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Introduction This study aimed to compare the clinical outcomes of silicon ring tourniquets and conventional pneumatic tourniquets in total knee arthroplasty (TKA). The study compared the operation time, total bleeding amount, length from the tourniquet distal end to the patella superior pole (L_TP), and complications related to the two tourniquet application methods and attempted to determine whether the silicon ring tourniquet has advantages over conventional pneumatic tourniquets. Materials and methods This prospective comparative study included 30 patients who underwent bilateral simultaneous TKA for degenerative osteoarthritis in August to December 2021. All patients underwent TKA on one side with a conventional pneumatic tourniquet, while TKA on the other side with a silicon ring tourniquet. The primary outcomes were the L_TP, operation time, tourniquet time, total bleeding amount, total drainage amount, and postoperative visual analog scale (VAS) score of the tourniquet applied site at 6, 24, and 48 h postoperatively. The secondary outcome was tourniquet-related complications in both groups. Results L_TP was significantly longer in the silicon ring tourniquet group compared with that in the pneumatic tourniquet group (20.22 ± 2.74 cm versus 15.12 ± 2.40, p Conclusions Silicon ring tourniquet application resulted in better clinical outcomes than conventional pneumatic tourniquets in TKA. Because we can obtain a wider surgical field using silicon ring tourniquets without complications, silicon ring tourniquets could be a substitute for conventional pneumatic tourniquets in total knee arthroplasty or distal femoral surgeries.

Introduction: The purpose of this study was to evaluate peripheral nerve block (PNB) effectiveness on postoperative pain management and surgical outcomes for displaced femoral-neck fracture in geriatric patients (>70 years) who underwent bipolar hemiarthroplasty (BHA). Methods: From January 2017 to December 2021, 231 geriatric patients with displaced femoral-neck fracture who consecutively underwent BHA were retrospectively reviewed. Patients were divided into two groups: patient-controlled analgesia (PCA) group (n=132) who received only intravenous (IV) PCA for postoperative pain management, and all others who received PNB with IV PCA (PNB+PCA) such as femoral nerve block or fascia iliaca compartment block after surgery (n=99). Primary outcomes were postoperative visual analog scale (VAS) at rest and during activity at 6, 24, and 48 hours postoperatively. Secondary outcomes were postoperative complications, changes in hemoglobin (Hb), length of hospital stay, and total morphine usage after surgery. Results: Postoperative resting VAS at 6 hours and 48 hours was significantly lower in the PNB+PCA group compared with the PCA group (p=0.075, p=0.0318, respectively). However, there was no significant difference in either resting VAS at 24 hours or active VAS. Complications of pneumonia and delirium until one month postoperative were significantly lower in the PNB + PCA group than the PCA group (p=0.0022, p=0.0055, respectively). Conclusion: PNB with IV PCA seems to have a beneficial effect on geriatric femoral-neck patients who underwent BHA with postoperative analgesia for reducing postoperative resting pain and complications, especially pneumonia and delirium.

Introduction This study aimed to compare the clinical outcomes of silicon ring tourniquets and conventional pneumatic tourniquets in total knee arthroplasty (TKA). The study compared the operation time, total bleeding amount, length from the tourniquet distal end to the patella superior pole (L_TP), and complications related to the two tourniquet application methods and attempted to determine whether the silicon ring tourniquet has advantages over conventional pneumatic tourniquets. Material and Methods This prospective comparative study included 30 patients who underwent bilateral simultaneous TKA for degenerative osteoarthritis in August to December 2021. All patients underwent TKA on one side with a conventional pneumatic tourniquet, while TKA on the other side with a silicon ring tourniquet. The primary outcomes were the L_TP, operation time, tourniquet time, total bleeding amount, total drainage amount, and postoperative visual analog scale (VAS) score at 6, 24, and 48 h postoperatively. The secondary outcome was tourniquet-related complications in both groups. Results L_TP was significantly longer in the silicon ring tourniquet group compared with that in the pneumatic tourniquet group (20.22 ± 2.74 cm versus 15.12 ± 2.40, p

The present study was conducted to investigate the inhibitory effects of the cell-free culture supernatant of L. curvatus Wikim 38 (LC38-CS) on RANKL-induced osteoclast differentiation and bone loss in a mice model of ovariectomy-induced post-menopausal osteoporosis. LC38-CS inhibited the RANKL-induced differentiation of bone marrow-derived macrophages (BMDMs) into osteoclasts in a dose-dependent manner. F-actin ring formation and bone resorption were also reduced by LC38-CS treatment of RANKL-treated BMDMs. In addition, LC38-CS decreased the RANKL-induced activation of the TRAF6/NF-κB/MAPKs axis at the early stage and the expression of osteoclastogenesis-related genes in BMDMs treated with RANKL. PRMT1 and ADMA levels, new biomarkers for osteoclastogenesis, were decreased by LC38-CS treatment. The administration of LC38-CS increased bone volume and bone mineral density (BMD) in ovariectomized (OVX) mice in μ-CT analysis. These findings suggest that LC38-CS inhibited RANKL-induced osteoclast differentiation via the downregulation of molecular mechanisms and exerted anti-osteoporotic effects.

Background Arginine methylation is a posttranslational modification mediated by protein arginine methyltransferases (PRMTs). Although previous studies have shown that PRMT1 contributes to the severity of allergic airway inflammation or asthma, the underlying mechanism is poorly understood. Objective This study aimed to explore the role of PRMT1 and its relevant mechanism in the development of allergic rhinitis (AR). Methods The expression levels of PRMTs and cytokines were determined by RT-PCR, and the localization of PRMT1 was determined by immunohistochemistry and confocal microscopy. The levels of house dust mite (HDM)-specific immunoglobulins in serum and of cytokines in nasal lavage fluids were determined by ELISA. PRMT1 inhibition was achieved by siRNA and treatment with the pan PRMT inhibitor arginine N-methyltransferase inhibitor-1. Results PRMT1 expression was significantly increased in the nasal mucosa of patients and mice with AR. The degree of eosinophilic infiltration in the nasal mucosa was reduced in PRMT1+/− AR mice compared with wild-type mice. PRMT1 haploinsufficiency reduced the levels of HDM-specific immunoglobulins in serum and those of TH2 (IL-4, IL-5, and IL-13) and epithelial (thymic stromal lymphopoietin [TSLP], IL-25, and IL-33) cytokines in the nasal lavage fluids of AR mice. In nasal epithelial cells, HDM and IL-4 cooperate to enhance PRMT1 expression through a mitogen-activated protein kinase–dependent pathway. In addition, PRMT1 was essential for the production of TSLP, IL-25, and IL-33 in response to HDM and IL-4. Arginine N-methyltransferase inhibitor-1 treatment alleviated AR in the mouse model. Conclusions PRMT1 plays an important role in AR development by regulating epithelial-derived cytokine production and might be a new therapeutic target for AR.

This article presents a 1.2-V, 1.8-Gb/s/pin 16-Tb NAND flash memory multi-chip package incorporating 16 dies of 1-Tb NAND flash memory and the third-generation F-chip. The proposed third-generation F-chip is developed to meet the performance requirements of a high-capacity storage device that adopts a PCIe Gen four-host interface for higher data throughput. It is implemented with dual bi-directional transceiver architecture and signal retiming scheme to maximize the valid data window opening on solid-state drive (SSD) channels. Also, it facilitates training between F-chip and NAND using an on-chip delay-locked loop whose locking is proposed in strobe-based NAND systems to achieve sufficient signal integrity (SI) of the in-package channel at a speed of 1.8 Gb/s/pin. Embedded built-in self-test evaluates un-selected paths and determines if re-training is required without losing data throughput performance. This work achieves a 35% improvement in the I/O operational speed performance and a 23% reduction in the I/O power consumption in comparison with the previous generations.

Memristive switching with digital set and multistep analog reset characteristics were demonstrated in tantalum oxide (Ta2O5)-based resistive random access memory (RRAM) devices using Ti and Ag top ...

A memristor is defined as a non-volatile memory switching two-terminal resistor, and a memristor with digital switching characteristics is widely studied as a next-generation non-volatile memory because of its simple structure, high integration density, and low power consumption. Recently, analog memristors with gradual resistance switching (RS) characteristics have garnered great attention because of their potential to implement artificial synapses that can emulate the brain functions. Transition metal oxides are thought to be strong candidate materials for the RS. In particular, tantalum oxide (TaO

Mycobacterium abscessus(MAB) is one of the rapidly growing, multidrug-resistant non-tuberculous mycobacteria (NTM) causing various diseases including pulmonary disorder. Although it has been known that type I interferons (IFNs) contribute to host defense against bacterial infections, the role of type I IFNs against MAB infection is still unclear. In the present study, we show that rIFN-β treatment reduced the intracellular growth of MAB in macrophages. Deficiency of IFN-α/β receptor (IFNAR) led to the reduction of nitric oxide (NO) production in MAB-infected macrophages. Consistently, rIFN-β treatment enhanced the expression of iNOS gene and protein, and NO production in response to MAB. We also found that NO is essential for the intracellular growth control of MAB within macrophages in an inhibitor assay using iNOS-deficient cells. In addition, pretreatment of rIFN-β before MAB infection in mice increased production of NO in the lungs at day 1 after infection and promoted the bacterial clearance at day 5. However, when alveolar macrophages were depleted by treatment of clodronate liposome, rIFN-β did not promote the bacterial clearance in the lungs. Moreover, we found that a cytosolic receptor nucleotide-binding oligomerization domain 2 (NOD2) is required for MAB-induced TANK binding kinase 1 (TBK1) phosphorylation and IFN-β gene expression in macrophages. Finally, increase in the bacterial loads caused by reduction of NO levels was reversed by rIFN-β treatment in the lungs of NOD2-deficient mice. Collectively, our findings suggest that type I IFNs act as an intermediator of NOD2-induced NO production in macrophages and thus contribute to host defense against MAB infection.

Problem Chorioamnionitis is caused by a bacterial infection that ascends from the vagina and can cause adverse pregnancy outcomes (APOs). Fusobacterium nucleatum (F. nucleatum) is a periodontal pathogen associated with the occurrence of APOs. In this study, we evaluated whether receptor-interacting protein kinase 2 (Ripk2), an adaptor protein of the cytosolic receptors nucleotide-binding oligomerization domain (NOD)1 and NOD2, in macrophages and human decidual stromal cells (hDSCs) contributes to immune responses against F. nucleatum. Method of study Bone marrow-derived macrophages (BMDMs) isolated from wild-type (WT) and Ripk2-deficient mice and hDSCs were cultured with F. nucleatum (MOI 1, 10, 100). BMDMs and hDSCs were assessed using enzyme-linked immunosorbent assay, Western blot analysis, real-time PCR, and nitrite assay. Results Fusobacterium nucleatum-induced production of IL-6, but not of TNF-α and IL-10, was lower in Ripk2-deficient BMDMs than in WT cells. Western blotting revealed a decrease in F. nucleatum-induced p65 phosphorylation in Ripk2-deficient macrophages, whereas mitogen-activated protein kinases activation was comparable between WT and Ripk2-deficient cells. The production of nitric oxide (NO) in response to F. nucleatum and the gene and protein expression of inducible NO synthase was impaired in Ripk2-deficient BMDMs. In hDSCs, F. nucleatum upregulated the gene and protein expression of NOD1, NOD2, and Ripk2 in a time-dependent manner. F. nucleatum also increased the production of IL-6, CXCL8, and CCL2, whereas this production was decreased by the Ripk2 inhibitors SB203580 and PP2. Conclusions In conclusion, Ripk2 signaling appears to contribute to the F. nucleatum-induced immune response and can be a preventive and therapeutic target against APOs.

A prominent mandible that gives a squared face in Asians is considered unattractive as it imparts a coarse and masculine image. Mandibular contouring surgery allows slender oval faces. The purpose of conventional mandible reduction is to make the lower face appear slim in frontal view and to have a smooth contour in lateral view. As shaping the lateral contour of the mandible alone may result in minimal improvement in the frontal view, surgical techniques to reduce the width of the lower face through narrowing genioplasty (i.e., the “V-line” surgery) and sagittal resection of the lateral cortex should be combined. Examination of the shape and symmetry, the relationship between the maxilla and the mandible, understanding overlying soft tissue contribution, and understanding the overall balance of the face are mandatory. An important factor influencing ideal facial shape is patient's personal preference, which is often influenced by his/her ethnic and cultural background. Especially when consulting patients of different nationalities or ethnic backgrounds, careful attention should be paid to the patient's aesthetic sensibility regarding the ideal or desirable facial shape. Narrowing the chin and modification of chin shape can be accomplished by narrowing genioplasty with central strip resection. This midsymphyseal sectioning procedure yields safe and very satisfactory results. This procedure not only augments the narrowing effect by leaving soft tissues attached to the bone but also enables modification of chin shape by altering the shape of resection. The surgeon should customize the surgery based on a comprehensive assessment of the patient's preoperative chin and mandible morphology complemented by an assessment of their aesthetic goals.

A memristor is defined as a non-volatile memory switching two-terminal resistor, and a memristor with digital switching characteristics is widely studied as a next-generation non-volatile memory because of its simple structure, high integration density, and low power consumption. Recently, analog memristors with gradual resistance switching (RS) characteristics have garnered great attention because of their potential to implement artificial synapses that can emulate the brain functions. Transition metal oxides are thought to be strong candidate materials for the RS. In particular, tantalum oxide (TaO x )-based memristive devices provide stable and durable switching characteristics. TaO x -based memristors utilize analog switching characteristics and have excellent durability and reliability, so they can be applied as artificial synaptic device. In this study, the characteristics of analog RS using Ta2O5-based memristive devices were investigated. The current level of the Pt/Ta2O5/Pt memristors was improved by adjusting the thickness of Ta2O5. In particular, when an indium-tin-oxide (ITO) buffer layer was added to Ta2O5 forming a Pt/ITO/Ta2O5/Pt heterostructured double-layer device, it showed more symmetrical potentiation and depression characteristics under both polarities than a single-layer device without ITO layer. The symmetrical and linear potentiation and depression characteristics are essential for the development of efficient memristor-based neuromorphic systems. Insertion of the ITO buffer layer improves linearity, symmetry, and stability of the analog RS properties of Ta2O5-based memristors to artificial synapses.

Helicobacter pylori is a gram-negative, microaerophilic, and spiral-shaped bacterium and causes gastrointestinal diseases in human. IL-1β is a representative cytokine produced in innate immune cells and is considered to be a key factor in the development of gastrointestinal malignancies. However, the mechanism of IL-1β production by neutrophils during H. pylori infection is still unknown. We designed this study to identify host and bacterial factors involved in regulation of H. pylori-induced IL-1β production in neutrophils. We found that H. pylori-induced IL-1β production is abolished in NLRP3-, ASC-, and caspase-1/11-deficient neutrophils, suggesting essential role for NLRP3 inflammasome in IL-1β response against H. pylori. Host TLR2, but not TLR4 and Nod2, was also required for transcription of NLRP3 and IL-1β as well as secretion of IL-1β. H. pylori lacking cagL, a key component of the type IV secretion system (T4SS), induced less IL-1β production in neutrophils than did its isogenic WT strain, whereas vacA and ureA were dispensable. Moreover, T4SS was involved in caspase-1 activation and IL-1β maturation in H. pylori-infected neutrophils. We also found that FlaA is essential for H. pylori-mediated IL-1β production in neutrophils, but not dendritic cells. TLR5 and NLRC4 were not required for H. pylori-induced IL-1β production in neutrophils. Instead, bacterial motility is essential for the production of IL-1β in response to H. pylori. In conclusion, our study shows that host TLR2 and NLRP3 inflammasome and bacterial T4SS and motility are essential factors for IL-1β production by neutrophils in response to H. pylori.IMPORTANCEIL-1β is a representative pro-inflammatory cytokine and is considered to be a central host factor for the development of gastric cancers. Although neutrophils have been considered to be involved in H. pylori-induced gastric inflammation, the underlying mechanism by which H. pylori triggers IL-1β production in neutrophils remains to be defined. In this study, our data suggested a critical role for the host TLR2 and NLRP3 inflammasome in IL-1β production by neutrophil during H. pylori infection. Moreover, we found the bacterial factors, T4SS and FlaA, to be essential for IL-1β production and NLRP3 activation during the course of H. pylori infection. Our current findings provide detailed molecular genetic mechanisms associated with IL-1β production in neutrophils in response to H. pylori infection, which can serve as innovative anti-inflammatory targets to reduce H. pylori-induced gastric malignancies.

A 1.2 V, 1.8 Gb/s/pin 16Tb-NAND flash memory multi-chip package incorporating with 16-dies of 1-Tb NAND flash memory and the 3rd generation F-Chip is proposed. The proposed F-Chip is developed to meet the performance requirements of high capacity storage devices that adopts PCIe Gen 4 host interface for faster data throughput. It is implemented with Toggle 4.0 standard on dual bi-directional transceiver architecture to achieve maximum valid data window on SSD channels. Also, it facilitates training between F-chip and NAND using on chip DLL and BIST to achieve sufficient signal integrity on in-package channel for 1.8Gb/s/pin. This work achieves a 35% improvement in the I/O operational speed performance and a 23% reduction in the I/O power consumption in comparison with the previous generations.

Acinetobacter baumannii is known for its multidrug antibiotic resistance. New approaches to treating drug-resistant bacterial infections are urgently required. Cathelicidin-related antimicrobial peptide (CRAMP) is a murine antimicrobial peptide that exerts diverse immune functions, including both direct bacterial cell killing and immunomodulatory effects. In this study, we sought to identify the role of CRAMP in the host immune response to multidrug-resistant Acinetobacter baumannii. Wild-type (WT) and CRAMP knockout mice were infected intranasally with the bacteria. CRAMP−/− mice exhibited increased bacterial colony-forming units (CFUs) in bronchoalveolar lavage (BAL) fluid after A. baumannii infection compared to WT mice. The loss of CRAMP expression resulted in a significant decrease in the recruitment of immune cells, primarily neutrophils. The levels of IL-6 and CXCL1 were lower, whereas the levels of IL-10 were significantly higher in the BAL fluid of CRAMP−/− mice compared to WT mice 1 day after infection. In an in vitro assay using thioglycollate-induced peritoneal neutrophils, the ability of bacterial phagocytosis and killing was impaired in CRAMP−/− neutrophils compared to the WT cells. CRAMP was also essential for the production of cytokines and chemokines in response to A. baumannii in neutrophils. In addition, the A. baumannii-induced inhibitor of κB-α degradation and phosphorylation of p38 MAPK were impaired in CRAMP−/− neutrophils, whereas ERK and JNK phosphorylation was upregulated. Our results indicate that CRAMP plays an important role in the host defense against pulmonary infection with A. baumannii by promoting the antibacterial activity of neutrophils and regulating the innate immune responses.

Acinetobacter baumannii is known for its multidrug antibiotic resistance. New approaches to treating drug-resistant bacterial infections are urgently required. Cathelicidin-related antimicrobial peptide (CRAMP) is a murine antimicrobial peptide that exerts diverse immune functions, including both direct bacterial cell killing and immunomodulatory effects. In this study, we sought to identify the role of CRAMP in the host immune response to multidrug-resistant Acinetobacter baumannii. Wild-type (WT) and CRAMP knockout mice were infected intranasally with the bacteria. CRAMP-/- mice exhibited increased bacterial colony-forming units (CFUs) in bronchoalveolar lavage (BAL) fluid after A. baumannii infection compared to WT mice. The loss of CRAMP expression resulted in a significant decrease in the recruitment of immune cells, primarily neutrophils. The levels of IL-6 and CXCL1 were lower, whereas the levels of IL-10 were significantly higher in the BAL fluid of CRAMP-/- mice compared to WT mice 1 day after infection. In an in vitro assay using thioglycollate-induced peritoneal neutrophils, the ability of bacterial phagocytosis and killing was impaired in CRAMP-/- neutrophils compared to the WT cells. CRAMP was also essential for the production of cytokines and chemokines in response to A. baumannii in neutrophils. In addition, the A. baumannii-induced inhibitor of κB-α degradation and phosphorylation of p38 MAPK were impaired in CRAMP-/- neutrophils, whereas ERK and JNK phosphorylation was upregulated. Our results indicate that CRAMP plays an important role in the host defense against pulmonary infection with A. baumannii by promoting the antibacterial activity of neutrophils and regulating the innate immune responses.

The occlusal plane angle is an important factor in lateral facial aesthetics. Low occlusal plane facial profiles appear planar and long-faced, whereas high occlusal plane facial profiles are considered more attractive, especially in Asian regions. Clockwise rotation of the occlusal plane for truly aesthetic purposes can be accomplished with double jaw surgery, without need for orthodontic treatments. Patients with normal occlusion who desired to improve their lateral facial aesthetics were included in this study. A conventional Le Fort I osteotomy was followed by a sagittal split ramus osteotomy under general anesthesia. The movement of the maxillomandibular complex was determined in accord with a preoperative analysis. From 2015 to 2017, 43 patients with normal occlusion underwent double jaw surgery without orthodontic treatment. Whereas all patients were subjectively satisfied with the surgery, two underwent orthodontic treatment to correct mild occlusal discrepancies noticed after surgery. There were no delayed occlusal problems or relapses reported during the study. For patients who desired to improve their lateral facial aesthetics but had normal occlusion, orthognathic surgery without orthodontic treatment can be effective. Clockwise rotation of the occlusal plane by double jaw surgery without orthodontic treatment resulted in satisfactory aesthetic outcomes with stable and reliable long-term results. CLINICAL QUESTION/LEVEL OF EVIDENCE:: Therapeutic, IV.

Helicobacter pylori is a gram-negative, microaerophilic, and spiral-shaped bacterium and causes gastrointestinal diseases in human. IL-1β is a representative cytokine produced in innate immune cells and is considered to be a key factor in the development of gastrointestinal malignancies. However, the mechanism of IL-1β production by neutrophils during H. pylori infection is still unknown. We designed this study to identify host and bacterial factors involved in regulation of H. pylori-induced IL-1β production in neutrophils. We found that H. pylori-induced IL-1β production is abolished in NLRP3-, ASC-, and caspase-1/11-deficient neutrophils, suggesting essential role for NLRP3 inflammasome in IL-1β response against H. pylori. Host TLR2, but not TLR4 and Nod2, was also required for transcription of NLRP3 and IL-1β as well as secretion of IL-1β. H. pylori lacking cagL, a key component of the type IV secretion system (T4SS), induced less IL-1β production in neutrophils than did its isogenic WT strain, whereas vacA and ureA were dispensable. Moreover, T4SS was involved in caspase-1 activation and IL-1β maturation in H. pylori-infected neutrophils. We also found that FlaA is essential for H. pylori-mediated IL-1β production in neutrophils, but not dendritic cells. TLR5 and NLRC4 were not required for H. pylori-induced IL-1β production in neutrophils. Instead, bacterial motility is essential for the production of IL-1β in response to H. pylori. In conclusion, our study shows that host TLR2 and NLRP3 inflammasome and bacterial T4SS and motility are essential factors for IL-1β production by neutrophils in response to H. pylori.

The resistive switching characteristics of MnO and CeO2 layers with a large resistance ratio (> 105) were demonstrated. The Ag/MnO/CeO2/Pt devices with heterostructures were fabricated. The bipolar resistive switching behaviors were caused by the formation and disruption of conducting filaments in the switching layers. In CeO2 layer, the formation and rupture of conducting filaments was attributed to the reduction-oxidation reaction of CeO2 and CeO2 − x. The conduction mechanisms of ohmic conduction and Schottky emission had been investigated for resistance switching mechanism.

Interleukin-10 plays important, yet contrasting, roles in host protection against bacterial infections and in the septic response. To determine the role of IL-10 in the host defense against Acinetobacter baumannii infection, wild-type (WT) and IL-10-deficient mice were infected intranasally with the bacteria. IL-10-deficient mice exhibited increased mortality, severe pathology, and excess production of proinflammatory cytokines and chemokines in the lungs, and increased bacterial burdens in bronchoalveolar lavage (BAL) fluids and lung homogenates after A. baumannii infection, compared to WT mice. Intranasal administration of recombinant IL-10 rescued mice from the lethality of the bacterial infection by promoting bacterial clearance and reducing production of cytokines and chemokines in the lungs. In vitro experiments revealed that IL-10 enhanced phagocytosis and bacterial killing by macrophages by upregulating the macrophage receptor with collagenous structure (MARCO). In addition, A. baumannii-induced activation of STAT3 was impaired in IL-10-deficient macrophages, which was essential for expression of MARCO. Intranasal adoptive transfer of WT macrophages resulted in significant increases in mice survival and bacterial clearance in IL-10-deficient mice infected with A. baumannii. Our results show that IL-10 played an important role in the host defense against pulmonary infection of A. baumannii by promoting the antibacterial function of macrophages by regulating MARCO expression through the STAT3-mediated pathway.

Reduction of mid-face width is a major concern in Asian facial contouring surgery, and some patients want their mild or borderline problems to be improved in a minimally invasive manner. The authors' mini-zygoma reduction surgery technique is indicated for patients who seek both minimal invasiveness and reliability. Patients presenting with a wide mid-face and isolated zygomatic arch protrusion without severe zygomatic body prominence were included into the study. All surgeries are performed under local anesthesia and on an outpatient basis. Through temporal and sideburn incisions, complete osteotomy was performed on the temporal process of the zygomatic body and just in front of the anterior tubercle of the zygomatic arch. After transposition to a proper inward position, the osteotomized segment was rigidly fixed on the zygomatic arch with metal fixtures. All surgeries were successfully performed without excessive blood loss or any unpredicted events. Over the 6 to 18-month follow-up period, most patients were satisfied with the aesthetic results of the surgery, the rapid recovery, and the minimal postoperative swelling. Even with a 1-point fixation, the segment remained stable and did not show displacement of the bony segment. In patients showing a minimal zygomatic arch prominence and seeking minimally invasive surgery, the proposed technique can be a proper surgical option with reliable and predictable results. The surgery can be performed without general anesthesia and on an outpatient basis, thereby resulting in prompt postoperative recovery. Predictability and reliability is assured with rigid fixation with a metal fixture on the zygomatic arch.

In our study, the devices with Pt/Ti/TaOx/Pt, where x ranges from 1.34 to 1.47, Pt/Ti/HfO2/Pt and Pt/Ti/TaOy/HfO2/Pt were fabricated. The TaOx and HfO2 were the switching layers for single layer devices and for hybrid device TaOy acted as oxygen reservoir and HfO2 acted as switching layer. The single layer devices exhibited co-existence of bipolar and unipolar switching. For bipolar switching the SET process occurred when positive sweep voltage was applied and RESET process occurred for negative sweep. The transition from bipolar to unipolar was observed to be irreversible. The hybrid device exhibited the unipolar switching with two high resistance state (HRS) levels. Moreover, the conduction mechanism of ohmic conduction, space charge limited conduction (SCLC); Schottky conduction and Poole-Frenkel (P-F) conduction have been investigated. Display Omitted The resistive switching behavior of tantalum oxide, hafnium oxide and their hybrid devices are studied.The tantalum oxide and hafnium oxide monolayer devices exhibited co-existence of unipolar and bipolar switching.The transition from bipolar to unipolar switching is observed to be irreversible for the mono layer devices.The hybrid device with structure Pt/Ti/TaOx/HfO2/Pt presented only unipolar switching.The resistive switching was improved by the fabrication of hybrid device.

Backgroud To compare the risk of low back pain (LBP) and related spinal diseases between smokers (exposure group) and nonsmokers (non-exposure group). No large registry study has so far investigated the association between smoking and LBP-related spinal diseases such as intervertebral disc disease, spinal stenosis, spinal instability, and spondylolisthesis. Methods A random sample was taken from the Korean National Health Insurance Research Database. In total, 204,066 men (160,105 smokers, 43,961 nonsmokers) who were followed up between 2002 and 2013 were included in the analysis. Patients with previous back pain or spinal disease in 2003 and 2004, patients with inappropriate data, and women (due to the lower percentage of smokers) were excluded. The Cox proportional hazard model was used to investigate the risk of LBP and related spinal diseases associated with smoking, while adjusting for demographic, clinical, and socioeconomic factors. Results The overall median follow-up period was 5.6 years (interquartile range, 3.48–8.43 years). Compared to the nonsmoker group, the smoker group had a higher incidence of LBP (p = 0.01), intervertebral disc disease (p < 0.001), spinal stenosis (p = 0.004), spinal instability (p < 0.001), and spondylolisthesis (p = 0.023). Compared to the nonsmoker group, the smoker group had a higher adjusted hazard ratio (HR) per year of LBP (HR, 1.18; 95% confidence interval [CI], 1.15 to 1.21), intervertebral disc disease (HR, 1.25; 95% CI, 1.21 to 1.30), spinal stenosis (HR, 1.52; 95% CI, 1.41 to 1.64), spinal instability (HR, 1.33; 95% CI, 1.24 to 1.44), and spondylolisthesis (HR, 1.49; 95% CI, 1.23 to 1.80). Conclusions Smokers in male samples were at higher risk for LBP and related spinal diseases than nonsmokers.

BACKGROUND Sagittal resection of the mandible has been widely used to reduce the width of the lower face and is usually carried out in combination with a mandibular contouring procedure. However, the surgical outcomes of this procedure are unclear because sagittal resection is rarely performed as a single procedure. The authors clarify misunderstandings regarding this procedure and introduce an improved strategic approach for sagittal resection of the mandible. METHODS Under general anesthesia, mandible contouring was performed first with a curved osteotomy, followed by sagittal resection of the outer cortex of mandible. The amount and extent of each procedure was determined in accordance with preoperative analysis. RESULTS From 2012 to 2014, a consecutive series of 212 patients who underwent mandible contouring surgery without concomitant chin surgery were included in the study. A total of 189 patients underwent both mandibular contouring surgery and sagittal resection, whereas 13 underwent only sagittal resection and 10 underwent only mandibular contouring surgery. All operations were carried out successfully without any severe complications, and most patients had satisfactory aesthetic outcomes. CONCLUSIONS The authors found that the sagittal resection of the mandible should be performed in accordance with the shape of the mandible to effectively reduce facial width and achieve better aesthetic outcomes for both profile and frontal views. In an outcurved-type mandible, conventional mandibular contouring may be effective alone, whereas sagittal resection focusing on removing the mandible body region is essential for incurved-type mandibles. In straight line-type mandibles, both procedures are necessary. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.

The resistive random access memory (RRAM) devices with heterostuctures have been investigated due to cycling stability, nonlinear switching, complementary resistive switching and self-compliance. The heterostructured devices can modulate the resistive switching (RS) behavior appropriately by bilayer structure with a variety of materials. In this study, the bipolar resistive switching characteristics of the bilayer structures composed of Ta

Endometrioid stromal sarcoma is a rare malignancy that originates from mesenchymal cells. It is classified into low-grade endometrioid stromal sarcoma (LGESS) and high-grade endometrioid stromal sarcoma. Ultrasonographic findings of LGESS resemble those of submucosal myomas, leading to the possible preoperative misdiagnosis of LGESS as uterine leiomyoma. Electronic morcellation during laparoscopic surgery in women with LGESS can result in iatrogenic intraabdominal dissemination and a poorer prognosis. Here, we report a patient with LGESS who underwent a supracervical hysterectomy and electronic morcellation for a presumed myoma in another hospital. Disseminated metastatic lesions of LGESS in the posterior cul-de-sac and rectal serosal surface were absent on primary surgery, but found during reexploration. In conclusion, when LGESS is found incidentally following previous morcellation during laparoscopic surgery for presumed benign uterine disease, we highly recommend surgical reexploration, even when there is no evidence of a metastatic lesion in imaging studies.

Alternating field causes energy loss due to induced back electromotive force (EMF) to high-temperature superconducting (HTS) coils in the superconducting electric machines. Therefore, a method of reducing the effects of the alternating fields on the HTS coils in superconducting machines according to the winding insulation conditions has been investigated. In addition, the HTS coils cowound with turn-to-turn inserted materials to control the time constant has been proposed. The charge-discharge delay can be determined with the time constant, also the time constant is related to the radial directional resistance of the no-insulation coil. The variation of the radial resistance would affect the reduction effect of ac disturbance on the no-insulation coil. Therefore, trade-off between the reduction effect of the alternating disturbance and charge-discharge delay could be considered. In this paper, we evaluated the effects of alternating magnetic fields on the HTS coils according to the varying radial resistance caused by cowinding method with metal tapes in liquid nitrogen. Four types of the HTS coils are: 1) no-insulation coil, 2) cowound coil with copper tape, 3) cowound coil with stainless steel tape and 4) insulation coil which have different radial resistance respectively. The experimental result shows that the co-winding method can be applicable in the superconducting electric machines.

OBJECTIVE The purpose of this study was to evaluate the expression of epidermal growth factor-like domain 7 (EGFL7) in epithelial ovarian cancer, and to assess its relevance to clinicopathological characteristics and patients' survival. METHODS A total of 177 patients with epithelial ovarian cancer were enrolled in the current study. For each patient, a retrospective review of medical records was conducted. Immunohistochemical staining for EGFL7 was performed using tissue microarrays made with paraffin-embedded tissue block. EGFL7 expression levels were graded on a grade of 0 to 3 based on the percentage of positive cancer cells. We analyzed the correlations between the expression of EGFL7 and various clinical parameters, and also analyzed the survival outcome according to the EGFL7 expression. RESULTS The expression of EGFL7 in ovarian cancer tissues was observed in 98 patients (55.4%). High expression of EGFL7 (grade 2 or 3) was significantly correlated with pathologic type, differentiation, stage, residual tumor after debulking surgery, lymphovascular space involvement, lymph node metastasis, high cancer antigen 125, peritoneal cytology, and ascites. Among these clinicopathologic factors, differentiation was significantly correlated with EGFL7 expression in multivariate analysis (p

The T-osteotomy technique is widely performed to improve lower face aesthetics. During this narrowing genioplasty procedure, metal fixtures are required to rigidly fix the bone segments. Specifically, the use of biodegradable osteofixations has become a viable surgical option as more patients now have the desire to surreptitiously undergo aesthetic surgery. The present report describes a narrowing genioplasty procedure with the use of biodegradable screws only. When the T-osteotomy technique was performed to narrow the chin, the bone segments were first temporarily fixed with a 4-hole titanium plate and screws. Later during the operation, the plate and screws were replaced with 4 biodegradable screws with bicortical fixation. Completion of bone healing can be confirmed by follow-up radiographs taken 6 months after the surgery. Despite increasing demand for the use of absorbable materials in aesthetic surgeries, biodegradable fixation systems have not been widely used for aesthetic surgeries due to a perception of high cost, inconvenient manipulation, prolonged operative time, and suspicions on long-term stability. Our novel method of using only biodegradable screws allows such limitations to be easily overcome by surgeons.

The pedicled buccal fat pad has occasionally been used for the closure of oroantral and oronasal fistulae. However, this versatile and convenient technique has not been used widely in the field of esthetic surgery. The main cosmetic interest in the buccal fat pads was to surgically extract them to reduce cheek prominence. Here, the authors introduce a novel operative technique using the pedicled buccal fat pad for midface augmentation in patients with deficient soft-tissue volume, particularly in the anterior malar or paranasal region. This rather simple surgical method can be performed either individually or concomitantly with reduction malarplasty. The surgical outcomes include a natural appearance with reliable long-term stability.

1. Conventional mandible contouring surgery usually involves the chin narrowing procedure that is combined with mandible angle reduction, which is renowned as the “V-line surgery.” 2. In cases with a disproportionately wide chin without an excessive mandible angle, it is possible to achieve a well-balanced lower face by narrowing only the anterior portion of the mandible and leaving the mandible angle. 3. Patients with unsatisfactory results after previous mandible contouring surgeries can also be considered eligible for this “mini V-line surgery” procedure. 4. Under general anesthesia, narrowing genioplasty is performed by the T-osteotomy technique followed by further reduction of the bony steps at the chin-mandible junction. 5. Postoperative complications such as transient neurosensory loss, soft-tissue sagging, surgical site infections, and hematoma are reported, while other complications such as asymmetry, over- and under-correction, unexpected fractures, malunion or nonunion of the bone segments, and facial paralysis may occur. 6. Surgeons planning lower face contouring surgery should consider the “mini V-line surgery” to achieve aesthetically harmonic and pleasing results in properly selected cases.

1. More patients are willing to undergo a secondary mandibular contouring procedure due to dissatisfactory aesthetic results of the prior surgery. 2. Lack of a combined narrowing genioplasty procedure during mandibular contouring may cause a disproportionately broad chin. Additional chin narrowing surgery is required in such cases. 3. Excessive resection in the mandible angle region can result in an unnatural and hollow appearance. Implants may be used to correct the overly resected jaw contours. 4. Postoperative jawline asymmetry, irregular and uneven jaw contours and ‘secondary angle’ formation may result from technical faults during the surgery. Further bone contouring can improve these aesthetically unfavourable conditions.

1. Considerations on facial aesthetics, facial expression muscles, branches of the facial nerve and sensory nerves must be made before the placement of incisions on the face. 2. The intraoral approach is the main approach for most facial bone contouring surgeries, as incisions in the oral cavity allow superb exposure of most of the facial skeleton with a completely hidden scar. 3. The bicoronal approach is a versatile surgical approach to the upper and middle facial skeleton including the zygomatic arch. The scars can be hidden within the hairline while providing excellent access. 4. Transcutaneous incisions such as the Gillies’ approach and incision on the sideburn region are used to excess the zygoma. Scars from the Gillies’ approach can be hidden within the hairline, while sideburn incisions allow direct excess to the posterior zygomatic arch. 5. Approaches through the lower eyelid, including the subciliary incision or the transconjunctival incision, offer good exposure to the inferior orbital rim, lower part of the lateral orbital rim and the upper region of the zygoma body. Especially in transconjunctival approaches, the scar is hidden within the conjunctiva.