A universal ratiometric method for Micro-RNA detection based on the ratio of electrochemical/electrochemiluminescence signal, and toehold-mediated strand displacement amplification

An ultra-selective and reproductive ratiometric platform was introduced based on the ratio of Ru(phen)₃²⁺ electrochemiluminescence (ECL) signal and methylene blue (MB) electrochemistry (EC) signal, which was amplified using a specific and efficient toehold-mediated strand displacement (TMSD). The stable DNA nanoclews (NCs) were efficiently loaded with MB (MB-NCs) as EC signal tags after being synthesized utilizing a simple rolling circle amplification reaction. Besides, Ti₃C₂-based nanocomposite could apply as a superb carrier for both Ru(phen)₃²⁺ and gold nanoparticles (Ti₃C₂-Au-Ru), resulting in a nearly constant ECL internal reference to eliminate the possible interferences. The Ti₃C₂-Au-Ru was attached to the surface of the electrode using Nafion, which exhibited excellent conductivity, and hairpin DNAs (hDNAs) were fixed on AuNPs via an Au-S bond. The designed biosensor was finally applied for miRNA-18a detection as a target model. The TMSD method made it possible to concurrently convert and amplify a single miRNA-18ainput into a large amount of output DNAs with high selectivity. These output DNAs were designed to unfold the stem-locked area of hDNAs. The opened hDNAs then hybridized with the MB-NCs to produce an EC signal. In the proposed biosensing system, by raising the target concentration of miRNA, the EC signal gradually rose, the ECL signal remained nearly constant, and the ratiometric detection method markedly promoted biosensor accuracy. Linear correlations of the ratio value of the EC/ECL with miRNA-18a concentrations between 20 aM and 50 pMwere observed, with the limit of detection of 9 aM. The biosensor was applied to detect miRNA-18a in real serum samples with satisfactory results.

Investigation of Job Fatigue, Quality of Life and Sleep of shift staff working in the electric distribution company of Ilam Province

Introduction: Shift work is one of the social phenomena that has its roots in the history of human origin and still exists today for economic and technological reasons. Due to the complications of shift work, the present study was conducted to investigate job fatigue, quality of life, and sleep of shift staff working in Ilam Electric Distribution Company. Materials and Methods: In this descriptive-analytical study, all shift workers of Ilam Electric Distribution Company were selected. Data collection tools included the Swedish Job Exhaustion Questionnaire, Quality of Life (SF-36), the Insomnia Assessment Questionnaire, and the Survey of shift workers (SOS). SPSS software version 26 was used to analyze data using independent sample T-Test, One-way ANOVA, and Chi-square tests.  Results: Pearson correlation test showed that there was a direct and positive correlation between age and physical function (r = 0.439; p = 0.022), smoking and sleep problems (r = 0.528; p = 0.006), and education and limitation of the role of emotional problems (r = 0.382; p = 0.049). Also, the was a significant indirect correlation was found between age and physical role limitation (r = - 0.501; p = 0.008), shift work with satisfaction with individual life (p <0.045), social life (p <0.038), family life (p <0.023) and family dissatisfaction. Conclusion: shift working has adverse effects on family satisfaction, circadian rhythms, digestive performance, and mental health. It is suggested that managers be more careful about working hours, work shifts, and rest times

EPIC: an evaluation of the psychological impact of early-phase clinical trials in cancer patients

Background

Anxiety and depression in patients with cancer is associated with decreased quality of life and increased morbidity and mortality. However, these are often overlooked and untreated. Early-phase clinical trials (EPCTs) recruit patients with advanced cancers who frequently lack future treatment options, which may lead to increased anxiety and depression. Despite this, EPCTs do not routinely consider psychological screening for patients.

Patients and methods

This prospective observational study explored levels of anxiety and depression alongside impact of trial participation in the context of EPCTs. The Hospital Anxiety and Depression Scale and the Brief Illness Perceptions Questionnaire were completed at the point of EPCT consent, the end of screening and at pre-specified time points thereafter.

Results

Sixty-four patients (median age 56 years; median Eastern Cooperative Oncology Group performance status 1) were recruited. At consent, 57 patients returned questionnaires; 39% reported clinically relevant levels of anxiety whilst 18% reported clinically relevant levels of depression. Sixty-three percent of patients experiencing psychological distress had never previously reported this. Males were more likely to be depressed (P = 0.037) and females were more likely to be anxious (P = 0.011). Changes in anxiety or depression were observed after trial enrolment on an individual level, but not significant on a population level.

Conclusions

Patients on EPCTs are at an increased risk of anxiety and depression but may not seek relevant support. Sites offering EPCTs should consider including psychological screening to encourage a more holistic approach to cancer care and consider the sex of individuals when tailoring psychological support to meet specific needs.

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Early-phase cancer trial patients have an increased risk of anxiety and depression.

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Patients at risk were not seeking support for anxiety and depression.

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Male patients were more likely to be depressed; female patients were more likely to be anxious.

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This work highlights the need to screen for psychological symptoms in patients entering early-phase trials.

Integrated two-phase acidogenic-methanogenic treatment of municipal sludge with thermal hydrolysis

The purpose of this research was to investigate the impact of two process configurations integrating two-phase anaerobic digestion (AD) of municipal sludge with thermal hydrolysis (TH). The TH was positioned either before or after the acidogenic fermentation phase. The fermentation process was carried out under the semi-continuous flow regime with a retention time of three days. The TH was done at a temperature of 170 °C and for 30 min. Among all the tested scenarios, the TH of sludge followed by the acidogenic fermentation resulted in the highest COD solubilization ratio (39.5%) and volatile fatty acids production (6,420 ± 400 mg/L), which was 630% and 500% more than that of the raw sludge, respectively. The sequential TH/fermentation process achieved 40% higher ultimate methane yield (240 mL/g COD) than the non-pretreated (raw) sludge. Positioning TH after the fermentation process reduced the ultimate methane yield to 231 240 mL/g COD, although it was still 32% higher than that of the raw sludge. The analysis of methane production rate and biodegradation kinetics data suggested the formation of refractory intermediates during the thermal process of sludge, which reduced the overall performance rate during the first week of the AD process. It was also revealed that acidogenic fermentation of thermally-processed sludge could diminish the adverse effect of the recalcitrant compounds formed during the thermal hydrolysis on the subsequent AD process.

Synthesis and characterization of Mg-doped ZnO thin-films electrochemically grown on FTO substrates for optoelectronic applications

Mg-doped ZnO (MZO) thin films were successfully fabricated on fluorine-doped tin-oxide (FTO)-coated glass substrates by an electrochemical deposition method using aqueous electrolytes of 80 mM Zn(NO₃)₂ with different concentrations of Mg(NO₃)₂. The effects of Mg doping concentration on the electronic, microstructural, morphological, optical and electrical properties of the prepared films were investigated. The results of the Mott–Schottky (M–S) analysis revealed that the charge carrier density of n-type MZO films increases considerably when increasing the amount of Mg. As Mg concentration increased the Fermi level energy was also found to be increased by inclusion of Mg doping, which was confirmed by negative shifting of the flat band potential. XRD analysis showed that both undoped and Mg-doped ZnO thin films have a polycrystalline nature and hexagonal wurtzite structure with preferential orientation along the (002) axis. It is evident that the intensity of the (002) peak decreased with increasing Mg concentration. From scanning electron microscopy (SEM) analysis, it was found that when the amount of Mg concentration was increased in the solution, a decrease in the size of the grains was observed. The optical transmittance was found to be very high (∼85%) in the visible region of the solar spectrum. When the Mg content in the ZnO system was increased, a blue shifting of the absorption edge of the films was observed. The result of I–V measurements showed that the Mg doping was found to lead to an enhancement of the electrical properties of MZO thin films and the design of high-performance transparent conductive oxide (TCO) material.

Mg-doped ZnO (MZO) thin films were successfully fabricated on fluorine-doped tin-oxide (FTO)-coated glass substrates by an electrochemical deposition method using aqueous electrolytes of 80 mM Zn(NO₃)₂ with different concentrations of Mg(NO₃)₂.

Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study

BACKGROUND

This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery.

METHODS

This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery.

RESULTS

A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498).

CONCLUSION

There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.

Nutritive value of treated Quercus infectoria and Quercus libani leaves with the tannin-degrading bacterium Klebsiella pneumoniae for ruminant feeding in vitro

AIMS

This study was conducted to evaluate the chemical composition and in vitro gas production (GP) and fermentation parameters of Quercus infectoria and Quercus libani leaves following treatment with the Klebsiella pneumoniae, a tannin-degrading bacterium.

METHODS AND RESULTS

This isolate was isolated on medium containing tannic acid as the sole source of carbon and energy, and identified based on 16S rRNA sequencing analysis. In both oak leaf species (i.e. Q. infectoria and Q. libani), inoculation with Klebsiella pneumoniae significantly increased (P < 0·05) dry matter (DM) loss. For Q. libani, crude protein content was increased (P = 0·02) by bacterial treatment vs. control. In both oak leaves, total phenolic content and total tannins were decreased (P < 0·05) as a consequence of bacterial treatment. However, bacterial processing didn't changed (P > 0·05) organic matter (OM), neutral detergent fibre, acid detergent fibre or acid detergent lignin content of treated leaves. In both oak leaves the measuring parameters including GP volume, in vitro digestibility of DM and OM, estimated metabolizable energy, total volatile fatty acids, acetate, ammonia nitrogen concentration, total protozoal population and the subfamily Isotricha in treatments were higher (P < 0·05) than control.

CONCLUSIONS

It can be concluded that biological treatment of Q. infectoria and Q. libani leaves with K. pneumoniae represents a useful approach to decrease their phenolic compound content and improve their nutritive value as ruminant feed.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study demonstrated that biologically processing of tannin-containing by-products with K. pneumoniae could increase their nutritive value as ruminant feeds and increase animal productivity.

A comprehensive dataset on anaerobic digestion of cattle manure, source separated organics, and municipal sludge using different inoculum sources

The dataset reported in this article provides quantitative data on anaerobic digestion of cattle manure, source separated organics (SSO), primary sludge (PS), and thickened waste activated sludge (TWAS) using different inoculum sources. The discussion and interpretation of the data are provided in another publication entitled “Comparison of liquid and dewatered digestate as inoculum for anaerobic digestion of organic solid wastes” [1]. The data presented in this article include 1) the gas chromatography (GC) procedure of determining the biogas composition, 2) the procedure of converting the daily biogas/methane production data from the experimental condition (mesophilic temperature of 38 °C and room pressure) to the standard temperature (0 °C) and pressure (1 atm) condition, 3) the specific methanogenic activity data, and 4) the methane daily production rate data, and 5) the organics biodegradation kinetic rates.

Comparison of liquid and dewatered digestate as inoculum for anaerobic digestion of organic solid wastes

In this study, the application of liquid and dewatered digestate was compared for the inoculation of the anaerobic digestion (AD) process. In addition to the specific methanogenic activity and biohydrogen potential tests, biochemical methane potential assay was also conducted using four different types of municipal and industrial waste streams (primary sludge, thickened waste activated sludge, source separated organics, and cattle manure). The specific methanogenic activity of the digestate cake (5.0 ± 0.5 mL-CH₄/g-VSS.d) was higher than that of the liquid digestate (3.4 ± 0.2 mL-CH₄/g-VSS.d) for the food to microorganism ratio of 0.5. The BMP results also revealed that regardless of the type of the substrate used, the application of the digestate cake as inoculum achieved statistically significantly higher methane production rate compared to the utilization of liquid digestate, most likely due to the lower concentration of dissolved contents (i.e., ammonia, soluble organic matter, heavy metals, etc.) in the diluted digestate cake. Despite the increased process rate, no statistically significant effect of the type of the inoculum was observed on the ultimate methane yield. The biohydrogen potential test revealed the similar performance of the digestate- and digestate cake-inoculated digesters in terms of biohydrogen and volatile fatty acids production. The findings of this study suggest that the digestate cake can be used as an effective alternative to the liquid digestate for the inoculation of full-scale anaerobic digesters, reducing the transportation volume by up to 90%.

Enzymatic pretreatment of lignocellulosic biomass for enhanced biomethane production-A review

The rapid depletion of natural resources and the environmental concerns associated with the use of fossil fuels as the main source of global energy is leading to an increased interest in alternative and renewable energy sources. Particular interest has been given to the lignocellulosic biomass as the most abundant source of organic matter with a potential of being utilized for energy recovery. Different approaches have been applied to convert the lignocellulosic biomass to energy products including anaerobic digestion (AD), fermentation, combustion, pyrolysis, and gasification. The AD process has been proven as an effective technology for converting organic material into energy in the form of methane-rich biogas. However, the complex structure of the lignocellulosic biomass comprised of cellulose, hemicelluloses, and lignin hinders the ability of microorganisms in an AD process to degrade and convert these compounds to biogas. Therefore, a pretreatment step is essential to improve the degradability of the lignocellulosic biomass to achieve higher biogas rate and yield. A system that uses pretreatment and AD is known as advanced AD. Several pretreatment methods have been studied over the past few years including physical, thermal, chemical and biological pretreatment. This paper reviews the enzymatic pretreatment as one of the biological pretreatment methods which has received less attention in the literature than the other pretreatment methods. This paper includes a review of lignocellulosic biomass composition, AD process, challenges in degrading lignocellulosic materials, the current status of research to improve the biogas rate and yield from the AD of lignocellulosic biomass via enzymatic pretreatment, and the future trend in research for the reduction of enzymatic pretreatment cost.

Comparative efficacy of two-dimensional mode and color Doppler sonography in predicting gender of the equine fetus

Background and Aim:

Ultrasonographic fetal sexing is of utmost economic importance for horse breeders. Relatively, a few studies have been conducted to determine fetal sex in mare using transrectal Doppler ultrasound. This study aimed to compare two sexing techniques, two-dimensional (2D) mode and color Doppler ultrasonography.

Materials and Methods:

The study was conducted on 39 mares under field conditions. Examinations were performed using the ultrasonic model device (Medison SonoAce Pico, South Korea), equipped with real-time 3-7 MHz convex multifrequency transducer. Fetal sex diagnosis was carried out in two periods of pregnancy, early period (57-80 days of gestation) and late period (80-150 days of gestation).

Results:

No difference (p=0.4) was observed between the efficiency of the 2D mode and Doppler ultrasound in sex determination with the respective frequency of 74% and 85%. The best time to sex the early fetus was between 57 and 70 days of gestation and between 90 and 120 days for the older fetus.

Conclusion:

The accuracy of sex determination can be increased using Doppler mode compared to 2D mode, especially in the early period between 57 and 70 days, in male more than female sex.

Bioenergy production data from anaerobic digestion of thermally hydrolyzed organic fraction of municipal solid waste

The presented dataset in this data article provides quantitative data on the production of bioenergy (biogas and biomethane) from mesophilic batch anaerobic digestion (AD) of thermally hydrolyzed organic fraction of municipal solid waste (OFMSW). The discussion and interpretation of the data are provided in another publication entitled “Hydrothermal Pretreatment of Source Separated Organics for Enhanced Solubilization and Biomethane Recovery” (Razavi et al., 2019). The data and information presented in the current data article include (1) the ratio of soluble to particulate chemical oxygen demand (COD) under different thermal hydrolysis condition, (2) the daily measured biogas and biomethane data, (3) the cumulative methane yield data in terms of mL CH₄ produced per gram of volatile suspended solids (VSS) as well as feedstock added, (4) the ultimate methane yield data as well as the relative improvement in methane recovery compared to the control (non-hydrolyzed) digester, (5) the data of first-order organics biodegradation rate constants, (6) the procedure of measuring biogas composition via gas chromatography, (7) the procedure of converting the biogas/methane volume data acquired under the actual experimental condition (mesophilic temperature of 38 °C and atmospheric pressure) to the standard temperature (0 °C) and pressure (1 atm) condition, and (8) the procedure of determining the first-order kinetic rate constants.

Hydrothermal pretreatment of source separated organics for enhanced solubilization and biomethane recovery

The objective of this research was to evaluate the effect of the hydrothermal pretreatment on the solubilization of source separated organics (SSO) as well as the biomethane recovery through the mesophilic batch anaerobic digestion process. For this purpose, the SSO was subjected to fifteen different pretreatment conditions within five different severity index (SI) values (3, 3.5, 4, 4.5, and 5). The pretreatment temperature, holding time, and pressure ranged from 150 to 240 °C, 5 to 30 min, and 476 to 3367 kPa, respectively. The highest solubilization improvement of ∼50% was achieved under the pretreatment condition of "220 °C-10 min-2323 kPa" corresponding to the SI value of 4.5. However, the maximum biomethane production yield of 280 mL/g TCOD_added and biomethane production rate of 30 mL/g TCOD_added were obtained under the less intense pretreatment conditions of "190 °C-20 min-1247 kPa" and "170 °C-30 min-786 kPa", respectively.

Interaction between the sequence of feeding of hay and concentrate, and boiling of barley on feed intake, the activity of hydrolytic enzymes and fermentation in the hindgut of Arabian mares

The interaction between the sequence of feeding of hay and concentrate and the hydrothermal processing of barley in alleviating concentrate effects on intake, and hindgut fermentation in horses was tested. Six Arabian mares (4-10 years of age, 410 ± 35 kg body weight) were used to evaluate the effects of feeding sequence (FS) and type of barley (TB) on intake, and faecal volatile fatty acids (VFA), activities of α-amylase (AA: EC 3.2.1.1), carboxymethyl cellulase (CMCase: EC 3.2.1.4), microcrystalline cellulase (MCCase: EC 3.2.1.91) and general filter paper degrading activity (FPD). Mares were offered a ration of air-dried alfalfa and concentrate (70:30 as-fed) in four subsequent periods of 14 days including 8 days of adaptation and 6 days of sampling. In each period and each meal, mares received concentrate either 30 min after (HC) or 30 min before (CH) alfalfa hay. Barley was either milled or boiled in water. Rectal samples were grabbed directly from rectum once per period. Mares subjected to CH had higher dry matter intakes than mares under HC regime. The acetate:propionate ratio (A:P ratio) in rectal content was higher with CH than HC. The AA activity was higher under CH than under HC. Mares fed boiled barley had lower rectal concentrations of VFA and propionate and a higher A:P ratio than mares fed milled barley. Furthermore, the rectal content showed a higher MCCase activity but a lower AA activity when mares were fed boiled compared with milled barley. Interactions between FS and TB were observed with respect to CMCase activity, and concentrations of propionate and valerate. In conclusion, the present results suggest that both, feeding concentrate before hay and boiling the barley, might improve the hindgut environment in Arabian mares, and that the two measures were mostly additive and sometimes even synergistic.

Prevalence and Clinical Characteristics of Metabolic Syndrome among Malaysian Hypertensive Subjects using the International Diabetes Federation Definition

Individuals with metabolic syndrome are at increased risk for developing cardiovascular disease and diabetes mellitus. This study was carried out to determine the prevalence of metabolic syndrome and clinical characteristics in hypertensive patients according to the criteria of the new International Diabetes Federation (IDF) definition. Hypertensive patients were recruited from the Medical Out-Patient Department, Kuantan Hospital. The five components of metabolic syndrome were examined which included blood pressure (≥130/85 mmHg), fasting glucose (≥5.6mmol/L), fasting triglycerides (≥1.7 mmol/L), high-density lipoprotein (HDL) cholesterol level (<1.03mmol/L in males and ><1.29mmol/L in females), and abdominal obesity (waist circumference: men>90cm; women>80cm). Out of 139 hypertensive patients, there were 113 met all the selection criteria consisted of 61 male and 52 female subjects. The participants’ age ranged from 21 to 91 years (51.9±16.8 years; mean±SD), and body mass index 13.5-42.3 kg/m2 (27.5±4.9 kg/m2 ). According to the IDF criteria, the prevalence of central obesity was 67.2% in men and 84.6% in women. Among the 113 hypertensive subjects over 21 years of age, 51 subjects or 45.1% had metabolic syndrome. The present data revealed that there was high prevalence of metabolic syndrome in Malaysian hypertensive subjects. This finding was supported by the fact of high prevalence of central obesity among the study subjects.

Comparison of three combined sequencing batch reactor followed by enhanced Fenton process for an azo dye degradation: Bio-decolorization kinetics study

The purpose of this research was to compare three combined sequencing batch reactor (SBR) - Fenton processes as post-treatment for the treatment of azo dye Acid Red 18 (AR18). Three combined treatment systems (CTS1, CTS2 and CTS3) were operated to investigate the biomass concentration, COD removal, AR18 dye decolorization and kinetics study. The MLSS concentration of CTS2 reached 7200 mg/L due to the use of external feeding in the SBR reactor of CTS2. The COD concentration remained 273 mg/L and 95 mg/L (initial COD=3270 mg/L) at the end of alternating anaerobic-aerobic SBR with external feeding (An-A MSBR) and CTS2, respectively, resulting in almost 65% of Fenton process efficiency. The dye concentration of 500 mg/L was finally reduced to less than 10mg/L in all systems indicating almost complete AR18 decolorization, which was also confirmed by UV-vis analysis. The dye was removed following two successive parts as parts 1 and 2 with pseudo zero-order and pseudo first-order kinetics, respectively, in all CTSs. Higher intermediate metabolites degradation was obtained using HPLC analysis in CTS2. Accordingly, a combined treatment system can be proposed as an appropriate and environmentally-friendly system for the treatment of the azo dye AR18 in wastewater.

Repositioned lateral crural flap technique for cephalic malposition in rhinoplasty

BACKGROUND

Cephalic malposition of the lower lateral cartilage (CMLLC) is a relatively common anatomical variant, particularly in Middle Eastern patients. The characteristics of CMLLC include long alar creases, a boxy and ball-shaped nasal tip, parenthesis tip deformity and external valvular incompetence. The gold standard for correcting CMLLC is the lateral crural strut graft (Gunter graft), but many patients experience problems after this technique.

OBJECTIVE

To evaluate the efficacy of the repositioned lateral crural flap (RLCF) technique in correcting CMLLC, and to discuss the cosmetic and functional results.

METHODS

In the present study, 123 primary septorhinoplasty operations using the RLCF technique were performed between May 2012 and March 2013. The mean follow-up period was 11.4 months (range nine to 24 months). Four parameters were measured and compared pre- and postoperatively: the angle between the line connecting the maximum convexity of the lower lateral cartilage (LLC) to the tip-defining point and midline on each side (angle of rotation); the total distance between the maximum convexity of LLC right and left to midline (representing the size of the parenthesis deformity); satisfaction scale rating of the patients' nasal tip appearance; and the satisfaction scale rating of patients' breathing through their nostrils.

RESULTS

The mean angle of the LLC to the midline significantly increased and the mean distance between the maximum convexities was significantly reduced, indicating correction of the malposition and reduction of the parenthesis deformity, respectively. The mean satisfactory scale ratings of nasal tip appearance and breathing quality were also significantly improved.

CONCLUSION

CMLLC can be corrected using the RLCF technique, resulting in both aesthetic and functional improvements.

Repositioned lateral crural flap technique for cephalic malposition in rhinoplasty

Background

Cephalic malposition of the lower lateral cartilage (CMLLC) is a relatively common anatomical variant, particularly in Middle Eastern patients. The characteristics of CMLLC include long alar creases, a boxy and ball-shaped nasal tip, parenthesis tip deformity and external valvular incompetence. The gold standard for correcting CMLLC is the lateral crural strut graft (Gunter graft), but many patients experience problems after this technique.

Objective

To evaluate the efficacy of the repositioned lateral crural flap (RLCF) technique in correcting CMLLC, and to discuss the cosmetic and functional results.

Methods

In the present study, 123 primary septorhinoplasty operations using the RLCF technique were performed between May 2012 and March 2013. The mean follow-up period was 11.4 months (range nine to 24 months). Four parameters were measured and compared pre- and postoperatively: the angle between the line connecting the maximum convexity of the lower lateral cartilage (LLC) to the tip-defining point and midline on each side (angle of rotation); the total distance between the maximum convexity of LLC right and left to midline (representing the size of the parenthesis deformity); satisfaction scale rating of the patients' nasal tip appearance; and the satisfaction scale rating of patients' breathing through their nostrils.

Results

The mean angle of the LLC to the midline significantly increased and the mean distance between the maximum convexities was significantly reduced, indicating correction of the malposition and reduction of the parenthesis deformity, respectively. The mean satisfactory scale ratings of nasal tip appearance and breathing quality were also significantly improved.

Conclusion

CMLLC can be corrected using the RLCF technique, resulting in both aesthetic and functional improvements.

Inflammatory appendix mass in patients with acute appendicitis: CT diagnosis and clinical relevance

The purpose of our study was to analyze the clinical relevance of computerized tomography (CT) in providing the diagnosis of inflammatory appendix mass (IAM) in patients with acute appendicitis. The CT images of 134 patients were reviewed. Two groups of patients were made according to the presence (group 1; n = 21) or the absence (group 2; n = 113) of IAM. Clinical signs of patients, CT features, complications at surgery, and histological examinations were noted. Inter-observer agreement was assessed by using kappa statistics. Twenty-one patients presenting with CT features of IAM were diagnosed. An excellent inter-observer agreement (κ = 0.94) was assessed for the diagnosis of IAM. No significant statistical difference in the age distribution was observed between patients with IAM (mean age 55) and patients without (mean age 45) (p = 0.2232). No clinical sign showed a statistically significant association with the presence of IAM (p = 0.707) or with complication encountered at surgery (p = 0.180). Delay to CT examination was 5.4 days in patients presenting with CT features of IAM and of 1.7 days for patients presenting without (p = 0.0001). Conversely to acute appendicitis complicated by simple perforation (p = 0.153) or peri-appendicular abscess (p = 0.501), acute appendicitis presenting with IAM showed a statistically significant association with complications encountered at surgery (p = 0.0003) and the need for conversion to open surgery (p = 0.001). Performing CT in complicated acute appendicitis provides the diagnosis of IAM. Distinction of IAM appeared to be of clinical relevance, since immediate surgery in IAM was statistically associated with surgical complications and conversion to open surgery in our study.