The Minimal Inhibitory Concentrations of Antifungal Agents for Clinical Isolates in Fungal Keratitis

This study was performed for the standardization and proper selection of effective antifungal agents by measuring the minimal inhibitory concentra-tions[MICs]of antifungals to fungi, separated from keratitis patients.Two strains of A.fumigatus and single strain of F.solani, A.falciforme, and A . alternata were used for this test.Standard powders of miconazole, itraconazole, clotrimazole, ketoconazole, and amphotericin B were used as antifungal agents. Microscopic and macroscopic measurements of MIC after 24, 48 and 72 hours of inoculation[105 conidia /ml]into YNB broth with culture temperature of 25 degrees C were performed by use of broth microdilution method.The results are as follows : itraconazole, amphotericin B, and clotrimazole were effective against A.fumigatus.F.solani showed resistance to all kinds of antifungal agents.A.falciforme and A.alternata were sensitive to amphotericin B and itraconazole, respectively. Further studies may be needed for the standardized measurement of MIC against filamentous fungi and also for in Vitro-in Vivo correlations for the treatment of fungal keratitis.

One Case of Sebaceous Carcinoma that Masquerades as a Chronic Unilateral Blepharo conjunctivitis

Sebaceous carcinoma of the eyelid is a rare tumor that usually arises from tarsal sebaceous gland. Because the clinical manifestations can masquerade as unilateral recurrent chalasion or chronic blepharoconjunctivitis, its diagnosis may be delayed. Therefore, early biopsy for diagnosis is needed for the persistently recurring unilateral blepharoconjunctivitis. The masquerade syndrome was first described in 1967 by Theodore and Irvine as chronic blepharoconjunctivitis due to an underlying conjunctival carcinoma. While the originally described neoplasms were squamous cell carcinomas, many of the tumors producing this clinical picture are believed to be sebaceous in origin. We experienced a case of pathologically confirmed sebaceous carcinoma of the eyelid which originally masqueraded as chronic blepharoconjunctivitis and was treated with topical antibiotics and steroids for 1 year and 8 months, finally being treated by partial orbital exenteration.

Phagocytosis and Acid Phosphatase Activity against Candida Albicans in Cultured Rabbit Keratocyte

It has been reported that keratocytes endocytose foreign particles both in vitro and in vivo, suggesting the active participation of keratocytes in corneal wound healing and host defense mechanism. This study was conducted to investigate the phagocytosis of keratocytes against Candida albicans[C.albicans]and the intracellular response after phagocytosis. C.albicans were fixed with glutaraldehyde and then coated with fibronectin. After exposing these C.albicans to the cultured rabbit keratocytes, the phagocytosis of keratocytes against C.albicans was evaluated by light microscope[LM]and transmission electron microscope[TEM], while the intracellular response was evaluated by changes of acid phosphatase activity. Also the study about latex beads was performed at the same time to know even if keratocytes can phagocytose foreign particles, regardless of wheather or not the particles are biodegradable. After Wright staining, phagocytosed latex beads and C.albicans were observed on LM and these were recognized to be surrounded by limiting membranes inside the cytoplasm of keratocytes on TEM. The phagocytic rates of fibronectin-coated were increased to 1.5 times , as compared with that of non-coated group. Acid phosphatase activities were higher in C.albicans-exposed groups than in control[keratocytes cultured without C.albicans or latex beads]during the culture period of 24 hours and they also increased according to culture duration and reached to the plateau after 12 hours. In comparison with non-coated group, fibronectin-coated groups showed a increasing tendency of acid phosphatase activity. These results suggest that keratocytes can phagocytose not only foreign particles but also C.albicans and that fibronectin may act as effective opsonin on phagocytosis, and that keratocytes phagocytosing C.albicans increase acid phosphatase activity to digest engulfed C.albicans when corneal stroma was wounded or inflammed.