Human Dura Mater Research Articles

溶媒乾燥硬膜挿入によるＦｒｅｙ症候群の予防法

We attempted to prevent Frey's syndrome by using solvent dehydrated human dura mater in the closing procedure after parotidectomy. The area was covered by the dura and sutured. The presence or absence of symptome was noted subjectively and by Minor's method. One out of 17 patients reported a positive symptom during the observation period of 6 to 35 months.Neither foreign body reaction, infection nor other adverse reaction occured after the dura implantation. This method is useful in prevention of Frey's syndrome.

The resistance of the human dura mater to needle penetration.

An aneroid manometer attached to a needle during lumbar puncture for spinal anesthesia was used to record the pressure in the epidural space, and an attempt was made to define the moment the needle contacted and indented the dura mater. By measuring the distance the needle travelled after contact with the dura and before its actual perforation, it was determined that the dura mater indents 2-6 mm. The finding indicated that the dura mater is relatively resistant to puncture.

In vitro production and subsequent transplantation of a living skin substitute in rat model.

Three different transplants were generated for in vitro production of a living skin substitute in a rat animal model. In all cases epithelial cells from a small skin biopsy were grown in cell culture. Compound 1 consisted of cells outgrowing on lyophilized human dura mater. Compound 2 was fabricated with lyophilized porcine dermis. In compound 3 a lamella of dehydrated human fascia lata was seeded with epidermal cells. These skin substitutes were used to cover full-thickness skin defects. The production of a 6 cm2 substitute required 4-5 weeks time. After grafting autologous skin substitutes from compounds 1 and 2, vascularization and integration of the grafts failed to occur with 3 weeks. In contrast, transplantation of compound 3 resulted in the complete epithelialization of wound beds within 2-3 weeks accompanied by permanent integration of the skin substitute. Histological examination 1 year after grafting showed a dense, uniform structure of collagen fibers with an overlying epithelium of 4-6 cell layers. Secondary derivatives such as hair follicles and sweat glands were absent. When the fascia in compound 3 was replaced by a collagen lattice populated with cultured fibroblasts, transplantation results were unsatisfactory because of the deficient tensile strength of the collagen lattice.

Glycocalyceal bodies in a human rectal carcinoma cell line and their interstitial collagenolytic activities

In co-cultivation on a membrane of connective tissue matrix (CTM) obtained from human dura mater, human adenocarcinoma cells (RCM-1) degraded CTM. Morphologically, the destruction of CTM was associated with the shedding of membrane vesicles from the cells. Transmission electron microscopy, using ruthenium red (RR), showed that the shed vesicles were composed of various-sized membrane bound vesicles (MV). A large majority were small glycocalyceal bodies (G-bodies) measuring 20-120 nm in diameter, composed of an amorphous matrix of moderate electron-density surrounded by an RR-positive, trilaminar membrane. G-bodies were separated from medium-sized and large MVs by ultracentrifugation. Ultrastructural observation of the isolated collagen fibrils from CTM co-cultured with RCM-1 cells, showed G-bodies attached to degraded collagen fibrils with characteristic transverse notches along their axes. The lesions occurred as microerosions in the apolar region between the e and d bands of collagen fibrils. Collagenolytic activity in serum-free RCM-1 conditioned medium was localized in the G-body and MV fractions (80% and 20% of the total activity, respectively, when tested against 3H-labeled type I collagen). No activity was detected in the supernatant. The activity in G-bodies was also confirmed by ultrastructural analysis using reconstituted native type I collagen fibrils. The results suggest that RCM-1 cells release interstitial collagenase as a component of G-bodies which facilitates local breakdown of connective tissue during the process of invasion.

Fluorophores from aging human articular cartilage.

Human articular cartilages of various ages were digested with collagenase, and the fluorescence of the digests was measured as a function of age. At acidic pH, all collagenase-treated fractions were found to contain two main fluorophores with fluorescence maxima at 395 and 385 nm (excitation at 295 and 335 nm, respectively). Each fluorophore was isolated from the hydrolysate and its structure was deduced from spectral and chemical data. The 395/295 nm fluorophore was identified as pyridinoline, which is one of the non-reducible cross-linkages in collagen. The 385/335 nm fluorophore was identical to pentosidine, which was isolated from human dura mater and characterized by Sell and Monnier in 1989. Our results showed that the amount of pentosidine per collagen in human articular cartilage increases linearly with age (r = 0.929, p less than 0.005), while the amount of pyridinoline per collagen remained constant and was not correlated with age (r = 0.20). On the other hand, the amount of pentosidine per pyridinoline increased exponentially during life (r2 = 0.839, p less than 0.05).

Femoral vessel coverage with dura mater after inguinofemoral lymphadenectomy

Twenty patients undergoing inguinofemoral lymphadenectomy for vulvar malignancy had the femoral vessels covered with freezedried human cadaver dura mater; 5 patients had a radical vulvectomy and 15 had a modified radical vulvectomy, and a total of 38 groins were explored. The dura mater was sutured to the inguinal ligament, sartorius muscle fascia, and adductor longus muscle fascia. Three of the thirty-eight wounds had wound breakdown uncovering the dura mater; each of the groins healed satisfactorily by secondary intention without exposing the femoral vessels. Three patients developed cellulitis without wound breakdown and three patients developed lymphocysts. All groin wounds have healed completely and there have been no delayed complications. The mean follow up was 12.5 months (range, 2–30 months). Coverage of the femoral vessels with dura mater after inguinofemoral lymphadenectomy appears to be a safe and effective alternative to the technically more difficult and more time-consuming sartorius muscle transplant.

Evaluation of NaOH treatment of human dura mater implants to obviate Creutzfeldt- Jakob Disease transmission

One of the few disinfectants known to inactivate the causative agent of Creutzfeldt-Jakob Disease is NaOH. In this study, NaOH was evaluated as a possible routine treatment for human dura mater alloimplants. Use of high concentration NaOH (1 M) resulted in protein loss and macroscopic changes to the tissue. Lower concentrations (0.1 M), although exhibiting little direct detrimental effect, greatly increased the susceptibility of the tissue to collagenase digestion. The use of NaOH treated commercial or institutionally prepared human dura mater should be approached with caution.

Precautions Prevent Spread of Creutzfeldt-Jakob Disease

Currently some experts are predicting the incidence of the rare yet rapidly fatal Creutzfeldt-Jakob disease (CJD) is on the rise. Worldwide, there is about one case per million people per year, but iatrogenic transmission is increasing. There have been documented cases of CJD transmission through corneal transplants, stereotactic equipment, human growth hormone and dura mater grafts. In addition, there are now three cases of laboratory workers with CJD from exposure in the workplace. No known treatment alters the relentless course of CJD and there is no vaccine. In every rapidly progressive unexplained dementia CJD must remain a diagnostic possibility. Because the etiologic agent is virulent, definition of necessary precautions for staff members associated with such patients is needed. Thus it is imperative medical personnel be well trained in the practice of universal precautions.

Structural changes in implanted cardiac valvular bioprostheses constructed of glycerol-treated human dura mater

Histological, scanning and transmission electron microscope studies were made of normal human dura mater and cardiac valvular bioprostheses made of glycerol-treated human dura mater recovered after having been implanted in the aortic position (8 patients) or the mitral position (1 patient) for periods up to 4 years. Human dura mater has two layers: an inner or meningeal layer and an outer or endosteal layer. The surface of the inner layer is smoother than that of the outer layer. Both layers are composed mainly of large, wavy collagen fibrils (which are thought to correspond to type I collagen) and are relatively poor in elastic fibers and proteoglycans. Small calcific deposits were found in normal dura from older patients. Changes occurring in dura mater bioprostheses within 2 days after implantation consisted mainly of small surface thrombi. Calcific nodules, degenerated collagen and evidence of penetration of erythrocytes and plasma proteins into the cusps were observed in bioprostheses that had failed after being in place for 1-4 years. The calcific deposits and the degenerated collagen appeared structurally similar to those in glutaraldehyde-treated porcine aortic valvular bioprostheses. However, collagen fibrils in the latter were smaller than those in dura mater. Platelet aggregates on the cuspal surfaces were much less numerous in dura mater bioprostheses than in porcine aortic valvular bioprostheses. It is postulated that this difference is a function of the size of the collagen fibrils in the bioprostheses and that this accounts for the very low incidence of clinically evident thromboembolism in patients with implanted dura mater valves.

Immunohistochemical expression of glutathione S-transferase placental type (GST-π), a detoxifying enzyme, in normal arachnoid villi and meningiomas

Human normal dura mater containing arachnoid villi were examined for their expression of glutathione S-transferase placental type (GST-pi), a detoxifying enzyme, using an immunohistochemical method. All of the arachnoid villi and arachnoid cells in five normal cases were found to have expression of GST-pi, although no positive reaction for the enzyme was present in other tissues of the dura mater. The results show a possible role for arachnoid tissues in protecting human brain from hazardous xenobiotics in the cerebrospinal fluid. Twenty-six meningiomas were also examined for expression of the enzyme. Tissues of meningotheliomatous meningiomas were always positive for expression of the enzyme. Transitional meningiomas also showed the expression in their meningotheliomatous components. No staining reaction of GST-pi was recognized in fibroblastic meningiomas except for two cases with a tendency to meningotheliomatous differentiation. The findings suggest a functional similarity between the arachnoid tissues and meningotheliomatous components of meningiomas.

Orientation of Fibers in Human Dorsal Lumbar Dura Mater in Relation to Lumbar Puncture

Longitudinal insertion of a lumbar puncture needle bevel is less likely to cause post-lumbar puncture headache than is transverse insertion. The reason for this has not been entirely clear. We investigated the direction of dural fibers in posterior L3-4 dura mater obtained from three autopsies and tallied it in three orthogonal planes. Under low-power light microscopy the tissue appeared to be composed of lamellae branching irregularly and directed concentrically to the spinal cord. Electron micrographs (x5000) revealed that the lamellae consisted mainly of bundles of collagen fibers that pursued wavy courses in various directions. The lamellae also contained branching elastic fibers, many of which were directed longitudinally. This arrangement of fibers probably minimizes the tendency of a dural puncture hole to gape under tension if the needle bevel is directed longitudinally.

Relationship of Invasiveness to Proliferating Activity and to Cytoskeletal Protein Production in Human Neuroepithelial Tumors Maintained in an Organ Culture System: Use of Human Cortex and Dura as Supporting Matrices

Abstract The proliferation and invasiveness of cultured human neuroepithelial tumors were studied. A human malignant astrocytic glioma cell line (U-251 MG) and a medulloblastoma cell line (D283 Med) were maintained for 3 weeks in an organ culture system using adult human brain cortex, dura mater, or Gelfoam sponge as growth matrices. The cells were labeled with bromodeoxyuridine (BrdU) at different time points, and immunohistochemistry was performed for BrdU, glial fibrillary acidic (GFA) protein (in U-251 MG), and neurofilament (NF) protein (in D283 Med). In the U251 MG line, the cells grew successfully in each matrix, forming a fibrillated solid area and a peripheral zone of invasion. The labeling index (LI) expressed as the percentage of BrdU-labeled cells and the percentage of GFA protein-positive cells in the two zones of the explants were analyzed. The LIs in all cultures were significantly higher in the peripheral than in the central zones. On the other hand, the percentage of GFA protein-positive cells in each matrix was greater in the central zone than in the periphery. The LI was inversely correlated with the percentage of GFA protein-positive cells over the areas counted in each growth matrix. GFA protein production in cells grown on cortex and on dura mater was significantly higher than that in cells grown on Gelfoam. In the D283 Med line, the cells formed an aggregated zone, with peripheral cells infiltrating the Gelfoam. This line showed poor growth on human cortex. Cells grown on the dura demonstrated an LI similar to that on Gelfoam, and cells often infiltrated the dura. The LI of these cells was higher in the peripheral than in the central zone of the explants, both on dura and on Gelfoam. The cells showed variable immunopositivity for each NF protein subunit. No apparent difference in the percentage of immunopositive cells for each NF protein subunit was detected between cells grown on dura and on Gelfoam; however, cells grown on dura often demonstrated neurite-like processes. The results indicate that an organ culture system using human brain cortex or dura mater as matrices for in vitro growth is a promising tool for the study of neuroglial differentiation and of the invasiveness of cultured human neuroepithelial tumors.

Relationship of invasiveness to proliferating activity and to cytoskeletal protein production in human neuroepithelial tumors maintained in an organ culture system

The proliferation and invasiveness of cultured human neuroepithelial tumors were studied. A human malignant astrocytic glioma cell line (U-251 MG) and a medulloblastoma cell line (D283 Med) were maintained for 3 weeks in an organ culture system using adult human brain cortex, dura mater, or Gelfoam sponge as growth matrices. The cells were labeled with bromodeoxyuridine (BrdU) at different time points, and immunohistochemistry was performed for BrdU, glial fibrillary acidic (GFA) protein (in U-251 MG), and neurofilament (NF) protein (in D283 Med). In the U-251 MG line, the cells grew successfully in each matrix, forming a fibrillated solid area and a peripheral zone of invasion. The labeling index (LI) expressed as the percentage of BrdU-labeled cells and the percentage of GFA protein-positive cells in the two zones of the explants were analyzed. The LIs in all cultures were significantly higher in the peripheral than in the central zones. On the other hand, the percentage of GFA protein-positive cells in each matrix was greater in the central zone than in the periphery. The LI was inversely correlated with the percentage of GFA protein-positive cells over the areas counted in each growth matrix. GFA protein production in cells grown on cortex and on dura mater was significantly higher than that in cells grown on Gelfoam. In the D283 Med line, the cells formed an aggregated zone, with peripheral cells infiltrating the Gelfoam. This line showed poor growth on human cortex. Cells grown on the dura demonstrated an LI similar to that on Gelfoam, and cells often infiltrated the dura.(ABSTRACT TRUNCATED AT 250 WORDS)

Plasty of tendon with dura mater

The authors present an experimental study of 30 rats, in which human dura mater preserved in glycerin was used to repair gaps in the Achilles tendon. The animals were killed 8 weeks after the surgery and evaluated by gross and microscopic examination. The results showed that the dura mater did not cause foreign-body reactions or adhesions and was surrounded by concentric layers of fibroblasts and collagen fibers, suggesting that it could be employed as a substitute for damaged tendons.

Comparative study of lyophilized human dura mater and lyophilized bovine pericardium as dural substitutes in neurosurgery

In a prospective, controlled randomized study either lyophilized bovine pericardium or lyophilized human dura mater have been used as a patch for the closure of the dura in 102 patients. The aim of this investigation was to compare both materials in terms of immunogenic response of the patients. The rate of post-operative complications was comparably low in both groups (wound infection in 1/51 patients each). In regard of workability, thickness of the material and flexibility the pericardium patches were judged to be by far superior. Neither signs of a cellular nor of an intesified humoral response could be detected in patients who received the pericardium implants. Thus, lyophilized bovine pericardium seems to be a superior alternative for the surgical repair of dural defects.

Cadaveric dura mater graft for correctionof penile curvature in peyronie disease

The use of autologous human dura mater as a graft material in 7 cases of Peyronie disease is described. In 3 cases, preoperative erectile ability was thought to be inadequate, and a penile prosthesis was simultaneously inserted. No complications occurred related to the graft material although 1 patient has inadequate erections postoperatively and another appears to have recurrent Peyronie disease.

Orientation of Fibers in Human Dorsal Lumbar Dura Mater in Relation to Lumbar Puncture

Longitudinal insertion of a lumbar puncture needle bevel is less likely to cause post-lumbar puncture headache than is transverse insertion. The reason for this has not been entirely clear. We investigated the direction of dural fibers in posterior L3-4 dura mater obtained from three autopsies and tallied it in three orthogonal planes. Under low-power light microscopy the tissue appeared to be composed of lamellae branching irregularly and directed concentrically to the spinal cord. Electron micrographs (x5000) revealed that the lamellae consisted mainly of bundles of collagen fibers that pursued wavy courses in various directions. The lamellae also contained branching elastic fibers, many of which were directed longitudinally. This arrangement of fibers probably minimizes the tendency of a dural puncture hole to gape under tension if the needle bevel is directed longitudinally.

A constitutive equation for the human dura mater encephali

A constitutive equation for the human dura mater encephali

Pathology of bioprosthetic cardiac valves

.A description of the normal and abnormal anatomic features of bioprosthetic cardiac valves (BP) is ~rese~ted in this article, .with emphasis on cuspal calclficat~on. and perforatlo~, which are their major c~mphcatIons. The following types of bioprosthetic (tissue) heart valves are considered: porcine aortic valvular b~oprostheses (~erein referred to as porcine BPs); bovme and porcme parietal pericardial BPs; human dura mater valves; fascia lata valves and human aortic homografts. '

Chronic Subdural Hematoma after External Decompression in Traumatic Intracranial Hematoma

Two cases of chronic subdural hematoma after craniotomy, removal of the hematoma, dural plasty using lyophilized human cadaver dura mater, and external decompression for acute traumatic intracranial hematoma are reported. One of these was acute subdural hematoma and the other acute epidural hematoma. The pathophysiology of the chronic subdural hematoma in these two cases was considered to be: collection of a mixture of cerebrospinal fluid and blood in the subdural space caused by torn arachnoid at head injury or craniotomy, and unbalanced volume between the brain and subdural space caused by excessive dural plasty and intracranial hypotension due to external decompression. Opening and irrigation of the hematoma cavity were sufficient treatment at cranioplasty.