Prevalence of antibodies to Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma hominis in infertile women

A total of 57 infertile women, who had been referred for in vitro fertilisation or for diagnostic laparoscopy, were tested for the presence of antibodies to Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma hominis. Four were excluded from the study. Of the remaining 53, 33 had laparoscopically obvious tubal disorders, such as adhesions, distal occlusions and strictures, and 20 did not. Antibodies to C trachomatis were found in 7/33 (21.2%) v 0/20, antibodies to N gonorrhoeae in 20/38 (60.6%) v 5/20 (25%), and antibodies to M hominis in 18/24 (75%) women with tubal disorders v 13/19 (68.4%) of those with no disorder. Antibodies to C trachomatis and N gonorrhoeae were significantly (p less than 0.05) more common in women with tubal disorders. The high prevalence of antibodies to N gonorrhoeae in infertile women without tubal disorders suggests that ciliated tubal epithelium is damaged after inflammation without this being laparoscopically visible. Our results confirm the important role of N gonorrhoeae and C trachomatis in the aetiology of infertility after tubal inflammation.

Mucopolysaccharides in suspensions of Treponema pallidum extracted from infected rabbit testes

The amount and nature of mucopolysaccharides present in extraction fluids routinely obtained in the isolation procedure of Treponema pallidum from infected rabbit testes was investigated. The mean quantity of mucopolysaccharides extracted from both testes of groups of 10 rabbits was 3.09 mg after infection for seven days and 26.88 mg after infection for 12 days, while from the testes of uninfected rabbits a mean of 0.42 mg was obtained. On electrophoresis the isolated mucopolysaccharides showed only one single band with the migration characteristics of hyaluronic acid. This band disappeared completely after pretreatment with hyaluronidase from bovine testes, which showed that during infection with T pallidum increasing amounts of hyaluronic acid accumulate. They can, at least in part, be extracted by a gentle extraction procedure, suggesting that this material binds loosely. The amount of hyaluronic acid isolated 12 days after infection showed positive correlations with the wet weight of testes as well as the number of treponemes isolated; seven days after infection such correlations were not present.

Contact stomatitis and dermatitis to nickel and palladium

17 subjects were tested epicutaneously with 22 materials, including Ni, Pd, Cr and Co. 5 subjects with a positive allergic skin reaction to Ni were tested with a pure metallic nickel plate 3 X 5 mm, which was attached to the buccal side of one lower premolar. These 5 subjects all developed local allergic contact stomatitis on the mucosa of the cheek adjacent to the metal plate. This was confirmed histologically. The same oral test with pure metallic palladium gave no reaction in subjects with a positive patch test. A control group gave no reactions to the metal plates. Allergic contact stomatitis was diagnosed with the help of both clinical and histological examinations.

Treatment of non-complicated urogenital, rectal and oropharyngeal gonorrhoea with intramuscular cefotaxime 1.0 g or cefuroxime 1.5 g

In an open randomized study in a large Rotterdam male and female population (n = 1500), suffering from uncomplicated urogenital, rectal and oropharyngeal gonorrhoea treatment with cefotaxime 1.0 g proved to be more effective than with cefuroxime 1.5 g in all patients studied. However, statistically significant differences between the failure rates of the cefotaxime and the cefuroxime treatment were found only for all male and female patients, in urethral or urogenital and rectal infections in this group, for all male patients, and in urethral infections in men. Failure rates were low (1.7 and 5.6%, respectively for cefotaxime and cefuroxime). Oropharygeal gonorrhoea responded less well than urethral or urogenital and rectal gonorrhoea. Both drugs were very effective in the eradication of uncomplicated gonococcal infections caused by both non-beta-lactamase producing and beta-lactamase producing gonococci. High (greater than 30%) post-gonococcal urethritis rates were observed. Side-effects were minor.

Shifts of delayed immune response to persulphates and other allergens

Certain chemicals such as persulphates and formaldehyde are able to induce both immediate and delayed type reactions in the skin. The levels of delayed type response to persulphates (at 48 and 74 h), obtained by epicutaneous tests were subjected to comparative studies of shifts (48 versus 72 h) and statistical analysis. The 95% confidence limit of the mean value of shifts to persulphates was significantly higher than that of a standard routine battery as a whole and, with the exception of formaldehyde, also to that of other individual constituents of this battery. In the case of persulphates, this difference in shifts was due to an extremely low mean value of delayed-type response read at 48 h. The possible underlying mechanisms and the possible limiting rôle of vaso-active amines in the early evolution of delayed-type response is discussed.

Survival of Chlamydia trachomatis in different transport media and at different temperatures: diagnostic implications

We compared the survival of a laboratory strain of Chlamydia trachomatis serovar L-2 in different media and at different temperatures (room temperature, 4 degrees C, and -70 degrees C). At these temperatures the best storage medium was 2SP (0.2 mol/l sucrose in 0.02 mol/l phosphate buffer supplemented with 10% fetal calf serum). We used material obtained from patients to study the sensitivity of the culture method as a function of sample storage time and temperature. Compared with results on direct inoculation, material stored in 2SP for 48 hours gave 11% fewer positive cultures at 4 degrees C and 14% fewer at room temperature. Of samples which gave negative results on direct inoculation, 4% were positive after storage at 4 degrees C for 48 hours and 2% after storage at -70 degrees C for a week. As expected, the number of inclusion forming units in the original material proved to be important for the percentage of positive cultures among the stored samples.

Late prurigo of pregnancy

Seven patients who developed a characteristic pruritic rash in late pregnancy are described. Clinically, the lesions consisted of erythematous urticarial papules and plaques, with vesicles in some cases. The eruption started in the striae on the abdomen and spread over the thighs and in most cases also over the arms and buttocks. Biopsy showed lymphocytic vasculitis with a varying admixture of eosinophils and only minor epidermal changes. Immunofluorescence examination of six cases showed C3 deposition among the dermoepidermal junction in only one case. The lymphocytes, identified by a specific anti-T-cell serum, appeared to be mostly T-cells. The nomenclature of pruritic skin disease in late pregnancy is confusing, but the term 'late prurigo of pregnancy' seems appropriate for this condition.

Sensitization to olive oil (olea europeae)

Sensitization to olive oil is seldom reported in the literature. By use of epicutaneous tests a delayed type of hypersensitivity to pure freshly-prepared olive oil could be demonstrated in two patients. Patch tests with certain major constituents of olive oil; the methyl ester of linoleic acid, the glyceryl ester of palmitic acid, the glyceryl ester of stearic acid, glyceryl trioleate and glycerids of arachidic acid, appeared to be negative. In one patient a weak reaction to balsam of Peru was found. It is concluded that sensitization to olive oil must be taken into consideration, especially when it is used as a vehicle in patch testing.