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Biomedical subjects

E R Alexander

Publications and source records attributed to E R Alexander.

At least 73 records · Page 4Linked to original sources
PubMed1979

Etiology, manifestations and therapy of acute epididymitis: prospective study of 50 cases.

There were 50 patients with acute epididymitis who were evaluated prospectively by history, examination and microbiologic studies, including cultures for aerobes, anaerobes, Neisseria gonorrhoeae, Chlamydia trachomatis and Ureaplasma urealyticum. Escherichia coli was the predominant pathogen isolated from the urine of men more than 35 years old, while Chlamydia trachomatis and Neisseria gonorrhoeae were the predominant pathogens isolated from the urethra of men less than 35 years old. The etiologic role of Escherichia coli and Chlamydia trachomatis was confirmed by isolation from epididymal aspirates from a high proportion of men with positive urine or urethral cultures for these agents. Chlamydia trachomatis epididymitis accounted for two-thirds of idiopathic epididymitis in young men and often was associated with oligospermia. Of 9 female sexual partners of men with Chlamydia trachomatis infection 6 had antibody to Chlamydia trachomatis, of whom 2 had positive cervical cultures for this organism and 2 others had non-gonococcal pelvic inflammatory disease. Antibiotic therapy with tetracycline was effective for the treatment of men with Chlamydia trachomatis epididymitis and should be offered to the female sex partners.

Adolescent↗
PubMed1979

Experimental nasopharyngitis and pneumonia caused by Chlamydia trachomatis in infant baboons: histopathologic comparison with a case in a human infant.

Three infant male baboons were inoculated with a strain of CHLAMYDIA TRACHOMATIS ISOLATED FROM A HUMAN INFANT WITH PNEUMONITIS. One baboon, inoculated by intratracheal, nasopharyngeal, and oropharyngeal seeding, had rales, radiographic evidence of pneumonia, persistent nasopharyngeal C. trachomatis infection, and a four-fold rise in titer of antibody. At sacrifice 24 days after inoculation, nasopharynx, trachea, airways, and lung yielded C. trachomatis, and epithelial inclusions were seen by light and immunofluorescent microscopy. Histopathologic changes noted were nearly identical to those in a lung biopsy specimen from a human infant and pneumonitis and nasopharyngeal C. trachomatis. The second baboon was inoculated by tracheal seeding and maintained nasopharyngeal C. trachomatis until killed 30 days later. Autopsy revealed nasopharyngitis and patchy mild pneumonitis. The third baboon was inoculated by nasopharyngeal seeding and maintained nasopharyngeal C. trachomatis for 49 days. Both of the latter baboons seroconverted. Infant baboons appear to be useful animal models for C. trachomatis nasopharyngitis and pneumonia.

Animals↗
PubMed1979

Acute epididymitis: etiology and therapy.

Fifty patients with acute epididymitis were evaluated prospectively by history, examination, and microbiologic studies, including cultures for aerobes, anaerobes, N. gonorrhoeae, Chlamydia trachomatis, and Ureaplasma urealyticum. E. Coli was the predominant pathogen isolated from the urine of men over 35 years old and C. trachomatis and N. gonnorrheae were the predominant pathogens isolated from the urethra of men under 35. The etiologic role of E. Coli and C. trachomatis was confirmed by isolation from epididymal aspirates from a high proportion of men with positive urine of urethral cultures for these agents. C. trachomatis epididymitis accounted for two thirds of "idiopathic epididymitis" in men, and was often associated with oligozoospermia. Of nine female sexual partners of men with C. trachomatis infection, six had antibody to C. trachomatis, of whom two had positive cervical cultures for this organism, and the others had nongonococcal pelvic inflammatory disease. Antibiotic therapy with tetracycline was effective for the treatment of men with C. trachomatis epididymitis, and should be offered to their female sex partner.

Adolescent↗
PubMed1978

Chlamydia trachomatis infant pneumonitis: comparison with matched controls and other infant pneumonitis.

We determined the prevalence of Chlamydia trachomatis infection in 30 consecutive hospitalized infants less than six months of age with pneumonitis and in 28 matched controls (nine of 30 vs. one of 28. P less than 0.05). In comparing 16 cases of pneumonitis due to C. trachomatis with 27 not due to that agent, we found several distinguishing clinical and laboratory features: C. trachomatis was highly correlated with radiographic hyperinflation, prolonged cough and congestion, greater than or equal to 400 eosinophils per cubic millimeter and serum lgG greater than or equal to 500 and lgM greater than or equal to 110 mg per deciliter. C. trachomatis was responsible for 13 of 21 cases seen at three to 11 weeks vs. three of 22 seen at other ages. Antibody to C. trachomatis in tears (13 of 14 vs. two of 27), nasopharynx (12 of 14 vs. one of 27) and blood (16 of 16 vs. two of 23) was specific for C. trachomatis pneumonitis. C. trachomatis is prevalent among hospitalized infants with pneumonitis. Conjunctival infection precedes C. trachomatis pneumonitis more commonly than has previously been thought.

Antibodies, Bacterial↗
PubMed1978

Chlamydia trachomatis as a cause of acute "idiopathic" epididymitis.

To assess the etiologic role of C. trachomatis and other micro-organisms in "idiopathic" epididymitis, 23 men underwent microbiologic studies, including cultures of epididymal aspirates in 16. Eleven of 13 men under the age of 35 years had C. trachomatis infection whereas eight of 10 over 35 had coliform urinary-tract infection. Cultures of epididymal aspirates yielded C. trachomatis alone in five of six men under 35, and coliform bacteria alone in five of 10 over 35. These results suggest that C. trachomatis is the major cause of "idiopathic" epididymitis, and coliform bacteria the major cause of epididymitis in older men. Expressible urethral discharge and inguinal pain were more common in the chlamydial cases, whereas concurrent genitourinary abnormality and scrotal edema and erythema occurred more commonly in the coliform cases. The morbidity attributable to C. trachomatis is as serious as that attributable to Neisseria gonorrhoeae.

Acute Disease↗
PubMed1978

Prediction of efficacy of antimicrobial agents in treatment of infections due to Chlamydia trachomatis.

Although Chlamydia trachomatis is readily eradicated by systemic therapy in patients with acute urethritis, systemic therapy is less satisfactory in treatment of chronic trachoma. The activities of antimicrobial agents against C. trachomatis in cell cultures when the antimicrobial agents are added 1 hr after the C. trachomatis (minimal inhibitory concentration [MIC]) predicts efficacy of the drugs in the treatment of urethritis but does not necessarily predict efficacy in the treatment of chronic ocular trachoma. Concentrations of antimicrobial agents required to eradicate C. trachomatis when the agents were added 48 hr after inoculation of the cell cultures with C. trachomatis exceeded the MIC by several logarithms, and minocycline, doxycycline, and rifampin were markedly more active than tetracycline, erythromycin, or several other antimicrobial agents. Of the three most active antimicrobial agents, only doxycycline has been used systemically to treat ocular infections due to C. trachomatis, and it has been reported to be the most effective antimicrobial agent that has been utilized. In vitro testing of obligate intracellular pathogens such as C. trachomatis presents unique problems. Utilization of several methods of testing may help to identify antimicrobial agents with improved clinical efficacy, particularly in the treatment of ocular trachoma.

Anti-Bacterial Agents↗
PubMed1978

Antigenic relatedness of 17 strains of human cytomegalovirus.

A 10 minute kinetic neutralization test was used to assess antigenic relatedness among 17 strains of human cytomegalovirus. Hyperimmune guinea pig sera exhibited extensive cross-reactivity. However, the data did suggest that there may be four antigenic groups represented in this collection of CMV strains. Available epidemiologic data for these strains do not provide any discernible basis for this grouping.

Animals↗
PubMed1978

In vitro assays of the efficacy of antimicrobial agents in controlling Chlamydia trachomatis propagation.

The antimicrobial susceptibility of a low-laboratory-passage, slow-growing, genital Chlamydia trachomatis strain was studied by five different procedures with the use of McCoy cells pretreated with 5-iodo-2-deoxyuridine. The effects of antimicrobial agents when added to cultures on day 0 or day 2 after inoculation with C. trachomatis and the effects of washing and reincubating treated cultures in antimicrobial-free media were investigated. Tetracycline and erythromycin inhibited C. trachomatis growth at concentrations attainable in human serum, although their actions were reversible and significantly higher concentrations were needed to "cure" 48-h infected cultures. On a weight basis, spectinomycin was relatively ineffective in inhibiting C. trachomatis growth. The minimal inhibitory concentration of penicillin measured by our assay procedures was higher than that reported by other investigators. The five assay procedures used in this study were reproducible, and our results indicate that we can obtain more pertinent information about the efficacy of an antimicrobial agent in controlling C. trachomatis growth by using a combination of these assays than by simple minimal inhibitory concentration determinations, as had been previously described by other investigators. In addition, we failed to demonstrate changes in tetracycline susceptibility of C. trachomatis isolates from two patients who had received tetracycline therapy.

Animals↗
PubMed1977

Hepatitis B surface antigen (HBsAg) and antibody to HBsAg. Prevalence in homosexual and heterosexual men.

The prevalence rates of serum hepatitis B surface antigen (HBsAg) and antibody to HBsAg (anti-HBs) were 5.6% and 34% in 144 homosexual men in Seattle. Prevalence rates were only 0.9% and 3.6% in 111 heterosexual male venereal disease clinic patients with nongonococcal urethritis, and also 0.9% and 3.6% in 111 healthy men undergoing routine physical examinations. Thus, previous exposure to hepatitis B virus (HBV) was estimated to be 8.8 times greater for homosexual men than for heterosexual men. Four of four HBsAg positive sera from homosexual men were subtyped as "ad," whereas subtype "ay" is preponderant in intravenous drug abusers. Future public health measures to control HBV infection should address the prevention of sexually transmitted HBV infection among homosexual men.

Adult↗
PubMed1977

Aetiology of acute epididymitis.

24 patients with acute epididymitis were examined and underwent urethral and urine cultures for Neisseria gonorrhoeae, Ureaplasma urealyticum, herpes-simplex virus, Chlamydia trachomatis, cytomegalovirus, and gram-negative aerobic bacteria. The results suggest that in young men the sexually transmitted organisms which cause urethritis (N. gonorrhoeae, C. trachomatis, and possibly U. urealyticum) may also lead to acute epididymitis, whereas in older men coliforms and Pseudomonas are the predominant causes of epididymitis.

Acute Disease↗
PubMed1977

Identification of a tumor-associated antigen in cervical carcinoma by two dimensional (crossed) immunoelectrophoresis.

Two-dimensional immunoelectrophoresis was used to evaluate 8 cervical cancer speciments, 11 other gynecologic tumors, and 5 specimens of normal cervix. Antigens were water-soluble tissue extracts and antisera prepared in rabbits. When tested against antisera to cervical cancer, cancer antigens showed 14-17 precipitin lines whereas normal cervix showed 10-16. A single heavy heterogeneous precipitin line with an electrophoretic mobility of 0.58 relative to bovine albumin was observed in all cervical cancer specimens but not in normal cervical or other tumor specimens. Further evidence for the uniqueness of this antigen was sought by enhancement (addition of another antigen to the first phase of electrophoresis which increased the size of common peaks) and suppression (addition of another antiserum to the second phase, whereby the peak size of components to which both sera have antibody was decreased). The specific precipitin line was neither suppressed by the addition of antisera to normal tissue nor enhanced when normal tissue antigen was added to the tumor antigen preparation. More conclusively, adsorption of the tumor antiserum with normal tissue had no effect on the unique tumor-associated precipitin line, whereas all other precipitin lines were removed. This antigen was common to other cervical tumors because enhancement was demonstrated with three other cervical tumor specimens. The identification of a distinct and separate antigen associated with cervical carcinoma will permit further characterization and possible development of immunodiagnostic methods.

Antigen-Antibody Reactions↗
PubMed1977

Bacteriology of the urethra in normal men and men with nongonococcal urethritis.

Sixty-nine Caucasian males without a previous history of urethritis and who developed nongonococcal urethritis (NGU) and 39 similar men without urethritis (NU) were cultured from the urethra for Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum, aerobes, and anaerobes. C. trachomatis infection was proven by culture of serology in 26 (38%) of the NGU group and 1 (3%) of the NU group; the C. trachomatis-negative NGU group had significantly more U. urealyticum (81%) than the C. trachomatis-positive NGU group (42%) or the NU group (59%). Aerobes were isolated from significantly more NU men (91%) than from men with NGU (66%). The aerobic and anaerobic flora of the two NGU groups were similar. The NU group had significantly more aerobic lactobacilli. Haemophilus vaginalis, alpha-hemolytic streptococci (not Streptococcus faecalis), and anaerobes, predominantly Bacteroides species. This study has provided information about the prevalence and the variety of the aerobic and anaerobic microbiological flora of the anterior urethra of sexually active males. It does not implicate any bacteria other than C. trachomatis and U. urealyticum as potential causes of NGU.

Aerobiosis↗
PubMed1977

Etiology of nongonococcal urethritis. Evidence for Chlamydia trachomatis and Ureaplasma urealyticum.

Chlamydia trachomatis, Ureaplasma urealyticum (T-mycoplasma), and Hemophilus vaginalis have previously been considered possible etiological agents in nongonococcal urethritis (NGU). In this study, current C. trachomatis infection was confirmed by culture and (or) micro-immunofluorescence serology in 26 of 69 men experiencing afirst episode of NGU, and 1 of 39 with no urethritis. Serum IgM immunofluorescent antibody to chlamydia was demonstrated in 16 of 20 men with chlamydia culture positive NGU, and 3 of 39 with chlamydia culture negative NG, and none of 34 with no urethritis. 9 of 10 culture positive men with less than or equal to 10 days symptoms developed immunofluorescent antibody seroconversion in paired sera. U. realyticum was isolated significantly more often and in significantly higher concentration from first voided urine from chlamydia-negative cases of NGU than from chlamydia-positive NGU. Ureaplasmacidal antibody titers increased fourfold in six men, four of whom had negative cultures for for unreaplasma. H. vaginalis was isolated from c9 of 33 men with no urethritis and 2 of 69 with NGU. C. trachomatis is susceptible, and U. urealyticum is resistant to sulfonamides. A 10-day course of sulfisoxazole therapy produced improvement in 13 of 13 chlamydia-positive, unreaplasma-negative, and only 14 of 29 chlamydia-negative, unreaplasma-positive NGU cases (P less than 0.002). Thus, culture, serology, and response to therapy support the etiologic role of chlamydia in NGU. Quantitative culture and response to therapy suggest U. unrealyticum may cause many cases of chlamydia-netative NGU.

Adult↗
PubMed1976

Differential response of chlamydial and ureaplasma-associated urethritis to sulphafurazole (sulfisoxazole) and aminocyclitols.

91 men with non-gonococcal urethritis (N.G.U.) were randomly treated with either sulphafurazole (sulfisoxazole), 500 mg orally q.i.d. for 10 days, or an aminocyclitol (streptomycin or spectinomycin), 2 g intramuscularity for 1 to 3 doses at 12 h intervals. Initial urethral cultures were positive for Chlamydia trachomatis (C) in 36 (40%). Ureaplasma urealyticum (U) was isolated from the urethra or urine from20 (95%) of 21 White men in a first episode of N.G.U. who had negative chlamydia cultures. Sulphafurazole, active against C. trachomatis but not U. urealyticum in vitro, produced a clinical response in 7 of 7 men with C+U- N.G.U. and 5 of 19 with C-U+ N.G.U. (P less than 0-01). Aminocyclitols, active against U. urealyticum but relatively inactive against C. trachomatis in vitro produced a clinical response in 0 of 6 men with C+U-N.G.U., 9 of 11 men with C-U+N.G.U. from whom ureaplasma was eradicated (P less than 0-01), and 0 of 8 with C-U+ N.G.U. from whom ureaplasma was not eradicated. C+U+ N.G.U. responded poorly to both antimicrobials alone. These results support the aetiological importance of both C. trachomatis and U. urealyticum in N.G.U.

Administration, Oral↗
PubMed1976

Circulatory and cellular immune responses to squamous cell carcinoma of the uterine cervix.

The sera from 176 patients with cervical cancer were examined by indirect immunofluorescence against cervical cancer cells (imprints of cervical cancer tissue). The mean serum titer in these patients was significantly higher than the titer in two control groups of identical size. These tumor-related antibodies were also higher in titer in sera from a small sample of nine husbands of cancer patients than in 18 control group patients. A cell-mediated immune response was studied with the use of leukocyte-migration inhibition from 39 blood specimens, including 23 patients with invasive epithelial carcinoma, five with intraepithelial carcinoma of the uterine cervix, six with other gynecologic diseases, and five without gynecologic disease. Migration inhibition was demonstrated for squamous cell carcinoma of the uterine cervix, suggesting a common specific cell-mediated response.

Antibodies, Neoplasm↗
PubMed1976

Genital herpetic infection in men and women: clinical course and effect of topical application of adenine arabinoside.

Sixty-three episodes of genital herpetic infection in 55 men and 45 episodes in 42 women were randomly assigned to topical treatment with 3% adenine arabinoside, topical treatment with placebo ointment, or no therapy. In addition, 10 episodes in women who were not randomly assigned to therapy were evaluated and followed. Clinical evaluation and viral cultures were done on day 3, day 8, and weekly thereafter until the lesions had healed. The natural clinical course of genital herpetic infection was defined in patients given placebo or no therapy. Patients with a history of previous genital herpetic infection had significantly less pain, few lesions, and shorter duration of illness and viral shedding than patients who had no history of previous genital infection with Herpesvirus. An unexpected finding was that 87% of women experiencing their first episode of genital herpetic infection had cervical cultures positive for Herpesvirus hominis, whereas only 4% of women with recurrent herpetic infection had a positive cervical culture. Treatment with 3% adenine arabinoside did not influence the course of either primary or recurrent genital infection with Herpesvirus.

Administration, Topical↗