High- vs Low-Dose Corticosteroid Injection in the Treatment of Adhesive Capsulitis with Severe Pain: A Randomized Controlled Double-Blind Study.

Objective: To compare the degree of pain relief between high-dose (40 mg of triamcinolone acetonide) and low-dose (20 mg of triamcinolone acetonide) corticosteroid injections in patients with severe pain due to adhesive capsulitis. Design: A prospective, randomized, double-blind, dose-comparative study. Subjects: A total of 32 patients who were diagnosed with adhesive capsulitis and who expressed severe pain intensity, 8 or more points on a numeric rating scale (NRS). Methods: Patients received injections of high- or low-dose triamcinolone acetonide under ultrasound guidance. NRS, Shoulder Pain and Disability Index (SPADI), and the passive range of motion (PROM) in four directions were evaluated before and three weeks after the injection. Results: NRS scores showed significant improvement three weeks after the injection in both groups (P = 0.01 in both the low-dose group and high-dose group), but there was no statistically significant difference between the two groups (P = 0.63). SPADI score significantly improved at three weeks after the injection in both groups (P = 0.02 in the low-dose group and P < 0.01 in the high-dose group), but group difference was not observed (P = 0.06). The change of PROM in four directions after the injection did not show any significant difference between the low- and high-dose groups. Conclusions: Injection of 20 mg of triamcinolone acetonide is sufficient to elicit symptom relief in patients with severe adhesive capsulitis; hence, 20 mg of triamcinolone acetonide can be recommended in patients with adhesive capsulitis with severe pain.

Post-thinning using Ar ion-milling system for transmission electron microscopy specimens prepared by focused ion beam system.

We investigate Ar ion-milling rates and Ga-ion induced damage on sample surfaces of Si and GaAs single crystals prepared by focused ion beam (FIB) method for transmission electron microscopy observation. The convergent beam electron diffraction technique with Bloch simulation is used to measure the thickness of the Ar-ion milled samples to calculate the milling rates of Si and GaAs single crystals. The measurement shows that an amorphous layer is formed on the sample surface and can be removed by further Ar-ion milling. In addition, the local symmetry breaking induced by FIB is investigated using quantitative symmetry measurement. The FIBed-GaAs sample shows local symmetry breaking after FIB milling, although the FIBed-Si sample has no considerable symmetry breaking.

In situ heating transmission electron microscopy observation of nanoeutectic lamellar structure in Sn-Ag-Cu alloy on Au under-bump metallization.

We investigated the microstructural evolution of Sn(96.4)Ag(2.8)Cu(0.8) solder through in situ heating transmission electron microscopy observations. As-soldered bump consisted of seven layers, containing the nanoeutectic lamella structure of AuSn and Au5Sn phases, and the polygonal grains of AuSn2 and AuSn4, on Au-plated Cu bond pads. Here, we found that there are two nanoeutectic lamellar layers with lamella spacing of 40 and 250 nm. By in situ heating above 140°C, the nanoeutectic lamella of AuSn and Au5Sn was decomposed with structural degradation by sphering and coarsening processes of the lamellar interface. At the third layer neighboring to the lamella layer, on the other hand, Au5Sn particles with a zig-zag shape in AuSn matrix became spherical and were finally dissipated in order to minimize the interface energy between two phases. In the other layers except both lamella layers, polycrystal grains of AuSn2 and AuSn4 grew by normal grain growth during in situ heating. The high interface energy of nanoeutectic lamella and polygonal nanograins, which are formed by rapid solidification, acted as a principal driving force on the microstructural change during the in situ heating.

In(x)Ga(1-x)As nanowires on silicon: one-dimensional heterogeneous epitaxy, bandgap engineering, and photovoltaics.

We report on the one-dimensional (1D) heteroepitaxial growth of In(x)Ga(1-x)As (x = 0.2-1) nanowires (NWs) on silicon (Si) substrates over almost the entire composition range using metalorganic chemical vapor deposition (MOCVD) without catalysts or masks. The epitaxial growth takes place spontaneously producing uniform, nontapered, high aspect ratio NW arrays with a density exceeding 1 × 10(8)/cm(2). NW diameter (∼30-250 nm) is inversely proportional to the lattice mismatch between In(x)Ga(1-x)As and Si (∼4-11%), and can be further tuned by MOCVD growth condition. Remarkably, no dislocations have been found in all composition In(x)Ga(1-x)As NWs, even though massive stacking faults and twin planes are present. Indium rich NWs show more zinc-blende and Ga-rich NWs exhibit dominantly wurtzite polytype, as confirmed by scanning transmission electron microscopy (STEM) and photoluminescence spectra. Solar cells fabricated using an n-type In(0.3)Ga(0.7)As NW array on a p-type Si(111) substrate with a ∼ 2.2% area coverage, operates at an open circuit voltage, V(oc), and a short circuit current density, J(sc), of 0.37 V and 12.9 mA/cm(2), respectively. This work represents the first systematic report on direct 1D heteroepitaxy of ternary In(x)Ga(1-x)As NWs on silicon substrate in a wide composition/bandgap range that can be used for wafer-scale monolithic heterogeneous integration for high performance photovoltaics.

Nonlithographic patterning and metal-assisted chemical etching for manufacturing of tunable light-emitting silicon nanowire arrays.

Semiconductor nanowires have potential applications in photovoltaics, batteries, and thermoelectrics. We report a top-down fabrication method that involves the combination of superionic-solid-state-stamping (S4) patterning with metal-assisted-chemical-etching (MacEtch), to produce silicon nanowire arrays with defined geometry and optical properties in a manufacturable fashion. Strong light emission in the entire visible and near infrared wavelength range at room temperature, tunable by etching condition, attributed to surface features, and enhanced by silver surface plasmon, is demonstrated.

Sensitivity of quantitative symmetry measurement algorithms for convergent beam electron diffraction technique.

We investigate the sensitivity of symmetry quantification algorithms based on the profile R-factor (Rp) and the normalized cross-correlation (NCC) coefficient (γ). A DM (Digital Micrograph©) script embedded in the Gatan digital microscopy software is used to develop the symmetry quantification program. Using the Bloch method, a variety of CBED patterns are simulated and used to investigate the sensitivity of symmetry quantification algorithms. The quantification results show that two symmetry quantification coefficients are significantly sensitive to structural changes even for small strain values of < 1%.

Early Rehabilitation after Total Mastectomy and Immediate Reconstruction with Tissue Expander Insertion in Breast Cancer Patients: A Retrospective Case-control Study.

PURPOSE: To prevent surgical site complications, many plastic surgeons use the so-called "conventional protocol," which immobilizes the shoulder and upper arm for 1 month after reconstruction. In an effort to improve the shoulder mobility of patients who received immediate breast reconstruction with tissue expander insertion (TEI), we introduced an early rehabilitation protocol with a short-term immobilization period of 2 weeks. This study aims to compare this early rehabilitation exercise program with the conventional protocol and to determine factors affecting shoulder mobility and quality of life of patients after immediate breast reconstruction. METHODS: A total of 115 patients with breast cancer who underwent reconstructive surgery were retrospectively reviewed. For patients who underwent reconstruction before January 2017, the conventional protocol was followed with immobilization of their shoulder for over 4 weeks. Patients who underwent reconstruction after January 2017 were educated to undergo a self-exercise program after a short-term immobilization period of 2 weeks. We compared shoulder mobility, pain, quality of life, and complications at postoperative 1 and 2 months between the groups. RESULTS: Patients who received early rehabilitation showed greater shoulder flexion and abduction range at postoperative 1 month than those who received the conventional protocol. This increased shoulder abduction range continued until postoperative 2 months. There were no significant surgical site problems in both groups during the 2 months of follow-up. CONCLUSION: To enhance the recovery of shoulder mobility, early rehabilitation with a shorter immobilization period should be recommended to patients with breast cancer undergoing reconstruction surgery with TEI. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03541161.

TEM based high resolution and low-dose scanning electron nanodiffraction technique for nanostructure imaging and analysis.

We report a high resolution and low-dose scanning electron nanodiffraction (SEND) technique for nanostructure analysis. The SEND patterns are recorded in a transmission electron microscope (TEM) using a low-brightness ∼2 nm electron beam with a LaB6 thermionic source obtained by a large demagnification of the condenser 1 lens. The diffraction pattern is directly recorded using a CCD camera optimized for low-dose imaging. A custom script was developed for calibration and automated data acquisition. The performance of low-dose SEND is evaluated using nanostructured Au as a test sample for the quality of diffraction patterns, sample stability and probe size. We demonstrate that our method provides an effective and robust way for recording diffraction patterns from nanometer-sized grains.

Symmetry quantification and mapping using convergent beam electron diffraction.

We propose a new algorithm to quantify symmetry recorded in convergent beam electron diffraction (CBED) patterns and use it for symmetry mapping in materials applications. We evaluate the effectiveness of the profile R-factor (R(p)) and the normalized cross-correlation coefficient (γ) for quantifying the amount of symmetry in a CBED pattern. The symmetry quantification procedures are automated and the algorithm is implemented as a DM (Digital Micrograph(©)) script. Experimental and simulated CBED patterns recorded from a Si single crystal are used to calibrate the proposed algorithm for the symmetry quantification. The proposed algorithm is then applied to a Si sample with defects to test the sensitivity of symmetry quantification to defects. Using the mirror symmetry as an example, we demonstrate that the normalized cross-correlation coefficient provides an effective and robust measurement of the symmetry recorded in experimental CBED patterns.