Preparation of sperm-free seminal plasma from human semen.

Whole human semen was centrifuged at various centrifugal forces to obtain sperm-free seminal plasma. Most samples of seminal plasma collected after centrifguation of up to 10,000 g were contaminated with spermatozoa. Centrifugation at 40,000 g yielded sperm-free seminal plasma in two thirds of the samples centrifuged. Filtration of whole semen with Millipore filters (pore size 0.45 mu) removed all spermatozoa.

Administration of norethandrolone and testosterone as a contraceptive agent for men.

PIP: A study of norethandrolone as a male oral contraceptive is presented. 4 subjects received 20 mg/day of the drug for 3 months concurrent with 2 or 3 subdermal capsule implants containing 20-mg testosterone. A considerable variation in sperm counts was observed during the cycle, though an azoospermic condition was not realized. Sperm counts in all subjects were markedly lower at some time during the treatment. Circulating levels of serum androgens, follicle-stimulating hormone, dihydrotestosterone, and testosterone were more consistently suppressed than were luteinizing hormone levels. Libido was slightly decreased in all subjects during treatment. All hormone levels returned to pretreatment values within 3 months of discontinued treatment. The amount of testosterone released from the capsules was between 32.2-36.4 mcg/cm/day. It is concluded that the dosage administered was inadequate for contraceptive purposes.^ieng

[The treatment of male infertility by selective catheterisation of the spermatic vein. Technique, indications, complications, results (author's transl)]. / Perkutane Behandlung männlicher Infertilität im Rahmen der selektiven der selektiven Spermatikaphlebographic mit Katheter.

Sclerosis of the spermatic vein for male infertility and varicoceles was carried out in 84 patients by a percutaneous method. If the catheter is correctly placed in the spermatic vein, sclerosis is possible in almost all cases, as was shown by controlled examinations after periods of more than three months. Together with the radiologic changes, there was also an improvement in the spermatologic parameters. 58% of the patients examined after three months were regarded as fertile.

[The technique and results of spermatic vein phlebography in 136 men with primary sterility (author's transl)]. / Technik und Ergebnisse der Spermatica-Phlebographie bei 136 Männern mit primärer Sterilität.

The results of selective phlebography of the spermatic vein in patients with primary sterility and suspected varicoceles are reported. In 60% of those examined there was left-sided, and in 8.8% right-sided, spermatic vein insufficiency or a varicocoele. The value of spermatic vein phlebography is borne out by the large number of anomalies of the venous system (67%) and by the finding of 82 left-sided varicoceles.

[Varicocele and distal reflux]. / Varikozele und distaler Reflux.

The distal reflux as we call it raises several anatomical, operative technical and andrological questions. Based on our experiences with four patients with reduced seminal quality, we wish to make some contributions to this subject which has been only occasionally addressed in the past. In these patients, venous reflux could be demonstrated over the left funiculus spermaticus by means of Doppler sonography. The retrograde phlebography, carried out to sclerose transvenously the supposedly insufficient internal spermatic vein revealed, however, sufficient venous cuspids without reflux. The inguino-scrotal exploration of the funiculus, indicated to clarify further the distal venous testicular supply, showed the external spermatic and/or the deferential veins with their collaterals congested and dilated. All these vessels were ligated and divided. The demonstration and the topically correct treatment of the distal venous reflux seems to diminish, at least partially, the failure rate of the suprainguinal operation according to Bernardi. The correlation between the results of Doppler sonography, phlebography and the selection of the incision has not been clearly established yet. The different venous supplies of the testis are initially described.

[Open multicenter study of the differential diagnosis of erectile dysfunction with a papaverine-phentolamine combination (BY023)]. / Offene Multizenterstudie zur Differentialdiagnostik der erektilen Dysfunktion mit einer Papaverin-Phentolamin-Kombination (BY023).

We report the results of an open multicenter clinical trial with 115 patients. The results of a pharmacological test using intracavernously applied mixture of papaverine and phentolamine were compared with the results of a multidisciplinary evaluation of erectile dysfunction. Sensitivity and specificity of our test were determined. The injection of our drug solution caused an increase in tumescence and/or rigidity in all patients. The evaluation of the dose dependent erectile response makes it possible to distinguish between the three main pathogenetic principles: non-vascular, arterial and venous etiology of erectile dysfunction. The pharmacological test requires one to four intracavernous injections of 0.5-3.0 ml of the drug solution (7.5-45 mg papaverine hydrochloride, 0.25-1.5 mg phentolamine mesylate).

Stigmatization experience, coping and sense of coherence in vitiligo patients.

OBJECTIVE: This study examines the extent of stigmatization experienced by vitiligo patients considering the visibility of the lesions. METHODS: 363 vitiligo patients were assessed using the Experience with Skin Complaints (QES), Adjustment to Chronic Skin Disorders (ASC), and Sense of Coherence (SOC) questionnaires. Out of the total patients group two representative samples with 52 patients each were identified comparable for age, gender, and the duration of the skin disease, the first with visible and the second with invisible lesions. RESULTS: Data indicate a significant negative correlation between the QES dimensions, except for 'Composure', and between coping scales with sense of coherence withstanding. The 'visible lesions' group scored higher compared to the 'invisible lesions' group on the two QES scales 'Self-Esteem' and 'Refusal', i.e., patients with visible lesions experienced a higher level of stigmatization. CONCLUSION: This study provides new information which supports the notion that the stigmatization experience of vitiligo patients is psychologically relevant.

[Levamisol therapy in chronic prostatistis and epididymitis]. / Levamisol-Therapie bei chronischer Prostatis und Epididymitis.

Eight patients suffering from chronic epididymitis, prostatis and urethritis were treated with levamisole. A definite and lasting improvement was seen six of the eight patients.

Altered cellular immunity in Werner's syndrome.

A cellular immunodeficiency was revealed in a 39-year-old female patient suffering from Werner's syndrome. Relevant findings were negative intracutaneous tests to candidin, trichophytin, tuberculin and bacterial antigens, reduced lymphocyte response to PHA, and impaired intracellular killing of Candida albicans by granulocytes. The inclination of patients suffering from Werner's syndrome to develop neoplasms may be related to this immunodeficiency.

Percutaneous sclerotherapy of varicocele.

The results of selective phlebography of the spermatic vein are reported in 580 infertile men with abnormal sperm morphology and suspected varicoceles. Percutaneous transvenous retrograde sclerotherapy of the internal spermatic vein was performed in 260 of the patients. Follow-up phlebography in 109 patients 3 to 6 months after treatment revealed a persistent varicocele in only 3% of them.

[The effect of a synthetic androgen (mesterolone) on semen quality]. / Der Einfluss eines synthetischen androgens (mesterolon) auf die Samenqualität.

224 infertile men were treated with mesterolone (M.;30, or 60 mg/die) for a minimum of three months. When comparing semen analyses done before and after treatment with M., a small but distinct reduction of hyperspermia as well as an augmentation of hypospermia were evident, an increase of sperm density in oligozoospermia grade I (20-40 kx 10(6) sperm/ml) was revealed, and an improvement of sperm motility in asthenozoospermia was seen. These was no change in sperm morphology. According to our data, careful selection of patients for treatment with M. Based on aetio-pathogenic considerations appears to be the "salient point" in the administration M. As a general rule, treatment with M. should be confined to patients with mild idiopathic oligo (astheno) zoospermia where no specific therapy - such as, e.g., high ligation for varicocele - is available.

Selective sclerotherapy of the internal spermatic vein in patients with varicoceles.

Percutaneous occlusion therapy of insufficient internal spermatic veins was performed successfully as an outpatient procedure in 155 patients with varicoceles. The administration of the sclerosing agent (Varicocid) through a catheter selectively introduced into the spermatic vein caused therapeutic occlusion. Follow-up studies, both clinical and phlebographic, confirmed the effectiveness of the treatment.

Short-term increase of sperm output under metoclopramide administration.

Nine volunteers were treated with metoclopramide (10 mg T.D.S.) for 4 weeks. Prolactin levels rose both in serum and in seminal plasma 1 week following the initiation of metoclopramide administration. At this point in time, sperm density and total sperm count increased about twofold. Thereafter, levels of prolactin slowly decreased while sperm density and total sperm count fell back to initial values.

Investigation of the hormonal axis hypothalamus-pituitary-gonads in 20 dialyzed men. GnRH-test in dialyzed men.

20 male patients suffering from end-stage chronic renal failure and maintained on hemodialysis were investigated for pituitary response to GnRH. The GnRH-Test was performed simultaneously with hemodialysis; however, hemodialysis was started 60 min. after the injection of GnRH. Basal values of LH and FSH were significantly higher (P less than 0.0001 and 0.005, respectively) than the normal range, while basal values of testosterone were in the subnormal range or depressed (P less than 0.0001). Poststimulatory values of LH were significantly lower (P less than 0.01) than normal and--other than normal--did not decline within 180 min. following injection of GnRH (P less than 0.001). The same pattern was seen for FSH, however, no statistical significance could be secured. Testosteron was elevated 30 min. after stimulation with GnRH (P less than 0.001).

Gonadal steroid and gonadotropin response to dexamethasone: a study in sexual dysfunction and normal controls.

Numerous investigations have reported an alteration of hormonal response to dexamethasone in depressive disorder. No such data are available in psychogenic sexual dysfunction. Pre- and postdexamethasone levels of testosterone, estradiol, LH and FSH were studied in 20 male patients with sexual dysfunction and 20 male healthy controls. Dexamethasone had no influence on testosterone, estradiol, LH and FSH in normal controls. The patients showed an increase in testosterone and LH but not in FSH levels in the morning after dexamethasone administration. When compared with basal levels, the increase in postdexamethasone levels in sexual dysfunction was significant for testosterone (delta T) but not for LH (delta LH). The altered gonadal steroid and gonadotropin response to dexamethasone in sexual dysfunction might be due to disturbances of dexamethasone metabolism and glucocorticoid receptor density comparable to similar findings in depressive disorder.

Prolactin response to dexamethasone: a study on normal controls and depressed patients.

Pre- and post-dexamethasone prolactin and cortisol levels of 40 endogenous and non-endogenous depressive patients and of 20 controls were studied. Dexamethasone had a suppressive effect on prolactin levels, which was expressed more in normal controls and in non-endogenous depressive patients than in endogenous depression. A "prolactin suppression test" by dexamethasone was constructed and provided comparable results to the usual DST. However, it failed to be a specific marker for endogenous depression. There are close relationships between various endocrine axes, which might be altered in depression.