Koji Asakura

Effects of a cysteinyl leukotriene antagonist, ONO-1078 (pranlukast), on total airway resistance after antigen challenge in sensitized guinea pigs.

Abstract.Objective and Design: To define the role of leukotriene (LT) in allergic rhinitis, we examined the effects of a cysteinyl (Cys) LT antagonist (ONO-1078, pranlukast).¶Material: Actively sensitized Dunkin-Hartley guinea pigs.¶Treatment: ONO-1078 (pranlukast), 3–100 mg/kg p.o. l h before antigen challenge.¶Methods: Nasal symptoms (sneezing, nasal scratches), changes of total airway resistance (TAR by plethysmography) and eosinophil infiltration into the nasal mucosa were determined following topical antigen (OA) challenge. Dunnets test (TAR and symptoms) and the Mann-Whitney U-test (eosinophils) were applied.¶Results: Control animals showed bi-phasic nasal responses, peaking 10 min and 240 min after the topical antigen challenge, respectively. While the early-phase response was characterized by nasal symptoms of sneezing and scratching accompanied by the increase in TAR, the late-phase was characterized by an increase in TAR accompanied by eosinophil infiltration into nasal mucosa. The nasal symptoms (sneezing and scratching) were not inhibited by pretreatment with ONO-1078 at doses up to 100 mg/kg (p.o., n = 15). Although early peak responses of TAR were not affected with even the highest dose (30 mg/kg, p.o., n = 6), late-phase TAR peak response (control: 174.8 ± 8.2%, n = 6) were significantly inhibited by 10 mg/kg (142.7 ± 15.8%; p < 0.05, n = 6) and 30 mg/kg (118.0 ± 6.6%; p < 0.01, n = 6) of ONO-1078 (p.o.). In addition, the eosinophil infiltration induced by the antigen was not inhibited by ONO-1078 (30 and 100 mg/kg, p.o., n = 6).¶Conclusions: Our results suggest that Cys LT may play an important role in the late-phase increase in TAR in the guinea pig model of allergic rhinitis.

Definitive Diagnosis and Location of Peanuts in the Airways Using Magnetic Resonance Imaging Techniques

A 14-month-old boy suspected to have aspirated peanut fragments into the airways was transferred to our hospital. His chest radiographs revealed Holzknechts sign, which indicated left mainstem bronchial obstruction. Magnetic resonance imaging with T1-weighted images clearly showed a high-intensity signal of peanut fragments in the left mainstem bronchus. Removal was performed by bronchoscopy in a shorter time under general anesthesia. Magnetic resonance imaging with T1-weighted images (T1WI) is useful for definitive diagnosis and location of peanut fragments in the lower airway because the peanut material appears as a high-intensity signal surrounded by the low-intensity lung tissue. Various slice orientations of T1WI provide accurate information concerning anatomic location of such fragments, thus facilitating removal by bronchoscopy.

Reversible acquired tracheobronchomalacia of a combined crescent type and saber-sheath type

A case of tracheobronchomalacia (TBM) in a 71-year-old woman, who had suffered a cough syncope, is reported. It was a combination of both the crescent type (the posterior membranous portion of trachea or bronchus protrudes into the lumen) and the saber-sheath type (the lateral cartilaginous wall of trachea or bronchus protrudes into the lumen). In this patient, acute bronchitis had developed superimposed upon a chronic bronchitis in addition to age-related regressive changes of the trachea and bronchus. A TBM due to acute inflammation can be reversible, but aggressive airway management as well as medical treatment of the underlying inflammation are critical to a successful outcome.

The effects of NK1 receptor antagonists (FK224 and FK888) on agonist- and antigen-induced nasal microvascular leakage in guinea pigs

Abstract.  Objective: To study the inhibitory effects of two NK1 receptor antagonists on substance P (SP) and antigen-induced increase of nasal vascular permeability in ovalbumen (OA)-sensitized guinea pigs. ¶Material: Male Dunkin-Hartley guinea pigs. ¶Treatment: SP (100 ;mol/l), FK224 (1–10  mol/kg) and FK888 (0.2– 2 mol/kg). ¶Methods: The in vivo model of nasal microvascular leakage was used for nasal allergic challenge in ovalbumin (OA)-sensitized guinea pigs, or nasal stimulation with substance P (SP) in non-sensitized animals. Nasal microvascular leakage was measured by the accumulation of Evans Blue dye after intravenous injection. ¶Results: Following nasal stimulation with SP 100 M, the concentration of dye in the nasal lavage fluid rapidly increased. NK1 receptor antagonists FK224 (10 mol/kg i.v.) and FK888 (2 mol/kg i.v.) inhibited SP-induced microvascular leakage. In OA-sensitized guinea pigs, exudation of dye into nasal lavage fluid was observed soon after topical antigenic stimulation and continued for over 60 min. Both NK1 receptor antagonists inhibited the immediate phase of the antigen-induced microvascular leakage. ¶Conclusions: We conclude that the immediate change of vascular permeability during the nasal allergic response is mediated by activation of the NK1 receptor in the guinea-pig.

Study on the IL-5 expression in allergic nasal mucosa

An immunohistological study was performed on allergic and nonallergic nasal mucosa to examine interleukin-5 (IL-5) expression. Many cells in the superficial portion of lamina propria expressed IL-5 in allergic nasal mucosa, whereas few cells expressed IL-5 in nonallergic mucosa. Furthermore, it was suggested by immunohistological double staining that CD45RO-positive cells, EG2-positive cells and metachromasia-positive cells expressed IL-5 in allergic nasal mucosa.

Squamous cell carcinoma of bladder diverticulum with initial symptoms produced by metastasis to maxillary sinus

A rare case of squamous cell carcinoma in the bladder diverticula of a 74-year-old man with initial clinical symptoms caused by metastasis to the maxillary sinus is reported. The histopathological examination at autopsy confirmed the metastatic squamous cell carcinoma in the maxillary sinus from the bladder diverticula. The vertebral vein plexus seems responsible for this type of metastasis.

TRAUMATIC CERVICAL TRACHEAL DISRUPTION : REPORT OF TWO CASES

We report herein the cases of two patients who suffered traumatic tracheal disruption, both of whom under-went successful surgical treatment. The first patient was a 48-year-old truck driver who suffered severe dyspnea after jamming his neck in a truck door. An endotracheal tube was unable to be inserted due to bleeding and thus, an emergency tracheostomy was performed. On admission massive subcutaneous emphysema was noted in the neck and anterior chest, and tracheal disruption was confirmed by a lateral neck X-ray, computed tomography (CT), and fiberscopy. An emergency end-to-end anastomosis of the trachea with insertion of a T-type silicon tube into the lower trachea was performed. The second patient was a 36-year-old man who suffered severe dyspnea after having his neck caught in a chain while driving a motorcycle. On admission, marked subcutaneous emphysema in the neck and paradoxical movement of the trachea were noted. Tracheal disruption was confirmed by a lateral neck X-ray and CT, and a similar operation to that of the first patient was performed. This type of injury is rare; however, lateral neck X-ray, CT, and fiberscopy proved extremely useful for making an accurate diagnosis following which successful emergency surgery was able to be performed, achieving good long-term results.

A case of anaplastic thyroid carcinoma surviving disease free for over 2 years

A 52-year female presented with an enlarged thyroid mass and lump sensation in the throat. The cytologic examination showed class five and she was admitted to the hospital to undergo operation. Total thyroidectomy was done and the tumoral invasion of the trachea was removed. We performed tracheoplasty using a sternocleidomastoid muscle-clavicle myoosseous flap in a single stage operation. Histologic diagnosis revealed anaplastic thyroid carcinoma After upper mediastinal dissection had been performed, systemic chemotherapy using pirarubicin, cisplatin and etoposide was administered. In addition, she was treated with radiochemotherapy using pirarubicin, cisplatin and a total of 58 Gy was administered. No recurrence of the tumor has been noted since the above operation 2 years ago. Immunohistochemical studies of primary and metastatic tissues in this case revealed a positive expression of p53 protein in both.

Effects of Emedastine on Guinea Pig Models of Allergic Rhinitis.

Emedastine difumarate is a selective H1-antagonist as well as a histamine release inhibitor. The effects of emedastine on patients with allergic rhinitis have been previously reported. We examined the effects of emedastine difumarate (0.03, 0.3 and 1.0mg/kg) on nasal symptoms, changes in the total airway resistance (TAR) and eosinophil infiltration into the nasal mucosa induced by topical antigen challenge in actively sensitized guinea pigs.Nasal symptoms (the number of sneezes and scratches) were significantly inhibited by emedastine pretreatment in a dose dependent manner. We noted a biphasic increase in the TAR after antigen challenge. The first peak response of the TAR was partially but significantly inhibited by emedastine (0.3 and 1.0mg/kg). The second peak response of the TAR was also inhibited by emedastine (1.0mg/kg). Furthermore, emedastine (1.0mg/kg) significantly inhibited antigen-induced eosinophil infiltration into the nasal mucosa.In conclusion, our results suggest that emedastine difumarate may suppress nasal symptoms in guinea pig models of allergic rhinitis.

Pediatric otolaryngological diseases found on screening tests in Hokkaido rural district.

Otolaryngological examinations were carried out on 1017 children (1-13, mean 4.9 years old) in 5 rural towns in Hokkaido. In addition to the usual ENT examinations, tympanometric examination and cytological study of nasal secretions were performed in all children.The incidence of abnormal nasal findings and nasal eosinophilia increased, whereas that of abnormal ear findings and abnormal tympanograms decreased with age. There was no correlation between the occurence of nasal eosinophilia and abnormal tympanograms. A history of allergy, included asthma, also showed no correlation with the incidence of abnormal ear findings. The incidence of upper respiratory tract infection was lower in the older children.These findings suggest that allergy is not related to otological abnormalities, including otitis media with effusion.