Density-controlled electrochemical synthesis of ZnO nanowire arrays using nanotextured cathode.

Zinc oxide (ZnO) nanowires fabricated via wet chemical synthesis on flexible polymer substrates are inherently unstable against mechanical bending stress because of their high density and weak adhesion to the substrate. We introduce a novel method for controlling the density of such ZnO nanowire arrays using a three-dimensional corrugated metal substrate. These metal substrates, featuring extruded and recessed patterns fabricated via nanoimprint lithography, were employed as cathodes during the electrochemical deposition of ZnO nanowire arrays. The ZnO nanowire arrays synthesized on the patterned metal thin film exhibited smaller diameters and lower densities compared to those on non-patterned metal films. This reduction in density can be attributed to aligned nucleation and limited growth on the patterned metal surface. Crucially, ZnO nanowires synthesized on patterned metal substrates displayed remarkable mechanical robustness against external forces, a direct consequence of their reduced density. In contrast, nanowires synthesized on non-patterned metal substrates were broken under mechanical bending. Detailed morphological analyses performed after mechanical bending tests confirm that ZnO nanowires synthesized on nanoimprinted metal electrodes exhibited enhanced mechanical characteristics compared to those on non-patterned metal electrodes. These findings clearly demonstrate the promise of utilizing density-controlled ZnO nanowires in piezoelectric devices.

Endometriosis Is Associated with Adverse Pregnancy Outcomes: a National Population-Based Study.

Pregnancy and neonatal outcomes in women diagnosed with endometriosis were investigated using data collected from the Korea National Health Insurance Claims Database and the National Health Screening Program for Infants and Children. A total of 3,778,561 women who gave birth between 2007 and 2015 were identified, and 1,938,424 primiparous women and their newborns were included in this study. Women with a diagnosis of endometriosis had a significantly higher incidence of multiple pregnancy, cesarean section, breech presentation, postpartum hemorrhage, placental abruption, placenta previa, and stillbirth than women without endometriosis (P < 0.0001). The rates of preterm birth and low birth weight were also increased in women with endometriosis (P < 0.0001). After adjusting for age, the estimated risks of these outcomes remained significant. Women previously diagnosed with endometriosis have an increased risk of adverse pregnancy and neonatal outcomes. Particular attention and information regarding these conditions should be provided to women with endometriosis during the preconception or antenatal periods.

The prevalence and treatment pattern of clinically diagnosed pelvic organ prolapse: a Korean National Health Insurance Database-based cross-sectional study 2009-2015.

The study aim was to evaluate the prevalence of pelvic organ prolapse using claim data of South Korea and to evaluate treatment patterns. The Korea National Health Insurance Corporation pay medical costs for most diseases. This study used Health Insurance Review & Assessment Service-National Inpatient Sample (HIRA-NIS) 2009-2015. Pelvic organ prolapse was defined by diagnostic code (N81.x). Of the approximately 4.5 million women included in HIRA-NIS 2009-2015, 10,305 women were selected as having pelvic organ prolapse, and the mean age of the pelvic organ prolapse group was 63.9 ± 0.2 years. The prevalence of pelvic organ prolapse was 180 ± 4 per 100,000 population in women older than 50 years old. In logistic regression analysis, constipation increased the prevalence of all pelvic organ prolapse (odds ratio, 4.04; 95% confidence interval, 3.52-4.63; P < 0.01). The number of women requiring pessary only and surgery only were 26 ± 2 per 100,000 population and 89 ± 1 per 100,000 population, respectively, for women over 50 years of age. The prevalence of pelvic organ prolapse was quite lower than in previous studies. Surgery peaked at approximately 70 years of age. Pessary increased dramatically among women after the age of 65.

Increased expression of resistin in ectopic endometrial tissue of women with endometriosis.

PROBLEM: Inflammation is a key process in the establishment and progression of endometriosis. Resistin, an adipocytokine, has biological properties linked to immunologic functions, but its role in endometriosis is unclear. METHOD OF STUDY: Resistin gene expression was examined in eutopic and ectopic endometrial tissues from women with (n=25) or without (n=25) endometriosis. Resistin mRNA and protein levels were determined in endometrial tissue using quantitative real-time reverse transcription PCR and Western blotting, following adipokine profiling arrays. RESULTS: Resistin protein was detected in human endometrial tissues using an adipokine array test. Resistin mRNA and protein levels were significantly higher in ectopic endometrial tissue of patients with endometriosis than in normal eutopic endometrial tissue. CONCLUSION: Our results indicate that resistin is differentially expressed in endometrial tissues from women with endometriosis and imply a role for resistin in endometriosis-associated pelvic inflammation.

Surgical proficiency decreases the rate of healing abnormalities using anterior transobturator mesh in cystocele women.

Aims: The objective of this study is to report the outcomes of cystocele repair with anterior transobutrator mesh kits.  Methods: 119 consecutive women with cystoceles were treated between January 2006 and November 2010 by a single surgeon at a university hospital using the anterior transobturator mesh kit procedure. Postoperative follow-up visits were scheduled at 1, 6, and 12 months after surgery. Results: A total of 114 women who were operated on with the anterior transobturator mesh kit completed 12 months of follow-up. The population had a mean age of 65.8 ± 7.0, a body mass index of 25.1 ± 3.0, and a parity average of 4.0 ± 1.7. An overall anatomic cure was reported for 108 patients (94.7%). The Ba point of the POP-Q exam used for grading cystoceles decreased significantly from 2.5 ± 1.6 cm to -2.8 ± 0.8 cm after 12 months (P < 0.01). One patient (0.9%) presented with bladder perforation, and five patients (4.4%) showed with healing abnormalities. Surgical case volume was negatively correlated with healing abnormalities after adjusting for age, body mass index, operation time, and parity (P = 0.15).  Conclusion: The surgeon's experience decreases the incidence of healing abnormalities using anterior transobturator mesh in cystocele women. The anatomical cure rate of anterior transobturator mesh is quite good.

Nanotextured Polymer Substrate for Flexible and Mechanically Robust Metal Electrodes by Nanoimprint Lithography.

Metal thin film electrodes on flexible polymer substrates are inherently unstable against humidity and mechanical stresses because of their poor adhesion properties. We introduce a novel approach for improving the adhesion characteristics of metal-polymer interface based on the nanostructuring of the polymer substrate by using nanoimprint lithography. The adhesion characteristics of metal-polymer interface were measured by accelerated test, cyclic bending test and double cantilever beam (DCB) test. The interface of Au/Ti dual layer thin film and nanoimprinted PMMA substrate shows over 2.03 and 1.95 times higher adhesion energy (G(c)) than that of Au/Ti dual layer thin film and plane PMMA substrate in air and wet environments, respectively. The adhesion energy between metal thin film and polymer substrate was dramatically improved by the increased surface roughness and mechanical interlocking effect of numerous nanoscale anchors at the edges of nanoimprinted surface, which was verified by both experiment and numerical analysis.

Chemerin Expression in the Peritoneal Fluid, Serum, and Ovarian Endometrioma of Women with Endometriosis.

PROBLEM: Inflammation is an essential process in the pathogenesis of endometriosis. METHOD OF STUDY: Serum and peritoneal fluid (PF) samples were collected from women with endometriosis (n = 31) and women without endometriosis (n = 48). Chemerin, tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) levels in serum and PF samples were determined with a specific enzyme-linked immunosorbent assay. Eutopic endometrial tissue from controls and ovarian endometriotic cysts were obtained during surgery. Expression of chemerin and chemerin receptors in ectopic and eutopic endometrial tissues was measured on real-time reverse transcriptase-polymerase chain reaction. Protein expression was examined with Western blot and densitometric analysis. RESULTS: Chemerin concentrations were higher in PF from women with endometriosis than that in that from controls. PF chemerin concentrations were significantly correlated with both TNF-α and IL-6 levels in PF. The mRNA and protein of chemerin and its receptor were significantly increased in the ovarian endometrioma tissue compared with eutopic endometrium of controls. CONCLUSION: These findings suggest that chemerin plays a role in endometriosis-related pelvic inflammation.

High rate of nickel allergy in women with endometriosis: a 3-year population-based study.

AIM: The aim of this study was to evaluate the prevalence rates of nickel allergy, contact dermatitis, drug allergy, allergic rhinitis and atopic dermatitis among women with and without endometriosis. MATERIAL AND METHODS: Data were obtained from the National Patient Sample of the Republic of Korea, which was provided by the Korean Health Insurance Review and Assessment Service. We evaluated women aged 20-40 years who visited a health care institution from 2009-2011. We estimated the prevalence of allergic diseases among women with and without endometriosis. RESULTS: We extracted a sample of 1 843 447 women from the total patient sample of approximately 3 million. We identified 7259 women with endometriosis and 535 818 women without endometriosis. After adjusting for age and data year, the women with endometriosis had higher rates of nickel allergy (odds ratio = 1.175; 95% confidence interval, 1.011-1.366; P = 0.04). Additionally, after adjusting for age, data year and other allergic diseases, the women with endometriosis had higher rates of nickel allergy (odds ratio = 1.167; 95% confidence interval, 1.004-1.357; P = 0.04). After adjusting for other covariates, we found that other allergic disorders, such as allergic rhinitis, atopic dermatitis and contact dermatitis, were not associated with endometriosis. CONCLUSION: Women with endometriosis had higher rates of nickel allergy. Further research is required to clarify the relation between nickel allergy and endometriosis.

Comparing the prevalence of condylomata acuminata between pregnant women and nonpregnant controls in South Korea: a population-based, cross-sectional study.

We analyzed and estimated the prevalence of condylomata acuminata from South Korea claim data in 2009. The prevalence in pregnant women aged 20 to 34 years (46 ± 7 per 100,000 persons) was lower than that in nonpregnant women aged 20 to 34 years (59 ± 1 per 100,000 persons; P < 0.001).

Association between pregnancy and acute appendicitis in South Korea: a population-based, cross-sectional study.

PURPOSE: To estimate the prevalence of acute appendicitis and the relationship between pregnancy and acute appendicitis among South Korean women in 2009. METHODS: This was a cross-sectional study over 1 year period using a national registry data. We analyzed a national patient sample (n = 1,116,040) from a database complied by the South Korean National Health Insurance in 2009. RESULTS: We identified 15,974 cases of acute appendicitis from 2009. The prevalence rate of acute appendicitis was 228 ± 2 per 100,000 persons. The prevalence in men was higher than in women. The peak prevalence of the disease in both genders occurred in patients aged 10 to 14 years. After that, prevalence declined with age. The prevalence of acute appendicitis in women aged 20 to 39 years was negatively associated with age and pregnancy (P < 0.001) but was not associated with socioeconomic status. The prevalence of perforated appendicitis cases by age is represented by a U-shaped curve. The prevalence was highest in people less than five years of age and in people older than 60 years. CONCLUSION: We found that the prevalence of acute appendicitis decreased with increasing age after early teens, and that the prevalence of acute appendicitis in pregnant women was lower than in nonpregnant women.

Effects of estrogen receptor α and ß on the expression of visfatin and retinol-binding protein 4 in 3T3-L1 adipocytes.

The aim of this study was to investigate the effects of estrogen and estrogen receptor α (ERα) and ß (ERß) on the expression of visfatin and retinol-binding protein 4 (RBP4) by treating 3T3-L1 adipocytes with estradiol (E2), estrogen receptor agonists and antagonists. Mature adipocytes were exposed to E2, the ERα agonist, 4,4',4''-(4-propyl-[1H]-pyrazole-1,3,5-triyl)trisphenol (PPT), the ERß agonist, 2,3-bis(4-hydroxyphenyl)-propionitrile (DPN), E2 with the ERα antagonist, 1,3-bis(4-hydroxyphenyl)-4-methyl-5-[4-(2-piperidinylethoxy)phenol]-1H-pyrazole dihydrochloride (MPP), and E2 with the ERß antagonist, (5R, 11R)-5,11-diethyl-5,6,11,12-tetrahydro-2,8-chrysenediol [(R,R)-THC], at various concentrations. To determine the effects of ER subtypes on the expression of adipokines, quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) and western blot analyses were performed. E2 concentrations of 10-5 and 10-6 mol/l induced a statistically significant increase in the expression of RBP4 (P=0.012 and P=0.011, respectively). In the cells treated with 10-5 mol/l PPT, RBP4 expression significantly increased (P<0.05) in a dose-dependent manner. Treatment with the ERα antagonist, MPP (10-5 mol/l), and E2 suppressed the expression of RBP4 (P=0.032). However, the expression of RBP4 was not significantly altered when the cells were treated with the ERß agonist or antagonist. The expression of visfatin was not affected by different concentrations of E2 and ERs. 17ß-estradiol significantly increased the secretion of RBP4 and upregulated RBP4 expression via ERα but not ERß in 3T3-L1 adipocytes. RBP4 expression was regulated by estrogen in the 3T3-L1 adipocytes and this effect was selectively mediated by ERα.

Association between socioeconomic status and ectopic pregnancy rate in the Republic of Korea.

OBJECTIVE: To estimate the ectopic pregnancy rate in the Republic of Korea and to identify whether socioeconomic factors contribute to the incidence of ectopic pregnancy. METHODS: Korean National Health Insurance data from January to December 2009 were analyzed to calculate the rate of ectopic pregnancy. RESULTS: Among the patient sample (n=599186), 59261 had diagnosis codes for ectopic pregnancies, abortions, or deliveries, and 1102 ectopic pregnancies were identified. The frequency of ectopic pregnancy treated by either surgery or methotrexate was 16.60 per 1000 pregnancies. Low socioeconomic status was a risk factor for ectopic pregnancy (odds ratio [OR], 1.718; 95% confidence interval [CI], 1.065-2.772; P=0.03), as was older age (OR, 1.016; 95% CI, 0.998-1.033, P=0.07), although the association was not significant. Among women aged 25-44years, low socioeconomic status and age were associated with a high incidence of ectopic pregnancy (OR, 1.863; 95% CI, 1.074-3.233, P=0.03; and OR, 1.061; 95% CI, 1.041-1.081, P<0.01, respectively). Surgical and methotrexate treatment rates were 90.7% and 9.3%, respectively. The methotrexate failure rate was 30.7%. The recorded ectopic pregnancy sites were tubal or ovarian (90.2%), cornual (6.0%), cervical (2.8%), and abdominal (1.0%). CONCLUSION: Older age and low socioeconomic status were risk factors for ectopic pregnancy.

Incidence of Bartholin duct cysts and abscesses in the Republic of Korea.

OBJECTIVE: To estimate the incidence of Bartholin duct cysts and abscesses in the Republic of Korea during 2009. METHODS: A national patient sample (n=599 186) was obtained from Korean Health Insurance Review and Assessment Service data and analyzed to estimate the incidence of Bartholin duct cysts and abscesses among Korean women in 2009. RESULTS: There were 587 Bartholin duct cysts and 757 Bartholin duct abscesses during 2009. The total incidence of Bartholin duct cysts and abscesses was 0.55 per 1000 person-years and 0.95 per 1000 person-years, respectively. In women aged 35-50 years, the incidence was 1.21 per 1000 person-years and 1.87 per 1000 person-years, respectively. In multivariate logistic regression analysis, the incidence of Bartholin duct cysts and abscesses was associated with age (P<0.01), but not with season or socioeconomic status, among women aged 15-50 years. The main operation performed was marsupialization (45.2%) for Bartholin duct cysts and incision (71.5%) for Bartholin duct abscesses. CONCLUSION: The incidence of Bartholin duct cysts and abscesses increased with age until menopause, decreasing thereafter.

Anterior transobturator polypropylene mesh in the correction of cystocele: 2-point method vs 4-point method.

STUDY OBJECTIVE: To compare the effectiveness and safety of 2 anterior transobturator mesh methods for treating anterior vaginal wall prolapse. DESIGN: Randomized controlled study (Canadian Task Force classification I). SETTING: University hospital. PATIENTS: Eighty-seven women with anterior vaginal wall prolapse stage ≥2 (Pelvic Organ Prolapse Quantification [POP-Q]) underwent an anterior transobturator mesh procedure using macropore polypropylene mesh. INTERVENTIONS: Forty-five patients underwent the operation via the conventional 4-point, full-sized mesh method, and 42 patients underwent the operation via a novel 2-point, half-sized mesh method. MEASUREMENTS AND MAIN RESULTS: Patient characteristics were comparable between the 2 groups. The anatomic cure rate was significantly lower in the 2-point group compared with the 4-point group at 12 months after surgery (87.2% vs 100%; p = .03). Healing abnormalities were significantly higher in the 2-point group than in the 4-point group (12.8% vs 0%; p = .03). Bladder perforation (2.6% vs 0%), stress urinary incontinence (23.1% vs 22.5%), urinary frequency (12.8% vs 22.5%), and voiding difficulty and dyspareunia (0% vs 0%) were not statistically different between the 2 groups. At linear regression analysis, mean (SD) operation time did not differ between the 2 groups (74.9 [32.7] minutes vs 87.8 [36.7] minutes; p = .11). CONCLUSION: Compared with the 4-point method, the 2-point anterior transobturator mesh method resulted in a lower rate of anatomic cure and a higher rate of healing abnormality.

Serum calcium level is associated with metabolic syndrome in elderly women.

OBJECTIVE: To investigate the association between serum calcium level and metabolic syndrome, defined using the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) definition, in Korean elderly women. STUDY DESIGN: We conducted a cross-sectional study of 1941 elderly women (mean age: 65.16±4.58 years) who participated in annual health examinations at Korea university Medical Center between January 1, 2006 and December 31, 2009 and had normal serum calcium levels. RESULTS: Women with metabolic syndrome had higher serum calcium levels than those without metabolic syndrome (9.26±0.35 vs. 9.20±0.33, P<0.001). In multiple logistic regression analysis, serum calcium level within normal range was positively associated with the risk of having metabolic syndrome (odds ratio 2.12, 95% confidence interval 1.50-2.98). With regard to components of metabolic syndrome, serum calcium level was also positively associated with the risk of having high triglyceride, and high glucose, whereas it was inversely associated with the risk of having low high density lipoprotein. However, there was no association of serum calcium level with abdominal obesity or high blood pressure. CONCLUSIONS: The higher was the level of calcium within normal range, the greater were the odds of metabolic syndrome in healthy and elderly women. Prospective studies are needed to investigate the role of calcium in the development of metabolic syndrome in the future.

Resistin concentration is increased in the peritoneal fluid of women with endometriosis.

PROBLEM: The aim of this study was to investigate the concentration of resistin and adiponectin in the peritoneal fluid (PF) of patients with endometriosis. METHOD OF STUDY: PF sampling was obtained from women with (n = 48) and without endometriosis (n = 36), and the anthropometric indices of the patients were measured. Resistin and adiponectin concentrations in the PF were determined using the enzyme-linked immunosorbent assay. RESULTS: The mean concentration of PF resistin was significantly higher in women with endometriosis compared to the controls. PF resistin concentrations were not associated with any of the anthropometric indices. The PF adiponectin did not differ between the two groups, but showed a significant association with the weight, body mass index, and hip circumference. After adjusting for these factors, PF adiponectin expression was not associated with endometriosis. CONCLUSION: The findings of this study suggest a potent role for resistin in endometriosis. Further studies are needed to elucidate the biological implications of resistin in endometriosis.

Giant endocervical polyp mimicking cervical malignancy: primary excision and hysteroscopic resection.

Giant cervical polyps are characterized by an unusually large size and appear clinically as malignant. A 35-year-old woman had increased vaginal discharge and lower abdominal discomfort. At examination, a fist-sized, hard, consistent mass was found in the vagina. Pelvic magnetic resonance imaging revealed a 12.6 x 8-cm solid tumor with internal papillary growth within the entire vaginal cavity. The tumor base was suspected to have originated from the endocervix by a connecting stalk. Primary excision of the tumor was performed via the vagina, and the remnant tissue was completely removed at hysteroscopic resection. The final histopathologic findings confirmed a benign giant cervical polyp.

Accessory breast tissue presenting as a vulvar mass in an adolescent girl.

BACKGROUND: The development of an accessory breast tissue is attributed to the failure of regression of milk line remnants during embryogenesis. The accessory breasts can develop anywhere along the milk line, extending from axilla to the groin. The vulvar accessory breast is extremely rare among these. CASE: We report an 18-year-old girl presenting a solitary vulvar mass which is later pathologically confirmed to be an accessory breast tissue. On preoperative ultrasonographic examination, a lobulated echogenic mass with internal septa was seen in the subcutaneous fat layer of the mons pubis. Excisional biopsy was performed, which revealed an accessory breast tissue. She had no specific developmental abnormalities and had no familial history. CONCLUSION: An accessory breast in the vulva is an extremely rare case among the ectopic breasts, especially in an adolescent girl. Pathological confirmation is mandatory in this case to exclude a possibility of other tumor, including malignancy.

Association of body mass index with severity of endometriosis in Korean women.

OBJECTIVE: To investigate the relationship between endometriosis severity and body mass index (BMI). METHODS: Of 481 women seen for endometriosis at a university hospital in Korea, 153 had stage I, 113 had stage II, 110 had stage III, and 105 had stage IV disease. The patients' BMIs were categorized according to World Health Organization criteria for Asian-Pacific populations. RESULTS: Women with early or mild endometriosis (stages I or II) had a significantly higher BMI than those with advanced disease (stages III or IV) (P<0.001). After adjusting for age, parity, and menstrual factors, an association between BMI and disease stage remained significant (P<0.001). CONCLUSION: Women with advanced-stage endometriosis had lower BMIs than those with minimal or mild disease, and BMI was significantly associated with disease severity.