Kotaro Ukai

Nasal Mucociliary Clearance Under Various Conditions

We applied the tagged-particle method or the saccharin method or both to the nasal mucociliary clearance. There was no effect of ageing on the transport time of saccharin in control subjects of ages under 60, and 70% of control subjects of ages more than 60 had the same transport time as that obtained in younger control subjects. The significant inverse correlation between the mucociliary transport rates with the particle method and the transport time with the saccharin method were established in control subjects, but not, however, in patients with chronic sinusitis. The mucociliary transport rates were measured under non-physiologic conditions of the nose: laryngectomy, chronic sinusitis, Sjögrens syndrome, and Kartageners syndrome.

Increased expression of histamine H1 receptor mRNA in allergic rhinitis

Background Histamine plays an important role in producing nasal symptoms via histamine H1 receptor (H1R) in allergic rhinitis. It is reported that the minimum histamine concentration that induces sneezing is lower in allergic patients than in normal control subjects. Previous studies by binding assay on H1R gave divided results on whether the number of H1Rs is increased in allergic rhinitis or not.

Hearing impairment and quality of life for the elderly in nursing homes

OBJECTIVE The purpose of this study is to find out the effects of hearing impairment on the QOL of nursing home residents. METHODS We constructed the self-assessment questionnaire designed for evaluating the QOL for the elderly in nursing homes. The questionnaire is constructed of physical, social, communicational and psychological states. It was administered to 60 subjects >65 years of age (mean age: 79 years) living in nursing homes, with hearing threshold levels in the better ear ranging from normal to severe and their response were analyzed. RESULTS Chronbachs alpha-values of the questionnaire obtained ranged from 0.66 to 0.91 and was 0.84 overall. The reliability and validity of the questionnaire as well as its brevity, simplicity, ease of administration and interpretation, all satisfied its use in assessing the QOL of the elderly in nursing homes. It tended to decrease the points of communication scale, sociability scale and psychological scale (PGC Morale Scale) accordingly to elevate the threshold. As for subscales of communication, hearing disability was correlated statistically to the sociability and psychological. CONCLUSION Our questionnaire is regarded as a useful tool for evaluating the QOL of the elderly. Hearing loss affects the communication, sociability and psychological aspect of the QOL for the elderly in the nursing homes.

Lymphocyte subsets of maxillary mucosa in chronic inflammation

Subsets of infiltrating lymphocytes within maxillary sinus mucosae of patients with chronic sinusitis were investigated by immunoperoxidase staining of frozen sections with the use of monoclonal antibodies. The most commonly observed infiltrating cell type was suppressor/cytotoxic T cells (CD8+) and smaller subpopulations of lymphocytes were helper/inducer T cells (CD4+) and B cells (CD20+). Variable numbers of HLA-DR+ cells were commonly observed in the lamina propria. The fibrous type of chronic sinusitis was found to have more suppressor/cytotoxic T cells (CD8+) and lower CD4/CD8 ratio than the other histopathological types.

Anaplastic Small Cell Carcinoma of the Larynx

Anaplastic small cell carcinoma of the larynx is an uncommon neuroendocrine tumor. We report a case of this neoplasm of a 53-year-old male. The patient showed persistent hyponatremia accompanied with continuous loss of sodium in the urine, which resulted from inappropriate secretion of antidiuretic hormone (ADH). It is postulated that hyponatremia in this case was due to production of ADH by the tumor cells.

Ultrastructure of Mucous Blanket in Otitis Media with Effusion

We used transmission electron microscopy to study the mucous blanket of the promontory from children with otitis media with effusion. The vast majority of the epithelial cells were secretory, and the rest were ciliated. The mucous blanket consisted of the electron-lucent periciliary fluid and the mucous layer. In the mucous layer, two layers were identified: An inner layer with migrating cells, and an outer layer with specks. Moreover, there was a lucent zone over the nonciliated surface that was as high as the microvilli. The thickness of the periciliary layer was predominantly as great as that of the ciliary tips, which just make contact with the mucous layer; however, the mucous layer occasionally penetrated into the periciliary space. These findings indicated that there is a mucociliary dysfunction in the middle ear caused by a decrease in the number of ciliated cells, and an abnormal interaction between cilia and mucus that would interfere with ciliary movement. Thus, such a system would fail to transport the mucous blanket.

Word deafness after resection of a pineal body tumor in the presence of normal wave latencies of the auditory brain stem response.

We studied the case of a 48-year-old woman who had resection of a pineal body tumor in terms of postoperative audiological function. Postoperative magnetic resonance imaging disclosed partial inferior colliculi destruction and medial geniculate body degeneration. A pure tone audiogram revealed only moderate sensorineural hearing loss, but her speech perception was totally impaired. The binaural sound localization function was also impaired. The auditory brain stem response (ABR) showed waves I, III, and V to have normal latencies. The amplitude of wave III was larger than that of wave V. These results support the view that the waves of the ABR are elicited from multiple sources in the auditory brain stem nuclei and tracts. This case suggests a substantial role for the inferior colliculus and medial geniculate body in the processing of speech perception and sound localization.

Expression and localization of histamine H2 receptor messenger RNA in human nasal mucosa

BACKGROUND Histamine is an important chemical mediator in allergic rhinitis. Histamine H2 receptor (H2R) stimulation controls histamine release and mediates mucus secretion, suggesting that H2R might play some role in allergic rhinitis. OBJECTIVE The objective of this study was to examine whether H2R mRNA expression is increased in patients with allergic rhinitis compared with normal subjects and to determine the localization of H2R mRNA in the human nasal mucosa. METHODS We extracted RNA from scrapings of the inferior turbinate mucosa of 11 patients with allergic rhinitis. H2R and beta-actin mRNA were amplified by RT-PCR. In situ hybridization with a digoxigenin-labeled H2R cRNA probe was performed on surgical specimens of nasal turbinate of patients with allergic rhinitis. RESULTS The mean +/- SD of H2R/beta-actin ratios were 0.12 +/- 0.16 for the scrapings of normal subjects and 0.35 +/- 0.20 for the scrapings of patients with allergic rhinitis; the difference was statistically significant (P <.01). H2R mRNA was localized in the epithelium, serous cells, and mucous cells. CONCLUSION These data suggest that H2R mRNA is localized in the epithelium and the submucosal glands and that increased H2R may be playing some role in patients with allergic rhinitis.

Histamine H1 receptor and reactivity of the nasal mucosa in sensitized guinea pigs

OBJECTIVE Nasal Hypersensitivity to histamine is higher in allergic patients than that in normal control, suggesting that affinity and/or density of H1 receptors in nasal mucosa may be increased in patients with allergic rhinitis. The purpose in this study is to examine the correlation between the hyperresponsiveness and number of histamine H1 receptors in guinea pig nasal mucosa. METHODS Guinea pigs were sensitized by DNP-Ascaris antigen. To block histamine H1 receptors, ketotifen was used and the number of receptors was counted by receptor binding assay technique. These data were compared with nasal airway volume (VOL) assessed by acoustic rhinometry of the same animals to know whether the number of H1 receptors is correlated to the nasal responsiveness to the antigen, or not. Eighty animals were divided into five groups which are composed of nonsensitized and sensitized group pretreated with saline, 0.1, 1.0 and 10 mg/kg of ketotifen, respectively. RESULTS The number of H1 receptors (Bmax) was significantly increased in sensitized group compared with that in control. It decreased dose dependently by pretreatment of ketotifen. The percent change of VOL showed - 31.1 +/- 4.1% at 10 min and - 42.9 +/- 4.1% at 30 min after antigen challenge in sensitized animals. This was dose dependently inhibited by ketotifen. There was a highly inverse correlation between VOL and Bmax (r = -0.708, P< 0.0001). CONCLUSION These results suggest that sensitization increases the number of histamine H1 receptor, and that increased number of H1 receptor in nasal mucosa in sensitized guinea pigs may be one of the causes of nasal hyperresponsiveness to antigen.

Analysis of HLA Antigens in Japanese Patients With Chronic Sinusitis

Objectives: Genetic factors likely play a role in the etiology of chronic sinusitis and this disease is often associated with diffuse panbronchiolitis, which is strongly associated with HLA B54 antigen. The purpose of this study is to examine whether genetic factors are involved in the pathogenesis of chronic sinusitis. Study Design: Eighty‐two Japanese patients with intractable chronic sinusitis were selected on the basis of the following criteria: 1) persistent mucous or mucopurulent nasal discharge and/or postnasal dripping for longer than 3 years and 2) opacification in bilateral maxillary sinuses and ethmoid cells in plain X‐ray films. Methods: Both class I and class II HLA antigens were analyzed by conventional micro‐cytotoxicity assays in these patients and 176 healthy control subjects. Results: In class I antigens, B54 antigen significantly increased in the patient group (antigen frequency = 29.3%, relative risk = 3.23, corrected P value = .037) compared with normal control group (antigen frequency = 11.4%). For class II antigens, no antigens were significantly increased. Conclusion: These data indicate that certain genetic factors play a role in the etiology of chronic sinusitis.