These results suggest that the area of augmented bone increases significantly with the length of healing, filling the occlusive space after 6 months, and that the density of augmented bone depends on that of the existing bone, such that augmented bone has a density about half that of the existing bone.
Background/Aim: For alveolar ridge reconstruction prior to dental implant placement, a barrier membrane is placed to create space over the bone defect. Although periosteum possesses osteogenic capacity, direct contact between defects and periosteum has been avoided. The present study aimed to investigate whether pedicle periosteum could be used as a barrier membrane. Materials and Methods: Twelve rabbits were used. A U-shaped incision was made in the frontal bone, and the skin-periosteum over the frontal bone was stripped. Two trephine-drilled holes with a diameter of 5 mm were prepared in the frontal bone. One hole was covered with pedicle periosteum (periosteum side), and the periosteum was secured to the contralateral side. The other defect was covered with an occlusive membrane (membrane side). Results: The histological observation showed that both defects, which were covered either by the periosteum or by the membrane, were closed almost completely after 12 weeks of healing. No statistically significant difference was observed in the bone defect closure rates between the two sides at 4 and 12 weeks. Conclusion: This study demonstrated that the pedicle periosteum possesses regenerative effects equivalent to those of occlusive membrane. The periosteum contributes to new bone formation by acting as a mechanical barrier and a source of osteogenic components.
We present herein the case of a 75-year-old woman with multiple myeloma who underwent a left lower lobectomy for endobronchial metastasis from an uterine osteosarcoma. She had initially been admitted to our hospital for chemotherapy more than 1 year earlier, soon after which a primary uterine osteosarcoma was discovered and a total abdominal hysterectomy and bilateral salpingo-oophorectomy performed. One year after the operation, the patient developed hemoptysis. A flexible bronchofiberscopy demonstrated a polypoid mass obstructing the left basal bronchus, and computed tomographic scans showed three pulmonary nodules. Surgery was performed to control the hemoptysis. At thoracotomy, two metastatic nodules were identified in the left lower lobe, and the endobronchial extension of the tumor was resected en bloc with the left lower lobe. The tumor was diagnosed as lung metastasis from the uterine osteosarcoma. Although further lung tumors have recently appeared, the patient has remained well for the 3 years since her last operation without any hemoptysis.
of acute aortic dissections with balloon catheter to closeDespite recent advances in medical treatment, an acute aortic dissection is still now often fatal because of the seriousness of its condition. The currently available therapies include blocking the progress of dissection with intensive drug therapy, a process leading to the chronic stage. However, the dissection often proceeds rapidly and may result in death. Various surgical procedures have been attempted so far, but they produce highly invasive stress and high risks. Accordingly, we designed a cylinder-type balloon catheter and developed a new closing procedure, wherein a balloon catheter is introduced and inflated at the site with an intimal tear to maintain the blood flow to the distal vessels and also to close the entry. With this procedure, the complaints will be relieved or disappear, the progress of the dissection can be stopped, and the blood flow can be restored to the reduced and collapsed true lumen. When the blood in the pseudolumen becomes coagulated and organized, the balloon is removed. If this catheter is introduced from the femoral artery (similar to an intra-aortic balloon pumping method), the invasive stress will be further reduced. This method appears to be the most useful for DeBakey type III dissections. We are now intensively studying the safe and effective application of this balloon catheter under various clinical conditions.
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