Complete Labial Adhesion in a Post-Pubertal Girl: A Case Report

Labial adhesion usually occurs in the infancy period and in prepubertal girls. It is a rare entity in reproductive age without any hypoestrogenism condition. Voiding dysfunction is a rare manifestation of these conditions. Here, we report a 19-year-old girl with complete labial adhesion presented with urinary retention. A 19-year-old virgin girl was referred to the obstetrics and gynecology department of Ghaem Hospital. She complained of urinary retention. Physical examination was normal except that was moderate hypogastric tenderness and a huge vesical globe. Genital examination revealed complete fusion of the labia minora in the midline, extended from the posterior fourchette to the region of the clitoris covering the entire vaginal introitus, urethral meatus, and clitoris. Despite the use of topical estrogen cream and surgical labial separation, re-adhesion occurred for the third time. Vulvar biopsy confirmed severe inflammation. Finally, topical anti-inflammatory medication improved the symptoms. Although labial adhesion is very rare in the post-pubertal period, it can successfully be managed by medical and surgical treatment.

The Effect of Kryptonite Bone Cement combined with a Standard Kirschner Wire on Tibial Bone Fracture in Rats

Objective This study aims to observe whether Kryptonite Bone Cement combined with a standard Kirschner wire, instead of autogenous bone grafts, increases bone healing and mechanical strength in rats with tibia fractures. Methods The study included sixteen rats, which were divided into two groups as a control group (n=8) and an experimental group (n=8). After segmental fractures were made in both groups, intramedullary fixation of tibia procedures were conducted with the use of a Kirschner wire. No additional procedures were performed inthe control group, but Kryptonite Bone Cement was applied in the experimental group. The rats were evaluated clinically, radiologically and histologically4 times; immediately after the operation, and atthe 1st, 3rd, and 6thweeks following surgery. Results One rat from the experimental and one from the control group had both wound dehiscence and wound site infection. No recovery was observed in any rats either in the control or experimental group immediately after surgery. During week 1, callus formation was identified in 5 rats in the experimental group (p=0.0072), and during week 3, fracture lines disappeared in 4 rats in the experimental group (p=0.064); the differences between control and experimental groups were statistically significant. During week 6, no statistical significance was observed in radiological assessments for the control group and experimental group (p=0.71). The rate of non-union was higher in the control group (37.50%) than in the experimental one, while the rate of complete fusion was higher in the experimental group (87.50%) than that in the control group. Conclusion Osteoconductivity and ergonomic qualities of Kryptonite Bone Cement prove helpful in bone repair. Future studies to be conducted in a prospective and randomized manner will be effective on demonstrating the effectiveness of Kryptonite Bone Cement.

Isolation and phylogenetic analysis of Avian orthoavulavirus 1 sub-genotypes VII.2 and XXI.1.2 from caged birds in the Lahore district, Pakistan – Short communication

In this study, the prevalence of Avian orthoavulavirus-1 (AOAV-1) (also commonly known as Newcastle disease virus) was investigated in caged birds kept in bird markets in the Lahore district of Pakistan. A total of 354 swab samples were obtained from 14 different species of clinically healthy birds. The overall virus prevalence was 12.7% in 9 out of the 14 species. Phylogenetic analysis of the complete fusion protein (F) gene showed that 23 isolates from different avian species belonged to sub-genotype VII.2 while three isolates of pigeon origin clustered with sub-genotype XXI.1.2. The VII.2 viruses isolated had a high nucleotide identity to viruses repeatedly isolated from poultry in Pakistan from 2011 to 2018. To date, sub-genotype XXI.1.2 viruses have only been identified in Pakistan. These findings suggest that the Newcastle disease (ND) outbreaks occurring in Pakistan involve multiple hosts and environments. The study emphasises the importance of continuing to monitor multiple avian species for the presence of AOAV-1s and implementing effective ND control strategies.

Hydroxyapatite/collagen composite graft for posterior lumbar interbody fusion: a comparison with local bone graft

Background Autologous bone has been used for posterior lumbar intervertebral fusion (PLIF). However, harvesting autologous bone graft is associated with donor site complications. We previously developed a hydroxyapatite/collagen (HAp/Col) composite as an osteoconductive artificial bone, characterized by having a highly porous structure with sponge‐like elasticity. This study aims to investigate the effectiveness of HAp/Col composite with bone marrow aspirate (BMA) as a graft substitute in PLIF for the treatment of lumbar spinal diseases. Methods This study prospectively investigated patients who received one-level PLIF. For the interbody fusion, two titanium cages were inserted. On the one side of interbody space, HAp/Col composite incorporated with BMA filling the titanium cage was grafted. On the other side, local bone graft (LBG) harvested during decompressive laminotomy was grafted and then one-level instrumentation using pedicle screws was performed. The target levels were at L2/3 in 2 cases, L3/4 in 3 cases, L4/5 in 36 cases, and L5/S in 5 cases. We evaluated clinical symptoms and radiological outcomes of 46 patients and compared the fusion status of HAp/Col composite with that of LBG. Results The 1-year postoperative CT evaluation demonstrated that, in the HAp/Col, a complete fusion was observed in 38 patients (82.6%), whereas in the LBG, a complete fusion was observed in 35 patients (76.1%). There were no statistical differences between the HAp/Col and LBG. In the HAp/Col, incomplete fusion was observed in five patients (10.9%) and non-fusion in two patients (4.3%), and in the LBG, incomplete fusion was observed in nine patients (19.6%) and non-fusion in two patients (4.3%). At 2 years after the surgery, complete fusion increased to 44 patients (95.7%) in the HAp/Col and 41 patients (89.1%) in the LBG. There were no significant differences in the clinical scores for lumbar spine between patients with fusion and non-fusion. Conclusions The HAp/Col composite with BMA in the titanium cage can be effectively used as an alternative to conventional autologous LBG for intervertebral spinal fusion. Trial registration University hospital Medical Information Network, UMIN000045010, July 30th, 2021, Retrospectively registered, https://www.umin.ac.jp/english/.

New radiation techniques in controlling bone regeneration in fractures

Objective: comparative study of the possibilities of radiation methods in control of bone regeneration in fractures.Materials and methods. A study of bone calluse formation was conducted in 116 patients with broken tubular bones of the upper and lower limbs from the first day of the fracture to the complete consolidation of the fractures. In X-rays and CT determined the mineral density of bone calluses, with ultrasonic elastography shear wave and compression elastography determined the rigidity of bone calluses in kPa.Results. X-ray bone corn was determined at the end of the second – the beginning of the third stage of bone calluse formation. On CT bone corn density (in the HU), its structure and the condition of bone breaks were determined in some patients in all stages of bone regenerate formation. In ultrasound examination in the multiparametric mode studied the rigidity, structure and vascularization of bone calluses, the correct comparison of bone breaks from the first day of the fracture to their complete fusion.Conclusions. Ultrasonic studies in multiparametric mode can be used to control bone regeneration in fractures. Ultrasonic elastography shear wave, in determining the rigidity of bone calluse, in sensitivity and specificity exceeds the indicators of ultrasonic compression elastography at all stages of bone regenerate formation.

Incomplete ossification of the atlas in cats: seven cases detected on computed tomography

Defects of the ventral arch of the atlas were detected on computed tomography in nine cats aged 3…12 months with signs of upper cervical injury including paina and ataxia. Seven cats have an ambulatory tetraparesis, and two cats have a nonambulatory tetraparesis. The bone defects were consistent with the normal location of the ventral arch growth areas of the atlas. In all observed cats, the pattern of ossification abnormalities was similar — the lateral portion of the arch was completely absent in seven cats on the left and in two cats on the right. The structure of the ventral tubercle was traceable in 8 of 9 cats. Also, in 8 of 9 cases an isolated bone fragment was observed lateral to the dens of the axis, the exact origin of which was not determined. This fragment was observed in 6 cases on the right, in two cases on the left, and only in two cases it corresponded to the side of the undeveloped arch. In 7 out of 9 cats, the dorsal arch was not fused; in 2 cats with complete fusion, the dorsal arch was deformed. An dens fracture was visualized in 3 cases, no hypoplasia of the dens was visualized, and one cat have atlantoaxial subluxation. Seven cats received conservative treatment and 2 cats received surgical treatment. Clinical improvement was observed in all cats. Disorder the ossification of the ventral arch of the atlas should be considered as the differential diagnosis in young cats with suspected atlanto-axial instability and trauma of the cervical spine. The authors were unable to find publications describing this atlas developmental abnormality in cats, so the authors believe that this is the first mention of incomplete ossification of the atlas in cats.

Fusion of near-infrared and RGB images on a FPGA using high level synthesis tool

Several applications utilizing a set of red green blue (RGB) and near infrared (NIR) images have been emerging over recent years. The present work proposes a technique of enhancing an image by combining color (RGB) and near infrared information (NIR). In order to fuse the two types of images, the NIR-channel is considered as a luminance counterpart to the visible image. International standard database (RGB-NIR Scene Dataset) is used in this work for image fusion. The objective of the paper is to present a simple and hardware efficient fusion method, where the original RGB image is converted into two different color spaces, namely, HSV and YCbCr. Later, the luminance channel of the RGB image is replaced with the near infrared channel, thereby obtaining a fused enhanced image. The above procedure is effectively implemented on FPGA using the Xilinx HLS tool. RGB-NIR dataset is used in the present work for testing the proposed image fusion algorithm, and the quality of the fused image is measured through peak signal to noise ratio (PSNR). The experimental results indicate that HSV color space is more efficient in image fusion compared to YCbCr color space based on the average PSNR values of approximately 29db for HSV and 25db for YCbCr for various images, respectively. Finally, this complete fusion algorithm is implemented on Xilinx Nexys4 FPGA board to be able to obtain real-time outputs in the form of vivid, contrasted images that are pleasing to the observers. The experimental results illustrate that the Xilinx FPGA utilizes only 50% of the available hardware resources and consumes approximately 5.3 Watts to implement the fusion process.

Intraarticular bone grafting in atlantoaxial facet joints via a posterior approach: nonstructural or structural—a minimum 24-month follow-up

Objective To investigate the necessity of nonstructural or structural intraarticular bone grafting in atlantoaxial facet joints via a posterior approach and the influence by the presence of basilar invagination (BI). Methods From November 2016 to October 2018, patients who underwent posterior atlantoaxial or occipitocervical arthrodesis surgery at one institute were retrospectively reviewed. Operation records, preoperative and postoperative clinical status, and radiological films were analyzed. Results Thirty-three patients (19 without BI, 14 with BI) underwent posterior facet joint release followed by intraarticular bone grafting were enrolled finally. Twenty-four nonstructural (15 without BI, 9 with BI) and 9 structural (4 without BI, 5 with BI) grafting were performed. The average follow-up was 32.15±6.73 months (24–47 months). Among them, 1 (3.03%) implant failure occurred, and 32 (96.97%) achieved satisfactory neurological outcomes, including 28 (84.85%) complete and 4 (12.12%) acceptable reductions with complete fusion within 6 months. For patients without BI, structural and nonstructural grafting showed no significant difference in terms of reduction maintenance (100% vs 73.33%, p = 0.530), while for those with BI, structural grafting significantly increased the postoperative height of the joint space (5.67±1.22 mm vs 3.43±1.78 mm, p = 0.002) and maintained it much better than nonstructural grafting (88.89% vs 20.00%, p = 0.023), contributing notably to BI correction. Conclusion Intraarticular structural bone grafting in atlantoaxial facet joints has the advantage of maintaining anterior column height in the case of lateral mass collapse or when BI correction is needed; otherwise, nonstructural bone grafting is enough.

First Experimental Study of the Influence of Extracellular Vesicles Derived from Multipotent Stromal Cells on Osseointegration of Dental Implants

Herein, the aim was to study the state of the bone tissue adjacent to dental implants after the use of extracellular vesicles derived from multipotent stromal cells (MSC EVs) of bone marrow origin in the experiment. In compliance with the rules of asepsis and antiseptics under general intravenous anesthesia with propofol, the screw dental implants were installed in the proximal condyles of the tibia of outbred rabbits without and with preliminary introduction of 19.2 μg MSC EVs into each bone tissue defect. In 3, 7, and 10 days after the operation, the density of bone tissue adjacent to different parts of the implant using an X-ray unit with densitometer was measured. In addition, the histological examinations of the bone site with the hole from the removed device and the soft tissues from the surface of the proximal tibial condyle in the area of intra-bone implants were made. It was found out that 3 days after implantation with the use of MSC EVs, the bone density was statistically significantly higher by 47.2% than after the same implantation, but without the injection of MSC EVs. It is possible that as a result of the immunomodulatory action of MSC EVs, the activity of inflammation decreases, and, respectively, the degree of vasodilation in bones and leukocyte infiltration of the soft tissues are lower, in comparison with the surgery performed in the control group. The bone fragments formed during implantation are mainly consolidated with each other and with the regenerating bone. Day 10 demonstrated that all animals with the use of MSC EVs had almost complete fusion of the screw device with the bone tissue, whereas after the operation without the application of MSC EVs, the heterogeneous histologic pattern was observed: From almost complete osseointegration of the implant to the absolute absence of contact between the foreign body and the new formed bone. Therefore, the use of MSC EVs during the introduction of dental implants into the proximal condyle of the tibia of rabbits contributes to an increase of the bone tissue density near the device after 3 days and to the achievement of consistently successful osseointegration of implants 10 days after the surgery.