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We investigated the influence of the multilayered hybrid buffer consisting of Al2O3/PA (polyacrylic) organic layer/Al2O3 on the electrical and mechanical properties of amorphous InGaZnO (a-IGZO) thin-film transistors (TFTs). The multilayered organic/inorganic hybrid buffer has multiple beneficial effects on the flexible TFTs under repetitive bending stress. First, compared to the PA or Al2O3 single-layered buffer, the multilayered hybrid buffer showed an improved WVTR value of 1.1 × 10-4 g/m2 day. Even after 40,000 bending cycles, the WVTR value of the hybrid buffer increased only by 17%, while the WVTR value of the Al2O3 layer doubled after cyclical bending stress. We also confirmed that the hybrid buffer has advantages in mechanical durability of the TFT layers because of the change in the position of the neutral plane and the strain reduction effect by the PA organic layer. When we fabricate a top-gate a-IGZO TFT with the hybrid buffer layer (HB TFT), the device shows Vth = 0.74 V, µFE = 14.4 cm2/V·s, a subthreshold slope of 0.27 V/dec, and hysteresis of 0.21 V, which are superior to that of TFTs fabricated on an Al2O3 single-layer buffer (IB TFT). From the X-ray photoelectron spectroscopy and elastic recoil detection analysis, the difference in the electrical performance of TFTs could be explained by hydrogen-related molecules. After annealing at 270 °C, the amounts of hydrogen found in the a-IGZO layer for the IB, HB, and OB TFTs were 3.57 × 1021, 5.77 × 1021, and 7.34 × 1021 atoms/cm3, respectively. A top-gate bottom-contact structured a-IGZO TFT fabricated on the PA layer (OB TFT) showed a gate dielectric breakdown because of excessively high hydrogen content and high nonbonding oxygen content. On the other hand, HB TFTs showed better positive bias stability because of the higher hydrogen concentration, as hydrogen (when not excessive) is beneficial in passivating electron traps. Finally, we conducted 60,000 repetitive bending cycles on IB TFTs and HB TFTs with various bending radii down to 1.5 mm. The HB TFT shows improved mechanical durability and exhibits less electrical degradation during and after repetitive bending stress, compared to the IB TFT.
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Purpose@#Endoscopic tattooing is used to mark colorectal lesions for subsequent surgery. As a tattooing agent, India ink has been widely used but is not currently available in Korea. Indocyanine green (ICG) can be applied as an alternative agent. However, studies on colonoscopic tattooing by the direct injection of indocyanine green are lacking. This study aimed to compare the efficacy and safety between an ICG direct injection method and an India ink saline test injection method. @*Methods@#A total of 227 patients who underwent preoperative endoscopic tattooing for colorectal neoplasm (149 patients in the ICG direct injection group and 78 patients in the India ink saline test injection group) were included in the study. The efficacy of the two methods was compared by visualization and safety was compared by evaluating the perioperative tattooing complications. @*Results@#The visualization of lesions in the ICG group was not different from that of the India ink group (p=0.42, 96.0% vs 98.7%, respectively). Only one patient in the ICG group had abdominal pain related to tattooing, but no complications developed in the India ink group. @*Conclusion@#Considering the good visualization and low complication rate, the direct injection of ICG can be used as an alternative tattooing method.
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Purpose@#Endoscopic tattooing is used to mark colorectal lesions for subsequent surgery. As a tattooing agent, India ink has been widely used but is not currently available in Korea. Indocyanine green (ICG) can be applied as an alternative agent. However, studies on colonoscopic tattooing by the direct injection of indocyanine green are lacking. This study aimed to compare the efficacy and safety between an ICG direct injection method and an India ink saline test injection method. @*Methods@#A total of 227 patients who underwent preoperative endoscopic tattooing for colorectal neoplasm (149 patients in the ICG direct injection group and 78 patients in the India ink saline test injection group) were included in the study. The efficacy of the two methods was compared by visualization and safety was compared by evaluating the perioperative tattooing complications. @*Results@#The visualization of lesions in the ICG group was not different from that of the India ink group (p=0.42, 96.0% vs 98.7%, respectively). Only one patient in the ICG group had abdominal pain related to tattooing, but no complications developed in the India ink group. @*Conclusion@#Considering the good visualization and low complication rate, the direct injection of ICG can be used as an alternative tattooing method.
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Gastrointestinal graft-versus-host disease (GVHD) is a common complication after hematopoietic stem cell transplantation. Concomitant cytomegalovirus (CMV) enteritis worsens the prognosis of this condition. We report a case of small bowel perforation associated with gastrointestinal GVHD and CMV enteritis in a patient with leukemia who was successfully treated surgically. A 39-year-old man presented with intestinal perforation necessitating emergency surgical intervention. He was diagnosed with T-cell acute lymphoblastic leukemia and developed severe gastrointestinal GVHD and CMV enteritis after hematopoietic stem cell transplantation. His terminal ileum showed a perforation with diffuse wall thinning, and petechiae were observed over long segments of the distal ileum and the proximal colon. Small bowel segmental resection and a subtotal colectomy with a double-barreled ileocolostomy were performed. The patient recovered uneventfully after the operation. Based on reports described in the literature, surgery plays a minor role in the management of gastrointestinal GVHD; however, timely surgical intervention could be effective in selected patients.
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Purpose@#Retroperitoneal sarcomas (RPS) are rare malignant tumors arising from mesenchymal cells. The objective of this study was to review the treatment experiences and to identify prognostic factors for overall survival (OS) after primary resection and subsequent reoperations for recurrences. @*Methods@#The medical records of patients who underwent resection for RPS at our institution between June 2002 and December 2016 were retrospectively reviewed. Univariate and multivariable Cox proportional hazards modeling was used to assess the prognostic factors for OS. @*Results@#A total of 48 patients were enrolled. On multivariable analysis in primary resection group, the FNCLCC (Fédération Nationale des Centres de Lutte Contre le Cancer) grade was a significant prognostic factor for OS (P=0.006). The patients who received chemotherapy after primary resection were significantly associated with poor prognosis (P=0.009). The 5-year OS rate after primary resection (n=48) were 58.1% and the 5-year cumulative reoperation rate after primary resection was 62.5%. After second resection for recurrence after primary resection (n=23), the 5-year OS rate was 64.3%. There was a tendency towards decreased surgery-free survival rate as the number of repeated resections for recurrent RPS increased. In the subset of patients (n=16) who underwent more than 3 repeated resections at our institute, the 5-year OS rate was 75.0%, indicating that repeated resections are not associated with worse outcome. @*Conclusion@#Only low tumor grade was an independent favorable prognostic factor for OS. Although the prognosis for RPS remains poor, repeated resections for recurrence are not associated with poor prognosis. Aggressive surgical strategies for recurred RPS patients are warranted.
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Purpose@#Retroperitoneal sarcomas (RPS) are rare malignant tumors arising from mesenchymal cells. The objective of this study was to review the treatment experiences and to identify prognostic factors for overall survival (OS) after primary resection and subsequent reoperations for recurrences. @*Methods@#The medical records of patients who underwent resection for RPS at our institution between June 2002 and December 2016 were retrospectively reviewed. Univariate and multivariable Cox proportional hazards modeling was used to assess the prognostic factors for OS. @*Results@#A total of 48 patients were enrolled. On multivariable analysis in primary resection group, the FNCLCC (Fédération Nationale des Centres de Lutte Contre le Cancer) grade was a significant prognostic factor for OS (P=0.006). The patients who received chemotherapy after primary resection were significantly associated with poor prognosis (P=0.009). The 5-year OS rate after primary resection (n=48) were 58.1% and the 5-year cumulative reoperation rate after primary resection was 62.5%. After second resection for recurrence after primary resection (n=23), the 5-year OS rate was 64.3%. There was a tendency towards decreased surgery-free survival rate as the number of repeated resections for recurrent RPS increased. In the subset of patients (n=16) who underwent more than 3 repeated resections at our institute, the 5-year OS rate was 75.0%, indicating that repeated resections are not associated with worse outcome. @*Conclusion@#Only low tumor grade was an independent favorable prognostic factor for OS. Although the prognosis for RPS remains poor, repeated resections for recurrence are not associated with poor prognosis. Aggressive surgical strategies for recurred RPS patients are warranted.
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In this study, we investigated the effects of intense pulsed light (IPL) on the electrical performance properties of zinc oxynitride (ZnON) thin films and thin-film transistors (TFTs) with different irradiation energies. Using the IPL process on the oxide/oxynitride semiconductors has various advantages, such as an ultrashort process time (â¼100 ms) and high electrical performance without any additional thermal processes. As the irradiation energy of IPL increased from 30 to 50 J/cm2, the carrier concentration of ZnON thin films decreased from 5.07 × 1019 to 9.96 × 1016 cm-3 and the electrical performance of TFTs changed significantly, which is optimized at an energy of 40 J/cm2 (field effect mobility of 48.4 cm2 V-1 s-1). The properties of TFTs, such as mobility, subthreshold swing, and hysteresis, and the stability of the device under negative bias degraded as the irradiation energy increased. This degradation contributed to the change in nitrogen-related bonding states, such as nonstoichiometric Zn xN y and N-N bonding, rather than that of oxygen-related bonding states and the atomic composition of ZnON thin films. Optimization of the IPL process in our results makes it possible to produce high-performance ZnON TFTs very fast without any additional thermal treatment, which indicates that highly productive TFT fabrication can be achieved via this process.
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We report a case of common bile duct (CBD) cancer, successfully managed with pancreaticoduodenectomy, in a patient with isolated levocardia, malrotation, and situs ambiguous (without splenic anomalies). A 59-year-old male patient was referred to Chung-Ang University Hospital with epigastric pain and jaundice. CT and MRI revealed distal CBD cancer without significant lymphadenopathy. Multiple abdominal anatomic anomalies were identified preoperatively, whereas no anatomic anomalies were detected within the chest. The patient had a right-sided stomach and spleen, liver at the midline, several vascular variations around the celiac axis, and intestinal malrotation, but the inferior vena cava and portal vein were normal. A pancreaticoduodenectomy was performed to treat the cancer. The postoperative course was favorable, and the patient was started on combined chemotherapy and radiotherapy 15 days after the surgery. In this case study, we report that pylorus preserving pancreaticoduodenectomy was successful for distal CBD cancer in a patient with rare situs anomalies.
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Humanos , Masculino , Pessoa de Meia-Idade , Vértebra Cervical Áxis , Ducto Colédoco , Tratamento Farmacológico , Icterícia , Levocardia , Fígado , Doenças Linfáticas , Imageamento por Ressonância Magnética , Pancreaticoduodenectomia , Veia Porta , Piloro , Radioterapia , Baço , Estômago , Tórax , Veia Cava InferiorRESUMO
PURPOSE: The aim of this study was to assess clinical correlations with postoperative alteration of p16 DNA methylation, and to clarify whether postoperative changes in the serum DNA methylation status of p16 could be used as a reliable prognostic factor for gastric cancer. MATERIALS AND METHODS: Fifty-three consecutive gastric adenocarcinoma patients who underwent gastric resection (Chung-Ang University Hospital, Seoul, Korea) were included. DNA methylation of p16 was evaluated by methylation-specific polymerase chain reaction using serum DNA preoperatively and at the 10th postoperative day. The correlation between changes in methylation status and patients' prognosis was analyzed. RESULTS: p16 was methylated in 79.2% of preoperative serum DNA and in 54.7% of postoperative serum DNA, respectively. Methylation in p16 disappeared more frequently in patients who underwent standard D2 lymphadenectomy compared to those who underwent modified D1+ lymphadenectomy (P=0.016). Whereas methylation of preoperative serum DNA was not correlated with survival, patients with postoperative disappearance of p16 methylation showed longer survival than those without postoperative disappearance of p16 methylation in the patients who had gastric cancer with lymph node metastasis (P=0.042). CONCLUSIONS: Postoperative disappearance of p16 methylation could be an available prognostic factor for node-positive gastric cancer.
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Humanos , Adenocarcinoma , DNA , Metilação de DNA , Genes p16 , Excisão de Linfonodo , Linfonodos , Metilação , Metástase Neoplásica , Reação em Cadeia da Polimerase , Prognóstico , Neoplasias GástricasRESUMO
PURPOSE: To investigate the improvement in balance after TKA and the difference of balance between posterior cruciate ligament retaining & posterior cruciate ligament substituting prostheses. MATERIALS AND METHODS: Twenty-six patients scheduled to undergo TKA were randomly assigned to receive either PCL-retaining or PCL-substituting prosthesis. The balance of the subjects were checked prior to and at least six months after the operation by computerized dynamic posturography. We investigated whether the balance improve and the difference of change between the implants. RESULTS: Patients showed significantly the improvement of balance by the knee proprioception after TKA (p0.05). CONCLUSION: The balance by the proprioception improves as the HSS Knee Score increases after TKA, and does not show the difference between the implants.
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Humanos , Compensação e Reparação , Joelho , Ligamento Cruzado Posterior , Propriocepção , Próteses e ImplantesRESUMO
Candida infections after total knee replacement are extremely rare and show no specific symptoms and signs, thus make it difficult to diagnose. It is desirable to perform fungi culture from the beginning in case of persistent swelling and burning sensation in patients after total knee replacement with risk factors such as intraarticular steroid injection, intravenous drug abuse, immunosuppressive therapy, malignant hematologic tumor, etc. Positive culture of candida should never be considered as contaminated study, and be treated immediately. We report a case of candida infection after total knee arthroplasty, which was treated with staged reimplantation.