Biomedical subjects
Publications and source records attributed to T F Smith.
Chlamydia organisms were found in 42 per cent of patients with non-specific urethritis and these organisms probably were the cause of the urethritis. Contact is by venereal means. The drug of choice is 500 mg. tetracycline every 6 hours for 10 days.
Urethral specimens known to contain Chlamydia were stored at -70 C in transport medium (2SP). For the test, circular glass coverslips were placed in the bottom of each culture vessel (glass shell vials and plastic microtiters plates [5 by 15 cm]) and seeded with McCoy's cells in medium containing 5-iodo-2-deoxyuridine. After 72 hours, cultures were inoculated with the specimens, and after 72 additional hours the monolayers on the coverslips were stained with iodine. Of 43 specimens, Chlamydia was recovered from 29 in glass vials but only from three in plastic plates (P less than .001). Chlamydia isolates could be passed serially only by vial-to-vial transfer; losses of 1,800 inclusion-forming units occurred after one subpassage from plates to either vials or plates. The extents of inactivation at 36 C of Chlamydia suspended in medium and placed in plastic plates and in glass vials were similar after seven hours. A substance toxic for Chlamydia could not be demonstrated in the plastic plates. Any new system for isolating Chlamydia from clinical specimens should be evaluated by comparison with culturing in glass vials.
Rhesus monkey kidney and cynomolgus monkey kidney cell cultures were compared for viral isolation by using clinical specimens that yielded 203 viral isolates. Cynomolgus and rhesus monkey kidney cells were comparable for the isolation of 22 adenoviruses, 12 coxsackieviruses, and one poliovirus. Four of 50 echoviruses and seven of ten herpesviruses were detected only in cynomolgus monkey kidney cells. Influenza virus was isolated in 84 instances, of which eight were detected only in rhesus and four only in cynomolgus monkey kidney cells. Rhesus monkey kidney cells yielded six more parainfluenza virus isolates. Except possibly for parainfluenza virus, cynomolgus monkey kidney cells appear to be as sensitive as rhesus monkey kidney cells for viral isolation from clinical specimens.
Urethral swabs from 75 males with urethritis were extracted into tryptose phosphate broth and then equal aliquots were dispensed into vials containing sucrose phosphate buffer (2SP) and urease color test medium (U-9). No antibiotics were present in the media. After transport to the laboratory, the recovery of Chlamydia trachomatis and Ureaplasma urealyticum was evaluated after inoculation into McCoy's cell cultures and agar medium, respectively. C. trachomatis was recovered from significantly more patients (17 versus 12, P = 0.03) with higher inclusion counts (P less than 0.01) in specimens transported in 2SP as compared with those in U-9 medium. No significant differences between the isolation rate of U. urealyticum and that of Mycoplasma hominis were found with the two media. The rate of inactivation of C. trachomatis and U. realyticum at 4 C was examined by means of reference strains. The inactivation of C. trachomatis was similar in both 2SP and U-9 media, but the number of inclusions was consistently greater in the 2SP medium. In contrast, the number of colony-forming units of U. urealyticum actually increased over a 24-hour period in both media. We conclude that 2SP is the best medium for the combined recovery of C. trachomatis and genital Mycoplasma. The use of one transport medium and hence a single swab culture has the obvious advantages of saving time and expense for both physician and laboratory, and for the patient it will eliminate the possible discomfort of having multiple cultures taken.
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The time course of formation of inclusion bodies produced by Chlamydia in 5-iodo-2-deoxyuridine (IUdR)-treated McCoy's cells was studied with the use of a known isolate of Chlamydia trachomatis D/UW-184/Ur and 47 frozen clinical urethral specimens previously shown to be either positive or negative for chlamydial inclusions after 3 days of incubation. Subsequent examination of 369 clinical specimens from the genitourinary tract over a 6-month period revealed 47 (13%) Chlamydia-positive cultures, all of which demonstrated inclusion bodies by iodine staining at 40 and 64 h postinoculation. Another 146 similar detected by iodine staining from 22 (15%). This study indicates that, although Chlamydia subgroup A inclusions are larger at 64 h, they can be readily detected from clinical specimens in IUdR-treated McCoy's cells at 40 h postinfection.
Cytomegalovirus (CMV) was isolated from lung tissue in 8 of 55 (14-6%) necropsies on patients who had received immunosuppressive therapy. Recovery of CMV was best (14 of 16 specimens, 87%) from fresh tissue that had been processed immediately. Storage of specimens at 4 degrees C before inoculation into cell cultures slightly reduced, to 58%, the recovery of CMV. However, conventional freezing of tissue to -- 20 degrees C for four to seven days significantly reduced the recovery of CMV, to 25% (p less than 0-001). In three of eight specimens from which virus was recovered, CMV inclusion bodies were found on tracheal smears. Sixty-five percent of the virus-negative group had measurable complement-fixing antibody in blood taken at necropsy, compared with 86% in the virus-positive group. However, there was no significant differences in antibody levels in the two groups. Our study indicates that specimens submitted for CMV isolation should be sent for virus isolation as rapidly as possible and should not be frozen. The level of antibody in a single serum taken in necropsy does not correlate well with morphological or cultural evidence of active infection.
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Explore the source record for details and available documents.
The case described here represents the first laboratory-confirmed case of inclusion blennorrhea at the Mayo Clinic since laboratory isolation of Chlamydia trachomatis was instituted in 1974. Treatment with a sulfonamide preparation proved effective. Further aspects of the diagnosis and treatment of inclusion blennorrhea are discussed.
In 70 male patients with urethritis, Chlamydia was recovered from 18 urethral swabs (26%), 5 urinary sediments (7%), and 3 urine specimens (4%). All Chlamydia isolates were recovered from urethral swabs.
A 27-year-old male renal transplant recipient acquired cytomegalovirus (CMV) infection of both eyes. This was characterized early by a distinctive necrotic retinitis with discrete advancing edges. A large exudative retinal detachment and hypopyon developed in one eye, and cultures from the anterior chamber aspirate grew CMV. Cytomegalovirus was also isolated from the urine and throat; after serial negative base-line titers, CMV antibody titer became positive. At autopsy CMV was isolated from lung, esophagus, and kidney tissue. Light and electron microscopic studies demonstrated extensive necrosis and disruption of the sensory retina and retinal pigment epithelium with exudative retinal detachments. The diseased retinal cells contained a multiplicity of viral particles in various stages of maturity. Cytomegalic inclusion-bearing cells were demonstrated in the choroid of the more severely affected eye.
Acclaimed subjects exercised intermittently for 8 hrs in 25 to 50 degrees environments. Thermal and metalobic determinations were made. Results showed the time-weighted WBGT heat strain index for intermittent work needs re-evaluation. For acclimated subjects working steadily at 350 kcal/hr, 30% max, the ULPZ is more than 33% WBGT.
From January through September 1973, 55 virus isolates were recovered from lung and kidney specimens from 44 (8.8%) of 502 unselected autopsy cases. Cytomegalovirus (CMV) was isolated 42 times in 34 cases (36 from lung, four from kidney, and one each from pleural and bronchial tissues). Virus isolation was approximately six times more sensitive than histologic detection of CMV infections. Major causes of death included solid malignant tumors, leukemia, lymphoma, and renal allograft rejection; 13 patients had a variety of other diseases, predominantly cardiopulmonary. CMV was recovered from more males than females. The mean age of the CMV-positive group did not differ significantly from that of the CMV-negative group. CMV-positive cases were not preselected on the basis of specimen processing time. Serologic results indicate that recovery of CMV from an autopsy case was seven times more likely when the complement-fixing antibody titer was 1:16 or more.
Cytomegaloviruses (CMV) were recovered from lung tissue in 34 (6.8%) of 502 unselected autopsy cases. Inclusion bodies were detected in the lung in nine of these cases (26%) and in organs other than the lung in three others. Overall, the incidence of inclusion bodies in this series of 502 cases was 2.4%. Our data strongly indicate that virus isolation is more sensitive than histopathologic study in establishing the presence of CMV infection. However, CMV was not recovered from one kidney and one liver in which inclusion bodies were present, although the virus was isolated from lung. Four of five cases of renal allograft rejection were positive for both CMV and inclusion bodies. The incidence of CMV recovery and inclusion body detection in leukemia and lymphoma cases was more than twice that in cases with other diseases. CMV inclusion bodies with or without associated inflammation were found, in descending order of frequency, in the lung, kidney, liver, pancreas, adrenal gland, esophagus, prostate, testes, thyroid gland, parathyroid gland, stomach, small intestine, large intestine, and heart.
Indian Muntiacus muntjac G-banded chromosomes were used for computerized analysis for standardized karyotype generation. Individual chromosomes on high-contrast photographic negatives were scanned densitometrically. Alignment of each chromosome for analysis was achieved by locating predominant peaks as well as the centromere. This provided better alignment that the use of the chromosome-end locations. The standardized set was obtained by determing the root-mean-square average density along 10-20 homologous chromosomes. The resulting standard karyotype differs from those published earlier. Prophase chromosomes exhibited greater detail than more condensed metaphase chromosomes. Although Indian muntjac chromosomes were used as a model, the method of analysis should be readily adaptable for examining chromosomes of any origin. The analytic technique should be within the capabilities of the smallest cytogenetic laboratories.
From October 1973 through August 1974, 335 genitourinary tract specimens from patients with urethritis were inoculated into McCoy's cell cultures for the diagnosis of Chlamydia infections. Of the 45 Chlamydia isolates, 42 were recovered when glass vials rather than plastic microtiter plates were used as cell culture vessels. Herpes simplex virus was isolated 15 times. Bacterial overgrowth occurred 42 times; however, in 20 specimens the contamination was not apparent until after the first subculture. This is the first report of the frequency of Chlamydia infections in patients with urethritis in the Midwest and indicates that these organisms have a significant etiologic role in nongonococcal urethritis in this community.