Heiichi Yano

Pulmonary alveolar proteinosis : Xe-133 scintigraphic findings before and after bronchopulmonary lavage

A 44-year-old woman with pulmonary alveolar proteinosis was treated by repeated unilateral bronchopulmonary lavages over 6.5 years. The effectiveness of the treatment was assessed by Xe-133 scintigraphy as well as lung function tests and chest roentgenograms. Xe-133 scintigraphy clearly demonstrated improvement of regional ventilation and perfusion, and equalization of the ventilation and perfusion ratio. Therefore, Xe-133 scintigraphy was found to be useful in the analysis of changes in regional aeration, ventilation, and perfusion before and after bronchopulmonary lavage in pulmonary alveolar proteinosis.

The Role of Complement-Derived Chemotactic Factors in Lung Injury Induced by Preformed Immune Complexes

Our previous studies have suggested a role for complement fragments presumably activated by immune complexes in patients with hypersensitivity pneumonitis. The present study has shown that circulating complement depletion by cobra venom factor resulted in the reduction in severity of immune-complex-mediated pulmonary inflammation. The activity of chemotactic factors for neutrophils generated in bronchoalveolar lavage fluids in complement-depleted animals was significantly diminished to 61.2% compared to the undepleted animals. In addition, reduced activity of chemotactic factors resulted in a marked reduction of accumulation of neutrophils in bronchoalveolar lavage fluids indicating that chemotactic factors play an important role in the sequestration of neutrophils on the alveolar side of the lung. In conclusion, chemotactic factors in bronchoalveolar lavage fluids which preceded the accumulation of polymorphonuclear cells are partially derived from complement.

Disease Extent and Response to Chemotherapy in non-small Cell Lung Cancer

Comments on published articles, short communications of a preliminary nature, case reports, technical notes and the like are accepted under this heading. The articles should be short and concise and contain a minimum of figures, tables and references.

Accessory Cell Function of Human Alveolar Macrophages in Antigen-Induced T Lymphocyte Proliferation

We compared the accessory cell function of human alveolar macrophages (AM) to that of human blood monocytes (Mo) obtained by bronchoalveolar lavage and venipuncture from normal volunteers. Graded numbers of either AM or Mo were added to autologous peripheral blood T lymphocytes that were stimulated with a purified protein derivative of tuberculin (PPD). Either AM or Mo were cocultured with allogeneic T lymphocytes in mixed lymphocyte reaction (MLR) experiments. Both AM and Mo supported the PPD-induced T lymphocyte proliferation and allogeneic MLR at low ratios of AM or Mo to T lymphocytes with similar efficiency. However, AM showed marked suppressive effects at higher ratios of AM to T lymphocytes (1:1). PPD-pulsed AM, but not AM killed by physical treatments (heat, freeze-thaw, sonication), induced T lymphocyte proliferation. An indirect immunofluorescent study demonstrated that most AM express HLA-DR antigens. Furthermore, AM synthesized DR antigens with molecular weights of 33,000 and 29,000-31,000 daltons. When AM were treated with both anti-DR monoclonal antibody and complement, PPD-induced T lymphocyte proliferation and MLR were diminished. These results suggest that human AM function as accessory cells in the antigen-induced T lymphocyte proliferation and DR antigens on AM play an important role in the accessory cell function.

Sequential changes in lung injury induced by preformed immune complexes

Immune complexes formed in the airside may be involved in the early parenchymal changes in hypersensitivity pneumonitis. The present study was undertaken to compare the responses of animals after an intratracheal injection with preformed immune complexes to those of patients with acute hypersensitivity pneumonitis, with special emphasis on sequential bronchoalveolar lavage findings and the possible role of chemotactic factors in the immune complex-induced lung injury. An increased number and percentage of polymorphonuclear cells could be detected in bronchoalveolar lavage fluids of guinea pigs within 48 hr following an intratracheal injection of preformed immune complexes. Chemotactic factor activity preceded the observed increase of polymorphonuclear cells in bronchoalveolar lavage fluids, suggesting a role for chemotactic factors in the sequestration of these cells in the lung. In addition, this study confirmed the usefulness of bronchoalveolar lavage in evaluating the pulmonary findings because the changes in bronchoalveolar lavage cell populations correlated with sequential histological findings. The sequential characteristics of the involved areas were noted to be of a peribronchial or bronchiolar infiltration with polymorphonuclear cells at early stages, then alveolar sac infiltration, followed by mild infiltration of mononuclear cells into the alveolar walls. The findings suggest a possible role for chemotactic factors in the accumulation of polymorphonuclear cells, and the sequential changes of bronchoalveolar lavage and histological findings in animals are comparable to those in patients with acute hypersensitivity pneumonitis.

A Case of Henoch-Schoenlein Purpura that Developed after Chemotherapy for Adenocarcinoma of the Lung.

才の男性が咳漱, 血痰を主訴として入院し, 肺線維症に合併した右S4原発の肺腺癌, T2N2M1 (PUL) と診断された.Cisplatin, Ifosfamide, Vindesineによる化学療法2クール開始20日目に紫斑, 腹痛, 血尿および蛋白尿をきたし, Henoch-Schonlein紫斑病と診断された.皮膚生検像では軽度の血管炎を認め, 血中Immune complexは軽度に増加していた.ステロイドに対し反応良好であった.経過から原因抗原は腫瘍細胞由来または薬剤由来と推定される.

Significance of postoperative radiotherapy in the treatment of locally advanced non-small cell lung cancer(NSCLC).

局所進行非小細胞癌71例を対象として, 切除の根治性, 縦隔リンパ節転移部位数などの観点から術後照射の意義を検討した.39例に照射が行われたが, 39Gy以上照射されたものは30例であった. 相対的治癒切除例では局所再発率の低下, 遠隔成績の向上に照射が貢献しており, その再発様式から2ヶ所以上に縦隔リンパ節転移があった場合は, 鎖骨上窩も照射野に含める必要があると考えられた. しかし術後病巣遺残例では照射を企図あるいは完遂できなかったものが多く, 予後不良であった.