| Home | E-Submission | Sitemap | Contact us |  
top_img
Korean J Parasitol > Volume 20(2):1982 > Article

Original Article
Korean J Parasitol. 1982 Dec;20(2):169-190. English.
Published online Mar 20, 1994.  http://dx.doi.org/10.3347/kjp.1982.20.2.169
Copyright © 1982 by The Korean Society for Parasitology
Therapeutic trial of praziquantal (Embay 8440; Biltricide®) on the dermal and cerebral human cysticercosis
Han-Jong Rim,Joon-Sang Lee,Kyoung-Hwan Joo,Soo-Jin Kim,Chang-Ryong Won and Chang-Yun Park
Department of Parasitology and Institute for Tropical Endemic Diseases, College of Medicine, Korea University, Korea.
Abstract

A total of 28 adult cases who were confirmed cysticercosis with or without cerebral involvements were treated with praziquantel at the daily dose of 3 × 25mg/kg for 3 to 7 consecutive days and was evaluated for tolerance and therapeutic effects in the trials clinically performed.The assessment of drug efficacy of praziquantel in the dermal cysticercosis was made by comparing the numbers of cysticercus nodules and histopathological findings of the biopsied parasites by means of light, scanning and transmission electron microscope. In the cerebral cysticercosis, the assessment was considered by the frequency of the episodes of convulsive seizure before and after treatment with praziquantel and by the findings of the disapearance or decreased densities of the lesions in C.T. scan in comparison with those of before and after treatment.

The results were as follows:

1. The cysticerci in the subcutaneous tissues began to disappear within one month of drug administration of 3 × 25mg/kg praziquantel over 3 to 7 days. Within 3 to 6 months most of the cysticerci had disappeared, although in some case a small number of cysticercus nodules remained even one year after treatment.

2. Histological observation of the cysticerci biopsied at different times during the course of treatment revealed that morphological changes were already taking place within two weeks after the 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 parts of cysticercus.

3. In 12 cases of cerebral cysticercosis treated with praziquantel at the daily dose of 3 × 35 mg/kg for 3 or 4 consecutive days, there were no ceasing of the convulsive seizures during the 6 months follow-up. Among them 9 cases were given again 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 time. At the same treatment the lesions of the brain C.T. scan disappeared, decreasd in size or calcified after treatment. In other 3 cerebral cysticercosis cases, complete cure was also obtained after the oral medication of praziquantel at the daily dose of 3 × 25 mg/kg for 7 consecutive days.

4. In the treatment of cerebral cysticercosis with praziquantel, it was found that the concomitant oral medication of dexamethasone during the course of treatment was effective for preventing and minimizing the side-effects.

Figures


Figs. 1-4
Fig. 1. Scanning electron micrograph (SEM) of untreated Cysticercus cellulosae: scolex (Sc), suckers and neck region. (&36)

Fig. 2. SEM of treated C. cellulosae (1 week after treatment): scolex, suckers, neck region and bladder wall (cw). (&36)

Fig. 3. SEM of untreated C. cellulosae: microtriches (M) of neck region. (&4,400)

Fig. 4. SEM of treated C. cellulosae (1 week after treatment): the neck region is covered with many bleb like structure (B). (&4,400)



Figs. 5-10
Fig. 5. Untreated normal scolex of C. cellulosae. (&25)

Fig. 6. Scolex of C. cellulosae at 5 weeks after treatment: the dead cysticercus shows narrowing of neck region. (&25)

Fig. 7. Untreated C. cellulosae the section of neck region showing organization of syncytial tegument (&480)

Fig. 8. Treated C. cellulosae (5 weeks after treatment): the section of neck region showing vacuolization in syncytial tegument. (&480)

Fig. 9. Untreated C. cellulosae: thin section of bladder wall showing organization of syncytial tegument covered with microtriches (M), tegumental cell body (TGC) and longitudinal musculature (LM). (&10,000).

Fig. 10. Treated C. cellulosae (5 weeks after treatment): the thing section of bladder wall showing degeneration with pronounced vacuolization (V) of different size. (&10,000)



Figs. 11-14
Fig. 11. Treated cysticercus (5 weeks after treatment): many vacuoles (V) of different size are scattered in the tegument (TG). (&10,000)

Fig. 12. Untreated cysticercus: thin section of neck region showing organization of syncytial tegument (TG) covered with microtriches (M), tegumental cell body (TGC), circular musculature (CM) and longitudinal musculature (LM). (&10,000)

Fig. 13. Untreated cysticercus: the neck region showing cilia of flame cells (CF). (&10,000)

Fig. 14. Treated cysticercus (5 weeks after treatment): degenerated flame cell like structure are seen in the neck region. (&10,000)



Fig. 15-16
Fig. 15. Disintegrated and necrotized cysticercus biopsied on 6 months after treatment: sucker(S), hooklets(h). (&240)

Fig. 16. Disintegrated and necrotized cysticercus biopsied on one months after treatment: capsule (C), worm(W). (&17)


Tables


Table 1
Results of treatment of dermal cysticercosis with praziquantel


Table 2
Results of treatment of cerebral cysticercosis with praziquantel

References
1. Becker B, Mehlhorn H, Andrews P, Thomas H. Scanning and transmission electron microscope studies on the efficacy of praziquantel on Hymenolepis nana (Cestoda) in vitro. Z Parasitenkd 1980;61(2):121–133.
  
2. Botero D, Castaño S. Treatment of cysticercosis with praziquantel in Colombia. Am J Trop Med Hyg 1982;31(4):811–821.
 
3. Brink G, Schenone H, Díaz V, Parra M, Corrales M. [Neurocysticercosis. Treatment with praziquantel. A preliminary study (author's transl)]. Bol Chil Parasitol 1980;35(3-4):66–70.
 
4. Byun JU, et al. J Korean Ophthalm Soc 1965;6:73–77.
5. Chi HS, Chi JG. A Histopathological Study On Human Cysticercosis. Korean J Parasitol 1978;16(2):123–133.
 
6. Espejo H. [Treatment of infections by Hymenolepis nana, Taenia saginata, Taenia solium and Diphyllobothrium pacificum with praziquantel (Embay 8440) (author's transl)]. Bol Chil Parasitol 1977;32(1-2):39–40.
 
7. Jung HR, et al. Korea Univ Med 1973;10:169–177.
8. Jung HW, et al. J Korean Neurosurgical Soc 1978;7(2):507–512.
9. Kim KH, et al. J Korean Rad Soc 1979;15(2):295–302.
10. Kim SU, et al. J Korean Surg Soc 1960;2:101–105.
11. Ku KH, et al. New Med J 1960;3:127–134.
12. Lee NJ, et al. New Med J 1960;3:921–923.
13. Lee KT, Kim CH, Park CT, Lee MY. [Cysticercosis and taeniasis in Chollapukdo Province]. Korean J Parasitol 1966;4(1):39–45.
 
14. Leopold G, Ungethüm W, Groll E, Diekmann HW, Nowak H, Wegner DH. Clinical pharmacology in normal volunteers of praziquantel, a new drug against schistosomes and cestodes. An example of a complex study covering both tolerance and pharmacokinetics. Eur J Clin Pharmacol 1978;14(4):281–291.
  
15. Mehlhorn H, et al. Drug Research 1981;31:544–554.
 
16. Nakao S, et al. J Chosen Med Assoc 1937;27:1587.
17. Park CY, et al. Korea Univ Med J 1982;19(3):595–615.
18. Park CG. J Army Medical Officers Corp 1958;6:69–71.
19. Rim CS, et al. J Korean Neurosurg Soc 1979;8(2):479–488.
20. Rim HJ, Park SB, Lee JS, Joo KH. Therapeutic Effects Of Praziquantel (Embay 8440) Against Taenia Solium Infection. Korean J Parasitol 1979;17(1):67–72.
 
21. Rim HJ, et al. Korea Univ Med J 1980;17:459–475.
22. Rim HJ, Song KW, Joo KH, Lee JS, Kim JJ. [An Epidemiological Note On The Taeniasis In Korea]. Korean J Parasitol 1980;18(2):235–240.
 
23. Spina-França A, Nobrega JP, Livramento JA, Machado LR. Administration of praziquantel in neurocysticercosis. Tropenmed Parasitol 1982;33(1):1–4.
24. Son CG. J Korean Ophthal Soc 1958;1:13–23.
25. Tagashira K. J Chosen Med Assoc 1938;28:1973.
26. Thomas H, et al. Pestic Sci 1977;8:556–560.
 
27. Thomas H, Andrews P, Mehlhorn H. New results on the effect of praziquantel in experimental cysticercosis. Am J Trop Med Hyg 1982;31(4):803–810.
 
28. Weinstein JD, Toy FJ, Jaffe ME, Goldberg HI. The effect of dexamethasone on brain edema in patients with metastatic brain tumors. Neurology 1973;23(2):121–129.
 
Editorial Office
c/o Department of Medical Environmental Biology
Chung-AngUniversity College of Medicine, Dongjak-gu, Seoul 06974, Korea
Tel: +82-2-820-5683   Fax: +82-2-826-1123   E-mail: kjp.editor@gmail.com
About |  Browse Articles |  Current Issue |  For Authors and Reviewers
Copyright © 2020 by The Korean Society for Parasitology and Tropical Medicine. All rights reserved.     powerd by m2community