Search Results (1,063)

Background: Achondroplasia, the most common genetic dwarfism caused by the FGFR3 mutation (autosomal dominant, 80% de novo), results in a disproportionately short stature. Thoracolumbar kyphosis (TLK), combined with characteristic spinal canal stenosis, increases the risk of symptomatic compression, yet the literature lacks clear thresholds for symptom onset or progressive deformity angles. Methods: A 16-year-old female with achondroplasia presented with rapidly progressive kyphosis despite conservative management (bracing and therapy). Over six months, she developed neurogenic claudication; bilateral leg pain; weakness; and paresthesia that worsened with standing/walking, which was relieved by flexion/sitting. Imaging demonstrated surgical-threshold kyphosis with progressive spinal misalignment. Her symptoms indicated compressive myeloradiculopathy from lumbar stenosis, critical given achondroplasia’s congenitally narrowed canal and heightened neurologic vulnerability. Results: Staged surgery planned: Posterior fusion T6-L4 with pedicle screws and then extensive decompression (laminectomy/foraminotomy T11-L3), L1 corpectomy with expandable titanium cage, and Ponte osteotomies. Intraoperative complications included a malpositioned left T10 screw breaching the anterior/lateral cortex near the aorta, requiring urgent revision. Postoperatively: Neurogenic bladder, wound leakage, and E. coli urinary tract infection (UTI) with fever (treated with IV antibiotics). After infection resolution, definitive surgery removed the malpositioned screw and completed decompression, corpectomy, cage placement, bone grafting, and osteotomies, successfully resolving neurological symptoms. However, 13 cm trunk lengthening caused severe functional impairment—disproportionately short arms prevented independent toileting and dressing. Left arm lengthening via external fixation restored partial function. At 2.5-year follow-up, there was solid fusion, no neurological deficits, and improved quality of life. Conclusions: Surgery addresses severe TLK, vertebral wedging, and neurogenic claudication in achondroplasia. Vertebral column resection effectively corrects TLK and neurological deficits but carries a high complication risk. This should be reserved for severe TLK with hypoplastic vertebrae, performed by experienced surgeons. Critically, correction magnitude must preserve limb–trunk proportions to prevent functional disability, as excessive lengthening may necessitate additional limb procedures for independence restoration. Full article

Temporomandibular joint osteoarthritis (TMJOA) is a degenerative maxillofacial disorder marked by progressive cartilage degradation and subchondral bone resorption, severely compromising patients’ quality of life. Intra-articular injection (IA), a standard route for conservative therapy, offers clinical advantages in safety and efficacy; however, outcomes remain limited due to short drug retention, poor tissue penetration, and variable agent efficacy, necessitating repeated administration. To overcome these limitations, fisetin-loaded poly (lactic-co-glycolic acid) nanoparticles (FST-PNP) were developed as a localized drug delivery system (DDS) for TMJOA treatment. Physicochemical analyses showed FST-PNP had uniform spherical morphology, excellent dispersibility, stability, high encapsulation efficiency, and substantial drug loading capacity. An in vitro study demonstrated more sustained and stable release from FST-PNP than free fisetin. The in vivo IA administration of FST-PNP preserved mandibular condylar osteochondral structures in TMJOA models. Notably, FST-PNP suppressed the expression of metalloproteinase-13 and a disintegrin and metalloproteinase with thrombospondin motifs-5 (ADAMTS5) as catabolic enzymes and downregulated p16 and p21 as senescence markers, indicating synergistic anti-inflammatory and anti-senescent effects. These findings highlight FST-PNP as a DDS integrating controlled-release with multifaceted therapeutic actions, providing a promising strategy for IA therapy of TMJOA. Full article

Background: Management of skeletal Class III malocclusion of maxillary origin in late adolescence remains challenging, as conventional tooth-borne orthopedic approaches show reduced effectiveness at advanced stages of skeletal maturation. Minimally invasive, bone-anchored alternatives supported by digital workflows may improve clinical feasibility and patient acceptance. Objective: To describe a digitally guided clinical protocol combining a hybrid maxillary expander and supragingival mandibular miniplates, and to explore skeletal and dentoalveolar outcomes in late adolescents. Methods: This retrospective pilot clinical study included ten late adolescents (mean age 16.0 ± 1.3 years; range 13.8–17.7) in advanced skeletal maturation stages (CS4–CS6) with skeletal Class III malocclusion of maxillary origin. Treatment consisted of a hybrid maxillary expander anchored to palatal miniscrews and custom supragingival mandibular miniplates, placed using a fully digital workflow. Maxillary protraction was performed using a modified Alt-RAMEC protocol followed by continuous intermaxillary elastic traction for 12 months. Pre- and post-treatment cephalometric analyses were conducted. Results: A significant increase in SNA was observed (mean +6.1°, p < 0.001), indicating forward maxillary displacement. The Wits appraisal improved by 3.3 mm (p = 0.007), and the SeMax increased by 2.9 mm (p = 0.0013). No significant changes were found in the SNB or mandibular plane angle. Dentoalveolar effects were limited. Conclusions: Within the limitations of this pilot clinical study, the proposed digitally guided protocol demonstrated clinically relevant maxillary advancement with minimal dentoalveolar side effects and preserved vertical control. This relatively minimally invasive approach compared to conventional subgingival miniplates and orthognathic surgery may represent a feasible treatment option for selected late adolescent patients. Further controlled studies are required to confirm these findings. Full article

Background/Objectives: Chondromyxoid fibroma (CMF) is a rare benign cartilaginous bone tumor, accounting for less than 1% of all primary bone tumors. Although CMF most commonly arises in the metaphysis of long bones, involvement of the phalanges of the toes is uncommon. We report a pediatric case of CMF arising in the distal phalanx of the second toe that recurred four years after initial surgical treatment and discuss its management. Methods: A 10-year-old girl presented with a painless mass in the distal phalanx of the second toe. Imaging studies demonstrated an expansile osteolytic lesion with cortical thinning, showing a somewhat aggressive radiologic appearance. Intralesional curettage and debridement were performed to preserve the digit, and the bone defect was reconstructed using allogenic cancellous bone graft and demineralized bone matrix. Histopathological examination confirmed the diagnosis of CMF. Results: Four years later, the patient returned with progressive enlargement of the lesion, indicating tumor recurrence. Because of the recurrent nature of the tumor and progressive cosmetic deformity and recurrence-related anxiety, distal phalangectomy was performed. At the one-year follow-up, the patient showed no evidence of recurrence and maintained satisfactory functional and cosmetic outcomes. Conclusions: CMF of the toe phalanx may show delayed recurrence after curettage, requiring prolonged radiologic surveillance. In recurrent cases, definitive resection should be considered based on a combination of oncologic, anatomic, and patient-centered factors, with distal phalangectomy providing reliable local control in anatomically expendable digits. Full article

Testicular tumors are the most common neoplasms of the canine male reproductive tract, corresponding to approximately 25% of all tumors in intact males. A large percentage of cases are characterized by one of three main tumor types: seminomas, interstitial Leydig cell tumors, or Sertoli cell tumors. Clinical importance is primarily associated with endocrine activity rather than malignant behavior; orchiectomy is the treatment of choice for most canine testicular cancers. Endocrine activity, particularly estrogen secretion, may result in feminization syndrome and, in severe cases, bone marrow suppression. The diagnostic approach combines physical examination, ultrasonography with hormonal assessment using endocrine testing (testosterone, estradiol, and T:E ratio), and/or tissue level evidence of the estrogen effect (preputial cytology). Management is centered on orchiectomy; unilateral surgery may be considered when the contralateral testis is clinically and ultrasonographically normal and when preservation of reproductive capacity or working ability is still a priority. Dogs with hormonally active tumors benefit from postoperative hematologic and endocrine monitoring. Recent advances in immunohistochemistry (IHC), such as Ki-67 and inhibin-α markers, and imaging techniques are improving tumor characterization and individualized clinical decision making. Full article

Surgical fixation techniques for bone fracture healing are well established and effective; however, opportunities remain to improve both functional outcomes and the patient experience. The Biofiligree^® concept integrates medicine, engineering, and design by reimagining conventional osteosynthesis plates as both therapeutic and aesthetic devices. Inspired by traditional Portuguese filigree, these plates allow patient participation through personalized geometries, patterns, or engravings and may later be transformed into wearable jewellery after removal, preserving them as symbolic artefacts of recovery. This study introduces and biomechanically evaluates a novel calcaneal fixation plate incorporating the biofiligree geometry concept. A biofiligree plate was designed for calcaneus fracture fixation and manufactured in stainless steel 306L. Experimental testing was conducted on synthetic composite calcaneus bone models to simulate anatomical conditions and compare the new design with a standard commercial plate. The biofiligree plate, 2 mm thick, was fixed using five screws and two percutaneous screws positioned at 45° to compress the fracture line. Results demonstrated comparable biomechanical performance between both systems, with similar strain distributions and fracture stabilization. The biofiligree plate showed stresses around 430 MPa and fracture displacement below 0.7 mm. Fixation stiffness values were 1445 N/mm for intact calcaneus, 1065 N/mm for the commercial plate, and 725 N/mm for the biofiligree plate, indicating adequate support for bone healing. Full article

3D bird pose estimation plays a pivotal role in ecological conservation research. However, it remains a formidable challenge due to extensive joint deformation, severe self-occlusion, and the scarcity of 3D ground truth data. Therefore, practical solutions typically rely on accurate 2D keypoint detection from monocular images and subsequent 3D lifting. Although the High-Resolution Network (HRNet) has established a benchmark in 2D pose estimation by preserving high-resolution feature representations, its architecture, which relies on small convolution kernels, faces difficulties in capturing the global long-range dependencies necessary to resolve severe occlusions. To address these deficiencies, the core contributions of this work are summarized as follows: (1) We design a Gated LS-Block with a partial channel gating strategy to decouple channel mixing from spatial mixing, and extract global long-range dependencies via the proposed Large–Small Convolution (LSConv) to minimize feature redundancy. (2) We embed this block into Stage 2 of HRNet, enhancing multi-scale feature learning while slightly reducing model parameters and computational overhead; (3) To alleviate the ill-posed nature of monocular 3D lifting without paired supervision, we develop an unsupervised 3D reconstruction algorithm. Experimental results on the Animal Kingdom dataset demonstrate that our method achieves a 0.9% improvement in PCK@0.05 while reducing GFLOPs by 3.3%. These results verify that the proposed architecture enhances the model’s representation capability for bird poses while ensuring efficient inference. Meanwhile, we validate the applicability of the proposed 3D reconstruction algorithm via qualitative experiments, and further demonstrate that our unsupervised 3D lifting algorithm successfully preserves low symmetry error and robust bone length consistency with proxy metrics. Full article

Clinically, bone mineral density (BMD) accounts for only approximately 50% of the observed variance in bone fragility fractures. This review examines the dynamic and mechanistic role of the non-collagenous organic matrix, specifically proteoglycans (PGs) and glycosaminoglycans (GAGs), in maintaining bone toughness and bone quality. During aging, bulk cortical GAG levels decrease by up to ~17% and are highly associated with reduced bone tissue toughness. We analyze how this age-related loss may arise from uncoupled bone remodeling and tissue aging, including the accumulation of older, interstitial tissue and dysregulated osteocyte-mediated matrix maintenance. We then discuss the functional importance of PG/GAG composition, maturation, and catabolism and how perturbations in these processes can promote pro-inflammatory signaling that accelerates matrix degradation and contributes to systemic aging. Lastly, we discuss potential interventions to preserve or restore GAGs/PGs in bone and improve overall bone quality. Full article

Alveolar ridge preservation using biomaterials is a well-established approach to counteract post-extraction bone resorption and optimize conditions for implant placement. However, most studies rely only on a single evaluation method and thereby risk overlooking essential aspects of alveolar regeneration. This preliminary analysis aimed to assess alveolar ridge preservation outcome using a multimodal approach combining histomorphometric, radiological, and image-based visualization methods. Twenty out of a planned 60 patients per group from an ongoing randomized controlled clinical trial were included. Patients were allocated to alveolar ridge preservation with a bone substitute material (BSM), a collagen-based material, a combination of both, or natural healing as control. Outcomes included CBCT-based volumetric analysis, histomorphometry, and primary implant stability via ISQ. Mineralized bone volume was significantly better preserved in bone substitute material groups compared to other groups, with BSM combined with collagen yielding the highest values. Histomorphometrically determined hard tissue fractions and implant stability were comparable across groups. Notably, CBCT-based visualization revealed non-ossified hypodense regions, so-called cavitations or covered socket residuum (CSR) within the former extraction sockets across all groups, independent of the biomaterial applied. BSM-based alveolar ridge preservation, particularly combined with a collagen membrane, most effectively maintained mineralized bone volume after extraction. Beside volumetric benefits, this preliminary in-dept analysis of the first part of the trial highlights cavitations/CSRs as a potentially underrecognized feature of post-extraction healing. Integrating quantitative with qualitative visualization-based assessments provides a more complete understanding of alveolar bone regeneration. Full article

Conventional therapies for rheumatoid arthritis (RA) are limited by poor selectivity, insufficient modulation of the oxidative inflammatory microenvironment, and systemic side effects. Oxidative stress and macrophage-driven immune dysregulation represent critical therapeutic targets. Cinnamaldehyde (CA) and arginine (Arg) possess antioxidant, anti-inflammatory, and anti-osteoclastogenic activities, but their poor solubility, instability, and lack of targeting restrict clinical application. Here, we report a pH-responsive cinnamaldehyde–arginine nanoprodrug (Arg-CA NPs), synthesized via Schiff base reaction, that spontaneously self-assembles into uniform nanoparticles capable of acid-triggered dual-drug release. Arg-CA NPs enhanced the solubility and stability of CA, exhibited excellent dispersibility and circulatory stability, and demonstrated intrinsic antioxidant and anti-inflammatory properties. Mechanistically, Arg-CA NPs attenuated intracellular ROS accumulation, preserved mitochondrial function, and reprogrammed macrophages toward an anti-inflammatory M2 phenotype by suppressing hypoxia-inducible factor-1α (HIF-1α), cyclooxygenase-2 (COX-2), and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) signaling. In an adjuvant-induced arthritis (AIA) rat model, Arg-CA NPs selectively accumulated in inflamed joints and significantly alleviated joint swelling, synovial inflammation, cartilage erosion, and bone destruction. These findings identify Arg-CA NPs as a promising redox-active nanoplatform for RA therapy by targeting oxidative stress and immune dysregulation. Full article

Frontal sinus fractures typically reflect high-energy trauma and must be evaluated and treated carefully to avoid long-term problems including contour deformity, sinus dysfunction, cerebrospinal fluid (CSF) leakage, chronic sinusitis, and mucocele formation. This article outlines frontal sinus anatomy, diagnostic pathways, and evolving treatment concepts in detail. An anatomically driven treatment algorithm is emphasized, with a focus on preservation of sinus function whenever possible and preference for conservative management. Advanced procedures, such as endoscopic sinus surgery and cranialization, are reviewed in the context of managing more severe injuries. Key points: (1) Clinical decision-making in the management of frontal sinus fractures is best guided by evaluating the status of the anterior table, posterior table, and nasofrontal outflow tract, with treatment options ranging from nonoperative care to open or endoscopic surgery. (2) Improvements in endoscopic techniques, combined with evidence supporting less aggressive strategies, have shifted management toward more conservative approaches, reserving open procedures for higher-grade injuries. (3) Extended follow-up is essential to identify delayed problems such as mucoceles, chronic sinusitis, frontal bone osteomyelitis, and contour irregularities. Full article

The high-fidelity 3D digitization of small, detailed cultural heritage objects, such as Oracle Bones, presents significant challenges for which existing reconstruction workflows are often inadequate. Methods based on Structure-from-Motion (SfM) often lack the geometric density required to capture fine inscription details, while Light Detection and Ranging and RGB-Depth approaches may introduce high data overhead and unstable color mapping. Recent specialized studies have utilized multi-shading-based techniques to extract such hidden surface textures, yet integrating these results into a cohesive mesh remains difficult. To address these limitations, we propose a digitization framework specifically designed for object-level archaeological artifacts. Our method combines semi-automatic alignment with ICP-based refinement for robust camera pose estimation, reducing misalignment issues associated with feature-only registration. Furthermore, we employ an efficient mesh-based representation with vertex-level coloring, enabling detailed geometry and consistent texturing while maintaining compact storage requirements. Our contributions include: (1) a high-quality mesh reconstruction framework that preserves fine inscription geometry; (2) a hybrid camera pose estimation strategy that improves alignment robustness; and (3) an integrated hardware-assisted workflow tailored for digitizing small archaeological artifacts under controlled acquisition conditions. Experimental results on physical Oracle Bone artifacts demonstrate that the proposed method achieves a mean geometric reconstruction error of approximately 0.075 mm with a Hausdorff distance of 1 mm. These results demonstrate the effectiveness of the proposed workflow for digitization of oracle bone artifacts. Full article

Objectives: The objective of this study is to investigate the clinical potential of generating artificial bone scintigraphy (aBS), defined here as a deep learning-generated bone scintigraphy image that simulates delayed-phase bone scintigraphy (dBS) characteristics, from early-phase bone scintigraphy (eBS) obtained with a short waiting time using an unpaired image-to-image translation method in patients with breast cancer (BC). Methods: In this single-center prospective study involving 245 patients with BC (195 for training and 50 for testing), eBS and dBS were performed. Using the contrastive unpaired translation (CUT) model, we trained with anterior and posterior images of the eBS and dBS from the training group. We then generated aBS images targeting dBS by inputting eBS from the test group for both anterior and posterior views. We conducted quantitative, qualitative, and visual assessments to evaluate aBS. Results: The points of the anterior and posterior images of aBS on the qualitative four-point and five-point rating scales were significantly higher than those of eBS (p < 0.0001). Three nuclear medicine physicians performed visual assessments, demonstrating consistent findings on the presence of bone metastases in both aBS and dBS. Their visual evaluations indicated that the bone-to-soft tissue contrast in aBS was superior to that in eBS. The quantitative metrics of aBS were superior to those of eBS. However, aBS was inferior to the targeted dBS in terms of qualitative and visual assessments. Conclusions: The aBS generated through CUT was superior to eBS in quantitative, qualitative, and visual assessments and preserved lesion-related information comparable to dBS. Although these findings do not support replacement of dBS for definitive diagnosis, they support the feasibility of aBS as an assistive delayed-phase-like image generation approach from earlier-acquired bone scintigraphy. Full article

Endoscopic sinus surgery (ESS) is commonly performed to treat chronic rhinosinusitis and selected sinonasal tumors, yet postoperative complications such as neo-osteogenesis and restenosis remain frequent, largely due to impaired mucosal regeneration after extensive epithelial and bony tissue loss. Successful nasal epithelial repair requires a microenvironment that preserves cell viability, phenotype, and barrier integrity. Conventional culture substrates often lack physiological relevance or rely on animal-derived components, limiting translational applicability. In this study, we evaluated nanofibrillar cellulose (NFC) hydrogel (GrowDex^®) as a xeno-free scaffold for primary human nasal epithelial cells (NECs). NECs isolated from healthy donor tissue were characterized by immunofluorescence and qPCR for basal, goblet, and ciliated cell markers. Cells embedded in NFC were assessed for viability, cytotoxicity, epithelial morphology, and barrier function. Transepithelial electrical resistance (TEER) and FITC-dextran permeability assays were used to quantify barrier integrity and compared with collagen- and polylysine-based controls. NECs cultured in NFC maintained high viability, stable epithelial morphology, and preserved subtype-specific marker expression without detectable cytotoxicity. NFC-supported cultures demonstrated enhanced barrier formation, indicated by higher TEER values and reduced paracellular permeability relative to controls, and sustained structural integrity during extended culture. These findings identify NFC hydrogel as a biocompatible, non-animal scaffold that supports functional human nasal epithelium regeneration and may contribute to advanced tissue engineering strategies for craniofacial bone repair. Full article

Preservation of biological specimens over extended periods is essential for morphological research, especially in contexts where sample collection is limited or unrepeatable, such as spaceflight studies. However, the impact of long-term exposure to chemical fixatives remains underexplored. In this study, we used high-resolution X-ray microtomography and X-ray phase contrast tomography to investigate the stability of mineralized tissues subjected to prolonged chemical fixation. We examined the forelimb digits of geckos (Chondrodactylus turneri) preserved for over six years using a protocol involving formalin and ethanol, as well as the humeral bone of gerbils (Meriones unguiculatus) stored in fixative for more than four years. The gecko samples originated from the delayed vivarium control group of the Bion-M No. 1 space mission, offering a valuable chance to evaluate the preservation effects on specimens of significant scientific value. Comparative analysis revealed distinct changes in bone volume and linear attenuation coefficient of bone associated with formalin storage, highlighting the need for optimized storage strategies in long-term biorepositories. These findings offer valuable guidance for maintaining morphological fidelity in chemically preserved skeletal tissues. Full article