In this study we were able to certify the utility of three-demensional CT imaging with a helical scan on otorhinopharyngolaryngological lesions. Our cases included two tympanoplasties, one trauma of the ossicular chain, one cholesteatoma otitis media, one patient who underwent craniofacial surgery and one with thyroplasty type I. Each CT scan was later compared with the findings of operations and then wereevaluated for their diagnostic value. The charateristics of three- demensional CT imaging with a helical scan are herein discussed regarding efficacy along with related problems in making accurate diagnoses for otorhinopharyngolaryngological lesions.

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Tympanoplasty was perfomed using a hydroxyapatite prosthesis in 41 ears (35 ears with cholesteatoma, 3 ears with chronic otitis media, 3 ears with an anomaly of the ossicular chain). The prosthesis was used for tympanoplasty type III in 26 ears and type IV in 15 ears. The postoperative hearing results were as follows: 27 ears (66%) satisfied at least one of the following criteria of success: 1. an air conduction (AC) hearing level better than 40dB 2. an AC hearing gain more than 15 dB 3. an air-bone gap which closed to less than 20dB.

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A 31-year-old female visited us 2 weeks after the birth of her child complaining of a progressive nasal obstruction and a tumor was found in the nasal cavity which she had first noticed at 36 weeks of gestation. The smooth surface, red-colored swelling tumor was seen to arise from the right inferior turbinate. Examinations including CT scanning and MRI revealed the tumor to be located in the nasal cavity. The tumor later decreased in size and the nasal obstruction slightly improved after undergoing surgical treatment 7 weeks after delivery in which a total removal of the tumor was carried out with only a small amount of bleeding. A histopathological study showed typical angiofibroma. Analyses for androgen, estrogen and progesterone receptor were all negative.

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The DNA ploidy patterns of fresh specimens from the oral cavity and pharyngeal epidermal squamous cell carcinoma from 30 patients were analyzed. The specimens were embedded in paraffin and flow cytometry was used for the analysis of the DNA ploidy patterns. A retrospective analysis was performed with regard to the effectiveness of cancer chemotherapy. Aneuploid patterns were found in 80% (24/30) of the patients. Seventy-three percent of the patients (CR, PR) responded to chemotherapy, while 27% were unresponsive. In patients with diploid patterns only 33% (2 patients) were responders, while in patients with aneuploid patterns 80% (20 patients) were responders. The efficacy rate of chemotherapy was higher in patients with an aneuploid pattern. However, patients with aneuploid patterns had a higher rate of recurrence, and the overall control rate was wrose for this pattern. Although more studies on this method of analysis in necessary for us to reach a definitive conclusion, our findings strongly suggest that the analysis of DNA ploidy patterns is useful in predicting the efficacy of therapeutic agents as well as in the selection of modes of therapy.

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It is known that IgE receptors are divided into FcεRI and FcεRII. In particular, FcεRII receptor is a low affinity receptor and proteolysis on the surface of the inflammatory cell cleavages the FcεRII and releases soluble CD23 into the circulating blood. On the other hand, ketotifen (Zaditen(R)), an antiallergic drug with an inhibitory activity for platelet-activating factor inhibited the development of IgE receptor. In this paper, we estimated the level of soluble CD23 in the serum of patients with nasal allergy during the administration of ketotifen and studied the relationship between the change of CD23 and its parameters on nasal allergy. In the present study the results were as follows:
1) The soluble CD23 level in the serum of patients with a nasal allergy increased significantly (p<0.001) before the administration of ketotifen, compared to that in healthy adults.
2) Differences of soluble CD23 concentration before and after the administration of ketotifen showed a reverse correlation and also correlated significantly with the eosinophil count (p<0.05 r=-0.43). From the above-mentioned results, it was suggested that a decrease of eosinophil, bearing CD23 cells, caused an increase in the amount of soluble CD23 in the circulating blood after the administration of ketotifen.

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Basic and clinical studies were carried out with loracarbef in the treatment of sinusitis. The levels of loracarbef in the maxillary sinus mucosa, ethmoid sinus mucosa and polyps were determined following the oral administrarion of 200mg. The ratio of the tissue concentrations to each blood level were 0.05-4.48, 0.13-1.31 and 0.56-0.63 respectively. The clinical efficacy of loracarbef was evaluated in 53 patients with sinusitis. The drug was given at a standard dose 200mg or 400mg, either 2 or 3 times daily for 3 to 14 days by oral administration. The efficacy rates were 83% in cases of acute sinusitis, 80% in chronic sinusitis and 73% in acute exacerbation of chronic sinusitis, while its overall efficacy rate was 78%. The overall bacteriological eradication rate was 74%. The improvement rate, including the remarkably improved, the improved and the slightly improved cases, was 68%. Regarding adverse effects, instances of rash, xerostomia with bitter gustation and diarrhea were observed in one case each, respectively. No abnormal changes in the laboratory findings were noticed. The above results suggest that loracarbef is a useful oral antibiotic for the treatment of sinusitis at a dose of 200mg 3 times daily (for a total of 600mg per day).

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Basic and clinical studies were carried out with loracarbef in the treatment of otitis media and otitis externa. The levels of loracarbef in the mucous membrane of the middle ear and mastoid antrum were determined following the oral administration of 200mg. The ratio of the tissue concentrations to each blood level were 0.23 and 0.60, respectively. The clinical efficacy of loracarbef was evaluated in 111 patients with otitis media and in 19 patients with otitis externa. The drug was given at a standard dose of either 200mg or 400mg, 2 or 3 times daily. The efficacy rates were 61% in the cases of otitis media and 68% in those of otitis externa. The bacteriological eradication rate was 65% for cases of otitis media and 87% in otitis externa. Regarding adverse effects, instances of diarrhea, loose stool and fever were each observed in one case, respectively. No abnormal changes in the laboratory findings were observed.

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Basic and clinical studies were carried out with loracarbef in the treatment of tonsillitis, pharyngolaryngitis and sialoadenitis. The levels of loracarbef in the tonsils and the porotids were determined following the administration of 200mg. The ratios of the tissue concentration to each blood level were 0.17 and 0.27, respectively. The clinical efficacy of loracarbef was evaluated in 49 patients with acute tonsilitis, in 6 patients with acute pharyngolaryngitis and in 4 patients with suppurative sialoadenitis. The drug was given at a dose of either 200mg or 400mg, 2 or 3 times daily. The efficacy rate were 90% in cases of acute tonsillitis, 83% in the cases of acute pharyngolaryngitis and 100% in the cases of suppurative sialoadenitis. The bacteriological eradication rate was 84% in the cases of acute tonsillitis and 100% in the cases of acute pharyngolaryngitis and suppurative sialoadenitis. Regarding adverse effects, instances of stomach pain, diarrhea, stomach discomfort, headache with dizziness and a rash were each observed in one case, respectively. No abnormal changes in the loboratory findings were noticed except for elevations of GOT in one case and BUN in another.

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The penetration of SY5555, a new oral penem antimicrobial agent, into various otorhinolaryngological tissue specimens was studied and the following results were obtained:
1) The amount of SY5555 in the palatine tonsil ranged from less than the assay limit to 0.65,μg/g and less than the assay limit to 0.45μg/g. The mean ration of the palatine tonsil to plasma concentration (transferrate) was 11.4%.
2) The concentration in the maxillary sinus mucosa ranged from less than the assay limit to 0.15μg/g after the administration of 200mg and less than the assay limit to 0.32μg/g after the administration of 300mg. The mean transfer rate was 21.2%.
3) The concentrations of SY5555 in the middle ear mucosa, the granulation tissue of the middle ear and other otorhinolaryngological tissue after the oral administration of either 200mg or 300mg ranged from less than the assay limit to 0.36μg/g. In addition, the transfer rate ranged from 2.5% to 65.5%.

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Laboratory and clinical studies were carried out to evaluate the effectiveness and safety of SY5555 for the treatment of otorhinolaryngological infections and the following results were obtaind:
1)The MICso values of SY5555 against clinical isolates from patients with infections in otorhinolaryngology were found to be 0.1mcg/ml against Streptococcus pneumoniae, 0.2mcg/ml against, Staphylococcus aureus, coagulase negative Staphylococcus and Moraxella catarrhalis, 0.39mcg/ml against Staphylococcus epidermidis and 0.78 mcg/ml against Haemophilus influenzae.
2)The clinical efficacy rates evaluated were 65.0% for otitis media, 69.6% for sinusitis, 87.2% for otitus externa, with an overall efficacy rate of 73.1%.
3)Bacteriological efficacy evaluations demonstrated eradication rates of 76.3% for monobacterial infections with Gram-positive organisms, 65.2% for monobacterial infections with Gram-negative organisms and 69.8% for polybacterial infections,while the overall eradication rate was 73.1%.
4)Side effects were observed in 17 of 244 patients (7.0%), while abnormal laboratory findings were observed in 12 of the 144 patients (8.3%) who underwent evaluation after treatment.
From the above results, SY5555 was shown to be highly useful for the treatment of various otorhinolaryngological infections such as otitis media, sinusitis, tonsillitis(including peritonsillitis and peritonsillar abscess) and otitis externa.

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The positive rate of 35 allergens were examined using the MAST system for 7 cities in Japan consisting of: Sapporo, Tokyo, Nara, Wakayama, Osaka, Kobe, and Oita. The subjects included 100 healthy adults from each city made up of 50 males and 50 females whose ages ranged from 20 to 29 years. Dermatophagoides pteronyssinus and D. farinae were the main allergens found in all cities and the positive rate was 33%. The Japanese cedar allergen came in second with 14%. On the other hand, the rates were low for all food allergens. The positive rate for the Japanese cedar allergen was highest of the 10 pollens investigated in all cities except Sapporo. Overall, the positive rates of the male group tended to exceed those of the female group for each allergen. As mentioned above, the positive rates were therefore influenced by several factors including sex, area and population.

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