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5.  Which Neisseria? 
A case of disseminated gonococcal infection in which the gonococcus was isolated from the blood and genitalia and the meningococcus from the throat is described. A second patient, in whom the meningococcus was isolated from the throat and the gonococcus from the genitals but in whom no organisms were recovered from the blood, had lesions resembling those of a disseminated infection. The results of 150 throat cultures from patients who were examined at a clinic because they had a history of oral sexual intercourse are presented. The meningococcus was isolated nearly six times more often in patients with genital gonorrhoea than in those in whom genital cultures were negative, while the gonococcus was found 2 1/2 times more often in those who carried the meningococcus in the throat than in those who did not. If these findings can be confirmed it could indicate an individual susceptibility to the acquisition of Neisserian organisms that would merit further investigation.
PMCID: PMC1045452  PMID: 414818
6.  Unusual location of condyloma lata. A case report. 
The case of a woman with secondary syphilis is described. The outstanding features were the presence of condylomata lata of the axilla and vulva as well as of the anal region.
PMCID: PMC1045451  PMID: 606337
8.  A patient with primary syphilis of the hand. 
The case history of a man with primary syphilis of the right hand is described. This type of luetic condition nowadays is rare. The incidence of genital, anorectal, and extragenital primary syphilis in both men and women and in sailors presenting at the Venereological Outpatient Clinic of the Department of Dermatology of the University Hospital Rotterdam-Dijkzigt during a period of seven years was studied. In sailors and women only genital primary lesions were found, whereas in male civilians 6.3% of cases of primary syphilis had anorectal lesions. The primary lesions in this study were different from those reported in earlier literature.
PMCID: PMC1045449  PMID: 606335
9.  Benign transient lymphangiectasis (sclerosing lymphangitis) of the penis 
The literature on benign transient lymphangiectasis of the penis (BTLP) was reviewed; reports of 45 cases were collected and a further series, comprising 21 cases, is presented. Both the published and present series support the view that BTLP is associated with recent sexual activity; little support is given for an infective cause and it is confirmed that BTLP is a benign, self-limiting condition presenting in the sexually active man between 20 and 40 years old. There can be recurrences, and susceptibility to them may be encouraged by circumcision in which disturbances of lymphatic drainage may play a part. As so few cases have been reported and few were diagnosed in the present series these comments can only be pointers to further studies. The descriptions in six histological examinations, the reports as `phlebitis' of apparently similar lesions, the report of `sclerosing lymphangitis' in other sites, and the known histological similarity between veins and lymphatics suggest that `sclerosing lymphangitis' is too specific a term. Until further knowledge is available, we suggest that this condition is best regarded as simple dilatation of a lymphatic vessel—namely, lymphangiectasis. As the condition is both benign and transient we propose the term benign transient lymphangiectasis of the penis for the condition formerly known as sclerosing lymphangitis.
PMCID: PMC1045448  PMID: 606334
10.  Antibodies to Candida albicans in human cervicovaginal secretions. 
The incidence of IgA and IgG antibodies against Candida albicans was determined in cervicovaginal secretions from 95 non-pregnant women. IgG antibodies were detected in 21.2% of women with vaginal candidosis, in 23.5% of women harbouring yeasts in the vagina without clinical signs of infection, and in 26.6% of women not harbouring yeasts in the vagina. IgA antibodies were found in 6.1% of women with vaginal candidosis, in 5.9% of women harbouring yeasts in the vagina without clinical signs of infection, and in 8.9% of women not harbouring yeasts in the vagina. IgG antibodies against C. albicans were detected in the serum of all 95 women. It is suggested that a proportion of the antibodies found in the secretions was derived from the circulation.
PMCID: PMC1045447  PMID: 342069
11.  Hepatitis-B surface antigen and antibody in Black and White patients with venereal diseases. 
The prevalence of both the hepatitis-B surface antigen (HBsAg) and its specific antibody (anti-HBs) was significantly greater in the sera of White patients suffering from sexually transmitted diseases than that in White blood donors. However, Black patients with venereal diseases did not show an increased prevalence of either HBsAg or anti-HBs. These findings support the view that heterosexual transmission of the hepatitis-B virus is less likely to occur in populations in whom this infection is largely acquired before the age of sexual maturity.
PMCID: PMC1045446  PMID: 580069
12.  The possible role of anaerobic bacteria in the aetiology of non-gonococcal urethritis in men. 
Men with non-gonococcal urethritis (NGU) were divided into two groups and treated with either lymecycline or tinidazole; anaerobic cultures were performed before and after treatment. Neither treatment affected the anaerobic flora. However, the men treated with lymecycline were relieved of symptoms and signs, while those treated with tinidazole were not. The anaerobic bacteria found are considered normal inhabitants of the urethral tract and without significance in the aetiology of NGU.
PMCID: PMC1045445  PMID: 606333
13.  The impact of urban community hospital surveillance for gonorrhoea on the infection rate and complications in the female. A progress report. 
This study substantiates a previous report concerning the importance of the urban community hospital, particularly its emergency room, in the detection of gonorrhoea in women. Pelvic inflammatory disease (PID), a major complication of gonorrhoea in women, significantly declined during a nine-year surveillance and control programme in the Memphis-Shelby County area. This suggests that the programme may have prevented PID developing in women through the early detection and treatment of asymptomatic infections.
PMCID: PMC1045444  PMID: 606332
14.  Release of enzymes from human leucocytes during incubation with Neisseria gonorrhoeae 
The effect of Neisseria gonorrhoeae on release of enzymes from human leucocytes was determined. Supernatants from incubation mixtures containing leucocytes and gonococci were assayed for activity of the cytoplasmic enzyme, lactic acid dehydrogenase, as well as for activity of the hydrolytic enzymes, β-glucuronidase and lysozyme, which are found primarily in leucocyte granules. Thirty-minute incubation of leucocytes with pilated T1 gonococci resulted in a negligible release of lactic acid dehydrogenase and little release of β-glucuronidase even at bacteria to leucocyte ratios as high as 50 to 1. Lysozyme release, however, was significant at this ratio and at 20 to 1 but not at 5 to 1. Incubation with non-pilated T4 bacteria yielded no significant release of lactic acid dehydrogenase or β-glucuronidase, but it caused a significant release of lysozyme at bacteria to leucocyte ratios as low as 2 to 1. These results suggested that the lysozyme release might be related to the degree of phagocytic activity since, at low ratios, T4 was readily ingested but T1 was not. Consistent with this hypothesis, serum which promoted the phagocytosis of the pilated gonococci also stimulated lysozyme release at low ratios of T1 to leucocyte. Absorption of the serum with T1 abolished the opsonic effect and markedly diminished the amount of lysozyme released.
PMCID: PMC1045443  PMID: 414817
15.  Cell-mediated immune response in gonococcal infections. 
Peripheral blood lymphocyte (PBL) transformation stimulated by gonococcal and meningococcal antigens was studied in 29 men and 21 women with uncomplicated gonorrhoea. The blastogenic responses of PBLs from these men and women were substantially higher than from normal controls. Cross-reactivity between Neisseria gonorrhoeae and Neisseria meningitidis was manifested by the PBL transformation responses in patients with gonorrhoea to non-purified meningococcal antigen (MGC-I). In both male and female patients the PBLs were stimulated by non-purified gonococcal antigen (GC-I) and by non-purified meningococcal antigen. The extent of the blastogenic response in women was much greater than in men. Partial purification of these antigens by gel chromatography resulted in reduced cross-reactive responses to the semi-purified meningococcal antigen (MGC-II). Female patients demonstrated marked stimulation with the semi-purified gonococcal antigen (GC-II), while male patients showed slight stimulation with GC-II. It is possible that cell-mediated immunity may act to limit the spread of gonococcal infection beyond the genital mucous membranes.
PMCID: PMC1045442  PMID: 414816
16.  Screening tests for syphilis. A comparison of the Treponema pallidum haemagglutination assay with two automated serological tests. 
Two Treponema pallidum haemagglutination assay (TPHA) tests (Wellcome and Fuzizoki) were compared with the automated reagin test and the automated Reiter protein complement-fixation test in a routine screening system. The Wellcome TPHA was shown to lack sensitivity, and it is recommended that it should be used at a lower screening dilution. The Fuzizoki TPHA recorded a significant number of false positive and false negative results, and was therefore inferior to the fluorescent treponemal antibody absorption (FTA-ABS) test as a definitive test for syphilis. It is suggested that the TPHA be used in conjunction with a reagin test to replace some of the more inadequate screening tests currently in use. The automated screening tests were shown to have a similar sensitivity to the TPHA as well as several other advantages; they are recommended for testing large numbers of specimens.
PMCID: PMC1045441  PMID: 606331
17.  How suitable are available pharmaceuticals for the treatment of sexually transmitted diseases? (2) Conditions presenting as sores or tumours 
The pharmaceutical industry is not supplying the penicillin preparations that are required for the treatment of syphilis. For those in whom penicillin hypersensitivity is suspected there is a need for a safe injectable alternative that is effective if given once daily or, preferably, at two- or three-day intervals. Existing treatments for chancroid, lymphogranuloma venereum, and granuloma inguinale are described, but even collectively there are few cases and treatments for other sexually transmitted diseases merit priority. Treatments for scabies and pediculosis pubis, although not perfect, are reasonable. There is a need for better local treatment for condylomata acuminata and systemic immunological methods, including those that increase cell-mediated immunity, deserve attention. The same is true for molluscum contagiosum. There is an urgent need for an effective, safe treatment of herpes genitalis that is able to eradicate the virus from the host. If it is proved that the herpes virus is responsible for carcinoma of the cervix this could then be the most serious sexually transmitted disease as in many countries such carcinomas are responsible for approximate seven times more deaths in women than is syphilis in men and women together. The limitations of prophylactic methods in preventing all possibility of infection with one or more of the sexually transmitted diseases are discussed.
PMCID: PMC1045440  PMID: 580068
19.  Cultivation of Treponema pallidum. 
PMCID: PMC1045438  PMID: 342067
20.  Book Review 
PMCID: PMC1045434
21.  Abstracts 
PMCID: PMC1045432
22.  Short-term psychosomatic treatment of sexual problems. 
This is a review of 172 couples presenting with psychosexual problems. Ninety-four per cent of couples treated showed improvement after a mean time of 2.1 hours with the doctor. Older patients and those with longstanding problems showed lower rates of improvement. It is suggested that if such problems are treated it may help to reduce the rate of sexually transmitted diseases.
PMCID: PMC1045431  PMID: 589426
23.  How suitable are available pharmaceuticals for the treatment of sexually transmitted diseases? 1: Conditions presenting as genital discharges 
The relative prevalence of sexually transmitted diseases and the agents available for the treatment of these diseases commonly presenting as genital discharges—namely, gonorrhoea, candidosis, trichomoniasis, and non-specific genital infection—are reviewed. The many agents that are active against gonorrhoea are listed, but none is ideal. Penicillin, in spite of its allergic side effects, has remained the drug of choice for 25 years because it is cheap, easily obtained, lacks toxicity even in pregnancy, and is effective. Its use is now threatened by the emergence of some strains that are able to produce penicillinase. At present the policy is to obtain the best results from penicillin while these are acceptable, but the clinician in some countries is badly served by the availability of procaine penicillin in aqueous suspension. There is a need for an effective penicillin or cephalosporin that is penicillinase resistant and cheap. Cefuroxime offers considerable hope but it is likely to be expensive in the immediate future.
There are many preparations for the local treatment of candidosis. The confidence expressed by the manufacturers in recommending a three-day treatment is, it is hoped, based on a superior product. Nevertheless there is a need for a safe systemically absorbed fungicide which could be used orally, or some substance that could render the vagina an inhospitable environment for the organism.
In the treatment of trichomoniasis the pharmaceutical industry in providing substances more than 90% effective in a single dose has done all that can be expected. Any further advances lie in the field of human behaviour rather than pharmaceutical research.
In the treatment of non-specific genital infection the needs are more of research than of therapy. More knowledge is required of the cause of the condition and the relative role of contending pathogens, and of the results of treatment of patients and contacts in which Chlamydia or other suspect pathogens have been isolated.
PMCID: PMC1045430  PMID: 338125
24.  Diagnosis of rectal gonorrhoea by blind anorectal swabs compared with direct vision swabs taken via a proctoscope. 
Eight hundred and twenty-three examinations were carried out on 662 homosexual patients. At each examination a blind anorectal swab and a rectal swab taken via a proctoscope were inoculated on to a culture plate. From a total of 100 gonococcal infections of the rectum 96 gave positive results from blind anorectal swabs and 99 from swabs taken via a proctoscope. Blind anorectal swabs proved to be a reliable method in the diagnosis of rectal gonorrhoea.
PMCID: PMC1045429  PMID: 412559
25.  Recent micturition does not affect the detection of urethral gonorrhoea. 
In 202 men with urethral gonorrhoea (176 symptomatic and 26 asymptomatic) who had modified Thayer-Martin cultures taken before and within five minutes after micturition there was complete agreement between results of the two cultures. Micturition did, however, temporarily eliminate the discharge in 100 (56.8%) and make interpretation of Gram-stained smears more laborious.
PMCID: PMC1045428  PMID: 589425

Results 1-25 (107)