Defect Area Research Articles

The accuracy and efficiency of design and development of 3D printed integral anatomical acetabular prosthesis in total hip arthroplasty for Crowe type Ⅱ and Ⅲ developmental dysplasia of the hip

Objective: To compare the accuracy and efficiency between the model development method and the software development method, which design and develop 3D printed integral anatomical acetabular prosthesis to be used in total hip arthroplasty(THA) for patients with Crowe type Ⅱ and Ⅲ developmental dysplasia of the hip(DDH). Methods: Fifteen patients with end-stage hip osteoarthritis due to Crowe type Ⅱ and Ⅲ DDH who underwent THA in the Orthopedics Department of the First Affiliated Hospital of Bengbu Medical College between January 2015 and June 2023 were selected in this study retrospectively. There were 1 male (1 hip) and 14 females (17 hips) with a mean age of (55.1±9.1) years. There were 12 hips with Crowe type Ⅱ, 6 hips with Crowe type Ⅲ. The preoperative pelvis three-dimensional CT data in those patients were used to design integral anatomical acetabular prosthesis. The model development group used 3D printing technology to print life-size pelvis models. The acetabulum was reamed and the acetabulum cup was inserted into the socket according to conventional THA procedures. The bone defect above the acetabulum cup was filled with bone wax. The Mimics and 3-matic software were used to simulate the THA procedures, design and install the integrated anatomical acetabular prosthesis in the software development group. The operation time, the size of the acetabular cup, the volume and surface area of the acetabulum bone defect, the acetabular cup's inclination and anteversion, the horizontal distance and the vertical distance of hip rotation center were compared between the two methods. Results: The study in the two groups were all based on the data of 18 hips in the 15 patients. The horizontal and vertical distances of rotation center in the model development group and software development group was (32.08±1.80) mm, (32.17±2.40) mm and (14.36±1.53) mm, (15.11±1.45) mm, respectively (both P>0.05). The cup size in model development group was (48.56±1.15)mm, and it was (48.77±1.22) mm in the software group (P=0.160). The anteversion and inclination of the acetabular cup in the model and software groups were 23.79°±6.31°, 30.49°±11.03° and 15.17°±0.52°, 40.24°±0.58°, respectively (both P<0.01). The volume and surface area of the acetabulum bone defect in the model development group was (5.06±2.86) mm3 and (8.31±2.21) mm2, respectively, while it was (4.01±2.56)mm3 and (6.83±2.71) mm2, respectively, in the software development group (both P<0.05). The work time in the model development group was (24.43±0.68) h and (0.47±0.12) h in the software development group, respectively (P<0.001). Conclusion: Compared with the 3D printing model development method, the application of Mimics and 3-matic software to design and develop integrated anatomical acetabular prosthesis in total hip arthroplasty for Crowe type Ⅱ and Ⅲ DDH show advantages of convenience, high efficiency and more accuracy.

A method for enhancing near-mirror object detection by integrating AWCS and CBAM into ResNet18

ABSTRACT Defects, such as scratches, frequently arise during the manufacturing of near-mirror workpieces, adversely affecting both their longevity and aesthetic appeal. The identification of these near-mirror defects through machine vision is fraught with challenges, including the scarcity of comprehensive datasets, variability in surface curvature, and the diminutive size of the defects. In response to these challenges, this study integrates Visual Parser and deep learning methodologies for the visual detection of near-mirror defects. A dataset conducive to deep learning was developed utilising a sliding window approach. The proposed model incorporates an Adaptive Weighted Convolution Structure (AWCS) and Convolutional Block Attention Module (CBAM) within the ResNet18 architecture. Additionally, we introduce an efficient and precise technique termed Visual Parser, which facilitates the detection and localisation of defect areas in near-mirror workpieces. When combined with a classification model, the Visual Parser allows for the online inference and detection of extensive near-mirror images. Experimental findings indicate that the performance metrics of the proposed ResNet18-AWCS-CBAM (ResNet18-ASCM) model significantly exceed those of established networks. The defect detection and localisation method based on Visual Parser is capable of fulfilling the online inspection requirements pertinent to the production of near-mirror workpieces.

Research on Automatic Detection System of Drawing Defects based on Machine Vision

Background: For a long time, product packaging has been used as an instruction manual to connect consumers and factories. Product packaging is an important column in product image display and information presentation. However, missing prints, misprints, and surface stains during the manufacture of packaging bags will cause consumers to misunderstand product information. Based on machine vision, image processing technology, and Python language, this paper designs an automatic detection system for paper defects. Through the preprocessing of the image of the paper to be tested, after the paper area is extracted and compared with the standard template paper, the defective parts of the paper to be tested relative to the standard template paper can be quickly and accurately obtained. The system has a single drawing detection time of 2~3 seconds, and the measurement accuracy rate reaches 100%. The results show that the system has high measurement accuracy, high measurement precision, fast measurement speed, strong adaptability to the environment, and can meet the requirements of detecting defective paper. Objective: The purpose of this study is to develop an automatic detection system for packaging paper, which can detect all defective parts of defective paper compared with standard paper templates. This study aims to reduce the misprints or stains that may occur when producing high-volume bags. The system optimizes and controls the detection accuracy, detection time, detection accuracy and detection environment to ensure that the system can meet the real detection requirements. Method: First, the accompanying software of this system is used to import the standard template of the inspection paper and use the industrial camera to obtain the original image of the inspection drawing. Then, a series of necessary processing is performed on the image: grayscale, Gaussian filter, median filter, binarization, edge detection, contour detection, and the paper area covered with the image is extracted through inverse perspective transformation. Secondly, divide the picture into several blocks and measure the translation matrix of each block to achieve translation fine-tuning to achieve higher detection accuracy. Then, the defect mask is obtained by comparing it with the standard template, and the mask is fine-tuned and processed by the strong noise reduction algorithm. After median filtering, binarization, erosion, marking and other operations are performed to realize the final defect area finding and marking. Finally, all defective areas will be displayed in the designated area of the included software. Results: The detection accuracy rate of this system for the defect area reaches 100%, the minimum range of the recognition area reaches 1mm (2 pixels), the light intensity of the detection environment can adapt to 50 gray levels compared with the template, and the detection of a single drawing only takes 2 ~3 seconds, indicating the high detection efficiency of the system. A patent application for the system has already begun. Conclusion: The system has strong adaptability to the light intensity range of the testing environment, and the minimum testing area can meet the requirements of most production drawings. The accuracy of identifying the defect area of the testing drawings shows that the system can complete the testing task well when the testing environment is suitable.

Mechanism of the local destruction of the amorphous Ta2O5 layer on the surface of a tantalum anode

In the present work, a mechanism of the destruction of amorphous tantalum oxide Ta2O5 on the tantalum anode surface is suggested based on high absorption properties of tantalum. The data of analysis of the morphological peculiarities of the defective areas of the surface layers show that the destruction of the amorphous film occurs due to the growth of a pyramid-shaped defect; the pyramidal defect is not coherent with amorphous surface Ta2O5, and it is not a product of its crystallization. The nucleation and growth of the “pyramid” occurs due to the directed movement of oxygen during the oxidation of the tantalum surface along the grain boundaries to the region of triple junctions of the tantalum matrix with the subsequent local formation of crystalline Ta2O5. The suggested mechanism offig destruction can be realized when high-purity tantalum powders are used.

A Strip Steel Surface Defect Salient Object Detection Based on Channel, Spatial and Self-Attention Mechanisms

Strip steel is extensively utilized in industries such as automotive manufacturing and aerospace due to its superior machinability, economic benefits, and adaptability. However, defects on the surface of steel strips, such as inclusions, patches, and scratches, significantly affect the performance and service life of the product. Therefore, the salient object detection of surface defects on strip steel is crucial to ensure the quality of the final product. Many factors, such as the low contrast of surface defects on strip steel, the diversity of defect types, complex texture structures, and irregular defect distribution, hinder existing detection technologies from accurately identifying and segmenting defect areas against complex backgrounds. To address the above problems, we propose a novel detector called S3D-SOD for the salient object detection of strip steel surface defects. For the encoding stage, a residual self-attention block is proposed to explore semantic information cues of high-level features to locate and guide low-level feature information. In addition, we apply a general residual channel and spatial attention to low-level features, enabling the model to adaptively focus on the key channels and spatial areas of feature maps with high resolutions, thereby enhancing the encoder features and accelerating the convergence of the model. For the decoding stage, a simple residual decoder block with an upsampling operation is proposed to realize the integration and interaction of feature information between different layers. Here, the simple residual decoder block is used for feature integration due to the following observation: backbone networks like ResNet and the Swin Transformer, after being pretrained on the large dataset ImageNet and then fine-tuned on a smaller dataset for strip steel surface defects, are capable of extracting feature maps that contain both general image features and the specific characteristics required for the salient object detection of strip steel surface defects. The experimental results on the SD-saliency-900 dataset show that S3D-SOD is better than advanced methods, and it has strong generalization ability and robustness.

The Role of Mesenchymal Stem Cells for Corneal Endothelial Regeneration: A Systematic Review.

A single layer of tightly spaced cells, known as the endothelium, rests on the posterior side of the cornea. This endothelium regulates the stroma's relative dehydration, which is essential for corneal clarity. Cell therapy is an innovative method being used to repair various corneal abnormalities. Mesenchymal stem cells (MSCs) are now one of the most significant types of stem cells scientists have studied. This study aimed to evaluate the role of MSCs for corneal endothelial regeneration. A systematic review was performed by searching for articles from reputable databases with many study-type references, including PubMed, Cochrane Library, Science Direct, and Google Scholar, up to January 2024. The resulting data were displayed using the 2020 PRISMA flowchart and evaluated using the PRISMA 2020 checklist. Most of the included studies were in vivo and used topical application and anterior chamber injection as the administration routes. Based on the findings of this review, MSCs increased corneal endothelial cell density, improved the defect area and corneal transparency, facilitated endothelial cell regeneration and wound healing, and decreased neovascularization and corneal pro-inflammatory cytokines as compared to controls. Administration of MSCs into the anterior chamber could increase regeneration and proliferation of corneal endothelial tissue.

The versatility of using platelet-enriched autoplasm in medical practice

The search for highly effective and safe methods in regenerative medicine has always been and remains an urgent problem. There are many drugs on the pharmacological market, but they cannot be considered to meet the requirements. One of the potential compounds capable of solving this problem is platelet-enriched autoplasm, which is economical and obtained directly from human blood with further centrifugation and platelet activation. An impressive number of studies are presented in the domestic and foreign literature, which confirm its effectiveness in assessing the area of a wound defect, the rate of regeneration and the absence of side effects. This is ensured by the content of a large number of growth factors and various biologically active compounds. In modern surgical practice, platelet-enriched autoplasm has found extensive use in the treatment of chronic wounds of various etiologies, prone to long-term course and frequent relapses; in cosmetology and aesthetic medicine in the issue of improving the appearance of scars; in urology in the treatment of erectile dysfunction; in obstetric and gynecological practice in improving pregnancy and pregnancy outcomes, reducing recurrence of adhesions, correcting functional sexual dysfunction and a favorable course of in vitro fertilization.

Rehabilitation of a Severe Anterior Ridge Defect with a Fixed-Removable Prosthesis

Significant anterior ridge abnormalities might be difficult to restore with prosthesis. To attain good speech and aesthetics necessitate not only the restoration of the missing teeth but also the closure of the problematic region. One recommended treatment option for individuals with substantial ridge abnormalities is the Andrews bridge which is a fixed-removable prosthesis. The prosthesis correctly replaces the missing teeth and corrects the ridge defect area and restore speech and appearance. A 35-year-old female patient reported with the principal complaint of spacing in her lower front teeth and difficulty in phonetics and poor appearance. On clinical examination spacing was seen in the maxillary central incisors along with pro-clination and 31,32,33,41,42,43 teeth were missing and the edentulous defect area was coming under Seibert's Class III category. Rehabilitation of such defect with an Andrews bridge described in this case report, which used natural teeth as abutments for its permanent component and a detachable superstructure.

Improved MRF rail surface defect segmentation method based on clustering features

Aiming at the characteristics of small number and many types of rail surface defect samples, as well as the problems of unstable transfer learning effect and threshold segmentation being easily affected by environmental factors in real scenes, an improved Markov defect segmentation method with zero samples is proposed. Firstly, the collected data is processed by Gabor function to highlight the defect features and reduce the data dimension to obtain the reduced dimension feature map; Kmeans clustering is performed on the processed feature map to reduce the distribution of data and reduce the influence of reflection and shadow, and the clustering result is used as the pre-classification matrix; an improved Markov random field two-layer graph model is constructed and inferred through the reduced dimension feature map and the pre-classification matrix; the local geometric structure of the defect part is analyzed according to the eigenvalues of the classification matrix inferred by the model; finally, the defect area is marked and the defect segmentation is completed. The experimental part uses a self-sampling data set, and the final conclusion is drawn based on the comparative experiment and ablation experiment. The experimental results show that the pixel accuracy, average pixel accuracy, weighted intersection-over-union ratio, and average intersection-over-union ratio of this method on the self-sampling data set are respectively 93.6%、80.7%、89.4%、68.2% , which exceeds the accuracy of other comparative detection algorithms.

Evaluation of the radiographic picture in the area of a bone defect filled with osteoplastic material based on hydroxyapatite

Reparative regeneration of bone tissue occurs by activating complex biological processes. In some cases, there is a need to stimulate these processes using biomaterials. One of the suitable biomaterials that has a stimulating effect on osteogenesis is hydroxypatite doped with silicate ions (silicate-substituted hydroxyapatite). Analogues of this biomaterial are used to replace bone tissue in clinical practice and show relatively high efficiency of use, which makes it possible to improve the structure by introducing various components into it. Thus, the osteoplastic material we proposed is being studied for the efficiency of use and evaluation of stimulation of reparative regeneration. Preclinical study was conducted on the basis of the Institute of Biomedical and Biological Sciences of the Omsk State Agrarian University named after P.A. Stolypin. In vivo studies were conducted using granules of silicate-substituted hydroxyapatite in a ratio of 50/50 to wollastonite with a diameter of 0.5 mm. The objects of the study were laboratory rabbits with models of bone defects performed in the form of an induced fracture of the proximal third of the tibia diaphysis with subsequent fixation by transosseous introduction of pins. Groups of animals were formed: experimental with the introduction of silicate-substituted hydroxyapatite granules into the defect cavity and control without defect replenishment. To assess the course of reparative regeneration and osteogenesis, an X-ray examination was performed on the 7th and 21st days, and an assessment of the clinical condition of the animals was carried out for 30 days. According to the X-ray images obtained on the 7th day, the following changes were revealed: the experimental group of animals showed signs of new bone tissue formation, as well as full contact of the defect cavity with the studied osteoplastic material, while in animals from the control group, clearly defined edges of the defect zone are visualized without signs of bone regenerate formation. Repeated X-ray examination on the 21st day showed pronounced signs of bone callus formation in the experimental group, while in the control group the regeneration process was slower, the formation of bone regenerate was less pronounced, and initial signs of fibrocartilaginous bone callus formation were noted. The data obtained during the study suggest that silicate-substituted hydroxyapatite has a stimulating effect on reparative regeneration and requires further study.

Comprehensive Medical and Psychological Rehabilitation in War Trauma (clinical case)

The purpose of the work was to analyze a clinical case of the course of war trauma and presents the experience of providing comprehensive medical and psychological clinical rehabilitation to a patient who suffered as a result of a terrorist attack. Patient D., 65 years old, sustained a mine-blast injury (MBI) to the right upper limb extremity during shelling. The optimal restoration of the functions of the upper injured limb and the patient's health (physical, somatic, mental) was carried out according to the algorithm of comprehensive medical and psychological clinical rehabilitation. As a result of the course of comprehensive medical and psychological clinical rehabilitation, significant positive dynamics was observed, including a decrease in edematous, painful, and inflammatory syndromes. The range of motion in the right upper limb and cervical-thoracic spine increased. Supination and pronation of the right hand became clearer and less painful (from 8 to 2 points), movement in the fingers of the right hand increased and became more steady, a clear pulsation appeared in the area of the skin defect on the right forearm, regression of pain in the elbow and shoulder joints on the right was noted, and the patient began to walk without a mobilization bandage. The course helped to reduce anxiety (from -1.82 to 0.85), asthenic symptoms (from 0.48 to 3.71), obsessive-phobic symptoms (from -1.96 to 1.74), and autonomic disorders (from -0.83 to 2.03). Low cortisol levels (61 nmol/l) in against acute stress indicated the development of post-traumatic stress disorder. Upon completion of the rehabilitation course, cortisol levels rose to a healthy level (246 nmol/l), indicating the effectiveness of the process of restoring the psychophysiological state and adapting to a stressful situation. War trauma is a complex and severe condition that requires an integrated approach to treatment and rehabilitation, covering not only physical but also psychological and social aspects of patients' health.

Container Plasty in Advanced Painful Osteolytic Vertebral Metastases With Posterior Wall Defect

Study Design: Review of mesh-container plasty (MCP) in osteolytic vertebral metastases. Objective: This study aims to assess the efficacy and safety of MCP in treating advanced vertebral metastases with posterior wall defects. Background: Diagnosis of vertebral metastases typically relies on the patient’s tumor history, bone scans, or vertebral MRI. Surgical intervention often involves sampling vertebral body tissue for pathologic diagnosis. The revised Tokuhashi score is commonly used to predict survival time in patients with bone metastases. Outcome evaluation frequently employs the visual analog scale (VAS) and the Oswestry disability index (ODI) in assessing spinal surgery outcomes. Methods: A retrospective analysis included 111 patients treated between January 2014 and January 2018 in our hospital. Patients were categorized into 2 groups: MCP group (n=51) and PVP group (n=60). Grades based on the percentage of posterior wall defect area were established: grade I (≤25%), grade II (26% to 50%), grade III (51% to 75%), and grade IV (76% to 100%). Efficacy was assessed using VAS and ODI. Results: Both MCP and PVP groups exhibited significant pain relief and improved motor function. No significant differences were observed in VAS and ODI scores at any follow-up point (P&gt;0.05). In the MCP group, bone cement leakage occurred in 13 cases, with a leakage rate of 25.49%. However, none of the patients experienced clinical or neurological symptoms. In the PVP group, bone cement leakage occurred in 50% of patients, with 6 patients developing neurological symptoms. Significant differences between the groups were observed in major complications related to bone cement leakage (P=0.03). Conclusion: MCP demonstrates efficacy in pain relief and safety in treating vertebral metastases with deficient posterior walls. It represents a promising option for spinal surgeons managing vertebral metastases with posterior wall deficiencies.

Photoactivated Hydrogel Therapeutic System with MXene-Based Nanoarchitectonics Potentiates Endogenous Bone Repair Through Reshaping the Osteo-Vascularization Network.

The repair and reconstruction of large-scale bone defects face enormous challenges because of the failure to reconstruct the osteo-vascularization network. Herein, a near-infrared (NIR) light-responsive hydrogel system is reported to achieve programmed tissue repair and regeneration through the synergetic effects of on-demand drug delivery and mild heat stimulation. The spatiotemporal hydrogel system (HG/MPa) composed of polydopamine-coated Ti3C2Tx MXene (MP) nanosheets decorated with acidic fibroblast growth factor (aFGF, a potent angiogenic drug) and hydroxypropyl chitosan/gelatin (HG) hydrogel is developed to orchestrate the reconstruction of the osteo-vascularization network and boost bone regeneration. Upon exposure to NIR light irradiation, the engineered HG/MPa hydrogel can achieve the initial complete release of aFGF to induce rapid angiogenesis and provide sufficient blood supply, maximizing its biofunction in the defect area. This integrated hydrogel system demonstrated good therapeutic efficacy in promoting cell adhesion, proliferation, migration, angiogenesis, and osteogenic differentiation through periodic NIR irradiation. In vivo, animal experiments further revealed that the spatiotemporalized hydrogel platform synergized with mild photothermal treatment significantly accelerated critical-sized bone defect healing by increasing the osteo-vascularization network density, recruiting endogenous stem cells, and facilitating the production of osteogenesis/angiogenesis-related factors. Overall, smart-responsive hydrogel couldenhance the reconstruction of the osteo-vascularization network in bone regeneration.

Phrenoplasty Techniques for the Reconstruction of Basal Chest Wall Defects

Background: Primary and secondary tumors of the abdominal lower third of the bony thorax are relatively rare. Therefore, indications and techniques for chest wall reconstructions in this area are not well defined. Methods: The techniques for reconstructing basal chest wall defects using the diaphragm are described. Indications for phrenoplasty are limited to reconstruction after full-thickness resection of at least two of the last four ribs in the midaxillary line. The diaphragm can be used for reconstructive purposes both if it is intact and if it is partially involved in the resection of the chest wall. Results: At our institution, the abovementioned reconstructive technique was successfully performed in five patients with an uneventful post-operative course. Conclusions: The main advantages of these methods are the use of promptly available, high-quality autologous tissue and the exclusion of the pleural space from the defect area, thus transforming a thoracic defect into an abdominal one. The disadvantage is a variable reduction in the volume of the hemithorax. These techniques could be compared with other reconstruction techniques using pre-/post-operative respiratory functional tests.

A cadaveric study of induced isolated orbital floor fractures and implications for surgical decision-making: comparison of two preoperative imaging modalities

Computed tomography (CT) is the gold standard for the diagnosis of isolated orbital floor fractures, while cone beam computed tomography (CBCT) is an alternative. The aim of this study was to compare the diagnostic accuracy of CT and CBCT for isolated orbital floor fractures. Forty-eight isolated orbital floor fractures were systematically induced in cadaver orbits. CBCT and CT scans of each cadaver head were performed and the image data imported into ProPlan CMF for analysis. The orbital floor area (OFA), orbital defect area (ODA), and peri-orbital tissue herniation were evaluated. Surgical decision-making differed significantly according to the imaging modality (P = 0.031). The odds of decision discrepancy between CBCT and CT were higher with increasing ODA/OFA ratios, when adjusted for peri-orbital tissue herniation and fracture localization (P = 0.026). An ODA/OFA ratio cut-off value of >36.25% had a sensitivity of 100% and specificity of 71% (area under the curve 0.83, P = 0.011) for predicting discrepancies between CBCT and CT in surgical decision-making. In this cadaveric study, CT and CBCT were diagnostically equivalent for isolated orbital floor fractures with an ODA/OFA ratio ≤36.25%. However, fractures exceeding this threshold may be better evaluated by CT to avoid discrepancies in surgical decision-making.

Comparative histomorphological assessment of the osteoinductive capacity of a nanofibrillated cellulose-based composite and autologous blood clot.

The present study aimed to evaluate and compare the effect of nanofibrillated cellulose (NFC)-based composite with dicalcium phosphate dihydrate and an autologous blood clot (ABC) on the formation of new bone tissue in vivo by histological and histomorphometric assessment. A total of 72 rats with created femoral defects (2 mm) were used. The rats were divided into three groups: (1) with filling of the defect with an ABC, (2) NFC-1-with filling of both the cortical plate and intramedullary space in the defect area, and (3) NFC-2-with filling of only the intramedullary space in the defect area. Histological and histomorphometric analysis was performed to assess the healing of the bone defect after 14, 30 and 60 days. Complete closure of the cortical plate defect was detected in the NFC-2 group on Day 30 (p < 0.0001). Moreover, in both NFC groups on the 30th and 60th days, ongoing osteogenesis was observed, characterized by a large volume of newly formed circular pattern bone tissue in the intramedullary space. This study demonstrated that the NFC-based composite, which is located below the level of the cortical plate, tamponing only the intramedullary space (NFC-2), improves bone tissue repair at the site of a bone defect of the cortical plate and has the potential of prolonged osteoinductivity. Not applicable.

Comparison of the Effects of Microfracture, Soft Callus Implantation, and Matrix-Supported Chondrocyte Implantation in an Experimental Osteochondral Defect Model in Rats

Background: The treatment of cartilage defects remains challenging due to the avascular nature of cartilage. Aim: This study investigates the therapeutic effect of soft callus in osteochondral defects and explores the ability of multipotent and pluripotent cells within the callus to form fibrous or hyaline cartilage in the defective area. Methods: Twenty-one rats were divided into three equal groups: Group 1 received only microfracture (MF), group 2 received microfracture with autologous chondrocyte implantation (MF+ACI), and group 3 received microfracture with soft callus implantation (MF+SCI). All rats underwent diaphyseal fracture in their left tibias, which was stabilized with a Kirshner wire. One week later, osteochondral defects were created in the right knees of all rats. For group 1, microfracture alone was applied to initiate healing in the defects. In group 2, heterologous chondrocytes, previously harvested from the lateral condyle of a rat’s left femur and cultivated in a laboratory environment, were implanted into the microfracture site. In group 3, soft callus tissue obtained from the left tibial fracture was compressed and implanted into the defective area. All groups were sacrificed at the 6th week, and the healing status of the osteochondral defect areas was histopathologically evaluated. Results: Macroscopic examination at the end of the study revealed comparable ICRS-1 scores for MF+ACI (group 2) (11.28 ± 1.25) and MF+SCI (group 3) (11.14 ± 0.37), while MF alone (group 1) (4.28 ± 1.25) showed significantly lower results. Microscopic examination yielded similar outcomes. Regarding histological scores, ICRS-2 scores for MF (group 1) (35.30 ± 1.13), MF+ACI (group 2) (47.09 ± 1.63), and MF+SCI (group 3) (43.97 ± 1.49) were statistically significantly lower. Conclusion: Defects treated with soft callus implantation demonstrated comparable outcomes to the widely used and gold-standard autologous chondrocyte implantation. When compared to microfracture alone, better macroscopic and microscopic results were achieved with soft callus implantation.

Does defect size matter in abdominal wall reconstruction with successful fascial closure?

BackgroundConflicting literature suggests that larger defects in abdominal wall reconstruction both increase the risk of recurrence and have no impact on recurrence. In our prior work, hernias with defect areas ≥100 cm2 were associated with increased discomfort, operative time, and length of stay but not recurrence or reoperation. Our goal was to determine if defect size, even in giant hernias, would impact recurrence after mesh repair with complete fascial closure. MethodsA prospectively maintained hernia database was reviewed for clean, abdominal wall reconstruction with fascial closure and synthetic mesh. Patients were grouped and compared by defect area: moderate hernias <200 cm2 (LT200) and giant hernias ≥200 cm2 (GT200). ResultsOf 984 patients, 607 LT200 (average area: 92.8 ± 60.8 cm2) were compared with 377 GT200 (average area: 363.2 ± 196.7 cm2). LT200 and GT200 had similar mean age, body mass index, and smoking rate, but GT200 had higher rates of diabetes (22.1% vs 27.9%; P = .040), recurrent hernias (52.7% vs 63.4%; P = .001), preoperative Botox (0.7% vs 8.8%; P < .001), component separation (23.4% vs 59.9%; P < .001), panniculectomy (8.7% vs 15.4%; P = .001), and negative-pressure incisional vacuum placement (5.9% vs 13.5%; P < .001). GT200 had increased mesh size (753.5 ± 367.1 vs 1168.2 ± 412.0 cm2; P < .001), operative time (147.8 ± 55.7 vs 205.3 ± 59.9 minutes; P < .001), and length of stay (5.1 ± 3.2 vs 6.9 ± 4.4 days; P < .001). GT200 had more wound complications (24.7% vs 36.1%; P < .001) and readmissions (9.1% vs 15.1%; P = .004) but similar recurrence rates (3.0% vs 3.7%; P = .520) over the mean follow-up of 30.1 ± 38.9 and 23.0 ± 33.6 months for LT200 and GT200, respectively. On multivariable regression, previous abdominal wall reconstruction, lightweight mesh, and wound complications independently predicted recurrence; component separation was protective, but defect size was not predictive of recurrence. ConclusionGT200 required more complex measures to achieve fascial closure and resulted in increased length of stay, wound complications, and readmissions; however, GT200 had the same recurrence rate as smaller defects when fascial closure was achieved.

The Papilla Base CTG: A Novel Approach for Interdental Soft Tissue Reconstruction.

Impairment or loss of interdental papilla is a common issue in patients with periodontal disease, leading to phonetic, functional, and aesthetic concerns. Numerous techniques have been explored to reconstruct and regenerate interdental papillae, but consistent success remains challenging. This article presents a novel surgical approach that applies the principles of the Connective Tissue Graft (CTG) wall technique to enhance papilla volume when interdental clinical attachment loss is present in the aesthetic zone. The case of a 35-year-old woman with an RT3 recession defect associated with loss of interdental hard and soft tissues is discussed. The patient underwent a procedure involving palatal incisions, application of amelogenins, and a trapezoidal shape CTG fixed at the base of the papilla under a coronally advanced flap. This approach aimed to stabilize the blood clot and prevent soft tissue collapse into the defect area, enhancing the position and volume of the interdental papilla. Results at 6- and 12-months follow-up indicated significant improvement in papilla appearance and complete root coverage. This case suggests that the modified CTG wall technique can effectively treat buccal and interdental gingival recessions associated with horizontal or infrabony defects. Further clinical trials are necessary to confirm these findings and establish the most effective approach for interdental papilla reconstruction.

Nonlinear characteristics in the cylindrical roller bearing with raceway defects

Cylindrical roller bearings (CRBs) are subjected to significant cyclic stress under extreme operating conditions. This leads to the formation of localized wave defects on the raceway surface, such as burn. Thus, a new mathematical model is proposed to consider the local wave defects on the raceway caused by burns in this paper. Further, a dynamic model of CRB incorporating raceway defects is developed based on the contact relationships between components, and the proposed model is verified by measured acceleration responses. The effects of local wave defects on the nonlinear vibration characteristics of the bearings are studied and the results show that an increase in the number of defect waves reduces the additional displacement of rollers passing through the defect area, obscuring signal characteristics induced by the defect. Moreover, the presence of the defect influences the nonlinear interaction between the roller and raceway, which subsequently affects the cage whirling motion. This study of bearing dynamic behavior in this paper can contribute to the condition monitoring of bearings.