Japanese Journal of Medical Mycology
Online ISSN : 1884-6971
Print ISSN : 0583-0516
ISSN-L : 0583-0516
Volume 19, Issue 2
Displaying 1-15 of 15 articles from this issue
  • Tatsuya Kasai, Yoshie Miura
    1978 Volume 19 Issue 2 Pages 87-88
    Published: August 07, 1978
    Released on J-STAGE: December 18, 2009
    JOURNAL FREE ACCESS
    Download PDF (868K)
  • Hiroshi Kurata
    1978 Volume 19 Issue 2 Pages 89-93
    Published: August 07, 1978
    Released on J-STAGE: December 18, 2009
    JOURNAL FREE ACCESS
    The Phycomycoses are a different group of mycoses caused by fungi belonging to the Class, Phycomycetes. Recently the name has been criticized because Class Phycomycetes is no longer recognized in the formal taxonomic system. On the basis of this premise, Ajello recommended that the relic term “Phycomycosis” be replaced by zygomycosis. However, a name of the phycomycoses cannot exclude in present because zygomycoses cannot cover all infections caused by Oomycetous fungi. Some of the pathogenic species of Mucorales reported in the literature in Japan were reviewed and discussed with their taxonomic position in this symposium.
    Download PDF (545K)
  • Masao Hotchi
    1978 Volume 19 Issue 2 Pages 94-100
    Published: August 07, 1978
    Released on J-STAGE: December 18, 2009
    JOURNAL FREE ACCESS
    Phycomycosis is an acute and fluminant fungous infection in debilitated patients, but generally the diagnosis of the disease has been made histopathologically in autopsy cases. In Japan, it may be restricted to mucormycosis caused by several species of the genera Rhizopus, Mucor and Absidia. Therefore, the following descriptions refer to the mucormycosis.
    In histopathology, mucormycosis is characterized by direct invasion of fungi to the walls of arteries and thrombosis, which cause infarction and hemorrhagic necrosis of adjacent tissue. The hyphae in tissue are greatly broad (5 to 50μ), sparsely septate, and haphazardly branched. Furthermore, in contrast to most fungi, the hyphae are fairly well stained with hematoxylin, but not constantly. The Gomori methenamine silver stain is more preferable than the other staining methods for fungi.
    Mucormycosis is usually a secondary infection. Baker emphasized diabetes and blood diseases as the most frequently antecedent conditions in 1957. In our statistical survery of deep-seated mycoses using the Annual of the Pathological Autopsy Cases in Japan during the ten year period from 1966 to 1975, 154 cases of mucormycosis were reported, which were 0.068% of 224, 436 all autopsy cases and 3.45% of the total of 4, 464 autopsy cases of mycoses. In this series, leukemias were present in 61% of the cases of mucormycosis, although diabetes was in 1% of them. In addition, anticancer and corticosteroid therapies for blood diseases and malignant neoplasms were emphasized as predisposing factors in the experimental studies in the rabbits pretreated with cyclophosphamide, mitomycin C and predonine.
    Download PDF (2057K)
  • Problem of Diagnosis
    Kazuyoshi Watanabe
    1978 Volume 19 Issue 2 Pages 101-107
    Published: August 07, 1978
    Released on J-STAGE: December 18, 2009
    JOURNAL FREE ACCESS
    Phycomycosis, or the so-called mucormycosis, is an acute and fatal disease. The patients with this disease have a very poor prognosis. No work at all has so far been done in Japan concerning its diagnosis in the field of internal medicine.
    The paper to be read at this symposium deals with 57 cases of mucormycosis which have been described to date in Japan and compares them with those which have been reported in other countries since 1960. The Japanese cases consisted of 14 patients with a pulmonary type of mucormycosis, 10 patients with an alimentary type, 10 patients with rhino-orbito-cerebral type and 23 patients with a disseminated type.
    Attention has been focused on diabetes mellitus as a predisposing disease of mucormycosis, whereas such is acute myelogenous leukemia in 20 (35.1%) cases of mucormycosis in Japan. Blood disease accounts for 50.9% (29 cases) while diadetes mellitus accounts for only 5.3% (3 cases).
    The possible involvement of this disease in the terminal infection in various blood disease including acute myelogenous leukemia should be taken into consideration as one of the diagnostic problems of this disease in internal medicine. When a suspicion of the pulmonary type of mucormycosis is enteratained, lung biopsy, bronchoscopy and detailed examination of sputum should be carried out where possible, since these procedures are the only means to detect the disease in its early stage. For the rhino-orbital type early detection is imperative, because many of its victims can be saved from death if a definite diagnosis of the disease can be established in its early stage.
    Download PDF (1582K)
  • Problems in Therapy of the Field of Internal Medicine
    Akira Ito
    1978 Volume 19 Issue 2 Pages 108-113
    Published: August 07, 1978
    Released on J-STAGE: December 18, 2009
    JOURNAL FREE ACCESS
    There are three main problems in the treatment of mucormycosis. First, it is not easy to make a diagnosis while the patient is alive. Second, therapy virtually is impossible because it is mainly found in patients with underlying diseases and it is therefore hard to notice mucormycosis in the terminal stage. And third, there are no good antifungal drugs except Amphotericin B. It should always be administered with care taking side effects into consideration.
    386 cases of mucormycosis reported in Japan and foreign countries and 76 noted in the Annual of Pathological Autopsy cases in Japan plus our own cases are discussed. Particularly, 81 of those patients showing “good response” showed that the treatment of mucormycosis is not always hopeless if diagnosed in the early stage; treated by Amphotericin B concurrently with the therapy for the underlying disease; and if local and surgical therapy can be performed as long as there are no such lethal underlying diseases as leukemia and malignant carcinoma. But, it is actually difficult to treat most mucormycosis and the problems mentioned above will still remain in the future.
    Download PDF (1410K)
  • Cutaneous Mucormycosis and Entomophthoramycosis
    Yasuo Asada, Yoshio Matsuda
    1978 Volume 19 Issue 2 Pages 114-121
    Published: August 07, 1978
    Released on J-STAGE: December 18, 2009
    JOURNAL FREE ACCESS
    The review of literatures of twenty eight cases of cutaneous mucormycosis and of ninety one cases of entomophthoramycosis was made. The experimental studies by subcutaneous inoculation of various strains belonging Mucoraceae on the nude mice were also added.
    1) Cutaneous mucormycosis in the world literatures were very rare and only three cases were reported in Japan until 1977. The etiological agents of cutaneous mucormycosis were fungi belonging Mucoraceae including M. corymbifera, M. ramosus, M. pusillus, R. arrhizus, R. rhizopodiformis, A. ramosa etc. The cases in Japan were caused by R. ramosus (2 cases) and Rhizopus sp.. The main predisposing diseases of cutaneous mucormycosis were diabetes mellitus, leucemia andot her malignant tumors including lymphomas.
    Experimentally, the authors could make the cutaneous lesions on the skin of the nude mice by inoculating various strains of Mucoraceae including R. stolonifer, R. arrhizus, M. pusillus, A. ramosa, A. corymbifera. The emulsion containing spores 106-8/ml in concentration was inoculated subcutaneously by B. C. G. needle on the back of the mice. The inoculated area were covered by Drenison-tape (plastic film containing corticosteroid) with the method of occlusive technique. After 4 to 10 days erythema, swelling and subcutaneous nodules on the inoculated skin. Histologically, the nonseptated, wide, branching hyphae were observed in the inflammatory lesions of the dermis and of the epidermis. Spores were not seen in tissue specimens. The perifungal tissue reaction was very slight.
    2) Sensitivity tests of 17 strains of fungi belonging Mucoraceae against various antimycotics: trichlomazol, 5-FC, griseofulvin, merzonine, nystatine, amphotericine B, were made. Amphotericine B, trichlomazol and merzonine showed good inhibitory effect in vitro, while inhibitory effect of 5-FC was very poor.
    3) Entomophthoramycosis is a disease usually found in the tropical countries, such as countries in African continent, Indonesia, India and countries in South American continent. No cases were found in Japan until 1977. Entomophthoramycosis is divided into two groups: Entomophthoramycosis basidiobolae (subcutaneous phycomycosis) and Entomophthoramycosis conidiobolae (rhinophycomycosis). The clinical, histological and mycological problems were discussed.
    Download PDF (1626K)
  • Michiaki Kawano
    1978 Volume 19 Issue 2 Pages 122-124
    Published: August 07, 1978
    Released on J-STAGE: December 18, 2009
    JOURNAL FREE ACCESS
    A case of phycomycosis during the course of acute lymphatic leukemia was reported and host factors inducing mycosis was discussed on the case and literatures. During the therapy of antil-eukemic agents and the corticosteroid, he got acute ileus of a small intestine. The histological examination of the resected intestine after the surgcial operation revealed broad and nonseptate hyphae in blood vessel with invasion into vessel wall. He was successfully treated with Clotrimazole and Amphotericine B for 10 days without dissemination of phycomycosis. Autopsy showed on fungal cells on all organs examined. During his hospitalization, suppression of cellular immunity such as negative skin test for PPD, low response of lymphocytes to PHA and decrease number of rosette forming cells. NBT test was negative. In most of the described cases phycomycosis also occurred in patients in whom the immune defence mechanisms were impaired. These conditions of patients are not specific for phycomycosis, but lowered host defence may relate to the induction of opportunistic infections as well as phycomycosis.
    Download PDF (424K)
  • Hikaru Kume, Masahiko Okudaira, Michiko Abe
    1978 Volume 19 Issue 2 Pages 125-128
    Published: August 07, 1978
    Released on J-STAGE: December 18, 2009
    JOURNAL FREE ACCESS
    We attempted to study on a rapid immunological method for diagnosis of deep fungus infections. Antisera from rabbits immunized with C. albicans, A. fumigatus, C. neoformans, N. asteroides, and Mucor sp. respectively were used for a preliminary study. Capillary precipitin test, Ouchterlony's immunodiffusion test, and counter immunoelectrophoresis (CIE) using rabbit anti-Candida serum were comparatively studied, and the results indicated that CIE was most sensitive.
    Sera investigated by CIE were obtained from 13 patients (4 with candidiasis, 6 with aspergillosis, 2 with cryptococcosis, and one with nocardiosis). An exactly compatible diagnosis was obtained by CIE in 12 cases. Occasional non-specific reactions were eliminated with the dilution method (1:1 to 1:8). In 2 patients with pulmonary aspergillosis and one with cryptococcal meningitis, patients' sera were obtained several times during the course. The results of the specific precipitin test by CIE were surprisingly correlated with clinical improvement.
    From the results obtained, CIE could be assumed as an useful tool for a serological rapid method to diagnose deep fungus infections, probably including phycomycosis.
    Download PDF (958K)
  • Kazue Ohara
    1978 Volume 19 Issue 2 Pages 129-132
    Published: August 07, 1978
    Released on J-STAGE: December 18, 2009
    JOURNAL FREE ACCESS
    On June 6 1959, a 17-year-old boy was first seen complaining of a granulomatous ulcer on his left dorsal foot. He had received antituberculous chemotherapy, antibiotics and also corticosteroids for arthritis during past 1 year and a half. From this primary lesion, broad non-septate hyphae were demonstrated microscopically in smear, and a kind of “Mucoraceae” grew on Sabouraud's agar on culture. However, these data were neglected because this fungus was considered to be a saprophyte.
    Four weeks after his first examination, numerous dull-red small papules, hemorrhagic vesicles and pustules were seen on his legs. They were generalized soon being accompanied by high fever. At the end of July 1959, numerous thick crusted rupia-like lesions appeared on the extremities and then these lesions eroded in August 1959. In September, all the toe nails were affected and fell out one month later, followed by same lesion of finger nails in October 1959. During those times, the same fungi were isolated from skin and nail lesions repeatedly and abundantly.
    The strain isolated was identified as Absidia ramosa by Dr. K. Tsubaki. Further-more, a serum antibody titer against the cell body antigen revealed 1:160 (August 1959) and 1:2560 (Jan. 1960) in complement fixation test. This high titer of serum antibody decreased soon paralleling the improvement of the clinical symptoms to 1:40 (April and August 1960). Intracutaneous test against the same antigen was strongly positive in immediate (15m) and delayed (48hrs) reaction, followed by eczematous delayed reaction 25 days after injection. It was very interesting that the intracutaneous test revealed positive even 5 years after recovery.
    The patient was healed 1 year and 8 months after the onset of the primary lesion with residual pigmentation. No recurrence was observed until 1977.
    Download PDF (1127K)
  • Hiroshi Hachisuka, Takeo Nakama
    1978 Volume 19 Issue 2 Pages 133-140
    Published: August 07, 1978
    Released on J-STAGE: December 18, 2009
    JOURNAL FREE ACCESS
    Under inspection of 14, 098 children in Okinawa Prefecture, 19 cases of tinea capitis were found. Age of patients were varied from 4 to 12. There were no difference between sexes. Causative fungi were Trichophyton glabrum, 15 cases; followed by T. violaceum, 3 cases; T. ferrugineum one case; T. rubrum, one case. Double infection with T. violaceum and T. rubrum was found in one boy of Naha City. Clinical features were common type of superficial tinea capitis, neither black dot nor kerion.
    Download PDF (2498K)
  • Katsutaro Nishimoto, Kazuki Maezima, Fumiko Matsuo, Tadayoshi Moriyama ...
    1978 Volume 19 Issue 2 Pages 141-148
    Published: August 07, 1978
    Released on J-STAGE: December 18, 2009
    JOURNAL FREE ACCESS
    Case 1) 29-year-old female. The lesion arised as a verrucous to papillomatous proliferation on her right leg when she was twelve years old. Phialophora verrucosa was isolated but surgical exision could not stop its spreading. Metastatic lesions appeared repeatedly on scalp, nose, pharynx and cervical lymph-nodes. She died of cachexia due to generalized skin lesions with lymphnode metastasis. On autopsy, however, there was no metastasis to brain or visceral organs.
    Case 2) A 34-year-old female received craniotomy because of increasing headache and diplopia which suggested the presense of intracranial tumors. Multiple spherical, gray to dark brown nodules were seen scattered in the brain tissue. Histological examination revealed numerous brown fungal spores and hyphae in necrotic area surrounded by grsanulomatous reaction and Phialophora pedrosoi was isolated. The patient was treated with oral administration of 5-Fluorocytosine with temporary improvement, though she later died of bronchopneumonia. On autopsy, multiple fungus granulomata were seen in the brain and also in the kidney but there were no skin or mucous membrane lesions.
    Chromomycosis cases with metastatic lesions to other than skin reported in Japan were summarized and relatively frequent occurence of metastasis to visceral organs including the brain were shown comparing them with those of tropical or subtropical areas.
    Download PDF (2464K)
  • Isolation of Trichophyton terrestre from Their Garden Soil
    Kohkichi Hamasaka, Noritaka Ohkuma
    1978 Volume 19 Issue 2 Pages 149-155
    Published: August 07, 1978
    Released on J-STAGE: December 18, 2009
    JOURNAL FREE ACCESS
    6 familial cases of the Microsporum canis infection were presented. They all exhibited the clinical form of Trichophytia maculovesiculosa and the cause of the infection was considered from an infected cat.
    By the hair baiting technique, Trichophyton ajelloi, Trichophyton terrestre, Chrysosporium keratinophilum but not Microsporum canis were isolated from their garden soil. Trichophyton terrestre was mated with the perfect form of tester strain which revealed Arthroderma quadrifidum.
    The isolation of Trichophyton terrestre from the garden soil was first reported in Japan.
    Download PDF (4245K)
  • Kiyoshi Kawai, Takeshi Akita, Ryuji Watanabe, Yoshinori Nozawa
    1978 Volume 19 Issue 2 Pages 156-162
    Published: August 07, 1978
    Released on J-STAGE: December 18, 2009
    JOURNAL FREE ACCESS
    The enzymatic oxido-reduction of xanthomegnin has been investigated spectroscopically using rat liver mitochondria and microsomes. Xanthomegnin, a binaphthoquinone pigment isolated from a dermatophyte Microsporum cookei, has been shown to strongly uncouple mitochondrial respiration and has been suggested to exert a cyto-toxic effect in animals. The redox response of this pigment has also been suggested to participate in uncoupling of oxidative phosphorylation in mitochondria, by forming a bypass to the electron transport system. In the presence of succinate or L-glutamate as substrate, xanthomegnin was reduced by mitochondria after dissolved oxygen was completely consumed. This suggests that complex IV of the respiratory chain of mitochondria is concerned with enzymatic reduction of xanthomegnin and that its redox response is not involved in the uncoupling effect on mitochondrial respiration. On the other hand, when NADH was added, xanthomegnin was immediately reduced by mitochondria, submitochondrial particles, and microsomes, indicating the xanthomegnin is reduced by NAD-linked electron transport system of mitochondria and microsomes. Xanthomegnin reduced by ascorbate was auto-oxidized by dissolved oxygen.
    These results would indicate that xanthomegnin forms an electron transport bypass to the NAD-linked respiratory chain and readily oxidize cytosol NADH. This may cause the cyto-toxic effect to animals.
    Download PDF (697K)
  • Tatsuya Kasai, Yoshie Miura, Tsuneo Namiki, Takashi Miura, Yoko Kuramo ...
    1978 Volume 19 Issue 2 Pages 163-171
    Published: August 07, 1978
    Released on J-STAGE: December 18, 2009
    JOURNAL FREE ACCESS
    A thirty-year-old female patient, suffering from lymphocytic lymphoma, had multiple cutaneous lesions of candidiasis on her whole body surface. All of her cutaneous lesions of candidiasis consisted of quite round ring-shaped and papular plaques apparently looking like tinea circinata. The size of these circular lesions, however, remained mainly within 5cm in diameter, and several plaques frequently gathered together in a large ring-shaped arrangement as a whole, but these lesions never coalesced in one plaque each other. From the scales of the lesions Candida albicans was isolated constantly. In addition to these cutaneous lesions, oral and vaginal mucosa and finger- and toenails were affected with Candida albicans, too. The patient had suffered from these muco-cutaneous candidiasis for about two years, and then, one and a half year later, multiple indurated cutaneous nodules appeared on the extremities. Histologic examinations revealed that these nodules were poorly differentiated lymphocytic lymphoma (lymphosarcoma). Laboratory findings were showed remarkable suppression of cell-mediated immunity. It was suggested that these suppression of immune response of this patient played a role of a causative factor in the formation of these extraordinary ring-shaped lesions of cutaneous candidiasis. The lesions of cutaneous candidiasis except for nails were cleared by external applications of clotrimazole cream, but the patient died after five months treatments from acute and severe infiltrations of lymphoma-cells to the lung. The results of autopsy were also reported.
    Download PDF (4496K)
  • Satoshi Morozumi
    1978 Volume 19 Issue 2 Pages 172-180
    Published: August 07, 1978
    Released on J-STAGE: December 18, 2009
    JOURNAL FREE ACCESS
    Isolation and purification of antifungal substances from powdered cinnamon was undertaken, and orthomethoxycinnamaldehyde (OMCA) was obtained in a pure state. The substance has the molecular formula C10H10O2 and m. w. 162. It is pale yellow flakes soluble in various organic solvents but hardly soluble in water.
    OMCA inhibited the growth of four strains of mycotoxin-producing fungi at the concentrations from 100μg to 200μg per ml, and substantially inhibited the mycotoxin production at the concentrations from 6.25μg to 50μg per ml.
    Moreover, the substance also had a strong inhibitory effect on the growth of five strains of dermatophytes (MIC; 3.12-6.25μg/ml), e. g. Microsporum cauis. However, OMCA showed no antibacterial activity even at the concentration of 50μg per ml.
    Download PDF (1094K)
feedback
Top