Parietal Bone Research Articles

Follow up of infants with skull fractures by neurosurgeons due to the risk of growing fractures; is it needed?

Introduction Growing skull fractures are a rare complication of paediatric skull fractures. Despite its rarity, a large proportion of resources go towards detecting this complication. This study aims to identify the factors associated with growing skull fracture development to determine which children require follow-up. Materials and methods This was a single-centre retrospective study examining the referral data from all patients under one years old referred with head trauma between 2013 and 2023 (n = 246). Of these patients 189 sustained skull fractures, with two requiring surgery for a growing skull fracture. Referral data for all head injuries between 2008 and 2013 was unavailable but surgical records were accessed for the only case of a child who developed a growing skull fracture in this time period. Each fracture was analysed using the commuted tomography (CT) head for its characteristics, including fracture splay distance and fracture elevation/depression. Results A total of 190 cases were reviewed, which showed a male to female ratio of 1.6:1. The majority of patients presented prior to one month of age and the most common mechanism of injury was a fall (80%). The most common fracture sustained was a linear fracture (87.4%). Of all fractures, the most common bone affected was the parietal bone (88.4%). Of those who developed a growing skull fracture, there was a significant difference in both the fracture splay distance (p < .05) and fracture elevation/depression distance (p < .05). All three patients who had growing skull fractures had a fracture splay distance above 5 mm at presentation and an elevation/depression of over 4 mm. 32% of children (n = 61) who had fractures had follow-up, with only nine having a fracture diastasis over 4mm. Conclusion Resources and investigations should focus on children with fracture displacement over 4mm and/or elevation/depression distance of over 3mm, as they are at significantly greater risk of growing skull fracture development.

Fibrous Dysplasia of Parietal Bone: A Case Report and Review of Literature

Fibrous Dysplasia of Parietal Bone: A Case Report and Review of Literature

Computed tomography study of cranial vault thickness in Malaysian subadult population.

Cranial vault thickness (CVT) and its variations provide valuable insights into an individual's biological attributes such as age and sex. This paper aimed to assess the correlations of CVT with age and sex and develop a regression model for age estimation in Malaysian subadults using computed tomography (CT) images. A total of 521 CT images (male/female: 279/242; age range: 0-20 years; Malay/Chinese/Indian: 221/145/155) were included in the study. Correlations of CVT measurements with age and sex, including frontal bone thickness (FBT), occipital bone thickness (OBT), left parietal bone thickness (LPBT), and right parietal bone thickness (RPBT) were assessed and regression formulae were developed for age estimation in subadults. A significant correlation between CVT measurements and age was demonstrated (p < 0.001). Age estimation was most accurate in the younger age group (< 2 years) at frontal and occipital, and accuracy decreases in the older age groups. Additionally, sexual dimorphism was evident in the frontal and parietal bone thickness within the age range of 3-6 years and 16-20 years, respectively. In conclusion, the findings suggested CVT measurements could be used to corroborate other age estimation methods for subadults.

023. Isolated Calvarial Tuberculosis in An Immunocompromised Patient: A Case Report

Background: Isolated Calvarial tuberculosis is a rare occurrence, first reported by Reid in 1842, with majority of cases (75-90%) appearing under the age group of 20-30 years and involving frontal and parietal bones because of the greater amount of cancellous bone with diploic channels. The Human Immunodeficiency Virus (HIV) Infection is currently a huge threat to Indonesia, with Tuberculosis (TB) infection is one example of opportunistic infection that can lead to death in People living with HIV. The objective of this article is to report a rare case of Isolated Calvarial Tuberculosis in an Immunocompromised Patient Case: A 26-year-old male, known to be immunocompromised with HIV infection, presented to hospital with chief complaint of a painless lump on the left temple since 1 month prior. Head CT-Scan examination revealed osteolytic appearance in the left frontal area and swelling of the surrounding soft tissue. The patient then underwent surgery with intraoperative findings of a cystic mass filled with yellowish fluid. A craniotomy of the surrounding healthy bone including the dura mater and excision of the overlying soft tissue were performed, and histopathological result revealed a chronic tuberculosis inflammation. Conclusion: Calvarial Tuberculosis is a rare form of skeletal tuberculosis occurring in younger population, but can also present in older patient with immunocompromised state, that present with main complaint of painless swelling or lump in the frontal or parietal area because of its favourable bone structure. Diagnostic including X-ray and CT-Scan with microbiologic findings of multiple epithelioid granulomas with Langerhans type giant cells. Preferred treatment including both surgical and antituberculosis therapy to achieve favourable outcome.

Tubercular Osteomyelitis of Skull: Case Report and Review of the literature

Skeletal tuberculosis constitutes about 1j of all cases. Usually, spine and limb bones are involved. Tubercular osteomyelitis of the skull is a rare entity; therefore, diagnosis is rarely suspected. We report one such rare case of an atypical calvaria skull osteomyelitis in a14 years old female who presented with swelling on the right frontoparietal region for 3 months. CT scan of brain and bony window revealed a lytic bony lesion at the right parietal bone with associated epidural soft tissue component at the right parietal top causing compression over adjacent parenchyma- possibly eosinophilic granuloma or chronic osteomyelitis. Patient was treated surgically by excision of the lesion with cranioplasty by synthetic bone cement. After surgical treatment, the specimen was sent for histopathology which showed granulomatous inflammation histologically consistent with tuberculosis. She was treated with antitubercular therapy. Our Case highlights all these aspects of skull tuberculosis with review of the available literature relevant to skull tubercular osteomyelitis. EWMCJ Vol. 12, No. 1&amp;2, January-July 2024: 111-119

Topiramate Inhibits Capsaicin-Induced Mast Cell Degranulation and CGRP Release in Rat Dura Mater

Background/Objectives: Migraine is a disease that stands out for its high prevalence and socioeconomic costs. It involves the entire trigeminovascular system, the signaling substances, and their targets. However, the role of meningeal mast cells in migraine is still unclear. To better understand one of the components of neurogenic inflammation underlying migraine pathophysiology, we developed an in vivo rat model in which the dura mater was exposed bilaterally to investigate the influence of topiramate on capsaicin-induced mast cell degranulation and CGRP release from dura mater. Methods: On the day of the experiment, rats were anesthetized, and a craniectomy was performed on each parietal bone. Test substances were applied in situ over the dura mater using the right and left sides of the dura mater for the test and control, respectively. After exposure, the dura mater was processed for mast cell staining and counting. Using this setup, the effect of capsaicin (10−3 M) was evaluated in rats of both sexes, and subsequently the effect of in situ (10−3 M, 20 µL) and (20 mg/kg/day for 10 days) topiramate treatment on mast cell degranulation and CGRP release were evaluated. Results: In both female and male rats, there was a greater amount of degranulated mast cells in the side stimulated by capsaicin compared to the control side in both females (18 ± 3% vs. 74 ± 3%; p = 0.016) and males (28 ± 2% vs. 74 ± 3%, p = 0.016). In the group treated with topiramate for 10 days prior to the experiments, capsaicin did not induce mast cell degranulation (control 20 ± 1% vs. capsaicin 22 ± 1%, p = 0.375) in contrast to animals treated for 10 days with gavage control (control 25 ± 1% vs. capsaicin 76 ± 1%, p = 0.016). Topiramate applied in situ concomitant with capsaicin did not protect the mast cells from degranulation in response to capsaicin (38 ± 2% vs. 44 ± 1%, p = 0.016). There was a significant reduction in CGRP release from the dura mater in the group treated with topiramate for 10 days compared to the control. Conclusions: This study demonstrates a novel experimental model wherein systemic administration of topiramate is observed to modulate the impact of capsaicin on meningeal mast cell degranulation.

Injectable calcium phosphate cement integrated with BMSCs-encapsulated microcapsules for bone tissue regeneration

Injectable calcium phosphate cement (CPC) offers significant benefits for the minimally invasive repair of irregular bone defects. However, the main limitations of CPC, including its deficiency in osteogenic properties and insufficient large porosity, require further investigation and resolution. In this study, alginate-chitosan-alginate (ACA) microcapsules were used to encapsulate and deliver rat bone mesenchymal stem cells (rBMSCs) into CPC paste, while a porous CPC scaffold was established to support cell growth. Our results demonstrated that the ACA cell microcapsules effectively protect the cells and facilitate their transport into the CPC paste, thereby enhancing cell viability post-implantation. Additionally, the ACA + CPC extracts were found to stimulate osteogenic differentiation of rBMSCs. Furthermore, results from a rat cranial parietal bone defect model showed that ACA microcapsules containing exogenous rBMSCs initially improved thein situosteogenic potential of CPC within bone defects, providing multiple sites for bone growth. Over time, the osteogenic potential of the exogenous cells diminishes, yet the pores created by the microcapsules persist in supporting ongoing bone formation by recruiting endogenous cells to the osteogenic sites. In conclusion, the utilization of ACA loaded stem cell microcapsules satisfactorily facilitate osteogenesis and degradation of CPC, making it a promising scaffold for bone defect transplantation.

Anomalous bipartite parietal bone variant mimicking fracture in a human skull-A case report

The proper growth of the skull depends on the cranial sutures. There have been references in the literature to the occurrence of bipartite, tripartite and quadripartite parietal bones. Regular ante mortem and postmortem investigations may reveal these fracture-mimicking anatomical variations, which might change the path of the diagnosis and medico legal certification. Therefore, having sufficient knowledge about the occurrence of these abnormal suture variations will improve both postmortem and ante mortem diagnosis. In this case study, the genesis and clinical relevance of a unilateral bipartite parietal bone discovered in a museum specimen are discussed.

Synthetic Bone Blocks Produced by Additive Manufacturing in the Repair of Critical Bone Defects.

This study evaluated the efficacy of synthetic bone blocks, composed of hydroxyapatite (HA) or β-tricalcium phosphate (B-TCP), which were produced by additive manufacturing and used for the repair of critical size bone defects (CSDs) in rat calvaria. Sixty rats were divided into five groups (n = 12): blood clot (CONTROL), 3D-printed HA (HA), 3D-printed β-TCP (B-TCP), 3D-printed HA + autologous micrograft (HA+RIG), and 3D-printed β-TCP + autologous micrograft (B-TCP+RIG). CSDs were surgically created in the parietal bone and treated with the respective biomaterials. The animals were euthanized at 30 and 60 days postsurgery for microcomputed tomography (micro-CT) histomorphometric, and immunohistochemical analysis to assess new bone formation. Micro-CT analysis showed that both biomaterials were incorporated into the animals' calvaria. The HA+RIG group, especially at 60 days, exhibited a significant increase in bone formation compared with the control. The use of 3D-printed bioceramics resulted in thinner trabeculae but a higher number of trabeculae compared with the control. Histomorphometric analysis showed bone islands in close contact with the B-TCP and HA blocks at 30 days. The HA blocks (HA and HA+RIG groups) showed statistically higher new bone formation values with further improvement when autologous micrografts were included. Immunohistochemical analysis showed the expression of bone repair proteins. At 30 days, the HA+RIG group had moderate Osteopontin (OPN) staining, indicating that the repair process had started, whereas other groups showed no staining. At 60 days, the HA+RIG group showed slight staining, similar to that of the control. Osteocalcin (OCN) staining, indicating osteoblastic activity, showed moderate expression in the HA and HA+RIG groups at 30 days, with slight expression in the B-TCP and B-TCP+RIG groups. The combination of HA blocks with autologous micrografts significantly enhanced bone repair, suggesting that the presence of progenitor cells and growth factors in the micrografts contributed to the improved outcomes. It was concluded that 3D-printed bone substitute blocks, associated with autologous micrografts, are highly effective in promoting bone repair in CSDs in rat calvaria.

Acalvaria, rare congenital malformation in palestine: case report and literature review

Introduction and Importance: Acalvaria is a rare congenital anomaly characterized by absent cranial vault bones, often misdiagnosed as anencephaly or encephalocele. Case Presentation: We present a case of a 10-day-old male neonate with Acalvaria, delivered normally at 37+5 weeks, with a birth weight of 2.7 kg and dysmorphic features including low-set ears and a sandal gap. Skull X-ray revealed absent parietal, temporal, and frontal bones. Initially admitted for potential sepsis, he has since shown normal development at three months, with ongoing conservative management. Clinical Discussion: Acalvaria is a rare congenital malformation marked by the absence of cranial vault bones, dura mater, and scalp muscles. Our case presents partial calvaria absence with normal skull base, classified as primary acalvaria. Associated anomalies necessitate thorough evaluation for prognosis. Diagnosis can occur as early as 12 weeks gestation via ultrasound, but management remains conservative, focusing on supportive care and monitoring for potential surgical interventions later. Conclusion: Acalvaria is a rare, fatal anomaly requiring conservative management; antenatal care and psychological preparation are essential for affected families.

12460 Bilateral Parietal Thinning: A Rare Condition Of Unclear Etiology

Abstract Disclosure: T.L. Madsen-Barbosa: None. M. Cheikh: None. I. Marcano: None. Background: Bilateral parietal bone thinning (BPT) is an infrequent and often underdiagnosed condition characterized by the external thinning of the skull's parietal bone. The pathophysiology is unclear, but some studies suggest a link to osteoporosis. We present a case of osteoporosis diagnosed on evaluation of BPT. Case Description: A 77-year-old woman with a history of chronic kidney disease (CKD stage IV) and type 2 diabetes was referred to the Bone Health Clinic for evaluation of low bone density. She initially presented to Neurosurgery clinic for evaluation of head indentations. A dual energy x-ray absorptiometry (DEXA) scan showed values in osteopenia range (left total hip bone mineral density (BMD) 0.678 and T-score of -2.2, left femoral neck BMD 0.272 and T-score of -1.6, and left 33% radius BMD 0.577 and T-score of -2.0), leading to the referral. The patient reported painless indentations in the parietal bones that had been progressing for four years, with no history of head trauma, inflammatory disease, or prolonged steroid use. A head computed tomography (CT) scan showed symmetric thinning of the skull’s parietal bones, with an average thickness of 2.34 mm (compared to 5.1 mm four years earlier). Review of prior images also revealed a T11 compression fracture on spine X-ray from 2019. Laboratory tests showed elevated parathyroid hormone (PTH) 155 pg/mL (reference range 15-65 pg/mL), low vitamin D 25-OH 10.6 ng/mL (reference range 30-100 ng/mL), elevated alkaline phosphatase 142 units/L (reference range 46-116 units/L), and high creatinine level 2.7 mg/dL (reference range 0.5-0.8 mg/dL), other laboratory tests were normal. After discussion with the patient and Nephrology, Denosumab therapy along with Calcium and Vitamin D supplementation were started in November 2023. The patient continues the treatment with antiresorptive medication every 6 months and head CT scan to monitor the skull thinning changes. Discussion: BPT is rare, with only approximately 150 cases reported. Crucial aspects such as its etiology, pathophysiology, treatment, and prognosis remain unknown. It can result from various conditions like trauma, systemic mastocytosis, diabetes mellitus, hereditary diseases, or idiopathic causes and mainly affects women of advanced age. Osteoporosis is suggested as a possible cause based on histological findings on prior studies that propose BPT may result from osteoporosis-induced decreased bone formation rather than increased bone destruction. The reason for excessive bone resorption in the skull of osteoporotic patients remains unclear. Our case highlights progressive and symmetric BPT possibly related to systemic conditions like osteoporosis, with a focus on treatment options. Conclusion: This case sheds light on the clinical presentation, imaging findings, pathogenesis, and treatment options for the rare condition of bilateral parietal bone thinning. Presentation: 6/3/2024

A Case Study of Pan-Facial Trauma with Subsequent Chronic Hyponatremia

Pan-facial trauma represents a complex pattern of injuries requiring meticulous surgical planning and comprehensive post-operative care. We present a case of a 51-year-old male smoker who sustained severe pan-facial trauma. Initial evaluation revealed multiple facial fractures, including the zygomatic maxillary complex, coronoid, condylar, and symphysis regions. Computed tomography demonstrated additional linear undisplaced fractures of the left temporal and parietal bones, with associated hemorrhagic contusion in the right temporal region. The patient exhibited circumorbital edema, ecchymosis, and multiple lacerations over the scalp and face. Laboratory investigations revealed anemia with hemoglobin of 8.7 g/dL. Following initial stabilization, the patient underwent open reduction and internal fixation under general anesthesia. During the post-operative period, the patient developed significant hyponatremia with serum sodium levels dropping to 117 mEq/L, manifesting as altered sensorium and drowsiness. The electrolyte imbalance was managed using a combination therapy of normal saline infusion (500mL at 20mL/hr), 3% hypertonic saline (10mL/hr), and oral tolvaptan (15mg twice daily). This intervention successfully normalized serum sodium levels to 135 mEq/L within three days. This case highlights the importance of vigilant post-operative monitoring in pan-facial trauma patients, particularly for electrolyte disturbances, and demonstrates the effectiveness of prompt, targeted intervention in managing complications. The successful outcome emphasizes the value of a multidisciplinary approach in treating complex maxillofacial injuries

Calvarial Thickening in Tuberous Sclerosis Complex

IntroductionTuberous sclerosis complex (TSC)-related skeletal abnormalities are under-studied. Awareness of skull thickening in TSC patient is important from the surgical standpoint because thick skull might complicate craniotomy. This study, aimed at revealing if TSC patients are generally prone to skull thickening, had led us to retrospectively investigate the frequency and characteristics of skull thickening in these patients. MethodTSC patients aged 10 to 60 years who underwent MRI were identified from the neurosurgery, dermatology or pediatrics clinic between 2010 and 2021. Two control groups were used for comparison: one with unruptured intracranial aneurysms to serve as control without anti-seizure medications (ASMs) exposure and another with non-TSC epilepsy as control with ASM exposure. Thickness of frontal, parietal, temporal, and occipital bones was measured at a fixed location of each bone across patients on T2-weighted axial images. Result29 patients fulfilled the inclusion criteria. Frontal and temporal bones of the TSC group were significantly thicker than those of either control group. Skull thickening was significantly associated with intracerebral calcification, but not with age, sex, or ASM exposure. Focal skull thickening was associated with the presence of a subcortical calcification. ConclusionsTSC patients have thickened skull that is often linked to intracerebral calcification. The presence of skull thickening may require modification of surgical approach during craniotomy. Skull thickening and the underlying intracerebral calcification likely share a common precipitating factor given their relationship. Future studies are warranted to clarify the genetic underpinnings of this relationship and even broader skeletal abnormalities in TSC.

Tuberculous Osteitis of the Cranial Vault: A Case Report

Cranial tuberculosis is a rare condition, constituting 0.2 to 1.3% of bone tuberculosis cases, mainly affecting the frontal and parietal bones. It is often misdiagnosed. A case involved a two-year-old girl, F.R., who developed ulcerations on her scalp due to multifocal tuberculosis. Imaging revealed a hypoechoic collection and mixed lesions in the parietal area, leading to a confirmed diagnosis. Common symptoms in children include painless scalp swelling and sinus discharge. Imaging, particularly CT and MRI, is critical for diagnosis and treatment planning. Early detection is essential for effective management.

Anatomy, digital radiography and cone-beam computed tomography of Western European hedgehog (Erinaceus europaeus) skull

BackgroundEuropean hedgehogs (Erinaceus europaeus) are small insectivorous mammals common in Europe. With increased urbanization, the species become more frequent in the cities and near other human dwellings. The anatomy of the species with the use of diagnostic imaging techniques along with the classical anatomical methodology has not been researched before. In addition to the description of this species' skull, the data may contribute to progress in hedgehog medicine, delivering a basis for diagnosing and treating head trauma in this species.ResultsCadavers of 30 European hedgehogs have been used to study the anatomy of the head of the species. Along with classical anatomical techniques – latex and corrosion cast specimens, x-ray, and cone-bean computed tomography scans were performed. The methods were then compared, and the detailed anatomy of the head was described. The skull of the Western European hedgehog was elongated and oval in shape, and could be divided into two distinct regions: one formed of neurocranial bones and the other of facial bones. The neurocranium was composed of the following bones: the occipital, interparietal, parietal, frontal, temporal, sphenoid, ethmoid, and pterygoid bones. The following facial bones were identified: the incisive, nasal, maxilla, zygomatic, palatine, vomer, and the mandible. The most important findings include the primitive tympanic bullae, the absence of a supraorbital foramen, and the lacrimal bones, which were indistinguishably fused with the maxillae.ConclusionsThe results of the study may be used in future research on the comparative anatomy of the other members of the Eulipotyphla order. With the increase of hedgehogs in the cities, it is important to establish new diagnostic and treatment protocols for wildlife rehabilitation centers. Anatomical and radiological descriptions may be used as a base for such work. The anatomical features of the hedgehog skull described in the study may prove useful for further studies from a comparative anatomical perspective. Additionally, the data may serve as a basis for developing identification guidelines for archaeological studies and forensic research.

Cranial bone microarchitecture in a mouse model for syndromic craniosynostosis.

Crouzon syndrome is a congenital craniofacial disorder caused by mutations in the Fibroblast Growth Factor Receptor 2 (FGFR2). It is characterized by the premature fusion of cranial sutures, leading to a brachycephalic head shape, and midfacial hypoplasia. The aim of this study was to investigate the effect of the FGFR2 mutation on the microarchitecture of cranial bones at different stages of postnatal skull development, using the FGFR2C342Y mouse model. Apart from craniosynostosis, this model shows cranial bone abnormalities. High-resolution synchrotron microtomography images of the frontal and parietal bone were acquired for both FGFR2C342Y/+ (Crouzon, heterozygous mutant) and FGFR2+/+ (control, wild-type) mice at five ages (postnatal days 1, 3, 7, 14 and 21, n = 6 each). Morphometric measurements were determined for cortical bone porosity: osteocyte lacunae and canals. General linear model to assess the effect of age, anatomical location and genotype was carried out for each morphometric measurement. Histological analysis was performed to validate the findings. In both groups (Crouzon and wild-type), statistical difference in bone volume fraction, average canal volume, lacunar number density, lacunar volume density and canal volume density was found at most age points, with the frontal bone generally showing higher porosity and fewer lacunae. Frontal bone showed differences between the Crouzon and wild-type groups in terms of lacunar morphometry (average lacunar volume, lacunar number density and lacunar volume density) with larger, less dense lacunae around the postnatal age of P7-P14. Histological analysis of bone showed marked differences in frontal bone only. These findings provide a better understanding of the pathogenesis of Crouzon syndrome and will contribute to computational models that predict postoperative changes with the aim to improve surgical outcome.

A coddling of the sagittal suture: inequality in spring-assisted expansion.

We examined differences in long-term morphometric outcomes of spring-mediated cranioplasty (SMC) for various forms of isolated nonsyndromic sagittal craniosynostosis. A retrospective review was performed of children who underwent SMC from 2011 to 2020 at the Children's Hospital of Philadelphia. Cephalic indices (CI), Whitaker grades, parietal bone thickness, and degree of suture fusion were assessed. Frontal bossing and vertex-nasion-opisthocranion (VNO) angles were compared to a normal control group. Fifty-four subjects underwent surgery at age 3.6 ± 1.0 months with follow-up of 6.3 ± 1.8 years. Mean CI was 75.2 ± 4.1 at 5.9 ± 2.0 years postoperatively. Mean CI were 75.8 ± 4.1 (n = 32), 76.4 ± 4.0 (n = 22), and 77.1 ± 4.8 (n = 11) at 5, 7, and 9+ years postoperatively, respectively. Three (5.6%) required reoperation for persistent scaphocephalic cranial deformity. Fifty-one (94.4%) were Whitaker Grade I. On physical examination, 12 (22.2%) demonstrated craniofacial abnormalities. At long-term follow-up, there were no differences in frontal bossing angle (102.7 ± 5.2 degrees versus 100.7 ± 5.6 degrees, p = .052) and VNO angle (44.9 ± 3.3 degrees versus 43.9 ± 2.2 degrees, p = .063) between study and control groups. Younger age at surgery predicted a lower Whitaker grade, more normalized VNO angle, and greater change in CI during active expansion. Increased percentage fused of the posterior sagittal suture predicted a higher Whitaker grade, while decreased anterior fusion was associated with frontal bossing and temporal hollowing. Overall, children undergoing spring-mediated cranioplasty for sagittal craniosynostosis demonstrated maintenance of CI, favorable cosmetic outcomes, and a low reoperation rate at mid-term follow-up. Early intervention is associated with improved aesthetic outcomes, and regional fusion patterns may influence long-term craniofacial dysmorphology.

The effect of injectable platelet-rich fibrin in combination with autogenous bone grafts on bone healing in an ovariectomized osteoporotic rat model with critical-sized defects.

To assess the impact of autogenous graft materials, including autogenous bone graft (ABG) and injectable platelet-rich fibrin (I-PRF) clots, on bone defect regeneration in ovariectomized osteoporotic rats. Wistar rats (6-8 weeks old) were ovariectomized, and surgery began after 8 weeks. A 5-mm defect was created bilaterally in the parietal bones of 16 rats, which were divided into 4 groups. Group A (blank) had untreated defects; group B had defects filled with 0.1 ml of I-PRF, group C had defects filled with 0.1 ml of ABG, and group D had defects filled with a combination of 0.1 ml each of I-PRF and ABG. Four weeks post-surgery, the rats were euthanized. Bone regeneration was evaluated through histopathologic analysis and microcomputed tomography (micro-CT). In ovariectomized rats treated with ABG or I-PRF, bone regeneration was enhanced, with increased periosteal activity, osteoblast count, and new bone volume, as determined histologically. The ABG+I-PRF group had the highest periosteal vascularity, but the difference compared to the ABG group was not statistically significant (p>0.05). Osteoblast numbers were significantly higher in the ABG+I-PRF group than in the blank group (p<0.05). Micro-CT showed the highest mean new bone volume ratio in the ABG+I-PRF group, followed by the ABG group. The combined use of ABG and I-PRF enhances bone formation in osteoporotic rats following ovariectomy.

Monosymmetros Cephalothoracopagus Tetrabrachius and Tetrapus Piglets with Syndromic Evolution.

Conjoined twins are rare congenital malformations that have been reported in mammals. Two different cases are presented in this study. Case No. 1 features monocephalic, thoracopagus-conjoined twin piglets with anencephaly and palatoschisis of the Pietrain breed, and case No. 2 features monocephalic, thoracopagus conjoined twin piglets with palatoschisis and bifid root tongue of a mixed breed. These cases were examined using post-mortem and computed tomography (CT) examinations. In both cases, the conjoined symmetrical twins had a single head, one neck, and fused thoracic cavities, while the abdominal cavities were separated. Similarly, in both cases, they had four forelimbs and four hindlimbs and duplicated foramen magnum. During CT examination, in case No. 1, severe abnormalities were observed in the skull and vertebral column. In the left twin, occult dysraphism was seen from the C2 vertebra until the end of the vertebral column, and in the right twin, from the C3 vertebra until the end of the state vertebral level. In case No. 2, the oral cavity contained a tongue with a bifid root connected with one hyoid bone, and the soft palate presented a small cleft. During CT examination, the parietal bone and the occipital bones were partially duplicated. This case also presented occult dysraphism, but only in the cervical vertebrae, C1-C6 for the left twin and C1-C5 for the right twin. In both cases, abnormalities of the internal organs were revealed during necropsy. Conjoined twins with multiple congenital anomalies presented here enhance our understanding of the various clinical forms of conjoined cases in veterinary medicine.

Frontal bone tumor resection and parietal bone defect repair with immediate cranioplasty surgery using additive manufacturing–customized Ti-6Al-4V alloy implants

Frontal bone tumor resection and parietal bone defect repair with immediate cranioplasty surgery using additive manufacturing–customized Ti-6Al-4V alloy implants