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Ditemukan 7 dokumen yang sesuai dengan query
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Pradono
"A young girl 20 years old with mandibular prognatism has been treated with orthodontics and surgical treatment in between. Mandibular set back was done intra orally 5mm length with bilateral sagital split ramus osteotomy method. And rigid fixation was done by inserting three 2mm bicortical screws for stabilizing the fragment. This method allowed the bony segments to heal properly and allowed the patients to function sooner."
Jakarta: Jurnal Kedokteran Gigi Universitas Indonesia, 2003
AJ-Pdf
Artikel Jurnal  Universitas Indonesia Library
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Sianipar, Harry Jonathan
"Pendahuluan: Ekstrofi buli merupakan suatu kelainan kongenital yang ditandai dengan tidak menutupnya dinding anterior dari rongga abdomen disertai kandung kemih yang membuka dengan manifestasi pada sistem traktus urinarius dan muskuloskeletal. Meskipun tatalaksana ekstrofi berkembang pesat, studi mengenai luaran klinis pasien ekstrofi buli masih jarang dilakukan. Di Indonesia, belum ada penelitian yang membahas mengenai luaran anatomis dan fungsional pasien ekstrofi buli pada tahun 2011-2017.
Metode: Studi penelitian ini adalah studi kohor retrospektif melalui penulusuran data rekam medis dari tahun 2011 hingga 2017 dan dilakukan di bulan Januari 2017. Seluruh pasien diperiksa untuk luaran klinis di poliklinik orthopaedi. Luaran anatomis dinilai dengan mengukur presentasi aproksimasi pubis pada foto pelvis. Sementara itu, luaran fungsional dinilai dengan menggunakan kuesioner Pediatric Quality of Life Inventory (PedsQL 4.0).
Hasil: 19 pasien ekstrofi buli dengan rerata usia 4,8±2,4 tahun kontrol rutin ke poli orthopaedi. Data yang dikumpulkan terdiri dari jenis kelamin laki-laki 11 (57,9%); perempuan 8 (42,1%), tipe ekstrofi buli (17 (89,5%); ekstrofi kloaka (2 (10,5%), anomali organ terkait yaitu epispadia 2 (10,5%); hipospadia 1 (5,3%); sisanya tidak kelainan tambahan 16 (84,2%), metode fiksasi gips 10 (52,6%); eksternal fiksasi 9 (47,4%), periode pasca operasi ≤36 bulan 10 (52,6%); >36 bulan 9 (47,4%), median usia operasi 6 bulan dengan kisaran 1-71 bulan, median nilai presentase aproksimasi 78,5% dengan kisaran 65-98,1%, rerata skor PedsQL setelah operasi 97,2±1,6. Terdapat hubungan bermakna antara usia operasi dan diastasis setelah operasi terhadap presentase aproksimasi dan skor PedsQL setelah operasi (p<0,05).
Diskusi: Luaran anatomis dan fungsional pada pasien ekstrofi buli menunjukkan hasil yang baik. Faktor usia operasi dan diastasis setelah operasi mempengaruhi nilai presentase aproksimasi dan kualitas hidup pasien ekstrofi buli.

Introduction: Bladder extrophy is an embryologic malformation that results in complex deficiency of the anterior midline, with urogenital and skeletal manifestations. Despite advances in management of bladder extrophy, the study of the patient outcome is rarely done. In Indonesia, there are no studies concerning about the anatomical and functional outcome of bladder extrophy patients in 2011-2017.
Method: A cohort retrospective study of the hospital medical records from 2011 to 2017 was performed in January 2017. The patients were assesed for the clinical outcome in orthopaedic outpatient clinic. Data of patients with bladder exstrophy managed by anterior and posterior innominate osteotomy were analysed. The anatomical outcome was assessed by calculating the percentage pubic approximation and the functional outcome was assessed by using Pediatric Quality of Life Inventory (PedsQL 4.0) and compared with those of typical peers.
Result: Nineteen children age 4,6±2,3 years presented to outpatient clinic for a routine control. Data was collected for gender man 11 (57,9%); woman 8 (42,1%), bladder extrophy 17 (89,5%); cloacal extrophy 2 (10,5%), epispadia 2 (10,5%); hipospadia 1 (5,3%); not having other congenital organ anomaly 16 (84,2%), fixation method slabs 10 (52,6%); external fixation 9 (47,4%), post operation period ≤36 months 10 (52,6%); >36 months9 (47,4%), the median of age at operation 6 months old with range from 1-71 m, the median of aproximation percentage 78,5% with range 65-98,1%, the mean of PedsQL score post operation 97,2±1,6. There was a significant correlation between age at operation and diastasis post operation to aproximation percentage and PedsQL score (p<0,05).
Discussion: The clinical outcome of the bladder extrophy patients shows good result that's measured by percentage pubic approximation and PedsQL score. Age at operation and diastasis post operation affect aproximation percentage and quality of life of bladder extrophy patient."
Depok: Fakultas Kedokteran Universitas Indonesia, 2017
SP-Pdf
UI - Tugas Akhir  Universitas Indonesia Library
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Abdul Latif
"A young man 21 years old with prognathic mandible and disharmony in dental and skeletal, is treated by orthodonsics and orthognathic surgery. Eleven month after orthodonsic treatment, osteotomi subsigmoid is done. The oblique cutting line in both ramus mandible is operated via intra oral approach. After 8 weeks post operative, finishing treatment in orthodonsics is performed. Panoramic and cephalometric post operative and one year after are shown that mandible is in good position and no relaps evidence."
Jakarta: Jurnal Kedokteran Gigi Universitas Indonesia, 2003
AJ-Pdf
Artikel Jurnal  Universitas Indonesia Library
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Muhammad Ramaditto
"Latar belakang: Kehilangan darah memiliki pengaruh terhadap kejadian komplikasi pasca operasi. Kehilangan darah intraoperatif berfungsi sebagai penanda keberhasilan operasi dan prognosis bagi pasien. Prosedur bedah seperti bedah ortognatik termasuk bedah mayor dengan resiko kehilangan darah intraoperatif yang banyak. Kehilangan darah setelah bedah ortognatik sangat bervariasi, dan terkadang diperlukan transfusi. Ahli bedah perlu mengevaluasi faktor yang mempengaruhi kehilangan darah intraoperatif dan menilai tingkat transfusi sehingga dapat mengurangi resiko komplikasi kehilangan darah dan menghindari penggunaan transfusi berlebihan.
Tujuan: Studi ini bertujuan untuk menganalisis hubungan lama operasi, jenis bedah ortognatik dan indeks massa tubuh terhadap jumlah kehilangan darah intraoperatif pada bedah ortognatik.
Metode: Studi ini menggunakan metode analitik observasional dengan desain penelitian retrospektif.
Hasil: Terdapat hubungan yang signifikan antara jenis bedah ortognatik dan lama operasi dengan kehilangan darah intraoperatif pada pasien bedah ortognatik. Double jaw surgery dan Lefort I osteotomy serta faktor lama operasi menunjukkan adanya korelasi yang kuat terhadap jumlah kehilangan darah intraoperatif pada pasien bedah ortognatik. Indeks massa tubuh tidak menunjukkan hubungan yang signifikan terhadap jumlah kehilangan darah intraoperatif pada pasien bedah ortognatik.
Kesimpulan: Jenis bedah ortognatik double jaw surgery dan Lefort I osteotomy serta lama operasi lebih dari 5 jam mempengaruhi jumlah kehilangan darah intraoperatif yang signifikan pada pasien bedah ortognatik.
......Background: Blood loss has an influence on the incidence of postoperative complications. Intraoperative blood loss can be serves as a marker of successful surgery and prognosis for patients. Surgical procedures such as orthognathic surgery is one of major surgery with a high risk of intraoperative blood loss. Blood loss after orthognathic surgery varies greatly, and sometimes transfusion is needed. Surgeons need to evaluate factors that affect intraoperative blood loss and assess transfusion rates so as to reduce the risk of blood loss complications and avoid excessive transfusion use.
Objective: This study aims to analyze the relationship between duration of surgery, type of orthognathic surgery and body mass index to the amount of intraoperative blood loss in orthognathic surgery.
Method: This study uses observational analytic methods with a retrospective research design.
Results: There is a significant relationship between the type of orthognathic surgery and the length of surgery with intraoperative blood loss in orthognathic surgery patients. Double jaw surgery and Lefort I osteotomy as well as the duration of surgery showed a strong correlation with the amount of intraoperative blood loss in orthognathic surgery patients. Body mass index did not show a significant relationship to the amount of intraoperative blood loss in orthognathic surgical patients.
Conclusion: The type of orthognathic double jaw surgery and Lefort I osteotomy as well as the operating duration of more than 5 hours affect the amount of significant intraoperative blood loss in orthognathic surgery patients."
Depok: Fakultas Kedokteran Gigi Universitas Indonesia, 2020
T-pdf
UI - Tesis Membership  Universitas Indonesia Library
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Omar Luthfi
"ABSTRAK
Pendahuluan: Strategi koreksi akut pada penyakit Blount menyajikan metode yang lebih praktis dan singkat tanpa memberikan dampak psikososial dan resiko infeksi situs pin. Namun demikian, luaran anatomis pada berbagai derajat deformitas perlu dikaji kembali. Disamping itu, luaran fungsional juga merupakan aspek penting yang belum banyak dilaporkan. Metode: Sampel diambil tahun 2014-2017 dan dibagi menjadi kelompok deformitas ringan-sedang dan deformitas berat. Luaran anatomis dievaluasi berdasarkan Tibiofemoral Angle (TFA) dan Metaphyseal-Diaphyseal Angle (MDA). Rekurensi dinilai satu tahun pasca operasi. Luaran fungsional dievaluasi berdasarkan Lower Extremity Functional Scale (LEFS). Hasil: Terdapat 19 pasien dengan total 31 ekstremitas dan rerata usia operasi 8,19 (±3,10). Pada deformitas ringan-sedang, rerata pre operatif TFA adalah 32,90 (±4,38) dan MDA adalah 24,60 (±6,16). Pada deformitas berat, rerata pre operatif TFA adalah 57,57 (±11,88) dan MDA adalah 45,20 (±16,85). Berdasarkan analisa statistik, tidak didapatkan hubungan bermakna antara derajat deformitas pre operasi dengan luaran post operasi (TFA p=0,147; MDA p=0,327), satu tahun post operasi (TFA p=0,981; MDA p=0,265) dan angka rekurensi (TFA p=0,690; MDA p=0,445). Tidak didapatkan komplikasi neurovaskular maupun sindrom kompartemen post operasi. Rerata LEFS pre operasi adalah 67,00 (±7,95) pada deformitas ringan-sedangan dan 70,08 (±4,35) pada deformitas berat. Sedangkan post operasi adalah 73,85 (±2,73) pada deformitas ringan-sedang dan 75,33 (±2,46) pada deformitas berat. Pembahasan: Luaran anatomis koreksi akut pada deformitas ringan-sedang dan deformitas berat memberikan hasil yang sama baiknya. Angka rekurensi tidak dipengaruhi oleh besarnya deformitas pre operasi. Strategi ini aman diterapkan sepanjang tidak adanya komplikasi neurovaskular dan sindrom kompartemen yang didapatkan. Secara umum didapatkan peningkatan fungsional pada pre dan post operasi pada kedua kelompok.

ABSTRACT
Introduction: Acute correction strategy in Blount disease provides more practical technique and shorter monitoring without psychosocial impact and pin site infections. However, the anatomical outcomes in various degree of deformity need more investigation. Moreover, functional outcomes are important aspect that had not widely reported. Method: Samples took in 2014-2017 and divided into mild-moderate deformity and severe deformity group. Anatomical outcomes evaluated from the tibiofemoral angle (TFA) and metaphyseal-diaphyseal angle (MDA). Recurrences were evaluated one year after operation. Functional outcome was evaluated with Lower Extremity Functional Scale. Result: There are 19 patients with total of 31extremity and operation age mean 8.19 (±3.10). In mild-moderate deformity group, the pre-operative TFA mean was 32.90 (±4.38) and MDA was 24.60 (±6.16). In severe deformity group, the pre-operative TFA mean was 57.57 (±11.88) and MDA was 45.20 (±16.85). By statistical analysis, we found no correlation between the pre-operative degree of deformity with outcomes in post-operative (TFA p=0.147; MDA p=0.327), one year after operation (TFA p=0.981; MDA p=0.265) and recurrence rate (TFA p=0,690; MDA p=0.445). There are no post-operative neurovascular and compartment syndrome complication. The pre-operative LEFS score mean was 67.00 (±7.95) in mild-moderate deformity group and 70.08 (±4.35) in severe deformity group. The post-operative mean was 73.85 (±2.73) in mild-moderate deformity group and 75.33 (±2.46) in severe deformity group. Discussion: Anatomical outcomes of acute correction strategy between mild-moderate deformity group and severe deformity group show equal good result. Recurrence rate were not related by pre-operative degree of deformity. The acute correction was a safe strategy since there were no neurovascular and compartment syndrome complication founded in this study. Generally, the functional state was increase from pre to post-operative in two groups.
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Depok: Fakultas Kedokteran Universitas Indonesia, 2017
SP-Pdf
UI - Tugas Akhir  Universitas Indonesia Library
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Zulkarnain A.M.
"Le Fort I osteotomy is the surgery in the maksila similar to the live fracture of the Fort I. In the orthognathic surgery, Le Fort I osteotomy is the best choice for the correction of vertical dimension and relatively easy and middle and sufficient to reposisi and maksila. For the open bite case anteriory and postering in the patient could be performed. Le Fort I osteotomy in the posterior and repositioned part of maksila toward posuride so it could be occluded, functional and restored in the intended aesthetic."
Jakarta: Fakultas Kedokteran Gigi Universitas Indonesia, 2003
AJ-Pdf
Artikel Jurnal  Universitas Indonesia Library
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Bram Swandika
"Pendahuluan
Suprakondiler humerus merupakan fraktur terbanyak kedua pada anak setelah distal radius, menjadikannya fraktur yang paling banyak membutuhkan intervensi bedah pada anak. Malunion merupakan salah satu komplikasi yang banyak terjadi di negara berkembang. Cubitus varus sering terjadi pada malunion supracondylar humerus anak, yang menyebabkan masalah kosmetik dan fungsional. Teknik osteotomi korektif pada cubitus varus meliputi lateral closing-wedge, step-cut, dome, distraksi osteogenesis, dan osteotomi multiplanar 3D dengan bantuan komputer. Sampai saat ini, belum terdapat systematic review terupdate mengenai luaran dari berbagai teknik osteotomi korektif terhadap cubitus varus pada malunion supracondylar humerus anak. Penelitian ini dilakukan untuk mengetahui teknik osteotomi korektif yang memiliki luaran paling baik terhadap cubitus varus pada malunion supracondylar humerus anak berdasarkan telaah sistematis literatur yang ada.
Metode
Pencarian literatur secara sistematis dilakukan pada database PubMed, EMBASE, Scopus, dan Cochrane Library, yang diterbitkan hingga April 2023 dengan mengikuti pedoman PRISMA. Artikel yang telah lolos seleksi dilakukan review oleh dua orang reviewer untuk dinilai kembali eligibilitas nya sesuai kriteria inklusi yang telah ditentukan. Kualitas dan bias masing-masing artikel dinilai menggunakan The Newcastle- Ottawa Scale (NOS) untuk studi non-randomized dan Cochrane Risk of Bias Tool untuk studi randomized.
Hasil
Sebanyak 39 dari total 754 artikel yang teridentifikasi disertakan dalam penelitian telaah sistematis ini, meliputi 2 studi Randomized Controlled Trial dan 37 studi Cohort Prospective. Didapatkan total 863 pasien yang telah dilakukan berbagai macam osteotomi korektif, terdiri atas 348 (40,3%) pasien lateral wedge osteotomy, 225 (26,0%) pasien step-cut osteotomy, 132 (15,3%) pasien dome osteotomy, 120 (13,9%) pasien multiplanar 3D osteotomy, dan 38 (4,4%) pasien distraction osteogenesis. Rerata usia saat dilakukan koreksi 9 tahun dengan usia paling muda 2 tahun dan paling tua 17 tahun. Keseluruhan pasien dalam sample dilakukan follow-up minimal 6 bulan hingga 61 bulan dengan rerata 27,3 bulan. Data mengenai peningkatan lingkup gerak sendi, besar koreksi humerus-elbow-wrist angle dan Baumann angle sebagai variabel luaran klinis dikumpulkan dan dibandingkan secara statistik. Kriteria penilaian luaran fungsional yang digunakan cukup beragam, sebanyak 3 studi menggunakan Mayo Elbow Performance Index (MEPI), 3 studi Flynn criteria, 11 studi Oppenheim criteria, 3 studi Bellemore criteria. Komplikasi yang dilaporkan meliputi infeksi sebanyak 34 pasien, cidera saraf 19
pasien, re-operasi 7 pasien, deformitas varus tersisa pada 1 pasien, serta tidak ada penonjolan lateral condyle berdasarkan LCPI (lateral condyle prominence index).
Diskusi
Desain penelitian Randomized controlled trial ditemukan sangat sedikit pada telaah sistematik osteotomi korektif untuk tatalaksana cubitus varus. Kesulitan dalam pembuatan RCT terkait dengan kendala randomisasi, surgical learning curve untuk teknik operasi yang berbeda, kesetaraan atau keberimbangan pasien dan operator (patient and surgeon equipoise) yang secara langsung berkorelasi dengan pertimbangan etik. Telaah sistematis ini hanya melibatkan studi prospektif untuk menghindari kekurangan yang dapat ditemukan pada studi retrospektif seperti pengaruh confounding factor yang tidak diperhatikan sehingga mempengaruhi bias dalam menarik kesimpulan pada studi tersebut. Hasil luaran fungsional yang excellent dapat dicapai dengan berbagai teknik osteotomi korektif dan tidak ada satu teknik yang unggul dalam segala aspek. Pemilihan teknik osteotomi suprakondiler humerus dapat dilakukan dengan mempertimbangkan kelebihan dan kekurangan dari masing-masing teknik. Lateral closing wedge dapat direkomendasikan pada pasien dengan defisit ruang lingkup sendi pre operasi karena terbukti memberikan peningkatan paling tinggi post operasi. Selain itu, peningkatan HEW angle juga cukup tinggi. Proporsi tidak memuaskan secara luaran fungsional pun paling rendah dibandikan teknik lainnya meskipun memiliki proporsi kejadian ulnar nerve injury paling tinggi. Oleh karena itu, penulis menilai bahwa preservasi ulnar nerve penting untuk dilakukan pada teknik ini. Step-cut osteotomy memiliki kemampuan koreksi Humerus-elbow-wrist angle yang paling tinggi. Komplikasi berupa ulnar nerve injury juga banyak ditemui pada dome osteotomy. Teknik ini juga memiliki risiko infeksi paling tinggi bila dibandingkan teknik osteotomy lainnya, hal ini mungkin disebabkan karena permukaan osteotomy yang luas dan membentuk hematoma yang massif. Meta- analisis hanya dapat dilakukan pada sebagian kecil studi yang membandingkan dome dan lateral closing wedge osteotomy serta multiplanar 3D dan lateral closing wedge osteotomy. Uji statistic menunjukkan perbedaan bermakna hasil memuaskan (satisfactory) luaran fungsional berdasarkan Oppenheim criteria yang 1,8 lebih tinggi pada teknik lateral closing wedge osteotomy dibandingkan dome osteotomy. Hasil ini masih harus dipahami dengan lebih berhati-hati mengingat keterbatasan studi yang dapat disertakan dalam meta-analisis tersebut.
...... Introduction
Supracondylar humerus fractures are the second most common fractures in children after distal radius fractures, making them the most frequently requiring surgical intervention in pediatric patients. Malunion is a prevalent complication, particularly in developing countries. Cubitus varus frequently ensues as a consequence of malunion in supracondylar humerus fractures in children, leading to cosmetic and functional issues. Corrective osteotomy techniques for cubitus varus include lateral closing-wedge, step- cut, dome, distraction osteogenesis, and computer-assisted multiplanar 3D osteotomies. To date, there is no up-to-date systematic review available on the outcomes of various corrective osteotomy techniques for cubitus varus in pediatric malunion of the supracondylar humerus. This study aims to ascertain the most effective corrective osteotomy technique for cubitus varus in paediatric malunion of the supracondylar humerus based on a systematic literature review.
Method
A systematic literature search was conducted across the PubMed, EMBASE, Scopus, and Cochrane Library databases, encompassing publications up to January 2023, following the PRISMA guidelines. Selected articles underwent a review process by two independent reviewers to reassess their eligibility based on predefined inclusion criteria. The quality and potential biases of each article were assessed utilizing The Newcastle-Ottawa Scale (NOS) for non-randomized studies and the Cochrane Risk of Bias Tool for randomized studies.
Result
A total of 39 out of 754 identified articles were included in this systematic review, comprising of 2 RCTs and 37 Prospective Cohort Studies. The cumulative study population consisted of 863 patients who underwent various corrective osteotomies, comprising of 348 (40.3%) patients undergoing lateral wedge osteotomy, 225 (26.0%) undergoing step-cut osteotomy, 132 (15.3%) undergoing dome osteotomy, 120 (13.9%) undergoing multiplanar 3D osteotomy, and 38 (4.4%) undergoing distraction osteogenesis. The mean age at the time of correction was 9 years, with the youngest patient being 2 years old and the oldest 17 years. All patients in the sample were followed up for a minimum of 6 months to a maximum of 61 months, with an average follow-up duration of 27.3 months. Data regarding the improvement in range of motion, the extent of humerus-elbow-wrist angle correction, and Baumann angle as clinical outcome variables were collected and statistically compared. The assessment criteria used for functional outcomes were quite diverse, with 3 studies using the Mayo Elbow Performance Index (MEPI), 3 studies using the Flynn criteria, 11 studies using the Oppenheim criteria, and 3 studies using the Bellemore criteria. Reported complications included infections in 34 patients, nerve injuries in 19 patients, re-operations in 7 patients, residual varus deformity in 1 patient, and no lateral condyle prominence based on the LCPI (lateral condyle prominence index).
Discussion
The design of RCTs was found to be notably scarce in the systematic review of corrective osteotomies for the management of cubitus varus. The challenges associated with conducting RCTs in this context include difficulties in achieving randomization, navigating the surgical learning curve for different operative techniques, and ensuring patient and surgeon equipoise, which directly correlates with ethical considerations. This systematic review exclusively incorporated prospective studies to circumvent the limitations that may be encountered in retrospective studies, such as the influence of unaccounted confounding factors, thereby mitigating bias in drawing conclusions from the studies. Excellent functional outcomes can be achieved with various corrective osteotomy techniques, with no single technique demonstrating superiority in all aspects. The selection of a supracondylar humerus osteotomy technique can be made by considering the advantages and disadvantages of each technique. Lateral closing wedge osteotomy can be recommended for patients with preoperative joint range of motion (ROM) deficits, as it has been shown to provide the highest postoperative improvement. Additionally, it yields a substantial increase in the HEW angle. The proportion of unsatisfactory functional outcomes is also the lowest compared to other techniques, despite a higher incidence of ulnar nerve injury. Therefore, preserving the ulnar nerve is deemed crucial for this technique. Step-cut osteotomy exhibits the highest capability for correcting the HEW angle. Ulnar nerve injuries are also frequently observed with dome osteotomy. This technique carries the highest risk of infection compared to other osteotomy techniques, possibly due to its extensive osteotomy surface and the formation of massive hematomas. Meta-analysis could only be performed on a small subset of studies comparing dome and lateral closing wedge osteotomy, as well as multiplanar 3D and lateral closing wedge osteotomy. Statistical tests indicated a significant difference in satisfactory functional outcomes based on the Oppenheim criteria, with a 1.8-fold higher rate in favor of lateral closing wedge osteotomy over dome osteotomy. These results should be interpreted cautiously, due to the limitations of the studies eligible for inclusion in the meta-analysis."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library