Research on effect of Light emitting diode(LED) on treating skin ulcer of Hansen's disease / 나학회지

Leprosy is disease of skin and peripheral nerve especially. Sequale and disability of musculoskeletal system, especially peripheral extremities (hands and foots) can be developed due to severe and irreversible peripheral nerve damage in leprosy. In leprosy, Skin ulcers can relapse very often and progress to deformity and amputation of hands or foot. We need methods to treat skin ulcer effectively. We have used various therapies such as antibiotics in infectious state, disinfectant, variable wet dressing materials(transparent film, foams, gels&hydrogels, hydrocolloids, calcium alignate), silver dressing, Vacuum Assisted Closure unit, debridement, curettage, surgery to treat skin ulcer in leprosy patients. Sometimes we can treat skin ulcer successfully but, we often encounter ulcer resistant to treat. We need to find and develop methods to treat ulcer successfully. Several researches have reported articles to treat wound successfully using light emitting diode(LED). We tried to treat ulcer in old leprosy patients using LED. We divided ulcers patients into case group(conventional dressing therapy + LED therapy) and control group (only conventional dressing therapy) randomly in out patient department and in ward. This research was carried out from February 2012 to September 2012. Case group and control group have composed of 30 patients respectively. Average age of patients was 74 years old in case group and 69 years old in control group. We have used LED device composed of 700 pieces of diodes emitting 635nm and 500 pieces of diodes emitting 830nm, totally 1200 pieces of diodes. We have observed the size of wounds twice per week in control group and case group. Before treatment average size of wounds was 8509.76mm3 in case group and 8625.33mm3 in control group. P-vale was 0.49. There was no significant difference in case and control group. After treatment average size of wounds was 787.83mm3 in case group and 8074.63mm3 in control group. P-vale was 0.02. There was significant difference in case and control group. After treatment average reduction of size per time was 338.02mm3/day in case group and 26.55mm3/day in control group. P-vale was 0.002. There was significant difference in case and control group. Therefore we have concluded that LED device was effective in wound treatment. Some articles have reported that LED Device have helped to treat wounds in DM ulcer, third degree burn, oral ulcer, skin ulcer in Klippel-Trenaunay syndrome patient, some retinopathy etc. We have concluded that LED of infrared or long visible wavelength light can be used effectively in treatment of wound along with conventional treatment concurrently.

Status of Hepatitis C in Hansen's Disease / 나학회지

According to the reports, the prevalence of anti-HCV is about 1%. In past, the results of the high prevalence of anti-HCV in the patients of Hansen's disease were reported. So we study about the status of Hepatitis C of persons affected Hansen's disease. 1. The prevalence of anti-HCV is 35.1%(persons affected Hansen's disease), 0%(health contact), 0.71%(control, general populations). 2. Positivity of RT PCR is 88% in HCV-Ab-positive persons affected Hansen's disease. In the genotype of hepatitis C, type 1 genotype is 68%, and type 2 is 32%. 3. Statistical signification between patients & non-patients in ALT and HCV-Ab-positivity is found P=0.02, P=0.00) and statistical signification according to result of Hepatitis C antibody in ALT, GTT, and AFP is found in persons affected Hansen's disease(P=0.015, P=0.036, P=0.017).

12 Cases of Hansen's Disease(New case & Relapse) / 나학회지

Between 2008 and 2009, We found 9 new cases and 3 relapse cases, diagnosis by the clinical finding, skin smear, skin biopsy, lepromin test, ELISA for PGL-I antibody, and DNA-PCR. The obtained results were summarized as follows: 1. In 9 new cases, the mean age was 56.2 in 5 Koreans and 28.2 in 4 foreigners(Nepal, Thailand, Sri Lanka, Philippines), the types of Hansen's disease were 5 lepromatous(2 Koreans and 3 foreigners), 1 borderline(1 foreigner) and 2 tuberculoid(2 Koreans), mean BI was 3.4+, mean O.D. of PGL-I antibody was 0.445, numbers of TTC repeat are 16(2 Korean and 2 foreigners), 11(2 Koreans), 12(1 Koreans) and 13(1 Koreans), and of GACATC repeats are 4(4 Koreans) and 3(1 Korean and 4 foreigners). Among 9 new cases, 1 case has the mutation offolP1 gene. 2. All new cases had no mutation of & rpoB gene. 3. In 3 relapse cases, the mean age was 63.7, the types of Hansen's disease were 3 lepromatous(3 Koreans), mean BI was 4.0+,and mean O.D. of PGL-I antibody was 0.846, and numbers of TTC repeat were 12(2 cases), 11(1 case), and of GACATC repeats are 4(all 3 Koreans). Among 3 relapse cases, 1 case has the mutation ofrpoB gene.

The Prospectives on The Association between Disability Resulted from Hansen's Disease and Orthosis Prescribed to Patients with Hansen's Disease / 나학회지

BACKGROUND: Hansen's disease is chronic disease, often resulting in musculoskeletal complication such as chronic ulcer, deformity, disability. The aim of this article is to know the present status of prescription of orthosis and to assess the usefulness of orthosis. METHODS: Analysis was done on subjects who had were prescribed orthosis from December, 2007 to November, 2008 at the Clinic of Reserch Center. We have asked the patients questionnaire such as frequency of use of the prescribed orhtosis, the degree of pain reduction and comfortability with orthosis,the cause of disuse of orthosis ,the degree of preventing relapse of ulcer with orthosis, request about prescribed orthosis. RESULTS: The total number who were prescribed orthosis was 173. About 69.4% patients have used orthosis very frequently or nearly at all times. About 83.2% patients said that orthosis had done them good in pain reduction, preventing relapse of ulcer. The major reason of disuse of orthosis was inconvenience of management, not no-helfulness. The major request about orthosis were improvement of quality, imprvement of strength of orthosis, shortening of limitation term of prescription. CONCLUSINON: The prescription of orthosis to Hansen patients with musculoskeletal sequale improve quality of life and is available in preventing relapse of ulcer.

Factors associated with Receiving Rescreening in High Risk Group Diagnosed by Endoscopic Screening of Stomach Cancer

BACKGROUND: Stomach cancer is the most common cancer in Korea. Lifelong health management program recommends that males over 40 years and women over 50 years should undergo stomach cancer screening by endoscopy or upper gastrointestinal series every two years. The importance of re-screening of stomach cancer in a high risk group is emphasized. METHODS: A telephone questionnaire was done one year after to 123 patients over 40 years old considered as a high risk group with either chronic atropic gastritis, intestinal metaplasia, gastric ulcer, gastric adenoma among 804 subjects who had undergone anendoscopic examination from February 2002 to June 2003 at a university hospital health promotion center. RESULTS: The number of patients who responded were 109. The average recognition rate of high risk group was 53.2%. The rate of recognition of high risk group was lower in good subjective health estimation group and in less educated group, in old age group, and in chronic atrophic gastritis and intestinal metaplasia group. The rate of not receiving re-screening after 1 year was 48 (44.0%). Re-screening rate in patients with intestinal metaplasia (35.3%) and chronic atropic gastritis (39.1%) compared to gastric ulcer (77.8%) and gastric polyp (90.0%), in those not recognizing themselves as high risk group, in low education group, in old age, was lower. CONCLUSION: In patients with chronic atropic gastritis and intestinal metaplasia, in those not recognizing themselves as high risk group, in old age and in good subjective health state. We need to educate the importance for regular screening of stomach cancer more intensively.