聚维酮碘乳膏治疗足癣的临床研究

目的:观察聚维酮碘乳膏治疗足癣的疗效。方法:将符合入选标准的94例患者随机分两组,治疗组清洁局部后将聚维酮碘乳膏涂敷于患处,bid。对照组予派瑞松霜按照药品说明书使用。两组均疗程3周。对痊愈者随访半年。结果:临床治愈率治疗组64.44%,两组比较U=2.883,P<0.01;有效率治疗组93.33%,两组比较X2=7.866,P<0.01;真菌清除率治疗组94.77%,两组比较X2=0.679,P=0.372;不良反应率治疗组4.44%,两组比较X2=4.0226,P=0.0432;随访半年痊愈者复发率治疗组6.89%(2/29),两组比较X2=3.9455,P=0.0421。结论:聚维酮碘乳膏治疗足癣安全有效。     

Interdigital, Cutaneous Phaeohyphomycosis Due to Scytalidium lignicola Pesante 1957. A Case Report/Interdigitale Phaeohyphomykose durch Scytalidium lignicola Pesante 1957. Ein Fallbericht

Summary:  The authors report a case of tinea pedis with interdigital lesions of the feet, caused by Scytalidium lignicola , anamorphous state of Hendersonula toruloidea. Microscopic examination of pota-to-dextrose agar culture showed catenulate and bicellular ochreous arthroconidia. Initially diagnosed as dermatophytosis, the case showed no success with the use of itraconazole.
The main taxonomic aspects referring to Scytalidium lignicola, S. hyalinum and Hendersonula toruloidea are discussed due to the mycological importance of the present case in dermatology.
Scytalidium hyalinum , actually anamorph of Hendersonula toruloidea , should be incorporated in the future in a new genus (Dickinson et al. 1980, McGinnis 1985).
Zusammenfassung:  Die Autoren beschreiben einen Fall von Tinea pedis verursacht durch Scytalidium lignicola , die anamorphe Form von Hendersonula toruloidea.
Das mikromorphologische Aussehen auf Kartoffel-Dextrose-Agar zeigte die Anwesenheit von ockerfarbigen, uni- und doppelzellulären langen Ketten von Arthrokonidien. Anfangs wurde die Diagnose einer Dermatophytose gestellt und deshalb mit Itraconazol behandelt, aber ohne klinische Besserung. Da dieser Fall für die Dermatologie recht wichtig erscheint, wird die Taxonomie des Erregers näher erörtert, insbesondere in Bezug auf die Pilze Scytalidium lignicola, S. hyalinum und Hendersonula toruloidea. Scytalidium hyalinum sollte künftig nicht mehr nur als anamorphe Form von Hendersonula toruloidea (Dickinson et al. 1983; Mc Ginnis, 1985) aufgefaßt, sondern einer neuen Gattung zugeordnet werden.     

Doppelblindversuch mit Clotrimazol und Econazol bei Tinea pedis*

Zusammenfassung: Zwei Antimykotika aus der Gruppe der Imidazole (Clotrimazol und Econazol) in der galenischen Zubereitungsform der Creme wurden in einer Doppelblindstudie an Patienten mit Tinea pedis - unter Berücksichtigung der klinischen Erscheinungsformen - einer klinischen und mykologischen Beurteilung unterzogen. Die Studie umfaßte 60 beurteilbare Fälle (Clotrimazol-Gruppe und Econazol-Gruppe je 30 Patienten). Die Therapiedauer betrug 4 Wochen. Eine Gesamttherapiebeurteilung erfolgte am Ende der 4wöchigen Behandlungsperiode, eine Zwischenbeurteilung 2 Wochen nach Therapiebeginn. Unter der Behandlung mit Clotrimazol-Creme kam es nach 4wöchiger Therapie häufiger zur Heilung als unter Econazol-Creme. Dieser Zusammenhang war für Clotrimazol-Creme signifikant (p 0,02). Von den 30 mit Clotrimazol Behandelten zeigten 20 (=67%) eine Heilung und 10 (=33%) eine Besserung. Von 30 Patienten in der Econazol-Gruppe wurden 11 (=37%) als geheilt und 18 (=60%) als gebessert, 1 Patient als unverändert bezeichnet. In der Clotrimazol-Behandlungsgruppe war es in keinem Fall, in der Econazol-Gruppe in 4 Fällen zum Auftreten von Nebenwirkungen gekommen. Ein Zwang zum Abbruch der Therapie war nicht gegeben. Summary: Two antimycotics from the group of imidazoles (clotrimazole and econazole) in the galenic cream formulation were subjected to a clinical and mycological evaluation in a double-blind study on patients suffering from tinea pedis, with due consideration of the clinical types. The study covered 60 evaluatable cases (clotrimazole group and econazole group comprising 30 patients each). The duration of treatment was four weeks. An overall evaluation of the treatment was established at the end of the four-week treatment period, with an interim evaluation two weeks after the start of the treatment. A cure was obtained more frequently after four weeks of treatment with clotrimazole cream than with econazole cream. This relationship was significant for clotrimazole cream (p 0.02). Of the 30 patients treated with clotrimazole, 20 (67%) showed a cure and 10 (33%) an improvement. Of the 30 patients in the econazole group, 11 (37%) were cured and 18 (60%) showed improvement; one patient showed no change. Side effects did not occur within the clotrimazole treatment group, while they occurred in four cases in the econazole group. It was not necessary to discontinue the treatment.     

An epidemiological and clinical study of untreated patients with tinea pedis within a company in Japan

In this study, we investigated epidemiological and clinical aspects of dermatophyte foot infections among employees of one dairy product company located in Kanagawa prefecture in central Japan. Sixty-nine of 377 subjects were reported having "athlete's foot" in response to a simple questionnaire. A subsequent mycological examination revealed 41 untreated patients with tinea pedis and/or tinea unguium (89% of subjects examined) and the overall prevalence was estimated at 18%. Comparing severity scores of five clinical symptoms (itching, erythema, vesicles/pustules, erosion/maceration, and scales) between those untreated patients within the subjects and another group of patients who spontaneously attended dermatological clinics to treat tinea pedis, itching, erythema, and total score were significantly higher in the latter group.     

Efficacy testing of antimycotic prophylactics in an animal model

Trichophyton mentagrophytes is both zoophilic and a common causative organism in human dermatomycosis. Therefore this dermatophyte is widely used for experimental efficacy testing of antimycotic agents and their active ingredients. The use of the guinea pig as an animal model for dermatomycosis is based on the predisposition of this species to spontaneous dermal fungal infections. A previously described guinea pig model was modified according to the results of pilot experiments. The modification consists of 1) evaluation of the infectious activity of the primary mycotic tissue cultures obtained from patients and 2) the efficacy testing itself with treatment of the infected skin area including the continuous clinical observation for 28 days. At first the required duration of cultivation and the number of spores for a reproducible infection of all animals were determined. The following efficacy test consisted of four groups with ten animals each. Group I (control of infection) remained without further treatment after experimental infections, groups II-IV received a single treatment by spraying at the day of infection with isopropanol (70%) (negative control), water (mechanic control) and the antimycotic agent (treated group), respectively. After 28 days under continuous examination, clinical symptoms (scabs; reddening, scaliness) were statistically analyzed. The model takes into account the duration and severity of infection in order to evaluate the differences between the four groups. The experimental protocol presented allows the efficacy of antimycotic agents to be demonstrated by means of statistical analyses. As an example the results of a successful prophylactic treatment against T. mentagrophytes with the antimycotic prophylactic Laudamonium (1%) are presented.     

Epidemiological survey of foot diseases in Japan: Results of 30 000 foot checks by dermatologists

There has been no epidemiological survey of foot diseases in Japan. In this study we determined the prevalence of foot diseases, especially tinea pedis (TP) and tinea unguium (TU) in Japan. We conducted a randomized survey of outpatients who visited a dermatologist during the third week of May in 1999, 2000 and 2006. The most frequently reported condition was “fungal infection” in 8737 (40.0%) of 21 820 patients in 1999/2000, and 3848 (49.4%) of 7783 patients in 2006. The patients who visited a dermatologist for reasons other than superficial fungal infection but were diagnosed with TP or TU comprised 18.6% of the study population in 2000 and 24.1% in 2006. Of the patients with TP or TU, 63.2% used topical medication only. This survey showed that often patients are not aware of fungal infections and that their treatment is sometimes insufficient. Dermatologists should actively examine and treat patients with TP and TU.     

Dermatophytosis in Children and Adolescents: Epidemiological Study in the City of Barcelona, Spain/Dermatophytosis bei Kindern und Erwachsenen: Epidemiologische Studie in Barcelona, Spanien

Summary: We studied the epidemiologic characteristics of dermatophyte infection in a group of 170 children and adolescents from Barcelona, Spain. Ages of the patients ranged from 11 months to 18 years. Most children resided in urban districts with poor hygiene and social conditions. There was a predominance of single skin lesions (156 cases or 92%) and a greater number of tinea corporis cases (59%). Trichophyton mentagrophytes (72%) and Microsporum canis (15%) were most frequent causative fungi. Anthropophilic species (E. floccosum) were isolated in 67% of patients with tinea cruris and in 50% of patients with tinea pedis. Most children with dermatophytosis (11% cases or 67%) were aged between 14 and 11 years.
Zusammenfassung: Bei einer Gruppe von 170 Kindem im Alter von 11 Monaten bis 18 Jahren wurden in Barcelona, Spanien, die epidemiologischen Eigenschaften der Dermatophyteninfektion untersucht. Die Mehrzahl der Kinder stammte aus Stadtgebieten mit erheblichen sanitären hygienischen und sozialen Problemen. Es wurden überwiegend Einzelherde (156 Fälle oder 92%), sowie eine große Anzahl von Tinea corporis (59%) festgestellt. Trichophyton mentagrophytes (72%) und Microsporum canis (15%) waren die häufigsten Pilzerreger. Anthropophile Spezies (E. floccosum) wurden bei 67% der Patienten mit Tinea cruris und bei 50% mit Tinea pedis isoliert. Die Mehrzahl der Kinder mit Dermatophytose (114 Fälle oder 67%) befanden sich im Alter von 4 bis 11 Jahren.     

Periaqueductal gray inhibition of viscerointercostal and galvanic skin reflexes

In adult cats anesthetized with urethan-chloralose, effects of descending volleys from the mesencephalic periaqueductal gray (PAG) upon the viscerointercostal and galvanic skin reflexes were studied. The viscerointercostal reflex (VIR) was evoked by electrical stimulation of the greater splanchnic nerve and was recorded from the 11th, 12th or 13th intercostal nerve. Conditioning stimuli applied to the PAG inhibited the VIR. The inhibition was particularly marked when the nucleus raphe dorsalis (NRD) or its immediately adjacent ventromedial PAG was stimulated. A train of pulses was required in order to produce a recognizable PAG/NRD inhibition of the VIR. When the PAG/NRD was stimulated at 300-500 Hz, stimulation-produced inhibition became more pronounced in parallel with increase in number of pulses in each train and levelled off at about 5 pulses. The most effective frequency of PAG/NRD stimulation was found within this frequency range. Degree of PAG/NRD stimulation-produced inhibition of the VIR was dependent upon the strength of the test stimulus applied to the splanchnic nerve; the weaker the test stimulus, the more marked the inhibition. PAG/NRD stimulation-produced inhibition of the VIR was completely eliminated by bilateral section of the dorsolateral funiculi. The same section enhanced the VIR per se. It was suggested that PAG/NRD stimulation-produced inhibition of the VIR is mediated by descending pathways in the ipsi- as well as contralateral dorsolateral funiculi, and that the VIR per se is tonically inhibited by descending impulses in these pathways. PAG/NRD stimulation inhibited the segmental polysynaptic reflex in the intercostal nerve, but had little effect on the segmental monosynaptic reflex in the same nerve. Intravenous administration of morphine suppressed the VIR. The suppression was antagonized by intravenous naloxone. In contrast, PAG/NRD stimulation-produced inhibition of the VIR was unaffected by intravenous naloxone. Electrical stimulation of the splanchnic nerve evoked the galvanic skin reflex (GSR) from the forepaw pad. The GSR was inhibited by electrical stimulation of the PAG/NRD. The PAG/NRD stimulation-produced inhibition of the GSR was completely eliminated by intravenous administration of naloxone (0.4 mg/kg).     

丘脑与丘脑枕空间形态和位置的研究

目的 :对丘脑与丘脑枕在脑内的空间形态和位置资料进行定位研究 ,为脑立体定向手术提供解剖学基础。方法 :将成人 6 1只整脑制成 2mm厚的三维连续切片 ,并在各脑片上直接进行观测。结果 :获得丘脑和丘脑枕前后径、左右径 ,上下径 ,体积及“靶心”座标值。丘脑总体前后径 (2 9.48mm ) >上下径 (18.82mm) >左右径 (13 .91mm ) ,丘脑枕总体上下径 (10 .0 9mm ) >前后径 (9.5 5mm ) >左右径 (7.14mm)。丘脑体积左右均值为 (6 2 6 4.42± 42 .98)mm3;丘脑枕体积左右均值为 (75 0 .82± 16 .32 )mm3。通过还原、重建、重叠 ,绘出两个核团的空间投影轮廓叠加图。结论 :揭示三维切面上丘脑与丘脑枕在脑内空间的整体构型 ,其结果对脑的立体定向手术有参考价值。