[Intrahepatic calcifications in the newborn].
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Calcinosis↗
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Results for “LIVER DISEASES, PARASITIC”
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[Treatment of hepatosplenic schistosomiasis mansoni with praziquantel].
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Adolescent↗
Reduction of morbidity in hepatosplenic schistosomiasis mansoni after treatment with praziquantel: a long term study.
Forty-two with hepatosplenic patients treated with praziquantel and followed up for 5 years. One half of the patients received a single 30 mg/kg dose and the other half, two doses of 25 mg/kg given 4 hrs apart. According to Hoffman and Kato-Katz stool exams, an 83.3% cure rate, was observed after twelve months. Stool egg counts in cases of incomplete cure were greatly reduced. Liver function, as assessed by serum levels of aspartate aminotransferase, alanine aminotransferase, gamma glutamyltransferase and alkaline phosphatase activities as well as albumin and gamma globulin showed marked improvement after one year. Hepatomegaly was reduced in 81.0% of patients and splenomegaly in 78.8%. Spleen regression was complete in 15.1% of the total, and in 18.5% of those with compensated hepatosplenic disease. As a result of these observations, the authors recommend early treatment with anti-schistosomal medication, either oxamniquine or praziquantel, to halt progression of disease and reduce splenomegaly.
Adolescent↗
Promotion of the health of rural women towards safe motherhood--an intervention project in northeast Thailand.
An intervention project focusing on the health of women in the reproductive age was conducted in three districts of Khon Kaen Province, northeast Thailand between 1991 and 1996. Main emphasis was placed on improving reproductive health, the nutritional status including the iron deficiency anemia (IDA) as well as iodine deficiency disorders (IDD), and the parasitic diseases liver fluke (Opisthorchis viverrini) and hookworm. For implementation a community based Primary Health Care approach was used including the training of health officials in health matters, primary health care workers and villagers as well as enhancing health education and the dissemination of health information. The health delivery system was encouraged to take appropriate actions such as in the treatment of parasitic diseases and the control of IDA and IDD. Monitoring was done on a regular basis. The outcome of the project was assessed by comparing baseline data compiled from a random sample of the target population with the results of the final evaluation. An attempt to compare results obtained from villages within and outside of the project area failed most probably because of spill over effects. A number of important indicators on family planning and mother and child health care improved during the time the project was implemented; this included practising family planning, and participation in antenatal care. Also the proportion of females becoming pregnant for the first time when 20 years or older increased. Child-raising also improved in that almost all females gave colostrum to their babies by this time. Almost 75% of the women breast-fed their children. Improvements occurred in the nutritional status as far as the micronutrients iron and iodine were concerned, however the overall nutritional status of females did not change, but a rather high proportion of females were found to be overnourished. The project failed in reducing abortion and the proportion of females becoming pregnant when they are 18 years old or younger. It was also not possible to improve the usage of postnatal care. As anticipated, the results achieved so far are most suitable in serving as a training ground and providing a favorable example to improve family planning, mother- and child health care, and also the general health of females in the region, particularly in neighboring countries such as Lao PDR, Cambodia and Vietnam.
Adolescent↗
Repeated exposure to Opisthorchis viverrini and treatment with the antihelminthic Praziquantel lacks carcinogenic potential.
The effects of repeated Praziquantel administration, subsequent to infection and reinfection with Opisthorchis viverrini (OV), on lesion development in the Syrian hamster liver were investigated. Five applications of the antihelminthic drug were made (300 mg/kg body wt, i.g.), each time approximately 5 weeks after dosing with 60-80 OV metacercariae at weeks 0, 8, 16, 24 and 32. The animals were then maintained until week 40 when they were killed; histopathological investigation revealed no significant development of either hepatocellular of cholangiocellular preneoplastic/neoplastic lesions. The results indicate that repeated exposure to Praziquantel at levels sufficient for successful removal of parasite infestation does not itself carry carcinogenic risk.
Animals↗
Parasitological and bacteriological studies in recurrent diarrhoea in patients with chronic liver diseases.
Sixty patients with chronic liver disease complaining of persistent or recurrent diarrhoea where studied. The stools were examined by direct smear, formol ether concentration method and modified Ziehl Neelsen technique for Cryptosporidium in addition to stool cultures for enteric pathogenic bacteria as Salmonella, Shigella and E. coli. Giardia lamblia was the most prevalent pathogen responsible for diarrhoea in 23.3% of cases followed by Entamoeba histolytica in 21.6%, Schistosoma mansoni in 5% and Hymenolepis nana and Ascaris lumbricoides in 1.6%. Concerning bacteria, Salmonella was detected (10%), Shigella (6.7%) and E. coli (13.3%). In conclusion, Cryptosporidium was not a cause of diarrhoea in patients with chronic liver disease.
Adolescent↗
Pattern of liver disease in the western region of Saudi Arabia.
In a series of 124 patients admitted to hospital with liver disease, 23 (18.6%) had malignant liver disease, either primary or secondary; 12 (9.7%) had cirrhosis of the liver, while another 25 (20.2%) had inflammatory liver disease, including such parasitic infections as hydatid disease and schistosomiasis. The remaining biopsies showed non-specific changes or normal livers.
Adolescent↗
Serum glutamyl transferase and other liver function tests in Opisthorchis viverrini infection.
Serum glutamyl transferase (gamma-GT), serum total protein, albumin, aspartate aminotransferase (GOT), alanine aminotransferase (GPT), alkaline phosphatase and bilirubin were measured in 55 males and 45 females suffering from O. viverrini infection and in apparently healthy non-infected individuals. A decrease in total protein, albumin and bilirubin, as well as an increase in GOT, GPT and gamma-GT was observed in males with O. viverrini infection, whereas alkaline phosphatase remained unaffected. In female patients with O. viverrini, serum total protein and albumin also decreased, GOT and GPT increased, whereas gamma-GT remained unchanged. The difference in gamma-GT alteration between females and males is discussed with regard to the possible significance of alcohol consumption and in relation to the parasitic infection and its possible implications for malignancy, associated with liver fluke infection.
Adult↗
[Hepatic manifestations in giardiasis].
In 25 patients with diagnostic of Giardiasis by duodenal intubation we studied the hepatic functional tests and hepatic biopsy. 60% of patients presented alterations of hepatic histology; 36% steatosis and 24% inflammatory lesions, chronic persistent hepatitis 3 cases and chronic active hepatitis two of them. Hepatic lesions regression was reached only with antiparasitic treatment and in some cases reappearance of lesions depended on parasitic's reinfections. For every patient with histologic diagnosis of chronic hepatitis without viral markers we suggested to dismiss Giardiasis and to treat it before to undergo other therapeutical behavior.
Adult↗
Biochemical and endocrinological studies in parasite-infested patients with and without infantilism.
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17-Hydroxycorticosteroids↗
Association of intestinal helminths with decreased liver size and sCD23 concentration during falciparum malaria.
To determine if intestinal helminths and the CD23/nitric oxide pathway had an influence on liver size, we conducted a cross-sectional study on 438 patients with confirmed P. falciparum malaria admitted at the Hospital for Tropical Diseases in Bangkok. For all patients the liver size was measured as number of centimeters below the rib cage, a stool examination was conducted, and CD23 and reactive nitrogen intermediates were measured. The median liver size was smaller in helminth-infected patients than in helminth-free patients (chi2 for trend = 9.1, p = 0.003). Liver size significantly increased with the concentration of sCD23 (p < 0.0001). The median sCD23 concentration (OD) was significantly lower in helminth-infected patients than in helminth-free patients, respectively 0.33 (quartiles 0.24-0.57) and 0.45 (quartiles 0.27-0.59), (p = 0.01). There was a negative correlation between sCD23 concentrations and RNI (Spearman's rho = -0.40, p < 0.0001). All the above results remained significant after controlling for potential confounders. These results are compatible with a CD23/NO-mediated decrease in liver size in helminth-infected patients.
Adolescent↗
Helminths in the induction of cancer: Opisthorchis viverrini, Clonorchis sinensis and cholangiocarcinoma.
Opisthorchis and Clonorchis parasitize the bile ducts of millions of persons in the Far East. The most important aspect of infection with these flukes is their ability to initiate cancer. Numerous studies have shown these flukes to occur in association with cholangiocarcinoma far more frequently than can be explained by chance. Experimental studies in animals have confirmed the carcinogenic potential of these parasites. Although the pathogenesis remains unclear, the initial carcinogenic event is probably a function of the length and severity of infection, the host's immune response, and such variables as ingestion of dietary carcinogens.
Adenoma, Bile Duct↗
The use of liver grafts infested with Clonorchis sinensis for orthotopic liver transplantation.
In the Orient, millions are known to have Clonorchis sinensis (biliary trematodiasis) infestation. When these infested livers become available as donor organs, there are potentially serious implications that the transplant team would need to consider. We report the use of two such infested livers, one from a cadaveric donor and the other from a live related donor, for orthotopic liver transplantation. The parasite was encountered not only during organ procurement, but also caused early postoperative blockage of the hepatico-jejunostomy splintage tube and cessation of bile flow in the second recipient. Upon follow-up for four and two years, respectively, no other ill effect has been observed in either patient. Repeated examination of stool for ova of C sinensis in both patients during follow-up visits had been negative, indicating that all the parasites probably had been killed by the cold perfusion. In view of the severe shortage of liver grafts and the lack of serious morbidity associated with the use of these infested livers, we have adopted the policy to include these livers for future transplantation. Special considerations and precautions are, however, required during the perioperative period and on long-term follow-up.
Animals↗
[Liver tumors and parasites].
The risk of a liver resection is determined by 3 factors: 1. Extent of the tumor 2. functional reserve of the remaining tissue 3. technique of resection. ad 1: Ultrasound and computed tomography are the most important methods to find out a liver tumor. ad 2: A modified model to judge the functional reserve is presented by means of the galactose-elimination-test, amino-pyrin-exhalation-test and indocyanin-green-test. ad 3: It is most important to avoid intraoperative blood loss.
Hepatectomy↗
Schistosoma mansoni: development and modulation of the granuloma after or multiple exposures in the baboon (Papio cynocephalus anubis).
The ability of the host to modulate the granulomatous response around ova trapped in tissues determines the severity of disease to schistosome infections. Multiple factors may affect this modulation such as age, prior sensitization, history of treatment, and exposure. The present study examines the effect of different patterns of exposure on the sequential development and modulation of granuloma in juvenile Kenyan baboons (Papio cynocephalus anubis) after receiving either a single infection (SI) of 1500 Schistosoma mansoni cercariae or multiple infections (MI) of 150 cercariae, once a week for 10 weeks. Prior to sacrifice at 17 weeks postinfection (p.i.), liver biopsies were obtained at Weeks 0, 6, 9, and 13. SI animals experienced more prolonged dysentery and greater weight loss compared to MI animals. Peak hepatic granuloma size (mean 355 +/- 65.5 microns diameter), the maximum percentage of eosinophils in the granuloma (61%), and severity of disease occurred at 6 weeks in SI animals. Peak granuloma size and pathology did not appear until Week 9 in the MI animals (mean 317.7 +/- 67.3 microns diameter). Granuloma size, tissue eosinophilia, and gross pathology diminished by Week 13 p.i. and were virtually absent in both groups by Week 17. The decrease in granuloma size, pathology, and clinical illness resolved more rapidly in the MI baboons. Singly infected baboons were more susceptible to infection (83 +/- 12% of cercariae developed into adult worms) compared to MI baboons (67 +/- 7%, P < 0.01). Eggs recovered from tissues at necropsy were primarily confined to the large intestine (85% of total egg recovered), followed by liver (10%) and small intestine (5%). Significantly more eggs were recovered from MI compared to SI animals, indicating a higher fecundity of female worms in the MI baboons. These date demonstrate that granulomatous responses develop more slowly and modulate more rapidly with repeated infection compared to a single heavy infection and suggest the type of exposure may affect the pathologic response to infection.
Animals↗
Calomys callosus: an alternative model to study fibrosis in schistosomiasis mansoni. The pathology of the acute phase.
Twenty Calomys callosus, Rengger, 1830 (Rodentia-Cricetidae) were studied in the early stage of the acute schistosomal mansoni infection (42nd day). The same number of Swiss Webster mice were used as a comparative standard. Liver and intestinal sections, fixed in formalin-Millonig and embedded in paraffin, were stained with hematoxilin and eosin, PAS-Alcian Blue, pH = 1.0 and 2.5, Lennert's Giemsa, Picrosirius plus polarization microscopy, Periodic acid methanamine silver, Gomori's silver reticulin and resorcin-fuchsin. Immunohistological study (indirect immunofluorescence and peroxidase labeled extravidin-biotin methods) was done with antibodies specific to pro-collagen III, fibronectin, elastin, condroitin-sulfate, tenascin, alpha smooth muscle actin, vimentin and desmin. The hepatic granulomas were small, reaching only 27% of the volume of the hepatic Swiss Webster granuloma. They were composed mainly by large immature macrophages, often filled by schistosomal pigment, characterizing an exsudative-macrophage granuloma type. The granulomas were situated in the parenchyma and in the portal space. They were often intravascular, poor of extracellular matrix components, except fibronectin and presented, sometimes alpha smooth muscle actin and vimentin positive cells. The C. callosus intestinal granulomas were similar to Swiss Webster, showing predominance of macrophages. Therefore, the C. callosus acquire very well the Schistosoma mansoni infection, without developing strong hepatic acute granulomatous reaction, suggesting lack of histopathological signs of hypersensitivity.
Acute Disease↗
Primary liver cancer coincident with Schistosomiasis japonica. A study of 24 necropsies.
The etiologic relationship of parasitic liver disease to primary liver cancer has long been debated. For this reason, a review of 4611 necropsies was carried out to determine the frequency with which hepatocellular carcinoma occurred in association with schistosomiasis. Of 227 cases of hepatocellular carcinoma, 24 (10.6%) were associated with schistosomiasis japonica. This was significantly higher than the incidence of this carcinoma without schistosomiasis (2.78%). The majority of the 24 cases exhibited the features of a mixed macronodular and micronodular cirrhosis (Gall's posthepatitic cirrhosis); this was super-imposed upon and caused a masking of schistosomiasis fibrosis. By radioimmunoassay hepatitis B antigen was positive in 27% of these cases. A review of the literature indicated that chronic schistosomiasis, on its own, is unlikely to be the cause of primary liver cell carcinoma. Histologic features resembling post-hepatitic cirrhosis combined with a high frequency of hepatitis B antigen suggest that viral hepatitis rather than S. japonicum is the more likely etiologic factor involved, or has a synergistic effect on carcinogenesis.
Adult↗
Liver-specific gene expression in various pathophysiologic states.
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Albumins↗