肝吸虫症の臨床的疫学的研究

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タイトル別名
  • キモスイチュウショウ ノ リンショウテキエキガクテキ ケンキュウ
  • Clinical and Epidemiological Studies on Clonorchiasis
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  • Original Article

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The present studies were carried out in the outpatients of Omigawa Central Hospital, as well as in the inhabitants of Omigawa-Machi, Katori-Gun, Chiba Prefecture, located along the Tone river. 1. 98.89 % of 267 inhabitants of Ichinowakeme-shinden who were investigated habitually eat fresh water fish. Crucian carp ranks first as the fresh water fish eaten by them, followed by Ctenopharyngodon dellus. 2. 16.34 % of those under investigation eat fresh water fish once a week and 34.64 % once a month. Persons who are positive for the eggs of Clonorchis have a high incidence of eating fresh water fish than those negative for them, and men have a higher incidence than women. 3. 56.86 % eat raw fresh water fish. Persons who are positive for the eggs of Clonorchis have a higher incidence of eating raw fresh water fish than those negative for them, and men have a higher incidence than women. 4. Carriers of the eggs of Clonorchis are distributed in all the age groups above 21 years, especially in those over 31 years. The incidence of carriers is higher among men than among, women. 5. Of all the parasite worms other than Clonorchis, Ascaris .has the highest rate of infestation (38.57 %), while Ancylostoma only has a low rate of 1.42 %. Ascaris has the highest incidence of double infestation with Clonorchis, while Ascaris and Trichuris trichiura have the highest incidence of triple infestation with it. 6. A modification of AMS method, dilute hydrochloric acid ether method, M.G.L. method, formalin method, smear method and suspension method were employed to detect the eggs of Clonorchis. A modification of AMS method had the highest rate of detection. 7. Among the subjective symptoms most frequently encountered are upper abdominal pains and ennui, followed by the sense of fullness in the upper abdominal region, dizziness, loss of appetite and palpitation. 8. Tenderness in the upper abdominal region is the objective symptom most frequently encountered.

Other objective symptoms included jaundice, enlargement of the liver, anemia, edema, ascites and flatulence. 9. Peripheral blood picture showed anemia and an increase in eosinophil cell count. Specific gravity of the whole blood and serum and serum protein levels were nearly normal. 10. Of all the bile pigments detected in the urine, urobilinogen showed the highest rate of detection (20%). 11. Bromsulphalein tests, serum cadomium reaction tests, serum cobalt reaction tests, Meulengracht's test and serum Takada reaction tests were performed to determine liver function. The persons showing marked changes were: 13.89 % by serum cadomium reaction tests, 5.31 % by Meulengracht's tests, 12.7 % by serum Takada reaction tests, and 10.81 % by bromsulphalein tests. Chloroquine diphosphate was given to 5 patients. The treatment was very effective, causing the disappearance of the eggs from the duodenal juice and feces.

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