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1.
Artigo em Inglês | MEDLINE | ID: mdl-39026394

RESUMO

Given the widespread clinical demand, addressing irregular cranial bone defects poses a significant challenge following surgical procedures and traumatic events. In situ-formed injectable hydrogels are attractive for irregular bone defects due to their ease of administration and the ability to incorporate ceramics, ions, and proteins into the hydrogel. In this study, a multifunctional hydrogel composed of oxidized sodium alginate (OSA)-grafted dopamine (DO), carboxymethyl chitosan (CMCS), calcium ions (Ca2+), nanohydroxyapatite (nHA), and magnesium oxide (MgO) (DOCMCHM) was prepared to address irregular cranial bone defects via dynamic Schiff base and chelation reactions. DOCMCHM hydrogel exhibits strong adhesion to wet tissues, self-healing properties, and antibacterial characteristics. Biological evaluations indicate that DOCMCHM hydrogel has good biocompatibility, in vivo degradability, and the ability to promote cell proliferation. Importantly, DOCMCHM hydrogel, containing MgO, promotes the expression of osteogenic protein markers COL-1, OCN, and RUNX2, and stimulates the formation of new blood vessels by upregulating CD31. This study could provide meaningful insights into ion therapy for the repair of cranial bone defects.

2.
Neuroradiology ; 2024 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-38871879

RESUMO

PURPOSE: The diagnosis of chronic increased intracranial pressure (IIP)is often based on subjective evaluation or clinical metrics with low predictive value. We aimed to quantify cranial bone changes associated with pediatric IIP using CT images and to identify patients at risk. METHODS: We retrospectively quantified local cranial bone thickness and mineral density from the CT images of children with chronic IIP and compared their statistical differences to normative children without IIP adjusting for age, sex and image resolution. Subsequently, we developed a classifier to identify IIP based on these measurements. Finally, we demonstrated our methods to explore signs of IIP in patients with non-syndromic sagittal craniosynostosis (NSSC). RESULTS: We quantified a significant decrease of bone density in 48 patients with IIP compared to 1,018 normative subjects (P < .001), but no differences in bone thickness (P = .56 and P = .89 for age groups 0-2 and 2-10 years, respectively). Our classifier demonstrated 83.33% (95% CI: 69.24%, 92.03%) sensitivity and 87.13% (95% CI: 84.88%, 89.10%) specificity in identifying patients with IIP. Compared to normative subjects, 242 patients with NSSC presented significantly lower cranial bone density (P < .001), but no differences were found compared to patients with IIP (P = .57). Of patients with NSSC, 36.78% (95% CI: 30.76%, 43.22%) presented signs of IIP. CONCLUSION: Cranial bone changes associated with pediatric IIP can be quantified from CT images to support earlier diagnoses of IIP, and to study the presence of IIP secondary to cranial pathology such as non-syndromic sagittal craniosynostosis.

3.
Childs Nerv Syst ; 40(7): 2145-2151, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38530414

RESUMO

PURPOSE: To introduce a method of cranial bone reconstruction for cranial burst fractures and early-stage growing skull fractures, named bone flap binding and transposition. METHODS: Cranial burst fractures, severe head injuries predominantly observed in infants, are characterized by widely diastatic skull fractures coupled with acute extracranial cerebral herniation beneath an intact scalp through ruptured dura mater. These injuries can develop into growing skull fractures. This study included two cases to illustrate the procedure, with a particular focus on the bone steps in managing these conditions. The medical history, clinical presentation, surgical procedures, and postoperative follow-up were retrospectively studied. The details of the surgical procedure were described. RESULTS: The method of bone reconstruction, named bone flap binding and transposition, was applied after the lacerated dural repair. Two bone pieces were combined to eliminate the diastatic bone defect and then fixed by an absorbable cranial fixation clip and bound by sutures. The combined bone flap was repositioned into the bone window, completely covering the area of the original dural laceration. Subsequently, the bone defect was transferred to the area of normal dura. The postoperative courses for the two infants were uneventful. Follow-up CT scans revealed new bone formation at the previous bone defect and no progressive growing skull fracture. The major cranial defects had disappeared, leaving only small residual defects at the corners of the skull bone window, which required further recovery and did not affect the solidity of the skull. CONCLUSION: Bone flap binding and transposition provide a straightforward, cost-effective, and reliable method for cranial bone reconstruction of cranial burst fractures and early-stage growing skull fractures. This method has taken full advantage of the small infant's dura osteogenic potential without the need for artificial or metallic bone repair materials. The effectiveness of the method needs further validation with more cases in the future.


Assuntos
Procedimentos de Cirurgia Plástica , Fraturas Cranianas , Retalhos Cirúrgicos , Humanos , Fraturas Cranianas/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Lactente , Masculino , Feminino , Crânio/cirurgia , Crânio/lesões , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
4.
Materials (Basel) ; 17(2)2024 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-38255520

RESUMO

Recent years have witnessed the rapid development of 3D porous scaffolds with excellent biocompatibility, tunable porosity, and pore interconnectivity, sufficient mechanical strength, controlled biodegradability, and favorable osteogenesis for improved results in cranioplasty. However, clinical translation of these scaffolds has lagged far behind, mainly because of the absence of a series of biological evaluations. Herein, we designed and fabricated a composite 3D porous scaffold composed of poly (lactic-co-glycolic) acid (PLGA), ß-tricalcium phosphate (ß-TCP), and Mg using the low-temperature deposition manufacturing (LDM) technique. The LDM-engineered scaffolds possessed highly porous and interconnected microstructures with a porosity of 63%. Meanwhile, the scaffolds exhibited mechanical properties close to that of cancellous bone, as confirmed by the compression tests. It was also found that the original composition of scaffolds could be maintained throughout the fabrication process. Particularly, two important biologic evaluations designed for non-active medical devices, i.e., local effects after implantation and subchronic systemic toxicity tests, were conducted to evaluate the local and systemic toxicity of the scaffolds. Additionally, the scaffolds exhibited significant higher mRNA levels of osteogenic genes compared to control scaffolds, as confirmed by an in vitro osteogenic differentiation test of MC3T3-E1 cells. Finally, we demonstrated the improved cranial bone regeneration performance of the scaffolds in a rabbit model. We envision that our investigation could pave the way for translating the LDM-engineered composite scaffolds into clinical products for cranial bone regeneration.

5.
MAGMA ; 37(1): 83-92, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37934295

RESUMO

OBJECTIVES: CT is the clinical standard for surgical planning of craniofacial abnormalities in pediatric patients. This study evaluated three MRI cranial bone imaging techniques for their strengths and limitations as a radiation-free alternative to CT. METHODS: Ten healthy adults were scanned at 3 T with three MRI sequences: dual-radiofrequency and dual-echo ultrashort echo time sequence (DURANDE), zero echo time (ZTE), and gradient-echo (GRE). DURANDE bright-bone images were generated by exploiting bone signal intensity dependence on RF pulse duration and echo time, while ZTE bright-bone images were obtained via logarithmic inversion. Three skull segmentations were derived, and the overlap of the binary masks was quantified using dice similarity coefficient. Craniometric distances were measured, and their agreement was quantified. RESULTS: There was good overlap of the three masks and excellent agreement among craniometric distances. DURANDE and ZTE showed superior air-bone contrast (i.e., sinuses) and soft-tissue suppression compared to GRE. DISCUSSIONS: ZTE has low levels of acoustic noise, however, ZTE images had lower contrast near facial bones (e.g., zygomatic) and require effective bias-field correction to separate bone from air and soft-tissue. DURANDE utilizes a dual-echo subtraction post-processing approach to yield bone-specific images, but the sequence is not currently manufacturer-supported and requires scanner-specific gradient-delay corrections.


Assuntos
Processamento de Imagem Assistida por Computador , Crânio , Adulto , Humanos , Criança , Processamento de Imagem Assistida por Computador/métodos , Crânio/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos
6.
World Neurosurg ; 182: 116-123, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38042293

RESUMO

BACKGROUND: Autologous cranioplasty has been used for decades and is the gold standard treatment in patients who underwent decompressive craniectomy (DC). One of the most common methods to store the cranial bone flap is cryopreservation at very low temperatures (-70 to -80°). The only way to achieve these low temperatures is by using special freezers which are not always available in all medical facilities, especially in low-resource centers. This paper describes our experience with the storage of cranial bone flaps in freezers of conventional refrigerators. METHODS: This retrospective study included patients treated with autologous cranioplasty, operated between 2015 and 2020. The cranial bone flap was stored at -18°C in the freezer of conventional refrigerators. Complications and outcomes were analyzed and compared with reports of patients in whom ultra-low temperature freezers were used for bone flap preservation. RESULTS: Twenty-five patients were included. The average follow-up period was 33 months. Trauma was the most common cause of DC, followed by stroke. The mean age was 36.7. Aseptic bone flap resorption was observed in 4 cases (16%). No cases of infection were observed. CONCLUSIONS: The use of freezers from conventional refrigerators may be an acceptable alternative for the preservation of the cranial bone flap in facilities where special freezers are not available. The rate of aseptic bone necrosis and infections observed in this paper was similar to the incidence of these complications reported in studies where ultra-low temperatures were used.


Assuntos
Reabsorção Óssea , Craniectomia Descompressiva , Procedimentos de Cirurgia Plástica , Humanos , Adulto , Estudos Retrospectivos , Região de Recursos Limitados , Craniectomia Descompressiva/métodos , Retalhos Cirúrgicos/cirurgia , Crânio/cirurgia , Reabsorção Óssea/etiologia , Complicações Pós-Operatórias/etiologia
7.
Childs Nerv Syst ; 40(4): 1315-1318, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38151547

RESUMO

Acalvaria is a rare congenital malformation characterized by the absence of bones and related muscles in a section of the skull. The number of reported cases in the literature is quite low, and it is generally considered a fatal malformation. We present a case of a newborn diagnosed with acalvaria malformation along with a review of the literature, emphasizing the importance of distinguishing this rare condition from malformations such as anencephaly, exencephaly and acrania. INTRODUCTION: The clinical landscape of acalvaria is scarcely populated, with the malformation often signifying a dire prognosis. Despite the embryological origin and pathogenesis remaining largely enigmatic, it has critical implications for the prenatal and postnatal therapeutic strategies. We investigate a case coupled with a comprehensive literary review to present a clearer clinical portrait and advance the alertness about this lethal anomaly among healthcare providers. DISCUSSION: The rarity of acalvaria constrains the establishment of a definitive incidence rate or a standardized treatment protocol. Varied associations with other neurological and systemic anomalies pose a significant ambiguity regarding its etiopathogenesis. Differential diagnosis remains intricate, relying on nuanced ultrasonographic examinations and an informed interpretation of embryological developments. CONCLUSION: Through our report of an acalvaria-affected newborn undetectable in prenatal ultrasound, we highlight the implications of rarity - the obstacle in uniform diagnosis and the resultant therapeutic challenge. The discussion fosters a need for heightened awareness and consolidating case reports to nurture clinical consensus. Furthermore, it underscores the necessity for multifaceted research efforts towards understanding etiology and optimizing treatment modalities.


Assuntos
Defeitos do Tubo Neural , Crânio , Recém-Nascido , Gravidez , Feminino , Humanos , Crânio/anormalidades , Defeitos do Tubo Neural/complicações
8.
Aging Cell ; 22(11): e13980, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37681346

RESUMO

The craniofacial bones provide structural support for the skull and accommodate the vulnerable brain tissue with a protective cavity. The bone tissue undergoes constant turnover, which relies on skeletal stem cells (SSCs) and/or mesenchymal stem cells (MSCs) and their niches. SSCs/MSCs and their perivascular niche within the bone marrow are well characterized in long bones. As for cranial bones, besides bone marrow, the suture mesenchyme has been identified as a unique niche for SSCs/MSCs of craniofacial bones. However, a comprehensive study of the two different cranial stem cell niches at single-cell resolution is still lacking. In addition, during the progression of aging, age-associated changes in cranial stem cell niches and resident cells remain uncovered. In this study, we investigated age-related changes in cranial stem cell niches via single-cell RNA sequencing (scRNA-seq). The transcriptomic profiles and cellular compositions have been delineated, indicating alterations of the cranial bone marrow microenvironment influenced by inflammaging. Moreover, we identified a senescent mesenchymal cell subcluster and several age-related immune cell subclusters by reclustering and pseudotime trajectory analysis, which might be closely linked to inflammaging. Finally, differentially expressed genes (DEGs) and cell-cell communications were analyzed during aging, revealing potential regulatory factors. Overall, this work highlights the age-related changes in cranial stem cell niches, which deepens the current understanding of cranial bone and suture biology and may provide therapeutic targets for antiaging and regenerative medicine.


Assuntos
Células-Tronco Mesenquimais , Nicho de Células-Tronco , Camundongos , Animais , Nicho de Células-Tronco/genética , Transcriptoma/genética , Crânio , Células-Tronco
9.
Front Neuroimaging ; 2: 959601, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37554651

RESUMO

Introduction: Mitochondria are extremely important organelles in the regulation of bone marrow and brain activity. However, live imaging of these subcellular features with high resolution in scattering tissues like brain or bone has proven challenging. Methods: In this study, we developed a two-photon fluorescence microscope with adaptive optics (TPFM-AO) for high-resolution imaging, which uses a home-built Shack-Hartmann wavefront sensor (SHWFS) to correct system aberrations and a sensorless approach for correcting low order tissue aberrations. Results: Using AO increases the fluorescence intensity of the point spread function (PSF) and achieves fast imaging of subcellular organelles with 400 nm resolution through 85 µm of highly scattering tissue. We achieved ~1.55×, ~3.58×, and ~1.77× intensity increases using AO, and a reduction of the PSF width by ~0.83×, ~0.74×, and ~0.9× at the depths of 0, 50 µm and 85 µm in living mouse bone marrow respectively, allowing us to characterize mitochondrial health and the survival of functioning cells with a field of view of 67.5× 67.5 µm. We also investigate the role of initial signal and background levels in sample correction quality by varying the laser power and camera exposure time and develop an intensity-based criteria for sample correction. Discussion: This study demonstrates a promising tool for imaging of mitochondria and other organelles in optically distorting biological environments, which could facilitate the study of a variety of diseases connected to mitochondrial morphology and activity in a range of biological tissues.

10.
MethodsX ; 10: 102246, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37424760

RESUMO

Mechanical characterization experiments of brain tissue are performed to understand the mechanical behavior of brain tissue during normal physiology and pathophysiological processes including traumatic brain injury. Normal, healthy, undamaged, unfixed brain tissue specimens are required for these mechanical characterization experiments to ensure the properties being measured are not from damaged/diseased tissue which may lead to inaccurate and unreliable results regarding the mechanical behavior of healthy undamaged brain tissue. The process of excising brain tissue from the cranial vault of mouse cadavers can induce lacerations in the tissue that may affect its mechanical behavior. Therefore, it is imperative that brain tissue samples are excised without inducing damage to the tissue so that the normal undamaged mechanical properties can be measured. Here, a method to excise the entire intact mouse brain is presented:•The scalp is resected exposing the anterior portion of the skull.•Cranial bone is resected by incising along the cranial sutures and using the scalpel blade to remove the cranial segments.•Connective tissue is resected and the brain is removed from the cranial vault.

11.
ACS Appl Mater Interfaces ; 15(26): 31243-31255, 2023 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-37350582

RESUMO

Increased intracranial pressure after traumatic brain injury (TBI) is an urgent problem in clinical practice. A pliable hydrogel is preferred for cranioplasty applications after TBI since it can protect brain tissue and promote bone healing. Nevertheless, biohydrogels for cranial bone regeneration still face challenges of poor mechanical properties, large swelling ratios, and low osteogenesis activity. Herein, inspired by Hofmeister effects, biopolymer hydrogels composed of protein and polysaccharides were treated with a Hofmeister series including a series of monovalent and divalent anions. Our results reveal that the divalent anion-cross-linked biohydrogels exhibit stronger mechanical properties and lower swelling ratios compared with monovalent-anion treated gels. Intriguingly, the divalent HPO42- anion induced biohybrid hydrogels with excellent mechanical behaviors (3.7 ± 0.58 MPa, 484 ± 76.7 kPa, and 148.3 ± 6.85 kJ/m3), anti-swelling capability (16.7%), and gradual degradation ability, significantly stimulating osteogenic differentiation and in vivo cranial bone regeneration. Overall, this study may provide new insights into the design of biomimetic hydrogels for treating cranial bone defects after TBI.


Assuntos
Regeneração Óssea , Osteogênese , Crânio , Hidrogéis/farmacologia , Hidrogéis/metabolismo , Encéfalo
12.
Int J Rheum Dis ; 26(11): 2304-2309, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37218535

RESUMO

Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a rare autoimmune inflammatory disease characterized by osteoarticular and dermatological manifestations. The most common osteoarticular manifestations involve the anterior chest wall, axial skeleton, and long bones. Cranial bone involvement is less reported in SAPHO syndrome. We herein present three cases of SAPHO syndrome with cranial bone involvement, and review the previous literature on similar manifestations. It was revealed that SAPHO syndrome could lead to cranial bone involvement, which could involve the dura mater, leading to hypertrophic pachymeningitis, but the outcome is usually good. Janus kinase inhibitors may be a potential treatment option.


Assuntos
Acne Vulgar , Síndrome de Hiperostose Adquirida , Hiperostose , Osteíte , Sinovite , Humanos , Síndrome de Hiperostose Adquirida/complicações , Síndrome de Hiperostose Adquirida/diagnóstico , Síndrome de Hiperostose Adquirida/tratamento farmacológico , Osteíte/diagnóstico por imagem , Osteíte/tratamento farmacológico , Hiperostose/diagnóstico por imagem , Hiperostose/tratamento farmacológico , Acne Vulgar/diagnóstico , Acne Vulgar/tratamento farmacológico , Doenças Raras
13.
Biol Rev Camb Philos Soc ; 98(5): 1749-1767, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37171117

RESUMO

Cranial bones constitute a protective shield for the vulnerable brain tissue, bound together as a rigid entity by unique immovable joints known as sutures. Cranial sutures serve as major growth centres for calvarial morphogenesis and have been identified as a niche for mesenchymal stem cells (MSCs) and/or skeletal stem cells (SSCs) in the craniofacial skeleton. Despite the established dogma of cranial bone and suture biology, technological advancements now allow us to investigate these tissues and structures at unprecedented resolution and embrace multiple novel biological insights. For instance, a decrease or imbalance of representation of SSCs within sutures might underlie craniosynostosis; dural sinuses enable neuroimmune crosstalk and are newly defined as immune hubs; skull bone marrow acts as a myeloid cell reservoir for the meninges and central nervous system (CNS) parenchyma in mediating immune surveillance, etc. In this review, we revisit a growing body of recent studies that explored cranial bone and suture biology using cutting-edge techniques and have expanded our current understanding of this research field, especially from the perspective of development, homeostasis, injury repair, resident MSCs/SSCs, immunosurveillance at the brain's border, and beyond.


Assuntos
Craniossinostoses , Crânio , Humanos , Suturas Cranianas/metabolismo , Craniossinostoses/metabolismo , Morfogênese/fisiologia , Suturas
14.
Neurosci Lett ; 799: 137103, 2023 03 16.
Artigo em Inglês | MEDLINE | ID: mdl-36738956

RESUMO

Impairments of the central nervous system, such as stroke, brain trauma, and spinal cord injury (SCI), cannot be reversed using current treatment options. Herein, we compared the characteristics of rat cranial bone-derived mesenchymal stem cells (rcMSCs) and rat bone marrow-derived mesenchymal stem cells (rbMSCs). We also investigated the therapeutic effects of intravenously administered rcMSCs and rbMSCs in a rat model of cervical SCI (cSCI) and elucidated its undrelying mechanism. Comprehensive comparative bioinformatics analysis of rcMSCs and rbMSCs RNA sequencing revealed that genes associated with leukocyte transendothelial migration and chemokine signaling were significantly downregulated in rcMSCs. Rats were divided into three groups that received intrtravenous administration of rcMSC, rbMSC, or phosphate-buffered saline (control) 24 h after cSCI. The rcMSC-treated group showed improved functional recovery over the rbMSC-treated and control groups, and reduced lesion volume compared with the control group. The mRNA expression of nitric oxide synthase 2 at the spinal cord lesion site was significantly higher in the rcMSC-treated group than in the control and rbMSCs-treated groups, whereas that of transforming growth factor-ß was significantly higher in the rcMSC-treated group compared to that in the control group. The transcriptome data indicated that rcMSCs and rbMSCs differentially affect inflammation. The intravenous administration of rcMSCs contributed to functional recovery and lesion reduction in cSCI. The rcMSCs have the potential to induce an anti-inflammatory environment in cSCI.


Assuntos
Transplante de Células-Tronco Mesenquimais , Células-Tronco Mesenquimais , Doenças da Medula Espinal , Traumatismos da Medula Espinal , Acidente Vascular Cerebral , Ratos , Animais , Traumatismos da Medula Espinal/patologia , Doenças da Medula Espinal/metabolismo , Células-Tronco Mesenquimais/metabolismo , Acidente Vascular Cerebral/metabolismo , Sistema Nervoso Central , Recuperação de Função Fisiológica , Medula Espinal/patologia
15.
Clin Neuroradiol ; 33(1): 57-64, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35763060

RESUMO

PURPOSE: To evaluate the diagnostic value of CT-like images based on a 3D T1-weighted spoiled gradient echo-based sequence (T1SGRE) for the visualization of the pediatric skull and the identification of pathologies, such as craniosynostosis or fractures. METHODS: In this prospective study, 20 patients with suspected craniosynostosis (mean age 1.26 ± 1.38 years, 10 females) underwent MR imaging including the T1SGRE sequence and 2 more patients were included who presented with skull fractures (0.5 and 6.3 years, both male). Additionally, the skull of all patients was assessed using radiography or CT in combination with ultrasound. Two radiologists, blinded to the clinical information, evaluated the CT-like images. The results were compared to the diagnosis derived from the other imaging modalities and intraoperative findings. Intrarater and interrater agreement was calculated using Cohen's κ. RESULTS: Of the 22 patients 8 had a metopic, 4 a coronal and 2 a sagittal craniosynostosis and 2 patients showed a complex combination of craniosynostoses. The agreement between the diagnosis based on the T1SGRE and the final diagnosis was substantial (Cohen's κ = 0.92, 95% confidence interval (CI) 0.77-1.00 for radiologist 1 and κ = 0.76, CI 0.51-1.00 for radiologist 2). Of the patients with fractures, one presented with a ping pong fracture and one with a fracture of the temporal bone. Both radiologists could identify the fractures using the T1SGRE. CONCLUSION: The visualization of the pediatric skull and the assessment of sutures using a CT-like T1SGRE MR-sequence is feasible and comparable to other imaging modalities, and thus may help to reduce radiation exposure in pediatric patients. The technique may also be a promising imaging tool for other pathologies, such as fractures.


Assuntos
Craniossinostoses , Tomografia Computadorizada por Raios X , Feminino , Humanos , Criança , Masculino , Lactente , Pré-Escolar , Estudos Prospectivos , Tomografia Computadorizada por Raios X/métodos , Craniossinostoses/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Osso Temporal
16.
J Funct Biomater ; 13(3)2022 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-36135591

RESUMO

BACKGROUND: Biomaterials and biotechnology are becoming increasingly important fields in modern medicine. For cranial bone defects of various aetiologies, artificial materials, such as poly-methyl-methacrylate, are often used. We report our clinical experience with poly-methyl-methacrylate for a novel in vivo bone defect closure and artificial bone flap development in various neurosurgical operations. METHODS: The experimental study included 12 patients at a single centre in 2018. They presented with cranial bone defects after various neurosurgical procedures, including tumour, traumatic brain injury and vascular pathologies. The patients underwent an in vivo bone reconstruction from poly-methyl-methacrylate, which was performed immediately after the tumour removal in the tumour group, whereas the trauma and vascular patients required a second surgery for cranial bone reconstruction due to the bone decompression. The artificial bone flap was modelled in vivo just before the skin closure. Clinical and surgical data were reviewed. RESULTS: All patients had significant bony destruction or unusable bone flap. The tumour group included five patients with meningiomas destruction and the trauma group comprised four patients, all with severe traumatic brain injury. In the vascular group, there were three patients. The average modelling time for the artificial flap modelling was approximately 10 min. The convenient location of the bone defect enabled a relatively straightforward and fast reconstruction procedure. No deformations of flaps or other complications were encountered, except in one patient, who suffered a postoperative infection. CONCLUSIONS: Poly-methyl-methacrylate can be used as a suitable material to deliver good cranioplasty cosmesis. It offers an optimal dural covering and brain protection and allows fast intraoperative reconstruction with excellent cosmetic effect during the one-stage procedure. The observations of our study support the use of poly-methyl-methacrylate for the ad hoc reconstruction of cranial bone defects.

17.
Artigo em Inglês | MEDLINE | ID: mdl-35954963

RESUMO

(1) Background: Among the four paranasal sinuses, the frontal sinus is in the frontal bone. Recent research trends have been focusing on identifying sex based on the frontal sinus. Thus, this study aimed to provide reference data for the frontal sinus in Korean adults by comparing their sizes using a 3D program. Moreover, this study examined the correlation between the size of the frontal sinus and the length of cranial bone. (2) Methods: Cone-beam computed tomography (CBCT) data were obtained from 60 (male 30, female 30) patients in their 20 s who visited the Department of Dankook University Hospital (DKUDH IRB 2020-01-007). The provided patient CBCT data were utilized to reconstruct the patients' frontal sinuses and cranial bones in 3D using the Mimics (version 22.0, Materialise, Leuven, Belgium) 3D program. All measurements were analyzed using SPSS (ver. 23.0, IBM Corporation, Armonk, NY, USA). (3) Results: By comparing the frontal sinus size of Korean adults according to sex using a 3D program, this study revealed that males had larger frontal sinuses than females. (4) Conclusions: The findings of this study could help in preventing complications that occur in various clinical treatments and analyzing the growth of the frontal sinus in the future.


Assuntos
Seio Frontal , Adulto , Tomografia Computadorizada de Feixe Cônico , Feminino , Seio Frontal/diagnóstico por imagem , Humanos , Imageamento Tridimensional , Masculino , República da Coreia , Crânio
18.
Quant Imaging Med Surg ; 12(6): 3126-3137, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35655838

RESUMO

Background: To use conventional magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) to investigate the effects of long-term hypoxia on cranial bone marrow conversion in healthy people at high altitudes. Methods: A total of 1,130 individuals were selected from altitudinal areas of 2,000-3,000, 3,100-4,000, and >4,100 m. Each altitude range was divided into 5 age groups: 0-5, 6-14, 15-29, 30-49, and ≥50 years. Firstly, cranial bone marrow typing of the participants in each altitude range was performed on sagittal T1-weighted images (T1WI) according to the average diploe thickness and signal intensity of the normal skull, and the relationship between bone marrow conversion and age was analyzed. Secondly, the apparent diffusion coefficient (ADC) values of the frontal bone, parietal bone, occipital bone, and temporal bone were measured in the DWI post-processing workstation and statistical methods were used to analyze whether different altitudinal gradients and long-term hypoxic environment had any effect on cranial bone marrow conversion. Results: There was a positive correlation between bone marrow type and age in the healthy populations at all 3 levels of altitude (P<0.05). The average thickness of the cranial diploe also positively correlated with age (P<0.05); in the age ranges of 30-49 and ≥50 years, the ADC values of the occipital and temporal bone marrow positively correlated with increasing altitude (P<0.05). Conclusions: The cranial bone marrow of normal people at high altitudes changes from Type I to Type IV with increasing age and under the influence of long-term chronic hypoxia. The bone marrow of the occipital and temporal bones of healthy people aged 30-49 and ≥50 years showed erythromedularization during the process of Type III and IV bone marrow conversion.

19.
Front Cell Dev Biol ; 10: 888598, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35663398

RESUMO

Objective: To explore the repair effect of the prepared drug-loaded AM1241 poly(ethylene glycol)-dithiothreitol (PEG-DTT) hydrogel on cranial bone defects in SD rats. Methods: The PEG-DTT hydrogel under borax catalysis was quickly prepared, and the characterization of the material was observed by a scanning electron microscope. The effect of AM1241 on cell activity and bone tissue differentiation was tested. The SD rat model of cranial bone defect was established, and the defect was repaired by injecting the prepared hydrogel into the defect. The defect was divided into four groups, namely, sham group, blank group, PEG-DTT group, and PEG-DTT + AM1241 group. The rats were euthanized, and whole cranial bone was taken out for micro-CT and histological observation. Results: The prepared hydrogel is porous; it is liquid when heated to 80°C and a hydrogel when cooled to 25°C. 5-10 µM AM1241 increased osteoblast activity. A moderate amount of AM1241 can promote osteogenic differentiation. Both the PEG-DTT group and PEG-DTT + AM1241 group showed obvious new bone tissue formation, but the PEG-DTT + AM1241 group had a better effect. In addition, the new bone tissue in the PEG-DTT + AM1241 group was significantly more than that in the other groups. Conclusion: The prepared AM1241-loaded PEG-DTT hydrogel showed a good repair effect on SD rats with cranial bone defects. It can be used as materials for cranial bone repair in SD rats with cranial bone defects, but the repair effect is weaker than that of normal bone. These results provide a theoretical and practical basis for its further clinical application.

20.
Tissue Cell ; 77: 101829, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35660272

RESUMO

Craniofacial bone defects cause significant problems to patients with harmful consequences. Mesenchymal stem cells (MSCs) can self-renew and exhibit multilineage differentiation, which could be applied to bone regeneration. However, craniofacial bone tissue MSCs have unique properties, differing in their characteristics to MSCs derived from long bones. CDC20 promotes osteogenic differentiation in long bones; however, its role in craniofacial bone tissues remains unknown. In this study, we found that Cdc20 conditional knockout in mice triggered distinctive cranial and mandibular bone loss. Moreover, the osteogenic differentiation potential of cranial suture-derived MSCs and mandibular bone marrow-derived MSCs was impaired in Cdc20 conditional knockout mice. The conditional knockout of Cdc20 impaired osteogenesis in craniofacial bones. Our findings provide new insights into craniofacial bone regeneration and the treatments of craniofacial bone-related diseases.


Assuntos
Proteínas Cdc20/metabolismo , Células-Tronco Mesenquimais , Osteogênese , Animais , Regeneração Óssea , Diferenciação Celular , Camundongos , Osteogênese/genética , Crânio
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