Tomohisa Hirai

Reduced expression of p27 is correlated with progression in precancerous lesions of the larynx

OBJECTIVES Factors related to malignant transformation of laryngeal precancerous lesions remain largely unknown, so we investigated the relationship between the expression of p27 and precancerous laryngeal lesion. STUDY DESIGN In this study we investigated the expressions of p27 and p53 protein in 56 cases with laryngeal precancerous or cancer lesions (20 cases of hyperplasia, 19 of dysplasia, and 17 of squamous cell carcinoma), and went on to evaluate the relationship between immunoreactivity of each of them and the histological findings. We also evaluated the correlation between immunoreactivity and proliferative activity with the aid of Ki-67 nuclear antigen staining. METHODS A retrospective study was performed in 56 cases (20 with epithelial hyperplasia, 19 with epithelial dysplasia and 17 with laryngeal cancer). Immunohistochemistry was performed to investigate expression of p27, p53 protein and Ki-67 nuclear antigen staining, using the avidian-biotin-peroxidase complex technique. RESULTS p27 immunostaining was observed in 12 out of 20 cases of hyperplasia (60%), six out of 19 cases of dysplasia (31%), and 2/17 (12%) of carcinoma. We found significant association between p27 immunostaining and the histological findings. On the other hand, p53 immunostaining was observed in 6/20 (30%) of hyperplasia, 3/19 (16%) of dysplasia, and 7/17 (41%) of carcinoma. No significant association was found between p53 and the histological findings. CONCLUSIONS Our results revealed that immunohistochemical assessment of p27 in bioptic samples of laryngeal precancerous lesions might be useful in selective patients who should undergo a more specific follow-up evaluation.

Effect of JTH-601, a putative α1L-adrenoceptor antagonist, on guinea pig nasal mucosa vasculature

Abstract The existence of α 1 -adrenoceptors with low affinity for prazosin, an α 1L subtype, has been proposed in addition to α 1 -adrenoceptor subtypes with high affinity for prazosin, i.e. the α 1H group: α 1A , α 1B and α 1D subtypes. In the present study, we investigated the effect of JTH-601 (3-( N -[2-(4-hydroxy-2-isopropyl-5-methylphenoxy)ethyl]- N -methylaminomethyl)-4-methoxy-2,5,6-trimethylphenol hemifumarate), a putative α 1L -adrenoceptor antagonist, on the isolated guinea pig nasal mucosa vasculature. JTH-601 (0.01–0.03 μM) competitively antagonized the noradrenaline-induced contraction of the tissue in a concentration-dependent manner. The p A 2 value for JTH-601 was 8.14±0.04 (means±SEM, n =6). The data suggests that the α 1L -subtype is involved in the noradrenaline-induced contraction of the guinea pig nasal mucosa vasculature.

[Submucosal Partial-turbinectomy (SPT) Preceding an Endoscopic Sinus Surgery (ESS) Procedure].

Preceding a endoscopic sinus surgery (ESS), we have proposed performing a submucosal partial-turbinectomy (SPT) which removes a part of the inferior nasal concha bone attached to maxillary sinus with an antrostomy. By this method, we could not only make a large antrostomy but also obtain good maneuverability by opening the middle nasal meatus in ESS. We performed SPT preceding ESS in 140 cases (261 sides) between January 2012 and June 2014. The stenosis rates of the middle nasal meatus were 14.2% (37 sides from 261 sides) in one month, 7.4% (18 sides from 243 sides) in three months and 3.7% (6 sides from 163 sides) in 6 months after surgery. The closing rates of the antrostomy were 1.5% (4 sides from 261 sides) in one month, 2.9% (7 sides from 243 sides) in three months and 6.7% (11 sides from 163 sides) in 6 months after surgery. We considered that the SPT method would contribute to secure sufficient ventilation routes for wound healing of sinusitis following surgery on the mucous membrane. In addition, the SPT method has merit from the point of deceasing risks of atrophic rhinitis and empty nose syndrome by preserving most of the inferior nasal concha.

Clinical study of secondary cholesteatoma

Acquired middle ear cholesteatoma is considered to be formed by retraction of the tympanic membrane. There are rare cases in which the tympanic membrane epidermis extends into the medial surface of the tympanic membrane from the margin of its perforation, namely so-called secondary cholesteatoma. We studied the cases of secondary cholesteatoma clinically. These cases were found in 13 of 419 ears (3.1%) with acquired middle ear cholesteatoma operated on in our hospital from March 2001 to October 2010. The average age of all the cases was 51.5 years old, with a range of 11-65 years. We adopted the canal wall down tympanoplasty procedure with canal reconstruction in all cases. The postoperative hearing improvement rate was 84.6%. There were no cases of recurrence of the cholesteatoma.