Disappearance of pulmonary metastases by OK-432 treatment in a case of hepatocellular carcinoma.

We report here a case of hepatocellular carcinoma (HCC) with multiple lung metastases, which were disappeared by treatment of OK-432. The patient was a 65-year-old man and was diagnosed in 1986 with a small (17 x 11 mm) HCC in the anterior-superior segment of the liver. A part of the right hepatic lobe including the tumor was surgically removed, and transarterial injections of adriamycin (10 mg/week) and subcutaneous injections of OK-432 (10 KE/week) were given. Two and a half years later, recurrence of HCC in the liver and its invasion to vena cava inferior (IVC) were found. OK-432 administration was then stopped and percutaneous ethanol injection therapy (PEIT) was performed 10 times. Six months later, the PEIT was effective and the liver tumor with IVC invasion diminished. However, multiple lung metastases were visible on roentgenograms of the chest, and serum alphafetoprotein (AFP) concentration increased to 50,000 ng/ml. The OK-432 treatment resumed. After 6 months of OK-432 treatment, the multiple lung metastases were disappeared and the serum AFP level decreased to 100 ng/ml. At present, the patient is surviving without any sign of recurrence in either the liver or the lung. The clinical course of this case suggests that OK-432 might have effectively treated lung metastases of HCC, although the exact mechanisms are at present unclear.</p

Spa therapy and drug therapy in patients with bronchial asthma

気管支喘息は,その臨床病態より,Ia.単純性気管支攣縮型,Ib.気管支痙攣縮+過分泌型,Ⅱ.細気管支閉塞型の3つの基本病型に分けることができる｡また,発症病態からは,アトピー型と非アトピー型に分けられる｡気管支喘息に対する温泉療法や薬物療法の際には,これらの臨床病態や発症病態を十分把握した上で最も適切な治療法を選ぶ必要がある｡気管支喘息に対する薬物療法では,気管支拡張薬,去痰薬,抗アレルギー薬,副腎皮質ホルモンなどがその主たるものであるが,特に薬物療法では気管支拡張作用と抗炎症作用が重要である｡一方,温泉療法では,気道の浄化作用や気管支粘膜の正常化作用などが得られ,臨床病型では,過分泌型や細気管支閉塞型に対してより効果的である｡また,発症病態からすれば,アトピー型ではヒスタミンとロイコトリエンが,非アトピー型ではロイコトリエンがより優勢な化学伝達物質であり,このような発症病態を十分把握した上で,適切な抗アレルギー薬を選ぶ必要が ある｡Bronchial asthma can be classified into three fundamental clinical types : Ia. simple bronchoconstriction type, Ib. bronchoconstriction + hypersecretion type and Ⅱ. bronchiolar obstruction type, by clinical pathophysiology. While. bronchial asthma is divided into two types : atopic and nonatopic, by the onset mechanisms of the disease. Spa therapy accompanied with drug therapy should be carried out according to the clinical pathophysiology and the onset mechanisms of the disease. In drug therapy for bronchial asthma, actions of drugs such as bronchodilating and anti-inflammatory actions are more important. While spa therapy is more effective in asthma patients with hypersecretion and bronchiolar obstruction compared to those with simple bronchoconstriction type. In atopic asthma, histamine and leukotrienes are more active in the onset mechanisms of the disease. In contrast, in nonatopic asthma, lrukotrienes are more important. Anti-allergic drugs should be applied for the treatment of asthma on the bases of these findings

IgE-mediated allergy in elderly patients with asthma

The incidence of a positive family history with asthma and levels of serum IgE and IgE antibodies were examined in 136 patients with asthma in relation to age at onset of the disease. The frequency of subjects with a family history of asthma ranged from 37.9 to 75.0% in all groups classified by age at onset. The frequency of patients with a high serum IgE level (≥ 150 IU/mL) was higher (51.7–63.2%) in all groups than the frequency of patients with a low serum level (< 150 IU/mL). The mean level of serum IgE was significantly higher in patients with a family history than in those without a family history, in subjects between the ages of 50 and 59 years at onset (mean age 63.4 years; P < 0.02) and in those over the age of 60 years at onset (74.0 years; P < 0.01). The number of patients with a positive RAST score either to house dust mite (HDM), cockroach, and Candida tended to decrease as the age at onset increased. However, the frequency of positive RAST to HDM was higher in patients with a family history and who were over the age of 50 years at onset compared with those patients between the ages of 40 and 49 years at onset, although the frequency was significantly higher in patients with family history than in those without family history (P < 0.02). These results suggest that IgE-mediated allergic reactions are significant not only in those patients who are younger, but also in elderly patients with asthma