Humans ; Leprosy, Tuberculoid ; diagnosis ; pathology ; Male ; Middle Aged ; Toes ; pathology

Appreciable amounts of high-quality DNA are frequently required for use in molecular diagnostic and epidemiology studies. The limited availability of DNA can be a critical obstacle to meeting research and clinical needs. And molecular methods have not been routinely applied to the obligate intracellular organism Mycobacterium leprae because of the difficulty of obtaining a genomic DNA template from clinical material. The MDA (multiple displacement amplification) reaction is increasingly the method of choice for many applications because of its extensive coverage of the genome, the generation of extremely long DNA products compared with older whole genome amplification methods and the high DNA yields, even from exceedingly low amounts of starting material. In the study, the author evaluated the usefulness of this method for the molecular studies in Hansen's disease.
Displacement (Psychology) ; DNA ; Genome ; Leprosy ; Mycobacterium leprae ; Pathology, Molecular

Adult ; Erythromelalgia ; pathology ; Humans ; Leg ; physiopathology ; Leprosy ; diagnosis ; pathology ; Male ; Singapore

Leprosy is a chronic granulomatous infection caused by Mycobacterium leprae, which primarily affects the skin and peripheral nerves. In this article, we present a 45-year-old man and a 39-year-old women who suffered from asymptomatic irregular erythemas on their trunk and extremities. Since both patients denied the history of exposure to leprosy patients and were absent clinical signs of superficial sensation dysfunction and enlarged peripheral nerves, they were diagnosed of mycosis fungoides and livedo reticularis clinically. Nevertheless the biopsies of erythemas showed perineural and periadnexal foamy-cell granulomas in the dermis and Fite staining revealed a large number of acid-fast bacilli. A diagnosis of multibacillary leprosy was made finally. These cases revealed that since leprosy is still epidemic in some remote area in China and in other developing countries and its clinical manifestations may be very weird sometimes, the dermatologists should be alert of it and skin biopsy could confirm the diagnosis.
Adult ; Erythema ; pathology ; Female ; Humans ; Leprosy, Multibacillary ; diagnosis ; pathology ; Male ; Middle Aged

Leprosy is a chronic systemic disease with ocular complications including lagophthalmos, uveal diseases, and corneal diseases. Blindness may result unless appropriate treatment is done. The authors report the ocular leprosy with generalized systemic nodules associated with severe proptosis, corneal opacity and retinal pathology.
Blindness ; Corneal Diseases ; Corneal Opacity ; Exophthalmos ; Humans ; Leprosy* ; Pathology ; Retinaldehyde ; Uveal Diseases

Leprosy is a chronic systemic disease with ocular complications including lagophthalmos, uveal diseases, and corneal diseases. Blindness may result unless appropriate treatment is done. The authors report the ocular leprosy with generalized systemic nodules associated with severe proptosis, corneal opacity and retinal pathology.
Blindness ; Corneal Diseases ; Corneal Opacity ; Exophthalmos ; Humans ; Leprosy* ; Pathology ; Retinaldehyde ; Uveal Diseases

Leprosy, one of the oldest diseases known to humans, still affects almost 10-15 million people throughout the world. Neuropathy affects 15-20% of infected individuals. Therefore leprous neuropathy is still one of the most common neuropathy in the world. It is due to infection with Mycobacterium leprae and occurs primarily in Asia and Africa. The cardinal symptom of leprosy is sensory loss caused by superficial neuropathy. Anesthetic depigmented skin lesions are an important finding and should be sought. Nerve involvement is a hallmark of leprosy. Nerve involvement is rare in other diseases, so the finding of skin lesions with enlarged nerves should raise the possibility of leprosy. Nerve involvement tends to occur with skin lesions, and the pattern of nerve involvement parrellels the skin disease. In the tuberculoid form, mononeuropathy multiplex is typical pattern, whereas asymmetrical or symmetrical polyneuropathy is most common in the lepromatous form. Motor involvement occurs in a predictable sequence as a result of nerve trunk damage to those nerves that course close to the skin surface and hence are locally cool. Nerve involved include the ulnar nerve at the elbow, the deep peroneal branch at the ankle, superficial branches of the facial nerve, and the median nerve at the wrist, and especially the greater auricular nerve. Nerve involvement without skin lesions, called pure neural leprosy, can occur. Other characteristic findings are thickened nerve, trophic ulcers, mutilated digits, and Charcot joint. In clinically affected nerves, the motor nerve conduction velocities are minimally slow. The terminal latency is often prolonged and the compound muscle action potentials are temporally dispersed and decreased in amplitude. Sensory and mixed compound nerve action potentials are often difficult to obtain or else a reduced amplitude. The facial nerve is commonly involved in leprosy. Improvement in motor nerve conduction was reported in leprosy patients under sulfone treatment. Nerve biopsy reveals subperineurial edema and various amounts of loss of myelinated and unmyelinated fibers. Teased fiber studies reveal paranodal demyelination affecting successive internodes. Therefore segmental demyelination is the main pathology in leprous neuropathy.
Action Potentials ; Africa ; Ankle ; Arthropathy, Neurogenic ; Asia ; Biopsy ; Demyelinating Diseases ; Edema ; Elbow ; Facial Nerve ; Humans ; Leprosy ; Leprosy, Tuberculoid ; Median Nerve ; Mononeuropathies ; Mycobacterium leprae ; Myelin Sheath ; Neural Conduction ; Pathology ; Polyneuropathies ; Skin ; Skin Diseases ; Ulcer ; Ulnar Nerve ; Wrist

PURPOSE: The purpose of this study was to identify life experiences of Korean patients with Hansen's disease (leprosy). METHODS: For this study, 5 participants from Sorok Island Hospital were purposively chosen. Data were collected through in-depth individual interviews from June to July 2014. Data analysis method was based on Colaizzi's approach. RESULTS: The study results showed that experiences of patients with Hansen's disease consisted of 14 themes and six theme clusters: 1) Bad disease approaching as fate; 2) Family breakup and far from the village; 3) New life in Sorok Island Hospital; 4) Treatment of Hansen's disease and disability; 5) Life in the disease community; 6) Comfort and hope of life. CONCLUSION: The findings of this study indicate that health care professionals should pay attention to patients with Hansen's disease not only to reduce their physical and psychological suffering, but also to help the community and public culture to reduce the social stigma surrounding this disease and causing suffering for the patients. The results of the present study can help us to have a better understanding of various aspects of patients' lived experiences.
Aged ; Asian Continental Ancestry Group ; Family Relations ; Female ; Hospitals ; Humans ; Interviews as Topic ; Leprosy/*pathology ; *Life Change Events ; Male ; Questionnaires ; Republic of Korea

Acid-fast microorganisms were isolated from 240 soil samples collected at two areas, Hiroshima, Japan and Seoul, Korea. The biological and biochemical characteristics of the isolated mycobacteria were tested and compared with those of 36 reference mycobacteria Strains. The isolation rate and distribution of these mycobacterial species from soil were compared using three kinds of media with emphasis on the two methods of isolation between the different geographical areas. One Strain from each of the 10 species among atypical mycobacteria isolated from soil in both areas was inoculated into ddY mice and the pathogenicity compared with that of Mycobacterium tuberculosis H37Rv up to 6 weeks. Susceptibility of the reisolated acid-fast bacilli to antimycobacterial agents was tested in vitro. Antibody responses against various mycobacterial antigens were tested using lepromatous type and tuberculoid type patient sera by the agar gel immunodiffusion. 1) No significant differences in the distribution of acid-fast bacilli were observed between soil samples from the two regions. 2) Rapid growers were by far the most frequent acid-fast bacilli isolated while no photochromogens were isolated from these soil samples. In addition, a minimal number of fastidious mycobacteria were isolated but not cultivable in subcultures. 3) Some of these soil acid-fast bacilli were capable of inducing only transient bacteriological and pathologic changes in mouse organs. 4) Acid-fast bacilli reisolated from organs of these infected mice were, in general, found to be resistant to antimycobacterial agents. 5) M. scrofulaceum antigen showed a precipitation reaction in agar gel immunodiffusion with the highest number of sera from leprosy patients.
Animal ; Leprosy/immunology ; Mice ; Mycobacteria, Atypical/drug effects ; Mycobacteria, Atypical/isolation & purification* ; Mycobacteria, Atypical/pathogenicity ; Mycobacterium/isolation & purification* ; Mycobacterium Infections/pathology ; Soil Microbiology*

We reviewed dinical, histological and ultrastructural findings of 124 cases of sural nerve biopsy specimens to delineate the trends of peripheral nerve diseases in our institute. Eighty-one were men and 43 were women. We categorized them into five groups: specific diagnosis (66 cases, 53.2%), axonal degeneration type (47 cases, 37.9%), demyelinating type (4 cases, 3.2%), mixed axonal degeneration-demyelinating type (6 cases, 4.8%) and normal (1 case, 0.9%). Cases with specific diagnosis included 21 inflammatory demyelinating polyneuropathy (15 chronic inflammatory demyelinating polyradiculoneuropathy, 6 Guillain-Barre disease), 13 hereditary motor and sensory neuropathy (7 Charcot-Marie-Tooth type I, 6 Charcot-Marie-Tooth type II), 10 vasculitis, 6 toxic neuropathy, 4 leprosy, 3 diabetic neuropathy, 2 alcoholic neuropathy, 1 Fabry's disease and other specific diseases (5 cases). In our cases, the proportion of specific diagnoses was higher, while the proportion of demyelinating peripheral neuropathies and normal were lower than those of Western series. The results of this study indicate that 1) a dose clinicopathologic correlation is important to make a precise diagnosis of peripheral nerve biopsy, 2) Biopsy under strict indication may reduce unnecessary histologic examination, 3) There is no difference in disease pattern of peripheral neuropathy between Western people and Koreans.
Adult ; Biopsy ; Charcot-Marie-Tooth Disease/pathology ; Demyelinating Diseases/pathology ; Fabry Disease/pathology ; Female ; Hereditary Motor and Sensory Neuropathies/pathology ; Human ; Korea ; Leprosy/pathology ; Male ; Microscopy, Electron ; Nerve Fibers, Myelinated/pathology ; Peripheral Nerves/ultrastructure ; Peripheral Nerves/pathology ; Peripheral Nervous System Diseases/pathology* ; Peripheral Nervous System Diseases/microbiology ; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating/pathology ; Sural Nerve/ultrastructure ; Sural Nerve/pathology*