Kouji Deguchi

Ciliogenesis and Mucus Synthesis in Cultured Human Respiratory Epithelial Cells

The mechanisms for the regulation of ciliogenesis and for the synthesis of mucus are not well understood. We sought to develop a culture system for differentiating ciliated and secretory types of human respiratory epithelial (HRE) cells. Dissociated HRE cells obtained from nasal polyps and maxillary sinus mucosa were cultured on type I collagen gel. Cells grown to confluence on collagen gel lost their cilia and exhibited a flat, squamouslike appearance. After reaching confluence, the cultured cells with a collagen gel substrate were removed from plastic dishes and floated in the culture medium. After 7 days in the floating culture, some cells exhibited several centrioles or basal bodies, while others showed secretory granules. The secretory phenotype predominated after 7 days. After 14 days in the floating culture, nearly all cells were ciliated. The results demonstrate that the differentiation of HRE cells can be induced by floating cultured cells with a collagen gel substrate in a defined culture medium.

Application of cyberknife for the treatment of juvenile nasopharyngeal angiofibroma: a case report.

Juvenile nasopharyngeal angiofibroma (JNA) tumors can be locally destructive when they spread submucosally. The purpose of this study was to present an image-guided, robotic radiotherapy (Cyberknife) to successfully treat a 12-year-old boy with Juvenile nasopharyngeal angiofibroma (JNA). He complained of progressive right nasal obstruction, intermittent epistaxis. Computed tomography (CT), and magnetic resonance imaging (MRI) revealed the presence of a tumor in the right nasal cavity and nasopharynx with significant hypervascularization from the right maxillary artery. Pathological findings confirmed the diagnosis of JNA. Surgical treatment was recommended but refused by religious reasons. We initially treated the patient with external-beam radiation therapy (total treatments, 12; total dose, 2400 cGy), which, after 7 months, failed to reduce the size of the tumor or relieve the patients symptoms. We subsequently treated the patient with Cyberknife therapy (total treatments, 3; total dose, 4512 cGy) and observed almost complete disappearance of the tumor after 7 months. After 2 years of observation, there has been no tumor recurrence. Cyberknife therapy is compared with other therapeutic options for JNA, and its benefits are discussed in the context of the findings in the literature.

Ciliary motility and surface morphology of cultured humanrespiratory epithelial cells during ciliogenesis

Summary— We used human respiratory epithelial cells in floating culture to study the motility and surface morphology of the cilia during ciliogenesis. Ciliary motility and surface morphology was examined by a high‐speed video system and electron microscopy, respectively. On day 8 of floating culture, but rarely before, cells with numerous moving short cilia with mean ciliary beat frequency (CBF) of 17.8 ± 2.5 Hz (mean ± SD) were seen. The mean CBF was highest on day 10 (19.6 ± 3.9 Hz) and reached 17.4 ± 2.5 Hz on day 14. The ciliary beat amplitude (CBA) was recognized on day 8, abruptly increased on day 9, then continued with aging of the culture. The intracellular coordination of ciliary beats was poor on day 8 with random beat direction but improved up to day 12 when the intracellular uniform beat direction was established. However, intercellular coordination remained absent even on day 14. Results suggest that immature short cilia have a rigid beat pattern. With the elongation of the cilia and the resulting whip‐like movement, the ciliary beat was gradually synchronized. Although a ciliary elongation seems to be required for making intracellular coordination, other factors are involved in intercellular coordination. Also, a high CBF does not always indicate the activity of mature cilia.

Adenocarcinoma of the paranasal sinuses and nasal cavity with lung metastasis showing complete response to combination chemotherapy with docetaxel, cisplatin and 5-fluorouracil (TPF): a case report.

Malignant tumors in the paranasal sinuses and nasal cavity are mostly squamous cell carcinomas, with comparatively few adenocarcinomas. Adenocarcinoma developing in paranasal sinuses and nasal cavity generally has a low response to radiotherapy and low chemotherapeutic sensitivity, making surgery the most reliable treatment. However, advanced adenocarcinoma is often difficult to treat due to anatomical complexity, and the outcome may not be satisfactory. We report the case of a 62-year-old man who presented with nasal congestion and epistaxis. We were unable to observe an oncogenic lesion in the nasal cavity directly, but the tumor gave inhomogeneous low intensity signals on T1-weighted images and an isointense signal on T2-weighted images in MRI. Adenocarcinoma was diagnosed by open biopsy. Six courses of chemotherapy by super-selective intra-arterial infusion of cisplatin with concurrent intensity-modulated radiation therapy of 70Gy were performed at another hospital. However, the tumor enlarged and developed distant metastasis to the lung after this therapy. Therefore, TPF chemotherapy (docetaxel, cisplatin and 5-fluorouracil) was performed 5 times, after which the tumor gradually reduced in size. The patient is alive after a follow-up period of 43 months, indicating that TPF chemotherapy may be useful for adenocarcinoma of the paranasal sinuses and nasal cavity.

Case of ageusia from a variety of causes

We report a case of a 31-year-old woman with ageusia. Her ageusia was related to a variety of causes including an unbalanced diet, administration of the anti-epileptic drug, carbamazepine and psychological factors. Her taste function recovered after stopping the carbamazepine and treatment with liver extracts and zinc sulphate.

Necrotizing Fasciitis of Cervicothoracic Region after Treatment for Tonsillar Carcinoma.

Necrotizing fasciitis is a rare disease characterized by cutaneous necrosis, suppurative fasciitis, and vascular thrombosis. The disease commonly causes a rapidly progressive toxic systemic illness (i. e. toxic shock-like syndrome) in which the mortality has been reported to be between 20 and 36%.Necrotizing fasciitis of the neck and chest occurred in a patient with tonsillar carcinoma one month after treatment with surgery and radiotherapy. The patient was admitted to our hospital ICU in renal and respiratory failure, septic shock and DIC. He recovered after treatment which included debridement of necrotized tissue in the cervicothoracic region. Streptococcus pyogenes was solated in blood cultures. We speculated that the bacterial infection might have entered through the incision for tumor resection.The recent literature concerning necrotizing fasciitis is reviewed. It is important for otolaryngologists to be aware of this disease since early excision of necrotic tissue and high dose intravenous antibiotics are necessary for patient survival.