Osamu Jinnouchi

Gene expression of D-amino acid oxidase in cultured rat astrocytes: regional and cell type specific expression

Neuromodulative free D-serine is present in mammalian brain, and localized to type-2 astrocytes in culture. D-amino acid oxidase (DAO) is a flavoenzyme that catalyzes D-amino acids. We examined the DAO gene expression in cultured rat astrocytes by reverse transcriptase-polymerase chain reaction. We established a method to prepare highly purified culture of type-1 and type-2 astrocytes from any brain region. This method utilizes combination of cell type specific separation by shaking and subsequent purification by immunopanning or treatment with cytosine arabinoside. We detected higher DAO gene expression in type-1 astrocyte cultures from cerebellum than that from cerebral cortex. In cerebellum, we observed higher DAO expression in type-1 astrocyte cultures than that in type-2. We also revealed that DAO expression in C6, corresponding to type-1 astrocyte, was higher than that in CG-4 derived type-2 astrocytes.

effects of aural stimulation with capsaicin ointment on swallowing function in elderly patients with non-obstructive dysphagia

Objective In the present study, an attempt was made to examine the effects of aural stimulation with ointment containing capsaicin on swallowing function in order to develop a novel and safe treatment for non-obstructive dysphagia in elderly patients. Design A prospective pilot, non-blinded, non-controlled study with case series evaluating a new treatment. Setting Secondary hospitals. Patients and methods The present study included 26 elderly patients with non-obstructive dysphagia. Ointment containing 0.025% capsaicin (0.5 g) was applied to the external auditory canal with a cotton swab under otoscope only once or once a day for 7 days before swallowing of a bolus of colored water (3 mL), which was recorded by transnasal videoendoscopy and evaluated according to the endoscopic swallowing score. Results After a single application of 0.025% capsaicin ointment to the right external auditory canal, the endoscopic swallowing score was significantly decreased, and this effect lasted for 60 minutes. After repeated applications of the ointment to each external auditory canal alternatively once a day for 7 days, the endoscopic swallowing score decreased significantly in patients with more severe non-obstructive dysphagia. Of the eight tube-fed patients of this group, three began direct swallowing exercises using jelly, which subsequently restored their oral food intake. Conclusion These findings suggest that stimulation of the external auditory canal with ointment containing capsaicin improves swallowing function in elderly patients with non-obstructive dysphagia. By the same mechanism used by angiotensin-converting enzyme inhibitors to induce cough reflex, which has been shown to prevent aspiration pneumonia, aural stimulation with capsaicin may reduce the incidence of aspiration pneumonia in dysphagia patients via Arnold’s ear-cough reflex stimulation.

Efficacy of percutaneous endoscopic gastrostomy on unplanned treatment interruption and nutritional status in patients undergoing chemoradiotherapy for advanced head and neck cancer

OBJECTIVE Efficacy of percutaneous endoscopic gastrostomy (PEG) on unplanned treatment interruption and nutritional status was examined in patients undergoing chemoradiotherapy (CRT) for advanced head and neck cancer. METHODS We retrospectively reviewed hospital charts of 44 patients with advanced head and neck cancer who were treated with CRT. RESULTS CRT-induced mucositis of grade 3 or worse and inadequate oral intake of less than one third of their usual intake developed in 33 patients who were recommended PEG placement, but not in 11 patients. Thirteen patients accepted PEG placement and then completed CRT (compliant group). However, among 20 patients who refused both PEG and nasogastoric tube (NGT) placements (non-compliant group), 10 required unplanned interruptions of CRT at a radiation dose around 30-40 Gy (UI-CRT group) while 10 others could complete CRT without interruption (C-CRT group) CRT. Total serum protein levels were significantly decreased after CRT in all patients. DISCUSSION It is suggested that therapeutic PEG placement is useful for preventing unplanned interruption of CRT in patients with advanced head and neck cancer. After severe mucositis and inadequate oral intake have developed during CRT, PEG placement should be considered before the radiation therapy dose of 30 Gy.

Anti-microbial and therapeutic effects of modified Burow's solution on refractory otorrhea

OBJECTIVE Burows solution, which contains 13% aluminum acetate, has been shown to be effective against chronic otitis media. Since the preparation of Burows solution is time-consuming, its rapid preparation method has been recently developed. In this study, we evaluated the therapeutic effects of the modified Burows solution on refractory otorrhea in patients with chronic suppurative otitis and its anti-microbial activity in vitro. METHODS Fourteen ears of 12 patients with chronic otitis media, granular myringitis, otitis externa and postoperative mastoid cavity problems were treated topically with cotton swab/ball soaked with modified Burows solution or its four-fold diluted ear drops once a week. We then examined the antimicrobial spectrum of modified Burows solution against clinical bacterial isolates from otorrhea and laboratory bacterial strains in vitro. RESULTS In all ears, refractory otorrhea disappeared after 1-17 weeks treatment of modified Burows solution with a mean of 5.4 weeks without apparent side-effects such as ototoxicity. Modified Burows solution inactivated all Gram positive bacteria within 5min except Enterococcus species, all Gram negative bacteria including Pseudomonas aeruginosa within 30s and Candida albicans within 2min. In addition, modified Burows solution inactivated MRSA completely within 5min, while 80.6% of MRSA survived even a 20-min contact with 0.3% ofloxacin. CONCLUSION These findings indicate that modified Burows solution, in addition to bearing a broad antimicrobial activity, is as effective as the original Burows solution in the treatment of chronic suppurative otitis.

Aural stimulation with capsaicin ointment improved swallowing function in elderly patients with dysphagia: a randomized, placebo-controlled, double-blind, comparative study

Objective The aim of this study was to assess whether aural stimulation with ointment containing capsaicin improves swallowing function in elderly patients with dysphagia. Study design A randomized, placebo-controlled, double-blind, comparative study. Settings Secondary hospital. Patients and methods Twenty elderly dysphagic patients with a history of cerebrovascular disorder or Parkinson’s disease were randomly divided into two groups: 10 receiving aural stimulation with 0.025% capsaicin ointment and 10 stimulated with placebo. The ointments were applied to the external auditory canal with a cotton swab. Then, swallowing of a bolus of blue-dyed water was recorded using transnasal videoendoscopy, and the swallowing function was evaluated according to both endoscopic swallowing scoring and Sensory-Motor-Reflex-Clearance (SMRC) scale. Results The sum of endoscopic swallowing scores was significantly decreased 30 and 60 min after a single administration in patients treated with capsaicin, but not with placebo. Reflex score, but not Sensory, Motion and Clearance scores, of the SMRC scale was significantly increased 5, 30 and 60 min after single administration in patients treated with capsaicin, but not with placebo. No patient showed signs of adverse effects. Conclusion As capsaicin is an agonist of the transient receptor potential vanilloid 1 (TRPV1), these findings suggest that improvement of the swallowing function, especially glottal closure and cough reflexes, in elderly dysphagic patients was due to TRPV1-mediated aural stimulation of vagal Arnold’s nerve with capsaicin, but not with a nonspecific mechanical stimulation with a cotton swab.

Automatic snore sound extraction from sleep sound recordings via auditory image modeling

One of humans’ auditory abilities is differentiation between sounds with slightly different frequencies. Recently, the auditory image model (AIM) was developed to numerically explain this auditory phenomenon. Acoustic analyses of snore sounds have been performed recently by using non-contact microphones. Snore/non-snore classification techniques have been required at the front-end of snore analyses. The performances of sound classification methods can be evaluated based on human hearing, which is considered to be the gold standard. In this paper, we propose a novel method of automatically extracting snore sounds from sleep sounds by using an AIM-based snore/non-snore classification system. We report that the proposed automatic classification method could achieve a sensitivity of 97.2% and specificity of 96.3% when analyzing snore and non-snore sounds from 40 subjects. It is anticipated that our findings will contribute to the development of an automated snore analysis system to be used in sleep studies.

Detection of sleep breathing sound based on artificial neural network analysis

Obstructive sleep apnea-hypopnea syndrome (OSAHS) is known to cause daytime drowsiness and an association with diseases such as Type II diabetes, cardiovascular disease, and stroke. A polysomnography (PSG) test is the traditional method for diagnosing OSAHS. However, this test is expensive, inconvenient, and requires the placement of body contact sensors during sleep. Recently, in several studies, the snoring/breathing episodes (SBEs) acquired by non-contact microphones have been used for OSAHS diagnosis. SBEs may range from barely audible to loud. SBE detection, especially low-intensity SBEs, can be challenging in noisy environments because of the low signal-to-noise ratio (SNR). In this paper, we propose a novel method for the rapid detection of low-intensity SBEs from data recorded during sleep. Our method is based on an artificial neural network (ANN) technique. When an ANN is trained as subject-specific classifier, we show that the proposed method is capable of detecting low-intensity SBEs more rapidly compared to our previous method. When an ANN is used as subject-independent classifier, we show that the proposed method can classify low-intensity SBEs and low-intensity non-SBEs that may occur during actual sleep with an average accuracy of 75.10%

Two Cases of Invasive Aspergillus Sinusitis and Mastoiditis Successfully Treated with Voriconazole

We report two cases of invasive aspergillosis of the head and neck regions. One patient was a 56-year-old male with invasive aspergillus sinusitis. The other patient was a 14-year-old boy with aspergillus mastoiditis after bone-marrow transplantation. Both cases were inoperable because of vascular invasion by aspergillus, and treatment with antifungal agents was discontinued due to severe side effects. A novel triazole voriconazole (VRCZ) was then used for salvage therapy and successfully treated invasive aspergillosis in both cases. VRCZ is an effective and well tolerated agent to treat invasive aspergillosis of the head and neck regions.