BACKGROUND: Fascioliasis is a zoonotic helminthiasis by fasciola species and is occasionally complicated by liver abscess, and the treatment of choice is oral bithionol, which is not available in Korea. Most clinical reports showed that praziquantel given at usual dosage (75 mg/kg for 1day) failed to cure Fasciola hepatica infections, however, it has not been investigated whether long-term praziquantel (70 mg/kg/d for 7 days) would be effective. We evaluated the effectiveness of long term praziquantel therapy in patients with Fasiola liver abscess. METHOD: Three patients who were diagnosed as liver abscess by F. hepatica were included in the current study. The diagnostic criteria for inclusion were 1) eosinophilia, 2) positive serologic test for F. hepatica antigen, 3) characteristic findings on CT scan and 4) demonstration of aggregates of eosinophils on ultrasonography-guided aspirates of the abscess. Praziquantel was given orally to patients at the daily dose of 70-84mg/kg for 7 days. The effectiveness was assessed by the normalization of eosinophil count at the end of 3 months and the disappearance of abscess cavity on ultrasonography or CT scan one year after treatment. RESULTS: Blood eosinophil count decreased less than 500/mm3 in all patients within 2 to 3 months. The liver abscesses reduced in size by 90% in 5 months in one patient and disappeared within a year in two patients. No major adverse effects were observed. CONCLUSION: We conclude that 7-day praziquantel therapy may be effective and safe in the treatment of liver abscess caused by F. hepatica.
Abscess ; Bithionol ; Eosinophilia ; Eosinophils ; Fasciola hepatica ; Fasciola* ; Fascioliasis ; Helminthiasis ; Humans ; Korea ; Liver Abscess* ; Liver* ; Praziquantel* ; Ranunculaceae ; Serologic Tests ; Tomography, X-Ray Computed ; Ultrasonography

Two human cases of Heterophyes heterophyes nocens infection were proved by identifying adult worms after treatment with bithionol or praziquantel in 1983 in Korea. They are 37 (Case 1) and 24-year old (Case 2) males whose residence or native village is a southern coastal area in Kohung-gun, Chollanam-do. The Case 1 had the gastrointestinal symptoms such as epigastric pain and indigestion, and the Case 2 heart problems such as arrhythmia and ventricular premature beat in EKG and digestive symptoms such as diarrhea and abdominal pain. After the treatments, 35 and 67 specimens of H. heterophyes nocens respectively were collected from the diarrheal stools through stereomicroscopy. The Case 1 was concommitantly infected with Clonorchis sinensis and the case 2 with 3 other kinds of heterophyid flukes and with Diphyllobothrium latum. The cases said to have eaten raw brackish water fish such as mullets (Mugil cephalus), perches (Lateolabrax japonicus) and gobies (Acanthogobius flavimanus) which are the intermediate hosts of H. heterophyes nocens in Korea.
parasitology-helminth-trematoda ; Heterophyes heterophyes nocens ; Clonorchis sinensis ; case report ; bithionol ; praziquantel ; chemotherapy ; Mugil cephalus ; Lateolabrax japonicus ; Acanthogobius flavimanus

Five cases of Diphyllobothrium latum infection were proved by collection of worms after treatment with bithionol, niclosamide or praziquantel, during 1975-1983. The patients were 4 males and one female aged 10-64 years residing in Seoul or Wando-gun, Chollanam-do, Korea. All of them remembered the history of eating several kinds of raw marine fish and 2 persons said they ate the raw flesh of perch, Lateolabrax japonicus. Three among them experienced abdominal pain, 2 natural discharge of a chain of segments, but none revealed any sign of anemia. The average egg size in stool varied 59-67 x 41-48 micrometer according to cases. The eggs were characterized by ovoid to elliptical shape, terminal operculum, and distinct abopercular protuberance. One naturally discharged segment (30 cm) and 4 complete strobilae (320~680 cm) with scolices obtained after treatments were examined. The morphological characters of proglottids such as rosette-form uterus with 3-6 loops, vaginal pore included in the cirrus sac, separated seminal vesicle from cirrus sac etc. were all compatible with D. latum. These are the 7th~11th cases of D. latum infection proved by worms in Korea.
parasitology-helminth-cestoda ; Diphyllobothrium latum ; case report ; diphyllobothriasis ; chemotherapy-praziquantel ; niclosamide ; bithionol ; praziquantel

It is believed that the photopatch test is a valuable screening procedure for the determination of responsible antigenic substances in photoallergic contact dermatitis. But the technigues used for this procedure are cumbersome and require expensive equipment. In the present study, we adapted an easy and inexpensive photopatch test met- hod to our need. We report the results of this test method which was performed. in 21 patients with photodermatitis and 9 patients with polymorphic light eruption. 1. The UVB sensitivity determined by minimal erytherna dose (mean+-standard deviation) was I1618mW sec/cm in photodermatitis group, 108+ROmW sec/cm in polymorphic light eruption group and 126-+32mW-sec/cm in control group. But there was no significant difference among them (p>0. 05). 2. The reaction to UVA were negative in all groups. R. The photopatch test using IO potential photosensitizers revealed 12 positive responses in 9 patients; including 7 patients in photodermatitis group and 2 patients in polymorphic light eruption group. And the number of positive photopatch responses obtaied with each photosensitizer in RO patients with photodermatoses was 5 in chlorhexidine, 2 in paraaminobenzoic acid, musk ambrette and bithionol and 1 in chlorpromazine, respectively.
Bithionol ; Chlorhexidine ; Chlorpromazine ; Dermatitis, Photoallergic ; Humans ; Mass Screening ; Photosensitivity Disorders ; Photosensitizing Agents

The present study was undertaken to evaluate in vitro activities of following drugs against adult worms of Clororchis sinensis: i.e., stibnal, chloroquine diphosphate, Hetol (1,4-bis-trichloromethylbenzol), dehydroemetine 'Roche' (Ro 1-9334), niridazole (Ambilhar), bisbendazole, gentian violet, dithiazanine iodide, hexachlorophene, bithionol, niclofolan (Bilevon, Bayer 9015) and praziquantel (Embay 8440, Biltricide). After isolation from bile ducts of experimentally infected rabbits (3 months infection), the parasites were rinsed in sterilized Tyrode's solution and incubated for 24 hours at 37 C in TC 199 medium with Earle's balanced salt solution containing 0, 0.01, 0.1, 1.0, 10 and 100 microgram/ml concentrations of each above drugs. The activities of each concentrations with each drugs were evaluated by the motility of the worms in culture tubes observing at 15, 30, 60 minutes and 2, 4, 6, 12, 18 and 24 hours by stereomicroscope. In the results, no effect was found at the adult worms of C. sinensis in all concentrations with stibnal, chloroquine diphosphate, Hetol, dehydroemetine, niridazole and bisbendazole. However, moderate activities were observed in the concentrations of 1.0 and 0.1 microgram/ml of gentian violet, dithiazanine iodide, hexachlorophene and bithionol. The highest activities were observed in all concentrations of niclofolan and praziquantel.
parasitology-helminth-trematoda ; Clonorchis sinensis ; chemotherapy ; in vitro ; stibnal ; chloroquine diphosphate ; Hetol(1,4-bis-trichloromethylbenzol) ; dehydroemetine ; 'Roche'(Ro 1-9334) ; niridazole(Ambilhar) ; bisbendazole ; gentian violet ; dithiazanine iodide ; hexachlorophene ; bithionol ; niclofolan ; praziquantel

Two cases of cerebral infestation with Paragonimus westermani complicating obstructive hydrocephalus are presented. The diagnosis was aided by brain CT scan and Conray ventriculogram. Both cases showed a strong positive intradermal test with relevant histories of eating crayfishes in roast form. In simple skull X-ray, one showed characteristic shell-like calcifications over the temporo-occipital region and the other showed multiple round calcifications over the suboccipital region. Brain CT scan demonstrated much more characteristic calcifications with marked ventricular dilatation. Conray ventriculogram disclosed obstructive hydrocephalus in both cases, one at the level of the cerebral aqueduct and the other at the level of the fourth ventricle outlet. Both patients were subjected to ventriculoatrial shunts and concomitant Bithionol therapy with marked improvement. The case involving the cerebellum and the fourth ventricle outlet was submitted to the posterior fossa exploration to be verified as a rare cerebellar paragonimiasis.
Astacoidea ; Bithionol ; Brain ; Cerebellum ; Cerebral Aqueduct ; Diagnosis ; Dilatation ; Eating ; Fourth Ventricle ; Humans ; Hydrocephalus* ; Intradermal Tests ; Paragonimiasis ; Paragonimus westermani ; Skull ; Tomography, X-Ray Computed

Eleven cases of paragonimus brain abscess which were surgically treated from 1975 to 1978 were reviewed. All patients received supplementary bithionol therapy. Ten patient's clinical condition improved. Only one patient died due to post operative wound infections.
Bithionol ; Brain Abscess* ; Brain* ; Humans ; Paragonimus* ; Wound Infection

The infection of Metagonimus yokogawai has been known to be present nationwidely and endemic in some parts in Korea. In order to select a highly effective compound against Metagonimus infections, the therapeutic effects were observed in 156 cases who were treated with several anthelmintic i.e. bithionol, niclosamide, niclofolan and praziquantel. All of the above drugs showed highly effective to the treatment of metagonimiasis by a single or two medication days. The egg reduction rates were in the range of 80.2 to 100 per cent. However, relatively low cure rates(8.3 to 37.5 percent) were observed in the groups treated by two doses of 30 mg/kg of bithionol, a single day treatment with 100 mg/kg of niclosamide and two doses of 1.0 mg/kg of niclofolan. On the other hand, the high cure rates were observed at the following dose rates of each drugs, i.e. the cure rate of 66.7 percent was obtained at two doses of 100 mg/kg of niclosamide, 88.9 percent of cure rate was observed at two doses of 2.0 mg/kg of niclofolan and a single dose of 10 and 20 mg/kg of praziquantel were shown as 85.0 percent and 88.0 percent of cure rates respectively. But the complete radical cure was obtained in the group treated by two doses of 20 mg/kg of praziquantel in 10 metagonimiasis cases. From the above results praziquantel was shown as the most highly effective against metagonimiasis and it was well tolerated without any side effect. Therefore, praziquantel is a very promising drug for mass treatment against metagonimiasis.
parasitology-helminth-trematoda ; Metagonimus yokogawai-metagonimiasis ; bithionol ; niclosamide ; niclofolan ; praziquantel ; chemotherapy

Pagonimus Westmani, occuring as an important human infestation of the lung, is widely distributed in the Far East ; Korea, Japan, China and the Philippines. Since Otani found the parasites for the first time in the human brain in 1887, it has been established that cerebral infestation occurs with the highest frequency among extrapulmonary involvement. In 0.8 to 25 percent of patients infested with the lung flukes cerebral paragonimiasis may be developed. The larvae may procedure arachnoiditis, abscess, fibrous cystic lesions and granulomas in the brain. Based on a review of the literatures and upon the 7 cases of cerebral paragonimiasis which have been observed by the authors at the National Medical Center, Seoul, Korea, the following points are stressed. 1) Males had a significantly higher prevalence than females. Cerebral paragonimiasis was most commonly found in young adults(16 to 25yrs). 2) Clinically the patients with cerebral involvement were characterized by Jacksonian type of epilepsy, headache and visual disturbance. Mental deterioration, hemiplegia, hemihypesthesia, homonymous hemianopsia and optic atrophy were the five major signs. 3) The patients having symptoms for less than 6 months developed mild leukocytosis in many cases. All the cases of cerebral paragonimiasis revealed positive reaction in the intradermal tests with purified antigens of P. Westermani. 4) On skull films multiple round or oval cystic calcification was diagnostic value for cerebral paragonimiasis. On angiogram vascular staining and abnormal vessels were not disclosed. On pneumoencephalogram subcortical atrophy or filling defect of the ventricle may be showed. 5) The predilection area of the granuloma and fibrous cystic mass were the occipital, posterior parietal and posterior temporal lobes. 6) The patients with chronic stabilized cerebral paragonimiasis. having intractable symptoms and signs, could not be improved with Bithionol treatment. But headache, vomiting, visual disturbance, facial weakness and especially intractable seizure were improved in our cases treated with surgical operation.
Abscess ; Arachnoid ; Arachnoiditis ; Atrophy ; Bithionol ; Brain ; China ; Epilepsy ; Far East ; Female ; Granuloma ; Headache ; Hemianopsia ; Hemiplegia ; Humans ; Intradermal Tests ; Japan ; Korea ; Larva ; Leukocytosis ; Lung ; Male ; Optic Atrophy ; Paragonimiasis* ; Parasites ; Philippines ; Prevalence ; Rabeprazole ; Seizures ; Seoul ; Skull ; Temporal Lobe ; Trematoda ; Vomiting

Paragonimiasis is one of the most important endemic diseases in Korea. However, recognition of the limitation of microscopic examination of sputum and feces for Paragonimus eggs has led to the investigation of immunoserological techniques for paragonimiasis. The other hand, bithionol preparation has been used as a drug of choice in paragonimiasis but recently niclofolan preparation has introduced as a new agent. By the time, the authors attempted the evaluation of above both agents against experimental rat paragonimiasis by immunoelectrophoresis and Ouchterlony test. The immunoeletrophoresis and Ouchterlony tests were performed according to the method Tsuji and Grabar et Williams respectively, with antigen extracted from lyophilized worm of P. westermani with 0.1 per cemt saline solution. Meanwhile, rats were infected with per os 20 metacercariae of P. westermani above two kinds of serologic tests and were undertaken at biweekly intervals. Then, bithionol was administered every other day for 5 successively for 2 weeks or 6 weeks after infection. Another groups, niclofolan was administered per os single dose same as above. The sera from the rats infected with P. westermani, after treatment with bithionol or niclofolan preparations began to show the precipitin bands against P. westermani antigen 8 weeks after the infection in immunoelectrophoresis and Ouchterlony test, but from 10 or 12 weeks after infection, the number of bands were decreased or disappeared gradually. In genera1, the sera from the rats treated with bithionol or niclofolan showed the precipitin bands delaying 2 weeks than control rat groups. The sera from the rats administered with hydrocortisone showed precipitin bands neither in immunoelectrophoresis nor in Ouchterlony test.
parasitology-helminth-trematoda ; Paragonimus westermani ; paragonimiasis ; rat ; immunoelectrophoresis ; immunology ; bithionol-chemotherapy ; bithionol