The diagnostic and treatment modalities of liver abscess have developed rapidly over the past few years but morbidity and mortality has not been markedly reduced. A total of 482 cases of liver abscess admitted to the Yonsei Medical Center over the past 20 years (Jan. 1971-Dec. 1990) were divided into 261 cases from the 1970s and 221 cases from the 1980s and the clinical and laboratory parameters were analyzed comparatively to determine if the clinical features, therapies and prognosis of liver abscess had changed. The proportion of amebic relative to pyogenic liver abscess decreased. Transbiliary infections increased in pyogenic liver abscess of the 1980s. Clinical signs such as jaundice and hepatomegaly and symptom duration before admission decreased. Abnormal laboratory features including hypoalbuminemia and elevation of alkaline phosphatase decreased and increased, respectively, in the 1980s. Ultrasonically guided percutaneous aspiration was the choice of treatment instead of surgical drainage in the 1980s. Despite diagnostic and therapeutic advances in the management of liver abscess, the prognosis has not improved in the 1980s as compared to the 1970s. This may reflect an increase in the incidence of liver abscess in old aged patients and patients with diabetes mellitus or underlying malignancy in the 1980s.
Adult ; Amebiasis/diagnosis ; Demography ; Drainage ; Female ; Human ; Incidence ; Liver Abscess/etiology/*pathology/physiopathology ; Male ; Mortality ; Serologic Tests ; Suppuration/microbiology

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.
Amebiasis ; Anisakiasis ; Ascariasis ; Biopsy* ; Clonorchiasis ; Cysticercosis ; Enterobiasis ; Gallbladder ; Humans ; Incidence ; Korea ; Liver ; Muscle, Skeletal ; Paragonimiasis ; Parasitic Diseases* ; Pathology ; Pleura ; Rectum ; Scabies ; Sparganosis ; Subcutaneous Tissue ; Taeniasis

After bathing at a hot spring resort, a 75-year-old man presented to the emergency department because of seizure-like attack with loss of conscious. This is the first case of primary amebic meningoencephalitis (PAM) caused by Naegleria fowleri in Taiwan. PAM was diagnosed based on detection of actively motile trophozoites in cerebrospinal fluid using a wet-mount smear and the Liu's stain. The amoebae were further confirmed by PCR and gene sequencing. In spite of administering amphotericin B treatment, the patient died 25 days later.
Aged ; Amebiasis/*diagnosis/parasitology/*pathology ; Central Nervous System Protozoal Infections/*diagnosis/parasitology/*pathology ; Cerebrospinal Fluid/parasitology ; DNA, Protozoan/chemistry/genetics ; Fatal Outcome ; Humans ; Male ; Microscopy ; Naegleria fowleri/classification/genetics/*isolation & purification ; Polymerase Chain Reaction ; Sequence Analysis, DNA ; Taiwan

Acanthamoeba cysts are resistant to unfavorable physiological conditions and various disinfectants. Acanthamoeba cysts have 2 walls containing various sugar moieties, and in particular, one third of the inner wall is composed of cellulose. In this study, it has been shown that down-regulation of cellulose synthase by small interfering RNA (siRNA) significantly inhibits the formation of mature Acanthamoeba castellanii cysts. Calcofluor white staining and transmission electron microscopy revealed that siRNA transfected amoeba failed to form an inner wall during encystation and thus are likely to be more vulnerable. In addition, the expression of xylose isomerase, which is involved in cyst wall formation, was not altered in cellulose synthase down-regulated amoeba, indicating that cellulose synthase is a crucial factor for inner wall formation by Acanthamoeba during encystation.
Acanthamoeba castellanii/*enzymology/genetics/metabolism ; Aldose-Ketose Isomerases/*biosynthesis ; Amebiasis/*pathology ; Benzenesulfonates ; Cell Wall/chemistry/genetics/*metabolism ; Cellulose/biosynthesis ; Down-Regulation ; Encephalitis/parasitology ; Glucosyltransferases/*biosynthesis/genetics ; Keratitis/parasitology ; Microscopy, Electron, Transmission ; RNA Interference ; RNA, Small Interfering