Glial cell line-derived neurotrophic factor is constitutively produced by human testicular peritubular cells and may contribute to the spermatogonial stem cell niche in man.

Background: Testicular peritubular cells form an ill-characterized cellular compartment of the human testis, which forms a border with Sertoli cells and spermatogonial stem cells (SSCs). A recently developed culture method has identified parts of the secretory repertoire of human testicular peritubular cells (HTPCs), which includes nerve growth factor. Whether peritubular cells produce glial cell line-derived neurotrophic factor (GDNF) and may thus contribute to the stem cell niche is not known.

15-Deoxy-delta 12-14-prostaglandin-J2 induces hypertrophy and loss of contractility in human testicular peritubular cells: implications for human male fertility.

The wall of the seminiferous tubules contains contractile smooth-muscle-like peritubular cells, thought to be important for sperm transport. Impaired spermatogenesis in men typically involves remodeling of this wall, and we now found that smooth muscle cell (SMC) markers, namely myosin heavy chain (MYH11) and smooth muscle actin (SMA) are often lost or diminished in peritubular cells of testes of men with impaired spermatogenesis. This suggests reduced contractility of the peritubular wall, which may contribute to sub- or infertility.

Mother and daughter with a terminal Xp deletion: implication of chromosomal mosaicism and X-inactivation in the high clinical variability of the microphthalmia with linear skin defects (MLS) syndrome.

The microphthalmia with linear skin defects (MLS or MIDAS) syndrome is a rare X-linked dominant inherited disorder with male lethality, associated with segmental aneuploidy of the Xp22.2 region in most of the cases. However, we recently described heterozygous sequence alterations in a single gene, HCCS, in females with MLS.

A defect in dolichol phosphate biosynthesis causes a new inherited disorder with death in early infancy.

The following study describes the discovery of a new inherited metabolic disorder, dolichol kinase (DK1) deficiency. DK1 is responsible for the final step of the de novo biosynthesis of dolichol phosphate. Dolichol phosphate is involved in several glycosylation reactions, such as N-glycosylation, glycosylphosphatidylinositol (GPI)-anchor biosynthesis, and C- and O-mannosylation.

[Andrological diagnosis and treatment of azoospermia].

10-20% of the men who seek the help of an andrologist present with azoospermia. Possible causes are of genetic origin or are acquired disorders of production and transport. On the basis of a comprehensive andrological work-up this disturbances can be identified.

Epidemiology of Peyronie's disease.

Francois Gigot de la Peyronie, surgeon to Louis XV of France, has become synonymous with the rather enigmatic though not uncommon condition of Peyronie's disease (PD), a localized connective tissue disorder of the penile tunica albuginea. The true prevalence of Peyronie's disease is unknown. Therefore, we decided to perform an evaluation of existing epidemiological data.

Cycling and penile oxygen pressure: the type of saddle matters.

Objectives: Temporary genital numbness is a common side effect of long-distance cycling; cases of impotence have even been reported. Recent reports have shown that perineal compression leads to a decrease in penile blood flow. Reduced oxygen tension leads to penile fibrosis, which works counterproductively to the achievement of an erection.

The prevalence of Peyronie's disease: results of a large survey.

Objectives: To determine the prevalence of Peyronie's disease, a localized connective tissue disorder of the penile tunica albuginea, the symptoms of which include palpable plaque, painful erections and curvature of the penis, in a large sample of men in Germany.

Subjects And Methods: A standardized questionnaire was sent to 8000 male inhabitants (age range 30-80 years) of the greater Cologne area (approximately 1.5 million inhabitants).

Microscopic and biochemical fertility characteristics of semen after shockwave lithotripsy of distal ureteral calculi.

Purpose: To elucidate the frequency and adversity of the effects of shockwave lithotripsy (SWL) on the male reproductive system. We investigated the possible alterations in the quality of semen in patients treated by SWL for pelvic ureteral stones.

Patients And Methods: The semen of 10 men was examined 1 day before and 5 and 90 days after SWL for distal ureteral stones, in accordance with the World Health Organisation guidelines.

Impotence and genital numbness in cyclists.

Cyclists often complain of genital numbness and even of impotence. The purpose of this study was to determine if perineal compression during cycling causes changes in the penile blood supply, impotence and penile numbness. Forty healthy athletic men with a mean age of 30 +/- 5.

[Changes in penile blood flow during cycling--how does one prevent a decreased perfusion?].

Background And Objectives: An increased incidence of erectile dysfunction has been observed in cycling enthusiasts. Compression of the perineal region during cycling seems to cause decreased penile perfusion. The resulting hypoxaemia in the corpus cavernosum is associated with penile fibrosis, which leads in the long run to erectile dysfunction.

Erectile dysfunction in cyclists. Is there any difference in penile blood flow during cycling in an upright versus a reclining position?

Objective: Perineal compression during bicycling appears to be responsible for some cases of erectile dysfunction.

Material And Methods: In 46 healthy athletic men transcutaneous penile oxygen pressure (tpO(2)) at the glands of the penis was measured, using a transcutaneous measurement device. It has been shown that the tpO(2) levels measured at the glans correlate with the penile blood flow.

Human cyritestin genes (CYRN1 and CYRN2) are non-functional.

The mouse cyritestin gene is a member of the ADAM (a disintegrin and metalloprotease) gene family and codes for a membrane-anchored sperm protein. Recently, it was shown that cyritestin is critical for male fertility in the mouse. Spermatozoa of cyritestin-deficient mice are not able to bind to the zona pellucida of the oocyte and therefore unable to fertilize the egg.

Transcutaneous penile oxygen pressure during bicycling.

Objective: To evaluate the blood supply to the penis during bicycling and thus determine whether the associated perineal compression might be responsible for some cases of impotence.

Subjects And Methods: The transcutaneous penile oxygen partial pressure (pO2 ) at the glans of the penis was measured in 25 healthy athletic men; pO2 is readily measured by noninvasive techniques currently widely used in the management of premature infants, and which have been shown to give pO2 levels that correlate with arterial pO2 levels. The measurements in the healthy subjects were taken in various positions, before, during and after bicycling.

[Intracytoplasmic injection (ICSI) of cryopreserved testicular spermatozoa (Cryo-TESE): a retrospective study of the first 250 treatment cycles].

It is reported on the results of 250 treatment cycles in which we carried out intracytoplasmic injections (ICSI) with frozen and thawed testicular spermatozoa (cryo-TESE). Up to July 1997 we treated 127 patients, 225 embryo transfers were performed (90%), and an average of 2.3 preimplantation embryos were transferred.

Down syndrome, transient myeloproliferative disorder, and infantile liver fibrosis.

Background: In neonates, Down syndrome is rarely accompanied by the leukemoid reaction called transient myeloproliferative disorder.

Procedures And Results: We present clinical and histopathologic data of another Down syndrome neonate with transient myeloproliferative disorder and severe infantile liver fibrosis. These findings in our patients are compared in detail with the 20 cases published previously.

[Intracytoplasmic injection of epididymal and testicular sperm after failed heterologous insemination].

We report on our experiences with intracytoplasmic injection (ICSI) of epididymal and testicular spermatozoa (MESA, TESE) from azoospermic men whose wives had previously failed to become pregnant after several cycles of artificial insemination by donor (AID); because we do not perform AID treatment in our clinic, all these treatments were carried out in other fertility centers as well as the female diagnostic of sterility. In 3 husbands we could not find any testicular spermatozoa or spermatids, leaving 15 women under treatment. Of these 15 women, 9 became pregnant.

[Pregnancy and delivery after in vitro fertilization (IVF) of human ova via intracytoplasmatic sperm injection (ICSI) of testicular sperm (TESE)].

This is a report on a pregnancy achieved by in-vitro fertilisation (IVF) with intracytoplasmatic sperm injection (ICSI) after testicular sperm extraction (TESE). Because of a bilateral absence of the ductus deferens, microsurgical epididymal sperm aspiration (MESA) was not possible. This anatomic situation was probably caused by a bilateral herniotom during childhood.

[Triplet pregnancy after intracytoplasmatic sperm injection of cryopreserved testicular sperm].

For the first time we report on an intact and ongoing triplet pregnancy after intracytoplasmatic sperm injection of cryopreserved testicular sperm. Indication was azoospermia due to hypergonadotropic hypogonadism. The patient conceived in the third treatment cycle after 25 treatment cycles with donor sperm that had been carried out without success in two other treatment centers.

[Pregnancies after in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) of testicular spermatozoa (TESE) from frozen semen].

This case report describes the possibility of establishing intact pregnancies by using cryopreserved testicular sperm for in-vitro-fertilization (IVF) with intracytoplasmatic sperm injection (ICSI). Because of a bilateral postinflammatory occlusion of the ductus deferens the patient underwent two cycles of IVF without ICSI by using epididymal sperm (MESA), however no fertilization occurred. In a third attempt with ICSI we used testicular sperm (TESE), because epididymal sperm was not detectable any longer.

MESA and TESE: experiences of the German section of urological microsurgery.

The introduction of microsurgical epididymal sperm aspiration (MESA) and testicular sperm extraction (TESE) followed by intracytoplasmic sperm injection (ICSI) has enlarged the therapeutic options for irreparable azoospermia. After standardization of the indications and surgical procedure, the German section for urological microsurgery combined the data of all groups performing assisted reproduction. The indication for MESA or TESE is given in cases of congenital aplasia of the vas deferens, irreparable obstruction of the reproductive tract, failure after refertilization, in combination with tubulovasostomy for subsequent cryopreservation and for conservatively untreatable ejaculatory disturbances.

["Tropical" pyomyositis in childhood].

We report on a 14 year old boy, who developed bacterial pyomyositis (Staphylococcus aureus) in his left thigh. Ultrasound and magnetic resonance imaging were very helpful for the differential diagnosis and follow-up of this infection which in large skeletal muscles frequently is associated with abscess formation. Treatment consisted of antibiotics and surgical drainage.

[Integrated imaging of head and neck tumors in children].

Examinations of 28 children with various tumors of the visceral cranium and neck have shown that both ultrasound and magnetic resonance tomography should be used primarily for diagnosis and follow-up. These tomographic methods are especially suitable for use in children. Ultrasound is better suited to visualization of localized, superficial masses and MRT to examination of deeper lying tumors within the complex structures of the visceral cranium and neck.

[Human dignity and aging. Social ethical comments on insuring nursing care risk].

The increasing share of old people in our society faces us with new social and economic problems. It is pointed out here with the example of safeguarding nursing risk, which socio-ethical questions have to be answered. The idea of human dignity as a central topic in the ethics discussion has attained increasing importance.