Inertial focusing in triangular microchannels with various apex angles

We consider inertial focusing of particles in channels with triangular cross sections. The number and the location of inertial focusing positions in isosceles triangular channels can change with varying blockage ratios (a/H) and Reynolds numbers (Re). In triangular channels, asymmetric velocity gradient induced by the sloped sidewalls leads to changes in the direction and the strength of the inertial lift forces. Therefore, varying the configuration (specifically, angle) of the triangular cross section is expected to lead to a better understanding of the nature of the inertial lift forces. We fabricated triangular microchannels with various apex angles using channel molds that were shaped by a planing process, which provides precise apex angles and sharp corners. The focusing position shift was found to be affected by the channel cross section, as expected. It was determined that the direction of the focusing position shift can be reversed depending on whether the vertex is acute or obtuse. More interestingly, corner focusing modes and splitting of the corner focusing were observed with increasing Re, which could explain the origin of the inertial focusing position changes in triangular channels. We conducted fluid dynamic simulations to create force maps under various conditions. These force maps were analyzed to identify the basins of attraction of various attractors and pinpoint focusing locations using linear stability analysis. Calculating the relative sizes of the basins of attractions and exhaustively identifying the focusing positions, which are very difficult to investigate experimentally, provided us a better understanding of trends in the focusing mechanism

Metastasis to the breast from colonic adenocarcinoma

A 63-year-old woman was referred to a breast surgeon with a breast mass discovered incidentally during follow-up study after colon cancer surgery. Invasive adenocarcinoma was revealed on core needle biopsy. Wide excision of the breast including the tumor was performed. On standard histological examination the tumor showed features of moderately differentiated adenocarcinoma. The immunohistochemistry study revealed positive results for cytokeratin (CK)20 and CDX2, but negative for CK7. These are typical characteristics for colon cancer. Considering her history of subtotal colectomy for sigmoid colon cancer, it is presumable that the mass in the breast was of colonic origin, and it was an extremely rare case of metastasis to the breast from primary colorectal neoplasm. Although the instance is rare, clinicians should keep the possibility of breast metastasis from colorectal cancer in mind for early and correct diagnosis

Is restrictive transfusion sufficient in colorectal cancer surgery? A retrospective study before and during the COVID-19 pandemic in Korea

Purpose Blood transfusion is one of the most common procedures used to treat anemia in colorectal surgery. Despite controversy regarding the adverse effects of blood products, surgeons have maintained standards for administering blood transfusions. However, this trend was restrictive during the COVID-19 pandemic because of a shortage of blood products. In this study, we conducted an analysis to investigate whether the restriction of blood transfusions affected postoperative surgical outcomes. Methods Medical records of 318 patients who underwent surgery for colon and rectal cancer at Ewha Womans University Mokdong Hospital between June 2018 and March 2022 were reviewed retrospectively. The surgical outcomes between the liberal and restrictive transfusion strategies in pre– and post–COVID-19 groups were analyzed. Results In univariate analysis, postoperative transfusion was associated with infectious complications (odds ratio [OR], 1.705; 95% confidence interval [CI], 1.015–2.865; P=0.044). However, postoperative transfusion was not an independent risk factor for the development of infectious complications in multivariate analysis (OR, 1.305; 95% CI, 0.749–2.274; P=0.348). In subgroup analysis, there was no significant association between infectious complications and the hemoglobin threshold level for the administration of a transfusion (OR, 1.249; 95% CI, 0.928–1.682; P=0.142). Conclusion During colorectal surgery, the decision to perform a blood transfusion is an important step in ensuring favorable surgical outcomes. According to the results of this study, restrictive transfusion is sufficient for favorable surgical outcomes compared with liberal transfusion. Therefore, modification of guidelines is suggested to minimize unnecessary transfusion-related side effects and prevent the overuse of blood products