Clinical study of albendazole therapy for strongyloidiasis]

We reported the efficacy of albendazole (ABZ) for the treatment of 27 patients with strongyloidiasis. Twenty-seven patients, 23 males and 4 females, received 200 mg of ABZ one hour before breakfast and supper for 3 days and this treatment was repeated 2 weeks later. The following results were obtained: 1) The eradication rate at 2 weeks after the initial treatment was 70.4% (19 of 27 patients) and 2 weeks after the second course was 66.7% (16 of 24 patients). 2) One patients (3.7%) complained of abdominal pain after the first treatment. Four patients (14.8%) complained of headache (n = 2), nausea (n = 1) and exanthema (n = 1) after the second treatment. But all symptoms were mild and required no treatment and subsided in a few days. 3) Positive rate of HTLV-1 antibody was 45.8% in the patients. As described above, side effects occurred in some cases, although they were mild and transient. From these results, it can be concluded that on increased dose of ABZ could be much more favorable for the treatment of strongyloidiasis.     

The value of ultrasonography and computerized tomography in estimating the histopathological severity of nonalcoholic steatohepatitis

BACKGROUND & AIMS: Liver biopsy is the gold standard for the diagnosis of non-alcoholic steatohepatitis (NASH), but is an invasive method. There is a need for non-invasive methods that can reflect the histopathological severity of NASH. The aim of this study was to compare the ultrasonography and computerized tomography findings with the histopathological severity in patients with NASH. MATERIAL AND METHODS: Twenty-two consecutive patients with biopsy proven NASH and 20 age- and sex-matched healthy individuals were enrolled. Clinical and demographic data were collected at the time of liver biopsy. Histopathological grading and staging were made by an expert pathologist. Each patient underwent ultrasonography and computerized tomography. RESULTS: Liver ultrasonographic findings were not correlated with histopathological grade and stage (r: 0.134, P > 0.05; r: 0.130, P > 0.05). Mean liver densities obtained by computed tomography of NASH patients were lower than that of controls (P < 0.05) and liver/spleen density ratios were lower than that of controls (P < 0.05). These results were significantly correlated with histopathological grade (r: -0.716, P < 0.001; r: -0.663, P: 0.001), but not with the histopathologic stage (r: -0.416, P: 0.05; r: -0.356, P: 0.1). CONCLUSIONS: Ultrasonography findings do not reflect histopathological severity in patients with NASH. Computed tomography attenuation of the liver is significantly correlated with histopathologic grade but not with histopathological stage.     

Detection of malignant focal hepatic lesions. Comparison of ultrasonography, computerized tomography during arterial portography, delayed computerized tomography and magnetic resonance imaging

AIMS: This study was performed to compare the sensitivity of ultrasonography, computerized tomography during arterial portography, delayed computerized tomography, and magnetic resonance imaging to detect focal liver lesions. Forty three patients with primary or secondary malignant liver lesions were studied prior to surgical intervention. METHODS: The results of the imaging studies were compared with intraoperative examination of the liver, intraoperative ultrasonography and pathology results (29 patients). In the non-operated (14 patients) group, we compared the number of lesions detected by each technique. RESULTS: One hundred and forty six lesions were detected. There was 84% sensitivity with computerized tomography during arterial portography, 61.3% with delayed scan, 63.3% with magnetic resonance imaging and 51% with ultrasonography in operated patients. In patients who did not undergo surgery, magnetic resonance imaging was more sensitive in detecting lesions. CONCLUSIONS: In operated and non-operated patients series, CT during arterial portography had the highest sensitivity, but magnetic resonance imaging had the most consistent overall results.     

阿苯达唑和地塞米松对广州管圆线虫病疗效的动物试验

目的观察阿苯达唑和地塞米松治疗广州管圆线虫病的效果,探讨药物的作用机制。方法:以Balb/c小鼠为动物模型,在感染后不同时间,用不同剂量的阿苯达唑治疗,并设立地塞米松进行联合治疗对照组。小鼠于感染后第22d解剖,计数脑组织中存活虫体,以减虫数统计药物疗效;同时观察脑组织切片病理变化;应用透射电镜观察阿苯达唑对虫体超微结构的影响,对药物的作用机制进行探讨。结果阿苯达唑为治疗广州管圆线虫病的有效药物,感染早期用药效果显著。杀虫药和地塞米松的合用可有效减轻脑部炎症反应。阿苯达唑主要通过虫体体壁及肠道吸收而发挥作用。结论阿苯达唑和地塞米松的联合应用可以有效治疗广州管圆线虫病。     

Parasiticidal effect of chemotherapy in alveolar hydatid disease: review of experience with mebendazole and albendazole in Alaskan Eskimos.

Evidence that the larval stage of Echinococcus multilocularis in humans is killed by chemotherapy is presented in a review of our 17-year experience with treatment of alveolar hydatid disease in Alaska. The efficacy of chemotherapy was assessed with use of an in vivo assay of parasite viability by means of inoculation of voles, immunohistochemical tests, and histopathologic findings. Of 14 tests performed for nine patients, 12 in vivo assays (86%) were negative after chemotherapy, while only two (17%) of 12 vole tests for seven untreated patients were negative. Regression of arrest of growth of metastatic and primary hepatic lesions, together with their partial-to-complete calcification and prolonged survival times has been observed among patients treated with the benzimidazole compounds. For six who received appropriate chemotherapy, treatment has been discontinued for an average of 4.6 years (range, 3-7 years) without an increase lesion size or other evidence of reactivation.     

1518例细粒棘球蚴病综合治疗效果观察

细粒棘球蚴寄生于人和多种食草类动物 ,随畜牧业的发展而扩散 ,已成为世界性的公共卫生问题。 1985～ 1999年 ,经我中心治疗过的肝及腹腔细粒棘球蚴病患者 15 18例 (不包括多次在新疆及青海基层现场治疗的患者 ) ,治疗效果报告如下。材料与方法一般资料　 15 18例中 ,男性 96 3例 ,女性 5 5 5例 ,年龄 2 .5～ 3岁 183例 ,4～ 14岁 2 2 0例 ,14岁以上 1115例。按世界卫生组织 (WHO)暂行细粒棘球蚴病临床与基础研究B超分类标准 ,T1型 415例、 T2型 378例、 T3型 2 30例、T4型 2 31例、T5型 148例、T6型 116例。患者来自青海、新疆、甘肃、…     

Lipomatous hypertrophy of the interauricular septum: diagnosis with transesophageal echocardiography and computerized tomography]

Transesophageal echocardiographic and computed tomographic imaging in a patient with lipomatous hypertrophy of the interatrial septum and advanced left bundle branch block are presented. Transesophageal echocardiography demonstrated a thickening of the atrial septum sparing the fossa ovalis region. Computed tomographic scan at the level of the interatrial septum showed a mass of fat density, and the HIS bundle electrogram showed an advanced infra-his block after intravenous ajmaline. We stress the utility of transesophageal echocardiography in this disorder, and the possible relationship between lipomatous hypertrophy of the interatrial septum and conduction disturbances.     

Evaluation of the therapeutic effect of albendazole on experimental and human infections by Hymenolepis nana

With the objective of knowing adequately the spectrum of activity of albendazole against intestinal helminthiases, we made observations regarding hymenolepiasis caused by Hymenolepis nana. Two series of investigations were carried out: a) treatment of mice with single doses of either 25 or 50 mg/kg, repeated after ten days, using as controls animals treated with 25 mg/kg of praziquantel or not treated with any antiparasitic drugs; b) treatment of adults and children with 400 mg daily for three consecutive days, repeated after ten days.     

Considerations in diagnosing brain abscess with computerized axial tomography

Four studies with computerized axial tomography (CT scan) were performed in a 20-year-old man in whom multiple brain abscesses developed while hospitalized for complications of regional enteritis. A large frontal lobe abscess appeared as a nonspecific region of decreased density on the initial CT scans. When iodine was used to enhance the diagnostic sensitivity of the CT scan, this areas was identifiable as an abscess. However, a 1-cm lesion in the right parietal area that extended into the choroid plexus was not delineated. Radionuclide scans detected both lesions, but did not allow pathological identification. We conclude that CT scans should be performed with iodine enhancement whenever brain abscesses are suspected, and that some abscesses that are undetected by CT scans even with iodine enhancment may be delineated but not identified by sodium pertechnetate Tc 99m imaging.     

The value of ultrasound and computerized tomography in detection of cystic changes in chronic pancreatitis]

Intra- or extrapancreatic pseudocysts (PP) are the most common local complication in chronic pancreatitis. Aim of this study was to investigate frequency, localisation and size of pseudocysts in patients with chronic pancreatitis by means of ultrasound (US) and computed tomography (CT). 155 patients (females 35, males 120) with chronic pancreatitis, that underwent simultaneous (within two weeks) CT and US examinations, from January 1982 to June 1989, were included in this study. Cystic lesions were detected in 62% by CT, in 52% by US. Sensitivity in detection of cysts based on intraoperative findings (gold standard) was 98% for CT and 94% for US. 80% of the pseudocysts were smaller than 6 cm. 46% were in the range from 2 to 66 cm and 34% were smaller than 2 cm. The most common localisation was the pancreatic head region (50%), 20 of 102 patients with chronic pancreatitis were found to have a direct communication of a pseudocyst with the ductal system by ERP. No specific clinical or laboratory pattern were associated with the presence of pseudocysts. Increased pancreatic serum amylase concentration was detected in 29% of patients with and in 27% of patients without pseudocysts.     

Comparative study of transrectal ultrasonography, pelvic computerized tomography, and magnetic resonance imaging in preoperative staging of rectal cancer

PURPOSE: The preoperative assessment of rectal cancer wall invasion and regional lymph node metastasis is essential for the planning of optimal therapy. This study was done to determine the accuracy and clinical usefulness of transrectal ultrasonography, pelvic computed tomography, and magnetic resonance imaging in preoperative staging. METHODS: A total of 89 patients with rectal cancer were examined with transrectal ultrasonography (n=89), pelvic computed tomography (n=69), and magnetic resonance imaging with endorectal coil (n=73). The results obtained by these diagnostic modalities were compared with the histopathologic staging of specimens. RESULTS: In staging depth of invasion, the overall accuracy was 81.1 percent (72/89) by transrectal ultrasonography, 65.2 percent (45/69) by computed tomography, and 81 percent (59/73) by magnetic resonance imaging. Overstaging was 10 percent (9/89) by transrectal ultrasonography, 17.4 percent (12/69) by computed tomography, and 11 percent (8/73) by magnetic resonance imaging; and understaging was 8 of 89 (8.9 percent) by transrectal ultrasonography, 12 of 69 (17.4 percent) by computed tomography, and 6 of 73 (8 percent) by magnetic resonance imaging. In staging lymph node metastasis, the overall accuracy rate was 54 of 85 (63.5 percent) in transrectal ultrasonography, 39 of 69 (56.5 percent) in computed tomography, and 46 of 73 (63 percent) in magnetic resonance imaging. The sensitivity was 24 of 45 (53.3 percent) in transrectal ultrasonography, 14 of 25 (56 percent) in computed tomography, and 33 of 42 (78.5 percent) in magnetic resonance imaging; and specificity was 30 of 40 (75.0 percent) in transrectal ultrasonography, 25 of 44 (56.8 percent) in computed tomography, and 13 of 31 (41.9 percent) in magnetic resonance imaging. The accuracy in detection of positive lateral pelvic lymph nodes under magnetic resonance imaging (n=8) was 12.5 percent. The accuracy in detection of posterior vaginal wall invasion was 100 percent in transrectal ultrasonography (n=7) and 100 percent in magnetic resonance imaging (n=3), but 28.5 percent in computed tomography (n=7). CONCLUSIONS: Both transrectal ultrasonography and magnetic resonance imaging with endorectal coil exhibited similar accuracy and were superior to conventional computed tomography in preoperative assessment of depth of invasion and adjacent organ invasion. Because transrectal ultrasonography is a safer and more cost-effective modality than magnetic resonance imaging, transrectal ultrasonography is an appropriate method for preoperative staging of rectal cancer. Further efforts will be needed to provide a better staging of lymph node involvement.Read at the meeting of The American Society of Colon and Rectal Surgeons, San Antonio, Texas, May 2 to 7, 1998.     

Extrapleural hematoma: emergency diagnostic pitfall. Value of computerized x-ray tomography]

A case of extrapleural haematoma consecutive to a chest injury is reported. This is a rare site of blood effusion since such injuries usually result in haemothorax. These two diagnosis can be distinguished not only by exploratory thoracotomy but also by computerized tomography which shows a characteristic subpleural fat-like ribbon.     

The experimental chemotherapy of larval alveolar echinococcosis. The search for an optimal regimen of albendazole use]

The antiechinococcal activity of albendazole resynthesized at the E. I. Martsinovski? Institute of Medical Parasitology and Tropical Medicine was studied on infection models in rats and mouse in different experimental modifications. The efficiency of the therapy was determined in relation to the dose of the drug and its routes administrations, to the single or intermittent daily dose, to the presence or absence of intervals in the treatment regimen, to dosage forms. The trials indicated that albendazole was most active against larval alveolar echinococcosis of mice or cotton rats when it was used with their feed, i.e. through the gastrointestinal tract.     

Echinococcus multilocularis: ultrastructural effect of in vivo albendazole and praziquantel therapy, singly and in combination

Cotton rats with Echinococcus multilocularis infections of one month's standing were treated for six months with albendazole (50 mg kg-1 day-1), or praziquantel (500 mg kg-1 day-1), or both drugs simultaneously. The germinal layer of albendazole-treated cysts differed little from control tissue apart from marginal increase in cyton vesiculation and the presence of small lamellated residual bodies. Protoscolex tissue appeared unaffected. The germinal layer of praziquantel-treated cysts differed markedly from control tissue, with increased vesiculation and mitochondrial number in those with intact germinal layers, and disintegration and detachment of the layer in other cysts. Protoscoleces were necrotic. After combined therapy, the germinal layer was either intact but with increased vesiculation and residual bodies present, or was disintegrating and detaching from the laminated layer.     

Long-term albendazole treatment in one case of alveolar echinococcosis. Case report

AIMS: Curative therapy of alveolar echinococcosis is total surgical removal of the infected tissue and concomitant chemotherapy. However, this curative resection can be done on a limited number of patients, for the remaining ones various palliative procedures can be performed. METHOD: In this article it is aimed to present the result of long-term albendazole treatment in patient who had a palliative hepatojejunostomy for obstructive jaundice due to unresectable alveolar echinococcosis. RESULTS: Systemic albendazole treatment was initiated in this patient after palliative hepatojejunostomy procedure. During follow up there was no abnormality in blood chemistry and a considerable regression in size of the lesion was found in postoperative month 24. Residual hepatic lesion was histopathologically documented and showed apparently non-viable parasitic cysts by biopsy. These findings suggest the long-term albendazole therapy being parasitocidal. CONCLUSIONS: Palliative or mass reduction surgery combined with long-term albendazole therapy is the standard therapy for advanced disease, especially when curative resection might result in significant morbidity and mortality.