Evaluation of the efficacy of a 3.2% glutaraldehyde product for disinfection of fibreoptic endoscopes with an automatic machine.

The efficacy of 'Cidex Plus' 3.2% alkaline glutaraldehyde was evaluated for the disinfection of fibreoptic endoscopes. The glutaraldehyde concentration in 'Cidex Plus', stored in an automatic machine (Olympus EW-20), remained higher than 2% (2.21%) even after a total of 102 disinfection cycles during 28 consecutive days. The results of the in-vitro study on antimicrobial activity showed that this alkaline glutaraldehyde product had a greater activity against 20 test organisms, including vegetative bacteria, bacterial spores, mycobacteria, and fungi, than 2% glutaraldehyde alone. The presence of 10 or 30% human serum did not appear to affect the activity of glutaraldehyde adversely. Instrument samples made from a variety of materials such as stainless steel, glass, teflon, etc. were not damaged after 168 h of immersion in alkaline glutaraldehyde, although it contained approximately 1.7 times more glutaraldehyde than 2% glutaraldehyde alone. Based on these results, 3.2% alkaline glutaraldehyde is considered to be a more effective disinfectant for fibreoptic endoscopes, with the use of an automatic machine, than 2% glutaraldehyde.

Acute primary cutaneous nocardiosis.

An acute localized, purulent skin lesion developed on the right knee of an 8-year-old girl and was subsequently diagnosed as a primary cutaneous Nocardia brasiliensis infection. It was soon accompanied by intense lymphangitis and regional adenopathy. The patient had a history of a minor abrasion contaminated by soil at the site of infection 8 days before the infection became evident. The infection was successfully treated with a combination of minocycline and dapsone.

Phialophora repens, an emerging agent of subcutaneous phaeohyphomycosis in humans.

A 63-year-old Japanese man had phaeohyphomycosis that occurred as a solitary subcutaneous nodule on the dorsal aspect of his left hand. In the nodule there were foci of mixed granulomatous and suppurative infiltrations circumscribed by thick fibrous tissue reaction. The foci contained short septate hyphae and occasionally small rounded aggregates of irregularly branched septate hyphae, both of which were nonpigmented or rarely weakly pale brown. Fungal culture from the nodule was positive for a dematiaceous mold. The mycologic features of the mold were typical of Phialophora repens. The infection was successfully treated by excision of the nodule. This is the second reported case of infection due to P. repens.

Trichophyton mentagrophytes granulomas. Unique systemic dissemination to lymph nodes, testes, vertebrae, and brain.

A man had Trichophyton mentagrophytes infection that ultimately involved the lymph nodes, testes, vertebrae, and CNS. It was associated with anergy and defective lymphocyte transformation to T mentagrophytes antigen. The patient was also anergic to repeated delayed skin testing with PPD and dinitrochlorobenzene. His lymphocyte responsiveness, as demonstrated by lymphocyte transformation to phytohemagglutinin and PPD, was substantially decreased. However, the results of an in vitro leukocyte migration inhibition assay showed that his lymphocytes were responsive to T mentagrophytes antigen as well as to PPD. The patient's serum IgE level was increased, but serum transferrin levels were persistently abnormal. Therapeutic attempts, including the systemic administration of griseofulvin, amphotericin B, clotrimazole, and transfer factor failed, and the patient died five years after systemic disease onset.

Mating types and serotypes of Cryptococcus neoformans isolated in Japan.

Thirty-two isolates of Cryptococcus neoformans from patients and one from the wild obtained in Japan were characterized for their serotype, self-fertility, and mating behaviour by crossing them with two mating types of Filobasidiella neoformans var. neoformans and F. neoformans var. bacillispora. Of the 32 isolates from patients, 31 were of serotype A and the remaining one was of serotype D. Although these 32 isolates were all self-sterile, 23 serotype A and one serotype D isolates produced a complete sexual state when mixed with the alpha mating type of F. neoformans var. neoformans. The one natural isolate was of serotype A-D and self-fertile. The Japanese clinical isolates of C. neoformans appear to be predominantly serotype A and alpha mating type of F. neoformans var. neoformans as is the case in the U.S.A.

Cutaneous calcinosis in a neonate following extravasation of calcium gluconate.

Cutaneous calcinosis following extravasation of calcium gluconate in a 6-day-old neonate is reported. After extravasation of a 10% calcium gluconate infusion, rapid and marked swelling, erythema, and signs of soft tissue necrosis developed over the dorsum of the right hand and wrist. Small eschars were soon formed on the skin surface and began to slough, the underlying base appearing necrotic. Through the small channels of the destroyed epidermis, tiny white pieces of calcific masses were eliminated spontaneously. Histologically, the dermal collagen was massively degenerated and the calcium deposits were found as amorphous masses throughout the dermis and subcutaneous adipose tissue, surrounded by mild lymphohistiocytic cell infiltration. This is a case which again warns of the danger of using 10% calcium gluconate intravenously in the neonate or young infant.

Distribution of mating types among clinical isolates of the Microsporum gypseum complex.

Forty-five clinical isolates of Microsporum gypseum were crossed with the + and - tester strains of Nannizzia gypsea, N. incurvata and N. fulva to determine their mating type. Thirty-two produced fertile gymnothecia when crossed with N. gypsea, of which 13 reacted as + and 19 as -. Ten produced fertile gymnothecia when crossed with N. incurvata, of which 7 reacted as + and 3 as -. The remaining 3 were sterile in all crosses with N. gypsea. N. incurvata and N. fulva. Of these 3, 2 were fluffy, degenerated cultures of M. gypseum, and the other one appeared to bae identical with the description of M. gypseum var. vinosum in cultural and morphological characteristics. There was approximately a 1:1 overall ratio of mating types among a total of 90 clinical isolates of M. gypseum in Japan on the basis of the above results and the data recently reported in the literature by other Japanese workers. The present results suggest that the ability to cause skin infection of humans by the soil-inhabiting organisms is approximately equal in the mating types and probably independent of sexuality.

Optical-fiber laser Doppler velocimeter for high-resolution measurement of pulsatile blood flows.

A high-resolution laser Doppler velocimeter with an optical-fiber pickup has been developed, and we have succeeded for the first time in measuring velocities of pulsatile blood flows in femoral and coronary arteries of mongrel dogs. The measurements were in real time with 100-microm spatial and 8-msec temporal resolutions, using a 150-m long fiber to reach the animal operation laboratory from the optics laboratory.

Trichophyton mentagrophytes skin infections in laboratory animals as a cause of zoonosis.

Recent sporadic distribution in Japan of Trichophyton mentagrophytes skin infections among laboratory rats or guinea pigs is reported. Six cases of laboratory infection by the fungus in humans who came in direct contact with the affected animals are also presented. Mating experiments with the causative fungi isolated from the animal and human skin lesions revealed that all but one sexually reactive strains belonged to the "+" mating type of Arthroderma vanbreuseghemii. A retrospective epidemiologic study ascertained that most of the affected rats were those derived from the same breeding colony of a certain experimental animal producing-co-operation in Saitama prefecture, where it had been produced by conventional methods of specific pathogen-free parental colony maintained in a barrier system. These two pieces of evidence suggest a possible transmission of the etiologic agent from some healthy carrier or infected hair-droppings in the environment to the breeding colony, during its breeding, or maintenance by the producer.

Annellated conidiogenous cells in Petriellidium boydii (Scedosporium apiospermum).

Annellated conidiogenous cells of both the mononematous (Scedosporium state) and synnematous (Graphium state) conidiophores develop in the conidial state of Petriellidium (= Allescheria) boydii, Scedosporium (= Monosporium) apiospermum. Conidiogenesis in this species is characterized by percurrent proliferation of the conidiogenous cells and the conidia are holoblastic and annellidic.

Cerebral phaeohyphomycosis caused by Cladosporium bantianum: a case in a female who had cutaneous alternariosis in her childhood.

A rare case is presented of mycotic infection in a Japanese female, who had cutaneous alternariosis in the face at age 9, and died of cerebral phacohyphomycosis 8 years later. To our knowledge, this is the first reported case in which these two unusual and different mycoses have occurred successively in the same person. The cerebral lesions were located in the right parietal region close to the sulcus centralis and in the region of the right cerebral lateral fissure. They were granulomatous and characterized by the presence of numerouse microabscesses. In the center of these were seen many dematiaceous fungal elements that consisted mainly of light brown, septate hyphae 1.5-2.5 micrometer in diameter, from which elongated cells 3-4 X 8-10 microgram in size were seen proliferating. In addition, yeast-like cells 8-10 microgram in diameter were observed. The etiologic agent isolated from the brain lesions was identified as Cladosporium bantianum (Sace.) Borelli (=Cladosporium trichnoides Emmons) on the basis of our morphological and physiological findings and its neurotropism in experimentally inoculated mice.