OBJECTIVETo evaluate the efficacy of a novel compound derived from Traditional Chinese Medicine (TCM) for treatment of alveolar echinococcosis in the Kuming mouse.

METHODSThe compound was extracted from TCM by serial procedures including amalgamation of TCM drugs, boiling in a beaker, cold condensation using a reflux instrument, evaporation by mild heating and finally, formation of a deep brown powder. An animal model of alveolar echinococcosis was established concurrently. A bit of alveococcus tissue derived from alveolar echinococcosis in the mouse was transplanted into the peritoneal cavity of the musculus of a Kuming mouse. The duration of infection after inoculation was classified as either 1 week or 10 weeks; the animals were again divided into treated groups and control groups. Estimation of the alveococcus inhibitory rate and electron microscopic observation served as the main methods for assessment of efficacy. The infected mice in the treated groups were intra-gastrically administered once per day with the TCM extractive powder at doses of 20 mg.kg(-1) for three months continuously. All the animals were sacrificed and examined half a month after the end of TCM treatment.

RESULTSTotal wet weight of alveococcus collected from the 9 mice in the treated group after one week of infection was 37.8 g (x +/- s, 4.196 +/- 2.090 g), which was markedly lower than the amount collected from 10 mice of the control group (121.3 g, x +/- s, 12.1 +/- 4.3 g). Therefore, the inhibitory rate of the alveococcus was 65.7% (P < 0.01). Similarly, the total wet weight of alveococcus from 7 mice of the treated group after 10 weeks of infection was 4.3 g (x +/- s, 0.62 +/- 1.21 g), which was much lower than the amount collected from 6 mice of the control group (17.85 g, x +/- s, 2.93 +/- 3.28 g). The inhibitory rate of alveococcus was 80.6% (P < 0.01). Furthermore, the ultrastructural appearances of alveococcus showed obvious differences between the two groups.

CONCLUSIONTCM extractive powder for treatment of murine alveococcosis is considered to be a hopeful anti-echinococcus compound; it is a topic for further study.

Animals ; Echinococcosis ; drug therapy ; pathology ; Female ; Medicine, Chinese Traditional ; Mice ; Microscopy, Electron

Adult ; Benzimidazoles ; therapeutic use ; Echinococcosis, Pulmonary ; diagnosis ; drug therapy ; Female ; Humans

Adult ; Albendazole ; therapeutic use ; Biopsy ; Brain ; parasitology ; pathology ; Echinococcosis, Hepatic ; complications ; drug therapy ; pathology ; Echinococcosis, Pulmonary ; etiology ; pathology ; Female ; Humans ; Male ; Middle Aged

OBJECTIVE: More than 70% of hepatic alveolar echinococcosis (HAE) are inoperable. Thus, long-term, or even life-long, pharmacological treatment with benzimidazoles is necessary. For effective treatment, it is of great importance to employ imaging techniques to detect and monitor the non-resectable parasitic viability. Therefore, this study aimed to evaluate diffusion-weighted imaging (DWI) in assessing the viability of HAE in comparison to 18-fluoro-deoxyglucose (18F-FDG) positron emission tomography, combined with computed tomography (PET/CT). MATERIALS AND METHODS: Positron emission tomography, computed tomography and DWI (b-values: 0, 800 s/mm2) were retrospectively analysed in eight patients with clinically-verified HAE to, generate the apparent diffusion coefficient (ADC) map. The activity of HAE lesions in both techniques were determined independently by two radiologists according to the following standard: (+), marked focally or perilesionally increased FDG uptake/high signal intensity; (−), a hepatic defect without FDG uptake/no high signal intensity. Every lesion's maximum standardized uptake value (SUV(max)) on the PET/CT images and mean ADC values on the parametric ADC maps were measured respectively. Results of PET/CT and DWI were compared on a per-lesion-basis. Pearson's correlation coefficient was assessed for statistical analysis. RESULTS: A total of 14 HAE lesions were detected. Eight lesions (diameter 3–15 cm) showed perilesional hyper-signal intensity on DWI. This was visualised on PET/CT as increased FDG uptake. They mainly existed in the lesion's border with normal liver parenchyma. Five lesions (diameter < 2 cm) were detected as nodular hyperintensity on DWI and a ‘hot spot’ on PET/CT in the same distribution. One patient, who had received oral drug therapy for three years showed significantly decreased perilesional hyperintensity on the DWI and a hepatic defect without any FDG uptake on PET/CT. Pearson's correlation coefficient indicated a significant inverse correlation of the ADC and the SUV(max) (r = −0.67, p < 0.001). CONCLUSION: Diffusion-weighted imaging is capable of offering information on visually detecting the HAE lesions' viability and may be useful for routine application in the initial diagnosis of HAE.
Benzimidazoles ; Diagnosis ; Diffusion ; Drug Therapy ; Echinococcosis ; Echinococcosis, Hepatic ; Electrons ; Humans ; Liver ; Magnetic Resonance Imaging ; Parasites ; Positron-Emission Tomography and Computed Tomography ; Positron-Emission Tomography ; Retrospective Studies

Although alveolar echinococcosis (AE) can cause a serious disease with high mortality and morbidity similar to malign neoplasms. A 62-year-old woman admitted to a hospital located in Sivas, Turkey, with the complaints of fatigue and right upper abdominal pain. On contrast abdominal CT, a 54x70x45 mm sized cystic lesion was detected in the left lobe of the liver that was seen to extend to the posterior mediastinum and invade the diaphragm, esophagus, and pericardium. The cystic lesion was seen to be occluding the inferior vena cava and left hepatic vein at the level where the hepatic veins poured into the inferior vena cava. Bilateral pleural effusion was also detected. We discussed this secondary Budd-Chiari Syndrome (BCS) case, resulting from the AE occlusion of the left hepatic vein and inferior vena cava, in light of the information in literature.
Animals ; Anthelmintics/therapeutic use ; Budd-Chiari Syndrome/drug therapy/*etiology/parasitology ; Echinococcosis, Hepatic/*complications/drug therapy/parasitology ; Echinococcus multilocularis/isolation & purification ; Female ; Humans ; Middle Aged

Treatment of hydatid disease is mainly surgical, with medical treatment being reserved as a coadjuvant treatment. Use of effective scolicidal agents during surgery of cystic echinococcosis is essential to reduce the recurrence rate. The goal of this study was to evaluate the in vitro scolicidal effects of hydroalcoholic extracts of Satureja khuzestanica leaves and aqueous extracts of Olea europaea leaves on hydatid cyst protoscolices. Echinococcus granulosus protoscolices were collected from the liver of sheep infected with the hydatid cyst. Various concentrations of plant extracts were used in different exposure times for viability assay of protoscolices. Among the olive leaf extracts tested, 0.1% and 0.01% concentrations had strong scolicidal effects in 120 min. S. khuzestanica 0.1% had very strong scolicidal effects in 30, 60, and 120 min of exposure times and the mortality rate decreased with the lower concentration. The finding have shown that the scolicidal activity of S. khuzestanica against cystic echinococosis protoscolices were more effective, while the O. europaea extract showed less effects.
Animals ; Anthelmintics/*pharmacology ; Dose-Response Relationship, Drug ; Echinococcosis/drug therapy/*parasitology ; Echinococcus granulosus/drug effects/physiology ; Humans ; Olea/*chemistry ; Plant Extracts/*pharmacology ; Plant Leaves/chemistry ; Satureja/*chemistry

Animals ; Anthelmintics ; pharmacology ; therapeutic use ; Culture Media ; Echinococcosis ; drug therapy ; parasitology ; Echinococcus granulosus ; drug effects ; growth & development ; pathogenicity ; ultrastructure ; Parasitic Sensitivity Tests

Hydatid disease is a parasitic infestation caused by the larval form of Echinocococcus. In human, the most commonly affected organs are liver and lung. Most cysts remain clinically silent and are diagnosed incidentally or when complications occur. In Korea, hydatid disease is rare and surgically treated cases have been reported in the Korean literature. However, it is expected to confront this disease sooner or later, because of recent increase in traveling to the endemic area and industrial workers originating from those areas. With this trend, we experienced a case of hydatid cyst of the liver in a male patient from Uzbekistan. This patient was presented with anaphylactic shock combined with hydatid cyst. We successfully treated using ultrasound-guided transhepatic percutaneous drainage [termed puncture, aspiration, injection, and re-aspiration (PAIR)] of the hydatid cyst and concomitant albendazole instead of surgery. In this clinical case report, we describe all the course of the patient and recommend the PAIR as a first choice method for treatment of hepatic hydatid cyst.
Adult ; Albendazole/therapeutic use ; Anaphylaxis/*complications ; Animals ; Anticestodal Agents/therapeutic use ; Drainage ; Echinococcosis, Hepatic/complications/drug therapy/radiography/*therapy ; Echinococcus/isolation & purification ; Humans ; Korea ; Male ; Uzbekistan

Alveolar echinococcosis is one of the most important lethal zoonotic helminth infections in the northern hemisphere. Currently, the threat to public health is increasing, as evidenced by the rising prevalence rate of alveolar echinococcosis, as well as the invasion of urban areas by infected wild foxes. This threat is further increased due to the involvement of pet dogs, and probably cats, as emerging sources of infection. These increased threats to public health also have associated economic risks; therefore, there is a need for effective and sustainable methods of control. In this paper, initiatives to control alveolar echinococcosis by targeting its definitive hosts through anthelmintic baiting campaigns initiated by local residents who used local resources for bait production, distribution and collection of fecal samples for diagnosis are described. Further, when such distribution programs are coupled with the use of GIS-based maps, the optimum distribution of bait was obtained. These programs have also included the use of intravital diagnostic analyses of infection rates, which have been overseen by the Forum on Environment and Animals (FEA), and also allowed a nationwide monitoring of echinococcosis in difinitive hosts. In addition, a government initiative requiring mandatory reporting of echinococcosis in dogs to health authorities was recently initiated in Japan. Overall, the results of this study have shown that use of collaborative control initiatives targeting zoonotic agents of alveolar echinococcosis can be an effective method for reducing the threat of lethal echinococcosis in the northern hemisphere.
Animals ; Anthelmintics/economics/therapeutic use ; Echinococcosis, Hepatic/drug therapy/epidemiology/*parasitology/*prevention & control ; Echinococcus/*physiology ; Government Programs ; Humans ; Public Health/methods ; *Zoonoses/epidemiology/parasitology

OBJECTIVETo explore and compare the clinical effect and safety of liposomal albendazole (L-ABZ) and tablet-albendazole (T-ABZ) in the treatment of cystic echinococcosis (CE1, CE2, and CE3).

METHODSA total of 269 cases treated with cystic echinococcosis (CE) in Xinjiang Medical University the First Affiliated Hospital from 1998 to 2008 were reviewed. 51 cases were excluded and 218 cases were enrolled in this research by retrospective case-control method. Among 110 cases were treated with L-ABZ and 108 cases were treated with T-ABZ for short-term (3 months) and long-term courses (6 months) respectively. The effects and safety of the two medicines were compared by analyzing the clinical symptoms, imaging check and serologic test results.

RESULTSIn short-term effect evaluation, the total effective rates and curative rates of L-ABZ group and T-ABZ group were 77.9% and 49.1% vs 28.4% and 13.9%, respectively. The effects of L-ABZ group was better than that of T-ABZ group, with remarkable difference in total effective rates and curative rates (x2 value was 19.581, 6.877, respectively, P is less than 0.05). In long-term effect evaluation, the total effective rates and curative rates of L-ABZ and T-ABZ group were 81.7% and 49.0% vs 47.6% and 20.6%, respectively. There was significant difference between L-ABZ group and T-ABZ group in total effective rates and curative rates (x2 value was 20.977, 15.049, respectively, P is less than 0.05). In T-ABZ group the short-term curative rates were 50.0% (15/30), 8.8% (8/91) and 33.3% (7/21) respectively in CE1, CE2, and CE3, the short-term total effective rates were 56.7% (17/30), 35.2% (32/91) and 61.9% (13/21) respectively in CE1, CE2, and CE3. The long-term curative rates were 58.3% (7/12), 28.6% (12/42) and 70.0% (7/10) respectively in CE1, CE2 and CE3, the long-term total effective rates were 75.0% (9/12), 69.0% (29/42) and 100.0% (10/10) respectively in CE1, CE2, and CE3. When compared with CE2, differences existed in CE1 (x2 = 24.887, 4.329; P is less than 0.05) and CE3 groups (x2 = 8.860, 5.076; P is less than 0.05) in terms of short-term effects. In L-ABZ group, the short-term curative rates were 47.4% (18/38), 12.2% (12/98) and 61.5% (8/13) respectively in CE1, CE2 and CE3, the short-term total effective rates were 92.1% (35/38), 65.3% (64/98) and 92.3% (12/13) respectively in CE1, CE2 and CE3, the long-term curative rates were 79.3% (23/29), 35.9% (23/64) and 50.0% (3/6) respectively in CE1, CE2 and CE3, the long-term total effective rates were 96.6% (28/29), 84.4% (54/64) and 100% (6/6) respectively in CE1, CE2 and CE3. When compared with CE2, there were significant differences in CE1 (x2 = 19.648, 9.930; P is less than 0.05) and CE3 groups (x2 = 18.880, 3.876; P is less than 0.05) in terms of short-term effect. In L-ABZ and T-ABZ groups, the drug-related adverse effects were 11.1% (12/108) and 12.7% (14/110) respectively without significant difference (x2 = 0.155, P is more than 0.05).

CONCLUSIONL-ABZ and T-ABZ were both effective anti-echinococcosis drugs without dominant side-effects. The clinical effect of L-ABZ was better than that of T-ABZ.

Adolescent ; Adult ; Aged ; Albendazole ; administration & dosage ; adverse effects ; therapeutic use ; Echinococcosis ; drug therapy ; Female ; Humans ; Liposomes ; administration & dosage ; Male ; Middle Aged ; Retrospective Studies ; Tablets ; administration & dosage ; Young Adult