Hansenologia internationalis最新文献

Authors analyse the counterstain with methylene blue solution in the usual Ziehl-Neelsen method. Considerations are made on the characteristics of the dye substance. A technique alteration is proposed: a "concomitant alkalization" of the classic aqueous methylene blue solution, by adding some drops of sodium hydroxide solution, 1:500, on the slide at the moment of the staining. By this technique it was observed: a) a larger validity period of the solution; b) an absence of precipitate in the slides; c) an easier visualization of the substrate; d) a larger contrast among the substrate and the bacilli.

The lepromin test was studied in 64 medical students and in a control group consisted of 40 patients from the orthopedic clinic. Both groups matched with respect to age and sex, but differed with regard to socio-economical conditions. The Fernandez reaction showed low frequency of positive results in both groups: 10% in the first group and 5,6% in the second one. This difference was not significant. The Mitsuda reaction showed high frequency of positive results: 98,4% in the medical students and 85,0% in the control group. This difference was significant. The authors discuss the factors that might have caused the high positivity of the lepromin test among the medical students.

The presence of acid-fast bacilli in the waters of the lake of Aleixo is recorded. This site is a hanseniasis colony. The physical-chemical environment of this lake is described by an annual cycle and it is intended to relate the quality of the water to the highest or to the lowest frequency of detected mycobacteria. It is suggested that the work in this lake system should be continued towards a more specific characterization of these microorganisms and the determination of their viability.

The present study incorporates a study of 42 cases of lepromatous leprosy for hepatic involvement and role of indigenous herbal preparation in protecting the liver in leprosy. Liver was enlarged in 32 cases which was tender in 8 patients. Alteration in liver function irrespective of extent and duration of the illness (3 months to 10 years with mean duration of illness = 2 years 5 months) was mainly seen as uniform elevation of serum proteins (6.2-9.2 gms%, mean = 7.5 gms%) with hypoalbuminaemia (2.0-4.4 gms%, mean = 2.9 gms%). Highest level of serum bilirubin of 1.6 mg% was detected in 6 cases, emphasising the presence of leprous hepatitis. Raised level of serum transaminases (SGOT = 65.2 IU, SGPT = 78.7 IU) were proportionate to the liver and muscle involvement. Presence of characteristic granulomata in the liver around the central vein, periportal area and even distribution at various locations in the liver lobules were the most significant changes in 12 out of 15 liver tissues. Acid fast M. leprae were demonstrated in 12 patients. The present work emphasises the detection of hepatic involvement in the early stage of the disease and hepato-protective role of indigenous drug Liv-52 in lepromatous leprosy which usually lead to dreaded mutilated complications in the body.

A comparative study of the Ridley-Jopling's (RJ) and of the Congress of Madrid's (CM) pathological criteria was made in the different clinical types and groups of hanseniasis. A concordance between both criteria was found in the Indeterminate group and in the regressive phases of the Virchowian (V), Tuberculoid (T) and Reactional tuberculoid (RT) types. Clinical RT was confirmed by pathology in 81.2% of the cases according to CM, whereas 46.2% were considered "Borderline" according to RJ. Out of the 48 clinically V patients, 17 (35.4%) were "Borderline" (BL-2, BL-1 and BB), but practically all were also pathologically V according to CM. It is concluded that there is no practical convenience in the establishment of histopathological sub-groups that do not perfectly agree with clinical criteria. The Authors stress the importance of the study of the plasmocytes in the V infiltrates, of the lymphocytes in all granulomas and of the differences in the involvement of the neural ends, specially between the T and V poles. The dyeing of lipids by the Sudan III is useful to perfectly characterize the V pole, recognize residual V structures, separate the sub-groups BT, BB and BL, help in the early diagnosis of V infiltrations and differentiate the edematous, diffuse, non-granular cytoplasmatic vacuolization of RT.

The association of mast cells and lepra bacilli was studied in the foot pad skin of immunosuppressed mice inoculated with 10(5) lepra bacilli. The mice were killed at intervals varying from 2 1/2-14 months postinoculation. M. leprae are found in large numbers in nerves, blood vessels, muscle fibres, hair follicles, sweat and sebaceous glands. Mastocytosis and extensive degranulation are seen at similar sites. Since these are the structures most affected in leprosy where the lepra bacilli and degranulating mast cells accumulate, there appears a close relationship between the two. This could be due to the composite role of mast cells in host tissue response and mastocytosis and degranulation may be related to this.

Following a previous work, this one intends to add new data on the occurrence of hanseniasis in the Public Health District of Londrina, in the state of Parana, Brazil. In this study, it was observed an increasing percentage of patients coming from the urban area of the near towns and one of the aspects stressed in this research was the great importance of the V and D forms in the dissemination of the disease, since they affect mostly male individuals. Once this area is characterized by a high endemicity, a new sanitary policy should be put into practice comprising aspects of control and search for cases. Besides it should be developed a special program of case detection among the students carried out by large scale medical examinations and through extensive observation of contacts of the bacilloscopic positive patients, mainly in the household contacts.

A 39 year old white man, with advanced Virchowian hanseniasis died with signs of extensive meningeal involvement. His medical background showed repeated episodes of Erythema nodosum hansenicum (ENH) in the last three years of his life, besides ischemic gangrena with amputation of the left leg and cerebral vascular ischemic attacks. The autopsy revealed an advanced stage of arteriosclerosis affecting mainly the brain and the distal segment of the aorta and its ramifications. A propagating thrombus was found along the left femoral and iliac arteries and in the terminal portion of the aorta extending to the renal arteries. Thrombosis was also found along the left femoral vein, left iliac vein and distal segment of the inferior cava. The brain showed anemic infarction in organization and a generalized meningoencephalic involvement with granulomatous reaction caused by Cryptococcus neoformans. It was suggested a possible relationship between Erythema nodosum reactions and thrombosis phenomena. Torulosis was considered as a final occurrence and the proliferative vasculitis due to the granulomatous process in the sub-arachnoidal space has certainly aggravated the cerebral ischemia.