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Cell Reports. Medicine Aug 2023We describe a general approach to produce bone and cartilaginous structures utilizing the self-regenerative capacity of the intercostal rib space to treat a deformed...
We describe a general approach to produce bone and cartilaginous structures utilizing the self-regenerative capacity of the intercostal rib space to treat a deformed metacarpophalangeal joint and microtia. Anatomically precise 3D molds were positioned on the perichondro-periosteal or perichondral flap of the intercostal rib without any other exogenous elements. We find anatomically precise metacarpal head and auricle constructs within the implanted molds after 6 months. The regenerated metacarpal head was used successfully to surgically repair the deformed metacarpophalangeal joint. Auricle reconstructive surgery in five unilateral microtia patients yielded good aesthetic and functional results. Long-term follow-up revealed the auricle constructs were safe and stable. Single-cell RNA sequencing analysis reveal early infiltration of a cell population consistent with mesenchymal stem cells, followed by IL-8-stimulated differentiation into chondrocytes. Our results demonstrate the repair and regeneration of tissues using only endogenous factors and a viable treatment strategy for bone and tissue structural defects.
Topics: Humans; Ear Cartilage; Tissue Engineering; Congenital Microtia; Chondrocytes; Mesenchymal Stem Cells
PubMed: 37586324
DOI: 10.1016/j.xcrm.2023.101156 -
Progress in Brain Research 2024The period begins with the work of Richard Wiseman who was associated with royalists in the English Civil War. A little later Dionis was the first to note a relationship...
The period begins with the work of Richard Wiseman who was associated with royalists in the English Civil War. A little later Dionis was the first to note a relationship between a disturbance of consciousness and extravasation of blood. This notion was continued and expanded by Le Dran, Pott, and Benjamin Bell, with Pott providing a pathophysiological explanation of the phenomenon. Daniel Turner commented on how confusing Galenic teaching was on the topic of consciousness. Heister further emphasized the relationship between clinical disturbance and the extravasation of blood. Le Dran stated that symptoms following cranial trauma related to cerebral injury, an opinion supported by Pott and never subsequently challenged. Latta noted the importance of meningeal arteries in the development of hematomas. Benjamin Bell considered trepanation only appropriate for a clinical deterioration consistent with hemorrhagic extravasation. The two Irish surgeons made it clear that the presence of periosteal separation was not in fact a reliable indicator of an extravasation. The most striking change of instruments was disappearance of simple straight trepans with non-perforating tips for making small holes safely. The use of scrapers gradually declined as did that of lenticulars. There was a great debate about the value of a conical rather than a cylindrical crown. The former was said to be safer. But this opinion faded and the cylindrical crown became preferred. Another improvement in technique involved the use of constant probing to check the depth of the drilled groove.
Topics: Humans; History, 17th Century; History, 18th Century; History, 19th Century; Consciousness; Brain Injuries; Trephining
PubMed: 38705719
DOI: 10.1016/bs.pbr.2024.02.016 -
Journal of Plastic, Reconstructive &... Jul 2023Fibula Jaw-in-a-Day (JIAD) is considered the most advanced approach for segmental mandibular defect reconstruction and dental rehabilitation. However, it has limitations...
BACKGROUND
Fibula Jaw-in-a-Day (JIAD) is considered the most advanced approach for segmental mandibular defect reconstruction and dental rehabilitation. However, it has limitations and challenges for further pursuit. We propose Fibula Jaw-during-Admission (JDA) as a solution.
MATERIALS AND METHODS
From 2019 to 2021, six patients received fibula "Jaw-during-Admission." Segmental mandibulectomy, fibula transfer, and immediate dental implantation were performed simultaneously during a single surgery. Intraoral scans were used to fabricate temporary light occlusion contact dental prostheses while on the ward prior to discharge during the first and second week post operation. The prostheses were installed before discharge and changed to permanent ones with normal occlusal contact in the clinic at about six months after X-ray confirmation of bone healing.
RESULTS
All six surgeries succeeded. Four patients received palatal muco-periosteal graft after debridement of peri-implant overgrown granulation tissue. Follow-up ranged from 12 to 34 months (average 21.2 months) and revealed good function and appearance in all patients.
CONCLUSION
Fibula JDA is superior to the Fibula JIAD approach for simultaneous mandibular reconstruction with fibula and dental rehabilitation. There is no need for postoperative intermaxillary fixation. The surgery can be performed more reliably with less stress. It provides an additional opportunity for dental rehabilitation if initial dental prosthesis installation during JIAD fails. Postreconstruction intraoral scans provide greater precision and more flexibility in milling dental prosthesis which are mapped to the reconstructed mandible during the postoperative period.
Topics: Humans; Fibula; Mandible; Plastic Surgery Procedures; Mandibular Osteotomy; Mandibular Reconstruction; Bone Transplantation; Dental Implantation, Endosseous; Free Tissue Flaps
PubMed: 37207438
DOI: 10.1016/j.bjps.2023.01.010