日本らい学会雑誌
Online ISSN : 2185-1360
Print ISSN : 0386-3980
ISSN-L : 0386-3980
46 巻, 4 号
選択された号の論文の3件中1~3を表示しています
  • III らい腫型における急性浸潤反応
    滝沢 英夫
    1977 年 46 巻 4 号 p. 139-146
    発行日: 1977/12/30
    公開日: 2008/02/26
    ジャーナル フリー
    This is a report of lepromatous cases with acute infiltration reaction (Tajiri) in his clinical course under chemotherapy. They were all males, among whom one case showed localized skin lesions and other two cases had generalized lesions upon admission. Skin biopsies revealed all borderline-lepromatous features (Ridley-Jopling's classification). This reactions developed one and half to 4 months after the start of treatment, and lasted 9 months to two years intermittently. After this reaction the Mitsuda rection test gave the same result as before in one case, but other two cases became weakly or modelately positive. Bacterial Clearance Time (Takizawa) was 2.7, 4.3 and 5.9 years, respectively.
    The nomenclature and the nature of this reaction was discussed, especially with relation to chemotherapy.
  • らい化学療法協同研究班
    1977 年 46 巻 4 号 p. 147-158
    発行日: 1977/12/30
    公開日: 2008/02/26
    ジャーナル フリー
    Almost thirty years went by since the chemotherapy of leprosy had been introduced in Japan. At present, it is one of the most important problems for us how control the cases of the so-called persistently bacillary positive cases which are found in lepromatous leprosy.
    At the first step to dissolving this problem, we tried, from clinical side, to make clear the standard bacillary clearance time (BCT, Takizawa)6) of the patients which were treated in the past. We had organized a co-operative research team among leprosaria and two medical faculties of universities in Japan to collect the results of the past chemotherapy of leprosy.
    We made a preliminary investigation on the new cases of which treatments were started from 1957 to 1963. The number of the cases is listed in Table 1. Among these cases, the main detailed investigation was performed on 367 cases, and finally on 263 cases of lepromatous and borderline cases in which past bacillary indices were well arranged. For lepromatous cases, we divided three grades according to the extent of the eruptions, those are L1 L2 and L3, as shown in Fig. 1. In the main investigation, we collected the records on transition of bacillary indices, kind of the drugs, their doses regularities, grades of ENL and som factors which we shall referred later.
    Practically, the descending line of bacillary indices (B. I.) in the course of chemotherapy takes the polygonal line which is shown in Fig. 2. This might depend on variety of the technic and portions of taking smear. We adopted the highest values of B. I. through a year and showed them with Ridley's B. I. scale. As an indicator of judging negativation of the bacilli, we adopted the first point of becoming negative and remained so at least more than one year, following Takizawa's adovocation as bacterial clearance time (BCT)6).
    We calculated BCT of each group, divided according to the types and grades of the disease and kinds of drugs which were administered, as shown in Table 2.
    The ranges and the mean values of each group are diagrammed in Fig. 3.
    As we can see in Table 2 and Fig. 3, the number of L3 (diffuse or papulo-nodular) treated with Promin and DDS was most numerous. Therefore, taking this value as a standard, we compared it with others. The results of this comparison are also shown in Table 2.
    We calculated the estimated equation with Rao's method7) for each group and diagrammed in Fig. 4. From this calculation, we take the BCT value of L3 (diffuse or papulo-nodular), namely 6.91 (about seven years) as the standard BCT and we constructed the longest limit of BCT in the ususal lepromatous cases by chemotherapy as 6.91+1.92×2=10.85 years.
    Then we made multiple regression analysis for estimating BCT from some values of B. I.. But the result was not always satisfactory for practical use as shown in Table 3.
    Finally we studied to find correlation BCT and some factors which might give some influence upon BCT. No correlation or significant difference was found between BCT and time of appearing eruptions before the start of the treatment, lepromin test at the start of the treatment, presence of the same disease in the family, and age of the patients at the start of the treatment, respectively. However, as shown in Table 4, occurence of ENL prolonged BCT significantly. The comparison of BCT between male and female also revealed significant longer BCT in female than in male, contrary to our expectation. In fact, the female cases in our observation had a tendency to comlicate ENL more frequently, compared with male cases. But we could not make it clear statistically by the lack of materials. Further observation shall be expected.
  • 佐々木 紀典, 福島 和子
    1977 年 46 巻 4 号 p. 225-233
    発行日: 1977/12/30
    公開日: 2008/02/26
    ジャーナル フリー
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