Search Results (194)

Background: Surgical management of adult patients with post-dysplastic coxarthrosis using total hip arthroplasty is technically demanding and carries an increased risk of complications. In cases of high iliac dislocation classified as Crowe type IV, restoring the acetabular component to the anatomical hip centre often requires femoral shortening osteotomy to enable safe reduction in the prosthetic joint. Nevertheless, long-term evidence on functional outcomes and prosthesis survival with this approach is limited. Methods: A retrospective cohort study included 19 patients with 22 cases of Crowe type IV post-dysplastic hip osteoarthritis treated with uncemented total hip arthroplasty (Pinnacle/S-ROM, DePuy, Warsaw, IN, USA) combined with transverse subtrochanteric femoral shortening osteotomy. Patients underwent serial clinical follow-up, including assessment of range of motion, measurement of limb-length discrepancy, and functional evaluation using the Harris Hip Score and the WOMAC questionnaire. Radiological assessment included evaluation of osteotomy union, implant positioning, and osteolysis on standardized radiographs. Vertical distances of the centre of rotation (CR), the tip of the greater trochanter (GT), and the tip of the lesser trochanter (LT) from both reference lines were measured bilaterally, and inter-side differences were calculated. The reference lines consisted of the line connecting the inferior margins of the ischial bones and the teardrop (TD) line. Results: All osteotomies united at a mean of 5.57 months, with a mean follow-up of 129 months. Mean limb-length discrepancy decreased from 5.27 cm to 1.5 cm, and mean hip flexion improved from 82.9° to 106°. Functional outcomes improved significantly, with mean WOMAC increasing from 55.4 to 80.1 (p < 0.001) and mean Harris Hip Score from 49.8 to 84.66 at up to 3 years of follow-up (p < 0.001). Osteotomy length correlated strongly with lesser trochanter–teardrop distance (p = 0.00000048). Complications included distal femoral fissure (27.3%) and revision (18%), with no infection or permanent neurological deficit. Conclusions: Total hip arthroplasty combined with subtrochanteric femoral shortening osteotomy for Crowe type IV post-dysplastic hip osteoarthritis appears to be a feasible and effective procedure in an experienced centre, providing reliable osteotomy healing and significant early functional improvement that is sustained over time. Limb-length discrepancy was reduced and satisfactory biomechanical restoration was achieved, with an acceptable complication profile and implant survival of 81.3% at long-term follow-up. The LT–TD parameter was identified as a potential predictor of osteotomy length, enabling the proposal of a preoperative planning equation. However, given the limited sample size and lack of validation, these findings should be interpreted cautiously. Further studies are needed to confirm their broader applicability. Full article

Background and Objectives: Laparoscopic procedures have become a routine approach in colorectal surgery. We aimed to evaluate intraoperative, postoperative and pathological outcomes of laparoscopic right hemicolectomy in comparison with open right hemicolectomy. Materials and Methods: We reviewed our database for colorectal surgery and collected data regarding right hemicolectomies performed over a period of 10 years regarding patient characteristics, operative outcomes and postoperative outcomes. We compared laparoscopic with open right hemicolectomies. All the anastomoses in the laparoscopic group were performed intracorporeally. Results: We included 384 cases, 74 (19.3%) laparoscopic and 310 (80.7%) open right hemicolectomies. Baseline characteristics were comparable between the two groups. Conversion rate was low (2.7%). A drain was placed more often in the open colectomies (p < 0.001). Laparoscopic colectomies lasted longer by 25 min on average in the entire cohort (p = 0.002) and by 30 min in cancer-only cases without concomitant procedures (p < 0.001). Laparoscopic procedures yielded more lymph nodes (p = 0.007), as well as longer distal resection margins (p < 0.001) and total specimen (p < 0.001). There was no difference between the two approaches concerning intraoperative complications (p = 0.36) or need for transfusion (p = 0.708). There was also no difference regarding overall (p = 0.361) or major complications (p = 1), as well as anastomotic leak (p = 0.475), surgical site infections (p = 0.275) or readmission rates (p = 1). Hospitalisation duration was shorter by 3 days after laparoscopic surgery in the entire cohort (p < 0.001), as well as when cancer-only cases without concomitant procedures were considered (p < 0.001). Conclusions: Laparoscopic right hemicolectomy with intracorporeal anastomosis provides perioperative safety and pathology outcomes comparable to open surgery, while significantly reducing hospital stay. Full article

New ammonite discoveries from the south-facing flank of Mont Ventoux (southern France) provide robust and refined age constraints on the maximum northward progradation of Urgonian depositional environments in northern Provence during the late Barremian to early Aptian. The succession records distal Urgonian depositional environments during the late Barremian, spanning from the Toxancyloceras vandenheckii to the upper Gerhardtia sartousiana Zone, followed by strongly progradational distal Urgonian deposits with an age interval from the terminal Barremian into the early Aptian. These new data permit an updated and simplified regional correlation of Urgonian successions across the Barremian–Aptian boundary in northern Provence and along the northern margin of the Vocontian Basin. Our correlations reveal clear, coeval sedimentary signals across both regions, emphasizing the regional synchronicity of Urgonian platform development at the basin scale. Full article

Syspastoxyelidae is an extinct basal hymenopteran lineage currently known only from mid-Cretaceous Burmese amber. Here, we describe a new genus and species, Cilioxyela setosa gen. et sp. nov., based on a well-preserved female specimen from the Hukawng Valley, northern Myanmar. The new taxon is assigned to Syspastoxyelidae based on diagnostic characters, including strongly proximally condensed forewing venation, a composite first flagellomere formed by fused ancestral segments, tibiae bearing dense robust spines, and segmented cerci. Cilioxyela gen. nov. differs from all previously described genera by a unique character combination, most notably, a distal forewing veinless membrane lacking longitudinal corrugation and conspicuously elongated marginal setae, together with a narrowed forewing, elongate pterostigma and anal cell, and distinctive antennal segmentation. These features support the establishment of a new genus. Comparative analysis indicates that distal forewing morphology in Syspastoxyelidae is more variable than previously recognized. The presence or absence of longitudinal corrugation in the distal forewing membrane likely reflects genus-level differentiation rather than a stable family-level synapomorphy. The new genus also supports a tentative division of Syspastoxyelidae into at least two morphologically cohesive groups, pending testing through additional fossil discoveries and quantitative phylogenetic analyses. The discovery of Cilioxyela setosa expands the known morphological disparity of Syspastoxyelidae and highlights evolutionary plasticity in distal forewing architecture among early Hymenoptera, contributing to a better understanding of morphological diversification in mid-Cretaceous forest ecosystems. Full article

The biodiversity of euplotid ciliates in high-latitude regions has long been underestimated due to a historical research focus on mid- to low-latitude areas. This study describes three new species collected from high latitudes, Euplotes aspergilliformis sp. nov., E. borealis sp. nov., and E. verebkovi sp. nov. Euplotes aspergilliformis sp. nov. is characterized by medium body size (60–85 × 40–60 μm). It possesses nine frontoventral cirri, two marginal cirri and two caudal cirri with forked distal ends. It also has eight dorsal kinetids (with 13–17 dikinetids in the mid-dorsal kinety) and a double-eurystomus type silverline system. Euplotes borealis sp. nov. is a medium-sized (45–55 × 25–35 μm) freshwater ciliate. It can be recognized by nine frontoventral cirri, one marginal and two caudal cirri. It has nine dorsal kineties with about nine basal bodies in the mid-dorsal kinety, and a double-eurystomus type silverline system. Euplotes verebkovi sp. nov. features an elongated oval body (40–54 × 22–31 μm). It has ten frontoventral, five transverse, one marginal, and two caudal cirri. It possesses seven dorsal kineties with eight or nine bristles in the mid-dorsal row, seven conspicuous dorsal ridges, and a double-eurystomus type dorsal silverline system. Phylogenetic analyses based on molecular data revealed the systematic positions of the three new taxa and confirmed the validity of the three organisms as distinct species. Full article

Campanacci grade III giant cell tumors of the distal radius frequently require en bloc resection to achieve adequate oncologic control. Reconstruction of the resulting defect remains challenging, particularly with respect to preservation of distal radioulnar joint stability and forearm rotation. Although proximal fibular autograft reconstruction is well established, ligamentous stabilization of the distal radioulnar joint is rarely incorporated in oncologic settings. This technical note describes an integrated reconstructive strategy combining proximal fibular autograft with distal oblique bundle reconstruction, illustrated by a representative clinical case. The technique involves segmental en bloc resection of the distal radius followed by reconstruction using an ipsilateral, nonvascularized proximal fibular autograft including the fibular head. Distal radioulnar joint stability is addressed through reconstruction of the distal oblique bundle using an autologous palmaris longus tendon graft. Surgical indications, operative steps, donor site stabilization, and perioperative management are detailed. Functional evolution was assessed using the Musculoskeletal Tumor Society scoring system and range-of-motion measurements. Histopathological examination confirmed negative oncologic margins. Early postoperative events included donor-site common peroneal nerve dysfunction and radiocarpal instability requiring temporary Kirschner wire stabilization. At nine months, the Musculoskeletal Tumor Society score reached 80%, with forearm rotation preserved at 68.8% pronation and 81.3% supination of normal values. Combined osseous and ligamentous reconstruction following distal radius resection is technically feasible and may allow preservation of distal forearm mechanics while maintaining oncologic principles. Broader validation will require application in larger clinical series and longer follow-up. Full article

Prosthetic factors, including abutment angulation and the crown–implant ratio (CIR), have been suggested to influence peri-implant marginal bone loss; however, their long-term effects remain unclear. This study aimed to evaluate the pattern of peri-implant bone loss over 2 years and to analyze the clinical relevance of abutment angulation and CIR. A total of 200 posterior internal-connection implants placed between 2017 and 2021 were retrospectively evaluated using standardized periapical radiographs taken at baseline, 6 months, 1 year, and 2 years after loading. Bone level changes were measured mesially and distally and average per implant. Patients were categorized according to abutment angulation (<30° or ≥30°) and CIR (<1:1.5 or ≥1:1.5). The mean marginal bone loss increased during the first year (0.61 mm at 6 months to 1.08 mm at 1 year) and remained stable thereafter (1.12 mm at 2 years). Significantly greater bone loss was observed in implants restored with abutment angulation ≥ 30° (p < 0.05), whereas CIR showed no significant association at any time point (p > 0.05). No interaction effect was found between the two variables. Most peri-implant bone remodeling occurred within the first year after loading, followed by a stable phase. Abutment angulation of ≥30° was associated with increased bone loss, while CIR alone did not demonstrate clinical significance. When possible, minimizing abutment angulation may help improve long-term peri-implant bone stability. Full article

Background/Objectives: Marginal fit is a key determinant of the clinical performance of CAD/CAM (Computer-Aided DesignComputer-Aided Manufacturing) inlay restorations. This in vitro study compared the vertical marginal gap (VMG) of three chairside CAD/CAM inlay materials—VITA Enamic, CEREC Tessera, and Celtra Duo—using scanning electron microscopy (SEM) under a standardized digital workflow. Methods: Standardized Class I inlay preparations were performed in 15 extracted human molars (n = 5/material). Restorations were fabricated using a chairside workflow (Primescan intraoral scanning, CEREC 5.3 design, Primemill milling) followed by material-specific surface treatment and cementation with a self-adhesive resin cement. VMG was measured on SEM micrographs (500× for quantitative measurements; 200× for orientation) at three sites (mesial, central, distal), with three points per site (nine points/tooth; 135 point measurements). Triplicate points were averaged to site-level means and analyzed using a linear mixed-effects model (fixed effects: material, site, material × site; random intercept: tooth), Type II ANOVA, and Tukey-adjusted pairwise comparisons. Results: Mean VMG values were lowest for Celtra Duo (8.09 ± 1.98 µm), followed by VITA Enamic (27.90 ± 29.76 µm) and CEREC Tessera (32.72 ± 21.80 µm). The model indicated an overall effect of material (F(2,36) = 3.51, p = 0.040), whereas site and material × site effects were not significant. Tukey-adjusted pairwise comparisons did not reach statistical significance. Conclusions: Within the standardized chairside workflow evaluated, an overall material effect on VMG was detected, but pairwise separation was inconclusive in this sample with overlapping distributions. Celtra Duo showed smaller VMG values with narrower dispersion in overall per-tooth means, while VITA Enamic and CEREC Tessera showed wider and overlapping distributions; all group means were below commonly cited clinical acceptability ranges for marginal gap. Full article

This study compares the two (2D)- and three-dimensional (3D) accuracy of tooth reduction depths in porcelain laminate veneer prepared using conventional and 3D-printed guide techniques. Forty 3D-printed maxillary casts were divided into four groups: freehand (FH) (n = 10), silicone guide (SG) (n = 10), cross-shaped 3D-printed guide (3D_C) (n = 10), and stackable 3D-printed guides (3D_S) (n = 10). Butt-joint veneer preparation was performed on the left central incisor. Two-dimensional analysis was performed to assess trueness using mean absolute differences (MADs) from the planned depth at eight designated points, while precision was compared within groups. Three-dimensional analysis evaluated trueness by superimposing post-preparation scans with reference casts and precision via intra-group superimposition, with deviation errors measured using the Root Mean Square (RMS) method. One-way ANOVA and Bonferroni post hoc tests were used (α = 0.05). In 2D analysis, 3D_S exhibited a significantly lower MAD than FH at most of the measured points (p < 0.05), more accurate incisal reduction at mesial and distal points compared to 3D_C (p < 0.001), and more accurate mesial (p = 0.011) and distal (p = 0.001) cervical margin preparation than SG. In the 3D trueness assessment, 3D_S exhibited significantly lower deviation errors than FH (p < 0.001) and SG (p = 0.012) while also achieving the highest overall 3D precision with the lowest RMS (0.067 ± 0.013), followed by 3D_C (0.086 ± 0.019). Veneer preparation guided by a stackable 3D-printed guide resulted in more accurate tooth reduction depths compared to the other three techniques. Full article

Background/Objectives: Edentulism represents a major public health challenge, causing disorders of social, psychological and biological origin. Full-arch implant-supported restorations represent a viable alternative to mitigate this problem. This study aimed to evaluate immediate implant-supported restorations for the rehabilitation of the edentulous maxilla using four implants and distal implant tilting between 15 and 20 years. Methods: A total of 740 patients were included (women: 440; men: 300; average age: 55.3 years) rehabilitated with 740 prostheses, supported by 2960 dental implants. The primary outcome measure was prosthetic/implant cumulative survival and success (CSurR;CSucR). Secondary outcome measures included marginal bone loss (MBL), and the incidence of complications was evaluated as a secondary outcome measure. The outcomes were evaluated at 15 and 20 years. Results: In total, 287 patients (38.8%) with 1148 implants (38.8%) were lost to follow-up. A total of 170 implants (5.7%) in 101 patients (13.6%) failed, resulting in an implant CSurR and CSucR of 90.7% and 84.6%, respectively, after up to 20 years of follow-up. The prosthetic success rate was 98.1%. The average MBL was 1.07 mm ± 1.38 mm and 1.46 mm ± 1.56 mm at 15- and 20-years, respectively. Mechanical complication incidence was 78.5%, occurring in 581 patients (provisional prostheses: n = 448, 60.5%; definitive prostheses: n = 374, 50.5%). Biological complications occurred in 449 implants (15.2%) in 260 patients (35.1%). Biological complications and smoking habits were major risk indicators. Conclusions: Considering the study limitations, it can be concluded that the current rehabilitation concept is a viable treatment option in the long term, with mechanical and biological maintenance being necessary throughout the patients’ lives. Full article

We describe a new species of Desmoscolex collected from subtidal muddy sediments off Jindo Island, on the southern margin of Korea’s west coast. Desmoscolex (Desmoscolex) curuvus sp. nov. is distinguished by 17 main rings, a 9/8 somatic setal arrangement, subdorsal setae with a slightly swollen and hollow distal end, an oval head with laterally extended foreign material, a rounded amphidial fovea confined within the head region, and broad cephalic setae bearing a fine central canal with lateral membranes. The terminal ring is strongly bent ventrally. Females exhibit pronounced sexual dimorphism, including a pair of dorsal setae on the thirteenth main ring and a thicker terminal ring (maximum width 25–26 μm in males and 24–31 μm in females). High-resolution scanning electron microscopy (SEM) observations revealed a distinctive lip-region ultrastructure composed of a tuberculate membrane and six fragment-like membranous elements, representing a rare configuration within the genus. By documenting a new species possessing membranous structures in the cephalic setae and providing detailed ultrastructural characterization of the lip region, this study offers important new evidence for refining species delimitations in Desmoscolex. These findings underscore the diagnostic value of lip-region morphology and highlight the need for targeted sampling and further ultrastructural analyses to better resolve the hidden morphological diversity of the genus, particularly in the underexplored northwestern Pacific. Full article

Background: Reconstruction of the thigh extensor mechanism following wide excision of a soft-tissue sarcoma is difficult. The aim of this study was to describe the outcomes following complete quadriceps resection for large high-grade soft-tissue sarcomas. Methods: Ten patients with AJCC grade IIIB soft-tissue sarcomas of the anterior thigh were treated with total wide margin quadricectomy, with a mean follow-up of 4 years (range: 51–163 months) in the five surviving patients with conservative surgical procedures. The minimum follow-up period for four of these patients was 8 years. The extensor mechanism was reconstructed with local muscle transfers (eight cases) or a neurotized free flap of the contralateral vastus lateralis (two cases). Results: Four patients died, two due to non-tumor related causes and two due to metastatic disease at 50 months and 43 months. The remaining six were alive and disease-free at the final follow-up. All patients received surgical revision due to wound necrosis. Another patient required an external hemipelvectomy due to early local recurrence of the disease. Functional results of the five patients who remained alive and retained their limb were good or excellent in two cases, acceptable in one, and poor in two, according to their MSTS scores. Average knee flexion was 80° (range: 10–150°). Passive extension was complete in all cases, though no patients achieved it actively. Extensor strength was 2/5 in four patients and 4/5 in the other. Conclusion: Total quadricectomy for high-grade soft-tissue sarcomas of the anterior thigh compartment ensures wide resection margins and local disease control, although local wound complications are common, particularly in older patients. Resection appears to be technically easier if performed distally to proximally in the thigh. Local muscle transfers are more suited for low-demand patients, while neurotized free muscle flaps are mainly an option for young, motivated patients. Full article

We report a rare case of squamous cell carcinoma (SCC) arising from an intraosseous epidermal cyst (EC) in the distal phalanx of the left thumb. A 76-year-old male presented with progressive thumb pain experienced over the previous six months. Radiography revealed a radiolucent lesion without marginal sclerosis, and magnetic resonance imaging showed peripheral contrast enhancement with no solid components. Surgery revealed a bone-originating mass without adhesion to the surrounding skin or nail bed, which histopathological findings determined contained both cystic epithelium with laminated keratin and invasive keratinizing tumor cells, confirming SCC arising from an intraosseous EC. No primary lesion or lymph node enlargement was identified by postoperative computed tomography. Although wide resection and chemotherapy were proposed, the patient declined further intervention beyond the curettage performed during surgery, opting for close observation only. No recurrence or metastasis has been observed in the five years since the surgery. Intraosseous ECs are extremely rare, with malignant transformation even more uncommon. Accurate diagnosis requires histopathological confirmation, as imaging alone is insufficient. This case highlights the importance of considering intraosseous EC in the differential diagnosis of bone lesions and underscores the need for further case accumulation to clarify optimal management strategies. Full article

Currently, the synonymy of the two morphologically analogous copepod species, Mongolodiaptomus birulai (Rylov, 1922) and M. formosanus Kiefer, 1937, remains doubtful. While examining the detailed morphology of diaptomid copepods from China, Cambodia, and Vietnam, we came across two undescribed species whose morphology is closely similar to that of M. birulai from Northeast China and M. formosanus from Taiwan. In this paper, descriptions of M. parabirulai sp. nov. from Yunnan, Southwestern China, and M. longiserratus sp. nov. from Cambodia and Vietnam are presented. The first new species, M. parabirulai sp. nov., can be distinguished from its congeners in the male P5 by it having the distal outer portion of the second right exopod produce a wing-shaped expansion and its strongly robust left and right basis. The second new species, M. longiserratus sp. nov., can be differentiated by the following characteristics in the male: the spiniform process on segment 20 of the right antennule is longer than that of segment 21 and has a serrate outer margin, and the right P5 basis has two (longitudinal and semicircular) hyaline lamellae. Furthermore, the status of M. birulai and M. formosanus is reviewed and recommended. Full article

Background: The Orbay approach to volar distal radius described a volar zig-zag incision across the wrist crease, allowing a more distal exposure than traditional approaches. This adaptation enhances mobilization of the proximal radial fragment and improves visualization of both the articular surface and dorsally displaced distal radius fractures. Methods: In the present paper, we propose a further modification of the volar zig-zag approach, positioning the apex of the incision at the level of the radial styloid. Results: This modification aims to improve visualization of the radial styloid, the articular comminution, and the dorsal aspect of the distal radius, thereby optimizing fracture exposure and reduction. Conclusions: The principal advantage lies in the reduced need for traction along the radial margin of the incision to achieve adequate visualization and the avoidance of crossing the wrist crease, thereby preventing the formation of unsightly or adherent scars. Full article