Three-dimensional Printed Polylactic Acid and Hydroxyapatite Composite Scaffold with Urine-derived Stem Cells Treatment for Bone Defects

BACKGROUND: Bone defects still pose various challenges in osteology. As one of the treatment options for bone defects, bone tissue engineering requires biomaterials with good biocompatibility and seed cells with good differentiation capacity. This study aimed to fabricate a 3D-printed polylactic acid and hydroxyapatite (PLA/HA) composite scaffold with urine-derived stem cells (USCs) to study its therapeutic effect in a model of skull defect in rats.METHODS: USCs, isolated and extracted from the urine of healthy adult males, were inoculated onto a 3D-printed PLA/HA composite scaffold and a PLA scaffold. Skull defect model rats were randomly divided into three groups (control, PLA, and PLA/HA). Twelve weeks after implanting scaffolds containing USCs into rats with a skull defect, the therapeutic efficacy was evaluated by real-time PCR, micro-CT, histology, and immunohistochemistry.RESULTS: The 3D-printed PLA/HA composite scaffold had good mechanical properties and porosity. The adhesion and proliferation of USCs on scaffolds also demonstrated excellent biocompatibility. PLA and PLA/HA containing USCs promoted bone regeneration in the defect area, supported by the general observation and CT images at 12 weeks after treatment, with coverage of 74.6%±1.9% and 96.7%±1.6%, respectively. Immunohistochemical staining showed a progressive process of new bone formation on PLA/HA scaffolds containing USCs at the defect site compared to that in PLA and control groups.CONCLUSION: The 3D-printed PLA/HA composite scaffold with USCs was successfully applied to the skull defect in rats. Under the linkage of the scaffold, the proliferation, differentiation, and osteogenesis expression of USCs were promoted near the bone defect area. These findings demonstrated broad application prospects of PLA/HA scaffolds with USCs in bone tissue engineering.

Atypical Presentation of Frontoethmoidal Encephaloceles in a Child - A Case Report

Encephalocele is a form of neural tube defect affecting many children, more common in the occipital regions. The frontoethmoidal encephaloceles (FEE) are rare and the aetiology is unclear since it varies genetically and is linked to multiple reasons. The child with FEE mainly presents with swelling over the bridge of the nose or inner canthus of an eye since birth, with varying degrees of hypertelorism. Here we report a child who has facial asymmetry with FEE. Encephalocele is a defect in the calvarium that causes the cranial contents to protrude outside the natural limits of the skull. It can have meninges (meningocele), brain matter and meninges (meningoencephalocele), or communication with the ventricles. Suwanwela and Suwanwela defined encephaloceles based on the location and form of skull defect as occipital encephaloceles, cranial vault encephaloceles, frontoethmoidal encephaloceles, and basal encephaloceles. The internal skull defect in frontoethmoidal encephalocele (FEE) is in the midline, but the external skull defect may vary in the facial bony structure. 1–3 It is also classified into three subtypes: nasofrontal (NF), naso-ethmoidal (NE), and naso-orbital (NO). These swellings are classified as sessile or pedunculated, and their palpability ranges from robust and rigid to soft and cystic. We present a case of an infant with frontoethmoidal encephaloceles as well as a facial deformity.

HAZARDS OF TITANIUM MESH CRANIOPLASTY – OUR EXPERIENCE

INTRODUCTION: Titanium is biologically inert, hard, rigid, strong, durable, light-weight, resistant to infection, easy to handle and relatively inexpensive, hence frequently used as the material of choice for cranioplasty. But at the same time there is signicant rate of complications, most commonly infection, poor cosmesis, hematoma, headache, seizure and implant exposure necessitating re-operation and implant removal. MATERIALS AND METHODS: The present study was conducted in the department of neurosurgery, Bangur Institute of Neurosciences(B.I.N), Kolkata & SSKM Hospital, IPGME & R, Kolkata from January 2019 to December 2020. The study design was non-randomized prospective observational study. The period of study was 2 years. The sample size was 30. OBSERVATIONS AND RESULTS: Total 30 patients underwent cranioplasty. Their mean age was 38 years (range, 20-62 years) with a male:female ratio of 3:2. Ten patients developed postoperative complications, making a cranioplasty complication rate of 33.34%. Out of 10 patients, 5 (50%) required further surgical procedure including 4 cases of cranioplasty removal, the overall removal rate of 13.34%. Overall mortality was nil. CONCLUSION: Titanium mesh cranioplasty though a very common procedure used for correction of craniectomy skull defect is not totally free from complication. Our present study analyse the various causative factors which may lead to complications and implant failure. We have to be very judicious in the use of materials and other modalities used for skull defect repair depending upon the current materials available, the patient's general condition, co-morbidity, their economic status and modality of surgery.

PERSISTENT EMBRYONIC FALCINE SINUS PRESENTING AS ATRETIC PARIETAL CEPHALOCELE: CASE REPORT

Cephaloceles are congenital neural tube defect causing herniations of intracranial structures (dura, brous tissue and dysplastic brain tissue) through a skull defect. Frequently associated with other intracranial anomalies like grey matter heterotopia, Vein of Galen malformations, Ventriculomegaly, Walker–Warburg syndrome, lobar holoprosencephaly, Dandy–Walker syndrome, hypogenesis of the corpus callosum, interhemispheric cysts, microphthalmia, and retro-ocular cysts.We are presenting a rare case of persistent embryonic sinus presenting with parietal cephalocele.