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Having gained preliminary knowledge in a selected group of 64 patients treated for three months by a transcutaneous form of estrogen therapy (Estraderm TTS) for postcastration and climacteric syndromes, the authors report in this paper on the results of a one-year follow-up of a series of 42 patients treated by ETTS 25 and 50 for the same diagnoses. Administration of ETTS makes it possible to take advantage of the therapeutic transdermal system for the transfer of 17 beta-estradiol directly into the blood stream. Estradiol in a daily dose of 25, 50 or 100 microgrammes is deposited in ethanol gel as a reservoir in a special sticking tape. From there it is absorbed across a microsporous membrane by molecular diffusion into the subcapillary plexus at a constant speed till an equilibration of the diffusion gradient between skin and the system is attained. For the aim of this study is to evaluate both the recession of the subjective as well as objective complaints in patients suffering from postcastration and climacteric syndromes and the reflection of the treatment in the blood levels of gonadotropins, estrogens, gestagens and cortisol and likewise the vaginal hormonal cytology. Both the systemic and local side-effects of treatment are subject to a careful study. On the basis of a comprehensive statistical study of these changes in every patient as well as in the whole series in the course of one year the authors reach the conclusion that the ETTS administration strikingly improves the subjective as well as objective complaints of the patients, and, in agreement with the literary data, objectively influences the laboratory results concerning especially the circulating levels of gonadotropins and of estradiol. In conclusion, the authors comment on the favourable contribution of this form of treatment to gynaecological practice in the therapy of postcastration, climacteric and estrogen-losing syndromes. A special modification of the record was prepared for this study when the running subjective evaluations of the effect of the treatment by the patient, as obtained in the course of directed interviews, as well as objective results of somatic and laboratory changes including the aggregate yearly evaluation of the effect of the treatment in every individual woman of the series are clearly arranged.

The authors tested the possibility of assessment of fertile and infertile days during the menstrual cycle by investigating the crystallization of saliva by means of a minimicroscope PC 2000 IMPCON. They followed up for five months a total of 58 women where they assessed by a combination of at least three classical examination methods ovulatory and anovulatory cycles. They monitored a total of 120 cycles and examined 1649 specimens of saliva. Some women had to be eliminated on account of virosis during a flu epidemic (a total of 11 cycles). During the periovulatory period the authors recorded in ovulatory cycles the foreseen crystalline structures in saliva in 78.57%. In anovulatory cycles agreement between the expected character of the saliva specimen and anovulation was found in 84% of the examined cycles. In addition to structures suggesting fertile or infertile days, the authors identified also intermediary types. In the discussion the authors analyze various aspects as regards evaluation of the correlation between salivary and serum levels of gonadotropins and ovarian steroids. They evaluate physical and chemical changes of saliva and vaginal secretion and discuss the problem of crystallization of the saliva during the menstrual cycle. Based on their findings, when testing the minimicroscope PC 2000, they supplement the list of factors with influence the results of examinations. They consider PC 2000 a suitable modern equipment which extends the range of contraceptives and at the same time helps to assess the optimal time for conception in planned pregnancies.

The authors report on the results of a follow-up of 64 women aged 25-64 years, to whom oestrogens were administered transdermally by means of the preparation Estraderm TTS 25 or 50 for three months. 55 women were treated for postcastration syndrome and nine women for climacteric syndrome. The authors deal with the problems of dosage of the transdermal oestrogen therapy, study the side-effects of treatment and evaluate the results of therapy. In conclusion, they recommend the transdermal form of treatment by Estraderm TTS because of its very good therapeutic effect, acceptability by the patients, and only minimal local and general side-effects.

The authors investigated within the framework of non-specific immunity reactions proteins of the acute phase during spontaneous delivery and Caesarean section up to the 5th day after delivery and on the 1st, 5th and 10th day after delivery in forty women, half of them healthy and half suffering from late gestoses. Half the women had spontaneous deliveries, half had deliveries by Caesarean section. The proteins of the acute phase reacted sensitively to the stress of childbirth during spontaneous delivery and their activation was inhibited by general anaesthesia in deliveries by Caesarean section. After spontaneous delivery the elevated proteins of the acute phase returned to baseline values by the 5th day, after operation their levels rose further up to the 5th day, orosomucoid to the 10th day after operation. In late gestoses with spontaneous delivery or by Caesarean section there were significantly elevated alpha-1-antitrypsin and alpha-2-macroglobulin and orosomucoid levels, whole in patients with late gestoses in the prealbumin levels were reduced. The elevated levels of proteinase inhibitors in late gestoses support the view on a possibly impaired coagulation equilibrium in late gestoses, and the high ceruloplasmin levels suggest an enhanced catecholamine breakdown during the stress alarm reaction.

Within the framework of the stress theory the authors investigated total cortisol levels in the maternal serum during spontaneous delivery and 24 hours after delivery in 20 women half of whom had a non-complicated pregnancy and half had an EPH gestosis. They investigated also cortisol levels in 20 women during delivery by Caesarean section; half of them had a normal pregnancy and half had suffered from gestosis. At the onset of delivery and operation resp. women with gestosis had significantly elevated cortisol levels, as compared with healthy women. During spontaneous delivery the levels of this hormone had a rising trend with the peak during delivery of the foetus and return to pre-delivery values after 24 hours. During Caesarean section the cortisol levels rose only insignificantly and in gestoses they declined already at the end of the operation. In the discussion the authors draw attention to the activation of the stress axes during delivery and attempt to explain the elevated cortisol levels during delivery and in late gestoses.

Using a standard isometric method, the authors investigated the effect of some cations and nifedipine on the contractility of isolated strips of the human uterus in vitro. Evidence was provided that the contractility depends on the extracellular surface concentration of the calcium cation. Under the experimental set-up used intracellular calcium does not play any part and the contractions of the uterine strip depend on the state of the calcium channels.