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Aiming at the future applications of a lattice structure manufactured by selective laser sintering for bone scaffold in the biomedical field, by putting highlight on the possible imperfections influenced by different manufacturing strategies, a numerical prediction method was studied and compared with compressive test results. To consider the geometrical imperfections as well as the uncertainty in sintered material property, the first-order perturbation based stochastic homogenization (FPSH) method was employed. To be able to compare products made by three different printing service companies, maraging steel was used in this study, which was commonly available. Several geometrical imperfections were categorized into kink, notch and hole, and representative dimensions were parameterized and measured statistically using micro-CT images. They were also correlated to the building direction and support types. The numerical prediction revealed the reduction of stiffness in a stochastic way qualitatively. The constructed database of the geometrical imperfections and the FPSH method will be useful in the next occasion of manufacturing unexperienced product.

In order to know leprosy chemotherapy status in Japan, three recently conducted Government-supported nation-wide survey, namely chemotherapy research group survey (Takizawa, 1994, 71 cases) follow up result of Takizawa's study (Miyagi, 1997, 59 cases) and leprosy patient registry (Goto, 1996, 130 cases) were compared and analyzed. For most fresh and relapse cases, multi-drug therapy were applied, among them rifampicin/dapsone or rifampicin/dapsone/clofazimine combinations were selected in about half of new cases and about 1/3 of relapse cases. In many cases dose and intervals were based on WHO protocol, however smaller dosage was used in some cases. Quinolone (ofloxacin) was used in 40% of cases during the therapy. Reversal reaction was observed in 7/71 cases and erythema nodosum leprosum was observed in 6/71 cases. In order to prevent chemotherapy-induced deformities, we propose a modified protocol for new cases accompanied by reactional status, which starts with clofazimine monotherapy and followed by WHO/MB.

A survey of dermatophytes isolated from patients was made from May, 1991 to June, 1992 in Amami-Oshima. One hundred and ninety-one isolates were obtained from 321 cases consisting of tinea capitis 7 (2.2%), tinea corporis 86 (26.8%), tinea cruris 63 (19.6%), tinea pedis 140 (43.6%), tinea manuum 4 (1.2%) and tinea unguium 21 (6.5%). The isolates were 152 (79.6%) of Trichophyton rubrum, 16 (8.4%) of T. mentagrophytes, 3 (1.6%) of T. violaceum, 3 (1.6%) of Trichophyton spp., 14 (7.3%) of Microsporum canis and 3 (1.6%) of M. gypseum. Out of 152 T. rubrum isolates, 104 were granular or powdery, and urease-positive. The dermatophyte flora in Amami-Oshima was intermediate between those in Kyushu and Okinawa.

National sanatoria for Hansen's disease in Japan were special institutions that only treated in-patients.But a few sanatoria for Hansen's disease located in islands and rural districts should have other duty, namely service to community health because there was no other clinic office.New patients with Hansen's disease are very small in number and inpatients become older and older. Then the new role should be seeked to National sanatoria for Hansen's diaease in Japan. Amami-wakoen, National sanatoium for Hansen's disease in Amami island started skin clinic for out -patients with skin diseases in March, 1983 because there were few skin clinics in Amami district. The number of patients with skin diseases increases year by year (from 12.3 persons every day in 1983 to 36.4 in 1989).We surveyed receipts of Naional health insurance for the purpose of studying the main diseases in Amami main island and the behavior of the patients with skin diseases.The results of survey are followings; 1. The percentage of patients with skin diseases in Amami main island in August, 1987 was significantly superior. 2. The percentage of patients with mental diseases and pregnant woman in hospital and patients with gastrointestinal disorders and pregnant women in clinic were significantly large in May, 1987 in Amami main island. 3. There was a tendency that the patients with skin diseases visited to the clinic near in place. It was found that we treated only 5.1 percent persons of patients with skin diseases in August, 1987.

✓ Pressure volume index (PVI) and cerebrospinal fluid (CSF) outflow resistance (Ro) were estimated in spontaneously breathing anestheized cats by the bolus injection test under normal conditions and also under abnormal conditions produced by slow infusion of saline into the CSF space. Bolus injections were made separately into the lumbar subarachnoid space, cisterna magna, and lateral ventricle. The mean PVI values in the lumbar sac, cisterna magna, and lateral ventricle under normal conditions were 0.70, 0.71, and 0.64 ml, respectively; not significantly different from each other. Saline infusion lowered PVI significantly at every site; PVI values in the lumbar sac, cisterna magna, and lateral ventricle were 0.54, 0.52, and 0.53 ml, respectively; not significantly different from each other. Indirect values of PVI were calculated from the pressure responses observed at sites other than where the bolus had been injected. These indirect PVI values were always greater than PVI at the injection site under normal conditions, but differences between direct and indirect PVI values were abolished during saline loading of the CSF space. The Ro was estimated under normal conditions in the lumbar sac, cisterna magna, and lateral ventricle to be 81.6, 85.6, and 110.3 mm Hg/ml/min, respectively. The lateral ventricle Ro was significantly higher than at other places. These findings suggest that, when there is no blockage in the craniospinal axis, the pressure response to a bolus change in CSF volume is freely transmitted, direct measurements of PVI are independent of location, and indirect measurements are larger because of “buffering” in the CSF space. When PVI is lowered and buffering capacity is exhausted, these differences between direct and indirect PVI values disappear.

A female case 56 years old had the variously sized erythemata on her face, neck, buttock, and extremities. They were from coin-sized to twice the size of palm. Some patches had the apparently normal area in their inner part. In addition to those erythemata, the papules which were from marking-pin-head-sized to lens-sized, well-defined, hemispherically raised, and hard were scattered on the back of both hands, fingers, lower arms, legs, and neck.The macroscopical findings that the skin lesions were multiple, some eruptions were small in size, and some patches had the punched-out appearance suggested us the borderline nature of skin lesions. But the skin biopsy revealed the typical tuberculoid features. The bacteriological examination of skin lesions were negative, and the Mitsuda-test was positive. The small dosis of CIBA 1906 was given to her every day, except for the 1 st week when CIBA 1906 was given 5 days a week. About 5 weeks after the start of chemotherapy, the remarkable desquamation appeared on the patches of legs. And about 4 weeks later, two ulcers came out on the patches of the right leg. Thereafter, the ulcers expanded gradually, and new other ulcers appeared on both legs. About 3 months after the start of chemotherapy, the drug was changed from CIBA 1906 to DDS. But the ulcers did not improve. By the suspicion of skin tuberculosis, INH and PAS were administered, but they had no effect. The biopsy of a nerve which was enlarged revealed the tuberculoid change in the nerve. This result decided that she had the leprosy. Besides, the skin reaction against PPD was not positive, and the cultivation of tubercle bacilli from a eruption was negative. And also the comparative study of macroscopical and microscopical findings of skin eruptions denied the combination of skin tuberculosis. The mycotic dermatitis, syphilis, and the ulcer caused by Mycobacterium ulcerans were denied, too. Thus, it was fixed that they were the ulcers which came out on the leprous tuberculoid patches. About 6 months after the appearance of ulcers, they were cured.The literatures on the lazarine leprosy were reviewed in this paper. This case is similar to neither Mexican type of lazarine leprosy nor Cuban type, and similar to the cases reported by Ryrie, and Ota and Sato.The term "lazarine leprosy" should not be used hereafter, because many confusions arose concerning the interpretation of "lazarine leprosy". The terms "Lucio's leprosy" and "Pacha's leprosy" should be used. The former means the spotted leprosy with ulcers in diffuse lepromatous case reported first by Lucio, and the latter expresses the monosymptomatic case having destructive ulcer reported first by Pacha.

This is a report of lepromatous cases with acute infiltration reaction (Tajiri) in his clinical course under chemotherapy. They were all males, among whom one case showed localized skin lesions and other two cases had generalized lesions upon admission. Skin biopsies revealed all borderline-lepromatous features (Ridley-Jopling's classification). This reactions developed one and half to 4 months after the start of treatment, and lasted 9 months to two years intermittently. After this reaction the Mitsuda rection test gave the same result as before in one case, but other two cases became weakly or modelately positive. Bacterial Clearance Time (Takizawa) was 2.7, 4.3 and 5.9 years, respectively.The nomenclature and the nature of this reaction was discussed, especially with relation to chemotherapy.

During experimental supratentorial epidural compression of the brain, cerebrospinal fluid (CSF) pressure and pressure-volume index (PVI) were measured in the supra- and infratentorial compartments of the craniospinal axis in anesthetized ventilated cats. A transtentorial gradient of CSF pressure developed when CSF pressure in the lateral ventricle exceeded 20 mm Hg at balloon volumes of 0.4 to 1.2 ml. The shapes of both the pressure vs. volume and the pressure gradient vs. volume curves were exponential. PVI in the supratentorial compartment was lowered more rapidly as brain compression advanced than PVI in the infratentorial compartment. An index was calculated to represent the relative resistance to the flow of CSF across the tentorial hiatus during supratentorial brain compression. This revealed different resistances to the flow of CSF in the cephalic and caudal directions. A hypothesis concerning the hydrodynamic aspects of the development of tentorial herniation is presented.

Two hundreds and eighty one patients receiving sulfones (DDS, Protogen or Promin) or sulfamethoxypyridazine were examined by a Dichlorophenol indophenol (DPIP) test for Glucose-6-phosphate dehydrogenase (G6PD).The blood samples of 230 cases decolorized the dye within 80 minutes, while the residual 51 samples required 80 minutes or more. A quantitative UV test for G6PD were performed on 48 cases of these 51 patients.The result of the UV test showed that all of patients had G6PD values between 120 and 240 mU per 109 red blood cells except one male patient (114.4 mU). His red blood cells count and the hemoglobin index were within normal range and Heinz body in the red blood cells was negative though he was receiving 50 mg of DDS everyday.

A case of a 19-year-old man with a right parasellar chondroma examined with computed tomography (CT) and nuclear magnetic resonance (NMR) scan is reported. The literature about CT and NMR scan findings of intracranial chondroma is reviewed. Typical CT findings are a round, high density mass with calcification, that is only slightly enhanced by contrast medium.

Blowout fractures most frequently involve the orbital floor. The contour of the orbit has been postulated as one of the factors responsible for this phenomenon, but only a few studies have been carried out. The present study was planned to determine the effect of the contour of the orbit when intraorbital pressure is raised to simulate the hydraulic mechanism of blowout fracture. The profile of the orbit was estimated from five dry human skulls, and the measurements were approximated to frame models. The deformation of these models by raised intraorbital pressure was calculated by computer simulation using the finite element method. In all ofthe orbital models, the deformation of the orbital floor was significantly greater than that of the roof. These findings verified that the orbital roof has a higher resistance than the floor against raised intraorbital pressure. We suspect that this resistance is due to the arched shape of the orbital roof, whereas the floor is rather flat.

The frequency spectrum of the cerebrospinal fluid (CSF) pulse and the amplitude transfer function between arterial and CSF pressures were measured from the cisterna magna of anesthetized, artificially ventilated cats when the intracranial pressure (ICP) was raised by saline infusion. The spectrum of CSF pulsation was composed of a fundamental and three higher harmonic waves. The amplitude and the amplitude transfer function of each spectral component revealed significant positive correlation with ICP and negative correlation with cerebral perfusion pressure (CPP). Both the amplitude and the transfer function of the fundamental CSF pulse wave showed an exponential correlation with ICP and CPP. A distortion factor of the CSF pulse wave, a measure of its difference from a simple sine wave, was calculated from the spectral components. This showed that distortion of the CSF pulse wave was rapidly and progressively reduced as the ICP rose to 50 mm Hg and then was reduced less thereafter.

A silicone catheter manufactured originally for ventricular fluid drainage was used for continuous monitoring of intracranial pressure. It can be placed under the dura mater immediately before replacing the craniotomy flap or by introduction through an ordinary burr hole. Pressure is monitored isovolumetrically by connecting the catheter to a pressure transducer mounted at the bedside. This technique has been used in 34 neurosurgical patients for periods of up to 12 days without any untoward effects. This monitoring system by a subdurally placed silicone catheter is simple, safe, inexpensive, and acceptably reliable. It has a place in clinical practice, particularly when the lateral ventricle cannot be tapped because of its deviation or collapse.

Positivity of lepromin reaction (LR) was often said to be increased after leprosy skin lesions were improved by chemotherapy. But there were no special reports dealing with long term observation of LR in the same patients.This study in Kuryu-Rakusenen concerned the 248 in-patients, whose clinical records were relatively complete and who were followed for more than 20 years. And the LR by standard Mitsuda antigen was tested covering 20 years (every year between 1957 and 1969 and each other year between 1970 and 1977). The following results were obtained.1. Thirty three tuberculoid patients showed slight increase in LR during these 20 years (r=0.58).2. There were also slight increase in lepromatous patient during these 20 years (p