Fertility of testicular cancer patients after anticancer treatment--experience of 11 years.

Testicular cancer affects men mostly in their reproductive age with a cure rate over 90%. Preserved fertility is one of the main concerns of the survivors. To further elucidate the question of fertility after anticancer treatment for testicular cancer, we performed a survey among patients who underwent sperm cryopreservation procedure in our department. A structured questionnaire was designed to collect data on demography, anticancer treatment, histological type of cancer, family planning intentions and fertility prior to and after treatment. During a period of 11 years 86 men underwent semen cryopreservation before starting chemo-or radiotherapy. Fifty-nine of them consented to participate in the study. The average length of follow up was 4.6 +/- 3.8 years. In case of 11.9% of the patients their banked sperm was used, which led to live birth in 57% of the couples. The partners of 6 patients became pregnant after in vitro fertilization (IVF) resulting in 4 live births and 2 miscarriages. The spontaneous pregnancy rate was 22%. Spontaneous pregnancy occurred in 13 partners resulting in 18 pregnancies followed by 12 live births, 2 artificial abortions and 4 miscarriages. We could not prove any association between preserved fertility and anticancer treatment or the histological type of the cancer. In conclusion, although spontaneous pregnancy rate is remarkably high after anticancer treatment for testicular cancer, the risk of infertility after receiving gonadotoxic treatment cannot be predicted. Cryopreservation is a safe and effective method to preserve fertility in these cases. As a result we strongly recommend discussing the advantages of semen cryopreservation with all patients awaiting treatment for testicular cancer.

Chemical enhancers for transdermal drug transport.

In its first part, this review paper discusses skin morphology and barrier function of the stratum corneum for drug permeation after its transdermal administration or topical application. Further, the paper presents the main methods for overcoming the skin permeation barrier, which plays an important role for transdermal drug administration. Focus is on the method of chemical permeation enhancement. The chemical enhancers are categorised by their chemical structure. Examples of the most effective enhancers are given for the chemical groups of alcohols, amines and amides, polyalcohols, terpenes, fatty acids and their esters, macro cyclic compounds, sulfoxides, tensides, and others, as e.g. soft enhancers.

Contribution to the penetration of radionuclides across the skin. Concentration dependence of strontium through the skin in vitro.

Toxicological studies of radionuclide passage across the skin, which represents a crucial barrier of radiation, are important for ensuring the quality of the environment. Both (137)Cs and (90)Sr are most frequently involved in radionuclide contamination of the human body. In our study, we selected (90)Sr because this radionuclide is chemically very close to the bio-element calcium. The permeation of (90)Sr from donor solution across the intact skin of 5- or 9-day-old rats (5DR, 9DR) and across stripped and split skin of the 5DR was studied. The experiments in vitro were carried out using vertical diffusion cells. Strontium chloride (SrCl(2)) was used as carrier in the donor solution in different concentrations. Liquid scintillation spectrometry was applied for radiation detection. The experiments showed that: the permeated fraction of (90)Sr(2+) was indirectly proportional to the carrier concentration in the donor solution; the stratum corneum was found to be the principal penetration barrier of strontium; and in the case of the 9DR the dominant route of strontium penetration was along the follicles.

[Functioning conditions of laboratories dealing with cryopreservation of human pre-embryos]. / A humán préembriók fagyasztásával foglalkozó laboratóriumok müködési feltételei.

The authors discuss about the functional conditions of the Human Reproductive Laboratories dealing with the cryopreservation of the human preembryos. They determine the safety specifications and recommend documentation of the cryopreservation based on their own practice. Finally they suggest the licensing-controlling system of the Human Reproductive Laboratories concerning cryopreservation of the human preembryos.

[Programmed pre-embryonic freezing in the pronuclear stage]. / Programozott préembrió fagyasztás pronukleusz állapotban.

The authors discuss about freezing procedure of surplus pronuclear stage praeembryos in six cases. The total amount of praeembryos were 36. From these nine were thawing and were cultured further. The surviving rate was 88.8%, the development to blastocysts rate was 77.7%. The freezing procedure in pronuclear stage needs some extra methodological force. The success, increasing influence on pregnancy rate and the benefit that reduces the IVF-ET patient's intolerance procedure is also an important factor. Beneath the cost saving effect of this intervention, the cryopreservation technique for the institutes performing this way of assisted reproduction is highly suggested.

Sexual steroid levels and their clinical significance in the early neonatal age.

Serum concentrations of progesterone (P) and estradiol (E2) in the umbilical cord blood were measured in healthy full term newborn infants and were related to the serum levels of indirect bilirubin at 72 hr postpartum in the same group of neonates. In those having higher concentration of bilirubin than 204 mumol/l at 72 hr after birth, cord P and E2 levels were significantly higher than in the rest of the group. Furthermore, strong correlation was found between serum levels of progesterone at 24 hr after birth and that of bilirubin at 72 hr postpartum in the same subjects. According to the authors' conclusion serum progesterone levels 24 hours after birth prognosticate the occurrence of neonatal hyperbilirubinaemia.

Importance of the DHEA-sulphate-test in pregnancy.

The DHEA-sulphate was applied in the 34th-41st weeks of pregnancy for the estimation of placental function (foetoplacental unit) in normal and pathological pregnancies. It has been established that: the peak of oestrogen excretion is in the dawn hours; the diurnal rhythm of E1 + E2 + E3 excretion is identical; the DHEA-SO4----oestrogen conversion takes place immediately, and within the subsequent 8-10 hours the urinary oestrogen values return to the original level; in physiological pregnancies between the 34th-36th weeks the DHEA-sulphate test indicated normal function in 91% of the cases; in the 37th-41st weeks of apparently normal pregnancies the test showed pathological placental function in 50% of the cases; in pathological pregnancies between the 37th-41st weeks the test in 77% of the cases predicted placental dysfunction.

[The coincidence of gonadal dysgenesis and hyperprolactinemia]. / Koinzidenz von Gonadendysgenesie und Hyperprolaktinämie.

It was reported about 6 female patients aged from 3 to 31 years (average age 18 years) with gonadal dysgenesis and hyperprolactinemia. Beside one all these females were not treated with synthetic sexual steroids. In 5 of the 6 patients both hyperprolactinemic and hypergonadotropic serum levels were observed. In one case the gonadotropic serum levels were normal. In 4 patients a stimulation test with GRH-TRH or Arg-GRH-TRH, respectively, was performed. In patients with gonadal dysgenesis a change on the area of the hypothalamic-hypophyseal axis is supposed to cause the hyperprolactinemia.

[Primary hyperprolactinemic amenorrhea. Report of 4 patients]. / Hyperprolaktinämische primäre Amenorrhoe. Bericht über 4 Patientinnen.

Report about 4 female patients with hyperprolactinemic primary amenorrhea. In two of these women there was a suspicion of adenoma of hypophysis. In the stimulation test with gonadotropin-releasing hormone and thyrotropin-releasing hormone in two females the very high basal PRL secretion could not have been stimulated in one case. In the other case the TRH-stimulated PRL serum levels increased. Biphasic menstrual cycles resulted by therapy in two females treated with bromoergocryptine.