A Case of Unexpected Clinostomum complanatum Infection Initially Presenting as Foreign Body in Pharynx.

A 46-year old man visited our outpatient clinic with complaint of foreign body sensation in throat after consuming raw freshwater fish 5 days ago. Laryngoscopic examination revealed a motile worm attached on posterior pharyngeal wall. The worm was removed using biopsy forceps under transnasal endoscopy and evidently identified as Clinostomum complanatum after microscopic examination. Patient's subjective foreign body sensation of throat and hyperemia of laryngeal mucosa remained for approximately 2 weeks post-removal, which were eventually resolved after administration of non-steroidal anti-inflammatory drug and anti-refluxant drug for 2 weeks. Treatment was ended at three weeks since the first visit. C. complanatum infections in humans are rare, and only four cases have been reported in Korea. Symptoms resembling pharyngitis or laryngitis occurs by consumption of raw, infected freshwater fish and treatment is done by mechanically removing the parasite.

Effects of IL-3 and SCF on Histamine Production Kinetics and Cell Phenotype in Rat Bone Marrow-derived Mast Cells.

BACKGROUND: Rat mast cells were regarded as a good model for mast cell function in immune response. METHODS: Rat bone marrow mast cells (BMMC) were prepared both by recombinant rat IL-3 (rrIL-3) and by recombinant mouse stem cell factor (rmSCF), and investigated for both proliferation and differentiation in time course. Rat BMMC was induced by culture of rat bone marrow cells (BMCs) in the presence of both rrIL-3 (5 ng/ml) and rmSCF (5 ng/ml). Culture media were changed 2 times per week with the cell number condition of 5x10(4)/ml in 6 well plate. Proliferation was analyzed by cell number and cell counting kit-8 (CCK-8) and differentiation was by rat mast cell protease (RMCP) II and histamine. RESULTS: Cell proliferation rates reached a maximum at 8 or 11 days of culture and decreased thereafter. However, both RMCP II production and histamine synthesis peaked after 11 days of culture. By real time RT-PCR, the level of histidine decarboxylase mRNA was more than 500 times higher on culture day 11 than on culture day 5. By transmission electron microscopy, the cells were heterogeneous in size and contained cytoplasmic granules. Using gated flow cytometry, we showed that cultured BMCs expressed high levels of FcepsilonRI and the mast cell antigen, ganglioside, on culture day 11. CONCLUSION: These results indicate that rat BMMCs were generated by culturing BMCs in the presence of rrIL-3 and rmSCF and that the BMMCs have the characteristics of mucosal mast cells.

Intramuscular and subcutaneous sparganosis: Sonographic findings.

A case of subcutaneous and intramuscular sparganosis was confirmed on surgical excision of a worm in a 60-year-old woman suffering from painful masses in the right thigh. Sonography and MRI revealed an ill-defined intramuscular lesion and multiple cystic lesions in the subcutaneous tissue. At the time of the excision, a sparganum larva was found in the adductor longus muscle. If an intramuscular mass with a serpiginous cystic tract is seen on imaging studies in an endemic area, musculoskeletal sparganosis should be included in the differential diagnosis of a soft tissue tumor.

Protective immunity and antibody response of rats infected with Trichinella spiralis.

OBJECTIVE: To study the protective immunity and antibody (IgG, IgG1 and IgG2a) response against adult and larva infection of T. spiralis Korean isolate in rats. METHODS: Forty-six rats were randomly divided into 7 groups. Group A (A1, A2, 10 rats) was used for the determination of protective efficacy from adult stage infection, group B (B1, B2, 14 rats) was for the protective efficacy from muscle larva stage infection, group C (C1, C2, 17 rats) was for challenge control, and group D (5 rats) served as normal control. Rats in groups A, B and C were infected with 1,000 T.spiralis muscle larvae, and the infected rats were treated with flubendazole (20 mg/kg, 10 d) at day 7 (A1, A2) and at day 30 (B1, B2). Rats in groups A and B were re-infected with 500 T. spiralis muscle larvae at day 10 after treatment. Rats in groups A1 and B1 were killed at day 7 and day 30 to inspect the reduction of adult worms in the intestines. Rats in groups A2 and B2 were killed at day 30 to detect the reduction of muscle larvae in diaphragms. Rats in groups C and D were killed at the same time, and all rats were bled at the same time. Specific anti-Trichinella IgG, IgG1 and IgG2a were detected by ELISA. RESULTS: Adult stage infection induced protective efficacy by 100% against adult stage and by 99.96% against larva stage. Larval stage infection induced protective efficacy by 99.92% against adult stage and 99.89% against muscle larvae. Anti-muscle stage larval ES Ag (IgG 3.0, IgG1 2.2, IgG2a 0.8) and anti-adult crude Ag antibodies (IgG 1.9, IgG1 0.8, IgG2a 0.3) significantly increased in the muscle larval stage infection compared to normal control (IgG 0.5, IgG1 0.1, IgG2a 0.1) and adult stage infection (IgG 0.5, IgG1 0.09, IgG2a 0.09) (P < 0.01). Higher specific IgG1 antibody (IgG1 2.2) in larva stage infection was shown than specific IgG2a antibody response (IgG2a 0.8)(P < 0.01). CONCLUSION: Protective immunity against both adult and larva worms has been induced from adult and muscle larva stage infections of T. spiralis.

Immune reactions and allergy in experimental anisakiasis.

The third-stage larvae (L3) of the parasitic nematode, Anisakis simplex, have been implicated in the induction of hyperimmune allergic reactions in orally infected humans. In this work, we have conducted a review of an investigation into immune reactions occurring in animals experimentally infected with A. simplex L3. The patterns of serum antibody productions in the experimental animals against excretory-secretory products (ESP) of A. simplex L3 contributed to our current knowledge regarding specific humoral immune reactions in humans. In our review, we were able to determine that L3 infection of experimental animals may constitute a good model system for further exploration of immune mechanisms and allergy in anisakiasis of humans.

Human anisakiasis: Diversity in antibody response profiles to the changing antigens in larval excretions/secretions.

Anisakiasis is an infectious parasitic disease contracted by eating third stage larvae of Anisakis simplex (L3) carried by marine fishes. Human anisakiasis was researched for specific IgG with L3 excretory secretory products (ESP). L3ESP were prepared by daily harvesting of culture supernatant from day 2 to day 5, using two kinds culture media of RPMI-1640 and phosphate buffered saline (PBS). When the sera from persons diagnosed with anisakiasis by means of endoscopy were analyzed using indirect ELISA and Western blot, the sera was classified into four groups depending on specific antigen recognition patterns. In addition, the presence of a new antigen for L3, located at less than 13 kDa (AgLT13) was demonstrated in L3ESP with a modified Western blot condition. The production of AgLT13 was mainly found in L3ESP harvested both on day 2 and day 3, and that in PBS was predominant over that in RPMI-1640. Among those sera, the high reactive sera to L3ESP-day two prepared with phosphate buffer in indirect ELISA recognized AgLT13, and 33% of the low reactive sera did so. These results indicate that the binding pattern of human L3 specific antibody is diverse depending on L3ESP preparations and that AgLT13 demonstrated with a Western blot condition is a specific antigen for L3.

Proliferation and cytokine production of lymphocytes from Clonorchis sinensis-infected rats in response to stimulators in vitro.

OBJECTIVE: To study the rat lymphocyte proliferation, differentiation and cytokine production in response to Clonorchis sinensis infection. METHODS: The lymphocyte proliferation and cytokine production (IFN-gamma, IL-2, IL-4, IL-10) in response to mitogen phytohaemagglutinin (PHA), C. sinensis excretory-secretory antigen (ES Ag), C. sinensis crude antigen (crude Ag) and Anisakis larvae antigen were detected in vitro from splenic lymphocytes (SLC) and mesenteric lymph node cells (MLNC) of rats infected with C. sinensis. Statistical analysis was performed by Sigma Plot System. RESULTS: Lymphocyte proliferations in MLNC were higher than that in SLC. At concentrations of 3 x 10(6) or 9 x 10(6) cells/well, lymphocyte proliferations were significantly higher in both SLS and MLNC than in the control with cell alone (P < 0.01). At the lymphocyte concentration of 5 x 10(6) cells/well and stimulator concentration of 5 or 10 micrograms/ml, significant lymphocyte activation was observed. Under the same culture condition (5 x 10(6) cells/ well with 10 micrograms/ml stimulator), cytokine IFN-gamma and IL-10 production in vitro increased significantly in MLNC. CONCLUSION: Concentrations of 5 x 10(6) lymphocytes/well and 10 micrograms/ml stimulator were selected as the optimal culture condition for activation of lymphocyte proliferation and cytokine production. Since the production of Th1-type cytokine IFN-gamma and Th2-type cytokine IL-10 was much enhanced from MLNC of C. sinensis-infected rats, it is considered that C. sinensis ES Ag may stimulate lymphocyte proliferation and cytokine production in C. sinensis-infected rats in vivo.