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Volume 55 (2012)
- Issue 6 Pages 408-
- Issue 5 Pages 272-
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Volume 34 (1991)
- Issue 6 Pages 595-
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- Issue 3 Pages 261-
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Volume 31 (1988)
- Issue 6 Pages 757-
- Issue 5 Pages 613-
- Issue 4 Pages 425-
- Issue 3 Pages 273-
- Issue 2 Pages 127-
- Issue 1 Pages 9-
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Volume 55, Issue Supplement1
Displaying 1-14 of 14 articles from this issue
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[in Japanese], [in Japanese]2012 Volume 55 Issue Supplement1 Pages s4
Published: 2012
Released on J-STAGE: August 29, 2013
JOURNAL FREE ACCESSDownload PDF (153K) -
Osamu Shibasaki, Yasuhiro Kase2012 Volume 55 Issue Supplement1 Pages s5-s10
Published: 2012
Released on J-STAGE: August 29, 2013
JOURNAL FREE ACCESSThe mainstream of regional therapy in Japan for the external auditory canal and middle ear is an ear dropper or application of ointment.
We had examined the possible use of an external ear spray as a new therapeutic approach for the external auditory canal offering treatment of an exact and a simple nature, and had already reported the safety and validity of an external ear spray for external ear models in volunteer subjects.
In the present report, the external ear spray was compared with an ear dropper for fluid osmosis to the middle ear in cadavers with a perforated tympanic membrane. In both methods, no fluid osmosis to the middle ear was recognized in models with a small perforation of the tympanic membrane and a ventilation tube in the tympanic membrane. In the middle and large perforation models and another model with polypropylene fiber added to the ventilation tube, fluid spread into the middle ear with both methods.View full abstractDownload PDF (995K) -
Tatsunori Sakamoto, Rie Horie, Yasuhiko Tabata, Takayuki Nakagawa, Jui ...2012 Volume 55 Issue Supplement1 Pages s11-s14
Published: 2012
Released on J-STAGE: August 29, 2013
JOURNAL FREE ACCESSOne major reason for the difficulty in the treatment of inner ear disorders is that only a tiny fraction of drug molecules administrated systemically or intratympanically arrive in the inner ear. Several approaches to override this difficulty are discussed. Steroid encapsulated in Stealth-type nano particles made of biodegradable polymer and coated with poly-ethylene glycol was injected intravenously after noise exposure to induce hearing impairment in guinea pigs. Delivery via Stealth particles resulted in a higher tissue concentration of the steroid in the inner ear and better hearing recovery compared to the steroid alone or encapsulated in non-coated nano particles. Lidocaine, a potential tinnitus attenuator, was encapsulated in microparticles made of biodegradable polymer. The microparticles were placed on the round window membrane (RWM) in guinea pigs, and achieved controlled and sustained delivery of lidocaine into the inner ear. Biodegradable gelatin hydrogels saturated with insulin-like growth factor 1 (IGF-1) were placed on the RWM, and showed a protective effect after inner ear damages in rodents. In humans, a phase I/II clinical trial has been completed in which gelatin hydrogels with IGF-1 were applied to the RWM. Patients with sudden onset hearing impairment, in whom treatment with a 7-day systemic steroid failed, were included in the trial. Hearing recovery was better than the historical control (hyperbaric oxygen therapy as a rescue treatment after the failure of systemic steroids), and no major adverse events were observed. The phase II randomized trial to test the effectiveness of the treatment compared to intratympanic steroids is being conducted in 9 institutes in Japan.View full abstractDownload PDF (494K) -
Hideaki Shiga, Junpei Yamamoto, Takaki Miwa2012 Volume 55 Issue Supplement1 Pages s15-s19
Published: 2012
Released on J-STAGE: August 29, 2013
JOURNAL FREE ACCESSNasal administration of macromolecular drugs (including peptides and nanoparticles) has the potential to enable drug delivery system beyond the blood brain barrier (BBB) via olfactory nerve transport. Basic research on drug deliver systems to the brain via nasal administration has been well reported.
Insulin-like growth factor-I (IGF-I) is associated with the development and growth of the central nervous system. Clinical application of IGF-I with nasal administration is intended to enable drug delivery to brain through the BBB. Uptake of IGF-I in the olfactory bulb and central nervous system increased according to the dosage of nasally administered IGF-I in normal ICR mice, however IGF-I uptake in the trigeminal nerve remained unchanged. Olfactory nerve transport is important for the delivery of nasally administered IGF-I to the brain in vivo.
Because a safe olfactory nerve tracer has not been clinically available, olfactory nerve transport has not been well studied in humans. Nasal thallium-201 (201Tl) administration has been safely used to assess the direct pathway to the brain via the nose in healthy volunteers with a normal olfactory threshold. 201Tl olfactory nerve transport has recently been shown to decrease in patients with hyposmia. The olfactory nerve transport function in patients with olfactory disorders will be determined using 201Tl olfacto-scintigraphy for the exclusion of candidates in a clinical trial to assess the usefulness of nasal administration of IGF-I.View full abstractDownload PDF (622K) -
[in Japanese], [in Japanese]2012 Volume 55 Issue Supplement1 Pages s20
Published: 2012
Released on J-STAGE: August 29, 2013
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Sota Yamaguchi, Motofumi Ohki, Haruka Ookubo, Yoshiko Ishii, Shuichiro ...2012 Volume 55 Issue Supplement1 Pages s21-s26
Published: 2012
Released on J-STAGE: August 29, 2013
JOURNAL FREE ACCESSAlthough nebulizer treatment has become widespread in otolaryngology, many issues, such as the indications, advantages, disadvantages and choice of drugs, need to be addressed. Reports of nebulizer treatment were considered, and a questionnaire survey was carried out to clarify the present situation of nebulizer treatment. A nebulizer apparatus was used in 100% of the hospital group, 98.2% of the clinic group, and 76.6% in the university group, so nebulizer use was lowest in the university group. It is generally considered that frequent and regular attendance at a hospital for nebulizer treatment is impractical. Jet type nebulizers are used at many hospitals and clinics. In sinusitis, the use of cefmenoxime (CMX) has increased compared to past reports. It is possible that, in the 15 years since CMX was approved for nebulizer use in 1996, its validity has been evaluated. In laryngitis, CMX accounts for 46.3% of the antibacterial drugs currently given via nebulizer. There are still many issues surrounding nebulizer treatment that need to be examined, including the kind of nebulizer being used, the drugs used, and concomitant drugs. It is important to evaluate the usefulness of nebulizer treatment correctly.View full abstractDownload PDF (813K) -
Toshiyuki Fujisawa2012 Volume 55 Issue Supplement1 Pages s27-s31
Published: 2012
Released on J-STAGE: August 29, 2013
JOURNAL FREE ACCESSThe nebulizer treatment is used commonly. Because of its high safety, it can be used in all age groups from children to elderly. The choice of the drugs depend on the hospital. The main drug use are Cefmenoxime, Fosfomycin and Amikacine. The nebulizer therapy is peculiar to Japan so that the evidence of the clinical efficacy is limited. In acute sinusitis treatment guidelines, recommended grades for nebulizer therapy is C1 (It has no scientific evidence, but it can be recommended).
This paper presents a review of using nebulizer therapy in the past and the nebulizer therapy guidelines including the necessary items for efficient therapy.View full abstractDownload PDF (546K) -
Hiroshi Takano, Motofumi Ohki, Toshio Ogoshi, Masayuki Itoh2012 Volume 55 Issue Supplement1 Pages s32-s39
Published: 2012
Released on J-STAGE: August 29, 2013
JOURNAL FREE ACCESSAdvanced aerosol therapy in otorhinolaryngology should be sufficiently discussed in relation to applicable inhalation devices and clinical indications. In this paper, the specifications, advantages and disadvantages, procedures, and notes of the medical therapeutic devices are reviewed with the choice available and their performance. In particular, the physiochemical properties of the drug solution, which affects the specifications of inhalation devices, the spray angle into the nasal cavity, and the drug delivery to the paranasal sinuses are represented as inhalation techniques. In addition, some techniques of aerosolized treatments are also mentioned corresponding to the development of new therapeutic medical devices in inhalation therapy.View full abstractDownload PDF (1694K) -
Yuji Yoshiyama2012 Volume 55 Issue Supplement1 Pages s40-s43
Published: 2012
Released on J-STAGE: August 29, 2013
JOURNAL FREE ACCESSAerosolized nebulizer therapy is widely performed for inhalant therapy. This therapeutic approach is an ideal drug delivery system (DDS) because it can effectively deliver medications directly to the affected area, and is recognized as a useful route of administration in therapy for various fields. However, some problems still remain regarding the stability of the drug in inhalant solutions during nebulization. We planned a series of studies on the stability of medications used in nebulizer therapies. We have reported that the remaining ratios of some drugs were below 90% after nebulization using a conventional nebulizer. The drugs that showed a decrease in content, a change in appearance or produced a bad smell after nebulization should be used carefully. It is moreover necessary to develop special preparations for nebulization therapy.
A new nebulizer has been developed. We investigated the effect of the nebulizer on the stability of some drugs including antibiotics for inhalant therapy. Stability tests were performed on drugs in terms of visible changes, pH, smell and degradation rate of the drug after nebulization. The changes in pH, apparent appearance and smell were not observed for the drugs. The ratios of all drugs remained at more than 95% after nebulization using the nebulizer.
Therefore, the drugs are highly stable using this nebulizer and should be effective. We concluded that the nebulizing method can be applied for inhalant therapy with many inhalant preparations. As health care professionals we must be responsible for providing patient care that ensures the optimal medication therapy outcomes. We can therefore intervene in aerosolized nebulizer therapy.View full abstractDownload PDF (407K) -
Motofumi Ohki, Sota Yamaguchi, Haruka Okubo, Yoshiko Ishii, Shuichiro ...2012 Volume 55 Issue Supplement1 Pages s44-s48
Published: 2012
Released on J-STAGE: August 29, 2013
JOURNAL FREE ACCESSTopical steroid therapy is useful in the treatment of patients with allergic rhinitis. Inhalation therapy with a nebulizer is advantageous because the risk of adverse effects is lower than with systemic drug administration. Recently, the portable mesh type nebulizer was developed, and more recently we have designed a new mesh type nebulizer device for nasal disease. Development has particularly concentrated on the intermittent type of device. The aim of the study was to investigate the usefulness of this new portable device for the treatment of allergic rhinitis.
We enrolled 12 patients with Japanese cedar allergic rhinitis who consulted our hospital, and randomly assigned into 3 groups for treatment for 4 weeks with intermittent type of nebulizer and the continuous type of nebulizer. The patients of group A were inhaled 0.5mg/2ml of Budesonide twice a day for first 2 weeks with intermittent type of nebulizer and inhaled same dose of Budesonide with continuous type of nebulizer for next 2 weeks. The patients of B group were 0.5mg/2ml of Budesonide for 2 weeks with continuous type for first 2 weeks and inhaled same dose of Budesonide with intermittent type for next 2 weeks. The patients of C group were inhaled 0.25mg/2ml of Budesonide for first 2 weeks with intermittent type of nebulizer and inhaled same dose of Budesonide with continuous type for next 2 weeks.
Nasal symptoms and nasal resistance were compared before and after treatment.
All of the patients could comfortably use these devices and showed a significant improvement in their nasal symptom 2 weeks after steroid inhalation. The effect of the lower dose of steroid inhalation using the intermittent type of nebulizer was statistically the same as the higher dose. The intermittent type of mesh nebulizer was useful tool in treating allergic rhinitis.View full abstractDownload PDF (659K) -
Hiroshi Takano, Yuta Kitazato, Hidenori Murayama, Chiyohiko Shindoh, H ...2012 Volume 55 Issue Supplement1 Pages s49-s55
Published: 2012
Released on J-STAGE: August 29, 2013
JOURNAL FREE ACCESSAnti-influenza virus inhalers formulated as a dry powder have been applied clinically in the treatment of seasonal influenza, which is one of the upper respiratory tract infections. In this study, the optimum respiratory conditions were examined together with the degrees of suitable drug delivery efficiency to the the local upper airways, because the degree of efficiency varied as functions of the particle size distributions of inhaled drugs and the respiratory conditions. Dry powder inhalers, such as zanamivir hydrate and laninamivir octanoate hydrate, were used in the experiments. From the experimental results in the measurement of the inhaled particle size distributions and the analysis of the degree of drug delivery efficiency, the optimum degree of respiratory effect based on the efficiency findings was adequately obtained in patients breathing normally in a sitting position.View full abstractDownload PDF (687K) -
Yuji Yoshiyama, Yoko Tashiro, Takahiro Ohshima, Ikuko Hashimoto, Hidet ...2012 Volume 55 Issue Supplement1 Pages s56-s59
Published: 2012
Released on J-STAGE: August 29, 2013
JOURNAL FREE ACCESSThe condition of dry mouth is an influential factor in the incidence of caries, periodontal disease, masticatory dysfunctions and denture function. The elderly often suffer from oral dryness and the aim of this study was to measure the amount of moisture in the oral mucosa of dry mouths at a community pharmacy. We further evaluated the usefulness of hyaluronic acid spray for treatment of dry mouth in elderly patients. The subjects were 140 elderly patients (mean age: 75.1+/-6.0 years) attending a community pharmacy. Measurement of moisture at the dorsum of the tongue and sublingual mucosa was performed using a wetness tester (L-SALIVO) with a measurement time of 10s. Further, clinical diagnosis of dry mouth was carried out using a clinical classification scale of the tongue mucosa (grade range, 0-3). Hyaluronic acid spray was then used for the treatment of the patients with dry mouth. Tongue dorsum moisture measurements were performed after treatment with the hyaluronic acid spray. It was possible to measure tongue dorsum moisture in all subjects with the wetness tester. The average moisture value was 2.2+/-1.3mm in elderly subjects with a dry mouth which increased to A 3.6+/-1.6mm after treatment with the hyaluronic acid spray. Our results show that this tester could be useful for evaluating oral dryness and diagnosing dry mouth. Furthermore, dry mouth of the dorsum of the tongue in the elderly requiring care was improved by treatment with the hyaluronic acid spray.View full abstractDownload PDF (395K) -
Masayuki Takahashi, Takuya Hirano, Mizue Takimoto, Yukiko Kato, Akiko ...2012 Volume 55 Issue Supplement1 Pages s60-s64
Published: 2012
Released on J-STAGE: August 29, 2013
JOURNAL FREE ACCESSTo provide patients with appropriate drug administration guidance depending on their different backgrounds is one of the most important responsibilities of a pharmacist. The guidance ensures patients' understanding of the correct usage and precautions for each particular drug, which is the key in obtaining the maximal medicinal effect. For the use of aerosol drugs that require accurate operation, an instruction sheet with a list of precautions is provided from the pharmaceutical companies, however, there remains a problem that supplementary explanations are not adequately performed by a pharmacist to suit the background of each particular patient. To overcome this problem, we developed an explanatory tool and a drug administration guidance support tool for pharmacists to explain the appropriate usage to patients. We also examined the appropriateness of the drug administration guidance when these tools were used.
The use of both the patient explanation tool and drug administration guidance support tool resulted in an increased number of patients understanding the appropriate usage method. This lead to a decrease in left-over drugs and improved compliance. Furthermore, patients were able to continue use of the drugs, therefore it can be expected that patient symptoms improve over a shorter time span. In conclusion, this study strongly indicated that appropriate drug administration guidance plays an important role in improving the medicinal effects of drugs for patients.View full abstractDownload PDF (960K) -
Hiroshi Takano, Michiko Manabe, Mai Yamamura, Satoru Takamoto, Junichi ...2012 Volume 55 Issue Supplement1 Pages s65-s69
Published: 2012
Released on J-STAGE: August 29, 2013
JOURNAL FREE ACCESSInsufficient assessment has been performed regarding the specific differences in the atomization characteristics of inhalation devices in the use of corticosteroid budesonide suspension for inhalation treatment of local airway inflammation. In this study, the atomization characteristics such as amount of atomized drug solution and particle size distribution were experimentally evaluated for four jet-type and two mesh-type nebulizers. Both the amount of atomized drug solution and the particle size distribution produced from those inhalation devices were simultaneously measured with an optical measurement system. For budesonide concentrations in the range of 0, 25, 50, 75 and 100% in physiological saline dilution, the atomized drug solution was not significantly different among the jet-type nebulizers, showing a slight difference in the mesh-type nebulizers. Especially in the mesh nebulizers, the amount of atomized drug solution was almost the same as that of physiological saline solution, but was lower than that of the jet nebulizers. On the other hand, the geometric mean particle diameter of budesonide droplets showed a value smaller than that of the physiological saline solution. In addition, no specific difference was recognized between the two mesh nebulizers in the geometric mean particle diameter and the geometric standard deviation of inhaled drugs. Moreover, the degree of airway drug delivery at local sites was evaluated in the use of those inhalation devices in the treatment of airway inflammation.View full abstractDownload PDF (824K)
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