bromochloroacetic-acid and Rupture

Epidermoid cysts of the spinal cord may rupture, resulting in keratin dissemination in the subarachnoid space, in the ventricles, and along the central canal of the spinal cord causing meningitis, myelopathic changes, or hydrocephalus.. A 53-year-old woman with no past medical history presented with a 2-week history of headache located in the occipital region associated with neck pain. Brain magnetic resonance imaging demonstrated multiple fat droplets scattered throughout the subarachnoid and intraventricular spaces with significant edema of the right posterior temporoparietal lobes with trapping of the right temporal horn of the lateral ventricle and atrium. An intracranial lesion could not be observed in the study. The spinal region was suspected as the possible culprit, and spinal imaging showed a large cystic lesion at the level of the conus medullaris. The patient underwent neuronavigation endoscopic exploration of the right lateral ventricle with flushing of the keratin particles followed by a posterior lumbar decompression with resection of the epidermoid cyst. Pathology was consistent with an epidermoid cyst. Successful recovery with improvement in symptoms was quickly observed.. When an epidermoid cyst is suspected but no intracranial lesion is found, the intraspinal area should be studied. Rupture of a spinal epidermoid cyst may cause meningitis and inflammation producing obstructive hydrocephalus. We present this rare entity and describe the diagnostic and surgical techniques used.

Topics: Cerebral Ventricles; Decompression, Surgical; Endoscopy; Epidermal Cyst; Female; Humans; Hydrocephalus; Keratins; Magnetic Resonance Imaging; Meningitis; Middle Aged; Neuronavigation; Neurosurgical Procedures; Rupture; Spinal Diseases; Subarachnoid Space; Treatment Outcome

Massive rotator cuff tears (MRCTs) represent a major clinical concern, especially when degeneration and chronicity are involved, which highly compromise healing capacity.. To study the effect of the secretome of mesenchymal stem cells (MSCs) on tendon cells (TCs) followed by the combination of these activated TCs with an electrospun keratin-based scaffold to develop a tissue engineering strategy to improve tendon-bone interface (TBi) healing in a chronic MRCT rat model.. Controlled laboratory study.. Human TCs (hTCs) cultured with the human MSCs (hMSCs) secretome (as conditioned media [CM]) were combined with keratin electrospun scaffolds and further implanted in a chronic MRCT rat model. Wistar-Han rats (N = 15) were randomly assigned to 1 of 3 groups: untreated lesion (MRCT group, n = 5), lesion treated with a scaffold only (scaffold-only group, n = 5), and lesion treated with a scaffold seeded with hTCs preconditioned with hMSCs-CM (STC_hMSC_CM group, n = 5). After sacrifice, 16 weeks after surgery, the rotator cuff TBi was harvested for histological analysis and biomechanical testing.. The hMSCs secretome increased hTCs viability and density in vitro. In vivo, a significant improvement of the tendon maturing score was observed in the STC_hMSC_CM group (mean ± standard error of the mean, 15.6 ± 1.08) compared with the MRCT group (11.0 ± 1.38; P < .05). Biomechanical tests revealed a significant increase in the total elongation to rupture (STC_hMSC_CM, 11.99 ± 3.30 mm; scaffold-only, 9.89 ± 3.47 mm; MRCT, 5.86 ± 3.16 mm; P < .05) as well as a lower stiffness (STC_hMSC_CM, 6.25 ± 1.74 N/mm; scaffold-only, 6.72 ± 1.28 N/mm; MRCT, 11.54 ± 2.99 N/mm; P < .01).. The results demonstrated that hMSCs-CM increased hTCs viability and density in vitro. Clear benefits also were observed when these primed cells were integrated into a tissue engineering strategy with an electrospun keratin scaffold, as evidenced by improved histological and biomechanical properties for the STC_hMSC_CM group compared with the MRCT group.. This work supports further investigation into the use of MSC secretome for priming TCs toward a more differentiated phenotype, and it promotes the tissue engineering strategy as a promising modality to help improve treatment outcomes for chronic MRCTs.

Topics: Animals; Bone and Bones; Cell Survival; Culture Media, Conditioned; Humans; Keratins; Male; Mesenchymal Stem Cell Transplantation; Mesenchymal Stem Cells; Random Allocation; Rats; Rats, Wistar; Rotator Cuff; Rotator Cuff Injuries; Rupture; Tendons; Tissue Engineering; Tissue Scaffolds

Both the centrifugal keratin dispersion on the pars tensa as well as the centripetal proliferative properties at the inferior annular tympanic region are discussed. There is evidence, histological and clinical, that these features are two distinct and different phenomena which both have clinical implications. While the centrifugal keratin dispersion is a physiological cleaning mechanism, the cytokeratin expression demonstrates the unusual but for years clinically noticed proliferative nature of the lower annular epithelium and provides biochemical evidence for a relationship between this epithelium and cholesteatoma formation.

Topics: Cell Movement; Cholesteatoma; Culture Techniques; Ear Diseases; Epithelial Cells; Humans; Keratins; Rupture; Tympanic Membrane

Topics: Acne Vulgaris; Cysts; Edema; Folliculitis; Hair; Humans; Hyperplasia; Keratins; Male; Rupture; Sebaceous Glands; Skin