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Effects and safety of COVID-19 vaccination on assisted reproductive technology and pregnancy: A comprehensive review and joint statements of the KSRM, the KSRI, and the KOSAR

  • Han, Ae Ra;Lee, Dayong;Kim, Seul Ki;Choo, Chang Woo;Park, Joon Cheol;Lee, Jung Ryeol;Choi, Won Jun;Jun, Jin Hyun;Rhee, Jeong Ho;Kim, Seok Hyun;Korean Society for Reproductive Medicine (KSRM),;Korean Society for Reproductive Immunology (KSRI),;Korean Society for Assisted Reproduction (KOSAR),
    • Clinical and Experimental Reproductive Medicine
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    • v.49 no.1
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    • pp.2-8
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    • 2022
  • Humanity is in the midst of the coronavirus disease 2019 (COVID-19) pandemic, and vaccines-including mRNA vaccines-have been developed at an unprecedented speed. It is necessary to develop guidelines for vaccination for people undergoing treatment with assisted reproductive technology (ART) and for pregnancy-related situations based on the extant laboratory and clinical data. COVID-19 vaccines do not appear to adversely affect gametes, embryos, or implantation; therefore, active vaccination is recommended for women or men who are preparing for ART. The use of intravenous immunoglobulin G (IVIG) for the treatment of immune-related infertility is unlikely to impact the effectiveness of the vaccines, so COVID-19 vaccines can be administered around ART cycles in which IVIG is scheduled. Pregnant women have been proven to be at risk of severe maternal and neonatal complications from COVID-19. It does not appear that COVID-19 vaccines harm pregnant women or fetuses; instead, they have been observed to deliver antibodies against severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) to the fetus. Accordingly, it is recommended that pregnant women receive COVID-19 vaccination. There is no rationale for adverse effects, or clinical cases of adverse reactions, in mothers or neonates after COVID-19 vaccination in lactating women. Instead, antibodies to SARS-CoV-2 can be delivered through breast milk. Therefore, breastfeeding mothers should consider vaccination. In summary, active administration of COVID-19 vaccines will help ensure the safe implementation of ART, pregnancy, and breastfeeding.

A Nationwide Analysis Evaluating the Safety of Using Acellular Dermal Matrix with Tissue Expander-Based Breast Reconstruction

  • Jessica Luo;Whitney D. Moss;Giovanna R. Pires;Irfan A. Rhemtulla;Megan Rosales;Gregory J. Stoddard;Jayant P. Agarwal;Alvin C. Kwok
    • Archives of Plastic Surgery
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    • v.49 no.6
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    • pp.716-723
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    • 2022
  • Background In March 2021, the United States Food and Drug Administration (FDA) safety communication cautioned against the use of acellular dermal matrix (ADM) products in breast reconstruction and reiterated that the FDA does not approve ADM use in breast surgery. This study aims to assess the safety of ADM use in breast reconstruction. Methods Women who underwent ADM and non-ADM assisted tissue expander (TE)-based breast reconstruction were identified using the National Surgical Quality Improvement Program database (2012-2019). Trends of ADM use over time, and 30-day outcomes of surgical site infection (SSI), dehiscence, and unplanned reoperation were assessed. Results Of the 49,049 TE-based breast reconstructive cases, 42.4% were ADM assisted and 57.6% non-ADM assisted. From 2012 to 2019, the use of ADM increased from 26.1 to 55.6% (relative risk [RR] =1.10; p < 0.01). Higher rates of SSI (3.9 vs. 3.4%; p = 0.003) and reoperation (7.4 vs. 6.0%; p < 0.001) were seen in the ADM cohort. There was no significant difference seen in dehiscence rates (0.7 vs. 0.7%; p = 0.73). The most common reoperation within 30 days for the ADM group (17.6%) was removal of TE without insertion of implant (current procedural terminology: 11,971). ADM-assisted breast reconstruction was associated with increased relative risk of SSI by 10% (RR = 1.10, confidence interval [CI]: 1.01-1.21; p = 0.03) and reoperation by 15% (RR = 1.15, CI: 1.08-1.23; p < 0.001). Conclusions ADM-assisted breast reconstruction more than doubled from 2012 to 2019. There are statistically higher complication rates of SSI (0.5%) and reoperation (1.4%) with ADM use in TE-based breast reconstruction, suggesting that reconstruction without ADM is safe when comparing immediate postoperative outcomes.

Application of Matrix-assisted Laser Desorption/Ionization Time-of-flight Mass Spectrometry (Matrix-assisted Laser Desorption/Ionization Time-of-flight Mass Spectrometry의 활용)

  • Pil Seung KWON
    • Korean Journal of Clinical Laboratory Science
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    • v.55 no.4
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    • pp.244-252
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    • 2023
  • The timeliness and accuracy of test results are crucial factors for clinicians to decide and promptly administer effective and targeted antimicrobial therapy, especially in life-threatening infections or when vital organs and functions, such as sight, are at risk. Further research is needed to refine and optimize matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS)-based assays to obtain accurate and reliable results in the shortest time possible. MALDI-TOF MS-based bacterial identification focuses primarily on techniques for isolating and purifying pathogens from clinical samples, the expansion of spectral libraries, and the upgrading of software. As technology advances, many MALDI-based microbial identification databases and systems have been licensed and put into clinical use. Nevertheless, it is still necessary to develop MALDI-TOF MS-based antimicrobial-resistance analysis for comprehensive clinical microbiology characterization. The important applications of MALDI-TOF MS in clinical research include specific application categories, common analytes, main methods, limitations, and solutions. In order to utilize clinical microbiology laboratories, it is essential to secure expertise through education and training of clinical laboratory scientists, and database construction and experience must be maximized. In the future, MALDI-TOF mass spectrometry is expected to be applied in various fields through the use of more powerful databases.

Usefulness of Silent MRA for Evaluation of Aneurysm after Stent-Assisted Coil Embolization

  • You Na Kim;Jin Wook Choi;Yong Cheol Lim;Jihye Song;Ji Hyun Park;Woo Sang Jung
    • Korean Journal of Radiology
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    • v.23 no.2
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    • pp.246-255
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    • 2022
  • Objective: To determine the usefulness of Silent MR angiography (MRA) for evaluating intracranial aneurysms treated with stent-assisted coil embolization. Materials and Methods: Ninety-nine patients (101 aneurysms) treated with stent-assisted coil embolization (Neuroform atlas, 71 cases; Enterprise, 17; LVIS Jr, 9; and Solitaire AB, 4 cases) underwent time-of-flight (TOF) MRA and Silent MRA in the same session using a 3T MRI system within 24 hours of embolization. Two radiologists independently interpreted both MRA images retrospectively and rated the image quality using a 5-point Likert scale. The image quality and diagnostic accuracy of the two modalities in the detection of aneurysm occlusion were further compared based on the stent design and the site of aneurysm. Results: The average image quality scores of the Silent MRA and TOF MRA were 4.38 ± 0.83 and 2.78 ± 1.04, respectively (p < 0.001), with an almost perfect interobserver agreement. Silent MRA had a significantly higher image quality score than TOF MRA at the distal internal carotid artery (n = 57, 4.25 ± 0.91 vs. 3.05 ± 1.16, p < 0.001), middle cerebral artery (n = 21, 4.57 ± 0.75 vs. 2.19 ± 0.68, p < 0.001), anterior cerebral artery (n = 13, 4.54 ± 0.66 vs. 2.46 ± 0.66, p < 0.001), and posterior circulation artery (n = 10, 4.50 ± 0.71 vs. 2.90 ± 0.74, p = 0.013). Silent MRA had superior image quality score to TOF MRA in the stented arteries when using Neuroform atlas (4.66 ± 0.53 vs. 3.21 ± 0.84, p < 0.001), Enterprise (3.29 ± 1.59 vs. 1.59 ± 0.51, p = 0.003), LVIS Jr (4.33 ± 1.89 vs. 1.89 ± 0.78, p = 0.033), and Solitaire AB stents (4.00 ± 2.25 vs. 2.25 ± 0.96, p = 0.356). The interpretation of the status of aneurysm occlusion exhibited significantly higher sensitivity with Silent MRA than with TOF MRA when using the Neuroform Atlas stent (96.4% vs. 14.3%, respectively, p < 0.001) and LVIS Jr stent (100% vs. 20%, respectively, p = 0.046). Conclusion: Silent MRA can be useful to evaluate aneurysms treated with stent-assisted coil embolization, regardless of the aneurysm location and type of stent used.

Suprapubic Bladder Aspiration Assisted by Ultrasound (초음파 보조하에 시행한 치골상부 방광천자의 유용성)

  • Lee Jung Won;Park Soeun;Cho Su Jin;Yoo Eun Sun;Kim Hae Soon;Lee Seoung Joo
    • Childhood Kidney Diseases
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    • v.6 no.1
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    • pp.68-74
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    • 2002
  • Purpose: Suprapubic bladder aspiration(SBA) of urine is the most reliable method to obtain urine avoiding contamination in non-toilet trained infants. Ultrasonography is a useful tool for guiding the anatomic location as well as for direct visualization during procedure. We evaluated the success rate and complication of ultrasound(US) assisted SBA Methods. Sixty infants who visited Ewha Womans University Mokdong Hospital, with suspected urinary tract infection were randomly divided into the US assisted (n=32) and blind SBA(control, n=28) group. In US assisted SBA group, the anteroposterior(AP), transverse, and sagittal diameters and the volume of the bladder were measured. In the blind SBA group, urine was blindly aspirated when the urinary bladder was palpated at the suprapubic area. The rate of successful urine aspiration, the number of attempts until successful aspiration, aspirated urine volume were compared between the two groups. Results: The success rate was $100\%$(32/32) in the US assisted group, which was significantly higher than $85.7\%$(24/28) of the control group (P<0.05). The aspirated urine volume in the US assisted group was $7.4{\pm}3.7\;mL$, which was significantly higher than $4.5{\pm}3.4\;mL$ of the control group (P<0.05), The diameters and volume of bladder in successful aspiration were $2.1{\pm}0.7\;cm$ in AP diameter, $3.1{\pm}0.6\;cm$ in transverse diameter, $4.2{\pm}1.0\;cm$ in sagittal diameter and $15.2{\pm}10.4\;mL$ in volume, which were significantly higher than those ($1.7{\pm}0.3\;cm,\;1.7{\pm}0.3\;cm,\;1.8{\pm}0.7\;cm,\;2.4{\pm]0.6\;cm,\;3.9{\pm}2.5$) of the control group (P<0.05) The correlations between the AP(r=0.78), transverse (r=0.72), sagittal(r=0.91) diameter and bladder volume were significant (P<0.05). SBA was $100\%$ successful in the AP diameter >3 cm, transverse diameter >4 cm, depth >4 cm and bladder volume >5 mL. Conclusion: US assistance can significantly improve the success rate of SBA in infant with suspected urinary tract infection. (J Korean Soc Pediatr Nephrol 2002 ; 6 : 68-74)

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The Effect of Strong Acid and Ionic Material Addition in the Microwave-assisted Solubilization of Waste Activated Sludge (Microwave를 이용한 폐활성슬러지의 가용화 반응에서 강산과 이온성 물질의 첨가가 미치는 영향)

  • Lee, Jeongmin;Lee, Jaeho;Lim, Jisung;Kim, Youngwoo;Byun, Imgyu;Park, Taejoo
    • Journal of Korean Society of Environmental Engineers
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    • v.37 no.1
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    • pp.60-68
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    • 2015
  • The study of waste activated sludge (WAS) solubilization has been increased for sludge volume reduction and enhancing the efficiency of anaerobic digestion. Microwave (MW)-assisted solubilization is an effective method for the solubilization of WAS because this method can lead to thermal, nonthermal effect and ionic conduction by dielectric heating. In this study, the solubilization of WAS by MW heating and conductive heating (CH) was compared and to enhance the MW-assisted solubilization of WAS at low MW output power, chemical agents were applied such as $H_2SO_4$ as the strong acid and $CaCl_2$, NaCl as the ionic materials. Compared to the COD solubilization of WAS by CH, that by MW heating was approximately 1.4, 6.2 times higher at $50^{\circ}C$, $100^{\circ}C$, respectively and the highest COD solubilization of WAS was 10.0% in this study of low MW output power condition. At the same MW output power and reaction time in chemically agents assisted experiments, the COD solubilization of WAS were increased up to 18.1% and 12.7% with the addition of $H_2SO_4$ and NaCl, however, that with the addition of $CaCl_2$ was 10.7%. This result might be due to the fact that the precipitation reaction occurred by calcium ion ($Ca^{2+}$) and phosphate ion (${PO_4}^{3-}$) produced in WAS after MW-assisted solubilization. In this study, $H_2SO_4$ turned out to be the optimal agent for the enhancement of MW efficiency, the addition of 0.2 M $H_2SO_4$ was the most effective condition for MW-assisted WAS solubilization.