Background The quality of surgical procedures are assessed by textbook outcomes (TO). Laparoscopic liver resection (LLR) is considered a standard treatment for hepatocellular carcinoma (HCC) in the anterolateral segments of the liver. The main objective of this study was to evaluate the factors affecting achievement of TO for LLR and its impact on survival. Methods We conducted a retrospective cohort study of patients who underwent LLR for lesions located in the anterolateral segments (n = 309). Patients were divided into TO and non‐TO group. Results A TO was achieved in 55.0% of patients (n = 170). In multivariable analysis, Model for End‐stage Liver Disease (MELD) score ≥ 10 (odds ratio[OR] 3.076; 95% confidence interval[CI] 1.134–8.342), absence of diabetes mellitus (OR: 2.325; 95% CI: 1.227–4.407) and thrombocytopenia (OR: 2.115; 95% CI: 1.134–8.342) were independently associated with not achieving TO. The 5‐year overall (82.9% vs 72.8%, P = .017) and recurrence‐free (48.8% vs 35.4%; P = .036) survival rates were significantly greater in the TO group than in the non‐TO group. Conclusion The MELD score, thrombocytopenia, and hypoalbuminemia were independent risk factors influencing the achievement of TO. TO influences the short‐ and long‐term outcomes after LLR for HCC.

Splenectomy is the definitive second-line therapy for refractory immune thrombocytopenic purpura (ITP), and has a reported response rate of 50-80%. Medical attention should be reconsidered when there is no evidence of accessory spleen in refractory ITP patients after splenectomy. The purpose of this study was to determine whether platelet count evolution differs between patients with a successful or unsuccessful result after splenectomy for ITP. Archived records of 104 consecutive patients that underwent splenectomy for ITP were reviewed. Patients were divided into two groups (failures and successes) using a final follow-up platelet count of 100,000/μL as a cut-off. Platelet count evolutions in these two groups were compared using the Student's t test. Successes and failures were found to have significantly different platelet counts from two days postoperatively (P = 0.016). The area under the receiver operating characteristic curve was 0.630 (95% confidence interval, 0.518-0.741, P = 0.030), and when a cut-off value of 100,000/μL was used, sensitivity and specificity were 68.2 and 51.2%, respectively. To obtain positive and negative predictive values exceeding 50%, additional platelet counts were required at one week and one month after splenectomy. We propose a protocol for ITP follow-up after splenectomy.

Inertial navigation systems/Doppler velocity log (INS/DVL) integrated navigation systems are widely used in underwater environments where GPS is unavailable. An INS/DVL integrated navigation system is generally loosely coupled; however, this does not work if any of the DVL transducers do not work. If a system is tightly coupled, velocity error can be estimated with fair accuracy even if some of the transducers fail. However, despite the robustness of a tightly coupled system compared to a loosely coupled one, velocity error estimation accuracy of the former decreases as the number of faulty transducers increases. Therefore, this paper proposes an INS/DVL/revolutions per minute (RPM) integrated navigation filter designed to improve the performance of conventional tightly coupled integrated systems by estimating data from faulty transducers using RPM data. Two salient features of the proposed filter are (1) estimating RPM data accounting for error from the effect of tidal currents and (2) continuous estimation of error in RPM data by selectively converting only the measurements of faulty transducers. The performance of the proposed filter was first verified using Monte Carlo numerical simulations with the analysis range set to 1 standard deviation (1σ, 68%) and then with real sea test measurement data.

Introduction. Studies on the pharyngeal airway space (PAS) changes using three-dimensional computed tomography (CT) have shed more light on patients with Class III than Class II malocclusion. This paper focuses on analyzing the long-term changes in the PAS and evaluating the postoperative association between these PAS and skeletal changes in patients with skeletal Class II malocclusion who have undergone orthognathic surgery. Methods. The records of 21 patients with skeletal Class II malocclusion who had undergone orthognathic surgery were included. The anatomical modifications in both jaws, changes in volume, sectional area (SA), minimum sectional area (MSA), and anterior-posterior (AP) and transverse (TV) width in the airway at one month before surgery ( T 0 ), and one month ( T 1 ) and one year ( T 2 ) after surgery were analyzed using CT images. The association between the skeletal and airway changes was evaluated between T 0 , T 1 , and T 2 . Results. After surgery, the ANS, A point, and PNS demonstrated significant posterior and superior movement. The B point and the pogonion exhibited substantial anterior and superior movement. The total and inferior oropharyngeal volumes (vol 3, vol 4) notably increased, while the nasopharyngeal volume (vol 1) decreased. The anterior-posterior movement at the ANS and PNS after surgery was significantly associated with the total volume, vol 2, vol 3, SA 1, MSA, and TV width 1, while substantial association with the total volume was found at the pogonion. Conclusion. Thus, an ideal treatment plan can be formulated for patients with skeletal Class II malocclusion by considering the postoperative PAS changes.

Portosystemic shunt (PSS) without a definable cause is a rare condition, and most of the studies on this topic are small series or based on case reports. Moreover, no firm agreement has been reached on the definition and classification of various forms of PSS, which makes it difficult to compare and analyze the management. The blood flow can be seen very similar to an electric current, governed by Ohm's law. The simulation of PSS using an electric circuit, combined with the interpretation of reported management results, can provide intuitive insights into the underlying mechanism of PSS development. In this article, we have built a model of PSS using electric circuit symbols and explained clinical manifestations as well as the possible mechanisms underlying a PSS formation.