JIBI INKOKA TEMBO

All lives have heat shock response (HSR) that is characterized by activation of heat shock transcription factor 1 (HSF1) and induction of heat shock proteins (HSPs) in response to stresses. When proteins are damaged due to various stresses, HSPs undergo cytoprotective function by acting as molecular chaperones that stabilize denatured proteins and facilitate their refolding and degradation. HSF1 and HSPs exist in the inner ear and play a protective role against cochlear damage. We showed that HSR inducer, geranylgeranylacetone (GGA) activate HSF1 and induce HSPs in cochlea and repetitive preventive administration of the agent could ameliorate ABR threshold shift up and loss of outer hair cell drastically. The mechanism of protection by GGA were considered that via chaperon function, anti-apoptosis effect, anti-oxidant effect, enhancement of stiffness and anti-inflammation.
We also showed here that HSPs in cochlea diminished during aging and pharmacological upregulation of HSPs attenuate age-related hearing loss (ARHL) using one of this model. In addition, when ARHL model mice were exposed to intense noise at elder age, there were less induction of HSPs than that of young age. These results indicate that HSR in cochlea diminishes with aging and that result in vulnerable to aging and sound stress.
We demonstrated that importance of HSR in oto-protection and possibility of GGA to clinical application.

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Inferior blowout fractures are typically classified based on the state of the bone fragments after the fracture. These fractures are classified into linear type, in which the bone fragments are not displaced, the trap door type, in which the bone fragments on one side of the fracture have separated, and the blowout type, in which the bone fragments have become completely detached. At the same time, in performing surgical repairs for inferior blowout fractures with an endoscope, much more delicate manipulations can be performed than was previously possible. It therefore becomes very important to observe the state of not only the bone fragments, but also that of the orbital bone membrane and maxillary mucosa when performing treatment. This is because the procedural order or difficulty of the surgery will change based on the state of damage to the orbital bone membrane and maxillary mucosa. Out of the 29 patients with inferior blowout fractures enrolled for this study, 19 were of the trap door type, 7 were of the blowout type, and 3 were of the linear type. Investigation of the state of the fracture and damage (or lack thereof) to the orbital bone membrane and maxillary mucosa in these cases revealed that while all of the 3 patients with the linear-type fracture had rupture of both the orbital bone membrane and the maxillary mucosa, in most of the cases with the trapdoor-or blowout-type fractures showed no damage to the orbital bone membrane or maxillary mucosa. I believe that surgical results can be improved by confirmation and treatment based on these observations when operating on inferior blowout fractures.

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Schwannoma of the larynx is not common, and only 84 cases have been reported in the Japanese literature. We recently encountered a patient with schwannoma of the larynx, and report the case herein. A 37-year-old female presented with a 3-year history of hoarseness of the voice. Clinical examination by fiberoptic laryngoscopy revealed a smooth mass localized in the left false cord of the larynx.
The tumor was successfully removed under general anesthesia by laryngofissure.
The histopathological diagnosis was schwannoma, Antoni-A, B mixed type. No evidence of reccurence has been noted since the surgery.

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We report a case of Guillain-Barré syndrome associated with facial diplegia in a child. A 7-year-old boy began to show little facial expression after an episode of upper respiratory tract infection. We made an intense effort to obtain a precise diagnosis before using an adrenal cortical hormone, because the patient was a child. After confirming the diagnosis of Guillain-Barré syndrome, the patient was treated with intravenous immunoglobulin injections. Dramatic improvement of the facial diplegia was noted with this treatment, and the patient was discharged from the hospital 19 days after admission. Although facial diplegia is very rare otorhinolaryngologists must keep this condition in mind as a possible presenting symptom of Guillain-Barré symdrome and facial diplegia with paresthesia.

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