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KMID : 0352519820190030595
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Korea Univercity Medical Journal
1982 Volume.19 No. 3 p.595 ~ p.612
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Clinical observations on the chemotherapy of cerebral cysticercosis
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朴昌潤/Park, Chang-Yun
朱炅煥/林漢鍾/Joo, Kyoung-Hwan/Rim, Han-Jong
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Abstract
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The purpose of this study was to evaluate the therapeutic effect of praziquantel (Embay 8440, Biltricide(D) on human cerebral cysticercosis. The praziquantel is a broad spectrum anthelmintic agent and has a high activity against cestodes and trematodes.
Before and after the treatment with oral administration of the praziquantel the changes in structure of Cysticercus cellulosae biopsied in subcutaneous tissue were studied by scanning and transmission electron microscope, and cerebral cysticercosis by computerized tomographic scanning.
The results were as follows
1. The findings of the observations on subcutaneous Cysticercus biopsied after treatment were compared with those of before treatment. At the early stage of the treatment, small vacuoles were scattered along the basement layer in the tegumental syncytium of the scolex and neck regions. In the scanning electron microscopic observation, marked surface changes were present in the neck region with many bleb-like structures formed by the bursting of the large vacuoles in the tegumental syncytium. In the specimens biopsied at 2 or 5 weeks after treatment, the degenerations and necrosis of the tegumental syncytium were seen in all part of Cysticercus.
2. The scanning electron microscopic findings of Cysticercus cellulosae obtained from the 4th ventricle of the cerebral cysticercosis patients by the surgical operation were identical with those of subcutaneous tissues.
3. In 12 cases of cerebral cysticercosis treated with prziquantel in dosage of 3 x 25 mg/kg for 3 or 4 consecutive days, there were no cessations of the convulsive seizures during the 6 months follow up. Among them 9 cases were given again with the same doses of the drug for 4 or 7 days. In 7 of 9 cases, no more convulsive seizure was experienced over
one or two years after the second treatment. At the same time the lesions of the brain C.T. scanning were disappeared, decreased in size or calcified. In the other 3 cerebral cysticercosis cases, the complete cure was also obtained after the oral medication of praziquantel with the doses of 3x25 mg/kg for 7 consecutive days.
4. In the treatment of cerebral cysticercosis with praziquantel, it was found that the combined oral medication of dexamethasone during the course of treatment was effective on preventing and minimizing the side effects.
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