The isolation frequency of cultivated acid-fast organisms from nasal washings of leprosy patients was 90.0% by the method that has been reportedl1).
The present communication describes the experience whether the organisms produce virulence in experimental animals or not.
The cultivable organisms of Mycobacterium sp. I strain isolated from nasal washings of the patient with lepromatous leprosy were suspended in strile saline solution on the living condition. Then, the suspension was inoculated subcutaneously, intraperitoneally and into foot-pads of rabbits, guinea-pigs and mice.
The organisms did not produce progressive lesions in any partes of used experimental animals macro-and micro-scopically.
However, in case of inoculation into mice foot-pads, the acid-fast organisms similar to leprosy bacilli were observed in the inoculated sites, and these organisms seemed to multiply in numbers.
The organisms harvested from infected foot-pads of mice were tried to be cultivated onto the egg-yolk media, but there was no growth of acid-fast organisms.

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The observations reported here are concerned with the cyto-morphological studies on the cellular organelle of Mycobacterium lepraemurium (Hawaiian strain), and the capsular structure around the bacilli in the host cells.
As the peripheral parts of the bacilli, the capsular structure, the cell wall and the cytoplasmic membrane were clearly observed.
In the cytoplasm of the bacilli, two kinds of typical organelle, that is, the intracellular membranous organelle and the electron dense or homogenous granules were generally found.
The large electron dense and homogenous bodies were found in murine-leproma cells, and there were the small electron dense granules in these bodies.
In the cell division process, the division site on the surface of cell wall became weakly, and then the cytoplasmic membrane, adjacent to this wall site, distorted towards the center of cytoplasm. Thus, the septum formation occurred and some of intracellular membranous organelle arranged parallel to the edge of septum. These membranous organelle, at this time, seemed to play a role in the cell division process.
After the construction of cross wall (septum), the old wall around two new halves of the new cell was separated and released from new cell wall.
These disrupted old walls seemed to remain meanwhile as a thin layers, and then to become amorphous substances.
From the facts mentioned above, it could be explained that the capsular structure around M. lepraenzurium was mostly originated from bacterial side.

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The name Lingular Disease, 10) 19) regardless of etiology, altogether with the middle lobe syndrome11)12)13)14)15)16)17)18) is suggested to be included in the middle lobe disease20)21) and is for all cases of atelectasis and pneumonitis which are not caused by active tuberculosis or by neoplasm. While conceivably some cases might have been caused originally by tuberculous lymphadenitis in the earliest time, the sequential pneumonitis later in life is non-specific and not distinguished from pneumonitis brought about by nontuberculous lymph nodes or by mucus plugs and poor drainage. Lingular Disease10)19) can thus be defined as characterized clinically by hemoptysis, blood-tinged sputum and recurrent episodes of pulmonry infection and pathologically by atelectasis, fibrosis and bronchiectasis and is occasionally made an erroneous diagnosis as pulmonary tuberculosis, chronic bronichitis, bronchial asthma, cardiopathy and neuropathy, 16, 18) in spite of its characteristic and peculiar roentgenological appearance.
For aught we know, this disease has not been previously described in the Japanese literatures, except one introduction of its conception, 16) though this disease is never rare. The primary aim of the repart is not to impart knowleoge but to increase understanding concerning the dignity of human life and reverence to more advanced medicine.

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Since 1912, when Murata first described this syndrome called Erythema Nodosum Leprosum (ENL) as a clinical entity, we have had so many papers on ENL. The characteristics of ENL, which were clinically observed on 177 patients with lepromatous leprosy, could be arranged as follows;
1. ENL is essentially the manifestation of antigen-antibody reactions and occurs in the pure and near lepromatous patients. But some of lepromatous cases (49.4%) escape ENL in their course.
2. This condition usually starts several months to 24 months after treatment begins.
3. ENL can be graded as slight, moderate or severe in degree. This condition is definitely more frequent and more severe in clinically more advanced, more mature cases than in those with slight lesions.
4. Although ENL has become much more common since the initation of sulfone therapy, it can be caused by other antileprosy drugs including chaulmoogra oil. 5. As far as bacterial negativity is concerned, prognosis of patients with severe ENL is not always worse than that of the patients without ENL.
6. We have tried to notice previously the occurrence of ENL in the lepromatous patients. Twenty three cases of 34 new cases (68%), who took the serologic test for syphilis (STS), showed positive STS at the start of chemotherapy. These biological false positive cases of STS were confirmed by RPCF and TPHA. There was only one case who showed latent syphilis. The correlation between the occurrence of ENL and the positive STS in the lepromatous cases was statisically significant.
7. The Leproagglutination (Ogata)6), which has antigen made from cardiolipin and lecitin (1: 1) was shown in this paper as a more useful test for ENL. The lepromatous cases with positive Leproagglutination test in serum dilutions of 1: 64 or greater before chemotherapy were apt to have episodes of ENL in their clinical course (p=0.01).

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感染マウス足底より調製されたらい菌浮遊液にリファンピシンを2mg/mlの割合に混じて4分し,一半は4°Cに,他半は30°Cに60分間保ったのち,それぞれの一つずつをHanks液でよく洗浄した。これらの4種の前処置を施したらい菌をマウス足底内に接種してリファンピシンに直接曝露したさいのらい菌の増殖能を検討した。
リファンピシンに曝露後洗浄せず,そのまま接種したさいには,供試曝露温度による差はみとめられず,らい菌は全く増殖しえなかった。4°Cの低温で前処理したのち洗浄した場合には,らい菌はリファンピシンの影響をうけておらず,対照と同様の増殖パターンを示したが,前処理温度が30°Cの場合には洗浄したにもかかわらず,かなりの発育遅延がみとめられた。
洗浄しない場合は勿論,たとえ洗浄しても,菌液中のリファンピシンはおそらく菌に付着して,マウス足底内接種後も暫時その増殖能にある程度の影響を与えると考えられるが,今回の実験における30°C洗浄菌の発育遅延は,リファンピシンの継続効果というよりはむしろ30°Cでの孵置中にその致死作用をうけたためで,静止状態(4°C)の菌にはその作用が及ばなかったものと推測される。

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癩研究の進展にとり,癩菌の培養と共に,その動物移植の達成が強く要望されたことは当然であり,漸く1960年にShepardのマウスfoot pad法に解決の手がかりが得られ,さらにReesらにより胸腺剔出, X線照射など免疫能発現抑制処置動物において著明な増菌と病変が報告された。
一方,近年先天性胸腺欠損ヌードマウスが免疫異常動物として,細胞免疫を担うべき胸腺細胞が誘導されず,従って感染抵抗性の減弱,自己免疫現象の促進,異種組織の移植に対する拒絶反応の消失など,細胞免疫不全が知られている。ために通常の飼育では諸種の感染症により早期に死亡するが,これを無菌若しくはSPF条件下で飼育すると長期生存が可能であるとされている。
そこで,このヌードマウスに癩菌を接種し,ビニールアイソレーター内でSPF飼育,観察することを計画し,1974年7月11日に実験を開始した。マウスは5週齢ヌードマウス(BALB,/c-nc/nu)を実中研より購入し,8匹を実験に供した。また対照としてKKマウスを加えた。
癩菌浮遊液は再燃患者結節より調製,1.0×104/0.03mlを右側後趾足蹠内に注射し,アイソレーター内で飼育した。飼料,飲料水などアイソレーター内に搬入するものはすべてオートクレーブで滅菌済みのものである。一方KKマウスは同様に注射し,普通飼育を行った。飼育室温度は20℃～25℃である。
成績:ヌードマウス8匹のうち,早期に死亡した2匹を除き,6匹が実験の対象になった。接種8ヵ月後の剖検において,2匹の足蹠部からそれぞれ3.5×105,4.6×105の菌数が算えられ,とくに前者では右ソケイリンパ節の塗抹標本に200個近い抗酸菌が検出された。さらに13ヵ月後死亡した1例では,2.6×106以上の菌が算えられたほか,組織片に混在して無数の菌塊が認められた。同時に左右のソケイリンパ節および肝臓の塗抹にも抗酸菌が見出され,足蹠内における経時的な増菌と全身性感染の可能性が示唆された。17ヵ月に至り,生存した3匹の菌接種足蹠に肉眼的腫脹が認められ,このうち2匹は尾根部に潰瘍を,2匹には眼瞼の腫脹が同時に見られた。3匹をそれぞれ17ヵ月,19ヵ月および22ヵ月目に剖検したが,3例はともにほぼ同程度の病状を呈し,肉眼的病変部よりの塗抹標本には無数の抗酸菌が見出きれた。病理組織学的検査において,足蹠の腫脹部は抗酸菌を充満せる癩細胞と空泡細胞からなる癩腫様病巣の所見を呈し,加えて眼瞼,耳介および尾など低体温部への転移病巣がみられたほか,リンパ節,内臓にも抗酸菌が見出された。とくに足蹠病変部の末梢神経はもとより,大腿部経骨神経および腓骨神経への菌の侵入と増殖が顕著であった。血管壁の肥厚と血管腔内の菌の存在も観察された。
ヌードマウスの全身性に生じた病巣部の抗酸菌が,はたして接種された癩菌の増殖によったものか否かを調べるために,病巣部より分離した増殖菌について同定試験を行い,以下の成績を得た。1) 小川培地で集落の形成なし,2) 普通マウスに増菌像が認められない,3) ピリジン処理により,抗酸性が失われた,4) D-dopa oxi-dase活性陽性,5) レプロミン反応はL型に陰性,T型に陽性。以上の結果から,増殖菌は癩菌の性状をもつことが確かめられ,このことはヌードマウスの足蹠内に接種された癩菌が,その局所で増殖し,接種局所のみならず全身性に癩腫癩病巣を生ぜしめたことを示した。
今回の研究は,ヌードマウスが胸腺剔出およびX線照射動物あるいはアルマジロによる実験癩以外の新しい実験動物癩のモデルの確立を示めしたものであり,ヌードマウスの利用は,今後の癩の化学療法および免疫学を一層発展せしめるものと期待される。

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