Ikuro Kimura

Basophils in bronchial asthma with reference to reagin‐type allergy

The relationship of the basophils in the peripheral blood of patients with bronchial asthma to their allergic reactions has been studied. The basophils were stained and counted using our improved method of Kovács. The results showed that the basophils increased in the pre‐attack stage and a count of 65/mm3 or more made it possible to predict a forthcoming attack. Among the patients on prolonged treatment, the basophils which were over this level during repeated asthmatic attacks decreased during the attack‐free stage, reflecting the effects of therapy. It was also found that the basophils were increased in those patients with allergic asthma whose sera gave positive Prausnitz‐Küstner reactions. This study suggests a significant relationship of peripheral blood basophils with the allergic reaction.

Human B cell, T cell and null cell leukaemic cell lines derived from acute lymphoblastic leukaemias

CONTINUOUS culture of human leukaemic cells is still a difficult task, although several leukaemic cell lines have been derived from patients with acute and chronic myelogenous leukaemia1,2 and acute lymphoblastic leukaemia (ALL) (refs 3–6). We describe here B-cell, T-cell and null-cell leukaemic cell lines newly established from three patients with ALL.

Clinical course and prognosis of chronic pancreatitis.

Course and prognosis of 125 patients with chronic pancreatitis (CP) were evaluated. Follow-up period ranged from 1–20 years with a median of 6.3 years. The following conclusions were obtained. Recent increase of CP in our clinics was ascribed to alcoholic CP and idiopathic CP in the aged. Of 106 patients with pain, 74 showed improvement or disappearance of pain. Drinking habit and observation period were the main factors determining the rate of pain relief. Serial endoscopic retrograde pancreatography (ERP) showed aggravation in 17/47 patients, cholecystokinin-pancreozymin (CCK-PZ) secretin test in 4/40 patients, and oral glucose tolerance test (OGTT) in 7/25 patients. Exocrine function showed improvement in five patients, whereas endocrine function showed none. Improvement or aggravation of exocrine function was closely related to drinking habit. Main complications included 15 cases of peptic ulcer, 19 of pancreatic pseudocyst, and 15 of bile duct stenosis. Twenty-six patients died, often due to malignant neoplasms and diabetic complications. Those who continued drinking as much showed a lower survival rate than those who discontinued or decreased alcohol intake. The socioeconomic status deteriorated often due to pain or alcoholism. Three patients had to degrade jobs and six fell into inactive social life.

2/8 translocation in a Japanese Burkitt's lymphoma.

A new translocation between chromsomes 2 and 8 t(2p−; 8q+), was found in fresh lymphoma cells from a Japanese patient with Epstein-Barr virus-carrying Burkitts lymphoma, and in a lymphoma cell line derived from this patient. There was no 14q+ translocation, as has been previously described in African and North American Burkitts lymphomas.

Appearance of basophils in the sputum of patients with bronchial asthma

A total of 108 samples of sputum obtained from twenty patients with bronchial asthma were examined for appearance of basophils and eosinophils. Both cell types are present in sputum during an asthmatic attack and disappear at the conclusion of the attack. Their presence correlates with the severity of the disease. It has previously been demonstrated that the blood basophils count falls during attacks of bronchial asthma, and the present study suggests that basophils move from the blood stream into bronchial tissue during the acute phase of an asthmatic attack.

Immunochemotherapy in human lung cancer using the streptococcal agent OK-432.

Streptococcal agent OK‐432 was administered at maintenance levels with conventional inductive chemotherapeutic agents to stage III and IV lung cancer patients. Survival rates were longer in patients treated with OK‐432 than in patients treated without OK‐432. An enhancement of lymphocyte blastogenic activity and a delayed PPD skin reaction were found in patients treated by OK‐432. A low grade fever was present as a side effect of this agent in some patients. The results suggest that OK‐432 may be a useful immunotherapeutic agent in combination with induction chemotherapy in reducing host damage in advanced stages of lung cancer.

Comparative study of prophylactic cranial irradiation in patients with small cell lung cancer achieving a complete response: a long-term follow-up result

Between 1981 and 1986, a total of 46 patients with small cell lung cancer (SCLC) achieving a complete response by chemotherapy with or without chest irradiation were randomized either to receive prophylactic cranial irradiation (PCI) or not. With a median follow-up time of 8.5 years for both groups, only five of 23 patients (22%) in the PCI group developed brain relapse, while 12 out of 23 (52%) in the no PCI group did so (P < 0.05). The frequency of patients developing a sole brain relapse during their whole clinical course was 4% for the PCI group and 17% for the no PCI group, however, the difference was not statistically significant. Patient survival was better for the PCI group (median survival time of 21 months, and 5-year survival rate of 22%) as compared with the no PCI group (median survival time of 15 months, and 5-year survival rate of 13%), showing a marginal significance (P = 0.097). Late neurologic toxicity was infrequent; only one developed a mild deterioration among seven long-term disease-free survivors in the PCI group. These results appear to warrant further clinical trials to clarify the utility of PCI in patients with SCLC achieving a complete response.

Clinical evaluation of muscle strength in 20-79-years-old obese Japanese.

It is well known that obesity is closely related to non-insulin-dependent diabetes mellitus, hyperlipidemia, hypertension and cardiovascular disease, and the insulin resistance associated with obesity is supposed to play a central role for the development of these diseases. Thus, effective prevention and treatment of obesity need to be explored. In 357 obese (body mass index > or =26.4) subjects, aged 20-79 years, grip and leg strength were determined and compared with age- and sex-matched 1683 nonobese control subjects. Age-dependent alteration of body composition, evaluated by waist-hip ratio and the relative fat mass volume, was also compared. Finally, the relationship between the number of risk factors related to atherosclerosis and muscle strength was evaluated. Grip and leg strength in obese subjects were obviously stronger than controls under the age of 60 in both sexes. However, in the subjects over 60 years old, muscle strength was similar between obese subjects and controls. Weight bearing index (WBI) (leg strength (kg)/body weight (kg)) in obese subjects was remarkably lower than that in controls in all generations. In obese subjects, the waist-hip ratio and relative percentage of fat increased with aging, and obese subjects with multiple risk factors had higher waist-hip ratio and a tendency for lower muscle strength. Reduced WBI was considered to be a fundamental feature of obese subjects, and obese subjects increased fat composition with aging, which may be linked with low muscle strength. Thus, we need to design the most effective protocols to maximize and maintain quantitative and qualitative properties of muscle.

Phase II study of vinorelbine in heavily previously treated small cell lung cancer

Twenty-four previously treated patients with refractory or relapsed small cell lung cancer (SCLC) were entered into a prospective, multicenter phase II study. All 24 patients had been pretreated with some form of cisplatin-based chemotherapy. The median time of chemotherapy was 4.2 months (range 1.4–9.4 months). Patients were treated with a dose of 25 mg/m2 of vinorelbine weekly. Twenty-four patients were eligible for response and for toxicity. Partial response was observed in 3 out of 24 eligible patients (12.5%; 95% confidence interval, 2.7–32.4%). All 3 patients who responded had previous chemotherapy including vincristine. The most common toxicity was leukopenia (91.7%, 66.7% in WHO 3-4 grade) and anemia (70.8%, 20.8% in WHO 3 grade). Nonhematological toxicities were moderate and mild. These results support a two-stage sequential study design of previously untreated patients for further phase II study in SCLC.

Allergen- and Anti-IgE-Induced Histamine Release from Whole Blood

The release of histamine by allergen and anti-IgE from whole blood was observed in 34 asthmatic subjects with a positive skin test to house dust. The time course of histamine release showed that the release by allergen and anti-IgE peaked after 15 min incubation. There was no significant difference in the time course of the release from whole blood between allergen and anti-IgE. Anti-IgE-induced histamine release correlated to a certain extent with the serum IgE level. Histamine release by house dust, on the other hand, correlated with the radioallergosorbent test score. A striking difference was present in the dose-response slope between allergen and anti-IgE. The maximum percent release correlated with the dose-response slope by allergen, but not by anti-IgE. The amount of histamine release induced by anti-IgE paralleled the amount of the release by house dust in the cases sensitive to the allergen; less sensitive basophils to anti-IgE were less sensitive to house dust.