[Treatment of leprotic neuritis. Exclusive medical treatment or combined with decompression]. / Evolution du traitement des nevrites hanséniennes. Traitement médical exclusif ou associé à la décompression.

The authors consider the evolution of the treatment of leprotic neuritis based on homogenous series of numerous observations (a minimum of 250-300). These observations are well registered and documented with some results dimensioned by the classical A. L. E. R. T. tests carried out at intervals of time and verified by comparison between series only medical treatment and series of medico-surgical treatment. Considering some remote results and some comparative series, the indications of the exclusive medical treatment have been well defined, and the ones of the surgical decompression have been reduced. The early case finding of a leprotic neuritis by the mean of easy methods as well as its monitoring during its early specific treatment is essential. By this way we get an important proportion of functional results: satisfactory (50 p.c.) or interesting (20 p.c.). In the case of painful hypertrophia, the complementary decompression secure not only the functional recovery of mortricity, but also the epicritic sensibility.

[Surgical decompression of neuritis of Hansen's disease]. / Décompression chirurgicale des névrites de la maladie de Hansen.

The recent progress were focused on: the identification of the general immunological mechanism of the hansenian neuritis, demonstrated by endoneural biopsies; the different pathology of the two categories of neuritis; the pathophysiologic derangements, inducing hypoxia or anoxia in the truncular involved segment. The adjuvant role of the canals is important; the clinical differences of the two categories of neuritis and the cases we shall treat by emergency; the importance of antireactionnal treatment and of the notation by tests for the study of the results. The goals are the hemodynamic decompression, useful in the first stage of ENL neuritis, the mechanical decompression of neural fasciculus and the urgent exeresis of necroses or evacuation of febrile abscess. Three technics a re studied: Extraneural and epineural decompression fascicular endoneural necrosis, neurolysis and complex neurolysis for evaluated ENL neuritis and for endoneural necrosis. The different indication according to the two categories: medico-surgical treatment for ENL neuritis, and according the precocity and the delay of the antireactional treatment, and also the absolute emergency of the necrosis and febrile abscess. The results of the treatment of 258 cases of recent neuritis are presented.

[Morphologic and biologic properties of diphtherroid organisms (LDC) isolated in leprosy]. / Propriétés morphologiques et biologiques des organismes diphtéroïdes (LCD) isolés chez les lépreux.

Acid-alcohol-fast bacteria are not always detectable in all leprosy lesions. Non acid-fast microorganisms may be associated with acid-fast bacteria. The most frequently isolated strains from leprosy lesions are non acid-fast bacteria, morphologically related to C. diptheirae. Hence their designation as diphtheroïds or LDC (leprosy derived corynebacteria). Their antigenic structure is more closely related to M. leprae and other mycobacteria than to classical corynebacteria. This leads to the hypothesis of a potential role in the pathogenesis of leprosy and their use as an antigen for skin tests by leprosy patients.