Nano/Micro-Structured ZnO Rods Synthesized by Thermal Chemical Vapor Deposition with Perpendicular Configuration.

Under a one-step process, catalyst-free growth of one-dimensional (1D) ZnO hierarchical nanostructures was performed on ZnO-seeded Si substrate by thermal chemical vapor deposition with a perpendicular setup. The morphological and crystallographic properties of the nano/micro-structured ZnO rods were investigated with varying growth temperature and growth time. X-ray diffraction patterns of 1D ZnO double-structured rods showed the hexagonal wurtzite structure. The morphology and crystal structure of the ZnO double-structured rods were sensitive to the growth temperature and growth time. From Raman scattering and photoluminescence spectra, the orientation and size effects of the ZnO double-structured rods were discussed in relation to growth temperatures and growth times.

Genotypes of Clinical and Environmental Isolates of Cryptococcus neoformans and Cryptococcus gattii in Korea.

Multilocus sequence typing analysis was applied to determine the genotypes of 147 (137 clinical and 10 environmental) Cryptococcus neoformans and three clinical Cryptococcus gattii isolates from 1993 to 2014 in Korea. Among the 137 clinical isolates of C. neoformans, the most prevalent genotype was ST5 (n = 131), followed by ST31 (n = 5) and ST127 (n = 1). Three C. gattii strains were identified as ST57, ST7, and ST113. All environmental isolates were identified as C. neoformans with two genotypes, ST5 (n = 7) and ST31 (n = 3). Our results show that C. neoformans isolates in Korea are genetically homogeneous, and represent a close genetic relationship between clinical and environmental isolates.

Effects of Ce Ion-Modification on an Open Circuit Photovoltage Properties of ZnO Nanowires-Based Dye-Sensitized Solar Cell.

We investigated the photoelectrochemical effects on Ce ion-modified ZnO nanowires for dye-sensitized solar cells (DSSCs), preparing four kinds of samples grown in solutions with 0, 1, 2, and 3 atomic percent (at%) of Ce precursors. It was found that Ce ion modifications lead to an increase in the lattice constant of ZnO nanowires, resulting in widening of their PL visible band and UV blueshift. I-V results tell that the photoelectrochemical properties increase in the order of 1, 2, 0, and 3 at% Ce ion-modified ZnO nanowire-based DSSCs. To further analyze and explain the experimental results, we measured absorbance, incident to photon-to-current efficiency (IPCE), and concluded that the DSSCs fabricated by using 3 at% Ce ion-modified ZnO nanowires exhibit the best device performances due to large VOC enhancements, suggesting that Ce ion modification leads to the VOC, changes of DSSCs, which can be explained by Burstein-Moss effect.

Effects of Polyethyleneimine on the Sonochemical Synthesis of Gadolinium Ion-Modified ZnO Nanorods.

We prepared gadolinium (Gd) ion-modified ZnO nanorods by a sonochemical decomposition of zinc acetate dehydrate and gadolinium acetate hydrate precursor solutions with and without polyethyleneimine (PEI). We investigated the effects of PEI on the sonochemical synthesis of ZnO nanorods with and without Gd ion modifications. In the case of nascent ZnO nanorods, PEI in the precursor solutions can prohibit radial growth but allow axial growth, resulting in changes in the degree of preferred crystal orientations, and in the PL properties of the resulting nanorods. In the case of Gd ion-modified ZnO nanorods, we observed that the ZnO nanorods, fabricated sonochemically in the precursor solutions with PEI, exhibited a peak broadening of the ZnO(002) crystal plane and decreasing crystal orientation with respect to the c plane. We note that PEI can negatively affect the crystal orientation and crystallinity of Gd ion-modified ZnO nanorods, even though it cannot affect the lattice constant.

Effect of Self-myofascial Release on Reduction of Physical Stress: A Pilot Study.

[Purpose] This study aims to examined the effect of the self-myofascial release induced with a foam roller on the reduction of stress by measuring the serum concentration of cortisol. [Subjects and Methods] The subjects of this study were healthy females in their 20s. They were divided into the experimental and control groups. Both groups, each consisting of 12 subjects, were directed to walk for 30 minutes on a treadmill. The control group rested for 30 minutes of rest by lying down, whereas the experimental group was performed a 30 minutes of self-myofascial release program. [Results] Statistically significant levels of cortisol concentration reduction were observed in both the experimental group, which used the foam roller, and the control group. There was no statistically significant difference between the two groups. [Conclusion] The Self-myofascial release induced with a foam roller did not affect the reduction of stress.

Effects of lanthanum ion modifications on the photoelectrochemical properties of ZnO nanorods-based dye-sensitized solar cells.

We investigated the photoelectrochemical effects on La ion-modified ZnO nanorods for dye-sensitized solar cells (DSSCs), preparing four kinds of samples grown in solutions with 0, 1, 2, and 3 at% of La precursors. It was found that La ion modifications lead to an increase in the lattice constant of ZnO nanorods, resulting in widening of their energy bandgap. I-V results tell that the photoelectrochemical properties increase in the order of 2, 1, 0, and 3 at% La ion-modified ZnO nanorod-based DSSCs. To further analyze and explain the experimental results, we measured absorbance, IPCE, and EIS and concluded that the DSSCs fabricated by using 3 at% La ion-modified ZnO nanorods exhibit better device performances such as Voc, Jsc, and efficiency, suggesting that the amount of La ions is a key parameter of La modified-DSSCs. The results can be explained by Burstein-Mott effects, vertical growth, and La oxide coating effects of the ZnO nanorods.

Efficacy of fibrin sealant in reducing hemorrhage after a loop electrosurgical excision procedure.

BACKGROUND/AIMS: We examined the association of fibrin sealant use with post-operative hemorrhage in patients who underwent a loop electrosurgical excision procedure (LEEP). METHODS: We retrospectively collected clinicopathologic data of 344 patients who underwent LEEP at our institute between 2007 and 2009. We defined hemorrhage which occurred between 1 and 30 days after LEEP and required electrocautery to achieve hemostasis as severe secondary hemorrhage (SSH). We determined whether or not the use of fibrin sealant during LEEP was associated with a decreased occurrence of SSH. In addition, we examined the associations of other clinicopathologic variables with SSH and fibrin sealant use. RESULTS: SSH occurred in 6 of 200 patients (3%) with fibrin sealant and in 12 of 144 patients (8%) without fibrin sealant. Based on univariate analysis, the use of fibrin sealant was associated with SSH (p = 0.028). However, age, surgeons and pathologic diagnosis were not associated with SSH. Based on multivariate analysis, the use of fibrin sealant was associated with less SSH (p = 0.033, OR = 0.328, 95% CI 0.117-0.917). CONCLUSION: Fibrin sealant use reduces the incidence of severe post-operative hemorrhage after LEEP.

Clinicopathologic factors for central recurrence in patients with locally advanced bulky cervical cancer.

OBJECTIVE: Locally advanced bulky cervical cancer (LABCC) is characterized by poor local control. The objective of this study was to identify the clinicopathologic variables associated with one-year central-only recurrence, which will serve as criteria for adjuvant hysterectomy after radiation (AHR) in patients with LABCC. STUDY DESIGN: Between January 2000 and August 2007, we retrospectively evaluated outcomes in 225 patients with LABCC who were initially treated with radiation or chemoradiation. RESULTS: Among the 225 patients with LABCC, there were 41 recurrences within one year after treatment (8 central-only and 33 pelvis and/or distant site recurrences). Age, stage, and treatment type were not associated with the one-year central-only recurrences, but tumor size ≥8cm had a statistically significant association based on multivariate analysis (OR, 5.39; 95% CI, 1.15-25.31; p=0.03). The combination of non-squamous cell (non-SCC) type and tumor size ≥8cm had a significantly higher rate of recurrence within one year (OR, 43.0; 95% CI, 4.78-386.68; p<0.01). CONCLUSIONS: Of patients with LABCC, those with non-SCC tumors ≥8cm in size were at high risk for early central-only recurrence after cisplatin-based chemoradiation, and represent the subset of patients for whom AHR is beneficial.

Characteristics of thyroid incidentalomas detected by pre-treatment [F]FDG PET or PET/CT in patients with cervical cancer.

OBJECTIVE: Considering the increased use of [(18)F]FDG PET or PET/CT, the clinical significance of thyroid incidentalomas is the subject of controversy. The aim of this study was to determine the incidence of malignancies associated with thyroid incidentalomas detected by pre-treatment PET or PET/CT in patients with cervical cancer. METHODS: We retrospectively reviewed the medical records of patients with cervical cancer who had thyroid incidentalomas detected by pre-treatment PET or PET/CT and were treated at our institute between January 2001 and December 2009. RESULTS: Of 327 patients who underwent pre-treatment PET or PET/CT, 33 patients had thyroid incidentalomas (10.1%) and 4 patients were diagnosed with thyroid malignancies by percutaneous needle aspiration (PCNA) or surgery. To put it concretely, of 33 patients with thyroid incidentaloma, 16 patients had a diffuse uptake and 17 patients had a focal uptake. Four of 17 patients with focal uptake were diagnosed with thyroid malignancies (23.5%). One patient with a focal uptake had an atypical cell based on PCNA, but did not undergo additional studies. The mean SUV(max) of thyroid malignancies did not differ from that of benign thyroid diseases. CONCLUSION: Thyroid incidentalomas are frequently detected by pre-treatment PET or PET/CT in patients with cervical cancer. Focal uptake on PET or PET/CT has a high risk of thyroid cancer.

Risk of metastatic ovarian involvement in nongynecologic malignancies.

OBJECTIVE: The objectives were to evaluate the risk of malignant adnexal tumors in women with nongynecologic malignancies and to identify variables associated with the risk of malignant adnexal tumors. METHODS: The eligibility criteria included the diagnosis of a nongynecologic malignancy and adnexal tumors, which were resected or subjected to biopsy at our institute between 1999 and 2010. The risk of malignant adnexal tumors was assessed by dividing the number of patients with metastatic tumors to the adnexa or primary adnexal cancers by the total number of patients. The association of clinicopathologic variables with the risk of malignant adnexal tumors was evaluated using the Fisher exact test and binary logistic regression analysis. In patients with metastatic tumors to the adnexa, the association of clinicopathologic variables with overall survival after adnexal surgery was examined using the log-rank test. RESULTS: In 166 patients with adnexal tumors, 41 benign tumors, 113 metastatic tumors to the adnexa, and 12 primary adnexal cancers were diagnosed. Age older than 46 years, a tumor type associated with a high risk for malignant adnexal tumors, and bilateral tumors significantly increased the risk of malignant adnexal tumors. The overall survival of the patients with stomach cancer was significantly worse than the patients with colorectal or breast cancers. CONCLUSION: One hundred twenty-five of the 166 patients with nongynecologic malignancies who had adnexal tumors managed surgically were shown to have malignant tumors, and most of the tumors were metastatic from primary sites. The risk of malignant adnexal tumors was associated with age, nongynecologic malignancy, and bilaterality.

Randomized clinical trial of weekly vs. triweekly cisplatin-based chemotherapy concurrent with radiotherapy in the treatment of locally advanced cervical cancer.

PURPOSE: To compare compliance, toxicity, and outcome of weekly and triweekly cisplatin administration concurrent with radiotherapy in locally advanced cervical cancer. METHODS AND MATERIALS: In this open-label, randomized trial, 104 patients with histologically proven Stage IIB-IVA cervical cancer were randomly assigned by a computer-generated procedure to weekly (weekly cisplatin 40 mg/m(2), six cycles) and triweekly (cisplatin 75 mg/m(2) every 3 weeks, three cycles) chemotherapy arms during concurrent radiotherapy. The difference of compliance and the toxicity profiles between the two arms were investigated, and the overall survival rate was analyzed after 5 years. RESULTS: All patients tolerated both treatments very well, with a high completion rate of scheduled chemotherapy cycles. There was no statistically significant difference in compliance between the two arms (86.3% in the weekly arm, 92.5% in the triweekly arm, p > 0.05). Grade 3-4 neutropenia was more frequent in the weekly arm (39.2%) than in the triweekly arm (22.6%) (p = 0.03). The overall 5-year survival rate was significantly higher in the triweekly arm (88.7%) than in the weekly arm (66.5%) (hazard ratio 0.375; 95% confidence interval 0.154-0.914; p = 0.03). CONCLUSIONS: Triweekly cisplatin 75-mg/m(2) chemotherapy concurrent with radiotherapy is more effective and feasible than the conventional weekly cisplatin 40-mg/m(2) regimen and may be a strong candidate for the optimal cisplatin dose and dosing schedule in the treatment of locally advanced cervical cancer.

Guideline adherence to chemotherapy administration safety standards: a survey on nurses in a single institute.

OBJECTIVE: Little is known about the guideline adherence of nurses to chemotherapy administration guidelines. We determined the guideline adherence of nurses to the Chemotherapy Administration Safety Standards and the relationship between demographic characteristics and guideline adherence. METHODS: Survey sheets containing two questions on demographic characteristics and 16 questions on the guideline adherence of nurses regarding chemotherapy administration were distributed to all in-patient departments in our hospital in which chemotherapy was performed. All clinical nurses in the department were recommended to respond. RESULTS: Of 202 nurses, 123 responses were collected (61% response rate). The guideline adherence rate was >70% for 15 of 16 questions, but 55% of respondents indicated that there was no competency monitoring for nurses. Nurses with >7 years of clinical nursing experience felt more competent in performing cardiopulmonary resuscitation (CPR) than nurses with <7 years of clinical nursing experience (p=0.032). CONCLUSION: The guideline adherence rate of nurses with respect to chemotherapy administration was high, with the exception of the absence of a competency monitoring for nurses. A significant number of nurses with <7 years of clinical nursing experience felt incompetent in performing CPR.

Is adjuvant chemoradiotherapy overtreatment in cervical cancer patients with intermediate risk factors?

PURPOSE: To determine whether adjuvant chemoradiotherapy (CRT) improves the outcome of cervical cancer patients with intermediate risk factors. METHODS AND MATERIALS: Between January 2000 and June 2006, the medical records of 735 patients who had undergone radical surgery for Stage IB-IIA cervical cancer were reviewed retrospectively. Of the 735 patients, 172 with two or more intermediate risk factors (i.e., lymphovascular space involvement, deep stromal invasion, and tumor size≥2 cm) were grouped as follows according to the adjuvant treatment received: 34 patients, no further treatment; 49 patients, RT; and 89 patients, CRT. The significance of the clinical parameters and recurrence-free survival of each group were analyzed. RESULTS: Of the 172 patients with any of the intermediate risk factors, 137 (79.6%) had two or more intermediate risk factors. Of the 172 patients, 12 developed recurrences (6.4%)->(7.0%), with 6 in the pelvis and 6 in distant sites. All 12 recurrences occurred in those who had two or more intermediate risk factors (sensitivity, 100%); however, only six recurrences were detected in patients who met the Gynecologic Oncology Group criteria for the intermediate-risk group (sensitivity, 50%; Z test, p<.05). A statistically significant difference was found in the 3-year recurrence-free survival rate among the no further treatment, RT, and CRT groups (67.5%, 90.5%, and 97.5%, respectively; p<.05). The incidence of Grade 3-4 hematologic and gastrointestinal toxicities was not significantly different statistically between the RT and CRT groups (6.1% and 13.4%, respectively; p > .05). CONCLUSION: Postoperative adjuvant CRT can improve the outcome of cervical cancer patients with intermediate risk factors, with low increase in toxicity.

The type of metastasis is a prognostic factor in disseminated cervical cancer.

OBJECTIVE: THE OBJECTIVES OF THIS STUDY WERE TWOFOLD: to verify whether the type of metastasis (lymphatic vs. hematogenous) is a prognostic factor, and to identify molecular markers associated with survival in patients with disseminated cervical cancer. METHODS: Between April 1997 and May 2008, 30 patients with disseminated cervical cancer who had supraclavicular lymph node (N=13) or hematogenous metastases (N=17) were initially treated at our institute. We reviewed medical records to extract clinicopathologic variables. For 17 patients with available pathological specimens, we evaluated the association of immunohistochemical staining for metalloproteinase (MMP)-2, vascular endothelial growth factor (VEGF)-A, and laminin V gamma (LAMC)-2 with survival and clinicopathologic variables via a log-rank test and Cox regression analysis. RESULTS: Patients who had only lymphatic metastasis (odds ratio [OR], 5.3; 95% confidence interval [CI], 1.4 to 19.5) or completed initial treatment (OR, 3.2; 95% CI, 1.1 to 9.9) showed better survival than patients who did not, but none of the molecular markers were associated with survival. Out of 13 patients with only lymphatic metastasis, three patients who had received volume-directed radiation with concurrent chemotherapy had a long-term survival of over two years. However, patients with hematogenous metastasis showed extremely poor prognosis. CONCLUSION: The type of metastasis and completion of initial treatment were associated with prolonged survival in patients with disseminated cervical cancer, and over 20% of patients with lymphatic metastasis were salvaged with volume-directed radiation with concurrent chemotherapy. None of the molecular markers were associated with survival in patients with disseminated cervical cancer.

Detection of recurrence by 18F-FDG PET in patients with endometrial cancer showing no evidence of disease.

This study assessed the feasibility of F-18-fluorodeoxyglucose positron-emission tomography ((18)F-FDG PET) in the post-therapy surveillance for patients with endometrial cancer showing no evidence of disease (NED). From April 1997 to June 2007, 127 patients with endometrial cancer showing NED were performed (18)F-FDG PET scan. The feasibility of (18)F-FDG PET for the early detection of recurrence in patients with endometrial cancer was evaluated retrospectively. Of the 127 patients, 32 patients showed positive lesions on (18)F-FDG PET scan. Nineteen (19/127 cases, 15%) of them were confirmed to have a recurrence clinically or histologically. The sensitivity, specificity and positive and negative predictive value of (18)F-FDG PET for detecting recurrences in patients with endometrial cancer were 100%, 88%, 59% and 100%, respectively. In conclusion, (18)F-FDG PET may be a useful method for the post-therapy surveillance in patients with endometrial cancer.

Current status of gynecological cancer in China.

The aim of this review is to examine the current status of gynecological cancer in China focusing on epidemiological data. Epidemiological data on gynecological cancer in China is sparse. Therefore, most of the data were estimated via extrapolation based on a few available datasets. Cervical cancer is relatively rare and the incidence and mortality rate are largely decreasing. However, in young women, the incidence and mortality rates are increasing. The overall and age-specific incidence rates of cervical cancer appear to be varied according to geographical areas. The overall prevalence rate of human papillomavirus (HPV) in China is similar with other eastern Asian countries, but the age-specific HPV prevalence showed sustained high HPV prevalence rates in elderly women. There is not yet an established national program for cervical cancer prevention. The incidence rate of corpus and ovarian cancers in China slightly increased between 2000 and 2005, but is still lower than Japan or Korea. There is no reliable, national-level data on mortality rates of corpus and ovarian cancer in China. Breast cancer is one of the most rapidly increasing cancers in China. The increase was sharper in young women than in elderly women. Both increased risk and change of population size/structure contributed to the increase of breast cancer.

Inadvertent potential risk of neoadjuvant chemotherapy in cervical cancer.

Randomized clinical trials comparing neoadjuvant chemotherapy (NAC) followed by surgery with initial surgery in cervical cancer reported conflicting results. We provided a hypothesis explaining the different outcomes between trials. NAC was reported to make a lymph node metastasis smaller. Smaller tumors are hard to detect and potentially undetected at pathologic examination. Undetected metastasis would lead to an erroneous exclusion of high-risk patients from adjuvant therapy. An erroneous exclusion would lead to a recurrence. This harmful concealing effect of NAC could negate the potentially beneficial effect of NAC and the conflicting results of trials could be the result of the balance between harmful and beneficial effect of NAC. Because the concealing effect of NAC can be reversed by adjuvant therapy, trials comparing NAC followed by surgery with initial surgery in which all patients in both arms received adjuvant therapy reported positive result. However, in a trial in which only patients with lymph node or parametrial involvements received adjuvant therapy, the concealing effect was not reversed by adjuvant therapy and reported negative result. Our empirical data showed that patients who underwent NAC followed by surgery and were classified as low-risk based on pathologic parameters had unexpectedly high recurrence rate. To evaluate our hypothesis, a trial comparing a conventional pathologic examination with a more sophisticated examination such as ultrastaging in patients with cervical cancer who received NAC followed by surgery would be necessary. If our hypothesis is proven, trials considering the concealing effect of NAC should be performed to accurately evaluate the role of NAC in cervical cancer.

Major clinical research advances in gynecologic cancer 2008.

In this review, we summarized 14 major clinical advances in gynecology which occurred in 2008. For cervical cancer, clinical impact of HPV vaccine, prognostic value of imaging during radiotherapy, and oncologic/obstetric outcomes of fertility-sparing surgery were chosen. For uterine cancer, optimal method of adjuvant radiotherapy in intermediate-risk patients, extent of lymph node dissection, outcome of robot-assisted staging surgery, new standard chemotherapy regimen for leiomyosarcoma were selected. For ovarian cancer, recent changes in adjuvant therapy, feasibility of neoadjuvant chemotherapy, prediction of optimal secondary cytoreduction, studies on new biomarkers, advances in screening and treatment of women with BRCA mutations were included. For other cancers, the safety of sentinel lymph node dissection in vulvar cancer and chemotherapy regimens for low-risk gestational trophoblastic tumors were reviewed.