Our study demonstrated that hepatic resection for BCLC stage B, Child A HCC patients had better survival rates than TACE group. Thus, hepatic resection is indicated in selected patients with BCLC stage B.

The aim of this study is to analyze the combined impact of preoperative T1 slope (T1S) and C2-C7 sagittal vertical axis (C2-C7 SVA) on determination of cervical alignment after laminoplasty.Forty patients undergoing laminoplasty for cervical spondylotic myelopathy (CSM) with more than 2 years follow-up were enrolled. Three parameters, including cervical lordosis, T1S, and C2-C7 SVA, were measured by preoperative and postoperative radiographs. Receiver operating characteristics (ROC) curve analysis was used to determine the optimal cut-off values of preoperative T1S and C2-C7 SVA for predicting postoperative loss of cervical lordosis. Patients were classified into 4 categories based on cut-off values of preoperative T1S and C2-C7 SVA. The primary outcome was postoperative C2-C7 SVA. Change in radiographic parameters between 4 groups were compared and analyzed.Optimal cut-off values for predicting loss of cervical lordosis were T1S of 20 degrees and C2-C7 SVA of 22 mm. Patients with small C2-C7 SVA, no matter what the value of T1S, got slight loss of cervical lordosis and increase in C2-C7 SVA. Patients with low T1S and large SVA (T1 ≤20° and SVA >22 mm) got postoperative correction of kyphosis and decrease of C2-C7 SVA. However, patients with high T1S and large SVA (T1 >20° and SVA >22 mm) got mean postoperative C2-C7 SVA value of 37.06 mm, close to the threshold value of 40 mm.Determination of cervical alignment after laminoplasty relies on the equilibrium between destruction of cervical structure, kyphotic force, and adaptive compensation of whole spine, lordotic force. Lower T1S means bigger compensatory ability to adjust different severity of cervical sagittal malalignment, and vice versa.

Successful and efficient cryopreservation of living cells and organs is a key clinical application of regenerative medicine. Recently, magnetic cryopreservation has been reported for intact tooth banking and cryopreservation of dental tissue. The aim of this study was to assess the cryoprotective effects of static magnetic fields (SMFs) on human dental pulp stem cells (DPSCs) during cryopreservation. Human DPSCs isolated from extracted teeth were frozen with a 0.4-T or 0.8-T SMF and then stored at -196 °C for 24 h. During freezing, the cells were suspended in freezing media containing with 0, 3 or 10% DMSO. After thawing, the changes in survival rate of the DPSCs were determined by flow cytometry. To understand the possible cryoprotective mechanisms of the SMF, the membrane fluidity of SMF-exposed DPSCs was tested. The results showed that when the freezing medium was DMSO-free, the survival rates of the thawed DPSCs increased 2- or 2.5-fold when the cells were exposed to 0.4-T or 0.8-T SMFs, respectively (p < 0.01). In addition, after exposure to the 0.4-T SMF, the fluorescence anisotropy of the DPSCs increased significantly (p < 0.01) in the hydrophilic region. These results show that SMF exposure improved DMSO-free cryopreservation. This phenomenon may be due to the improvement of membrane stability for resisting damage caused by ice crystals during the freezing procedure.

Complete circumferential degloving injury of the digits usually results in a large cutaneous defect with tendinous structure and bone and joint exposure. When revascularization is not possible, a thin and adequately sized flap is required to resurface the defect, restore finger function, and prevent amputation. In this report, we present our experience with reconstruction of the entire circumferential degloving injury of the digits using free fasciocutaneous flaps. Between February 2006 and January 2011, 9 male patients with circumferential degloving injury of 9 digits underwent reconstruction using free fasciocutaneous flap transfer with the posterior interosseous artery flap, medial sural artery flap, anteromedial thigh flap, or radial forearm flap. The average flap size was 14.2 × 6.9 cm. Donor sites were closed primarily or covered with split-thickness skin graft. All flaps survived completely and the donor sites healed without complications. The mean follow-up period was 34.8 months. A maximum Kapandji score (10/10) was seen in 2 cases with crushed thumbs. All patients could achieve good key pinch and grasping functions. All skin flaps showed acceptable static 2-point discrimination and adequate protective sensation. Patient satisfaction for resurfaced digits averaged 9 on a 10-points visual analogic scale. In conclusion, the free fasciocutaneous flaps used were thin and did not interfere with finger movements. The patient's finger formed a smooth contour and acceptable functional results were obtained after reconstruction. This method may be a valuable alternative for reconstruction of entire circumferential avulsion injury of the digits.

Background: Malignant peripheral nerve sheath tumors (MPNST) are defined as any malignant tumor deriving from or differentiating into cells of the peripheral nerve sheaths, with a high risk of local recurrence and distant metastasis. Despite aggressive surgery and adjuvant therapy, the prognosis of MPNST is poor with reported 5-year survival rates of about 50%. Case Report: We report a case of a patient with MPNST of the neck, who developed multiple thoracic metastases after a 14-year disease-free interval. The patient underwent a total of 4 thoracic surgeries in the last 3 years because of local recurrence with tumor invasion to the chest wall and pericardium. Aggressive surgical intervention and adjuvant radiotherapy resulted in good outcome and long-term survival. Conclusion: Although MPNST is an aggressive carcinoma with poor survival, aggressive surgical intervention and radiotherapy resulted in good survival.

No abstract

The effect of silanization and filler fraction on the mechanical properties of aged dental composites was investigated. Experimental composites (75/25 Bis-GMA/TEGDMA resin reinforced with 0, 12.6, 30.0, and 56.5 vol% 8 microm silanized/unsilanized BaSiO6) were fabricated into 4.7 mm diameter x 2.2 mm thick discs and 3.5 mm diameter x 7.3 mm thick discs for diametral tensile and compressive tests, respectively. The effect of immersion in 75% ethanol at 37 degrees C for 0-30 days on the diametral tensile strength (DTS) and compressive strength (CS) of the samples was evaluated and analysed by ANOVA and Tukey LSD test. The fracture interface between filler and resin matrix was then examined by scanning electron microscope. Results and subsequent statistical evidence from DTS (18.6+/-7.6 MPa, silanized versus 11.7+/-2.6 MPa, unsilanized) and CS (85.1+/-29.7 MPa, silanized versus 56.0+/-11.3 MPa, unsilanized) strongly implies that silanization may greatly enhance the mechanical properties of the resin composites. Furthermore, it also shows that both DTS and CS increased proportionally as the filler fraction of the composites increased. However, in the unsilanized groups, DTS decreased (up to 40%) as the filler fraction increased, and CS showed no relevance to the filler fraction at all. As for the influence of aging, it was found that both DTS and CS showed a significant decrease after immersion in 75% ethanol, and silanization heavily correlated with the filler fraction of aged-resin composites. Microscopic examination of the fractured samples showed that failure primarily occurred within the resin matrix per se for silanized composites and adjacent to the filler particles for unsilanized composites. All the evidence points to the conclusion that mechanical properties of aged-resin composites can be greatly influenced by silanization and the filler fraction.

Early debridement and wound coverage in Fournier's gangrene are mandatory to allow patients to return to normal life. Pedicle ALT perforator flaps provide pliable and reliable soft-tissue coverage for large perineoscrotal defects with adequate contour that result in satisfactory function and cosmesis.