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Copyright of West China Journal of Stomatology is the property of Sichuan University, West China College of Stomatology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Mengya Dong,1 Chenyuan Liang,1 Gong Cheng2 1Department of Cardiovascular Medicine, Shaanxi Provincial People’s Hospital, Xi’an, People’s Republic of China; 2Department of Cardiovascular Medicine, Honghui Hospital, Xi’an Jiaotong University, Xi’an, People’s Republic of ChinaCorrespondence: Gong Cheng, Department of Cardiovascular Medicine, Honghui Hospital, Xi’an Jiaotong University, 555 East Youyi Road, Xi’an, Shaanxi, 710054, People’s Republic of China, Tel +86– 18629529996, Email Xianchenggong@163.comObjective: A new approach called the loop technique has been proven safe and effective for repeated intraoperative transvenous left ventricular (LV) lead dislocations during cardiac resynchronization therapy (CRT) in a 3-year follow-up. This study aimed to report on the 5-year safety and effectiveness of the loop technique.Methods: This study was a prospective cohort study. Forty-four patients who underwent CRT device implantation at the Cardiology Department of Shaanxi Provincial People’s Hospital between January 2013 and June 2019 were included. Data on patient demographics, medical history, laboratory test results, and echocardiography images at admission were collected. The loop technique was performed with repeated intraoperative dislocations of the LV lead. The intraoperative CRT parameters were also recorded. All patients were followed for 5 years. Several auxiliary examinations were performed during follow-up.Results: The 44 patients were divided into the traditional operation group (n=36, 81.8%) and loop technique group (n=8, 18.2%). The baseline patient characteristics were almost balanced. During the 5-year follow-up, 8 (22.2%) patients in the traditional operation group and 2 (25.0%) patients in the loop technique group died. No lead dislocation or other complications related to CRT were observed. There were no significant differences in mortality rate (P=0.87), cardiac function (P=0.56), echocardiographic indices, threshold (P=0.58), or impedance (P=0.22) of the LV lead. There were no significant differences in the threshold and impedance between postoperative, 3-year, and 5-year follow-ups in the loop technique group (P=0.53).Conclusion: The loop technique is an ideal solution for repeated intraoperative LV lead dislocation during CRT implantation.Keywords: loop technique, new technique, cardiac resynchronization therapy, left ventricular lead, repeated intraoperative dislocations

Objective: This study was performed with the aim to evaluate the results of the treatment of vaginal fistulas caused by pelvic malignancy and to present a new surgical technique. In this retrospective study, patients with vaginal fistula who have been treated in Ghaem and Omid Hospitals of Mashhad University of Medical Sciences from 2004 to 2020 were studied. The inclusion criteria were the patients whose fistulas were caused by malignant neoplasia with pelvic organ origin. The patients with fistulas caused by other causes were excluded from the study. Patients' information was collected from the electronic records and the hospital archives and also the information recorded by the surgeon. Results: Out of 26 patients with vaginal fistula caused by pelvic malignancies, 18 cases had enterovaginal fistula. Cancer of cervix (11 cases) was the most prevalent cancer. Time interval between the incidence of fistula and the onset of the disease was 43.5 months. About 16 patients had a history of radiotherapy before the onset of the fistula, and 23 cases had undergone surgery before the onset of fistula. About 11 patients were treated with resection, 8 patients with ostomy, and 5 with fistulized loop bypass. Discussion and conclusion: In cases of extensive pelvic involvement with a tumor, it is recommended to use intestinal bypass in fistula site with the technique provided in this article, since it controls the symptoms of the patient and has limited complications. [ABSTRACT FROM AUTHOR]

We have developed a biopsy technique aimed at preoperative evaluating the extent of Paget’s vulvar disease in order to plan subsequent radical vulvar surgery. The aim is to find all possible lesion sites that are not visible macroscopically, to obtain a clear evaluation of the disease spread and to tailor the radical surgical procedure to remove even microscopic lesions, avoiding recurrences and excessively destructive surgery, adopting as conservative an approach as possible. We used this procedure for the first time to establish the radicality of the surgical intervention in a 68-year-old patient initially suffering from a single invasive vulvar Paget’s lesion.

Anticipatory behavior describes the actions taken to prepare for an upcoming event. It is considered a promising tool for welfare assessment, but it is not fully applied in zoos and other facilities. This is probably due to the need to train animals, which can take a long time and make its use impractical. In this work, we tested, on a group of six dolphins (Tursiops truncatus), the effectiveness of a new technique to induce and measure anticipatory behavior without training animals. Our results show how this new methodology, which we called The Fast Technique (TFT), has been able to induce and measure anticipatory behavior toward the event studied, i.e., the play sessions with objects (PSO). Furthermore, it has produced the same result obtained with The Classical Technique (TCT), which requires a training phase. Therefore, our finding demonstrates the efficacy of a new technique that could facilitate the use of anticipatory behavior for both research and animal welfare assessment protocols. [ABSTRACT FROM AUTHOR]

Fracture of the hallucial sesamoids is a pathology that causes difficulty for surgeons and patients. Because of the low incidence and the fact that up to 64–90 % heal with non-operative management, there is a lack of clear guidance in the literature for the surgical treatment of sesamoid fracture in cases of failure of non-operative management. Here long term follow up of an alternative method of surgical treatment of sesamoid fracture recalcitrant to nonoperative management is presented. 32 individuals were treated with temporary surgical immobilisation of the 1st metatarsophalangeal joint using either crossed wires or two orthogonally placed two hole plates. The patients then underwent removal of the construct at 8 weeks post op after confirmation of healing on a CT scan. There was a 94 % union rate. Return to work was 61 days (15–90) return to sport 80 days (64–112) with no immediate complications and no recurrence. At last follow up mean 10 years (4–16) only 2 patients had gone on to asymptomatic non-union and one patient developed arthritis between the sesamoid and the metatarsal head. No patient has required further surgical intervention. This retrospective cohort of patients demonstrate that this method of treatment is a valuable option in the management of sesamoid fracture which does not alter the biomechanics of the foot and has none of the long term complications of sesamoidectomy or partial sesamoidectomy. • Alternative technique to sesamoidectomy for sesamoid stress fracture. • Rigid temporary internal fixation of the 1st MTPJ eliminates sesamoid shear stresses. • Single surgeon's sample of 32 patients found a 94 % union rate. • Long term follow up of sesamoid fracture management. [ABSTRACT FROM AUTHOR]

Transcrestal maxillary sinus floor elevation is an effective method to solve the problem of insufficient bone height in the posterior maxillary region. However, current methods, such as osteotome sinus floor elevation, cushioned grind-out technique, Smart Drill technique, etc., require specialized surgical tool boxes. In this article, we introduce a new method of transcrestal maxillary sinus elevation that uses built-in reamers of various implant systems to scrap residual bone at the sinus floor and uses the implant to push the sinus membrane during implant placement. This technique is easy to operate and time saving and has a low rate of sinus membrane perforation. After a one-year follow-up observation of 146 people and 175 implants, the endo-sinus bone gains were 5.00 (4.70, 5.30) mm and 2.10 (1.40, 2.70) mm in the group of 3 mm≤residual bone height (RBH)<5 mm and the group of 5 mm≤RBH<8 mm, respectively, which can meet the clinical requirements of implant stability. This technique is suitable in generalizing dental implantation.

We have developed a biopsy technique aimed at preoperative evaluating the extent of Paget's vulvar disease in order to plan subsequent radical vulvar surgery. The aim is to find all possible lesion sites that are not visible macroscopically, to obtain a clear evaluation of the disease spread and to tailor the radical surgical procedure to remove even microscopic lesions, avoiding recurrences and excessively destructive surgery, adopting as conservative an approach as possible. We used this procedure for the first time to establish the radicality of the surgical intervention in a 68-year-old patient initially suffering from a single invasive vulvar Paget's lesion., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Della Corte, Ascione and Bifulco.)

Workflow for cortical bone trajectory (CBT) screws includes tapping line-to-line or under tapping by 1 mm. We describe a non-tapping, two-step workflow for CBT screw placement, and compare the safety profile and time savings to the Tap (three-step) workflow. Patients undergoing robotic assisted 1-3 level posterior fusion with CBT screws for degenerative conditions were identified and separated into either a No-Tap or Tap workflow. Number of total screws, screw-related complications, estimated blood loss, operative time, robotic time, and return to the operating room were collected and analyzed. There were 91 cases (458 screws) in the No-Tap and 88 cases (466 screws) in the Tap groups, with no difference in demographics, revision status, ASA grade, approach, number of levels fused or diagnosis between cohorts. Total robotic time was lower in the No-Tap (26.7 min) versus the Tap group (30.3 min, p = 0.053). There was no difference in the number of malpositioned screws identified intraoperatively (10 vs 6, p = 0.427), screws converted to freehand (3 vs 3, p = 0.699), or screws abandoned (3 vs 2, p = 1.000). No pedicle/pars fracture or fixation failure was seen in the No-Tap cohort and one in the Tap cohort (p = 1.00). No patients in either cohort were returned to OR for malpositioned screws. This study showed that the No-Tap screw insertion workflow for robot-assisted CBT reduces robotic time without increasing complications., (© 2024. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)

Gigantomastia, characterized by excessive breast size (usually heavier than 2.5 kg), can result from various causes and significantly affect patients' lives. Surgical intervention is often required, and over time, several techniques have been developed for its treatment. These techniques aim to address the functional and aesthetic concerns associated with gigantomastia, providing relief to patients and improving their quality of life. A 40-year-old primiparous housewife developed unilateral gigantomastia as a consequence of hormone therapy. To address this, a modified reduction mammoplasty procedure was undertaken, incorporating NAC (Nipple-Areola Complex) grafting. The reduction involved removing 3450 g of tissue, resulting in restored breast symmetry and enabling the patient to reintegrate into normal daily life. Compared to the traditional technique, the introduction of some modifications in the design allowed for the absence of complications such as dehiscence of the scar at the intersection of the T, the failure of the nipple graft attachment, and the maintenance of a conical shape over time, enabling complete symmetrization of the two breasts. The use of a modified version of the Thorek technique allowed for optimal functional and aesthetic restoration even in the case of a significantly disproportionate breast compared to the contralateral one, with no complications. • Gigantomastia is a debilitating condition with multiple potential causes. • It can manifest as either bilateral or unilateral, leading to noticeable asymmetry between the two breasts. • Various approaches can be employed for its treatment, distinguished by the use of pedicled nipple flap or nipple grafting. • In this work we present our experience with a modified Nipple-Areola Complex grafting technique. [ABSTRACT FROM AUTHOR]

Introduction: Coronary artery disease is a condition arising from the occlusion of the coronary arteries and resulting in a mismatch between oxygen supply and demand. The atherosclerotic process in the coronary arteries begins with endothelial dysfunction and can cause thrombotic total occlusion and myocardial infarction. This presentation aims to deepen the theory of coronary obstruction, in which the cause is usually the progressive accumulation of atherosclerotic plaques on the walls of the coronary arteries, leading to their narrowing and slow blockage and sometimes even to acute thrombotic total blockage. Case Report: The authors present a case of a 45-year-old man found dead in his backyard, under unclear circumstances. An autopsy was performed. The coronary arteries were approached at emergence and injected with a mixture of semiliquid orange substances with partial solidification at contact and plastic memory, completely revealing (up to millimetric 5th rank branches) the coronary vascular trunk. Discussions : The necropsy revealed the presence of an atheroma plaque in the lumen of a coronary artery. Using a specific paste technique on the atheroma plaque, a clear imprint of the thrombus was found attached to the atheroma plaque. With these results the final cause of death was established. Conclusions: The method of complete visualisation of the coronary system allowed the precise identification of the cause of death and of the preexistent pathologic background - advanced coronary disease with associated thrombosis, in a young male. [ABSTRACT FROM AUTHOR]