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

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.

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.

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*

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.

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.

BACKGROUND: Behçet disease (BD) is a relapsing inflammatory disease with increased production of inflammatory cytokines in peripheral blood mononuclear cells (PBMCs); however, the underlying molecular mechanisms are not well known. OBJECTIVE: To analyze whether the differential expression of transcription factors is involved in the increased tumor necrosis factor (TNF)-α and interleukin (IL)-6 production by PBMCs of BD patients compared to healthy controls (HCs). METHODS: Expression of transcription factors was examined by real-time reverse transcriptase-polymerase chain reaction and western blotting. Cytokine production by CD11b+ cells transfected with siRNAs against transcription factors was measured by enzyme-linked immunosorbent assay. RESULTS: In the absence of lipopolysaccharide stimulation, the transcript level of CCAAT-enhancer-binding proteins (C/EBP) β was increased in PBMCs from patients with active BD compared to that in PBMCs from patients with stable BD. The C/EBPδ transcript level was higher in PBMCs from patients with active BD than in those from HCs. The activating transcription factor 3 (ATF3) transcript level was increased in PBMCs from patients with stable BD compared to that in PBMCs from HCs. siRNAs targeting C/EBPβ and C/EBPδ significantly reduced the production of IL-6 and TNF-α in lipopolysaccharide-stimulated CD11b+ cells from patients with BD as well as from HCs. CONCLUSION: We found differential expression of C/EBPβ, C/EBPδ, and ATF3 in PBMCs from patients with BD depending on disease activity, indicating the involvement of these molecules in BD pathogenesis.
Activating Transcription Factor 3 ; Behcet Syndrome* ; Blotting, Western ; CCAAT-Enhancer-Binding Proteins ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Gene Expression ; Humans ; Interleukin-6 ; Interleukins ; RNA, Small Interfering ; Transcription Factors* ; Tumor Necrosis Factor-alpha

The Shikani Optical Stylet(TM) (SOS, Clarus Medical, USA) is another tool to facilitate tracheal intubation. It combines the benefits of a lightwand and a fiberoptic bronchoscope. We report the application of SOS in facilitating the tracheal intubation of two-person with history of difficult airway management. A 25-year-old woman with micrognathia was scheduled to undergo an exploratory laparotomy. Intubation attemps failed with a direct laryngoscope because of difficulty in her mouth opening. Although airway management was re-attempted by a laryngeal mask airway, it also failed for the same reason. Airway management was successfully performed using the SOS instead of a laryngeal mask airway. The second case was a 38-year-old woman with ankylosing spondylitis, scheduled for spinal fusion. She had difficulty in extending her neck. Intubation was successfully performed via the SOS. We believe that intubation by the SOS is a useful and readily available alternative technique for patients with difficult airways.
Adult ; Airway Management ; Bronchoscopes ; Female ; Humans ; Intubation ; Laparotomy ; Laryngeal Masks ; Laryngoscopes ; Mouth ; Neck ; Spinal Fusion ; Spondylitis, Ankylosing

PURPOSE: The purpose of this research was to describe our group counseling methods for medical students with drop-out experiences. METHODS: Group counseling was offered to 11 medical students with drop-out experiences in their previous second semester. All subjects provided written informed consent before participating and completed a 2-day group counseling program using the Gestalt approach. The self-assertiveness training group counseling program consisted of 6 sessions, each of which lasted 90 minutes. Experience reports by participants after the program and data from semi-structured qualitative interviews were qualitatively analyzed. RESULTS: Program participants reported that they were moderately satisfied with the program regarding its usefulness and helpfulness on self-awareness, understanding, and reminding them of attempts to change behavior. Most students showed heightened levels of sincerity perceptions and positive attitudes in every session. The results demonstrated significant changes in experience in self-esteem, self-recognition, and interpersonal relationships. CONCLUSION: A group counseling program using the Gestalt approach could help medical students with drop-out experiences to adjust with 1 year their juniors, enhance their self-esteem, contribute to their psychological well-being, and prevent student re-failure through effective stress management and improved interpersonal relationships.
Counseling ; Humans ; Informed Consent ; Students, Medical

There are various types of foreign body reactions, such as inflammation, edema, fluid collection, hematoma, infection, abscess and granulomas. There are various imaging findings according to types of foreign bodies and depending on the lapse of time. Therefore, correct diagnosis of a foreign body reaction is difficult and easily confused with soft tissue neoplasm. The MRI is ideal for the detection of foreign bodies regardless of radiolucency or acoustic impedance. It is especially very useful in the evaluation of the surrounding tissue reaction. The authors report a case of a 26-year-old female patient with both forearm swelling due to self-injection of a mixture of powdered tablets and saline. The lesion shows numerous internal T1 and T2 dark signal intensity micro-spots with surrounding fluid collection, which are diagnosed as foreign bodies with surrounding inflammatory changes during an operation.
Abscess ; Acoustics ; Edema ; Electric Impedance ; Female ; Forearm ; Foreign Bodies ; Foreign-Body Reaction ; Granuloma ; Granuloma, Foreign-Body ; Hematoma ; Humans ; Inflammation ; Injections, Intramuscular ; Soft Tissue Neoplasms ; Tablets