Yoshimitsu Hayashi

Co-administration of L-cystine and L-theanine enhances efficacy of influenza vaccination in elderly persons: Nutritional status-dependent immunogenicity

Aim:  The immune response to influenza vaccine is attenuated in elderly persons, though they are at greatest risk for morbidity and mortality by influenza virus infection. Experimental studies demonstrate that co‐administration of l‐cystine and l‐theanine enhanced antigen‐specific production of immunoglobulin in aged mice infected with influenza virus. We thus investigated the effect of l‐cystine and l‐theanine on antibody induction by influenza vaccines in elderly persons.

Structure and synthesis of leonurine

Abstract The structure of leonurine (I), an alkaloid isolated from Leonurus sibiricus L., has been revised as Ia′. Three different methods of synthesis are described.

Selection bias in evaluating of influenza vaccine effectiveness : A lesson from an observational study of elderly nursing home residents

Selection bias is of critical concern in the study of influenza vaccine effectiveness when using an observational study design. This bias is attributable to the inherently different characteristics between vaccinees and non-vaccinees. The differences, which are related both to vaccination and signs of clinical disease as an outcome, may lead to erroneous estimation of the effectiveness. In this report, we describe how selection bias among elderly nursing home residents may lead to a spurious interpretation of the protective effect of influenza vaccine. Our results should be a lesson in the importance of regarding selection bias when assessing influenza vaccine effectiveness.

Chemokine (C‐C motif) ligand 3 detection in the serum of persons exposed to asbestos: A patient‐based study

Exposure to asbestos results in serious risk of developing lung and mesothelial diseases. Currently, there are no biomarkers that can be used to diagnose asbestos exposure. The purpose of the present study was to determine whether the levels or detection rate of chemokine (C‐C motif) ligand 3 (CCL3) in the serum are elevated in persons exposed to asbestos. The primary study group consisted of 76 healthy subjects not exposed to asbestos and 172 healthy subjects possibly exposed to asbestos. The secondary study group consisted of 535 subjects possibly exposed to asbestos and diagnosed with pleural plaque (412), benign hydrothorax (10), asbestosis (86), lung cancer (17), and malignant mesothelioma (10). All study subjects who were possibly exposed to asbestos had a certificate of asbestos exposure issued by the Japanese Ministry of Health, Labour and Welfare. For the primary study group, levels of serum CCL3 did not differ between the two groups. However, the detection rate of CCL3 in the serum of healthy subjects possibly exposed to asbestos (30.2%) was significantly higher (P < 0.001) than for the control group (6.6%). The pleural plaque, benign hydrothorax, asbestosis, and lung cancer groups had serum CCL3 levels and detection rates similar to that of healthy subjects possibly exposed to asbestos. The CCL3 chemokine was detected in the serum of 9 of the 10 patients diagnosed with malignant mesothelioma. Three of the patients with malignant mesothelioma had exceptionally high CCL3 levels. Malignant mesothelioma cells from four biopsy cases and an autopsy case were positive for CCL3, possibly identifying the source of the CCL3 in the three malignant mesothelioma patients with exceptionally high serum CCL3 levels. In conclusion, a significantly higher percentage of healthy persons possibly exposed to asbestos had detectable levels of serum CCL3 compared to healthy unexposed control subjects.

菌球型肺アスペルギルス症例における経時的気管支肺胞洗浄の検討:病変部の細胞反応とmiconazole,flucytosineの局所移行について

We have performed serial bronchoalveolar lavage (BAL) examination in two patients with asperigilloma and compared that of total cell count and cell population with control groups (5 non-smokers, 10 smokers) and other pulmonary infectious diseases: 7 each with mycoplasmal pneumonia and pulmonary tuberculosis, 6 with bacterial pneumonia, and 5 with chlamydial pneumonia. Miconazole (MCZ) by drip intravenous infusion of 400 mg/day and flucytosine (5-FC) by oral intake of 4.5 to 6.0 g/day were administered to one patient with aspergilloma, and we studied the serum and BALF concentration about 5 hours after administration. The followings results were obtained: 1. In aspergilloma, the cell population of neutrophils in BALF increased compared with control groups (p < 0.01) and other pulmonary infectious disease. 2. The serum and BALF levels of MCZ ranged from 0.1 to 0.3 micrograms/ml, < 0.1 14.4 micrograms/ml, respectively. On the other hand, the serum and BALF levels of 5-FC ranged from < 0.2 to 9.3 micrograms/ml, and < 0.4 to 1.5 micrograms/ml, respectively. From these results, we consider that neutrophils play the main role in the immune host defense in aspergilloma, and the combination of intracavitary infusion of MCZ and oral administration of 5-FC should be the treatment of choice.

Ultrasonography for the early diagnosis of pleural effusion. Comparison between cancerous and non-cancerous pleurisy.

胸水症例は日常診療でよく遭遇する疾患であり, その鑑別診断は重要である.初診時胸部X線において肺野に著変を示さない胸水症例に対する超音波断層法の有用性を癌性胸膜炎11例, 非癌性胸膜炎25例について検討した.癌性胸膜炎11例のうち, 8例に不透明肺内部に腫瘤が描出でき, 胸膜生検の場所, その後の検査の方針の決定に有用であった.非癌性胸膜炎の膿胸3例のうち2例ではフィブリンネッツがみられ強い炎症が疑われた.