Thirty-nine patients with cold urticaria seen over a 12-year-period were re-examined. All but 12 still had positive skin tests for cold and only five of these had shown a spontaneous cure. Fourteen patients were prone to collapse on cold exposure. The incidence of atopy in this group was comparable to that in control groups. Cold urticaria is an extremely chronic disease. The mean disease duration was 9.3 years. Serum antibodies to Epstein-Barr virus, measles virus, cytomegalovirus (CMV), varicella-zoster virus (VZV), herpes simplex virus (HSV), Chlamydia psittaci and Mycoplasma pneumoniae were determined in all 39 patients and compared with control groups. The EBV-antibody patterns (heterophile antibodies and different types of EBV-specific antibodies) showed no evidence of current or of recent primary or secondary infection with EBV. Complement fixing antibody titres to measles virus, CMV, HSV and Mycoplasma pneumoniae were significantly higher in cold urticaria patients than in controls. The existence of a basic immuno-regulatory defect responsible for both the cold urticaria and the elevated antibody levels is proposed.

The recently developed early antigen immunofluorescence (IF) method for the detection of infectious cytomegalovirus (CMV) in clinical specimens has hardly been applied on blood samples. We compared the CMV early antigen detection technique with the conventional cell culture method in 415 different buffy coat samples from 85 different immunocompromised patients. Duplicate coverslips were stained with two different monoclonal antibodies 4-6 days after inoculation. The conventional cultures were examined for typical cytopathic effects (CPE) during 10 weeks. Forty samples from 19 patients were positive by the IF technique, most of them with both monoclonal antibodies. Only 22 of these samples were positive in the conventional cell culture assay, on average after 15.8 days. CMV viraemia was detected exclusively by the IF method in 18 samples, 7 of which were from five patients without any further evidence of an active CMV infection. CMV viraemia was detected exclusively by the CPE method in eight samples, on average after no less than 36.6 days. CMV viraemia was not found in blood samples from 10 patients with laboratory proven active CMV infections and 53 patients without any evidence of an active CMV infection. In our hands the early antigen method for the detection of infectious CMV in blood is nearly as specific (at least 98.1%) and clearly much faster and more sensitive than the conventional cell culture method. The early CMV antigen detection method is therefore a very useful tool for the rapid detection of infectious CMV in blood.

A study to compare the polymerase chain reaction (PCR) test with the cell culture method in diagnosing urogenital Chiamydia trachomatis infections was performed. From 497 patients (212 women, 285 men) attending an outpatient clinic for sexually transmitted diseases, a total of 814 samples (female patients, cervix and urethra; male patients, urethra) were collected. This total included follow-up samples from 35 women and 35 men positive for C. trachomatis by cell culture and/or PCR test, which were collected 2 weeks after treatment with doxycycline (two 100-mg doses per day for 7 days). The PCR test was performed directly on clinical samples without performing phenol-chloroform extraction and ethanol precipitation of DNA. The prevalence of C. trachomatis as measured by positive cell culture was 64 of 497 (12.9%,) for all patients, 31 of 212 (14.6%) for women, and 33 of 285 (11.6%) for men. The prevalences as measured by positive PCR test were 71 of 497 (14.3%), 36 of 212 (17.0%/o), and 35 of 285 (12.3%), respectively. The sensitivities of the cell culture and the PCR test compared with that of true-positive samples were 77.5 to 78.4% and 99.0 to 100.0%/z, respectively. Discrepancies between cell culture and the PCR test were found for 23 of 497 patients (4.9%), 19 of 212 females (9.0,%), and 4 of 285 males (1.4%). Nineteen pretreatment samples from 19 patients (4 female endocervical, 13 female urethral, and 2 male urethral samples) were cell culture negative and PCR test positive, while 1 pretreatment female endocervical sample was cell culture positive and PCR test negative. The posttreatment samples from all patients were cell culture negative, but the PCR test remained positive for 3 of 70 patients (1 female endocervical and 2 male urethral samples). One of these samples became spontaneously negative in three more weeks. The medical history of the individual patient and the negative PCR tests after treatment for nearly all patients support our hypothesis that the positive PCR test results were clinically relevant for the cell culture-negative but PCR test-positive patients of the population studied. Chlamydia trachomatis is the most frequent cause of sexually transmitted disease in the Western world. Every year, an estimated 4 million cases occur in the United States

Summary The aim of this paper was to provide epidemiological evidence to support the notion that cervical intraepithelial neoplasia (CIN) without human papillomavirus (HPV) is a true entity. If a diagnosis of HPVnegative cervical neoplasia is erroneous, one would not expect there to be any differences in risk factors between HPV-positive and HPV-negative patients. Patients at a gynaecological outpatient clinic of a university hospital [a total of 265 consecutive women with dyskaryotic cervical smears who were subsequently diagnosed with CIN I (n = 37), CIN II (n = 48) or CIN III (n = 180)] completed a structured questionnaire regarding smoking habits and sexual history. Analysis of an endocervical swab for Chlamydia trachomatis, analysis of a cervical scrape for HPV, and morphological examination of cervical biopsy specimens were also performed. HPV was found in 205 (77.4%) out of the 265 women. Univariate analysis showed that current age (P= 0.02), current smoking behaviour (P = 0.002) and the number of sexual partners (P = 0.02) were significantly associated with the presence of HPV. Age at first sexual intercourse, a past history of venereal disease or genital warts, and current infection with Chiamydia trachomatis were not associated with the presence of HPV. Using multivariate logistic regression analysis, the number of sexual partners and current smoking behaviour showed an independent significant association with HPV. HPV-negative and HPV-positive CIN patients differ with respect to the risk factors for HPV. These findings suggest that HPV-negative CIN is a separate true entity.Keywords: cervix dysplasia; papillomavirus; risk factor Cervical intraepithelial neoplasia (CIN) is a morphologically defined lesion associated with the development of cervical carcinoma. In the conventional morphogenetic model CIN is separated into three grades according to the degree of cellular atypia and disturbance of the epithelial architecture (Richart, 1973). The infection with human papillomavirus (HPV) is strongly associated with cervical neoplasia. HPV shows considerable genetic heterogeneity (De Villiers, 1989), and a great diversity of HPV types is found in CIN Lungu et al., 1992; Bergeron et al., 1992). Known risk factors for cervical HPV infection are a comparatively young age and an increased lifetime number of sexual partners (Schiffman, 1994;Woodman, 1994). Smoking has also been identified as a risk factor 95%. Franco (1994) reported that this figure was still being scrutinised by the authors and it was likely that additional HPV-positive samples would be declared, raising the detection rate to very close to 100%. Such a result would be at odds with previous observations that HPV-negative and HPV-positive patients with squamous cell cancer of the cervix differ with respect to age and prognosis (Higgins et al., 1991;Riou et al., 1990). Opinions regarding the prevalence of HPV in CIN are fairly consistent. Schiffman (1994) mentioned that in their studies the prevalence of HPV in definite cases of CIN approached ...

A serological study using the complement fixation reaction for herpes zoster virus (HZV) and herpes simplex virus (HSV) was carried out on 120 patients with Bell's palsy and 5 with Ramsay-Hunt syndrome. Three Bell's palsy patients (2.5%) showed a significant HZV antibody titre rise. In no case was a rise of HSV antibody titre observed. Two Ramsay-Hunt patients showed a significant rise of HZV antibody titre. Rise of HSV antibody titre was not observed in this group either. The Monosticon test to exclude infectious mononucleosis, proved to be negative in all cases of Bell's palsy. In 2 cases of Bell's palsy, a biopsy specimen for virus isolation was obtained during a decompression operation. No virus could be cultured from the epineurium of the first patient. That of the second patient was found to contain HSV type I. There was no serological evidence of a HSV antibody titre rise.