• Title/Summary/Keyword: Dura

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Effects of a Temperature-Sensitive, Anti-Adhesive Agent on the Reduction of Adhesion in a Rabbit Laminectomy Model

  • Park, Jeong Woo;Bak, Koang Hum;Cho, Tae Koo;Chun, Hyoung-Joon;Ryu, Je Il
    • Journal of Korean Neurosurgical Society
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    • v.59 no.3
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    • pp.250-258
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    • 2016
  • Objective : A common cause of failure in laminectomy surgery is when epidural, peridural, or perineural adhesion occurs postoperatively. The purpose of this study is to examine the efficacy of a temperature-sensitive, anti-adhesive agent (TSAA agent), Guardix-SG$^{(R)}$, as a mechanical barrier for the prevention or reduction of peridural scar adhesion in a rabbit laminectomy model. Methods : Twenty-six mature rabbits were used for this study. Each rabbit underwent two separate laminectomies at lumbar vertebrae L3 and L6, left empty (the control group) and applied 2 mL of the TSAA agent (the experimental group), respectively. Invasive scar formation or inflammation after laminectomy was quantitatively evaluated by measuring the thickness of the dura, the distance from the surface of dura to the scar tissues, the number of inflammatory cells in the scar tissues at the laminectomy site, and the concentration of collagen in histological sections. Results : At 6 weeks postsurgery, the dura was significantly thinner and the distance from the surface of dura to the scar tissues was greater in the experimental group than in the control group (p=0.04 and p=0.01). The number of inflammatory cells was not significantly different in the two groups (p=0.08), although the mean number of inflammatory cells was relatively lower in the experimental group than in the control group. Conclusion : The current study suggests that the TSAA agent, Guardix-SG$^{(R)}$, could be useful as an interpositional physical barrier after laminectomy for the prevention or reduction of adhesion.

Multifocal Calcifications of the Falx Cerebri and Dura Presenting as Hot Spots in the Skull on Bone Scintigraphy (골 신티그래피상 두개골에 열소로 나타난 대뇌겸과 경수뇌막에 다발성석회화)

  • Sohn, Myung-Hee;Jeong, Hwan-Jeong;Lim, Seok-Tae;Yim, Chang-Yeol
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.1
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    • pp.64-65
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    • 2007
  • A 49-year-old woman with invasive ductal carcinoma of the right breast underwent Tc-99m MDP bone scintigraphy for an evaluation of skeletal metastases. Multiple focal hot spots in the midline and left frontoparietal skull region were observed. The plain radiographs revealed the typical findings of the calcification of the falx cerebri and dura. These findings might be mistaken for metastases of the skull in cancer patients. Therefore, a radiographic correlation is essential when multifocal hot spots in the skull are observed in cancer patients.

IgG4-Related Intracranial Hypertrophic Pachymeningitis : A Case Report and Review of the Literature

  • Takeuchi, Satoru;Osada, Hideo;Seno, Soichiro;Nawashiro, Hiroshi
    • Journal of Korean Neurosurgical Society
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    • v.55 no.5
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    • pp.300-302
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    • 2014
  • Hypertrophic pachymeningitis is an uncommon disorder that causes a localized or diffuse thickening of the dura mater. Recently, the possibility that IgG4-related sclerosing disease may underlie some cases of intracranial hypertrophic pachymeningitis has been suggested. We herein report the tenth case of IgG4-related intracranial hypertrophic pachymeningitis and review the previous literature. A 45-year-old male presented with left-sided focal seizures with generalization. Magnetic resonance imaging (MRI) revealed a diffuse thickening and enhancement of the right convexity dura matter and falx with focal nodularity. The surgically resected specimens exhibited the proliferation of fibroblast-like spindle cells and an infiltration of mononuclear cells, including predominantly plasma cells. The ratio of IgG4-positive plasma cells to the overall IgG-positive cells was 45% in the area containing the highest infiltration of plasma cells. On the basis of the above findings, IgG4-related sclerosing disease arising from the dura mater was suspected. IgG4-related sclerosing disease should be added to the pachymeningitis spectrum.

The Use of Multiple Fenestrations of the Dura in Acute Traumatic Subdural Hematoma in Elderly (노인 급성 외상성 경막하출혈 환자에서 시행한 다발성 경막천공술의 이용)

  • Park, Jongtae;Yun, Jikwang
    • Journal of Trauma and Injury
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    • v.26 no.3
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    • pp.226-228
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    • 2013
  • Elderly patients with acute subdural hematomas have higher mortality and lower functional recovery rates compared with those of other head-injured patients. Early and widely surgical decompression and active intensive care represent the best way to assist these patients. However, abrupt decompression of the hematoma can lead to brain disruption and secondary ischemia in the brain surrounding the craniectomy site. Acute brain swelling and brain extrusion, which take place shortly after decompression, can lead to a catastrophic situation during the operation due to the impossibility of appropriate closure of the dura and scalp. To avoid the deleterious consequences of disruption of brain tissue, we have adopted multiple fenestrations of the dura in a mesh-like fashion and gradual release of subdural clots through the small dural openings that are left open. This is especially important in cases in which there are massive amount of subdural hematomas with small parenchymal lesion and severe midline shifts in elderly patients. Further clinical experiences should be conducted in a more selected series patients to estimate the impact of this technique on morbidity and mortality rates.

Development of Two Dimensional Chloride Ion Penetration Model Using Moving Mesh Technique (Moving Mesh Technique을 이용한 2차원 염해 침투 예측 모델의 개발)

  • Choi, Won;Kim, Hanjoong
    • Journal of The Korean Society of Agricultural Engineers
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    • v.57 no.6
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    • pp.1-7
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    • 2015
  • Most of chloride diffusion models based on finite difference method (FDM) could not express the diffusion in horizontal direction at each elevation. To overcome these weakness, two dimensional chloride ion penetration model based on finite element method (FEM) to be able to combine various multi-physics simultaneously was suggested by introducing moving mesh technique. To avoid the generation of mesh being able to be distorted depending on the relative movement of water level to static concrete, a rectangular type of mesh was intentionally adopted and the total number of meshes was empirically selected. The simulated results showed that the contents of surface chloride decreased following to the increase of elevation in the top part of low sea level, whereas there were no changes in the bottom part of low level. In the DuraCrete model, the diffusion coefficient of splashed zone is generally smaller than submerged zone, whereas the trend of Life365 model is reverse. Therefore, it could be understood that the developed model using moving mesh technique effectively reflects $DuraCrete^{TM}$ model rather than $Life365^{TM}$ model. In the future, the model will be easily expanded to be combined with various multi-physics models considering water evaporation, heat of hydration, irradiation effect of sun and so on because it is based on FEM.

Intracranial Pressure and Cerebral Blood Flow Monitoring after Bilateral Decompressive Craniectomy in Patients with Acute Massive Brain Swelling (급성 중증 뇌종창 환자의 양측성 감압개두술 후 뇌압 및 뇌혈류 측정)

  • Yoo, Do-Sung;Kim, Dal-Soo;Huh, Pil-Woo;Cho, Kyoung-Suck;Park, Chun-Kun;Kang, Joon-Ki
    • Journal of Korean Neurosurgical Society
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    • v.30 no.3
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    • pp.295-306
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    • 2001
  • Objectives : The management of massive brain swelling remains an unsolved problem in neurosurgical field. Despite newly developed medical and pharmacological therapy, the mortality and morbidity due to massive brain swelling remains high. According to many recent reports, surgical decompression with dura expansion is superior to medical management in patients with massive brain swelling. We performed surgical treatment on the first line of treatment, and followed medical management in case with refractory increased intracranial pressure(ICP). To show the quantitative effect of decompressive surgery on the intracranial pressure, we performed ventricular puncture and checked the ventricular ICP continuously during the decompressive surgery and postoperative period. Materials and Methods : Fifty-one patients with massive brain swelling, undergoing bilateral decompressive craniectomy with dura expansion, were studied in this study. In all patients, ventricular puncture was performed at Kocher's point on the opposite side of massive brain swelling. The ventricular pressure was monitored continuously, during the bilateral decompression procedures and postoperative period. Results : The initial ventricular ICP were varied from 13mmHg to 112mmHg. Immediately after the bilateral craniectomy, mean ventricular ICP decreased to $53.1{\pm}15.8%$ of the initial ICP(ranges from 5mmHg to 87mmHg). Dura opening decreased mean ICP by additional 36.7% and made the ventricular pressure $16.4{\pm}10.5%$ of the initial pressure (ranges from 0mmHg to 28mmHg). Postoperatively, ventricular pressure was lowered to $20.2{\pm}22.6%$(ranged from 0mmHg to 62.3mmHg) of the initial ICP. The ventricular ICP value during the first 24 hours after decompressive surgery was found to be an important prognostic factor. If ICP was over 35mmHg, the mortality was 100% instead of additional medical(barbiturate coma therapy and hypothermia) treatments. Conclusion : Bilateral decompression with dura expansion is considered an effective therapeutic modality in ICP control. To obtain favorable clinical outcome in patients with massive brain swelling, early decision making on surgical management and proper patient selection are mandatory.

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Community Structure, Species Composition and Population Status of NTFPs of Ziro Valley in Arunachal Pradesh, India

  • Bamin, Yakang;Gajurel, Padma Raj;Paul, Ashish
    • Journal of Forest and Environmental Science
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    • v.33 no.3
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    • pp.202-225
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    • 2017
  • Non Timber Forest Products (NTFPs) has gained a lot of significance over the years as a means of income generation. Forests are playing a vital role in the supply of these products, however, due to their continuous extraction, the population of many species might have depleted. Very little information is known about community structure and population status of NTFPs. No specific studies have been made to find out the occurrence, availability of species and population status in the forests, supplying the resources. The present study has been carried out in community forests of the naturally occurring NTFPs in the temperate forest of the Ziro valley of Arunachal Pradesh. The main aim is to determine community structure, species composition and population status of NTFPs. Three forest stands viz., Nyilii, Dura and Gyachi were selected which are used by the Apatani tribe for extraction of the NTFPs. For evaluation of species composition and community characteristics, the sampling of the vegetation was done using the quadrat method. A total 137 species representing 68 families and 116 genera were recorded. Herbs represent the maximum diversity with 71 species followed by 35 shrub species and 31 tree species. The families Asteraceae and Rosaceaeae exhibited maximum representation followed by Urticaceae. The species under Fagaceae, Lauraceae, Rosaceae and Rutaceae were found to be important NTFP yielding species. Highest species richness was recorded in Nyilii having 124 species, while lowest in Dura with 102 species. Density of tree, shrub and herb ranged between 376 to $456\;individuals\;ha^{-1}$, 2848 to $3696\;individuals\;ha^{-1}$ and 31.44 to $36.64\;individuals\;m^{-2}$, respectively. The total basal area was found to be highest ($51.64m^2\;ha^{-1}$) in Dura followed by Nyilii ($25.32m^2\;ha^{-1}$) and lowest in Gyachi ($22.82m^2\;ha^{-1}$). In all the three study stands the species diversity indices showed the trend, herbs > shrubs > trees while the evenness index showed the trend as shrubs > herbs > trees. The overall species similarity index was highest (82.35%) between Dura and Gyachi. About 80% of the total recorded species showed clumped distribution while, no regular distribution was shown by any species. The three selected stands harbor about 50 important NTFP yielding species which are being used commonly by the Apatani people in their day to day life. Among the three study sites, overall diversity of NTFP was found highest in the Nyilii stand while the density of population was found better in Dura and Gyachi stands. The population of many species was found to be low due to continue harvesting without any sustainable management by the communities. All the selected forest stands have the potentiality to grow the high value NTFP yielding species and if managed properly, they can support the livelihood and economy of the local communities.

A STUDY ON THE EFFECT OF THERMOCYCLING TO THE PHYSICAL PROPERTIES OF DENTURE LINERS (열 순환에 따른 의치이장채의 물리적 성질의 변화에 관한 연구)

  • Lee Dong-Su;Lim Heon-Song;Lim Ju-Hwan;Cho In-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.39 no.5
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    • pp.556-575
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    • 2001
  • For the improvement of denture fitness of changed residual ridge, denture liner can be used. Denture liner should be very stable physically in various environments of the mouth as well as be bonded strongly with denture resin. In this study. the specimens bonded with four kinds of soft denture liner and three kinds of hard denture liner were used to test the physical properties of the liners. All experimental groups were stored in $37{\pm}1^{\circ}C$ distilled water for 24hours, followed by thermocycling between $15^{\circ}C$ and $45^{\circ}C$ with 15 second dwell time. 1000, 2000, 3000 cycles of thermocycling were excuted and physical properties were measured by Instron Universal Testing Machine. The obtained results were as follows : 1. In tensile bond test of sea liners, it was shown that both of $Molloplast-B^{(R)}$ specimens before and after thermocycling had the highest tensile strength, and in case of hard liners, Dura-Liner $II^{(R)}$ specimen had the highest tensile strength before and after thermocycling. Depending on thermocycling, $Soft-Relining^{(R)}$, $Denture-Relining^{(R)}$, $Molloplast-B^{(R)}$, $Coe-Soft^{(R)}$ and $Kooliner^{(R)}$ specimen showed significant difference(p<0.05). 2. In strain test of soft liners, it was shown that $Molloplast-B^{(R)}$ specimen before thermocycling and the $Coe-Soft^{(R)}$ after thermocycling showed highest results, and in case of hard liners, the Dura-Liner $II^{(R)}$ specimen before and after thermocycling had the highest result. Depending on thormocycling, $Denture-Relining^{(R)}$, $Molloplast-B^{(R)}$ and Dura-Liner $II^{(R)}$ specimen showed significant difference(p<0.05). 3. In maximum distance test of soft liners. the $Molloplast-B^{(R)}$ specimen before thermocycling and the $Coe-Soft^{(R)}$ after thermocycling showed highest results. and in case of hard liners, the Dura-Liner $II^{(R)}$ specimen before and after thermocycling showed highest result. Depending on thermocycling, $Denture-Relining^{(R)}$, $Molloplast-B^{(R)}$ specimens showed significant difference(p<0.05). 4. In elasticity test of soft liners, the $Molloplast-B^{(R)}$ specimen before and after thermocycling showed highest result. and in case of hard liners, the Dura-Liner $II^{(R)}$ specimen before thermocycling and the $Tokuso-Rebase^{(R)}$ after thermocycling showed highest results. Depending on thermocycling, $Soft-Relining^{(R)}$ $Molloplast-B^{(R)}$ specimens showed significant difference (p<0.05).

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Fistula Formation Between the Disc and Dura after Percutaneous Endoscopic Lumbar Discectomy - A Case Report - (경피적 내시경 요추 추간판 절제술 후 발생한 추간판과 경막 사이의 누공 형성 - 증례 보고 -)

  • Kim, Hak Sun;Kim, Hyoung Bok;Chung, Hoon-Jae;Yang, Jea Ho
    • Journal of Korean Society of Spine Surgery
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    • v.25 no.4
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    • pp.180-184
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    • 2018
  • Study Design: Case report Objectives: To document fistula formation between the disc and dura by an unrecognized dural tear after percutaneous endoscopic lumbar discectomy (PELD). Summary of Literature Review: The risk of durotomy is relatively low with PELD, but cases of unrecognized durotomies have been reported. An effective diagnostic tool for such situations has not yet been identified. Materials and Methods: A patient twice underwent transforaminal PELD under the diagnosis of a herniated lumbar disc at L4-5. She still complained of intractable pain and motor weakness around the left lower extremity at 6 months postoperatively. Magnetic resonance imaging showed no specific findings suggestive of violation of the nerve root. However, L5 and S1 nerve root injury was noted on electromyography. An exploratory operation was planned to characterize damage to the neural structures. Results: In the exploration, a dural tear was found at the previous operative site, along with a fistula between the disc and dura was also found at the dural tear site. The durotomy site was located on the ventrolateral side of the dura and measured approximately 5 mm. The durotomy site was repaired with Nylon 5-0 and adhesive sealants. The patient's preoperative symptoms diminished considerably. Conclusions: Fistula formation between the disc and dura can be caused by an unrecognized dural tear after PELD. Discography is a reliable diagnostic tool for fistulas formed by an unrecognized durotomy.