Misato Hirai

Microarray analysis of the effect of dexamethasone on murine cochlear explants

Abstract Conclusions: The microarray analysis identified 39 genes up- or down-regulated by dexamethasone in the cultured tissue of mice cochlea. Of the eight genes most highly affected, several are suggested to have protective effects in the traumatized inner ear (Fkbp5, Glucocorticoid-induced leucine zipper (Gilz), glutathione peroxidase 3) and for others, a plausible mechanism of action can be offered (claudin 10, glutamate-ammonia ligase). The present data may support the use of dexamethasone to treat acute sensorineural hearing loss. It is warrantable to test these results in the in vivo cochlea. Objectives: To identify genes whose expression is markedly up- or down-regulated by dexamethasone in the cochlear tissue. Methods: Murine cochlear tissue was cultured with or without dexamethasone for 48 h in vitro. The gene expression profiles were compared between the dexamethasone-treated and untreated cochlear tissue using a microarray that covers 33 696 transcripts (24 878 genes) of mice and quantitative real-time RT-PCR. Results: The microarray analysis identified 39 genes that are up- or down-regulated by more than twofold in the presence of dexamethasone in the cochlear culture. Genes up- or down-regulated by at least threefold include Fkbp5, Gilz, glutathione peroxidase 3, claudin 10, glutamate-ammonia ligase, proteoglycan 1, integrin beta-like 1, and alpha subunit of glycoprotein hormone.

Neuroendocrine carcinoma of the larynx presenting as a primary unknown carcinoma

OBJECTIVE The case of an 80-year-old man showing a metastatic cervical small cell neuroendocrine carcinoma is presented. RESULTS The primary site could not be found at first; it took 8-10 months to detect the primary lesion in the larynx. CONCLUSION (18)F-deoxyglucose positron emission tomography (FDG-PET) was useful to find the submucosal lesion. Despite surgical treatments and chemotherapy, the patient survived for only 21 months.

Cervical lymph node extirpation for the diagnosis of malignant lymphoma.

PurposeLymph node enlargement in the neck is a common presentation of malignant lymphoma (ML) and requires tissue sampling for accurate diagnosis. Although delayed diagnosis may be critical for some patients, unnecessary biopsy should be avoided wherever possible. This study examined the process for determining the necessity to perform a biopsy and evaluated the value of an open biopsy as a diagnostic tool to enable definite subclassification of the disease.MethodsThe subjects included 20 patients with suspected ML who underwent cervical lymph node extirpation at Okayama Saiseikai general hospital between 2007 and 2010. The decision to perform a biopsy was made based on the results of sonographic evaluation, fine needle aspiration cytology (FNAC), and serum levels of lactate dehydrase (LDH) and soluble interleukin-2 receptor (sIL-2r).ResultsThe diagnosis was ML in 15 patients (75%), Castleman’s disease in 1 (5%), and benign lymphadenopathy in 4 (20%).ConclusionsA lymph node biopsy remains the gold standard for the diagnostic evaluation of ML. Sonographic evaluation combined with serum levels of LDH and sIL-2r is useful in determining the need for biopsy. Many of the cases of ML where it was difficult to determine whether a biopsy should be performed were relatively low grade and critical conditions could be avoided by close observation of the patient.

Satellite tumors surrounding primary pleomorphic adenomas of the parotid gland

The occasional local recurrence of benign pleomorphic adenoma (PA) has generally been attributed to the vulnerability of the tumor capsule. Although some reports have also noted the presence of satellite tumors associated with PA recurrence, only few reports have focused on this issue. We paid special attention to the satellite lesions apart from the main tumors and discussed their frequency, origin, nature and the ways of treating them. A total of 108 specimens of primary parotid gland PA resected at the Okayama Saiseikai General Hospital from 1988 to 2008 were microscopically reviewed. Four (3.7%) patients displayed a main mass with satellite tumors in a single parotid gland. The immunohistochemical analysis of p53 and Ki-67 index showed no distinct difference between PAs with satellite tumors and those without. Satellite tumors surrounding the main mass of parotid PA is relatively rare. In most cases, such satellite tumors will arise from capsular perforation of the primary tumor cells. Preoperative evaluation to recognize the existence of satellite tumors would be important and capsular dissection should be discouraged. We could not find any evidence suggesting that primary PA with satellite tumors could be more biologically aggressive than those without.

Glottic cancer in patients without complaints of hoarseness

Few studies have investigated the clinical characteristics of patients with glottic cancer without hoarseness.

Expression analysis of microRNAs in murine cochlear explants

MicroRNAs (miRNAs) play functional roles in sound transduction in cochlea. This study focuses on the validity of cochlear culture as an in vitro experimental tool, in view of miRNA expression. E15 cochleae were dissected and maintained in vitro for 48 h before extraction of miRNAs. MiRNA expression was comprehensively screened in explanted cochleae using a miRNA array that covers 380 miRNAs. A strong correlation was observed between expression levels of miRNAs in in vitro and in in vivo cochleae. Levels of 43 miRNAs were altered in vitro and these changes were reproducible over three trials. These findings indicate that in vitro miRNA profiling is a viable method for analysis of gene expression and action of chemical compounds on cochleae.

Early interventional treatment with intranasal corticosteroids is superior to post-onset treatment in Japanese cedar/cypress pollinosis

Background The usefulness of early interventional treatment (EIT) with intranasal corticosteroids (INS) as compared to post-onset treatment (POT) has not been clarified. We sought to determine the efficacy and safety of EIT with INS compared with POT and placebo in Japanese cedar/cypress pollinosis. Method Results The placebo and POT groups, but not the EIT group, showed a significant exacerbation of TNSS and TOSS soon after the start of pollen counts being high on conse- cutive days. The 12-week average TSS in the EIT group (score, 2.3) was significantly lower than in the placebo (5.0; P<0.01) and POT (3.9; P=0.03) groups. All subjects in the placebo and POT groups were classified as having persistent rhinitis, while 80% of the EIT group met the ARIA classification criteria (P=0.03). QOL score and nasal ECP levels were lower in the EIT and POT groups as compared with the placebo group. Daytime sleepiness, smell disturbance and the average dose of loratadine taken as the rescue medication were similar. Treatment with mometasone was well tolerated. Conclusion

Neck metastasis in patients with T1-2 supraglottic cancer

OBJECTIVES Unlike glottic cancer, supraglottic cancer often presents with neck metastases. This different might be attributable to the location of the primary lesion. This study aimed to clarify the relationships between the sublocation of T1-2 supraglottic cancer, human papillomavirus (HPV) infection, neck metastasis, and prognosis of supraglottic cancer. METHODS This retrospective clinical study investigated 55 Japanese patients with T1-2 supraglottic cancer treated between 1994 and 2015. RESULTS Of 55 patients with T1-2 supraglottic cancer, neck metastasis was present at initial diagnosis in 14 patients (25.5%). Presence of neck metastasis was the only factor associated with worse prognosis of T1-2 supraglottic cancer (p=0.004). In multivariate analysis, age <70years (p=0.033) and sublocation of the primary lesion in the superior epilaryngeal portion (p=0.017) were significantly associated with presence of neck metastasis in multivariate analysis. Twelve (27.9%) of 43 patients showed positive results for human papillomavirus infection. However, human papillomavirus infection was not associated with prognosis, presence of neck metastasis, or primary lesion sublocation in T1-2 supraglottic cancer. CONCLUSION Relatively young patients with supraglottic cancer at the superior epilaryngeal portion are more likely to show neck metastasis. Human papillomavirus infection was not associated with frequency of neck metastasis.

末梢性めまいとの鑑別を要した脳血管障害による isolated vertigo の5症例

tient visits to internal medicine practitioners and the emergency room. Most of these patients are diagnosed as having peripheral vertigo. However, central vertigo is identified in some cases that is sometimes life threatening and the diagnoses require careful attention. Although vertigo due to cerebrovascular disorders is usually associated with other neurologic symptoms or signs, small infarcts in the cerebellum or brainstem can present with vertigo without other localizing symptoms. Diagnosis of such isolated vertigo has been increasing with recent developments in clinical neuro-otology and neuroimaging. We recently encountered five patients with central vertigo who were referred to the otolaryngology department as having peripheral vertigo from an internal medicine department and an emergency room. We present on and discuss the clinical manifestations of nystagmus, localization of the lesion based on magnetic resonance imaging (MRI) findings of the brain, and risk factors (hypertension and diabetes, obesity, heart disorder) of these cases. 原 著

How long should we continue S-1 as adjuvant chemotherapy for squamous cell carcinoma of the head and neck?

Abstract Conclusion: It appears that patients with SCCHN should be recommended to take S-1 for more than 1 year and, if possible, more than 2 years, as adjuvant chemotherapy for SCCHN. Objectives: There is no established consensus on the duration of administration of S-1 as adjuvant chemotherapy for squamous cell carcinoma of the head and neck (SCCHN). Since it might be difficult to undergo prospective randomized study to identify the optimal duration of the administration period of S-1 without a standard, the authors have undergone a retrospective clinical study to decide the tentative standard of therapeutic duration of S-1 as adjuvant chemotherapy for SCCHN. Methods: The clinical records of 89 patients with SCCHN who underwent adjuvant chemotherapy with S-1 were investigated. Results: The median duration of S-1 administration as adjuvant chemotherapy for SCCHN was 7 months (range = 0.1–58 months). Disease-free survivals (DFSs) were generally longer when S-1 administration periods were longer. After adjusting for prognostic factors, S-1 administration periods of 24 months or longer showed significantly lower hazard ratios (HRs) than 0–12 months.