• Journal of Korean Neurosurgical Society
• /
• v.62 no.4
• /
• pp.382-388
• /
• 2019

Objective : The primary aim of this investigation was to explore the nature of dura mater biomechanics following the introduction of puncture defect(s). Methods : Twenty-eight dura mater specimens were collected during autopsy from the department of forensic medicine of the authors' institution. Specimens were divided randomly into one of four groups : group I (cranial dura mater; n=7), group II (cranial dura mater with one puncture defect; n=7); group III (cranial dura mater with two puncture defects; n=7), and group IV (cranial dura mater with three puncture defects; n=7). Results : The mean${\pm}$standard deviation tensile strengths of the dura mater were $8.35{\pm}3.16$, $8.22{\pm}3.32$, $7.13{\pm}1.77$, and $6.94{\pm}1.93MPa$ for groups I, II, III, and IV, respectively. There was no statistical difference between all groups. A single, two or more punctures of the dura mater using a 20-gauge Quincke needle did not affect cranial dura tensile strength. Conclusion : This biomechanical study may contribute to the future development of artificial dura mater substitutes and medical needles that have a lower negative impact on the biomechanical properties of dura mater.

• Journal of Korean Neurosurgical Society
• /
• v.62 no.6
• /
• pp.635-642
• /
• 2019

Objective : The aim of this study was to investigate the biomechanical differences between human dura mater and dura mater substitutes to optimize biomimetic materials. Methods : Four groups were investigated. Group I used cranial dura mater (n=10), group II used $Gore-Tex^{(R)}$ Expanded Cardiovascular Patch (W.L. Gore & Associates Inc., Flagstaff, AZ, USA) (n=6), group III used $Durepair^{(R)}$ (Medtronic Inc., Goleta, CA, USA) (n=6), and group IV used $Tutopatch^{(R)}$ (Tutogen Medical GmbH, Neunkirchen am Brand, Germany) (n=6). We used an axial compression machine to measure maximum tensile strength. Results : The mean tensile strengths were $7.01{\pm}0.77MPa$ for group I, $22.03{\pm}0.60MPa$ for group II, $19.59{\pm}0.65MPa$ for group III, and $3.51{\pm}0.63MPa$ for group IV. The materials in groups II and III were stronger than those in group I. However, the materials in group IV were weaker than those in group I. Conclusion : An important dura mater graft property is biomechanical similarity to cranial human dura mater. This biomechanical study contributed to the future development of artificial dura mater substitutes with biomechanical properties similar to those of human dura mater.

• Journal of Periodontal and Implant Science
• /
• v.27 no.3
• /
• pp.479-493
• /
• 1997

There are various treatment methods including barrier membranes in attaining periodontal regeneration and regaining the function of destructed periodontal tissues due to periodontal disease. Barrier membranes consist of non-Resorbable and resorbable types such as Dura mater and $Guidor^{(R)}$ used in the treatment of intrabony defects and classII furcation defects have been shown to be effectively increased the amount of new bone and cementum.In our study we used premolars with class III furcation defects created by removing the bone 4mm apically from CEJ in adult dogs and placed resorbable membrane Dura mater and $Guidor^{(R)}$ for the test group and flap operation was carried out for the control groups. The effect of membrane on junctional epithelium, alveloar bone, cementum, and gingival connective tisssue in the regeneration and healing potential of periodontal tissues was evaluated and healing results were evaluated histologically and histometrically 8 weeks following the surgical procedure. 1. In the clinical observation, there was no exposure of furcation defects in the control group, whereas slight membrane exposure was noted in the test group. 2. New bone was formed up to the level of the notch in the control group, whereas in the test group new bone formation was observed above the level of the notch. 3. New cementum was formed in both groups of the experiment. 4. The connective tissue observed between the new cementum and new bone in the test group were functionally orientated, compared to the irregular formation of connective tissues found in the control group. 5. Root resorption or ankylosis was not observed in any of the groups 6. The mean and median of the control group were 4.31% and 2.23% and for the Dura mater group were 27.85% and 15.57% respectively. There was no significant difference between Dura mater and the control group. 7. The mean and median of the control group were 4.31% and 2.23% and for the $Guidor^{(R)}$ group were 37.27% and 37.19% respectively. There was a significant difference in these two groups(P$Guidor^{(R)}$ were 37.27% and 37.19%. There was no significant difference between the two test groups. Thus, by using Dura mater and Guidor in classIII furcation defects, the predictable amount of periodontal ligament and alveolar bone regeneration may result.

• Journal of Periodontal and Implant Science
• /
• v.26 no.3
• /
• pp.591-604
• /
• 1996

The present study evaluates the effects of dura mater barrier membranes In class III furcation defects on the regeneration of periodontal tissues in dogs. Experimental class III furcation defects were created surgically by removing alveolar bone horizontally down to 4mm from CEJ in mandibular premolars of adult dogs. Dura mater barrier membranes were applied bucco-lingually in the test group, and flap surgery only with no membranes in the control group. The healing was evaluated clinically and histologically after 8weeks. Clinically, the test group showed slight exposures of the membranes, while the control group showed no furcation exposure, The test specimens showed new bone formation coronal to the notch, while the control specimens had new bone formation up to the level of the notch. New cementum was observed in both groups. The test specimens showed functional arrangements of connective tissue fibers between new bone and new cenentum, while irregular arrangements were observed in the controls. No root resorption or ankylosis were observed in either groups,These results suggest that dura mater resorbable barrier membranes on class III furcation defects may be effective in regeneration of alveolar bone and peridontal ligament.

• Biomedical Science Letters
• /
• v.11 no.3
• /
• pp.375-382
• /
• 2005

This study aimed to investigate whether nociceptin is implicated in the, trigeminovascular responses to electrical stimulation of trigeminal ganglion in rats. An open cranial window was prepared on the right parietal bone of male Sprague-Dawley rats. Trigeminovascular system was stimulated by electrical stimulation of trigeminal ganglion (ETS; 5ms, 5Hz, 3V). Neonatal capsaicin treatment was performed with subcutaneous administration of capsaicin (50mg/kg) within the first 24 hours after birth. Changes in regional cerebral blood flow were continuously measured through the cranial window by laser-Doppler flowmetry, and the expression of nociceptin-like immunoreactivity was determined by immunohistochemistry. ETS caused increases in regional blood flow of pial arteriole in a voltage-dependent manner. ETS markedly and voltage-dependently increased the expression of nociceptin-like immunoreactivity in dura mater ipsilateral rather than contralateral to ETS. The nociceptin-like immunoreactivity was markedly reduced by pretreatments with calcitonin gene-related peptide(8-37) ($CGRP_{8-37},\;a\;CGRP_1$ receptor antagonist), L-733060 (a $NK_1$ receptor antagonist), and $[Nphe^1]$ nociceptin(1-13)$NH_2$ (a selective and competitive nociceptin receptor antagonist) as well as by neonatal capsaicin treatment. These results suggest that the electrical stimulation of trigeminal ganglion causes prominent expression of nociceptin within dura mater, in which not only neuropeptides inducing substance P and CGRP but also nociceptin are implicated in the trigeminovascular responses to electrical trigeminal ganglion stimulation.

• Archives of Reconstructive Microsurgery
• /
• v.18 no.1
• /
• pp.23-26
• /
• 2009

Purpose: Artificial dura maters are commonly used in cranioplasty, but sometimes they can result in serious postoperative infection. Once complications such as epidural abscess or chronic draining ulcer arise, they are very difficult to treat. In this case, reclosure of dura defect using artificial dura mater may give rise to recurrence of infection. We experienced a case of intractable epidural abscess caused by use of artificial dura. To avoid repeated infection, we decided to use autologous tissue for the coverage of dura and soft tissue defect. Therefore, autologous tensor fascia lata graft and anterolateral thigh free flap were harvested at the same donor site incision to cover composite defect on the scalp and dura mater. Methods: A 13 year old male patient, who underwent the decompression cranioplasty and duroplasty, suffered from the intractable infection lesion. Twice, the epidural abscess was removed, both times the infection recurred. And eventually dura mater was exposed through the infected open wound. Nine months after dura exposed, infected aritificial dura mater was removed and extensive debridement was performed. Through a surgical incision on donor thigh, first, tensor fascia lata graft was harvested in process of the anterolateral thigh flap elevation. After the fascia lata graft was fixed over the dural defect, the anterolateral thigh flap was used to fill the dead space as well as the scalp defect. Results: Postoperatively, no recurrent infection and cerebrospinal fluid leakage are observed for a year. After the surgery, on the first and second day, venous congestion of the flap was observed, this problem was solved by thrombectomy and vein reanastomosis. And partial necrosis of flap occurred, but completely healed as conservative treatment for two weeks. Conclusion: Using the autologous tensor fascia lata graft and anterolateral thigh flap, we could obtain satisfactory results as treatment for the intractable infection lesion after duroplasty. Autologous tensor fascia lata in conjunction with anterolateral thigh flap is useful method for covering composite defect of scalp and dura mater.

• Archives of Craniofacial Surgery
• /
• v.10 no.2
• /
• pp.138-141
• /
• 2009

Purpose: Squamous cell carcinoma of the scalp sometimes exhibits unusually aggressive behavior. We report a case of extradordinarily aggressive squamous cell carcinoma of the scalp with invasion into the skull and dura mater. Method: The patient is a 38-year-old man with two cystic masses on the occipital area. He was diagnosed as squamous cell carcinoma in that region and have undergone surgical resections including cortical osteotomy of the skull, several years ago. On this occasion, 3-dimensional computed tomographic imaging revealed an erosive lesion on the occipital bone and magnetic resonance imaging showed two cystic masses invasion into the skull and dura mater. Results: He has undergone wide resection of the masses and cranioplasty with dural repair. Histopathologic examination indicated squamous cell carcinoma with moderate differentiation of the masses, bone marrow and dura mater. Conclusion: Squamous cell carcinoma on the scalp can readily penetrate the full thickness of the cranium and invade the dura mater, sagittal sinus and brain. We suggest wide resection of the scalp and split thickness skin graft with sentinel lymph node biopsy, following by postoperative radiation therapy.

• Journal of Periodontal and Implant Science
• /
• v.31 no.1
• /
• pp.91-109
• /
• 2001

The purpose of this study is to evaluate histologically the resorption and tissue response of various resorbale membranes used for guided tissue regneration procedures, using a subcutaneous model on the dorsal surface of the rat. In this study, 12 Sprague-Dawley male rats(mean BW 150gm) were used and the commercially available materials included dense collagen membrane, freeze-dried bovine dura mater loos collagen membrane, PLA/PLGA membrane. Animals were sacrificed at 3, 6 and 8 weeks after implantation of various resorbable membranes. Specimens were prepared with Hematoxylin-Eosin stain for light microscopic evaluation. The results of this study were as follows: 1. Resorption : Loose collagen membrane group was resorbed most rapidly. Dense collagen membrane group and freeze-dried bovine dura mater group were rarely resorbed. 2. Inflammatory reactions : PLA/PLGA membrane group showed persistent and severe inflammatory reactions for 3 to 8 weeks. Moderate inflammatory reactions and the ectopic formation of calcified material were observed in dense collagen membrane group. Freeze-dried bovine dura mater group and loose collagen membrane group showed mild inflammatory reactions 3. In PLA/PLGA membrane group, multinucleated giant cells by foreign body reactions were observed. In conclusion, the resorption of freeze-dried bovine dura mater didn't happen for 3-6weeks, which showed the best bio-compatibility. Therefore, freeze-dried bovine dura mater was considered proper resorbable membrane for guided tissue regeneration.

• Journal of Periodontal and Implant Science
• /
• v.28 no.2
• /
• pp.205-221
• /
• 1998

The present study invetigates the effects of root planing only(control group), DFDBA alone(test group 1) and combined use of DFDB and Dura mater(test group 2) in dehiscence defects in dogs. The results of 8weeks post-surgery by histological comparison between the three groups are as follows. 1. The contol group showed minimum regeneration of new cementum and new bone with limited migration of epitheilal cells, and healed by connective tissue attachment. 2. The test group 1 showed minimum regeneration of new cementum and new bone with limited migration of epitheilal cells, and healed by connective tissue attachment. 3. The test group 2 showed significant amount of the new cementum and new bone. 4. Both control and test groups healed without any observable root resorption and ankylosis. The above the results suggest that the use of resorbable Dura mater only does not improve the regeneration of new bone and periodontal ligament due to difficulties of space making, but the combined use with DFDB may be more effective.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.18 no.1
• /
• pp.33-39
• /
• 1996

Human Dura mater treated by various processes was used to restore small periodontal defects, large bony defects for improvement of new bone formation, and soft tissue defects and replace the disc of TMJ, etc.. Tutoplast Dura is the solvent-preserved Human Dura mater and sterilized by gamma radiation. In our department, Tutoplast Dura was implanted in 32 patients, from 1994, 6 to 1995, 7. We implanted the Tutoplast Dura at 11 various cysts, 6 implantations, 4 fractures, 3 clefts, 2 TMJ disease, 2 maxillary sinusitis, etc.. We performed the retrospective study about the purpose of Tutoplast Dura implantation, postoperative complication and histologic examination of biopsy specimen at implant second surgery.