Globozoospermia is a rare type of teratozoospermia. It occurs in 0.1% of all andrological patient's and used to be considered sterile. Globozoospermic patient has 100% round headed spermatozoa, but the spermiogram is normal. The spermatozoa show oval-shape head, the lack of a nuclear envelope, acrosome, and post acrosomal sheath. OBJECTIVE: To report that a couple with infertility secondary to globozoospermia received ICSI treatment. MATERIAL AND METHOD: Case report. RESULTS: In the first trial, fertilization was failed. In the second trial, 40% of oocytes were fertilized and all of these embryos were cleaved, but pregnancy did not achieved. In the third trial, sperm injected oocytes were exposed to 10 micrometer calcium ionophore for 15 min. All of the injected oocytes were fertilized and proceeded to develop. Triplet pregnancy was achieved after the transfer of six embryos in their third cycle. One embryo vanished and the remaining twins (female) were delivered at 33 weeks of gestation by Caesarean section. CONCLUSION: This result shows that assisted activation following ICSI may overcome infertility associated with globozoospermia.
Acrosome ; Calcium ; Cesarean Section ; Embryonic Structures ; Female ; Fertilization ; Head ; Humans ; Infertility ; Male ; Nuclear Envelope ; Oocytes* ; Pregnancy* ; Pregnancy, Triplet ; Sperm Injections, Intracytoplasmic ; Spermatozoa* ; Twins

PURPOSE: To quantify the cardiac dose reduction during breathing adapted radiotherapy using Real-time Position Management (RPM) system in the treatment of left-sided breast cancer. MATERIALS AND METHODS: Twenty-two patients with left-sided breast cancer underwent CT scans during breathing maneuvers including free breathing (FB), deep inspiration breath-hold (DIBH), and end inspiration breath-hold (EIBH). The RPM system was used to monitor respiratory motion, and the in-house self respiration monitoring (SRM) system was used for visual feedback. For each scan, treatment plans were generated and dosimetric parameters from DIBH and EIBH plans were compared to those of FB plans. RESULTS: All patients completed CT scans with different breathing maneuvers. When compared with FB plans, DIBH plans demonstrated significant reductions in irradiated heart volume and the heart V25, with the relative reduction of 71% and 70%, respectively (p < 0.001). EIBH plans also resulted in significantly smaller irradiated heart volume and lower heart V25 than FB plans, with the relative reduction of 39% and 37%, respectively (p = 0.002). Despite of significant expansion of lung volume using inspiration breath-hold, there were no significant differences in left lung V25 among the three plans. CONCLUSION: In comparison with FB, both DIBH and EIBH plans demonstrated a significant reduction of radiation dose to the heart. In the training course, SRM system was useful and effective in terms of positional reproducibility and patient compliance.
Breast Neoplasms* ; Cardiac Volume ; Feedback, Sensory ; Heart ; Humans ; Lung ; Patient Compliance ; Radiotherapy* ; Respiration* ; Tomography, X-Ray Computed

No abstract available.
Blastocyst* ; Female ; Humans ; Oocytes* ; Parturition* ; Polycystic Ovary Syndrome*

PURPOSE: This study examined self-efficacy, self-care behavior, posttraumatic growth, and quality of life in cancer patients and their levels by disease characteristics groups to identify patient groups that require psychosocial intervention. METHODS: We surveyed 107 patients using a structured questionnaire about the four factors and analyzed the factors by stratifying the patients by the period after the cancer diagnosis, by stage and by current treatment status. RESULTS: The mean score for self-efficacy was 37.78, and that for self-care behavior 49.96. Patients who were diagnosed less than one year ago scored higher on medication, a sub-category of self-care behavior, than the post-diagnosis period of 1~2 year group. The score was higher in the currently-treated group than the follow-up and distant metastasis groups. For posttraumatic growth, the mean was 56.17, and the factor was higher in the 1~2 year post-diagnosis group after than the less than one year group. The score was higher in the follow-up group than the currently-treated group. With regard to quality of life, the mean score was 25.79, and no significant correlation was found with disease characteristics. CONCLUSION: A shorter post-diagnosis period increased self-care behavior, and the greatest posttraumatic growth was reported by the 1~2 year post-diagnosis group. It may be necessary to provide cancer patients with an education program and other strategies less than one year after the diagnosis to improve self-efficacy and self-care behavior. To promote post-traumatic growth, it may be helpful to provide patients with psychosocial intervention within two years after the diagnosis.
Diagnosis ; Education ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Quality of Life* ; Self Care* ; Stress, Psychological

Background: Both allogenous fibular bone graft and minimally invasive plate osteosynthesis have been developed to reduce issues such as fixation failure, displacement, angulation, and nonunion after plate fixation of proximal humeral fractures. However, there have been no studies investigating the differences in clinical results between these methods. The purpose of this study was to investigate the clinical differences between open reduction and plate fixation via a deltopectoral approach with allogenous fibular bone graft and a minimally invasive approach, in Neer's classification two-, three-part proximal humeral fractures. Methods: In this retrospective study, 77 patients with Neer classification two-, three-part proximal humeral fractures were treated at two different institutions. Clinical and radiological evaluations were performed in 39 patients who underwent minimally invasive plate osteosynthesis at one institution (group A) and 38 patients who underwent the deltopectoral approach with allogenous fibular bone graft at another institution (group B). The results between the groups were compared. Results: The minimally invasive plate osteosynthesis procedure (group A) was significantly less time- consuming and caused less bleeding than allogenous fibular bone graft through a deltopectoral approach (group B) (P<0.05). The duration of the fracture union was significantly reduced in group A (14.5±3.4 weeks; range, 10–22 weeks) compared to group B (16.4±4.3 weeks; range, 12–28 weeks) (P<0.05). There were no statistically significant differences between the two groups when evaluating the visual analog scale and Constant scores 1 year postoperatively. Radiological evaluation including neck-shaft angle and plate height were measured on the final follow-up X-ray image. There was no difference in radiological outcomes between the two groups. There were no statistically significant differences in malunion between the two groups; there were three malunion cases (7.7%) in group A and four (10.5%) in group B. Conclusions The minimally invasive plate osteosynthesis procedure and deltopectoral approach with allogenous fibula bone graft for Neer's classification two-, three-part proximal humeral fractures demonstrated similar clinical and radiological results. However, allogenous fibula grafts require longer surgery, cause more bleeding, and result in longer fracture healing time than the minimally invasive plate osteosynthesis procedure.

Hypertension is the leading factor of cardiovascular mortality and morbidity. Although antihypertensive medical treatment is the cornerstone of blood pressure control, lifestyle modification, including optimal diet therapy, such as dietary approaches to stop hypertension (DASH), cannot be overemphasized.Current Concepts: Due to the mismatch between sodium intake and excretion process being the key mechanisms according to physiologic principles, low sodium and high potassium intakes are the critical components of DASH. If the patient has a sensitive elevation of blood pressure following increased sodium intake, a low sodium diet could be essential for optimal blood pressure control. Salt sensitivity is increased by the activated reninangiotensin system, sympathetic nervous activity, sodium channels disorder, and endothelial dysfunction and frequently observed in the elderly and patients with obesity and chronic kidney disease. Increased potassium intake could attenuate sodium absorption by affecting the intracellular chloride and WNK4 activity, especially in patients with salt sensitivity or high salt intake.Discussion and Conclusion: For low sodium and high potassium intakes, the Na/K diet ratio could be a good target for intervention, and this approach is a critical component of DASH.

Purpose: We evaluated risk factors associated with reoperation following exposed hydroxyapatite orbital implant placement. Methods: We retrospectively analyzed 34 patients (34 eyes) diagnosed with exposed hydroxyapatite orbital implants at our institution between 2008 and 2022; all patients had a minimum follow-up of 12 months. All patients initially received conservative management. However, if symptoms, such as pain, discharge, or progressive exposure persisted, surgery was undertaken. We analyzed several variables, including age, sex, diabetic status, preoperative diagnosis, surgical approach, implant type and size, and exposed implant surface area. Regression analysis was performed to identify variables associated with reoperation. Results: Of the 34 patients (34 eyes), 17 (50.0%) were managed conservatively, whereas 17 (50.0%) required surgical intervention. Regression analysis revealed a significant association between the size of the exposed area and the need for reoperation (p = 0.018); however, other factors did not significantly impact reoperation rates. Receiver operating characteristic curve analysis identified a threshold of 4.5 mm for exposed area size, with an area under the curve of 0.934, sensitivity of 0.882, and specificity of 0.824. Patients categorized into small and large groups based on the 4.5 mm threshold revealed a statistically significant difference in reoperation rates (p < 0.001). Conclusions Our study demonstrates that the size of the exposed area is the single most significant predictor of revision surgery in patients with exposed hydroxyapatite orbital implants. Notably, an exposed area > 4.5 mm was associated with a significantly increased risk of reoperation.

Purpose: We evaluated risk factors associated with reoperation following exposed hydroxyapatite orbital implant placement. Methods: We retrospectively analyzed 34 patients (34 eyes) diagnosed with exposed hydroxyapatite orbital implants at our institution between 2008 and 2022; all patients had a minimum follow-up of 12 months. All patients initially received conservative management. However, if symptoms, such as pain, discharge, or progressive exposure persisted, surgery was undertaken. We analyzed several variables, including age, sex, diabetic status, preoperative diagnosis, surgical approach, implant type and size, and exposed implant surface area. Regression analysis was performed to identify variables associated with reoperation. Results: Of the 34 patients (34 eyes), 17 (50.0%) were managed conservatively, whereas 17 (50.0%) required surgical intervention. Regression analysis revealed a significant association between the size of the exposed area and the need for reoperation (p = 0.018); however, other factors did not significantly impact reoperation rates. Receiver operating characteristic curve analysis identified a threshold of 4.5 mm for exposed area size, with an area under the curve of 0.934, sensitivity of 0.882, and specificity of 0.824. Patients categorized into small and large groups based on the 4.5 mm threshold revealed a statistically significant difference in reoperation rates (p < 0.001). Conclusions Our study demonstrates that the size of the exposed area is the single most significant predictor of revision surgery in patients with exposed hydroxyapatite orbital implants. Notably, an exposed area > 4.5 mm was associated with a significantly increased risk of reoperation.

Purpose: We evaluated risk factors associated with reoperation following exposed hydroxyapatite orbital implant placement. Methods: We retrospectively analyzed 34 patients (34 eyes) diagnosed with exposed hydroxyapatite orbital implants at our institution between 2008 and 2022; all patients had a minimum follow-up of 12 months. All patients initially received conservative management. However, if symptoms, such as pain, discharge, or progressive exposure persisted, surgery was undertaken. We analyzed several variables, including age, sex, diabetic status, preoperative diagnosis, surgical approach, implant type and size, and exposed implant surface area. Regression analysis was performed to identify variables associated with reoperation. Results: Of the 34 patients (34 eyes), 17 (50.0%) were managed conservatively, whereas 17 (50.0%) required surgical intervention. Regression analysis revealed a significant association between the size of the exposed area and the need for reoperation (p = 0.018); however, other factors did not significantly impact reoperation rates. Receiver operating characteristic curve analysis identified a threshold of 4.5 mm for exposed area size, with an area under the curve of 0.934, sensitivity of 0.882, and specificity of 0.824. Patients categorized into small and large groups based on the 4.5 mm threshold revealed a statistically significant difference in reoperation rates (p < 0.001). Conclusions Our study demonstrates that the size of the exposed area is the single most significant predictor of revision surgery in patients with exposed hydroxyapatite orbital implants. Notably, an exposed area > 4.5 mm was associated with a significantly increased risk of reoperation.

Purpose: We evaluated risk factors associated with reoperation following exposed hydroxyapatite orbital implant placement. Methods: We retrospectively analyzed 34 patients (34 eyes) diagnosed with exposed hydroxyapatite orbital implants at our institution between 2008 and 2022; all patients had a minimum follow-up of 12 months. All patients initially received conservative management. However, if symptoms, such as pain, discharge, or progressive exposure persisted, surgery was undertaken. We analyzed several variables, including age, sex, diabetic status, preoperative diagnosis, surgical approach, implant type and size, and exposed implant surface area. Regression analysis was performed to identify variables associated with reoperation. Results: Of the 34 patients (34 eyes), 17 (50.0%) were managed conservatively, whereas 17 (50.0%) required surgical intervention. Regression analysis revealed a significant association between the size of the exposed area and the need for reoperation (p = 0.018); however, other factors did not significantly impact reoperation rates. Receiver operating characteristic curve analysis identified a threshold of 4.5 mm for exposed area size, with an area under the curve of 0.934, sensitivity of 0.882, and specificity of 0.824. Patients categorized into small and large groups based on the 4.5 mm threshold revealed a statistically significant difference in reoperation rates (p < 0.001). Conclusions Our study demonstrates that the size of the exposed area is the single most significant predictor of revision surgery in patients with exposed hydroxyapatite orbital implants. Notably, an exposed area > 4.5 mm was associated with a significantly increased risk of reoperation.