Quantitative western immunoblotting analysis in survey of human immunodeficiency virus-seropositive patients.

Identifying criteria for the early prediction of progression to acquired immunodeficiency syndrome in asymptomatic human immunodeficiency virus-seropositive patients have become necessary in order to widen the indications for antiviral treatment by azidothymidine and to increase its efficiency. With this aim in mind, we studied a cohort of seropositive homosexual men in the southwest region of France (Midi-Pyrénées). Of all the factors analyzed, the decline in p24 antibodies, assayed by second-generation enzyme-linked immunosorbent assay, was found to be the most reliable. On the basis of the work of Blomberg and Schmidt, we developed a quantitative approach to Western blotting (immunoblotting) for use in the follow-up of human immunodeficiency virus-infected patients. Our technique of quantitative Western blotting is unique because it uses a densitometric reading which, through a computerized system, gives a curve allowing the exact quantification of each stained Western blotting band. The results are expressed as integrals. This technique confirms the decrease in p24 and p17 antibodies as the criterion giving the earliest prediction of the progression to acquired immunodeficiency syndrome.

Lower genital tract infections in women: comparison of clinical and epidemiologic findings with microbiology.

We screened 392 women attending the Laboratory of Microbiology of Toulouse Purpan Hospital for symptoms of lower genital tract infection for six microorganisms. Rates of isolation of Neisseria gonorrhoeae, Chlamydia trachomatis, Candida albicans, Mycoplasma hominis, and Gardnerella vaginalis were 1%, 7.7%, 29.8%, 23.8%, and 37.5%, respectively. Trichomonas vaginalis was detected by direct examination in specimens from 3.1% of patients. Another goal of this study was to determine the relative prevalence of these microorganisms in relation to clinical and epidemiologic findings. C. trachomatis was isolated significantly more often from patients under 25 year old (P less than 0.001), from those who use oral contraceptives (P less than 0.01), from those who have a male sexual partner with symptoms of sexually transmitted disease (P less than 0.001), and from those who present signs of cervicitis (P less than 0.05). Isolation of C. albicans was significantly associated with vulvar pruritus (P less than 0.01), vulvitis (P less than 0.01), and vaginitis (P less than 0.001). G. vaginalis and M. hominis are significantly associated with bacterial vaginosis (P less than 0.001). This syndrome was diagnosed clinically in 27.2% of our study population and was highly correlated with use of an intrauterine device (P less than 0.05).

[Physicochemical analysis of subcutaneous calcifications in a case of Thibierge-Weissenbach syndrome]. / Analyse physicochimique de calcifications sous-cutanées dans un cas de syndrome de Thibierge-Weissenbach.

A physicochemical study of subcutaneous calcium deposits was performed in a patient with typical Thibierge-Weissenbach syndrome which had begun, ten years previously, with Raynaud's phenomenon and sclerodactylia. Calcium deposits had progressively developed, forming large plates on the arms, flanks and thighs. In the course of the disease they had become ulcerated, exuding a white, chalky material. X-ray films and xerograms demonstrated the extent of these deposits. The calcium-phosphorus balance was normal, and the other clinical and laboratory examinations were concordant with a diagnosis of Thibierge-Weissenbach syndrome (calcinosis). Only systemic corticosteroid therapy slowed down the pathological process; calcium chelating agents (diphosphonate) proved ineffective. The physicochemical study showed that the deposits consisted of carbonated apatite type B with the following formula: Ca8.0(PO4)4.1(CO3)1.2(HPO4)0.8 The mineral substance seemed to be less reactive and more stable than normal bone. This would account for the total lack of effectiveness of all treatments, notably calcium chelating agents, on the course of the deposits. Treatments usually produce bone demineralization before they influence the calcium deposits. This study provides much more detailed information than was hitherto available on calcium deposits and on carbonate ion contents in the apatite phase. The presence of carbonates increases the solubility and reactivity of calcium apatite.

Postmeningococcal urethritis caused by Chlamydia trachomatis: a case report.

The authors describe a case of meningococcal urethritis that was followed, after treatment with spectinomycin, by development of urethritis due to Chlamydia trachomatis. This case report emphasizes the need for thorough differentiation of species of Neisseria and of direct microbiologic diagnosis of chlamydial infection in laboratories.

[Etiology of bacterial vaginosis (non-specific vaginitis)]. / Etiologie de la vaginose bactérienne (vaginite non spécifique).

56 women who were diagnosed bioclinically as having a bacterial vaginal infection were studied, as were 35 women as a control group. The study was a semi-quantitative analysis of the vaginal bacterial flora, both aerobic and anaerobic. It shows that Gardnerella vaginalis and anaerobic bacteria such as Peptococcus, Peptostreptococcus, Bacteroïdes, Veillonella and Mobiluncus were associated in a statistically significant way with bacterial vaginitis. On the other hand Lactobacilli were less frequently found (p less than 0.001) than in the control group of women. The way in which the microbial flora is changed has been observed during attacks of vaginitis and is discussed, as is the importance of making the diagnosis and of treating this syndrome.

[Gynecomastia and cancer of the bladder: an ectopic secretion of chorionic gonadotropin hormone]. / Gynécomastie et cancer de la vessie: mise en évidence d'une sécrétion ectopique d'hormone gonadotrophine chorionique.

Among the paraneoplastic endocrine syndromes, gynecomastia induced by an ectopic production of human chorionic gonadotrophin remains infrequent. The authors report the case of a fifty-year-old man presenting with a bilateral gynecomastia which had been evolving over three months. The etiological investigation was rapidly guided by a macroscopic hematuria. Intravenous nephro-urotomographies visualized a filling defect in the bladder, and a grade III stage A urothelial carcinoma was completely resected cystoscopically, leading to progressive disappearance of the gynecomastia. Hormonal investigation revealed an ectopic production of HCG, inducing hyperestrogenia.