In cases of ordinary superficial candidiasis, it is easy to make a diagnosis by direct microscopic examination, because fungal elements in the skin scrapings taken from candidiasis patients consist of pseudomycelia and clusters of grape-like yeast cells which are characteristic features of this condition. However, there is a peculiar onychomycosis caused by Candida which cannot be distinguished from tinea unguium by microscopic examination or through the clinical picture; it can only be recognized by culturing of Candida and by the lack of effectiveness of griseofulvin. We previously revealed that such candidiasis was different in the clinical and pathological points from candidial onychia as described in a textbook. We termed such cases nail candidiasis since they represented a new clinical entity. However, we could not completely eliminate the possibility that the isolated Candida may be a contamination, because Candida species were very often present as saprophytes. Here, an immunohistochemical study was performed to confirm whether the fungal elements in the involved nailplate taken from the nail candidiasis patients was Candida, and whether the antibody to Candida albicans used here was specific for candidiasis. We demonstrated the positive staining of fungal elements in sections taken only from candidiasis patients and negative staining of those taken from other patients, in this way we were able to prove the presence of Candida in the nailplate of the former patients and confirm the existence of the disease.

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A latex agglutination test (LA) to detect Candida mannan antigen has been developed for the diagnosis of severe visceral candidiasis. Latex beads were sensitized with antibodies purified through affinity column chromatography conjugated with Candida mannan antigens. The LA reagent was strongly cross-reacted with C. tropicalis, C. pseudo tropicalis, C. glabrata and Saccharomyces cerevisiae, and was weakly with C. hrusei, C. parapsilosis, C. guillermondii, Trichosporon beigelii and Rhodotorula sp. The reagent was not cross-reacted with Aspergillus fumigatus or Cryptococcus neoformans.
In the LA test, a treatment of serum with protease is essential and mannan antigens of more than 3.9ng/ml in serum can be detected. Three of 5 sera of patients with systemic candidiasis (60%), 2 of 3 sera of patients with Candida sepsis (67%), 5 of 7 sera of patients with lung candidiasis (72%) and 4 of 6 sera of patients with severe candidiasis of the digestive tract (67%) showed positive reaction. However, all sera obtained from patients with Candida colonization and from normal healthy adults were negative (0%) in the LA test. It is concluded that the LA test to detect Candida mannan antigen is a useful, simple and specific method for the diagnosis of visceral candidiasis.

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The cotton swab sampling method combined with Sabouraud's dextrose agar with antibiotics plate was applied for the isolation of dermatophytes from healthy looking skin surfaces of unilateral tinea pedis patients.
From 31 cases (39.2%) out of a total of 79, dermatophytes considered to be the causative pathogens of the lesions were obtained only from the feet with tinea lesions. On the other hand, from 23 cases (29.0%) dermatophytes were isolated from the opposite feet without tinea lesions, and among these, the same dermatophyte species were detected from both feet of 12 patients. However, from 7 patients the dermatophyte species isolated were different from those of tinea lesions, and from 4 patients dermatophytes were isolated only from the healthy feet. These examinations showed the relatively frequent presence of dermatophytes even on the skin without lesions of tinea pedis patients. Some of these dermatophytes present on the healthy skin are thought to be in the stage of subclinical infection, not merely saprophytic growth.
The importance of these subclinical infections in the effective control and prevention of the development of tinea pedis lesions is emphasized.

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The number of Candida, secretory IgA and lysozyme in sputum were measured to examine the clinical features for complication of respiratory Candida infection in patients with certain respiratory diseases (lung cancer, bronchitis and pulmonary tuberculosis) who had 10³10⁸ Candida/g sputum.
In patients with lung cancer, the incidences of such complication were numerous, while cases with high lysozyme or SlgA level in the sputum showed a tendency of inhibited Candida growth in sputum. Lysozyme in the sputum of patients without Candida infection was significantly higher than in that of patients with this infection. In vitro, the growth of Candida albicans was also inhibited by lysozyme isolated from chicken egg white.
It was thus demonstrated clinically and experimentally that the lysozyme secreted from lung or bronchus protects from respiratory Candida infection.

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Systemic candidiasis in premature infants is a grave infection with a poor prognosis which has recently received considerable attention. We report two cases of extremely low birth weight infants : one with systemic candidiasis accompanied by a pulmonary artery embolus due to Candida albicans, and another in whom Candida albicans was identified from a culture of the ascites obtained at the time of an operation on the small intestine.
Our experience with these two cases indicated the need to be constantly alert for the occurrence of candidiasis in the management of severely ill neonates.

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Amorolfine (MT-861), a new class of morpholine derivative, is an antifungal agent with high activity against dermatophytes, pathogenic yeasts and filamentous fungi. In this study, the effect of MT-861 on the ultrastructure of hyphae of Trichophyton mentagrophytes in a liquid medium was investigated by scanning and transmission electron microscopy. Hyphal growth was inhibited at the drug concentration of 0.8ng/ml, and several morphological changes such as waving of the surface structure and contour deformation were observed. In thin sections, accumulation of electron dense granular structures formed within both the wall and the cytoplasmic membrane was visible. With 80ng/ml of MT-861, collapsed and distorted hyphae and exfoliation of surface structures were also observed. Moreover, degeneration of the cytoplasmic membrane and alteration of organelles were clearly seen at this concentration of the drug. From these results, it is concluded that ultrastructural changes caused by MT-861 lead to the death of fungal hyphae.

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