Dissection Method Research Articles

Micro-CT study of human laryngeal structures using phosphotungstic agent staining.

Traditional dissection methods are primarily limited by challenges in identifying minute structures, which can lead to irreversible tissue damage. Anatomical observation of the larynx is particularly challenging in educational and clinical settings owing to its microscopic structures and complex three-dimensional (3D) nature, making it difficult to dissect. Therefore, this study aimed to demonstrate that micro-computed tomography (micro-CT) imaging of the larynx can serve as an effective alternative for educational and clinical purposes, overcoming these limitations. Three laryngeal specimens were obtained from cadavers, stained with a phosphotungstic acid-based contrast agent, and imaged using enhanced micro-CT. The resulting images were reconstructed in three dimensions, allowing for a detailed 3D observation of the specimens. Phosphotungstic contrast-enhanced micro-CT provided comprehensive anatomical information on laryngeal structures, including muscles, nerves, arteries, and vocal folds. This study demonstrates the high effectiveness of micro-CT in producing detailed structural images of the larynx, enabling 3D observation of even the smallest anatomical structures. These images can be applied in both educational and clinical settings to analyze the human larynx, effectively overcoming the limitations of traditional dissection methods. This approach facilitates the analysis of laryngeal structures that are otherwise difficult to observe with the naked eye.

Outcomes of tunnelled cuffed centrally inserted central catheter removal: A retrospective cohort study.

Most children with cancer will require a central venous access device (CVAD) to administer cancer treatment. A commonly used CVAD is a tunnelled cuffed centrally inserted central catheter (TC-CICC). There is little information available to guide best practice when removing this type of CVAD. At our institution, TC-CICCs are removed by using either the traction or dissection methods. This study will describe the outcomes associated with each technique. A retrospective cohort study was undertaken at a quaternary children's hospital in Melbourne, Australia. Data related to characteristics of TC-CICC removal success, post-removal complications and an economic evaluation were carried out. There were 149 patients who underwent traction removal and 100 who had their TC-CICC removed using the dissection technique. In the traction group, 136/149 (91%) patients had their device successfully removed on the first attempt, whereas 99/100 (99%) were removed on the first attempt with dissection. Of the 136 successful traction removals, cuff status was documented in 72 cases. The cuff remained in situ in 46/72 (64%) cases, and six of 72 (8%) patients experienced a complication. There were no documented cases of cuff retention in the dissection group. In the 2019-2020 financial year, the estimated average cost of traction removal was A$387, whereas the estimated average cost of day case surgery was A$2560. This study has highlighted that the traction technique is a safe, efficient and cost-effective approach to TC-CICC removal. Further research is required to understand the patient and family experience of TC-CICC removal.

Randomized Controlled Study of Ultrasonic Scalpel Tonsillectomy Versus Cold Dissection Tonsillectomy

Background The purpose of this study is to compare two different techniques of tonsillectomy, the ultrasonic scalpel, and the cold dissection tonsillectomy. In this study, the duration of the surgery, intraoperative blood loss, post-operative pain and post-operative hemorrhage rate will be compared. Material and Methods This is a randomized controlled study involving 72 patients within the age of 3-40 years old with history of recurrent tonsillitis or tonsillar hypertrophy with obstructive symptoms. The patients are randomized to have both tonsils removed either by cold dissection method or ultrasonic scalpel method. During the surgery, operative time and intra-operative blood loss will be documented. The post-operative pain score was documented by the patient using the visual analog pain score. Post-operative hemorrhage will also be documented if present. Results The data collected will be analysed statistically. The duration of surgery for ultrasonic scalpel tonsillectomy was significantly shorter (mean 14.11 minutes versus 29.09 minutes, p <0.001) and intra-operative bleeding was also significantly lower (mean 9.58 ml versus 87.57 ml, p <0.001). There were no significant mean differences of post-operative pain score between cold dissection and ultrasonic scalpel in first 6 hours up to day 6 of post-surgery. However, post-operative pain score for cold dissection tonsillectomy was significantly less on the 7th day of post-surgery. Conclusions There was no documented post-operative hemorrhage. Ultrasonic scalpel tonsillectomy is more superior compared to cold dissection tonsillectomy in terms of operative time and intra-operative blood loss, however there is no difference in the post-operative pain score. Bangladesh Journal of Medical Science Vol. 23 No. 04 October’24 Page : 1142-1148

Evolution of overall survival (OS) after curative-intent lung cancer surgery in a population-based Mississippi Delta cohort.

278 Background: Surgical resection is the most important curative modality for patients with lung cancer, with long-term OS influenced by both surgical quality and cancer biology. We compared surgical care and outcomes over 4 eras in the population-based Mid-South Quality of Surgical Resection (MS-QSR) cohort, an ongoing regional surgical and pathologic quality improvement (QI) dissemination and implementation project. Methods: We implemented a surgical lymph node collection kit and a novel pathology gross dissection method across 12 hospitals encompassing >95% of lung cancer resections in 5 contiguous Dartmouth Hospital Referral Regions. We analyzed the MS-QSR cohort at 5-year intervals characterized by stepped-wedge implementation of specific QI interventions: Era 1 (2004-2008; baseline, no QI), Era 2 (2009-2013; quality feedback, surgical QI pilot), Era 3 (2014-2018; surgical QI implementation), and Era 4 (2019-2023; combined surgical QI and pathology QI implementation). We used standard statistical methods to compare surgical quality; Kaplan-Meier plot, log-rank test, and Cox proportional hazards model with Era 1 as reference to compare OS across eras. Results: Of 7240 resections, 14%, 31%, 29%, and 26% were performed in Eras 1-4, respectively (Table). Attainment of the stringent International Association for the Study of Lung Cancer (IASLC) definition of complete resection increased from 0% in Era 1 to 32% in Era 4; attainment of the American College of Surgeons Operative Standard 5.8 (ACS_OS 5.8), the current US definition of surgical quality, improved from 4% in Era 1 to 67% in Era 4; 120-day mortality rate decreased from 10% to 4% (p<0.0001 for all comparisons). With median follow-up of 4.7, 5.5, 5.6, and 2 years for Eras 1-4, 3-year OS rates were 60%, 64%, 70%, and 79%; 5-year OS rates were 48%, 52%, 58%, and 70%, respectively (p<0.0001). The Hazard Ratio (HR) for mortality decreased from 0.91 (95% CI: 0.8-0.99) in Era 2 to 0.49 (95% CI: 0.43-0.56) in Era 4. Conclusions: Surgical quality and OS sequentially improved in this diverse, high-risk population-based Mississippi Delta surgical resection cohort. We are evaluating the full range of factors associated with this striking OS improvement. Ongoing work is exploring biologic correlates to this improvement. Variable Era 1 N= 988 Era 2 N=2235 Era 3 N=2107 Era 4 N=1910 Median age (Q1, Q3) 68 (62, 74) 68 (62, 74) 68 (61, 74) 68 (61, 74) Male sex (%) 514 (52%) 1234 (55%) 1082 (51%) 977 (51%) Black race 221 (22%) 416 (19%) 450 (21%) 451 (24%) Attained ACS_OS 5.8 40 (4%) 533 (24%) 1050 (50%) 1272 (67%) IASLC complete resectionUncertain completeness 0 (0%)930 (94%) 194 (9%)1932 (86%) 435 (21%)1594 (76%) 606 (32%)1227 (64%) 120-day mortality 100 (10%) 197 (9%) 139 (7%) 72 (4%) 5-year OS 48 (45-51) 52 (50-55) 58 (56-60) 70 (66-74) HR (95% CI) Reference 0.91 (0.83-0.99) 0.75 (0.69-0.83) 0.49 (0.43-0.56)

Enhancing protein signal detection in asexual and viviparous pea aphids: A guided protocol for tissue dissection and proteinase K treatment

Aphids, as hemipteran insects, reproduce via parthenogenesis and viviparity, resulting in rapid and exponential offspring production. To investigate the molecular mechanisms underlying parthenogenetic viviparity in asexual aphids, precise protein detection through immunostaining is essential. Our previous research demonstrated the need for proteinase K (PK) treatment to improve tissue permeability, enabling antibodies targeting the germ-cell marker Ap-Vas1 to access gastrulating and later-stage embryos. However, optimal PK digestion protocols have not been thoroughly explored. In this study, we propose strategies to optimize PK digestion conditions for early, middle, and late-stage pea aphid embryos, which have varying tissue thicknesses. Additionally, we extend the application of PK treatment to salivary glands, a representative somatic tissue, by optimizing conditions for antibody penetration against the salivary gland marker C002. To enhance spatial precision in signal detection, we provide a detailed protocol for tissue dissection specific to pea aphids, focusing on the preservation of tissue integrity. These comprehensive guidelines, covering tissue dissection and PK titration, are expected to improve the specificity and intensity of protein signals in pea aphids and other aphid species.•Provide aphid-specific dissection methods to obtain intact embryos and salivary glands.•Present strategies for optimizing PK treatment conditions across different tissue types.

Double Anterior Interventricular Arteries: Prevalence and Morphological Types-A Dissection Study.

This study aimed to evaluate the prevalence of double anterior interventricular artery using the dissection method. A retrospective study was conducted between 2010 and 2024 at the Anatomy and Embryology Laboratory of the Victor Babes University of Medicine and Pharmacy in Timisoara. Eighty cases were analyzed for morphological variants of the coronary arteries, especially the anterior interventricular artery. Two cases of double anterior interventricular arteries were identified. In the first case, the two anterior interventricular arteries originated from the anterior interventricular branch of the left coronary artery. In the second case, an additional anterior interventricular artery with an aortic origin was found running along the lower third of the two interventricular grooves. This shape has not been described before in the specialized literature. Knowing the potential variations of the double left anterior descending artery is critical for interpreting cardiac imaging and choosing and planning percutaneous and surgical reperfusion strategies.

Development and Characterization of Primary Brain Cultures from Japanese Quail Embryos.

Cell cultures play a crucial role in neuroscience research, facilitating the elucidation of the complexities of cellular physiology and pathology. The relative simplicity in producing cultures and the accessibility to cells that the cultures provide, in contrast to in vivo settings, allow users to manipulate and monitor cells more easily at higher throughputs and lower costs. These are ideal for screening purposes and electrophysiological characterizations. Despite the prevalence of methodologies for producing brain cultures from various animal models, rodents in particular, approaches for culturing neurons (and glia) from birds are less established or completely absent as in the case of the Japanese quail model. Here, we present a unique culturing protocol for brain cells (e.g., neurons at different maturation levels, such as progenitor cells, excitatory and inhibitory neurons, microglia, and endothelial cells) from entire forebrains of Japanese quail embryos for high-throughput screening of viral vectors in vitro and other various purposes. Following dissection and digestion methods uniquely suited for avian brains, we tailored the growth media and culturing surface to allow the survival of quail brain cultures for more than three weeks in vitro. Key features • We introduce a detailed protocol for producing primary brain cultures from quail embryos' forebrains for up to 30 days. • We show that the cultures support in vitro viral transfections effectively. • We demonstrate the use of the cultures for rapid (days) screening for suitable viruses for quail brain cells, electrophysiological characterizations, and single mRNA sequencing.

OCCURRENCE OF LAMPROGLENA PULCHELLA (NORDMANN, 1832) (COPEPODA: LERNAEIDAE) IN SOME CYPRINID FISH FROM OHRID LAKE (MACEDONIA)

The representatives of the class Copepoda are of great importance in fish pathology. Lamproglena pulchella (Nordmann, 1832) (Copepoda: Lernaeidae) is an ectoparasite of many cyprinid fish, widespread in Europe up to the Aral Sea. During the long-term investigations of 12 species of cyprinid fish from the Lake Ohrid, a total of 7 specimens of Lamproglena pulchella was found in 5 fish from 4 fish species: Rutilus ohridanus, Squalius squalus, Scardinius knezevici and Chondrostoma ohridanus. Only fresh fish were subjected to routine parasitological examinations, dissection, and observation methods. Parasite identification was performed morphologically, based on the character of their maxilla, maxilliped, antennae, legs and uropods, using a referent key for determination. The 3 parasite specimens were found in two samples of Rutilus ohridanus, followed by 2 parasite specimens in Squalius squalus and one specimen in Scardinius knezevici and Chondrostoma ohridanus, each. These parasites attach to gills and general body surfaces by their maxilla and maxilliped, causing wounds that become the spots of secondary infection by microbes. The damage caused by this parasite is more pronounced in aquaculture systems. We did not find many parasites, but considering the potential danger that Lamproglena pulchella poses to the fish health, we point out the need to monitor infestations with this parasite and take preventive measures so that the parasite does not spread massively among fish in Lake Ohrid and to prevent its introduction into other waters in Macedonia. The record of Lamproglena pulchella in all four cyprinid fish in the present study is considered as the first from the Ohrid Lake. At the same time, Rutilus ohridanus, Scardinius knezevici and Chondrostoma ohridanus represent new hosts for this parasite, worldwide.

Comparative Analysis of the Distribution of the Main Helminthiasis Causative Agents in the Absheron Peninsula and Khizi Region

The research was conducted on sheep farms located in the Absheron region in 2015-2020. The major helminth fauna in sheep in the private and farmer farms of the Absheron region was found to consist of helminth species: Fasciola hepatica, F. gigantica, Dicrocoelium lanceatum, Paramphistomum cervi, Moniezia expansa, M. benedeni, Taenia hydatigena, T. ovis, Multiceps multiceps, Echinococcus granulosus, Protostrongylus hobmaieri, P. kochi, P. railleti, Muellerius capillaris, Trichocephalus ovis, Chabertia ovina, Haemonchus contortus, Dictyocaulus filaria. The extensiveness and intensity of the distribution of the 18 main helminths detected in the region by the complete helminthological dissection method in 19 research areas (14 in the Absheron peninsula: Zire, Hovsan, Mashtagha, Mehdiabad, Gobu, Sulutepe, Z. Taghiyev, Fatmayi, Novkhani, Mammadli, Khirdalan, Jeyranbatan, Mushvigabad, Guzdek; 5 in the Khizi region: Yeni Yashma, Shorabad, Altiaghaj, Gizilgazma, Tudar) are described in tables. Higher invasion levels were identifi­ed for T. ovis(43.2%, 1-53 samples), E. granulosus (39.2%, 1-18 samples), H. contortus (35.0%, 2-56 samp­les), and they we­re con­si­de­red the do­mi­nant hel­minth spe­ci­es of the re­gi­on. Ba­sed on the complete helminthological dissection, in the Absheron peninsula, IE was 17.7% and II was 1-64 samples, and in the Khizi district, IE was 29.0% and II was 1-83 samples. Thus, complete helminthological examination methods allowed us to conclude that the infection rate in the Khizi region is higher than in the Absheron Peninsula. This makes it necessary for farmers and veterinarians to start veterinary sanitary measures, both prophylactic and treatment measures against helminths in the Khizi district.

Pain Related Secondary Outcomes Associated with Cold Tonsillectomy and Role of Topical Sucralfate in Mitigating Their Severity: A Comparative Observational Study

The aim of the study was to assess the pain related secondary outcomes associated with cold tonsillectomy and role of topical sucralfate to reduce their intensity. Material and Methods: This comparative observational study was conducted in the ENT department of the Pakistan Institute of Medical Sciences (P.I.M.S.), affiliated with the Shaheed Zulfiqar Ali Bhutto Medical University (SZABMU), Islamabad, spanned from December 2016 to August 2017, following institutional ethical approval. The study comprised 112 patients with recurrent tonsillitis, evenly assigned to group A (subjects) and group B (control). Tonsillectomy, employing the cold steel dissection method, was administered to all patients. Group A received 10ml of topical sucralfate every 8 hours on the zero and first postoperative days, while group B received a placebo. Comparative analysis between the groups focused on pain-related secondary outcomes, including referred otalgia and the ability to initiate a regular oral diet on the morning of the first postoperative day. SPSS version 21 facilitated data analysis, with significance set at p < 0.005. Results: In group A, the mean age was 12.14±5.17, and in group B, it was 11.53±3.95, resulting in an overall mean age of 11.83±4.59 for both groups. Among 112 patients, 55.4% (n=62) were male, and 44.6% (n=50) were female. The frequency of referred earache was significantly lower in group A (15, 26.8%) compared to group B (25, 54.6%) [n1=n2=56, p=0.049]. Intolerance to start a normal diet was significantly lower in group A (17, 30.4%) compared to group B (39, 69.6%) at the first post-op day [n1=n2=56, p=0.034].Conclusion: Utilizing topical sucralfate alongside other pain management strategies proves to be an effective approach in reducing the intensity of pain related secondary complication i.e. referred otalgia and intolerance to oral intake among patients undergoing tonsillectomy using the cold steel dissection technique.

Linking excess entropy and acentric factor in spherical fluids.

Introduced by Pitzer in 1955, the acentric factor (ω) has been used to evaluate a molecule's deviation from the corresponding state principle. Pitzer devised ω based on a concept called perfect liquid (or centric fluid), a hypothetical species perfectly adhering to this principle. However, its physical significance remains unclear. This work attempts to clarify the centric fluid from an excess entropy perspective. We observe that the excess entropy per particle of centric fluids approximates -kB at their critical points, akin to the communal entropy of an ideal gas in classical cell theory. We devise an excess entropy dissection and apply it to model fluids (square-well, Lennard-Jones, Mie n-6, and the two-body abinitio models) to interpret this similarity. The dissection method identifies both centricity-independent and centricity-dependent entropic features. Regardless of the acentric factor, the attractive interaction contribution to the excess entropy peaks at the density where local density is most enhanced due to the competition between the local attraction and critical fluctuations. However, only in centric fluids does the entropic contribution from the local attractive potential become comparable to that of the hard sphere exclusion, making the centric fluid more structured than acentric ones. These findings elucidate the physical significance of the centric fluid as a system of particles where the repulsive and attractive contributions to the excess entropy become equal at its gas-liquid criticality. We expect these findings to offer a way to find suitable intermolecular potentials and assess the physical adequacy of equations of state.

552. COMPARING ROBOTIC ESOPHAGECTOMY TO VIDEO-ASSISTED THORACOSCOPIC ESOPHAGECTOMY FOR ESOPHAGEAL SQUAMOUS CELL CARCINOMA: RESULTS FROM THE REVATE RANDOMIZED CLINICAL TRIAL

Abstract Background The treatment of esophageal squamous cell carcinoma (ESCC) includes dissecting lymph nodes along the recurrent laryngeal nerve (RLN), which is oncologically important but is technical demanding. Vocal cord palsy as a result from RLN injury, carries significant morbidities. This randomized clinical trial (RCT) compared the efficacy and safety of robotic esophagectomy (RE) and video-assisted thoracoscopic esophagectomy (VATE) for performing RLN lymph node dissection (LND) Methods We conducted a multicenter RCT(NCT03713749) from November 2018 to March 2022, enrolling patients with ESCC who required McKeown esophagectomy. The primary endpoint was to determine the success rate of left RLN LND. Success was defined as the removal of lymph nodes confirmed by pathology, without causing permanent nerve palsy (duration > 6 months). Secondary endpoints encompassed perioperative and oncological outcomes. Results The per-protocol analysis included data from 203 patients (RE group: n=103; VATE group: n=100). The primary endpoint was achieved in 88.3% of the RE group and 69% of the VATE group (p<0.001). Additionally, the RE group had a higher mediastinal lymph node harvest (16 [12−22] versus 14 [10−20], p=0.04), shorter thoracic operating time (110 [89−137] min versus 124[103.5−154] min, p=0.004), and earlier drainage removal (4 [3−7] days versus 6 [4−9] days, p=0.007) compared to the VATE group. The two study arms exhibited comparable complication rates with no recorded in-hospital deaths in either group. Conclusion This multicenter trial demonstrates the effectiveness of RE in enhancing the feasibility and safety of RLN LND in ESCC. Additionally, RE leads to an improved mediastinal lymphadenectomy, shorter operating times, and earlier removal of drainage.

A Comparative Study Between Coblation-Assisted Tonsillectomy and Conventional Dissection and Snare Tonsillectomy.

Background Tonsillitis is a vastly prevalent disease, accounting for the majority of outpatient visits. The dissection and snare method has been the predominant approach for tonsillectomy for centuries. Coblation-assisted tonsillectomy offers advantages such as faster healing, shorter surgery duration, minimal blood loss, and fewer postoperative complications. Therefore, a study was conducted to evaluate the distinctions and compare the efficacy of traditional dissection and coblation-assisted tonsillectomy. Materials and methods Patients were divided into two groups: Group I was operated on using the conventional method, and Group II was operated on using the coblation method. Both groups were then assessed for intraoperative time, intraoperative bleeding, postoperative pain, and postoperative complications. Results Coblation-assisted tonsillectomy patients had a significantly shorter mean duration for the procedure and significantly lower blood loss in comparison to the conventional method. There were no statistically significant variations in the incidence of postoperative complications. Coblation-assisted tonsillectomy patients experienced considerably higher pain scores on various postoperative days. Conclusion Coblation-assisted tonsillectomy had the added advantage of reduced intraoperative blood loss, shorter surgical time, and faster recovery postoperatively. Coblation-assisted tonsillectomy can be considered an effective alternative to conventional methods. However, it's important to consider factors such as cost-effectiveness and surgeon experience. Further research involving larger sample sizes and longer follow-up periods could yield more insightful knowledge of the outcomes of these two tonsillectomy techniques.

Application of tissue pneumoperitoneum technique around lymph nodes in thoracoscopic lung cancer resection.

Thoracoscopic surgery is a primary treatment for lung cancer, with lobectomy and mediastinal lymph node dissection being the predominant surgical approaches for invasive lung cancer. While many thoracic surgeons can proficiently perform lobectomy, thorough and standardized lymph node dissection remains challenging. This study aimed to explore a safer and more efficient surgical method for mediastinal lymph node dissection in lung cancer. A prospective randomized controlled study was conducted, involving 100 patients with right lung cancer who were admitted to our hospital from January 2021 to April 2024 and met the inclusion criteria. These patients were randomly divided into an observation group (tissue pneumoperitoneum technique around lymph nodes group) and a control group (conventional surgery group). Thoracoscopic lobectomy and mediastinal lymph node dissection were performed. Intraoperative and postoperative related indicators were observed to validate the effectiveness and safety of the tissue pneumoperitoneum technique around lymph nodes. The observation group showed a significantly shorter lymph node dissection surgery time compared to the control group, with a statistically significant difference (p < 0.05). The number of lymph nodes dissected in the observation group was significantly higher than that in the control group, with a statistically significant difference (p < 0.05). Although the observation group had slightly more mediastinal lymph node stations dissected than the control group, the difference was not statistically significant (p > 0.05). The total drainage volume within three days postoperatively was comparable between the two groups, with no statistically significant difference (p > 0.05). The observation group had shorter chest tube indwelling time and postoperative hospital stay than the control group, with statistically significant differences (p < 0.05). The incidence of surgical complications was similar between the two groups, and there were no perioperative deaths. The tissue pneumoperitoneum technique around lymph nodes is a more efficient method for mediastinal lymph node dissection in lung cancer, demonstrating safety and feasibility, and is worthy of promotion.

Vitrectomy for cases of diabetic retinopathy.

Microvascular complications of diabetic retinopathy (DR) may require surgical intervention in the form of vitrectomy. Since its inception, diabetic vitrectomy has evolved with introduction of better instruments, newer techniques, and smaller port sizes. Common indications for diabetic vitrectomy include nonresolving vitreous hemorrhage, tractional retinal detachment, epiretinal membrane, progression of fibrovascular membranes despite laser therapy, recalcitrant diabetic macular edema, and neovascular glaucoma. Preoperative systemic stabilization is essential prior to planning surgery. Surgical techniques commonly used in diabetic vitrectomy are segmentation, delamination, and rarely en-bloc dissection. Modification in surgical techniques such as chandelier-assisted bimanual dissection and pharmacological adjuvants improve surgical outcomes in these patients. Prognosis in these patients could be improved with early intervention. Studies evaluating the outcome of vitrectomy in patients with early proliferative DR are required to understand the appropriate time of intervention in patients. Treatment aimed at arresting the progression of DR and gene therapy are avenues that need further evaluation. The following review will focus on covering the epidemiology of DR, indications of vitrectomy, preoperative considerations, surgical procedures of diabetic vitrectomy, methods of membrane dissection, pharmacological adjuvants to vitrectomy, outcomes of diabetic vitrectomy, and future directions of diabetic vitrectomy.

Efficacy of a novel traction method: outside-lesion clip-thread method for gastric endoscopic submucosal dissection of lesions of the greater curvature of the upper/middle stomach (with video).

Gastric endoscopic submucosal dissection (ESD) for lesions located on the greater curvature of the upper and middle (U/M) third of the stomach remains challenging, even for experienced endoscopists. Accordingly, we have developed a novel traction technique, termed the outside-lesion clip-thread method (O-CTM). In this method, a clip thread is attached to the healthy mucosa outside the circumferential incision line, and traction is applied to bring the scope and lesion into proximity for ESD. Here, we assessed the efficacy of ESD using the O-CTM compared to ESD without the O-CTM. We retrospectively reviewed data from 63 consecutive patients who underwent gastric ESD for 63 lesions located on the greater curvature of the U/M third of the stomach between September 2015 and April 2024. The primary outcome was the operation time, and secondary outcomes were resection speed, en bloc resection, R0 resection and complications in the O-CTM and without O-CTM ESD groups. Of the 63 included lesions, 37 were resected without the O-CTM between September 2015 and June 2022 (without O-CTM group), and 26 lesions were resected using the O-CTM between July 2022 and April 2024 (O-CTM group). The O-CTM group had significantly shorter operation times (40min vs. 77min, p = 0.01) than the without O-CTM group. The resection speed was also significantly faster (20.1 mm2/min vs. 11.3 mm2/min, p = 0.02). No significant differences in en bloc resection rate, R0 resection rate, and complications were observed. Gastric ESD using O-CTM is beneficial when compared with the ESD without O-CTM in reducing operation time and improving resection speeds for treating lesions located on the greater curvature of the U/M region.

Systematic review of factors related to quality of life in patients with oral cancer: a systematic review.

This study aims to evaluate factors related to quality of life of patients with oral cancer. CNKI, Wanfang, VIP, CBM, Pubmed, Medline, Web of Science, Embase, and The Cochrane Library were searched up to May 2023 for studies that evaluated the quality of life of patients with oral cancer. All the included studies were independently selected, extracted, and rated by two researchers, and results are summarized by qualitative analysis. Twenty-four articles on 2 717 patients were included. Factors related to the quality of life of patients with oral cancer mainly included age, tumor TNM stage, radiochemotherapy, and gender, which could be summarized into three aspects: personal factors, disease-related factors, and surgical factors. More than five studies reported on the analysis of age, gender, tumor TNM stage, pathological stage, neck dissection method, marital status, recurrence, smoking, education level, etc. The results are relatively consistent. The incidence of oral cancer increases, and many factors affected the quality of life. The included literature is a cross-sectional study, and the sample size is limited. The causal relationship between relevant factors and quality of life should be verified using large sample sizes.

Prediction of Drug-Induced Liver Injury: From Molecular Physicochemical Properties and Scaffold Architectures to Machine Learning Approaches.

The process of developing new drugs is widely acknowledged as being time-intensive and requiring substantial financial investment. Despite ongoing efforts to reduce time and expenses in drug development, ensuring medication safety remains an urgent problem. One of the major problems involved in drug development is hepatotoxicity, specifically known as drug-induced liver injury (DILI). The popularity of new drugs often poses a significant barrier during development and frequently leads to their recall after launch. In silico methods have many advantages compared with traditional invivo and invitro assays. To establish a more precise and reliable prediction model, it is necessary to utilize an extensive and high-quality database consisting of information on drug molecule properties and structural patterns. In addition, we should also carefully select appropriate molecular descriptors that can be used to accurately depict compound characteristics. The aim of this study was to conduct a comprehensive investigation into the prediction of DILI. First, we conducted a comparative analysis of the physicochemical properties of extensively well-prepared DILI-positive and DILI-negative compounds. Then, we used classic substructure dissection methods to identify structural pattern differences between these two different types of chemical molecules. These findings indicate that it is not feasible to establish property or substructure-based rules for distinguishing between DILI-positive and DILI-negative compounds. Finally, we developed quantitative classification models for predicting DILI using the naïve Bayes classifier (NBC) and recursive partitioning (RP) machine learning techniques. The optimal DILI prediction model was obtained using NBC, which combines 21 physicochemical properties, the VolSurf descriptors and the LCFP_10 fingerprint set. This model achieved a global accuracy (GA) of 0.855 and an area under the curve (AUC) of 0.704 for the training set, while the corresponding values were 0.619 and 0.674 for the test set, respectively. Moreover, indicative substructural fragments favorable or unfavorable for DILI were identified from the best naïve Bayesian classification model. These findings may help prioritize lead compounds in the early stage of drug development pipelines.

Comparison of the Results of Conventional and Laparoscopic Methods of Lymph Node Dissection Performed in Endometrial Cancer Surgery

Comparison of the Results of Conventional and Laparoscopic Methods of Lymph Node Dissection Performed in Endometrial Cancer Surgery

New anatomical findings in the mandibular body region: Two parts that make up bucco-mandibular space.

Soft tissue spaces not only enable gliding by contraction of the facial muscles, but they also cause drooping of the superficial fat due to gravity in the upright position. This study was performed to clarify the structures around the bucco-mandibular space (BMS) and to apply this anatomical knowledge to clinical practice. Four sides of the face were dissected using a conventional gross anatomical dissection technique, and 10 sides (5 horizontal and 5 frontal sections) of the removed semi-facial soft tissue were dissected using the stretched tissue dissection (STD) method. Histological examination of the mandible was performed on two sides to confirm the findings of conventional gross anatomical dissection and STD. In all cases, both gross dissection and STD revealed that the BMS was composed of two parts. The superficial part was filled with adipose tissue containing nerves and vessels, including the marginal mandibular branch of the facial nerve, facial artery, facial vein, and mental nerve. We named this part the adipo-neuromandibular part. By contrast, the deep part was separated from the adipo-neurovascular part by facial deep fascia and composed of loose connective tissue. We named this deep part the loose connective tissue part. The STD method enabled us to obtain detailed anatomical findings of the mandibular region and elucidate two parts of the BMS in which the neurovasculature is distributed. We believe that these findings provide new insights into facial anatomy by resolving existing anatomical uncertainties and will contribute to safer surgical treatment in the facial region.