Chromosomally derived sterility has long been recognized. A review of the literature of somatic chromosome investigations in infertile males has shown that 13.7% of azoospermic males and 4.6% of oligozoospermic males have an abnormal karyotype. In the first group, sex chromosome abnormalities predominate (mainly 47,XXY), whereas in the latter, autosome anomalies (i.e. Robertsonian and reciprocal translocations) are the most frequent. A similar review on meiotic studies revealed that meiotic chromosome anomalies can explain male infertility in 4.3-40.4% of patients. Recently, fluorescent in-situ hybridization studies on spermatozoa from infertile men were published; it was suggested that both X-Y pairing and pairing of the autosomes were impaired, resulting in spermatogenic disruption. It is estimated that there are 2,000 genes that regulate spermatogenesis, most of these being present on the autosomes, but there are approximately 30 genes on the Y chromosome. In general, autosomal genes that regulate spermatogenesis are concerned with regulation of metabolic processes in other cells in the body as well as in the cells of spermatogenesis, whereas Y genes are not essential for vital functions related to reproduction. To be able to provide proper counseling for those couples whose male infertility can now be treated by intracytoplasmic sperm injection, it is suggested that clinical investigations should include mitotic and meiotic studies, an analysis of the chromosome content of individual spermatozoa and a DNA analysis of blood and spermatozoa to detect partially deleted Y chromosome material. We have experienced a case of azoospermia associated with inversion of chromosome 1. So we report this case with a brief review of literatures.
Abnormal Karyotype ; Azoospermia* ; Chromosomes, Human, Pair 1* ; Counseling ; DNA ; Family Characteristics ; Humans ; Infertility ; Infertility, Male ; Male ; Metabolism ; Reproduction ; Sex Chromosome Aberrations ; Sperm Injections, Intracytoplasmic ; Spermatogenesis ; Spermatozoa ; Y Chromosome

In the orthopaedic field, some elective surgeries such as joint replacement, spinal surgery and limb salvage procedures for musculoskeletal tumors frequently need various amounts of blood transfusions. However, homologous transfusion occasionally results in various side effects, such as allergic reaction, febrile reaction, and the transmission of infectious diseases such as syphilis, hepatitis and AIDS, ctc. Recently, these complications especially in elective surgery might result in medicolegal or social problems. Risks from transfusions in elective surgery can be minimized with prebanked autologous transfusion. To evaluate the necessity of prehanked autogenous transfusion, fifty five patients who had unilateral hybrid total knee arthroplasty (noncemented at the femoral side and cemented at the tibial and patellar sides) were operated on by the same surgeon from April 199S to July 1997 and had autogenous shed blood transfusion were evaluated for postoperative blood loss, amount of autogenous shed blood, amount of transfusion, hemoglobin and hematocrit. The results were as follows: 1. The distribution of preoperative hemoglobin was from 9.6g/dL to 16.5g/dL (average: 1.8g/dL). 2. The distribution of the amount of blood loss for three days postoperatively was from 156ml to 2001 ml (average: 798ml). 3. The distrihution of the amount of transfusion of autogenous shed blood was from 30ml to 600ml (average: 448ml). 4. There were two patients who had febrile reactions above 38 after transfusion of autogenous shed blood. 5. Forty-six patient(84%) had a homologous transfusion and the average amount of transfusion was 1.9 pint. 6. Total amount of homologous transfusion was decreased according to the increased amount of hemoglobin and the amount of transfusion was statistically decreased above the level of I 3g/dL(Students t-test, P=0.0005). 7. There were no significant differences in the amount of homologous transfusion between age, sex, type of disease, type of implants. In conclusion, most of our patients(84%) needed homologous blood transfusion in unilateral hyhrid total knee arthroplasty and the amount of transfusion decreased in patients who had hemoglobin above 13.0g/dL. So we recommend preparing banked autogenous hlood preoperatively in patients who have a lower hemoglobin level in unilateral hyhrid total knee arthroplasty.
Arthroplasty* ; Blood Transfusion* ; Communicable Diseases ; Hematocrit ; Hepatitis ; Humans ; Hypersensitivity ; Joints ; Knee* ; Limb Salvage ; Postoperative Hemorrhage ; Social Problems ; Syphilis

No abstract available.
Echocardiography, Doppler*

The placenta is a temporary fetomaternal organ capable of supporting fetal growth and development during pregnancy. In particular, abnormal development and dysfunction of the placenta due to cha nges in the proliferation, differentiation, cell death, and invasion of trophoblasts induce several gynecological diseases as well as abnormal fetal development. Autophagy is a catalytic process that maintains cellular structures by recycling building blocks derived from damaged microorganelles or proteins resulting from digestion in lysosomes. Additionally, autophagy is necessary to maintain homeostasis during cellular growth, development, and differentiation, and to protect cells from nutritional deficiencies or factors related to metabolism inhibition. Induced autophagy by various environmental factors has a dual role: it facilitates cellular survival in normal conditions, but the cascade of cellular death is accelerated by over-activated autophagy. Therefore, cellular death by autophagy has been known as programmed cell death type II. Autophagy causes or inhibits cellular death via the other mechanism, apoptosis, which is programmed cell death type I. Recently, it has been reported that autophagy increases in placenta-related obstetrical diseases such as preeclampsia and intrauterine growth retardation, although the mechanisms are still unclear. In particular, abnormal autophagic mechanisms prevent trophoblast invasion and inhibit trophoblast functions. Therefore, the objectives of this review are to examine the characteristics and functions of autophagy and to investigate the role of autophagy in the placenta and the trophoblast as a regulator of cell death.
Apoptosis ; Autophagy* ; Cell Death* ; Cell Differentiation ; Cellular Structures ; Digestion ; Fetal Development ; Fetal Growth Retardation ; Homeostasis ; Lysosomes ; Malnutrition ; Metabolism ; Placenta* ; Pre-Eclampsia ; Pregnancy ; Recycling ; Trophoblasts

A putative polypeptide hormone identified as amylin[islet amyloid polypeptide] is synthesized and co-localized with insulin in B cells of pancreatic islets in several animal species including man. However, there is growing evidence that somatostatin cells are also expressed and contained amylin in the pancreatic islets of the rat The aim of the present study was to investigate the immunocytochemical expression of the amylin within the endocrine pancreas of the man, rabbit and guinea pig, with special reference to the possible ability of islet cells other than insulin cells to synthesize amylin. For this purpose serial sections of the pancreatic islets were stainedimmunocytochemically using anti-amylin, anti-insulin, anti-glucagon, anti-somatostatin antisera. In serial sections of pancreatic islets of the man and rabbit, it was shown that amylin immunoreactivity occurred in insulin-reactive B cells predominantly located in interior of the islets. In contrast, amylin immunoreacivity appeared in glucagon-reactive A cells peripherally located in the islets of the guinea pig. These results suggest that in both the man and rabbit, amylin is synthesized by B cells for subsequent co-secretion with insulin, and that in guinea pig, amylin is synthesized by A cells for co-secretion with glucagon. It thus appears that amylin release may be mediated by different secretory mechanisms according to animal species.
Amyloid ; Animals ; B-Lymphocytes ; Glucagon ; Guinea Pigs* ; Guinea* ; Immune Sera ; Immunohistochemistry ; Insulin ; Islet Amyloid Polypeptide* ; Islets of Langerhans* ; Rats ; Somatostatin-Secreting Cells

OBJECTIVE: Public concerns and awareness of automated external defibrillators (AEDs) are essential for improving the survival outcomes of out-of-hospital cardiac arrest (OHCA) in the community. On the other hand, the proportion of OHCA, in which AED is used in a prehospital setting, is very low in Korea. The aim of this study was to identify the barriers and training issues of AEDs. METHODS: A nationwide population-based survey was conducted to analyze the current public trends in AED awareness, training, and intention to use in 2017 (n=506). The barriers and training issues of AEDs were then documented. For trend analysis, previous tri-temporal surveys were obtained in 2007, 2011, and 2015. RESULTS: Public awareness of AEDs has increased: from 5.8% in 2007, to 30.6% in 2011, 82.6% in 2015, and 79.4% in 2017 (P<0.001). The training experience of AEDs has increased over time: from 0.5% in 2007 to 8.2% in 2011 and 33.2% in 2017. Thirty-two percent of respondents knew how and where to find the AEDs, but only 12.5% were able to certainly locate their public-access AED near their residency or work places. The reasons for being unwilling to use the AED included not knowing how to use (65.0%), fear of causing harm to the victim (21.3%), and legal liability (11.7%). CONCLUSION: Not knowing the location of AED and how to use it, and being unaware of the Good Samaritan Law were the major barriers to public access defibrillation. Further research is urgently needed if AEDs are to be increased and more lives saved.
Cardiopulmonary Resuscitation ; Defibrillators ; Hand ; Intention ; Internship and Residency ; Jurisprudence ; Korea ; Liability, Legal ; Out-of-Hospital Cardiac Arrest ; Public Health ; Surveys and Questionnaires ; Workplace

A balanced translocation in a parent may produce unbalanced gametes leading to abortions or defective liveborn children, or interval infertility. It also may give rise to a balanced gamete resulting in a balanced carrier, or it may produce a cytogenetically normal gamete. The incidence of balanced chromosomal translocations in couples with multiple abortions was reported as 0% to 31%. This wide variation is related to the heterogeneous criteria used for patient selection. Because parents with balanced chromosomal rearrangements and history of only repeated abortions have a significant chance with each pregnancy of having a child with normal or balanced karyotype, the usual criteria for investigation include at least two abortions or reproductive losses. There is no evidence from several reported series that increasing the number of losses to three or more leads to any change in the yield of chromosomal rearrangements detected.
Abortion, Spontaneous* ; Child ; Family Characteristics ; Female ; Germ Cells ; Humans ; Incidence ; Infertility ; Karyotype ; Parents ; Patient Selection ; Pregnancy ; Translocation, Genetic

Pulsatile secretion of GnRH from the hypothalamus is a prerequisite for both the initiation and maintenance of the reproductive axis in humans. Failure of this episodic GnRH secretion results in the clinical syndrome of hypogonadotropic hypogonadism. Deficient GnRH secretion may occur in isolation (idiopathic hypogonadotropic hypogonadism: IHH), in association with anosmia (Kallmann syndrome), or as a result of a variety of structural and functional lesions of the hypothalamic pituitary axis. The familial occurrence of hypogonadotropic hypogonadism associated with anosmia, color blindness, synkinesia, and mental defect is the classic Kallmann syndrome. Affected individuals respond readily to pulsatile administration of exogenous GnRH, and clearly this is the most physiologic approach to ovulation induction. For women not seeking pregnancy, replacement therapy with exogenous estrogen and progestin is indicated. We have experienced a case of Kallmann syndrome which was conceived by administration of gonadotropin. So we report this case with a brief review of literatures.
Axis, Cervical Vertebra ; Color Vision Defects ; Estrogens ; Female ; Gonadotropin-Releasing Hormone ; Gonadotropins* ; Humans ; Hypogonadism ; Hypothalamus ; Kallmann Syndrome* ; Olfaction Disorders ; Ovulation Induction ; Pregnancy

The clinical studies were performed on 757 patients who had been admitted to Severance Hospital from May, 1964 to June, 1975 with the diagnosis of congenital heart disease. The following results were obtained; 1. Among 757 patients, cardiac catheterization was performed on 367 patients. 2. Four hundred and thirty eight patients were male and 319 were female. Over half of them were below two years of age, but among 357 cardiac catheterized patients, 137 (37.3%) patients were ranged between 6 to 10 years. 3. V.S.D., Tetralogy of Fallot, P.D.A., A.S.D. were found in order of frequency. 4. Among 757 patients, combined extra-cardiac anomalies were found in 42 patients, and 14 patients were with Downanjx syndrome. 5. Among 367 cardiac catheterized patients, 164 (44.7%) patients had cardiac operations, and among these, 18 (11.0%) patients died including 7 patients of Tetralogy of Fallot.
Cardiac Catheterization ; Cardiac Catheters ; Diagnosis ; Female ; Heart Defects, Congenital* ; Humans ; Male ; Tetralogy of Fallot

No abstract available.
Female ; Humans ; Pregnancy ; Pregnancy, Tubal* ; Pregnancy, Twin* ; Salpingectomy* ; Twins*