The superficial mycoses.

The various agents of the superficial mycoses have been recognized for more than a century as causes of mild diseases affecting humankind. Two of these, Malassezia furfur and Trichosporon beigelii, are ubiquitous organisms now known to be opportunistic pathogens in susceptible patient populations. The clinical manifestation, pathogenesis, and treatment of the common skin presentation of these and the other superficial mycoses are reviewed.

Quantitation of human immunoglobulin G and albumin in electroimmunodiffusion gels containing ionic and nonionic detergents.

Quantitation of human immunoglobulin G (IgG) and albumin by agarose electroimmunodiffusion is influenced by the incorporation of ionic and nonionic detergents in the gel. The highest concentrations of each detergent at which human IgG and albumin determinations could be performed without perturbing the quantitations were 4% Triton X-100, 4% Tween 80, 1% NP-40, 0.5% sodium deoxycholate (SDOC), 0.5% Zwittergent, and 0.1% sodium dodecyl sulfate (SDS), and mixtures of Triton X-100, SDOC, and SDS. These detergent combinations all resulted in greater perturbations of albumin quantitation than of IgG. Immunoprecipitation of human IgG was quantitated in the absence and presence of Triton X-100, Zwittergent, and SDS. SDS was shown to cause nonspecific precipitation, whereas below 1% Triton X-100 or 0.5% Zwittergent no effects upon the immunoprecipitations were observed.

Cerebritis due to group B streptococcus.

A premature infant who died of early-onset group B streptococcal meningitis was found to have cerebritis with direct bacterial infection of the basal ganglia. Although the organism was sensitive to penicillin by in vitro testing, it was not eradicated from the cerebrospinal fluid after 48 h of antibiotic treatment. These findings illustrate that suppurative extension with cerebritis of the basal ganglia as a complication of group B streptococcal meningitis may be one of the factors responsible for treatment failure.

Immunoglobulin G from subacute sclerosing panencephalitis brain as an immunological reagent.

Proteins were extracted at pH 2.5 from carefully washed brain homogenates of patients with subacute sclerosing panencephalitis. Immunoglobulin G was isolated from the extracts by gel filtration and immunoadsorbent chromatography and was 125I radioiodinated. The labeled immunoglobulin G was reacted with purified measles virus antigens by crossed immunoelectrophoresis and utilized to identify antigens in measles-infected cell cultures and hamster brain tissue subjected to treatment corresponding to that used for elution of immunoglobulin G. The method described is useful in identifying the specific nature of antibodies as well as antigens in tissue-associated immune complexes.

Electrophoresis of immunoglobulin G. Facilitated migration of minute amounts in agarose.

Migration of very small amounts of immunoglobulin (20 ng) is restricted in agarose electrophoresis. Incorporation of a stable protein matrix (rabbit gamma globulin 1 mg/ml) in the agarose permits unrestricted migration so that immunoelectrophoresis of this quantity of radiolabelled antibody is possible. Very small amounts of radiolabelled and non-radiolabelled antibody were subjected to successful crossed immunoelectrophoresis through barriers of antigen under conditions which provide favorable ratios of antibody to antigen. These methods should be useful for studies of antibody eluted from tissue in acquired and autoimmune diseases associated with tissue bound immunoglobulin.

Progressive rubella virus panencephalitis: synthesis of oligoclonal virus-specific IgG antibodies and homogeneous free light chains in the central nervous system.

The occurrence of oligoclonal IgG and homogeneous free lambda light chains in the cerebrospinal fluid (CSF) of a patient with progressive rubella virus panencephalitis is reported. Fractions of oligoclonal IgG corresponding to those of the CSF occurred also in the serum. Evidence is presented that the oligoclonal IgG of serum and CSF represent rubella virus-specific antibodies. Different populations of oligoclonal IgG appear to be associated with antibody specificities to different antigenic components of the virus.

Measles virus: study of induced transfer of biological properties. II. Fluorescence studies on rescue of neurotropic strain in cell culture.

HeLa cells are non-permissive for the neurotropic suckling mouse strain of measles virus (MMV), but are permissive for cell-adapted Edmonston strain of measles virus (EDm). Fluorescence and electron microscopy demonstrated no membrane fluorescence and no membrane associated viral components, as well as characteristic lack of nuclear antigen after MMV infection of HeLa cells. This appearance differs markedly from the membrane, cytoplasmic and nuclear fluorescence after Edm infection of HeLa cells. Fluorescence microscopy demonstrates fusion of the two dissimilar syncytia after mixed infection. This suggests Edm envelopment of MMV nucleocapsids may be the means of MMV rescue in this system.

Release of bound immunoglobulin from SSPE brain by acid elution.

SSPE brain homogenate extracted at pH 7.4 yields immunoglobulin with a 4- to 5-fold greater hemagglutination inhibition activity per microgram of IgG than serum from the same patient. Serial washing of the homogenate results in a low level steady-state release of IgG. Elution of the washed sediment with pH 2.5, 0.1 M glycine buffer results in a 2- to 3-fold increase in recovery of hemagglutination inhibition activity with a greater hemagglutination inhibition activity per milligram of IgG than the IgG recovered by phosphate-saline extraction at pH 7.4.

Isolation of rubella virus from brain in chronic progressive panencephalitis.

Rubella virus was isolated from the brain of a congenitally-infected, 12-year-old child in whom progressive mental and motor deterioration became evident at age 8 and 11 years respectively. The virus was initially isolated in a co-culture of CV-I cells with the trypsinized brain tissue; subsequently the culture of the brain tissue also showed evidence of rubella virus infection recognized by indirect fluorescent antibody technique (IFA) using anti-rubella virus antibody prepared in rabbits as intermediate serum. Both isolates interfered with infection of BSC-I cell lines by echovirus type II. The interfering virus was identified as rubella virus by IFA with the specific antiserum, and it is designated as the NTr strain of rubella virus. The complement fixing antibody titre to rubella virus in serum was I:256. The spinal fluid was anticomplementary. Rubella virus haemagglutinating antibody titre (HI) in serum was I:8196 and in the spinal fluid I:128. The HI antibody was of the IgG class. The corresponding HI titres to rubeola virus in serum and spinal fluid were I:8 and less than I:2 respectively.

Bilirubin interaction with ganglioside: possible mechanism in kernicterus.

Reaction of bilirubin with increasing amounts of ganglioside purified from neonatal brain significantly alters the spectral absorption of bilirubin in proportion to the quantity of ganglioside added. Increments in absorbance occur at 353 nm with a prompt but transient increase at 486 nm. A decrease in absorbance occurs which is most marked at 447 nm. When gangliosides are added to bilirubin (9.1 mug/ml or 0.016 muM/ml), the decrease in absorbance is essentially linear up to the highest concentration of purified ganglioside tested (182 mug/ml or 0.097 muM/ml), which represents a molar ratio of 6.1:1. The asymptotic nature of the bilirubin-ganglioside reaction as measured by the decrease in absorbance with time suggests a stoichiometric relationship between the two substances. An isosbestic point was demonstrated at 405 nm. Observations reported here suggest bilirubin reaction with ganglioside is at least a two-step process.

Chronic progressive panencephalitis due to rubella virus simulating subacute sclerosing panencephalitis.

Late-onset chronic progressive panencephalitis developed in a 12-year-old boy with congenital rubella syndrome from whose brain rubella virus was isolated. Progressive dementia began at eight, and ataxia, choreiform movements, myoclonic seizures, and fine perimacular pigmentation appeared at 11 years of age. The cerebrospinal fluid was minimally pleocytotic and had a total protein of 156 mg per deciliter, of which 52 per cent was gamma globulin. Electroencephalography demonstrated generalized medium and occasional high-voltage slowing without burst suppression. The antibody titer to rubella virus (hemagglutination inhibition) was 1:8192 in serum and 1:256 in cerebrospinal fluid. Antibody titer to measles virus (complement fixation) was less than 1:8 in serum. Microscopical study of biopsied brain tissue at the age of 11 disclosed panencephalitis similar to subacute sclerosing panencephalitis, but with perivascular deposits and without inclusion bodies. Rubella virus was isolated from the brain by cocultivation with CV-1 cells.

Cytosine arabinoside therapy for herpes simplex encephalitis--clinical experience with six patients.

Two neonates and four adults with herpes simplex virus (HSV) encephalitis were treated with cytosine arabinoside (Ara-C). A low dose of 40 to 160 mg per m(2) per day was given for 4 to 6 days by continuous intravenous infusion and, except in two cases, by intrathecal administration. In one patient, idoxuridine (IUdR) at the dose of 1 g every 4 h was also administered after 4 days of Ara-C therapy. Both neonates and two of four adults survived. Their clinical improvement was closely related in time to the onset of therapy with Ara-C (cases 1, 2, 3) and with IUdR (case 4). In one adult who died on the 27th day of illness of a massive pulmonary embolus, postmortem examination of the brain did not disclose viral inclusions, and viral culture was negative. In the other patient who died, however, brain culture postmortem was still positive for HSV despite 4 days of Ara-C therapy. Ara-C, in addition to IUdR, may be effective in HSV encephalitis treatment, but double-blind, controlled studies appear to be necessary with these agents.