1990年6月現在,国立駿河療養所で長期肝機能異常(GPT35karmen単位以上が6カ月以上持続)を示した入所者は14名,長期肝機能以上の既往のある入所者は3名認められた。これは,入所者全数(230名)の約7%にあたる。長期肝機能異常を示した17名のうち,2名は肝細胞癌,2名は糖尿病と診断され,1名は慢性反復性のアミラーゼ高値にともなう肝機能異常が認められた。この17名のHBs抗原及びHBe抗原ははいずれも陰性,3名はHBs抗体陽性,1名はHBe抗体陽性であった。以上のことから,17名の長期肝機能異常を示す入所者において5名は肝内腫瘍や合併疾患を認めたが,残りの12名については肝機能異常に関連する合併疾患や病因を明らかにできなかった。
一方入所者の中には,肝機能異常の原因として治らい薬による肝機能障害と考え不安を語る患者がある。このような不安は,閉鎖的ならい療養所では肝機能異常を示さない入所者にも広がる可能性があり,場合によっては全入所者の基礎疾患であるらい治療に影響を及ぼしかねない。
この研究は,1989年に米国で確立されたC型肝炎ウイルス関連抗体(以下HCV抗体と略す)の測定方法を用いて(1)(2),当療養所の長期肝機能異常を示す入所者のHCV抗体の測定を行い肝機能異常の原因を検討すること,さらに入所者全員のHCV抗体を測定して当療養所におけるC型肝炎

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It is well known that monokines, IL-1(Interleukin-1) and TNF (Tumor Necrosis Factor), are produced by macrophages after stimulated with various agents. These cytokines are involved in various aspects of the inflammatory process and immunolo-gical response in addition to their original activities to proliferate T lymphocytes and causing tumor necrosis, respectively. Recently, there have been reported that IL-1 and TNF also play an important role in mycobacterial infections such as granuloma formation.
In the present study, IL-1 and TNF productions were observed by mouse peritoneal exudate and resi-dent macrophages after incubation with heat-killed M. lepraemurium and M. avium in vitro. The pro-duction was enhanced by Phagocytosis of these mycobacteria in a dose dependent manner, and the time course of the production was maximum within 24 hr after phagocytosis of these mycobacteria. It was also shown of morphological changes and en-hanced glucose consumption in media by these mac-rophages.
Above results suggest that phagocytosis of myco-bacteria by macrophages leads to monokine produc-tion, which would not only causes well known im-munological reactions but also makes characteristic phenomena to be observed in mycobacterial infec-tions.

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As of the year 1991 there were 358 leprosy pa-tients in National Leprosarium Matsuoka Hoyo-En, including 223 patients (62.3%) who had received the injections of chaulmoogra oil before. Calcinosis cutis caused probably from the injections was noted on 73 patients (32.7%): 67 lepromatous and 6 tuberculosis cases. It has never been reported be-fore that the T type patient suffering from calcino-sis cutis was observed in the cases of the chaul-moogra oil injection in Japan.
The detectable positions of calcinosis cutis were mostly at the injected sites, that is, outside the right brachium followed by bilateral-branchia and crura. In the group of patients with calcinosis cutis, the anti-PGL antibody was negative for the most part. Urinalyses, peripheral blood figure analyses, histopathological tissue examinations of calcium deposition, X-ray diffraction patterns, dif-ferential thermal and gravitational analyses, and chemical analyses were performed on all patients with this disease.
Further, as the result of this study six patients with calcinosis cutis caused by sulpyrine was also found. The major component of the deposit by the drug was calcium phosphate.
These calcinosis cutis were considered to be of trophopathic calcinosis based on the disorder of subcutaneous tissue due to the injections of respec-tive drugs : chaulmoogra oil and sulpyrine.

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The author have been engaged in medical consul-tant work with leprosy patients in the field of otorhino-laryngology at the National Leprosarium Tama Zensho-En for five years since 1938, and on the other hand he had many opportunities to con-duct autopsies which helped him in pursuing clinic-al and pathological researches on the upper re-spiratory tract, particularly, from a point of otorhinolaryngological view.
The author wanted to conclude his five years re-search in a book under the title "Leprosy of the upper respiratory tract", but the book was not published unfortunately as being burnt in air raids during the press in 1945.
The postwar appearance of PROMIN and DDS discouraged the author from republishing his work. However, in 1981, the author began to think that the clinical pictures of leprosy lesions in the nose, pharynx and larynx which were painted at the time of Chaulmoogra oil had a scarcity value in litera-ture on the subject and this had led to a decision to republish the book "Leprosy of the upper respira-tory tract-Atlas of Clinical Picture and Notes on the Research (1938-'43)".

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明治40年3月,法律第11号の公布により,長年懸案であった日本の「らい対策」が始動することになった。内務省は,この法律に基き明治42年4月,全国に5カ所の道府県連合立らい療養所(以下,公立療養所と略す)を設置することになった。当時,内務省衛生局長であった窪田靜太郎は,後年次の様な意味の回顧談を残している(1)。即ち,療養所の設置にあたり,当初,施設費及び経常費は国費で賄うことを考えたが,実際には道府県に応分の負担をしてもらうことになったと。これは施設運営に関する経費支弁についてふれたもので,管理運営上の国立療養所設置にふれたものではない。その事は,次に述べる沖縄県での臨時国立療養所設置でも明らかである。

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