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Biomedical subjects

R J Hay

Publications and source records attributed to R J Hay.

At least 37 records · Page 2Linked to original sources

Production of a species specific monoclonal antibody against a 56-kDa Mycobacterium marinum antigen which is potentially useful in culture identification.

A monoclonal antibody (MoAb) designated 1H11 has been produced against a 56-kDa antigen from Mycobacterium marinum. This MoAb has been shown to be species specific by both enzyme-linked immunosorbent assay and Western blot. The relationship of this 56 kDa to other known mycobacterial antigens is currently under investigation. MoAb 1H11 recognised bacilli taken from cultures by both immunofluorescence and immunoperoxidase staining. This MoAb 1H11 may provide a simple method for rapid identification of M. marinum from cultures of clinical isolates.

Animals↗

The future of onychomycosis therapy may involve a combination of approaches.

Onychomycosis is a fungal infection of the nail unit, most commonly caused by the anthropophilic dermatophyte fungi. It is generally accepted that this disease is increasing in prevalence despite the introduction of new and efficacious antifungal drugs. Several studies have documented health-related quality-of-life issues associated with onychomycosis and it is clear that patient treatment is both necessary and desirable. The aetiology and pathogenesis of onychomycosis is coming under increasing scrutiny and work in this field has grown substantially in recent years. This is reflected by the increased assurance with which clinicians can now prescribe treatment and be confident of improvement in a majority of their patients. However, a significant proportion of patients, perhaps as many as 25-40% of those encountered in clinical practice, are classified as treatment failures. Clinical indicators for poor prognosis include the development of residual foci of subungual fungal growth, onycholysis and severe disease. These observations have led to a resurgence of interest in combination treatments for use in patients at risk of failure/relapse. Several types of combination can be considered, including the use of oral or topical drugs and the concomitant use of surgical techniques, all of which have a place in the treatment of onychomycosis.

Administration, Oral↗

Oesophageal lichen planus.

We present a case of lichen planus affecting the oesophagus of an 80-year-old woman. Symptomatically, the lesions manifested themselves as dysphagia requiring repeated oesophageal dilatations. The patient was unable to tolerate several conventional treatments and so pulsed methylprednisolone was given with some beneficial short-term effects. Due to potential for malignant change in lichen planus of the mucous membranes it is important to remember this complication and investigate patients with oesophageal symptoms.

Aged↗

Production and characterization of recombinant Aspergillus fumigatus Cu,Zn superoxide dismutase and its recognition by immune human sera.

The Cu,Zn superoxide dismutase (SOD) of Aspergillus fumigatus has previously been purified and shown to be immunoreactive to the sera of patients with aspergillosis; however, the purification of large quantities of the enzyme for expanded immunological analysis is both difficult and time-consuming. Accordingly, a lambdaEMBL3 A. fumigatus genomic library was screened with degenerate oligonucleotides based on N-terminal amino acid sequence data; from this initial screen a 1,400-bp fragment was identified, labelled, and used to screen an A. fumigatus lambdagt11 cDNA library. A full-length cDNA encoding Cu,Zn SOD was subsequently identified and cloned. The cDNA encodes a protein of 154 amino acids, which does not have a signal peptide. The A. fumigatus Cu,Zn SOD possesses the typical metal binding ligands of fungal Cu,Zn SODs (six histidines and one aspartic acid) and has significant overall homology with Cu, Zn SODs in general. A recombinant A. fumigatus Cu,Zn SOD has been expressed in Pichia pastoris, is enzymatically active, and has biochemical and biophysical properties that are similar to those of the native enzyme. A sheep polyclonal antibody raised against purified native A. fumigatus Cu,Zn SOD was reactive to the recombinant enzyme by immunoenzyme development of Western blots. Sixty percent of serum samples from patients with A. fumigatus infections were reactive against the recombinant Cu,Zn SOD via immunoenzyme development of Western blots, indicating that the recombinant protein may be useful in the serodiagnostic identification of A. fumigatus infections.

Amino Acid Sequence↗

Semi-invasive allergic aspergillosis of the paranasal sinuses.

Aspergillosis of the nose and paranasal sinuses has classically been divided into four types: allergic, non-invasive, invasive and fulminant. Recent reports have suggested that a semi-invasive form with bone destruction and erosion, but without fungal tissue invasion, may occur. We present a case of allergic non-invasive aspergillosis of the paranasal sinuses with associated bone destruction extending into the orbit and anterior cranial fossa, in a non-immunocompromised patient. Surgical debridement combined with a prolonged course of oral itraconazole has resulted in long-term resolution with no evidence of recurrence of disease five years later.

Adult↗

Epidemiology of tinea capitis.

This paper addresses the changing epidemiology of tinea capitis in the USA and in Europe that has occurred over the last several decades. Several dermatophytes are involved in the etiology, and the primary etiological agents of tinea capitis are limited to the genera Microsporum and Trichophyton. In addition, the sources of these infections are discussed and although geophilic dermatophytes occur worldwide, anthropophilic species and some zoophilic fungi may be geographically restricted, depending on host range. For example, tinea capitis due to geophilic organisms is rare in the USA.

Animals↗

The management of superficial candidiasis.

Superficial Candida infection includes several common conditions, most often related to some underlying local or systemic predisposition. Appropriate identification of the pathogen is important in the management of candidiasis as the result of differences in susceptibility among species and strains of Candida to different antifungal drugs. Treatment options are reviewed for oropharyngeal candidiasis, vaginal candidiasis, cutaneous candidiasis, paronychia and onychomycosis, and chronic mucocutaneous candidiasis. Because of the importance of predisposing conditions for candidiasis, adjunctive measures to abate these may be useful, although they are seldom effective in immunocompromised patients.

Antifungal Agents↗

Therapeutic potential of terbinafine in subcutaneous and systemic mycoses.

Mycoses vary widely in severity, and may present as superficial, subcutaneous and/or systemic infection. Effective treatments for most superficial mycoses now exist, but new agents with convenient dosing regimens and a low level of adverse events are still needed to reduce morbidity and mortality from serious subcutaneous and systemic fungal infections. In vitro, terbinafine exhibits a broad spectrum of activity against the pathogenic fungi responsible for deep mycoses. Clinical data, while not abundant, suggest that this in vitro activity of terbinafine is reflected in its in vivo efficacy. The limited data show that terbinafine is a useful first-line treatment in chromoblastomycosis patients and has efficacy in pulmonary aspergillosis. There are also data to suggest that terbinafine may be effective in treating histoplasmosis, Pneumocystis carinii infection, fungal mycetoma, and cutaneous leishmaniasis. Moreover, there is some evidence of terbinafine having synergistic activity with amphotericin B, itraconazole, and fluconazole against clinical isolates of Candida species. Thus, the therapeutic potential of terbinafine extends well beyond its current use in acute and chronic dermatophytoses to include a wide range of subcutaneous and systemic mycoses. Studies are needed to determine the optimum dose in each disease, and whether combination therapy would have advantages in certain circumstances.

Antifungal Agents↗

Reactivation of cutaneous leishmaniasis after surgery.

Cutaneous leishmaniasis (CL) is caused by a parasite from the genus Leishmania. Infection is transmitted to humans from the bite of sandflies. We describe an 85-year-old man who developed CL on his face after recent cutaneous surgery in that site. The case is also unusual because the most likely source of exposure to the infection occurred over 50 years previously. Polymerase chain reaction, slit-skin smear, serology and the leishmanin test were not helpful in diagnosis, which was confirmed by histopathological demonstration of the parasite.

Aged↗