Biomedical subjects
Publications and source records attributed to C Scherwitz.
During a 2-week period, a 9-year-old girl developed a tender, dark red, centrally ulcerated 3 cm tumor on her left thigh, associated with inguinal lymphadenopathy. Histologic and immunohistopathologic evaluation disclosed a Ki-1+ large-cell anaplastic lymphoma. The patient received multiagent chemotherapy followed by autologous bone marrow transplantation and is in her second remission.
A 73-year-old patient complained of increasing macroglossia and symmetrical enlargement of the submandibular region. A tongue biopsy showed typical deposits of amyloid by Congo red staining and polarization microscopy. Similar deposits were found in biopsy specimens of the submaxillary gland and the rectum. Electron microscopy revealed typical amyloid fibrils. With the indirect immunoperoxidase technique the amyloid was classified as being of immunoglobulin kappa-light-chain origin (A-kappa), because only anti-A kappa, but not anti-A lambda (several antisera of non-overlapping specificity), anti-ASc1 or anti-AF antisera were found to be reactive. Correspondingly, Bence Jones protein of the kappa type was found in the urine. In the bone marrow there was an increase in plasma cells of up to 10%. Cytostatic therapy with melphalan and methylprednisolone seemed to stop the progression of amyloid deposition.
This in vitro study investigates the phagocytosis and killing rate of Candida albicans blastospores and germ tubes by polymorphonuclear leukocytes. Suspensions of C. albicans blastospores and germ tubes were incubated for 60 and 150 min with a neutrophil suspension. The rate of phagocytosis was found to be 92 +/- 3% for blastospores, but only 9.5 +/- 2.5% for germ tubes. The candidacidal activity rate was 29 +/- 6% for blastospores, but only 5.5 +/- 1.5% for germ tubes. Electronmicroscopically, cytoplasmic and plasma membrane alterations of phagocytized yeast cells lying in phagosomes were observed. Short germ tubes surrounded by a phagosomal membrane were found in neutrophils. Older, longer germ tubes were seen in an extracellular position. Usually, several neutrophils were adjacent to these long tubes. Obviously phagocytosis could not take place owing to the size of the germ tubes. The findings indicate that the transition of the yeast phase to the mycelium phase in a case of Candida infection may be a mechanism enabling the parasite to escape phagocytosis by the host.
Candida (C) albicans cells were exposed to 8-Methoxypsoralen (8-MOP) concentrations of 1.0 microgram/ml and 10.0 microgram/ml medium and irradiated with 365 nm light. The amount of energy emitted was 4.8 J/cm2. Two divergent types of cell damage occured concerning yeast cell cytoplasm and cell wall. Two hours after exposure cytoplasmic changes involving mitochondria, which showed irregularities in shape, blurred appearance or loss of mitochondrial cristae and outer membrane were seen. The number of vacuoles was increased. The cytoplasm showed large electron transparent areas, the cytoplasmic membrane disappeared in some areas completely. Nucleus and nuclear envelope usually remained intact in early stages. 24h after exposure conspicuous cell wall alterations were observed in addition to cytoplasmic changes. Newly produced cell wall material formed ball-like protrusions or was adherent sickle-shaped to the cell wall. The investigations strongly suggest that the results found after 8-MOP-UVA treatment of C. albicans cells can not be interpreted in the sense of a general cytotoxic effect. Apparently it takes the form of a combination of events involving regressive and progressive alterations.
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Experience with the germ tube test for the diagnosis of candida mycosis in gynaecology and dermatology is reported. Candida albicans forms germ tubes in human serum and other culture media at 37 degrees C within 2 to 3 hours. If the initial culture grows yeast, the germ tube test permits the exact identification of the yeast as candida albicans within three to five hours. The specificity of the test is approximately 99%. Of 3270 samples 934 grew yeast and 742 were candida albicans by the germ tube test. 6 samples with a negative germ tube test were identified as candida albicans by the Chlamydospore test. 125 samples showed a candida species, 45 samples showed a torulopsis species and 16 tests identified a trichosporon species. This test is valuable in the routine office practice of gynaecology because of its simplicity and speed.
Germ tubes, blastospores and pseudomycelia of Candida albicans were studied under the electron microscope. Both germ tube and blastospore formation begin with comparable changes in the cell wall of the mother cell. The major part of the germ tube wall consists of the fourth of the five layers forming the C. albicans cell wall. Germ tubes are precursors of mycelia which can ramify. Septa and septal pores can be demonstrated in later phases. Pseudomycelia can be clearly discerned by means of transmission electron microscopy.
Candida (C.) albicans cells were exposed to 8-Methoxypsoralen (8-MOP) concentrations of 1.0 microgram/ml and 10.0 micrograms/ml medium and irradiated with 365 nm light. The amount of energy emitted was 4.8 J/cm2. Two divergent types of cell damage occured concerning yeast cell cytoplasm and cell wall. Two hours after exposure cytoplasmic changes involving mitochondria, which showed irregularities in shape, blurred appearance or loss of mitochondrial cristae and outer membrane were seen. The number of vacuoles was increased. The cytoplasm showed large electron transparent areas, the cytoplasmic membrane disappeared in some areas completely. Nucleus and nuclear envelope usually remained intact in early stages. 24 h after exposure conspicuous cell wall alterations were observed in addition to cytoplasmic changes. Newly produced cell wall material formed ball-like protrusions or was adherent sickle-shaped to the cell wall. The investigations strongly suggest that the results found after 8-MOP-UVA treatment of C. albicans cells can not be interpreted in the sense of a general cytotoxic effect. Apparently it takes the form of a combination of events involving regressive and progressive alterations.
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Econazole-nitrate is a new potent antifungal drug with a broad spectrum against dermatophytes, yeasts and moulds; in addition it is effective against gram-positive bacteria. Econazole nitrate was tested in-vitro for antifungal and anti-microbial properties. In an open trial 75 patients were treated with a 1 percent econazole cream. Cure was achieved in tinea pedis in 91 percent; in tinea genitocruralis in 100 percent and in tinea corporis in 92 percent. The remainder were greatly improved. 22 patients with erythrasma were cured within 3 weeks.
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In a prospective randomized multicenter trial for the therapy of erythema migrans, 40 patients received ceftriaxone 1 g daily for 5 days and 33 patients obtained phenoxymethylpenicillin, 1 million units 3 times daily, for 12 days. Follow-up was for a mean of 10 +/- 5 months. Eight oral penicillin recipients (24%) and six ceftriaxone recipients (15%) developed minor consecutive manifestations. Two ceftriaxone and one penicillin recipient(s) still had elevated IgG antibody titers 10 to 20 months after therapy. Borrelia burgdorferi could be isolated from the erythema migrans in 29 out of 56 patients (52%) before therapy and in one oral penicillin recipient but none of 24 other patients after therapy. Ceftriaxone was superior to oral penicillin in a subgroup of patients with more than one symptom prior to therapy (p less than 0.01), but not in the overall evaluation of clinical, serological and bacteriological outcome data. Ceftriaxone ought to be preferred to oral penicillin in patients with more severe early Lyme borreliosis.