The most frequently used serodiagnostic test for syphilis in Korea is VDRL test, which is one of several flocculation tests utilizing cardiolipin-lecithin as antigen. This test remains popular because it is easily performed, inexpensive, is standard for screening purposes, and is useful for following the serologic response to treatment. A common problem is weakly reactive (or 'rough' result) VDRL test or reactive VDRL in the absence of definite evidence of present or past syphilis; the diagnosis of syphilis in these cases should be confirmed by using the specific treponemal antigen tests. The Fluorescent Treponemal Antibody-Absorption (FTA-ARS) test is the result of continued attempts to improve the original FTA procedures. This test uses virulent T. pallidum (Nichols strain) as antigen and uses fluorescein-tagged antihuman globulin as reaction indicator. The FTA-ABS test is very sensitive in all stage of syphilis, especially in early syphilis. The FTA-ABS test was carried out on 448 persons with reactive and weakly reactive VDRL tests and divided the groups of routine physical check and out patients. (countinued..)
Diagnosis ; Flocculation Tests ; Fluorescent Treponemal Antibody-Absorption Test ; Humans ; Korea ; Mass Screening ; Outpatients ; Syphilis*

The present study has been undertaken, using 307 seemingly "normal" male rabbits sold in Korea, which were tested for sysphilis with two serologic tests, the RPR card test and the TPHA test. Among thc rabbits which were seropositive in these tests, 10 rabbits were selected for further tests, namely, the FTA test a.nd FTA-ABS test. The following results have been obtained. Nine rabbits(2.9%) were reactive in both the RPR card test and the TPHA test; 10(3.2%) were reactive in the RPR card test and non-reactive in the TPHA test; 8(2. 6%) were reactive in the TPHA test and non-reactive in the RPR card test, and 27(8.7%) were reactive in either tests. 2. The rabbits which were reactive in the TPHA test were also reactive in the FTA and FTA-ABS test. As can be seen in the results, 8.7% of the normal male rabbits sold in Korea are seropositive in the serologic tests for syphilis. Cnnsequently, all rabbit's undergoing syphilis experiments should be screened for possible reactive serologic tests and excluded from the experiments.
Dronabinol ; Fluorescent Treponemal Antibody-Absorption Test ; Humans ; Korea* ; Male* ; Rabbits* ; Serologic Tests* ; Syphilis*

Serologic tests for syphilis including VDRLand FTA-ABS tests have been carried out in 2,753 VISA applicants for emigration, 8, 501 blood donors and 2, 588 pregnant women from January to December 1981. We have also been observing biologic false positive rate in 759 VDRL-reactive persons among those tested for STS in Severance Hospital in the year 1981, All the above subjects were twenty years old or over. The results are summarized as follows: l. I 2, 753 VISA applicants, VDRL test showed postive in 42 applicants (l. 5 %). Of these 42 applicants, 37(1. 3%) had a rmotie FTA ABS test. 2. In 8,501 blood donors, the reactive rate for the VLRL test was 1.0pk. 3. ln 2, 588 pregnent women, the VDRL test showed gositive in 20 women (0.8%). Of these 20 women, l8(0.7%) had a reactive FTA-ABS test. 4. The cuantitative test of VL'RL resulted in low titer below 1: 4 in 97. 6% of VDRL-reactive VISA applicants and in 85. 0% of VLRL-reactive pregnant women, 5. The overall biologic false positive rate was 8. 7/o in 759 VDRL-reactive persons amorg those tested for STS in Severance Hospital in time year l98l, using the FTA-ABS test as the standard. In particular, it was higher, namely l7. 0/a, in 32 persons who were wezkly reactive to the VDRL test. From the results it is clear that the prevalence of syphilis is gradually decreasing recently compared to the mid 1970 s.
Blood Donors ; Emigration and Immigration ; Female ; Fluorescent Treponemal Antibody-Absorption Test ; Humans ; Korea* ; Pregnant Women ; Prevalence* ; Serologic Tests ; Syphilis*

On a total 375 sera with reactive results on VDRL and/or FTA-ABS test(s), derived from severance Hospital, qualitative and quantitative TPHA tests were carried out. The objectives of the present study were to compare the result of VDRL, FTA-ABS and TPHA teats in different syphilis stages, and to as sess the suitability of the TPHA test as a screening test for syphilis. The results are summarized as follows: 1. The sensitivity of VDRL test was poor compared with TPHA and FTA-ABS tests except in secondary syphilis. 2. The FTA-ABS test(10Qp,) was more sensitive than the TPHA test(86g) in primary syphilis, but it is time consuming and costly. 3 The TPHA titers were relatively low in primary syphilis. 4, Below 1: 32Q in TPHA titer, the percentage of sera from patients tested over 1 year(64%) after the completion of treatment was higher than within 1 year(41%). The TPHA test showed 77%. agreement with VDRL test and 89% agreement with FTA-ABS test. The VDRL test is easy to perform and economic, but it showed poor effeetiveness as screening test for the detection of syphilis. On the other hand the TPHA test had a wide spectrum of reactivity in different stages of syphilis and was easy to perform. So on the basis of the results presented, we concluded that the TPHA test provides a very effective screen for syphilis.
Fluorescent Treponemal Antibody-Absorption Test ; Hand ; Hemagglutination Tests* ; Hemagglutination* ; Humans ; Mass Screening ; Serologic Tests* ; Syphilis* ; Treponema pallidum* ; Treponema*

A retrospective study was made of the previous medical records of 32 infants with congenital syphilis borne from mothers with untreated syphilis at Severence Hospital, Yonsei University College of Medicine during the years 1,972 through 19g3, These infants had a VDRL titer higher than 1: 8 with reactive FTA-ABS test and were also subjected to radiologic examinations. Radiologic changes and clinical features were analyzed, The following results were obtained: Of the total of 32 infants with congenital syphilis under 5 months of age, those under 1 month of age, were the most common group numbering a total of twelve. Of 32 infants with congenital syphilis, twenty-nine(91%) showed skeletal changes upon radiologic examination, Among them the different sites of bone involvernent revealed that the femur(92%) was the most commonly affected bone, followed by the humerus(88%), tibia(81%,), fibula(80%), ulna(72%), radius (68%). Among the same 29 infants a study of the presence of various abnormal bone changes showed that periostitis was the most common, being involved in 83%, the others being metaphysitis and periostitis(72%), metaphysitis(66%). 3. Among the clinicaI features presented in the 32 infants with congenital syphilis, hepatomegaly was the most common(63%,), followed by erythema with desquamation(47%), pneumonia(38%), maulopapules(34%).
Erythema ; Fluorescent Treponemal Antibody-Absorption Test ; Hepatomegaly ; Humans ; Infant ; Medical Records ; Mothers ; Periostitis ; Radius ; Retrospective Studies ; Syphilis ; Syphilis, Congenital*

The serologic testa for syphilis including VDRL and FTA-abs tests have been carried out in adult VISA applicants for emigration and bIood donors from February, 1977 to May, 1978. The results are summarized as followa: l. In 3,393 VISA applicants the reactive rate af VDRL test was 2.9%, and th biologic false positive rate of VDRL test was 5.1% using the FTA-abs test as the atandared. 2. VDRL test showed a positive rate of 2.3% in 6,220 blood donors. 3. The quantitative test of VDRL resulted in low titer belaw 1:4 in 93.9% of VDRL reactive VISA applicants. From the results it is clear that the prevalence of syphilis is grariually increasing recently compared to the late 1960s and early 1970s.
Adult ; Blood Donors ; Emigration and Immigration ; Fluorescent Treponemal Antibody-Absorption Test ; Humans ; Prevalence ; Skin Diseases* ; Syphilis ; Tissue Donors ; Zinc*

With 37 formalin-fixed, paraffin embedded specimens from the lesions of 30 patients with primary, secondary or gastric syphilis, we performed avidin-biotin-peroxidase complex (ABC), indirect immunoperoxidase (IIP) and FTA-ABS complement techniques. Darkfield examination was done in 17 skin lesions. The immunoperoxidase technique, especially the ABC technique, revealed higher reactivity than the FTA-ABS complement technique and darkfield examination in detecting Treponema pallidum in tissues. Furthermore, the ABC technique produced less intense nonspecific background staining than the IIP technique. Histologically, most of the treponemes were located in the upper dermis, epidermis and vessel walls in the order named, and rarely in the lower dermis of the syphilitic skin lesions.
Avidin/diagnostic use ; Biotin/diagnostic use ; Comparative Study ; Fluorescent Antibody Technique ; Fluorescent Treponemal Antibody-Absorption Test ; Human ; Immunoenzyme Techniques ; Treponema pallidum/*isolation & purification

BACKGROUND: Current status of external quality assessment (EQA) of laboratory tests for syphilis in Korea was analyzed to find out the problems that should be improved in the future. METHODS: Based on the data from the external quality assessment program performed twice a year by the Immunoserology Subcommittee of the Korean Association of Quality Assurance for Clinical Laboratory from the year 2004 to 2006, discordance rates were analyzed according to the test method and commercial kit used. RESULTS: Among the laboratories participating in the EQA program for syphilis test, about 90% of them used non-treponemal tests and about 55% treponemal tests. The non-treponemal tests included RPR (rapid plasma reagin) and VDRL tests used in 88% (363/412) and 11% (45/412), respectively, of the laboratories. The discordance rates were 2.2% for RPR test and 3.6% for VDRL. For the treponemal tests, Treponema pallidum hemagglutination assay (TPHA) was used in 60-76% and Immunochromatography assay (ICA) in about 30% of the laboratories in 2006. A high discordance rate of over 10% was reported in both TPHA and in ICA methods, possibly due to a low titer (1:1 in VDRL) of EQA samples in 2005. Analysis of the accumulated data from year 2004 to 2006 showed that the discordance rates of TPHA, ICA, and FTA-ABS were 4.6%, 3.7%, and 2.7%, respectively. CONCLUSIONS: For syphilis tests, RPR test, TPHA, and ICA are mainly used in Korea. A high discordance rate is still reported in TPHA and ICA, especially when testing samples with a low titer. Further analysis of data and education of laboratory personnel are needed for the improvement of the EQA program.
Enzyme-Linked Immunosorbent Assay ; False Positive Reactions ; Fluorescent Treponemal Antibody-Absorption Test ; Humans ; Korea ; Quality Control ; Reagent Kits, Diagnostic ; Syphilis/*diagnosis ; Syphilis Serodiagnosis/methods/*standards ; Treponema Immobilization Test

PURPOSE: To report the manifestation of ocular syphilis combined with neurosyphilis in patients who present with uveitis clinically and are diagnosed initially by an ophthalmologist. METHODS: This study is a retrospective, clinical investigation of seven male patients with ocular syphilis from a single tertiary center between 2009 and 2012. RESULTS: The average age of the patients at onset was 44.4 years (range, 33-71 years). Posterior segment involvement was found in all patients. Two patients had papillitis. In serologic testing, all patients had positive responses to Venereal Disease Research Laboratory (VDRL), fluorescent treponemal antibody-absorption test (FTA-ABS) and Treponema pallidum hemagglutination (TPHA). In fluorescein angiography (FAG), retinal vascular and disc leakage was the most common finding. Cerebrospinal fluid (CSF) analysis was performed for six patients and demonstrated positive CSF FTA-ABS and CSF TPHA tests in all patients. CSF VDRL was reactive in 2 patients (33.3%). CONCLUSIONS: All patients with ocular syphilis were diagnosed with neurosyphilis based on the analysis of CSF with FTA-ABS and TPHA. Ophthalmologists play an important role in the early diagnosis and treatment of syphilis.
Cerebrospinal Fluid ; Early Diagnosis ; Fluorescein Angiography ; Fluorescent Treponemal Antibody-Absorption Test ; Hemagglutination ; Humans ; Male ; Neurosyphilis* ; Papilledema ; Retinaldehyde ; Retrospective Studies ; Serologic Tests ; Sexually Transmitted Diseases ; Syphilis* ; Treponema pallidum ; Uveitis

BACKGROUND: Automated analyzer-based nontreponemal serological tests for syphilis (STS) have been used for several decades. OBJECTIVE: In this study, we evaluated serological responses to treatment and proposed clinical guidelines for automated STS. METHODS: This retrospective cohort study analyzed human immunodeficiency virus-negative syphilis patients who were diagnosed with automated rapid plasma reagin (auto RPR) tests as a nontreponemal STS, and who also received the fluorescent treponemal antibody-absorption test as a confirmatory test. The ratio of auto RPR values after treatment against those at baseline was defined as the auto RPR ratio for the analysis of the serological response to treatment. The cutoff value for reliable seroreversion prediction was assessed with receiver-operating-characteristic curves. RESULTS: Overall, 89.7% of participants (78/87) seroreverted and 10.3% of participants (9/87) remained serofast during the two-year follow-up period. We were unable to describe trends in the changes among auto RPR values within six months after treatment because of high variation. All of the patients who had an auto RPR ratio ≥1.0 after six months continuously had positive serologic results during their 24-month follow-up and were classified as a serofast group. The receiver-operating-characteristic curves revealed a 25% reduction in auto RPR values nine months after treatment and predicted seroreversion with a sensitivity of 96.2% and a specificity of 100%. CONCLUSION: The most important primary checkpoint for syphilis treatment response is an increase in automated nontreponemal STS six months after treatment. Thus, we recommend monitoring the treatment response with an auto RPR.
Cohort Studies ; Fluorescent Treponemal Antibody-Absorption Test ; Follow-Up Studies ; Humans* ; Plasma ; Retrospective Studies ; Sensitivity and Specificity ; Serologic Tests* ; Sexually Transmitted Diseases ; Syphilis Serodiagnosis ; Syphilis* ; Treponema pallidum