JIBI INKOKA TEMBO

ROLE OF AEROSOL THERAPY WITH A NEBULIZER IN THE POSTOPERATIVE CARE OF PATIENTS WITH CHRONIC SINUSITIS

Keiichi Ichimura

2009 Volume 52 Issue Supplement Pages s3-s8
Published: 2009
Released on J-STAGE: August 15, 2010

DOIhttps://doi.org/10.11453/orltokyo.52.s3

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The primary aim of treatment of chronic sinusitis is to break the vicious cycle of sinusitis. Sinus surgery is a tool to attain this purpose and is one of the most effective measures to accelerate the healing process. Needless to say, postoperative care plays an important role. Mucociliary function is said to improve within 6 weeks to 3 months after the surgery; it, however, takes much longer until it becomes normal. Topical treatments, including nebulizer treatment are considered to be useful for wound healing during the postoperative period. From the viewpoint of nebulizer treatment, anatomic problems, such as a narrow ostiomeatal complex, hamper the penetration of aerosol particles into the sinuses. Thus, ways of increasing particle entry, such as application of a pressure gradient between the nasal cavity and the sinuses or enlargement of the ostial diameter, have been used for the treatment of chronic sinusitis. Surgery provides larger ostia and makes cleaning of rhinorrhea easy, which leads to improved deposition of aerosol particles in the sinuses, promoting the postoperative healing process.
Evidence on the value of nebulizer treatment in the postoperative management of paranasal sinusitis is presented. However, even a combination of endoscopic sinus surgery and nebulizer therapy does not appear to be effective for eosinophilic sinusitis at present. Further investigation addressing this issue is necessary.

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WHAT WAS CLARIFIED FROM A FUNCTION ANALYSIS OF THE HUMAN NASAL MUCOSA?

Tetsuo Himi, Mitsuru Go, Atsushi Kondo, Ken-ichi Takano, Tomoyuki Masa ...

2009 Volume 52 Issue Supplement Pages s9-s18
Published: 2009
Released on J-STAGE: August 15, 2010

DOIhttps://doi.org/10.11453/orltokyo.52.s9

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Analysis of the mucosal barrier function using a primary culture system of human nasal mucosal epithelium is important to establish a methodology of inflammation control by the transnasal drug delivery route. Tight junctions are one of the important factors contributing to the permeability of the nasal mucosa to drugs, and it is important to study the factors regulating the nasal mucosal permeability to drugs. Furthermore, examination of the immunocompetence of an individual by sampling cells such as dendritic cells and M cells may be expected to contribute to the establishment of immunotherapy for allergic rhinitis or upper respiratory infections using the transnasal approach. In addition, tight junctions are also known as one of the viral receptors, and it is important for the future to study the characteristics of tight junctions to develop treatment strategies for the prevention of viral infections.

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MUCOSAL IMMUNE SYSTEM FOR THE REGULATION OF RESPIRATORY IMMUNE RESPONSES

Jun Kunisawa, Hiroshi Kiyono

2009 Volume 52 Issue Supplement Pages s19-s23
Published: 2009
Released on J-STAGE: August 15, 2010

DOIhttps://doi.org/10.11453/orltokyo.52.s19

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The respiratory and gastrointestinal tracts are equipped with a unique mucosal immune system that contributes to immunosurveillance and immunological homeostasis in the harsh environments of the mucosal surfaces. While the respiratory and gastrointestinal immune systems share common mucosa-associated immunological features, they also show distinctive immunological phenotypes, functions, and developmental pathways. We describe here the common immunological features of the respiratory and gastrointestinal immune systems and their application to the potential development of mucosal immune therapy.

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COMPUTATIONAL FLUID DYNAMICS ANALYSIS OF THE NASAL CAVITY

Takahisa Yamamoto, Seiichi Nakata, Makoto Monya, Tsutomu Nakashima

2009 Volume 52 Issue Supplement Pages s24-s29
Published: 2009
Released on J-STAGE: August 15, 2010

DOIhttps://doi.org/10.11453/orltokyo.52.s24

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Individual differences in nasal cavity shape affect transport within it, e.g., medicinal mist transport in nebulizer inhalation. Based on computed tomography (CT) data, we simulated medicinal mist transport within the nasal cavity based on computational fluid dynamics (CFD). The subject had a deviated nasal septum, chronic sinus infection, and inferior tubinate hypertrophy. CFD simulation showed that the unusual nasal topography caused over 90% of the medicinal mist to be deposited near the external nostril, where the nasal cross-section was narrowest. Changing the nebulized angle to between 30 and 60 degrees enabled most of the medicinal mist to be directed toward the lower nasal cavity.

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DATABASE OF VALUE-ADDED GENERIC DRUGS

Akane Kakuyama, Tomoko Miyazaki, Miyoshi Kido, Toshihiro Noda, Megumi ...

2009 Volume 52 Issue Supplement Pages s30-s35
Published: 2009
Released on J-STAGE: August 15, 2010

DOIhttps://doi.org/10.11453/orltokyo.52.s30

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The use of generic drugs has gradually become more widespread in Japan, and is now an accepted part of health care. A generic drug is usually considerably less expensive than the brand name original. A key element in the use of a generic drug is the establishment of bio-equivalency: bio-equivalency means that the product to be evaluated has essentially the same biological availability as the original branded drug when given in the same dose. Value-added generic drugs are usually developed using innovative pharmaceutical technologies and such products allow the goal of the products being more patient-friendly to be achieved. The patient compliance is higher, the therapeutic drug concentrations are more constant, and there are fewer adverse side effects. Value-added generic drugs must meet all the requirements of bio-equivalency and have the same quality, efficacy and safety as the original drug. Drug information has a very important role in clinical pharmacy. We need more information about value-added generic drugs to resolve clinical problems. The purpose of this study was to establish a database for proper use of value-added generic drugs and to provide quick and accurate information from the database. The product name and content of the value-added generic drugs supplied by each pharmaceutical company were investigated for 107 pharmaceutical companies in Japan. A database of the value-added generic drugs was made taking into consideration additional values like on the improvement of patient convenience (oral-disintegrating tablets, miniaturization, etc.). Fifty-two of the 88 companies (collection rate 82.2%) included in a questionnaire survey reported that they were supplying value-added generic drugs. Fluticasone propionate for nebulization is one of value-added generic drugs and a useful information from the database is that the smell has been improved by menthol mixing. The treatment adherence of some patients improves with the use of value-added generic drugs.

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ANALYSIS OF ALLERGIC RHINITIS PATIENTS COMPLICATED BY BRONCHIAL ASTHMA

Kazuhiko Takeuchi, Hitomi Ogihara, Yukiko Miyamoto, Tetsu Takeo, Atsus ...

2009 Volume 52 Issue Supplement Pages s36-s40
Published: 2009
Released on J-STAGE: August 15, 2010

DOIhttps://doi.org/10.11453/orltokyo.52.s36

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We conducted a clinical survey on 567 patients who visited our allergic rhinitis clinic at the Department of Otorhinolaryngology, Head & Neck Surgery in Mie University Hospital from 1991 to 2008. We compared the characteristics of allergic rhinitis patients with and without asthma, in order to clarify the features of allergic rhinitis associated with asthma. In total, 17% of the allergic rhinitis patients had complicating asthma. The age at onset of allergic rhinitis was significantly lower in the rhinitis patients with asthma than in those without asthma. The total serum IgE levels were also significantly higher in the rhinitis patients with asthma. The CAP-RAST scores for house dust mites were significantly higher in the patients with asthma. Significantly fewer patients with cedar pollinosis had complicating bronchial asthma.

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