Evaluation of a modified EUCAST fragmented-mycelium inoculum method for in vitro susceptibility testing of dermatophytes and the activity of novel antifungal agents.

For antifungal susceptibility testing of nonsporulating or poorly sporulating dermatophytes, a fragmented-mycelium inoculum preparation method was established and compared to broth microdilution testing according to CLSI and EUCAST guidelines. Moreover, the in vitro activity of new antifungal agents against dermatophytes was evaluated. Agreement between the mycelial inoculum method and the CLSI broth microdilution method was high (93% to 100%). Echinocandins (minimal effective concentration [MEC], ≤0.5 mg/liter) and posaconazole (MIC, ≤3.00 mg/liter) showed good activity against all tested dermatophytes.

Species and susceptibility distribution of 1062 clinical yeast isolates to azoles, echinocandins, flucytosine and amphotericin B from a multi-centre study.

Descriptive values were determined for eight antifungal agents within the course of a multi-centre study encompassing 1062 German and Austrian clinical yeast isolates. Candida albicans (54%) was the predominant species isolated followed by Candida glabrata (22%), Candida parapsilosis (6%), Candida tropicalis (5.7%), Candida krusei (4.3%), as well as eleven further candidal and four non-Candida yeast species. While 519 (48.9%) isolates were tested susceptible to all antifungals tested, no isolate was found to exhibit complete cross resistance. For C. albicans, the proportions of susceptible isolates were 93.2% (amphotericin B), 95.6% (flucytosine), 84.3% (fluconazole), 83.8% (posaconazole), 91.8% (voriconazole), 96.5% (anidulafungin), 96.2% (caspofungin) and 97.6% (micafungin). Patterns of complete parallel resistances were observed within azoles (8.8%) and echinocandins (1.7%). While a decreased susceptibility was found infrequently for echinocandins and flucytosine, it was more common for azoles with highest proportions for isolates of C. glabrata (fluconazole, 40.6%; posaconazole, 37.2%), Candida guilliermondii (fluconazole and posaconazole, each 25.0%), C. krusei (posaconazole, 28.3%; voriconazole, 60%), C. parapsilosis (fluconazole, 70.3%) and C. tropicalis (fluconazole, 62.3%). The descriptive values obtained in this study represent a valid basis for the comparison of recent and future epidemiological surveys to analyse the susceptibility of yeast isolates towards major antifungal substances.

[Cystocele and perineal ultrasound : Comparison of reliability and patient satisfaction]. / Zystozele und perinealer Ultraschall : Vergleich von Reliabilität und Patientenzufriedenheit.

BACKGROUND: Pelvic organ prolapse is a common medical finding. The use of perineal ultrasound for diagnosis of cystoceles is gaining in importance. OBJECTIVES: The purpose of this work was to test whether perineal ultrasound can be used to diagnose a cystocele before surgery and for follow-up examination. Furthermore, patient satisfaction during speculum examination and perineal ultrasound was compared. MATERIALS AND METHODS: 33 women with cystocele were examined before and after anterior colporrhaphy. Symptoms and satisfaction were documented with questionnaires. RESULTS: Ultrasound measurements of both examiners were correlated before and after colporrhaphy. Also, the degree of cystocele and ultrasound were correlated during Valsalva after surgery. There was no clear relation between typical symptoms of the cystocele and ultrasound measurements. The patient's comfort is higher during ultrasound than during speculum examination (r = 0.45; p = 0.04. t = 4,418; p < 0.01). CONCLUSION: The results of the perineal ultrasound are reproducible before and after colporrhaphy. Patients prefer ultrasound to the speculum examination. A sonographic scale of the cystocele would extend the use of perineal ultrasound.

A novel cysteine cathepsin inhibitor yields macrophage cell death and mammary tumor regression.

Although cysteine cathepsins have been identified as key regulators of cancer growth, their specific role in tumor development remains unclear. Recent studies have shown that high activity levels of tumor cathepsins are primarily a result of increased cathepsin activity in cancer-promoting tumor-associated macrophages (TAMs). To further investigate the role of cysteine cathepsin activity in normal and polarized macrophages, we established in vitro and in vivo models of macrophage differentiation and polarization and used a novel cysteine cathepsin inhibitor, GB111-NH2, to block the activity of cathepsins B, L and S. Here we show that in vitro, cysteine cathepsin inhibition yields both apoptosis and proliferation of macrophages, owing to increased oxidative stress. Proteomic analysis of cathepsin- inhibited macrophages demonstrates inhibition of autophagy, suggesting a likely cause of elevated reactive oxygen species (ROS) levels. In vivo models of mammary cancer further show that cathepsin inhibition yields TAM death owing to increased ROS levels. Strikingly, apoptosis in TAMs yields a seemingly cell non-autonomous death of neighboring cancer cells, and regression of the primary growth. These results show that cysteine cathepsin inhibitors can specifically trigger macrophage cell death and may function as an effective anticancer therapy in tumors with high levels of TAMs.

Characterization of Escherichia coli strains isolated from environmental water habitats and from stool samples of healthy volunteers.

This study was undertaken to determine the frequency of pathogenic Escherichia coli strains among wild-type E. coli strain isolates from the microbial flora of healthy volunteers and from natural residential water habitats of a defined geographic area. In total, 131 stool and 95 water isolates as well as 14 E.coli K12 strains were examined for DNA sequences specific for 20 different genes encoding E. coli pathogenicity factors, including adherence factors, toxins, invasins, capsules and iron uptake systems. The expression of the corresponding pathogenicity factors was also investigated. No pathogenicity factors were found to be present in the tested E. coli K12 strains. In contrast, 41.0% of the water samples and 63.4% of the stool samples contained pathogenicity factors specific for extraintestinal E. coli pathogens. While no virulence determinants specific for intestinal E. coli pathogens were found among the investigated environmental water isolates, 4.5% of the stool samples contained either only intestinal or both intestinal and extraintestinal virulence genes. Both the prevalence of the virulence genes and the expression of the corresponding pathogenicity factors were, in general, higher in stool than in water samples. These findings might indicate the prevalence of different clonal types and/or differential regulation of pathogenicity factor expression in diverse ecological niches.

Selective inattention to anxiety-linked stimuli.

The term selective inattention as used here subsumes those phenomena whose primary function is the active blocking or attenuation of partially processed contents en route to conscious expression. Examples are anxiety-motivated forgetting or perceptual distortion and hypnotically induced negative hallucinations. Studies in the field of selective attention have typically been designed to explain what takes place in a task in which the subject is first instructed to attend to a particular stimulus and then to consciously execute that instruction as well as he can. The rejection of content in process is examined only sceondarily as a consequence of the acceptance of relevant information. In the present experiments and theorizing, the emphasis instead is on inhibitory operations that take place automatically, without conscious intent, in response to a potential anxiety reaction. Experiment 1 explored the interaction of anxiety-linked inattention with strength of a target stimulus. Three female subjects were programmed under hypnosis to respond posthypnotically in the On condition with prescribed degrees of anxiety when certain Blacky pictures popped into mind later ,t the end of experimental trials; in the Off conditionall pictures were to become neutral. With the three female subjects still under hypnosis, each of the loaded pictures was then paired with a four-letter work relevant to the individual's own version of what was happening in the picture. The waking recognition task, carried out with amnesia for the prior hypnotic programming, consisted of tachistoscopic exposure of loaded words and physically similar filler words at four durations within a baseline range of recognition accuracy from 50%--75% correct. The data yielded a curvilinear relationship in which the recognition of only the loaded words was significnatly lower in the On condition at the 60%--70% range of recognition accuracy but not at shorter or longer stimulus durations. Experiment 2, for which the prior hypnotic programming of the same three subjects was similar to Experiment 1, used an anagram approach to comparable four-letter words, except that pleasure-loaded words were introduced as a control along with filler words. Four durations of tachistoscopic exposure of the anagrams were used with each individual, and the major dependent variable was response latency measured in milliseconds. An independent measure of perceptual discriminability of the scrambled stimulus letters was obtained to isolate perceptual from cognitive aspects of the task. The results indicated that both low perceivability and high solvability increase the likelihood of response delays specifically in the presence of anxiety-linked stimuli. Experiment 3 was a nonhypnotic replication of Experiment 2, using 12 male and 13 female subjects. The potential affective loading of key anxiety and pleasure words was accomplished by structured scenarios for the Blacky pictures in which subjects were asked to place themselves as vividly as possible...

Gene clusters encoding the cytotoxic necrotizing factor type 1, Prs-fimbriae and alpha-hemolysin form the pathogenicity island II of the uropathogenic Escherichia coli strain J96.

The uropathogenic Escherichia coli strain J96 (04:K6) is able to produce four adherence factors [P-fimbriae (pap and prs), F1C-fimbriae (foc) and Type 1-fimbriae (fim)], two alpha-hemolysins (hlyI and II) and the cytotoxic necrotizing factor type 1 (cnf1). Using phenotypic test systems and genotypic analysis, it has been shown that the mutant strain J96-M1 has lost the hlyII, prs and cnf1 genes. The three virulence associated determinants are linked on one particular region on the chromosome, which is termed 'pathogenicity island II' (Pai II).

Comparative methodology to investigate the presence of Escherichia coli K-12 strains in environmental and human stool samples.

This study was undertaken to evaluate the specificity and efficiency of different methods to detect Escherichia coli K-12 strains. Another aim was to determine the frequency of E. coli K-12 strains among wild-type E. coli isolates from different sources. The detection of K-12 strains was performed both genotypically by K-12 specific polymerase chain reaction (PCR) and on the basis of phenotypical tests. In addition, the genome structures of E. coli strains were characterized by pulsed-field gel electrophoresis (PFGE). The most specific results could be obtained by the genotypical tests PCR and PFGE as well as by the K-12 specific phage assay. In total, 131 stool and 95 water isolates as well as 14 K-12 derivatives were examined by the different methods. No E. coli K-12 strains were detected among the wild-type isolates.

In vitro determination of the antimicrobial properties of two cyanoacrylate preparations.

Isobutyl and trifluoro cyanoacrylates showed varying degrees of inhibition for Lactobacillus casei and Staphylococcus aureus when tested by the spread plate technique. Candida albicans and Pseudomonas aeruginosa were resistant. The results tend to support the view that inhibition of growth was due to the vapor effect and not the diffusibility of the cyanoacrylates.

Evaluation of halometasone cream in the treatment of paediatric patients with acute eczematous dermatoses.

Sixty children under 10 years of age (including 18 under 3 years) suffering from non-infected acute eczematous dermatoses were treated with 0.05% halometasone cream containing a new high-potency trihalogenated synthetic dermatocorticosteroid. The trial population consisted of patients with acute atopic dermatitis, seborrhoeic dermatitis, nummular dermatitis and contact dermatitis. Halometasone cream yielded very satisfactory results and showed excellent tolerability. It produced 'good' or 'very good' results in 90% of the cases and gave an overall cure rate of 74.3%. The number of patients obtaining an early cure, i.e. in less than 20 days, was thirty-seven (62%). The onset of action was reported in 78.3% of the patients within 3 days of starting the treatment. All patients tolerated the treatment well and no adverse effects, either due to the topical application or the transcutaneous systemic absorption of the corticoid, were reported.

[A rare tumor of the ovary: Krukenberg's tumor. Apropos of 11 cases]. / Une tumeur rare de l'ovaire: la tumeur de Krukenberg. A propos de 11 observations.

The authors present 11 cases of Krukenberg tumour and have reviewed the literature concerning this condition. They conclude that the expectation of cure is increased if the primary tumour is removed early and if chemotherapy, hormono-therapy when indicated and immunotherapy are carried out, preferably together. No treatment at present seems to be specific for this condition.

In vitro and in vivo role of heat shock protein 90 in Amphotericin B resistance of Aspergillus terreus.

Aspergillus terreus (A. terreus) is of serious concern because of a high propensity to dissemination and in vitro and in vivo resistance to Amphotericin B (AmB). The underlying molecular mechanism of AmB is not known yet and here we want to explore whether fungal heat shock protein 90 (HSP90) is involved in polyene resistance in A. terreus. AmB-susceptible (ATS) and AmB-resistant (ATR) A. terreus and AmB-susceptible Aspergillus fumigatus (AFS) were investigated in response to AmB with a special focus on HSP90. HSP90 inhibitors resulted in significant improvement of AmB activity against ATR as minimum inhibitory concentrations (MIC) decreased from 32 to 0.38 mg/L. Gene expression profiling showed a greater basal amount of HSP90 levels in ATR and ATS when compared with AFS. HSP90 blockers in combination with AmB were evaluated in a murine model of disseminated aspergillosis. HSP90 inhibitors were not beneficial for mice infected with ATR, and neither mono- nor combination treatment with AmB yielded clinical improvement. HSP90 inhibition with 17-allylamino-17-demethoxygeldanamycin (17-AAG) was harmful. HSP90 seems to play a vital role in antifungal stress response in all aspergilli tested, whereas HSP90 does not substantiate the origin of AmB resistance in ATR.

Modelización de ítems de matrices figurales y pautas específicas propuestas para su construcción / Modelling figural matrix items and specification of guidelines for their construction

Este artículo da a conocer los resultados de la modelización de un Test de Analogías Figurales (TAF) utilizando los aportes conjuntos de la Teoría Clásica de Tests (TCT) y de la Teoría de Respuesta al Ítem (TRI), así como la posterior interpretación de las desventajas y posibles soluciones del diseño de dicho test. Se desarrolla el marco conceptual que dio origen al armado del TAF, así como los estudios realizados con esta prueba al administrarla a dos muestras. Una de las muestras corresponde a un estudio piloto con estudiantes de Psicología, mientras que la otra muestra consistió en estudiantes de carreras artísticas y de diseño. Los resultados principales revelan indicadores favorables de unidimensionalidad y confiabilidad, así como parámetros aceptables de discriminación (a), dificultad (b) y pseudoazar (c). Se discuten las desventajas del diseño de ítems con tres reglas y nuevas especificaciones en cuanto al armado de reactivos matriciales de 2x2

This manuscript publicizes the results that concern the modelling of a Test of Figural Analogies (TFA) using Classical Test Theory (CTT) and Item Response Theory (IRT) on a joint basis, as well as the interpretation of the disadvantages and possible solutions of the test design. The theoretical background for the TFA construction is outlined, and studies accomplished after its administration to two samples is explained. One of these samples corresponds to a pilot study with Psychology students, while the other sample consisted of Art and Design college students. Main results indicate good unidimensionality and reliability, as well as acceptable discrimination (a), difficulty (b) and guessing value (c) parameters. Design disadvantages of three-rule based items are discussed, and new specifications for the 2x2 matrix item construction are given