Myelosuppression, especially leukopenia, as a side effect of anticancer agent often becomes a dose limiting factor for progression of cancer therapy. In view of this fact, we conducted this study in patients with head and neck cancer under chemotherapy to determine the clinical significance of examination of leukocyte phagocytosing activity as a supplementary examination for smooth progression of treatment.
A total of 40 patients with head and neck cancer were included as the subjacts. Significant reduction in the phagocytosed area was observed when the number of multinucleated granulocytes decreased. From these results, the granulocyte count of 2, 000/mm³ or more was judged as indicating phagocytosis within the nomral range, 1, 000-1, 900/mm³ as poor, and 900/mm³ or less as remarkably poor. In patients with elevated body temperature to 38°C or higher due to infection, phagocytosis was not good in the presence of pronounced increase in the count of multinucleated granulocytes. These findings indicate reduction in phagocytotic function during anticancer chemotherapy in the presence of infection, and the clinical utility of this examination was confirmed. Then, factors which give influences on this examination were assessed. As to sex, reduction in functions was observed in males. There was difference in performance status between Grade 0 and Grade 1-3. The classification by regimen revealed a decreasing tendency in phagocytic function by PAF therapy and PF therapy using THP-adriamycin and 5-FU. Age and radiation therapy as a pretreatment gave no influences. In the last, abnormal phagocytosis pattern, which is the qualitative significance of this examination, was analyzed. In all cases malnutritioned condition was observed, indicating that malnutrition give influences on phagocytes.
From these results, our examination of leukocyte phagocytosis function was proven to be useful as a supplementary examination of myelosuppression which is a side effect of anticancer chemotherapy. In the future it will be required to take measures against a tendency of getting infections easily during the treatment of cancer therapy not only based on blood cell count but also from various veiwpoints such as phagocytotic functions, reticular functions and immunological fonctions.

View full abstract

The author examined the immunohistochemical distribution of fibronectin (FN) and fibronectin receptor (FNR) in the normal nasal mucosa, in the nasal mucosa with allergic rhinitis and in the paranasal sinus mucosa with chronic sinusitis by the use of the peroxidase antiperoxidase method, and measured FN concentration of nasal fluid using enzyme immunoassay.
The results are as follows: FN was found in most of the serous cells and some of the mucous cells in both nasal and paranasal glands, and also in the nasal fluid in the lumina. FN was not found elsewhere, such as in interstitial tissue except for only 2 of 35 chronic sinusitis cases. FNR-immunoreactivation was present in some of the infiltrated cells in the paranasal sinus mucosa with chronic sinusitis, and absent in the nasal mucosa. FN concentration of nasal fluid was significantly higher (P<0.01) in chronic sinusites (average ±SD, 31.73±16.39μg/ml) than in allergic rhinitis (4.33±3.86, μg/ml).
These results suggest that FN is produced in the nasal glands and secreted into the nasal fluid. It is postulated that bacterial adherence to the mucosa produced by FN and FNR increases in chronic sinusitis, which results in prolonged inflammation.

View full abstract

Tegafur-induced olfactory disturbances were studied imunohistochenmically in guinea pigs using anti-BrdU antibodies.
Tegafur was orally administered for 3 weeks.
The results were as follows.
1) The number of cells taking up BrdU decreased with increasing doses of Tegafur.
2) There were no marked morphological changes such as atrophy of the olfactory epithelium or a decrease in the number of olfactory cells.
Tegafur induced no marked morphological changes of the olfactory epithelium probably because the period of administration was only 3 weeks. However, the immunohistochemical observation using anti-BrdU antibodies revealed that dividing cells in the olfactory epithelium were inhibited in proportion to the dose of Tegafur.
Continual inhibition was presumed to induce such morphological changes of the olfactory epithelium as have been observed in human cases.

View full abstract

In order to observe amphibian larvae in development, the normal table of development of them is nesessary. Developing larvae can be classified into several stages according to the lenght of body or time after fertilization but these methods seem to get a variety in each stage. Any examination of the gloss external features of body changes is relevant to a classification. In this study, each specimens, Bufo japonicus, were devided into several stages in accordance with the normal table of development of Bufo japonicus by Iwasawa and their ears were observed morphologically under light microscopy.
The development of the inner ear
At the time of hatching (about stage 21), the otic placord has been formed and has led the otic vesicle during stage 22 to 26. At stage 27, the recessus labyrinthi has developed at the dorsomedial side of the otic veside and has become later the ductus and saccus endolymphaticus. At stage 28, the otic veside is devided into two parts by septum, representing respectively utriculus and sacculus. At the same time, the tree semicircular canals have been separeted from the utriculus and have been completed at stage 34. In the sacculus, the maculae lagenae and sacculi and the papillae amphibiorum and basilaris are formed at stage 33 to 34. The inner ear has been almost completed by the initiation of swimming and eating activity (about stage 34).
The development of the middle ear and its surrouding cirgans
At stage 37, the operculum begins to from as a mesenchymal condensation in the posterior portion of the fenestra ovalis. This condensation begins to condrify and becames a cartilaginous flat plate. By stage 41, the operculum has been formed. The completion of the opercular system is consistent with the connection of the opercular muscle between the scapula and the operculum. The formation of the opercular system is coincide with forelimb development. At the timing of the completion of the operculum (stage 41), the columella (stapes) has been formed as a mesenchymal condensation in the anterior edge of the fenestra ovalis, in contact with the membrane of the fenestra ovalis. The mesenchyme has developed a cartilaginous ball and projected anterolaterally, toward the side of the head. This cartilaginous boll is the proximal portion of the columella. The plectrum has been formed as the ventral extension of the distal portion of the columella, passing underneath the skin that will eventurally form the tynpanic membrane. At the time of begining of the terrestrial life (stage 43 to 44c), dynamic changes have occured in the temporal region. The palatoguadrate and Meckel's cartilage have rotated posteriorly. The tympanic annular cartilage is first formed as a posterior outgrowth of the palatoguadrate near the jow joint. The Meckel's contilage has become to the mandibula and the oro-cleft has grown backward. The thymus, situating laterally to the otic capsule, has begun to move backward during metamorphosis. The otosalpinx and the middle ear cavity have seemed to be formed as the invagination of the pharyngeal mucosa as if replacing the space of the thymus. Most of the investigaters think that the orosalpix and the middle ear cavity come from the first branchial pouch. In this observation, such findings have not been confirmed. As mentioned above, the middle earsound conduction system has been almost completed by the 7th day after the first terrous activity.
The normal table of development of Bufo japonicus ear described in this paper is thought to be useful to the further studies.
Stage 21; neural tube formation III. Stage 22; early tail bud. Stage 26; appearance of gill bud II. Stage 27; ramification of gill bud. Stage 28; simple external gill. Stage 33; operculum formation III. Stage 34; completion of operculum. Stage 37; toe differentiation I. Stage 41; completion of hindlimb. Stage 43; emergence of forelimb I. Stage 44c; vestigial tail. Stage 45;. completion of meta morphosis.

View full abstract

Many cases of adhesive otitis media have both dysfunction of the eustachian tube and disease of the tympanic orifice of the eustachian tube. Therefore, it is difficult to obtain good postoperative ventilation of the middle ear cavity, and the improvement in hearing is thus poor. Some cases of adhesive otitis media develop pars tensa cholesteatoma, and some cases experience sensory neural hearing loss in the natural course. Surgical treatment is needed for these cases.
It is not so easy to classify this disease clearly according to the pathological state, which is complicated. In this report, we attempted to classify this disease into two groups, a total adherent type and a PSQ adherent type, based on the region of adhesion of the tympanic membrane. We have experienced 48 cases (above 16 years old) of initial surgery in the last 12 years. We analyzed these cases in relation to their age, condition of the contralateral ear, bone conduction, disease of the tympanic orifice of the eustachian tube, ossicular damage, pathology of the adherent tympanic membrane, etc.

View full abstract

This report is on a method of the nutritional management in the patients with dysphagia. The gastric fistula is not suitable for patients who require rehabilitation for disorders in the limbs, because the tube in the stomach disturbs the movement and training. Continual placement of the naso-gastric tube (N-G tube) is uncomfortable to the patients and the patient hesitates to go out of the hospital with the N-G tube on. Selfinsertion of the N-G tube was tried on five patients with dysphagia: the patients inserted the N-G tube when they would like to eat or drink and after finishing the N-G tube was taken out by the patinets thmeselves and kept clean like they do with dishes. This method was tried on five patients with dysphaga. One of them could work by the use of this method, another patient who could not swallow water could take water easily, and the another one could get weight by this method.

View full abstract

Since the introduction of cisplatin into clinical use, remarkable progress has been achieved in chemotherapy for head and neck cancer. Subsequently, the multi-drug combination therapies using cisplatin as the main drug have become the main therapy. We used a regimen which combines cisplatin and peplomycin with moderate amount of methotrexate for the treatment of advanced and recurrent cancer of the head and neck. Almost simultaneously we also used the regimen combining cisplatin and 5-FU, which has been reported to be highly effective. In the present study these two regimen were compared to determine the clinical efficacy of the combination chemotherapy consisting of cisplatin, methotrexate and peplomycin.
As to clinical results obtained with PPM therapy, the overall response rate was 76%. Complete response was rated in 12% of the cases. Similar results were obtained with PF therapy with response rate of 65%. Complete response was obtained in 9% of the cases.
Detailed analysis concerning each background factor revealed no difference between PPM therapy and PF therapy. As the factors which give influences on the results of chemotherapy, performance status, whether the evaluable lesion is single or not, stage of TNM and possibility of operative resection were considered important.
The secondary effect was compared by Kaplan-meier method based on cumulative survival rate. In terms of prognosis at 24 months the secondary efficacy rate was 32% for PPM therapy and 21% for PF therapy, indicating that PPM therapy is similar or even superior to PF therapy. The stratified analysis by factor which gives influences revealed little or no difference between the two regimens. Even the results contrasting to the primary efficacy were obtained for some factors. Thus, the short duration of response was indicated.
From these results it is considered that the combination chemotherapy consisting of cisplatin, peplocycin and methotrexate is presently a multi-drug regimen well expected to be effective for the treatment of head and neck cancer.

View full abstract

The olfactory mucosa of a patient with anosmia caused by complete transection of the bilateral olfactory nerve was examined using H.E. and immunohistochemical staining. The patient was a 52-year-old female who visited our clinic after intracranial surgery for anterior commissural aneurysm. A specimen was obtained from the patient by using Nakano's forceps without anesthesia.
H.E. staining revealed decreased numbers of olfactory receptor cells in most parts of the epithelium. However in some parts, olfactory receptor cells were still present. Supporting cells and basal cells remained in the olfactory epithelium at normal levels.
Immunohistochemically, only a few receptor cells in the epithelium reacted to anti-neuronspecific enolase (NSE) antiserum in the most part of the epithelium, but partly many NSE-reacting receptor cells were recognized. CK immunoreactivity was found in the cytoplasm of basal cells which were arranged regularly on the basement membrane. S-100 reactivity was found in many nerve bundles and Bowman's glands in the lamina propria. These results indicate that in human only recptor cells disappear and supporting cells and basal cells remain after olfactory nerve transection as same as animal experiments. On the other hand, olfactory receptor cells do not regenerate in human, though in animal it is observed.

View full abstract

The incidence of Japanese cedar pollinosis is said to be increasing. Various causes have been proposed for the increase of the incidence but there are only a few reports about the incidence in non-selective populace. This year we measured serum level of cedar-specific IgE using RAST and AIaSTAT in non-selective subjects of Wakayama Prefecture. The data were compared with those of 1985 and the following conclusions were reached.
1. RAST scores 1 or higher for Japanese cedar were observed in 22.7% of the subjects, and scores 2 or higher were found in 18.3%. AIaSTAT score 1 or higher for Japanese cedar were seen in 33.8%, and score 2 or higher in 20.1%.
2. Positive results were seen more in men than in woman.
3. Positive results were most frequently seen in subjects 16 to 19 years of age and the frequency tapered off with increasing ages.
4. Compared with the study of 5 years ago, the percentage of those with positive RAST for Japanese cedar was higher and pollinosis patients younger in this year.
5. Those positive for Japanese cedar specific IgE tended to flock in areas abounding in coniferous trees. The correlation between high incidence of pollinosis and air pollution was not demonstrated.

View full abstract

A clinical survey was done on 10 patients with lateral cervical cysts and fistulas in our clinic from 1977 to 1989.
A 26-year-old male, complaining of a growth on right side of neck, visited our clinic. The lateral cervical cyst increased in size into 100mm from 40mm in diameter within less than two months. The patient developed a high fever, thus an emergency operation was to be performed. No other particular data were observed in those we inspected among 10 patients.

View full abstract