Recent Developments in (K, Na)NbO3-Based Lead-Free Piezoceramics.

(K0.5Na0.5)NbO3 (KNN)-based ceramics have been extensively investigated as replacements for Pb(Zr, Ti)O3-based ceramics. KNN-based ceramics exhibit an orthorhombic structure at room temperature and a rhombohedral-orthorhombic (R-O) phase transition temperature (TR-O), orthorhombic-tetragonal (O-T) phase transition temperature (TO-T), and Curie temperature of -110, 190, and 420 °C, respectively. Forming KNN-based ceramics with a multistructure that can assist in domain rotation is one technique for enhancing their piezoelectric properties. This review investigates and introduces KNN-based ceramics with various multistructures. A reactive-templated grain growth method that aligns the grains of piezoceramics in a specific orientation is another approach for improving the piezoelectric properties of KNN-modified ceramics. The piezoelectric properties of the [001]-textured KNN-based ceramics are improved because their microstructures are similar to those of the [001]-oriented single crystals. The improvement in the piezoelectric properties after [001] texturing is largely influenced by the crystal structure of the textured ceramics. In this review, [001]-textured KNN-based ceramics with different crystal structures are investigated and systematically summarized.

Risk Factors for the Mortality of Patients With Coronavirus Disease 2019 Requiring Extracorporeal Membrane Oxygenation in a Non-Centralized Setting: A Nationwide Study.

BACKGROUND: Limited data are available on the mortality rates of patients receiving extracorporeal membrane oxygenation (ECMO) support for coronavirus disease 2019 (COVID-19). We aimed to analyze the relationship between COVID-19 and clinical outcomes for patients receiving ECMO. METHODS: We retrospectively investigated patients with COVID-19 pneumonia requiring ECMO in 19 hospitals across Korea from January 1, 2020 to August 31, 2021. The primary outcome was the 90-day mortality after ECMO initiation. We performed multivariate analysis using a logistic regression model to estimate the odds ratio (OR) of 90-day mortality. Survival differences were analyzed using the Kaplan-Meier (KM) method. RESULTS: Of 127 patients with COVID-19 pneumonia who received ECMO, 70 patients (55.1%) died within 90 days of ECMO initiation. The median age was 64 years, and 63% of patients were male. The incidence of ECMO was increased with age but was decreased after 70 years of age. However, the survival rate was decreased linearly with age. In multivariate analysis, age (OR, 1.048; 95% confidence interval [CI], 1.010-1.089; P = 0.014) and receipt of continuous renal replacement therapy (CRRT) (OR, 3.069; 95% CI, 1.312-7.180; P = 0.010) were significantly associated with an increased risk of 90-day mortality. KM curves showed significant differences in survival between groups according to age (65 years) (log-rank P = 0.021) and receipt of CRRT (log-rank P = 0.004). CONCLUSION: Older age and receipt of CRRT were associated with higher mortality rates among patients with COVID-19 who received ECMO.

Deep learning prediction of steep and flat corneal curvature using fundus photography in post-COVID telemedicine era.

Recently, fundus photography (FP) is being increasingly used. Corneal curvature is an essential factor in refractive errors and is associated with several pathological corneal conditions. As FP-based examination systems have already been widely distributed, it would be helpful for telemedicine to extract information such as corneal curvature using FP. This study aims to develop a deep learning model based on FP for corneal curvature prediction by categorizing corneas into steep, regular, and flat groups. The EfficientNetB0 architecture with transfer learning was used to learn FP patterns to predict flat, regular, and steep corneas. In validation, the model achieved a multiclass accuracy of 0.727, a Matthews correlation coefficient of 0.519, and an unweighted Cohen's κ of 0.590. The areas under the receiver operating characteristic curves for binary prediction of flat and steep corneas were 0.863 and 0.848, respectively. The optic nerve and its peripheral areas were the main focus of the model. The developed algorithm shows that FP can potentially be used as an imaging modality to estimate corneal curvature in the post-COVID-19 era, whereby patients may benefit from the detection of abnormal corneal curvatures using FP in the telemedicine setting.

Postrhinoplasty Nasal Radix Cyst Treated with Endoscopic Marsupialization.

Postrhinoplasty nasal radix cyst is a rare late complication, with few cases being reported in the literature. The appropriate treatment for this cyst is surgical removal. To date, an open approach or intracartilagenous incision has been performed in most cases. Herein, we present a case of a 68-year-old man with a bulging mass of radix who visited our clinic. The patient underwent open surgery for the mass, but the mass recurred 2 years after surgery. Although removal using the open approach was planned as in the previous surgery, marsupialization was performed because a connection with the frontal recess was seen on a computed tomography scan. We report a rare case of nasal radix cyst successfully treated with marsupialization without an external scar.

Chemical Burn Injury on the Cornea Following Skin Preparation With Chlorhexidine in Tonsillectomy and Adenoidectomy.

This article report discusses a pediatric patient who suffered a corneal chemical burn injury after tonsillectomy and adenoidectomy surgery due to skin preparation with chlorhexidine. In this case, inadequate sealing of the eye shield during skin preparation allowed the chlorhexidine-alcohol solution to accumulate at its edge and gradually penetrate, resulting in the corneal injury. Prompt ophthalmological intervention and appropriate eye care treatment led to a gradual improvement in the patient's symptoms. The authors aim to present the case, share the revisions made to our skin preparation policy, and emphasize the importance of cautious antiseptic use to minimize the risk of adverse events. Adverse effects of chlorhexidine, such as hypersensitivity reactions and burns, including corneal damage, are highlighted. Health care providers should exercise caution when selecting and applying antiseptics, considering patient-specific factors, and comprehensive training should be provided to promote adherence to safe antiseptic practices during surgical procedures.

Bilateral Nostril Abrasion in Endoscopic Sinus Surgery with Micodebrider.

The emergence of microdebrider technology has revolutionized endoscopic sinus surgery (ESS). Although widely used, it has been associated with complications such as cerebrospinal fluid leakage, ocular and brain injuries, and synechia formation. However, reports on cases of skin abrasion associated with the use of microdebriders in ESS are scarce. We herein present a unique observation of bilateral nostril abrasion after ESS using the microdebrider in a 53-year-old man. The patient underwent ESS and septoplasty for nasal obstruction and polyps. Bilateral nostril erythema and skin abrasion were observed after surgery, which resolved without scarring. Nostril abrasion is attributed to the lever-like use of the microdebrider against the medial aspect of the nostril during the procedure, particularly among inexperienced surgeons. This prompts the need for a cautious approach when using microdebriders in ESS to minimize complications. Increased awareness and precautionary measures can enhance the safety of microdebriders in ESS.

Effects of Grafting Degree on the Formation of Waterborne Polyurethane-Acrylate Film with Hard Core-Soft Shell Structure.

Waterborne polyurethane-acrylate (WPUA) grafted with polyurethane was prepared to improve the film-forming ability of hard-type acrylic latex. To balance the film-formation ability and hardness, the WPUA latex was designed with a hard core (polyacrylate) and soft shell (polyurethane). The grafting ratio was controlled through varying the content of 2-hydroxyethyl methacrylate (HEMA) used to cap the ends of the polyurethane prepolymer. The morphologies of the latex particles, film surface, and fracture surface of the film were characterized through transmission electron microscopy, atomic force microscopy, and scanning electron microscopy, respectively. An increase in the grafting ratio resulted in the enhanced miscibility of polyurethane and polyacrylate but reduced adhesion between particles and increased minimum film formation temperature. In addition, grafting was essential to obtain transparent WPUA films. Excessive grafting induced defects such as micropores within the film, leading to the decreased hardness and adhesive strength of the film. The optimal HEMA content for the preparation of a WPUA coating with excellent film-forming ability and high hardness in ambient conditions was noted to be 50%. The final WPUA film was prepared without coalescence agents that generate volatile organic compounds.

Prospective, multicenter validation of the deep learning-based cardiac arrest risk management system for predicting in-hospital cardiac arrest or unplanned intensive care unit transfer in patients admitted to general wards.

BACKGROUND: Retrospective studies have demonstrated that the deep learning-based cardiac arrest risk management system (DeepCARS™) is superior to the conventional methods in predicting in-hospital cardiac arrest (IHCA). This prospective study aimed to investigate the predictive accuracy of the DeepCARS™ for IHCA or unplanned intensive care unit transfer (UIT) among general ward patients, compared with that of conventional methods in real-world practice. METHODS: This prospective, multicenter cohort study was conducted at four teaching hospitals in South Korea. All adult patients admitted to general wards during the 3-month study period were included. The primary outcome was predictive accuracy for the occurrence of IHCA or UIT within 24 h of the alarm being triggered. Area under the receiver operating characteristic curve (AUROC) values were used to compare the DeepCARS™ with the modified early warning score (MEWS), national early warning Score (NEWS), and single-parameter track-and-trigger systems. RESULTS: Among 55,083 patients, the incidence rates of IHCA and UIT were 0.90 and 6.44 per 1,000 admissions, respectively. In terms of the composite outcome, the AUROC for the DeepCARS™ was superior to those for the MEWS and NEWS (0.869 vs. 0.756/0.767). At the same sensitivity level of the cutoff values, the mean alarm counts per day per 1,000 beds were significantly reduced for the DeepCARS™, and the rate of appropriate alarms was higher when using the DeepCARS™ than when using conventional systems. CONCLUSION: The DeepCARS™ predicts IHCA and UIT more accurately and efficiently than conventional methods. Thus, the DeepCARS™ may be an effective screening tool for detecting clinical deterioration in real-world clinical practice. Trial registration This study was registered at ClinicalTrials.gov ( NCT04951973 ) on June 30, 2021.

Gastrodia elata rhizoma ameliorates thioacetamide-induced liver injury in dogs.

Objective: The study aimed to investigate the hepatoprotective effects of Gastrodia elata rhizome (GR) on thioacetamide (TAA)-induced liver injury in dogs. We evaluated serum biochemical and hematological parameters, with emphasis on alanine transaminase (ALT), alanine phosphates (ALP), and nitric oxide (NO) levels, in dogs with TAA-induced liver injury. Materials and Methods: The animals were divided into a control group (Con), TAA group, Silymarin group (Sil, 50 mg/kg), Gastrodia rhizome low dose (GRL) (low) + TAA, GRH (high) + TAA, and GR high-dose group (GRH) control group. GRL and GRH were given daily at 50 and 100 mg/kg, respectively. TAA was given on days 1, 4, and 7 at a dose of 300 mg/kg. Results: GR significantly reduced liver injury in treated animals, as indicated by lowered levels of ALT (about 32% at day 21 in both GRL + TAA and GRH + TAA groups), ALP (about 17% and 21% at day 21 in both GRL + TAA, GRH + TAA groups, respectively), and NO (about 36% at day 21 in both GRL + TAA, GRH + TAA groups) compared to the TAA control group. Hematological parameters showed mild changes during the experiment. High-performance liquid chromatography analysis revealed gastrodin, a major component of the GR extract, constitutes 2.6% of the extract. Conclusion: The GR demonstrated significant hepatoprotective effects against TAA-induced liver injury in dogs. The study provides evidence for the potential therapeutic use of GR in the management of liver diseases.

Dual-Cure Adhesives Using a Newly Synthesized Itaconic Acid-Based Epoxy Acrylate Oligomer.

Herein, a novel biomass-derived itaconic acid (IA)-based epoxy acrylate oligomer (EAO) is synthesized by means of the esterification reaction of the epoxy group of bisphenol A diglycidyl ether (BADGE) with the carboxylic group of IA. The detailed chemical structure of the as-prepared bisphenol A diglycidyl ether diitaconate (BI) is characterized via the KOH value, FT-IR spectrum, and 1H-NMR spectrum. Further, a dual-cure adhesive system is formulated using BADGE, acrylic acid, and trimethylolpropane triacrylate with various BI contents, and the adhesive performance is investigated by measuring the thermal stability, adhesive properties, pencil hardness, and surface energy properties. Thus, the dual-cure adhesive with a BI content of 0.3 mol is shown to provide excellent thermal stability, along with an adhesive strength of 10.7 MPa, a pencil hardness of 2H, and a similar surface energy to that of a typical polycarbonate film. In addition, the properties of the BI-based dual-cure adhesive are compared with those of the dual-cure adhesives based on bisphenol A glycerolate diacrylate or bisphenol A glycerolate dimethacrylate.

Effect of Peel Ply on Resin Flow during Vacuum Infusion.

Although various simulations have been conducted for the vacuum infusion process, most of the studies have considered only fabrics and flow medium and ignored the effect of peel ply. However, peel ply can affect resin flow because it is placed between the fabrics and flow medium. To verify this, permeability of two types of peel plies was measured, and it was found that the permeability between the peel plies differed significantly. Moreover, the permeability of the peel plies was lower than that of the carbon fabric; thus, peel ply can cause a bottleneck in the flow in the out-of-plane direction. Some 3D flow simulations were conducted in cases of no peel ply and for two types of the peel plies to confirm the effect of peel ply, and experiments were also conducted for two types of the peel plies. It was observed that filling time and flow pattern were highly dependent on the peel plies. The smaller permeability of peel ply has, the greater effect of peel ply is. These results indicate that the permeability of peel ply is one of the dominant factors and should be considered in process design in vacuum infusion. Additionally, by adding one layer of peel ply and applying permeability, the accuracy of flow simulations can be improved for filling time and pattern.

Artificial Action Potential and Ionic Power Device Inspired by Ion Channels and Excitable Cell.

In vivo, the membrane potential of the excitable cell working by ion gradients plays a significant role in bioelectricity generation and nervous system operation. Conventional bioinspired power systems generally have adopted ion gradients, but overlook the functions of ion channels and Donnan effect to generate efficient ion flow in the cell. Here, cell-inspired ionic power device implementing the Donnan effect using multi-ions and monovalent ion exchange membranes as artificial ion channels is realized. Different ion-rich electrolytes on either side of the selective membrane generate the ion gradient potentials with high ionic currents and reduce the osmotic imbalance of the membrane. Based on this device, the artificial neuronal signaling is presented by the mechanical switching system of the ion selectivity like mechanosensitive ion channels in a sensory neuron. Compared with reverse electrodialysis, which requires a low concentration, a high-power device with ten times the current and 8.5 times the power density is fabricated. This device activates grown muscle cells by increasing power through serial connection like an electric eel, and shows the possibility of an ion-based artificial nervous system.

Quality Characteristics of Rice-Based Ice Creams with Different Amylose Contents.

Ice cream consumption has increased over the years. In this study, we investigated the potential of using rice varieties with varying amylose contents for ice cream production. We analyzed the physical and chemical properties and sensory quality characteristics (appearance, taste, texture, chewiness, aroma, and rice flavor) of rice-based ice cream made from five varieties with low and high amylose levels. To make the ice cream, we ground rice into a fine powder and combined it with skim milk powder, butter, sugar, glycerin esters of fatty acids, locust bean gum, and water to form a gelatinized mixture. This mixture was then aged, frozen, and hardened. The ice cream's key quality characteristics, such as viscosity (2170-25,030 cP), hardness (4.27-49.55 N cm-2), and overrun (17.95-46.99%), showed a wide range. Ice cream made from Saemimyeon (high amylose content rice variety) exhibited the highest hardness value (49.55 N cm-2) among the varieties tested, but had relatively low viscosity (4030 cP), overrun (17.95%), and drip-through (0.75 g/min) values. These findings suggest that rice varieties with different amylose contents are suitable for making ice cream and have the potential to expand the rice processing market and increase its value.

Arrested Pneumatization of the Sphenoid Sinus.

The sphenoid bone is a complex structure in terms of its embryological origin. At birth, the sphenoid sinus is nonpneumatized. Arrested pneumatization of the sphenoid sinus is considered a normal anatomic variant but may be mistaken for disease in imaging studies. We report 2 cases of arrested pneumatization of the sphenoid sinus, a normal variant commonly misdiagnosed as a serious disease of the skull base. A 29-year-old man with a complaint of dizziness visited a local clinic for assessment. Computed tomography (CT) of the paranasal sinuses (PNS) showed a noneroding, nonexpansile, and nonhomogenous lesion in the sphenoid bone. Magnetic resonance imaging (MRI) of the brain revealed a high-signal lesion on both T1-weighted and T2-weighted images. Given these typical findings in the CT of PNS and MRI of the brain, the lesion was diagnosed as arrested pneumatization of the sphenoid sinus. In the second case, a 60-year-old woman with a complaint of headache visited a local clinic for assessment. CT of PNS showed a fibro-osseous lesion (with features of sclerosis and osteolysis) in the skull base. Brain MRI revealed a low-signal lesion on a T1-weighted image containing a high-signal intensity around the sphenoid bone, thereby suggesting internal fat contents. A precise interpretation of CT of PNS and brain MRI is essential to distinguish arrested pneumatization of the sphenoid sinus and to help establish a differential diagnosis and avoid needless biopsy.

Efficacy of crizotinib retreatment after crizotinib-related interstitial lung disease in a patient with ROS1-rearranged advanced lung adenocarcinoma: A case report and potential crizotinib retreatment strategy.

Crizotinib is an oral selective small-molecular tyrosine kinase inhibitor (TKI) that suppress the activity of anaplastic lymphoma kinase (ALK) and ROS1 kinases, as well as mesenchymal-epithelial transition. The cumulative clinical trials in patients with advanced ALK- or ROS1-rearrangement NSCLC indicate that crizotinib has significant antitumor activity and a tolerable safety profile, with mild or moderate adverse events of visual disorders, diarrhea, nausea, and vomiting. As with other TKIs, however, the occurrence of crizotinib-related interstitial lung disease (crizotinib-ILD) remains a major clinical dilemma that can lead to the permanent discontinuation of TKI during cancer treatment. When there is no suitable alternative therapy for patients who develop crizotinib-ILD, some clinicians have reported successful crizotinib retreatment in cases of ALK-rearrangement NSCLC. Unfortunately, there are no specific guidelines for the treatment or retreatment of TKI-related ILD. We herein report the first successful crizotinib retreatment after crizotinib-ILD in a patient with ROS1-rearranged NSCLC, and suggest a retreatment strategy after crizotinib-ILD based on a literature review.

Enhanced Mechanical and Thermal Properties of Chain-Extended Waterborne Polyurethane Coatings with Cellulose Acetate Butyrate.

A series of waterborne polyurethane (WPU) dispersions were prepared by chain-extending a prepolymer made of polyester diol, isophorone diisocyanate, and dimethylol propionic acid using cellulose acetate butyrate (CAB). The particle size and viscosity of the WPU dispersion were measured. In addition, we investigated the effects of CAB on the thermal, mechanical, and optical properties of WPU films. The use of CAB effectively improved the crosslinking degree of the WPUs, increasing the thermal stability and water resistance of the corresponding films. In particular, CAB increased the tensile strength of the WPU films up to 67%, while maintaining their elongation at break unchanged. In addition, CAB improved the optical transmittance by reducing the microphase separation between the soft and hard segments of PU. The rough surface structure of the WPU films formed by CAB led to improved matting properties.

Oculomics for sarcopenia prediction: a machine learning approach toward predictive, preventive, and personalized medicine.

Aims: Sarcopenia is characterized by a gradual loss of skeletal muscle mass and strength with increased adverse outcomes. Recently, large-scale epidemiological studies have demonstrated a relationship between several chronic disorders and ocular pathological conditions using an oculomics approach. We hypothesized that sarcopenia can be predicted through eye examinations, without invasive tests or radiologic evaluations in the context of predictive, preventive, and personalized medicine (PPPM/3PM). Methods: We analyzed data from the Korean National Health and Nutrition Examination Survey (KNHANES). The training set (80%, randomly selected from 2008 to 2010) data were used to construct the machine learning models. Internal (20%, randomly selected from 2008 to 2010) and external (from the KNHANES 2011) validation sets were used to assess the ability to predict sarcopenia. We included 8092 participants in the final dataset. Machine learning models (XGBoost) were trained on ophthalmological examinations and demographic factors to detect sarcopenia. Results: In the exploratory analysis, decreased levator function (odds ratio [OR], 1.41; P value <0.001), cataracts (OR, 1.31; P value = 0.013), and age-related macular degeneration (OR, 1.38; P value = 0.026) were associated with an increased risk of sarcopenia in men. In women, an increased risk of sarcopenia was associated with blepharoptosis (OR, 1.23; P value = 0.038) and cataracts (OR, 1.29; P value = 0.010). The XGBoost technique showed areas under the receiver operating characteristic curves (AUCs) of 0.746 and 0.762 in men and women, respectively. The external validation achieved AUCs of 0.751 and 0.785 for men and women, respectively. For practical and fast hands-on experience with the predictive model for practitioners who may be willing to test the whole idea of sarcopenia prediction based on oculomics data, we developed a simple web-based calculator application (https://knhanesoculomics.github.io/sarcopenia) to predict the risk of sarcopenia and facilitate screening, based on the model established in this study. Conclusion: Sarcopenia is treatable before the vicious cycle of sarcopenia-related deterioration begins. Therefore, early identification of individuals at a high risk of sarcopenia is essential in the context of PPPM. Our oculomics-based approach provides an effective strategy for sarcopenia prediction. The proposed method shows promise in significantly increasing the number of patients diagnosed with sarcopenia, potentially facilitating earlier intervention. Through patient oculometric monitoring, various pathological factors related to sarcopenia can be simultaneously analyzed, and doctors can provide personalized medical services according to each cause. Further studies are needed to confirm whether such a prediction algorithm can be used in real-world clinical settings to improve the diagnosis of sarcopenia. Supplementary Information: The online version contains supplementary material available at 10.1007/s13167-022-00292-3.

Computational Approach to the Surface-Crosslinking Process of Superabsorbent Polymer via Central Composite Design.

The improvement of gel strength and absorption properties through the surface-crosslinking of superabsorbent polymers (SAPs) is essential for sanitary industry applications. We prepared core-SAP via aqueous solution copolymerization, and then surface-crosslinked the core-SAP under various conditions. The structure of the SAP was characterized using Fourier transform infrared (FT-IR) spectroscopy. Central composite design (CCD) of response surface methodology (RSM) has been applied to determine the optimum surface-crosslinking conditions such as surface-crosslinker content, reaction temperature, and reaction time. The optimal surface-crosslinking conditions were identified at a surface-crosslinker content of 2.22 mol%, reaction temperature of 160 °C, and reaction time of 8.7 min. The surface-crosslinked SAP showed excellent absorbency under load of 50 g/g with a permeability of 50 s. Other absorption properties were also evaluated by measuring the free absorbency and centrifuge retention capacity in saline solution.

Bilateral paranasal sinus fungal balls: A retrospective cohort study in 28 patients over a 21-year period.

Paranasal fungal balls are rare entities for which a recent increase in reported cases has been observed. Fungal balls are most commonly unilateral, and there are few bilateral cases in the literature. Here we report the clinical features of bilateral fungal balls in 24 patients treated in our institution over the past 20 years. In this retrospective study, we reviewed the medical records of 5279 patients who underwent endoscopic sinus surgery performed by a single surgeon from January 1996 to December 2016 at a tertiary care center in order to identify patients diagnosed with fungal balls confirmed histopathologically. Demographic data and radiologic findings of patients with bilateral fungal balls were compared with those who had unilateral fungal balls. Multiple logistic regression test was used to compare demographic information between patients with unilateral and bilateral fungal balls. The most commonly involved sinus in bilateral cases was maxillary (87.5%), followed by ethmoid (37.5%) and sphenoid (33.3%). Of the 24 patients, 19 were female, and patient age ranged from 45 to 83 years, with an average of 65.1 years. Common existing comorbidities were hypertension (45.8%), diabetes (29.2%), cardiac problem (16.7%), cerebral infarction (8.3%), pulmonary tuberculosis (8.3%), and lung cancer (4.2%). The clinically relevant features of patients diagnosed with bilateral fungal balls from our review include advanced age and immunocompromised status compared to those with unilateral fungal balls. These features contribute to the clinical distinction of bilateral fungal ball disease from unilateral fungal balls and invasive fungal sinusitis.

Patient Discomfort After Rhinoplasty With and Without Osteotomy Under Conscious Sedation.

OBJECTIVE: Many rhinoplasty techniques, including dorsum augmentation and tip surgery, could be performed under conscious sedation rather than general anesthesia. However, as osteotomy is an invasive procedure, it is burdensome for surgeons to perform osteotomy under conscious sedation. As patient ratings of pain and satisfaction when osteotomy is performed under conscious sedation are unknown, this study aimed to determine discomfort of osteotomy performed under conscious sedation. METHODS: Patients who underwent rhinoplasty with conscious sedation were prospectively included in the study. The patients were classified into an osteotomy and a nonosteotomy group. Questionnaires with a visual analog scale ranging from 0 to 10 were utilized to assess patient pain and satisfaction. Patients were also asked whether they would choose conscious sedation for future rhinoplasty operations. To evaluate adverse events, cardiopulmonary vital signs and nausea or vomiting were assessed. RESULTS: Forty-five patients with a mean age of 32.7 years were included in the study. The mean patients' visual analog scale scores for pain and satisfaction were 3.3±2.0 and 7.2±1.9, respectively. Most of the patients [42, (93%)] stated that they would choose conscious sedation again if they had further operations in the future. No significant adverse effects occurred, and there were no significant differences in patients' ratings of pain and satisfaction between osteotomy and nonosteotomy groups when conscious sedation was used. CONCLUSION: Patients' ratings of pain and satisfaction, and a lack of significant adverse effects, indicated that rhinoplasty can be performed under conscious sedation, even with osteotomy.