Quality of life (QOL) is recognized as a crucial aspect for assessing the impact of diseases, including allergic rhinitis, on the every day life of patients.
We used the Japanese Rhino-Conjunctivitis Quality of Life Questionnaire (JRQLQ) to evaluate the QOL of 361 patients with allergic rhinitis between July of 2004 and August of 2005. The clinical symptoms and the local findings on nasal examination were also evaluated. The QOL of females tended to be more impaired than that of males, and by seasonal more than by perennial allergy. The QOL scores of the patients whose major symptoms were nasal discharge and/or sneezing (ND-S type) were higher than those of the patients who mainly complained of nasal obstruction. Among the patients with the ND-S-type of allergic rhinitis, the QOL scores were significantly lower in those with mild to moderate symptoms than in those with severe symptoms. Of the three major nasal symptoms, nasal discharge had the strongest influence on the total score in the QOL questionnaire as well as in all the QOL domains, except for sleep, which was mainly affected by nasal obstruction.
When treating patients with allergic rhinitis, we must take into account the QOL of the patients as well as the nasal symptoms and local findings on nasal examination.

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The odontogenic keratocyst shows characteristic histopathological feature and high recurrence rate and but malignant transformation is rare.
We report a rare case of keratocyst in the maxillary sinus region in a 13-year-old girl. The patient was hospitalized in January, 2005. Plain X-rays showed a homogenous cystic opacity in the maxillary sinus and a tooth-like structure in the upper part of the sinus cavity.
After clinical and radiological examinations, we made a clinical diagnosis of follicular cyst, and 2 weeks later, resection of follicular cyst in the right maxilla was performed under general anesthesia, histopathological examination revealed the diagnosis of keratocyst in the maxillary sinus. Postoperative follow-up of the patient has revealed satisfactory progress and no evidence of recurrence of the odontogenic keratocyst until now, two years after the surgery.

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Chronic rhinosinusitis (CRS) with eosinophil infiltration is characterized by unrestrained proliferation of eosinophils that form clusters in the mucus where they release toxic granules. The mechanisms by which eosinophilic inflammation damages the epithelium and contributes to recurrent acute exacerbations in the disease have not been fully elucidated. Local or systematic administration of glucocorticoids is considered to be potent treatment strategy to prevent relapse of nasal poyposis.
In the present study, we assessed whether topical instillation of beclomethasone dipropionate dry powder onto the paranasal sinus improved the post-operative nasal symptoms and radiological sinus scores in patients with CRS after appropriate surgical intervention. Eighteen CRS patients with eosinophil infiltration who underwent endoscopic sinus surgery were recruited. The patients were treated with 800μg beclomethasone every two weeks using an application device at least for 2 months. We found an improvement in the endoscopic appearance scores in 91.4% of patients who received beclomethasone. The result was better than that obtained from the previous study treated with conventional postoperative therapy (71.7%). Significant decreases in the averaged CT scores for the paranasal sinuses were noted from 5.62 to 1.93 after treatment.
We consider that topical use of beclomethasone dry powder is effective for the post-surgical treatment of CRS with eosinophil infiltration through the control of the inflammatory process that persists in the nasal cavity.

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Background: A high incidence of Japanese cedar pollinosis has been reported in Japan. Most of these patients are also known to suffer from cypress pollinosis. This is related to the similarity of the sequences in Cry j 1 of Japanese cedar pollen and Cha o 1 of cypress pollen. The purpose of this study was to determine the efficacy of Immunotherapy with Japanese cedar pollen extract against cypress pollinosis.
Methods: We posted questionnaire to patients with Japanese cedar pollinosis that had been receiving Immunotherapy for more than three years (IT-group), and received anonymous responses from 16 of these patients. The same questionnaire was also sent to patients who were on medication (M-group). The patients were selected from those who also had cypress pollinosis.
Results: The IT-group showed statistically significantly better scores on the visual analog scale (VAS) in sneezing, watery rhinorrhea and eye itching during the cedar pollen season than the M-group. However, no differences were observed between the two groups during the cypress pollen season.
Conclusion: Immunotherapy with Japanese cedar pollen is not effective for cypress pollinosis.

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The pathology of chronic sinusitis has been changing in recent years in Japan. This has been attributed to the increasing frequency of the association of sinusitis with allergic rhinitis and/or bronchial asthma. To investigate the pathology of chronic sinusitis and the changes in the pathology over the years, the inflammatory cells infiltrating the paranasal sinus mucosa were counted in cases of chronic sinusitis with different disease durations. The number of inflammatory cells infiltrating the ethmoidal sinus mucosa was also comparatively assessed according to the presence or absence of association of the chronic sinusitis with bronchial asthma and/or perennial allergic rhinitis.
Specimens of the paranasal sinus mucosa from adult patients with chronic sinusitis were collected at the time of paranasal sinus surgery. Fourteen, 16 and 16 patients, respectively, were selected randomly from among patients treated between 1980 and 1985, 1990 and 1995, and 2000 and 2004, for a comparative assessment. The patients treated between 2000 and 2004 were divided into the following groups for a comparative assessment: chronic sinusitis associated with aspirin-induced asthma (Group I: 6 patients), chronic sinusitis associated with bronchial asthma (other than aspirin-induced asthma) (Group II: 11 patients), chronic sinusitis associated with perennial allergic rhinitis (Group III: 16 patients), and chronic sinusitis alone (Group IV: 8 patients). The lamina propria just beneath the epithelial layer was observed under a light microscope, and the number of infiltrating inflammatory cells per visual field at ×400 magnification was counted.
An increase in the number of eosinophils infiltrating the paranasal sinus mucosa and decrease in the number of infiltrating neutrophils and lymphocytes were observed in the patients treated in the later years, as compared with the observations in specimens from patients treated in the 1980's. The number of eosinophils was significantly larger in the patients in whom the chronic sinusitis was associated with bronchial asthma (Groups I and II) as compared with that in those in whom the condition was not associated with asthma (Groups III and IV). There were no significant differences in the number of eosinophils between Group I and Group II or between Group III and Group IV. The number of mast cells was also larger in the patients in whom the chronic sinusitis was associated with bronchial asthma (Groups I and II), similar to the case for the eosinophils.

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