Effect of vitamins on the growth of M. lepraemurium in different kinds of cell-free iquid media improved from NC-5 and ND-5 were investigated, and the results obtained vere as follows; the growth of M. lepraemurium were stimulated by addition of vitamin 36, B12, H1 (PABA) and K3 at the concentration of 200υg, 0.4υg, 120υg and 0.005υg/ml, espectively. A slight stimulating effect was found in vitamin-C, E, H (Biotin), K5 and M, whereas no effect of each vitamin B1, L (ortho-aminobenzoic acid), and P was recognized.

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Effect of amino acids on the growth of M. lepraemurium was investigated and the results obtained were as follows:
1. The growth of M. lepraemurium in cell-free liquid medium was markedly stimulated by DL-aspartic acid at the final concentration of 0.02%.
2. A slight growth stimulating effect was found in each case added with glutamate, glycine, histidine, isoleucin, proline, serine, tyrosine, and rnithine, respectively.
3. No any effect was recognized in the cases of alanine, arginine, glutamine, leucine lysine, methionine, phenylalanine, threonine, tryptophane and valine.

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There is a very rare case of triple cancer among the autopsy cases during 1980 in National Leprosarium OKU-KOMYOEN. The case is reported in this article. The patient is a sixty six years old male, whose disease became manifest at twenty two years age. His lepromatous leprosy was treated with Chaulmoogra oil, Promine, TBI and Promizole from twenty five to thirty nine years age and became quiecent. His leprosy was quiecent till his death, and was confirmed in the regular examination.
At the time of death, his diseases were diagnosed as renal insufficiency, hepatitis, severe anemia, coronary insufficiency, and the cause of death was bronchopneumonia. He had chronic nephritis, hypertension, enlarged heart, myocardial disturbance, pulmonary tuberculosis and repeated plantar ulcer in his past history.
Final diagnosis after the autopsy are as following; triple cancer (renal cell cancer, pancreatic head cancer and prostatic cancer), high grade myloidosis, old pulmonary tuberculosis, old lepromatous changes and miscellaneous changes.
Incidence of multiple malignant neoplasma was getting higher during these last few years. But there is neither any case with the same combination as this case nor any reported leprosy case with triple cancer as this case with severe amyloidosis. The review of tendency of incidence of triple cancer is added in discussion of this report.

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This is a report of tracheobronchopathia chondro-osteoplastica (TBCO) in a fifty five year old male leprosy patient (TN) who complained of the feeling of foreign body in his larynx for a long time. This is the first report of TBCO with leprosy. The case showed marked amyloidosis in the thyroid, kidney and wall of small blood vessels in various organs. The thyroid finding was the most striking and showed several foreign body giant cell reactions in these amyloid degenerated areas. The case showed also a peculiar heterotopic thyroid nodule (20g weight) in the right anterior neck which separated completely from the proper thyroid lobe. The heterotopic thyroid nodule showed no amyloid degeneration. We discounted the relationship of the amyloid degeneration and TBCO.

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Recently much attention has been focused on many neuropathies, of which some problems will be discussed.
1) Some degenerative neuropathies including Dejerine-Sottas disease, Von Rechling-hausen disease etc. have similarities with leprosy in regard to tumorous swelling of the peripheral nerves. Since some neurinomas can be detected by X-ray and accoustic neurinoma can be demonstrated as positive shadow by CT scan, a new objective evaluation of swollen nerves should be eagerly looked for, from our experience it is quite hopeful.
2) Guillain-Barre syndrome is regarded as an allergic neuritis. Some evidence for that is found in experimental allergic neuritis (EAN). Some humoral factors can also be found in these patients with G-B syndrome. Therefore some immunological processes play an important part in the pathogensis, like leprosy. We found a humoral factor in the serum of lepromatous leprosy which induced nerve damage in animals. The biopsied nerve of sarcoid neuropathy revealed granuloma in it, which is quite similar to that of tuberculoid leprosy.
3) Herpes Zoster is induced by exacerbation of persistent varicella-zoster virus in ganglia. In fact lymphocyte infiltration could be found in 20% of the trigeminal ganglia in autopsied cases which suggests the latent presence of herpes virus. The onset of herpes zoster depends on the immunological situation of the host. This pathogenesis also has some similarity to leprosy.
4) In some toxic neuropathies, the lesion of sensory receptor organs play a part in the pathogenesis of dysesthesia. This mechanism is also true in skin leprosy with patchy sensory loss.
5) PEP syndrome (pigmentation, edema, polyneuritis & plasma cell dyscrasia) which is now prevalent in Japan, is now suggested to be induced by some biogen active substance which is excreted from osteosclerotic bone. In some reports concerning humoral factors, leprosy may have some common mechanism with PEP syndrome.
6) Vitamin B dificiency is one of the neuropathies. We found a resurgence of beri-beri here and confirmed it to be due to thiamine deficiency. Nowadays the vitamin B group is not only effective to vitamine B deficiency but also has some pharmacological effect. In leprosy, methyl B12 was found to be quite effective for the treatment of neuralgia.
7) In leprosy we found some vascular change by angiography. In this regard some ischemic neuropathies including collagen diseases, vasculitis and diabetic neuropathies have some common mechanism with leprosy.
From these observations, it can be regarded that leprosy has a common mechanism with each type of neuropathy. Therefore as our conclusion leprosy should be the most cardinal thema in the study of neuropathies.

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