A phenomenological study was conducted to investigate the experiences of mothers pregnant via in vitro fertilization (IVF). Sample of nine mothers participated. Ten theme clusters emerged when the formulated meanings were organized into categories. During the infertility period, the participants were subject to self- depreciation, envy, anxiety, and depression. It changed their priorities in life from a job-oriented life to one where having a baby was the most important thing. After trying numerous alternative therapies, IVF became their last hope in having a baby. Since the success rate for IVF is low (only 20-30%), the participants for the treatment were overwhelmed with uncertainty, and it led to further anxiety, depression and despair. Success of pregnancy gave them extreme satisfaction, but they became very cautious in their day-to-day life because of their fear of abortion and early delivery. Some were even worried about the side effect of IVF during the pregnancy. Finally, the delivery of the baby gave them relief from the obligation of having a baby. Women did not have any difficulties in rearing a "test tube baby" except in the case of twins. Most women had no ethical difficulty in having a baby by IVF. However they did not wish this information to be revealed to other people. They again turned to IVF to have a son(s) when the resultory child(s) was a daughter(s). This is because of the strong preference for sons in Korean society.
Anxiety ; Complementary Therapies ; Depreciation ; Depression ; Female ; Fertilization in Vitro* ; Hope ; Humans ; Infertility ; Mothers* ; Pregnancy ; Twins ; Uncertainty

Purpose: To assess the diagnostic value of optical coherence tomography angiography (OCTA), and the factors affecting the diagnosis of polypoidal choroidal vasculopathy (PCV) by OCTA and indocyanine green angiography (ICGA). Methods: The numbers and area of polyps, and the presence and area of a branched vascular network (BVN) as revealed by ICGA and OCTA, were retrospectively analyzed in 43 patients with active PCV. The patients were divided into two groups according to whether the number of polyps matched between the two methods: group 1, equal number of polyps revealed by ICGA and OCTA; group 2, different number of polyps revealed by ICGA and OCTA. Results: In 43 PCV patients, the total number of polyps was 1.47 ± 0.83 in ICGA and 1.07 ± 0.91 in OCTA (p < 0.001), and the polyp area was 0.27 ± 0.42 mm2 in ICGA and 0.17 ± 0.15 mm2 in OCTA (p = 0.023). BVN was found in 33 eyes (76.7%) by ICGA and 29 eyes (67.4%) by OCTA (p < 0.001). The BVN area was 3.61 ± 2.59 mm2 in ICGA and 2.74 ± 2.76 mm2 in OCTA (p = 0.002). Central retinal thickness and central choroidal thickness were significantly greater in group 2 than group 1 (p < 0.001, respectively). Subretinal fluid (SRF) (p = 0.009) and subretinal hemorrhage (SRH) (p = 0.005) were significantly more prevalent in group 2 than group 1. Polyp height (p = 0.022) and diameter (p = 0.042) were significantly greater in group 2 than group 1. Conclusions OCTA is a supplementary diagnostic technique for detecting PCV. The presence of SRF and SHR, and large polyp height and diameter, were associated with the polyp detection rate of OCTA for PCV.

Purpose: To assess the diagnostic value of optical coherence tomography angiography (OCTA), and the factors affecting the diagnosis of polypoidal choroidal vasculopathy (PCV) by OCTA and indocyanine green angiography (ICGA). Methods: The numbers and area of polyps, and the presence and area of a branched vascular network (BVN) as revealed by ICGA and OCTA, were retrospectively analyzed in 43 patients with active PCV. The patients were divided into two groups according to whether the number of polyps matched between the two methods: group 1, equal number of polyps revealed by ICGA and OCTA; group 2, different number of polyps revealed by ICGA and OCTA. Results: In 43 PCV patients, the total number of polyps was 1.47 ± 0.83 in ICGA and 1.07 ± 0.91 in OCTA (p < 0.001), and the polyp area was 0.27 ± 0.42 mm2 in ICGA and 0.17 ± 0.15 mm2 in OCTA (p = 0.023). BVN was found in 33 eyes (76.7%) by ICGA and 29 eyes (67.4%) by OCTA (p < 0.001). The BVN area was 3.61 ± 2.59 mm2 in ICGA and 2.74 ± 2.76 mm2 in OCTA (p = 0.002). Central retinal thickness and central choroidal thickness were significantly greater in group 2 than group 1 (p < 0.001, respectively). Subretinal fluid (SRF) (p = 0.009) and subretinal hemorrhage (SRH) (p = 0.005) were significantly more prevalent in group 2 than group 1. Polyp height (p = 0.022) and diameter (p = 0.042) were significantly greater in group 2 than group 1. Conclusions OCTA is a supplementary diagnostic technique for detecting PCV. The presence of SRF and SHR, and large polyp height and diameter, were associated with the polyp detection rate of OCTA for PCV.

BACKGROUND: Quality-adjusted life expectancy (QALE) means life expectancy (LE) reflecting health-related quality of life and is one of the indicators of healthy LE. We determined the trends in QALE in Korea by age, gender, educational level, and subregion from 2005 to 2013. METHODS: We applied the Sullivan method to estimate QALE. We calculated QALE from 2005 to 2013 by gender and QALE for 2005 and 2010 by educational level at the national level. Furthermore, we estimated QALE for 2005, 2008, and 2011 by subregion according to metropolitan and provincial levels. RESULTS: Population health in Korea measured by LE and QALE at age 0 increased steadily from 2005 to 2013. Annual percent changes of LE and QALE in men were 0.52 and 0.73, respectively (P value < 0.05), and those in women were 0.47 and 0.71, respectively (P value < 0.05). Koreans with a higher educational level had longer LE and QALE than those with a lower educational level, but the differences in LE and QALE according to educational level narrowed from 2005 to 2010. The LE and QALE at age 0 for each of the 16 subnational regions in 2011 increased compared to 2005, but there was still a difference of up to 4.57 years in QALE between subnational regions. CONCLUSION We showed that QALE could be easily calculated and be an appropriate measure for tracking the overall population's health level. The results from this study are expected to aid the Ministry of Health of Republic of Korea in setting up a goal for the National Health Plan.

OBJECTIVE: This study was designed to evaluate the effect of nasogastric tube on swallowing function in stroke patients with dysphagia. METHOD: Twelve stroke patients with dysphagia were included in this study. We evaluated the Functional Dysphagia Scale using videofluoroscopic swallowing study. Swallowing tasks were composed of swallowing 5 cc of thick food and same volume of fluid on nasogastric tube insertion state and then nasogastric tube removal state. RESULTS: As the result of measuring oral phase score before and after removing nasogastric tube, all of 12 patients showed no significant difference. There was statistically significant increase in score of residue in piriform sinuses on thick food swallowing after removing nasogastric tube (p<0.05). After removing nasogastric tube, aspiration was decreased on fluid swallowing in cases of 2 patients, while aspiration on thick food swallowing was increased in cases of 2 patients, compared with nasogastic tube insertion state. CONCLUSION: As the result of this study, the stroke patients with dysphagia on nasogastric tube were increased on fluid aspiration due to rapid descending and inhibition of epiglottic closure compared with the removal state of nasogastric tube. And there was significant increased in scores of residue in piriform sinuses on thick food swallowing and aspiration pneumonia after removing nasogastric tube.
Deglutition Disorders* ; Deglutition* ; Humans ; Pneumonia, Aspiration ; Pyriform Sinus ; Stroke*

Severe side effects of adenoviral-vectored-DNA COVID-19 vaccines such as thrombosis have been reported. Herein, we report a case of sudden massive deep vein thrombosis (DVT) in a young man with inferior vena cava anomaly 20 hours after the second dose of the mRNA vaccine for COVID-19. There was recurrence of iliofemoral DVT after one year, despite complete resolution and administration of prophylactic anticoagulants. We suggest that the sudden episode was triggered by the vaccine rather than the venous anomaly, which can be associated with recurrence due to inadequate venous return through the small and tortuous infrarenal veins or increased venous pressure and stasis. There are no standard guidelines for the management of DVT following mRNA vaccination. However, we highlight the importance of initial workups, regular follow-ups, and standard treatment options, including the continuous administration of prophylactic anticoagulants which should be considered to prevent recurrence.

Group D streptococci are known to cause newborn septicemia and meningitis, but the Streptococcus bovis group strains rarely cause serious neonatal infections in Korea. Central nervous system (CNS) complications of neonatal S. bovis group infection have rarely been reported. In adults, S. bovis group strains cause bacteremia and endocarditis, and are associated with gastrointestinal malignancy. However, only a few studies have reported meningitis and septicemia in infants. Here, we describe a case of bacteremia and meningitis due to Streptococcus gallolyticus subsp. pasteurianus with a delayed CNS complication in an infant. A 28-day-old male infant was admitted to the hospital with a 1-day history of fever. Cultures of blood, cerebrospinal fluid, and urine showed the presence of S. bovis group strain-S. gallolyticus subsp. pasteurianus. He was discharged after 21 days of intravenous ampicillin and cefotaxime administration. Two weeks later, he was readmitted with a fever and short episodes of tonic-clonic movements. Brain magnetic resonance imaging showed marked bilateral frontal subdural effusion. He was discharged after 31 days of antibiotic therapy, and no neurological sequelae were observed at the 9-month follow-up. In conclusion, we present a rare case of neonatal S. gallolyticus subsp. pasteurianus infection causing urinary tract infection, septicemia, meningitis, and delayed CNS complications. This case emphasizes the need for physicians to be aware of S. bovis infection in infants.
Adult ; Ampicillin ; Bacteremia ; Brain ; Cefotaxime ; Central Nervous System* ; Cerebrospinal Fluid ; Endocarditis ; Fever ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Korea ; Magnetic Resonance Imaging ; Male ; Meningitis ; Sepsis ; Streptococcal Infections ; Streptococcus bovis ; Streptococcus* ; Subdural Effusion ; Urinary Tract Infections

BACKGROUND: A tumor must continuously stimulate the growth of new capillary blood vessels for the tumor itself to grow and metastasize. Vascular endothelial growth factor (VEGF) promotes vascular permeability and endothelial cell growth. A hepatocellular carcinoma (HCC) is a typical hypervascular tumor. METHODS: We evaluated the expression of VEGF in 36 cases of HCC by using immunohistochemical staining in order to define its prognostic value. RESULTS: The expression rate of VEGF was 44.4% (16/36) in tumor cells and 0% (0/36) in non- tumorous liver parenchyme. VEGF expression did not correlate with any clinicopathological characteristics. And patients with expression of VEGF in tumor cells had no survival difference in comparison to those without VEGF expression. CONCLUSIONS: These results suggest that the expression of VEGF in HCC cells by itself may not be a significant factor in the prognosis of HCC.
Blood Vessels ; Capillaries ; Capillary Permeability ; Carcinoma, Hepatocellular* ; Endothelial Cells ; Humans ; Liver ; Prognosis ; Vascular Endothelial Growth Factor A*

BACKGROUND: Several publications have reported the successful, safe use of Laryngeal Mask Airway (LMA)-Classic devices in patients undergoing laparoscopic surgery. However, there have been no studies that have examined the application of volume-controlled ventilation (VCV) or pressure-controlled ventilation (PCV) using a LMA during gynecological laparoscopy. The aim of this study is to compare how the VCV and PCV modes and using a LMA affect the pulmonary mechanics, the gas exchange and the cardiovascular responses in patients who are undergoing gynecological laparoscopy. METHODS: Sixty female patients were randomly allocated to one of two groups, (the VCV or PCV groups). In the VCV group, baseline ventilation of the lung was performed with volume-controlled ventilation and a tidal volume of 10 ml/kg ideal body weight (IBW). In the PCV group, baseline ventilation of the lung using pressure-controlled ventilation was initiated with a peak airway pressure that provided a tidal volume of 10 ml/kg IBW and an upper limit of 35 cmH2O. The end-tidal CO2, the peak airway pressures (Ppeak), the compliance, the airway resistance and the arterial oxygen saturation were recorded at T1: 5 minutes after insertion of the laryngeal airway, and at T2 and T3: 5 and 15 minutes, respectively, after CO2 insufflation. RESULTS: The Ppeak at 5 minutes and 15 minutes after CO2 insufflation were significantly increased compared to the baseline values in both groups. Also, at 5 minutes and 15 minutes after CO2 insufflation, there were significant differences of the Ppeak between the two groups. The compliance decreased in both groups after creating the pneumopertoneim (P < 0.05). CONCLUSIONS: Our results demonstrate that PCV may be an effective method of ventilation during gynecological laparoscopy, and it ensures oxygenation while minimizing the increases of the peak airway pressure after CO2 insufflation.
Airway Resistance ; Compliance ; Female ; Humans ; Ideal Body Weight ; Insufflation ; Laparoscopy ; Laryngeal Masks ; Lung ; Mechanics ; Oxygen ; Tidal Volume ; Ventilation

Fibroma of the tendon sheath is an uncommon soft tissue tumor presenting as a solitary, slow-growing, firm, painless, small nodule, which shows strong attachment to the tendon or tendon sheath. It is usually localized on fingers and hand tendons in adults between the age of 20 and 40 years old. This case concerns a 61-year-old man presenting with a 5-year history of multiple cutaneous nodules on both palms and soles. Skin biopsy confirmed fibroma of the tendon sheath. Blood tests showed a high titer of rheumatoid factor and positivity to anti-nuclear antibody. No case of fibroma of the tendon sheath occurring multifocally on both palms and soles has been previously reported. Herein, we report on a very rare case of multiple fibromas of the tendon sheath arising from palms and soles, which supports the pathogenetic hypothesis that this tumor may be a reactive process rather than a true neoplasm.
Adult ; Biopsy ; Fibroma ; Fingers ; Hand ; Hematologic Tests ; Humans ; Middle Aged ; Rheumatoid Factor ; Skin ; Tendons