Vacuum Tunneling Transistor with Nano Vacuum Chamber for Harsh Environments.

A nano vacuum tube which consists of a vacuum transistor and a nano vacuum chamber was demonstrated. For the device, a vacuum region is an electron transport channel, and a vacuum is a tunneling barrier. Tilted angle evaporation was studied for the formation of the nano level vacuum chamber structure. This vacuum tube was ultraminiaturized with several tens of 10-18 L scale volume and 10-6 Torr of pressure. The device structure made it possible to achieve a high integration density and to sustain the vacuum state in various real operations. In particular, the vacuum transistor performed stably in extreme external environments because the tunneling mechanism showed a wide range of working stability. The vacuum was sustained well by the sealing layer and provided a defect-free tunneling junction. In tests, the high vacuum level was maintained for more than 15 months with high reliability. The Al sealing layer and tube structure can effectively block exposed light such as visible light and UV, enabling the stable operation of the tunneling transistor. In addition, it is estimated that the structure blocks approximately 5 keV of X-ray. The device showed stable operating characteristics in a wide temperature range of 100-390 K. Therefore, the vacuum tube can be used in a wide range of applications involving integrated circuits while resolving the disadvantages of a large volume in old vacuum tubes. Additionally, it can be an important solution for next-generation devices in various fields such as aerospace, artificial intelligence, and THz applications.

A Novel VPS33B Variant Identified by Exome Sequencing in a Patient with Arthrogryposis-Renal Dysfunction-Cholestasis Syndrome.

Arthrogryposis-renal dysfunction-cholestasis (ARC) syndrome is a rare autosomal recessive multisystemic disease that is associated with the liver, kidney, skin, and central nervous and musculoskeletal systems. ARC occurs as a result of mutations in the VPS33B (Vacuolar protein sorting 33 homolog B) or VIPAR (VPS33B interacting protein, apical-basolateral polarity regulator) genes. A female infant presented with neonatal cholestasis with a severe clinical outcome. She was diagnosed with ARC syndrome using targeted exome sequencing (TES). Exome sequencing revealed compound heterozygous mutations, c.707A>T and c.239+5G>A, in VPS33B, where c.707A>T was a novel variant; the resultant functional protein defects were predicted via in silico analysis. c.239+5G>A, a pathogenic mutation that affects splicing, is found in less than 0.1% of the general population. Invasive techniques, such as liver biopsies, did not contribute to a differential diagnosis of ARC syndrome; thus, early TES together with clinical presentations constituted an apparently accurate diagnostic procedure.

Electronic Skin to Feel "Pain": Detecting "Prick" and "Hot" Pain Sensations.

An artificial tactile system has attracted tremendous interest and intensive study, since it can be applied as a new functional interface between humans and electronic devices. Unfortunately, most previous works focused on improving the sensitivity of sensors. However, humans also respond to psychological feelings for sensations such as pain, softness, or roughness, which are important factors for interacting with others and objects. Here, we present an electronic skin concept that generates a "pain" warning signal, specifically, to sharp "prick" and "hot" sensations. To simplify the sensor structure for these two feelings, a single-body tactile sensor design is proposed. By exploiting "hot" feeling based on the Seebeck effect instead of the pyroelectric property, it is possible to distinguish points registering a "hot" feeling from those generating a "prick" feeling, which is based on the piezoelectric effect. The control of free carrier concentration in nanowire induced the appropriate level of Seebeck current, which enabled the sensor system to be more reliable. The first derivatives of the piezo and Seebeck output signals are the key factors for the signal processing of the "pain" feeling. The main idea can be applied to mimic other psychological tactile feelings.

Hemodynamic Effects on Systemic Blood Flow and Ductal Shunting Flow after Loading Dose of Intravenous Caffeine in Preterm Infants according to the Patency of Ductus Arteriosus.

BACKGROUND: In preterm infants, caffeine citrate is used to stimulate breathing before they are weaned from mechanical ventilation and to reduce the frequency of apnea. In recent studies, effects of caffeine on the cardiovascular system have been emphasized in preterm infants with patent ductus arteriosus (PDA). METHODS: This study aimed to assess the short-term hemodynamic effects on systemic blood flow and ductal shunting flow after loading standard doses of intravenous caffeine in preterm infants. Echocardiographic studies were performed by a single investigator, before and at 1 hour and 4 hours after an intravenous infusion of a loading dose as 20 mg/kg caffeine citrate for 30 minutes. RESULTS: In 25 preterm infants with PDA, left ventricular output decreased progressively during 4 hours after caffeine loading. Superior vena cava (SVC) flow decreased and ductal shunting flow increased at 1 hour and then recovered at 4-hour to baseline values. A diameter of PDA significantly decreased only at 4-hour after caffeine loading. There were no significant changes of these hemodynamic parameters in 29 preterm infants without PDA. CONCLUSION: In preterm infants with PDA, a standard intravenous loading dose of 20 mg/kg caffeine citrate was associated with increasing ductal shunting flow and decreasing SVC flow (as a surrogate for systemic blood flow) 1 hour after caffeine loading, however, these hemodynamic parameters recovered at 4 hours according to partial constriction of the ductus arteriosus. Close monitoring of hemodynamic changes would be needed to observe the risk for pulmonary over-circulation or systemic hypo-perfusion due to transient increasing ductal shunting flow during caffeine loading in preterm infants with PDA.

Structural Solution to Enhance the Sensitivity of a Self-Powered Pressure Sensor for an Artificial Tactile System.

Structural design factors of sensor units have been studied in order to enhance the sensitivity of pressure sensors based on utilizing a piezoelectric material for an artificial tactile sensor. In this study, we have primarily demonstrated the effect of a square pattern array design in a pressure sensor using ZnO nanowires. Nanowires grown on the edge of cells can be bent easily because of growth direction, density control, and buckling effect. Since smaller square pattern arrays induce a higher circumference to cell area ratio, if one sensor unit consists of many micro-level square pattern arrays, the design enhances the piezoelectric efficiency and the sensitivity. As a result, 20 µ m×20 µ m cell arrays showed three times higher pressure sensitivity than 250 µ m×250 µ m cell array structures at a pressure range from 4 kPa to 14 kPa. The induced piezoelectric voltage with the same pressure level also increased drastically. Therefore, the square pattern array design is more appropriate for a high-sensitive pressure sensor than a simple one-body cell design for tactile systems, and it has the advantage of better power efficiency, which is also important for artificial tactile systems. This suggested cell array design can be applied to various systems using piezoelectric nanowires.

Characteristics and antioxidant effect of garlic in the fermentation of Cheonggukjang by Bacillus amyloliquefaciens MJ1-4.

The changes in the ß-glucosidase activity, total phenolic contents, isoflavone contents, and antioxidant activities during the fermentation of cheonggukjang by Bacillus amyloliquefaciens MJ1-4 with and without garlic were investigated. The levels of total phenolic and isoflavonemalonylglycoside, -acetylglycoside, and -aglycone contents increased, whereas the 2,2-diphenyl- 1-picrylhydrazyl (DPPH) and 2,2'-azino-bis (3-ethylbenzthiazoline-6-sulfonic acid) (ABTS) radical scavenging activities and ferric reducing/antioxidant power (FRAP) assay results increased, but isoflavone-glycoside levels decreased during cheonggukjang fermentation. The levels of total phenolic and total isoflavone contents and the antioxidant activities were higher in cheonggukjang fermented without garlic (CFWOG) than in cheonggukjang fermented with garlic (CFWG) after 24 h of fermentation, but they were lower in CFWOG than in CFWG after 72h of fermentation. In particular, the highest levels of total phenolic, daidzein, glycitein, and genistein were present at concentrations of 15.18 mg/g, 264.4 µg/g, 16.4 µg/g, and 31.1 µg/g after 72h of fermentation in CFWG, showing 82.89% in DPPH radical scavenging activity, 106.32% in ABTS radical scavenging activity, and 1.47 (OD593 nm) in FRAP assay, respectively. From these results, we suggest that the high antioxidant activity of CFWG might be related to the markedly higher levels of total phenolic contents, isoflavone-malonylglycosides, - acetylglycosides, and -aglycones achieved during fermentation.

A novel PRF1 gene mutation in a fatal neonate case with type 2 familial hemophagocytic lymphohistiocytosis.

Hemophagocytic lymphohistiocytosis (HLH) occurs in the primary form (genetic or familial) or secondary form (acquired). The familial form of HLH (FHL) is a potentially fatal autosomal recessive disorder that occurs because of constitutional defects in cell-mediated cytotoxicity. Here, we report a fatal neonatal case of type 2 FHL (FHL2) that involved a novel frameshift mutation. Clinically, the newborn presented with severe sepsis-like features and required mechanical ventilation and continuous venovenous hemodiafiltration. Flow cytometry analysis showed marked HLH and complete absence of intracytoplasmic perforin expression in cytotoxic cells; therefore, we performed molecular genetic analyses for PRF1 mutations, which showed that the patient had a compound heterozygous mutation in PRF1, that is, c.65delC (p.Pro22Argfs*2) and c.1090_1091delCT (p.Leu364Glufs*93). Clinical and genetic assessments for FHL are required for neonates with refractory fever and progressive multiple organ failure, particularly when there is no evidence of microbiological or metabolic cause.

Micro-size antenna structure with vertical nanowires for wireless power transmission and communication.

For biomedical implanted devices, a wireless power or a signal transmission is essential to protect an infection and to enhance durability. In this study, we present a magnetic induction technique for a power transmission without any wire connection between transmitter (Tx) and receiver (Rx) in a micro scale. Due to a micro size effect of a flat spiral coil, a magnetic inductance is not high. To enhance the magnetic inductance, a three dimensional magnetic core is added to an antenna structure, which is consisted of ZnO nano wires coated by a nickel (Ni) layer. ZnO nano wires easily supply a large effective surface area with a vertical structural effect to the magnetic core structure, which induces a higher magnetic inductance with a ferro-magnetic material Ni. The magnetic induction antenna with the magnetic core shows a high inductance value, a low reflection power and a strong power transmission. The power transmission efficiencies are tested under the air and the water medium are almost the same values, so that the magnetic induction technique is quite proper to body implanted systems.

Retropharyngeal abscess coinfected with Staphylococcus aureus and Mycobacterium tuberculosis after rhinoviral infection in a 1-month-old infant.

A retropharyngeal abscess is a rare disease entity in young infants but can develop after nasopharyngeal viral infection. Group B Streptococcus and Staphylococcus aureus are the most common pathogens in young infants, however, Mycobacterium tuberculosis is very rare. We report the case of retropharyngeal abscess and coinfection with S. aureus and M. tuberculosis in a very young infant presenting with respiratory symptoms due to upper airway obstruction. Usually tuberculous retropharyngeal abscesses are caused by the direct invasion of the bacteria from the spine via anterior longitudinal ligament of the spine. However, in this case, no associated spinal disease was observed.

Can early B-type natriuretic peptide assays predict symptomatic patent ductus arteriosus in extremely low birth weight infants?

BACKGROUND: Earlier and more accurate identification of a high-risk group of preterm infants that are likely to develop a hemodynamically significant patent ductus arteriosus (hsPDA) would allow specific targeting of early treatment and thus possibly minimize the morbidity and mortality associated with a PDA in extremely low birth weight (ELBW) infants. OBJECTIVE: To investigate the predictability of B-type natriuretic peptide (BNP) for early targeted treatment of hsPDA in ELBW infants. METHODS: 73 ELBW infants that underwent echocardiographic evaluation and plasma BNP measurement after birth were enrolled. 31 infants developed hsPDA (HsPDA group) and 42 infants did not develop hsPDA (nPDA group). RESULTS: BNP levels of the HsPDA group were significantly higher than those of the nPDA group at 24 h of age (921 [318-2,133] vs. 152 [91-450] pg/ml) but not different at 12 h of age. BNP levels at 24 h of age were significantly correlated with the magnitudes of the ductal shunt but not at 12 h of age. The area under the receiver operator characteristic curve of BNP levels for prediction of hsPDA at 24 h of age was 0.830. At the cutoff BNP levels of 200 and 900 pg/ml at 24 h of age, sensitivity was 83.9 and 54.8% and specificity was 61.9 and 95.2%, respectively. CONCLUSIONS: BNP levels at 24 h of age can be used as a guide for early targeted treatment of hsPDA and avoid the unnecessary use of cyclooxygenase inhibitors in ELBW infants.

Sequential magnetic resonance spectroscopic changes in a patient with nonketotic hyperglycinemia.

Nonketotic hyperglycinemia (NKH) is a rare inborn error of amino acid metabolism. A defect in the glycine cleavage enzyme system results in highly elevated concentrations of glycine in the plasma, urine, cerebrospinal fluid, and brain, resulting in glycine-induced encephalopathy and neuropathy. The prevalence of NKH in Korea is very low, and no reports of surviving patients are available, given the scarcity and poor prognosis of this disease. In the current study, we present a patient with NKH diagnosed on the basis of clinical features, biochemical profiles, and genetic analysis. Magnetic resonance spectroscopy (MRS) allowed the measurement of absolute glycine concentrations in different parts of the brain that showed a significantly increased glycine peak, consolidating the diagnosis of NKH. In additional, serial MRS follow-up showed changes in the glycine/creatinine ratios in different parts of the brain. In conclusion, MRS is an effective, noninvasive diagnostic tool for NKH that can be used to distinguish this disease from other glycine metabolism disorders. It may also be useful for monitoring NKH treatment.

Permissive hypotension in extremely low birth weight infants (≤1000 gm).

PURPOSE: We performed this study to evaluate the safety of permissive hypotension management in extremely low birth weight infants (ELBWIs). MATERIALS AND METHODS: Medical records of all inborn ELBWIs admitted to Samsung Medical Center from January 2004 to December 2008 were reviewed retrospectively. Of a total of 261 ELBWIs, 47 (18%) required treatment for hypotension (group T), 110 (42%) remained normotensive (group N), and 104 (40%) experienced more than one episode of hypotension without treatment (group P) during the first 72 hours of life. Treatment of hypotension included inotropic support and/or fluid loading. RESULTS: Birth weight and Apgar scores were significantly lower in the T group than the other two groups. In the N group, the rate of pathologically confirmed maternal chorioamnionitis was significantly higher than other two groups, and the rate was higher in the P group than the T group. After adjusting for covariate factors, no significant differences in mortality and major morbidities were found between the N and P groups. However, the mortality rate and the incidence of intraventricular hemorrhage (≥stage 3) and bronchopulmonary dysplasia (≥moderate) were significantly higher in the T group than the other two groups. Long term neurodevelopmental outcomes were not significantly different between the N and P groups. CONCLUSION: Close observation of hypotensive ELBWIs who showed good clinical perfusion signs without intervention allowed to avoid unnecessary medications and resulted in good neurological outcomes.

Post-traumatic Back Pain Revealed as Tuberculous Spondylitis -A Case Report-.

Tuberculous spondylitis is a very rare disease, but it can result in bone destruction, kyphotic deformity, spinal instability, and neurologic complications unless early diagnosis and proper management are done. Because the most common symptom of tuberculous spondylitis is back pain, it can often be misdiagnosed. Atypical tuberculous spondylitis can be presented as a metastatic cancer or a primary vertebral tumor. We must make a differential diagnosis through adequate biopsy. A 30-year-old man visited our clinic due to back and chest pain after a recent traffic accident. About 1 year ago, he had successfully recovered from tuberculous pleurisy after taking anti-tuberculosis medication. We performed epidural and intercostal blocks but the pain was not relieved. For the further evaluation, several imaging and laboratory tests were done. Finally, we confirmed tuberculous spondylitis diagnosis with the biopsy results.