[Combination chemotherapy with cis-platinum, adriamycin and mitomycin C (PAM) in the treatment of non-small cell carcinoma of the lung]

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.

Tubulointerstitial immune complex nephritis in a patient with cutaneous vasculitis

We report a patient who suffered from cutaneous vasculitis with renal involvement comprising tubulointerstitial (TI) nephritis and relatively mild glomerulitis. Renal biopsy revealed immune deposits both in mesangium and along tubular basement membrane (TBM), suggesting that immune complexes played a significant role in the development of renal damage. Although it is well known that vasculitic syndromes commonly affect glomeruli, this report is the first to demonstrate tubulointerstitial immune complex nephritis in a patient with cutaneous vasculitis.

Antinuclear antibodies in the relatives of patients with systemic sclerosis

Antinuclear antibodies were studied by indirect immunofluorescence and double immunodiffusion in 21 patients with systemic sclerosis and 35 of their relatives. When HEp-2 cells were used as the substrate, the frequency of antinuclear antibodies in the patients' sera was 100% and that in the relatives was 26%. When rat liver sections were used, the values were 86% and 17%, respectively. Anticentromere antibody was detected in the serum from the mother of one patient whose serum had anti-Scl-70 antibody. Antibody to n-RNP was positive in the sera from the brother and daughter of another patient whose serum was positive for anti-n-RNP and anti-Scl-70 antibodies. The high frequency of antinuclear antibodies in the sera from the relatives of systemic sclerosis patients suggests that immunological abnormalities play a part in the pathogenesis of this condition.

Antinuclear antibodies in localized scleroderma

When HeLa cells were used as the substrate for detection by the indirect immunofluorescence method, antinuclear antibodies were demonstrated in 16 of 22 (72.7%) sera from patients with localized scleroderma. When mouse kidney sections were used, the positive rate for antinuclear antibodies was 50% (11 of 22). In the 3 subgroups of localized scleroderma, frequencies of antinuclear antibodies on HeLa cells were as follows: morphea, 50% (2 of 4), generalized morphea, 100% (6 of 6), linear scleroderma, 67% (8 of 12). Antibodies to centromere, Scl-70, nuclear RNP, Sm, and SS-B antigens were not detected in any patients with localized scleroderma. The high frequency of antinuclear antibodies in localized scleroderma sera suggests that localized scleroderma is a disease which, though different from diffuse scleroderma, also involves an immunologic abnormality.

Membranous glomerulonephritis associated with eosinophilic lymphfolliculosis of the skin (Kimura's disease): report of a case and review of the literature

A 48-year-old male, who had been suffering from eosinophilic lymphfolliculosis of the skin (Kimura's disease) for six years, developed the nephrotic syndrome. Renal biopsy revealed immunopathological and electron microscopic changes characteristic of membranous glomerulonephritis. A review of the literature disclosed a high frequency of renal involvement in Kimura's disease. Out of 175 reported cases of the disease, 21 (12%) were found to have proteinuria including 13 who had the nephrotic syndrome. Some of the patients were noticed to have proteinuria before the onset of the skin lesions, suggesting the existence of common etiological factor(s) capable of inducing both skin and kidney lesions.