• 대한핵의학회:학술대회논문집
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• 대한핵의학회 1977년도 제16차 학술대회
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• pp.90.2-91
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• 1977

• Parasites, Hosts and Diseases
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• 제21권2호
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• pp.265-269
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• 1983

간흡충증 환자 혈청에서 Thin layer immunoassay에 의하여 항체를 정량적으로 측정하여 감수성과 특이성을 알아보고, 효소표식면역 법(ELISA)에 의한 성적과 비교하였다. 냉동 건조한 간흡충 성충의 생리식염수 추출물을 항원으로 사용하였고, TIA는 Elwing등(1976)의 방법으로, 효소표식면 역법은 Veiler등(1974)의 방법에 의해 실시하였다. 1. 간홉충중 환자 60명의 혈청에서 TIA zone 크기의 평균은 4.14mm였고, 3mm 이상을 양성으로 판정하였을 때 감수성은 100%, 특이성은 61.1%였다. 2. 효소표식면역 법에 의하면 ELISA치 0.8이상을 양성으로 판정하였을 때 감수성은 88.3%, 특이성은 87.3%였다. 3. 혈청내 IgG 농도는 TIA zone 크기와 상관이 없었으나 좌소표식면역법에 의한 ELISA치와는 상관이 있어 그 계수는 0.69였다. 4. TIA zone 크기는 효소표식면역 법에 의한 ELISA치와 그 분포에 있어 상관이 없었다.

• Parasites, Hosts and Diseases
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• 제33권2호
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• pp.117-124
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• 1995

간흡충증의 진단에 흔히 쓰이는 초음파검사의 민감도와 특이도를 알아보기 위하여 1994년 3월부터 11월까지 유행지역인 형산강 유역 포항 통합시 근로자 609명을 대상으로 피내반응검사. 대변검사. 초음파검사 및 설문조사를 시행하였다. 초음파검사에서 진단적인 소견으로 간내 담관의 확장만을 인정할 경우의 민감도는 21%이었고, 담관주위 에코가 있는 경우까지 포함하면 민감도는 52%이었다. 피내반응검사의 민감도는 62%이었다. 피내반응검사 양성이면서 초음파 소견이 하나라도 있는 경우를 진단기준으로 삼으면 민감도는 46%이었다 본 조사에서는 간흡충 혹은 간흡충의 집합체에 의해 생성되는 것으로 알려진 초음파검사상 방추상이고 약하게 반향을 보이는 담관이나 담낭내의 비음영의 초점이 뚜렷하게 보이는 환자는 없었다. 초음파검사의 특이도는 간내 담관의 확장만을 진단적 소견으로 인정할 경우 95%. 담관주의 에코까지 진단적 소견에 포함하면 83%이었다. 피내반응검사의 특이도는 52%이었다. 피내반응검사 양성이면서 초음파 소견이 하나 라도 있는 경우를 진단기준으로 삼으면 특이도는 90%이었다.

• Parasites, Hosts and Diseases
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• 제40권1호
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• pp.9-16
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• 2002

The endemic status of clonorchiasis and metagonimiasis along the Geum gang (River) in Okcheon-gun (County) in Korea was examined. From February to December 7000, stools of total 1,081 inhabitants living in 5 villages were examined. Each stool specimen was examined by both the cellophane thick smear method and the formalin-ether sedimentation technique. Egg-positive cases were further analyzed by Stoll's egg-counting technique. and praziquantel was administered to positive cases. The egg-positive rates for Clonorchis sinensis and Metafonimus species were 9.3% and 5.5%, respectively, and the double infection rate was 3.5%. The numbers of eggs per gram (EPG) of feces of C. sinensis and Metafoninus sp. were $918{\pm}1,463$ and $711{\pm}947$, respectively. The egg-positive rates for C. sinensis and Metagoninus sp. in the riverside area were 14.2% and 8.4%, respectively, which were significantly higher than those of the inland area (3.2% and 1.7%. respectively). The egg-positive rates of C. sinensis and Metagoninus sp. in males (16.7% and 10.0%) were significantly higher than those of females (3.5% and 1.8%) However, there were no significant differences of EPG values between localities and sexes. The prevalence of clonorchiasis and metagonimiasis in this survey was significantly lower than that in the previous reports. However. there is still a high prevalence of infection with C. sinensis and Metagoninus sp. in this region. especially in the riverside area.

• Molecular & Cellular Toxicology
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• 제3권3호
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• pp.195-197
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• 2007

Currently praziquantel is used for treatment of not only clonorchiasis but also other trematodes and cestodes. But cure rate of praziquantel is just 60-80% for most trematodes. It needs for the treatment-failed patients to have more drugs. The cause of failure of treatment is not studied. We just know that the blood level of praziquantel is severely different among the people. We guess that this factor may influence the results of treatment. In an endemic area of human clonorchiasis in Heilongjiang Providence, China, 78 subjects were selected for the study. Three doses of 25 mg/kg (total 75 mg/kg) of praziquantel were administered to 78 clonorchiasis patients. After three weeks of treatment, stool examination was undertaken once again to confirm the cured and uncured subjects. To analyze SNP (single nucleotide polymorphism) of CYP3A5 PS2-1, CYP3A5 PS2-2, and CYP3A5*6, PCR method was done with specifically designed primers. The mutation rates of all sites were not significant statistically. The number of subjects was too small, so we need more subjects and other delivery proteins of bile ducts (ex. MRP etc.) were also considered for effects of praziquantel. We analyzed, for the first time, the entire CYP3A5 gene in a French population, using a polymerase chain reaction- single strand conformational polymorphism (PCR-SSCP) strategy.

• Parasites, Hosts and Diseases
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• 제47권1호
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• pp.19-23
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• 2009

We measured changes in sonographic findings of patients with clonorchiasis after a treatment in a highly endemic area. A total of 347 residents showed positive stool results for Clonorchis sinensis eggs in a village in northeastern China, and were treated with praziquantel. Of them, 132 patients underwent abdominal sonography both before and 1 year after treatment, and the changes in sonographic findings of 83 cured subjects were compared. Diffuse dilatation of intrahepatic bile ducts (DDIHD) was found in 82 patients (98.2%) before and 80 (96.4%) after treatment, which was improved in 3, aggravated in 1, and unchanged in 79 patients. Increased periductal echogenicity (IPDE) as observed in 42 patients (50.6%) before and 45 (54.2%) after treatment, which was improved in 5, aggravated in 8, and unchanged in 70 patients. Floating echogenic foci in the gallbladder (FEFGB) was detected in 32 patients (38.6%) before and 17 (20.5%) after treatment, which was improved in 20, aggravated in 5, and unchanged in 58 patients. Improvement of FEFGB only was statistically significantly (P = 0.004). The present results confirm that DDIHD and IPDE persist but FEFGB decreases significantly at 1 year after treatment. In a heavy endemic area, the sonographic finding of FEFGB may suggest active clonorchiasis 1 year after treatment.

• 농촌의학ㆍ지역보건
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• 제29권1호
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• pp.163-175
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• 2004

섬진강 유역 곡성군 및 순창군 지역은 주민의 간흡충증 유병률이 약 10~40%이다. 이 지역의 간흡충 질환의 퇴치를 위해 지역 주민을 대상으로 간흡충 간염자를 진단 및 치료하고 예방교육을 통해 이 질환의 관리효과를 관찰 하였다. 간흡충 집중관리 이전의 제1차 간흡충증 유병률 조사를 실시하였다. 비확률 표본추출의 방법에 따랐다. 전남 곡성군 주민 1,243명에 대하여 대변을 받아 Formalin-ether 집란법으로, 전북 순창군 주민 1,004명에 대해서는 혈청을 받아 ELISA 검사로 간흡충증을 진단함으로써 두 지역의 간흡충증 유병률을 파악하였다. 간흡충 감염자 전원을 디스토시드 약물로 치료해 주고 재감염 방지를 위한 예방교육을 실시하였다. 간흡충 집중관리 이후의 제2차 간흡충증 유병률 조사를 1차 조사 후 9개월 뒤에 곡성군 주민 616명, 순창군 주민 2,637명을 대상으로 1차 조사 때와 같은 방법으로 실시하여 얼마나 유의하게 유병률이 감소하였는지를 판정하였다. 조사 결과는 다음과 같다. 1. 곡성군 및 순창군의 집중관리 이전의 제1차 간흡충 유병 각각 평균 39.0%, 30.1% 이었고 두 군을 통 털어 면 단위별로는 61.5%에서 8.9% 범위이었다. 두 군 모두 섬진강변에 위치한 면에서 강으로부터 먼 면보다 유병률이 높았다. 또한 대변검사와 ELISA의 Field survey 상의 진단적 신뢰도에 큰 문제가 없다고 판단하였다. 2. 간흡충 감염자 전원을 약물 치료 및 예방교육을 실시하고 9개윌 후에 실시한 제2차 조사 결과, 곡성군 및 순창군의 간흡충 유병률은 22.4%, 16.3%로 집중관리 이전과 비교하여 통계적으로 두 군 공히 유의하세 감소한 것으로 나타났다(P<0.0001). 이상의 결과에서, 섬진강 유역의 곡성군, 순창군 지역은 간흡충 감염이 고도로 유행하고 있었고, 집중관리에 의해 유병률이 유의하게 감소함을 확인하였다. 따라서, 섬진강 유역의 다른 지역도 간흡충증의 집중관리가 이루어져야 하며 본 연구의 간흡충증 관리 모형을 적용할 것을 제언한다.

• 한국건강관리협회지
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• 제3권1호
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• pp.72-83
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• 2005

The present pilot project was executed to recommend a strategy of clonorchiasis control in China. The pilot area of this project was Zhaoyuan, Hailin, and Ningan, Heiloagjiang province. A baseline survey subjecting 4,865 residents in Heilongjiang confirmed Zhaoyuan asa high endemic area and Hailin and Ningan as moderate endemic areas. Six different control strategies were implemented in Zhaoyuan, two were in Hailin, and one was in Ningan. Including the baseline survey and project programs from 2000 to 2004, total 63,274subject-times were examined of their feces for Clonorchiseggs, 26,680 were treated, 10,082 were screened by ELISA, and 6,130 subjects were examined of their liver by sonography. The egg Positive rates in 6 villages of Zhaoyuan were as high as 44.8% 70,0%. Following the protocolof each strategy, the subjected residents were examined of their feces and treated with 25 mg/kg praziquantel, 3 times. Except the control group, all of the villages showed 72.8% to 92.0% reduction of their original egg Positive rates at Zhaoyuan. Mass treatments of all subjected residents in 2001 and 2003 reduced the egg rate from 68.8% to18.7% and 4 annual mass treatments reduced the rate from 44.8% in 2001 to 8.7% in 2004.Selective annual treatments of egg positive subjects reduced the egg rates from 50.8% in2001 to 13.8% in 2004 or from 70.0% in 2001 to 11.6% in 2004, and two treatments in a year reduced the rate from 57.6% in 2001 to 4.6% in 2004. According to repeated treatments, EPG counts decreased remarkably. In moderate endemic areas, the original egg rates were 22.6% and 28.3% in 2001 but were 1.7% and 1.1% after 2 or 3 selective treatments. The present findings of the chemotherapeutic control of clonorchiasis prove that repeated medication is important. The reduction is directly correlated with dose of praziquantel but not with mass or selective treatments. Chemotherapeutic control of reservoirhosts has little effect on reinfection of clonorchiasis because the field along the Songhua-jiang is too wide to be impacted. ELISA confirmed many serologically positive cases to Clonorchisantigen but only a few cases were positive to other antigens (Paragonimus, cysticercus, sparganum). The abdominal soaography visualized intrahepatic bile duct dilatation and periductal echo in 2,002 of 6,070 examined subjects. In addition to these examinations and treatment, health education supplemented tㅗe control activities. The present findings prove clonorchiasis is very widely prevalent and heavily endemic along the rivers in Heiloagjiang. The results suggest that group chemotherapy with praziquantel is effective to reduce endemicity of clonorchiasis. Mass treatment without individual fecal examination is recommended in heavy endemic areas where the egg rate is over 40% while one selective treatment is effective enough in moderate endemic areas.

• Parasites, Hosts and Diseases
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• 제31권3호
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• pp.207-214
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• 1993

경상남도 산청군 주민의 간흡충 감염 현황을 파악하고 1984년 조사자료와 비교 평가하기 위하여 1992년 10월에 역학조사를 하였다. 일반 주민의 간흘충 충란양성률은 837명에 대한 조사에서 37.6%(남자 48.1%. 여자 28.6%)였다. 국민학생은 145명중 평균 9.7%(남자 9.9%, 여자 9.4%)를 보였다. 일반주민의 EPG(599 Per gram offices) 평균치는 3.310(남자 4.221 여자 1.978)이었다. 국민학생은 711(남자 620. 여자 833)을 보였으며 20대에서 7.852로 가장 높았다 EPG에 따는 감염자의 분포는 72.6%가 1,000미만의 경감염자이었고 10.000미만의 중등도까지 93 9%가 포함되었다. 중감염자로는 EPG 120.000이상에 속하는 사람이 0.3%를 차지했다. 감염자의 민물고기 생식 경험률은 90.5%. 최근 2년내 생식한 사람은 71.1%였다. 1984년과 1992년에 조사된 동일인 138명 중 반복감염자가 31명(22.5%). 음성으로 전환된 자가 35명(25.4%), 새로 양성 전환자가 22명(15.9%)이었다. 그러므로 1984년 자료와 비교할때 충란양성률은 국민학생은 줄고 일반 주민은 변화가 없었으며. 감염강도는 주민과 국민학생 모두에게서 감소하였고, 주민의 민물고기 생식습관은 변하지 않았음을 알 수 있었다. 이 지역에서는 주민들의 식습관의 변화가 앞으로 간흡충 퇴치사업에 가장 중요한 요인이다.

• Parasites, Hosts and Diseases
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• 제44권4호
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• pp.361-366
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• 2006

Sustained-releasing praziquantel (SRP) tablet was designed for single dose treatment regimen of clonorchiasis. A previous pre-clinical study confirmed its sustained-releasing characteristics and a better cure rate than conventional praziquantel (PZQ). In this clinical study, the pharmacokinetics of this SRP tablet were investigated in human volunteers (phase 1; 12 volunteers), and its curative efficacy was examined in clonorchiasis patients (phase 2; 20 volunteers). In the phase 1 clinical study, blood concentrations of both tablets showed wide individual variation. The $AUC_{last}$ of SRP was $497.9{\pm}519.0ng{\cdot}hr/ml\;(mean{\pm}SD)$ and PZQ of $628.6{\pm}695.5\;ng{\cdot}hr/ml$, and the $AUC_{inf}$ of SRP was $776.0{\pm}538.5\;ng{\cdot}hr/ml$ and of PZQ $658.6{\pm}709.9\;ng{\cdot}hr/ml$. $C_{max}$ values of SRP and PZQ were $90.7{\pm}82.2ng/ml\;and\;214.9{\pm}251.9\;ng/ml$, and $T_{max}$ values were $3.42{\pm}1.43\;hr\;and\;1.96{\pm}1.23\;hr$, respectively. SRP tablets showed similar AUC values, but lower $C_{max}$ and longer $T_{max}$ values than PZQ. In the phase 2 study, SRP at 30 mg/kg (single dose) achieved a 60% cure rate and a 95.5% egg reduction rate. The cure rate of a single dose SRP was unsatisfactory compared with that of the conventional PZQ dose, but much better than that achieved by a single dose PZQ.