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Background and Objectives: Hepatic resection offers promising outcomes for patients with hepatocellular carcinoma (HCC) but can be constrained by factors like patient suitability. Continuous advancements in laparoscopic and robotic technologies have made minimally invasive hepatectomies (MIHs) a viable alternative to open hepatectomies with benefits in terms of recovery and complications. Materials and Methods: We completed a retrospective review on 138 HCC patients who underwent OH or MIH between 2010 and 2020 at the Hume-Lee Transplant Center. Univariate and multivariate analyses were completed on demographic, clinical, and tumor-specific data to assess the impact of these variables on overall and disease-free survival at 1, 3, and 5 years. Preoperative metrics like length of hospital stay (LOS) and operation duration were also evaluated. Results: Of the 109 OH and 29 MIH patients, MIH patients demonstrated shorter LOS and operative times. However, overall survival (OS) and disease-free survival (DFS) were similar between groups, with no significant variations in 1-, 3-, and 5-year survival rates. Age > 60 years and a lack of preoperative transcatheter arterial chemoembolization (TACE) were significant predictors of inferior OS and DFS in multivariate analyses. Conclusions: MIH is an efficient substitute for OH with comparable survival, even in older patients. The reduced LOS and operation time enhance its feasibility, and older patients previously denied for curative resection may qualify for MIH. Preoperative TACE also enhances survival outcomes, emphasizing its general role in managing resectable HCCs. Both robotic and laparoscopic hepatectomies offer acceptable short- and long-term clinical outcomes, highlighting MIH as the standard choice for HCC patients. [ABSTRACT FROM AUTHOR]

Objective: To evaluate perforation of an air-bone gap closure success using fascia-cartilage composite graft in endoscopic Trans canal tympanoplasty. Study Design: Randomized Control Trial (Clinical Trials.gov Identifier: NCT04945811). Place and Duration of Study: ENT Department Combined Military Hospital, Quetta Pakistan, from Apr 2020 to May 2021. Methodology: One hundred and thirty-three cases of chronic Suppurative otitis media fulfilling the selection criteria were operated upon, and an endoscopic fascia-cartilage composite graft was used. A successful outcome in terms of perforation closure and air-bone gap closure was evaluated in all patients. Results: In the 138 patients operated, complete fascia-cartilage composite graft uptake was achieved in 129 (93.5%) patients. Nine (6.5%) patients had graft failure. The pre-operative mean air-bone gap was 36.49±4.61 decibels, and the postoperative mean air-bone gap was 12.57±5.09 decibels. This improvement was found to be significant, with the p-value < 0.001. Conclusion: Endoscopic per-meatal fascia-cartilage composite grafting has a high graft uptake and air-bone gap closure percentage in chronic Suppurative otitis media cases. [ABSTRACT FROM AUTHOR]

Objective: To compare the recovery of patients in both groups having acute otitis externa induced by cotton buds/various objects. One group by old method and second group by unique method. Study Design: Quasi-experimental study. Place and Duration of Study: Pakistan Naval Ship Shifa Karachi, from Jan to Dec 2020. Methodology: Non-probability convenience sampling technique was applied. Out of 50 cases were selected for group 1 management. Fifty cases were selected for group 2 management. A chi-square test was applied to compare the recovery of two groups of patients on the 14th day and 42nd day of follow-up. p-value was kept 0.05 as significant. Results: A total of 100 cases were treated in 2 groups. The gender distribution of the study was 54 females and 46 males. The mean age of the study population was 33.09 ± 12.93 years. p-value was calculated on the 14th day and 42nd days. A 2x2 table of 14th follow up day showed recovery by both groups with a p-value of 0.041 which is <0.05. This showed that group 2 management was statistically better than group 1 management. Conclusion: The second group was managed with eardrops containing Betamethasone and Neomycin. This management protocol is unique and better than conventional management as done in the first group. [ABSTRACT FROM AUTHOR]

In the ideal case, a precise synthesis yields molecules with a constitutional as well as a conformational perfectness. Such a case of precision is demonstrated by the synthesis of semi-rigid amphiphilic polyphenylene dendrimers (PPDs). Polar sulfonate groups are precisely placed on their periphery in such a manner that patches of polar and non-polar regions are created. Key structural features are the semi-rigid framework and shape-persistent nature of PPDs since the limited flexibility introduces a nano-phase-separated amphiphilic rim of the dendrimer. This results in both attractive and repulsive interactions with a given solvent. Frustrated solvent structures then lead to a remarkable solubility in solvents of different polarity such as toluene, methanol, and water or their mixtures. Water solubility combined with defined surface structuring and variable hydrophobicity of PPDs that resemble the delicate surface textures of proteins are important prerequisites for their biological and medical applications based upon cellular internalization. [ABSTRACT FROM AUTHOR]

Cp*TiCI[sub2](L) [L = C[sub3]H[sub3]N[sub2] (1), 3,5-Me[sub2]C[sub3]HN[sub2] (2) and 3,5-[supi]Pr[sub2]C[sub3]HN[sub2] (3)], and Cp*Ti(C[sub3]H[sub3]N[sub2])[sub3] (4) were prepared in moderate yields by treating Cp*TICI[sub3] with the pyrazoles in the presence of Et[sub3]N or with their corresponding lithium salts in Et[sub2]O. The structures of 1 and 2 determined by X-ray crystallography indicate that these complexes fold a distorted tetrahedral geometry around Ti, and the pyrazolato ligands coordinate to Ti with η[sup2]-N,N'-coordination mode. In contrast, one of the pyrazolato ligand in 4 coordinates to Ti with η[sup1]-N-bonding, whereas the other two ligands were bound to Ti with η[sup2]-N,N'-fashion. The Cp analogues, CpTiCI[sub2](L) [L = C[sub3]H[sub3]N[sub2] (5), 3,5-Me[sub2]C[sub3]HN[sub2] (6), 3,5[supi]Pr[sub2]C[sub3]HN[sub2] (7), and 3,5-Ph[sub2]C[sub3]HN[sub2] (8)], were also prepared by the reaction of CpTiCI[sub3] with the corresponding lithium saits in Et[sub2]O or n-hexane. The crystallographic analyses of 5 and 6 revealed that the pyrazolato ligands coordinate to Ti with η[sup2]-N,N'-coordination mode. These complexes (1-3, 5-8) exhibited moderate catalytic activities for ethylene polymedzation in the presence of methylaluminoxane (MAO), and the actMties were highly affected by the substituent on the pyrazolato ligand employed. Complex 1 exhibited the highest activity affording polymer with uniform molecular weight distribution, suggesting that the polymerization proceeded with uniform catalytically active species. An increase in the steric bulk in the pyrazolato ligand led to a slight decrease in the activity by the Cp* analogues, whereas the activity by the Cp analogues increased upon increasing the steric bulk in the pyrazolato ligand employed. [ABSTRACT FROM AUTHOR]

The 3‐ and 4‐aminophenylacetylenes protected by t‐butoxycarbonyl (t‐Boc) and 9‐fluorenylmethoxycarbonyl (Fmoc) groups (3a–6a) were synthesized and polymerized using [(nbd)RhCl]2 (1) and [(nbd)Rh+‐η6‐PhB−Ph3] (2) catalysts. The t‐Boc‐containing polymers [poly(3a) and poly(4a)] were obtained in high yield (82–91%). Among the Fmoc‐protected monomers, the para‐derivative polymerized well [poly(6a); yield = 85–94%], whereas its meta‐substituted analogue did not afford high molecular weight polymer in good yield [poly(5a); yield = 10–15%]. The use of KN(SiMe3)2 as a cocatalyst in conjunction with 1 led to a dramatic increase in the molecular weight of the polymers. The acid‐ and base‐catalyzed removal of the t‐Boc and the Fmoc groups, respectively, generated primary amine‐containing polymers [poly(3b)–poly(6b)] which cannot be obtained directly by the polymerization of the corresponding monomers. The solubility characteristics of the polymers bearing protected amino groups were quite different from those of the unprotected ones, the former being soluble in polar solvents, whereas the latter displayed poor solubility even in polar protic or highly polar aprotic solvents. The attempts to accomplish the free‐standing membrane fabrication by solution casting were successful only for poly(3a), and an augmentation in the gas permeability and CO2/N2 permselectivity was discerned in comparison with the unsubstituted poly(phenylacetylene) and poly(m‐t‐butyldimethylsiloxyphenylacetylene). © 2009 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem 47: 1853–1863, 2009 [ABSTRACT FROM AUTHOR]

Novel living polymerization catalysts for the synthesis of substituted polyacetylenes were developed on the basis of design of Rh catalysts. Phenylacetylene (PA), which is one of the typical substituted acetylene monomers, was applied to a newly developed ternary catalyst consisting of [(tfb) RhCl]2/LiCPh = CPh2/Ph3P (tfb = tetrafluorobenzobarrelene). The polymer that formed with the ternary catalyst showed the narrowest molecular weight distribution (MWD, Mw/Mn = 1.04) among those reported so far. A vinylrhodium complex ([(tfb) Rh (CPh = CPh2) (PPh3) 1), which has the structure of the proposed initiating species, could be isolated in high yield. This Rh complex also effected the living polymerization of PA in the presence of Ph3P ligand. Compared to the previously developed analogous catalyst bearing 2,5-norbornadiene (nbd) as a ligand, the tfb catalyst gives better-defined poly(phenylacetylene) (PPA). The syntheses of poly (macromonomers), which have PPA mainchains and either polystyrene or poly (methyl methacrylate) side chains, were accomplished using both Rh-based classic and living polymerization catalysts namely [(nbd)RhCl]2/Et3N and [(nbd)Rh(CPh=CPh2){P(4-FC6H4)3}]/(4-FC6H4)3P. The former catalyst afforded graft polymers having high molecular weights and relatively broad MWDs, while the latter gave polymers with much narrower MWDs with lower molecular weights. [ABSTRACT FROM AUTHOR]

Back Cover: Like an artist, a chemist can decorate different functionalities on shape‐persistent materials. Positioning of polar and nonpolar patches on the periphery of semi‐rigid polyphenylene dendrimers leads to remarkable solubility in solvents of different polarity such as toluene, methanol, and water. Precise surface structuring and the adjustment of size, shape, and lipophilicity/polarity resembles the delicate surface textures of proteins. Further details can be found in the article by R. Stangenberg, I. Saeed, S. L. Kuan, M. Baumgarten, T. Weil, M. Klapper, and K. Müllen* on page 152. [ABSTRACT FROM AUTHOR]

Hepatic angiomyolipoma (HAML) is a rare, benign mesenchymal liver tumor encountered in Asia, primarily in females, and can be found within the right hepatic lobe, but also in other areas of the liver. Immunohistochemically, HAMLs are characteristically positive for human melanoma black-45 antigen (HMB-45) and can histochemically vary in the composition of angiomatous, lipomatous, and myomatous tissue, together with the presence of epithelioid cells. In this case report, we discuss a previously healthy patient presenting with bloating and previously documented concern of liver lesions, found to have HAML confirmed by surgical pathology. Surgery was decided, as HAMLs greater than 10 cm are at risk of rupture. This is one of the first documented cases of HAML resected through robot-assisted bisegmentectomy and cholecystectomy, and therefore, intraoperative images have been included to assist in the planning of future robotic cases.

Background: In the Western Hemisphere, Intraductal papillary mucinous neoplasm of the biliary tract (IPMN-B) is a rare lesion with uncertain aetiology. This report outlines a scarcely documented instance of IPMN-B treated using robotic hepatectomy and cholecystectomy supplemented with intraoperative imagery aimed at informing future robotic procedures., Methods: A healthy person with acute cholangitis symptoms underwent diagnostic imaging followed by successful robotic hepatectomy and cholecystectomy. Pathological examination confirmed IPMN-B., Results: The patient was consulted regarding the proposed procedure of robotic left hepatectomy, cholecystectomy, and potential hepaticojejunostomy, to which she provided consent. Subsequent surgical intervention resulted in clear margins for malignancy, and the patient recovered without complications., Conclusions: This case emphasises the importance of early diagnosis and intervention in managing IPMN. The use of a robotic approach, specifically through robotic left hepatectomy combined with cholecystectomy, offers minimally invasive surgery that provides exceptional visualisation and precise control., (© 2023 The Authors. The International Journal of Medical Robotics and Computer Assisted Surgery published by John Wiley & Sons Ltd.)

Kidneys are the most frequently transplanted organ in the United States. An infrequently encountered cause of end-stage renal disease requiring permanent dialysis is prune belly syndrome. Prune belly syndrome is mostly seen in males and over a third of patients require permanent dialysis. Due to defects in abdominal wall musculature, transplantation in these patients is technically challenging. We present a novel case of a third renal transplant in a patient with prune belly syndrome with two previous failed transplants., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Drevets et al.)

A case of acute epiglottic abscess is reported in an adult female patient who presented with odynophagia and fever. Initial treatment with parenteral antibiotics was not much of a success until incision and drainage of abscess was carried out under general anaesthesia after securing airway with preliminary tracheostomy. Diagnostic difficulties due to different mode of presentation in adults are emphasized. The diagnostic workup and treatment options are discussed.