OBJECTIVE: The purpose of this study was to evaluate the validity of midsagittal reference (MSR) planes constructed in maxillofacial 3D images. METHODS: Maxillofacial computed tomography (CT) images were obtained in 36 normal occlusion individuals who did not have apparent facial asymmetry, and 3D images were reconstructed using a computer software. Six MSR planes (Cg-ANS-Ba, Cg-ANS-Op, Cg-PNS-Ba, Cg- PNS-Op, FH perpendicular (Cg, Ba), FH perpendicular (Cg, Op)) were constructed using the landmarks located in the midsagittal area of the maxillofacial structure, such as Cg, ANS, PNS, Ba and Op, and FH plane constructed with Po and Or. The six pairs of landmarks (Z, Fr, Fs, Zy, Mx, Ms), which represent right and left symmetry in the maxillofacial structure, were selected. Statistically significant differences of the right and the left measurements were examined through t-test, and the difference of the right and the left measurement was compared among the six MSR planes. RESULTS: The distances from the right and the left landmarks in each pair to each MSR plane did not show a statistically significant difference. The reproducibility of the landmark identification was excellent. CONCLUSION: All the six planes constructed in this study can be used as a MSR plane in maxillofacial 3D analysis, particularly, the planes including Cg and ANS.
Facial Asymmetry

Patients undergoing insertion of cardiac implantable electronic devices often exhibit perioperative hemorrhagic complications. Perioperative antithrombotic management, which balances the risk of acute thrombosis and postoperative bleeding, is therefore important for these patients. In this case report, we present three cases of cardiovascular implantable electronic device (CIED) insertion. While the three patients each had different reasons for not discontinuing antithrombotic medications, they all needed CIEDs. During the CIED implantation procedures, a small incision was made on the pectoralis muscle region to obtain a small subcutaneous pocket, and Tachosil, a fibrin sealant patch, was inserted below and above the inserted device. The patients showed no pocket hematoma formation or any hemorrhagic complications. We thus concluded the application of a fibrin sealant patch could be an option for perioperative anticoagulation management without interruption of anticoagulants and antiplatelets.

Background: Povidone-iodine (PVP-I) is an antiseptic that is commonly used as an alternative to alcohol in clinical settings, including for perioperative skin disinfection. However, the presence of iodine in PVP-I can result it adverse effects on thyroid function. This study explored the effect of PVP-I on thyroid function and assessed its safety profile. Methods: We assessed thyroid function in patients before and after treatment with Repigel (topical liposomal hydrogel with 3% PVP-I) between January 2017 and January 2023, for a period of at least 2 weeks. Patients were stratified by age, sex, and previous history. Results: No significant changes in thyroid function were observed in the 61 patients enrolled until 2 weeks after application of Repigel. Significant increases in T3, T4, and free T4 levels were detected 4 weeks after Repigel application. A comparison of the initial thyroid function test (TFT) and TFT 4 weeks post-application found that the mean T3 levels were 71.12 ± 17.55 ng/dL and 59.84 ± 18.60 ng/dL and mean T4 levels were 6.48 ± 1.49 µg/dL and 5.50 ± 1.36 µg/dL, respectively. The mean free T4 levels were 1.08 ± 0.39 ng/dL and 0.90 ± 0.19 ng/dL, respectively. Conclusion Changes in thyroid function during the application of Repigel were observed. We conclude that thyroid function should be examined at regular intervals before and after topical application of Repigel. Additionally, clinicians should exercise caution when administering iodine-containing substances such as Repigel to patients with abnormal thyroid function, and schedule follow-up TFTs at 4 weeks.

Patients undergoing insertion of cardiac implantable electronic devices often exhibit perioperative hemorrhagic complications. Perioperative antithrombotic management, which balances the risk of acute thrombosis and postoperative bleeding, is therefore important for these patients. In this case report, we present three cases of cardiovascular implantable electronic device (CIED) insertion. While the three patients each had different reasons for not discontinuing antithrombotic medications, they all needed CIEDs. During the CIED implantation procedures, a small incision was made on the pectoralis muscle region to obtain a small subcutaneous pocket, and Tachosil, a fibrin sealant patch, was inserted below and above the inserted device. The patients showed no pocket hematoma formation or any hemorrhagic complications. We thus concluded the application of a fibrin sealant patch could be an option for perioperative anticoagulation management without interruption of anticoagulants and antiplatelets.

Background: Povidone-iodine (PVP-I) is an antiseptic that is commonly used as an alternative to alcohol in clinical settings, including for perioperative skin disinfection. However, the presence of iodine in PVP-I can result it adverse effects on thyroid function. This study explored the effect of PVP-I on thyroid function and assessed its safety profile. Methods: We assessed thyroid function in patients before and after treatment with Repigel (topical liposomal hydrogel with 3% PVP-I) between January 2017 and January 2023, for a period of at least 2 weeks. Patients were stratified by age, sex, and previous history. Results: No significant changes in thyroid function were observed in the 61 patients enrolled until 2 weeks after application of Repigel. Significant increases in T3, T4, and free T4 levels were detected 4 weeks after Repigel application. A comparison of the initial thyroid function test (TFT) and TFT 4 weeks post-application found that the mean T3 levels were 71.12 ± 17.55 ng/dL and 59.84 ± 18.60 ng/dL and mean T4 levels were 6.48 ± 1.49 µg/dL and 5.50 ± 1.36 µg/dL, respectively. The mean free T4 levels were 1.08 ± 0.39 ng/dL and 0.90 ± 0.19 ng/dL, respectively. Conclusion Changes in thyroid function during the application of Repigel were observed. We conclude that thyroid function should be examined at regular intervals before and after topical application of Repigel. Additionally, clinicians should exercise caution when administering iodine-containing substances such as Repigel to patients with abnormal thyroid function, and schedule follow-up TFTs at 4 weeks.

Identifying tumors or wounds on the scalp is difficult because hair blocks the vision during surgery and suturing. In the meantime, we have commonly used hairpins to hold the hair for a clearer view; however, we would like to suggest a new method, a “hair-fixing sheet,” consisting of hook-like surface. We applied the two methods, hair-fixing sheets and hairpins, assuming several situations. In these situations, it was possible to fix a wider range or various shapes more conveniently using a hair-fixing sheet than using several hairpins at a similarly low cost. In addition, it was easy to change the hair to be fixed, remove it postoperatively, and prevent the hair from being pulled out, thereby preventing additional postoperative pain.

Patients undergoing insertion of cardiac implantable electronic devices often exhibit perioperative hemorrhagic complications. Perioperative antithrombotic management, which balances the risk of acute thrombosis and postoperative bleeding, is therefore important for these patients. In this case report, we present three cases of cardiovascular implantable electronic device (CIED) insertion. While the three patients each had different reasons for not discontinuing antithrombotic medications, they all needed CIEDs. During the CIED implantation procedures, a small incision was made on the pectoralis muscle region to obtain a small subcutaneous pocket, and Tachosil, a fibrin sealant patch, was inserted below and above the inserted device. The patients showed no pocket hematoma formation or any hemorrhagic complications. We thus concluded the application of a fibrin sealant patch could be an option for perioperative anticoagulation management without interruption of anticoagulants and antiplatelets.

Background: Povidone-iodine (PVP-I) is an antiseptic that is commonly used as an alternative to alcohol in clinical settings, including for perioperative skin disinfection. However, the presence of iodine in PVP-I can result it adverse effects on thyroid function. This study explored the effect of PVP-I on thyroid function and assessed its safety profile. Methods: We assessed thyroid function in patients before and after treatment with Repigel (topical liposomal hydrogel with 3% PVP-I) between January 2017 and January 2023, for a period of at least 2 weeks. Patients were stratified by age, sex, and previous history. Results: No significant changes in thyroid function were observed in the 61 patients enrolled until 2 weeks after application of Repigel. Significant increases in T3, T4, and free T4 levels were detected 4 weeks after Repigel application. A comparison of the initial thyroid function test (TFT) and TFT 4 weeks post-application found that the mean T3 levels were 71.12 ± 17.55 ng/dL and 59.84 ± 18.60 ng/dL and mean T4 levels were 6.48 ± 1.49 µg/dL and 5.50 ± 1.36 µg/dL, respectively. The mean free T4 levels were 1.08 ± 0.39 ng/dL and 0.90 ± 0.19 ng/dL, respectively. Conclusion Changes in thyroid function during the application of Repigel were observed. We conclude that thyroid function should be examined at regular intervals before and after topical application of Repigel. Additionally, clinicians should exercise caution when administering iodine-containing substances such as Repigel to patients with abnormal thyroid function, and schedule follow-up TFTs at 4 weeks.

Patients undergoing insertion of cardiac implantable electronic devices often exhibit perioperative hemorrhagic complications. Perioperative antithrombotic management, which balances the risk of acute thrombosis and postoperative bleeding, is therefore important for these patients. In this case report, we present three cases of cardiovascular implantable electronic device (CIED) insertion. While the three patients each had different reasons for not discontinuing antithrombotic medications, they all needed CIEDs. During the CIED implantation procedures, a small incision was made on the pectoralis muscle region to obtain a small subcutaneous pocket, and Tachosil, a fibrin sealant patch, was inserted below and above the inserted device. The patients showed no pocket hematoma formation or any hemorrhagic complications. We thus concluded the application of a fibrin sealant patch could be an option for perioperative anticoagulation management without interruption of anticoagulants and antiplatelets.

Background: Povidone-iodine (PVP-I) is an antiseptic that is commonly used as an alternative to alcohol in clinical settings, including for perioperative skin disinfection. However, the presence of iodine in PVP-I can result it adverse effects on thyroid function. This study explored the effect of PVP-I on thyroid function and assessed its safety profile. Methods: We assessed thyroid function in patients before and after treatment with Repigel (topical liposomal hydrogel with 3% PVP-I) between January 2017 and January 2023, for a period of at least 2 weeks. Patients were stratified by age, sex, and previous history. Results: No significant changes in thyroid function were observed in the 61 patients enrolled until 2 weeks after application of Repigel. Significant increases in T3, T4, and free T4 levels were detected 4 weeks after Repigel application. A comparison of the initial thyroid function test (TFT) and TFT 4 weeks post-application found that the mean T3 levels were 71.12 ± 17.55 ng/dL and 59.84 ± 18.60 ng/dL and mean T4 levels were 6.48 ± 1.49 µg/dL and 5.50 ± 1.36 µg/dL, respectively. The mean free T4 levels were 1.08 ± 0.39 ng/dL and 0.90 ± 0.19 ng/dL, respectively. Conclusion Changes in thyroid function during the application of Repigel were observed. We conclude that thyroid function should be examined at regular intervals before and after topical application of Repigel. Additionally, clinicians should exercise caution when administering iodine-containing substances such as Repigel to patients with abnormal thyroid function, and schedule follow-up TFTs at 4 weeks.