[Menarche in Bulgarian--secular trend in twenty century].

UNLABELLED: The aim of the study was to determine the time of menarche in Bulgarian girls and specify the changes in menarcheal age during 20 century. MATERIAL AND METHODS: We examined in a longitudinal study 93 girls from 3 schools in Sofia in the period from 1994-2000. RESULTS: Mean age of menarche in girls was 11.96 + 0.75 years, (x + SD), median 12, 00 years. At the age of eleven 41.9% of the investigated girls have already had menarche and at the age of 10--4.3%. By the completion of the 12 years 90.3% were with menarche and at 14 years of age--100%. In a study in Bulgaria, done by the beginning of 20 century (1904-1906), the mean age of menarche was 15.0 + 3.32 years, 3 years later than it was found by us at the end of the century. CONCLUSION: We observed a secular trend of earlier time of menarche in Bulgarian girls during 20th century.

[Sperm disorder in males with obesity and metabolic syndrome--pilot study].

UNLABELLED: The aim of the study was to compare the semen quality in men with metabolic syndrome /MS/ and controls. MATERIALS AND METHODS: Semen samples were collected from 42 males (mean age--27.69 +/- 7.98 years). 21 of them had the features of the metabolic syndrome according to the IDF definition and 21 were healthy volunteers. The semen samples were analyzed according to the World Health Organization 1999 guidelines. RESULTS: The patients with MS had similar age, ejaculate volume, percentage of spermatozoa with normal morphology, sperm concentration (in million per milliliter), and total sperm count (in million) compared to controls. However, they had lower percentage of motile spermatozoa (p = 0.002). Men with obesity (BMI > 30) had significantly lower sperm concentration and total sperm count in comparison to normal- or overweight males (BMI < 30). CONCLUSION: reduced semen quality could be established in patients with obesity and MS. Further investigations are necessary to clarify the changes in the exocrine testicular function in males with MS and their consequences for the reproduction.

[The anti-mullerian hormone--physiology and application into clinical practice].

The Anti-Mullerian hormone /AMH/ is a glycoprotein of the transforming growth factor-beta superfamily. It induces regression of the Mullerian ducts during the male sex differentiation. The hormone actions occur through serin/threonin kinase receptors-AMHRI and AMHRII. The AMH and AMHRII gene defects in men cause the syndrome of oviductus persistens. Recent findings accent not only on the hormone fetal role, but also on the postnatal AMH secretion, especially in women. The hormone is produced mostly by granulosa cells of the preantral and small antral follicles. Therefore, its levels in women after puberty are similar to those in males and it could be used as a marker for the ovarian reserve and preantral and small antral follicle count. In this review, we discuss the role of AMH in the follicular development, the polycystic ovary syndrome and the ovarian ageing. After gathering all data, it could be assumed that in the future AMH will be widely used in the clinical practice as a marker of the ovarian function.

[Multiple pregnancy and microelements: zinc (preliminary report)]. / Mnogoplodna bremennost i mikroelementi: tsink (predvaritelno suobshtenie).

The aim af the study was to define the concentration of zinc in sera of women with multiple pregnancies during the last trimester and to compare it with the values in normal pregnancies. The study included 12 women with gemini and 67 with single fetus pregnancies. A statistically significant decrease was found in the mean zinc concentration in twin pregnancies--8.1 +/- 1.72 mcmol/L compared to the mean values in normal pregnancies--10.5 +/- 1.90 mcmol/L (p < 0.001). Various mechanisms, possibly responsible for the stated changes, their relation to some complications of multiple pregnancy and delivery are discussed, as well as their prophylactics.

[The copper concentration in the maternal serum in missed abortion]. / Kontsentratsiia na medta v maichiniia serum pri missed abortion.

Two groups of women with missed abortion examined in different periods of time were included in the study--the first group of 43 patients was examined in 1989-1990 and the second group of 24 in 1994. The control group consist of 73 women in the first trimester of normal pregnancy and 75 nonpregnant women. The serum copper concentration of the first group with missed abortion (19.47 +/- 4.62 mumol/l) was significantly (p < 0.001) lower than those of control group with normal pregnancy (23.40 +/- 5.10 mumol/l). The serum concentration of the second group with missed abortion was even lower--17.82 +/- 2.95 mumol/l. The serum copper level was measured directly with flame atomic absorption spectrometry. The histology reveals dystrophic and necrotic changes and also inflammatory changes with edema of chorion villi without enhanced collagenisation. We discuss the possible mechanisms of the observed changes.

[Endocrine changes in males with anorexia nervosa: 2 of the authors' own cases]. / Endokrinni promeni u muzhe s nervna anoreksiia po povod na dva sobstveni sluchaia.

Two men with nervous anorexia were fully investigated and the results were compared with those of 15 healthy men and 19 women with the same disease. A similarity of the hormonal changes in both sexes concerning the somatotropic hormone, thyroid and cortico-suprarenal axis was established. A difference was found between the women and the two men concerning the gonadotropic hormones which in the men showed a well expressed reaction to gonadoliberin with an early maximum.

[Diagnosis and treatment of idiopathic hypogonadotropic hypogonadism in men based on a clinical case]. / Diagnoza i lechenie na idiopatichniia khipogonadotropen khipogonadizum pri muzhe po povod na edin klinichen sluchai.

A patient with tertiary hypogonadotropic hypogonadism was followed up for many years. On the basis of this observation the possibilities for a correct diagnosis with the gonadoliberin test are pointed out. A positive effect of the treatment with gonadotropic hormones, especially on the spermatogenesis, is established. Several other new therapeutic means which can be applied in these patients are discussed.

[Prolactin secretion and gynecomastia]. / Prolaktinova sekretsiia i ginekomastiia.

Nine males with gynecomastia were examined. The serum levels of LH, FSH, prolactin, testosteron, estradiol were determined, in some of the patients--progesteron. A stimulation with thyreoliberin was carried out to follow up prolactin reaction. The same examinations were performed with a control group of healthy males. Contrary to the healthy subjects, the patients with gynecomastia had a significantly higher levels of FSH and progesteron and testosteron was reduced with statistical significance. The basal level of prolactin in the patients with gynecomastia was not significantly increased and no deviations in the parameters of prolactin reaction was observed after the stimulation by thyreoliberin. On the base of those results progesteron in the males with gynecomastia is admitted to be able to support the mammo--tropic effect of estrogens, together with the reduced androgens and the altered receptivity of the mammary glands. Prolactin is of no great importance for gynecomastia.