A clinical study of schizophrenic suicides. 42 cases in Taiwan

A clinical study of 25 male and 17 female schizophrenic suicides is presented. Jumping from a height was the most common method used. The 42 suicidal schizophrenics in Taiwan were compared with both 84 sex- and age-matched and 60 5-year illness course non-suicidal schizophrenic control groups. The suicidal schizophrenics were not significantly different from the non-suicidal counterparts of both control groups with regard to age, sex, ethnicity, religion, educational background, the presence of suicide cases in the family history, and the presence of insight, but were significantly different in characteristics of a history of previous suicide attempts, presence of psychotic symptoms during their final month, depression during their final month, a history of depression, a history of previous psychiatric hospitalizations, and the number of hospitalizations. We discuss the findings from this study and others in the literature in the context of the different clinical and socio-cultural backgrounds of these Taiwanese schizophrenic suicides.

Lack of correlation between frontalis electromyography and self-ratings of either frontalis tension or state anxiety

Since training in deep muscular relaxation is common to most behavioral treatments for anxiety and tension-related disorders, muscle tension measures, such as electromyography (EMG), would provide valuable information as to the efficacy of these treatments. In the past, however, the majority of clinical reports on behavioral treatments employing muscular relaxation have based results primarily on self-rated outcome measures, despite evidence in the literature of a lack of correspondence between self-ratings and physiological measures of muscle tension. An experiment was performed on 20 normal subjects comparing self-ratings of anxiety and frontalis muscle tension with frontalis EMG before and after a 15-min. relaxation period accompanied by frontalis EMG biofeedback. Analysis showed that the self-ratings of anxiety and frontalis tension correlated significantly both before and after the relaxation period. However, no correlation was observed between self-rated anxiety or frontalis tension and frontalis EMG either before or after the relaxation period. The relaxation period had no significant effect on the dependent measures. It is suggested that, if people are unable to report accurately on their somatic states, then physiological outcome measures, such as EMG, would be preferable to self-rated measures in assessments of relaxation training procedures.

Effects of cranial transcutaneous electrical nerve stimulation in normal subjects at rest and during psychological stress

Some effects of sub-threshold sine-wave transcutaneous electrical nerve stimulation (TENS), passed between earlobe electrodes at a constant alternating current (AC) frequency of 100 Hertz (Hz), were investigated in 90 normal subjects after 30 minutes of treatment, and after 3 minutes of standardized mental stress (mental arithmetic) which immediately followed the 30 minute treatment. In a double-blind protocol, five groups received 1) active TENS during treatment and active TENS during stress; 2) active TENS during treatment and placebo TENS during stress; 3) placebo TENS during treatment and placebo TENS during stress; 4) placebo TENS during treatment and active TENS during stress; and 5) no treatment during both treatment and stress. Results showed significant reductions in systolic blood pressure, pulse rate and anxiety, but not in diastolic blood pressure or peripheral vascular tension, after 30 minutes of active TENS as compared to no treatment. No placebo TENS effect was observed. No significant differences were observed between active TENS; placebo TENS and no treatment in physiological or psychological response to the stress procedure. Results are discussed in terms of the applicability of this technique to the management of stress.

General criteria for nonclassical photon statistics in multimode radiations

Using Muirhead's inequality based on the concept of majorization, general criteria for nonclassical photon statistics of arbitrary orders and involving any number of modes of radiations are derived. For the case of second-order correlations, it implies that both intramode antibunching and intermode bunching can contribute toward making multimode radiations nonclassical.

Dermatologic surgery--its scope and some practical aspects

Dermatologic surgery is of increasing interest to both dermatologists and other medical practitioners. It includes procedure like biopsy, excisional surgery, laser surgery, electrosurgery, curettage surgery, nail surgery, cryosurgery, minigrafting, sclerotherapy, collagen implant, punch grafting, Moh's micrographic surgery, dermabrasion and hair transplant. This article highlights the important aspects of the various procedures and some of the more important practical points.

Pyodermas: an analysis of 127 cases

In an analysis of 127 patients with pyodermas, 38 (30%) had primary pyodermas and 89 (70%) had secondary pyodermas. Seventy-one percent (71%) of the primary pyodermas were due to Staphylococcus aureus (S. aureus). Five (5%) of the primary pyodermas were due to multiple organisms. Among the patients with secondary pyodermas, 45% were due to S. aureus, 21% Streptococci, 9% Pseudomonas and 9% Proteus species. Forty-four percent (44%) of the secondary pyodermas were due to multiple organisms. S. aureus is highly sensitive to cephalothin, cloxacillin, erythromycin, methicillin and co-trimoxazole. Streptococci are highly sensitive to cephalothin, erythromycin, ampicillin and penicillin. The gram-negative organisms are sensitive to amikacin, gentamicin, kanamycin and co-trimoxazole. Cloxacillin, or erythromycin (for patients with penicillin allergy) is the antibiotic of choice in patients with primary pyodermas. In patients with infected eczemas, first-generation cephalosporin or cloxacillin is the preferred antibiotic. In patients with infected ulcers, a combination of cloxacillin and gentamicin or a cephalosporin effective against the causative agent is most suitable.

Evaluation of cerebrospinal fluid in asymptomatic late syphilis

A prospective study of the cerebrospinal fluid (CSF) of 49 previously untreated patients with asymptomatic late syphilis of more than two year's duration was conducted. The sera of all patients had reactive fluorescent treponemal antibody absorption (FTA-Abs) tests or Treponema pallidum haemagglutination tests (TPHA), and reactive or non-reactive Venereal Disease Research Laboratory (VDRL) tests. Five (10%) patients had abnormal CSF findings; these included elevated protein in four of 49 and pleocytosis in three of 49. Asymptomatic neurosyphilis, diagnosed on the basis of a reactive VDRL test of the CSF, was present in one (2%) of 49 patients.

Epidemiology of acute epididymo-orchitis in Singapore

A prospective study on 55 patients with acute epididymo-orchitis was studied. Their ages ranged from 15 to 65 years. Thirty-three (60%) were within the 20-29 year age group and 9 were above 35 years of age. 69% cited prostitutes as the source of sexual contact. Twenty-six patients did not receive and 29 patients received antibiotic therapy before recruitment. In the former untreated group, 6 patients (23%) had gonococcal urethritis, 3 patients (11%) had chlamydial urethritis and 2 patients (8%) had combined gonococcal and chlamydial urethritis. No pathogens were isolated from the urethra from the remaining 15 (58%) patients, 8 of whom had nonspecific urethritis. In the latter treated group, 4 patients (14%) had gonococcal urethritis and no organisms were isolated from the remaining 25 (86%) of whom 6 had non-specific urethritis. None of the 55 patients had urinary tract infections. Forty-three patients (78%) had unilateral involvement of both the testis and epididymis, and 4 patients (7%) had bilateral epididymo-orchitis. Semen analysis was performed on 13 patients of whom 8 showed pyospermia.

Endocervical chlamydial infection in female contacts of patients with nongonococcal urethritis

Eighty-five female contacts of patients with nongonococcal urethritis attending Middle Road Hospital were examined. Chlamydia trachomatis was isolated from the cervix in 39% of them. Forty-five per cent of the chlamydia-positive patients were asymptomatic and 79% of them showed signs of a cervicitis. None of the patients developed complications. Neisseria gonorrhoeae was not isolated from any of the patients. Clinical markers other than cervicitis are not useful for detecting chlamydial infections in female contacts of NGU. Until such time when cheaper, more convenient and accurate methods of laboratory diagnosis of C. trachomatis are put to routine use, it would seem prudent to treat all female contacts of NGU patients after exclusion of other sexually transmitted diseases.

Bacampicillin to treat non-gonococcal urethritis in men: pilot study

Of 84 men with non-gonococcal urethritis (NGU), 24 yielded Chlamydia trachomatis by either cell culture or MicroTrak immunofluorescence test. All 84 were treated with bacampicillin 800 mg twice a day for seven days. Five (one chlamydia positive) defaulted from follow up 10 to 14 days after the start of treatment. Of the 23 chlamydia positive patients who attended follow up, 22 became chlamydia negative; 14 of the 23 patients also became asymptomatic and had normal urethral smears. Of the 56 chlamydia negative patients who attended follow up, 21 were cleared of their urethritis. Two patients reported side effects; one drowsiness and one mild diffuse alopecia. Bacampicillin may therefore be a safe and effective alternative to tetracycline or erythromycin in treating chlamydial urethritis in men.

The effects of cranial TENS on measures of autonomic somatic and cognitive activity

Peripheral and central nervous system effects of the cranial application of sub-threshold transcutaneous electrical nerve stimulation (TENS), of sinusoid waveform passed between earlobe electrodes at an AC frequency of 100 Hertz, were investigated. In a single-blind study, each of thirty healthy volunteer subjects was administered one 30 minute treatment of either active TENS, placebo TENS or no treatment. Pretreatment to post-treatment changes in measures of autonomic activity (blood pressure, pulse rate, peripheral vasomotor activity), somatic activity (skeletal muscle tension), and anxiety were evaluated. Significant reductions in systolic blood pressure (p less than .05), diastolic blood pressure (p less than .01), pulse rate (p less than .05), peripheral vasomotor activity (marginally significant: p less than .07) and anxiety (p less than .05) were observed subsequent to active. TENS as compared to both placebo TENS and no TENS. No significant placebo TENS effect was observed. Possible mechanisms of action of this form of cranial TENS on the peripheral and central nervous system are discussed.

A case of malignant pyoderma with neurological manifestations

A case of malignant pyoderma with a fatal course is presented. A 62-year-old Chinese man was admitted with a 8-month history of progressive ulcerative nodular skin lesions starting on the right antecubital fossa and spreading to the chest, face, arms and legs. The lesions failed to respond to many antibiotics. Examination revealed multiple large crusted foul-smelling ulcers with erythematous raised vegetative edges and tender erythematous nodules. Investigations showed an anaemia of chronic disease and an erythrocyte sedimentation rate of 135mm/1st hour. Histology showed multiple circumscribed microabscesses in the upper dermis. The skin lesions responded well to systemic corticosteroid therapy. Three months after admission, he developed multiple cranial nerve palsies, and severe progressive peripheral neuropathy. Radiographic studies revealed cavitating lesion in the right upper lobe consistent with a diagnosis of carcinoma of the lung. Five months after admission, patient was intubated for stridor but he succumbed to aspiration pneumonia. Malignant pyoderma should be considered if an ulcer fails to respond to antibiotics, and possible neurological complications should be thought of.

Single dose oral norfloxacin or intramuscular spectinomycin to treat gonorrhoea (PPNG and non-PPNG infections): analysis of efficacy and patient preference

Norfloxacin, a new oral quinolone, was compared with intramuscular spectinomycin for treating culture proved gonorrhoea (caused by penicillinase producing strains of Neisseria gonorrhoeae (PPNG) and non-PPNG strains. A total of 547 infected men and women were randomly allocated to treatment with either single dose norfloxacin (800 mg by mouth) or spectinomycin (2 g intramuscularly). Patient preference for tablets or injections was noted at this visit. Patients returned four to eight days later for assessment of efficacy, safety, and preference. Of the 482 patients who attended follow up, all those treated with norfloxacin (94 infected with PPNG strains, 145 with non-PPNG strains) and all 82 infected with PPNG strains and treated with spectinomycin were cured. Of 161 infected with non-PPNG strains and treated with spectinomycin, 159 (99%) were cured. Side effects (headache, nausea, and sleepiness) occurred in three patients receiving norfloxacin and in 17 (16 pain at injection site, 1 giddiness) receiving spectinomycin. Most patients preferred tablets to injection both on day 1 (313 v 200) and at follow up (373 v 104). This study showed that norfloxacin was a highly effective alternative to spectinomycin, produced fewer side effects, and was the preferred mode of administration.

Genital herpes in Singapore

As in many parts of the world, the incidence of genital herpes has increased in Singapore, the increase occurring sharply from 1982 onwards, and affecting females to a greater extent than males. Peak incidence in both sexes was found to occur in the 15-34 year age group. Changes in sexual practices, a decreasing prevalence of age-specific antibody to herpes simplex type 1 virus in sexually active adults, and greater interest in the disease following publicity in the media, are factors which have contributed to both a real and an apparent increase in incidence. However, the incidence in Malay males is very low, and neonatal herpes is extremely rare in the local population. Herpes simplex virus type 1 is responsible for about 30% of initial genital infections and an even higher proportion of primary genital herpes infections. Approximately 16% of purulent penile ulcers in Singapore are associated with genital herpes infection.

Condyloma latum mimicking keratoacanthoma in patient with secondary syphilis

A 31 year old man with a condyloma latum simulating a keratoacanthoma at the umbilicus is reported. The umbilicus should be included in the list of known sites of predilection for condylomata lata.

Initial experience with CO2 laser in treating dermatological conditions

CO2 laser was first used in the treatment of melanomas in animals. Since then, it has been successfully used in treating many dermatological conditions. A total of 47 patients were treated once as outpatients in Middle Road Hospital by using Model 720 Sharplan CO2 Laser System and Yoshida Opelaser-01 CO2 Laser System to determine the usefulness of CO2 laser in the treatment of various dermatological conditions. The laser was used mainly in the defocused mode at 10 watts. Local anaesthetic with 1% lignocaine HCL was employed in all cases. 3 patients defaulted follow-up. Of the 30 patients with warts, most of which were recalcitrant, 14 were cured and the remaining 16 showed marked improvement. 4 of the 5 patients with lichen simplex chronicus were cured. 1 patient each of the following conditions were also treated; prurigo nodularis, psoriasis, solar keratosis, ingrowing toe nail, Bowen's disease, infected callosity and lichen amyloidosis; cure was achieved in the former 4 conditions. The laser failed to cure 2 patients with pyogenic granuloma. Side effects included hypopigmentation (62%), mild post-operative pain (11%), scarring (11%), excess granulation tissue (11%), and infection (2%). CO2 laser is a potentially useful, effective and safe treatment modality for many dermatological conditions.

Single dose piperacillin in treating uncomplicated gonococcal urethritis in men

A single intramuscular dose of piperacillin 2 g, with probenecid 1 g orally, was used to treat 82 men with uncomplicated gonococcal urethritis due to penicillinase producing strains of Neisseria gonorrhoeae (PPNG) or non-PPNG. All 49 patients infected with non-PPNG strains were cured, as opposed to only 25 (76%) of 33 patients infected with PPNG strains, giving an overall success rate of 90%. No serious side effects of treatment were observed. Post gonococcal urethritis (PGU) occurred in 18% of the patients treated. Antibiotic susceptibility tests showed that 44 (96%) of the 46 non-PPNG strains tested had MICs of piperacillin of 2 mg/l or less and 26 (76%) of the 34 PPNG strains had MICs of 32 mg/l or more. This regimen is not recommended for use as first line treatment in areas where there is a high incidence of infection with PPNG strains. It is, however, highly effective against non-PPNG strains.

Epidemiology of syphilis in Singapore over three decades (1955-1986)

The overall incidence of syphilis in the last three decades has decreased from 93.3 cases per 100,000 population in 1955 to 42.5 in 1986 amidst fluctuations in between. The decrease from 1955 to 1965 might be related to the widespread use of penicillins. The increase from 1965 to 1973 could be attributed to the influx of tourists and the use of Singapore as a rest and recreation centre during the Vietnam war period; better reporting system; and waning herd immunity as a result of disappearance of yaws. The introduction of the Medical Scheme and better contact tracing methods might account for the drop from 1974 to 1979. In the last 7 years, there was some fluctuations in the overall incidence, but the incidence of early infectious syphilis rose from 10 per 100,000 in 1979 to 29 in 1986 with the greatest increase in the female patients with early latent syphilis. Female prostitutes contributed a substantial proportion of all the cases of early infectious cases, accounting for 32% of all the cases in 1984. Moreover, female prostitutes were cited as the main source of contact, 46% in a local study. The incidence rate of congenital syphilis remained low over the last three decades, averaging 0.36 per 1000 live births. Both early and late syphilis occurred most commonly in the 20-29-year-old age group. The male to female ratio changed from 3.5 in 1976 to one in 1986 for early infectious syphilis while the ratio for late syphilis was 0.7 in 1976 and 1 in 1986. The closing of the gap reflects better clinic acceptance by both sexes, good contact tracing and better public health education.

Total and Candida - Specific IgE in Recurrent Vaginal Candidiasis

Total and candida specific serum IgE levels were studied in 21 patients who fulfilled the criteria for recurrent vaginal candidiasis, and 45 controls. The candida specific IgE levels were significantly higher in patients with recurrent vaginal candidiasis when compared with the controls. There was no significant difference in the total IgE levels between patients and the controls. IgE is postulated to inhibit the cellular immune respsnse to candida and thereby prevent its eradication. There may be a genetic basis for the increased IgE levels.

The significance of Candida-specific serum IgE in recurrent vaginal candidiasis

Total and Candida-specific serum concentrations of IgE were studied in 21 patients who fulfilled the criteria for recurrent vaginal candidiasis, and 45 controls. The candida specific IgE levels were significantly higher in patients with recurrent vaginal candidiasis than the controls. There was no significant difference in the total IgE levels between the patients and the controls. IgE is postulated to inhibit the cellular immune response to Candida and thereby prevent the eradication of the organism. There may be a genetic basis for the increased serum IgE levels. Hyposensitisation may be an effective mode of therapy.

Ceftriaxone for treatment of primary syphilis in men: a preliminary study

Eighteen male patients with primary syphilis were randomly assigned to one of the following treatment schedules: ceftriaxone (3 g in a single intramuscular [im] injection), ceftriaxone (2 g im daily for two days), ceftriaxone (2 g im daily for five days), and benzathine penicillin (2.4 X 10(6) units in a single im injection). The single 3-g dose of ceftriaxone cured three men, one had a sustained response, and one failed to be cured. Of the patients given 2 g of ceftriaxone im daily for two days, three were cured and two had a sustained response. All three men treated with 2 g of ceftriaxone daily for five days had a sustained response. In the group given penicillin, three men were cured, one had a sustained response, and one was lost to follow-up.

Self-application of podophyllin resin for penile condylomata acuminata

Two methods of podophyllin application, namely hospital-application (regimen A) and self-application (regimen B) of 25% podophyllin in tincture of benzoin compound for the treatment of penile condylomata were compared. The objective was to compare the response and safety of self-application with traditional hospital-application. A total of 100 men were selected, of which 64 were valid for evaluation of response. At six weeks' follow-up 66% and 72% of patients treated with regimen A and B, respectively were cured. Patients treated with regimen A were less compliant making only 58% of the required number of applications as compared with those treated with regimen B who made 92% of the applications. Of the patients successfully treated, 43% and 20% of those treated with regimens A and B, respectively were cured after only one or two applications (p greater than 0.1). Three patients--two treated with regimen A and one treated with regimen B suffered local reactions to the first application of podophyllin. All these patients recovered without sequelae. Self-application of podophyllin can therefore be used safely and effectively in selected men with penile condyloma acuminata.

Foscarnet (phosphonoformate sodium) in the treatment of recurrent male genital herpes

Foscarnet 0.3% cream was compared with placebo in a randomised double-blind study. The objective was to investigate the therapeutic efficacy and safety in men with recurrent genital herpes simplex virus (HSV) infections. A total of 51 patients were selected, of which 49 (25 treated with foscarnet) were valid for efficacy analysis. Different variables were analysed including the time to healing, alleviation of symptoms, side effects and the results of viral cultures. The median time to healing was 4 days in foscarnet treated patients compared to 5 days in placebo controls. The difference was not statistically significant (p = 0.22). However, foscarnet alleviated the severity of pain and also significantly reduced the median time to abolition pain to 3 days from 6.6 days in placebo treated patients (p = 0.0028). An antiviral effect of foscarnet was evident. The percentage of positive viral cultures found after starting treatment was 15% in the foscarnet-treated group compared to 44% in the placebo-treated group (p = 0.01). Treatment with foscarnet cream was not associated with any significant side effects.

Purulent penile ulcers of patients in Singapore

In 80 patients with painful purulent penile ulcers who attended the outpatient service of Middle Road Hospital in Singapore, Haemophilus ducreyi was isolated from 18 (22%), herpes simplex virus type 2 from nine (11%), and Neisseria gonorrhoeae from eight (10%). Primary pathogens were not isolated from 45 (57%) men. Painful purulent penile ulcers were more common in uncircumcised men, and patients had often acquired the disease after sexual intercourse with prostitutes in Singapore.

Single dose cefoxitin in treating uncomplicated gonorrhoea caused by penicillinase producing Neisseria gonorrhoeae (PPNG) and non-PPNG strains

A total of 136 patients with uncomplicated gonorrhoea were treated with intramuscular cefoxitin 2 g (25 patients) or 1 g (111 patients) and oral probenecid 1 g. Cefoxitin 1 g cured 95% (42 out of 45 men and all of 14 women) with infections caused by penicillinase producing Neisseria gonorrhoeae (PPNG) strains and 98% (all of 38 men and 13 out of 14 women) with non-PPNG infections, giving an overall cure rate of 96%. The rate of postgonococcal urethritis (PGU) in men treated with 1 g cefoxitin was 28%. No serious side effects of treatment were observed in patients treated with either dose. The failure rate of 7% in men infected with PPNG strains who were treated with the 1 g dose is, however, disturbing. We therefore recommend that intramuscular cefoxitin 2 g and oral probenecid 1 g may be used to treat uncomplicated gonorrhoea, especially in areas where PPNG strains are common.

Clinical experience in the use of clavulanic acid/penicillin regimens in the treatment of uncomplicated gonorrhoea

In an attempt to investigate the possibility of re-establishing the use of penicillins in the treatment of gonorrhoea in Singapore, a series of studies were conducted between 1981 and 1984, to evaluate the efficacy of a variety of penicillin-clavulanic acid combinations. A total of 6 different regimens were evaluated, and we concluded that 3 regimens consisting of 2 doses of Augmentin 3.25 g P.O., 4 hours apart (regimen C), aqueous procaine penicillin G (APPG) 4.5 mega units I.M. + Augmentin 375 mg + probenecid 1g P.O. (regimen E), and APPG 4.5 mega units I.M. + Augmentin 750 mg + probenecid 1g P.O. (regimen F) were very efficacious against infection due to PPNG and non PPNG. The cure rates obtained were 96.6% (regimens C and E), and 95% (regimen F) for infection due to PPNG and 95.6% (regimen C), and 100% (regimens E and F) for those due to non PPNG. Regimen E consisting of aqueous procaine penicillin G 4.5 meg units I.M. + Augmentin 375 mg + probenecid 1g P.O. was felt to be economical as well as effective against PPNG and non PPNG, and had the potential advantage of being effective against incubating syphillis. Regimen consisting 2 oral doses of Augmentin 3.25 g, 4 hours apart was an effective therapy for patients who preferred oral medication alone. However, this therapy was most costly. No serious side effects of treatment were observed with any of the regimens used.

Three regimens of procaine penicillin G, Augmentin, and probenecid compared for treating acute gonorrhoea in men

The efficacy of three penicillin regimens in treating uncomplicated gonorrhoea in men was evaluated. The regimens consisted of: Augmentin 3.25 g plus probenecid 1 g orally: aqueous procaine penicillin G 4.5 MIU intramuscularly and probenecid 1 g plus one tablet of Augmentin 375 mg orally; or aqueous procaine penicillin G 4.5 MIU intramuscularly and probenecid 1 g plus two tablets of Augmentin 375 mg orally. Cure rates for infections caused by penicillinase (beta lactamase) producing Neisseria gonorrhoeae (PPNG) were 87% (20/23) for regimen 1, 97% (28/29) for regimen 2, and 95% (19/20) for regimen 3. Thus the addition of one or two tablets of Augmentin 375 mg to aqueous procaine penicillin G and probenecid cured 96% (47/49) of infections caused by PPNG strains. All three regimens were 100% effective in eradicating infections caused by non-PPNG strains. Post gonococcal urethritis occurred in 24% of cases treated with regimen 1, 14% of cases treated with regimen 2, and 15% of cases treated with regimen 3. The geometric minimum inhibitory concentrations (MIC90) of Augmentin for 72 PPNG and 162 non-PPNG isolates of N gonorrhoeae obtained before treatment were 1.98 and 0.55 mg/l, respectively. Regimen 2, besides being effective against infections caused by PPNG or non-PPNG strains, has the advantage of cost effectiveness and low toxicity. This regimen may be useful in treating gonorrhoea in areas of high prevalence of PPNG strains, such as South East Asia and Africa.

Epidemiology of infectious syphilis in Singapore

The incidence of early infectious syphilis in Singapore rose from 8.7 per 100,000 in 1980 to 25 per 100,000 in 1984. In this epidemiological study of 100 patients with early syphilis, 70 were men, the mean age was 31.7 (range 17 to 68) years, 25 patients had primary syphilis, 47 secondary syphilis, and the remaining 28 had early latent syphilis. Female prostitutes were cited as sources of infection by 46 and homosexual contacts by 11. Reduced herd immunity, decreased use of penicillin, greater population movement, and decreased surveillance and awareness have contributed to this rise in infectious syphilis.

Chronic bullous dermatosis of childhood in Singapore

Five cases of chronic bullous dermatosis of childhood (CBDC), a rare bullous disease, are presented. Also known as linear IgA bullous dermatitis, it has significant immunofluorescence findings. Treatment with dapsone, 50 mg daily, is recommended.

The microbiology of non-gonococcal urethritis (NGU) in Singapore

Ninety-six men with non-gonococcal urethritis (NGU) were studied to determine the microbiology of NGU in Singapore. Chlamydia trachomatis emerged as the most common aetiologic agent, being isolated in 29 (30.2%) of 96 patients. The recovery rate of other potential pathogens and their significance locally are discussed.

Absence of generalized immunosuppression in C57BL/6J mice implanted with Lewis T241 fibrosarcoma or Lewis lung carcinoma

The immune status of C57BL/6J mice implanted with Lewis T241 fibrosarcoma or Lewis lung (LL) carcinoma was investigated on days 14 and 28 after implantation. Splenic lymphocyte responses were assessed in mitogen (Con A, LPS) mixed lymphocyte culture (MLC), natural killer (NK), graft-vs-host (GVH), and interleukin production assays. Except for NK-cell cytotoxicity, all other immunologic parameters were either comparable to those in medium-implanted controls or augmented. NK cytotoxicity was reduced in both tumor-bearing groups on day 28. The provision of NK potentiation therapy (beta-interferon, polyinosinic: polycytidylic acid) to T241 mice under various treatment conditions did not have any significant effect on lung metastasis or survival. The results of this study do not support the thesis that T241- or LL-bearing C57BL/6J mice are generally immunosuppressed. Indeed, when immune functions were assessed on the basis of total splenic activity, each of the measured immunologic parameters was substantially greater in animals with tumors than without. Further it seems improbable, considering the magnitude of the NK-cell defect in T241 mice on days 14 and 28 after implantation and the absence of a therapeutic response to NK-cell stimulants, that NK-cell cytotoxicity is intrinsically associated with resistance to tumor progression in this model.

Tiamulin feed medication for the maintenance of weight gains in the presence of mycoplasmal pneumonia in swine

Tiamulin, a semisynthetic antibiotic, was fed to growing pigs and its value in maintaining weight gain and feed efficiency in the face of mycoplasmal pneumonia was determined. Four treatments divided among 64 growing pigs from a conventional pig farm were used to test the effects of tiamulin administered in feed at levels of 10, 20 and 30 ppm. All pigs were artificially infected with Mycoplasma hyopneumoniae. Medication was started on the 14th day after infection (d 0) and continued for 28 d (d 0 to 28). Pigs were continued on test for an additional 14-d period for further observation (d 28 to 42) after the medicated feed was withdrawn. Tiamulin fed at 10, 20 and 30 ppm for 28 d did not cure the mycoplasmal pneumonia. The effect of tiamulin on growth performance was not the same for all periods. During the medication period (d 0 to 28), both daily gain and feed conversion were not significantly affected by dietary tiamulin concentrations. For the post-treatment period (d 28 to 42), tiamulin improved daily gain (P less than .05) and feed conversion (P less than .05) over those of nonmedicated controls, and the responses of both daily gain and feed efficiency increased linearly (P less than .05) as dietary tiamulin levels increased.

Simple method for quantifying pulmonary metastases in a murine fibrosarcoma

A simple method is described for quantitating pulmonary metastases in C57BL/6J mice implanted with the Lewis T241 fibrosarcoma. Lungs were removed from tumor-bearing mice, homogenized, and diluted to 14 ml with supplemented Roswell Park Memorial Institute Tissue Culture Medium 1640 (+5% fetal calf serum). Twenty-five microliters of lung suspension from individual mice were added to a flat-bottomed microtiter plate containing 175 microliters of supplemented media, pulsed with [3H]thymidine, and incubated for 20 hr at 37 degrees. The cells were processed with a multiple automated sample harvester and counted in a liquid scintillator. Total lung burden was extrapolated from measured radioactivity (as cpm) through the use of a standard curve. This method is reasonably accurate and precise and provides more quantitative information on the pulmonary metastatic process than most conventional assays.

Radioimmunoassay for immunoglobulin G autoantibody on the surface of mouse erythrocytes

A radioimmunoassay (RIA) for the determination of autoantibody on the surface of erythrocytes from New Zealand Black (NZB) mice is described. This method was adapted to hemagglutination plates in order to facilitate the separation of bound and unbound 125I-labeled rabbit anti-mouse immunoglobulin G with an automated cell harvester. Intra- and interday precision, over the useful quantitative range of the standard curve, was 3.9 and 12.9%, respectively. The RIA was five to ten times more sensitive than the direct antiglobulin test which, unlike the RIA, provided little quantitative information on a group of 20 experimental NZB mice. This is publication number 562 from the Department of Basic and Clinical Immunology and Microbiology, Medical University of South Carolina.

beta-Glucuronidase activation of latent aggression-promoting cues in mouse bladder urine

The present study was designed to investigate the chemical properties of the aggression-promoting cues present in bladder urine of male mice. The results of the first experiment confirmed earlier work by demonstrating the presence of an aggression-promoting chemosignal in bladder urine. In Experiment 2, behavioral assays were separately performed on the organic and aqueous layers of bladder urine obtained by repeated dichloromethane extractions. Only the combined organic layers of the initial three extractions demonstrated behavioral activity. A fourth extraction showed no behavioral activity for both organic and aqueous layers. However, the findings of Experiment 3 showed that incubation of the aqueous layer from the third CH2Cl2 extraction in beta-glucuronidase can free additional aggression-promoting cues into a subsequent CH2Cl2 extraction. It is concluded that two forms of the aggression-promoting chemosignal are present in bladder urine. One is lipophilic and behaviorally active, whereas the other is conjugated, possessing latent chemosignal properties.