Yukimitsu Takahashi

Clinical effects of immunotherapy on Japanese cedar pollinosis in the season of cedar and cypress pollination

Because of cross-allergenicity between Cryptomeria japonica (Japanese cedar) and Chamaecyparis obtusa (Japanese cypress) pollens, many Japanese cedar pollinosis patients have symptoms during the cypress pollination season. Therefore, the effect of immunotherapy (IT) specific for Japanese cedar pollinosis must be evaluated not only in the cedar season but also in the cypress season. Eight out of 16 patients with cedar pollinosis who received IT and the same number not receiving IT (non-IT) was studied. Nasal and ocular symptoms and medication(s) prescribed were classified from score 0 to 4 and score 0 to 3, respectively. The sum of these scores was used as the symptom-medication score (SMS). IT with Japanese cedar pollen extract reduced the daily SMS not only in cedar but also in the cypress pollination season, but not significantly. However, after the season, the mean SMS in the IT group tended to be lower than that in the non-IT group (P < 0.1). In conclusion, IT was useful as well as concomitant medications also in the cypress season, and considered to shorten the long-drawn symptoms persisting after the season.

Effects of indomethacin, dexamethasone, and erythromycin on endotoxin-induced intraepithelial mucus production of rat nasal epithelium.

We produced hypertrophic and metaplastic changes of goblet cells in rat nasal respiratory epithelium by the intranasal instillation of endotoxin (ETN). In the present study, we examined in vivo effects of indomethacin (IND), dexamethasone (DEX), and erythromycin (EM) on intraepithelial mucus production using this animal model. Intraperitoneal injection of IND (2 to 4 mg/kg body weight x 4 days) or DEX (4 to 8 mg/kg body weight x 4 days) significantly inhibited intraepithelial mucus production induced after 3 days of ETN instillations. Intraperitoneal injection of EM (100 mg/kg body weight x 8 days), aminobenzylpenicillin (ABPC, 200 mg/kg body weight x 8 days), and cephalothin (CET, 200 mg/kg body weight x 8 days) also inhibited intraepithelial mucus production induced after 7 days of ETN instillations. When compared with ABPC and CET, EM had a greater inhibitory effect. These results indicate that ETN-induced intraepithelial mucus production can be inhibited by treatment with the anti-inflammatory drugs IND and DEX. Antibiotics such as EM, ABPC, and CET will also be effective, probably by preventing secondary bacterial infection, and EM has an additional inhibitory effect on intraepithelial mucus production.

Role of neutrophil elastase in endotoxin-induced mucus hypersecretion in rat nasal epithelium.

In the present study, hypertrophic and metaplastic changes of goblet cells were induced in rat nasal epithelium by intranasal instillation of endotoxin or elastase. A significant increase in the amount of intraepithelial mucosubstance was observed after 24 hours during 3 days of instillation. The elastase-induced mucus production was not inhibited in neutrophil-depleted rats, but the endotoxin-induced change was significantly inhibited. Intranasal instillation of the neutrophil elastase inhibitor ONO-5046 partially inhibited the endotoxin-induced mucus production. Epithelial mucus secretion was evaluated by the temporary decrease in the amount of intraepithelial mucosubstance. The endotoxin-induced mucus secretion peaked 3 to 6 hours after intranasal instillation, coinciding with the peak of the intraepithelial neutrophil infiltration. The elastase-induced mucus secretion peaked 1 to 3 hours after intranasal instillation; intraepithelial neutrophil infiltration was not induced by elastase. These results indicate that neutrophil elastase is an important mediator of the intraepithelial mucus synthesis and secretion induced by endotoxin.

Echo-Guided Aspiration Biopsy Cytology of Thyroid.

Echo-guided aspiration biopsy cytology (EGABC) performed for nodular goiter in the past 3 years was evaluated in 605 cases. A correlation of cytologic findings with histologic findings was possible in 127 patients who underwent surgery. Fifty-two of 62 cancers diagnosed histologically were cytologically positive (83.9%), 4 were suspicious (6.5%) and 6 were negative (9.7%). EGABC of the thyroid is an excellent method for eliminating unnecessary operations in patients with thyroid nodules.