Spontaneous remission of small cell lung cancer: a case report and review in the literature.

Spontaneous remission (SR) of cancer, especially of lung tumor, is a rare biological event. Only seven cases in which small cell lung cancer (SCLC) regressed spontaneously had been previously reported. We report here a rare case of complete SR of SCLC in an 86-year-old man. Paraneoplastic sensory neuronopathy (PSN) is a rare syndrome, which is associated with malignancy such as SCLC and starts with dysesthetic pain and numbness in the distal extremities, then spreading all four limbs and trunk causing severe sensory ataxia. In the previous reports, SR of SCLC is suggested to result from surgical trauma or PSN, which may be able to enhance anti-tumoral immunity. Our report is the case of SR of SCLC, without any therapies nor any invasive examinations. Although the reason of SR of SCLC in the present case is unknown, PSN could be one of the diagnosis by exclusion.

[Study on the perception of influencing factors in the course of alcoholism--a comparison among alcoholics, families, and health care professionals].

(1) We prepared a questionnaire modified from that of Edwards, G. et al, to investigate the factors influencing drinking behaviors. Responses of the questionnaire were filled out by the alcoholics, their families, and health care professionals in four psychiatric hospitals having intensive alcoholic rehabilitation programmes. Clinical course of them were traced back for at least two years. (2) We examined the relationship between the course of alcoholism and the differences in perceptions among alcoholics, their families, and health care professionals. (3) We obtained sufficient responses from 76 alcoholics. Those were divided into two groups; one is a group of alcoholics with a history of continuous abstinence of over one year (50 cases), and the other is the group of less than one year of recent abstinence period (26 cases). (4) As the overall results from the participants, items on "self-help group" were favorably responded for the improvement of drinking behavior. Families tend to perceive more sensitively into the internal psychological changes of the alcoholics than the health care professionals, whereas the health care professionals tend to make general and common responses regardless of any alcoholics. We, health care professionals should be aware of such a limit to promote more efficient collaborative works with alcoholics and their families. (5) We compared these two groups ("over one year group" vs. "less than one year group") with regard to their demographic and family backgrounds, clinical features, treatment, self-help group attendance, employment, etc. (6) A significant accordance of responses among three groups (alcoholics, family, health care professionals) was found in the "over one year group" than in the "less than one year group". Such a high level of accordance is considered to reflect a favorable family adaptation along with the recovery from alcoholism, deep understanding on the part of health care professionals, progress in the treatment and in the relationship in a self-help group. (7) As regards the "less than one year" group, it includes more single individuals and less frequent attendances to self-help groups. For this group of alcoholics, group therapy in a smaller group, individualistically oriented approaches for their needs including various supportive resources in the society should be addressed.

Renal actinomycosis mimicking renal tumor: case report.

A 68-year-old man was admitted after fever and general fatigue with severe inflammatory signs and anemia. T1- and T2-weighted magnetic resonance imaging showed low- to isointensity and low-intensity tumor in the right kidney, respectively, suggesting renal actinomycosis. However, the right kidney was explored transabdominally because the possibility of renal malignant lymphoma could not be excluded. After nephrectomy, characteristic colonies of Actinomyces were seen microscopically, and the histologic diagnosis was renal actinomycosis. The patient was treated with antibiotics and made good progress after operation. This case highlights the importance of magnetic resonance imaging for the diagnosis of renal actinomycosis.