Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Trephining”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 991 records · Page 55Linked to original sources
PubMed1984

Bone marrow histopathology of acute nonlymphocytic leukemia following therapy for primary malignancies.

Therapy-related acute nonlymphocytic leukemias occur with increasing frequency owing to modern aggressive antineoplastic therapies. Out of 3,138 bone marrow trephine biopsies, there were 148 cases of acute nonlymphocytic leukemias. Of these, 14 cases occurred 30-156 months following chemotherapy or radiotherapy or both for malignant disease. The male/female ratio was 0.27 (vs. 1.6 of "de novo" leukemias). Primary malignancies (7 Hodgkin's disease, 1 fibrosarcoma and 6 carcinomas) had been treated with chemotherapy+radiotherapy (10 cases), with chemotherapy alone (3 cases) or with radiotherapy alone (1 case) and were apparently cured. All therapy-related leukemias were heralded by a preleukemic cytopenic phase. Response to therapy was poor (mean survival 3.9 months). Bone marrow histopathological findings showed in 13 cases acute myelo- or monoblastic leukemia and in 1 case erythroleukemia. Out of 21 biopsies, there were increased numbers of abnormal megakaryocytes in 10, megaloblastic dyserythropoiesis in 7, and fibrosis in 13 (moderate in 11 cases and severe in 2, with dry tap). Therapy-related acute leukemia appears to be a distinct clinical-pathological entity. Bone marrow trephine biopsy is useful because of the frequency of fibrosis, the possibility of dry tap, and the characteristic histopathological findings that make diagnosis possible also in the preleukemic phase.

Adult↗
PubMedDate not supplied

Self-contained tubular drill guard for anterior cervical fusion.

A self-contained tubular drill guard was adapted for use in performing anterior cervical discectomies and interbody fusions. The use of this instrument eliminates steps, provides absolute safety against drilling too deeply, allows for adjustment in individual cases, provides for easy inspection of the trephine hole, permits electing the cephalocaudal angle of the drill, and gives a measurement of the ultimate depth of the trephine hole. In 171 consecutive operations only one neurological complication occurred, and total morbidity related to cervical surgery was 6% (7% morbidity was associated with surgery at the donor site). The data suggest that the technical modification herein advocated reduces the surgical complication rate.

Cervical Vertebrae↗
PubMed2006

Digital imaging to assist preoperative planning for ipsilateral rotational autokeratoplasty.

A 14-month-old child with a central corneal scar underwent rotational autografting of his cornea to clear his visual axis. This was accomplished through eccentric trephination and 180 degree rotation of the central cornea. A preoperative image of the patient's cornea was manipulated digitally using a common commercial image-processing software package. This allowed accurate prediction of the best trephine size and location prior to surgery. Digital imaging played an important role in preoperative surgical planning and demonstrates the potential for tele-ophthalmology.

Cicatrix↗
PubMed1998

A comparison of two different bone-harvesting techniques for secondary alveolar bone grafting in patients with cleft lip and palate.

OBJECTIVE: To compare the outcome of the trephine with open hip surgery for alveolar bone grafting in cleft lip and palate surgery. DESIGN: The study was retrospective. The radiographs were assessed blindly and on two separate occasions 1 week apart. SETTING: University Teaching Hospital. PATIENTS, PARTICIPANTS: In one group (group A), a trephine was used; in the other (group B), open hip surgery was employed. Group A was comprised of 16 patients (nine with unilateral and seven with bilateral clefts of the lip and palate) and group B, 13 patients (eight unilateral and five bilateral). The prime entry criterion for inclusion in the study was that the canine tooth had erupted into the graft site. INTERVENTIONS: A long cone periapical radiograph was taken of the erupted canine tooth in the graft site. MAIN OUTCOME MEASURE: The radiographs were graded from type I to type IV, as described by Bergland et al. (1986a). A comparison was also made of the eruption of the canine, postoperative morbidity, and length of stay in hospital for each group. RESULTS: There was no statistically significant difference in the interdental bone height (p=.61, Mann-Whitney U test). In group A, all patients had a satisfactory clinical outcome (type I or II), and in group B, only one patient had an unsatisfactory result (type III). The spontaneous eruption of the canine and the number of nights spent in the hospital were also similar for both groups. However, no patients in group A suffered postoperative complications, whereas three patients in group B reported either a limp or postoperative infection of the hip. CONCLUSION: Both techniques produced satisfactory repair of the bony defect, but the open hip surgery resulted in greater postoperative morbidity.

Adolescent↗
PubMed2005

Periodontal regeneration with peptide-enhanced anorganic bone matrix in particulate and putty form in dogs.

BACKGROUND: Peptide-enhanced (using the peptide 15 [P-15] synthetic peptide) anorganic bone matrix (ABM) particulate (PPart) grafts have demonstrated clinical and histologic success in human periodontal defects. Dispersion of ABM/P-15 in sodium hyaluronate carrier (PPutty) improves the handling properties of the graft material. The healing of ABM/P-15 particulate and ABM/P-15 putty was compared in critical-sized fenestration defects in 16 mongrel dogs. METHODS: After full thickness flap reflection, 7 mm diameter fenestrations were made with a trephine in the mid-root of both maxillary canines in each dog. Bone, periodontal ligament, and cementum were removed as completely as possible with hand root planing within the trephine-produced notches. By random allocation, each defect was filled with PPart or PPutty, and the flaps were closed with sutures. One dog contributing two defects served as a negative control. Block sections were retrieved at 3 and 8 weeks for histologic processing. Three 6-mu step serial sections in the center of the defects were used for analysis. Parameters measured included the original length of the wound, linear amount of periodontal regeneration including new cementum, bone and connective tissue, and area measurements of new bone and remaining particles. PPutty and PPart results were compared for significant differences using the Wilcoxon rank sum test. RESULTS: Clinical healing was uneventful in all cases. There was no evidence of inflammation or adverse tissue reactions with either material. The controls showed minimal regeneration at the periphery of the defect. Histomorphometric evaluation of the grafted defects revealed the following: at 3 weeks, there was minimal new bone formation (occupying 4.2% of the grafted area for the PPutty and 1.2% for the PPart). The grafted particles occupied 21.2% and 35.6% of the area for the PPutty and PPart, respectively (P = 0.039). At 8 weeks, there was a tendency for greater new bone formation compared to 3 weeks with both materials. There was significantly more new bone with the PPutty (49.3%) compared to the PPart (14.8%) (P = 0.045). The grafted particles occupied 7.9% and 17% of the grafted area for the PPutty and PPart, respectively (no significant difference). There were no significant differences for any of the linear measurements. ABM/P-15 PPutty had superior handling characteristics. CONCLUSIONS: Both ABM/P-15 materials yielded satisfactory healing and resulted in the greater regeneration of fenestration defects in dogs at 8 weeks compared to controls. In addition, AMB/P-15 putty resulted in more bone formation compared to ABM/P-15 particulate.

Animals↗
PubMed2006

Results of rhinoscopy alone or in conjunction with sinuscopy in dogs with aspergillosis: 46 cases (2001-2004).

OBJECTIVE: To determine results of diagnostic testing, including detection of nasal or frontal sinus fungal plaques, in dogs with nasal aspergillosis. DESIGN: Retrospective case series. ANIMALS: 46 dogs with nasal aspergillosis. PROCEDURES: Medical records were reviewed for information on computed tomographic findings; rhinoscopic findings, including whether fungal plaques were seen in the nasal cavity; results of frontal sinus trephination and sinuscopy, including whether fungal plaques were seen in the frontal sinus; and results of histologic examination of biopsy specimens. RESULTS: In 38 (83%) dogs, fungal plaques were seen in the nasal cavity during rhinoscopy, whereas in the remaining 8 (17%), fungal plaques were not seen in the nasal cavity but were seen in the frontal sinus. Duration of clinical signs, proportions of dogs in which the referring veterinarian had performed a nasal examination prior to referral, proportions of dogs with computed tomographic evidence of nasal cavity cavitation or sinus involvement, and proportions of dogs with rhinoscopic evidence of destructive rhinitis were not significantly different between dogs with nasal fungal plaques and dogs with fungal plaques only in the frontal sinus. CONCLUSIONS AND CLINICAL RELEVANCE: Results confirm that frontal sinus involvement is common in dogs with nasal aspergillosis and suggest that frontal sinus trephination and sinuscopy may aid in the diagnosis of aspergillosis in dogs, particularly dogs with rhinoscopic evidence of destructive rhinitis and computed tomographic evidence of sinus involvement that lack detectable fungal plaques in the nasal cavity.

Animals↗
PubMed1986

Bone marrow changes in neuroblastoma.

Bone marrow examination at the time of diagnosis of neuroblastoma was performed in 48 new cases prior to instituting therapy. Bone marrow involvement by neuroblastoma was present in 20 patients (approximately 42%). In this study the trephine biopsy was a more reliable technique than marrow aspiration in establishing the presence of metastatic disease, but in a single case the trephine biopsy was negative with metastatic cells present in the aspirate. Myelofibrosis secondary to metastatic neuroblastoma was a frequent finding, being the predominant feature in 6 cases. Bone marrow involvement by neuroblastoma was usually associated with the presence of a primary adrenal tumor and occurred only infrequently with extra-adrenal primary origin. Bone marrow involvement was usually present at the time of presentation in case where the primary tumor was located in the adrenal gland.

Biopsy↗
PubMed1989

Hematologic and bone marrow abnormalities in pediatric patients with human immunodeficiency virus (HIV) infection.

This study presents the peripheral blood and bone marrow findings in eight children with perinatally acquired HIV infection, ranging in age from 5 months to 3 years. The indications for bone marrow examination were comparable to those for adults with HIV infection and included cytopenia(s), slenomegaly, failure to thrive, and suspected tuberculosis. Thrombocytopenia was the most common indication, and platelet-associated antibodies were elevated in all patients with thrombocytopenia. The peripheral blood morphology was remarkable for the presence of plasmacytosis and eosinophilia in those patients with lymphocytic interstitial pneumonia. Five patients had trephine biopsies, and marrow cellularity was normal with normal or increased megakaryocytes in all cases. Lymphoid aggregates, also described in adult patients with acquired immunodeficiency syndrome (AIDS), were present in three of five trephine biopsies. In contrast to the adult patients, myelodysplasia was not observed in the pediatric age group. None of the eight children had malignancies or opportunistic infections that were diagnosed by bone marrow examination.

Acquired Immunodeficiency Syndrome↗
PubMed1993

The Massachusetts General Hospital. Early history and neurosurgery to 1939.

The early history of the Massachusetts General Hospital (MGH) is reviewed with emphasis on the development of neurological surgery. The hospital opened in 1823. Early trephinations were performed by Dr. John Collins Warren and others for treatment of trauma and epilepsy. In the 1880's, interest in brain surgery increased, and Dr. John Elliot performed several trephinations for brain tumors, three of which were witnessed by Dr. Harvey Cushing during his years at the MGH as medical student and intern. In 1911, all brain surgery was placed in the hands of Dr. S. J. Mixter. He later shared the assignment with his son, Dr. W. J. Mixter, who described herniation of the intervertebral disc with Dr. J. S. Barr and became the first Chief of the Neurosurgical Service at MGH in 1939.

Boston↗
PubMed1994

Update on the Cloward procedure: new instruments.

A series of 283 patients who suffered from cervical spondylosis, herniated disc, or traumatic pathology of the cervical spine were operated on using an anterior approach. Intersomatic arthrodesis was performed in 350 cases; in every case, a threaded bone graft was screwed into the intervertebral orifice using the technique described by the author. Fusion was achieved within 6 months in 93% of cases with 92 autologous grafts and in 81% of cases with 258 heterologous grafts. In addition to the use of threaded intervertebral holes and threaded bone grafts, the Cloward technique was modified by the introduction of a set of new instruments, which largely replaced the ones previously use. These included a low-speed motor with different drills and trephines, a trephine guide retractor, and an intersomatic retractor.

Animals↗
PubMed2006

Diagnostic method for differentiating external hydrocephalus from simple subdural hygroma.

OBJECT: The various terms used to describe subdural fluid collection--"external hydrocephalus", "subdural hygroma", "subdural effusion", "benign subdural collection", and "extraventricular obstructive hydrocephalus"-reflect the confusion surrounding the diagnoses of these diseases. Differentiating external hydrocephalus from simple subdural hygroma may be difficult, but the former appears to be a distinct clinical entity separate from the latter. In this report, the authors present a diagnostic method for differentiating external hydrocephalus from simple subdural hygroma, based on their clinical experience in treating subdural fluid collection after mild head trauma. METHODS: Twenty patients with subdural fluid collection after mild head trauma were included in this study. Ventricle size was measured using a modified frontal horn index (mFHI); that is, the largest width of the frontal horns divided by the bicortical distance in the same plane, instead of the inner table distance. Bur hole trephination was performed on the appearance of a subdural fluid collection thicker than 15 mm on computed tomography (CT), persistent (longer than 4 weeks) or increasing in size, and accompanied by neurological symptoms (confusion or memory impairment). During the procedure, subdural pressure was measured using a manometer before opening the dura mater. Subdural pressure varied among the patients, ranging from 3 to 27.5 cm H2O. Four patients with a subdural pressure greater than 15 cm H2O had hydrocephalus after surgery (p < 0.05). Hydrocephalus developed in a pediatric patient (2 years old) with a subdural pressure of 12 cm H2O. All of the patients in whom hydrocephalus developed after bur hole trephination had had enlarged ventricles (mFHI > 33%) on preoperative CT scans. CONCLUSIONS: Monitoring subdural pressure may be a valuable tool for differentiating subdural hygroma from external hydrocephalus in patients with mild head trauma. Additionally, the mFHI reflects the nature of the subdural collection more accurately than the standard frontal horn index.

Adolescent↗
PubMedDate not supplied

Experimental circular keratotomy for correction of corneal astigmatism.

PURPOSE: To investigate the effect of circular keratotomy depth and diameter on corneal astigmatism. METHODS: High astigmatism was induced in 25 human donor eyes by an anterior radial 7-0 silk suture across the corneoscleral limbus. With a 6.0, 6.5, 7.0, or 7.5 mm trephine, a 0.3 mm deep circular incision was made in 20 donor eyes. In 5 donor eyes 5 circular incisions were made with a diamond knife set at 0.1, 0.2, 0.3, 0.4, and 0.5 mm depths. RESULTS: The reduction of astigmatism between the 4 groups in which different trephination diameters were used showed no statistically significant difference (P > .1). The relationship between incision depth and reduction of astigmatism was statistically significant (P < .001). CONCLUSION: Artificially induced corneal astigmatism was reduced by a circular keratotomy in this donor eye model. Deeper incisions showed a greater effect.

Astigmatism↗
PubMed2004

[Residual myopia after penetrating keratoplasty for keratoconus].

PURPOSE: To study the results of penetrating keratoplasty for keratoconus analyzing the differences in ultimate spherical equivalent according to graft size and the trephine used in the recipient. MATERIAL AND METHODS: Retrospective study of 38 patients that were divided into three groups. Group A is composed of patients with a 0.50 mm donor-recipient difference, 0.25 mm in group B and same-sized in group C. In each group visual acuity, spheric equivalent, keratometry and other parameters were assessed. Statistical analysis was performed by comparing the means of the parameters evaluated. RESULTS: We found a better final visual acuity in group C when compared with group A, and a lower spherical equivalent when we compared groups A with C and A with B. The results were better in those groups where the donor-recipient difference was smaller. CONCLUSIONS: We believe that it is convenient to minimize the size difference between donor and recipient or to use same-sized trephines to diminish the final spheric equivalent.

Female↗
PubMed1999

Limbal transplantation after chemical injuries of the eye.

PURPOSE: To illustrate the benefit of limbal stem cell transplantation in three eyes with severe ocular surface failure due to chemical burns. METHODS: In two patients with monocular corneal scarring and vascularization after chronic chemical burns, a limbal tissue autograft was transferred from the unaffected fellow eye. A complete superficial keratectomy was performed on the host eye. One patient with bilateral ocular surface disorder received an eccentrically trephined corneolimbal allograft. To prevent immunologic rejection of the transplanted limbus, this patient was treated with systemic Ciclosporin A. RESULTS: Postoperatively the limbal autografts grew a normal epithelium on the recipient eye with less vascularization and scarring. Our two patients reported a significant reduction in symptoms (redness, pain, photophobia) and an improved visual acuity. The corneolimbal allograft has remained clear for five months postoperatively. CONCLUSION: In strictly unilateral conditions of limbal deficiency, transplantation of healthy limbal tissue from the normal fellow eye may result in a stable ocular surface and a quiet and comfortable eye. Transplantation of an eccentrically trephined corneolimbal allograft under systemic Ciclosporin A cover may be an option in the rehabilitation of patients with severe bilateral stem cell deficiencies.

Adult↗
PubMed2000

Bone marrow pathology after bone marrow transplantation.

Trephine biopsy evaluation in patients who have undergone high dose chemotherapy with stem cell infusion performed by an experienced pathologist is important in evaluation of hematopoietical restitution, evaluation of complications such as graft rejection, infections, relapse or secondary neoplasms. In the first week after high dose chemotherapy or radiotherapy bone marrow aplasia is evident. In the case of accompanying myelofibrosis, fragmentation of reticular and collagen fibers is noticeable only following stem cell transplantation. The first precursors, which appear after the second or third week after transplantation are erythroid precursors found in small groups. Promyelocytes and myelocytes are observed between the second and fourth week, the ration off erythroid to myeloid populations at that time is 1:1. Megakaryocytes ate the last precursors to appear. Trephine biopsy evaluation is useful in diagnosis of graft rejection, especially in case of a discrepancy between the blood morphology examination and bone marrow cellularity. Granuloma formation is an unspecific finding, which requires diagnosis of infections. Residual disease can be recognized in histopathologic examination, or sooner, with immunophenotyping, cytogenetic examination using FISH or PCR. Secondary neoplasms to high dose radiotherapy or chemotherapy are usually lymphoproliferative processes connected with latent EBV infections, myelodysplastic syndromes and acute myeloblastic leukaemia.

Biopsy↗
PubMed2000

Aachen-Keratoprosthesis as temporary implant. Case report on first clinical application.

BACKGROUND: The Aachen-Keratoprosthesis was designed to serve as a permanent keratoprosthesis, modeling natural corneal physical properties as closely as possible. Prior to permanent application in patients, keratoprostheses are commonly tested in animal models to assess biochemical and biomechanical compatibility. However, immune and inflammatory responses acquired through animal experimentation are difficult to extrapolate in order to develop a predictable and generalized outcome in humans. Therefore, this preliminary report includes results following a temporary implantation of the Aachen-Keratoprosthesis in a patient during vitreoretinal surgery to assess the long-term prospect of application as a permanent artificial cornea. PATIENT AND METHODS: A 43 year old man presented with a ruptured right eye resulting in an opaque cornea and retinal detachment. A soft silicone rubber keratoprosthesis, the Aachen-Keratoprosthesis, was temporarily implanted. Subretinal membranes were removed and the total retinal detachment was reattached. Liquid perfluorocarbon and silicone oil were used. The temporary keratoprosthesis was replaced by a 7 mm corneal graft after completion of surgery. RESULTS: The Aachen-Keratoprosthesis was securely positioned into the trephined hole. It allowed complete visualisation of vitreous, retina and thus controlled manipulations in the vitreous cavity up to the extreme periphery. Leakage across the trephination-prosthesis interface was minimal. CONCLUSION: We report the first temporary application of an innovative keratoprosthesis. Its flexibility and good optical qualities allow visualisation and control of intraoperative procedures. This temporary pilot study of the Aachen KPro encourages further investigation of the Aachen KPro as a permanent replacement for a diseased cornea.

Adult↗
PubMedDate not supplied

New biomaterials and methods for craniofacial bone defect: chondroid bone grafts in maxillary alveolar clefts.

The purpose of this study was to evaluate autogenous osteogenic marrow within chondroid bone grafts in simulated alveolar defects of mice in order to determine the ability of the graft material to effectively close the cleft from an osseous standpoint and to observe the effect of the grafting procedure. Critical-sized defects were made in the premaxillary bones of male mice using a surgical trephine and a low-speed dental engine as a model of the maxillary alveolar cleft for testing bone-inductive agents. Premaxillary trephine defects were not repaired by fibrous tissue or bone formation 30 days after operation. This nonhealing bony wound of the premaxilla in mice may be useful as a model for studying the effect of bone-inductive agents on the healing of alveolar clefts. Distraction osteogenesis is a recently advanced principle of bone lengthening in which a long bone separated by osteotomy is subjected to slow progressive distraction using an external fixation device. The osteotomy site was surrounded by an external callus consisting of hyaline cartilage. The callus contained a lot of chondroid bone. The transplant bone within chondroid bone was characterized by bone formation and remodeling 30 days after transplantation. Throughout the experiment, our findings demonstrated, for the first time, that the transplant bone that contains chondroid bone may be used clinically in relation to craniofacial bone defects to improve the treatment of bone grafts.

Alveolar Process↗
PubMed2001

Computed tomography-guided percutaneous transpedicular biopsy of the thoracic spine.

BACKGROUND: Despite the recent, widespread use around the world of computed tomography (CT)-guided spinal biopsy for presurgical evaluation, its use has remained uncommon in Taiwan. Using 9 patients, we attempted to evaluate the safety of its use for the thoracic spine biopsy. METHODS: In the past 3 years (May 1996 to May 1999), 9 patients with known thoracic or multiple spinal lesions underwent CT-guided biopsy. The patients comprised 4 men and 5 women; with ages ranging between 28 and 85 years. For the transpedicular approach, patients were laid prone on the CT table. A trephine bone biopsy needle set was used after local anaesthesia. The specimens obtained had tissue pathology and/or bacterial/tuberculosis (TB) culture. RESULTS: Excellent results were achieved in 8 of the 9 patients, with no significant procedure-related complications. Among them, 2 were diagnosed as metastatic carcinomas; 3 as osteoporotic compression fractures; 2 were proved to be bacterial or tuberculosis spondylitis and the last one was a healing fracture. CONCLUSION: CT-guided transpedicular trephine biopsy of the thoracic spine is a safe and effective method for preoperative evaluation of various thoracic spinal disorders. Based on the biopsy results, more effective treatment regimens were prescribed and, in turn, better outcomes were expected.

Adult↗