• Parasites, Hosts and Diseases
• /
• 제60권2호
• /
• pp.79-96
• /
• 2022

The infection nature of Clonorchis sinensis metacercariae (CsMc) in freshwater fish hosts is closely related to the transmission of human clonorchiasis. This article reviewed the infection characteristics of CsMc in freshwater fish in the Republic of Korea (Korea). The status of CsMc infection was examined in a total of 17,792 cyprinid fish of 49 species in 9 water systems, which included Hantan-/Imjin-gang, Han-gang, Geum-gang, Mangyeong-gang, Yeongsan-gang, Tamjin-gang, Seomjin-gang, Nakdong-gang, and streams in the east coastal areas from 2010 to 2020. The infection status of CsMc was examined according to cyprinid fish species and water systems, after which analyzed by endemicity and susceptibility index. The high endemicity was shown in the cyprinid fish from 3 regions (6.1%) in the upper reaches of Nakdong-gang, such as Banbyeon-cheon (stream), Yongjeon-cheon, and Wi-cheon. The moderate levels were observed in fishes from 8 regions (16.3%), and low endemicity was shown in fishes from 20 regions (40.8%). No CsMc were detected in fish from 18 regions (36.7%). The susceptibility of CsMc in index fish, Puntungia herzi, was found to be a reliable index without examination of other fish species. CsMc infection rates were closely related to subfamily groups in the cyprinid fish hosts in a highly endemic area. In Korea, a total of 58 fish species in 10 families has been listed as the second intermediate hosts for C. sinensis. This review provides several novel features of CsMc infection and clarifies the species of second intermediate freshwater fish host in Korea.

• Parasites, Hosts and Diseases
• /
• 제21권2호
• /
• pp.116-186
• /
• 1983

An epidemiological study on Clonorchis sinensis infection along the Nam-river (total length ; 186km) flowing in Gyeongsang-nam-do, southern part of Korea, was carried out. Formalin-ether concentration technique and Stoll's egg counting method were employed to figure out the prevalence of C. sinensis infection. For the detection of cercariae from Parafossarulus sp., the snail host of C. sinensis, each snail was placed in aerated tap water, and examined for expelled cercariae. For observing the metacercariae the fresh water fish favorably eaten in raw conditions wore prepared by means of pressing the muscles between two slide glasses and/or by digesting them with artificial gastric juice. The fresh water fish were fed to the rabbits to get the worms and to identify the morphology of adult C. sinensis. The results are summarized as follows: 1. Overall Prevalence of C. sinensis infection was 38.75 from 5,291 examinees; 44.15 (1,408 out of 3,196) in male and 30.4% (637 out of 2,095) in female. 2. The prevalence rates were 42.0% at the upper stream, 41.2% around the vicinity of Jinyanglake, 34.2% at Jinju city, 34.2% at middle stream and 40.3% at down stream regions, respectively. 3. By age, the highest positive rate (53.4∼54.3%) was observed in 30 to 59 years of age. In this age group, the rate in males was 59.7∼62.2%, and in females 42.2∼44.4%, In the age group of less than 19 years it was 7.5∼20.9%. 4. By social strata, the positive rate was 16.5% in the primary school children, 22.6% in school students, 46.2% in teachers and local officers and 49.6% in the general inhabitants. 5. The quantitative examinations with the stool collected from clonorchiasis cases revealed that the light infection (less than 4,000/EPG) was 53.6%, moderate infection (4,001∼10,000 /EPG) 30.3% and heavy infection (more than 10,001/EPG) 16.1%, respectively. More than half of total cases examined were light infection, and 73.2% of female examinees were lightly infected with this cuke. 6. The average value of EPG was 4,963 (male, 6,057; female, 2,557 and the highest value was obtained from the age group of 30 to 59 years (5,240∼6,454). 7. The prevalence of Metagonimus yokogawai infection in humans was 5.5%, and 89.8% of metagonimiasis cases wore double-infected arith C. sinensis. The highest prevalence rate was observed in Jinju city (11.2%). 8. Total of 5,005 Parafossarulus sp., the snail intermediate host of C. sinensis, were examined for the detection of cercariae. The cercarial expulsion rate was 0.34%, and the snails collected in Jin-yang-lake side and in the down stream expelled mainly the cercariae of C, sinensis. 9. About 788 cercariaejday (range: 127∼1,503) were expelled daily from a snail naturally infected with C. sinensis. The snails which released more than 1,000 cercariae/day were 30.8% out of total collected. A snail uniquely released 5,840 cercariae/day in this study. 10. The other trematode cercariae besides C. sinensis were also detected, and the rates out of total snails were the cercariae of Losogenes liberum 6.71%, Cyathocotyle orientalis 0.26%, Notocotylus attenuatus 2.52% and Mucobucaris 0.54%, 11. Ten out of 18 species of fresh water fish caught along the river harbored the metacercariae of C, sinensis. The highest rate of metacercarial infection in fish was detected in Pseudorasbora larva (85.9%). The fish mainly eaten by the inhabitants along the Nam-river, and the metacercarial infection rates were: Zacco platypus 8.0%, Hemibarbus sp. 18.2∼26.7%, Gnathepcgcn sp. 37.5%, Ischikauia steenackeri 42.9% and Pseudogobio esocinus 16.7%. 12. Out of 36 P. larva, the number of metacercariae were about 109 (ranEe; 18∼446) per fish and 27 per gram of flesh. The fish caught in spring harbored the highest number of metacercariae. As indicated above, the prevalence of C. sinensis infection in the inhabitants residing around the Nam-river was relatively high. The farther toward the upper stream areas, the higher was the positive rate of C. sinensis infection, and most of clonorchiasis cases were lightly infected. The snail hosts of C. sinensis distributed all around the Nam-river. Several species of freshwater fish were infected with the metacercariae of C. sinensis and the infection rates were relatively high. To prevent C. sinensis infection in the endemic areas, the effective health education system is suggested as a control measure, although mass treatment is also expected to be useful, using chemotherapeutic agents such as "praziquantel", a recently developed anthelminthic for C. sinensis inftraction.

• Parasites, Hosts and Diseases
• /
• 제26권2호
• /
• pp.73-86
• /
• 1988

간흡충(Clonorchis sinensis)의 조항원(WWA), 정제항원(ABA)의 민감도와 특이도를 비교해 보는 한편, 발육단계별로 충란 항원(EGA)-피낭유충 항원(MEA)-성충 항원(WWA)의 단백질 구성물질의 차이를 SDS-polyacrylamide gel electrophoresis(SDS-PAGE)로 관찰하고 이들 항원의 유용성을 효소면역반응(enzyme-linked immunosorbent assay: ELISA)으로 비교하여 다음과 같은 결과를 얻었다. 간흡충의 조항원으로부터 정제된 항원(ABA)은 항체와 결합한 결합항원(affinity-purified antibody(IgG) binding antigen:ABA)으로서 Ouchterlony 반응으로 간흡충 감염 가토혈청과 4개의 침모대 (WWA는 7개)를 형성하였다. WWA의 major protein들은 분자량 16,300∼18,500 및 28,000∼29,000 dalton의 Polypeptide band였고, ABA는 분자량 18,000∼21,000 및 29,000∼31,000 dalton의 단백질로 다소의 차이를 보였다. ELISA시첩에서 ABA는 WWA에 비해 현저히 민감도가 낮았다. WWA와 ABA에 대한 폐흡충 감염 사람혈청의 ELISA 정사에서 WWA는 Ouchterlony 양성자 8예중 3예에서 교차반응을 나타내었으나 ABA는 교차반응을 나타내지 않았다. 간흡충의 발육단계별 항원 단백질의 분자량 범위는 WWA 11,000∼80,000, MEA 15,000∼100,000, EGA 15,000∼200,000 dalton이었다. 주류원 단백질의 분자량은 EGA는 각각 36,600 (band No. 22), 38,500(No. 20), 64,000(No. 9), 62,000(No. 10), 54,500(No. 11), 53,000(No. 12) dalton, MEA는 각각 65,600(No. 3), 44,700 (No.7), 43,900(No. 8) dalton, WWA는 각각 16,300∼18,500(No. 31-32), 28,000∼29,000(No. 25), 11,000w13,000 (No. 35) 및 31,000(No. 24) dalton이었다. 즉, MEA와 EGA가 WWA보다 고분자의 단백질로 구성되어 있었다. 각 발육단계별 항원의 항원성은 ELISA 반응으로 볼 때 WWA가 가장 높았고, MEA는 약한 항원성만을 나타내었으며 EGA는 음성이었다. WWA와 간흡충 감염 가토혈청은 감염 4∼6주에 OD>1.0, 12주 이후 항체가의 plateau를 나타내었으나 MEA는 Ouchterlony 반응에서 EGA와 함께 음성반응을 보였다. ELISA에서도 중감염군(12∼20주)에서만 OD>0.6으로 미약한 항원성이 인정되었으며 경감염군은 전감염기간중 OD<0.6를 나타내었다. 이상의 결과로 보아 성충 항원이 가장 강력한 함원성 물질을 포함하고 있음이 명백하다고 생각된다. 그러나 성충 조항원은 면역진단에 사용할 겹우 타흡충과의 빈번한 교차반응이 예상되므로 민감도 및 특이도가 높은 정제 항원물질을 분리하는 일이 중요하다고 생각된다.

• Parasites, Hosts and Diseases
• /
• 제21권2호
• /
• pp.193-204
• /
• 1983

The Jinyang Lake is dammed up Nam River, and surrounded by Jinju city and four counties; Jinyang, Sanchong, Hading, and Sachon in kyongsang-Nam-Bo, Korea. The areas around this man-made lake have been known as an endemic focus of clonorchiasis in Korea. The present study was first aimed to know the distribution of freshwater mollusks including medically important snails, and larval trematodes shed from Parafossarulus manchouricus and Semisulcospira libertina. In addition to above studies, water analyses in each snail habitat were carried out in order to figure out a part of their environmental factors. This malaco-ecological survey was done at the sirs areas around upper, middle and lower parts of the lake for 4 months, August-November, 1983. Total nine species of freshwater mollusks were collected throughout the study: 4 species of gastropods: Semisulcospira libertina, Cipangopaludina chinensis, Parafossarulus manchouricus and Radin auricularia, and 5 species of bit.alves; Unio dcuglasiae, Ancdonta woodiana, Lamprotula gottschei, Corbicula yuminea and Limncperma lucustris. Out of nine species of freshwater mollusks, three species of gastropods; S. Zibertina, p. manchouricus and R. auricularia were medically important in terms of the transmission of digenetic trematodes to humans. P. manchouricus and R. auricularia were mainly collected from the shallow ponds and the irrigation channels with the muddy basin, but S. libertine and the bivalves were only collected from the stream of Nam River where the gravels and rocks were dominant. The levels of dissolved oxygen (D.O.) and biochemical oxygen demand \(B.O.D._5)\ of the water specimens sampled from the study areas ranged from 6.0 to 9.6 ppm and from 0.4 to 1.6 ppm respectively. As a result, it is considered that water system around the Jinyang Lake might be relatively clean without any heavy pollution of aquatic microorganisms and organic materials during the period of this study. On the other hand, eight metalic constituents from the water samples were also assayed, and all metalic ions detected were remarkably low below the legal criteria. However, calcium ion in the water samples from the habitats of P. manchouricus was considerably higher than others. Infection rates of digenetic trematodes in the snails were 6.9% in P. manchouricus and 4.8% in S. libertine, respectively. P. manchouricus snails harboring with thc cercariae of Clonorchis sinensis were only 0.14% among the snails examined, and other trematode cercariae except cercaria of C. sinensis were: furcocercus cercariae, cercaria of Loxogenes liberum type I and II. S. libertine snails parasitized with the cercariae of Metagonimus yokogawai were 1, 5% out of the snails examined, and no cercaria of Paragonimus westermani was found in S. libertine snails in the present study. Digenetic trematode cercariae other than M. yokogawai observed in S. libertina snails were: Cercaria yoshidae (B type) , Cercaria cristata, Cercaria innominatum, Cercaria of Centrocestus formosanus and Cercaria nipponensis.

• Parasites, Hosts and Diseases
• /
• 제32권1호
• /
• pp.35-42
• /
• 1994

간흡충 특이 IgG 항체와 간흡충 분비배설항원간의 면역반응이 간흡충 감염과 치료에 의해 어떻게 변화되고 치료 후 소실되는 것이 있는지 관찰하였다. 간흡충 피낭유충 150, 450개씩 토끼에 감염시키고 감염대조군은 22개월. 프라지콴텔 치료군은 감염 4개월에 투약하였으나 완치되지 않아 이후 $4\frac{1}{2}$개월에 재투약하여 완치시킨 후 13개월까지 관찰하였다. 간흡충 분비배설항원은 SDS-PAGE에서 114, 102, 94, 80, 66, 63, 61, 59, 54, 52, 50, 47, 45, 42, 40, 38, 34, 33, 30, 27, 25, 23, 20, 19, 18, 17, 16, 12.5, 12, 11.5 kDa 단백질 구성이었다. 이중 항 원 단백질은 감염혈청과 치료후 혈청으로 Immunoblot할 경우 66, 63(A군) 54-38(B군) 34. 33(C군), 30-23(D군) 20-14(I군) 12, 12.5, 11.5(K군) kDa 단백질이었다. 특히 33. 27, 13. 12.5 kDa 항원은 감염기간 동안 가장 강한 면역반응을 나타낸 항원이었고 피낭유층 감염강도에 의한 차이는 없었다. 또한 투약은 했으나 완치되지 않은 4개월여 동안 면역반응의 변화는 없었다. 치료후 면역반응은 33 27 kDa 항원의 경우 환치후 13개월까지 지속되었고 치료전과 정도 차이가 없었다. 그러나 13, 12.5 kDa 항원의 면역반응은 완치후 1개월부터 약화되기 시작하여 6 개훨이면 소멸되는 양상이 뚜렷하였다. 12.5 MDa 항원은 SDS-PAGE상 단백질 함량이 많고 간흡충 감염의 강한 항원이면서 치료 후에는 특이항체와의 면역반응이 치료전에 비해 현격히 감소되므로 간흡충 현증 감염만을 혈청학적으로 진단해 줄 수 있는 항원으로 판단하고 간흡충 'K2-항원'이라 명명하였다.

• 대한약리학회지
• /
• 제12권2호
• /
• pp.51-59
• /
• 1976

Methylene bis (3, 4, 6-trichlorophenoxy acetic acid) 'MTPA' has been developed for the purpose of treatment of clonorchiasis. It has been rpeorted that, in patients treated with MTPA, the flukes in the liver were killed, elevated serum bilirubin returned to normal and the patients´ general condition was improved. However it took $1{\sim}4 $ weeks to obtain sufficient therapeutic effects. In rabbits, excretion of bilirubin in the bile was increased by the MTPA, and this action was enhanced by a combination of deoxycholic acid with MTPA. This study was designed as a part of a series to increase the therapeutic effect of MTPA, by observing the relation of the blood level of MTPA with the excretion of MTPA in the bile, and the excretion of MTPA with bilirubin excretion in the bile caused by the injection of MTPA alone or in combination with deoxycholic acid. $^{14}C-labeled$ MTPA alone or with deoxycholic acid were injected into the ear veins of rabbits. The amout of bile, MTPA and bilirubin in the bile and the blood level of MTPA were measured. The results obtained were as follows: 1. The amount of excreted bile was decreased gradually as the time elapsed in both groups, that is groups injected with MTPA alone and with deoxycholic acid, without any significant difference between either group. 2. The largest amount of MTPA excretion in the early stage of the MTPA excretion in both groups, but deoxycholic acid caused an increase in blood level of MTPA whereas biliary excretion of MTPA decreased, especially in the early stage after drug injection. 3. The significant increment of bilirubin excretion began within an hour and it reached peak level in $2{\sim}2\frac{1}{2}$ hours after drug injection in both groups, but the amount of excreted bilirubin was larger in the combined group. The above results suggest that deoxycholic acid interferes with the biliary excretion of MTPA, and that there is no close relation between the increased excretion of MTPA and bilirubin excretion. But there is a close relation between blood level or tissue concentration of MTPA and bilirubin excretion. Concerning the influence of deoxycholic acid on the therapeutic effect of MTPA, deoxycholic acid would enhance the effect of MTPA, if the parasites take the drug from the blood, but diminish its effectiveness if they take the drug from the bile.

• 대한약리학회지
• /
• 제2권2호
• /
• pp.3-22
• /
• 1966

An experimental study was done on rabbits to observe the effects of several anticlonorchial drugs on the pathology of the liver infested with Clonorchis sinensis. After two months of infestation with Clonorchis sinensis by giving $400{\sim}500$ metacercariae by mouth, hexachlorophene, chloroquine 2,2' methylenebis (3,4,6 trichlorophenoxy acetic acid) and Hetol were administered orally and follow up macro-and microscopic studies of the liver pathology were done in 2 to 3 days, one month, 2 months and 3 months after the completion of medications. The results obtained in this study are as follows: 1. In both groups which were administered hexachlorophene piperazine 20mg/kg for seven days or 8mg/kg for 18 days, the macroscopic findings of the liver after 3 months revealed only minimal changes of the color and consistency The histopathological findings were the reduction of fibrosis, pseudolobulation, proliferation and adenomatous hyperplasia of bile ducts, and regeneration of liver parenchyma. 2. In groups which were administered chloroquine phosphate 20mg/kg for 18 days or 40mg/kg for 5 days, and also in groups which were administered dithiazanine iodide 30mg/kg for 18 days or 60mg/kg for 5 days, no significant findings of recovery were observed either macroscopically or microscopically. 3. In the group which was given 20mg/kg of 2,2' methylenebis(3,4,6 trichlorophenoxy acetic acid) for 5 days, prominent healing of the damaged tissues was observed after 2 months, revealing the decrease of fibrous tissue, caliber of bile ducts and adenomatous hyperplasia of the epitherial cells of the bile ducts, and regenerationof liver parenchyma. 4. In the group which was given Hetol 200mg/kg for 5 days, swelling, congestion and eddish-brown discoloration of the liver were noted macroscopically after 3 days of completion of drug administration. Hemorrhage, congestion, necrosis and degeneration of the parenchyma were observed microscopically After 10 days, liver appeared almost normal macroscopically, but marked fat degeneration was noted microscopically. After 2 months, the liver was almost normal in gross appearence with only slight atrophy and also marked healing was observed microscopically, i. e. decrease of fibrous tissue and reduction of the previously enlarged bile duct and the regeneration of the liver parenchyma.

• Parasites, Hosts and Diseases
• /
• 제32권2호
• /
• pp.93-100
• /
• 1994

조직학적으로 진단할 수 있는 인체 기생충증의 종류 및 감염양상에 대하여 알아보고자 1980년부터 1989년까지 10년 동안 전남대학교병원 병리과에 통상적인 조직검사가 의뢰된 80,947례 중 기생충 감염으로 진단된 149례(0.18%)를 대상으로 본 조사를 시행하였다. 조직학적으로 진단된 기생충증은 낭미충증 112례. 례흡충증 17례. 간흡충증 7례. 아메바증 4례. 간질증 스파르가눔증. 요충증 및 아니사키스증 각각 1례 등이었다. 낭미충증은 여성에서 약간 많았으며. 연령별 감염빈도는 20대에서 가장 높았고, 주로 침범하는 부위는 피하조직 및 골격근이었다. 절편상에서 충체가 확인된 94례의 낭미충증은 형태적인 보존정도로 보아 19례(20.2%)에서는 거의 변성이 없었고, 중등 도변성 38례(40.4%). 고도변성 37례(39.4%)를 보였다 폐에 기생한 2례를 제외한 15례의 이소기생 폐흡충은 복강(8례)과 중추신경계(7례)에 분포하였고, 20대 및 30대에서 가장 호발하였으며. 남성에서의 감염이 73.3%로 많았다. 담관내 간질증은 국내 13번째 인체감염례에 해당된다. 조직학적으로 진단되는 기생충증의 빈도는 연도가 경과할수록 점차 감소하고 있었으나, 낭미충증과 이소기생 폐흡충증에서는 생검이 매우 유용하게 이용되는 진단 방법임을 알 수 있었다.

• Parasites, Hosts and Diseases
• /
• 제22권2호
• /
• pp.223-228
• /
• 1984

외과적으로 충체를 적출하여 진단한 스파르가눔증 환자 7명으로부터 혈청을 수집하고 혈청내 스파르가눔 특이 IgG 항체가를 호소면역 측정 법으로 측정하였다. 스파르가눔 항원은 유혈목이에 자쳔 감염된 충체를 갈아 생리 식염수로 추출한 것으로 단백질 함량은 Smgyxnl이었다. 효소면역측정법은 McLaren 등(1978)의 방법에 따라 실시하였다. 스파르가눔중 환자 혈청이 폐흡충 항원 또는 유구낭미충 항원에 교차반응이 있는지 여부도 측정하였다. 또한 스파르가눔 항원에 대해서 정상인, 케흡충중 환자, 간홉충 감염자, 유구낭미충증 환자와 무구조충 감염자 등 모두 71명에 대해서도 교차반응을 나타내는지 를 관찰하고자 효소면역 측정 법을 실시하였다. 그 결과를 요약하면 다음과 같다. 1. 스파르가늠증 환자 7명중 석회화한 스파르가눔에 감염되어 있었고 수술후 1개월에 혈청을 수집한 1례를 제외하면 모두 홉광도 0.3 이상을 나타내었다. 양성판정기준을 흠광도 0.25로 하였을 때 효소면역 측정 법의 민감도(sensitivity)는 85.7이 었다. 2. 기타 기생충 감염자와 정상인 71명중에서 스파르가눔 항원에 대한 특이항체 양성자는 무구조충감염자 3명으로 특이도(specificity)는 97.5%이었다. 3. 스파르가눔중 환자 혈청은 폐흡충 항원 및 유구낭미충 항원에 대해서 항체가는 낮은 값을 보이고 있어 교차 반응은 발견할 수 없었다. 4. 중추신경계를 침범한 스파르가눔중 환자 2례에서 뇌척수액을 희석하지 않은 상태로 효소면역 측정 법을 실시하였던 바 1례는 폐흡충 및 유구낭미충 항원에 대해 교차반응 없이 스파르가눔항원에 대해 높은 항체가를 보인데 비해 다른 1례에서는 스파르가눔 항원 및 유구낭미충 항원에 대해 비슷한 항체가를 나타내고 있었다. 이상의 결과에서 효소면역 측정 법을 이용하여 스파르가눔중을 혈청학적으로 진단하는 경우 매우 특이하고 민감한 결과를 얻을 수 있을 것으로 생각하였다. 스파르가눔중의 수술전 진단이 실제로 어려운 것이 현실이므로 혈청학적 잖단은 역학적 유해조사나 형태학적으로 감별이 어려운 병리소견을 보인 경우 등에서 보조적인 진단법으로 이용할 수 있을 것으로 생각한다.

• Journal of Preventive Medicine and Public Health
• /
• 제21권2호
• /
• pp.329-339
• /
• 1988

간기능에 대한 음주와 흡연의 영향을 보기 위해서 1986년 12월 25일부터 1987년 4월 30일까지 약 4개월에 걸쳐 대구의료원을 찾은 채용신체검사 수검자들 중에서 AST 및 ALT 활성도검사, 간염 항원 항체검사, 간디스토마 피내반응검사를 실시한 900명의 검사성적과 설문지를 분석하여 AST 및 ALT 이상자율을 비교검토 하였다. AST 및 ALT 이상자율을 유해인자 수별로 보면 간기능 유해요인수의 증가에 따라 이상자율이 높았다. 특히 HBs-Ag, 음주 및 흡연의 상호복합작용에 있어서 AST 및 ALT 이상자율이 높았다. 단일 음주군, 흡연군에 대한 연령에 따른 AST 및 ALT 이상자율은 유의한 상관성이 없었고, 30대에서 다소 이상자율이 높게 나타났다. 단일 음주군의 AST 및 ALT 이상자율은 음주기간이 길 수록, 음주량이 많을 수록, 음주빈도가 잦을 수록 증가하는 경향을 보였다. 다만, 막걸리와 소량의 맥주 음주자에게서는 이상자가 없었다. 단일 흡연군의 전이효소 활성치 이상자율도 흡연기간이 길 수록, 일일 흡연량이 많을 수록 증가하는 경향이었다. 음주 및 흡연군에 대한 AST 및 ALT의 이상자율은 변량상관행렬에서 음주와 흡연기간이 길수록, 흡연량 및 나이가 많을수록 높았으며, 다중회귀분석결과는 음주기간, 음주량 및 음주빈도와는 유의한 상관성을 보였으나, 흡연량, 흡연기간과는 유의한 상관성이 없었다. AST 및 ALT의 이상율에 대한 이들 선택된 변수들은 13.0%의 설명력을 가지고 있다.