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Abstract Background Clostridium perfringens sepsis associated with massive intravascular hemolysis has an extremely poor prognosis. We here report a case of C. perfringens sepsis associated with massive intravascular hemolysis that developed secondary to a post-pancreaticoduodenectomy (PD) hepatic abscess. Case presentation A 70-year-old man with Type 2 diabetes underwent PD for an ampulla of Vater carcinoma. His postoperative course was uneventful. He was discharged on the 16th post-operative day (POD 16) after confirming no major abnormalities on abdominal contrast computed tomography (CT) on POD 14 or laboratory results on POD 16. Two days after discharge, he was readmitted because of fever and chills. Laboratory tests showed only a mild inflammatory reaction (white blood cell count, 11,980/mm3; C-reactive protein, 2.07 mg/dL). Abdominal CT showed an irregular, approximately 20-mm diameter, low-density area in the liver S6 region that had not been seen on a recent previous scan. We initially suspected postoperative cholangitis associated with biliary reconstruction and started empirical treatment with sulbactam/ampicillin after drawing blood for culture. Eight hours after admission, he developed septic shock with body temperature 40.0 ℃ and blood pressure 70/40 mm Hg. Laboratory findings showed a severe inflammatory reaction, severe anemia, and massive hemolysis (white blood cell count, 37,400/mm3; hemoglobin, 7.7 g/dL; total bilirubin, 8.05 mg/dL; direct bilirubin, 2.66 mg/dL; and lactate dehydrogenase, 1686 U/L). Hemoglobinuria was noted in the urinary catheter output. Repeat CT 9 h after admission showed the low-density area in S6 had become a gas-forming abscess. C. perfringens sepsis was strongly suspected on the basis of these findings and the abscess was drained percutaneously immediately after its diagnosis. His vital signs improved dramatically and he recovered within 24 h. Blood and abscess cultures grew C. perfringens 4 days after admission, leading to a definitive diagnosis of C. perfringens sepsis associated with massive intravascular hemolysis. He was discharged 18 days after admission. His sepsis has not recurred. Conclusions Clostridium perfringens infection should be considered in patients who have undergone PD and present with gas-forming hepatic abscesses and/or sepsis associated with intravascular hemolysis. Prompt aggressive treatment is crucial, because C. perfringens infections can cause death within hours.

PEDOT:PSS/Si hybrid photovoltaic cells have been attracting attention as a potential way to simplify the manufacturing process and democratize solar energy production. Control of the PEDOT/Si interface is also one of the primary ways to ensure the improved performance and lifetimes of multijunction devices, such as perovskite/Si tandem solar cells. In this work, the effects of the interfacial silicon oxide layer were investigated by creating a novel and controllable neutral beam oxide interlayer with different thicknesses. A novel self-doped PEDOT (S-PEDOT) was used to improve interfacial contact and avoid the secondary doping of PEDOT:PSS. X-ray photoelectron spectroscopy (XPS) showed that the saturation of interfacial silicon atoms in SiOx-Si bonds as well as a very thin, (~1 nm) damage-free oxide interlayer were the keys to maintaining good passivation with a high tunneling current. Lifetime measurements also showed that the interlayers with the most SiO2 content degraded the least. The degradation of the devices was due to the continued growth of the oxide layer through reactions with silicon sub-oxides and the degradation of S-PEDOT.

We investigated a high electron mobility Ge FinFET fabricated by defect-free and roughness-free atomic layer neutral beam etching (NBE) compared with one fabricated by conventional plasma etching (PE). The etching interface roughness and defect were estimated by high-resolution transmission electron microscopy (TEM). In the case of using atomic layer defect-free NBE, the root-mean-square roughness of the Ge Fin sidewall surface is 1/3 times smaller than that using PE. Then, the electron mobility of Ge FinFET was improved by 1.65 times compared with that of a PE etched FinFET sample. For the subthreshold swing, the defect density of the interface between the Ge and gate dielectric film was improved by NBE. Ioff average currents of NBE and PE were around 18.1 and 57.6 nA/μm, respectively. As a result, NBE reduces the off-leakage current to 1/3 times less than PE. This corresponded to the differences in surface roughness and defect generation between NBE and PE. Therefore, we found that NBE could achieve a good performance by defect-free and atomically-flat etching the surface.

The phonon transport in the lateral direction for gap-controlled Si nanopillar (NP) /SiGe interlayer composite materials was investigated to eliminate heat generation in the channel area for advanced MOS transistors. The gap-controlled Si NP/SiGe composite layer showed 1/250 times lower thermal conductivity than Si bulk. Then, the phonon transport behavior in lateral direction could be predicted by the combination between the 3-omega measurement method for thermal conductivity and the Landauer approach for phonon transport in Si NP/Si0.7Ge0.3 interlayer composite structure. We found that the NP structure could regulate the phonon transport in the lateral direction by changing the NP gaps by preventing the phonon transportation from the drain region and the potential heat generation. As such, this structure achieves the first step toward phonon transport management in the same electron transportation direction of planar-type MOSFETs and represents a promising solution to heat generation for advanced CMOS devices.

We fabricated a highly water-repellent quartz nanopillar (NP) structure to investigate the effect of varying the contact angle (CA) by using 10-nm-order gaps and 10-nm-diameter NPs. Gaps from 15 to 30 nm led to CAs of more than 100°, showing hydrophobicity, to a maximum of 105°. The mechanism of repelling water on quartz could be explained by the Cassie-Baxter model with a filling factor. A gap of more than 30 nm fills with water due to capillarity, but a gap of less than 30 nm causes water to be repelled by air. We were able to repeatedly fabricate a quartz NP structure with a controllable gap by using a combination of a bio-template and neutral-beam etching and found this structure to be highly water-repellent. The structure has high durability and optical transparency. As a result, we conclude that it can be used in sensors and lenses on various devices such as cameras and radars.

This report presents a case of Schloffer tumour at the small intestinal mesentery, mimicking a malignant tumour, treated laparoscopically. Six years prior, a 57-year-old woman underwent laparoscopic salpingo-oophorectomy for a benign, cystic, ovarian tumour, but she had no history of malignancy. She was treated at an outpatient clinic for gastrointestinal complaints and was relieved of these symptoms. Abdominal computed tomography showed an incidental mesenteric tumour of the small intestine, tending toward growth. Due to the tumour's malignant potential, laparoscopic examination was performed. A spherical tumour with a base in the jejunum mesentery was observed. It was removed without damage. The post-operative course was uneventful, and the patient was discharged 3 days after the operation without complications. Histological diagnosis showed this to be a Schloffer tumour, but no malignancy was observed. Unidentified intraperitoneal tumours in patients with surgical histories may be Schloffer tumours, and this should be kept in mind.

Abstract Background Neuroendocrine tumors (NETs) of the gallbladder are rare and generally considered low-grade malignancies. We herein describe a case of a patient with a 0.8-cm clear cell NET G1 of the gallbladder with nodal involvement. Case presentation A 65-year-old man with no medical history indicative of von Hippel-Lindau (VHL) disease underwent laparoscopic cholecystectomy for cholecystolithiasis. There was a 0.8-cm tumor in the neck of the gallbladder. Histologic examination revealed nests or trabecular growth of clear cells with small round-to-oval nuclei. Immunohistochemically, tumor cells showed positivity for chromogranin A and synaptophysin; Ki-67 index was

Studies examining the effect of operator experience on the accuracy of static guided implant surgery have used postoperative computed tomography (CT) images to measure the error, with inconsistent results. The purpose of this study was to try to clarify this issue by using a measurement method based on the postoperative optical scan. Thirty dentists were divided into an experienced group and an inexperienced group. On a partially edentulous mandibular model in the manikin head, each dentist placed three implants via the stereolithographic (SLA) surgical guide. The implant positions were identified by a desktop scanner and compared with the planned positions using a metrology software program. No statistically significant differences were observed for any of the measured positional and angular deviations of the three implant sites between experienced and inexperienced operators (p > 0.01). All the mean values of deviations of the inexperienced group, except the depth deviation, were less than the experienced group. Implants inserted by dentists under 40 years old had significantly better accuracy than senior doctors in the global deviation at implant apex (p = 0.006). Within the limits of this study, we concluded that operator experience is not a critical factor in achieving the accuracy of guided implant surgery via the tooth-supported SLA surgical guide. Large deviations could occur even with the aid of the SLA surgical guide, and care must be taken to avoid errors for both experienced and inexperienced operators.

This study developed a promising approach (low-temperature plasma polymerization with allylamine) to modify the titanium (Ti) surface, which helps the damaged tissue to heal faster. The Ti surface was first cleaned by argon (Ar) plasma, and then the functional amino-groups were coated on the Ti surface via plasma polymerization. The topography characteristics, wettability, and optimal plasma modification parameters were investigated through atomic force spectroscopy, secondary ion mass spectroscopy, and response surface methodology (RSM). Analytical results showed that the formation of a porous surface was found on the Ar plasma-modified Ti surfaces after Ar plasma modification with different parameters. The Ar plasma modification is an effective approach to remove surface contaminants and generate a porous topography on the Ti surface. As the Ti with Ar plasma modification was at 100 W and 190 m Torr for 12 min, the surface exhibited the maximum hydrophilic performance. In the allylamine plasma modifications, the contact angle values of the allylamine plasma-modified Ti surfaces varied between 70.15° and 88.26° in the designed parameters. The maximum concentration of amino-groups (31.58 nmole/cm2) can be obtained from the plasma-polymerized sample at 80 W and 150 mTorr for 22 min. Moreover, the cell response also demonstrated that the allylamine plasma-modified Ti sample with an optimal modification parameter (80 W, 22 min, and 150 mTorr) possessed great potential to increase cell adhesion ability. Thus, the optimal parameters of the low-temperature plasma polymerization with allylamine can be harvested using the RSM design. These data could provide new scientific information in the surface modification of Ti implant.

We propose a tunnel field-effect transistor (TFET) having a trimmed gate (TG) structure, which considerably improves the subthreshold swing (SS). The TG structure truncates the needless long band-to-band tunneling (BTBT) paths to a “channel”, which normally appear in a conventional TFET, and realize a sudden switching to the on-state arising from a short BTBT path. Our simulations demonstrate that the TG-TFET can achieve an extremely steep SS, less than 10 mV/decade, in the double-gated Si-channel configuration. The TG structure also improves the ratio ION/IOFF to a value higher than that of ideal MOSFETs in the operation voltage range up to 0.35 V. The mechanism of steep switching is based on a simple modification of the gate electrostatic control; therefore, in addition to the demonstrated TFETs, the TG structure is universally applicable to many types of TFETs.

The scaled charge trapping (CT) type silicon on insulator (SOI) FinFET flash memories with different blocking layer materials of Al2O3 and SiO2 have successfully been fabricated, and their electrical characteristics including short-channel effect (SCE) immunity, threshold voltage (Vt) variability, and the memory characteristics have been comparatively investigated. It was experimentally found that the better SCE immunity and a larger memory window are obtained by introducing a high-k Al2O3 blocking layer instead of a SiO2 blocking layer. It was also confirmed that the variability of Vt before and after one program/erase (P/E) cycle is almost independent of the blocking layer materials.

A threshold voltage (Vth) controllable multigate FinFET on a 10-nm-thick ultrathin BOX (UTB) SOI substrate have been investigated. It is revealed that the Vth of the FinFET on the UTB SOI substrate is effectively modulated thanks to the improved coupling between the Si channel and the back gate. We have also carried out analysis of the Vth controllability in terms of the size dependence such as the gate length (LG) and the fin width (TFin).

Resin–dentin bonding was first achieved through mechanical hybridization between resin and collagen fibrils using a functional monomer containing resin system. In the last decade, new adhesive resin systems were frequently released onto the market within a short-period of time. Before and after commercialization, the bond integrity has been tested by bond tests, and leakage evaluation by researchers, but it is very difficult for clinicians to obtain a comprehensive, up-to-date understanding of their nature and degradation. Although newly developed adhesive resins have attempted to improve the bond strength at least in the first 24 h after bonding, the long-term durability of the bonds has not yet been established analytically. However, numerous recent studies have shown micromorphological evidence of biodegradation of resin–dentin bonds, due to hydrolysis of the resin and collagen fibrils within the bonds. This review mainly summarizes the most recent work in biodegradation of resin–dentin bonds based on micromorphological analyses of data obtained by scanning and transmission electron microscopy.