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PubMed1989

[Diagnosis and treatment of hepatic echinococcosis with fistulas of the major bile ducts].

The authors report their experience of secondary major biliary fistula (MBF) for hepatic echinococcosis. The analysis of the results of the surgical treatments showed that "conservative" operations have major mortality than "radical" operations. The importance of an exact preoperative diagnosis of presence, side and size of MBF, in order to a correct choice of the most suitable operations, is underlined. Endoscopic retrograde cholangio-pancreatography seems to be a reliable diagnostical technique, also if compared with traditional methods (U.S., C.T.).

Bile Duct Diseases↗
PubMedDate not supplied

[Seroepidemiologic study of echinococcosis foci in southeastern Kazakhstan].

Mass screening of the southeastern Kazakhstan population with respect to echinococcosis by RDHA provided positive results in 3.1% cases. The highest seropositive reaction rate (6.1%) was obtained during examination of shepherds. In other population groups, this rate was equal and accounted for 2.6%. No difference was found in positive reaction rates between children and adults. The risk of echinococcal infestation in the area is the same for all groups of rural population except shepherds, which may be regarded as a risk group.

Age Factors↗
PubMed1989

[Echinococcosis].

Echinococcosis is parasite disease quite spread out in our country. It is known that Dalmatia and then Montenegro are the most infected areas in Yugoslavia. Echinococcus disease is not only disease of the organ attacked but one whose repercussions very often give poly-organic character in clinical, morphological and therapeutic sense. Due to a great number of infected dogs still existing insufficient number of hygienic slaughterhouses, slaughtering livestock without veterinary control, ignorance, lack of education as well as not enough prophylactic measures conducted, this disease represents an outstanding problem. In respect of identification of this disease number of cysts, location complications arising as well as operative approach, so far diagnostic methods are enriched by introducing electronic diagnostic methods (scintigraphy, US and CT). Numerous operating methods aimed to removal of parasite, elimination of irreversible sequelae and achievement of anatomo-physiological restitution of the organ in which the diseased are applied.

Adolescent↗
PubMedDate not supplied

[X-ray diagnosis of echinococcosis of the bones].

The paper is devoted to the authors' experience in echinococcosis of the bones in 18 patients. The most important method for the recognition of this disease is x-ray investigation.

Adult↗
PubMedDate not supplied

[Clinical trial of the possibility of increasing the bioavailability of mebendazole using sunflower oil in echinococcosis].

Increasing mebendazole bioavailability is one of the most important problems to be solved in echinococcosis chemotherapy. The method of mebendazole administration with sunflower oil, elaborated by the authors, serves to this purpose: drug concentration exceeding the minimal effective one was attained in 86% patients treated with mebendazole and sunflower oil and only in 40% patients treated with the drug alone.

Adolescent↗
PubMed1989

[Cardiac echinococcosis. Description of a case with cysts localized in the free wall of the left ventricle].

A case of isolated cardiac echinococcosis is reported. A 19-year-old man was hospitalized for chest pain with electrocardiographic pathological Q waves in D1, aVL, V5, V6. Two-dimensional echocardiography and chest computed tomography documented pericardial effusion and an intramyocardial cyst. Casoni's reaction and immunological tests completed the diagnosis of cardiac hydatidosis. The localization and the etiology of the cyst were confirmed during cardiac surgery.

Adult↗
PubMed1989

Cellular immune response in Echinococcus multilocularis infection in humans. I. Lymphocyte reactivity to Echinococcus antigens in patients with alveolar echinococcosis.

The involvement of cellular immunity in alveolar echinococcosis (AE) due to E. multilocularis is strongly suggested by the intense granulomatous infiltration observed around the hepatic parasitic lesions, and a progressive decrease of specific cellular immunity has been described in murine AE. However, specific cellular immunity against E. multilocularis has never been documented in human AE. The reactivity to phytohaemagglutinin (PHA) and E. multilocularis antigens of peripheral blood mononuclear cells (PBMC) from 48 patients with AE and 35 control subjects was evaluated by incorporation of 3H-methylthymidine into DNA. A sequential measurement of the proliferative response of PBMC was performed in 20 patients 2 years later, and again in five of them 4 years after the first determination. After stimulation by PHA, the mean proliferation index (PI) of the patients with AE was somewhat higher than that observed in the uninfected controls, but the difference was not significant. The PI obtained with E. multilocularis antigens was higher than the threshold value in all the patients but one, and in five control subjects. The difference between the PI values in the patients with AE and those obtained in the control subjects was highly significant. There was no correlation between the lymphocyte proliferation indices and the specific antibodies assessed using the Em 2-ELISA, or the volume of the parasitic lesions. All the five 'positive' control subjects were living in areas endemic for AE. A previous contract of these subjects with E. multilocularis in the past, followed by a spontaneous elimination of the parasite is possible. The long-term persistence of lymphocyte reactivity to parasite antigens was emphasized by the results of the follow-up of 20 patients with AE: reactivity of PBMC decreased progressively but persisted more than 4 years after complete resection of the parasitic lesions in the patients who underwent a radical surgical procedure. Conversely, an increase in the PI was shown to be usually associated with a progression of the liver lesions.

Adult↗
PubMed1989

Cellular immune response in Echinococcus multilocularis infection in humans. II. Natural killer cell activity and cell subpopulations in the blood and in the periparasitic granuloma of patients with alveolar echinococcosis.

In animal models, the development of Echinococcus multilocularis larvae has been shown to correlate with the immune status of the host, and particularly with cellular immunity. In humans, a defect in immune regulation may explain the persistence of cellular infiltration and fibrogenesis. We assessed natural killer (NK) activity in the peripheral blood mononuclear cells (PBMC) of patients with alveolar echinococcosis, and compared in 12 patients who underwent a surgical procedure the cell populations in the PBMC with those present in the periparasitic granuloma. The results indicated that (i) the NK cell activity of the PBMC was significantly altered at the lower NK cell: target cell ratios; (ii) the percentage of CD8+ cells was significantly decreased in the PBMC with an increased CD4:CD8 cell ratio; (iii) inversely, the CD8+ cells constituted the main population of T cells in the liver of most patients; and (iv) the periparasitic granuloma was mainly composed of macrophages, T cells and myofibroblasts in close association with the developing fibrosis. A relatively high number of CD4+ cells in the periparasitic granuloma of two patients with 'abortive' parasitic lesions suggested that, as it is observed in experimental E. multilocularis infection, differential evolution of the phenotypic pattern of the periparasitic granuloma could be related to resistance or sensitivity to infection by E. multilocularis in humans.

Adult↗
PubMed1985

[Phenotype of periparasitic hepatic infiltrating mononuclear cell in human alveolar echinococcosis].

Phenotypic analysis with monoclonal antibodies showed that OKT8+ T cells represent the main cell population of the periparasitic mononuclear cell infiltrate in the liver of 7 patients with alveolar echinococcosis. A significant decrease of the OKT8+ subpopulation had been previously demonstrated in the peripheral blood mononuclear cells of these patients. The results obtained in this study suggest an intrahepatic homing for these particular T cells. However, functional analysis of these cells is required in order to assess the physiopathological significance of these observations.

Antibodies, Monoclonal↗
PubMed1985

[Circulating and basophil-fixed specific IgE in human alveolar echinococcosis].

Biological parameters of immediate type hypersensitivity were assessed in 19 patients with alveolar echinococcosis. Serum total IgE concentrations were higher than normal values in 12 patients, and parasite-specific IgE were present in 9 patients. A significant relationship was observed between these two parameters. Evolution of specific IgE during a 1-year period appeared to correlate with surgical removal of parasitic material; it did not correlate with the clinical evolution in patients treated with mebendazole. Specific basophil fixed-IgE were demonstrated using both a basophil degranulation test and a histamine release test in the 19 patients under study, including serologically negative and circulating specific IgE-negative patients.

Basophils↗
PubMedDate not supplied

Cytologic diagnosis of echinococcosis.

An asymptomatic echinococcal cyst of the liver discovered during laparotomy was initially diagnosed by cytologic smears. The case probably represents an aseptic necrosis of the parasitic elements in which the cytologic diagnosis had to be based on the presence of the characteristic echinococcal hooklets alone. Subsequent histologic examination of the cyst revealed degenerated scolices, as well as detached hooklets. This paper illustrates the usefulness of cytologic smears in the definitive diagnosis of echinococcosis and cites other cases in the literature in which the disgnosis was made by cytology. Also included is a brief review of the pathology and laboratory diagnosis of the disease.

Adult↗
PubMed1988

[Ultrasonic diagnosis of hepatic echinococcosis].

Echotomography was used in the complex examination of 84 patients operated upon for echinococcosis of the liver. An analysis of the data obtained has shown echotomography to be highly sensitive in patients with cavital newformations. The method is expedient to be used first in the complex examination of patients with any pathology of the liver for the detection of patients with echinococcus disease, for the establishment of the topographic localization and recurrences of the pathological process.

Adolescent↗
PubMed1979

Immunoreactivity in pulmonary echinococcosis. 2. Evaluation of antibody response.

The part played by certain factors in determining the antibody response in pulmonary echinococcosis has been studied. Five immunodiagnostic procedures were used-complement fixation, latex agglutination, bentonite flocculation, passive haemagglutination, and intradermal tests-and parasitological and pathological examinations were carried out. The number of hydatid cysts had only a small influence on the qualitative nature of the immune response while the quantitative effect was considerable. The immune response did not vary significantly in relation to the size of hydatid cysts but it was affected by changes within the cysts and the surrounding lung tissue. In patients with cysts full of clear hydatid fluid the proportions with negative results and relatively low antibody titres were highest. In these patients the size of hydatid cyst appeared to be significant-the smaller the size, the lower the antibody level. The immune response is weak or completely absent when the hydatid cyst has a thick fibrous capsule. When suppurative changes are present in the hydatid fluid and/or in the fibrous capsule, and when there is inflammatory involvement of the surrounding lung tissue an easily detectable immune response may be seen at an early stage, sometimes even with a high antibody level, but later it usually decreases and may disappear completely. A hypothesis for the explanation of immunological reactivity in pulmonary hydatid disease is discussed.

Antibodies↗
PubMed1987

Serological investigations in Nigeria for anthropozoonoses in human sera: brucellosis, echinococcosis, toxoplasmosis, chlamydial diseases, listeriosis, rickettsiosis (Coxiella burneti and Rickettsia conori).

176 blood sera taken from patients in the hospital of Minna and Abeokuta (Nigeria) were examined for anthropozoonoses. The following positive reactions could be found: Brucella abortus 9%, Brucella melitensis 11.7%, Echinococcosis 0.53%, Toxoplasmosis 79.2% (CF-Test 6.9%), Chlamydial diseases 45%, Listeriosis 28.7% (Typ 1H) and 19.7% (Typ 4bH), Rickettsiosis--Rickettsia conori 18.6% and Coxiella burneti 63.3%.

Antibodies, Bacterial↗
PubMed1986

[Imaging diagnosis in echinococcosis of the liver].

Liver echinococcosis, the most frequently occurring form of parasitosis, is caused by the following two types of tapeworm: echinococcus granulosus and echinococcus multilocularis. Both types are to be found in Austria, the latter even being endemic. Imaging techniques such as computed tomography and sonography enable the diagnosis to be made easily, quickly and accurately, although the number of conditions to be considered in the differential diagnosis is considerable. A comparison of the two methods in 32 patients, 25 with echinococcus multilocularis and 7 with echinococcus granulosus demonstrates that ultrasound is slightly inferior to computed tomography. However, ultrasound should be the primary method of investigation and is of great importance in follow-up, whilst computed tomography is necessary pre-operatively to assess the extrahepatic involvement.

Adult↗
PubMed1986

[Morphological and functional study of the liver using scintigraphy with 99m-Tc-HIDA before and after major resection for echinococcosis].

Personal experience in the monitoring of liver function and morphology after resection using hepatobiliary HIDA 99mTc scintigraphy is reported. This investigation provides useful functional and morphological data. In three patients subjected to right hepatectomy for echinococcosis the examination performed preoperatively and 25 and 90 days after surgery revealed functional normalisation of the residual liver and biliary excretion. On the basis of this experience and data from the literature the value of the technique is confirmed and it is suggested that it might be usefully adopted in the study of other liver conditions such as neoplasms, traumas as well as in the monitoring of transplanted livers.

Bile Ducts↗