The number of patients with fungal rhinosinusitis has increased in recent years. We studied 33 patients with paranasal sinus mycosis treated at Kobe University Hospital between September 1988 and May 2002. Subjects were 8 men and 25 women aged 36 to 78 years (mean: 62 years) . Computed tomography (CT) and/or magnetic resonance imaging (MRI) was performed preoperatively in 30. A high-density lesion in CT of fungal masses appeared as a low signal area in both T1 and T2 weighted MRI, indicating fungal rhinosinusitis. This diagnosis was confirmed by histopathological study of fungal mycelia from the sinonasal cavity. Of the 33, 28 underwent surgery and 5 were treated with conservative modalities such as antral irrigation and removal of fungal masses from the maxillary ostium. Fungal masses and sinus mucosa were resected together using the Caidwell-Luc procedure in 11. In 17, they were endonasally removed using an endoscope while preserving the sinus mucosa. Although 1 patient with invasive aspergillosis in the ethmoid sinus died due to a brain abscess, no recurrence was seen in the 32 with noninvasive fungal rhinosinusitis without the use of antifungal drugs.
Japanese cedar and cypress airborne pollen counts were measured using a Durham-type pollen sampler, an IS-Rotary-type pollen sampler, and a real-time pollen counter (KH-3000; Yamato Manufacturing Co., Ltd., Japan) at Toyoake city, Aichi, from 2001 to 2004. The pollen counts measured by the real-time pollen counter were significantly correlated with those measured by both the Durham-and IS-Rotary-type pollen samplers. According to the real-time pollen counter data, the weather conditions that led to an increase in the airborne cedar and cypress pollen counts of during the cedar and cypress pollinating seasons were higher temperatures, higher wind velocities and lower humidity. We believe that the real-time pollen counter may be a useful tool for research on airborne pollen and pollinosis.
PURPOSE and METHODS: Although many reports have been described a direct relation between reactive oxygen species (ROS) and nitric oxide (NO) and several disorders, the relationship between ROS/NO and epistaxis remains unclear. In this study, differences in the mRNA expression of Mn-SOD, CuZn-SOD, Catalase, iNOS, eNOS, COX-I, COX-II and p22phox (a subunit of NADPH oxidase) were studied in the epithelium of the nasal mucosa in patients with epistaxis (n=28) and healthy subjects (n=24). RESULTS: The expression of Mn-SOD, CuZn-SOD and catalase was significantly higher in the epistaxis group than in the healthy group. This finding suggests that O2- is related to epistaxis and that these mRNAs were expressed as part of a protective reaction against oxidative stress. The expression of iNOS, COX-I and COX-II was also significantly higher in the epistaxis group. The expression of iNOS produces NO, and NO activates COX-I and COX-II to produce more free radicals. In addition, p22phox expression in the epistaxis group was stronger than in the healthy group, indicating that NADPH oxidase may also cause epistaxis through the production of O2-. CONCLUSION: We demonstrated that ROS produced by COX-I, COX-II and NADPH oxidase and NO produced by iNOS may be involved in pathogenesis of epistaxis and that a protective reaciton involving SOD and catalase may be active.
Total and unilateral nasal resistance in 48 patients with sleep apnea syndrome (SAS) and 35 normal subjects were compared upright and supinely to determine the importance of nasal resistnce in supine SAS patients. Active anterior rhinomanometry was conducted with a Nippon Kohden MPR-3100 rhinomanometer to measure unilateral (inspiratory and expiratory) and total (inspiratory and expiratory) nasal resistance. Total (both expiratory (Δ100Pa andΔ150Pa) and inspiratory (Δ100Pa) ) nasal resistance in normal subjects increase more significantly in supine than upright subjects. Total inspiratory (Δ100Pa) nasal resistance in SAS patients increases more significantly in supine than upright patients. No correlation was seen between BMI and increasing nasal resistance in changing from supine to upright in normal subjects and SAS patients. In conclusion, when measuring nasal resistance in SAS patients, the supine position which is closer to sleeping condition, may be more suitable than upright.
In asthma, an abundance of fenestrated capillaries in bronchial mucosa may be related to epithelial damage or local eosinophilia in the bronchi. To determine the relationship between such abundance and eosinophilia or epithelial damage in patients with nasal allergy, we used electron microscopy to study nasal mucosa obtained surgically from 45 patients with allergic rhinitis and 10 with nonallergic rhinitis. No significant difference in the abundance of fenestrated capillaries was found between allergic and nonallergic patients. No significant relationship was found between the abundance of fenestrated capillaries in nasal mucosa and local eosinophilia or the grade of torn tight junction of nasal mucosal epithelial cells. No implicative relationships of abundance of fenestrated capillaries, eosinophilia, or epithelial damage in allergic nasal mucosa was thus seen.