Treatment of men with urethritis negative for Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyticum

OBJECTIVE: Some patients with symptomatic non-gonococcal urethritis (NGU) are negative for Chlamydia trachomatis, mycoplasmas and ureaplasmas. The optimal antimicrobial chemotherapy for such NGU has not fully been elucidated, though many studies of antimicrobial chemotherapies for C. trachomatis-positive NGU have been performed. We assessed the efficacy of antimicrobial agents that are active against C. trachomatis on non-mycoplasmal, non-ureaplasmal and non-chlamydial NGU (NMNUNCNGU). METHODS: One hundred men whose first-pass urine samples were negative for C. trachomatis, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum, and Ureaplasma urealyticum were treated with levofloxacin, gatifloxacin, minocycline, or clarithromycin for 7 days. Urethritis symptoms and the presence of polymorphonuclear leukocytes (PMNL) in urethral smears were assessed before and after treatment. RESULTS: Eighty-eight (88.0%) of 100 men with NMNUNCNGU showed no signs of urethral inflammation after treatment, but two men complained of some symptoms of urethritis. Twelve (12.0%) of 100 men had significant numbers of PMNL in urethral smears, but five of these 12 men had no symptoms of urethritis. The efficacy for normalization of urethral smears was 90.7% for clarithromycin, 89.7% for levofloxacin, 87.5% for gatifloxacin, and 75.0% for minocycline. The 12 men who showed signs of urethral inflammation were retreated with levofloxacin, gatifloxacin, minocycline or clarithromycin for an additional 7 days. The 10 men who returned after the second treatment had negative urethral smears. CONCLUSION: Our present findings suggest that antimicrobial agents active against C. trachomatis are effective against NMNUNCNGU and that a 7-day treatment regimen with an appropriate antimicrobial agent may be sufficient to manage patients with NMNUNCNGU.     

Azithromycin treatment for nongonococcal urethritis negative for Chlamydia trachomatis,Mycoplasma genitalium,Mycoplasma hominis,Ureaplasma parvum,and Ureaplasma urealyticum

Some patients with nongonococcal urethritis (NGU) are negative for Chlamydia trachomatis, mycoplasmas, and ureaplasmas. The optimal antimicrobial chemotherapy for such NGU has not fully been clarified. We assessed the efficacy of azithromycin for treatment of nonmycoplasmal, nonureaplasmal, nonchlamydial NGU (NMNUNCNGU). Thirty‐eight men whose first‐pass urine was negative for Chlamydia trachomatis, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum, and Ureaplasma urealyticum were treated with a single dose of 1 g azithromycin. Urethritis symptoms and polymorphonuclear leukocytes in urethral smears or in first‐pass urine were assessed before and after treatment with azithromycin. Thirty‐two (84.2%) of the 38 men with NMNUNCNGU showed no signs of urethral inflammation after treatment. The efficacy of this azithromycin regimen was comparable to that of the 7‐day regimen of levofloxacin, gatifloxacin, minocycline, or clarithromycin reported previously. A single dose of 1 g azithromycin, which is effective not only for NGU due to specific pathogens but also for NMNUNCNGU, is an appropriate treatment for NGU.     

Assessment of Chlamydia trachomatis, Ureaplasma urealyticum, Ureaplasma parvum, Mycoplasma hominis, and Mycoplasma genitalium in semen and first void urine specimens of asymptomatic male partners of infertile couples

The purpose of this study was threefold: to compare semen and first void urine (FVU) specimens from asymptomatic infertile men for the detection of Chlamydia trachomatis, genital ureaplasma, and genital mycoplasma infections using in-house inhibitor-controlled polymerase chain reaction (PCR)-microtiter plate hybridization assay; to determine the prevalence of those organisms in infertile men in Tunisia; and to study the relationship between these bacteria and male infertility. Paired urine and semen specimens from 104 patients were examined by in-house PCR for the presence of DNA of Chlamydia trachomatis, genital ureaplasmas (Ureaplasma urealyticum and Ureaplasma parvum) and genital mycoplasmas (Mycoplasma hominis and Mycoplasma genitalium). Semen analysis was assessed according to the guidelines of the World Health Organization. Nominal scale variables, the Mann-Whitney test, and the Kruskal-Wallis nonparametric analysis of variance test were used for statistical analysis. There was a very high concordance (>95%) and a very good agreement (kappa > 0.9) between the detection of Chlamydia trachomatis, genital ureaplasmas, and Mycoplasma hominis in semen and corresponding FVU specimens. Our findings also show a high concordance (81.1%) and a good agreement (kappa = 0.79) between the detection of Mycoplasma genitalium in both specimens. C trachomatis, genital mycoplasmas, and genital ureaplasmas were found to be widespread among infertile male patients in Tunisia, as shown by their respective prevalences of 43.3%, 18.3%, and 14.4%. The mean values of seminal volume, sperm concentration, sperm viability, sperm motility, sperm morphology, and leukocyte count were not significantly related either to the detection of C trachomatis DNA or to that of genital ureaplasma or mycoplasma DNA in semen specimens. Using our in-house PCR, both semen and FVU were found to be sensitive diagnostic specimens for the detection of C trachomatis, ureaplasmas, and mycoplasmas. The FVU, a less invasive and self-collected specimen, can serve as a marker for the presence of these organisms in the genital tract and can be used as a reliable way of detecting asymptomatic carriers of infection.     

男性非淋菌性尿道炎患者支原体对抗菌药物的敏感性

目的:了解支原体在男性非淋菌性尿道炎(NGU)的作用和体外对药物敏感性。方法:对864例疑为NGU的男性患者泌尿生殖道标本进行了支原体型别鉴定,用微量肉汤稀释法对支原体进行9种抗菌药物的敏感性测定。结果:272例(31.4%)支原体培养阳性,其中解脲支原体(Uu)176例,人型支原体(Mh)9例;Uu Mh混合感染87例。97.2%的支原体对9种抗菌药物有不同程度的耐药。Uu Mh混合感染的耐药率明显高于单纯Uu感染。结论:Uu Mh混合感染耐药性升高并发生耐药谱变化。对支原体的定期耐药性监测,对临床用药有重要指导意义。     

Ureaplasma urealyticum and Mycoplasma hominis in men attending for routine semen analysis. Prevalence, incidence by age and clinical settings, influence on sperm characteristics, relationship with the leukocyte count and clinical value

AIM: To investigate the clinical value of the screening of Ureaplasma urealyticum and Mycoplasma hominis in routine semen analysis. MATERIAL AND METHODS: Semen samples of 234 patients with several clinical settings (infertility, varicocele, spontaneous abortion, genital infections, undescended testicles, hemospermia, etc.) were distributed in three study groups: group 1--negative cultures; group 2--normal colonization (< or =10(3) colony-forming units (cfu)/ml), and group --pathogenic colonization (>10(3) cfu/ml). Frequency rates, incidence by age and clinical settings, association with abnormal sperm characteristics (density, vitality, motility and morphology) and with the leukocyte count were investigated. RESULTS: Prevalence of U. urealyticum was higher than M. hominis (< or = 10(3) cfu/ml: 28.2 vs. 24.8%; >10(3) cfu/ml: 20.5 vs. 13.3%). No difference was detected on the incidence of mycoplasmas by age and clinical settings, as well as in regard to the mean values of sperm density, vitality, motility, oval-headed sperm and leukocyte count (p > 0.05). CONCLUSION: In spite of the high incidence of mycoplasmas, not enough information was available regarding the influence of these microorganisms on the sperm quality and their relationship with the leukocyte count. Therefore, screening of U. urealyticum and M. hominis for routine semen analysis is not clinically relevant.     

Detection of Chlamydia trachomatis with a direct specimen test (MicroTrack) in urethritis patients

The urethral smear specimens from 197 male urethritis patients attending our department and 4 affiliated hospitals were examined for Chlamydia trachomatis between April, 1984 and May, 1985, using fluorescein-labeled monoclonal antibodies (Direct Specimen Test; MicroTrack, Syva Co., USA). C. trachomatis was detected in 7 (25.0%) out of 28 patients with gonococcal urethritis, and 83 (49.1%) out of 169 patients with nongonococcal urethritis. The detection rates were almost comparable to those of other reports that used the cell culture method. The direct test is a time-saving, non-culture method useful for the diagnosis of chlamydial infection.     

Epstein-Barr virus hepatitis: diagnostic value of in situ hybridization, polymerase chain reaction, and immunohistochemistry on liver biopsy from immunocompetent patients

Epstein-Barr virus (EBV) hepatitis is an uncommon, almost always self-limited disease in immunocompetent patients. Accurate diagnosis is imperative for appropriate clinical management. The aim of this study was to compare 3 available methods for EBV detection on routinely processed liver biopsies to determine their effectiveness in aiding the diagnosis. In 6 of the 8 cases of EBV hepatitis, EBV was detected by both polymerase chain reaction (PCR) for EBV DNA and in situ hybridization (ISH) for EBV early RNA (EBER). EBV was detected by PCR only in 1 case, and by ISH only in another. EBER-positive cells detected by ISH were typically few and individually distributed in the portal tracts and sinusoids. Immunohistochemical staining for EBV latent membrane proteins was negative in all 8 cases. Five cases of chronic hepatitis C used as negative controls were negative by all 3 detection methods for EBV. These data indicate that PCR and ISH are equally sensitive in detecting EBV in routinely processed liver biopsies. The ready implementation of ISH in pathology laboratories makes it a useful ancillary tool in confirming the diagnosis of EBV hepatitis in equivocal cases. However, EBER-positive cells can be sparse and easily overlooked. Immunohistochemistry for EBV latent membrane proteins apparently has no utility in the diagnosis of EBV hepatitis.     

SLC35F2在非小细胞肺癌中的表达及意义

目的 探讨人类溶质载体家族35成员F2(SLC35F2)在非小细胞肺癌(NSCLC)中的表达及意义.方法 选取于我中心行手术治疗的NSCLC患者52例,43例使用Trizol法处理肿瘤组织提取总RNA,9例将手术切除标本制成冰冻切片,使用激光捕获显微切割(LCM)技术分离得到NSCLC组织中的单一纯净癌细胞提取总RNA,两组均采用荧光实时定量PCR SYBR GREEN法检测SLC35F2基因表达,并与癌旁正常肺组织进行对比.结果 普通方法与LCM方法检测的SLC35F2基因在NSCLC细胞或组织中的表达量均明显高于其在癌旁正常肺组织中的表达(NSCLC 2.460±0.970比癌旁正常0.006±0.001,P<0.05),相关性分析及方差分析均证实病理分期与SLC35F2在NSCLC组织中相对表达量明显相关(早期0.30±0.14比晚期4.80±1.93,P<0.01).结论 SLC35F2可能是与NSCLC发病相关的原癌基因.     

SLC35F2在非小细胞肺癌中的表达及意义

Objective To evaluate the expression of Homo sapiens solute carrier family 35 member F2 (SLC35F2) in non-small-cell lung cancer (NSCLC). Methods Fifty-two cases of NSCLC and corresponding adjacent normal lung tissues were obtained by surgery in our center. Forty-three cases of the tissues were treated with Trizol as traditional method. Nine cases of the tissues were made into frozen slides firstly, then the carcinoma cells were separated by laser capture microdissection respectively from NSCLC tissues. The expression of SLC35F2 was detected by the method of quantitative real-time polymerase chain reaction. Results In both two groups, the data demonstrated that SLC35F2 expression was significantly up-regulated in NSCLC cells and tissues as compared with corresponding adjacent normal lung tissues ( NSCLC 2.460 ±0. 970 vs Normal 0. 006 ±0. 001 ,P <0. 05). The tumor pathology stage had a correlation with the expression of SLC35F2 ( Early stage 0. 30 ± 0. 14 vs Advanced stage 4. 80 ± 1. 93,P < 0. 01). Conclusion SLC35F2 was a potential oncogene of NSCLC.     

SLC35F2在非小细胞肺癌中的表达及意义

Objective To evaluate the expression of Homo sapiens solute carrier family 35 member F2 (SLC35F2) in non-small-cell lung cancer (NSCLC). Methods Fifty-two cases of NSCLC and corresponding adjacent normal lung tissues were obtained by surgery in our center. Forty-three cases of the tissues were treated with Trizol as traditional method. Nine cases of the tissues were made into frozen slides firstly, then the carcinoma cells were separated by laser capture microdissection respectively from NSCLC tissues. The expression of SLC35F2 was detected by the method of quantitative real-time polymerase chain reaction. Results In both two groups, the data demonstrated that SLC35F2 expression was significantly up-regulated in NSCLC cells and tissues as compared with corresponding adjacent normal lung tissues ( NSCLC 2.460 ±0. 970 vs Normal 0. 006 ±0. 001 ,P <0. 05). The tumor pathology stage had a correlation with the expression of SLC35F2 ( Early stage 0. 30 ± 0. 14 vs Advanced stage 4. 80 ± 1. 93,P < 0. 01). Conclusion SLC35F2 was a potential oncogene of NSCLC.     

利用逆转录聚合酶链反应及DNA印迹杂交技术检测乳腺癌腋窝淋巴结微转移

目的　评价检测原发性乳腺癌腋窝淋巴结微转移的方法。方法　用逆转录聚合酶链反应(RT-PCR)和Southern杂交方法,检测腋窝淋巴结中CK-19基因表达。同时与免疫组织化学(组化)方法比较其检测敏感性。结果　RT-PCR、Southern杂交及免疫组化方法的检测敏感性分别为1∶5×10     

Negative bacterial polymerase chain reaction (PCR) findings in prostate tissue from patients with symptoms of chronic pelvic pain syndrome (CPPS) and localized prostate cancer

BACKGROUND: The etiology of chronic pelvic pain syndrome (CPPS) remains obscure. Although, bacterial etiology has frequently been suggested, evidence of both bacterial involvement in CPPS and the presence of normal bacterial flora in the prostate remain uncertain. MATERIALS AND METHODS: We investigated the presence of bacterial DNA using polymerase chain reaction (PCR) techniques on prostatic tissue samples obtained in radical prostatectomy from 10 patients with moderate to severe symptoms of CPPS and 10 nonsymptomatic patients with localized prostate cancer. For symptom evaluation we used the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI). RESULTS: All but one sample were negative for bacterial DNA. The PCR from a symptomatic patient was reproducibly positive in 16S rDNA PCR but negative in 23S rDNA PCR. Bacterial DNA was found in only one out of two sample aliquots and cloning yielded different sequences in two PCR products. CONCLUSIONS: A bacterial etiology for CPPS symptoms could not be demonstrated in patients with prostate cancer. The results also suggest that the prostate is unlikely to harbor bacterial normal flora.     

Increased levels of alpha-defensin (-1, -2 and -3) in type 1 diabetic patients with nephropathy.

OBJECTIVE: Diabetic nephropathy is associated with low-grade inflammation and activation of the complement system. Defensins, as part of the innate immune system, may play a regulatory role in the complement cascade and may also augment the production of proinflammatory cytokines. The aim of this study was therefore to elucidate whether alpha-defensin is associated with diabetic nephropathy, low-grade inflammation and lipid profiles. RESEARCH DESIGN AND METHODS: Data were obtained from 189 patients with type 1 diabetes selected from the FinnDiane Study. Patients were divided into three groups according to their albumin excretion rate (AER) in three consecutive overnight or 24-h urine collections: normoalbuminuria (AER <20 microg/min or <30 mg/24 h), microalbuminuria (20 200 microg/min or >300 mg/24 h). Alpha-defensin was determined by a novel, solid-phase radioimmunoassay (RIA) based on a monoclonal antibody, which recognizes alpha-defensin isoforms 1-3. RESULTS: Total serum alpha-defensin (-1, -2 and -3) concentrations were higher (P < 0.001) in patients with macroalbuminuria compared to micro- and normoalbuminuria, but no difference was observed between normoalbuminuria and microalbuminuria. In multiple linear regression analysis alpha-defensin was associated with systolic blood pressure (P = 0.032), HDL-cholesterol (P = 0.013), total cholesterol (P = 0.008), age (P = 0.001) and estimated glomerular filtration rate (P = 0.001), but not with low-grade inflammatory markers. CONCLUSIONS; Serum alpha-defensin (-1, -2 and -3) concentrations are increased in type 1 diabetic patients with diabetic nephropathy.     

巢式RT-PCR定量检测肝癌、癌旁组织及正常肝组织内AFPmRNA

目的:探讨肝癌、癌旁组织及正常肝组织内AFPmRNA的表达含量 。方法:应用巢式RT-PCR定量检测肝癌、癌旁组织及正常肝组织内AFPmRNA 。结果:17例AFP（+）癌旁组织内AFPmRNA表达强阳性（+++）,其癌旁组织内AFPmRNA表达呈中度阳性（++）。15例AFP（-）肝癌、癌旁组织及正常肝组织内AFPmRNA表达弱阳性（+） 。结论:AFP（+）肝癌组织过量表达AFPmRNA基因,正常肝组织仅微弱表达AFPmRNA。     

Detection of serum and urinary lipoprotein(a) in patients with renal diseases

We measured and analysed serum and urinary lipoprotein(a) [Lp(a)] in 73 patients with various renal diseases, and 168 control subjects. The results revealed that serum Lp(a) levels were significantly elevated in patients with mesangial proliferative glomerulonephritis, membranous nephropathy, chronic renal failure and diabetic nephropathy, except patients with IgA nephropathy (IgAN) with gross haematuria. Serum Lp(a) concentrations were found to be significantly correlated with serum albumin ( r =−0.5033, P <0.001) and urinary protein excretion ( r =0.3541, P <0.005), while not with serum creatinine ( r =−0.0144, P >0.05). Patients with selective urinary protein excretion had a lower serum Lp(a) level than those with non-selective urinary protein excretion. The correlation between serum albumin and serum Lp(a) levels remained significant ( P <0.001) after adjustment for serum creatinine, urinary protein excretion and the selectivity of urinary protein by multivariate regression analysis. Urinary Lp(a) excretion was decreased and related to the serum creatinine level ( r =−0.312, P <0.01). Our conclusion is that renal patients with proteinuria and hypoalbuminemia tend to have elevated levels of Lp(a) which are more significantly correlated to serum albumin levels than other parameters such as serum 24-h urinary protein, selectivity of urinary protein and serum creatinine; while urinary Lp(a) excretion varies inversely with serum creatinine levels.     

Detection of serum and urinary lipoprotein(a) in patients with renal diseases

SUMMARY: We measured and analysed serum and urinary lipoprotein(a) [Lp(a)] in 73 patients with various renal diseases, and 168 control subjects. the results revealed that serum Lp(a) levels were significantly elevated in patients with mesangial proliferative glomerulonephritis, membranous nephropathy, chronic renal failure and diabetic nephropathy, except patients with IgA nephropathy (IgAN) with gross haematuria. Serum Lp(a) concentrations were found to be significantly correlated with serum albumin ( r =−0.5033, P <0.001) and urinary protein excretion ( r = 0.3541, P <0.005), while not with serum creatinine ( r =−0.0144, P >0.05). Patients with selective urinary protein excretion had a lower serum Lp(a) level than those with non-selective urinary protein excretion. the correlation between serum albumin and serum Lp(a) levels remained significant ( P <0.001) after adjustment for serum creatinine, urinary protein excretion and the selectivity of urinary protein by multivariate regression analysis. Urinary Lp(a) excretion was decreased and related to the serum creatinine level ( r =−0.312, P <0.01). Our conclusion is that renal patients with proteinuria and hypoalbuminemia tend to have elevated levels of Lp(a) which are more significantly correlated to serum albumin levels than other parameters such as serum 24-h urinary protein, selectivity of urinary protein and serum creatinine; while urinary Lp(a) excretion varies inversely with serum creatinine levels.