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Biomedical subjects

C K Job

Publications and source records attributed to C K Job.

At least 37 records · Page 2Linked to original sources
PubMed1998

Epidemiological significance of first skin lesion in leprosy.

The epidemiological significance of monolesions in leprosy and the possible inferences on the mode of entry by Mycobacterium leprae into the body are presented based on data from the clinical records of the Leprosy Control Programme of Gudiyatham Taluk in India; 660 children with monolesions (335 males, 305 females) younger than 15 years of age and detected during the period 1990-1995 were included in the study. Detailed investigations on the location of monolesions were carried out and compared with a random sample of 669 normal rural children matched for age and sex. A large majority of the leprosy monolesions were in the uncovered parts of the body, with special predilection for the posterior aspects of the upper extremities and the anterior aspects of the lower extremities. Based on observation of normal children, these happen to be precisely the sites vulnerable for trauma since they are exposed to the environment where M. Leprae could enter through abraded skin and manifest as a patch. The need for further studies is emphasized.

Adolescent↗
PubMed1997

Pathology of iris in leprosy.

AIM: The histopathological features of the iris in leprosy were studied by light microscopy. METHOD: Formalin fixed and paraffin embedded iris tissue excised during cataract surgery from 20 leprosy patients were sectioned and studied with haematoxylin and eosin stain and modified Fite Faraco's stain for acid fast bacilli (AFB). RESULTS: Chronic inflammatory reactions were seen in the iris of 11 patients, seven of whom did not have any clinically demonstrable evidence of iridocyclitis. Smooth muscle disruption and destruction were seen in two specimens. AFB were found in the iris tissue of a polar lepromatous patient whose skin smears were negative for AFB and who had completed the WHO recommended antileprosy multidrug therapy (MDT). CONCLUSION: Histopathology discloses far more silent chronic iridocyclitis in leprosy patients than are diagnosed clinically. AFB can persist in the iris tissue even after completion of MDT. Smooth muscle disruption and destruction, a cause of the miotic pupil in leprosy has been conclusively demonstrated histopathologically.

Adult↗
PubMed1997

Pathologic changes in a tibial nerve with surviving M. leprae in a healed tuberculoid leprosy patient.

A tibial nerve from a disease-arrested borderline tuberculoid (BT) leprosy patient was dissected out and examined almost in its entirety using hematoxylin and eosin staining, a modified Fite's stain for acid-fast bacilli (AFB), solochrome cyanin stain for myelin, and van Gieson's stain for fibrous tissue. Fibrosis of the perineurium and epineurium and fibrous replacement of the nerve parenchyma, which was maximum at the ankle joint area, were seen. In focal areas inflammation was present, especially in the epineurium around blood and lymph vessels. Even 21 years after adequate antileprosy therapy, AFB were present in the endoneurium in all except 2 of the 10 segments of the nerve, evoking hardly an inflammatory reaction or other ill effects. It is pointed out that BT leprosy should also be considered a generalized disease, especially when there is peripheral nerve trunk involvement and, in such cases, a longer duration of currently available antileprosy therapy is advisable. Trauma to nerve trunk plays a major role in producing nerve destruction and paralysis.

Adult↗
PubMed1997

M. leprae binds to a 28-30-kDa phosphorylated glycoprotein of rat peripheral nerve.

To understand Mycobacterium leprae-peripheral nerve interaction, we have investigated the binding of M. leprae to rat peripheral nerve proteins in an in vitro model using 32P-phosphorylated proteins of the peripheral nerve. Intact M. leprae binds to a major phosphorylated protein of 28-30 kDa and, to a minor extent, to a few proteins of molecular weight 45-55 kDa. This binding was more specific for M. leprae since only insignificant binding was observed with other bacteria, such as M. bovis or Escherichia coli. M. leprae did not show binding to several phosphorylated proteins of the rat brain. The 28-30-kDa binding protein of the rat peripheral nerve was found to be a glycoprotein by concanavalin A-Sepharose column chromatography.

Animals↗
PubMed1997

Histopathologic evidence to show that indeterminate leprosy may be a primary lesion of the disease.

Five biopsies of patients with indeterminate leprosy and five with skin lesions of nonspecific chronic inflammation were chosen. Histopathologic changes in the presence of acid-fast bacilli (AFB) in an average number of 145 serial sections from the entire paraffin block from each were evaluated. In all five indeterminate lesions AFB were found in the dermis, but intraneural AFB were present in only two cases. Mainly, lymphocytic infiltrate was present in two and early, poorly formed granulomas were seen in three. It is suggested that nonspecific chronic inflammation of the skin could precede indeterminate disease and that AFB, before they entered the dermal nerves, may be found in other dermal tissues. In most if not all early lesions of indeterminate leprosy Mycobacterium leprae would be found if an adequate number of sections stained for AFB were examined. The histopathologic and immunologic features of indeterminate disease were in favor of it being a primary lesion in leprosy.

Adolescent↗
PubMed1997

Role of polymerase chain reaction in the diagnosis of early leprosy.

For 39 patients suspected of early leprosy, skin biopsies of the lesions were done and bisected. One piece was used for histopathologic examination and the other for polymerase chain reaction (PCR) studies to detect Mycobacterium leprae. The diagnosis of early leprosy was made clinically in 14 patients and by histopathologic study in 26 patients. Acid-fast bacilli were seen in the histopathologic sections of only two patients, and M. leprae were detected using PCR techniques in 11 patients. In one patient the diagnosis of leprosy was made only because of the detection of M. leprae in the PCR study. Since even in endemic countries the profile of leprosy is changing, detection of leprosy lesions in their early stages has become increasingly important. Since the finding of M. leprae is crucial in the confirmatory diagnosis of early leprosy, it is suggested that PCR studies to detect M. leprae be done wherever possible in conjunction with histopathologic examination. It is also recommended that the feasibility and the cost-effectiveness of both of these methods to find M. leprae be evaluated.

Adolescent↗
PubMed1996

Viability of Mycobacterium leprae in skin and peripheral nerves and persistence of nerve destruction in multibacillary patients after 2 years of multidrug therapy.

The pathological changes, bacterial load, and viability of Mycobacterium leprae in the skin and nerves of nine lepromatous leprosy patients who had undergone 2 years of multidrug therapy (MDT) were studied. M. leprae and varying amounts of their remnants were present in the nerves and skin of all but one patient. M. leprae isolated from skin biopsies of six patients and nerve biopsies of nine patients were inoculated into mouse foot pads. No growth was obtained from any one of them. During the electron-microscopic examination of three nerve biopsies, only one specimen showed a small number of solid-staining M. leprae. These findings would explain the low relapse rate in patients treated with 2 years of fix-duration MDT. Results of a long-term follow up of patients is awaited with interest. The possibility of nerve paralysis due to intraneural microreaction and fibrosis consequent to the continued presence of dead bacterial remnants should be seriously considered.

Adult↗
PubMed1996

Silent iritis in treated bacillary negative leprosy.

Iridectomy specimens from 59 leprosy patients who had adequate medical records of whom 33 belong to the lepromatous (LL) leprosy variety and 16 normal controls were studied histopathologically. All patients were bacteriologically negative and had received dapsone followed by multidrug therapy (MDT), or MDT only, or only dapsone for varying periods. It was found that leprosy, particularly lepromatous disease, did not significantly decrease the age of formation of cataract. Of the 33 LL patients studied 60.6% had silent iritis. The duration of treatment had no obvious influence on the persistence of iritis. Treatment with only 2 years of MDT for LL patients did not significantly increase the prevalence of persistent silent iritis compared to those who received other types of antileprosy therapy for long periods. It is pointed out that chronic iritis is a serious complication that continues even after the patient is declared clinically and bacteriologically cured, especially in patients who had a history of chronic iritis clinically.

Aged↗
PubMed1996

Pterygium in lepromatous leprosy.

Pterygia from the eyes of three lepromatous leprosy patients were histopathologically studied. All of the specimens contained acid-fast bacilli (AFB) and exhibited features of chronic inflammation. In the etio-pathogenesis of the pterygium that occurs in leprosy patients, the chronic inflammation that is a feature of the disease, the involvement of the nerves within the pterygium, the increased exposure to sunlight, dust and wind (especially in patients having lagophthalmos), and the ostrasization by society that necessitates living predominantly outdoor lives, should be taken into account.

Aged↗
PubMed1994

Transmission of leprosy in nude mice through thorn pricks.

The dorsum of the feet of 10 nude mice was smeared with 10(7) Mycobacterium leprae and then pricked with cactus thorns contaminated with M. leprae. In 15 months five of them developed lepromatous nodules at the infected site and disseminated lesions in the ears, nose, tail and the organs of the reticuloendothelial system. Penetrating injuries through unprotected skin contaminated with M. leprae from the environment may play a role in the transmission of leprosy in humans.

Animals↗
PubMed1993

Lepromin skin testing in the classification of Hansen's disease in the United States.

Hansen's disease, or leprosy, although a relatively uncommon disease in the United States, continues to be important because of its implications--physical, psychological, and social--for the patient. Prognosis and treatment of the disease are based largely on clinical classification, which ranges from the multibacillary "lepromatous" to the paucibacillary "tuberculoid" forms, depending on the patient's specific immune capabilities. Traditionally, skin testing with lepromins--suspensions of the etiologic agent of Hansen's disease, Mycobacterium leprae--have been used as adjuncts to clinical parameters for classification in endemic areas. However, these have not been systematically studied in the United States. This report describes the results obtained from skin testing 38 volunteers (22 patients and 16 uninfected persons) with standard lepromin preparations. These results support the adjunctive value of lepromins for clinically classifying Hansen's disease in our "hypoendemic" population.

Animals↗