Impact of Reactive Oxygen Species Scavenging on the Intermediate Production of Anthracene and Anthraquinone in Fresh versus Saltwater Environments.

While salinity can alter the photodegradation of hydrophobic organic compounds (HOCs), the cause of their altered kinetics in seawater is not well understood. Because HOC intermediate photoproducts are often more toxic than their parent compounds, characterizing the generation of intermediates in saline environments is needed to accurately predict their health effects. The present study investigated the influence of salinity on the generation of anthraquinone through the photolysis of anthracene and the generation of anthrone and 1-hydroxyanthraquinone from the photolysis of anthraquinone as well as their reactivities with hydroxyl radicals. This was conducted by measuring the photolysis rates of anthracene and anthraquinone and characterizing their product formation in buffered deionized water, artificial seawater, individual seawater halides (bromide, chloride, and iodide), dimethyl sulfoxide, furfuryl alcohol, and solutions of hydrogen peroxide. Salinity enhanced the persistence of anthraquinone by a factor >10 and altered its product formation, including the generation of the suspected carcinogen 1-hydroxyanthraquinone. In part, this was attributed to reactive oxygen species (ROS) scavenging by the seawater constituents chloride and bromide. In addition, anthraquinone and its hydroxylated products were found to be moderately to highly reactive with hydroxyl radicals, further illustrating their tendency to react with ROS in aqueous environments. The present study emphasizes the importance of considering the effects of salinity on organic contaminant degradation; it can significantly enhance the persistence of HOCs and alter their intermediate formation, subsequently impacting chemical exposure times and potential toxic effects on estuarine/marine organisms. Environ Toxicol Chem 2023;42:1721-1729. © 2023 SETAC.

Post-traumatic Telecanthus Induced by a Missed Diagnosis of Avulsion Fracture of the Medial Canthal Tendon.

Telecanthus is commonly accompanied by severe naso-orbito-ethmoid fractures. If there is only an avulsion fracture of the medial canthal tendon (MCT), the initial diagnosis may be missed, and post-traumatic telecanthus may follow. To avoid misdiagnosis of post-traumatic telecanthus, the following should be considered: avulsion fracture of the MCT should be suspected in the presence of an injury or edema of the medial canthal area; the facial computed tomography images should be carefully analyzed to confirm the presence of bone segment caused by the avulsion fracture of the MCT; physical examinations, such as the bowstring test and bimanual palpation, also provide essential data for early diagnosis. And even if early diagnosis is delayed, post-traumatic telecanthus can be improved through aggressive surgical correction.

Simulation of radioactive plume transport in the atmosphere including dynamics of particle aggregation and breakup.

Accurate prediction of the atmospheric transport of debris particles relies heavily on our knowledge of the size distribution of the particles within a debris cloud. Assuming a fixed particle size during simulations is not always viable since the size distribution of the debris can change during transport. Various microphysical processes, such as aggregation and breakup, influence debris particles and dictate any changes to the size distribution. To track those changes that can occur, a population balance model can be adopted and instituted within a model framework. Nonetheless, many of the models that simulate the transport of radioactive debris following a device-driven fission incident have historically neglected to consider these processes. As such, this work describes our effort to develop a modeling framework capable of simulating the transport and deposition of a radioactive plume generated from a fission incident with a dynamic population balance including particle aggregation and breakup. The impact of aggregation and breakup, individually and collectively, on the particle size distribution is explored using the developed framework. When simulating aggregation, for example, six mechanisms, including Brownian coagulation, the convective enhancement to Brownian coagulation, van der Waals-viscous force correction for Brownian coagulation, gravitational collection, turbulent inertial motion, and turbulent shear, are considered. Brownian coagulation and its corrections have, as one would expect, a large impact on relatively small aggregates. Aggregates with a diameter that is less than or equal to 1.0 µm, for instance, comprise 50.6 vol % of all aggregates in the absence of aggregation and 31.2 vol % when Brownian coagulation and its corrections are considered. Gravitational collection and, to a much lesser extent, turbulent shear and turbulent inertial motion are, conversely, of great importance to relatively large aggregates (i.e., diameter greater than 3.0 µm). Additionally, the individual effects of atmospheric and particle parameters, such as wind speed and particle density, are examined. Of the parameters examined, turbulent energy dissipation and aggregate fractal dimension (i.e., aggregate shape with lower values representing more irregular particles) were of substantial importance since both terms directly impact aggregate stability and, by extension, the breakup rate. Large-scale transport and deposition simulations in a dry atmosphere are also presented and discussed as a proof of concept.

Cosmetic Open Rhinoplasty in Acute Nasal Bone Fracture With Pre-Existing Deformity.

The simultaneous reduction of nasal bone fracture and cosmetic rhinoplasty is a challenging procedure, because of fracture severity and skeletal instability. Our aim was to investigate the surgical strategy and outcomes of cosmetic rhinoplasty according to the pre-existing nasal deformity when performing simultaneous reduction of nasal bone fracture and cosmetic rhinoplasty. In total, 71 patients who underwent cosmetic rhinoplasty were included. All patients were categorized according to pre-existing deformity, dorsal hump and irregularities, and deviation of the nose, wide nose, and flat nasal dorsum. The authors performed individual maneuvers to correct each deformity. Autologous tissue was used in all maneuvers for graft. Photoanalysis was performed to measure the deviation, nasal length, radix height, dorsal height, tip projection, nasofrontal angle, and nasolabial angle. Subjective evaluation of the functional and esthetic problems was confirmed through rhinoplasty outcome evaluation. In the analysis of the photographs, most patients presented improved scores ( P <0.05). The scores of satisfaction were significantly higher in the postoperative state ( P <0.05). As a postoperative complication, 2 cases of deviated tip occurred due to septal instability and were successfully revised with septoplasty and columellar strut graft. The authors created a harmonious face by evaluating, categorizing, and treating each deformity of the nose in patients with nasal fractures according to our algorithm.

Dll4 Inhibition Promotes Graft Retention in Fat Grafting Enriched with Adipose-Derived Stem Cells.

Autologous fat grafting is among the safest and most effective treatments for soft-tissue restoration and augmentation, and many efforts have been made to improve its efficiency, including adipose-derived stem cell (ASC) supplementation. Here, we investigated the role of Notch ligand Delta-like ligand 4 (Dll4) in angiogenesis within grafted fat and its effect on graft retention, as well as the effect of Dll4 inhibition on ASC supplementation. Using a murine fat graft model, we investigated the expression of Dll4 in fat grafts and assessed the graft volume, vascularity, and perfusion within the graft, and ASC differentiation patterns depending on the blockade of Dll4. The underlying mechanism of Dll4 inhibition on ASC supplemented fat grafts was investigated using transcriptome analysis. Dll4 was highly expressed in vascular endothelial cells (ECs) within grafted fat, where Dll4-blocking antibody treatment-induced angiogenesis, promoting fat graft retention. In addition, its effect on fat graft retention was synergistically improved when ASCs were concomitantly supplemented. The expression of junctional proteins was increased in ECs, and inflammatory processes were downregulated in grafted fat upon ASC supplementation and Dll4 inhibition. Dll4 inhibition induced vascularization within the grafted fat, thereby promoting graft retention and exhibiting synergistic effects with concomitant ASC supplementation. This study serves as a basis for developing new potential therapeutic approaches targeting Dll4 to improve graft retention after cell-assisted transfer.

Charging of radioactive and environmental airborne particles.

The charging of various airborne particles was investigated using single-particle levitation and charge-balance equations. Though radioactive decay and triboelectrification can induce charging, it is typically assumed that the aerosols in a radioactive plume will not carry significant charge at steady state since atmospheric particles can have their charge neutralized through the capture of adjacent counter-ions (i.e., diffusion charging). To assess this assumption, we directly measured the surface charge and charge density of various triboelectrically charged aerosols including radioactive uranium oxide (<1 µm), urban dust, Arizona desert dust, hydrophilic and hydrophobic silica nanoparticles, and graphene oxide powders using an electric field-assisted particle levitator in air. Of these particles, uranium oxide aerosols exhibited the highest surface charge density. Charge balance equations were employed to predict the average charge gained from radioactive decay as a function of time and to evaluate the effects of diffusion charging on triboelectrically charged radioactive and non-radioactive particles in the atmosphere. Simulation results show that particles, initially charged through triboelectrification, can be quickly discharged by diffusion charging in the absence of radioactive decay. Nevertheless, simulation results also indicate that particles can be strongly charged when they carry radionuclides. These experimental and simulation results suggest that radioactive decay can induce strong particle charging that may potentially affect atmospheric transport of airborne radionuclides.

Supernumerary Nostril: Formation of a Large Additional Nasal Cavity in an Adult Patient.

ABSTRACT: The supernumerary nostril is one of the rarest congenital nasal deformities. Most of the reported cases published were in young patients, and surgery was performed according to the surgeon's preference. The authors report a case of supernumerary nostril in an adult with a large additional nasal cavity and describe an effective surgical method. The operation was performed with the following steps: alar base and open rhinoplasty incisions were performed to widen the surgical field of view. An incision was made around the additional nostril in the nasal vestibule. The tract of the additional nostril was circumferentially excised, and the raw areas were approximated. The remnant portion was completely removed to combine the two nasal cavities into one. Weir excision, augmentation rhinoplasty, and tip-plasty were performed. The authors were able to obtain satisfactory aesthetic and functional effects by performing separate surgical methods for a supernumerary nostril with large additional nasal cavities in an adult.

The Incidence of Traumatic Optic Neuropathy Associated With Subtypes of Orbital Wall Fracture.

BACKGROUND: Traumatic optic neuropathy (TON) is a rare disease but leaves critical sequelae to patient. Purpose of this study is to evaluate the incidence of TON in each orbital wall fracture. MATERIALS AND METHODS: Retrospective review of 2629 patients with orbital wall fracture was performed in from January 2010 to March 2019, based on diagnostic code, Korean Standard Classification of Diseases, 7th Revision. The orbital wall fractures were divided into 4 subtypes: superior, medial, inferior, and lateral wall. Incidence of TON is analyzed according to subtypes, single and multiple wall fracture. RESULTS: Among 2629 patients with orbital wall fractures, 27 patients were diagnosed with TON with an incidence of 1.02%. In single wall fracture, only lateral wall showed significantly high TON incidence, which only zygomatic fracture was included in single lateral wall fracture. In multiple wall fracture, it was statistically significant in the superior wall. CONCLUSIONS: Fracture on lateral and superior orbital wall showed a tendency to increase the incidence of TON. Based on the above results, radiologic evaluation and physical examination is necessary for patient who has lateral and superior orbital wall fracture.

Analysis of the risk factors influencing complications in surgical treatment of mandibular fractures: A retrospective study.

The study aim was to identify risk factors associated with complications following open reduction and internal fixation of mandibular fractures. A retrospective cohort study was conducted in patients who were treated for mandibular fractures in a single center between January 2010 and December 2020. Authors classified postoperative complications as overall complications, infections, and reoperations. Factors that may be associated with these complications were grouped as patient, wound, and management variables. Statistical analysis was performed to determine whether these factors influenced complications. Among 175 patients, 125 underwent open reduction and internal fixation. Among patient variables, alcohol consumption was a risk factor for overall complications (p = 0.03) and reoperation (p = 0.02). Among wound variables, the more severe the external wound, the greater the incidence of overall complications (p = 0.001) and infections (p < 0.001). Presence of two or more fracture sites was a risk factor for reoperation (p = 0.038). Among management variables, intraoral and extraoral approaches increased the rates of overall complications, infections, and reoperation. In the multivariate analysis, only intraoral and extraoral approaches were associated with significant risks for overall complications (OR = 5.63, p = 0.017) and infections (OR = 11.53, p = 0.005). Alcohol consumption, external wound severity, multiple fracture site, and incision approach were related to postoperative complications. These findings can help guide surgical decisions and manage patient expectations after surgery.

Anti-Adhesive Effect of Porous Polylactide Film in Rats.

Excessive adhesion between tissues on a significant area can cause the development of disorders, cosmetic problems, and ileus. Methods for preventing adhesion include the use of drugs and anti-adhesion barriers for physical blocking. In this study, the adhesion prevention effect of polylactide film in porous form was analyzed. A porous polylactide film was manufactured using a molecular weight of at least 100,000. To generate porosity, 98% methylene chloride and 95% ethyl alcohol were used as solvents. The thickness, surface, and internal pore shape of film were investigated. The crystal structures and melting temperature of film were measured. In the rat model, the presence and severity of adhesion were then analyzed. The thickness of the film ranged from 10 to 20 µm. The surface of the film contained pores with diameters of less than 10 µm. Partial crystallinity appeared from 15° to 20°, but the structure was amorphous overall. In the rat cecum abrasion model, adhesion occurred in 3 of the 13 rats in the polylactide experimental group, representing a 23.1% incidence rate. There were statistically significant differences in the severity of adhesion. The use of porous polylactide films can reduce the incidence of adhesion.

Analysis of Complication in Mandibular Angle Fracture: Champy Technique Versus Rigid Fixation.

INTRODUCTION: The mandibular angle endures tension and compression during mastication, and proper internal fixation is essential when a fracture occurs. The authors analyzed the complication rate between Champy technique and rigid fixation, used in the treatment of mandibular angle fracture. METHODS: The retrospective study included patients with mandibular angle fracture in single center, from January 2003 to December 2019. The patients were categorized into 2 groups by fixation method of angle fracture: Champy technique which uses single miniplate and rigid fixation which uses multiple miniplate, reconstruction plate, compression plate, lag screw, and wire. Pearson chi-square test was used to analyze the complication rates. RESULTS: A total of 64 patients met inclusion criteria. Thirty-four patients had isolated angle fractures and 30 patients had multiple mandibular fractures. In isolated angle fracture, there were no significant differences in all complications between the Champy technique group and rigid fixation group. In multiple mandibular fractures, there were no significant differences in all complications between 2 groups. CONCLUSIONS: For isolated angle fractures, Champy technique is a reliable treatment method. Additionally, in case of multiple mandibular fractures, Champy technique is an effective fixation method in angle fractures when proper rigid fixation is performed for accompanying fractures.

Big Data Statistical Analysis of Facial Fractures in Korea.

BACKGROUND: The big data provided by Health Insurance Review and Assessment (HIRA) contains data from nearly all Korean populations enrolled in the National Health Insurance Service. We aimed to identify the incidence of facial fractures and its trends in Korea using this big data from HIRA. METHODS: We used the Korean Standard Classification of Disease and Cause of Death 6, 7 for diagnosis codes. A total of 582,318 patients were included in the final analysis. All statistical analyses were performed using SAS software and SPSS software. RESULTS: The incidence of facial fractures consistently declined, from 107,695 cases in 2011 to 87,306 cases in 2016. The incidence of facial fractures was the highest in June 2011 (n = 26,423) and lowest in January 2014 (n = 10,282). Nasal bone fractures were the most common, followed by orbit and frontal sinus fractures. The percentage of nasal bone fractures declined, whereas those of orbital fractures increased from 2011 to 2016 (P < 0.001). Among orbital fractures, inferior wall fractures were the most common, followed by medial wall fractures. Among mandibular fractures, angle fractures were the most common, followed by condylar process and symphysis fractures. Although it was difficult to predict the most common type of zygomatic and maxilla fractures, their incidence consistently declined since 2011. CONCLUSION: We observed trends in facial fractures in Korea using big data including information for nearly all nations in Korea. Therefore, it is possible to predict the incidence of facial fractures. This study is meaningful in that it is the first study that investigated the incidence of facial fractures by specific type.

A Comparative Analysis of Outcomes After Reduction of Zygomatic Fractures Using the Carroll-Girard T-bar Screw.

PURPOSE: Several approaches are available for managing zygomatic fractures; however, each approach has its complications. Use of the Carroll-Girard T-bar screw (CGTS) can reduce complications because it reduces the number of approaches needed for reduction. This study aimed to analyze the efficiency of the CGTS compared with the 3-point approach. METHODS: A retrospective study was conducted by reviewing the computed tomography scans of 204 patients who underwent reduction surgery of Knight and North type 3, 4, or 5 zygomatic fractures from March 2009 to August 2017. Facial asymmetry, operative time, and complications were evaluated to compare 2 groups of patients: those who underwent CGTS and those who did not. Bilateral differences in the distance from the reference plane to the malar eminence in 3 dimensions based on computed tomography scans were used to calculate facial asymmetry. RESULTS: Among 204 patients, 91 were treated with CGTS whereas 113 patients underwent a 3-point approach. Bilateral differences in the position of the malar eminence and facial asymmetry were not statistically different in both groups. Operative time was not different in both groups. However, when patients with type 4 fracture were independently compared, the mean operative time was significantly shorter for the CGTS group. Wound dehiscence occurred in 11 patients (9.7%) in the 3-point approach group, compared with none in the CGTS group. None of the patients in the CGTS group complained of postoperative cheek scars over their incision sites. CONCLUSIONS: This study revealed that CGTS is a useful and feasible instrument that can reduce the number of approaches for zygomatic bone reduction and help clinicians achieve satisfactory outcomes.

Oblique transnasal wiring canthopexy via Y-V epicanthoplasty for telecanthus correction in a patient with Waardenburg syndrome.

Telecanthus is a common symptom accompanied by Waardenburg syndrome, a rare genetic disorder. The optimal surgery for telecanthus correction is still debated. A 28-year-old patient with Waardenburg syndrome underwent transnasal wiring canthopexy using a Y-V epicanthoplasty for telecanthus correction. A Mini-Monoka stent was used to prevent damage to the lacrimal apparatus. The intercanthal distance decreased from 50 mm to 43.2 mm. The easily designed Y-V epicanthoplasty incision provides sufficient operative field for oblique transnasal wiring, which is effective in properly positioning the medial canthal tendon. It has minimal scarring resulting in satisfactory cosmetic outcomes.

Effect of fractional ablative carbon dioxide laser with lidocaine spray on skin flap survival in rats.

BACKGROUND: Lidocaine spray is a local anesthetic that improves random-pattern skin flap survival. The fractional ablative carbon dioxide laser (FxCL) produces vertical microchannels that delivers topically applied drugs to the skin. In this study, we hypothesized that FxCL therapy would enhance the lidocaine effect to improve random-pattern skin flap survival in rats. METHODS: McFarlane random-pattern skin flaps were elevated in 48 rats, which were divided into four groups according to treatment: FxCL+lidocaine, FxCL, lidocaine, and nontreatment (control). On postoperative day 7, necrotic flap areas, the number of capillary vessels, and neutrophil count were evaluated. Anti-rat vascular endothelial growth factor (VEGF) and CD31 antibody activity were also evaluated by immunohistochemical staining. RESULTS: Flap survival rate was 53.41%± 5.43%, 58.16%± 4.80%, 57.08%± 5.91%, and 69.08%±3.20% in the control, lidocaine, FxCL, and FxCL+lidocaine groups, respectively. Mean neutrophil count in the intermediate zone excluding the necrotic tissue was 41.70± 8.40, 35.43± 6.41, 37.23±7.15, and 27.20± 4.24 cells/field in the control, lidocaine, FxCL, and FxCL+lidocaine groups, respectively. Anti-rat VEGF and CD31 antibody activity were the highest in the FxCL+lidocaine group. CONCLUSION: FxCL with lidocaine had a positive effect on random-pattern skin flap survival in rats. Thus, FxCL with lidocaine spray should be considered as a new treatment option to improve flap viability.

Ischemic Time in Free-Flap Surgery With Arteriovenous Bundle Interposition Graft: Comparison of Two Anastomosis Sequences.

BACKGROUND: During free-tissue transfer for scalp reconstruction, pedicle lengthening may be required when finding a recipient vessel is difficult because of defects from previous surgery. Arteriovenous (AV) bundle interposition grafting is a good option. This study compared 2 sequences of AV bundle interposition grafting when flap pedicle lengthening is needed. METHODS: Two anastomosis methods were used. In the recipient lengthening type (R type), the flap was harvested and the AV bundle was harvested from a donor vessel for lengthening. In the flap lengthening type (F type), the flap was harvested first. Next, in contrast to that in the R type method, the authors performed anastomosis with a flap pedicle and bundle before the AV bundle was harvested. RESULTS: The mean flap pedicle length was 8.75 cm (range, 5-11 cm). The AV bundle had a mean length of 9.25 cm (range, 6-13 cm), meaning that 13 cm of additional pedicle length can be added. The mean length of the extended vascular pedicle was 18 cm (range, 14-23 cm). CONCLUSION: This study compared the results of F type and R type AV bundle interposition grafting. The F type allowed easy monitoring of the anastomosis of the flap pedicle and ensured flap stability by reducing continuous ischemic time. Finally, this study confirmed the efficacy and safety of the AV bundle interposition graft in scalp reconstruction.