OBJECTIVE: The purpose of this present study was to compare mouse embryo development in 3 commercial media and hatching competence of mouse embryo with or without enzymatic treatment. METHODS: Collected 375 mouse embryos were divided into three groups, and then cultured in IVF-20 (G2), Medicult IVF (M3), P-1 (blastocyst M), respectively. Three day mouse morulae were cultured in G2 media treated with pronase. The results were analyzed using Chi-square test, and considered statistically significant when p<0.01. RESULTS: The developmental rate of 2 cell mouse embryo after 72 hours was highest in IVF-20 (G2) among conventional 3 media. The hatching rate of mouse morulae was low when clultured in G2 media without pronase during 48 hours. However, it was higher when cultured in media treated with l mg/ml, 2.5 mg/ml, 5 mg/ml pronase, respectively. CONCLUSIONS: Using good media and digestion of zona pellucida with enzymatic treatment improve development and hatching rate of embryo. Therefore, implantation and pregnancy rate could be improved.
Animals ; Digestion ; Embryonic Development ; Embryonic Structures* ; Female ; Mental Competency ; Mice* ; Morula ; Pregnancy ; Pregnancy Rate ; Pronase* ; Zona Pellucida

Luteal phase defect (LPD) is an ovulatory disorder of considerable clinical importance that leads to delayed endometrial maturation and inadequate endometrium for blastocyst implantation. This disorder is implicated in infertility and recurrent spontaneous abortion. We analyzed the endometrial histological maturation, and the estrogen receptor(ER) and progesterone receptor(PR) status in patients with unexplained delayed ovulation, and in patients with ovulation induction by clomiphen citrate. The purpose of this study was to determine whether the length of the follicular phase influences the endometrial histological maturation and the hormonal receptor status, and to know the effect of clomiphen citrate on the endometrium. In the delayed ovulation group, the endometrium was characterized by an irregular outpouching and dilated lumina of the glands, a decreased secretory activity and predecidualization, and a decreased number of granulocytes in the stroma. In the clomiphen citrate-ovulation induction group, glandular proliferation was markedly diminished with poorly convoluted and narrow glands, secretory activity was decreased, stroma was undecidualized, and there was an absence of granulocytes. ER expression was increased in the glandular epithelium in the delayed ovulation group, and both ER and PR expressions were markedly decreased in the glandular epithelium and stromal cells in the ovulation induction group. Endometrial maturation and differentiation may be diminished by increased estrogenic and relatively deficient progesterone effects in patients with delayed ovulation. The hormonal receptor status might also be influenced by hormonal changes. Clomiphen citrate successfully induced ovulation in patients with delayed ovulation, however, endometrial proliferation and maturation were markedly suppressed. This might be related to the lower pregnancy rate and higher abortion rate in patients with clomiphen citrate induced ovulation.
Pregnancy ; Female ; Humans

PURPOSE: This study was to identify the relationship between physical suffering, emotional state, and nursing needs of pregnant women in preterm labor and the difference depending on general characteristics. METHODS: The participants in this descriptive survey, selected by convenience sampling, were 126 pregnant women who were hospitalized after being diagnosed with preterm labor at 3 university hospitals. RESULTS: The level of personal hygiene was assessed in physical suffering, level of fear was assessed by the emotional state, and level of perterm labor was assessed by the nursing cares. In the analysis, physical suffering, emotional state, and nursing needs in the subjects all showed a significantly positive correlation. Differences in physical suffering, emotional state, and nursing needs depending on general characteristics were as follows: age, job, family type, economic condition, smoking, drinking admission days, previous delivery type, and artificial insemination. CONCLUSION: Based on the results of this study, the nurse should focus on the domain of personal hygiene, and teaching contents specific for abdominal breathing exercises for relieving the women's fear and anxiety should be added.
Anxiety ; Breathing Exercises ; Drinking ; Female ; Hospitals, University ; Humans ; Hygiene ; Insemination, Artificial ; Obstetric Labor, Premature ; Pregnancy ; Pregnant Women ; Smoke ; Smoking ; Stress, Psychological

Since the renal epidermoid cyst is too rare, the mechanisms of squamous morphogenesis have not well characterized. A 73-year-old female was referred with an incidentally detected renal pelvis mass. Abdominopelvic computed tomography scan revealed a noncalcified soft tissue mass in the renal pelvis. Total nephroureterectomy was performed under the impression of a renal pelvis malignancy. The patient was discharged without postoperative complication. The outer surface of mass lesion was lined with urothelia and squamous epithelia, containing keratinous materials. The urothelia were positively stained against uroplakin II and cytokeratin 7, whereas almost of the squamous epithelia were negative with uroplakin II. The two different epithelia were generally sharply demarcated. Interestingly, some part of squamous epithelia contained uroplakin-positive and many more cytokeratin 7-positive cells. The atypical clinical features in our case can reconsider the diagnostic clues of renal epidermoid cysts that have been reported before, and the unique immunohistochemical results may understand the histogenetic implications of the lesion.
Epidermal Cyst ; Female ; Humans ; Keratin-7 ; Keratins ; Kidney ; Kidney Pelvis ; Morphogenesis ; Postoperative Complications ; Uroplakin II ; Uroplakins

Uterine perforation is a serious complication in users of intrauterine devices for contraception. Authors encountered one case of displacement of Copper-T IVD into urinary blpossibly due to uterine perforation on insertion of the Copper-T IUD in a 28 year old 1-multipara, who experienced normal intrauterine pregnancy in the circumstances. This patient was in silent, asymptomatic condition and underwent cesarean section. And Copper-T IUD was removed under the cystotomy. So we report one case with brief review of literatures
Adult ; Asymptomatic Diseases ; Cesarean Section ; Contraception ; Copper* ; Cystotomy ; Female ; Humans ; Intrauterine Devices ; Pregnancy ; Urinary Bladder* ; Uterine Perforation

BACKGROUND: Interest in pharmacist participation in the multidisciplinary intensive care team is increasing. However, studies examining pharmacist interventions in the medical intensive care unit (MICU) are limited in Korea. The aim of this study was to describe the current status of pharmacist interventions and to identify common pharmacologic problems requiring pharmacist intervention in the MICU. METHODS: Between September 2013 and August 2014, a retrospective, observational study was conducted in the 22-bed MICU at a university hospital. Data were obtained from two trained pharmacists who participated in MICU rounds three times a week. In addition to patient characteristics, data on the cause, type, related drug, and acceptance rate of interventions were collected. RESULTS: In 340 patients, a total of 1211 pharmacologic interventions were performed. The majority of pharmacologic interventions were suggested by pharmacists at multidisciplinary rounds in the MICU. The most common pharmacologic interventions were adjustment of dosage and administration (n = 328, 26.0%), followed by parenteral/enteral nutritional support (n = 228, 18.1%), the provision of drug information (n = 228, 18.1%), and advice regarding pharmacokinetics (n = 118, 9.3%). Antimicrobial agents (n = 516, 42.6%) were the most frequent type of drug associated with pharmacist interventions. The acceptance rate of interventions was 84.1% with most accepted by physicians within 24 hours (n = 602, 92.8%). CONCLUSIONS: Medication and nutritional problems are frequently encountered pharmacotherapeutic problems in the MICU. Pharmacist interventions play an important role in the management of these problems.
Anti-Infective Agents ; Humans ; Critical Care ; Intensive Care Units* ; Korea ; Nutritional Support ; Observational Study ; Pharmacists* ; Pharmacokinetics ; Retrospective Studies

The purpose of this study was to evaluate the effect of the nutrition education on preschool children's nutrition knowledge and behaviors. The study subjects were preschool children attending J kindergarten located in Wonju. Each of the control group and the education group consisted of 49 children and the education group was exposed to nutrition education while the control group did not. The nutrition education intervention lasted 9 weeks weekly basis. The t-test for the homogeneity of each group showed no meaningful difference at the beginning point of nutrition education. After nutrition education a test of nutrition knowledge using picture-questionnaire was carried out by the researcher for the subjects of education group and control group and the caretakers of the education group were offered self-administered questionnaire on the changes in children's dietary behaviors. The results of the study were as follows: 1. Nutrition education intervention showed a meaningful difference in children's understanding nutrition; the kinds and function of food, the relationship between food and body, the function of nutrients and enhanced their idea on hygiene compared to the control group (p < p.005). 2. However, nutrition education intervention made no statistically meaningful difference in children's dietary behaviors such as having breakfast, keeping balanced diet, washing hands before meals, saying "thanks" before and after meals, cleaning the table after meals, brushing teeth after meals and so on. Therefore, we found that it is hard to expect children to correct their dietary behaviors in such a short period of 9 weeks and nutrition education for preschool children should be offered to caretakers at the same time.
Breakfast ; Child ; Child, Preschool ; Diet ; Hand ; Humans ; Hygiene ; Meals ; Surveys and Questionnaires ; Tooth

BACKGROUND AND OBJECTIVES: Ten to twenty percent of children with Kawasaki disease (KD) do not respond to initial intravenous immunoglobulin (IVIG) treatment. If untreated, approximately 15% to 25% of KD patients have complications. The aim of this study was to find useful predictors of responsiveness to initial IVIG treatment in KD. SUBJECTS AND METHODS: We retrospectively reviewed medical records of 91 children diagnosed with KD at Myong Ji Hospital from March 2012 to April 2014. Before and after (24 hours to 36 hours) IVIG treatment, the following laboratory data were obtained: hemoglobin (Hb) level, white blood cell count, proportion of neutrophil, lymphocyte and eosinophil, platelet count, erythrocyte sedimentation rate (ERS), C-reactive protein (CRP), creatine kinase (CK), creatine kinase MB (CK-MB), and N-terminal pro-brain natriuretic peptide (NT-proBNP). Subjects were then divided into two groups: IVIG-responsive or IVIG-resistant. RESULTS: Of 91 patients, 11 (12%) required retreatment. By univariate analysis, before-IVIG laboratory parameters of white blood cell count, % neutrophil, ERS, CRP, sodium, CK, CK-MB, and NT-proBNP were significantly different between IVIG-responsive and IVIG-resistant patient groups. In the after-IVIG laboratory parameters, Hb level, white blood cell count, % neutrophil, % lymphocyte, CRP, CK, CK-MB, and NT-pro-BNP were significantly different between the two groups. While the mean-differences were not statistically significant, fractional change (FC)-CRP and FC-% neutrophil showed significant difference. By multivariate analysis, FC-CRP was confirmed to be an independent predictor for initial IVIG resistance. CONCLUSION: Fractional change-C-reactive protein might be a useful and important value for predicting initial IVIG resistance in KD patients.
Blood Sedimentation ; C-Reactive Protein ; Child ; Creatine Kinase ; Eosinophils ; Humans ; Immunization, Passive* ; Immunoglobulins ; Immunoglobulins, Intravenous ; Leukocyte Count ; Lymphocytes ; Medical Records ; Mucocutaneous Lymph Node Syndrome* ; Multivariate Analysis ; Neutrophils ; Platelet Count ; Retreatment ; Retrospective Studies ; Risk Factors ; Sodium

Purpose: This pilot study aimed to evaluate the efficacy of high dose ampicillin-sulbactam and colistin combination therapy for ventilator-associated pneumonia (VAP) caused by carbapenem-resistant Acinetobacter baumannii (CRAB) in the pediatric intensive care unit of Pusan National University Children's Hospital. Methods: We retrospectively reviewed 17 pediatric patients with VAP caused by CRAB from June 2017 to August 2018. Ten (58.8%) patients were treated with high dose ampicillin-sulbactam and colistin combination therapy (combination therapy group), whereas 7 were treated with colistin only or with various combinations with or without colistin (other antibiotics group). Clinical and bacteriological outcomes were compared between the groups. Results: The mean duration of fever after antibiotic use was 1.30±1.70 days in the combination therapy group and 1.71±1.49 days in the other antibiotics group. The mean duration of days for negative conversion of endotracheal aspirate bacterial culture afterantibiotic therapy was 3.40±1.71 days in the combination therapy group and 11.80±8.86 days in the other antibiotics group. The mortality rate within 30 days of antibiotic therapy was 1/10 (10%) in the combination therapy group and 3/7 (42.9%) in the other antibiotics group. Conclusions High dose ampicillin-sulbactam and colistin combination therapy as early antibiotic treatment in VAP caused by CRAB in children could improve clinical outcomes.

Purpose: The aim of this study was to investigate the outcomes of endodontic treatment of mandibular second molar with C-shaped canal in elderly patients and related factors affecting the survival of the tooth. Materials and Methods: From 2010 to 2015, the survival rate following endodontic treatment was evaluated in elderly patients over 60 years who visited the Veterans Health Service Medical Center for endodontic treatment. The presence of C-shaped canals was confirmed using clinical records and radiographic features. Patientʼs age, sex, systemic diseases, tooth location, vitality, signs and symptoms, fractures, caries, apical radiolucency, canal shaping methods, sealer leakage, filling voids, and restoration of prosthesis were included in the analyses as confounding variables. The survival rate of teeth was analyzed using Kaplan–Meire analysis and the relationship between the survival rate and variables was analyzed using Simple and Multiple Cox regression analysis.Result: In total, 107 teeth in elderly patients had C-shaped canal. The survival rate of teeth that received endodontic treatment was 63.70%. None of the factors investigated significantly influenced the survival rate (P>0.05). Conclusion In elderly patients with C-shaped canal, the survival rate after root canal treatment was not significantly different from that of other mandibular molars.