Search results for: plastic surgery
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1997

Search results for: plastic surgery

407 Properties of Adipose Tissue Derived Mesenchymal Stem Cells with Long-Term Cryopreservation

Authors: Jienny Lee, In-Soo Cho, Sang-Ho Cha

Abstract:

Adult mesenchymal stem cells (MSCs) have been investigated using preclinical approaches for tissue regeneration. Porcine MSCs (pMSCs) are capable of growing and attaching to plastic with a fibroblast-like morphology and then differentiating into bone, adipose, and cartilage tissues in vitro. This study was conducted to investigate the proliferating abilities, differentiation potentials, and multipotency of miniature pig adipose tissue-derived MSCs (mpAD-MSCs) with or without long-term cryopreservation, considering that cryostorage has the potential for use in clinical applications. After confirming the characteristics of the mpAD-MSCs, we examined the effect of long-term cryopreservation (> 2 years) on expression of cell surface markers (CD34, CD90 and CD105), proliferating abilities (cumulative population doubling level, doubling time, colony-forming unit, and MTT assay) and differentiation potentials into mesodermal cell lineages. As a result, the expression of cell surface markers is similar between thawed and fresh mpAD-MSCs. However, long-term cryopreservation significantly lowered the differentiation potentials (adipogenic, chondrogenic, and osteogenic) of mpAD-MSCs. When compared with fresh mpAD-MSCs, thawed mpAD-MSCs exhibited lower expression of mesodermal cell lineage-related genes such as peroxisome proliferator-activated receptor-g2, lipoprotein lipase, collagen Type II alpha 1, osteonectin, and osteocalcin. Interestingly, long-term cryostoraged mpAD-MSCs exhibited significantly higher cell viability than the fresh mpAD-MSCs. Long-term cryopreservation induced a 30% increase in the cell viability of mpAD-MSCs when compared with the fresh mpAD-MSCs at 5 days after thawing. However, long-term cryopreservation significantly lowered expression of stemness markers such as Oct3/4, Sox2, and Nanog. Furthermore, long-term cryopreservation negatively affected expression of senescence-associated genes such as telomerase reverse transcriptase and heat shock protein 90 of mpAD-MSCs when compared with the fresh mpAD-MSCs. The results from this study might be important for the successful application of MSCs in clinical trials after long-term cryopreservation.

Keywords: mesenchymal stem cells, cryopreservation, stemness, senescence

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406 Using MALDI-TOF MS to Detect Environmental Microplastics (Polyethylene, Polyethylene Terephthalate, and Polystyrene) within a Simulated Tissue Sample

Authors: Kara J. Coffman-Rea, Karen E. Samonds

Abstract:

Microplastic pollution is an urgent global threat to our planet and human health. Microplastic particles have been detected within our food, water, and atmosphere, and found within the human stool, placenta, and lung tissue. However, most spectrometric microplastic detection methods require chemical digestion which can alter or destroy microplastic particles and makes it impossible to acquire information about their in-situ distribution. MALDI TOF MS (Matrix-assisted laser desorption ionization-time of flight mass spectrometry) is an analytical method using a soft ionization technique that can be used for polymer analysis. This method provides a valuable opportunity to both acquire information regarding the in-situ distribution of microplastics and also minimizes the destructive element of chemical digestion. In addition, MALDI TOF MS allows for expanded analysis of the microplastics including detection of specific additives that may be present within them. MALDI TOF MS is particularly sensitive to sample preparation and has not yet been used to analyze environmental microplastics within their specific location (e.g., biological tissues, sediment, water). In this study, microplastics were created using polyethylene gloves, polystyrene micro-foam, and polyethylene terephthalate cable sleeving. Plastics were frozen using liquid nitrogen and ground to obtain small fragments. An artificial tissue was created using a cellulose sponge as scaffolding coated with a MaxGel Extracellular Matrix to simulate human lung tissue. Optimal preparation techniques (e.g., matrix, cationization reagent, solvent, mixing ratio, laser intensity) were first established for each specific polymer type. The artificial tissue sample was subsequently spiked with microplastics, and specific polymers were detected using MALDI-TOF-MS. This study presents a novel method for the detection of environmental polyethylene, polyethylene terephthalate, and polystyrene microplastics within a complex sample. Results of this study provide an effective method that can be used in future microplastics research and can aid in determining the potential threats to environmental and human health that they pose.

Keywords: environmental plastic pollution, MALDI-TOF MS, microplastics, polymer identification

Procedia PDF Downloads 233
405 Lower Limb Oedema in Beckwith-Wiedemann Syndrome

Authors: Mihai-Ionut Firescu, Mark A. P. Carson

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We present a case of inferior vena cava agenesis (IVCA) associated with bilateral deep venous thrombosis (DVT) in a patient with Beckwith-Wiedemann syndrome (BWS). In adult patients with BWS presenting with bilateral lower limb oedema, specific aetiological factors should be considered. These include cardiomyopathy and intraabdominal tumours. Congenital malformations of the IVC, through causing relative venous stasis, can lead to lower limb oedema either directly or indirectly by favouring lower limb venous thromboembolism; however, they are yet to be reported as an associated feature of BWS. Given its life-threatening potential, the prompt initiation of treatment for bilateral DVT is paramount. In BWS patients, however, this can prove more complicated. Due to overgrowth, the above-average birth weight can continue throughout childhood. In this case, the patient’s weight reached 170 kg, impacting on anticoagulation choice, as direct oral anticoagulants have a limited evidence base in patients with a body mass above 120 kg. Furthermore, the presence of IVCA leads to a long-term increased venous thrombosis risk. Therefore, patients with IVCA and bilateral DVT warrant specialist consideration and may benefit from multidisciplinary team management, with hematology and vascular surgery input. Conclusion: Here, we showcased a rare cause for bilateral lower limb oedema, respectively bilateral deep venous thrombosis complicating IVCA in a patient with Beckwith-Wiedemann syndrome. The importance of this case lies in its novelty, as the association between IVC agenesis and BWS has not yet been described. Furthermore, the treatment of DVT in such situations requires special consideration, taking into account the patient’s weight and the presence of a significant, predisposing vascular abnormality.

Keywords: Beckwith-Wiedemann syndrome, bilateral deep venous thrombosis, inferior vena cava agenesis, venous thromboembolism

Procedia PDF Downloads 217
404 The Impact of the New Head Injury Pathway on the Number of CTs Performed in a Paediatric Population

Authors: Amel M. A. Osman, Roy Mahony, Lisa Dann, McKenna S.

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Background: Computed Tomography (CT) is a significant source of radiation in the pediatric population. A new head injury (HI) pathway was introduced in 2021, which altered the previous process of HI being jointly admitted with general pediatrics and surgery to admit these patients under the Emergency Medicine Team. Admitted patients included those with positive CT findings not requiring immediate neurosurgical intervention and those who did not meet current criteria for urgent CT brain as per NICE guidelines but were still symptomatic for prolonged observations. This approach aims to decrease the number of CT scans performed. The main aim is to assess the variation in CT scanning rates since the change in the admitting process. A retrospective review of patients presenting to CHI PECU with HI over 6-month period (01/01/19-31/05/19) compared to a 6-month period post introduction of the new pathway (01/06/2022-31/12/2022). Data was collected from the electronic record databases, symphony, and PACS. Results: In 2019, there were 869 presentations of HI, among which 32 (3.68%) had CT scans performed. 2 (6.25%) of those scanned had positive findings. In 2022, there were 1122 HI presentations, with 47 (4.19%) CT scans performed and positive findings in 5 (10.6%) cases. 57 patients were admitted under the new pathway for observation, with 1 having a CT scan following admission. Conclusion: Quantitative lifetime radiation risks for children are not negligible. While there was no statistically significant reduction in CTs performed amongst HIs presenting to our department, a significant group met the criteria for admission under the PECU consultant for prolonged monitoring. There was also a greater proportion of abnormalities on CT scans performed in 2022, demonstrating improved patient selection for imaging. Further data analysis is ongoing to determine if those who were admitted would have previously been scanned under the old pathway.

Keywords: head injury, CT, admission, guidline

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403 A Primary Care Diagnosis of Middle-Aged Men with Oral Cancer Who Underwent Extensive Resection and Flap Repair: A Case Report

Authors: Ching-Yi Huang, Pi-Fen Cheng, Hui-Zhu Chen, Shi Ting Huang, Heng-Hua Wang

Abstract:

This is a case of oral cancer after extensive resection and modified right lateral neck lymph node dissection followed by reconstruction with a skin flap. The nursing period lasted From September 25 to October 3, 2017, through observation, interview, physical assessment, and medical record review, the author identified the following nursing problems: acute pain, impaired oral mucous membrane, and body image change. During the nursing period, the author provided individual and overall nursing care and established mutual trust through the use of empathy. Author listened and eased the patient's physical indisposition, such as wound pain, we use medications and acupuncture massage to relieve pain. However, for oral mucosa change caused by surgery, provide continuous and complete oral care and oral exercise training to improve oral mucosal healing and restore swallowing function. In the body-image changes, guided him to express his feeling after the body-image change, and enhanced support and from the family, and encouraged him to attend head and neck cancer survivor alliance which allowed the patient to accept the altered body image and reaffirm self-worth. Hopefully, through sharing this nursing experience will help to the nursing care quality of nursing care for oral cancer patients after extensive resection and modified right lateral neck lymph node dissection followed by reconstruction with a skin flap.

Keywords: oral cancer, acute pain, impaired oral mucous membrane, body image change

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402 Height of Highway Embankment for Tolerable Residual Settlement of Loose Cohesionless Subsoil Overlain by Stronger Soil

Authors: Sharifullah Ahmed

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Residual settlement of cohesionless or non-plastic soil of different strength underlying highway embankment overlain by stronger soil layer highway embankment is studied. A parametric study is carried out for different height of embankment and for different ESAL factor. The sum of elastic settlements of cohesionless subsoil due to axle induced stress and due to self-weight of pavement layers is termed as the residual settlement. The values of residual settlement (Sr) for different heights of road embankment (He) are obtained and presented as design charts for different SPT Value (N60) and ESAL factor. For rigid pavement and flexible pavement in approach to bridge or culvert, the tolerable residual settlement is 0.100m. This limit is taken as 0.200m for flexible pavement in general sections of highway without approach to bridge or culvert. A simplified guideline is developed for design of highway embankment underlain by very loose to loose cohesionless subsoil overlain by a stronger soil layer for limiting value of the residual settlement. In the current research study range of ESAL factor is 1-10 and range of SPT value (N60) is 1-10. That is found that, ground improvement is not required if the overlying stronger layer is minimum 1.5m and 4.0m for general road section of flexible pavement except bridge or culvert approach and for rigid pavement or flexible pavement in bridge or culvert approach. Tables and charts are included in the prepared guideline to obtain minimum allowable height of highway embankment to limit the residual settlement with in mentioned tolerable limit. Allowable values of the embankment height (He) are obtained corresponding to tolerable or limiting level of the residual settlement of loose subsoil for different SPT value, thickness of stronger layer (d) and ESAL factor. The developed guideline is may be issued to be used in assessment of the necessity of ground improvement in case of cohesionless subsoil underlying highway embankment overlain by stronger subsoil layer for limiting residual settlement. The ground improvement is only to be required if the residual settlement of subsoil is more than tolerable limit.

Keywords: axle pressure, equivalent single axle load, ground improvement, highway embankment, tolerable residual settlement

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401 Microbial Pathogens Associated with Banded Sugar Ants (Camponotus consobrinus) in Calabar, Nigeria

Authors: Ofonime Ogba, Augustine Akpan

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Objectives and Goals: The study was aimed at determining pathogenic microbial carriage on the external body parts of Camponotus consobrinus which is also known as the banded sugar ant because of its liking for sugar and sweet food. The level of pathogenic microbial carriage of Camponotus consobrinus in association to the environment in which they have been collected is not known. Methods: The ants were purposively collected from four locations including the kitchens, bedroom of various homes, food shops, and bakeries. The sample collection took place within the hours of 6:30 pm to 11:00 pm. The ants were trapped in transparent plastic containers of which sugar, pineapple peels, sugar cane and soft drinks were used as bait. The ants were removed with a sterile spatula and put in 10mls of peptone water in sterile universal bottles. The containers were vigorously shaken to wash the external surface of the ant. It was left overnight and transported to the Microbiology Laboratory, University of Calabar Teaching Hospital for analysis. The overnight peptone broths were inoculated on Chocolate agar, Blood agar, Cystine Lactose Electrolyte-Deficient agar (CLED) and Sabouraud dextrose agar. Incubation was done aerobically and in a carbon dioxide jar for 24 to 48 hours at 37°C. Isolates were identified based on colonial characteristics, Gram staining, and biochemical tests. Results: Out of the 250 Camponotus consobrinus caught for the study, 90(36.0%) were caught in the kitchen, 75(30.0%) in the bedrooms 40(16.0%) in the bakery while 45(18.0%) were caught in the shops. A total of 82.0% prevalence of different microbial isolates was associated with the ants. The kitchen had the highest number of isolates 75(36.6%) followed by the bedroom 55(26.8%) while the bakery recorded the lowest number of isolates 35(17.1%). The profile of micro-organisms associated with Camponotus consobrinus was Escherichia coli 73(30.0%), Morganella morganii 45(18.0%), Candida species 25(10.0%), Serratia marcescens 10(4.0%) and Citrobacter freundii 10(4.0%). Conclusion: Most of the Camponotus consobrinus examined in the four locations harboured potential pathogens. The presence of ants in homes and shops can facilitate the propagation and spread of pathogenic microorganisms. Therefore, the development of basic preventive measures and the control of ants must be taken seriously.

Keywords: Camponotus consobrinus, potential pathogens, microbial isolates, spread

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400 The Addition of Opioids to Bupivacaine in Bilateral Infraorbital Nerve Block for Postoperative Pain Relief in Paediatric Patients for Cleft Lip Repair-Comparative Effects of Pethidine and Fentanyl: A Prospective Randomized Double Blind Study

Authors: Mrudula Kudtarkar, Rajesh Mane

Abstract:

Introduction: Cleft lip repair is one of the common surgeries performed in India and the usual method used for post-operative analgesia is perioperative opioids and NSAIDs. There has been an increase in use of regional techniques and Opioids are the common adjuvants but their efficacy and safety have not been studied extensively in children. Aim: A prospective, randomized, double-blind study was done to compare the efficacy, duration and safety of intraoral infraorbital nerve block on post-operative pain relief using bupivacaine alone or in combination with fentanyl or pethidine in paediatric cleft lip repair. Methodology: 45 children between the age group 5 – 60 months undergoing cleft lip surgery randomly allocated into 3 groups of 15 each received bilateral intraoral infraorbital nerve block with 0.75ml of solution. Group B received 0.25% bupivacaine; group P received 0.25% bupivacaine with 0.25mg/kg pethidine, group F received 0.25% bupivacaine with 0.25microgm/kg fentanyl. Sedation after recovery, post-operative pain intensity and duration of post-operative analgesia were assessed using Modified Hannallah Pain Score. Results: The mean duration of analgesia was 17.8 hrs in Group B, 23.53 hrs in Group F and 35.13 hrs in Group P. There was statistically significant difference between the means of the three groups- ANOVA (p < 0.05). Conclusion: Thus we conclude that addition of fentanyl or pethidine to bupivacaine for Bilateral Intraoral Infraorbital Nerve Block prolong the duration of analgesia with no complications and can be used safely in paediatric patients.

Keywords: cleft lip, infraorbital block, NSAIDS, Opiods

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399 The Causes and Effects of Poor Household Sanitation: Case Study of Kansanga Parish

Authors: Rosine Angelique Uwacu

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Poor household sanitation is rife in Uganda, especially in Kampala. This study was carried out with he goal of establishing the main causes and effects of poor household sanitation in Kansanga parish. The study objectively sought to: To identify various ways through which wastes are generated and disposed of in Kansanga parish, identify different hygiene procedures/behaviors of waste handling in Kansanga parish and assess health effects of poor household sanitation and suggest the recommended appropriate measures of addressing cases of lack of hygiene in Kansanga parish. The study used a survey method where cluster sampling was employed. This is because there is no register of population or sufficient information, or geographic distribution of individuals is widely scattered. Data was collected through the use of interviews accompanied by observation and questionnaires. The study involved a sample of 100 households. The study revealed that; some households use wheeled bin collection, skip hire and roll on/off contained others take their wastes to refuse collection vehicles. Surprisingly, majority of the households submitted that they use polythene bags 'Kavera' and at times plastic sacs to dispose of their wastes which are dumped in drainage patterns or dustbins and other illegal dumping site. The study showed that washing hands with small jerrycans after using the toilet was being adopted by most households as there were no or few other alternatives. The study revealed that the common health effects that come as a result of poor household sanitation in Kansanga Parish are diseases outbreaks such as malaria, typhoid and diarrhea. Finally, the study gave a number of recommendations or suggestions on maintaining and achieving an adequate household sanitation in Kansanga Parish such as sensitization of community members by their leaders like Local Counselors could help to improve the situation, establishment of community sanitation days for people to collectively and voluntarily carry out good sanitation practices like digging trenches, burning garbage and proper waste management and disposal. Authorities like Kampala Capital City Authority should distribute dumping containers or allocate dumping sites where people can dispose of their wastes preferably at a minimum cost for proper management.

Keywords: household sanitation, kansanga parish, Uganda, waste

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398 Numerical Buckling of Composite Cylindrical Shells under Axial Compression Using Asymmetric Meshing Technique (AMT)

Authors: Zia R. Tahir, P. Mandal

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This paper presents the details of a numerical study of buckling and post buckling behaviour of laminated carbon fiber reinforced plastic (CFRP) thin-walled cylindrical shell under axial compression using asymmetric meshing technique (AMT) by ABAQUS. AMT is considered to be a new perturbation method to introduce disturbance without changing geometry, boundary conditions or loading conditions. Asymmetric meshing affects both predicted buckling load and buckling mode shapes. Cylindrical shell having lay-up orientation [0°/+45°/-45°/0°] with radius to thickness ratio (R/t) equal to 265 and length to radius ratio (L/R) equal to 1.5 is analysed numerically. A series of numerical simulations (experiments) are carried out with symmetric and asymmetric meshing to study the effect of asymmetric meshing on predicted buckling behaviour. Asymmetric meshing technique is employed in both axial direction and circumferential direction separately using two different methods, first by changing the shell element size and varying the total number elements, and second by varying the shell element size and keeping total number of elements constant. The results of linear analysis (Eigenvalue analysis) and non-linear analysis (Riks analysis) using symmetric meshing agree well with analytical results. The results of numerical analysis are presented in form of non-dimensional load factor, which is the ratio of buckling load using asymmetric meshing technique to buckling load using symmetric meshing technique. Using AMT, load factor has about 2% variation for linear eigenvalue analysis and about 2% variation for non-linear Riks analysis. The behaviour of load end-shortening curve for pre-buckling is same for both symmetric and asymmetric meshing but for asymmetric meshing curve behaviour in post-buckling becomes extraordinarily complex. The major conclusions are: different methods of AMT have small influence on predicted buckling load and significant influence on load displacement curve behaviour in post buckling; AMT in axial direction and AMT in circumferential direction have different influence on buckling load and load displacement curve in post-buckling.

Keywords: CFRP composite cylindrical shell, asymmetric meshing technique, primary buckling, secondary buckling, linear eigenvalue analysis, non-linear riks analysis

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397 The Bespoke ‘Hybrid Virtual Fracture Clinic’ during the COVID-19 Pandemic: A Paradigm Shift?

Authors: Anirudh Sharma

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Introduction: The Covid-19 pandemic necessitated a change in the manner outpatient fracture clinics are conducted due to the need to reduce footfall in hospital. While studies regarding virtual fracture clinics have shown these to be useful and effective, they focus exclusively on remote consultations. However, our service was bespoke to the patient – either a face-to-face or telephone consultation depending on patient need – a ‘hybrid virtual clinic (HVC).’ We report patient satisfaction and outcomes with this novel service. Methods: Patients booked onto our fracture clinics during the first 2 weeks of national lockdown were retrospectively contacted to assess the mode of consultations (virtual, face-to-face, or hybrid), patient experience, and outcome. Patient experience was assessed using the net promoter (NPS), customer effort (CES) and customer satisfaction scores (CSS), and their likelihood of using the HVC in the absence of a pandemic. Patient outcomes were assessed using the components of the EQ5D score. Results: Of 269 possible patients, 140 patients responded to the questionnaire. Of these, 66.4% had ‘hybrid’ consultations, 27.1% had only virtual consultations, and 6.4% had only face-to-face consultations. The mean overall NPS, CES, and CSS (on a scale of 1-10) were 7.27, 7.25, and 7.37, respectively. The mean likelihood of patients using the HVC in the absence of a pandemic was 6.5/10. Patients who had ‘hybrid’ consultations showed better effort scores and greater overall satisfaction than those with virtual consultations only and also reported superior EQ5D outcomes (mean 79.27 vs. 72.7). Patients who did not require surgery reported increased satisfaction (mean 7.51 vs. 7.08) and were more likely to use the HVC in the absence of a pandemic. Conclusion: Our study indicates that a bespoke HVC has good overall patient satisfaction and outcomes and is a better format of fracture clinic service than virtual consultations alone. It may be the preferred mode for fracture clinics in similar situations in the future. Further analysis needs to be conducted in order to explore the impact on resources and clinician experience of HVC in order to appreciate this new paradigm shift.

Keywords: hybrid virtual clinic, coronavirus, COVID-19, fracture clinic, remote consultation

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396 Pulmonary Embolism Indicative of Myxoma of the Right Atrium

Authors: A. Kherraf, M. Bouziane, A. Drighil, L. Azzouzi, R. Habbal

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Objective: Myxomas are rare heart tumors most commonly found in the left atrium. The purpose of this observation is to report a rare case of myxoma of the right atrium revealed by pulmonary embolism. Observation: A 34-year-old patient with no history presented to the emergency room with sudden onset dyspnea. Clinical examination showed arterial pressure at 110/70mmHg, tachycardia at 110bpm, and 90% oxygen saturation. The ECG enrolled in incomplete right bundle branch block. The radio-thorax was normal. Echocardiography revealed the presence of a large homogeneous intra-OD mass, contiguous to the inter-atrial septum, prolapsing through the tricuspid valve, and causing mild tricuspid insufficiency, with dilation of the right ventricle and retained systolic function with PAPs estimated at 45mmHg. A chest scan was performed, revealing the presence of right segmental pulmonary embolism. The patient was put under anticoagulant and underwent surgical resection of the mass; its pathological examination concluded to a myxoma. The post-operative consequences were simple, without recurrence of the mass after one year follow-up. Discussion: Myxomas represent 50% of heart tumors. Most often, they originate in the left atrium, and more rarely in the right atrium or the ventricles. Myxoma of the right atrium can be responsible for life-threatening pulmonary embolism. The most predictive factor for embolization remains the morphology of the myxomas; papillary or villous myxomas are the most friable. Surgery is the standard treatment, with regular postoperative follow-up to detect recurrence. Conclusion: Myxomas of the right atrium are a rare location for these tumors. Pulmonary embolism is the main complication and should routinely involve careful study of the right chambers on echocardiography.

Keywords: pulmonary embolism, myxoma, right atrium, heart tumors

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395 Trial of Resorbable versus Non-Resorbable Sutures for Traumatic Lacerations of the Face: A Demonstration of Maxillo-Facial Trainee Led Research

Authors: R. Botrugno, S Basyuni, G. Nugent, I. Jenkyn, A. Ferro, H. Bennett, C. Hjalmarsson, J. Chu, V. Santhanam

Abstract:

This trainee led randomised controlled trial (RCT) aims to assess various outcomes for resorbable versus non-resorbable sutures for traumatic lacerations to the face. Within this trial of resorbable versus non-resorbable sutures for traumatic lacerations of the face (TORNFace), patient recruitment was facilitated by trainees who were employed at an NHS University Teaching Hospital in the United Kingdom. The trainees received appropriate training prior to recruiting patients for the trial. This included the completion of a national research e-learning module and face-to-face training that was provided locally. The locally delivered training provided an understanding of the eligibility criteria for the trial and the consent process. Existing trainee skills were utilised involving clinical photography to record baseline data and delivering the intervention based on the treatment arm selected. Eligible patients who required primary closure of traumatic lacerations of the face were randomised into one of two treatment arms. These comprised of resorbable (vicryl rapide) or non-resorbable sutures (ethilon). Primarily the cosmetic outcome was assessed. Secondary outcomes included: complications rates, health care economics, and patient-reported outcomes. Remote follow-up of recruited patients utilised photographs of the facial laceration which had received the intervention. These took place at 1 week, 3 months and 6 months post-intervention. This study aims to demonstrate an example of trainee-led research within the specialty of oral and maxillofacial surgery. The available data for the randomised controlled trial will also be presented.

Keywords: laceration, suture, trauma, trial

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394 Biochar-induced Metals Immobilization in the Soil as Affected by Citric Acid

Authors: Md. Shoffikul Islam, Hongqing Hu

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Reducing trace elements' mobility and bioavailability through amendment addition, especially biochar (BC), is a cost-effective and efficient method to address their toxicity in the soil environment. However, the low molecular weight organic acids (LMWOAs) in the rhizosphere could affect BC's efficiency to stabilize trace metals as the LMWOAs could either mobilize or fix metals in the soils. Therefore, understanding the BC's and LMWOAs' interaction mechanisms on metals stabilization in the rhizosphere is crucial. The present study explored the impact of BC derived from rice husk and citric acid (CA) and the combination of BC and CA on the redistribution of cadmium (Cd), lead (Pb), and zinc (Zn) among their geochemical forms through incubation experiment. The changes of zeta potential and X-ray diffraction (XRD) pattern of BC and BC-amended soils to investigate the probable mechanisms of trace elements' immobilization by BC under the CA attack were also examined. The rice husk BC at 5% (w/w) was mixed with the air-dry soil (an Anthrosols) contaminated with Cd, Pb, and Zn in the plastic pot. The 2, 5, 10, and 20 mM kg-1 (w/v) of CA were added separately into the pot. All the ingredients were mixed thoroughly with the soil. A control (CK) treatment was also prepared without BC and CA addition. After 7, 15, and 60 days of incubation with 60% (w/v) moisture level at 25 °C, the incubated soils were determined for pH and EC and were sequentially extracted to assess the metals' transformation in soil. The electronegative charges and XRD peaks of BC and BC-amended soils were also measured. Compared to CK, the application of BC, low level of CA (2 mM kg-1 soil) (CA2), and BC plus the low concentration of CA (BC-CA2) considerably declined the acid-soluble Cd, Pb, and Zn in which BC-CA2 was found to be the most effective treatment. The reversed trends were observed concerning the high levels of CA (>5-20 mM kg-1 soil) and the BC plus high concentrations of CA treatments. BC-CA2 changed the highest amounts of acid-soluble and reducible metals to the oxidizable and residual forms with time. The most increased electronegative charges of BC-CA2 indicate its (BC-CA2) highest Cd, Pb, and Zn immobilizing efficiency, probably through metals adsorption and fixation with the negative charge sites. The XRD study revealed the presence of P, O, CO32-, and Cl1- in BC, which might be responsible for the precipitation of CdCO3, pyromorphite, and hopeite in the case of Cd, Pb, and Zn immobilization, respectively. The findings depicted that the low concentration of CA increased metals' stabilization, whereas the high levels of CA enhanced their mobilization. The BC-CA2 emerged as the best amendment among treatments for metals stabilization in contaminated soils.

Keywords: Biochar, citric acid, immobilization, trace elements contaminated soil

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393 Periodontal Soft Tissue Sculpturing and Use of Interim Appliance for Rehabilitation of Anterior Edentulousness: Case Report

Authors: Hande Yesil, Seda Aycan Altan, M. Vehbi Bal, Alper Uyar, O. Cumhur Sipahi

Abstract:

Purpose: Fixed partial dentures (FPDs) must fulfill functional requirements such as phonetics, chewing efficiency and esthetics especially in the anterior region. A convex type tissue surface is usually recommended for pontics of FPDs. That pontic design also provides suitable oral hygiene and ease of cleaning. However, high esthetic requirements and correct emergence profile are not always achievable because of the convex shape of adjacent soft tissues. Therefore, the ovate type pontic which fulfills the high esthetic demands of the patients may be a good alternative to the modified ridge lap pontic design. Clinical Report: A female patient referred with the complaint of anterior upper edentulousness. In the oral examination it was determined that teeth 11, 12, 21, 22 were deficient. A thick and convex gingival tissue that may cause aesthetic problems was also observed.. Periodontal augmentation surgery was performed to ensure proper papillary configuration and gingival contour. An interim removable partial denture (IRPD) which applied pressure to operated gingival tissues was fabricated postoperatively. The IRPD was used for 4 weeks and after completion of tissue sculpting, the permanent FPD with an ovate pontic was fabricated and cemented. After a follow-up period of 6 months, not any esthetical and hygienic problem was detected and the patient was satisfied with her prosthesis. Conclusion: It was concluded that shaping of gingival contours with IRPD and use of a FPD with ovate pontic fulfills all esthetic and hygienic requirements.

Keywords: interim appliance, ovate pontic, tissue sculpturing, fixed partial denture

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392 Organic Fertilizers Mitigate Microplastics Toxicity in Agricultural Soil

Authors: Ghulam Abbas Shah, Maqsood Sadiq, Ahsan Yasin

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Massive global plastic production, combined with poor degradation and recycling, leads to significant environmental pollution from microplastics, whose effects on plants in the soil remain understudied. Besides, effective mitigation strategies and their impact on ammonia (NH₃) emissions under varying fertilizer management practices remains sketchy. Therefore, the objectives of the study were (i) to determine the impact of organic fertilizers on the toxicity of microplastics in sorghum and physicochemical characteristics of microplastics-contaminated soil and (ii) to assess the impacts of these fertilizers on NH₃ emissions from this soil. A field experiment was conducted using sorghum as a test crop. Treatments were: (i) Control (C), (ii) Microplastics (MP), (iii) Inorganic fertilizer (IF), (iv) MPIF, (v) Farmyard manure (FM), (vi) MPFM, (vii) Biochar (BC), and (viii) MPBC, arranged in a randomized complete block design (RCBD) with three replicates. Microplastics of polyvinyl chloride (PVC) were applied at a rate of 1.5 tons ha-¹, and all fertilizers were applied at the recommended dose of 90 kg N ha-¹. Soil sampling was done before sowing and after harvesting the sorghum, with samples analyzed for chemical properties and microbial biomass. Crop growth and yield attributes were measured. In a parallel pot experiment, NH₃ emissions were measured using passive flux samplers over 72 hours following the application of treatments similar to those used in the field experiment. Application of MPFM, MPBC and MPIF reduced soil mineral nitrogen by 8, 20 and 38% compared to their sole treatments, respectively. Microbial biomass carbon (MBC) was reduced by 19, 25 and 59% in MPIF, MPBC and MPFM as compared to their sole application, respectively. Similarly, the respective reduction in microbial biomass nitrogen (MBN) was 10, 27 and 66%. The toxicity of microplastics was mitigated by MPFM and MPBC, each with only a 5% reduction in grain yield of sorghum relative to their sole treatments. The differences in nitrogen uptake between BC vs. MPBC, FM vs. MPFM, and IF vs. MPIF were 8, 10, and 12 kg N ha-¹, respectively, indicating that organic fertilizers mitigate microplastic toxicity in the soil. NH₃ emission was reduced by 5, 11 and 20% after application of MPFM, MPBC and MPIF than their sole treatments, respectively. The study concludes that organic fertilizers such as FM and BC can effectively mitigate the toxicity of microplastics in soil, leading to improved crop growth and yield.

Keywords: microplastics, soil characteristics, crop n uptake, biochar, NH₃ emissions

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391 Nanoindentation Studies of Metallic Cu-CuZr Composites Synthesized by Accumulative Roll Bonding

Authors: Ehsan Alishahi, Chuang Deng

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Materials with microstructural heterogeneity have recently attracted dramatic attention in the materials science community. Although most of the metals are identified as crystalline, the new class of amorphous alloys, sometimes are known as metallic glasses (MGs), exhibited remarkable properties, particularly high mechanical strength and elastic limit. The unique properties of MGs led to the wide range of studies in developing and characterizing of new alloys or composites which met the commercial desires. In spite of applicable properties of MGs, commercializing of metallic glasses was limited due to a major drawback, the lack of ductility and sudden brittle failure mode. Hence, crystalline-amorphous (C-A) composites were introduced almost in 2000s as a toughening strategy to improve the ductility of MGs. Despite the considerable progress reported in previous studies, there are still challenges in both synthesis and characterization of metallic C-A composites. In this study, accumulative roll bonding (ARB) was used to synthesize bulk crystalline-amorphous composites starting from crystalline Cu-Zr multilayers. Due to the severe plastic deformation state, new CuZr phases were formed during the rolling process which was reflected in SEM-EDS analysis. EDS elemental analysis showed the variation in the composition of CuZr phases such as 38-62, 50-50 to 68-32 at Cu-Zr % respectively. Moreover, TEM with electron diffraction analysis indicated the presence of both crystalline and amorphous structures for the new formed CuZr phases. In addition to the microstructural analysis, the mechanical properties of the synthesized composites were studied using the nanoindentation technique. Hysitron Nanoindentation instrument was used to conduct nanoindentation tests with cube corner tip. The maximum load of 5000 µN was applied in load control mode to measure the elastic modulus and hardness of different phases. The trend of results indicated three distinct regimes of hardness and elastic modulus including pure Cu, pure Zr, and new formed CuZr phases. More specifically, pure Cu regions showed the lowest values for both nanoindentation hardness and elastic modulus while the CuZr phases take the highest values. Consequently, pure Zr was placed in the intermediate range which is harder than pure Cu but softer than CuZr phases. In overall, it was found that CuZr phases with higher hardness were nucleated during ARB process as a result of mechanical alloying phenomenon.

Keywords: ARB, crystalline-amorphous composites, mechanical alloying, nanoindentation hardness

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390 Identification of the Best Blend Composition of Natural Rubber-High Density Polyethylene Blends for Roofing Applications

Authors: W. V. W. H. Wickramaarachchi, S. Walpalage, S. M. Egodage

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Thermoplastic elastomer (TPE) is a multifunctional polymeric material which possesses a combination of excellent properties of parent materials. Basically, TPE has a rubber phase and a thermoplastic phase which gives processability as thermoplastics. When the rubber phase is partially or fully crosslinked in the thermoplastic matrix, TPE is called as thermoplastic elastomer vulcanizate (TPV). If the rubber phase is non-crosslinked, it is called as thermoplastic elastomer olefin (TPO). Nowadays TPEs are introduced into the commercial market with different products. However, the application of TPE as a roofing material is limited. Out of the commercially available roofing products from different materials, only single ply roofing membranes and plastic roofing sheets are produced from rubbers and plastics. Natural rubber (NR) and high density polyethylene (HDPE) are used in various industrial applications individually with some drawbacks. Therefore, this study was focused to develop both TPO and TPV blends from NR and HDPE at different compositions and then to identify the best blend composition to use as a roofing material. A series of blends by varying NR loading from 10 wt% to 50 wt%, at 10 wt% intervals, were prepared using a twin screw extruder. Dicumyl peroxide was used as a crosslinker for TPV. The standard properties for a roofing material like tensile properties tear strength, hardness, impact strength, water absorption, swell/gel analysis and thermal characteristics of the blends were investigated. Change of tensile strength after exposing to UV radiation was also studied. Tensile strength, hardness, tear strength, melting temperature and gel content of TPVs show higher values compared to TPOs at every loading studied, while water absorption and swelling index show lower values, suggesting TPVs are more suitable than TPOs for roofing applications. Most of the optimum properties were shown at 10/90 (NR/HDPE) composition. However, high impact strength and gel content were shown at 20/80 (NR/HDPE) composition. Impact strength, as being an energy absorbing property, is the most important for a roofing material in order to resist impact loads. Therefore, 20/80 (NR/HDPE) is identified as the best blend composition. UV resistance and other properties required for a roofing material could be achieved by incorporating suitable additives to TPVs.

Keywords: thermoplastic elastomer, natural rubber, high density polyethylene, roofing material

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389 Patient-Specific Design Optimization of Cardiovascular Grafts

Authors: Pegah Ebrahimi, Farshad Oveissi, Iman Manavi-Tehrani, Sina Naficy, David F. Fletcher, Fariba Dehghani, David S. Winlaw

Abstract:

Despite advances in modern surgery, congenital heart disease remains a medical challenge and a major cause of infant mortality. Cardiovascular prostheses are routinely used in surgical procedures to address congenital malformations, for example establishing a pathway from the right ventricle to the pulmonary arteries in pulmonary valvar atresia. Current off-the-shelf options including human and adult products have limited biocompatibility and durability, and their fixed size necessitates multiple subsequent operations to upsize the conduit to match with patients’ growth over their lifetime. Non-physiological blood flow is another major problem, reducing the longevity of these prostheses. These limitations call for better designs that take into account the hemodynamical and anatomical characteristics of different patients. We have integrated tissue engineering techniques with modern medical imaging and image processing tools along with mathematical modeling to optimize the design of cardiovascular grafts in a patient-specific manner. Computational Fluid Dynamics (CFD) analysis is done according to models constructed from each individual patient’s data. This allows for improved geometrical design and achieving better hemodynamic performance. Tissue engineering strives to provide a material that grows with the patient and mimic the durability and elasticity of the native tissue. Simulations also give insight on the performance of the tissues produced in our lab and reduce the need for costly and time-consuming methods of evaluation of the grafts. We are also developing a methodology for the fabrication of the optimized designs.

Keywords: computational fluid dynamics, cardiovascular grafts, design optimization, tissue engineering

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388 Characterization of Natural Polymers for Guided Bone Regeneration Applications

Authors: Benedetta Isella, Aleksander Drinic, Alissa Heim, Phillip Czichowski, Lisa Lauts, Hans Leemhuis

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Introduction: Membranes for guided bone regeneration are essential to perform a barrier function between the soft and the regenerating bone tissue. Bioabsorbable membranes are desirable in this field as they do not require a secondary surgery for removal, decreasing patient surgical risk. Collagen was the first bioabsorbable alternative introduced on the market, but its degradation time may be too fast to guarantee bone regeneration, and optimisation is needed. Silk fibroin, being biocompatible, slowly bioabsorbable, and processable into different scaffold types, could be a promising alternative. Objectives: The objective is to compare the general performance of a silk fibroin membrane for guided bone regeneration to current collagen alternatives developing suitable standardized tests for the mechanical and morphological characterization. Methods: Silk fibroin and collagen-based membranes were compared from the morphological and chemical perspective, with techniques such as SEM imaging and from the mechanical point of view with techniques such as tensile and suture retention strength (SRS) tests. Results: Silk fibroin revealed a high degree of reproducibility in surface density. The SRS of silk fibroin (0.76 ± 0.04 N), although lower than collagen, was still comparable to native tissues such as the internal mammary artery (0.56 N), and the same can be extended to general mechanical behaviour in tensile tests. The SRS could be increased by an increase in thickness. Conclusion: Silk fibroin is a promising material in the field of guided bone regeneration, covering the interesting position of not being considered a product containing cells or tissues of animal origin from the regulatory perspective and having longer degradation times with respect to collagen.

Keywords: guided bone regeneration, mechanical characterization, membrane, silk fibroin

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387 Empirical Investigation of Barriers to Industrial Energy Conservation Measures in the Manufacturing Small and Medium Enterprises (SME's) of Pakistan

Authors: Muhammad Tahir Hassan, Stas Burek, Muhammad Asif, Mohamed Emad

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Industrial sector in Pakistan accounts for 25% of total energy consumption in the country. The performance of this sector has been severely affected due to the adverse effect of current energy crises in the country. Energy conservation potentials of Pakistan’s industrial sectors through energy management can save wasted energy which would ultimately leads to economic and environmental benefits. However due to lack of financial incentives of energy efficiency and absence of energy benchmarking within same industrial sectors are some of the main challenges in the implementation of energy management. In Pakistan, this area has not been adequately explored, and there is a lack of focus on the need for industrial energy efficiency and proper management. The main objective of this research is to evaluate the current energy management performance of Pakistani industrial sector and empirical investigation of the existence of various barriers to industrial energy efficiency. Data was collected from the respondents of 192 small and medium-sized enterprises (SME’s) of Pakistan i.e. foundries, textile, plastic industries, light engineering, auto and spare parts and ceramic manufacturers and analysed using Statistical Package for the Social Sciences (SPSS) software. Current energy management performance of manufacturing SME’s in Pakistan has been evaluated by employing two significant indicators, ‘Energy Management Matrix’ and ‘pay-off criteria’, with modified approach. Using the energy management matrix, energy management profiles of overall industry and the individual sectors have been drawn to assess the energy management performance and identify the weak and strong areas as well. Results reveal that, energy management practices in overall surveyed industries are at very low level. Energy management profiles drawn against each sector suggest that performance of textile sector is better among all the surveyed manufacturing SME’s. The empirical barriers to industrial energy efficiency have also been ranked according to the overall responses. The results further reveal that there is a significant relationship exists among the industrial size, sector type and nature of barriers to industrial energy efficiency for the manufacturing SME’s in Pakistan. The findings of this study may help the industries and policy makers in Pakistan to formulate a sustainable energy policy to support industrial energy efficiency keeping in view the actual existing energy efficiency scenario in the industrial sector.

Keywords: barriers, energy conservation, energy management profile, environment, manufacturing SME's of Pakistan

Procedia PDF Downloads 276
386 Chemical, Structural and Mechanical Optimization of Zr-Based Bulk Metallic Glass for Biomedical Applications

Authors: Eliott Guérin, Remi Daudin, Georges Kalepsi, Alexis Lenain, Sebastien Gravier, Benoit Ter-Ovanessian, Damien Fabregue, Jean-Jacques Blandin

Abstract:

Due to interesting compromise between mechanical and corrosion properties, Zr-based BMGs are attractive for biomedical applications. However, the enhancement of their glass forming ability (GFA) is often achieved by addition of toxic elements like Ni or Be, which is of course a problem for such applications. Consequently, the development of Ni-free Be-free Zr-based BMGs is of great interest. We have developed a Zr-based (Ni and Be-free) amorphous metallic alloy with an elastic limit twice the one of Ti-6Al-4V. The Zr56Co28Al16 composition exhibits a yield strength close to 2 GPa and low Young’s modulus (close to 90 GPa) [1-2]. In this work, we investigated Niobium (Nb) addition through substitution of Zr up to 8 at%. Cobalt substitution has already been reported [3], but we chose Zr substitution to preserve the glass forming ability. In this case, we show that the glass forming ability for 5 mm diameters rods is maintained up to 3 at% of Nb substitution using suction casting in cooper moulds. Concerning the thermal stability, we measure a strong compositional dependence on the glass transition (Tg). Using DSC analysis (heating rate 20 K/min), we show that the Tg rises from 752 K for 0 at% of Nb to 759 K for 3 at% of Nb. Yet, the thermal range between Tg and the crystallisation temperature (Tx) remains almost unchanged from 33 K to 35 K. Uniaxial compression tests on 2 mm diameter pillars and 3 points bending (3PB) tests on 1 mm thick plates are performed to study the Nb addition on the mechanical properties and the plastic behaviour. With these tests, an optimal Nb concentration is found, improving both plasticity and fatigue resistance. Through interpretations of DSC measurements, an attempt is made to correlate the modifications of the mechanical properties with the structural changes. The optimized chemical, structural and mechanical properties through Nb addition are encouraging to develop the potential of this BMG alloy for biomedical applications. For this purpose, we performed polarisation, immersion and cytotoxicity tests. The figure illustrates the polarisation response of Zr56Co28Al16, Zr54Co28Al16Nb2 and TA6V as a reference after 2h of open circuit potential. The results show that the substitution of Zr by a small amount of Nb significantly improves the corrosion resistance of the alloy.

Keywords: metallic glasses, amorphous metal, medical, mechanical resistance, biocompatibility

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385 Ethanol Chlorobenzene Dosimetr Usage for Measuring Dose of the Intraoperative Linear Electron Accelerator System

Authors: Mojtaba Barzegar, Alireza Shirazi, Saied Rabi Mahdavi

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Intraoperative radiation therapy (IORT) is an innovative treatment modality that the delivery of a large single dose of radiation to the tumor bed during the surgery. The radiotherapy success depends on the absorbed dose delivered to the tumor. The achievement better accuracy in patient treatment depends upon the measured dose by standard dosimeter such as ionization chamber, but because of the high density of electric charge/pulse produced by the accelerator in the ionization chamber volume, the standard correction factor for ion recombination Ksat calculated with the classic two-voltage method is overestimated so the use of dose/pulse independent dosimeters such as chemical Fricke and ethanol chlorobenzene (ECB) dosimeters have been suggested. Dose measurement is usually calculated and calibrated in the Zmax. Ksat calculated by comparison of ion chamber response and ECB dosimeter at each applicator degree, size, and dose. The relative output factors for IORT applicators have been calculated and compared with experimentally determined values and the results simulated by Monte Carlo software. The absorbed doses have been calculated and measured with statistical uncertainties less than 0.7% and 2.5% consecutively. The relative differences between calculated and measured OF’s were up to 2.5%, for major OF’s the agreement was better. In these conditions, together with the relative absorbed dose calculations, the OF’s could be considered as an indication that the IORT electron beams have been well simulated. These investigations demonstrate the utility of the full Monte Carlo simulation of accelerator head with ECB dosimeter allow us to obtain detailed information of clinical IORT beams.

Keywords: intra operative radiotherapy, ethanol chlorobenzene, ksat, output factor, monte carlo simulation

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384 Place of Radiotherapy in the Treatment of Intracranial Meningiomas: Experience of the Cancer Center Emir Abdelkader of Oran Algeria

Authors: Taleb L., Benarbia M., Boutira F. M., Allam H., Boukerche A.

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Introduction and purpose of the study: Meningiomas are the most common non-glial intracranial tumors in adults, accounting for approximately 30% of all central nervous system tumors. The aim of our study is to determine the epidemiological, clinical, therapeutic, and evolutionary characteristics of a cohort of patients with intracranial meningioma treated with radiotherapy at the Emir Abdelkader Cancer Center in Oran. Material and methods: This is a retrospective study of 44 patients during the period from 2014 to 2020. The overall survival and relapse-free survival curves were calculated using the Kaplan-Meier method. Results and statistical analysis: The median age of the patients was 49 years [21-76 years] with a clear female predominance (sex ratio=2.4). The average diagnostic delay was seven months [2 to 24 months], the circumstances of the discovery of which were dominated by headaches in 54.5% of cases (n=24), visual disturbances in 40.9% (n=18), and motor disorders in 15.9% (n=7). The seat of the tumor was essentially at the level of the base of the skull in 52.3% of patients (n=23), including 29.5% (n=13) at the level of the cavernous sinus, 27.3% (n=12) at the parasagittal level and 20.5% (n=9) at the convexity. The diagnosis was confirmed surgically in 36 patients (81.8%) whose anatomopathological study returned in favor of grades I, II, and III in respectively 40.9%, 29.5%, and 11.4% of the cases. Radiotherapy was indicated postoperatively in 45.5% of patients (n=20), exclusive in 27.3% (n=12) and after tumor recurrence in 27.3% of cases (n=18). The irradiation doses delivered were as follows: 50 Gy (20.5%), 54 Gy (65.9%), and 60 Gy (13.6%). With a median follow-up of 69 months, the probabilities of relapse-free survival and overall survival at three years are 93.2% and 95.4%, respectively, whereas they are 71.2% and 80.7% at five years. Conclusion: Meningiomas are common primary brain tumors. Most often benign but can also progress aggressively. Their treatment is essentially surgical, but radiotherapy retains its place in specific situations, allowing good tumor control and overall survival.

Keywords: diagnosis, meningioma, surgery, radiotherapy, survival

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383 Comparative Study in Treatment of Distal Humerus Fracture with Lateral Column Plate Percutaneous Medial Screw and Intercondylar Screw

Authors: Sameer Gupta, Prant Gupta

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Context: Fractures in the distal humerus are complex and challenging injuries for orthopaedic surgeons that can be effectively treated with open reduction and internal fixation. Aims: The study analyses clinical outcomes in patients with intra-articular distal humerus fractures (AO type 13 C3 excluded) treated using a different method of fixation ( LCPMS). Subject and Methods: A study was performed, and the author's personal experiences were reported. Thirty patients were treated using an intercondylar screw with lateral column plating and percutaneous medial column screw fixation. Detailed analysis was done for functional outcomes (average arc of motion, union rate, and complications). Statistical Analysis Used: SPSS software version 22.0 was used for statistical analysis. Results: In our study, at the end of 6 months, Overall good to excellent results were achieved in 28 patients out of 30 after analysis on the basis of MEP score. The majority of patients regained full arc of motion, achieved fracture union without any major complications, and were able to perform almost all activities of daily living (which required good elbow joint movements and functions). Conclusion: We concluded that this novel method provides adequate stability and anatomical reconstruction with an early union rate observed at the end of 6 months. Excellent functional outcome was observed in almost all the patients because of less operating time and initiation of early physiotherapy, as most of the patients experienced mild nature of pain post-surgery.

Keywords: intra arricular distal humerus fracture, percutaneous medial screw, lateral column plate, arc of motion

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382 Acute Cartilage Defects of the Knee Treated With Chondral Restoration Procedures and Patellofemoral Stabilisation

Authors: John Scanlon, Antony Raymond, Randeep Aujla, Peter D’Alessandro, Satyen Gohil

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Background: The incidence of significant acute chondral injuries with patella dislocation is around 10-15%. It is accepted that chondral procedures should only be performed in the presence of joint stability Methods:Patients were identified from surgeon/hospital logs. Patient demographics, lesion size and location, surgical procedure, patient reported outcome measures, post-operative MR imaging, and complications were recorded. PROMs and patient satisfaction was obtained. Results:20 knees (18 patients) were included. Mean age was 18.6 years (range; 11-39), and the mean follow-up was 16.6 months (range; 2-70). The defect locations were the lateral femoral condyle (9/20; 45%), patella (9/20; 45%), medial femoral condyle (1/20; 5%) and the trochlea (1/20; 5%). The mean defect size was 2.6cm2. Twelve knees were treated with cartilage fixation, 5 with microfracture, and 3 with OATS. At follow up, the overall mean Lysholm score was 77.4 (± 17.1), with no chondral regenerative procedure being statistically superior. There was no difference in Lysholm scores between those patients having acute medial patellofemoral ligament reconstruction versus medial soft tissue plication (p=0.59). Five (25%) knees required re-operation (one arthroscopic arthrolysis; one patella chondroplasty; two removal of loose bodies; one implant adjustment). Overall, 90% responded as being satisfied with surgery. Conclusion: Our aggressive pathway to identify and treat acute cartilage defects with early operative intervention and patella stabilisation has shown high rates of satisfaction and Lysholm scores. The full range of chondral restoration options should be considered by surgeons managing these patients.

Keywords: patella dislocation, chondral restoration, knee, patella stabilisation

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381 Spontaneous Reformation of Dehiscent Frontal Sinus Wall after Endoscopic Removal of Mucocele

Authors: Tan Dexian Arthur, James Wei Ming Kwek, Ian Loh, Lee Tee Sin

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Statement of the Problem: Mucoceles most commonly affect the frontal sinus, which results from chronic obstruction of the sinus ostium or cystic dilatation of mucous glands with ductal obstruction. They are known to cause bony erosion of the sinus walls, which can lead to large defects. These defects were typically managed by obliteration or cranialization of the frontal sinus. Although short term outcomes of conservative management of significant posterior table defects from fractures are promising, there have been no studies on the long-term outcomes of large dehiscences in the posterior wall of the frontal sinus. Methodology & Findings : Computed Tomography (CT) Paranasal Sinuses images were analyzed and found complete spontaneous osteogenesis of a large dehiscent frontal sinus posterior wall, secondary to a large mucocele, 9 years from functional endoscopic sinus surgery with the defect managed conservatively. Conclusion & Significance: The dura is well known for its osteogenic properties. Prior studies have showed that dura could induce osteogenesis in cutaneous tissue in the absence of other central nervous system structures. It was also demonstrated that osteogenesis and chondrogenesis were possible in zygomatic fractures by transplanting neonatal dura grafts to the bony defects in rats. Extrapolating from these studies, the authors postulate that the presence of dura beneath the bony deformity of the posterior frontal sinus wall had likely initiated the osteogenesis and restored the bony defect in the patient. In our literature review, we did not find any reports of spontaneous osteogenesis of large frontal sinus defects. While our experience is incidental, it reinforces the osteogenetic potential of an intact dura and further highlights that selected large defects of the posterior wall of the frontal sinus can be conservatively managed.

Keywords: paranasal sinus mucocele, mucocele, osteogenesis, dehiscence

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380 Mechanisms of Metals Stabilization in the Soil by Biochar Material as Affected by the Low Molecular Weight Organic Acids

Authors: Md. Shoffikul Islam, Hongqing Hu

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Immobilizing trace elements by reducing their mobility and bioavailability through amendment application, especially biochar (BC), is a cost-effective and efficient method to address their toxicity in the soil environment. However, the low molecular weight organic acids (LMWOAs) in the rhizosphere could affect BC's efficiency to immobilize trace metals as the LMWOAs could either mobilize or fix metals in the soils. Therefore, understanding the BC's and LMWOAs' interaction mechanisms on metals stabilization in the rhizosphere is crucial. The present study examined the impact of BC derived from rice husk, tartaric acid (TA), and oxalic acid (OA), and the combination of BC and TA/OA on the changes of cadmium (Cd), lead (Pb), and zinc (Zn) among their geochemical forms through incubation experiment. The changes of zeta potential and X-ray diffraction (XRD) pattern of BC and BC-amended soils to investigate the probable mechanisms of trace elements' immobilization by BC under the attacks of TA and OA were also examined. The rice husk BC at 5% (w/w) was mixed with the air-dry soil (an Anthrosols) contaminated with Cd, Pb, and Zn in the plastic pot. The TA and OA each at 2, 5, 10, and 20 mM kg-1 (w/v) were added separately into the pot. All the ingredients were mixed thoroughly with the soil. A control (CK) treatment was also prepared without BC, TA, and OA addition. After 7, 15, and 60 days of incubation with 60% (w/v) moisture level at 25 °C, the incubated soils were determined for pH and EC and were sequentially extracted to assess the metals' transformation in soil. The electronegative charges and XRD peaks of BC and BC-amended soils were also measured. The BC, low level of TA (2 mM kg-1 soil), and BC plus the low concentration of TA (BC-TA2) addition considerably declined the acid-soluble Cd, Pb, and Zn in which BC-TA2 was found to be the most effective treatment. The trends were reversed concerning the high levels of TA (>5-20 mM kg-1 soil), all levels of OA (2-20 mM kg-1 soil), and the BC plus high levels of TA/OA treatments. BC-TA2 changed the highest amounts of acid-soluble and reducible metals to the oxidizable and residual fractions with time. The most increased electronegative charges of BC-TA2 indicate its (BC-TA2) highest metals' immobilizing efficiency, probably through metals adsorption and fixation with the negative charge sites. The XRD study revealed the presence of P, O, CO32-, and Cl1- in BC, which might be responsible for the precipitation of CdCO3, pyromorphite, and hopeite concerning Cd, Pb, and Zn immobilization, respectively. The findings demonstrated that the low level of TA increased metals immobilization, while the high levels of TA and all levels of OA enhanced their mobilization. The BC-TA2 was the best treatment in stabilizing metals in soil.

Keywords: biochar, immobilization, low molecular weight organic acids, trace elements contaminated soil

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379 3D Dentofacial Surgery Full Planning Procedures

Authors: Oliveira M., Gonçalves L., Francisco I., Caramelo F., Vale F., Sanz D., Domingues M., Lopes M., Moreia D., Lopes T., Santos T., Cardoso H.

Abstract:

The ARTHUR project consists of a platform that allows the virtual performance of maxillofacial surgeries, offering, in a photorealistic concept, the possibility for the patient to have an idea of the surgical changes before they are performed on their face. For this, the system brings together several image formats, dicoms and objs that, after loading, will generate the bone volume, soft tissues and hard tissues. The system also incorporates the patient's stereophotogrammetry, in addition to their data and clinical history. After loading and inserting data, the clinician can virtually perform the surgical operation and present the final result to the patient, generating a new facial surface that contemplates the changes made in the bone and tissues of the maxillary area. This tool acts in different situations that require facial reconstruction, however this project focuses specifically on two types of use cases: bone congenital disfigurement and acquired disfiguration such as oral cancer with bone attainment. Being developed a cloud based solution, with mobile support, the tool aims to reduce the decision time window of patient. Because the current simulations are not realistic or, if realistic, need time due to the need of building plaster models, patient rates on decision, rely on a long time window (1,2 months), because they don’t identify themselves with the presented surgical outcome. On the other hand, this planning was performed time based on average estimated values of the position of the maxilla and mandible. The team was based on averages of the facial measurements of the population, without specifying racial variability, so the proposed solution was not adjusted to the real individual physiognomic needs.

Keywords: 3D computing, image processing, image registry, image reconstruction

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378 Increased Cytolytic Activity of Effector T-Cells against Cholangiocarcinoma Cells by Self-Differentiated Dendritic Cells with Down-Regulation of Interleukin-10 and Transforming Growth Factor-β Receptors

Authors: Chutamas Thepmalee, Aussara Panya, Mutita Junking, Jatuporn Sujjitjoon, Nunghathai Sawasdee, Pa-Thai Yenchitsomanus

Abstract:

Cholangiocarcinoma (CCA) is an aggressive malignancy of bile duct epithelial cells in which the standard treatments, including surgery, radiotherapy, chemotherapy, and targeted therapy are partially effective. Many solid tumors including CCA escape host immune responses by creating tumor microenvironment and generating immunosuppressive cytokines such as interleukin-10 (IL-10) and transforming growth factor-β (TGF-β). These cytokines can inhibit dendritic cell (DC) differentiation and function, leading to decreased activation and response of effector CD4+ and CD8+ T cells for cancer cell elimination. To overcome the effects of these immunosuppressive cytokines and to increase ability of DC to activate effector CD4+ and CD8+ T cells, we generated self-differentiated DCs (SD-DCs) with down-regulation of IL-10 and TGF-β receptors for activation of effector CD4+ and CD8+ T cells. Human peripheral blood monocytes were initially transduced with lentiviral particles containing the genes encoding GM-CSF and IL-4 and then secondly transduced with lentiviral particles containing short-hairpin RNAs (shRNAs) to knock-down mRNAs of IL-10 and TGF-β receptors. The generated SD-DCs showed up-regulation of MHC class II (HLA-DR) and co-stimulatory molecules (CD40 and CD86), comparable to those of DCs generated by convention method. Suppression of IL-10 and TGF-β receptors on SD-DCs by specific shRNAs significantly increased levels of IFN-γ and also increased cytolytic activity of DC-activated effector T cells against CCA cell lines (KKU-213 and KKU-100), but it had little effect to immortalized cholangiocytes (MMNK-1). Thus, SD-DCs with down-regulation of IL-10 and TGF-β receptors increased activation of effector T cells, which is a recommended method to improve DC function for the preparation of DC-activated effector T cells for adoptive T-cell therapy.

Keywords: cholangiocarcinoma, IL-10 receptor, self-differentiated dendritic cells, TGF-β receptor

Procedia PDF Downloads 125