We studied the influence of environmental pollutants such as diesel exhaust particulates (DEP) and their ingredients, benzo (a) pyrene and 1-nitropyrene, on proliferation and cytokine production of mouse bone marrow-derived mast cells (BMMCs).
DEP and 1-nitropyrene showed no inhibitory effect on proliferation of BMMCs. However, significant increase in the number of cells after incubation for 72 hours and effect to accelerate proliferation of BMMCs were detected in the presence of benzo (a) -pyrene (0.1 and 0.5 At g/ml).
Although significant increase in the production of interleukin-4 (IL-4) by calcium ionophore-stimulat-ed BMMCs was detected in the presence of DEP (0.8μg/ml), benzo (a) pyrene (0.1 and 0.5 μg/ml) and 1-nitropyrene (0.1, 0.5 and 1 lig/ml), production of IL-6 showed no tendency toward increase. The production of IL-4 by antigen-stimulated BMMCs significantly increased in the presence of DEP at 0.4 and 0.8 pg/ml and tended to increase in the presence of benzo (a) pyrene (0.5 and 1 pg/ml) and 1-nitropyrene (0.1, 0.5 and 1 μg/ml).
The enhancing activitity of these environmental pollutants such as DEP and their ingredients, benzo (a) -pyrene and 1-nitropyrene may possibly be related to onset and exacerbation of allergic diseases.

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ESS is widely accepted and performed to treat chronic sinusitis. However, there are still poor prognostic maxillary lesion, which can not be controlled by ESS itself, such as antrochoanal polyps and chronic sinusitis with asthma. For these poor maxillary lesions, we obtained some favorable results when we treated them with Hammer method together with ESS. First, we made 5 mm control hall on canine fossa, then inserted a Hammer blade into a maxillary cavity while observing the maxillary cavity with a 70-degree endoscope from endonasal site. Hammer is suitable to treat a maxillary sinus mucosa with a single cavity. It is possible to treat most part of a maxillary cavity if we handle a tip of Hammer blade adequately. Unlike Caldwell-Luc method, lips sensory paralysis does not occur by treating with Hammer method. Moreover, Hammer method can prevent postoperative maxillary cyst because a maxillary sinus becomes a cave cavity after it is recovered. Hammer method takes about 15 to 20 minutes for operation, requires easy technique, and therefore, we can conclude that it is a very effective method to treat poor prognosis cases.

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Acute epiglottitis is a bacterial infection that is often found in otolaryngological practice. Most cases are cured by conservative therapy with antibiotics and local treatment without developing severe airway obstruction.
Pulmonary edema is known to result from airway obstruction due to laryngospasm after general anesthesia, laryngeal edema, or croup. We reported a patient with acute epiglottitis who suddenly developed pulmonary edema and was resuscitated after intratracheal intubation. The pulmonary edema appeared to be non-cardiogenic and was related to changes of permeability of pulmonary capillaries. The pulmonary edema markedly improved by antibiotic, steroidal and diuretic therapy, as well as assisted ventilation. It is necessary to be aware of the possibility of sudden onset of pulmonary edema in patients with acute epiglottitis.

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Nasolacrimal duct obstruction in 5 eyes of 4 patients was treated by endonasal endoscopic surgery in combination with silicone loop intubation (SLI) during the period from November 1994 to October 1997. After operation, the symptom improved markedly. Operation to open obstructed nasolacrimal duct is chiefly conducted by oculists without cooperation from other specialists. However, our study demonstrated that lacrimal passage obstruction can be treated more smoothly in a less invasive manner when operation is conducted through cooperation by an otorhinolaryngologist and oculist.

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Acoustic rhinometry (AR) was used to assess nasal airway patency before and after nasal allergen challenge and was compared with anterior rhinomanometry and visual analog scale. Twelve medical students who had been diagnosed as having allergic rhinitis by skin tests or IgE RAST and nasal eosinophilia underwent nasal challenges with serialtenfold dilution starting from 105 to 102 of commercial allergen extracts for skin testing. Responses were assessed by measuring (a) the minimum crosssectional area (A-min) and volume (VOL) in nasal cavity using acoustic rhinometry, (b) nasal airway resistance in expiration using anterior rhinomanometry (RM) and (c) subjective nasal congestion using visual analog scale (VAS).
After challenge, AR and RM showed a significant change compared with that measured before challenge. AR appears to be superior to clinical symptoms in quantifying the response to nasal allergen challenge.

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A case of intraparotid facial nerve schwannoma is reported. The patient, a 50-year-old woman, complained of swelling in the right infraauricular region.Although the tumor with the capsule was carefully dissected from the facial nerve, incomplete facial palsy appeared after the operation. After 5 years of postoperative follow-up, the patient has no tumor recurrence, but facial function is not recovered completely. Intracapsular removal of intraparotid facial nerve schwannoma might be recommendable for preservation of facial nerve function, based on a review of the literature.

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Juvenile angiofibroma is a benign tumor that occurs in adolescent males at the highest rate. The tumor is easy to bleed and recur. In the majority of cases, the tumor develops in the nasopharynx.
We encountered an extremely rare type of angiofibroma that developed in the bilateral sinonasal cavity of a 19-year-old male. The first tumor was found in the right nasal cavity. The second tumor developed in the left maxillary sinus 2 years after the first operation. In the first operation, the tumor was completely removed by a transmaxillary approach after embolization of the right maxillary artery. In the second operation, the tumor was completely removed by the same approach after embolization of the left maxillary artery.

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We experienced 3 cases of maxillary sinus dental foreign bodies. The dental foreign bodies were root canal filling agent in 2 cases and implant in 1 case. In all cases the foreign bodies were removed under endoscopic sinus surgery. The entrance routes were considered to be the first and the second molars and the first false molar, respectively, showing a similar tendency as observed in cases reported previously. With the recent tendency for increase in size of the maxillary sinus cavity and propagation of the dental treatment, the incidence of iatrogenic foreign bodies, especially those in the field of dentistry, is increasing in place of foreign bodies attributable to trauma. Therefore, caution should be exercised in giving explanation to patients undergoing removal of foreign bodies, and the endonasal method, which is less invasive, is considered to be the first choice.

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[in Japanese]

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[in Japanese]

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