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Biomedical subjects

C K Job

Publications and source records attributed to C K Job.

At least 109 records · Page 6Linked to original sources
PubMed1981

Histology of the Fernandez reaction. An appraisal.

The early lepromin reaction was studied clinically and histologically in 38 leprosy patients. There was a quantitative and a qualitative difference in the character of the early inflammatory response to lepromin in the different groups of leprosy patients. In tuberculoid patients, the extent and degree of inflammation and the density of lymphocytic infiltration were maximal. In the polar lepromatous group, the inflammatory reaction was far less intense, and lymphocytes were scarce or absent. An intermediate histology was noted in the borderline and indeterminate groups of patients. In 11 patients with negative clinical reactions, the histology showed moderately dense lymphocytic infiltrations. The paucity of the clinical reaction could be due to the injection and localization of the antigen in the mid- and deep dermis. The correlation between early and late lepromin reactivity, both clinically and histologically, in the polar tuberculoid group and the polar lepromatous group was good. In the borderline and indeterminate groups, only the correlation between the early and late histological reactions to lepromin was good. The relationships between the early and late clinical reactions to lepromin showed marked variation. It is suggested that the early reaction is as good an indicator of lepromin reactivity as the late reaction in all forms of leprosy but only if it is assessed histologically.

Adolescent↗
PubMed1980

T-cell depletion of spleen in patients with longstanding lepromatous leprosy.

In 8 autopsied lepromatous patients the spleen was examined histopathologically and their differential cell population was counted in subcapsular area, red pulp and white pulp. There was considerable reduction of lymphocytes and well marked increase in macrophages and plasma cells in the thymus dependent white pulp. In the subcapsular area and the red pulp, although there was an increase in plasma cells and macrophages no significant reduction of lymphocytes was recorded. Therefore, it is suggested that in lepromatous leprosy there is a selective reduction in the number of T lymphocytes.

Adult↗
PubMed1980

Segmental necrotizing granulomatous neuritis of leprosy.

In leprosy, the occurrence of necrotizing nodular lesions in peripheral nerves is a relatively uncommon complication. Despite clinical and gross similarities, there are microscopical differences among groups of such cases, indicating that in all probability different pathogenetic mechanisms are operative. Furthermore, the vast majority of such cases are not true abscesses but are characterized by caseous necrosis and granulomatous inflammation. The traditional collective name "nerve abscess" is therefore inappropriate. Presented herein is an analytic study of 30 cases of the commonest variant, which we suggest should be called segmental necrotizing granulomatous neuritis of leprosy (SNGN). This lesion commonly affects the right ulnar nerve just above the elbow and occurs most often in those with the borderline tuberculoid form of leprosy. It appears to represent the result of a hypersensitivity phenomenon marked by a preponderance of epithelioid cells rather than a reaction of immunity in which lymphocytes predominate. Acid fast bacilli were demonstrable in the lesion in 77% of cases.

Adolescent↗
PubMed1980

Skin adnexa in leprosy and their role in the dissemination of M. leprae.

Skin biopsies from twenty patients each of tuberculoid, border-line and lepromatous leprosy were studied with a view to find out the presence of bacilli in sweat glands, sebaceous glands, hair follicles and arrector pili muscles and also the pattern of destruction of these tissues by leprous granuloma. M. leprae are found in large numbers in sweat glands, sweat ducts, sebaceous glands, hair follicles and arrector pili muscles. Further in lepromatous leprosy the granulomas mainly surround the skin adnexa which atrophy due to pressure by the granuloma. However in tuberculoid leprosy the inflammatory cells infiltrate the adnexal tissues and destroy them. This study confirms that M. leprae are discharged and disseminated through sweat and sebaceous secretions and therefore infection through skin to skin contact can be one of the common modes of transmission of the disease.

Hair↗
PubMed1980

Risks of treating leprosy in a general hospital.

The Christian Medical College and Hospital, Vellore, with 1208 beds, is situated in an endemic area in which the prevalence of leprosy among adults is 3.4%. Two percent of the beds are occupied by leprosy patients, and about 4000 are seen as outpatients per year. They share with other patients all medical, nursing, laboratory, and other services. The impact of these attitudes and practices on the incidence of leprosy among staff and students was studied. This hospital has 2665 staff, including housekeeping personnel, technicians, nurses, and doctors. There are 777 medical, nursing, and paramedical students. Every employee and student is screened prior to entry into this institution and subjected to routine annual examinations. Of those who at initial screening had no evidence of leprosy, 24 acquired the disease. Sixteen had tuberculoid, two borderline, and six indeterminate leprosy. The attack rate of 0.7% is significantly lower than the incidence or prevalence of leprosy in the area. Factors contributing to this low attack rate are discussed with particular reference to age, sex, educational background, residential status, and area of work. It is suggested that staff and students serving leprosy patients for whom no isolation is practiced do not carry any additional risk of acquiring clinical leprosy.

Adolescent↗
PubMed1980

Prevalence of secondary dapsone resistance in Gudiyattam Taluk, the leprosy control area of the Schieffelin Leprosy Research and Training Centre, Karigiri. 1. Preliminary report.

A preliminary study of the prevalence rate of secondary dapsone resistance among leprosy patients in Gudiyattam Taluk, Tamil Nadu, was undertaken. During the period March 1978 to February 1979, there were 1580 lepromatous and borderline lepromatous patients considered to be at risk of developing secondary resistance. Of them, 1431 were examined clinically, and reactivation and/or relapse was found in 114 patients. Of these, 46 had a bacteriological index of 2,000 and more. Skin biopsies were taken from 26 patients for mouse foot pad studies. Resistance to dapsone at the highest drug concentration was found in 22 and partial resistance in two patients. The organisms from two patients were sensitive to dapsone. Twenty patients were not biopsied because they had been absent from treatment for significant periods of time. These patients are now under observation. Prior to this study, nine patients had been confirmed to have dapsone resistance in the control area, and during the present study 24 additional patients with secondary resistance have so far been detected. Thus 33 patients with dapsone resistance among the 1431 patients examined yields a crude prevalence rate of 2.3% in Gudiyattam Taluk.

Dapsone↗
PubMed1979

The significance of changes in the nasal mucosa in indeterminate, tuberculoid and borderline leprosy.

A study of nasal biopsies from 137 leprosy patients classified on the basis of clinical, microbiological and skin biopsy as Indeterminate, Tuberculoid, Borderline-tuberculoid and Borderline-leproma was undertaken. Changes suggestive of leprosy viz., nerve and smooth muscle inflammation with a few acid fast bacilli in a proportion of the biopsies were seen in all groups of patients examined. This suggests, that even in Indeterminate and Tuberculoid leprosy the disease becomes generalised by the time clinical manifestations appear in skin. Tuberculoid granuloma was seen in two nasal biopsies from Borderline-tuberculoid leprosy patients, one of which was located in the wall of a vein, suggesting the possibility of intravascular dissemination of the disease even in non-lepromatous leprosy. 33 of the patients were children 15 years and below and they also showed changes such as nerve and smooth muscle inflammation but bacilli were seen only in the Borderline group. These findings suggest involvement of the nasal mucosa early in the course of the disease as 70% of the children had the skin lesion for less than one year. The nasal mucosa offers favourable conditions for the growth of the organisms and is readily accessible to infection by droplets, and therefore, it could be one of the primary sites of involvement in leprosy.

Adolescent↗
PubMed1978

Reversal reactions in lepromatous leprosy following transfer factor therapy.

Five patients with active leprosy, four with polar lepromatous (LL) and one with borderline lepromatous (BL) disease, were each treated with transfer factor (TF) from approximately 7.4 x 10(9) lymphocytes given in 36 divided doses over a 12-week period. The TF was prepared from blood donated by normal, healthy, lepromin skin test-positive individuals. During treatment all four of the LL patients, but not the BL patient, developed clinical reversal reactions. Histopathologically, skin biopsies in these four LL patients showed evidence of transformation of collections of multibacillary macrophages into paucibacillary epithelioid cells and giant cells. To our knowledge, this is the first histopahtologic documentation of reversal reactions occurring in polar LL. To the extent that reversal reactions are evidence of effective cell-mediated immunity of Mycobacterium leprae, these results indicate that TF is capable of at least partial correction of the immunologic deficit of lepromatous leprosy.

Adult↗
PubMed1978

The early cellular response to M. leprae. An ultrastructural study.

The ultrastructural changes that develop in mouse peritoneal macrophages from 10 minutes up to 14 weeks after exposure to Mycobacterium leprae are presented. Phagocytosis occurred by a process of engulfment by cytoplasmic processes and incorporation into a phagosome, into which lysosomal enzymes were subsequently introduced. Electron transparent zones (E.T.Z.) were not observed around phagocytosed bacilli in this study, however discrete droplets of lipid-like material appeared in the cytoplasm of macrophages, between 2 and 4 weeks after ingestion of the micro-organisms. Phagosomes with double limiting membranes were observed in macrophages harvested as early as 40 minutes after exposure to M. leprae, contrary to the observations of Evans and Levy (1972).

Animals↗
PubMed1977

Electromicroscopic study of histoid leprosy with special reference to its histogenesis.

Biopsies from 2 patients clinically diagnosed and confirmed by histopathological studies as histoid leprosy were examined using and electronmicroscope. The cells that form the nodule are found to contain far more solid bacilli and much less electron transparent substance than those in lepromatous lesions. They have the characteristics of both macrophages and fibroblasts. It is reasonable to conclude that they are histiocytes produced by local multiplication in response to stimulation by rapidly proliferating M. leprae rather than from accumulation of blood monocytes at the site of inflammation as lepromatous lesions.

Humans↗
PubMed1977

Tuberculoid leprosy and tuberculosis skin: a comparative histopathological study.

Since it has been found hard to differentiate histopathologically tuberculoid leprosy from tuberculosis of the skin, a study of 20 biopsies from each of those conditions was undertaken to identify if possible some of their characteristic features. In tuberculoid leprosy along with tuberculoid granulomata there is always selective involvement and destruction of nerves, lack of fibrosis, absence of caseous necrosis and often epidermal atrophy. In cutaneous tuberculosis, on the other hand, in addition to tuberculous granuloma, there is often a proliferation reaction of the epidermis, areas of ulceration, absence of nerve destruction, marked increase in the reticulin, significant fibrosis and occasionally caseous necrosis.

Biopsy↗
PubMed1976

The immunosuppressive effect of concanavalin A in monkeys.

These studies were performed to evaluate the immunosuppressive effect of concanavalin A (ConA) in monkeys. Bonnet monkeys (Macaca radiata) weighing between 2.5-3.5 kg were used. Following the exchange of full thickness skin allografts in randomly selected animals, gross and histopathological studies of the rejection reaction were performed. Gross observations showed the allograft reaction in control animals to be a well defined phenomenon occurring at 9.0 +/- 0.7 days. In contrast the rejection process in animals that received i.v. ConA was a poorly defined prolonged process occurring at 14.8 +/- 3.9 days (single 75-mg dose of ConA), and 19.0 +/- 2.2 days (75 mg 1 day before and 25 mg 3 days after grafting). In monkeys that received the double dose schedule of ConA, histopathological studies showed distinct retardation of the rejection reaction with reduced lymphocytic infiltration of the graft-host junction. Control grafts showed almost complete rejection in 7-9 days while allografts on ConA-treated animals showed corresponding degrees of destruction only by the 15th day. These studies indicate that ConA does have an immunosuppressive effect in vivo in monkeys. The local and systemic toxic effects of ConA encountered in these animals have been reported and its haematological effects in vivo briefly described.

Animals↗
PubMed1976

An evaluation of the self administration of DDS in Gudiyatham Taluk.

This study using the dapsone/creatinine (D/C) ratio was undertaken to find out how many of the patients attending the Village Clinics were actually taking the DDS tablets. The Urine D/C ratio was estimated in 35 patients who were receiving a supervised daily dosage of either 50 or 100 mgs of DDS. The D/C ratio was also estimated in 100 out patients who were on either 50 or 100 mgs of dapsone. It was determined that 72% of this group had taken DDS in the previous 24 hours. It was also seen that the 55 patients who were receiving 100 mgs of DDS had taken 79.3% of their dapsone dosage, and the 45 patients receiving 50 mgs of DDS had taken 96% of their dosage.

Adult↗