Medical Mycology Journal
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54 巻 , 3 号
選択された号の論文の9件中1~9を表示しています
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教育シリーズ:Dermatomycosis
原  著
  • Yoshiyuki Okumura, Makoto Suzukawa, Kei-ichi Uchiya, Kenji Ogawa, Yumi ...
    原稿種別: Original Article
    54 巻 (2013) 3 号 p. 279-284
    公開日: 2013/08/30
    ジャーナル フリー
    A novel elastase inhibitor from Aspergillus nidulans NBRC 4340, Asnidin, was isolated, and biochemical properties and partial amino acid sequence were examined. Column chromatography using diethylaminoethyl (DE) 52-Cellulose and reversed-phase HPLC were used to purify the inhibitor. Purified Asnidin was found to be homogeneous as indicated by reversed-phase HPLC and TOF-MS (Time of Flight Mass Spectrometry). Asnidin has a molecular weight of 4,181.63 as determined by TOF-MS. The elastolytic activities of elastases from A. fumigatus, A. flavus, and human leukocytes but not chymotrypsin, and elastases from snake venom and bacteria were inhibited by Asnidin. The fibrinogenase and collagen type IV hydrolytic activities of the elastase from A. fumigatus were inhibited by Asnidin. Asnidin was found to be stable under heat treatment and over a wide pH range. The elastolytic inhibitory activity of Asnidin was inhibited by dithiothreitol (DTT), while no inhibition was observed with ethylenediaminetetraacetic acid (EDTA-2Na) and benzamidine. Since there is a possibility of Asnidin becoming another drug in the arsenal of weapons against aspergillosis or interstitial pneumonia, further studies are warranted.
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  • 永川 博康, 猪狩 英俊, 小西 建治, 加志崎 史大, 青山 眞弓, 渡邉 哲, 巽 浩一郎, 亀井 克彦
    原稿種別: 原  著
    54 巻 (2013) 3 号 p. 285-289
    公開日: 2013/08/30
    ジャーナル フリー
     症例は50歳,男性.近医で慢性糸球体腎炎(人工透析)と間質性肺炎にて通院中であった.その後,間質性肺炎急性増悪にて同院より紹介された.入院直後からICU管理となり,人工呼吸管理,各種抗菌薬治療,ステロイドパルス療法,エンドキサンパルス療法を施行したが,肺炎像は増悪傾向を示した.その後,左中肺野に空洞性陰影を認め,アムホテリシンBを併用したが,第10病日に左の緊張性気胸を併発し永眠された.剖検にて左S3に穿破した空洞病変を認め,特徴的な病理所見から侵襲性肺ムーコル症と診断した.本症において,人工呼吸管理中に気胸を併発した場合,報告例は少ないが致死的となる可能性が高く,文献的考察を加え報告する.
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  • 桑江 義介, 小川 祐美, 吉池 高志, 池田 玲子, 杉田 隆
    原稿種別: 原  著
    54 巻 (2013) 3 号 p. 291-296
    公開日: 2013/08/30
    ジャーナル フリー
     症例は88歳,女性.慢性炎症性脱髄性多発神経炎のためプレドニゾロン15mg/日を内服中.2012年4月に肺炎の疑いで入院となり,胸部レントゲン・CT所見および血中クリプトコックス抗原高値により,肺クリプトコックス症と診断された.フルコナゾール200mg/日の点滴開始により,発熱などの全身状態は軽快したが,入院時より存在した左手背部・左大腿部の皮膚潰瘍が急速に拡大し,精査目的で皮膚科受診となった.左手背部に4×6cm大,左大腿部に2×3cm大の皮膚潰瘍を認め,皮膚生検,浸出液の直接鏡検・真菌培養の所見から皮膚クリプトコックス症と診断した.治療は,フルコナゾール200mg/日を7日間点滴投与後,イトラコナゾール200mg/日の内服に変更した.しかし,1週間ほどで肝障害が出現したため,フルコナゾール200mg/日内服に変更し,潰瘍は2ヵ月目には縮小傾向を示した.高齢者や基礎疾患による副腎皮質ステロイド薬・免疫抑制薬使用者で皮膚潰瘍を伴う場合には,鑑別疾患として皮膚クリプトコックス症などの深在性皮膚真菌症を念頭に置いておく必要がある.
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  • Tatsuo Fukai, Masataro Hiruma, Yumi Ogawa, Shigaku Ikeda, Hiroshi Iked ...
    原稿種別: Original Article
    54 巻 (2013) 3 号 p. 297-301
    公開日: 2013/08/30
    ジャーナル フリー
    A 58-year-old Japanese woman who was engaged in dairy farming presented with multiple subcutaneous nodules and abscesses on the dorsum of her left hand from 5 months ago. These had been unsuccessfully treated with oral itraconazole. The patient had a history of Sjögren syndrome and diabetes mellitus, for which she had been taking oral prednisolone for 10 years. Direct microscopy of a pus sample treated with potassium hydroxide (KOH) showed brownish-red branching hyphae. In fungal culture, black colonies covered with gray-white villi were formed. Slide culture showed conidiogenesis from an annellide. The fungal strain was identified as Exophialia oligosperma by molecular biological techniques. Histopathological examination revealed abscesses and surrounding granulomatous infiltration in the dermis and subcutis, and hyphae in the granulomatous infiltration in the outer area. However, no eumycotic granules were observed. The diagnosis was phaeohyphomycosis caused by E. oligosperma. Since the previous treatment with itraconazole had not been effective, we performed daily hyperthermia using a disposable body warmer and drainage of the pus, which ceased after 3 weeks. After approximately 4 months, the skin eruptions became scarred. To the best of our knowledge, this is the second case of phaeohyphomycosis caused by E. oligosperma reported in Japan which was successfully treated with hyperthermia.
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