Among several diagnostic tools for clonorchiasis (Clonorchis sinensis infection), radiologic examinations are commonly used in clinical practices. During the 2 past decades, many reports regarding imaging findings of clonorchiasis were introduced. The basic imaging finding of clonorchiasis is diffuse dilatation of the peripheral intrahepatic bile ducts, without dilation of the large intrahepatic or extrahepatic bile ducts. By this finding, however, active clonorchiasis cannot be differentiated from cured infection. Some recent radiologic studies suggested specific findings of active clonorchiasis. Besides direct demonstration of worms, increased periductal echogenicity on sonography and periductal enhancement on dynamic contrast-enhanced CT or MR imaging possibly represent active clonorchiasis. Those images of the liver clonorchiasis are known to be correlated with worm burdens (EPG counts) in their frequency and also severity. The images of cholangiocarcinoma associated with clonorchiasis show both the tumor with obstruction images and diffuse dilatation of the peripheral intrahepatic bile ducts. Radiological images can be a good practical alternative diagnostic method of clonorchiasis.
Bile Ducts/parasitology/pathology ; *Cholangiography ; Clonorchiasis/*diagnosis/ultrasonography ; Humans

Liver fluke disease is a chronic parasitic inflammatory disease of the bile ducts. Infection occurs through ingestion of fluke-infested, fresh-water raw fish. The most well-known species that cause human infection are Clonorchis sinensis, Opisthorchis viverrini and Opisthorchis felineus. Adult flukes settle in the small intrahepatic bile ducts and then they live there for 20-30 years. The long-lived flukes cause long-lasting chronic inflammation of the bile ducts and this produces epithelial hyperplasia, periductal fibrosis and bile duct dilatation. The vast majority of patients are asymptomatic, but the patients with heavy infection suffer from lassitude and nonspecific abdominal complaints. The complications are stone formation, recurrent pyogenic cholangitis and cholangiocarcinoma. Approximately 35 million people are infected with liver flukes throughout the world and the exceptionally high incidence of cholangiocarcinoma in some endemic areas is closely related with a high prevalence of liver fluke infection. Considering the impact of this food-borne malady on public health and the severe possible clinical consequences, liver fluke infection should not be forgotten or neglected.
Animals ; Bile Duct Neoplasms/*diagnosis/epidemiology/*parasitology ; Bile Ducts, Intrahepatic/*parasitology ; Biological Markers/analysis ; Cholangiocarcinoma/*diagnosis/epidemiology/*parasitology ; Cholangitis/diagnosis/parasitology ; Clonorchiasis/*complications/*diagnosis/epidemiology/parasitology ; Clonorchis sinensis ; Humans ; Incidence ; Opisthorchiasis/*complications/*diagnosis/epidemiology/parasitology ; Opisthorchis

In 2009, infection with the liver fluke Clonorchis sinensis (C. sinensis) was classified as "carcinogenic to humans" (Group 1) based on its involvement in the etiology of cholangiocarcinoma by the International Agency for Research on Cancer. However, little is known about the descriptive epidemiology of cholangiocarcinoma in Korea. We examined incidence trends of intrahepatic and extrahepatic cholangiocarcinomas, using data from the Korea National Cancer Incidence database for 1999-2005. The prevalence of C. sinensis infection was estimated from a recent population-based survey in rural endemic areas. Cholangiocarcinoma incidence rates are currently rising, even while primary liver cancer incidence rates are decreasing. Annual percent changes in cholangiocarcinoma incidence rates were 8% for males and 11% in females. Known areas of C. sinensis endemicity showed high incidence rates of cholangiocarcinoma. The positivity of C. sinensis eggs in stool samples from endemic areas was more than 25% of adults tested during 2005-2008. From a meta-analysis, the summary odds ratio for cholangiocarcinoma due to C. sinensis infection was 4.7 (95% confidence interval: 2.2-9.8). Approximately 10% of cholangiocarcinomas in Korea were caused by chronic C. sinensis infections. More specific policies, including health education and an extensive effort for early detection in endemic areas, are needed.
Adult ; Aged ; Aged, 80 and over ; Animals ; Bile Duct Neoplasms/*epidemiology/parasitology ; Bile Ducts, Intrahepatic/parasitology/*pathology ; Cholangiocarcinoma/*epidemiology/parasitology ; Clonorchiasis/*epidemiology ; Female ; Humans ; Korea/epidemiology ; Male ; Middle Aged

No abstract available.
Animals ; Bile Duct Neoplasms/*diagnosis/parasitology/pathology ; *Bile Ducts, Intrahepatic ; Cholangiocarcinoma/*diagnosis/parasitology/pathology ; Clonorchiasis/*complications/pathology ; Clonorchis sinensis/*isolation & purification ; Humans ; Male ; Middle Aged

We describe the imaging features of two cases of biliary ascariasis. Ultrasonography and CT showed no specific abnormal findings, but MR cholangiography clearly demonstrated an intraductal linear filling defect that led to the correct diagnosis. MR cholangiography is thus a useful technique for the diagnosis of biliary ascariasis.
Adult ; Animal ; Ascariasis/*diagnosis ; *Ascaris lumbricoides ; *Bile Ducts, Intrahepatic ; Biliary Tract Diseases/*diagnosis/*parasitology ; Common Bile Duct Diseases/*diagnosis/*parasitology ; Female ; Human ; *Magnetic Resonance Imaging

The present study was undertaken to observe the changes of hepatocyte and biliary epithelium in the liver of guinea pigs infected with C. sinensis. Ten guinea pigs infected with 500 metacercariae of C. sinensis each were reared for 11 weeks. After sacrifice, the liver tissues were processed both for conventional light microscopy and for electronmicroscopy. The following results were obtained by light and electronmicroscopic observation of these tissue preparations. The dilatation of bile ducts with chronic inflammatory cell infiltration and fibrosis, and flattening of lining epithelium were observed by light microscopy. Bile duct showed a single low columnar or cuboidal epithelium and subepithelial small round cell infiltration. Papillary proliferation, adenomatous hyperplasia and increase of goblet cells in the subepithelial glands were also noted in some areas of bile ducts. Occasionally, small fibrous nodules in the portal tract replacing bile ducts, surrounded by a heavy infiltrate of small round cells and neutrophils were observed. On light microscopic examination, no cellular damages were seen in the liver cells except mild fatty degeneration. Electronmicroscopic examination of the biliary epithelium revealed increased mucin granules, cytoplasmic projection into lumen, decreased microvilli and obstruction of bile canaliculi. Indistinct and/or irregular appearances of intercellular lateral interdigitation were observed in most of biliary epithelium. On the electronmicrographs of hepatocytes, dilation of endoplasmic reticulum(ER) and destruction of cristae in some mitochondriae were prominent features. Disappearance of cytoplasmic organells and dilatation of bile canaliculi were also monitored. Endothelial cells in the sinusoids were remained intact.
parasitology-helminth-trematoda ; Clonorchis sinensis ; guinea pig ; pathology ; bile duct ; ultrastructure-electronmicroscopy ; fibrosis ; hyperplasia ; goblet cell

Fascioliasis has not been confirmed as a human disease entity until now in Korea despite of sporadic discovery of ova of Fasciola sp. in human fecal materials being never traced to the confirmation of infection. Almost all of the cases with ova in their stool have been related with consumption of cattle liver whether eaten in raw or processed. The present authors confirmed a human fascioliasis case who was a Korean housewife of 42-year-old living in Seoul, during the exploratory laparotomy. The patient had been healthy until October 1975 when abrupt onset of urticaria, dyspepsia, epigastric discomfort developed. And the fluctuation of these symptoms was followed by epigastric colicky pain attacks from December 4, 1975. A complete worm of Fasciola sp. was removed during the bile-duct exploration with stone forceps in lower half of common bile duct, on January 20, 1976. The patient only agreed that she had eaten some raw liver of cattle on September 1975 but denied any possible sources of infection such as drinking of untreated water, handling of water flower and grass, and eating of raw watercress. The measurements of the removed worm: 35. 61 mm in body length, 14.00 mm in maximum body width(Length/width ratio, 2.54:1), distribution of testes to body length 33.9 per cent , number of branches of ovary 22, the size of intrauterine ova 157.2 x 108. 4 micrometer in average. These findings are not compatible with the classical descriptions of both Fasciola hepatica and F. gigantica, and it was concluded it is so-called Fasciola sp. which is intermediate between two species as proposed by many Japanese workers.
parasitology-helminth-trematoda ; Fasciola hepatica ; Fasciola gigantica ; Fasciola sp. ; case report ; fascioliasis ; laparotomy ; bile-duct

A 77-year old man living in Kyunggi-Do, Korea was surgically treated at Seoul National University Hospital on April 1981, because of acute abdomen. At laparotomy, a 1.77m long adult Taenia saginata was found both in gallbladder and in common bile duct to cause acute gangrenous cholecystitis. The relevant literature were reviewed and possible mechanisms of the disease were discussed.
parasitology-helminth-cestoda ; Taenia saginata-taeniasis ; case report ; gallbladder ; common bile duct ; acute abdomen ; laparatomy

Clonorchis sinensis is a biological carcinogen inducing human cholangiocarcinoma, and clonorchiasis is one of the important endemic infectious diseases in East Asia. The present study investigated survival longevity of C. sinensis adult worms in various in vitro conditions to find the best way of keeping the worms longer. The worms were maintained in 0.85% NaCl, 1xPBS, 1xLocke's solution, RPMI-1640, DMEM, and IMDM media, and in 1xLocke's solution with different supplements. All of the worms died within 3 and 7 days in 0.85% NaCl and 1xPBS, respectively, but survived up to 57 days in 1xLocke's solution. The worms lived for 106 days in DMEM, and 114 days in both RPMI-1640 and IMDM media. The survival rate in RPMI-1640 medium was the highest (50%) compared to that in DMEM (20+/-10%) and in IMDM (33.3+/-25.2%) after 3 months. The 1xLocke's solution with 0.005% bovine bile supplement showed increased duration of maximum survival from 42 days to 70 days. Higher concentration of bile supplements than 0.005% or addition of glucose were disadvantageous for the worm survival. The worms died rapidly in solutions containing L-aspartic acid, L-glutamic acid, and adenine compared to L-arginine, L-serine, and L-tryptophan. In conclusion, the 1xLocke's solution best supports the worms alive among inorganic solutions for 57 days, and the RPMI-1640 medium maintains living C. sinensis adults better and longer up to 114 days in vitro than other media.
Adenine/metabolism ; Amino Acids/metabolism ; Animals ; Bile/parasitology ; Bile Acids and Salts/*metabolism ; Cattle ; Cell Survival ; Clonorchiasis/*parasitology ; Clonorchis sinensis/*growth & development/physiology ; *Culture Media ; Cyprinidae ; Fish Diseases/parasitology ; Humans ; Rabbits ; Rats ; Time Factors

A microsporidian parasite Enterocytozoon bieneusi is the most common microorganism recognized in AIDS patients, and slow scientific progress is attributed to our inability to propagate the parasite. We report upon the development of a system of propagation using the pig biliary system. The parasite spores were continuously detected in the bile samples post onset of spore shedding in the gall bladder, which suggests that this organism maintain persistent infection in the biliary system and that the hepatobiliary tree may represent a reservoir of infection. In conclusion the biliary tree is an adequate niche for the propagation of E. bieneusi. This work has also resulted in the development of a procedure of ultrasound-guided cholecystocentesis for aspirating biles. This is a simple and non-surgical procedure, and creates no signs of clinical complications in the livers and the gall bladders after dozens of separate attempts. Thus, this is a very useful and safe technique for the aspiration of bile from live animals.
AIDS-Related Opportunistic Infections/*parasitology ; Animals ; Bile/parasitology ; Biliary Tract/*parasitology ; DNA, Protozoan/analysis ; Disease Models, Animal ; Enterocytozoon/*growth & development/physiology ; Feces/parasitology ; Gallbladder/parasitology/ultrasonography ; Immunosuppression/veterinary ; Microsporidiosis/*parasitology ; Paracentesis/methods/veterinary ; Polymerase Chain Reaction/veterinary ; Specimen Handling/methods/veterinary ; Spores, Protozoan/isolation & purification/physiology ; Swine