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KMID : 0352519800170030459
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Korea Univercity Medical Journal
1980 Volume.17 No. 3 p.459 ~ p.471
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Studies on the human cysticercosis and its therapeutic trial with praziquantel(Embay 8440)
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林漢鐘/Rim, Han-Jong
元昶龍/朱正和/Won, Chang-Ryong/Chu, Jeong-Wha
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Abstract
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Clinical and histopathological analysis were made on 47 cysticercosis patients who, visited our institute during the years of 1972 to 1979. Among 47 cases 28 (59.60) were males and the ages ranged from 20 to 40. Of the total, 20 cases (42.6%) experienced vomiting by unknown cause before the occurrence of cysticercosis. This fact may be-suggested that one of the modes of occurrence of cysticercosis is considered by the= mechanism of internal autoinfection depending on the reverse peristalsis. Furthermore-in this analysis, at least 18 cases (38.3%) were considered cerebral cysticercosis by the episodes of convulsive seizure in their history.
For therapeutic trial, praziquantel, 3 x 25 mg/kg/day, was administered orally for 3 or 4 consecutive days to 20 cases with or without cerebral cysticercosis. The assessment of´ drug efficacy of praziquantel was judged by comparing the numbers of cysticercus nodules in the subcutaneous tissues, histopathological findings of the biopsied parasites: and the frequencies of epileptic seizures with those before and after treatment with the drug.
From one month after the administration of the drug, some cysticercus nodules began, to disappear in the subcutaneous tissues, and that, a large numbers of the nodules disappeared during the period of 3 to 6 months after the administration. In some patients,. however, very few numbers of the nodules were remained over one year after the treatment.
Among 20 cases treated with the drug, 8 had cerebral involvement of the parasite and had convulsive seizure. However there were no cessation of the seizure during the
period of 6 months after the treatment. Among those cases with seizures, 4 cases were treated again with the same doses of the drug for 4 consecutive days at 6 months after the first trial of treatment. No epileptic seizures were experienced in these cases over one year after the second treatment.
Histopathologically the appearance of vesiculation in tegument as well as desquamation of tegument were observed in 2 week´s specimens of the nodules. Some cysticerci biopsied at one month after the treatment were damaged with high disintegration, and some nodules were necrotized completely. Even some cysticerci which were remained in the subcutaneous tissue over one year were also observed to have some histopathological changes.
None of the cases treated with the drug was observed with laboratory abnormalities in the findings of hematology, blood biochemistry and urinalysis.
It may be well to say that praziquantel is effective for the treatment of human cysticercosis. However unwanted side effects, such as headache, nausea and vomiting were encountered in the group of patients with cerebral involvement. These side effects could be prevented and minimized by the application of dexamethasone during the course of treatment with praziquantel.
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