Language：Japanese   Publisher：日本シミュレーション医療教育学会  

researchmap

Language：Japanese   Publisher：日本シミュレーション医療教育学会  

researchmap

Language：Japanese   Publisher：(一社)日本医学教育学会  

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本医学教育学会  

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.15694/mep.2018.0000125.1

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer New York LLC  

Introduction: We introduced laparoscopic simulator training for medical students in 2007. This study was designed to identify factors that predict the laparoscopic skill of medical students, to identify intergenerational differences in abilities, and to estimate the variability of results in each training group. Our ultimate goal was to determine the optimal educational program for teaching laparoscopic surgery to medical students. Methods: Between 2007 and 2015, a total of 270 fifth-year medical students were enrolled in this observational study. Before training, the participants were asked questions about their interest in laparoscopic surgery, experience with playing video games, confidence about driving, and manual dexterity. After the training, aspects of their competence (execution time, instrument path length, and economy of instrument movement) were assessed. Results: Multiple regression analysis identified significant effects of manual dexterity, gender, and confidence about driving on the results of the training. The training results have significantly improved over recent years. The variability among the results in each training group was relatively small. Conclusions: We identified the characteristics of medical students with excellent laparoscopic skills. We observed educational benefits from interactions between medical students within each training group. Our study suggests that selection and grouping are important to the success of modern programs designed to train medical students in laparoscopic surgery.

DOI： 10.1007/s00464-017-5643-5

Scopus

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

It is predicted that in the near future robot simulated patients (SPs) will come into use. Through the impressions of five SPs about robot SPs, we explored their vision of the future of medical education as an indicator of what ordinary citizens think. The opinions of SPs were collected using a semi-structured focus group interview, after which the perspectives provided were explored using a qualitative research method called Steps for Coding and Theorization (SCAT). Although SPs accepted the introduction of robot SPs, they regard them as potential substitutes. The use of robot SPs raised concerns about the level of response to human diversity and the level of emotional intelligence. The problem of how much diversity among patients and doctors is acceptable in the field of education was identified. On the part of citizens, there is not much expectation that artificial intelligence (AI) will lead to sophisticated machines capable of human conversation. However, looking ahead to the AI era, real SPs anticipate that, along with the evolution of AI, the next generation of SPs will have thought deeply about their role within a program employing both humans and robots.

DOI： 10.1272/jnms.JNMS.2018_85-57

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

INTRODUCTION: Definitive assessment of laparoscopic skill improvement after virtual reality simulator training is best obtained during an actual operation. However, this is impossible in medical students. Therefore, we developed an alternative assessment technique using an augmented reality simulator. METHODS: Nineteen medical students completed a 6-week training program using a virtual reality simulator (LapSim). The pretest and post-test were performed using an object-positioning module and cholecystectomy on an augmented reality simulator(ProMIS). The mean performance measures between pre- and post-training on the LapSim were compared with a paired t-test. RESULTS: In the object-positioning module, the execution time of the task (P < 0.001), left and right instrument path length (P = 0.001), and left and right instrument economy of movement (P < 0.001) were significantly shorter after than before the LapSim training. With respect to improvement in laparoscopic cholecystectomy using a gallbladder model, the execution time to identify, clip, and cut the cystic duct and cystic artery as well as the execution time to dissect the gallbladder away from the liver bed were both significantly shorter after than before the LapSim training (P = 0.01). CONCLUSIONS: Our training curriculum using a virtual reality simulator improved the operative skills of medical students as objectively evaluated by assessment using an augmented reality simulator instead of an actual operation. We hope that these findings help to establish an effective training program for medical students.

DOI： 10.1111/ases.12209

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：MEDICAL ASSOC NIPPON MEDICAL SCH  

International accreditation of medical education was introduced in Japan in 2013 and is planning to be applied in late 2014 or 2015. Students will need to cope with the resulting changes and to recognize by what route they will learn medicine. Therefore, a freshman orientation course, which was based on problem-based learning (PBL) and had been held for first-year students, was modified as an awareness reform program in which students would learn "how to learn medicine." We investigated whether this program has led to useful changes in students' recognition of the way of learning in medical school and their directions as learners. The program was held for 114 first-year medical school students in 2013 and consisted of PBL tutorials, large-classroom lectures, simulation learning using role-play with simulated patients, and team-based learning (TBL), presented in this order. Learning modules that is made with an integration of the clinical sciences with the basic biomedical and the behavioral and social sciences were provided. A nonanonymous questionnaire survey asking "what learning methods are effective for you?" was conducted before and after completion of the course. Furthermore, group answers obtained in TBL were investigated. The score for the question "To what extent can you imagine your route of learning during your 6 years?" significantly increased from 3.1 +/- 0.99 (mean +/- SD) before the course to 3.5 +/- 0.88 (p&lt;0.01) after the course. The score for the question "To what extent is the small-group learning, such as PBL, useful for you?" significantly increased from 3.9 +/- 0.73 to 4.2 +/- 0.71 (p&lt;0.05). Group responses in TBL sessions indicated that students desired classes that presented tasks and regarded "emphasis on reflection" and "observation of senior physicians as role models" as the most important methods for learning interview skills. We believe students should acquire active learning attitudes as adults early in their 6 years of medical school. The level of understanding of "how to learn as adults" was 3.7 and indicated a moderate result. This course employed many educational strategies, and we believe it helped students understand what they learn and how to learn during their 6 years of medical and to get an overview of the learning roadmap.

DOI： 10.1272/jnms.81.378

Web of Science

PubMed

researchmap

Language：Japanese   Publisher：(一社)日本医学教育学会  

DOI： 10.11307/mededjapan.44.365

CiNii Books

researchmap

Other Link： https://jlc.jst.go.jp/DN/JLC/20012759796?from=CiNii

Language：Japanese   Publisher：(一社)日本外科学会  

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：MEDICAL ASSOC NIPPON MEDICAL SCH  

Following the "Guidelines for reporting TBL" by Haidet et al, we report on a team-based learning (TBL) course we adopted for our 4th-year students in 2011. Our TBL course is a modified version of the one suggested in the guidelines, but its structure generally follows the core elements described therein. Using an audience response system (ARS), we were able to obtain individual and group readiness assurance test scores immediately and give instant feedback to the students. Instructors were thus able to monitor students' understanding in real time and so appreciated the system, which supports interactive classes even in large classrooms. However, TBL is teacher-oriented, and students were less appreciative of ARS, because they recognized that it could be easily used for grading. Nevertheless, we believe that a combination of TBL, and problem-based learning in a mature design can improve both motivation and understanding among learners. (J Nippon Med Sch 2013; 80: 63-69)

DOI： 10.1272/jnms.80.63

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：MEDICAL ASSOC NIPPON MEDICAL SCH  

Solitary fibrous tumor is a rare neoplasm, which was first described as a primary spindle-cell tumor of the pleura, is a type of mesenchymal tumor. Although the majority of these tumors originate in the pleura, they can also derive from extrapleural sites, such as the liver. lung, abdomen, and extremities. We report a rare case of a nasal solitary fibrous tumor that originated from the nasal superior turbinate. The tumor. measuring 45 x 25 x 10 mm, was in the right nasal cavity. We successfully removed the tumor in one piece through endonasal endoscopic surgery. The tumor had spindle-shaped cells within a collagenous stroma and was positive for CD34. There has been no evidence of tumor recurrence in the 14 months following surgery. (J Nippon Med Sch 2012: 79: 373-376)

DOI： 10.1272/jnms.79.373

Web of Science

PubMed

researchmap

Language：Japanese   Publisher：日本医科大学医学会  

医学教育におけるproblem-based learning(問題に基づく学習、PBL)の歴史的経緯、基本概念について述べ、狭義のPBL、小グループ学習、自己主導型学習、自己評価型学習およびPBLのアウトカムについて概説した。PBLを根幹としたカリキュラムは、将来において実際に患者を診る際に、自らの責任において学んだ知識を適用し、技術を用い、患者、家族やスタッフとコミュニケーションをとりながらその患者の抱える問題の解決を行える人材を育成することができると考えられる。

DOI： 10.1272/manms.8.188

CiNii Books

J-GLOBAL

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

Adrenomedullin (AM) is a potent hypotensive and vasodilatory peptide. AM may exert protective actions against the development of many diseases by modulating the blood circulation and body fluid balance. In addition to these functions, it has recently been reported to play important roles in the development of allergy and infections. The purpose of the present study was to demonstrate the existence of AM in the human nasal mucosa and to discuss whether AM might contribute to the pathogenesis of nasal congestion. We measured the total AM concentrations in the nasal discharge. The total AM concentration in the nasal discharge was significantly higher in the non-allergy group (72.1 +/- 55.5 fmol/ml) than in the allergy group (37.1 +/- 44.2 fmol/ml). By immunohistochemical examination, we identified AM-containing cells in the nasal mucosa from both subjects with and without nasal allergy, and also in nasal polyps. Moreover, those cells were positive for anti-tryptase antibody which recognizes mast cells. In nasal allergy, vasodilatation and increase in vascular permeability are characteristic features of the immediate phase response. Reduced AM levels in the nasal discharge may be associated with attenuation of both of these factors. On the other hand, immunohistochemical analysis demonstrated AM-immunoreactive cells in the chronic phase of rhinosinusitis. In the late and inflammatory phase, mast cells produce AM, which possibly acts as an inhibitor of inflammatory cell migration. In conclusion, AM may be actively secreted into the nasal discharge. AM in the nasal discharge may have protective and anti-inflammatory effects in the nasal mucosa. (C) 2010 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.peptides.2010.10.028

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

Myoepithelioma is a rare neoplasm that can occur in either the major or minor salivary gland and accounts for less than 1% of salivary gland neoplasms. We report a rare case of a nasal myoepithelioma that originated from the nasal inferior turbinate. The tumor, measuring 50 x 30 x 20 mm, was in the right nasal cavity and had a necrotic surface. We removed the tumor through endonasal endoscopic surgery. The tumor had spindle-shaped cells and was positive for cytokeratin, (AE1/AE3), vimentin, S-100β, and MIB-1 but was negative for CD34, desmin, neuron-specific enolase, and synaptophysin. Slight immunoreactivity for smooth muscle actin was noted in some tumor cells. There has been no evidence of tumor recurrence in the 18 months following surgery.

DOI： 10.1272/jnms.77.273

Scopus

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：TAYLOR & FRANCIS AS  

Conclusions: Computer processing of conventional CT images can provide virtual endoscopic images (VEIs). Surgeons observing these images feel as if they are observing the lesion using an endoscope. Simulation based on animated VEIs before endoscopic sinus surgery (ESS) is useful for the improvement of surgical safety and surgeons&apos; education. Although the production of VEIs requires certain surgical experience, after the production of VEIs, surgeons can repeat simulation of a surgical procedure and have confidence in the actual operation. Objective: We investigated the clinical application of CT-reconstructed VEIs as a support system for ESS. Materials and methods: A GE Light Speed Ultra 16 as a 16-slice CT scanner and Advantage Workstation 4.2 were used. Software called Navigator in this workstation allows the production of CT-reconstructed VEIs. We applied simulation based on VEIs to endoscopic operations for mucocele or sinusitis. Results: In nine cases of mucoceles and sinusitis, simulation based on animated VEIs was applied. According to the simulation, surgeries were performed, and the mucoceles and obstructed sinuses could be opened readily and safely. This system was more effective when there were landmarks such as polyps or irregular mucosal surfaces allowing macroscopic confirmation ahead of the viewpoint.

DOI： 10.1080/00016480802360640

Web of Science

PubMed

researchmap

Language：Japanese   Publisher：東京女子医科大学学会  

2005年にマクマスター大学ではCOMPASSと呼ばれる新しいカリキュラムを導入した。これは医学を11の重要なConceptから理解し修得することを目標としており、従来の臓器別に構成されたカリキュラムとは異なる。「ヒトはConceptをいかに学び活用するか」という点に関する認知心理学的研究の成果に基づいている。ひとつのConceptを他の場面で活用するには、他ともリンクさせつつ綿密にデザインされた順序、頻度で学習者に提示したうえで、これを使いこなすPracticeをさせる必要がある。従来のproblem-based learningテュートリアルを学習の中心的位置付けとしている一方で、Conceptを適切に提示し、他と統合させる上での手段として講義形式も重視する。Practiceを行う上では学内Webサイトを利用したe-learning、各種シミュレーションツールなども用いる。臨床実習もCOMPASSに密接にリンクした形で行われる。さらに臨床医1名とコメディカル1名がペアとなり10名の学生を受持つprofessional competenciesテュートリアルも導入され、医療従事者として身に付けるべき技能、倫理観、コミュニケーション能力なども学ぶ。この一連のカリキュラム改訂はマクマスターの教職員にとって、全人的医療人育成という使命において新しい活力を与えるものと認識されている。(著者抄録)

CiNii Books

J-GLOBAL

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society of Allergology  

Background: CC chemokines have been shown to play an important role in inducing selective recruitment of inflammatory cells into local allergic inflammatory sites. CC chemokines are also known as histamine releasing factors. We previously showed that histamine enhances transcription of CC chemokines from nasal mucosa which leads to further induction of histamine release. This cyclic cascade may cause prolonged allergic inflammation. The aim of this study is to clarify the relationship between histamine and CC chemokine production by using human nasal epithelial cells (HNECs) and to examine the potential of H1 receptor (H1R) antagonists in new therapeutic approaches for the treatment of nasal allergy. Methods: HNECs were isolated from the nasal turbinates of patients diagnosed with nasal allergy. HNEC monolayers were cultured for 48 hours with or without histamine (10-3 to 1 10-5 mol/L). Furthermore, an H1R antagonist, either carebastine or olopatadine, was added to the supernatant (10-3 to 10-7 mol/L) 30 minutes before incubation with histamine. The expression of Regulated on Activation, Normal T-cell Expressed and Secreted (RANTES) and monocyte chemotactic protein-1 (MCP-1) in the culture media were measured by ELISA. Results: The release of RANTES and MCP-1 was significantly upregulated by histamine compared with the control group. Both carebastine and olopatadine inhibited the release of CC chemokine production to the control level in both groups. Conclusions: This study suggests that the interaction between histamine and CC chemokines may prolong allergic inflammation in human nasal mucosa. We also demonstrate the potential use of H1R antagonists in new therapeutic approaches to the treatment of nasal allergy through inhibiting this histamine-CC chemokine interaction. ©2007 Japanese Society of Allergology.

DOI： 10.2332/allergolint.O-06-446

Scopus

PubMed

researchmap

Language：Japanese   Publisher：Society of Oto-rhino-laryngology Tokyo  

A multicenter study of combination therapy for Japanese-cedar pollinosis consisting of ramatroban plus an antihistamine was conducted in Tokyo during 2005, when pollen levels were at record highs. A pollinosis diary and Japanese Allergic Rhinitis Standard QOL Questionnaires (JRQLQ No. 1 and No. 2 for symptoms other than nose and eye symptoms) were used to assess the effect of combination therapy on nasal symptoms and quality of life. A comparison was made between patients who received prophylactic treatment and those who were treated only after the start of the pollen season. Both the nasal symptom scores and quality of life scores at the peak of the pollen season were better in the prophylaxis group than the other group. No adverse reactions were reported. These results suggest that combination therapy consisting of ramatroban and an antihistamine, which have different mechanisms of action, is useful for improving nasal symptoms and improving quality of life during the peak pollen season, even in a year when a large quantity of pollen exceeding 10, 000/cm2 is present in the air.

DOI： 10.11453/orltokyo1958.48.427

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCI LTD  

Objective: In the year 2000, the Otological Society of Japan proposed a new criteria to assess the levek of hearing known as Criteria 2(m. However, these criteria are intended to assess pure tone threshold after tympanoplasty and the results do not necessarily reflect the hearing condition from the patient's perspective. Thus, it is essential to stud), the relationship between the subjective evaluation ot post-operative hearing based oil the patient's own assessment and the objective assessment by audiometry. Methods: The present study is a questionnaire-based survey on the levels of post-operative hearing in 460 patients whose degree of satisfaction with their levels of hearing was assessed by visual analogue scale (VAS). The hearing level was assessed based on the Criteria 2000 established by the Otological Society of Japan. Results: The post-operative results indicated a success rate of 78.7%. According to the questionnaire-based survey, 64.4% patients considered their hearing as "improved". The average VAS score was the highest in the "improved" group and gradually decreased when in the "deteriorated" group. The highest success rate was obtained in patients who assessed their hearing as "improved" and the lowest rate was seen in those who assessed their hearing as "deteriorated". On the other hand, the success rate in the three groups. "slightly improved". "unchanged", and "slightly deteriorated", was almost similar and did not relate to the objective audiometry findings. Therefore. except for the "improved" and deteriorated" groups, there is no relation between the subjective self-assessment and the objective post-operative, hearing. Conclusion: A bi-directional approach. one from an audiological (objective) and one front the patient's perspective (subjective). especially using VAS. is quite useful for the post-operative assessment of hearing, (C) 2004 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.anl.2004.03.010

Web of Science

PubMed

researchmap

Language：English  

A questionnaire survey was conducted in 324 patients with chronic, simple, suppurative otitis media who had undergone tympanoplasty 6 months or more previously to investigate post-operative hearing, tinnitus, vertigo, occlusive feeling of the ear and otorrhea. In addition, the overall satisfaction with tympanoplasty was assessed by VAS value. Subjective hearing improvement was observed in 73.1% of the patients whose hearing was poor and in 50% of those whose hearing was good before the operation. The degree of satisfaction assessed by VAS value corresponded with the subjective hearing assessment. As to tinnitus, 66.2% of the patients became aware of the disappearance or alleviation of symptoms. In the case of patients who had tinnitus before the operation, the degree of awareness of tinnitus and the degree of satisfaction assessed by VAS value coincided. However, no changes in the VAS value were observed in those who did not have tinnitus before the operation. As for vertigo, 30.5% of the patients who had vertigo preoperatively became aware of the disappearance of the symptoms after the operation. The degree of satisfaction assessed by VAS value corresponded with the presence or absence, severity and frequency of vertigo. As to the fullness of the ear, alleviation of the symptoms was subjectively noted by 85.9% of the patients who had symptoms before the operation. The degree of satisfaction assessed by VAS value corresponded with the severity of the symptoms in those who had symptoms before the operation. As for otorrhea, the disappearance of the symptoms was subjectively noted by 85.5% of the patients who had otorrhea before the operation. The degree of satisfaction assessed by VAS value corresponded with the post-operative changes in otorrhea. Based on the above results, it was assumed that the patients placed greatest expectation on hearing improvement when they underwent tympanoplasty. VAS is considered a useful method to evaluate the degree of satisfaction of patients after surgery.

DOI： 10.1272/jnms.71.17

Scopus

PubMed

researchmap

Language：English   Publisher：PROUS SCIENCE, SAU-THOMSON REUTERS  

Histamine is recognized as an important mediator of allergic rhinitis. In addition to the role it plays in the immediate-phase reaction of nasal allergy, histamine may play an important role in the late-phase reaction and protracted allergic inflammation. Histamine induces the synthesis or secretion of proinflammatory cytokines and the expression of adhesion molecules. Besides their traditional effects via Hi receptor antagonism, antihistamines have been reported to possess multiple antiinflammatory effects. Continuous use of antihistamines may reduce the level of minimal persistent inflammation of nasal mucosa in allergy. Treatment of allergic rhinitis using antihistamines could contribute to the improvement in coexisting allergic inflammation of the lower airways. (C) 2001 Prous Science. All rights reserved.

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：MOSBY-ELSEVIER  

Background: Allergic rhinitis is characterized by tissue accumulati on of inflammatory cells. CC chemokines, including monocyte chemotactic protein (MCP) 1, MCP-3, RANTES, and eotaxin, are thought to play an important role in inducing selective recruitment of these cells to the allergic inflammatory site. Furthermore, MCPs have been indicated as histamine-releasing factors. Histamine is an important mediator in the pathogenesis of nasal allergy. The regulation of histamine may have a role In the management of allergic inflammation.
Objective: The objectives of this study were to investigate the expression of MCP-1, MCP3, RANTES, and eotaxin In the nasal mucosa of patients with allergic rhinitis and to clarify the effect of histamine and antihistamine on the regulation of the expression of these CC chemokines.
Methods: By using a semiquantitative reverse transcriptase PCR technique, the numbers of copies of messenger RNA encoding MCP-1, MCP-3 RANTES, and eotaxin were measured in explant cultures of human nasal mucosa. In culture medium specific antigen or histamine was added. Furthermore, the effect of preincubation with the antihistamine carebastine was estimated.
Results: Mite antigen (1:2 x 10(4) dilution) and histamine (10(-4) to 10(-3) mol/L) upregulated the messenger RNA expression of these CC chemokines at 3- to 10-fold increases. Carebastine (10(-7) to 10(-6) mol/L,) inhibited this upregulation.
Conclusion: Our results suggest that histamine may induce CC chemokine production in the nasal mucosa of patients with allergic rhinitis. This Indicates that there may be a prolonged inflammatory cycle in the histamine-MCP axis In allergic rhinitis, The regulation of histamine-CC chemokine interaction could lead to new therapeutic approaches in the treatment of nasal allergy.

DOI： 10.1067/mai.2001.111236

Web of Science

PubMed

researchmap

Language：Japanese   Publisher：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.48.979_3

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：AMER MEDICAL ASSOC  

Objectives: To demonstrate the existence and localization of monocyte chemotactic and activating factor or monocyte chemoattractant protein-1 (MCAF/MCP-1) in human nasal mucosa and to verify its activity as a histamine-releasing factor.
Design: Detection of MCAF/MCP-1 in culture supernatants of nasal mucosa using Western blot analysis and assay of histamine release from basophils induced by these culture supernatants. Detection of MCAF/MCP-1 expression in nasal mucosa of patients with perennial allergic rhinitis using immunohistochemistry.
Patients: Twenty-one patients with house dust mite allergy, 7 nonallergic patients, and 5 patients with chronic inflammatory sinusitis participated in the study. All the allergic patients had positive test results for mite nasal allergy, detected,by a clinical history, a nasal provocation test, and determination of specific mite IgE antibodies by a radioallergosorbent test.
Results: In Western blot analysis of supernatants of explant culture of human nasal mucosa, the band corresponding to approximately 13 to 15 kd was observed. This band was considered to be MCAF/MCP-1. These supernatants induced histamine release from basophils (approximately 3%-5% in net histamine release), and anti-MCAF/MCP-1 antibody inhibited this histamine-releasing activity. Immunoreactivity of MCAF/MCP-1 was observed in the nasal submucosa but not in the epithelium. Immunoreactive cells of MCAF/MCP-1 were also stained with the antibody, which recognizes monocytes and macrophages.
Conclusions: These results suggest that MCAF/MCP-1, which is produced constantly by monocytes and macrophages and is stored in human nasal mucosa, possibly participates in the protracted histamine release from basophils and in the pathogenesis of perennial allergic rhinitis.

Web of Science

PubMed

researchmap

Language：Japanese   Publisher：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.47.1033_2

researchmap

Language：Japanese   Publisher：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.46.929_3

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：MOSBY-YEAR BOOK INC  

Background: In allergic rhinitis, metachromatic cells in the nasal epithelium increase in number and are thought to play an important role in nasal allergic manifestation.
Methods: To determine immunohistochemical and functional characteristics of the metachromatic cells, nasal scrapings and their dispersed cells from patients with perennial allergic rhinitis were studied.
Results: Eighty-three percent of all metachromatic cells in dispersed cell preparations were tryptase-positive mast cells (MC(T)), 10% were tryptase-chymase-positive cells (MC(TC)), and 7% were negative (n = 10), The mean histamine content per metachromatic cell was 1.9 +/- 0.2 pg. The histamine content and histamine release from nasal surface scrapings of patients sensitized with mire antigen were strongly correlated with the level of serum IgE antibody for mite antigen. The net histamine release from nasal scrapings was antigen-dose-dependent (1:2 x 10(7) to 1:2 x 10(3) dilution), and the antigen stimulated release of Icp to 17% of cell-associated histamine within 5 to 7 minutes. Histamine release from nasal scrapings induced by calcium ionophore A23187 was lip to 21% of cell-associated histamine within 2 to 4 minutes, but no histamine release was stimulated by compound 48/80 substance P, ol poly-L-lysine. Histamine release fi on? nasal scrapings was inhibited 46% (10(-5) mol/L) to 96% (10(-4) mol/L) by quercetin and 58% (10(-4) mol/L) to 72% (10(-3) mol/L) by sodium cromoglycate.
Conclusions: These findings show the predominant characteristics of mast cells in the nasal epithelium in allergic rhinitis, and this information may be useful in relation to a therapeutic approach.

Web of Science

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：(一社)日本耳鼻咽喉科学会  

Recently monocyte chemotactic and activating factor (MCAF) has been reported to be a potent histamine releasing factor (HRF) for human basophils. In this study we investigated the localization and biological activity of MCAF in human nasal mucosa. To investigate the localization of MCAF within the nasal mucosa we performed specific immunohistochemica! staining of sections of large pieces of the inferior turbinate obtained by conchotomy from patients with nasal allergy and without nasal allergy and compared them. Sections of nasal mucosa from allergic subjects stained with anti-MCAF mAb demonstrated the presence of many MCAF-positive cells in the lamina propria especially around small vessels and excretory gland, but only a few positive cells were found in the nasal mucosa of normal subjects. We cultured allergic nasal mucosa and sinus mucosa from patients with chronic inflammation for 2 days and detected MCAF by western blot analysis of the culture supernatants. One portion separated from sinus mucosa supernatunt by column chromatography also released histamine from human basophils. Mean release was 3- 4% and the difference from the control was statistically significant (p&lt
0. 05). In the human nasal mucosa it seemed to exist IgE independent histamine releasing system sustained by MCAF producing cells. These results suggested that MCAF is one of the important mediators causing histamine release in the late phase reaction and in protracted inflammation of the nasal mucosa. © 1995, The Oto-Rhino-Laryngological Society of Japan, Inc. All rights reserved.

DOI： 10.3950/jibiinkoka.98.579

Scopus

PubMed

J-GLOBAL

researchmap

Language：Japanese   Publisher：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.43.1054_4

researchmap

Language：Japanese   Publisher：Japan Rhinologic Society  

We have examined the influence of preservation before fixation and the procedure of making permanent section on the staining properties of mast cells in human nasal mucosa. Operative specimens of human nasal mucosa was fixed in MLA (Mota's basic lead acetate fixative). And sections were stained with toluidine blue solution.<br>1. The influence of preservation of specimen in saline upon the stainability of mast cells.<br>Before fixation a part of specimen was rinsed and preserved in saline for 1 hr. Another part of specimen was fixed directly in MLA without preserving in saline. There was no significant differnce of mast cell counts whether specimen was preserved in saline before fixation or not.<br>2. The influence of mounting procedure on the staining property of mast cells.<br>After fixation in Mota's BLA fixative, sections were stained with toluidine blue PH0.5. One drop of toluidine blue was put on the section and immediately mast cell count was done for 20min. After counting mast cells, the same section was rinsed in water and taken through graded alcohls to xylene and mounted in coverbond malinol. Then mast cell counting was done again. The number of mast cells in permanent section were fewer than that of mast cells counted immediately after staining. About 20% of mast cell stainability was reduced after mounting procedure. The reduction of stainability was seen in epithelial layer and in lamina propria at same grade.

DOI： 10.7248/jjrhi1982.31.2_259

J-GLOBAL

researchmap

Language：Japanese   Publisher：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.42.1312_1

researchmap

Language：Japanese   Publisher：耳鼻と臨床会  

アンケート調査を用い,術後経過観察しえたBlowout fracture 14症例について受傷部位,術式と予後との関係を検討した.治癒率は100%で,症状増悪例,不変例はなかった.術式,受傷から手術までの日数と予後との間には相関はなかったが,不完全治癒例には,頬骨,上顎骨骨折など骨折が広範囲に及ぶもの,骨折が後方にまで及ぶものが認められた

DOI： 10.11334/jibi1954.38.5_587

J-GLOBAL

researchmap

Language：Japanese   Publisher：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.41.1298_2

researchmap

Publisher：Japan Rhinologic Society  

From 1980 to 1986, 254 patients with nasal allergy were found to have sensitivity to Japanese Ceder Pollen at the ENT allergic clinic of Nippon Medical School. These patients were divided into two groups, one was treated with immunotherapy untill May 1987. Questionnaire were mailed to all the patients asking about severity of nasal symptom at the time of the first visit and after immunotherapy, and whether or not they were being treated with other methods for the last few seasons.<br>Answers were received from 144 patients. Improvement after the immunotherapy was noted 27% for 6 months, 48% for 7-24 months, 50% for 25 months or more of the immunotherapy.<br>Of 73 patients in the non-immunotherapy group 36% improved. There was no statistically significant difference in improvement between the immunotherapy group and the non-immunotherapy. Improvement at present time was noted 33% for 6 mouths, 37% for 7-24 months, 65% for 25 months or more of the immunotherapy with a significant difference compared with the non-immunotherapy group in which improvement noted 36%. In the percentage of the patients received other methods at present time there was no significant difference between the immunotherapy group and the non-immunotherapy.

DOI： 10.7248/jjrhi1982.29.2_241

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese   Publisher：日本医科大学医学会  

DOI： 10.1272/manms.12.141

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本医学教育学会  

researchmap

Language：Japanese   Publisher：(一社)日本医学教育学会  

researchmap

Language：Japanese   Publisher：(一社)日本医学教育学会  

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本医学教育学会  

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本医学教育学会  

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese   Publishing type：Meeting report   Publisher：(一社)日本医学教育学会  

researchmap

Language：Japanese   Publisher：医薬ジャーナル社  

CiNii Books

researchmap

Other Link： http://search.jamas.or.jp/link/ui/2013240418

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese   Publisher：一般社団法人日本外科学会  

CiNii Books

researchmap

Language：Japanese   Publisher：神奈川県医師会  

researchmap

Language：Japanese   Publisher：(一社)日本医学教育学会  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本耳鼻咽喉科学会  

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

J-GLOBAL

researchmap

Language：Japanese   Publisher：The Society of Practical Otolaryngology  

DOI： 10.5631/jibirin.105.178

CiNii Books

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本鼻科学会  

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

DOI： 10.11453/orltokyo.53.265

J-GLOBAL

researchmap

Language：Japanese  

DOI： 10.11453/orltokyo.53.s59

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

DOI： 10.11453/orltokyo.52.474

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

DOI： 10.15036/arerugi.58.1323_1

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

DOI： 10.15036/arerugi.58.426_3

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese   Publisher：医薬ジャ-ナル社  

CiNii Books

researchmap

Other Link： http://search.jamas.or.jp/link/ui/2008165125

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese   Publisher：医薬ジャ-ナル社  

CiNii Books

researchmap

Other Link： http://search.jamas.or.jp/link/ui/2006162239

Language：Japanese  

DOI： 10.15036/arerugi.54.1074_4

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

CiNii Books

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

DOI： 10.11334/jibi1954.48.6_412

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

DOI： 10.15036/arerugi.50.303_1

J-GLOBAL

researchmap

Language：Japanese  

DOI： 10.11453/orltokyo1958.43.475

J-GLOBAL

researchmap

Language：Japanese  

DOI： 10.15036/arerugi.49.207_3

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

CiNii Books

researchmap

Language：English  

Patients who have been suffering from Japanese cedar pollinosis for more than five years tend to visit our outpatient clinic before beginning of the cedar pollen season. The mean of the day of first visit in season was 2 to 16 days before being exposed to pollen. The patients, however, do not always visit our hospital for the purpose of preseasonal medication. The ratio of those who do is 36% of patients who have been suffering from Japanese cedar pollinosis for more than five years. The ratio of patients who visit the clinic immediately after onset of symptoms or before the symptoms get severe is 28%. On the other hand, patients who have been suffering from Japanese cedar pollinosis for only three years tend to visit the clinic after they have been exposed to a large amount of pollen with resultant severe nasal symptoms. The ratio of those patients is 48% of patients who have been suffering from Japanese cedar pollinosis for only three years. Although about 40% of all patients are treated with preseasonal medication, many patients visit our hospital after the onset of nasal symptoms. Because the number of patients with Japanese cedar pollinosis is thought to be increasing, their treatment requirements are various. Although preseasonal medication is useful, it is difficult to recommend all patients to visit the hospital before the beginning of the season. The treatment requirements for each patient must be assessed individually. The planning of treatment for patients who visit our hospital after the onset of nasal symptoms is also necessary. © 1999, Society of Oto-rhino-laryngology Tokyo. All rights reserved.

DOI： 10.11453/orltokyo1958.42.292

Scopus

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese   Publisher：Society of Oto-rhino-laryngology Tokyo  

From November 1995 to July 1996, we treated five patients with deep neck infection, containing two cases of gas gangrene. We also discussed recent 36 cases of deep neck infection including our 5 cases. Recent case reports of deep neck infection, especially cases of non-Clostridial gas gangrene, are increasing. For the treatment administration of antibiotics protecting against both aerobic and anaerobic bacterial infection is necessary. For example, administration of PIPC and CLDM is useful as the first choice. We treated 5 cases by administration of PIPC and CLDM, with surgical drainage for 3 cases. The appropriate therapy should be carried out quickly before the infection leads to a severe state and the planing of surgical drainage is also necessary at the same time. For the planing of surgical treatment CT scan is useful. Therefore if abscess formation is suspected CT scan should be done early without hesitations. Because the patients with deep neck infections often visit clinicians whose specialty is not otorhinolaryngology, the pathogenesis and severity should be discussed sufficiently with them. We have to care the cases which possibly lead to severe deep neck infections, such as the cases with diffuse neck swelling and redness, peri-tonsillitis, odontogenous infection, to prevent an increase in such cases.

DOI： 10.11453/orltokyo1958.40.180

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

DOI： 10.11334/jibi1954.41.2Supplement1_281

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

DOI： 10.11334/jibi1954.41.2Supplement1_301

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：English   Publisher：HEADLEY BROTHERS LTD  

The distribution and abundance of mast cells in nasal polyps, the maxillary sinus mucosa of patients with sinusitis and the turbinate mucosa of allergic rhinitis was microscopically examined using different methods of fixation. In the epithelium of the surface and the ducts of nasal polyps (n = 8), the mean number of mast cells was over 20,000 per mm3 using Mota's fixation and the increase was correlated with the epithelial thickness (P&lt;0.05). On the other hand those of the maxillary sinus mucosa (n = 6) and the nasal turbinate mucosa (n = 7) were less than 6,000 per mm3. In the subepithelial layer or areas deeper than the area with the glands, however, mast cell counts were less than 3,200 per mm3 in all diseases. More than 70-90 per cent of all mast cells in the epithelium of the mucosal surface and the ducts of the polyp, the maxillary sinus mucosa and nasal turbinates were formalin sensitive. Most of the mast cells in the subepithelial and deeper areas were formalin resistant in all diseases.
These results suggest that conditions for mast cell growth differ between polyps and the other diseases, and that the conditions which affect mast cells may contribute to polyp development.

Web of Science

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

DOI： 10.11334/jibi1954.39.2_139

J-GLOBAL

researchmap

Language：Japanese  

DOI： 10.11334/jibi1954.39.1_35

J-GLOBAL

researchmap

Language：Japanese  

DOI： 10.5631/jibirinsuppl1986.1992.Supplement57_227

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese   Publisher：THE JAPAN OTOLOGICAL SOCIETY  

Two cases, a female and her mother, of van der Hoeve syndrome are reported. They showed a conductive or mixed hearing loss. A stapedotomy was performed on each case. The findings at surgery were similar in both cases. The stapedial footplates in both cases were fixed firmly, and were normal in shape. The histopathological findings of stapes indicated similar type to that of otosclerosis in one patient, and those were almost normal in the other patient. After the stapedotomy, ecxellent hearing level was obtained in both patients.

DOI： 10.11289/otoljpn1991.2.251

J-GLOBAL

researchmap

Language：Japanese  

DOI： 10.11334/jibi1954.37.5Supplement4_1073

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：English  

We examined the conditions, kinetics and cell sources for basophil/mast cell and eosinophil colony stimulating activity (CSA) production by nasal epithelial cells taken from house dust (HD) nasal allergic patients. Epithelial scrapings removed from HD nasal allergic patients were grown to confluence over 7 days as a monolayer of epithelial cells in medium supplemented with fetal calf serum (FCS) on collagen coated microwell plates. CSA in nasal epithelial cells conditioned medium (CM) was assessed with density-gradient separated, nonadherent peripheral blood mononuclear cells in 14-day and 21-day methylcellulose assays. In the 14-day methylcellulose assays, the number of Eo-type colonies in the presence of either 10% or 5% CM was significantly higher than the background number of Eo-type colonies (negative control). Comparison of Gm CSA among 1%, 5% and 10% CM with negative, revealed no significant differences. We also compared the Eo-type CSA in the presence of 10% CM in the 14 -day methylcellulose assay with 21-day methylcellulose assay. There was no significant difference in the number of Eo-type colony between the 14-day and 21-day methylcellulose assays. We also examined the composition of the cells in the colonies in the 14-day and 21-day methylcellulose cultures. The percentage of metachromatic granule containing cells in a Eo-type colony in 14-day methylcellulose assay was significantly higher than in a Eo-type colony in 21-day methylcellulose assay. On the other hand, the percentage of eosinophilic granule containing cells in a Eo-type colony in 14-day methylcellulose assay was significantly lower than in a Eo-type colony in 21-day methylcellulose assay. We also measured histamine content in individual Eo-type colonies in 14-day and 21-day methylcellulose culture. Average histamine content in a Eo-type colony was 1. 8 ± 2. 2ng (N = 15) in 14-day methylcellulose culture and 0. 7 ± 0. 8ng (N = 15) in 21-day methylcellulose culture. These studies confirmed the existence of regulatory growth factors in the nasal epithelial cell CM taken from HD nasal allergic patients that stimulate and/or inhibit the growth and differentiation of human basophils/mast cells and eosinophils from common, committed progenitor cells and point to the existence of a unique microenvironment for basophil/mast cell and eosinophil development provided by nasal allergic epithelium. © 1991, The Oto-Rhino-Laryngological Society of Japan, Inc. All rights reserved.

DOI： 10.3950/jibiinkoka.94.9_1280

Scopus

PubMed

J-GLOBAL

researchmap

Language：Japanese   Presentation type：Symposium, workshop panel (nominated)  

researchmap

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

Language：Japanese   Presentation type：Symposium, workshop panel (nominated)  

researchmap

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

Language：Japanese   Presentation type：Symposium, workshop panel (nominated)  

researchmap

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

Language：Japanese   Presentation type：Symposium, workshop panel (nominated)  

researchmap

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

researchmap

Language：Japanese   Presentation type：Symposium, workshop panel (nominated)  

researchmap

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

researchmap

Language：Japanese   Presentation type：Poster presentation  

researchmap

Language：Japanese   Presentation type：Oral presentation (invited, special)  

researchmap

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

researchmap

researchmap