Functional evaluation of Septal L-strut extension graft in East Asians.

BACKGROUND: The septal L-strut extension graft (SLEG) consists of anterior extended spreader graft and caudal septal extension graft. SLEG is used to increase the anterocaudal projection from a low-profile nose by creating the de-novo septum. This retrospective study verified the effectiveness of SLEG in improving the nasal function in East Asians. MATERIALS: Medical records of patients who underwent septorhinoplasty with SLEG were retrospectively reviewed. The clinical features showed under-projected lower two-thirds of the nose with septal deviation, saddle nose, and short nose. We analyzed the post-operative changes in the NOSE score and variables of nasal geometry measured using acoustic rhinometry through long-term follow-up. RESULTS: Patients were divided into two groups, those who underwent SLEG with turbinoplasty (Group A) and SLEG alone (group B). The NOSE scores decreased significantly in groups A and B, and the improvement was statistically more significant in Group A (p < 0.05). Acoustic rhinometry showed an increase in nasal cavity volume (VOL1) on the deviated side in Group A, and an increase in minimal cross-sectional area 1 (MCA1) on the deviated side in Group B (p < 0.05). The non-deviated side did not show significant reduction in MCA1 and VOL1 after SLEG with or without turbinoplasty. Thus, SLEG, by itself, improved airway function in East Asians. CONCLUSIONS: SLEG has proven to be valuable in improving nasal function.

Myomucosal composite graft: A simple technique for full-thickness vermilion defects of the lower lip.

Reconstruction of vermillion defects of the lower lip requires careful consideration of functional and aesthetic aspects. Traditionally, various local flap methods involving tissue advancement from the corner of the mouth, lateral chin, and medial cheek have been commonly employed to fill lower lip defects. However, these approaches have inherent limitations, which include technical complexity, disruption of the orbicularis oris muscle, lip tightening, microstomia, and visible scarring. To overcome these limitations, we employed a free myomucosal composite graft from the lower lip to reconstruct small to medium vermilion defects. Our technique is based on a simple and reproducible surgical approach that facilitates natural volume rearrangement of tissues. Moreover, this method enables precise inset and tension-free repair, prevents lip tightening, and offers excellent aesthetic outcomes with no vertical scarring and appropriate color matching with surrounding tissues.

Epidemiological characteristics and importance of lobulation of giant epidermal cysts: An 18-year retrospective review of 19 cases.

Giant epidermal cysts, which have a diameter of ≥5 cm, have rarely been reported. Giant epidermal cysts that have multiple lobules are referred to as multilocular giant epidermal cysts. This study aims to establish the epidemiological characteristics and statistically determine the significance of lobulation in giant epidermal cysts. Data on 19 patients who developed giant epidermal cysts between January 2003 and February 2021 were retrospectively reviewed. Patients were divided into 2 groups based on the presence of septa and the differences in characteristics were analyzed. Among the 19 patients, 16 (84.2%) were male, and the mean age was 57.7 ±â€…10.6 years. The mean patient-reported tumor duration was 14.8 ±â€…12.5 years. Seven (36.8%) patients had multilocular giant epidermal cysts, whereas 12 (63.2%) had unilocular giant epidermal cysts. Compared with unilocular giant epidermal cysts, multilocular giant epidermal cysts had a significantly larger mean diameter (6.0 ±â€…0.7 vs 8.2 ±â€…1.8 cm, P = .02) and estimated volume (91.8 ±â€…43.3 vs 250.0 ±â€…157.0 mL, P = .02). Giant epidermal cysts have distinctive epidemiologic characteristics with predominance among males, those in their 50s, and a long tumor duration. Multilocular giant epidermal cysts are significantly larger in diameter and volume than unilocular ones.

Staged Excision Technique to Reduce Scar Length.

Patients and surgeons are often disappointed with the scar length after conventional staged excision of large disfiguring skin lesions. We have developed an alternative approach to facilitate scar length reduction. We aimed to report the efficacy of our staged excision method, which includes a hexagonal-pattern excision, wide undermining, and purse-string suture. Sixty-five patients, each with one lesion, were included in the current study. The lesion length and width were recorded, and the scar area was calculated at each stage. The final scar length after performing the altered staged excision method was compared with that obtained after the conventional staged excision method, which was calculated using a theoretical scar model. Patient satisfaction was also evaluated. The mean longest axis length was 9.41 ± 3.83 cm preoperatively, 9.50 ± 3.92 cm after the first stage postoperatively, and 10.19 ± 3.98 cm after the final stage. The mean lesion width was 6.50 ± 3.48 cm preoperatively, 3.60 ± 1.77 cm after the first stage postoperatively, and 0.42 ± 0.31 cm after the final stage. The final scar length obtained using the altered procedure was much shorter than what would be obtained using conventional staged excision. The patient satisfaction score was 8.8 ± 1.1 out of a possible 10.0 rating. Staged excision with a hexagonal-pattern excision, wide undermining, and purse-string closure may improve aesthetic results.

Long-Term Resorption Rate of Autogenous Onlay Graft in East Asian Rhinoplasty: A Retrospective Study.

BACKGROUND: Autologous material remains the preferred graft material for use in rhinoplasty. However, resorption rates of autografts remain controversial. In addition, long-term follow-up studies on autografts are rare. Thus, the objective of the present study was to access long-term resorption rates of various autologous grafts on the upper nasal third. METHODS: Medical records of patients who had undergone septorhinoplasty with dorsal augmentation using autologous tissues between 2009 and 2018 were retrospectively reviewed. Autogenous grafts applied on the nasal dorsum were categorized into three groups: rolled superficial mastoid fascia, diced cartilage wrapped with superficial mastoid fascia, and rolled sacral dermis. Preoperative and postoperative photographs were used to evaluate resorption rates and projection. RESULTS: The rolled sacral dermis group showed a steep increase in postoperative projection but a sharp decrease in long-term follow-up projection compared to the other two groups. Among these three groups, there were statistically significant trend differences in rhinion (p < 0.001) and ½ nasion-rhinion point (p < 0.001), but not in nasion. Of these three groups, the rolled sacral dermis group showed the most projection, followed by the diced cartilage wrapped with superficial mastoid fascia group. The resorption rate was the highest in the rolled superficial mastoid fascia group (p < 0.001). Regarding resorption rates in the other two groups, the rolled sacral dermis group had a higher rate than the diced cartilage wrapped with superficial mastoid fascia group. CONCLUSIONS: At least 50 percent of resorption was observed in almost all groups in the long term. The choice of graft material and proper decision-making could determine success or failure. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

Late-Onset Inflammation in Asian Rhinoplasty Using Alloplastic Implants.

BACKGROUND: Late-onset inflammation is a rare complication that may occur several months to years after undergoing an uneventful rhinoplasty using alloplastic implants and an uneventful postoperative course. Studies to determine the pathophysiological mechanisms of late-onset inflammation related to implants used in rhinoplasty are limited. The purpose of the study was to analyze differences between non-healthy capsules (NHC) with late-onset inflammation and healthy capsules (HC) without inflammation as controls to determine the possible cause of the inflammation. METHODS: Between April 2009 and May 2018, 39 patients who underwent rhinoplasty with alloplastic implants underwent histological studies. Twenty-one patients in the NHC group showed late-onset inflammation, while 18 patients in the HC group did not display late-onset inflammation. Capsules around the alloplastic implants were harvested, and histological studies using hematoxylin and eosin, Masson's trichrome, colloidal iron, and CD31 staining were performed and compared between the NHC and HC groups. RESULTS: In hematoxylin and eosin and Masson's trichrome staining, edematous granulation tissues, inflammatory cellular contents, and a disorganized collagen layer were increased in the NHC group compared to the HC group. The colloidal iron staining revealed mucin deposition in the NHC group. CD31-positive cells were observed lining the capsule in both groups; however, the lining cells were damaged in the NHC group. CONCLUSION: Granulation tissues, inflammatory reaction, collagen degeneration, mucin deposition, and endothelial lining cell damage were greater in the NHC group compared to the HC group. Damaged capsules may play a crucial role in late-onset inflammation. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A 10 nV/rt Hz noise level 32-channel neural impedance sensing ASIC for local activation imaging on nerve section.

A 10 nV/rt Hz noise level 32-channel neural impedance sensing ASIC is presented for the application of local activation imaging in nerve section. It is increasingly known that the monitoring and control of nerve signals can improve physical and mental health. Major nerves, such as the vagus nerve and the sciatic nerve, consist of a bundle of fascicles. Therefore, to accurately control a particular application without any side effects, we need to know exactly which fascicle was activated. The only way to find locally activated fascicle is to use electrical impedance tomography (EIT). The ASIC to be introduced is designed for neural EIT applications. A neural impedance sensing ASIC was implemented using CMOS 180-nm process technology. The integrated input referred noise was calculated to be 0.46 µVrms (noise floor 10.3 nVrms/rt Hz) in the measured noise spectrum. At an input of 80 mV, the squared correlation coefficient for linear regression was 0.99998. The amplification gain uniformity of 32 channels was in the range of + 0.23% and - 0.29%. Using the resistor phantom, the simplest model of nerve, it was verified that a single readout channel could detect a signal-to- noise ratio of 75.6 dB or more. Through the reservoir phantom, real-time EIT images were reconstructed at a rate of 8.3 frames per second. The developed ASIC has been applied to in vivo experiments with rat sciatic nerves, and signal processing is currently underway to obtain activated nerve cross-sectional images. The developed ASIC was also applied to in-vivo experiments with rat sciatic nerves, and signal processing is currently underway to obtain locally activated nerve cross-sectional images.

Influence of Deposition Pressure on the Properties of Round Pyramid Textured a-Si:H Solar Cells for Maglev.

HIT (Heterojunction with Intrinsic Thin-layer) photovoltaic cells is one of the highest efficiencies in the commercial solar cells. The pyramid texturization for reducing surface reflectance of HIT solar cells silicon wafers is widely used. For the low leakage current and high shunt of solar cells, the intrinsic amorphous silicon (a-Si:H) on substrate must be uniformly thick of pyramid structure. However, it is difficult to control the thickness in the traditional pyramid texturing process. Thus, we textured the intrinsic a-Si:H thin films with the round pyramidal structure by using HNO3, HF, and CH3COOH solution. The characteristics of round pyramid a-Si:H solar cells deposited at pressure of 500, 1000, 1500, and 2000 mTorr by PECVD (Plasma Enhanced Chemical Vapor Deposition) was investigated. The lifetime, open circuit voltage, fill factor and efficiency of a-Si:H solar cells were investigated with respect to various deposition pressure.

SIMULATION OF ION CONDUCTION IN α-HEMOLYSIN NANOPORES WITH COVALENTLY ATTACHED ß-CYCLODEXTRIN BASED ON BOLTZMANN TRANSPORT MONTE CARLO MODEL.

Ion channels, as natures' solution to regulating biological environments, are particularly interesting to device engineers seeking to understand how natural molecular systems realize device-like functions, such as stochastic sensing of organic analytes. What's more, attaching molecular adaptors in desired orientations inside genetically engineered ion channels, enhances the system functionality as a biosensor. In general, a hierarchy of simulation methodologies is needed to study different aspects of a biological system like ion channels. Biology Monte Carlo (BioMOCA), a three-dimensional coarse-grained particle ion channel simulator, offers a powerful and general approach to study ion channel permeation. BioMOCA is based on the Boltzmann Transport Monte Carlo (BTMC) and Particle-Particle-Particle-Mesh (P(3)M) methodologies developed at the University of Illinois at Urbana-Champaign. In this paper, we have employed BioMOCA to study two engineered mutations of α-HL, namely (M113F)(6)(M113C-D8RL2)(1)-ß-CD and (M113N)(6)(T117C-D8RL3)(1)-ß-CD. The channel conductance calculated by BioMOCA is slightly higher than experimental values. Permanent charge distributions and the geometrical shape of the channels gives rise to selectivity towards anions and also an asymmetry in I-V curves, promoting a rectification largely for cations.