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1.
Pediatr Int ; 65(1): e15622, 2023.
Article in English | MEDLINE | ID: mdl-37690080

ABSTRACT

BACKGROUND: Stuttering is a childhood-onset fluency disorder. Part of the counseling for middle and high school students with persistent stuttering is related to school refusal. Anxiety disorders are known to contribute to school refusal. However, it is not known whether social anxiety disorder (SAD) is a factor in school refusal among adolescents who stutter. METHODS: In our first study, we examined the relationship between school refusal and SAD in 84 middle and high school students who stutter; 26% of the 84 students were in the school refusal group and the remaining 74% were in the school attendance group. The second study examined whether SAD was associated with 10 factors related to speech and stuttering frequency using the Japanese version of the Liebowitz Social Anxiety Scale for Children and Adolescents to determine the presence of SAD. Of the 84 students in the first study, 40 participated in the second study. RESULTS: The school refusal group of adolescents who stutter had significantly higher rates of SAD than the school attendance group. Fifty percent of adolescents who stutter met the criteria for SAD. Moreover, adolescents who stutter with SAD had significantly higher scores on the items "When speaking in public, do you experience tremors in your limbs?" and "After you stutter, do you have negative thoughts about yourself?" than the adolescents who stutter without SAD. CONCLUSIONS: When examining adolescents who stutter, checking for comorbid SAD may lead to better support. Moreover, noticing their repetitive negative thinking, nervousness, and trembling during speech may help to resolve SAD.


Subject(s)
Phobia, Social , Stuttering , Child , Humans , Adolescent , Phobia, Social/epidemiology , Stuttering/diagnosis , Stuttering/epidemiology , Stuttering/etiology , Anxiety/psychology , Anxiety Disorders , Students
2.
ORL J Otorhinolaryngol Relat Spec ; 85(3): 163-171, 2023.
Article in English | MEDLINE | ID: mdl-37100042

ABSTRACT

INTRODUCTION: Type I thyroplasty is one of the most useful surgeries for unilateral vocal fold paralysis. The study objective was to determine whether type I thyroplasty is safe and perioperative antithrombotic management is acceptable in patients undergoing antithrombotic therapy. METHODS: This is a single-hospital retrospective cohort study. The records of 204 patients who underwent type I thyroplasty at a Japanese university hospital, between 2008 and July 2018 were reviewed. We compared the prothrombin time international normalized ratio, prothrombin time, operative time, intraoperative blood loss, and intra- and postoperative complications between patients who did and did not receive antithrombotic therapy. RESULTS: Of 204 patients, 51 (25%) received antithrombotic therapy (antithrombotic group). The remaining 153 patients were assigned to the control group. There were no significant differences in operative time, intraoperative blood loss, or intraoperative complications between the two groups. Sixteen (31%) patients in the antithrombotic group had a hemorrhage or hematoma in the vocal fold mucosa postoperatively, no patient had airway obstruction necessitating tracheostomy, and all patients recovered with follow-up observation only. There were no cases of intraoperative or postoperative complications, such as ischemic heart disease, ischemic stroke, or deep vein thrombosis. CONCLUSION: Type I thyroplasty with careful pre- and postoperative management is safe in patients undergoing antithrombotic therapy.


Subject(s)
Fibrinolytic Agents , Laryngoplasty , Humans , Fibrinolytic Agents/adverse effects , Blood Loss, Surgical , Retrospective Studies , Postoperative Complications/prevention & control
3.
Auris Nasus Larynx ; 48(4): 636-645, 2021 Aug.
Article in English | MEDLINE | ID: mdl-33446371

ABSTRACT

OBJECTIVE: In recent decades, posterior nasal neurectomy (PNN) with submucosal inferior turbinectomy (ST) has been increasingly used for the treatment of intractable severe rhinitis; however, to the best of our knowledge, there have been few studies regarding its long-term therapeutic effects or its influence on patient quality of life (QOL). Therefore, this study examined the long-term therapeutic effects in patients who underwent PNN with ST, as well as their QOL and medication use after surgery. METHODS: This retrospective cohort study initially included 16 consecutive patients who underwent PNN with ST from January 2010 to December 2011. Ten of the 16 patients participated in a paper-based survey questionnaire between June 2018 and November 2018; the responses of these 10 patients were used for analysis in this study. To clarify the effects of surgical treatment on symptoms, QOL, and medication status, data recorded before and 3 months after surgery were compared with data recorded at 8 years after surgery using the Japan Rhinoconjunctivitis Quality of Life Questionnaire No. 1 and Classification of the Severity of Allergic Rhinitis Symptoms I and II. RESULTS: Nasal symptoms including runny nose and nasal congestion, medication score, respective total symptoms medication scores (i.e., combined average total symptoms score and medication score), and the scores of troubles with daily life and total QOL were significantly improved at 3 months and 8 years after surgery, compared with before surgery; scores were not significantly worsened at 8 years after surgery, compared with 3 months after surgery. In addition, there were no adverse events requiring treatment after surgery. CONCLUSION: Our findings suggest that PNN with ST is effective and safe for long-term treatment of severe chronic rhinitis symptoms, as well as reduction of medication use and improvement of QOL.


Subject(s)
Denervation , Nose/innervation , Quality of Life , Rhinitis, Allergic/surgery , Turbinates/surgery , Adolescent , Adult , Chronic Disease , Denervation/adverse effects , Endoscopy/adverse effects , Female , Humans , Japan , Male , Middle Aged , Patient Reported Outcome Measures , Retrospective Studies , Rhinitis, Allergic/complications , Rhinitis, Allergic/drug therapy
4.
Pediatr Int ; 63(2): 150-153, 2021 Feb.
Article in English | MEDLINE | ID: mdl-32692895

ABSTRACT

BACKGROUND: Boey et al. (2009) devised a questionnaire for measuring children's awareness of stuttering and showed that even very young children were often aware of their stuttering. There has been no replication of studies using Boey et al.'s parent-reported questionnaire. The aim of this study was to test whether using Boey et al.'s seven questions, developed for a Dutch speaking population could be effective for measuring the awareness of stuttering in Japanese children. METHODS: Participants were 54 children who stutter (CWS) aged 3-7 years. Parents answered seven questions about their child's awareness of stuttering according to the questions developed Boey et al. RESULTS: Parental-reported observations of the child responses citing at least one awareness incident were 76%. The percentage of stuttering children with awareness of their own speech difficulties, according to chronological age, were as follows: 70% at age 3 years; 67% at age 4 years; 75% at age 5 years; 81% at age 6 years; and 90% at age 7 years. CONCLUSIONS: We found that even at age 3 years, many CWS were already aware of their stuttering. The similarity of the data with the seminal study by Boey et al. suggests that the question-based assessment is reproducible even in a country with a different spoken language. The seven questions in Boey et al. are useful for evaluating whether children's awareness of stuttering could contribute to a clinical decision as well as stuttering severity.


Subject(s)
Stuttering , Child , Child, Preschool , Humans , Infant, Newborn , Japan/epidemiology , Parents , Speech , Speech Disorders , Stuttering/diagnosis , Stuttering/epidemiology
5.
Anticancer Res ; 40(8): 4687-4694, 2020 Aug.
Article in English | MEDLINE | ID: mdl-32727793

ABSTRACT

BACKGROUND/AIM: The Japanese apricot "Prunus mume" is a traditional Japanese medicine. MK615, a compound extract from Prunus mume has been reported to have anti-tumor effects. Herein, we used 3D floating (3DF) culture to evaluate the anticancer effects of MK615 against human colorectal cancer (CRC) cells that contain mutant (mt) KRAS. MATERIALS AND METHODS: HKe3 cells exogenously expressing mtKRAS (HKe3-mtKRAS) were treated with MK615 in 3DF cultures. The protein levels of hypoxia-inducible factor 1 (HIF-1) and E-cadherin were quantified by western blotting. RESULTS: MtKRAS enhanced hypoxia tolerance via up-regulation of HIF-1. The expression of HIF-1 protein was suppressed by constitutive overexpression of E-cadherin in CRC HCT116 spheroids. MK615 increased the expression of E-cadherin and decreased the expression of HIF-1 in HKe3-mtKRAS. These results suggest that MK615 suppresses hypoxia tolerance by up-regulation of E-cadherin in CRC cells with mtKRAS. CONCLUSION: MK615 exhibits properties useful for the potential treatment of CRC patients with mtKRAS.


Subject(s)
Antigens, CD/metabolism , Cadherins/metabolism , Cell Hypoxia/physiology , Colonic Neoplasms/metabolism , Colorectal Neoplasms/metabolism , Plant Extracts/pharmacology , Proto-Oncogene Proteins p21(ras)/metabolism , Up-Regulation/drug effects , Cell Hypoxia/drug effects , Cell Line, Tumor , Cell Proliferation/drug effects , Colorectal Neoplasms/drug therapy , Colorectal Neoplasms/pathology , HCT116 Cells , Humans , Hypoxia-Inducible Factor 1, alpha Subunit/metabolism , Prunus/chemistry , Transcriptional Activation/drug effects
6.
J Clin Exp Hematop ; 59(3): 101-107, 2019 Sep 30.
Article in English | MEDLINE | ID: mdl-31391402

ABSTRACT

The present study investigated histological subtypes of lymphoma in patients newly diagnosed with malignant lymphoma in the human T-cell leukemia virus type 1 (HTLV-1) endemic area of Japan, and further analyzed the clinicopathological features and clinical outcomes of patients with primary sinonasal lymphoma. We retrospectively examined 151 patients aged 18-90 years in Fukuoka, Japan. Subtypes of lymphoma were determined according to the WHO classification. Among the 151 patients, 104 were diagnosed with malignant lymphoma, including 96 at the time of initial diagnosis. Ninety-two of the 96 lymphomas (96%) were non-Hodgkin lymphoma. Mature B-cell neoplasms comprised 78% (n = 75). Primary lymphoma of the sinonasal cavity was found in six patients (6%). The histological subtype of sinonasal lymphoma was diffuse large B-cell lymphoma (DLBCL) in all six tumors. Furthermore, overall survival was significantly different among three distinct DLBCL patient groups, including primary sinonasal lymphoma patients (p = 0.0016; 3-year overall survival: sinonasal DLBCL group, 53%; DLBCL of the CNS group, 0%; other DLBCL group, 83%). Our study suggests that primary DLBCL of the sinonasal tract is a distinct disease entity of DLBCL.


Subject(s)
Human T-lymphotropic virus 1 , Lymphoma, Large B-Cell, Diffuse , Paranasal Sinus Neoplasms , Adolescent , Adult , Aged , Aged, 80 and over , Disease-Free Survival , Female , Humans , Japan/epidemiology , Lymphoma, Large B-Cell, Diffuse/diagnosis , Lymphoma, Large B-Cell, Diffuse/mortality , Lymphoma, Large B-Cell, Diffuse/pathology , Lymphoma, Large B-Cell, Diffuse/therapy , Male , Middle Aged , Paranasal Sinus Neoplasms/diagnosis , Paranasal Sinus Neoplasms/mortality , Paranasal Sinus Neoplasms/pathology , Paranasal Sinus Neoplasms/therapy , Retrospective Studies , Survival Rate
7.
Brain Behav ; 8(6): e00999, 2018 06.
Article in English | MEDLINE | ID: mdl-29781209

ABSTRACT

INTRODUCTION: Facial onset motor and sensory neuronopathy (FOSMN) is a rare disease whose cardinal features are initial asymmetrical facial sensory deficits followed by bulbar symptoms and spreading of sensory and motor deficits from face to scalp, neck, upper trunk, and upper extremities in a rostral-caudal direction. Although bulbar involvement is frequently observed in FOSMN, dysphagia in these patients has not been fully described. In this study, we aimed to characterize dysphagia as a prognostic factor in FOSMN by investigating our institutional case series. METHODS: We retrospectively reviewed the medical records, including swallowing function tests, of six patients with FOSMN (three men and three women) who were thoroughly examined at Kyushu University Hospital between 1 January 2005 and 30 November 2017. RESULTS: Average age at onset was 58.5 years; average disease duration was 5.7 years. All patients developed bulbar dysfunction and dysphagia (at an average of 1.8 and 2.6 years from onset, respectively), resulting in choking episodes in three patients, percutaneous endoscopic gastrostomy placement in three, and recurrent aspiration pneumonia in one. Four of five patients evaluated with videofluoroscopic swallowing studies had poor oral retention, leading to bolus flowing into the pharynx before swallowing; the fifth patient showed poor lingual transfer. Fiberoptic endoscopic evaluation of swallowing revealed leakage of blue-dyed water from the mouth to the pharynx in three patients because of poor oral retention, but only mild pharyngeal phase dysphagia in all four cases evaluated. CONCLUSIONS: Oral phase dysphagia predominates in the early stage of FOSMN.


Subject(s)
Deglutition Disorders/etiology , Facial Nerve Diseases/complications , Motor Neuron Disease/complications , Adult , Age of Onset , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Retrospective Studies
8.
Laryngoscope ; 128(4): 806-811, 2018 04.
Article in English | MEDLINE | ID: mdl-28868616

ABSTRACT

OBJECTIVES: It is important to evaluate swallowing movements by dividing them into periods of laryngeal closure and release. The purpose of this study was to evaluate penetration-aspiration (PA) according to human pathophysiology and to identify the factors for predicting PA. STUDY DESIGN: Case-control study. METHODS: Eighty-one patients with complaints of dysphagia caused by various etiologies were enrolled in this study. Videofluoroscopic swallowing studies were conducted, and the spatial and temporal factors were analyzed by computer-assisted motion analysis. RESULTS: The initiation of laryngeal vestibule closure in the laryngeal elevating period and its duration in the laryngeal descending period were significant factors for evaluating PA. CONCLUSION: A knowledge of the delay of laryngeal vestibule closure in the laryngeal elevating period and its short duration in the laryngeal descending period could make it easier to evaluate the risk of PA. LEVEL OF EVIDENCE: 3b. Laryngoscope, 128:806-811, 2018.


Subject(s)
Deglutition Disorders/physiopathology , Deglutition/physiology , Larynx/physiopathology , Aged , Biomechanical Phenomena , Case-Control Studies , Female , Fluoroscopy/methods , Humans , Male , Middle Aged , Periodicity , Time Factors , Video Recording
9.
J Fluency Disord ; 57: 51-58, 2018 09.
Article in English | MEDLINE | ID: mdl-29157667

ABSTRACT

Both developmental and acquired stuttering are related to the function of the basal ganglia-thalamocortical loop, which includes the putamen. Here, we present a case of stuttering- and palilalia-like dysfluencies that manifested as an early symptom of multiple system atrophy-parkinsonian type (MSA-P) and bilateral atrophy of the putamen. The patient was a 72-year-old man with no history of developmental stuttering who presented with a stutter for consultation with our otorhinolaryngology department. The patient was diagnosed with MSA-P based on parkinsonism, autonomic dysfunction, and bilateral putaminal atrophy revealed by T2-weighted magnetic resonance imaging. Treatment with levodopa improved both the motor functional deficits related to MSA-P and stuttering-like dysfluencies while reading; however, the palilalia-like dysfluencies were much less responsive to levodopa therapy. The patient died of aspiration pneumonia two years after his first consultation at our hospital. In conclusion, adult-onset stuttering- and palilalia-like dysfluencies warrant careful examination of the basal ganglia-thalamocortical loop, and especially the putamen, using neuroimaging techniques. Acquired stuttering may be related to deficits in dopaminergic function.


Subject(s)
Magnetic Resonance Imaging/methods , Multiple System Atrophy/physiopathology , Parkinsonian Disorders/physiopathology , Putamen/abnormalities , Stuttering/diagnosis , Aged , Humans , Male , Stuttering/pathology
10.
Sci Rep ; 7: 46142, 2017 04 11.
Article in English | MEDLINE | ID: mdl-28397833

ABSTRACT

Current allergen-specific immunotherapy (AIT) for pollinosis requires long-term treatment with potentially severe side effects. Therefore, development of an AIT that is safe and more convenient with a shorter regimen is needed. This prospective, double-blind, placebo-controlled trial randomized 55 participants with Japanese cedar pollinosis (JCP) to active or placebo groups to test the safety and efficacy of short-term oral immunotherapy (OIT) with Cry j 1-galactomannan conjugate for JCP. Mean symptom-medication score as the primary outcome in the active group improved 27.8% relative to the placebo group during the entire pollen season. As the secondary outcomes, mean medication score in active group improved significantly, by 56.2%, compared with placebo during the entire pollen season. Mean total symptom score was similar between active and placebo groups during the entire pollen season. There were no severe treatment-emergent adverse events in the active and placebo groups. Therefore short-term OIT with Cry j 1-galactomannan conjugate is safe, and effective for reducing the amount of medication use for JCP.


Subject(s)
Cryptomeria/immunology , Desensitization, Immunologic/adverse effects , Mannans/immunology , Pollen/immunology , Rhinitis, Allergic, Seasonal/immunology , Rhinitis, Allergic, Seasonal/therapy , Administration, Oral , Adult , Aged , Female , Galactose/analogs & derivatives , Humans , Male , Rhinitis, Allergic, Seasonal/pathology , Seasons , Treatment Outcome , Young Adult
11.
Auris Nasus Larynx ; 44(1): 98-103, 2017 Feb.
Article in English | MEDLINE | ID: mdl-27108101

ABSTRACT

OBJECTIVE: The aim of this study was to investigate the clinical features and prognosis of patients with squamous cell carcinoma (SCC) associated with sinonasal inverted papilloma (IP). METHODS: The medical records of 95 patients who were diagnosed with IP or SCC associated with IP were retrospectively reviewed. Out of 95 patients, 15 were diagnosed with SCC associated with IP. The clinical characteristics, treatment modalities, and survival outcomes of the patients were analyzed. RESULTS: The incidence of SCC associated with IP was 15.8%. Although differential diagnosis between IP and SCC associated with IP is difficult, epistaxis may be the specific symptom in SCC associated with IP cases. The 3-year disease-specific survival rate was higher in cases with T1, 2 and 3 than in cases with T4. There was no significant difference in survival rate between maxillary sinus and other primary sites. On the other hand, there was a significant difference in survival rate between the microscopic SCC with IP cases and the other cases. In addition, the patients with <70 years old better than those with >70 years old with a 3-year disease free survival of 80% versus 0%. CONCLUSIONS: Some T4 patients were found to have a highly aggressive disease. Therefore, complete surgical resection followed by chemo-radiation therapy is the recommended treatment for patients with T4 disease to control of the primary tumor site.


Subject(s)
Antineoplastic Agents/therapeutic use , Carcinoma, Squamous Cell/therapy , Chemoradiotherapy, Adjuvant , Head and Neck Neoplasms/therapy , Maxillary Sinus Neoplasms/therapy , Neoplasms, Multiple Primary/therapy , Nose Neoplasms/therapy , Otorhinolaryngologic Surgical Procedures , Papilloma, Inverted/therapy , Adult , Age Factors , Aged , Aged, 80 and over , Carcinoma, Squamous Cell/complications , Carcinoma, Squamous Cell/diagnostic imaging , Carcinoma, Squamous Cell/pathology , Disease-Free Survival , Drug Combinations , Epistaxis/etiology , Female , Fluorouracil/therapeutic use , Head and Neck Neoplasms/complications , Head and Neck Neoplasms/diagnostic imaging , Head and Neck Neoplasms/pathology , Humans , Kaplan-Meier Estimate , Magnetic Resonance Imaging , Male , Maxillary Sinus Neoplasms/complications , Maxillary Sinus Neoplasms/diagnostic imaging , Maxillary Sinus Neoplasms/pathology , Middle Aged , Nasal Cavity , Nasal Obstruction/etiology , Neoplasm Staging , Neoplasms, Multiple Primary/complications , Neoplasms, Multiple Primary/diagnostic imaging , Neoplasms, Multiple Primary/pathology , Nose Neoplasms/complications , Nose Neoplasms/diagnostic imaging , Nose Neoplasms/pathology , Oxonic Acid/therapeutic use , Papilloma, Inverted/complications , Papilloma, Inverted/diagnostic imaging , Papilloma, Inverted/pathology , Paranasal Sinus Neoplasms/complications , Paranasal Sinus Neoplasms/diagnostic imaging , Paranasal Sinus Neoplasms/pathology , Paranasal Sinus Neoplasms/therapy , Radiotherapy, Adjuvant , Retrospective Studies , Squamous Cell Carcinoma of Head and Neck , Tegafur/therapeutic use , Tomography, X-Ray Computed
13.
Auris Nasus Larynx ; 43(1): 50-5, 2016 Feb.
Article in English | MEDLINE | ID: mdl-26197940

ABSTRACT

OBJECTIVE: We have recently reported that a new regimen of short-term oral immunotherapy (OIT) with the Cry j1-galactomannan conjugate for Japanese cedar pollinosis (JCP) is effective to the improvement in the symptoms and medication use during the pollen season and relatively safe. The effect of OIT on quality of life (QOL) of JCP patients has not been assessed. Therefore, we evaluated for the first time the effect of OIT on QOL during the Japanese cedar/cypress pollen season. METHODS: A prospective, randomized, open-label trial was conducted over a period of 4 months. Participants were randomly divided into two groups. The OIT and control groups comprised 23 and 24 subjects, respectively. The build-up phase was initiated 1 month before the expected pollen season. The maintenance phase was continued for 51 days during the peak of the cedar pollen season. The QOL score in the Japan Rhinoconjunctivitis Quality of Life Questionnaire (JRQLQ) No. 1 and visual analog scale (VAS) throughout the pollen season were evaluated. RESULTS: Participants receiving OIT showed significant improvements in the total QOL score and VAS throughout the pollen season compared with the control group. In addition, the mean total QOL score and VAS correlated in both groups during the pollen season. CONCLUSION: The new regimen of short-term OIT using the Cry j1-galactomannan conjugate results in meaningful improvements in QOL of JCP patients. Our findings suggest that short-term OIT using allergen-galactomannan conjugates, as well as sublingual and subcutaneous immunotherapy, improves QOL of patients with pollinosis. The study was registered in UMIN-CTR (UMIN000013408) as the name of "a prospective, randomized, open study of oral Cry j1-galactomannan conjugate immunotherapy for Japanese cedar pollen allergy".


Subject(s)
Antigens, Plant/therapeutic use , Desensitization, Immunologic/methods , Mannans/therapeutic use , Plant Proteins/therapeutic use , Quality of Life , Rhinitis, Allergic, Seasonal/drug therapy , Administration, Oral , Adult , Anti-Allergic Agents/therapeutic use , Cryptomeria/immunology , Female , Galactose/analogs & derivatives , Humans , Immunoglobulin E/immunology , Japan , Male , Middle Aged , Rhinitis, Allergic, Seasonal/immunology , Surveys and Questionnaires , Visual Analog Scale , Young Adult
15.
Allergol Int ; 64(2): 161-8, 2015 Apr.
Article in English | MEDLINE | ID: mdl-25838092

ABSTRACT

BACKGROUND: Short-term oral immunotherapy (OIT) using the Cry j1-galactomannan conjugate for Japanese cedar pollinosis may be effective and relatively safe. However, a treatment regimen has not been established. In the present study, we examined a new OIT regimen with a build-up phase and extended the maintenance phase of OIT to the peak period of the pollen season to enhance the therapeutic effect and safety of OIT. METHODS: A prospective, randomized, open-label trial was conducted over a period of 4 months. Participants were randomly divided into two groups. The OIT group comprised 23 subjects. The build-up phase was initiated 1 month before the expected pollen season. The maintenance phase was continued for 51 days during the peak pollen season. The control group comprised 24 subjects. The symptoms and medication score, levels of allergen-specific serum antibodies throughout the pollen season, and adverse effects with OIT were evaluated. RESULTS: Participants receiving OIT showed significant improvements in total symptom scores, medication score, and total symptom-medication scores throughout the pollen season compared with the control group. The levels of allergen-specific serum IgG4 were significantly increased in the OIT group but not in the control group throughout the cedar pollen season. Importantly, no severe adverse effects were observed with OIT. CONCLUSIONS: The new regimen of short-term OIT using the Cry j1-galactomannan conjugate for Japanese cedar pollinosis is effective, relatively safe and induces immune tolerance. Thus, OIT using allergen-galactomannan conjugates may provide a rapid, effective, and thus convenient immunotherapy for pollinosis instead of SLIT or SCIT.


Subject(s)
Antigens, Plant/immunology , Desensitization, Immunologic , Mannans/immunology , Plant Proteins/immunology , Rhinitis, Allergic, Seasonal/therapy , Administration, Oral , Adult , Antigens, Plant/chemistry , Cell Count , Cryptomeria/immunology , Desensitization, Immunologic/adverse effects , Female , Galactose/analogs & derivatives , Humans , Male , Mannans/chemistry , Middle Aged , Plant Proteins/chemistry , Pollen , Treatment Outcome , Young Adult
16.
Auris Nasus Larynx ; 41(4): 350-8, 2014 Aug.
Article in English | MEDLINE | ID: mdl-24698163

ABSTRACT

OBJECTIVE: Among many immunotherapeutic approaches, oral immunotherapy (OIT) is thought to be an effective route for desensitization against a variety of allergens. However, there is little evidence that OIT is effective for airway allergic diseases such as pollen allergy. Thus, in the present study, we assessed the safety, efficacy and immune response of OIT using the Cry j1-galactomannan conjugate for Japanese cedar pollen allergy. METHODS: An open trial was conducted over a period of 4 months. The OIT group comprised of 23 subjects. Treatment was initiated 1 month before the estimated pollen season and continued for 1 month. The control group (the pharmacological treatment group without OIT) comprised of 11 subjects. The symptoms and medication score, levels of allergen-specific serum antibodies, cellular components of lymphocytes and cytokine production from peripheral blood mononuclear cells (PBMCs) were evaluated throughout the pollen season. RESULTS: The participants receiving OIT treatment showed significant improvements in total symptom scores and symptom-medication scores during the pollen season compared with the control group. The levels of allergen-specific serum IgG4 and IL-10 production in PBMCs were significantly increased in the OIT group compared with that in the control group. Importantly, no severe adverse effects were observed in the participants receiving OIT treatment. CONCLUSION: Short-term OIT using the Cry j1-galactomannan conjugate is effective, relatively safe and induces tolerant immune responses such as increased allergen-specific serum IgG4 and IL-10 production in PBMCs. These results suggest that OIT using allergen-galactomannan conjugates may provide a rapid, effective, and safe immunotherapy regimen for cedar pollen allergy.


Subject(s)
Antigens, Plant/immunology , Desensitization, Immunologic/methods , Mannans/immunology , Plant Proteins/immunology , Rhinitis, Allergic, Seasonal/therapy , Administration, Oral , Adult , Antibodies/analysis , Antigens, Plant/administration & dosage , Antigens, Plant/adverse effects , Cryptomeria/immunology , Cytokines/biosynthesis , Female , Galactose/analogs & derivatives , Humans , Leukocytes, Mononuclear/metabolism , Male , Mannans/administration & dosage , Mannans/adverse effects , Middle Aged , Plant Proteins/administration & dosage , Plant Proteins/adverse effects
17.
Neuroimage ; 88: 162-9, 2014 03.
Article in English | MEDLINE | ID: mdl-24246493

ABSTRACT

The sensory projections from the oral cavity, pharynx, and larynx are crucial in assuring safe deglutition, coughing, breathing, and voice production/speaking. Although several studies using neuroimaging techniques have demonstrated cortical activation related to pharyngeal and laryngeal functions, little is known regarding sensory projections from the laryngeal area to the somatosensory cortex. The purpose of this study was to establish the cortical activity evoked by somatic air-puff stimulation at the laryngeal mucosa using magnetoencephalography. Twelve healthy volunteers were trained to inhibit swallowing in response to air stimuli delivered to the larynx. Minimum norm estimates was performed on the laryngeal somatosensory evoked fields (LSEFs) to best differentiate the target activations from non-task-related activations. Evoked magnetic fields were recorded with acceptable reproducibility in the left hemisphere, with a peak latency of approximately 100ms in 10 subjects. Peak activation was estimated at the caudolateral region of the primary somatosensory area (S1). These results establish the ability to detect LSEFs with an acceptable reproducibility within a single subject and among subjects. These results also suggest the existence of laryngeal somatic afferent input to the caudolateral region of S1 in human. Our findings indicate that further investigation in this area is needed, and should focus on laryngeal lateralization, swallowing, and speech processing.


Subject(s)
Evoked Potentials, Somatosensory/physiology , Larynx/physiology , Magnetoencephalography/methods , Somatosensory Cortex/physiology , Adult , Afferent Pathways/physiology , Female , Humans , Male , Physical Stimulation , Young Adult
18.
Auris Nasus Larynx ; 40(3): 338-41, 2013 Jun.
Article in English | MEDLINE | ID: mdl-22867522

ABSTRACT

Osteoblastoma is categorized as a benign bone-forming tumor, which occurs rarely in the craniofacial region. We report a case of osteoblastoma developed in the nasal cavity and ethmoid sinus in a 14-year-old girl whose chief symptom was nasal obstruction and exophthalmos on the right side. CT revealed the lesion having the same density as bone and a ground-glass border, expanding to the nasal and paranasal cavities. Complete removal was accomplished under endoscopic view, although the tumor was removed piece by piece. Histologic inspection showed exuberant osteoid trabeculae and immature bone formation by osteoblasts with vascularized connective tissue. We diagnosed the tumor as osteoblastoma based on the clinical presentation and the size of the tumor. No recurrence was evident at the 1-year follow-up visit.


Subject(s)
Bone Neoplasms/pathology , Ethmoid Sinus/pathology , Osteoblastoma/pathology , Adolescent , Bone Neoplasms/surgery , Ethmoid Sinus/surgery , Exophthalmos/etiology , Female , Humans , Nasal Obstruction/etiology , Osteoblastoma/surgery
19.
Laryngoscope ; 122(12): 2793-9, 2012 Dec.
Article in English | MEDLINE | ID: mdl-22965906

ABSTRACT

OBJECTIVES/HYPOTHESIS: The pathophysiology of dysphagia caused by brain infarction varies with the site of the lesion in the brain. Patients with suprabulbar lesions have demonstrated delayed triggering of pharyngeal stage including delayed laryngeal elevation. Patients with severe pharyngeal stage delay have a high risk of intractable aspiration to the lower respiratory tract. Despite this, few studies have compared the pharyngeal stage delay with the lesion site. We defined a new temporal parameter of the pharyngeal stage delay to assess laryngeal elevation delay against the bolus inflow into the pharyngeal space. This study aimed to elucidate whether this parameter of pharyngeal stage delay is clinically useful to assess the pathophysiology of brain lesions after brain infarction. STUDY DESIGN: Case-control study. METHODS: Videofluoroscopic assessment of swallowing examinations was performed from January 7, 2000 to March 29, 2011 at Kyushu University Hospital. We evaluated the pharyngeal stage delay using motion analysis on videofluoroscopic swallowing examination in patients with normal swallowing and brain infarction patients divided into pathophysiologic lesion groups. Laryngeal elevation delay time and pharyngeal delay time were analyzed. RESULTS: Significant differences in laryngeal elevation delay time were observed between each pathophysiologic lesion group. However, pharyngeal delay time remained similar among groups. Brain infarctions of corticobulbar tract and basal ganglion were significantly associated with laryngeal elevation delay time prolongation. CONCLUSIONS: Laryngeal elevation delay time with low-viscosity contrast medium is a recommended parameter to discriminate the corticobulbar tract and the basal ganglion lesion.


Subject(s)
Brain Infarction/complications , Deglutition Disorders/diagnostic imaging , Deglutition/physiology , Fluoroscopy/methods , Pharynx/physiopathology , Video Recording , Adult , Aged , Aged, 80 and over , Brain Infarction/diagnosis , Deglutition Disorders/etiology , Deglutition Disorders/physiopathology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Pharynx/diagnostic imaging , Reproducibility of Results , Retrospective Studies
20.
Ann Otol Rhinol Laryngol ; 121(3): 174-8, 2012 Mar.
Article in English | MEDLINE | ID: mdl-22530477

ABSTRACT

OBJECTIVES: Precise assessment of the risk of aspiration is critical in older patients with a history of pneumonia. However, the currently popular videofluoroscopic and videoendoscopic examinations of swallowing only evaluate volitional swallowing. A method for quantitative analysis of reflexive swallowing is not yet available. METHODS: We evaluated volitional swallowing in the sitting position by videoendoscopic examination and then measured the volume of injected water that triggered reflexive swallowing in the supine position in 54 patients with a history of pneumonia and 24 control patients of a similar age who had no history of pneumonia. RESULTS: The volume of injected water that triggered reflexive swallowing was larger in the pneumonia group than in the control group (mean, 1.64 +/- 0.61 mL versus 0.71 +/- 0.28 mL; p < 0.001). Both impaired volitional swallowing and impaired reflexive swallowing independently correlated with a history of pneumonia. CONCLUSIONS: The endoscopic supine swallow-evoking test ("ESSET") may detect previously omitted risk factors for aspiration in patients who can volitionally swallow.


Subject(s)
Deglutition , Respiratory Aspiration/physiopathology , Aged , Aged, 80 and over , Comorbidity , Endoscopy , Female , Humans , Male , Pneumonia/epidemiology , Pneumonia, Aspiration/physiopathology , Reflex/physiology , Respiratory Aspiration/epidemiology , Retrospective Studies , Volition/physiology , Water
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