Localization of Chlamydia trachomatis infection by direct immunofluorescence and culture in pelvic inflammatory disease.

Fifty-five women with suspected pelvic inflammatory disease underwent diagnostic laparoscopy and endometrial and tubal biopsy, with specimens for isolation of Chlamydia trachomatis and for staining with a species-specific monoclonal fluorescein-conjugated antibody to C. trachomatis were obtained from the urethra, rectum, endocervix, endometrium, tubes, and cul-de-sac. C.

Etiology of cervical inflammation.

We studied the relationships of selected microbial, clinical, demographic, and behavioral variables to mucopurulent cervicitis in two clinical settings, a sexually transmitted disease clinic and a student health clinic. From each clinic, we studied a group of women referred for suspected mucopurulent cervicitis and a representative sample of other women attending the clinic. After the women were stratified by patient group and summary odds ratios for all groups were obtained, mucopurulent cervicitis was most strongly associated with the isolation of Chlamydia trachomatis; other variables associated with mucopurulent cervicitis included the isolation of Ureaplasma urealyticum, Gardnerella vaginalis, and Trichomonas vaginalis, the presence of serum antibody to C.

Microbial causes of proven pelvic inflammatory disease and efficacy of clindamycin and tobramycin.

Thirty-six women with suspected pelvic inflammatory disease were examined by laparoscopy and endometrial biopsy. Acute salpingitis was diagnosed by laparoscopy in 22. Among women with evaluable biopsy samples, plasma cell endometritis was present in 14 of 20 with acute salpingitis and in 1 of 13 without acute salpingitis (p less than 0.

Methods for diagnosing papillomavirus infection.

The morphology of the lesion and the site in which the lesion is found are the initial clues in classifying papillomavirus-induced neoplasia. Human papillomavirus (HPV) types have limited site-specificity and differ in their association with benign or malignant neoplastic development. Cytopathology, electron microscopy, antigen detection and molecular hybridization all play a role in the armamentarium of diagnostic methods.

Detection and localization of human papillomavirus DNA in human genital condylomas by in situ hybridization with biotinylated probes.

We have examined the distribution of human papillomavirus (HPV) DNA in paraffin sections of humans warts by in situ hybridization with biotin-labeled DNA probes. Recombinant plasmid DNAs (HPV-1, -6, -11, -16) were labeled by nick translation with biotinylated deoxyuridine triphosphate. Paraffin sections were hybridized with the probes for 18 h in stringent or non-stringent conditions, and DNA-DNA hybrids were detected by immunocytochemistry.

Prevalence and manifestations of endometritis among women with cervicitis.

Thirty-five women referred from a clinic treating sexually transmitted diseases, because of suspected cervicitis, were studied for the presence of endometritis by transcervical endometrial biopsies and cervical and endometrial cultures. Fourteen (40%) of the patients had histologic evidence of endometritis. Findings that significantly correlated with endometritis included a history of intermenstrual vaginal bleeding, the presence of Chlamydia trachomatis, Neisseria gonorrhoeae, or Streptococcus agalactiae in the cervix, and the presence of serum antibodies to C.

Cytologic manifestations of cervical and vaginal infections. I. Epithelial and inflammatory cellular changes.

We used multiple logistic regression to analyze microbiological and clinical correlates of inflammatory and epithelial cell changes on Papanicolaou-stained cervical smears in patients from a sexually transmitted disease clinic. Among randomly selected patients, increased numbers of histiocytes and polymorphonuclear leukocytes and the presence of transformed lymphocytes were associated with Chlamydia trachomatis infection, while increased lymphocytes were associated with Trichomonas vaginalis infection; minimal squamous atypia was associated with yeast infection; and moderate squamous atypia and koilocytosis were associated with cervical condylomata visualized by colposcopy. Among patients referred for cervicitis, C trachomatis infection was also associated with reactive or atypical metaplastic cells.

Cytologic manifestations of cervical and vaginal infections. II. Confirmation of Chlamydia trachomatis infection by direct immunofluorescence using monoclonal antibodies.

We found inflammatory patterns of transparent lymphocytes on increased numbers of histiocytes suggestive of chlamydial infection in 68 (56%) of 121 cervical cytologic smears. Chlamydia trachomatis was isolated from 36 (53%) of those with and only two (4%) of those without such inflammatory patterns. Direct stain with fluorescein-conjugated monoclonal antibodies demonstrated elementary bodies of C trachomatis in 30 (79%) of the 38 culture-positive patients, including 29 of the culture-positive patients who had an inflammatory cytologic pattern suggestive of C trachomatis infection.

Mucopurulent cervicitis--the ignored counterpart in women of urethritis in men.

Among 100 randomly selected nonmenstruating women attending a clinic for sexually transmitted diseases, we assessed objective criteria for the clinical diagnosis of mucopurulent cervicitis. Visualization of yellow mucopurulent endocervical secretions on a white swab and the presence of 10 or more polymorphonuclear leukocytes per microscopical field (at a magnification of 1000) in satisfactory gram-stained endocervical smears were independently correlated with cervical Chlamydia trachomatis infection. Neither finding correlated with gonorrhea or genital herpes, although herpes caused characteristic cervical ulcerations.

Mycoplasma hominis in cervicitis and endometritis.

The presence of serum IgG antibody to Mycoplasma hominis was studied by enzyme immunoassay in 150 women with suspected cervicitis at a clinic for sexually transmitted diseases. Positive levels of antibody were associated with gravidity and parity but not with age, method of birth control, or sexual behavior. Women from whom M.

The usefulness of percutaneous fine-needle aspiration biopsy in infants and children.

During the past 2 years percutaneous fine-needle aspiration biopsy has been employed to help establish or confirm diagnosis in 32 infants and children. A 22-gauge needle is used to aspirate the site of suspected disease. For lesions inside the chest or abdomen, the needle is guided with the help of fluoroscopy, ultrasound, or computed tomography (CT) scan.

Aspiration cytology: an efficient and cost-effective modality.

Aspiration cytology is under-utilized in the evaluation of neck masses. This paper establishes the historical perspectives for the procedure which document its accuracy and safety. The discussion emphasizes the appropriate application of the technique and the strong arguments for its cost effective use as a primary diagnostic modality in evaluation of head and neck mass lesions.

Therapy and outcome in 51 children with mesoblastic nephroma: a report of the National Wilms' Tumor Study.

Mesoblastic nephroma is a distinctive pathologic renal tumor with unique clinical, therapeutic, and prognostic patterns. This report reviews 51 patients (2.8% of 1905 patients submitted to NWTS with renal tumors) with this diagnosis from the NWTS contrasting this disease entity with Wilms' tumor.

Metachronous bilateral Wilms' tumor, National Wilms' Tumor Study.

Eighteen of the patients randomized for treatment according to the first and second National Wilms' Tumor Studies have developed clinically evident tumor in the contralateral kidney subsequent to the initial diagnosis. Only seven of 18 had an adequate exploration of the opposite kidney during the initial surgery and of these seven, four had abnormal findings. Thirteen of 18 cases showed some form of nephroblastomatosis histologically.

High prevalence of cervical dysplasia in STD clinic patients warrants routine cytologic screening.

The results of routine cervical cytology screening at a Planned Parenthood Center (PPC) clinic were compared to those at a nearby sexually transmitted diseases (STD) clinic in Seattle. Cervical cytologic findings were consistent with cervical intraepithelial neoplasia (CIN), grades 1 (mild dysplasia), 2 (moderate dysplasia), or 3 (severe dysplasia to carcinoma in situ) in 502 (5.9 per cent) of 8,504 PPC patients and 87 (11.

Oestrogens and endometrial cancer: effect of other risk factors on the association.

We analyzed data from a case-control study of endometrial cancer to determine whether, in a woman's menstrual and medical history, factors could be identified that modify the increased risk resulting from menopausal oestrogen use. Overweight, hypertension, low parity, non-smoking, late age at menopause, and a history of cholecystectomy were all associated with endometrial cancer, but oestrogen use produced large increases in risk both in the presence and absence of these characteristics. We conclude that information on other known risk factors for endometrial cancer provides little or no guidance as to which patients to select in the perimenopause.