Risk factors for infection were evaluated in patients with active SLE. The active SLE patients complicated by infection within one year after initiation of steroid therapy for SLE (n=19) were compared with those not complicated by infection (n=71) with regard to age, disease duration, laboratory findings, disease activity (SLE Disease Activity Index), and treatment. There was a significant difference in levels of serum albumin, urine protein, serum creatinine, blood urea nitrogen, serum IgA, IgG, and prednisolone dose between the two groups. By using logistic regression analysis, the dependence of infection on the above variables was investigated. The incidence of infection was significantly related to serum albumin level, the severity of SLE (the Healht and Welfare Ministry criteria) and initial prednisolone dose. The severity of SLE, urine protein level, pleural or pericardial effusion, age, and CH 50 were found to contribute in the decreasing order to serum albumin level. We conclude that hypoalbuminemia not only from proteinuria but also from other causes, such as the severity of SLE, may increase the risk of infection in patients with active SLE.

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The functional antigenic expressions of peripheral blood lymphocytes (PBL) in 39 premature and 28 mature infants were investigated using monoclonal antibodies and flow cytometry to evaluate the age-related phenotypic differentiation in their cellular immune system. Although the cells expressed mature T cell differentiation antigens (CD 3 Ag) detected on PBL in extremely low birth weight (ELBW), very low birth weight (VLBW) and mature infants increased in the order of their gestational age, the percentage of the CD 3⁺ T cells in PBL from the ELBW infants elevated to a level comparable to that in adults until 2 months of age. The expression of CD 3 Ag on PBL from the VLBW infants was at approximately the same frequencies with that on adult PBL. And the percentage of the CD 3⁺ T cells in PBL from mature infants was rather higher than that in adult PBL. The relative percentages of CD 4⁺ T cells in the CD 3⁺ T cells from premature and mature infants were significantly higher figure than that detected in adult CD 3⁺ T cells and decreased to a level comparable to that in adults until 6 months of age. In contrast, the relative proportions of CD 8⁺ T cells in both premature and mature infants were significantly lower than the adult level during the first 3 months. There was no significant difference in the percentage of CD 4⁺ T cells or CD 8⁺T cells between ELBW, VLBW and mature infants. These data observed in the postnatal phenotipic changes in the T cell subsets suggest that the differentiational expression of the CD 4 or CD 8 antigen on CD 3⁺ T cells might occur at least during the last trimester and the quantitative maturation of CD 3⁺ T cells might be near completion until 40 weeks of gestation. The predominance of Leu 8⁺ suppressor inducer T cells in the CD 4 subset during the first 6 months of age in premature and mature infants was also characteristic in neonatal T cell subsets. The Leu 8^-CD 4⁺ subset was predominantly detecte in the CD 3⁺ T cells from the ELBW infants after birth who had higher risk for the exposure to foreign antigens than other 2 groups. Both VLBW and mature infants were lack in the percentage of Leu 8^-CD 4⁺ T cells at birth, but the rapid increase in the percentage of the Leu 8^-CD 4⁺ T cells nearly to adultlevel until 6 months of age was observed in the VLBW infants. These alterations in the percentage of distinct T cell subsets may be associated with the induction of suppression of immune responses rather than that of the up-regulation in neonates, however, our results indicate the possibility of early accomplishment of the phenotipic differentiation of the T cell subsets in premature and mature infants to provide adult levels of cellular immune system.

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Serum levels of cytokines including tumor necrosis factor (TNF-α), interleukin-1α (IL-1α), interleukin-1β (IL-1β), interleukin-6 (IL-6) and granulocyte macrophage-colony stimulating factor (GM-CSF) were examined in patients with gall bladder stone before and after operation Serum level of each cytokine showed different time course from each otehr after operation. Time course of serum levels of cytokines expect for GM-CSF had two peaks. The first peak for TNF-α, IL-1α, IL-1β, or IL-6 was observed at 15, 18, 21, or 24 hrs after operation, respectively. The second peak for each of them was 2, 3, 5, or 7 days after operation, respectively. The time course for GM-CSF showed that the serum level remained within normal during the first 24 hrs after operation and reached the peak 3 days after. The serum levels of these cytokines at their peaks were higher than those in control sera.
WBC and CRP were also examined in patients. The time course of WBC or CRP showed one peak at 24 hrs or at 2 days after operation and reached the peak 3 days after. The serum levels of these cytokines at their peaks were higher than those in cotrol sera.
WBC and CRP were also examined in patients. The time course of WBC or CRP showed one peak at 24hrs or at 2 days after operation, which was between the first and the second peaks in the time course of serum cytokine levels.
These data suggest that the production of these cytokines is closely related to surgical infection and recovery from that, and imply that they influence each other.

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A correlation between serum levels of IgE and IgG, was examined in 79 patients with bronchial asthma. High levels of IgG₄ were not always correlated to high levels of IgE in all subjects with asthma. IgG₄ levels tended to increase as IgE levels increased in patients over age 60, but not in those under age 59. The results show that serum IgG₄ levels are associated with serum IgE levels in patients over age 60 and are related to patient age in all subjects with asthma.

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The presence of anticardiolipin antibody (ACA) in preeclampsia and eclampsia, and its clinical significance were studied. Serum samples were taken from 57 cases of preeclampsia including 29 cases of the severe type and 37 normal pregnant women ranging from 28 to 40 weeks of pregnancy. ACA was measured by an enzyme-linked immunosorbent assay using Harris' standard. Values above or equal to the mean plus 3 standard deviations were considered positive. The mean values and standard deviation of 41 normal pregnant women was 4.3 and 3.2U/ml respectively. In all cases of preeclampsia, ACA was positive in 7 of 57 cases (12.3%). In mild cases of preeclampsia, ACA was positive in 3 of 28 cases (10.7%). In severe cases ACA was positive in 4 of 29 (13.8%). Three cases of 7 ACA positive fetuses delivered light for date neonates. Four fetuses suffered from fetal distress. Activated partial thromboplastin time (APTT) was measured in 5 cases. In 2 of them (40%), APPT was prolonged. Thrombocytopenia (less than 15×10⁴/cmm) was found in 3 of 7 cases (43%). Incidence of intrauterine growth retardation (IUGR) in preeclampsia was 21.1%. Higher incidence of IUGR was found in ACA positive (42.9%) than in ACA negative preeclampsia (18.0%).
We suggest that ACA appears in some cases of preeclampsia, and that ACA may be associated with clinical abnormalities such as IUGR and coagulation disturbances in preeclampsia.

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Cyclosporine A (CsA) produces potent immunosuppression through its main inhibitory effect on activation of helper/inducer and cytotoxic T lymphocytes. Although CsA therapy has shown promising results in various diseases associated with disordered immuneregulation (i.e. uveitis, type I diabetes, psoriasis), therapeutic trials for systemic lupus erythematosus (SLE) seem to have been restricted chiefly because of its deleterious nephrotoxicity.
We reported an active case of SLE complicated with avascular bone necrosis of bilateral femoral heads. Our patient received 3mg/kg/day of CsA for the initial six weeks. When CsA dosage was incremented to 6mg/kg (the blood trough level of CsA was 210.6ng/ml at that point), minimal rises of the value of serum β 2-microglobulin and its urinary excretion were observed but returned to the normal level promptly after the dosage was reduced. Hypocomplementemia began to normalize at sixth week and discoid rash disappeared successively. Although hypergammaglobulinemia was not improved after six months of CsA therapy, number of lymphocyte absolutely increased and the titers of the following autoantibodies significantly decreased after several months: anti-nuclear antibody, anti-Sm antibody, anti-RNP antibody, anti-RBC antibody and anti-platelet antibody.
Although the immunological mechanism should be further elucidated, the favorable response observed in our patient might raise the possibility that CsA could induce remission in the group who suffer from side effects caused by long-term use of steroids, including osteoporosis, cataracts and atherosclerosis.

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A male hemophiliac with HIV infection was tentatively diagnosed to have pulmonary tuberculosis by his symptoms and radiographic findings (cavity and coin lesion). Although PPD skin test and cultures of sputa showed negative results, electrophoretic analysis of PCR-amplified DNA from patient's sputa demonstrated the DNA band correponding to authentic mycobacterial DNA (311 bp). In addition, anti-tuberculosis chemotherapy drastically improved his symptoms and radiographic findings. A usefulness of PCR analysis in the diagnosis of mycobacterial infection in patients with HIV infection is discussed.

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We report and old male case of subdural hematoma associated with temporal arteritis. The case is a 75-year-old man who had a sudden on set of headache. The diagnosis of subdural hematoma was made by a neurosurgeon. He had been suffered from pyrexia. On physical examination, stiff neck was noted. His erythrocyte sedimentation rate was 72mm/hr, C-reative protein (CRP) was positive in a high titer, and rheumatoid factor elevated. A biopsy specimen taken from bilateral temporal artery showed necrotic arteritis. Steroid therapy with prednisolone (30mg/day) was stared. After the therapy, headache and pyrexia were improved with laboratory improvment.
Several reports have stated CNS involvement from PN, such as cerebral hemorrhage, subarchroid hemorrhage, and cerebral thrombosis. He is thought to be a rare case of temporal arteritis with subdural hematoma.

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Macroscopically normal appearing fresh surgical tissues were obtained from the operated lungs and were fixed in PLP fluid or Carnoy's fluid. Samples were incubated with a murine monoclonal antitryptase antibody provided commercially for the use of RIA assay for mast cell tryptase. Immunohistochemical method with SAB showed that tryptase positive lung mast cells were stained in a brown color and these cells were predominant in alveoli. These results above suggest that the present method is an useful immunohistochemical procedure to see the possible involvement of mast cells in the pathogenesis of allergic pulmonary diseases.

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The rate of gastric emptying in patients with collagen diseases and normal subjects was studies using the acetaminophen method. As an indicator of gastric emptying rate, the plasma acetaminophen concentration was measured by fluorescence polarization immunoassay at 45 minutes after ingestion of a high calory pasty test meal (200 ml) with 1.5gram ofacetaminophen. In 8 normal subjects, the plasma concentration was 9.2±0.5μg/ml (Mean±SE). In 15 patients with systemic lupus erythematosus (SLE), 9 patients with progressive systemic sclerosis (PSS) and 4 patients with mixed connective tissue disease (MCTD), the concentration were 10.6±1.2μg/ml, 6.6±1.1μg/ml and 6.6±1.6μg/ml, respectively. 4 of 15 patients with SLE, 5 of 9 patients with PSS and 2 of 4 patients with MCTD showed reduced rate of gastric emptying. The acetaminophen method is considered to be new, simple, safe, and highly reproducible. It is therefore useful for gastric emptying rate in patients with collagen diseases.

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