HANSENÍASE: RESUMOSHANSENIASIS ABSTRACTS

BACTERIOLOGIA, IMUNOLOGIABACTERIOLOGY, IMMUNOLOGY

B

B

B

cwmavth

of 18 to 20 weeks of incubation at 37.°C.This has been possible due to metabolicstimulating action of thyroxine sodium so-lution as well as diffusion of nutrients intosolution from the medium. Intracutaneousinoculation of culture fluid on the surfaceof foot pad in cortisone treated mousehelped in rapid appearance of the specificlesion at the site within 20 days after injec-tion. Both the intracutaneous method ofinoculation and treatment of mouse withhigh doses of cortisone may play some rolein shortening the period of development ofsuch lesion.

Author's abstract

BROWNE, S.G. A vaccine for HD? Star,38(2):8, 1978.

CAUZZI, N. Aspectos antigénicos del My-cobacterium leprae. Bol. Inf. Soc.

ANTIA, N.H Radioisotope labelling of M.leprae. Editorial. Lepr. India, 50 (2) :123-125, 1978.

Therefore, before such techniques canbe undertaken as routine procedures theyneed further refinement and standardiza-tion so that they can be confirmed andcarried out in other centres where similarfacilities are available. The search forother metabolites which may be more specific in terms of being constituents of M.leprae or its metabolic profile, thus offeringa higher and more rapid labelling, shouldbe explored. A better understanding of themetabolic and energy needs of this fas-tidious organism may help in the selectionof such compounds for isotope studies. Itis also possible that isotopic techniquesmay provide a better understanding of thenutritional needs of M. leprae and thushelp towards its cultivation.

From the editorial

ACKE, J.T.; CHARLESWORTH, E.N.;GARCIA, R.L. IgM deposits in tubercu-loid leprosy. Arch. Dermatol., 112:557-558, 1976. (Letter to the Editor).

HUTANI, L.K. Mycobacterium lepraecaptured? Editorial. Indian J. Derma-tol. Venereol. Leprol, 42 (5):201-202,1976.

ISWAS, S.K. Growth of Mycobacteriumleprae in thyroxine treated culture me-dium — a preliminary report. Lepr.India, 50 (1): 57-63, 1978.

A new approach in cultivation of My-obacterium leprae in thyroxine treated Lo-enstein-Jensen media is reported. Theethod has been proved to be successful

s the organisms multiplied and remainediable in the thyroxine solution added ate bottom of the culture vial, for a period

Argent. Leprol., 2(5): 29-30, 1978.

CHIRON, J.P.; DENIS, F.; MAUPAS, P.;LANGUILLON, J.; ROUX, G. Infectionpar le virus de l'hépatite B chez leshanséniens. 1. Detection de l'antigèneet de l'anticorps de surface du virus del'hèpatite B par radio-immunologie.Bull. Soc. Med. Ajr. Noire Lang. Fr.,23(2): 174-182, 1978.

The frequence of surface antigen ofhepatitis B virus (HBs Ag) and the corres-ponding antibody (anti-HBs) has been re-searched in 553 patients with leprosy and 100Senegalese blood donors. This study has beencarried out by radio-immunoa-ssay. HBs Aghas been found in the serum of 25.5 % of thehansenians as against 12 % of the controlswhereas the presence of antibodies (anti-HBs)has been shown to be 44.1 % and 38 %respectively. HBs Ag and/or anti-HBs markershave been revealed in 67.1 % of the leprosypatients sera. The lepromatous forms morefrequently

Hansen. Int., 4(1) :51-85, 1979

52 Hanseníase: resumos/Hanseniasís abstracts

ptstb

C

p

stpcetmHarcimetrtr

C

D

Mreacebtc

DELJtpchem., 84 :604-605, 1976.

H

ossess HBs Ag and/or anti-HBs (74.6 %)han the tuberculoid forms (62.9 %). Noignificant statistical difference with regardo sex, ethnic groups or mode of life haveeen discovered.

Author's summary

HIRON, J.P.; DENIS, F.; MAUPAS, P.;GOUDEAU, A.; COURSAGET, P.; LAN-GUILLON, J.; ROUX, G. Les marqueursdu virus de l'hepatite B chez les lé-preux. Nouv. Presse Med., 8(9):659-662,1979.

Tatie

Ttudrolsresontd inrolsarkBeppeecenarrnfec

ainrshateveitisoma

UOB:

AVFDtD1

Tyco

iophd andrysd uy thomyrys

FLIEB:32, 1978.

FLIESS, E.L. & PACIN, A. La respuestainmunologica a traves del espectro cli-nico de la lepra. In: REUNION LE-PROLOGICA DEL CONO SUD, 2 Bue-nos Aires, 1977. Apud Arch. Argent.Dermat., 27(2-3): 11-116, 1977.

We studied cell mediated immunity insixty leprosy patients (13 LL, 12 BL, 11 BB,12 BT and 12 TT) . In all cases its testedblastic dedifferentiation, with phytohema-gluttinin (PHA) and Lepromin, and CellMigration Inhibition test with Lepromin.We observed a stepdown in the immuneresponse between normal response in TTpole to intense depression in LL pole. Samecorrelation is observed in responses toPHA and Lepromin in Blastic Dedifferen-tiation Test.

Authors' summary

FLIESS, E.; HERRERA, M.P. de; CARO-SELLA, E.D.; BALIÑA, L.M.; CAR-DAMA, J.E.; GATTI, J.C. Estudiosinmunologicos en pacientes de lepraindeterminada. In: REUNION LEPRO-LOGICA DEL CONO SUD, 2.ª ,BuenosAires, 1977. apud Arch. Argent. Der-mat., 27(2-3): 117-122, 1977.A longitudinal immunologic study of

patients with indetermined type of leprosywas done. Two kinds of tests were used:lepromin-reaction and rosette-E formationtogether with the clinical aspects. Thosewere performed in 1973 and subsequentlyin 1937. A striking difference could be de-termined between the lepromin-positivepatients and those who were negative(p < 0.01) in 1973 in regard to the roset-te-E test, being even more accentuated thatdifference in 1977. At the same time therewas correlations between the immunologicresponse and the evolution up to for. Thisevolution could be influenced by the spe-cific treatment. The twist of lepromin-reacttions of patients with normal rosette-Etested en 1973 speak in favor of a bettersensibility of that test "in vitro" as a prog-nostic sign.

anse

he hepatitis B virus markers, leprousnts.he hepatitis B virus markers were

ied on 553 leprous sera and 100 con-sera. HBs Ag detected by RIA were

ent on 25,4 % of leprous and 12 % ofrols; the anti-HBs by RIA were reveal-

44,1 % of patients out 38 % of con-. The leprous was not carrying thisers were HBe Ag or anti-HBe or anti-positive. By this vertical study it

ars that 2,4 % of the cases presentedt or acute hepatitis; 23 % were chronic

iers; 41,7 % had been in times pastted but were cured and the third re-ing had been infected but coat mark-

were absent, it is more than likelyis an old infected group. The study

aled no significant difference in hepa-chronic forms frequency between lep-tous and tuberculoid patients.

Authors' summary

MO, G. Inmunidad sérica en lepra.ol. Inf . Soc. Argent. Leprol., 2(5)

31, 1978.

ID, H.L.; CLAVEL, S.; CLEMENT,.; MEYER, L.; DRAPER, P.; BUR-ETT, I.D.J. Interaction of Mycobac-

erium leprae and Mycobacteriophage29. Ann. Microbial, (Inst. Pasteur),29B (4): 561-570, 1978.

his study of the interaction betweenbacterium leprae and the mycobacte-age D29 showed that the viruses caus-patchy damage of cell wall structure

the accumulation in the host of internaltalline structures. Whether the observ-ltrastructural alterations were causede replication of D29 was not olear. Mi-cin C also caused the accumulation oftalline structures in M. leprae.

Authors' summary

n. Int., 4(I):51-85, 1979

VILLE, J.; HUYBRECHTS-GODIN, G.;ACQUES, P.J. Germicidal activity ofhe PIGO system on Mycobacterium le-rae in vitro. Arch. Int. Physiol. Bio-

SS, E.L. Inmunogenética y lepraoi. Inf. Soc. Argent. Leprol., 2(5)

Authors' summary

Hanseníase: resumos/Hanseniasis abstracts 53

GATTI, J.C. Inmunoterapia. Boi. Inf. Soc.Argent. Leprol., 2(5): 32-33, 1978.

GATTI, J.C.; BALIÑA, L.M.; CARDAMA,J.E.; PIZZARIELLO, G.E.A.; LUPPIM.S.; GABRIELLI, M.; VALDEZ, R.Estado actual de los cultivos e inocula-ción del bacilo de Hansen. Arch. Ar-gent. Dermatol., 28(1): 1-16, 1978.

GOODMAN, H.C. Immunology and tropicaldiseases: challenges and opportunities.Ann. Immunol., 129C(2-3): 267-274, 1978.

Immunologists and leprologists, in theprototype TDR scientific working groupon immunology of leprosy (IMMLEP), havebeen meeting and stimulating and coordi.nating research towards a leprosy vaccinesince 1974. At their first meeting in1974, the leprologists and immunologistsagreed upon a strategic plan to develop aleprosy vaccine to be ready for clinicaltrial in five years. This is a particularlyimportant goal, since drug resistance hasrecently been shown to exist to dapsone,the only practical chemotherapy nowavailable for leprosy. The third meeting ofthe IMMEP Scientific Working Group(SWG), in February 1976, reportedencouraging progress and that thestrategic plan was on schedule. Althoughin vitro cultivation of Mycobacteriumleprae has still not been accomplishedthe supply of M. leprae from in vivoinfected armadillos had been doubled,and killed organisms so obtained couldbe shown to produce cell mediatedimmunity in experimental animals and toprotect mice from M. leprae infection. Itis hoped that studies in man of theimmune response to killed M. leprae maybe underway before the end of 1978.

From the articleGREIDING, L.; CUOMO, G.; MATHOV, E.;

CASALÁ, A.; ROIZMAN, N.; PAS-SANISSI, M.; NUÑEZ, J.; SZIAZER, M.Plasmaferesis en pacientes afectados delepra lepromatosa: evaluación clinica einmunologica de los resultadosobtenidos. In: CONGRESSO LATINO-AMERICANO DE ALERGIA E IMUNO-LOGIA, 6.°, Guarujá, 1977. Resumos detrabalhos científicos. São Paulo, So-ciedade Latino-Americana de Alergia eImunologia, 1977. p. 54-55.

HADDAD, N.; BECHELLI, L.M.; SIMÃO,E.T.; KWAPINSKI, J.B.G. Reativida-de à tuberculina e à lepromina apósaplicação de B.C.G. intradérmico em

crianças de 6 meses a 4 anos. In: CON-GRESSO BRASILEIRO DE HIGIENE,19.° CONGRESSO PAULISTA DE SAÚ-DE PÚBLICA, 1 °, São Paulo. 1977.Resumos dos trabalhos: temas livres.São Paulo, 1977. item 9.4.

HAN, 5.11. & KUO, S.L. Ability of theleprous macrophage to accept cytophi-lieantibodies. Chin. J. Microbiol., 8(1) :59-63,1975.

The ability of leprous macrophages toaccept cytophilic antibodies was not damaged.Blood macrophages derived from both types ofleprosy formed rosettes with cyto-philicantibody sensitized goat red cells. Therosette forming rates of tuberculoid (65.0%)and lepromatous macrophages (66.4%))were essentially the same as that of normalblood macrophages (68.8%).

Authors' abstract

JOB, C.K. Immunology and the changingprofile of leprosy. Lepr. India, 50(2):214-230,1978.

Introduction. Causative organism. Pa-thology and classification. Transmission toexperimental animals. Lepromin test.Defense against infection. Immunogenetics.Immunotherapy. Leprosy vaccine. Conclu-sion.

KAUR, S.; KUMAR, B.; GUPTA, S.K. Fineneedle aspiration of lymph nodes in le-prosy. A study of bacteriologic andmorphologic indices. Int..J.Lepr., 45(4):369-372,1977.

Lymph node aspiration was performedfrom the inguinal group of lymph nodes in 16patients having lepromatous or borderlineleprosy. In the same group of patientsimpression smears of excised lymph nodeand slit smears of the skin were also studied.This study made it obvious that theaspiration biopsy technic gave similar in-formation regarding the Bacteriologic (BI)and Morphologic Indices (MI) as the im-pression smears of excised lymph nodes.The technic of aspiration being simple andnontraumatic is recommended for the follow-up of patients on antileprosy drugs and inreactional phases.

Authors' summary

KRONVALL, G.; GLOSS, O.; BJUNE, G.Common antigen of Mycobacterium le-prae, M. lepraemurium, M. avium andM. fortuitum in comparative studies

Hansen. Int., 4(1) :51-85, 1979

cfointwp(Laa2e2AfoTp2spfo

L

frrnimacriluothgmthRcmafrsyalecgtM

H

54 H

using two different types of antisera.Infect, Immun., 16(2): 542-546, 1977.

No. 21 mycobacterial antigens of My-obacterium lepraemurium, M. avium, M.rtuitum, and M. leprae were comparedcrossed immunoelectrophoresis using

o different antibody sources, a serumool from lepromatous 1 eprosy patientsSII) and a rabbit anti-M. smegmatis

ntiserum. M. lepraemurium, like M.vium, was found to contain the 21 A and1 C determinants. M. fortuitum contain-d in addition a new type of determinant,1 D. M. leprae antigen no. 21 carried theas well as the B determinants, the latterund so far only in the leprosy bacillus.he separate taxonomic position of M. le-rae, suggested by earlier studies of the no.1 antigen, is further supported by the pre-ent results, which also demonstrate theotential use of submolecular heterogeneityr such investigations.

Authors' abstract

AUB, R.; DELVIT.LF, J.; COCITO, C.Immunological relatedness of ribosomesfrom mycobacteria, nocardiae and co-rynebacteria, and microorganisms inleprosy lesions. Infect. Immun., 22(2):540-547,1978.

Serological relatedness of ribosomesom microorganisms of the Mycobacte-

ium, Nocardia, and Corynebacterium ge-era has been analyzed by the microplatemunodiffusion technique. Mycobacterium

nd Nocardia proved homogeneous andlosely related taxa, whereas Corynebacte-um was found to be a heterogeneous phy-m connected by remote links to the

thers. The taxonomic position of "diph-eroid microorganisms" (non-acid-fast,

ram-positive bacteria morphologicaly si-ilar to corynebacteria), which were found

ogether with Mycobacterium leprae inuman leprosy lesions, was also investigated.ibosomes of diph-theroid bacteria stronglyross-reacted with antisera against severalycobacteria and nocardiae but not

gainst corynebacteria. Moreover, ribosomesom independently isolated diph-theroidtrains proved serologically related andielded strong cross-reactions with antiseragainst M. leprae as well as with sera fromprosy patients. Hence, diph-theroid mi-roorganisms represent a homogeneousroup immunologically related to mycobac-eria in general and more specifically to. leprae.

Authors' abstract

LESER,M.RA.;turachopelanadincuPHAcomformticaIn:NOGuacienno-19'7

LESERRI,N.FlinfhanCONALEjá,ficoAm197

MASUDBERsenLATIMUsumPauAler

MASUDBERcitáIn:DErujátíficAm197

MATSUtemlepr20(5

MIRANDdeInf .197

MORI,prayolk197

ansen. Int., 4(1) :51-85, 1979

anseníase: resumos/Hanseníasís abstracts

P.G.; MARGARIDO, L.; SANTOS..M.; SARTORI, S.G.; HARES, W.MENDES, N.F.; LESER, W. Cul-

de linfócitos de 5 pacientes vir-vianos com estimulação por 3 dias,

fitohemaglutinina (PHA) adicio-a inicialmente e após 14 dias debação com dose subestimulante de, em meios com soro autólogo esoro homólogo. Indices de trans-

ação blástica antes e após terapêu-com fator de transferência (FT).CONGRESSO LATINO-AMERICA-DE ALERGIA E IMUNOLOGIA, 6 °,rujá, 1977. Resumos de trabalhostíficos. São Paulo, Sociedade Lati-

Americana de Alergia e Imunologia,7. p. 86.

, P.G.; SANTOS, M.R.M.; SARTO-S.G.; HARES, W.A.; MENDES,

.; NASPITZ, C. Determinação deócitos T e de linfócitos B em 15senianos Mitsuda-negativos. In :GRESSO LATINO-AMERICANO DERGIA E IMUNOLOGIA, 6°, Guaru-

1977. Resumos de trabalhos cientí-s. São Paulo, Sociedade Latino-ericana de Alergia e Imunologia,7. p. 87.

A, A.; MENDES, N.F.; SCHEING, M.A. Anergia cutãnea em han-

íase virchowiana. In: CONGRESSOINO-AMERICANO DE ALERGIA ENOLOGIA, 6 °, Guarujá, 1977. Re-os de trabalhos científicos. São

lo, Sociedade Latino-Americana degia e Imunologia, 1977. p. 53.

A, A.; MENDES, N.F.; SCHEIN-G, M.A. Estudo da função mono-

ria em pacientes com hanseníase.CONGRESSO LATINO-AMERICANOALERGIA E IMUNOLOGIA, 6 °, Gua-, 1977. Resumos de trabalhos cien-os. São Paulo, Sociedade Latino-ericana de Alergia e Imunologia,7. p. 53.

O, Y. & UTSUNOMIYA, S. At-pts at cultivation of Mycobacteriumae in cell cultures. Jap. J. Microbiol.,) :471-473, 1976.

A, R.O. Inhibición de la sintesisanticuerpos por la talidomida. Bol.

Soc. Argent. Leprol., 2(5): 33,8.

T. Cultivation of Mycobacterium le-emurium on modified 1% Ogawa

media. Jap. J. Leprosy, 46(2) :48,7.

Hanseníase: resumos/Hanseniasis abstracts 55

MORINO, J. Estudios inmunológicos enpacientes de lepra y convivientes. Boi.Inf. Soc. Arg. Leprol., 1(4) :23-24, 1977.

MORINI, J.C. Inmunidad mediada por cé-lulas en lepra. Bol. Inf. Soc. Argent.Leprol., 2(5) :30-31, 1978.

MUROHASHI, T. & YOSHIDA, K. Culti-vation of Mycobacterium leprae usingsemi-synthetic medium. Kitasato Arch.Exp. Med., 49(3) :55-61.

MUROHASHI, T. & YOSHIDA, K. Isola-tion of M. leprae using semi-syntheticsolid agar medium. Acta Leprol., (70):3-21, 1978.

MUROHASHI, T. & YOSHIDA, K. Stimu-lating effect of leucine on the growthof M. leprae. Acta Leprol., (70) :23-33,1978.

M-Y 16j agar slant was prepared bymodifying M-Y 14b which has hitherto beenused most widely in our experiments byincreasing, the amount of Na pantothenateand adding leucine, and the growth stimu-lating effect was investigated referring tothe foregoing subculture experiments. Theresults revealed that the growth of M. le-prae was stimulated remarkably in the pri-mary isolation quite similarly to the sub-culture. This seemed to be resulted fromstimulated biosynthesis of fatty acids bythe leucine metabolism.

Authors' summary

NIGAM, P.; GOYAL, B.M.; MUKHIJA, R.D.; VAJPEYI, G.N. Leprosy: suscepti-bility concerning ABO blood groupsand study of VDRL reaction. Indian J.Berm. Venereol., Leprol., 42(2) :75-79,1976.

NUTI, M.; TARABINI, C. G.; TARABI-NI, C.G.L. Lebbra e mycobactteri ati-pici: 1) Studio della cutireattivitá, avarie sensitine atipiche in pazienti por-tatori di lebbra lepromatosa e tuber-culoide. Acta Leprol, (68) :25-34, 1977.

This study was carried out in Jilib.south of Somalia, on patients with lepro-matous (57 cases) and tuberculoid (24cases) leprosy; in each case a series of 6skin-test antigens was employed (from M.tuberculosis, M. scrofulaceum, M. xenopei,M. africanum, N. farcinica, N. otididis).

The results obtained showed an unex-pected and anomalous high percentages ofpositive - reactions; the largest recorded

mean diameter of induration was 100 mmto PPD-S from M. tuberculosis. The meansize with this antigens was 19,8 mm in lep-romatous group and 11,1 mm in tuber-culoid one. The most severe reactionsoccurred among lepromatous patients andin 5 cases ulceration was produced; ulcera-tion occurred also in 3 tuberculoid patientsafter skin testing. Reactivity to the antigensvaries from 75 % for M. tuberculosis to3 % for M. farcinica in L group, while inT forms the percentage was respectively70 % and 8 %; the most significant differ-ence among two leprosy groups of patientsit was found for testing with M. scrofula-ceum with percentage of '73% in L form and41 % in T form and for M. xenopei with26 % and 4 °A respectively.

Authors' summary

OMS, Genève. Immunology of leprosy. Bull.OMS. WHO, 56 (6) :870-871, 1978.

OMS, Genève. Immunoprophylactic aspectsof the IMMLEP programme. Newslet-ter: spec. prog. res. train. trop. dis.,(9) :13-15, 1977.

PETTY, M. India and Carville collaborateon HD vaccine research. Star, 37 (3):2, 1978.

PRABHAKARAN, K. Tissue specificity ofMycobacterium leprae. Star, 37(2) :2-3,1977.

PRABHAKARAN, K.; KIRCHEIMER, W.F.; HARRIS, E.B. Hansen bacillus:failure of culture attempts. Star, 36(6):

13, 1977.

REICH, C.V. Immediate-type hypersensiti-vity response to Mitsuda lepromin com-ponent. Correspondence. Int. J. Lepr.;45(4) :381, 1977.

RIDLEY, M.J.; RIDLEY, D.S.; TURK, J.LSurface markers on lymphocytes andcells of the mononuclear phagocyte se-ries in skin sections in leprosy. J. Pa-thol., 125(2): 91-98, 1978.

E, EA and EAC rosetting techniques andIg fluorescence were used in a study of re-ceptor sites in cryostat sections of lesionsthrough the spectrum of leprosy, and forcomparison in some other mycobacterialand granulomatous lesions. Anti-C3, andtrypsin were used as blocking agents. Lym-phocytes in borderline lepromatous leprosyproduced EA adherence and IgC fluores-cence indicating B type cells. Lymphocytes

Hansen. Int., 4(1):51-85, 1979

56 Hanseníase: resumos/Hanseníasis abstracts

in tuberculoid leprosy produced neither E orEA adherence and no fluorescence; these cellswere presumed to be T cells. EAC and EAadherence was more marked in areas ofmacrophage infiltration, where there werefew lymphocytes, than over the lymphocytesthemselves. Two distinct patterns emerged- (i)EA binding together with IgG fluorescence wasseen in active lepromatous leprosy and could belocalised to the surface of individualmacrophages, and (ii) EAC binding togetherwith IgM fluorescence was seen in thegranuloma of tuberculoid leprosy andsarcoidosis, but could not be definitely relatedto cell surface; rather it was diffuselyspread over the whole granulo- ma; EACadherence was diminished by anti- C3 serum.Trypsin removed EA binding completely,but only diminished EAC ad-herence. It issuggested that the EA pattern indicatesimmunoglobulin receptors on macrophage andlymphocyte surfaces: and that the EACbinding (which is stronger than EA) involvesCa and IgM receptors at extracellular sitesas well as C3 receptor sites on epithelioidcell surfaces. EA and EAC binding wereenhanced in borderline tuberculoid leprosy inreaction and erythema nodosum leprosum,suggesting that im-munoglobulin andcomplement receptor sites increase innumber with enhanced hypersensitivity.

Authors' summary

ROTBERG, A. O defeito especifico da imu-nidade celular na hanseníase (margemanérgica). In: REUNION LEPROLO-GICA DEL CONO SUD, 2.11, BuenosAires, 1977. apud Arch. Argent. Der-mat., 27(2-3) :89-92, 1977.

The “Factor N-Anergic margin" theory isrevisited after 40 years of being postulated.New methods and technics applied to thishypothesis could eventually contribute to thebetter knowledge of the immunology ofhanseniasis and give new approaches toresearch in this field.

Adapted from the summary

ROTBERG, A. O "defeito da imunidade ce-lular" na hanseníase: a velha hipótesebrasileira da "margem enérgica". In:CONGRESSO LATINO-AMERICANO DEALERGIA E IMUNOLOGIA, 6', Guaru-já,1977. Resumos de trabalhos cientí-ficos.SEW Paulo, Sociedade Latino-Ame-ricanade Alergia e Imunologia, 1977. p. 52-53.

SAHA, K. & CHAT+ ABORTY, A.K. Serumcomplement profile in human leprosy

Hansen. Int., 4(1):51-85, 1979

and its comparison with immune com-plex diseases. Int. J. Lepr., 45(4) :327-337- 1977.

In the present study we have estimatedthe serum levels of early, middle, and distalcomplement components, e.g., Clq, C3, C4,C5, C8, and C9 along with C1-inactivadorand CH5O in patients with tuberculoid andlepromatous leprosy and have comparedthese results with the levels in healthy sub-jects as with levels in patients with otherimmune complex diseases. We have alsoanalyzed the cryoglobulins present in thesera of these patients; they consisted ofeither a single or mixed IgG, IgB or fibri-nogen in most instances. The componentC3 was found in only one sample. Itappears that unlike lupus nephritis. in whichcomplement is activated by direct path inabout 30% to 500/13 of leprosy patients, sig-nificant C3 complement consumption takesplace primarily via the alternate pathwayand is probably initiated by the aggregatedimmunoglobulins represented in cryopreci-pitates. This is further supported by thestudy of serum factor B and its breakdownproduct (Ba) in these patients. The questionof the role of the middle and distalcomplement components, such as C5, C8and C9, during total hemolytic complementand C3 consumption in leprosy remainsunanswered.

Authors' summary

SAHA, K.; MITTAL, M.M.; MAHESHWA-RI,H.B. Passive transfer of immunity intoleprosy patients by transfusion oflymphocytes and by transfusion of Law-rence's transfer factor. .1. Clin. Mi-crobial., 1(3) :279-288, 1975.

SAHA, K.; SARIN, G.S.; CHAKRABORTY,A.K.; SEN, D.S. Ocular immunoglo-bulins in lepromatous leprosy. Int. J.Lepr., 45(4) :338-342, 1977.

Immunoglobulin levels in the ocularfluids have been estimated in normal subjectsand lepromatous leprosy patients. In thenormal tear, IgA is the major immuno-globulinwhile IgG is the only immunoglo-bulindetected in the aqueous humor. Theimmunoglobulin profiles in the tear and theaqueous humor in normal subjects aredifferent. The mean IgA level in the tears ofthe lepromatous leprosy group is signi-ficantly lower than in the control patients.IgA and IgG levels are raised in the ague.ous humor of some leprosy cases who hadsuffered from uveitis in the past and also inall cases with active endogenous uveitis.

Hanseníase: resumos/Hanseniasis abstracts 57

Therefore, in lepromatous leprosy the patternof immunoglobulin alteration in the tear andthe aqueous humor is not parallel.

Authors' summary

SAOJI, A.M. & MENE, A.R. Persistence ofAustralia antigen in leprosy — Afrustrating puzzle in immunology. Lepr.India, 50(1) :7-10, 1978.

This paper deals with the relationship ofAustralia antigen (Au) to various subgroupsof leprosy, in a total of 200 cases. Au wasfound to be present up to 4% inlepromatous leprosy, 2%/a in tuberculoidleprosy and lepra reaction, and 3% of antibodyin lepromatous leprosy. Presence of antibodydenotes past antigenemia. The quantitationof the antigen is done using the newtechnique of Electro-immuno-diffusion (EID)ou Laurell, synonymous with rockettechnique. The persistence of the antigen isexplained in the light of derangedimmunological mechanisms

Authors' abstract

SAOJI, A.; MENE, A.; SHARMA, K.D.Electrophoresis and immuno electropho-resis in leprosy. Lepr. India, 50 (2):161-165,1978.

50 cases of leprosy belonging to varioussubgroups i.e. 10 tuberculoid, 25 leproma-tousleprosy, 10 lepra reaction, 5 dimorphic leprosy,and 25 cases or normal individual weresubjected to agar gel electrophoresis. Theslides were scanned by densitometry. Itshowed profound departure from normal invarious fractions of electrophoreticpatterns. All of them showed rise of gammaglobulin. Albumin was markedly decreasedin lepromatous leprosy and lepra reaction. Indimorphic leprosy Alfa-1, was decreased.Qualitative immuno electropho-resis was doneby using antihuman serum raised in thelaboratory, by immunising rabbits. Itrevealed changes in IgM and IgC arcs. Resultsare discussed and tried to explain onimmunological derangement.

Authors' abstract

SASIAIN, M.C. Exploración de la inmuni-dad mediada por células en pacientescon lepra. Boi. Inf. Soc. Arg. Leprol.,1(4) :23, 1977.

SERJEANTSON, S. & WOODFIELD, D.G.Immune response of leprosy patients to

hepatitis B virus. Am. J. Epidemiol.,107(4) :321-327, 1978.

The immune responses of 323 Melane-sian leprosy patients and 290 controls tohepatitis virus type B were examined byanalyzing prevalence rates of hepatitis Bantigen (HBsAg) and its antibody (antiHBs)in an area of Papua New Guinea hy-perendemic for the virus. By use of multi-variate techniques, extraneous variablesknown to be correlated with both leprosyseverity and HBsAg prevalence, such as ins-titutionalization, age, sex and place of resi-dence, could be statistically controlled. Inmultivariate analysis of HBsAg rates, afterremoval of the variation due to age, whichwas the most important single factor con-tributing to HBsAg carrier-status, lepromatousleprosy was a significant determinant ofantigenemia. Similarly, when the series wasgrouped into three immune-responsecategories of HBsAg, anti-HBs or no serolo-gicevidence of exposure to the virus, diseaseseverity was a significant factor in determiningimmune response. For lepro-matous andborderline lepromatous patients, theprobability of responding antigeni-cally tothe virus, given that some measurableresponse has occurred (HBsAg/ (HBsAg+ anti-HBs) was 0.42. The correspondingprobability for tuberculoid patients was0.25 and for healthy controls, 0.29. Theseprobabilities indicate that lep-romatouspatients have an impaired im-muneresponse that not only predisposes them tothe most severe form of leprosy but mayalso decrease their efficiency in terminatingHBsAg infection with anti-HBs.

Authors' summary

SHER, R.; ANDERSON, R.; GLOVER, A.;WADEE, A.A. Polymorphonuclear cellfunction in the various polar types ofleprosy and erythema nodosum lepro-sum. Infect. Immun., 21(3) :959-965,1978.

Polymorphonuclear leukocyte motility,both vivo and in vitro, and reduction of Ni-tro Blue Tetrazolium was studied in tuber-culoid and lepromatous leprosy patients and agroup of lepromatous patients with erythemanodosum leprosum (ENL). A profound defectin random migration, chemo-taxis, andchemokinesis was found in lepro-matouspatients with and without compli-

Hansen. Int., 4(1):51-85, 1979

H

58 Hanseníase: resumos/Hanseniasís abstracts

eating ENL, and marked depletion of skinwindow migration confirmed these in vitrofindings. Tuberculoid patients exhibited amild defect in polymorphonuclear leukocy-te motility. Serum inhibitors of normal po-lymorphonuclear leukocyte chemotaxis werefound in all types of leprosy, but sera fromlepromatous and ENL patients were mostinhibitory. Resting levels of Nitro Blue Te-trazolium reduction were normal in allthree groups. Reconstitution of polymor-phonuclear leukocyte cells from normal andENL patients with ENL serum, however,showed increased Nitro Blue Tetrazoliumreduction well above the normal range,whereas reconstitution with normal, lepro-matous, and tuberculoid sera failed to in-crease Nitro Blue Tetrazolium reductionabove the normal values.

Authors' abstract

SHER, R.; MACKAY, M.E.; MACNAB, G.M.;KOK, S.H.; KOORNHOF, H.J. Hepati-tis B antigen, hepatitis B antibody, andsubtypes in leprosy. Infect. Immun.,17(l) :l-3, 1977.

The prevalence of hepatitis B antigen(HBsAg), hepatitis B antibody (HBsAb),and subtypes in 242 casevs of leprosy is re-ported. Patients were divided into threesubgroups, lepromatous (174), tuberculoid(55), and borderline (13). A total of 131patients were tested on admission; the re-maining 111 had been institutionalised fora period of 3 months or more when tested.Of the 131 cases tested on admission, 88were retested 6 to 12 months after admis-sion. There was no statistical difference inthe incidence of HBsAg and HBsAb amongthe three groups or between normal con-trols and the leprosy patients. The predo-minant subtype was ADW (84.1%). Afterinstitutionalization, one lepromatous caseconverted to HBsAg positive and four con-verted to HBsAb positive.

Authors' abstract

SKINSNES, O.K. Lepromin and the Arthusreaction Editorial. Int. J. Lepr., 45(4):373-376,1977.

STONER, G.L.; TOUW, J.; BELEHU, A.;NAAFS, B. In-vitro lymphoproliferativeresponse to Mycobacterium leprae ofHDL-D-identical siblings of lepromatousleprosy patients. Lancet, 2(8089): 543-:374.476,1977.

ansen. Int., 4( I ) :51-85, 1979

Lymphoproliferative responses to My-cobacterium leprae and P.P.D. were measur-ed in 23 lepromatous and borderlinelepromatous leprosy patients and in 27 oftheir normal siblings. At the same timesiblings HLA-D-identical with the patientswere identified by the absence of a mixed-lymphocyte reaction. The 7 siblings whowere HLA-identical to lepromatous patientsresponded as well to M. leprae as did the20 HLA-non-identical normal siblings. Incontrast, 22 of the 23 lepromatous patientsfailed to respond to M. leprae but respond-ed normally to P.P.D. The specific unre-sponsiveness of lepromatous patients thusdoes not result from an HLA-linked geneticdefect and the defective cell-mediated im-mune response to M. leprae seems to beacquired, not inherited. Lepromatouspatients may be high responders to antigenshared by M. leprae and other microorga-nisms in whom a strong antibody responsehas blocked the induction of an M. lepraespecififc cell-mediated immune response.

Authors' summary

TALWAR, G.P.; HANJAN, S.N.S.; ME-HRA, V . L. ; KIDWAI, Z. Lack of inter-action of circulating T cells with phy-tohemagglutinin in bacillary positiveuntreated lepromatous leprosy patients.Identification of subpopulation of lym-phocytes by shifts in electrophoreticmobility. J. Immunol., 118(1) :242-247,1977.

Incubation of human peripheral bloodlymphocytes from normal healthy subjectswith phytohemagglutinin (PHA), causes thereduction of the surface charge of a subpo-pulation of T cells by 1363 ± 242 e.s.u./cm2.The affected subpopulation was predominantly the high charge-bearing cells identifiablewith early (10 min) rosette-forming cellswith sheep erythrocytes. Purified lympho-cytes obtained from untreated bacillary-positive, lepromatous leprosy patients con-tained- high charge-bearing T lymphocytesubpopulation. However, incubation withPHA did not result in the shift of electro-phoretic mobility of these cells, suggestingthe absence of interacting sites for themitogen on the surface of these cells.The absence of mitogen-interacting sites isnot an inherent trait of leprosy patients;the surface charge of lymphocytes fromDapsone-treated bacillary-negative subjectswas reduced upon incubation with PHA.A close correlation was found between the

Hanseníase: resumos/Hanseniacis abstracts

number of cells whose charge alters onincubation with PHA and the transformationindex obtained with this mitogen.

Authors' abstract

TARABINI, C.G.; NUTI, M.; TARABINI,C.G.L. Lebbra e mycobatteri atipici: 2)Studio sulle lebbroreazione provocate dasensitine tubercolari tipiche ed ati-pichein casi di lebbra lepromatosa. ActaLeprol., (68) :35-44, 1977.

Groups of patients with lepromatous (57cases) and tuberculoid (24 cases) leprosyhave been skin-tested with a series of anti-gens from M. tuberculosis, M. scrofulace-um,M. xenopei, M. africanum, N. farcini-ca, N.otididis.

It was found that a reactional state witherythema nodosum leprosum occurred in 15lepromatous cases after skin testing; thesepatients, and other 23 lepromatous patientswho also have had a reactional state inthe previous course of the disease, haveshown after skin testing a more severereation with painful swellings, vesicles andbullae at injection sites and ulceration in 5cases; such severe skin reaction with ulcer-ation also occurred in 3 cases of tubercu-loid leprosy. The percentages of positivereaction in the group of the 19 lepromatouspatients who have never shown, before orafter skin testing, a reactional state were thelowest (with a mean size of 11,1 mm for

59

M. tuberculosis and 6,6 mm for M. africa-num) among each group tested with themycobacteria antigens:a) patients with tuberculoid leprosy (the

mean size was 19,8 mm for M. tuber-culosis; 11,5 mm for 1W. africanum);

b) patients with pulmonary tuberculosis(mean size 12,4 mm for M. tuberculosis;9,9 mm for M. africanum);

c) controls (mean size 13,8 mm for M. tu-berculosis; 14,0 mm for M. africanum).

Authors' summary

YAMADA, M. & FUJIMOTO, F. Lymphocytetransformation using Mitsuda antigen(lepromin). J. Dermatol , 2 :175-178,1975.

A lymphocyte transformation test wasperformed adding Mitsuda antigen (lepro-min) to the lymphocyte culture from theperipheral blood of 4 leprosy patients 9borderline lepromatous and 2 lepromatousones) and 6 control persons (1 Kimura dis-easepatient, 1 kerion celsi patient, 2 latent syphilispatients and 2 normal controls-doc-tors). All 4leprosy patients showed negative results, while1 to 3% blast cells were observed in 5 of thecontrol cases; the one case with Kimuradisease showed a negative result. Only 12 to21% blast cells stimulated by PHA wereobserved in the lepromatous patients.

Authors' abstract

PATOLOGIA, FISIOPATOLOGIA, BIOQUÍMICAPATHOLOGY, PHYSIOPATHOLOGY, BIOCHEMISTRY

ANDERS, R.F.; PRICE, M.A.; WILKEY,I.S. ; HUSBY, G.; TAKITAKI, F.; NAT-VIGS, J.B.; McADAM, K.P.W.J. Amy-loid fibril protein AA in Papua NewGuinean amyloidosis. Clin. Exp. Im-munol., 24: 49-53, 1976.

BERGEL, M. Nutrition and leprosy. Cor-respondence. Int. J. Lepr., 45(4) :380,1977.

BHARADWAJ, V.P.; VENKATESAN, K.;RAMU, G.; DESIKAN, K.V. Serumiron and total iron binding capacity inleprosy patients. Lepr. India, 50(1): 11-17,1978.

Serum Iron and Total Iron Binding ca-pacity were estimated on the sera collected

from 45 leprosy patients attending the out-patient department of the Central JALMAInstitute for Leprosy, Agra. The sera from15 healthy subjects were included in thestudy as controls. Hypoferraemia wasobserved in lepromatous leprosy and wasparticularly marked during the reactivephase. Further investigations to elucidatethe pathogenesis of anaemia in leprosy arebeing planned.

Authors' abstract

BODDINGIUS, J. Ultrastructural changesin blood vessels of peripheral nerves inleprosy neuropathy. Acta Neuropathol.,35 :159-181,1976.

Hansen. Int., 4(1):51-85, 1979

60 Hanseníase: resumos/Hanseniasis abstracts

Radial or superficial peroneal nervebiopsies of 6 patients with tuberculoid orborderline-tuberculoid leprosy and 6 controlnerve biopsies were examined by electronmicroscopy. Endoneurial blood vesselsshowed histopathology in all the leprosypatients. Changes, in particular, involvedthe basement membrane in postcapillaryvenules and venules. Multilayered parallelbasement membranes, with collagen andground substance, formed a thick coat("hyaline zone") around the vessels. It issuggested that the zone inhibits passage ofnutrients and metabolites and, thus, contributesto or is the main cause of the local destructionof (unmyelinated) nerve fibres and the lackof nerve fibre regeneration observed in thistype of leprosy. The peri-vascular zone,presumably, is produced by pericytes inresponse to defects in the "blood-nervebarrier" of endoneurial vessels. Ingranulomataof leprosy skin lesions, a perivascular zonewas not present.

The endothelium of endoneurial vessels, inaffected nerves, generally was normal.Occasionally, however, gaps and fenes-trations were seen and there were histolo-gical indications that leakage of bloodplasma had occurred through the gaps andthrough the basement membrane of theendothelium.

Occlusion of endoneurial vessels wasfound only in the oldest patient and thedegeneration of nerve fibres generally observedthus is considered not to be caused byischaemia. Histopathology in epi and per-ineurial vessels was definitely less pro-nounced than in endoneurial vessels.

Author's summary

BONNAUD, E.; RIVEL, J.; VITAL, C.;BRECHENMACHER, C.; HEDREVIL-LE, M.A.; KHATIB, M. Etudes du nerfpériphérique en microscopie électroni-que. Bord. Med., 11(20) :1757-1762, 1978.

The electron microscope allows the ana-lysis of elementary lesions of the peripheralnerve: segmentary demyelinization, waller-ian degeneration and bulb type image,non-specific images already observed in se-rial histologic sections. Specific images dur-ing peripheral neurologic disease are seldomobserved, but when present give pre-cisions as to the etiology: during a predo-minating interstitial disease; during polyra-diculonevritis: acute Guillain-Barré syndromes,relapsing and symptomatic polyradi-culonevritis; during familial and heriditary

Hansen. Int., 4(1):51-85, 1979

diseases; during toxic and metabolic dis-eases.

Authors' summary

CAMPOS, M.P. Sinovite hansênica. Mogi dasCruzes, 1977. 62p. /Tese — Faculda-de deMedicina da Universidade de Mogi dasCruzes/

Estudando trinta pacientes portadoresde hanseníase, escolhidos ao acaso e divi-didos em dois grupos de quine cada um,sendo um grupo constituído de pacientesem pleno surto reacional de eritema nodosoou de eritema polimorfo, e outro constituídode quinze pacientes sem reação especifica,após biopsia da membrana sinovial do joelho, oexame histológico permite concluir que existeum processo inflamatório de caráterespecifico. Optamos pela designação desinovite hansênica, uma, vez que indica aespecificidade e obedece às normas atuais danomenclatura.

Conclusões do autor

FLIESS, E.L. Inmunogenética y lepra. Boi.Inf. Soc. Argent. Leprol., 2(5) :32,1978.

FURUTA, M.; OZAKI, M.; HARADA, N.;MATSUMOTO, S.; NAGAO, E.; SUGI-YAMA, K.; OGASAWARA, T.; MAT-SUMOTO, Y. Frequency of cerebrovas-cular lesions in leprosaria. Jap. J. Lep-rosy, 47 (2): 61, 1978.

One hundred and twenty seven patientsdied in Komyo-en Leprosarium between1962, January, and 1971, June. Autopsy wasdone on 110 cases. The average age was62.5 years old. Malignant neoplasms (33cases) were more frequent than cerebro-vascular diseases (hemorrhage: 9 cases, soft-ening: 3, microscopic hemorrhage: 11).The major direct cause of death was bron-chopneumonia. Investigation of the deathcertificates in Seisho-en Leprosarium for theyears 1967-1976 also revealed that cere-brovascular diseases were not the majorcause of death. These results are differentfrom informations of the cause of death inJapan published by the Ministry of Healthand Welfare. This discrepancy probablycomes from inaccurate description of thedeath certificates and low autopsy rate inthis country.

From authors' abstract

GUPTA, J.C.; PANDA, P.K.; SHRIVASTA-VA, K.K.; SINGH, S.; GUPTA, D.K.A histopathological study of lymphno-

Hanseníase: resumos/Hanseniasis abstracts 61

des in 43 cases of leprosy. Lepr. India,50(2) :196-203, 1978.

Eighty cases of leprosy including 60cases of lepromatous type and 20 cases oftuberculoid type, during the period of 197475,have been examined for evidence oflymphnode enlargement. Of the 52 cases ofenlarged lymphnodes, lymphnode biopsy wasdone in 43 cases including 38 cases oflepromatous type and 5 cases of tuberculoidtype. The lymphnodes have been studiedfor evidence of any pathological changesand presence of acid-fast bacilli. In cases oflepromatous leprosy, lepromas and acid- fastbacilli were seen in 92.2 per cent of thecases and patchy fibrosis was noted in 23.6per cent of the cases. No amyloid could bedemonstrated. In cases of tuber-culoidleprosy, only non-specific reticularhyperplasia was noted. No specific granulomaor acid-fast bacilli could be demonstrated.The findings have been described in detailand discussed in the light of pre-viouspublished data.

Authors' abstract

HITZEROTH, H.W.; WALTER, HIL- L, M.Genetic markers and leprosy in SouthAfrican negroes: Part I. Serum proteinpolymorphisms. S. Afr. Med. J.; 54(16):653-658, 1978.

The phenotype frequencies of the serumprotein polymorphisms Hp. Gc, Tf, Gm andInv were determined on a sample of 2500South African Negroes with leprosy. Theseresults were compared with data derivedfrom 918-977 (depending on the polymor-phism tested) healthy Negro controls ofsimilar geographical and ethnic origin, inorder to determine whether or not anyassociation existed between specific pheno-types and the occurrence of leprosy. Thedata derived from the present study werealso compared with those of similar com-parative analyses on African and non-Africanpopulations. Because of the contradictoryresults between samples with regard to thepolymorphisms Hp, Ge and Inv, an asso-ciation of any of these phenotypes withleprosy appears to be highly improbable.With regard to the polymorphisms Tf andGm, however, such associations cannot beruled out. The questions arising from theresults are discussed.

Authors' summary

KARAT, A.B.A. & RAO, P.S.S. Haemato-logical profile in leprosy: Part II — Re-lationship to severity of disease andtreatment status. Lepr. India, 50(1):18-25,1978.

321 adult male lepromatous leprosy pa-tients were studied for relationship betweenhaematological findings, severity of diseaseand duration of treatment. Significant changeswere noticed in relation to haemoglo-binconcentration, serum vitamin B12 and serumfolate levels, serum albumin and glo-bulin. Nosignificant changes were observed in serumiron levels in relation to dis-ease andtreatment status. With rising bac-terial load,there was a trend towards lowerhaemoglobin concentration, higher vi-taminB12 level and lowered serum folate levels.Serum albumin showed a significant decline,while serum globulin showed a sig-nificantrise. The findings are discussed in relationto replacement of bone marrow bylepromatous tissue as well as possibleinterference in the metabolism of haema-tinics by M. leprae. The exact mechanism ofneurological deficit in leprosy in relation todeficiency of vitamin B12 and folic acid needto be further elucidated.

Authors' abstract

KONDO, E. & KANAI, K. A suggested role ofhost-parasite lipid complex in myco-bacterial infection. Jap. J. Med. Sci.Biol., 29(4) :199-210, 1976.

KORANNE, R.V.; SINGH, R.; IYENGAR, B.Bone-marrow in tuberculoid leprosy. Lepr.India, 50(2) :181-184, 1978.

Twenty-four untreated patients of provedtuberculoid leprosy and five healthy con-trolswere investigated for the involvement ofbone-marrow. The cytology was essentiallynormal and non acid-fast bacilli was seen inthe bone-marrow smears.

MALIK, S.K.; KHER, V.; KUMAR, B.;KAUR, S. Impaired cough-receptor func-tion in leprosy. Letter to the Editor.Lancet,1(8073) :1094-1095, 1978.

We infer that the cough response isimpaired in leprosy patients because of in-volvement of the afferent vagal fibressupplying the irritant receptors. The invol-vement must be diffuse throughout the res-piratory tract because ultrasonically nebu-lisedaerosols do reach the peripheral parts of thelung. We are now investigating other vagalnerve functions in this disease.

From the letter

Hansen. Int., 4(1) :51-85, 1979

6

M

ptvva

N

aapvntts

N

crvghllmGoledlaepsiacssel"cca

2 Hanseníase: resumos/Hanseníasís abstracts

OLERES, R. Bone absorption in HD.Star, 37(2) :3, 1977.

Infection with M. leprae affecting theeriosteum, cortex and medulla of boneissue, as well as involvement of joint syno-ium and articular cartilage are the source ofarious patterns of development of bonebsorption in HD.

Author's summaryAAFS, B. & DAGNE, T. Sensory testing: a

sensitive method in the follow-up ofnerve involvement. Int. J. Lepr., 45 (4):364.368, 1977.

Sensory testing (ST) as a parameter inssessing nerve damage and as a guide inntireaction treatment is discussed in com-arison with established methods likeoluntary muscle testing (VMT) and motorerve conduction velocity (MCV) . Sensoryesting is shown to be a valuable addition tohe existing tests and may even be used as aingle parameter. Authors' summary

IGAM, P.; DAYAL, S.G.; GOYAL, B.M.;NIMKHEDAKAR, K. V . ; JOSHI, L.D.;SAMUEL, K.C. Leprous hepatitis: clinico-pathological study and therapeutic efficacyof Liv 52. Lepr. India, 50(2): 185-195,1978.

Fifty cases of leprosy were studied forlinico-biochemical and histological featu-es pertaining to hepato-biliary system in-olvement. Therapeutic efficacy of an indi-enous drug Liv 52 was also studied for itsepatic restorative and protective effects in

eprous hepatitis. Specific granulomatousesions suggestive of leprous hepatitis was

ainly seen in lepromatous leprosy (40%).ranulomata in liver were seen in all typesf leprosy (70%). Some of the hepaticesions progressed to stellate fibrosis andarly cirrhotic changes (40%). Functionalerangement was the main feature in

epromatous cases irrespective of the extentnd duration of the disease. Uniformlevation of normal level of total serumroteins was mainly due to increase inerum globulin with reversal of A:G ratio,ndicating deranged hepatocyte functionnd hyperplasia of reticulo-endothelialells. Hyperbilirubinoemia (highest level oferum bilirubin = 5.6 mg%) was chieflyeen in lepromatous leprosy. A study tovaluate the effi-cacy of treatment ofeprous hepatitis with an indigenous drugLiv 52" was also undertaken in these 50ases — 20 cases served as control and 30ases received Liv. 52 along with thentileprosy drug. The clini-

Hansen. Int., 4(1):51-85, 1979

cal and biochemical with histopathologicalresponse was significant in Group A (Liv 52treated cases) as it cut short the duration,course and severity of the disease and showedremarkable improvement towards normalvalues without any untoward side- effects. Wefeel that Liv 52 richly deserves to be used asa routine treatment specially in all cases oflepromatous leprosy, as inci-dence of hepato-biliary system involvement is much more inour county.

Authors' abstract

NIGAN, P.; MUKHIJA, R.D.; GOYAL, B.M.; JOSHI, L.D.; SAMUEL, K.C. Studyof histo-functional complex of liver inleprosy. Ind. J. Dem. Venereol.Leprol., 42(5) :217-222, 1977.

Seventy six cases of diferente types ofleprosy, with varying duration of illness,were studied for their changes in liver func-tionand hepatic lesions. Specific granulo-matouslesion suggestive of lepromatous hepatitiswere mainly seen in lepromatous leprosy (17cases out of 28 cases of leprosy).Granulomata in liver were present in alltypes of leprosy. Some of them had progressedto stellate fibrosis (7 cases) and earlycirrhotic changes (6 cases) Non-specificchanges were seen in 22 cases, of which 6 (3lepromatous) showed stellate fibrosis withattempt to incomplete lobule formation.Amyloid deposits were not seen in any ofthese cases. Functional derangement has beennoted mainly in lepromatous patientsirrespective of the extent and duration of thedisease. There was a uniform elevation oftotal serum proteins (6.4 9.2 gms%)mainly due to increase in serum globulin(2.2-4.0 gms%). Serum albumin was lowerthan normal (2.6-5.2 gms%). Thymol turbidityshowed abnormal results (3-9 units) andserum cholesterol (102-206 mg%) levels werelow. Other biochemical estimations werenormal.

Authors' summary

RATNAKAR, K.S. & MOHAN, M. Amyloi-dosis of the iris. Can. .1. Opthal., 11:256-257,1976.

REA, T.H. & TAYLOR, C.R. Serum andtissue lysozyme in leprosy. Infect. Im-mun., 18(3) :847-856, 1977.

Mean serum lysozyme values were found tobe elevated in untreated leprosy patients.Statistically significant elevations were

Hanseníase: resumos/Hanseníasis abstracts 63

present in each of the three major categories ofleprosy, tuberculoid, borderline, and le-promatous. Values were particularly high inpatients with severe reversal reactions orLucio's phenomenon. Prolonged sulfonetherapy was associated with a fall in serumlysozime values. With an immunoperoxidasemethod to localize lysozyme in leprous tissues,two distinct staining patterns were found,granular and saccular. The granular pattern oflysozymal staining was found in epithelioidcells and in giant cells, and the intensity ofstaining showed a positive correlation withserum lysozyme levels. Conversely, asaccular pattern of lysouymal staining wasfound in lepromatous histiocy-tes, but theintensity staining was unrelated to serumlysozyme levels, the saccular struc-turescontained dense aggregates of Myco-bacterium legrae. These two patterns ofstaining probably represent different func-tional responses of monocyte-derived gra-nuloma cells, whereas the serum levels re-flect, to a varying degree, both the absolutenumber of such cells and the rate of secre-tory activity of this cell population as awhole.

Authors' abstract

ROSTANT, M. Dégénérescence épithélioma-teuse des places, ulcères et maux perfo-rants plantaires chez les lépreux. Acta.(73) :29-38, 1978.

Sans vouloir entrer dans des considé-rations étio-pathogéniques, il est bon derappeler que les troubles trophiques du lé-preux sont dûs à une ischiémie consecutive àdes facteurs vasculo-nerveux, favorisés pardes phénomènes traumatiques ou infec- tieux.Mais nous savons qu'il existe aussi, chez lelépreux, un déficit immunitacre, no- tammentdes cellules thymo-dépendantes, déficit qu'onretrouve d'aclleurs en cancéro- logie. Dés lors,on peut se demander si le lépreux, dépourvudu facteur de Rotberg, c'est-à-dire de moyensde défense naturelle, n'offrirait pas unterrain favorable aux transformationsépithéliomateuses. En effet, jusqu'ici, nousréservions le traite- ment par lesimmunostimulants auxseuls malades lépreuxprésentant des états de resistance à lathérapeutique spécifique anti- Hansénienne.Ainsi, les cas que nous publions, n'avaientjamais reçu de medication immuno-stimulante.

Commentaires de l'auteur

Six cases of epitheliomatous degenera-tion, among which five spino-cellulars and

one baso-cellular, happened among leprosypatients showing sores, ulcerations andplanter ulcers, are quoted in this study.Here, the authors underline the favorablepart of the defects of cellular immunity for thleprous pathogenesis, and the need of usinghistological exams systematically whennoticing any continued delay of cicatrisation.An immuno-stimulating medication should beused for any leprosy patient showing obstinatetrophical troubles.

Author's summary

SEBILLE, A. Respective importance of dif-ferent nerve conduction velocities inleprosy. J. Neurol. Sci., 38: 89-95, 1978.

Motor and sensory nerve conductionstudies were performed in the distal part ofthe ulnar, median and radial nerves of 12tuberculoid and 12 lepromatous leprosypatients, compared with 15 normal subjects.Slowing of sensory conduction velocity(SCV) was shown in all nerves with nodifference between tuberculoid and lepro-matous patients. The radial SCV slowing iscorrelated (P < 0.001) with the clinicalfindings. Impairment of motor distallatencies was observed only in tuberculoid pa-tients. It is concluded that the radial SCV isthe most reliable conduction test and isproposed as an early diagnostic test forleprosy.

Authors' summary

SHARMA, S.; SARIN, R.C.; PARKASH, S.Secondary amyloidosis in leprosy (acase report). Indian J. Dermatol. Ve-nereol. Lepr., 44(1) :31-33, 1978.

A case of amyloidosis secondary to le-promatous leprosy has been discussed. Hehad proteinuria, Congo red retention 64 percent (first hour), hyperglobulinaemia, andrenal biopsy revealed amyloid deposits.Factors responsible for amyloidosis arehighlighted.

Authors' summary

SINHA, S.N.; GUPTA, S.C.; BISHT, D.Serum calcium and magnesium in dif-

ferent types of leprosy. Lepr. India, 50(1) :54.56, 1978.

Serum calcium and magnesium werestudied in 200 leprosy patients and 25 ap-parently healthy individuals. Serum calciumwas found to be significantly decreased in alltypes of leprosy except tuberculoid. The

Hansen. Int., 4(1):51-85, 1979

6

dsb

V

wodAt

wlpcpi

A

fnctmsbmpbsImcT

H

4

ecrease in serum magnesium was highlyignificant in tuberculoid, lepromatous andorderline lepromatous cases.

Authors' abstract

ARMA, K.C.; ,KUMAR, R.; BHARGAVAN.C. Histopathological study of liver inleprosy. Indian J. Dermat. Venereol.Leprol., 44(2) :108-109, 1978.

Fifty patients with lepromatous leprosyere studied. Involvement of liver wasbserved in 90 per cent of the cases. Fattyegeneration was seen in two cases only.myloid deposit was not seen in any ofhem.

Authors' summary

VENKATESAN, K. & BHARADWAJ, V.P.Sequential biochemical investigations inlepromatous leprosy. Lepr. India, 50(2):

166-172,1978.

Sequential biochemical investigationsere conducted in cases of lepromatous

eprosy in the reactive as well as subsidedhases. Low levels of blood sugar and serumholesterol were indicated in the reactivehase of lepromatous leprosy. Significantncrease in thymol turbidity and de-

Hanseníase: resumos/Hanseniasis abstracts

crease in A/G ratio were noted in most ofthe cases of lepromatous leprosy. En-hancement of serum levels of transaminaseswas observed in the reactive phase of le-promatous leprosy. Serum protein electro-phoresis indicated increases in a globulinand r-globulin and decrease in albumin inthe reactive as well as subsided phases.The results are discussed in this paper.

Authors' abstract

WESTERHOF, W. A possible dysfunction ofmelanosome transfer in leprosy: anelectron-microscopic study. Acta Der-mato-Venereol., 58(4) :297-304, 1977.

An E.M. study was carried out to in-vestigate whether Mycobacterium lepraeoccur intracellularly in epidermal melano-cytes. As this could not be confirmed, theselective killing of melanocytes by cytotoxiclymphocytes could not explain the hypo-pigmentation in types of 1 eprosy with arelative good immune response. There wereindications that these hypopigmentedlesions resulted from a disturbed transfer ofmelanosomes from melanocytes to ke-ratinocytes. Further research is in progress

Author's abstract

HANSENIASE EXPERIMENTAL, LEPRA ANIMALEXPERIMENTAL HANSENIASIS, ANIMAL LEPROSY

LEXANDER, J. & SMITH, C.C. Growth ofMycobacterium lepraemurium innonstimulated and stimulated mouseperitoneal-derived and bone marrow-derived macrophages in vitro. Infect.Immun., 22(3) :631-636, 1978.

Mycobacterium lepraemurium cells wereound to multiply in normal mouse perito-.eal-derived and bone marrow-derived ma-rophages in vitro. Whereas activated peri-oneal-derived macrophages demonstratedarked bacteriostasis for M. lepraemurium,

ignificant bactericidal activity was exhibitedy activated bone marrow-derivedacrophages. However, only a small pro-

ortion of the bacteria were killed by activatedone marrow-derived macrophages withubsequent and enhanced bacterial growth.t is suggested that a rapid turnover ofonocytes in active lesions is required to

ontrol mycobacterial infections in vivo.hese results would suggest that

ansen. Int., 4(1):51-85, 1979

careful consideration be given to the choice ofthe host cell in studies involving obligateintracellular parasites.

Authors' abstract

BAPAT, C.V. & MODAK, M.S. Growth of theICRC bacilli in the foot-pad of mice. Lepr.India, 50(2) :144-155, 1978.

The ICRC bacilli are acid-fast bacillicultivated from M. leprae isolates of lepro-matous tissue. The ICRC bacilli from C-44 inthe conditioned medium were subjected tofoot-pad test, in both normal andT/900r mice. The bacilli exhibit a limitedmultiplication in normal mice while a con-tinuous growth in T/900r mice. The maxi-mum yield for normal and T/900r mice,was 107 and 109 foot-pad, respectively. Theinfiltration of voluntary muscle tissue asthe main localization site was common forboth normal and T/900r mice with evidence

Hanseníase: resumos/Hanseníasis abstracts 65

of dissemination in the latter. The spreadof APB to sciatic nerve, induction of livergranuloma and the foot-drop was observedonly in T/900r mice. These experimentsshown that the growth of ICRC bacilli inmouse foot-pad is very similar to that ofM. leprae confirming a test for identifi-cation.

Author's abstract

BEDI, B.M.S. Is there leprosy-like diseasein wild armadillos? Editorial. IndianJ. Dermatol. Venereol. Lepr., 44(1):1-2, 1978.

DELVILLE, J.; PICHEL, A.M.; BOUC-KAERT, A. Influence de la penicillinsur l'infection experimentale à Myco-bacterium leprae chez la Souris. Ann.Soc. Beige. Med. Trop., 58(2) :125-131,1978.

After a brief survey of the litteratureon the use of penicillin as a therapeuticagent in leprosy, the influence of this drugon the experimental. M. leprae infection ofmice is investigated. Statistically significantreduction of M. leprae is observed in peni-cillin treated mice. The infection developsnormally again after stopping of treatment.This is in accordance with a bacteriostaticeffect of penicillin.

Authors' summary

DHARMENDRA. The question of leprosyin wild armadillos. Editorial. Lepr.India, 50(2) :126-130, 1978.

So far we have all been believing andsaying that a patient of leprosy is the onlysource of infection and that there is noanimal reservoir. However, the present dis-cussion going on in lay press on the pre-sence of leprosy or leprosy-like disease inferal armadillos is likely to shake the beliefof an increasing number of the public. Thematter, therefore, urgently needs an inde-pendent investigation. Moreover, the doubtmay not remain confined to armadillos,but may be extended to some other rodentswhich may be found harbouring some acid-fast bacilli. Such a view if not confirmedby experimental work is likely to cause analarm in the public about the possibilityof transmission of leprosy from armadillosto the human beings, although this looksimprobable. However, public alarm andscare is not always based on proved scien-tific facts. The flesh of armadillo is popu

larly eaten and relished in the Americas;but it is understood that some alarm hasalready been caused and people are nowgetting scared of eating armadillo fleshThe undersigned, therefore, repeats his pleathat the matter should be taken up for in-dependent investigation at a high level byexperienced workers so far unconnectedwith the work on the subject, and that allaspects of the matter should be investigatedincluding the possible sources of infectionin the armadillos in which leprosy or lepro-sy-like disease has been reported in feralarmadillos.

From the editorial

GOIHMAN-YAHR, M.; CONVIT, J.; RO-DRIGUEZ-OCHOA, G. ARANZAZU, N.;VILLALBA-PIMENTEL, L.; OCANTO,A.; GÓMEZ, M.E. Significance of neu-trophil activation in reactional leproma-tous leprosy: effects of thalidomide invivo and in vitro. Activation in adju-vant disease. Int.-Arch. Allerg. Appi.Immunol., 57 :317-332, 1978.

HOBBS, H.E.; HARMAN, D.J. ;REES, R.J.W.; McDOUGALL, A.C.Ocular his-topathology in animalsexperimentally infected withMycobacterium leprae and M.lepraemurium. 1. Mycobacteriumleprae and M lepraemurium infectionsin the mouse. 2. Mycobacterium lepraeinfections in the 9-banded armadillo(Dasypus novemcinctus I.) Brit. J.Ophthalmoi., 62(8) :516-524, 1978.

At varying periods of time following thesuccessful establishment of systemic infec-tions with Mycobacterium leprae or M. le-praemurium in the mouse and the nine-banded armadillo eyes were examined bylight microscopy. Inoculation of bacilli wasby the intravenous or intraperitoneal routeor directly into the hind footpads; eyeswere no directly inoculated in this study.During periods of up to 3 years under la-boratory conditions no animal showedevidence of impaired vision or blindness,and the external appearance of both eyeswas normal. The ocular histopathology andthe sites of accumulation of bacilli are des-cribed. In immunologically normal miceinfected with M. lepraemurium bacilli weremuch commoner in extraorbital tissues, butthey were, nevertheless, found in varioustissues within the orbit, including the ciliarybody and sclera. In immunologically normalmice (and one rat) injected with M. leprae

Hansen. Int., 4(1):51-85, 1979

6

6 Hanseníase: resumos/Hanseniasis abstracts

of human origin no bacilli were found inthe eye, but in mice immunologically de-.pressed by thymectomy and total bodyirradiation considerable numbers of bacilliwere present in the iris and ciliary bodyand also in the timbal cornea. In the armadillobacilli were found in large numbers invirtually all tissues except the lens, retina,optict nerve, and aqueous and vitreoushumours, but the uveal tract was heavilyinvolved. Findings are discussed in relation tothe great frequency of ocular involvementand the importance of immune-complexdisease in patients with lepromatous leprosy,and to factors which may favour thelocalisation and multiplication of My-cobacterium leprae in the eye.

Authors' summary

KAWAGUCHI, Y.; MATSUOKA, M.; KAWA-TSU, K. Pathogenicity of cultivatedmurine leprosy bacilli of Hawaii-Ogawastrain in mice. Japan. J. Exp. Med.,48(1) :17-26, 1978.

KAWAGUCHI, Y.; MATSUOKA, M.; KAWA-TSU, K. Pathogenicity of cultivatedmurine leprosy bacilli in mice. 2. Thepathogenicity of bacilli from smoothcolonies. Japan J. Exp. Med., 48(3):211-217,1978.

KIRCHHEIMER, W.F. Experimental trans-mission of HD world-wide. Star, 37(3): 3,1978.

KIRCHHEIMER, W.F. & SANCHEZ, R.M.Examination of North American arma-dillos for mycobacteriosis. Lepr. India,50(2):156-160,1978.

1. Between 1 January 1974 and 31 De-cember 1977, Carville has found no leprosy-like mycobacteriosis in 373 armadillos.Two hundred eighty-two of these armadilloswere caught in Louisiana, 78 in Florida and 13in Texas. 2. Seventy-five of the Louisianaarmadillos were caught by personnel fromthe Lousiana Wildlife and Fisheries Com-mission in the area where Walsh et al saidthey found 10 per cent "naturally" infectedarmadillos. 3. Two hundred and seven ofCarville's armadillos came from the mosthuman-leprosy prevalent part of Louisiana. 4.Alleged claim of man to armadillo trans-mission of leprosy as an explanation forexistence of leprous armadillos in naturealso is at odds with South American findingsand conditions 5. Independent verifi-

Hansen. Int., 4(1):51-85, 1979

cation of the claim of Walsh et al is calledfor and if confirmed investigation of thevarious possible ways such a situation mighthave arisen.

Authors' summary

KNIGHT, V. Leprosy-like disease in nine-banded armadillos. Star, 37(3) :10, 14,1978.

MATSUO, Y.; UTSUNOMIYA, S.; KAJIHARA,N.; KIM, S.K. Combinations of rifampicinand isoprodian in the treatment ofMycobacterium leprae infections inmice. Jap. J. Leprosy, 47(1): 43-47,1978.

Combinations of rifampicin and isoprodianwere tested against Mycobacterium leprae inmice. Drugs were given by gavage once tinily,6 times per week, starting from the day ofinfection to day 21 after infection in the firstexperiment, and from day 51 to day 80 afterinfection in the second experiment. Althougha few combinations had some increases of thegrowth delay over single drugs, it is notlikely that appreciably additive effect of theboth drugs has been noticed in the treatmentof M. leprae infections in mice.

Authors' abstract

MINAGAWA, F.; YOSHINO, Y.; ABE, M.Early immune responses in nude mousefollowing intravenous injection of My-cobacterium. leprae. Jap. J. Leprosy,47(1): 37-42, 1978.

OGAWA, T. Observations on a case of sup-posed contamination with another acid-fast bacillus. I. The isolation culture ofcontaminated acid-fast bacillus and invitro examination of isolates. Jap. J.Leprosy, 47(1): 37-42, 1978.

OGAWA, T. Observation on a case of sup-posed contamination with another acidfast bacillus. II. In vivo examination ofisolates (Bacillus n.' 4). Jap. J. Lepr.,47(2), 1978.

PATEL, P.J.; & LEFFORD, M.J. Induction ofcell-mediated immunity to Mycobac-terium leprae in mice. Infect. Immun.,19(1) :87-93, 1978.

The immune response of mice to arma-dillo-derived, irradiation-killed Mycobacte-rium leprae (I-ML) was investigated. Follow-

Hanseníase: resumos/Hanseniasis abstracts 67

ing injection of 100 µg of I-ML into theleft hind footpads of mice, a state of cell-mediated immunity (CMI) was engenderedto antigens of M. leprae. The evidence forCMI was as follows: (i) development ofdelayed-type hypersensitivity to both humantuberculin purified protein derivativeand soluble M. leprae antigens; (ii) T-lym-phocyte-dependent macrophage activationat the inoculation site; (ill) specific sys-temic resistance to the cross-reactive speciesM. tuberculosis; and (iv) immunopotentia-lion of the delayed-type hypersensitivityresponse to an unrelated antigen. The CMIinduced by I-ML in aqueous suspension wasgreater than that obtained with the sameantigen in water-in-oil emulsion, eventhough the latter generated a more severereaction at the site of immunization. I-MLalso induced a stronger CMI response thanthe corresponding dose of heat-killed BCG.

Authors' abstract

PATEL, P.J. & LEFFORD, M.J. Specificand nonspecific resistance in mice im-munized with irradiated Mycobacteriumleprae. Infect. Immun., 20(3): 692-697,1978.

Following subcutaneous inoculation ofirradiated Mycobacterium leprae (I-ML)into the left hind footpad of mice, there wasincreased resistance to Listeria monocyto-genes, indicative of macrophage activation,at the immunization site. In spite of thehigh level of localized macrophage activa-tion which was proportioned to the immu-nizing dose of I-ML, no such activity couldbe demonstrated systemically in these mice,as evidenced by the absence of increasedresistance to an intravenous challenge withL. monocytogenes. Under these conditions,I-ML-immunized mice were nonetheless re-sistant to intravenous infection with eitherM. tuberculosis or M. bovis BCG, and thisimmunity was transferred to normal reci-pients using spleen or lymph node cells.Neonatal thymectomy completely abolishedthe development of antimycobacterial im-munity after vaccination with I-ML, butimmunity was restored by an intraperitonealinfusion of syngeneic thymocytes. Systemicnonspecific resistance could be generatedin I-HL-immunized mice by an intravenousinjection of disrupted I-ML. This study re-veals that, after subcutaneous vaccinationwith I-ML, there is local accumulation ofactivated macrophages at the inoculationsite and a widespread distribution of lym-phocytes which are sensitized to mycobac-

terial antigens. Nonspecific resistance ismediated by the former cells and specificantimycobacterial immunity by the latter.

Authors' abstract

POULTER, L. W. & LEFFORD, M.J. Rela-tionship between delayed-type hypersen-sitivity and the progression of Myco-bacterium lepraemurium infection, In-fec. Immun., 20(2) :530-540, 1978.

The relationship between the level ofdelayed-type hypersensitivity (DTH) and theprogression of Mycobacterium lepraemuriuminfection was examined after inoculation ofmice with 108 M. lepraemurium in the lefthind footpad. The expression of DTH de-veloped over the first 4 weeks of infection,remained high up to week 8, and then drop-ped to a low level at which it remained for12 more weeks. The development of DTHwas concordant with an initial swelling ofthe inoculated foot, the appearance of amononuclear infiltrate at this site, and aprevention of any increase in the numberof mycobacteria in this foot and in othertissues studied. A decay of DTH reactivitywas associated with a progressive increasein the number of M. lepraemurium initiallyat the original site of inoculation and sub-sequently in all other tissues. Although theexpression of DTH was lost, adoptive im-munization experiments showed that a po-pulation of sensitized lymphocytes persistedwithin the host. Further experimentationoffered evidence to suggest that the level ofsystemic antigen may be in part responsiblefor the loss of DTH reactivity.

Authors' abstract

PRABHAKARAN, K.; HARRIS, E.B.; KIR-CHHEIMER, W.K. Survival of Myco-bacterium leprae in tissues kept frozenat 80°C. Microbios Lett., 1(3-4): 193-195,1976.

Intact organs obtained from armadil-los experimentally infected with Mycobac-terium leprae were kept frozen at-80°C.After approximately ten months of storage,suspensions of M. leprae were preparedfrom these tissues. When inoculated intofoot pads of mice, the organisms showedmultiplication characteristic of the leprosybacilli. The results demonstrate that a pro-portion of M. leprae occurring in infectedorgans are able to survive prolonged expo-sure to ultracold temperatures.

Authors' abstract

Hansen. Int., 4(1) :51-85, 1979

6

S

S

S

spihccocie1cwtdvslvoTho

A

A

A

A

H

8

ANCHEZ, R.M. & KIRCHHEIMER, W.F.Examination of North American arma-dillos for mycobacteriosis. Star, 37(3):10, 14, 1978.

ASIAIN, M.C. Estudios inmunológicos enarmadillos. Bol. Inf. Soc. Argent. Le-prol., 2(5) :31-32, 1978.

HEPARD, C.C.; WALKER, L.L.; VANLANDINGHAM, R.M. Immunity toMycobacterium leprae infections inducedin mice by BCG vaccination at differenttimes before or after challenge. Infect.Immun., 19(2) :391-394, 1978.

Viable suspensions of BCG, an attenuatedtain of Mycobacterium bovis, have beenreviously shown to immunize mice against

nfections with M. leprae. Usually, the miceave been vaccinated about 1 month beforehallenge. Experiments have now beenarried out with single intradermal injectionsf BCG given before or after the M. lepraehallenge. Approximately equalmmunizing effect was seen in onexperiment when the BCG was given at —68, —119, —70, and —28 days relative tohallenge. Approximately equal protectionas observed in another experiment when

he vaccine was given at —28, +28, and +56ays. In the latter experiment, however,accine given at +91 days appeared to beomewhat less effective. Enlargement of theymph nodes regional to the intradermalaccine site persisted for at least the durationf the experiment, approximately 400 days.hus, antigenic stimulation appears toave continued throughout the period ofbservation.

Authors' abstract

Hanseníase: resumos/Hanseníasis abstracts

SHEPARD, C.C.; WALKER, L.L.; VAN LAND-INGHAM, R. Heat stability of Myco-bacterium leprae immunogenicity. In-fect. Immun., 22(1) :87-93, 1978.

The protection provided to mice byvaccines administered intradermally wasmeasured after footpad challenge with My-cobacterium leprae. The protection offeredby M. leprae suspension was not decreasedwhen the vaccines were killed by 60°C heator at the higher temperatures tested, whichincluded 215°C (autoclave). Even highlypurified suspensions retained theirimmunogenicity. In contrast, the vaccineprotection provided by intradermal M. bovis(strain BCG) was markedly reduced whenheated to 60°C. The enlargement of thelymph nodes regional to the intradermalvaccines was measured and found generally toparallel the vaccine protection provided byM. leprae and by BCG.

Authors' abstract

SUSHIDA, K. Attenuation of drug-treatedmurine leprous bacilli to mice. a Exa-mination on acid-fast bacilli isolatedfrom the murine leprous mice adminis-tered with the drugs (in vivo). b.Examination on the drug-resistant murineleprous bacilli (in vitro). Jap. J.Leprosy, 47(1) :13-23, 1978.

SUSHIDA, K. & NAKANO, H. Distribution inpregnant mice of radioactivity afterinjection of 1311, and immunosuppressiveeffect by the whole body irradiation. Jap.J. Leprosy, 47(1) :7-12, 1978.

CLÍNICA, DIAGNÓSTICOCLINICAL ASPECTS, DIAGNOSIS

LCÓN, R.; ANTOLA, M.; TERRTT,FS, O.;VAQUERO, N.; MELAMJED, A.J. Cro-

momicose y lepra. Temas Leproi., 20(61) :8-13, 1977.

NTOLA, M.C. Radiologia del pie en laenfermedad de Hansen: el pie neuropá-tico. Temas Leprol., 20(61): 14-17, 1977.

NTOLA, M.C. La iridociclitis reaccionalaguda lepromatosa. Temas Leprol., 20(61) :23-28, 1977.

UBERTIN, J.; TEXIER, L.; GENIAUX,M.; TAMISIER, J.M. Maladie de Han-

ansen. Int., 4( I ) :51.85, 1979

sen lépromateuse. Bordeaux Med., 11(1) :4, 1978.

BALIÑA, L.M.; CHAROSKY, C.B.; KAUF-MANN de SWIEC, A.; BALIÑA de VAL-DEZ, M. Garra cubital iatrogenica porimpetuosidad diagnostica. Rev.Leprol. Fontilles., 11(2) :145-150,1977.An ulnas biopsy was practiced to a

patient to confirm the diagnosis of leprosy,getting as result an iatrogenic claw hand. Asthis biopsy has always been dangerous, theauthors believe that at the present era of

Hanseníase: resumos/Hanseníasis abstracts 69

preventive medicine and prevention of inca-pacities, ulnar biopsy should not be practicedanymore.

From authors' summary

BARR, R.J.; HERZLINGER, D.C.; CALIF, I.Nevi in leprosy. Letters to the Editor.Arch. Dermatol., 113(8) :1131-1132, 1977.

The discovery of Mycobacterium lepraewithin an otherwise normal cellular nevus wasnot expected, but its occurrence seemsreasonable due to the well-known affinitythat the organism has for neural crest cells,particularly Schwann's cells. As previouslystated, a biopsy should have been takenfrom normal skin at the time of the re-moval of the nevus, but the patient was un-available. It is still unlikely that this findingwas just a coincidence since, with theexception of lepromatous leprosy, organismsare not usually found in uninvolved skin.Although this represents only a single case, itis hoped that physicians who see manypatients with leprosy will consider examiningnevi when organisms may be difficult to findin skin lesions, which is frequently the case inindeterminant or tuberculoid varieties. Such aprocedure is considerably less traumatic thannerve biopsies and possibly may prove to bejust as useful.

From the letter

BERNARD, J.C. & VILLAGRAN, N. Diag-nóstico inicial de lepra por lesionesganglionares. In: REUNION LEPRO-LOGICA DEL CONO SUD, 2.ª, BuenosAires, 1977. apud Arch. Argent, Dermat.,27(2-3) :131-136, 1977.

Three patients from Paraguay with head-ache, fever, artralgias, muscle-pain, sple-nomegaly and enlarged lymph-nodes wereseen Two of the three patients have alsovomiting, diarrhea, colic-pain and abdominalpain. In one of the latter there was alsohepatic dysfunction signs, subicteric stain ofthe skin and choluria. The first case showeda toxic erythema, the second erythemanodosum and the third one had a diagnosisof rheumatic fever. The lymph- node biopsyshowed in the three patients a hansenianlymphnode inflamation.

Authors' summary

BEYLOT, C.;; BIOULAC, P.; BABIN, B.;DEVARS, D.; BAUDET, J.; LEMAIRE,

J.M. Un cas de lèpre. borderline. Bor-deaux Med., 11(1) :12-13, 1978.

BRUSCO, C.M. Concepto filosofico quedebe aplicarse a una clasificación delepra. In: REUNION PROLOGICA DELCONO SUD, 2ª, Buenos Aires, 1977.apud Arch. Argent. Dermat., 27 (2-3):77-80, 1977.

A critical review of the up-to-date clas-sification of leprosy is made. At the sametime the main aspects of a classificationdirected to those in charge of the control ofthe disease is given.

Author's summary

CAMPOS, E.P.; GUERRA, J.M.M.; AZE-VEDO, M.M.; ASHCAR, H.; MASSIG-NANI, A.M.; DELLE, CAVE, J. Cromo-blastomicose em paciente com hanse-níase. Rev. Inst. Adolfo Lutz, 35136:41-46,1975/1976.

Um paciente procedente da Amazô-nia,Brasil, seringueiro, portador de uma formabranqueada de hanseniase, tratado comsulfonas, tendo como seqüelas lestesdistróficas das extremidades e man-chashipocrômicas, com perturbações dasensibilidade, apresentou no hipocôndrioesquerdo uma lesão verrucosa extensa, comevolução de mais de 10 anos, rebelde aostratamentos feitos. Foram feitas biópsiaspara esclarecimento histopatológico da do-ença, tendo-se concluído tratar-se de der-matite verrucosa cromomicótica, com pre-sença dos fungos bem caracterizados pelascolorações de rotina, e histoquímicas (Phia-lophora verrucosa).

Do resumo dos autores

A 32 years old half-breed male comingfrom Amazonia, Brazil, had been treatedwith sulfone and was showing sequels in-cluding dystrophic lesion of the extremitiesand hypocromia with anesthesia. On ex-amination he showed an extensive verrucouslesion on the left hypochondrial regionwhich had lasted 10 years and was resistant tovarious treatments. A biopsy of theverrucous lesion showed the picture of ver-rucous dermatitis with fungi evidenced bycommon and histochemical staining techni-ques (Phialophora verrucosa).

From authors' summary

Hansen. Int., 4(1):51-85, 1979

70 Hanseníase: resumos/Hanseniasis abstracts

CASTILLA PERTIÑEZ, R. & TERENCIO DELAS AGUAS, J. Clasificación de laslesiones osteoarticulares de la lepra ypatogenia neurotrófica. Rev. Leprol.Fontilles, 11(5) :467-478, 1978.

CHOVET, M.; METGE, P.; FAUXPOINT,B.; SAINT-ANDRÉ; P. Uvéite post&rieure lépreuse: incidence de la réactionlépromateuse. Bull. Soc. Ophtalmol. Fr.,76(12) :1215-1217, 1976.

Sur un lot de 79 lépromateux examines,55 avaient présenté des réactions léproma-teuses. Six malades avaient un fundus pA-thologique, caractérisé par une uvéopapil- lite(un cas) avec périvascularite localisée (troiscas) des hémorragies (deux cas). Les auteursincriminent " 1'érythème noueux lépreux "comme élément étiopathogénique principal.

Résumé des auteurs

CONSIGLI, C.A. Ubicación de la formaindeterminada In: REUNION LEPRO-LOGICA DEL CONO SUD, 2ª BuenosAires, 1977. apud Arch. Argent. Der-mat., 27(2-3) :81-87, 1977.

The historical review in regard to theclassification of leprosy is done. The Inde-termined group is analized giving support toits inclusion into the International Clas-sification of Leprosy.

Author's summary

DAVID-CHAUSSÉ, J.; TEXIER, L.; DE-HAIS, J.; BULLIER, R.; LOUIS-JO-SEPH, L. Manifestations articulaires aucours de 2 cas de lèpre. Bordeaux Med.11(14): 1183-1190, 1978.

The authors report on two observations ofinflammatory arthrosynovitis occurring inthe course of " leprous reaction ". Oneinvolved a case of nervous leprosy, in which anintradermo-reaction of Lepromin wasfollowed by a monoarthritis of the knee;the other a case of lepromatous leprosy inwhich, a few months after the administrationof Disulone, polyarticular damageoccurred in the course of an arthritic ery-thema. Various cases noted from the lite-rature are analysed. The immunizationdisorders observed in the course of the leprousreaction provide the most satisfactoryexplanation. Rifampicin, successfully used inone of the cases reported, provides acomplement to the therapeutic meansagainst leprous reaction, in which corticoids,

Hansen. Int., 4(1):51-85, 1979

Thalidomide and Lamprene have all proved tobe truly effective.

Authors' summary

FARIA, E. WHO panel reports on HD: part II— Reactions. Star, 37(3) :5-6, 16, 1978.

FLIESS, E.L.G.; PACIN, A.; FLIESS, M.E.Leprologia practice. El laboratorio cli-nico en lepra. Temas Leprol., 20(61):

50-58,1977.GANOPOL, J. & PERRUELO, N. Fracturas

patológicas en el pie del enfermo delepra. Temas Leprol., 20(61): 46-49, 1977.

HINCKY, J.M. Le spectre clinique et im-munologique de la lèpre. Nouv. Presse.Med., 8(9) :657, 1979.

JOPLING, W.H. Vitiligo and leprosy. Cor-respondence. Brit. J. Dermatol., 99(1):112, 1978.

I have found 8 cases of vitiligo among114 lepromatous patients, an incidence of7%, but no cases of vitiligo among a largernumber of non-lepromatous patients, and Iwould be interested to know if this asso-ciation has been noted elsewhere or if ithas been reported in the literature. Thisobservation, when fully investigated by mysucessor at the Hospital for Tropical Dis-eases, may lend support to the hypothesisthat vitiligo is an auto-immune disorder,having regard to the wide variety of circulatingauto-antibodies which have been described inlepromatous leprosy, such as antinuclear,antithyroid and antisperm antibodies, andrheumatoid factor.

From the letter.

KAUR, S. & KUMAR, B. Study of apparentlyuninvolved skin leprosy as regardsbacillary population at various sites.Lepr. India, 50(1):38-44, 1978.

Slit smears from 16 LL and 4 BLpatients were taken from scalp, exile, ingui-nal regions and apparently involved skinpatch. The bacilli were found in 100%LLand 57%BL patients at all sites. Scalpshowed AFB in all LL and 3 out of 4 BLcases No lesions were seen on the scalp.Bacterial morphology showed no uniformpattern. Contrary to belief, no immunezones were found on the skin as judged byresults of bacteriological examination. Ourstudies do not support the view that the

Hanseníase: resumos/Hanseníasis abstracts 71

leprosy bacillus has a predilection for siteswith relatively low temperature as far ashuman leprosy is concerned.

Authors' abstract

LEPROSY Polyneuritis. Lancet, 1(8108):140,1979.

LYNCH, P. Greater auricular nerve in diag-nosis of leprosy. .Brit. Med. J., 2.,(6148) :1340,1978.

We may reasonably conclude thereforethat the greater auricular nerve is oftendetectable in normal individuals from anendemic area and that its usefulness in thediagnosis of leprosy is thereby diminished.

MATSUMOTO, T. & SASAKI, N. A casereport of seborrheic keratosis with anexacerbated leproma. Jap. J. Leprosy,46(3) :73-77, 1977.

MEDEIROS, J.E.G.; NASCIMENTO, J.G.;MOURA, J.B.A. Alguns aspectos dahanseníase e suas manifestações ocula-res. Arq. Bras. Oftalmol., 40(5) :316-323, 1977.

MITTAL, R. R.; HANDA, F.; SHRMA,S.C. Inoculation leprosy subsequent toroadside injury. Indian J. Dermatol.Venereol. Leprol., 42(4) :175-177, 1976.

A case of high resistance tuberculoidinoculation leprosy occuring after 5 months atthe site of road side injury in a 30 years oldmale is reported. It is the first case reportof inoculation leprosy occurring as a resultof road side abrasion wound. This caseconfirms that tuberculoid leprosy can occur byinoculation and without prolong-ed skin toskin contact.

Authors' summary

MOLERE FERRANDIS, R. Artropatia neu-ropática hanseniana. Gaceta Med. Esp.,50(8) :411-412, 1976.

NICOLAS, P. Erythème noueux lèpreuxinduct par la vaccination au B.C.G. Apropos d'un cas chez une jeune Marti-niquaise lépromateuse. Bordeaux, 1976./Thèse de Bordeaux, 1976, n.° 338/ apudBordeaux Med., 11(3) :246, 1978.

OKADA, S., IZUMI, S.; NAKAI, E.; NIS-HIURA, M.; TAKIZAWA, H.; ORARA,

A.; SUGIYAMA, K.; OZAKI, M. A tu-berculoid leprosy case with ulcers ofher patches. Jap. J. Leprosy, 47(1):25-36, 1978.

REA, T.H. & LEVAN, N.E. Lucia's pheno-menon and diffuse nonnodular leproma-tous leprosy. Arch. Dermatol., 114(7):1023-1028, 1978.

The records of ten patients with Lucio'sphenomenon showed clinical and histopa-thological changes similar to those describedby others. Lucio's phenomenon is asyndrome distinct from erythema nodosumleprosum as indicated by an absence offever, leukocytosis and tenderness, a failure torespond to thalidomide, and a restriction topatients with diffuse nonnodular lepromatousleprosy. Lymphopenia associated withsplenomegaly in three patients andglomerulonephritis in one patient wereunexpected findings of unknown relevance.

Authors' summary

The existence of diffuse, nonnodularlepromatous leprosy raises two reciprocalquestions. Why do no nodular lesions form?What is the mechanism of nodule forma-tion? That PPDL represents early disease isnot a satisfactory explanation becausepatients with PPDL often manifest signsindicating extensive and far advancedillness, such as splenomegaly, perforations ofthe nasal septum, and neurological deficits.Also, the presence of notably high serumlevels of lysozyme and angiotensinconvertingenzyme in patients with Lucia's phenomenon isconsistent with the idea that these patientshave particularly extensive histiocyteinfiltrations. Current views of granulomaformation include the accumulation andorganization of monocyte-derived cells asmodulated by lymphokines controlled byantigen-specific. T-lymphocytes. Current viewsof the immunology of leprosy include scantor absent cell-mediated immune responsestoward antigens of Mycobacterium leprae inlepromatous patients. Perhaps the failureof nodule formation in PPDL could beattributed to the absence of any specific cell-mediated immune responses. Conversely,nodule formation then becomes interpretableas an expression of a specific cell-mediatedimmune response, however feeble andwithout evident benefit to the host. Thesespeculative ideas are consistent with theobservations of Leiker, who found a greaterdegree of lepromin

Hansen. Int., 4(1):51-85, 1979

72 Hanseníase: resumos/Hanseniasís abstracts

responsivity in patients with nodular lepro-matous leprosy than in those with diffuselepromatous leprosy.

From authors' comment

RENDALL, J. R. & McDOUGALL, A.C.Reddening of the upper central incisorsassociated with periapical granuloma inlepromatous leprosy. Br. J. Oral. Surg.,13 :271-277, 1976.

REDDY, B.S.N.; CHANDRA, S.; JHA, P.R.;SINGH, G. Waardenburg's syndromewith leprosy. Indian J. Dermatol. Ve-nereol. Lepr., 44(1): 24-26, 1978.

A rare association of Waardenburg'ssyndrome and tuberculoid leprosy in a 13year male patient is described. This is anunrecorded feature in the literature. Thesetwo disorders are quite unrelated entitiesand their occurrence in the same patient isa casual one. All the classical features ofWaardenburg's syndrome except deafnesswere present and the disease manifested as anisolated case in the family. The pertinentliterature is briefly reviewed.

Authors' summary

SCHMITT, J.; SCHMIDT, C.; ADAM-GOL-BERG, E.; FLOQUET, J. La lèprenerveuse en France métropolitaine,réflexions sur les problèmes posés.Ann. Med. Intern., 127(3) :247-251, 1976.

SILVA, D. Leishmaniose anérgica hanse-nóide. An Brasil. Dermat., 53(2): 161-168, 1978.Assim, todas as que relacionam esta

forma de leishmaniose com os qualificativos:"lepromatóide", "lepromas leishmanióticos","simulando lepra", "pseudo-lepromatosa","lepróide" ou "lepromatosa". Ainda querealmente justificáveis pelo fato das lessapresentarem a mesma conotação quehanseníase virchowiana, somos forçados arelembrar que hit, em todo o mundo, umgrande esforço no sentido de proscrever apalavra lepra e derivados, pelas sériasimplicações sociais de todos conhecidas.Assim sendo, nada justifica que se adicione Itleishmaniose um verbete interdito. Paraobviar os inconvenientes acima referidos,sem desvincular entretanto de sua semelhançado ponto de vista semiótico com a hansenfase,e à enfase que tem sido dada por quasetodos os autores, insistimos na novadesignação: Leishmaniose AnérgicaHansenóide, que propusemos desde 1972.

Do trabalho

SZYNKIER, V.P.; YAMADA, S.;ALCHORNE, M.M.A. ; ISHIOKA,C.O. Fenômeno de Lúcio em um casode hanseniase. In: CONGRESSOBRASILEIRO DE DERMATOLOGIA 33.°;JORNADA BRASILEIRA DEHANSENOLOGIA, 9º; ENCONTRONACIONAL DO PÊNFIGO, 6º Brasília,1976 Resumos dos trabalhos p. 115-115.

TAKIZAWA, H. Studies of clinical courseand prognosis of Hansen's disease duringchemotherapy. 3. Acute infiltrationreaction (Tajiri) in lepromatous lep-rosy. Jap. J. Leprosy, 46(4): 139-146,1977.

This is a report of lepromatous caseswith acute infiltration reaction (Tajiri) in hisclinical course under chemotherapy. Theywere all males, among whom one case showedlocalized skin lesions and other two cases hadgeneralized lesions upon admission. Skinbiopsies revealed all borderlinelepromatousfeatures (Ridley-Jopling's classification) . Thisreactions developed one and half to 4months after the start of treatment, andlasted 9 months to two years intermittently.After this reaction the Mitsuda reactiontest gave the same result as before inone case, but other two cases becameweakly or moderately positive. BacterialClearance Time (Takizawa) was 2.7, 4.3 and5.9 years, respectively. The nomenclature andthe nature cf this reaction were discussed,especially with relation to chemotherapy.

Author's abstract

TERENCIO DE LAS AGUAS, J. & CASTIL-LAPERTIÑEZ, R. Las lesiones osteo-articulares neurotroficas en la lepra.Rev. Leprol. Fontilles., 11(3) :287-297,1977.

TERRILES, O. Pie reaccional. Definicióny patogenia. Temas Leprol. 20(61) :3-7,1977.

TORCHINSKY, O.M. Dermatologia del pieneuropatico en lepra. Temas Leprol.,20(61) :18-19, 1977.

TORRES PERIS, V.; SEDRAOUI, H.;JORDA, E. Un caso de psoriasis convitiligo y artropatia psoriasica: Estudioínmunológico. Rev. Leprol. Fontilles,11(2) :161-173. 1977.

Hansen. Int., 4(1) :51-85, 1979

Hanseníase: resumos/Hanseníasis abstracts 73

TERAPÊUTICATHERAPY

AMBROSE, E.J.; KHANOLKAR, S. R.;CHULAWALLA, R.G. A rapid test forbacillary resistance to dapsone. Lepr.India, 50(2) :131-143, 1978.

A long term study of the application ofthe method to assess correlations withclinical results and mouse foot pad tests ona statistical basis will require a further study.But we believe that we have already shownthat the use of radioactive metabolites orother rapid tests for metabolism andbiosynthesis by living bacilli of M. leprae,before contaminating organisms can arise, willbe the method of choice for a future test inclinical studies of relapsed lepromatousleprosy cases.

From the discussion

BARRETT, D.F. Lepromatous leprosy:dapsone resistance. Proc. R. Soc. Med.69 :391-392,1976.

BEDI, T.R. & BHUTANI, L.K. Reactions inleprosy — II (management). Indian J.Dermatol, Venereol. Leprol., 42(2): 71-74,1976.

Limited information available on thepathogenetic mechanisms involved in reac-tional states of leprosy makes the task ofmanagement difficult. In the recent past anumber of new drugs have been introduced.Various known etiopathogenetic factors andthe present status of management ofreactions in leprosy is briefly reviewedherein.

Authors' summary

BRIDE, M. B. Hydnocarpus oil in thetreatment of HD. Star, 37(3) : 4, 1978.

BRIDE, M.B. & NAIK, P.Y. Mechanism ofaction of thalidomide in leprosypatients suffering from reactions. As-pects Allergy Applied Immun., 8 :149-151, 1975

Using sonicated suspension of an acid fastbacillus — ICRC bacillus — antigen and serumof the leprosy patients as antibody, it wasshown that thalidomide prevents the release ofhistamine from the interaction. Thalidomidealso prevented PCA reaction in rats butfailed to influence passive reverse Arthusreaction in rats.

Authors' summary

BOGAERT DIAZ, H. Progresos en eltratamiento de la lepra. Rev. Dominic.Dermat. 12(1) 3540, 1978.

BRAND, M.B. The care of the eye. Part 4.Star, 38(2) :6-7, 1978.

BRAND, M.B. The care of the eye: parttwo. Star, 37(6): 2-3, 1978.

BROWNE, S. Treating BD today and to-morrow. Star, 37(1) :2-3, 1977.

BROWNE, S.G. Drug resistance in lep-sory. London Leprosy Mission, 1979. 5p.

CASTRO-COTO, A. Clofazimina; G30320 —B663 — lamp/en. Dermatologia: rev.mex., 21(1) :49-56, 1977.

Presentaré un pequeño resumen (sinpretender que sea completo), de las indica-ciones de la clofazimina en lepra, según laopinión de diferentes autores: 1. Pacientescon lepra lepromatosa en general o enaquellos con exacerbaciones o reaccionesleprosas frecuentes, repetidas y muy se-veras; 2. Estados agudos en alguns casosborderline o tuberculoides reaccionales, en loscuales la talidomida no es efectiva;3. Pacientes con cuadro de RL muy severa,sobre todo mujeres que deseen procrear;4. Pacientes con complicaciones neuriticasmuy severas, por to general consecutivas aRL; 5. (Pacientes con corticodependencia,permitiendo su uso, eliminar los esteroidesgradualmente; 6. Pacientes con cuadros refractarios al tratamiento con sulfonas;sulfonorresistencia; intolerancia o idiosin-crasia a las sulfonas.

Del trabajo

CARVALHO, J.C.S.; HILDEBRAND, W.M.;MIGDAL, S.; WAKAMATSU, A. Expe-rimentação terapêutica com imunomo-duladores na hanseniase — levamisole etetramisole. Foi. Med., 78(3) :193198,1979.

Os autores estudaram a atividade tera-pêutica do Levamisole, um modulador quí-mico da imuno resposta celular em 43pacientes portadores de hansenfase, sendo39 da forma clínica L(v), 3 da forma di-morfa e 1 da forma tuberculóide reacional.Os resultados foram bastante animadores:todos os pacientes se beneficiaram com o

Hansen. Int., 4(1):51-85, 1979

74 Hanseníase: resumos/Hanseniasís abstracts

uso do medicamento, principalmente os queapresentavam eritema nodoso. Foi observadauma intensa desinfiltração, com regressãodos lepromas, paralelamente a uma reduçãode bacilos na mucosa nasal e escarificaçõescutâneas. A tolerância ao Levamisole foiconsiderada boa, embora usado emassociação com outras drogas especificas.

Resumo dos autores

FARIA, E. Drug resistance in HD. Star,37(1) :5. 1977.

FREERKSEN, E.; ROSENFELD, M.; BON-NICI, E.; DEPASQUALE, G.; KRUGER-THIEMER, M. Combined therapy inleprosy: background and findings. Che-motherapy, 24 :187-201, 1978.

This report is based on data obtainedfrom 64 lepromatous cases. Despite manyyears of DDS monotherapy, the homoge-nates from biopsies of these patientsrevealed 104 or more bacteria. From thebeginning of combination therapy withsynergistic-acting substances (rifampicin +PTH + DDS) the logarithms of the numberof bacteria in the homogenates decreased,both during treatment period and duringtreatment-free observation period (Figs.3-8). During the whole time biopsies weretaken almost monthly. A considerable re-gression of the bacterial mass or even"negativity" could be observed within arelatively short time. Once started, theprocess of reduction of bacteria continuedalso after termination of therapy. To beable to evaluate a medication therapy, freeobservation periods (for a minimum of 5years) are indispensable.

Authors' abstract

FROUIN, E. Aspects de la lèpre en Nou-velle-Calédonie. A propos de 91 ma-lades traités par la rifampicine auCentre Raoul-Follereu. Bordeaux, 1976./Thèse de Bordeaux, 1976, n.° 48/. apudBordeaux Med., 11(3), 1978.

FUSARO, R.M. Immunotherapy of leprosy.Letters to the Editor. Arch. Dermatol.,113(8) :1129, 1977.

In 1972, Lim et al reported that repeat-ed whole WBC transfusions given overapproximately a three-month period subs-tantially cleared patients with either lepro-matous or tuberculoid leprosy. The clinical,bacteriologic, and histologic data all be-

Hansen. Int., 4( I):51-85, 1979

came normal soon after the end of theimmunotherapy and remained normal.These results were recently confirmed in acommunication that also reiterates the previ-ous failure of the use of transfer factor.

From the letter

GAILHBAUD, M. Immuno-stimulation nonspécifique par le B.C.G. Intradermiquedans les lèpres lépromateuses. Bor-deaux, Ed. Bergeret, 1976. /Thèse deBordeaux, 1976, n:° 35/ apud BordeauxMed., 11(3) :242-243, 1978.

Dans ce travail, inspiré par l'InstitutPasteur de Cayenne, l'auteur étudie lesrésultats de l'immuno-stimulation par leB.C.G. intradermique selon lá méthode deRuscher. Les résultats semblent favorablesdans 61% des cas caractérisés par des modi-fications immunologiques ou histologiques. Ilsemble que les formes BL soient les plus aptesà répondre à un immuno-stimulant. Mais cesderniers sont peut-être faussés par le faitque la plupart des malades ont été traitéssimultanément par la rifampicine.

M. Géniaux.

GATTI, J.C. & CARDAMA, J.E. Inmuno-terapia en lepra. Rev. Leprol. Fontilles,11(4) :357-370, 1978.

The results of the innoculation of M.leprae in the mouse footdpad and in thenine banded armadillo and the usefulnessof these innoculations in the leprologic fieldare discussed. And the utility of M. I.,and first line drugs in antileprae therapy.The deficient immunological capacity ofthe lepromatous patient is commented.Also the discovery of the principal immu-notherapeutically techniques such as diph-teriae toxoid, B. C. G., levamisole andisomers, allogeneic leucocytes, transferfactor, etc., their results and side effects.

Authors' summary

HARVEY, R. F. ; HARMAN, R. R. M.;BLACK, C.; READ, A.E.; BADDELEY,H.; DAVIS, J.; ESPINER, H.J. Abdo-minal pain and malabsorption due totissue deposition of clofazimine (Lam-prene) crystals. In- BRITISH ASSO-CIATION OF DERMATOLOGISTS.ANNUAL MEETING, 57th, Bristol, 1977.apud British J. Dermat. 97(supl 15):19, 1977.

Hanseníase: resumos/Hanseníasis abstracts 75

The benign and acceptable side offectsof clofazimine are well recognized amongstleprologists. But in addition it is becomingevident that gastro-intestinal symptomsmay be not only very severe, but due totissue deposition of crystals they can beirreversible and life threatening.

From the summary

HUIKESHOVEN, H.; LANDEHEER, J.E.;DENDEREN, A.C.V.; VLASMAN, M.;LEIKER, D.L.; DAS, P.K.; GOLDRING,O. L.; PONDMAN, K.W. Demonstra-tion of dapsone in urine and serumby Elisa inhibition. Letter to the editor.Lancet, 1(8058) :280-281, 1978.

Conventional methods for demonstrat-ing dapsone are either insensitive or notpracticable for general use in leprosy en-demic areas. We have developed animmunoassay that is both simple andsensitive. The urine samples were usedto compare ELISA inhibition with twoconventional spectrophotometric proce-dures. Out of ten samples, negative onone or both spectrophotometric procedures,9 were positive and 1 equivocal on ELISAinhibition testing. Sera from patientstaking dapsone, which would be expected tocontain l-3 µg/ml13 were dapsone positiveby ELISIT even when diluted a hundred-fold. The sensitivity of ELISIT and itssimplicity may be of practical value inleprosy-endemic countries with limited labo-ratory services,

From the letter

JOLLIFFE, D.S. Leprosy reactional statesand their treatment. Brit. J. Dermatol.,97(3) :345-352, 1977.

Leprosy reactions can be broadly clas-sified into two aetiological groups. TypeI (Lepra) reaction is the result of changesin cell-mediated immunity and type 2(ENL) reaction is probably due to forma-tion of immune complexes. Therapy mustat all times include effective antibacterialdrugs to which specific reaction suppres-sants should be added. Prednisolone andclofazimine are effective in suppressingboth types of- reaction and thalidomideonly in the treatment of Type 2 reaction.

Author's conclusion

LEVY, L. & PETERS, J. H. Susceptibilityof Mycobacterium, leprae to dapsoneas a determinant of patient response to

acedapsone. Antimocrob. Agents Che-mother., 9(1) :102-112, 1976.

LESER, P.G.; MONTENEGRO, M R.;FLEURY, R.; MARGARIDO, L.; BEL-DA, W.; MENDES, N.F.; NASPITZ,C.K. Avaliação terapêutica do fatorde transferência (FT), preparado apartir de baço humano, em hansenianosMitsuda-negativos. In: CONGRESSOLATINO-AMERICANO DE ALERGIA EIMUNOLOGIA, 6 °, Guarujá, 1977. Re-sumos de trabalhos científicos. SãoPaulo, Sociedade Latino-Americana deAlergia e Imunologia, 1977. p. 85.

MAGNA, L.M.; PINTO JUNIOR, W.; BEI-GUELMAN, B. Hematócrito e sulfa-nemia em hansenianos. Rev. Paul.Med., 93(1/2) :10-12, 1979.

O nível sangüineo de dapsona (DDS)foi investigado em 105 hansenianos adultos(80 homens e 25 mulheres) que apresen-tavam valores extremos de hematócrito. Aconcentração sangüínea de dapsona 6 horasapós a ingestão de 100 mg desse medica-mento mostrou-se independente do sexo ede o hematócrito ser alto ou baixo.

Resumo dos autores

The level of dapsone (DDS) in theblood was investigated in 105 adult leprosypatients (80 males and 25 females) exhi-biting extreme hematocrit values. Theconcentration of dapsone in the blood afterthe ingestion of 100 mg of this drug wasindependent of sex and of the hematocritbeing high or low,

Authors' summary

MUROHASHI, T. & YOSHIDA, K. Drugsensitivity of M. leprae isolated fromleprosy patients administered DDS forlong period of time. Acta Leprol., (73):13-28, 1978.

Drug sensitivity was tested using liquidmedium on three strains isolated from thesubcutaneous nodules of L-type patients whohave long been administered DDS alone.The results revealed that the first strainwas resistant to DDS up to the concentra-tion of 1.0µg/ml suggesting as if it wereDDS dependent or enhanced strain, whereasthe second strain was completely sensitiveto DDS even at the lowest concentration of0.01 µg/ml suggesting possible inactivationof this drug in the host patient. The third

Hansen. Int., 4(1):51-85, 1979

7

sbtertcprastbc

N

sipH2wpiabttctav

O

O

P

S

6 Hanseníase: resumos/Hanseniasis abstracts

train was completely resistant to 0.1 µg/ml,ut sensitive to 1.0 µg/ml of DDS, suggestinghat the therapeutic effect can not bexpected any more, when the strain becomesesistant to 0.1 µg/ml of DDS- All of thehree strains were sensitive to RFP at theoncentration of 0.01 µg/ml, and the hostatients of the former two strains showedapid improvement of the clinical symptomesfter RFP administration. That the secondtrain was sensitive to INH at the concen-ration of 0.01 µg/ml suggested the availa-ility of the combined use of INH in thehemotherapy of leprosy.

Authors' summary

AIK, S.S. Irregularity of dapsone intake ininfectious leprosy patients attending anurban treatment centre — its magnitudeand causes. Lepr. India., 50(l): 4553, 1978.

The Dapsone/creatinine ratio in randomamples of urine was determined in 910nfectious leprosy patients attending the out-atient department of the Acworth Leprosyospital, Bombay during the period 20-9-76 to0-11-1976. It was found that 48.7% of themere not taking regular treatment. Theatients who were detected to be irregular

n treatment were interviewed when they nextttended the clinic to find the reasonehind their irregularity. It was noticedhat the majority of them (63%) attendedhe clinic for DDS treatment but could notome regularly for valid reasons, e.g. no timeo attend, no money to travel to the clinicnd absence from Bombay to go to nativeillage.

Author's abstract

MS, Genève. Standard protocol for che-motherapy trials in lepromatous leprosy.Newsletter: spec. prog. res. train. trop.dis., (9) :15-16, 1977.

MS, Geneva. The chemotherapy of leprosy(THELEP) programme/ Le programmede recherche sur la chimiothérapie de lalèpre (THELEP): Bull. OMS/WHO, 56(1):76-77,80-81,1978.

RABHAKARAN, K. A new approach tochemotherapy of Hansen's disease. Star,88(3): 2-3, 1979.

ANGARE; M. Essais thdrapeutiques desadjuvants bactériens de l'immunité à

Hansen. Int., 4(1):51-85, 1979

médiation cellulaire sur la forme lépro-mateuse de la lèpre et vue gènèrale enmatière de santé au Mali. Bordeaux,1976. /Thèse de Bordeaux, 1976, n.o 714/apud Bordeaux Med., 11(3) :247, 1978.

SIMONOVICH, I.; TERRILES, O.B.; AN-TOLA, M.; ALCÕN, R. Tratamiento de lalepra lepromatosa con la asociación:rifampicina, D.D.S. durante cuatroanos. Temas Leprol., 20(61): 20-22, 1977.

SEHGAL, V.N.; REGE, V.L. & KHARAN-GATE, V.N. Limitation of clofazimine inreactions in leprosy. Indian. J. Dem.Vener., Leprol., 43(3) :152-154, 197'J.

Exacerbation or precipitation of reac-tionin leprosy due to clofazimine treatment aredescribed in 7 of 24 patients, highlightingits limitations in such cases and hencewarranting its judicious use.

Authors' summary

TARABINI, C.G.; TARABINI, C.G.L.;NUTI, M. Lebbra e mycobatteri atipici: 3)Sulla terapia delle lebbroreazioni dasensitine tubercolari tipiche ed atipiche inpazienti con lebbra lepromatosa. ActaLeprol., (68) :45-52, 1977.

In our leprosy patients the treatment ofsevere reactional precipitated by skintesting (with antigens from M tuberculosis, M.scrofulaceum, M. xenopei, M. africanum, N.farcinica, N. otididis) was longer and moredifficult than treatment of the other forms ofreactional state. Clofazimina alone (300 mg/die)did not control erythema nodosum leprosumand it was necessary to add thalidomide (400mg/die for one week) and corticosteroids(dexamethasone : 3 mg/die for 7 days); inthe moderately severe reactions we usedclofazimina in the usually dose, with a shortperiod of thalidomide at the same time.Finally, once reaction is controlled, the doseof clofazimina can be temporarily reduced to100 mg/die. but increased again whenrelapse occurs.

Authors' summary

TERENCIO DE LAS AGUAS, J. & SANTA-MARIA, L. Resistencia suitor lea detres casos de lepra lepromatosa. Rev.Leprol. Fontilles, 11(2): 151-159, 1977.

TERENCIO DE LAS AGUAS, J. & GATTI,C.F. Asociacion clofazimina sulfonas en eltratamiento de la lepra. Rev. Leprol.Fontilles, 11(4) :371-387, 1978.

Hanseníase: resumos/Hanseniasis abstracts

15 cases of lepromatous patients weretreated with sulphones and Clofazimine in adose of 100 mg. Lamprene, 3 times a weekalternatively with 50 mg. Dapsone 3 timesa week, in some cases and 3 injections ofPromin in others. Because of a bigger clinicand bacteriologic activity and the minimumof secondary effects we believe that this isthe ideal treatment for lepromatous patientsduring the two years of treatment.

Authors' summary

VENKATESAN, T. V. Treatment of lepro-matous leprosy with clofazimine (B-633lamprene). Indian J. Dermatol. Vene-reol. Lepr., 44(1) :16-17, 1978.

The present clinical study comprises ofeleven lepromatous leprosy patients. In allthese patients lepra reaction was noticed.These patients were previously taking sul-phones. Patients were followed for twoyears and the results are given.

Authors' summary

WATERS, M.F.R.; REES, R.J.W.; PEAR-SON, J.M.H.; LAING, A.B.G.; HELMY,H.S.; GELBER, R.H. Rifampicin forlepromatous leprosy: nine years' experi-

77

ence. British Med, J., 1(6106): 133-136,1978.

Over 100 patients with lepromatousleprosy were treated with rifampicin in aseries of pilot, uncontrolled, and controlledtrials in 1968-77. The rapid bactericidaleffect of rifampicin on Mycobacterium le-prae was confirmed. Clinical improvementbecame apparent sometimes as early as 14days after the start of treatment. Never-theless, a few persisting viable M. lepraewere detected as long as five years afterthe start of treatment with rifampicin eitherby itself or in combination with the bacte-riostatic drug thiambutosine. Treatment withrifampicin and dapsone for six monthsreduced the number of persisting leprosybacteria more than treatment with dapsonealone.

Although rifampicin proved more effec-tive than dapsone, it is unlikely that usedby itself it can significantly shorten thelength of treatment in lepromatous leprosy.Therefore initial intensive combined treat-ment with two or more bactericidal drugs(including rifampicin) warrants furtherinvestigation in both untreated leprosy andlepromatous leprosy resistant to dapsone.

Authors' summary and conclusions

CIRURGIA, FISIOTERAPIA, REABILITAÇÃO FÍSICASURGERY, PHYSIOTHERAPY, PHYSICAL REHABILITATION

APPEL, G. From CERPLE to CERPHA.Progress in HD work in Brazil. Star,37(1) :8-9, 1977.

ARVELO, J.J. Moderns enfoques en reha-bilitación en la lepra. Bol. Inf. SocArg. Leprol. 1(4) :22-23, 1977.

CHAROSKY, C.B. La mano del enfermo delepra. Bol. Inf . Soc. Arg. Leprol . ,1(4) :26, 1977.

FRITSCHI, E.; HAMILTON, J.; JAMES,J.H. Repair of the dorsal apparatus ofthe finger. Hand, 8 :22-31, 1976.

This paper describes a simple methodof assessing the constituent features offlexion deformities of the proximal inter-phalangeal joints in Hansen's disease, anda simple operation to correct the anteriordisplacement of the lateral band and theassociated contractures,

Authors’ summary

GONÇALVES, A.; JORGE, M.D.; GONÇAL-VES, N.N.S.; SANTOS, V.C. Incapa-cidade em hansenfase: ordenadas bá-sicas e resultados preliminares. In:CONGRESSO BRASILEIRO DE HIGIE-NE, 190. CONGRESSO PAULISTA DESAÚDE PÚBLICA, 1°., São Paulo, 1977.Resumo dos trabalhos: temas livres.São Paulo, 1977. item 9-5.

HASHIZUME, C. Surgical treatment offunctional limb disturbance in leprosy.Jap. J. Leprosy, 46(3): 112-138, 1977.

LAGARRIGUE, A. Traiement des paralysiesmédico-cubitales du lépreux par l'opera-tion de Brand modifiée (procédéGiraudeau). Bordeaux, 1977. /Thèse deBordeaux, 1977 n.o 157/ apudBordeaux Med. 11(3) :249, 1978.

LESSA, S. & CARREIRAO, S. Use of anencircling silicone rubber string for the

Hansen. Int., 4(1):51-85, 1979

78

correction of lagophthalmos. Plastic.Reconstr. Surg., 61(5) :719-723, 1978.

We describe a modification of Arion'stechnique for the correction of lagoph-thalmos by a circle of silicone rubber stringplaced subcutaneously near the lid margin.We have operated on 14 cases by this tech-nique with good results observed in 13after a two-year follow-up.

Authors' summary

Hanseníase: resumos/Hanseniasís abstracts

MILLER, S.H. & WOOD, A.M. Surgicaltreatment of facial nerve involvementcaused by leprosy. Am. J. Trop. Med.Hyg., 25(3) :445-448, 1976.

PALANDE, D.D. Surgery and rehabilitationin Hansen's disease. Star, 37(1) :6-7,1977.

EPIDEMIOLOGIA, PREVENÇÃOEPIDEMIOLOGY, CONTROL

ABREU, A.; WERTHEIN, L.J.; RUIZ DEZARATE, S. Programa de control delepra en Cuba. Rev. Dominic. Dermat.,12(2) 23-30, 1978.

ARCURI, P.B. Lepra: epidemiología. Bol.Inf. Soc. Arg. Leprol., 1(4) :23-24, 1977.

ARGELLIES, M.J.L. Incidence de la ma-ladie de Hansen en Martinique: analyseépidémiologique critique des modes dedepistage. Bordeaux Med., 11(30):2775-2786,1978.

The incidence rate of leprosy mostlydepends on the efficiency of the means ofdetection, that's why it's often referred to,as " case detection rate ". Proceeding fromthe new which have come out in Martiniquethese last ten years a method of efficiencytesting for active and passive detectionstructure is suggested. It is shown that thedetection in schools can only diagnose atthe utmost 25 % of the potential new casesas it actually concerns the group of lessfrequently contaminated people. Proceedingfrom the actual rates of incidence calculatedon the proportion : new cases/actually exa-mined children, an estimation of the prob-able incidence rate may be proposed bymaking an extrapolation upon the wholepopulation. It is thus shown that the num-ber of new fictive cases being 174 in 1976and the number of detected cases 52 it isprobable that 122 diseased people are aboutwithout being diagnosed. The active detec-tion in schools must then, in order to beoptimized, select the age group where thenumber of case is the highest, and, pro-ceeding from these new cases, must striveto reinforce the epidemiological actions infamilies.

Authors' summary

Hansen. Int., 4(1):51-85, 1979

BASTOS, J.M.G. A política nacional decontrole da hanseniase. Boi. Soc. Med.Cir. Park, 4(20): 6, 1978.

1 — Desestigmatização da hanseniase. 2 —Desmistificação do diagnóstico. 3 — Inte-gração de fato. 4 — Realização efetiva daspráticas de prevenção de incapacidades.

BELDA, W. Aspectos da hanseniase indi-ferenciada no Estado de São Paulo. In:REUNION LEPROLOGICA DEL CONOSUD, 2 ª, Buenos Aires, 1977. apud Arch.Argent. Dermat., 27(2-3): 99-100, 1977.

The various epidemiologycal aspectsof 16.534 patients of hanseniasis are consi-dered. From this study the importance ofthe Indetermined group and the fact thatit is more frequent in the younger groupare stressed.

Adapted from the author's summary

BLANC, M. Note d'information sus l'enquêteconcernant la lèpre et la tuberculose enHaut Volta. Acta Leprol., (68) :15-24,1977.

A la fin de cette enquête, on peut énon-cer les conclusions suivantes: — Le premierpoint important, c'est la participation mas-sive de la population à cette enquête. Lepourcentage moyen de presence dépasse91%. — En ce qui concerne la lìpre, ii Tautnoter les excellents résultats obtenus par lacampagne de manse contre cette maladie.Même ;apres les nombreuses liberationsdécidées au tours des 6 ou 7 dernièresannées, on peut encore libérer les deuxtiers de l'effectif en compte fin 1975. Cepen-dant, il y a lieu de faire un gros effort dedépistage pour trouver les quelques 6.000

Hanseníase: resumos/Hanseniasis abstracts 79

lépreux que l'on peut s'attendre à trouverclans ura futur immédiat. L'examen desdifférentes étapes du programme de luttemontre qu'il serait utile d'améliorer le dé-pistage, la surveillance du traitement etl'application des critères de guérison. Onpourra ainsi avoir une vue plus exacte dela situation et préparer une nouvelle chutedu nombre des malades. — En ce qui con-cerne la tuberculose, it semble bien qu'ellene constitue pas ura problème majeur desanté publique en zone rurale. Le dépistageet le traitement de cette maladie pourraientdonc are intégrés dans les activités delutte contre la lèpre.

Author's conclusion

BLANC, M. Evaluation de la campagne demasse contre la lèpre en Haute-Voltaaprès dix ans d'activité (1966-1976). ActaLeprol , (73) :39-58, 1978.

L'enquête !par sondage effectuée enHaute Volta pour évaluer l'efficacité de lacampagne de masse contre la lèpre pen-dant les dix ans écoulés (1966 — 1976) amontre que cette lutte avait été un grandsuccès: 1 — La tendance à la diminutionrégulière du nombre des cas de lèpre a étéconfirmée et même trouvée bien plus im-portante que ne le montraient les chiffresofficiels. La prevalence diminue de 84,98%,passant de 35,01% à 5,26%,,. 2 — La dyna-mique de la maladie est moiras forte qu'ily a dix ans. L'incidence est passée de 1,77%à 0,540/0o, c'est à dire a baissé de69,5%. 3 — Le nombre de malades àlibérer des contrôles est de beaucoup plusimportant que les statistiques officiellesle montraient. Il s'agit done dune campagneplei-nement réussie. Cependant it resteencore plusieurs dizaines de milliers delépreux en Haute Volta et ce n'est pas lemoment d'arrêter les efforts entrepris iiy a une vingtaine d'années.

De la conclusion de l'auteur

BOGAERT DIAZ, H. Propaganda y luchaantileprosa. Rev. Dominic. Dermat.,10(1) :25-31, 1976.

BOGAERT DIAZ, H. & MARTÏNEZ, D.Normas y procedimientos administra-tivos del programa de control de lalepra de Republica Dominicana. Rev.Dominic. Dermat., 11(2) :21-38, 1977.

BOGAERT DIAZ, H.; MARTINEZ, D.;CASTELLAZI, Z.; GÓMEZ, A. Programade control de la lepra en RepublicaDominicana 1978-1982. Rev. Dominic.Dermat., 11(1) :23-48, 1977.

The new program of leprosy control inthe Dominican Republic for 1978-1982 is ana-lyzed by the authors. The problem leprosyin each region of the country is reviewedand the goals to obtain by physicians andauxiliaries are outlined. The basis of theprogram will be the supervised treatmentof LL, BL and negative lepromin reactionIL cases.

Authors' summary

BROWNE, S.G. India's role in the fightagainst leprosy. Leer. India, 50(2):231-239,1978.

I close with a challenge from the lipsof him whose martyrdom we remembertoday: "Leprosy work is not merely medi-cal relief; it is transforming the frus-tration in life into the joy of dedication,personal ambition into selfless service. Ifyou can transform the life of a patient orchange his values of life, you can changethe village and country." And so he wouldchallenge us in practical and persuasiveterms to care for the individual leprosysufferer, to abolish discrimination of allkinds, to prevent the spread of leprosy andprevent deformity, and to insist on theimportance of non-medical factors in thetreatment of leprosy in the individual andits control in the community.

From the article

BURSTEIN ALVA, Z. Lepra indeterminadaen el Peru. In: REUNION LEPROLO-GICA CONO SUD, 2.ª, Buenos Aires,1977. apud Arch. Argent. Dermat.,27(2-3) :101-108, 1977.

CASAGRANDE, N.; TORNERO, N.L.;MAGALHAES, L.B. Alguns aspectos dahanseníase no 170. Distrito Sanitário(Londrina, PR) . 1972 a 1976. In: CON-GRESSO BRASILEIRO DE HIGIENE,19.0, CONGRESSO PAULISTA DE SAÚ-DE PUBLICA, 10., São Paulo, 1977.Resumos dos trabalhos: temas livres.São Paulo, 1977. item 9.3.

EKAMBARAM, V. Leprosy control in devel-oping countries. Star, 37(6): 4-5, 1978.

EmmausSwiss Palamaner Leprosy Project,Chittoor Dist. (A.P.), India. Acta Le-prol., (73) :59-72, 1978.

FARIA, E. Application gap in HD. Star,36(6) :1, 11, 1977.

FARIA, E. Status of ED in the U.S. Star,38(3) :12-13, 1979.

Hansen. Int., 4(1):51-85, 1979

80 Hanseníase: resumos/Hanseníasís abstracts

FELDMAN, R.A. & STURDIVANT, M. Lep-rosy in the United States, 1950-1969: anepidemiologic review. South. Med. J.,69 :970-979,1976.

FILICE, G.A. & FRASER, D.W. Manage-ment of household contacts of leprosypatients. Ann. Intern. Met., 88(4) :538-542, 1978.

We describe an approach to the mana-gement of household contacts of leprosypatients and the rationale on which it isbased. Initially, all household contactsshould be interviewed and examined forsymptoms and signs consistent with leprosyand appropriate diagnostic measures taken.Contacts of untreated lepromatous anddimorphous (borderline) leprosy patientsare at relatively high risk of disease andshould be examined annually for at least 5years. Dapsone prophylaxis has been shownto prevent secondary cases in contacts upto 25 years old and should be used in theseand possibly in older persons. Insufficientdata exist to support a recommendation foruse of BCG at present.

Authors' summary

FREERKSEN, E. & ROSENFELD, M.Leprosy eradication project of Malta.Chemotherapy, 23 :356-386, 1977.

GARCIA SZABÓ, R.R.; BOGAERT DIAZ,H.; VARGAS MENA, D. Lepra conjugal.Rev. Dominic. Dermat., 12(2) :31-36,1978.

GIMENEZ, M.; RISSO, H.; WAISMAN, R.Lepra indeterminada y control de laenfermedad. In: REUNION LEPRO-LOGICA DEL CONO SUM, 2ª , BuenosAires, 1977. apud Arch. Argent. Der-mat., 27(2-3) :123-126, 1977.

GURD, C.H. Leprosy in the Northern ter-ritory. Correspondence. Med. J. Aus-tralia, 2(19) :652, 1977.

GUARNERI, B.; RANDAllO, S.D.; GIAR-DINA, A. A proposito di alcuni çasi dilebbra autoctona in Sicilia. G. Ital.Dermatol., 112(9) :541-543, 1977.

HARI, S. Greater Visakha leprosy treat-ment and health education scheme,Visakhapatnam. Lepr. India, 50(2):210-213, 1978.

INTERNATIONAL T,9PROSY CONGRESS,llth, Mexico, 1978. Epidemiology andcontrol including field therapy. Star,38(3) :10-11, 1979.

Hansen, Int., 4(1):51-85, 1979

JAGADISAN, T.N. The human problem ofleprosy control. Star, 37(6) :10-11, 1978.

JARRAMS, A.G. A dermatological surveyof the Ghurka Brigade. J. Roy. Army.Med., Cps., 122: 135-142, 1976.

A survey was carried out on 4,500 serv-ing officers and soldiers of the Brigade ofGurkhas in Singapore, Malaya and HongKong in 1971 and 1972. The results showeda prevalence of 11.3 cases of leprosy perthousand in this highly selected group. It issuggested that some previous estimates ofthe prevalence of leprosy in the generalpopulation of the Himalayan foothillsunderestimated the problem.

Authors' summary

JESUDASAN, M. & MATTHEWS, C.M.E.Involvement of community leaders inleprosy control. Leaders training camps— an evaluation study. J. Rehabil, Asia,19(3): 24-40, 1978.

KAUR, P. Prevention of leprosy. Indian J.Dermatol. Venereol. Lepr., 44(1) :12-17,1978.

Leprosy evolves over a long period andafter the time of contact it takes long timebefore pathological changes become evident.Prevention may be achieved by increasingthe level of detection and controlling therisk factors. In this paper, the methodsof prevention of leprosy are described.Primary prevention, or prophylaxis is ofprime importance and this can be achievedby reducing an individual's susceptibility aswell as by reducing his/her exposure tosusceptible individuals. The former needsgeneral health promotion, immunoprophy-laxis and ohemoprophylaxis. The latter isachieved by isolation and early detectionof cases. A critical review of merits anddemerits of these measures is presented.Secondary prevention is through early de-tection of cases and their prompt treatment.Tertiary prevention is the prevention ofdeformities, and rehabilitation of these whoare already disabled.

Authors' summary

KEELER, R.F. HD control in Trinidad andTobago. Star, 37 (3) :6-7, 1978.

KRAJEWSKI, S. Leprosy in the LibyanArab Republic. Przegl. Dermatol., 62:433-436,1975.

Hanseníase: resumos/Hanseniasis abstracts 81

LARA, C.B. DDS chemoprophylaxis forleprosy in children at Gulion SanitariumPalawan, Philippines. Acta Leprol.,(70) :35-58, 1978.

The conclusions that can be drawnfrom the main (Project I) and subsidiarystudy (Project II) are: 1. The effect ofDDS chemoprophylaxis has been temporaryand of limited value. 2. The greatest benefitis in the group of children without knowndirect contacts when protection after fouryears prophylaxis may reach 88.4%, declin-ing in the subsequent four years ofobservation to 62.4%. The next to benefitare the children of lepromatous parents,with 46.8% protection at cessation ofprophylaxis and diminishing to 18.9%.Slight to negligible protection appears tobe afforded to the children of non-lepro-matous families. 3. The investigator con-siders that although most children startwith tuberculoid or indeterminate lesions,as they grow older self healing is relativelygreater among females than males. 4. Thatthe main action of DDS chemoprophylaxisis that of reducing the incidence of mildcases and those that have an inherent trendtowards self-healing i.e which in the na-tural course affects chiefly the female sex,and temporarily also reduces the severityof other cases. 5. Chemoprophylaxis maybe justified in contact children under theage of five years (considered the mostvulnerable period for both sexes), for aperiod of not more than six years. A noteof caution must be sounded on the toxiceffects of DDS and prophylaxis should beaccompanied by a suitable iron preparation.Where expert examination is available twiceyearly to this age group, chemoprophylaxiscan be considered unnecessary.

Author's conclusions

5. Leprosy — Lépre. In: II. Current data— Données courantes infectious dis-eases; monthly or four-weekly numberof reported cases, 1976 and 1977/ Ma-ladies infectieuses: nombre de casnotifiés par moss ou périodes de quatresemaines, 1976 et 1977. WH StatisticsQuarterly/Rapport trimestrie de Statis-tiques Sanitaires mondiales, 31(2):200-202,1978.

MATHUR, N.K.; KANWAR, A.J.; KALLA,G.; UJWAL, J.S. Leprosy in Jodhpur(Rajasthan): clinical and epidemio-logical study. Lepr. India, 50(2) :204-209,1978.

A clinical and epidemiological study ofleprosy revealed 232 cases in Jodhpur(Rajasthan); a non-endemic area. Maleswere three times more affected than fe-males. Lepromatous leprosy was the mostcommon type (70.70%). Maximum numberof cases were observed in the age group20-49 years. The probable causes for anincrease in incidence are discussed.

Authors' abstract

MELLO, A. Hanseníase nas áreas metropo-litanas. In: CONGRESSO BRASILEIRODE HIGIENE, 19°. CONGRESSO PAU-LISTA DE SAÚDE PUBLICA, 1.°, SãoPaulo, 1977. Resumos dos trabalhos:temas livres. São Paulo, 1977. item 9.6.

NASSERI, K. & KO, Y.H. Epidemiologyof leprosy in Iran. Int. J. Lepr., 45(4): 1977.

A total of 907 cases of leprosy from twosources, records from Baba-Baghi Leprosa-rium (709 cases) and Ahar case findingsurvey (198 cases), have been studied. Themain characteristics of the cases are: a)about 50% of all cases are lepromatousleprosy; b) the leprosarium cases are about2.5 years younger; c) about 70% of all casesare male; and d) the incidence of leprosyshows a steady increase up to 25-30 yearsof age and levels off thereafter. These andother findings are discussed.

Authors' summary

OMS, Geneva. Renforcement de la for-mation et du réseau institutionnel pourla recherche sur la lèpre. Bull.OMS/WHO, 56(4): 561-563, 1978.

OMS, Geneva. Leprosy / Lèpre. Wkly,Epidem. Rec. / Relevé Epidém. Hebd,53: 147, 1978.

OMS, Geneva. Leprosy / Lèpre. Wkly,Epidem. Rec. / Relevé Epidém. Hebd.,53(33): 249-250, 1978.

OMS, Genève. IMMLEP: focus on immuno-prophylaxis. Newsletter: spec. prog.res. train. trop. dis., (12): 15-17, 1978.

PFALTZGRAFF, R.E. Managing HD in thefield Star, 36(6): 4-5, 1977.

PRASAD, K R Family planning in relationto leprosy, venereology and dermato-logy. Indian J. Dermatol. Venereol.,43(4): 225-227, 1977.

Hansen. Int., 4(1) :51-85, 1979

82 Hanseníase: resumos/Hanseníasis abstracts

The futility of compulsory sterilizationof leprosy patients as a method of con-trolling leprosy is pointed out. Howeverleprosy patients do need family planningadvice and methods as do the generalpopulation. In addition infectious leprosypatients need to postpone marriage orpregnancy till they become non-infectious.The possible way in which family planningmay influence sexually transmitted diseasesand skin disorders are briefly indicated.

Author's summary

PORTUGAL. Ministério dos Assuntos So-ciais. Decreto-Lei nº. 547/76 de 10 dejulho. Rovisco Pais: rev. port. doençaHansen, 15(1) :69-78, 1976.

PORTUGAL. Ministério dos Assuntos So-ciais. Portaria n.º 131/77 de 14 demarço. Regulamento da luta contra adoença de Hansen. Rovisco Pais, rev.port. doença Hansen., 15(1) :79-83, 1976.

ROTBERG, A. Nasce no Brasil a fase IIIda prevenção da hanseniase. In:REUNION LEPROLOGICA DEL CONOSIM, 2.ª, Buenos Aires, 1977. apudArch. Argent. Dermat., 27(2-3) :93-98,1977.

The new program of prophylaxis ofhanseniasis in Brazil (Phase III) is basedon the social and psychological aspects ofthe disease.

Adapted from the summary

SAIKAWA, K. The epidemiological study onleprosy in Okinawa Island the thirdreport; on the Islets. Jap. J Leprosy,46(1) :1-7, 1977.

SAIKAWA, K. The epidemiological study onleprosy in the Ryukyu Island the 4threport: on leprosy in the urban area.Jap. J. Leprosy, 46(1) :8-13, 1977.

SALVADOR, M.A.; BIAGINI, R.E.; MAR-TINEZ, T.E. Actualización de la en-demia leprosa en Salta.Arch.Arg. Dermatol., 26(3-4) :181-186, 1976.

The authors have reported several timesa number of facts which show the "State"or "Province" of Salta, in Argentina, is anendemic area of leprosy. In the last fiveyears the number of patients has been four

Hansen. Int., 4(1):51.85, 1979

times superior to those seen in previous5-years period. A study is made on thebasis of the area where the population ismore dense. The results show thatalthough there is not a program for thecontrol of the disease, the incidence at theend of this decade would be more than0,5%.

Authors' summary

SEHGAL, V.N.; REGE, V.L.; MASCA-RENHAS, M.F.; REYS, M. The preva-lence and pattern of leprosy it a schoolsurvey. Int. J. Lepr., 45(4): 360-363, 1977.The prevalence of leprosy in a school

survey conducted in Panaji, India was foundto be 5.3 per 1,000 with males predomi-nating. The majority of patients had asingle lesion on exposed parts of the bodyshowing the clinical characteristics of tuber-culoid leprosy. However, clinical featuresof indeterminate leprosy were seen in twopatients and borderline tuberculoid in asingle case. On the other hand, histopa-thologically, the majority of the patientswere classified as having borderline tuber-culoid or indeterminate leprosy. A disparitybetween the clinical and histopathologicdiagnosis was evident. This observationemphasizes the importance of studying boththe clinical and histopathologic features indeciding the precise status of a patient inthe leprosy spectrum.

Authors' summary

SERVIÇOS oficiais de saúde pública. 35.Casos de hanseniase, em registro ativoem 31 — 12 e registrados no período,segundo as Unidades da Federação,1976. Anu. Estat. Brasil, 38: 197,1977.

SILVA, N.C. & AYRES, A.C.S. Estratégiaglobal na organização da luta contraa hanseniase. In: CONGRESSO BRASI-LEIRO DE HIGIENE; 19.° CONGRESSOPAULISTA DE SAÚDE PÚBLICA, 1.ºSão Paulo, 1977. Resumos dos tra-balhos: temas livres. São Paulo, 1977.item 9.1.

STANFORD, J.L. A vaccine for leprosy.Star, 37(6): 6-7, 1978.

TERENCIO DE LAS AGUAS, J. Epidemio-logia de la lepra en España (l). Rev.Leprol. Fontilles, 11(5): 493-501, 1978.

Hanseníase: resumos/Hanseniasis abstracts

VALENCIA TELLERIA, A. & ZEBALLOSJ.L. Manual de normas técnicas yprocedimientos administrativos para elcontrol de la enfermedad de Hansen.Bolivia, Div. Nac. de Epidemiol , 1979.45p.

Introducción. Definición de Terminos.Busqueda de Casos. Criterios para el Diag-nóstico de la Enfermedad de Hansen.Criterios para el Tratamiento Ambulatorio.Complicaciones de la Enfermedad deHansen. Actividades de Apoyo. Criteriospara la Hospitalization. Criterios de Controly Altas. Organization Administrativa. Atri-buciones del Hansenologo Regional. Normasde Trabajo para los Servicios o Centrosde Salud a Nivel Distrital. Funciones delAuxiliar Polivalente Entrenado en Hansen.Funciones del Encargado de los Puestos deSalud. Sistemas de Evaluation y Control.Manejo de Formularios.

VARELA, N.; MARGOUNATO, M.; VIG-NALE, R.; ROZEN, V. La lepra en elUruguay en ei período 1961-1976. In:REUNION LEPROLOGICA DEL CONOSUD, 2.a, Buenos Aires, 19'77. apudArch. Argent. Dermat., 27(2-3): 109-110,1977.

The endemic aspects of leprosy inUruguay are analyzed. The Indeterminedcases are very few. The difficulties concern

83

ing the endemic control in Uruguay arepointed out.Authors' summary

WALTER, J. Manpower formation for lep-rosy control. Acta Leprol., (68): 9-14,1977.

The objective of training activities inleprosy is the formation of sufficient andqualified manpower necessary to controlthe disease. A clear definition of the leprosyproblem in each country or area is anessential requirement for the planning oftraining activities. The existing and plan-ned health infrastructure is another mile-stone on which specific manpower needs forleprosy and other disease control must bebased. Hasty extension and creation ofspecialized services, which in leprosy areof a longterm nature, 20 years or more,often create more problems than theyare intended to solve. Closecoordination and integral developmentof leprosy control with other healthactivities in most instances will be thesoundest approach towards meetingthe training needs for leprosy control.Some exceptions for high leprosy endemiccountries, or areas inside such countries,must be made and specialized trainingwill be needed for such conditions.

From author's summay

PSICOLOGIA, EDUCAÇÃO, REABILITAÇÃO SOCIALPSYCHOLOGY, EDUCATION, SOCIAL REHABILITATION

BALIÑA, L.M.; CHAROSKY, C.B.; KAUF-MANN de SWIEC, A.; BALIÑA deVALDEZ, M. Educación programadaen Leprologia. N.º 1. Un caso para elmédico, el trabajador psico-social, elrehabilitador físico, ei terapeuta ocupa-cional y ei estudiante de estas disci-plines. Rev. Leprol. Fontilles. 11(2):141-143, 1977.

BROWNE, S.G. India's role in the fightagainst leprosy. Lepr. India, 50(2):231-239, 1978.

GIMENEZ, M. & CAUDERER, L.E.de.Algunos aspectos de la experienciachaqueña sobre el control de la lepra.In: REUNION LEPROLOGICA DELCONO SUD, 2.ª, Buenos Aires, 1977.

apud Arch. Argent. Dermat., 27(2-3):127-130, 1977.

The psycho-linguistic search has showedthat up to this time a new word for thedesignation of leprosy is not indicated. Thesin is not in the word but in the painfulimplication of the meaning of that word.

Authors' summary

INTERNATIONAL 1'.8. ERATION OF,ANTI-LEPROSY ASSOCIATIONS. Basicknowledge about leprosy; a guide fornon-medical personnel. Sierra Leone,West African Leprosy Secretariat /apr.1977/ 15p.

JAGADISAN, T.N. The human problem ofleprosy control. Star, 37(6) :10-11, 1978.

Hansen. Int., 4(1):51.85, 1979

84

KULKARNI, A. Sponsorship of children ofleprosy parents. Lepr. India, 50(2):173-180,1978.

What is sponsorship? The GASP pro-gramme. The methods of sponsorship. Theprogress of the programme. Difficulties incarrying out the programme. Separation ofchildren. Some examples of sponsorship ofchildren of leprosy parents and theproblems. Need for day school for childrensuffering from infectious leprosy. Lookingforward.

ROTBERG, A. A fase III do controle dahanseníase começa no Brasil / PhaseIII of hanseniasis control commencesin Brazil. Editorial. Hansen.: res./not.abs. news, 8(1-2) :3-13, 1977.

Hanseníase: resumos/Hanseniasis abstracts

Fase I: Isolamento compulsório. FaseII: tratamento de pacientes de ambulatórioem serviços integrados. Fase III: Apriordade dos problemas psico-sociais.Outras medidas convencionais e não-convencionais. A fase III aprovada em testespreliminares. Conversa franca com ospaíses endêmicos.

*Phase I: Compulsory isolation. PhaseII: treatment of out-patients in integratedservices. Phase III: The priority of psycho-social problems. Other conventional andnonconventional measures. Phase IIIapproved in the preliminary tests. A franktalk between endemic countries

THEOPHILUS, S. Hansen's disease: doctor,patient and society. Star, 36(6): 2-3, 1977.

GENERALIDADES, HISTÓRIAGENERAL AND HISTORY

CABRAL, O.R. Maculo, varíola, lepra. Arq.Cat. Med., Edição Cultural (1) :33-41,1977.

CONTRERAS DUMAS, F. Enfermedadesde la piel. Actas Dermo-Sifiliogr., 68(9/10) :618, 1977.

"Enfermedades de la piel" es el títulodel capitulo XIII del Levitico en las reel-entes ediciones que se han publicado en lamayoría de los idiomas europeos de la llamad. Nueva Biblia, que nos satisface aicomprobar que la Biblia anteriormenteconocida se ha transformado totalmente encuanto a Biblia se refine. En las antiguasediciones, el título del capítulo XIII era"Leyes de policia sobre el discernimiento dela lepra, el cual pertenece a los sacerdotes".

Este capítulo XIII constaba de 59 pár-rafos, en los que se reiteraban las palabras"lepra" y "leproso", y en cambio en lanueva Biblia ocupa la mitad de espacio,sólo 43 párrafos, sin mencionar ningunavez las palabras aludidas. Además de lodel Levítico, han sido modificados en elmismo sentido el libro del Exodo, el de losNúmeros, las Crónicas, los Paralipómenos yel libro de Job, y tambidn del NuevoTestamento desaparecieron las palabrascitadas y todas las medidas discriminatoriascon los enfermos. Por supuesto, que la

Hansen. Int., 4(1):51-85, 1979

edición española está editada por Ediciones deCristiandad, y las ediciones francesas,italianas e inglesas, lo mismo que la española,están autorizadas con el Nihil obstat.

CONTRERAS DUEÑAS, R. Lucha contra lalepra en España desde 1901 hasta 1978.Acta Leprol., (70) :59-103, 1978.

Lo más importante es que durantesiglos, hasta comienzos del siglo XX, lapalabra "LEPRA" se utilizó como um cajón desastre, al que iban a parar todas lasenfermedades repugnantes que nadie sabiadiagnosticar. Con más propriedad, como unmonstruoso depósito de basura, al quearrojaban todas las irunundicias, todas lasmutilaciones, que no sablan curar, juntocon todas las dermatosis de aspecto repug-nante que los curanderos de todos lostiempos y lugares no lograban aliviar endos plazos de siete dias. Aunque nosotrosnos vamos a referir a Espana, esto era igual entoda Europa y en los demás continentes ymientras esto ocurria es impossible precisarninguna evolución, en ningún país, por sernecesario empezar discriminandoexclusivamente sobre la nfermedad producidapor el Micobacterium leprae.

Del trabajo

FARINA, D.C. Leprosos na província deSão Paulo. J. Assoc. Paul. Med., 14(217) :7-8, 1979.

Hanseníase: resumos/Hanseniasis abstracts 85

GATTI, J.C. Recientes avances y estudiosactuales en la investigación en lepra.Boi. Inf. Soc. Arg. Leprol, 1(4): 25,1977.

GOMEZ, A. Lepra en la provincia de PuertoPlata. Rev. Dominic. Dernutt., 12(2):3740, 1978.

Some historial data about leprosy thera-py before Sulfones at the Province ofPuerto Plata are reviewed; a brief biographyof Margarita Mears, precursor of leprosycontrol in the Dominican Republic, isincluded.

Author's summary

HIND Kusht Nivaran Sangh. (Indian Lep-rosy Association). Annual report for1976. New Delhi /1977/.

JACOBSON, R.R. & TRAUTMAN, J.R. Thediagnosis and treatment of leprosy.South. Med. J., 69 :979-985, 1976.

JOPLING, W.H. Leprosy today. Indian J.Dermatol. Venereol., 44(4) :190-196,1978.

The paper begins with an account ofthe present world distribution of leprosyand is followed by a description of the cli-nical features of the various types of thedisease. The differing views regarding themode of spread are discussed, and, on thesubject of the management of leprosy,special emphasis is placed on the short-comings of the antileprosy drugs which areat present available, on the question of bac-terial resistance to dapsone, and on theproblem of absenteeism and of defaultingon treatment. The outlook for the produc-tion of an effective vaccine is discussed,and the paper ends with a tribute to theall-important role played by medical auxi-liaries in countries where leprosy is endemic.

Author's summary

KATO, L. & MARCHAND, J. Leprosy:"Loathsome disease in Tracadie, NewBrunswick" — a glimpse into the pastcentury. Can. Med. Assoc. J., 114:440-442,1976.

LAGARRIGUE, J. La lèpre. Aspects épidé-miologique, immunologique, clinique etthérapeutique en Guyane française.

Bordeaux, 1976. /Thèse Med., Bordeaux,1976, nri 514/ apud Bordeaux Méd., 11(3) :247, 1978.

LANGUILLON, J. Activités de l'Institut deLéprologie appliqués de Dakar. Fonda-tion de l'Ordre de Malte de 1972 a 1977.Acta Leprol., (69): 9-70, 1977.

MIRANDA, R.M. Cemitério de lázaros. J.Assoc. Paul. Med., 14(217) :5-6, 1979.

O QUE se deve saber sobre hanseníase.Saúde, 2(13) :1, 1977.

OMS, Geneva. 3. Examen de cuestiones téc-nicas especiales. Lucha contra la lepra.Actas Oficiales OMS, (241) :610-616, 1977.

OMS, Genève. Training and institutionstrengthening for leprosy research.Newsletter: spec. prog. res. train.trop. dis., (11) :18-19, 1978.

PATTYN, S.R. Tuberculosis and leprosy acomparison. Acta Leprol., (73) :3-11,1978.

ROCCA, P. Del dispensario al hospital dedermatologia. Temas Leprol., 20(61):29-45, 1977.

ROTBERG, A. Hanseníase. In: PRADO,F.C. et al. Atualização. terapêutica.11.a ed. São Paulo, Artes Médicas, 1978.p. 584-585.

"SEDARE dolorem divinum opus est."Preconceitos milenares não se coadu-nam com a verdade científica. Saúde,3(25/26) :8-9, 1978.

SKINSNES, O.K. Leprosy and Dar-Kosis.Editorial. Int. J. Lepr., 45(4) :376-377,1977.

TERENCIO DE LAS AGUAS, J. La lepraen el reino de Valencia. V. Arnau deVilanova. Editorial. Rev. Leprol. Fon-tilles, 11(3) :237-240, 1977.

TERENCIO DE LAS AGUAS,, J. La lepraen el reino de Valencia: VI — SigloXIX. Rev. Leprol. Fontii les, 11(4):347-350, 1978.

TERENCIO DE LAS AGUAS, J. La lepraen el reino de Valencia. Siglo XX.Editorial. Rev. Leprol. Fontilles, 11(5):465-466, 1978.

Hansen. Int., 4(1):51-85, 1979