[Epidemiology of Japanese cedar pollinosis: result of the survey in Mibu-machi].

The prevalence rate of Japanese cedar pollinosis has increased since 1979. We conducted a survey of the residents of Mibu-mach, Tochigi, in 1988 and 1996 using a questionnaire to determine the prevalence rate of cedar pollinosis. Results showed its rate was 15.6% in 1988, and 25.6% in 1996. Age distribution analysis of patients with Japanese cedar pollinosis showed the highest prevalence in patients between the ages of 10 to 49 years in 1988, and between the ages of 10 to 59 years old in 1996. Within these age groups, the majority of the patients were females, but males were more prevalent than females in the age group under 19 years old. The prevalence rate of patients by age group revealed the same pattern as the age distribution of the patients. Age distribution of cedar pollinosis showed a peak in patients in their thirties both in 1988 and 1996. In conclusion, the numbers of patients with Japanese cedar pollinosis has been increasing remarkably in Mibu-mach. As climate or environmental conditions are varied in different geographical regions in Japan, further epidemiological studies in various regions of the country are required to clarify the actual prevalence rate of cedar pollinosis.

Study of nasal surface basophilic cells in patients with nasal polyp.

Surface basophilic cells in samples obtained from the inferior concha of nasal polyp patients were examined microscopically. Although the cells were believed to be specific to nasal allergy patients, we were also able to observe them in nasal polyp patients without nasal allergy. These cells were found in 5% of normal controls, in 14% of patients with chronic sinusitis without nasal polyp, in 65% with nasal polyp and in 91% with nasal allergy. In patients with unilateral nasal polyp the surface basophilic cells increased on the side with nasal polyp but not on the side without nasal polyp. As the nasal polyp grew in size, so the number of cells grew. After the polyp was removed, the cells decreased appreciably in number. With regard to other nasal diseases, surface basophilic cells were observed in 80% of tracheotomized patients, in 88% of laryngectomized patients due to laryngeal cancer, in 100% of patients with a tumor in nasal cavity, in 100% of patients with irradiation treatment of the nasal cavity and in 90% of patients with atrophic rhinitis. The surface basophilic cells seem to increase in number through some mechanism induced by a blockage of nasal airway by nasal polyp.

[Efficacy evaluation of aztreonam for suppurative otitis media].

Preclinical and clinical studies were performed to evaluate usefulness and safety of aztreonam (AZT) in the treatment of acute otitis media, acute exacerbation of chronic otitis media and chronic otitis media and the following results were obtained. MICs for P. aeruginosa, P. mirabilis and P. inconstans isolated from the patients with suppurative otitis media were 1.56 micrograms/ml, less than or equal to 0.025 micrograms/ml and less than or equal to 0.025 micrograms/ml respectively in their peaks. In the intravenous injection of 1 g, AZT concentration in the mastoid cell mucosa was 7.52 micrograms/g on average and serum concentration 51.6 micrograms/ml sufficiently suggesting clinical efficacy of AZT. In the clinical trial by administering AZT 1-2 g/day for the patients with suppurative otitis media, effective rates were 2/3 (66.7%) for acute otitis media, 16/22 (72.7%) for acute exacerbation of chronic otitis media, 21/34 (61.8%) for chronic otitis media and 6/7 (85.7%) for cholesteatoma of the middle ear. Elimination rate of single Gram-negative pathogens was 82.1% in the bacteriological studies of AZT. As for abnormal laboratory findings, 7 cases showed GOT, GPT elevations. However, they were in minor degree and transient. Side effect was not noted except 1 case of flushing with itching. It was considered from the above results that AZT is a highly useful antibiotic for suppurative otitis media.

X-ray tomographical observations of the interrelationships among structures of the nasal airway.

In order to elucidate upon the interrelationships among the different structures in and around the nasal cavity, the noses of 95 adults without severe rhinitis, paranasal sinusitis, cysts or tumors were examined by means of X-ray tomography. The results indicate a close correlation between the width of the nasal cavity and 1) the width of the maxillary sinus, 2) the size, form and height of the inferior turbinate, 3) the size of the middle turbinate or 4) the nasal septal deviation; between the height of the nasal cavity and the length and height of the inferior turbinate or the length of the middle turbinate, and also between the degree of septal deviation and the width of the nasal cavity, the nasal meatus or olfactory slit or the form of the inferior turbinate. In conclusion, it is recognized that correction of the abnormal interrelationships among the different structures is important for functional nasal surgery.

[Moderate dose methotrexate with citrovorum factor rescue therapy in the treatment of head and neck cancer].

A clinical trial of moderate dose methotrexate (MTX)-CF rescue was conducted in 12 institutions. Thirty-seven patients with head and neck carcinoma entered this trial, of which 32 were evaluable. MTX was administered 350 mg/m2 (500 mg/body) by i.v. drip over 6 hours. Three hours after completion of MTX infusion, CF rescue was started. There was no complete response in 32 patients. Nine patients showed partial response with the response rate of 28%. The response rates were 21% for the group of patients treated previously, and 75% for the group untreated previously. MTX concentration in plasma was determined at 6, 24, 48 and 72 hours after the initiation of MTX infusion, and the assay results revealed a safe range. GI disturbances were seen at the rates of 11 to 38%. Bone marrow suppression was mild and no renal toxicity was observed. We concluded that the moderate dose MTX-CF rescue therapy was useful for head and neck carcinoma. As a next step, we are planning to conduct a clinical trial of high-dose MTX.