Fourteen patients with unclassified connective tissue disease (UCTD) were presented. All patients were followed for above two years from the initial diagnosis and duration of disease were from 2 to 23 years. The certain clinical features were characterized by non-erosive polyarthritis and Raynaud's phenomenon appearing transiently and recurrently.
They never had swollen hand, sausage like fingers, esophageal disturbance which commonly occur in patients with mixed connective tissue disease (MCTD). None of patients developed systemic lupus erythematosus (SLE), progressive systemic sclerosis (PSS) and MCTD. 9 had hyper gammaglobulinemia, rheumatoid factor was positive in 9, serum test for syphilis was biological false positive in 2, Coombs direct test was positive in 4, LE cell test was positive in 5, speckled type antinuclear antibody was positive in all patients.
Antibody to ribonucleoprotein was positive in 6, but antibody to RNase resistant ENA in only one.
Renal biopsies were performed in 8 of 14, and light microscopies showed mild mesangial hypercellularity with normal capillary loops in 6 and showed no remarkable change in 2. IgG, IgM and C3 were detected in 4 of 8 by direct immunofluorescence.
In summary, UCTD is different from MCTD, other connective tissue diseases and their pre-syndrome.

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Three hundred and seventy three patients with various diseases were evaluated with 4 types of delayed hypersensitivity skin tests (PPD, PHA, Candida and SK-SD) before operation. The tests were considered positive when reddish erythema was larger than 10 mm in diameter, but it was 25 mm in PHA. Skin test index (STI) was defined as follows: STI=logDT+logDC+logDP+logDS-0.4/4
where DT, DC, DP and DS were mean diameter of PPD, PHA, Candida and SK-SD, respectively.
The following results were obtained:
1) Mean diameters of PPD and SK-SD were reduced in patients with malignant diseases.
2) Accordingly, anergy for PPD, Candida and SK-SD was present in 32%, 50%, 37% of the patients with malignant diseases.
3) Subnormal response, namely, STI smaller than 1.0, existed in 44% of patients with malignant diseases, 25% with benign diseases and 3% in healthy subjects.

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One hundred and fifty one patients with various malignant diseases were tested with 4 types of delayed hypersensitive skin tests (PPD, PHA, Candida and SK-SD) and evaluated their nutritional status by hemoglobin, lymphocyte, serum albumin and ratio of weight to height before operation. The skin test index was calculated by using an equation: STI=logDT+logDC+logDP+logDS-0.4/4
(DT, DC, DP, DS: mean diameter of PPD, PHA, Candida and SK-SD).
The STI was compared with nutritional parameters using linear regression.
The following results were obtained:
1. Subnormal response, namely, STI smaller than 1.0, existed in 44% of respiratory malignant diseases, 39% with digestive malignant diseases and 47% with other malignant diseases.
2. STI was well related with hemoglobin, serum albumin and ratio of weight to height in the respiratory malignant diseases.
3. STI was well related with lymphocyte in the digestive malignant diseases.
4. STI was well related with serum albumin and ratio of weight to height in the other malignant diseases.
5. The depressed STI in malignant diseases were well related with operability.

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The large lymphocytes of peripheral blood increased in patients with autoantibodies and reduced in patients with the cancer. They were rich in azur granules, PAS granules, acid phosphatase granules and β-glucuronidase granules. They had the well developed mitochondria, many ribosomes and central dense bodies. They had a lot of microvilli on their surface membrane. Most of them were null lymphocytes and they contained no Tγ. They did not develop the immunoglobulin producing cells by the PWM stimulation. They increased the development of immunoglobulin producing cells from the normal blood B lymphocytes by the PWM stimulation. Their increasing effect on the development of immunoglobulin producing cells was not influenced by SLE lymphotoxin. These facts suggest that their effect might be due to the helper effect.

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A 48 years old male patient with dermatomyositis associated with prominent monocytic leukemoid reaction is reported.
He received the radical operation of stomach cancer on April, 1978, and was quite well until he complained of fever, backache, difficulty in swallowing and rash on the 18 months after the operation. On hematologic examinations, WBC count was 132, 000/mm
with a differential count of 4% promyelocytes, 4% myelocytes, 11% metamyelocytes, 32% stab., 8% segment, 35% monocytes and 6% lymphocytes. On other examinations, serum CPK, GOT, aldolase and lysozyme levels increased.
He was initially treated with predonisolone and showed a marked improvement not only in clinical symptoms but also in hematological findings. Laboratory data became normal soon thereafter. But, several month later, he relapsed and died of heart failure in spite of intensive treatment.

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A patient with systemic lupus erythematosus developed intestinal infarction and exacerbation of lupus nephritis after abrupt discontinuance of corticosteroid therapy. A 31-year-old woman was diagnosed as systemic lupus erythematosus two years ago when she had facial erythema, polyarthralgia, thrombocytopenia, proteinuria, casturia and positive antinuclear antibody. Prednisolone 45mg daily was begun with clinical and laboratory improvement. Prednisolone was gradually tapered to 17.5mg, when she stopped to take medication by herself. One month later abdominal pain and distention developed, and she was admitted to this hospital. On examination she had dehydration, fever, abdominal distention and renal failure. Prednisolone was administered with little clinical improvement. On the tenth hospital day because of massive melena, she underwent emergency laparotomy, which revealed necrosis of the terminal ileum. After the operation, disseminated intravascular coagulation and progressive renal failure developed and the patientdied on the 9th day after laparotomy.
Histopathologic examination of the resected terminal ileum demonstrated fibrinoid necrosis of small arteries and arterioles with thrombi in the necrotic intestinal walls.
In many cases of systemic lupus erythematosus associated with intestinal necrosis, necrotizing vasculitis was found. However, there was one case report of systemic lupus eryt-hematosus associated with hemorrhagic necrosis of the intestines without evidence of vasculitis, in which intimal hyperplasia, medial elastosis and reduplication of the laminaelastica in the small mesenteric arteries were found. In our case the necrosis of the terminal ileum might have developed due to ischemia from necrotizing vasculitis and thrombi.
Postmortem examination demonstrated marked fibrinoid necrosis in glomerular tufts and intimal thickening of the afferent arterioles, which might explain rapid deterioration of renal function. Fibrinoid necrosis was also found in the spleen and the pancreas.
It is suggested that the abrupt discontinuance of corticosteroid therapy may have aggravated the systemic vasculitis causing necrosis of the terminal ileum and rapidly progressive renal failure.

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This communication describes a successful application of two-directional rocket method to simultaneous quantitation of various substances. Differential assay of albumin and IgG, which have different mobility and antigenicity, was found easiest, by changing the agarose/agar ratio to get an appropriate electroendosmosis of the gel. That of C3PA and C3A, which have identical antigenicity but different mobility, was found likewise easy, for on addition of EDTA to agar, anodal migration of C3PA alone took place, while C3A remained in cathodal side.
Differential assay of SC and SIgA was also successful: After transferring SC from β₁-region to α₁-region by addition of heparin-Ca EDTA the two substances were separated in the opposite direction by changing agarose/agar ratio. The height of the rocket-shaped precipitation peaks formed in two directions was found proportional to the concentration of the antigens.
According to our postulation the effect of the polyanionic charge of heparin is a contributing factor to this effect of heparin-Ca EDTA on SC, because the electric mobility of SC was altered by other anion surfectants, and in addition, this effect was quite vulnerable to the influences of pH and ionic strength.
In using this method as a screening assay of saliva donors for detection of primary immunodeficiency, 2 cases of isolated IgA immunodeficiency and 2 cases of hypoglobulinemia were picked up from 16, 000 infants in Shida District over a 3 year period.
In view of the significant role of SIgA in local protective mechanism, this two-directional rocket method seems to be recommended, because of its easy sampling procedure.

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