In this prospective study of 303 pregnant women C. albicans was found in 50 patients (16.5 per cent) but only once was it isolated from the healthy vagina. The majority of isolates (84 per cent) were associated with signs of vaginitis or vulvovaginitis. In the remainder, isolation of the fungus was associated with discharge or other sign of morbidity. Discharge and irritation were not specifically associated with isolation of the thrush fungus, but 85 per cent of women with vaginitis during pregnancy had precipitins in their serum, or C. albicans in the vagina. Candida albicans was isolated from 23 of 28 women with vulvitis, and from 11 out of 16 women with vaginal plaques or a cheesy appearance of the vaginal epithelium.
MATERIALS AND METHODS
Preparation of antigensThree antigens derived from a strain of Candida albicans, group A (London School of Hygiene and Tropical Medicine no. 3153), were produced in bulk to minimise batch variation and stored in the freeze-dried state.(a) Mickle-disintegrated cytoplasmic antigen. A modification of the methods of Stallybrass (1964) and Taschdjian et al. (1964a) was used. The fungus was grown in shaken culture at 37°C for 48 hr. The culture medium was modified Sabouraud's glucose broth (peptone
Simultaneous measurement of cortisol, cortisone, and prednisolone is described. A dichloromethane extract of plasma is separated and purified by partition thin-layer chromatography and assayed by competitive protein binding. Using 0.2 ml of plasma, we could assay about 1 µg of these three steroids per 100 ml. We measured plasma corticosteroids in men on prednisone therapy, during ACTH stimulation, and in pregnant women at the time of delivery, and also in arterial and venous blood samples collected from the umbilical cord. Plasma concentrations of prednisolone (4.46 ± 1.07 µg/100 ml) were maximal 2 h after oral administration of prednisone (10 mg). Basal concentrations of cortisol and cortisone in these subjects were 10.50 ± 1.04 and 1.88 ± 0.69 (SD) µg/100 ml, respectively. The values decreased to less than 1 µg/100 ml 4 h after administration and returned to 12.82 ± 1.92 and 2.16 ± 0.49 µg/100 ml, respectively, by 24 h. After intramuscular injection of synthetic ACTH, values for cortisol and cortisone were maximal at 30 min, declining to pre-injection concentrations within 4 h. Plasma cortisol and cortisone values for maternal venous blood at delivery were 47.0 ± 8.5 and 7.1 ± 2.2, umbilical vein blood 4.9 ± 2.6 and 19.7 ± 2.8 and in blood from the umbilical arteries 7.3 ± 4.5 and 11.6 ± 4.9 µg/ 100 ml, respectively. Cortisol was higher (P < 0.05) in the umbilical arteries, cortisone (P < 0.01) in the umbilical vein.
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