흔히 먹는 생선회에 문제가 되는 기생충

蔡鍾一 대한의사협회 1999 대한의사협회지 Vol.42 No.6

식품-매개 기생충 질환

채종일 대한의사협회 2004 대한의사협회지 Vol.47 No.6

國産 Praziquantel (Cestocide^(�)의 無鉤條蟲 및 廣節裂頭條蟲에 對한 治療效果

蔡鐘一,孫運睦,洪性琮,李純炯,徐丙卨 대한화학요법학회 1985 대한화학요법학회지 Vol.3 No.2

Praziquantel(Cestocide^ⓡ), Korean product, was tested for its efficacy in the treatment of Taenia saginata and Diphylobothrium latum infection during the period from May 1983 to October 1985, A total of 30 patients were treated with 10~30㎎/㎏ single dose of praziquantel and purged with 20~30g of magnesium sulfate to recover the worms. The results were as follows: 1. The patients were 26 cases of T. saginata and 4 cases of D. latum and after the treatment all of them discharged tapeworm segments with or without their scolices. The scolex recovery rate was 43.3%(from 11 and 2 cases of T. saginata and D. Iatum respectively). 2. The follow[up examination for eggs and/or proglottides performed 2~3 months later or 11 out of 17 scolex-unidentified cases gave all negative results. From the results it is concluded that praziquantel(Cestocide^ⓡ) in 10㎎/㎏ single dose is highly effective in treatment of these tapeworm infections.

腸內 線蟲類 感染症에 대한 化學療法

蔡鐘一,洪性台 대한화학요법학회 1985 대한화학요법학회지 Vol.3 No.2

Anthelmintics used in the treatment of intestnal nematode infections such as Ascaris iumbricoides, Trichuris trichiura, hookworms, Enterobius vermicularis and Trichostrongylus orientalis were reviewedfor the drug efficacy, simplicity of regimen, side effects and applicability to indvidual treatment or under field conditions. Provided that the diagnosis of such intestinal nematode infections is accurate, there seems no problem in the treatment of most kinds of infections anthelmintics currently available in this country. To ascariasis, pyrantel pamoate, mebendazole, tetramisole and albendazole are applicable in single doses both in individual treatment and in community based control activities. Oxantel pamoate is a most promising anthelmintic against trichuriasis, however, mebendazole and albendazole may also be used in the field control. Enterobiasis is treated by mebendazole, albendazole, pyrantel or pyrvinium pamoate but 3~4 times repeated treatments every 20days are indispensible for its long-term control in a family or in an endemic community. Anthelmintics against hookworm infections and trichostrongyliasis are nearly the same as incase of ascariasis. Most of these anthelmintics reveal mild and transient side effects. so that no prolonged clinical problems are encountered.

국산 알벨다졸(안젠탈^(�))의 臟內線蟲類에 대한 驅蟲效果

蔡鐘一,洪性台,孫運睦,李純炯 대한화학요법학회 1986 대한화학요법학회지 Vol.4 No.1

An anthelmintic trial of albendazole was carried out an total of 186 inhabitants of Namhaegun, Kyongsangnam-do. For this purpose they were examined for their intestinal parasites, by cellophane thick smear and/or anal swab techniques before and 2 weeks after anthelmintic treatment. The examinations revealed A. lumbricoides 5.9%, T. trichiura 26.9%, E. vermicularis 52.4%, Echinostomia sp. 0.02% and Taenia sp. 0.01%. The infected cases were treated with 400㎎ single dose of albendazola. The egg negative conversion rate(NCR) and the egg reduction rate(ERR) were calculated based upon the results of pre and post-fecal examinations. For Ascaris, NCR was 87.5%, ERR 97.1%, and NCR 51.1% and ERR 78.6% for Trichuris. NCR was 100% for Enterobius. Albendazole(Alzental) is regarded as one of recommendable anthelmintics for the nationwide mass treatment programme of intestinal nematodes especially for ascariasis.

吸蟲症 및 條蟲症 治療에 있어서의 Praziquantel

李純炯,蔡鐘一 대한화학요법학회 1985 대한화학요법학회지 Vol.3 No.2

Praziquantel, a broad-spectrum anthelmintic against various kinds of trematodes and cestodes, was reviewed in terms of its pharmacokinetics, in vitro and in vivo effects on wormsi mode of action, clinical application and side effects. Orally administered praziquantel is absorbed rapidly though gastrointestinal tract, metabolized in the liver and excreted in urine and feces. It causes rapid contraction of worms and extensive vacuolization of their tegument and/or parenchymal layers, which results in the worm death. Such effects are known to be calcium(Ca^++)dependent. Clinically it can be used in the treatment of infections by liver flukes, lung flukes, intestinal flukes, schistosomes, adult and/or larval tapeworms. Various kinds of side effects may occur but they are usually mild and transient. Points to be further studied were discussed.

Heterophyes noces 人體 感染 2例 및 慶南 三千浦産 崇魚에 있어서 異形 吸蟲類 被囊幼蟲 感染 狀況

손운목,채종일,이순형 인제대학교 1989 仁濟醫學 Vol.10 No.3

1988年 3月과 12月에 Heterophyes nocens에 의한 人體 感染 2例를 檢出하였으며, 이 吸蟲의 人體 感染源 조사의 일환으로 慶南 三千浦産 崇魚에서 異形 吸蟲類 被囊幼蟲 感染 狀況을 조사하였던 바, 조사한 5마리의 崇魚 모두에서 10∼25個(평균 24個)의 H. nocens 피낭유충과 8∼4,751個(평균 1,545個)의 P. summa 피낭유충이 검출되었다. H. nocens의 피낭유충은 주로 숭어의 筋肉과 頭部에서 검출되었으며, P. summa는 頭部와 內臟에서 검출되었다. Two cases of natural human infection by Heterophyes nocens were identified by collection of adult worms after praziquantel treatment on March and December, 1988. And in order to know the source of infection mullets from Samcheonpo, Kyongnam Province, were examined. The cases were 33 and 52-year old males residing in Seoul. They had the clinical complaints of abdominal pain and precoidial discomfort. Praziquantel in single dose 10-15 mg/kg was given followed by purgation with magnesium salt and 14 and 4 H. nocens were collected from the diarrheal stools. They said to have eaten raw flesh of several kinds of fishes. The results of the observation of worms from patients and experimental animals, and the examination of mullet for metacercarial infections were as follows. 1. Worms from patients were dorsoventrally flattened, 1.32×0.57 mm and 0.99×0.43mm in average size. Ventral suckers well developed with their locations on median line of the body and much larger than oral suckers. The average numbers of rodlets around genital sucker were 54 and 53 in both cases. 2. All mullets examined harboured the metacercariae of H. nocens and P. summa. The average numbers of metacercariae detected were 24 and 1,545 respectively. 3. After the metacercariae were collected and experimentally fed to albino rats and cats, adult worms were recovered from both animals. These worms were identified as H. nocens and P. summa. H. nocens from experimental cat was the average size of 0.88×0.41 mm, and had the average number of 55 rodlets in genital sucker. From the results, 2 human cases of H. nocens infection were added and the mullets from Samcheonpo were proved to be the second intermediate host of H. nocens and P. summa.

요꼬가와吸蟲症 治療에 있어서 Praziquantel(Distocide^(�))의 效果

李純炯,蔡鐘一,洪性琮,全英淑,徐丙卨 대한화학요법학회 1984 대한화학요법학회지 Vol.2 No.2

國産 praziquantel(Distocide^(ⓡ))의 요꼬가와吸蟲感染에 대한 治療效果를 알아보기 위하여 전라남도 강진군 탐진강 流域의 住民 중에서 68名의 蟲卵陽性者를 색출하고 體重당 100㎎/㎏의 praziquantel을 單回 투여한 후 70일에 追跡大使檢査를 실시하여 驅蟲效果를 判定하였다. 結果는 다음과 같다. 1. 총 45名의 追跡檢査者 중 41名이 蟲卵陰轉되어 91.1%의 治療率(care rate)을 보였으며 이들의 投藥前 E.P.G 合計가 125,600이었던 것이 投藥後 800으로 減少되어 99.4%의 蟲卵率을 보였다. 2. 驅蟲效果는 投藥前 感染强度(E.P.G)에 따라 다소 다른 것으로 나타났으며 輕感染者일수록 높은 效果를 보였다. 3. 藥劑服用에 의한 副作用은 2例에서 가벼운 頭痛이나 현기증을 호소한 이외에는 전혀 문제되지 않았다. 이상의 結果로 볼 때 國産 praziquantel(Distocide^(ⓡ)) 요꼬가와吸蟲症에 대하여 10㎎/㎏ 單回投與로 매우 우수한 驅蟲效果를 보이는 것이 立證되었고 效果, 投藥法, 副作用 등을 감안할 때 집단치료 약제로서 손색이 없을 것으로 생각되었다. Fraziquantel(Cistocide", Chinpoc:-g Pharm. Co). a 'croad spectrum anthelmintic zgzirs: tremato6es and cestodes, ~ 5 - i - a ~ tested for its efficacy In treatment of A!letclgonin.zis yok~govias infection. during the priod fron? Jzmsry t o Ajmi. 1984. A total of 68 egg ~ o s i t i r e cases TTES selected from the inhabitants of Kangjin-gun, South Choila Do, 2nd treated a i t h lOmg/kg ?x<:- weight of I;raziquar.te! in single dose. Among them 25 heavy infection cases were purged ~ i t l 20-20g of magnesium sulfzte(MIgS04) one hour after the treatrcent. Follow up stool exammztion was done after 70 days and the drug efficacy was estimated in terms of cure(=egg negati7-e conversion) and egg reduction rates. The results were as follows: 1. AIiong 45 follm- up cases 41 were cured(91.1% in cure rate) and the pre-treatment E.P. G.(eggs per gram of feces). 125,600, was reduced to 800 after the treatment(gg.4X in egg reduction rate). 2. The cure rates x-ere dependent upon the degiee of E.P.G.; the lower the intensity of infection before treatment, the higher the cure rate was obtained. 3. There x-ere nearly no side effects due t o drug administration except f o r slight degree of headache and dizziness in 2 cases. From these results, it is concluded that lOmg/kg single dose of praziquantel (Distocide") is highly recommendable in treatment of M. gokogawat infection.

유입 바베시아증 1예

우준희,조용균,김은옥,채종일,김양수,양성연,유지소,이성순 대한감염학회 1997 감염 Vol.29 No.1

최근 외국으로의 여행이 빈번해지면서 유입 감염되는 경우가 많아지고 있는 추세이며 임상 증세가 말라리아와 유사하여 다소 진단이 어려울 수가 있어 한번쯤 바베시아증을 생각하는 것이 바람직하겠다. 저자들은 아프리카에 다녀온 뒤 나타난 바베시아증을 경험하였기에 문헌고찰과 함께 보고하는 바이다. Babesiosis is a tick-borne, malaria-like illness caused by Babesia species that infect erythrocytes of mammals incidentally. The family Babesiidae is characterized by consisting of nonpigmented intraerythrocytic parasites that reproduce within erythocytes by asynchronous, asexual budding into two or four daughter cells (tetrad). We experienced a case of human babesiosis presenting fever and chills. The patient was a 49-year old man, who had been in Africa (Ethiopia, Uganda). Three weeks before admission intermittent spiking fever had developed, which had been accompanied by severe chills. The peripheral blood smear (Giemsa-stain) revealed characteristic forms of a intracellular quadraple parasite compatible with Babesia. The patient was improved significantly by the treatment with quinine and clindamycin for a week.

Fasciola의 간농양에서 Praziquantel 7일 요법의 임상

김정룡,이효석,채종일,김선미,김찬규 대한감염학회 1997 감염 Vol.29 No.5

목 적 : Fasciola hepatica에 의한 간농양으로 진단 받은 환자에게 장기간 praziquantel을 투여하여, fasciola에 의한 간농양에 대한 장기간의 Praziquantel두여 효과를 알아보고자 하였다. 방 법 : F. hepatica에 의한 간농양으로 진단 받은 3명의 환자를 대상으로 하였다. F. hepatica에 의한 간농양으로 진단한 기준은 1) micro-ELISA에 의한 기생충에 대한 항체검사에서 fasciola 항원에 대한 반응이 양성이고 2) 말초 혈액 검사상 호산구증다증 을 보이며 3) 복부초음파 또는 복부컴퓨터단층촬영상 간질에 의한 간농양의특징적 소견을 보이며 4) 간내점 유병소에 대한 조직검사상 호산구성 농양을 보이는 경우로 하였다. Praziquantel의 투여는 하루 70-84mg/kg으로 7일간 투여 하였다. Praziquantel 투여 후 치료 효과 유무의 판정은 3개월 내에 말초혈액 호산구수의 500/㎣ 이하로의 감소 및 1년 이내에 간농양 의 소멸 여부로 결정하였다. 결 과 : 호산구다증은 2-3개월 내에 정상화 되었고, 간농양은 1예에서 치료 5개월 후에 병변의 크기가 90%이하로 감소하였고 나머지 2예에서 1년 이내에 소실되었다. Praziquantel의 투여를 중단할만한 심각한 부작용은 없었다. 결 론 : 7일간의 praziquantel 투여는 간질증에 의한 간농양에 대해 효과가 있으리라 생각되며 안전하다. 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(75mg/kg for 1day) failed to cure Fasciola fepatica infections, however, it has not been investigated whether long term praziquantel(70mg/kg/d for 7 days) would be effective. We evaluated the effectiveness of long term praziquantel therapy in patients with Fasiola liver abscess. Method : There patients were included in the current study who were diagnosed as liver abscess by F. hepatica. The diagnostic criteria for inclusion were 1) hypereosinophilia, 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 does of 70-84mg/kg for 7 days. the effectiveness was assessed by the normalization of count at the end of 3 months and the disappearance of abscess cavity on ultrasonography or CT scam one year after treatment. Results : Blood eosinophil count decreased to less than 500/mm³ in all patient 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.