Masato Ushikai

Effects of Clarithromycin on Cultured Human Nasal Epithelial Cells and Fibroblasts

Objective/Methods: Long‐term administration of clarithromycin has been reported to be effective in the treatment of chronic sinusitis. To investigate the mechanism underlying the anti‐inflammatory activity of clarithromycin, the authors evaluated the effect of clarithromycin on the gene expression of proinflammatory cytokine and the DNA‐binding activity of nuclear factor (NF)‐κB in cultured human nasal epithelial cells and fibroblasts. Cells were incubated with endotoxin purified from nontypeable Haemophilus influenzae or interleukin (IL)‐1β in the presence of clarithromycin.

Hypoxia in paranasal sinuses of patients with chronic sinusitis with or without the complication of nasal allergy.

Objective--In order to elucidate the pathogenesis of the radiologic opacity of the sinuses frequently observed in patients with allergic rhinitis, the mechanisms underlying their sinus mucosal swelling were studied clinically.Material and methods--We confirmed the presence of hypoxia in inflamed sinuses and obstruction of the sinus ostium in operated patients with chronic sinusitis by digitally monitoring the oxygen tension. The possibility of radiologic sinus shadow was also investigated after transient obstruction of the natural ostium.Results--The oxygen tension was significantly lower in inflamed than non-inflamed sinuses (p<0.01), irrespective of the presence or absence of allergic rhinitis. In 54.5% of patients without sinusitis, transient obstruction of the middle meatus by gauze packing resulted in the appearance of a pathologic sinus shadow on radiograms obtained after septoplasty and turbinotomy. In both allergic and non-allergic rhinitis, thick opacity was the most frequently encountered pattern (p<0.01).Conclusion--Our study revealed that in the absence of a primary allergic reaction in the sinus mucosa, blocking of the middle meatus and ostium by allergic swelling of the nasal mucosa may induce hypoxia and secondary mucosal swelling in the sinuses.

Inhibition of Vascular Endothelial Growth Factor by Macrolides in Cultured Fibroblasts from Nasal Polyps

Objective: In order to study a new mechanism of efficacy of 14‐membered ring macrolides in treating chronic rhinosinusitis, inhibitory effects of macrolides on vascular endothelial growth factor production were examined in vitro.

A study on the relationship between adenoid vegetation and rhinosinusitis

The relationship between adenoidal-nasopharyngeal ratios (AN ratios) and sinusitis were evaluated in 404 children. The AN ratios of children with snoring, mouth breathing, or nasal obstruction (major symptoms of adenoidal enlargement) were significantly higher than those of children without these symptoms. However, the AN ratios of children with sinusitis were almost equal to those of normal children.

Detection and Cloning of Human Papillomavirus DNA Associated with Recurrent Respiratory Papillomatosis in Thailand

Recurrent respiratory papillomatosis (RRP) is highly prevalent in Thailand. In this study, we examined the presence of human papillomavirus (HPV) DNA in 25 RRP patients in Thailand by means of dot blot analysis and/or polymerase chain reaction. Eighty‐four percent (21/25) of cases and 4% (1/25) of cases were positive for HPV‐11 DNA and HPV‐6 DNA, respectively. Three cases (3/25) were negative for all of the examined HPV types. No cases were positive for HPV‐16 or 18. Furthermore, we isolated the recombinant HPV‐11 DNA clone from a genomic library constructed with the DNA of RRP tissue. The restriction map of the cloned HPV DNA was identical with the map of known HPV‐11 DNA. These results suggest at least that no specific HPV type or subtype is likely to be associated with RRP in Thailand.

Demonstration of antibodies against human papillomavirus type-11 E6 and L2 proteins in patients with recurrent respiratory papillomatosis.

Recurrent respiratory papillomatosis (RRP) is highly prevalent in Thailand, with the human papillomavirus (HPV) type-11 being the most widespread. In this study, we isolated the HPV type-11 (HPV-11) genome from subjects with RRP and subcloned the E6 and L2 open reading frames (ORFs) with the expression vectors pEX1 and pEX3. The recombinant E6/beta-gal and L2/beta-gal fusion proteins were expressed in E. coli. Using the recombinant proteins, we demonstrated the presence of antibodies against HPV-11 E6 and L2 in RRP patients by Western blot analysis. The prevalence of seropositivity for HPV-11 E6 and L2 were 5% (1/20) and 10% (2/20), respectively. Although RRP is caused by infection on the mucosal surface, it appears that an immune response occurs against viral proteins expressed in the epithelial lesions.

Immune responses of palatine tonsil against bacterial antigens

Abstract Background: Although various bacterial antigens are frequently found in upper respiratory tract mucosal secretions, fatal responses, such as endotoxin shock, are rare, suggesting the presence of some regulatory system in mucosal as well as systemic tissues. In the present study, we examined the immune responses of tonsillar mononuclear cells against bacterial antigens. Materials and methods: Mononuclear cells were isolated from the palatine tonsils and peripheral blood (tonsil mononuclear cells [TNMC] and peripheral blood mononuclear cells [PBMC]) of patients who underwent palatine tonsillectomy. TNMC and PBMC were stimulated using lipopolysaccharide (LPS) or lipoteichoic acid (LTA) for 24 h, and cytokine production were determined by ELISA. Furthermore, the expression of Toll-like receptor (TLR) 4 and TLR2 on CD14+ and CD11c+ cells were examined by FACS. Results: The production of TNFα, IL-1β, IL-6 and IL-8 from TNMC after stimulation with LPS or LTA were significantly lower than those from PBMC. Although CD11c+ cells were observed in both TNMC and PBMC, the incidence of TLR4 or TLR2 expressing cells was lower in TNMC than in PBMC. Conclusions: Results suggest that the decreased expression of TLR4 and TLR2 in TNMC might be associated with the hyporesponses of palatine tonsils against LPS and LTA.

A Patient with Double Dermoid Cysts Occurring in Submental and Submandibular Spaces.

A dermoid cyst is one of the most common head and neck cystic diseases and is usually found in the submandibular area. We report a rare case of double dermoid cysts that occurred in submental and submandibular spaces at the same time in a 53-year-old woman who visited our hospital with the chief complaint of cervical swelling. MRI and CT scans revealed two tumors in the submental and submandibular spaces. The submandibular tumor had a calcified lesion. The two tumors were removed under general anesthesia. The submental tumor strongly adhered to connective tissue such as muscles and the hyoid bone. No adhesion to the surrounding tissues was observed in the submandibular tumor. Both tumors had a white muddy substance in the inside and were diagnosed as epidermal type dermoid cysts histopathologically.