Diabetes mellitus/male infertility.

Diabetes mellitus (DM), associated with very subtle disorders, affects, either directly or indirectly, various functions of the reproductive system. Adequate, regular, and timely therapy may prevent or delay these disorders. The T synthesis disorder is caused by molecular changes at the level of Leydig cells and may lead to other disorders in all target organs and tissues. The close correlation between Leydig and Sertoli cells function, i.e., between spermatogenesis and second sex glands function, results in certain anomalies in diabetic patients' spermiograms. Parallel lesions associated with DM, through CNS (hypothalamus-hypophysis), and endocrine profile are indirectly intensified or induced by these disorders, which reflect dysfunction of homeostatic balance in carbohydrate metabolism. Sexual dysfunction in all its forms (reduced erection, impotence, and other libido dissociations) is an accompanying phenomenon of the diabetic disease. However, manifestations of these disorders are related to the regulation of carbohydrate metabolism and to the duration of disease. The duration of disease is not necessarily correlated with sexual dysfunction. Even carbohydrate metabolism remains within normal range in addition to other lesions, diabetes leads gradually but progressively to premature aging of body cells.

[Hematoma of the parametrium due to birth trauma]. / Hematom parametrija kao posljedica porodajne traume.

From 1973 to 1980, assisting 59,068 vaginally completed deliveries, the authors encountered 19 hematomas of the parametrium (0.032%). Labour was prolonged in 13 out of these 19 cases and the instruments applied were the outlet forceps in 6 and the vacuum extractor in 2 cases, while the expulsion of the child in 5 cases was helped by an intravenous injection of Syntocin. Half the parturients were in the third and half in the fourth decade of their life; a third of them were primiparae. Clinically the picture of atony or uterine rupture prevailed. In the development of the hematoma of the parametrium a large number of etiological factors are to be pointed out: birth injury, parity, age, predisposition, and others. In 6 women subtotal hysterectomy, in 4 the ligature of the uterine artery, and in 5 the evacuation of the hematoma were applied, while in the remaining ones the treatment as conservative.

[Primary carcinoma of the fallopian tube (report on 3 cases)]. / Primarni karcinom jajovoda (povodom tri bolesnice).

Three patients with the primary carcinoma of the fallopian tube, aged 51, 68, and 42, are presented. The disease was diagnosed in the period from 1971 to 1980. In all three patients there was a triad of symptoms: bleeding, adnexal tumour, and pain, but the diagnosis was made only during surgery. The operative therapy with consecutive radiation was applied in all three patients.

[Cervical infection as a cause of female sterility]. / Infekcija cerviska kao uzrok infertiliteta zene.

The study covered 116 infertile women in whom other etiological factors were ruled out, while 55 fertile patients served as controls. In infertile women, within the ovulation term, microorganisms of intestinal origin were isolated in 42.24%. Banal flora was present in 24.13%, while the saprophytic flora was verified in 21.5%. Culture media remained sterile in 8.62%. In the control group the differences are self, evident: the pathogenic flora was present only in 12.18% and the culture media remained sterile in 38.18%. In spite of the findings in the endocervix, the cervix was macroscopically normal in 54.31% of infertile persons. In patients from the control group, with regard to deliveries, pathologic changes of the portion were present in a higher percentage. The number of spermagglutinins in the serum was somewhat higher in patients from the infertile group in whom the infection of the endocervix was observed.

[Local morphological and functional changes in patients with obstructed testicular excretory ducts]. / Lokalne morfoloske i funkcionalne promene u pacijenata sa obstrukcijom u ekskretornim putevima testisa.

Following a short introduction to the physiology and function of gonads in men, the authors present their material and exploration methods. the study covered 39 patients with azoospermia of obstructive origin. The obstruction of v. deferens developed in 29 patients after a non-specific inflammatory reaction, in 7 patients after a trauma, in 2 patients after vasectomy, and one patient was a case of congenital anomaly. Concentrations of FSH and ICSH in the plasma of the patients studied did not show any major deviations. Histological analysis showed normal morphological spermatids and primary spermatocytes with degenerative changes in later stages in 29 patients. In the remaining 10 patients, most probably due to the inflammatory reaction and as the result of congenital anomaly, the destruction of the germinal epithelium was evident. Spermagglutinins in the serum of the patients were detected in 56.8%. Such a high percentage of antispermatic agglutinins is meant to be the result of obstruction and the presence of the inflammatory agent.

[Structural chromosomal aberrations in parents with spontaneous abortions]. / Strukturne hromozomske aberacije u roditelja sa spontanim pobacajima.

In the Laboratory for Human Cytogenetics of the University Hospital Department of Gynecology and Obstetrics in Beograd a cytogenetic analysis of 30 families with spontaneous abortion was performed. In two families structural chromosome aberrations--Y chromosome deletion and 13/14 translocation--were detected. Phenotypic normal male members of one family revealed the same type of deletion of the larger part of the distal region of the long Y chromosome arm (46, X, del (Y) (q12)). In the other family, in a phenotypically normal parent, a balanced translocation (45, XY, t (13/14)) was observed. The authors discuss the correlation between structural aberrations. Yq delation and 13/14 translocation on the one hand and spontaneous abortion on the other.