Direct detection of Chlamydia trachomatis with monoclonal antibodies

A total of 571 specimens obtained from the Heidelberg outpatient clinic for sexually transmitted diseases (STD) and 254 specimens sent in by mail were examined for Chlamydia trachomatis, using a direct immunofluorescence technique with monoclonal antibodies and tissue culture. With respect to tissue culture, the sensitivity of specimens from male STD patients was 77% and specificity was 99%; for specimens from female STD patients the corresponding values were 77% and 96%, respectively. In female prostitutes the sensitivity of specimens reached only 55%, and specificity in this group was 96%. Follow-up of the patients with discrepant results confirmed the results of the test, which had initially indicated the chlamydial infection. In the material sent in by mail, the detection rate of C. trachomatis by direct immunofluorescence with monoclonal antibodies was significantly higher than in tissue culture. When specimens have to be transported long distances, the direct test with monoclonal antibodies has proved to be superior to tissue culture. However, the advantage of this test (Micro Trak) is counterbalanced by a relatively low sensitivity.     

Evaluation of a radioactive rRNA:cDNA-hybridisation assay for the direct detection of Chlamydia trachomatis in urogenital specimens.

A radioactive cDNA probe complementary to chlamydial ribosomal RNA was used to detect C trachomatis in urogenital specimens. Of 37 specimens positive with cell culture 31 were confirmed by the rRNA:cDNA hybridisation test, the sensitivity being 83.8%. The specificity of the hybridisation test was 94.4%, as 186 of 197 specimens that were negative by cell culture were also negative when assessed by the hybridisation method. Given a prevalence of 15.8% the predictive values for positive and negative results were 73.8% and 96.9%, respectively. In additional experiments the possible role of microorganisms added to the specimen collection medium was investigated. However, no indication for crosshybridisation was found; at high concentrations microorganisms interfered with the test procedure.     

Hodgkin's disease in HIV infection--detection of Epstein-Barr virus DNA in tongue epithelium and lymphoma]

We present an HIV-infected patient with lymphadenopathy syndrome in whom an unusually aggressive case of Hodgkin's disease developed. Examination of tissue excised from the lymphoma and of epithelial cells scraped from the tongue of the patient revealed Epstein-Barr virus (EBV). The relationship between an enhanced replication of EBV in the epithelium of the tongue and the elevated frequency of Hodgkin's lymphomas containing EBV-DNA among HIV-infected patients is discussed.     

Epidemiological analysis of Neisseria gonorrhoeae in the Federal Republic of Germany by auxotyping and serological classification using monoclonal antibodies.

We evaluated a new serological classification system for Neisseria gonorrhoeae based on monoclonal antibodies directed against epitopes on the outer membrane protein I, in conjunction with auxotyping, to analyse gonococci from two cities in the Federal Republic of Germany. Isolates of N gonorrhoeae were collected during 1976-8 and 1980-2 in Lübeck, and during 1980-2 in Heidelberg. Between the two study periods in Lübeck, we observed an appreciable decrease in strains of the auxotype that requires arginine, hypoxanthine, and uracil (AHU-) and with serovar class PrIA-1 and the emergence of strains with the proline requiring auxotype and PrIB-1 serovar class. Serovar PrIA-1 accounted for 89 (97%) of 92 strains with the AHU- auxotype as opposed to 12 (4%) of 297 strains with other auxotypes (p less than 0.0001). Disseminated gonococcal infection was associated with AHU-/PrIA-1 strains. Penicillinase producing N gonorrhoeae (PPNG) strains belonged to eight different auxotype and serovar classes, which indicated that different strains had been imported. Classification of strains of N gonorrhoeae by auxotype and serovar class permits analysis of temporal changes in gonococcal populations, and of migrations of gonococci between different geographical areas. Typing N gonorrhoeae, together with assessing antibiotic susceptibilities, may prove useful for further studies of the epidemiology and control of gonorrhoea.     

Der gepulste Farbstofflaser – Möglichkeiten und Grenzen

Zusammenfassung Der gepulste Farbstofflaser (Wellenl?nge 585 nm, Pulsdauer 0,3–0,45 ms) eignet sich sehr gut zur schonenden Therapie von Feuermalen, initialen H?mangiomen, Teleangiektasien, Spider N?vi, Xanthelasmen, Talgdrüsenhyperplasien und flachen roten hypertrophen Narben. Bei kindlichen Feuermalen gilt der gepulste Farbstofflaser als Therapie der Wahl. Begrenzt werden seine Einsatzm?glichkeiten durch die relativ geringe Eindringtiefe von maximal 1,5 mm. In der folgenden übersicht wird über die Einsatzgebiete und Grenzen des gepulsten Farbstofflasers berichtet. Eingegangen am 14. Mai 1996 Angenommen am 15. November 1996     

Cardiovascular dynamics during peroral endoscopic myotomy for esophageal achalasia: a prospective observational study using non-invasive finger cuff-derived pulse wave analysis

Peroral endoscopic myotomy (POEM) is natural orifice transluminal endoscopic surgery to treat esophageal achalasia. During POEM, cardiovascular dynamics can be impaired by capnoperitoneum, capnomediastinum, and systemic carbon dioxide accumulation. We systematically investigated changes in cardiovascular dynamics during POEM. We included 31 patients having POEM in this single-center prospective observational study. Before and every 5 min during POEM we measured mean arterial pressure (MAP), heart rate (HR), cardiac index (CI), stroke volume index (SVI), and systemic vascular resistance index (SVRI) using non-invasive finger cuff-derived pulse wave analysis. During POEM, the median MAP was higher than the median baseline MAP of 77 (67;86) mmHg. HR (median at baseline: 67 (60;72) bpm), CI (2.8 (2.5;3.2) L/min/m²), SVI (42 (34;51) mL/m²), and SVRI (1994 (1652; 2559) dyn × s × cm^?5 × m^?2) remained stable during POEM. Mixed model-derived 95% confidence limits of hemodynamic variables during POEM were 72 to 106 mmHg for MAP, 65 to 79 bpm for HR, 2.7 to 3.3 L/min/m² for CI, 37 and 46 mL/m² for SVI, and 1856 and 2954 dyn × s × cm^?5 × m^?2 for SVRI. POEM is a safe procedure with regard to cardiovascular dynamics as it does not markedly impair MAP, HR, CI, SVI, or SVRI.

     

Effect of a corticosteroid additive on the result of local therapy of bacterial superinfection in tinea pedis intertriginosa]

Sixty cases of tinea pedum intertriginosa were topically treated in a double-blind trial. In 34 cases a cream was used, which contained 5-chloro-8-hydroxyquinoline, gentamycin and fluprednyliden-21-acetate. In 26 cases a cream was used, which contained 5-chloro-8-hydroxyquinoline and gentamycin alone. Treatment was continued over three weeks. In weekly intervalls mycological, bacteriological and clinical controls were performed, which showed that the steroid-component had no disadvantageous effect on the course of infection. In contrast the steroid containing preparation proved to be slightly superior.     

Sensitivity of Neisseria gonorrhoeae to penicillin in West Germany.

The sensitivity of gonococci to penicillin in Germany has largely decreased in the last 22 years. No significant decrease has occurred, however, in the last three years, but the results show that a slight tendency to decrease may be persisting.