Regulation of the inhibitor-of-apoptosis family member survivin in normal cord blood and bone marrow CD34(+) cells by hematopoietic growth factors: implication of survivin expression in normal hematopoiesis

The inhibitor-of-apoptosis protein survivin is expressed in most cancers and leukemias and during fetal development, but not in most normal adult tissues. Survivin expression was analyzed in umbilical cord blood (UCB) and adult bone marrow CD34(+) cells and in the factor-dependent MO7e cell line; also investigated was whether survivin expression was regulated by hematopoietic growth factors. Survivin messsenger RNA (mRNA) and protein were expressed in fresh UCB and marrow CD34(+) cells. The combination of thrombopoietin, Flt3 ligand, and stem cell factor upregulated survivin expression in CD34(+) cells within 24 hours; survivin expression was cell-cycle related and highest during G2/M, whereas growth-factor withdrawal resulted in decreased survivin expression. Cell-cycle fractionation of UCB CD34(+) with Hoechst-33342/pyronin-Y demonstrated that survivin message was undetectable in freshly isolated G0 cells, but present in G1 cells. After cytokine stimulation, survivin mRNA and protein expression were observed in both G0 and G1 CD34(+) cells as well as in cells that had progressed to S and G2/M phase, indicating that survivin expression is regulated in all phases of the cell cycle. This contrasts with the expression of survivin predominantly during G2/M in cancer cells. In CD34(+) cells and MO7e cells, growth factor-mediated upregulation of survivin was associated with inhibition of apoptosis, and downregulation of survivin was coincident with increased apoptosis. Furthermore, an inverse correlation between survivin and active caspase-3 was observed in CD34(+) cells. These findings demonstrate that survivin is not a cancer-specific antiapoptotic protein and plays a regulatory role in normal adult hematopoiesis.

[Retinal hazard from blue light emitting diode]

PURPOSE

To compare the effect of exposure time from a blue(460 nm) light emitting diode(LED) on the morphology of the outer retina and determine conditions where damage occurs.

MATERIALS AND METHODS

Young adult rhesus monkeys were anesthetized, and received blue LED exposure from a modified slit-lamp. A 3 mm beam of 0.85 mW was imaged onto the retina through a lens positioned before the cornea and exposure damage was determined at time intervals for 12 to 90 min. Fundus photography, fluorescein angiography(FAG), retinal tomography(HRT), and s-cone electororetinogram(S-ERG) were recorded at baseline, 2, and 30 days.

RESULTS

Two days after 40 min exposure, there was a grey, discolored region, which was over-fluorescent in FAG, and an incresse in HRT and S-ERG corresponding to the site which was exposed to LED light. In histological examination at 30 days, the LED had caused produced a marked disruption of the disks of photoreceptor cells, damaged retinal pigment epithelium(RPE) apical villi, and a loss of RPE melanin after 90 min exposure.

CONCLUSION

A threshold level was found around 40 min. This morphological damage may impair function and continuous exposure to blue light is potentially dangerous to vision.

Preventive effect of Coriandrum sativum (Chinese parsley) on localized lead deposition in ICR mice

The preventive effect of Coriandrum sativum, Fam. UMBELLIFERAE (Chinese parsley) on lead deposition was investigated in male ICR mice given lead (1000 ppm) as lead acetate trihydrate in drinking water for 32 days. Administration of Chinese parsley to mice by gastric intubation was performed for 25 days from day 7 after the start of lead exposure up to the end of the experiment. The mice were then sacrificed for comparison of lead distribution. The lead reached its highest concentration in the femur but localized lead deposition in the femur was significantly decreased by meso-2,3-dimercaptosuccinic acid (DMSA), a chelating agent used as a positive control to validate this experimental model. Administration of Chinese parsley also significantly decreased lead deposition in the femur and severe lead-induced injury in the kidneys. In addition, urinary excretion of delta-aminolevulinic acid (ALA) which is known to increase with lead intake was significantly decreased after administration of Chinese parsley. The MeOH extract of Chinese parsley also reduced lead-induced inhibition of delta-aminolevulinic acid dehydratase (ALAD) activity in vitro. These results suggest that Chinese parsley has suppressive activity on lead deposition, probably resulting from the chelation of lead by some substances contained in Chinese parsley.

Tracheal allotransplantation in beagle dogs without immunosuppressants

BACKGROUND

The antigenicity of tracheal grafts is still unclear. We investigated the possibility of performing tracheal allotransplantation without immunosuppressants.

METHODS

Intrathoracic five-ring tracheal replacements were performed in beagle dogs without immunosuppressants (n = 18). The dogs were divided into 9 pairs, and grafts were exchanged within the pairs. In group 1 (n = 6), the paired dogs were blood relatives, whereas in group 2 (n = 12), the paired dogs were not related. Full-thickness skin transplantation was also performed in both groups.

RESULTS

In group 1, 5 animals survived uneventfully for more than 3 months. No stenosis was observed in any of the dogs. In group 2, the grafts were incorporated by the host trachea in 2 dogs. Four animals died of airway obstruction within 3 months. Moderate or slight airway stenosis was observed in 6 dogs. Rejection was confirmed by histologic examination. In both groups, all of the skin allografts were destroyed within 2 weeks.

CONCLUSIONS

After tracheal allotransplantation, long-term survival was achieved, especially in recipient dogs that were blood relatives of donors. We conclude that it is possible to perform tracheal allotransplantation using histocompatible matched grafts without immunosuppressants.

[Surgical treatment of chronic pulmonary thromboembolism caused by a cavernous hemangioma at the lower limb]

A 48-years old man complained of dyspnea and was admitted to the hospital. Chest enhanced CT confirmed the presence of the thrombus in the pulmonary artery. Cardiac catheterization showed severe pulmonary hypertension (mean PAP 75 mmHg). ATIII level, protein C and S antigen were within normal range. Anticardiolipin antibody and lupus anti-coagulant determination were negative. He was diagnosed as chronic pulmonary thromboembolism, and underwent pulmonary thromboendarterectomy via median sternotomy under deep hypothermic intermittent circulatory arrest. At the same time IVC filter was inserted. The origin of the thrombus was not detected before operation, but after surgery, MR angiography of total body showed a cavernous hemangioma at left lower limb. We speculated this lesion was the origin of pulmonary embolism.

Health behaviors and their relation to metabolic control and periodontal status in type 2 diabetic patients: a model tested using a linear structural relations program

BACKGROUND

Although it has been reported that diabetic control is beneficial in managing periodontal disease, there are few studies in the literature where the relationship between singular behavioral factors and periodontal status has been examined. The aim of this study was to examine the simultaneous interrelationships among selected medical/dental variables and 5 behavior components with general health behavior (GHB), perceived fatigue (PF), diet control (DC), regular diet (RD), and dental behavioral inventory (HU-DBI) scores, using data from a study of 102 type 2 diabetic patients.

METHODS

A hypothesized model was tested by a linear structural relations program (LISREL).

RESULTS

There was a significant correlation between oral health behavior and calculus accumulation (r = 0.399; P<0.001). Correlations were found between calculus and periodontal status measured by gingivitis index and probing depth (r = 0.232; P<0.05, r = 0.279; P<0.01, respectively). The final model was found to be consistent with the data (chi2 = 55.0, df = 47, P = 0.197; GFI = 0.922). Oral health behavior affected periodontal status through its effect on calculus but not plaque accumulation. General health behavior had significant effects on oral health behavior and diet behavior (P<0.05 and P<0.001, respectively). Diet behavior affected both plaque accumulation and metabolic control (P<0.05 and P<0.01, respectively). However, the result was the virtual absence of a significant pass coefficient between metabolic control and periodontal status.

CONCLUSIONS

The severity of the 2 diseases seemed to be connected indirectly through health behaviors such as diet behavior and oral health behavior.

Computational analysis of full-length mouse cDNAs compared with human genome sequences

Although the sequencing of the human genome is complete, identification of encoded genes and determination of their structures remain a major challenge. In this report, we introduce a method that effectively uses full-length mouse cDNAs to complement efforts in carrying out these difficult tasks. A total of 61,227 RIKEN mouse cDNAs (21,076 full-length and 40,151 EST sequences containing certain redundancies) were aligned with the draft human sequences. We found 35,141 non-redundant genomic regions that showed a significant alignment with the mouse cDNAs. We analyzed the structures and compositional properties of the regions detected by the full-length cDNAs, including cross-species comparisons, and noted a systematic bias of GENSCAN against exons of small size and/or low GC-content. Of the cDNAs locating the 35,141 genomic regions, 3,217 did not match any sequences of the known human genes or ESTs. Among those 3,217 cDNAs, 1,141 did not show any significant similarity to any protein sequence in the GenBank non-redundant protein database and thus are candidates for novel genes.

Percutaneous microwave coagulation therapy for primary or recurrent hepatocellular carcinoma: long-term results

BACKGROUND/AIMS

To clarify the indication of percutaneous microwave coagulation therapy for hepatocellular carcinoma.

METHODOLOGY

Thirty-three hepatocellular carcinoma patients who underwent percutaneous microwave coagulation therapy were enrolled in this study, including 18 primary and 15 recurrent hepatocellular carcinoma patients. We examined the local recurrence rates and the long-term results after the treatment.

RESULTS

The overall survival rates of the primary group at 1, 2, 3, 4 and 5 years were 94.4%, 77.8%, 77.8%, 77.8% and 48.6%, respectively, whereas those of the recurrent group were 100%, 85.7%, 66.7% and 50.0% at 1, 2, 3 and 4 years, respectively. Local recurrence after percutaneous microwave coagulation therapy was found in about 50% of patients in both groups. Seventeen of the 27 patients (63.0%) with a moderately or poorly differentiated hepatocellular carcinoma tumor had local recurrence, while none of the 6 patients with a well-differentiated hepatocellular carcinoma tumor did (P = 0.005).

CONCLUSIONS

Irrespective of primary or recurrent hepatocellular carcinoma, the indication of percutaneous microwave coagulation therapy as an alternative to hepatic resection should be limited to cases of a well-differentiated hepatocellular carcinoma tumor smaller than 2 cm in diameter.

[Delayed traumatic diaphragmatic hernia diagnosed by magnetic resonance imaging and direct coronal computed tomography: report of a case]

A 59-year-old woman was admitted to our hospital with abdominal symptoms. A diagnosis of delayed traumatic diaphragmatic hernia was made from the findings of a plain X-ray film, magnetic resonance imaging (MRI) and computed tomography (CT). We successfully performed repair of the diaphragm via abdominal approach. Thus, MRI and direct coronal CT can be very useful for establishing a diagnosis of traumatic diaphragmatic hernia.

Quantitation of varicella-zoster virus DNA in patients with Ramsay Hunt syndrome and zoster sine herpete

Varicella-zoster virus (VZV) reactivation causes facial nerve palsy in Ramsay Hunt syndrome (RHS) and zoster sine herpete (ZSH) with and without zoster rash, respectively. In the present study, we analyzed the VZV DNA copy number in saliva samples from 25 patients with RHS and 31 patients with ZSH using a TaqMan PCR assay to determine differences in the viral load between the two diseases. VZV copy number in saliva peaked near the day of the appearance of zoster in patients with RHS. Consequently, VZV DNA was less frequently detected in patients with RHS who exhibited facial palsy several days after the appearance of zoster. These findings suggest that the VZV load in saliva samples reflects the kinetics of viral reactivation in patients with RHS. In addition, VZV DNA was equally detected in saliva from patients with RHS and ZSH, and there was no significant difference in the highest viral copy number between patients with RHS and those with ZSH. The VZV load does not appear to reflect a major difference between RHS and ZSH.

Medication for hearing loss after fractionated stereotactic radiotherapy (SRT) for vestibular schwannoma

PURPOSE

To investigate the effectiveness of corticosteroid treatments for patients showing decreases in hearing levels after stereotactic radiotherapy for vestibular schwannoma.

METHODS AND MATERIALS

Twenty-one patients experienced a hearing loss in pure-tone average at greater than 20 dB or less than 10 dB within 1 year after irradiation administration of 44 Gy/22 fractions followed by a 4 Gy boost. Eight received oral prednisone at a daily dose of 30 mg, which was gradually decreased (medicated group), and 13 received none (nonmedicated group). The average observation period was 26.7 +/- 16.6 (range: 6--69) months.

RESULTS

Hearing recovery was seen after initial onset of the hearing loss in all 8 patients in the medicated group and in 2 of 13 patients in the nonmedicated group (p = 0.001). The hearing recovery, that is, the change in pure-tone average (dB) at the last follow-up from the onset of hearing loss, was 9.8 +/- 6.9 dB (recovery) in the medicated group and -9.4 +/- 12.8 dB (further loss) in the nonmedicated group (p = 0.0013). The hearing recovery rate, normalizing to the degree of the hearing loss before medication, was also significantly higher in the medicated group than in the nonmedicated group (p = 0.0014).

CONCLUSIONS

Corticosteroidal intake is suggested to be effective in improving hearing loss after stereotactic radiotherapy, at least in young patients having a useful pretreatment hearing level, if the treatment for hearing loss is administered immediately after the hearing loss is first detected.

Inflammatory cytokines and antigen-responsive mononuclear cells in peripheral blood of cattle infected with Salmonella takoradi

To determine the immunological response in lactating dairy cows infected with Salmonella (S.) Takoradi, the relationships among distributions of peripheral blood mononuclear cell (PBMC) subpopulations, endotoxin concentrations and dynamics of inflammatory cytokines in blood were investigated. The ratio of CD4+ T cells to CD8+ T cells was significantly lower in the affected cattle than in the control cattle (p<0.05) to decrease in the number of CD4+ T cells in the infected cattle. In contrast, the numbers of gammadeltaT cells, MHC class II-positive cells were significantly higher in the affected cattle than in the control cattle (p<0.01 respectively). Endotoxemia was found in all but one of the affected cattle. Serum IL-1 and IL-6 bioactivities were significantly higher in the affected cattle than in the control cattle (IL-1, p<0.05; IL-6. p<0.01). Serum TNF-alpha activities and levels were not detected in the control and affected cattle. The activities of proinflammatory cytokines determined by the bioassay are important to the relationships between concentration of endotoxin, cytokines and clinical signs. such as leukocytosis, leukopenia, fever or bacterial shedding. Serum IL-2 levels were lower in the affected cattle than in the control cattle. Serum IFN-y was not detected in the affected cattle except one. These results by the ELISA seemed to reflect the condition of subpopulation in the PBMCs from the shedding cattle. The present results suggest that cellular immunity is suppressed while the humoral immunity is activated in acute bovine salmonellosis.

[Recurrent angina due to high grade re-stenosis of the left subclavian artery after coronary artery bypass grafting in a patient on hemodialysis for chronic renal failure: report of a case]

A 49-year-old woman on hemodialysis for chronic renal failure was admitted to our hospital with chest pain. She had undergone quadruple coronary artery bypass grafting (CABG) including a left internal thoracic to left anterior descending coronary artery anastomosis 9 months earlier. The blood flow through the left internal thoracic artery had decreased due to high grade stenosis at the proximal portion of the left subclavian artery, and recurrent angina had developed. She was treated by the placement of Palmaz biliary stents in the left subclavian artery, but re-stenosis occurred after 9 months, causing recurrent angina again. There fore, an operation was proposed and bypass grafting from the descending aorta to the left subclavian artery was successfully performed, resulting in complete resolution of her recurrent angina. This case serves to reinforce that patients on dialysis must be carefully followed up after CABG.

Oxidative ring cleavage of cyclic acetals with hypervalent tert-butylperoxy-lambda(3)-iodanes

[reaction: see text] Exposure of cyclic acetals to 1-tert-butylperoxy-1,2-benziodoxol-3(1H)-one in the presence of tert-butyl hydroperoxide and potassium carbonate in benzene at room temperature results in oxidative ring cleavage to glycol monoesters via intermediate tert-butylperoxy ortho esters.

The effect of the weight reduction on the salivary cortisol levels of judo players

The purpose of this study was to investigate the effect of weight reduction prior to a competition on the salivary cortisol level for first-rate judo players. Subjects were divided into three groups by the weight reduction rate. On the day before the competition, the cortisol levels of the low- and high-weight reduction group showed a tendency to decrease and were significantly lower than that of the non-weight reduction group (p<0.05). However, with regard to the change in the stress indices, there was a difference between the high- and low-weight reduction groups. In the high-weight reduction group alone, there was a significant increase in the stress indices on the day before the competition (p<0.05). These findings suggest that the HPA axis is affected during the relatively early stage of weight reduction and mental stress is increased at the higher weight reduction rate.

KAI1, CAR, and Smad4 expression in the progression of colorectal tumor

PURPOSE

The abnormal expression of several genes is involved in the development of colorectal tumors. The aim of this study was to examine the expression of KAI1, CAR, and Smad4, which has been associated with the progression of other cancers.

METHODS

We examined 12 adenomas, 38 primary carcinomas, 10 liver metastases, and 7 adenocarcinoma cell lines, by fluorescent multiplex reverse transcription-polymerase chain reaction (RT-PCR).

RESULTS

KAI1 expression was higher in adenomas (2.55 +/- 0.61; P < 0.05) and primary carcinomas (3.30 +/- 0.42; P < 0.005) than in normal mucosa, but it was not correlated with tumor stage. CAR expression was lower in Dukes' B (1.28 +/- 0.53) than in Dukes' A (2.38 +/- 0.48) (P < 0.05), but increased with tumor progression; Dukes' C (1.45 +/- 0.25), Dukes' D (1.53 +/- 0.14), and metastases (2.09 +/- 0.39) (P < 0.05). Smad4 expression increased in adenomas (2.30 +/- 0.46; P < 0.05), but decreased with tumor progression; Dukes' A (2.14 +/- 0.37), Dukes' B (1.65 +/- 0.41), Dukes' C (1.57 +/- 0.25), Dukes' D (1.08 +/- 0.18), and metastases (0.82 +/- 0.21) (P < 0.05).

CONCLUSIONS

These results suggest that the upregulation of CAR and down-regulation of Smad4 are associated with the progression of colorectal tumors, while the upregulation of these genes and of KAI1 seems to be involved in the early stage.

[Utility of OAE screener (GSI 70) for the evaluation of distortion product otoacoustic emissions]

The purpose of this study was to investigate the ability of the OAE screener GSI 70 to evaluate of cochlea function in neonates, infants and adults. Distortion product otoacoustic emissions (DPOAEs) were measured using the GSI 70 DPOAE Analyzer and evaluated in 123 human ears between December 1999 and June 2000. We performed the following four general clinical tests to determine the reliability of the GSI 70: 1) comparison of DPOAE levels measured using the ILO 92 and the GSI 70 in 55 adult ears, 2) comparison of DPOAE levels measured using the GSI 70 and hearing levels in 55 adult ears, 3) comparison of DPOAE levels measured using the GSI 70 and ABR levels in 45 neonate and infant ears, and 4) evaluation of the utility of DPOAE measurements obtained using the GSI 70 in functional deafness cases. The following results were obtained: 1) DPOAE levels measured with the ILO 92 and the GSI 70 were closely correlated (correlation coefficient, 0.773 at 2 kHz and 0.813 at 4 kHz). 2) The sensitivity of the GSI 70 in adult ears confirmed to have normal hearing was 80% at 2 kHz and 100% at 4 kHz; the specificity of hearing-impaired ears was 94% at 2 kHz and 94% at 4 kHz. 3) The sensitivity of the GSI 70 in normal neonate and infant ears with normal hearing was 100% at 2 kHz and 100% at 4 kHz; the specificity of hearing-impaired neonate and infant ears was 97% at 2 kHz and 94% at 4 kHz. 4) All of the functionally deaf ears showed excellent DPOAE responses. Examinations using the GSI 70 DPOAE analyzer were very easy and fast. Also, the results were highly reliable, with the exception of one adult who was classified as having normal hearing in an out-of-scale hearing level at 2 kHz. We suggest that specific criteria be established for the clinical usage of the GSI 70 in performing objective hearing evaluations.

Herpes virus reactivation and gadolinium-enhanced magnetic resonance imaging in patients with facial palsy

OBJECTIVE

This study investigated whether magnetic resonance imaging (MRI) patterns were different between patients with Bell's palsy and those with herpetic facial palsy in whom varicella-zoster virus (VZV) or herpes simplex virus type 1 (HSV-1) reactivation had been confirmed by polymerase chain reaction (PCR) or serologic assay.

STUDY DESIGN

A retrospective study of 15 patients with acute peripheral facial palsy was performed to compare virologic tests and gadolinium (Gd)-enhanced MRI findings.

RESULTS

Ramsay Hunt syndrome was diagnosed in one patient. By use of virologic tests, zoster sine herpete (VZV reactivation without zoster) was diagnosed in four patients and HSV-1 reactivation in three. Bell's palsy was diagnosed in the remaining seven patients. No significant difference in the frequency of Gd-enhanced MRI was observed between herpetic facial palsy and Bell's palsy. However, in those patients who underwent MRI on the day viral reactivation was confirmed by PCR, Gd enhancement of the meatal fundus was observed infrequently. In addition, when MRI was performed within 10 days of the onset of palsy, Gd enhancement was not detected at the geniculate ganglion in any patients with herpetic facial palsy. By contrast, both the meatal fundus and the geniculate ganglion were enhanced in all patients with Bell's palsy, regardless of when MRI was performed with respect to the onset of palsy.

CONCLUSION

This study shows a difference in the pattern of Gd enhancement at the meatal fundus and the geniculate ganglion between patients with Bell's palsy and those with herpetic facial palsy. The results suggest that the meatal fundus or the geniculate ganglion may be affected first by virus reactivation in patients with herpetic facial palsy.

Annual rate of hearing loss falls after fractionated stereotactic irradiation for vestibular schwannoma

PURPOSE

The rate of hearing loss in a population before and after irradiation was investigated to determine the effect of irradiation on hearing impairment.

METHODS AND MATERIALS

In 72 patients with vestibular schwannoma who received fractionated stereotactic irradiation from 1992 to 1999, 21 had had their hearing levels examined 3 months or more before the treatment. The mean time between the initial examination and treatment was 18.6 months (range: 3-89 months), and the mean time between treatment and the last follow-up was 24.2 months (12-69 months). Thirty-six to 50 Gy in 20-25 fractions over 5 to 6 weeks was given using an X-ray beam from a linear accelerator. Pure tone average (PTA) was measured using the mean hearing level at five frequencies, and the annual rate of hearing loss was defined as [(hearing loss in PTA(dB))/(follow-up period (months)x12)].

RESULTS

The actual cumulative curve of decrease in tumor size of 2 mm or more was 38.3% at 2 years and 80.0% at 3 years. The mean of hearing loss in PTA was 11.6+/-10.3 dB (-1 to 35 dB) from the initial examination to the start of irradiation and 11.9+/-14.4 dB (-14 to 37 dB) from the start of irradiation to the last follow-up. The mean annual rates of hearing loss before irradiation and in the 1st,2nd,3rd and 4th years after irradiation were, respectively, 18.6, 11.2, 6.2, 5.1, and 5.0 dB/year. The annual rates of hearing loss in the 2nd year (P=0.025) and 3rd year (P=0.018) were significantly slower than the rate before irradiation.

CONCLUSIONS

The mean annual rate of hearing loss was higher before irradiation than after irradiation, and hearing loss slowed rather than accelerated after irradiation. Although hearing loss after the treatment was usually permanent, fractionated stereotactic irradiation was suggested to be effective to lower the rate of hearing loss.

Local fundus response to blue (LED and laser) and infrared (LED and laser) sources

Light damage research began during the early years of laser light exploration. There is a clear and significant literature that identifies an easily demonstrated retina-pigment epithelium pathology which is associated with short wavelength exposures below 520 nm. Recent interest has expanded because of the growing evidence for a blue light contribution to the retina aging process by way of a poorly understood chemical process(es) that involve circulation, oxidative reactions and the spectral absorption properties of the pigment epithelium. New powerful sources of relatively inexpensive blue energy have become available as a family of light emitting diodes. In this experiment, we examined funduscopic, angiographic and scanning laser tomographic measures of the retinal-pigment epithelium response to LED and laser spectral blue and infrared emissions closely matched in wavelengths and delivered under carefully matched circumstances. Ten retinas in normal young rhesus monkeys were locally exposed to various energy density values at 458 nm (Argon laser) ranging from 5 to 54 J cm(-2). Eight rhesus eyes were exposed to LED irradiation with a peak wavelength of 460 nm ranging from 9 to 62 J cm(-2). Similarly, a matched infrared (IR) laser and IR LED pair were used to expose an additional ten eyes for comparison of the long wavelengths. IR irradiance ranged from 21 to 306 J cm(-2). There was no response to IR exposure in any of the eyes. Blue light exposure results were measured from the color fundus photographs, scanning laser tomographs and early- and late-phase fluorescein angiogram responses at 2 and 30 days after the exposure. Results scores were accumulated for the four measures at the two time periods. The resulting lesion scores when plotted against the exposure in J cm(-2)showed no demonstrable effect at irradiance lower than 10 J cm(-2)and near 100% effectiveness for irradiance greater than 30 J cm(-2). The most sensitive and enduring indicator of change was the late fluorescein angiograms. Nonparametric statistical analysis of the scores from the two samples support the conclusion that there is no difference in the consequences of LED and laser light exposures under these matched conditions.

Incidence of pyometra in colony-raised beagle dogs

Incidence of pyometra observed in our colony-raised beagle dogs over a 12-year period is described. Pyometra was observed in 25 female dogs of more than 4 years old, frequently at 8-11 years, with the average age of onset 9.36 +/- 0.38 years. The incidence of the disease was 15.2% of the female dogs (n = 165) more than 4 years old. Clinical findings useful in the diagnosis of this disease included an excretion of pus from the cervix, rapid increase in leukocyte count, and enlarged uterus as revealed by radiography. The relationships of delivery, estrus cycles to this disease are discussed. Ovariohysterectomy or uterectomy was the only effective method of treatment. In conclusion, the results indicated that pyometra might be an age-related disease because it occurred particularly in aged dogs.

Characteristics of wine produced by mushroom fermentation

Saccharomyces cerevisiae is the main microorganism used in wine brewing, because this microbe has potent ability to produce alcohol dehydrogenase. We have recently discovered that some genera of mushroom produced alcohol dehydrogenase, and made wine by using a mushroom in place of S. cerevisiae. The highest alcohol concentration in this wine was achieved with Pleurotus ostreatus (2.6 M, 12.2%). In the case of Agaricus blazei, the same alcohol concentration (1.7 M, 8%) was produced under both aerobic and anaerobic conditions. This wine produced by A. blazei contained about 0.68% beta-D-glucan, which is known to have a preventive effects against cancer. The wine made by using Flammulina velutipes showed thrombosis-preventing activity, giving a prolonged thrombin clotting time 2.2-fold that of the control. Thus, the wine made by using mushroom seems to be a functional food which can be expected to have preventive effects against cancer and thrombosis.

Malignant sarcomatoid tumor of the liver: report of a case

A 65-year-old man was referred to our hospital for treatment of a liver tumor. Abdominal ultrasonography (US) demonstrated a low echoic mass in the S2-S4 region of the liver, which was confirmed by abdominal computed tomography (CT). In the delayed phase of angio-CT, the inside of the mass was not enhanced. Abdominal angiography showed a hypovascular area in the liver. An extended left lobectomy was performed. Macroscopically, the tumor was 9.5 x 9.5 cm in size, and on cross section, it was white and clearly demarcated from the surrounding tissue. Microscopic observation of hematoxylin-eosin-stained specimens did not show any glandular or trabecular formation. Histologically, there was diffuse proliferation of atypical spindle cells that had hyperchromatic, short, spindle-shaped nuclei, and pale cytoplasm with poor intercellular adhesion. The nontumorous tissue was almost normal with no sign of cirrhosis. Immunohistochemical examination showed that the spindle cells were positive for vimentin and cytokeratins (AE1/AE3, CAM 5.2), but negative for all other markers. The final diagnosis was a sarcomatoid carcinoma, the origin of which was not able to be confirmed immunohistochemically. This case of a primary hepatic tumor composed of malignant cells with sarcomatous features is described, and the immunohistochemical findings are discussed.

Constraints on neutrino oscillations using 1258 days of Super-Kamiokande solar neutrino data

We report the result of a search for neutrino oscillations using precise measurements of the recoil electron energy spectrum and zenith angle variations of the solar neutrino flux from 1258 days of neutrino-electron scattering data in Super-Kamiokande. The absence of significant zenith angle variation and spectrum distortion places strong constraints on neutrino mixing and mass difference in a flux-independent way. Using the Super-Kamiokande flux measurement in addition, two allowed regions at large mixing are found.

Solar 8B and hep neutrino measurements from 1258 days of Super-Kamiokande data

Solar neutrino measurements from 1258 days of data from the Super-Kamiokande detector are presented. The measurements are based on recoil electrons in the energy range 5.0-20.0 MeV. The measured solar neutrino flux is 2.32+/-0.03(stat)+0.08-0.07(syst)x10(6) cm(-2) x s(-1), which is 45.1+/-0.5(stat)+1.6-1.4(syst)% of that predicted by the BP2000 SSM. The day vs night flux asymmetry (Phi(n)-Phi(d))/Phi(average) is 0.033+/-0.022(stat)+0.013-0.012(syst). The recoil electron energy spectrum is consistent with no spectral distortion. For the hep neutrino flux, we set a 90% C.L. upper limit of 40x10(3) cm(-2) x s(-1), which is 4.3 times the BP2000 SSM prediction.

The acquisition of complex predicates in japanese specifically language-impaired and normally developing children

Japanese exhibits two different types of morphological processes. Some morphologically complex predicates are generated within the domain of the lexicon, whereas others are generated outside the domain of the lexicon. An elicited production task involving both types of complex predicates was administered to six Japanese children with specific language impairment (JSLI) and six children with normal language development (JNLD). The JSLI children experienced significant difficulty forming the lexicon-external complex predicates but much less difficulty with the lexicon-internal complex predicates while the performance of the JNLD children exhibited no such asymmetry. These preliminary results suggest that the deficit of SLI affects the ability to construct implicit procedural rules for morphology that are generated outside the lexicon while their lexical operations for morphology that are generated within the domain of the lexicon remain relatively unimpaired.

Antibacterial compounds of licorice against upper airway respiratory tract pathogens

The antibacterial activity of compounds obtained from licorice was measured against upper airway respiratory tract bacteria such as Streptococcus pyogenes, Haemophilus influenzae and Moraxella catarrhalis. Among the tested compounds, licoricidin exhibited the highest activity against all tested microorganisms with an MIC of 12.5 microg/mL. Three coumarin derivatives, glycyrol, glycyrin and glycycoumarin also showed antibacterial activity.

[Nasal allergies in Kushiro]

A clinical study of 107 patients with nasal allergies who were treated at Kushiro General Hospital between April 1998 and March 2000 was performed. Radioallergosorbent tests (RAST), X-rays, and nasal smears for the detection of eosinophilia were performed to obtain a diagnosis of nasal allergy. The patients (50 males, 57 females) ranged in age from 3 to 71 years. The RAST was positive for timothy in 22.4% of the patients, 14.0% for birch and 12.1% for mugwort. The most common pollinosis allergen in the Kushiro area was grass pollen. Other pollinosis allergens were birch pollen and mugwort pollen. We measured the daily count of dispersed birch pollen and timothy pollen in Kushiro and Sapporo. Birch pollen and timothy pollen was dispersed earlier in Kushiro than in Sapporo. Nasal allergies in the Kushiro area appear to be related to local characteristics, such as climate and geographical features.

Trehalose-producing operon treYZ from Arthrobacter ramosus S34

Arthrobacter ramosus S34, which produces trehalose from maltooligosaccharide, was isolated. A trehalose-producing operon, treYZ, was cloned from the genome. Expression experiments with treY and treZ confirmed that they coded malto-oligosyltrehalose synthase and malto-oligosyltrehalose trehalohydrolase, respectively. The amino acid sequence of TreY from A. ramosus S34 and that from Arthrobacter sp. Q36 did not show high identity, nor did those of TreZ.

Concurrent chemotherapy and radiotherapy as initial treatment for stage II supraglottic squamous cell carcinoma

OBJECTIVE

To evaluate the efficacy and safety of concurrent carboplatin (CBDCA) and radiotherapy for laryngeal carcinoma. we investigated survival rates and laryngeal preservation rates in patients with this treatment modality and those with radiation therapy only.

METHODS

We underwent chemotherapy with CBDCA and conventional radiotherapy concurrently to 17 patients with untreated stage II (T2NOM0) supraglottic squamous cell carcinoma since November 1990. CBDCA (100 mg/m2) was administered intravenously once a week concurrently with radiotherapy (2.5 Gy/fr, 4 times a week). At the dose of 40 Gy, the results were evaluated, and some of the patients underwent planned surgery and others continued the radiotherapy up to 65 Gy.

RESULTS

Overall 5-year survival rate by Kaplan-Meier method was 81.1%. Actual laryngeal preservation rate was 76.0%. Toxicity over grade III was noticed in two patients. Compared with 14 cases of historical controls, which were treated by radiation therapy alone between 1988 and 1990, the cases with concurrent radiotherapy and chemotherapy had statistically significant advantage in overall successful laryngeal preservation rate (P < 0.05), whereas the two groups were not significantly different in the overall 5-year survival rate.

Churg-Strauss syndrome with pachymeningitis refractory to steroid therapy atone--a case report

Churg-Strauss syndrome (CSS) is a rare syndrome of unknown cause, which is characterized by bronchial asthma and hypereosinophilia followed by systemic symptoms of angiitis. In 1951, Churg and Strauss first distinguished this disease from periarteritis nodosa. Our patient in particular was also complicated with otorhinological symptoms, which have less frequently been reported in CSS cases. We have detailed her clinical symptoms.

A rare aneurysmal bone cyst of the maxillary sinus: a case report

Aneurysmal bone cyst (ABC) is a non-neoplastic expansile bone lesion that is common in the long bones; only 2% occurs in the head and neck. We present a case of ABC in a 23-year-old male and describe the clinical and radiological features, histopathology and treatment. Magnetic resonance imaging (MRI) demonstrated multiple internal septations, cysts with fluid-fluid levels of varying intensity, and an intact rim of low-intensity signal completely surrounding the lesion. The tumor was removed by enucleation with resection of the lateral nasal cavity. Histopathologic diagnosis was ABC and fibrous dysplasia. We suggest that MRI is very useful for the diagnosis of ABC. ABC is thought to follow other lesions, and thus when treating ABC, it is important to determine whether any pre-existing lesion has preceded or not; in particular, if the lesion site is in the head and neck region.

Hearing loss and growth rate of acoustic neuromas in follow-up observation policy

OBJECTIVE

It is important to know the growth rate of acoustic neuroma in setting up its observation policy. One aimed to evaluate the significance of growth rate and hearing loss speed from a retrospective study of 31 patients.

METHODS

Thirty-one patients with acoustic neuroma (mean age, 57.1 years; range, 9-81 years) who had undergone MRI and audiometry were retrospectively examined. Changes in tumor size and hearing level during follow-up periods were analyzed.

RESULTS

The mean annual growth rate was 2.4 mm/year (maximum, 17 mm/year), and the average annual hearing loss speed was 2.3 dB/year (-15.0 - 19.2 dB/year) in the follow-up, and a correlation was recognized between them. Whereas significant difference was noted in annual growth rate and hearing loss speed between the sexes, no correlation was recognized between the annual growth rate or hearing loss speed and the age, tumor size and pure tone average (PTA) at the initial diagnosis.

CONCLUSION

Attention must be paid to the acoustic neuroma cases where tumor growth rate is markedly high and those where hearing level rapidly declines during follow-ups. It is difficult, however, to estimate tumor diameter in relation with the changes in hearing level because the natural course of an acoustic neuroma varies in each individual.

Effects of spontaneous otoacoustic emissions on distortion product otoacoustic emission

OBJECTIVE

It has been reported that spontaneous otoacoustic emission (SOAE) can prolong the responses or increase the echo power of transiently evoked otoacoustic emission (TEOAE), yet the effects of SOAE on distortion product otoacoustic emission (DPOAE) have been studied less thoroughly. As most of the previous studies have not paid attention to the patient's age, sex and hearing level, they have not reflected possible effects of those factors. We studied the effects of SOAE specifically on DPOAE in the following subjects.

SUBJECTS AND METHODS

The subjects were all females ranging in age from 19 to 24 (average: 21.4) and the 78 ears had a hearing threshold under 15 dB for 1.2, and 4 kHz on pure-tone hearing test. IL088 (Otodynamics) was used for measurement of SOAE and IL092 (Otodynamics) for DPOAE. SOAEs were measured by time-averaging over 100 of the responses, of which those showing a clear peak 3 dB above the noise floor and being reproducible were considered as SOAE-positive. In all the ears. DPOAE responses were measured at L1 = L2 = 70 dB, and in 42 ears also at L1 = L2 = 60 dB and L1/L2 = 60/50 dB. The subjected ears were grouped into two by the presence or the absence of SOAE, and DPOAE amplitudes of 1, 2, and 4 kHz were compared. respectively.

RESULTS

Of the total, 39 ears were SOAE-positive and 39 SOAE-negative. Statistically no significant difference was observed in the average hearing level between the SOAE-positive and SOAE-negative groups. The hearing levels did not significantly differ in the frequencies of 1, 2. and 4 kHz, respectively, indicating that influence of the hearing level on DPOAE could be excludable. DPOAE amplitudes at L1 = L2 = 70 dB in the frequencies of 1, 2, and 4 kHz were higher in the SOAE-positive group than in the SOAE-negative group. And DPOAE amplitudes were also higher in SOAE-positive group at L1 = L2 = 60 dB and L1/L2 = 60/50 dB in the frequency of 1.2, and 4 kHz, but significant differences were observed only in the frequencies of 4 kHz. By grouping the ears by the number of SOAE. we revealed the tendency that the larger the number of SOAE, the higher the DPOAE amplitudes.

CONCLUSIONS

We evidenced that SOAE has significant effects on DPOAE responses. In clinical application of DPOAE measurement, therefore, the effects should be seriously taken into account.

Herpes virus reactivation and serum tumor necrosis factor-alpha levels in patients with acute peripheral facial palsy

Recent studies have shown that tumor necrosis factor-alpha (TNF-alpha) plays an important regulatory role in several inflammatory and infectious diseases. In the present study, we evaluated serum TNF-alpha levels of patients with acute peripheral facial palsy using an ELISA method. We examined sera from each group (n = 25 per group) of patients with herpes simplex virus type 1 reactivation (HSV-1). varicella-zoster virus (VZV) reactivation, and with no HSV or VZV reactivation. We also tested the sera of 25 normal controls. No significant difference was found between the serum TNF-alpha levels in facial palsy and controls. No correlation was found between serum TNF-alpha levels in cases with HSV-1 or VZV reactivation and with no HSV-1 or VZV reactivation. These results indicate that serum TNF-alpha levels are not affected by HSV-1 or VZV reactivation in patients with facial palsy.

Vestibular evoked myogenic potential (VEMP) in patients with acoustic neuromas

OBJECTIVE

To study the utility of VEMP (vestibular-evoked myogenic potential) in the diagnosis of acoustic neuromas.

METHODS

Eighteen patients with unilateral acoustic neuromas were subjected to this study. Myogenic potential responding to loud click stimuli was recorded at ipsilateral sternocleidomastoid muscle. A normal range of VEMP was obtained from 20 controls. VEMP responses were compared with both, clinical symptoms and results of caloric tests.

RESULT

Thirteen out of 18 patients showed decreased responses of VEMP at the affected side. VEMP responses seemed to have little relation with dysequilibrium, spontaneous nystagmus, canal paresis and pure-tone hearing.

CONCLUSION

VEMP is useful for detecting dysfunction of inferior vestibular nerve in patients with acoustic neuromas.

A clinical study on the cervical lymph node metastasis of maxillary sinus carcinoma

OBJECTIVE

To improve the management of maxillary sinus carcinoma, we retrospectively investigated the significance of cervical lymph node metastasis in our treated cases and discussed how to deal with the cervical lymph node metastasis as a prognostic factor.

METHODS

Medical records of 118 patients with maxillary sinus carcinoma diagnosed and treated in our institute from 1982 to 1997 were retrospectively reviewed. Tumors were staged according to UICC classification 1987. The cumulative survival was analyzed by the Kaplan-Meier method. Generally, the patients had undergone preoperative radiotherapy and surgery. We examined the cervical lymph node metastasis detected at the first examination and the subsequent cervical lymph node metastasis in relation to the prognoses.

RESULTS

The incidence of cervical lymph node metastasis at the initial diagnosis was 7.9% (n = 9), and that of secondary cervical lymph node metastasis without recurrence at the primary site after the first treatment was 8.3% (n = 9). In most cases, we observed metastasis to the lymph nodes in the submandibular region and in the jugular chain. The result of treatment of cervical lymph node metastasis was grave. Among the patients with cervical lymph node metastasis detected at the first examination, four patients developed local recurrence and three patients developed distant metastasis. On the other hand, among those with secondary cervical metastasis, three patients developed neck recurrence and three patients developed distant metastasis, but no local recurrence.

CONCLUSIONS

In the cervical metastasis of maxillary sinus carcinoma, it is important to treat the primary lesion completely. In addition to it. we should control cervical metastasis and careful neck dissection is required. For the patients with cervical lymph node metastasis, it is necessary to consider the further treatment of distant metastasis.

Histological findings in biopsies from patients with cytoplasmic-antineutrophil cytoplasmic antibody (cANCA)-positive Wegener's granulomatosis

OBJECTIVE

Currently Wegener's granulomatosis (WG) is diagnosed from clinical features, a test for antineutrophil cytoplasmic antibody (ANCA) and histological confirmation. The purpose of our study was to evaluate histological findings, in particular those in the biopsy samples of head and neck region.

METHODS

Fifty-one biopsy specimens from 24 WG patients who were confirmed to be positive for cANCA were examined retrospectively.

RESULTS

Only 12 biopsies out of 51 biopsies (24%) were diagnosed as typical of WG, and diagnosis could be confirmed in only 10 patients (42%) as typical of WG from the results of multiple biopsy specimens.

CONCLUSION

In the diagnosis of WG. biopsy can be utilized restrictedly only in the cases when cANCA is negative or clinical symptoms are atypical of WG.

Optimal stimulus level conditions for measurements of distortion product otoacoustic emissions

OBJECTIVE

Distortion product otoacoustic emission (DPOAE) is a tool for an objective examination of the cochlea function. While the clinical application of DPOEA test is in progress, the measurements vary depending on the stimulus conditions. We aimed to determine the most appropriate stimulus level in the clinical application of DPOAE test.

METHODS

Ninety-seven normal hearing ears and 80 hearing-impaired ears (total 177) were subjected to this study. Two levels of stimulations (L1 and L2) were applied as follows: L1 = L2 = 70 dB; L1 = L2 = 60 dB and L1 = 60/L2 = 50 dB, and DP level was measured at each stimulation, and compared with hearing level.

RESULTS

DP level was highest at L1 = L2 = 70 dB. Normal hearing ears and hearing-impaired ears were well differentiated at L1 = L2 = 60 dB.

CONCLUSION

In clinical application of DPOAE test, DP levels should be measured at the stimulus level most appropriate for the purposes.

Correlation of clinicopathological parameters and biological markers related to apoptosis and proliferative activity with a clinical outcome in squamous cell carcinoma of the larynx treated with concurrent chemoradiotherapy

OBJECTIVE

This study was designed to determine whether biological markers related to apoptosis or proliferative activity are associated with the clinical outcome in patients with squamous cell carcinoma (SCC) of the larynx treated with concurrent chemoradiotherapy.

METHODS

Immunostaining with antibodies specific to p53, bcl-2, bax, and MIB-1 was performed to evaluate expression of these proteins in formalin-fixed, paraffin-embedded specimens of 59 patients treated with concurrent chemoradiotherapy (carboplatin, 100 mg/m2, four to six times every week; total radiation dose of 40-65 Gy over 4-6.5 weeks).

RESULTS

Multivariate analysis indicated that nodal status was a significant indicator of overall survival (OS: P = 0.001). Patients with bcl-2 positive tumors had better OS than those with bcl-2 negative tumors in both univariate (P = 0.002) and multivariate analyses (P < 0.001 ). In the univariate analysis, a considerable difference in OS was observed among the expressions of bax (P = 0.077), MIB-1 proteins (P = 0.071). and OS. but the difference was not statistically significant.

CONCLUSION

This study indicates that nodal status is the major prognostic tactor in patients with SCC of the larynx treated with concurrent chemoradiotherapy. These results provide useful information for predicting prognosis. Further analysis of biological factors is needed to evaluate the value as predictive markers.

Clinical study of adenoid cystic carcinoma of the head and neck

OBJECTIVE

We examined prognostic factors and outcome of the primary treatment in patients with adenoid cystic carcinoma (ACC) of the head and neck.

METHODS

Twenty patients with ACC of the head and neck who had been treated in our institution from 1985 to 1998 were enrolled in this study. Disease-specific survival rate was analyzed by the Kaplan-Mejer method, and the log-rank test was applied to compare the survival rates.

RESULTS

The overall 5- and 10-year survival rates determined by Kaplan-Meier analysis were 81 and 57%, respectively. Patients with major salivary gland ACC obtained the best 10-year survival rate (83%), while those with paranasal sinus ACC had the worst survival rate (33%). Predominance of the solid component on pathological examination might indicate a worse prognosis. Our study revealed that postoperative radiotherapy could yield better control of the lesion focus. Chemotherapy failed in some patients and was not dramatically effective by itself.

CONCLUSIONS

The long-term prognosis of ACC was poor. Long-term follow-up is necessary for better prognosis of patients treated with radical treatment regimens.

Therapy for otitis-prone children in Tenshi hospital

With the recent emergence and increases of multiple-drugs-resistant Streptococcus pneumoniae, we have been seeing an increasing number of infants with intractable recurrent otitis media which is resistant to the general conservative out-patient treatments such as oral administration of medicines or tympanotomy. In this study, we investigated the inflammation-causing bacteria in the infants with otitis media which were treated in our hospital from January to December in 1997, and in six serious cases among them, we measured IgG subclass and specific IgG2 antibody to S. pneumoniae to examine them. As a result, S. pneumoniae was found to be the cause in 45% of the cases of initial development of otitis media, and in 88% of them the S. pneumoniae was penicillin-resistant. The level of specific IgG2 antibody to S. pneumoniae was low in all the cases, whereas IgG2 subclass was deficient only in one out of the six cases; from these findings, the selectively low level of immune status was thought to be the cause of the recurrences of otitis media. In two cases, clinical condition was markedly improved by immunoglobulin substitute therapy, which demonstrates that immunoglobulin is effective for the intractable recurrent otitis media in infants.

Myeloperoxidase-antineutrophil cytoplasmic antibody-associated sensorineural hearing loss

A 36-year-old female with hyperthyroidism that had been treated with propilthiouracil (PTU) complained of tinnitus and hearing loss in both ears. She was treated with steroid administration by an otolaryngologist; however, hearing continued to fluctuate when the steroids were tapered. Laboratory evaluation revealed a decreased complement level and elevated levels of immunoglobulin M (IgM) and myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA). With the withdrawal of PTU and high-dose methylprednisolone, she had excellent return of right-sided hearing. In recent years, there have been many reports about MPO-ANCA-associated small vessel vasculitis. Although any organ may be affected by this disease, there are no reports about MPO-ANCA-associated progressive hearing loss without any other organ involvement. The present case suggests the possibility that inner ear blood flow impairment due to ANCA-associated small vessel vasculitis induces the so-called autoimmune sensorineural hearing loss.

Relapsing polychondritis: a report of eight cases

OBJECTIVE

To investigate clinical manifestations of relapsing polychondritis and to clarify the significance of type II collagen antibody in the disease.

METHODS

Clinical manifestations and antibody titers were examined in eight cases of relapsing polychondritis which had been treated at Otolaryngology Department, Hokkaido University during the eight years from 1991 to 1998. Anti-type II collagen antibody titer was measured by ELISA method.

RESULTS

The most frequent symptom was auricular chondritis; it was seen in 88% (7/8) of the cases. Ocular symptom, nasal chondritis, arthritis, respiratory tract chondritis, and audio-vestibular symptom were also common in the cases. Compared with previous reports, no difference was recognized in the manifestation frequency. Considering none of the samples from the controls was positive for anti-type II collagen antibody, two samples from the disease group were positive. The antibody positive rate was 25% (2/8).

CONCLUSION

Though the measurement of type II collagen antibody titer is not a decisive factor for detection of relapsing polychondritis, it is useful as one of the complementary factors for the diagnosis, since there is no specific test for this disease.

Preserved otoacoustic emission in a child with a profound unilateral sensorineural hearing loss

We report a case of profound unilateral sensorineural hearing loss with good response of otoacoustic emission. The patient was a 5-year-old boy. who was diagnosed to have unilateral hearing impairment on pure tone audiometry at the first visit. The affected ear showed the absence of auditory brainstem response; however, its transiently evoked otoacoutic emission and distortion product otoacoustic emission were considered to be normal. These findings indicated that the outer hair cell of cochlea was not impaired and that the impairment should be localized between inner hair cells, primary afferent fiber or its synapses, spiral ganglion of the cochlea and acoustic fiber, or at a combination of these areas. That is, evaluation of otoacoustic emission was useful in determining the region of impairment in sensorineural hearing loss. Further follow-up will be necessary to differentiate the present case from auditory neuropathy.

Springtime pollinosis and oral allergy syndrome in Sapporo

OBJECTIVE

The purpose of this present study was to investigate pollinosis in the spring and oral allergy syndrome (OAS) in Sapporo to utilize it for future treatment.

MATERIALS AND METHODS

Of the patients referred to our out-patient clinic during April and May in 1999. all those that were suspected to have pollinosis were asked to fill in a questionnaire. A 101 patients (30 males and 71 females) with a mean age of 33 years (range 7-74 years) answered the questionnaire. In all, the patients specific IgE tests were performed.

RESULTS

The most common allergen was birch, affecting 54 of 87 patients (62%). In 61% of patients with birch allergy, we observed fruit and vegetable allergy. Among them, apple was the most prevalent allergen (97%), followed by peach (67%), cherry (58%), pear (40%), plum (40%) and melon (33%). The sensitivity of skin prick test with commercial extract to apple was low (11%).

CONCLUSION

Patients with birch pollen allergy had OAS much more frequently than ever reported in Japan, although OAS has not widely been known in Japan. Patients with birch pollen allergy should be informed about the possibility of hypersensitivity to certain fruits.