Anterior perineal hernia - A case report of a rare complication after pelvic exenteration.

INTRODUCTION AND IMPORTANCE: Perineal hernias are protrusions of intra-abdominal contents resulting from weakness of the pelvic floor muscles. They are an uncommon complication after ultraradical pelvic surgeries, with no established gold standard for surgical treatment. This case describes a rare anterior perineal hernia that developed after radical surgery for bladder carcinoma. CASE PRESENTATION: A 77-year-old Caucasian woman presented with a painful 10 cm bulge in the perineal region. The hernial sac involved the entire left labia majora and developed 4 years after radical surgery for bladder carcinoma. She had been misdiagnosed twice in the past with vaginal prolapse, leading to two unsuccessful vaginoplasty procedures due to recurrence. She underwent hernia repair with perineal approach and polypropylene mesh placement. The postoperative period was uncomplicated, and the patient was discharged after five days, with histology showing no malignancy. CLINICAL DISCUSSION: Perineal hernias are protrusions of intra- or extraperitoneal contents into the perineum due to a defect in the pelvic musculature. Various surgical modalities exist for perineal hernia repair, which adhere to the fundamental principles of hernia surgery: sac mobilization, precise incision, sac debridement and excision, and defect repair. Here, we successfully applied the perineal approach in a complicated case of a misdiagnosed perineal hernia after radical surgery. CONCLUSION: The perineal approach for hernia repair, involving an implantation of a polypropylene mesh and tissue flap was successfully applied, confirming its main place in the surgical treatment of perineal hernias. During the two-year follow-up no postoperative complications or recurrence hernia were registered.

Exploring Nitric Oxide as a Regulator in Salt Tolerance: Insights into Photosynthetic Efficiency in Maize.

The growing issue of salinity is a significant threat to global agriculture, affecting diverse regions worldwide. Nitric oxide (NO) serves as an essential signal molecule in regulating photosynthetic performance under physiological and stress conditions. The present study reveals the protective effects of different concentrations (0-300 µM) of sodium nitroprusside (SNP, a donor of NO) on the functions of the main complexes within the photosynthetic apparatus of maize (Zea mays L. Kerala) under salt stress (150 mM NaCl). The data showed that SNP alleviates salt-induced oxidative stress and prevents changes in the fluidity of thylakoid membranes (Laurdan GP) and energy redistribution between the two photosystems (77K chlorophyll fluorescence ratio F735/F685). Chlorophyll fluorescence measurements demonstrated that the foliar spray with SNP under salt stress prevents the decline of photosystem II (PSII) open reaction centers (qP) and improves their efficiency (Φexc), thereby influencing QA- reoxidation. The data also revealed that SNP protects the rate constants for two pathways of QA- reoxidation (k1 and k2) from the changes caused by NaCl treatment alone. Additionally, there is a predominance of QA- interaction with plastoquinone in comparison to the recombination of electrons in QA QB- with the oxygen-evolving complex (OEC). The analysis of flash oxygen evolution showed that SNP treatment prevents a salt-induced 10% increase in PSII centers in the S0 state, i.e., protects the initial S0-S1 state distribution, and the modification of the Mn cluster in the OEC. Moreover, this study demonstrates that SNP-induced defense occurs on both the donor and acceptor sides of the PSII, leading to the protection of overall photosystems performance (PIABS) and efficient electron transfer from the PSII donor side to the reduction of PSI end electron acceptors (PItotal). This study clearly shows that the optimal protection under salt stress occurs at approximately 50-63 nmoles NO/g FW in leaves, corresponding to foliar spray with 50-150 µM SNP.

Changes in Photosystem II Complex and Physiological Activities in Pea and Maize Plants in Response to Salt Stress.

Salt stress significantly impacts the functions of the photosynthetic apparatus, with varying degrees of damage to its components. Photosystem II (PSII) is more sensitive to environmental stresses, including salinity, than photosystem I (PSI). This study investigated the effects of different salinity levels (0 to 200 mM NaCl) on the PSII complex in isolated thylakoid membranes from hydroponically grown pea (Pisum sativum L.) and maize (Zea mays L.) plants treated with NaCl for 5 days. The data revealed that salt stress inhibits the photochemical activity of PSII (H2O → BQ), affecting the energy transfer between the pigment-protein complexes of PSII (as indicated by the fluorescence emission ratio F695/F685), QA reoxidation, and the function of the oxygen-evolving complex (OEC). These processes were more significantly affected in pea than in maize under salinity. Analysis of the oxygen evolution curves after flashes and continuous illumination showed a stronger influence on the PSIIα than PSIIß centers. The inhibition of oxygen evolution was associated with an increase in misses (α), double hits (ß), and blocked centers (SB) and a decrease in the rate constant of turnover of PSII reaction centers (KD). Salinity had different effects on the two pathways of QA reoxidation in maize and pea. In maize, the electron flow from QA- to plastoquinone was dominant after treatment with higher NaCl concentrations (150 mM and 200 mM), while in pea, the electron recombination on QAQB- with oxidized S2 (or S3) of the OEC was more pronounced. Analysis of the 77 K fluorescence emission spectra revealed changes in the ratio of the light-harvesting complex of PSII (LHCII) monomers and trimers to LHCII aggregates after salt treatment. There was also a decrease in pigment composition and an increase in oxidative stress markers, membrane injury index, antioxidant activity (FRAP assay), and antiradical activity (DPPH assay). These effects were more pronounced in pea than in maize after treatment with higher NaCl concentrations (150 mM-200 mM). This study provides insights into how salinity influences the processes in the donor and acceptor sides of PSII in plants with different salt sensitivity.

What animal model should I use to study necrotizing enterocolitis?

Unfortunately, we are all too familiar with the statement: "Necrotizing enterocolitis remains the leading cause of gastrointestinal surgical emergency in preterm neonates". It's been five decades since the first animal models of necrotizing enterocolitis (NEC) were described. There remains much investigative work to be done on identifying various aspects of NEC, ranging from the underlying mechanisms to treatment modalities. Experimental NEC is mainly focused on a rat, mouse, and piglet models. Our aim is to not only highlight the pros and cons of these three main models, but to also present some of the less-used animal models that have contributed to the body of knowledge about NEC. Choosing an appropriate model is essential to conducting effective research and answering the questions asked. As such, this paper reviews some of the variations that come with each model.

Robot-Assisted Hysterectomy for Primary Choriocarcinoma of the Cervix - A Novel Approach.

The incidence of ectopic choriocarcinoma with primary localization in the uterine cervix is extremely low, with less than hundred cases reported in the English language literature to date. We present a case of primary cervical choriocarcinoma in a 41-year-old woman, originally suspected for cancer of the cervix. After histological investigation, the decision was made for primary surgical treatment due to extensive hemorrhage, finished family planning, and the localization of the tumor. Currently, after six months of follow-up, the patient is disease-free without evidence of recurrence or metastasis. Our case demonstrates an innovative use of the robot-assisted technique, the feasibility and the efficacy of this approach for primary treatment of ectopic choriocarcinoma.

Multiple Perianal Epidermal Cysts Found in a Case of Lowe Syndrome: A Case Report and Review of the Literature.

BACKGROUND Lowe syndrome, also known as oculocerebrorenal syndrome, is a rare genetic condition caused by an X-linked mutation of the OCRL1 gene, with an estimated prevalence in the general population of approximately 1 in 500 000. It is a multisystem disorder most commonly affecting the eyes, central nervous system, and kidneys. These commonly manifest as congenital cataracts, intellectual disability, and proximal renal dysfunction (Fanconi-type). Epidermal lesions are an uncommon manifestation of this condition, and the association is not completely understood. CASE REPORT Here we present a case of a 9-year-old boy with Lowe syndrome who presented with multiple cystic masses found in the perianal region. An excision was then performed to remove the masses and found that the lesions were epidermal cysts, which are infrequently found in Lowe syndrome. After excision, the patient recovered uneventfully without complications. CONCLUSIONS While epidermal cysts are an uncommon manifestation that have been documented, our case remains unique given the location and associated symptoms of the lesions. At presentation, the constellation of pain and perianal masses was concerning for a malignant etiology. However, after diagnostic imaging was performed, these lesions were found to be epidermal cysts, an infrequent manifestation of Lowe syndrome. Few previous case reports described cystic lesions in association with Lowe syndrome, and none, to our knowledge, have described multiple symptomatic perianal lesions. This case is important to consider because epidermal cystic lesions can be found with this presentation and should be considered on differential diagnoses for dermatologic findings in Lowe syndrome patients.

Protective Effects of Sodium Nitroprusside on Photosynthetic Performance of Sorghum bicolor L. under Salt Stress.

In this study, the impacts of the foliar application of different sodium nitroprusside (SNP, as a donor of nitric oxide) concentrations (0-300 µM) on two sorghum varieties (Sorghum bicolor L. Albanus and Sorghum bicolor L. Shamal) under salt stress (150 mM NaCl) were investigated. The data revealed that salinity leads to an increase in oxidative stress markers and damage of the membrane integrity, accompanied by a decrease in the chlorophyll content, the open photosystem II (PSII) centers, and the performance indexes (PI ABS and PI total), as well as having an influence on the electron flux reducing photosystem I (PSI) end acceptors (REo/RC). Spraying with SNP alleviated the NaCl toxicity on the photosynthetic functions; the protection was concentration-dependent, and greater in Shamal than in Albanus, i.e., variety specific. Furthermore, the experimental results revealed that the degree of SNP protection under salt stress also depends on the endogenous nitric oxide (NO) amount in leaves, the number of active reaction centers per PSII antenna chlorophylls, the enhanced electron flux reducing end acceptors at the acceptor side of PSI, as well as the stimulation of the cyclic electron transport around PSI. The results showed better protection in both varieties of sorghum for SNP concentrations up to 150 µM, which corresponds to about a 50% increase in the endogenous NO leaf content in comparison to the control plants. Our study provides valuable insight into the molecular mechanisms underlying SNP-induced salt tolerance in sorghum varieties and might be a practical approach to correcting salt intolerance.

Impact of Salinity on the Energy Transfer between Pigment-Protein Complexes in Photosynthetic Apparatus, Functions of the Oxygen-Evolving Complex and Photochemical Activities of Photosystem II and Photosystem I in Two Paulownia Lines.

The present study shows the effect of salinity on the functions of thylakoid membranes from two hybrid lines of Paulownia: Paulownia tomentosa x fortunei and Paulownia elongate x elongata, grown in a Hoagland solution with two NaCl concentrations (100 and 150 mM) and different exposure times (10 and 25 days). We observed inhibition of the photochemical activities of photosystem I (DCPIH2 → MV) and photosystem II (H2O → BQ) only after the short treatment (10 days) with the higher NaCl concentration. Data also revealed alterations in the energy transfer between pigment-protein complexes (fluorescence emission ratios F735/F685 and F695/F685), the kinetic parameters of the oxygen-evolving reactions (initial S0-S1 state distribution, misses (α), double hits (ß) and blocked centers (SB)). Moreover, the experimental results showed that after prolonged treatment with NaCl Paulownia tomentosa x fortunei adapted to the higher concentration of NaCl (150 mM), while this concentration is lethal for Paulownia elongata x elongata. This study demonstrated the relationship between the salt-induced inhibition of the photochemistry of both photosystems and the salt-induced changes in the energy transfer between the pigment-protein complexes and the alterations in the Mn cluster of the oxygen-evolving complex under salt stress.

Impact of Sodium Nitroprusside on the Photosynthetic Performance of Maize and Sorghum.

Nitric oxide (NO) is an important molecule in regulating plant growth, development and photosynthetic performance. This study investigates the impact of varying concentrations (0-300 µM) of sodium nitroprusside (SNP, a donor of NO) on the functions of the photosynthetic apparatus in sorghum (Sorghum bicolor L. Albanus) and maize (Zea mays L. Kerala) under physiological conditions. Analysis of the chlorophyll fluorescence signals (using PAM and the JIP-test) revealed an increased amount of open PSII reaction centers (qP increased), but it did not affect the number of active reaction centers per PSII antenna chlorophyll (RC/ABS). In addition, the smaller SNP concentrations (up to 150 µM) alleviated the interaction of QA with plastoquine in maize, while at 300 µM it predominates the electron recombination on QAQB-, with the oxidized S2 (or S3) states of oxygen evolving in complex ways in both studied plant species. At the same time, SNP application stimulated the electron flux-reducing end electron acceptors at the PSI acceptor side per reaction center (REo/RC increased up to 26%) and the probability of their reduction (φRo increased up to 20%). An increase in MDA (by about 30%) and H2O2 contents was registered only at the highest SNP concentration (300 µM). At this concentration, SNP differentially affected the amount of P700+ in studied plant species, i.e., it increased (by 10%) in maize but decreased (by 16%) in sorghum. The effects of SNP on the functions of the photosynthetic apparatus were accompanied by an increase in carotenoid content in both studied plants. Additionally, data revealed that SNP-induced changes in the photosynthetic apparatus differed between maize and sorghum, suggesting species specificity for SNP's impact on plants.

Uterine tumor resembling ovarian sex-cord tumor - a rare gynecological neoplasm.

Uterine tumor resembling ovarian sex-cord tumor is a rare group of uterine neoplasms with unknown histogenesis and differentiation towards ovarian sex-cord elements. They are benign in nature with low malignancy potential. Diagnosis is based on immunohistochemistry and morphological features, and the distinction from other more malignant differentials is paramount to correctly individualizing treatment.

Assessment of the Photosynthetic Apparatus Functions by Chlorophyll Fluorescence and P700 Absorbance in C3 and C4 Plants under Physiological Conditions and under Salt Stress.

Functions of the photosynthetic apparatus of C3 (Pisum sativum L.) and C4 (Zea mays L.) plants under physiological conditions and after treatment with different NaCl concentrations (0-200 mM) were investigated using chlorophyll a fluorescence (pulse-amplitude-modulated (PAM) and JIP test) and P700 photooxidation measurement. Data revealed lower density of the photosynthetic structures (RC/CSo), larger relative size of the plastoquinone (PQ) pool (N) and higher electron transport capacity and photosynthetic rate (parameter RFd) in C4 than in C3 plants. Furthermore, the differences were observed between the two studied species in the parameters characterizing the possibility of reduction in the photosystem (PSI) end acceptors (REo/RC, REo/CSo and δRo). Data revealed that NaCl treatment caused a decrease in the density of the photosynthetic structures and relative size of the PQ pool as well as decrease in the electron transport to the PSI end electron acceptors and the probability of their reduction as well as an increase in the thermal dissipation. The effects were stronger in pea than in maize. The enhanced energy losses after high salt treatment in maize were mainly from the increase in the regulated energy losses (ΦNPQ), while in pea from the increase in non-regulated energy losses (ΦNO). The reduction in the electron transport from QA to the PSI end electron acceptors influenced PSI activity. Analysis of the P700 photooxidation and its decay kinetics revealed an influence of two PSI populations in pea after treatment with 150 mM and 200 mM NaCl, while in maize the negligible changes were registered only at 200 mM NaCl. The experimental results clearly show less salt tolerance of pea than maize.

Different Sensitivity Levels of the Photosynthetic Apparatus in Zea mays L. and Sorghum bicolor L. under Salt Stress.

The impacts of different NaCl concentrations (0-250 mM) on the photosynthesis of new hybrid lines of maize (Zea mays L. Kerala) and sorghum (Sorghum bicolor L. Shamal) were investigated. Salt-induced changes in the functions of photosynthetic apparatus were assessed using chlorophyll a fluorescence (PAM and OJIP test) and P700 photooxidation. Greater differences between the studied species in response to salinization were observed at 150 mM and 200 mM NaCl. The data revealed the stronger influence of maize in comparison to sorghum on the amount of closed PSII centers (1-qp) and their efficiency (Φexc), as well as on the effective quantum yield of the photochemical energy conversion of PSII (ΦPSII). Changes in the effective antenna size of PSII (ABS/RC), the electron flux per active reaction center (REo/RC) and the electron transport flux further QA (ETo/RC) were also registered. These changes in primary PSII photochemistry influenced the electron transport rate (ETR) and photosynthetic rate (parameter RFd), with the impacts being stronger in maize than sorghum. Moreover, the lowering of the electron transport rate from QA to the PSI end electron acceptors (REo/RC) and the probability of their reduction (φRo) altered the PSI photochemical activity, which influenced photooxidation of P700 and its decay kinetics. The pigment content and stress markers of oxidative damage were also determined. The data revealed a better salt tolerance of sorghum than maize, associated with the structural alterations in the photosynthetic membranes and the stimulation of the cyclic electron flow around PSI at higher NaCl concentrations. The relationships between the decreased pigment content, increased levels of stress markers and different inhibition levels of the function of both photosystems are discussed.

Precise parallel volumetric comparison of molecular surfaces and electrostatic isopotentials.

Geometric comparisons of binding sites and their electrostatic properties can identify subtle variations that select different binding partners and subtle similarities that accommodate similar partners. Because subtle features are central for explaining how proteins achieve specificity, algorithmic efficiency and geometric precision are central to algorithmic design. To address these concerns, this paper presents pClay, the first algorithm to perform parallel and arbitrarily precise comparisons of molecular surfaces and electrostatic isopotentials as geometric solids. pClay was presented at the 2019 Workshop on Algorithms in Bioinformatics (WABI 2019) and is described in expanded detail here, especially with regard to the comparison of electrostatic isopotentials. Earlier methods have generally used parallelism to enhance computational throughput, pClay is the first algorithm to use parallelism to make arbitrarily high precision comparisons practical. It is also the first method to demonstrate that high precision comparisons of geometric solids can yield more precise structural inferences than algorithms that use existing standards of precision. One advantage of added precision is that statistical models can be trained with more accurate data. Using structural data from an existing method, a model of steric variations between binding cavities can overlook 53% of authentic steric influences on specificity, whereas a model trained with data from pClay overlooks none. Our results also demonstrate the parallel performance of pClay on both workstation CPUs and a 61-core Xeon Phi. While slower on one core, additional processor cores rapidly outpaced single core performance and existing methods. Based on these results, it is clear that pClay has applications in the automatic explanation of binding mechanisms and in the rational design of protein binding preferences.

Effects of exogenous 24-epibrassinolide on the photosynthetic membranes under non-stress conditions.

In the present work the effects of exogenous 24-epibrassinolide (EBR) on functional and structural characteristics of the thylakoid membranes under non-stress conditions were evaluated 48 h after spraying of pea plants with different concentrations of EBR (0.01, 0.1 and 1.0 mg.L(-1)). The results show that the application of 0.1 mg.L(-1) EBR has the most pronounced effect on the studied characteristics of the photosynthetic membranes. The observed changes in 540 nm light scattering and in the calorimetric transitions suggest alterations in the structural organization of the thylakoid membranes after EBR treatment, which in turn influence the kinetics of oxygen evolution, accelerate the electron transport rate, increase the effective quantum yield of photosystem II and the photochemical quenching. The EBR-induced changes in the photosynthetic membranes are most probably involved in the stress tolerance of plants.

Association study of single-nucleotide polymorphisms in FASLG, JMJDIA, LOC203413, TEX15, BRDT, OR2W3, INSR, and TAS2R38 genes with male infertility.

Infertility is a major health problem today, affecting about 15% of couples trying to conceive a child. Impaired fertility of the male factor is causative in 20% of infertile couples and contributory in up to another 30%-40%. Based on association studies, an increasing number of gene polymorphisms have been proposed to modulate the efficiency of spermatogenesis. Here, we have investigated the possible association of 9 single-nucleotide polymorphisms (SNP) in 8 different genes-FASLG, JMJDIA, LOC203413, TEX15, BRDT, OR2W3, INSR, and TAS2R38--with male infertility. We analyzed a total of 136 men with idiopathic infertility (60 azoospermic and 76 oligozoospermic) and 161 fertile controls. Our study group included individuals of different ethnic origin: 93 of the infertile men were Macedonians, 32 were Albanians, and 11 were of other origin. The control group was composed of 125 Macedonian and 36 Albanian men. The methodology included multiplex polymerase chain reaction/SNaPshot analyses, followed by capillary electrophoresis on an ABI3130 Genetic Analyzer. Of the 9 SNPs evaluated, 3 are significantly associated (P < .05) with male infertility: SNPs rs5911500 in LOC203413, rs3088232 in BRDT, and rs11204546 in OR2W3. SNP rs5911500 showed the strongest association with infertility among Albanians (P = .0001), whereas rs3088232 was most significantly associated with azoospermia among Macedonians (P = .0082). Moreover, the frequency of co-occurrence of LOC203413 minor T allele with either homozygosity or heterozygosity for the BRDT minor G allele was significantly higher among both azoospermic (6 of 60 [10%]; P = .0057; odds ratio [95% confidence interval], 8.83 [1.73-45.08]) and oligozoospermic (10 of 76 [13.2%]; P = .0002; odds ratio [95% confidence interval], 12.04 [2.57-56.47]) men in comparison with fertile controls (2 of 161 [1.2%]).

Self-assembly of novel molecular complexes of 1,10-phenanthroline and 5-amino-1,10-phenanthroline and evaluation of their in vitro antitumour activity.

Novel molecular complexes of 1,10-phenanthroline (phen) and 5-amino-1,10-phenanthroline (5-NH2-phen) [(5-NH2-phen)2(phen) (H2O)3 (1), (phen)2(imidazole) (H+) (BF4-) (2), (phen)2(benzimidazole) (H+) (BF4-) (3), (5-NH2-phen)4(H2O)3 (4), and (phen)3 (indole) (H+) (BF4-) (5)] were synthesized via self-assembly processes and their in vitro anticancer activity was investigated. The structures of the compounds were confirmed by UV, FTIR, CIMS(CH4) and elemental analysis. The crystal structure of 2 was determined by X-ray diffraction. Cytotoxicity of the substances was measured using the cultivated human tumour cell lines HepG2, HEp-2, and 8-MB-GA. The tested substances showed different activity depending on the cell line and amount used. Substances 2 and 3 were not toxic to the non-tumour cells (Lep-3), but significantly toxic to all tumour ones. This is not the case with compounds 4 and 5, which are non-toxic towards carcinogenic cell lines, but even stimulate both HepG2 and HEp-2.

Strong intra- and inter-continental differentiation revealed by Y chromosome SNPs M269, U106 and U152.

More than 2700 unrelated individuals from Europe, northern Africa and western Asia were analyzed for the marker M269, which defines the Y chromosome haplogroup R1b1b2. A total of 593 subjects belonging to this haplogroup were identified and further analyzed for two SNPs, U106 and U152, which define haplogroups R1b1b2g and R1b1b2h, respectively. These haplogroups showed quite different frequency distribution patterns within Europe, with frequency peaks in northern Europe (R1b1b2g) and northern Italy/France (R1b1b2h).

Interaction of gentamicin with phosphatidylserine/phosphatidylcholine mixtures in adsorption monolayers and thin liquid films: morphology and thermodynamic properties.

Gentamicin possesses strong adverse actions like oto and nephrotoxicity. The latter is a result of strong gentamicin-acid phospholipid interactions, resulting in cell fusion, fission, etc., ions as calcium interact with gentamicin and effectively deter its toxicity. In this work, the interactions of gentamicin and Ca(2+) with phosphatidylserine/phosphatidylcholine (PS/PC) mixtures of different ratio are experimentally characterized. Special attention is paid to bridge thermodynamic and morphological properties of adsorption monolayers and thin liquid films (TLFs) composed of these lipid mixtures. Our results show that gentamicin decreases the stability of common black TLFs formed of pure PS coupled with suppression of lipid surface adsorption to the monolayers at the air-water interface; also, gentamicin reveals effects of lowering of lipid spreading on the interface and significant loss of material during monolayer cycling, increase of condensed phase, and organization of dense net-like domain monolayer texture. Gentamicin addition results in opposite effects for films formed of DPPC/PS (95:5) mixture. It increases the stability of Newton black TLFs formed by DPPC/PS correlated with faster and stronger surface adsorption and better surface spreading; also, gentamicin lowers the amount of condensed phase and organization of domains of smaller size. We also showed that Ca(2+) itself decreases the stability of common black TLFs formed of PS accompanied with weaker surface adsorption, formation of higher amounts of condensed phase and organization of domains. In our experiments, Ca(2+) softens, even deters, the effects of gentamicin on both PS and DPPC/PS films.

Quantitative fluorescent-PCR detection of sex chromosome aneuploidies and AZF deletions/duplications.

The most common genetic causes of spermatogenic failure are sex chromosomal abnormalities (most frequently Klinefelter's syndrome) and deletions of the azoospermia factor (AZF) regions (AZFa, AZFb, and AZFc) of the Y chromosome. Several studies have proposed that partial AZFc deletions/duplications may be a risk factor for spermatogenic impairment. We describe a multiplex quantitative fluorescent-polymerase chain reaction (QF-PCR) method that allows simultaneous detection of these genetic causes and risk factors of male infertility. The 11-plex QF-PCR permitted the amplification of the amelogenin gene, four polymorphic X-specific short tandem repeat (STR) markers (XHPRT, DXS6803, DXS981, and exon 1 of the androgen receptor gene), nonpolymorphic Y-specific marker (SRY gene), polymorphic Y-specific STR marker (DYS448), and coamplification of DAZ/DAZL, MYPT2Y/MYPT2, and two CDY2/CDY1 fragments that allow for determination of the DAZ, MYPT2Y, and CDY gene copy number. A total of 357 DNA samples from infertile/subfertile men (n = 205) and fertile controls (n = 152) was studied. We detected 14 infertile males with sex chromosome aneuploidy (10 with Klinefelter's syndrome, 2 XX, and 2 XYY males). All previously detected AZF deletions, that is, AZFc (n8), AZFb (n1), AZFb + c (n1), gr/gr (n11), gr/gr with b2/b4 duplication (n3), and b2/b3 (n5), gave a specific pattern with the 11-plex QF-PCR. In addition, 32 DNA samples showed a pattern consistent with presence of gr/gr or b2/b4 and 4 with b2/b3 duplication. We conclude that multiplex QF-PCR is a rapid, simple, reliable, and inexpensive method that can be used as a first-step genetic analysis in infertile/subfertile patients.