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Biomedical subjects

G Haidl

Publications and source records attributed to G Haidl.

At least 55 records · Page 3Linked to original sources
PubMed1994

[The aging man from the andrologic viewpoint].

In view of demographic trends, andrology will increasingly be concerned with problems of the aging male. These will involve aspects of fertility and general quality of life rather than specific clinical pictures. While there is considerable interindividual variation, fertility in men usually persists well into old age. However, increased occurrence of spontaneous mutations means a higher genetic risk for children of older fathers. Diminished androgen levels in old age lead to diminished sexual activity and changes in muscles and bones, which raise the question of hormone substitution.

Aged↗
PubMed1994

[Pregnancy after drug therapy of severe andrological disorder].

Initial examination of an andrological patient revealed high-grade oligoasthenoteratozoospermia and ureaplasma infection. An elevated FSH level and significantly reduced testicular size were indicative of severely damaged testicular parenchyma. The presence of macrophages in the sperm smear was interpreted as a sign of chronic epididymitis. Antibiotic couple therapy with doxycycline, followed by a 3-month recovery period with combined treatment with vitamin C and E and zinc, resulted in a significantly improved spermiogram. After another 2 months intrauterine insemination resulted in pregnancy, and the birth of a healthy daughter followed. Preparation of the ejaculate was done by glasswool filtration. At that time, the patient had only mild teratozoospermia.

Adult↗
PubMed1994

When to treat varicocele?

In order to find criteria that might prognosticate the outcome of varicocele treatment, we studied 48 patients with unilateral or bilateral varicocele. Examinations prior to therapy included GnRH test and determination of alpha-glucosidase in addition to normal sperm analysis. The morphological analysis was performed according to the Düsseldorf classification. Thirty-five of the 48 patients underwent varicocele sclerosing, 13 patients received no therapy. Ten normozoospermic donors served as control. At 6-7 months after sclerosing, the aforementioned parameters were checked in all patients. Almost all of the untreated patients had pathological GnRH tests initially and on control, and sperm parameters had deteriorated. In the treated group, 75% had pathological GnRH tests initially. Of these, 70% improved, particularly sperm morphology with reduction of hyperelongated forms, and 30% had GnRH tests returned to normal. However, improved sperm parameters were also observed in 75% of patients who had normal GnRH tests initially. The improvement of sperm parameters was not associated with significant changes in alpha-glucosidase (normal initial values). According to these results, the GnRH test does not seem to be an important prognostic parameter for the outcome of varicocele therapy. However, patients with pathological values should be treated. Determination of alpha-glucosidase as an epididymal marker is no decisive criterion either. The most significant improvement was observed in patients with increased occurrence of hyperelongated spermatozoa.

Case-Control Studies↗
PubMed1993

Disturbances of sperm flagella due to failure of epididymal maturation and their possible relationship to phospholipids.

A recent classification of alterations of midpiece and flagellum describes the phenomenon of abnormal staining behaviour of human sperm flagella during Papanicolaou and Shorr staining. In these techniques, human sperm tails normally stain red; however, if epididymal function is disturbed, the flagella appear bluish, while they are devoid of other recognizable defects. Such spermatozoa were shown to be immotile, the motility disturbance being referred to as epididymal dysfunction. To define the physiological substrates of this descriptive phenomenon, caput spermatozoa from 10 epididymides of five patients who had undergone orchiectomy because of prostatic cancer were investigated. These spermatozoa showed severe motility disturbances, and almost all their flagella stained atypically. Attempts to stimulate such spermatozoa by pentoxifylline achieved a slight improvement in motility. However, addition of seminal plasma from fertile donors resulted in a significant improvement in motility, accompanied by an increase in the number of normally stained flagella. Even better results were achieved by incubation with liposomes made from soybean lipids, mainly phosphatidylcholine. It is concluded that poor motility and atypical staining behaviour of human caput sperm tails can at least partly be related to a lack of phospholipids in the flagellar membrane. Substitution of phospholipids may be a therapeutic approach in procedures using caput spermatozoa, although in addition to the improvement of sperm motility, the enhancement of fertilizing capacity remains to be established.

Aged↗
PubMed1992

[Fertility disorders in the male. Part 2: Therapeutic possibilities].

In Part 1 of this paper, the various diagnostic procedures employed to establish the fertility status of the male are described. Apart from the important aspect of psychological counseling offered the couple, therapy includes surgical, including microsurgical procedures, and medicinal treatment. The possibilities of causal pharmacological treatment of disordered spermatogenesis are limited, while in the case of disturbances affecting the epididymis and other adnexa this approach is frequently successful. In the fertility clinic, endocrinological diseases are of only minor importance.

Diagnosis, Differential↗
PubMed1991

[Male fertility disorders. 1: Diagnostic procedures].

The current situation in the diagnosis of male fertility disorders is discussed. The importance of an accurate diagnosis to provide a basis for rational therapy is emphasized. In addition, an accurate prognosis can obviate the need for reproductive-medical measures in the female partner in some cases.

Autoantibodies↗
PubMed1991

Poor development of outer dense fibers as a major cause of tail abnormalities in the spermatozoa of asthenoteratozoospermic men.

For a reasonable analysis of sperm motility, consideration should be given to the morphology of the flagellum. Among various tail disturbances, the present paper describes a structural shaft defect that is characterized by variations in diameter, poor outline and/or lacking endpiece. Electron microscopical examinations, especially the negative staining technique, have shown that in addition to membrane alterations there is one essential cause for the limited extension of the outer dense fibres. This disturbance may be of genetic origin or due to toxic or inflammatory influences. Further molecular biological studies are required to detect the actual cause of this defect, for which there is so far no adequate therapy.

Humans↗
PubMed1991

Guidelines for drug treatment of male infertility.

The prerequisite for rational therapy of male fertility disorders is an exact diagnosis. While the possibilities of influencing disturbances of spermiogenesis are limited, male adnexal diseases can be successfully treated in many cases. Drugs for the treatment of fertility disorders must be applied with this in mind, and empiric therapy is often performed in addition to causal treatment which, however, may be quite rationally determined. The therapeutic spectrum in andrology includes antibiotic and antiphlogistic agents, mast cell blockers, zinc, vitamins, and immunosuppressive drugs (corticosteroids). These agents are used for the treatment of inflammatory diseases of the testes and the accessory glands or for suppression of antispermatozoal antibodies. Hormonal disturbances are infrequently encountered by the andrologist, but they can be treated, with proven efficacy, with gonadotrophins, gonadotrophin-releasing hormone (GnRH) or androgens. In certain cases that are not hormonally related, the use of antiestrogens (clomifene, tamoxifen) as stimulating agents may be successful. Furthermore, tissue hormone releasing proteases (kallikrein) can be used both therapeutically (especially in motility disturbances that are not due to structural flagellar defects) and diagnostically (in order to distinguish between inflammatory and noninflammatory testicular damage). Anticholinergics and alpha-sympathomimetics are applied to ameliorate ejaculation or emission failure. In addition to a review of these treatment forms, the development of new concepts, e.g. angiotensin converting enzyme (ACE) inhibitors, is discussed.

Adrenal Cortex Hormones↗
PubMed1991

[Electron microscopy findings in human spermatozoa with flagellar defects].

Spermatozoal motility disorders must be interpreted with reference to whether the flagella are intact or impaired. A new classification of alterations of midpiece and flagellum includes a shaft disturbance that is increasingly often observed and can be recognized by light microscopy. Electron microscope examinations have shown that missing or poorly developed outer dense fibres are one cause of this flagellar disorder. As suitable longitudinal sections are rarely obtained in transmission electron microscopy, the negative staining technique was used in addition for this purpose. This method was found to be most suitable for an exact analysis of the periaxonemal structures of the sperm flagellum. Consideration of this hitherto unknown flagellar disturbance is important, because various therapeutic approaches have had little success so far and patients should be referred in good time for other gynaecological or andrological treatments.

Cell Membrane↗
PubMed1990

[Diagnosis and therapy of erectile disorders].

The current diagnostic and therapeutic possibilities in patients with erectile dysfunction are discussed. The anatomical and physiological aspects of erection, and the most frequent causes of erectile dysfunction are presented, with special consideration being given to the situation in the older man.

Aged↗
PubMed1990

Macrophages in semen are indicative of chronic epididymal infection.

Chronic unspecific genital infections cause unexplained male fertility disorders. The andrologist in clinical practice is referred to the significance of macrophages in the seminal fluid and to an abnormal staining of the spermatozoal flagella during the Papanicolaou' and Shorr' techniques. These two criteria may be helpful in diagnosing chronic unspecific genital infection and in differentiating chronic epididymal inflammation from chronic prostatitis, whereas the influence of bacteria is still controversial.

Chronic Disease↗
PubMed1976

[Lyophilized vein as an arterial substitution].

The use of homologous preserved veins for replacing seems to have special importance in the surgery on peripheric and coronary arteries. Preliminary results from animal experiments are discussed in which lyophilized veins replaced arteries. Within 8 weeks after implantation into dog aorta develops a functionally satisfactory substitute. No immune reactions can be found histologically. The destruction of the graft and its replacement by host's tissue are temporally balanced. The experiments are to be continued.

Angiography↗
PubMedDate not supplied

Sexual satisfaction in male infertility.

Infertility is proposed to be a continuing stressor for couples suffering from involuntary childlessness. A long duration of the desire for a child and, correspondingly, a longer period of diagnostic and treatment procedures could have a negative impact on sexual satisfaction, thus leading to an unfavorable psychological circuit. The present evaluation should clarify the state of sexual satisfaction and relationships, with relevant parameters in 68 men with fertility problems, of couples with involuntary childlessness. Subjects reported relatively high average levels of present sexual satisfaction with only nonsignificant lower scores (p = .08) compared to recalled sexual satisfaction prior to diagnosis of infertility. Multiple regression analyses revealed that a positive age difference between men and their spouses (p = .042) and a higher weekly coitus frequency (p = .002) were the only significant parameters associated independently with higher sexual satisfaction. Neither the age of partners, attitudes toward sexuality, treatment duration, duration of the partnership and the duration of the desire for a child, nor andrological findings had an influence on present sexual satisfaction. The results propose that treatment duration and duration of the desire for a child may not necessarily be connected to lowered sexual satisfaction in infertile males and that coitus frequency seems to be an indicator of sexual satisfaction in this patient group.

Adult↗