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早期獺에 關한 硏究

Studies on Early Leprosy

경북의대잡지 1964년 5권 1호 p.26 ~ 47
서성탁 (  ) - 경북대학교 의과대학 비뇨기과학교실

Abstract


Though there are some differences in the Leprosy Control Project according to the actual circumstances of each country, home-treatment is recommended, mostly replacing isolation treatment and allowing all leprosy patients to be treated at mobile clinics, health centres, or general hospitals, in Korea.
Laying particular stress on out-patients, the author studied the actual condition of 52´7 cases of early leprosy, who visited the Department of Dermatology, Kyungpook University Hospital and their type or group was decided in Part I with the following conclusions.
1. The number of out-patients varied according to the distance from their home to the outpatient clinic. The locality with good leprosy facilities showed the greater number of leprosy patients in I group.
2. The order of frequency according to type and group were: I group 193 cases (36.60 , L type 172 cases (32.60 , T type 139 cases (26. 4~), and B group 23 cases (4.4%). Whenc ompared with the data of leprosaria the number of [ group was higher.
3. The ratio between male and female in all the cases was 3.6:1. In T type it was 4.6 ; 1, in L type 3.3 : 1 and 3´.1:1 in I group. ´There are more married patient, than single.
4. As to occupations of the patients, farmers occupied the largest, 251 cases ~(47,6y), Among students and soldiers I group was predominant.
5. Of the 52´7 cases, 49 had leprosy patients in their family, and 16 of these were fathers.
6. The number of cases who lived with leprosy patients before onset of their symptoms was 71,and the incidence was highest where there was a 25 years´ contact.
7. The age at which they began to live with leprosy patients was 1620 in 21 cases (29.6 o)> 1115 in 17 cases (23.9?/), and1125 in 11 cases (15.5io).
8. although the person who discovered the initia]. lesion was mostly the patient himself, there was some variation accrding to type and group.
9. About half of the patients visited hospital after their first manifestation but others wcnt to herb-doctors or took home-remedies.
10. Mot more than ninety cases (12.3%) kncw definit+:ly that they had leprosy at the ti_mc of the first visit to hospital, and the ma jorit}´ didn´t :know they had leprosy at all.
11. After being diagnosed as leprosy about half of the cases told their family. The milder their symptoms were, the more they did not tell their family ;and there was almost no case in which wives told their husbands.
12. Most patients were against isolation, anti approved of being treated as out-patients. In particular they disliked being treated at iota] health centers.
13. As to the age of onset at the first manif station o.f symptoms, we found the highest incidence at the ages of 2I25 (115 cases, 21.9J).
14. Though the sites of initial lesions varied according to type and group, the ratio among lower extremities, upper extremies, trunk, and face was 4:3:1:1.
15. In about half of the cases the initial symptom vas anesthesia. But the incidence of anes-thesia varied much according to type and group.
16. The seasonal onset, on the whole, was high in both Spring and Winter. L type was predominant in Summer and Spring, T type in Spring and Winter.
17. The findings at the first visit were in general of a lesion of the early disease and there was no case of deformity. Of superficial nerves ulnar nerve was enlarged in 161 cases (30.5%), great auricular nerve in 89 cases (16.90, but there was some somc variation according to type and group.
18. Clinical therapeutic effects with D. D. S. began to be evident after six months of treatinent, and many cases showed marked improvement ~~.fter 34 years of treatment. L type showed more rapid improvement than T type, but it was difficult to evaluate in I group.
19. Improvement of histological findings after admi~listration of D. D.S. vas more rapid in T type than L type, but variable in j group.
20. The number of patients who visited continuously after initiatiion of treatment was 193 at 6 months (36.60, 147 at 12 months (28~o), and a few after 1 year of treatment. Patients who received continuous treatment for ~ years were :not more than 12 in number.

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