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Recycled Concrete Aggregate (RCA) of the chemical and biological effects must be understood to avoid potential adverse impacts to the bay’s aquatic ecosystem. RCA application as a base material for oyster reefs did not adversely affect oyster spat growth and survival, or the surrounding environment. Evaluated RCA leaching for petroleum byproducts showed that RCA as a base material for oyster reefs did not leach any hydrocarbon chemicals, and no water extractable SVOC were detected. The research found potential RCA application to the Chesapeake Bay watershed as a bottom conditioning material for oyster aquaculture. Overall, the findings support the use of RCA for oyster aquaculture.

As a technique in artificial intelligence, a convolution neural network model has been utilized to extract average surface roughness from the geometric characteristics of a membrane image featuring micro- and nanostructures. For surface roughness measurement, e.g. atomic force microscopy and optical profiler, the previous methods have been performed to analyze a porous membrane surface on an interest of region with a few micrometers of the restricted area according to the depth resolution. However, an image from the scanning electron microscope, combined with the feature extraction process, provides clarity on surface roughness for multiple areas with various depth resolutions. Through image preprocessing, the geometric pattern is elucidated by amplifying the disparity in pixel intensity values between the bright and dark regions of the image. The geometric pattern of the binary image and magnitude spectrum confirmed the classification of the surface roughness of images in a categorical scatter plot. A group of cropped images from an original image is used to predict the logarithmic average surface roughness values. The model predicted 4.80 % MAPE for the test dataset. The method of extracting geometric patterns through a feature map-based CNN, combined with a statistical approach, suggests an indirect surface measurement. The process is achieved through a bundle of predicted output data, which helps reduce the randomness error of the structural characteristics. A novel feature extraction approach of CNN with statistical analysis is a valuable method for revealing hidden physical characteristics in surface geometries from irregular pixel patterns in an array of images.

Excessive land application of poultry litter (PL) may lead to surface runoff of nitrogen (N) and phosphorus (P), which cause eutrophication, fish death, and water pollution that ultimately have negative effects on humans and animals. Increases in poultry production in the Delmarva Peninsula underscore the need for more efficient, cost-effective, and sustainable disposal technologies for processing PL instead of direct land application. The pyrolysis conversion process can potentially produce nutrient-rich poultry litter biochar (PLB), while the pyrolysis process can change the N and P to a more stable component, thus reducing its runoff. Pyrolysis also kills off any microorganisms that would otherwise trigger negative environmental health effects. This study is to apply an integrated method and investigate the effect of pyrolysis temperature (300 °C, 500 °C), poultry litter source (different feedstock composition), and bedding material mixture (10% pine shavings) on PLB qualities and quantities. Proximate and ultimate analysis showed PL sources and bedding material addition influenced the physicochemical properties of feedstock. The SEM and BET surface results indicate that pyrolysis temperature had a significant effect on changing the PLB morphology and structure, as well as the pH value (7.78 at 300 °C vs. 8.78 at 500 °C), extractable phosphorus (P) (18.73 ppm at 300 °C vs. 11.72 ppm at 500 °C), sulfur (S) (363 ppm at 300 °C vs. 344 ppm at 500 °C), and production yield of PLBs (47.65% at 300 °C vs. 60.62% at 500 °C). The results further suggest that adding a bedding material mixture (10% pine shavings) to PLs improved qualities by reducing the content of extractable P and S, as well as pH values of PLBs. This study also found the increment in both the pore volume and the area of Bethel Farm was higher than that of Sun Farm. Characterization and investigation of qualities and quantities of PLB using the integrated framework suggest that PL from Bethel Farm could produce better-quality PLB at a higher pyrolysis temperature and bedding material mixture to control N and P runoff problems.

Abstract Background Hydrogels have been widely used in many research fields owing to optical transparency, good biocompatibility, tunable mechanical properties, etc. Unlike typical hydrogels in the form of an unstructured bulk material, we developed aqueous dispersions of fiber-shaped hydrogel structures with high stability under ambient conditions and their application to various types of transparent soft cell culture interfaces with anisotropic nanoscale topography. Method Nanofibers based on the polyvinyl alcohol and polyacrylic acid mixture were prepared by electrospinning and hydrogelified to nano-fibrous hydrogels (nFHs) after thermal crosslinking and sulfuric acid treatment. By modifying various material surfaces with positively-charged polymers, negatively-charged superabsorbent nFHs could be selectively patterned by employing micro-contact printing or horizontally aligned by applying shear force with a wired bar coater. Results The angular distribution of bar-coated nFHs was dramatically reduced to ± 20° along the applied shear direction unlike the drop-coated nFHs which exhibit random orientations. Next, various types of cells were cultured on top of transparent soft nFHs which showed good viability and attachment while their behaviors could be easily monitored by both upright and inverted optical microscopy. Particularly, neuronal lineage cells such as PC 12 cells and embryonic hippocampal neurons showed highly stretched morphology along the overall fiber orientation with aspect ratios ranging from 1 to 14. Furthermore, the resultant neurite outgrowth and migration behaviors could be effectively controlled by the horizontal orientation and the three-dimensional arrangement of underlying nFHs, respectively. Conclusion We expect that surface modifications with transparent soft nFHs will be beneficial for various biological/biomedical studies such as fundamental cellular studies, neuronal/stem cell and/or organoid cultures, implantable probe/device coatings, etc.

Over the past few decades, there has been a notable surge in interest in green stormwater infrastructure (GSI). This trend is a result of the need to effectively address issues related to runoff, pollution, and the adverse effects of urbanization and impervious surfaces on waterways. Concurrently, umanned aerial vehicles (UAVs) have gained prominence across applications, including photogrammetry, military applications, precision farming, agricultural land, forestry, environmental surveillance, remote-sensing, and infrastructure maintenance. Despite the widespread use of GSI and UAV technologies, there remains a glaring gap in research focused on the evaluation and maintenance of the GSIs using UAV-based imagery. This study aimed to develop an integrated framework to evaluate plant density and health within GSIs using UAV-based imagery. This integrated framework incorporated the UAV (commonly known as a drone), WebOpenDroneMap (WebDOM), ArcMap, PyCharm, and the Canopeo application. The UAV-based images of GSI components, encompassing trees, grass, soil, and unhealthy trees, as well as entire GSIs (e.g., bioretention and green roofs) within the Morgan State University (MSU) campus were collected, processed, and analyzed using this integrated framework. Results indicated that the framework yielded highly accurate predictions of plant density with a high R2 value of 95.8% and lower estimation errors of between 3.9% and 9.7%. Plant density was observed to vary between 63.63% and 75.30% in the GSIs at the MSU campus, potentially attributable to the different types of GSI, varying facility ages, and inadequate maintenance. Normalized difference vegetation index (NDVI) maps and scales of two GSIs were also generated to evaluate plant health. The NDVI and plant density results can be used to suggest where new plants can be added and to provide proper maintenance to achieve proper functions within the GSIs. This study provides a framework for evaluating plant performance within the GSIs using the collected UAV-based imagery.

Biocompatible field-effect-transistor-based biosensors have drawn attention for the development of next-generation human-friendly electronics. High-performance electronic devices must achieve low-voltage operation, long-term operational stability, and biocompatibility. Herein, we propose an electrolyte-gated thin-film transistor made of large-area solution-processed indium–gallium–zinc oxide (IGZO) semiconductors capable of directly interacting with live cells at physiological conditions. The fabricated transistors exhibit good electrical performance operating under sub-0.5 V conditions with high on-/off-current ratios (>107) and transconductance (>1.0 mS) over an extended operational lifetime. Furthermore, we verified the biocompatibility of the IGZO surface to various types of mammalian cells in terms of cell viability, proliferation, morphology, and drug responsiveness. Finally, the prolonged stable operation of electrolyte-gated transistor devices directly integrated with live cells provides the proof-of-concept for solution-processed metal oxide material-based direct cellular interfaces.

Background This study assessed the effect of a single bolus administration of lidocaine on the prevention of tourniquet-induced hypertension (TIH) and compared the effect of lidocaine to that of ketamine in patients undergoing general anesthesia. Methods This randomized, controlled, double-blind study included 75 patients who underwent lower limb surgery using a tourniquet. The patients were administered lidocaine (1.5 mg/kg, n = 25), ketamine (0.2 mg/kg, n = 25) or placebo (n = 25). The study drugs were administered intravenously 10 min before tourniquet inflation. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were measured before tourniquet inflation, after tourniquet inflation for 60 min at 10 min intervals, and immediately after tourniquet deflation. The incidence of TIH, defined as an increase of 30% or more in SBP or DBP during tourniquet inflation, was also recorded. Results SBP, DBP, and HR increased significantly over time in the control group compared to those in the lidocaine and ketamine groups for 60 min after tourniquet inflation (P < 0.001, P < 0.001, and P = 0.007, respectively). The incidence of TIH was significantly lower in the lidocaine (n = 4, 16%) and ketamine (n = 3, 12%) group than in the control group (n = 14, 56%) (P = 0.001). Conclusion Single-bolus lidocaine effectively attenuated blood pressure increase due to tourniquet inflation, with an effect comparable to that of bolus ketamine.

An anatomical understanding of median nerve variation is essential for successful decompression of carpal tunnel syndrome (CTS). Although iatrogenic injury of the thenar branch after carpal tunnel release (CTR) has not been reported in many cases, it can cause serious damage to the patient. In case of rapidly progressing thenar atrophy after CTS surgery, thenar branch of median nerve injury should be suspected. Nerve conduction examination and ultrasound before surgery can be a useful tool for diagnosis.

The blood–brain barrier (BBB) is a selective barrier that controls the transport between the blood and neural tissue features and maintains brain homeostasis to protect the central nervous system (CNS). In vitro models can be useful to understand the role of the BBB in disease and assess the effects of drug delivery. Recently, we reported a 3D BBB model with perfusable microvasculature in a Transwell insert. It replicates several key features of the native BBB, as it showed size-selective permeability of different molecular weights of dextran, activity of the P-glycoprotein efflux pump, and functionality of receptor-mediated transcytosis (RMT), which is the most investigated pathway for the transportation of macromolecules through endothelial cells of the BBB. For quality control and permeability evaluation in commercial use, visualization and quantification of the 3D vascular lumen structures is absolutely crucial. Here, for the first time, we report a rapid, non-invasive optical coherence tomography (OCT)-based approach to quantify the microvessel network in the 3D in vitro BBB model. Briefly, we successfully obtained the 3D OCT images of the BBB model and further processed the images using three strategies: morphological imaging processing (MIP), random forest machine learning using the Trainable Weka Segmentation plugin (RF-TWS), and deep learning using pix2pix cGAN. The performance of these methods was evaluated by comparing their output images with manually selected ground truth images. It suggested that deep learning performed well on object identification of OCT images and its computation results of vessel counts and surface areas were close to the ground truth results. This study not only facilitates the permeability evaluation of the BBB model but also offers a rapid, non-invasive observational and quantitative approach for the increasing number of other 3D in vitro models.

Mammalian cell-based cultured meat has mostly been unstructured, leaving a demand for artificial steak-like meat. Here the authors present an assembled steak-like tissue of bovine skeletal muscle, adipose tissue, and blood capillary tissue fabricated by tendon-gel integrated printing technology.

The blood-brain barrier (BBB), a selective barrier regulating the active and passive transport of solutes in the extracellular fluid of the central nervous system, prevents the delivery of therapeutics for brain disorders. The BBB is composed of brain microvascular endothelial cells (BMEC), pericytes and astrocytes. Current in vitro BBB models cannot reproduce the human structural complexity of the brain microvasculature, and thus their functions are not enough for drug assessments. In this study, we developed a 3D self-assembled microvascular network formed by BMEC covered by pericytes and astrocyte end feet. It exhibited perfusable microvasculature due to the presence of capillary opening ends on the bottom of the hydrogel. It also demonstrated size-selective permeation of different molecular weights of fluorescent-labeled dextran, as similarly reported for in vivo rodent brain, suggesting the same permeability with actual in vivo brain. The activity of P-glycoprotein efflux pump was confirmed using the substrate Rhodamine 123. Finally, the functionality of the receptor-mediated transcytosis, one of the main routes for drug delivery of large molecules into the brain, could be validated using transferrin receptor (TfR) with confocal imaging, competition assays and permeability assays. Efficient permeability coefficient (Pe) value of transportable anti-TfR antibody (MEM-189) was seven-fold higher than those of isotype antibody (IgG1) and low transportable anti-TfR antibody (13E4), suggesting a higher TfR transport function than previous reports. The BBB model with capillary openings could thus be a valuable tool for the screening of therapeutics that can be transported across the BBB, including those using TfR-mediated transport.

Background After the laws regulating emergency medicine were amended in 2012, regional trauma centers were established in South Korea. Plastic surgeons specialize in the simultaneous surgical care of patients with facial trauma, burns, and complicated wounds. The objective of this study was to evaluate the role of the plastic surgery department in treating severe trauma patients. Methods From January 2012 to December 2018, we enrolled 366 severe trauma patients with an Injury Severity Score (ISS) over 15 who received treatment by specialists in the plastic surgery department. Of these patients, 298 (81.4%) were male, and their mean age was 51.35 years (range, 6–91 years). The average ISS was 22.01 points (range, 16–75 points). Results The most common diagnosis was facial trauma (95.1%), and facial bone fracture (65.9%) was most common injury within this subgroup. Patients were referred to 1.8 departments on average, with the neurosurgery department accounting for a high proportion of collaborations (37.0%). The most common cause of trauma was traffic accidents (62.3%), and the average length of stay in the general ward and intensive care unit was 36.90 and 8.01 days, respectively. Most patients were discharged home (62.0%) without additional transfer or readmission. Conclusions Through this study, we scoped out the role of the specialty of plastic surgery in the multidisciplinary team at regional trauma centers. These results may have implications for trauma system planning.

Abstract In the case of a cat bite patient, even if the external wound is small, prophylactic antibiotics should be used early and a closed observation is needed. If symptoms persist, deep infection should be considered.

Purpose This study aimed to investigate the outcomes of gonadotropin-releasing hormone agonist (GnRHa) therapy with or without growth hormone (GH) therapy for girls with idiopathic central precocious puberty (CPP). Methods The medical records of 166 girls diagnosed with CPP from 2002 to 2017 were retrospectively reviewed. All included patients were treated with GnRHa for ≥36 months. Changes in height standard deviation score (SDS) for bone age, chronological age (CA), and predicted adult height (PAH) were assessed for the first three years of treatment. The final height gain SDS was calculated as the difference between the initial PAH SDS and adult height (AH) SDS; these were then compared between the GnRHa group (group A, n=135) and the combined GnRHa/GH group (group B, n=31). Results The initial mean CA was 7.89 years. The mean menarcheal age was 13.12 years (group A, 13.1±0.99; group B, 13.18±0.58 years; P=0.755). PAH SDS at the start of GnRHa treatment and AH SDS were significantly lower in group B than in group A (PAH SDS: -2.20±0.83 vs. -3.19±0.84, P

Prophylactic antibiotics that are used to prevent post-operative infection can commonly cause anaphylactic reactions during anesthesia. It is therefore necessary to perform a skin test before antibiotics are administered in order to diagnose and prevent anaphylactic reactions. However, the results of the antibiotic skin test can differ according to the drug, dose, and reagent concentration. We report a case of anaphylactic shock with bronchospasm and cardiovascular collapse immediately following administration of the prophylactic cefazedone after induction of general anesthesia for laparoscopic cholecystectomy.

The development of soft tissue regeneration has recently gained importance due to safety concerns about artificial breast implants. Current autologous fat graft implantations can result in up to 90% of volume loss in long-term outcomes due to their limited revascularization. Adipose tissue has a highly vascularized structure which enables its proper homeostasis as well as its endocrine function. Mature adipocytes surrounded by a dense vascular network are the specific features required for efficient regeneration of the adipose tissue to perform host anastomosis after its implantation. Recently, bioprinting has been introduced as a promising solution to recreate in vitro this architecture in large-scale tissues. However, the in vitro induction of both the angiogenesis and adipogenesis differentiations from stem cells yields limited maturation states for these two pathways. To overcome these issues, we report a novel method for obtaining a fully vascularized adipose tissue reconstruction using supporting bath bioprinting. For the first time, directly isolated mature adipocytes encapsulated in a bioink containing physiological collagen microfibers (CMF) were bioprinted in a gellan gum supporting bath. These multilayered bioprinted tissues retained high viability even after 7 days of culture. Moreover, the functionality was also confirmed by the maintenance of fatty acid uptake from mature adipocytes. Therefore, this method of constructing fully functional adipose tissue regeneration holds promise for future clinical applications.

Abstract The growing importance of human–machine interfaces and the rapid expansion of the internet of things (IoT) have inspired the integration of displays with sound generation systems to afford stretchable sound‐in‐display devices and thus establish human‐to‐machine connections via auditory system visualization. Herein, the synchronized generation of sound and color is demonstrated for a stretchable sound‐in‐display device with electrodes of strain‐insensitive silver nanowires (AgNWs) and emissive layers of field‐induced inorganic electroluminescent (EL) phosphors. In this device, EL phosphors embedded in a dielectric elastomer actuator (DEA) emit light under alternating‐current bias, while audible sound waves are simultaneously generated via DEA actuation along with input sound signals. The electroluminescence and sound‐generation performances of the fabricated device are highly robust and reliable, being insensitive to stretch‐release cycling because of the presence of the AgNW stretchable electrodes. The presented principle of integrating light emission and acoustic systems in a single stretchable device can be further expanded to realize sound‐in‐display electronics for IoT and human–machine interface applications.

Single crystals have been shown to incorporate guest materials (e.g., gel networks and functional particles) and the incorporated materials endow the crystal hosts with non-intrinsic properties. The acquisition of the non-intrinsic crystal properties impels us to diversify the incorporated guest materials and thus to spread the potential applications of single-crystalline materials. Here, fluorescent NIPAM-based microgels have been selected as the guest materials to be incorporated into the crystal hosts. In the presence of microgels, calcite crystallize from either solution or gel media have been examined. Solution-grown crystals exclude the microgels, while two gel-grown methods have proved effective for incorporating these microgels inside calcite single crystals. On one hand, an additional macroscopic agarose gel-network is introduced to trap the microgels. Crystallization in the agarose gel leads to incorporation of agarose gel-network together with the trapped microgels. The microgel concentration in the crystal reaches 33 mg/mL. On the other hand, dispersions of microgels are concentrated to about 352 mg/mL and the microgels aggregate into non-flowing macroscopic gels (termed as macrogels). Crystallization in a macrogel results in its incorporation. By showing the incorporation of microgels through physical entrapment, this work provides a new platform to functionalize single crystals by the microgels.

Background Condylar process fractures account for one-third of all mandibular fractures, and the distal fragment is prone to dislocate to the medial side due to the pulling of the lateral pterygoid muscle. Retromandibular approaches are commonly used, but the intraoperative view becomes limited in medially dislocated fractures. This study summarized a series of cases of retromandibular reduction for medially dislocated condylar process fractures and described our supplementary procedure to realign the dislocated condylar process.

Currently, almost 70% of the world’s population occupies urban areas. Owing to the high population density in these regions, they are exposed to various types of air pollutants. Fine particle air pollutants (

Fluorescence-linked immunosorbent assay (FLISA) is a commonly used, quantitative technique for detecting biochemical changes based on antigen–antibody binding reactions using a well-plate platform. As the manufacturing technology of microfluidic system evolves, FLISA can be implemented onto microfluidic disk platforms which allows the detection of trace biochemical reactions with high resolutions. Herein, we propose a novel microfluidic system comprising a disk with a three-dimensional incubation chamber, which can reduce the amount of the reagents to 1/10 and the required time for the entire process to less than an hour. The incubation process achieves an antigen–antibody binding reaction as well as the binding of fluorogenic substrates to target proteins. The FLISA protocol in the 3D incubation chamber necessitates performing the antibody-conjugated microbeads’ movement during each step in order to ensure sufficient binding reactions. Vascular endothelial growth factor as concentration with ng mL−1 is detected sequentially using a benchtop process employing this 3D microfluidic disk. The 3D microfluidic disk works without requiring manual intervention or additional procedures for liquid control. During the incubation process, microbead movement is controlled by centrifugal force from the rotating disk and the sedimentation by gravitational force at the tilted floor of the chamber.

A nanofiber membrane with a high surface-to-volume ratio has advantages in applications such as those used for particulate matter filtration and gas detection. To maximize the potentials of the membrane structure, recent research has been attempted to control nanofiber geometries. In this paper, surface modification of a nanofiber membrane with a metal/ceramic nanostructure is performed to improve multi-functional filter performance, enhancing fine particle filtration and toxic gas absorption. Here, a smart filter is fabricated by electrospinning polyvinylidene difluoride (PVDF) nanofiber onto a nylon mesh and hydrothermal synthesis of ZnO nanoparticles onto a nanowire array on a PVDF nanofiber surface. On the ZnO nanowires–PVDF nanofiber layer filter, the pressure difference (ΔP = 4.13 kPa) is higher than the pure PVDF nanofiber layer. However, the filtration efficiency is 94.3% for a 0.3 μm particle size, which is higher than that of other sizes. Additionally, a ZnO nanowire array with high density on a PVDF nanofiber layer affects sensitivity (S = 39.37), with high resolution. The photocurrent characteristics of a smart filter have the potential for a photo-assisted redox reaction to detect toxic polar molecules in continuous airflow in real-time in indoor environments.

Background Enophthalmos may not appear immediately after trauma due to periorbital swelling in a blowout fracture, and preoperative measurements of enophthalmos cannot be used as a reliable guideline. It is important to predict the eventual final extent of enophthalmos in order to determine whether to perform surgery, and there have been several attempts to predict the degree of late enophthalmos using preoperative orbital volume. The purpose of this study is to investigate the correlation between the orbital volume ratio (OVR) with final enophthalmos and the palpebral fissure, and to find the OVR that induced 2 mm of enophthalmos in unilateral unoperated blowout fractures. Methods We retrospectively reviewed the medical records of 38 patients and divided them into 3 groups, determined by the fracture location. The relationships between the OVR and both the degree of enophthalmos and the palpebral fissure ratio (PFR) were assessed and, in particular, the OVR that induced 2 mm of enophthalmos was sought. Results Enophthalmos increased in proportion to the OVR, and there was a highly significant correlation between the increase in the OVR and the degree of enophthalmos (P0.05). The OVR that induced 2-mm enophthalmos was 112.18%. Conclusions The final degree of enophthalmos can be estimated by the preoperative measurement of OVR. Preoperative measurements of OVR can be used as quantitative values to predict the final degree of enophthalmos in pure blowout fractures.

Background Bioabsorbable plates and screws are commonly used to reduce maxillofacial bones, particularly in pediatric patients because they degrade completely without complications after bone healing. In this study, we encountered eight cases of a delayed foreign body reaction after surgical fixation with bioabsorbable plates and screws. Methods A total of 234 patients with a maxillofacial fracture underwent surgical treatment from March 2006 to October 2013, in which rigid fixation was achieved with the Inion CPS (Inion, Tampere, Finland) plating system in 173 patients and Rapidsorb (Synthes, West Chester, PA, USA) in 61 patients. Their mean age was 35.2 years (range, 15-84 years). Most patients were stabilized with two- or three-point fixation at the frontozygomatic suture, infraorbital rim, and anterior wall of the maxilla. Results Complications occurred in eight (3.4%) of 234 patients, including palpable, fixed masses in six patients and focal swelling in two patients. The period from surgical fixation to the onset of symptoms was 9-23 months. Six patients with a mass underwent secondary surgery for mass removal. The masses contained fibrous tissue with a yellow, grainy, cloudy fluid and remnants of an incompletely degraded bioabsorbable plate and screws. Their histological findings demonstrated a foreign body reaction. Conclusions Inadequate degradation of bioabsorbable plates caused a delayed inflammatory foreign body reaction requiring secondary surgery. Therefore, it is prudent to consider the possibility of delayed complications when using bioabsorbable plates and surgeons must conduct longer and closer follow-up observations.

Background Restoring orbital volume in large blowout fractures is still a technically challenge to the orbital surgeon. In this study, we restored the orbital wall using the combination of transorbital and transnasal approach with additional supports from the paranasal sinuses, and we compared the surgical outcome to that of a conventional transorbital method. Methods A retrospective review of all patients with pure unilateral blowout fractures between March 2007 and March 2013 was conducted. 150 patients were classified into two groups according to the surgical method: conventional transorbital method (group A, 75 patients, control group), and the combination of transorbital and transnasal approach with additional supports from the paranasal sinuses (group B, 75 patients, experimental group). Each group was subdivided depending on fracture location: group I (inferior wall), group IM (inferomedial wall), and group M (medial wall). The surgical results were assessed by the Hertel scale and a comparison of preoperative and postoperative orbital volume ratio (OVR) values. Results In the volumetric analysis, the OVR decreased more by the experimental groups than each corresponding control groups (P0.05). Conclusions Our surgical results suggest that orbital volume was more effectively restored by the combination of transorbital and transnasal approach with additional supports from the paranasal sinuses than the conventional method, regardless of the type of fracture.

ObjectivesThis study was investigated the recovery characteristics of propofol-remifentanil and sevoflurane-remifentanil anesthesia for total thyroidectomy MethodsEighty patients in ASA physical status 1 and 2 scheduled for total thyroidectomy were allocated randomly to either group P (n = 40) or group S (n = 40). Anesthesia was maintained with remifentanil effect site concentration (Ce) 1-3 ng/mL and propofol Ce 2-4 μ g/mL in the group P, and was maintained with remifentanil Ce 1-3 ng/mL and sevoflurane 1.5-2% in the group S. Blood pressure, heart rate, and bispectral (BIS) index were measured during perioperative period. The times from discontinuance of anesthetic agent to eye opening, to extubation, and to stating name were measured. Postoperative complications were evaluated. ObjectivesThis study was investigated the recovery characteristics of propofol-remifentanil and sevoflurane-remifentanil anesthesia for total thyroidectomy MethodsEighty patients in ASA physical status 1 and 2 scheduled for total thyroidectomy were allocated randomly to either group P (n = 40) or group S (n = 40). Anesthesia was maintained with remifentanil effect site concentration (Ce) 1-3 ng/mL and propofol Ce 2-4 μ g/mL in the group P, and was maintained with remifentanil Ce 1-3 ng/mL and sevoflurane 1.5-2% in the group S. Blood pressure, heart rate, and bispectral (BIS) index were measured during perioperative period. The times from discontinuance of anesthetic agent to eye opening, to extubation, and to stating name were measured. Postoperative complications were evaluated. ResultsThere were no significant differences between group P and S on the blood pressure, heart rate, and recovery time. BIS index of group P showed lower than that of group S during operation (P < 0.05). The incidences of side effects were similar in the two groups, though the incidence of nausea was higher in the group S (P < 0.05). ConclusionsPropofol-remifentanil anesthesia was more advantageous than sevoflurane-remifentanil anesthesia for thyroidectomy in view of side effect incidences.

BackgroundTemporalis muscle transfer produces prompt surgical results with a one-stage operation in facial palsy patients. The orthodromic method is surgically simple, and the vector of muscle action is similar to the temporalis muscle action direction. This article describes transferring temporalis muscle insertion to reconstruct incomplete facial nerve palsy patients.MethodsBetween August 2009 and November 2011, 6 unilateral incomplete facial nerve palsy patients underwent surgery for orthodromic temporalis muscle transfer. A preauricular incision was performed to expose the mandibular coronoid process. Using a saw, the coronoid process was transected. Three strips of the fascia lata were anchored to the muscle of the nasolabial fold through subcutaneous tunneling. The tension of the strips was adjusted by observing the shape of the nasolabial fold. When optimal tension was achieved, the temporalis muscle was sutured to the strips. The surgical results were assessed by comparing pre- and postoperative photographs. Three independent observers evaluated the photographs.ResultsThe symmetry of the mouth corner was improved in the resting state, and movement of the oral commissure was enhanced in facial animation after surgery.ConclusionsThe orthodromic transfer of temporalis muscle technique can produce prompt results by applying the natural temporalis muscle vector. This technique preserves residual facial nerve function in incomplete facial nerve palsy patients and produces satisfying cosmetic outcomes without malar muscle bulging, which often occurs in the turn-over technique.