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Background The aim of this study was to compare olfactory function change in patients who underwent endoscopic skull-base surgery. Methodology A total of 928 patients were included in this retrospective study. Olfactory function was measured using the non- validated Likert scale (0â€"100), the Cross-Cultural Smell Identification Test (CC-SIT) and the butanol threshold test (BTT). Patients were divided into two groups: an endoscopic trans-sellar approach group (ETA, n = 768) and an extended endoscopic endonasal approach group (EEEA, n = 160). The ETA group was sub-divided into Nasoseptal flap (NSF) and no NSF groups. Results Non-validated olfactory function significantly worsened in the EEEA and ETA-NSF groups compared with that in the ETA- no NSF group for at least 6 months post-operatively. Validated olfactory impairment (BTT and CC-SIT) was also significantly worse in the EEEA and NSF groups compared with that in the ETA-no NSF group 3 months post-operatively. Additionally, the degrees of non-validated and validated olfactory deterioration were not significantly different between the EEEA and ETA-NSF groups. We also found that CC-SIT score changes were significantly impaired in tuberculum sellae meningioma patients than in craniopharyn- gioma patients. Conclusions We conclude that NSF was the key factor that led to olfactory impairment after endoscopic skull-base surgery.

Background Several new biomarkers for the detection of early tubular injury have been investigated in kidney transplant recipients. We recently identified day 2 urinary neutrophil gelatinase-associated lipocalin (NGAL) as a predictor of slow graft function and adverse 1-year outcome. In the present study, we further investigated the value of urinary NGAL and liver-type fatty acid binding protein (L-FABP) for predicting long-term graft outcomes up to 2 years. Methods This study was a single-center, prospective observational study. Serial urinary NGAL and L-FABP levels at 0 hours, 2 days, and 6 days after kidney transplantation (KT) were measured, and the clinical data were assessed during the 2-year period after KT. Results During the 2-year follow-up period, 13 (18.8%), 5 (7.2%), and 4 (5.8%) patients were diagnosed with acute T-cell–mediated rejection, acute antibody-mediated rejection (AMR) and chronic AMR, respectively. In addition, 10 patients (14.3%) developed calcineurin inhibitor toxicity and 6 (8.7%) developed BK viremia. The mean estimated glomerular filtration rates (eGFR) at 1 and 2 years after KT were 65.1 ± 19.1 and 58.5 ± 22.6 mL/min/1.73 m2, respectively, When poor long-term graft function was defined as eGFR of less than 50 mL/min/1.73 m2 at 2 years, elderly donors, acute rejection, and high 0-hour urinary L-FABP levels were significant risk factors. Furthermore, in rejection-free patients, L-FABP was strongly associated with poor long-term graft function (P = .006). Multivariate logistic regression analysis showed that high 0-hour L-FABP (P = .015) and acute rejection (P = .006) were independent factors predicting poor long-term graft function. Receiver operating characteristic analysis showed that the area under the curve for urinary L-FABP was 0.692 (P = .036). Conclusions Our results suggest that urinary L-FABP may be a useful predictor of adverse long-term outcomes in KT patients.

In order to supply liquid fuel in DMFC (Direct Methanol Fuel Cell) system, a small but high-output micropump is needed. This study presents a design concept, fabrication and experimental results of the newly devised piezoelectric micropump by using resonance and fluid inertia. The micropump consists of a resonantly-driven pumping unit, an inlet check valve, and a pipeline element with a small diameter employed in an outlet. The resonance mechanism is used to oscillate the pumping chamber. It simply magnifies a small displacement of the used multilayer-piezoelectric actuator. The fluid inertia effect uses a fast flow through a narrow pipeline element employed instead of the outlet check valve. First, an analysis on each element such as a diaphragm and a check valve is performed. Based on the obtained analysis results, a prototype micropump is designed, and fabricated. Then, pumping characteristics such as frequency-dependent displacement, and flow rate without load pressure are experimentally investigated. Finally, a refabrication of the micropump is carried out to improve load characteristics, and the obtained experimental results are presented and discussed.

9544 Background: In locally advanced breast cancer, selection of adjuvant regimen after neoadjuvant chemotherapy and surgery is still in controversy. Methods: 46 locally advanced breast cancer pati...