Search

The symptoms of self-observation of the menstrual cycle (basal body temperature, mucus symptom, autopalpation of the cervix) are often regarded as not reliable for ovulation detection. In a prospective study 87 NFP cycles are monitored additionally with ultrasound and LH tests to calculate the correlation of the ovulation-time with the symptoms of self-observation. Our results show that the symptoms of self-observation allow a reliable detection of the time of ovulation. Only a short introduction into the method of self-observation is a necessary precondition. The reliable detection of ovulation gives the opportunity of cycle analysis of large groups especially in long time investigations. In this way a large set of valuable and reliable data on normal and disturbed menstrual cycles will be available.

The sperm-cervical mucus-penetration test (SCMPT) was used in vitro to examine the influence of heavy metals (mercury, cadmium and copper) on sperm function. 30 each of freshly obtained different sperm samples with varying starting sperm motility and oestrogen-stimulated cervical mucosa from women of known fertility were used. Mercury chloride (HgCl2; 0.005-0.5 mmol/l), cadmium chloride (CdCl2; 0.05-10 mmol/l) and copper sulphate (CuSO4; 0.0001-10 mmol/l) were added to the in-vitro system. After incubation, at 37 degrees C for 6 hours, linear progression, penetration depth and motility index of the sperm (cumulative SCMPT score) were analysed. An untreated control was run in parallel with each test. The added substances, especially CdCl2 and HgCl2, significantly reduced the quantitative and qualitative penetrability of sperm (P = 0.001), in step with the concentration. The concentrations which were used, especially those of mercury, were in the range of in-vivo. measured levels. These results make clear that heavy metals can influence human sperm function.

Knowledge of the immune response to natural infection with Neisseria gonorrhoeae is presupposition for the development of a gonococcal vaccine. Pili and protein I have gained importance for a subunite vaccine. A pilus vaccine proved to be ineffective in a field trial due to extensive pilus variability. According to an alternative strategy protein I may represent an important vaccine candidate for a gonococcal vaccine. To study the local and systemic, humoral immune response to N. gonorrhoeae cervical secretion, vaginal fluid and serum from prostitutes and family planning patients were compared by the use of a protein I ELISA. In local secretions and in serum patients in the study group showed significantly higher anti-protein-I-IgA-levels than patients in the control group. In cervical secretion immune response to an acute gonococcal infection consisted of a short lived, significant increase of anti-protein-I-IgA, while anti-protein-I-IgG showed a lower, but longer lasting significant increase. The course of the immune response in vaginal fluid reflected the immune response of cervical secretion at a lower level. In serum antigenic stimulus of a local gonococcal infection resulted in a significant but short lived protein I specific IgG immune response. In local infection with N. gonorrhoeae protein I represents a target antigen of the local and systemic immune response. Clear differences exist between local and systemic humoral immune response in the protein I reactive immunoglobulin class and in the course of reactivity. In the future it may be possible to define epitopes on protein I which induce protective immunity.

HSV infections are the cause of 15%-25% of all venereal diseases. According to the rise of genital HSV infections a similar rise in seriously infected newborn babies can be expected. We obtained 159 cervix smears from 114 pregnant women for a direct test with monoclonal antibodies against HSV I and HSV II infections in the obstetrical division of the University Clinic Frankfurt. 17 (14.9%) of the 114 patients were discovered to be infected with HSV. Blood samples of 15 of these women were examined for IgG and IgM antibodies against HSV I and HSV II. Four samples were negative for IgG and IgM antibodies, 11 samples had visible IgG antibodies but no IgM antibodies could be seen. The direct proof of monoclonal antibodies is simple and quickly obtainable in any laboratory and thus is an improvement towards quick diagnosis and typing of HSV infections. An overall screening of HSV infections in pregnant women does not seem recommendable since the antepartal result does not correlate to the risk of infection during delivery.

The early detection of chlamydial infections is very important because they may cause cervicitis, endometritis and salpingitis and because of that reason for sterility in women. In routine cervical smears the morphologic picture is aspecific. One of the most specific methods for identification of Chlamydia trachomatis is the direct immunofluorescence with monoclonal antibodies (DIF). 100 women of age 18 - 45 years are examined with DIF test produced by Orion Diagnostica. In the cytological smears of 15 women morphological signs, inclusion and vacuolization, suspicious of Chlamydia trachomatis infection were seen. Using DIF, positive reactions have been found in 17 women. A conclusion for the high specificity of DIF with monoclonal antibodies is made.

The authors investigated 10 free amino acids, LDH, pyruvic acid and the levels of glucose in mucus of the cervix of patients in cases of gradually malignisation. We could show that the levels of all free amino acids are lower in cases of invasive carcinomas than in cases with dysplasias. LDH and pyruvic acid had an higher level in cases invasive carcinomas. We found no differences in cases of dysplasias and normal patients cervical mucus.

Flame photometric determinations of sodium, potassium, and calcium, moreover magnesium concentrations according to a complexometric method in 197 healthy nonpregnant women aged 16-46 years were performed in serum and fluid of the vagina. The concentrations of K+, Ca++, and Mg++ in vaginal fluid showed marked increase of some 5, 6, respectively 4 times from those of serum. The sodium concentration of the vaginal fluid is half of serum. The concentration of magnesium in vaginal fluid showed a significant increase of a quarter in comparison with serum after application of hormonal contraceptiva. The origin of vaginal fluid is discussed.

We examined 97 healthy and non-pregnant women aged between 17 and 58 years, who especially did not show any symptoms of vulvitis or colpitis, for the contents of cholesterol in serum and vaginal smear. In the vaginal smear we found significantly lower concentrations of total cholesterol as in serum, whereas the part of free cholesterol on total cholesterol in vaginal smear was triple than in serum and its absolutely concentration was double than that in serum. Possible reasons are discussed.

Evaluation of 2,276 cycles in 439 patients who had been employing the double-check family planning method described by Thyma. The average length of the hyperthermic phase was 12 days. A tendency to longer hyperthermic phases was recorded in case of cycles of longer duration. In 74% of all cycles, the mucus peak was observed 1 to 3 days previous to the temperature rise. In 2,242 cycles, 3 pregnancies occurred which had not been planned, which corresponds to a Pearl index of 1.6. The temperature curves originally evaluated according to Thyma's criteria, were also assessed according to Roetzer's criteria. This analysis yielded 89.8% evaluable temperature curves according to Roetzer, in contrast to 77.8% evaluable curves according to Thyma. An additional disadvantage when using the "coverline" as suggested by Thyma, is the shortening of the post-ovulatory infertile phase which may occur occasionally.

Described in this paper is a new penetration chamber in which to test the penetration capacity of spermatozoa in cervical mucus. The technique has proved to be highly suitable for penetration testing practice and is likely to provide valuable information for diagnosis.

Vaginal smears were taken by means of a metal spatula from the dorsal part of the vaginal vestibule of sexually mature sheep with intach genitals for the purpose of following up changes in the vaginal cell structure. The smears were taken daily over the whole testing period of 35 days. The cells were defferentiated by means of the dyeing method according to Papanicolaou as well as by using Shorr's staining which had been modified according to Pundel. Differentiation was made between occurrences ob basal, parabasal, intermediary, and superficial cells, with the view to figuring out the cycle phases. That vaginal smear method, when used in two or three folloow-up examinations on the basis of random checks, has proved to enable determination of cyclic activity of a complete herd. This is of great importance to heart synchronization or heart induction, since all results so far have shown that all success depended strongly on the given degree of cyclic activity of the sheep concerned.

A case of persistent infertility due to a cervical factor is reported which did not respond to several treatment regimes to make the cervical mucous penetrable for the sperms of the husband. Intra-uterine insemination was equally unsuccessful, however the in-vitro incubation of the semen of the husband in donor cervical mucous and subsequent intra-uterine insemination of this incubated mucous resulted in a pregnancy.

The content of immunoglobulins in the cervical mucus has been determined quantitatively by the method of radial immunodiffusion. IgG and IgA has been ascertained in all samples, whereas IgM was not measurable. The concentrations of IgG and IgA in the cervical mucus was compared with those of mucous--membrane and of blood-serum. It was discussed the importance of periodical changes of cervical mucus for the penetration of spermatozoa.

A new simple test of the identification of ruptured fetus membranes has been studied which is based on the heating of the dry sample slide in which endocervix specimen has been placed. When this specimen contains amniotic fluid, the dry sample slide turns white. When the amniotic fluid doesn't exist, it turns brown. 275 cases of ruptured membranes in term pregnancy have been studied and our test has proved 100% percent successful. We have also studied 225 cases of term pregnancies with unruptured membranes and the rupture of membranes appeared in 24 of the cases. (10.6% false positive results). This new method is simple, fast, economical and reliable in the testing of ruptured membranes with a small percentage of false positive results in cases of unruptured membranes.

The dynamics of estradiol, estrone, 17 alpha-hydroxyprogesterone, progesterone and 20 alpha-dihydroprogesterone were investigated in the blood plasma of the pavian (papio, hamadryas) with regard to the menstrual cycle and in comparison with the human. Furthermore results were presented about the basal temperature, the fern phenomenon and the development of the sex-skin in the pavian.

If the indicating thread of intrauterine contraceptive devices is situated inside the uterine cavity, it is incrustated in the same way with calcium carbonate like the device itself. In 20 per cent the intracervical part of the thread is incrustated, too. The danger of an ascending inflammatory disease is increasing with the precipitation of substances, probably, denaturated fibrine or mucine according to the infrared spectral analysis.

CEA estimations are effected in serum samples and in cervico vaginal fluids (n = 144) of patients with cervical condylomas, cytological undecided and cytological positive findings and in follow up performed histology. 21 healthy women were used as a control group. For taking cervico-vaginal fluids 5 ml isotonic NaCl solution were instilled in the fornix vaginae. After that 5 ml of the solution mixed with cervico vaginal fluids were aspirated. A polyclonal anti-CEA-antiserum was applied to radioimmunoassay. Remarkable high concentrations were found in cervico vaginal fluids compared with serum values. (Table: see text). In cases of cervical condylomas and cervical intraepithelial neoplasia significant increased CEA levels were determined in fluids compared with the control group. These results must be seen in consideration that the local CEA concentrations are scattered over a brand range. Regarding to CEA serum concentrations only slight increased values were found in cases of CIN I/II. (table; see text) Therefore CEA-serum estimations are not a diagnostic tool in CIN. The normal range of 10 micrograms/l was exceeded in only one sample of CIN II.

This paper first reviews the relatively abundant literature on crystallization phenomena in human secretions, then our experiments, aimed at artificial imitation, are discussed. Threadlike crystals appear when the inorganic share of the solution shows 530mg% NaCl and 70mg% KCl and the organic one either 34mg% hyaluronic acid or 200 to 500mg% glucose. By overstepping the concentration limit of glucose or human albumin, crystallization can be prevented. The prevention of crystallization by proteins might gain some significance in diagnostic cytology as a primitive method to analyse colloid semiquantitatively.

The percentage of Y spermatozoa was determined in sperm specimens from 73 donors with known spermiogram; mean value was 46%. No difference between donors with high or low sperm counts was observed. The penetration capacity of the sperm in cervical mucus was investigated in 59 cases using an in vitro test. The cervical mucus content of Y spermatozoa was significantly higher (54.2-56.7%) than that of the sperm specimens. It thus appears that cervical mucus may be somewhat selective of Y spermatozoa.

In-vitro experiments had been undertaken in order to clarify sperm selection by cervical mucus. Sperm samples, preferably with a high rate of abnormal cells, were obtained from fertile and infertile men for 35 penetration tests. Cervical mucus was collected from fertile women during praeovulatory phase. The penetration tests resulted in a statistically high amount of normal sperm cells which had migrated through cervical mucus as compared to abnormal cells. The significance of this filtration capacity of the cervical mucus will be discussed.

State of vaginal cells and arborisation grade of cervical mucus were studied in 364 Merino ewes of meat type from the 7. day ante partum. The Pundel modified Shorr-straining method and the Papanicolaou-straining method were used for differentiation of the cells (casal-, parabasal-, intermediate-and superficialcells). Near the 44., 54. and 70. day post partum a maximum of superficialcells and simultaneously a high grade of cervical mucus arborisation in elongating cyclic intervals can be observed in lactating ewes. In conclusion an early weaning of lambs between the 40. and 50. day post partum is considered to be in aggreement with cyclus.

Bacteriological tests were applied to cattle with endometritis and vaginitis. Included were cervical mucus samples and immunofluorescence tests to detect in that mucus as well as in blood serum antibody to Corynebacterium pyogenes and Streptococcus haemolyticus. The results pointed at intensive contact of the animals with the above pathogens and to their frequent occurrence in cervical mucus of cattle afflicted with endometritis and vaginitis. They also supported the assumption of localised antibody formation in the sexual organs or female cattle.

The in vitro penetrability of cervical mucus by sperm was investigated in women who were taking Ovanon or Sequilar. Measurements were made under constant experimental conditions on every day of the cycle. The depth of penetration differed strikingly between women with normal menstrual cycles and women taking the sequential hormonal contraceptives. The penetration depth was substantially less when Sequilar or Ovanon was used. The Sequilar induced cervical sperm barrier during the entire cycle was almost as strong as that observed when combined preparations are used. During the proliferative phase of the cycle the penetration depth allowed by Ovanon was less than that observed during normal cycles but greater than that seen with Sequilar. During the secretion phase no appreciable differences in the penetrability of cervical mucus between the two contraceptives was observed. The hypothetical relationship between these data and the problem of cervical carcinoma was described.

I. Basal cells occurring focally beneath the columnar epithelium of the endocervix are generally regarded as "reserve cells". Single "reserve cells" cannot be identified among the columnar epithelial cells. II. Single "reserve cells" would not be needed for the regeneration of the cervical mucosa, since the normal columnar, cells themselves are capable of undergoing mitotic division. During such mitoses the mitotic spindle is located above the regular row of nuclei, the axis of the spindle running parallel to the basement membrane and surface of the cell, so that the daughter cells separate in a horizontal direction. Consequently, the term "reserve cell" with its functional implication is misleading and should be replaced by a more descriptive term such as the "subcylindrical"cell. III. It seems that for development of focal groups of subcylindrical cells according to I the columnar cells must proliferate locally. That proliferation could occur with the axis of the mitotic spindle rotated 90 degrees to be perpendicular to the basement membrane. More likely, however, the columnar cells seem to undergo mitoses with their spindles parallel to the basement membrane and accumulate locally to form two layers. On further proliferation of the basal layer, with the mitotic spindles rotated 90 degrees to be perpendicular to the basement membrane and with desquamation of the overlying columnar cells, the than multilayered epithelium may differentiate by indirect metaplasia into squamous epithelium.

The Fitz-Hugh--Curtis syndrome is an extragenital manifestation of gonorrhea, characterized by fibrinous inflammation of the subphrenic area with violinstring-like adhesions between the liver surface and the parietal peritoneum. When such patients present with acute upper right quadrant pain, the differential diagnosis to other abdominal emergencies (cholecystitis, peptic ulcer disease etc.) may be difficult, because it will not always be possible to isolate the causative agent from the external genitals. In such cases only a laparoscopic approach will allow a correct diagnosis. Two case reports are discussed in the light of the literature.

Signs of different activities in the dynamic morphology of the epithelium and mucus of the cervix uteri are demonstrated in the female fetus, newborn, child and adolescent. Besides the morphological description of the ectropium, transitional zone, s.c. "reserve-cells", squamous cell nodes and production and secretion of mucus other investigations were done by allometry, caryometry and histochemistry. The examinations allow insight into the hormonal activities specially of the estrogenes in different periods of female life.