OBJECTIVES: Despite severe oligospermia, males with Y chromosome microdeletion can achieve conception through ICSI (Intracytoplasmic Sperm Injection). However, ICSI may not only result in the transmission of microdeletions but also the expansion of deletion to the offspring. The purpose of this study was to screen vertical transmission, expansion of microdeletions and de novo deletion in male fetuses conceived by ICSI. MATERIALS AND METHODS: A total of 32 ICSI treated patients with their 33 (a case of twin) male fetuses conceived by ICSI were used to make this study group. Sequence-tagged sites (STSs)-based PCR analyses were performed on genomic DNA isolated from peripheral blood of fathers and from the amniocytes of male fetuses. Ten primer pairs namely, sY134, sY138, MK5, sY152, sY147, sY254, sY255, SPGY1, sY269 and sY158 were used. The samples with deletions were verified at least three times. RESULTS: We detected a frequency of 12.5% (4 of the 32 patients) of microdeletions in ICSI patients. In 4 patients with detected deletions, two patients have proven deletions on single STS marker and their male fetuses have the identical deletion in this region. Another two patients have two and three deletions, but their male fetuses have more than 3 deletions which include deletions to their father's. Meanwhile, seven male fetuses, whose fathers were analyzed to have all 10 STS markers present, have deletions present in at least one or more of the markers. CONCLUSIONS: Although the majority of deletions on the Y chromosome are believed to arise de novo, in some cases a deletion has been transmitted from the fertile father to the infertile patient. In other cases the deletion was transmitted through ICSI treatment, it is likely that one sperm cell is injected through the oocyte's cytoplasm and fertilization can be obtained from spermatozoa. Our tests for deletion were determined by PCR and our results show that the ICSI treatment may lead to vertical transmission, expansion and de novo Y chromosome microdeletions in male fetuses. Because the sample group was relatively small, one should be cautious in analyzing these data. However, it is important to counsel infertile couples contemplating ICSI if the male carries Y chromosomal microdeletions.
Cytoplasm ; DNA ; Family Characteristics ; Fathers ; Fertilization ; Fetus* ; Humans ; Male* ; Oligospermia ; Polymerase Chain Reaction ; Sequence Tagged Sites ; Sperm Injections, Intracytoplasmic* ; Spermatozoa ; Y Chromosome*

Percutaneous endoscopic gastrostomy (PEG) has widely accepted for providing safe, long-term enteral nutrition for patients with swallowing disabilities. Though safe and technically simple, this procedure is often associated with some complications, such as wound infection, bleeding, stroma leaks and tube transposition. Major complications are rare and these include aspiration pneumonia, perforations, peritonitis and necrotizing fasciitis. We report here on a patient who developed extensive subcutaneous emphysema with hemoperitoneum and peritonitis following PEG. Medical treatment without removal of the PEG led to resolution of the emphysema and the peritonitis and successful PEG feeding.
Deglutition ; Emphysema ; Enteral Nutrition ; Fasciitis, Necrotizing ; Gastrostomy ; Hemoperitoneum ; Hemorrhage ; Humans ; Peritonitis ; Pneumonia, Aspiration ; Subcutaneous Emphysema ; Wound Infection

The salivary glands produce 1.5 l of fluid per day. As in other organs, the general paradigm in the salivary glands is that water movement occurs secondary to osmotic driving forces created by active salt transport. Therefore, high water permeability in salivary glands is expected to need a variety of aquaporin (AQP), a water channel. Although four AQPs have been known to reside in salivary glands, the precise location and roles of AQPs have been not well examined. This study is aimed to investigate the distribution of AQPs in 3 major salivary glands and their changes after cholinergic stimulation using immunohistochemical study in Sprague Dawley rats weighing 300 g under pentobarbital sodium anesthesia. AQP1 was localized in the endothelial cells of all salivary capillary vessels and the myoepithelial cells. AQP4 was demonstrated in the epithelium of the excretory ductal cells of all salivary glands. AQP5 and 8 were abundantly present in the basolateral membrane and apical membranes of the serous acini including intercellular secretory canaliculi, whereas AQP5 was weakly present in mucous acini. In addition, AQP5 was found in the epithelium of the intercalated and striated ducts. Upon stimulation of carbachol (10 micro gram/kg, I.P). AQP5 and 8 tended to translocate from basolateral membrane to the apical membrane, appearing as clusters of dots. These results suggest that AQP5 and 8 are the candidate molecules responsible for the water movement in salivary acinar cells.
Acinar Cells ; Anesthesia ; Animals ; Aquaporins* ; Capillaries ; Carbachol ; Endothelial Cells ; Epithelium ; Immunohistochemistry ; Membranes ; Pentobarbital ; Permeability ; Rats* ; Rats, Sprague-Dawley ; Salivary Glands* ; Water Movements

BACKGROUND AND OBJECTIVES: Right heart catheterization is traditionally performed using a femoral vein approach that involves admission, bed rest, and risks of bleeding and hematoma. Recent studies have confirmed safety of the use of forearm vein for right cardiac catheterization. In the present study, we evaluated the feasibility of right cardiac catheterization via the antecubital fossa vein in Korean patients. SUBJECTS AND METHODS: The medical records of all patients who underwent right heart catheterization at our hospital between January 2003 and December 2014 were reviewed retrospectively. Right cardiac catheterizations via the antecubital fossa vein and the femoral vein were compared in terms of demographic data (age, sex, weight, height, and body mass index), indications for right cardiac catheterization, and procedural and outcome data (initial success rate, procedure time, compression to ambulation time, and complications). RESULTS: We reviewed 132 cases (antecubital fossa vein approach, n=37; femoral vein approach, n=95). The demographic data, initial success rate (100% vs. 100%) and procedure time (21.6±16.8 min vs. 25.6±12.6 min, p=0.14) were similar in both groups. The antecubital fossa vein group had a shorter mean compression to ambulation time than the femoral vein group (0.0 min vs. 201.2±48.1 min, p<0.01). No complications were observed in either group. CONCLUSION: Our study indicated the ease of performance of right cardiac catheterization via the antecubital fossa vein. Thus, the antecubital fossa vein can be an alternative access site for right cardiac catheterization in Korean patients.
Bed Rest ; Cardiac Catheterization* ; Cardiac Catheters* ; Femoral Vein ; Forearm ; Hematoma ; Hemorrhage ; Humans ; Medical Records ; Retrospective Studies ; Veins* ; Walking

Purpose: Tumescent in nipple-sparing mastectomy (NSM) has been reported to increase the risk of necrosis by impairing blood flow to the skin flap and nipple-areolar complex. At our institution, we introduced a tumescent-free robotic NSM using the da Vinci single-port system (Intuitive Surgical, Inc.). Methods: We conducted a retrospective analysis of patients who underwent tumescent-free robotic NSM between October 2020 and March 2023 at Asan Medical Center (Seoul, Korea). Clinicopathological characteristics, adverse events, and operative time were evaluated. Results: During the study period, 118 patients underwent tumescent-free robotic NSM. Thirty-one patients (26.3%) experienced an adverse event. Five patients (4.2%) were classified as grade III based on the Clavien-Dindo classification and required surgery. The mean total operative time was 467 minutes for autologous tissue reconstruction (n = 49) and 252 minutes for implants (n = 69). No correlation was found between the cumulative number of surgical cases and the breast operative time (P = 0.30, 0.52, 0.59 for surgeons A, B, C) for the 3 surgeons. However, a significant linear relationship (P < 0.001) was observed, with the operative time increasing by 13 minutes for every 100-g increase in specimen weight. Conclusion Tumescent-free robotic NSM is a safe procedure with a feasible operative time and few adverse events.