Percutaneous autologous concentrated bone marrow grafting in the treatment for nonunion

The purpose of this study was to evaluate the clinical and radiographic treatment effects of percutaneous autologous concentrated bone marrow grafting in nonunion cases and to evaluate the effectiveness of this grafting procedure. We enrolled 17 cases those had atrophic changes due to continuous nonunion for over 9 months after injury and had undergone low-intensity pulsed ultrasound treatment for more than 3 months. The site of nonunion was the femur in 10 cases, the tibia in 5 cases, the humerus in 1 case, and the ulna in 1 case. They underwent percutaneous autologous concentrated bone marrow grafting and continued low-intensity pulsed ultrasound stimulation treatment after grafting. Patients were evaluated using the visual analogue scale for pain at immediately before the procedure, 3, 6, and 12 months after grafting. Plain radiographs of the affected site were taken and evaluated about the healing of the nonunion site at each clinical evaluation. As quantitative assessment, CT scans were undertaken before the procedure and 6 months after grafting. The visual analogue scale pain score was reduced consistently after grafting in all patients. About the healing at the nonunion site, 11 and 13 cases of bone union were observed at 6 and 12 months after grafting. The mean volume of callus formation based on CT images was 4,147 (262–27,392) mm³ total between grafting and 6 months. Percutaneous autologous concentrated bone marrow grafting is an effective procedure for the treatment of patients with nonunion.     

Effectiveness of 16S ribosomal DNA real-time PCR and sequencing for diagnosing bacterial keratitis

Graefe's Archive for Clinical and Experimental Ophthalmology - To evaluate the efficacy of real-time PCR for 16S ribosomal DNA (16S r-DNA) and sequencing for diagnosing microbial keratitis. We...     

Sialolithiasis in two areas of the upper lip

Objective

Minor salivary gland sialolithiasis occurs in ~1 % of all sialolithiasis cases. We report a case of sialolithiasis considered to have occurred in the minor salivary gland in two areas of the upper lip, with special emphasis on the findings from image examinations.

Case report

A 33-year-old male complained of a painless mass on the left upper lip. At the first examination, there was a nodular, hard swelling that involved the left cuspid area of the upper lip. Although a panoramic radiograph revealed no abnormality, an intraoral radiograph showed a small radiopaque body with a laminar pattern. Computed tomography images indicated that a calcified body was present in two areas of the upper lip. On magnetic resonance imaging, the lesion was observed as a lower-signal area than the surrounding soft tissue. The mass had a high signal in the central area in the T2 and short T1 inversion recovery images. The sonogram showed a hypoechoic mass with an echogenic structure in the central area. An excisional biopsy of the left upper lip was performed under local anesthesia. A well-demarcated mass with a calcified body was enucleated. The histopathologic diagnosis was sialoadenitis with sialolithiasis.

Conclusion

Most cases of minor salivary gland sialolithiasis are solitary, with multiple sialolithiasis being extremely rare. Sonograms are useful in the diagnosis of minor salivary gland sialolithiasis. Careful imaging examination is necessary to identify multiple lesions and select appropriate treatments.