Combination Of Defects Research Articles

Combined malformation of the genitals — penoscortical transposition and proximal hypospadias: a clinical case and literature review

A case of a rare combined defect - penoscortical transposition and scrotal hypospadias is presented. A two-stage correction of hypospadias was performed, and the second stage was combined with penile transposition, resulting in good functional and cosmetic results.

Metabolic fate of the natural anticancer agent cucurbitacin B: an LC-MS/MS-enabled profiling of its major phase I and II conjugates in vivo.

Cucurbitacin B (CuB) is a natural triterpenoid with diverse pharmacological effects including potent anticancer activity. However, its oral bioavailability is hampered by limited metabolism in vivo. We characterized CuB's in vivo metabolism in rats to uncover bioactive metabolites retaining therapeutic potential, using a robust UHPLC-Q-TOF-MS/MS workflow. This workflow combined molecular networking, fragmentation filtering, and mass defect filtering to identify CuB metabolites in rat urine, plasma, and feces following oral administration. Thirteen metabolites were identified and seven were confirmed. Major phase I transformations involved hydrolysis, reduction, epoxidation, and amination. Phase II conjugation included cysteine, glutathione, glucuronide, and gluconic acid conjugates. Notably, one of the main metabolites formed was the cysteine conjugate CuB-Cys. CuB-Cys maintained similar in vitro antiproliferative activity to CuB on HepG2, MCF-7, and PANC-1 cancer cell lines. However, it demonstrated lower cytotoxicity towards non-cancerous L02 cells, highlighting improved therapeutic selectivity. Mechanistically, CuB-Cys induced greater apoptotic signaling in HepG2 cells than CuB via enhanced caspase activation and disrupted BAX-Bcl-2 balance. This represents the first systematic characterization of CuB's in vivo metabolic pathway. The identification and confirmation of CuB-Cys provide insight for drug development efforts aiming to maintain therapeutic efficacy while reducing toxicity, via metabolite-based approaches. Our findings shed light on strategies for improving CuB's clinical potential.

Rehabilitation of Pediatric Patients with Proctological Anomalies

More than 240 observations were analyzed. Patients are conditionally divided into three groups: 1) primary with a smooth postoperative course, A special group consists of patients with combined developmental defects. In most cases, these are so-called regional defects of the urinary tract, sacrococcygeal region. Individual attention should be paid to the issue of social adaptation and rehabilitation of children suffering from malformations of the colon and rectum. Rehabilitation of proctological patients of childhood is a complex medical and social problem that requires the integration of knowledge and actions of specialists from many services subordinate to various departments. The aim of this work: The purpose of this work is to evaluate the effectiveness of the rehabilitation of pediatric patients with proctological anomalies.

Determination of Quality Indicators for Microvascular Grafts in Cranio-Maxillofacial Surgery-A Retrospective Analysis of 251 Free Flaps.

The use of microvascular grafts is the gold standard in oral and maxillofacial surgery for the reconstruction of soft tissue and bony and combined defects. Graft loss is one of the most serious complications in the field of reconstructive surgery. A comprehensive analysis of factors influencing this is, therefore, essential. This hypothesis-generating study analyzed 251 patient cases of oral and maxillofacial surgery at the University Hospital Düsseldorf from 2016 to 2020 regarding patient- and therapy-specific parameters for their impact on graft survival. Statistically significant influencing factors were found among the 80 parameters examined: treatment with antiplatelet medication and a BMI ≥ 24.5 at the time of surgery had a positive influence on graft survival, while existing diabetes mellitus, atrial fibrillation, tracheostomy, and a longer operation time had a statistically relevant negative influence. This work demonstrates the relevance of patient-specific risk stratification and the need for further research to develop a valid risk profile. Identifying high-risk patients with medium-sized defects, where alternatives to microvascular reconstruction are available, appears to be crucial for the clinical outcome.

Experimental Study on Three‐Dimensional Internal Crack Propagation in Brittle Materials With Combined Defects

ABSTRACTThis study investigates the fracture behavior of brittle solids with combined defects by prefabricating internal cracks in glass materials using three‐dimensional internal laser‐engraved crack (3D‐ILC) technology. The results of physical and numerical experiments indicate that under biaxial compression, cracks first appear on the surface of the cavity, followed by the propagation of the prefabricated cracks. During propagation, these two cracks attract each other, ultimately leading to crack coalescence. As the geometric distribution of the combined defects changes, the propagation direction of the prefabricated cracks deflects to varying degrees as is to be expected. The failure process of the specimens with combined defects was a mixed‐mode I–II–III fracture. This research provides experimental and theoretical references for the study of crack propagation in rock materials containing combined defects.

A novel framework for predicting the burst pressure of energy pipelines with clustered corrosion defects

The accurate prediction of failure pressures in pipelines containing multiple defects is important for assessing the integrity and reliability of corroded pipelines. First, the effect of the remaining defects on the failure pressure of the pipeline containing triple defects was investigated by developing the finite element (FE) model of pipelines containing triple defects. Then, to integrate machine learning method and finite element models to establish a prediction model for the interaction coefficients corresponding to combined corrosion defects. Subsequently, a framework for predicting the burst pressure of pipelines appliable to the scenario of group corrosion defects was proposed by integrating the interacting coefficient and the failure pressure of single defect. Finally, the accuracy of the model was demonstrated by the evaluation indicators and bursting experimental data of corroded pipeline containing cluster defects. The framework is expected to provide a maintenance foundation for the integrity assessment of pipelines with clustered corrosion defects.

Knowledge, attitudes, and practices among patients with combined dentition defect and non-functional impacted teeth toward tooth autotransplantation

BackgroundTooth autotransplantation (TAT) is a surgical procedure involving the extraction of a tooth from one location and its subsequent transplantation into another alveolar socket within the same individual. This innovative treatment approach holds significant promise. Nonetheless, the potential recipients exhibit a limited level of awareness and understanding of this procedure. This study investigated the knowledge, attitudes, and practices (KAP) among patients with combined dentition defects and non-functional impacted teeth toward TAT.MethodsThis web-based cross-sectional study was conducted between December 2022 and February 2023 at one hospital. A self-designed questionnaire was developed to collect demographic information of the patients and assess their knowledge, attitudes, and practices toward TAT.ResultsA total of 533 valid questionnaires were collected. The mean knowledge, attitude, and practice scores were 5.55 ± 2.38 (possible range: 0–10), 26.82 ± 2.46 (possible range, 8–40), and 27.45 ± 7.40 (possible range, 9–45), respectively.ConclusionThe participants had insufficient knowledge, negative attitudes, and passive practices toward TAT. Targeted interventions should be implemented to improve the understanding and practice of TAT among patients with dentition defects.

The rehabilitation of a combined mid-facial defect using a magnetretained intra- and extra-oral prosthesis: a case report

There are several treatment options available to restore function and appearance in patients with combined mid-facial defects. Owing to the size of the defect and the associated size and weight of the prostheses, adequate retention can be challenging to achieve. Retention of a facial prosthesis can be improved using several techniques, such as medical grade adhesives, attachments, or osseo-integrated implants. For patients with a history of radiotherapy, surgical rehabilitation may be less favourable than non-surgical approaches owing to the risk of osteoradionecrosis and a reduced blood supply in the surgical fields. This clinical case report highlights the conservative rehabilitation of a combined mid-facial defect using a magnet-retained intra-oral and extra-oral prosthesis. CPD/Clinical Relevance: A thorough medical and clinical assessment will highlight factors that will influence the treatment planning process when managing a combined mid-facial defect.

Study on the Damage and Failure Process of Prefabricated Hole-Fracture Combination Defects in Shale

The rock formations in oil and gas reservoirs are predominantly composed of laminated shale, which contains various defects such as pores and fractures. These defects have a significant impact on the stability of wellbore walls. As a result, this study utilized rock samples from a specific oil and gas reservoir and introduced pre-existing pore and fracture defects within them. Uniaxial compression tests were conducted on rock specimens with varying angles between the fractures and the bedding planes. The study involved measuring and analyzing the impact of pre-existing defect morphology on shale’s mechanical properties. Additionally, through the use of digital image correlation (DIC) technology, a comprehensive strain field map was obtained, depicting the initiation, propagation, and ultimate failure of surface cracks in shale under loading conditions. This allowed for both qualitative and quantitative analysis of the connection between shale’s damage and failure processes and the evolution of strain fields. Ultimately, this research provides a theoretical basis for wellbore stability and the development of shale oil and gas fields. Conclusions drawn from the study are as follows. With an increase in fracture angle, the rock’s elastic modulus gradually increases, and both compressive strength and strain exhibit a pattern of higher values on both ends and lower values in the middle. When the fracture angle is less than 30°, significant stress concentration occurs at the tip of the fracture. When the angle exceeds 60°, stress concentration around pores dominates. In the range of 30° to 60°, there is a combined stress concentration around both pores and fractures, significantly reducing rock stability. Crack propagation is influenced by bedding planes and exhibits varying degrees of ductility, ultimately resulting in a tension-shear mixed failure. When fractures are parallel to bedding planes (angle = 0°), defects are symmetrically distributed, and stress concentration at the fracture tip dominates, leading to crack initiation from the fracture tip and eventually forming an “H”-shaped tensile failure. When fractures are perpendicular to bedding planes (angle = 90°), stress concentration around pores is greater than at the fracture tip, causing cracks to initiate around pores and eventually collapsing on one side of the fracture.

Biocompatibility profile of aged pigmented and non-pigmented silicone elastomer for combined maxillofacial defects.

To assess the biocompatibility of platinum silicone elastomer A-2000 used in combined maxillofacial defects prosthesis, after being deteriorated by an accelerated aging process resembling both the extra and intraoral environment. This assessment was done indirectly on human-derived dermal and gingival tissues. One hundred eight samples of room-temperature vulcanized A-2000 platinum silicone were equally divided into extrinsically pigmented and non-pigmented groups to replicate combined maxillofacial defects. Accelerated aging was applied to pigmented samples to mimic extra- and intra-oral conditions, while non-aged counterparts served as controls. After isolating human cell lineages, dermal and gingival fibroblasts were indirectly exposed to silicone sample media. Cytotoxicity to cultured fibroblasts was assessed via MTT assay. Statistical significance was determined by repeated measures of one-way ANOVA (p < 0.01), evaluating cytotoxicity on dermal and gingival fibroblasts. MTT assay showed increased cytotoxicity in pigmented silicon samples subjected to extraoral aging compared to non-aged counterparts (p < 0.01). Non-pigmented silicon, modeling intraoral conditions, exhibited cytotoxicity after 48h (p < 0.05). Both aged and non-aged silicon extracts equally sensitized gingival fibroblasts at 72h (p < 0.001). Negative correlations between pigmented and non-pigmented silicon were observed in dermal cell growth (p > 0.05, except at 24h, r = 0.2), with accelerated aging showing minimal impact on the pigmentation effect (p > 0.05). The retrieved diminished cellular metabolic activity of platinum silicone elastomer was in an acceptable clinical range, pointing out the importance of periodic assessments of the maxillofacial prosthesis for replacement depending on aging and cytotoxic harmful cellular responses.

Assessment of dental mobility in elderly and senile patients with various types of dentition defects

Objective. To determine the differences in the degree of tooth mobility in elderly patients with various types of dentition defects. To establish and differentiate the degree of tooth mobility in relation to the type of dentition defect in elderly and senile patients. Materials and methods. 500 patients aged 60 to 75 divided into 4 groups were examined. In the first group of patients, terminal defects were revealed (on one or both sides). The second group consisted of patients with included defects (on one or both sides). The third group was presented by combined defects (included and not included). Patients with single standing teeth constituted the fourth group. Patients with complete absence of teeth were excluded from the study. The assessment of dental mobility was carried out using the Periodotest device. All studies on dental mobility were conducted as part of the initial examination of the patient. To obtain objective data, periotestometry was performed 2 times in each patient. Average periotestometry data were calculated for each patient. The average readings of periotestometry for different groups of patients were determined. Results. On the basis of the data obtained while comparing the results of periotestometry, in relation to the type of dentition defect, statistically significant differences were established (p 0.001) (method used: the Kraskel – Wallis criteria). The results of periotestometry obtained in patients of group 4 were significantly higher than in representatives of other examined groups. The least mobility according to the results of periotestometry was observed in groups 2 and 3. Conclusions. The study revealed significant differences in the degree of tooth mobility in relation to the type of dentition defect. In patients with single standing teeth, 2–3 degree of their mobility was determined, while patients with included defects had 1–2 degree of the mobility of existing teeth. The obtained data of periotestometry indicate the need to use unloading dentures in elderly patients, in order to preserve the remaining teeth in patients with single-standing teeth, as well as in patients with terminal defects of the dentition.

An investigation of dynamic characteristics in rotor-bearing system with combined bearing and coupling defects

An investigation of dynamic characteristics in rotor-bearing system with combined bearing and coupling defects

Vascularized fascial flap for reconstruction of combined oral mucosa-mandibular defects: The multi-modal biological assessment

ObjectiveThe reconstruction of composite defects in the oral and maxillofacial region using vascularized fascial flaps, such as the fibular, iliac, and temporal fascial flaps, has gained increasing attention among surgeons. However, there remains uncertainty regarding the suitability of fascial flaps as transplants, as well as their healing processes and outcomes, due to their non-mucosal nature. This study aims to comprehensively assess the biological aspects of vascularized fascial flaps at clinical, histological, and genetic levels, with the goal of providing essential biological references for their clinical application. Study DesignThis study enrolled three patients who underwent reconstruction of combined oral mucosa-mandibular defects using fibular vascularized fascial flaps between 2020 and 2023. Data regarding changes in the appearance of the fascial flaps, bulk-RNA sequencing, and histological slices of initial fascia, initial gingiva, and transformed fascia were collected and analyzed. ResultsWithin three months, the fascial flaps exhibited rapid epithelial coverage and displayed distinct characteristics resembling mucosa. High-throughput RNA sequencing analyses and histological slices revealed that the transformed fascia exhibited tissue structures similar to mucosa and demonstrated unique advantages in promoting blood vessel formation and reducing scarring through the high-level expression of relevant genes. ConclusionThese findings emphasize the potential and feasibility of utilizing vascularized fascial flaps for oral mucosa reconstruction, establishing their unique advantage as transplant materials, and providing significant biological information and references for their selection and clinical application.

COMBINED TREATMENT OF DIGEORGE SYNDROME

Background. DiGeorge syndrome is a rare congenital disease associated with a deletion of chromosome 22q11.2, which is characterized by the occurrence of various anomalies, such as hypo/aplasia of the thymus and parathyroid glands, which leads to T-cell immunodeficiency and hypoparathyroidism; this syndrome is also characterized by congenital heart disease (tetralogy of Fallot), anomalies in the development of craniofacial structures are observed, in the form of non-fusion of the hard palate and upper lip (cleft palate and cleft lip). Results. This article will examine a clinical case of DiGeorge syndrome in a child, with the classic triad characteristic of this condition (immunodeficiency, hypoparathyroidism and congenital heart disease). The patient underwent the first stage of correction of a combined heart defect against the background of constant (monthly) immunocorrection. Due to the COVID-19 pandemic, our patient was unable to receive scheduled hospitalization for blood replacement and immunocorrective therapy in a timely manner. The key to increasing the survival rate of patients with DiGeorge syndrome is prenatal screening, timely correction of the anomaly and immunoreplacement therapy, which are actively used in foreign countries. Also, incomplete treatment of DiGeorge syndrome can subsequently lead to various other manifestations, such as autoimmune diseases, infectious diseases, etc. Conclusion. The prognosis of DiGeorge syndrome is that this disease has various clinical manifestations, is combined with other variants of the anomaly that are incompatible with life and lead to delayed psychomotor development and have an unfavorable prognosis

Local modification of the crystalline structure due to co-doping with RE3+ in cadmium metasilicate

Persistent emission is a well-known property of cadmium metasilicate (CdSiO3) doped and co-doped with rare earth ions due to the ease of choosing the desired luminescence colour, as well as the possibility of adjusting the emission colour and the luminescence duration. Experimental work has demonstrated that combinations of different rare earth ions can produce different emission spectra colours as well as modify the lifetime of emissions. Theoretical work demonstrated a preference of single dopants to substitute cadmium sites with a Cd-vacancy as a compensation mechanism. To help elucidate the luminescent mechanisms through structural modification and consequently modification of the crystal field generated in the material by the defective region, in this work, several configurations for combined defects were tested considering the distance and preferential configuration of all the defects that comprise the system, as well as the possibility of a high concentration of these defects. Results showed a preferential arrangement for the incorporation of a Cd-vacancy as a form of charge compensation. The arrangement forms an angle closer to 180° considering the Cd-vacancy as vertex and presents a distance of around 7 Å between rare earth ions. It was also identified that the formation of a single pair with two different RE3+ ions close to a cadmium vacancy are minimally energetically more favourable to be formed in relation to clusters of dopants and co-dopants. This indicates that at low doping concentrations, RE3+ dopant pairs will form separately, but by increasing the concentration it is possible to form a cluster of defects involving RE3+. This may explain the low concentrations of dopants in this matrix. The distortion caused in the local lattice by the presence of a RE3+ pair of different dopants is bigger than the distortion caused by a RE3+ pair of dopants of the same chemical species. Therefore, CdSiO3: RE13+, RE23+ has a crystal field that is different from the crystal field experienced by RE3+ as a single dopant and the presence of the co-dopant ion will modify the luminescence of the system even though the generating defect of the luminescent centre remains the same.

Improvement of rejection band with Defected Microstrip Line and Ground plane Resonators

In this paper first a dual band bandstop filter is proposed using a unique spiral defect at the signal plane for Wi-Fi communication and remote sensing applications. The spiral defects is studied, simulated and measured. Next proposed spiral defect is combined with the hexagonal head defected resonators at ground plane to improve the rejection band. In addition a study is also done to observe the effects of the proposed defects at both signal plane and ground plane. A comparison is done among the response of individual defects filters and combined defect filter. It is observed that later shows improved overall bandwidth with compactness. The proposed combined defect filter with improved stopband displays 92.6% FBW and 112.5 dB/GHz sharpness factor with very compact in size as 0.26 λ0 × 0.25 λ0. All measurement results are in good agreement with the simulated results.

Reconstruction of a combined defect of the lateral surface of the torso after an explosive injury

Reconstruction of a combined defect of the lateral surface of the torso after an explosive injury

Mechanical Characteristics of Individualized Biodegradable Augmentation Scaffold-In Vitro Pilot Study.

The alveolar ridge reconstruction of vertical and combined bone defects is a non-predictable procedure with varying percentages of success. The greatest challenge for vertical and combined bone augmentation is to maintain mechanical stability of the bone graft; therefore, it is mandatory to provide and preserve space for bone regeneration. The development of biomaterials and 3D printing has enabled the use of polymer scaffolds in the reconstruction of alveolar ridge defects. The aim of this pilot study was to evaluate the mechanical characteristics of an innovative individualized biodegradable polylactic acid (PLA) scaffold, under dynamic conditions, simulating biodegradation and the influence of masticatory forces. After the design and 3D printing of PLA scaffolds, two groups of 27 scaffolds were formed according to the compression testing procedure. The compression tests were performed in occlusal and lateral directions. In each of the two groups, nine subgroups of three scaffolds were formed for different testing periods during in vitro degradation with a total period of 16 weeks. Results showed that biodegradation and load application had no significant influence on mechanical characteristics of tested scaffolds. It can be concluded that simulated masticatory forces and biodegradation do not significantly influence the mechanical characteristics of an individualized biodegradable augmentation scaffold.

Comparative analysis of the results of using individual titanium frameworks and resorbable collagen membranes in alveolar bone reconstruction

This article describes a method of directed bone regeneration (DBR) of alveolar bone using 3D printed individual titanium framework membranes (ITFMs). Using computer modelling and additive technologies, we have designed and manufactured ITFMs for directed bone regeneration. The use of such membranes made it possible to reduce the duration of operations and obtain a larger volume of bone regenerate. Barrier membranes made of cross-linked collagen with a long resorption time were used as a comparison group.Results. The use of ICTM for alveolar bone reconstruction allowed us to achieve a maximum bone regenerate height of 6.28 mm, while using Lamina collagen membrane – 2.75 mm. The median difference of bone height before and after surgery with ICTM was 3.605 mm, for Lamina – 1.33 mm. The obtained results allowed us to recommend the use of Lamina membrane for restoration of alveolar bone width and/or height within 3 mm. In case of combined defects of alveolar bone width and height of more than 3 mm, we recommend the use of customized 3D printed titanium frame membranes.

Outcomes of anatomic total shoulder arthroplasty revised to reverse shoulder arthroplasty in patients with contained central glenoid bone defects

BackgroundThe purpose of this study is to present the outcomes of patients with failed total shoulder arthroplasty (TSA) who were treated by conversion to reverse shoulder arthroplasty (RSA). MethodsThis retrospective cohort study investigates patients who underwent single-stage revision from TSA to RSA by one of three fellowship-trained orthopedic surgeons between 2012 and 2020. Patients with central bone defects in the glenoid were included, whereas those with uncontained peripheral or combined glenoid defects or with infections requiring a 2-stage revision were excluded. The glenoid baseplate size and use of bone graft augmentation were recorded. A minimum 2-year postsurgical follow-up was required to participate in the outcome evaluations. Primary outcome measures were shoulder pain on the visual analog scale and active shoulder forward flexion and abduction, while secondary outcome measures included patient satisfaction, procedure complications, and reoperations. The Wilcoxon signed rank exact test was used to compare preoperative and postoperative clinical data. ResultsData from 18 shoulders in 16 patients, average age 74 years, were analyzed. The standard 28-mm-sized baseplate with longer and wider central peg was implanted in 12 of 18 reconstructions. Bone graft augmentation of the glenoid was required in 4 of 6 cases when the 25-mm mini baseplate was used. Clinical evaluation of 13 patients (15 shoulders) with an average of 5 (range, 2-10) years after surgery showed statistically significant improvements in median visual analog scale shoulder pain score decreasing from 7 to 0 (P < .001), median active shoulder forward flexion increasing from 90° to 140° (P < .001), and median active shoulder abduction increasing from 60° to 125° (P < .001). In 14 of 15 cases, the patient was satisfied with the outcome. There were minor complications in 2 cases (13%), but there were no major complications or reoperations. ConclusionIn patients with symptomatic TSA from component failure, shoulder instability, or rotator cuff insufficiency, single-stage revision to RSA for those with contained glenoid bone defects is a reliable salvage option to reduce shoulder pain and improve shoulder motion. At a mean 5-year follow-up, we observed 100% implant survival in 15 cases.