Using a Kirschner Wire as an Internal Splint at Nasal Fractures Accompanied with Fractures of Frontal Process of Maxilla or Perpendicular Plate of Ethmoid

PURPOSE: In cases where nasal fractures involve frontal process of maxilla or perpendicular plate of ethmoid, 4-5 days of nasal packing may not provide sufficient support for avoiding displacement after packing removal. Therefore a single Kirschner-wire(K-wire) is used as an internal splint when nasal fractures involve the above two areas. METHODS: Thirty five patients were treated during the last 3 practical years with a K-wire pinning according to the anatomic locations of nasal fractures. We performed a retrospective study using 13 nasal fractures out of total 35 patients. Among 13 cases, 10 patients involved frontal process of maxilla, and 3 patients were diagnosed as bilateral nasal side wall fractures accompanied with fractures of perpendicular plate of ethmoid. One patient in the last three cases had been augmented with dorsal silicone implant long before the trauma. We analyzed the anteroposterior displacement of key stone area and the width between both lateral walls by comparing immediate postoperative radiographs with 2 month follow-ups. To reduce the errors, the same measurements were taken by two different inspectors, and the mean of each inspector's measurements was compared. Patient satisfaction was analyzed using a questionnaire regarding the esthetic and functional outcomes. RESULTS: Ten patients underwent a longitudinal K-wire fixation in submucoperiosteal plane underneath the frontal process of maxilla. And three patients underwent a transverse K-wire fixation from the one side of lateral wall to the perpendicular plate of ethmoid and to the other side of lateral wall. The mean postoperative anteroposterior displacement of the key stone area measured by two inspectors were 1.84% and 3.06%; mean narrowing of bony pyramid were 1.33% and 1.48%, respectively. Subjective satisfaction scores regarding the esthetic appearance and the maintenance of nasal shape compared with immediate post-operative state with the long term ones were not different(p>0.05). CONCLUSION: K-wire pinning after closed reduction is a reliable and useful method for the treatment of nasal fractures involving frontal process of maxilla or perpendicular plate of ethmoid. This is because it achieves longer intranasal support after reduction. This method also leaves conspicuous external scar, and minimal soft-tissue injury.

Isolation and characterization of canine umbilical cord blood-derived mesenchymal stem cells

Human umbilical cord blood-derived mesenchymal stem cells (MSCs) are known to possess the potential for multiple differentiations abilities in vitro and in vivo. In canine system, studying stem cell therapy is important, but so far, stem cells from canine were not identified and characterized. In this study, we successfully isolated and characterized MSCs from the canine umbilical cord and its fetal blood. Canine MSCs (cMSCs) were grown in medium containing low glucose DMEM with 20% FBS. The cMSCs have stem cells expression patterns which are concerned with MSCs surface markers by fluorescence-activated cell sorter analysis. The cMSCs had multipotent abilities. In the neuronal differentiation study, the cMSCs expressed the neuronal markers glial fibrillary acidic protein (GFAP), neuronal class III beta tubulin (Tuj-1), neurofilament M (NF160) in the basal culture media. After neuronal differentiation, the cMSCs expressed the neuronal markers Nestin, GFAP, Tuj-1, microtubule-associated protein 2, NF160. In the osteogenic & chondrogenic differentiation studies, cMSCs were stained with alizarin red and toluidine blue staining, respectively. With osteogenic differentiation, the cMSCs presented osteoblastic differentiation genes by RT-PCR. This finding also suggests that cMSCs might have the ability to differentiate multipotentially. It was concluded that isolated MSCs from canine cord blood have multipotential differentiation abilities. Therefore, it is suggested that cMSCs may represent a be a good model system for stem cell biology and could be useful as a therapeutic modality for canine incurable or intractable diseases, including spinal cord injuries in future regenerative medicine studies.

New Measurement Method of Wound Healing by Stereoimage Optical Topometer System

PURPOSE: In order to determine the amount of wound healing, objective sequential assessments of changes in wound size and depth are essential. Although a variety of measurements for wound healing have been proposed, a gold standard for quantifying day-to-day changes in healing has not been established. We present here a simple and non-invasive wound measurement method that quantitatively and accurately documents changes of the size of a raw surface and the volume of a soft tissue defect using a stereoimage optical topometer(SOT) system. METHODS: Using a 5mm diameter biopsy punch, four circular wounds were created on abdominal area of a diabetic mouse. Photographs were taken using SOT system at baseline, 5th day and 10th postoperative day. The wound margin was traced on a digitalized photo and evaluated the area and the volume of the wound by SOT system. RESULTS: The SOT system calculated a mean wound surface of 15.93+/-0.29mm2 and volume of 827.50+/-88.86 intensity/pixel x area(I/PA) immediately after wounding. On the 5th day after the operation wound surface declined by 10.73mm2 and on the 10th day declined by 5.95mm2. The wound volume also declined from 827.50 I/PA to 161.75 I/PA and 30.50 I/PA on 0, 5th and 10th day, respectively. CONCLUSION: The SOT system described in this study represents a reliable, simple, practical, and non-invasive technique to accurately monitor and evaluate wound healing.