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An analytical on the dental cares in leprous patients.

Korean Leprosy Bulletin.2002;35(1):89-121.

The purpose of this study was to investigate the oral health care conditions of patients who have Leprous disease, which is an infectious disease fixed for the third-class by law, to understand oral health care methods and effects of infectious disease patient, and to analyse those methods and effects in order to apply them to the national oral health occupation baseline data for utilizing continuous oral health occupation and to the treatment for handicapped person. he objects for this study were 7,491 patients(male:4,511, female:2,980) treated in the oral health center among Leprous disease patients, residents in the Sorokdo from 1995, May 1st to 1999, April 30th. We divided them into the first, second, third preventive care group according to the year by preventive classification of oral disease, analysed oral health statistics, classification according to the sex, age, practice, and each consultation hours. The subdivided results carrying out continuous oral health care system for four years were as follows: 1. The distribution for the age indicated that the number of 70-79 year-old patients group was the most, 2,169 and that of 60-69 year-old patients group was the second, 2,406. 2. All the number of consultation hours was 13,454. The consultation hours of first preventive care group were 1,359, 10.1% of them (male:812 female:547), the second group 3,942, 29.3%(male:2,103 female:1,839), the third 8,153, 60.6%(male:5,524 female:2,629) 3. The results of oral health care conditions indicated that DMF rate was 99.2% of them, DMFT rate 59.2%, DMF index 18.9, DT rate 2.6%, FT rate 7.4%, MT rate 49.1%, CPITN0 5%, CPITN10%, CPITN2 24%, CPITN3 71%. 4. It was analysed that the number of patients treated with continuous bridgework was 60 and that the number of patients wearing complete denture and partial denture was 290.
Classification ; Communicable Diseases ; Denture, Complete ; Denture, Partial ; Disabled Persons ; DMF Index ; Humans ; Jurisprudence ; Occupations ; Oral Health

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Complication of Temporalis Muscle Transfer in Lagophthalmos and Ectropion of Korean Leprosy Patients.

Sung Yul AHN ; Hayang Joon PARK ; Jong Pill KIM

Korean Leprosy Bulletin.2002;35(1):81-88.

Recently, there has been a strong decrease in the number of temporalis muscle transfer(TMT) operations in cases of lagophthalmos. The primary cause of this decline is patient dissatisfaction with drawbacks of eye clinching in concert with mouth closure, ectropion and ptosis. This is mostly true of patients who are now more commonly exposed to urban social environments. In 1997, I discontinued the use of TMT as part of my combination treatment method reported in this journal. Since 1998, I have removed the fascia in 20 TMT cases due to complications in the upper and lower eyelid areas. I then corrected these complications using my combination method. I still use TMT in cases of lower lip drooping. Lagophthalmos patients are treated using my combination method of gold lid loading in the upper eyelid and Alloderm insertion in the lower eyelid through fixation of both ends to the medial and lateral canthal ligaments respectively. Previously, I recommended the use of conchal cartilage but noted the complication of cartilage warping which caused creating new partial ectropion several months later. Alloderm has shown no complications and the results of its use remain most satisfactory.
Cartilage ; Ectropion* ; Eyelids ; Fascia ; Humans ; Leprosy* ; Ligaments ; Lip ; Mouth ; Social Environment

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The Study of the Applicablility of the results of PGL-I Antibody IgM ELISA test for the Leprosy Control Program.

Jong Pill KIM ; Young Hoon KO

Korean Leprosy Bulletin.2002;35(1):11-56.

Though the early detection of leprosy is very important, it has been difficult to determine the M. leprae transmission in the community partly due to a lack of easy specific tools to measure it. A development of a seroepidemiological tool based on the phenolic glycolipid I(PGL-I), an M. leprae-specific antigen, made it possible to detect the M. leprae infection or exposure to the organism. In Korea, 11 studies, used it, were reported in the Korean Leprosy Bulletin. For the reduction of bias, we performed the integrated study of past 11 studies. In our study, we tried to find the useful values of the results of PGL-I Antibody IgM ELISA test for the control of leprosy and to know the further study for more valuable results.
Bias (Epidemiology) ; Enzyme-Linked Immunosorbent Assay* ; Immunoglobulin M* ; Korea ; Leprosy* ; Phenol

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Protective Immune Mechanism against Mycobacterial tuberculosis Infection.

Sungae CHO

Korean Leprosy Bulletin.2002;35(1):3-10.

Because tuberculosis (TB) causes two - three million deaths annually, development of a vaccine to control and eradicate the infection is an important unmet medical need. Analysis of the mechanisms of protective immunity in mouse models has indicated that both MHC class I- and class II-restricted T cells contribute to immunity against TB. MHC class II-restricted CD4+ T cells release lymphokines such as IFN-gamma and tumor necrosis factor-alpha that result in macrophage activation. More importantly, beta(2)-microglobulin (beta(2)m)-deficient mice are unable to develop MHC class I-restricted cytotoxic T lymphocytes (CTL) and rapidly succumb to Mycobacterium tuberculosis (MTB) infection. This pathway of protective immunity appears to involve CD8+ T cells and transporters associated with antigen processing (TAP)-dependent presentation of peptide antigen. Thus, studies of mouse models of tuberculosis (TB) infection have indicated a central role for MHC class I-restricted CD8+ T cells in protective immunity. Furthermore, CD8+ T cells not only are able to lyse MTB infected cells but also can simultaneously kill intracellular bacteria by the release of the antimicrobial peptide granulysin. To define antigens and epitopes of Mycobacterium tuberculosis (MTB) proteins that are presented by infected cells to CD8+ T cells, we screened 40 MTB proteins for HLA class I A(*)0201-binding motifs. Peptides that bound with high affinity to purified HLA molecules were subsequently analyzed for recognition by CD8+ cytotoxic T lymphocytes. We identified three epitopes recognized by CD8+ T cells from patients recovering from TB infection. Those three epitopes were derived from three different antigens: thymidylate synthase (ThyA(30-38)), RNA polymerase beta-subunit (RpoB(127-135)), and a putative phosphate transport system permease protein A-1 (PstA1(75-83)). In addition, CD8+ T cell lines specific for three peptides (ThyA(30-38), PstA1(75-83), and 85B(15-23)) were generated from peripheral blood mononuclear cells of normal HLA-Al(*)0201 donors. These CD8+ T cell lines specifically recognized MTB-infected macrophages, as demonstrated by production of IFN-gamma and lysis of the infected target cells. Finally, CD8+ cytotoxic T lymphocytes reduced the viability of the intracellular MTB, providing evidence that CD8+ T cell recognition of MHC class I-restricted epitopes of these MTB antigens can contribute to effective immunity against tuberculosis. Currently, the frequencies of circulating CD8+ T cells specific for each epitope peptide are being investigated in TB patients, normal PPD+ and PPD- donors in order to evaluate the relationship of epitope-specific CD8+ T cell population to the immune responses to MTB infection.
Animals ; Antigen Presentation ; Bacteria ; Cell Line ; DNA-Directed RNA Polymerases ; Epitopes ; Humans ; Lymphokines ; Macrophage Activation ; Macrophages ; Mice ; Mycobacterium tuberculosis ; Peptides ; T-Lymphocytes ; T-Lymphocytes, Cytotoxic ; Thymidylate Synthase ; Tissue Donors ; Tuberculosis* ; Tumor Necrosis Factor-alpha

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Acridine orange stain of Mycobacterium leprae.

Jong Pill KIM ; Min Seok LEE ; Jeoung Won KANG

Korean Leprosy Bulletin.2013;46(1):3-16.

The Ziehl-Neelson's AFB staining method was mainly used for the AFB observation of the diagnosis of leprosy. However, the fluorescent stain performs better and allows the detection of more positive smears. The limitation for its widespread use has been the high cost for fluorescent microscopes. Novel light-emitting diodes (LED) are inexpensive solutions for fluorescent microscopes, and thus fluorescent stain may be a cost-effective step to improve the diagnosis of leprosy in resource-poor countries. And the comparison of auramine and acridine orange for staining of acid-fast bacteria was showed significantly more acid-fast rods after using acridine orange and the number of "false positive" results was somewhat higher on auramine staining. So acridine orange offers a good alternative to auramine which is considered carcinogenic. This study evaluated the comparison of the Ziehl-Neelson's AFB stain and the acridine orange stain in the skin smear based on PCR. As PCR results were taken as gold standard, results of the study revealed that the sensitivity of Ziehl-Neelson's AFB stain was 50% and that of acridine orange stain was 92.2%. This study confirmed that the fluorescence stain method is more sensitive than the Ziehl-Neelsen's staining method. It is suggested that the training of laboratory technicians on fluorescence microscopy should be scaled up for increased disease control.
Acridine Orange* ; Bacteria ; Benzophenoneidum ; Diagnosis ; Fluorescence ; Humans ; Laboratory Personnel ; Leprosy ; Microscopy, Fluorescence ; Mycobacterium leprae* ; Mycobacterium* ; Polymerase Chain Reaction ; Skin

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The Study of Status about Hearing Loss in Person Affected Leprosy.

Jong Pill KIM ; Youn Sil KIM ; Young Hoon KO

Korean Leprosy Bulletin.2005;38(2):95-101.

Leprosy related service of our country is including new patient finding and treatment, preventing the relapse and rehabilitation service. Latest new patient's occurrence is decreasing much than past, and the persons affected leprosy are gradually older. So the necessity of rehabilitation service about them is increased. Influences of hearing ability in human's life is the communication, the recognition of sound, the studying of speech faculty, and the perception ability about several circumstance. NCHS of U.S.A. was reported the hearing loss is one of high incidence disease along with the hypertension and the arthritis in the old persons, and especially the inclination of hearing loss becomes serious as do graying. It was carefully presumed that 20% of old persons more than 65 years old has some difficulties of hearing ability in Korea. The 52 persons affected leprosy(PALs) were examined the pure tone audiometry for the evaluating of the hearing loss. Among them, we have found the 12 persons(23.1%) with the hearing loss, by the results of pure tone audiometry(more than 40 dB).
Aged ; Arthritis ; Audiometry ; Hearing Loss* ; Hearing* ; Humans ; Hypertension ; Incidence ; Korea ; Leprosy* ; Perception ; Recurrence ; Rehabilitation

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An analytical on the periodontal conditions and treatment in leprous patients.

Dong Chan OH ; Bu Rim YOO ; Gi hyun PARK ; Jong Tag YUONG ; Jae woo PARK ; Jung Won KIM

Korean Leprosy Bulletin.2005;38(2):81-94.

The purpose of this study was to investigate the oral health periodontal conditions (CPITN(0), CPITN(1) CPITN(2) CPITN(3)) and periodontal treatment (non-surgical periodontal treatment and surgical periodontal treatment) of patients who have leprous disease. The objects for this study were 754patients (male: 453, female: 301, 60-69ages: 340, 70-79ages: 414) treated in the oral health center among Leprous disease patients with gingivitis and periodontal disease, residents in the Sirocco from 2003, May 1st to 2005, April 30th. The subdivided result carrying out periodontal conditions and treatment were as follows: 1. The results of periodontal conditions investigated that the number of 60-69year-old patients group were Community Periodontal treatment need index (CPITN)0: 15, CPITN1: 2, CPITN2: 66, CPITN3: 257, and 70-79year-old patients group were CPITN0: 27, CPITN1: 1, CPITN2: 116, CPITN3: 271 (Community Periodontal treatment need index(CPITN)0 of patients who have Leprous disease means exodontias states) 2. The results of periodontal treatment investigated that Non surgical periodontal treatment 25%, Surgical periodontal treatment 70%
Female ; Gingivitis ; Humans ; Leprosy ; Oral Health ; Periodontal Diseases ; Periodontal Index

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No title available.

Sung Yul AHN ; Hyang Joon PARK

Korean Leprosy Bulletin.2005;38(2):69-79.

The lower eyelid is anatomically composed of three layers consisting of the anterior lamellar, the middle lamellar and the posterior lamellar. The anterior lamellar is composed of skin and the orbicularis muscle. The middle lamellar is composed of the orbital septum and orbital fat. The posterior lamellar is composed of the tarsus and the capsulopalpebral fascia and conjunctiva. The function of the lower eyelid is dependent upon a net result of balanced forces from the tarsal plate, canthal tendon and the orbicularis muscle sling acting on the lower eyelid. These forces provide the intrinsic support required to maintain contact between the lower eyelid and the globe. Forces acting against the intrinsic support of the lower eyelid (extrinsic forces) provide inferior and anterior net vector from the globe. The normal anatomic function and aesthetic appearance of the eyelid is achieved when the intrinsic forces are greater than or equal to extrinsic forces. The lower lid descent and ectropion characterized by unfavorable imbalance are a result of either a decrease in intrinsic forces by weaking the support as in senescence or an increase in extrinsic forces by strengthening the distraction forces as a result of surgery, laser treatment, or trauma. Either way, the extrinsic forces become greater than intrinsic forces. Facial nerve palsy of a leprosy patient causes paralysis of the orbicularis muscle but its antagonistic action muscles (the levator muscle of the upper lid and the capulapalpebral fascia of the lower lid) are functioning resulting in retraction and lapophthalmus of the upper and lower eyelid. Ectropion and retraction in the lower eyelid require various traditional surgical methods such as cantopexy, canthoplasty, lateral tarsal strip procedure as well as medial tarsorrhaphy. In addition to traditional methods, we used a spacer graft consisting of hard palate mucosa or Alloderm. Spacer grafts can be used in either a posterior or anterior method. In the posterior method, the spacer graft is used to create separation between the tarsal plate and the capsulopalpebral fascia / conjunctiva structure. A 5 to 25mm elliptical strip of hard palate mucosa is harvested from the patient and insterted between the two structures. The conjunctiva is dissected in this procedure. In the anterior method, we disinserted the lower edge of the tarsus and the capsulopalpebral fascia. A 5 to 25mm elliptical shaped strip of Alloderm was then inserted between the two structures. The conjunctiva remains intact in this procedure. In addition, a 5 to 35mm Alloderm strip was inserted to immitate the function of the fascia sling and increase the elevation of the lower lid as a spacer graft. The spacer graft with traditional surgical methods was more effective in elevating the lower lid and significantly reducing retraction than using traditional methods alone.
Aging ; Ankle ; Conjunctiva ; Ectropion ; Eyelids ; Facial Nerve ; Fascia ; Humans ; Laser Therapy ; Leprosy ; Mucous Membrane ; Muscles ; Orbit ; Palate, Hard ; Paralysis ; Skin ; Tendons ; Transplants

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Hepatic and hematological adverse reactions associated with the use of multidrug therapy in leprosy.

Jong Pill KIM ; Yeon sil KIM ; Young hyun KO

Korean Leprosy Bulletin.2005;38(2):25-68.

One of the risks of combination therapy is probably the collective side effects. Fortunately, side effects reported worldwide after the use of MDT in thousands of patients remain mild and rare. This study analyses retrospectively some of the risks associated with the use of WHO-multidrug therapy (MDT) in Korea. Case records of 40 new cases of leprosy attending the Institute for Leprosy Research during 1991-2000, were analysed for adverse drug reactions involving the liver and blood. There were only some reports of suspected hematological adverse reactions(RBC count, hematocrit &, platelet count) associated with the use of MDT, but we could not find the clinical association of that finding. So we sustain that the MDT, recommended by KCDC, is relatively safe.
Blood Platelets ; Drug-Related Side Effects and Adverse Reactions ; Hematocrit ; Humans ; Korea ; Leprosy* ; Liver ; Retrospective Studies

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The decision for termination of leprosy treatment using reticulum stain of leprosy skin lesions.

Phil Seung SEO ; Jae Young LEE ; Nyung Hoon YOON ; Seok Don PARK

Korean Leprosy Bulletin.2005;38(2):15-24.

The rate of the relapse of leprosy differs from researcher to researcher, so it is thought that the exact decision on the termination of a treatment would play an important role in lowering the rate of the relapse of leprosy. This study attempts to lower the rate of the relapse of leprosy by the decision for termination of leprosy treatment by using reticulum stain of skin in leprosy which is one of granulomatous diseases, as granuloma can be easily observed in reticulum stain in sarcoidosis which is one of the common granulomatous diseases. The patients for this study consisted of five cases of lepromatous type leprosy, three cases of tuberculoid type leprosy, and one case of borderline tuberculoid leprosy. They were treated by a multidrug therapy, and its clinical lesions were observed every month. Also skin biopsy was performed every six months, and the changes of granuloma and acid-fast bacilli were observed in accordance with hematoxylin-eosin, Fite-Farraco, and reticulum stain which provides a better observation of granuloma lesion. Skin lesion of paucibacillary leprosy disappeared in 8 to 12 months, but seen from skin biopsy, epitheloid cell granuloma began to disappear after several months and after 12 months, it almost disappeared. But in some lesion, it remained until 21 months, and even after 33 months, perivascular inflammatory cell infiltrations were found. Skin lesions of multibacillary leprosy disappeared within 9 to 33 months, and bacilli checked by skin smear turned negative, but according to a skin biopsy, the number or the size of the foamy histiocytic granuloma became smaller. There was an example that it still remained after 84-month treatment. As a rule, reticulum stain in leprosy made reticulum fibers surround granuloma in various ways, so it helped us to observe distinctively granuloma. In a treatment of leprosy, it could prevent the relapse of leprosy that the already treated lesions should be checked with repeated skin biopsies at certain intervals, though skin lesions disappear and bacilli are not found in a skin smear. It is concluded that reticulum stain could be one of the useful methods in observing granulomatous lesions for determination of healing of leprosy.
Biopsy ; Granuloma ; Humans ; Leprosy* ; Leprosy, Multibacillary ; Leprosy, Paucibacillary ; Recurrence ; Reticulum* ; Sarcoidosis ; Skin*

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