In the present study, the purpose was to investigate whether it is feasible to evaluate the cerebral activity to olfactory sensation by measuring the relevant changes in the concentration of cerebral oxygenated hemoglobin during exposure to various types of smell stimuli in adult subjects, using nearinfrared spectroscopy. Regarding the near-infrared oxygen monitor unit, the NIRO-300 (Hammamatsu Photonics K. K., Japan) device was employed. The study subjects consisted of a total of 13 adults with normal olfaction, and as smell stimuli, vanilla essence, strawberry essence, and E5 of the T & T Olfactometer were used. A statistical evaluation was carried out using the t-test, with a p value of p<0.05 considered to indicate a statistically significant difference. In all of the odorant sources, the concentration of oxyhemoglobin showed a transient decrease after the initiation of the olfactory stimulation and thereafter exhibited an increase. Smell stimulus-evoked fluctuations in the concentration of oxyhemoglobin were though to reflect the cerebral activity of the orbital gyri of the frontal lobe that is said to be implicated in olfactory perception.

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We examined the efficiency of echo in evaluating the function of eating and swallowing. A main subject of this study was to establish the method of evaluation when using the echo test, and we especially focused our attention on the movement in the oral phase. We evaluated eight healthy adults (3 males and 5 females, range from 25-40 years of age), who had no functional or morphologic abnormality in the stomatognathic region. All subjects were required to swallow 3mQ of water or 3m9 of pudding during the evaluation. The echo apparatus was a 5 in ALOKA, the probe was electro-micro convex. We converted the filed DV-AVI to 30 frames a second, set up tracers forward, center and backwards and measured the moving distance from the locus. We analyzed the results with an image analyzer (by Desimo Co.). As a result, the distance of the tongue movement increased in the subjects who swallowed the pudding more than in those who swallowed the water, and we were able to quantify the momentum in the bolus transportation. In addition, the coefficient of variation in the cases varied only slightly for water but they showed wide variations for pudding. We hypothesize that such variation was due to the greater individual differences in the swallowing of pudding in comparison to the swallowing of water, and these differences were easily identified in our study.

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Nasal symptoms such as sneezing, a stuffy nose and a runny nose occur in association with allergic rhinitis. It is necessary to define the severity of symptoms to both properly diagnose such patients and to also select the most therapy. In Japan, many doctors use the guideline scale, while in the USA and Europe, a different scale (non, mild, moderate, severe) is used. The same grading scale is used by the JRQLQ (Japanese rhinoconjunctivits quality of life questionnaire). In this study, we examined the correlation between these two scales in the evaluation of 336 allergic rhinits patients. In general, a good correlation was obtained when using these two scales; runny nose: r=0.59, p<0.001, sneezing: r=0.61, p<0.001, stuffy nose: r=0.74, p<0.001. However, 49% of the patients who showed 1 to 5 sneezes/day in the guideline scale complained of no sneezing according to the JRQLQ scale. As a result, 54% of the patients who showed a frequency of 1 to 5 times of experiencing a runny nose/day also complained no symptoms in the JRQLQ scale. From these results, we think that both scales are useful for grading severity in allergic rhinitis, however, doctors should be aware of the possibility that some discrepancise may be observed.

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For 73 patients suffering from Japanese-cedar pollinosis, we examined the annual change in the Japanese-cedar specific IgE antibody titers based on the drift in the quantity of cedar pollen scattering in Jan. 2001, Jan. 2002, and Jan. 2003. The specific antibody titer of Japanese-cypress pollen was measured in 60 patients, while in several patients house dust (HD), mites (Dermatophagoides pteronyssinus) and orchard grass were also measured. The pollen counts of Japanese-cedar were 888/cm² in 2000, 3, 445/cm² in 2001 and 1, 243/cm² in 2002 at Osaka University (Suita, Osaka). The pollen counts of Japanese-cypress were 333/cm², 2,028/cm², and 238/cm², respectively. The geometric mean (GM) titer of Japanese-cedar specific IgE antibody was 12.17U/ml in 2001, 16.66U/ml in 2002, and 10.89U/ml in 2003. The GM titer was significantly elevated in 2002 in comparison to that observed in 2001, and it also significantly fell in 2003. The GM titer of Japanese-cypress specific IgE antibody was 2.15U/ml, 2.63U/ml, and 1.99U/ml, respectively. The GM titer was also significantly elevated in 2002 in comparison to that observed in 2001, and it significantly fell in 2003 in a manner similar to that of Japanese-cedar. These changes in the specific IgE antibody were observed regardless of the antibody levels before scattering, as well as age and sex. However, the GM titer of HD and orchard grass showed no significant change. Based on our findings, the specific IgE antibody of Japanese-cedar a

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We examined 117 ears suffering middle ear cholesteatoma in fresh cases operated on from 1993 to 2003. To evaluate the importance of the attic ventilation route, we compared the occurrence of tympanic membrane retraction and cholesteatoma recurrence in the cases that had undergone tympanoplasty type I and other prodedures, including type III, type IV and w/o. There was no significant difference in the occurrence of tympanic membrane retraction and cholesteatoma recurrence between the cases that underwent tympanoplasty type I and other prodedures. As a result, no clear effect in preventing cholesteatoma recurrence was observed when comparing patients that had undergone either an anterior tympanotomy or a posterior tympanotomy. However, only the cases undergoing tympanoplasty type I with ventilation tube insertion demonstrated a significant effect in preventing cholesteatoma recurrence.

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We report a case of SNL presenting with HPS. A 46-year-old female visited our clinic with a high fever and left neck lymphadenopathy. A lymph node biopsy showed a necrotic lesion and an apoptosis body-like figure, thus indicating that she had previously suffered from SNL. Under this diagnosis, we administered steroids (i. v.), however, a high fever and pancytopenia continued and the patient unfortunately died due to an intestinal hemorrhage. Her serum levels of ferritin, LDH and sIL-2R were remarkably elevated. We thus suspected HPS and performed bone marrow aspiration cytology, but the findings did not show any blood-cell phagocytosis figures in the neutrophils. However, the post-mortem findings definitely showed phagocytosis figures in the blood cells.

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Case 1, a 61-year-old male had suffered from dysphagia after undergoing an operation for oral base carcinoma. Case 2, a 79-year-old male with dysphagia due to pseudobulbar paralysis as a result of a cerebrovascular disorder and case 3, a 54-year-old male who demonstrated dysphagia after undergoing concurrent chemoradiotherapy for mesopharyngeal carcinoma. All 3 patients were treated by swallowing training and nutritional control by a nutrition support team (NST). Case 1 could eat nothing orally at admission. After treatment, however, he was able to eat highly softened rice gruel with highly softened chopped up foods and drink high caloric liquid food at the time of discharge. Case 2 could eat only a small amount of pulpy food that was mixed in a blender on admission, but after treatment, he was able to eat rice gruel with softened chopped food. Case 3 could eat nothing orally at admission, but after treatment, he was able to eat rice gruel with thickened pulpy food mixed in a blender and drink high caloric liquid food. In all cases the severity of the dysphagia improved while the nutritional condition of the 3 patients also became better. Based on these findings, close cooperation with the NST is thus considered to improve the outcome when performing swallowing training.

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