Pub Date : 2009-12-01DOI: 10.1016/j.surneu.2009.06.007
Tao-Chen Lee MD , Nyuk-Kong Chang DVM , Feng-Wen Su MD , Yu-Lin Yang PhD , Thung-Ming Su MD , Yu-Jun Lin MD , Wan-Ching Lin BS , Hsiu-Yu Huang MD
Background
Ostene®, a synthetic water-soluble bone hemostatic agent, is commercially available. In the current study, we evaluated the systemic and local effects of this copolymer in a rabbit model.
Methods
Eighteen rabbits underwent creation of a bony defect at right iliac crest. These rabbits were then evenly divided into 3 groups. In group 1, the defect surfaces were treated with bone wax; in group 2, the defect surfaces were treated with Ostene®; in group 3, the defect surfaces were not treated with anything. Then, the animals underwent blood examinations, including WBC count, CRP, and ESR at 0, 1, 3, and 6 weeks, and were killed at 6 weeks for histologic examination. Another 6 rabbits (group 4) underwent the same surgical treatment of group 2 animals but had blood examinations of BUN and creatinine.
Results
The blood examinations showed that the WBC count, CRP, and ESR of all the animals in the first 3 groups were within normal limits in the postoperative periods. Microscopic examinations demonstrated residual bone wax and fibrotic tissue at the defect surfaces in group 1 animals. However, there was no Ostene® at the defect surfaces in group 2 animals. The groups 2 and 3 animals showed no fibrotic tissue at the defect surfaces. The group 4 animals showed normal serum levels of BUN and creatinine in the postoperative periods.
Conclusion
Ostene® is absorbable and induces no systemic inflammation (including acute renal damage) and local inflammation in animal bodies.
{"title":"Systemic and local reactions of a water-soluble copolymer bone on a bony defect of rabbit model","authors":"Tao-Chen Lee MD , Nyuk-Kong Chang DVM , Feng-Wen Su MD , Yu-Lin Yang PhD , Thung-Ming Su MD , Yu-Jun Lin MD , Wan-Ching Lin BS , Hsiu-Yu Huang MD","doi":"10.1016/j.surneu.2009.06.007","DOIUrl":"10.1016/j.surneu.2009.06.007","url":null,"abstract":"<div><h3>Background</h3><p>Ostene®, a synthetic water-soluble bone hemostatic agent, is commercially available. In the current study, we evaluated the systemic and local effects of this copolymer in a rabbit model.</p></div><div><h3>Methods</h3><p>Eighteen rabbits underwent creation of a bony defect at right iliac crest. These rabbits were then evenly divided into 3 groups. In group 1, the defect surfaces were treated with bone wax; in group 2, the defect surfaces were treated with Ostene®; in group 3, the defect surfaces were not treated with anything. Then, the animals underwent blood examinations, including WBC count, CRP, and ESR at 0, 1, 3, and 6 weeks, and were killed at 6 weeks for histologic examination. Another 6 rabbits (group 4) underwent the same surgical treatment of group 2 animals but had blood examinations of BUN and creatinine.</p></div><div><h3>Results</h3><p>The blood examinations showed that the WBC count, CRP, and ESR of all the animals in the first 3 groups were within normal limits in the postoperative periods. Microscopic examinations demonstrated residual bone wax and fibrotic tissue at the defect surfaces in group 1 animals. However, there was no Ostene® at the defect surfaces in group 2 animals. The groups 2 and 3 animals showed no fibrotic tissue at the defect surfaces. The group 4 animals showed normal serum levels of BUN and creatinine in the postoperative periods.</p></div><div><h3>Conclusion</h3><p>Ostene® is absorbable and induces no systemic inflammation (including acute renal damage) and local inflammation in animal bodies.</p></div>","PeriodicalId":22153,"journal":{"name":"Surgical Neurology","volume":"72 ","pages":"Pages S75-S79"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.surneu.2009.06.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40021327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-12-01DOI: 10.1016/j.wneu.2009.09.012
James I. Ausman MD, PhD (Editor)
{"title":"A note of appreciation to the editorial board","authors":"James I. Ausman MD, PhD (Editor)","doi":"10.1016/j.wneu.2009.09.012","DOIUrl":"10.1016/j.wneu.2009.09.012","url":null,"abstract":"","PeriodicalId":22153,"journal":{"name":"Surgical Neurology","volume":"72 6","pages":"Page 560"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.wneu.2009.09.012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55278018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-12-01DOI: 10.1016/j.surneu.2008.12.008
Jon Olabe MD, Javier Olabe MD, PhD
Background
Microneurovascular anastomosis and aneurysm clipping require extensive training before mastering the technique and are a surgical challenge. We developed the “infused chicken wing method” to provide a simple but realistic training method minimizing animal use and need for special facilities for animal care and anesthesia.
Methods
Fresh chicken wings were used in this model. The main brachial artery was cannulated, and water was infused at 140 mm Hg followed by anatomical neurovascular dissection. Multiple microsurgical training exercises were performed under microscope vision including terminoterminal, lateroterminal, laterolateral vascular anastomosis, and nerve anastomosis. Different complexity aneurysms were created using venous patches, clipping, rupture, and vascular reconstruction techniques were performed.
Results
This novel training model is inexpensive, easily obtainable, and no live animals are required. The diameter and characteristics of arteries and veins used are similar to those of the human brain. Great microsurgical technique progress may be obtained.
Conclusions
The infused chicken wing artery model presents a realistic microvascular training method. It is inexpensive and easy to set up. Such simplicity provides the adequate environment for developing microsurgical technique.
背景:在掌握微神经血管吻合和动脉瘤夹闭技术之前需要广泛的训练，这是一项外科挑战。我们开发了“注入鸡翅法”，提供了一种简单而现实的训练方法，最大限度地减少了动物的使用和对动物护理和麻醉的特殊设施的需求。方法采用新鲜鸡翅作为实验材料。臂主动脉插管，140 mm Hg灌注水，解剖解剖神经血管解剖。在显微镜下进行多种显微外科训练，包括末端、侧端、外侧血管吻合和神经吻合。使用静脉贴片、夹闭、破裂和血管重建技术创建不同复杂性的动脉瘤。结果该新型训练模型成本低廉，易于获得，且不需要活体动物。所使用的动脉和静脉的直径和特征与人类的大脑相似。显微外科技术可以取得很大的进步。结论灌注式鸡翅动脉模型是一种真实的微血管训练方法。它既便宜又容易安装。这种简单性为显微外科技术的发展提供了良好的环境。
{"title":"Microsurgical training on an in vitro chicken wing infusion model","authors":"Jon Olabe MD, Javier Olabe MD, PhD","doi":"10.1016/j.surneu.2008.12.008","DOIUrl":"10.1016/j.surneu.2008.12.008","url":null,"abstract":"<div><h3>Background</h3><p>Microneurovascular anastomosis and aneurysm clipping require extensive training before mastering the technique and are a surgical challenge. We developed the “infused chicken wing method” to provide a simple but realistic training method minimizing animal use and need for special facilities for animal care and anesthesia.</p></div><div><h3>Methods</h3><p>Fresh chicken wings were used in this model. The main brachial artery was cannulated, and water was infused at 140 mm Hg followed by anatomical neurovascular dissection. Multiple microsurgical training exercises were performed under microscope vision including terminoterminal, lateroterminal, laterolateral vascular anastomosis, and nerve anastomosis. Different complexity aneurysms were created using venous patches, clipping, rupture, and vascular reconstruction techniques were performed.</p></div><div><h3>Results</h3><p>This novel training model is inexpensive, easily obtainable, and no live animals are required. The diameter and characteristics of arteries and veins used are similar to those of the human brain. Great microsurgical technique progress may be obtained.</p></div><div><h3>Conclusions</h3><p>The infused chicken wing artery model presents a realistic microvascular training method. It is inexpensive and easy to set up. Such simplicity provides the adequate environment for developing microsurgical technique.</p></div>","PeriodicalId":22153,"journal":{"name":"Surgical Neurology","volume":"72 6","pages":"Pages 695-699"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.surneu.2008.12.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28079789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-12-01DOI: 10.1016/j.surneu.2009.07.010
Ibrahim Sbeih MBCHB, FRCS, FRCSSN
{"title":"Do we need a neurosurgical Interpol?","authors":"Ibrahim Sbeih MBCHB, FRCS, FRCSSN","doi":"10.1016/j.surneu.2009.07.010","DOIUrl":"10.1016/j.surneu.2009.07.010","url":null,"abstract":"","PeriodicalId":22153,"journal":{"name":"Surgical Neurology","volume":"72 6","pages":"Pages 628-629"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.surneu.2009.07.010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28428926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
For cervical spine ABC, staged surgery and the combination of both anterior and posterior approaches are usually necessary for lesions involving all 3 (anterior, middle, and posterior) columns of the spine (holovertebral).
Case Description
A 20-year-old young man presented with quadriplegia and acute urine retention lasting for 3 days in November 2006. The diagnosis of an ABC involving the C2 vertebral body, pedicles, laminae, and spinous process was made by MRI. One-stage surgery with intralesional injection of fibrin glue via the posterior approach only was able to deliver complete resection and spinal stabilization. His neurologic function recovered well, and he was able to walk independently 10 days postoperation. At the 1-year follow-up, image studies of the cervical spine demonstrated good bone fusion without recurrence of ABC. The C2 vertebral body also showed resolution of ABC and good trabeculation.
Conclusions
Intralesional injection of fibrin glue during the operation for holovertebral ABC can be beneficial to (1) avoid using an anterior approach for complete resection and reconstruction, which was usually required in previous reports, and (2) effectively decrease the blood loss during surgery.
{"title":"One-stage posterior resection is feasible for a holovertebral aneurysmal bone cyst of the axis: a case report and literature review","authors":"Li-Yu Fay MD , Jau-Ching Wu MD , Wen-Cheng Huang MD , Yang-Hsin Shih MD , Henrich Cheng MD, PhD","doi":"10.1016/j.wneu.2009.09.007","DOIUrl":"10.1016/j.wneu.2009.09.007","url":null,"abstract":"<div><h3>Background</h3><p>For cervical spine ABC, staged surgery and the combination of both anterior and posterior approaches are usually necessary for lesions involving all 3 (anterior, middle, and posterior) columns of the spine (holovertebral).</p></div><div><h3>Case Description</h3><p>A 20-year-old young man presented with quadriplegia and acute urine retention lasting for 3 days in November 2006. The diagnosis of an ABC involving the C2 vertebral body, pedicles, laminae, and spinous process was made by MRI. One-stage surgery with intralesional injection of fibrin glue via the posterior approach only was able to deliver complete resection and spinal stabilization. His neurologic function recovered well, and he was able to walk independently 10 days postoperation. At the 1-year follow-up, image studies of the cervical spine demonstrated good bone fusion without recurrence of ABC. The C2 vertebral body also showed resolution of ABC and good trabeculation.</p></div><div><h3>Conclusions</h3><p>Intralesional injection of fibrin glue during the operation for holovertebral ABC can be beneficial to (1) avoid using an anterior approach for complete resection and reconstruction, which was usually required in previous reports, and (2) effectively decrease the blood loss during surgery.</p></div>","PeriodicalId":22153,"journal":{"name":"Surgical Neurology","volume":"72 ","pages":"Pages S80-S85"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.wneu.2009.09.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28534051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-12-01DOI: 10.1016/j.wneu.2009.08.001
Hsing-Hong Chen MD
{"title":"Response to Re: Orbitozygomatic approach for excisions of orbital tumors with 1 piece of craniotomy bone flap: 2 case reports by Chi-Wen Chang et al. Surg Neurol 2007; 68 (S1):56-58 [Surg Neurol 2008; 70 (S1):91]","authors":"Hsing-Hong Chen MD","doi":"10.1016/j.wneu.2009.08.001","DOIUrl":"10.1016/j.wneu.2009.08.001","url":null,"abstract":"","PeriodicalId":22153,"journal":{"name":"Surgical Neurology","volume":"72 ","pages":"Page S86"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.wneu.2009.08.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28534052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To investigate biomaterials seeking for their possible use for aneurysm treatment, in vivo screening tests using a number of potential materials are required. However, there is no established animal model that is suitable for such purpose. Some models require special preparation of tested materials for transcatheter delivery and others are inappropriate in view of their cost-effectiveness. The purpose of this study is to establish an animal model that overcomes these limitations and help us select potential materials before the preclinical evaluation.
Methods
Bilateral CCAs in a rabbit were surgically ligated, and a 2-cm segment of either a bare platinum coil or a polymeric coil (a platinum coil coated with PLGA 10/90) was implanted into each blind-ended arterial segment (n = 26). They were harvested at day 1, 7, 10, 14, or 30, respectively. Angiographic and histologic evaluations as well as quantitative analysis on the development of the organized thrombus were performed.
Results
One day after the implantation, both platinum and PLGA coils were surrounded by immature thrombus that was induced by blood flow stagnation in the arterial segment. At day 7, minimal thrombus organization was observed around both types of materials. At postimplantation days 10 and 14, fibrocellular responses, the early findings of the thrombus organization process, were observed in both material groups. Such histologic findings were more prominent in the PLGA coil group as compared to the platinum coil group (day 10, P = .051; day 14, P = .011). Well-organized thrombus was observed in both material groups at day 30 without showing statistical difference (P = .12).
Conclusion
Given the cost-effectiveness, the simple material preparation process, and its feasible histologic evaluation methods, this new animal model can be useful in screening other potential biomaterials for the development of new coil devices.
{"title":"A rabbit model for efficacy evaluation of endovascular coil materials","authors":"Masaki Ebara MD , Ichiro Yuki MD , Yuichi Murayama MD , Takayuki Saguchi MD , Yih-Lin Nien MD , Harry V. Vinters MD , Fernando Vinuela MD , Toshiaki Abe MD","doi":"10.1016/j.surneu.2009.04.017","DOIUrl":"10.1016/j.surneu.2009.04.017","url":null,"abstract":"<div><h3>Background</h3><p>To investigate biomaterials seeking for their possible use for aneurysm treatment, in vivo screening tests using a number of potential materials are required. However, there is no established animal model that is suitable for such purpose. Some models require special preparation of tested materials for transcatheter delivery and others are inappropriate in view of their cost-effectiveness. The purpose of this study is to establish an animal model that overcomes these limitations and help us select potential materials before the preclinical evaluation.</p></div><div><h3>Methods</h3><p>Bilateral CCAs in a rabbit were surgically ligated, and a 2-cm segment of either a bare platinum coil or a polymeric coil (a platinum coil coated with PLGA 10/90) was implanted into each blind-ended arterial segment (n = 26). They were harvested at day 1, 7, 10, 14, or 30, respectively. Angiographic and histologic evaluations as well as quantitative analysis on the development of the organized thrombus were performed.</p></div><div><h3>Results</h3><p>One day after the implantation, both platinum and PLGA coils were surrounded by immature thrombus that was induced by blood flow stagnation in the arterial segment. At day 7, minimal thrombus organization was observed around both types of materials. At postimplantation days 10 and 14, fibrocellular responses, the early findings of the thrombus organization process, were observed in both material groups. Such histologic findings were more prominent in the PLGA coil group as compared to the platinum coil group (day 10, <em>P</em> = .051; day 14, <em>P</em> = .011). Well-organized thrombus was observed in both material groups at day 30 without showing statistical difference (<em>P</em> = .12).</p></div><div><h3>Conclusion</h3><p>Given the cost-effectiveness, the simple material preparation process, and its feasible histologic evaluation methods, this new animal model can be useful in screening other potential biomaterials for the development of new coil devices.</p></div>","PeriodicalId":22153,"journal":{"name":"Surgical Neurology","volume":"72 6","pages":"Pages 620-627"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.surneu.2009.04.017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28654349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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