日本らい学会雑誌
Online ISSN : 2185-1360
Print ISSN : 0386-3980
ISSN-L : 0386-3980
57 巻, 4 号
選択された号の論文の6件中1~6を表示しています
  • 第5報 外来患者についての統計的観察
    阿部 正英, 皆川 文重, 吉野 勇次, 小沢 利治, 斉藤 七子, 大沢 佳子, 犀川 一夫, 馬場 省二, 井手 二郎
    1988 年 57 巻 4 号 p. 171-185
    発行日: 1988/12/30
    公開日: 2008/02/26
    ジャーナル フリー
    One hundred and seventy-four outpatients attending the skin clinic in Naha or Miyako were surveyed by the same methods as those used for the inpatients in the first report of this series. As the age-distribution of outpatients was significantly deviated from normal distribution, Kolmogorov-Smirnov's test was used for statistical examination of their age, age at onset, years after onset and period of contact with consanguineous patient accrding to the subgroups classified by personal and family histories and clinical findings. The results were shown in Tables 1-5. Average age of the patients at home after the onset was significantly lower than that of the discharged cases, but the latter was also lower than that of inpatients. Average age of outpatients showed signi-ficant difference according to presence or absence of consanguineous patient, classification (form) of leprosy and living place, but not according to the other findings. Average age at onset was also significantly different between two subgroups with or without consanguineous patient, the result being similar to those of inpatients. Average years after onset of outpatients were significantly different according to the form of leprosy and its stage. However, average period of contact with consanguineous patient was not significantly different among the subgroups classified by consanguinity and leprosy form of index case, the fact being discrepant from that of the inpatients.
    A correlation between two items or a comparison of two or more percentages among the subgroups was examined by chi-square test, as shown in Tables 6-17. Male patients were more frequently found in Yaeyama and other islands than those in Main Okinawa and Miyako islands. No difference by sex was found in the other subgroups. The outpatients with lepromatous leprosy were more frequently found in the discharged cases than those at home, in Yaeyama and other islands than in Main Okinawa and Miyako islands, and in physical workers than in brain workers. The skin eruption was more fre-quently found in progressive and retrogressive stages than in quiescent and arrested. However, the frequencies of fall of eyebrow and nose involvement were significantly less than those of inpatients and not significantly different among the subgroups classified by sex, form and stage of leprosy of outpatients.
    On the other hand, the frequency of the enlargement of peripheral nerve was not significantly different between in- and out-patients but significantly higher in male than in female. The other neural symptoms such as claw hand, drop hand or foot, facial palsy and lagophthalmos were far less frequently found in the outpatients than in the inpatients, but the frequency of these symptoms showed no significant difference among the subgroups of outpatients as described above. The percentage of outpatients under conti-nuous treatment was significantly higher than that of inpatients. Nearly 62% of outpa-tients was bacteriologically negative (BI= 0). This percentage was not significantly different from that of inpatients, but significantly different among the subgroups classified by leprosy form, stage and complication.
    Based on these findings, it is concluded that relatively mild cases with leprosy and those at early stage were more frequently found in the outpatients than in the inpatients and that because of this mildness they might be suited to the treatment at a skin clinic. The results also suggest that the appearance of mild leprosy may be more strongly influenced by post-natal and empirical conditions than by genetic and physiologi-cal factors.
  • 中村 一成, 與儀 ヤス子
    1988 年 57 巻 4 号 p. 186-190
    発行日: 1988/12/30
    公開日: 2008/02/26
    ジャーナル フリー
    ヌードマウスの遺伝的背景の遺伝子が異なるとらい腫らい病巣の形成能も異なることを始めて明らかにし得た。すなわち,スイス系で純系であるNFS/NヌードマウスはoutbredのN: NIH(s)ヌードマウスと同様,らい腫らい病巣の形成が高く,感受性能が良好であったのに対し,同様にスイス系であるoutbredのJcl:1CRヌードマウスおよびCrj: CD-1ヌードマウスはいずれもらい腫らいの形成能は軽度でらい菌に対し"抵抗性"であった。しかしながら,Jcl: ICRより分離・系統化されたNODマウスにCrj: CD-1(1CR)のヌード遺伝子を導入した雑種ヌードマウスはらい菌に高い感受性能を有することを明らかにし得た。
    そこで本報では,NFS/NおよびN: NIH(s)ヌードマウスの雄を用いてのクロスインタークロス方式により雑種ヌードマウス(M1)を作出した。一方,クレアではJcl: ICRマウスより分離・系統化したIAIと雄のNFS/Nヌードマウスとの雑種ヌードマウスJcl:AF-nuを開発市販しているので購入し,らい菌に対する感受性能をそれぞれ検討したところ,らい腫らい病巣の形成能が高いことが判明した。この知見は,既報のICRラザットマウスを作出する過程で得られた同胞ヌードマウスが,らい菌感受性能がよいこと,さらにヌードラットでも遺伝的背景が同じウイスター系であるのにSHR雑種ヌードラットはらい菌感受性能が高いのに対し,WKY, WM,あるいはLOU/N雑種ヌードラットでは感受性能が低いことを解明し得たことを考え合せると興味ある免疫遺伝学的知見と考えられる。従って,今後さらにらい菌感受性能あるいは"抵抗性"の遺伝的解析を続行し,その生体防御の機能を究明してみたい。
  • 與儀 ヤス子, 中村 一成
    1988 年 57 巻 4 号 p. 191-198
    発行日: 1988/12/30
    公開日: 2008/02/26
    ジャーナル フリー
    先天性無脾無胸腺(Lasat)マウスおよび生後4週齢で脾臓摘出を実施した数系統の先天性無胸腺(ヌード)マウスの右後肢足内と右上唇内のそれぞれにらい菌を接種して,それらのらい菌感受性について検討を行った。先天性無脾無胸腺マウスと脾摘出無胸腺マウスのいずれにおいても,それらの対照に比較して良好な感受性が認められた。加えて,脾摘出無胸腺マウス間では系統差がみられ,別報(4)で高感受性であったNFS/N, C3H/HeN+MTVとCBA/N無胸腺マウスでは,脾摘出によってさらに感受性が増強された。組織の萎縮を伴う高度に異常な奇形肢,足,趾を呈する先天性無脾臓マウスの後肢奇形足内でのらい菌の増殖は困難であったのに対して,先天性無脾無胸腺マウスの場合は,重篤な奇形肢,足,趾内でもらい菌の増殖は可能で,骨髄に及ぶらい菌増殖像が観察された。さらに先天性無脾無胸腺マウスには,後肢,足,趾奇形度に伴う接種足腫脹の個体差に加えて,らい菌接種後後期に腫瘍の発生が出現する個体がみられ,それらの個体ではらい病巣が抑制された。得られた所見から,らい菌に高感受性の遺伝的背景をもつ先天性無胸腺マウスにDh/+遺伝子を導入して新たな先天性無脾無胸腺マウスを作出すれば,さらにらい菌に対して高感受性の実験モデルマウスが作出できるものと思われる。
  • 石田 裕, 小原 安喜子, 吉野 美重子, 原田 禹雄
    1988 年 57 巻 4 号 p. 199-204
    発行日: 1988/12/30
    公開日: 2008/07/09
    ジャーナル フリー
    This article reports that a 60 year-old Korean male patient suffered from the type 1 lepra reaction of which the dominant manifestation was peripheral neuritis accompanied by secondary diabetes mellitus and hypothyroidism.
    The patient has been hospitalized in National Leprosarium Oku-Komyoen since 1945, his case being diagnosed as lepromatous leprosy in 1944. As the result of the regular treatment, such as injection of Chaulmoogra oil and the following sulfone therapy, the skin lesions had been clearly absorbed by 1949. The patient, therefore, was regarded as a clinically cured case and the dapsone treatment had been regularly continued afterward till 1987.
    About 6 years ago, the patient noticed drop foot which appeared insidiously on his left foot without neuralgia.
    In October 1987, the patient began to suffer from left sciatica followed by neuralgia, sensory disorder and motor palsy on bilateral hands and the left of the face.
    In January 1987, his blood sugar level went up to 520mg/dl, and it is considered that it resulted from secondary diabetes mellitus. We administrated insulin to him. After three months, blood sugar became normal. But symptoms of hypothyroidism were obse-rved in April; manifesting general fatigue, chill, anorrhexia, loss of body weight, constipation and so on. And besides he presented the ophthalmological symptom of iridocyclitis at the same time. Thyroid hormone was administrated. Symptoms of hypo-thyroidism have almost disappered now (August, 1988), though he has not recovered from his neural palsy yet.
    In this case, neuritis, and iridocyclitis are thought to be due to the type 1 reaction, judging from the facts of the positive conversion of lepromin reaction (Mitsuda) and change of MLPA from negative to positive. Secondary diabetes mellitus and hypo-thyroidism subsequent to peripheral neuritis are also thought to be closely related with the immunological response associated with the type 1 lepra reaction, though the me-chanism is still unknown.
  • 森 龍男
    1988 年 57 巻 4 号 p. 205-212
    発行日: 1988/12/30
    公開日: 2008/02/26
    ジャーナル フリー
    Since all of catalase, peroxidase and cytochromes a and c have not been detected in Mycobacterium leprae, the cultivation of this pathogenic acid-fast strain is presumed to be impossible especially under aerobic condition. In this reason the supplementation of these defected enzymes was planned by introducing DNAs from cultivable acid-fast strains, which have all of these defected enzyme activities. As a model experiment, the introduction of SM resistant DNA into SM sensitive M. smegmatis was examined to verify the transformation. High voltage cell processor, freezing and thawing, and that combined with contusion shock were mutually compared in introducing DNA from cracks becterial cell wall, because the formation of a spheroplast was unsuccessful in M. leprae.
    All the experimental results were negative. Many negative results have been seen in transformation of mycobacteria. Still more Mizuguchi also said that no genetic expression was detected in purified DNA transformation, even though positive in bacterial mating system such that arginine and methionine requirement could recover by the mating. Mycobacteria may destroy the purified DNA introduced from outside. There-fore, it was presumed that the purified DNA should be introduced to the recipient ba-cillus after integrated to bacteriophage DNA. Just then, at the 23 th U. S.-Japan Joint Conference Leprosy Panel in 1988 Jacobs reported that kanamycin resistant DNA which was inserted into the DNA of lysogenic bacteriophage L1 was expressed in M. smegmatis 607 strain.
  • 野間口 博子, 松岡 正典, 宮田 泰代, 執行 祐爾, 高坂 健二, スボオ , 伊藤 利根太郎
    1988 年 57 巻 4 号 p. 213-217
    発行日: 1988/12/30
    公開日: 2008/02/26
    ジャーナル フリー
    らい菌菌体成分に対するモノクローナル抗体3A(MAb 3A)について既に報告した。今回は新たに分離した抗体について,またMAb 3Aについての新しい知見について報告したい。
    前回とほぼ同様の方法を用いてモノクローナル抗体を4クローン分離した。これらは全て癩菌65kDに対する抗体であった。また,これら4種類のMAbの他の抗酸菌との交差反応をDot blottingを用いて検討したところ,らい菌特異抗体ではなく検査した20種類の抗酸菌のうち,5種類の抗酸菌のエピトープを認識するものから15種類のを認識するものまで多種であった。
    MAb 3Aは,検査した全ての抗酸菌と交差したが,これに加えて大腸菌など抗酸菌ではない菌体の≦65kD蛋白質をも認識した。
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