c-Axis Aligned 3 nm Thick In2O3 Crystal Using New Liquid DBADMIn Precursor for Highly Scaled FET Beyond the Mobility-Stability Trade-off.

Oxide semiconductors (OS) are attractive materials for memory and logic device applications owing to their low off-current, high field effect mobility, and superior large-area uniformity. Recently, successful research has reported the high field-effect mobility (µFE) of crystalline OS channel transistors (above 50 cm2 V-1 s-1). However, the memory and logic device application presents challenges in mobility and stability trade-offs. Here, we propose a method for achieving high-mobility and high-stability by lowering the grain boundary effect. A DBADMIn precursor was synthesized to deposit highly c-axis-aligned C(222) crystalline 3 nm thick In2O3 films. In this study, the 250 °C deposited 3 nm thick In2O3 channel transistor exhibited high µFE of 41.12 cm2 V-1 s-1, Vth of -0.50 V, and SS of 150 mV decade-1 with superior stability of 0.16 V positive shift during PBTS at 100 °C, 3 MV cm-1 stress conditions for 3 h.

Long-Term Outcome of Unilateral Acoustic Neuromas With or Without Hearing Loss: Over 10 Years and Beyond After Gamma Knife Radiosurgery.

BACKGROUND: Since the long-term outcomes of 162 patients who underwent gamma knife radiosurgery (GKS) as an initial or adjuvant treatment for acoustic neuromas (ANs) with unilateral hearing loss were first reported in 1998, there has been no report of a comprehensive analysis of what has changed in GKS practice. METHODS: We performed a retrospective study of the long-term outcomes of 106 patients with unilateral sporadic ANs who underwent GKS as an initial treatment. The mean patient age was 50 years, and the mean initial tumor volume was 3.68 cm3 (range, 0.10-23.30 cm3). The median marginal tumor dose was 12.5 Gy (range, 8.0-15.0 Gy) and the median follow-up duration was 153 months (range, 120-216 months). RESULTS: The tumor volume increased in 11 patients (10.4%), remained stationary in 27 (25.5%), and decreased in 68 patients (64.2%). The actuarial 3, 5, 10, and 15-year tumor control rates were 95.3 ± 2.1%, 94.3 ± 2.2%, 87.7 ± 3.2%, and 86.6 ± 3.3%, respectively. The 10-year actuarial tumor control rate was significantly lower in the patients with tumor volumes of ≥ 8 cm3 (P = 0.010). The rate of maintaining the same Gardner-Robertson scale grade was 28.6%, and that of serviceable hearing was 46.4%. The rates of newly developed facial and trigeminal neuropathy were 2.8% and 4.7%, respectively. The patients who received marginal doses of less than 12 Gy revealed higher tumor control failure rates (P = 0.129) and newly occurred facial or trigeminal neuropathy rates (P = 0.040 and 0.313, respectively). CONCLUSION: GKS as an initial treatment for ANs could be helpful in terms of tumor control, the preservation of serviceable hearing, and the prevention of cranial neuropathy. It is recommended to perform GKS as soon as possible not only for tumor control in unilateral ANs with hearing loss but also for hearing preservation in those without hearing loss.

Thermally Activated Defect Engineering for Highly Stable and Uniform ALD-Amorphous IGZO TFTs with High-Temperature Compatibility.

Highly stable IGZO thin-film transistors derived from atomic layer deposition are crucial for the semiconductor industry. However, unavoidable defect generation during high-temperature annealing results in abnormal positive bias temperature stress (PBTS). Herein, we propose a defect engineering method by controlling the gate insulator (GI) deposition temperature. Applying a GI deposition temperature of 400 °C to the In0.52Ga0.18Zn0.30O active layer effectively suppresses defects even after 600 °C annealing, preserving the amorphous phase of IGZO. The device exhibits a threshold voltage (VTH) of 0.05 V, a field-effect mobility of 27.6 cm2/Vs, a subthreshold swing of 61 mV/decade, and a hysteresis voltage of 0.01 V, demonstrating highly reliable PBTS and negative bias temperature stress. A power-law fit of the PBTS stability under 2 MV/cm of gate field stress and 120 °C of temperature stress predicts a VTH shift of -0.01 V after 10 years. Moreover, the proposed method ensures reliable uniformity over a large 4 in. area.

Type-II Red Phosphorus: Wavy Packing of Twisted Pentagonal Tubes.

Elemental phosphorus exhibits fascinating structural varieties and versatile properties. The unique nature of phosphorus bonds can lead to the formation of extremely complex structures, and detailed structural information on some phosphorus polymorphs is yet to be investigated. In this study, we investigated an unidentified crystalline phase of phosphorus, type-II red phosphorus (RP), by combining state-of-the-art structural characterization techniques. Electron diffraction tomography, atomic-resolution scanning transmission electron microscopy (STEM), powder X-ray diffraction, and Raman spectroscopy were concurrently used to elucidate the hidden structural motifs and their packing in type-II RP. Electron diffraction tomography, performed using individual crystalline nanowires, was used to identify a triclinic unit cell with volume of 5330 Å3 , which is the largest unit cell for elemental phosphorus crystals up to now and contains approximately 250 phosphorus atoms. Atomic-resolution STEM imaging, which was performed along different crystal-zone axes, confirmed that the twisted wavy tubular motif is the basic building block of type-II RP. Our study discovered and presented a new variation of building blocks in phosphorus, and it provides insights to clarify the complexities observed in phosphorus as well as other relevant systems.

Selectively Nitrogen Doped ALD-IGZO TFTs with Extremely High Mobility and Reliability.

Achieving high mobility and reliability in atomic layer deposition (ALD)-based IGZO thin-film transistors (TFTs) with an amorphous phase is vital for practical applications in relevant fields. Here, we suggest a method to effectively increase stability while maintaining high mobility by employing the selective application of nitrous oxide plasma reactant during plasma-enhanced ALD (PEALD) at 200 °C process temperature. The nitrogen-doping mechanism is highly dependent on the intrinsic carbon impurities or nature of each cation, as demonstrated by a combination of theoretical and experimental research. The Ga2O3 subgap states are especially dependent on plasma reactants. Based on these insights, we can obtain high-performance indium-rich PEALD-IGZO TFTs (threshold voltage: -0.47 V; field-effect mobility: 106.5 cm2/(V s); subthreshold swing: 113.5 mV/decade; hysteresis: 0.05 V). In addition, the device shows minimal threshold voltage shifts of +0.45 and -0.10 V under harsh positive/negative bias temperature stress environments (field stress: ±2 MV/cm; temperature stress: 95 °C) after 10000 s.

Thyroid lobectomy is sufficient for differentiated thyroid cancer with upgraded risk after surgery.

Background: It is difficult to reliably distinguish between American Thyroid Association (ATA) low-risk and intermediate-risk differentiated thyroid cancer (DTC) before surgery. Therefore, physicians are faced with a dilemma regarding the necessity and timing of completion total thyroidectomy (CT) after thyroid lobectomy (TL). We evaluated proper surgical methods by analyzing oncologic outcomes of TL in patients with DTC whose risk had been upgraded after surgery. Methods: We retrospectively reviewed the medical records of 1,702 patients with DTC who underwent TL and ipsilateral central lymph node (LN) dissection between January 2006 and December 2011. The patients were classified into Group A (n=1,159; low risk; ≤5 central LN metastases or the absence of pathologic microscopic capsular invasion) and Group B (n=543; upgraded intermediate risk after surgery; >5 central LN metastases or the presence of pathologic microscopic capsular invasion). We analyzed their clinicopathological characteristics and recurrence-free survival. Results: All 32 patients who experienced recurrence underwent CT. After the first operation, the duration until reoperation in Groups A and B were 8.00±2.74 (range, 3.42-12.17) and 5.10±3.09 (range, 1.25-11.67) years, respectively. There was no significant difference in recurrence rates, disease-related mortality rates, or 10-year recurrence-free survival rates between the two groups. The mean follow-up durations in Groups A and B were 10.22±1.58 and 10.13±1.47 years, respectively. Univariate analysis showed that sex, age, tumor size, multifocality, extrathyroidal extension (ETE), and number of central LN metastases were not associated with recurrence after TL, although the rate of central LN metastases was. Multivariate analysis showed that sex, age, tumor size, multifocality, ETE, central LN metastases, and the number of central LN metastases were not associated with recurrence after TL, although multifocality was. Conclusions: TL with prophylactic central compartment neck dissection (CCND) is sufficient for patients with DTC whose risk is upgraded after surgery because they have a good prognosis at long-term follow-up. Larger-scale randomized clinical trials are required to confirm our findings.

Factors associated with radiation toxicity and long-term tumor control more than 10 years after Gamma Knife surgery for non-skull base, nonperioptic benign supratentorial meningiomas.

OBJECTIVE: Gamma Knife surgery (GKS) is a well-established treatment for benign intracranial meningiomas; however, the dosimetric factors associated with long-term GKS efficacy and safety remain to be elucidated. Using data obtained with at least 10 years of follow-up, the authors aimed 1) to analyze GKS efficacy and safety for the treatment of benign meningiomas confined to non-skull base, nonperioptic supratentorial locations and 2) to determine the radiation dose window that allows for long-term efficacy and safety, namely the minimum dose to achieve long-term local control (LC) and the maximum safe dose to avoid adverse radiation effects (AREs). METHODS: A retrospective analysis was performed on patients who underwent GKS for benign meningiomas in the abovementioned location at the authors' institution between 1998 and 2010 and who received follow-up for more than 10 years. The authors meticulously extracted the values of various dosimetric factors by using a dose-volume histogram. Cox proportional hazard regression analyses were performed to investigate the dosimetric factors associated with LC and ARE. RESULTS: Fifty-five patients (male/female ratio 1:4.2) with 68 tumors were enrolled. The median (range) gross target volume and marginal dose were 4.2 (0.2-31.7) cm3 and 14.3 (9-20) Gy, respectively. In total, 23.5% of tumors progressed at an average of 72 months, with 10- and 15-year progression-free survival rates of 80.9% and 73.5%, respectively. In univariate analysis, higher marginal dose, coverage (%), Dmin, D98%, Dmean, D2%, Dmax, and Paddick conformity index were significantly associated with LC. In multivariate analysis, D98% was the significant factor, with a cutoff value of 11 Gy (HR 0.754, p < 0.001). Symptomatic AREs occurred in 7 patients at an average of 7 months after GKS. AREs were significantly associated with the volume of normal tissue irradiated with more than 14 Gy (nV14Gy), with a cutoff value of 0.66 cm3 (HR 2.459, p = 0.002). CONCLUSIONS: D98% was a barometer of the minimum required dose associated with long-term LC, and nV14Gy was related to symptomatic AREs. The authors recommend a marginal dose ranging from 11 to 14 Gy to achieve long-term efficacy and safety in patients with non-skull base, nonperioptic benign supratentorial meningiomas, with the assumption of thorough tumor coverage.

Ion-Selective Electrode Based on a Novel Biomimetic Nicotinamide Compound for Phosphate Ion Sensor.

Phosphorus is not only an import nutrient to aquatic habitats, but it also acts as a growth inhibitor in aquatic ecosystems; however, it also aggravates environmental issues, such as eutrophication. There is a growing interest in rapid phosphorus detection to manage and protect water resources. Due to the large molecular structure and high hydration energy of phosphate ions, ion-selective electrodes (ISEs) remain in their infancy for real-time measurements in terms of practical application. In this study, a newly developed ionophore based on a biomimetic nicotinamide functional group was used to detect phosphate selectively, displaying efficient binding through charge interactions and hydrogen bonds. The ISE membrane containing silicone rubber demonstrated an effective detection performance over a long period of time. With a dynamic range between 10-6 and 10-2 M and a limit of detection of 0.85 × 10-6 M (26 µg/L), the newly synthesized ISE membranes demonstrated selectivity for phosphate ions over other ions, including acetate, sulfate, and chloride.

Experimental study on polycaprolactone scaffold cell-based nasal implant using 3D printing.

BACKGROUND: This study was conducted to address the potential of combining porous biocompatible scaffolds with primary cells or autologous diced cartilage in cartilage tissue engineering in the animal model. The purpose of this study is an experimental evaluation of polycaprolactone (PCL) scaffold cell-based nasal implant using three-dimensional (3D) printing. METHODS: In this study, we applied hollow PCL cage scaffolds with 200 and 400 µm pore sizes. The scaffolds were divided into three groups (n = 4 for each group): (1) PCL cage scaffolds loaded with agarose gel and chondrocytes; (2) PCL cage scaffolds loaded with agarose gel and fibroblasts, and (3) PCL cages loaded with autologous diced cartilage. In each group, chondrocytes and fibroblasts were seeded into the agarose gel at the density of 5 × 106 cells/mL. RESULTS: All implants showed sufficient integration into the surrounding tissue. It was revealed that chondrocytes were proliferated and differentiated better in the "400 µm" scaffolds than in the "200 µm" group. However, a pore size of 200 µm was optimal for fibroblasts' proliferation. In addition, the results of our study showed that the use of PCL-based scaffolds can achieve the desirable stable augmentation effect with almost none of the changes of contour. CONCLUSION: In this study, both groups: (1) PCL cage scaffolds loaded with agarose gel and chondrocytes and (2) PCL cages loaded with autologous diced cartilage demonstrated chondrogenic potential with scaffolds with 400 µm pore size. The PCL cage scaffolds loaded with agarose gel and fibroblasts demonstrated potential in cartilage tissue formation within the pore size of 200 µm.

Re-do Operation Using a Robotic System due to Locoregional Recurrence after Initial Thyroidectomy for Thyroid Cancer.

Locoregional recurrent thyroid cancer is commonly treated with re-do operation. This study aimed to investigate the feasibility of using robotic system for re-do operation in locoregional recurrent thyroid cancer. Sixty-five patients who underwent re-do robotic operation using trans-axillary approach for locoregional recurrent thyroid cancer from October 2007 to April 2021 at Yonsei University Hospital were analyzed. Completion total thyroidectomy (CTT) was performed in 26 cases, CTT and modified radical neck node dissection (mRND) in 16, and mRND in 23. Most of the re-do robotic operations were performed at site of previous incision. All patients were diagnosed with papillary thyroid carcinoma (PTC). CTT with central compartment neck dissection (CCND) took 117.6 ± 26.3 min, CTT with mRND 255.6 ± 38.6 min, and mRND, 211.7 ± 52.9 min. Transient hypocalcemia occurred in 17 (26.2%) patients and permanent hypocalcemia occurred in 3 (4.6%). There was one case of recurrent laryngeal nerve(RLN) injury. One patient was diagnosed with structural recurrence after re-do robotic operation. Median follow-up duration was 50.7 ± 37.1 months. Re-do robotic operation can be an alternative for patients who are diagnosed with locoregional recurrent thyroid cancer after thyroidectomy, with no increase in morbidity, similar oncologic outcomes, and superior cosmetic satisfaction.

Retrospective study of the absorbable braided polydioxanone threads' usefulness in the aged lower eyelids' rejuvenation.

BACKGROUND: Tear trough deformity, hyperpigmentation, and skin laxity of the lower eyelid make individuals appear fatigued and elderly. Many patients prefer less invasive, cosmetic correction of the aged lower eyelid. Polydioxanone (PDO)-barbed threads introduced braided fine threads design, which works as a template for attraction of the regenerative factors and for cells' migration and proliferation. The purpose of this study was to estimate the outcomes of simultaneous additional application of braided type PDO threads (N-scaffold) for aged lower eyelids' rejuvenation in patients, who underwent the midface PDO thread lifting. MATERIALS AND METHODS: A total of 30 patients with mildly loose skin in the facial area, who underwent the thread lifting using PDO threads, were included in this study. Patients were divided into two groups, 15 patients per group. The first group underwent the midface thread lifting using PDO threads ("non-SCA" group). The second group underwent midface thread lifting in combination with braided PDO threads for tear trough deformity improvement ("N-scaffold" group). The results were evaluated subjectively, based on the patients' satisfaction rates, and objectively, by evaluating photographs. RESULTS: According to Barton's grading system, 7 months after the treatment, there was a statistically significant difference between the two groups: 1.733 ± 0.74 in the non-SCA group and 0.733 ± 0.83 in the N-scaffold group (p < 0.05). Based on patients' self-assessment, there was a significant difference at 7 months after the treatment: 2.86 ± 0.84 in "non-SCA" group and 3.76 ± 0.90 in "N-scaffold" group, p < 0.05. Complications such as persistent swelling, hematoma, skin irregularity, and infection were not observed during follow-up assessments. CONCLUSION: The application of braided type PDO threads (N-scaffold) as part of the midface thread lifting, for aged lower eyelids rejuvenation appears to be effective and safe within a period. This study suggests that PDO threads insertion may be a useful, additional, and non-invasive tool for the aged lower eyelids rejuvenation.

A Low-Power Analog Processor-in-Memory-Based Convolutional Neural Network for Biosensor Applications.

This paper presents an on-chip implementation of an analog processor-in-memory (PIM)-based convolutional neural network (CNN) in a biosensor. The operator was designed with low power to implement CNN as an on-chip device on the biosensor, which consists of plates of 32 × 32 material. In this paper, 10T SRAM-based analog PIM, which performs multiple and average (MAV) operations with multiplication and accumulation (MAC), is used as a filter to implement CNN at low power. PIM proceeds with MAV operations, with feature extraction as a filter, using an analog method. To prepare the input feature, an input matrix is formed by scanning a 32 × 32 biosensor based on a digital controller operating at 32 MHz frequency. Memory reuse techniques were applied to the analog SRAM filter, which is the core of low power implementation, and in order to accurately grasp the MAC operational efficiency and classification, we modeled and trained numerous input features based on biosignal data, confirming the classification. When the learned weight data was input, 19 mW of power was consumed during analog-based MAC operation. The implementation showed an energy efficiency of 5.38 TOPS/W and was differentiated through the implementation of 8 bits of high resolution in the 180 nm CMOS process.

Manifestation of Subclinical Extrapulmonary Tuberculosis after COVID-19 Vaccination as Supraclavicular Lymphadenopathy.

Lymphadenopathy after coronavirus disease 2019 (COVID-19) vaccination is a common side effect that usually resolves within several days to weeks, and only observation is recommended. However, for prolonged lymphadenopathy, other possibilities, including malignancy or other lymphoproliferative diseases, may be considered. Herein, we report the case of a 66-year-old woman who experienced prolonged ipsilateral supraclavicular lymph node enlargement after the second dose of the ChAdOx1 (Oxford-AstraZeneca) COVID-19 vaccine, which was eventually diagnosed as extrapulmonary tuberculosis.

Metformin ameliorates olanzapine-induced disturbances in POMC neuron number, axonal projection, and hypothalamic leptin resistance.

Antipsychotics have been widely accepted as a treatment of choice for psychiatric illnesses such as schizophrenia. While atypical antipsychotics such as aripiprazole are not associated with obesity and diabetes, olanzapine is still widely used based on the anticipation that it is more effective in treating severe schizophrenia than aripiprazole, despite its metabolic side effects. To address metabolic problems, metformin is widely prescribed. Hypothalamic proopiomelanocortin (POMC) neurons have been identified as the main regulator of metabolism and energy expenditure. Although the relation between POMC neurons and metabolic disorders is well established, little is known about the effects of olanzapine and metformin on hypothalamic POMC neurons. In the present study, we investigated the effect of olanzapine and metformin on the hypothalamic POMC neurons in female mice. Olanzapine administration for 5 days significantly decreased Pomc mRNA expression, POMC neuron numbers, POMC projections, and induced leptin resistance before the onset of obesity. It was also observed that coadministration of metformin with olanzapine not only increased POMC neuron numbers and projections but also improved the leptin response of POMC neurons in the olanzapine-treated female mice. These findings suggest that olanzapine-induced hypothalamic POMC neuron abnormality and leptin resistance, which can be ameliorated by metformin administration, are the possible causes of subsequent hyperphagia. [BMB Reports 2022; 55(6): 293-298].

Reusable and pH-Stable Luminescent Sensors for Highly Selective Detection of Phosphate.

Phosphate sensors have been actively studied owing to their importance in water environment monitoring because phosphate is one of the nutrients that result in algal blooms. As with other nutrients, seamless monitoring of phosphate is important for understanding and evaluating eutrophication. However, field-deployable phosphate sensors have not been well developed yet due to the chemical characteristics of phosphate. In this paper, we report on a luminescent coordination polymer particle (CPP) that can respond selectively and sensitively to a phosphate ion against other ions in an aquatic ecosystem. The CPPs with an average size of 88.1 ± 12.2 nm are embedded into membranes for reusable purpose. Due to the specific binding of phosphates to europium ions, the luminescence quenching behavior of CPPs embedded into membranes shows a linear relationship with phosphate concentrations (3-500 µM) and detection limit of 1.52 µM. Consistent luminescence signals were also observed during repeated measurements in the pH range of 3-10. Moreover, the practical application was confirmed by sensing phosphate in actual environmental samples such as tap water and lake water.

"Fasting: An Effective Preconditioning Method to Increase Fat Graft Survival".

BACKGROUND: Most preconditioning techniques before fat grafting require external manipulation. Since nutrition is the main factor maintaining the balance of lipogenesis and lipolysis, we hypothesized that fasting before undergoing autologous fat grafting may increase lipolysis and reduce adipocyte size, thereby improving the fat graft survival rate. METHODS: C57BL/6 mice were divided into 24 h starved or fed groups. Adipose tissue lipolysis, adipogenesis, and angiogenesis-related gene expression, in fat from both groups, were analyzed. The volume and weight of the grafted fat at 4-8 weeks postoperatively were measured using micro-computed tomography. Immunohistochemistry staining and mRNA expression analysis were also performed to evaluate the effect of fasting on fat graft survival. RESULTS: Fasting decreased adipocyte size by inducing adipose tissue lipolysis. Adipogenesis-related genes were remarkably downregulated while lipolysis-related genes and angiogenesis inducer genes were significantly upregulated in the starved adipose tissue. The mice grafted with the fat from the 24 h starved group had approximately 20% larger volumes and considerably heavier weights than those from the fed group. Increased viable adipocytes and vessels, and reduced macrophages in the fat grafts obtained from the 24 h starved group were also observed. CONCLUSIONS: Fasting for 24 h before harvesting fat increased the retention volume of fat graft by increasing angiogenesis via VEGF induction. Therefore, fasting would be a novel and reliable preconditioning strategy to improve graft survival in autologous fat grafting. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Dosimetric parameters associated with the long-term oncological outcomes of Gamma Knife surgery for sellar and parasellar tumors in pediatric patients.

OBJECTIVE: The authors aimed to investigate the dosimetric parameter and the minimally required dose associated with long-term control of sellar and parasellar tumors after Gamma Knife surgery (GKS) in children. METHODS: A retrospective analysis was performed on pediatric patients younger than 19 years of age who were diagnosed with sellar and parasellar tumors and received GKS at the authors' institution from 1998 to 2019. Cox proportional hazards regression analyses were used to investigate the dosimetric parameters associated with treatment outcome. The Kaplan-Meier method was used to analyze tumor control rates after GKS. RESULTS: Overall, 37 patients with 40 sellar and parasellar tumors, including 22 craniopharyngiomas and 12 pituitary adenomas, had a mean follow-up of 85.8 months. The gross target volume was 0.05 cm3 to 15.28 cm3, and the mean marginal dose was 15.8 Gy (range 9.6-30.0 Gy). Ten patients experienced treatment failure at a mean of 28.0 ± 26.7 months. The actuarial 5- and 10-year tumor control rates were 79.0% and 69.8%, respectively. D98% was an independent predictive factor of tumor control (HR 0.846 [95% CI 0.749-0.956], p = 0.007), with a cutoff value of 11.5 Gy for the entire cohort and 10 Gy for the craniopharyngioma group. Visual deterioration occurred in 2 patients with the maximum point dose of 10.1 Gy and 10.6 Gy to the optic apparatus. CONCLUSIONS: In pediatric patients, D98% was a reliable index of the minimum required dose for long-term control of sellar and parasellar tumors after GKS. The optimal D98% value for each tumor diagnosis needs to be elucidated in the future.

Comparison of antimicrobial resistance and molecular characterization of Escherichia coli isolates from layer breeder farms in Korea.

In Korea, 4 big layer companies that possess one grandparent and 3 parent stocks are in charge of 100% of the layer chicken industry. In this study, we investigated the antimicrobial resistance of commensal 578 E. coli isolated from 20 flocks of 4-layer breeder farms (A, B, C, and D), moreover, compared the characteristics of their resistance and virulence genes. Isolates from farms B and D showed significantly higher resistance to the ß-lactam antimicrobials (amoxicillin, ampicillin, and 1st-, 2nd-, and 3rd-generation cephalosporins). However, resistance to ciprofloxacin, nalidixic acid, and tetracycline was significantly higher in the isolates from farm A (P < 0.05). Interestingly, the isolates from farm C showed significantly lower resistance to most antimicrobials tested in this study. The isolates from farms B, C, and D showed the high multiple resistance to the 3 antimicrobial classes. Furthermore, the isolates from farm A showed the highest multiple resistance against the 5 classes. Among the 412 ß-lactam-resistant isolates, 123 (29.9%) carried blaTEM-1, but the distribution was significantly different among the farms from 17.5% to 51.4% (P < 0.05). Similarly, the most prevalent tetracycline resistance gene in the isolates from farms B, C, and D was tetA (50.0-77.0%); however, the isolates from farm A showed the highest prevalence in tetB (70.6%). The distribution of quinolone (qnrB, qnrD, and qnrS) and sulfonamide (su12)-resistant genes were also significantly different among the farms but that of chloramphenicol (catA1)- and aminoglycoside (aac [3]-II, and aac [6']-Ib)-resistant genes possessed no significant difference among the farms. Moreover, the isolates from farm C showed significantly higher prevalence in virulence genes (iroN, ompT, hlyF, and iss) than the other 3 farms (P < 0.05). Furthermore, the phenotypic and genotypic characteristics of E. coli isolates were significantly different among the farms, and improved management protocols are required to control of horizontal and vertical transmission of avian disease, including the dissemination of resistant bacteria in breeder flocks.

Volumetric Evaluation of Dead Space in Ischial Pressure Injuries Using Magnetic Resonance Imaging: A Case Series.

OBJECTIVE: To establish a preoperative evaluation procedure by measuring the volume of dead space using MRI in patients with ischial pressure injuries. METHODS: Patients with spinal cord injury and ischial pressure injuries who underwent treatment between August 2016 and November 2019 were included in the study. Preoperative MRI scan was conducted on all patients. The volume estimation and three-dimensional (3D) reconstruction were performed based on MRI data using a 3D Slicer. Based on the resulting volume, a muscle flap that could fit the dead space was selected. Surgery was performed with the selected muscle flap, and a fasciocutaneous flap was added, if necessary. RESULTS: A total of eight patients with ischial pressure injuries were included in the study. The mean patient age was 59.0 ± 11.0 years. The mean body mass index was 26.62 ± 3.89 kg/m2. The mean volume of dead space was 104.75 ± 81.05 cm3. The gracilis muscle was the most selected muscle flap and was used in four patients. In five of eight cases, a fasciocutaneous flap was used as well. The mean follow-up period was 16 months, and by that point, none of the patients evinced complications that required surgery. CONCLUSIONS: To the authors' knowledge, this is the first report on volumetric evaluation of dead space in ischial pressure injuries. The authors believe that the 3D reconstruction process would enable adequate dead space obliteration in ischial pressure injuries. The authors propose that preoperative MRI scans in patients with ischial pressure injury should become an essential part of the process.

Prediction of hearing outcomes in chronic otitis media patients underwent tympanoplasty using ossiculoplasty outcome parameter staging or middle ear risk indices.

PURPOSE: Ossiculoplasty outcome parameter staging (OOPS) and middle ear risk index (MERI) are the most commonly used indices for predicting prognosis of patients with chronic otitis media (COM). This study aimed to verify the efficiency of OOPS and MERI scores in predicting outcomes of patients with COM who underwent tympanoplasty. METHODS: We retrospectively reviewed the data of patients who underwent tympanoplasty (n = 526). OOPS, and MERI scores were collected. Hearing data were measured 1 day preoperatively, and 3 and 12 months postoperatively. Operation success was defined according to the Korean Society of Otology guidelines. RESULTS: For calculation of success, the ROC values of MERI were 0.551 at 12 months. ROC values of OOPS were 0.637 at 12 months. There were no significant differences in hearing variables among the three groups according to MERI. There were significantly favorable outcomes in hearing variables in the low-risk group in OOPS. The mean OOPS score was greater in patients with success than those with non-success. Otorrhea, ossicle status, and status of mucosa as variables in both indices were associated with success. The type of mastoidectomy as a variable in OOPS alone was associated with success. Absence of hypertension, presence of ossiculoplasty, and use of incus as ossiculoplasty material were associated with poor success rate. CONCLUSION: Compared with MERI, the OOPS index was more closely associated with the hearing outcomes, which may be due to the extent of inflammation in the OOPS index.