Hansen's disease is one of six main tropic communicable diseases in African, Asian and Central-South American countries. It chiefly involves the peripheral nerves. The Hansen's disease is much behind with its study due to the lack of a method of cultivation of M. leprae.
In the past 40 years, a remarkable progress of chemotherapy has been made for the disease, so that we can cure the patients without difficulty within a short period. More recently, a definite advance has been achieved in Hansenology. The multiplication of Hansen's bacilli in the soles of the feet of the mouse, the experimental production of lepromatous leprosy in the armadillo, the introduction of chemotherapy using multiple drugs, and the development of molecular biologic approaches to the production of vaccine against Hansen's bacilli are important advances.
In Japan, there are about 8, 700 registered cases. All patients are under regular treatment at the 13 National Leprosarium (7, 700 cases), 3 private Leprosy Hospital (100 cases) and at home (900 cases). There may be 20 million estimated cases of Hansen's disease worldwide. The disease remains a serious problem in terms of public health and socioeconomic point in the developing countries. The need for progressing a method of prevention continues to be very important for the control of Hansen's diseases.

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Mycobacteria can be classified as acid-fast and chromophobic. The chromophobic bacilli cannot be stained with carbol fuchsin or counterstain. Both types of bacilli are stained with periodic acid-carbol pararosanilin or periodic acid-methenamine silver. The mechanism of these staining methods depends upon the prolonged periodic acid oxidation of the cells to produce aldehydes and subsequent staining with carbol pararosanilin or methenamine silver. With latter treatment, arylamine can be condensed with aldehydes into Schiff's bases or methenamine silver can be reduced with aldehydes to metallic silver.
In tuberculous or leprous lesions, even after chemotherapy, these methods reveal a large number of bacilli in the lesion, though carbol fuchsin shows few or no bacilli.
The tubercle bacilli can survive in caseation cavity as in vitro, whereas the leprosy bacilli can survive in macrophages and Schwann's cells.

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Increased creative kinase (CK) activity in serum is frequenently observed in many pathological conditions, such as cardiac infarction, muscular, neuromuscular, neurological and malignant diseases, etc. In these diseases, appearance of CK-BB and CK-MB type isoenzymes are observed. On the other hand, in 40-50% of acute “functional” psychotic patients without any somatic diseases mentioned above, increases in CK activity are frequently noticed. The increases in CK activity occur in various psychotic diseases, such as acute schizophrenia, manic-depressive disease, periodic psychosis, etc. Though the increased CK activity cannot differentiate these functional psychosis, it clearly corresponds to the symptoms of excitement, agitation or psychiatric stress. The isoenzyme type of the increased CK in psychotic patients is always MM type. Skeletal muscle abnormalities are found in psychotic patients with high CK serum activity. Subterminal branching of the terminal motor neuron is significantly increased in the patients. Electron microscopy revealed some changes in morphology of Z band in the patients. These findings altogether suggest that the high CK activity in the psychotic patients sera results from leakage of the enzyme from the muscle cells due to higher permeability or other kind of damage to the muscle cell membrane.
There is a myth how the pathologic condition in the brain influences the muscle cell to cause leakage of the enzyme molecule. The link between these two apparantly unrelated phenomena are discussed and the role of calcium ion is proposed in the psychotic patient.
Serum Ca level is delicately regulated by many factors, such as hormones and neural activity, etc. In psychotic patients, the fluctuations of serum Ca level is frequently observed. In an excitement phase or an acute psychotic phase, the serum Ca level is high, while in a non-psychotic period or a depressive stage, the serum Ca level is normal or even lower than the normal Ca level. The CSF Ca level control is more intriguing.
The CSF Ca level is low when the patient is in an excitement phase with high serum Ca level. The increase in serum Ca level is only temporary, and it seems Ca surge in serum may trigger the psychotic excitement, resulting in the “switch-on” of the excitement phase. Experimental infusion of Ca into the ventricle of cat causes drowsiness, inactivity and mimicking the symptom of depression or catatonic stupor. On the other hand, infusion of EDTA or dihydrotachysterol, both of which decrease Ca, into CNS causes excitement and agitation in the animal.
The decrease in CSF Ca level causes neural excitation resulting in behavioral excitement and agitation. In physiological situation, the fine homeostatic mechanism is functioning to regulate CSF Ca level compensating the fluctuations of serum Ca level. Actually, the healthy people shows little fluctuations of CSF Ca level after experimental or pathological modification of serum Ca level. In psychotic patients, however, the change in serum Ca level is excessively compensated by CSF Ca controlling mechanism, resulting in the reverse shift of CSF Ca level. This unstable regulation of CSF Ca could be the mechanism underlying the onset of psychotic symptoms. We speculate the homeostatic regulation of Ca in CSF is essential for CNS activity and the function of thyroid may play the most important role in this homeostasis of Ca.

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A study of chromosome in 49 patients in Duchenne type muscular dystrophy was performed.
The lymphocytes from peripheral blood were cultured in a folic acid-deficient and BrdU-added culture medium for 96 hours.
The presence of hot spot in 2% or more of the metaphases was judged as positive.
Its frequency was most highest at 6q12or 13, which was found in 20 patients (408%).
Because 6q12 or 13 was found in a folic acid-deficient and BrdU-added conditions, we considered that there might be dysfunction of DNA synthesis in the site of 6q12 or 13.
At present, it is considered that the gene locus of Duchenne type muscular dystrophy might be Xp21 or 22, but our findings suggested that hot spot at 6q12 or 13 might be associated with the gene locus of Duchenne type muscular dystrophy.
Thus, many patients with Duchenne type muscular dystrophy should be studied for 6q12 or 13.

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Using pre-incubation with [³⁵S] methionine followed by extraction with petroleum ether, it was shown that cultivated tumor cells including HA-60 (acute promyelocytic leu-kemia cell-line), K-562 (chronic myeologenous leukemia cell-line) and NKM-1 (acute my-elomonocytic leukemia cell-line), contained sulfolipid. Such sulfolipid was not found in normal lymphocytes and mouse organs. The liver of mice did not contain sulfolipid read-ily extractable with petroleum ether after extraction with a trichloroacetic acid solution, but it contained sulfolipid that was liberated by hydrolysis with potassium hydroxide-methanol solution.

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This study was designed to investigate the response of [Sar^-1, Ile^-8] angiotensin II in various hypertensive rats.
Hypertensive rats were two-kidney one clip Goldblatt hypertensive rats (GB-HT), DOCA-salt hypertensive rats (DOCA-salt HT rats) and spontaneously hypertensive rats (SHR).
The effects of arterial pressure by one bolus injection of [Sar^-1, Ile^-8] 100 μg/kg of angiotensin II were observed about agonistic actions and depressor response. Plasma renin concentration (PRC) was determined by radioimmunoassay.
PRC was high in GB-HT rats and SHR, but low in DOCA-salt HT rats. The first transient response of arterial pressure was blunted in GB-HT rats and SHR, but rised slightly in DOCA-salt HT rats. The depressor response was markedly intensified in GB-HT rats, but was not seen in control rats, DOCA-salt HT rats and SHR.
These results indicate that the role of renin-angiotensin system in hypertension was important in the pathogenesis of GB-HT rats, but not so important in DOCA-salt HT rats and SHR. [Sar^-1, Ile^-8] angiotensin II was useful for the screening of renin-dependent hypertension.

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B 663 (clofazimine) is a rimino-compound derived from progressive chemical alteration of alinoaposafranine molecule (Barry, 1957).
In 1962 Brawn reported that the clinical and bacteriological efficacy of this drug on leprosy. This medicine can be used for the treatment of leprosy and its reaction.
Seventy-six male patients with lepromatous leprosy suffering from lepra reaction were treated with B 663 alone at a dosage of 100 mg daily for two years. During the course of treatment, he developed brown pigmentation of the skin, and B 663 was discontinued. Though it was improved rapidly, he died of acute pancreatitis.
Histopathological findings of the skin biopsy, the rete ridge and papillae were either flattened or disappeared. The collagen fibers in the dermis lost its characteristic com-munication, were conglomerated each other and/or accumulated around appendages, and fragmented elastic fibers were also observed.
Autopsy revealed CPM (Central Pontine Myelinolysis), but he had not taken so much alcohol, and hyponatremia had not been found during his life.

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Electron microscopic observations were performed on typical papular eruptions of an 18-year-old and a 23-year-old male students with prurigo pigmentosa. In the epidermis, intercellular edema, dyskeratotic materials and cytoid bodies with poor electron density were observed. Keratinocytes of the basal layer revealed evidences of intracellular edema, degeneration and atrophy. In the dermis, inflammatory cell infiltrates composed of lymphocytes and macrophages were observed, and the latter phagocytized congromerate melanin granules. These electron microscopic findings appear to be similar to those of lichen pIanus, the prototype of lichenoid tissue reaction.

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In two patients receiving valproic acid (VPA) who showed asymptomatic hyperammonemia, plasma amino acids and organic acids were serially determined while the dosage of VPA was reduced weekly.
The patient M. M. is a 21-year-old female with cerebral palsy and generalized tonic clonic convulsion (GTC). She was born prematurely (36 weeks, 1400g) and had neonatal distress. She developed the first convulsive episode at 2 years of age. She took anticonvulsants such as diphenylhydantoin (DPH) and Phenobarbital (PB) thereafter. Although their plasma concentration was within the effective level, she developed GTC frequently from 15 years of age. She then began to take VPA (30mg/kg/day) in addition to DPH and PB, resulting in marked reduction of GTC frequency. Regular check-up revealed hyperammonemia after 5 years and 2 months of VPA administration. Plasma ammonium concentration was 233.6 μg/dl which was approximately three times higher than the controls (Normal range: 24.0-79.0μg/dl). No family history suggesting congenital metabolic disorders was obtained.
Plasma VPA and hyperammonemia were not detected one and two weeks after the cessation of VPA, respectively. Amino acid analysis showed numerous imbalance: hyperglycinemia, hyperglutaminemia, low concentration of glutamate family (glutamate, proline, hydroxyproline) and aspartate family (aspartate, lysine, homoserine, methionine, threonine, isoleucine). The plasma concentration of lactic acid was low and that of pyruvic acid was high. Those imbalance of amino acid and organic acid became within normal limits 3 months after the cessation of VPA.
In another patient S. M. (a 12-year-old boy, severe mental retardation with GTC) receiving VPA, almost the same results were obtained. It is, however, not yet ascertained whether or not these imbalance are universally detected in all patients receiving VPA.
There have been no reports describing the long-term effects of metabolic imbalance induced by VPA, and these might be related to many side effects of VPA. Although VPA is a highly effecttve anticonvulsant against various types of seizures, we conclude that it is necessary to evaluate the metabolic status regularly in those patients receiving VPA.

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Two kinds of commercially available sustained release preparation of theophylline (A, and B) were studied on their dissolution behaviors and bioavailability. The dissolution behaviors were examined with the J. P. X dissolution tester in the 1st fluid (pH 1.2) in J. P. X disintegration test and in the 2nd fluid (pH 6.8) in J. P. X one. The bioavailability was tested in 2 healthy volunteers by a cross over method, sustained release preparation of 400 mg of theophylline was orally administered to the volunteers after the same meal. The following results were obtained. 1) In the 1st fluid, 50% dissolution time (T 50%) for both preparations were about 8 hours. 2) In the 2nd fluid, T 50% of A was about 12 hours, but that of B was about 4 hours. 3) In the bioavailability test, the mean ratio of AUC of B and A was about 1.6.

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The purposes of the Joint Use System of Nuclear Medicine are to collect samples from the participating institutions at the Nuclear Medicine Center of the 2nd Tokyo National Hospital, to test and measure many items efficiently, and to report the data accurately and speedily. The system has been designed and operated to meet with the consolidation, modernization and rationalization of the regional medical care.
In this report, we conducted a statistical study on the use of the system during the past 5 years. Both the total number of samples handled and the total income are steadily increasing.
It is reasonable to assume that the institutions which sent a small number of samples from the beginning have the ability to measure samples by themselves.
In the future, it is considered urgent to save delay and to decrease complexity in data handling by the introduction of computer into the system.

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Seventy-eight cases of urological autopsy during the 20 years from 1963 to 1983 at the Fukuoka-Chuo National Hospital were briefly analysed.
The rate of urological autopsy was 5.5% of all 1, 422 autopsies in the Hospital. Autopsy rate varied in each year between 13% and 100%, but the real reason of this difference was not found out.
Seventy-three % of autopsy patients died from the malignant disease. Malignant lymphomas associated with hydronephrosis and pyrexia were often mistaken for primary urological diseases.

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Comparative study was performed between the two groups :39 patients treated with L-dopy and carbidopa, and 20 patients treated with L-dopa and benserazide for several years. The therapeutic efficacy and the maximal side effects were comparatively investi-gated between the two groups. The ratio of L-dopa to carbidopa was 10 and that of L-dopa to benserazide was 4. The mean grade of disability (Parkinson Score and Yahr's stage) and the mean therapeutic period did not show any significant differences between the two groups before the therapy.
The following results were obtained.
1) The maximal improvement in Parkinson Score showed no significant differences between the two groups. But the maximal improvement of Yahr's stage in the therapy of L-dopa with benseragide was significantly superior to the therapy of L-dopa with car-bidopa (p<0.05). But the improvement of Parkinson Score and Yahr's stage showed no significant differences between the two groups at the final examination. No significant difference was recognized in mean daily L-dopa dosage at the maximal therapeutic effect and final examination.
2) L-dopa-induced dyskinesis was significantly lower in the group of L-dopa and ben-serazide than the group of L-dopa and carbidopa (p<0.05). The frequency of gastric and autonomic side effects in the group of L-dopa and carbidopa was higher than the group of L-dopa and benserazide without any statistical significance. As to the psychiatric side effects severe symptoms were seen only in the group of L-dopa and carbidopa. The mean daily L-dopa dosage showed no significant differences between the two groups with refe-rence to the side effects.
3) From the standpoint mentioned above, it was concluded that the therapy of L-dopa with benserazide (the ratio of L-dopa to benserazide was 4) was significantly superior to the therapy of L-dopa with carbidopa (the ratio of L-dopa to carbidopa was 10). The neuropharmacological analysis between carbidopa and benserazide was also discussed

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A new antibacterial substance ofloxacin (DL8280) was used in the treatment of pulmo-nary tuberculosis. A total of 19 patients who received the DL8280 had chronic cavities in sclerotic lesion or cavity with sclerotic wall and were discharging tubercle bacilli resistant to various antituberculous agents. The DL8280 was given orally at a single dose of 300 mg daily for 6 to 8 months. No other antituberculous agents were given to the patients or only antituberculous agents to which the tubercle bacilli of the patients showed resistance were given in combination with the DL8280. Sputum cultures became negative promptly in three patients and after 3 months in other two patients. In the patients who showed no sputum conversion, tubercle bacilli resistant to DL8280 appeared on the third or fourth month of administration. No adverse effects were observed.
Thus, it is considered that the DL 8280 is a useful agent in the treatment of pulmonary tuberculosis

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The responses of intravenous therapy with intact gammaglobulin to idiopathic thrombo-cytopenic purpura (ITP) and Evans' syndrome were investigated in vivo.
GV-523 (Nikon Seiyaku K. K. ) purified from human plasma by using polyethylene glycols and ion exchanger was used as gammaglobulin. High-dose intravenous gammaglobulin (400mg/kg, 5 consecutive days)was given to 2 cases of acute ITP, 2 cases of chronic ITP and one case of Evans' syndrome. In all patients with ITP the platelet counts rose sig-nificantly to more than 40×10₄/mm³ in 5 and 10 days. During the next 30 days of obser-vation platelet counts decreased gradually and turned back to initial levels in three cases. In only one case remained the platelet counts within the range of 5-lo×10⁴/mm³. No effect was observed in cases of Evans' syndrome.
Platelet-associated immunoglobulin G (PAIgG) levels were determined before and after the therapy. PAIgG levels showed a tendency to decrease after therapy. In one case with chronic ITP PAIgG level remained unchanged.
Serum levels of IgG increased substantially with the infusion of GV-523. Peak values ranged from 2, 000-3, 000mg/dl in cases of ITP. On the contrary, a rise of IgG value in cases of Evans' syndrome was less than in cases of ITP.
A high-dose intravenous IgG therapy is very expensive and palliative, but seems to be effective in patients with ITP who have severe bleeding or are undergoing surgical op-eration

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Statistical observations were made on patients operated on from April, 1969 to December, 1983. A total of 2466 patients were operated on during this period. There were 1, 967 men (79.8%) and 499 women (20.2%). As to the age of male patients the number of patients in the age group of 61-70 years was the highest (362 or 18.496), followed by the group of 70-80 years (320 or 16.3%), 51-60 years (249 or 12.7%) and 0-10 years (250 or 12.7%) in order of frequency. There were 206 patients in the age group of 41-50 years, 305 in 21-30 years, 123 in 11-20 years and 37 in 81-90 years. In cases of female patients, the number was the highest in the age group of 41-50 years (101 or 20.2%), followed by 51-70 years(91 or 18.2%), and 61-70 years (84 or 16.8%) in order of frequency. There was little difference between the age groups of 31-40 years (76), 21-30 years (56), and 71-80 years (53). The numbers were small in the age groups of 11-20 years (23) 0-10 years (8) and 81-90 years (7). The total number of operated cases was 3, 269. The figure includes a few cases in which two or more kinds of operations were performed on one patient. The kidney operations were done for 508 cases (15.5%), the ureter for 405 cases (12.4%), the urinary bladder for 367 cases (11.296), operations under cystoscopy for 210 cases (6.4%), the prostate for 304 cases (9.3%), the penis and urethra for 319 cases (11.6%), the scrotum and scrotal content for 566 cases (17.4%) and other operations for 530 cases (16.2%). With the operations for the kidney, the surgical procedure often used was nephrectomy in 150 cases, nephrolithotomy in 142 cases and pelviolithotomy in 81 cases. With the operations for the ureter, the procedure often used was ureterolithotomy in 215 cases and ureterovesicostomy in 84 cases. With the operations for the urinary bladder, the procedure consisted mainly of partial resection of the bladder in 124 cases and total resection of the bladder in 80 cases. The operations under cystoscopy consisted of 146 cases of TUR-p and 45 cases of TUR-Bt. Operations for the prostate included 261 cases of subcapsular extirpation and 32 cases of the total extirpation of the prostate. The operations for the penis and urethra comprised 244 cases of operation for phimosis, 40 cases of urethral divulsion and 34 cases of urethroplasty. With the operations for the scrotum and scrotal content, the procedure mainly consisted of the ligation of deference in 151 cases, extirpation of the testicle in 147 cases and fixation of the testicle in 124 cases, Other operations included radical operation for inguinal hernia in 96 cases and ileal conduit in 63 cases.

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