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S. Dieterle - One of the best experts on this subject based on the ideXlab platform.
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Presence of the major outer-membrane protein of Chlamydia trachomatis in patients with chronic Salpingitis and Salpingitis isthmica nodosa with tubal occlusion
Fertility and sterility, 1998Co-Authors: S. Dieterle, Carola Rummel, L.werner Bader, Heiko Petersen, Thomas FennerAbstract:Abstract Objective: To determine the presence of the major outer-membrane protein of Chlamydia trachomatis in fallopian tube tissue specimens of infertile women with chronic Salpingitis and/or Salpingitis isthmica nodosa with tubal occlusion. Design: Prospective controlled study. Setting: Department of Obstetrics and Gynecology, University of Bochum, Herne, Germany. Patient(s): Fifty-six consecutive infertile women with histologically documented chronic Salpingitis and/or Salpingitis isthmica nodosa and bilateral tubal occlusions were evaluated. They were compared with 28 fertile women. Intervention(s): Fallopian tube tissue specimens were taken during reconstructive infertility surgery, including cesarean section and tubal ligation. Main Outcome Measure(s): Detection of the major outer-membrane protein of C. trachomatis in fallopian tube tissue specimens by a direct fluorescent antibody test. Result(s): The major outer-membrane protein of C. trachomatis was found in fallopian tube tissue specimens in 11 of 56 infertile patients (20%) with chronic Salpingitis and/or Salpingitis isthmica nodosa. The median titer of IgG serum antibodies to Chlamydia was significantly higher in women with the major outer-membrane protein of C. trachomatis than in patients without this antigen. In comparison, the major outer-membrane protein of C. trachomatis was not found in any of the fallopian tube tissue specimens of the control group. Conclusion(s): The presence of the major outer-membrane protein of C. trachomatis is associated with chronic Salpingitis and/or Salpingitis isthmica nodosa with tubal occlusion.
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humoral immune response to the chlamydial heat shock proteins hsp60 and hsp70 in chlamydia associated chronic Salpingitis with tubal occlusion
Human Reproduction, 1996Co-Authors: S. Dieterle, J WollenhauptAbstract:The aim of this study was to evaluate the prevalence of serum immunoglobulin (Ig) G and IgA antibodies to recombinant chlamydial 60 kDa heat shock protein (C-hsp60) and to assess the prevalence of serum IgG antibodies to recombinant chlamydial 70 kDa heat shock protein (C-hsp70) in Chlamydia-associated chronic Salpingitis and/or Salpingitis isthmica nodosa with tubal occlusion. Infertile patients (n = 34) with Chlamydia-associated, histologically documented chronic Salpingitis and/or Salpingitis isthmica nodosa and bilateral tubal occlusions (group I) were compared with infertile patients (n = 19) without tubal occlusions (group II). The prevalence of chlamydial antigen in endocervical, urethral and urine samples was low in both groups. The median chlamydial serum IgG and IgA antibody titres were significantly higher in group I than in group II (P < 0.0001 and P = 0.0002 respectively). Serum IgG antibodies to C-hsp60 and C-hsp70 were detected in 24 out of 34 patients (71%) in group I compared with 10 out of 19 (53%) and nine out of 19 (47%) patients in group II (not significantly different). There was a significant difference (P = 0.035) between the prevalences of serum IgA antibodies to C-hsp60 in groups I (seven out of 34 patients ; 21%) and II (none of the 19 patients). The association between the presence of serum IgA antibodies to C-hsp60 and Chlamydia-associated chronic Salpingitis and/or Salpingitis isthmica nodosa with tubal occlusion underlines the significance of chlamydial 60 kDa heat shock protein in the pathogenesis of tubal infertility.
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Is there a correlation between tubal occlusions in chronic Salpingitis and urogenital chlamydia infections
Geburtshilfe und Frauenheilkunde, 1994Co-Authors: S. Dieterle, M. Mesrogli, B. Triebler, J Wollenhaupt, E Nettelnbreker, H.-w. SchlösserAbstract:A prospective study was performed to analyse the relationship between urogenital infections caused by Chlamydia trachomatis and occlusions of the fallopian tubes with histologically confirmed chronic Salpingitis and Salpingitis isthmica nodosa. 110 infertile patients were tested for C. trachomatis infection. 23 patients with tubal occlusions and histologically confirmed chronic Salpingitis (group 1) and eight patients with Salpingitis isthmica nodosa (group 2) were compared to 13 patients with tubal occlusions after tuboligation (group 3), and to 66 patients with patent fallopian tubes as demonstrated by laparoscopy or hysterosalpingography (group 4). The prevalence of infections of the endocervix or urethra and the presence of Chlamydia in urine was low in all four groups. However, in groups 1 and 2, the median Chlamydia IgG and IgA serum antibody titres were significantly higher (p < or = 0.0002) than in groups 3 and 4. This result illustrates the association between urogenital infections with Chlamydia and tubal occlusions with histologically documented chronic Salpingitis and Salpingitis isthmica nodosa.
J Wollenhaupt - One of the best experts on this subject based on the ideXlab platform.
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humoral immune response to the chlamydial heat shock proteins hsp60 and hsp70 in chlamydia associated chronic Salpingitis with tubal occlusion
Human Reproduction, 1996Co-Authors: S. Dieterle, J WollenhauptAbstract:The aim of this study was to evaluate the prevalence of serum immunoglobulin (Ig) G and IgA antibodies to recombinant chlamydial 60 kDa heat shock protein (C-hsp60) and to assess the prevalence of serum IgG antibodies to recombinant chlamydial 70 kDa heat shock protein (C-hsp70) in Chlamydia-associated chronic Salpingitis and/or Salpingitis isthmica nodosa with tubal occlusion. Infertile patients (n = 34) with Chlamydia-associated, histologically documented chronic Salpingitis and/or Salpingitis isthmica nodosa and bilateral tubal occlusions (group I) were compared with infertile patients (n = 19) without tubal occlusions (group II). The prevalence of chlamydial antigen in endocervical, urethral and urine samples was low in both groups. The median chlamydial serum IgG and IgA antibody titres were significantly higher in group I than in group II (P < 0.0001 and P = 0.0002 respectively). Serum IgG antibodies to C-hsp60 and C-hsp70 were detected in 24 out of 34 patients (71%) in group I compared with 10 out of 19 (53%) and nine out of 19 (47%) patients in group II (not significantly different). There was a significant difference (P = 0.035) between the prevalences of serum IgA antibodies to C-hsp60 in groups I (seven out of 34 patients ; 21%) and II (none of the 19 patients). The association between the presence of serum IgA antibodies to C-hsp60 and Chlamydia-associated chronic Salpingitis and/or Salpingitis isthmica nodosa with tubal occlusion underlines the significance of chlamydial 60 kDa heat shock protein in the pathogenesis of tubal infertility.
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Is there a correlation between tubal occlusions in chronic Salpingitis and urogenital chlamydia infections
Geburtshilfe und Frauenheilkunde, 1994Co-Authors: S. Dieterle, M. Mesrogli, B. Triebler, J Wollenhaupt, E Nettelnbreker, H.-w. SchlösserAbstract:A prospective study was performed to analyse the relationship between urogenital infections caused by Chlamydia trachomatis and occlusions of the fallopian tubes with histologically confirmed chronic Salpingitis and Salpingitis isthmica nodosa. 110 infertile patients were tested for C. trachomatis infection. 23 patients with tubal occlusions and histologically confirmed chronic Salpingitis (group 1) and eight patients with Salpingitis isthmica nodosa (group 2) were compared to 13 patients with tubal occlusions after tuboligation (group 3), and to 66 patients with patent fallopian tubes as demonstrated by laparoscopy or hysterosalpingography (group 4). The prevalence of infections of the endocervix or urethra and the presence of Chlamydia in urine was low in all four groups. However, in groups 1 and 2, the median Chlamydia IgG and IgA serum antibody titres were significantly higher (p < or = 0.0002) than in groups 3 and 4. This result illustrates the association between urogenital infections with Chlamydia and tubal occlusions with histologically documented chronic Salpingitis and Salpingitis isthmica nodosa.
Grant E Schmidt - One of the best experts on this subject based on the ideXlab platform.
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Salpingitis isthmica nodosa a review of the literature discussion of clinical significance and consideration of patient management
Fertility and Sterility, 1993Co-Authors: Carol S Jenkins, Steven R Williams, Grant E SchmidtAbstract:Objectives To examine and discuss the pathology, diagnosis, incidence, and patient profile of Salpingitis isthmica nodosa and to question its natural history, propose management strategies, and identify areas of promising research. Design Over 50 studies were reviewed, evaluated, and compared to offer the clinician a foundation on which to generate treatment plans. Results Salpingitis isthmica nodosa is diagnosed by the pathological presence of isthmic diverticula and may be suggested by characteristic changes on hysterosalpingogram. Its incidence in healthy, fertile women ranges from 0.6% to 11%, but it is significantly more common in the setting of ectopic pregnancy and infertility. There are no studies, retrospective or prospective, that clearly dictate appropriate therapy. Conclusion Given its progressive nature and probable deleterious effects on fertility, we propose that microtubal surgery be the definitive treatment for qualified women who have Salpingitis isthmica nodosa.
Thomas Fenner - One of the best experts on this subject based on the ideXlab platform.
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Presence of the major outer-membrane protein of Chlamydia trachomatis in patients with chronic Salpingitis and Salpingitis isthmica nodosa with tubal occlusion
Fertility and sterility, 1998Co-Authors: S. Dieterle, Carola Rummel, L.werner Bader, Heiko Petersen, Thomas FennerAbstract:Abstract Objective: To determine the presence of the major outer-membrane protein of Chlamydia trachomatis in fallopian tube tissue specimens of infertile women with chronic Salpingitis and/or Salpingitis isthmica nodosa with tubal occlusion. Design: Prospective controlled study. Setting: Department of Obstetrics and Gynecology, University of Bochum, Herne, Germany. Patient(s): Fifty-six consecutive infertile women with histologically documented chronic Salpingitis and/or Salpingitis isthmica nodosa and bilateral tubal occlusions were evaluated. They were compared with 28 fertile women. Intervention(s): Fallopian tube tissue specimens were taken during reconstructive infertility surgery, including cesarean section and tubal ligation. Main Outcome Measure(s): Detection of the major outer-membrane protein of C. trachomatis in fallopian tube tissue specimens by a direct fluorescent antibody test. Result(s): The major outer-membrane protein of C. trachomatis was found in fallopian tube tissue specimens in 11 of 56 infertile patients (20%) with chronic Salpingitis and/or Salpingitis isthmica nodosa. The median titer of IgG serum antibodies to Chlamydia was significantly higher in women with the major outer-membrane protein of C. trachomatis than in patients without this antigen. In comparison, the major outer-membrane protein of C. trachomatis was not found in any of the fallopian tube tissue specimens of the control group. Conclusion(s): The presence of the major outer-membrane protein of C. trachomatis is associated with chronic Salpingitis and/or Salpingitis isthmica nodosa with tubal occlusion.
Gina Romosan - One of the best experts on this subject based on the ideXlab platform.
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2016Co-Authors: Phd Frcog, Gina RomosanAbstract:1 Ultrasound for diagnosing acute Salpingitis: a prospective observational diagnostic stud
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Ultrasound for diagnosing acute Salpingitis: a prospective observational diagnostic study
Human reproduction (Oxford England), 2013Co-Authors: Gina Romosan, L Skoog, Carina Bjartling, L ValentinAbstract:STUDY QUESTION: What are the diagnostic benefits of using ultrasound in patients with a clinical suspicion of acute Salpingitis and signs of pelvic inflammatory disease (PID)? SUMMARY ANSWER: In patients with a clinical suspicion of acute Salpingitis, the absence of bilateral adnexal masses at ultrasound decreases the odds of mild-to-severe acute Salpingitis about five times, while the presence of bilateral adnexal masses increases the odds about five times. WHAT IS KNOWN ALREADY: PID is difficult to diagnose because the symptoms are often subtle and mild. The diagnosis is usually based on clinical findings, and these are unspecific. The sensitivity and specificity of ultrasound with regard to Salpingitis have been reported in one study (n = 30) of appropriate design, where most patients had severe Salpingitis (i.e. pyosalpinx) or tubo-ovarian abscess. STUDY DESIGN, SIZE, DURATION: This diagnostic test study included 52 patients fulfilling the clinical criteria of PID. Patients were recruited between October 1999 and August 2008. PARTICIPANTS/MATERIALS, SETTING, METHODS: The patients underwent a standardized transvaginal gray scale and Doppler ultrasound examination by one experienced sonologist (index test) before diagnostic laparoscopy by a laparoscopist blinded to the ultrasound results. The final diagnosis was determined by laparoscopy, histology of the endometrium and other histology where relevant (reference standard). MAIN RESULTS AND THE ROLE OF CHANCE: Of the 52 patients, 23 (44%) had a final diagnosis unrelated to genital infection, while the other 29 had cervicitis (n = 3), endometritis (n = 9) or Salpingitis (n = 17; mild n = 4, moderate n = 8, severe, i.e. pyosalpinx n = 5). Bilateral adnexal masses and bilateral masses lying adjacent to the ovary were seen more often on ultrasound in patients with Salpingitis than with other diagnoses (bilateral adnexal masses: 82 versus 17%, i.e. 14/17 versus 6/35, P = 0.000, positive likelihood ratio 4.8, negative likelihood ratio 0.22; bilateral masses adjacent to ovary: 65 versus 17%, i.e.11/17 versus 6/35, P = 0.001, positive likelihood ratio 3.8, negative likelihood ratio 0.42). In cases of Salpingitis, the masses lying adjacent to the ovaries were on average 2-3 cm in diameter, solid (n = 14), unilocular cystic (n = 4), multilocular cystic (n = 3) or multilocular solid (n = 1), with thick walls and well vascularized at colour Doppler. In no case were the cogwheel sign or incomplete septae seen. All 13 cases of moderate or severe Salpingitis were diagnosed with ultrasound (detection rate 100%, 95% confidence interval 78-100%) compared with 1 of 4 cases of mild Salpingitis. Three of six cases of appendicitis, and two of two ovarian cysts were correctly diagnosed with ultrasound, and one case of adnexal torsion was suspected and then verified at laparoscopy. LIMITATIONS, REASONS FOR CAUTION: The sample size is small. This is explained by difficulties with patient recruitment. There are few cases of mild Salpingitis, which means that we cannot estimate with any precision the ability of ultrasound to detect very early Salpingitis. The proportion of cases with Salpingitis of different grade affects the sensitivity and specificity of ultrasound, and the sensitivity and specificity that we report here are applicable only to patient populations similar to ours. WIDER IMPLICATIONS OF THE FINDINGS: The information provided by transvaginal ultrasound is likely to be of help when deciding whether or not to proceed with diagnostic laparoscopy in patients with symptoms and signs suggesting PID and, if laparoscopy is not performed, to select treatment and plan follow-up. STUDY FUNDING/COMPETING INTEREST(S): This work was supported by funds administered by Malmo University Hospital and two Swedish governmental grants (ALF-medel and Landstingsfinansierad Regional Forskning). The authors have no conflict of interest.
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op19 05 ultrasound for discrimination between acute Salpingitis and other conditions in patients with clinical signs and symptoms suggesting acute salpingits a prospective observational cross sectional study
Ultrasound in Obstetrics & Gynecology, 2012Co-Authors: Gina Romosan, C Bjartling, L Skoog, L ValentinAbstract:Objectives: To describe ultrasound findings in patients with acute Salpingitis and to determine if it is possible using ultrasound to discriminate between acute Salpingitis and other painful conditions mimicking clinical symptoms/ findings of acute Salpingitis. Methods: 52 patients underwent a standardized transvaginal ultrasound scan before diagnostic laparoscopy because of clinical suspicion of acute Salpingitis. The laparoscopist was blinded to scan results. Final diagnosis was based on laparoscopy, histology of the endometrium or other histology where relevant. Results: 29 patients had a final diagnosis of cervicitis (n = 3), endometritis (n = 9), or Salpingitis (n = 17), 23 (44%) had a diagnosis unrelated to genital infection. In 4 cases the Salpingitis was mild, in 8 moderate, in 5 severe (pyosalpinx). Bilateral adnexal masses and bilateral masses lying adjacent to the ovary were seen more often at scan in patients with Salpingitis than with other diagnoses (14/17 vs. 6/35, P = 0.000; 11/17 vs. 6/35, P = 0.001). In Salpingitis, the masses lying adjacent to the ovaries were on average 2–3 cm in diameter, solid (n = 14), unilocular (n = 4) or multilocular (n = 3) cystic, or multilocular solid (n = 1), and well vascularized at color Doppler. Spectral Doppler results overlapped between patients with different diagnoses. The sensitivity with regard to acute Salpingitis of subjective assessment of scan findings by the sonologist was 82%, specificity 77%, positive and negative likelihood ratio (LR+) 3.6 and 0.23. Those of scan findings of bilateral masses lying adjacent to the ovary were 65%, 83%, LR+ 3.8 and LR− 0.42. The corresponding figures for bilateral adnexal masses were 82%, 83%, 4.8 and 0.22. Conclusions: In patients with clinical suspicion of acute Salpingitis, absence of bilateral adnexal masses at scan decreases the odds of acute Salpingitis 5-fold.
