Light-Triggerable and Gate-Tunable Negative Differential Resistance in Small Molecules Heterojunction.

Negative differential resistance (NDR), a phenomenon in which the current decreases when the applied voltage is increased, is attracting attention as a unique electrical property. Here, we propose a broad spectral photo/gate cotunable channel switching NDR (CS-NDR) device. The proposed CS-NDR device has superior linear gate-tunable NDR behavior and highly reproducible properties compared to the previously reported NDR devices, as the fundamental mechanism of the CS-NDR device is directly related to a charge transport channel switching by the linear increase of the applied drain voltage. We also experimentally demonstrate that the photoinduced NDR behavior of the CS-NDR device was derived from the grain boundaries of dinaphtho[2;3-b:2',3'-f]-thieno[3,2-b]thiophene. Furthermore, this work produces a 9 × 9 CS-NDR device array composed of 81 devices, providing the reproducibility and uniformity of the CS-NDR device. Finally, we successfully demonstrate the detection of text images with 81 CS-NDR devices using the proposed photo/gate cotunable NDR behavior.

A cochleate formulation optimized by D-optimal mixture design enhances oral bioavailability of Revaprazan.

A cochleate formulation was developed to enhance the oral bioavailability of revaprazan (RVP). Dimyristoyl phosphatidylcholine (DMPC) liposome containing dicetyl phosphate (DCP) successfully formed a cochleate after treatment with CaCl2, whereas that containing sodium deoxycholate did not. Cochleate was optimised using a D-optimal mixture design with three independent variables-DMPC (X1, 70.58 mol%), cholesterol (X2, 22.54 mol%), and DCP (X3, 6.88 mol%)-and three response variables: encapsulation efficiency (Y1, 76.92%), released amount of free fatty acid at 2 h (Y2, 39.82%), and released amount of RVP at 6 h (Y3, 73.72%). The desirability function was 0.616, showing an excellent agreement between the predicted and experimental values. The cylindrical morphology of the optimised cochleate was visualised, and laurdan spectroscopy confirmed the dehydrated membrane interface, showing an increased generalised polarisation value (approximately 0.5) over small unilamellar vesicle of RVP (RVP-SUV; approximately 0.1). The optimised cochleate showed greater resistance to pancreatic enzyme than RVP-SUV. RVP was released in a controlled manner, achieving approximately 94% release in 12 h. Following oral administration in rats, the optimised cochleate improved the relative bioavailability of RVP by approximately 274%, 255%, and 172% compared to RVP suspension, a physical mixture of RVP and the cochleate, and RVP-SUV, respectively. Thus, the optimised cochleate formulation might be a good candidate for the practical development of RVP.

Comparative Analysis of Integrated Filtering Methods Using UWB Localization in Indoor Environment.

This research delves into advancing an ultra-wideband (UWB) localization system through the integration of filtering technologies (moving average (MVG), Kalman filter (KF), extended Kalman filter (EKF)) with a low-pass filter (LPF). We investigated new approaches to enhance the precision and reduce noise of the current filtering methods-MVG, KF, and EKF. Using a TurtleBot robotic platform with a camera, our research thoroughly examines the UWB system in various trajectory situations (square, circular, and free paths with 2 m, 2.2 m, and 5 m distances). Particularly in the square path trajectory with the lowest root mean square error (RMSE) values (40.22 mm on the X axis, and 78.71 mm on the Y axis), the extended Kalman filter with low-pass filter (EKF + LPF) shows notable accuracy. This filter stands out among the others. Furthermore, we find that integrated method using LPF outperforms MVG, KF, and EKF consistently, reducing the mean absolute error (MAE) to 3.39% for square paths, 4.21% for circular paths, and 6.16% for free paths. This study highlights the effectiveness of EKF + LPF for accurate indoor localization for UWB systems.

Impact of Preoperative Immunonutrition on the Outcomes of Colon Cancer Surgery: Results from a Randomized Controlled Trial.

OBJECTIVE: This study aimed to assess the impact of preoperative immunonutrition on the outcomes of colon cancer surgery. BACKGROUND: Although current guidelines recommend that immunonutrition should be prescribed for malnourished patients before major gastrointestinal surgery, the benefit of preoperative immunonutrition remains debatable. METHODS: Between April 2019 and October 2020, 176 patients with primary colon cancer were enrolled and randomly assigned (1:1) to receive preoperative immunonutrition plus a normal diet (n = 88) or a normal diet alone (n = 88). Patients in the immunonutrition group received oral nutritional supplementation (400 mL/d) with arginine and ω-3 fatty acids for 7 days before elective surgery. The primary endpoint was the rate of infectious complications, and the secondary endpoints were the postoperative complication rate, change in body weight, and length of hospital stay. RESULTS: The rates of infectious (17.7% vs 15.9%, P = 0.751) and total (31.6% vs 29.3%, P = 0.743) complications were not different between the two groups. Old age was the only significant predictive factor for the occurrence of infectious complications (odds ratio = 2.990, 95% confidence interval 1.179-7.586, P = 0.021). The length of hospital stay (7.6 ± 2.5 vs 7.4 ± 2.3 days, P = 0.635) and overall change in body weight ( P = 0.379) were similar between the two groups. However, only the immunonutrition group showed weight recovery after discharge (+0.4 ± 2.1 vs -0.7 ± 2.3 kg, P = 0.002). CONCLUSIONS: Preoperative immunonutrition was not associated with infectious complications in patients undergoing colon cancer surgery. Routine administration of immunonutrition before colon cancer surgery cannot be justified.

Preoperative sequential short-course radiation therapy and FOLFOX chemotherapy versus long-course chemoradiotherapy for locally advanced rectal cancer: a multicenter, randomized controlled trial (SOLAR trial).

BACKGROUND: Preoperative (chemo)radiotherapy has been widely used as an effective treatment for locally advanced rectal cancer (LARC), leading to a significant reduction in pelvic recurrence rates. Because early administration of intensive chemotherapy for LARC has more advantages than adjuvant chemotherapy, total neoadjuvant therapy (TNT) has been introduced and evaluated to determine whether it can improve tumor response or treatment outcomes. This study aims to investigate whether short-course radiotherapy (SCRT) followed by intensive chemotherapy improves oncologic outcomes compared with traditional preoperative long-course chemoradiotherapy (CRT). METHODS: A multicenter randomized phase II trial involving 364 patients with LARC (cT3-4, cN+, or presence of extramural vascular invasion) will be conducted. Patients will be randomly assigned to the experimental or control arm at a ratio of 1:1. Participants in the experimental arm will receive SCRT (25 Gy in 5 fractions, daily) followed by four cycles of FOLFOX (oxaliplatin, 5-fluorouracil, and folinic acid) as a neoadjuvant treatment, and those in the control arm will receive conventional radiotherapy (45-50.4 Gy in 25-28 fractions, 5 times a week) concurrently with capecitabine or 5-fluorouracil. As a mandatory surgical procedure, total mesorectal excision will be performed 2-5 weeks from the last cycle of chemotherapy in the experimental arm and 6-8 weeks after the last day of radiotherapy in the control arm. The primary endpoint is 3-year disease-free survival, and the secondary endpoints are tumor response, overall survival, toxicities, quality of life, and cost-effectiveness. DISCUSSION: This is the first Korean randomized controlled study comparing SCRT-based TNT with traditional preoperative LC-CRT for LARC. The involvement of experienced colorectal surgeons ensures high-quality surgical resection. SCRT followed by FOLFOX chemotherapy is expected to improve disease-free survival compared with CRT, with potential advantages in tumor response, quality of life, and cost-effectiveness. TRIAL REGISTRATION: This trial is registered at Clinical Research Information under the identifier Service KCT0004874 on April 02, 2020, and at Clinicaltrial.gov under the identifier NCT05673772 on January 06, 2023.

Oncological impact of intraperitoneal chemotherapy after cytoreductive surgery for patients with colorectal peritoneal metastasis: A bi-institutional retrospective analysis.

BACKGROUND AND OBJECTIVES: There is a paucity of evidence on the value of intraperitoneal chemotherapy (IPC) following cytoreductive surgery (CRS) for colorectal peritoneal metastasis. This study aimed to evaluate the association between mitomycin C-IPC and survival outcomes following CRS. METHODS: The institutional databases of two tertiary hospitals were reviewed to identify patients who underwent CRS for colorectal peritoneal metastasis. The outcomes of patients who underwent CRS without IPC were compared with those of patients who underwent CRS plus early postoperative intraperitoneal chemotherapy (EPIC) or CRS plus hyperthermic intraperitoneal chemotherapy (HIPEC). The primary endpoints were cancer-specific survival (CSS), progression-free survival (PFS), and peritoneal PFS (P-PFS). RESULTS: In 149 patients with peritoneal metastasis alone, EPIC and HIPEC use was significantly associated with better CSS, PFS, and P-PFS in the multivariate analysis. CSS was also significantly associated with perioperative systemic chemotherapy. Among 42 patients with both peritoneal and extraperitoneal metastases, CSS was independently related to the completeness of cytoreduction score, location of extraperitoneal metastasis, and grade 3-4 complications. CONCLUSIONS: Mitomycin C-IPC after CRS was associated with better survival outcomes than CRS alone in patients with resectable peritoneal metastasis of colorectal cancer. This study found that IPC had beneficial effects regarding P-PFS in patients with both peritoneal and extraperitoneal metastases.

Immediate-release tablet formulation of rebamipide and a pharmacokinetic study in healthy human subjects.

OBJECTIVE: To develop an immediate-release tablet preparation containing rebamipide (RBM) and perform the bioavailability assessment in the healthy human subjects. MATERIALS AND METHODS: Raw RBM powder was characterized using differential scanning calorimetry, powder X-ray diffraction, and scanning electron microscopy (SEM). RBM tablets were manufactured by the wet granulation method, and their dissolution behavior was compared with the reference tablet (Mucosta). A phase I study (n = 47; sequence-randomized, open-label, single-dose, and two-way cross-over design) was designed for oral administration of a test formulation (F4) and Mucosta to healthy human male subjects, and pharmacokinetic parameters including the maximum plasma concentration (Cmax) and area under the curve from 0 to 12 hours (AUC0-12h) were compared. RESULTS: RBM powder had a multimodal size distribution with typical crystallinity, and the needle-like and elongated morphologies of RBM were visualized using SEM. Various tablet formulations (F1 - F6) were successfully manufactured using wet granulation method. F4 formulation was selected based on the dissolution profile most equivalent to that of Mucosta. F4 was stable for 6 months under accelerated and long-term storage conditions. Based on one-way analysis of variance, the AUC0-12h (F(1,92) = 2.40, p = 0.13) and tmax (F(1,92) = 0.04, p = 0.85) were not significantly different; however, the Cmax (F(1,92) = 5.45, p = 0.022) showed significant difference between F4 and reference tablets. CONCLUSION: Despite similar in vitro dissolution profiles, in vivo pharmacokinetic results revealed a partial difference between F4 and reference tablets. Thus, further study on formulation development is still needed.

NSrp70 is a lymphocyte-essential splicing factor that controls thymocyte development.

Alternative pre-mRNA splicing is a critical step to generate multiple transcripts, thereby dramatically enlarging the proteomic diversity. Thus, a common feature of most alternative splicing factor knockout models is lethality. However, little is known about lineage-specific alternative splicing regulators in a physiological setting. Here, we report that NSrp70 is selectively expressed in developing thymocytes, highest at the double-positive (DP) stage. Global splicing and transcriptional profiling revealed that NSrp70 regulates the cell cycle and survival of thymocytes by controlling the alternative processing of various RNA splicing factors, including the oncogenic splicing factor SRSF1. A conditional-knockout of Nsrp1 (NSrp70-cKO) using CD4Cre developed severe defects in T cell maturation to single-positive thymocytes, due to insufficient T cell receptor (TCR) signaling and uncontrolled cell growth and death. Mice displayed severe peripheral lymphopenia and could not optimally control tumor growth. This study establishes a model to address the function of lymphoid-lineage-specific alternative splicing factor NSrp70 in a thymic T cell developmental pathway.

Solution-processed zirconium acetylacetonate charge-trap layer for multi-bit nonvolatile thin-film memory transistors.

The charge trap property of solution-processed zirconium acetylacetonate (ZAA) for solution-processed nonvolatile charge-trap memory (CTM) transistors is demonstrated. Increasing the annealing temperature of the ZAA from room temperature (RT) to 300°C in ambient, the carbon double bonds within the ZAA decreases. The RT-dried ZAA for the p-type organic-based CTM shows the widest threshold voltage shift (∆VTH ≈ 80 V), four distinct VTHs for a multi-bit memory operation and retained memory currents for 103 s with high memory on- and off-current ratio (IM,ON/IM,OFF ≈ 5Ⅹ104). The n-type oxide-based CTM (Ox-CTM) also shows a ∆VTH of 14 V and retained memory currents for 103 s with IM,ON/IM,OFF ≈ 104. The inability of the Ox-CTM to be electrically erasable is well explained with simulated electrical potential contour maps. It is deduced that, irrespective of the varied solution-processed semiconductor used, the RT-dried organic ZAA as CTL shows the best memory functionality in the fabricated CTMs. This implies that the high carbon double bonds in the low-temperature processed ZAA CTL are very useful for low-cost multi-bit CTMs in flexible electronics.

Trampoline Stiffness Estimation by Using Robotic System for Quantitative Evaluation of Jumping Exercises.

Trampolines are recognized as a valuable tool in exercise and rehabilitation due to their unique properties like elasticity, rebound force, low-impact exercise, and enhancement of posture, balance, and cardiopulmonary function. To quantitatively assess the effects of trampoline exercises, it is essential to estimate factors such as stiffness, elements influencing jump dynamics, and user safety. Previous studies assessing trampoline characteristics had limitations in performing repetitive experiments at various locations on the trampoline. Therefore, this research introduces a robotic system equipped with foot-shaped jigs to evaluate trampoline stiffness and quantitatively measure exercise effects. This system, through automated, repetitive movements at various locations on the trampoline, accurately measures the elastic coefficient and vertical forces. The robot maneuvers based on the coordinates of the trampoline, as determined by its torque and position sensors. The force sensor measures data related to the force exerted, along with the vertical force data at X, Y, and Z coordinates. The model's accuracy was evaluated using linear regression based on Hooke's Law, with Mean Absolute Error (MAE), Root Mean Square Error (RMSE), and Correlation Coefficient Squared (R-squared) metrics. In the analysis including only the distance between X and the foot-shaped jigs, the average MAE, RMSE, and R-squared values were 17.9702, 21.7226, and 0.9840, respectively. Notably, expanding the model to include distances in X, Y, and between the foot-shaped jigs resulted in a decrease in MAE to 15.7347, RMSE to 18.8226, and an increase in R-squared to 0.9854. The integrated model, including distances in X, Y, and between the foot-shaped jigs, showed improved predictive capability with lower MAE and RMSE and higher R-squared, indicating its effectiveness in more accurately predicting trampoline dynamics, vital in fitness and rehabilitation fields.

Fault Diagnosis Method for Human Coexistence Robots Based on Convolutional Neural Networks Using Time-Series Data Generation and Image Encoding.

This paper proposes fault diagnosis methods aimed at proactively preventing potential safety issues in robot systems, particularly human coexistence robots (HCRs) used in industrial environments. The data were collected from durability tests of the driving module for HCRs, gathering time-series vibration data until the module failed. In this study, to apply classification methods in the absence of post-failure data, the initial 50% of the collected data were designated as the normal section, and the data from the 10 h immediately preceding the failure were selected as the fault section. To generate additional data for the limited fault dataset, the Wasserstein generative adversarial networks with gradient penalty (WGAN-GP) model was utilized and residual connections were added to the generator to maintain the basic structure while preventing the loss of key features of the data. Considering that the performance of image encoding techniques varies depending on the dataset type, this study applied and compared five image encoding methods and four CNN models to facilitate the selection of the most suitable algorithm. The time-series data were converted into image data using image encoding techniques including recurrence plot, Gramian angular field, Markov transition field, spectrogram, and scalogram. These images were then applied to CNN models, including VGGNet, GoogleNet, ResNet, and DenseNet, to calculate the accuracy of fault diagnosis and compare the performance of each model. The experimental results demonstrated significant improvements in diagnostic accuracy when employing the WGAN-GP model to generate fault data, and among the image encoding techniques and convolutional neural network models, spectrogram and DenseNet exhibited superior performance, respectively.

Optimization of a solidified micelle formulation for enhanced oral bioavailability of atorvastatin calcium using statistical experimental design.

To enhance the oral bioavailability of atorvastatin calcium (ATV), a novel solidified micelle (S-micelle) was developed. Two surfactants, Gelucire 48/16 (G48) and Tween 20 (T20), were employed for micelle formation, and two solid carriers (SC), Florite PS-10 (FLO) and Vivapur 105 (VP105), were selected as solid carriers. The S-micelle was optimized using a Box-Behnken design with three independent variables, including G48:T20 (X1, 1.8:1), SC:G48 + T20 (X2, 0.65:1), and FLO:VP105 (X3, 1.4:0.6), resulting in a droplet size (Y1) of 198.4 nm, dissolution efficiency at 15 min in the pH 1.2 medium (Y2) of 47.6%, Carr's index (Y3) of 16.9, and total quantity (Y4) of 562.5 mg. The optimized S-micelle resulted in good correlation showing percentage prediction values less than 10%. The optimized S-micelle formed a nanosized dispersion in the aqueous phase, with a higher dissolution rate than raw ATV and crushed Lipitor®. The optimized S-micelle improved the relative bioavailability of oral ATV (25 mg equivalent/kg) in rats by approximately 509 and 271% compared to raw ATV and crushed Lipitor®, respectively. In conclusion, the optimized S-micelle possesses great potential for the development of solidified formulations for improved oral absorption of poorly water-soluble drugs.

Minimally Invasive Open Reduction and Maintenance Technique for Anterior Sacrococcygeal Dislocation: A Case Report.

Anterior dislocation of the coccyx is rare, but it can occur due to trauma. Conservative treatment is usually performed. However, dislocation reduction may be required to control severe pain in the acute phase or to prevent chronic complications. If manual reduction fails, open reduction is required. The extent of the incision and the method used to maintain the reduction should be considered during open reduction. A 56-year-old male patient experienced a dislocation of the sacrococcygeal joint after falling backwards. Despite conservative treatment, the patient complained of persistent pain during sitting and when using the bathroom. A manual reduction was attempted but failed. We performed joystick reduction via minimal incision and maintained the reduction using a one-strand trans-osseous suture passing through the skin. The patient was advised to use a soft cushion when sitting or lying down for four weeks after surgery. The supine position was not restricted. The patient's symptoms significantly improved after surgery. At the 6-month follow-up, the sacrococcygeal joint showed good alignment and no surgical complications occurred. During the treatment of sacrococcygeal dislocation, the rapid alleviation of acute pain and minimizing potential complications are key points. If open reduction is needed, the minimally invasive reduction technique with a one-strand trans-osseous suture may offer patient satisfaction and a good surgical outcome.

Periumbilical Transverse Incision for Reducing Incisional Hernia in Laparoscopic Colon Cancer Surgery.

BACKGROUND: Although off-midline incisions (unilateral low transverse or Pfannenstiel incision) have been reported to have a lower incidence of incisional hernia (IH) than periumbilical vertical incision for the purpose of specimen extraction, it is most commonly used in laparoscopic colon cancer surgery because off-midline incisions are associated with the limitation of colon exteriorization. This study aims to investigate the risk of IH after laparoscopic colectomy and compare midline vertical incision versus transverse incision focusing on the incidence of IH. METHODS: Patients who underwent elective laparoscopic colectomy due to colon malignancy from June 2015 to May 2017 were included. All patients had either vertical (n = 429) or muscle splitting periumbilical transverse incisions (n = 125). RESULTS: Median duration of the follow-up period was 23.6 months, during which IHs occurred in 12.1% patients. The incidence of hernia was significantly lower in the transverse group (3 vs. 64, 2.4% vs. 14.9%, p < 0.001). On multivariate analysis, BMI ≥ 23 [odds ratio (OR) 2.282, 95% confidence interval (CI) 1.245-4.182, p = 0.008], postoperative surgical site infection (OR 3.780, 95% CI 1.969-7.254, p < 0.001) and vertical incision (OR 7.113, 95% CI 2.173-23.287, p < 0.001) were independently related with increased incidence of IH. CONCLUSIONS: A muscle splitting periumbilical transverse incision could significantly reduce the rate of IH in minimally invasive colon cancer surgery.

Effect of the First Assistant on Anastomotic Leakage after Rectal Cancer Surgery with Double-Stapling Anastomosis: A Propensity Score Matching Analysis.

INTRODUCTION: Proper handling and firing of the circular stapler are important for secure anastomosis in rectal cancer surgery. This study aimed to investigate the association between the first assistant and anastomotic leakage (AL) after rectal cancer surgery with double-stapling anastomosis. METHODS: Patients with primary rectal cancer who underwent low anterior resection with double-stapling anastomosis between January 2015 and September 2019 were included. Data on clinicopathological characteristics, including the first assistant's sex and experience level, were retrospectively reviewed, and the risk factors for AL were analyzed using propensity score matching analysis. RESULTS: Among 758 rectal cancer surgeries, residents participated in 401 (52.9%) surgeries, and fellows participated in 357 (47.1%) surgeries as first assistants. After propensity score matching (n = 650), AL occurred in 5.4% (35/650). The first assistant's experience level (resident: 5.5% vs. fellow: 5.2%, p = 0.862) and sex (male: 5.4% vs. female: 4.9%, p = 0.849) were not associated with the occurrence of AL. Male sex in patients was the only significant predictive factor for AL (odds ratio = 2.804, 95% confidence interval 1.070-7.351, p = 0.036). DISCUSSION/CONCLUSION: The first assistant's sex and experience level were not associated with AL after rectal cancer surgery with double-stapling anastomosis. These findings may justify resident participation in rectal cancer surgeries in which circular staplers are used.

Three-Dimensional Foot Position Estimation Based on Footprint Shadow Image Processing and Deep Learning for Smart Trampoline Fitness System.

In the wake of COVID-19, the digital fitness market combining health equipment and ICT technologies is experiencing unexpected high growth. A smart trampoline fitness system is a new representative home exercise equipment for muscle strengthening and rehabilitation exercises. Recognizing the motions of the user and evaluating user activity is critical for implementing its self-guided exercising system. This study aimed to estimate the three-dimensional positions of the user's foot using deep learning-based image processing algorithms for footprint shadow images acquired from the system. The proposed system comprises a jumping fitness trampoline; an upward-looking camera with a wide-angle and fish-eye lens; and an embedded board to process deep learning algorithms. Compared with our previous approach, which suffered from a geometric calibration process, a camera calibration method for highly distorted images, and algorithmic sensitivity to environmental changes such as illumination conditions, the proposed deep learning algorithm utilizes end-to-end learning without calibration. The network is configured with a modified Fast-RCNN based on ResNet-50, where the region proposal network is modified to process location regression different from box regression. To verify the effectiveness and accuracy of the proposed algorithm, a series of experiments are performed using a prototype system with a robotic manipulator to handle a foot mockup. The three root mean square errors corresponding to X, Y, and Z directions were revealed to be 8.32, 15.14, and 4.05 mm, respectively. Thus, the system can be utilized for motion recognition and performance evaluation of jumping exercises.

Enhanced dissolution and bioavailability of revaprazan using self-nanoemulsifying drug delivery system.

A self-nanoemulsifying drug delivery system (SNEDDS) was developed to enhance the dissolution and oral bioavailability (BA) of revaprazan (RVP). Various SNEDDSs containing 200 mg of RVP were formulated using Capmul MCM, Tween 80, and Brij L4, and they were characterized according to their size, polydispersity index, and dissolution behavior. Dissolution rates of all SNEDDS formulations significantly (p < 0.05) improved with the formation of nanoemulsion with monodispersity. Formulation D resulted in RVP dissolution exceeding 70% at 2 h. Compared to raw RVP, SNEDDS exhibited a 4.8- to 7.4-fold improved effective permeability coefficient (Peff) throughout the intestine in the in situ single pass intestinal permeability study and a 5.1-fold increased oral BA in the in vivo oral absorption assessment in rats. To evaluate the degree of lymphatic uptake, cycloheximide (CYC), a chylomicron flowing blocker, was pretreated prior to the experiment. This pretreatment barely affected the absorption of raw RVP; however, it greatly influenced the absorption of SNEDDS, resulting in an approximately 40% reduction in both the Peff value and oral BA representing lymphatic transport. Thus, we suggest that the SNEDDS formulation is a good candidate for improving oral absorption of RVP through enhanced lymphatic uptake.

Subtrochanteric Insufficiency Fracture Occurring 5 Years after Surgery at the Steinmann Pin Insertion Site for Fracture Reduction.

Background and Objectives: Steinmann pins are commonly used in orthopedics, with a low rate of complications. However, thermal osteonecrosis may occur when a pin is inserted using a drill. There have been no reports on late-onset fractures at the Steinmann pin insertion site. Materials and Methods: A 32-year-old man who underwent surgery for a femoral shaft fracture 5 years ago complained of proximal thigh pain 1 month after the removal of the internal device. On physical examination, the patient showed a limping gait due to pain, and tenderness was observed on the lateral aspect of the proximal thigh. Magnetic resonance imaging was performed because the symptoms did not improve, despite conservative treatment. A new fracture line was observed in the lateral cortical bone of the proximal femur. It was found that a fracture occurred at the site where the Steinmann pin was inserted for a closed reduction at the time of the first operation. The patient was instructed to limit weight bearing and to use crutches while walking. Parathyroid hormone was additionally administered to promote bone formation. Results: Six months after diagnosis, a complete union was achieved at the subtrochanteric fracture site, and the patient's pain subsided. Conclusions: A fracture that occurs as a late onset at the provisional Steinmann pin insertion site is an extremely rare complication; however, orthopedic surgeons must consider this possibility and make more efforts to lower the occurrence of thermal damage. In addition, if the patient complains of pain in the region where the pin was inserted after surgery, surgeons should spare no effort to determine whether a new fracture has occurred.

Proper surgical extent for clinical Stage I right colon cancer.

PURPOSE: Pre-operative evaluation identifying clinical-stage affects the decision regarding the extent of surgical resection in right colon cancer. This study was designed to predict a proper surgical resection through the prognosis of clinical Stage I right colon cancer. PATIENTS AND METHODS: We included patients who were diagnosed with clinical and pathological Stage I right-sided colon cancer, including appendiceal, caecal, ascending, hepatic flexure and proximal transverse colon cancer, between August 2010 and December 2016 in two tertiary teaching hospitals. Patients who underwent open surgeries were excluded because laparoscopic surgery is the initial approach for colorectal cancer in our institutions. RESULTS: Eighty patients with clinical Stage I and 104 patients with pathological Stage I were included in the study. The biopsy reports showed that the tumour size was larger in the clinical Stage I group than in the pathological Stage I group (3.4 vs. 2.3 cm, P < 0.001). Further, the clinical Stage I group had some pathological Stage III cases (positive lymph nodes, P = 0.023). The clinical Stage I group had a higher rate of distant metastases (P = 0.046) and a lower rate of overall (P = 0.031) and cancer-specific survival (P = 0.021) than the pathological Stage I group. Compared to pathological Stage II included in the period, some of the survival curves were located below the pathological Stage II, but there was no statistical difference. CONCLUSION: The study results show that even clinical Stage I cases, radical resection should be considered in accordance with T3 and T4 tumours.

Systematic Control of Negative Transconductance in Organic Heterojunction Transistor for High-Performance, Low-Power Flexible Ternary Logic Circuits.

Organic multi-valued logic (MVL) circuits can substantially improve the data processing efficiency in highly advanced wearable electronics. Organic ternary logic circuits can be implemented by utilizing the negative transconductance (NTC) of heterojunction transistors (H-TRs). To achieve high-performance organic ternary logic circuits, the range of NTC in H-TRs must be optimized in advance to ensure the well-defined intermediate logic state in ternary logic inverters (T-inverters). Herein, a simple and efficient strategy, which enables the systematic control of the range and position of NTC in H-TRs is presented. Each thickness of p-/n-type semiconductor in H-TRs is adjusted to control the channel conductivity. Furthermore, asymmetric source/drain (S/D) electrode structure is newly developed for H-TRs, which can adjust the amount of hole and electron injection, independently. Based on the semiconductor thickness variation and asymmetric S/D electrodes, the T-inverter exhibits full-swing operation with three distinguishable logic states, resulting in unprecedentedly high static noise margin (≈48% of the ideal value). Moreover, a flexible T-inverter with an ultrathin polymer dielectric is demonstrated, whose operating voltage is less than 8 V. The proposed strategy is fully compatible with the conventional integrated circuit design, which is highly desirable for broad applicability and scalability for various types of T-inverter production.