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Biomedical subjects

R R Jacobson

Publications and source records attributed to R R Jacobson.

At least 55 records · Page 3Linked to original sources
PubMed1980

Lucio's phenomenon.

A 38-year-old woman had diffuse, nonnodular, lepromatous leprosy and Lucio's phenomenon. Most cases of Lucio's phenomenon have been reported to have a leukocytoclastic vasculitis as the underlying pathologic abnormality. In this patient, however, the histologic picture of an early lesion of Lucio's phenomenon showed a milk, mononuclear cell infiltration, endothelial swelling, vascular thrombosis, and ischemic necrosis. Lepra bacilli were abundant around nerves and blood vessels, and many were noted in vascular walls and endothelium. Our findings raise the possibility that some cases of Lucio's phenomenon may be caused by vascular damage due to direct invasion of Mycobacterium leprae and not necessarily by leukocytoclastic vasculitis.

Adult↗
PubMed1976

The diagnosis and treatment of leprosy.

Leprosy is a complex disease, but recent research and the Ridley-Jopling classification which emphasize its immunologic aspects have greatly aided our understanding of and approach to the problem. The diagnosis should be considered whenever skin lesions and sensory loss occur. Dapsone remains the treatment of choice, but several newer drugs show great promise, especially in those cases whose bacilli have become sulfone resistant. Immunotherapy may play an increasingly prominent role in the future. Reactive episodes continue to be a serious complication, but the availability of thalidomide to control erythema nodosum leprosum has markedly improved the prognosis. Physicians of the US Public Health Service Hospital at Carville, Louisiana, are available at all times for consultation on these and other matters related to leprosy.

Biopsy↗
PubMed1974

Thymus-dependent lymphocytes of peripheral blood in leprosy patients.

Study of the numbers of thymus-derived lymphocytes by the rosette assay (T-RFC) in patients with leprosy reveals that lower than normal numbers of T-RFC are regularly seen in those patients with the active lepromatous form of this disease. Essentially normal numbers of T-RFC were found in inactive lepromatous, borderline, and indeterminate types of leprosy. The lowest percentages and lowest absolute numbers of T-RFC were encountered in patients with lepromatous leprosy resistant to chemotherapy. Patients with lepromatous leprosy complicated by erythema nodosum leprosum show numbers of T-RFC that are more nearly normal than the numbers of T-RFC in patients with uncomplicated lepromatous leprosy. These findings are discussed with respect to the pathogenesis of lepromatous leprosy and the T-RFC deficiency demonstrated in this disease. The possibility that transient defects in T-RFC numbers or function may predispose to lepromatous leprosy is proposed.

Adult↗
PubMedDate not supplied

Leprosy XII. Quantitative analysis of thymus-derived lymphocyte response to phytohemagglutinin in leprosy.

The immune status of various leprosy patients was evaluated by using a micromethod to evaluate lymphocyte responses to phytohemagglutinin (PHA). In our study, whole blood was used and the degree of response to PHA stimulation was expressed in terms of unit volume of blood. A markedly decreased response to PHA stimulation was noted in patients with active lepromatous leprosy. Patients with active lepromatous leprosy who have been proved drug (DDS) resistant showed less response than did those of drug sensitive patients with active lepromatous disease, while the patients with active lepromatous leprosy complicated by erythema nodosum leprosum (ENL) showed higher response than did those of patients with no complicated ENL. Comparing the results obtained to those obtained using other methods for T cell analysis indicates that these results reflect the number of T lymphocytes in the leprosy patient. Thus, this simple method is of value in assaying the presence and responses of T lymphocytes in the leprosy patient.

Dapsone↗
PubMedDate not supplied

Mean circadian cosinors of vital signs, performance of blood and urinary constituents in patients with leprosy.

We have herewith examined the characteristics of circadian rhythms in patients with lepromatous leprosy, active or inactive, allowing a comparison with corresponding properties of rhythms in healthy subjects mapped earlier. Group results were illustrated by cosinor plots, produced directly on microfilm by computer. Eventually such reference standards in the form of cosinors, among other displays, notably of waveform, may be individualized and carried on a person's health record. Such a quantitative assessment of an individual's rhythms in health may serve for rigorous comparison with any changes accompanying increased susceptibility or occult or overt disease.

Adult↗
PubMedDate not supplied

Hansen's disease in native-born citizens of the United States.

This paper presents a statistical analysis of data on 1,309 Hansen's disease (HD) patients born in the continental United States during the 50 year period 1932-81. Fifty-six percent of them were born in Texas. The cases of 66 percent were classed as multibacillary, 31 percent were considered paucibacillary, and the type was unknown for 3 percent. Blacks and whites appeared to be equally susceptible to Hansen's disease. Thirty percent had a history of contact with Hansen's disease. The age at diagnosis has increased an average of 2.7 years per decade, and the increase has accelerated in the last two decades. If the present trend continues, Hansen's disease among native-born citizens of the United States will ultimately disappear.

Adolescent↗
PubMedDate not supplied

Metabolism of clofazimine in leprosy patients.

We have identified two metabolites of clofazimine (B663; Lamprene; 3-(p-chloroanilino)-10-(p-chlorophenyl)-2,10-dihydro-2-isopropyliminophenazine) in our initial investigation of its metabolism in leprosy patients. Based on mass, ultraviolet, and visible spectrometry, we characterized an unconjugated (metabolite I, 3-(p-hydroxyanilino)-10-(p-chlorophenyl)-2,10-dihydro-2-isopropyliminophenazine ) and a conjugated (metabolite II, 3-(beta-D-glucopyranosiduronic acid)-10-(p-chlorophenyl)-2,10-dihydro-2-isopropyliminophenazine) metabolite from the urine of patients. Both metabolites were red in color, similar to clofazimine; however, both were considerably more polar than the parent drug. We suggest that metabolite I was formed by a hydrolytic dehalogenation reaction, and metabolite II by hydrolytic deamination followed by glucuronidation.

Clofazimine↗