A Janus branch filter for washing machines: Simultaneous removal of microplastics and surfactants.

Emerging pollutants, such as microplastics (MPs), are becoming a significant issue worldwide. The highest percentage of MPs released into the environment occurs through daily laundry. The average weight of dreg obtained from 5 kg of laundry was 1.26 g/kg. According to energy dispersive X-ray (EDX) and thermogravimetric analysis (TGA) analyses, the dreg consisted of MPs (78.3-89 wt%, organic elements: C/O) and alien materials (11-21.7 wt%, inorganic elements: Al/Fe/Ca, etc.). Thus, to reproduce the real environment, alien materials (Fe3O4 and CaCO3) were added to various types of model MPs in the presence and absence of sodium dodecyl benzenesulfonate (SDBS) to test MP removal. Hydrophobic and hydrophilic MPs were generated upon laundering, accounting for 55-59% and 41-45% of MPs, respectively. We provide a novel approach to design a laundry filter system for the simultaneous removal of SDBS and hydrophilic/hydrophobic MPs.

Effects of a lower limb rehabilitation robot with various training modes in patients with stroke: A randomized controlled trial.

BACKGROUND: The effect of robot-assisted gait training has been demonstrated to improve gait recovery in patients with stroke. The aim of this study was to determine effects of robot-assisted gait training with various training modes in patients post stroke. METHODS: Forty-seven patients post stroke were randomly assigned to one of 4 groups: Healbot T with pelvic off mode (pelvic off group; n = 11); Healbot T with pelvic control mode (pelvic on group; n = 12); Healbot T with constraint-induced movement therapy (CIMT) mode (CIMT group; n = 10); and conventional physiotherapy (control group; n = 10). All patients received a 30-minute session 10 times for 4 weeks. The primary outcomes were the 10-meter walk test (10MWT) and Berg Balance Scale (BBS). The secondary outcomes were functional ambulation category, timed up and go (TUG), and motricity index of the lower extremities (MI-Lower). RESULTS: The pelvic off group showed significant improvements in BBS, TUG, and MI-Lower (P < .05). The pelvic on and CIMT groups showed significant improvement in 10MWT, BBS, TUG, and MI-Lower (P < .05). Compared with control group, the pelvic on group showed greater improvement in the TUG and BBS scores; the CIMT group showed greater improvement in 10MWT and MI-Lower (P < .05). CONCLUSION: This study suggested that Healbot T-assisted gait training benefited patients with stroke. The Healbot T with pelvic motion and CIMT modes were more helpful in improving balance and walking ability and lower limb strength, respectively, compared with conventional physiotherapy.

Hybrid Bead Air Filters with Low Pressure Drops at a High Flow Rate for the Removal of Particulate Matter and HCHO.

A tower air filtration system was designed in which bead air filters (BAFs) were actively rotated by a fan motor to remove particulate matter (PM) or HCHO gas. Three types of BAF, hydrophilic, hydrophobic, and hybrid, were prepared and compared for the removal of PM and HCHO gas. A tower air filtration system loaded with hybrid BAFs purified 3.73 L of PM (2500 µg/m3 PM2.5) at a high flow rate of 3.4 m/s with high removal efficiency (99.4% for PM2.5) and a low pressure drop (19 Pa) in 6 min. Against our expectations, the PM2.5 removal efficiency slightly increased as the air velocity increased. The hybrid BAF-200 showed excellent recyclability up to 50 cycles with high removal efficiencies (99.4-93.4% for PM2.5). Furthermore, hydrophilic BAF-200 could permanently remove 3.73 L of HCHO gas (4.87 ppm) and return the atmosphere to safe levels (0.41-0.31 ppm) within 60 min without any desorption of HCHO gas.

Solar-Driven Unmanned Hazardous and Noxious Substance Trapping Devices Equipped with Reverse Piloti Structures and Cooling Systems.

A solar-driven unmanned hazardous and noxious substance (HNS) trapping device that can absorb, evaporate, condense, and collect HNSs was prepared. The HNS trapping device was composed of three parts: a reverse piloti structure (RPS) for absorption and evaporation of HNSs, Al mirrors with optimized angles for focusing light, and a cooling line system for the condensation of HNSs. The RPS was fabricated by assembling a lower rectangle structure and an upper hollow column. The lower rectangular structure showed a toluene evaporation rate of 6.31 kg/m2 h, which was significantly increased by the installation of the upper hollow column (11.21 kg/m2 h) and led to the formation of the RPS. The installation of Al mirrors on the RPS could further enhance the evaporation rate by 9.1% (12.28 kg/m2 h). The RPS system equipped with an Al mirror could rapidly remove toluene, xylene, and toluene-xylene with high evaporation rates (12.28-8.37 kg/m2 h) and could effectively collect these substances with high efficiencies (81-65%) in an unmanned HNS trapping device. This prototype HNS trapping device works perfectly without human involvement, does not need electricity, and thus is suitable for fast cleanup and collection of HNSs in the ocean.

Who Will Continuously Depend on Compression to Control Persistent or Progressive Breast Cancer-Related Lymphedema Despite 2 Years of Conservative Care?

BACKGROUND: When a patient with breast cancer-related lymphedema (BCRL) depends on continuous compression management, that is, when interstitial fluid accumulation is continuously ongoing, surgical treatment should be considered. Physiologic surgery is considered more effective for early-stage lymphedema. The purpose of this study was to identify predictors of patients with BCRL who will be compression-dependent despite 2 years of conservative care. METHODS: This study included patients with BCRL who followed up for 2 years. Patients were classified into two groups (compression-dependent vs. compression-free). We identified the proportion of compression-dependent patients and predictors of compression dependence. RESULTS: Among 208 patients, 125 (60.1%) were classified into the compression-dependent group. Compression dependence was higher in patients with direct radiotherapy to the lymph nodes (LNs), those with five or more LNs resections, and those with BCRL occurring at least 1 year after surgery. CONCLUSIONS: BCRL patients with direct radiotherapy to the LNs, extensive LN dissection, and delayed onset may be compression-dependent despite 2 years of conservative care. Initially moderate to severe BCRL and a history of cellulitis also seem to be strongly associated with compression dependence. Our results allow for the early prediction of compression-dependent patients who should be considered for physiologic surgery.

Bioimpedance Analysis for Predicting Outcomes of Complex Decongestive Therapy for Gynecological Cancer Related Lymphedema: A Feasibility Study.

OBJECTIVE: To determine whether the bioimpedance analysis (BIA) ratios of upper to lower extremities could predict treatment outcomes after complex decongestive therapy (CDT) for gynecological cancer related lymphedema (GCRL). METHODS: A retrospective study, from March 2015 to December 2018, was conducted. The study sample comprised patients receiving CDT, 30 minutes per day, for 10 days. Bioimpedance was measured pre- and post-CDT. Circumference measurements were obtained at 20 and 10 cm above the knee (AK) and 10 cm below the knee (BK). We calculated the expected impedance at 0 Hz (R0) of extremities and upper/lower extremity R0 ratios (R0U/L). We evaluated the relationship between R0U/L and changes in R0U/L and circumferences, pre- and post-CDT. RESULTS: Overall, 59 patients were included in this study. Thirty-one lower extremities in 26 patients comprised the acute group, and 38 lower extremities in 33 patients comprised the chronic group. Pre-treatment R0U/L was significantly correlated with R0U/L change after adjusting for age and BMI (acute: R=0.513, p<0.01; chronic: R=0.423, p<0.01). In the acute group, pre-treatment R0U/L showed a tendency to be correlated with circumference change (AK 20 cm: R=0.427, p=0.02; AK 10 cm: R=0.399, p=0.03). CONCLUSION: Our study results suggested that pre-treatment BIA could predict volume reductions after CDT in the early stages of GCRL. These findings implied that BIA value could be one possible parameter to apply in treatment outcomes prediction, during the early stage of GCRL. Therefore, further large-scale prospective studies will be beneficial.

Feasibility, safety, and functional recovery after active rehabilitation in critically ill surgical patients.

BACKGROUND: The characteristics of critically ill surgical patients differ from those of medical patients. Few studies have evaluated rehabilitation in surgical intensive care units (SICUs), particularly in non-Western countries and in elderly patients. OBJECTIVE: The objective of this study was to investigate the rehabilitation characteristics, safety, and functional recovery in non-Western SICU patients. METHODS: Data from patients who received active rehabilitation in 2016 were retrospectively reviewed. Clinical characteristics, functional recovery, and safety were investigated and compared in patients aged <65 or ≥65 years. Potential safety events were also compared between the two age groups and according to the reason for SICU admission. RESULTS: Data from 157 patients were included in the analysis. The number of patients who were able to stand or walk increased from the beginning of rehabilitation to the time of ICU discharge (from 52 to 102 patients, P < 0.01). The Activity Measure for Post-Acute Care (AM-PAC) score also increased during rehabilitation (from 11.6 to 13.9, P < 0.01). Functional recovery did not differ between the two age groups. During 780 rehabilitation sessions, 23 potential safety events (3.0%) were noted; no significant differences were seen between the two age groups. A significant difference was noted when patients were grouped according to the reason for SICU admission (1.7% in postoperative care patients vs 4.5% in patients admitted for other reasons, P = 0.02). CONCLUSIONS: Active rehabilitation in critically ill surgical patients is feasible and safe and resulted in improved mobility, regardless of age. However, the reason for SICU admission should be considered.

Reference values of bioelectrical impedance analysis for detecting breast cancer-related lymphedema.

Secondary lymphedema is a chronic debilitating lifelong complication and early diagnosis is crucial. The Inbody 720, which is widely used, has no universal index of diagnostic criteria for test results. We aim to determine the normal range, cutoff values, and mean + standard deviation values of extracellular fluid (ECF) and the single frequency bioimpedance (SFBIA) ratios for the diagnosis of lymphedema and suggest the usefulness of these values for detecting lymphedema.Seventy patients with unilateral breast cancer-related lymphedema and 643 healthy subjects were enrolled. All patients with breast cancer underwent surgeries with dissection of lymph nodes. We analyzed the ECF volume, SFBIA at 1- and 5-kHz frequencies using Inbody 720.There were significant differences between patients with BCRL and healthy controls. The optimal cutoff values for ECF ratios were 1.010 for both the dominant and non-dominant arms. At 1 kHz, the cutoff values of SFBIA were 1.050 and 1.046, and at 5 kHz, those were 1.070 and 1.030 for the dominant and non-dominant affected arms, respectively. The mean + 2SD values for ECF ratio were 1.018 and 1.020 and at 1 kHz, the mean + 2SD values of SFBIA were 1.144 and 1.0135 and at 5 kHz, the cutoff values of SFBIA were 1.141 and 1.124 for the dominant and non-dominant affected arms, respectively. The mean + 3SD values for ECF ratio were 1.026 and 1.030 and at 1 kHz, the mean + 3SD values of SFBIA were 1.206 and 1.203 and at 5 kHz, those were 1.201 and 1.187 for the arms, respectively. The cutoff, mean + 2SD, and mean + 3SD values were applied to 70 patients with unilateral BCRL. When the cutoff values were applied, a higher proportion of BCRL patients were included.When these figures were applied to the patient group, the cutoff values included a higher proportion of patients with lymphedema. Further studies are needed to investigate whether bioimpedance analysis can accurately predict the development of lymphedema.

Hemolysis During Open-Heart Surgery With Vacuum-Assisted Venous Drainage at Different Negative Pressures in Pediatric Patients Weighing Less Than 10 kilograms.

BACKGROUND: This study examined the degree of hemolysis during vacuum-assisted venous drainage at different negative pressures to identify an adequate negative pressure that provides effective venous drainage without significant hemolysis in open-heart surgery in children weighing less than 10 kg. METHODS: Patients weighing less than 10 kg who underwent surgery for ventricular septal defect or atrial septal defect from 2011 to 2014 were enrolled. We used one of four negative pressures (20, 30, 40, or 60 mm Hg) for each patient. We measured haptoglobin, plasma hemoglobin, aspartate aminotransferase, and lactate dehydrogenase levels in the patients' blood three times perioperatively and determined the potential correlation between the change in each parameter with the level of negative pressure. RESULTS: Forty-six patients were enrolled in this study (mean age: 7.1 ± 7.0 months, mean body weight: 6.1 ± 1.8 kg). There were no significant differences according to the degree of negative pressure with respect to patient age, body weight, cardiopulmonary bypass (CPB) time, aorta cross-clamping time, blood flow during CPB, or lowest body temperature. All parameters that we measured reflected progression of hemolysis during CPB; however, the degree of change in the parameters did not correlate with negative pressure. CONCLUSION: In pediatric patients weighing less than 10 kg, the change in the degree of hemolysis did not differ with the amount of negative pressure. We may apply negative pressures up to 60 mm Hg without increasing the risk of hemolysis, with almost same the level of hemolysis using negative pressures of 20, 30, and 40 mm Hg for effective venous drainage and an ideal operative field during open-heart surgery.

Strategic camouflage treatment of skeletal Class III malocclusion (mandibular prognathism) using bone-borne rapid maxillary expansion and mandibular anterior subapical osteotomy.

This case report presents the camouflage treatment that successfully improved the facial profile of a patient with a skeletal Class III malocclusion using bone-borne rapid maxillary expansion and mandibular anterior subapical osteotomy. The patient was an 18-year-old woman with chief complaints of crooked teeth and a protruded jaw. Camouflage treatment was chosen because she rejected orthognathic surgery under general anesthesia. A hybrid type of bone-borne rapid maxillary expander with palatal mini-implants was used to correct the transverse discrepancy, and a mandibular anterior subapical osteotomy was conducted to achieve proper overjet with normal incisal inclination and to improve her lip and chin profile. As a result, a Class I occlusion with a favorable inclination of the anterior teeth and a good esthetic profile was achieved with no adverse effects. Therefore, the hybrid type of bone-borne rapid maxillary expander and a mandibular anterior subapical osteotomy can be considered effective camouflage treatment of a skeletal Class III malocclusion, providing improved inclination of the dentition and lip profile.

Accuracy and precision of integumental linear dimensions in a three-dimensional facial imaging system.

OBJECTIVE: A recently developed facial scanning method uses three-dimensional (3D) surface imaging with a light-emitting diode. Such scanning enables surface data to be captured in high-resolution color and at relatively fast speeds. The purpose of this study was to evaluate the accuracy and precision of 3D images obtained using the Morpheus 3D® scanner (Morpheus Co., Seoul, Korea). METHODS: The sample comprised 30 subjects aged 24-34 years (mean 29.0 ± 2.5 years). To test the correlation between direct and 3D image measurements, 21 landmarks were labeled on the face of each subject. Sixteen direct measurements were obtained twice using digital calipers; the same measurements were then made on two sets of 3D facial images. The mean values of measurements obtained from both methods were compared. To investigate the precision, a comparison was made between two sets of measurements taken with each method. RESULTS: When comparing the variables from both methods, five of the 16 possible anthropometric variables were found to be significantly different. However, in 12 of the 16 cases, the mean difference was under 1 mm. The average value of the differences for all variables was 0.75 mm. Precision was high in both methods, with error magnitudes under 0.5 mm. CONCLUSIONS: 3D scanning images have high levels of precision and fairly good congruence with traditional anthropometry methods, with mean differences of less than 1 mm. 3D surface imaging using the Morpheus 3D® scanner is therefore a clinically acceptable method of recording facial integumental data.

Effect of self-ligating bracket type and vibration on frictional force and stick-slip phenomenon in diverse tooth displacement conditions: an in vitro mechanical analysis.

OBJECTIVE: To evaluate the effects of self-ligating bracket (SLB) type and vibration on frictional force and stick-slip phenomenon (SSP) in diverse tooth displacement conditions when a levelling/alignment wire was drawn. MATERIALS AND METHODS: A total of 16 groups were tested (n = 10/group): Two types of SLBs [active SLB (ASLB, In-Ovation R) and passive SLB (PSLB, Damon Q)]; vibration (30 Hz and 0.25 N) and non-vibration conditions; and 4 types of displacement [2mm lingual displacement of the maxillary right lateral incisor (LD), 2mm gingival displacement of the maxillary right canine (GD), combination of LD and GD (LGD), and control]. After applying artificial saliva to the typodont system, 0.018 copper nickel-titanium archwire was drawn by Instron with a speed of 0.5mm/min for 5 minutes at 36.5°C. After static/kinetic frictional forces (SFF/KFF), and frequency/amplitude of SSP were measured, statistical analysis was performed. RESULTS: ASLB exhibited higher SFF, KFF, and SSP amplitude (all P < 0.001) and lower SSF frequency (all P < 0.05) than PSLB in all displacement groups. Vibration decreased SFF, KFF, and SSP amplitude and increased SSP frequency in control and all displacement groups (all P < 0.001). ASLB exhibited lower SSP frequency than PSLB only under non-vibration condition (P < 0.05 in LD and GD, P < 0.01 in LGD). However, regardless of vibration conditions, ASLB demonstrated higher SSP amplitude than PSLB in all displacement groups (all P < 0.001 under non-vibration; all P < 0.01 under vibration). CONCLUSION: Even in tooth displacement conditions, vibration significantly reduced SFF, KFF, SSP amplitude, and increased SPP frequency in both PSLB and ASLB. However, in vivo studies would be needed to confirm the clinical significance.

Camouflage treatment of skeletal class III malocclusion with asymmetry using a bone-borne rapid maxillary expander.

This case report presents the successful use of palatal mini-implants for rapid maxillary expansion and mandibular distalization in a skeletal Class III malocclusion. The patient was a 13-year-old girl with the chief complaint of facial asymmetry and a protruded chin. Camouflage orthodontic treatment was chosen, acknowledging the possibility of need for orthognathic surgery after completion of her growth. A bone-borne rapid expander (BBRME) was used to correct the transverse discrepancy and was then used as indirect anchorage for distalization of the lower dentition with Class III elastics. As a result, a Class I occlusion with favorable inclination of the upper teeth was achieved without any adverse effects. The total treatment period was 25 months. Therefore, BBRME can be considered an alternative treatment in skeletal Class III malocclusion.

Effect of tooth displacement and vibration on frictional force and stick-slip phenomenon in conventional brackets: a preliminary in vitro mechanical analysis.

OBJECTIVE: To evaluate the effects of tooth displacement and vibration on frictional force and stick-slip phenomenon (SSP) when conventional brackets were used with a levelling/alignment wire. MATERIALS AND METHODS: The samples consisted of six groups (n = 10 per group) with combinations of tooth displacement (2mm lingual displacement [LD], 2mm gingival displacement [GD], and no displacement [control]) and vibration conditions (absence and presence at 30 Hz and 0.25 N). A stereolithographically made typodont system was used with conventional brackets and elastomeric ligatures. After application of artificial saliva, static/kinetic frictional forces (SFF/KFF) and frequency/amplitude of SSP were measured while drawing a 0.018-inch copper nickel-titanium (Cu-NiTi) archwire at a speed of 0.5mm/min for 5 minutes at 36.5 degree celsius. Two-way analysis of variance and independent t-test were performed. RESULTS: Tooth displacement increased SFF and KFF (control < LD < GD, all P < 0.001) and reduced SSP frequency (control > [LD, GD], P < 0.01). Vibration reduced SFF, KFF, and SSP amplitude in the control group (P < 0.05, P < 0.05, and P < 0.001, respectively), but not in the LD and GD groups. SSP frequency was increased by vibration in the control, LD, and GD groups (all P < 0.001), and it was lower in the LD and GD groups than in the control group (P < 0.01). CONCLUSIONS: When conventional brackets and a 0.018-inch Cu-NiTi archwire were used in the tooth displacement conditions (LD and GD), vibration did not significantly reduce SFF, KFF, or SSP amplitude.

Treatment and retention of relapsed anterior open-bite with low tongue posture and tongue-tie: A 10-year follow-up.

The purpose of the current report is to present 6-year long-term stability and 10-year follow-up data for an adult patient who was treated with a tongue elevator for relapsed anterior open-bite. The 19-year-old male patient presented with the chief complaint of difficulty in chewing his food. Collectively, clinical and radiographic examinations revealed an anterior open-bite, low tongue posture, and tongue-tie. The patient opted for orthodontic treatment alone, without any surgical procedure. A lingual frenectomy was recommended to avoid the risk of relapse, but the patient declined because he was not experiencing tongue discomfort. Initial treatment of the anterior open-bite with molar intrusion and tongue exercises was successful, but relapse occurred during the retention period. A tongue elevator was used for retreatment, because the approach was minimally invasive and suited the patient's requirements regarding discomfort, cost, and time. The appliance changed the tongue posture and generated an altered tongue force, which ultimately resulted in intrusive dentoalveolar effects, and a subsequent counterclockwise rotation of the mandible. The results showed long-term stability and were maintained for six years through continual use of the tongue elevator. The results of this case indicated that a tongue elevator could be used not only as an alternative treatment for open-bite, but also as an active retainer.

Enhanced device performance of germanium nanowire junctionless (GeNW-JL) MOSFETs by germanide contact formation with Ar plasma treatment.

In this study, germanium nanowire junctionless (GeNW-JL) metal-oxide-semiconductor-field-effect-transistors (MOSFETs) exhibited enhanced electrical performance with low source/drain (S/D) contact resistance under the influence of Ar plasma treatment on the contact regions. We found that the transformation of the surface oxide states by Ar plasma treatment affected the S/D contact resistance. With Ar plasma treatment, the germanium dioxide on the GeNW surface was effectively removed and increased oxygen vacancies were formed in the suboxide on the GeNW, whose germanium-enrichment surface was obtained to form a germanide contact at low temperature. After a rapid thermal annealing process, Ni-germanide contacts were formed on the Ar-plasma-treated GeNW surface. Ni-germanide contact resistance was improved by more than an order of magnitude compared to that of the other devices without Ni-germanide contact. Moreover, the peak field effect mobility value of the GeNW-JL MOSFETs was dramatically improved from 15 cm(2)/(V s) to 550 cm(2)/(V s), and the Ion/off ratio was enhanced from 1 × 10 to 3 × 10(3) due to Ar plasma treatment. The Ar plasma treatment process is essential for forming uniform Ni-germanide-contacts with reduced time and low temperature. It is also crucial for increasing mass productivity and lowering the thermal budget without sacrificing the performance of GeNW-JL MOSFETs.

Associations between the risk of tooth agenesis and single-nucleotide polymorphisms of MSX1 and PAX9 genes in nonsyndromic cleft patients.

OBJECTIVE: To investigate the association between the risk of tooth agenesis and single-nucleotide polymorphisms (SNPs) of MSX1 and PAX9 genes in nonsyndromic cleft patients. MATERIALS AND METHODS: The subjects were 126 Korean nonsyndromic cleft patients. Tooth agenesis type (TAT) was classified as none (0); cleft area (1); cleft area + other area (2); and other area (3) based on agenesis of the maxillary lateral incisor (MXLI) and another tooth within or outside the cleft area. TAT was further grouped into two subcategories (0 and 1) and four subcategories (0, 1, 2, and 3). Three SNPs of MSX1 and 10 SNPs of PAX9 were investigated using Fisher's exact test and logistic regression analysis. RESULTS: Although the association between genotype distribution of PAX9-rs7142363 and TAT was significant (P < .05 in four subcategories), genotypic odds ratios (GORs) of SNPs in each TAT were not meaningful. However, for MSX1-rs12532 and PAX9-rs2073247, associations between genotypic distribution and TAT were significant (P < .01 in four subcategories and P < .05 in two subcategories; P < .01 in two subcategories, respectively). In cleft area, GORs of MXLI agenesis in genotypes GA of MSX1-rs12532 and CT of PAX9-rs2073247 were increased by 3.14-fold and 4.15-fold compared with genotype GG of MSX1-rs12532 and CC of PAX9-rs2073247, respectively (P <. 01; P < .05). In cleft area + other area, the GOR of agenesis of MXLI and another tooth in genotype AA of MSX1-rs12532 was increased by fivefold compared with genotype GG (P < .05). CONCLUSION: Genetic disturbances of MSX1 and PAX9 genes are associated with tooth agenesis within and outside the cleft area.

New approach for the surgico-orthodontic treatment of hemifacial microsomia.

One of the important clinical findings in hemifacial microsomia (HFM) is facial asymmetry (FA) with unilateral underdevelopment and malformation of the mandible and/or maxilla. Unilateral distraction osteogenesis (UDOG) of the mandible has been used for correction of FA in HFM patients. However, return to the original FA status often occurs because of contraction of the distracted bony segment of the mandible and insufficient compensatory downward growth and skeletal midline correction of the maxilla on the affected side. Although bimaxillary UDOG procedure in the maxilla with Le Fort I osteotomy and the mandible with ramus osteotomy was suggested as an alternative treatment modality, it has some disadvantages including elongation of the face, inaccuracy of vector control, and less predictable results. Occlusal plane canting, skeletal midline deviation of the maxilla, and unilateral mandibular hypoplasia might be simultaneously corrected by fixation of the maxilla into a proper position after Le Fort I osteotomy and UDOG of the mandible. Three-dimensional virtual simulation using three-dimensional computed tomography data could help to accurately predict surgical outcomes. In addition, transarch elastic traction from the orthodontic mini-implants on the unaffected side of the mandible to the maxillary posterior teeth on the affected side can produce a plastic molding of the regenerated bone in the distraction area of the mandible and induce compensatory dentoalveolar downward development of the maxillary posterior teeth. Therefore, the purpose of this article was to introduce a new approach for the surgico-orthodontic treatment consisting of simultaneous maxillary fixation and unilateral mandibular distraction with transarch elastic traction in HFM patients.