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Biomedical subjects

Yoshihito Yamada

Publications and source records attributed to Yoshihito Yamada.

5 recordsLinked to original sources
PubMed2004

Impaired IFN-gamma production of Valpha24 NKT cells in non-remitting sarcoidosis.

Sarcoidosis is a systemic disorder associated with granuloma characterized by an abnormal T(h)1-type cytokine production and accumulation of T(h)1 CD4 T cells in the granuloma lesions, suggesting an importance of T(h)1 responses in sarcoidosis. However, the pathogenesis of sarcoidosis remains to be solved. Here, we investigated the nature of V(alpha)24 NKT cells with immunoregulatory functions in sarcoidosis. Patients with non-remitting sarcoidosis displayed a decrease in the number of V(alpha)24 NKT cells in peripheral blood, but an accumulation of these cells in granulomatous lesions. When stimulated with the specific glycolipid ligand, alpha-galactosylceramide, peripheral blood V(alpha)24 NKT cells from patients with non-remitting disease produced significantly less IFN-gamma than those from healthy volunteers, but normal levels of IL-4. The reduced IFN-gamma production was observed only in V(alpha)24 NKT cells and not conventional CD4 T cells, but was normal in patients with remitting disease, suggesting that non-remitting sarcoidosis involves an insufficient IFN-gamma production of V(alpha)24 NKT cells which is well correlated with disease activity. Thus, these results suggest that V(alpha)24 NKT cells play a crucial role in the disease status of sarcoidosis.

Adult↗
PubMed2004

[A case of bronchostenosis in the allograft after lung transplantation in pulmonary lymphangioleiomyomatosis].

Pulmonary lymphangioleiomyomatosis (LAM) is a rare disease characterized by hamartomatous proliferation of abnormal smooth muscle cells in the lungs. Recently, severe LAM has been listed as an indicated disease for lung transplantation. A 34-yr-old woman with severe pulmonary cystic changes in a chest CT scan was diagnosed as having an isolated form of pulmonary LAM without genetic disorders. Despite intensive progesterone treatment, her pulmonary functions deteriorated rapidly. In January 2001, a left single-lung transplantation was performed from a cadaveric donor. The total operating time was 8 hours and 47 minutes. Total ischemic time was 5 hours and 59 minutes, which was within the permitted time limit. Except for right pneumothorax, the postoperative course was fairly good without any sign of rejection or infection in the allograft. For about two months after transplantation, bronchostenosis occurred in the left lower lobe bronchus, and necessitated a stent placement. During the following three months, stenosis of the bronchi in the anastomotic and peripheral sites occurred repeatedly, which also necessitated stent placement or balloon dilations on each occasion. Despite all the intensive treatment, the bronchostenosis of the peripheral sites still remains and improvement of her pulmonary functions has been poor. Moreover, a recent chest CT scan revealed a progression of the disease in the native lung. Consequently, we registered her as a candidate for transplantation of the right lung. Bronchostenosis should be kept in mind as a complication of lung transplantation.

Adult↗
PubMed2004

[Recurrence of non-small cell lung cancer after successful treatment with gefitinib--report of three cases].

Gefitinib, a first epidermal growth factor receptor (EGFR) inhibitor has been reported to be effective in chemotherapy-resistant non-small cell lung cancer. Gefitinib was also reported, however, to produce severe adverse effects, such as interstitial lung disease. Thus, clinical evaluation of gefitinib is still controversial and further studies are needed. We present 3 cases of non-small cell lung cancer (stage IV adeno-carcinoma) that showed recurrence after successful gefitinib treatment. Symptoms of all patients ameliorated in a week after the therapy, and radiograph and laboratory data improved. However, all showed recurrence in 3 to 7 months. After recurrence, patient 1 was re-treated with gefitinib at the request of the patient. Patient 2 has been on gefitinib. Patient 3 was treated with gefitinib, which was later replaced by another chemotherapy agent. After recurrence, however, no effective response was obtained in any of the 3 cases. There have been several reports of good response to gefitinib therapy at the first time in patients with advanced non-small cell lung cancer, but few reports of recurrence in patients after successful therapy with this agent. This report is thought to be important for the clinical evaluation of gefitinib and useful in terms of information about the resistance of gefitinib.

Adenocarcinoma↗
PubMed2003

Influence of stressful life events on the onset of sarcoidosis.

OBJECTIVE: The onset of sarcoidosis may be triggered by any hereditary and/or environmental factor. Among these factors, psychosocial stress may play a critical role in the onset of sarcoidosis. The aim of the present study was to evaluate the influence of stressful life events on the onset of sarcoidosis. METHODOLOGY: The social and/or life events experienced prior to diagnosis in 55 patients with sarcoidosis, were evaluated quantitatively using the Social Readjustment Rating Scale (SRRS), the most authoritative method to quantify the magnitude of the events requiring changes in lifestyle. In addition, personality with respect to stress-reactivity was simultaneously evaluated using the Minnesota Multiphasic Personality Inventory (MMPI) alexithymia scale. Both the degree of stress, evaluated by SRRS, and stress-reactivity, evaluated by MMPI scale, of sarcoidosis patients were compared with those of 92 healthy controls. RESULTS: The magnitude of stressful life events was significantly higher in patients with sarcoidosis compared with healthy controls. In addition, capacity for coping with stress was found to be inferior in sarcoidosis patients compared with that in the control groups. CONCLUSION: These results indicated that psychosocial stress assessed on the basis of alexithymic characteristics of the self perception of stress may be partly implicated in the development of sarcoidosis.

Adult↗