[Delayed Hydrocephalus Following Embolization with Hydrogel Coils for an Unruptured Aneurysm at the Tip of the Basilar Artery:A Case Report].

We report the case of a 62-year-old woman with delayed hydrocephalus following endovascular embolization with hydrogel coils for an unruptured aneurysm at the tip of the basilar artery. She underwent the first and second embolizations with bare platinum coils and matrix coils, respectively. However, recanalization and regrowth of the aneurysm was observed, and a successful third embolization with hydrogel coils(2 mm/4 cm×2)was performed. However, progressive ventricular enlargement was observed during 8 months after the third treatment. MRI with fluid-attenuated inversion recovery sequence showed edema in the perianeurysmal white matter, as well as marked communicating hydrocephalus. The aneurysmal wall was enhanced with the administration of gadolinium-DTPA. The cerebrospinal fluid(CSF)protein level was 113 mg/dL. A ventriculo-peritoneal shunt was placed, and the patient was discharged without symptoms. It was postulated that endovascular embolization with hydrogel coils causes inflammation of the aneurysmal wall and perianeurysmal white matter, followed by elevation of CSF protein and subsequent communicating hydrocephalus.

[Thoracocervical giant perimedullary arteriovenous fistula treated with transarterial embolization: a case report].

A 43-year-old woman with progressive gait disturbance and dysesthesia of the limbs and trunk visited our hospital. Upon examination, a thoracocervical giant perimedullary arteriovenous fistula(GPMAVF)was detected. The GPMAVF was fed by both of the highest intercostal arteries and the thyrocervical trunk. The dilated drainage vein widely compressed the spinal cord from the upper thoracic to the cervical regions. Transarterial embolization with n-butyl 2-cyanoacrylate was performed, and the fistula was completely obliterated. The dilated drainage vein was thrombosed, and it decreased in size after treatment. The patient's symptoms and magnetic resonance imaging results significantly improved. We suggest that endovascular treatment is effective for GPMAVFs, given sufficient analysis of the anatomical architecture.

Utilization of a biodegradable mulch sheet produced from poly(lactic acid)/ecoflex/modified starch in mandarin orange groves.

We have developed a mulch sheet made by inflation molding of PLA, Ecoflex((R)) and modified starch, which all have different biodegradabilities. A field test of use as an agricultural mulch sheet for mandarin oranges was carried out over two years. The mechanical properties of the mulch sheet were weakened with time during the field test, but the quality of the mandarin oranges increased, a result of the controlled degradation of the sheet. The most degradable modified starch degraded first, allowing control of the moisture on the soil. Accelerator mass spectroscopy was used for evaluation of the biomass carbon ratio. The biomass carbon ratio decreased by degradation of the biobased materials, PLA and modified starch in the mulch sheet.

Use of the facial dismasking flap approach for surgical treatment of a multifocal craniofacial abscess.

The decision of which surgical approach to use for the treatment of a multifocal craniofacial abscess is still a controversial matter. A failure to control disease progress in the craniofacial region can potentially put the patient's life at risk. Therefore, understanding the various ways to approach the craniofacial region helps surgeons to obtain satisfactory results in such cases. In this report, we describe a patient who visited the emergency department with a large swelling in his right cheek. A blood test and computed tomography revealed odontogenic maxillary sinusitis. The patient developed sepsis due to a progressive multifocal abscess. An abscess was seen in the temporal muscle, infratemporal fossa, and interorbital region. To control this multifocal abscess, we used the facial dismasking flap (FDF) approach. After debridement using the FDF approach, we succeeded in obtaining sufficient drainage of the abscess, and the patient recovered from sepsis. The advantages of the FDF approach are that it provides a wide surgical field, extending from the parietal region to the mid-facial region, and that it leaves no aesthetically displeasing scars on the face. The FDF approach may be one of the best options to approach multifocal abscesses in the craniofacial region.

Photoinduced electron transfer and hole migration along copolymer of vinylbenzenepyrrolidinofullerene[60] and N-vinylcarbazole.

Photoinduced electron-transfer and hole-migration processes for newly prepared copolymers of C60 and N-vinylcarbazole (VCz) with the several compositions have been investigated using time-resolved fluorescence and absorption methods. Shortening of fluorescence lifetime of the C60 moiety in PVCz-C60 was observed, suggesting that the charge-separation takes place via the excited singlet state of C60; the rate constants of the charge-separation were evaluated to be larger than 10(9) S(-1) in polar solvents. In the nanosecond transient absorption spectra in the visible and near-IR regions obtained by excitation of the C60 moiety, the generation of PVCz(*+)-C60(*-) was confirmed. The time profiles of these radical ions showed slow decay continuing more than 800 micros in polar solvents. From the simulations of the decay curves on the basis of the proposed kinetic model, in which the charge-recombination takes place competitively with hole-migration, the rate parameters have been evaluated; i.e., the rate constant of hole migration was evaluated to be 5 x 10(7) s(-1), which was 50 times faster than that of the charge-recombination (ca. 10(6) s(-1)) in polar solvent. The charge-recombination takes place after hole migration among 200-300 Cz units along the PVCz chain in PVCz-C60.

Rotational Distraction for the Treatment of Severe Mandibular Retrognathia.

BACKGROUNDS: The main problem with intraoral distraction of the mandible is the inability to achieve the three-dimensional mandibular correction as planned preoperatively. We developed a technique that allows spontaneous changes in the direction of mandibular elongation using an intraoral distractor. METHODS: After mandibular osteotomy, the distractor is fixed to the distal segment of the mandible using a single bicortical screw, allowing anterior-posterior, vertical and limited lateromedial changes in the vector of distraction. Mandibular lengthening is performed while keeping the maxilla and mandible in class I occlusion with intermaxillary fixation. RESULTS: As the distraction device is activated allowing mandibular elongation, the proximal segment, guided by the surrounding soft tissues, moves and rotates posterosuperiorly. Mandibular lengthening is continued until the condylar head reaches an adequate position in the mandibular fossa as confirmed clinically and radiographically. CONCLUSION: Thirty-three patients with mandibular retrognathia received this treatment and good results were obtained.

Maxillary bone transportation in alveolar cleft-transport distraction osteogenesis for treatment of alveolar cleft repair.

Secondary autogenous cancellous bone grafting is a widely used method for the treatment of alveolar clefts and oronasal fistulae. However, failure of iliac bone grafting sometimes occurs due to inadequate covering with the surrounding soft tissue and marked scar formation, inappropriate patient age, or large clefts. For alveolar clefts, we developed a method consisting of alveolar bone transportation, closure of the alveolar cleft, and/or grafting of new bone. Transport distraction osteogenesis along the curve of the dental arch is ideal. Alveolar bone was transported in the planned direction using a ready-made bone-borne distractor in combination with an orthodontic arch wire for transport guidance. This method allows simultaneous correction of nasal septal deviation and also correction of maxillary arch deformities and malocclusion since, the dental arch is expanded without donor sacrifice. This method can be regarded as tissue engineering to expand bone tissue. This method can be safely performed not only in patients undergoing initial treatment for alveolar clefts but also in patients in whom bone grafting has failed. Since 1997, we have performed this method in 22 patients and obtained good results.

Usefulness of palatal mucoperiosteal grafts for artificial eye socket contracture.

The authors performed palatal mucoperiosteal grafting for contracture of the artificial eye socket in 4 patients. Mucoperiosteal grafts were collected from the paramedian area of the hard palate. After release of contracture, the grafts were sutured with absorbable thread to the defective areas on the conjunctival side of the artificial eye socket after release of contracture. All patients showed mucoperiosteal graft survival without problems, no recurrence of contracture, and good courses of artificial eye wear. The mucoperiosteal donor areas showed closed healing after 3 to 4 weeks. Palatal mucoperiosteal grafts can be collected en bloc and are relatively rigid, which allows the simultaneous reconstruction of the conjunctival side and supportive tissue of the eyelid. Although the size of graft collection is limited, grafts with adequate size for partial reconstruction can be collected. Mucoperiosteal grafts are a good reconstruction material for contracture of the artificial eye socket.