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Suokai Qian - One of the best experts on this subject based on the ideXlab platform.
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diagnosis and stereotactic aspiration treatment of cerebral Sparganosis summary of 11 cases
Journal of Neurosurgery, 2011Co-Authors: Lei Deng, Pengju Xiong, Suokai QianAbstract:OBJECT: Cerebral Sparganosis is a rare but underestimated parasitic disease caused by infestation by sparganum. It is difficult to make a confirmed preoperational diagnosis of this disease given the absence of characteristic clinical manifestations. A detailed protocol for the diagnosis and treatment of cerebral Sparganosis is still lacking in the literature. In this article the authors set out comprehensive procedures for the diagnosis and treatment of cerebral Sparganosis, describing the use of a stereotactic aspiration technique complemented by microsurgery based on experience gained from multiple cases. METHODS: The disease history, clinical manifestations, imaging features, and therapeutic procedures for 11 patients with cerebral Sparganosis were retrospectively analyzed. Stereotactic aspiration procedures were performed in all 11 patients and were complemented by microsurgeries in 3 patients. The learning and experience gained from these treatments were summarized, and a comprehensive protocol for the diagnosis and treatment of cerebral Sparganosis was reviewed. RESULTS: Larvae of Spirometra mansoni were taken from all 11 patients: completely removed in 10 cases and partially removed in 1 case (discovered later). After surgery, clinical symptoms in all 11 patients were significantly improved. All epileptic symptoms were successfully cured, although in 1 case occasional seizures still occurred because of the incomplete removal of the larva. Muscle strength in the 4 patients who had hemiparesis prior to surgery recovered to normal. Symptoms in the 1 patient who had presented with partial body sensory disturbance resolved after surgery. There were no complications or deaths. CONCLUSIONS: The authors concluded that an effective preoperative diagnosis of cerebral Sparganosis can be made by detailed inquiry into the possible infection history and disease symptoms as well as careful scrutiny of characteristic radiological features and immunological testing results. In stereotactic operations performed to remove the larva, priority should be given to image-guided stereotactic aspiration given that it causes the smallest wounds. In cases in which stereotactic aspiration fails, stereotactic microsurgery should be performed to remove the larva. The surgeon must carefully avoid breaking the larva and leaving behind any larva residue during surgery.
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Diagnosis and stereotactic aspiration treatment of cerebral Sparganosis: summary of 11 cases
Journal of Neurosurgery, 2011Co-Authors: Lei Deng, Pengju Xiong, Suokai QianAbstract:Object Cerebral Sparganosis is a rare but underestimated parasitic disease caused by infestation by sparganum. It is difficult to make a confirmed preoperational diagnosis of this disease given the absence of characteristic clinical manifestations. A detailed protocol for the diagnosis and treatment of cerebral Sparganosis is still lacking in the literature. In this article the authors set out comprehensive procedures for the diagnosis and treatment of cerebral Sparganosis, describing the use of a stereotactic aspiration technique complemented by microsurgery based on experience gained from multiple cases. Methods The disease history, clinical manifestations, imaging features, and therapeutic procedures for 11 patients with cerebral Sparganosis were retrospectively analyzed. Stereotactic aspiration procedures were performed in all 11 patients and were complemented by microsurgeries in 3 patients. The learning and experience gained from these treatments were summarized, and a comprehensive protocol for the...
Lei Deng - One of the best experts on this subject based on the ideXlab platform.
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diagnosis and stereotactic aspiration treatment of cerebral Sparganosis summary of 11 cases
Journal of Neurosurgery, 2011Co-Authors: Lei Deng, Pengju Xiong, Suokai QianAbstract:OBJECT: Cerebral Sparganosis is a rare but underestimated parasitic disease caused by infestation by sparganum. It is difficult to make a confirmed preoperational diagnosis of this disease given the absence of characteristic clinical manifestations. A detailed protocol for the diagnosis and treatment of cerebral Sparganosis is still lacking in the literature. In this article the authors set out comprehensive procedures for the diagnosis and treatment of cerebral Sparganosis, describing the use of a stereotactic aspiration technique complemented by microsurgery based on experience gained from multiple cases. METHODS: The disease history, clinical manifestations, imaging features, and therapeutic procedures for 11 patients with cerebral Sparganosis were retrospectively analyzed. Stereotactic aspiration procedures were performed in all 11 patients and were complemented by microsurgeries in 3 patients. The learning and experience gained from these treatments were summarized, and a comprehensive protocol for the diagnosis and treatment of cerebral Sparganosis was reviewed. RESULTS: Larvae of Spirometra mansoni were taken from all 11 patients: completely removed in 10 cases and partially removed in 1 case (discovered later). After surgery, clinical symptoms in all 11 patients were significantly improved. All epileptic symptoms were successfully cured, although in 1 case occasional seizures still occurred because of the incomplete removal of the larva. Muscle strength in the 4 patients who had hemiparesis prior to surgery recovered to normal. Symptoms in the 1 patient who had presented with partial body sensory disturbance resolved after surgery. There were no complications or deaths. CONCLUSIONS: The authors concluded that an effective preoperative diagnosis of cerebral Sparganosis can be made by detailed inquiry into the possible infection history and disease symptoms as well as careful scrutiny of characteristic radiological features and immunological testing results. In stereotactic operations performed to remove the larva, priority should be given to image-guided stereotactic aspiration given that it causes the smallest wounds. In cases in which stereotactic aspiration fails, stereotactic microsurgery should be performed to remove the larva. The surgeon must carefully avoid breaking the larva and leaving behind any larva residue during surgery.
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Diagnosis and stereotactic aspiration treatment of cerebral Sparganosis: summary of 11 cases
Journal of Neurosurgery, 2011Co-Authors: Lei Deng, Pengju Xiong, Suokai QianAbstract:Object Cerebral Sparganosis is a rare but underestimated parasitic disease caused by infestation by sparganum. It is difficult to make a confirmed preoperational diagnosis of this disease given the absence of characteristic clinical manifestations. A detailed protocol for the diagnosis and treatment of cerebral Sparganosis is still lacking in the literature. In this article the authors set out comprehensive procedures for the diagnosis and treatment of cerebral Sparganosis, describing the use of a stereotactic aspiration technique complemented by microsurgery based on experience gained from multiple cases. Methods The disease history, clinical manifestations, imaging features, and therapeutic procedures for 11 patients with cerebral Sparganosis were retrospectively analyzed. Stereotactic aspiration procedures were performed in all 11 patients and were complemented by microsurgeries in 3 patients. The learning and experience gained from these treatments were summarized, and a comprehensive protocol for the...
Zhong Quan Wang - One of the best experts on this subject based on the ideXlab platform.
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characterization of spirometra erinaceieuropaei plerocercoid cysteine protease and potential application for serodiagnosis of Sparganosis
PLOS Neglected Tropical Diseases, 2015Co-Authors: Li Na Liu, Zhong Quan Wang, Peng Jiang, Xi Zhang, Ruo Dan Liu, Zi Fang Zhang, Jing CuiAbstract:Background Sparganosis is a neglected but important food-borne parasitic zoonosis. Clinical diagnosis of Sparganosis is difficult because there are no specific manifestations. ELISA using plerocercoid crude or excretory–secretory (ES) antigens has high sensitivity but has cross-reactions with other helminthiases. The aim of this study was to characterize Spirometra erinaceieuropaei cysteine protease (SeCP) and to evaluate its potential application for serodiagnosis of Sparganosis. Methodology/Principal Findings The full length SeCP gene was cloned, and recombinant SeCP (rSeCP) was expressed and purified. Western blotting showed that rSeCP was recognized by the serum of sparganum-infected mice, and anti-rSeCP serum recognized the native SeCP protein of plerocercoid crude or ES antigens. Expression of SeCP was observed at plerocercoid stages but not at the adult and egg stages. Immunolocalization identified SeCP in plerocercoid tegument and parenchymal tissue. The rSeCP had CP activity, and the optimum pH and temperature were 5.5 and 37°C, respectively. Enzymatic activity was significantly inhibited by E-64. rSeCP functions to degrade different proteins and the function was inhibited by anti-rSeCP serum and E-64. Immunization of mice with rSeCP induced Th2-predominant immune responses and anti-rSeCP antibodies had the potential capabilities to kill plerocercoids in an ADCC assay. The sensitivity of rSeCP-ELISA and ES antigen ELISA was 100% when performed on sera of patients with Sparganosis. The specificity of rSeCP-ELISA and ES antigen ELISA was 98.22% (166/169) and 87.57% (148/169), respectively (P<0.05). Conclusions The rSeCP had the CP enzymatic activity and SeCP seems to be important for the survival of plerocercoids in host. The rSeCP is a potential diagnostic antigen for Sparganosis.
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Serodiagnosis of Sparganosis by ELISA using recombinant cysteine protease of Spirometra erinaceieuropaei spargana
Parasitology Research, 2014Co-Authors: Xi Zhang, Jian Zhou, Rui Zhe He, Peng Jiang, Zhong Quan WangAbstract:The Spirometra erinaceieuropaei cysteine protease (SeCP) gene encoding a 36 kDa protein was expressed in Escherichia coli, and the potential of recombinant SeCP protein (rSeCP) as an antigen for the serodiagnosis of Sparganosis was investigated by ELISA and compared with those of ELISA with sparganum excretory–secretory (ES) antigens. The sensitivity of rSeCP-ELISA and ES-ELISA was 96.67 % (29/30) and 100 % (30/30) respectively, for the detection of anti-sparganum IgG antibodies in sera of the experimentally infected mice (P > 0.05), and the specificities of both ELISA were 100 % (77/77). In heavily, moderately, and lightly infected mice (five, three, and one larvae per mouse), anti-sparganum antibodies were firstly detected by rSeCP-ELISA at 10–12 days post-infection (dpi), respectively, and then continued to increase with a detection rate of 100 % at 14–22 dpi. In three groups of infected mice, the anti-sparganum antibody levels at different times after infection were statistically different (P < 0.05). The results showed that the rSeCP might be a potential candidate antigen for early and specific serodiagnosis of Sparganosis. But, it needs to be further evaluated with sera of the patients with Sparganosis and other helminthiasis.
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immunoproteomic analysis of the excretory secretory proteins from spirometra mansoni sparganum
Iranian Journal of Parasitology, 2013Co-Authors: Dan Dan Hu, Li Wang, Zhong Quan WangAbstract:Background: Sparganosis is caused by the invasion of Spirometra sparganum into various tissues/organs. Subcutaneous Sparganosis can be diagnosed by biopsy , while visceral/cerebral Sparganosis is not easy to be diagnosed. The diagnosis de-pends largely on the detection of specific anti-sparganum antibodies. T he specific-ity of the ELISA could be increased by using S. mansoni sparganum excretory– secretory (ES) antigens, but it also had the cross-reactions with sera of p atients with cysticercosis or paragonimiasis . The aim of this study was to identify early specific diagnostic antigens in S. mansoni sparganum ES proteins . Methods: The sparganum ES proteins were analyzed by two-dimensional electro-phoresis (2-DE) and Western blot probed with early sera from infected mice at 14 days post-infection. The immunoreactive protein spots were characterized by MALDI-TOF/ TOF-MS. Results: A total of approximately 149 proteins spots were detected with isoelectric point (pI) varying from 3 to 7.5 and molecular weight from 20 to 115 kDa and sev-en protein spots with molecular weight of 23-31 kDa were recognized by the infec-tion sera. Three of seven spots were successfully identified and characterized as the same S. mansoni protein (cysteine protease), and the proteins of other 4 spots were not included in the databases. Conclusion: The cysteine protease from S. mansoni ES proteins recognized by early infection sera might be the early diagnostic antigens for Sparganosis.
Pengju Xiong - One of the best experts on this subject based on the ideXlab platform.
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diagnosis and stereotactic aspiration treatment of cerebral Sparganosis summary of 11 cases
Journal of Neurosurgery, 2011Co-Authors: Lei Deng, Pengju Xiong, Suokai QianAbstract:OBJECT: Cerebral Sparganosis is a rare but underestimated parasitic disease caused by infestation by sparganum. It is difficult to make a confirmed preoperational diagnosis of this disease given the absence of characteristic clinical manifestations. A detailed protocol for the diagnosis and treatment of cerebral Sparganosis is still lacking in the literature. In this article the authors set out comprehensive procedures for the diagnosis and treatment of cerebral Sparganosis, describing the use of a stereotactic aspiration technique complemented by microsurgery based on experience gained from multiple cases. METHODS: The disease history, clinical manifestations, imaging features, and therapeutic procedures for 11 patients with cerebral Sparganosis were retrospectively analyzed. Stereotactic aspiration procedures were performed in all 11 patients and were complemented by microsurgeries in 3 patients. The learning and experience gained from these treatments were summarized, and a comprehensive protocol for the diagnosis and treatment of cerebral Sparganosis was reviewed. RESULTS: Larvae of Spirometra mansoni were taken from all 11 patients: completely removed in 10 cases and partially removed in 1 case (discovered later). After surgery, clinical symptoms in all 11 patients were significantly improved. All epileptic symptoms were successfully cured, although in 1 case occasional seizures still occurred because of the incomplete removal of the larva. Muscle strength in the 4 patients who had hemiparesis prior to surgery recovered to normal. Symptoms in the 1 patient who had presented with partial body sensory disturbance resolved after surgery. There were no complications or deaths. CONCLUSIONS: The authors concluded that an effective preoperative diagnosis of cerebral Sparganosis can be made by detailed inquiry into the possible infection history and disease symptoms as well as careful scrutiny of characteristic radiological features and immunological testing results. In stereotactic operations performed to remove the larva, priority should be given to image-guided stereotactic aspiration given that it causes the smallest wounds. In cases in which stereotactic aspiration fails, stereotactic microsurgery should be performed to remove the larva. The surgeon must carefully avoid breaking the larva and leaving behind any larva residue during surgery.
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Diagnosis and stereotactic aspiration treatment of cerebral Sparganosis: summary of 11 cases
Journal of Neurosurgery, 2011Co-Authors: Lei Deng, Pengju Xiong, Suokai QianAbstract:Object Cerebral Sparganosis is a rare but underestimated parasitic disease caused by infestation by sparganum. It is difficult to make a confirmed preoperational diagnosis of this disease given the absence of characteristic clinical manifestations. A detailed protocol for the diagnosis and treatment of cerebral Sparganosis is still lacking in the literature. In this article the authors set out comprehensive procedures for the diagnosis and treatment of cerebral Sparganosis, describing the use of a stereotactic aspiration technique complemented by microsurgery based on experience gained from multiple cases. Methods The disease history, clinical manifestations, imaging features, and therapeutic procedures for 11 patients with cerebral Sparganosis were retrospectively analyzed. Stereotactic aspiration procedures were performed in all 11 patients and were complemented by microsurgeries in 3 patients. The learning and experience gained from these treatments were summarized, and a comprehensive protocol for the...
Daojun Hong - One of the best experts on this subject based on the ideXlab platform.
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efficacy comparison between long term high dose praziquantel and surgical therapy for cerebral Sparganosis a multicenter retrospective cohort study
PLOS Neglected Tropical Diseases, 2018Co-Authors: Daojun Hong, Huiqun Xie, Hui Wan, Jun ZhangAbstract:Background Sparganosis is a parasitic infection caused by the plerocercoid larvae of Spirometra mansoni in East and Southeast Asia. The plerocercoid larvae sometimes invade the encephalon, resulting in severe cerebral Sparganosis. Surgical removal of the larvae is considered a standard therapy for cerebral Sparganosis. In contrast, the efficacy and safety of long-term, high-dose praziquantel treatment for cerebral Sparganosis have not been explored. Methodology/Principal findings In this multicenter retrospective study, we assessed the records of 96 patients with cerebral Sparganosis who consulted at three medical centers from 2013 to 2017. Forty-two patients underwent surgical lesion removal, and the other 54 patients received long-term, high-dose praziquantel (50 mg/kg/day for 10 days, repeated at monthly intervals). The primary outcome was the complete disappearance of active lesions on cerebral magnetic resonance imaging. The secondary outcomes included the modified Rankin scale score at 90 days, incidence of seizure, eosinophil count, and serological Spirometra. mansoni antibody titer. The efficacy of praziquantel treatment was similar to that of surgical lesion removal for cerebral Sparganosis with respect to both the primary outcome and secondary outcomes. Although binary logistic regression models also supported the primary outcome after adjustment for age, sex, lesion location, and loss to follow-up, some unavoidable confounders might have biased the statistical power. No significant clinical complications or laboratory side effects occurred in the praziquantel group with the exception of a relatively benign allergic reaction. Conclusions/Significance In this small-sample, nonrandomized, retrospective exploratory study, some patients with cerebral Sparganosis were responsive to long-term, high-dose praziquantel with an efficacy similar to that of surgical lesion removal. These findings increase the treatment flexibility for this serious infection.
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cerebral Sparganosis in mainland chinese patients
Journal of Clinical Neuroscience, 2013Co-Authors: Daojun Hong, Huiqun Xie, Min Zhu, Hui WanAbstract:Cerebral Sparganosis is a severe parasitic infection caused by the larvae of Spirometra mansoni. We retrospectively reviewed the clinical data of 26 patients with cerebral Sparganosis diagnosed in our center and reviewed the literature on cerebral Sparganosis in mainland China. Among our 26 patients, 20 suffered from seizures, 11 had limb weakness and 11 experienced headaches. The characteristic MRI features included ring-like enhancement in 24 patients, tunnel lesions in 14 patients and lesion migration in seven patients. Twenty-three patients underwent surgery, with the brain tissues of all patients revealling many inflammatory tunnels. Inside these tunnels, live or degenerate larvae were identified in 20 patients, but only eosinophilic tunnels were identified in the three remaining patients. All patients in this series received praziquantel, with three patients receiving praziquantel alone, with no surgical intervention, and all had a favorable outcome on long term follow-up. At least 82 patients with cerebral Sparganosis with histo pathological confirmation have been reported in mainland China. The clinical course, radiological features, and pathological features of mainland Chinese patients were mostly similar to those reported in other regions. There exists an inherent correlation between radiological features and pathological changes, with worm migration causing multiple inflammatory tunnels, especially eosinophilic tunnels, which thus form the basis of tunnel-like or ring-like enhancement on multi-planar MRI, and might be predictors for a poor prognosis. Surgical therapy is optimal in the treatment for cerebral Sparganosis, but medication (praziquantel and dexamethasone) has achieved favorable outcomes in some patients.