OBJECTIVE: To evaluat the effects of a culture medium with glucose in the presence of glutamine on the development of mouse embryos. METHODS: Two-cell embryos recovered from ICR mice at 48 hrs after hCG injection (mated just after hCG injection) were cultured in DMEM (with 20% hFF) supplemented with or without glucose on the presence of glutamine. Embryos were cultured under three different glucose regimens: (1) 0 mM (control); (2) 0.5 mM (group I); or (3) 3.15 mM (group II), and were analyzed at 24, 48, 72 and 96 hours intervals. Chi-square test (x2-test) was used to compare values of groups. RESULTS: No differences were found in the number of embryos showing morula (control: 37.5%; group I: 51.0%; group II: 48.4%), blastocyst (control: 21.5%; group I: 33.3%; group II: 34.4%) and blastocyst and hatching or hatched blastocyst (control: 81.9%; group I: 83.3%; group II: 82.8%) between groups at 24 hrs, 48 hrs or 72 hrs respectively. However at 96 hrs, the number of hatched and attached blastocyst was significantly higher in group I (82.3%) and II (78.5%) than control (63.2%; P<0.05). CONCLUSION: The addition of glucose (0.5 mM) to the DMEM, as energy source, improved the rate of development of late stage embryos in mice.
Animals ; Blastocyst ; Eagles* ; Embryonic Development* ; Embryonic Structures* ; Female ; Glucose* ; Glutamine* ; Mice* ; Mice, Inbred ICR ; Morula ; Pregnancy

OBJECTIVES: To compare results of 4 different extraction methods in laparoscopic management of dermoid cyst. STUDY DESIGN: This article is a retrospective, multicenter study for 247 patients with benign dermoid cyst in period of 1995-1998. Dermoid cyst was extracted by Endopouch (99 cases), puncture-irrigation-extraction (69 cases), colpotomy (35 cases), and dermoid cyst as a "pouch bag" (44 cases). RESULTS: We analyzed irrigation amount, operative time, postoperative hospital stay and complications by four different extraction methods. Endopouch extraction method needed less amount of irrigation fluid for cleaning the abdominal cavity and had a shorter postoperative hospital stay (ANOVA, p=0.0001). There were no significant differences in operative times among groups. There were four cases of morbidity in puncture-irrigation-extraction method (6%), three had fever (> 38degrees C) and one intraabdominal abscess. One incisional hernia was noted in "pouch bag" method (2%). CONCLUSIONS: We recommend minimal spillage method for extraction of dermoid and careful irrigation of abdominal cavity to prevent potential risk of chemical peritonitis such as Endopouch, "pouch bag", and colpotomy with the exception of puncture-irrigation-extraction method.
Abdominal Cavity ; Abscess ; Colpotomy ; Dermoid Cyst* ; Fever ; Hernia ; Humans ; Laparoscopy* ; Length of Stay ; Operative Time ; Peritonitis ; Retrospective Studies*

The main cause of decreased visual acuity in branch retinal vein occlusion (BRVO) are macular edema and vitreous hemorrhage due to retinal neovascularization.We retrospec- tively studied the association of macular edema, neovas- cularization and vitreous hemorrhage according to the vitreoretinal relationship in 51 eyes of 51 BRVO patients. The eyes were classified as having vitreomacular attachment (VMA) or vitromacular separation (VMS) and posterior vitreous detachment (PVD) state and studied macular edema and retinal neovascularization development according to the vitreoretinal realtionship. The prevalence of VMA was 37 (72.5%) of the eyes and VMS was 14 (27.5%) eyes. VMA group had macular edema in 75.7% (28 of 37 eyes)and no macular edema was present in VMS group.Those 42 eyes who had partial or no PVD, 35.7% (15 of 42 eyes)developed retinal neovascularization and 9 eyes of complete PVD did not occur neovascularization. Although no significant relationship was found, vitreous hemorrhage developed in 21.4% (9 of 42 eyes) of only partial or no PVD group. VMA and PVD state may influence the presence of macular edema and retinal neovascularization in association with BRVO.
Humans ; Macular Edema* ; Prevalence ; Retinal Neovascularization ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Visual Acuity ; Vitreous Detachment ; Vitreous Hemorrhage

PURPOSE: To evaluate the nation-wide results of statistics related to the neonatal period of 1996, we collected data of a total of 64 hospitals in Korea (42 university hos- pitals and 22 general hospitals). METHODS: We obtained the results of 129,175 inboms and 9,379 outborns, and analyzed the statistics of live-births, ig, distribution of live-births by gestational age and birth weight, incidence of pre-term infants and low birth weight infants (LBWI), neonatal mortality, and incidence of discharge against medical advice (DAMA). RESULTS: According to birth weight, incidence of LBWI, normal birth weight, infant and high birth weight infants was 3.6%, 86.6% and 9.8%, respectively in the case of inborn group. But incidence of LBWI was higher in outborn group as compared with the inbom group. According to gestational age, incidence of preterm, term, and post-term was 11.1%, 87.1Yo and 1.8% respectively in the inbom group. The incidence of preterm in outborn group was higher than that of inborn group, because of the influnce of transpor- tation of high risk neonates to 2nd or 3rd levels of neonatal intensive care units (NICU). Overall neonatal mortality per 1,000 live-births was 9.3 in the inborn group amd 37.6% in the outborn group. These data revealed a high neonatal mortality, because the numbers of DAMA cases was also included. The incidence of DAMA was 0.44% and 1.15% in inborn and outborn groups, respectively. The percentage of the DAMA among the numbers of neonatal mortality was 47.2-48.8M in the inborn group. CONCLUSIONS: We obtained the statistics related to live-birth, incidence of prematurity and LBWI, neonatal mortality, and incidence of DAMA in Korea. The data revealed high levels of neonatal mortality (which included the sum of neonatal death and the number of DAMA) and incidence of DAMA in Korea at present. To achieve a low-level of neonatal mortality, more efforts to decrease the incidence of DAMA are needed. Also, a greater facility for NICU and a stronger support system from a nation-wide govemment policy and system of insurance are seen to be necessary.
Birth Weight ; Gestational Age ; Humans ; Incidence* ; Infant ; Infant Mortality* ; Infant, Low Birth Weight ; Infant, Newborn ; Insurance ; Intensive Care Units, Neonatal ; Korea* ; Parturition*

Cesarean hysterectomy is associated with high risks of severe blood loss, postoperative complication, and maternal morbidity. This study was undertaken to identify the risk factors of cesarean hysterectomy and to reduce the postoperative complications and maternal morbidity. There were 6,362 deliveries between January 1992 and December 1996 at department of obstetrics and gynecology, Inchon Christian Hospital. 1'he results of this study were as follows, 15 cases of cesarean hysterectomy were performed during this period. Cesarean hysterectomy was performed in 10 cases (0.32 %) among 3178 cesarean deliveries and in 5 cases (0.16 %) among 3184 vaginal deliveries. The incidence of cesarean hysterectomy was 0.24 % (15/6,362). The age of patients ranged from 24 to 38 years old. The maternal mortality and morbidity were 0 % (0/15) and 86.7% (13/15), respectively. Indications for cesarean hysterectomy were uterine atony (53.3 %), uterine myoma with pregnancy (20.0 %), placenta accreta and/or increta(20.0 %), and placenta previa (6.7 %) in orders. The associated risk factors of cesarean hysterectomy were prior cesarean delivery (46.7 %) and placenta previa (6.7 %). The postoperative complications were anemia (60.0%), febrile morbidity (13.3 %), paralytic ileus (6.7 %), and wound disruption (6.7 %). We concluded that risk factors of cesarean hysterectomy were cesarean delivery, prior cesarean delivery, uterine myoma with pregnancy, placenta accreta and/or increta, and placenta previa and that sufficient fresh blood and careful prenatal care were needed in risk group of postpartum bleeding.
Adult ; Anemia ; Gynecology ; Hemorrhage ; Humans ; Hysterectomy* ; Incheon ; Incidence ; Intestinal Pseudo-Obstruction ; Leiomyoma ; Maternal Mortality ; Obstetrics ; Placenta Accreta ; Placenta Previa ; Postoperative Complications ; Postoperative Hemorrhage ; Postpartum Period ; Pregnancy ; Prenatal Care ; Risk Factors ; Uterine Inertia ; Wounds and Injuries

BACKGROUND: The aim of this study was to investigate the effects of information with videotape to platelet donors on the degree of anxiety and discomfort. METHODS: Between April and September 1999, we evaluated 200 first-time donors; 100 donors were selected for experiment group and informed of the platelet donation with videotape, while 100 other donors in the control group were not informed with videotape. Data were collected by using constructed questionnaires. RESLUTS: There were not significant differences regarding the degree of state anxiety between the control group and the experiment group. The degree of discomfort felt by the platelet donors of the experiment group was similar compared to the control group. There was a correlation between the anxiety and the discomfort induced during platelet donation in both experiment and control groups. The only factor influencing anxiety and discomfort was the physical condition. CONCLUSIONS: This study showed that providing information through videotape did not have noticeable effect on reducing the anxiety and discomfort of the platelet donors. It is important to assess physical condition of platelet donors for more comfortable platelet donation. Based on these results, it can be proposed that more developed and effective videotape made under supervision of a specialist should be used for further providing information to the donors.
Anxiety* ; Blood Platelets ; Humans ; Organization and Administration ; Plateletpheresis* ; Specialization ; Tissue Donors* ; Videotape Recording* ; Surveys and Questionnaires

BACKGROUND AND PURPOSE: This study was undertaken to determine the knowledge that people with epilepsy (PWE) have regarding the nature of epilepsy and its management, and also to identify the factors contributing to their knowledge of epilepsy. METHODS: We studied 79 consecutive PWE who visited the outpatient clinic of Seoul National University Hospital using a structured questionnaire consisting of 27 questions in 3 categories. The mean correct response rate was 61%, with 81% believing that brain cells die during a seizure, 29% considering it dangerous to take a bath or shower alone, and more than 70% believing that taking antiepileptic drugs (AEDs) will impair memory and damage the liver and kidneys. RESULTS: The mean overall correct-answer rate was significantly related to gender, length of education, type of seizures, and regularity of hospital visits (all p<0.05). CONCLUSIONS: The level of knowledge deviated significantly from the scientific data, especially in the causes of epilepsy, safety issues, and side effects of AEDs. A large-scale study should identify those PWE with the lowest knowledge of epilepsy, and then develop and implement suitable educational intervention programs to improve their knowledge.
Ambulatory Care Facilities ; Anticonvulsants ; Baths ; Brain ; Education ; Epilepsy* ; Kidney ; Liver ; Memory ; Seizures ; Seoul ; Surveys and Questionnaires

Objective: To assess the incremental prognostic value of coronary computed tomography angiography (CCTA) in comparison toa clinical risk model (Framingham risk score, FRS) and coronary artery calcium score (CACS) for future cardiac events in ischemicstroke patients without chest pain. Materials and Methods: This retrospective study included 1418 patients with acute stroke who had no previous cardiac diseaseand underwent CCTA, including CACS. Stenosis degree and plaque types (high-risk, non-calcified, mixed, or calcified plaques) wereassessed as CCTA variables. High-risk plaque was defined when at least two of the following characteristics were observed:low-density plaque, positive remodeling, spotty calcification, or napkin-ring sign. We compared the incremental prognosticvalue of CCTA for major adverse cardiovascular events (MACE) over CACS and FRS. Results: The prevalence of any plaque and obstructive coronary artery disease (CAD) (stenosis ≥ 50%) were 70.7% and 30.2%,respectively. During the median follow-up period of 48 months, 108 patients (7.6%) experienced MACE. Increasing FRS, CACS,and stenosis degree were positively associated with MACE (all p< 0.05). Patients with high-risk plaque type showed the highestincidence of MACE, followed by non-calcified, mixed, and calcified plaque, respectively (log-rank p< 0.001). Among theprediction models for MACE, adding stenosis degree to FRS showed better discrimination and risk reclassification compared toFRS or the FRS + CACS model (all p< 0.05). Furthermore, incorporating plaque type in the prediction model significantly improvedreclassification (integrated discrimination improvement, 0.08; p= 0.023) and showed the highest discrimination index(C-statistics, 0.85). However, the addition of CACS on CCTA with FRS did not add to the prediction ability for MACE (p> 0.05). Conclusion Assessment of stenosis degree and plaque type using CCTA provided additional prognostic value over CACS andFRS to risk stratify stroke patients without prior history of CAD better.

Purpose: Neuroinflammation is considered an important pathway associated with several diseases that result in cognitive decline. 18F-THK5351 positron emission tomography (PET) signals might indicate the presence of neuroinflammation, as well as Alzheimer’s disease-type tau aggregates. β-amyloid (Aβ)-negative (Aβ–) amnestic mild cognitive impairment (aMCI) may be associated with non-Alzheimer’s disease pathophysiology. Accordingly, we investigated associations between 18F-THK5351 PET positivity and cognitive decline among Aβ– aMCI patients. Materials and Methods: The present study included 25 amyloid PET negative aMCI patients who underwent a minimum of two follow-up neuropsychological evaluations, including clinical dementia rating-sum of boxes (CDR-SOB). The patients were classified into two groups: 18F-THK5351-positive and -negative groups. The present study used a linear mixed effects model to estimate the effects of 18F-THK5351 PET positivity on cognitive prognosis among Aβ– aMCI patients. Results: Among the 25 Aβ– aMCI patients, 10 (40.0%) were 18F-THK5351 positive. The patients in the 18F-THK5351-positive group were older than those in the 18F-THK5351-negative group (77.4±2.2 years vs. 70.0±5.5 years; p<0.001). There was no difference between the two groups with regard to the proportion of apolipoprotein E ε4 carriers. Interestingly, however, the CDR-SOB scores of the 18F-THK5351-positive group deteriorated at a faster rate than those of the 18F-THK5351-negative group (B=0.003, p=0.033). Conclusion The results of the present study suggest that increased 18F-THK5351 uptake might be a useful predictor of poor prognosis among Aβ– aMCI patients, which might be associated with increased neuroinflammation (ClinicalTrials.gov NCT02656498).

BACKGROUND: Medical skin care is essential for the treatment of skin diseases all over the world. Medical skin care is also part of medical practice and this must be differentiated from the simple skin care that is given for normal healthy skin. OBJECTIVE: We wanted to discuss medical skin care and the related medical devices and legal issues. METHODS: We reviewed the related laws and regulations, we consulted experts and associations and we analyzed the result of the survey. RESULTS: Legally, medical skin care and simple skin care are well classified. However, many illegal procedures are still performed by non-medical personnel and many adverse effects have been reported as a result. Furthermore, there are no legal restrictions for the performer based on the grade of each medical skin care procedure. CONCLUSION: For the best results and safe procedures, medical skin care must be performed by approved medical equipment under the supervision of a physician or medical personnel. Continuous control and guidance by the government is strongly needed.
Jurisprudence ; Organization and Administration ; Skin ; Skin Care ; Skin Diseases ; Social Control, Formal