Analysis of Parasitic Diseases Diagnosed by Tissue Biopsy Specimens at KyungHee Medical Center (1984-2005) in Seoul, Korea

We analyzed parasitic diseases diagnosed by tissue biopsy specimens at KyungHee Medical Center (KMC) from 1984 to 2005. The total number of parasite infection cases was 150 (0.07%) out of the total 211,859 biopsy specimens submitted for histopathological examinations. They consisted of 62 cysticercosis, 23 sparganosis, 16 paragonimiasis, 15 amebiasis, 11 anisakiasis, 11 clonorchiasis, 3 ascariasis, 2 scabies, 2 enterobiasis, 2 trichuriasis, 1 leishmaniasis, 1 taeniasis, and 1 thelaziasis. Out of 62 cysticercosis cases, 55 were detected in subcutaneous tissues or the central nerve system. Eighteen out of 23 sparganosis cases were involved in muscular and subcutaneous tissues. In most anisakiasis cases, the involved organ was the stomach. The lung and the pleura were the most common site of paragonimiasis. The incidence of parasitic diseases during the first 5 years (1984-1988) was the highest of all observed periods. After 1989, similar incidences were shown throughout the period. Whereas cysticercosis was diagnosed in 34 cases during 1984-1988, no case has been diagnosed since 2000. In the case of sparganosis, the chronological incidence was almost uniform throughout the period 1984-2005. Paragonimiasis showed a similar tendency to cysticercosis. In gender and age distribution of parasitic diseases, men showed higher incidence rates than females, and the age groups of the 40s or older indicated higher infection frequencies than other age groups. Therefore, these results are a significant report to appear the tendency of human parasitic disease diagnosed by tissue biopsy in association with parasitosis at KMC in Seoul.

A Case of Probable Mixed-Infection with Clonorchis sinensis and Fasciola sp.: CT and Parasitological Findings

We report here a human case probably mixed-infected with Clonorchis sinensis and Fasciola sp. who was diagnosed by computed tomography (CT) scan, serological findings, and/or fecal examination. The patient was a 43-year-old Korean female and was admitted to Kyung Hee University Hospital with the complaints of fever and abdominal pain. On admission, marked eosinophilia was noted in her peripheral blood. CT scan showed specific lesions for clonorchiasis and fascioliasis in the liver, along with lesions suggestive of amebic abscess. Micro-ELISA revealed positive results for the 2 helminthic infections. Eggs of C. sinensis and trophozoites of Entamoeba histolytica were observed in the stool. Treatment with praziquantel followed by metronidazole and tinidazole reduced abnormalities in the liver and eosinophilia. This is the first case report of a possible co-infection with 2 kinds of liver flukes in the Republic of Korea.

A Case Report of Human Thelaziasis / 감염과화학요법

The authors report a case of infection with Thelazia callipaeda in a Korean man. The patient was a 47 year-old man. He experienced epiphora and foreign body sensation of the right eye since 3 weeks ago. Total of 2 worms were removed from the conjunctival sac; one by himself 1 day prior to examination and the other by an ophthalmologist. The worm was slender creamy white in color which was fixed in a 10% formaline solution. The worm was 17.38 mm in length, 0.45 mm in body width, 0.026 mm in length of buccal cavity, 0.63 mm in length of anterior end to vaginal opening, 0.76 mm in length of anterior end to the esophagointestinal junction and 0.06 mm in length of posterior end to the anus. There were numerous striations on surface of worms and vaginal opening was located anterior to the esophagointestinal junction. Based on aforementioned findings, it was confirmed as a female worm of Thelazia callipaeda, and the authors report it with literature.

A Case Report of Human Thelaziasis / 감염과화학요법

The authors report a case of infection with Thelazia callipaeda in a Korean man. The patient was a 47 year-old man. He experienced epiphora and foreign body sensation of the right eye since 3 weeks ago. Total of 2 worms were removed from the conjunctival sac; one by himself 1 day prior to examination and the other by an ophthalmologist. The worm was slender creamy white in color which was fixed in a 10% formaline solution. The worm was 17.38 mm in length, 0.45 mm in body width, 0.026 mm in length of buccal cavity, 0.63 mm in length of anterior end to vaginal opening, 0.76 mm in length of anterior end to the esophagointestinal junction and 0.06 mm in length of posterior end to the anus. There were numerous striations on surface of worms and vaginal opening was located anterior to the esophagointestinal junction. Based on aforementioned findings, it was confirmed as a female worm of Thelazia callipaeda, and the authors report it with literature.

Growth Inhibitory Effects of Various Herbal Extracts on Metronidazole Resistant Strain of Trichomonas vaginalis / 감염과화학요법

BACKGROUND: Metronidazole has been known as the most effective drug for treatment of Trichomonas vaginalis-related diseases. However, it has been reported that metronidazole has adverse effects and incidence of metronidazole-resistant T. vaginalis (CDC085) has increased. Development of new drug, which is effective against metronidazole-resistant T. vaginalis and showing no adverse effects, has been required. METHODS: The purpose of this study was to investigate effects of various extracts from herbs such as Quisqualis indica, Gleditsia sinensis, Prunus armeniaca, Morus alba, Platycodon grandiflorum, Ailanthus altissima, Stemona japonica, Biota orientalis, Dryobalanops aromatica, and Cimicifuga heracleifolia on metronidazole resistant strain of T. vaginalis in vitro (CDC085). RESULTS: Anti-Trichomonas activities were observed in T. vaginalis treated with G. sinensis, P. armeniaca, and P. grandiflorum on the growth and fine structure of metronidazole resistant strain of T. vaginalis. Of the three standard extracts that showed the most effective anti-trichomonas activity, G. sinensis was the most effective. The inhibitory effects of fraction extracts of this drug were shown on the growth of T. vaginalis. The fine structure of the cytoplasm was changed after application of G. sinensis extract. The number of polyribosome and hydrogenosome decreased whereas the number of food vacuole and vacuole in the cytoplasm increased, compared with that of untreated control group. CONCLUSION: The results of our study indicate that G. sinensis may induce the inhibition of cell multiplication as well as impairment of protein synthesis of metronidazole resistant strain of T. vaginalis in vitro.

Growth Inhibitory Effects of Various Herbal Extracts on Metronidazole Resistant Strain of Trichomonas vaginalis / 감염과화학요법

BACKGROUND: Metronidazole has been known as the most effective drug for treatment of Trichomonas vaginalis-related diseases. However, it has been reported that metronidazole has adverse effects and incidence of metronidazole-resistant T. vaginalis (CDC085) has increased. Development of new drug, which is effective against metronidazole-resistant T. vaginalis and showing no adverse effects, has been required. METHODS: The purpose of this study was to investigate effects of various extracts from herbs such as Quisqualis indica, Gleditsia sinensis, Prunus armeniaca, Morus alba, Platycodon grandiflorum, Ailanthus altissima, Stemona japonica, Biota orientalis, Dryobalanops aromatica, and Cimicifuga heracleifolia on metronidazole resistant strain of T. vaginalis in vitro (CDC085). RESULTS: Anti-Trichomonas activities were observed in T. vaginalis treated with G. sinensis, P. armeniaca, and P. grandiflorum on the growth and fine structure of metronidazole resistant strain of T. vaginalis. Of the three standard extracts that showed the most effective anti-trichomonas activity, G. sinensis was the most effective. The inhibitory effects of fraction extracts of this drug were shown on the growth of T. vaginalis. The fine structure of the cytoplasm was changed after application of G. sinensis extract. The number of polyribosome and hydrogenosome decreased whereas the number of food vacuole and vacuole in the cytoplasm increased, compared with that of untreated control group. CONCLUSION: The results of our study indicate that G. sinensis may induce the inhibition of cell multiplication as well as impairment of protein synthesis of metronidazole resistant strain of T. vaginalis in vitro.

In vitro Effect of Kalopanaxsaponin A on the Ultrastructure of Trichomonas vaginalis / 감염과화학요법

BACKGROUND: T. vaginalis is a pathogenic protozoa infecting genitourinary tract. Metronidazole is a drug of choice to treat T. vaginalis infection. However, because of appearance of metronidazole- resistant T. vaginalis, it is needed to develop an alternative drug. So, we evaluated the effects of various concentration of kalopanaxsaponin A against T. vaginalis. METHODS: The antiprotozoal effect of kalopanaxsaponin A on the growth and fine structure of T. vaginalis was examined by using trypan blue exclusion assay and electron microscopy. RESULTS: The viability test showed markedly decreased number of T. vaginalis, treated with increasing concentration of kalopanaxsaponin A. We evaluated the electron microscopic findings for antiprotozoan effects against T. vaginalis. SEM showed that in T. vaginalis treated with 4 microgram/mL for 1 hour, axostyle was shrinked and flagella began to disappear. With gradual increase of the concentration of kalopanaxsaponin A, destruction of cell membrane was getting more severe, and degenerative change was observed in T. vaginalis treated with 8 microgram/mL for 2 hours. TEM showed that in T. vaginalis treated with 4 microgram/mL for 2 hours, the vacuoles in cytoplasm were larger and hydrogenosomes were smaller than those in control group. The number of vacuole was increased, the nucleus was destroyed, the number of polyribosome and free ribosome was also decreased in trichomonads treated with kalopanaxsaponin A (8 microgram/mL), which indicated the occurrence of degenerative changes. CONCLUSION: These results indicated that kalopanaxsaponin A had the antiprotozoal effect on T. vaginalis by inhibition of cell multiplication as well as an impairment of protein synthesis.

In vitro Effect of Kalopanaxsaponin A on the Ultrastructure of Trichomonas vaginalis / 감염과화학요법

BACKGROUND: T. vaginalis is a pathogenic protozoa infecting genitourinary tract. Metronidazole is a drug of choice to treat T. vaginalis infection. However, because of appearance of metronidazole- resistant T. vaginalis, it is needed to develop an alternative drug. So, we evaluated the effects of various concentration of kalopanaxsaponin A against T. vaginalis. METHODS: The antiprotozoal effect of kalopanaxsaponin A on the growth and fine structure of T. vaginalis was examined by using trypan blue exclusion assay and electron microscopy. RESULTS: The viability test showed markedly decreased number of T. vaginalis, treated with increasing concentration of kalopanaxsaponin A. We evaluated the electron microscopic findings for antiprotozoan effects against T. vaginalis. SEM showed that in T. vaginalis treated with 4 microgram/mL for 1 hour, axostyle was shrinked and flagella began to disappear. With gradual increase of the concentration of kalopanaxsaponin A, destruction of cell membrane was getting more severe, and degenerative change was observed in T. vaginalis treated with 8 microgram/mL for 2 hours. TEM showed that in T. vaginalis treated with 4 microgram/mL for 2 hours, the vacuoles in cytoplasm were larger and hydrogenosomes were smaller than those in control group. The number of vacuole was increased, the nucleus was destroyed, the number of polyribosome and free ribosome was also decreased in trichomonads treated with kalopanaxsaponin A (8 microgram/mL), which indicated the occurrence of degenerative changes. CONCLUSION: These results indicated that kalopanaxsaponin A had the antiprotozoal effect on T. vaginalis by inhibition of cell multiplication as well as an impairment of protein synthesis.

Viability of Clonorchis sinensis Metacercaria according to the Food-processing Methods / 감염

BACKGROUND: Endemic areas of Clonorchis sinensis are in Asia including Korea, China, Taiwan and Vietnam. Its metacercariae consumed in uncooked, or undercooked, unfrozen fish can present human a hazard. Purposes of this study are 1) to observe the effect of each food-processing method and each storage method on C. sinensis metacercariae and 2) to suggest basis to be referred as an indicator in prevention. METHODS: Live metacercariae of C. sinensis in fish collected from Nakdong River in Korea were isolated by pepsin digestion, then were injected into the center of regular-sized muscle protein (1 cm3) of flesh water fish. The sample proteins containing metacercaria were processed according to each food-processing method (heating, frying, boiling) and each storage method (chilling, freezing, pickling with vinegar, salt and soybean sauce). After these procedures, the number of dead metacercariae were counted. RESULTS: It took 10 seconds to kill all the metacercariae in muscle protein in deep frying (180 degrees C), 30 seconds in boiling (100 degrees C) and 60 seconds in dry heating. Metacercariae did not lose all the viability in 4-6 degrees C after 40 days, but lost in -10degrees C and pickling after 5 days, and in salting (salt and soybean sauce) after 3 days. CONCLUSION: These results indicated that the storing in low temperature and in such as vinegar, salt, and soybean sauce was not effective to lose the viability unless if it was kept for a long period of time. Among the food-processing methods, frying in soybean oil was the most effective method to lose the viability of metacercariae.

In vitro Effect of Sophora flavescens on the Ultrastructure of Trichomonas vaginalis Donne / 감염

BACKGROUND: Trichomonas vaginalis is a pathogenic protozoa infecting human genitourinary tract. Metronidazole is currently the drug of choice to treat T. vaginalis infection. However, because of the side effects and the occurrence of resistant strains of metronidazole, it is needed to investigate alternatives. METHODS: The antiprotozoal effect of aquatic extract from Sophora flavescens on the growth and fine structure of T. vaginalis was examined by using trypan blue exclusion assay and electron microscopy. RESULTS: One hour after the addition of 4 mg/mL extract and half hour after the addition of 5 mg/mL showed antiprotozoal effect. One to two hours after the addition of 3 mg/mL extract, the movement of flagella and axostyle had disappeared, but death of the cells had not occurred until two hours after the addition. The fine structure of the cytoplasm was also changed half an hour to two hours after addition. The number of polyribosome decreased when that of single ribosomes in the cytoplasm increased. CONCLUSION: These results indicated that S. flavescens had the antiprotozoal effect on T. vaginalis by inhibition of cell multiplication as well as an impairment of protein synthesis.

Analysis of Parasitic Diseases by Biopsy in Kyunghee Medical Center(1972~1983) / 감염

BACKGROUND: Tissue biopsy is of significant importance to the parasitic diseases. This report describes in order to know the species and frequency of human parasitic infection diagnosed by biopsy at the department of anatomical pathology, KyungHee Medical Center. Finally, we estimated the trend of parasitic diseases of tissue in a feature, in Korea. METHOD: 262(0.57%) cases of parasitic infection were reviewed for analysis of the different types of parasitic infection, 45,651 biopsied materials were submitted for routine histopathological examination during a period of 12 years from 1972 to 1983 at the department of anatomical pathology, KyungHee Medical Center. RESULTS: They consisted of 136 cases of cysticercosis, 73 clonorchiasis, 16 amebiasis, 12 paragonimiasis, 9 ascariasis, 9 sparganosis, 4 scabies, 1 taeniasis, 1 enterobiasis and 1 anisakiasis. 136 cases of cysticercosis were mainly of the skeletal muscle and subcutaneous tissue. The 73 cases of clonorchiasis occurred mainly in the liver and gallbladder. In the 16 cases of amebiasis, the liver and the rectum were the main loci. In 12 cases of paragonimiasis, pleura was the main site. CONCLUSION: The frequency of parasitic infections found in biopsied specimens was found to decrease as the years passed by, but some disease such as sparganosis showed a possible increase. Tissue biopsy is an important method for detection of tissue or ectopic parasitic infections.

A Case of Tick Infestation in Chest Wall by Ixodes Nipponensis / 감염

We report herein an unusual case of tick bite. A 56 year old woman complained of erythematous nodular skin lesion on the left upper chest. An excision biopsy specimen of the lesion showed darkish-red nodule, in which there was a tick. It was identified as an adult female of Ixodes nipponensis by the scanning electron microscopic examination.

Study on the cestodes in Theragra chalcrogamma

This study was performed to investigate the intestinal parasites (especially cestoda) in the guts of Theragra chalcogramma in Korea. The cestode larvae collected were morphologically observed and measured, and at the same time, microscopical study was done with the section slides of the cestode larvae. They were identified on the basis of the descriptions by Schmidt and Yamaguti. The results obtained in this study are as follows: The cestode larvae were identified as Khawia sinesis, Eulacistorhynchus chiloscyllius, Tentacularia coryphaenea, Pseudonybelinia odontacantha and Nybelinia lingualis. These are new species reported in Korea. The characteristics of Khawia sinesis are its scolex lacking loculi and broad, flat and fimbriate shape. Its neck is not separated from the body but a little constricted. Eulacistorhynchus chiloscyllius is characterized by fairly long and acraspedote scolex. The bulbs are long; retractor muscles are attached to bases of the bulbs. The two bothridia are oval or round in shape and lacking posterior notch. The tentacles are long and poeciloacanthus; double chainette present. Tentacularia coryphaenea is characterized by its long craspedote and subcylindrical scolex. The bothridia are separated, without free borders and spinous. The tentacles are short, slender, armed with solid hooks in spirals, similar except the base of tentacle. The tentacle sheaths are not twisted. The bulbs are ellipsoidal. Pseudonybelinia odontacantha is characterized by its craspedote scolex. The tentacles are inserted near anterior margin of bothridia and armed with hooks in spirals ascending left to right. The hooks are similar, throughout tentacle, with feeble curve and provided with a tooth-like protuberance on the ventral side. The bulbs are three times longer than its width. The posterior margins of bothridia have a pair of eversible ciliated pits; or fossettes. Nybelinia lingualis is characterized by its short and craspedote scolex. The bothridia are separated, with free boarders. The tentacles are cylindrical, armed with solid and similar hooks in quincunxes.

Histochemical studies on Echinorhynchus gadi (Acanthocephala)

The distribution of glycogen, polysaccharide, mucopolysaccharide, lipid and nucleic acid has been studied in Echinorhynchus gadi(Acanthocephala). The results were summarized as follows: Glycogen and polysaccharide was demonstrated by Bauer PAS reaction technique and was found in fertilization membrane in ovum, central nuclear mass in acanthor and lemnisci, hypodermis in cystacanth. Mucopolysaccharide was demonstrated by Mowry alcian blue staining technique and was found in outer membrane, fibrillar coat, fertilization membrane and inner membrane in acanthocephalan ova. Lipid was demonstrated by Smith Nile blue stain and Lison Sudan black B staining technique and was found roughly parallel to that of polysaccharide. Nucleic acid was demonstrated by Rosenbeck Feulgen reaction, Taft methylgreen-pyronin stain and Diengdoh acridine orange staining technique and found in central nuclear mass in acanthor, also, was found in lemnisci, proboscis and hypodermis in cystacanth.