Microstructure and its effect on field electron emission of grain-size-controlled nanocrystalline diamond films Ultrananocrystalline diamond ͑UNCD͒ films 0.1-2.4 m thick were conformally deposited on sharp single Si microtip emitters, using microwave CH 4 -Ar plasma-enhanced chemical vapor deposition in combination with a dielectrophoretic seeding process. Field-emission studies exhibited stable, extremely high ͑60-100 A/tip͒ emission current, with little variation in threshold fields as a function of film thickness or Si tip radius. The electron emission properties of high aspect ratio Si microtips, coated with diamond using the hot filament chemical vapor deposition ͑HFCVD͒ process were found to be very different from those of the UNCD-coated tips. For the HFCVD process, there is a strong dependence of the emission threshold on both the diamond coating thickness and Si tip radius. Quantum photoyield measurements of the UNCD films revealed that these films have an enhanced density of states within the bulk diamond band gap that is correlated with a reduction in the threshold field for electron emission. In addition, scanning tunneling microscopy studies indicate that the emission sites from UNCD films are related to minima or inflection points in the surface topography, and not to surface asperities. These data, in conjunction with tight binding pseudopotential calculations, indicate that grain boundaries play a critical role in the electron emission properties of UNCD films, such that these boundaries: ͑a͒ provide a conducting path from the substrate to the diamond-vacuum interface, ͑b͒ produce a geometric enhancement in the local electric field via internal structures, rather than surface topography, and ͑c͒ produce an enhancement in the local density of states within the bulk diamond band gap.
Background: Non-steroidal anti-inflammatory drugs (NSAIDs) are recommended for multimodal postoperative pain management. We evaluated opioid-sparing effects and rehabilitative results after perioperative celecoxib administration for total knee arthroplasty.
Randomized controlled trials have demonstrated that laparoscopic surgery for rectal cancer is safe and can accelerate recovery without compromising oncological outcomes. However, such a surgery is technically demanding, limiting its application in nonspecialized centers. The operational features of a robotic system may facilitate overcoming this limitation. Studies have reported the potential advantages of robotic surgery. However, only a few of them have featured the application of this surgery in patients with advanced rectal cancer undergoing neoadjuvant chemoradiation therapy (nCRT).From January 2012 to April 2015, after undergoing nCRT, 40 patients with mid or low rectal cancer were operated using the robotic approach at our institution. Another 38 patients who were operated using the conventional laparoscopic approach were matched to patients in the robotic group by sex, age, the body mass index, and procedure. All operations were performed by a single surgical team. The clinicopathological characteristics and short-term outcomes of these patients were compared. To assess the effect of the learning curve on the outcomes, patients in the robotic group were further subdivided into 2 groups according to the sequential order of their procedures, with an equal number of patients in each group. Their outcome measures were compared.The robotic and laparoscopic groups were comparable with regard to pretreatment characteristics, rectal resection type, and pathological examination result. After undergoing nCRT, more patients in the robotic group exhibited clinically advanced diseases. The complication rate was similar between the 2 groups. The operation time and the time to the resumption of a soft diet were significantly prolonged in the robotic group. Further analysis revealed that the difference was mainly observed in the first robotic group. No significant difference was observed between the second robotic and laparoscopic groups.Although the robotic approach may offer potential advantages for rectal surgery, comparable short-term outcomes may be achieved when laparoscopic surgery is performed by experienced surgeons. However, our results suggested a shorter learning curve for robotic surgery for rectal cancer, even in patients who exhibited more advanced disease after undergoing nCRT.
Internal herniation of the small bowel is a relatively rare cause of intestinal obstruction. Left paraduodenal hernia resulting from abnormal rotation of the midgut during embryonic development is the most common form of congenital internal hernia. We report our experience in the diagnosis and management of a young male with left paraduodenal hernia presenting as recurrent intestinal obstruction. Correct preoperative diagnosis of left paraduodenal hernia had been difficult due to non-specific clinical presentations, but the advent of modern imaging technology makes early and correct diagnosis possible. Due to the risk of obstruction and strangulation, surgical treatment is indicated; however, timely intervention increases the likelihood of a favorable outcome.
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