To assess the presence of Chlamydia trachomatis in nonacute abacterial prostatitis 30 patients with urethral cultures positive for Chlamydia trachomatis underwent microbiological studies, including cultures of transrectal aspiration biopsies of the prostate. Chlamydia trachomatis was isolated from 10 of the prostatic specimens (33 per cent). In 3 cases a nonspecific cytopathogenic effect caused the destruction of the tissue cultures. Our findings demonstrate that Chlamydia trachomatis may cause ascending infections of the prostate and that this microorganism may have an etiological role in the pathogenesis of nonacute abacterial prostatitis.

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In the present study we have evaluated the use of pretibial ultrasound for the diagnosis of pretibial myxedema (PTM). We studied 76 patients, 58 with Graves' disease, 13 with Hashimoto's thyroiditis and five with idiopathic hypothyroidism. Thirty-two normal subjects were also studied as controls. Sixty-four patients had associated ophthalmopathy. The ultrasound scanner was equipped with 10- and 13-MHz probes. Punch biopsies were carried out in 11 patients and tissue sections examined on a light microscope. On clinical examination 21 patients (28%) had suspected PTM. By ultrasound, we measured the thickness of dermis and subcutaneous tissue (D1) and that including only deeper dermis (D2) in normal subjects to define the echographic parameters of normal pretibial skin. We then found increased skin thickness in 25 patients (33%), with mean D1 and D2 values significantly higher than those measured in controls (p < 0.00001). The echographic study was positive in 20 patients with ophthalmopathy (31%). Ultrasound showed increased skin thickness in 16 of 21 patients (76%) with clinically suspected PTM. Histopathological findings confirmed the presence of PTM in all the patients who underwent pretibial skin biopsy. We believe that the measurement of pretibial skin thickness by ultrasound may be useful for revealing the presence of PTM.

Purified human syphilitic antibodies against both 15.5 Kd and 45 Kd treponemal antigens appear T. pallidum specific and do not cross react with antigens possessed by other treponemes (T. phagedenis, T. hyodysenteriae and a human intestinal treponeme). By using Western immunoblotting technique, 107 out of 110 syphilitic patients and 291 out of 294 subjects with serologically positive diagnostic tests for syphilis were found to have in their sera antibodies against a 15.5 Kd specific antigen of T. pallidum. These antibodies were present in 100% of the patient with secondary or early latent syphilis, both untreated and treated, in 98.24% of those with late latent treated syphilis and in 100% of patients with neurosyphilis. On the contrary, they were absent in 47 patients with false positive reactions for syphilis and in 121 healthy blood donors. For these reasons, the demonstration of these kind of antibodies in a patient's serum can be considered of high value in differentiating syphilitic patients from non infected individuals.

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