Psychiatric comorbidities and quality of life in breast cancer patients undergoing radiation treatment: Risk and protective factors.

OBJECTIVE: The primary goal was to evaluate the prevalence of psychiatric comorbidities and changes in psychological distress levels among breast cancer patients receiving radiotherapy (RT). The secondary goal was to determine risk and protective factors for psychiatric comorbidities of these patients. METHODS: From June 2018 to November 2019, patients were recruited from the hospital, Department of Psychiatry. Patients completed baseline surveys after seeing their radiation oncologist and prior to the first treatment, which was scheduled to take place within 7 days (visit 1, baseline); visit 2 occurred within 7 days after RT completion, and visit 3 occurred at 6 weeks after RT completion. A total of 99 patients participated in the study at visit 1; 56 patients completed the study through visit 3. RESULTS: Although changes in psychiatric comorbidities and overall quality of life were observed in patients with breast cancer prior to, during, and after RT, the differences were not significant among visits. Patients diagnosed with psychiatric comorbidities after RT had exhibited risk factors at previous visits, including preexisting psychiatric comorbidities, functional deterioration, and more severe symptoms related to breast cancer. Based on the results, the psychological characteristics of optimism and resilience can be considered as protective factors for psychiatric comorbidities. CONCLUSIONS: The results suggest that early detection and follow-up of psychological distress and poor quality of life at the onset of RT are of paramount importance, and that psychosocial interventions to enhance protective factors (optimism and resilience) may be helpful.

A Prospective Randomized Control Study Comparing the Effects of Dermal Staples and Intradermal Sutures on Postoperative Scarring After Thyroidectomy.

BACKGROUND: We compared cosmetic outcomes, pain intensity, and costs between dermal stapling and intradermal suturing in patients who underwent thyroidectomy through cervical incision. PATIENTS AND METHODS: In total, 40 patients were randomly assigned to undergo thyroidectomy through a low cervical incision and dermal closure using either absorbable staples (n = 20, staple group) or interrupted intradermal sutures (n = 20, suture group). Wound complications, cosmetic outcomes (modified Stony Brook Scar Evaluation Scale [SBSES] and Manchester Scar Scale [MSS]), and pain intensity (visual analog scale) were assessed at 1, 4, 12, and 24 weeks postoperatively. The difference in total "wound-closure cost" between the two groups was also analyzed. RESULTS: There were no wound-related complications and no significant differences in SBSES or MSS scores between the two groups (P = 0.609 and P = 0.141, respectively). However, the staple group had significantly higher SBSES scores, compared to the suture group, at 24 wk postoperatively (4.06 ± 0.94 versus 3.26 ± 1.24; P = 0.030, respectively); MSS scores were significantly lower in the staple group than in the suture group at 24 wk postoperatively (6.72 ± 1.27 versus 8.16 ± 2.17, respectively; P = 0.028). Visual analog scale scores were significantly lower in the suture group than in the staple group (P = 0.038). The total wound-closure cost was significantly higher in the staple group than in the suture group (137.10 ± 8.39 versus 81.79 ± 19.95 USD; P < 0.001). CONCLUSIONS: When dermal staples were used, wound complications were absent and long-term cosmetic outcomes were superior; however, pain intensity was higher and the cost was greater, although healing was significantly more rapid, compared to intradermal sutures. Closure using absorbable dermal staples may be safe and effective for cervical incisions during thyroid surgery. Further studies with larger number of participants are needed to confirm our findings.

A prospective, randomized controlled study of the safety and efficacy of gasless bilateral axillo-breast approach (BABA) robotic thyroidectomy.

BACKGROUND: During bilateral axillo-breast approach (BABA) robotic thyroidectomy (RoT), carbon dioxide (CO2) gas is insufflated into the operative cavity, not only triggering hemodynamic and metabolic changes, but also inducing postoperative pain and gas embolism. Here, we explored whether the new gasless BABA RoT approach was as safe and efficacious as conventional robotic surgery using CO2 insufflation. PATIENTS AND METHODS: We performed a prospective, randomized controlled trial comparing conventional BABA RoT to gasless BABA RoT (CO2 group, n = 14; gasless group, n = 14). All clinicopathological and oncological outcomes were evaluated. The hemodynamic parameters [heart rate (HR), mean arterial pressure (MAP), cardiac output (CO), and cardiac index (CI)] and metabolic parameters [partial pressure of carbon dioxide (PaCO2) and pH] were measured at baseline; 30, 60, 90, and 120 min after CO2 insufflation; and 30 min after desufflation. Pain parameters [numeric rating scale (NRS) score, number of analgesics (NA), and bottom hit count (BHC)] were measured at 2, 24, 48, and 72 h after surgery. RESULTS: We found no statistically significant differences between the two groups in terms of any demographic or baseline characteristic. The clinicopathological and oncological outcomes did not differ significantly between the two groups, but the operation time was longer for the gasless group (187.50 ± 42.64 vs. 212.50 ± 35.88 min; P = 0.028). In terms of the hemodynamic, metabolic, and pain parameters, the pH fell significantly less in the gasless group (P = 0.047), but there were no significant between-group differences in the HR, MAP, CO, CI, PaCO2, NRS, NA, or BHC. No safety concerns arose. CONCLUSION: The new, gasless BABA RoT technique employing the da Vinci robotic surgical system is safe. Although metabolic changes during operation are thereby minimized, gasless BABA RoT should be used carefully when engaging in thyroid surgery; more experience is required.

A Propensity Score-matched Comparison Study of Surgical Outcomes in Patients with Differentiated Thyroid Cancer After Robotic Versus Open Total Thyroidectomy.

INTRODUCTION: The aim of this study, from a surgical, oncological, and functional perspective, was to identify whether bilateral axillo-breast approach robotic total thyroidectomy (RTT) for differentiated thyroid cancer (DTC) has different surgical outcomes compared to open total thyroidectomy (OTT). METHODS: Initially, 796 patients who underwent total thyroidectomy were primarily reviewed and 178 who were ineligible for analysis were excluded. Propensity score matching analysis adjusted for clinicopathological characteristics (sex, age, body mass index, extent of central node dissection, tumor size, extrathyroidal extension, and thyroiditis) was conducted, with 246 patients in the OTT group matched with 123 patients in the RTT group. RESULTS: There were no significant differences in surgical outcomes in terms of surgical safety and oncological safety between the OTT and RTT groups, except in mean operation times (123.51 ± 32.63 vs. 198.39 ± 37.93 min, respectively; P < 0.001). However, the median parathyroid and laryngeal function recovery times were shorter in the RTT group than in the OTT group [88 ± 33.09 (95% CI: 23.148-152.852) vs. 100 ± 16.20 (95% CI: 68.242-131.768) days; P = 0.044 and 87 ± 32.40 (95% CI: 23.489-150.511) vs. 118 ± 49.50 (95% CI: 20.985-215.015) days; P = 0.002]. CONCLUSIONS: The recovery times of laryngeal and parathyroid function were significantly shorter in RTT patients than in OTT patients for DTC. To verify a definitive conclusion about the superiority of robotic total thyroidectomy in terms of parathyroid and laryngeal function recovery, further studies may be necessary.

Structure Analysis and Ferroelectric Response of Bi0.5Na0.5TiO3 Nanopowder Synthesized by Sol-Gel Method.

In this work, bismuth sodium titanate, Bi0.5±xNa0.5±yTiO3 (BNT, x, y = -0.05-0.08) nanopowders were produced using the low-temperature sol-gel technique. The effects of deficient and excess amounts of Bi and Na on BNT structure were systemically examined through X-ray powder diffraction (XRD), energy dispersive analysis (EDS) and scanning electron microscope (SEM). The optimized composition of the BNT nanopowder was pelletized and sintered at different temperatures (950°C-1150 °C). Highly dense ceramics possessing pure perovskite phase was observed for the sample sintered at an optimum sintering temperature (1100 °C). The ferroelectric properties were found to increase with an increase in sintering temperature up to 1100 °C and then decrease. This study justifies that Bi and Na non-stoichiometry (proper excess), processing and sintering temperatures play important role in the successful synthesis of BNT ceramics.

Facile Synthesis of Efficient Antibacterial Agent as CoFe2O4/Ag Composite Material Against Both Gram-Negative Escherichia coli and Gram-Positive Bacillus subtilis Bacteria.

We have suggested that a facile synthesis of CoFe2O4/Ag composite material as an antibacterial agent for substitution of a chlorination agent for microbial infected wastewater treatment. The CoFe2O4/Ag was synthesized by an impregnation method in assistance with trisodium citrate as a reducing agent. The as-prepared uncalcined CoFe2O4 (CFG), calcined CoFe2O4 (CFG600), and calcined CoFe2O4/Ag (CFG600/Ag) composites were characterized by X-ray diffraction (XRD), Field Emission Scanning Electron Microscope (FE-SEM) and Energy Dispersive X-ray (EDX) techniques. Antibacterial activities were also determined in liquid culture by measuring the minimum inhibitory concentrations (MIC) against Gram-negative Escherichia coli (E. coli) and Gram-positive Bacillus subtilis (B. subtilis) bacteria in vitro. Results showed that CFG600/Ag composites had an excellent antibacterial activity in comparison with CFG and CFG600 composites. The CFG600/Ag composites have completely inhibited the growth of both E. coli and B. subtilis bacteria from concentrations of more than 0.25 mg/ml. Furthermore, the FE-SEM study demonstrated the physical damage of bacteria when treated with CFG600/Ag composite material at a concentration of 0.10 mg/ml.

Anxiety or agitation in mood disorder with mixed features: A review with a focus on validity as a dimensional criterion.

BACKGROUND: The diagnostic validity of mixed features, excluding anxiety or psychomotor agitation in mood disorders, has not yet been fully examined. METHOD: PubMed and relevant English-language literature (regardless of year) were searched. Keywords were mixed or mixed state or mixed features or mixed episode and anxious or anxiety or agitation and bipolar disorder or depressive disorder or mood disorder or affective disorder. RESULTS: Most studies on anxiety or psychomotor agitation have included a significant correlation relevant to the "with mixed features" specifier, although it is common in both poles of mood episodes regardless of the predominant polarity. There is some confusion between the characteristic of classical mixed states and the definition of the mixed features specifier with the newly added anxious distress specifier in DSM-5, specifically, whether to include anxiety and agitation as significant characteristics. This change is of concern because a large proportion of patients with mixed features are now unspecified, and this may influence treatment planning and prognosis. CONCLUSIONS: The findings of our review suggest that anxiety and psychomotor agitation can be core symptoms in mood episodes with mixed features and important clinical clues for prediction of treatment effects and disease course.

Aging, hypercoagulability, and leg necrosis in critical limb ischemia.

BACKGROUND: Aging is associated with changes in coagulation status and progression of arterial insufficiency. The purpose of this study was to identify interrelationships among aging, coagulation status, and leg necrosis in patients with critical limb ischemia (CLI). METHODS: Between March 2010 and February 2013, 103 consecutive patients with CLI were enrolled in this study. Retrospective analyses were performed on patient characteristics including age, gender, the presence or the absence of leg necrosis, diabetes mellitus (DM), hypertension, and smoking, and preoperatively measured baseline coagulability factors, which included measurements of coagulation factors anticardiolipin antibodies IgG and IgM, lupus anticoagulant and factor 8, the fibrinolytic factor tissue plasminogen activator (t-PA), and natural anticoagulants proteins C and S and antithrombin III. RESULTS: Among 103 patients with CLI, a total of 49 legs from 41 patients presented varying degrees of necrosis. CLI patients with DM and hypertension showed significantly increased incidences of leg necrosis compared with those without (P = 0.000, 0.039, respectively). Patients with CLI and leg necrosis were significantly older compared with the age of those without necrosis (P = 0.007). Blood levels of anticardiolipin antibodies IgG and IgM, factor 8, lupus anticoagulant, and t-PA tended to increase with age. However, blood levels of proteins C and S and antithrombin III decreased with patient age. Patients with CLI and leg necrosis showed significantly increased levels of lupus anticoagulant (P = 0.049) and significantly decreased levels of proteins C and S (P = 0.009 and 0.018, respectively) compared with patients without leg necrosis. CONCLUSIONS: Patients with CLI and leg necrosis were significantly older compared with those without necrosis; similarly, our results revealed age-related hypercoagulability, with significantly elevated coagulation factor lupus anticoagulant and decreased natural anticoagulants protein C and S levels. From these observations, we conclude that age-related hypercoagulability may be an important mechanism that may facilitate leg necrosis in patients with CLI.

Current status of robotic thyroid surgery in South Korea: a web-based survey.

BACKGROUND: More than 8,000 cases of robotic thyroidectomy (RoT) were performed in South Korea from 2007 to 2011 using either a transaxillary approach (TAA) or a bilateral axillo-breast approach (BABA). However, there is no consensus regarding patient selection for RoT. This study used a web-based survey questionnaire to examine the current status of RoT in South Korea. METHODS: Thirty-two of 50 surgeons (64.0 %) who had performed RoT in South Korea participated in the web-based survey in August 2011. The questionnaires comprised four main domains: surgeon characteristics, surgical approach, patient selection, and future prospects. RESULTS: In terms of surgical approach, 43.8 % respondents used the TAA method and 53.1 % used the BABA method. The main advantage cited by surgeons using the TAA method was that it made lateral lymph node dissection easier (35.7 %), whereas those using the BABA method cited more cosmesis (100 %) and ease of performing a contralateral thyroidectomy (88.2 %). Papillary thyroid cancer ≤2 cm (65.3 %), intracapsular lesion (76.7 %), nonposterior location (53.6 %), and no clinical evidence of lateral lymph node metastasis (76.7 %) were cited as main indications for RoT. Of respondents, 87.5 % agreed that RoT would play a future role as a treatment modality for thyroid disease. CONCLUSIONS: Opinions differed regarding the advantages and disadvantages of two approaches for RoT. This may be due to differences in surgical procedure itself between two approach methods. Accumulation of RoT surgeon's experiences might establish consensus regarding patient selection and indications for the RoT will need to be further investigated.

Use of spiral computed tomography volumetry for determining the operative approach in patients with Graves' disease.

BACKGROUND: The purposes of the present study were to assess (1) the correlation between the weight of the postoperative thyroid specimen and the spiral computed tomography (CT) volumetry results of the thyroid gland in patients with Graves' disease, and (2) the utility of CT volumetry for determining the operative approach. METHODS: From 2009 to 2010, a total of 56 patients with Graves' disease underwent total or subtotal thyroidectomy. An enhanced spiral CT was taken in all patients prior to the operation. From 2.5 mm-thick slices of the thyroid gland, the surface area was calculated to measure the volume of the thyroid gland. The glandular volume was compared to the weight of the postoperative thyroid specimen. RESULTS: A total of 42 and 14 patients underwent total and subtotal thyroidectomy, respectively. The mean weight of the postoperative thyroid specimen was 43.9 ± 33.4 g, and the mean volume obtained by CT volumetry was 44.2 ± 32.8 mL. A good correlation was observed between the weight of the postoperative thyroid specimen and the volume calculated by CT (r = 0.98, p < 0.001). When 100 mL was set as the higher cut-off value of the thyroid volume for minimally invasive thyroid surgery, the estimated blood loss showed a significant difference between the >100 mL and the ≤100 mL groups (608.3 ± 540.8 vs. 119.7 ± 110.4 mL; p = 0.036). CONCLUSIONS: Spiral CT volumetry may be used to measure the thyroid volume reliably in patients with Graves' disease. For cases in which surgery is indicated in patients with Graves' disease, CT volumetry provides useful information from which to determine the operative approach. One hundred milliliter or less of thyroid volume in CT volumetry is recommended to perform minimally invasive thyroid surgery.

Synthesis and electrochemical characterization of LiMn0.6Fe0.4PO4/C cathode material via a modified-solid state reaction method.

LiMn0.6Fe0.4PO4/C cathode material is synthesized via a modified-solid state reaction method. The calcination temperature is adjusted in the range of 500-700 degrees C for 10 h. The crystal structure, morphology, and carbon coating layer of the synthesized LiMn0.6Fe0.4PO4/C are analyzed using X-ray diffraction (XRD), scanning electron microscopy (SEM), and transmission electron microscopy (TEM), respectively. The electrochemical performance of LiMn0.6Fe0.4PO4/C, such as initial capacity, rate capability, cycling performance and EIS is also evaluated. The synthesized cathode material shows around 100-200 nm of primary particle size with no impurities. The highest initial discharge capacity of 162.1 mA h g(-1) and columbic efficiency of 98.5% are obtained at a heat treatment temperature of 600 degrees C. In addition, LiMn0.6Fe0.4PO4/C active material shows the high capacity retention of 85% at 5 C compared to 0.2 C. It also shows the excellent capacity retention of 97.5% after the 50th charge/discharge.

Study on the microstructures and the magnetic properties of precipitates in a Cu75-Fe5-Ni20 alloy.

The microstructural evolutions of precipitates formed in a Cu75-Fe5-Ni20 alloy on isothermal annealing at 873 K and 1073 K have been investigated by means of transmission electron microscopy (TEM). Nano-scale magnetic particles were formed randomly in the Cu-rich matrix after receiving a short annealing due to phase decomposition in the alloy. With increasing the isothermal annealing time, however, the striking features that two or more nano-scale particles with a cubic shape and a rod shape were aligned linearly along (100) directions were observed on isothermal annealing at 873 K and 1073 K, respectively. To investigate electro-magnetic properties of precipitates in a Cu-Fe-Ni alloy, the superconducting quantum interference device (SQUID) magnetometer and physical property measurement system (PPMS) were also complemented. The present study revealed significant influences that the magnetic properties of the specimens were closely related to the microstructures in the Cu-Fe-Ni alloy, which microstructures significantly depend on the isothermal annealing temperature.

Comparison of the Postoperative Outcomes of the Mini-Flap Bilateral Axillo-Breast Approach (BABA) and Conventional BABA Robot-Assisted Thyroidectomy.

The bilateral axillo-breast approach (BABA) for robot-assisted thyroidectomy has some advantages over other minimally invasive thyroidectomies. However, some people do not consider this as a minimally invasive thyroidectomy because of the wider surgical skin flap. Thus, we devised mini-flap BABA robot-assisted thyroidectomy and analyzed the postoperative outcomes. The clinical records of 44 patients undergoing BABA robot-assisted thyroidectomy using a conventional flap or mini-flap were evaluated retrospectively. There were no significant group differences in clinicopathological characteristics. The operating and flap making times were shorter in the mini-flap group (206.18 ± 31.09 vs. 178.90 ± 34.43 min, p = 0.009; 38.85 ± 2.73 vs. 32.21 ± 8.62 min, p = 0.003, respectively). The total drainage amount was smaller in the mini-flap group (196.57 ± 81.40 vs. 150.74 ± 40.80 mL, p = 0.027). The numeric rating scale score and number of analgesics were lower at 2 h postoperatively in the mini-flap group (5.52 ± 0.87 vs. 4.57 ± 1.31, p = 0.006; 0.95 ± 0.22 vs. 0.65 ± 0.49, p = 0.012, respectively). There was no significant group difference in immediate oncological outcomes (p = 1.000). Mini-flap BABA robot-assisted thyroidectomy minimized the surgical flap and improved surgical outcomes. Therefore, it is a form of minimally invasive thyroidectomy. However, long-term follow-up of oncological outcomes is needed.

Glucocorticoid Receptor Gene (NR3C1) Expression in the Pathogenesis of Depression in Cancer.

Background: This study aimed to compare the NR3C1 expression among cancer patients with major depressive disorder (cancer depression), cancer patients without major depressive disorder (cancer non-depression), and major depressive disorder patients without cancer (general depression), as a preliminary investigation of epigenetic changes in the glucocorticoid receptor gene. Methods: From May 2019 to November 2019, patients were recruited from the Department of Psychiatry, Cancer Center in Busan, Korea. For gene expression studies, primers were designed using the Primer3 web tool (http://frodo.wi.mit.edu/primer3), and amplification reactions were performed. Results: Expression levels of NR3C1 were lower in cancer depression and general depression than in cancer non-depression group. Given that we observed downregulation of the NR3C1 gene expression in depressive patients regardless of cancer status, it appears that methylation changes in NR3C1 may contribute to the pathophysiology of depression. Conclusion: The results of this study imply that the expression of NR3C1 may be decreased in major depressive disorder.

TEM study and magnetic measurements of precipitates formed in Cu-Fe-Ni alloys.

The precipitation behavior of Cu-Fe alloys with Ni addition on isothermal annealing at 878 K was investigated by means of transmission electron microscopy (TEM), electron dispersive X-ray spectroscopy (EDS), and field-emission scanning electron microscopy (FE-SEM). Magnetic element atoms were segregated from the solid solution in supersaturated state, and nano-scale magnetic particles were randomly formed in the copper matrix at the initial stage of annealing at 873 K. With increasing the isothermal annealing time, however, the striking feature that two or more nano-scale magnetic particles with a cubic shape aligned linearly along (100) directions were observed upon the isothermal annealing at 873 K. To investigate the relationship between micro-structures and magnetic properties of the heterogeneous Cu-Fe-Ni alloys, magnetic measurements such as M-H measurements were also carried out, using a superconducting quantum interference device (SQUID) magnetometer. In this study, it was revealed that the magnetic properties of the specimen presented the ferromagnetic behavior, during the precipitation process in a Cu-Fe-Ni alloy.

One-Pot Synthesis of SiO2@Ag Mesoporous Nanoparticle Coating for Inhibition of Escherichia coli Bacteria on Various Surfaces.

Silver nanoparticles (Ag NPs) as antibacterial agents are of considerable interest owing to their simplicity, high surface area to volume ratio, and efficient oligodynamic properties. Hence, we investigated the synthesis of silica-supported Ag NPs (SiO2@Ag) as an effective antibacterial agent by using a wet-impregnation method. The formation of SiO2@Ag with Ag NP (5-15 nm diameter) on the silica particle (100-130 nm diameter) was confirmed with transmission electron microscopy (TEM). The study on antibacterial activity was performed in a liquid culture to determine the minimum inhibitory concentration (MIC) against Escherichia coli (E. coli) and Bacillus subtilis (B. subtilis) bacteria. Both bacteria are chosen to understand difference in the effect of Ag NPs against Gram-negative (E. coli) and Gram-positive (B. subtilis) bacteria. SiO2@Ag mesoporous nanoparticles had excellent antibacterial activity against E. coli bacteria and fully restricted the bacterial growth when the material concentration was increased up to 1.00 mg/mL. In addition, the obtained material had good adhesion to both steel and polyethylene substrates and exhibited a high inhibition effect against E. coli bacteria.

Effect of Botulinum Toxin A on Scar Healing after Thyroidectomy: A Prospective Double-blind Randomized Controlled Trial.

The persistence of neck scarring is a common concern among patients undergoing thyroidectomy. Botulinum toxin A (BTA (Botox)) has been shown to suppress scar enlargement at the incision site. The objective of this study was to evaluate the effect of intraoperative Botox administration on neck scarring after thyroidectomy. A prospective double-blind randomized clinical trial was performed in patients undergoing conventional thyroidectomy. Forty patients were randomly allocated to a Botox or a control group (both, n = 20). The wound was closed after injection into the platysma muscle of 50 U of Botox diluted in 1 mL of normal saline or 1 mL of saline alone. Skin scars were assessed using the modified Stony Brook Scar Evaluation Scale (SBSES) and Manchester Scar Scale (MSS) at 1, 12, and 24 weeks postoperatively. The SBSES and MSS scores of the Botox group were significantly better than those of the control group (p = 0.034 and p = 0.039). At 24 weeks postoperatively, the SBSES and MSS scores were significantly better in the Botox group (p = 0.006 and p = 0.030). BTA injected into the incision site can suppress postoperative scar formation and thereby improve the cosmetic outcome.

Differences in depressive and anxiety symptoms between cancer and noncancer patients with psychological distress.

BACKGROUND: Cancer patients are particularly vulnerable to psychological problems. The purpose of the present study was to compare differences in psychological difficulties, including depression and anxiety, between cancer patients and noncancer patients. This study assessed the differences in depressive and anxiety symptoms between patients with and without cancer. MATERIALS AND METHODS: Participants included 219 patients at The Cancer Center, Dongnam Institute of Radiological and Medical Sciences, Busan, Korea, who reported depressive or anxiety symptoms between April 2014 and April 2016. Patients were categorized into cancer and noncancer groups based on medical histories showing a diagnosis of any type of cancer. The Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were used to evaluate psychological distress at each patient's first visit. Patients' charts were reviewed for clinical data, including BDI and BAI scores and duration of cancer treatment, and for demographic data such as age and sex. RESULTS: The results showed that patients in the cancer group experienced greater discomfort related to somatic symptoms; higher BDI subscale scores were related to work difficulties, insomnia, loss of appetite, somatic worries (fatigue), and loss of libido compared with patients in the noncancer group. The BAI subscale scores for fear of the worst happening, feeling unsteady, feeling terrified or afraid, a sense of choking, fear of dying, and feeling scared were higher in patients with than in those without cancer. CONCLUSION: High levels of depressive symptoms related to somatic discomfort and anxiety symptoms related to fear of cancer were associated with considerable psychological distress in patients with cancer diagnosis and treatment.

Anomalous absorption of isolated silver nanoparticulate films in visible region of electromagnetic field.

Anomalous absorption of isolated silver nanoparticulate films with different morphological patterns prepared by the wet colloidal route and followed by thermal treatment were investigated. A polymer embedded silver nanoparticulate film thermally treated at 200 degrees C showed maximum absorbance at approximately 412 nm. The peak position of the surface plasmon band was slightly different but still consistent with theoretical prediction derived by the Mie theory. An isolated nanopariculate film thermally treated at 300 degrees C showed anomalous absorption. Its maximum absorption band was shifted to green regime of 506.9 nm and the bandwidth at half-maximum absorbance of the surface plasmon band was greatly broadened. The plasmon band and its bandwidth were much deviated compared to the theoretical prediction calculated for the silver nanoparticles in the surrounding medium of air and poly(vinyl pyrrolidone) or soda-lime-silica glass. Even though there was no significant growth of silver nanoparticles during thermal treatment at 300 degrees C, the anomalous absorption was observed. The anomalous absorption was not attributed to effects of particle shape and size but to effects of pores induced by development of a great number of pores in the nanoparticulate film. The anomalous absorption greatly decreased with increase in heating temperature from 400 degrees C to 500 degrees C. The extraordinary plasmon damping of the isolated film decreased and the plasmon absorption band was re-shifted to violet regime of 416 nm because of large decrease in size of particles with dramatic change of pore morphology from circular pores with rim to small continuous pores induced by spontaneous formation of new silver nanoparticles.

Bilateral Axillo-Breast Approach to Endoscopic Thyroidectomy in a Porcine Model.

Traditional surgical training methods to teach young doctors have changed because of the emergence of animal models. The present article summarizes a protocol for bilateral axillo-breast approach (BABA) endoscopic thyroidectomy in a pig model. All procedures were approved by the local ethics committee and the pigs were anesthetized by a veterinarian. Formation of the flap involved skin marking, hydrodissection, blunt dissection and, finally, trocar insertion. BABA endoscopic thyroidectomy is performed by midline division, identification of the thyroid, thyroidectomy and, finally, surveillance of bleeding. Four cases of endoscopic thyroidectomy using porcine models were performed using the BABA approach. The mean weight of the pigs was 60 kg, and the mean operation time was 74.3 minutes. All surgeries were completed without complications. Surgical training for BABA endoscopic thyroidectomy using a porcine model is a valuable education method for young surgeons who need practice before performing surgery on human patients.