The present study aims to discuss two successful identification cases of the search warrants on unknown bodies by the Baranya County Police Department. In both cases, identification was only possible by using lot numbers of the traumatological metal implants removed during exhumation, several years after the bodies had been discovered and the post-mortem investigation was completed. We hope that the cases provided will highlight the importance of secondary identifiers, specifically the lot numbers of medical implants, in forensic identification practice. We would also like to draw attention to the fact that the only way to identify the majority of the over a thousand unknown corpses in Hungary (742 of them have been under warrant for more than ten years) is to re-examine the corpses using recent years\' results in technical and technological improvements. The presented cases highlight the importance of documenting the identification numbers of implanted surgical devices during autopsies. Orv Hetil. 2023; 164(23): 911-918.
Munkánk a Baranya Vármegyei Rendőr-főkapitányság ismeretlen holttestre vonatkozó körözési anyagából két sikeres személyazonosítási esetet tárgyal. Mindkét esetben, több évvel a holttestek megtalálása, valamint a rendkívüli halálesettel kapcsolatos közigazgatási hatósági eljárások befejezése után, a holttestek exhumálását követően sikerült az azonosítás a kihantoláskor eltávolított traumatológiai fémimplantátumok tétel (lot)-száma alapján. Az esetekkel célunk egyrészről rámutatni a másodlagos azonosítók, ezen belül is a tételszámmal rendelkező orvosi implantátumok fontosságára az igazságügyi személyazonosítási gyakorlatban, illetve felhívni a figyelmet arra, hogy a több mint ezer (ezen belül 742, tíz évnél régebb óta körözött) magyarországi ismeretlen holttest egy jelentős részének azonosítására csak akkor van lehetőség, ha a holttesteket újravizsgáljuk, kihasználva az elmúlt időszakban bekövetkezett technikai, technológiai fejlesztések eredményeit is. Az ismertetett esetek rávilágítanak a beültetett fémeszközök azonosítóinak a boncolás során történő dokumentálásának fontosságára. Orv Hetil. 2023; 164(23): 911–918.

This work presents a novel nanoparticle-based thermosensor implant able to reveal the precise temperature variations along the polymer filaments, as it contracts and expands due to changes in the macroscale local temperature. The multimodal device is able to trace the position and the temperature of a polypropylene mesh, employed in abdominal hernia repair, by combining plasmon resonance and Raman spectroscopy with hydrogel responsive system. The novelty relies on the attachment of the biocompatible nanoparticles, based on gold stabilized by a chitosan-shell, already charged with the Raman reporter (RaR) molecules, to the robust prosthesis, without the need of chemical linkers. The SERS enhanced effect observed is potentiated by the presence of a quite thick layer of the copolymer (poly(N-isopropylacrylamide)-co-poly(acrylamide)) hydrogel. At temperatures above the LCST of PNIPAAm-co-PAAm, the water molecules are expulsed and the hydrogel layer contracts, leaving the RaR molecules more accessible to the Raman source. In vitro studies with fibroblast cells reveal that the functionalized surgical mesh is biocompatible and no toxic substances are leached in the medium. The mesh sensor opens new frontiers to semi-invasive diagnosis and infection prevention in hernia repair by using SERS spectroscopy. It also offers new possibilities to the functionalization of other healthcare products.

The burden of irreversible vision loss from Glaucoma continues to rise. While the disease pathogenesis is not well understood, intraocular pressure (IOP) is the only modifiable risk factor identified to prevent glaucomatous vision loss. Medical management remains the first-line of treatment in most adult glaucomas and the evolution of medical therapy for glaucoma has followed an exponential curve. This review tracks the rapid development of new medications and drug delivery systems in the recent years. Introduction of Rho kinase inhibitors with an entirely new mechanism of action from that of the currently used anti glaucoma medications has been a significant milestone. Latanoprostene Bunod is a novel, single molecule which provides two active metabolites that work through two different pathways for reducing intra ocular pressure. Bimatoprost implants and travoprost punctum plugs attempt to ease chronic medication use in glaucoma patients. Nanotechnology is an evolving route of drug delivery. Role of cannabinoids in medical management of glaucoma remain equivocal. The relatively short term effect on IOP, the risks of developing tolerance and side effects impacting patients\' neurocognitive health greatly outweigh the potential benefit. Research on Latrunculin B, Adenosine receptor agonists, Specific gene silencing and Stem cell therapy are poised to make an impact on glaucoma treatment. While there is some evidence to support the role of Brimonidine in neuroprotection, further research is needed to clarify the role of Memantine and Neurotrophins. Evidence for benefit from dietary supplementation with Alpha lipoic acid, Forskolin , and Ginko Biloba is limited.

Drug delivery systems (DDS) that can temporally control the rate and extent of release of therapeutically active molecules find applications in many clinical settings, ranging from infection control to cancer therapy. With an aim to design a locally implantable, controlled-release DDS, we demonstrated the feasibility of using cellulose nanocrystal (CNC)-reinforced poly (l-lactic acid) (PLA) composite beads. The performance of the platform was evaluated using doxorubicin (DOX) as a model drug for applications in triple-negative breast cancer. A facile, nonsolvent-induced phase separation (NIPS) method was adopted to form composite beads. We observed that CNC loading within these beads played a critical role in the mechanical stability, porosity, water uptake, diffusion, release, and pharmacological activity of the drug from the delivery system. When loaded with DOX, composite beads significantly controlled the release of the drug in a pH-dependent pattern. For example, PLA/CNC beads containing 37.5 wt % of CNCs showed a biphasic release of DOX, where 41 and 82% of the loaded drug were released at pH 7.4 and pH 5.5, respectively, over 7 days. Drug release followed Korsmeyer\'s kinetics, indicating that the release mechanism was mostly diffusion and swelling-controlled. We showed that DOX released from drug-loaded PLA/CNC composite beads locally suppressed the growth and proliferation of triple-negative breast cancer cells, MBA-MB-231, via the apoptotic pathway. The efficacy of the DDS was evaluated in human tissue explants. We envision that such systems will find applications for designing biobased platforms with programmed stability and drug delivery functions.

The female pelvic cavity involves muscles, ligaments, endopelvic fasciae and multiple organs where different pathologies may occur, namely the pelvic organ prolapse (POP). The synthetic implants are used for the reconstructive surgery of POP, but severe complications associated with their use have been reported, mainly related to their mechanical properties (e.g., implant stiffness) and microstructure. In this study, we mimicked a transvaginal reconstructive surgery to repair the apical ligaments (uterosacral ligaments (USLs) and cardinal ligaments (CLs)), by modeling, their impairment (90% and 50%) and/or total rupture. The implants to reinforce/replace these ligaments were built based on literature specifications and their mechanical properties were obtained through uniaxial tensile tests. The main aim of this study was to simulate the effect of mesh anchoring technique (simple stich and continuous stitch), and compare the displacement magnitude of the pelvic tissues, during Valsalva maneuver. The absence/presence of the synthetic implant was simulated when total rupture of the CLs and USLs occurs, causing a variation of the vaginal displacement (9% for the CLs and 27% for the USLs). Additionally, the simulations showed that there was a variation of the supero-inferior displacement of the vaginal wall between different anchoring techniques (simple stich and continuous stitch) being approximately of 10% for the simulation USLs and CLs implant. The computational simulation was able to mimic the biomechanical behavior of the USLs and CLs, in response to different anchoring techniques, which can be help improving the outcomes of the prolapse surgery.

Since 1989, three-dimensional (3D) printing has developed rapidly in biomedical engineering because it is individually customizable. By printing medical products at clinics, this powerful tool can be used by doctors, which will enhance the response to surgery and increase the creative freedom of surgeons. In this article, we reviewed the progress of 3D printing in biomedicine with particular emphasis on the types of 3D printing methods that are most suitable for the clinical application, and proposed the concept of Printing@clinic. The four levels of Printing@clinic are discussed, from surgical implants to direct printing during surgery. Three major applications of Printing@clinic, which could be rapidly implemented in the clinical setting, are fabricating prosthesis to assist with surgeries, printing 3D implantable scaffolds, and bioprinting for tissue repair. We believe that Printing@clinic will be an attractive service in the decades to come.

The insertion of an implant in the body of a patient raises the risk of a posterior infection and formation of a biofilm, which can have critical consequences on the patient\'s health and be associated with a high sanitary cost. While antibacterial agents can be used to prevent the infection, such a strategy is time-limited and causes bacteria resistance. As an alternative to biochemical approaches, we propose here to use light-induced local hyperthermia with plasmonic nanoparticles. This strategy is implemented on surgical meshes, extensively used in the context of hernia repairing, one of the most common general surgeries. Surgical meshes were homogeneously coated with gold nanorods designed to efficiently convert near-infrared light into heat. The modified mesh was exposed to a biofilm of Staphylococcus aureus ( S. aureus) bacteria before being treated with a train of light pulses. We systematically study how the illumination parameters, namely fluence, peak intensity and pulse length, influence the elimination of attached bacteria. Additionally, fluorescence confocal microscopy provides us some insight on the mechanism involved in the degradation of the biofilm. This proof-of-principle study opens a new set of opportunities for the development of novel disinfection approaches combining light and nanotechnology.

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BACKGROUND: The modulus of elasticity of an assortment of materials used in spinal surgery, as well as cortical and cancellous bones, is determined by direct measurements and plotting of the appropriate curves. When utilized in spine surgery, the stiffness of a surgical implant can affect its material characteristics. The modulus of elasticity, or Young\'s modulus, measures the stiffness of a material by calculating the slope of the material\'s stress-strain curve. While many papers and presentations refer to the modulus of elasticity as a reason for the choice of a particular spinal implant, no peer-reviewed surgical journal article has previously been published where the Young\'s modulus values of interbody implants have been measured.
METHODS: Materials were tested under pure compression at the rate of 2 mm/min. A maximum of 45 kilonewtons (kN) compressive force was applied. Stress-strain characteristics under compressive force were plotted and this plot was used to calculate the elastic modulus.
RESULTS: The elastic modulus calculated for metals was more than 50 Gigapascals (GPa) and had significantly higher modulus values compared to poly-ether-ether-ketone (PEEK) materials and allograft bone.
CONCLUSIONS: The data generated in this paper may facilitate surgeons to make informed decisions on their choices of interbody implants with specific attention to the stiffness of the implant chosen.

BACKGROUND: Under predicted climate change scenarios, koala distribution in Australia is expected to be adversely affected. Recent studies have attempted to identify suitable habitat, based on models of bioclimatic regions, but to more accurately reflect the thermal tolerance and behavioural adaptations of the various regional populations, the koala\'s response to periods of heat stress will need to be investigated at the individual animal level.
OBJECTIVE: To explore the safety and suitability of temperature-sensitive intra-abdominal implants for monitoring core body temperature in the koala.
METHODS: A temperature-sensitive radio transmitter and thermal iButton data-logger, waxed together as a package, were surgically implanted into the abdominal cavity of four captive koalas. In one animal the implant was tethered and in the other three, it was left free-floating.
RESULTS: After 3 months, the implants were removed and all four koalas recovered without complications. The tethering of the package in the one koala resulted in minor inflammation and adhesion, so this practice was subsequently abandoned. The free-floating deployments were complication-free and revealed a diurnal body temperature rhythm, with daily ranges of 0.4-2.8°C. The minimum recorded body temperature was 34.2°C and the maximum was 37.7°C. The difference in the readings obtained from the transmitters and iButtons never exceeded 0.3°C.
CONCLUSIONS: The suitability of the surgical approach was confirmed, from both the animal welfare and data collection points of view.