Adaptability of bipedicled scalp advancement flap for coverage of huge scalp defects after tumor resection

Background:Several reconstructive techniques have been used to reconstruct scalp defects.Numerous researchers have studied the utilization of bipedicled scalp advancement flaps for scalp defect coverage.In this study,we will assess the adaptability of a bipedicled scalp advancement flap for coverage of huge scalp defects after tumor resection.Methods:This study was performed at the Plastic Surgery Department,Fayoum University Hospital,on 20 patients with huge scalp tumors treated by adequate excision and reconstructed using a bipedicled scalp advancement flap from December 2021 to July 2023.Results:The study was conducted on 20 patients:16(80%)were men and 4(20%)were women presenting with large scalp tumors.The mean age was 57.4 years(33-68 years).The sites of the tumors were 10(50%)occipital,6(30%)parietal,and 4(20%)parieto-occipital.No major complications occurred postoperatively,and the bipedicled flaps survived well in all cases,with no necrosis.Conclusion:Huge scalp defects after tumor resection can be safely reconstructed with a large versatile bipedicled advancement scalp flap,either transversely or longitudinally oriented,with favorable functional results and accepted aesthetic results,apart from the alopecic area over the grafted donor site,which can be treated by tissue expansion if desired later.

Survey of lightweighting methods of huge 3D models for online Web3D visualization

Background With the rapid development of Web3D technologies, the online Web3D visualization, particularly for complex models or scenes, has been in a great demand. Owing to the major conflict between the Web3D system load and resource consumption in the processing of these huge models, the huge 3D model lightweighting methods for online Web3D visualization are reviewed in this paper. Methods By observing the geometry redundancy introduced by man-made operations in the modeling procedure, several categories of light-weighting related work that aim at reducing the amount of data and resource consumption are elaborated for Web3D visualization. Results By comparing perspectives, the characteristics of each method are summarized, and among the reviewed methods, the geometric redundancy removal that achieves the lightweight goal by detecting and removing the repeated components is an appropriate method for current online Web3D visualization. Meanwhile, the learning algorithm, still in improvement period at present, is our expected future research topic. Conclusions Various aspects should be considered in an efficient lightweight method for online Web3D visualization, such as characteristics of original data, combination or extension of existing methods, scheduling strategy, cache man-agement, and rendering mechanism. Meanwhile, innovation methods, particularly the learning algorithm, are worth exploring.

Huge Bartholin’s cyst managed by primary marsupialization:A case report

BACKGROUND We report on the case of a 21-year-old female who could not walk due to a huge Bartholin's cyst occupying the right vulvar region.The patient was treated by marsupialization of the Bartholin’s cyst and postoperative antibiotic therapy.CASE SUMMARY A 21-year-old female without a medical history of sexually transmitted diseases presented to our outpatient clinic with complaints of a painful vulvar lump and a green-yellowish discharge for 4 d.A large Bartholin’s cyst,10 cm in diameter,was suspected over the right side of the vulva.She was advised to be admitted to the ward for intravenous antibiotic treatment and to perform marsupialization several days later.However,the patient requested immediate surgery because of time limitations.The patient underwent marsupialization under local anesthesia.The procedure was well-tolerated.After making the incision,a significant amount of malodorous pus(approximately 30 mL)was removed from the abscess.The patient was followed up for 1 wk postoperatively.The Bartholin’s cyst regressed,and the surgical wound healed well.CONCLUSION Our case shows that an initial marsupialization followed by oral antibiotic therapy can be an appropriate treatment option for a large Bartholin’s cyst.However,depending on the patient’s condition,a suitable treatment,either cystectomy or marsupialization,can be considered.

Novel Discrete Particle Swarm Optimization Based on Huge Value Penalty for Solving Engineering Problem

For the purpose of solving the engineering constrained discrete optimization problem, a novel discrete particle swarm optimization（DPSO） is proposed. The proposed novel DPSO is based on the idea of normal particle swarm optimization（PSO）, but deals with the variables as discrete type, the discrete optimum solution is found through updating the location of discrete variable. To avoid long calculation time and improve the efficiency of algorithm, scheme of constraint level and huge value penalty are proposed to deal with the constraints, the stratagem of reproducing the new particles and best keeping model of particle are employed to increase the diversity of particles. The validity of the proposed DPSO is examined by benchmark numerical examples, the results show that the novel DPSO has great advantages over current algorithm. The optimum designs of the 100-1 500 mm bellows under 0.25 MPa are fulfilled by DPSO. Comparing the optimization results with the bellows in-service, optimization results by discrete penalty particle swarm optimization（DPPSO） and theory solution, the comparison result shows that the global discrete optima of bellows are obtained by proposed DPSO, and confirms that the proposed novel DPSO and schemes can be used to solve the engineering constrained discrete problem successfully.

Hepatectomy for huge hepatocellular carcinoma in 634 cases

AIM： To clarify the safety and feasibility of hepatectomy for huge hepatocellular carcinoma （HCC）. METHODS： A total of 4765 patients with HCC operated at Tongji Hospital were retrospectively studied, of them, 780 patients had huge HCC （10 cm or more in diameter）. Hepatectomy was carried out on 634 patients （81.2%）. The majority of the liver resection were major resections, and combined resection of the adjacent organs or structures was common （17.2%）. The liver resection was combined with portal vein thrombectomy in 139 patients （21.9%）. RESULTS： Postoperative complications were common （26.8%） and required another laparotomy to prevent the complications in 5 patients （0.8%）. The 30-d mortality was 2.2%. The main causes of postoperative deaths were liver failure （n = 9）, postoperative bleeding （n = 4） and septic complication （n = 1）. The 3-, 5- and 10-year survival rates after liver resection were 35.1%, 18.2% and 3.5%, respectively. CONCLUSION： Hepatectomy for huge HCC is safe and effective. It should be used to treat patients with low surgical risks and resectable tumours.

Huge primary dedifferentiated pancreatic liposarcoma mimicking carcinosarcoma in a young female: A case report

BACKGROUND Pancreatic liposarcoma is a rare tumor. According to a literature review, the patient described in this study is the seventh case of pancreatic liposarcoma reported in the English literature and the third case of dedifferentiated liposarcoma. Furthermore, this case had the largest primary tumor volume, and a primary pancreatic liposarcoma was diagnosed based on sufficient evidence. CASE SUMMARY We here report a rare case of a 28-year-old female with a huge dedifferentiated liposarcoma in the pancreatic tail. In June 2015, the patient underwent distal pancreatectomy with splenectomy. During the operation, a huge liposarcoma of approximately 28.0 cm × 19.0 cm × 8.0 cm was found, which had a yellow and white fish-like incisal surface. Based on both pathology and MDM2 gene amplification, the tumor was diagnosed as a dedifferentiated liposarcoma. The patient was treated with surgery but declined postoperative chemotherapy. She was well at the 26-mo follow-up, and no relapse was observed. CONCLUSION Pancreatic liposarcoma has a low incidence. Chemotherapy should be included in the treatment regimens. Complete resection is the only effective treatment.

Huge thick conglomerate movement induced by full thick longwall mining huge thick coal seam

A discrete elemental method was used to study the thickness of conglomerate layer in a full thick seam mining activities under the influence of the law, pointing out the thickness of the conglomerate at different seam mining, and during the destruction and instability of existing state of laws. At 21141 thick seam mining, the face toward the direction of separation between the thick layer of conglomerate rock and the next bit after reaching its maximum capacity due to pull from the bottom of the plastic zone, formed a stratified and hierarchical down collapse. The shape of caving area is a ''triangular block'', the length of the plastic zone and face advancement from the linear fit between the height of the plastic zone and the advancing face is a quadratic function of distance, while the top layer of thick gravel layer is the overall bending subsidence trend. Tilting the direction of the face, a thick gob of collapsed conglomerate layer is formed in the coal gob entity on both sides of the thick conglomerate at the top of the overall fracture morphology performance, thus forming a mutual extrusion of articulated block structure. The instability, separation and balance of the thick conglomerate layer in the hinged block stope stress leads to abnormal occurrence of rock burst induced by face as the major factor in the accident. This research reveals the form of stress distribution in the destroyed layer of the thick conglomerate rock, analyzes the stope law of coupling for the pressure burst behavior law for the mining work face, and the choice of preventive measures to provide a theoretical basis and implementation.

Thoracoscopic resection of a huge esophageal dedifferentiated liposarcoma: A case report

BACKGROUND Esophageal liposarcoma is a rare malignant tumor and an esophageal dedifferentiated liposarcoma(DDL)is extremely rare.There are no reports on the treatment of DDL by thoracoscopic surgery.CASE SUMMARY A 38-year-old woman presented with dysphagia and dyspnea.Imaging examination showed a large mass in the posterior mediastinum.The patient also developed respiratory failure and it was unclear whether this was caused by a mass from inside or outside the esophagus.We decided to perform thoracoscopic exploration to relieve the obstruction caused by tracheal compression.The upper segment of the esophagus was split longitudinally,and most of the mass could be removed from the esophageal lumen to the thoracic cavity.The pedicle was excised by linear cutting closers under mirrors.Little residual mass was visualized by gastroscopy.The mucous and muscular layers were closed by interrupted sutures.Pathological examination showed that the mass was a DDL.The patient did not have any dysphagia or dyspnea 2 wk postoperatively and refused any further treatment.Computed tomography and esophagoscopy did not find any recurrence at up to 20 mo postoperatively.CONCLUSION Thoracoscopy can be used to treat large esophageal masses.

在Windows环境下如何避开huge指针传递的雷区

直接使用ｈｕｇｅ指针来进行子程序参数传递是相当危险的，本文提出一个在Ｗｉｎｄｏｗｓ环境下使用句柄代替ｈｕｇｅ指针进行传递的新方法，从而避开了这个“雷区”。

Electromagnetic Emissions Recorded by a Borehole TOA Installment before Four Huge Destructive <i>M</i>_S≥ 8.0 Earthquakes in Asia

In this paper, electromagnetic emissions recorded by a borehole TOA installment with three observing channels of CH1 (0.01 - 0.1 Hz), CH2 (0.1 - 1.0 Hz) and CH3 (1 - 9 kHz) before four large earthquakes with magnitudes more than 8.0 have been depicted. These abnormities present different fluctuating processes from one another. For the Wenchuan MS 8.0 earthquake on 12 May 2008, the nearest one among these four events and only 660 km from the TOA station, electromagnetic information appeared at least 5 months ago in two low frequency bands of CH1 and CH2 and it was subjected to an obvious fluctuating process with several developing stages: initial information, intensive anomaly and large amplitude signals. The typical pulse-like emissions in CH2 happened group by group with large various magnitudes, which can be of 10 mV in the climax period. While during this period, compatible wave-like information with little magnitudes also happened in CH1 channel and a few pulses in CH3. Anomalous emissions occurred about 4 months prior to the 25 April 2015 Nepal MS 8.1 event, 1560 km away from the TOA station. The abnormal information in CH2 also appeared group by group but with small various magnitudes, more than 2 mV during their climax. This process is also effective for the Sumatra MS 8.9 earthquake on 26 December 2004, 2500 km from the borehole TOA, only with a different duration of 2 months and less magnitudes of 0.1 mV in CH1 and 1 mV in CH2 in this case. However, there is no obvious fluctuation and only small constant amplitude signals being ~0.15 mV appeared during 2 weeks before the Japan MS 9.0 earthquake on 11 March 2011. It is the farthest one among these four events and beyond 4000 km from the observing station. So, we can make a conclusion that there is a near relationship between the properties of the abnormities associated with these four earthquakes, such as amplitudes, duration and signal types, and the distances from TOA station: on one hand, the amplitude and duration decreases as the distance increases;on the other hand, there is an evolution for emission properties from complex various magnitude signals to single equal magnitude ones as the distance changes to be far. However, one common feature of the anomalous information related to these four events is that almost electromagnetic emissions were collected in two low frequency bands of CH2 and CH1 instead of CH3 band, which means ULF band (0.01 - 1.0 Hz) is more sensitive than VLF band (1 - 9 kHz) at this TOA station.

Simulation by Dislocation Model and Anomaly Property Determination of Huge Leveling Deformation at Linfen Seismic Station

In this study,under the assumption that the two huge leveling deformation anomalies at Linfen seismic station were caused by the Luoyunshan fault( Tumen-Yuli section)movement, we computed the vertical deformation field distribution based on the rectangular fault dislocation model and measured the ground deformation field of the study area using D-InS AR technology. The results are as follows:( 1) Theoretically,the ground vertical deformation field caused by fault movement could be within the elliptical deformation area with the long axis parallel to the fault strike. The largest deformation region is located in the center of the area in the hanging wall of the fault,and the deformation gradually decreases to zero toward the periphery; the impact range induced by the two deformations is respectively as follows: The long axes are about 18 km and26km,the short axes are about 12 km and 17 km and the obvious deformation amplitude is about 1- 3mm and 4- 14 mm.( 2) The measured deformation field by D-InS AR shows that there is no continuous deformation area consistent with the fault strike,and only the presence of land subsidence possibly caused by groundwater excessive exploitation,with the deformation amplitude about 10- 12 mm and 1- 5mm.( 3) The measured deformation field is not consistent with the theoretical result on deformation area and amplitude,which indicates that the fault movement is not the main cause of Linfen huge leveling deformation,but may rather be because of local deformation of the soil layers in the hanging wall of the fault.( 4) By combining the fault dislocation model simulation with the D-InS AR technology measurement,we can determine effectively the nature of the anomalyof the huge cross-fault leveling deformation,thus provide scientific basis for verification of significant leveling anomalies.

Treatment Strategies for Huge Central Neurocytomas

Central neurocytomas（CNs）, initially asymptomatic, sometimes become huge before detection. We described and analyzed the clinical, radiological, operational and outcome data of 13 cases of huge intraventricular CNs, and discussed the treatment strategies in this study. All huge CNs（n=13） in our study were located in bilateral lateral ventricle with diameter ≥5.0 cm and had a broad-based attachment to at least one side of the ventricle wall. All patients received craniotomy to remove the tumor through transcallosal or transcortical approach and CNs were of typical histologic and immunohistochemical features. Adjuvant therapies including conventional radiation therapy（RT） or gamma knife radiosurgery（GKRS） were also performed postoperatively. Transcallosal and transcortical approaches were used in 8 and 5 patients, respectively. Two patients died within one month after operation and 3 patients with gross total resection（GTR） were additionally given a decompressive craniectomy（DC） and/or ventriculoperitoneal shunt（VPS） as the salvage therapy. Six patients received GTR（＋RT） and 7 patients received subtotal resection（STR）（＋GKRS）. Eight patients suffered serious complications such as hydrocephalus, paralysis and seizure after operation, and patients who underwent GTR showed worse functional outcome [less Karnofsky performance scale（KPS） scores] than those having STR（＋GKRS） during the follow-up period. The clinical outcome of huge CNs seemed not to be favorable as that described in previous reports. Surgical resection for huge CNs should be meticulously considered to guarantee the maximum safety. Better results were achieved in STR（＋GKRS） compared with GTR（＋RT） for huge CNs, suggesting that STR（＋GKRS） may be a better treatment choice. The recurrent or residual tumor can be treated with GKRS effectively.

RESULTS OF HEPATECTOMY FOR HUGE PRIMARY LIVER CANCER

From 1964 to 1991 , hepatectomy had been done in 166 cases of huge primary liver cancer (PLC) in our hospital.The tumor located in` the left lobe of the liver in 75 cases, right lobe in 75 cases and in the both lobes in 16 cases. The tumor size of these patients was 10 cm to 14. 9 cm in diameter in 109 cases, 15 cm to 20 cm in diameter in 45 cases, larger than 20 cm in 12 cases. The largest one was 28 cm × 26 cm. Hepatocellular carcinoma was verified in 93. 4% of these cases. Of them, 125 cases (75 3%) were associated with hepatic cirrhosis. Regular hepatectomy was done in 10 cases; irregular hepatectomy in 156 cases. The following techniques for the interruption of hepatic blood flow were used : continuous mattress suture, hepatic clamp ,temporary occlusion of the hepatic hilum, and microwave coagulation of liver parenchyma. In this series, 95 cases underwent radical resection and 71 cases palliative resection.The postoperative complications were jaundice and ascites in 18 cases, wound infection in 7 cases and right pleural effusion in 7 cases. Three cases died within 1 month after hepatectomy with an operative mortality of 1. 8%. The duration of follow up over 5 yearo was in 64 cases. The 5year survival rate was 17. 5%. All cases who underwent palliative resection died from 2 to 36 months after hepatectomy with an average survival time of 7 months.The biological features of huge PLC and the approaches to improve the prognosis were discussed.

A Case of Huge Fibroma in the Palate

Fibroma-like lesions occur with relatively high frequency in oral soft tissues, but represent reactive proliferation against chronic irritation. True fibromas are rare. Tumor size is often seen to range from the mass of a red bean to a soybean. We encountered a case of huge fibroma in the palate with a long history of more than 30 years. The patient was a 60-year-old man who became aware of a tumor in the right palate about 30 years earlier. The mass had tended to increase in size in recent years, and was introduced to our department for the first visit. As an intraoral finding, a pedicled mass measuring 29 × 27 mm was found in the right palate. We also considered the possibility of verrucous carcinoma, and performed biopsy, obtaining a diagnosis of fibroma. Right palatectomy was performed under general anesthesia in October 2016. We performed immunohistochemical examination of the surgical specimen, obtaining a definitive diagnosis of fibroma. As of 1 year postoperatively, no recurrence has been identified and the course has been good.

Clinical analysis for an unusual huge recurrent meningioma:a case report

The authors reported the case of a 35-year-old woman with an unusual huge recurrent meningioma in the left cerebral hemisphere confirmed by the pathological examination.This patient's clinical presentation was very unusual.Brain magnetic resonance imaging(MRI) demonstrated a huge tumor in the left frontal region.The extracranial surface dimensions of the mass were 12cm craniocaudal × 11cm transverse × 9cm anteroposterior;and the intracranial dimensions were 9cm craniocaudal × 7cm transverse × 10cm anteroposterior respectively.The patient underwent left frontal recurrent meningioma resection by microsurgery,with total tumor resection.Following which the patient was discharged in a stable condition.To the best of the authors' knowledge,such an unusual huge recurrent meningioma has not been reported.The authors reviewed the literatures with reference to recurrent meningioma,analyzed the unusual imaging appearances of this patient,and explored the mechanism underlying the huge volume formation.The fundamental principle to reducing or completely avoiding meningioma recurrence is to achieve total tumour resection.Recurrent meningiomas are also amenable to surgery.

A Huge Home Demand Potential Awaits Tapping

Indeed, deficit-spending of massive amounts on public-works, lowering inter-est rates and promoting exports are the common phenomenon seen in today’s post-crisis Asia. But none of them is sustainable, nor a substitute for the agonizing re-form, industrial restructuring and sci-tech innovations. The basis for long-term e-

Analysis of Parameters of Coal Pillar Setting under the Mining Condition of Huge Thick Loose Layer

According to the characteristic of huge thick loose layer in Huainan mining area, based on the measured data, the correlation between the relative parameters of coal pillar setting and the ratio of loose layer thickness to mining depth in Huainan mining area under the mining condition of huge thick loose layer was mainly studied by using regression analysis method, and corresponding mathematical models were established and analyzed. It makes a theoretical supplement for the the analysis and research of mining subsidence rules in Huainan mining area under the condition of huge thick loose layer.

The construction types of inner river wharf with huge water fluctuation and their development

This paper introduces the main construction types of inner fiver whar~ analyses the developing trend of the construction types of wharf in mountainous areas, point out that suspended vertical wharf is the main construction type for deep-water, huge water fluctuation river terminals. Opentype wharf on pilcs is also a new- type wharf structure in mountainous areas with great water fluctuation.

Constructing Large Capacity Power Plant on Collapsible Loess Stratum with Huge Thickness

1 Preface In the northern and northwestern parts of China, quite a large portion of area, approximately 630,000 km^2, is covered by loess and loess-liked soils. The loess thickness ranges from several meters to several hundred meters along the river’s terraces to those geomorphologic plateaus. In geology, "China Loess" has become a geologic term, because the loess in China has evolved with the widest distribution and greatest thickness in the world, and is also a typical and significant deposit in Quaternary Period.