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3.  Paul Ehrlich: pioneer of chemotherapy and cure by arsenic (1854-1915). 
Paul Ehrlich's experiments in staining techniques at the end of the nineteenth century resulted in many discoveries which help to form the basis of present research work. Ehrlich's chemotherapy research led to his formulating the arsenic compound, Salvarsan, which was used in the treatment of syphilis during the first half of this century until it was superseded by penicillin.
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PMCID: PMC1046247  PMID: 6196079
4.  Chancriform papule. A case report. 
We describe a chancriform papule, a typically chancre like lesion, which was situated well away from the genital area in a patient diagnosed as having secondary syphilis. The diagnosis was confirmed by dark field microscopy, the effectiveness of antisyphilitic treatment, and the presence of a preputial scar.
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PMCID: PMC1046246  PMID: 6640264
5.  Uveitis due to secondary syphilis. 
The incidence of uveitis caused by syphilis has fluctuated during the past century. This paper suggests ways in which the diagnosis of this condition may be helped by reactions to chemotherapy. It also reports on a 22 year old woman presenting with anterior uveitis due to secondary syphilis, who rapidly developed bilateral papilloedema on starting antisyphilitic chemotherapy. She later developed psychiatric symptoms which were partly the result of corticosteroid treatment.
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PMCID: PMC1046245  PMID: 6640263
6.  A reappraisal of non-specific genital infection with reference to the work of the late Dr E. Weston Hurst. 
It is easy to overlook work that is before its time, especially if it has been done in the recent past. In his animal experimental work with Chlamydia spp, the late Dr E. Weston Hurst found that although he was able to effect a clinical cure in his intraperitoneally infected mice, he was unable to eradicate their infections. As his work appears to have relevance to today's growing problems concerning genital infections associated with chlamydiae, it should not fall into obscurity.
PMCID: PMC1046244  PMID: 6357349
7.  Social and psychological factors in the distribution of STD in male clinic attenders. III Sexual activity. 
We report on the relation between various aspects of sexual activity and risk of infection with sexually transmitted disease (STD) in two groups of men attending an STD clinic. Sexual promiscuity appeared to have little effect on the distribution of most STDs, showing a strong association only with gonorrhoea. This finding was contrary to expectation but consistent with the results reported in the first two papers in this series. In contrast to promiscuity, however, sexual orientation subgroups showed a sharp difference in incidence of the major STDs. Hepatitis and syphilis occurred equally commonly among bisexual and homosexual men, but much less commonly among heterosexuals; NSU occurred more commonly among heterosexual men; and gonorrhoea, though common in all three groups, occurred most commonly in bisexual men and least commonly among heterosexuals. For certain STDs the form of intercourse may be as important a risk factor as sexual promiscuity but the precise mechanisms by which sexual orientation influences risk of STD remain undefined.
PMCID: PMC1046243  PMID: 6688961
8.  Social and psychological factors in the distribution of STD in male clinic attenders. II Personality disorders, psychiatric illness, and abnormal sexual attitudes. 
Using standardised questionnaires we examined the possible contributions of psychiatric illness, delinquent and other abnormal personality traits, and disturbed attitudes to sex to the risk of sexually transmitted disease (STD) infection in men attending an STD clinic. We found certain differences in personality and in attitudes between the clinic sample and control men. These differences, however, a) were not comparable with those found in groups of clinically abnormal subjects, b) were confined to homosexual and bisexual men, and c), with the possible exception of gonorrhoea, were not related to risk of STD infection.
PMCID: PMC1046242  PMID: 6688960
9.  Social and psychological factors in the distribution of STD in male clinic attenders. I Demographic and social factors. 
We describe three related studies of possible aetiological risk factors for sexually transmitted diseases (STDs) in men attending an STD clinic. In this paper we present the results for a variety of social and demographic variables traditionally associated with STD. In contrast to the results in the next two papers, these were largely negative. Occurrence rates of overall STD or of hepatitis, syphilis, gonorrhoea, or non-specific urethritis (NSU) had no aetiologically relevant association with age, nationality, marital status, social class, occupation, non-sexual social contact, drug abuse, or aggressive attitudes and behaviour. Gonorrhoea, however, was the only STD which correlated with alcohol abuse and with eating out rather than at home. We conclude that, with the possible exception of gonorrhoea, social factors contribute little to the distribution of STD risk within the study population.
PMCID: PMC1046241  PMID: 6688959
10.  Isolation of Chlamydia trachomatis from prostatic fluid in association with inflammatory joint or eye disease. 
We describe two patients, one with peripheral arthritis, sacro-iliitis, positive HLA B27, and autoantibodies to smooth muscle and gastric parietal cell; the other with aphthoid ulcers, geographical tongue, conjunctivitis, anterior uveitis, peripheral arthralgia, and diarrhoea with distal proctocolitis. Neither patient would have been diagnosed as having urethritis on the basis of accepted microscopic criteria. In both patients, however, Chlamydia trachomatis was isolated from the prostatic fluid, but not the urethra.
PMCID: PMC1046240  PMID: 6640262
11.  A study of inactivation of Chlamydia trachomatis by normal human serum. 
To assess the effect of human serum on the viability of Chlamydia trachomatis, organisms were mixed with unheated and heat inactivated homologous serum, and the numbers surviving after incubation at 37 degrees C for 1 hour were compared. With a pool of sera obtained from 12 donors, the number of chlamydiae surviving incubation in unheated serum was less than 1% of that surviving incubation in heat inactivated serum. The antichlamydial activity of the unheated pooled serum samples could be noticeably reduced by treatment with Mg-EGTA (ethyleneglycolbis (beta-amino ethyl ether)-N,N'-tetra-acetic acid). This indicated a requirement for calcium ions and showed that the alternative pathway of complement activation played only a minor role, if any, in the inactivation process. When 12 serum samples were tested individually it was found that four inactivated chlamydiae to an extent comparable with that seen with the pooled serum. The other eight samples showed only moderate (or slight) antichlamydial activity, with survival rates in unheated serum of 20-60% (or more than 60%) of those in heat inactivated serum. There was no correlation between the titres of antichlamydial antibodies and antichlamydial activity, all serum samples having undetectable or low concentrations of antibody on measurement by micro-immunofluorescence. The antichlamydial activity destroyed by heating was restored, however, when heat inactivated serum was mixed with an equal volume of an unheated serum that was not inhibitory to chlamydiae. When the latter serum was heated before addition antichlamydial activity was not restored, indicating the requirement of both a heat stable and a heat labile factor. This observation and the need for calcium ions for inactivation of chlamydiae are compatable with killing mediated by antibody and complement. Thus serum samples from individuals with no clinical or serological evidence of infection with chlamydiae vary in their ability to inactivate the organism, some having antichlamydial activity which is possibly mediated by antibody and complement.
PMCID: PMC1046239  PMID: 6416608
12.  Imported penicillinase producing Neisseria gonorrhoeae becomes endemic in London. 
We review all cases of gonorrhoea caused by penicillinase producing Neisseria gonorrhoeae (PPNG) seen between 1976 and 1983 at the sexually transmitted disease (STD) clinic of this hospital, which accounted for 11% of all such cases reported in that period in the United Kingdom. While the overall incidence of gonorrhoea remained relatively stable in this clinic, that of PPNG rose to 4.4% of all such cases by 1982. Until last year, 75% of these cases were imported, mainly from Nigeria and Ghana, but a marked change was seen in the second half of 1982, when 71% of cases were indigenous in origin. Casual partners and prostitutes in London were mentioned as the source of infection by 34% of patients, a much higher percentage than that seen previously. Such sources are notoriously difficult to trace and these figures show a very disturbing trend. Although rectal infection tends to be asymptomatic, PPNG was isolated in rectal cultures from two of five homosexuals and 19 of 26 women. There is therefore a risk that PPNG could spread rapidly through the homosexual population. We suggest that spectinomycin should no longer be the first drug of choice in the treatment of gonorrhoea caused by PPNG but should be replaced by the newer cephalosporins.
PMCID: PMC1046238  PMID: 6416607
13.  Studies of rabbit testes infected with Treponema pallidum. II Local synthesis of antibodies. 
Samples of serum and testicular fluid from normal rabbits and those infected with Treponema pallidum were examined for total protein, albumin, IgG, and IgM concentrations. Total protein concentrations were similar in testicular fluid from normal and infected animals but were lower than in serum. The concentrations of individual proteins in serum did not differ substantially between infected and non-infected rabbits. In testicular fluid, however, the concentrations of all three proteins, especially IgM, were greater in infected rabbits. A significantly (p less than 0.02) raised testis-IgM index, together with a higher concentration of anti-treponemal IgM in the infected testicular fluid than in autologous serum, suggests local synthesis of IgM antibodies.
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PMCID: PMC1046237  PMID: 6416606
14.  Studies of rabbit testes infected with Treponema pallidum. I Immunopathology. 
Rabbit testes were injected with suspensions of Treponema pallidum, washed T pallidum, heat killed T pallidum, or Reiter treponemes. The testes were removed three to 24 days after injection and examined for the number of treponemes, the presence of treponemal antibodies, histopathological changes, and presence of T and B cells. In animals infected with T pallidum a substantial number (10(6)-10(7)/ml) of organisms were still present at day 24 in spite of early local production of antibodies and increasing infiltration with plasma cells, T lymphocytes, and macrophages. In animals infected with washed T pallidum a lower degree of inflammation was observed than in those infected with unmodified T pallidum, and the treponemal antibodies were detected simultaneously in samples of testicular fluid and serum. In the groups injected with heat killed T pallidum and Reiter treponemes no macroscopical or microscopical changes were detected, although in the group injected with heat killed T pallidum treponemal antibodies were detected in the testicular fluid on day 24.
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PMCID: PMC1046236  PMID: 6357348
15.  Abstracts 
PMCID: PMC1046233
22.  A survey of sexually transmitted disease centres in Australia. 
In a nationwide survey carried out in 1981 centres offering free treatment for sexually transmitted diseases (STD) were located and the facilities available to the public were assessed. At least one special centre was located in each of the eight states and territories of Australia, but not in all cases did the clinics meet the basic requirements recommended by the Australian National Health and Medical Research Council. The STD clinics were almost exclusively found in capital cities, leaving large populations with no locally available specialist advice. The major centres, with one or two notable exceptions, were open only during routine office hours. In several centres staffing levels were barely adequate to cope with patient loads let alone deal with other important work required of reference centres--the training of health care workers, education of high risk groups, and institution of STD control programmes. In several respects the sexually transmitted diseases services in Australia were found to be inadequate to meet the needs of the population.
PMCID: PMC1046221  PMID: 6688541
23.  Natural history of cervical epithelial abnormalities in patients with vulval warts. A colposcopic study. 
The natural history of intraepithelial abnormalities of the cervix associated with human papillomavirus infection was investigated in a prospective study of 50 women with vulval warts, of whom 28 had colposcopic evidence of a cervical epithelial abnormality and 22 a normal cervix. Of the 28 with a cervical abnormality, 26 were re-examined by colposcopy after three months; the epithelial abnormality had persisted in 23 women. Nineteen women who had initially shown abnormality by colposcopy were re-examined six months after their first attendance; the epithelial abnormality had persisted in 14 women. Of the 22 women who initially had a normal cervix, 19 were re-examined after three months; the cervix remained normal in 18, but an epithelial abnormality had developed in one. Fourteen women who initially had a normal cervix were re-examined six months after their first attendance; the cervix was still normal in 11, but an epithelial abnormality had developed in three. Colposcopically directed biopsy specimens were obtained from 21 women who showed an epithelial abnormality; of these, evidence of wart virus infection was present in four, cervical intraepithelial neoplasia in two, both conditions in 13, and no abnormality in two. It is concluded that lesions of the cervix associated with wart virus infection show little evidence of short term regression.
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PMCID: PMC1046220  PMID: 6311324
24.  Intraoral condylomata acuminata. A case report. 
Condylomata acuminata occurred intraorally in a 6 year old Nigerian girl. Since she had no skin or genital lesions and no history of sexual contact, the virus was probably acquired from environmental sources. Non-sexual modes of transmission should, therefore, be considered, particularly when the lesions are extragenital.
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PMCID: PMC1046219  PMID: 6311323
25.  Treatment of chancroid. A comparison of sulphamethoxazole and trimethoprim-sulphamethoxazole. 
Since sulphonamides are no longer predictably effective in the treatment of chancroid the combination of trimethoprim-sulphamethoxazole (TMP-SMX) was evaluated to identify other effective regimens. One hundred and nine patients with genital ulcers (75 men and 34 women) seen at the Special Treatment Clinic in Nairobi, Kenya, were randomly assigned to treatment with a seven day course of either sulphamethoxazole 1000 mg twice daily or trimethoprim (160 mg)-sulphamethoxazole (800 mg) (TMP-SMX) twice daily. Haemophilus ducreyi was isolated from the ulcer in 57 patients (33 men and 24 women). 16 patients were subsequently diagnosed serologically as having syphilis. No aetiological diagnosis was made in 40 patients. Treatment with sulphamethoxazole failed in five of 21 (24%) culture positive patients who were available for evaluation after seven days, whereas all 19 of such patients who were treated with TMP-SMX responded to treatment. Of the 21 isolates available for susceptibility testing, all were susceptible to trimethoprim alone (MIC less than 0.5 mg/l) and three were resistant to sulphonamides, all three containing a 4.9 megadalton (Mdal) plasmid. Two of the three patients from whom these isolates had been obtained were treated with sulphamethoxazole and both were clinical and bacteriological failures. Five of six patients with sulphonamide-susceptible H ducreyi responded to treatment with sulphamethoxazole. Failure of sulphonamides to eradicate H ducreyi in some patients with chancroid is associated with the presence of a sulphonamide resistant plasmid. In regions where this plasmid is present in H ducreyi TMP-SMX is the preferred treatment for chancroid.
PMCID: PMC1046218  PMID: 6351957

Results 1-25 (121)