鼠らい菌ハワイ株をddY系マウスに接種し,マウス体内の臓器等各部分に形成された鼠らい腫を電顕的に観察した。
その観察の対象は,軟口蓋,舌,肺,肝,脾,腸間膜,脂肪体,睾丸,足蹠,皮下であった。
いずれの鼠らい腫においても,各菌体あるいは菌の集団の周囲に,electron-transparent zoneを観察することができた。
菌の様相は,いずれの鼠らい腫でも短桿状あるいは桿状で概ね同じようであったが,足蹠に形成された鼠らい腫の中の菌体は,顆粒状になっているものが多く観察された。

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A total of 430 persons in the age group of 20-60 years atending the JALMA hospital were included in the present study. In the disease spectrum 200 were lepromatous patients, 100 were borderline, 80 tuberculoid and 50 controls. The patients were investigated for clinical, biochemical, electrocardiographic and radiographic involvement of the cardio-vascular system. The study revealed that the symptomatic involvement of cardiovascular system is highest in the lepromatous group (72.5%), p value <0.001, lesser in borderline group (67%) p<0.001, still lesser in tuberculoid group (12%) p>0.1 and least of (4%) in control group. Clinical signs of involvement of cardiovascular system were observed in (57.5%) p<0.001 in lepromatous patients, (49%) p<0.001 in borderline patients, (20%) p>0.1 in tuberculoid patients and (12%) in control group. The electrocardiographic examination also revealed the same trend i. e. (55%) p<0.001 abnormality in lepromatous cases, (49%) p<0.001 abnormality in borderline cases (18.8%) p>0.1 abnormality in tuberculoid cases and (8%) abnormality in healthy controls.

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This is a report of an autopsy case of untreated lepromatous leprosy with advanced le-promatous lesions in upper respiratory tract.
The patient was a 67 year-old male. The color of his face became darker in 1977. Hypoesthesia of extremities and loss of hair, eye blows and eye lashes occured at the same time. The swelling of the face increased and he became aware of hoarseness in the beginning of 1981. The general emaciation and hoarseness increased in the summar of 1981. The patient died of choking spell in November 1981. Clinical and histopathological diagnosis is LLP. B.I. is 6+.
The autopsy findings are as follows :
1) The root of tongue was infiltrated with lepromas.
2) Submucosa of larynx was infiltrated by dffuse lepromatous granulomas.
3) The normal structures of submandibular lymph node was completely destroyed and replaced by lepra cells.
4) Numerous microlepromas were disseminated in the liver (both in hepatic lobules and Glisson's capsule), spleen (both T cell and B cell areas), cortex of adrenal glands, and testes.

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I had a brief study on the occupation of the leprosy patients treated in Ghatampur and Etawah clinics which were established by JALMA in the rural area of Uttar Pradesh State, India. The purpose of the study was to analyze the occupation of L-type leprosy patients in the local society and to discuss the possibility of them as the important source of leprosy infection.
The number of the patients who were consulted for the study was 5, 573 (male 4, 632 and female 941) including newly registered patients then. The data were collected in the months of May and June of 1967. The patients were divided into four groups; male adult, female adult, boy and girl groups (both under 14 years old).
In the group of male adult, farmer occupied over 60% and labourer showed 16.6% which contained some percentages of the agricultural labourer. After all, over 70% of the male adult patients were agricultural workers. The high percentage of them would be due to the situation of the clinics which were opened in the agricultural areas.
In the group of female adult, about one third of them were agricultural workers. A large number of the patients were occupied in the house holding works.
In the boy group, 57% was student or school pupil and about one third had various occupations including 18% farmer and 7% labourer.
In the girl group, student or school girl was only 23% and 50% was doing house holding works. The percentage of reading girls was much lower than it of the boys.
Sixty percents of lepromatous patients in male group were farmers and 18.5% were labourers. In female adult group, a large number of lepromatous cases were occupied in house holding.
The person who may or must have a frequent and repeated contact with the people of the local society is shop-keeper or shop-master, greengrocer, tailor, barber, washer man and so on in village bazar and private servant, sweeper, aya (nursemaid) in home. The following person may have a fairly important contact with children; school teacher, driver of riksha, tanga or yukka by which a good number of children (especially more younger children) are going to school or kindergarten every day. These persons may give an important influence to children and babies from the point of the contageous infection of leprosy. Some of male lepromatous patients were occupied in these works in the society.
To decrease the infection of leprosy in the society, the enough treatment must be given to the lepromatous patients occupied in the above mentioned works especially in the early stage of the disease.
Further, to find out the disease as early as possible, the knowledge about the early signs of leprosy must be given to people of the local society through the public health education and only the repeated efforts in it will lead us to the early dignosis and early treatment' of leprosy.

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The mass examinations of in-patients of National Sanatorium Oshima Seisho-en were made in all in-patients except long out-stayer since March of 1982.
The objects were narrowed down to three points, finding out of latent disease, finding out of malignant tumor as early as possible, general grasping of health condition of inpatients.
The kinds of examination and the number of examined patients are as follows : routine examination of urine (protein, pH, suger, occult blood, acetone, sediment and urobilinogen); 415 patients, routine examination of blood (number of RBC, number of W BC, hematocrit and hemoglobin); 422 patients, CRP and ESR; 422 patients, biochemistry of serum (total protein, albumin, total bilirubin, direct bilirubin, indirect bilirubin, ZTT, total cholesterol, uric acid, urea nitrogen, alkali phosphatase, cholin esterase, LAP, GOT, GPT, γ-GTP and LDH); 425 patients, fraction of serum protein; 411 patients, lipid of serum (j3-lipoprotein, HDL-cholesterol); 393 patients, amylase of serum; 405 patients, ECG; 408 patients, blood pressure; 408 patients, stool examination; 342 patients, chest x-ray; 382 patients.
The gynaecological examinations by internal examination and smear test were made in 45 candidates.
Besides, pyelography by intravenous injection of 75% Urographin and cytodiagnosis of urine were made in 40 cases showing abnormal results (urine protein positive, over five erythrocytes in a microscopical field of sediment and over 10 leucocytes in a field) in routine urine examination, Indocyanine green-test in the cases showing high level of ZTT among liver function test, and blood suger tolerance test by oral administration of 50 gram of Toleran G in 26 urine suger positive cases. The measurement of insulin in blood was made in 8 cases in total. They are composed of 4 cases who were diagnosed as diabetes mellitus by blood suger tolerance test and 4 cases who were diagnosed as borderline positive cases. Results
The cases in whom some disease was found newly and immediate admission in sick-ward or treatment was requested were 9 in number, made up as follows ; a case of diabetes insipidus, 6 cases of anemia and 2 cases of dysfunction of liver.
The percentage of cases showing abnormality who need treatment or further investigation was 12 in routine urine examination, 13 in routine blood examination, 5 in urine suger test, 5 in serum lipid test, 14 in blood pressure, 10 in liver function test, 1.4 in bile duct test, 10 in kidney function test, and 12.5 in pancreas function test. The percentage of the cases who showed over 4 plus in CRP test was 3 and that of the cases who showed suspected plus to 3 plus was 27.3.
The percentage of cases who showed abnormality in gynaecological examination was 6.7, and they were suspected cases of chronic inflammatory disease.
The percentage of cases who showed abnormal finding in chest x ray photograph was 11. Among them only one case has active tuberculosis.
The percentage of cases who showed abnormality in ECG was 58, and when the cases who showed over 2 abnormality were added, it became 64. Among them, the percentage of suspected myocardial injury was 4, suspected block 18 and suspected coronary insufficiency 26. Among the cases having suspected myocardial injury, 2 cases had no clinical sign. Among the patients measured their blood pressure, the percentage of the cases whose maximum pressure was over 160 mm Hg was 27, and that of the case whose minimum pressure was below 95 mm Hg was 8. The percentage of the cases whose maximum pressure was over 160 mm Hg and minimum pressure was below 95 mm Hg was 4.
The cases who showed abnormality in the pelvis of kidney by pyelography was 18 among 40 (45%). No case was diagnosed as suspected malignant tumor by cytodiagnosis. Accordingly it was considered that the pyelographic findings of 18 cases were not caused by malignant tumor.

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Circulating immune complexes (CIC) were detected by Clq solid phase assay in 120 Japanese patients with leprosy and evaluated in relation to clinical activity, antileprosy agents, bacterial indexes and anti DNA antibodies.
Following results were obtained ;
1) The mean level of CIC in lepromatous, borderline and tuberculoid leprosy was high in comparison with those of control (Fig. 1.).
2) In lepromatous leprosy, the positivity and mean level of CIC had the tendency to increase with activity of clinical stage. Statistical analysis revealed the significant difference between p & r₁ and r₃ & q groups (0.02<P<0.05) but no significant difference between p & r₁ and r₂ (Fig. 1).
3) The incidence of CIC in B. I. (0) was 38.1% and that in B. I. (0.1-1.9) was 30.6%. The incidence in BI (2.0-2.9) and in BI (over 3.0) groups were relatively high, compared with BI (0) group. The mean CIC level of each BI varied almost parallel with the positivity of CIC. Maximum level of CIC was observed in BI (2.0-2.9), which was significantly different from BI (0) (p<0.01) (Fig. 2 and Table 1).
4) The effects of antileprosy agents on CIC level in inactive patients with lepromatous leprosy were studied but there were no significant differences in CIC level (Fig. 3).
5) Anti DNA antibodies, that is, anti single stranded DNA antibody, anti double-stranded DNA antibody and anti extractable nuclear antigen (ENA) antibody, were determined by radioimmunoassay in lepromatous and tuberculoid leprosy. A significant increase of anti ENA antibodies was found (Fig. 4).
6) Correlation study between CIC and appearance of some anti DNA antibodies suggested anti DNA antibodies dib not play the significant role in the pathogenesis of leprosy (Table 2 and Table 3).

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An experiment on symbiosis of M. lepraemurium with M. leprae in vitro was carried out, and the results obtained were as follows;
1) The growth of M. lepraemurium was extremely inhibited by addition of a suspension of M. leprae. This inhibitory effect of M. leprae was reduced when the suspension of M. leprae was diluted at about 100 times and was heated, as well as when cultivation period was prolonged.
2) The growth of M. lepraemurium was also inhibited by addition of a high concentration of normal mouse liver extract, but was slightly stimulated by a low concentration of the extract.
3) The growth of purified sample of M. lepraemurium was superior than that of crude material.
4) Calf serum enhanced the growth, compared to albumin, but morphological features of the grown bacilli in the medium using albumin were more solid than that in the medium containing calf serum.
The results mentioned above might suggest the presence of natural inhibitors in a suspension of M. leprae, in normal subcutaneous tissues and infected tissues with M. leprae-murium and in calf serum. In other words, it could be presumed that M. leprae as well as M. lepraemurium might be strongly sensitive to natural inhibitors, and this fact should be considered as one of the important factors in M. leprae and M. lepraemurium cultivation experiments.

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