The sensitivity, reactivity, and efficacy of treatment for Japanese cedar pollinosis varies from individual to individual. Specific serum IgE levels are not related to this responsiveness. The whole blood histamine release test (HRT) is based on the in vitro measurement of an immediate allergic reaction. This method, using peripheral whole blood, may be used to reveal the influence of not only specific IgE antibodies, but IgG4 and cytokines on the release of histamines from basophils. Japanese cedar pollinosis patients with high specific serum IgE levels were divided into high class of HRT (hHRT) and low class HRT (lHRT) groups. No differences in age, sex, period of symptoms, first day of allergic symptoms (sensitivity), positivity for other specific IgE levels, and symptom score at the time of the first visit (reactivity) were observed between the two groups. Treatment with new anti-histamines significantly improved the symptom score of the lHRT patients but not the hHRT patients. This result suggests that HRT is useful for estimating the efficacy of new anti-histamines and selecting an appropriate treatment. In conclusion, these results indicate that HRT is not useful for determining the sensitivity or reactivity of patients with Japanese cedar pollinosis but is useful for estimating the efficacy of new anti-histamines treatments.
To clarify the nasal mucosa reaction pattern in allergic rhinitis, we conducted nasal lavage with cold water or warmed saline water in 11 patients allergic to Japanese cedar and cypress pollen after chemosurgery with trichloroacetic acid in the pollen dispersion season. Total protein, albumin, and 26kD protein concentrations were higher in nontreated than in subjects treated with either type of lavage. These findings indicated that postchemosurgery nasal mucosa became less sensitive to cold water and antigens.
We studied the clinical features of 3 patients pathologically diagnosed with sphenoid sinus mycosis. The causative organism was aspergillus in 2 patients and mucormycosis in 1. We discuss clinical, diagnostic, and histogenic aspects in 32 cases, including our 3, reported from 1968 to 2001 in the Japanese literature. Typical clinical symptoms were headache and visual disturbance. Magnetic resonance imaging (MRI) was useful in diagnosing sphenoid sinus mycosis, showing decreased signal intensity in T1-weighted and a very low signal in T2-weighted images. Endoscopic sinus surgery and postoperative antifungal medication are recommended to prevent disease recurrence.
We report here two rare cases of angiofibroma located in the nasal cavity. After angiographic embolization to reduce operative hemorrhage, surgical resection was performed by a transantral approach in both cases. Case 1 was a 24-year-old male who presented with a left nasal obstruction and recurrent nasal bleeding. An anterior rhinoscopy showed a reddish tumor occupying the left nasal cavity; the tumor was histologically diagnosed as an angiofibroma. An angiography showed that the feeding artery was the left sphenopalatine artery. One day after angiographic embolization using gelform, the tumor was completely removed from the middle meatus using a transantral approach. Blood loss for the operation was no more than 140ml, and no sign of recurrence was observed one year after the operation. Case 2 was a 17-year-old male who presented with a left nasal obstruction. An anterior rhinoscopy showed a reddish tumor occupying the left nasal cavity, and a histological examination revealed an angiofibroma. The day after angiographic embolization, the tumor was resected from the middle meatus using a transantral approach, similar to Case 1. Blood loss was no more than 132ml, and no postoperative bleeding occurred. No sign of recurrence was observed six months after the operation.
The reconstruction of zygomatic bone after extensive resection in maxillary cancer is important to the postoperative quality of life in patients. We conducted en bloc resection of maxillo-zygomatic lesions and concurrent by reconstructed the area with Ceratite®. Achieving a satisfactory facial shape, CERETITE® has excellent biocompatibility and was useful in reconstruction facial bone. We made a reconstruction model of Ceratite® using a 3-D solid model that reproduced the shape of zygomatic bone correctly and produced good aesthetic results.
We determined whether expiratory flow influences the level of exhaled nitric oxide (NO) in a test using a bagtrap. Subjects were 14 healthy volunteers whose exhaled NO was measured through the mouth and nose at 4 different expiratory flow rates. Oral and nasal exhaled NO were measured with subjects inhaling NO-free air using a bagtrap based on a chemiluminescence NO analyzer, ML9841, at a detection limit of 1 part per billion (ppb). The 4 expiratory flow rates were identified at 0.05, 0.1, 0.2, and 0.3L/s. Oral exhaled NO concentrations were 36.7 (SE:±7.30) ppb at an expiratory flow of 0.05L-/s, 26.7 (±5.45) at 0.1, 20.18 (±4.25) at 0.2, and 16.4 (±3.85) at 0.3. Oral exhaled NO concentrations inversely correlated with the expiratory flow rate (R=0.941). Nasal exhaled NO concentrations were 72.6 (±8.39) at 0.05L/s, 59.9 (±8.31) at 0.1, 39.0 (±4.49) at 0.2, and 29.1 (±4.09) at 0.3. Nasal exhaled NO concentrations had also inversely correlated with the expiratory flow rate (R=0.983). Nasal exhaled NO concentrations were significantly higher than oral at all flow rates. We concluded that oral and nasal exhaled NO concentrations using a bagtrap were flow-dependent, and thus constant expiration (0.1L/s) is recommended.