Kosaku Sakaguchi

Effect of anti-allergic treatment on nasal surface basophilic metachromatic cells in allergic rhinitis.

The nasal surface basophilic metachromatic cells increase in allergic rhinitis and play an important role in the manifestation of nasal symptom. Their numbers were decreased in good correlation with the severity of symptom and nasal provocation reaction after clinical treatment with specific immunotherapy or topical steroid, beclomethasone dipropionate. The percentages of allergen induced histamine release from these cells were not changed after clinical treatment with cromolyn sodium.

Use of phytohemagglutinin in the treatment of maxillary cancer.

ZusammenfassungBehandlung von 24 Patienten mit einem Plattenepithelkarzinom der Kieferhöhle mit 50 μg Phytohaemagglutinin (PHA). Das Präparat wurde mittels Gelita in die peroral eröffnete Kieferhöhle eingebracht und die Therapie mit einer Telekobaltbestrahlung von 4000 rad (20×200 rad über einen Monat) sowie arteriellen Infusionen von 5-Fluorouracil (5-FU), 20×250 mg, kombiniert. Nach 20 Behandlungen mit PHA war der Tumor in 83,3% der Fälle verschwunden, während er bei den Patienten ohne PHA-Therapie nur in 62,6% nicht mehr nachzuweisen war. Bei der histologischen Untersuchung fand sich in der PHA-Gruppe in 66,6% kein Tumor mehr, bei der Gruppe ohne PHA dagegen nur in 15,8%. Nebenwirkungen wurden nicht beobachtet. In der 3 Jahre-Überlebensrate bestand zwischen beiden Gruppen kein signifikanter Unterschied.SummaryTwenty-four patients with maxillary squamous cell carcinoma were treated with 50 μg of phytohemagglutinin (PHA), saturated into pieces of gelatin sponge, and applied to the maxillary sinus which was in advance surgically exposed via the peroral route. Treatment was combined with cobalt 60 irradiation at 4,000 rads (200 rads×20 doses over a one month period) and concurrent arterial infusion of 5-fluorouracil (5-FU) with a total dosage of 5,000 mg (250 mg× 20 doses). After 20 treatments with phytohemagglutinin, gross examination showed that tumors were no longer apparent in 83.3% of the cases treated with PHA vs. 52.6% in the control group without PHA. On histological examination, 66.6% in the PHA group showed no signs of tumors vs. 15.8% in the control group. Microscopically, the disappearance of the tumors was frequently observed in tumor of T2 more than that of T3 in extent of primary tumor. No side effects were observed nor was there a significant difference between the control group and the PHA group in the 3-year crude survival rate (control group: 68.4%; PHA group: 62.5%)

Characteristics of patients tested for Japanese cedar pollinosis.

Allergy tests showed the following characteristics of patients with Japanese cedar pollinosis.1) Unlike patients with perennial allergy, many of those with Japanese cedar pollinosis were women above 20 years of age.2) Pollinosis patients had more severe symptoms than perennial allergy patients. Nevertheless, they had a lower rate of positive allergy tests.3) In 1984, when more pollen was in the air, there was a higher incidence of onset of symptoms and the rate of positive allergy tests was higher than in 1983.4) The rate of positive allergy tests was higher early in the pollen season than in the middle or at the end of the season.5) The more pollen in the air and the longer the period of exposure, the higher was the incidence of eosinophilia in nasal smears, the percentage of eosinophiles in the blood and of surface basophilic cells in the nasal mucosa. Nevertheless, the serum IgE level was always low, regardless of the amount of pollen or the duration of exposure to the pollen.

Basophil degranulation test for nasal allergy.

Allergolam is a new kit (Institute Pasteur Production, Paris) for human basophil degranulation testing (HBDT) and is used to diagnose reaginic allergy.To test the reliability of this kit, we compared the results of HBDT with those of skin tests, RAST and nasal provocation tests in 49 patients. To test its reproducibility, we performed the HBDT four times in one patient, and twice in three patients. To test the specificity of this test to allergens, five patients allergic to Japanese cedar, were tested for house dust allergen (HD).We found a significant correlation between the results of the HD HBDT and HD provocation test and HD RAST. We also found a significant correlation between the results of mite HBDT and mite skin test or mite RAST. There was, however, no significant correlation between the results of HD HBDT and HD skin tests. In regard to the specificity to allergens, HBDT for HD allergen was negative in five patients with Japanese cedar allergy. The test results were not markedly different in two or four repetitions.The above results indicate that HBDT is highly reproducible, specific to allergen and useful in the diagnosis of reaginic allergy. In a comparison of HBDT with RAST, HBDT required a minimum equipment, was easier to perform and almost as reliable as RAST.

Peripharyngeal space invasion of head and neck cancer--incidence, mechanisms, and management.

We studied the incidence and mode of development of peripharyngeal invasion from head and neck cancers by both retrospective examination of our 127 patients and tracing the dynamics of lymph flow from the hypopharyngeal wall to the peripharyngeal space. We also presented three experiences of the surgical approach to the peripharyngeal invasion by our modification of Attias technique. Peripharyngeal space invasions occur frequently in a direct or indirect way when meso- or hypopharyngeal or posterior oral cancer invades deeply into the muscle layers and extends to the palatine arch, retromolar region, pharyngoepiglottic fold, pharyngeal tongue, or posterior buccal mucosa. The lymph flow was revealed to move quickly from the lateral hypopharyngeal wall to the base of the skull and occasionally to the opposite side. The peripharyngeal space invasions were successfully removed under a wide surgical field without injuring the important nerves and vessels and with preservation of mandibular function. We should cover all routes for extension of head and neck cancers, including the peripharyngeal space, in the diagnosis and management of these conditions.