Yasuhiko Yamashita

Presence and characterization of sensitization to staphylococcal enterotoxins in patients with allergic rhinitis.

Exotoxins derived from Staphylococcus aureus appear to be involved in the pathogenesis of allergic diseases, especially atopic dermatitis (AD). However, little is known about sensitization to enterotoxins in cases of respiratory allergies. Because the nasal cavity is a primary site of colonization by S. aureus, we sought to determine the prevalence and role of serum immunoglobulin E (IgE) antibodies against staphylococcal enterotoxin A (SEA) and SEB in patients with allergic rhinitis (AR). The presence of SEA- and SEB-specific IgE was determined in 40 patients with AR and 16 healthy control subjects. In the rhinitis group, nasal symptom score, total serum IgE, sensitization to other inhaled allergens and the presence of sinusitis were determined. Twenty-five percent of patients with AR were sensitized to SEA/SEB whereas 6.3% of controls were sensitized to the toxins. Sensitization to SEB was predominant relative to SEA. There were no significant differences in the severity of nasal symptoms and complications of other allergic diseases including AD and bronchial asthma, between patients with or without sensitization to SEA/SEB. However, patients sensitized to these toxins were likely to show increased total serum IgE and polyvalent sensitization, suggesting that exposure and subsequent sensitization to SEA/SEB may be involved in polyvalent sensitization.

Rosai-dorfman disease with extranodal involvement

Rosai‐Dorfman disease is a rare condition of marrow hematopoietic stem‐cell origin. Patients can show extranodal involvement as well as lymphatic involvement, but only about 5% of extranodal cases involve intracranial lesions. A 53‐year‐old male was admitted to our hospital with bilateral cervical lymphadenopathy. Intracranial tumors and bone lesions were also detected. Cervical lymph node biopsy and intracranial tumor resection were performed, and histopathological examination revealed Rosai‐Dorfman disease. The patient showed good clinical course without significant enlargement of the tumor. This study describes the case of a patient with Rosai‐Dorfman disease presenting with massive cervical lymphadenopathy mimicking malignant neoplasm. Laryngoscope, 124:701–704, 2014

Novel and simple prognostic index for nasal natural killer/T‐cell lymphoma

Few studies have investigated the prognostic factors for nasal natural killer (NK)/T‐cell lymphoma.

Characteristic ultrasound features of mucosa-associated lymphoid tissue lymphoma of the salivary and thyroid gland

Abstract Conclusion: The characteristic ultrasound appearance of mucosa-associated lymphoid tissue (MALT) lymphoma of the head and neck provides diagnostic information regarding masses or swellings in the head and neck region. Objectives: There are only a few reports about ultrasound features of malignant lymphoma (ML) of the head and neck. We have noticed that the ultrasound appearances of cases with MALT lymphoma resembled each other even when the appearances of other images like computed tomography were absolutely different. The objective of this study was to delineate the reliability of this characteristic ultrasound appearance of MALT lymphoma of the head and neck. Methods: The ultrasound examinations of 30 patients with histopathologically proven primary ML of the head and neck (15 cases of MALT) were reviewed. The ultrasound results of each case were independently compared to the results of the histopathological examination. Results: Two ultrasound patterns were observed for MALT lymphoma. The first was characterized by a marked hypoechoic area with interspersed linear echogenic strands (linear echogenic strands pattern), and the second was characterized by multiple, relatively large, hypoechoic segments (segmental pattern). Histopathologically, these patterns could be explained on the basis of the expansion of lymphoma cells demarcated by narrow or wide fibrous bands.

Subcutaneous inflammatory reaction to a synthetic auditory ossicle (Bioceram) in rats.

Cellular response and inflammatory reaction to synthetic auditory ossicle (Bioceram) made from aluminium oxide are investigated. Local inflammatory effects are important in wound healing and in determining biocompatibility of an implant, necessitating the study of biologic effects of implants, especially inflammation and fibrous capsule formation. Bioceram discs were implanted subcutaneously in the interscapular region of rats for various periods of time, ranging from 1 day to 300 days. Histological sections 6 microns thick were stained with haematoxylin and eosin. Cell types around the implants were examined quantitatively by light microscopy. Inflammatory cell reaction to Bioceram decreased rapidly within 14 days, similar to the reaction in control groups. From 30 days to 300 days after implantation, there was continuous reduction to very low levels for macrophages and lymphocytes, but fibrous connective tissue capsule around implants matured. Preliminary results suggest that Bioceram is a satisfactory biocompatible material for reconstructive surgery from the viewpoint of cellular response. We also briefly discuss the different tissue responses in light of our previous study on hydroxyapatite (Apaceram).

Laryngeal squamous cell papilloma is highly associated with human papillomavirus

Objective To delineate the association between characteristics of adult-onset laryngeal squamous cell papilloma and human papillomavirus (HPV) infection. Methods Clinical records and paraffin-embedded specimens of 77 papilloma patients who had been treated between 1998 and 2014 were collected. Of the 77 cases, 34 were identified in the larynx, 28 in the oral cavity and 15 in the oropharynx. Specimens were investigated by polymerase chain reaction (PCR) to detect HPV 6, 11, 16, 18, 31, 33, 35, 52b and 58, and immunohistochemical (IHC) staining for anti-p16INK4a antibody. Results In 21 cases (61.8%) with laryngeal squamous cell papilloma, various types of HPV were detected: 14 cases (41.2%) were positive of high-risk HPV, 18 (52.9%) were positive of low-risk HPV and 11 (32.4%) were positive of both high-risk HPV and low-risk HPV. Younger patients (<60 years) showed a higher rate of HPV infection than older patients. Among the 34 cases with laryngeal papilloma, no malignant transformation was observed during the study period. With IHC staining, positive expression of p16 was observed in 20 cases (58.8%). HPV infection and p16-expression were associated with the pathological finding of koilocytosis. Only four cases (14.3%) showed HPV-positivity in the oral cavity, and none of the 15 oropharyngeal cases were positive for HPV, and none of the oral cavity and oropharyngeal cases showed koilocytosis. Results of HPV-PCR and p16-IHC staining were significantly correlated each other. Conclusions HPV infection is frequently associated with laryngeal squamous cell papilloma, and koilocytosis is a characteristic pathological finding. To the best of our knowledge, this is the first report which have described infections with multiple HPV types in laryngeal papilloma.

Long-term observation of surface structure of synthetic auditory ossicle (Apaceram)*

Methods: A study was made to obtain information about the surface structure of thin Apaceram disks of dense hydroxyapatite (HA) implanted in the soft tissue of rats for 6, 14, and 20 months. Thin Apaceram disks were implanted subcutaneously into the interscapular regions of 12 rats. Apaceram surfaces were analyzed by laser-Raman spectrometry at the molecular level and observed by scanning electron microscope. Surfaces of Apaceram specimens were compared with untreated Apaceram used as a control. Results: Apaceram surfaces were observed by scanning electron microscopy at magnifications of • • and • Many small crater-like cavities observed in the smooth surface area at 6-month implantation decreased prominently after 20 months, whereas the untreated surface was smooth. Numerous crystal grains were observed on original particle surfaces of Apaceram after implantation for 20 months. The study monitored a Raman spectral signal of v 1 (wave number = 960 cm-l: the strongest peak) on the basis of vibration due to PO43of HA as an indicator of the Apaceram component. Half-peak breadths (HPBs) of v I signal, as an indicator of demineralization and renfineralization, were compared. (1) Mean HPB (4.148 _+ 0.065, n = 12) of Apaceram surface after 14 months was significantly narrower than (4.310 + 0.173, n = 10) after 6 months (P < 0.05). (2) Mean HPB (4.225 _+ 0.028, n = 13) after 20 months was significantly wider than (4.148 _+ 0.065, n = 12) after 14 months of implantation (P < 0.01). (3) Comparison of mean HPB between untreated Apaceram surface and 20 months of implantation showed no significant difference. Using scanning electron microscopy, although untreated particle surfaces appeared to differ from implanted particle surfaces at 20 months, both had basically the same composition because there was no significant difference in mean HPBs. Conclusions: Ions such as Ca 2+ and PO43were released from the Apaceram surface implanted in the subcutaneous tissue of rats. Remineralization might have progressed gradually on the surface of Apaceram when released ions were saturated in the interfacial region (body fluid phase) between the Apaceram disk and the tissue. (Supported by grant no. 10671594 from the Ministry of Education, Science, Sports and Culture of the Japanese Government.)