Drug sensitivity was examined using semi-synthetic liquid media on two strains of M. leprae isolated from nodules of L-type leprosy patients. The results revealed that L-Ju1-74-1 strain was sensitive to both DDS and Rifampicin, and L-Feb-75 strain was senstitive to all of DDS, Rifampicin and Isoniazed. According to the informations of the leprosaria, to which the host patients of these strains belong, the adiministration of DDS to the former case and Rifampicin to the latter, respectively, resulted in the rapid and remarkable improvement of clinical symptomes, in good agreement with the above mentioned test results. It was revealed, further, that the drug sensitivity of M. leprae could be determined by this in vitro test method as early as about 3 months' incubation at 37°C. Drug sensitivity test using liquid culture media will facilitate the selection of adequate drugs to be administered to the concerned leprosy patients.

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Historical review of chemotherapy in the treatment of leprosy reveals a gradual transfer from a purely empirical approach to a more rational one.¹⁾²⁾ A long and futile search for anti-leprosy agents has at last given rise to an extensive and systematic research method, which, in turn, led to the discovery of the present standard drug^3)4)5)6), resulting in having brought about essentially quantitative and qualitative changes not only to leprosy therapy but also to the leprosy patients themselves.
As a result, the leprosy patients in Japan have become possible to live so far as advancing age, having increasing elderly diseases, especially circuratory ones. In the standpoint of the above-mentioned fact, an electrocardiographic study was performed on 42 leprosy patients, the following results being obtained.
1) Neither congenital affections of the heart nor idiopathic myocardosis was found.
2) The abnormal electrocardiographic findings seemed to be subject to the age, blood pressure and type of the disease.
3) It seemed that there was relationship between the abnormal electrocardiographic findings and nervous injury.
4) The most remarkable findings were changes of STsegment and Twave.
5) The cases with nothing but right, left and bilateral ventricular hypertrophies were little found.
6) The cardiopathy should not be diagnosed only by means of electrocardiograms.
The other primary aim of this report is not impart knowledge but to increase understanding for the purpose of formulating rational and consistent attitudes and approaches to the problems as a whole and provide the basically necessary foundations on which future studies may proceed and on which treatment may be integrated most effectively into the program for the leprosy patients here who will be more and more aged.¹⁶⁾

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An annual chest mass survey for Pulmonary Tuberculosis was performed on all the patients at this leprosarium in the year of 1975, the results obtained were as follows:
1) The number of the patients having abnormal tubercular X-ray findings, including the calcification of the hilar nodes and/or lung fields was 85.69%.
2) Stable and non-cavitary tuberculosis viz. V-type and IV-type were 75.74% and 0.81% respectively.
3) Unstable cavitary tuberculosis, namely, II-type was 3.13% in the male and 0.4% in the female.
4) Therapy should be applied more concentratedly to the cavitary tuberculosis.
5) In comparison with the number of the dead tuberculous patients about four years ago, no Hansenian patient here has died of pulmonary tuberculosis since that time; therefore the chest mass survey here is successfully on the high road of well-controlling of pulmonary tuberculosis in this leprosarium.
Nevertheless, more efforts are positively necessary for the better treatment of pulmonary tuberculosis in order to eliminate the cavitary pulmonary tuberculosis.

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Illustrating 12 cases of nontuberculous adults having compression of the middle lobe bronchus by enlarged lymph nodes, Graham, E. et al. first introduced the conception on the middle lobe syndrome into medicine in 1948. Katz, L. H., for the first time, described the relationship between Graham's syndrome and traction diverticula of the oesophagus in 1952, notwithstanding the previous reportors about the oesophageal diverticula. Kunigoshi, U. first here in Japan recognized Katz's fact in 1955. Rosenman, E., on the other hand, reported an article entitled "Acute, Transient Middle Lobe Disease" in 1955.
In the light of Graham's syndrome, Katz's report, Kunigoshi's one and Rosen-man's disease, the conception of the middle lobe syndrome has to be revised and newly defined as follows:
Graham's syndome has to be summarized in Rosenman's disease: that is a group of the diseases which is characterized clinically by hemoptysis and recurrent episodes of pulmonary infection and pathologically by atelectasis, fibrosis, bronchiectasis and/or bronchostenosis after Rosenman's disease has already become irreversible and chronic and which is with peculiar roentgenological appearance easily overlooked, sometimes the formation of oesophageal diverticula and/or displacement and is occasionally made an erroneous diagnosis as neuropathy, cardiopathy or bronchial asthma due to the patients' unexplainable complaints.

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