Shigeru Furuta

Suitability of the odor stick identification test for the japanese in patients suffering from olfactory Disturbance

We studied the suitability of the Odor Stick Identification Test for the Japanese (OSIT-J) in patients suffering from olfactory disturbance. In 120 patients with olfactory disturbance (age range 12-85 years) there were statistically significant correlations between the odor identification rate on the OSIT-J, the results of the Japanese standardized olfactory test (T&T olfactometry) and subjective symptom scores. In every patient treated for olfactory disturbance, the OSIT-J reflected the grade of recovery from the olfactory disturbance as determined by means of T&T olfactometry. The odor identification rate on the OSIT-J also correlated significantly with the results of the i.v. Alinamin test. Regarding the rate of correct recognition of odors on the OSIT-J, menthol and curry odors were recognized with a high rate and orange and wood odors with a low rate. Although the OSIT-J includes 13 kinds of odorants, the number of odorants used can be reduced to a minimum of 5 as the results obtained with this reduced form of the OSIT-J also correlated with the results of T&T olfactometry and the subjective symptom scores as well as with the results obtained with the 13-odorant OSIT-J. We conclude that the OSIT-J is suitable not only as a screening test for olfactory disturbance but also for practical use in clinical otorhinolaryngology.

Synovial sarcoma in the parapharyngeal space: case report and review of the literature.

We encountered a rare case of synovial sarcoma in the parapharynx of a 47-year-old Japanese man. This patient presented with an enlarging tumor in the right side of his neck that had grown progressively over a 4-week period. Radiological examinations revealed that the tumor arose from the parapharyngeal space. The tumor could not be completely removed at surgery. Metastasis to the lumbar vertebra was detected postoperatively. The patient underwent three courses of chemotherapy and the delivery of palliative radiation to the lumbar vertebra without success. The patient died of lung metastasis 7 months after surgery.

Clinical evaluation of taste dysfunction using a salt-impregnated taste strip

We have used special tests to investigate taste function in detail. To evaluate acuity for a salty taste, we used a paper with salt crystals, Salsave. The procedure is simple and takes only a few minutes. We analyzed the relationships between the magnitude of the threshold of response to this test and the results of other taste function tests in 126 patients who visited our clinic. The mean magnitude of the response to Salsave significantly correlated with the results of other taste tests. Thus, this is a useful method for screening the detection and recognition threshold of a salty taste.

Retinoblastoma protein expression and prognosis in laryngeal cancer.

Expression of retinoblastoma (Rb) protein was immunohistochemically examined in laryngeal squamous cell neoplasias from 72 patients. Staining patterns were considered with reference to such prognostic factors as patients age, histologic grade, tumour size and lymph node status, and 5-year survival rate. Rb protein negativity, either partial or complete, was noted in 28.8% of cases and was associated with a significantly lower 5-year survival rate, as well as with a higher likelihood of lymph node metastasis. This suggests that Rb alteration may be a prognostic indicator in patients with laryngeal carcinoma.

Laserthermia on Head and Neck Malignancies— Experimental and Clinical Studies

In recent years, remarkable progress has been made in thermotherapy. However, there is little information on localized laser hyperthermia (laserthermia) or on conventional hyperthermia technique applied to head and neck cancers. We have developed a ceramic probe to insert into tumor tissue and irradiate the Nd:YAG laser omnidirectionally. This probe can heat a spherical range of 1.5 cm to 43 degrees C. This paper concerns experimental and clinical studies on the effectiveness of laserthermia using our technique in the tumor of head and neck regions. The results obtained were as follows: histological findings and biochemical studies of arachidonic acid metabolites on normal rabbit tongue after laserthermia showed very slight effect and relatively short duration of the concomitant inflammation. The combination of laserthermia and CDDP chemotherapy was found to give a much better cytocidal effect on the tumor tissue in nude mice implanted with human thyroid cancer cells. In a clinical study on 21 cases with head and neck cancers, four cases showed complete and 13 cases showed partial remission after combined treatments of laserthermia and radiochemotherapy. Both basic experimental and clinical results have indicated a role for laserthermia in the treatment of head and neck cancer. Possible uses include the treatment of early cancer as well as advanced or recurrent cancer, where its therapeutic effect may be increased by combination with radiotherapy or chemotherapy.

Effects of oxygen radicals on ciliary motility in cultured human respiratory epithelial cells.

There are few reports about direct effects of specific oxygen products on ciliary function because of their instability and reactivity. We investigated the direct effects of superoxide anion (O2-) and of hydrogen peroxide (H2O2) on the ciliary function of human respiratory epithelial cells, using monolayer cell cultures, high speed video analysis of frequency (CBF), amplitude (CBA), and coordination of ciliary beats and evaluating the surface structural changes of ciliated cells at the same time. 10(-2) M H2O2 decreased ciliary beat activity. The CBF was 36.5 +/- 4.4% and the CBA was 51.0 +/- 3.8% of the baseline (time = 0) after 5 min (all p < 0.001). Catalase (2 micrograms/ml) abolished the ciliotoxic effect of H2O2. The O2- produced by reaction of xanthine (0.06 mM)-xanthine oxidase (0.04 U/ml) caused a temporary rapid increase of 26.8 +/- 1.7% in CBF and an increase of 42.5 +/- 4.1% in CBA after 15 sec (all p < 0.001). Superoxide dismutase significantly reduced these increases. Results indicated that O2- activated ciliary function with a temporary increase in O2(-)-production. This suggests that the removal of H2O2 from the O2- reaction is important in improving mucociliary clearance in excessive oxygen metabolites.

Olfactory Dysfunction in Patients with Minamata Disease

We studied the olfactory functions of organic mercury poisoning (Minamata disease) by using both the smell identification test and the olfactory detection threshold test (with phenyl ethyl alcohol). The subjects were 19 patients with Minamata disease who were treated in Meisuien, Minamata, Kumamoto, Japan and include cases that developed the disease in utero. The mean age was 78.7 ± 14.3 years old. Both smell identification and olfactory detection tests in the majority of patients decreased significantly compared with those of healthy elder subjects. A few cases showed normal olfactory identification and detection functions. The olfactory identification function deceased with advancing age. Correlation existed between detection threshold and background factors such as age and duration after documented Minamata disease was found. No significant relationship was identified between olfactory function and the typical symptoms of Minamata disease.

Chondrosarcoma of the hyoid bone.

Chondrosarcoma of the head and neck is relatively rare. We report the sixth case known to us in which the chondrosarcoma had originated in the hyoid bone. The patient, a 66-year-old man, underwent surgery. The resected tumour was a 5 cm encapsulated lesion composed of lobulated, firm, gray-white tissue. Histologically it showed mature chondrocytes without capsular invasion. There was high cellularity and a few binucleated chondrocytes. Although the tumour grade was prognostic significance, our literature review of the five other cases suggests that the location of the primary lesion and the adequacy of its resection to be more important. Our patient continues to do well 15 months post-operatively. However, long-term follow-up is essential as recurrences have been reported even after eight or 10 years.

Laser-assisted uvulopalatoplasty with Nd : YAG laser for sleep disorders

We evaluated the apnea index (AI), the oxygen saturation above 95% (SA95), the lowest oxygen saturation (LSAT), and snoring before and after laser‐assisted uvulopalatoplasty (LAUP) in 106 patients with obstructive sleep apnea syndrome (n=59) or snoring (n=47). Type 1 LAUP was performed in 42 patients and type 2 LAUP in 64 patients. A 50% or greater reduction in AI was observed in 15 patients (35.7%) who underwent type 1 LAUP and 37 patients(57.8%) who underwent type 2 LAUP. Snoring was diminished in 18 (51.4%) of 35 patients who underwent type 1 LAUP and 30 (55.6%) of 54 patients who underwent type 2 LAUP. SA95 and LSAT showed no difference. No serious complications such as significant bleeding, postoperative episodes of asphyxia, nasopharyngeal stenosis, or nasal regurgitation were observed. LAUP was an effective outpatient treatment.

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.