The normal configuration and interindividual differences in intramural lymphatic vessels of the esophagus.

OBJECTIVE: Recently, interindividual differences in lymphatic vessel density among patients with cancer have become a focus of interest for surgeons as a significant prognostic factor. Little morphometric information is available about esophageal lymphatics in the absence of esophageal pathologic changes. We used D2-40 immunohistochemical examination to clarify the normal configuration of the esophageal intramural lymphatics and to evaluate morphometrically preexisting mucosal vessels. METHODS: D2-40 immunohistochemical staining for human lymphatic epithelium was performed at three sites in the cervical and thoracic esophagus in 16 donated cadavers without macroscopic malignancy or chronic inflammation. We determined the total numbers of lymphatic vessels and their complete circumferential lengths. RESULTS: Our immunohistochemical evaluation consistently demonstrated mucosal longitudinal and intermuscular circumferential vessels. In contrast to a previous diagram, the submucosal lymphatics were limited to a few circumferential and marginal vessels. On the basis of these findings, we suggest a new scheme for the intramural lymphatic vessels. In this morphometric study, interindividual differences in number and circumferential length of mucosal lymphatic vessels ranged from 100% to 200% (2-3 times), and site-dependent differences were not evident. After correction for esophageal thickness, interindividual differences in lymphatic vessel density were still 2-fold. CONCLUSION: We hypothesized that the greater length and number of lymphatic vessels in the lamina propria mucosae are likely to provide greater opportunity for lymphatic vessel invasion of cancer. Thus propensity toward cancer invasion would seem to depend not only on cancer pathology but also on individual anatomic features.

Effect of antihistamine eye drops on the conjunctival provocation test with Japanese cedar pollen allergen.

BACKGROUND: Approximately 16.2% of the Japanese population suffer from cedar pollinosis, with various manifestations such as ophthalmic, laryngo-pharyngeal and skin symptoms in addition to nasal symptoms. Thus, the annual pollen season is an agonizing period for patients. No study has reported symptoms and their clinical courses after conjunctival provocation with purified cedar pollen allergen Cry j1 as well as suppression of these allergen-induced ocular symptoms by antihistamine eye drops. METHODS: Nine patients with Japanese cedar pollinosis who had no nasal or ocular symptoms were included in the present study, after obtaining informed consent in writing. 1) Purified cedar pollen allergen Cry j1 was instilled in the left eye and phosphate-buffered saline (PBS) in the right eye as a control. 2) Levocabastine hydrochloride ophthalmic suspension and ketotifen fumarate ophthalmic solution were respectively instilled in the left and right eyes, which were then challenged with the allergen. Ocular symptoms after provocation with the allergen were recorded through the clinical course. RESULTS: Pollen allergen-induced ocular symptoms were itching and hyperemia of the palpebral conjunctiva, and itching lasted for more than 5 hours. Moreover, preadministration of antihistamine eye drops suppressed the increases in the ocular symptom scores, eliminating itching within 1 hour. Allergen provoked not only ocular symptoms but also nasal symptoms in 77.8% of patients. CONCLUSIONS: Preadministration of antihistamine eye drops suppressed the symptoms induced by the allergen, which suggests that this is an effective early therapy for Japanese cedar pollinosis, if it is started before the pollen season. However, self-protection by patients using a mask may not be effective enough to suppress nasal symptoms during the pollen season, requiring them to additionally wear glasses to avoid exposure to the allergen.

Transient evoked otoacoustic emissions in newborn infants: Effects of ear asymmetry, gender, and age.

Our aim was to examine the effects of gender, ear asymmetry, and age of infants on various parameters of transient evoked otoacoustic emissions (TEOAEs). Three hundred thirty-two infants (181 males, 151 females) were tested using the ILO292 Otodynamics Analyzer (Otodynamics Ltd, England) as a screening procedure. The subjects were divided into two age groups: group 1, newborn infants prior to hospital discharge (mean age of 4 days), and group 2, infants at the 1-month-old health checkup (mean age of 35 days). Responses to TEOAE stimuli were recorded at 1.0, 1.5, 2.0, 3.0, and 4.0 kHz. There were significant effects of gender and ear (left/right) on the signal-to-noise ratio, response level, and whole-wave and band reproducibility values in TEOAEs. The right ear had higher values of whole-wave reproducibility, response level, signal-to-noise ratio, and band reproducibility than the left ear. Females displayed higher whole-wave reproducibility, response level, band reproducibility, and signal-to-noise ratio values than males. There was no significant difference in response level, signal-to-noise ratio, and band reproducibility between the two age groups. The findings of the present investigation may contribute toward future improvements in neonatal hearing screening based on the community.

[A comparative study between real time monitor KH-3000 and conventional Durham sampler measuring airborne pollen].

Real time monitoring of airborne pollen has gradually increased because monitoring is laborsaving and provides better real-time information. A problem arose, however, due to differences between the KH3000 (Yamato Co. Ltd) monitor and the conventional Durham sampler pointed out in results of airborne pollen monitoring in Wakayama in 2004. We compared the two monitors for airborne pollen in Wakayama in 2004, which less dispersed than usual. The peak monitored by the KH-3000 monitor was not consistent with the prime period of Japanese cedar and cypress pollen dispersion, especially in February and April, although they correlated highly in March. The inconsistency in February is thought to be caused by snow, and that in April by falsely monitoring beech-tree airborne pollen-which is similar in size-in addition to Japanese cedar and cypress pollen. This report points out the need to take these conditions (snow and other plants pollen) into account when a real time monitor is used for collecting pollen information.