Yohji Hori

Platelet-Activating Factor and Leukotrienes in Acute Otitis Media, Secretory Otitis Media, and Chronic Otitis Media on the Acute Excerbation

The present study was carried out for the purpose of measuring platelet activating factor (PAF) and leukotrienes (LTs) in middle ear fluid (MEF) or in otorrhea of children with acute otitis media (AOM), with secretory otitis media (SOM), and with chronic otitis media (COM) on the acute exacerbation. PAF, LTC4, and LTD4+LTE4 concentrations were measured by radioimmunoassay in purulent MEFs obtained from 15 ears of 15 children with AOM, in mucoid or gluey MEFs from 16 ears of 15 children with SOM, and in purulent otorrhea from 9 ears of 9 children with COM on the acute exacerbation. PAF concentrations were 25.4 +/- 9.0 ng/mg total phospholipid (TPL) in AOM, 4.9 +/- 1.9 ng/mg TPL in SOM, 20.7 +/- 15.7 ng/mg TPL in COM, demonstrating significant differences between AOM and SOM (p < 0.05) and between COM and SOM (p < 0.01). LTC4 concentrations were 92.9 +/- 73.8 pg/mg total protein (TP) in AOM, 52.0 +/- 42.5 pg/mg TP in SOM, and 28.5 +/- 11.2 pg/mg TP in COM. LTD4+LTE4 concentrations were 326.5 +/- 177.0 pg/mg TP in AOM, 288.2 +/- 144.6 pg/mg TP in SOM, and 94.0 +/- 58.1 pg/mg TP in COM, demonstrating significant differences between AOM and COM and between SOM and COM (p < 0.01). The results obtained indicated that PAF was involved in the onset of AOM and COM on the acute exacerbation, and that LTs played an important role in SOM.

Combination of Bernouilli effect producing maneuver-induced pharyngeal narrowing rate with body mass index as predictive tool for obstructive sleep apnea syndrome

Conclusions. It is suggested that the combination of the pharyngeal narrowing rate during the Bernouilli effect producing maneuver (BEPM) with the body mass index (BMI) might be a promising predictive method for obstructive sleep apnea syndrome (OSAS). Objectives. An attempt was made to clarify the possibility that the dynamic narrowing of the pharynx evaluated by nasopharyngoscopy with BEPM, a forced inspiration through the nose with the mouth closed, might be a reliable clinical daytime predictor for identifying patients at risk of developing OSAS. Subjects and methods. Subjects were 57 patients complaining of snoring and sleepiness during daytime. Endoscopic images of the retropalatal pharynx were obtained and their area was measured by NIH imaging. The pharyngeal narrowing rate during quiet nasal breathing and that during BEPM were compared to assess pharyngeal dynamics. To increase the sensitivity of this method, BMI was added to the pharyngeal narrowing rate during BEPM. Results. The criterion of BEPM at a cut-off value of 50% with BMI at a cut-off value of 25 kg/m2 achieved a sensitivity of 93%, while the specificity was 67% in differentiating simple snorers from OSAS patients (apnea index >5). In addition, the likelihood ratio of the method was found to be 2.81.

Clinical Studies on Roxithromycin Treatment of Chronic Sinusitis.

Roxithromycin (RXM) was administered to 191 patients with chronic paranasal sinusitis. The overall rate of excellent and good clinical response was 58.1% as judged by the attending otolaryngologists and 56.0% as judged by the committee.In bacteriological examinations performed on 39 patients before administration 52 organisms were isolated, and 25 (83.3%) of the 30 cultures examined showed sensitivities to RXM. Among patients infected with sensitive organisms the clinical efficacy rate (CER) was 81.0%.X-ray examinations were performed on 59 patients with an CER of 66.1%. The rates for excellent and good results were 75.9% for maxillary sinusitis and 78.3% for ethmoid sinusitis.Side effects, in the form of mild digestive symptoms, were noted in only 3 patients (1.6%), but no treatment was required even though RXM was administered for a long period of time, up to 178 days.These results indicate that RXM is effective in the treatment of chronic paranasal sinusitis.