In order to analyze the relation between the lepromin reaction and the tuberculin reaction, both animal experiments and investigations in human bodies were conducted.
The results were obtained as follows.
1) In the guinea pigs injected with tubercle bacilli or BCG the tuberculin and lepromin reactivity appeared at the same time.
2) In healthy human bodies which had ever received natural tuberculous infection or BCG vaccination, a high correlation was observed between the tuberculin and early lepromin reactions concerning the size of redness.
3) In leprous patints, however, such a correlation was scarcely observed regardless of the clinical type.

抄録全体を表示

The antigen for the complement fixation test devised by Honda and Yoshino (1951) was modified.
A mixture was made in a ratio of 0.2% C. L (1):1% C (10):1% Ch (5). Pure
alcohol was added to make 1cc. This antigen was treated with 0.1% Kaolin and then used for experiment.
Sixty (92.4%) out of 65 lepromatous type, 17 (73.9%) out of 23 macular type, and 19 (86.4%) out of 22 neural type were positive.
Three cases out of 38 syphilitic cases, (7.9%), showed a non-specific positive, while none of 19 tuberculous cases, none of 6 cancer cases, 2 of 10 pregnant cases and none of 40 healthy subjects showed this.
The high ratio found in pregnancy does not seem significant in the diagnosis of leprosy. The reaction was little affectated by therapy for the following 6 months on the contrary. Some cases showed an increased reaction.

抄録全体を表示

Acute infiltration is temporary exantheme which appeas in the course of lepromatous leprosy and is presented either in indeterminate or in polyneuritic case. Histologically epithe lioid cells and giant cells can be observed and the Mitsuda test changes from negative into positive. That appears in indeterminate case can be easily mistaken for borderline case and the cas of polynenric case takes place upon the part of old lepra cells (stainable by Sudan III), the one of indeterminate occurs from the place of newer lepra cells (stainable with Sudan black). Histologically it is consisted of every zone of epithelioid cells, lymphocytes, lepra cells and giant cells in the center and distinguishable from the acute aggravation by the presence of lepra cells. The change in such a case is nearer to fatty necrosis rather than tuberculoid.
The changes shown in giant and epithelioid cells certificated histochmically originated in the decomposed products of fatty acids and the absorption.

抄録全体を表示

The author examined the upper respiratory tract of the leprosy in-patients of the National Leprosarium Tama-Zenshoen during the period from 1938 to 1943 and also studied the histopathological changes of the autopsied cases of the leprosy of the larynx.
The monograph on the present author on "Leprosy of the Upper Re-piratory Tract" was destroyed while under printing by the bombing of Tokyo in 1943. Reported in the following is a part of the above monograph.
The author investigated the leprosy of the larynx of 973 leprosy patients (leprornatous type 711 cases, tuberculoid type 129 cases and neural type 133 cases) in respects of the rate and the time of the involvement, the part of predilection, symptoms and course of the disease.
Out of the 711 lepromatous patients including L1. L2 and L3, 460 cases (64.7% ) presented the lesions of some form in the larynx and the rate of the involvement was 96.6% for the highly advanced cases.
Tuberculoid changes in the epiglottis of the larynx were noticed in 7 tuberculoid cases (5.4%), one of which was confirmed to be free from tuberculosis on histopathological examination and animal experiment.
Paralysis of the laryngeal nerves was seen in 12 cases (9.0%) of the rteural leprosy. The larynx was involved, in the majority of the cases, during the 10 years period from the onset of leprosy and 55% of those occured within 6 years from the onset.
The initial lesion of the laryngeal involvement became manifest mostly in the epiglottis. Initial symptoms revealed as the congestion and the swelling of the epiglottis, arytenoids or vocal cords, but lasted generally only for several months being followed by recession to almost normal condition. After this apparently quiescent period of years, characteristic infiltration and nodulation developed in successive steps. Thus, it is the characteristic of the course of leprosy to present acute or subacute phase and spontaneous recession alternatively.
Nodules were frequently observed to occur around the entrance of the larynx and in the advanced stage they were observed in rosary shape.
Sometimes, plaques surrounded with red halo were noted to occur symmetrically on the arytenoid on both sides and to ulcerate superficially with relative Tepidity.
Diffuse infilti ations occur in the epiglottis, arytenoid as well as in the false and vocal cord. Infiltrated mucous membrane passes into dry and yellowing one and is covered with leukoplakia at the site of advanced hypertrophy.
Ulceration in the larynx was only observed in 9.4% of the total cases examined. Scar formation and constriction take place at the site of infiltration resulting in many kinds of distortions, e, g. backward inclination arid destruction of the epiglottis, stricture of the laryngeal tract.
Immobility of the cord rarely occurs in laryngeal leprosy, it develops the restrictiori of abduction of the cord as the result of the paralysis of m. posticus and, in more advanced cases, the fixation in the cadaver position of the cord owing to the paralysis of the recurrent laryngeal nerve which invites severe dispnoea.
The author confirmed, on a number of autopsy cases, the involvement of superior laryngeal nerve in all cases and that of the inferior nerve commonly in severe cases of the laryngeal leprosy.
In view of the above mentioned findings, the laryngeal dispnoea of the lepromatous leprosy is believed to occur as the result of the highly advanced infiltration and the paralysis of recurrent nerve owing to the lepromatous involvement.
As regard to the course of the laryngeal leprosy, lepromatous involvement frequently occurs during the period from 3 to 6 years after onset of leprosy, continual huskiness develops further 3 to 6 years after and the laryngeal stridor develops additional 3 to 6 years later.

抄録全体を表示

The material from the murine leprous rats administered with INAH, 4mg pro kg per os, daily, and total 51mg for 2 months, transplanted into rats. The second leproma was diluted and 0.5cc of the 10-4 suspension was injected into the subcutan of 40 rats. The Group I of 10 rats was administered per os with INAH 4mg pro kg, the Group II with 20mg, the Group III 40mg and the rest Group IV remained as the nontreated control. The results are as shown in Fig. and Table. In the Group I, as well as the control Group, the disease appeared, while, the 20mg and 40mg administration completely prevented the development of the disease. Namely, the bacillus presented the INAH-resistance against 4mg administration, but no resistance more than 20mg administration. This strain, however, produced the disease soon after the discontinuation of the administration, as shown in the Fig.
These above results are available upon the consideration of useful administration of chemical agents and mechanism of the resistance.

抄録全体を表示

This paper reports the simplest and the most exact judgement of the evolution of murine leprosy and selection of the adequate strain of mice after the subcutaneous inoculation.
The standards of judgement generally adapted up to now are valuation such as 1) the size of local leproma (weight an spread), 2) micro-and macroscopical changes in the lymph nodes and viscera and 3) distribution of bacilli in the various organs. As the results of our experiments, we aknowledged a proportional relation between the spread of local leproma and its weight, distribution of bacilli and the degrees of other changes. Therefore, when the spread is measured, the other two standards such as 2) and 3) can be neglected. The methods are presented in photopictures and tables.
Spread of leproma mark index 1-10mm² ⊥ 1 11-30mm² + 2 31-70mm ++ 3 71-mm² +++4
The experimental strains of mice are the following 10 strains, such as NA1, NA2, S417 (Osaka Junkeidobutsu Kenkyusho), DD (Takeda Pharmaceutical Institute), dbr, DBA, S (National Institute of Genetics), B (Nagoya University), SM (Tokyo Chuo Jikkendobutsu Kenkyusho) and non-pure strain (Gifu-ken, Japan). The highest sensitivity to the murine leprosy and the smallest individual variation are recognized in B strain, (GEN. CCSSaaBB, BW _??_ 16.23g±0.61, _??_ 17.02g±0.40, CHA. Black, small strain). The rests are dbr, S, S417, DD, SM, NA1, NA2, DBA in turn. But, nowadays, the large production of B strain animal is impossible and the mortality of dbr, S, S417 is high, therefore, we are obliged to employ NA1 and NA2 mice which have lower mortality and can be produced easily.

抄録全体を表示