Comparison of volume-controlled and pressure-controlled ventilation using a laryngeal mask airway during gynecological laparoscopy

Background: Several publications have reported the successful, safe use of Laryngeal Mask Airway (LMA)-Classic devices in patients undergoing laparoscopic surgery. However, there have been no studies that have examined the application of volume-controlled ventilation (VCV) or pressure-controlled ventilation (PCV) using a LMA during gynecological laparoscopy. The aim of this study is to compare how the VCV and PCV modes and using a LMA affect the pulmonary mechanics, the gas exchange and the cardiovascular responses in patients who are undergoing gynecological laparoscopy. Methods: Sixty female patients were randomly allocated to one of two groups, (the VCV or PCV groups). In the VCV group, baseline ventilation of the lung was performed with volume-controlled ventilation and a tidal volume of 10 ml/kg ideal body weight (IBW). In the PCV group, baseline ventilation of the lung using pressure-controlled ventilation was initiated with a peak airway pressure that provided a tidal volume of 10 ml/kg IBW and an upper limit of 35 cmH2O. The end-tidal CO2, the peak airway pressures (Ppeak), the compliance, the airway resistance and the arterial oxygen saturation were recorded at T1: 5 minutes after insertion of the laryngeal airway, and at T2 and T3: 5 and 15 minutes, respectively, after CO2 insufflation. Results: The Ppeak at 5 minutes and 15 minutes after CO2 insufflation were significantly increased compared to the baseline values in both groups. Also, at 5 minutes and 15 minutes after CO2 insufflation, there were significant differences of the Ppeak between the two groups. The compliance decreased in both groups after creating the pneumopertoneim (P < 0.05). Conclusions: Our results demonstrate that PCV may be an effective method of ventilation during gynecological laparoscopy, and it ensures oxygenation while minimizing the increases of the peak airway pressure after CO2 insufflation. ��� the Korean Society of Anesthesiologists, 2011

Hybrid passivation for foldable indium gallium zinc oxide thin-film transistors mediated by low-temperature and low-damage parylene-C/atomic layer deposition-AlOx coating

Indium gallium zinc oxide (IGZO) thin‐film transistors (TFTs) are primary components in active integrated electronics, such as displays and sensor arrays, which heavily involve high‐throughput passivation techniques during multilayer fabrication processes. Though oxide compound semiconductors are commonly used for providing uniform and robust passivation, it usually causes performance degradation on IGZO TFTs during passivation process. Herein, a parylene‐C and aluminum oxide (AlOx) hybrid passivation approach are introduced to reduce the damage during AlOx atomic layer deposition (ALD), which results in high‐performance depletion‐mode IGZO TFT to be fabricated on polyethylene naphthalate (PEN) substrate with enhanced bias stability. Compared with parylene‐C passivation, the hybrid‐passivated IGZO TFTs exhibit excellent saturation mobility (7.9 cm2 (V s)−1), ON/OFF ratio (107), hysteresis window (0.73 V), and bias stability (1.44 and −0.27 V threshold voltage shift, Vds = 20 V). Based on systematic Mott–Schottky and X‐ray diffraction characterizations, it is found that TFT performance enhancement is originated from their doping density variation that resulted from a parylene‐C/ALD‐AlOx microstructural hybridization. Finally, this method is implemented to wafer‐scale integrated circuits with high uniformity and a flexible 10 × 10 IGZO TFT backplane matrix on a PEN substrate (2.5 cm × 2.5 cm)

Nano-to-microporous networks via inkjet printing of ZnO nanoparticles/graphene hybrid for ultraviolet photodetectors

Inkjet-printed photodetectors have gained enormous attention over the past decade. However, device performance is limited without postprocessing, such as annealing and UV exposure. In addition, it is difficult to manipulate the surface morphology of the printed film using an inkjet printer because of the limited options of low viscosity ink solutions. Here, we employ a concept involving the control of the inkjet-printed film morphology via modulation of cosolvent vapor pressure and surface tension for the creation of a high-performance ZnO-based photodetector on a flexible substrate. The solvent boiling point across different cosolvent systems is found to affect the film morphology, which results in not only distinct photoresponse time but also photodetectivity. ZnO-based photodetectors were printed using different solvents, which display a fast photoresponse in low-boiling point solvents because of the low carbon residue and larger photodetectivity in high-boiling point solvent systems due to the porous structure. The porous structure is obtained using both gas–liquid surface tension differences and solid–liquid surface differences, and the size of porosity is modulated from nanosize to microsize depending on the ratio between two solvents or two nanomaterials. Moreover, the conductive nature of graphene enhances the transport behavior of the photocarrier, which enables a high-performance photodetector with high photoresponsivity (7.5 × 102AW–1) and fast photoresponse (0.18 s) to be achieved without the use of high-boiling point solvents

Coinfection of hepatitis A virus genotype IA and IIIA complicated with autoimmune hemolytic anemia, prolonged cholestasis, and false-positive immunoglobulin M anti-hepatitis E virus: a case report

A 37-year-old male presented with fever and jaundice was diagnosed as hepatitis A complicated with progressive cholestasis and severe autoimmune hemolytic anemia. He was treated with high-dose prednisolone (1.5 mg/kg), and eventually recovered. His initial serum contained genotype IA hepatitis A virus (HAV), which was subsequently replaced by genotype IIIA HAV. Moreover, at the time of development of hemolytic anemia, he became positive for immunoglobulin M (IgM) anti-hepatitis E virus (HEV). We detected HAV antigens in the liver biopsy specimen, while we detected neither HEV antigen in the liver nor HEV RNA in his serum. This is the first report of hepatitis A coinfected with two different genotypes manifesting with autoimmune hemolytic anemia, prolonged cholestasis, and false-positive IgM anti-HEV

Tumor evolution and intratumor heterogeneity of an epithelial ovarian cancer investigated using next-generation sequencing

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.Abstract Background The extent to which metastatic tumors further evolve by accumulating additional mutations is unclear and has yet to be addressed extensively using next-generation sequencing of high-grade serous ovarian cancer. Methods Eleven spatially separated tumor samples from the primary tumor and associated metastatic sites and two normal samples were obtained from a Stage IIIC ovarian cancer patient during cytoreductive surgery prior to chemotherapy. Whole exome sequencing and copy number analysis were performed. Omental exomes were sequenced with a high depth of coverage to thoroughly explore the variants in metastatic lesions. Somatic mutations were further validated by ultra-deep targeted sequencing to sort out false positives and false negatives. Based on the somatic mutations and copy number variation profiles, a phylogenetic tree was generated to explore the evolutionary relationship among tumor samples. Results Only 6% of the somatic mutations were present in every sample of a given case with TP53 as the only known mutant gene consistently present in all samples. Two non-spatial clusters of primary tumors (cluster P1 and P2), and a cluster of metastatic regions (cluster M) were identified. The patterns of mutations indicate that cluster P1 and P2 diverged in the early phase of tumorigenesis, and that metastatic cluster M originated from the common ancestral clone of cluster P1 with few somatic mutations and copy number variations. Conclusions Although a high level of intratumor heterogeneity was evident in high-grade serous ovarian cancer, our results suggest that transcoelomic metastasis arises with little accumulation of somatic mutations and copy number alterations in this patient

Lattice marginal reconstruction enabled high ambient-tolerance Perovskite Quantum Dots phototransistors

Perovskite quantum dots (PeQDs) have been developed rapidly as photoactive materials in hybrid phototransistors because of their strong light absorption, broad bandgap customizability, and defect-tolerance in charge-transport properties. The solvent treatment has been well recognized as a practical approach for improving the charge transport of PeQDs and the photoresponsivity of PeQD phototransistors. However, there is a lack of fundamental understanding of the origin of its impacts on the material’s ambient stability as well as phototransistor’s operational lifetime. Especially, the relationship between surface ligands dissociation and their microstructural reconstruction has not been fully elucidated so far. Herein, we report that a simultaneous enhancement of photoresponsivity and ambient tolerance for PeQD-based hybrid phototransistors can be realized via medium-polarity-solvent treatment on solid-state PeQDs. Our comprehensive optoelectronic characterization and electron microscopic study reveals that the crystal morphology, instead of surface ligands, is the dominating factor that results in the PeQD’s stability enhancement associated with the preservation of optical property and quantum confinement. Besides, we unveil a marginal reconstruction process occurred during solvent treatment, which opens up a new route for facets-oriented attachment of PeQDs along the zone axis to suppress the damage from water molecules penetration. Our study yields a new understanding of the solvent impact on PeQD microstructures reconstruction and suggests new routes for perovskite materials and corresponding device operational stability enhancement

Role of Amphipathic Helix of a Herpesviral Protein in Membrane Deformation and T Cell Receptor Downregulation

Lipid rafts are membrane microdomains that function as platforms for signal transduction and membrane trafficking. Tyrosine kinase interacting protein (Tip) of T lymphotropic Herpesvirus saimiri (HVS) is targeted to lipid rafts in T cells and downregulates TCR and CD4 surface expression. Here, we report that the membrane-proximal amphipathic helix preceding Tip's transmembrane (TM) domain mediates lipid raft localization and membrane deformation. In turn, this motif directs Tip's lysosomal trafficking and selective TCR downregulation. The amphipathic helix binds to the negatively charged lipids and induces liposome tubulation, the TM domain mediates oligomerization, and cooperation of the membrane-proximal helix with the TM domain is sufficient for localization to lipid rafts and lysosomal compartments, especially the mutivesicular bodies. These findings suggest that the membrane-proximal amphipathic helix and TM domain provide HVS Tip with the unique ability to deform the cellular membranes in lipid rafts and to downregulate TCRs potentially through MVB formation

Ultra-Sharp Nanowire Arrays Natively Permeate, Record, and Stimulate Intracellular Activity in Neuronal and Cardiac Networks

Intracellular access with high spatiotemporal resolution can enhance our understanding of how neurons or cardiomyocytes regulate and orchestrate network activity, and how this activity can be affected with pharmacology or other interventional modalities. Nanoscale devices often employ electroporation to transiently permeate the cell membrane and record intracellular potentials, which tend to decrease rapidly to extracellular potential amplitudes with time. Here, we report innovative scalable, vertical, ultra-sharp nanowire arrays that are individually addressable to enable long-term, native recordings of intracellular potentials. We report large action potential amplitudes that are indicative of intracellular access from 3D tissue-like networks of neurons and cardiomyocytes across recording days and that do not decrease to extracellular amplitudes for the duration of the recording of several minutes. Our findings are validated with cross-sectional microscopy, pharmacology, and electrical interventions. Our experiments and simulations demonstrate that individual electrical addressability of nanowires is necessary for high-fidelity intracellular electrophysiological recordings. This study advances our understanding of and control over high-quality multi-channel intracellular recordings, and paves the way toward predictive, high-throughput, and low-cost electrophysiological drug screening platforms.Comment: Main manuscript: 33 pages, 4 figures, Supporting information: 43 pages, 27 figures, Submitted to Advanced Material