Coclass of the second 3-class group

Trends in the most cited articles in shoulder surgery, 1900–2019

The aim of this study was to investigate the effect of piezoelectric surgery (piezosurgery) on soft tissue in open septorhinoplasty. A total of 30 patients (21 females, 9 males; mean age 29.16 ± 8.17 years; range, 18-43 years) who underwent open septorhinoplasty between January 2019 and February 2019 were randomly divided into 2 groups. After the nasal dorsum was opened in all groups, 1 mm tissue under the skin in radix region was taken as punch biopsy. In the first group (classical group, n = 15), the cartilage hump was resected with number 15 scalpel and the bone hump with the help of a chisel. Lateral and median osteotomies were conducted using 4 mm sharp osteotomes. Rasping was performed to dorsum to correct bone deformities. Then, 1 mm punch biopsy was taken from under the skin tissue of the nose back near the radix. In the second group (piezo group, n = 15) hump excision, osteotomies and rasping were performed by piezoelectric surgery. Then, 1 mm punch biopsy was taken from the subcutaneous tissue of the nose back near the radix. Biopsies were examined histopathologically in the light microscope for edema, necrosis, and inflammation. Of the 30 patients presented in this series, 21 were female and 9 were male. In the classical group, edema in the soft tissue was seen in 86.7% of the cases after osteotomy, while this rate was 26.7% in the piezosurgery group. The difference was statistically significant (P < 0.05). Although necrosis was not seen prior to the osteotomy in both groups, the rate of necrosis in the classical group was 13.3% and in the piezo group it was 66.7%. Necrosis was significantly different in the piezosurgery group compared with the classical osteotomy group (P < 0.05). Piezosurgery is not completely harmless to soft tissue. A statistically significant increase in subcutaneous necrosis compared with the classical group can be explained by long-term soft tissue trauma caused by piezoelectric vibrations. We think that developing necrosis may cause problems in late period, especially in patients with thin skin.

e21034 Background: Epidermal growth factor receptor (EGFR) exon 19 deletion (Ex19del) in non-small cell lung cancer (NSCLC) consists of many subtypes, and their sensitivity to tyrosine kinase inhibitors (TKIs) has not been clearly defined. This study aimed to investigate the clinical outcomes of advanced NSCLC patients with different EGFR ex19del subtypes treated with different TKIs. Methods: We retrospectively analyzed stage IIIB-IV NSCLC patients with EGFR Ex19del and first-line TKIs therapy. E746_A750del was defined as classic group, and the others as non-classic group, which was further divided into subgroups according to deletion with or without insertion, starting codon or length of deletion. The primary endpoint was progression free survival (PFS). Results: There were 17 Ex19del subtypes identified in 101 patients. The frequency of E746_A750del was 64.4% (65/101), and the top three frequent non-classic subtypes were L747_T751del (6.9%, 7/101), L747_P753delinsS (5.9%, 6/101) and E746_S752delinsV (5.0%, 5/101). In all patients, the median PFS (mPFS) of first-line TKIs in classic and non-classic groups were 14.3 months (m) and 19.3 m ( p &gt; 0.05). In non-classic group, the mPFS in deletion with insertion (delins) and without insertion subgroups were 25.3 m and 11.2 m; in deletion starting with E746 and with other codon subgroups were 29.7 m and 19.3 m; and in deletion length of 15 nucleotides (n) and of other length subgroups were 11.2 m and 25.3 m. The mPFS of these non-classic subgroups were not statistically different with that of classic group ( p &gt; 0.05). In all patients, the mPFS of first-line therapy with the 1st, 2nd and 3rd generation TKIs were 17.4 m, 15.6 m and 20.5 m, respectively ( p＞0.05); in classic group, the mPFS were 14.3 m, 16.9 m and 20.5 m, respectively ( p＞0.05). However, in non-classic delins subgroup (29.7 m, 15.6 m and 11.9 m) and in deletion length of ≥18 n subgroup (25.3 m，12.3 m and 11.9 m), the 1st generation TKIs had an insignificantly longest mPFS ( p＞0.05). When resistant to 1st or 2nd generation TKIs, patients in classic group showed a trend of higher incidence of T790M mutation than non-classic group (72.0% vs 43.8%, p = 0.070). In multivariant analysis, pleural metastasis (PM) had interaction with Ex19del grouping, warranting stratification analysis. In patients without PM, the mPFS of first-line TKIs in classic group was significantly shorter than non-classic group (13.8 m and 29.7 m, p = 0.026). However, in patients with PM, the mPFS of classic group was numerically longer than non-classic group (16.9 m and 11.7 m, p &gt; 0.05), with the shortest mPFS in non-classic without insertion subgroup, and in non-classic with 15 n deletion subgroup. Conclusions: In advanced NSCLC patients with EGFR Ex19del, the efficacy of first-line TKIs therapy was affected by the presence of pleural metastasis, Ex19del subtypes and different generation of TKIs.

Classical rapid sequence induction and intubation (RSII) is used to reduce pulmonary aspiration, but it increases the risk of hypoxemia. Apneic oxygenation (ApOx) has been studied to prolong safe apneic time, and to decrease the incidence of hypoxemia in adults. The aim of this study was to investigate the effectiveness of ApOx via low-flow nasal cannula to reduce the incidence of hypoxemia in pediatric rapid sequence induction. This prospective single-blind randomized controlled trial included patients aged 0-7 years, American Society of Anesthesiologists (ASA) physical status 1 to 3, who underwent elective or emergency surgery under general anesthesia with rapid sequence induction during February 2020 to March 2021. Participants were randomized to the ApOx group or the classical rapid sequence induction group. The ApOx group received oxygen flow via regular nasal cannula, as follows: 1 liter per minute (LPM) in age 0-1 month, 2 LPM in age 1-12 months, and 4 LPM in age 1-7 years. The classical group did not receive oxygen supplementation during intubation. The primary outcome was the incidence of hypoxemia, defined as oxygen saturation (SpO2) ≤92%. Sixty-four participants were recruited. The incidence of hypoxemia in both groups was 8 of 32 participants (25%) (P=1.000). Among desaturated patients, the median time to desaturation was 29.5 and 35 seconds in the ApOx and classical groups, respectively (P=0.527). The median lowest SpO2 was 91% and 88.5% in the ApOx and classical groups, respectively (P=0.079). In non-desaturated patients, the median time to successful intubation was 40.5 and 35.5 seconds in the ApOx and classical groups, respectively (P=0.069). In this small sample study, ApOx using age-adjusted low-flow nasal cannula was ineffective for reducing the incidence of hypoxemia in pediatric RSII. Thai Clinical Trials Registry TCTR20210802002.

Background. This study aims to evaluate and compare the results of inguinal herniorrhaphy with mesh in classic and preperitoneal method. Methods. Our study community includes 150 candidate patients for inguinal herniorrhaphy with mesh. Totally, 150 candidate patients for inguinal herniorrhaphy were randomly divided into two groups: (1) classic group in which the floor of the canal was repaired and the mesh was located on the floor of the canal and (2) preperitoneal group in which the mesh was installed under the canal and then the floor was repaired. Results. The frequency of recurrence was 10 (13.3%) and 2 (2.66%) in the classic and preperitoneal group, respectively. The frequency of postsurgical pain was 21 (28%) in the classic group and 9 (12%) in the preperitoneal group. The postsurgical hematoma was observed in 7 (9.3%) and 9 (12%) in the classic and preperitoneal group, respectively. Also, the frequency of postsurgical seroma was 8 (10.7%) and 1 (1.3%) in the patients treated with the classic and preperitoneal method, respectively. Conclusion. The findings of the present study demonstrated that the preperitoneal method is a more suitable method for inguinal herniorrhaphy than the classic one because of fewer complications, according to the findings of this study.

The recurrence rate of anal fistula following classic surgery is a common issue. The purpose of the present study was to compare the recurrence rate of anal fistula following classic surgery (fistulectomy or seton) and proximal anal sinus resection (PASR) in a cohort study. From May 2016 to May 2018, 106 patients who did the anal fistula surgery (classic or PASR) were studied with 2 groups; 74 patients were allocated to the classic surgery group and 32 patients were allocated to the PASR group. Fifty-two patients were excluded because they did not meet the inclusion criteria. We analyzed the recurrence rate of anal fistula, wound healing time, surgical complications, and duration of pain. Patient characteristics, grouped by surgical approach, showed no significant difference. There was a significant difference in the recurrence rate between the classic surgery group and the PASR group (16.2% vs. 0%, P<0.05). There was no significant difference in the surgical complications in the 2 groups (P>0.05). The mean healing time in the 2 groups was not significantly different; 41.6 days in the classic group (P>0.05) and 40.8 days in the PASR group. Our results also found no significant difference in the duration of pain between the 2 groups; 5.1±1.5 days in the classic group and 5.0±1.0 days in the PASR group (P>0.05). PASR was found to have a lower recurrence rate of anal fistula and did not increase the risk of complications. Therefore, PASR should be considered as a first line of treatment for patients at risk of anal fistula recurrence.

The purpose of this study was to introduce a new surgical technique for pedicled TRAM flap that removes a part of the rectus abdominis muscle inserting into ribs, and to analyze this technique in comparison with classical pedicled TRAM flap. A retrospective review of patient charts from May 2006 to February 2016 was performed. The patient group that underwent the removal of the part of the rectus abdominis that inserts into the thorax (partial muscle resection; PMR group) was compared with the group that did not undergo this muscle resection (Classical group). The complications and aesthetic effects of surgery between the two groups were analyzed. There were 34 patients in the classical group and 28 in the PMR group. There were no significant differences in postoperative complications between these two groups. The rates of fat necrosis were 32.1% in the PMR group and 36.1% in the classical group. The postoperative aesthetic outcome of the inframammary fold showed no significant differences in outcome between the classical and PMR groups. However, all items received higher scores in the PMR group. The authors' new surgical method was associated with a positive cosmetic effect of improving inframammary fold aesthetics and could thus represent a new option for pTRAM breast reconstruction.

“Benign” lactic acidosis is common in adolescents and children following congenital heart surgery

Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS): Short-term outcome, functional changes in the future liver remnant, and tumor growth activity

By a classical group we mean one of the groups GLJ(R), GLn(C), GL,(H), U(p, q), OQ(C), O(p, q), SO*(2n), Sp21(C), Sp2n(R), or Sp(p, q). Let G be a classical group and L its Lie algebra. For each x E L we determine the closure of the orbit G x (for the adjoint action of G on L). The problem is first reduced to the case when x is nilpotent. By using the exponential map we also determine the closures of conjugacy classes of G. 0. Introduction. Let G be a classical real linear Lie group (see ?1 for precise definition) and L its Lie algebra. There are ten infinite series of such groups and we use indexj (1 s j s 10) to label these series. G acts on L via the adjoint representation and on itself by conjugation. The classification of orbits of G in L and the classification of conjugacy classes of G are now well known; see for instance [1] and the references mentioned there. In this paper we determine the closure of an arbitrary orbit 0 and the closure of an arbitrary conjugacy class C(. (The topological terms refer to the ordinary topology of G and L.) For complex groups this problem was solved by M. Gerstenhaber [5,6]. An independent proof for complex special linear groups was given by J. Dixmier [2], and for complex orthogonal and symplectic groups by W. Hesselink [7] and the author [3]. In fact the results of Gerstenhaber and Hesselink are more general since they consider classical groups over any algebraically closed field. In our previous paper [4] on the same subject we have announced the main result of the present paper. For the sake of convenience we repeat all the necessary definitions so that the reader does not need to consult [4] except for the proofs of Theorem 1 (?2), Theorem 2 (?3), and the necessity part of Theorem 5 (?7). The two problems, closures of orbits and closures of conjugacy classes, are closely related. We give a full treatment to the first problem while the second is treated in a cavalier fashion in ?13. In this introduction we shall comment only on the first problem. In ?2 we state the Centralizer Theorem (Theorem 1) which asserts that the centralizer CG(x) in G of a semisimple element x E L is a direct product of classical groups. The direct factors of CG(x) may belong to different series of classical groups. Received by the editors May 5, 1980 and, in revised form, January 22, 1981. 1980 Mathematics Subject Classification. Primary 20G20; Secondary 22E46, 22E60.

In this paper we establish a result on the subgroup structure of classical groups over algebraically closed ®elds, and use this to give a new proof of a fundamental theorem of M. Aschbacher on subgroups of ®nite classical groups. Let V be a ®nite-dimensional vector space over an algebraically closed ®eld K, and let G be one of the classical algebraic groups SL V †; Sp V † or SO V †. Our result is a reduction theorem concerning the subgroups of G: we de®ne a certain collection C of natural proper subgroups of G, and prove that any closed (®nite or in®nite) subgroup of G either lies in a member of C, or is, roughly speaking, a simple group acting irreducibly on V . Aschbacher's result is an analogous reduction theorem for subgroups of ®nite classical groups. We obtain this as a relatively easy consequence of our main result by taking ®xed points under the action of a Frobenius morphism, using a standard process involving Lang's theorem. The proof of the main result uses elementary linear algebra, together with a few basic facts from the theory of algebraic groups. Various complications which arise in the ®nite group setting in [As] become much more straightforward in the algebraic group setting; in particular, questions involving extension ®elds do not occur, and issues of conjugacy are easily settled. When we descend to ®nite Invent. math. 134, 427 ± 453 (1998)

Pilonidal sinus (PS) remains a relevant surgical problem due to its high recurrence rate (13.3-95.2%), postoperative complications (4.2-25.0%), and prolonged treatment period (30-70 days). The lack of a universally accepted treatment strategy necessitates the search for optimal surgical techniques. A promising approach is the cutaneous-subcutaneous-fascial plasty with a rotational flap, which helps to reduce tissue tension and redistribute soft tissues in the sacrococcygeal region. Objective. To develop a mathematical model to justify the shape and parameters of the surgical access for pilonidal disease treatment using the cutaneous-subcutaneous-fascial plasty method with a computational solution. Materials and Methods. We analyzed 50 pediatric cases of PS in patients aged 15-18 years who underwent inpatient treatment at the Municipal Children's City Clinical Hospital in Chernivtsi between 2020 and 2023. The patients were divided into two groups: Group I (n=35): Underwent classical technique (excision of PS with suturing of wound edges to the sacrococcygeal fascia). Group II (n=15): Underwent subcutaneous fascial flap plastic surgery using a customized mathematical model. The following parameters were analyzed: healing time, pain intensity (assessed by visual analog scale), duration of surgery, length of hospital stay, postoperative complications. Results. The mathematical model is based on geometric analysis and optimization of the incision shape to minimize the excision area while ensuring adequate coverage of pathological fistulous openings. An optimal quadrilateral shape was used instead of the traditional rhomboid shape. Spatial relationships of pathological tracts and rotational flap closure were considered. The primary incision was optimized to reduce tissue tension and decrease the risk of postoperative complications. On day 1, pain intensity in group II was more than twice as low as in the classic surgery group. On the second and third days, pain intensity was nearly 70% lower in the SFFP group compared to the classic closure group. Hospital stay was 17% shorter in the SFFP group and pain duration was 40% less than in the classic group. Wound healing time was almost 70% shorter in group II compared to group I. Conclusions. 1. The developed model for spatial justification of surgical access in pilonidal sinus treatment demonstrated the effectiveness of delta-shaped incisions, whose parameters are determined by the location of the external fistulous openings relative to the intergluteal fold. A precisely calculated incision contour allows for optimized plastic surgery procedures, reducing postoperative complications by 3.75 times and improving overall treatment outcomes. 2. The proposed method reduces postoperative pain intensity by 70% and pain duration by 40% in pediatric patients. In addition, it reduces wound healing time by a factor of 3, making subcutaneous fascial flap plastic surgery with mathematical model-based calculations a recommended technique of choice for pilonidal sinus treatment.

Surgical treatment of preauricular sinus in children: Temporalis muscle fascia anchoring suture

The efficiency and optimal combination strategies of immune checkpoint inhibitors (ICI) in lung adenocarcinoma (LUAD) patients with epidermal growth factor receptor (EGFR) other mutations apart from 19del/L858R (classical), which account for up to 20% EGFR mutations, remains unclear. In this retrospective multi-center study, a total of 656 EGFR-mut patients receiving ICI alone or with other therapies from several centers were integrated as three independent cohorts and divided into uncommon, classical, and 20ins groups. In all three cohorts, patients in the EGFR uncommon group had longer median progression-free survival (mPFS) than classical or 20ins groups, and longer median overall survival (mOS) than classical group, which were more significant in programmed cell death-ligand 1 (PD-L1) ≥ 1% subgroup. For uncommon group, the mPFS and mOS of ICI alone were similar to ICI plus chemotherapy, but longer than chemotherapy. For 20ins group, the mPFS of ICI plus chemotherapy was longer than ICI alone or chemotherapy. For classical group, ICI plus chemotherapy and anti-angiogenic therapies or plus chemotherapy were found to prolong mPFS than chemotherapy. The tumor mutation burden (TMB) of the uncommon group was relatively higher than classical or 20ins group, with similar PD-L1 expression across them. Uncommon group had more M1 macrophages, less Tregs and M2 macrophages infiltrations than classical or 20ins group. Conclusively, LUAD patients with different EGFR mutations responded to ICI diversely, deserving customed stratification of ICI-based therapies according to specific mutations. EGFR uncommon mutations were linked to relatively higher TMB and heterogeneous immune cell infiltrations.Supplementary InformationThe online version contains supplementary material available at 10.1186/s43556-025-00331-1.

The aim of this study was to compare dentoskeletal effects and patient's satisfaction with a modified twin-block (clear twin-block) and classic twin-block. A total of 62 patients with skeletal class II malocclusion contributing to mandibular retrognathism with a minimum of 4 mm overjet, the FMA angle between 20 to 25 degree and being in stage 2 to 3 of cervical vertebral maturation participated in this study. Subjects were randomized in 1:1 ratio to classic and clear twin-block. Lateral cephalograms were taken at two stages-Pre- and post-treatment (when the overjet reduced to 1 to 0 mm). All the measurements were done with Dolphin software version 10.5. Four months after the start of the treatment the patients were asked to fill the questioners regarding their compliance from the appliances. Both classic and clear twin-block groups showed mandibular advancement without statistically significant difference between them. However, SNB angle increased slightly more in clear group than the classic one. "Headgear effect" is not statistically noticeable in both groups. However, SNA angle decreased slightly more in classic group. Increased in lower incisors proclination was happening in both groups, but in a clear group, this increase was significantly less. Overbite reduction could be seen in both groups with significantly more reduction in the classic group. Increase in lower incisors proclination was less in clear group than the classic one. Overbite reduction was more in the classic group than the classic one. Clear twin-block is more beneficial in skeletal class II patients with proclined lower incisors and vertical growth pattern.