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Between nerve defects, a bridge formed by multiple cells is the fundamental structure for guiding axons across this damaged region. Here, we developed a functional material that mimics hypoxia during the early stages of nerve regeneration by deferoxamine. We used this material and single-cell sequencing to analyze the "bridge" structure between peripheral nerve defects. We found that hypoxia in damaged tissues might play a key role in stimulating macrophages, promoting endothelial-to-mesenchymal transition, and driving the migration of endothelial cells to the injured region to form regenerative bridge tissue and guide the subsequent regeneration of Schwann cells and axons. The results showed that the final nerve defect repair outcomes were similar with autografts after intervention by this material. This study challenges the view that hypoxia is exclusively involved in peripheral nerve regeneration and provides a potentially valuable candidate material for clinical use.

Articular cartilage defects cause pain and progression to osteoarthritis, and there remains a critical need for safe and cost-effective interventions. Historically available treatments for articular cartilage defects are limited in success, in part due to the native biology of the cartilage, which has limited healing potential, as well as due to the inability to create a favorable signaling and cell environment. The evolution of cartilage treatment has been rapid, with emerging options for treatment and repair. Recent advances in platelet-rich plasma (PRP) have demonstrated efficacy in growth factor delivery as well as symptom modulation. Furthermore, cell-based approaches such as autologous chondrocyte implantation (ACI) and stem/stromal cell therapies have ushered in a new era of treatments which can be responsive to and interact with the local intra-articular environment. Finally, the technovolution of this field has led to the development of single-stage combination autologous/allogeneic treatments which have the potential to overcome logistical and recovery limitations of two-stage treatments while providing trophic factors, signaling orchestration, and autologous cells for defect repair.

The alarms of the program-semantic defect-detection report based on static analysis include defects and false positives. The repair of defects and the elimination of false positives are time-consuming and laborious, and new defects may be introduced in the process. To solve these problems, the safe constraints interval of related variables and methods are proposed for the semantic defects in the program, and proposes a functionally equivalent no-side-effect program-semantic defect repair and false-positive elimination strategy based on the test-equivalence theory. This paper realizes the automatic repair of the typical semantic defects of Java programs and the automatic elimination of false positives by adding safe constraint patches. After the repair, the program functions are equivalent and the status of each program point is within the safety range, so that the functions before and after the defect repair are consistent, and the functions and semantics before and after the false positives are eliminated. We have evaluated our approach by repairing 5 projects, our results show that the repair strategy does not require manual confirmation of alarms, automated repair of the program effectively, shortened the repair time greatly, and ensured the correctness of the program after the repair.

Background An increasing number of patients with previously repaired congenital heart disease (CHD) present with pulmonary arterial hypertension (PAH). This can occur immediately after repair (residual PAH) or years later. Case presentation We present the case of a young woman who underwent repair of a ventricular septal defect in later childhood. Three years after repair, she was found to have significant residual PAH. She remained stable on PAH therapies, but a decade later decided to become pregnant against medical advice. She deteriorated during pregnancy and required escalation of PAH therapies and eventual admission to the intensive care unit, with an uneventful delivery at 32 weeks. Despite successful delivery, she remained symptomatic post-partum, with evidence of disease progression at right heart catheterisation. Conclusions All patients with repaired CHD should undergo routine screening for PAH. Early diagnosis and expert management, including the use of PAH therapies, is recommended to optimise outcome. Pregnancy is contraindicated in PAH patients, including patients with CHD, and requires an expert multidisciplinary approach to reduce morbidity and mortality when patients opt to proceed.

Nanomachining is typically described as being a material-independent subtractive mask repair process. This is a correct statement, for the most part, since it does not require a material end-stop nor chemistries targeted to remove only a specific material. However, it is not true when considering the effect of materials being removed on the integrity of the nanomachining tip (also referred to here as NanoBitsTM). While many advanced absorber materials such as OMOG are easier to nanomachine than earlier absorber materials such as chrome and MoSi, the absorbers used in EUV have proven to be much harder and tougher (in a nanomechanical sense) while sitting atop a very fragile multilayer substrate. This work shows results from advancements on the latest nanomachining platform, nm-VI to minimize tip wear during the repair process. Consequently, this improves defect repair capability for smaller dimensions, decreases overhead from tip changeouts, decreases the cost of consumables by increasing NanoBit lifetime, and increases repair tool return-on-investment.

Nanomachining is one of the primary repair processes for leading-edge technology photomasks. Many hardware improvements have been made in successive nanomachining-tool generations to improve repair performance specifications (stability, drift, and z-depth control). However, improvement to the repair processes are still needed to address the use of the latest generation of high aspect-ratio (HAR) NanoBitsTM (1.8 AR and above). Although beneficial for repair of leading-edge photomasks, HAR NanoBitsTM exhibit greater degrees of nonlinear deflection, wear, and even breakage during traditional repair processes. In this work, the authors chronicle investigations into new nanomachining process options to enable subtractive hard defect repair with HAR NanoBitsTM down to the most advanced technology node with topographic z-depth control within ±0.5 nm and no detectable line edge, or multilayer capping layer, roughness.

A stem cell-based tissue-engineering approach is a promising strategy for treatment of cartilage defects. However, there are conflicting data in the feasibility of using this approach in young recipients. A young rabbit model with an average age of 7.7 months old was used to evaluate the effect of a tissue-engineering approach on the treatment of osteochondral defects. Following in vitro evaluation of proliferation and chondrogenic capacity of infrapatellar fat pad-derived stem cells (IPFSCs) after expansion on either tissue culture plastic (TCP) or decellularized extracellular matrix (dECM), a premature tissue construct engineered from pretreated IPFSCs was used to repair osteochondral defects in young rabbits. We found that dECM expanded IPFSCs exhibited higher proliferation and chondrogenic differentiation compared to TCP expanded cells in both pellet and tissue construct culture systems. Six weeks after creation of bilateral osteochondral defects in the femoral trochlear groove of rabbits, the Empty group (left untreated) had the best cartilage resurfacing with the highest score in Modified O'Driscoll Scale (MODS) than the other groups; however, this score had no significant difference compared to that of 15-week samples, indicating that young rabbits stop growing cartilage once they reach 9 months old. Interestingly, implantation of premature tissue constructs from both dECM and TCP groups exhibited significantly improved cartilage repair at 15 weeks compared to those at six weeks (about 9 months old), indicating that a tissue-engineering approach is able to repair adult cartilage defects. We also found that implanted pre-labeled cells in premature tissue constructs were undetectable in resurfaced cartilage at both time points. This study suggests that young rabbits (less than 9 months old) might respond differently to the classical tissue-engineering approach that is considered as a potential treatment for cartilage defects in adult rabbits.

Pt, as a common cocatalyst, has been widely used in photocatalytic H2 evolution. However, the specific role of Pt in photocatalytic H2 evolution has not been thoroughly studied. In this paper, by employing three Pt sources with different charges (positive, negative and neutral), we systematically studied the charge effect of Pt sources on photocatalytic H2 evolution via TiO2 catalyst. According to the results of Raman, X-ray photoelectron spectroscopy (XPS), recycle experiments and photocurrent characterizations, it was found that TiO2 would produce electropositive defects during photocatalytic H2 evolution, inevitably leading to the decline of H2 production activity. Thanks to the electrostatic interaction, the electronegative Pt source not only promoted charge separation, but preferential deposited on electropositive defects, which acted as the defect repair agent, and thus resulted in the increased photocatalytic stability. This work may provide a new perspective for enhancing photocatalytic stability of hydrogen production.

Introduction:Hospital readmission is an important driver of costs among patients with CHD. We assessed predictors of 30-day rehospitalisation following cardiac surgery in CHD patients across the lifespan.Methods:This was a retrospective analysis of 981 patients with CHD who had cardiac surgery between January 2011 and December 2012. A multivariate logistic regression model was used to identify demographic, clinical, and surgical predictors of 30-day readmission. Receiver operating curves derived from multivariate logistic modelling were utilised to discriminate between patients who were readmitted and not-readmitted at 30 days. Model goodness of fit was assessed using the Hosmer–Lemeshow test statistic.Results:Readmission in the 30 days following congenital heart surgery is common (14.0%). Among 981 patients risk factors associated with increased odds of 30-day readmission after congenital heart surgery through multivariate analysis included a history of previous cardiac surgery (p < 0.001), longer post-operative length of stay (p < 0.001), as well as nutritional (p < 0.001), haematologic (p < 0.02), and endocrine (p = 0.04) co-morbidities. Patients who underwent septal defect repair had reduced odds of readmission (p < 0.001), as did children (p = 0.04) and adult (p = 0.005) patients relative to neonates.Conclusion:Risk factors for readmission include a history of cardiac surgery, longer length of stay, and co-morbid conditions. This information may serve to guide efforts to prevent readmission and inform resource allocation in the transition of care to the outpatient setting. This study also demonstrated the feasibility of linking a national subspecialty registry to a clinical and administrative data repository to follow longitudinal outcomes of interest.

Background The traditional technique of gastrointestinal reconstruction of the esophagus after esophagectomy presents plenty of complications. Hence, tissue engineering has been introduced as an effective artificial alternative with potentially fewer complications. Three types of esophageal scaffolds have been used in experimental studies so far. The aim of our meta-analysis is to present the postoperative outcomes after esophageal replacement with artificial scaffolds and the investigation of possible factors that affect these outcomes. Methods The present proportional meta-analysis was designed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and A MeaSurement Tool to Assess systematic Reviews guidelines. We searched Medline, Scopus, Clinicaltrials.gov, EMBASE, Cochrane Central Register of Controlled Trials CENTRAL, and Google Scholar databases from inception until February 2020. Results Overall, 32 studies were included that recruited 587 animals. The pooled morbidity after esophageal scaffold implantation was 53.4% (95% CI = 36.6–70.0%). The pooled survival interval was 111.1 days (95% CI = 65.5–156.8 days). Graft stenosis (46%), postoperative dysphagia (15%), and anastomotic leak (12%) were the most common complications after esophageal scaffold implantation. Animals that underwent an implantation of an artificial scaffold in the thoracic part of their esophagus presented higher survival rates than animals that underwent scaffold implantation in the cervical or abdominal part of their esophagus (P Conclusion Tissue engineering seems to offer an effective alternative for the repair of esophageal defects in animal models. Nevertheless, issues like graft stenosis and lack of motility of the esophageal scaffolds need to be addressed in future experimental studies before scaffolds can be tested in human trials.

The growth and advancement of minimally invasive cardiac surgery in recent years has allowed robotic and totally endoscopic procedures to become safe and effective options for the treatment of patients with various diseases of the heart. However, despite these advances, outcome data for robotic correction of congenital cardiac anomalies are scarce. This is particularly true for robotic ventricular septal defect (VSD) repair with initial experiences only recently having been published by a single group. Here, we present the case of a 29-year-old female who underwent robotic totally endoscopic VSD repair due to persistent symptoms with resolution of preoperative shunting and severe tricuspid regurgitation following surgery. This unique case adds to the limited data currently available in the literature on robotic VSD repair to show that it is a safe procedure when performed by a dedicated surgical team experienced in minimally invasive robotic cardiac surgery. We feel that, in this setting, the benefits of a robotic surgical approach can be afforded to more patients with excellent results.

Postinfarction ventricular septal rupture is a rare and devastating complication of myocardial infarction. Despite attempts at acute surgical and percutaneous defect closure, morbidity and mortality remain high. Herein, we describe a hybrid surgical and catheter-based approach to defect closure in a 63-year-old woman with postinfarction ventricular septal rupture and cardiogenic shock.

Background Repair of the soft tissue defect in myelomeningoceles remains challenging. The literature currently lacks a systematic approach, reporting high rates of complications. We present outcomes from the largest series to date and describe a simplified approach that minimizes morbidity and streamlines decision making. Methods Patients 1 year or younger who underwent myelomeningocele repair between 2008 and 2018 were reviewed. Flap types were categorized by tissue composition. Complications were dichotomized into early and late ( 30 days postoperative, respectively). Logistic regression was used to measure the impact of flap tissue composition and skin closure technique on odds of postoperative complications. Results Ninety-seven patients met inclusion criteria. Reoperation was required in only 3 (3.0%) patients-1 for wound dehiscence and 2 for surgical site infections. Zero cases of tethered cord or cerebrospinal fluid leak occurred. The most common minor complications were early wound complications (n = 18, 18.6%) and early infection (n = 5, 5.2%). Fascia-only flaps and muscle + other tissue flaps were not associated with higher odds of complications compared with muscle-only flaps (odds ratio [OR], 2.13; 95% confidence interval [CI], 0.53-8.50, P = 0.29; OR = 2.87, 95% CI 0.66-12.51, P = 0.16, respectively). Rhomboid flaps for skin closure were associated with higher odds of complications (OR, 4.47; 95% CI, 1.00-19.97; P = 0.05). Conclusions Our approach to myelomeningocele repair demonstrated no cases of secondary tethered cord or cerebrospinal fluid leak, and reoperative rates were extremely low. Because complications were unrelated to flap type, we recommend a simplified approach using any tissue type for dural coverage and 2-layer primary closure of the skin.

Introduction: Transurethral endoscopic surgery is limited by its incompatibility in defect repair that requires suturing. Open surgery carries significant higher morbidities, whereas pneumoperitone...

It is reported that almost one in five women will need some form of pelvic organ prolapse surgery in their lifetime, with anterior wall repair accounting for nearly half of these. Cystoceles occur secondary to defect(s) in one or more of the vaginal wall support mechanisms, including its lateral paravaginal attachments. Paravaginal defects are very common in women presenting with cystocele, thus highlighting the importance of paravaginal defect repair for optimal cystocele correction in the majority of cases. Although there are several paravaginal defect repair procedures, some entail complex techniques, whereas others rely on the use of transvaginal mesh, which is currently not permitted in many countries. In this video article we present a novel trans-obturator native tissue paravaginal defect repair for the management of cystocele. This procedure has the advantages of avoiding complex transabdominal paravaginal defect repair, the controversial use of transvaginal mesh, or a single-point fixation to an arcus tendineus fasciae pelvis that might be difficult to identify. We believe that the trans-obturator cystocele repair procedure offers several advantages over existing paravaginal defect repair alternatives.

Background Outcomes after the arterial switch operation (ASO) for dextro-transposition of the great arteries have improved significantly since its inception in the 1980s. This study reviews contemporaneous outcomes and predictors for late reinterventions after ASO. Methods We retrospectively reviewed patients who underwent ASO for dextro-transposition of the great arteries from 1997 to 2017. Technical performance score (TPS) class (class 1, trivial or no residua; class 2, minor residua; class 3, major residua or reintervention) was assigned at discharge based on echocardiographic evaluation of components of the ASO. Multivariable Cox regression identified patient- and procedure-specific factors associated with postdischarge reinterventions. Results Among 598 patients, 410 (69%) underwent ASO and 188 (31%) underwent ASO with ventricular septal defect repair. Median age at surgery was 5 days (interquartile range, 3 to 7); median follow-up time was 8.2 years; 408 (68%) were male; 50 (8.3%) were premature; and 10 (1.7%) had noncardiac anomalies or syndromes. Survival to hospital discharge was 98% (n = 591). Among 349 patients with follow-up, freedom from unplanned reintervent2ion at 5 years was 99% for TPS class 1, compared with 84% for class 2 and 30% for class 3. On multivariable Cox regression, classes 2 and 3 had significantly higher hazard for reintervention (class 2 hazard ratio 10.6; 95% confidence interval, 2.5 to 44.2; P = .001; class 3 hazard ratio 58.2, 95% confidence interval, 13.1 to 259; P Conclusions At our center, ASO was associated with relatively low mortality. Class 2 and class 3 TPS were the most important independent predictors of reinterventions after discharge. Therefore, TPS can serve as a tool for identifying high-risk patients who warrant closer follow-up.

BACKGROUND: The present study aimed to investigate the healing of articular cartilage with boric acid (BA) injection in an experimental cartilage defect model of rabbit knee. METHODS: Nine skeletally mature female New Zealand White rabbits were used. The right knees of the rabbits were assigned as the study group and injected with the BA solution and the left knees of the rabbits as the control group. Under anesthesia, a cylindrical full-thickness osteochondral defect (4 mm in diameter and 3 mm in depth) was formed using a drill on the anterior side of the articular surface of the medial femur condyle. The BA solution was administered to the right knees of rabbits in the form of an intra-articular injection (8 mg/kg) for 6 weeks, at the same day and hours each week. The animals were euthanized at the end of the 2nd month. RESULTS: In both macroscopic evaluation and microscopic evaluation, statistically significant differences were observed in the BA injection group compared with the control group (p

The study objective is to describe currently available and optimal methods of central skull base reconstruction.Material and methods. This article describes a 10-year experience of endoscopic surgery in reconstructing the defects after the removal of chiasmosellar tumors.Results. We developed a strategy for assessing the risks for postoperative liquorrhea and choosing an optimal surgical technique. This strategy allows maintaining the incidence of postoperative liquorrhea of 4 %.Conclusion. Autografts are the most widely used material for reconstructing skull base defects after the removal of chiasmosellar tumors. The multilayer reconstruction is more preferable due to the high risk of postoperative liquorrhea.

Advances in the management of congenital heart disease (CHD) in children have resulted in growing numbers of adults with CHD. Pulmonary arterial hypertension related to CHD (PAH-CHD) is a common complication, affecting up to 10% of patients; and can arise even after successful and complete defect repair, with severe and potentially fatal consequences. Careful work-up in these patients is essential, particularly hemodynamic assessment, and can help define the most appropriate therapeutic approach. Management can be challenging, but the therapeutic armamentarium is continually expanding and now includes surgical, transcatheter and medical options. Timely correction of defects along with early treatment with advanced medical therapies appears to improve quality of life and possible even improve survival. Interestingly most studies of PAH-CHD have focused on its most severely afflicted patients, those with Eisenmenger Syndrome, making it less certain how to manage PAH-CHD of milder degrees. This review summarizes our current understanding of PAH-CHD and emphasizes the need for close follow-up in specialized centers of care where close collaboration is common practice.

The importance of a functioning Achilles tendon for normal gait underlies the need for adequate reconstruction in the event of problems with repair or initial surgical manipulation. Large segmental Achilles tendon defects present a difficult problem to treating surgeons, and catastrophic failure of the reconstruction can be very intimidating. Multiple procedures including fascial turndowns and allograft reconstruction have been utilized with varying degrees of success. Causes of failure are multifactorial and include poor intraoperative tensioning, postoperative adhesions, infection, and noncompliance with postoperative recovery protocols. After appropriate preoperative workup, the surgeon should be prepared to do an extensive resection of tendon and be prepared for a large defect repair. The benefits of a long turndown flap versus an allograft rebuilding have not been resolved: both procedures offer good results. The turndown flaps work well but require extensive dissection and have risk for significant scar formation. Dual semitendinosus allograft reconstruction offers preservation of the proximal muscle tendon unit and strength.

Ventricular septal defects – large, surgically closed or small, untreated – have demonstrated lower peak exercise capacity compared with healthy controls. The mechanisms behind these findings are not yet fully understood. Therefore, we evaluated biventricular morphology in adults with a ventricular septal defect using MRI. Adults with either childhood surgically closed or small, untreated ventricular septal defects and healthy controls underwent cine MRI for the evaluation of biventricular volumes and quantitative flow scans for measurement of stroke index. Scans were analysed post hoc in a blinded manner. In total, 20 operated patients (22±2 years) and 20 healthy controls (23±2 years) were included, along with 32 patients with small, unrepaired ventricular septal defects (26±6 years) and 28 controls (27±5 years). Operated patients demonstrated larger right ventricular end-diastolic volume index (103±20 ml/m2) compared with their controls (88±16 ml/m2), p=0.01. Heart rate and right ventricular stroke index did not differ between operated patients and controls. Patients with unrepaired ventricular septal defects revealed larger right ventricular end-diastolic volume index (105±17 ml/m2) compared with their controls (88±13 ml/m2), p2) compared with controls (46±8 ml/minute/m2), p=0.02, with similar heart rates. Both patient groups’ right ventricles were visually characterised by abundant coarse trabeculation. Positive correlations were demonstrated between right ventricular end-diastolic volume indices and peak exercise capacity in patients. Left ventricle measurements displayed no differences between groups. In conclusion, altered right ventricular morphology was demonstrated in adults 20 years after surgical ventricular septal defect repair and in adults with small, untreated ventricular septal defects.

Titanium mesh was widely used for cranium defect repair but associated with high complication rates. In this study, the authors describe a method using latissimus dorsi-myocutaneous flap in the repair of titanium mesh exposure and scalp defect after cranioplasty, and the plate retaining is also achieved. Fifteen patients from April 2012 to May 2016 underwent this procedure, the age ranged from 32 to 62 years and 47 years old on average, and all the patient had plate exposure combined with surgical site infection and variation of scalp defect. All the patients had fully flap survive, and follow up ranged from 6 months to 24 months, 1 patient had titanium mesh re-expose and received additional operation to remove the plate. The free latissimus dorsi musculocutaneous flap could supply large size of bulky tissue coverage with good blood supply and strong anti-infection ability. This method was an option for retaining the titanium mesh and repairing the exposure for the mild infection with small size scalp defect patient.

We currently perform open-heart procedures using bloodless priming of cardiopulmonary bypass circuits regardless of a patient’s body weight. This study presents results of this blood-saving approach in neonates and infants with a body weight of up to 7 kg. It tests with multivariate analysis factors that affect perioperative transfusion. A total of 498 open-heart procedures were carried out in the period 2014–2016 and were analysed. Priming volume ranged from 73 ml for patients weighing up to 2.5 kg to 110 ml for those weighing over 5 kg. Transfusion threshold during cardiopulmonary bypass was 8 g/dl of haemoglobin concentration. Transfusion factors were first analysed individually. Variables with a p-value lower than 0.2 underwent logistic regression. Extracorporeal circulation was conducted without transfusion of blood in 335 procedures – that is, 67% of cases. Transfusion-free operation was achieved in 136 patients (27%) and was more frequently observed after arterial switch operation and ventricular septal defect repair (12/18=66.7%). It was never observed after Norwood procedure (0/33=0%). Lower mortality score (p=0.001), anaesthesia provided by a certain physician (p=0.006), first chest entry (p=0.013), and higher haemoglobin concentration before going on bypass (p=0.013) supported transfusion-free operation. Early postoperative mortality was 4.4% (22/498). It was lower than expected (6.4%: 32/498). In conclusion, by adjusting the circuit, cardiopulmonary bypass could be conducted without donor blood in majority of patients, regardless of body weight. Transfusion-free open-heart surgery in neonates and infants requires team cooperation. It was more often achieved in procedures with lower mortality score.

This is a case presentation of successful defect repair after radical surgical excision of a moderately large basal cell carcinoma by a simple procedure taking advantage of a patient's individual face features.

INTRODUCTION AND HYPOTHESIS: Paravaginal defect (PVD) has been suggested as one of the main contributors to the development of prolapse in the anterior vaginal wall (AVW). We aimed to evaluate the descent of pelvic organs, presence of vaginal H configuration, and pubococcygeus (PC) muscle defect by pelvic magnetic resonance imaging (MRI), together with subjective symptoms of prolapse, before and 6 months after PVD repair. We also aimed to evaluate risk factors of recurrence.METHODS: Fifty women with PVD diagnosed by gynecological examination and scheduled for vaginal PVD repair were planned for enrollment. Preoperatively and 6 months postoperatively, subjective symptoms were evaluated using the International Consultation on Incontinence Questionnaire-Vaginal Symptoms (ICIQ-VS) together with MRI of the pelvis to evaluate defects in the PC muscle, vaginal shape, and pelvic organ descent.RESULTS: Forty-six women completed the study. Twenty had PVD repair alone, whereas 26 also had concomitant surgery performed. Prolapse grade, subjective symptoms, sexual problems, and quality of life (QoL) were significantly improved at follow-up. Missing vaginal H configuration was observed in 21 women before operation and was correlated with PC muscle defect. Recurrence rate was 39%, and significantly more women with recurrence had PC muscle defects and missing H configuration.CONCLUSION: Vaginal PVD repair alone or combined with concomitant surgery significantly reduces objective prolapse and subjective symptoms. We could not demonstrate MRI findings of missing H configuration to be a sign of PVD but, rather, a sign of defect in the PC muscle. Risk of recurrence is significantly higher in women with major PC muscle defects and missing H configuration.

Osteoarthritis (OA) poses a tough challenge worldwide. Adipose-derived stem cells (ASCs) have been proved to play a promising role in cartilage repair. However, enzymatic digestion, ex vivo culture and expansion, with significant senescence and decline in multipotency, limit their application. The present study was designed to obtain micro-fragmented adipose tissue (MFAT) through gentle mechanical force and determine the effect of this stem cell-based natural scaffold on repair of full-thickness cartilage defects. In this study, ASCs sprouted from MFAT were characterized by multi-differentiation induction and flow cytometry. Scratch and transwell migration assays were operated to determine whether MFAT could promote migration of chondrocytes in vitro. In a rat model, cartilage defects were created on the femoral groove and treated with intra-articular injection of MFAT or PBS for 6 weeks and 12 weeks ( n = 12). At the time points, the degree of cartilage repair was evaluated by histological staining, immunohistochemistry and scoring, respectively. Two unoperated age-matched animals served as native controls. ASCs derived from MFAT possessed properties to differentiate into adipocytes, osteocytes and chondrocytes, with expression of mesenchymal stem cell markers (CD29, 44, 90) and no expression of hematopoietic markers (CD31, 34, 45). In addition, MFAT could significantly promote migration of chondrocytes. MFAT-treated defects showed improved macroscopic appearance and histological evaluation compared with PBS-treated defects at both time points. After 12 weeks of treatment, MFAT-treated defects displayed regular surface, high amount of hyaline cartilage, intact subchondral bone reconstruction and corresponding formation of type I, II, and VI collagen, which resembled the normal cartilage. This study demonstrates the efficacy of MFAT on cartilage repair in an animal model for the first time, and the utility of MFAT as a ready-to-use therapeutic alternative to traditional stem cell therapy.

Tantalum (Ta)-coated porous Ti-6A1-4V scaffolds have better bioactivity than Ti-6A1-4V scaffolds; however, their bioperformance as an artificial vertebral body (AVB) is unknown. In the present study, we combined a Ta-coated Ti-6A1-4V scaffold with rabbit bone marrow stromal cells (BMSCs) for tissue-engineered AVB (TEAVB) construction and evaluated the healing and fusion efficacy of this scaffold in lumbar vertebral defects after corpectomy in rabbits. The results showed that BMSCs on the surface of the Ta-coated Ti scaffolds proliferated better than BMSCs on Ti scaffolds. Histomorphometry showed better bone formation when using Ta-coated TEAVBs than that with Ti TEAVBs at both 8 and 12 weeks after implantation. In addition, the vertical and rotational stiffness results showed that, compared with uncoated TEAVBs, Ta-coated TEAVBs enhanced rabbit lumbar vertebral defect repair. Our findings demonstrate that Ta-coated TEAVBs have better healing and fusion efficacy than Ti TEAVBs in rabbit lumbar vertebral defects, which indicates their good prospects for clinical application.

Cerebrospinal fluid rhinorrhea of the sphenoid sinus is a serious clinical condition. Endoscopic management has become the gold standard treatment. Use of multilayer closure to occlude the anatomical defect was suggested by some reports. The current study aims to evaluate endoscopic repair of sphenoid sinus CSF leak using multilayer closure. The present study included 17 patients. Their CSF leak was caused by accidental trauma in 9 patients (52.9 %), iatrogenic trauma in 1 patient (5.9 %) and in 7 patients (41.1 %), the leak occurred spontaneously. After localization of the leak, multilayer closure was used for anatomical defect repair. All patients achieved successful operative repair form the first attempt. The reported complications included meningitis in only 1 patient (5.9 %).Endoscopic repair of the sphenoid sinus CSF leaks using multilayer closure is a safe and effective approach. The Hadad–Bassagasteguy flap is the corner stone for sealing skull base defects in sphenoid sinus.

Even the simplest point defect in a two-dimensional (2D) material can have a significant influence on its electronic, magnetic, and chemical properties. Defect repairing in 2D materials has been a focus of concern in recent years. Based on first-principles calculations, the repair of C and N single vacancies with CO or NO molecules in a C3N monolayer has been studied. The repair process consists of two steps, i.e., filling of the vacancy with the first molecule and removal of the extra O atom by a second molecule. Overall, the repair processes of C and N single vacancies by CO or NO molecules are both thermodynamically and kinetically favorable, as evidenced by the significant energy released and the small energy barriers. In addition, the electronic and magnetic properties and the chemical activity of the C3N monolayer before and after the defect repair have been studied systematically. In addition to single vacancies, the repair of double vacancies with CO was also studied; this process is much less kinetically favorable than the case of single vacancies. This study provides useful insight into the effects of simple atomic vacancies on the physical and chemical properties of the C3N 2D semiconductor and also presents a promising strategy for repairing vacancies.

Study Objective To demonstratefull-thickness excision of the affected muscularis along the submucosal plane. Design Stepwise demonstration of LRSD technique with narrated video footage. Setting LRSD takes advantage of the submucosal layer of the bowel wall and uses it as an easier line of excision for rectal endometriosis compared with the very difficult traditional line of excision of irregular disease-muscularis interface. The expansion of the submucosal layer by the injection separates the affected muscularis away from the mucosa, making it safer to excise the lesion with less chance of entering the bowel lumen. Excision of disease is more complete with LRSD because the full-thickness excision of the muscularis layer includes the healthy deep muscularis, which will form the disease-free deep excision margin. Intervention This video will highlight anatomic and technical aspects of LRSD including the following key steps: 1. Mobilization of diseased bowel segment 2. Submucosal injection 3. Circumferential incision of the muscularis 4. Submucosal dissection along the submucosal plane 5. Bowel wall integrity test 6. Muscularis defect repair Conclusion Rectal shaving by LRSD appears to be easier, safer, and more complete in excision of bowel endometriosis than the classical rectal shaving technique. This modification requires further evaluation to confirm its potential in the surgical management of rectosigmoid deep infiltrative endometriosis.

Background Gastric mucosal defect could result from several causative factors including the use of nonsteroidal anti-inflammatory drugs, Helicobacter pylori infection, gastrointestinal and spinal cord diseases, and neoplasia. This study was performed to achieve a novel simple, inexpensive, and effective surgical technique for the repair of gastric mucosal defect. Methods Six adult male mongrel dogs were divided into two groups (three dogs each). In the control positive group (C + ve), dogs were subjected to surgical induction of gastric mucosal defect and then treated using traditional medicinal treatment for such a condition. In the amniotic membrane (AM) group, dogs were subjected to the same operation and then fresh AM allograft was applied. Clinical, endoscopic, biochemical (serum protein and lipid and pepsin activity in gastric juice), histopathological, and immunohistochemistry evaluations were performed. Results Regarding endoscopic examination, there was no sign of inflammatory reaction around the grafted area in the AM group compared to the C + ve group. The leukocytic infiltration in the gastric ulcer was well detected in the control group and was less observed in the AM group. In the AM group, the concentrations of both protein and lipid profiles were nearly the same as those in serum samples taken preoperatively at zero time, which indicated that the AM grafting acted the same as gastric mucosa. The re-epithelization of the gastric ulcer in the C + ve group was not yet detected at 21 days, while in the AM group it was well observed covering most of the gastric ulcer. AM accelerated the re-epithelization of the gastric ulcer. The fibrous connective tissue and the precursor of collagen (COL IA1) were poorly detected in the gastric ulcer with AM application. Conclusion Using fresh AM allograft for repairing gastric mucosal defect in dogs showed great impact as a novel method to achieve optimum reconstruction of the gastric mucosal architecture and restoration of pre-epithelial, epithelial, and post-epithelial normal gastric mucosal barriers.

Wood is a material that is familiar to humans and environment-friendly, and it is used widely as a building material. However, as the dispute over housing defects have increased in Korea, various defects have occurred in timberwork and have become disputes. Notwithstanding, efforts to analyze defects in timberwork systematically to reasonably solve the problem are lacking. In this study, defects in timberwork from housing complexes in Korea were standardized, and critical defects were selected to suggest a method as a management standard. The standard for defects includes time, types of facility work, location and subject, and defect phenomenon. The defect time is categorized into before handover and after handover, whereas facility work is divided into woodwork, door and window work, finishing work, and miscellaneous work. Location and subject are categorized into 13 areas, such as ceiling, floor, and door, and phenomena concerned are of 14 types, including faults and no installation. Therefore, the standardized defect items according to such criteria are classified into a total of 63 types. Ten defect items, whose numbers of defect occurrences per defect and defect repair cost ratio above the average, were selected, including discoloration and breakage of the wooden floor. The repair cost ratio of these defect items accounted for 85.62% of the total repair costs. On the contrary, the repair cost for the defects from the timber work outlined in the Construction Appraisal Practice, a representative defect standard in Korea, was 54.54% of the total. Meanwhile, according to the Defect Judgment Standard, the defect repair cost attributed 45.54% of the total. Therefore, since the 10 defect items proposed in this study can explain the defects in the timberwork compared with other standards, it would be reasonable to designate these 10 defect items as essential defects.

Three-dimensional (3D) bioprinting has become a promising strategy for bone manufacturing, with excellent control over geometry and microarchitectures of the scaffolds. The bioprinting ink for bone and cartilage engineering has thus become the key to developing 3D constructs for bone and cartilage defect repair. Maintaining the balance of cellular viability, drugs or cytokines’ function, and mechanical integrity is critical for constructing 3D bone and/or cartilage scaffolds. Photo-crosslinkable hydrogel is one of the most promising materials in tissue engineering; it can respond to light and induce structural or morphological transition. The biocompatibility, easy fabrication, as well as controllable mechanical and degradation properties of photo-crosslinkable hydrogel can meet various requirements of the bone and cartilage scaffolds, which enable it to serve as an effective bio-ink for 3D bioprinting. Here, in this review, we first introduce commonly used photo-crosslinkable hydrogel materials and additives (such as nanomaterials, functional cells, and drugs/cytokine), and then discuss the applications of the 3D bioprinted photo-crosslinkable hydrogel scaffolds for bone and cartilage engineering. Finally, we conclude the review with future perspectives about the development of 3D bioprinting photo-crosslinkable hydrogels in bone and cartilage engineering.

Beta-tricalcium phosphate (β-TCP) has been widely used for bone regeneration for many years. However, there are few studies on the osteoconduction ability of different shaped β-TCP scaffolds. In this study, we compared the osteoconductive potential between the tubular and cylindrical β-TCP scaffolds in long bone defect animal model. The results showed that more regenerated bone and a better healing property were observed in tubular group than that in cylindrical group. By hematoxylin-eosin staining, the central part of the callus was more compacted in tubular group. And moreover, the increased osteocalcin and osterix expression were found in tubular group, suggesting more vigorous regeneration of bone defect. These results demonstrated that tubular β-TCP scaffold would be more benefit to promote bone regeneration, indicating that tubular β-TCP scaffold has a good potential for long bone defect repair in clinical practice. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1934-1940, 2018.

Objective: Neural tube defects occur in approximately one in 1000 live births in the US. Myelomeningocele (MMC) is the most common and severe form of spina bifida aperta. In this study, we present a surgical modification of the bilateral fasciocutaneous rotation and advancement flap technique in MMC patients.Material and Methods: Twenty-four patients (12 male, 12 female) with MMC who were operated on between August 2011 and June 2013 were retrospectively evaluated. Presence of hydrocephalus, the neurological status, and the level and size of the MMC were recorded. We used bilateral perforator-based fasciocutaneous rotation and advancement flaps for defects larger than 3 cm in width, or in the presence of prominent kyphosis together with any defect size.Results: The follow-up period ranged from eight days to two years. One patient died on the eighth day after surgery because of sepsis secondary to aspiration pneumonia. One patient had cerebrospinal fluid accumulation under the repair zone. In another patient, cerebrospinal fluid leakage through the repaired incision was observed on the ninth day after surgery. Three patients had minimal wound dehiscence at the distal end of the suture line.Conclusion: In this study, 24 patients were treated with the described perforator-based technique by preserving at least one perforator vessel on each side. Reconstruction of MMC defects with paraspinal fasciocutaneous rotation and advancement flaps is still one of the best choices for closing moderate-to-large defects without using skin graft, and the safety of the flaps increases by preserving the perforators., Amaç: Nöral tüp defektleri Amerika Birleşik Devletleri'nde yılda 1000 canlı doğumda bir ortaya çıkmaktadır. Myelomeningosel, Spina Bifida Aperta deformitesinin en yaygın ve en ağır formudur. Bu çalışmada, myelomeningosel hastalarında bilateral fasyokutanöz rotasyon ve ilerletme flebi tekniğinin cerrahi modifikasyonunu sunuyoruz.Gereç ve Yöntemler: Ağustos 2011 ile Haziran 2013 arasında opere edilen 24 myelomeningosel hastası (12 erkek, 12 kız) retrospektif olarak analiz edildi. Hidrosefali varlığı, nörolojik durum ve myelomeningoselin düzeyi ve boyutu kaydedildi. Defekt boyutunun 3 cm'den daha geniş olduğu ya da kifoz deformitesinin eşlik ettiği durumlarda, perforatör bazlı bilateral fasyokutan rotasyon flebi kullandık.Bulgular: Takip süresi sekiz gün ile iki yıl arasında gerçekleşti. Bir hasta postoperatif sekizinci günde aspirasyon pnömonisine sekonder sepsis nedeniyle kaybedildi. Bir hastada onarım bölgesi altında beyin omurilik sıvısı birikimi saptandı. Bir hastada ise postoperatif dokuzuncu günde onarım hattından beyin omurilik sıvısı sızıntısı gözlendi. Üç hastada onarım hattı distalinde minimal dehissans gözlendi.Sonuç: Bu çalışmada 24 hastada defekt rekonstrüksiyonu, her bir tarafta en az bir perforatörün korunduğu perforatör bazlı teknik ile gerçekleştirildi. Paraspinal fasyokutan rotasyon ve ilerletme flepleri, geniş myelomeningosel defektlerin onarımında greft kullanımına gerek bırakmayan en uygun rekonstrüksiyon seçeneğidir ve perforatör korunması ile flep güvenliği artar.