Prevalence of birch pollinosis and oral allergy syndrome in the general population of Hokkaido, Japan.Ryuta Kamekura; Takumi Kumai; Masanobu Suzuki; Eri Maeda; Takayoshi Suzuki; Kentaro Izumi; Shunichiro Takezaki; Hiroyuki Sakai; Keisuke Morita; Tomohiro Sakashita; Kei Takamura; Tomonobu Satoh; Masami Yamazoe; Satoshi Konno; Hideyuki Ujiie; Kenichi Namba; Masahiro Ueki; Yoshinori Minami; Kazutaka Nogami; Risa Wakisaka; Michihisa Kono; Keisuke Yamamoto; Miki Takahara; Kenichi Takano; Akihiro Homma; Yuji Nakamaru
Auris, nasus, larynx, 53, 4, 506, 513, 2026年05月27日,
［国際誌］英語, 研究論文（学術雑誌）, OBJECTIVE: Birch pollen is the predominant tree pollen allergen in Hokkaido, Japan, and is frequently associated with oral allergy syndrome (OAS). However, most previous studies have been hospital-based, and population-level data remain limited. METHODS: We conducted a cross-sectional questionnaire survey of residents of Hokkaido recruited through 10 medical institutions and their family members. Data were collected on physician-diagnosed birch pollinosis, oral allergy symptoms after food ingestion, demographic factors, residential area, and comorbid allergic diseases. Associations were evaluated using chi-square tests, odds ratios (OR) with 95% confidence intervals (CI), and multivariate logistic regression analyses. RESULTS: A total of 3615 residents were included. The prevalence of physician-diagnosed birch pollinosis was 15.21%, higher than that of other pollen allergies. In multivariate analysis, residential area was an independent determinant of birch pollinosis, with significantly higher odds in northern, central, and eastern Hokkaido than in southern Hokkaido. Female sex, age, perennial allergic rhinitis and food allergy were also independently associated with birch pollinosis. Oral allergy symptoms were reported by 22.41% of participants and occurred in 66.55% of individuals with birch pollinosis. In the multivariate model for oral allergy symptoms, birch pollinosis was a strong independent factor, with additional associations observed for female sex, age, perennial allergic rhinitis and atopic dermatitis. CONCLUSIONS: Birch pollinosis and OAS are highly prevalent in Hokkaido. Oral allergy symptoms are strongly linked to birch pollinosis, supporting OAS as a characteristic clinical manifestation of birch pollen sensitization in birch-endemic regions.
VEXAS syndrome with cochleovestibular involvement.Keishi Fujiwara; Shinya Morita; Kimiko Hoshino; Hideaki Takeda; Kento Komatsuda; Kaoru Kahata; Yuji Nakamaru; Akihiro Homma
Auris, nasus, larynx, 53, 1, 70, 75, 2025年12月18日,
［国際誌］英語, 研究論文（学術雑誌）, We report a case of VEXAS syndrome in a 71-year-old man presenting with auricular chondritis, scleritis, hearing loss, and vestibular dysfunction. Although the clinical picture initially suggested relapsing polychondritis, hematologic findings and UBA1 variant confirmed VEXAS syndrome. Comprehensive audiovestibular testing revealed bilateral sensorineural hearing loss and global vestibular impairment. Steroid therapy led to partial improvement. This case highlights the potential for inner ear involvement in VEXAS syndrome, underscoring the importance of systematic audiovestibular evaluation and clinical awareness to differentiate it from similar conditions such as relapsing polychondritis.
Determinants of airway morphology in asthma: Inflammatory and noninflammatory factors.Kaoruko Shimizu; Naoya Tanabe; Hirokazu Kimura; Jun Miyata; Shotaro Chubachi; Yuji Nakamaru; Akira Oguma; Nobuyasu Wakazono; Kazufumi Okada; Houman Goudarzi; Ichizo Tsujino; Hironi Makira; Masaharu Nishimura; Satoshi Konno
The journal of allergy and clinical immunology. Global, 4, 4, 100555, 100555, 2025年11月,
［国際誌］英語, 研究論文（学術雑誌）, BACKGROUND: Patients with asthma may exhibit impaired airway tree morphology. The impact of difficult-to-treat traits on airway tree morphology remains unclear. OBJECTIVE: We sought to identify determinants of total airway branch count (TAC) detectable via computed tomography and explore associated blood and sputum biomarkers in nonsmokers and smokers with asthma. METHODS: Baseline computed tomography scans and pulmonary function tests (spirometry, diffusion capacity of carbon monoxide, and lung volume) were analyzed from the Hokkaido Severe Asthma Cohort (N = 190). TAC, segmental airway, visually evident mucus plugging and bronchiectasis, and parenchymal and extrapulmonary indices, such as the Lund-Mackay score, were evaluated. Relationships between TAC, difficult-to-treat traits, and blood/sputum biomarkers were analyzed using crude or multivariable regression models, adjusted for demographic factors. RESULTS: Blood or sputum eosinophilia, mucus plugs, high body mass index (BMI), asthma duration, and higher Lund-Mackay score correlated with low TAC. Low TAC was linked to airflow obstruction and heterogeneous ventilation (low alveolar volume/total lung capacity). BMI was inversely associated with TAC, independent of age, sex, smoking status, sputum eosinophil ratio, and asthma duration. The presence of bronchiectasis correlated with an increase in TAC. Sputum IL-5, IL-6, RANTES, and circulating YKL-40 (chitinase-3-like-1 protein) and leptin also inversely correlated with TAC. CONCLUSIONS: BMI, asthma duration, sinusitis, and the presence of bronchiectasis are significant determinants of airway tree morphology in asthma, alongside inflammation and mucus plugs. Both inflammatory and noninflammatory biomarkers were associated with low TAC.
Objective evaluation for Endoscopic Sinus Surgeries' proficiency by image analysis for postoperative 3D sinus models.Kaito Yamada; Masanobu Suzuki; Kou Miyaji; Kazuya Sase; Koki Ebina; Teppei Tsujita; Xiaoshuai Chen; Shunsuke Komizunai; Taku Senoo; Akira Nakazono; Ryosuke Watanabe; Shogo Kimura; Takayoshi Suzuki; Yuji Nakamaru; Kotaro Matoba; Dominik Hinder; Alexander Zhang; Alkis J Psaltis; Peter J Wormald; Atsushi Konno; Akihiro Homma
Auris, nasus, larynx, 52, 5, 567, 574, 2025年08月26日,
［国際誌］英語, 研究論文（学術雑誌）, OBJECTIVE: Objective assessment for endoscopic sinus surgery skill proficiency is challenging, partly due to the great diversity of anatomies. Recently developed 3D-printed sinus models provide standardized anatomy with realistic tissue-feel. In this study, we developed a method to evaluate endoscopic sinus surgery skill proficiency through pre- and post-operative image analysis of CT images of dissected 3D sinus models and validated it by comparing to other surgical proficiency indices. METHODS: Forty-seven otolaryngologists performed endoscopic sinus surgery for 3D sinus models. CT images of each postoperative 3D model were taken. The region growing method, an image segmentation technique, was utilized to assess the surgical space expansion. The region of interest (ROI) was defined as the space within nasal cavity and paranasal sinuses and continuous from the anterior nostril with a width of >4.00 mm kept. The volume of ROI was estimated and compared with conventional assessment methods such as board-certification, the objective structured assessment of technical skills score, and the number of experienced surgery cases. Further, the 3D-CG images of ROI were created. The completion of surgical steps within the allocated time was evaluated based on the 3D-CG and compared with the recorded endoscopic video. RESULTS: The volume in postoperative models was 24.48±4.34 cm3 across all participants, respectively. The postoperative volume was significantly larger in board-certified participants (certified; 25.51±4.22 cm3 vs. uncertified; 22.87±4.14 cm3, p = 0.03). The volume is positively correlated to the objective structured assessment of technical skills score (r = 0.72, p < 0.01) and the number of experienced cases (r = 0.51, p = 0.01). The accuracy of the 3D-CG judgement for completion of a surgical middle meatal antrostomy, sphenoidotomy, and frontal sinusotomy were 91.3 %, 69.6 %, and 84.8 %, when compared to recorded endoscopic video, with high sensitivity and specificity. CONCLUSION: The combination of standardized 3D models and image analysis provides a simple and objective tool for the assessment of surgical skill proficiency.
Practical guideline for the management of allergic rhinitis in Japan 2024.Mitsuhiro Okano; Kimihiro Okubo; Minoru Gotoh; Mikiya Asako; Nobuo Ohta; Atsushi Kamijo; Kayoko Kawashima; Masafumi Sakashita; Daiju Sakurai; Tetsuya Terada; Yuji Nakamaru; Takechiyo Yamada; Shuji Yonekura; Aiko Oka; Marie Yamada; Tomokazu Yoshizaki
Auris, nasus, larynx, 52, 4, 426, 441, 2025年08月,
［国際誌］英語, 研究論文（学術雑誌）, The Practical Guideline for the Management of Allergic Rhinitis in Japan was first published in 1993. After the COVID-19 pandemic, the current 10th edition was published in 2024. The most recent collection of evidence from the literature, such as the sustained post-treatment effect of sublingual immunotherapy on Japanese cedar pollinosis, was added to the revised guideline, which incorporates evidence-based medicine. In this revised guideline, a diagram illustrating the pathogenesis of allergic rhinitis and the mechanisms of action of various pharmacological treatments has been added. Also included is a diagram that shows the mechanism of action of allergen immunotherapy and a more detailed description of the oral allergy syndrome. The clinical question and answer section was also revised along with the introduction of new questions, such as: Does anti-IgE antibody treatment effectively reduce the symptoms of severe seasonal allergic rhinitis? Also updated was the evidence-based step-by-step strategy for treatment.
The Therapeutic Effects of Systemic Corticosteroid and Immunosuppressants for New-Onset Cases and Mepolizumab for Recurrent Cases of Otitis Media Associated With Eosinophilic Granulomatosis with Polyangiitis.Shinya Morita; Atsushi Fukuda; Kimiko Hoshino; Yuji Nakamaru; Keishi Fujiwara; Masanobu Suzuki; Aya Honma; Akira Nakazono; Akihiro Homma
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 2025年06月18日,
［国際誌］英語, 研究論文（学術雑誌）, OBJECTIVE: The aims of this study were to evaluate the otologic features and outcomes of otitis media associated with eosinophilic granulomatosis with polyangiitis (EGPA) and validate the current treatment strategies, including systemic corticosteroid (CS) and immunosuppressants for new-onset cases and therapeutic targeting of interleukin (IL)-5 for recurrent cases. STUDY DESIGN: Retrospective case series. SETTING: Tertiary referral center. PATIENTS: Patients with otitis media associated with EGPA were eligible for inclusion. INTERVENTION: Systemic CS alone or a combination of systemic CS and intravenous cyclophosphamide (IVCY) was performed as induction therapy. Maintenance therapy with oral CS and immunosuppressant, such as rituximab, methotrexate, or azathioprine, was administered. Treatment with mepolizumab was performed at the time of relapse of major organ involvement in EGPA, exacerbation of asthma, and/or recurrence of ear, nose, and throat symptoms after remission induction. MAIN OUTCOME MEASURES: Air- and bone-conduction pure-tone thresholds, overall survival rate, EGPA relapse rate, and otitis media recurrence rate. RESULTS: Systemic CS-based induction therapy achieved remission in all patients with EGPA. In both the CS + IVCY and CS-alone groups, hearing thresholds in the remission and/or resolution phase were significantly better than those at initial presentation at all frequencies (p < 0.01). The 5-year estimated relapse rate of major organ involvement was 29.2%, and the 5-year estimated recurrence rate of otitis media was 43.6%. All cases of recurrent otitis media treated with mepolizumab achieved improvement in otologic symptoms and subsequent reduction in maintenance CS dose. However, half of ears with recurrent otitis media showed repeated secretion and cessation of middle ear discharge and required additional topical CS treatment during mepolizumab administration. CONCLUSIONS: Immunosuppressive treatment affords a good response to systemic manifestations as well as otitis media associated with EGPA. Meanwhile, a significant proportion of patients experienced exacerbation of otitis media during maintenance therapy. Mepolizumab might be the treatment of choice for recurrent cases.
Poly(I:C)刺激は鼻粘膜上皮細胞のHLA-G発現を亢進させる
渡邉 良亮; 鈴木 正宣; 中薗 彬; 木村 将吾; 本間 あや; 中丸 裕爾; 本間 明宏
日本耳鼻咽喉科免疫アレルギー感染症学会抄録集, 5回, 204, 204, 日本耳鼻咽喉科免疫アレルギー感染症学会, 2025年04月
日本語
発がん関連因子TRIM27の分子メカニズムに関する検討
木村 将吾; 中丸 裕爾; 鈴木 正宣; 中薗 彬; 本間 あや; 渡邉 良亮; 本間 明宏; 畠山 鎮次
日本耳鼻咽喉科免疫アレルギー感染症学会抄録集, 5回, 167, 167, 日本耳鼻咽喉科免疫アレルギー感染症学会, 2025年04月
日本語
Post-operative vestibular function outcomes evaluated by video Head Impulse Test in patients with non-vestibular schwannoma cerebellopontine angle tumors.Keishi Fujiwara; Shinya Morita; Hiroaki Motegi; Shigeru Yamaguchi; Yukitomo Ishi; Kimiko Hoshino; Atsushi Fukuda; Hideaki Takeda; Yuji Nakamaru; Miki Fujimura; Akihiro Homma
Auris, nasus, larynx, 52, 1, 50, 58, 2025年02月,
［国際誌］英語, 研究論文（学術雑誌）, OBJECTIVES: To evaluate post-operative semicircular canal function in patients with non-vestibular schwannoma (VS) cerebellopontine angle (CPA) tumors by video Head Impulse Test (vHIT). METHODS: Fourteen patients with non-VS CPA tumors who underwent surgery. The gain in vestibulo-ocular reflex (VOR) was examined pre- and post-operatively for the semicircular canals in patients with non-VS CPA tumors. RESULTS: Ten of 14 patients showed semicircular canal dysfunction in one or more of the semicircular canals pre-operatively and VOR gain was significantly correlated with hearing function. Two patients showed improvement in one or more semicircular canals at 1 month after surgery compared to the pre-operative results. Significant improvements in VOR gain were observed when comparing VOR gain at 1 month and 6 months after surgery. CONCLUSIONS: Detailed evaluation of semicircular canal function was achieved by using vHIT in patients with non-VS CPA tumors. The good prognosis for vestibular function as evaluated by vHIT post-operatively was confirmed in patients with non-VS CPA tumors when compared to those in patients with VS. As improvement may occur post-operatively, surgical approaches that preserve the vestibular nerves and semicircular canals should be chosen for patients with non-VS CPA tumors, regardless of preoperative vestibular function. Even if vestibular function deteriorates immediately after surgery, it may improve over time if the nerve is preserved.
Surgical skill analysis using explainable AI in endoscopic sinus surgeryKaito Yamada; Masanobu Suzuki; Kou Miyaji; Koki Ebina; Kazuya Sase; Teppei Tsujita; Xiaoshuai Chen; Takashige Abe; Shunsuke Komizunai; Yuji Nakamaru; Taku Senoo; Akihiro Homma; Atsushi Konno
2025 IEEE/SICE International Symposium on System Integration (SII), 287, 291, IEEE, 2025年01月21日,
［査読有り］研究論文（国際会議プロシーディングス）
Motion analysis for objective evaluation of psychomotor skills in Endoscopic Sinus SurgeryK Miyaji; M Suzuki; R Watanabe; T Suzuki; K Matoba; A Nakazono; Y Nakamaru; K Ebina; T Abe; D Hinder; A J Psaltis; P J Wormald; A Homma; A Konno
Rhinology Journal, Stichting Nase, 2024年12月01日
研究論文（学術雑誌）, Background: This study aims to digitalize surgical maneuvers in ESS using a motion capture system under standardized conditionsprovided by 3D printed-sinus models. Methodology: Forty-seven otolaryngologists performed ESS on 3D printed modelsmanufactured from computed tomography (CT) images of actual patients. Participants were classified to 3 groups according tothe objective structured technical skills assessment score. All surgical maneuverers performed during ESS were captured by amotion capture system. The path length, velocity, acceleration, and jerk were calculated for each surgical instrument and comparedamong the groups. Principle Component Analysis (PCA) was utilized to identify which metrics reflected surgical skill level. Inaddition, ten registrars repeated the surgical dissection. Their motion metrics were also compared between first training and therepeated training and then subjected to the PCA. Results: Several metrics such as the angular acceleration and jerk of the cuttingforceps were identified by PCA as possible indicators distinguishing the different skill levels for the ESS maneuvers. PCA analysis inthe repetitive training also found the angular metrics of the upturned-cutting forceps correlating to their skill improvement.Conclusions: Combined with the validated 3D-printed sinus models, the motion capture system provided the objective evaluationof the surgical performances of ESS.
Nonspecific inflammatory pseudotumor of the maxillary and temporal fossa: a study of seven casesWataru Kakuguchi; Yuichi Ashikaga; Yasuhito Moritani; Shintaro Nakano; Naohiro Ogawa; Rieko Yoshitatsu; Aya Yanagawa-Matsuda; Nako Maishi; Akihiko Kudo; Nanase Okazaki; Yuji Nakamaru; Ichiro Yabe; Yoshihiro Matsuno; Yoichi Ohiro
Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 138, 4, 494, 501, Elsevier BV, 2024年10月,
［国際誌］英語, 研究論文（学術雑誌）, OBJECTIVE: Inflammatory pseudotumor (IPT) is a rare, locally aggressive, benign neoplasm of unknown etiology. Because of its aggressive clinical behavior and locally destructive or infiltrative features, it may be mistaken for a malignant tumor. Approximately 5%-44% of extrapulmonary IPT occur in the head and neck, primarily affecting the orbit. STUDY DESIGN: Between 2008 and 2021, our hospital received referrals for seven patients (three men and four women, aged 42-73 years) with pain, swelling, mass, and trismus. Computed tomography, magnetic resonance imaging, and biopsy were performed on all patients to diagnose IPT. RESULTS: Of the seven patients, four received low-dose prednisolone (PSL), one underwent surgery, and two were left untreated. The IPT disappeared in one of the two untreated cases, whereas it improved and later deteriorated in the other. The surgical patient had no recurrence. Low-dose PSL was effective in two patients; however, high-dose PSL and immunosuppressants were required in the remaining two cases owing to infiltration into each orbit or brain region. CONCLUSIONS: Low-dose PSL treatment was applicable in IPT cases affecting the maxillary to temporal fossa region, wherein symptoms did not improve without treatment. However, when low-dose PSL was ineffective, high-dose PSL and immunosuppressants were required.
鼻副鼻腔粘膜悪性黒色腫におけるTRIM27の検討
木村 将吾; 中丸 裕爾; 鈴木 正宣; 中薗 彬; 本間 あや; 渡邉 良亮; 加納 里志; 対馬 那由多; 鈴木 崇祥; 井戸川 寛志; 本間 明宏; 渡部 昌; 近藤 豪; 畠山 鎮次
日本鼻科学会会誌, 63, 3, 336, 336, (一社)日本鼻科学会, 2024年09月
日本語
鼻副鼻腔粘膜悪性黒色腫におけるTRIM27の検討
木村 将吾; 中丸 裕爾; 鈴木 正宣; 中薗 彬; 本間 あや; 渡邉 良亮; 加納 里志; 対馬 那由多; 鈴木 崇祥; 井戸川 寛志; 本間 明宏; 渡部 昌; 近藤 豪; 畠山 鎮次
日本鼻科学会会誌, 63, 3, 336, 336, (一社)日本鼻科学会, 2024年09月
日本語
Evaluation of Semicircular Canal Function in Relapsing Polychondritis Patients with Dizziness and Sensorineural Hearing Loss Using Video Head Impulse Test.Kimiko Hoshino; Keishi Fujiwara; Shinya Morita; Atsushi Fukuda; Hideaki Takeda; Yuji Nakamaru; Akihiro Homma
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 2024年08月26日,
［国際誌］英語, 研究論文（学術雑誌）, OBJECTIVE: To evaluate semicircular canal function using video head impulse test (vHIT) in relapsing polychondritis (RP) patients presenting with dizziness and sensorineural hearing loss. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Three patients with RP underwent vHIT and hearing tests. INTERVENTION: Diagnostic. MAIN OUTCOME MEASURES: The gain in vestibulo-ocular reflex (VOR) and the presence of catch-up saccade were examined, and the correlation between semicircular canal dysfunction and hearing loss was investigated. RESULTS: Of the six ears, five exhibited semicircular canal dysfunction. Among these, one ear showed dysfunction in two semicircular canals, while the remaining four ears demonstrated dysfunction in all three semicircular canals. Sensorineural hearing loss, ranging from moderate to profound, was detected by pure-tone audiometry in all six ears. Furthermore, a significant correlation was observed between VOR gain in the horizontal semicircular canal (HSC) and hearing level. CONCLUSIONS: This study demonstrated semicircular canal dysfunction in RP patients presenting with dizziness and hearing loss using vHIT. Moreover, a significant correlation was found between HSC dysfunction and the severity of hearing loss. While inner ear involvement is a key clinical symptom included in the diagnostic criteria for RP, there have been few reports evaluating vestibular dysfunction, and this is the first report on the evaluation of several cases using vHIT. Accurate assessment of vestibular function by vHIT may facilitate early diagnosis and intervention in RP, potentially improving patient outcomes.
Evaluation of quality of life for patients with resolved facial nerve palsy.Keishi Fujiwara; Shinya Morita; Atsushi Fukuda; Kimiko Hoshino; Makoto Kobayashi; Yuji Nakamaru; Yasushi Furuta; Akihiro Homma
Auris, nasus, larynx, 51, 3, 456, 459, 2024年06月,
［国際誌］英語, 研究論文（学術雑誌）, OBJECTIVES: The quality of life (QOL) for patients with resolved facial nerve palsy has not been evaluated adequately. The objective of this study is to investigate QOL for patients with resolved facial nerve palsy. METHODS: Forty-seven patients with resolved facial nerve palsy were included and the patients' QOL was evaluated using the Facial Clinimetric Evaluation Scale (FaCE Scale). RESULTS: Twenty-two of the 47 patients (46.8%) with resolved facial nerve palsy showed impaired QOL, especially in terms of facial comfort and eye comfort. In 10 cases followed-up after the condition was judged to be resolved, the median scores for the FaCE scale at the time the condition was judged to be resolved and at the last visit were 65.5 and 72, respectively. The mean durations from the onset of the palsy to diagnosis of cure and to the last visit were 2.4 ± 1.6 and 4.3 ± 2.2 months, respectively. There was a significant improvement in QOL after the condition was judged to be resolved. CONCLUSION: There were discrepancies between QOL and facial movement as evaluated by physicians in patients in whom facial nerve palsy was resolved as in patients with non-cured facial nerve palsy. Patients' QOL continued to improve even after physicians judged the condition to be resolved and this result indicated that there were cases where improvement in QOL was delayed in comparison to improvement in facial movement.
Evaluation of Semicircular Canal Function Using Video Head Impulse Test in Patients With Peripheral Vestibular Disorders Without Nystagmus.Keishi Fujiwara; Shinya Morita; Kimiko Hoshino; Atsushi Fukuda; Hideaki Takeda; Yuji Nakamaru; Akihiro Homma
Cureus, 16, 6, e62786, 2024年06月,
［国際誌］英語, 研究論文（学術雑誌）, Objectives This study aims to evaluate semicircular canal function using video head impulse test (vHIT) in patients with peripheral vestibular disorders without nystagmus. Methods Patients who underwent vHIT were enrolled in this study, and the proportion of abnormal findings on vHIT in patients without nystagmus was investigated. In addition, the results of vestibular testing were investigated in cases in which both vHIT and caloric testing were performed in patients without nystagmus. Results Forty-six patients (23.4%) of 197 patients who had no abnormal findings on the nystagmus tests, including the gaze nystagmus test, positional nystagmus test, and positioning nystagmus test, showed dysfunction in at least one semicircular canal on vHIT. The most frequent diagnosis was vestibular schwannoma (14/46, 30.4%), and cases with bilateral vestibular dysfunction were also included (12/46, 26.1%). A disorganized pattern of catch-up saccade was observed more frequently in patients with subjective symptoms of dizziness/vertigo compared to those without subjective symptoms. Although the sensitivity of vHIT was low compared to caloric testing, vHIT could detect isolated vertical canal dysfunction not detected by caloric testing. Conclusions vHIT is considered to be a useful test for patients without nystagmus, as vHIT could detect abnormalities in approximately one-quarter of patients without nystagmus. vHIT is considered to be one of the first tests to be performed following nystagmus testing, including the gaze nystagmus test, the positional nystagmus test, and the positioning nystagmus test. On the other hand, there are some cases in which vHIT shows no abnormality while caloric testing shows canal paresis. It is necessary to perform vHIT, bearing in mind that there are abnormalities that cannot be detected by vHIT alone.
Pre- and post-operative semicircular canal function evaluated by video head impulse test in patients with vestibular schwannoma.Keishi Fujiwara; Shinya Morita; Hiroaki Motegi; Shigeru Yamaguchi; Yukitomo Ishi; Kimiko Hoshino; Atsushi Fukuda; Makoto Kobayashi; Yuji Nakamaru; Miki Fujimura; Akihiro Homma
Auris, nasus, larynx, 51, 3, 542, 547, 2024年06月,
［国際誌］英語, 研究論文（学術雑誌）, OBJECTIVES: To evaluate pre- and post-operative semicircular canal function in patients with vestibular schwannoma (VS) by the video Head Impulse Test (vHIT). METHODS: Nineteen patients with VS who underwent surgery were enrolled in this study. The gain in vestibulo-ocular reflex (VOR) and the degree of scatter in catch-up saccades were examined pre- and post-operatively for the semicircular canals in VS patients. RESULTS: Ten of 19 cases (52.6 %) with VS were defined as demonstrating both superior vestibular nerve (SVN) and inferior vestibular nerve (IVN) impairment from the results of pre-operative vHIT. Hearing level and subjective vestibular symptoms showed significant correlations with pre-operative semicircular canal function. Compared to pre-operative vHIT results, VOR gains within 1 month after surgery were significantly reduced in all three canals; however, significant differences had disappeared in the anterior and posterior semicircular canals at 6 months after surgery. Cases of unknown origin had a significantly greater reduction in posterior semicircular canal function after surgery compared with those with disease of IVN origin. CONCLUSIONS: As vHIT could evaluate pre-operative vestibular nerve impairment, post-operative VOR gain reduction and the degree of vestibular compensation, semicircular canal function evaluated by vHIT provides a good deal of useful information regarding VS patients undergoing surgery compared to caloric testing, and vHIT should be performed pre- and post-operatively for patients with VS.
Validity of endoscopic ossiculoplasty immediately after its introduction for ossicular chain disruption.Atsushi Fukuda; Shinya Morita; Kimiko Hoshino; Keishi Fujiwara; Yuji Nakamaru; Akihiro Homma
BMC surgery, 24, 1, 149, 149, 2024年05月14日,
［国際誌］英語, 研究論文（学術雑誌）, BACKGROUND: Transcanal endoscopic ear surgery (TEES) reportedly requires a long learning curve and may be associated with more complications and longer operative times than microscopic ear surgery (MES). In this study, we aimed to examine the usefulness and validity of TEES for ossicular chain disruption in the early stages of its introduction in our institution. METHODS: TEES was performed on 11 ears (10 with congenital ossicular chain discontinuity and 1 with traumatic ossicular chain dislocation), and MES was performed with a retroauricular incision on 18 ears (6 with congenital ossicular chain discontinuity and 12 with traumatic ossicular chain dislocation) in a tertiary referral center. Postoperative hearing results, operative times, and postoperative hospital length of stay were retrospectively reviewed. The Mann-Whitney U test and Fisher's exact test was performed to compare variables between the TEES and MES groups. Pre- and postoperative air- and bone-conduction thresholds and the air-bone gap of each group were compared using the Wilcoxon signed-rank test. The Mann-Whitney U test and Wilcoxon signed-rank was performed to compare the pre- and postoperative air-bone gaps between the diagnoses. RESULTS: No significant differences in the postoperative air-conduction thresholds, bone-conduction thresholds, air-bone gaps, or incidence of air-bone gap ≤ 20 dB were observed between the TEES and MES groups. The air-conduction thresholds and air-bone gaps of the TEES group significantly improved postoperatively. The air-conduction thresholds and air-bone gaps of the MES group also significantly improved postoperatively. No significant difference was observed in the operative times between the groups (TEES group: median, 80 min; MES group: median, 85.5 min). The TEES group had a significantly shorter postoperative hospital stay (median, 2 days) than the MES group (median, 7.5 days). CONCLUSIONS: TEES was considered appropriate for the treatment of ossicular chain disruption, even immediately after its introduction at our institution. For expert microscopic ear surgeons, ossicular chain disruption may be considered a suitable indication for the introduction of TEES.
Increased adiposity to muscle ratio and severity of sinusitis affect quality of life in asthma—Computed tomographic analysis—Kaoruko Shimizu; Hirokazu Kimura; Naoya Tanabe; Kazuya Tanimura; Shotaro Chubachi; Hiroaki Iijima; Susumu Sato; Nobuyasu Wakazono; Yuji Nakamaru; Kazufumi Okada; Hironi Makita; Houman Goudarzi; Masaru Suzuki; Masaharu Nishimura; Satoshi Konno
Journal of Allergy and Clinical Immunology: Global, 3, 3, 100277, 100277, Elsevier BV, 2024年05月,
［国際誌］英語, 研究論文（学術雑誌）, BACKGROUND: Deteriorated sinusitis and increased adiposity relative to muscle mass may affect quality of life in patients with asthma. However, whether these effects are observed regardless of intrapulmonary pathology is unknown. OBJECTIVES: We evaluated the correlation of the cross-sectional ratio of abdominal visceral fat (VF) to erector spinae muscle (ESM) and sinus findings based on Lund-Mackey scoring system (LMS) on computed tomography (CT) with the impaired score of the Asthma Quality of Life Questionnaire (AQLQ), regardless of airway and parenchymal disease, in patients with asthma. METHODS: We recruited participants from the Hokkaido-based severe asthma cohort who had completed AQLQ and CT examination at the entry. The participants were divided into high (highest) and low (other quartiles) groups on the bases of the extrapulmonary indices. Multivariate analysis examined the association of VF/ESM for the adiposity-to-muscle ratio and LMS with AQLQ after adjusting for the airway fractal dimension for airway index and percentage of low attenuation volume to lung volume for parenchymal index. RESULTS: No significant differences were observed in VF/ESM and LMS in terms of sex. The AQLQ score in the high VF/ESM group and high LMS group was lower than those in low VF/ESM group and low LMS group (63 male and 100 female subjects). High VF/ESM (estimate [95% confidence interval] (-0.43 [-0.61, -0.25]) and high LMS scores (-0.22 [-0.41, -0.03]) were associated with low AQLQ scores when adjusted for age, body mass index, smoking status, blood eosinophil count, and intrapulmonary CT indices. CONCLUSIONS: Increased VF relative to ESM mass and high LMS may deteriorate asthma-related quality of life, regardless of presence of intrapulmonary disease.
内視鏡下副鼻腔手術における機械学習を用いた手術技量の数値化山田 海俊; 鈴木 正宣; 宮路 洸; 海老名 光希; 佐瀬 一弥; 辻田 哲平; 陳 暁帥; 安部 崇重; 小水内 俊介; 中丸 裕爾; 妹尾 拓; 本間 明宏; 近野 敦
ロボティクス・メカトロニクス講演会講演概要集, 2024, 2P1-F01, 一般社団法人 日本機械学会, 2024年
日本語, Endoscopic Sinus Surgery (ESS) is a widely performed but difficult procedure worldwide. Therefore, there is a need for quantitative feedback in ESS training. This paper describes the quantification of surgeons’ surgical skills using machine learning. A machine learning model was constructed using features calculated from the dynamic measurement data of surgical instruments in ESS. Five learning methods were applied: Support Vector Regression (SVR), Principal Component Analysis (PCA) SVR, Gradient Boosting Decision Tree (GBDT), Partial Least Squares (PLS), and Ridge. The mean absolute error (MAE) was calculated based on the score given by an experienced physician and was used as an accuracy index. Comparison of the methods showed that SVR and Ridge regression had the highest accuracy.
Long-term results of nasolacrimal duct and inferior turbinate swing technique for inverted papilloma of the maxillary sinus.Yuji Nakamaru; Masanobu Suzuki; Ken Shizuki; Aya Honma; Akira Nakazono; Shogo Kimura; Ryosuke Watanabe; Satoshi Kano; Nayuta Tsushima; Takayoshi Suzuki; Akihiro Homma
SAGE open medicine, 12, 20503121241271877, 20503121241271877, 2024年,
［国際誌］英語, 研究論文（学術雑誌）, BACKGROUND: We developed a technique to preserve the entire nasolacrimal duct and inferior turbinate, by swinging the nasolacrimal duct upward and the inferior turbinate backward; that is, a nasolacrimal duct and inferior turbinate swing technique for sinonasal inverted papilloma of the maxillary sinus. In this study, we evaluated the long-term results of this technique. METHODS: A retrospective analysis was performed on the data for 53 consecutive pathologically confirmed inverted papilloma patients who were treated using nasolacrimal duct and inferior turbinate swing technique. The frequency of recurrence, the degree of nasolacrimal duct and inferior turbinate preservation, and the frequency of adverse events were assessed. RESULTS: The median follow-up period was 51 months (mean 62.5 months; range 10-187 months). No cases of recurrence within the maxillary sinus were observed among the cases treated using this technique, whereas three (5.7%) of the 53 cases experienced recurrence in areas other than the maxillary sinus. We could preserve the nasolacrimal duct in all cases. On the other hand, the inferior turbinate was resected during surgery in one case. No epiphora, dacryocystiits, numbness of the cheek, or collapse of the ala of the nose was observed. CONCLUSION: This nasolacrimal duct and inferior turbinate swing technique method is a safe and effective method for the excision of primary or recurrent inverted papilloma and demonstrates low rates of recurrence and complications.
Can high-fidelity 3D models be a good alternative for cadaveric materials in skill assessment for endoscopic sinus surgery? A comparison study in assessment for surgical performance in 3D models and cadavers.Masanobu Suzuki; Ryosuke Watanabe; Akira Nakazono; Yuji Nakamaru; Takayoshi Suzuki; Shogo Kimura; Kotaro Matoba; Manabu Murakami; Dominik Hinder; A J Psaltis; Akihiro Homma; P J Wormald
Frontiers in medicine, 11, 1301511, 1301511, 2024年,
［国際誌］英語, 研究論文（学術雑誌）, INTRODUCTION: Traditionally formal assessment of surgical skills has not been part of a surgeon's accreditation process. The widely adopted apprentice model of "on-the-job training" does create additional risk for the patients. In the past surgical training has used cadavers, but these are expensive, require dedicated wet-lab facilities and are in increasingly short supply. In many countries religious and cultural practices also preclude cadaveric use. Recent 3D-printed technology allows mass reproduction of high-fidelity 3D models. In this study, we examined the utility of 3D sinus models compared to cadaver dissection for surgical skill assessment for endoscopic sinus surgery (ESS). MATERIALS AND METHODS: A total of 17 otolaryngologists performed Endoscopic Sinus Surgery (ESS) on 3D printed sinus models and then repeated these procedures on cadavers. Their surgical performance was assessed with the Objective Structured Assessment of Technical Skills (OSATS) score for ESS and time was taken to complete an ESS procedure. Their performance on the 3D models and cadavers was compared. RESULTS: There were no significant differences in the OSATS score between 3D models and cadavers (50.41 ± 13.31 vs. 48.29 ± 16.01, p = 0.36). There was a strong positive correlation between the score in 3D models and those in cadavers (r = 0.84, p < 0.001). No significant differences were found in time for a mini-ESS (21:29 ± 0:10 vs. 20:33 ± 0:07, p = 0.53). There were positive correlations between 3D models and cadavers in time taken for a mini-ESS (r = 0.55, p = 0.04). CONCLUSION: The surgical performance on the 3D models was comparable to that on cadavers. This supports the utility of the 3D models as an inexhaustible alternative for cadavers in ESS surgical skill assessment.
Neutrophil Extracellular Trap Formation and Deoxyribonuclease I Activity in Patients with Otitis Media with Antineutrophil Cytoplasmic Antibody-Associated Vasculitis.Shinya Morita; Yuji Nakamaru; Atsushi Fukuda; Keishi Fujiwara; Masanobu Suzuki; Kimiko Hoshino; Aya Honma; Akira Nakazono; Akihiro Homma
International archives of allergy and immunology, 185, 8, 810, 819, 2024年,
［国際誌］英語, 研究論文（学術雑誌）, INTRODUCTION: No previous studies have evaluated the levels of neutrophil extracellular trap (NET) remnants or the importance of deoxyribonuclease (DNase) I activity based on the disease activity of otitis media with antineutrophil cytoplasmic antibody-associated vasculitis (OMAAV). The aim of this study was to explore the formation of NETs in the middle ear of patients with OMAAV during the onset and remission phases of the disease, with a particular focus on the relationships between the quantifiable levels of NET remnants and DNase I activity. METHODS: OMAAV patients were eligible for inclusion. Patients with otitis media with effusion (OME) were examined as controls. The levels of cell-free deoxyribonucleic acid (DNA), citrullinated-histone H3 (cit-H3)-DNA complex, and myeloperoxidase (MPO)-DNA complex were quantified using an enzyme-linked immunosorbent assay. DNase I activity was measured using a fluorometric method. RESULTS: The quantifiable levels of cell-free DNA, cit-H3-DNA complex, and MPO-DNA complex in the middle ear lavage of patients with OMAAV at onset were significantly higher than those in patients with OMAAV at remission and in patients with OME. DNase I activity in the patients with OMAAV at onset was significantly lower than those in patients with OMAAV at remission and OME and was negatively correlated with the level of MPO-DNA complex. CONCLUSIONS: This study suggests that NET remnants and DNase I activity may be potentially useful biomarkers for the diagnosis and disease activity of OMAAV.
Clinical outcomes for olfactory neuroblastoma.Akira Nakazono; Hiroaki Motegi; Masanobu Suzuki; Yuji Nakamaru; Shigeru Yamaguchi; Yukitomo Ishi; Satoshi Kano; Nayuta Tsushima; Aya Honma; Takayoshi Suzuki; Shogo Kimura; Seijiro Hamada; Jun Taguchi; Yasushi Shimizu; Takashi Mori; Koichi Yasuda; Hidefumi Aoyama; Ichiro Kinoshita; Miki Fujimura; Akihiro Homma
Frontiers in oncology, 14, 1329572, 1329572, 2024年,
［国際誌］英語, 研究論文（学術雑誌）, BACKGROUND: Olfactory neuroblastoma (ONB) is a rare malignant tumor arising from the olfactory neuroepithelium. The standard of care for ONB is surgical resection; however, detailed treatment protocols vary by institution. Our treatment protocol consists of endoscopic skull base surgery (ESBS) for endoscopically resectable cases and induction chemotherapy followed by craniotomy combined with ESBS for locally advanced cases, with postoperative radiotherapy performed for all cases. Chemoradiotherapy (CRT) is performed in unresectable cases. In this study, we evaluate our treatment protocol and outcomes for ONB. METHODS: A retrospective review of patients with ONB was conducted. Outcomes included survival outcomes and perioperative data. RESULTS: Fifteen patients (53.6%) underwent ESBS, 12 (42.9%) underwent craniotomy combined with ESBS, and 1 (3.6%) received CRT. The 5- and 10-year overall survival rates for all patients were 92.9% and 82.5%, respectively, with a median follow-up period of 81 months. The 5- and 10-year disease-free survival rates were 77.3% and 70.3%, respectively, and the 5- and 10-year local control rates were 88.2% and 80.2%, respectively. Patients undergoing ESBS demonstrated a significantly shorter operating time, period from operation to ambulation, hospitalization period, and less blood loss than those undergoing craniotomy combined with ESBS. CONCLUSION: Our treatment protocol was found to afford favorable outcomes. Patients who underwent endoscopic resection showed lower complication rates and better perioperative data than those who underwent craniotomy combined with ESBS. With appropriate case selection, ESBS is considered a useful approach for ONB.
鼓室型グロムス腫瘍の3例
小林 諒; 森田 真也; 福田 篤; 干野 季美子; 藤原 圭志; 中丸 裕爾; 本間 明宏
日本耳科学会総会・学術講演会抄録集, 33回, 296, 296, (一社)日本耳科学会, 2023年11月
日本語
当科における耳小骨離断に対する経外耳道的内視鏡下耳科手術の成績
福田 篤; 森田 真也; 干野 季美子; 小林 諒; 藤原 圭志; 中丸 裕爾; 本間 明宏
日本耳科学会総会・学術講演会抄録集, 33回, 390, 390, (一社)日本耳科学会, 2023年11月
日本語
Quantitative Evaluations of Vestibular Function in Patients With Petrous Apex Cholesterol Granulomas Treated With an Endoscopic Transsphenoidal Approach: A Report of Two Cases.Yuuki Fujiwara; Keishi Fujiwara; Hiroaki Motegi; Yukitomo Ishi; Shinya Morita; Kimiko Hoshino; Atsushi Fukuda; Yuji Nakamaru; Akihiro Homma
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 44, 8, 809, 812, 2023年09月01日,
［国際誌］英語, 研究論文（学術雑誌）, OBJECTIVE: We report two cases of petrous apex cholesterol granuloma (PACG) treated with an endoscopic transsphenoidal approach. Vestibular functions of the two patients were evaluated quantitatively by video Head Impulse Test (vHIT) and/or vestibular evoked myogenic potentials (VEMPs). PATIENTS: Two patients with PACG who experienced episodes of dizziness are presented. INTERVENTION: An endoscopic transsphenoidal approach to PACG. MAIN OUTCOME MEASURE: The preoperative and postoperative vestibular functions as evaluated by vHIT and VEMP. RESULTS: Two cases of PACG were treated by a transsphenoidal approach. The internal auditory canal was compressed by the PACG in both cases. The patients both experienced episodes of dizziness before surgery and preoperative vestibular testing including vHIT and VEMP indicated dysfunction of vestibular nerves. After surgery, their symptoms were completely resolved, and the vestibular testing results were improved. CONCLUSIONS: This article is noteworthy for being the first to publish quantitative vestibular function testing for patients with PACG with vestibular dysfunction. PACG may show various symptoms, with dizziness being one of the most common symptoms. In cases in which the internal auditory canal is compressed by the PACG, vestibular functions should be evaluated by vHIT and VEMP. In the present cases, dizziness was found to be resolved by surgery to release the compression on internal auditory canal. Based on the present cases, the transsphenoidal approach is considered to be both safe and effective.
Treatment outcomes of the patient with sinonasal mucosal melanoma: the role of endoscopic resection and postoperative radiotherapy.Nayuta Tsushima; Satoshi Kano; Koichi Yasuda; Takayoshi Suzuki; Seijiro Hamada; Yuji Nakamaru; Masanobu Suzuki; Yusuke Uchinami; Hidefumi Aoyama; Akihiro Homma
International journal of clinical oncology, 28, 9, 1218, 1226, 2023年06月17日,
［国内誌］英語, 研究論文（学術雑誌）, BACKGROUND: The standard of care for sinonasal mucosal melanoma is surgery and postoperative radiotherapy (PORT). Our treatment strategy comprises endoscopic resection and PORT. We performed combined endoscopic and open resection or applied an external approach alone when sufficient resection was difficult to achieve endoscopically. The objective of this study was to evaluate the validity of our treatment strategy. METHODS: We assessed 30 patients with sinonasal mucosal melanoma who underwent definitive therapy between January 2002 and April 2021, and conducted a retrospective analysis. The median follow-up period was 2.2 years. The primary endpoint was overall survival. The Kaplan-Meier method was used for the calculation of survival rates, the cumulative incidence of distant metastasis, and local recurrence. RESULTS: Twenty-eight patients underwent surgery. The other two patients were treated by definitive proton beam therapy. Twenty-one of 28 (75%) patients underwent resection by endoscopic approach alone. Postoperative radiotherapy was performed for all 28 patients who underwent surgery. Twenty-one patients (70%) experienced recurrence during the observation period. Overall, distant metastasis was observed in 19 patients. Twelve patients died during the observation period, with 10 of the 12 patients (83%) dying of distant metastasis. The overall survival rate at 2 and 5 years was 70% and 46%, respectively. The cumulative incidence rate of distant metastasis at 2 years was 63%, while the 2-year cumulative incidence rate of local recurrence was 6.7%. CONCLUSION: The local disease was controlled by our treatment strategy. To improve treatment outcomes, control of the distant metastasis is needed.
疼痛を伴わなかった悪性外耳道炎例佐藤 禄; 福田 篤; 森田 真也; 藤原 圭志; 中丸 裕爾; 本間 明宏
耳鼻咽喉科臨床, 116, 6, 567, 572, 耳鼻咽喉科臨床学会, 2023年06月
日本語, 症例は76歳男性で、左耳漏、左顔面神経麻痺、嚥下困難の精査加療目的に当科入院となった。入院時、耳痛は認めなかったが、側頭骨CTで左外耳道前壁から鼓室前壁にかけて強い骨融解像を伴う軟部陰影が充満し、頭蓋底の一部にも骨融解像がみられた。第2病日に生検および左後壁保存型鼓室形成術IIIc型を施行し、病理組織所見・画像所見より悪性外耳道炎に合併した頭蓋底骨髄炎の診断に至った。術後は6週間にわたり抗菌薬の静注を続け、頭蓋底病変は改善傾向にあったため、内服に切り替え第52病日に軽快退院した。抗菌薬は内服開始2年後に終了し、顔面神経麻痺は回復し、抗菌薬中止後1年4ヵ月間にわたり明らかな再燃は認めなかった。
TRIM27 expression is associated with poor prognosis in sinonasal mucosal melanoma.S Kimura; M Suzuki; Y Nakamaru; S Kano; M Watanabe; A Honma; A Nakazono; N Tsushima; S Hatakeyama; A Homma
Rhinology, 2023年03月09日,
［国際誌］英語, 研究論文（学術雑誌）, BACKGROUND: Tripartite motif-containing 27 (TRIM27) has been implicated in the progression of various cancers. However, the role of TRIM27 in sinonasal mucosal melanoma (SNMM) remains poorly understood. MATERIALS & METHODS: We retrospectively examined 28 patients with SNMM treated with between 2003 and 2021. We undertook immunohistochemical analysis of TRIM27, Ki-67, and p-Akt1 expression in SNMM tissues. We also investigated the relationship between TRIM27 expression and clinical characteristics, prognosis, Ki-67 as a tumor growth potential marker, and p-Akt1 as one of the prognostic factors in mucosal melanoma. RESULTS: TRIM27 expression was significantly higher in T4 disease than in T3 disease and was higher in stage IV than in stage III. Patients with high-TRIM27 SNMM had a significantly poorer prognosis in terms of overall survival (OS) and disease-free survival.There was also a significantly higher rate of distant metastasis. Univariate analysis for OS revealed that TRIM27 and T classification were significant poor prognostic factors. In addition, the Ki-67 positive score and the p-Akt1 total staining score were significantly higher in the high-TRIM27 group than in the low-TRIM27 group. CONCLUSIONS: High TRIM27 expression in SNMM was associated with advanced T classification, poor prognosis and distant metastasis. We suggest that TRIM27 has potential as a novel biomarker for prognosis in SNMM.
Mental workload during endoscopic sinus surgery is associated with surgeons' skill levels.Masanobu Suzuki; Kou Miyaji; Kotaro Matoba; Takashige Abe; Yuji Nakamaru; Ryosuke Watanabe; Takayoshi Suzuki; Akira Nakazono; Atsushi Konno; Dominik Hinder; A J Psaltis; P J Wormald; Akihiro Homma
Frontiers in medicine, 10, 1090743, 1090743, 2023年,
［国際誌］英語, 研究論文（学術雑誌）, INTRODUCTION: Surgeons' mental workload during endoscopic sinus surgery (ESS) has not been fully evaluated. The assessment was challenging due to the great diversity of each patient's anatomy and the consequence variety of surgical difficulties. In this study, we examined the mental workload of surgeons with various surgical skill levels during ESS under the standardized condition provided by novel-designed 3D sinus models. MATERIALS AND METHODS: Forty-seven participants performed a high-fidelity ESS simulation with 3D-printed sinus models. Surgeons' mental workload was assessed with the national aeronautics and space administration-task load index (NASA-TLX). Associations between the total and subscales score of NASA-TLX and surgical skill index, including the board certification status, the number of experienced ESS cases, and the objective structured assessment of technical skills (OSATS), were analyzed. In addition, 10 registrars repeated the simulation surgery, and their NASA-TLX score was compared before and after the repetitive training. RESULTS: The total NASA-TLX score was significantly associated with OSATS score (p = 0.0001). Primary component analysis classified the surgeons' mental burden into three different categories: (1) the skill-level-dependent factors (temporal demand, effort, and performance), (2) the skill-level-independent factors (mental and physical demand), and (3) frustration. After the repetitive training, the skill-level-dependent factors were alleviated (temporal demand; z = -2.3664, p = 0.0091, effort; z = -2.1704, p = 0.0346, and performance; z = -2.5992, p = 0.0017), the independent factors were increased (mental demand; z = -2.5992, p = 0.0023 and physical demand; z = -2.2509, p = 0.0213), and frustration did not change (p = 0.3625). CONCLUSION: Some of the mental workload during ESS is associated with surgical skill level and alleviated with repetitive training. However, other aspects remain a burden or could worsen even when surgeons have gained surgical experience. Routine assessment of registrars' mental burdens would be necessary during surgical training to sustain their mental health.
アブミ骨手術の術後成績の検討 とくにピストントリミングの有無との関連について小林 諒; 福田 篤; 森田 真也; 藤原 圭志; 中丸 裕爾; 本間 明宏
耳鼻咽喉科臨床, 115, 9, 747, 752, 耳鼻咽喉科臨床学会, 2022年09月
日本語, 対象は2014年1月～2021年3月の39例44耳(男性10例、女性29例、平均年齢41.8歳)。診断は耳硬化症が30耳、耳小骨奇形が14耳であり、全例で顕微鏡下にstapedotomyを施行しCO2レーザーを用いてアブミ骨底板を開窓した。平均気導聴力は術前58.3dBから術後36.2dBと有意な改善を認めたが、平均骨導聴力は術後有意な変化を認めなかった。平均気骨導差は術前30.5dBから術後8.4dBと有意な改善を認めた。日本耳科学会基準に基づく術後成功例は36耳(81.8%)であった。術後聴力成績に影響を及ぼす因子として、テフロンピストンのリングをトリミングした場合に成功率が有意に低かった。ピストンリングのトリミングを行い成功に至らなかった症例のなかにはキヌタ骨長脚からピストンが脱落している症例もあり、テフロンピストンリングはできる限りトリミングせずに使用することが望ましい。
Association of gene mutations with clinicopathologic features in patients with external auditory canal squamous cell carcinoma.Shinya Morita; Satoshi Kano; Kanako C Hatanaka; Yutaka Hatanaka; Takayoshi Suzuki; Atsushi Fukuda; Kimiko Hoshino; Keishi Fujiwara; Yuji Nakamaru; Akihiro Homma
International journal of clinical oncology, 27, 9, 1394, 1403, 2022年09月,
［国内誌］英語, 研究論文（学術雑誌）, BACKGROUND: External auditory canal squamous cell carcinoma (EACSCC) is a rare form of malignant tumor. Due to the extremely limited understanding of the genomic landscape in EACSCC, the association between gene mutations and clinicopathologic features remains unclear. This study aimed to explore somatic gene mutations associated with the clinicopathological features in patients with EACSCC, and to identify the candidate gene mutations for predicting survival outcome in EACSCC. METHODS: Twenty-two tissue samples obtained from patients with EACSCC were analyzed for genetic mutations based on targeted next-generation sequencing and genetic expression based on IHC staining to investigate the driver of tumorigenesis and/or the candidates of genes for predicting clinical outcome in EACSCC. RESULTS: Gene alterations were most frequently observed in TP53 (59.1%), followed by CREBBP (9.1%). TP53 mutations showed significant correlation with T classification (P = 0.027) and p53 expression phenotype (P < 0.001). The 5-year overall survival (OS) rates for EACSCC patients with TP53 mutations and wild-type TP53 were 45.0% and 75.0%, respectively. Multivariable analysis using the Cox proportional hazards model demonstrated that TP53 mutations were independent predictors of OS rates for EACSCC patients (P = 0.007). CONCLUSION: This study has suggested that TP53 mutations have potential for use as a biomarker for identifying individuals at high risk of developing tumors and for predicting survival outcome in EACSCC. IHC staining for p53 might play a useful role as screening tool for detecting TP53 mutations in patients with EACSCC.
Repetitive simulation training with novel 3D-printed sinus models for functional endoscopic sinus surgeries.Masanobu Suzuki; Kou Miyaji; Ryosuke Watanabe; Takayoshi Suzuki; Kotaro Matoba; Akira Nakazono; Yuji Nakamaru; Atsushi Konno; Alkis James Psaltis; Takashige Abe; Akihiro Homma; Peter-John Wormald
Laryngoscope investigative otolaryngology, 7, 4, 943, 954, 2022年08月,
［国際誌］英語, 研究論文（学術雑誌）, Background: The purpose of this study was to find a utility of a newly developed 3D-printed sinus model and to evaluate the educational benefit of simulation training with the models for functional endoscopic sinus surgery (FESS). Material and methods: Forty-seven otolaryngologists were categorized as experts (board-certified physicians with ≥200 experiences of FESS, n = 9), intermediates (board-certified physicians with <200 experiences of FESS, n = 19), and novices (registrars, n = 19). They performed FESS simulation training on 3D-printed models manufactured from DICOM images of computed tomography (CT) scan of real patients. Their surgical performance was assessed with the objective structured assessment of technical skills (OSATS) score and dissection quality evaluated radiologically with a postdissection CT scan. First we evaluated the face, content, and constructive values. Second we evaluated the educational benefit of the training. Ten novices underwent training (training group) and their outcomes were compared to the remaining novices without training (control group). The training group performed cadaveric FESS surgeries before and after the repetitive training. Results: The feedback from experts revealed high face and content value of the 3D-printed models. Experts, intermediates, and novices demonstrated statistical differences in their OSATS scores (74.7 ± 3.6, 58.3 ± 10.1, and 43.1 ± 11.1, respectively, p < .001), and dissection quality (81.1 ± 13.1, 93.7 ± 15.1, and 126.4 ± 25.2, respectively, p < .001). The training group improved their OSATS score (41.1 ± 8.0 to 61.1 ± 6.9, p < .001) and dissection quality (122.1 ± 22.2 to 90.9 ± 10.3, p = .013), while the control group not. After training, 80% of novices with no prior FESS experiences completed surgeries on cadaver sinuses. Conclusion: Repeated training using the models revealed an initial learning curve in novices, which was confirmed in cadaveric mock FESS surgeries. Level of evidence: N/A.
Evaluation of Semicircular Canal Function by Video Head Impulse Test in Patients With Labyrinthine Fistula Due to Cholesteatoma.Keishi Fujiwara; Shinya Morita; Atsushi Fukuda; Kimiko Hoshino; Yuji Nakamaru; Akihiro Homma
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 43, 5, 587, 593, 2022年06月01日,
［国際誌］英語, 研究論文（学術雑誌）, OBJECTIVES: To evaluate semicircular canal function in patients with labyrinthine fistula (LF) due to cholesteatoma by the video Head Impulse Test (vHIT). STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Ten patients with LF due to cholesteatoma and six without LF underwent vestibular examination. INTERVENTION: Diagnostic. MAIN OUTCOME MEASURES: The gain in vestibulo-ocular reflex (VOR) and the presence of catch-up saccade were examined for the semicircular canals in patients with LF. RESULTS: Seven of 10 cases (70.0%) in the fistula group were judged to have semicircular canal dysfunction based on preoperative evaluation. VOR gains in the patients with LF were significantly lower than those in the patients without LF. VOR gain decreased significantly in accordance with the severity of the LF. The postoperative VOR gain more than 6 months after surgery was significantly improved compared with the preoperative VOR gain. CONCLUSIONS: The vHIT is thought to be the most suitable method for evaluating semicircular canal function in patients with LF due to cholesteatoma as it is not influenced by middle ear pathology and can evaluate the function of the vertical canals. The vHIT could predict whether a LF is present or not before surgery, and the vHIT is essential for surgery for patients with LF.
Discrepancies in the caloric testing and video Head Impulse Test results in a case with bilateral lateral semicircular canal malformations.Keishi Fujiwara; Shinya Morita; Atsushi Fukuda; Kimiko Hoshino; Yuji Nakamaru; Akihiro Homma
Auris, nasus, larynx, 2022年04月22日,
［国際誌］英語, Lateral semicircular canal (LSCC) malformations represent one of the most common types of inner ear malformation. As many cases of LSCC malformations are asymptomatic, detailed vestibular functions in such cases remain unclear. We present a case with bilateral LSCC malformations for whom the function of each vestibular organ was evaluated by caloric testing, video Head Impulse Test (vHIT) and vestibular evoked myogenic potentials (VEMP). Caloric testing showed canal paresis of the left side, whereas vHIT showed bilateral normal semicircular canal function. The results of VEMP indicated left saccular dysfunction. Discrepancies in caloric testing and vHIT results were observed and these discrepancies are thought to be due to endolymphatic hydrops rather than vestibular hypofunction, similar to that in Meniere disease.
難治性喘息 重症喘息における生物学的製剤の変更に影響する因子の検討
佐々木 真知子; 清水 薫子; 鈴木 正宣; 鈴木 雅; 松本 宗大; 木村 孔一; 中丸 裕爾; 伊藤 陽一; 今野 哲
日本呼吸器学会誌, 11, 増刊, 143, 143, (一社)日本呼吸器学会, 2022年04月
日本語
postコロナ・withコロナの耳鼻咽喉科診療 頭頸部の診療
本間 明宏; 中丸 裕爾; 鈴木 正宣; 本間 あや
日本耳鼻咽喉科免疫アレルギー感染症学会抄録集, 2回, 71, 71, 日本耳鼻咽喉科免疫アレルギー感染症学会, 2022年03月
日本語
術前呼吸機能検査による鼻茸を伴う副鼻腔炎の予後推測
中丸 裕爾; 鈴木 正宣; 本間 あや; 中薗 彬; 木村 将吾; 本間 明宏
日本耳鼻咽喉科免疫アレルギー感染症学会抄録集, 2回, 77, 77, 日本耳鼻咽喉科免疫アレルギー感染症学会, 2022年03月
日本語
鼻粘膜上皮細胞での細菌・ウィルス結合受容体発現に対する自然免疫シグナルの影響
中薗 彬; 木村 将吾; 本間 あや; 鈴木 正宣; 中丸 裕爾; 本間 明宏
日本耳鼻咽喉科免疫アレルギー感染症学会抄録集, 2回, 168, 168, 日本耳鼻咽喉科免疫アレルギー感染症学会, 2022年03月
日本語
鼻粘膜上皮におけるMetallothionein-3発現解析
鈴木 正宣; 中丸 裕爾; 中薗 彬; 本間 あや; 木村 将吾; 本間 明宏
日本耳鼻咽喉科免疫アレルギー感染症学会抄録集, 2回, 185, 185, 日本耳鼻咽喉科免疫アレルギー感染症学会, 2022年03月
日本語
The Quantification of Extracellular Trap Cell Death-Derived Products as Diagnostic Biomarkers for Otitis Media With Antineutrophil Cytoplasmic Antibody-Associated Vasculitis and Eosinophilic Otitis Media.Shinya Morita; Yuji Nakamaru; Atsushi Fukuda; Keishi Fujiwara; Masanobu Suzuki; Kimiko Hoshino; Aya Honma; Akihiro Homma
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 43, 3, e337-e343, 2022年03月01日,
［国際誌］英語, 研究論文（学術雑誌）, OBJECTIVE: This study aimed to quantify the cell-free deoxyribonucleic acid (DNA), citrullinated-histone H3 (cit-H3)-DNA complex, and myeloperoxidase (MPO)-DNA complex as extracellular trap cell death (ETosis)-derived products in the middle ear fluid, and to identify diagnostic biomarkers for the discrimination of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (OMAAV) from eosinophilic otitis media (EOM). STUDY DESIGN: Prospective study. SETTING: Tertiary referral center. PATIENTS: OMAAV patients were eligible for inclusion in this analysis. Patients with EOM were examined as controls. INTERVENTION: All samples were obtained from the middle ear fluid in patients with OMAAV or EOM. The fluid samples were aspirated from the middle ear through the anterior-inferior portion of the tympanic membrane using a 1-ml tuberculin syringe with a 24- or 26-gauge needle under a microscope. MAIN OUTCOME MEASURES: The levels of cell-free DNA, cit-H3-DNA complex and MPO-DNA complex in the fluid samples were quantified using an enzyme-linked immunosorbent assay. RESULTS: Patients with OMAAV showed significantly higher levels of MPO-DNA complex compared to patients with EOM, regardless of the serum ANCA status at the time of sampling (p < 0.001 and p < 0.001, respectively). Meanwhile, there were no significant differences in the values of cell-free DNA or cit-H3-DNA complex between the OMAAV and EOM patients. CONCLUSION: The findings of this study suggest that the detection and quantification of MPO-DNA complex in the otitis media fluid can be utilized to discriminate OMAAV, especially in cases of eosinophilic granulomatosis with polyangiitis, from EOM regardless of the serum ANCA status. It should be noted that it is possible for cell-free DNA and cit-H3-DNA complex in fluid samples to be derived from dead cells other than neutrophils that undergo ETosis.
前頭開頭術後に生じた前頭蓋底粘液嚢胞の2例山田 真司; 鈴木 正宣; 中丸 裕爾; 本間 あや; 中薗 彬; 木村 将吾; 安川 真一郎; 蠣崎 文彦; 本間 明宏
耳鼻咽喉科・頭頸部外科, 94, 2, 183, 187, 2022年02月
[A CASE OF SEVERE ASTHMA RESULTING IN DISEASE EXACERBATION AFTER PROLONGATION OF THE DOSING INTERVAL AFTER LONG-TERM OMALIZUMAB ADMINISTRATION].Machiko Matsumoto-Sasaki; Kaoruko Shimizu; Masanobu Suzuki; Masaru Suzuki; Hirokazu Kimura; Yuji Nakamaru; Satoshi Konno
Arerugi = [Allergy], 71, 8, 944, 948, 2022年,
［国内誌］日本語, 研究論文（学術雑誌）, At the time of writing of this manuscript, four biologics were clinically available for the treatment of severe asthma, and there were no established recommendations for the period of administration or timing of discontinuation of each biologic. We present a case of severe asthma that was well controlled with long-term omalizumab treatment; however, prolongation of the dosing intervals resulted in disease exacerbation that was refractory to omalizumab treatment despite the restoration of the recommended interval of administration. We suspect that the prolonged dosing intervals might have reduced the efficacy of omalizumab. We report this case because dosing intervals should be considered in clinical practice in cases of long-term omalizumab treatment.
Clinical Characteristics of Patients and Factors Associated with Switching Biologics in Asthma.Machiko Matsumoto-Sasaki; Kaoruko Simizu; Masanobu Suzuki; Masaru Suzuki; Hirokazu Kimura; Yuji Nakamaru; Yoichi M Ito; Akihiro Honma; Satoshi Konno
Journal of asthma and allergy, 15, 187, 195, 2022年,
［国際誌］英語, 研究論文（学術雑誌）, Purpose: Biologics have been used increasingly for the treatment of severe asthma. However, established guidelines for the selection, switching, or discontinuation of biologics do not exist. We aimed to identify the clinical characteristics of patients with asthma who required switching biologics and the factors associated with switching biologics. Patients and Methods: This was a retrospective study of 42 patients with severe asthma treated with biologics at the Hokkaido University Hospital between 23rd June 2016 and 30th April 2021, when two biologics were available in Japan. We compared the characteristics of subjects who continued and switched biologics. The time to switch the biologics was assessed by type 2 inflammatory biomarkers, pulmonary function indices, and the presence of comorbidities, including the Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis (JESREC) score and aspirin exacerbated respiratory diseases (AERD), using the Kaplan-Meier method and a multivariate Cox proportional hazards model. Results: Eight and five patients were treated by mepolizumab and benralizumab at baseline, respectively among the 31% (13/42) who switched the biologics. Subjects who required switching biologics were characterized by high blood eosinophil counts, younger age, JESREC scores of 11 points or higher, and AERD. The time taken to switch biologics was significantly shorter in the subgroups with high JESREC scores (≥11) or AERD, compared with their counterparts with low JESREC scores or without AERD (both, P < 0.05). JESREC scores of ≥11, but not the presence of AERD, were associated with time to switch biologics. Conclusion: The presence of eosinophilic chronic rhinosinusitis based on JESREC scores of ≥11 and younger age were factors associated with switching biologics in asthma.
後天性中耳真珠腫におけるNotchシグナル関連分子発現についての検討
福田 篤; 森田 真也; 藤原 圭志; 干野 季美子; 中丸 裕爾; 本間 明宏
日本耳科学会総会・学術講演会抄録集, 31回, 422, 422, (一社)日本耳科学会, 2021年10月
日本語
Remote Training of Functional Endoscopic Sinus Surgery With Advanced Manufactured 3D Sinus Models and a Telemedicine SystemMasanobu Suzuki; Erich Vyskocil; Kazuhiro Ogi; Kotaro Matoba; Yuji Nakamaru; Akihiro Homma; Peter J. Wormald; Alkis J. Psaltis
Frontiers in Surgery, 8, Frontiers Media SA, 2021年10月01日
研究論文（学術雑誌）,
Objective: Traditionally, cadaveric courses have been an important tool in surgical education for Functional Endoscopic Sinus Surgery (FESS). The recent COVID-19 pandemic, however, has had a significant global impact on such courses due to its travel restrictions, social distancing regulations, and infection risk. Here, we report the world-first remote (Functional Endoscopic Sinus Surgery) FESS training course between Japan and Australia, utilizing novel 3D-printed sinus models. We examined the feasibility and educational effect of the course conducted entirely remotely with encrypted telemedicine software.
Methods: Three otolaryngologists in Hokkaido, Japan, were trained to perform frontal sinus dissections on novel 3D sinus models of increasing difficulty, by two rhinologists located in Adelaide, South Australia. The advanced manufactured sinus models were 3D printed from the Computed tomography (CT) scans of patients with chronic rhinosinusitis. Using Zoom and the Quintree telemedicine platform, the surgeons in Adelaide first lectured the Japanese surgeons on the Building Block Concept for a three Dimensional understanding of the frontal recess. They in real time directly supervised the surgeons as they planned and then performed the frontal sinus dissections. The Japanese surgeons were asked to complete a questionnaire pertaining to their experience and the time taken to perform the frontal dissection was recorded. The course was streamed to over 200 otolaryngologists worldwide.
Results: All dissectors completed five frontal sinusotomies. The time to identify the frontal sinus drainage pathway (FSDP) significantly reduced from 1,292 ± 672 to 321 ± 267 s (
p = 0.02), despite an increase in the difficulty of the frontal recess anatomy. Image analysis revealed the volume of FSDP was improved (2.36 ± 0.00 to 9.70 ± 1.49 ml,
p = 0.014). Questionnaires showed the course's general benefit was 95.47 ± 5.13 in dissectors and 89.24 ± 15.75 in audiences.
Conclusion: The combination of telemedicine software, web-conferencing technology, standardized 3D sinus models, and expert supervision, provides excellent training outcomes for surgeons in circumstances when classical surgical workshops cannot be realized.
Metallothionein-3 is a clinical biomarker for tissue zinc levels in nasal mucosa.Masanobu Suzuki; Mahnaz Ramezanpour; Clare Cooksley; Kazuhiro Ogi; Alkis J Psaltis; Yuji Nakamaru; Akihiro Homma; Peter-John Wormald; Sarah Vreugde
Auris, nasus, larynx, 48, 5, 890, 897, 2021年10月,
［査読有り］,
［国際共著］,
［国際誌］英語, 研究論文（学術雑誌）, OBJECTIVE: Recently, depleted tissue zinc levels were found in nasal mucosa from patients with chronic rhinosinusitis (CRS) in correlation with tissue eosinophilia, however, no clinical biomarkers for tissue zinc levels have been identified. Metallothionein-3 (MT3) is an intracellular zinc chelator and previous data showed MT3 mRNA levels to be reduced in CRS patients with nasal polyps (CRSwNP). In this study, we examined the correlation between MT3 expression and zinc levels in nasal mucosa and primary human nasal epithelial cells (HNECs) to investigate whether MT3 could be a clinical biomarker for tissue zinc levels. METHOD: Tissue was harvested from 36 patients and mounted on tissue micro-array (TMA) slides. MT3 expression and tissue zinc fluorescence intensity were measured at different areas within the mucosa (surface epithelium and lamina propria) and compared between controls, CRSwNP and CRS without nasal polyps (CRSsNP) patients. MT3 mRNA and protein expression were examined in zinc-depleted HNECs by qPCR and immunofluorescence microscopy. RESULTS: MT3 expression in CRSwNP was significantly decreased in both surface epithelium (p<0.001 to controls) and lamina propria (p = 0.0491 to controls). There was a significant positive correlation between tissue zinc levels and MT3 expression in nasal mucosa (r = 0.45, p = 0.007). In zinc-deplete HNECs, MT3 expression was significantly decreased at mRNA (p = 0.02) and protein level (p<0.01). There was a significant positive correlation between tissue zinc levels and MT3 expression within individual HNECs (r = 0.59, p<0.001). CONCLUSIONS: MT3 expression reflects intramucosal zinc levels in both nasal mucosa and HNECs indicating MT3 could be used as a clinical biomarker for monitoring intracellular zinc levels in the nasal mucosa.
Notch Signaling in Acquired Middle Ear Cholesteatoma.Atsushi Fukuda; Satoshi Kano; Yuji Nakamaru; Shinya Morita; Kimiko Hoshino; Keishi Fujiwara; Akihiro Homma
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 42, 9, e1389-e1395, 2021年10月01日,
［査読有り］,
［国際誌］英語, 研究論文（学術雑誌）, HYPOTHESIS: We hypothesized that an anomalous change of Notch signaling might be involved in the pathophysiology of cholesteatoma. BACKGROUND: The Notch signaling pathway regulates integrated growth and differentiation control of keratinocytes. Its involvement in cholesteatoma proliferation has not been elucidated. METHODS: We obtained cholesteatoma and external auditory canal (EAC) skin samples from patients with middle ear cholesteatoma who underwent tympanomastoid surgery. We performed polymerase chain reaction using the RT2 Profiler™ PCR Array Human Notch Signaling Pathway (Qiagen) in the cholesteatoma and EAC skin samples (n = 6 each). This was followed by immunohistochemical staining of Notch1, enhancer of split-1 (HES1), and p53 in 41 and 8 cholesteatoma and EAC skin samples, respectively. RESULTS: The fold change of Notch1 gene expression was lowest in cholesteatoma, with a statistically significant difference (p = 0.0424). Moreover, the fold change of HES1 expression decreased (p = 0.272). The positive rates of Notch1 and HES1 protein expressions in the cholesteatoma (48.5 ± 32.4% and 44.9 ± 17.8%, respectively) were significantly lower than in the EAC skin (83.4 ± 17.5% and 55.7 ± 7.1%, respectively) (p < 0.001 and p < 0.01). In contrast, the positive rate of p53 expression in the cholesteatoma (8.5 ± 11.4%) was significantly higher than in the EAC skin (0.5 ± 0.7%) (p < 0.001). CONCLUSION: The decreases in Notch1 and HES1 protein expression might play an important role in the hyperproliferative character of the keratinizing squamous epithelium in cholesteatoma. An increase in p53 might reflect the reaction to cellular hyperproliferation.
鼻中隔前彎の客観的評価と適切な鼻中隔矯正術の術式選択
木村 将吾; 中丸 裕爾; 鈴木 正宣; 本間 あや; 中薗 彬; 本間 明宏
日本鼻科学会会誌, 60, 3, 312, 312, (一社)日本鼻科学会, 2021年09月
日本語
鼻粘膜上皮細胞におけるTLR3依存性自然免疫シグナル
鈴木 正宣; 中丸 裕爾; 中薗 彬; 本間 あや; 木村 将吾; Sarah Vreugde; Wormald PJ; 本間 明宏
日本鼻科学会会誌, 60, 3, 352, 352, (一社)日本鼻科学会, 2021年09月
日本語
Characteristics of and Prognosis for Facial Palsy in Patients With Otitis Media With ANCA-Associated Vasculitis (OMAAV).Keishi Fujiwara; Shinya Morita; Atsushi Fukuda; Hiroko Yanagi; Kimiko Hoshino; Yuji Nakamaru; Yasushi Furuta; Akihiro Homma
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 42, 10, e1577-e1582, 2021年08月04日,
［査読有り］,
［国際誌］英語, 研究論文（学術雑誌）, OBJECTIVES: The aim of the present study was to investigate the characteristics and prognosis of facial palsy in patients with otitis media with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (OMAAV). STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Thirty-seven patients with OMAAV. MAIN OUTCOME MEASURES: The patients were divided into the facial palsy group and non-palsy group. The severity of and prognosis for facial palsy were evaluated using the House-Brackmann facial grading system (HB). Characteristics were compared between the facial palsy group and non-palsy group. RESULTS: Facial palsy was observed in eight patients. The last HB grade for all patients was either grade I or II after treatment with a combination of corticosteroids and immunosuppressant therapy. There were no cases in which palsy relapsed. Facial palsy in OMAAV was significantly more common in female patients, and patients with facial palsy demonstrated significantly higher rates of hypertrophic pachymeningitis than did those without facial palsy. CONCLUSIONS: Facial palsy in patients with OMAAV was detected in 21.6% and a good prognosis was obtained by use of the appropriate treatment. Facial palsy is one of the most important symptoms by which to diagnose OMAAV. When encountering the patients with intractable otitis media complicated with facial palsy, appropriate examination including ANCA titer should be performed.
甲状腺穿刺吸引細胞診後に急速びまん性甲状腺腫大をきたした2例
本間 あや; 加納 里志; 中丸 裕爾; 本間 明宏
耳鼻咽喉科臨床 補冊, 補冊157, 113, 113, 耳鼻咽喉科臨床学会, 2021年06月
日本語
当科におけるアブミ骨手術症例の検討
小林 諒; 福田 篤; 藤原 圭志; 中丸 裕爾; 本間 明宏
耳鼻咽喉科臨床 補冊, 補冊157, 65, 65, 耳鼻咽喉科臨床学会, 2021年06月
日本語
Objective evaluation of caudal deviation of the nasal septum and selection of the appropriate septoplasty technique.Shogo Kimura; Masanobu Suzuki; Aya Honma; Akira Nakazono; Masayuki Osawa; Yuji Nakamaru; Akihiro Homma
Auris, nasus, larynx, 49, 1, 67, 76, 2021年05月06日,
［査読有り］,
［責任著者］,
［国際誌］英語, 研究論文（学術雑誌）, OBJECTIVE: Several methods have been reported to correct caudal deviation of the nasal septum, including open septorhinoplasty (OSR) and septoplasty with Killian incision (KI). In general, OSR is applied instead of KI for caudal deviation. However, there is little objective evidence own on the effects of OSR and KI for caudal deviation. In this study, we compared surgical outcomes between OSR and KI by quantifying nasal septum deviation using two simple and objective parameters on routine paranasal sinus CT scans. METHODS: We retrospectively analyzed 18 patients who underwent OSR and 11 patients who underwent septoplasty with KI between April 2006 and October 2019. Caudal deviation was defined on the basis of the "Anterior-posterior Position of the most deviated point of the nasal septum (AP)," which was measured on computerized tomography. The deformation rate (DR) of the nasal septum was also calculated. Nasal airway resistance and visual analogue scale (VAS) score for nasal obstruction were examined. RESULTS: The AP was significantly correlated with the VAS score (r=-0.58, p=0.017). The DR in patients with caudal septal deviation was significantly decreased by OSR (0.14±0.06 to 0.03±0.03, p=0.004), but not by KI (0.09±0.08 to 0.04±0.03, p=0.25). OSR also improved nasal airway resistance (1.10±0.44 to 0.42±0.15, p=0.02), and the VAS score (79.11±14.74 to 5.78±7.89, p=0.004). CONCLUSION: Nasal obstruction is more severe in patients with the caudal deviation. OSR corrects caudal deviation of the nasal septum more effectively than does KI. The AP could be useful for the evaluation of the deviation of the nasal septum and help in selecting the appropriate septoplastic technique.
Psychological evaluation for patients with non-cured facial nerve palsy.Keishi Fujiwara; Atsushi Fukuda; Shinya Morita; Hiroko Yanagi; Kimiko Hoshino; Yuji Nakamaru; Yasushi Furuta; Akihiro Homma
Auris, nasus, larynx, 49, 1, 53, 57, 2021年05月04日,
［査読有り］,
［国際誌］英語, 研究論文（学術雑誌）, OBJECTIVE: The aim of the present study was to evaluate the psychological condition of patients with non-cured facial nerve palsy and to investigate whether their psychological condition is correlated with the degree of facial nerve palsy, synkinesis or quality of life. METHODS: Thirty patients with non-cured facial nerve palsy were enrolled in this study. Psychological conditions were evaluated by questionnaires including State-Trait Anxiety Inventory and Self-rating Depression Scale. RESULTS: Of the thirty patients with non-cured facial nerve palsy, 17 (56.7%) and 15 patients (50.0%) felt anxiety and depression, respectively. Although there were no significant correlations between their psychological condition and the degree of facial nerve palsy or that of sequelae, significant correlations were observed between psychological condition and the degree of QOL, especially in terms of social function. CONCLUSIONS AND SIGNIFICANCE: Disabilities associated with facial nerve palsy may be overlooked when evaluation is performed by physician-graded instruments alone. To resolve this problem, patients with non-cured facial nerve palsy should be evaluated by not only physician-graded tools but also patient-based assessment tools.
鼻腔粘膜上皮細胞における新型コロナウィルス細胞侵入因子の発現制御機構
中薗 彬; 鈴木 正宣; 木村 将吾; 本間 あや; 中丸 裕爾; Ramezanpour Mahnaz; Vreugde Sarah; Wormald P.J.; 本間 明宏
日本耳鼻咽喉科免疫アレルギー感染症学会抄録集, 1回, 127, 127, 日本耳鼻咽喉科免疫アレルギー感染症学会, 2021年05月
日本語
Role of intracellular zinc in molecular and cellular function in allergic inflammatory diseases.Masanobu Suzuki; Takayoshi Suzuki; Masashi Watanabe; Shigetsugu Hatakeyama; Shogo Kimura; Akira Nakazono; Aya Honma; Yuji Nakamaru; Sarah Vreugde; Akihiro Homma
Allergology international : official journal of the Japanese Society of Allergology, 70, 2, 190, 200, 2021年04月,
［査読有り］,
［責任著者］,
［国際共著］,
［国際誌］英語, 研究論文（学術雑誌）, Zinc is an essential micronutrient in human body and a vital cofactor for the function of numerous proteins encoded by the human genome. Zinc has a critical role in maintaining many biochemical and physiological processes at the molecular, cellular, and multiple organ and systemic levels. The alteration of zinc homeostasis causes dysfunction of many organs and systems. In the immune system, zinc regulates the differentiation, proliferation and function of inflammatory cells, including T cells, eosinophils, and B cells, by modifying several signaling pathways such as NFκB signaling pathways and TCR signals. An adequate zinc level is essential for proper immune responses and decreased zinc levels were reported in many allergic inflammatory diseases, including atopic dermatitis, bronchial asthma, and chronic rhinosinusitis. Decreased zinc levels often enhance inflammatory activation. On the other hand, the inflammatory conditions alter the intracellular homeostasis of zinc, often decreasing zinc levels. These findings implied that there could be a vicious cycle between zinc deficiency and inflammatory conditions. In this review, we present recent evidence on the involvement of zinc in atopic dermatitis, bronchial asthma, and chronic rhinosinusitis, with insights into the involvement of zinc in the underlying molecular and cellular mechanisms related to these allergic inflammatory diseases.
Usefulness of the Video Head Impulse Test for the Evaluation of Vestibular Function in Patients With Otitis Media With Antineutrophil Cytoplasmic Antibody-Associated Vasculitis.Keishi Fujiwara; Shinya Morita; Atsushi Fukuda; Hiroko Yanagi; Kimiko Hoshino; Yuji Nakamaru; Akihiro Homma
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 42, 4, e483-e488, 2021年04月01日,
［査読有り］,
［国際誌］英語, 研究論文（学術雑誌）, OBJECTIVES: To investigate usefulness of the video Head Impulse Test (vHIT) as a method for evaluating semicircular canal function in patients with otitis media with antineutrophil cytoplasmic antibody-associated vasculitis (OMAAV). STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Fourteen patients with OMAAV underwent vestibular examination. MAIN OUTCOME MEASURES: The gain in vestibulo-ocular reflex (VOR) and the presence of catch-up saccade were examined for each semicircular canal. RESULTS: Seven (50.0%) of the 14 patients felt subjective symptoms of disequilibrium. Dysfunction in at least one semicircular canal was detected in all ears of the OMAAV patients evaluated by vHIT. Dysfunction in posterior semicircular canal was detected more frequently than that in the anterior or horizontal canal. There were no significant correlations between the gain in VOR and hearing loss. CONCLUSIONS: vHIT is thought to be the most suitable method for evaluating semicircular canal function in patients with OMAAV as vHIT is not influenced by middle ear pathology and was able to evaluate vertical canal function including the posterior canal.
Prognostic factors for duration of vertigo after stapes surgery via a time-to-event analysis.Atsushi Fukuda; Keishi Fujiwara; Shinya Morita; Kimiko Hoshino; Hiroko Yanagi; Yuji Nakamaru; Akihiro Homma
Acta oto-laryngologica, 141, 3, 216, 221, 2021年03月,
［査読有り］,
［国際誌］英語, 研究論文（学術雑誌）, BACKGROUND: Vertigo or dizziness after stapes surgery occurs sometimes, and it is generally temporary. However, while rare, it can be prolonged. AIMS/OBJECTIVES: To investigate the prognostic factors for duration of vertigo following stapedotomy using a time-to-event analysis. MATERIALS AND METHODS: The present study included a total of 35 primary ears (26 with otosclerosis and nine with congenital stapes fixation) from 31 patients. We assessed residual rates of nystagmus and complaints of subjective vestibular symptoms using Kaplan-Meier time-to-event methods. RESULTS: Postoperative spontaneous nystagmus was observed in 23 (65.7%) ears, and postoperative subjective vestibular symptoms were confirmed in 27 (77.1%) ears. The total mean duration of postoperative spontaneous nystagmus and subjective vestibular symptoms was 9.8 (range: 0-158) and 33.9 days (0-732), respectively. A history of stapes surgery in the opposite ear was a significant predictive factor for prolonged nystagmus and subjective vestibular symptoms (p = .0059 and p = .0146). CONCLUSIONS AND SIGNIFICANCE: For individuals with a history of stapes surgery in the opposite ear, spontaneous nystagmus and vertigo/dizziness sensations following stapedotomy may persist for a longer duration than in those without a history of stapes surgery in the opposite ear.
The role of endoscopic resection for selected patients with sinonasal squamous cell carcinoma.Yuji Nakamaru; Masanobu Suzuki; Satoshi Kano; Takatsugu Mizumachi; Nayuta Tsushima; Takayoshi Suzuki; Aya Honma; Akira Nakazono; Shogo Kimura; Rikiya Onimaru; Koichi Yasuda; Hiroki Shirato; Akihiro Homma
Auris, nasus, larynx, 48, 1, 131, 137, 2021年02月,
［査読有り］,
［筆頭著者, 責任著者］,
［国際誌］英語, 研究論文（学術雑誌）, OBJECTIVE: Despite of rapid advances in endoscopic surgery, the gold standard for sinonasal squamous cell carcinoma (SNSCC) surgery has remained the open approach with en-block resection due to the aggressive nature of SNSCC, including frequent recurrence and high mortality rate. For that reason, few studies have focused on SNSCC treated by endoscopic surgery alone. The objective of this study was to evaluate the usefulness of endoscopic surgery for patients with SNSCC. METHODS: A retrospective analysis was performed for 15 consecutive SNSCC patients who underwent endoscopic surgery without an open approach. We carefully selected patients whose tumor attachment sites could be fully visualized and completely resected through an endonasal approach. RESULTS: Of the fifteen patients, 4 patients (27%) were diagnosed with T1, 7 (47%) with T2, 4 (27%) with T3, and no patients with T4a or T4b disease. Four of the 15 (27%) patients showed positive surgical margins. The 5-yr overall survival, disease-specific survival, and local control rate was 72.4%, 79.6%, and 92.9%, respectively. The 5-yr disease-specific survival for T1, T2, and T3 disease was 100% and 75% and 75%, respectively. Patients with negative surgical margins had a better disease-specific survival rate than did those with positive surgical margins (p = 0.0253). CONCLUSION: Endoscopic surgery for patients with SNSCC appears to afford an effective method in selected cases. The achievement of negative surgical margins with a good view of the tumor attachment site was considered to be critical to the management of SNSCC.
Endonasal endoscopic surgery for sinonasal squamous cell carcinoma from an oncological perspective.Akihiro Homma; Yuji Nakamaru; Valerie J Lund; Ehab Y Hanna; Luiz Paulo Kowalski; Ronaldo Nunes Toledo; Antti A Mäkitie; Juan Pablo Rodrigo; Alessandra Rinaldo; Carl H Snyderman; Alfio Ferlito
Auris, nasus, larynx, 48, 1, 41, 49, 2021年02月,
［査読有り］,
［国際共著］,
［国際誌］英語, 研究論文（学術雑誌）, Endonasal endoscopic surgery (EES) has been applied to the management of sinonasal (SN) tumors based on recent advances in endoscopic surgical techniques and technologies over the past three decades. EES has been mainly indicated for benign tumors and less aggressive malignant tumors. Notwithstanding this, EES has been gradually adopted for squamous cell carcinoma (SCC), which is the most common histology among SN malignancies. However, an analysis of the outcomes of EES for patients with SCC is difficult because most articles included SCC a wide range of different tumor histologies. Therefore, we herein review and clarify the current status of EES focusing on SCC from an oncological perspective. The oncologic outcomes and the ability to achieve a histologically complete resection are similar between endoscopic and open approaches in highly selected patients with SN-SCC. Surgical complications associated with EES are likely similar for SN-SCC compared to other sinonasal malignancies. The indications for a minimally invasive approach such as EES in the management of patients with SN-SCC should be stricter than those for less aggressive malignant tumors because of the aggressive nature of SCC. Also, it is important to achieve negative surgical margins with EES in patients with SCC. We believe that the indications for EES for SN-SCC are widening due to advances in diagnostic imaging, and endoscopic surgical techniques and technologies. However, while expanding the indications for EES for SN-SCC we must carefully confirm that the outcomes support this strategy.
TLR Signals in Epithelial Cells in the Nasal Cavity and Paranasal Sinuses.Masanobu Suzuki; Clare Cooksley; Takayoshi Suzuki; Mahnaz Ramezanpour; Akira Nakazono; Yuji Nakamaru; Akihiro Homma; Sarah Vreugde
Frontiers in allergy, 2, 780425, 780425, 2021年,
［国際誌］英語, 研究論文（学術雑誌）, The respiratory tract is constantly at risk of invasion by microorganisms such as bacteria, viruses, and fungi. In particular, the mucosal epithelium of the nasal cavity and paranasal sinuses is at the very forefront of the battles between the host and the invading pathogens. Recent studies have revealed that the epithelium not only constitutes a physical barrier but also takes an essential role in the activation of the immune system. One of the mechanisms equipped in the epithelium to fight against microorganisms is the Toll-like receptor (TLR) response. TLRs recognize common structural components of microorganisms and activate the innate immune system, resulting in the production of a plethora of cytokines and chemokines in the response against microbes. As the epithelia-derived cytokines are deeply involved in the pathogenesis of inflammatory conditions in the nasal cavity and paranasal sinuses, such as chronic rhinosinusitis (CRS) and allergic rhinitis (AR), the molecules involved in the TLR response may be utilized as therapeutic targets for these diseases. There are several differences in the TLR response between nasal and bronchial epithelial cells, and knowledge of the TLR signals in the upper airway is sparse compared to that in the lower airway. In this review, we provide recent evidence on TLR signaling in the upper airway, focusing on the expression, regulation, and responsiveness of TLRs in human nasal epithelial cells (HNECs). We also discuss how TLRs in the epithelium are involved in the pathogenesis of, and possible therapeutic targeting, for CRS and AR.
Fluticasone Propionate Suppresses Poly(I:C)-Induced ACE2 in Primary Human Nasal Epithelial Cells.Akira Nakazono; Yuji Nakamaru; Mahnaz Ramezanpour; Takeshi Kondo; Masashi Watanabe; Shigetsugu Hatakeyama; Shogo Kimura; Aya Honma; P J Wormald; Sarah Vreugde; Masanobu Suzuki; Akihiro Homma
Frontiers in cellular and infection microbiology, 11, 655666, 655666, 2021年,
［査読有り］,
［国際共著］,
［国際誌］英語, 研究論文（学術雑誌）, Background: From the first detection in 2019, SARS-CoV-2 infections have spread rapidly worldwide and have been proven to cause an urgent and important health problem. SARS-CoV-2 cell entry depends on two proteins present on the surface of host cells, angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine 2 (TMPRSS2). The nasal cavity is thought to be one of the initial sites of infection and a possible reservoir for dissemination within and between individuals. However, it is not known how the expression of these genes is regulated in the nasal mucosa. Objective: In this study, we examined whether the expression of ACE2 and TMPRSS2 is affected by innate immune signals in the nasal mucosa. We also investigated how fluticasone propionate (FP), a corticosteroid used as an intranasal steroid spray, affects the gene expression. Methods: Primary human nasal epithelial cells (HNECs) were collected from the nasal mucosa and incubated with Toll-like receptor (TLR) agonists and/or fluticasone propionate (FP), followed by quantitative PCR, immunofluorescence, and immunoblot analyses. Results: Among the TLR agonists, the TLR3 agonist Poly(I:C) significantly increased ACE2 and TMPRSS2 mRNA expression in HNECs (ACE2 36.212±11.600-fold change, p<0.0001; TMPRSS2 5.598±2.434-fold change, p=0.031). The ACE2 protein level was also increased with Poly(I:C) stimulation (2.884±0.505-fold change, p=0.003). The Poly(I:C)-induced ACE2 expression was suppressed by co-incubation with FP (0.405±0.312-fold change, p=0.044). Conclusion: The activation of innate immune signals via TLR3 promotes the expression of genes related to SARS-CoV2 cell entry in the nasal mucosa, although this expression is suppressed in the presence of FP. Further studies are required to evaluate whether FP suppresses SARS-CoV-2 viral cell entry.
[A CASE OF SEVERE ASTHMA WHO REQUIRED A SWITCH OF FOUR BIOLOGICS: DIFFERENTIAL RESPONSES ON UPPER AND LOWER AIRWAYS].Machiko Matsumoto Sasaki; Kaoruko Shimizu; Masanobu Suzuki; Masaru Suzuki; Yuji Nakamaru; Satoshi Konno
Arerugi = [Allergy], 70, 4, 315, 320, 2021年,
［査読有り］,
［国内誌］日本語, 研究論文（学術雑誌）, At the time of writing of this manuscript, four biologics were clinically available for treatment against severe asthma. The choice of four biologics has been taking into account of the results of several type 2 inflammationrelated biomarkers, and the comorbidities of asthma, such as eosinophilic chronic rhinosinusitis, allergic rhinitis, and atopic dermatitis.In this study, we have experienced a case of severe asthma complicated by eosinophilic chronic rhinosinusitis and eosinophilic otitis media, resulting in the use of four biologics, and we observed differential response of upper and lower airways. As a clear algorithm has not been established for the use of four biologics, our experience of this case would provide important lesson for considering the therapeutic strategies against severe asthma.
Zinc-depletion associates with tissue eosinophilia and collagen depletion in chronic rhinosinusitis.M Suzuki; M Ramezanpour; C Cooksley; T J Lee; B Jeong; S Kao; T Suzuki; A J Psaltis; Y Nakamaru; A Homma; P J Wormald; S Vreugde
Rhinology, 58, 5, 451, 459, 2020年10月01日,
［査読有り］,
［国際共著］,
［国際誌］英語, 研究論文（学術雑誌）, BACKGROUND: Zinc plays an important role in many biological processes. Reduced zinc levels have been found in chronic rhinosinusitis (CRS) patients, however, its role in the pathophysiology of this disease remains unknown. This study examined zinc levels in the serum, mucus and tissue from CRS patients in relation to collagen content and eosinophil infiltration. The effect of zinc depletion on inflammatory cytokine production and collagen synthesis was assessed in vitro. METHODOLOGY: Zinc levels were determined in serum, mucus and tissue from controls, CRS with (CRSwNP) and without nasal polyps (CRSsNP) patients. Tissue zinc levels, collagen and inflammatory cell infiltration was examined using zinquin assays, immunofluorescence and histology on Tissue Micro Arrays. Cytokine expression and collagen synthesis was evaluated in zinc depleted primary human nasal epithelial cells (HNECs) and primary fibroblasts. RESULTS: CRSwNP patients showed reduced tissue zinc levels in correlation with a reduction in collagen content, and increased eosinophil numbers. Zinc depletion of HNECs and fibroblasts induced the production of pro-inflammatory cytokines and MUC5AC and reduced collagen secretion. CONCLUSIONS: These results suggest mucosal zinc depletion associates with tissue eosinophilia and collagen depletion in CRSwNP and induces pro-inflammatory cytokine expression and reduction of collagen synthesis in vitro.
頭頸部粘膜悪性黒色腫に対する術後陽子線治療30GyE/5回の初期経験
湊川 英樹; 安田 耕一; 出倉 康裕; 鈴木 正宣; 中丸 裕爾; 中薗 彬; 鈴木 崇祥; 対馬 那由多; 加納 里志; 鬼丸 力也; 清水 伸一; 本間 明宏; 青山 英史
頭頸部癌, 46, 2, 188, 188, (一社)日本頭頸部癌学会, 2020年07月
日本語
Evaluation of Semicircular Canal Function by Video Head Impulse Test in Patients With Facial Nerve Schwannoma.Keishi Fujiwara; Shinya Morita; Yasushi Furuta; Hiroko Yanagi; Kimiko Hoshino; Atsushi Fukuda; Yuji Nakamaru; Akihiro Homma
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 41, 5, e615-e622, 2020年06月,
［査読有り］,
［国際誌］英語, 研究論文（学術雑誌）, OBJECTIVES: The aim of the present study was to evaluate semicircular canal function by video Head Impulse Test (vHIT) in patients with facial nerve schwannoma (FNS). STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Seven patients with FNS underwent vHIT examination. MAIN OUTCOME MEASURES: The gain in vestibulo-ocular reflex and the presence of catch-up saccade were examined for the semicircular canals including the vertical canals. RESULTS: Dysfunction of the semicircular canals was detected by vHIT in three of seven cases. Nystagmus beating toward the non-affected side was observed in all three cases with semicircular canal dysfunction. Dysfunction was observed in a case with no direct compression of the vestibular nerve or semicircular canals by FNS. CONCLUSIONS: Semicircular canal function in patients with FNS could be evaluated by vHIT. vHIT has two advantages for the evaluation of vestibular function in patients with FNS. First, vHIT could be used for the patients in whom a tumor exists in the external auditory canal or middle ear, unlike caloric testing. Second, as vHIT could evaluate all three canals, impaired vestibular nerves could be speculated from vHIT results when a tumor exists in internal auditory canal. vHIT should be performed in patients with FNS, especially before surgery, to evaluate vestibular function.
Rosai-Dorfman disease: earlier spontaneous regression of skin lesions relative to nasal, pharyngeal, and bone lesions.Kazumasa Sato; Hideyuki Ujiie; Shinichi Nakazato; Mika Watanabe; Erika Watanabe; Teruki Yanagi; Yuji Nakamaru; Dai Takagi; Ryuta Arai; Tomohiro Onodera; Takeshi Kondo; Takanori Teshima; Hiroshi Shimizu
European journal of dermatology : EJD, 30, 2, 182, 183, 2020年04月01日,
［査読有り］,
［国際誌］英語, 研究論文（学術雑誌）
Analysis of semicircular canal function as evaluated by video Head Impulse Test in patients with vestibular schwannoma.Keishi Fujiwara; Shinya Morita; Atsushi Fukuda; Hiroki Akamatsu; Hiroko Yanagi; Kimiko Hoshino; Yuji Nakamaru; Satoshi Kano; Akihiro Homma
Journal of vestibular research : equilibrium & orientation, 30, 2, 101, 108, 2020年,
［査読有り］,
［国際誌］英語, 研究論文（学術雑誌）, OBJECTIVE: The aim of the present study was to investigate the factors influencing semicircular canal function as evaluated by video Head Impulse Test (vHIT) in patients with vestibular schwannoma. METHODS: Twenty-four patients with untreated vestibular schwannoma underwent vHIT examination. The correlations between semicircular canal function and factors including age, tumor size, disease duration and hearing loss were evaluated. RESULTS: The functions of all three semicircular canals on the affected side evaluated by vHIT were significantly lower than those on the unaffected side. Although there were no significant correlations between semicircular canal function and age, tumor size or disease duration, a negative significant correlation between vestibulo-ocular reflex (VOR) gain as evaluated by vHIT and hearing loss was observed. CONCLUSIONS: From the results of the relationship between hearing loss and VOR gain, the damage to the audio and vestibular systems in patients with VS may be correlated. As it has been suggested that tumor size was not a significant factor in the VOR gain evaluated by vHIT, multifactorial causes rather than the simple compression of the vestibular nerves alone may be related to the dysfunction of the semicircular canals in patients with vestibular schwannoma.
[A CASE OF SEVERE ASTHMA SWITCHED TO MEPOLIZUMAB DUE TO LATE-OCCURRING UNRESPONSIVENESS TO BENRALIZUMAB].Machiko Matsumoto-Sasaki; Kaoruko Shimizu; Masanobu Suzuki; Masaru Suzuki; Yuji Nakamaru; Satoshi Konno
Arerugi = [Allergy], 69, 8, 678, 682, 2020年,
［査読有り］,
［国内誌］日本語, 研究論文（学術雑誌）, We report the case of a 66-year-old patient with severe asthma complicated by eosinophilic chronic rhinosinusitis (ECRS). The patient was initially treated with benralizumab, which resulted in marked improvement of asthma symptoms and reduced the peripheral blood eosinophil count to 0/μL. Additionally, oral steroids were discontinued. After 7 months of benralizumab administration, the asthma symptoms worsened and peripheral blood eosinophil count increased to 813/μL. The neutralizing antibodies to benralizumab may have resulted in the recurrence of symptoms due to eosinophilic inflammation. The nasal symptoms, on which benralizumab had an unremarkable effect, improved when treatment was switched to mepolizumab. However, the difference in effects of biologics on ECRS has not been elucidated and warrants further investigation. To the best of our knowledge, this is the first report of a case of severe asthma in which mepolizumab administration reversed the clinical deterioration of asthma, which was possibly caused by neutralizing antibodies to benralizumab.
好酸球性中耳炎(EOM)と中耳炎を合併した好酸球性多発血管炎性肉芽腫症(EGPA)の比較
福田 篤; 森田 真也; 藤原 圭志; 干野 季美子; 中丸 裕爾; 本間 明宏
日本耳科学会総会・学術講演会抄録集, 29回, 508, 508, (一社)日本耳科学会, 2019年10月
日本語
当科における局所進行外耳道扁平上皮癌の治療成績の検討加納 里志; 森田 真也; 中丸 裕爾; 水町 貴諭; 対馬 那由多; 鈴木 崇祥; 中薗 彬; 福田 篤; 安田 耕一; 鬼丸 力也; 白土 博樹; 本間 明宏
頭頸部癌, 45, 3, 300, 304, (一社)日本頭頸部癌学会, 2019年10月
日本語
当院における外鼻形成術および鼻中隔矯正術施行例の検討
木村 将吾; 中丸 裕爾; 鈴木 正宣; 本間 あや; 中薗 彬; 本間 明宏
日本鼻科学会会誌, 58, 3, 632, 632, (一社)日本鼻科学会, 2019年09月
日本語
Differentiation Between Eosinophilic Otitis Media and Otitis Media Associated With Eosinophilic Granulomatosis With Polyangiitis.Atsushi Fukuda; Shinya Morita; Yuji Nakamaru; Kimiko Hoshino; Keishi Fujiwara; Akihiro Homma
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 40, 8, e796-e802, 2019年09月,
［査読有り］,
［国際誌］英語, 研究論文（学術雑誌）, OBJECTIVE: To perform comparisons and clarify differences in clinical manifestations between eosinophilic otitis media (EOM) and otitis media associated with eosinophilic granulomatosis with polyangiitis (EGPA). STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Twenty-two ears of 11 patients exhibiting EOM (EOM group) and 20 ears of 12 patients exhibiting otitis media associated with EGPA (EGPA group). MAIN OUTCOME MEASURES: Otological manifestations, nasal and paranasal manifestations, incidence of asthma, positivity for serum antineutrophil cytoplasmic antibodies (ANCA), total serum immunoglobulin (Ig) E level, peripheral blood eosinophil fraction, and hearing outcomes. RESULTS: The incidence and age of onset of asthma and chronic rhinosinusitis were comparable between the EOM and EGPA groups. Moreover, otological findings and hearing outcomes at the initial visit were similar in both groups. Computed tomography images of the paranasal sinus showed predominant opacification of the ethmoid sinus in both groups. Although the total serum IgE level was not significantly different, the peripheral blood eosinophil fraction was significantly larger in the EGPA group than in the EOM group (p = 0.0035). Furthermore, the rate of myeloperoxidase-antineutrophil cytoplasmic antibodies (ANCA) positivity was significantly higher in the EGPA group than in the EOM group (p = 0.019). CONCLUSIONS: The findings of the present study suggest that the phenotypic characteristics of EOM closely resemble those of otitis media associated with EGPA in early stages before the appearance of vasculitis. Therefore, it is challenging to differentiate the two conditions purely on the basis of otorhinological examinations.
Make-Up Therapy for Patients With Facial Nerve Palsy.Keishi Fujiwara; Yasushi Furuta; Wakae Aoki; Yuji Nakamaru; Shinya Morita; Kimiko Hoshino; Atsushi Fukuda; Akihiro Homma
The Annals of otology, rhinology, and laryngology, 128, 8, 721, 727, 2019年08月,
［査読有り］,
［国際誌］英語, 研究論文（学術雑誌）, OBJECTIVES: To investigate the effectiveness of make-up therapy for patients with facial nerve palsy. METHODS: Seven female patients with facial nerve palsy who received specialist make-up therapy were enrolled. The objective of the make-up therapy was to obtain a symmetrical facial appearance. RESULTS: Overall score for the Facial Clinimetric Evaluation (FaCE) scale was significantly improved after make-up therapy. There was a tendency for symptoms of depression to be improved among patients after make-up therapy. CONCLUSION: Make-up therapy to improve the symmetry of facial appearance could afford a noninvasive and low-cost treatment for patients with facial nerve palsy, especially in terms of patient quality of life and psychological condition.
Short-Term Hearing Prognosis of Ossiculoplasty in Pars Flaccida Cholesteatoma Using the EAONO/JOS Staging System.Fukuda A; Morita S; Nakamaru Y; Hoshino K; Fujiwara K; Homma A
The journal of international advanced otology, 15, 1, 2, 7, 2019年04月,
［査読有り］,
［国際誌］英語, 研究論文（学術雑誌）, OBJECTIVES: The aim of the present study was to investigate the prognostic factors for short-term hearing outcomes of ossiculoplasty for primary pars flaccida cholesteatoma according to the European Academy of Otology and Neurotology/Japanese Otological Society (EAONO/JOS) and 2015 JOS staging systems. MATERIALS AND METHODS: A total of 34 patients with primary pars flaccida cholesteatoma who underwent one-stage tympanomastoidectomy with partial ossicular reconstruction using double cartilage block were included in the study. The postoperative pure-tone average air-bone gap (PTA-ABG) was calculated, and two criteria of successful hearing outcomes were defined as ≤10 and ≤20 dB. Patients were classified according to the EAONO/JOS and 2015 JOS staging systems. Cochran-Armitage test was used to statistically analyze staging, and Fisher's exact test was used to analyze other factors. RESULTS: Successful hearing outcome with postoperative PTA-ABG ≤10 and ≤20 dB occurred in 23.5% and 55.9% of cases, respectively. When postoperative PTA-ABG ≤20 dB was defined as successful, the success rate significantly decreased with increase in EAONO/JOS stage, and S0 pathological status of the stapes (no involvement) was a significantly favorable predictive factor. When postoperative PTA-ABG ≤10 dB was regarded as successful, the significantly favorable predictive factors were S0 pathological status of the stapes and development of mastoid cells with MC2-3 (better developed cells). CONCLUSION: Favorable prognostic factors for hearing outcomes of tympanomastoidectomy with partial ossicular reconstruction for primary pars flaccida cholesteatoma were low stage following the EAONO/JOS staging system and no stapes involvement and better development of mastoid cells following the 2015 JOS staging system.
Evaluation of Vertical Semicircular Canal Function in Patients With Vestibular Schwannoma.Fujiwara K; Yanagi H; Morita S; Hoshino K; Fukuda A; Nakamaru Y; Homma A
The Annals of otology, rhinology, and laryngology, 128, 2, 113, 120, 2019年02月,
［査読有り］,
［国際誌］英語, 研究論文（学術雑誌）, OBJECTIVES:: The aim of this study was to investigate vertical semicircular canal function in patients with vestibular schwannoma (VS) by video head impulse test (vHIT). METHODS:: Fifteen patients with VS who had not received any treatment, including surgery or stereotactic radiotherapy, before vHIT examination were enrolled. Vestibulo-ocular reflex gain and catch-up saccade in vHIT were evaluated. RESULTS:: Dysfunction of anterior and posterior semicircular canals was detected by vHIT in 26.7% and 60.0%, respectively. Six patients (40.0%) demonstrated abnormalities referable to both vestibular nerve divisions. Abnormalities referable to the superior vestibular nerve were identified in 3 patients (20.0%), while 3 patients (20.0%) demonstrated a pattern indicative of inferior vestibular nerve involvement. Anterior semicircular canal vHIT produced fewer abnormalities than did either horizontal or posterior semicircular canal vHIT. CONCLUSIONS:: Dysfunction of the semicircular canals, including the vertical canals, in patients with VS was detected by vHIT. The anterior semicircular canal was less frequently involved than the horizontal or posterior semicircular canal. The examination of the vertical canals by vHIT is useful in the evaluation of vestibular function in patients with VS.
The Diagnostic and Clinical Utility of the Myeloperoxidase-DNA Complex as a Biomarker in Otitis Media With Antineutrophil Cytoplasmic Antibody-associated Vasculitis.Shinya Morita; Yuji Nakamaru; Daigo Nakazawa; Masanobu Suzuki; Kimiko Hoshino; Atsushi Fukuda; Fumihiko Hattanda; Kanako Kusunoki; Utano Tomaru; Akihiro Ishizu; Akihiro Homma
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 40, 2, e99-e106, e106, 2019年02月,
［査読有り］,
［責任著者］,
［国際誌］英語, 研究論文（学術雑誌）, OBJECTIVE: This prospective study aimed to evaluate the diagnostic and clinical utility of the myeloperoxidase (MPO)-DNA complex as a NETosis-derived product in the middle ear fluid of patients with otitis media with antineutrophil cytoplasmic antibody-associated vasculitis (OMAAV). STUDY DESIGN: Prospective study. SETTING: Tertiary referral center. PATIENTS: Twenty-two patients diagnosed with OMAAV. INTERVENTION: Collection of the fluid samples from middle ear. MAIN OUTCOME MEASURE: The levels of the MPO-DNA complex in the fluid samples were quantified using an enzyme-linked immunosorbent assay. RESULTS: Patients with both systemic and localized forms of OMAAV showed significantly higher levels of the MPO-DNA complex compared to the controls (p < 0.001 and p = 0.002, respectively). In particular, they showed significantly higher levels of MPO-DNA complex compared to the controls, regardless of serum antineutrophil cytoplasmic antibody status (p < 0.001 and p < 0.001, respectively) or immunosuppressive therapy (p < 0.001 and p < 0.001, respectively) at the time of sampling. An optical density cutoff value of 0.16 at 405 nm according to the receiver operating characteristic curve showed a sensitivity of 86.4%, specificity of 95.5%, positive predictive value of 95.0% and negative predictive value of 87.5% for the diagnosis of OMAAV. Significant positive correlations were observed between the levels of MPO-DNA complex and the values for air conduction - (r = 0.49, p = 0.022) and bone conduction - pure tone average thresholds (r = 0.45, p = 0.035). CONCLUSIONS: The detection and quantification of the MPO-DNA complex in the otitis media fluid may aid in providing a definite diagnosis as well as predicting the activity and severity of OMAAV.
Spontaneous Regression of Swollen Submandibular Glands in IgG4-Related DiseaseMasanobu Suzuki; Yuji Nakamaru; Dai Takagi; Aya Honma; Takayoshi Suzuki; Emi Takakuwa; Shinya Morita; Sarah Vreugde; Akihiro Homma
Allergy & Rhinology, 10, 215265671881673, 215265671881673, SAGE Publications, 2019年01月
研究論文（学術雑誌）,
Background IgG4-related disease is a new clinical entity frequently associated with swelling of the submandibular glands (SMGs). The long-term outcome of SMG swelling without steroid therapy remains unknown.
Objective To examine whether swollen SMGs spontaneously regress without steroid therapy in the context of IgG4-related disease and to identify biomarkers that can predict the spontaneous regression of SMG swelling.
Methods The SMG volume of 49 patients diagnosed with IgG4-related disease was calculated by measuring the axial and coronal planes of computed tomography scans. The change in SMG volume over time was measured and examined by treatment regimen, clinical data, and serum complement level.
Results We found 28 of 49 (57%) IgG4-related disease patients to have swollen SMGs, with 15 of 20 (75%) of the swollen SMGs regressing without steroid therapy. The time required for the SMGs swelling to regress was significantly shorter in the steroid therapy group than in the no-steroid therapy group. Serum complement components at the initial visit were significantly lower in the regressed SMG group than in the nonregressed SMG group.
Conclusion We observed 75% of swollen SMGs spontaneously regressed in patients with IgG4-related disease. The time required for the swollen SMGs to regress was longer in patients without steroid therapy than in those with steroid therapy. Serum complement level could be used as a predictor for the spontaneous regression of swollen SMGs in patients with IgG4-related disease.
Sirtuin-1 Controls Poly (I:C)-Dependent Matrix Metalloproteinase 9 Activation in Primary Human Nasal Epithelial Cells.Suzuki M; Ramezanpour M; Cooksley C; Li J; Nakamaru Y; Homma A; Psaltis A; Wormald PJ; Vreugde S
American journal of respiratory cell and molecular biology, 59, 4, 500, 510, 2018年10月,
［査読有り］,
［国際共著］,
［国際誌］英語, 研究論文（学術雑誌）, Matrix metalloproteinase (MMP)-9 is thought to be involved in the etiopathogenesis of chronic rhinosinusitis (CRS) with nasal polyps and cleaves collagen IV, causing hyperpermeability of the basement membrane within mucosal tissue. It is known that MMP-9 expression is negatively affected by sirtuin (SIRT)-1 in human monocytotic cells, retinal endothelial cells, and epithelial carcinoma cells. However, it is unknown which factors affect MMP-9 expression and activity in human nasal epithelial cells (HNECs). To examine factors affecting MMP-9 expression and activity in HNECs, HNECs were stimulated with Toll-like receptor (TLR) agonists, followed by quantitative PCR, immunofluorescence, and zymography to examine MMP-9 expression and activity. MMP-9 expression was evaluated in sinonasal tissue of control subjects without CRS, and patients with CRS without nasal polyps and those with CRS with nasal polyps, in relation to the expression of SIRT1 using a tissue microarray. The effect of SIRT1 stimulation/inhibition on MMP-9 expression in HNECs was also tested. TLR3 agonists increased MMP-9 mRNA expression (473 fold, P = 0.0198) and activity (20.4-fold, P < 0.05). SIRT1 activation or inhibition reciprocally affected MMP-9 expression in the presence of TLR3 agonists. MMP-9 and SIRT1 expression within the epithelial layer of sinonasal tissue was inversely correlated only in patients with CRS but not in control subjects. TLR3 agonists increased MMP-9 expression and activity in HNECs, and the effect was abolished in the presence of SIRT1 activation. SIRT1 and MMP-9 expression was inversely correlated in CRS tissue, supporting SIRT1 as a possible therapeutic target for nasal polyp formation.
Anti-mumps IgM antibody positive rate with sudden sensorineural hearing loss using second-generation enzyme immunoassay: A retrospective, multi-institutional investigation in Hokkaido, JapanAtsushi Fukuda; Shinya Morita; Yuji Nakamaru; Kimiko Hoshino; Keishi Fujiwara; Shigeru Akazawa; Tomohiro Sakashita; Nobuyuki Obara; Akihiro Homma
Auris Nasus Larynx, 45, 5, 911, 915, Elsevier Ireland Ltd, 2018年10月01日,
［査読有り］,
［国際誌］英語, 研究論文（学術雑誌）
EAONO/JOS中耳真珠腫進展度分類を用いた術後聴力予後因子の検討
福田 篤; 森田 真也; 干野 季美子; 藤原 圭志; 中丸 裕爾; 本間 明宏
Otology Japan, 28, 4, 468, 468, (一社)日本耳科学会, 2018年09月
日本語
vHITを用いた聴神経腫瘍症例の垂直半規管機能評価
藤原 圭志; 森田 真也; 干野 季美子; 福田 篤; 中丸 裕爾; 本間 明宏
Otology Japan, 28, 4, 637, 637, (一社)日本耳科学会, 2018年09月
日本語
当院における嗅神経芽細胞腫の治療方針と成績
中薗 彬; 中丸 裕爾; 鈴木 正宣; 水町 貴諭; 高木 大; 本間 明宏
日本鼻科学会会誌, 57, 3, 429, 429, (一社)日本鼻科学会, 2018年09月
日本語
篩骨動脈を茎とする鼻中隔粘膜弁を用いた鼻中隔穿孔閉鎖術の1例
勝俣 量平; 鈴木 正宣; 中薗 彬; 中丸 裕爾; 本間 明宏
日本鼻科学会会誌, 57, 3, 504, 504, (一社)日本鼻科学会, 2018年09月
日本語
Comparison of the University of Pittsburgh staging system and the eighth edition of the American Joint Committee on Cancer TNM classification for the prognostic evaluation of external auditory canal cancer.Morita S; Mizumachi T; Nakamaru Y; Sakashita T; Kano S; Hoshino K; Fukuda A; Fujiwara K; Homma A
International journal of clinical oncology, 23, 6, 1029, 1037, 2018年07月,
［査読有り］,
［国内誌］英語, 研究論文（学術雑誌）, BACKGROUND: The purpose was to compare survival differences between patients with external auditory canal (EAC) cancer treated according to the University of Pittsburgh modified TNM staging system and those treated in accordance with the 8th edition of the American Joint Committee on Cancer (AJCC) staging manual on the TNM staging system for cutaneous cancers of the head and neck. METHODS: We performed a retrospective, single-institution review of 60 patients with EAC cancer treated with curative intent between September 2002 and March 2018. Survival outcomes were measured on the basis of the two staging systems. RESULTS: The C-index values for the overall survival (OS) rate revealed that the University of Pittsburgh staging system had higher prognostic accuracy than the 8th edition of the AJCC staging system. Univariable and multivariable analysis showed that T classification according to the University of Pittsburgh staging system was an independent predictor of the OS rate (hazard ratio 5.25; 95% confidence interval 1.38-24.9; P = 0.015). Meanwhile, the AJCC staging system could not differentiate T2 from T3-4 cancers. CONCLUSION: The University of Pittsburgh staging system for patients with EAC cancer is a valuable tool for use in clinical decision-making and predicting survival outcome.
鼻粘膜上皮細胞においてSIRT-1はPolyICに誘導されるMMP9を負に制御する
鈴木 正宣; 中丸 裕爾; 高木 大; 本間 あや; Vreugde Sarah; Wormald Peter-John; 本間 明宏
耳鼻咽喉科免疫アレルギー, 36, 2, 118, 119, 日本耳鼻咽喉科免疫アレルギー学会, 2018年06月
日本語
当科における局所進行外耳道扁平上皮癌の治療成績の検討
加納 里志; 森田 真也; 中丸 裕爾; 水町 貴諭; 中薗 彬; 福田 篤; 安田 耕一; 鬼丸 力也; 白土 博樹; 本間 明宏
頭頸部癌, 44, 2, 181, 181, (一社)日本頭頸部癌学会, 2018年05月
日本語
当科における局所進行外耳道扁平上皮癌の治療成績の検討
加納 里志; 森田 真也; 中丸 裕爾; 水町 貴諭; 中薗 彬; 福田 篤; 安田 耕一; 鬼丸 力也; 白土 博樹; 本間 明宏
頭頸部癌, 44, 2, 181, 181, (一社)日本頭頸部癌学会, 2018年05月
日本語
鼻副鼻腔内反性乳頭腫の悪性転化に関与する遺伝子変異の解析安川 真一郎; 加納 里志; 畠山 博充; 中丸 裕爾; 高木 大; 水町 貴諭; 鈴木 正宣; 鈴木 崇祥; 中薗 彬; 本間 明宏
日本耳鼻咽喉科学会会報, 121, 4, 539, 539, (一社)日本耳鼻咽喉科学会, 2018年04月
日本語
当院における嗅神経芽細胞腫の治療方針と成績中丸 裕爾; 高木 大; 鈴木 正宣; 加納 里志; 水町 貴諭; 中薗 彬; 本間 明宏
日本耳鼻咽喉科学会会報, 121, 4, 567, 567, (一社)日本耳鼻咽喉科学会, 2018年04月
日本語
当院における嗅神経芽細胞腫の治療方針と成績中丸 裕爾; 高木 大; 鈴木 正宣; 加納 里志; 水町 貴諭; 中薗 彬; 本間 明宏
日本耳鼻咽喉科学会会報, 121, 4, 567, 567, (一社)日本耳鼻咽喉科学会, 2018年04月
日本語
鼻副鼻腔内反性乳頭腫の悪性転化に関与する遺伝子変異の解析
安川 真一郎; 加納 里志; 畠山 博充; 中丸 裕爾; 高木 大; 水町 貴諭; 鈴木 正宣; 鈴木 崇祥; 中薗 彬; 本間 明宏
日本耳鼻咽喉科学会会報, 121, 4, 539, 539, (一社)日本耳鼻咽喉科学会, 2018年04月
日本語
抗好中球細胞質抗体関連血管炎症候群に伴う難治性中耳炎における好中球細胞外トラップの発現
森田 真也; 中丸 裕爾; 干野 季美子; 福田 篤; 本間 明宏
Otology Japan, 27, 4, 429, 429, (一社)日本耳科学会, 2017年10月
日本語
鼻粘膜上皮細胞での自然免疫シグナルによるMMP9の発現誘導
鈴木 正宣; 中丸 裕爾; 高木 大; 本間 あや; Vreugde Sarah; Wormald Peter-John; 本間 明宏
日本鼻科学会会誌, 56, 3, 429, 429, (一社)日本鼻科学会, 2017年09月
日本語
鼻粘膜上皮細胞での自然免疫シグナルによるMMP9の発現誘導
鈴木 正宣; 中丸 裕爾; 高木 大; 本間 あや; Vreugde Sarah; Wormald Peter-John; 本間 明宏
日本鼻科学会会誌, 56, 3, 429, 429, (一社)日本鼻科学会, 2017年09月
日本語
IgG4関連疾患における鼻副鼻腔病変の検討高木 大; 中丸 裕爾; 鈴木 正宣; 本間 あや; 福田 諭
耳鼻咽喉科免疫アレルギー, 35, 2, 238, 239, 日本耳鼻咽喉科免疫アレルギー学会, 2017年08月
日本語
当科の弛緩部型中耳真珠腫の臨床的検討福田 篤; 森田 真也; 干野 季美子; 藤原 圭志; 中丸 裕爾; 福田 諭
日本耳鼻咽喉科学会会報, 120, 4, 535, 535, (一社)日本耳鼻咽喉科学会, 2017年04月
日本語
IgG4関連疾患における鼻副鼻腔病変の検討高木 大; 中丸 裕爾; 鈴木 正宣; 本間 あや; 福田 諭
日本耳鼻咽喉科学会会報, 120, 4, 557, 557, (一社)日本耳鼻咽喉科学会, 2017年04月
日本語
外耳道癌組織における免疫組織化学的手法に基づく発現分子解析
森田 真也; 本間 明宏; 中丸 裕爾; 安川 真一郎; 福田 篤; 福田 諭
日本耳鼻咽喉科学会会報, 120, 4, 566, 566, (一社)日本耳鼻咽喉科学会, 2017年04月
日本語
Sinus Computed Tomographic Findings in Adult Smokers and Nonsmokers with Asthma. Analysis of Clinical Indices and Biomarkers.Hirokazu Kimura; Satoshi Konno; Yuji Nakamaru; Hironi Makita; Natsuko Taniguchi; Kaoruko Shimizu; Masaru Suzuki; Junya Ono; Shoichiro Ohta; Kenji Izuhara; Masaharu Nishimura
Annals of the American Thoracic Society, 14, 3, 332, 341, 2017年03月,
［査読有り］,
［国際誌］英語, 研究論文（学術雑誌）, RATIONALE: When they occur together, sinusitis and asthma are often thought to represent anatomically separate components of the same chronic inflammatory airway disease. Information about the effect of smoking on the interaction between sinusitis and asthma in patients who have both disorders is limited. OBJECTIVES: To evaluate the effect of cigarette smoking on the relationship between the presence and severity of sinusitis and selected asthma-related indices in adults who have asthma. METHODS: This study included 127 patients with severe asthma and 79 patients with mild to moderate asthma. Clinical data were obtained from all subjects during a 2-day stay at Hokkaido University Hospital (Sapporo, Japan). The Lund-Mackay scoring system was used to assess the anatomic extent and severity of sinusitis as revealed by sinus computed tomographic (CT) images obtained during hospitalization. We examined associations between Lund-Mackay scores and a variety of asthma-related indices and levels of biomarkers in blood and sputum. To clarify the effect of smoking on these associations, we conducted separate analyses for nonsmoking (<10 pack-years; n = 130) and smoking subjects (≥10 pack-years; n = 76). MEASUREMENTS AND MAIN RESULTS: In our cohort of adults with asthma, we found significant positive relationships between the presence and severity of sinusitis as assessed by Lund-Mackay score and the severity of asthma as measured by percent predicted FEV1 or FEV1/FVC for nonsmoking subjects (<10 pack-years) but not for cigarette smokers (>10 pack-years). Lund-Mackay scores correlated with blood and sputum eosinophil counts, serum IgE levels, and fractional exhaled nitric oxide, regardless of smoking status. Lund-Mackay scores also showed significant positive associations with serum periostin and chemokine C-C motif ligand 18 levels, regardless of smoking status, whereas a positive association with plasma osteopontin level was seen only for nonsmoking subjects. CONCLUSIONS: We found an association between the severity of sinusitis on CT imaging and the severity of concomitant asthma on spirometry for nonsmoking adults but not for smokers. In adults with asthma, CT imaging evidence of severe sinusitis indicates intense Th2-related inflammation, regardless of smoking status.
Expression of p53, p16, cyclin D1, epidermal growth factor receptor and Notch1 in patients with temporal bone squamous cell carcinomaShinya Morita; Yuji Nakamaru; Akihiro Homma; Shinichiro Yasukawa; Hiromitsu Hatakeyama; Tomohiro Sakashita; Satoshi Kano; Atsushi Fukuda; Satoshi Fukuda
INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY, 22, 1, 181, 189, 2017年02月,
［査読有り］,
［国内誌］英語, 研究論文（学術雑誌）
アレルギー性鼻炎モデルマウスにおける鼻粘膜時計遺伝子発現リズム
本間 あや; 中丸 裕爾; 高木 大; 鈴木 正宣; 福田 諭
日本鼻科学会会誌, 55, 3, 468, 468, (一社)日本鼻科学会, 2016年09月
日本語
Microbially cleaved immunoglobulins are sensed by the innate immune receptor LILRA2.Kouyuki Hirayasu; Fumiji Saito; Tadahiro Suenaga; Kyoko Shida; Noriko Arase; Keita Oikawa; Toshifumi Yamaoka; Hiroyuki Murota; Hiroji Chibana; Ichiro Nakagawa; Tomoko Kubori; Hiroki Nagai; Yuji Nakamaru; Ichiro Katayama; Marco Colonna; Hisashi Arase
Nature microbiology, 1, 6, 16054, 16054, 2016年04月25日,
［査読有り］,
［国際誌］英語, Microbial proteases degrade a variety of host proteins(1-3). However, it has remained largely unknown why microorganisms have evolved to acquire such proteases and how the host responds to microbially degraded products. Here, we have found that immunoglobulins disrupted by microbial pathogens are specifically detected by leukocyte immunoglobulin-like receptor A2 (LILRA2), an orphan activating receptor expressed on human myeloid cells. Proteases from Mycoplasma hyorhinis, Legionella pneumophila, Streptococcus pneumonia and Candida albicans cleaved the N-terminus of immunoglobulins. Identification of the immunoglobulin-cleaving protease from L. pneumophila revealed that the protease is conserved across some bacteria including Vibrio spp. and Pseudomonas aeruginosa. These microbially cleaved immunoglobulins but not normal immunoglobulins stimulated human neutrophils via LILRA2. In addition, stimulation of primary monocytes via LILRA2 inhibited the growth of L. pneumophila. When mice were infected with L. pneumophila, immunoglobulins were cleaved and recognized by LILRA2. More importantly, cleaved immunoglobulins were detected in patients with bacterial infections and stimulated LILRA2-expressing cells. Our findings demonstrate that LILRA2 is a type of innate immune receptor in the host immune system that detects immunoglobulin abnormalities caused by microbial pathogens.
The effectiveness of escitalopram to tinnitus patients
Masayori Masuya; Yuji Nakamaru; Sinya Morita; Satoshi Fukuda
Otolaryngology - Head and Neck Surgery (Japan), 86, 12, 1047, 1050, Igaku-Shoin Ltd, 2014年11月01日
日本語, 研究論文（学術雑誌）
耳鳴に対するエスシタロプラムの有効性に関する検討
桝谷 将偉; 中丸 裕爾; 森田 真也; 福田 諭
Otology Japan, 23, 4, 774, 774, (一社)日本耳科学会, 2013年10月
日本語
外側側頭骨切除術に一期的鼓室形成術を施行した早期外耳道癌症例の検討
中丸 裕爾; 森田 真也; 桝谷 将偉; 福田 諭
Otology Japan, 23, 4, 669, 669, (一社)日本耳科学会, 2013年10月
日本語
Vogt-小柳-原田病における聴力像の特徴および聴力予後の検討
森田 真也; 中丸 裕爾; 小原 修幸; 桝谷 将偉; 福田 諭
Otology Japan, 23, 4, 513, 513, (一社)日本耳科学会, 2013年10月
日本語
IgG4関連硬化性疾患に併発した副鼻腔炎高木 大; 中丸 裕爾; 鈴木 正宣; 本間 あや; 福田 諭
耳鼻咽喉科免疫アレルギー, 31, 2, 73, 74, 日本耳鼻咽喉科免疫アレルギー学会, 2013年06月
日本語
急性副鼻腔炎に対するLevofloxacin 1日1回500mg投与の治療効果高木 大; 中丸 裕爾; 鈴木 正宣; 福田 諭
耳鼻咽喉科・頭頸部外科, 84, 13, 1021, 1026, (株)医学書院, 2012年12月
日本語, 急性副鼻腔炎に対するLevofloxacin 500mg1日1回投与の早期治療効果と安全性を検討した。解析対象は26症例で、急性炎症を起こしてから10日以内であり、投与期間は全て7日間であった。重症度は中等症6例、重症20例であった。投与開始3日後、自覚症状、他覚所見ともに有意なスコアの改善を認め、投与終了時の有効率は84.6%であり、特に重症例での有効率は90.0%であった。やや有効にとどまった症例を4例認めたが、自覚症状、他覚所見どちらも改善を示さない無効例はなかった。やや有効の4例中2例は、鼻中隔彎曲等による中鼻道の狭小化があり、その後内視鏡的副鼻腔手術を施行して改善した。24例には細菌学的検査を施行し、10例から12種の原因菌が同定された。Haemophilus influenzaeが5株と最多で、Streptococcus pneumoniaeの4株が続いた。副作用は1例に軽度の全身そう痒感が発現したが、内服は継続可能であった。
早期外耳道癌に対して外側側頭骨切除術に一期的鼓室形成術を施行した4症例
森田 真也; 中丸 裕爾; 福田 諭
Otology Japan, 22, 4, 579, 579, (一社)日本耳科学会, 2012年09月
日本語
IgG4関連疾患の鼻腔病変における組織学的検討鈴木 正宣; 中丸 裕爾; 赤澤 茂; 水町 貴諭; 前田 昌紀; 高木 大; 福田 諭
耳鼻咽喉科免疫アレルギー, 30, 2, 70, 71, 日本耳鼻咽喉科免疫アレルギー学会, 2012年06月
日本語
IgG4関連疾患の鼻腔病変における組織学的検討鈴木 正宣; 中丸 裕爾; 赤澤 茂; 水町 貴諭; 前田 昌紀; 高木 大; 福田 諭
日本耳鼻咽喉科学会会報, 115, 4, 413, 413, (一社)日本耳鼻咽喉科学会, 2012年04月
日本語
Modified Lothrop Procedureにより内視鏡的に切除した前頭洞内に茎を持つ内反性乳頭腫症例
中丸 裕爾; 高木 大; 鈴木 正宣; 福田 諭
日本鼻科学会会誌, 50, 3, 379, 379, (一社)日本鼻科学会, 2011年11月
日本語
Transoral surgery of the larynx and pharynx using Weerda-type videolaryngoscope
Nobuhiko Oridate; Akihiro Homma; Yuji Nakamaru; Seigo Suzuki; Satoshi Fukuda
Oto-Rhino-Laryngology Tokyo, 54, 5, 355, 359, 2011年10月15日
日本語, 研究論文（学術雑誌）
IgG4関連疾患における鼻腔病変の検討
赤澤 茂; 中丸 裕爾; 高木 大; 水町 貴諭; 福田 諭
耳鼻咽喉科免疫アレルギー, 29, 2, 77, 78, 日本耳鼻咽喉科免疫アレルギー学会, 2011年06月
日本語
Frontal trephination for frontal sinus mucocele
Yuji Nakamaru; Satoshi Iizuka; Dai Takagi; Satoshi Fukuda
Oto-Rhino-Laryngology Tokyo, 53, 5, 49, 50, 2010年10月
日本語, 研究論文（学術雑誌）
反復性鼻出血に対する内視鏡下蝶口蓋動脈結紮術施行例の検討鈴木 正宣; 大谷 文雄; 松村 道哉; 蠣崎 文彦; 森田 真也; 佐藤 宏紀; 中丸 裕爾; 古田 康
耳鼻咽喉科・頭頸部外科, 82, 1, 67, 72, (株)医学書院, 2010年01月
日本語, 反復性鼻出血に対し内視鏡下蝶口蓋動脈結紮術を施行した14例15側(男11例・女3例・42〜76歳)について報告した。適応は、保存的療法で止血できず、蝶口蓋動脈の支配領域からの出血が疑われる症例とした。鼻出血の危険因子として、高血圧合併8例、5例に抗凝固薬使用を認めた。術前全例にガーゼタンポンがなされ、うち9例はバルーンタンポンも施行した。術前の輸血は2例に要した。手術時間は平均80分で、粘膜下下甲介切除術を7例に、鼻中隔矯正術を4例に併施した。出血量はほとんどが少量であったが、4例では100〜400mlと多かった。術後のガーゼ留置期間は平均1.6日間で、ガーゼ抜去時の出血が3例でみられたが、動脈性ではなくガーゼで止血できた。血小板機能異常を合併した1例のみ術後も出血が続き、バイポーラー焼灼術、アルゴンプラズマレーザーによる鼻腔粘膜焼灼術を要した。手術から退院までの平均日数は4.9日で、重篤な合併症はなかった。
Endoscopic transseptal approach for sinonasal inverted papilloma attached to the anterior maxillary siuns
Yuji Nakamaru; Tosihiro Hara; Takatsugu Mizumachi; Fukuda Satosi; Furuta Yasushi
Oto-Rhino-Laryngology Tokyo, 52, 5, 386, 388, 2009年10月
日本語, 研究論文（学術雑誌）
術中に内反性乳頭腫と判明した一側性上顎洞病変症例
水町 貴諭; 中丸 裕爾; 高木 大; 福田 諭
日本鼻科学会会誌, 48, 3, 276, 276, (一社)日本鼻科学会, 2009年08月
日本語
鼻腔病変を有したIgG4関連疾患2症例
水町 貴諭; 中丸 裕爾; 前田 昌紀; 高木 大; 久保田 佳奈子; 河上 洋; 福田 諭
アレルギーの臨床, 29, 8, 712, 716, (株)北隆館, 2009年08月
日本語
Voice-Related Quality of Life After Treatment of Laryngeal CancerNobuhiko Oridate; Akihiro Homma; Seigo Suzuki; Yuji Nakamaru; Fumiyuki Suzuki; Hiromitsu Hatakeyama; Shigenari Taki; Tomohiro Sakashita; Noriko Nishizawa; Yasushi Furuta; Satoshi Fukuda
ARCHIVES OF OTOLARYNGOLOGY-HEAD & NECK SURGERY, 135, 4, 363, 368, 2009年04月,
［査読有り］英語, 研究論文（学術雑誌）
Complications of Skull Base Surgery: An Analysis of 30 CasesTomohiro Sakashita; Nobuhiko Oridate; Akihiro Homma; Yuji Nakamaru; Fumiyuki Suzuki; Hiromitsu Hatakeyama; Shigenari Taki; Yutaka Sawamura; Yuhei Yamamoto; Yasushi Furuta; Satoshi Fukuda
SKULL BASE-AN INTERDISCIPLINARY APPROACH, 19, 2, 127, 132, 2009年03月,
［査読有り］英語, 研究論文（学術雑誌）
マイクロデブリッダーが有用であった成人型多発性喉頭乳頭腫の1症例鈴木 正宣; 折舘 伸彦; 本間 明宏; 中丸 裕爾; 畠山 博充; 目須田 康; 古田 康; 福田 諭
耳鼻咽喉科・頭頸部外科, 81, 3, 219, 221, (株)医学書院, 2009年03月
日本語, 42歳男。4ヵ月前に嗄声が出現し、保存的治療でいったん改善したが、再増悪を来たした。間接喉頭鏡で左披裂部内側壁、左声帯に3ヶ所、右声帯に2ヶ所の喉頭腫瘍を認め、喉頭ファイバースコピーで腫瘍は乳頭状増殖を示した。喉頭乳頭腫の診断で喉頭直達鏡による腫瘍切除術を施行し、一部採取した腫瘍の迅速病理では悪性所見なしの結果であった。喉頭用スキマーブレード(2.9mm)を装着したマイクロデブリッダーを用いて腫瘍切除を行い、腫瘍自体は軟らかく、ブレード内に吸引された腫瘍のみを切除可能であった。回転数はブレードの熱による瘢痕化を防ぐため、毎分60回転の超低速とした。ごく少量の出血を認めたが、マイクロデブリッダーによる吸引と20万倍エピネフリン塗布で対処できた。切除組織の病理組織像は核異型、分裂像に乏しく、乳頭腫と診断された。術後は沈黙療法を行い、4日目に退院した。嗄声は改善し、術後5ヵ月で再増悪、腫瘍再発はない。
内視鏡下鼻副鼻腔内反性乳頭腫手術における上顎洞前壁の処理 対側鼻腔からのアプローチ法
中丸 裕爾; 古田 康; 原 敏浩; 水町 貴諭; 福田 諭
日本鼻科学会会誌, 47, 3, 290, 290, (一社)日本鼻科学会, 2008年08月
日本語
IgG4関連疾患としての鼻腔病変について
水町 貴諭; 前田 昌紀; 中丸 裕爾; 福田 諭
日本鼻科学会会誌, 47, 3, 276, 276, (一社)日本鼻科学会, 2008年08月
日本語
Surgical equipments for endoscopic medial maxillectomy
Yasushi Furuta; Masahiko Saheki; Yuji Nakamaru; Jun Furusawa; Satoshi Fukuda
Oto-Rhino-Laryngology Tokyo, 50, 5, 379, 381, 2007年10月
日本語, 研究論文（学術雑誌）
喉頭癌治療後の音声に関するQOLの検討
折舘 伸彦; 古田 康; 本間 明宏; 鈴木 清護; 中丸 裕爾; 鈴木 章之; 畠山 博充; 瀧 重成; 坂下 智博; 西澤 典子; 目須田 康; 福田 諭
頭頸部癌, 33, 2, 178, 178, (一社)日本頭頸部癌学会, 2007年05月
日本語
IL-21による樹状細胞の機能制御前田 昌紀; 柳川 芳毅; 岩淵 和也; 中丸 裕爾; 高木 大; 福田 諭; 小野江 和則
耳鼻咽喉科免疫アレルギー, 24, 2, 207, 208, 日本耳鼻咽喉科免疫アレルギー学会, 2006年09月
日本語
鼻副鼻腔乳頭腫T3症例に対する内視鏡下手術の検討
及川 敬太; 古田 康; 中丸 裕爾; 本間 明宏; 折舘 伸彦; 福田 諭
日本耳鼻咽喉科学会会報, 109, 4, 410, 410, (一社)日本耳鼻咽喉科学会, 2006年04月
日本語
鼻副鼻腔内反性乳頭腫の術式選択におけるstaging systemの問題点古田 康; 及川 敬太; 中丸 裕爾; 本間 明宏; 折舘 伸彦; 福田 諭
頭頸部外科, 15, 3, 195, 201, (NPO)日本頭頸部外科学会, 2006年02月
日本語, 著者らは術前MRIにより伸展範囲を評価して術式を選択している.そこで,この方法により治療を行った20例の術式選択についてまとめた.またKrouseのstaging systemの問題点について考察した.男性13例,女性7例を対象にした結果,T1は再発例の1例,T2と診断された8例中6例で,内視鏡下副鼻腔手術(ESS)を施行した.T3と診断された10例中5例は,lateral rhinotomyアプローチによるmedial maxillectomyを選択した.T4と診断されたのは,22年前に初回手術を行った後の再発例の1例だけであった.術後5ヵ月から40ヵ月の経過観察をし,T1からT3症例においては再発は認められていない.T4症例は,放射線照射により縮小したが,照射後7ヵ月が経過し腫瘍が増大しつつある
鼻副鼻腔内反性乳頭腫におけるstage別治療成績の検討
及川 敬太; 古田 康; 本間 明宏; 折舘 伸彦; 中丸 裕爾; 福田 諭
日本耳鼻咽喉科学会会報, 108, 4, 457, 457, (一社)日本耳鼻咽喉科学会, 2005年04月
日本語
頭蓋底再建手術を要した前頭洞嚢胞の一例藤原 圭志; 古田 康; 中丸 裕爾; 相澤 寛志; 澤村 豊; 福田 諭
頭頸部外科 = Journal of Japan Society for Head and Neck Surgery, 14, 3, 247, 251, (NPO)日本頭頸部外科学会, 2005年02月05日
日本語, 63歳男.左内眼角部の腫脹を指摘された.頭部CTで前頭洞内に充満する軟部組織陰影と前頭洞後壁の骨の菲薄化を認め,MRI所見と併せて前頭洞嚢胞と診断した.内視鏡下両鼻内前頭洞開放術および鼻中隔矯正術を施行し術後経過良好であったが,退院後より頭痛,膿性鼻漏が出現した.前頭洞後壁に肉芽の存在を確認し,画像所見より硬膜炎を合併した急性前頭洞炎と診断した.鼻漏の細菌培養でMRSAを認め,抗生剤投与や鼻洗浄などの保存的治療で頭痛は改善したが,鼻漏は持続した.肉芽除去が必要であったが,鼻内からは困難と考え,開頭による除去術を選択し,前頭開頭による肉芽のデブリードメンおよびgaleo-pericranial flap(GF)による前頭蓋底再建術を施行した.術後経過は良好で,細菌培養でMRSAは認められず,6ヵ月後に施行した頭部MRIガドリニウム造影ではGFで前頭洞内が充填され,硬膜炎が消退している像を認めた.1年9ヵ月経過し,炎症の再燃はない
鼻咽腔血管線維腫に対するナビゲーションガイド下鼻内内視鏡による摘出の経験本間 明宏; 中丸 裕爾; 佐伯 昌彦; 福田 諭
頭頸部外科, 14, 2, 109, 113, (NPO)日本頭頸部外科学会, 2004年10月
日本語, 25歳男.右鼻閉が出現し,時々鼻出血があった.ファイバースコープで上咽頭右側に表面平滑,毛細血管の豊富な拍動する腫瘤を認めた.CTでも上咽頭右側から鼻腔後方に造影CTで強く増強される陰影を認めた.MRIではT1強調画像で筋肉と同等の信号,T2強調画像で脳実質と同等の信号を呈していた.診断は上咽頭血管線維腫で,腫瘤が小さいため鼻内内視鏡下に摘出し,術前には塞栓術を行った.手術時にはナビゲーションを用い,出血量が少なく解剖学的位置を正確に確認し摘出できた
鼻副鼻腔乳頭腫の術式選択におけるstaging systemの検討
及川 敬太; 古田 康; 永橋 立望; 本間 明宏; 折舘 伸彦; 中丸 裕爾; 福田 諭
日本耳鼻咽喉科学会会報, 107, 4, 399, 399, (一社)日本耳鼻咽喉科学会, 2004年04月
日本語
喉頭全摘に至った喉頭帯状疱疹の一例
樋口 榮作; 中丸 裕爾; 大渡 隆一郎; 坂下 智博; 目須田 康; 本間 明宏; 古田 康; 福田 諭
耳鼻咽喉科免疫アレルギー, 21, 2, 80, 82, 日本耳鼻咽喉科免疫アレルギー学会, 2003年06月
日本語, 73歳男.咽頭痛が出現した.炎症所見と腎機能障害も認めた.造影CT所見では,左披裂部の腫脹と両頸部リンパ節の腫脹が認められた.病理組織所見では,一部の扁平上皮に中等度から高度の異型が認められた.咽頭痛が強く,喉頭もしくは下咽頭の悪性腫瘍を疑った.喉頭浮腫によると,思われる呼吸困難が出現したため,緊急気管切開術を行った.喘息発作,誤嚥を発症し,全身状態が悪化した.喉頭直達鏡下生検術を行った.臨床所見と経過,検査結果から,一側性第IX,X,XI脳神経麻痺を伴う喉頭帯状疱疹と確定診断した.気管食道分離による誤嚥の防止を目的とした喉頭全摘術を行った.術後経過は良好で退院した.その後現在まで経過良好である
頭頸部扁平上皮癌の放射線化学療法施行例におけるマクロファージ遊走阻止因子の発現の検討
鈴木 章之; 中丸 裕爾; 本間 明宏; 永橋 立望; 折館 伸彦; 古田 康; 福田 諭
頭頸部腫瘍, 29, 2, 363, 363, (一社)日本頭頸部癌学会, 2003年05月
日本語
鼻副鼻腔inverted papilloma再発例の検討
及川 敬太; 古田 康; 永橋 立望; 本間 明宏; 折舘 伸彦; 中丸 裕爾; 福田 諭
日本耳鼻咽喉科学会会報, 106, 4, 393, 393, (一社)日本耳鼻咽喉科学会, 2003年04月
日本語
Treatment of relapsing polychondritisYuji Nakamaru; Dai Takagi; Masanori Maeda; Yasushi Furuta; Satoshi Fukuda; Shiroh Maguchi
Journal of Otolaryngology of Japan, 106, 3, 185, 191, Oto-Rhino-Laryngological Society of Japan Inc., 2003年,
［査読有り］日本語, 研究論文（学術雑誌）
両側性ムンプス難聴の1例
水町 貴諭; 福田 諭; 千田 英二; 中丸 裕爾; 黒田 努; 犬山 征夫; 間口 四郎
日本耳鼻咽喉科学会会報, 104, 1増刊, 77, 77, (一社)日本耳鼻咽喉科学会, 2001年01月
日本語
Models of HTLV-I-induced diseases. Infectious transmission of HTLV-I in inbred rats and HTVL-I env-pX transgenic rats.T Yoshiki; H Ikeda; U Tomaru; O Ohya; T Kasai; I Yamashita; K Morita; H Yamazaki; A Ishizu; Y Nakamaru; K Kikuchi; S Tanaka; A Wakisaka
Leukemia, 11 Suppl 3, 245, 6, 1997年04月,
［国際誌］英語, 研究論文（学術雑誌）, To examine the pathogenic roles of HTLV-I in HTLV-I-induced diseases, we developed two models; namely HTLV-I carrier rats and HTLV-I env-pX transgenic rats. Among life long HTLV-I carriers in seven rat strains, only WKAH rats with the RT1k haplotype developed chronic progressive myeloneuropathy, resembling HAM/TSP clinically and histologically in humans, designated as HAM rat disease and after long incubation periods. Apoptosis of myelin forming cells, oligodendrocytes and Schwann cells associated with HTLV-I infection appears to be the primary cause of HAM rat disease. Local activation of the pX gene and TNF alpha gene was evident in these rats. WKAH rats transgenic for HTLV-I env-pX gene were established and at age 5 weeks, swelling of the bilateral ankle joints began to develop and histological features of the affected joints resembled findings in cases of rheumatoid arthritis (RA): high-titers of rheumatoid factors were present in these rats. A series of vascular collagen diseases such as polyarteritis nodosa-like angiitis, polymyositis, myocarditis, and Sjögren's syndrome-like sialodenitis together with RA were present, even in one individual animal. These transgenic rats as well as HAM rats appear to be suitable animal models for elucidating pathogenic mechanisms implicated in HTLV-I-induced diseases and also various demyelinating vascular collagen diseases of unknown etiology.
Wegener 肉芽腫症の治療とネフロスカラー・C-ANC による抗好中球細胞質抗体価の変動間口 四郎; 滝沢 昌彦; 宮武 由甲子; 中丸 裕爾; 福田 諭; 犬山 征夫
日本耳鼻咽喉科學會會報, 98, 6, 974, 983, The Oto-Rhino-Laryngological Society of Japan, Inc., 1995年06月20日
日本語, 保険適用となったネソロスカラー・C ANCによる抗好中球細胞質抗体の測定は従来の間接蛍光抗体法に比べ若干感度が低かったが, 特異性の高さ, 定量性, 簡便性などからWegener肉芽腫症 (WG) の診断, 治療に有用であった. WGの治療においては, 免疫抑制療法において多くの例で抗体価は低下し, 病状の軽快と平行し推移し有用なマーカーであった. しかしながら, cANCA再上昇は必ずしも再発を意味せず, その治療の変更は実際の症状増悪の後開始するのが良いと考えた. WGの治療に関しては従来の標準的免疫抑制療法以外の治療法も有用であり, 治療法の選択は症例個々の状況に応じたstage adapted treatmentが望まれると考えた.
縦隔内転移をきたした喉頭癌3症例柏村 正明; 山田 和之; 檜山 繁樹; 福田 諭; 間口 四郎; 依田 明治; 中丸 裕爾; 犬山 征夫
耳鼻咽喉科臨床, 88, 2, 219, 224, The Society of Practical Otolaryngology, 1995年02月01日
日本語, Mediastinal metastasis of or invasion by laryngeal carcinoma is not common. If it is not found in the early stage and treated, it causes miserable symptoms such as tracheal stenosis or intratrachal hemorrhage. We treated three patients with laryngeal carcinoma with mediastinal metastasis or invasion. The primary lesion was subglottic in two and glottic in one. The clinical course and some examination results suggested that two patients had metastases and one had direct invasion.
We concluded that patients with laryngeal cancer, especially subglottic, should be examined for mediastinal, as well as cervical lymphnode metastasis, as soon as possible. We otolaryngologists should be able to find mediastinal lesions early using examinations such as CT scans.
当科における鼻骨骨折症例の検討中丸 裕爾; 本間 明宏; 飯塚 桂司
耳鼻咽喉科・頭頸部外科, 65, 9, 745, 748, (株)医学書院, 1993年09月
日本語, 6年間に受診した鼻骨骨折症例について,成因と治療内容に対する満足度等につきアンケート調査を行った。鼻骨骨折の成因では,暴行,交通事故,スポーツの順に多く,それぞれの項目につき更に詳しく成因を検討した。治療に対するアンケートでは,整復後の外観に関しては,83%の患者が満足しているが,約1/3の患者が鼻閉感を訴えた。固定に関しては,内固定に関する不満が多く,固定期間は4日,外固定は7日程度が苦痛を与えないという面ではよい
鼻副鼻腔粘膜悪性黒色腫におけるTRIM27の検討木村将吾; 中丸裕爾; 鈴木正宣; 中薗彬; 本間あや; 渡邉良亮; 加納里志; 対馬那由多; 鈴木崇祥; 井戸川寛志; 本間明宏; 渡部昌; 近藤豪; 畠山鎮次, 日本鼻科学会会誌(Web), 63, 3, 2024年
機械学習を用いた内視鏡下副鼻腔手術の技量評価山田海俊; 鈴木正宣; 宮路洸; 海老名光希; 佐瀬一弥; 辻田哲平; CHEN Xiaoshuai; 安部崇重; 小水内俊介; 中丸裕爾; 妹尾拓; 本間明宏; 近野敦, 日本機械学会ロボティクス・メカトロニクス講演会講演論文集(CD-ROM), 2023, 2023年
副鼻腔3Dモデルを用いたESSトレーニングの妥当性・有効性の検討鈴木正宣; 中丸裕爾; 渡邉良亮; 中薗彬; 木村将吾; 本間あや; WORMALD Peter-John; WORMALD Peter-John; PSALTIS Alkis-James; 本間明宏, 日本鼻科学会会誌(Web), 61, 3, 2022年
内視鏡下副鼻腔手術の技量評価手法の検討山田海俊; 鈴木正宣; 宮路洸; 佐瀬一弥; 海老名光希; 辻田哲平; CHEN Xiaoshuai; 安部崇重; 中丸裕爾; 妹尾拓; 小水内俊介; 本間明宏; 近野敦, 計測自動制御学会システムインテグレーション部門講演会(CD-ROM), 23rd, 2022年
鼻腔内視鏡手術手技計測システムの開発宮路洸; 鈴木正宣; 中丸裕爾; 佐瀬一弥; CHEN Xiaoshuai; 辻田哲平; 小水内俊介; 本間明宏; 近野敦, 計測自動制御学会北海道支部学術講演会論文集, 53rd, 2021年
低亜鉛が鼻粘膜のサイトカイン産生と炎症細胞浸潤に及ぼす影響鈴木正宣; 中丸裕爾; 本間あや; 中薗彬; 木村将吾; RAMENZANPOIR Mahnaz; VREUGDE Sarah; WORMALD Peter-John; 本間明宏, 日本耳鼻咽喉科免疫アレルギー学会プログラム・抄録集, 38th, 2020年
アレルギー性鼻炎患者の睡眠と内因性メラトニンの評価本間あや; 本間あや; SUNKARANENI Vishnu S; SKENE Debra J; 鈴木正宣; 中丸裕爾; 本間明宏, 日本耳鼻咽喉科免疫アレルギー学会プログラム・抄録集, 38th, 2020年
嗅神経芽細胞腫に対する内視鏡頭蓋底外科茂木洋晃; 山口秀; 伊師雪友; 岡本迪成; 澤谷亮介; 中薗彬; 鈴木正宣; 中丸裕爾; 本間明宏, 日本神経内視鏡学会プログラム・抄録集, 27th, 2020年
Anti mumps igm antibody positive rate with sudden sensorineural hearing loss using second generation enzyme immunoassay : A retrospective, multi-institutional investigation in hokkaido, JapanAtsushi Fukuda; Shinya Morita; Yuji Nakamaru; Kimiko Hoshino; Keishi Fujiwara; Shigeru Akazawa; Tomohiro Sakashita; Nobuyuki Obara; Akihiro Homma, Journal of Otolaryngology of Japan, 122, 9, 1267, 1268, 2019年
Oto-Rhino-Laryngological Society of Japan Inc., 日本語, 速報，短報，研究ノート等（学術雑誌）
鼻粘膜において低亜鉛はコラーゲン産生を抑制する鈴木正宣; 鈴木正宣; 中丸裕爾; RAMEZANPOUR Mahnaz; 中薗彬; WORMALD Peter-John; VREUGDE Sarah; 本間明宏, 日本耳鼻咽喉科免疫アレルギー学会プログラム・抄録集, 37th, 2019年
鼻粘膜において低亜鉛はコラーゲン産生を抑制する鈴木正宣; 鈴木正宣; 中丸裕爾; RAMEZANPOUR Mahnaz; 中薗彬; WORMALD Peter-John; VREUDGE Sarah; 本間明宏, 耳鼻咽喉科免疫アレルギー(Web), 37, 2, 2019年
【手術に必要な画像診断-鼻編】 その他の疾患に対する鼻科手術 鼻副鼻腔良性腫瘍
中丸 裕爾, JOHNS, 33, 7, 891, 894, 2017年07月
(株)東京医学社, 日本語
当科の弛緩部型中耳真珠腫の臨床的検討
福田 篤; 森田 真也; 干野 季美子; 藤原 圭志; 中丸 裕爾; 福田 諭, 日本耳鼻咽喉科学会会報, 120, 4, 535, 535, 2017年04月
(一社)日本耳鼻咽喉科学会, 日本語
IgG4関連疾患における鼻副鼻腔病変の検討高木 大; 中丸 裕爾; 鈴木 正宣; 本間 あや; 福田 諭, 日本耳鼻咽喉科学会会報, 120, 4, 557, 557, 2017年04月
(一社)日本耳鼻咽喉科学会, 日本語
外耳道癌組織における免疫組織化学的手法に基づく発現分子解析
森田 真也; 本間 明宏; 中丸 裕爾; 安川 真一郎; 福田 篤; 福田 諭, 日本耳鼻咽喉科学会会報, 120, 4, 566, 566, 2017年04月
(一社)日本耳鼻咽喉科学会, 日本語
13歳発症の再発性多発軟骨炎
西村 弘基; 戸澤 雄介; 植木 将弘; 竹崎 俊一郎; 山田 雅文; 有賀 正; 中丸 裕爾; 三橋 智子; 中山 加奈子; 山本 さやか; 原 和也; 鎌田 晃嘉; 鈴木 雅彦; 八鍬 聡; 那須 敬; 植竹 公明, 日本小児科学会雑誌, 121, 1, 119, 119, 2017年01月
(公社)日本小児科学会, 日本語
HLAクラスI認識受容体群LILRの新展開 病原微生物によって壊された抗体を認識する生体防御機構平安 恒幸; 齋藤 史路; 末永 忠広; 信田 京子; 荒瀬 規子; 及川 敬太; 山岡 俊文; 室田 浩之; 知花 博治; 中川 一路; 久堀 智子; 永井 宏樹; 中丸 裕爾; 片山 一朗; Colonna Marco; 荒瀬 尚, MHC: Major Histocompatibility Complex, 23, 2Suppl., 95, 95, 2016年10月
日本組織適合性学会, 日本語
MRIで骨に異常信号を認めた再発性多発軟骨炎の小児例
戸澤 雄介; 山田 雅文; 植木 将弘; 竹崎 俊一郎; 中丸 裕爾; 中山 加奈子; 山本 さやか; 原 和也; 鎌田 晃嘉; 鈴木 雅彦; 八鍬 聡; 那須 敬; 植竹 公明; 三橋 智子; 有賀 正, 日本小児リウマチ学会総会・学術集会プログラム・抄録集, 26回, 124, 124, 2016年10月
(一社)日本小児リウマチ学会, 日本語
HLAクラスI認識受容体群LILRの新展開 病原微生物によって壊された抗体を認識する生体防御機構
平安 恒幸; 齋藤 史路; 末永 忠広; 信田 京子; 荒瀬 規子; 及川 敬太; 山岡 俊文; 室田 浩之; 知花 博治; 中川 一路; 久堀 智子; 永井 宏樹; 中丸 裕爾; 片山 一朗; Colonna Marco; 荒瀬 尚, MHC: Major Histocompatibility Complex, 23, 2Suppl., 95, 95, 2016年10月
日本組織適合性学会, 日本語
アレルギー性鼻炎モデルマウスにおける鼻粘膜時計遺伝子発現リズム
本間 あや; 中丸 裕爾; 高木 大; 鈴木 正宣; 福田 諭, 日本鼻科学会会誌, 55, 3, 468, 468, 2016年09月
(一社)日本鼻科学会, 日本語
【喘息と耳鼻咽喉科疾患】 アレルギー性鼻炎と気管支喘息の関連
中丸 裕爾, ENTONI, 197, 7, 12, 2016年09月
(株)全日本病院出版会, 日本語
隣接構造物の破壊を伴う外耳道真珠腫症例の検討
森田 真也; 中丸 裕爾; 福田 篤; 福田 諭, Otology Japan, 26, 4, 495, 495, 2016年09月
(一社)日本耳科学会, 日本語
IgG4関連疾患における鼻副鼻腔病変の検討高木 大; 中丸 裕爾; 鈴木 正宣; 本間 あや; 福田 諭, 耳鼻咽喉科免疫アレルギー, 34, 2, 179, 180, 2016年06月
日本耳鼻咽喉科免疫アレルギー学会, 日本語
次世代遺伝子シークエンサーを用いた、鼻副鼻腔内反性乳頭腫の悪性転化に関与する変異遺伝子の解析
安川 真一郎; 畠山 博充; 鈴木 崇祥; 水町 貴諭; 中丸 裕爾; 本間 明宏; 福田 諭, 頭頸部癌, 42, 2, 220, 220, 2016年05月
日本頭頸部癌学会, 日本語
膠原病・自己免疫疾患 膠原病と自己炎症性疾患 IgG4関連疾患における鼻副鼻腔病変の検討
高木 大; 中丸 裕爾; 鈴木 正宣; 本間 あや; 福田 諭, アレルギー, 65, 4-5, 557, 557, 2016年05月
(一社)日本アレルギー学会, 日本語
通年性アレルギー性鼻炎 鼻粘膜概日リズムを指標としたアレルギー性鼻炎の時間治療
本間 あや; 中丸 裕爾; 高木 大; 福田 諭; 本間 研一; 本間 さと, アレルギー, 65, 4-5, 586, 586, 2016年05月
(一社)日本アレルギー学会, 日本語
喘息患者における副鼻腔CT所見とバイオマーカーの検討 喫煙が及ぼす影響
木村 孔一; 今野 哲; 中丸 裕爾; 牧田 比呂仁; 谷口 菜津子; 清水 薫子; 木村 裕樹; 鈴木 雅; 小野 純也; 太田 昭一郎; 出原 賢治; 西村 正治, アレルギー, 65, 4-5, 654, 654, 2016年05月
(一社)日本アレルギー学会, 日本語
隣接構造物の破壊を伴う外耳道真珠腫症例の検討
森田 真也; 中丸 裕爾; 福田 篤; 福田 諭, 日本耳鼻咽喉科学会会報, 119, 4, 599, 599, 2016年04月
(一社)日本耳鼻咽喉科学会, 日本語
副鼻腔炎を合併したIgG4関連疾患症例高木 大; 中丸 裕爾; 鈴木 正宣; 本間 あや; 福田 諭, アレルギーの臨床, 35, 11, 1090, 1092, 2015年10月
(株)北隆館, 日本語
アレルギー疾患の最新治療 アレルギー性鼻炎に対する舌下免疫治療
中丸 裕爾, 日本臨床皮膚科医会雑誌, 32, 5, 561, 562, 2015年09月
日本臨床皮膚科医会, 日本語
耳鼻咽喉科領域疾患に関与するユビキチン化タンパク質修飾鈴木 正宣; 渡部 昌; 中丸 裕爾; 高木 大; 加納 里志; 本間 あや; 畠山 鎮次; 福田 諭, 耳鼻咽喉科免疫アレルギー, 33, 3, 185, 192, 2015年09月
日本耳鼻咽喉科免疫アレルギー学会, 日本語
鼻粘膜時計遺伝子発現の概日リズムにグルココルチコイドが影響を及ぼす
本間 あや; 中丸 裕爾; 高木 大; 鈴木 正宣; 本間 研一; 本間 さと; 福田 諭, 日本鼻科学会会誌, 54, 3, 376, 376, 2015年09月
(一社)日本鼻科学会, 日本語
アレルギー性鼻炎、鼻副鼻腔炎に続発する好酸球性多発血管炎性肉芽腫症(EGPA)
中丸 裕爾, 耳鼻咽喉科臨床 補冊, 補冊142, 81, 81, 2015年06月
耳鼻咽喉科臨床学会, 日本語
北海道上士幌町におけるアレルギー性疾患の疫学調査本間 あや; 中丸 裕爾; 高木 大; 鈴木 正宣; 今野 哲; 福田 諭, 耳鼻咽喉科免疫アレルギー, 33, 2, 128, 129, 2015年06月
日本耳鼻咽喉科免疫アレルギー学会, 日本語
【これからのアレルギー性鼻炎対策】 アレルギー性鼻炎の手術療法
中丸 裕爾, ENTONI, 180, 25, 30, 2015年05月
(株)全日本病院出版会, 日本語
アレルギー疾患の最新治療 アレルギー性鼻炎の最新治療
中丸 裕爾, 日本臨床皮膚科医会雑誌, 32, 3, 324, 324, 2015年05月
日本臨床皮膚科医会, 日本語
成人喘息病態 喘息患者における副鼻腔CT所見とその関連因子
木村 孔一; 今野 哲; 中丸 裕爾; 牧田 比呂仁; 谷口 菜津子; 清水 薫子; 鈴木 雅; 西村 正治, アレルギー, 64, 3-4, 468, 468, 2015年04月
(一社)日本アレルギー学会, 日本語
好酸球性副鼻腔炎における術後好酸球数の変動高木 大; 中丸 裕爾; 本間 あや; 鈴木 正宣; 福田 諭, アレルギー, 64, 3-4, 561, 561, 2015年04月
(一社)日本アレルギー学会, 日本語
各科における血管病の診療と研究 耳鼻咽喉科医が診るANCA関連血管炎
中丸 裕爾; 高木 大; 福田 諭, 脈管学, 54, 12, 212, 212, 2014年12月
(一社)日本脈管学会, 日本語
耳鳴に対するエスシタロプラムの有効性
桝谷 将偉; 中丸 裕爾; 森田 真也; 福田 諭, 耳鼻咽喉科・頭頸部外科, 86, 12, 1047, 1050, 2014年11月
耳鳴りに対する3ヵ月以上の内服治療で効果がなかった症例32例(男性23例、女性9例)を対象に、エスシタロプラム使用の有効性・安全性について検討した。対象のうち内服の継続が可能であった23例を評価対象とした。耳鳴りはTHIスコアで評価し、平均値は投与前41.3±25.9、8週目29.2±20.6、10週目29.1±20.4で、投与後8週目と10週目で有意な改善を認めた。8週目でスコアが低下したのは19例(82%)で、軽症(18〜36点)以下で11例中9例、中等症(38〜56点)で5例中3例、重症(59〜100点)で5例中5例、最重症で2例中2例であった。うち有意改善は9例(39%)で、軽症以下で2例、中等症で3例、重症で3例、最重症で1例であった。有害事象は参加症例32例中14例で認め、うち9例は内服中断後に症状は速やかに消失した。以上より、エスシタロプラムはTHIスコア中等症以上の耳鳴りに有効であることが示唆された。, (株)医学書院, 日本語
アレルギー性鼻炎に対する舌下免疫療法
中丸 裕爾, 北海道医学雑誌, 89, 2, 156, 156, 2014年11月
北海道医学会, 日本語
【こんなときどうする】 鼻科学領域 鼻副鼻腔乳頭腫の基部と進展範囲がはっきりしない!
中丸 裕爾, JOHNS, 30, 9, 1212, 1213, 2014年09月
(株)東京医学社, 日本語
経口ステロイド内服と鼓膜チューブ留置により治療した中耳コレステリン肉芽腫の2例
桝谷 将偉; 中丸 裕爾; 森田 真也; 福田 諭, Otology Japan, 24, 4, 381, 381, 2014年09月
(一社)日本耳科学会, 日本語
早期外耳道癌症例における治療前後の聴力に関する検討
森田 真也; 中丸 裕爾; 桝谷 将偉; 福田 諭, Otology Japan, 24, 4, 623, 623, 2014年09月
(一社)日本耳科学会, 日本語
非都市部におけるアレルギー性疾患の疫学調査本間 あや; 中丸 裕爾; 高木 大; 鈴木 正宣; 今野 哲; 福田 諭, 日本鼻科学会会誌, 53, 3, 408, 408, 2014年09月
(一社)日本鼻科学会, 日本語
好酸球性副鼻腔炎における術後好酸球数の変動について
高木 大; 本間 あや; 中丸 裕爾; 鈴木 正宣; 福田 諭, 日本鼻科学会会誌, 53, 3, 418, 418, 2014年09月
(一社)日本鼻科学会, 日本語
耳症状を呈したIgG4関連疾患症例の検討(Otologic manifestations of immunoglobulin G4-related disease)
高木 大; 中丸 裕爾; 福田 諭, 耳鼻咽喉科免疫アレルギー, 32, 2, 82, 83, 2014年07月
日本耳鼻咽喉科免疫アレルギー学会, 英語
アレルギー性鼻炎に対する手術療法と薬物療法
中丸 裕爾; 高木 大; 福田 諭, 耳鼻咽喉科免疫アレルギー, 32, 2, 178, 178, 2014年07月
日本耳鼻咽喉科免疫アレルギー学会, 日本語
MS5-2 ANCA関連血管炎疲候群の耳,鼻症状(MS5 IgG4関連疾患と膠原病類縁疾患,ミニシンポジウム,第63回日本アレルギー学会秋季学術大会)中丸 裕爾; 高木 大; 福田 諭, アレルギー, 62, 9, 1287, 1287, 2013年10月25日
一般社団法人日本アレルギー学会, 日本語
副鼻腔炎を合併したIgG4関連疾患症例
高木 大; 中丸 裕爾; 福田 諭, 日本鼻科学会会誌, 52, 3, 407, 407, 2013年09月
(一社)日本鼻科学会, 日本語
好酸球性副鼻腔炎の臨床像の検討本間あや; 高木大; 中丸裕爾, 日本耳鼻咽喉科免疫アレルギー学会プログラム・抄録集, 31st, 131, 2013年
日本語
副鼻腔炎を呈したIgG4関連疾患症例高木大; 中丸裕爾; 鈴木正宣; 本間あや; 福田諭, 日本耳鼻咽喉科免疫アレルギー学会プログラム・抄録集, 31st, 100, 2013年
日本語
重症喘息患者における副鼻腔陰影の検討中丸裕爾; 高木大; 本間あや; 福田諭; 谷口菜津子; 今野哲; 牧田比呂仁; 西村正治, 日本耳鼻咽喉科免疫アレルギー学会プログラム・抄録集, 31st, 108, 2013年
日本語
診断に苦慮したNK/T細胞リンパ腫の20例柳 紘子; 中丸 裕爾; 高木 大; 久保田 佳奈子; 福田 諭, 北海道醫學雜誌 = Acta medica Hokkaidonensia, 88, 1, 43, 43, 2013年01月01日
日本語
内視鏡下に摘出しえた鼻腔神経鞘腫例洲崎 真吾; 高木 大; 中丸 裕爾; 福田 諭, 耳鼻咽喉科臨床, 104, 3, 181, 185, 2011年
耳鼻咽喉科臨床学会, 日本語
小児通年性アレルギー性鼻炎に対する舌下免疫療法の臨床効果の検討
米倉 修二; 有本 昇平; 桜井 大樹; 堀口 茂俊; 花澤 豊行; 岡本 美孝; 仲野 敦子; 有本 友季子; 厳 瑩; 工藤 典代; 中丸 裕爾; 本田 耕平, 耳鼻咽喉科免疫アレルギー, 27, 2, 210, 211, 2009年09月
日本耳鼻咽喉科免疫アレルギー学会, 日本語
難聴遺伝子診断が有用であった人工内耳一症例武市 紀人; 柏村 正明; 中丸 裕爾; 津布久 崇; 福田 諭; 鈴木 美華; 宇佐美 真一, Audiology Japan, 52, 4, 214, 219, 2009年08月31日
日本語
小児アレルギーの病態と治療 小児アレルギー疾患に対するハウスダストエキスを用いた舌下免疫療法の検討 二重盲検試験より
米倉 修二; 櫻井 大樹; 堀口 茂俊; 花澤 豊行; 岡本 美孝; 仲野 敦子; 有本 友季子; 厳 瑩; 吉江 うらら; 工藤 典代; 中丸 裕爾; 本田 耕平, アレルギー, 58, 3-4, 376, 376, 2009年04月
(一社)日本アレルギー学会, 日本語
小児通年性アレルギー性鼻炎に対する舌下免疫療法の臨床効果の検討
米倉 修二; 吉江 うらら; 桜井 大樹; 堀口 茂俊; 花澤 豊行; 岡本 美孝; 仲野 敦子; 有本 有季子; 厳 瑩; 工藤 典代; 中丸 裕爾; 本田 耕平, 日本鼻科学会会誌, 47, 3, 231, 231, 2008年08月
(一社)日本鼻科学会, 日本語
346 ヒストン脱アセチル化酵素による肥満細胞におけるIL-4産生調節(肥満細胞,好塩基球4,一般演題(デジタルポスター),第57回日本アレルギー学会秋季学術大会)中丸 裕爾; 高木 大; 前田 昌紀; 福田 論, アレルギー, 56, 8, 1163, 1163, 2007年09月30日
一般社団法人日本アレルギー学会, 日本語
側頭骨に発生した好酸球肉芽腫症4例の検討松村 道哉; 柏村 正明; 千田 英二; 中丸 裕爾; 福田 諭, Otology Japan, 13, 4, 537, 537, 2003年09月12日
日本語
195 ウェゲナー肉芽腫症の耳症状高木 大; 中丸 裕爾; 間口 四郎; 福田 諭, アレルギー, 51, 2, 291, 291, 2002年03月01日
一般社団法人日本アレルギー学会, 日本語
ウェゲナー肉芽腫症の耳症状高木 大; 福田 諭; 中丸 裕爾; 千田 英二; 松村 直哉; 間口 四郎, Otology Japan, 11, 4, 361, 361, 2001年09月12日
日本語
難治性口腔咽頭潰瘍の臨床的検討高木 大; 福田 諭; 中丸 裕爾; 犬山 征夫; 間口 四郎, 耳鼻咽喉科免疫アレルギー, 19, 2, 186, 187, 2001年06月30日
日本語
釧路地方におけるアレルギー性鼻炎症例の臨床的検討高木 大; 福田 諭; 中丸 裕爾; 犬山 征夫; 間口 四郎; 飯塚 桂司, 日本耳鼻咽喉科學會會報, 104, 6, 675, 681, 2001年06月20日
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., 一般社団法人 日本耳鼻咽喉科学会, 日本語
Serum level of macrophage migration inhibitory factor as a useful parameter of clinical course in patients with Wegener’s granulomatosis and relapsing polychondritisOhwatari, R; Fukuda, S; Iwabuchi, K; Mizue, Y; Nakamaru, Y; Maguchi, S; Inuyama, T; Onoé, K; Nishihira, J, Ann. Oto. Rhino. Laryn., 110, 11, 1035, 1040, 2001年
イチイ花粉症について間口 四郎; 後藤田 裕之; 高木 大; 中丸 裕爾; 福田 諭, 耳鼻咽喉科免疫アレルギー, 18, 2, 80, 81, 2000年06月20日
日本語
釧路地方における鼻アレルギーの検討高木 大; 中丸 裕爾; 福田 諭; 犬山 征夫; 飯塚 桂司; 間口 四郎, 耳鼻咽喉科免疫アレルギー, 18, 2, 78, 79, 2000年06月20日
日本語
反復性多発性軟骨炎症例の検討中丸 裕爾; 福田 諭; 犬山 征夫; 間口 四郎; 劉 沢周, 耳鼻咽喉科免疫アレルギー, 17, 2, 206, 207, 1999年08月30日
日本語
HTLV-I LTR-env-pXトランスジェニックラットに認められる自己免疫疾患の発症機序の解析
富居 一範; 池田 仁; 菅谷 壽晃; 石津 明洋; 中丸 裕爾; 菊地 和徳; 田中 敏; 脇坂 明美; 吉木 敬; 山崎 英俊, 北海道医学雑誌, 73, 5, 531, 531, 1998年09月
北海道医学会, 日本語
