Design and implementation of thermal collection networks in 3-D IC structures.

The empirical affirmation in the electronics industry is that the power of chips per unit area is growing exponentially. The amount of heat generated is equal to the power; hence as power per unit area increases, so does the amount of heat generated within the chip. Thus, it necessary to mitigate the thermal problems of electronic systems. If not addressed or suppressed, thermal problems can lead to various issues including dielectric breakdown, electromigration, material creeping, unwanted chemical reactions, board warpage, drift in performance, and indirect heating. In this study, a dedicated thermal collection network (TCN) in the back end of the line area of an electronic chip was investigated. This network can help in creating a connection using a thermal through Silicon via (TTSV) to pump up the thermal energy to the heat-sink-fan assembly. Pre-empting heat from the sources could manage the thermal issues arising in chips as well as three-dimensional integrated circuit (3-D IC) structures. The finite-element method was the tool used for analysis. 31.62% of heat suction in TCNs of monolithic ICs, 11.36% in TCNs of 3-D IC structures, and 35.34% of heat suction in junctions of TTSVs compared with different approaches without the postulate used here. This procedure is expected to lead to a new path for redesigning electronic chips and 3-D IC structures.

Percutaneous coronary interventions in diabetic patients: is complete revascularization important?

BACKGROUND: The long-term prognosis of diabetic patients with multivessel coronary artery disease (CAD) treated by surgical or percutaneous coronary revascularization is significantly worse as compared to non-diabetics. Lower rates of complete revascularization may be one factor that influences the poor long-term outcome in the diabetic population. Our study assessed the impact of complete revascularization on the long-term prognosis in diabetic patients with CAD treated by percutaneous coronary intervention (PCI). The study included 658 consecutive diabetic patients (mean age, 60.9+/-10.1 years) who underwent PCI. Multivessel disease was present in 352 patients (53.5%). Revascularization was complete in 94 (26.7%) and incomplete in 258 (73.3%) patients with multivessel disease. Reasons for incomplete revascularization included angioplasty of only the culprit lesion (43.4%); small vessel size (22.8%); moderate lesion, defined as diameter stenosis 50-69% (18.6%); chronic total occlusion of the non-intervened vessel (6.6%); and others (8.5%). Overall survival rate at 5 years was 87.4%. Patients who underwent complete revascularization had a 94.5% survival rate, compared to 83.0% for those with incomplete revascularization (p<0.001). Similarly, the rates of myocardial infarction-free survival were significantly higher in patients with complete versus incomplete revascularization (92.9% versus 79.9%, respectively). Incomplete revascularization was the most powerful independent predictor of mortality at follow-up (relative risk 95% confidence interval, 1.54-7.69; p=0.003). Our data suggest that complete myocardial revascularization may improve the long-term prognosis after PCI of diabetic patients with multivessel CAD.

Ipsilateral intracerebral hemorrhage following carotid stent-assisted angioplasty: a manifestation of hyperperfusion syndrome--a case report.

A case of hyperperfusion syndrome manifested as intracerebral hemorrhage following carotid stent-assisted angioplasty while using intravenous abciximab is described. Review of literature regarding hyperperfusion syndrome in patients undergoing carotid artery revascularization is presented. Possible mechanisms of hyperperfusion and the role of arterial hypertension, anticoagulation, and antiplatelet treatment in the genesis of hyperperfusion syndrome are discussed. Widening use of percutaneous carotid revascularization necessitates physicians' awareness of early recognition of this complication.

Intermediate coronary artery stenosis: evidence-based decisions in interventions to avoid the oculostenotic reflex.

The prevalence of intermediate coronary artery stenosis (defined as a diameter stenosis of 40% to 70%) is quite large in patients undergoing PTCA. The coronary angiogram is considered the 'gold standard' for the definition of coronary anatomy, in spite of various limitations associated with its use. In recent years, sensor tipped guidewire based methods of physiologic assessment of stenosis severity, like myocardial fractional flow reserve, and poststenotic coronary flow reserve had established their role in the decision making in catheterization laboratory. The decision making should combine morphologic and physiologic assessment as better evidence based approach in guiding therapy to avoid the 'oculostenotic reflex'.