Lateral Tarsoplasty Combined with a Full-Thickness Skin Graft for Managing Severe Lower Eyelid Ectropion Following the Subciliary Approach for Infra-Orbital Rim Fracture: A Retrospective Observational Study.

Subciliary incision is a common approach for facial fracture surgery; however, it has a higher incidence of lower lid ectropion, which can be particularly challenging for beginning surgeons to manage. This study reports the usage of lateral tarsoplasty combined with a full-thickness skin graft (FTSG) to correct severe ectropion following the subciliary approach for infra-orbital rim fractures. We retrospectively reviewed all facial fracture cases involving infra-orbital rim fractures through a subciliary approach treated in our department between March 2021 and May 2023. Electronic medical records and clinical digital photographs of patients who met the inclusion criteria were reviewed. After reviewing 196 cases that used the subciliary approach, we found 6 patients (3.06%; 4 males and 2 females; mean age, 68.5 ± 4.89 years) with postoperative severe ectropion managed using lateral tarsoplasty and FTSG. The mean ectropion development and correction times after facial fracture surgery were 0.78 ± 0.24 and 0.91 ± 0.37 months, respectively. At the 12-month follow-up, all patients showed favorable outcomes, and the position of their lower eyelids was well maintained without ectropion recurrence. Based on these successful outcomes, lateral tarsoplasty combined with FTSG is proposed to be an effective and straightforward method for managing lower eyelid ectropion caused by facial fracture surgery.

Comparison of anaerobic digestion of starch- and petro-based bioplastic under hydrogen-rich conditions.

To identify an economically viable waste management system for bioplastics, thermoplastic starch (TPS) and poly(butylene adipate-co-terephthalate) (PBAT) were anaerobically digested under hydrogen (H2)/carbon dioxide (CO2) and nitrogen (N2) gas-purged conditions to compare methane (CH4) production and biodegradation. Regardless of the type of bioplastics, CH4 production was consistently higher with H2/CO2 than with N2. The highest amount of CH4 was produced at 307.74 mL CH4/g volatile solids when TPS digested with H2/CO2. A stepwise increased in CH4 yield was observed, with a nominal initial increment followed by accelerated methanogenesis conversion as H2 was depleted. This may be attributed to a substantial shift in the microbial structure from hydrogenotrophic methanogen (Methanobacteriales and Methanomicrobiales) to heterotrophs (Spirochaetia). In contrast, no significant change was observed with PBAT, regardless of the type of purged gas. TPS was broken down into numerous derivatives, including volatile fatty acids. TPS produced more byproducts with H2/CO2 (i.e., 430) than with N2 (i.e., 320). In contrast, differential scanning calorimetry analysis on PBAT revealed an increase in crystallinity from 10.20 % to 12.31 % and 11.36 % in the H2/CO2- and N2-purged conditions, respectively, after 65 days of testing. PBAT surface modifications were characterized via Fourier transform infrared spectroscopy and scanning electron microscopy. The results suggest that the addition of H2/CO2 can enhance the CH4 yield and increase the breakdown rate of TPS more than that of PBAT. This study provides novel insights into the CH4 production potential of two bioplastics with different biodegradabilities in H2/CO2-mediated anaerobic digestion systems.

A comparative study on the distribution behavior of microplastics through FT-IR analysis on different land uses in agricultural soils.

Plastic materials have been variously exposed to arable land for decades through soil mulching, plastic housing, and sewage sludge composting. Their mechanical abrasion and biochemical degradation induce the proliferation of myriad microplastics that can further be broken into smaller nano-sized pieces that can be further accumulated in living organisms (including soil invertebrates, fruits, and vegetables); they can also be widely dispersed in neighboring environments. Despite the intensive use of plastics in agriculture, little is known about their origin of occurrence and environmental fate, especially with a size below 100 µm. Therefore, in this study, microplastics with a size in the range of 20-2,000 µm were investigated in soil samples obtained from three different conditions of land uses: tilled with plastic mulch, bare ground (i.e., uncultivated land), and in between the greenhouses of the farmland D located in Namyangju-si, Gyeonggi-do, Republic of Korea. They were primarily identified using Fourier transform infrared (FT-IR) spectroscopy coupled with a microscope. Prior to performing the analysis, microplastic extraction from the soil samples was validated using standardized high-density polyethylene (HDPE) microplastics of various sizes ranging from 20 to 500 µm. As a result, the number of microplastics was estimated to be (241 ± 52), (195 ± 37), and (306 ± 56) particles per kg of dry soil in tillage, bare ground, and in between greenhouses, respectively. They consist of polyethylene (PE), polypropylene (PP), and poly(ethylene terephthalate) (PET), which are the basic constituents of commonly used agricultural products. The particle size distribution depends on the type of plastic, the time elapsed since their usage, and the degree and duration of environmental exposure; the plastic particle sizes were smaller in tillage and around the greenhouses since agricultural films have been weathered for a long time, whereas those with relatively large sizes were found in the uncultivated.

Rapid surface degradation of co-axially arranged polypropylene globules by nanoporous carbonized TiO2 assisted with UV-C.

The degradation of plastics, especially polypropylene (PP), is difficult since it is the most hydrophobic polymer. Photocatalytic degradation of PP films has been reported to be one of the most efficient degradation techniques. However, it is still insignificant to employ it in field applications. In this study, TiO2 nanoparticles supported on amorphous carbon with nanoporosity (TiO2@NC) are used as a photocatalyst to degrade macro-sized co-axially oriented PP globules under the influence of UV-C irradiation. Surface characterization such as SEM, ATR-FTIR, and XPS of the PP globules was performed. The SEM images distinctly showed the surface degradation phenomenon. Interestingly, the ATR-FTIR spectra demonstrated a significant rise in the band intensity in the -OH radical region and fairly in the CO region as well, with the increase in the photocatalytic time. Surprisingly, in the XPS spectra, the intensity of C-1s spectra kept on falling, and the intensity of O-1s spectra kept on rising with the increase in the photocatalytic time. The higher surface area due to nanoporosity of TiO2@NC enhanced the photocatalytic degradation of PP globules than previously reported studies. TiO2@NC seems to be a potential catalyst for the degradation of different types of polymers.

Management of epidermal cysts arising from scar tissues: A retrospective clinical study.

Few reports have described epidermal cysts (ECs) arising from scar tissues, and the standard course of treatment has not been established. We aimed to report the findings of a Korean patient series with ECs arising from scar tissues, to describe patient management in the context of previous publications, and to present a simple algorithm for managing ECs arising from scar tissues.We managed 6 patients with ECs arising from scar tissues, and retrospectively reviewed their demographic and clinical data.The scars were located on the anterior chest wall (n = 3), shoulder (n = 1), forehead (n = 1), and ear lobule (n = 1). Two patients with anterior chest wall scars, 1 with a shoulder scar, and 1 with an ear lobule scar had keloid scars, whereas the other patients had hypertrophic scars. The scar sizes ranged from 2 × 1 cm to 9 × 7 cm. The EC sizes ranged from 0.2 × 0.2 cm to 2 × 1.5 cm. Three patients underwent total scar revisions with complete EC excisions, 2 underwent partial scar tissue excisions with complete EC excisions, and 1 had laser therapy for the scar and EC. No complications occurred, and all patients' final outcomes were satisfactory during the mean follow-up period of 14.8 months.We successfully managed the patients with ECs arising from scar tissues. We recommend that surgeons and patients first decide whether the ECs and scar tissue should be completely removed. Moreover, consideration should be given to the options chosen for the management of ECs. Finally, postoperative scar care is necessary to prevent hypertrophic and keloid scar recurrences.

Reconstruction of infected trunk wounds with pedicled rectus abdominis musculocutaneous flaps: a retrospective case series.

OBJECTIVE: To completely treat and cover extensively infected trunk defects, reconstruction should be performed using a sufficiently vascularised flap, such as a muscle or musculocutaneous flap after perfect debridement. These reconstructive surgeries are challenging in patients with severe comorbidities. In this case series, we describe extensively infected trunk defect reconstruction, in patients with severe comorbidities, using a pedicled rectus abdominis musculocutaneous flap and suggest an algorithm for reconstruction. METHOD: Between March 2011 and March 2015, participating patients underwent reconstruction of extensively infected trunk defects using a pedicled rectus abdominis musculocutaneous flap. All patients had diabetes and hypertension, and several patients had severe comorbidities, including heart and renal failure. Bacterial cultures revealed that meticillin-resistant Staphylococcus aureus (MRSA) was present in seven patients (with concurrent Pseudomonas aeruginosa in two patients), multidrug-resistant Acinetobacter baumannii in one patient and Mycobacterium tuberculosis in two patients. RESULTS: A total of 10 patients underwent the procedure. The pedicled rectus abdominis musculocutaneous flaps survived completely in all 10 patients. There were no complications related to the flaps, although two patients developed minor wound dehiscence, which may be due to their comorbidities. There were no signs of recurrent infection during the follow-up period in each case. CONCLUSION: Reconstruction using the pedicled rectus abdominis musculocutaneous flap is a good treatment option for extensively infected three-dimensional trunk defects, even for patients with severe comorbidities.

Concordant Surgical Treatment: Non-melanocytic Skin Cancer of the Head and Neck.

BACKGROUND: Skin cancer is the most common type of cancer. Of the 4 million skin lesions excised annually worldwide, approximately 2 million are considered cancerous. In this study, we aimed to describe a regional experience with skin cancers treated by a single senior surgeon and to provide a treatment algorithm. METHODS: The medical records of 176 patients with head and neck non-melanocytic skin cancer (NMSC) who were treated by a single surgeon at our institution between January 2010 and May 2016 were retrospectively reviewed, and their data (age, sex, pathological type, tumor location/size, treatment modality) were analyzed. Patients with cutaneous squamous cell carcinoma (cSCC) who were classified as a high-risk group for nodal metastasis underwent sentinel node mapping according to the National Comprehensive Cancer Network guidelines. RESULTS: Among the patients with NMSC who were treated during this period, basal cell carcinoma (BCC; n=102, 57.9%) was the most common pathological type, followed by cSCC (n=66, 37.5%). Most lesions were treated by complete excision, with tumor-free surgical margins determined via frozen section pathology. Thirty-one patients with high-metastasis-risk cSCC underwent sentinel node mapping, and 17 (54.8%) exhibited radiologically positive sentinel nodes. Although these nodes were pathologically negative for metastasis, 2 patients (6.5%) later developed lymph node metastases. CONCLUSION: In our experience, BCC treatment should comprise wide excision with tumor-free surgical margins and proper reconstruction. In contrast, patients with cSCC should undergo lymphoscintigraphy, as nodal metastases are a possibility. Proper diagnosis and treatment could reduce the undesirably high morbidity and mortality rates.

Correlation between the 2-Dimensional Extent of Orbital Defects and the 3-Dimensional Volume of Herniated Orbital Content in Patients with Isolated Orbital Wall Fractures.

BACKGROUND: The purpose of this study was to assess the correlation between the 2-dimensional (2D) extent of orbital defects and the 3-dimensional (3D) volume of herniated orbital content in patients with an orbital wall fracture. METHODS: This retrospective study was based on the medical records and radiologic data of 60 patients from January 2014 to June 2016 for a unilateral isolated orbital wall fracture. They were classified into 2 groups depending on whether the fracture involved the inferior wall (group I, n=30) or the medial wall (group M, n=30). The 2D area of the orbital defect was calculated using the conventional formula. The 2D extent of the orbital defect and the 3D volume of herniated orbital content were measured with 3D image processing software. Statistical analysis was performed to evaluate the correlations between the 2D and 3D parameters. RESULTS: Varying degrees of positive correlation were found between the 2D extent of the orbital defects and the 3D herniated orbital volume in both groups (Pearson correlation coefficient, 0.568-0.788; R2=32.2%-62.1%). CONCLUSIONS: Both the calculated and measured 2D extent of the orbital defects showed a positive correlation with the 3D herniated orbital volume in orbital wall fractures. However, a relatively large volume of herniation (>0.9 cm3) occurred not infrequently despite the presence of a small orbital defect (<1.9 cm2). Therefore, estimating the 3D volume of the herniated content in addition to the 2D orbital defect would be helpful for determining whether surgery is indicated and ensuring adequate surgical outcomes.

Effects of 8-week combined training on body composition, isokinetic strength, and cardiovascular disease risk factors in older women.

BACKGROUND AND AIMS: Decline in muscle endurance and strength as well as attenuated cardiac function with aging not only leads to overall physical function decline but also has a close relationship with cardiovascular disease occurrence. This study examined the effects of an 8-week combined training program (i.e., consisting of both aerobic and resistance training) on body composition, isokinetic strength, and cardiovascular disease (CVD) risk factors in older women. METHODS: Nineteen women, aged 65-75 years, were randomly assigned to either a combined training (CT, n = 9) or an aerobic training (AT, n = 10) group. Body composition and isokinetic strength were assessed before and after the exercise program. Blood samples were collected to identify CVD risk factors. RESULTS: At the end of the training program, body mass, body fat mass, percent body fat, and body mass index decreased significantly and lean mass increased significantly in the CT group compared with those in the AT group (p < 0.05). Isokinetic strength was also significantly greater in the CT group than in the AT group (p < 0.05). In addition, the C-reactive protein level was significantly lower in the CT group than in the AT group, whereas interleukin-6, tumor necrosis factor-α, and total cholesterol levels were significantly lower in both groups (p < 0.05). CONCLUSIONS: An 8-week combined exercise program benefits body composition, especially lean mass, and positively affects isokinetic strength and CVD risk factors. Therefore, increasing lean mass and strength by continuously participating in a combined exercise program may be an effective treatment for preventing and improving CVD in older women.

The removal of 1,4-dioxane from polyester manufacturing process wastewater using an up-flow Biological Aerated Filter (UBAF) packed with tire chips.

1,4-Dioxane is one of the by-products from the polyester manufacturing process, which has been carelessly discharged into water bodies and is a weak human carcinogen. In this study, a laboratory-scale, up-flow biological aerated filter (UBAF), packed with tire chips, was investigated for the treatment of 1,4-dioxane. The UBAF was fed with effluent, containing an average of 31 mg/L of 1,4-dioxane, discharged from an anaerobic treatment unit at H Co. in the Gumi Industrial Complex, South Korea. In the batch, a maximum of 99.5 % 1,4-dioxane was removed from an influent containing 25.6 mg/L. In the continuous mode, the optimal empty bed contact time (EBCT) and air to liquid flow rate (A:L) were 8.5 hours and 30:1, respectively. It was also found that the removal efficiency of 1,4-dioxane increased with increasing loading rate within the range 0.04 to 0.31 kg 1,4-dioxane/m(3)·day. However, as the COD:1,4-dioxane ratio was increased within the range 3 to 46 (mg/L COD)/(mg/L 1,4-dioxane), the removal efficiency unexpectedly decreased.

Modified uvulopalatopharyngoplasty for the treatment of obstructive sleep apnea-hypopnea syndrome: resection of the musculus uvulae.

OBJECTIVE: To assess the outcome of a modified uvulopalatopharynbgoplasty (UPPP) technique with preservation of the uvula mucosa and partial resection of the musculus uvula. STUDY DESIGN AND METHODS: A prospective randomized controlled trial. Sixteen male patients underwent a classic UPPP, and another 16 male patients underwent a modified UPPP. The parameters evaluated were the subjective symptom score, the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), the Stanford Sleepiness Scale (SSS), and polysomnography results. RESULTS: Postoperative snoring, apnea, morning headache, daytime sleepiness, pharyngeal foreign body sensation, and global discomfort were not significantly different between the two groups. Among seven subjective measures of sleep quality from the PSQI, the subjective sleep quality was significantly improved in both groups. Postoperatively, the SSS was not significantly changed in both groups; however, the ESS was significantly improved in both groups. The polysomnographic findings showed a statistically significantly improvement in the apnea index and the apnea-hypopnea index. CONCLUSION: Although the modified group did not have more profound improvement in sleep quality and decreased postoperative pharyngeal discomfort, modified UPPP was an effective surgical method for the treatment of obstructive sleep apnea-hypopnea syndrome.