Viable tumour cells are produced in the surgical smoke from tumour dissection by ultrasonic scalpel. Surgical relevance Surgical smoke is a byproduct of dissection using a number of powered devices. Hazards to operating room personnel and patients are unclear. This study has shown that use of an ultrasonic dissection device can produce smoke that contains viable tumour cells. Although the model is somewhat artificial, a theoretical risk exists, and measures to evacuate surgical smoke efficiently are important.

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Aqueous free propofol in lipid emulsion elicits pain. • No data on the incidence and severity of injection pain for Aquafol™ (Daewon Pharmaceutical Co., Ltd, Seoul, Korea), a lipid‐free microemulsion propofol, are available. • Two hypotheses involving plasma bradykinin generation have been proposed to explain propofol‐induced pain; one implicates aqueous free propofol, the other implicates the lipid solvent. WHAT THIS STUDY ADDS • Microemulsion propofol produces more frequent and severe pain on injection, an effect that may be attributable to the high concentration of aqueous free propofol. • There was no evidence that plasma bradykinin generation caused propofol‐induced pain. • In addition, agents known to prevent propofol‐induced pain did not decrease aqueous free propofol concentrations. AIMS To evaluate the incidence and severity of injection pain caused by microemulsion propofol and lipid emulsion propofol in relation to plasma bradykinin generation and aqueous free propofol concentrations. METHODS Injection pain was evaluated in 147 patients. Aqueous free propofol concentrations in each formulation, and in formulation mixtures containing agents that reduce propofol‐induced pain, were measured by high‐performance liquid chromatography. Plasma bradykinin concentrations in both formulations and in their components mixed with blood sampled from six volunteers were measured by radioimmunoassays. Injection pain caused by 8% polyethylene glycol 660 hydroxystearate (PEG660 HS) was evaluated in another 10 volunteers. RESULTS The incidence of injection pain [visual analogue scale (VAS) >30 mm] caused by microemulsion and lipid emulsion propofol was 69.7 and 42.3% (P < 0.001), respectively. The median VAS scores for microemulsion and lipid emulsion propofol were 59 and 24 mm, respectively (95% confidence interval for the difference 12.5, 40.0). The aqueous free propofol concentration of microemulsion propofol was seven times higher than that of lipid emulsion propofol. Agents that reduce injection pain did not affect aqueous free propofol concentrations. Microemulsion propofol and 8% PEG660 HS enhanced plasma bradykinin generation, whereas lipid emulsion propofol and lipid solvent did not. PEG660 HS did not cause injection pain. CONCLUSIONS Higher aqueous free propofol concentrations of microemulsion propofol produce more frequent and severe pain. The plasma kallikrein–kinin system may not be involved, and the agents that reduce injection pain may not act by decreasing aqueous free propofol concentrations.

Microemulsion propofol produced a high concentration of free propofol in the aqueous phase. For the applied dose range, microemulsion propofol showed nonlinear pharmacokinetics.

Elucidating the imbalance of ANS in OSAS patients was feasible by HRV and its parameters.

The role of three-dimensional (3D) printing has expanded in diverse areas in medicine. As plastic surgery needs to fulfill the different demands from diverse individuals, the applications of tailored 3D printing will become indispensable. In this study, we evaluated the feasibility of using 3D-printed polycaprolactone (PCL) scaffold seeded with fibrin/chondrocytes as a new dorsal augmentation material for rhinoplasty. The construct was surgically implanted on the nasal dorsum in the subperiosteal plane of six rabbits. The implants were harvested 4 and 12 weeks after implantation and evaluated by gross morphological assessment, radiographic imaging, and histologic examination. The initial shape of the implant was unchanged in all cases, and no definite post-operative complications were seen over the 3-month period. Radiologic evaluation confirmed that implants remained in the initial location without migration or extrusion. Histologic evaluations showed that the scaffold architectures were maintained with minimal inflammatory reactions; however, expected neo-chondrogenesis was not definite in the constructs. A new PCL scaffold designed by 3D printing method seeded with fibrin/chondrocytes can be a biocompatible augmentation material in rhinoplasty in the future.

Normal-range sleep duration is an important factor for general health and metabolism, and insufficient or excessive sleep is associated with chronic metabolic disease. Among the many factors that affect sleep duration, sun exposure plays an important role in maintaining regular circadian rhythm and is also involved in the production and activation of 25-hydroxyvitamin D [25(OH)D], which regulates various functions in the body. However, 25(OH)D is available through food and various nutritional supplements without sun exposure, so it is important to find out the complex relationship among sun exposure, vitamin D status, and sleep duration. The relationship between sun exposure, vitamin D status, and sleep duration was analyzed in the nationwide survey and examination of 25,534 study populations, after adjusting for demographic characteristics, physical characteristics, lifestyle status, and socio-demographic variables. Vitamin D status alone did not show the relationship with sleep duration, although there were statistical relationships in the various factors including sun exposure with sleep duration. There was a statistical difference in 25(OH)D according to sleep duration, only in low sun exposure group. Subjects with low sun exposure and excessive sleep duration comparatively lower 25(OH)D than those with normal-range sleep, even after adjustment for potentially confounding factors. Individuals with limited exposure to sunlight should maintain adequate vitamin D status to have an appropriate sleep duration for health. Normal-range sleep duration is an important factor for general health and metabolism 1. Insufficient or excessive sleep duration is associated with various chronic physical or mental illness, such as obesity, hypertension, diabetes, metabolic syndrome, depression, and other psychiatric disease 2-4. Sleep insufficiency has been also associated with low thyroid hormone levels in rats and with high noradrenaline and cortisol levels in humans 5. Sleep duration is mainly affected by circadian rhythm, and circadian rhythm is affected by the melatonin level controlled by the light exposure 6-8. Therefore, sun exposure has an important role for determining sleep time 9-11. 25-hydroxyvitamin D [25(OH)D], which is also greatly affected by sunlight exposure, regulates the metabolism of calcium and phosphorus, which contribute to the maintenance of a healthy musculoskeletal system. Recent studies have suggested that vitamin D status are associated with impaired glucose metabolism, cardiovascular disease, infectious/inflammatory disease, psychiatric disease, and cancer 12-16. 25(OH)D is produced either through an endogenous pathway using UV light from sun exposure or an exogenous pathway through food intake. Vitamin D status are mainly regulated through serum phosphorus and parathyroid hormone, but are also affected by temperature, skin color, sunscreen use, clothing, obesity, and hepatic or renal function 17. Serum vitamin D status, measured as 25(OH)D, are also implicated in an increasing number of physiolog...

Robot-assisted SMG resection was feasible without any significant complications and satisfactory cosmetic results. The safety and oncologic outcome of the procedure should be verified with larger number of patients and longer follow up period.

These guidelines were developed as part of the 2016 Policy Research Servicing Project by the Korea Centers for Disease Control and Prevention. A multidisciplinary approach was taken to formulate this guideline to provide practical information about the diagnosis and treatment of adults with acute upper respiratory tract infection, with the ultimate aim to promote the appropriate use of antibiotics. The formulation of this guideline was based on a systematic literature review and analysis of the latest research findings to facilitate evidence-based practice, and focused on key questions to help clinicians obtain solutions to clinical questions that may arise during the care of a patient. These guidelines mainly cover the subjects on the assessment of antibiotic indications and appropriate selection of antibiotics for adult patients with acute pharyngotonsillitis or acute sinusitis.