The relationship between histamine H1 receptors of human nasal mucosa and nasal hypersensitivity was studied. The subjects were 81 patients who underwent surgery of the nasal and paranasal sinuses at our department between September 1988 and June 1990. Specific binding of 3H-pyrilamine by the nasal mucosa was classified into high and low affinity sections to the concentration of the former, and the concentration of the boundary of two sections was around 2nM. The number of histamine H1 receptors of the nasal allergy group was significantly higher in comparison with the non-allergy group (p<0.05). A number of the H1 receptours showed a tendency for a decline during the season of Japanese cedar pollinosis, in comparison with the remainder of the year. There was also a tendency for decrease in the H1 receptors with aging, with a significant difference (p<0.05) between subjects under 40 years and 41-years-olds and older. No difference was noted between two the sexes. The number of H1 receptors did not differ at mucosa of the inferior nasal concha, lateral wall of the inferior nasal meatus, and medial nasal meatus (p>0.05). The number of H1 receptors of the maxillary sinus mucosa was significantly less than that the nasal cavity (p<0.05). In each of these comparisons, no significant difference was noted (p>0.05) in the dissociation constant (Kd: indicating affinity). The result of these observation indicated that the number of histamine H1 receptors is on the decrease with aging and it increase with the development of nasal allergy. The quantity of receptors represents the difference in the threshold for histamine hypersensitivity and constitutes a factor in the development of nasal hypersensitivity.
A survey on the rhinomanometry was carried out, sending out questionnaire to the members of the Japan rhinologic society. 1 The answers could be obtained from 868 out of 2142 members (40.5%). 2 Three hundreds and eighty six members (44.5%) use the rhinomanometer to evaluate the nasal airway resistance. 3 Active anterior method wasthe most frequently employed (64%) for the rhinomanogram. 4 The usefullness of the rhinomanometry described by members was as follows; 1) easy to handle 2) not invasive to the patients. 5 Some members were not satisfied with rhinomanometry, because the rhinomanometry could not be applied to some patients or the results were not reproducible. 6 Some of the main reasons which make the members reluctant to use the rhinomanome try were that 1) there is a discrepancy between the test results and the symptom of the patien t 2) too busy to spend the time for testing 3) testing method is not yet uniformed.
From 1980 to 1986, 254 patients with nasal allergy were found to have sensitivity to Japanese Ceder Pollen at the ENT allergic clinic of Nippon Medical School. These patients were divided into two groups, one was treated with immunotherapy untill May 1987. Questionnaire were mailed to all the patients asking about severity of nasal symptom at the time of the first visit and after immunotherapy, and whether or not they were being treated with other methods for the last few seasons. Answers were received from 144 patients. Improvement after the immunotherapy was noted 27% for 6 months, 48% for 7-24 months, 50% for 25 months or more of the immunotherapy. Of 73 patients in the non-immunotherapy group 36% improved. There was no statistically significant difference in improvement between the immunotherapy group and the non-immunotherapy. Improvement at present time was noted 33% for 6 mouths, 37% for 7-24 months, 65% for 25 months or more of the immunotherapy with a significant difference compared with the non-immunotherapy group in which improvement noted 36%. In the percentage of the patients received other methods at present time there was no significant difference between the immunotherapy group and the non-immunotherapy.
The measurement of nasal resistance is important for understanding the pathophysiology of nasal obstruction. For this purpose, rhinomanometry is widely used at the centers of the world. The International Committee on Standardization of Rhinomanometry has attempted to establish the way for measurement of nasal resistance and to decide the normal range of resistance. However, it is difficult because of racial differences. Therefore, we need to understand how rhinomanometry is used in other countries in order to proceed the standardization. Its understanding also has a possibility to progress the study of nasal physiology in Japan. The present paper showes the difference of concept or clinical usage of rhinomanometry in Japan and foreign countries. During the past 10 years, there were 173 papers about rhinomanometry or nasal resistance published in Japan, and 353 papers in the other countries. These papers include basic or clinical research, and the number of the papers about basic research is a little larger than those of clinical research. In clinical research, European and North American papers even deal with the function of the external nose and rhinoplasty. The most important area which influences nasal resistance is the nasal valve area in the Caucasian nose, because the Caucasian nose is typically leptorrhine while the Oriental nose is platyrrhine. The structural difference between the two groups suggests the probability of associated differences in nasal patency. In fact, our results show nasal resistances to be greater in Caucasians than in Orientals. To measure nasal resistance using nasal splint which opens nasal ala widely is useful to understand the function of nasal valve on the standpoint of nasal physiology. The resistance with splinting showed 50% reduction in Caucasians and 35% in Orientals. These results indicates the nasal valve may influence the nasal airflow even in Oriental noses.