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Nipple size varies from person to person, but having a large nipple, or macrothelia, can be a concern for some women; therefore, some surgical methods have been developed for the reduction of nipple size. Conventional surgical methods for nipple reduction are classified into two types according to their purpose: reduction of length and reduction of diameter. For reduction of length, soft tissue is resected (except the central supplying vessel) and shortened by circumferential repair. The disadvantage of this method is possible necrosis of the nipple and impairment of the lactiferous duct. For reduction of diameter, a wedge-shaped resection is done from side to center and the defect is covered by a local advancement flap. The disadvantage of this method is the locally focused tension line, which is associated with unfavorable aesthetic outcomes. In this article, we present a case involving a novel method of nipple reduction surgery, referred to as the tripod wedge resection technique, which has three benefits compared to conventional nipple reduction surgery: simultaneous reduction of both length and diameter, relative safety for the vasculature and lactiferous duct, and an evenly tensioned incision line.

Lumbar spinal stenosis is a common spinal degenerative condition. Minimally invasive interlaminar full-endoscopic decompressive laminectomy provides greater patient satisfaction and faster recovery than open decompressive laminectomy. The aim of our randomized controlled trial will be to compare the safety and efficacy of interlaminar full-endoscopic laminectomy and open decompressive laminectomy. Our trial will include 120 participants (60 per group) who will undergo surgical treatment for lumbar spinal stenosis. The primary outcome will be the Oswestry Disability Index measured at 12 months postoperatively. Secondary patient-reported outcomes will include back and radicular leg pain measured via a visual analog scale; the Oswestry Disability Index; the Euro-QOL-5 Dimensions score measured at 2 weeks and at 3, 6, and 12 months postoperatively; and patient satisfaction. The functional measures will include time to return to daily activities postoperatively and walking distance/time. The surgical outcomes will include postoperative drainage, operation time, duration of hospital stay, postoperative creatine kinase (an indicator of muscle injury) level, and postoperative surgical scarring. Magnetic resonance and computed tomography images and simple radiographs will be obtained for all patients. The safety outcomes will include surgery-related complications and adverse effects. All evaluations will be performed by a single assessor at each participating hospital who will be blinded to group allocation. The evaluations will be conducted preoperatively and at 2 weeks and 3, 6, and 12 months postoperatively. The randomized, multicenter design of the trial, blinding, and justification of the sample size will reduce the risk of bias in our trial. The results of the trial will provide data regarding the use of interlaminar full-endoscopic laminectomy as an alternative to open decompressive laminectomy that results in similar surgical findings with less invasiveness. Trial registration: This trial is registered at cris.nih.go.kr. (KCT0006198; protocol version 1; 27 May 2021).

Polygalacturonase (PG) activity in plants can serve as an important index for plant disease. However, the conventional method to detect PG activity is a complex process and requires a skilled technician and expensive analytical equipment. In this study, a paper-based colorimetric sensor was developed based on the principle of the ruthenium red (RR) dye method for easy and simple measurement of PG activity. The proposed paper-based sensor has a three-layer structure for detection of PG activity in samples. The sensor sensitivity was enhanced by optimizing the pH of the sodium acetate buffer used in polygalacturonic acid (PGA)-RR complex formation and the reaction temperature for PG and the PGA-RR complex. Further, for quantitative analysis of PG activity, Delta RGB analysis was conducted to detect color changes in the sensing window of the sensor. Results presented that the linear measurement range of the paper sensor was 0.02-0.1 unit with the limit of detection of 0.02 unit, which showed a similar detection range, but a lower detection limit, compared to the spectrophotometry. Furthermore, PG activity based on culture condition was measured using samples from Sclerotium cepivorum to verify the potential application of the developed paper-based sensor in the field. The measured activity showed no statistically significant difference from the values obtained from the spectrophotometry at 95% confidence level. Therefore, the paper-based colorimetric sensor can be used to predict plant diseases in Allium crops during the stage of pathogen invasion, potentially contributing to the improvement of crop production.

Free proline, termed proline, is a biomarker used for diagnosing drought stress in plants. A previously developed proline–ninhydrin reaction-based paper sensor could quickly and easily detect proline, but it was limited by low sensitivity. In this study, we developed an enclosed multilayer paper-based microfluidic sensor with high sensitivity for the quantitative detection of proline in plants. The multilayer paper-based sensor was manufactured using simple wax printing and origami methods, and contained an internal mixing channel to allow good mixing of the proline with ninhydrin, increasing the proline–ninhydrin reactivity and providing accurate and sensitive proline detection. By preloading ninhydrin onto the sample loading area, uniform coloration of the sensing window was achieved, allowing quantitative analysis of various proline concentrations using a constant reaction time. Only the sensing window and sample loading area were exposed to limit sample evaporation and contamination from the external environment. The LOD of the fabricated sensor was 23 μM, which is approximately 29-fold lower than that of the previously proposed paper sensor (657 μM). Samples were extracted from A. thaliana plants subjected to drought stress for proline detection. The proline concentrations measured using the developed paper sensor and a spectrophotometric method were not statistically significant at a confidence level of 95%. Therefore, the developed sensor can be applied to measure proline concentrations precisely in the field with a low detection limit. The developed paper-based sensor can be used to detect the early stages of drought in plants and thus improve crop productivity.

Background Nasal skin defect closures are challenging because the nose is a complex anatomic structure with several subunits, and the nasal tip and ala represent particularly difficult subunits to reconstruct. The traditional full-thickness skin graft (FTSG) is an easy and well-established method, but often results in undesirable outcomes in terms of the nasal contour caused by a lack of dermal tissue. Aims The purpose of the study is to report the outcomes of the simultaneous application of the acellular dermal substitute (Matriderm® ) with FTSG in the treatment of nasal skin defects. Patients/methods Five patients with various nasal skin defects were treated with multilayered Matriderm grafts followed by FTSGs harvested from the pre- or postauricular region. Graft survival, scar quality, and patient satisfaction were evaluated and compared with 10 patients treated with conventional FTSGs. Results One-stage Matriderm-aided FTSGs were well-taken in all cases. Scar quality in the Matriderm group (8.0 ± 1.9) was statistically superior to that in the FTSG only group (10.8 ± 1.7). The Matriderm-aided graft was also superior in patient satisfaction. Conclusions The multilayered application of Matriderm in combination with FTSG is a reliable method for covering nasal skin defects, especially in the thick skin zone of the tip and ala.

Background and objectives Ablative fractional laser (AFL) systems are commonly used to treat various scars, and recent research has indicated that early treatment with AFL may have a preventive effect on scars. This study was designed to evaluate the efficacy of early treatment with a 10,600 nm carbon dioxide (CO2 ) AFL on thyroidectomy scars and compare it to late (conventional) treatment for the same and untreated controls. Study design/materials and methods We performed a prospective, evaluator-blinded, split-scar study on fresh thyroidectomy scars between July 2014 and July 2017. Scars were divided into two equal portions. Early AFL treatment had begun 1 month after surgery; five sessions on the right half of the scar was performed at 1-month intervals. Late AFL treatment followed for 1 month after the final early treatment session on the left half of the scar at the same interval. The scars were evaluated at 6 and 11 months postoperatively using scar analysis scales and patient questionnaires. Results Twenty-four out of 28 patients completed the study. The mean decrease in Vancouver Scar Scale (VSS) scores was significantly higher for the early treated right halves of the scars both at the 6th month (vs. untreated controls) and at the 11th month (vs. late treated controls). The VSS subset analysis showed that the early treated sides had significantly greater improvement in pliability and height than the control sides at each point of evaluation. Conclusions Early postoperative AFL treatment is safe and effective in improving linear surgical scars, such as thyroidectomy scars, and may be a promising option for scar prevention. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.

Background Advances in minimally invasive surgery have expanded the indications for interlaminar full-endoscopic discectomy. Although the clinical outcomes for this approach may be equivalent to those of conventional microscopic discectomy, the supporting evidence is still based on small, single-center, prospective, and retrospective studies. Therefore, a multicenter randomized controlled trial is warranted. Methods This will be a prospective, multicenter, randomized controlled trial comparing the efficacy and safety of interlaminar full-endoscopic discectomy to those of conventional microscopic discectomy. The trial will enroll 100 participants with a lumbar disc herniation, 50 in each group. The primary outcome will be the Oswestry Disability Index (ODI) score at 12 months post-surgery. Secondary outcomes will be back and leg pain (visual analog scale); the ODI; the EuroQol-5-dimension score; patient satisfaction; and walking distance/time and time to return to daily activities post-surgery. Surgical outcomes will include postoperative drainage, operative time, duration of hospital stay, postoperative creatine kinase level as an indicator of muscle injury, and postoperative scarring. Postoperative magnetic resonance imaging, computed tomography, and simple radiography will be performed to evaluate radiographic outcomes between the two surgical approaches. Surgery-related complications and adverse effects will be evaluated as safety outcomes. A single assessor at each participating hospital, blinded to group allocation, will assess the enrolled participants at baseline, at 2 weeks, and at 3, 6, and 12 months postoperatively. Discussion This trial is designed to determine whether interlaminar full-endoscopic discectomy is clinically comparable to microscopic discectomy to treat lumbar disc herniations. All efforts will be made to reduce bias, including adequate sample size, blinded analyses, and multicenter prospective registration. The outcomes will inform practice, providing the evidence needed for using interlaminar full-endoscopic over microscopic discectomy by confirming the potential of this technique to improve patient satisfaction and clinical outcomes. Trial registration: Clinical Research Information Service; cris.nih.go.kr. (KCT0006277); protocol version (v1, June 8, 2021).

Due to their ability to be internalized into cells by endocytosis through cell membranes, the application of nanoparticles in therapeutic and diagnostic fields has received much interest. In particular, ferrite magnetic nanoparticles (MNPs) are widely used as reagents for medical care, including in vitro magnetic separation, T2-weighted magnetic resonance imaging, magnetic hyperthermia therapy, and as drug delivery systems. However, little is known about the quantitative analysis of the cellular uptake of MNPs by the interaction of particle surfaces with biomolecules. Here, we quantitatively analyze the intracellular uptakes of 30 nm Fe- and Mn-ferrite MNPs. We confirm that the magnetic properties of MNPs change according to their microstructure and quantitatively analyze nanoparticle internalization in breast cell lines (MCF10A, MCF7, and MDA-MB-231) by measuring the magnetic moment using a vibrating sample magnetometer. Finally, we examine the effect of nanoparticle microstructure on cellular uptake in terms of the interaction between the nanoparticles and biomolecules.

A Raman lidar system is able to detect the range of gas distribution and measure the hydrogen gas concentration remotely. This paper discusses the development of a photon counting Raman lidar system for remotely measuring the hydrogen gas concentration. To verify the developed photon counting Raman lidar system, experiments were carried out in outdoor conditions. As the results indicate, the developed photon counting Raman lidar system is possible to measure 0.66 to 100 vol% hydrogen gas concentrations at a distance of 30 m. In addition, the measuring average error measured 0.54% and the standard deviation is 2.42% at a distance of 30 m.

We developed a high-throughput technique for highly sensitive measurement of trace amounts of proline, an indicator of drought stress in plants, using an optimized proline-ninhydrin reaction. In order to do this, proline detection time was minimized by omitting phosphoric acid from the ninhydrin reagent. Chromophore extraction using toluene was also omitted, thus lowering the risks to environment and human health, and allowing the use of readily available polystyrene plates. Proline detection sensitivity was assessed based on the concentration of sulfosalicylic acid in the solution, which indicated that 1% sulfosalicylic acid yielded the best sensitivity and linearity. These findings were applied to a multiwell plate-based multiplex analysis using a dry oven for the simultaneous analysis of a large number of drought-stressed plant samples with trace amounts of proline. The results showed that proline could be effectively detected in plants grown in soil with water content under 5%, demonstrating its potential for diagnosing drought early. The proposed multiwell plate-based multiplex assay is expected to be useful in manifold agricultural applications.

Electrohydrodynamic (EHD) printing was employed here to fabricate conductive micro patterns for printed electronic devices. EHD printing offers fine pattern fabrication through additive manufacturing that has several advantages when compared to conventional lithographic techniques. One of the major advantages of additive manufacturing is its ability to print on already fabricated devices for the purpose of alteration or repair. However, printing of micro patterns on a fabricated MEMS device is a tedious task due to the electrostatically induced disturbances in cone jet and the formation of satellite droplets. In this study, a modified EHD printing technique called drop on demand (DOD) process was used to print silver micro patterns on a MEMS device with high accuracy. The focus here was to optimize the technique and parameters, and modify the system hardware to enable patterning on an un-treated device surface. Parameters like supply voltage, waveform shape and frequency, pneumatic pressure, and ink flow rate have been studied and optimized to achieve repeatable and stable conductive patterns up to 3 μm. The modified EHD-DOD system also eliminates the problem of static surface charges by using low voltage thus enabling printing of highly repeatable sub-10 μm conductive patterns well suitable for MEMS repair.

Polyethylene oxide (PEO) is a polymer hydrogel possessing ionic conductivity that varies with different percentage of absorbed water molecules and ions. This property makes it a good candidate to be used in humidity sensors’ active layers. The degree of crystallinity of PEO thin films decrease with increasing humidity that facilitates the ion conduction in the thin films, thus reducing the film impedance. In this research work, the humidity sensing properties of the thin films of semi-crystalline PEO have been investigated and the material is then modified to its amorphous dominant phase by heating the thin films beyond the melting point of the polymer. The slowly cooled resulting thin films had a waxy solid like appearance and showed an excellent response towards quantitative detection of relative humidity in the surrounding environment. The results show a roughly linear impedance versus relative humidity curve in the range of 0% RH to 90% RH with a very high maximum achieved sensitivity of ∼35 kΩ/%RH. The response and recovery times measured for the modified sensors were 2.8 s and 5.7 s respectively. The 30 day trial of stability readings showed a standard deviation of only 1%. The results prove thermally modified amorphous PEO thin films to be strong candidates for high end electronic relative humidity sensors.

Purpose The optimal perioperative treatment for resectable esophageal squamous cell carcinoma (ESCC) remains controversial. We evaluated the efficacy and safety of leucovorin and 5-fluorouracil (LV5FU2) and LV5FU2 plus oxaliplatin (FOLFOX) combination chemotherapies administered adjuvantly for curatively-resected, node-positive ESCC. Materials and methods Patients with pathologically node-positive esophageal cancer after curative R0 resection were enrolled and randomly assigned to receive LV5FU2 or FOLFOX biweekly for up to eight cycles. The primary endpoint was disease-free survival (DFS). Results Between 2011 and 2015, 62 patients were randomized into the two treatment groups (32 in the LV5FU2 arm and 30 in the FOLFOX arm). The median age was 60 years and both groups had similar pathologic characteristics in tumor, nodal status, and location. Treatment completion rates were similarly high in both groups. The DFS rate at 12 months was 67% in the LV5FU2 group and 63% in the FOLFOX group with a hazard ratio of 1.3 (95% confidence interval [CI], 0.66 to 2.62). After a median follow-up period of 27 months, the median DFS was 29.6 months (95% CI, 4.9 to 54.2) in the LV5FU2 arm and 16.8 months (95% CI, 7.5 to 26.1) in the FOLFOX arm (p=0.428), respectively, while the median overall survival was not reached in either arm. Grade 3 or 4 neutropenia was more frequent in patients in the FOLFOX arm than the LV5FU2 arm (20.0% vs. 3.1%). Conclusion The addition of oxaliplatin (FOLFOX) did not lead to better efficacy compared to LV5FU2 chemotherapy in an adjuvant setting in node-positive ESCC patients.

In this paper, new tethered aerial robots including roaming tethered aerial robots (RTARs) for radioactive material sampling and stationary tethered aerial robots (STARs) for environment monitoring are proposed to meet extremely-long-endurance missions of nuclear power plants. The flight of the proposed tethered aerial robots may last for a few days or even a few months as long as the tethered cable provides continuous power. A high voltage AC or DC power system was newly adopted to reduce the mass of the tethered cable. The RTAR uses a tethered cable spooled from the aerial robot and an aerial tension control system. The aerial tension control system provides the appropriate tension to the tethered cable, which is accordingly laid down on the ground as the RTAR roams. The STAR includes a tethered cable spooled from the ground and a ground tension control system, which enables the STAR to reach high altitudes. Prototypes of the RTAR and STAR were designed and successfully demonstrated in outdoor environments, where the load power, power type, operating frequency, and flight attitude of the RTAR and STAR were: 180 W, AC 100 kHz, and 20 m; and 300 W, AC or DC 100 kHz, and 80 m, respectively.

This paper presents the implementation of a pulse-type LAser Detection And Ranging (LADAR) system based on heterodyne detection for long-range measurement. A pulse-type LADAR based on an intensity direct-detection is certainly simple and mature, but it requires a high peak-power laser and a low-noise avalanche photodiode for long-range measurement, which restricts the scope of the application due to the weight, power consumption, and cost of the laser and the photodetector. In this work, heterodyne detection using a PIN photodiode is implemented to increase receiver sensitivity instead of using a low-noise avalanche photodiode. An optical phase-locked loop is adopted to generate an optical local oscillator signal for heterodyne detection. The proposed heterodyne detection scheme achieves a minimum detectable signal level of -52.6 dBm at a bandwidth of 1.2 GHz, and it is adopted in a pulse-type LADAR system for long-range measurement. The pulse-type LADAR system can measure a distance of 2.77 km at a repetition rate of 40 kHz, and it demonstrates great advantages for realizing real-time 3D imaging for long-range measurement with a high frame rate.

In Korea, the mechanization rate of the seeding and transplanting work is 5% and the harvesting work is 13.3%. When the Chinese cabbage is transported from the harvested location to the collection part, the cabbage may be damaged due to the transportation speed, mechanical vibration, and contact with the mechanical parts. Power transmission need to be designed considering transmission efficiency, failure stress, and fatigue stress. Objectives of this study were to conduct 1) kinematic analysis of the transportation part to minimize the cabbage damage, and 2) stress and fatigue analysis of the power transmission part to optimize the component materials and dimensions. Transportation speed was from 0.2 to 1 m/s at a 0.2 m/s interval, and the length of the transfer link was 19, 22, and 25 cm. For the power transmission part, stress and fatigue were calculated using commercial software (midas NFX) for different materials, numbers of teeth, and pressure angles of the main sprocket gears as a result of the kinematic analysis of the transportation part, the optimum transfer speed of the Chinese cabbage was 0.4 m/s, the length of the link was 19 cm, and the width of the transportation part was 66 cm. And result of stress analysis, the safety factor of SCR420H material was more than 1 and the safety factor of SM45C was 0.48. The fatigue analysis results showed no significant difference according to the material and pressure angle. In order to improve the reliability of the simulation, field tests and validation would be necessary.

When light from an object or an astronomical star propagates in the earth’s atmosphere, atmospheric turbulence can distort and move the image in various ways. A quantitative measure of the intensity of optical turbulence with a refractive index structure parameter, C 2 , is widely used in the statistical characterization of the random refractive index fluctuations generally referred to as optical turbulence. I this study, we investigated the horizontal optical turbulence in the near infrared region (850nm) at two sites in South Korea (Kongju and Cheonan) by using a scintillometer. The scintillometer measured the refractive index structure parameter C 2 over 2.1- and 0.4-km paths, respectively, in Kongju and Cheonan. The first path was over an urban area characterized by a complicated land-use mix (residential houses, a river, bare ground, etc.) whereas the second path was a building-to-building path at a 15-m height on a university campus. In addition to the scintillometer, an independent weather station recorded meteorological conditions such as wind speed, relative humidity, and temperature. Study results indicate the general patterns of the optical turbulence at both sites agree with previous-reported diurnal patterns; they have two dips in C2n, one at around sunrise and the other at sunset, but the night profiles varied strongly depending on the atmospheric conditions. The average values of C 2 for the measurement period were × 10−15 and 2.90 × 10−14 m−2/3 in Kongju and Cheonan, espectively, thus confirming that the optical field is clearer in the former. In addition, the average values of the Fried parameter, r0, were accordingly estimated to be 8.0 and 2.5 cm over a 2-km optical distance at Kongju and Cheonan, respectively.

An immunochromatographic assay for the detection of hepatitis B surface antigen (HBsAg) was developed using Fe 3 O 4 nanoparticles as signal materials. Anti-HBsAg antibodies were labeled with carboxylated Fe 3 O 4 particles with an average diameter of 153.6 nm, and an immunochromatography strip was constructed. The detection capability of the assay developed here is 1 ng/mL HBsAg.