BACKGROUND: Dermatophytes are common pathogens of cutaneous fungal infections. Although antifungal agents have been used widely on the dermatophyte infections, the ultrastructural changes of dermatophytes caused by drugs have not been described in detail elsewhere. OBJECTIVE: We compared the ultrastructures of common dermatophytes and their changes after exposure to three antifungal agents, itraconazole, terbinafine and creosote, to inform the effectiveness of drugs on ultrastructures of dermatophytes. METHODS: Two strains of Trichophyton rubrum, Trichophyton mentagrophytes and Microsporum canis were cultivated on Sabouraud dextrose agar(SDA). Conventional electron microscopic specimen preparation was performed and examined by transmission electron microscope. After 24-hour exposure of each strain with 100 microgram/ml of itraconazole, 50 microgram/ml of terbinafine and 100 microgram/ml of creosote on SDA, the ultrastructural changes of their hyphae were investigated. RESULTS: The ultrastructural findings of each dermatophyte were similar. Tube-like hyphae and simple septal pores with Woronin bodies were typical findings. There were one or more than one nuclei and various intracellular organelles between the septa. A greater density of cytoplasm and organelles could be seen in the younger hyphae. Microscopically, destruction of the cell wall, edema and necrosis of intracellular organelles, and an increase in the number and size of vacuoles could be seen after drug exposure. After exposure to itraconazole and terbinafine, edema and necrosis of the cell wall and membranous structures were found, as well as, membranous bodies that represented destructive changes in the cell wall. The hyphae exposed to terbinafine showed various sized of lipid globule in the cytoplasm. Creosote exposure lead to a more non-specific and severer necrotic pattern of the intracellular structures. CONCLUSION: There seemed to be similar features of normal hyphae of dermatophytes. Antifungal agents, itraconazole and terbinafine, affected membranous structures of dermatophytes, whereas creosote acted on internal structures by a nonspecific direct toxic effect. Transmission electron microscope was a useful tool to investigate the changes of internal ultrastructure of dermatophyte by antifungal agents.
Antifungal Agents* ; Arthrodermataceae* ; Cell Wall ; Creosote ; Cytoplasm ; Edema ; Glucose ; Hyphae ; Itraconazole ; Microsporum ; Necrosis ; Organelles ; Trichophyton ; Vacuoles

Secondary peptic ulceration and gastritis have been known to be associated with stress, exogenous agents, drugs or infection. Salicylate (aspirin) ingestion has been known to be associated with increased incidence of gastric ulcer and more frequently as the cause of hemorrhagic gastric erosions and gastritis. Some medications such as tetracyclines and iron preparations have been associated with ulceration of the gastrointestinal tract. Chemotherapeutic agents including cytoxan and methotrexate also have been implicated in the development of mucosal and gastrointestinal ulcers. We have experienced two cases of hemorrhagic gastric ulcers due to creosote ingestion in a 13 month and a 45 year old boys. Creosote is a main component of one of the popular digestives, Jungrohwan in Japan and Korea.
Creosote* ; Cyclophosphamide ; Eating ; Gastritis ; Gastrointestinal Tract ; Humans ; Incidence ; Iron ; Japan ; Korea ; Methotrexate ; Middle Aged ; Peptic Ulcer ; Stomach Ulcer* ; Tetracyclines ; Ulcer

BACKGROUND: Even though recent improvement of antifungal agent is remarkable, side effect makes patient hesitate to use them. Instead, mixture of Jungrowhan(R)and vinegar is traditionally used and it makes contact dermatitis and secondary bacterial infection. OBJECTIVE: We tested antifungal activity of vinegar and Jungrowhan(R)to know their its efficacy. METHOD: Candida albicans(CA), Trichophyton rubrum(TR), Trichophyton mentagrophytes(TM) were cultivated in Sabouraud dextrose agar admixed with various amounts of Jungrowhan(R)and vinegar. We used the standard checkerboard titration for detecting synergy or antagonism of these two materials. Using the individual ingredients of Jungrowhan(R) sensitivity tests were done. RESULTS: Minimum inhibitory concentrations (MICs) of Jungrowhan(R) were 6~8mg/ml in CA, 2mg/ml in ra and 2~4mg/ml in TM. MICs of vinegar were 0.05~0.2m1/m1 in CA, 0.02~0.03m1/m1 in TR and 0.01~0.02m1/m1 in TM. The checkerboard titration of two materials revealed no synergism. MIC of creosote, one of ingredients of Jungrowhan(R), was the same of Jungrowhan(R), and the others revealed no antifungal effect. CONCLUSIONS: Even though Jungrowhan(R) and vinegar showed antifungal activity, using mixture of two material revealed no synergism. Their antifungal activity does not come from its herbal ingredients but just from creosote which is a kind of phenol mixture used for antiseptics, and acid of vinegar.
Acetic Acid* ; Agar ; Anti-Infective Agents, Local ; Bacterial Infections ; Candida ; Creosote ; Dermatitis, Contact ; Fungi* ; Glucose ; Humans ; Microbial Sensitivity Tests ; Phenol ; Skin* ; Trichophyton