This study investigated the efficacy of hyperbaric oxygen therapy (HBOT) as a secondary treatment for patients with idiopathic sudden sensorineural hearing loss (ISSNHL) in the subacute and chronic phases. Forty-eight ISSNHL patients (HBOT group) who had received primary conventional treatment within 4 weeks after onset and underwent HBOT between 4 and 20 weeks post-onset were retrospectively compared with 44 ISSNHL patients (control group) with primary conventional treatment alone. Mean hearing gain was slight, with gains of 5.2 ± 8.9 dB in the HBOT group and 2.0 ± 7.6 dB in the control group. However, no significant difference was recognized between the two groups. In the HBOT group, no significant difference was observed in hearing gain among patients with HBOT initial time at 4-7, 8-11, 12-15 or 16-20 weeks after onset. Meanwhile, hearing gain was significantly higher in patients with profound hearing loss than in the other patients. We conclude that the effectiveness of secondary HBOT for ISSNHL patients in either subacute or chronic phase remains unproven, and thus, the decision administer HBOT should be made with caution.

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Cerebral blood flow (CBF) measurements during mild hypothermia therapy were made in 30 adult patients with severe head injuries (Glasgow Coma Scale score ≦8), by xenon enhanced computed tomography (Xe-CT). All patients but one underwent removal of hematomas and decompressive craniectomy. Immediately after surgery, hypothermia was induced by surface cooling, and a brain temperature of 32 - 35℃ was maintained for 3 days. During hypothermia therapy, CBF measurements by Xe-CT were made for all patients on post-injury days 1 to 4. From the arteriovenous-oxygen content difference and CBF values, the cerebral metabolic rate of oxygen (CMRO2) values were obtained. Outcome was assessed at discharge according to the patients’ Glasgow Outcome Scale (GOS) scores. Patients were divided into two groups based on their outcomes. Nineteen patients (63%) showed good outcomes (GOS score of 4 or 5) and 11 (37%) showed poor outcomes (GOS score of 1, 2, or 3). Statistically significant differences were obtained for the mean global CBF and CMRO2 values between the good and poor outcome groups. In this study, we demonstrated that CBF measurement may be useful to predict neurological outcomes following severe traumatic brain injury in patients undergoing hypothermia as well as to identify those who might not likely benefit from hypothermia therapy.

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NAD(P)H:quinone acceptor oxidoreductase (NQO) 1 polymorphism is associated with various hematological malignancies, especially infant leukemia or therapy-related leukemias, which involve the rearrangement of mixed lineage leukemia (MLL ) gene. Epstein-Barr virus (EBV)- transformed lymphoblastoid cell lines (EBVLCLs) with either of 2 well known polymorphic variations of C609T and C465T were selected from our archives of EBV-LCL clones and studied the induction of p53 expression after DNA damage. Irradiation of cells with C609T/C609T polymorphism (NQO1 *2*2) did not affect the induction of p53 expression. However, irradiation of cells with C465T/WT polymorphism (NQO1 *1*3) resulted in attenuation of p53 and p21 induction. Our results suggest that increased risk of infant leukemia development in patients with NQO1 *1*3 polymorphism is partially dependent on the inhibition of p53 pathway, though further studies are needed to fully understand the pathological role of C465T variant in the development of childhood leukemia.

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Introduction : The aim of the study was to investigate the association between the difference (defined as the remainder, Rm) in laboratory values determined in the upright and supine positions and the severity of obstructive sleep apnea syndrome (OSAS). Materials and Methods : Thirty-three Japanese male subjects with OSAS [apnea/hypopnea index (AHI: the number of apneas and hypopneas per hour) ≥ 5] underwent cephalometric analysis and measurements of nasal resistance in the upright and supine positions. Several parameters in a dental model and physical features were also analyzed. Results : Significant associations of the logarithmic AHI, with neck depth, Rm for the facial axis, and the minimum airway behind the tongue in the supine position were found in multiple linear regression analysis. Conclusion : Our results suggest that neck depth, Rm for the facial axis and the minimum airway behind the tongue in the supine position may be determinants of the severity of OSAS.

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HER2 oncoprotein plays an essential role in breast cancer growth and differentiation. Determination of HER2 status contributes not only to predicting survival but also to selecting the patients for anti-HER2 therapy. HER2 protein expressed in human cancer cells often contains variant forms as well as the full-length wild-type form. In the present study, we investigated the subcellular localization of HER2 protein in 1053 primary breast cancer tissues. HER2 protein was stained by various immunohistochemical methods and studied by immunoelectron microscopy to confirm the intracellular localization. Thirty-four of 1053 specimens showed cytoplasmic staining of the intracellular domain of HER2 protein by the HercepTest® and CB-11. In contrast, no immunoreactivity to the antibodies against the extracellular domain was observed. None of the 34 specimens showed amplification of the HER2 protein by fluorescence in situ hybridization. Subsequently, we studied the association of the cytoplasmic expression of HER2 with neuroendocrine differentiation. Interestingly, all 34 specimens had some positive signals of neuroendocrine markers such as synaptophysin, chromogranin A, neuron-specific enolase, and CD56. Although the result is preliminary, it warrants further study on the role of the cytoplasmic variant form of HER2 in breast cancer growth, particularly in the aspect of neuroendocrine differentiation.

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Purpose: We investigated the significance of CD24 and CD44 expression for predicting responses to chemotherapy and prognosis in primary breast cancer patients. Patients and Methods: Diagnosis of breast cancer was confirmed by core needle biopsy, and immunohistochemical studies were performed. Preoperatively, patients received anthracyclinecontaining chemotherapy. Expression of CD44 and CD24 was assessed immunohistochemically and the relationship with chemotherapy response and with prognosis was analyzed. Results : Between 2001 and 2004, 139 women were enrolled in this study. In the correlation analysis, CD24 expression was negatively associated with pathological response to chemotherapy (p=0.0003). A machine learning technique with an alternating decision tree (ADTree) showed that four logical rules are involved in predicting the response depending on the combination of CD24, HER2, tumor stage, CD44, progesterone receptor, and patient age. In the survival analysis, patients having CD44 (++) showed a significantly favorable prognosis as compared with others (p=0.0002). A multivariate analysis showed that CD44 expression had an independent prognostic value (p<0.001). Conclusion : We found a significant correlation between CD44 expression and prognosis and between CD24 expression and response to chemotherapy. CD24 and CD44 expressions would be useful predictive markers, although further studies are needed.

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Objective: I examined the predictive value of the combination of three delayed recall tests to distinguish 1) those with probable Alzheimer’s disease (AD) from those within normal range, and 2) those with Mild cognitive impairment 1 (MCI) from those within normal range. The data from 90 visitors to a memory clinic in Tokyo was used. I first examined patients clinically, neuroradiologically, and excluded the mental and neurological illness. AD was diagnosed according to the NINCDS-ADRDA criteria 2, MCI according to the criteria of Petersen et al.1. Normal must be free from any disease examined above. Methods: After the diagnosis, the baseline neuropsychological tests were performed for all participants; the Mini Mental State Examination3, Raven’s Colored Progressive Matrices, the Stroop Test, a 10-words list learning and recall test, a story recall test, and the Rey-Osterrieth Complex Figure Test. After 10 years, all patients were reassessed and diagnosed again. Results: Of the MCI patients for follow-up (n=29), 19 were converted to AD, while 5 not. One died. 4 lost. All AD patients (n=30) remained as AD. The combination of 3 delayed recall battery provides clinically useful predictive values for both AD and MCI in a memory clinics and dementia research clinics.

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