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Tumor could directly invade or is adherent to other organs, but superior mesentery vein (SMV) and duodenum invasion are very rare. A 62-year-old woman was diagnosed with abdominal pain for several months. Multiple erythematous brownish skin patches and palpable mass were found at epigastric area. Computed tomography imaging showed focal wall thickening at the transverse colon that invaded to the rectus muscle and anterior abdominal wall. On exploration, we identified tumor invaded or was adherent to the duodenum and superior mesenteric vein and performed en-bloc resection. After surgery, the patient received chemotherapy and was followed up without any recurrence for 16 months. Adhesion and invasion of tumor to surrounding organs can be unexpectedly found during surgery. In our case, we found duodenum and SMV invasion and achieved R0 resection by SMV and duodenum resection, which could improve the patient’s prognosis.

Inguinal hernia repair using prosthetic mesh is used as a standard treatment in most countries and considered superior to primary suture repair. Although prosthetic mesh has greatly reduced the risk of recurrence, the risk of mesh infection remains. A 71-year-old man was diagnosed with symptomatic bilateral inguinal hernias. He underwent successful laparoscopic transabdominal preperitoneal (TAPP) repair and was discharged the same day. After 3 days, he was diagnosed with small bowel perforation, and underwent emergency surgery. We found perforation of the distal ileum caused by the fecal impaction and severe intra-abdominal contamination. We performed subtotal colectomy and ileosigmoid anastomosis, but did not remove the prosthetic mesh because the previous TAPP site was intact. The patient recovered well post-operatively. Therefore, contaminated or dirty surgery immediately after the hernia mesh surgery could be a feasible treatment.

Schwannoma is a benign and uncommon neoplasm arising from the neural crest cells. The most common tumor sites are the skin and subcutaneous tissue of the head and neck. Retroperitoneal schwannomas account for 1–3% of all schwannomas and are predominantly female. In particular, adrenal schwannoma is very rare, and due to its large size at the time of diagnosis, adrenal schwannoma is frequently misdiagnosed as adrenocortical carcinoma or pheochromocytoma. Adrenal schwannoma is difficult to distinguish it from other adrenal diseases based on imaging findings alone. In this report, we introduce the case of a huge left adrenal schwannoma.

Background Spontaneous dissection of the hepatic artery is a rare finding for which there is no specific treatment algorithm. Even though endovascular treatment and surgery have been used to treat other visceral artery dissections, these approaches can be challenging in the case of hepatic artery dissection because it is difficult to access the hepatic artery. Case summary 2 patients with spontaneous dissection of the hepatic artery were admitted due to epigastric pain. Although the liver function test results were normal, and there were no complications such as bleeding, shock, or ischemia in other organs, a subsequent computed tomography scan directly revealed the spontaneous dissection of the hepatic artery in both patients. The patients were treated with anticoagulants without surgery. Because it is difficult to perform surgery or endovascular treatment on the hepatic artery, we focused on preventing the progression of hepatic artery dissection and the formation of a new thrombus in the dissection. Conclusion Considering the risk of surgical treatment for the hepatic artery and the condition of the patients, medical treatment with anticoagulants may be considered as an initial treatment and provide more benefits than surgical treatment.

Purpose: The number of infrapopliteal runoff vessels seems to be one of the factors influencing arterial patency in patients who had undergone superficial femoral artery (SFA) angioplasty with stenting. However, the effectiveness of infrapopliteal runoff vessels in predicting patency during SFA angioplasty remains unclear. This study aimed to determine whether the number and quality of infrapopliteal runoff vessels affect the primary patency after SFA angioplasty with stenting in patients with claudication. Materials and Methods : : This study reviewed a retrospective database of patients with claudication who underwent SFA angioplasty with stenting between March 2011 and December 2016. The preoperative computed tomography findings of all patients were reviewed to assess infrapopliteal runoff vessels. The Trans-Atlantic Inter-Society (TASC) II classification and modified Society for Vascular Surgery (SVS) runoff score were used for subsequent analysis. Kaplan–Meier survival curves were constructed, and Fisher’s exact and chi-square tests were used for data analysis. Results : : A total of 153 limbs of 122 patients (88.2% male, mean age: 69.1 years) underwent SFA angioplasty with stenting. The overall primary patency rates of TASC II A/B and C/D cases were 77.1% and 31.2%, respectively, at 36 months (P

The Jisandong Tumuli—located in Daegaya-eup, Goryeong-gun in Gyeongsangbuk-do Province—is the largest tumuli of Daegaya. At this site, many earthen burial mounds, stonelined tombs, and stone chamber tombs are located along the major ridge of the Jusan Mountains and the surrounding area. Tumuli were established in the area after the fall of Daegaya, with cases of additional burials occurring by covering existing stone-lined tombs with soil or by extending or expanding them. This period is limited to the late 6th century. When looking at the archeological phenomena itself, these cases clearly show the changes from stone-lined tombs to horizontally-buried tombs as well as changes in funeral institutions. The subjects of additional burials can also be linked to local authorities who were related in some way to the subject who had been buried beforehand. In terms of the Jisandong Tumuli as a whole, it is very significant in the fact that it dramatically shows that in addition to the selective pressure regarding the styles of funeral institutions and earthenware after the conquer of Daegaya by the Shilla, the rule of the Goryeong region by the Shilla through the mediums of reverse leaf-type belt plaques and Tang-style metal belts is clearly achieved.

Highlights • Rectal cancer induced Fournier's gangrene is mainly caused by cancer perforation. • Vacuum assisted closure treatment helps to accelerate the healing of surgical wound. • Prompt diagnosis and urgent surgery are crucial for patient’s favorable outcome., Introduction Fournier’s gangrene (FG) is caused by a variety of causes, but FG led by rectal cancer is rare. Presentation of case A 62-year-old man presented with perineal pain for several days. Multiple black spots on the scrotum and perineum surrounded by erythema were found on a physical exam. Computed tomography showed diffuse air density with subcutaneous edema in the perineum, scrotum, anus, and left lower abdominal wall and showed 4.1 cm-size mass in anus. He was diagnosed with FG caused by rectal cancer. He underwent extensive debridement of the perineum, scrotum, medial buttocks, and diverting loop colostomy of transverse colon. After repeated debridement of some residual necrotic tissue, abdominal perineal resection was performed after 24 days after initial surgery. The patient received reconstruction surgery of the soft tissue defect and discharged on postoperative day 84. He is being followed up without any recurrence for 10 months. Conclusion Prompt clinical diagnosis and urgent surgical management are crucial for patient’s favorable outcome. The patient in our case study could be recovered by a combined modality therapy we provided.

Highlights • Minimally invasive thyroidectomy (MIT) is useful and famous technique that is being applied to thyroid carcinoma. • MIT without remote access is useful and applicable in thyroid disease and carcinoma in terms of cost effect and cosmetic outcome. • MIT without remote access can be feasible method for thyroid carcinoma with gross extra-thyroidal extension, especially, upper pole carcinoma., Introduction Minimally invasive thyroidectomy (MIT) is technically less damaging tissue and is better cosmetic results with small neck scar, decreasing postoperative pain and neck discomfort. We present the experience of MIT without remote access with case of grossly extra-thyroidal extension positive papillary thyroid carcinoma. Presentation of case A 44-year-old, female presented 1.6 cm irregular hypoechoic nodule at upper pole in Right thyroid gland and diagnosed to papillary thyroid carcinoma. The tumor was suspicious to have extra-thyroidal extension. We performed MIT without remote access for this patient with 2 cm cervical incision. Postoperative course was uneventful and patient was discharged on the 3th postoperative day. At present, she is taking 100mcg levothyroxine and is free of disease 3 years post-surgery. Conclusion If experienced surgeons can get sufficient resection margin and control bleeding of superior thyroid artery, MIT without remote access can be feasible method for thyroid carcinoma with gross extra-thyroidal extension, especially, upper pole carcinoma.

Discoveries of Hwangnyongsa-style metal belts, usually brackets and belts as well as round and edge ornaments, excavated from the lower part of the pillar built in the center of this wooden pagoda in Gyeongju led the existence of this site to become known. Subsequent excavations have intermittently targeted local burial tombs but few cases have so far been found; it is nevertheless important to carefully consider the appearance, development, and extinction of these tombs as occurrences are only known from a limited time period between the late sixth century and early seventh century. One characteristic feature of Hwangnyongsa-style metal belts is that the ornament and the pattern are raised together; this means that when a belt is worn it buckled by inserting a bracket needle into a round ornament. This is different from the inverted leap-like shape of a metal belt and somewhat similar to the way that these items are depicted as being buckled in Chinese burial mound and mural figures. Most of the patterns seen on these metal belts are also shared with decorative designs seen on reliefs and murals from North dynasty and Sui dynasty ancient tombs; on this basis, these artifacts can be viewed as Chinese-influenced Silla metal belts. Hwangnyongsa-style and Tang-style metal belts have also not been differentiated from one another in conventional interpretations and it has been considered reasonable to assume that the method of ornament making innovatively changed from the use of patterns to none. Hwangnyongsa-style metal belts can therefore be included within the same category as their Tang-style counterparts, as part of the evolution of these items in China. It is known that the Silla dynasty formed political ties with the Chinese dynasty at some point during the middle of the sixth century via the tributary appointment system. This led to a transformation of cultures and products inside China to fit the situation within the Silla dynasty which was then utilized for regional control; the Silla dynasty ruled rural areas by providing Oewie to local forces newly incorporated into the area and by including numerous local owners into the Gyeongwie system subsequent to unification. The time between the mid-sixth century and the early seventh century when the Oewie system was functioning within the Silla dynasty therefore functioned as a tool for regional control and is consistent with the timing of the appearance of Hwangnyongsa-style metal belts in rural areas and changes in their form.

Since the use of robot systems in thyroid surgery was introduced in 2007, we have advanced a novel method of robotic thyroidectomy (RT) using a gasless transaxillary approach (TAA). We report our experience with this technique and detail the surgical outcome of 5000 robotic thyroidectomies. From October 2007 to May 2016, we successfully performed 5000 robotic thyroidectomies using a gasless TAA at the Department of Surgery, Yonsei University Health System. The medical records of the patients are reviewed retrospectively, and the details of clinicopathologic characteristics, operation times, perioperative complications, and oncologic outcomes are analyzed. The 5000 patients with thyroid tumor (4804 with cancer and 196 with benign tumor) underwent RT using a gasless TAA. Mean operation time was 134.5 ± 122.0 min. The most common histologic subtype of thyroid cancer was papillary (98%), and the mean tumor size was 8.0 ± 6.0 mm. Stage I was found in 85.4% patients regarding tumor nodes metastasis staging. The 196 benign tumors consisted of 104 adenomatous hyperplasias (53.0%), 43 follicular adenomas (21.9%), 30 Graves’ diseases (15.3%), and 19 others (9.7%). Postoperative complication occurred in 24.1% without any serious one, and overall morbidity tended to decrease over time. No disease-specific mortality was observed during the follow-up period. Locoregional recurrence was developed in 26 patients (0.5%). The authors have tried to improve RT technique using gasless TAA and achieved acceptable surgical outcomes. The rapid evolution of surgical robot technology and our constant effort to advance RT technique using gasless TAA would make it possible to reduce the perioperative morbidity and gain the best possible operative and oncologic outcomes.

Abdominal cocoon syndrome (ACS) is a rare condition characterized by partial or complete encasement of small intestine by a thick fibro-collagenous membrane. A 65-year-old man presented to the surgical department with left inguinal. He underwent laparoscopic transabdominal preperitoneal inguinal hernia. When we inserted a trocar into the peritoneal cavity, the small intestine was injured and repaired immediately. We identified a fibrotic membrane covering the small intestine, which was found as ACS. Two weeks later after discharge, he presented to the emergency department with mechanical intestinal obstruction. Conservative treatment had no effect on the patient and membrane excision, adhesiolysis and small intestine resection with anastomosis were performed. Unfortunately, the patient was hospitalized for a long time with bowel leakage and discharged on postoperative day 48. The preoperative diagnosis is quite challenging and most cases are diagnosed intraoperatively. When finding the ACS during the operation, careful attention should be needed.

We study the magnetoconductance and dephasing in a strongly localized regime in black phosphorus (BP) devices. The phase coherence length, lφ obtained from the magnetoconductance follows a temperature dependence of T–1/3 in the strongly localized regime with kFle < 1 (ξ < lφ) based on the Ioffe–Regel criterion. Here kF, le and ξ are the Fermi wave vector, mean free path and localization length, respectively. The conductance behavior as a function of temperature confirms that the transport regime of our BP is in a variable-range-hopping regime, which results in the strongly localized regime.

Robotic modified radical neck dissection (MRND) using a gasless transaxillary approach has been reported to be a safe and meticulous technique in patients with papillary thyroid carcinoma (PTC) and lateral neck node metastasis (N1b). Few studies, however, have attempted to assess the long-term oncologic outcomes of robotic MRND in these patients. This study aimed to compare perioperative and 5-year oncologic outcomes of robotic MRND with conventional open procedures in patients with N1b PTC. Between September 2007 and February 2010, 193 patients with N1b PTC underwent total thyroidectomy and MRND by a single surgeon. Of these, 42 (21.8 %) underwent robotic procedures and 151 (78.2 %) underwent conventional open procedures. All patients received 3.7- to 5.5-GBq radioactive iodine (RAI) ablation, post-therapy whole-body scans (TxWBSs), and diagnostic WBS (DxWBSs) during follow-up. An exact 1:3 matching for age and stage was performed to minimize selection bias, and perioperative and 5-year oncologic outcomes were compared in the matched groups. The mean follow-up period was 66.0 months (range 60–90 months). Number of retrieved cervical lymph nodes (LNs) (p = .102) and postoperative ablation success rates (p = .864) were similar between the two groups. TSH-suppressed serum Tg concentrations after 5 years (0.7 ± 1.5 vs. 2.4 ± 14.1 ng/ml; p = .471) and recurrence rates in the robotic and open groups (1/41 [2.4 %] vs. 3/102 [2.9 %]; p = .864) were similar for the 5-year follow-up period. Four patients experienced recurrence: Three exhibited regional lymph node metastasis, and one showed bilateral lung metastases. The perioperative and 5-year oncologic outcomes were similar after robotic and conventional open MRND. Large, prospective randomized controlled trials with long-term follow-up data are needed to validate these results.

BACKGROUND AND AIMS Some recent guidelines recommend unilateral thyroidectomy for low-risk differentiated thyroid cancer (DTC) sized > 1 and < 4 cm. The present study was designed to evaluate the proper extent of thyroidectomy for patients who have DTC sized > 1 and < 4 cm. METHODS From April 1967 to December 2011, a total of 16,065 DTC patients underwent thyroidectomy at Yonsei University Hospital. Among them, 5,427 (33.7%) patients were classified as having DTC > 1 and < 4 cm and were enrolled in this study. Clinicopathologic features and prognostic results (disease-free and disease-specific survival rates) were analyzed by retrospective medical chart review. The mean follow-up duration was 57.3 ± 58.1 months. RESULTS In the subtypes of tumors, papillary thyroid carcinoma (PTC) was the most common cancer (96.9%) and follicular and poorly differentiated carcinoma comprised 2.7 and 0.1% respectively. The mean tumor size was 1.84 ± 0.74 cm. Patients had extrathyroidal extension (69.3%), multiplicity (35.0%), bilaterality (26.3%), central lymph node metastasis (35.8%), and lateral neck node metastases (20.2%). Of a total of 5,427 patients, 4,353 (80.2%) underwent total thyroidectomy and 1,043 (19.2%) patients underwent less- than-total thyroidectomy. The recurrence rates in total thyroidectomic and less-than-total thyroidectomic groups were 3.9 and 10.0% respectively. The less-than-total thyroidectomic group showed lower disease-free survival (DFS) rate (p= 0.039) and higher disease-specific survival (DSS) (p = 0.035) rate compared with the total thyroidectomic group. In multivariate analysis for DFS, tumor size, N stage, and the extent of thyroidectomy were independent risk factors. In multivariate analysis for DSS, age, gender, tumor size, and N and M stage were independent risk factors. CONCLUSION In patients with tumor size > 1 and ≤ 4 cm, total thyroidectomy was beneficial in reducing recurrence. However, our study confirmed that risk factors for DSS were not the extent of thyroidectomy but traditional prognostic factors, such as older age, male sex, large tumor size, lymph node metastasis, and distant metastasis.

Background Recent guidelines advocate unilateral thyroidectomy for low-risk 1-cm to 4-cm differentiated thyroid cancer (DTC). This study was designed to examine the association between the extent of thyroidectomy and oncologic outcomes in patients with 1-cm to 4-cm DTC. Materials and methods From April 1978 to December 2011, 16 057 patients with DTC underwent thyroidectomy at Yonsei University Hospital. Among them, 5266 (32.8%) patients were classified as having 1-cm to 4-cm DTC and were enrolled in this study. Clinicopathologic features and prognostic results (disease-free survival [DFS] and disease-specific survival [DSS] rates) were analyzed by retrospective medical record review. The mean follow-up duration was 57.3 ± 58.1 months. Results Of tumor subtypes in the study group, papillary thyroid carcinoma was the most common (97.5%) and follicular thyroid carcinoma occurred at a rate of 2.5%. In this study, the mean tumor size was 1.84 ± 0.74 cm. Patients had extrathyroidal extension (69.3%), multiplicity (35.1%), bilaterality (26.4%), central lymph node metastasis (53.0%), and lateral neck node metastases (19.9%). Of the 5266 patients, 4292 (81.5%) underwent total thyroidectomy and 974 (18.5%) had lobectomies. Recurrence rates in the total thyroidectomy and lobectomy groups were 5.7% and 9.4%, respectively. The lobectomy group had lower DFS (P = .007) and higher DSS (P = .034) than the total thyroidectomy group. A multivariate analysis for DFS revealed that tumor size, N classification, and extent of thyroidectomy were independent risk factors. On multivariate analysis, independent risk factors for DSS were age, sex, tumor size, and M classifications. Conclusion Although extent of thyroidectomy does not affect DSS, total thyroidectomy is beneficial for reducing recurrence in patients with 1-cm to 4-cm DTC. However, if such tumors have such low-risk features as being unifocal, intrathyroidal, and lymph node metastasis-negative, extent of thyroidectomy does not affect oncologic outcome and lobectomy may be sufficient.

Jung Bum Choi,1,* Woo Kyung Lee,2,3,* Seul Gi Lee,2,4 Haengrang Ryu,5 Cho Rok Lee,4 Sang Wook Kang,4 Jong Ju Jeong,4 Kee-Hyun Nam,4 Eun Jig Lee,2,3 Woong Youn Chung,4 Young Suk Jo,2,3 Jandee Lee4 1Department of Surgery, Pusan National University College of Medicine, Busan, South Korea; 2Brain Korea 21 PLUS Project for Medical Science, Yonsei University, Seoul, South Korea; 3Department of Internal Medicine, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea; 4Department of Surgery, Open NBI Convergence Technology Research Laboratory, Yonsei Cancer Center, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea; 5Department of Surgery, Hongik Hospital, Seoul, South Korea *These authors contributed equally to this work Purpose: Active surveillance (AS) of low-risk papillary thyroid microcarcinoma (PTMC) may reduce the risk of overtreatment of clinically insignificant cancer. However, the absence of predictor for the progression of PTMC resulted in treatment delay and potentially compromising cure of aggressive disease. Therefore, to anticipate potential damage of delayed surgery, we investigated the oncologic outcomes of patients with low-risk PTMC initially eligible for AS except clinically apparent lymph node metastasis (LNM), imitating delayed surgery with neck dissection. Materials and methods: A total of 5,348 patients, enrolled between 1987 and 2016, with low-risk PTMC initially eligible for AS were included regardless of LNM. We classified our study patients into two groups: Group I, lobectomy with prophylactic central cervical node dissection; Group II, total thyroidectomy with modified radical neck dissection for LNM. In addition, we investigated the oncological outcomes of patients with second-wave surgery due to lateral lymph node recurrence (Group III, subgroup of Group I). Results: Group I showed more favorable clinicopathological characteristics compared with Group II. In Group I, only 29 (0.58%) of 4,927 patients underwent second-wave surgery with neck dissection for lateral lymph node recurrences, whereas in Group II, all 22 (5.23%) of 421 patients underwent second-wave selective node dissection because of nodal recurrence. Disease-free survival rates were significantly different between Groups I and II (P

Purpose: Under the proper program, day-case laparoscopic cholecystectomy is feasible in the aspect of postoperative recovery consisting of patient"s satisfaction and postoperative complication. In this study, we plan a new protocol for laparoscopic cholecystectomy by analyzing factors that can reduce hospital days. Methods: A total of 175 patients who underwent three-day laparoscopic cholecystectomy were initially selected. Out of 175 patients, secondary selection was executed using inclusion criteria. The selected patients were scheduled for new two-day laparoscopic cholecystectomy, and 89 patients were included in the data analysis. This study elucidated the comparative analysis between the discharged in the postoperative day 0 group and the postoperative day 1 group. Results: The clinical characteristics were not significantly different between discharged in the postoperative day 0 group and the postoperative day 1 group. The combined diseases were not significantly different between the two groups. Post-operative complications in both groups were analyzed on the seventh day after the operation. No significant difference was observed between the two groups. Members of the patient group who were discharged on postoperative day 0 were given a survey regarding post-operative pain, desirability of discharge, and the level of satisfaction with patient education. The average score was 8.3 out of 10 points. In comparison of the total hospital cost between the two groups, the group discharged on postoperative day 0 had lower cost in all factors. Conclusion: We conclude that day-case laparoscopic cholecystectomy is as safe and effective as routine clinical pathway applied laparoscopic cholecystectomy in stable cardiovascular disease, uncomplicated pulmonary disease, and controlled DM patients.

For various additives doped- critical temperature sensors using the nature of semiconductor to metal transition, the crystallinity, microstructure, and temperature vs. resistance characteristics were systematically investigated. As a starting material of sensor, vanadium pentoxide () powders were used, and CaO, SrO, , , and PbO dopants were used, respectively. The powders with dopants were mixed with a vehicle to form paste. This paste was silk screen-printed on substrates and then -based thick films were heat-treated at for 2 hours in gas atmosphere for the reduction to . From X-ray diffraction analysis, phases for pure , and CaO and SrO-doped thick films were confirmed and their grain sizes were 0.57 to . The on/off resistance ratio of the sensor in phase transition temperature range was and that of the 0.5 wt.% CaO-doped sensor was . The presented critical temperature sensors could be commercialized for fire-protection and control systems.

We have implemented a Si-based coupled double-dot device with five independent gates vertically layered above the active channel, which can provide more effective controllability of interdot coupling without changing the potential shape of an individual dot. We observed a transition from a merged single dot to the coupled double dot by adjusting the interdot coupling strength via a central gate. From the honeycomb charge stability diagram, the capacitance-related critical parameters of the coupled double dot, which will be of impotance in the Si-based two-qubit gate applications, are deduced.

Supplemental Digital Content is available in the text, Regional lymph node (LN) metastasis has a significant impact for prediction of recurrence in patients with papillary thyroid cancers (PTC); however, the prognostic value of the lymph node ratio (LNR), which is defined as the ratio of the number of metastatic LNs to the total number of investigated LNs, is controversial. In this study, we determined the optimal cut-off values of LNRs for the prediction of recurrence in PTC patients. This large cohort study retrospectively evaluated 2294 patients who had undergone total thyroidectomy for PTC at a single institution from October 1985 to June 2009. The prediction probability of central LNR (cLNR, level VI) and total LNR (tLNR, levels II–VI) were estimated by binominal logistic regression analysis. Hazard ratios of the cut-off LNR values for cancer recurrence were calculated for relevant covariates using multivariate Cox regression analyses. Kaplan–Meier analyses were also utilized to assess the effects of estimated LNR cut-off values on recurrence-free survival (RFS). Of the 2294 patients, 138 (6.0%) presented cancer recurrence during the follow-up period (median duration = 107.1 months). The prediction probability indicated that LNRs of 0.4 and 0.5 for central LN and total LN, respectively, are optimal cut-off values for precise prediction with minimization of outliers. Multivariate Cox regression analyses revealed that cLNR ≥0.4 was independently predictive of recurrence in patients with N0 and N1a PTCs (hazard ratio [HR]: 7.016, 95% confidence interval [CI]: 3.72–12.986, P

Small single-electron devices (SEDs) consisting of many Si nanodots are fabricated on a silicon-on-insulator (SOI) wafer by means of pattern-dependent oxidation (PADOX) method. We investigated SEDs from two kinds of viewpoint. One is how to fabricate the nanodots, especially coupled nanodots, which are important to achieve quantum computers and single-electron transfer devices. The other is demonstration of new applications that tolerate the size fluctuation. In order to achieve multi-coupled nanodots, we developed an easy method by applying PADOX to a specially designed Si nanowire which has small constrictions at the ends of the wire. We confirmed the double-dot formation and position of the Si nanodots in the wire by analyzing the measured electrical characteristics. To achieve high functionality together with low-power consumption and tolerance to size fluctuation, we developed nanodot array device which has many input gates and outputs terminals. The fabricated three-input and two-output nanodot device actually provide high functionality such as a half adder and a full adder.

Purpose Recently, the American Thyroid Association (ATA) dynamic risk stratification (DRS) has been verified to be more valuable than the static anatomical staging system for predicting prognosis in patients with differentiated thyroid carcinoma (DTC). The purpose of this retrospective study was to compare the clinical usefulness of DRS, which is based on the response to initial treatment, with that of ATA initial risk stratification in pediatric patients. Methods A total of 144 pediatric patients underwent thyroid operation from August 1982 to December 2013 at Yonsei University Hospital (Seoul, Korea). Among them, 128 patients with complete clinical data were enrolled in this study. Clinicopathologic features and surgical outcomes were retrospectively analyzed by medical chart review. The mean follow-up duration was 11.5 years. Results The mean tumor size was 2.1 cm; 80.4% of patients were diagnosed with conventional papillary thyroid carcinoma, and 7.0% of patients were diagnosed with follicular thyroid carcinoma. Low-risk patients had the highest probability of an excellent response to initial treatment (66.6%). High-risk patients had the highest probability of a structural incomplete response (100%) and the lowest probability of an excellent response (11.1%). The ATA risk stratification and the DRS system were independent risk factors for disease-free survival (DFS) (P = 0.041 and P < 0.001, respectively). Conclusion The DRS system, which is based on the response to initial treatment, can offer more useful prognostic information compared with ATA risk stratification in pediatric patients with DTC.

We propose a simple method for fabricating Si single-electron transistors (SET) with coupled dots by means of a pattern-dependent-oxidation (PADOX) method. The PADOX method is known to convert a small one-dimensional Si wire formed on a silicon-on-insulator (SOI) substrate into a SET automatically. We fabricated a double-dot Si SET when we oxidized specially designed Si nanowires formed on SOI substrates. We analyzed the measured electrical characteristics by fitting the measurement and simulation results and confirmed the double-dot formation and the position of the two dots in the Si wire.

We have developed a flexible-logic-gate single-electron device (SED) with an array of nanodots. Although the small size of SEDs is highly advantageous, the size of the nanodots inevitably fluctuates, which causes variations in device characteristics. This variability can be eliminated and high device functionality can be obtained by exploiting the oscillatory characteristics and multigate capability of SEDs. We fabricated, on a silicon-on-insulator wafer, a Si nanodot array device with two input gates and a control gate and investigated its basic operation characteristics experimentally. The device was demonstrated to operate as a logic gate providing six important logic functions ( and, or, nand, nor, xor, and xnor), which are obtained by adjusting the control-gate voltage.

New multi-valued logic (MVL) families using the hybrid circuits consisting of three gates single-electron transistors (TG-SETs) and a metal-oxide-semiconductor field-effect transistor (MOSFET) are proposed. The use of SETs offers periodic literal characteristics due to Coulomb oscillation of SET, which allows a realization of binary logic (BL) circuits as well as multi-valued logic (MVL) circuits. The basic operations of the proposed MVL families are successfully confirmed through SPICE circuit simulation based on the physical device model of a TG-SET. The proposed MVL circuits are found to be much faster, but much larger power consumption than a previously reported MVL, and they have a trade-off between speed and power consumption. As an example to apply the newly developed MVL families, a half-adder is introduced.

We fabricated a nanodot-array device with multiple input gates on a silicon-on-insulator (SOI) wafer by using a pattern-dependent oxidation method with multiple input gates, which embodies a new concept of a flexible single-electron device. Although the device can generate many logic functions owing to the capacitive coupling between dots and many gates, the complicated structural configuration makes it difficult to confirm the formation of the nanodot array. For further investigation of this kind of device to achieve higher functionality, it is important to demonstrate experimentally that the dot array is actually formed. We analyzed the oscillation-peak shift caused by the gate voltage change, and successfully determined the location of the dots that contributed to the experimentally observed oscillations.

A half-adder (HA) and a full-adder (FA) using hybrid circuits combining three-gate single-electron transistors (TG-SETs) with metal-oxide-semiconductor field-effect-transistors (MOSFETs) are proposed. The proposed HA consists of three TG-SETs, two enhanced-mode NMOSFETs, and two depletion-mode NMOSFETs, and the proposed FA consists of eight TG-SETs, two enhanced-mode NMOSFETs, and two depletion-mode NMOSFETs. The complexities in the HA and the FA are 7 and 12, respectively, and the worst-case delays in the HA and the FA are 1.48 ns and 2.25 ns, respectively. Compared with the conventional CMOS FA with 0.35 μm technology, the proposed FA can be constructed with 0.43 of devices, and can operate with 3.5 of worst-case delay, 1/534 of average power consumption, and 1/152 of power-delay-product (PDP). The proposed HA and FA can be operated as a half-subtractor (HS) and a full-subtractor (FS) in the case when the levels of the control gates in the HA and the FA are fitly determined. The basic operations of the proposed HA and the proposed FA have been successfully confirmed through SPICE circuit simulation based on the physical device model of TG-SETs.

A half-adder (HA) and a full-adder (FA), using single-electron metal–oxide–semiconductor field-effect transistors (SE-MOSFET) hybrid circuits, are proposed. The proposed HA consists of three single-electron transistors (SETs), two enhancement-mode NMOSFETs and two depletion-mode NMOSFETs, and the proposed FA consists of four SETs, four enhancement-mode NMOSFETs, one enhancement-mode PMOSFET and three depletion-mode NMOSFETs. The total number of devices in the HA and the FA are 7 and 12, respectively. Compared with the conventional CMOS mirror FA with the 90 nm technology, the proposed FA can be constructed with 0.43 of devices and can operate with 5.6 of worst-case delay, 1/10.3 of average power consumption and 0.55 of power-delay product. The proposed HA and FA can be operated as a half-subtractor (HS) and a full-subtractor (FS) in the case when the levels of the control gates in the HA and the FA are suitably determined. The basic operations of the proposed HA, HS, FA and FS have been successfully confirmed through SPICE circuit simulation based on the physical device model of the SET.

The role of the robot in thyroid surgery remains uncertain, and it is unclear whether robotic total thyroidectomy (R-TT) can be justified as a standard treatment for patients with thyroid cancer. This study compared the long-term operative results and oncologic outcomes of R-TT and conventional open TT (O-TT) after propensity score matching of the cohorts. This study retrospectively evaluated patients with papillary thyroid cancer (PTC) who underwent TT with central compartment node dissection (CCND) by a single surgeon in tertiary medical center. Of the 833 patients, 94 (11.3 %) were lost to follow-up. 245 (33.2 %) underwent R-TT, and 494 (66.8 %) underwent O-TT. The mean follow-up duration was 74 (range 61–91) months. Propensity score matching in age, gender, tumor size, extrathyroidal invasion, multiplicity, bilaterality, and TNM stage identified 206 pairs of patients. The long-term oncologic outcomes were assessed in the R-TT and O-TT groups before and after adjustment for baseline covariates. After adjustment for baseline covariates, serum thyroglobulin (Tg) (p = 0.746) and anti-thyroglobulin antibody (TgAb) (p = 0.394) concentrations were similar in the two groups 5 years after surgery. Nine patients experienced locoregional recurrence, six in the O-TT and three in the R-TT group, with all recurrences in regional LNs. Disease-free survival (DFS) was similar in the R-TT and O-TT groups before matching (p = 0.890) and after adjustment for baseline covariates (p = 0.882). This represents the first report of 5-year surgical outcomes in patients who underwent R-TT for thyroid cancer. Long-term oncologic quality was similar after R-TT and O-TT.

Surgical excision of orbital lymphangiomas is difficult, and almost always incomplete due to the diffusely infiltrative pattern of these tumors. The present report describes the successful use of intralesional OK-432 administration to treat two patients with intractable hemorrhagic proptosis due to orbital lymphangiomas. A 3-year-old girl (case 1) presented with aggressive proptosis and ptosis, and a 1-year-old boy (case 2) presented with massive proptosis and exposure keratopathy, associated with recurrent intracystic bleeding of an orbital lymphangioma. In case 1, 0.02 mg OK-432 was intracystically injected in a volume of 2 ml of physiologic saline. Due to a lack of therapeutic response, a second injection of 0.05 mg OK-432 in 1 ml was administered. In case 2, a single dose of 0.05 mg OK-432 in 1 ml was administered. In both cases, intracystic administration of 0.05 mg of OK-432 in a 1-ml volume resulted in a successful outcome. The adverse effects were minor (mild transient fever and lid swelling), and rebleeding and intraocular pressure elevation did not occur. Proptosis and eyelid swelling gradually improved over 1 month, and completely resolved within 3 months of treatment. Intralesional administration of 0.05 mg/ml OK-432 (delivered in 1 ml) resulted in the successful treatment of two cases of orbital lymphangioma. Although this drug concentration is higher than in previous reports, there were no major adverse effects.

We have fabricated a new single-electron device (SED) that has many nanodots. Although SEDs have the great advantages of small size and low power consumption, they should have small dots on the order of a few nanometers, which makes them difficult to fabricate. The proposed device uses many nanodots aligned as an array, on which many gate electrodes are attached so as to couple capacitively to underlying nanodots. Some of the gates are used as input gates of a logic-gate device. The others are control gates that are used to change the logic function of the device, such as from an AND gate to an XOR (exclusive OR) one. The principal operations have been demonstrated using numerical simulations.

A 70-year-old female was diagnosed with a left frontal mucocele causing severe proptosis, lid swelling, and mild pain. After three days, her corrected visual acuity suddenly decreased to 5/500 with a relative afferent pupillary defect. Emergent endoscopic sinus surgery relieved her ocular signs and symptoms, and visual acuity quickly recovered to preoperative level. There have been relatively few reports of frontal mucoceles resulting in sudden vision loss with subsequent recovery. Our case demonstrates that a frontal mucocele can cause serious visual disturbance by acute optic neuropathy, even in the absence of any remarkable medical history or serious inflammation. Cooperation between an ophthalmologist and rhinologist is necessary, and early endoscopic sinus surgery may promise good visual prognosis.

We have studied the reliability problems in the degradation of the data retention characteristics of the stacked-gate flash EEPROM devices with the new interpoly dielectric of an Oxide–Nitride–Oxide–Nitride (ONON) layer instead of a conventional Oxide–Nitride–Oxide (ONO) layer. Based on the experimental results of cell threshold voltage shifts measured as a function of bake time at various temperatures by the high-temperature accelerated test, an empirical model equation has been developed and evaluated, which explains the dominant mechanisms for the spontaneous electron leakage through the interpoly dielectric. Through the threshold voltage and temperature dependency of cell threshold voltage shift rate, the model clearly shows that cell threshold voltage shift during the baking test is caused dominantly by the electron leakage mechanism due to the thermally-activated direct-tunneling which electrons tunnel finally through the thin top oxide of the ONON layer to the control gate after detrapping the internitride trap-sites near the interface between the internitride and top oxide by the thermionic emission mechanism. The simulation results using the model equation were quite consistent with the measurement data at all the tested temperatures and times.