3 sections. Measurement of new bone formation was highly correlated between histomorphometric analysis and micro-CT analysis, especially at the low lower threshold level at 2 weeks (adjusted r2=0.907, P<0.001). New bone formation of the BMP-2 group analyzed by micro-CT tended to decline sharply with an increasing lower threshold level, and it was statistically significant (P<0.001). CONCLUSIONS: Both histomorphometric analysis and micro-CT analysis were valid methods for measurement of the new bone in rat calvarial defects and the ability to detect the new bone in micro-CT analysis was highly influenced by the threshold level in the BMP-2 group at early stage.

Effects of enamel matrix derivatives on biologic activities of human periodontal fibloblasts to demineralized root surface / 대한치주과학회지

PURPOSE: The aim of this study was to investigate the effects of EMD on demineralized root surface using human periodontal ligament cells and compare the effects of root conditioning materials(tetracycline(TCN), EDTA). MATERIAL AND METHODS: Dentin slices were prepared from the extracted teeth and demineralized with TCN and EDTA. Demineralized dentin slices were incubated at culture plate with 25, 50 and 100 microgram/ml concentration of EMD. Cell attachment, alkaline phosphatase activity test, protein synthesis assay and scanning electronic microscopic examination were done. RESULTS: Cells were attached significantly higher in EMD treated group at 7 and 14 days. Cell numbers were significantly higher in EMD treated group. Alkaline phosphatase activity was significantly higher in EMD treated group at 7 and 14 days. Protein synthesis was significantly higher in EMD treated group at 7 and 14 days. CONCLUSION: Enamel matrix derivatives enhance the biologic activities of human periodontal ligament cells on demineralized root surface and its effects are dependent on the concentration of EMD.

Treatment of High-Grade Basilar Artery Stenosis by Primary Stenting

Patients with symptomatic stenosis of the basilar artery have a poor prognosis and the treatment options are limited. Surgical bypasses are technically difficult and there is no proven benefit. Percutaneous angioplasty shows significant complications because of dissection, restenosis secondary to elastic recoil and embolic phenomena. The medical treatment with aspirin and wafarin showed the annual risk of 20% for symptomatic basilar artery stenosis as repoted in WASID(Warfarin-Aspirin Symptomatic Intracranial Disease)study. We report a patient with symptomatic high grade stenosis of the basilar artery refractory to appropriate maximal medical therapy, in whom endovascular stenting was performed successfully without preliminary balloon angioplasty. Excellent angiographic result was achieved and there were no procedural and periprocedural complications. The patient was asymptomatic except preprocedural mild dysarthria and had no neurological symptoms during clinical follow-up of 2 months at outpatient department. Primary stenting of basilar artery stenosis may be an alternative to balloon angioplasty for patient with symptomatic lesions refractory to medical therapy or in whom anticoagulation is contraindicated.

Acute Spontaneous Subdural Hemorrhage by Cerebral Aneurysmal Rupture: Report of Two Cases

Two cases of acute spontaneous subdural hemorrhage caused by cerebral aneurysmal rupture are presented. The patients’ chief complaints were sudden bursting headache and comatose mentality. There was no history of trauma or proclivity for spontaneous bleeding, and CT scans of the brain indicated subdural hemorrhage without remarkable subarachnoid hemorrhage. In case 1, an aneurysm at the distal segment of the right anterior cerebral artery was identified by CT angiography; the subdural hemorrhage was evacuated and the aneurysm surgically clipped. In case 2, an aneurysm at the junction of the anterior communicating artery and the right anterior cerebral artery was revealed by CT angiography and digital subtraction angiography, and Guglielmi detachable coil embolization of the aneurysm was performed.

Post-Traumatic Syringomyelia Treated with Expansile Duraplasty and Syringosubarachnoid Shunt : Case Report

No abstract available.

Management of Perimedullary Giant Arteriovenous Fistula(Type IV c)by Embolization Operative Ligation

Intradural perimedullary arteriovenous fistulas(type IV spinal cord arteriovenous malformations) that occur at cervical level are rarely reported in the literature. A twelve year-old male patient was presented with suddenly developed progressing quadriparesis. MR imaging and angiography demonstrated focal intramedullary hemorrage at C5 vertebral level and intradural perimedullary arteriovenous fistula at C4 vertebral level and ectatic endocranial venous drainage, fed by anterior spinal artery, radicular branch of right vertebral artery, right thyrocervical trunk. The large draining vein ascends toward and into the posterior fossa along route which was anterior to the lower brain stem. The initial treatment consisted of selective embolization of arterial feeders arising from the right thyrocervical trunk and anterior spinal artery. The embolization procedures were performed using GDC coil. Eight days after embolization, corpectomy was performed at the C4-5 level and fistula ligation was done. Following these procedures, the patient has progressively improved in motor and sensory function and post operative angiogram revealed disappearance of fistula and abnormal endocranial venous drainage.

Endovascular Treatment of Basilar Bifurcation Aneurysm with Open Access of Vertebral Artery

Microsurgical clipping is considered the treatment of choice for ruptured intracranial aneurysms. However, ruptured posterior circulation aneurysms remain technically difficult to expose or clip and outcomes in these cases are poorer than those seen in cases of anterior circulation aneurysms. Therefore, endovascular treatment becomes another treatment option in cases of ruptured posterior circulation aneurysms. But, the vertebral artery may not be selected due to luminal narrowing, which are atherosclerotic stenosis clinically, congenital anomalies, or acquired kinking, and structural problem of angle between aorta, subclavian artery and vertebral artery. In these cases, other approaches can be used through, for example, subclavian, axillary, or brachial artery approach. But sometimes such prcedures may be also inappropriate. One other approach is direct percutaneous vertebral artery approach. Though this one also doesn't overcome many clinical and anatomical problems. The authors present two cases of ruptured basilar tip aneurysms which was treated with endovascular Guglielmi detachable coil embolization with open surgery and catheterization, because the one had anatomical problem, and the other had structural problem.

The influence of Advanced Adult Periodontitis on the pulp / 대한치주과학회지

The purpose of this study was to observe histopathologically the influence of advanced periodontitis on pulp tissue, and to conclude the correlation between the results with clinical madifestations. The samples were teeth with over 7mm pocket depth and over 50% radiographic bone loss. These were diagnosed to have very poor prognosis and thus planned to be extracted. Those with any of following conditions were excluded from the samples, loss of vitality, periapical pathology, restoration or prosthesis, dental caries, and attrition or abrasion. It was because these conditions could affect pulp without any correlation with periodontal disease. For the experiment, 17 teeth from 11 patients were selected. Average age of patient was 47. Each tooth was examined for following categoris; pocket depth, gingival recession, electric pulp test, mobility, percussion test, sensitivity test. The extracted teeth were fixed buffered neutral formalin solution. It was decalcified using 4% nitric acid. Sliced histological samples observed using light microscope, for pulp status, and severeity of inflammation. 4 samples were excluded due to histologic sample discrepency. Thus 13 samples were subject to observation. 4 showed normal conditions. Focal reversable pulpitis was shown in 5 samples. Chronic pulpitis was observed 1 samples. Pulpal abscess observed in 3 samples.

Intraoperative Facial EMG Monitoring during Decompression Operation for Hemifacial Spasm

Hemifacial spasm is a relatively uncommon but distressing condition characterized by insiduous development of paroxysmal, involuntary, unilateral hyperkinetic facial movement. In patients with hemifacial spasm, there is an abnormality in the facial nerve or its nucleus which allows the stimulus applied to one branch of the facial nerve to spread to other branches of that same nerve. This lateral spread response is presumed to be due to cross transmission of the antidromic activity in the branch of the facial nerve, and intraoperative monitoring of lateral spread responses provides a useful way of confirming complete facial nerve decompression. In 17 consecutive patients, intraoperative electromyographic(EMG) recordings were made from facial muscles during microvascular decompression for hemifacial spasm. At the beginning of the operation, electrical stimulation of the temporal or zygomatic branch of the facial nerve gave rise to electrically recordable activity in the mentalis muscle(lateral spread), with a latency of about 10msec, that in ten patients, lasted until the facial nerve was decompressed; In seven patients, however, it disappeared when the arachnoid membrane was opened. Early disappearance of lateral spread was frequently occurred in single offending vessel or cases where there was loose compression. Postsurgically the 16 patients in whom the lateral spread response disappeared totally were free from spasm after the operation and in the remaining patient, there was much improvement. These results support the use of lateral spread response monitoring during decompression surgery for hemifacial spasm, and provide strong circumstantial evidence that vascular cross-compression is an important etiologic factor in hemifacial spasm. During a decompression operation for hemifacial spasm, the authors now routinely monitor facial EMG response.

Intracranial Metastasis of Hepatocellular Carcinoma Associated with Epidural Hematoma: A Case Report

Intracranial metastasis of hepatocellular carcinoma have been rarely reported, even in the Orient and Africa where this carcinoma is one of the relatively common malignancies. Hepatocellular carcinomas usually spread to regional lymph nodes around the porta hepatis via lymphatics. But venous metastasis of this cacinoma can occur via intrahepatic vein. The lungs are the most common distant metastatic sites followed by stomach, bones, and adrenals. Recently, we experienced a case of intracranial metastasis of hepatocellular carcinoma associated with epidural hematoma. Although the epidural hematoma and the metastatic tumor mass were totally removed, the patient died of liver complications on the 9th day of postoperative care. The clinical and radiological details of this case are presented here with a brief review of the literature.