スギ花粉症の治療法としては薬物療法が最も一般的である。なかでも鼻噴霧用ステロイド薬は軽症から重症まで様々な重症度に応じて用いられている。しかしながら，最新のガイドラインでも初期療法には鼻噴霧用ステロイド薬は記載がない。これは鼻噴霧用ステロイド薬の初期療法の報告が少なくevidence としてまだ不十分であることが一因と考えられる。そこで今回我々はモメタゾンフランカルボン酸エステル（以下モメタゾン）を用いてスギ花粉症初期療法を行い，その効果を日本アレルギー性鼻炎標準QOL 調査票（JRQLQ No1）とピッツバーグ睡眠質問票（Pittsburg Sleep Quality Index PSQI）を用いて評価することとした。2012 年スギ花粉飛散期にモメタゾン点鼻にて初期療法を行ったスギ花粉症患者すなわちモメタゾン点鼻群と無治療受診群に対してアンケート調査を行った。なおスギ花粉飛散期を前期・中期・後期に分けて比較検討を行った。その結果飛散中期からモメタゾン点鼻群は症状悪化を抑制し，また同時にQOL 維持にも効果を認め，後期にもその効果は持続した。特に鼻閉症状については飛散後期まで持続的に抑制効果を認めた。PSQIによる睡眠スコアの比較では飛散中期のみ発症後受診群と有意差を認めた。モメタゾンフランカルボン酸エステル点鼻薬はスギ花粉症初期療法に有用であると考えられた。

We investigated regulatory mechanisms of Cl(-) secretion playing an essential role in the maintenance of surface fluid in human airway epithelial Calu-3 cells. The present study reports that quercetin (a flavonoid) stimulated bumetanide-sensitive Cl(-) secretion with reduction of apical Cl(-) conductance, suggesting that quercetin stimulates Cl(-) secretion by activating an entry step of Cl(-) across the basolateral membrane through Na(+)/K(+)/2Cl(-) cotransporter (NKCC1). To clarify the mechanism stimulating NKCC1 by quercetin, we verified involvement of protein kinase (PK)A, PKC, protein tyrosine kinase (PTK), and cytosolic Ca(2+)-dependent pathways. A PKA inhibitor (PKI-14-22 amide), a PKC inhibitor (Gö 6983) or a Ca(2+) chelating agent did not affect the quercetin-stimulated Cl(-) secretion. On the other hand, a PTK inhibitor (AG18) significantly diminished the stimulatory action of quercetin on Cl(-) secretion without inhibitory effects on apical Cl(-) conductance, suggesting that a PTK-mediated pathway is involved in the stimulatory action of quercetin. The quercetin action on Cl(-) secretion was suppressed with brefeldin A (BFA, an inhibitor of vesicular transport from ER to Golgi), and the BFA-sensitive Cl(-) secretion was not observed in the presence of an epidermal growth factor receptor (EGFR) kinase inhibitor (AG1478), suggesting that quercetin stimulates Cl(-) secretion by causing the EGFR kinase-mediated translocation of NKCC1 or an NKC1-activating factor to the basolateral membrane in human airway epithelial Calu-3 cells. However, the surface density of NKCC1 was not increased by quercetin, but quercetin elevated the activity of NKCC1. These observations indicate that quercetin stimulates Cl(-) secretion by activating NKCC1 via translocation of an NKCC1-activating factor through an EGFR kinase-dependent pathway.

Hemangioma is a benign tumor that originates from vascular tissue of the skin, mucosa, bone, muscles and glands. Hemangioma arising in the soft tissue is common in the head and neck region, but intraosseous hemangioma of the skull or facial bones is rare, particularly in the nasal bone. We treated a 60-year-old woman with primary hemangioma of the nasal bone. X-ray of the nasal bone revealed a sunburst appearance, and CT of the nasal bone showed honeycomb appearance. Surgical excision and reconstruction with a cartilage graft were performed. Postoperative pathological study revealed it to be a cavernous hemangioma. There has been no recurrence of the tumor for 1 year. When we treat nasal tumor, hemangioma of the nasal bone should be included in the differential diagnosis. Considering its benign nature, observation is often preferred, but surgical excision should be performed when it has a mass effect, hemorrhage, and cosmetic problems.

We report a 50-year old man with chronic sinusitis with frontal sinus cyst showing intracranial development. He complained of swelling in the medial angle of the right eyelid. Preoperative CT and MRI demonstrated a right frontal sinus cyst and ethmoid-maxillary sinusitis. The frontal sinus cyst compressed the right frontal lobe of the cerebrum, but no symptom was accompanied by frontal lobe impairment. Under general anesthesia, the frontal sinus cyst and sinusitis were accessed by intranasal ESS. We gently fenestrated the wall of the frontal sinus cyst with a microdebrider and drained the cystic component. The patient has been event free with no recurrence for 15 months postoperatively.

Otolaryngology–Head and Neck SurgeryVolume 134, Issue 5 p. 886-887 Case Report A Case of Angiosarcoma of the Nasal Cavity Successfully Treated with Recombinant Interleukin-2 Kazuto Fukushima MD, Kazuto Fukushima MD Department of Otolaryngology, Kyoto Second Red Cross Hospital, Kyoto, JapanSearch for more papers by this authorKenji Dejima MD, Corresponding Author Kenji Dejima MD [email protected] Department of Otolaryngology, Kyoto Second Red Cross Hospital, Kyoto, JapanDepartment of Otolaryngology, Kyoto Second Red Cross Hospital, 355-5 Haruobicho, Kamigyo ward Kyoto, 6028026, Japan; e-mail address: [email protected].Search for more papers by this authorShinobu Koike MD, Shinobu Koike MD Department of Otolaryngology, Saiseikai Kyoto Hospital, Kyoto, JapanSearch for more papers by this authorGou Tei MD, Gou Tei MD Department of Otolaryngology, Kyoto Second Red Cross Hospital, Kyoto, JapanSearch for more papers by this authorJunji Asano MD, Junji Asano MD Department of Otolaryngology, National Shiga Hospital, Shiga, JapanSearch for more papers by this authorMasayo Ueda MD, Masayo Ueda MD Department of Otolaryngology, Maizuru Red Cross Hospital, Kyoto, JapanSearch for more papers by this authorMakoto Hyuga MD, Makoto Hyuga MD Department of Otolaryngology, Kyoto Second Red Cross Hospital, Kyoto, JapanSearch for more papers by this authorWataru Oshima MD, Wataru Oshima MD Department of Otolaryngology, Kyoto Second Red Cross Hospital, Kyoto, JapanSearch for more papers by this author Kazuto Fukushima MD, Kazuto Fukushima MD Department of Otolaryngology, Kyoto Second Red Cross Hospital, Kyoto, JapanSearch for more papers by this authorKenji Dejima MD, Corresponding Author Kenji Dejima MD [email protected] Department of Otolaryngology, Kyoto Second Red Cross Hospital, Kyoto, JapanDepartment of Otolaryngology, Kyoto Second Red Cross Hospital, 355-5 Haruobicho, Kamigyo ward Kyoto, 6028026, Japan; e-mail address: [email protected].Search for more papers by this authorShinobu Koike MD, Shinobu Koike MD Department of Otolaryngology, Saiseikai Kyoto Hospital, Kyoto, JapanSearch for more papers by this authorGou Tei MD, Gou Tei MD Department of Otolaryngology, Kyoto Second Red Cross Hospital, Kyoto, JapanSearch for more papers by this authorJunji Asano MD, Junji Asano MD Department of Otolaryngology, National Shiga Hospital, Shiga, JapanSearch for more papers by this authorMasayo Ueda MD, Masayo Ueda MD Department of Otolaryngology, Maizuru Red Cross Hospital, Kyoto, JapanSearch for more papers by this authorMakoto Hyuga MD, Makoto Hyuga MD Department of Otolaryngology, Kyoto Second Red Cross Hospital, Kyoto, JapanSearch for more papers by this authorWataru Oshima MD, Wataru Oshima MD Department of Otolaryngology, Kyoto Second Red Cross Hospital, Kyoto, JapanSearch for more papers by this author First published: 17 May 2016 https://doi.org/10.1016/j.otohns.2005.03.053Citations: 1Read the full textAboutPDF ToolsExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. Volume134, Issue5May 2006Pages 886-887 RelatedInformation

われわれは最近1年間に，手術までに時間を要した小児気道異物2症例を経験した。1症例は枝豆誤嚥でX線透過性・舞踏性異物であったが，CTの経時的変化によって局在診断された。他の1症例は明らかな異物誤嚥のエピソードがなかったが，胸部X線にてクリップ誤嚥が診断された。手術までに症例1では誤嚥後9日間，症例2では症状出現後7日間を要した。2症例ともに，全麻下にてventilation bronchoscopeを用いて異物摘出術を施行した。枝豆症例では，膨化・脆弱化し細片化した異物を，吸引操作を行いながら慎重に摘出した。ともに術後経過は良好であった。気道異物は生死に関与する危険性があることを常に自覚して，迅速な対応処置と同時に一般家庭への啓蒙の必要性を再認識することが重要である。