Characteristics of Hepatitis B Virus Genotype and Sub-Genotype in Hepatocellular Cancer Patients in Vietnam.

Untreated chronic hepatitis B virus (HBV) infection can lead to chronic liver disease and may progress to cirrhosis or hepatocellular carcinoma (HCC). HBV infection has been prevalent in Vietnam, but there is little information available on the genotypes, sub-genotypes, and mutations of HBV in patients with HBV-related HCC confirmed by histopathological diagnosis. We studied the molecular characteristics of HBV and its genetic variants in Vietnamese HCC patients after liver tumor resection. We conducted a descriptive cross-sectional study on 107 HBV-related HCC hospitalized patients from October 2018 to April 2019. The specimens collected included EDTA anticoagulant blood and liver tissues. Extracted HBV DNA was subjected to whole genome sequencing by the Sanger method. We discovered 62 individuals (57.9%) with genotype B and 45 patients (42.1%) with genotype C, with only sub-genotypes B4 and C1. Among the mutations, the double mutation, A1762T-G1764A, had the most significant frequency (73/107 samples; 68.2%) and was higher in genotype C than in genotype B (p < 0.001). The most common genotypes found in HCC patients in this investigation were B and C, with sub-genotypes B4 and C1 for each. The prevalence of genotype B4 was greater in HBV-infected Vietnamese HCC patients.

Patient specific instrumentation for corrective osteotomy in case of posttraumatic cubitus varus in children.

Malunion in cubitus varus most often results from inadequate supracondylar fracture reduction or from secondary displacement. Treatment of cubitus varus needs an accurate preoperative planning to obtain a good functional and esthetical outcome. Planning based on conventional radiology is source of inaccuracy and clinical results are variable. Developments of computer-assisted orthopaedic surgery (CAOS) and of patient specific instruments (PSI) have made accurate three dimensional (3D) preoperative simulation possible. This original technique based on 3D-osteotomy planning and using PSI was developed to correct cubitus varus deformity in the three dimensions. A 3D-model of the deformity was created based on a CT-scan of the distal humerus. Ideal correction was calculated by software and a PSI was designed. The PSI was used to guide the saw blade on the deformed bone. After resection of a wedge fragment, osteosynthesis was performed using two crossed K-wires. Elbow radiographs were performed at least six months after surgery. At the latest follow-up, the correction of cubitus varus obtained was satisfying in the five cases of our series and all the patients had pain free elbow mobility. Ulnar nerve palsy complicated the evolution in one patient, which fully recovered within 6 months. Advantages of this technique include a decreased operating time and a smaller surgical incision. More-over, results showed increased correction accuracy without the need of fluoroscopy during the osteotomy procedure. These benefits are counterbalanced by the need of a preoperative CT-scan of the distal humerus and the additional cost for the PSI.