Wassermann Reaction Research Articles

Cardiolipin antigen in the serodiagnosis of syphilis

The Kahn and M.R.C. No. 1 Wassermann tests using crude tissue extract antigens have been compared with a Wassermann test using cardiolipin-lecithin-cholesterol antigen on 2,000 sera.

Aplastic anaemia and severe hepatic zonal necrosis after anti-syphilitic treatment.

A married man aged 53 reported to the venereal diseases clinic in March, 1949, when he was found to have syphilis with an early secondary rash. A penile sore was present, and the Wassermann reaction was strongly positive. Treatment with Stabilarsan and bismuth was begun, and he received a total of 16-2 g. of the former, and 5 7 g. of the latter (a normal course) between March, 1949, and January, 1950, when he was given his last injection. About December, 1949, he had begun to complain of lassitude and anorexia, and in January, 1950, he became increasingly pale and dyspnoeic on exertion. On March 18, 1950, he was admitted to Darlington Memorial Hospital in an extremely pale and semi-comatose condition with temperature 98 0° F., pulse 120, and respiration 30. No icterus was present. There was a good deal of dental caries and pyorrhoea together with a severe stomatitis and gingivitis. In addition, a bluish-grey line was visible near the gum margins, and there were small patches of similar pigmentation on the mucous membrane of the cheeks. There was a moderate degree of sacral but no ankle oedema, and the neck veins were distended. No cutaneous or retinal haemorrhages were visible, and there was no enlargement of superficial lymph nodes. The liver could be felt, firm and smooth, with a regular edge, 4 cm. below the costal margin, but the spleen was not palpable. No cardiac enlargement could be made out clinically; there was a soft apical systolic murmur, and many crepitations were heard at the lung bases. The blood pressure was 110/80. The capillary resistance test was positive. The urine contained a trace of albumin. On admission, haemoglobin was 16 per cent. (14 g. = 100 per cent.); red blood cells 730,000 per c.mm., white blood cells 7250 per c.mm. (polymorphonuclear * Received for publication October 6 1953. leucocytes 74 per cent., lymphocytes 25 per cent., monocytes 1 per cent.), platelets 208,000 per c.mm. A stained film showed the red cells to be normal in size, shape, and staining. No primitive cells were seen. Treatment with penicillin and iron was commenced, and packed cells from three pints of blood were given slowly during the first 2 days, the haemoglobin rising to 48 per cent. on March 21, 1950. Intramuscular injections of B.A L. (2,3 dimercaptopropanol) were started on March 19, 1950 (2 ml. intramuscularly four times on the first day, twice daily for 4 days, and then daily for 2 days). The general condition of the patient improved rapidly, although he was for some days very confused and required sedation with paraldehyde. By March 31, the oral sepsis had largely disappeared, though the pigmentation persisted. After the first day there was no albuminuria, and the specific gravity of the urine rose on occasions to 1,020. Sternal puncture was performed on March 21, the count on films made from the aspirated marrow being as in Table I. Radiography on March 27, 1950, showed generalized enlargement of the heart and

Lady in Waiting

of maternity patients. This special afternoon gives the nurse an opportunity to explain the clinic routine to the new patient and it gives the patient an opportunity to discuss her problems without feeling that she is being rushed. I met Maxine when she came to the health clinic for her first visit. She was approximately four months pregnant and weighed 146 pounds-six pounds above her normal weight. She was pale and she looked tired. Since Maxine had had a Wassermann test, a urinalysis, and a hemoglobin test, I looked on her record for the reports. I noted that the Wassermann was negative, the urinalysis normal, but her hemoglobin was only 60 per cent. In discussing Maxine's diet with her I discovered that it was low in calcium, phosphorous, iron, and all the vitamins except vitamin C. I told her about the importance of these food elements and urged her to drink at least a quart of milk each day, as it is important for the baby's bones and teeth. I knew that fresh milk was expensive so I suggested that she use powdered skim milk which is just as nourishing, yet lower in calories. The cost of the powdered milk is approximately eight cents a quart, whereas fresh milk is 27 cents a quart. When the powdered milk is mixed and chilled, it tastes like fresh milk. Flavoring may be used to make it more palatable or it may be hidden in prepared dishes. Maxine seemed very pleased to hear about this much cheaper but wholesome product and promised that she would try it. Although milk is very important during pregnancy, I also explained the value of other foods-lean meat, especially liver, fresh vegetables, fruits, and whole grain cereals. I suggested that she avoid starchy, sweet, and greasy foods to prevent a too rapid gain in weight. Maxine told me that at times she was bothered by constipation. I explained that this was not uncommon, and could be corrected. Usually, simple steps will do this, such as drinking fluids and eating plenty of fruit and vegetables. I also told her to practice regular habits and to follow a routine of light exercises. The clinic has some illustrated booklets which show how the baby grows inside the uterus. Maxine was interested and while she looked at the pictures I stressed the fact that the

PRESIDENT'S ADDRESS

OF ALL the men who have given hours and days of time and thought to the Academy and its affairs the President is the only one prescribed, by custom, an opportunity publicly to express his thoughts on these affairs. Others may write to the Executive Board or struggle for space in letters to the Editor or may explode with frustration. Only one or two have approached this last extremity. Usually, after attempting the first two methods they subside to the rumbling level of low pressure borborygmi. In taking advantage of this opportunity I first want to express my most sincere admiration, respect and gratitude to the men and women serving on the various Academy Committees. Even those of us who have served on a committee, anytime, anywhere, are apt to forget, when reading the report of another committee, the many hours of debate, of research, of correspondence, of correlation, of drafting and redrafting and the hours spent in committee meetings when they might have been having fun. We read the final report, we agree with most of it and we complain bitterly about the one or two points with which we do not agree. Isn't it odd how quick we are to criticize adversely and how seldom we take the trouble to offer thanks or praise? In the same way we are glad to accept a negative Wassermann or tuberculin test but always demand a repeat of a positive. I will not record here the various committees and their achievements. They and their membership are printed in the Fellowship list. Their achievements speak for them.

A standardized Wassermann screening test, which may be carried out in one tube.

A very simple one or two tube screening Wassermann test without preliminary complement and hemolytic antibody titrations can be carried out by using standardized test reagents. As reagents are used: a. Complement conserved according toRichardson; b. Sheep cells conserved in modified Alsever solution standardized colorimetrically to 2% red cell suspension; c. Hemolytic antibody prepared according to the prescriptions of the New York State Department of Health in a dilution giving maximal sensitization of the red cell.

Roentgenologic study of Meckel's diverticulum; case report.

The preoperative diagnosis of Meckel's diverticulum is unusual. Pfahler described two cases diagnosed roentgenologically in 1934, and since that time cases have been recorded by Ehrenpreis (1939), Skinner and Walters (1939), Rousseau and Martin, who collected 12 cases beside their own (1943), Hallendorf and Lovelace (1947), Grossman, Fishback, and Lovelace (1950), Elias and Ladin (1950), and Raffensperger and Markunas (1950). The following case is of interest not only because the diagnosis was made prior to operation but because of the detailed fluoroscopic observations, a feature which has been neglected by most writers. Case Report B. S., a woman of 35, had come to the United States in February 1949. Her husband and child had been killed during the war, and she had spent four years in a concentration camp. Her father and mother had died before she reached the age of ten. One sister was living, in a mental institution, As a child, the patient had measles, scarlet fever, and chickenpox. She was hospitalized for a few days in 1935 because of an abscess under the left arm, and in 1936 she had a so-called gallbladder attack, treated at home. For the past three years she had experienced gastric distress coming on one or two hours after meals and not relieved by alkalis. She complained also of a sense of fullness in the lower abdomen and of cramp-like pains occurring sometimes in the right upper quadrant, at times in the right lower quadrant, and again crossing the midline. Laboratory investigations, including a blood count, urinalysis, a Wassermann test, and blood chemistry determinations, were reported as normal. The physical examination was non-contributory. The blood pressure was 108/70. A chest film showed fibrotic lesions in both pulmonary apices, which remained unchanged over a period of three years. A gallbladder examination carried out on March 30, 1951, because of right quadrant pain, showed nothing of significance. Some relief was afforded by dietary measures and antispasmodics. Because of recurrence of pain, a gastrointestinal study was undertaken Nov. 1, 1951. On the four-and six-hour films (Fig. 1) a collection of air was demonstrable within a diverticulum arising from the distal ileum and located within the right upper quadrant. Its location and its relation to the distal ileum were suggestive of a Meckel's diverticulum. The remainder of the digestive tract was normal. Re-examination was done on Nov. 5. Repeated fluoroscopic observations of the small bowel were carried out and finally the diverticulum was again visualized, not in its earlier location but in the pelvis, crossing the mid-line toward the left. It no longer appeared as an air-containing sac but was filled with barium (Fig. 2). Peristalsis altered the outline (Fig. 3) changing the configuration and affecting the base but not the neck. The peristaltic action did not completely empty the diverticular contents during the period of fluoroscopic observation.

Corticotropin (ACTH) in lethal granuloma of the nose and face.

TREATMENT with corticotropin in the case being presented gave such dramatic results that it has seemed worth while to make a brief report. For years malignant (lethal) granuloma of the nose has resulted in a fatal outcome, in spite of what was done for the patient. Fortunately, encouraging results have appeared recently. Williams and Hochfilzer,¹in 1950, and Paul Moore and his associates,²in 1951, reported successful treatment of idiopathic granuloma of the face with cortisone. In 1933 Patrick Dempsey,³of Dublin, reported on "Nasal Granulomata" and under the heading of "malignant granuloma" recorded seven cases found in the literature up to that time. He stated that it is a tumor of unknown etiology, due to no visible organism, made up of granulation tissue, and malignant in its behavior. Syphilis was usually thought to be the cause of the condition, but the Wassermann reaction was negative, and antisyphilitic and local treatment

Incidence and Demonstration of Biologic Reactions in Routine Wassermann Tests

Incidence and Demonstration of Biologic Reactions in Routine Wassermann Tests

Biologically false positive serologic tests for syphilis; type, incidence, and cause.

The Wassermann test for the diagnosis of syphilis was introduced into clinical practice in 1907.1This immunologic reaction, utilizing the phenomenon of complement fixation, has since been modified, refined, and simplfied through the use of flocculation techniques (Michaelis2). Many improvements of original techniques have been made by subsequent workers, resulting in the introduction of new tests usually known by the names of their originators, e. g., in the United States, the Kolmer, Eagle, Kahn, Kline, Hinton, Mazzini, and other tests, or even subvariants of these, as the Kahn standard, presumptive, and verification tests. Although it is customary for each author-serologist to claim that his test has some special virtues that set it apart from others, it is none the less true that all of these tests depend on basically identical physiochemical and immunologic phenomena. They differ from each other only in minor technical details. It is also true

Standardization of the Wassermann Test using Preserved Complement Titrated to 50 per cent. Haemolysis

Standardization of the Wassermann Test using Preserved Complement Titrated to 50 per cent. Haemolysis

STUDIES ON THE WASSERMANN REACTION

Acta Pathologica Microbiologica ScandinavicaVolume 31, Issue 3 p. 312-316 STUDIES ON THE WASSERMANN REACTION VII. Effect of Normal Serum on the Activity of the Cardiolipin-Lecithin-Cholesterol Antigen. HOLGER LUNDBÄCK, HOLGER LUNDBÄCK STATE BACTERIOLOGICAL LABORATORY, STOCKHOLM, SWEDENSearch for more papers by this author HOLGER LUNDBÄCK, HOLGER LUNDBÄCK STATE BACTERIOLOGICAL LABORATORY, STOCKHOLM, SWEDENSearch for more papers by this author First published: September 1952 https://doi.org/10.1111/j.1699-0463.1952.tb00194.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Volume31, Issue3September 1952Pages 312-316 RelatedInformation

STUDIES ON THE WASSERMANN REACTION

Acta Pathologica Microbiologica ScandinavicaVolume 31, Issue 1 p. 73-78 STUDIES ON THE WASSERMANN REACTION III. Effect on the Activity of the Cardiolipin-Lecithin-Cholesterol Antigen of Variation of the Procedure for Diluting and Combining the Separate Components (cont.) HOLGER LUNDBÄCK, HOLGER LUNDBÄCK STATE BACTERIOLOGICAL LABORATORY, STOCKHOLM, SWEDENSearch for more papers by this author HOLGER LUNDBÄCK, HOLGER LUNDBÄCK STATE BACTERIOLOGICAL LABORATORY, STOCKHOLM, SWEDENSearch for more papers by this author First published: September 1952 https://doi.org/10.1111/j.1699-0463.1952.tb05058.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Volume31, Issue1September 1952Pages 73-78 RelatedInformation

STUDIES ON THE WASSERMANN REACTION

Acta Pathologica Microbiologica ScandinavicaVolume 31, Issue 1 p. 10-17 STUDIES ON THE WASSERMANN REACTION II. Effect on the Activity of the Cardiolipin-Lecithin-Cholesterol Antigen of Variation of the Procedure for Diluting and Combining the Separate Components HOLGER LUNDBÄCK, HOLGER LUNDBÄCK STATE BACTERIOLOGICAL LABORATORY, STOCKHOLM, SWEDENSearch for more papers by this author HOLGER LUNDBÄCK, HOLGER LUNDBÄCK STATE BACTERIOLOGICAL LABORATORY, STOCKHOLM, SWEDENSearch for more papers by this author First published: September 1952 https://doi.org/10.1111/j.1699-0463.1952.tb05049.xCitations: 4AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume31, Issue1September 1952Pages 10-17 RelatedInformation

Electroencephalographic changes in neurosyphilis

A study is reported of EEG findings in neurosyphilis based on 241 electroencephalograms obtained from 110 patients in the following clinical categories: 35 with dementia paralytica, 24 with taboparalysis, 19 with tabes dorsalis, and 32 with other varieties of neurosyphilis. After describing the criteria of abnormal tracings the EEGs of 110 patients are divided into 38 normal and 13 border-line; there are 23 cases of slight, 30 of moderate, and 6 of severe abnormality. Among the 59 abnormal EEGs, 53 showed marked constancy, characterized by a dominant frequency at the lower limit of normal, trains of 5–7 c/sec. activity of low amplitude, shifts in frequency, and numerous abnormal single potentials. The changes are diffuse, being most marked in the parietal and frontal leads, and are practically unaffected by hyperpnoea. A clear difference is found between the incidence of abnormality in the mainly spinal as compared with the mainly cerebral varieties, and this applies also the gravity of the electroencephalographic changes. Thus, moderate to severe abnormality occurred in only 9 per cent of the patients with tabes dorsalis, but in 52 per cent of thise with dementia paralytica. The incidence of abnormality is found to be much higher among the young than in the old age group, being 81 per cent in those under 40 as compared with 42 per cent in those over 60 yeats of age. This difference is real and is not a function of duration of the neurosyphilitic symptoms, type of lesion or type of treatment. In the presence of severe mental symptoms, especially euphoria and dementia, the incidence of abnormalities is high (79 per cent) whereas it is low in “non-organic” psychoses (43 per cent) and 38 per cent in the presence of only neurasthenic symptoms. EEG abnormality is not correlated with abnormal spinal fluid findings, although there is a somewhat higher incidence of EEG abnormality when spinal fluid and blood Wassermann reactions are positive. When the pneumoencephalograms are normal, the incidence of moderate and severe abnormality was only 11 per cent as compared with almost 70 per cent in the presence of ventricular or cortical atrophy. A study of 41 patients who had received fever therapy within 1–2 weeks showed less effect on the EEG than on the clinical condition. There was a tendancy, however, for the EEG to improve in a higher percentage of patients who were improved clinically, than in those whose clinical condition remained stationary after treatment.

Changes in the head of the femur in children suffering from Gaucher's disease.

1. Two children suffering from Gaucher's disease, who developed changes in the femoral head typical of Perthes' disease, are reported. Similar changes have been recorded in the literature in seventeen children under the age of fifteen years. 2. The possible factors giving rise to the bone changes are discussed and it is considered that they result from aseptic necrosis. Splenectomy does not appear to hasten the development of bone changes in this disease. 3. In one of the patients, the blood Wassermann reaction was positive, but syphilis was not thought to play any part in the production of the bone changes.

RESECTION OF AN ANEURYSM OF THE ABDOMINAL AORTA

Mr. Le G., aged 50 years, had an aneurysm of the abdominal aorta revealed by gross disturbances of function, predominantly in the left leg. Abdominal examination showed a large tumor in the left paraumbilical region, pulsating and expansile. The right femoral pulse was diminished and the left absent; oscillations were diminished on the right and absent on the left. One year before he had had a myocardial infarction. The blood Wassermann test was negative. The aortograph (Fig. 1) shows that the beginning of the aneurysm is just below the kidneys and that it extends as far as the bifurcation of the aorta. The left common iliac artery is blocked in its first 5 or 6 cm. The right common iliac artery, although patent, has at its origin two small aneurysmal dilatations. The superior mesenteric and renal arteries, perfectly delineated by the opaque medium, are clearly above the aneurysm. The inferior

Sickle cell anemia in a white adult.

Three cases of sickle cell anemia have been reported previously in Greece, but no instance in which the disease occurred in a white person in any other country is mentioned in the European literature. It is believed that the disease occurs in Greece in a mild form. A fourth case of sickle cell anemia in a white adult is reported. REPORT OF A CASE The patient, a 30-year-old Greek army officer, was admitted to the hospital complaining of weakness, languor, faintness, vertigo, and palpitations. His parents were healthy, with normal blood cell counts, blood bilirubin, Wassermann reactions, and absence of sickle cells in staining tests. A maternal uncle who is suffering from chronic malaria with anemia could not be contacted for a blood test. The disease started in early childhood. The skin and sclerae had a permanent yellow tint. Crises had occurred frequently and periodically, with pain in the long

Bicephalic monster; a case report.

According to Science Service there have been 15 reported births of bicephalic monsters, 3 of which have been published in the past two years in the lay press. The case reported here we believe to be the first recorded instance in which the condition was recognized by roentgenograms prior to delivery. The obstetrical aspects, while interesting, are not our primary concern. This unusual development is said to be due to incomplete fission of two impregnated ova. A negative history for previous irradiation in this case may be of interest to radiologists. Mrs. A. DeK., a 28-year-old white woman, was seen on Jan. 24, 1946. She had one child living and well. She had no miscarriages and her previous pregnancy was normal in every respect. Her last menstrual period had occurred on April 2, 1945. The Wassermann reaction was negative, and there had been no unusual diseases during the prenatal period. Mild nausea and vomiting had occurred during the first month of gestation. Menstruation had begun at the age of thirteen and had occurred regularly with periods of six days duration. On physical examination the only findings were limited to the abdomen, which was unduly large even for full-term pregnancy. One head could be palpated overriding the pubis and a second could be felt by rectal examination. Just above the pubis was an unusual depression quite different from what is seen in the usual case of twins, and this led to further investigation. Roentgenograms were made at 1 p.m., Jan. 24, and the obstetrician was advised of the unusual condition by telephone. Shortly after leaving the office, the patient began having labor pains, and at 8 p.m. dilatation was complete, with membranes intact. A low cervical cesarean section was done at 9:15 p.m. by Doctor Sheeran, and a stillborn, bicephalic quadribrachial, bipedal male monster was delivered (Fig. 1). The mother's postoperative course was uneventful. There was a single placenta. The roentgenograms showed two heads, four arms, fusion of the thoracic cages, two spines, but one pelvis and sacrum and only two legs. The latter finding made the diagnosis certain (Fig. 2). The skeletal systems are clearly shown in the roentgenogram of the stillborn fetus (Fig. 3.) An autopsy was not permitted.

Uncommon conditions in the field of otolaryngology seen in office practice.

THE PERIOD covered by this publication ranges from Aug. 1, 1946 to Jan. 1, 1948 (Goldsboro, N. C.) and from Feb. 1, 1948 to Aug. 1, 1950 (Kinston, N. C.). During this time a number of pathological conditions which were unusual by virtue of their inherent nature, location, or both were encountered in the office practice of otolaryngology, and it is believed that they are of sufficient interest to warrant recording. In the preparation of this abstract it was necessary to delete from the original thesis a considerable portion of the content and bibliography and to reduce the number of case reports and illustrations. Routine laboratory tests made on all hospitalized patients consisted of a complete blood count, urinalysis, and blood Wassermann test, but detailed results of the laboratory examinations have for the most part been omitted. I. TUMORS Angiolipoma of the Larynx A case of laryngeal angiolipoma was not

Resultados terapêuticos em 50 casos de neurossífilis

Estudo da evolução dos quadros liquóricos em 50 casos de neurossífilis submetidos aos seguintes processos terapêuticos: 1) malária e arsênico; 2) penicilina isolada; 3) penicilina, piretoterapia e arsênico; 4) penicilina e piretoterapia; 5) arsenoterapia isolada. Entre os dados fornecidos pelo exame do liqüido cefalorraqueano, só constituíram objeto de estudo a cito-metria, a taxa de proteínas, a reação do benjoim coloidal e as reações de desvio de complemento para sífilis. Em 34% dos casos foi obtido retorno à normalidade; em 42%, resultados satisfatórios; em 22%, resultados indefinidos; em 2%, falência do tratamento e recidiva. A aplicação da estatística t aos resultados liquóricos revelou: a) significância das diferenças entre os valores iniciais e finais da citometria, da proteinorraquia e da reação do benjoim coloidal, quer nos 45 casos, quer nos casos com 6 meses de seguimento, quer ainda nos três principais grupos terapêuticos; b) a comparação das médias finais da citometria nestes três grupos não revelou diferenças significantes: c) quanto à taxa de proteínas e à reação do benjoim, o mesmo processo comparativo revelou não haver significância entre os resultados dos grupos 1 e 3, enquanto que o grupo 2 diferiu significantemente dos demais; d) não houve diferença significante nas percentagens de negativaçao das reações de desvio de complemento, por qualquer dos três métodos de tratamento; e) foi significante a diferença entre as percentagens de negativaçao da reação de Wassermann e da de Steinfeld. Os resultados do estudo estatístico levam, pois, à conclusão de que os efeitos determinados pela penicilinoterapia isolada (grupo 2), embora eqüivalentes, no tocante à citometria, aos obtidos pelos demais méte dos de tratamento, foram superiores no referente à taxa de proteínas e à reação do benjoim coloidal. Este fato surpreendeu-nos, pois esperávamos que, se predomínio houvesse entre os três processos, êle deveria caber ao grupo 3, que consiste na soma dos meios terapêuticos utilizados nos grupos 1 e 2. Dados os riscos inerentes à malarioterapia, conclui-se que o tratamento atual de escolha, em casos de neurolues, é representado pelo emprego exclusivo da penicilina, em doses elevadas. A substituição da penicilina cristalina pela procainada, parece possível à vista da experiência dos autores americanos.