Metagenomics studies for the diagnosis and treatment of prostate cancer.

AIM: Mutation occurs in the prostate cell genes, leading to abnormal prostate proliferation and ultimately cancer. Prostate cancer (PC) is one of the most common cancers amongst men, and its prevalence worldwide increases relative to men's age. About 16% of the world's cancers are the result of microbes in the human body. Impaired population balance of symbiosis microbes in the human reproductive system is linked to PC development. DISCUSSION: With the advent of metagenomics science, the genome sequence of the microbiota of the human body has been unveiled. Therefore, it is now possible to identify a higher range of microbiome changes in PC tissue via the Next Generation Technique, which will have positive consequences in personalized medicine. In this review, we intend to question the role of metagenomics studies in the diagnosis and treatment of PC. CONCLUSION: The microbial imbalance in the men's genital tract might have an effect on prostate health. Based on next-generation sequencing-generated data, Proteobacteria, Firmicutes, Actinobacteria, and Bacteriodetes are the nine frequent phyla detected in a PC sample, which might be involved in inducing mutation in the prostate cells that cause cancer.

Prevalence and sociodemographic correlates of anogenital Human Papillomavirus (HPV) carriage in a cross-sectional, multi-ethnic, community-based Asian male population.

BACKGROUND: Addressing the burden of HPV-associated diseases among men is increasingly becoming a public health issue. The main objective of this study was to determine HPV prevalence among a healthy community-based Malaysian men. METHOD: This was a cross-sectional study that recruited 503 healthy males from 3 community-based clinics in Selangor, Malaysia. Genital and anal samples were collected from each participant for 14 high risk and 2 low risk HPV DNA detection and genotyping. All participants responded to a set of detailed sociodemographic and sexual behaviour questionnaire. RESULTS: The median age at enrolment was 40 years old (IQR: 31-50). The anogenital HPV6/11 prevalence was 3.2% whereas high risk HPV prevalence was 27.1%. The genital HPV prevalence for HPV6/11 was 2.9% while high risk HPV was 18.8%. HPV6/11 prevalence in the anal canal was 1.6% and high risk HPV was 12.7%. HPV 18 was the most prevalent genotype detected in the anogenital area. There was a significant independent association between genital and anal HPV infections. CONCLUSION: Anogenital HPV infection is common among Malaysian men. These findings emphasize the ubiquity of HPV infection and thus the value of population-wide access to HPV prevention.

Chlamydia trachomatis infection of the male genital tract: an update.

Chlamydia trachomatis (CT) is the most prevalent cause of sexually transmitted diseases. Although the prevalence of chlamydial infection is similar in men and women, current research and screening are still focused on women, who develop the most severe complications, leaving the study of male genital tract (MGT) infection underrated. Herein, we reviewed the literature on genital CT infection with special focus on the MGT. Data indicate that CT certainly infects different parts of the MGT such as the urethra, seminal vesicles, prostate, epididymis and testis. However, whether or not CT infection has detrimental effects on male fertility is still controversial. The most important features of CT infection are its chronic nature and the presence of a mild inflammation that remains subclinical in most individuals. Chlamydia antigens and pathogen recognition receptors (PRR), expressed on epithelial cells and immune cells from the MGT, have been studied in the last years. Toll-like receptor (TLR) expression has been observed in the testis, epididymis, prostate and vas deferens. It has been demonstrated that recognition of chlamydial antigens is associated with TLR2, TLR4, and possibly, other PRRs. CT recognition by PRRs induces a local production of cytokines/chemokines, which, in turn, provoke chronic inflammation that might evolve in the onset of an autoimmune process in genetically susceptible individuals. Understanding local immune response along the MGT, as well as the crosstalk between resident leukocytes, epithelial, and stromal cells, would be crucial in inducing a protective immunity, thus adding to the design of new therapeutic approaches to a Chlamydia vaccine.

Rough virulent strain of Brucella ovis induces pro- and anti-inflammatory cytokines in reproductive tissues in experimentally infected rams.

The ovine brucellosis caused by Brucella ovis has tropism for reproductive tissues but until now the mechanism of bacterial persistence is not understood. Cytokine expression profiles were studied for 8 months in rams after being experimentally infected with the rough virulent strain of B. ovis (R-B. ovis) to study the pathogenesis of B. ovis and immune mechanism possibly associated to bacteria tropism and persistence. The messenger RNA (mRNA) expression levels of interleukin-1α (IL-1α), IL-1ß, IL-6, IL-10, IL-12, interferon-γ (INF-γ) and tumour necrosis factor-α (TNF-α) cytokines were quantified by real-time quantitative RT-PCR (qRT-PCR) in reproductive tissues (epididymus, testicles, ampolae, vesicular glands and bulbourethral glands), and non-reproductive (liver, spleen and kidneys) tissues at 30, 60, 120 and 240 days post infection (dpi). During the acute phase of infection at 30 dpi, the host immune response was most notable demonstrating an up-regulation of several cytokines in reproductive tissues, including the epididymus (IL-6, IL-1ß and IL-1α), testicles (INF-γ and IL-12), bulbourethral glands (IL-6 and TNF-α) and ampolae (INF-γ, IL-10, IL-1ß and IL-1α). During the development of infection, cytokine gene expression levels decreased, providing evidence of immunosuppression and evidence of immune evasion that favoured persistence of chronic R-B. ovis infection. During the chronic phase of R-B. ovis infection (120 and 240 dpi), cytokine production was down-regulated in the epididymus (IL-1ß and IL-1α), testicles (INF-γ and IL-12), and ampolae (INF-γ, IL-10, IL-1ß and IL-1α), with the exception of the bulbourethral glands (IL-6 and TNF-α) and epididymus (IL-6); in these tissues, R-B. ovis infection resulted in up-regulation of the pro-inflammatory cytokine IL-6. Herein, we report cytokine expression profiles in tissues of rams experimentally infected with the rough strain of B. ovis, which are associated with bacterial persistence and macrophage activation.

Male urethral Pap smears and peniscopy examination and polymerase chain reaction human papillomavirus correlation.

The aims of this study were to determine HPV in a male population and its correlation with penile gross inspection and urethral pap smears. Fifty male volunteers were included in the study; all of them were sexual partners of women with evidence of HPV-related cervical diseases. Urethral Pap smear features and polymerase chain reaction (PCR; HPV detection) of urethral samples were correlated. Statistical analyses were conducted to identify variables associated with high and low-risk HPV types. Mean age of participants was 33.14 ± 1.52 (range, 23-50 years), and the mean age for those with high risk HPV was 32.12 ± 6.66 and 34.08 ± 6.58 for subjects with low-risk HPV (P = 0.820). Penile gross inspection revealed 19 (38%) cases with no lesions, papules in balanoprepusial furrol/sulcus in 23 (46%) cases, papilla in 23 (46%) cases, urethral lesions in 22 (44%) cases, penile body plaques in 22 (44%) cases, melanoses in 11 (22%) cases, sebaceous cysts on scrotum in 10 (20%) cases, and molting of the glands in 28 (56%) cases. Cytopathologic analysis revealed koilocytes in 24 (48%) cases. Dyskeratosis was observed in 24 (48%) cases. A bacterial background was found in 27 (54%) cases, and inflammatory cells were found in 27 (54%) cases. Twenty-six (52%) cases showed cytological features suggestive of Gardnerella Vaginalis. Twenty-four (48%) cases were high-risk HPV, and 26 (52%) were low-risk HPV (P = 0.037) as assessed by PCR-based detection. There was a statistically significant difference between koilocytes and bacterial background with high-risk human papillomavirus (P = 0.001). Abnormal colposcopy examination detected lesions were sampled for cytology by Pap smears.

Immunopathological responses and kinetics of Brucella melitensis Rev 1 infection after subcutaneous or conjunctival vaccination in rams.

The innocuousness of the Brucella melitensis Rev 1 live attenuated vaccine strain has never been fully assessed in rams. The immunopathological responses and the kinetics and distribution of the infection induced by this strain were determined after subcutaneous or conjunctival vaccination in both young (3-4 months old) and adult (12 months old) rams. At regular intervals after vaccination the animals were bled for serological studies, and slaughtered for both pathological and bacteriological examinations. The serological response after conjunctival inoculation was of lower intensity and duration than that induced subcutaneously, being the differences more evident in young rams. No genital lesions were produced and genital organs and accessory sexual glands were never found infected, being Rev 1 infection restricted to lymph nodes and spleen. Immunostained Rev 1 bacteria were located intracellularly in plasmablasts, dendritic follicular cells and macrophages in the target lymph nodes, in which cellular hyperplasia was the dominant pathological response. Subcutaneous vaccination induced a generalized infection by 2 weeks after vaccination, being then restricted to the prescapular target lymph node. Infection after conjunctival vaccination was less generalized, being restricted essentially to the cranial lymph nodes. Rev 1 infection was fully cleared by 3 months after vaccination in all animals. These results confirm the innocuousness of B. melitensis Rev 1 vaccine in rams.

[Microbiological diagnosis of sexually-transmitted infection (2007)]. / Diagnóstico microbiológico de las infecciones de transmisión sexual (2007).

Sexually transmitted infections (STIs) constitute an important world-wide public health problem. The use of sensitive and specific laboratory methods for diagnosing this condition is crucial to reduce the transmission and sequelae of STI. The present review describes current microbiological methods for the diagnosis of STIs. Neisseria gonorrhoeae and Chlamydia trachomatis are the pathogens most frequently involved in urethral and cervical infection. Culture continues to be the gold standard for diagnosing gonorrhea. Nucleic acid amplification assays are considered the new gold standard for C. trachomatis, although culture is till the most specific technique. Genital ulcers due to Treponema pallidum, Haemophilus ducreyi, or herpes simplex virus have little clinical and bacteriological correlation; therefore, it is essential to establish the microbiological diagnosis. Lesions present in the primary or secondary period of syphilis can be diagnosed by dark field microscopy. Serologic diagnosis for the remaining periods is based on non-treponemal tests associated with confirmatory treponemal tests. Cell culture is considered the gold standard for herpes simplex virus although molecular methods also have a sensitivity and specificity near 100%. Currently, microbiologic diagnosis of H. ducreyi and venereal lymphogranuloma is achieved with the use of molecular methods on samples obtained from the ulceration or lymph adenopathy. The diagnosis of genital warts in immunocompetent patients is based on clinical findings in most cases because the lesions are sufficiently characteristic. Culture is considered the reference method in Trichomonas vaginalis infection.

How to diagnose and treat fungal infections in chronic prostatitis.

Epidemiologic changes that include immune-compromised patients and drug-resistant fungi have caused an increase in nosocomial infections by Candida albicans and non-albicans Candida species. Other fungi, aspergilla and Cryptococcus (environmental contaminants), are opportunistic invaders of the immune-compromised (transplant, HIV) patients. The environmental fungi Coccidioides immitis (dry arid areas), Histoplasma capsulatum (Avian-infested areas), and Blastomyces dermatitidis (aquatic areas) can cause infections in immune-competent and immune-deficient patients. Each fungus can cause changes in the prostate that mimic bacterial infection, benign prostatic hypertrophy, or neoplasm. Diagnosis can be established by urine cultures or needle biopsy of the prostate. Prostate surgery for carcinoma or benign enlargement may detect latent fungal infection. Different fungal species can have divergent clinical manifestations and require different treatment. In some cases, asymptomatic localized fungal prostatitis can be cured by removal of the infected gland. Symptomatic and disseminated infection may require prostatectomy and systemic antifungal therapy.

Chronic prostatitis: Charlottesville to Seattle.

PURPOSE: Since few men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) have culturable bacteria by traditional approaches, we used sensitive molecular methods to determine presence of fastidious microorganisms. MATERIALS AND METHODS: We evaluated 135 men with CP/CPPS by standardized clinical evaluation, and by lower tract localization cultures and chamber counts of expressed prostatic secretions of leukocytes. We excluded from study patients with bacteriuria, bacterial prostatitis, urethritis or positive urethral cultures. Prostate biopsy was obtained using a double-needle technique to limit contamination. We chose molecular approaches because previous studies had used culture antigen detection in urine, urethral swabs and expressed prostatic secretions. However, interpretation of such studies is complicated because urogenital samples often acquire bacteria while passing through the urethra. We used specific and broad-spectrum polymerase chain reaction (PCR) assays. RESULTS: Only 10 (8%) of the 135 subjects had positive specific PCR assays, including Mycoplasmia genitalium, Chlamydia trachomatis and Trichomonas vaginalis. Our findings suggested that C. trachomatis, T. vaginalis and M. genitalium may be identified in some patients with CP/CPPS, even among men with no evidence of urethritis and with negative urethral cultures and other assays. The broad-spectrum PCR assays provided the most provocative findings. DNA encoding tetracycline resistance was identified in 25% of subjects, and 77% of subjects had evidence of 16S rDNAs. The white blood cell concentration in the prostatic secretions correlated with identification of 16S rDNAs in prostate tissue (p <0.01). CONCLUSIONS: Delineating the precise role of these organisms in the etiology of CP/CPPS may help define better diagnostic and treatment algorithms.

[Microbiological characteristics and clinical efficacy of phosphomycin]. / Microbiologicheskaia kharakteristika i klinicheskaia éffektivnost' fosfomitsina.

E. coli is the most frequent agent causing urinary infection (UI) both in adults and children. E. coli of UI outpatients is often resistant to ampicilline, amoxicilline and co-trimoxasol. The study of phosphomycin in UI outpatients showed its highest efficacy against E. coli. Phosphomycin in a single daily dose of 3 g is a drug of choice in acute uncomplicated cystitis. The results of the study also demonstrate that phosphomycin can be used for prevention of pyoinflammatory complications before endoscopic manipulations and operations as well as open operations on the lower urinary tracts and genital organs.

Outcome analysis in patients with Fournier's gangrene: report of 45 cases.

INTRODUCTION: Despite antibiotics and aggressive debridement, the mortality rate of Fournier's gangrene remains high. Attempts have been made to study factors that may affect prognosis; however, reliable criteria are still lacking. METHODS: The medical records of 45 patients with Fournier's gangrene who presented at the Ege University Medical Faculty Hospital from January 1990 to May 2001 were reviewed retrospectively to analyze the outcome and identify the risk factors and prognostic indicators of mortality. Univariate analysis was performed using the chi-squared test and Fisher's exact probability test, then multivariate analysis of statistically significant variables was performed using logistic regression. RESULTS: The most prominent associated disease was diabetes, affecting 55.6 percent of the patients. The overall mortality rate was 20 percent. However, the mortality rate among diabetics was 36 percent (P = 0.002). The other statistically significant predictors of outcome were the interval from the onset of symptoms to the initial surgical intervention (P = 0.001) and the need of fecal diversion (P = 0.009). Multivariate regression analysis disclosed that the interval from the onset of symptoms to the initial surgical intervention and diabetes were independent predictors of mortality (P = 0.001 and P = 0.003, respectively). CONCLUSION: The interval from the onset of clinical symptoms to the initial surgical intervention seems to be the most important prognostic factor with a significant impact on outcome. Given the significantly high mortality rate among diabetics, diabetes is also an independent prognostic factor. Despite the decreased number of idiopathic cases and extensive therapeutic efforts, Fournier's gangrene remains a surgical emergency, and early recognition with prompt radical debridement is the mainstays of management.

The association of herpes simplex virus type 2 (HSV-2), Haemophilus ducreyi, and syphilis with HIV infection in young men in northern Thailand.

To evaluate the association between sexually transmitted diseases that commonly may cause genital ulceration and prevalent and incident HIV infections, we conducted three case control studies in a cohort of 21-year-old male military conscripts in northern Thailand. The men were evaluated at baseline in 1991 and semiannually until their discharge 2 years later. Serologic evidence of infection with herpes simplex virus type 2 (HSV-2), Haemophilus ducreyi, and HIV were more frequent at baseline in 83 men with a history of genital ulcer than in 97 men without such a history. Seropositivity to H. ducreyi (odds ratio [OR] = 3.46), HSV-2 (OR = 3.83), and syphilis (OR = 1.53) were more common in HIV-positive than HIV-negative men. Men (N = 45) who seroconverted to HIV while in the military were more often seropositive for H. ducreyi and HSV-2 before HIV seroconversion and also were more likely to seroconvert to HSV-2 and H. ducreyi during the same interval as their HIV seroconversion compared with men who remained HIV-negative. These data suggest that HSV-2 and H. ducreyi may be both markers for high-risk sexual behavior and risk factors for HIV infection among young men in Thailand.

PIP: Three case-control studies conducted in 1991-93 in a cohort of 21-year-old male military conscripts in northern Thailand investigated the association between HIV infection and three sexually transmitted diseases (STDs) commonly associated with genital ulceration: herpes simplex virus type 2 (HSV-2), Haemophilus ducreyi, and Treponema pallidum. The studies compared 83 men with a history of genital ulcer disease (GUD) at baseline and 97 men without such a history, 103 men who were HIV-positive at baseline and 110 randomly selected HIV-negative conscripts, and 45 men who seroconverted to HIV while they were in the military and 124 men who remained HIV-negative throughout military service. The first study detected a significant dose-response association between number of commercial sex worker visits in the past year, lifetime number of sexual partners, and a history of GUD. Among men with GUD at baseline compared with those without GUD, the odds ratios were 2.52 for HSV-2, 2.02 for H. ducreyi, 0.97 for syphilis, and 2.14 for HIV. In the second study, HIV-infected men were significantly more likely than HIV-negative men to have antibodies to HSV-2 and H. ducreyi and a history of syphilis or gonorrhea. In the third study, men who converted to HIV were significantly more likely to have antibodies to H. ducreyi and HSV-2 at the visit before seroconversion than those who remained HIV-negative. Two independent predictors of seroconversion--HSV-2 seropositivity before conversion and 10 or more lifetime sexual partners--were identified. In northern Thailand, GUD, especially H. ducreyi and HSV-2, may be both a marker for increased HIV risk and a cofactor for HIV transmission.

Infección por virus del papiloma humano en genitales masculinos / Human papiloma virus infection in male genitalia

Se estudiaron 100 pacientes mediante un estudio prospectivo y transversal, de enero a diciembre de 1994 con el objetivo de conocer la prevalencia de infección por virus del papiloma humano en genitales masculinos. Los pacientes se estudiaron mediante historia clínica, revisión del área genital con colposcopio posterior a la aplicación de ácido acético al 5 por ciento, toma de biopsia de la región sospechosa, y estudio histipatológico. La edad de los pacientes fue de un rango de 16 a 71 años, con un promedio de 34.8 años. La edad de inicio de la vida sexual activa fue de un rango de 12 a 27 años, con un promedio de 17 años. Por lo menos el 41 por ciento de los pacientes habían tenido relaciones sexuales con prostitutas. El 26 por ciento contaba con antecedente de enfermedad de transmisión sexual. El 9 por ciento de los pacientes refería haber tenido solo una compañera sexual. El 82 por ciento fueron positivos a infección por virus del papiloma humano

Pathology and localization of simian immunodeficiency virus in the reproductive tract of chronically infected male rhesus macaques.

BACKGROUND: Despite the fact that human immunodeficiency virus (HIV) is transmitted by sexual contact, the biology of this mode of transmission remains largely undefined. HIV is present in semen in both cell-free and cell-associated forms and can be isolated from asymptomatic individuals and AIDS patients. The source of HIV in semen and the target cells for HIV transmission to men are unknown. Epidemiologic studies have shown that in men, the presence of an intact foreskin is associated with increased risk of HIV infection. EXPERIMENTAL DESIGN: The reproductive tracts from 13 chronically simian immunodeficiency virus (SIV)-infected adult male rhesus macaques were examined for this study. Routine histologic examination was undertaken to characterize the reproductive tract pathology. In situ hybridization and immunohistochemistry were used to localize SIV-infected cells and determine the immunophenotype of inflammatory infiltrates. RESULTS: SIV-infected cells (macrophages, T cells) were found at all levels of the reproductive tract and were commonly associated with inflammatory lesions. Infected cells were found most consistently in the epididymis. In one animal, SIV-infected cells (presumably Langerhans cells) were present in the stratified squamous epithelium of the foreskin. Testicular atrophy and degeneration were relatively common findings. The most common lesion in the accessory glands was mild lymphocytic inflammation. In addition, atrophy of the glandular elements and interstitial fibrosis in the prostate gland were found. One animal had a granulomatous epididymitis with multinucleate giant cells that may have been a primary SIV lesion. CONCLUSIONS: The reproductive tract pathology in chronically SIV-infected male rhesus macaques and AIDS patients is similar. SIV-infected cells can be found at all levels of the male rhesus macaque reproductive tract and SIV can infect cells in the mucosal epithelium of the foreskin. This latter finding indicates that target cells for HIV transmission may be present in the foreskin epithelium of uncircumcised men.

Detection of genital human papillomavirus (HPV) DNA by PCR and other conventional hybridisation techniques in male partners of women with abnormal Papanicolaou smears.

OBJECTIVE: To study the prevalence of human papillomavirus (HPV) infection, using several different hybridisation techniques, in men whose female sexual partners had cervical HPV and/or cervical intraepithelial neoplasia (CIN). METHODS: The male genital area was examined colposcopically and areas suspicious of HPV changes were biopsied. Each biopsy was subjected to histological examination and HPV DNA analysis by conventional DNA analysis such as Southern, reverse and dot blot as well as with polymerase chain reaction (PCR). RESULTS: Colposcopic examination of men showed 133 to be normal whilst 82 (38%) had clinical or subclinical lesions. Of 55 colposcopically directed biopsies from the male lesions taken, detection of HPV DNA by hybridisation with conventional techniques and by PCR showed HPV DNA in 29 (53%) and 47 (85%) of biopsies respectively. Overall HPV types 6/11 were the predominant types. In 18 (33%) biopsies positive by PCR, multiple types were found. CONCLUSION: HPV DNA was present in the majority of biopsy specimens taken, with HPV 6/11 being the predominant type. Among methods for HPV DNA detection, PCR was the most sensitive and useful technique.

Pathological changes in the reproductive tract of male rhesus monkeys associated with age and simian AIDS.

The pathological changes associated with ageing and simian immunodeficiency virus (SIV) infection in groups of immature, adult and ageing Rhesus monkeys were studied. Eighty three per cent (5 of 6) of uninfected ageing animals had hyperplasia of the prostate, 33 per cent (2 of 6) had mild prostatitis and in 66 per cent (4 of 6) there were calcified concretions in the seminal vesicles. The testes were normal and showed active spermatogenesis. In the SIV-infected animals, two types of lesion occurred; the most common, in 81 per cent (18 of 22 monkeys), was the presence of focal lymphoid infiltrations in the epididymis, prostate or seminal vesicles. The other was hypospermatogenesis (23 per cent, 4 of 17) with degeneration of seminiferous tubules. Immunocytochemical staining demonstrated that the lymphoid masses contained approximately equal numbers of B and T lymphocytes, but the majority of diffusely scattered cells were T lymphocytes. Staining for SIV antigen identified small numbers of positive lymphocytes and macrophages in all tissues.

Subclinical Epstein-Barr virus infection of both the male and female genital tract--indication for sexual transmission.

Epstein-Barr Virus (EBV) can infect B lymphocytes as well as epithelial cells of the oral cavity. Recently, infection of epithelial cells of the inflamed uterine cervix has been demonstrated, and EBV-DNA has been detected in urethral discharge of men suffering from genital infection. We investigated whether EBV can be found in the genital tract of both sexes independently from inflammatory disease states. Genital specimens of men and women of a sexually transmitted diseases outpatient clinic after excluding sexually transmitted diseases and clinically apparent signs of inflammation were investigated using the polymerase chain reaction to screen for EBV-DNA. In 13 of 47 samples (27.7%) swabbed from the uterine cervix, EBV-DNA could be detected. Similarly, 6 of 45 samples (13.3%) scraped from the sulcus coronarius contained EBV-DNA. Our study shows that the female genital tract and likewise the male genital tract can subclinically harbor EBV. These findings suggest i) that in addition to the oral cavity, the female and the male genital tract may be a reservoir for EBV and ii) that sexual transmission of this virus associated with an epidemiology different from that of oral infection may be possible.

[Study on Chlamydia trachomatis antigen detection by an EIA kit using a monoclonal antibody--comparison with a polyclonal EIA kit in urogenital infections].

We evaluated the clinical usefulness of a new EIA kit using a monoclonal antibody, IDEIA CHLAMYDIA (IDEIA, Novo Nordisk), for detection of C. trachomatis antigen from the genital tracts of male and female cases. The results were compared with those by Chlamydiazyme (Abbott). 1. C. trachomatis antigen detection by the IDEIA and Chlamydiazyme tests before treatment; IDEIA has a significantly higher detection rate (38.0%, 105/276) than Chlamydiazyme (29.8%, 80/276), for C. trachomatis antigen from urethral smears of 276 male patients with urethritis. In 646 female cases, including cervicitis and so on, IDEIA detected C. trachomatis antigen from cervical smears in 14.5% (94/648) of the total, while Chlamydiazyme did so in 11.9% (77/648). When considering the different results using IDEIA and Chlamydiazyme, approximately 20% of the IDEIA-positive cases were Chlamydiazyme-negative. However, when IDEIA was negative, less than 1% showed Chlamydia-positive. 2. C. trachomatis antigen detection during and after treatment; We studied the clinical courses of 14 male urethritis and 8 female cervicitis cases who had had positive results with both IDEIA and Chlamydiazyme before treatment. Two of the 14 urethritis cases showed positive results with IDEIA, but not with Chlamydiazyme after either 7 or 14 days treatment by an antimicrobial agent. These two also had symptoms indicating persistent urethritis. One of the 8 female cervicitis cases showed a positive result with IDEIA but not with Chlamydiazyme after 7 days treatment by an antimicrobial agent, and this case also had symptoms indicating persistent cervicitis. Thus, these clinical findings suggest that IDEIA can detect even a small quantity of antigen soon after treatment, but Chlamydiazyme can not. In conclusion, IDEIA has a higher sensitivity than Chlamydiazyme, in the detection of C. trachomatis antigen, suggesting that IDEIA is more useful.

Human papillomavirus segregation patterns in genital and nongenital warts in prepubertal children and adults.

This study compared the segregation patterns of human papillomavirus (HPV) in genital and nongenital warts in prepubertal children and adults. HPV 2 was detected in most nongenital warts in children and adults, whereas neither HPV 6 or 11 was detected at nongenital sites in either group with the use of in situ or Southern blot hybridization analyses. Of nine genital tract lesions in children. HPV 2 was detected in two and HPV 6 or 11 in six. More than 90% of cases of regional tract condylomata in adults contained HPV 6 or 11. HPV 2 was not detected in any of 99 genital tract lesions in adults. It is concluded that HPV 6/11 cannot proliferate at nongenital cutaneous sites and HPV 2 can proliferate in the genital tract of children but not adults. Thus, the detection of HPV 6 or 11 in a genital wart in a child implies, assuming cutaneous transmission, infection from a genital site, whereas the detection of HPV 2 presumes nongenital transmission.

[Detection of human papillomavirus DNA in the normal genitalia of men].

The study of human papillomavirus (HPV) in the genitalia of all normal males is difficult, therefore cases of chronic prostatitis, a common disease treated in urological clinics, were chosen to identify HPV DNA by using Vira Type (Life Technologies Inc.). Smears of glans and sulcus coronalius of 177 subjects, showed a HPV positive rate of 3.4%, while 86 cases of those cases were negative for HPV in urethral smears. The lack of clinical findings suggests that HPV is an asymptomatic infection. In a follow up examination of 5 HPV positive cases some weeks later, smears of glans, sulcus coronalius and urethra were all negative for HPV. Examination by Vira Type showed that HPV disappeared spontaneously in these cases.