Type 2 chronic rhinosinusitis (CRS), especially eosinophilic CRS (ECRS), is an intractable upper airway inflammatory disease. Establishment of serum biomarkers reflecting the pathophysiology of CRS is desirable in a clinical setting. As IgG4 production is regulated by type 2 cytokines, we sought to determine whether serum IgG4 levels can be used as a biomarker for CRS. Association between the serum IgG4 levels and clinicopathological factors was analyzed in 336 CRS patients. Receiver operating characteristics (ROC) analysis was performed to determine the cut-off value of serum IgG4 levels that can be used to predict the post-operative recurrence. Serum IgG4 levels were significantly higher in patients with moderate to severe ECRS versus those with non to mild ECRS. The levels were also significantly higher in asthmatic patients and patients exhibiting recurrence after surgery compared to controls. ROC analysis determined that the best cut-off value for the serum IgG4 level to predict the post-operative recurrence was 95 mg/dL. The corresponding sensitivity and specificity were 39.7% and 80.5%, respectively. When we combined the two cut-off values for the serum IgG4 and periostin, patients with high serum levels of either IgG4 or periostin exhibited a high post-operative recurrence (OR: 3.95) as compared to patients having low serum levels of both IgG4 and periostin. The present results demonstrate that the serum IgG4 level is associated with disease severity and post-operative course in CRS. In particular, the combination of serum IgG4 and periostin could be a novel biomarker that predicts post-operative recurrence.

Periostin

Pathophysiology

10.1016/j.alit.2019.12.004

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Citations (16)

Presence of Human Papillomavirus Type 6f in Tonsillar Condyloma Acuminatum and Clinically Normal Tonsillar Mucosa

Japanese Journal of Clinical Oncology (1996)

S Tominaga K Fukushima Kazunori Nishizaki Shogo Watanabe Yu Masuda

An attempt was made to detect human papillomavirus (HPV) in 8 cases of oral papilloma by Southern blot hybridization. HPV type 6 was identified in a case of tonsillar condyloma acuminatum, but neither HPV type 6 nor 11 was found in the 7 other cases of squamous papilloma. The hybridization pattern of the HPV type 6 DNA after digestion with restriction enzymes revealed that the HPV was of the 6f subtype. DNA samples isolated from the condyloma acuminatum, 3 peripheral specimens of clinically normal tonsillar mucosa, a swab sample and saliva from the male patient with this tonsillar condyloma acuminatum were examined further by polymerase chain reaction (PCR). HPV type 6 DNA was detected in the tonsillar condyloma acuminatum and the 3 specimens of clinically normal tonsillar mucosa, but no HPV type 6 DNA was detectable in the normal tonsillar mucosa by Southern blot hybridization using a whole HPV DNA probe. The presence of a small amount of HPV in clinically normal tissue detectable only by PCR suggests latent infection of peripheral tissues with HPV produced from the condyloma acuminatum. Although HPV type 6 DNA was not detectable in the swab and saliva samples of this single case, further study is necessary for the clinical application of preoperative virological diagnosis by PCR using these samples.

Condyloma Acuminatum

Southern blot

Koilocyte

Papillomaviridae

10.1093/oxfordjournals.jjco.a023254

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Citations (28)

Minimally Invasive Procedure for Accurate Diagnosis of Mucosa-associated Lymphoid Tissue Lymphoma of the Head and Neck

Japanese Journal of Clinical Oncology (2012)

Yorihisa Orita Yumiko Sato Eisei Kondo Hisashi Ishihara H. HIRAI

Sonography-guided cutting needle biopsy for the diagnosis of malignant lymphoma has recently come into wide use. However, surgery is sometimes unavoidable for the diagnosis of malignant lymphoma, particularly for low-grade malignant lymphoma such as extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue, because cutting needle biopsy offers limited diagnostic accuracy for low-grade malignant lymphoma. Of course, unnecessary invasive procedures like open biopsy should be avoided wherever possible, given the cosmetic problems and burden on the patient. We tried to diagnose malignant lymphoma using the combination of cutting needle biopsy, flow cytometry and polymerase chain reaction to identify monoclonal rearrangement of immunoglobulin heavy chain genes. We have used this method in two cases in whom malignant lymphoma was suspected in the head and neck region, allowing diagnosis of mucosa-associated lymphoid tissue lymphoma in both cases. One case involved a 23-year-old woman with mucosa-associated lymphoid tissue lymphoma in the parotid glands, and the other involved a 77-year-old man with mucosa-associated lymphoid tissue lymphoma in the thyroid. The combination of cutting needle biopsy, flow cytometry and immunoglobulin heavy chain gene rearrangement testing might offer a useful alternative to open biopsy for the diagnosis of mucosa-associated lymphoid tissue lymphoma. We recommend this procedure, particularly for young women or patients with poor performance status in whom malignant lymphoma is suspected.

Mucosa-associated lymphoid tissue

10.1093/jjco/hys011

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Citations (7)

Guidelines for acute otitis media in children

Okayama Igakkai Zasshi (Journal of Okayama Medical Association) (2014)

Yuko Kataoka Kazunori Nishizaki

急性中耳炎は3歳までに85%の児が1度は罹患するといわれている大変罹患率の高い疾患である.本邦においては2006年に“小児急性中耳炎診療ガイドライン”初版が作成され, 日常診療において活用されるようになった.しかしその頃においても, 依然小児急性中耳炎に関しては各国間で治療効果に関する見解の差から,治療方針にも大きな隔たりがあり,オランダを代表する欧州国の中には「小児急性中耳炎には抗菌薬を使用しない」という驚くべき方針で治療が行われている国もあった. 2011年頃,重症度診断を用いたエビデンスレベルの高い研究が発表されたことにより,ようやく諸外国ともに方向性の一致する治療が行われるようになった.本邦では2013年に,起炎菌の変化とその感受性,重症度判定基準の見直し,検査キットやワクチン,薬剤の新規導入や変化などを反映させた改訂第3版が作成,出版されている.本稿では2013 年版小児急性中耳炎診療ガイドラインの内容について概説する. 診断・重症度分類

Acute Otitis Media

10.4044/joma.126.241

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Citations (1)

A Case of Traumatic Disruption of the Ossicular Chain Detected with Reconstruction Techniques Multiplanar and Three-dimensional Computed Tomography

Practica Oto-Rhino-Laryngologica (2012)

Aya Murai Kozo Tamura Akira Doi Shin Kariya Kazunori Nishizaki

High-resolution computed tomography (CT) demonstrates the osseous structures of the temporal bone, and is particularly useful for diagnosis of middle ear diseases leading to conductive hearing loss. The axial and coronal section planes are commonly used for a conventional CT diagnosis of the temporal bone. In recent years, oblique section plane reformatted by high-resolution multiplanar reconstruction (MPR) CT images and three-dimensional (3D) CT images have allowed more detailed examinations of the ossicular chain. The creation of additional MPR images and 3D reconstruction images from the original CT data set can help overcome the limitations of conventional CT images by providing a more anatomically meaningful display of complex structures in the temporal bones. We report herein on the MPR-CT and 3D-CT findings of a case of traumatic ossicular chain disruption. A 27-year-old female had fractures of the cranial base, temporal bone, mandible, zygomatic bone, and optic canal sustained as the result of a traffic accident. She also had tinnitus and hearing loss in her right ear, and was referred to the Department of Otolaryngology. Her tympanic membranes were intact, and audiological examination revealed severe conductive hearing impairment in the right side. Conventional axial and coronal CT images showed no remarkable findings without temporal bone fracture, and the diagnosis of ossicular chain disruption was confirmed by intraoperative findings. We performed a type III-i tympanoplasty, and both conductive hearing loss and tinnitus improved. MPR-CT images and 3D reconstruction CT images showed the disruption in the ossicular chain. In conclusion, recent developments of image-processing technologies including MPR and 3D reconstruction provide a better understanding of middle ear diseases.

Conductive hearing loss

High-resolution computed tomography

10.5631/jibirin.105.939

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Citations (1)

Histopathological incidence of facial canal dehiscence in otosclerosis

European Archives of Oto-Rhino-Laryngology (2011)

Shigenobu Nomiya Sebahattin Cüreoğlu Shin Kariya Norimasa Morita Rie Nomiya

Facial canal

Oval window

Geniculate ganglion

Round window