Regeneration medicine is divided mainly into differentiation-induced and cell replenishment therapy. Bone marrow includes stem cell populations such as hematopoietic, mesenchymal and so on. These stem cells are shown experimentally and clinically to be pluripotent. It remains unclear, however, whether bone-marrow-derived cells differentiate into olfactory neurons and are engrafted as olfactory stem cells into olfactory tissue. We transplanted bone marrow cells of green fluorescence protein (GFP) mice into lethally irradiated recipients.
Double immunostaining for GFP and olfactory marker protein or cytokeratin showed the possibility that bone-marrow-derived cell population could do as hoped. Because the engraftment rates of this study were low far from a practical level, methimazole inducing selectively apoptosis into olfactory tissue and granulocyte colony-stimulating factor known to mobilize stem cells from bone marrow into circulation were added to a series of experiments, which increased engraftment rates.
Whether bone-marrow-derived cells or mesenchymal stem cells differentiate into olfactory cells remains controversial, necessitating the evaluation of regeneration medicine using such cells in further olfactory disorder studies.

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Omalizumab, a monoclonal antibody to human IgE, is used to treat severe asthma and is reportedly effective in other allergic diseases. We report a case of eosinophilic otitis media and sinusitis improved by omalizumab treatment. A 66-year-old woman with severe asthma, eosinophilic otitis media, and sinusitis had omalizumab started to treat asthma. Besides rapidly improving asthma symptoms, it ameliorated eosinophilic otitis media and sinusitis, confirming its hoped for effectiveness.

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Although the most common soft-tissue sarcoma in children, rhabdomyosarcoma (RMS) is rare in adults. We report 2 cases of adult RMS. Case 1: A 59-year-old man seen for a large right-neck mass was found in computed tomography (CT) and magnetic resonance imaging (MRI) to have an enhanced mass in the right ethmoid sinus with bone destruction and multiple bilateral cervical lymph nodes, but was no evident distant metastasis. Tumor biopsy showed alveolar rhabdosarcoma. The man was treated with chemoradiotherapy, but died of multiple metastases 5 months after treatment. Case 2: A 75-year-old woman was found in cranial MRI to have a right ethmoid sinus mass confirmed in CT to involve bone destruction, but no evident metastasis. The pathological diagnosis was embryonal rhabdosarcoma. After a poor result with chemoradiotherapy, the woman underwent surgery, and remains alive without local reccurence or distant metastasis in the 26 months since surgery.

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We report a case of oculomotor nerve paresis due to sphenoid sinus mucocele. A 81-year-old man developing left-side ptosis and diplopia over the previous 6 months was confirmed in opthalmological examination to have left-side ptosis, ocular movement disturbance upward, inward, and downward, and pupil dilation due to oculomotor nerve paresis. Computed tomography (CT) and magnetic resonance imaging (MRI) showed lateral smooth-margined sphenoid sinus lesions compressing the left cavernous sinus. Based on a diagnosis of sphenoid sinus mucocele, he underwent endonasal endoscopic surgery under general anesthesia, 6 months after which ptosis and ocular movement disturbance had disappeared.

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We report a case of sphenoid sinus aspergillosis with concomitant multiple brain abscesses. A 41-year-old man seen for headache, high fever, and diplopia was found in magnetic resonance imaging (MRI) to have an abnormal sphenoid sinus shadow. Computed tomography (CT) confirmed the right sphenoid sinus shadow with mixed high- and low-density areas. MRI also showed temporal and frontal lobe brain abscesses to be gradually growing, necessitating immediate endoscopic and endonasal sphenoidectomy under general anesthesia. The right sphenoid sinus contained a fungus ball in muddy green pus but now no bacteria or fungi grew from the pus. Histopathological examination showed the fungus to be a fungal-thread bolus with identifiable septa. The definitive diagnosis was invasive sphenoid sinus aspergillosis with multiple brain abscesses. Antifungal drug administration for six months postoperatively, resulting in an uneventful recovery.

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Intraparotid facial nerve schwannoma, an uncommon tumor documented sporadically in medical literature, must be differentiated from pleomorphic adenoma. Function-preserving surgical resection is also important. We report a case of intraparotid facial nerve schwannoma in a 42 year-old woman seen for a right parotid gland tumor 28 mm in diameter. Computed tomography (CT) and Magnetic resonance imaging (MRI) showed a noninvasive round mass between the tip of the mastoid process and the mandibular condyloid process. Fine-needle aspiration cytology confirmed a benign mass consisting of histiocytes or interstitial cells, although preoperative tests could not differentiate schwannoma from pleomorphic adenoma. Surgical exploration found a yellow encapsulated mass arising in the main facial nerve trunk and the nerve funiculus extending into the capsule. A surgeon diagnosed a facial neurogenic tumor, which was resected intracapsularly leaving no tumor tissue in surgical microscopy. Postoperative facial palsy eventually disappeared, completely restoring facial nerve function. No recurrence has been seen in the 7 years and 8 months since surgery, indicating that intracapsular resection may be an intraparotid schwannoma treatment providing a favorable prognosis.

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We report a case of PFAPA (Periodic fever with aphthous stomatitis, pharyngitis and cervical adenitis). A 5-year-old boy admitted for idiopathic fever 12 times within 8-months. Fever of >38°C occurred for 5 days at 10-to-20-days intervals. Antibiotics failed to decrease the fever. PFAPA was diagnosed when the boy was found to be febrile with aphthous stomatitis. Steroid administration decreased the fever, but not its recurrence. Following tonsillectomy, however, the boy had fever only once 2 weeks after surgery in the 12 months since. PFAPA etiology is unknown, but recent reports suggest irregular pro-inflammatory cytokine production. Serum IL-6, TNF-α and IFN-γ concentration increased during febrile attack in our case.

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Adult hypopharyngeal hemangiomas are uncommon neoplasms.
Adult hypopharyngeal hemangiomas are relatively easily diagnosed in flexible laryngoscopy, computed tomography (CT), and magnetic resonance imaging (MRI).
We reported 2 such cases. A 72-years-old woman seen for a hypopharyngeal lesion observed in flexible laryngoscopy was successfully treated by fulguration using a CO2 laser, and shows no recurrence as of this writing. A 64-years-old woman seen for hemorrhage and a feeling of a foreign-body presence, showed no lesion in flexible laryngoscopy of the hypopharynx. Direct laryngoscopy however showed cervical esophageal lesion with a very thin neck extending from the postcricoid area. The lesion was removed by cutting this neck.
Histopathological examination thus detected these cavernous hemangiomas.
We believe that our findings provide important information on both direct laryngoscopy and the basis of these lesions.

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Docetaxel, cisplatin, 5-fluorouracil (TPF)-based induction chemotherapy, while a durable, effective treatment for those with locally advanced squamous cell cancer of the head and neck, also induces toxicity problems, such as neutropenia.
We retrospectively compared TPF-based and cisplatin, 5-fluorouracil (PF)-based induction chemotherapy to clarify toxicity and safety.
Subjects numbered 54-19 undergoing TPF-based and 35 PF-based induction chemotherapy. Although the 2 groups did not differ significantly in other toxicities e.g., anorexia, diarrhea, and renal dysfunction, 89% of TPF group had grade 3-4 neutropenia significantly more often. Neutropenia was limited to a few days, making its occurrence easy to predict and its toxicity easier to manage in TPF-based induction chemotherapy.

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Multiple endocrine neoplasia type 2B (MEN 2B), an autosomal dominant syndrome, involves endocrine tumors caused by RET protooncogene germ-line mutations in chromosome 10. The case we report, initially suspected in jaw deformity surgery, was a 19-year-old man whose malocclusion was found in a school health checkup. In surgery, his somewhat abnormal buccal mucosa and mandible were biopsied and pathological findings indicated multiple mandibular and buccal mucosal neuromas suggesting de novo MEN 2B. Whole-body examination confirmed diagnosis, showing medullary thyroid carcinoma, megacolon, prominent corneal nerves, and mucosal tongue and lips neuromas. Gene examination showed germ-line mutations of the RET protooncogene affecting codon 918 in exon 16.
Medullary thyroid carcinoma was treated by total thyroidectomy with central compartment and bilateral neck dissection. Pathological analysis revealed multiple bilateral lobe cancer foci and one central-compartment lymph-node metastasis were detected pathologically. Normal calcitonin and CEA serum levels proved the biochemical cure for medullary thyroid carcinoma 7 months postoperatively.
MEN 2B-associated medullary thyroid carcinoma is more aggressive than that without known gene mutations, necessitating early diagnosis and close follow-up. Findings of multiple oral-cavity neuromas thus mandate examination for MEN 2B.

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Subjects with rheumatoid arthritis (RA) risk developing malignant lymphoproliferative disorder, although why remains controversial, immunosuppresive therapy—specifically low-dose methotrexate (MTX)- and Epstein-Barr virus infection are suspected of contributing to this risk. Widely used to treat RA, MTX has been suggested in several studies to increase malignant lymphoma risk. A 75-year-old man with RA and treated 9 years with MTX suffered right neck lymphoid node and tonsil swelling that eventually developed into an ulcer. Blood chemistry findings showed elevated lactic dehydrogenase (LDH) and soluble IL-2 receptor. Enhanced computed tomography (CT) confirmed bilateral neck lymph node and right-tonsil swelling.
Histopathologically, he was diagnosed with diffuse large B-cell lymphoma in neck lymph node biopsy with EBER-1. Clinically, he was diagnosed with MTX-associated lymphoproliferative disorder (MTX-LPD). MTX was discontinued 2 weeks after, his sore throat had disappeared, and CT 40 days later showed that all lesions also had disappeared. His clinical course continues to be good with no sign of recurrence.

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Pediatric neck-abscess incidence has decreased thanks to early treatment using antibiotics, but diagnosis remains difficult due to varied clinical symptoms and a lack of subjective complaints. It must be diagnosed and treated early, due to being potentially life-threatening.
We studied 15 such cases—12 boys and 3 girls, 0 to 11 years old (mean; 3.5)—treated from January 2005 to January 2010. Their chief complaints were 5 high fevers, 4 neck swellings, and 6 neck and throat pain. Neck computed tomography (CT) with contrast medium was useful in diagnosis. Neck abscesses were found in 4 patients in the retropharyngeal space and parapharyngeal space, 2 patients in the submandibular space, retrocervical space, thyroid glands, and peritonsillar space, plus 3 miscellaneous. Antibiotics were used to treat all cases. Eleven required surgery and one puncture. Bacteria detected in 10 cases were 4 of Streptococcus pyogenes (Group A), 3 of Staphylococcus aureus, and 1 each of Group F Streptococcus, Peptostreptococcus sp. and Actinomyces. Hospitalization ranged from 7 to 44 days (mean; 17.2).
All cases recovered satisfactorily.

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