The main element influencing the quality of potato starch is the environment. To investigate the effects of different altitude cultivation locations on the molecular structure and physicochemical properties of starch, two potato varieties, Jiusen No.1 B1 and Qingshu No.9 B2, were planted in three different altitude zones: A1 at low altitude (Chongzhou 450 m), A2 at middle altitude (Xichang 2800 m), and A3 at high altitude (Litang 3650 m). The results showed that the average volume, number, surface area diameter, average branched polymerization degree, crystallinity, and gelatinization temperature of two potato granules in high altitude areas were significantly lower than those in middle and low altitude areas were, and the gelatinization performance of potato starch was affected according to the correlation of starch structure characteristics. Potato starch with more short-branched chains and less long branched chains resulted in a lower gelatinization temperature in high altitude areas. The results showed that Jiusen No. 1 and Qingshu No. 9 were mainly affected by accumulated radiation and accumulated rainfall in Litang, a high altitude area, and by effective accumulated temperature in Xichang, a middle altitude area. This study quantified the influence of meteorological factors on the main starch quality of potato tubers. The results can be used as a theoretical basis for the scientific planting of high-quality potatoes. The potato is a solanaceae plant, which is known as one of the most promising economic crops in the 21st century. Medium starch is the main component of the potato tuber, which is between 66% and 80% by dry weight basis . MoreoveIn recent years, more attention has been paid to the influence of environmental conditions on the composition, structure, and properties of starch . CurrentTherefore, in this study, two kinds of potatoes, Jiusen No. 1 and Qingshu No. 9, were planted at different altitudes to study the effect of the fine structure of potato starch quality, amylopectin, on the physical and chemical properties of starch. Moreover, as far as we know, there is little research on the fine structure analysis of potato starch amylopectin, by environmental factor. The purpose of this study was to: 1) study the effects of different altitudes on the fine structure of potato starch; and 2) study the effects of different altitudes on the physicochemical and thermodynamic properties of potato starch. The results of this study provide new insights and can be used to improve the structure, properties, and quality of starch. In addition, this research provides important information for growers so that they can better choose the suitable planting place for potato starch quality and ensure that the characteristics of starch are the best for consumers.2. The experiment adopted single-ridge planting in the field, with 4 rows of ridges in each plot, 30 cm ridge height, 20 potatoes in each row, 20cm×70cm row spacing, and 10-15 cm planting depth. The rest were managed in the field according to conventional cultivation methods. Refer to The experiment was carried out in experimental bases in Sichuan Province . A two-factor randomized block experiment was adopted. The first factor was altitude change: A1 low altitude area (450 m in Chongzhou), A2 high-altitude area (2800 m in Xichang), and A3 high-altitude area (3650 m in Litang). Factor B was variety: B1 (Jiusen 1) and B2 (Qingshu 9). Three repetitions, 48 combinations (communities), each with an area of 11.2mAs can be seen from Wash the appropriate amount of fresh potatoes and cut them into pieces, mash them with water in a tissue masher, sieve them to remove cellulose and other substances, and leave the starch sediment in water. To obtain a starch sample, wash them with distilled water 3–4 times, stand still for 6-7 hours, pour off the supernatant, remove the brown powder layer, and dry them in an air-drying oven at 40°C for 48 hours to obtain a starch sample. The sample was screened with a 100-mesh sieve.The content of starch in potato tubers was determined by anthracene copper chromogenic method . The amyTake a 2~3 g mature potato tuber, break it off with tweezers to obtain a cross section, cut it with a blade to obtain another flat cross section, and fix it on the sample with conductive adhesive. After gold spraying, the sample was directly observed by a scanning electron microscope . A small amount of purified starch was picked up with tweezers and dispersed on the conductive adhesive. After gold spraying, it was directly observed by a scanning electron microscope. In order to compare the starch particle size distribution, the LS13320 laser diffraction particle size analyzer of Beckman Coulter Company analyzed starch particles. Put 50 mg of starch into a centrifuge tube, add 5 mL of distilled water for suspension, swirl and mix for 1 hour at 4°C, oscillate once every 10 minutes, then transfer to the dispersion box of a laser diffraction particle size analyzer, and measure its distribution.For an examination of starch chain length distribution, Isoamylase  was used to remove the branches of starch, and then the relative molecular weight distribution of starch was determined by high temperature gel exclusion chromatography . High performance liquid chromatography  was also used to look at the distribution of chain lengths in amylopectin .The relative crystallinity of starch was analyzed by a polycrystalline X-ray diffractometer . A Fourier transform infrared spectrometer  was used to analyze the short-range ordered structure of starch. The crystal lamellar strength and thickness of starch were analyzed by a small-angle X-ray scatterometer .Measure the thermal characteristics of DSC6. Weigh 4 mg (dry basis) of starch or rice flour samples in an aluminum crucible (PE0219-0062), add deionized water at a mass ratio of 1:2, cover and seal, place at room temperature and balance overnight, and then measure. The empty crucible was used as the reference. The scanning temperature range was 20-140°C, and the scanning rate was 10°C/min. The temperature was 30 -120°C, and the thermal characteristic parameters and enthalpy (H) values were calculated. Two parallel samples were taken from each sample, and the results were averaged .The data were processed using statistical analysis software such as Microsoft Excel 2010 and SPSS 27, and a variance analysis was performed.As shown in the data in According to In order to clarify the influence of starch fine structure on potato quality, the relative molecular weight distribution of these two potato starches was analyzed by high temperature gel permeation exclusion chromatography (GPC). As shown in In order to further clarify the chain length distribution characteristics of amylopectin, information was obtained by means of high performance liquid anion chromatograph (HPAEC). According to previous studies, the chain length distribution of amylopectin could be divided into four types: one short chain  and three long chains  Potato granules are mainly semi-crystalline complexes with double helix crystal structure formed by amylopectin molecules and amorphous structure formed by some amylopectin and amylose, so the molecular structure of starch has an important influence on the crystal type and crystallinity of starch . FirstlyFourier transform infrared spectroscopy can accurately analyze the short-range ordered structure of starch crystal structure. As shown in According To the comparative analysis of At different altitudes of Chongzhou, Xichang and Litang, the initial temperature, peak temperature, final gelatinization temperature and enthalpy change of Jiusen No.1 and Qingshu No.9 potato varieties all showed the same trend of first increasing and then decreasing. At all altitudes, the initial temperature, peak temperature, final gelatinization temperature and enthalpy change of Qingshu No.9 starch were slightly higher than those of Jiusen No.1 variety, and the changes were 58.17~63.70°C, 61.20~67.70°C and 67.29 ~74.60°C, respectively. In addition, because Qingshu No.9 starch has high enthalpy, it needs to absorbed more heat. -1. Accumulated radiation and accumulated precipitation have significant positive correlation with short chain A. Jiusen No.1 and Qingshu No.9 were mainly affected by accumulated radiation and accumulated rainfall in Litang at high altitude, and by accumulated temperature and accumulated effective accumulated temperature in Xichang at middle and high altitude.Further dimension reduction analysis of potato starch indexes showed in , 2~5μm (medium starch granules) and ≥5μm (large starch granules) according to their particle size. In the particle size distribution of potato starch granules, different varieties of potato starch granules account for the largest proportion . HoweverIn general, high temperatures tend to raise the proportion of amylopectin with a long chain A chain and decrease the proportion with a short chain B chain, whereas low temperatures have the reverse effect.  reported-1 and 1022/995 cm-1 (-1 in the high altitude area were lower. Previous studies had shown that the high crystallinity of starch improved the stability of starch, lead to an increase in gelatinization temperature, and reduced the eating quality of rice (The crystalline structure of starch from different sources was different. According to the different X-ray diffraction patterns, the crystalline structure of starch could be divided into three types, namely, type A, type B, and type C. The difference was that the rotation angle range of the strong diffraction peak was different . The res995 cm-1 . Compare of rice . TherefoThe thermodynamic properties of starch were an important index to reflect the quality of starch, which was not only affected by the content of amylose and amylopectin but also by the chain length distribution of amylose and amylopectin . On the Growing potatoes at various elevations had a substantial impact on the starch structure and qualities of potatoes, according to a research of the starch structure and characteristics of two potato kinds. The starch structure and characteristics of Jusen 1 and Green Potato 9 revealed notable variations between varieties, altitudes, and interactions between poster and variety. While Xichang is mostly influenced by cumulative temperature and cumulative effective cumulative temperature at intermediate and high altitudes, Litang is primarily influenced by cumulative temperature and cumulative radiation at high altitudes. Higher altitude Litang saw a rise in the proportion of small starch grains and a decrease in the average starch grain size compared to lower altitudes, while Chongzhou saw the opposite trend. Rice's starch crystal types are unaffected by altitude, but at higher altitudes, Litang increases the proportion of short chains of branched starch, decreases relative crystallinity and peak starch intensity, and lowers the temperature and enthalpy of starch pasting, which results in more delicately flavored potato varieties. Because of the higher cumulative radiation and cumulative rainfall at medium and high altitudes compared to low and medium altitudes, potatoes grow better and are more suitable for agriculture there. The findings of this study offer a critical point of reference for the production of potatoes at various elevations in Sichuan Province, which will aid in making the best use of ecological resources and enhance potato farming quality.The original contributions presented in the study are included in the article/supplementary material. Further inquiries can be directed to the corresponding author.All authors contributed to the article and approved the submitted version.


The results of the study showed that maximum moisture and protein content was taken by using 0.5% taro starch and stored for 0 days while maximum fat % was attained in 1.5% taro starch treatment and storage time was 0 days. The maximum water‐holding capacity was increased by adding 1.5% taro starch under 14 days' storage time. Water‐holding capacity started decreasing with the increasing taro concentration. The acidity of yogurt started increasing with the increasing taro starch and the maximum acidity was taken at 2.5% taro starch concentration. The viscosity of the yogurt was maximum at 2% taro starch. As far as it concerned, sensory evolution, aroma, and taste started changing with the increasing taro starch concentration and increasing storage time. The study's goals were to optimize the taro concentration for stabilizing the yogurt synthesis and to probe the impact of taro starch on the physiochemical attributes of yogurt.Stabilizers are essential components of manufactured products such as yogurt. The addition of stabilizers improves the body, texture, appearance, and mouth feel of yogurt while also preventing technical defects such as syneresis. A study was conducted to optimize the concentration of taro starch in yogurt. The yogurt was fortified at different concentrations of taro starch. Taro starch levels were 0%, 0.5%, 1%, 1.5%, 2%, 2.5%, and 3%, with different storage times . The Tukey honesty test was used for mean comparison ( The results of the study showed that maximum moisture and protein content was taken by using 0.5% taro starch and stored for 0 days while maximum fat percentage was attained in 1.5% taro starch treatment and storage time was 0 days. The maximum water‐holding capacity was increased by adding 1.5% taro starch under 14‐day storage time. Water‐holding capacity started decreasing with the increasing taro concentration. Because they increase the ratio of total solids, develop the viscosity and taste characteristics of the product, and prevent or reduce whey separation during storage, stabilizers are critical in the manufacturing of dairy products  is an excellent source of starch (70%–80%) since it aids in digestion and has favorable qualities for finished products. Because potatoes contain carbohydrates, vitamins A and C, minerals such as iron and potassium, and various fiber ratios; they are also a significant nutritional food  with three replications and two factors. The details of the experiment were described.2.1Milk was purchased from a local dairy shop in Faisalabad. Taro and yogurt culture were procured from the local market of Faisalabad city Figure .2.2Taro's nutritional value varies depending on its part. Taro is high in protein, vitamins C and E, riboflavin, phosphorus, thiamine, calcium, and other bioactive compounds Table . The nut2.3The sweet taro pulp was cleaned, peeled, cut, and sieved through a muslin bag. The starch milk was allowed to settle for a while before the supernatant was emptied to produce moist starch cake filtrated. The samples' moist starch cakes were sun‐dried, ground into a fine powder, and stored for further analysis , water, and unrefined fat as defined by AACC  standard2.6The moisture content of yogurt measured according to method no. 44‐15 A AACC .2.7Samples were analyzed for ash content by following the AACC  procedur2.8The crude fat was calculated using the method (30–25) described in AACC .2.9Kjeldahl method, as described in AACC  method n2.10Particularly, the nitrogen‐free extract was computed using the following equation expressed on the basis of dry matter:2.11The syneresis of starch samples at various storage periods was measured by heating (2% w/v) suspension at 850°C for 30 min and centrifuging at 3200 rpm for 15 min .2.14The collected data were analyzed using a complete randomized design, and their mean comparison was performed using the Tukey honesty test (HSD) at the 1% level of significance . The statistical analysis revealed significant differences between all samples. Salwa et al.  alternatives taste pretty sour and tart. That sour flavor can be off‐flavor, so many brands have flavored alternatives to cover that sour flavor. Figure 3.13p < .01) in flavor content in yogurt.Yogurt cultures are known for their bacteria. In milk, sugar fermentation produces the milk acid that works on milk protein, giving yogurt the texture and tart flavor. Yogurt is defined by fermentation with mixed crops as a product resulting from milk, the texture, the surface, and taste and health effects linked to yogurt. Figure 3.14p < .01).Acceptableness is the characteristic of something which is for some purpose subject to acceptance. Anything is acceptable if it is enough to fulfill the purpose it is for, even if it is far less useful than the ideal example. Food acceptability relates directly to the food interaction at a particular time. Customer characteristics, sensory characteristics, e.g., taste, texture, flavor, and aroma of food, and the ‘feeling good’ factor include factors that affect food acceptability as covered by the article. Figure 4The human body needs some essential nutrients like water, protein, fat, and carbohydrates and milk contains the entire essentials as well as the minor nutrients of minerals, enzymes, vitamins, and dissolved gases. Milk is easily perishable because the nutrients present in milk act as a hospitable environment for the growth of microorganisms. One strategy to deal with this is to diversify milk processing by using fermentation technology to produce yogurt.Lactobacillus bulgaricus and Streptococcus thermophilus are the two types of lactic acid bacteria that are typically employed in the production of yogurt. Many probiotic BAL species, such as L. acidophilus, can survive in low gastric pH and adhere to or colonize the intestine, improving function and nutritional value. The current study was executed to enhance the shelf life, aroma, texture, flavor, color, and viscosity. Different types of starches are used for enhancing the functional characteristics of yogurt synthetically and naturally. The experiment was designed with a completely randomized design and factor distribution across three replications. There were two factors considered for this study; first one is the different concentrations of taro starch , and the second one is the storage times . HSD test was employed for mean comparison and the level of significance was kept at 1%. The results of the study are given below.Yogurt is a dairy product with a milk casein coagulation pH of approximately 4.6. 3S2 where 1.5% taro starch was added and stored for 14 days. The maximum fat of 6.73% was recorded in the 1.5 taro starch added sample and remained for 0 days for storage, whereas the lowest fat percentage was noted in the ToS1 sample where no taro starch was added and stored for 0 days. The maximum acidity of yogurt was noted when 3% taro starch was added and stored for 14 days. The acidity of yogurt was increased with the increase of taro starch and increasing the storage days. Maximum protein content was achieved in T1S1 treatment where only 0.5% taro starch was added and stored for 0 days after some extent of taro starch, increasing the taro starch concentration which ultimately loses the protein content of yogurt. The maximum syneresis was recorded in T1S1 where 0.5% taro starch was added and stored for 0 days, while the minimum syneresis was taken in T3S2 where 1.5% taro was added as a supplement and stored for 14 days. The maximum viscosity was recorded in the T4 treatment with 2% taro starch and the lowest viscosity was recorded in the T4 treatment with 0.5% taro starch. The concentration of taro starch increased the viscosity of yogurt. Water‐holding capacity was maximum in the T3 treatment where 1.5% taro starch was added and the least water‐holding capacity was recorded in that treatment where no taro starch was added. It was concluded that water‐holding capacity can be enhanced by the addition of some taro starch and holding capacity can be decreased while lowering the taro concentration.Data regarding the moisture content of yogurt showed that maximum content was attained by that treatment where 0.5% taro starch was added and stored for 0 days while the lowest moisture content was present in T5Yogurt is an ancient milk product around the world and is widely used in the world due to its numerous characteristics and high nutritional attributes. The main issue faced by the yogurt industry during production and maintenance is ensuring yogurts’ stabilization and consistency. Yogurt stabilizers are used to upgrade the flavor, texture, and appearance of yogurt, while reducing syneresis. The overall results of the study showed that by adding 2% taro starch concentration, aroma, taste, water‐holding capacity, viscosity, fat, and protein content can be enhanced, and by increasing storage days of yogurt, sensory properties start decreasing, as well as water‐holding capacity, and yogurt can be stored for up to 14 days by adding 2% taro starch.Muhammad Shaheryar: Writing – original draft . Muhammad Afzaal: Supervision . Farhana Nosheen: Supervision . Ali Imran: Methodology ; visualization . Fakhar Islam: Methodology ; writing – review and editing . Rabia Noreen: Validation . Umber Shehzadi: Formal analysis . Mohd Asif Shah: Visualization . Adil Rasool: Software .The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.The authors that they have declare no conflict of interest.The study does not involve any human or animal testing.All the co‐authors are willing to participate in this manuscript.All authors are willing for publication of this manuscript.


Despite the favorable efficacy and safety, ixekizumab is also known for its high incidence of injection site reactions (ISRs), ranging from 6% to 55% in different studies according to different definitions and studied population. However, specific risk factors for ixekizumab-induced injection site reactions in patients with psoriatic diseases had not been well studied. In this retrospective study, we found that overweight or obesity might be a protective predictor for the occurrence of ixekizumab-induced ISRs in patients with psoriatic disease. Meanwhile, having a positive family history of psoriasis might be a potential risk factor. Last but not least, patients with diarrhea following ixekizumab injection were associated with a higher risk of developing ISRs. Future high-quality studies with larger samples are warranted to verify the relationship.Ixekizumab (Taltz Psoriasis is a chronic skin disease characterized by immune-mediated inflammation. It affects approximately 2% of the global population and is characterized by the presence of distinct red, scaly plaques that are well demarcated from the surrounding unaffected areas ,2. The iThe definition of ISRs varies in different studies and can refer to various reactions. While it is usually defined as swelling, erythema, pruritus, or pain around the site of injection, other terms may also be used to indicate different types of reactions . ISRs caIn the management of ISRs, several remedies have been proposed. One approach is to avoid injecting in the same site repeatedly and maintain a distance of at least 3 cm from the previous injection site . This heIn our previous study, 44% of patients with erythrodermic psoriasis developed ixekizumab-induced ISRs , which w2, overweight as 24 ≤ BMI < 27 kg/m2, normal as 18.5 < BMI < 24 kg/m2, and underweight as BMI < 18.5 kg/m2 using local statistic results [Consecutive patients with psoriatic diseases who had received ixekizumab injection in the dermatologic outpatient clinic of our hospital between December 2015 and October 2022 were enrolled for analysis. The baseline body mass index (BMI) categories were classified according to the Ministry of Health and Welfare of Taiwan, defining obesity as BMI ≥ 27 kg/m results . The basTo assess the association between the occurrence of ISRs and potential risk factors, chi-squared test, Fisher’s exact test, univariate and multivariate logistic regression analyses were performed using SPSS version 16. The parametric data were presented as mean ± standard deviation.In total, 116 patients with psoriatic diseases were included in the study. The baseline demographic data are summarized in An integrated database composed of three randomized trials in 2017 demonstrated a trend suggesting that a heavier body weight might be a protective factor against ixekizumab-induced ISRs in patients with plaque psoriasis . These fAlthough this was not proven in the multivariate analysis, younger patients or patients with earlier onset of psoriasis may have a higher risk of ixekizumab-induced ISRs. Previous studies have shown that the sensitization potential may decrease with age in patients with contact dermatitis ,25. We aRegarding the aspect of post-injection diarrhea, it is well-known that IL-17 contributes to epithelial and mucosal protection . PreviouThe incidence of ixekizumab-induced ISRs and diarrhea has been found to vary widely across different studies ,12. We bThe ixekizumab solution contains additional ingredients, including citrate, polysorbate, sodium chloride, sodium citrate dihydrate, and water for injection . While cThis study has several limitations that should be acknowledged. Firstly, its retrospective and uncontrolled design may have introduced bias into the results, potentially affecting the generalizability of the findings. Secondly, the assessment of outcomes, such as ISRs and diarrhea, relied on self-reporting by patients during clinic visits, without direct visualization or objective measurements. By the time the patients returned to the clinic, the ISRs had all resolved. This introduces the possibility of recall bias or subjective interpretation. Thirdly, the study did not analyze the incidences of ISRs associated with each dose of ixekizumab, and the relationship between the dosing interval of ixekizumab and the incidence of ISRs was not investigated. This limits our understanding of potential dose-dependent effects. Lastly, the lack of comprehensive and detailed data regarding the characteristics of ISRs or diarrhea may have restricted the depth and accuracy of the findings. Future studies with more rigorous designs and larger sample sizes are needed to address these limitations and provide more robust evidence on the topic.ISRs can occur in up to 50% of psoriasis patients receiving ixekizumab. Fortunately, most cases are mild in severity and resolve spontaneously, rarely requiring discontinuation of ixekizumab treatment. To alleviate ISRs, various approaches can be considered, including ice packing, the use of over-the-counter anti-histamines, analgesics, and topical steroids. It is also important to rotate between the injection sites to prevent the recurrence of ISRs. Overweight or obesity may be protective against ixekizumab-induced ISRs in patients with psoriatic diseases, while a positive family history of psoriasis may be a potential risk factor. Both of these factors are easily available in clinical practice. The development of ISRs is not related to the treatment response of ixekizumab. Additionally, psoriasis patients who experience ixekizumab-induced diarrhea are associated with a higher risk of developing ISRs. Future high-quality studies with larger participant samples are needed to verify this relationship.


Unusual grafts, including extended left liver plus caudate lobe, right anterior section, and right posterior section grafts, are alternatives to left and right lobe grafts for living-donor liver transplantation. This study aimed to investigate unusual grafts from the perspectives of recipients and donors.From 2016 to 2021, 497 patients received living-donor liver transplantation at Severance Hospital. Among them, 10 patients received unusual grafts. Three patients received extended left liver plus caudate lobe grafts, two patients received right anterior section grafts, and five patients received right posterior section grafts. Liver volumetrics and anatomy were analyzed for all recipients and donors. We collected data on laboratory examinations , imaging studies, graft survival, and complications. A 1:2 ratio propensity-score matching method was used to reduce selection bias and balance variables between the unusual and conventional graft groups.p = 0.492). The right and left subgroups did not differ from each counter-conventional subgroup . The incidence of major complications was not significantly different between unusual and conventional graft recipients (p = 0.513). Wound seromas were reported by unusual graft donors; the complication ratio was similar to that in conventional graft donors (p = 0.169).The median of Model for End-stage Liver Disease score of unusual graft recipients was 13.5 (interquartile range 11.5–19.3) and that of graft–recipient weight ratio was 0.767 (0.7–0.9). ABO incompatibility was observed in four cases. The alanine aminotransferase level, total bilirubin level, and international normalized ratio decreased in both recipients and donors. Unusual and conventional grafts had similar survival rates (Although unusual grafts require a complex indication, they may show feasible surgical outcomes for recipients with an acceptable donor complication. Liver transplantation (LT) is becoming a standard treatment for patients with liver cirrhosis. However, it is challenging to overcome the problem of deceased donor shortage, especially in Far East Asian countries where the number of deceased donors is lower than that in western countries . The conData of 497 patients who underwent LDLT at Severance Hospital from January 2016 to December 2021 were retrospectively collected. Pediatric patients and patients who received grafts from two separate donors or underwent re-liver transplantation were excluded. The donors of each recipient were paired during data collection. Ten patients received unusual grafts . The residual liver volume needed to exceed 30%, and the GRWR had to be greater than 0.8 for these calculations. In cases where the donors were not suitable for the conventional grafts, and there were multiple eligible donors for the recipient, we selected the preferred donor who could provide a conventional graft. However, when the recipient had only one potential donor, we considered the option of utilizing the unusual grafts. We assessed the anatomical variances in the portal vein (PV), hepatic artery (HA), and hepatic duct (HD) of the donor. Many types of HA branching have been reported, from the standard anatomy to the left HA arising from the left gastric artery and the right HA arising from the superior mesenteric artery . The intConsidering anatomical variances and GRWR, the donor who was unsuitable for donating conventional grafts was investigated for their eligibility to be the donor of unusual graft. Based on their anatomical variances, possible unusual graft was assessed. Each unusual graft has its favorable anatomy, and it will be described in detail later. We visualized each unusual graft using Synapse 3D Liver Analysis . The detailed information about graft selection is shown in Table The extrahepatic second-order bifurcation of the right HA favors right anterior section graft procurement because it can ensure a longer stump of the right anterior HA . No segmAfter ligamentum teres, falciform, coronary, and right triangular ligament divisions, hilar dissection was initiated posterolaterally. The right HA, right PV, and right HD were identified and isolated. The anterior branches of the right HA and PV were identified and isolated separately. The right anterior HA and right anterior PV were clamped to draw a demarcation line with electrocautery. Intraoperative ultrasonography was performed to identify the location of the right HV and middle HV. After confirming the dissection plane, the Cavitron Ultrasonic Surgical Aspirator was used to transect the liver. While parenchymal dissection along the right HV, branches of segments 5 and 8 connected to right HV were ligated gently and divided for reconstruction. Another transection was performed along the middle HV. The right anterior HD was identified and isolated using the Glissonian approach and divided, leaving a 3-mm HD stump for reconstruction. The right anterior HA and right anterior PV were divided gently and the middle HV was sealed with an endovascular stapler and transected. Intraoperative cholangiography was performed to confirm the integrity of the right posterior HD. The graft was flushed with a histidine–tryptophan–ketoglutarate solution. The right HV branches of segments 5 and 8 was reconstructed using the vascular interposition graft (reconstruction of right HV). The proximal end of the interposition graft was anastomosed to the middle HV of the graft for a common channel outflow.The stump of the recipient middle HV was left to reconstruct anastomosis. A bigger orifice was created in the middle HV using venotomy to ensure adequate venous outflow. The conjoined graft HV and enlarged recipient middle HV were anastomosed. The recipient right PV was connected to the donor right anterior PV, and the recipient right HA was connected to the donor right anterior HA. Intraoperative duplex ultrasonography was performed to confirm a successful flow of PV, HA and HV. Finally, the recipient right HD and the donor right anterior HD were anastomosed using the duct-to-duct method.The extrahepatic second-order bifurcation of right HA also favors right posterior section graft procurement. The type 3 PV variant is the ideal choice for right posterior section grafts. Another favorable anatomy is an extrahepatic right posterior HD that drains into the common HD. Additionally, the right posterior HD that runs through the ventral side of the right posterior PV is the most suitable anatomy , 12.Division of ligamentum teres to hilar dissection was performed in the same manner as that for right anterior section grafts. The posterior branches of the right HA and PV were identified and isolated separately. The right posterior HA and right posterior PV were clamped to establish a demarcation line and line was drawn with electrocautery. The right HV was identified using intraoperative ultrasonography and dissection plane was established. The Glissonian method was used to identify and isolate the right posterior HD, and parenchymal transection was performed toward the root of the right posterior HD with using the Cavitron Ultrasonic Surgical Aspirator. The right posterior HA and right posterior PV were separated gently and the right HV was transected after sealing with a vascular stapler. Intraoperative cholangiography was performed to confirm the integrity of the right anterior HD.The right HV of the donor and the right HV of the recipient were anastomosed. The donor right posterior PV was connected to the recipient right PV, and the donor right posterior HA was connected to the recipient right HA. A successful flow was confirmed using intraoperative duplex ultrasonography. Finally, the duct-to-duct approach was used to anastomose the donor right posterior HD with the recipient right HD. In some cases, the hepaticojejunostomy was utilized to rebuild the bile duct anastomosis.The favorable anatomy for extended left liver plus caudate lobe grafts is the caudate vein draining into the inferior vena cava far from the orifices of the middle and left HVs because it is difficult to anastomose the caudate vein when it is situated near the root of the middle HV or left HV.The left HA was isolated and looped. The left PV was isolated at the bifurcation with the Glissonian method, while its transverse portion was left undissected to preserve the caudate lobe branches. Caution should be taken to avoid damage when securing the caudate vein. The left caval ligament was dissected, then the caudate lobe was mobilized from the vena cava while preserving the caudate vein. The transection line was made from the midpoint between the trunks of the right and middle HVs to the right margin of the retrohepatic inferior vena cava. Identified left HA and left PV was clamped to draw demarcation line. The Cavitron Ultrasonic Surgical Aspirator was used to transect the liver, and the left HD was ligated. The left HA and left PV were ligated and the common trunk of middle and left HVs were transected after sealing with a vascular stapler. Caudate veins were separately ligated. Intraoperative cholangiography was performed to confirm the integrity of the right HD.A venotomy of the recipient middle HV and left HV were performed to construct a common channel. A venotomy using an end-to-side method was performed on the vena cava to anastomose the caudate vein . End-to-We collected data on laboratory findings, computed tomography findings, graft survival, overall survival, and complications of recipients and donors. We graded surgical complications using the Clavien–Dindo classification , and we Data are presented as numbers (proportions) for categorical variables and means and standard deviations for continuous variables. Due to the small sample size, non-parametric tests were required. To determine the significance of intergroup differences, Fisher’s exact test was used for categorical variables and the Mann–Whitney U test was used for continuous variables; data are summarized and reported as medians (interquartile ranges). Survival rates were evaluated using the Kaplan–Meier method, and the log-rank test was used for between-group comparisons.Propensity score matching (PSM) was performed to minimize selection bias and balance variables between the unusual graft and the conventional graft groups. Unusual graft recipients were matched with conventional graft-recipients in a ratio of 1:2 using the nearest neighbor matching algorithm without replacement with distances determined by logistic regression. The caliper was not applied because the unusual graft group only had 10 patients. PSM was performed based on the following variables: recipient model for end-stage liver disease (MELD) score, Milan’s criteria, and donor age, height, and weight.p-values < 0.05 were considered statistically significant.Statistical analyses were performed using IBM SPSS 26  and R 3.5.3 software . p = 0.049). Further, the donor sex (p = 0.006) and weight (p = 0.012) were different. After PSM using nearest neighbor matching, both groups were well balanced in all baseline clinicopathological characteristics.Among the 10 unusual graft recipients, five received right posterior section grafts, two received right anterior section grafts, and three received extended left liver plus caudate lobe grafts Table . The medAlanine aminotransferase (ALT), total bilirubin, and international normalized ratio (INR) values were evaluated. The follow-up period was confined to the initial hospital stay. The recipient’s ALT, total bilirubin, and INR values showed general decrement. The postoperative laboratory outcomes of the donors showed a similar tendency Fig. .Fig. 3Pop = 0.778) and after PSM (p = 0.492). The same result was observed for patient overall survival (data not shown). Additionally, we performed subgroup analysis of the unusual graft recipient group. Recipients of the right anterior section and right posterior section grafts did not show different graft survival and patient overall survival outcomes than those of right conventional grafts. Moreover, the survival rates of the extended left liver plus caudate lobe graft recipient group were not different from those of the left conventional graft recipient group.All 479 recipients were divided into the conventional graft recipient and unusual graft recipient groups. The graft survival is shown in Fig. p = 1.00). Regarding major complications, which were defined as Clavien–Dindo grade III or more, unusual graft recipients had an incidence rate of 50%, while conventional graft recipients had an incidence rate of 37.4% (p = 0.51). The types of complications were also investigated. Biliary complications were the most common major complication; 40% unusual graft recipients experienced bile duct problems, while 26.9% conventional graft recipients showed biliary complications (p = 0.47). HA and PV complications occurred in one case each. Subgroup analysis was performed in the same manner as the survival rate analysis. The complication rate in right unusual graft and left unusual graft recipients was not significantly different compared to that of unusual graft recipients.Postoperative complications in liver transplant recipients with unusual grafts and others are summarized in Table p = 1.69).Regarding donor outcomes, only one case (10%) from the unusual graft group showed complications—a wound seroma that occurred 9 days after surgery. Eight donors (1.6%) from the conventional graft group experienced complications , which was a wound seroma, a Clavien–Dindo classification II complication, which occurred on postoperative day 9. No other donor complications were observed in any other case, and the overall complication rate showed no significant difference (p = 0.169). Lee et at. reported the complication rates of LDLT donors from The Korean Organ Transplantation Registry (KOTRY) study [The complication rate of the unusual graft group was not significantly different from that of the conventional graft group. A detailed description of the major complication is as follows. Right anterior section graft recipient Case 5 underwent re-do anastomosis of the HA due to HA thrombosis. Additionally, during the follow-up period, percutaneous transhepatic biliary drainage was performed because of the anastomotic biliary stricture. Right posterior section graft recipient Case 2 underwent endoscopic retrograde biliary drainage stent insertion, and Case 8 underwent endoscopic retrograde biliary drainage and percutaneous transhepatic biliary drainage with rendezvous technique due to anastomotic biliary stricture. Case 4, which is the recipient of extended left liver plus caudate lobe graft, underwent PV stent insertion due to the narrowing of PV, and percutaneous transhepatic biliary drainage due to anastomotic biliary stricture. Case 7 suffered small-for-size syndrome. From the perspective of donor safety, unusual grafts did not yield a bad outcome. Only one case (Case 1) showed donor complication (Y) study . In the Unusual grafts have several difficulties, and the major issue is the transection plane. For right anterior section graft and posterior section graft, the second-order bifurcation of the right HA needs to be dissected. Not only this procedure faces many variations, but also time-consuming. Especially right anterior section graft has two transection plane which required delicate transection along hepatic veins. Furthermore, the difficult transection plane could lead to the infarction of the liver that affects not only the graft—which results in graft volume loss—but also the residual liver of the donor. It can be a critical weak point of the unusual graft, because small-for-size syndrome is a life-threatening complication for the recipient. Therefore, we should secure sufficient GRWR to avoid the risk of small-for-size syndrome in recipient. In addition to graft volume, reconstruction feasibility is another issue. Because the difficult transection plane leads to multiple vessel stumps or structures that are difficult to make engraftment. Furthermore, the unusual grafts exhibited significantly smaller and fragile stumps compared to conventional graft. As a result, additional reconstruction in bench surgery and time-consuming anastomosis were necessary, leading to prolonged ischemic time. Although no statistical difference was found, a higher incidence of biliary complications was observed in cases involving unusual graft when compared to those with conventional graft.Despite all these adversities, recent advance in technologies gives us the chance to prepare for these difficulties. Three-dimensional reconstruction of the donor’s liver is getting more and more precise, and volumetry of the graft is becoming more accurate. With this detailed information, the diverse variants of the liver can be more accurately expected, and we can select donors more precisely.This study has several limitations to consider. First, it is a single-center study with retrospective design. It has potential limited generalizability; however, it also has homogeneity of surgical method, immunosuppressive regimen, and follow-up protocols. Second, small case numbers; we only had two cases of right anterior section graft and three cases of extended left lobe plus caudate lobe graft. Therefore, further studies on unusual grafts for LDLT in a larger number of patients should be conducted.In conclusion, the results of this study suggest that unusual grafts offer acceptable surgical outcomes. As unusual grafts have been observed to be safe, these grafts can be considered alternatives when conventional grafts cannot be obtained from donors. Considering the shortage of LDLT donors, unusual grafts may extend the donor pool for LDLT with acceptable surgical outcomes.


The fingertip injury is the most common in the hand area. In this regard, skin grafting can be considered to preserve sensation, due to its functional importance, particularly for distal tip injuries. A full-thickness skin graft (FTSG) results in excellent function after engraftment and should be considered in reconstructing functionally and aesthetically important areas. Moreover, a thorough understanding of FTSG is required for a surgeon to have an excellent outcome.A 38-year-old man had the third fingertip injury of his right hand after being crushed by a mill. Physical examination revealed exposed bone distal to DIP, with intact periosteum and nail plate, negative active bleeding, and negative contaminants. There was no tendon or soft tissue left above the periosteum. In addition, an X-ray of the right manus revealed no fracture. The wound was applied with hydrogel and petroleum gauze to maintain hydration. A wound toilet was performed, followed by the closure of the wound with full-thickness skin grafting (FTSG). Follow-up was done in the first week and the fourth week after the procedure, as they showed good aesthetic results with satisfactory function. The sensory recovery showed normal result for touch and vibration. Meanwhile, sharp pain and warmth object sensation were minimally diminished.A literature review concludes that FTSGs are generally unreliable in cases with over poorly vascularized beds, and FTSG will only work with no serious blood supply issues. Therefore, severe fingertip injury was reconstructed by the graft.This procedure showed excellent graft survival with no additional surgical injury of the normal finger, satisfactory functional and aesthetic outcomes, and no need for secondary debulking procedures. Potential disadvantages consisted of insufficient volume of soft tissue and graft hyperpigmentation. However, delayed primary wound closure by FTSG may be an option for treating full-thickness finger defects with bone or tendon exposure. •The fingertip injury is the most common in the hand area. In this regard, skin grafting is can be performed to cover skin defects. However, FTSG are not a commonly used option for this district, which may however benefit some patients in select cases where more complex options are not warranted.•A full-thickness skin graft (FTSG) results in excellent function after engraftment and should be considered in reconstructing functionally and aesthetically important areas.•We performed FTSG on 38-year-old man had the third fingertip injury of his right hand after being crushed by a mill.•It revealed exposed bone distal to DIP, with intact periosteum and nail plate, negative active bleeding, and negative contaminants. There was no tendon or soft tissue left above the periosteum. In addition, an X-ray of the right manus revealed no fracture.•This procedure showed excellent graft survival with no additional surgical injury of the normal finger, satisfactory functional and aesthetic outcomes, and no need for secondary debulking procedures. Physical examination revealed exposed bone distal to DIP, with intact periosteum and nail plate, negative active bleeding, and negative contaminants .Fig. 1PrA right manus x-ray was performed, resulting in no fracture -A. The wThe favorable sensory recovery results of fingertip graft were obtained. The patient could identify touch and vibration sensation from cotton wool and 128 Hz tuning fork, respectively. However, sharp pain and warmth object sensory function were minimally diminished compared to the opposite fingers.3Fingertip injury is usually managed by secondary intention if the wound is less than 1 cm or by primary intention with flap or graft if the wound is greater than or equal to 1 cm. The primary intention with the graft will lead to poor aesthetic results and function. Hence, the flap is done to the nail deformity. When the wound is contaminated and left open due to infection prevention, its closure is performed after a few days. This condition is named delayed primary healing. The edges cannot be approximated when the tissue loss has been more extensive. Alternatively, the wound must be left open because of sepsis, and then the reparative process would be prolonged due to extensive granulation tissue that would fill the defect. This process is termed closure by secondary intention, where huge defects can heal in this process; however, the result is often less aesthetic than closed primary intention Concerning this, patients should be reminded that the donor vascular supply remains fragile for several weeks postoperatively. For this reason, showering with water directly on the area and excessive activity should be avoided for the next one to two weeks. In addition, FTSG complications can be classified into short-term problems and long-term functional and cosmetic problems.Staphylococcus and Streptococcus may be helpful, especially in patients with immunosuppression, diabetes mellitus, or long intraoperative times Short-term problems can occur, such as infection, hematoma, seroma, and excessive displacement of the donor on the surface of the recipient. Although postoperative infection is rare, it is essential to carefully manage intraoperative tissues and minimize electrocautery-induced tissue necrosis. Prophylactic antibiotics for Furthermore, long-term complications for cosmetic and functional problems can occur, so it is necessary to educate that healing results can take months to achieve natural results. Make-up can be worn after three to four weeks after the procedure. In addition, it should be noted that the FTSG site is often depressed during the first two to four weeks. Meanwhile, spot dermabrasion can be performed after six weeks to six months to correct the difference in elevation between the graft site and the surrounding skin and improve color and texture match. Topical hydroquinone and/or tretinoin may also be useful in treating donor site hyperpigmentation Patients with finger injury that have not exposed the bone or tendon and have less than 2-cm skin loss (not 1 cm) are deemed not viable for surgery and are better off receiving secondary healing, which has been shown to improve sensate nerve recovery compared to skin grafting In this case, a full-thickness skin graft (FTSG) results in excellent function after engraftment and should be considered; however, FTSGs are generally unreliable in cases with over poorly vascularized beds. FTSG will work with no serious blood supply issues if only the healthy peripheral wound bed is wider than the avascular bone or tendon area. It should also be noted that the center of the graft can survive over a bone or tendon area through the bridging phenomenon 4While short-term and long-term complications might occur, delayed primary intention with FTSG demonstrated excellent graft survival and satisfactory functional and aesthetic outcomes with no debulking procedures. An overall understanding of FTSG includes indications, contraindications, preoperative evaluation, selection of donor sites, procedure techniques, postoperative care, and postoperative complications, which might help enhance the outcomes of this procedure. In short, FTSG may be considered for covering full-thickness finger defects with bone or tendon exposure.This article is supported by Oncology Surgery Division, Department of Surgery, Sebelas Maret University, Moewardi Hospital, Surakarta, Indonesia.This case is approved by Health Research Ethics Committee of Dr. Moewardi General Hospital (No. 1.454/XI/HREC/2022). Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal on request.The authors declared that this study has received no financial support.Kristanto Yuli Yarso.N/A.All authors contributed equally to this manuscript. All authors read and approved the final manuscript. Galuh Aretnaningtyas and Kristanto Yuli Yarso: Chief of surgical procedure, conceptualization, reviewing, editing, supervision and validation of manuscript. Alia Adelina Dina Soraya, Monica Bellynda, Achmad Luthfi Tiflani: All clinical-laboratory examination, surgical procedure, writing-original initial draft and final manuscript.The authors declare no conflict of interest.


Superficial quadriceps autografts (QA) and hamstring autografts (HA) are popular graft choices in MPFL reconstruction with the lack of directly compared clinical studies between both methods. A total of 43 patellar instability patients, who underwent QA and HA for patellar stabilization at a specified center between 2012 and 2021, were retrospectively reviewed. 21 QA and 22 HA patients were 52.4% of males and 47.6% females with a median age of 25 years (range 12–58) in the QA group, while 63.6% were females with a median age of 21 years (range 14–58) in the HA group. The mean follow-up period was 46.9 months (range 24–77) in QA and 61 months (range 24–100) in the HA group. At the final follow-up, no complications were observed with either technique. No patients presented with recurrent dislocations after surgery. There was no statistically significant difference in postoperative mean Kujala scores (QA = 94.9+/− 4.1 and HA = 94.2+/− 8.0,  The laxity or injury of the medial patellofemoral ligament (MPFL), bony abnormalities such as trochlear dysplasia; patella alta; laterally positioned tibial tubercle; or femorotibial malrotation are the cause of the patellar instability4.Patellar dislocations occur at a rate of 5.8 per 100,000 persons. Higher incidence in younger patients (10–20 years), females, and athletic sports participation8. Thus, the treatment of MPFL incompetency or laxity is an essential procedure in surgically managing recurrent patellar dislocation.MPFL is a primary restraint of lateral patellar displacement from 0 to 30 degrees of knee flexion and is compromised in at least 80% of patellar dislocations9. There are many techniques for MPFL reconstruction. However, there is no gold standard according to procedures, graft choices, and fixation methods in MPFL reconstruction12.MPFL reconstruction is the standard surgical method for treating patellar instability patients with or without additional procedures . The indication for isolated MPFL reconstruction is patellar instability in patients without noticeable bony abnormalities such as; a TT-TG distance less than 20 mm, normal trochlear morphology or Dejour type A dysplasia, and absence of patella alta (Caton-Deschamps index < 1.2)10. However, despite the excellent clinical result, several complications have been reported in hamstring tendon graft use, including patellar fractures and implant breakage13.According to the reconstruction of MPFL, graft choice is of fundamental importance. The graft can be harvested from several donors, either autograft, allograft, or synthetic graft. In the recent systematic review of the subjective patient function outcome scores, Kujala scores demonstrated significant improvements across all graft types composed of hamstring and quadriceps tendon with no significant differences among graftsHowever, there is a lack of clinical studies directly comparing the superficial quadriceps autografts versus hamstring autografts in the same clinical setting, and the proper graft choice for MPFL reconstruction is still unclear. Therefore, this study aims to direct compare clinical outcomes between superficial quadriceps autografts and hamstring autografts. We also evaluated the medium to long-term follow-up complications between both techniques. The hypothesis of the study was no difference in the functional outcomes and complications related to both surgical techniques.A retrospective comparative study, level of evidence 3, investigated the outcomes of patients undergoing MPFL reconstruction with the superficial quadriceps tendon compared with the hamstring tendon for patellar instability and was conducted between 2012 and 2021. The study was approved by Thammasat University Hospital's ethics committee (MTU-EC-OT-6-214/64). All methods were carried out in accordance with relevant guidelines and regulations. Informed consent was obtained from all subjects and/or their legal guardians.14 and Lysholm scores15.Strict inclusion criteria were applied to all patients. These include recurrent patellar dislocation patients who failed conservative management for more than six months and isolated MPFL reconstruction without additional instability procedures with a minimum follow-up of 24 months. Exclusion criteria were the patients who had previous surgery on the affected knee, concomitant meniscal or other ligamentous injuries of the knee requiring repair/reconstruction, and articular cartilage erosion greater than Outerbridge grade II. Patellar instability is defined as the condition in which patellar dislocation has to occur twice or patellar instability after an initial dislocation. Preoperatively, all patients were evaluated using the standard clinical knee and patella examination. Before surgery, plain anteroposterior and lateral radiographs and magnetic resonance imaging (MRI) were obtained. Medical history, clinical data, and operative reports were collected retrospectively. Functional outcomes and knee range of motion were evaluated at the final follow-up. Functional outcomes were assessed using the Thai version of Kujala scoresThree experienced orthopedic surgeons performed all surgical interventions.  The surgical technique and graft selection depended on the surgeon’s and patient’s preferences.16. A section approximately 10–12 mm in width was dissected proximally to obtain the required length of 8–10 cm. The proximal edge of the graft was sutured in whip stitch fashion. Subperiosteally dissection of the proximal graft with a sharp knife in an oblique manner, keeping the medial side of the graft intact. The graft was then rotated medially. The femoral fixation point was created using Schottle’s point13 with fluoroscopy imaging guidance, and the femoral tunnel was reamed. The graft was passed through the subvastus space to the femoral tunnel from the patellar side. An interference screw 6 × 25 mm  was inserted with the proper tension at a knee flexion of 45°. Knee arthroscopy confirmed the patella was positioned in the groove and had good tension following reconstruction . The semitendinosus graft was passed through the patella tunnel with a suture loop. The graft's upper limb was redirected to the superior aspect of the patella and separated from the graft to the upper and lower limbs. The femoral tunnel was created by using Schottle’s point13. The two ends of the graft were passed from the anteromedial to the medial side and then through the lateral femoral cortex. An interference screw 6 × 25 mm  was inserted with the proper tension at knee flexion of 45° . The independent T-test was performed in all the comparisons, with values of p < 0.05 considered statistically significant.All data were analyzed using SPSS v.28 (IBM Corp.). Categorical data were reported as a percentage. Continuous data were reported as mean, standard deviation, and range (min–max). An a priori power analysis was performed to calculate the sample size required to detect minimal clinically relevant differences in the Kujala scoresTwenty-one patients in the superficial quadriceps graft group and twenty-two in the hamstring graft group were followed for a minimum of 24 months. 11 males and 10 females with a median age of 25 years (range 12–58) in the superficial quadriceps autograft group. There were 8 males and 14 females with a median age of 21 years (range 14–58) in the hamstring autograft group. The mean follow-up time of the superficial quadriceps group was 46.9 months (range 24–77). The mean follow-up period of the hamstring group was 61 months (range 24–100).The demographic characteristics of the patients are shown in Table There were no differences in pre-operative demographic data regarding age, gender, side of injury, the Caton–Deschamps ratio, and the mean TT-TG distance. In addition, the mean follow-up time in the superficial quadriceps group was less than in the hamstring group (p = 0.04) as the superficial quadriceps MPFL reconstruction technique was developed at a later time than the hamstring graft technique.The comparable clinical scores  and knee range of motion for superficial quadriceps autograft and hamstring autograft groups at the final follow-up are presented in Table No patients suffered from a patellar re-dislocation or subluxation at the final follow-up. No infection or patellar fracture was observed during the follow-up period in any patient. No patients had skin sensation loss around the affected knee after the final follow-up. No statistically significant differences in clinical scores were found between the groups.p = 0.04) as the superficial quadriceps MPFL reconstruction technique was developed at a later time than the hamstring graft technique.The most important finding of this study was that both procedures, superficial quadriceps and hamstring autograft for MPFL reconstruction, are safe and reproducible procedures with good clinical and functional outcomes at minimum, the two years of follow-up. There were no differences in pre-operative demographic data regarding age, gender, side of injury, the Caton-Deschamps ratio, and the mean TT-TG distance. In addition, the mean follow-up time in the superficial quadriceps group was less than in the hamstring group (10. A recent systematic review published by McNeilan et al.10 showed that the mean postoperative Kujala score ranged from 84.4 to 94 in quadriceps autograft and 81.7 to 94.6 in hamstring autograft.The mean postoperative Kujala scores were 94.9+ /− 4.1 and 94.2+/− 8.0 for the superficial quadriceps and hamstring groups, respectively. There were no statistically significant differences between the two groups. The results were compared with previous studies that used superficial quadriceps or hamstring tendons as the graft source21 to evaluate the ultimate failure load and stiffness of quadriceps tendon fixation and single tunnel patella fixation with gracilis autograft in MPFL reconstruction revealed no statistical difference in maximum load to failure and stiffness between both techniques. However, from the biomechanical study with the hamstring group, the patellar fixation method, graft type, and graft orientation technique differed when compared with our reconstruction technique.A biomechanics study5. Mountney et al.22 stated that the MPFL ruptured at a mean of 26+/− 7 mm, and the dislocated patella 50 mm, ensuring the rupture of MPFL. Graft selection for the MPFL reconstruction is important. The biomechanical properties of the grafts have been investigated. Tensile strength and viscoelastic properties of the reconstructed tendon graft are the critical mechanical parameters for successful reconstruction. The MPFL is a ligament of tissue connecting the tubercle of an adductor tubercle of the distal femur to the proximal aspect of the medial edge of the patella23. The native tensile strength of the MPFL is approximately 208 N19, both quadriceps and hamstring tendon grafts are more restrained25. Herbort et al.24 found that the tensile strength of the superficial quadriceps tendon is 205 N. The tensile strength of the semitendinosus and the gracilis tendon is 1060 N and 837 N, respectively26.The MPFL is the important medial restraint structure during the first 30° of knee flexion13. We used fluoroscopic landmarks to confirm the ideal location of the femoral footprint MPFL to avoid failure due to femoral tunnel malposition, which is the common cause of MPFL failure27. The appropriate knee flexion angle is still controversial, ranging from 30°, 45°, 60° to 90° of knee flexion from literature. Regardless of the degree of knee flexion, the range of motion following graft fixation should be fully obtained. There should be a suitable endpoint to lateral patellar translation from 0° to 30° of knee flexion, and proper tension confirmed in both techniques.All of the cases in our study's superficial quadriceps and hamstring graft groups use the same technique for femoral fixation. An interference screw fixation at the femoral tunnel using fluoroscopy to locate Schottle’s point28. Complications included graft failure, graft overtightening, and patellar fracture. The patellar fracture was one of the most serious complications reported after MPFL reconstruction with a hamstring graft. The superficial quadricep graft can eliminate complications associated with patellar fracture. The drawbacks of superficial quadriceps graft are increased scar formation at the harvested site and graft amputation during harvesting. However, our series had no reported patellar fractures or superficial quadriceps graft amputations.Despite a high success rate, the combined complication and failure rate of MPFL reconstruction remain substantial, reported at 26% in one systematic reviewThis study is the first study to directly compare the clinical outcomes between superficial quadriceps autograft and hamstring autograft in MPFL reconstruction. Many published studies were reported in the case series without comparing groups. This study has some limitations; the first was the wide range of follow-up time points to evaluate clinical outcomes and scores. The second was that both groups were not operated on by a single surgeon with different surgical techniques, which may result in a bias in clinical examination and clinical outcomes. The graft selection depended on the surgeon’s and patient’s preferences, leading to selection bias. The third was that the small sample size may have affected our finding that there was no difference in outcomes between the two groups. Fourth, no data on the preoperative Kujala and Lysholm scores due to a retrospective basis. Lastly, the donor site morbidity of the quadriceps and hamstring strength or functions was not evaluated post-operatively.MPFL reconstruction for patellar instability surgery using either superficial quadriceps or hamstring autograft achieved good clinical outcomes during a minimum follow-up of 2 years. No significant differences in clinical outcomes and complications were observed in both groups.


With the increase in DS, the viscosity of esterified chickpea starch decreased gradually. Compared with unmodified chickpea starch, the ability to form gel was poor.The effect of acetylation on the physicochemical properties of chickpea starch was studied. After the chickpea starch was acetylated, the basic properties were measured. When the degree of substitution (DS) was 0.1004 and the temperature was 95 °C, the solubility and swelling power of starch were 19.6% and 21.4 g/g, respectively. The freeze–thaw stability of acetylated starch paste increased with the increase in the degree of substitution. The surface morphology of starch granules changed, but the crystalline morphology did not change, and the C-type crystalline structure was still maintained. There are three new absorption peaks in the infrared spectroscopy of starch, and the -COCH Chickpeas are one of the main bean crops in the world. They are named for their beak-shaped protuberance near the navel. It is also known as peach bean and chicken pea. It is widely planted in the west of our country and is very resistant to drought and infertility; it has great market potential [otential . Chickpeotential . Among tStarch is a kind of natural macromolecular compound that is abundant in nature and has the advantage of a low price. It is easy to obtain, renewable, degradable, and non-polluting to the environment ,4. ThereAcetylation is a kind of chemical modification. The starch was chemically modified with acetic anhydride, using NaOH as the catalyst. The hydroxyl group of glucose in starch was replaced by the acetyl group, which results in some changes in the starch’s molecular structure. The main purpose of acetylated-modified starch is to change the properties of starch, such as the physicochemical properties, gelatinization, gel texture, crystal morphology, etc. The gelatinization properties and aging of starch modified by acetylation are very different from that of native starch. Lin et al. found that, compared with native starch, acetylated starch had better solubility and swelling powers . ColussiThe functional properties of acetylated starch changed with the degree of substitution. The main functional properties of acetylated starch depend on the type of starch, degree of substitution, and size of the acetyl group; the content of the acetyl group and DS in acetylated starch depend on the reaction time, catalyst, plant source, and amount of reagent . Some stChickpea starch was prepared by dilute alkali method in laboratory; the starch content was 95 DW%. Acetic anhydride was purchased from Comeo Chemical Reagent Co., Ltd. . Sodium hydroxide and potassium bromide were purchased from Chemical Reagents Co., Ltd. . Hydrochloric acid was purchased from Jing en Industrial Co., Ltd. .The chickpeas were ground and passed through 80 mesh; then, 5 g of the chickpea powder and NaOH solution (0.3% concentration) were mixed at ratio 1:4 of material to liquid. Under the condition of 40 °C, the mixture was stirred at constant temperature for 240 min in a magnetic stirring water bath and centrifuged at 4000 r/min after stirring. After centrifugation, the top layer of black protein solution was scraped off, the bottom layer of starch was washed with water, the starch was centrifuged until it was pure white, dried in a 40 °C drying box for 24 h, and then crushed using 80-mesh sieve.v/w  was added slowly to keep the pH in the range of 8.0–8.5. After adding acetic anhydride within 20 min and continuing the reaction for 1 h, the reaction was stopped by adjusting the pH to 6.5 with 0.5 mol/L HCL, the starch was washed to neutral, then dried in a 40 °C oven for 24 h, and crushed to obtain acetylated starch [Acetylated-modified starch was prepared with acetic anhydride as reagent. A 40% starch slurry was prepared by mixing chickpea starch with water. The range of acidity of the starch slurry was pH 8.0–8.5. The acetic anhydride d starch .1. Blank: using chickpea unmodified starch, consumption HCL volume was recorded as V0. According to Formula (1), which concerns the acetyl content of A [A total of 2 g of acetylated starch was put into iodine flask, and 50 mL of distilled water was added. Phenolphthalein was used as indicator; 0.1 mol/L NaOH was added to make the solution turn reddish, and 10 mL of 0.5 mol/L NaOH was added. After shaking for 0.5 h on the oscillator, the sample was titrated with 0.5 mol/L HCL until the color disappeared, and the volume of consumed HCL was recorded as Vent of A .(1)A=V10 is blank consumption HCL volume, mL; V1 is consumption HCL volume, mL; C is HCL concentration, and mol/L; m is the quality of the starch, g.In the formula, A is acetyl content, %; VThe degree of substitution DS is calculated in Formula (2):In formula, DS is degree of substitution, A is acetyl content, %.The starch sample M was taken and prepared as a 1% starch suspension. It was stirred in magnetic stirring water bath  for 30 min and cooled at room temperature. The supernatant was poured into a weighing bottle after it was centrifuged at 4000 r/min for 10 min. Then, the supernatant was dried in 100 °C oven to constant weight and weighed (label as A). The solubility (S), the precipitate (P), and swelling power (B) of starch were calculated using Formulas (3) and (4) .(3)S%=ATo prepare 1% starch suspension, it was stirred and heated at 100 °C for 0.5 h. Then, the paste was cooled at room temperature. The distilled water was used as a blank control. The absorbance A was determined at 620 nm with photometer, and the transparency of starch was calculated. Formula (5) is as follows :(5)T=1101). Then, the sample was stored at −18 °C for 24 h. It was centrifuged at 3000 r/min for 20 min after thawing. The sediment was weighed and labeled m2. To calculate the precipitation rate according to Formula (6), the above steps were cycled five times [A total of 6% starch suspension was prepared, after it was treated at 100 °C for 30 min, stored at 4 °C for 24 h, and then put into a centrifuge tube of known weight (mve times .(6)I=m1The granule morphology of the sample was analyzed by scanning electron microscope . The samples were evenly dispersed on the conductive adhesive, and then placed on the coating platform for gold spray treatment. The granule morphology was observed at an accelerated voltage of 5.0 KV, and micrographs were taken at 3000× magnification .The sample was dried and pressed. The samples were analyzed by X-ray diffraction . The diffraction conditions were as follows: copper target voltage of 40 kV, current of 40 mA, and CuKa radiation. The scanning range was 5° to 40°, the step length was 0.02°, and the scanning speed was 2°/min .−1; the scanning range was 4000 cm−1 to 400 cm−1; and the number of scans was 32 [The dried starch sample was mixed evenly with the KBr powder and quickly ground for 1 min, and then press the tablet. The thin film was scanned with an FTIR spectrophotometer . The spectral resolution was 4 cms was 32 .The properties of starch gelatinization were determined by rapid viscosity analyzer . The 3.0 g starch sample and 25 mL of water were mixed. The starch slurry was equilibrated at 50 °C for 1 min. The measuring temperature ranged from 50 °C to 95 °C, and the heating rate was 12 °C/min. The temperature was held at 95 °C for 2.7 min, and the slurry was reduced to 50 °C for 1 min. We recorded peak viscosity, trough viscosity, breakdown viscosity, final viscosity, setback viscosities, and gelatinization temperature .The concentration of starch suspension was 12%, and it was heated in a boiling water bath. Then, the cooled sample was placed at 4 °C for 24 h. To measure the gel properties of the samples, the TPA compression mode of texture analyzer was used. The pre-test speed was 2 mm/s; the mid-test speed was 5 mm/s; and the post-test speed was 5 mm/s. The compression rate was 50%. The probe was P/0.5 R .Significance analysis was performed using SPSS Statistics 25 one-way ANOVA test and Duncan, and relative crystallinity was calculated using Jade software.p < 0.05). The four acetylated-modified starches were all low DS starches.The effect of acetic anhydride on the acetyl content and the degree of substitution of chickpea starch is shown in p < 0.05). The greater the degree of substitution, the greater the solubility and swelling power of the starch. When the starch was heated in water, the hydrogen bond of the stable double helix structure was broken, the hydrogen bond was replaced by the water molecule, and the starch granule expanded and increased in size. Compared with the native starch, the acetylated starch retained more water, and the solubility of starch treated with acetic anhydride was higher at the same heating temperature. When DS was 0.1004 and the temperature was 95 °C, the solubility and swelling power of starch were 19.6% and 21.4 g/g, respectively, which were 4.4% and 4.8 g/g higher than those of native starch at 95 °C. The addition of an acetyl group to starch breaks the hydrogen bond between starch and water, changes its internal structure, and increases its solubility. Compared with native starches, the swelling degree of acetylated chickpea starches increased, which may be due to the following two main reasons: acetylated starches introduced acetyl groups, which made the molecular distance between chickpea starches become larger, and the steric hindrance of chickpea starches increased, which is unfavorable to the recovery of starch cohesion in chickpeas [As shown in hickpeas . The hydhickpeas , and wheThe transparency of native chickpea starch was significantly different from that of acetylated starch . As can The syneresis rate is often used as an indicator of the freeze–thaw stability of starch paste. Generally speaking, a lower syneresis rate means better freeze–thaw stability. As shown in The scanning electron microscope morphology of acetylated starches with different DS was observed by SEM . The surThe XRD patterns of chickpea starch are shown in −1 is the peak of –OH formed by bond breaking; the band at 2929 cm−1 is the stretching vibration peak of –CH–; the change in amylose and amylopectin contents result in the strength change in the –CH– expansion range [−1, 857 cm−1, 763 cm−1, and 576 cm−1. Compared with those native chickpea starches, the acetylated starch showed three new absorption peaks due to the introduction of an acetyl group: the absorption peak at 1730 cm−1 was C=O, 1375 cm−1 was –CH3, and 1245 cm−1 was C-O [3 group was introduced. The intensity of the absorption peak at 3400 cm−1 gradually decreased with an increasing DS compared with the native starch, which is mainly because of the continuous substitution of the –OH group by the introduction of –COCH3; so, the intensity at 3400 cm−1 of the original –OH absorption peak decreased gradually.In order to study the structure of acetylated starch, FTIR spectroscopy was used. The spectra of native chickpea starch, DS = 0.0486, 0.071, 0.0867, and 0.1004, are shown in on range . Due to  was C-O . This inp < 0.05). When DS was 0.1004, the peak viscosity decreased by 989 cP, trough viscosity decreased by 660 cP, breakdown viscosity decreased by 329 cP, final viscosity decreased by 2649 cP, and the setback viscosity decreased by 1989 cP (As shown in  1989 cP . The visp < 0.05). The gel parameters of acetylated starch were lower than those of native chickpea starch. When acetylated starch DS was 0.1004, the hardness decreased by 19.65 g, the cohesion decreased by 0.22 g, the elasticity decreased 1.5 mm, and adhesion and chewiness decreased by 16.33 g·s and 79.2 mj, respectively. The results indicate that the starch modified by acetylation was not easily retrograded and had better gel properties. Zdybel E. [As shown in dybel E.  argues t3 group. There were no changes in the crystal structure of starch by XRD. The viscosity of acetylated starch decreased with the increase in DS, and the ability to form gel decreased. However, acetylated starch has a higher solubility, swelling power, and transparency, and the stability of freeze–thaw improved with the increase in DS. Therefore, it can be concluded that acetylation has a certain positive effect on the solubility and freeze–thaw stability of starch, which can overcome the limitation of native starch in ready-to-eat and frozen foods through acetylation modification, thus improving the application value.In this paper, chickpea starch was acetylated. The FTIR spectra showed that acetylation introduced the COCH


Swelling and shrinkage anisotropy affect the susceptibility to an assembly of wooden elements by changing designed clearances or interference fits. This work described the new method to measure mounting holes’ moisture-induced shape instability and its verification using three sets of twin samples made of Scots pinewood. Each set of samples contained a pair with different grain patterns. All samples were conditioned under reference conditions (relative air humidity–RH = 60% and temperature 20 °C), and their moisture content (MC) reached equilibrium (10.7 ± 0.1%). On the side of each sample, the seven mounting holes of 12 mm in diameter were drilled. Immediately after drilling, Set 1 was used to measure the effective hole diameter with 15 cylindrical plug-gauges with diameters of 0.05 mm step, while Set 2 and Set 3 were separately re-seasoned by six months in two extreme conditions. Set 2 was conditioned with air at 85% RH (reached an equilibrium MC of 16.6 ± 0.5%), while Set 3 was exposed to air at 35% RH (reached an equilibrium MC of 7.6 ± 0.1%). Results of the plug gauge tests highlighted that holes in the samples subjected to swelling (Set 2) increased an effective diameter in the range of 12.2–12.3 mm (1.7–2.5%), while samples subjected to shrinking (Set 3) reduced the effective diameter to 11.9–11.95 mm (0.8–0.4%). To accurately reproduce the complex shape of the deformation, gypsum casts of holes were made. The 3D optical scanning method was used to read the gypsum casts’ shape and dimensions. The 3D surface map of deviations analysis provided more detailed information than the plug-gauge test results. Both the shrinking and swelling of the samples changed the shapes and sizes of the holes, but shrinking reduced the effective diameter of the hole more than swelling increased it. The moisture-induced changes in the shape of holes are complex: the holes ovalized with a different range, depending on the wood grain pattern and hole depth, and were slightly extended in diameter at the bottom. Our study provides a new way to measure 3D hole initial shape changes in wooden elements during desorption and absorption. Thuja plicata) [Tilia Americana [Most properties of wood are dependent on its moisture content (MC). This relationship occurs below the fiber saturation point (FSP). Tiemann  first deplicata)  to 32% fFurthermore, the actual FSP value depends on the temperature of the wood and decreases by approximately 0.1% per 1 °C. Some sources suggest that hardwoods may have a slightly higher FSP than softwoods because hardwood cells are more densely packed and have thicker cell walls . General2 layer theory [Pinus koraiensis in the tangential and radial direction ranged from 6.5 to 7.4% and from 2.5 to 2.8%, respectively [Many scientific papers reviewed the factors determining wood shrinking and swelling, including the influence of MC, temperature, and relative humidity (RH), and discussed how dimensional wood changes can be appropriately measured and predicted . A charar theory . The wooectively .The engineering tolerances for holes drilled into solid wood elements are specified in terms of the nominal diameter and location. Engineering tolerances are a rationalization of the inaccuracy of woodworking. The deviation of nominal diameter and the shape distortion of the drilled holes are cumulative of manufacturing variables: cutting speed, actual sharpness of the tool, machine spindle rigidity, clamping rigidity, and thermal expansion. Therefore, the drilling is not correct, and the dimensions and shape of the holes are inaccurate. Commercial twist drills may have a diameter slightly smaller than the nominal; however, the actual hole diameter will likely be larger than the nominal diameter of the used tool. The inaccuracy of wood processing both the MC changes in the dimensions of wooden elements caused by changes in air parameters makes the shapes of the holes far from cylindrical. In the previous study , we measIn comparison, changes in MC caused by an increase in RH from 60 to 85% (causing swelling) only slightly increased the effective diameter of the hole. Moreover, it was observed that changing the shape of the wood MC distorted the hole from round to oval. Significant changes in the shape of the drilled holes were observed in the case of timber blanks with a tangential grain pattern. Therefore, the grain pattern is critical to designing an engineering fit in solid wood elements for assembly in variable ambient air conditions.As a result of changes in MC, wood swells or shrinks. Then, cylindrical holes drilled in the wood elements may become deformed—various factors, such as the natural cylindrical ortotrophy and irregularity of wood structure, affect these shape changes. Changing the MC of the wooden elements affects many functional properties of the wooden products, e.g., changing the load capacity . The assPinus sylvestris L.) flat-sawn timber with a target moisture content (MC) of 12 ± 2%. The sample preparation procedure included: selecting clear sapwood planks without visible defects, gluing and cutting the planks, seasoning, and finally, drilling holes . cv = 300 m/min, feed rate 7.2 m/min, which means a chip load zf = 0.45 mm/tooth).In the first phase of experiments, all test samples were initially air-conditioned for four months over sodium bromide (NaBr) in a container with forced air circulation under reference conditions, i.e., RH = 60 ± 1% and 2·6H2O) were used to obtain conditions corresponding to the RH of 85, 60, and 35%, respectively. These salt solutions were chosen to obtain constant air RH during the air conditioning of test samples. Sets 2 and 3 were conditioned until they reached a constant mass, which took six months. Immediately after conditioning, Sets 2 and 3 were used to measure effective diameter with plug gauges.Immediately after drilling, Set 1 was used to measure the holes’ effective diameter with plug gauges, while Set 2 and Set 3 were separately placed in other containers in two extreme conditions that differed in air RH at 20°C from the reference conditions by +25% (Set 2) and by −25% (Set 3). It was assumed that these conditions corresponded to practical differences in humidity in which wooden elements could be stored before assembly. Set 2 was exposed to a higher RH of 85%, causing swelling. In contrast, Set 3 was exposed to a lower RH of 35%, causing shrinking. Potassium chloride (KCl), sodium bromide (NaBr), and calcium chloride  and calm = ± 0.001 g  was used to measure the mass of the wood samples. The MC was calculated for each air RH condition  as an average of two calculations. The MC of all samples, initially conditioned in the air with RH = 60% (Set 1), equilibrated at 10.7 ± 0.1%. Exposure to air with RH = 85% (Set 2) increased the MC of the wood by 5.9% (to 16.6 ± 0.5%); exposure to RH = 35% (Set 3) decreased the MC by 2.9% (to 7.6 ± 0.1%).An electronic laboratory balance with measurement inaccuracy ΔThe shape of the drilled holes could not be optically 3D-scanned directly, so it was decided to produce a gypsum cast. Synthetic casting gypsum  with less than 0.15% linear expansion was used to produce the casts. The gypsum casts were the counter-samples of drilled holes. The counter-sample preparation is shown in The gypsum counter-samples were scanned using a 3D optical laser scanner  with a noncontact laser sensor . Spot beam triangulation and the scanning pitch for rotary scanning with parameters: circumference from 0.18° to 3.6°, height direction from 0.2 to 406.4 mm, and repeat accuracy of ±0.05 mm were used. Each of the measured counter-samples was placed in a vertical position on the rotary measuring table of the 3D scanner. The vertical axis of the counter-sample coincided with the axis of rotation of the measuring table. A trial rotation was performed to minimize the deviation of the counter-sample vertical axis to the axis of the measuring table. If necessary, the position of the counter-sample was corrected. Then, an automated 3D scanning of the examined surface of the samples was performed with the following measurement settings: circumferential pitch of 0.18°, height direction pitch: of 0.2 mm, and rotation of the measuring table at a constant speed.As a result of the 3D scanning of each examined counter-sample with a nominal diameter of 12 mm and a length of 32 mm, a cloud containing approximately 320,000 measurement points was obtained; on average, the horizontal distance between the measurement points was 0.018 mm. The measurement time for a single sample was approx. 21 min. The procedure for processing the 3D scan results is presented in The point cloud of each examined counter-sample was exported to Geomagic software , and a 3D surface model was generated using a triangle mesh method. Next, each scanned model was registered, which spatially oriented the model of the counter-sample to the reference sample, with ideal dimensions and orientation in Cartesian coordinates (XYZ). In the next step, the 3D-scanned models were subjected to measuring diameters on five control planes . The central control plane was 16 mm from the lower base of the counter-sample, and the other planes were symmetrically 7 mm spaced. The upper and lower measuring planes, i.e., 1 and 5, corresponded to the inlet and the bottom of the drilled hole, respectively. In each control plane, measurements were carried out in two perpendicular directions , corresponding to the radial (R) and tangential (T) anatomical direction.The results of 3D-scanning the gypsum counter-samples were virtual models capable of comparing with a theoretical cylinder with a diameter of 12 mm and a length of 32 mm. As mentioned, six series of seven counter-samples of gypsum were analyzed, two for radial and tangential grain pattern planks for three seasoning conditions . The 3D scans of each series were averaged, thus obtaining six averaged 3D scans of gypsum counter-samples. A CAD model of an ideal cylinder with a diameter of 12 mm and height of 32 mm was superimposed on these averaged 3D scans. The result of this imposition is shown in The 3D scanning of the hole counter-samples revealed that reducing the MC of wood samples reduced the effective diameter of the holes , and incFurthermore, Wood constantly exchanges moisture with the ambient air, tending to an equilibrium moisture content (MC). The wood used under real-life conditions usually never attains equilibrium MC due to the long adsorption–desorption phenomenon and the varying nature of the ambient conditions, such as air RH and temperature . The sloThe results indicate that the drilled holes, although made with a new high-end tool and a new industrial CNC machine, were not ideally cylindrical. These holes had slightly smaller diameters in their lower part. This phenomenon was visible in 3D scanning of the counter-samples (gypsum casts of the holes). Therefore, the hole diameter inaccuracy was not caused by dulling of the tool . It shouUnder typical industrial conditions, wooden elements are exposed to varying ambient RH during transport or storage before being built into the produced furniture . The effChanges in the shapes of drilled holes under the influence of changes in wood MC occur with different ranges and scales depending on the anatomical direction ,27, but The exposure to air with a decreased RH of 60% to 35% decreased the equilibrium MC of the test samples by 3%. In contrast, an increase in the RH to 85% increased the equilibrium MC by 5.9%. The tested pinewood adsorbed water to times more then it desorbed. This was due to sorption hysteresis.Shapes of drilled holes were not ideally cylindrical. These holes were slightly wider at their bottoms. A potential cause of the increase in diameter with the hole depth may have been the cutting action of the chips generated during drilling. The deeper the hole, the more chips were not evacuated, and these chips could increase the hole diameter when drilling.Susceptibility to the assembly of wood elements depended on the direction of changes in the MC of wood. The desorption (a decrease in MC) negatively affected this susceptibility, significantly reducing the effective diameter of the holes; the cross-sections of holes deformed into ellipses, thus significantly reducing the diameter of the cylindrical gauge that could be inserted manually into such a deformed hole. The presented results and analyses are potentially helpful in optimizing the production of solid wood elements for robotic assembly.Changes in the shapes of holes under the influence of changes in wood MC are complex. The different intensity of the hole diameter changes concerning the depth of the hole were probably caused by different rates of water absorption and desorption occurring at a depth of the hole. The wood in the upper parts of the hole absorbed water more quickly and swelled more than the bottom. The nature of shrinkage and swelling and the range of holes’ deformations depended on the direction of the air’s impact on the wood  and the grain pattern in the element in which the holes were drilled.3D scanning of gypsum cast of holes provides very detailed information about the shape of the holes. The study confirmed the usefulness of the 3D scanning technique to assess the dimensional and shape instability of mounting holes in solid wood. The analysis of 3D scanning results confirmed the assumption that the classic “plug-gauging” technique is insufficient to properly assess the dimensional and shape instability of holes in solid wood affected by its MC changes. The study provides new insights into measuring 3D hole shape changes in wooden elements using 3D optical scanning.The shrinkage and swelling anisotropy affect the susceptibility to the mounting of elements of wooden furniture. The work presented a new method for accurate measurement of the shape of holes. The described experimental study identified the nature and value of the hole deformation and confirmed the usefulness of the 3D scanning technique used to measure the phenomena studied. The experiment included inducing swelling and shrinkage of pinewood elements with bored holes. Changes in moisture content (MC) were caused by a long-term increase and a decrease in RH of 25%. Effective hole diameters were measured using plug gauges, while the deformed shape of the holes was “read” with a 3D scanner. Based on the analysis of the results, the following general conclusions can be drawn: