Acral Metastasis in a Patient with Ampullary Carcinoma

Although Skin Metastasis From A Malignant Tumor Of An Internal Organ Usually Occurs At An Advanced Disease Stage, There Has Been No Prior Report Of A Cutaneous Acral Metastasis From Ampullary Carcinoma To Date. We Report A 71-year Old Male Patient With Cutaneous Metastasis From An Ampullary Adenocarcinoma. The Patient Had A History Of Pylorus Preserving Pancreaticoduodenectomy For Carcinoma Of The Ampulla Of Vater Two Years Prior To Presentation. Physical Examination Revealed Ill-defined, Painful And Hard Erythematous Nodules At The Left Thumb And Distal Phalanx Of The Right Middle Finger. The Computed Tomography Scan Showed Low Density Masses In The Retroperitoneum; The Histological Examination Of A Nodule From The Right Middle Finger Showed A Metastatic Adenocarcinoma. This Case Illustrates That Cutaneous Metastasis From Ampullary Carcinoma Has A Poor Prognosis

Efficacy and Safety of Enavogliflozin versus Dapagliflozin as Add-on to Metformin in Patients with Type 2 Diabetes Mellitus: A 24-Week, Double-Blind, Randomized Trial

Background Enavogliflozin is a novel sodium-glucose cotransporter-2 inhibitor currently under clinical development. This study evaluated the efficacy and safety of enavogliflozin as an add-on to metformin in Korean patients with type 2 diabetes mellitus (T2DM) against dapagliflozin. Methods In this multicenter, double-blind, randomized, phase 3 study, 200 patients were randomized to receive enavogliflozin 0.3 mg/day (n=101) or dapagliflozin 10 mg/day (n=99) in addition to ongoing metformin therapy for 24 weeks. The primary objective of the study was to prove the non-inferiority of enavogliflozin to dapagliflozin in glycosylated hemoglobin (HbA1c) change at week 24 (non-inferiority margin of 0.35%) (Clinical trial registration number: NCT04634500). Results Adjusted mean change of HbA1c at week 24 was –0.80% with enavogliflozin and –0.75% with dapagliflozin (difference, –0.04%; 95% confidence interval, –0.21% to 0.12%). Percentages of patients achieving HbA1c <7.0% were 61% and 62%, respectively. Adjusted mean change of fasting plasma glucose at week 24 was –32.53 and –29.14 mg/dL. An increase in urine glucose-creatinine ratio (60.48 vs. 44.94, P<0.0001) and decrease in homeostasis model assessment of insulin resistance (–1.85 vs. –1.31, P=0.0041) were significantly greater with enavogliflozin than dapagliflozin at week 24. Beneficial effects of enavogliflozin on body weight (–3.77 kg vs. –3.58 kg) and blood pressure (systolic/diastolic, –5.93/–5.41 mm Hg vs. –6.57/–4.26 mm Hg) were comparable with those of dapagliflozin, and both drugs were safe and well-tolerated. Conclusion Enavogliflozin added to metformin significantly improved glycemic control in patients with T2DM and was non-inferior to dapagliflozin 10 mg, suggesting enavogliflozin as a viable treatment option for patients with inadequate glycemic control on metformin alone

Enhancement of electrochromic response and cyclic durability of WO3 thin films by stacking Nb2O5 layers

This article reports on the control of interface morphology degradation between acid-based electrolytes and electrochromic WO3 thin films by stacking Nb2O5 layers to develop highly sustainable and durable electrochromic devices. Thin films of Nb2O5 sputtered at room temperature did not exhibit electrochromic properties, whereas WO3 thin films showed a typical electrochemical response by manifesting reversible color changes from dark blue (under negative potential) to transparent (under reverse potential). As the number of electrochromic cycles in the H2SO4 electrolyte increased, the columnar-structured WO3 thin film considerably changed to a nanoflake structure; however, the microstructure did not significantly change when Nb2O5 layers were stacked on the WO3 layers. The electrochromic performance of bilayer thin films was critically dependent on the stacking order and thickness of each layer. The thin film stack of 100-nm thick Nb2O5/200-nm thick WO3 exhibited enhanced transmittance modulation, response speed, and coloration efficiency compared with that of the 300-nm thick WO3 thin film. Furthermore, up to 1300 cycles, the bilayer thin film exhibited transmittance modulation exceeding 40%; it lost electrochromic switching at the 3500th cycle. In contrast, the single-layer WO3 lost its electrochromic properties at the 700th cycle. This study provides an excellent opportunity for fabricating devices with enhanced electrochromic properties and long-term cyclic durability that can be achieved by stacking Nb2O5 layers

Interfacial Mode Interactions of Surface Plasmon Polaritons on Gold Nanodome Films

Hollow metallic nanodome structures were fabricated using anodized aluminum oxide (AAO) nanopores as deposition and sacrificial templates. Individual Au nanodomes inherit the unique shapes of the well-defined AAO membranes whose pedestal cells become square or hexagonal lattices with hemispheres in close proximity. Minimal contact between the hollow nanodomes and the glass substrate provide an identical dielectric medium across the film. The nanodome Au films support surface plasmon polaritons (SPPs) of strong air–Au and weak Au–glass modes in the light transmission dispersions. The mode crossings of distinct SPPs exhibit characteristic energy gaps, which depend on the periodic geometries of the nanostructures