No abstract available.

No abstract available.
Adolescent* ; Female* ; Humans

OBJECTIVES: This study aimed to identify the process of psychosocial assessment, the experience of intervention, and the improvement after the disaster that Danwon high school students survived from the sinking of the Motor Vessel (MV) Sewol in South Korea on April 16, 2014. METHODS: We conducted in-depth qualitative research using individual interviews from January to February 2017. Twenty-one of 75 Danwon high school students survived by the MV Sewol disaster were studied. Two interviewers participated in the in-depth interview. Interviews were transcribed verbatim, coded, and analyzed through content analysis based on psychosocial assessment and intervention after the disaster. RESULTS: Twenty-one participants were 20 years old, where 10 were male (47.62%), and 11 were female (52.38%). More than 75% of the interviewed students felt that mental health services were needed, and more than 85% required mental health assessments. Regarding psychiatric symptoms, the students reported that they suffered depression and insomnia (19.05%), anxiety (14.29%), nightmares and phobias (9.52%), and difficulties regarding concentration, aggression, and game addiction (4.76%). CONCLUSION: Despite survivors experiencing the same disaster, there were differences in their responses to mental health assessments and interventions experienced during the three years, and conflicting opinions were reported. In planning future evaluations and interventions, it is necessary for strategies to cope with flexibly to consider the characteristics and symptoms of the survivors while maintaining principles.
Aggression ; Anxiety ; Depression ; Disasters* ; Dreams ; Female ; Humans ; Korea ; Male ; Mental Health Services ; Mental Health* ; Phobic Disorders ; Qualitative Research ; Sleep Initiation and Maintenance Disorders ; Survivors*

OBJECTIVE: To evaluate the viability and the characteristics of shed endometrial tissues obtained from menstrual fluid during in-vitro culture. METHODS: The menstrual fluids were collected using Wallace catheter from uterine cavity in 10 women with regular menstruation. The menstrual fluids were washed twice, and the pellets, containing blood cells and shed endometrium, were collected and diluted fivefold with Ham's F-10 medium containing 10% fetal bovine serum. The cell suspension was placed on culture dishes, and cultured for 7 days in an incubator. To evaluate the characteristics of the cultured endometrial cells, immunohistochemical (IHC) staining was performed using anti-cytokeratin and anti-vimentin antibody. RESULTS: The mean volume of menstrual fluids and pellets were 0.7ml and 0.3ml, respectively. Only 15% of the shed endometrial tissues were attached and proliferated in culture dishes, which was considered to have viability. Initially, endometrial epithelial cells and fibroblasts were attached and proliferated, and the area of these cells was increased according to prolong the culture time. Stromal cell colonys were located and proliferated on the epithelial cells. IHC staining showed strongly positive for cytokeratin in epithelial cells and for vimentin in stromal cells. In the confocal microscopic observation of 3-dimensional structure of cultured endometrium, cytokeratin-positive cells (epithelial cells) were located in the pheriphery and cytokeratin-negative cells (stromal cells) inside of the structure. CONCLUSION: From our study, shed endometrial tissues in menstrual fluid showed meaningful viability and closed relationship between epithelial cells and stromal cells during in-vitro culture. Thus, we suggest that the in-vitro culture system of shed endometrium is a suitable model for researches of endometriosis.
Blood Cells ; Catheters ; Endometriosis ; Endometrium ; Epithelial Cells ; Female ; Fibroblasts ; Humans ; Incubators ; Keratins ; Menstruation ; Stromal Cells ; Vimentin

BACKGROUND: Most current reseatch using prognostic scoring systems in critically ill patients have focused o prediction using the first intensive care unit(ICU) day data or daily updated data. Usually the mean ICU length of stay in Korea is longer than in the western world. Consequently, a more cost-effective and practical prognostic parameter is required. The principal aim of this study was to assess the prognostic value of the seventh day(7th day : the average mean ICU length of stay) APACHE III score in a medical intensive care unit. METHODS: 241 medical ICU patients from July 1997 to April 1998 were enrolled. The 1st and 7th scores were measured by using the APACHE III scoring system and compared between survivors and non-survivors. Logistic regression analysis was performed to determine the relationship between the 1st and 7th APACHE III scores and the mortality risk. RESULTS: 1) The mean length of stay in the ICU was 10.3±13.8 days. 2) The mean 1st and 7th day APACHE III scores were 59.7±30.9 and 37.9±27.7. 3) The mean 1st day APACHE III scores was significantly lower in survivors than in non- survivors(49.9±23.8 vs 86.3±32.3 P<0.0001). 4) The mean 7th day APACHE III scores was significantly lower in survivors than in non- survivors(30.1±18.5 vs 80.1±30.4, P<0.0001). 5) The odds ratios among the 1st and 7th day APACHE III scores and the mortality rate were 1.0507 and 1.0779 respectively. CONCLUSION: These results suggest that the seventh day APACHE III scores is as useful in predicting the outcome as is such like the first day APACHE III score. Therefore, in comparison to the daily APACHE III score, measuring the 1st and 7th day APACHE III scores are also useful for predicting the prognosis of critically ill patients in terms of cost-effectiveness. It is suggested that the 7th day APACHE III score is useful for predicting the clinical outcome.
APACHE* ; Critical Illness ; Humans ; Intensive Care Units* ; Critical Care* ; Korea ; Length of Stay ; Logistic Models ; Mortality ; Odds Ratio ; Prognosis ; Survivors ; Western World

OBJECTIVES: The purpose of this study was to determine whether or not the shed endometrial tissues in menstrual fluid (MF) have adhesive potentials, using human amniotic membrane (AM). METHODS: The MF from 20 patients with regular menstruation was collected with Wallace catheter by aspiration from the uterine cavity on the second or third day of the menstrual period. The AM was obtained from the placenta of term delivery without any complication. The MF was washed and diluted fivefold with Hams F-10 medium supplemented with 10% fetal bovine serum. The cell suspension was placed on either epithelial layer (EP) or extracellular matrix layer (ECM) of the AM. After 5 days of culture, the adhesion sites were observed under a stereomicroscope. For histological observation, each cultured AM was prepared for the serial paraffin section. RESULTS: The adhesion sites of endometrial tissues in MF were found both ECM (20/20) and EP (11/20) of the AM. The size of adhesion sites in each AM were highly variable from microscopic to macroscopic size. CONCLUSION: We found that the shed endometrial tissues in MF have adhesive potential to epithelial layer in addition to extracellular matrix layer of amniotic membrane. This adhesive potential may be related to pathogenesis of endometriosis. We suggest that this culture system can be useful as an in-vitro model for endometriosis.
Adhesives* ; Amnion* ; Catheters ; Endometriosis* ; Extracellular Matrix ; Female ; Humans ; Menstruation ; Paraffin ; Placenta

The purpose of a conculation is to seek the opinions and advice of those whom we recognize to be more expert in a particular field of medicine than we are. Most surgeons regard the anesthesiolgist as a conculatant. Thus we analyzed 308 cases of interdepartmental consulatation submitted to our department from June 1991 to Novermber 1991. All case were elective ones and emergent cases were excluded. The analysis were as follow. 1) The overall conculation rate were 11.5%. 2) The highest rate of consultation were requested from orthopedic surgery department(29.9%) followed by ophthalmology department(25.0%), neurosurgery department(24.6%) and urology department(13.4%). 3) Male was 42.8% and female was 57.2%. 4) Most requestered problem was hepatic diseases including elevated transaminase, hepatitis and liver cirrhosis(35.1%) and then cardiovascular problem was 20.5%. 5) Because of our opinion, 22 cases were postponed. 6) Consultation rate increased according to advancing of age.
Female ; Hepatitis ; Humans ; Liver ; Male ; Neurosurgery ; Ophthalmology ; Orthopedics ; Urology

Intracytoplasmic sperm injection (ICSI) recently has been utilized widely as the most successful technique to overcome the unfertilization problem in cases of severe male infertility in couples who could not be treated by conventional IVF. Recently, indications of ICSI have been extended further and more fertilized oocytes become available. Thus, it is necessary to examine the efficiency of freezing the surplus embryos obtained from ICSI. We compared the survival rate and the future outcome of cryopreserved embryos obtained either after conventional IVF or ICSI during the same period. After ICSI or IVF, five best-quality embryos from each patient were transferred in the stimulation cycle and the surplus pronuclear (PN) stage oocytes or multicellular embryos were cryopreserved by slow freezing protocol with 1,2-propanediol (PROH) as a cryoprotectant.4 total of 792 embryos from ICSI trial were thawed and 65.2% (516/792) survived. The survival rates of PN stage oocyte, multicellular embryo and PN + multicellular embryo were 63.5%, 68.2%, 64.0%, respectively. After 111 transfers, 34 pregnancies were achieved, corresponding to a clinical pregnancy rate of 30.6% per transfers. We thawed 1033 embryos from IVF trials and 57.5% (594/1033) survived. In IVF cycle, the survival rates of PN stage oocyte, multicellular embryo and PN + multicellular embryo were 58.2%, 65.2%, 40.2%, respectively. Thirty eight clinical pregnancies were established after 134 transfers, corresponding to a pregnancy rate of 28.4% per transfer The cleavage rate of thawed PN stage oocytes from ICSI trial (61.3%) was significantly higher than those from conventional IVF (53.4%). The developmental rates of good embryo (> or = grade II) in thawed PN stage oocytes obtained from conventional IVF and ICSI were 63% and 65%, respectively. We concluded that PN stage oocytes, multicellular embryos resulting from ICSI procedure can be successfully frozen/thawed with reasonable clinical pregnancy rates comparable to those of IVF.
Embryonic Structures* ; Family Characteristics ; Fertilization in Vitro* ; Freezing ; Humans ; Infertility, Male ; Male ; Oocytes ; Pregnancy ; Pregnancy Rate ; Propylene Glycol ; Sperm Injections, Intracytoplasmic* ; Survival Rate

OBJECTIVE: The aim of this study was to evaluate the efficacy of frozen-thawed ET in poor prognosis patients such as the old age (38~44 years; OA group) and the patients who did not achieve clinical pregnancy with the first fresh ET cycle (non-pregnant patients; NP group). METHODS: Laboratory and clinical data were collected from fresh and frozen-thawed ET cycles of OA and NP group. Controlled ovarian hyperstimulation (COH) and conventional insemination or ICSI, in vitro culture and ET were performed by routine procedures. Supernumerary embryos were frozen by the slow freezing method, and frozen embryos were thawed by the rapid thawing method. Embryo development, pregnancy and implantation rates were statistically analyzed by Student t-test and chi square test. RESULTS: Mean ages were similar between fresh ET (40.0+/-1.8 years, n=206) and frozen-thawed ET (39.9+/-1.9 years, n=69) cycles in OA group. However, the clinical pregnancy and implantation rate of subsequent frozen-thawed ET significantly higher than those of fresh ET cycles (29.0% and 11.2% vs. 16.5% and 7.0%, p<0.05). In NP group, there was no difference in the mean age between fresh ET (31.2+/-2.3 years, n=40) and frozen-thawed ET (31.9+/-3.1 years, n=119) in subsequent cycles. The clinical pregnancy and implantation rates were similar between the subsequent fresh ET (42.5% and 22.6%) and the frozen-thawed ET (40.3% and 18.8%). CONCLUSION: In old age patients, higher pregnancy rate of frozen-thawed ET compared to fresh ET cycles in this study. It may be related that better uterine environments for implantation in frozen-thawed ET cycles than that of non-physiological hormonal condition in uterus of fresh COH cycles.
Embryonic Development ; Embryonic Structures ; Female ; Freezing ; Humans ; Insemination ; Pregnancy ; Pregnancy Rate ; Prognosis ; Sperm Injections, Intracytoplasmic ; Uterus

BACKGROUND/AIMS: The p53 mutations have been described as the most common genetic alteration during development and progression of malignancy in a wide range of human cancers. Mutant p53 proteins have a prolonged half-life accounting for increased levels of p53 protein frequently detected in tumors. This can induce the production of anti-p53 in the senzn of patients with HCC. We determined the relationship of serum anti-p53 with p53 expression in the liver tissue of chronic liver disease and the correlation of serum anti-p53 with serum alpha- fetoprotein(AFP) in patients with HCC. METHODS: In sera of same patients, we analysed the anti- p53 using ELISA system As controls we tested 50 healthy individuals and 20 patients with chronic hepatitis. Immaiohistochemical study for the presence of mutant p53 was performed on liver tissue from 50 patients with cirrhosis and 30 patients with HCC using monoclonal antibody clone DO-7 and LSAB kit by ABC method. RESULTS: Anti-p53 was positive in 9(30%) of 30 patients with HCC. Among nine patients with positive anti-p53, only two patients had detectable p53 expression in their tumor tissues. Anti-p53 was positive in 5(10%) of 50 patients with liver cirrhosis. The AFP was elevated in 21(70%) of 30 patients with HCC. Among the 9 AFP- negative HCC patients, 4(44.4%) were found to be positive for anti-p53. P53 expression was detectable in 9(30%) of 30 HCCs and 1(3.3%) of RO surrounding non-tumorous cirrhotic tissues. CONCLUSION: Mese findings suggest that anti-p53 was not correlated with the status of p53 expression in liver tissue and serological testing for anti-p53 antibody may be complementary to serum AFP for diagnosing of HCC with normal serum AFP.
Carcinoma, Hepatocellular ; Chronic Disease* ; Clone Cells ; Enzyme-Linked Immunosorbent Assay ; Fibrosis ; Half-Life ; Hepatitis, Chronic ; Humans ; Liver Cirrhosis ; Liver Diseases ; Liver* ; Serologic Tests