The upper and the lower master models of Class II mod.1 by the Kennedy of classification were duplicated to the dentists in the dental clinic Suncheon, and the status of the surveying procedure, the form and type of the major connector, the form and type of the direct retainer, the location and status of the indirect retainer, and the modification of abutment were surveyed and analyzed and were compared to the principles of the design rationale of the removable partial denture to evaluate whether or not each component of the removable partial denture framework designed by the dentists. The analyzed results were as follows: 1. The status with or without the surveying procedure was showed 7 cases(10.29%) and 61 cases(89.71%) respectively. 2. Single palatal strap, A-P bar, broad palatal plate, complete coverage palatal major connector, single palatal bar, U-shaped palatal connector, and the others without drawing of the major connector were 27 cases (38.57%), 25 cases(35.71%), 5 cases(7.01%), 4 cases(5.71%), 2 cases (2.86%), 1 cases(1.43%), 6 cases(8.57%) respectively in the design patterns of the maxillary major connectors, and lingual bar, linguoplate, and others without drawing of the major connector were 55 cases(80.88%), 11 cases(16.18%), 2 cases(2.84%), respectively in the pattern of the mandibular major connectors. 3. The direct retainer designed to the 1st bicuspid of the upper left and the lower right adjacent to the free-end edentulous area was that the design of bar clasp was 67.41% in the highest rate and that of Akers clasp was 23.36%. 4. The direct retainer designed to the 1st bicuspid of the upper right and the lower left was that the of Akers clasp was 56.62% in the highest rate and that of bar clasp was 33.82%. 5. The mesial rests of the 1st bicuspid of the upper left and the lower right adjacent to the free-end edentulous area were 77.46%, 66.20% respectively and the distal rests and mesial rests of the 1st bicuspid of the upper left and the lower right were 58.82%, 55.71%, 38.24%, 38.57% respectively and the mesial rests of the 2nd molar of the upper right and the lower left were 95.71%, 95.65% respectively, viewed from the location of the occlusal rest seat. 6. The cases without the design of the indirect retainer were 51.47% in the upper and the lower master models respectively. 7. The modification of abutments(surveyed crown) of upper and lower teeth were 8.82%, 8.82% respectively.
Bicuspid ; Dental Clinics ; Dentists ; Denture, Partial, Removable ; Humans ; Leprosy ; Molar ; Tooth

Leprosy is disease of skin and peripheral nerve especially. Sequale and disability of musculoskeletal system, especially peripheral extremities (hands and foots) can be developed due to severe and irreversible peripheral nerve damage in leprosy. In leprosy, Skin ulcers can relapse very often and progress to deformity and amputation of hands or foot. We need methods to treat skin ulcer effectively. We have used various therapies such as antibiotics in infectious state, disinfectant, variable wet dressing materials(transparent film, foams, gels&hydrogels, hydrocolloids, calcium alignate), silver dressing, Vacuum Assisted Closure unit, debridement, curettage, surgery to treat skin ulcer in leprosy patients. Sometimes we can treat skin ulcer successfully but, we often encounter ulcer resistant to treat. We need to find and develop methods to treat ulcer successfully. Several researches have reported articles to treat wound successfully using light emitting diode(LED). We tried to treat ulcer in old leprosy patients using LED. We divided ulcers patients into case group(conventional dressing therapy + LED therapy) and control group (only conventional dressing therapy) randomly in out patient department and in ward. This research was carried out from February 2012 to September 2012. Case group and control group have composed of 30 patients respectively. Average age of patients was 74 years old in case group and 69 years old in control group. We have used LED device composed of 700 pieces of diodes emitting 635nm and 500 pieces of diodes emitting 830nm, totally 1200 pieces of diodes. We have observed the size of wounds twice per week in control group and case group. Before treatment average size of wounds was 8509.76mm3 in case group and 8625.33mm3 in control group. P-vale was 0.49. There was no significant difference in case and control group. After treatment average size of wounds was 787.83mm3 in case group and 8074.63mm3 in control group. P-vale was 0.02. There was significant difference in case and control group. After treatment average reduction of size per time was 338.02mm3/day in case group and 26.55mm3/day in control group. P-vale was 0.002. There was significant difference in case and control group. Therefore we have concluded that LED device was effective in wound treatment. Some articles have reported that LED Device have helped to treat wounds in DM ulcer, third degree burn, oral ulcer, skin ulcer in Klippel-Trenaunay syndrome patient, some retinopathy etc. We have concluded that LED of infrared or long visible wavelength light can be used effectively in treatment of wound along with conventional treatment concurrently.
Amputation ; Anti-Bacterial Agents ; Bandages ; Burns ; Calcium ; Colloids ; Congenital Abnormalities ; Curettage ; Debridement ; Enzyme Multiplied Immunoassay Technique ; Extremities ; Foot ; Foot Ulcer ; Hand ; Humans ; Klippel-Trenaunay-Weber Syndrome ; Leprosy ; Light ; Musculoskeletal System ; Negative-Pressure Wound Therapy ; Oral Ulcer ; Peripheral Nerves ; Recurrence ; Silver ; Skin ; Skin Ulcer ; Ulcer

Changes in the eye resulting from leprosy include lagophthalmos, ectropion and the eyelid retraction. In lagophthalmos, an interpalpebral gap(lid gap) of 2mm or less, which is most preferred after correction, does not have any adverse effect on the vision. However, a gap of 3mm or greater can cause or make the eye susceptible to the dryness of the cornea or other vision problems. Bell's phenomenon will adequately prevent eye damages, especially corneal damage when the lid gap is less than 3mm. Although static methods such as autogenous canthal sling, lateral tarsal strip, medial tarsorrhaphy and gold implant had a positive cosmetic effect when used in combination, the lid gap could hardly reduce to less than 3mm. Frequent recurrence of lagophthalmos and ectropion after static methods required further definite surgical treatment. We applied a dynamic method of modified Gillies to correct lagophthalmos and it was successful in reducing the lid gap to less than 2mm in most cases.
Cornea ; Cosmetics ; Ectropion ; Eye ; Eyelids ; Leprosy ; Recurrence ; Vision, Ocular

The emergence of multiple drug resistant Mycobacterium leprae has emphasized the need for early decision of effective antileprosy drug in the treatment for leprosy patients. Mutations in the genes associated with multiple drug resistance in Mycobacterium leprae isolates from 17 South Korean patients, who were already confirmed to have mutations in folP1 gene, were investigated using a PCR - single strand conformation polymorphism (SSCP) - DNA sequencing assay. Two strains, which has double mutations, were found in the two unrelated patients : one missense mutation in folP1 (Arg 55 for Pro) and in rpoB (Gly 522 for Ser), and in folP1 (Ala 53 for Thr) and in gyrB (Asn 426 for Asp), respectively. The patients were treated with the long monotheraphy of dapsone or with the inappropriate regimen of antileprosy drugs. These results emphasize the importance of multi-drug theraphy in order to prevent mult-idrug resistance and assist in the choice of the appropriate regimens for treating leprosy.
Dapsone ; Drug Resistance, Multiple* ; Humans ; Korea* ; Leprosy ; Mutation, Missense ; Mycobacterium leprae* ; Mycobacterium* ; Polymerase Chain Reaction ; Sequence Analysis, DNA

BACKGROUND: At the present time, more than 100 cases of squamous cell carcinoma (SCC) developing in neurotrophic ulcers of leprosy have been reported. But the histopathologic features and the differences between SCC in leprosy and de novo SCC was not described. OBJECTIVE: The purpose of this study was to evaluate the characteristics of SCC in leprosy and to investigate growth dynamics of SCC in ulcers in leprosy. METHODS: We reviewed the clinical features and the degree of histopathologic differentiation of 13 cases of SCC in ulcers of leprosy patients presenting at the KLCA from 1986 to 1998. And immunohistochemical staining with PCNA(proliferating cell nuclear antigen) and TUNEL staining were done in paraffin-embedded tissue sections from 18 sites of 13 cases of SCC in ulcers of leprosy. RESULTS: 1. The average duration of leprosy and of an ulcer prior to diagnosis of SCC was 43 years and 19 years, respectively. 2. Histopathologic grading of 13 cases was performed as follows:10 cases were well-differentiated and 3 cases were moderately-differentiated. 3. The PCNA LI(labelling index) was 47.26+/-7.38% in well-differentiated group and 48.86+/-9.39% in moderately -differentiated group. 4. The apoptotic index(AI) was 45.57+/-8.68% in well- differentiated group and 29.38+/-1.06% in moderately differentiated group. The AI in de novo SCC was 45.09+/-6.18%. CONCLUSION: (1) Malignant change in chronic ulcer in leprosy may be found more often if patients are examined with care. (2) Our leprosy case with SCC is a 63-year-old male with past history of lepromatous leprosy of 43 year duration having ulcer problems for 19 years before presenting with SCC on an average. (3) High-degrees of malignancy in SCC of leprosy patients might be caused by extended cell survival due to decreased apoptosis rather than increased cell proliferation.
Apoptosis ; Carcinoma, Squamous Cell* ; Cell Proliferation ; Cell Survival ; Diagnosis ; Humans ; In Situ Nick-End Labeling ; Leprosy* ; Leprosy, Lepromatous ; Male ; Middle Aged ; Proliferating Cell Nuclear Antigen ; Ulcer*

Internet* ; Leprosy*

To prepare the postelimination phase of Hansen's disease in Korea, it is mandatory to review antileprosy strategies that we have pursued in the past, present and future in medical aspects of the plans. The status of Hansen's disease in Korea has reached beyond the elimination period defined as less than one case per 10000 population. The successful control of Hansen's disease up to postelimination stage totally due to the careful support from governmental level, endless efforts of medical staffs who have been engaging in leprosy works, and cooperations of patients. We can suppose that eradication of Hansen's disease will become a true dream within next 25-50 years. With one hundred percent coverage of MDT(multidrug therapy), gradual decrease of new cases and effective health care systems, no re-emergence of Hansen's disease as seen in 1960's and 1970's is conclusive. However we are in the period of elimination of the disease, new cases will continue to occur in small numbers not more than twenty. Special strategies will have to be developed for postelimination phase in Korea. The strategies for Hansen's disease surveillance system need to be different from the past Hansen's disease control system. It should contain regional core groups which includes surgical and medical rehabilitation experts, and a few research group and one referral center. The budget for the groups will come from contraction between government and scientists in medical schools, and NGOs. For national and regional plan of COT(completion of the treatment), it could be more reasonable to separate MB(multibacillary)cases into two groups depend on their possible reactions and relapse after cessation of MDT. First group contains those patients with high BI(bacterial index) more than 4+ need MDT for 24 months. The second group means those patients with low BI less than 4+ need for 12 months MDT as seen in recommendation of WHO short term regimen. In case of PB(paucibacillary) there is few report of relapse following 6 month MDT. In the past period implementation of MDT was so imperative that the other important things for patients cares like prevention of deformities and rehabilitation surgery are neglected and many of them lost golden opportunities to correct deformities in the field. When it is possible to find changes of nerve functions within 12 months, corresponding deformities could be preventable. The mission of mobile team in the past is focused on detection of new cases, but time changes to find no new cases with mobile works. The mobile teams from KLCA(Korean Leprosy Control Association) and NGOs should reshape their aims for care of foot ulcer and prevention of neurological deformities. Outpatient clinics for Hansen's disease will be integrated gradually to horizontal medical care system as like university affiliated hospitals which was done in Japan during from 1973 to 1983. It will give the patients more better quality of medical service. Though the elimination of leprosy does not mean elimination of leprosy research work, there happened brain drain from leprosy to tuberculosis or other research areas. There has been a sympathetic agreement to get gradual decline for support for leprosy research. This will hamper the development of new technologies which are needed for leprosy elimination and beyond. The priorities for research in leprosy have changed as a result of the success of the MDT. Possible recommended leprosy research priorities in Korea should include development of methods to improve the early detection of reactions and nerve damage, development of more effective methods of treatment for reactions and nerve damage, development of more effective and efficient prevention of disability(POD), development of more effective self-care and footwear for patients with impairment and other research works in leprosy.
Ambulatory Care Facilities ; Brain ; Budgets ; Congenital Abnormalities ; Delivery of Health Care ; Foot Ulcer ; Humans ; Japan ; Korea* ; Leprosy* ; Medical Staff ; Missions and Missionaries ; Recurrence ; Referral and Consultation ; Rehabilitation ; Schools, Medical ; Self Care ; Tuberculosis

The Clofazimine is a rimino-phenazine dye. The color is a purplish-back. The drug is reported to be weakly bactericidal and also effective in the management of leprosy reactions apparently. The drug produces relatively few side effects in the majority of patients. The most prominent is coloration of the skin. The coloration can range anywhere from a reddish-tan to purplish-black. so, many patients avoid taking clofazimine. The Q-switched ND-YAG laser is a good medical instrument for clearing coloration of the skin. It releases two wavelength of 532nm and 1064nm. The wavelength of 532nm reachs shallow depth of the skin. So, it is effective in the clearance of a red, yellow tatto, freckle and lentigo. The wavelength of 1064nm reachs about 4-6mm depth of the skin. So, it is effective in the clearance of blue-black tatto and ota nevus. The leprosy patients who has purplish-black coloration of the skin in the face due to clofazimine is cleared by Q-switched ND-YAG laser. We operated twice with 3months interval. The wavelength is 532nm, spot size 3mm, energy 1.5J/cm2. The coloration of the skin in the face is almost cleared.
Clofazimine* ; Humans ; Lasers, Solid-State* ; Lentigo ; Leprosy ; Melanosis ; Nevus of Ota ; Skin*

The untreated leprosy skin takes on a waxy appearance & feel full. Thickening is most marked over the face, which starts to devolp into folds, hanging down to produce the classical lion-like facies. The deep folds in disease state change to the numerous compacted shallow wrinkle with less elasticity of the skin. To correct these wrinkles of the patients healed from the leprosy, we tried the stone-VK formula application to the 14 patients, who are men 10 & women 4 in the age distribution of 55~78 years old. The use of the phenol & croton oil chemical peeling this method is more effective than other chemical & conventional surgical method to remove facial wrinkle. We need more experience of this peeling. In preliminaxy report, our superior results in removing facial wrinkle is presented.
Age Distribution ; Croton Oil ; Elasticity ; Facies ; Female ; Humans ; Leprosy* ; Male ; Phenol* ; Skin

A main objective of public health work is to increase life expectancy in the best health conditions possible. Mortality data represent essential elements for the quantification of health problems. Death counts and related rates are among the simplest indicators to analyze mortality. They represent a summary measure of a population's mortality experience that may be used to establish and monitor health priorities or objectives. Years of Potential Life Lost (YPLL) is a measure of the relative impact of several diseases and health problems in a society, The objective of this indicator is to provide a wider view of the relative importance of the most relevant causes of premature mortality and it is used primarily in the planning and definition of health priorities. To proffer the idea for the development of total Hansen service system programme, I present the reviews of the life expectancy and Years of Potential Life Lost in the case under Hansen service and general population in Korea.
Health Priorities ; Humans ; Korea ; Leprosy* ; Life Expectancy* ; Mortality ; Mortality, Premature ; Public Health