In order to assess the reliability of ultrasonographic criteria of clonorchiasis, a prospective study was performed in 14 patients who were diagnosed as clonorchiasis by ultrasonogram only, using the criteria of peripheral duct dilatation without dilatation of extrah epatic duct. Eleven out of 14 patients were turned out to be clonorchiasis, showing 93% accuracy. Authors in tend to stress these ultrasonographic signs are very well correlated with the CT and E RCP findings and are proved to be highly reliable for clonorchiasis, and thus clonorchiasis could be diagnosed by ultrasonogram only.
Clonorchiasis ; Diagnosis ; Dilatation ; Humans ; Prospective Studies ; Ultrasonography

The sensitivity and specificity of crude and affinity-purified antigens of Clonorchis sinensis obtained from the infected rabbits were studied. Stage-specific antigenic proteins from the eggs, metacercariae and adult worms were characterized by SDS-polyacrylamide gel electrophoresis (SDS-PAGE) and enzyme-linked immunosorbent assay (ELISA) The results were as follows: The antibody-binding antigen (ABA) purified from whole worm crude antigen (WWA) by CNBr-activated Sepharose 4B affinity chromatography made 4 specific bands against rabbit anti-sera on Ouchterlony gel diffusion plate, while WWA made 7 bands. Major WWA protein bands by SDS-PAGE were found at 16,300-18,500 and 28,000-29,000 daltons, while major ABA protein bands were at 18,000-21,000 and 29,000-31,000 daltons. The reactivity of ABA with rabbit anti-sera in ELISA was remarkably less sensitive than that of WWA. Molecular weights of egg antigen (EGA), metacercarial antigen (MEA) and adult worm antigen (WWA) of C. sinensis ranged from 15,000-200,000 daltons, 15,000-100,000 daltons and 11,000-80,000 daltons, respectively. Major WWA proteins consisted mainly of polypeptide bands of low molecular weight, less than 31,000 daltons, while those of EGA and MEA consisted of higher molecular weights than 30,000 daltons. The ELISA reactivities of WWA to rabbit anti-sera were remarkably greater than those of MEA. EGA showed negative reaction throughout the experiments. WWA showed higher optical density (O.D.) than 1.0, when reacted with rabbit anti-sera obtained at 4-6 weeks after the infection. In the rabbit anti-sera later than 12 weeks after the infection, the O.D. reacting with WWA showed a plateau without variation. MEA showed relatively low O.D. values (<0.6), when reacted with anti-sera from lightly infected groups throughout the experiments, although there were some weak positive cases (O.D.>0.6) in heavily infected groups. MEA reacted with rabbit anti-sera showed negative results on Ouchterlony gel diffusion plates. Summarizing the above results, it is suggested that the whole worm antigen prepared from the adult worms of C. sinensis is most highly antigenic. However, this antigen might reveal cross reactions with other trematodes such as Paragonimus westermani, therefore, purification of antigenic proteins from the crude antigen is essential to increase the sensitivity and specificity for the immunodiagnosis of clonorchiasis.
parasitology-helminth-trematoda ; Clonorchis sinensis ; clonorchiasis ; rabbit ; immunology ; diagnosis ; antigen

Clonorchiasis procucts diffuse dilatation of the small and medium sized intrahepatic bile ducts and its cholangiogram shows visualization of many bile ducts, especially, tertiary, quaternary, and more peripheral tributaries up to the 6th tributaries. In an attempt to clarify this cholangiographic sign quantitively, we counted the visualized smaller bile ducts in clonorchiasis and compared the number of visualized ducts in normal cholangiogram, recurrent pyogenic chlangitis and carcinoma of the extrahepatic ducts. In clonorchiasis the number of visualized smaller bile ducts was considerably geater than in normal subjects and recurrent pyogenic cholangitis, but there was no singnificant statistical differences in the number of visualized bile duct tributaries between clonorchiasis and carcinoma of the bile ducts. Thus it is considered that too many ducts sign is not a unique cholangiographic finding of clonorchiasis, but we believe that in the presence of this sign with other we l known cholangiographic findings, diagnosis of clonorchiasis is very easy.
Bile Ducts ; Bile Ducts, Intrahepatic ; Cholangitis ; Clonorchiasis* ; Diagnosis ; Dilatation

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

Agar-gel diffusion test (AGD), counterimmunoelectrophoresis (CIEP) and enzyme-linked immunosorbent assay(ELISA) were examined with the sera of skin test positives for paragonimiasis. The crude antigen(Paragonimus whole worm extracts: protein concentration, 7.56mg/ml) and human sera were used in AGD and CIEP. And in ELISA test, diluted antigen with 1:40,000 of crude antigen and diluted sera with 1:100, 1:200 were used in the test. The positive identical ratio between AGD and CIEP reactions is 98 percent and negative identical ratio is 100 percent. One or three precipitin bands are observed in AGD. One to seven precipitin bands are also revealed in CIEP. Especially, deeply stained bands are observed in CIEP than those of AGD. The positive identical ratios between AGD and ELISA tests are 96 percent in 1:100 diluted sera, and 94 percent in 1:200 diluted sera. But the negative identical ratios between AGD and ELISA tests are 97 percent and 99 percent respectively in 1:100 and 1:200 diluted sera. The positive identical ratios between CIEP and ELISA tests are 98 percent and 96 percent respectively in 1:100 and 1:200 diluted sera, but also 97 percent and 99 percent in 1:100 and 1:200. Control sera, such as clonorchiasis, amoebiasis and toxoplasmosis, revealed all negatives with Paragonimus antigen in AGD, CIEP and ELISA tests. By above results, ELISA was most sensitive, next CIEP and AGD. But AGD test appears to be more useful when used to crude antigen without cross reaction with other parasitic infections. CIEP test is basically equal in terms of precipitin reaction, but CIEP is able to be detected more sensitively and rapidly though less simple in handiwork than AGD. Consequently, three methods for immunological tests of paragonimiasis have good correlations with one another. Also, each of these has both merits and demerits in immunological test for paragonimiasis. But the ELISA test was proved to be the most sensitive and convenient tool for mass screening test, especially in case of using purified antigen.
parasitology-helminth-trematoda ; Clonorchis sinensis ; clonorchiasis ; ELISA ; immunology ; diagnosis ; paragonimiasis ; Paragonimus westermani ; agar-gel diffusion ; counterimmunoelectrophoresis

A comparison was made of a new serological method, thin layer immunoassay (TIA), and an established method, enzyme-linked immunosorbent assay (ELISA), in the detection and quantification of antibodies in clonorchiasis. Saline extract of lyophilized Clonorchis sinensis adult worm was used as antigen, and TIA by the method of Elwing et al. (1976) and ELISA by Voller et al. (1974) were performed. Using sera from known clonorchiasis cases, 100 percent of the sera tested were positive by TIA and 88.3 percent by ELISA. TIA produced false positive results in 14 out of 36 cases, which were 10 amoebiasis cases, 16 paragonimiasis cases and 10 healthy controls. ELISA, however, produced a small number of false positives, 7 out of 55 cases. There was correlation between immunoglobulin G level in sera and ELISA value (correlation coefficient, 0.69), whereas no correlation between immunoglobulin G level and TIA result. The performance of TIA and ELISA was not correlated in the results using homologous antigen.
parasitology-helminth-trematoda ; Clonorchis sinensis ; clonorchiasis ; ELISA ; immunology ; diagnosis ; thin-layer immunoassay

OBJECTIVE: The purpose of this study was to evaluate the MR spectrum and MR cholangiographic imaging findings of clonorchiasis. MATERIALS AND METHODS: We reviewed 26 patients with confirmed clonorchiasis by either stool tests (n=24) or surgery (n=2). MR imaging was performed on a 1.5 T system (GE Medical Systems, Milwaukee, WI) with a torso coil. Axial T1-and T2-weighted, gadolinium-enhanced dynamic images and MR cholangiography were obtained. Image analyses were used to identify abnormalities of the intrahepatic and extrahepatic bile ducts and the presence of hepatobiliary malignancy. All MR examinations were reviewed by the consensus of two abdominal radiologists. RESULT: Intrahepatic bile duct abnormalities were seen in 23 (89%) of the 26 patients. The most common finding was mild dilatation of the intrahepatic bile duct which was found in 21 (81%). "Too many intrahepatic ducts" were found in 16 (62%), wall enhancement and thickening in 21 (81%) and filling defects and ductal stricture in the intrahepatic bile duct in 6 (24%) and 3 (12%) patients, respectively. Extrahepatic ductal dilation was found in 5 (19%) and 9 (35%) revealed hepatobiliary malignancy. CONCLUSION: MR imaging revealed various findings of clonorchiasis, including dilatation, wall enhancement, stricture of the intrahepatic ducts and filling defect within the intrahepatic bile duct.
Adult ; Aged ; Cholangiography/methods ; Clonorchiasis/*diagnosis/radiography ; Female ; Human ; *Magnetic Resonance Imaging/methods ; Male ; Middle Aged

Antigens for the diagnosis of clonorchiasis have been isolated from the adult Clonorchis. Following extracttion with a phosphate-citrate buffer solution, ultrasonic disintegration, and defatting with a chloroform-methanol mixture, the antigens were fractionated in a Diethylaminoethyl-Sephadex (DEAE-Sephadex) A 50 column using sodium chloride eluates. The antigens were evaluated by carrying out both skin tests and stool examinations to determine their sensitivity, specificity and cross reaction. These DEAE fractionated antigens show less cross reaction than Melcher's antigen. DEAE fractions were protein(280mmu peak) and nucleoprotein (260mmu peak) as indicated by spectrophotometry. These purified fractions represented by the 260mmu and 280mmu peaks were not free of cross reactions nor were they completely specific for clonorchiasis. It is therefore suggested that further attempts be made to eliminate cross reactions and to enhance specificity by a more detailed and complete method of purification or of preparation of the chemical components.
Animals ; *Antigens ; Cats ; Chromatography ; Clonorchiasis/*diagnosis ; Dogs ; Human ; In Vitro ; Rabbits ; Skin Tests

This special issue is devoted to a review of the current state of knowledge of clonorchiasis. Sections deal with: the biology of Clonorchis sinensis; geographical distribution, with particular regard to Korea; epidemiology; pathogenesis; clinical features; diagnosis; prevention and control; chemotherapy.
review ; parasitology-helminth-trematoda ; Clonorchis sinensis ; clonorchiasis ; epidemiology ; pathogenesis ; liver ; diagnosis ; chemotherapy ; praziquantel ; control ; hetol ; di

BACKGROUND: The intradermal test for the screening of Clonorchis sinensis is difficult to interpret because the sensitivity and persistence rates of reactions after treatment are not well known. METHODS: Stool egg examinations and intradermal tests for C. sinensis and Paragonimus westermani were performed for 1,207 persons who lived in endemic areas of C. sinensis infestation, and epidemiologic data were also surveyed. RESULTS: The infestation rate of C. sinensis was 12% (male 14%, female 9%). It was higher in Southeastern area of Gyungsang Namdo Province and Ulsan (22%) than in Busan (10%), whereas much higher in Gangseo/Buk/Sasang (28%) than in other areas of Busan. The performance of C. sinensis intradermal test was as belows; sensitivity 45%, specificity 80.8%, positive predictive value 24%, negative predictive value 92%, and diagnostic efficiency 77%. Positive C. sinensis intradermal reaction persisted for longer than 40 years after treatment of C. sinensis infestation in at least 30% of patients. C. sinensis intradermal reaction turned to be positive within 4 months after intake of raw fish in more than half the patients. CONCLUSION: The infestation rate of C. sinensis was still very high in inhabitants around Nakdong River, an endemic area. We think that C. sinensis intradermal test is inadequate to diagnose current clonorchiasis.
Busan ; Clonorchiasis ; Clonorchis sinensis* ; Diagnosis* ; Female ; Humans ; Intradermal Tests* ; Mass Screening ; Ovum ; Paragonimus westermani ; Rivers ; Sensitivity and Specificity ; Ulsan