In vitro photodynamic inactivation (PDI) of pathogenic germs inducing onychomycosis.

Onychomycosis is a fungal nail infection caused primarily by the dermatophytes Trichophyton rubrum and Trichophyton interdigitale or, less frequently, by molds like Aspergillus spp. and Scopulariopsis brevicaulis. Photodynamic treatment of onychomycosis is considered a promising future therapy to overcome the frequent failure of currently used antifungals. In this study, we tested the potential of three photosensitizers for photodynamic inactivation of the onychomycosis causing pathogens T. rubrum, T. interdigitale and S. brevicaulis. Photosensitizers used are 10,15,20-Tetrakis(1-methylpyridinium-4-yl) porphyrintetra(p-toluenesulfonate) (TMPyP), 5,10,15-tris-(1-methylpyridinium-2-yl)corrolato-(trans-dihydroxo)phosphorus(V) (PCor+) and 2',4',5',7'-tetrabromo-3',6'-dihydroxyspiro[2-benzofuran-3,9'-xanthene]-1-one (Eosin Y). The phototoxic effects caused by the cationic photosensitizers (PCor+ and TMPyP) were tested on suspension cultures of spores as well as on fungi during growth on surfaces where both photosensitizers cause high phototoxicity. The anionic Eosin Y was tested on surface-growing fungi only and induces remarkable phototoxic effects on dermatophytes and molds. In all cases, no spore regrowth was detected after PDI. This study is considered a first step towards successful and cost efficient treatment of onychomycosis.

Singlet oxygen luminescence kinetics under PDI relevant conditions of pathogenic dermatophytes and molds.

A treatment of onychomycosis using the photodynamic effect would be a favorable alternative to currently used antimycotic drugs. This study should be considered as a first step towards development and control of an efficient photodynamic inactivation of onychomycosis causative pathogens. Here, we evaluate the usage of time-resolved 2D singlet oxygen luminescence detection in combination with 2D fluorescence scanning as a tool to understand the behavior of the photosensitizer when applied to fungi on Petri dishes. To investigate the interaction of photosensitizer with fungi in various concentrations and in different stages of live, a photodynamic inactivation was avoided by keeping the samples in darkness. Scans of singlet oxygen luminescence and photosensitizer fluorescence were performed over a period of 24days. Two different photosensitizer, a cationic porphyrin and cationic corrole and two fungi strains, the dermatophyte Trichophyton rubrum and the mold Scopulariopsis brevicaulis, were investigated in this study. The two-dimensional correlation of photosensitizer fluorescence and singlet oxygen luminescence revealed differences in the diffusion of both photosensitizer. Even though the singlet oxygen luminescence was quenched with increasing growth of fungi, it was found that the kinetics of singlet oxygen luminescence could be detected on Petri dishes for both photosensitizers and both fungi strains for up to seven days.

"Smoking guns": hazards generated by laser and electrocautery smoke.

The smoke generated by laser surgery and electrocautery may contain significant amounts of toxic, carcinogenic, and infectious gases and particles. Although there is little scientific data on the actual type and extent of the hazards related to exposure, considering the potential for irreversible health damage, safety measures should not be delayed. All potentially exposed persons (including patients, medical, and cleaning staff) should be acquainted with the possible health and occupational hazards related to smoke from electrocautery and laser surgery procedures.