Comparative Review of the Treatment Methodologies of Carotid Stenosis

The treatment of carotid stenosis entails three methodologies, namely, medical management, carotid angioplasty and stenting (CAS), as well as carotid endarterectomy (CEA). The North American Symptomatic Carotid Endarterectomy Trial (NASCET) and European Carotid Surgery Trial (ECST) have shown that symptomatic carotid stenosis greater than 70% is best treated with CEA. In asymptomatic patients with carotid stenosis greater than 60%, CEA was more beneficial than treatment with aspirin alone according to the Asymptomatic Carotid Atherosclerosis (ACAS) and Asymptomatic Carotid Stenosis Trial (ACST) trials. When CAS is compared with CEA, the CREST resulted in similar rates of ipsilateral stroke and death rates regardless of symptoms. However, CAS not only increased adverse effects in women, it also amplified stroke rates and death in elderly patients compared with CEA. CAS can maximize its utility in treating focal restenosis after CEA and patients with overwhelming cardiac risk or prior neck irradiation. When performing CEA, using a patch was equated to a more durable result than primary closure, whereas eversion technique is a new methodology deserving a spotlight. Comparing the three major treatment strategies of carotid stenosis has intrinsic drawbacks, as most trials are outdated and they vary in their premises, definitions, and study designs. With the newly codified best medical management including antiplatelet therapies with aspirin and clopidogrel, statin, antihypertensive agents, strict diabetes control, smoking cessation, and life style change, the current trials may demonstrate that asymptomatic carotid stenosis is best treated with best medical therapy. The ongoing trials will illuminate and reshape the treatment paradigm for symptomatic and asymptomatic carotid stenosis

Towards molecular electronics with large-area molecular junctions

Electronic transport through single molecules has been studied extensively by academic(1-8) and industrial(9,10) research groups. Discrete tunnel junctions, or molecular diodes, have been reported using scanning probes(11,12), break junctions(13,14), metallic crossbars(6) and nanopores(8,15). For technological applications, molecular tunnel junctions must be reliable, stable and reproducible. The conductance per molecule, however, typically varies by many orders of magnitude(5). Self-assembled monolayers (SAMs) may offer a promising route to the fabrication of reliable devices, and charge transport through SAMs of alkanethiols within nanopores is well understood, with non-resonant tunnelling dominating the transport mechanism(8). Unfortunately, electrical shorts in SAMs are often formed upon vapour deposition of the top electrode(16-18), which limits the diameter of the nanopore diodes to about 45 nm. Here we demonstrate a method to manufacture molecular junctions with diameters up to 100 mu m with high yields (>95 per cent). The junctions show excellent stability and reproducibility, and the conductance per unit area is similar to that obtained for benchmark nanopore diodes. Our technique involves processing the molecular junctions in the holes of a lithographically patterned photoresist, and then inserting a conducting polymer interlayer between the SAM and the metal top electrode. This simple approach is potentially low-cost and could pave the way for practical molecular electronics

Measuring relative barrier heights in molecular electronic junctions with transition voltage spectroscopy

Though molecular devices exhibiting potentially useful electrical behavior have been demonstrated, a deep understanding of the factors that influence charge transport in molecular electronic junctions has yet to be fully realized. Recent work has shown that a mechanistic transition occurs from direct tunneling to field emission in molecular electronic devices. The magnitude of the voltage required to enact this transition is molecule-specific, and thus measurement of the transition voltage constitutes a form of spectroscopy. Here we determine that the transition voltage for a series of alkanethiol molecules is invariant with molecular length, while the transition voltage of a conjugated molecule depends directly on the manner in which the conjugation pathway has been extended. Finally, by examining the transition voltage as a function of contact metal, we show that this technique can be used to determine the dominant charge carrier for a given molecular junction

Ru<SUB>2</SUB>(ap)<SUB>4</SUB>(&#963;-oligo(phenyleneethynyl)) molecular wires: synthesis and electronic characterization

Reported in this contribution are the synthesis, characterization, and charge transport properties of wire-like Ru2(ap)4(OPEn), where ap is 2-anilinopyridinate and OPE is -(C&#8801;CC6H4)nSCH2CH2SiMe3 with n=1 (1) and 2 (2). Scanning tunneling microscopy (STM) measurements of compound 2 inserted into a SAM of C11 thiol reveal that molecule 2 exhibits (i) the stochastic switching characteristic of wire molecules embedded in insulating SAMs and (ii) higher conductivity than the C11 thiol SAM. More importantly, analysis of the molecular electronic decay constant (&#946;) exhibits a decrease of at least 15% as compared to purely organic molecular analogues. Hence, the transport characteristics of molecules can be significantly improved for nanoscale electronics through the incorporation of a Ru2 fragment into conjugated backbone

Molecularly inherent voltage-controlled conductance switching

Molecular electronics has been proposed as a pathway for high-density nanoelectronic devices. This pathway involves the development of a molecular memory device based on reversible switching of a molecule between two conducting states in response to a trigger, such as an applied voltage. Here we demonstrate that voltage-triggered switching is indeed a molecular phenomenon by carrying out studies on the same molecule using three different experimental configurations-scanning tunnelling microscopy, crossed-wire junction, and magnetic-bead junction. We also demonstrate that voltage-triggered switching is distinctly different from stochastic switching, essentially a transient (time-dependent) phenomenon that is independent of the applied voltage

An engineered virus as a scaffold for three-dimensional self-assembly on the nanoscale

Exquisite control over positioning nanoscale components on a protein scaffold allows bottom-up self-assembly of nanodevices. Using cowpea mosaic virus, modified to express cysteine residues on the capsid exterior, gold nanoparticles were attached to the viral scaffold to produce specific interparticle distances (see picture). The nanoparticles were then interconnected using thiol-terminated conjugated organic molecules that act as "molecular wires", resulting in a 3D spherical conductive network, which is only 30 nm in diameter