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HOME > ÇÐȸ°£Ç๰ >
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Relapse and Aggravation in Leproxy Among the Settlement Villagers |
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Joo Bong Lee, Shi Ryong Choi# |
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Dept. of Dermatology, Chronic Desiase Laboratory#, Catholic Medical College |
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1978 |
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53 |
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64 |
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Relapse and aggravation were confirmed by a study of the history of the disease after onset and clinical observations of 1,668 cases (935 male and 733 female). The patients were from seventeen settlement villages located in Seoul, Gyeonggi province, and Gangwon province, and were observed from May, 1974 to April, 1977. The results were as follows : 1. Of 1,668 patients, 48, or 2.9% were relapse cases and 29, or 1.7% were aggravation cases. Eight patients, or 0.5% were bacteriologically positive whey they came to the settlement villages but due to negative patients converting to positive while in the villages 3.4% of the total 1,668 settlement villagers are now positive. 2. For males, there were 27, or 2.9% relapse cases and 20, or 2. 1% aggravation cases for a total of 47(5.0%) relapse and aggravation patients. In females, the total relapse and aggravation cases were 30, or 4.1%; 21(2.9%) relapse cases and 9 (1.2%) aggravation cases. There was no significant between males and females. 3. The average age of patients was 43.79¡¾9.84 clears: 42.73¡¾7.45 years for relapse patients (lower than the average age) and 46.14¡¾9.66 years far aggravation patients (higher than the average age). However or, there was no significant difference between relapsed patients and aggravated patients'age. 4. The average duration of disease after onset was 24.15¡¾9.31 years; 23.98¡¾6.83 years for relapse patients(lower than the average) and 26.48¡¾11.32 years for aggravated patients(higher than the average). There was no significant difference in the average duration of disease after onset between relapsed patients and aggravated patients. 5. Relapse and aggravation appeared most often in L-type Patients. There were 48 (4.2%) relapse cases and 33(2.9%) aggravation cases in L-type, but only 6(1.2%) aggravation cases in T-type. No relapse or aggravation was found in I-group. Relapse and aggravation of L-type patients under irregular treatment was seven times that of patients under regular treatment. Aggravation in T-type patients under irregular treatment was 5 times that of patients under regular treatment. 6. The average duration of treatment was 20.25¡¾8.47 years. The duration of treatment for relapse and aggravation was a little higher-21.17¡¾6.80 years for relapsed patients, 21.66¡¾9.82 years for aggravated patients-but there was no statistical significance. 7. Of thssf on previous treatment taking only dapsone, 21 or 3.6% were relapse or aggravation cases. Those on previous treatment with sulfone and chaulmoogra oil showed 37 cases(4.5%) of relapse or aggravation, and those taking sulfones (other then dapsone) had 10 cases or 5.0% of relapse and aggravation. In the cases where previous treatment did not include a sulfone, there was a much higher proportion of relapse and aggravation. Those taking two types of antileprosy drugs (excluding dapsone) showed 3 cases or 17.6%, and those taking 3types of antileprosy drugs (excluding dapsone) showed 6 cases or 22.2% of relapse and aggravation. The frequency of relapse was significantly higher in cases of irregular treatment than in cases of regular treatment among those taking only dapsone, other sulfones and sulfone plus chaulmoogra oil. There was no significant difference bewtteen regular and iregular treatment among those taking two or three kinds of antileprosy drugs excluding sulfones. 8. Relapse and aggravation cccured most frequently 5 to 9 years after the patients converted from bacteriologically positive to negative or inactive; 12 of 48 relapsed patients and 10 of 29 aggravated patients. There were 11 cases of relapse and 3 cases of aggravation occuring less than 5 years after bacteriological conversion. Over 20 years after bacteriological conversion, there was 1 case of relapse and 2 cases of aggravation. 9. Of the skin smears from 34 relapsed patients after two and half years from the diagnosis of relapse, there were 20 negative cases, 12 cases of decrease and 2 cases of increase in bacterial index. There were 28 cases of 0%, 5 cases of decrease and 1 case of increase in morphological index. |
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