Biomedical subjects
Publications and source records attributed to C Schirren.
The article is a report about the history of the origin and usage of the term 'andrology' in the last 150 years. It is demonstrated that this term was used at different times by different authorities without any knowledge of the foregoing publications.
The problem of ethics in dermatology is explored using selected examples from the literature. The classic case of Neisser as well as Eduard Arning's experiments on a Hawaiian with leprosy convicted to death are discussed. In addition, inoculation studies with syphilis 100 years ago and the author's own experiences are cited. The differences in the approaches to medical ethics 100 years ago and today lead to the conclusion that ethics change to fit the needs of the society and do not have a permanent fixed status.
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The influence of certain harmful noxae on male fertility was investigated statistically in a large group of andrological patients. A significant correlation was found to exist between alcohol consumption and potency disorders. Patients admitting to a high level of drinking also indicated greater stress at work, and an elevated use of drugs, while more tended to use the sauna. In the case of nicotine a significant influence on sperm morphology and sperm count was shown.
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Medical treatment of fertility disorders in the male must be based on a definitive diagnostic work-up. Before initiating therapy, all possible endogenous and exogenous injurious factors, including a varicocele and the use of nicotine and a variety of medications, must first be excluded. A further important medical measure is actively involving the patient in the treatment plan, which is of particular importance with respect to the above-mentioned points. Another major role in the management of childless couples is andrological/gynecological cooperation. For the treatment of disorders of morphological quality, androgens are to be given preference, while disorders of motility in the presence of largely normal morphological quality respond well to kallikrein.
Down syndrome, the most common birth defect causing mental retardation, is characterized by a specific phenotype including subfertility or sterility and hypogonadism in males. In contrast, several females with Down syndrome have borne offspring. Here, a male with trisomy 21 fathering an infant is described. This observation is verified by serological markers, DNA fingerprinting using different DNA micro- or minisatellites and andrological investigations.
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Twenty patients (21.4 +/- 4.3 years) with extensive acne conglobata affecting the face, chest and back, were treated for a period of six months with isotretinoin (13-cis retinoic acid, 13-cis RA) at a dosage of 1 mg/kg body weight/day (mean daily dose 72.7 +/- 9.8 mg 13-cis RA). In all cases, the acne conglobata cleared up completely. With the exception of symptoms produced by mucocutaneous exsiccation, no side effects were observed; the laboratory parameters were all within normal limits during the anti-acne treatment phase. There was no recurrence of the disease within a period of one year after cessation of treatment (n = 13). Screening spermatograms performed at two-month intervals during the treatment phase revealed, from the fourth month of treatment onward, a statistically significant increase in the mean sperm density with sperm morphology and motility unchanged as compared with the situation prior to treatment. One year after conclusion of treatment, all measured spermatogram parameters had returned to the initial values. The investigations revealed no evidence of any negative influence of the 6-month treatment with isotretinoin on spermatogenesis.
On the basis of 300 andrological expertises made over the last 40 years to answer the question as to procreative capacity and other andrological problems, a position is taken up towards the expertise in general and to a number of characteristic data. In more than 95 percent of the cases, there was agreement between the conclusions of the expert and the subsequent decision taken by the client. It is emphasized that, within the period considered, there has been a general decrease in requests for expert opinions on procreative capacity in paternity suits, which is traced back to the increasing accuracy of the methods of blood group serology. In contrast, expertises in the case of occupational accidents, criminal offences and errors in medical treatment are on the increase.
The fertility potential of 54 men aged between 19 and 42 years, who had undergone unilateral orchidectomy was evaluated. In all cases the remaining testis was of normal volume and consistency. The patients were divided into four groups according to the cause of the orchidectomy: group I--cryptorchism (n = 19), group II--testicular torsion (n = 14), group III--testicular cancer (n = 12) and group IV--accidental (n = 9). The time between orchidectomy and seminal analysis varied from 6 months to 30 years (median 5 years). All semen samples were examined at the same laboratory, and no differences in sperm concentration were found among the groups. 53% in group I, 57% in group II, 50% in group III, and 56% in group IV had sperm counts of less than 20 million/ml. Our results suggest that unilateral orchidectomy leads to a considerable decrease in fertility potential, whatever the reason for it.
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In a testicular biopsy of an infertile man, most of the spermatids revealed a lack of the middle piece because of a malformed or untimely occurring spindle-shaped body. When during spermatid differentiation the spindle-shaped body appeared, it contained the typical bundles of tubules but was often reduced in size and arranged only unilaterally to the axoneme. After the disappearance of the incomplete spindle-shaped body, the annulus did not descend, the ribs of the fibrous sheath of the principal piece were found far proximally and the mitochondrial sheath of the middle piece could not be formed. In consequence of this faulty development, the spermatozoa were immotile.
In a katamnestic study, we analyzed both the clinical and spermatological data of 757 foreign andrological patients from 67 different nations--mainly neighboring countries in Europe, Africa, and the Middle East. Concerning the ejaculation parameters, our findings corresponded to those of other authors. The period between marriage and first andrological examination is about twice as high as that of Europeans. The sexual activity of males from the Mediterranean countries is clearly higher than that of Europeans.
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Based on two detailed case reports of idiopathic hyperlipemic xanthomatosis, we discuss the problems concerning xanthomatosis. The important role of a long-term follow-up of these patients as, in our cases, over 16 and 27 years, resp., by the same doctor is pointed out.