We had given the Anti-PGL-1 ELISA test to the 235 leprosy patients in our Hospital from July 1999 to Aug 2000. There are 48 patients(20.4%) who are over 200 PGL-1 Ab score and 11 patients(4.7%) who are over 500. The patients who are over 500 of PGL-1 Ab score are all lepromatous leprosy and they have been treated from 5 to 49 years. Two patients among them are positive patients and 9 patients are to be observed only I think that they need to be followed up and if the score of Ab has incresed. We suspect that those patients will become active.
Enzyme-Linked Immunosorbent Assay* ; Humans ; Leprosy ; Leprosy, Lepromatous

It is well known that M. leprae involves peripheral nerves, but it is a few known that M. leprae involves craninal nerves. I experienced one case of relapsed leprosy accompanied by multiple cranial nerve palsies. Revealed symptoms are to involve trigeminal nerve (V). facial nerve (VII), vestibular nerve (VIII), glossopharyngeal nerve (IX), vagus nerve (X). It is not effect to treat with corticosteroid, but is good effect to treat with MDT(multiple drug therapy)
Cranial Nerve Diseases* ; Cranial Nerves* ; Dystroglycans ; Facial Nerve ; Glossopharyngeal Nerve ; Leprosy* ; Peripheral Nerves ; Trigeminal Nerve ; Vagus Nerve ; Vestibular Nerve

Lepra bacilli invade the nasal mucosa from early stage. The infiltrated mucous membrane breaks down and ulcerates easily. Irritating crusts and ulcers occur, creating in perforation of the septum. When most of the septum and inner mucosal lining of the nose is destroyed, the nose is deprived of its support and it collapses. The nasal bones are typically intact, and the collapsed nose adheres to the facial skeleton, giving the characteristic 'sunken and short nose' deformities. We have operated on 25 patients with deformities such as short nose, sunken nose, collumela deformity and ala collapse since 1992. In short nose we operated with a paramedian forehead flap and rib cartilage graft in a cantilever pattern. In ala collapse we used a conchal cartilage graft. Lastly, in collumela deformity we used the local flap and a composite graft.
Cartilage ; Congenital Abnormalities* ; Forehead ; Humans ; Leprosy* ; Mucous Membrane ; Nasal Bone ; Nasal Mucosa ; Nose ; Ribs ; Skeleton ; Transplants ; Ulcer

To find out whether the susceptibility to Hansen's disease are associated with HLA genes, serological and nucleotide typing of HLA-A, B, and DRB1 alleles have been conducted in 301 Hansen's disease patients[190 Multibacillary cases(MB, LL/BL), 111 Paucibacillary cases(PB, TT/BT) confirmed at the time of diagnosis, almost of them were treated with Multidrug therapy] and 928 healthy controls from a population in Seoul and Northern area of Han River in Kyunggi Province, Korea. HLA-A30[relative risk(RR) 1.58, chi-square=4.89, P=0.04] was significantly associated with Hansen's disease. In contrast to HLA-B27(RR 0.20, chi-square=11.34, P=0.0002), which was negatively associated with Hansen's disease as a whole, in MB and PB separately, HLA-B52(RR 1.97, chi-square=6.89, P=0.002) and B46(RR 1.63, chi-square=4.84, P=0.04) were significantly increased in Hansen's disease. DRB1*02 was associated with MB(LL/BL)[RR 1.96, chi-square=13.47, P=0.0004] but not with PB(TT/BT). Further works about oligonuceotide typing of DQA,B, and DPB1 are ongoing. High resolution study to define DRB1*02 alleles will be performed.
Alleles ; Diagnosis ; Gyeonggi-do ; HLA-A Antigens* ; Korea ; Leprosy* ; Rivers ; Seoul

Since Mycobacterium leprae, the causative organism of Leprosy, proliferate inside macrophages, it has been speculated that catalase encoded by the katG gene may protect acid-fast bacilli from the deleterious effects of peroxide generated from macrophage and may play a crucial role in the survival of M. leprae in vivo. The homology of E. coli katG gene is also identified from M. tuberculosis and M. leprae recently. However, the katG gene of M. leprae is thought to be a pseudogene, unlike that of M. tuberculosis, because it contains multiple deletions, implicating that isoniazid(INH), which is activated to a potent tuberculocidal agent by catalase encoded by the katG gene, is unlikely to be of therapeutic benefit to leprosy patients. We have tested 1) the role of KatG protein in activation of INH by using INH susceptible test of M. smegmatis mc(2)155 and BH1, and 2) the effect of INH on M. leprae growth by radiorespirometric assay to examine the catalase-like activity in M. leprae. It was found that the viability of M. leprae was decreased at 20 microgram/ml of INH and higher concentrations. We confirmed the role of KatG protein in activation of INH and our results suggest that a catalase-like activity other than katG is present in M. leprae.
Catalase ; Humans ; Isoniazid* ; Leprosy ; Macrophages ; Mycobacterium leprae ; Pseudogenes ; Tuberculosis

The CD1 system is a novel antigen-presenting system for T cell recognition of lipid and glycolipids in antimicrobial immunity. Lepromatous leprosy is characterized by lack of cell-mediated immunity against M.leprae. The lack of cell-mediated immunity in lepromatous leprosy has been suggested to be correlated with weak CD1 expression on antigen presenting cells. In order to define how CD1 is down-regulated on M. leprae-infected antigen-presenting cells, we examined effects of interferon-gamma(IFN-gamma) on interleukin-10 (IL-10) secretion and CD1 expression of M.leprae-infected macrophages from granuloma of lepromatous leprosy. Our results showed that a significant trend of increased CD1 expression in response to decresed IL-10 secretion from M.leprae-infected macrophages by IFN-gamma. These results suggest that the local cytokine milieu, especially the balance between IFN-gamma and IL-10, is an important determinant in the regulation of CD1 in lepromatous lesions.
Antigen-Presenting Cells ; Glycolipids ; Granuloma ; Immunity, Cellular ; Interferon-gamma* ; Interleukin-10* ; Leprosy ; Leprosy, Lepromatous* ; Macrophages*

Peripheral nerve damage in leprosy would be related to the local cell-mediated immune response to mycobacterial antigens and, presumedly, metabolic and biochemical changes of Schwann cell or circulating demyelinating factors and otherwise, autoimmune process would be involved. The neuralipid composing of cholesterol, ethanolamine glycerophosphatide, sphingomyelin, galactocerebroside(GalC), ethanolamine plasmalogen, serine and choline glycerophophatide, sulfatide are abundant in the myelin and have immunogenicity. Especially, GalC and sulfatide are known to play an important role in myelin function and its stability. The study was undertaken to detect the titers of anti-GalC and anti-sulfatide antibodies for the neural destruction mechanism of leprosy. Subjects tested were 53 leprosy patients with polar type consisting of 25 in tuberculoid leprosy(TT) and 28 in lepromatous leprosy(LL). The titeration of the antibody was done in the sera of patients and controls by enzyme-linked immunosorbent assay(ELISA). The results obtained were as follows ; 1. The detection rate of anti-GalC antibody was in 13(24.5%) of the 53 leprosy patients compared with 3(13.0%) of the 23 normal controls. Among the leprosy patients, there was 8(32.0%) in TT and 5(17.9%) in LL. 2. The detection rate of anti-sulfatide antibody was in 24(45.3%) of leprosy patients compared with 7(26.1%) of normal controls. Both types showed almost same rate of 46.4% and 44.0%, respectively. 3. Mean titer of anti-GalC antibody was 18.9+/-17.0EU/ml in leprosy patients and 12.8+/-8.8EU/ml in normal controls, with statistically insignificant level(p>0.05, one-way ANOVA). Among the leprosy patients, mean titer was 24.7+/-20.9EU/ml in TT and 13.8+/-10.5EU/ml in LL, with significance in TT(p<0.05). 4. Mean titer of anti-sulfatide antibody was 25.3+/-14.5EU/ml in leprosy patients and 18.9+/-13.8EU/ml in normal controls(p>0.05). Among the leprosy patients, mean titer was 26.0+/-15.4EU/ml in TT and 24.7+/-14.0EU/ml in LL, which was nearly same quantities in both types. 5. Examinations using Pearson correlation analysis revealed that the association between anti-GalC and anti-sulfatide antibodies was non-specific in LL(r=0.09) and TT(r=0.04). The analysis between duration of illness and anti-GalC antibody was decreasing correlation(r=-0.89, p<0.05) in LL, but slightly increasing correlation in TT(r=0.44, p>0.05). In comparison with anti-sulfatide antibody and duration, LL was higher in 41-50 years, while being higher in 31-40 years in TT, but correlation in both types could not be found(r=0.08, -0.06) In conclusion, the anti-GalC and anti-sulfatide antibodies seemed to be related with nerve damage. Hereafter we think that more study for other neural lipid should be investigated
Antibodies* ; Cholesterol ; Choline ; Ethanolamine ; Humans ; Leprosy* ; Myelin Sheath ; Peripheral Nerves ; Serine

For the integrated leprosy control, including the elimination of leprosy and the leprosy related activity, the collection and analysis of the accurate data is essential. In Korea, we have applied the computerized information system of the leprosy control. This system was designed for data collection as well as data analysis. The major functions of this system include data entry, data transfer, from local level to central level, data sum-up, and production of information, including epidemiologial and clinical information and information for decision-making. Firstly we used this system for treatment workload only. Because the basic concept of our system's data structure is more flexible than other's, we try that we can use it more widely, for the leprosy related activity now. We think that this system has been supported effectively our integrated leprosy control work in Korea. We therefore present the computerized leprosy information system of Korea.
Data Collection ; Information Systems* ; Korea ; Leprosy* ; Statistics as Topic

A 36 year-old woman immigrated from Nepal showed erythematous plaques on her face, buttock and legs one month after the immigration. Before the correct diagnosis was made, the patient had been erroneously treated as anallergic dermatitis for three months. Clinico-pathologically, her skin lesion was borderline lepromatous type leprosy with bacilli positive. We report the case to keep the high index of suspicion for leprosy when we meet with patients from the countries where leprosy is still epidemic.
Buttocks ; Dermatitis ; Emigrants and Immigrants ; Emigration and Immigration ; Female ; Humans ; Leg ; Leprosy ; Leprosy, Multibacillary ; Nepal ; Skin

Between 2008 and 2009, We found 9 new cases and 3 relapse cases, diagnosis by the clinical finding, skin smear, skin biopsy, lepromin test, ELISA for PGL-I antibody, and DNA-PCR. The obtained results were summarized as follows: 1. In 9 new cases, the mean age was 56.2 in 5 Koreans and 28.2 in 4 foreigners(Nepal, Thailand, Sri Lanka, Philippines), the types of Hansen's disease were 5 lepromatous(2 Koreans and 3 foreigners), 1 borderline(1 foreigner) and 2 tuberculoid(2 Koreans), mean BI was 3.4+, mean O.D. of PGL-I antibody was 0.445, numbers of TTC repeat are 16(2 Korean and 2 foreigners), 11(2 Koreans), 12(1 Koreans) and 13(1 Koreans), and of GACATC repeats are 4(4 Koreans) and 3(1 Korean and 4 foreigners). Among 9 new cases, 1 case has the mutation offolP1 gene. 2. All new cases had no mutation of & rpoB gene. 3. In 3 relapse cases, the mean age was 63.7, the types of Hansen's disease were 3 lepromatous(3 Koreans), mean BI was 4.0+,and mean O.D. of PGL-I antibody was 0.846, and numbers of TTC repeat were 12(2 cases), 11(1 case), and of GACATC repeats are 4(all 3 Koreans). Among 3 relapse cases, 1 case has the mutation ofrpoB gene.
Biopsy ; Enzyme-Linked Immunosorbent Assay ; Lepromin ; Leprosy ; Recurrence ; Skin ; Sri Lanka ; Thailand