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Biomedical subjects

K Gründer

Publications and source records attributed to K Gründer.

At least 19 recordsLinked to original sources

Detection of extracellular phospholipase activity in Candida albicans and Rhodotorula rubra.

Phospholipases are important pathogenicity determinants in Candida albicans. They play a significant role in damaging cell membranes and invading host cells. High phospholipase production is correlated with an increased ability of adherence and a higher mortality rate in animal models. By means of an egg yolk-containing agar and the Pz (= phospholipase activity zone) value according to Price, the present study investigated phospholipase production in 170 strains of C. albicans. At an incubation temperature of 37 degrees C, Pz values ranged from 0.395 to 1; no clear relationship was found between clinical origin of the isolates and severity of the disease. In addition to C. albicans, a total of 110 strains of 16 other yeast species were investigated for possible phospholipase production. Only yeasts of the species Rhodotorula rubra showed phospholipase activity, with mean values exceeding those observed in C. albicans. This result was confirmed by an assay using sterile culture filtrates and phosphatidyl-[3H-methyl]-choline-dipalmitoyl as a substrate. Since Rh. rubra has only rarely been demonstrated as a pathogen in humans, we believe that factors such as reduced growth at 37 degrees C, absence of dimorphism and low ability of adherence lessen the importance of high phospholipase activity in Rh. rubra as a pathogenicity determinant. Therefore, potential virulence factors should always be considered in the context of the whole spectrum of pathogenic determinants.

1,2-Dipalmitoylphosphatidylcholine

[Diagnosis, clinical aspects and therapy of early chromoblastomycosis in a case example].

Despite the availability of modern antimycotics, which produce high cure rates in early infections, the therapy of advanced chromoblastomycosis is still unsatisfactory. An initial chromoblastomycosis caused by a hitherto unidentified species of the genus Phialophora was diagnosed in a 46-year-old teacher. The organism was isolated twice at an interval of 6 weeks from a partly psoriasiform, partly verrucous lesion on the 4th toe. The infection was apparently acquired 4 years ago during a holiday at Cape Verde. Treatment with itraconazole (Sempera). 200 mg/day, and amphotericin B (Ampho-Moronal) cream for 6 weeks initially resulted in rapid regression. However, 4 weeks after cessation of therapy, the Phialophora species was cultured again from skin scrapings. Complete healing was achieved after re-treatment with itraconazole for 20 weeks at the same dosage in combination with topical amorolfine and local hyperthermia. Until now, no relapse has occurred. The present case demonstrates that this rare disease, which mainly occurs as a traumatic mycosis in the rural population of tropical regions, must be included in the differential diagnosis of psoriasiform or verrucous skin lesions and also included in the list of diseases which may be acquired while on vacation in exotic locations.

Administration, Topical

[Fungi of the Trichosporon genus. Identification, epidemiology and significance of dermatologic disease pictures].

Based on molecular data, the genus Trichosporon was recently reclassified. Six human pathogenic species, which are closely related to specific types of infections can be differentiated. By means of commercial test systems and simple key criteria according to Gueho et al. [15], 44 isolates that had been identified as Tr. cutaneum between 7/92 and 1/96, were reclassified. The evaluation of clinical data also included 66 isolates that had not been preserved, and 27 strains of Tr. inkin. Trichosporon species were found in 4.8% of all yeast isolates (3.8% Tr. cutaneum, 1% Tr. inkin). Nearly every other isolate of Tr. cutaneum was cultivated from nail material, while Tr. inkin was mainly isolated from skin in the anogenital region. In 38 cases, reclassification revealed Tr. mucoides; Tr. ovoides and Tr. asteroides were identified in 3 cases each, while Tr. asahii, an especially remarkable pathogen in systemic mycoses, was not found. Clinically, isolates of Tr. mucoides were predominant in toenail mycoses which might be considered in the therapy of onychomycosis. Furthermore, isolates from the skin should be evaluated with respect to the increasing incidence of systemic Trichopsoron mycoses.

Adolescent

Hydrolysis of fatty acid esters by Malassezia furfur: different utilization depending on alcohol moiety.

The lipophilic yeast Malassezia furfur belongs to the resident skin flora but has been implicated in various skin diseases. While topical oily preparations may support its growth, their formulation may be altered by yeast-dependent enzymatic degradation. Different synthetic fatty acid (mono-)esters used as refatting agents were mixed with 10(4), 10(5) and 5 x 10(5) yeasts/microliters, respectively, and incubated at 35 degrees C for a maximum of 48 h on selective agar for pathogenic fungi (Merck). The amount and pattern of generated free acids were evaluated by densitometric and gas chromatographic analysis, while yeast density was determined in a Neubauer chamber. Depending on the inoculum, yeast-dependent hydrolysis occurred immediately and was best effected in ethyl esters, followed by isopropyl esters, whereas hydrolysis of decyl oleate was only limited. Of the fatty acids released, unsaturated fatty acids were more stimulative to growth than saturated fatty acids; no toxic effects were observed. In conclusion, yeast-dependent hydrolysis of these synthetic fatty acid (mono-)esters was critically dependent on alcohol moiety, while growth promotion was best effected by unsaturated fatty acids. These results may help to improve the compatibility of topical formulations, especially in seborrheic areas.

Alcohols

[Fox-Fordyce disease (apocrine miliaria)].

A 1-year follow-up in a 12 year old girl suffering from Fox-Fordyce disease is reported. Reddish papules were found in the typical locations in the regions with a high density of apocrine glands. A biopsy specimen showed keratin plugs in the infundibula of apocrine glands. Since hormone therapy could not yet be given, external therapy only was performed, with good results.

Administration, Topical

[Cutis marmorata teleangiectatica congenita (Van Lohuizen syndrome)].

The 2-year spontaneous course of a case of cutis marmorata teleangiectatica congenita in a girl is reported. The child had typical cutis marmorata, with teleangiectasis, phlebectasias and ulceration particularly on parts of the left leg and in the anogenital region, with no further anomalies. During symptomatic therapy over 2 years the lesions faded spontaneously.

Child, Preschool

[DNA determination by cytophotometry in bowenoid papules in comparison with condylomata acuminata and Bowen's disease].

The relation between bowenoid papules and Bowen's disease is characterized by largely corresponding histological pictures and diverging clinical-epidemiological features. In bowenoid papules and Bowen's disease, 5 cases each, compared with 5 cases of common condylomata acuminata, we determined the DNA by means of Feulgen's cytophotometry in visible light after Feulgen's staining. The following results were obtained: The average DNA content in bowenoid papules equals that in Bowen's disease, but it is significantly higher than in condylomata acuminata. What is different between the two groups "bowenoid papules" and "Bowen's disease" is the distribution of DNA: In Bowen's disease, DNA spreads into higher ranges of polyploidy. If we take recent molecular biological/virological findings into account, this result can be interpreted as a transition towards carcinoma in situ.

Adult

[Pruritic urticarial papules and plaques in pregnancy].

PUPPP is a distinct kind of dermatosis that occurs in pregnancy and is characterized by pruritic, mostly urticarial papules. The lesions usually occur during the last trimenon and regress shortly after delivery. In contrast to other types of dermatosis in pregnancy (e.g., herpes gestationis), PUPPP is not associated with a higher incidence of fetal or maternal complications. It is relatively rare and has only occasionally been mentioned in the German literature. The clinical features and courses of eight patients are described, and the differential diagnosis is discussed with regard to other dermatoses of pregnancy.

Adult

[Etiology of pathogen-induced changes between the toes in patients working under moist conditions].

Referring to recent studies, we discuss the epidemiology of tinea pedis and its position within the range of polyetiological foot infections caused by microbial agents. 201 industrial workers used to wear rubber boots because of moist working conditions were examined with regard to their feet. 107 of them showed clinically altered toe web; in 45 cases, we found ringworm infection (22.4%), in correlation to increased daily wearing time of rubber boots. 85 workers showed colonization of pathogenic bacteria (42.4%), especially gram-negative species (25.8%). Frequently, mixed infections were found. The clinical picture not always allows definite conclusions as to the causal agents. The symptom "maceration" is seen in each of the 3 pathogenic groups of germs (fungi, gram-positive pathogenic cocci, gram-negative bacteria), frequently in bacterial foot infections, especially gram-negative infections. Marked clinical symptoms involve increased infection rates. The predisposing factors to foot infection such as interdigital maceration and the promoting role of rubber boots have been confirmed. The final diagnosis is to be reassured by cultural investigations, in order to set up a specific treatment.

Adult

[Classification of Gonococcus: auxanologic and serologic aspects using monoclonal antibodies].

500 N. gonorrhoeae strains from the area of Lübeck/West Germany, collected in 1976-84, were auxologically and serologically classified by means of monoclonal antibodies from the Genetic Systems Corporation, Seattle, Washington (USA), against gonococcal outer membrane protein I. During the first years, auxological classification showed high proportions of AHU-strains (40%), which amounted to 20% over the total observation period. PPNG and DGI strains have characteristic type patterns. Our synopsis of serovars corresponds with the results obtained in a recent world-wide study. Combined auxological and serological classification shows two N. gonorrhoeae pools, 18% each, which cannot be further distinguished: AHU/A1 and prototrophic/B3. The advantages of the system have been proved in answering plain epidemiological questions. For further discrimination, an additional independent classification method might be useful.

Antibodies, Monoclonal

[Gonorrhea].

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Adult

[Effect of a corticosteroid additive on the result of local therapy of bacterial superinfection in tinea pedis intertriginosa].

Sixty cases of tinea pedum intertriginosa were topically treated in a double-blind trial. In 34 cases a cream was used, which contained 5-chloro-8-hydroxyquinoline, gentamycin and fluprednyliden-21-acetate. In 26 cases a cream was used, which contained 5-chloro-8-hydroxyquinoline and gentamycin alone. Treatment was continued over three weeks. In weekly intervalls mycological, bacteriological and clinical controls were performed, which showed that the steroid-component had no disadvantageous effect on the course of infection. In contrast the steroid containing preparation proved to be slightly superior.

Bacterial Infections

Investigations on antibacterial activity of cefazedone against Neisseria gonorrhoeae.

The sensitivity of 67 strains of Neisseria gonorrhoeae isolated from 1977 to 1978 were tested against the new cephalosporin derivative (6R,7R)-7-(2-[3,5-dichloro-4-oxo-1(4H)-pyridyl]-acetamido)-3-([(5-methyl-1,3,4-thiadiazol-2-yl)-thio]methyl)-8-oxo-5-thia-1-azabicyclo[4,2,0]oct-2-ene-2-carboxylic acid (cefazedone, Refosporen). All strains including three penicillin-resistant beta-lactamase producing Neisseria were sensitive at a range of 0.0078 to 2.0 micrograms/ml cefazedone.

Cephalosporins