Treatment of Egyptian Dicrocoeliasis in man and animals with Mirazid

Two human cases with Dicrocoeliasis dendriticum were successfully treated; one with praziquantel [25 mg/kg three times daily after meals for four successive days] and the second with mirazid [two capsules of 300 mg each, daily an hour before breakfast for six successive days] as indicated clinically and parasitologically. On the other hand, one imported sheep and two locally bred goats naturally infected with D. dendriticum were successfully treated with oleoresin solution [dose of 6 ml of 10 g% equal to two mirazid capsules before breakfast] per os once daily for four successive days. The animals were slaughtered on the 5th day. Mirazid [capsule or oleoresin solution] was effective against dicrocoeliasis in man and animal, respectively

Paragonimiasis in Yongjia County, Zhejiang Province, China: clinical, parasitological and karyotypic studies on Paragonimus westermani.

Paragonimiasis in Yongjia County, Zhejiang Province, China, has been of such public health concern that a specialized Institute for Paragonimiasis Control has been established there. The study reported here involved both parasitological research on Paragonimus westermani in the endemic areas and a clinical analysis of 94 cases of paragonimiasis. Eggs were found in sputum, feces and brain tissue in 45 cases. Twenty patients, 19 of whom where children under 10 years of age, showed hepatic injury. Treatment with praziquantel or bithionol had satisfactory results in all cases. Dimensions of the parasite eggs, metacercariae from freshwater crabs and adult flukes suggested that the form of P. westermani in Yongjia is the 'small type': a suggestion supported by karyotypic studies on gonad cells from adult flukes collected from experimentally infected animals as all were found to be diploid. In conclusion, the 'small type' or diploid form of P. westermani is the cause of paragonimiasis pulmonary symptoms in Yongjia.

Fasciolasis hepática en ninos: manifestaciones clinicas poco frecuentes / Hepatic fascioliasis in children: uncommon clinical manifestations

La presente revisión tiene como objetivo identificar las características clínicas, epidemiológicas y la evolución de cuatro niños con Fasciola hepática con manifestaciones poco usuales, evaluados en el Servicio de Gastroenterología Pediátrica del Instituto de Salud del Niño, Lima-Perú, entre 1988 y 1992. El primer paciente fue una niña de 9 años de edad que tenía fiebre, edema de miembros inferiores, circulación colateral y hepatomegalia predominantemente del lóbulo derecho. El diagnóstico inicial fue un neoplasma hepático. El segundo caso fue un niño de 6 años de edad que tuvo hemorragia gastrointestinal alta y fiebre; el diagnóstico endoscópico demonstró hemobilia. El tercer caso fue un niño de 12 año de edad que presentó edema generalizado y fue diagnosticado como sindrome nefrótico pero este diagnóstico fue descartado. El cuarto paciente fue un niño de 9 años de edad que presentó ictericia, fiebre y hemorragia gastrointestinal alta. Se verificaron cirrosis y várices esofágicas. En los cuatro pacientes el diagnóstico se realizó mediante la identificación de los huevos del parásito en heces. Los tres primeros casos respondieron satisfactoriamente al tratamiento con bithionol, el cuarto paciente falleció debido a falla sistémica.

Triclabendazole in treatment of human fascioliasis

Recent outbreaks of human fascioliasis had been reported in Alexandria and Behira provinces. The presentation of Fasciola species infection in man varies with the age of the patient and with the stage of the disease. Many drugs have been tried in human fascioliasis but still the drug of choice remains to be determined. Triclabendazole is a novel antihelminth that affects both immature and mature stages of Fasciola infection. Previous preliminary studies showed that the drug has a promising value in treatment of human fascioliasis. The present study was carried out on 54 patients with fascioliasis, 26 of them were incubating patients and 28 with established fascioliasis. Regarding the age, 37 were children and 17 were adult patients. Patients were assessed clinically and by laboratory investigations. They were treated with triclabendazole suspension 10% solution in a dose of 20 mg/kg body weight on fasting stomach. The study revealed that the drug is finely tolerated safe and effective. Acute or incubating fascioliasis in children is more preferably treated by two doses [second dose raised cure rate from 37 to 83%]. Adults require a single dose whatever the stage of the disease [cure rate of the single dose was 78-90%]

IL-1 activity in human fascioliasis before and after treatment with bithionol and dehydroemetine

Interleukin-1 [IL-1] activity level was measured in monocyte culture supernatant of twenty patients with established fascioliasis before and after treatment with two faciolcidal drugs; bithionol and dehydroemetine [ten cases each] as well as a group of control [fifteen normal parasite free individuals]. The IL-1 mean activity level was found to be significantly higher in patients [84 +/- 21.6 micro/ml] than in normal individuals [9.4 +/- 3.7 micro/ml] This indicates increase in many immunological reactions which IL-1 is involved especially the monocyte activities and most of the inflammatory processes considering the multifunctional role of IL-1 as an inflammatory mediator. This high IL-1 activity may be due to the effect of Th1- deriven monocyte activating factors such as TNFbeta and lFNalpha stimulated by the adult worm antigens. After treatment, IL-1 activity level was significantly decreased [21.9 +/- 6.9 after bithionol, and 13.9 +/- 5.6 after dehydroemetine] than that before treatment, indicating good effectiveness of both drugs. This study also revealed a slight difference between the therapeutic effect of the two drugs which seems to be due to their different mode of action

Clinical Response to 7-Day Praziquantel Therapy in Fasciola Liver Abscess / 감염

BACKGROUND: Fascioliasis is a zoonotic helminthiasis by fasciola species and is occasionally complicated by liver abscess, and the treatment of choice is oral bithionol, which is not available in Korea. Most clinical reports showed that praziquantel given at usual dosage (75 mg/kg for 1day) failed to cure Fasciola hepatica infections, however, it has not been investigated whether long-term praziquantel (70 mg/kg/d for 7 days) would be effective. We evaluated the effectiveness of long term praziquantel therapy in patients with Fasiola liver abscess. METHOD: Three patients who were diagnosed as liver abscess by F. hepatica were included in the current study. The diagnostic criteria for inclusion were 1) eosinophilia, 2) positive serologic test for F. hepatica antigen, 3) characteristic findings on CT scan and 4) demonstration of aggregates of eosinophils on ultrasonography-guided aspirates of the abscess. Praziquantel was given orally to patients at the daily dose of 70-84mg/kg for 7 days. The effectiveness was assessed by the normalization of eosinophil count at the end of 3 months and the disappearance of abscess cavity on ultrasonography or CT scan one year after treatment. RESULTS: Blood eosinophil count decreased less than 500/mm3 in all patients within 2 to 3 months. The liver abscesses reduced in size by 90% in 5 months in one patient and disappeared within a year in two patients. No major adverse effects were observed. CONCLUSION: We conclude that 7-day praziquantel therapy may be effective and safe in the treatment of liver abscess caused by F. hepatica.

Compartive studies on the effect of bithionol, praziquantel and triclabendazole in rabbit's fascioliasis, 1 Parasitological studies

In this study, rabbits were infected with 30 metacercariae each. Then, they were divided into four categories, each of two groups. One category served as control and the others were treated each with a drug. The first group from each group was treated when worms were still immature, the other group was treated after maturity. The effect of the drugs was monitored by stool examination for eggs, the percentage of egg reduction and worm recovery at autopsy were studied and the percentage of the drug efficacy was calculated. Some eggs were cultured and their embryonation and hatching were traced. The results pointed out that triclabendazole was the best fasciolicide, followed by bithionol. Praziquantel had a negligible effect

Eficacia del triclabendazole en paragonimiasis pulmonar humana refractaria a la emetina, bithionol y praziquantel / Efficacy of triclabendazole in human pulmonary paragonimiasis refractary to emetine, bithionol and praziquantel

Dentro del estudio clínico-terapéutico para determinar la posología efectiva de triclabendazole contra Paragonimus recibieron tratamiento con esta droga tres pacientes ecuatorianos con paragonimiasis pulmonar que fracasaron al tratamiento con emetina más cloroquina, bithienol y praziquantel individualmente. En todos los síntomas de tos, expectoración herrumbrosa y la presencia de huevos de Paragonimus mexicanus en esputo estaban presentes antes del tratamiento. Dos pacientes recibieron tricabendazole a 10mg/kg en dosis única, y el tercero a 5mg/kg una vez al día por tres días . El seguimiento hasta el año 1 postratamiento demostró la desaparición de la sintomatología y cura parasitológica. Los pacientes no presentaron efectos secundarios al fármaco.

Treatment of human taeniasis in the Philippines: a review.

Studies relating to the treatment of human taeniasis in the Philippines using Atabrine, bithionol, and mebendazole are reviewed. Cure rates of 93.7% for Atabrine, 85%-100% for bithionol, and 84.62% for mebendazole are reported. Aside from these studies, recent experience in the treatment of Taenia saginata infections at the Department of Parasitology, College of Public Health, is also reported. Twenty patients referred to the department were treated, 3 with bithionol, 17 with praziquantel. Of the 17 patients treated with praziquantel, the study reported cure rates of 47-88.24%.

Human fascioliasis: T cell subsets in liver before and after bithionol treatment

Liver biopsies from 5 patients with established fascioliasis, before and after bithionol treatment were studied by immunoalkaline phosphatase technique for relative distribution of T cells and their subpopulations. T cell and its subsets are defined for OKT3[+] [pan T], OKT4[+] [helper/inducer] and OKT8[+] [suppressor/cytotoxic] cells by using mouse monoclonal antibodies. Before bithionol treatment, lymphocytic infiltration in all hepatic lesions were predominantly of OKT3[+] [pan T] lymphocytes. The distribution of OKT8[+] cells was moderate to severe in comparison to the few OKT4[+] cells presentation. After bithionol a noticable regression of the OKT3[+] lymphocytic in all liver sections. The majority of the lymphocytic infiltration was of the OKT8[+] cells, in comparison to the absence of the OKT[4]+ ones. This may indicate that suppressor/cytotoxic lymphocytes may have a role in the immune regulation of the disease and the mode of action of bithionol is by the accentuation of this immunoregulartory effect

Human fascioliasis: ultrastructural study on the liver before and after bithionol treatment

The pathology of human fascioliasis was studied before and after bithionol treatment using light and transmission electron microscopy. Fine needle biopsies were taken from five patients, with established fascioliasis, before and after drug administration. By light microscope the pathology of human fascioliasis was similar to that reported in experimental fascioliasis. The ultrastructural picture revealed bile ductular hyperplasia, fibrosis of portal tracts, widening of the interhepatic spaces by many microvilli and dilated Disse space with collagen fibres. Bile ductular hyperplasia may be the initial factor to fibrinogenesis, which subsequenetly enhance the development of the microvilli on the surface of the hepatocytes. Both light and electron microscopic studies revealed regression of the picture of fascioliasis to normal after bithionol treatment with no sign of toxicity on the liver

Pulmonary paragonimiasis in childhood--a cause of recurrent haemoptysis and pneumonia.

A 2-year-old Manipuri girl had haemoptysis and a chest roentgenogram disclosed diffuse-infiltrates in the right lung. Microscopic examination of sputum and morning gastric aspirate showed numerous golden-brown, operculated ova, and microscopic examination of stool specimens confirmed these ova to be those of the lung fluke, Paragonimus westermani. She responded favourably to bithionol therapy and was asymptomatic and growing normally during follow up for one and half years.

Glutathione and related enzymes in fascioliasis before and after treatment with bithionol

The present work is an update evaluation of the glutathion status in patients with established fascioliasis before and after treatment with bithionol. Blood glutathione [GSH], erythrocyte glutathione S-transferase [GST] and serum gamma-glutamyl transferase [GGT] activities were studied. After treatment, the variations observed in these parameters were restored to the corresponding normal control values confirming the toxic features resulting from fascioliasis and suggesting no insult of bithionol on the parameters studied. We recommend the use of serum GGT, blood GSH and erythrocyte GST for the early detection of the therapeutic responses in fascioliasis

Studies on intestinal trematodes in Korea XI. Two cases of human infection by Heterophyes heterophyes nocens

Two human cases of Heterophyes heterophyes nocens infection were proved by identifying adult worms after treatment with bithionol or praziquantel in 1983 in Korea. They are 37 (Case 1) and 24-year old (Case 2) males whose residence or native village is a southern coastal area in Kohung-gun, Chollanam-do. The Case 1 had the gastrointestinal symptoms such as epigastric pain and indigestion, and the Case 2 heart problems such as arrhythmia and ventricular premature beat in EKG and digestive symptoms such as diarrhea and abdominal pain. After the treatments, 35 and 67 specimens of H. heterophyes nocens respectively were collected from the diarrheal stools through stereomicroscopy. The Case 1 was concommitantly infected with Clonorchis sinensis and the case 2 with 3 other kinds of heterophyid flukes and with Diphyllobothrium latum. The cases said to have eaten raw brackish water fish such as mullets (Mugil cephalus), perches (Lateolabrax japonicus) and gobies (Acanthogobius flavimanus) which are the intermediate hosts of H. heterophyes nocens in Korea.

A Study on Photopatch Test in Photodermatoses / 대한피부과학회지

It is believed that the photopatch test is a valuable screening procedure for the determination of responsible antigenic substances in photoallergic contact dermatitis. But the technigues used for this procedure are cumbersome and require expensive equipment. In the present study, we adapted an easy and inexpensive photopatch test met- hod to our need. We report the results of this test method which was performed. in 21 patients with photodermatitis and 9 patients with polymorphic light eruption. 1. The UVB sensitivity determined by minimal erytherna dose (mean+-standard deviation) was I1618mW sec/cm in photodermatitis group, 108+ROmW sec/cm in polymorphic light eruption group and 126-+32mW-sec/cm in control group. But there was no significant difference among them (p>0. 05). 2. The reaction to UVA were negative in all groups. R. The photopatch test using IO potential photosensitizers revealed 12 positive responses in 9 patients; including 7 patients in photodermatitis group and 2 patients in polymorphic light eruption group. And the number of positive photopatch responses obtaied with each photosensitizer in RO patients with photodermatoses was 5 in chlorhexidine, 2 in paraaminobenzoic acid, musk ambrette and bithionol and 1 in chlorpromazine, respectively.

Five cases of Diphyllobothrium latum infection

Five cases of Diphyllobothrium latum infection were proved by collection of worms after treatment with bithionol, niclosamide or praziquantel, during 1975-1983. The patients were 4 males and one female aged 10-64 years residing in Seoul or Wando-gun, Chollanam-do, Korea. All of them remembered the history of eating several kinds of raw marine fish and 2 persons said they ate the raw flesh of perch, Lateolabrax japonicus. Three among them experienced abdominal pain, 2 natural discharge of a chain of segments, but none revealed any sign of anemia. The average egg size in stool varied 59-67 x 41-48 micrometer according to cases. The eggs were characterized by ovoid to elliptical shape, terminal operculum, and distinct abopercular protuberance. One naturally discharged segment (30 cm) and 4 complete strobilae (320~680 cm) with scolices obtained after treatments were examined. The morphological characters of proglottids such as rosette-form uterus with 3-6 loops, vaginal pore included in the cirrus sac, separated seminal vesicle from cirrus sac etc. were all compatible with D. latum. These are the 7th~11th cases of D. latum infection proved by worms in Korea.

Alpha esterase enzyme in liver of rabbits infected with fasciola gigantica and treated with bithionol

Alpha esterase in the liver was the subject of histochemical and biochemical studies. The biochemical study confirmed the histochemical study. It was found that bithionol therapy was accompanied by a marked increase in alpha esterase activity in normal liver rabbits receiving bithionol. A slight decrease in enzyme activity was encountered in Fasciola gigantica-infected control group 10 weeks post infection. In F. gigantica, bithionol treated group, a slight increase in alpha esterase activity was observed. It seems possible that bithionol administration in this group has overcome the decrease in enzyme activity caused by Fasciola worms. This could be considered as an indication that bithionol has an active therapeutic effect

a case of pulmonary paragonimiasis in Mindanao, Philippines.

A case of pulmonary paragonmiasis was diagnosed in a woman of the Manobo tribe in Marilog, Calinan, in the Davao region of Mindanao, the second-largest island in the Phillippine Archipelago. She had the first case of this disease reported in Mindanao. The patient was initially mis-diagnosed as having pulmonary tuberculosis, but failure of the standard triad regimen led to microscopic identification of Paragonimus westermani eggs in sputum. Therapy with Bithionol was successful in this case. One additional case was confirmed, and several more suspected, among members of this population group. From an epidemiologic standpoint, careful examination of chest x-rays will allow early differentiation between pulmonary paragonimiasis and tuberculosis, in areas where both conditions are endemic.

In vitro activities of various drugs against adult worms of Clonorchis sinensis

The present study was undertaken to evaluate in vitro activities of following drugs against adult worms of Clororchis sinensis: i.e., stibnal, chloroquine diphosphate, Hetol (1,4-bis-trichloromethylbenzol), dehydroemetine 'Roche' (Ro 1-9334), niridazole (Ambilhar), bisbendazole, gentian violet, dithiazanine iodide, hexachlorophene, bithionol, niclofolan (Bilevon, Bayer 9015) and praziquantel (Embay 8440, Biltricide). After isolation from bile ducts of experimentally infected rabbits (3 months infection), the parasites were rinsed in sterilized Tyrode's solution and incubated for 24 hours at 37 C in TC 199 medium with Earle's balanced salt solution containing 0, 0.01, 0.1, 1.0, 10 and 100 microgram/ml concentrations of each above drugs. The activities of each concentrations with each drugs were evaluated by the motility of the worms in culture tubes observing at 15, 30, 60 minutes and 2, 4, 6, 12, 18 and 24 hours by stereomicroscope. In the results, no effect was found at the adult worms of C. sinensis in all concentrations with stibnal, chloroquine diphosphate, Hetol, dehydroemetine, niridazole and bisbendazole. However, moderate activities were observed in the concentrations of 1.0 and 0.1 microgram/ml of gentian violet, dithiazanine iodide, hexachlorophene and bithionol. The highest activities were observed in all concentrations of niclofolan and praziquantel.