Evaluation of graphene-derived bone scaffold exposure to the calvarial bone_in-vitro and in-vivo studies.

Graphene is a novel material which has recently been gaining great interest in the biomedical fields. Our previous study observed that graphene-derived particles help induce bone formation in a murine calvarial model. Here, we further developed a blended graphene-contained polycaprolactone (PCL/G) filament for application in a 3D-printed bone scaffold. Since implants are expected to be for long-term usage, in vitro cell culture and in vivo scaffold implants were evaluated in a critical-size bone defect calvarial model for over 60 weeks. Graphene greatly improved the mechanical strength by 30.2% compared to pure PCL. The fabricated PCL/G scaffolds also showed fine cell viability. In animal model, an abnormal electroencephalogram power spectrum and early signs of aging, such as hair graying and hair loss, were found in the group with a PCL/G scaffold compared to pure PCL scaffold. Neither of the abnormal symptoms caused death of all animals in both groups. The long-term use of graphene-derived biomaterials for in-vivo implants seems to be safe. But the comprehensive biosafety still needs further evaluation.

Carpal tunnel pressure is correlated with electrophysiological parameters but not the 3 month surgical outcome.

Tunnel pressure (TP) has been linked to carpal tunnel syndrome (CTS), but the clinical significance of TP is still under investigation. The present study included 58 hands that were diagnosed with idiopathic CTS by nerve conduction velocity (NCV) and received divisions of the flexor retinaculum through a mini-open procedure. Preoperative and postoperative TP were measured segmentally, and surgical outcomes were assessed by the Boston Symptom Severity Score for CTS before surgery and 3 months after surgery. We detected significantly increased TP in patients with CTS at 1.5-2.5 cm distal to the distal wrist crest (DWC), and the highest value was observed at 2 cm. Interestingly, there were still seven hands with a TP of > 30 mmHg at 3 cm distal to the DWC. The highest mean TP decreased from 52.7 mmHg to 7.8 mmHg after the operation. No patient had a pressure of >15 mmHg proximal to the DWC. The mean Boston Symptom Severity Score decreased from 3.1 to 1.8 at the 3-month follow-up. Although the highest preoperative TP was slightly correlated with the compound muscle action potential and was moderately correlated with the distal motor latency, the latency of the sensory nerve action potential and the sensory conduction velocity, highest preoperative TP could not predict the 3-month outcome. The correlations between the electrophysiological parameters and the highest TP in our series were stronger than previous reports; however, NCV is still better than TP as a tool for predicting the 3-month surgical outcome.

Metastatic carcinoma related long segment thoracic spinal epidural hematoma: a case report.

STUDY DESIGN: Case report. OBJECTIVE: To report a long segment epidural hematoma with thoracic cord compression caused by a metastatic carcinoma. SUMMARY OF BACKGROUND DATA: To our knowledge, there have been no previous reports of spontaneous spinal epidural hematoma caused by metastatic carcinoma. METHODS: A 60-year-old woman with back pain and progressive leg weakness suddenly developed complete paraplegia and anesthesia below T8. A thoracic spine MRI showed an epidural hematoma and metastatic tumor. We describe the clinical course, radiographic imaging, operative findings, and treatment results. RESULTS: Despite immediate surgery, the patient failed to have any significant improvement in her neurologic symptoms. A previously unsuspected primary lung tumor was diagnosed. She died 6 months after spine surgery. CONCLUSION: Spinal epidural hematoma can occur in association with metastatic tumors in that area.

Cerebral sinus thrombosis with intracerebral hemorrhage in pregnancy: a case report.

A 29-year-old woman who was pregnant for 12 weeks presented with headache for one week and drowsiness for two days. Computed tomography of the brain revealed multifocal hematomas with mass effect. Decompressive craniectomy was done to relieve the increased intracranial pressure. Magnetic resonance angiography and cerebral angiography were subsequently performed, both demonstrating thrombosis of the left transverse sinus. Treatment of sinus thrombosis generally includes correction of increased intracranial pressure and administration of anticoagulants, such as heparin. However, in this case heparin was contraindicated for the presence of intracranial bleeding, a clinical dilemma that requires careful considerations to balance treatment risks and benefits.

Delayed hemopericardium with constrictive pericarditis after blunt trauma: a report of a surgical case.

Constrictive pericarditis (CP) following hemopericardium has been reported in the literature but its pathogenesis is open to question. Proposed mechanisms include trauma leading to damage of the mesothelial lining resulting in decreased fibrinolytic activity in the presence of blood. We present a patient who sustained blunt thoracoabdominal trauma in a car accident and subsequently developed delayed hemopericardium leading to constrictive pericarditis and impending cardiac tamponade. We performed a pericardiectomy to relieve the compression. Closely prolonged monitoring and emergent operation are suggested for such kinds of delayed complications.