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Skin tests of the scratch type were performed on 132 asthmatic patients with 28 allergens. The threshold titers of skin test, RAST and ELISA of house dust, HD mites, Japanese cedar pollen, ragweed pollen and orchard grass pollen were included. The main skin-positive allergens among the patients were as follows: house dust, HD mites, Japanese cedar pollen, orchard grass pollen, timothy grass pollen and ragweed pollen. There are age differences on skin-positive rates among 4 age groups of the patients; 90% of the patients under 40 years old groups reacted positively to any of 28 allergens, while half number of the patients groups over 40 years old reacted positively to the allergens. According to the quantitative analysis between threshold titers of skin test and RAST titers using house dust and HD mites allergens, specific IgE production shall be decreased in the patients over 40 years old. Using 5 main allergens above mentioned, the agreements of positive responses between three methods were compared. RAST positive responses correlated well with the skin test results, while ELISA positive responses correlated rather poorly with the skin test results. However, correlation between RAST and ELISA results was relatively good. The correlation of positive responses to house dust and HD mites by the three methods was very good, but there were some cases where positive responses were obtained by only one of the methods.

Twenty-three patients with inoperable non-small cell lung cancer were treated with a combination chemotherapy of CDDP 100 mg/m2, ADM 30 mg/m2 and MMC 8 mg/m2 (PAM). Ten cases were adenocarcinoma, 9 cases were squamous cell carcinoma and 4 cases were large cell carcinoma. In 21 evaluable cases, partial response was obtained in 47.6%. (The response rates were 40.0% in patients with adenocarcinoma, 50.0% in those with squamous cell carcinoma and 66.7% in those with large cell carcinoma.) Leukocytopenia of less than 4,000/mm3 occurred in 100% of cases, thrombocytopenia of less than 100,000/mm3 occurred in 81.0%, and anemia(fall in hemoglobin over 2.0 g/dl) occurred in 66.7%. A transient elevation of Cr (over 1.5 mg/dl) and/or BUN (over 30 mg/dl) was observed in 23.8%. Nausea and vomiting occurred in almost all patients. No death occurred due to toxicity of PAM. These results demonstrate that PAM is an effective combination chemotherapy in patients with non-small cell carcinoma of the lung.

We have investigated the effect of nifedipine on acetylcholine-induced bronchoconstriction in 8 asthmatics and on histamine-induced bronchoconstriction in another 8 asthmatics on a single-blind basis. Expiratory spirograms were done at the beginning of the examination in all subjects, and repeated after 10 mg of oral nifedipine or a placebo. The change of respiratory resistance during the inhalation of acetylcholine or histamine was recorded continuously by an Astograph. Using this device, we were able to obtain the direct-writing dose-response curve of respiratory resistance measured during quiet breathing. Resting airway tone appeared to be generally unaffected by nifedipine, as there was no significant change in baseline spirograms. Nifedipine increased significantly the threshold of bronchial responsiveness, i.e., the cumulative dose of acetylcholine (Dmin) at which the respiratory resistance started to increase, compared with placebo (p less than 0.02). However, Sd, the slope of the increasing rate of respiratory resistance in the dose-response curve, was not attenuated by nifedipine. In histamine inhalation tests, neither Dmin nor Sd were modified by nifedipine. The discrepancy observed between the effects of nifedipine on acetylcholine- and histamine-induced bronchoconstriction may imply that, in asthmatics, nifedipine exerts its effect mainly by stabilizing mast cells rather than by directly inhibiting bronchial smooth muscle contractility. This hypothesis is based on the fact that mast cells have acetylcholine receptors on their surfaces but no histamine H1-receptors.

This report describes an extremely rare case of occupational allergy that developed in a frog handler. A 31-year-old female laboratory technician developed itching and urticaria one year after she began handling frogs and extracting their brains in the laboratory. Nine years later she noticed swelling of the right hand, stridor and dyspnea when she mistakenly injected her finger with a needle contaminated with extracts of frog brain. Specific IgE antibody to frog extracts was demonstrated by RAST and by P-K testing. However, no specific IgG antibody was found by agar gel diffusion or in heterologous PCA testing using guinea pigs. We suggest that allergic symptoms in this case were due to the development of Type I allergic reactivity to frog antigens.

A curious inhibitory effect of histamine H-1 and H-2 antagonists on isolated late asthmatic response (LAR) in an asthmatic patient was observed. When given alone, neither the H-1 nor the H-2 antagonist had an effect on LAR. The combination of drugs, however, provided marked inhibition of LAR. These findings suggest that histamine contributes to some types of LAR.

In order to examine the clinical efficacy of cepharanthin (Ceph.) for preventing leukopenia caused by chemotherapy in lung cancer patients, a randomized trial was carried out. Subjects were 45 patients with non-small cell lung cancer (NSCLC) receiving initial treatment with cisplatin (CDDP) +adriamycin (ADM) +mitomycin C (MMC). Ceph. was given at a dose of 1 mg/kg to the administration group (Ceph. group) and changes in the peripheral leukocyte count were examined in both the Ceph. and non-Ceph. groups. The Ceph. group showed a reduction in the number of cases with a count nadir less than 3,000/microliters (p less than 0.05), a shortening of the time that leukocyte counts stayed under 2,000/microliters, corresponding to the time in which granulocyte counts were less than 500/microliters (p less than 0.05), and also a reduction of the time for leukocyte counts to recover from nadir to 2,000 or 3,000/microliters (p less than 0.05) measured from the commencement of chemotherapy. These results suggest that administration of Ceph. has an antileukopenic effect in anticancer treatment, and makes it possible to reduce the period of risk for infection, allowing effective regimens to be administered repeatedly in shorter intervals.

Study of the influence of some parameters upon flow-volume curves and pressure-type body plethysmography during inhalation tests (acetylcholine; metaproterenol) in 10 asthmatic patients (5 males and 5 females). Although the specific conductance decreased when bronchoconstriction was induced and returned to values superior to those measured before provocation when a bronchodilator was administered, changes in specific conductance did not always parallel those of flow-volume curves (V/V), maximum expiratory volume/sec (VEMS) and mid-miximum expiratory flow rate (MMEFR). All the parameters of V/V used here are well correlated with VEMS and MMEFR but not so with the specific conductance. The inverse correlation between the time constants of V/V and residual/total pulmonary capacity (VR/CT) before provocation and the significant decrease after provocation, indicate that V 60 (or 70%) CT and V 75% vital capacity (CV) are most valuable for the evaluation of physiopathological ventilatory changes occurring in bronchoconstriction.

To observe possible changes in adrenal function during asthmatic attacks due to allergen inhalation, plasma cortisol levels were measured serially in asthmatic patients who showed immediate asthmatic responses, late asthmatic responses, and dual asthmatic responses were compared with their diurnal levels. There were slightly different patterns of cortisol responses among these groups. In the five patients who showed late asthmatic responses alone, cortisol levels fell significantly during late-type attacks although the decrease was quantitatively small. In the six patients who showed immediate asthmatic responses alone, cortisol levels tended to increase slightly during immediate-type attacks. Cortisol levels in the group with dual asthmatic responses increased slightly during immediate attacks and significantly decreased during late-type attacks, although the decrease was also small.

An asymptomatic 84-year-old man was admitted to our hospital for a further examination of an abnormal shadow in the right lower lung (S9) on chest X-ray film. Sputum and specimens of transbronchial brushing showed cytological characteristics of well differentiated adenocarcinoma. Considering his age, his family did not agree to any surgical operation, irradiation or intensive chemotherapy. Therefore, using PSK: 3.0 g/day, immunotherapy was started on October 26, 1984. However, the abnormal density continued to increase in size and was observed radiographically to infiltrate to the neighboring segment (S6) over the following four months. From March 1985, the tumor regressed gradually and had almost disappeared on chest X-ray films by December 1985. Since then, this remission has been maintained by administration of PSK alone (3.0 g/day).

The purpose of the present study was to examine the role of low cortisol levels which were observed during late asthmatic responses (LAR). Selective functions of the adrenals and pituitary glands were studied in three groups of asthmatics who showed LAR, immediate asthmatic responses (IAR), and DAR (dual asthmatic responses). Serial plasma ACTH levels in each group showed no apparent abnormalities when compared with diurnal levels. The cortisol response to ACTH changed within the normal range in all three groups with minor differences. We suggest that low cortisol levels that appear during LAR are not principally due to any dysfunction in the pituitary adrenal system.