OBJECTIVE: Evaluation of embryos using early cleavage to 2-cell stage has been proposed, but a critical time-point for selecting embryos is unclear. The aim of the present study is to provide a guideline including critical time-point in the selection of early cleaving embryo for the reduction of multiple pregnancies as well as the increase of pregnancy rate in human IVF. METHODS: This prospective study was performed in 116 cycles from 85 patients who underwent conventional IVF or ICSI at the infertility clinic of Good Moonhwa Hospital from January 2002 to December 2003. Early cleavage (EC) of embryos to 2-cell stage was assessed at 25 h and 27 h postinsemination/microinjection. Embryos that had early cleaved at each time point were designated as EC-1 and EC-2, respectively, while others were designated as non-early cleavage (NEC). RESULTS: At least one early cleavage embryo was observed in 54 (46.6%) for the EC-1 and 84 (72.4%) for the EC-2 of the 116 cycles assessed. Clinical pregnancy rates (PR) were significantly higher in the EC-1 group (66.7%) compared to the EC-2 group (53.6%) or the NEC group (31.2%) (p<0.05). Significant improvement of the pregnancy rate was found when at least two or more embryos were early cleaved at 25 h postinsemination or when the proportion of early cleavage embryo at 25 h postinsemination was higher than 20% (p<0.05). CONCLUSIONS: The critical time-point for the selection of early cleavage embryos with high implantation potential is more effective in 25 h postinsemination/microinjection compared to 27 h. The proportion as well as number of early cleavage embryos is also an important factor for the prediction of pregnancy outcome and the chance of multiple pregnancies. These results demonstrated that the evaluation of early cleavage embryos to 2-cell stage is an easy, simple, and objective method for the selection of good quality embryos suitable for embryo transfer.
Embryo Transfer ; Embryonic Structures* ; Female ; Humans* ; Infertility ; Pregnancy Outcome ; Pregnancy Rate* ; Pregnancy* ; Pregnancy, Multiple ; Prospective Studies ; Sperm Injections, Intracytoplasmic

Here we report a case of doxycycline-resistant tsutsugamushi meningoencephalitis. A 63-year-old man with altered mental status was diagnosed with a tsutsugamushi infection by a local clinic and administered standard doxycycline treatment for 5 days without improvement. Azithromycin treatment for 3 days dramatically improved his clinical status.

No abstract available.
Embryonic Development* ; Embryonic Structures* ; Female ; Nitric Oxide* ; Pregnancy

Background: Depression is increasing among college students in general. Moreover, almost one-third of college students have been reported to suffer from depression. Thus, this study aimed to assess differences in stress coping strategies and resilience between depressed and normal-mood groups among college students. Methods: A total of 3,306 college students participated in this study. The students responded to a questionnaire that included questions of the Center for Epidemiologic Studies Depression (CES-D) scale, stress coping scale (SCS), and brief resilience scale. Logistic regression analysis was conducted to evaluate the impact of variables on depression. Results: Using the CES-D (cutoff score ≥21), 423 (12.8%) college students were classified as depressed. Adjusting for individual demographic factors, the SCS results of the students with depression showed significantly higher scores in emotion-focused coping (p<0.001), wishful thinking (p<0.001), and lower problem-focused coping (p<0.001) than the normal-mood group. Moreover, they presented lower resilience scores. Students who had emotion-focused coping (odds ratio [OR], 1.11; p<0.001) and lower resilience scores (OR, 0.76; p<0.001) were associated with higher CES-D scores. Conclusion The study findings revealed significant differences between the depressed and normal-mood groups in terms of stress coping skills and resilience, suggesting the need for promoting stress coping strategies and resilience to lower depression-related problems among college students.

OBJECTIVES: The aim of this study was to evaluate the subjective well-being of schizophrenic patients who switched their antipsychotics to risperidone as the maintenance treatment over 24 weeks. METHODS: Thirty-one patients were evaluated using Positive and Negative Syndrome Scale (PANSS) for psychopathology and UKU side effects rating scale for drug-induced adverse events. Also the subjects were asked to score the 10 items self-rating scale (KmSWN-10), which derived from the 19-items of Korean modified version of Subjective Well-being under the neuroleptic treatment (KmSWN) scale. The assessments were administered at baseline, 2 weeks, 12 weeks and 24 weeks after switching to risperidone. Analysis were done using repeated measures of ANOVA. Pearson correlation analysis were also done to assess the correlation between KmSWN-10 and psychopathology and drug induced side effects. RESULTS: There were significant improvements on the scores of KmSWN-10 and reductions on the PANSS and UKU side effect rating scores during the treatment of risperidone. KmSWN-10 was negatively correlated with the total, negative and general psychopathology scales of PANSS at baseline, and also negatively corrleated with total, positive, negative, general psychopathology scales and depressive factor of PANSS scores and total UKU side effects rating scores at 24 weeks of treatment. CONCLUSION: The results suggest that the maintenance treatment with risperidone positively affected on the subjective well-being of schizophrenic patients due to improvement of psychotic symptoms and decrement of side effects. KmSWN-10 may be more related with negative and general psychopathlogy scales of PANSS in this study.
Antipsychotic Agents* ; Humans ; Psychopathology ; Quality of Life ; Risperidone* ; Schizophrenia ; Weights and Measures

This study was designed to identify the ultrastructural changes of mouse endometrum during peri-implantation period and obtain the fundamental information for the establishment of 3-dimensional culture system of mouse endometrial cells in vitro. The used female ICR mice (6~8 wks) were conducted on pregnant. The biopsies were obtained from whole uterus at cycle day 1 (D1) and day 5 (D5) after hCG injection and mating. The biopsies materials were fixed 2.5% glutaraldehyde and 1% osmium tetroxide. Subsequently, for observation using light and transmission electron microscopy (LM and TEM), they were dehydrated and embedded in Epon and the embedded biopsies were sectioned and stained. For scanning electron microscypy (SEM), the fixed specimens were dehydrated, dried and coated with gold. 1)For LM, the biopsied materials at D5 (late secretory phase) were appeared the extended stromal layer by increased connective tissues and the fully developed endometrial glands and vessels compared with D1 (early secretory phase). 2) For TEM, the mouse endometrium was consisted of 3-layers, a simple polarized columnar epithelial cells, basement membrane and stromal cells. At D5, the distribution of microvilli, endoplasmic reticulum, Golgi body, lipid and glycogen deposits, secretory granules and surface area of basement membrane were increased. 3) For SEM, the degree of folding and microvilli of surface of mouse epithelial cells was became more and more according to the process of secretory phase, and at D5, implantation time of mouse, the appearance of pinopodes as a specific marker of uterine receptivity was found. The uterine pinopodes of mouse were found in narrow sites at the luminal surface, irregularity and appeared the different stages in the same sample. Therefore, these results indicated that the mouse endometrium was experienced dramatic morphological changes during peri-implantation period.
Animals ; Basement Membrane ; Biopsy ; Connective Tissue ; Endometrium* ; Endoplasmic Reticulum ; Epithelial Cells ; Female ; Glutaral ; Glycogen ; Humans ; Mice* ; Mice, Inbred ICR ; Microscopy, Electron, Transmission ; Microvilli ; Osmium Tetroxide ; Phenobarbital ; Secretory Vesicles ; Stromal Cells ; Uterus

OBJECTIVE: To evaluate the effects of serum E2 levels on the day of hCG administration on the pregnancy outcome of IVF-ET after controlled ovarian hyperstimulation (COH). METHODS: Data of 455 cycles of fresh IVF-ET with COH were retrospectively investigated. Serum E2 levels on the day of hCG administration were categorized into 5 groups; A (<1,000 pg/mL), group B (1,000~2,000 pg/mL), group C (2,000~3,000 pg/mL), group D (3,000~4,000 pg/mL), and group E (> or =4,000 pg/mL). RESULTS: Mean E2 levels on the day of hCG administration were 3,745.3 pg/mL and mean number of retrieved oocytes were 10.1. Of 455 cycles, 148 (32.5%) cycles were clinically pregnant. Implantation rate was 12.2% and delivery rate was 18.7%. The number of obtained oocytes increased with increasing levels of serum E2. Pregnancy rate gradually increased as E2 levels increased up to the group D, but began to fall in the group E. In younger women (<38 yrs), the IVF-ET outcomes were similar to those of total patients but in older women (> or =38 yrs), pregnancy rate and delivery rate were significantly higher in the group C than other groups. CONCLUSIONS: This result shows that serum E2 levels have a concentration-dependent effect on the pregnancy outcome and there is an optimal range of E2 levels to achieve for a successful pregnancy. Excessive E2 levels seem more deleterious to the pregnancy outcome in older women aged > or =38 years.
Aged ; Female ; Humans ; Oocytes ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Retrospective Studies

OBJECTIVE: To evaluate the effect of short coasting, by withdrawing both gonadotropins and GnRH agonist (GnRHa), on the prevention in severe ovarian hyperstimulation syndrome (OHSS) without compromising pregnancy outcome. METHOD: Thirty-seven women who had been coasted during COH for IVF were coasted when > or =20 follicles > 15 mm with serum E2 level of 4,000 pg/ml were detected. Coasting was initiated for one or two days depending on the status of follicle on ultrasound and serum E2 level. Both gonadotropin and GnRHa were withheld for coasting. Retrospective study was carried and changes of serum E2 levels, number of oocytes retrieved, fertilization rate, pregnancy rate were compared and analyzed. RESULTS: The mean serum E2 level fell from 6,993 pg/ml on the onset of coasting to 3,396 pg/ml on the day of hCG administration. The mean number of oocytes retrieved and fertilization rate were 15.7 and 70.0%, respectively. Fifteen patients were pregnant (40.6%) and implantation rate was 15.2%. Twenty-six (70.3%) patients were coasted for one day and 11 (29.7%) were coasted for two days. The mean decrease rate of serum E2 level was 43% in one day coasting group and 15% (1st day) and 81% (2nd day) in two day coasting group. The pregnancy outcome was similar between the two groups. After coasting, no severe or moderate OHSS occurred in any patients and mild OHSS occurred in 3 (8.1%) patients. CONCLUSIONS: Coasting for one or two days can be used successfully in the prevention of OHSS without compromising IVF cycle outcome.
Female ; Fertilization ; Gonadotropin-Releasing Hormone* ; Gonadotropins* ; Humans ; Oocytes ; Ovarian Hyperstimulation Syndrome* ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Retrospective Studies ; Ultrasonography

Lou Gehrig's disease, also called amyotrophic lateral sclerosis, is a chronic progressive motor neuron disease of an unknown etiology, characterized by upper and lower motor neuron degeneration with a resultant progressive weakness of bulbar muscles or the extremities. The early symptoms may include twitching, cramping, muscle weakness of distal extremities and slurred nasal speech. Rhinolalia aperta is abnormal speech attributable to inadequate velopharyngeal closure. Hypernasality is thequality of voice in which the emission of air through the nose is excessive due to velopharyngeal insufficiency so that the voice is highpitched and speech intelligibility deteriorates. We experienced a rare case of Lou Gehrig's disease presenting with rhinolia aperta in its early stage. We report the case with a literature review.
Amyotrophic Lateral Sclerosis ; Extremities ; Motor Neuron Disease ; Motor Neurons ; Muscle Cramp ; Muscle Weakness ; Muscles ; Nose ; Speech Disorders ; Speech Intelligibility ; Velopharyngeal Insufficiency ; Voice

BACKGROUND: This study examined how mental health status influenced suicidal ideation among community-dwelling elderly at senior citizen centers in Korea.METHODS: Data were obtained from a survey on elderly mental health in Jeollanam-do (a southwest province in Korea) conducted by the Jeollanam-do Provincial Mental Health and Welfare Center. In total, 4,113 people were recruited from all 22 cities in Jeollanam-do. We evaluated sociodemographic factors and mental health status using self-reported questionnaires, namely, the Suicidal Ideation Scale, Geriatric Depression Scale-Short Form Korean Version, Multidimensional Scale of Perceived Social Support, Korean version of the General Health Questionale-12, and Satisfaction with Life Scale, to assess psychosocial factors affecting suicidal ideation. Multivariate logistic regression was performed to examine the factors associated with suicidal ideation.RESULTS: Among the 4,113 subjects, 325 (7.9%) reported recent suicidal ideation. Multivariate logistic regression analysis revealed that depression (p<0.001), low-level social support and life satisfaction (p=0.006), poor general mental health (p<0.001), physical disease (p=0.009), and poor self-perceived health status (p=0.039) were significantlyassociated with suicidal ideation.CONCLUSION: The presence of physical disease, poor self-perceived health status, depression, and poor general mental health conditions increase the risk of suicide ideation among the elderly. Social support and life satisfaction affected their suicidal ideation independently of depression.
Aged ; Depression ; Humans ; Jeollanam-do ; Korea ; Logistic Models ; Mental Health ; Psychology ; Suicidal Ideation ; Suicide