Carnitine in seminal plasma: its significance in diagnostic andrology.

Carnitine estimation in human semen is of diagnostic value for epididymal function. About 95% of the free carnitine originates from the epididymis. In patients with euspermia the median value of carnitine is 7 +/- 3 mg%. The clinical significance of carnitine determination is demonstrated in azoospermia, varicocele, and obstructive azoospermia. In order to obtain a general picture of seminal plasma we ought not to rely only on fructose estimations but should also take into account those of the citrate and carnitine.

Glutamic acid concentration in human semen--its origin and significance.

Glutamic acid content of semen was determined photometrically in over 400 semen specimens. Glutamatic acid content was found to increase proportionately to temperature in the first few hours post ejaculation. The glutamate estimation should therefore be performed on semen at 30 min. after ejaculation. The frequency distribution of glutamic acid concentration with 400 unselected specimens, 50 "normozoospermias" as well as 42 azoospermias is shown. The mean value of normozoospermias was 10.6 mg% (+/- 4.6 mg%) that of azoospermias 7.7 mg% (+/- 4.7 mg%). There was no correlation found between glutamic acid content and pH value. A correlation however, was demonstrated between glutamic acid and following: sperm count, citrate concentration, gamma-GT and carnitine. No correlation to fructose content was detectable. That suggests that glutamate gets to the ejaculate with the secretions from the prostate gland and epididymis whereas the seminal vesicles do not play a role in the level in the total semen.

[Acid phosphatase in seminal fluid--method of estimation and diagnostic significance]. / Zur Kenntnis der sauren Phosphatase im Seminalplasma--Bestimmungsmethode und diagnostische Bedeutung.

A new method for the estimation of acid phosphatase in seminal fluid based on the use of p-nitro-phenylphosphate is described as simple in practicability and appropriate for routine in clinics. The frequency distribution of acid phosphatase activity is specified with 66 samples showing a normal spermiogram. The values spread logarithmically with an average of 400 U/ml and a standard deviation ranging from 200 U/ml to 880 U/ml. Correlations between acid phosphatase content and general, cytological and biochemical spermiogram-parameters are investigated. A plain negative correlation with the pH (r = 0,4615, n = 250) and a very strong positive correlation with citrate (r = +0,9029, n = 200) turned out. The significance of these correlations is discussed. Among the biochemical parameters in spermiogram both citrate and acid phosphatase--each representing prostatic function--are equivalent in diagnostical significance.

[Citrate and acid phosphatase in the ejaculate in prostatic carcinoma and adenoma]. / Zitrat und saure Phosphatase im Ejakulat bei Prostatakarzinom und Prostataadenom.

The simultaneous determination of acid phosphatase and citrate concentration in the seminal fluid obtained from 16 patients with prostatic adenoma showed normal values, 6 patiients with prostatic carcinoma (cytologically and histologically verified) however extremely low values. The difference between persons with prostatic cancer and those with adenoma became particulary obvious with both experimental results evaluated in the way of a twodimensional diagram. This clear separation of both clusters by the simultaneouse estimation of both biochemical parameters may possible get useful diagnostic significance.

Carnitine in seminal fluid as parameter for the epididymal function.

Carnitine represents the secretion which is added to human seminal fluid by the epididymis. More than 94% of the free carnitine originates from the epididymis. The frequency distribution of carnitine concentration is investigated with patients showing a normal spermiogram and with those suffering from azoospermia. Correlations with conventional spermiogram parameters are discussed. The clinical significance of the carnitine determination is shown in various andrological clinical pictures, with special consideration given to postvasectomy semen and Klinefelter's Syndrome. Two case reports of high blockages in the male reproductive tract demonstrates the diagnosis of such a blockage with the simultaneous determination of fructose, citrate and carnitine. The evaluation of split ejaculates confirms that free carnitine does not originate from seminal vesicles, but rather flows into the seminal fluid via the ductus deferens.

[Unusually high gamma-glutamyltransferase level in the semen and ist diagnostic significance]. / Ungewöhnlich hoher Gamma-Glutamyltransferasegehalt im Sperma und seine diagnostische Bedeutung.

A remarkable high activity of the enzyme gamma-glutamyltransferase (gamma-GT) is found in seminal fluid in 200 to 500 fold higher concentrations as found in blood serum. The seminal fluid gamma-GT originates expecially in the prostate gland and, to a smaller extent, in spermatozoa and secretion of testis and epididymis. Gamma-GT could be valuable to investigate the function of the prostate gland.

[Effect of fluocortin butylester (0.75%) as an ointment in the pyrexal erythema test on human skin (author's transl)]. / Wirksamkeit von Fluocortin-butylester (0.75%) als Salbe im Pyrexalerythem-Test an der menschlichen Haut.

The antiinflammatory efficacy of butyl 6alpha-fluoro-11beta-hydroxy-16alpha-methyl-3,20-dioxo-1,4-pregnadien-21-oate (fluocortin butylester, Vaspit) as a 0,75% ointment was tested in comparison with 1% hydrocortisone acetate ointment in the model of the pyrexal erythema. Fluocortin butylester appeared to be significantly superior to hydrocortisone acetate.

[Documentation in the hospital--methods and types of system (author's transl)]. / Dokumentation in der Klinik. Methoden und Organisationsformen

Types of system and methods of documentation in clinic or hospital must be directed towards the object of the documentation: indexing or search documentation, informative or data documentation. Furthermore, a careful selection of the facts to be documented must be established, because a "complete clinical documentation" is unrealistic. Subtle knowledge of the methods of translation of medical facts into code numbers (coding techniques) is inevitable. Examples show how a very comprehensive data collection can be achieved in a short time from the documentation of only a few facts. Currently acquired data must be fed immediately for evaluation. The fact is criticized that some research promoters, when giving financial assistance for the installation of a data bank, shy away from providing the means for computer evaluation. In this way, useless "electronic data cemeteries" are produced. Consequently the demand, not only for the installation of data banks, but also to provide for their evaluation is deduced.

[Sperm agglutination, sperm immobilization and sperm immunofluorescence test in married couples with unexplained infertility (author's transl)]. / Spermienagglutinationstest, Spermienimmobilisationstest und Spermienimmunfluoreszenztest bei Ehepaaren mit unerklärbarer Infertilität

Thirty-four married couples with clinically unexplained infertility and normal spermiograms in all male partners were investigated for sperm antibodies by means of the sperm agglutination, sperm immobilization and sperm immunofluorescence test. In 50% of the couples, sperm antibodies were found in at least one of the partners and with at least one of the tests, e.g. ten times in the female partner alone, six times in the male partner alone, and once in both partners. The correspondance of the three tests was astonishingly low; it is assumed, therefore, that they indicate different types of antibodies. On the basis of the present investigations it is not possible to assess which type of antibody is responsible for the infertility of the female or male partner respectively. This seems only possible when the decrease of certain antibody types can be determined after a period of no antigen contact (avoidance of sperm contact) and when conception has taken place. The significance of autoantibodies against sperm in clinically healthy men with normal spermiograms remains open.

[An immunofluorescent study of circulating sperm antibodies in humans (author's transl)]. / Studie über Spermienantikörper in menschlichen Seren anhand der Immunfluorescenztechnik

1. By means of an indirect immunofluorescent technique with reference to Weller and Coons (1954), modified for spermatozoal immunofluorescence we found antibodies against spermatozoa in the sera of: 6 of 35 female partners of couples with unexplained infertility, 5 of 35 male partners of couples with unexplained infertility, 8 of 40 prostitutes, 8 of 18 men after orchitis and vasoresection. In contrast to these findings the sera of 20 fertile women, 25 fertile men, and 20 virgins showed negative results with the test mentioned above. 2. The site of the antigen-antibody reaction was mainly the spermatozoal tail and in the second place, the equatorial segment. 3. The immunoglobulins primarily belonged to the IgG and secondly to the IgA class. 4. Our results differ partly from the findings made by other authors perhaps on account of methodical differences. 5. The clinical relevance and associated problems are discussed.

[Circulating sperm antibodies in prostitutes (author's transl)]. / Uber zirkulierende Spermien-Antikörper bei Prostituierten

Spermatozoa antibodies are found uncommonly frequently in prostitutes both with regard to the spermatozoa immunofluorescence test and also sperm immobilisation. This is also true to a similar extent for the sperm immunofluorescence test in a group of women from infertile marriages, but not, on the other hand for the immobilisation test, in which the frequency of positive results in this group of women was significantly lower than in prostitutes. The outcome of comparative tests in virgins and fertile women were negative. The correlation of positive results in the sperm immobilisation test and in the sperm immunofluorescence test is strikingly small, so that a variable conclusiveness is to be assumed. Presumably, in the presence of sperm antibodies the probability of conception is reduced.