The molecular epidemiology and clinical implication of methicillin-resistant Staphylococcus aureus (MRSA) sequence types in pediatric bacteremia: a restrospective observational study, 2016-2021.

BACKGROUND: While there is a high burden of methicillin-resistant Staphylococcus aureus (MRSA) infections among pediatric patients, studies on the molecular epidemiology of MRSA infections in Korean children since the 2010s are lacking. This study aimed to investigate the molecular genotypes and clinical characteristics of MRSA isolates from children with MRSA bacteremia at Asan Medical Center Children's Hospital from 2016 to 2021. METHODS: Clinical data were retrospectively reviewed, and the molecular types of MRSA were determined using multilocus sequence typing (MLST) and Staphylococcal cassette chromosome mec (SCCmec) typing. RESULTS: The overall methicillin resistance rate of S. aureus bacteremia was 44.8% (77/172); 49.5% in the period 2016-2018 (period 1) and 37.3% in the period 2019-2021 (period 2) (P = 0.116). Community-acquired infections accounted for only 3.9% of cases. The predominant ST group was ST72 group (67.6%), followed by ST5 group (18.9%) and ST1 group (5.4%). The proportion of ST5 was significantly lower in period 2 compared to period 1 (P = 0.02). Compared to the ST5 and ST1 groups, the ST72 group exhibited lower overall antibiotic resistance and multidrug-resistant (MDR) rates (12.0% [6/50] in ST72 group vs. 100.0% [14/14] in ST5 group vs. 50.0% [2/4] in ST1 group; P < 0.001). In the multivariate analysis, the ST1 group was an independent risk factor for 30-day all-cause mortality (aOR, 44.12; 95% CI, 3.46-562.19). CONCLUSION: The ST72-MRSA strain remained the most frequently isolated genotype in Korean children, while the ST1 group emerged as an independent risk factor for 30-day all-cause mortality in pediatric MRSA bacteremia. Ongoing efforts to uncover the evolving epidemiology of MRSA are essential for developing effective strategies for prevention and treatment.

Distinct features of B cell receptors in neuromyelitis optica spectrum disorder among CNS inflammatory demyelinating diseases.

BACKGROUND: Neuromyelitis optica spectrum disorder (NMOSD) stands out among CNS inflammatory demyelinating diseases (CIDDs) due to its unique disease characteristics, including severe clinical attacks with extensive lesions and its association with systemic autoimmune diseases. We aimed to investigate whether characteristics of B cell receptors (BCRs) differ between NMOSD and other CIDDs using high-throughput sequencing. METHODS: From a prospective cohort, we recruited patients with CIDDs and categorized them based on the presence and type of autoantibodies: NMOSD with anti-aquaporin-4 antibodies, myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) with anti-myelin oligodendrocyte glycoprotein antibodies, double-seronegative demyelinating disease (DSN), and healthy controls (HCs). The BCR features, including isotype class, clonality, somatic hypermutation (SHM), and the third complementarity-determining region (CDR3) length, were analyzed and compared among the different disease groups. RESULTS: Blood samples from 33 patients with CIDDs (13 NMOSD, 12 MOGAD, and 8 DSN) and 34 HCs were investigated for BCR sequencing. Patients with NMOSD tended to have more activated BCR features compare to the other disease groups. They showed a lower proportion of unswitched isotypes (IgM and IgD) and a higher proportion of switched isotypes (IgG), increased clonality of BCRs, higher rates of SHM, and shorter lengths of CDR3. Notably, advanced age was identified as a clinical factor associated with these activated BCR features, including increased levels of clonality and SHM rates in the NMOSD group. Conversely, no such clinical factors were found to be associated with activated BCR features in the other CIDD groups. CONCLUSIONS: NMOSD patients, among those with CIDDs, displayed the most pronounced B cell activation, characterized by higher levels of isotype class switching, clonality, SHM rates, and shorter CDR3 lengths. These findings suggest that B cell-mediated humoral immune responses and characteristics in NMOSD patients are distinct from those observed in the other CIDDs, including MOGAD. Age was identified as a clinical factor associated with BCR activation specifically in NMOSD, implying the significance of persistent B cell activation attributed to anti-aquaporin-4 antibodies, even in the absence of clinical relapses throughout an individual's lifetime.

Hierarchically Interpenetrated and Reentrant Microcellular Frameworks for Stretchable Lithium Metal Batteries.

With the rapid development of human-friendly wearable devices, energy storage components are required to have skin-like stretchability or free-form to fit closer and more comfortably to the human body. This study introduces a hierarchically interpenetrated reentrant microcellular structure combined with 2D cellular graphene/MXene/carbon nanotubes (CNTs) and 3D cellular melamine foam. This composite structure works as a stretchable framework of lithium metal composite electrodes to provide stretchability for lithium metal electrodes, which are promising as next-generation energy storage systems. The interpenetrated but independent cellular structures successfully obtain stable structural deformability from the nonconductive and deformable melamine foam, while at the same time, high electrical conductivity, lithiophilicity, and mechanical stability of the graphene/CNT/MXene network serve as a lithium deposition support during the electrodeposition of lithium. The reentrant structure is fabricated by radial compressing the hierarchical cellular structures to take advantage of the structural stretchability of the accordion-like reentrant frameworks. The lithium-deposited composite electrodes exhibit much lower overpotential during Li stripping and plating than lithium metal foil anodes and show stable electrochemical performances under 30% of mechanical strain. The reentrant microcellular electrodes offer great potential for advanced designs of lithium metal electrodes for stretchable batteries with high energy density.

Quantitative gas pressure measurement by molecular spectroscopy using chip-based supercontinuum in the mid-infrared.

We demonstrate the quantitative pressure measurement of gas molecules in the mid-infrared using chip-based supercontinuum and cepstrum analysis without additional measurements for baseline normalization. A supercontinuum generated in an on-chip waveguide made of chalcogenide glass having high nonlinearity passes through CO gas and provides a transmission spectrum. The gas absorption information is deconvoluted from the original supercontinuum spectral information containing temporal fluctuation by cepstrum analysis and extracted simply by applying a bandpass filter in the temporal domain. The gas pressure estimated from the extracted absorption information is consistent with the value measured by a pressure gauge within a difference of 1.25%, despite spectral fluctuations in the supercontinuum baseline comparable to the spectral depth of the gas absorption lines.

Simulation-Based Cybersecurity Testing and Evaluation Method for Connected Car V2X Application Using Virtual Machine.

In a connected car, the vehicle's internal network is connected to the outside through communication technology. However, this can cause new security vulnerabilities. In particular, V2X communication, to provide the safety of connected cars, can directly threaten the lives of passengers if a security attack occurs. For V2X communication security, standards such as IEEE 1609.2 define the technical functions that digital signature and encryption to provide security of V2X messages. However, it is difficult to verify the security technology by applying it to the environment with real roads because it can be made up of other safety accidents. In addition, vehicle simulation R&D is steadily being carried out, but there is no simulation that evaluates security for the V2X application level. Therefore, in this paper, a virtual machine was used to implement a V2X communication simulation environment that satisfies the requirements for the security evaluation of connected cars. Then, we proposed scenarios for cybersecurity testing and evaluation, implemented and verified through CANoe Option.Car2X. Through this, it is possible to perform sufficient preliminary verification to minimize the variables before verifying security technology in a real road environment.

Supercontinuum generation in As2S3 waveguides fabricated without direct etching.

We report a supercontinuum generation (SCG) in a waveguide that spontaneously forms without an etching process during the deposition of a core material on a preformed ${\rm{Si}}{{\rm{O}}_2}$ substructure. The mechanism of dispersion control for this new, to the best of our knowledge, type of waveguide is analyzed by numerical simulation, which results in a design rule to achieve a target dispersion profile by adjusting the substructure geometry. SCG is experimentally demonstrated with a waveguide made of ${\rm{A}}{{\rm{s}}_2}{{\rm{S}}_3}$, chalcogenide glass, which has low material absorption over the mid-IR range. A dispersion-controlled waveguide with a length of 10 mm pumped with 77 pJ pulses at a telecommunication wavelength of 1560 nm resulted in a supercontinuum that extends by more than 1.5 octaves.

Fabrication of junction-free Cu nanowire networks via Ru-catalyzed electroless deposition and their application to transparent conducting electrodes.

Over the past few years, metal nanowire networks have attracted attention as an alternative to transparent conducting oxide materials such as indium tin oxide for transparent conducting electrode applications. Recently, electrodeposition of metal on nanoscale template is widely used for formation of metal network. In the present work, junctionless Cu nanowire networks were simply fabricated on a substrate by forming a nanostructured Ru with 80 nm width as a seed layer, followed by direct electroless deposition of Cu. By controlling the density of Ru nanowires or the electroless deposition time, we readily achieve desired transmittance and sheet resistance values ranging from ∼1 kΩ sq-1at 99% to 9 Ω sq-1at 89%. After being transferred to flexible substrates, the nanowire networks exhibited no obvious increase in resistance during 8000 cycles of a bending test to a radius of 2.5 mm. The durability was verified by evaluation of its heating performance. The maximum temperature was greater than 180 °C at 3 V and remained constant after three repeated cycles and for 10 min. Transmission electron microscopy and x-ray diffraction studies revealed that the adhesion between the electrolessly deposited Cu and the seed Ru nanowires strongly influenced the durability of the core-shell structured nanowire-based heaters.

Physical therapy treatments incorporating equine movement: a pilot study exploring interactions between children with cerebral palsy and the horse.

BACKGROUND: Physical therapy treatments incorporating equine movement are recognized as an effective tool to treat functional mobility and balance in children with cerebral palsy (CP). To date, only a few studies examined kinematic outputs of the horses and children when mounted. In this pilot study, to better understand the effectiveness of this type of treatment, we examined the interaction between the horses and children with CP during physical therapy sessions where equine movement was utilized. METHODS: Four children with CP participated in eight physical therapy sessions incorporating hippotherapy as a treatment intervention. Functional mobility was assessed using the Timed Up Go or the 10 m Walk Test. Inertial measurement unit sensors, attached to children and horses, recorded movements and tracked acceleration, angular velocity, and body orientation. Correlation between vertical accelerations of children and horses were analyzed. In addition, peak frequencies of vertical accelerations of children and horses were compared. RESULTS: Functional tests modestly improved over time. The children's movements, (quantified in frequency and temporal domains) increasingly synchronized to the vertical movement of the horse's walk, demonstrated by reduced frequency errors and increased correlation. CONCLUSIONS: The findings suggest that as the sessions progressed, the participants appeared to become more familiar with the horse's movement. Since the horse's gait at a walk mimics the human gait this type of treatment may provide individuals with CP, who have abnormal gait patterns, an opportunity for their neuromuscular system to experience a typical gait pattern. The horse's movement at the walk are consistent, cyclical, rhythmical, reciprocal and multi-dimensional, all of which can facilitate motor learning. The increased synchronization between horse and the mounted participant suggests that physical therapy utilizing equine movement is a viable treatment tool to enhance functional mobility. This study may provide a useful baseline for future work. Trial registrationTexas A&M University Institutional Review Board. IRB2018-0064. Registered 8 March 2018. Link: https://rcb.tamu.edu/humans/irb and https://github.com/pilwonhur/HPOT.

Defect Imaging Enhancement through Optimized Shape Factors of the RAPID Algorithm Based on Guided Wave Beam Pattern Analysis.

In this study, a modified imaging algorithm was implemented to improve the imaging accuracy for defects located on a structure. Based on analysis of the Lamb wave mode, a guided ultrasonic wave inspection technique was applied, which was able to illustrate images of defects in a 6 mm steel plate simulating containment liner plate (CLP) in nuclear power plants. The dominant Lamb wave mode was determined through short-time Fourier transform waveform analysis and imaging verification. Following tomography verification, limitations of the antisymmetric mode in the thick steel plate were identified. In addition, a modified shape factor, based on the energy distribution factor according to the beam pattern and beam width, was suggested for field applications and improved imaging accuracy. Results of the analysis revealed a beam skewing phenomenon for the Lamb wave mode. In the case of S0 2.7 MHz·mm, skewing as well as distortion effects are not observed in the experiment, while the S0 modes at 2.64 and 2.74 MHz·mm show either of them. Considering skewing width, the size of the shape function was modified. Application of the modified shape function allows us to obtain more accurate image to actual defect shape.

An Investigation on a Quantitative Tomographic SHM Technique for a Containment Liner Plate in a Nuclear Power Plant with Guided Wave Mode Selection.

The containment liner plate (CLP) in a nuclear power plant is the most critical part of the structure of a power plant, as it prevents the radioactive contamination of the surrounding area. This paper presents feasibility of structural health monitoring (SHM) and an elastic wave tomography method based on ultrasonic guided waves (GW), for evaluating the integrity of CLP. It aims to check the integrity for a dynamic response to a damaged isotropic structure. The proposed SHM technique relies on sensors and, therefore, it can be placed on the structure permanently and can monitor either passively or actively. For applying this method, a suitable guided wave mode tuning is required to verify wave propagation. A finite element analysis (FEA) is performed to figure out the suitable GW mode for a CLP by considering geometric and material condition. Furthermore, elastic wave tomography technique is modified to evaluate the CLP condition and its visualization. A modified reconstruction algorithm for the probabilistic inspection of damage tomography algorithm is used to quantify corrosion defects in the CLP. The location and shape of the wall-thinning defects are successfully obtained by using elastic GW based SHM. Making full use of verified GW mode to Omni-directional transducer, it can be expected to improve utilization of the SHM based evaluation technique for CLP.

Efficient Selection of Antibodies Reactive to Homologous Epitopes on Human and Mouse Hepatocyte Growth Factors by Next-Generation Sequencing-Based Analysis of the B Cell Repertoire.

: YYB-101 is a humanized rabbit anti-human hepatocyte growth factor (HGF)-neutralizing antibody currently in clinical trial. To test the effect of HGF neutralization with antibody on anti-cancer T cell immunity, we generated surrogate antibodies that are reactive to the mouse homologue of the epitope targeted by YYB-101. First, we immunized a chicken with human HGF and monitored changes in the B cell repertoire by next-generation sequencing (NGS). We then extracted the VH gene repertoire from the NGS data, clustered it into components by sequence homology, and classified the components by the change in the number of unique VH sequences and the frequencies of the VH sequences within each component following immunization. Those changes should accompany the preferential proliferation and somatic hypermutation or gene conversion of B cells encoding HGF-reactive antibodies. One component showed significant increases in the number and frequencies of unique VH sequences and harbored genes encoding antibodies that were reactive to human HGF and competitive with YYB-101 for HGF binding. Some of the antibodies also reacted to mouse HGF. The selected VH sequences shared 98.3% identity and 98.9% amino acid similarity. It is therefore likely that the antibodies encoded by them all react to the epitope targeted by YYB-101.

Monolithic integration of self-aligned nanoisland laser with shifted-air-hole waveguide.

We report a novel scheme for monolithic integration of a nanoisland laser with a shifted-air-hole waveguide by employing selective etching techniques. An active L3 laser cavity and passive shifted-air-hole waveguide are simultaneously formed through a single fabrication step. In the shifted-air-hole waveguide, the air-hole position is adjusted to be compatible with selective etching. The spectral overlap between the L3 laser resonance and guided mode is achieved by introducing small air holes at the nodes of the shifted-air-hole waveguide. Experiments show that >60% of the light is coupled from the nanoisland laser to the end of the 12-µm-long waveguide.

Self-aligned deterministic coupling of single quantum emitter to nanofocused plasmonic modes.

The quantum plasmonics field has emerged and been growing increasingly, including study of single emitter-light coupling using plasmonic system and scalable quantum plasmonic circuit. This offers opportunity for the quantum control of light with compact device footprint. However, coupling of a single emitter to highly localized plasmonic mode with nanoscale precision remains an important challenge. Today, the spatial overlap between metallic structure and single emitter mostly relies either on chance or on advanced nanopositioning control. Here, we demonstrate deterministic coupling between three-dimensionally nanofocused plasmonic modes and single quantum dots (QDs) without any positioning for single QDs. By depositing a thin silver layer on a site-controlled pyramid QD wafer, three-dimensional plasmonic nanofocusing on each QD at the pyramid apex is geometrically achieved through the silver-coated pyramid facets. Enhancement of the QD spontaneous emission rate as high as 22 ± 16 is measured for all processed QDs emitting over ∼150-meV spectral range. This approach could apply to high fabrication yield on-chip devices for wide application fields, e.g., high-efficiency light-emitting devices and quantum information processing.

Self-aligned nanoislands nanobeam bandedge lasers.

We propose and demonstrate a novel one-dimensional nanobeam bandedge laser constituted by self-aligned nanoisland quantum-well (QW) structures. The formation of self-aligned InGaAsP nanoislands sandwiched between two InP claddings is the result of selective removal of QW through wet-etching processes. By controlling wet-etching time, we show a good spatial and spectral overlap between the dielectric mode and the self-aligned nanoisland structures leads to the realization of nanobeam bandedge lasers with low-threshold operations and high slope efficiencies. Optical characterization results indicate a strong correlation between the size of individual nanoisland and the threshold power of our nanobeam bandedge lasers. We obtain an approximately 81% reduction in the absorbed threshold power as we optimize the size of the nanoislands.

Solution processible MoOx-incorporated graphene anode for efficient polymer light-emitting diodes.

Graphene has attracted great attention owing to its superb properties as an anode of organic or polymer light-emitting diodes (OLEDs or PLEDs). However, there are still barriers for graphene to replace existing indium tin oxide (ITO) due to relatively high sheet resistance and work function mismatch. In this study, PLEDs using molybdenum oxide (MoOx) nanoparticle-doped graphene are demonstrated on a plastic substrate to have a low sheet resistance and high work function. Also, this work shows how the doping amount influences the electronic properties of the graphene anode and the PLED performance. A facile and scalable spin coating process was used for doping graphene with MoOx. After doping, the sheet resistance and the optical transmittance of five-layer graphene were ∼180 Ω sq-1 and ∼88%, respectively. Moreover, the surface roughness of MoOx-doped graphene becomes smoother than that of pristine graphene. Furthermore, a nonlinear relationship was observed between the MoOx doping level and device performance. Therefore, a modified stacking structure of graphene electrode is presented to further enhance device performance. The maximum external quantum efficiency (EQE) and power efficiency of the PLED using the MoOx-doped graphene anode were 4.7% and 13.3 lm W-1, respectively. The MoOx-doped graphene anode showed enhanced device performance (261% for maximum EQE, 255% for maximum power efficiency) compared with the pristine graphene.

A terahertz metamaterial with unnaturally high refractive index.

Controlling the electromagnetic properties of materials, going beyond the limit that is attainable with naturally existing substances, has become a reality with the advent of metamaterials. The range of various structured artificial 'atoms' has promised a vast variety of otherwise unexpected physical phenomena, among which the experimental realization of a negative refractive index has been one of the main foci thus far. Expanding the refractive index into a high positive regime will complete the spectrum of achievable refractive index and provide more design flexibility for transformation optics. Naturally existing transparent materials possess small positive indices of refraction, except for a few semiconductors and insulators, such as lead sulphide or strontium titanate, that exhibit a rather high peak refractive index at mid- and far-infrared frequencies. Previous approaches using metamaterials were not successful in realizing broadband high refractive indices. A broadband high-refractive-index metamaterial structure was theoretically investigated only recently, but the proposed structure does not lend itself to easy implementation. Here we demonstrate that a broadband, extremely high index of refraction can be realized from large-area, free-standing, flexible terahertz metamaterials composed of strongly coupled unit cells. By drastically increasing the effective permittivity through strong capacitive coupling and decreasing the diamagnetic response with a thin metallic structure in the unit cell, a peak refractive index of 38.6 along with a low-frequency quasi-static value of over 20 were experimentally realized for a single-layer terahertz metamaterial, while maintaining low losses. As a natural extension of these single-layer metamaterials, we fabricated quasi-three-dimensional high-refractive-index metamaterials, and obtained a maximum bulk refractive index of 33.2 along with a value of around 8 at the quasi-static limit.

Microfiber-microcavity system for efficient single photon collection.

Single photon sources are key components for various quantum information processing. For practical quantum applications, bright single photon sources with efficient fiber-optical interfaces are highly required. Here, bright fiber-coupled single photon sources based on InAs quantum dots are demonstrated through the k-vector matching between a microfiber mode and a normal mode of the linear photonic crystal cavity. One of the modes of the linear photonic crystal cavity whose k-vector is similar to that of the microfiber mode is employed. From independent transmission measurement, the coupling efficiency directly into the fiber of 58% is obtained. When the quantum dot and cavity system is non-resonantly pumped with 80 MHz pulse train, a raw count rate of 1.81 MHz is obtained with g(2)(0) = 0.46. Resonant pump is expected to improve the rather high g(2)(0) value. Time-resolved photoluminescence is also measured to confirm the three-fold Purcell enhancement. This system provides a promising route for efficient direct fiber collections of single photons for quantum information processing.

Transvaginal Sonography-Guided Core Biopsy of Adnexal Masses as a Useful Diagnostic Alternative Replacing Cytologic Examination or Laparoscopy in Advanced Ovarian Cancer Patients.

OBJECTIVE: The aim of this study was to evaluate transvaginal sonography (TVS)-guided core biopsy of the adnexal masses for neoadjuvant chemotherapy (NACT) in patients with advanced ovarian malignancies. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 52 patients who had undergone TVS-guided core biopsies in our gynecologic cancer center between May 2009 and October 2015. TVS-guided core biopsies were performed on patients with advanced ovarian malignancies who were considered as candidates for NACT and patients with adnexal masses who required a differential diagnosis of non-gynecologic tumors. RESULTS: Thirty-seven patients (71.2%) were scheduled to undergo NACT owing to the presence of coexisting illness, age, tumor burden, and location of metastatic sites. Fifteen patients (28.8%) underwent TVS-guided core biopsies to determine if they had primary or secondary ovarian tumors. Histopathologic examinations revealed primary ovarian tumors in 44 patients (84.6%). Nongynecologic tumors including gastrointestinal stromal tumor and metastatic tumor from gallbladder, gastric, and colorectal cancer were found to be the second most common disease (n = 5 [9.6%]). Findings in the samples were nondiagnostic in 4 patients (5.8%). With respect to the histological concordance rate between TVS-guided core biopsy and surgical specimen, diagnostic accuracy was 93.6%. There were no biopsy-related complications. CONCLUSIONS: TVS-guided core biopsy may be a feasible procedure to diagnose adnexal masses, particularly in patients with advanced ovarian malignancies who are more likely to benefit from NACT.

A Predictive Model for Parametrial Invasion in Patients With FIGO Stage IB Cervical Cancer: Individualized Approach for Primary Treatment.

OBJECTIVE: The aim of this study was to preoperatively identify high- and low-risk subgroups of patients with parametrial involvement in those with FIGO (International Federation of Gynecology and Obstetrics) stage IB cervical cancer treated with radical hysterectomy according to menopause. MATERIALS AND METHODS: We retrospectively reviewed data of 197 patients with FIGO stage IB cervical cancer. None of the patients had definite evidence of parametrial invasion in a preoperative examination and underwent type III radical hysterectomy between February 2006 and March 2015. Preoperative risk criteria predicting parametrial involvement were identified in premenopausal and postmenopausal women, respectively. RESULTS: Tumor size on magnetic resonance imaging (MRI) more than 4 cm (odds ratio [OR], 10.029; 95% confidence interval [95% CI], 2.300-43.741; P = 0.002) and serum squamous cell carcinoma-antigen level of 3.60 ng/mL or more (OR, 4.132; 95% CI, 1.086-5.723; P = 0.037) were independent factors for parametrial invasion in premenopausal women. Significant factors associated with parametrial involvement in postmenopausal women were tumor size on MRI more than 3 cm (OR, 11.353; 95% CI, 2.614-49.306; P = 0.001) and Cyfra 21-1 level of 2.40 ng/mL or more (OR, 8.048; 95% CI, 1.240-52.221; P = 0.029). Patients were categorized into low- and high-risk groups according to risk criteria. Significant differences in the rates of parametrial invasion were observed between the groups (2.3% vs 38.6% in the premenopausal group, P < 0.001; 11.1% vs 77.3% in the postmenopausal group, P < 0.001). CONCLUSIONS: A model using preoperative tumor size on MRI, serum squamous cell carcinoma-antigen, and Cyfra 21-1 level was highly predictive of parametrial invasion in patients with FIGO stage IB cervical cancer. In particular, postmenopausal women were likely to have microscopic parametrial invasion, even among tumors 3 cm or less. Therefore, individualized approaches considering several preoperative factors are needed.

Patterns of recurrence and survival after abdominal versus laparoscopic/robotic radical hysterectomy in patients with early cervical cancer.

AIM: This study investigates the pattern of disease recurrence and identifies the clinicopathologic prognostic factors for patients with International Federation of Gynecology and Obstetrics (FIGO) stage IB and IIA cervical carcinoma treated with laparoscopic/robotic radical hysterectomy (LRH/RRH). METHODS: We conducted a retrospective analysis of 128 patients with FIGO stage IB and IIA cervical cancer. Preoperative examination did not uncover definitive evidence of parametrial invasion or lymph node metastasis in any of the patients; therefore, all patients underwent LRH/RRH with retroperitoneal lymphadenectomy between April 2006 and December 2013. Sites of disease recurrence and all possible clinicopathologic factors related to the risk of disease recurrence were determined. RESULTS: Multivariate analysis demonstrated that laparoscopic intracorporeal colpotomy (P < 0.041, odds ratio 7.038, 95% confidence interval 1.059-15.183) represented a strong prognostic factor related to disease recurrence. We categorized the minimally invasive surgery group into LRH through vaginal colpotomy (LRH-VC; 79 patients) and LRH/RRH through intracorporeal colpotomy (LRH/RRH-IC; 49 patients) according to the colpotomic approaches. Disease recurrence was higher in the LRH/RRH-IC group than in the LRH-VC group (16.3% vs 5.1%, P = 0.057), with five patients in the LRH/RRH-IC group experiencing intraperitoneal spreads. CONCLUSIONS: Total laparoscopic/robotic intracorporeal colpotomy under CO2 pneumoperitoneum may carry a risk of positive vaginal cuff margin, as well as intraperitoneal tumor spreads in patients with early-stage cervical cancer treated with LRH/RRH.