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제목 |
Studies on the Reactional States of Leprosy |
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저자 |
Sung Hyun Han, and Joon Lew |
소속 |
Dept. of Microbiology, Yonsei University College of Medicine |
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년도 |
1969 |
권 |
6 |
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호 |
1 |
번호 |
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시작페이지 |
25 |
끝페이지 |
42 |
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첨부 |
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요약 |
The occurrence of reactional states of leprosy in the course of the disease has long
been recogniged(Danielasen and Boeck, 1848; Hansen and Looft, 1895). Reactional states
are defined by Cochrane(1964) as "more or less sudden tissue responses, resulting from
the liberation of bacilli, or their products, into the tissue, the manifestation of which can
either he local or systemic". It is well known that the reactional states of leprosy are
the most distressing complications of the disease, and that if reactional states intervene
and continue to persist it 1) results in suffering of the patient and even death, 2)
obstructs the continuance of antileprosy treatment and 3) tends to induce visceral
amyloidosis-At Madrid Congress (1953 a) the official classification of reactional states of
leprosy into 3 main reactional phases [i.e., reactional lepromatous leprosy, reactional
tuberculoid leprosy and reactional borderline (dimorphous) leprosy] was made. Since
then, various methods of classification of reactional states have been proposed by
workers, and these have resulted in confusing classifications of reactional states. The
exact cause (or causes) or the pathogenesis of reactional states of leprosy is still
unknown, but it is generally accepted that the reactional states of leprosy arise from
antigen-antibody reactions, and many theories and hypotheses have been advocated by
leprologists, such as allergy, disturbance of the immunological equilibrium, autoimmune
phenomenon, general adaptation syndrome of Style and etc. Though little is known
about the pathogenesis of the reactional states of leprosy, it is generally agreed that a
reliable method of prevention or control would not only simplify and shorten the Period
of treatment but would also save much suffering and remove an important cause of
deformity in leprosy. Report of the Panel on Leprosy Reaction(1964) recommended that
rational therapy should be designed primarily to eliminate or interfere with the constant
or repeated action of the determining or 'trigger' causes, and likewise, be conditioned in
each case to the severity of the reactionat episodes. Basic general treatment intended to
central systemic symptoms, and symptomatic treatment designed to act on the acute,
focal or regional manifestations, are general practices in the treatment of reactional
states of leprosy. In addition, specific treatment of leprosy is maintained, reduced or
stopped according to the severity of the reactiona: states At present, the total number of
leprosy cases in Korea is estimated to be about 60,000 (Kim, 1969), and records indicate
that DDS has been brought into therapeutic use in Korea since 1955. However, no
signal result of the studies on reactional states has been reported in Korea. In this
study, a series of studies i.e., clinical epidemiology of reactions, classification, skin
bacteriology and leprosy reaction, and treatment, were carried out in order to define the
reactional states of leprose in Korean, to give some light on the pathogenesis of
reactional states in lepromatous leprosy and to evaluate over-all efficacy of the
treatment of leprosy reactions. |
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내용 |
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