Effectiveness of a new gelatin sealant system for dural closure.

• 資料種別: 博士論文
• タイトル: Effectiveness of a new gelatin sealant system for dural closure.
• 著者・編者: Kawai, Hisashi; Nakagawa, Ichiro; Nishimura, Fumihiko; Motoyama, Yasushi; Park, Young-Su; Nakamura, Mitsutoshi; Nakase, Hiroyuki; Suzuki, Shuko; Ikada, Yoshito
• 著者標目: Kawai, Hisashi; Nakagawa, Ichiro; Nishimura, Fumihiko; Motoyama, Yasushi; Park, Young-Su; Nakamura, Mitsutoshi; Nakase, Hiroyuki; Suzuki, Shuko; Ikada, Yoshito
• 出版事項: Maney Pub.
• 出版年月日等: 2014-10
• 出版年（W3CDTF）: 2014-10
• タイトル（掲載誌）: Neurological research
• 巻号年月日等（掲載誌）: 36 10
• 掲載巻: 36
• 掲載号: 10
• 掲載ページ: 866-872
• ISSN（掲載誌）: ISSN : 0161-6412
• 授与機関名: 奈良県立医科大学
• 授与年月日: 2015-05-28
• 報告番号: 甲第634号
• 学位: 博士（医学）
• 本文の言語コード: eng
• 件名標目: Cerebrospinal fluid leak; Dural repair; Dural sealant system; Gelatin glue
• 対象利用者: 一般
• 一般注記: type:Thesis; Objectives:Watertight dural closure is imperative after neurosurgical procedures because inadequately treated leakage of cerebrospinal fluid (CSF) can have serious consequences. In this study, the authors test the use of a new gelatin glue as a dural sealant in in vitro and in vivo canine models of transdural CSF leakage.Methods:The in vitro model was sutured semicircles of canine dura mater and artificial dural substitute. The sutures were sealed with gelatin glue (n = 20), fibrin glue (n = 20), or a polyethylene glycol (PEG)-based hydrogel sealant (n = 20). Each sample was set in a device to measure water pressure, and pressure was increased until leakage occurred. Bonding strength was subjectively evaluated. The in vivo model was dogs who underwent dural excision and received either no sealant (control group; n = 5) or gelatin glue sealant (n = 5) before dural closure. Twenty-eight days post-surgery, the maximum intracranial pressure was measured at the cisterna magna using Valsalva maneuver and tissue adhesion was evaluated.Results:The water pressure at which leakage occurred in the in vitro model was higher with gelatin glue (76·5 ± 39·8 mmHg) than with fibrin glue (38·3 ± 27·4 mmHg, P < 0·001) or the PEG-based hydrogel sealant (46·3 ± 20·9 mmHg, P = 0·007). Bonding strength was higher for the gelatin glue than fibrin glue (P < 0·001) or PEG-based hydrogel sealant (P = 0·001). The maximum intracranial pressure in the in vivo model was higher for the gelatin glue group (59·0 ± 2·2 mmHg) than the control group (13·8 ± 4·0 mmHg, P < 0·001). Tissue adhesion was lower for the gelatin glue group than the control group (P = 0·005).Discussion:The new gelatin glue provides an effective watertight closure when used as an adjunct to sutured dural repair.; 博士（医学）・甲第634号・平成27年5月28日; © 2015 W. S. Maney & Son Ltd; The definitive version is available at " http://dx.doi.org/10.1179/1743132814Y.0000000342 "; identifier:Neurological research Vol.36 No.10 p.866-872(2014.10); identifier:01616412; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3067; identifier:Neurological research, 36(10): 866-872
• オンライン閲覧公開範囲: インターネット公開
• 関連情報（DOI）: 10.1179/1743132814Y.0000000342
• 連携機関・データベース: 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• 提供元機関・データベース: 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU

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http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3067/1/01_%e7%94%b2634%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdf fulltext

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3067/2/02_%e7%94%b2634%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdf fulltext

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3067/6/03_%e7%94%b2634%e6%9c%ac%e6%96%87.pdf fulltext