The development of modern tumor immunology based on animal tumor models demonstrated the presence of tumor-specific antigens and the ability of tumor-specific immunity to protect against tumor cell challenge. However, neither of these characteristics are readily attributed to many human cancers. Although in certain animal models induced by virus or carcinogen, antigen-specific T cell (CTL) play an important role against tumor cell killing, the role of specific CTL is not so clear in human cancer.
Recently, Brimm et al reported that peripheral blood leukocytes from cancer patients could be activated in culture in preparation of interleukin-2 (IL-2), resulting in the development of effector cells cytotoxic for autologous fresh solid tumor cells. The IL-2-mediated activation of PBL to become cytotoxic to fresh autologous solid tumor cells probably reflects a common and non-specific activation mechanism of the host. As the anomalous killer cells distinct from CTL and NK cell, lectin-activated killer, alloantigen-activated killer and lymphokine-activated killer are included.
These cell killings were examined to the PBL of cancer patients.
Lymphokine-activated killers represent a unique and fundamental cytotoxic effector system that may play a role in immune surveillance against NK resistant solid tumor cells, and may have a possible role in the adoptive immunotherapy of tumors.
The generation of an immune response requires not only the appropriate interaction of cells from the monocytic and lymphoid lineages but also the release of appropriate cytokine by these cell populations. Evidemce is accumulating that many of the functions attributed to lymphocytes and monocytes are actually mediated by the cytokines they release. IL-2 is a lymphokine that is released by T cells after appropriate stimulation. IL-2 production activity in peripheral T cells of cancer patients was examined using IL-2 dependent T CTLL cell lines. The action of IL-2 is of the essential growth factor supporting the in vitro proliferation of T suppressor/cytotoxic cells, lymphokine-activated and NK cells. Furthermore, IL-2 enhances the functional activity of both lymphokine-activated and NK cells.
The adopttve immunotherapy using IL-2 will be effective to cancer patients. Tumor necrosis factor (TNF) in one of monokine which has marked anti-tumor activity in vitro and in vivo experiments.
Recently human recombinant IL-2 and TNF have been made in my country. The availability of molecular-cloned IL-2 and TNF offers the great advantages to the patients.

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Small portion of normal peripheral blood T cells has Ia-antigen on their surfaces, and these Ia-antigen positive T cells (Ia⁺ T cells) are thought to be immunologicaly activated T cells in vivo. In this studies we investigated the functional properties on in vitro immune reactions of normal adult lymphocytes.
Ia⁺ T cell fraction was depleted by negative selection using monoclonal anti-Ia antibody and complement. Ia⁺ T cells were responder or helper T cells for PHA-induced proliferation, and suppressor T cells for Con A or PWM-induced proliferation of normal peripheral lymphocytes. In autologous mixed lymphocyte reaction (AMLR) Ia⁺ T cells acted as responder or helper T cells. Moreover, Ia⁺ T cells had a helper action for PWM-induced production of immunoglobulin by normal peripheral B cells.
These findings showed that Ia-antigen on T cells would not be a single functional subset marker, but differentiating marker for various effector cells of T cells.

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164 cases with Wegener's granulomatosis (WG) in Japan for 20years since 1958 up to 1977 based on the Annual of the pathological Autopsy Cases in Japan and six patients with WG which we have experienced in our institute were observed. The diagnosis of six patients with WG was made on clinical symptoms and the histological examination of the biopsied materials from the nasal membrane, bronchus and kidney.
In our clinic, the male-tofemale ratio was 1 to 1 and the mean age at the onset of the initial manifestations of WG was 43.7years (range: 15.8 to 72.5years). Fever and upper respiratory symptoms were the first manifestations of WG in the majority of our cases. In the clinical features during the course of WG, upper respiratory and urinary manifes-tations were the most common (six cases). Pulmonary involvement was noted in five cases, eye in three cases, ear in one case, and central nervous system in one case. When the patients were given no drugs abnormal hematological manifestations were found: increase of erythrocyte sedimentation rate, C-reactive protein positive (5+_??_6+), neutrophilia and α₂-globulinemia in all cases, γ-globulinemia and increase of ALP in five cases, leukocytosis in four cases, hypoalbuminemia in three cases. Positive rheumatoid factor were seen in 50%, increase of IgG and IgA in four patients, and hype rcomplementemia in four ones. The abnormalities in T cell function, such as the decrease of T cell counts, impaired skin delayed hypersensitivity (PPD skin test), and reduced lymphocyte blastogenesis by PHA, were noted in died cases.
In autopsy cases of WG, the male-to-female ration was 84 to 80 and their ages ranged from 10 to 68years (the mean of 39.0years), The incidences of the organ system involvement in WG were given in Table 5. Upper respiratory tracts involvement was noted in 69.5% of 164 autopsy cases, pulmonary involvement in 47.0%, kidney in 43.9%, spleen in 23.8%, liver in 14.0% and so on.
These observations were discussed with reference to the reports in the literature.

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A 57-year-old female suffered from Hashimoto's thyroiditis since 1959. When she was hospitalized in Nov. 1979 for acute bronchitis, her home doctor pointed out her sera showed marked hypergammaglobulinemia. She was referred to our hospital for further examination. Her case was diagnosed as multiple myeloma according to the findings; increasement of IgG₁, k monoclonal gammaglobulin, increasement of immature plasmacytes in bone marrow and multiple osteolytic lesions in the skull. Her sera also showed anti-microsome antibody activity at a dilution of 1: 25, 600.
The monoclonal protein was purified from her sera to testify the presence of anti-microsome antibody activity. The results were as follows.
1) Patient's purified IgG, F (ab')₂ and light chain kappa F (ab')₂ showed anti-microsome antibody activity at a dilution of 1: 102, 400, 1: 102, 400 and 1: 25, 600 respectively. However, light chain lambda F (ab')₂ did not show this antibody activity.
2) Anti-idiotypic antybody was prepared by immunizing rabbit with F (ab')₂ fragment of patient's IgG followed by absorption with IgG of Cohn's fraction II. This anti-idiotypic antibody binded only F (ab')₂ of patient's IgG but not IgG of Cohn's fraction II. This anti-idiotypic antibody inhibited the binding between the monoclonal protein and microsome antigen.
These results suggested that patient's monoclonal protein was the antibody to microsome.
This is the first case reported in the literature whose serum monoclonal protein has been proved to be anti-microsome antibody.

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A 72-year-old man was admitted to the hospital because of muscle pain, stiffness involving the neck, shoulders and limbs, and joint pain. He was well until one month earlier, when high fever and myalgia appeared. The pain was worse with active motion and it was difficult for him to get around. Fatigue and malaise were prominent. He lost 5kg in one month.
On examination, general phisical findings were unremarkable except for high fever, myalgia and joint pain. His right wrist was slightly swollen. The temporal arteries were normal.
Laboratory data proved no muscle damage (GOT 27 IU/1, CPK 45 IU/1, aldolase 1.9mU/ml). ESR was 70mm in 1hour. WBC was 11, 800/cumm. Total protein was 7.5g/dl. Serum protein electrophoresis revealed an increase of α2-globulin to 14.1%. Circulating immune complexes were detected by means of Clq binding assay, while CH50 was slightly elevated. RAtest, HBsAg, HBsAb and HB immune complex were all negative. Biopsy of the left quadoriceps femoris muscle revealed slightly inflammatory cells surrounding arterioles. Biopsy of the right temporal artery revealed atherosclerotic change, but no evidence for giant cell arteritis was found.
The above findings are compatible with polymyalgia rheumatica. He was started on predonine (30 mg/day). His response to the therapy was dramatic and predonine was gradually decreased in dosage Two weeks of predonine therapy resulted in a marked improvement of his myalgia, and other symptoms disappeared. Circulating immune complexes dropped gradually after treatment.

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We present here two cases of systemic lupus erythematosus (SLE) involving the central nervous system and kidney. They showed subcutaneous and / or intramuscular abscesses in the course of the disease.
The first case had massive subcutaneous abscess in the right arm. The abscess may have been induced by palsy dominant on the right side and intramuscular injections of anticonvulsant near the lesion.
The second case had recurrent myalgia. Subcutaneous abscess was noted at the right internal malleolus. Intramuscular abscesses (pyomyositis) were noted in the left gluteal and thigh muscles by echography, CT scan and garium 67 citrate scintigraphy. Leukopenia, hypofunction of T lymphocytes and poor killing activity of granulocytes may be the cause of abscesses.
S.epidermidis, Bacteroides species and Candida albicans were cultured from the first case and S.aureus from the second.

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A 54-year-old female was admitted to our clinic for the evaluation of proteinuria and pancytopenia.
By immunological examination and renal histology, she was diagnosed as systemic lupus erythematosus.
On twenty hospital days, high fever, nuchal stiffness and consciousness disturbance appeared, and she was diagnosed as being complicated with meningitis of Listeria monocytogenes by the cerebrospinal fluids examination.
About 110 days after admission, hallucination and delusion have developed gradually and persisted despite several therapeutic attempts.
Grand mal-like convulsion and anisocoria appeared suddenly about one year after admission, then she took a down hill course and died of cardiorespiratory failure on May 19 1982.
In post mortal pathological observation, multiple hemorrhagic infarction-like lesions, up to thumb-head size, were noticed in the medulla of cerebrum and cerebellum.
Infiltrations of atypical lymphoid malignant cells were seen in these lesion, but neither evidence of vasculitis or infarction was present at all.
Since there were no infiltration of such pathological cells in systemic lymphnodes, the diagnosis of primary malignant lymphoma of the brain has been determined.
Both listeriosis and primary malignant lymphoma of the brain can be seen rather frequently in immunodeficient patients such as transplant recipients with immunosuppressants.
Several cases of SLE with one of these complications have been occasionally reported.
However, simultaneous complication of both listeriosis and primary malignant lymphoma of the brain is very rare in SLE patients.
The pathogenesis of the development of these complications in this case was discussed.

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Cytochrome-b and flavin adenine dinucleotide (FAD) were measured in neutrophils from a male patient and his family with the X-linked form of Chronic Granulomatous Disease (CGD). The membrane fraction of the patient's neutrophils contained 93pmol/mg protein of FAD (control 102±20, mean±sd), and 32pmol/mg protein of cytochrome-b (control 88±20, mean±sd). In the spectrophotometric study, the maximal absorbance peak of cytochrome-b was at 421nm, as that from control was at 427nm. Cytochrome-b in neutrophils from his mother and a sister, who were thought to be carriers, had their maximal absorbance peak at 425nm. These findings suggest that the spectral abnormality of cytochrome-b contribute to the pathogenesis of CGD in this case.

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