Leucocytes and intrinsic ROS production may be factors compromising sperm chromatin condensation status.

Considering that the final protection of the DNA against major assaults in terms of chromatin condensation is finalized in the epididymis, it is not known how sperm production of reactive oxygen species (ROS) and inflammatory processes can contribute to protamine deficiency that is predetermined in the testes. Therefore, this study aimed at investigating relationships between poor chromatin condensation, morphology, ROS production, DNA damage and the impact of the presence of leucocytes. In 70 patients, sperm DNA status was determined using TUNEL and chromomycin A(3) (CMA(3)) assays, and ROS-production by means of dihydroethidine. Morphology was evaluated according to strict criteria. The percentage of CMA(3)-positive spermatozoa and leucocyte concentration (r = 0.178, P = 0.0377) as well as percentage of ROS-positive spermatozoa (r = 0.3010; P = 0.012) correlated significantly. Particularly, patients with leucocyte counts >0.5 x 10(6) ml(-1) exhibited higher CMA(3) positivity. No association was found between CMA(3) positivity, TUNEL positivity and sperm morphology. While P- (poor prognosis: 0-4% normal morphology) and G-pattern (good prognosis: 5-14% normal morphology) morphology did not differ regarding chromatin condensation, P-pattern patients had a significantly higher percentage of DNA fragmentation (P = 0.0323). As oxidative stress is associated with disturbed chromatin condensation, results suggest that the idea that under-protamination of sperm DNA will automatically lead to DNA fragmentation might have to be revisited.

[The diagnostic value of serum hormone parameters in hirsutism]. / Zur diagnostischen Wertigkeit hormonaler Serumparameter beim Hirsutismus.

In 46 patients showing mild or moderate hirsutism, and 49 age-matched regularly menstruating women without symptoms the following hormone and protein serum levels were measured: Total testosterone (T), free testosterone (fT), dehydroepiandrosterone sulfate (DHEAS), androstendione (ASN), sex hormone binding globulin (SHBG), free androgen index (FAI) as expressed by the T/SHBG ratio, cortisol, Prolactin (PRL), LH/FSH ratio, 3 alpha-androstanediol glucuronide (ALG), basal and poststimulated 17-hydroxyprogesteron (17OH-P) and (in some cases) basal and poststimulated 11-deoxycortisol (S). The study was designed for exploring the diagnostic significance of these parameters and evaluating the extent to which they contribute in establishing the source of hyperandrogenism. The mean values of all but one (PRL) of the hormone and protein levels varied significantly from the controls, T, DHEAS, FAI and ALG showing the greatest differences. Most frequently elevations of T, DHEAS, and FAI values were established, the levels of which exhibited a highly significant correlation. In 96% of the hirsute women the elevation of 1 to 3 of these parameters was demonstrated. FAI was shown to be associated with a higher diagnostic accuracy than did SHBG or fT. In 9/43 patients increased values of ALG were found, which as an important metabolite of dihydrotestosterone reflects peripheral androgen activity, particularly of the skin. In every case these abnormal values were combined with elevated levels of other androgens (T, DHEAS, ASN). It is concluded from these limited data that an isolated elevation of ALG due to primary accentuation in 5 alpha-reductase is a rare or even non-existing occurrence.(ABSTRACT TRUNCATED AT 250 WORDS)

[A problematic case of dysfibrinogenemia in gynecology]. / Ein problematischer Fall von Dysfibrinogenämie in der Gynäkologie.

Following an hymenal incision in a thirtheen years old patient a haemostaseological examination was done. A hyperfibrinolysis was supposed. In spite of a good clinical recovery values remained pathological, so we had to suspect a dysfibrinogenaemie. Only a rapid examination of all attainable family members was able to secure the diagnosis: Dysfibrinogenaemie. Dysfibrinogenaemia is not a to rare case, that such a diagnostic problem may arise in every department.

[Effectiveness of supplemental bleomycin therapy in vulvar cancer]. / Zur Effektivität der Bleomycin-Zusatztherapie beim Vulvakarzinom.

It is reported about the application of bleomycin within a randomized prospective investigation. Bleomycin was used for additional chemo-therapy at the vulva-carcinoma. There were treated with Bleomycin 27 of 55 women from two gynaecological hospitals. -- After a period of two years and a half there can not be shown by the "life-table-method" advantage neither in comparison to the only surgical therapy not to the cryo-surgical treatment.

[Glucose assimilation under high-dose norethisterone-acetate therapy in adenocarcinoma of the corpus uteri]. / Glukoseassimilation unter hochdosierter Norethisteronazetattherapie beim Adenokarzinom des Corpus uteri.

In 29 patients suffering from adenocarcinom of the corpus uteri, who had been treated with high doses of norethisterone acetate (NEA) alone or in combination with irradiation, we performed a study in order to find out whether NEA will produce a clinically measurable and noteworthy modification of glucose tolerance. -- For this purpose, the glucose assimilation coefficient (k value), apart from its first determination, will be determined 6 weeks later under current therapy. The comparison of both values shows a statistically significant decrease of the k value after 6 weeks in all patients whose first value was k less than or equal to 1. For the patients with a first value of k greater than 1 a significant development was not detectable. The alteration of the k value under NEA therapy in patients with a primarily decreased value (n = 11; in 5 of them diabetes known) was accompanied merely by 2 diabetics with changes in the day profile of such an extent that a correction of therapy was necessary.

[Experiences with clomiphene therapy of endocrine sterility]. / Erfahrungen mit der Clomiphentherapie der endokrinen Sterilität.

Two hundred seventy-three infertile women with disturbances of the menstrual cycle were treated with clomiphene citrate a level of 50 or 100 mg daily for 5 days, or even--in cases of therapeutic failure--of 150 or 200 mg daily. According to the experiences of other authors the results indicate that conception can be obtained in a rate between 35 and 40%. The frequent occurence of additional factors diminishing fertility, however, reduces this relatively favorable pregnancy rate to a level of 30% under the conditions of practice. Patients with ovulatory failures, secondary amenorrhoe associated with sufficient endogenic estrogen secretion, and luteal insufficiencies respond most favorably to clomiphene citrate. If the preovulatory cervical mucus reaction is missed, the additional application of an estrogen preparation, in cases of repeated luteal phase defects the combination of clomiphene with HCG is recommended.