Detection of Chlamydia trachomatis in the prostate by in-situ hybridization and by transmission electron microscopy.

Chlamydia trachomatis infection has been investigated in the prostate gland using in-situ DNA hybridization and transmission electron microscopy. Sixty-four samples of tissue removed by trans-urethral resection or by open surgery from men with benign prostatic hypertrophy (BPH), were examined histologically and 20 of the cases were found to be positive for mononuclear cell infiltration. Some samples were then investigated using in-situ hybridization and transmission electron microscopy. Out of 20 tissue samples with mononuclear cell infiltration, nine were found to be positive for C. trachomatis infection.

Is seminal fluid a suitable specimen for detecting chlamydial infection in men?

As genital chlamydia infection is considered the most prevalent sexually transmitted bacterial disease worldwide, its correct diagnosis has a great clinical and epidemiological importance. Urethra is the recommended site for collecting specimen for detection of Chlamydia trachomatis in men, but urethral swabbing is very inconvenient for the patients. Testing of seminal fluid has two advantages: taking the sample is more convenient for the patient, and the ejaculate would provide more information on the possible infection of the upper genital tract. Three non-culture methods-enzyme immunoassay (EIA), DNA hybridization, and polymerase chain reaction (PCR)-were used for evaluation of suitability of seminal fluid as a sample for detection of Chlamydia in 4 patient groups comprising 259 symptomatic and asymptomatic, urology and andrology patients. The seminal fluids were tested parallel with the urethral samples. In one group of patients with typical prostatic complaints expressed prostatic secretion was examined parallel with urethral swab. C. trachomatis positivity rates were much higher in symptomatic (49.1%) than in asymptomatic patients (12.3%) in all kinds of sample. Seminal fluid was somewhat more frequently positive (7.9%) than urethral sample (6.2%). Simultaneous positivity was relatively rare (3.3%), it occurred most frequently in samples of patients with possible accessory gland infection tested by EIA. In a group of 17 patients with typical prostatic complaints the expressed prostatic secretion alone was positive in 7 cases, whereas only other two of the parallel urethral samples proved positive by PCR, simultaneous positivity occurred in one case. These findings suggest that testing of the ejaculate and/or the prostatic secretion parallel with the urethral sample would improve the sensitivity of detection of chlamydial infections.

Uro-Vaxom and the management of recurrent urinary tract infection in adults: a randomized multicenter double-blind trial.

A total of 112 patients with recurrent lower urinary tract infection (UTI) completed the 6-month period of the trial. Patients were treated for 3 months, under double-blind conditions, with one capsule daily of either Uro-Vaxom (UV) or placebo, together with an antibiotic or chemotherapeutic agent when necessary, and observed for a further 3 months. During the 6 months of the trial a significant decrease in the number of recurrences (p < 0.0005) was noted in the UV group as compared to the placebo group. A total of 67.2% of the patients had no recurrences (p < 0.0005). The incidence of bacteriuria (germs > or = 10(5)/ml), dysuria and leukocyturia was significantly reduced. UV was well tolerated, no side effects were recorded during the trial. The drug is a useful adjuvant for the management of UTIs and for the prevention of recurrences.

[Successful shock wave monotherapy of coral-shaped calculi in the kidney calix]. / Teljes veseüregrendszert kitöltö korallkö sikeres lökéshullám kezelése.

Authors reported about two patients with staghorn calculi, who have been treated by extracorporeal shock wave monotherapy by Direx Tripter-X-1 Lithotripter. They used in the first case percutaneous nephrostomy, in the second double J catheter as auxiliary method. Patients were treated 3 and 4 time, and they were stone free at three month follow up.

[Andrologic significance of genital mycoplasma]. / A genitális mycoplasmák andrológiai jelentösége.

The authors investigated the effect of genital mycoplasma infection of fertility. The rate of silent mycoplasma infection was studied in asymptomatic andrological patients (655 persons) and in a control group of so called "chronic prostatitis" (1085) patients with clinical symptoms. In the asymptomatic andrological group the urethral smear was positive in 12.5% of cases, the ejaculate in 22.0% of cases. In the "chronic prostatitic" group mycoplasma infection was present in urethral smear in 34.8% of cases, and in the ejaculate in 37.0% of cases. The isolation showed that 29.2% of positive ejaculate samples contained M. hominis, and 70.8% of samples was infected by U. urealyticum. For investigating the effect of mycoplasma infection on the male fertilization capacity, infected and non infected andrological patients was compared by conventional andrological parameters and by modern functional tests like bovin mucus penetration test, hypoosmotic swelling test and swim up procedure. All the modern parameters and one of the conventional tests (sperm motility) showed a significant difference between the two groups.

[Significant bacteriospermia. Value and limits of sperm count in andrology]. / A szignifikáns bakteriospermia. A csíraszámlálás jelentösége és határai az andrológiában.

The data concerning bacteriospermia--are very different in the literature. Asymptomatic andrologic patients, and as control group--patients of the outpatient department for male adnexitis--were studied. Cultivation of aerobic bacteria and mycoplasmas has been recently accomplished by quantitative bacteriological analysis and chlamydia diagnostic. The microbiological screening of 210 andrologic patients ejaculate has given the following results: 19.6% were sterile, 21.0% were colonised by apathogens, 59.1% were positive: 6.2% Mycoplasma hominis, 15.8% Ureaplasma urealyticum, 13.3% Chlamydia trachomatis, 51.9% other aerobic pathogens. 27.6% of samples contained more then one kind of bacteria strains. Quantitative isolation of aerobics and mycoplasmas in both andrological and male adnexitis patients groups showed the following distribution. In the andrologic groups 14.7% of samples contained 10(4) CFU/ml, 9.6% more than 10(4) CFU/ml aerobic bacteria; in the male adnexitis group nearly twice higher values could be observed (20.2% and 19.5%). The distribution of mycoplasma CFU/ml was the following; andrologie group: 20.1% of samples contained 10(4) mycoplasma CFU/ml, 37.5% more than 10(4) CFU/ml; in the male adnixitis group the identical values: 22.9%, 66.9%. Chi 2 statistical analysis showed significant difference ((p = 0.000) in the distribution of data in the two groups. On the other hand both of the groups contained all kinds of bacteriological concentration and even negative cases. Therefore authors suggest more biochemical investigations for detecting inflammatory diseases. Spermaparameters (motility and progressive motility) of andrological patients, divided by sperm concentration (cell number above and under 20 million/ml) and the degree of infection (non infected, slightly infected, and above 10(4) CFU/ml) were significantly different in the seriously infected group by variance analysis (p = 0.000).

[Experience with the Direx Tripter X-1]. / Direx Tripter x-1 lökéshullám közúzóval szerzett tapasztalataink.

In nonselected patients 81.5% stone-free rate could be reached in 3 months. In authors's opinion Direx Tripter X-1 is suitable in the treatment of renal and ureteral calculi. They treated staghorn calculi by ESWL monotherapy with success. The Direx lithotripter was found to be effective and easy to operate; the potential cost reduction is of great significance. The treatment requires general anaesthesia and the equipment causes significant noise. After all, Direx lithotripter is a useful machine in the armamentarium of stone disease treatment.

Experience with the Direx Tripter X-1 shock-wave lithotripter.

The authors give account of the experience they gained with the Direx Tripter X-1 (ESWL) apparatus. In a random material they succeeded to render 81.5% of the patients stone free within three months. They judge the apparatus suitable for in situ treatment of pelvic and ureteric stones and for the monotherapy of staghorn calculi. It is easy to handle, inexpensive to buy and maintain but noisy to operate, moreover the patient has to be anaesthetized. All in all it is highly useful in the treatment of renal lithiasis.

Clinical occurrence and virulence testing of coagulase-negative staphylococci.

A total of 650 coagulase-negative staphylococcal strains of miscellaneous clinical origin were isolated and identified during a 7-year-period. In all kinds of samples Staphylococcus epidermidis was the most frequently found species. In wounds the incidence of haemolytic species (S. cohnii, S. epidermidis, S. haemolyticus, S. simulans, S. warneri) was 79.3%. Among strains derived from male genitals (urethra, semen, etc.) S. epidermidis and S. simulans predominated. Only 8.2% of the strains were found not to harbour resistance determinants, while 63% proved to be multiply resistant. Only the incidence of resistance to oxacillin and first and second generation cephalosporins was low (12.8, 14.9 and 4.5%, respectively). Vancomycin was the only drug effective against all strains. Extracellular slime was produced by 42.2% of the strains. The frequency of slime-positivity among isolates causing clinical infection was twice as high as among contaminations. Slime production seems to be a stable characteristic of the isolates. The comparison of two methods used for detection of slime factor showed that incubation in test tube in Tryptone Soya Broth, or its application to microtiter plates evaluated by photometry are of equal diagnostic value.

Resection in renal tumour patients.

Nine cases (two of them bilateral) of renal resections for renal tumour are reviewed. The survival results of patients with bilateral renal tumours are considered particularly favourable, one of them has survived for 72, the other for 37 months. Of the patients with solitary renal tumour, one was lost 25 months postoperatively, after the development of a distant metastasis. The other patient has been free of recurrence and metastases after 31 months. The above results have proved the outdatedness of the old concept, i.e. to remove the tumorous kidney. As supported by the authors' cases, their patients have had a high survival rate after resection for renal tumour. The clear-cell tumours are well demarcated by a fibrous capsule and they can easily be resected. The granular-cell renal tumours are localized more centrally, they often infiltrate the kidney. In cases cautiously considered, the resection of the tumorous kidney can be performed under the present technical conditions by strict 6 monthly postoperative urographic, ultrasound, and angiographic examinations.

Diagnosis and treatment of adult polycystic kidney disease.

The methods applicable to the diagnosis of polycystic kidney disease are reviewed. By assessing the clinical data of 314 patients suffering from adult polycystic kidney disease who had been treated in the 30 years between 1950 and 1979, the importance of conservative therapy and nephrological care is emphasized. The significance of hemodialysis in therapy and the special circumstances of transplantation are discussed. The indication of surgical treatment can be extended in complication-free cases.

Diagnosis of an obstructed calyceal diverticulum by ultrasonography.

A case is reported in which diagnosis of a calyceal diverticulum, at the time of observation of cystic appearance, was made by ultrasonography, without requiring special roentgen diagnostic procedures of limited safety.

[Papillary tumors of the renal pelvis: 25-year-old clinical material]. / Uber die papillären Tumoren des Nierenhohlsystems--25jähriges klinisches Material.

A total of 83 patients with papillary tumour in the renal pelvis have been observed in 25 years. The peak incidence was in the age group between 51 and 70 years. The first symptom was almost always haematuria without any other symptom. The therapy is surgical, complemented with radiotherapy and/or chemotherapy. The problem of the involvement of the bladder is discussed.