Antal Borsos

Double probing individual human spermatozoa: aniline blue staining for persistent histones and fluorescence in situ hybridization for aneuploidies

OBJECTIVE To study the potential relationship between two sperm nuclear attributes: persistence of histones and occurrence of chromosomal aneuploidies. DESIGN The two variables were examined by double probing of the same spermatozoa. SETTING Academic Andrology Laboratory. PATIENT(S) Semen samples subjected for analyses were examined. INTERVENTION(S) We studied >58,000 spermatozoa, in seven men, first with aniline blue histone staining, graded as light (mature sperm), intermediate (moderately immature), and dark (severely arrested maturation). After recording the staining patterns and destaining, the same spermatozoa were subjected to fluorescence in situ hybridization (FISH), using centrometric X, Y, and 17 chromosome probes. MAIN OUTCOME MEASURE(S) Proportions of sperm with light, intermediate, and dark staining were assessed, and ploidy of these sperm was evaluated. RESULT(S) The aneuploidy frequencies in intermediate versus light (mature) spermatozoa were increased four- to sixfold. In addition, aneuploidy frequencies and proportions of intermediate sperm were related. There was no FISH signal detectable in the darkly stained, severely arrested mature sperm. CONCLUSION(S) The data suggest that in sperm with arrested maturity and DNA fragmentation, the binding of FISH probes is diminished. DNA damage is further aggravated by the decondensation and denaturation steps of FISH. Thus, there is a strong likelihood that in oligozoospermic men, with a higher proportion of sperm with arrested maturation, the sperm disomy frequencies are historically underestimated.

Variable response of Hermansky-Pudlak syndrome to prophylactic administration of 1-desamino 8D-arginine in subsequent pregnancies

Hermansky-Pudlak syndrome is characterised by oculocutaneous albinism and haemorrhagic diathesis. The bleeding tendency that is associated with this autosomal recessive disease is caused by storage-pool deficiency and has been reported to be controllable by prophylactic administration of 1-desamino 8D-arginine (desmopressin, DDAVP). The DDAVP prophylaxis at the first delivery of our patient did not prevent the severe haemorrhagic sequeal requiring transfusion of packed red cells and platelets, but the same preventive measure was successful at her second childbirth. Response to prophylactic DDAVP administration varies between as well as within patients with Hermansky-Pudlak syndrome.

Ovarian function after the menarche and hormonal contraception

The aim of the study was to determine the date of regular ovulation after the menarche to better understand the physiology of female adolescence, especially as it pertains to the use of hormonal contraception. Early morning urine samples were collected from 51 girls in the perimenarche for 9 weeks semi‐annually during 2 years. Estrone‐ and pregnanediol‐3‐glucuronide values were determined. Cycles lasting 35–40 days at the onset of menses shortened to 28 days after the 23rd–25th cycle. Menses reached a 5.0–5.5 day average length at about the same time. After the 20th cycle, ovulation could be demonstrated in more than 50% of the study patients. Using a scoring system, regular ovulation could be expected on the basis of somatic data with scores of > 16. Hormonal contraception may be prescribed 2 years after the menarche, based on scores of > 16 and ovulation proven by hormonal cytology and basal body temperature.

Female child sexual abuse within the family in a Hungarian county.

Background: The aim of the study was to analyze the characteristics of intrafamiliar female child sexual abuse and to explore common features that may be utilized as targets for possible methods of prevention. We also described the medical and legal approaches to handling child neglect. Methods: This was a descriptive, cross-sectional study on 52 sexually abused girls under the age of 18 at the Department of Obstetrics and Gynecology, Medical and Health Science Center of Debrecen. We prospectively recorded the data of all cases. Intrafamiliar events were defined if the victim and perpetrator belonged to the same family. Legal outcomes were also recorded. Results: During the 16-year period, 209 cases of sexual abuse were seen in our clinic, 52 of them had been involved in child sexual abuse within the family. This accounts for 25% of adolescent cases. Eighty-six percent of the victims were pupils, 50% of them were between 11 and 14 years of age. The perpetrator was the victim’s father in 44%, and the stepfather in 40%. There was a slight difference between the type of abuse among the pre- and postpubertal group of victims, but statistically it was not significant. The abuse occurred on multiple occasions in 52%. The occurrence rate of assault was the highest in the summer season (58%), mostly in the afternoon (42%) and it took place almost exclusively at home (98%). The mother accompanied the victim in 38% of the cases and the police in 40%. Vaginal penetration was the type of abuse in 75%, and sexual perversion in 25%. Six victims were physically injured, the presence of sperm could be confirmed on vulvovaginal smears in 2 cases. One pregnancy conceived. Nine cases were reported to the police and as a result of legal proceedings, 5 perpetrators have been sentenced. Conclusion: The majority of crimes take place within the family and are disclosed after multiple episodes. The small proportion of reported sexual assaults is the consequence of the lack of harmony between the Hungarian conditions of emergency care and the criminal law. Prevention calls for attention at all levels of child education, observation at off-school times, early involvement of health professionals, applying standardized medical guidelines and the modification of jurisdiction.

Laparoscopic removal of gonads in gonadal dysgenesis

Prophylactic gonadectomy is widely accepted in male pseudohermaphroditism because of the possible malignant conversion of the gonads. Gonadoblastoma or dysgerminoma may occur in the dysgenetic gonads. Laparoscopic gonadectomy has been performed on a patient and is suggested as the optimum mode of management of patients with dysgenetic gonads.

Ovarian function immediately after the menarche.

Estrone and pregnanediol‐glucuronide values of early morning urine samples collected from young girls in the perimenarche were determined by radioimmunological technique. A total of 58 teenage girls started collecting urine samples after their menarche at various times. Of these, 9 completed collection within 100 days of the onset of the first menstrual period. In 3 cases, insignificant changes in estrone and pregnanediol levels were noted. Normal estrone values were found in 3 cases together with pregnanediol levels suggestive of ovulation. In 2 further cases the possibility of ovulation without follicular release was suggested. The results indicate that ovarian activity is unpredictable immediately following the menarche. Between very low levels of sexual steroid hormone production and those normally observed in adult females, all transitional values could be found.

Ovarian malignancies in childhood and adolescence

We retrospectively reviewed all cases of ovarian malignancies during a 10-year period at the Department of Obstetrics and Gynecology, University Medical School of Debrecen, Hungary. The experience with 16 cases: three epithelial tumors, one granulosa cell tumor, 11 germ cell tumors (six dysgerminoma, four teratoma, one endodermal sinus tumor), and one metastatic ovarian cancer is discussed. Malignant ovarian tumors can best be treated with conservative surgery, followed by adjuvant chemotherapy. Survival mainly depends on tumor type and stage at the time of diagnosis.

The role of preoperative brachytherapy as an adjunct to surgery and postoperative radiotherapy in the treatment of stage I endometrial carcinoma

PURPOSE Between 1978 and 1993, 817 cases of endometrial carcinoma were treated with simple hysterectomy with bilateral salpingo-oophorectomy. Five hundred and twenty-six cases had preoperative brachytherapy (Preo), and 291 cases underwent surgery without preoperative radiotherapy (Nopre). The aim of the study was to compare disease-free survival of the two groups. METHODS AND MATERIALS Survival comparison of the two groups was controlled for postoperative treatment type, according to stage, histological type, degree of differentiation, depth of myometrial invasion and age. The life-table method was used for survival analysis. Cumulative disease-free survival probabilities were calculated as a function of the proportion of normal remaining life elapsed from the time of diagnosis. RESULTS Five-year disease-free survival of patients with and without preoperative brachytherapy in stage IA, IB and IC was 93 and 93.6%, 93 and 94%, and 80 and 65%, respectively. In well differentiated tumors and poorly differentiated tumors, there was no difference in disease-free survival between patients with and without preoperative brachytherapy. Patients with moderately differentiated tumor treated with preoperative brachytherapy had significantly better disease-free survival than those without preoperative radiotherapy, however, this was confounded by uneven distribution of invasion depth. CONCLUSION Preoperative brachytherapy plays a limited role in the treatment of early stage endometrial carcinoma.

Chlamydia trachomatis infection among Hungarian teenage girls

The presence of Chlamydia trachomatis antigen was examined in 20 sexually active teenage girls by enzyme immunoassay to prove chlamydial infection. Seven of the study group showed evidence of C. trachomatis infection. The infection was more frequent in girls who used a non-barrier method for contraception and had more than four sexual partners previously. Screening for and treatment of C. trachomatis infection in high-risk teenage girls is recommended.

Gyermek-nőgyógyászati műtétek 40 év tapasztalatai alapján | Pediatric gynecological operations based on 40 years’ experiences

A szerző tobb mint 40 ev alatt szerzett tapasztalatait elemzi a Debreceni Szuleszeti es Nőgyogyaszati Klinikan operalt gyermek-nőgyogyaszati betegek adatai alapjan. A műtetek reszben hagyomanyos uton tortentek, reszben pedig a szerző altal kidolgozott uj eljarasok szerint. A betegek eletkora csecsemőkortol 18 eves eletkorig terjedt. A kozlemeny celkitűzese olyan altalanos jellegű megallapitasokat tenni, amelyek segithetik azok munkajat, akik ezen a teruleten dolgoznak vagy a jovőben szeretnenek dolgozni. Elemzi a műteti tipusokat, az ellatas feltetelrendszeret es intezeti hatteret, a szukseges szemelyi es diagnosztikai ellatottsagot. Ramutat az elkovethető hibakra es azok kikuszobolesenek lehetősegeire. A kulonboző megoldasokat csoportositva targyalja. Ismerteti a sajat modosito eljarasat, amelyet a huvelyhiany megoldasara dolgozott ki, felhasznalva az eredeti leirast, ami Vecchietti nevehez kapcsolodik. A szerző tobb mint 60 sikeres modositott Vecchietti-műtet eredmenyei alapjan sajat eljarasat idealisna...