Neutrophils from peripheral blood of normal adult volunteers were cultured with G-CSF, GM-CSF, TNF-α, and IFN-γ for 24 hours, and effects of these cytokines on neutrophil cytotoxicity were examined. The cytotoxicity of neutrophils to K 562, an eryth-roleukemic cell line, and the production of superoxide from neutrophils primed with FMLP were more enhanced when neutrophils were cultured with each of these cytokines than when neutrophils were cultured alone. However, the correlation between the tumor cytotoxicity and the production of superoxide was not found. Apoptosis of K 562 cells occurred even when the K 562 cells were cultured alone without neutrophils and cytokines. Apoptotic tumor cell death was also detected when K 562 cells were cultured with neutrophils or with activated neutrophils after treatment with G-CSF, but acceleration of K 562 apoptosis was not demonstrated. On other hand, the production of IL-1, IL-8, and TNF-α was detected by the ELISA assay in culture supernatant of mixed culture of neutrophils and K 562.
In conclusion, the results suggested that the cytotocixity of neutrophils involves the production of free radicals including superoxide and their direct cytotoxic effects, production of cytokines, and their complex effects including neutrophil activation and tumor cell apoptosis.

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Thirty-one cases of functional hearing loss who visited us between 1992 and 1997 were studied. The patient group included 6 males and 25 females. The age range was 6 to 18 years, with a mean age of 10.4 years. Although 10 patients had hearing loss and 4 had tinnitus, 24 cases were pointed out a hearing loss in the school screening hearing test. The number of bilateral cases are 27 and the unilateral cases are 4. The hearing level of 34 ears were ranged in 40-69 (dB) and 18 ears in over 70 (dB) in pure tone audiogram. Pure tone audiograms showed a flat-shaped sensorineural hearing loss in 47 ears. For diagnosis, it was important to find out the discrepancy between subjective audiometry and objective measurements. Sixteen patients had a psychological problem and these cases showed a poor improvement.

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We report an uncommon case of inverted papilloma which originated from the bilateral nasal cavities. A 50-year-old man visited Mito General Hospital with a chief complaint of nasal obstruction for 2 months. Rhinoscopic examination revealed semitransparent polypoid masses arising from the bilateral middle meatuses. The findings in computed tomogram were compatible with bilateral chronic sinusitis. The patient underwent bilateral polysinusectomy with Caldwell-Luc procedure and the histopathological diagnosis was bilateral inverted papilloma. The present case emphasized that rather unusual findings, i.e. the bilateral involvement, the presence of secondary infection and absence of bone destruction, mask the true nature of inverted papilloma and make the preoperative diagnosis difficult

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Branchio-oto-renal syndrome (BORS) is an autosomal dominant disorder with branchial anom-alies : branchial fistulas and preauricular pits, hearing loss and renal anomalies. We treated a 15-year-old boy who had right cervical fistula, sensori-neural hearing loss of the right ear and horse-shoe kidney. A target CT revealed no abnormalities of ossicular bone or cochlea. Surgery was carried out for the cervical fistula. The tract crossed the hypoglossal nerve and passed between the external and internal carotid arteries deep to the digastric muscle. Due to BORS's variability and a high incidence of renal abnormalities, otolaryngologists should consider BORS when evaluating branchial cleft remnants in any patient.

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A case of nasopalatine cyst in a 21-year-old male was reported. The patient visited our clinic complaining bilateral nasal obstruction which was continuing for the last one or two years. The anterior rhinoscopic examination showed extensive nasal mucosal swelling from the floor of the nasal cavity to the nasal septum, and the choanal portion of the nasal cavitiy could not be observed. X-ray and CT scan examinations revealed a large cystic lesion in the upper jaw, which deformed the structures of the nasal cavity floor and nasal septum. According to WHO classification, this cystic lesion was diagnosed as nasopalatine cyst. The cyst was completely removed by the oral-vestibular approach, and the drainage route for exudative fluid was established by mucosal resection in the floor of the bilateral nasal cavity. Post-operative nasal fiberscopic examination showed that the bone defect was filled up gradually with granulation tissue. From the above findings, etiology, symptoms and treatment of nasopalatine cyst were briefly discussed with reference to the past literature.

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Literature survey revealed only 14 case of functional carotid body tumor. We report a case of noradrenaline-secreting carotid body tumor. A 25-year-old male with complaints of headache and tumor on left side neck came to our hospital. Functional carotid body tumor was based on the results of carotid body tumor was Echo, CT, MRI, Angiography, cathecolamine level of blood and urine VMA. Surgery was performed. We were able to remove the tumor by separating it at the white line. We should pay attention to a critical change in blood pressure and injury of the carotid during operation.

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From March 1996 to February 1998, we performed endoscopic sinus surgery for 292 patients with chronic sinusitis. In this paper, we compared the use of the shavers as a form of powered instumentation for endoscopic sinus surgery with standard endoscopic surgical techniques. A group of 228 patients undergoing surgery with the shavers was compared with a group of 93 patients undergoing standard procedures, in order to evaluate their intraoperative amount of bleeding and incidence of complications. The intraoperative amount of bleeding was 18.6 cc (shaver group) and 34.7 cc (standard procedure group), and the incidence of complications was 0.88% (shaver group) and 2.2% (standard procedure group).
The use of the shavers demonstrated less bleeding and smaller incidence of complications.

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[in Japanese]

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[in Japanese]

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