A Survey on the Actual Condition of the Use of Powered Wheelchair and Scooter

OBJECTIVE: To evaluate the efficiency of powered wheelchair and scooter and to investigate the factors affecting the accidents and injuries. METHOD: We investigated 90 subjects with mobility disability who had used powered wheelchair or scooter more than a year. The subjects responded to a questionnaire of the 34 items. RESULTS: Seventy (77.7%) of respondents used powered wheelchair or scooter more than 3 days a week. More than 50% of them regarded the obstacles such as curbs or thresholds as the most common hindering factor to outside mobility. The causes of breakdown were due to battery, wheel, gear box and motor. About a third of 58 respondents were dissatisfied with the result of repair. The high cost of the repair was regarded as the leading cause of dissatisfaction. Contusions were the most common, with abrasion and sprain accounting for most of the remainder. Of the 18 users who were affected by injuries, only 11.1% wore a safety seatbelt. Only 25 of 89 respondents had a safety education. CONCLUSION: Our study showed that the efficiency of power wheelchair and scooter was relatively high. But the obstacles such as curbs, recurrent breakdown, and concerns about the accident were regarded as the hindering factors to the outside mobility. The degree of satisfaction to the safety education is relatively low, so more systemic and practical programs need to be devised.

Study on the Development of Efficient Vitrification of Human Blastocysts / 대한불임학회지

OBJECTIVE: The purpose of this study was to evaluate the survival rate of vitrified blastocyst according to the freezing vessels, equilibration time in cryoprotectant and artificial dehydration method. METHODS: Human blastocysts were vitrified after loading onto the plastic straw, open-pulled straw (OPS), electron microscopy grid (EM grid) for 1.5 min or 3 min. They also were directly plunged into LN2 within 30sec. For artificial shrinkage of blastocysts, 36 gauge fine needle was pushed at the cellular junction of the trophectoderm into the blstocoele cavity until it shrank without damage of inner cell mass. RESULTS: The survival rate of vitrified blastocysts on plastic straw, OPS, EM grid as freezing vessels were 26.7, 13.0 and 60.5%, respectively. The survival rate of EM grid was significantly higher than that of plastic straw and OPS (p<0.05). For 1.5 min equilibrium, the survival rates of early blastocyst (EB), middle blastocyst (MB) and late blastocyst (LB) were 64.4, 81.0, and 20.0% respectively. For 3 min equilibrium, the survival rates of EB, MB, and LB were 69.9, 50.0 and 57.5% respectively. The survival rates of EB and MB were significantly higher than that of LB in 1.5 min equilibrium group (p<0.05), however, the significance was not observed in 3 min equilibrium groups. In cytoplasmic shrinkage before vitrification, the survival rates of EB, MB and LB were 92.9, 100 and 75.9% respectively. The survival rate of MB was significantly higher than that of LB (p<0.05). The survival rates of vitrified blastocysts by artificial dehydration and slow-frozen blastocysts were not significantly different as 88.9 and 66.7%, respectively. CONCLUSION: This study showed that the vitrification of human blastocysts using EM grid and artificial dehydration is an effective method. Therefore, these methods would be an useful techniques for blastocyst cryopreservation.

Trial of New Protocol (Modified Luteal Long; MLL) for Improvement of Outcomes in In Vitro Fertilization and Embryo Transfer / 대한산부인과학회잡지

OBJECTIVE: To evaluate the efficacy of new protocol (Modified luteal long; MLL protocol) to improve the clinical outcomes in IVF-ET. METHODS: New protocol was applied to repeated ART failure group for 7 months (GroupI, n=106) after informed consent. Outcomes of new protocol group were evaluated and compared to conventional long protocol group (Group II, n=315) prospectively and compared to same indication group with GroupI (Group III, n=144) historical prospectively. RESULTS: There were no differences in the clinical characteristics except patient's age between GroupI and II (35.16+/-4.35 vs. 33.22+/-4.14, p<0.05). Outcomes of IVF-ET, such as numbers of retrieved oocytes, numbers of transferred embryos, numbers of 2 PN, rates of ICSI, rates of blastocyst ET, rates of fertilization, ampules of gonadotropin between GroupI & II, and GroupI & III, respectively. But the embryo quality score of GroupII was significantly higher than GroupI. There was significant increase of implantation rate (25.2 vs. 17.1%, p=0.02) in GroupII compared to GroupI, especially in 31-35 years old group. Implantation rate of less than 35 years old group and clinical pregnancy rate of 31-35 years old group in GroupII tubal factor patients were significantly higher than GroupI tubal factor patients. Clinical pregnancy rate (47.2 vs. 12.8%, p=0.001) and implantation rate (15.2 vs. 5.5%, p=0.009) of GroupI was significantly higher than GroupIII, especially in 36-40 years old group. Implantation rates of ES factor patients (especially in 36-40 years old) and unknown factor patients (especially less than 35 years old), and clinical pregnancy rate of ES factor patients (especially in 36-40 years old) were significantly higher in GroupI than III. CONCLUSION: These results suggest that new protocol may play some role in the increase of endometrial receptivity. Further investigation, including molecular research work will be needed to clarify the factors concerned in the increase of implantation rate.

Study on the Vitrification of Haman Blastocysts: II. Effect of Vitrification on the Implantation and the Pregnancy of Haman Blastocysts / 대한불임학회지

OBJECTIVE: This study was conducted to investigate the effect of vitrification on the implantation the pregnancy of human blastocysts. METHOD: The transfer of the frozen-thawed blastocysts by the slow freezing or vitrification was performed between January 1998 and July 1999. The zygotes derives from IVF were cocultured with cumulus cells in YS medium containing 20% hFF for 5days. Two or three of the best balstocysts produced on day 5 were transferred into the uterus, and then supernumerary blastocysts were randomly divided into two groups. One was frozen by slow freezing and the other was frozen by vitrification method. The slow freezing procedure was performed in two steps (5% glycerol and 9% glycerol + 0.2 M sucrose for 10 min, respectively) using programmed freezer (-2degrees C/min to -7degrees C, 0.3degrees C and plunged into LN2). The blastocysts frozen by slow freezing were thawed at 36degrees C then removed glycerol in 7 steps. The vitrification procedure was performed in three steps (10% glycerol for 5 min, 10% glycerol + 20% ethylene glycol for 5 min, 25% glycerol + 25% ethylene glycol and directly LN2 within 1 min). The blastocysts frozen by vitrification were thawed at 20degrees C water then removed cryoprotectant in 3 steps. In each group, thawed blastocysts were cocultured with cumulus cells in YS medium containing 20% hFF for 18h and transferred into the uterus. The implantation rate was evaluated per transferred blastocysts and the pregnancy rate was evaluated per transfers. RESULTS: The survival rate of vitrified group (74.5%) was higher than slow freezing group (68.0%), but not significant. When 98 thawed blastocysts of vitrification were transferred in 40 cycles, 19 pregnancies (clinical pregnancy rate; 47.5%) were established. One miscarriage occurred in the eighth week of pregnancy (ongoing pregnancy rate; 45.0%). 7 pregnancies were ongoing, 11 pregnancies went to term, and 16 healthy infants were born. The Implantation rate was 31.6%. These results were higher than those obtained by the slow freezing (clinical pregnancy rate; 40.3%, ongoing pregnancy rate; 32.5% and implantation rate; 25.3%), but not significant. CONCLUSION: Vitrification is a simple, quick and economical method when compared to slow freezing. It will be chosen as a good method of human embryo freezing in IVF-ET programs.

Availability of Maternal Serum CA 125 in Diagnosis of Abruptio Placentae / 대한산부인과학회잡지

The diagnosis of abruptio placentae is frequently difficult despite advanced diagnostic tool because of symptomatic diversity, so additional diannostic parameter would be useful. Maternal serum CA 125, which is derived from decidua, shows an increase by the tenth weeks and then decreases, remaining low level until delivery.However, within 1 hour after term delivery, CA 125 level shows a second increase, probably because of decidual disruption. Serum CA 125 level was measured in 45 patients between 29 and 41 weeks gestation who were seen with vaginal bleeding and in 30 control patients of same gestational age.Mean(+/-SD) CA levels were higher(p < 0.05) among patients with abruptio placentae(61.2+/-52.9U/ml) than among those with bleeding due to placenta previa(17.4+/-8.5U/ml) or control patients(20.3+/-21.3U/ml).Mean(+/-SD) serum CA 125 level in 17 control patients within 6 hours postpartum(81.7+/-102.6U/ml) were higher than those among patients with palcenta previa or normal pregnancy(p < 0.05).Sensitivity and specificity of maternal serum level of CA 125 for diagnosis of abruptio placentae were 73% and 92% on cut off level of 30U/ml, respectively.

Availability of Maternal Serum CA 125 in Diagnosis of Abruptio Placentae / 대한산부인과학회잡지

The diagnosis of abruptio placentae is frequently difficult despite advanced diagnostic tool because of symptomatic diversity, so additional diannostic parameter would be useful. Maternal serum CA 125, which is derived from decidua, shows an increase by the tenth weeks and then decreases, remaining low level until delivery.However, within 1 hour after term delivery, CA 125 level shows a second increase, probably because of decidual disruption. Serum CA 125 level was measured in 45 patients between 29 and 41 weeks gestation who were seen with vaginal bleeding and in 30 control patients of same gestational age.Mean(+/-SD) CA levels were higher(p < 0.05) among patients with abruptio placentae(61.2+/-52.9U/ml) than among those with bleeding due to placenta previa(17.4+/-8.5U/ml) or control patients(20.3+/-21.3U/ml).Mean(+/-SD) serum CA 125 level in 17 control patients within 6 hours postpartum(81.7+/-102.6U/ml) were higher than those among patients with palcenta previa or normal pregnancy(p < 0.05).Sensitivity and specificity of maternal serum level of CA 125 for diagnosis of abruptio placentae were 73% and 92% on cut off level of 30U/ml, respectively.