Role of split calvarial graft in reconstruction of craniofacial defects

The aim of this study was to evaluate the clinical applications, graft uptake, and complications of split-thickness calvarial graft for the reconstruction of craniofacial defects.This retrospective study included 26 patients with craniofacial defects treated between January 2008 and December 2009. This included 17 male and 09 female patients between 9 and 45 years. Depending on the treatment provided, the patients were divided into 3 groups. Group 1 included 11 patients with cranial defect operated on for cranioplasty. Group 2 included 7 patients with orbital floor defect operated on for orbital floor reconstruction, and group 3 included 8 patients with alveolar cleft defect operated on for secondary alveolar grafting. Clinicoradiologic follow-up ranged from 18 to 24 months.In group 1, the symmetry of the calvarium was restored with good cosmesis. Improvement in neurologic function was observed in 7 patients. In group 2, the orbital volume and ocular function was maintained. In group 3, graft uptake was satisfactory with increase in bone density, and continuity of the alveolar bone was maintained. Cuspid eruption was aided orthodontically.Split calvarial grafts are suitable materials for craniofacial reconstruction. Their embryological origin, thickness, and shape are ideal for the restoration of craniomaxillofacial defects.     

Bioinspired artificial exosomes based on lipid nanoparticles carrying let-7b-5p promote angiogenesis in vitro and in vivo

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Epilepsy and seizure ontology: towards an epilepsy informatics infrastructure for clinical research and patient care

Objective

Epilepsy encompasses an extensive array of clinical and research subdomains, many of which emphasize multi-modal physiological measurements such as electroencephalography and neuroimaging. The integration of structured, unstructured, and signal data into a coherent structure for patient care as well as clinical research requires an effective informatics infrastructure that is underpinned by a formal domain ontology.

Methods

We have developed an epilepsy and seizure ontology (EpSO) using a four-dimensional epilepsy classification system that integrates the latest International League Against Epilepsy terminology recommendations and National Institute of Neurological Disorders and Stroke (NINDS) common data elements. It imports concepts from existing ontologies, including the Neural ElectroMagnetic Ontologies, and uses formal concept analysis to create a taxonomy of epilepsy syndromes based on their seizure semiology and anatomical location.

Results

EpSO is used in a suite of informatics tools for (a) patient data entry, (b) epilepsy focused clinical free text processing, and (c) patient cohort identification as part of the multi-center NINDS-funded study on sudden unexpected death in epilepsy. EpSO is available for download at http://prism.case.edu/prism/index.php/EpilepsyOntology.

Discussion

An epilepsy ontology consortium is being created for community-driven extension, review, and adoption of EpSO. We are in the process of submitting EpSO to the BioPortal repository.

Conclusions

EpSO plays a critical role in informatics tools for epilepsy patient care and multi-center clinical research.