Concentrations of H1-Receptor Antagonist in the Human Nasal Mucosa

Aims. To measure blood and tissue concentrations of the H1-receptor antagonist, bepotastine besilate (BB). Methods. Participants included 14 men and six women, whose age ranged from 13 to 76 years, with chronic rhinosinusitis, who underwent endoscopic sinus surgery at our university hospital. Among them, 10 participants had allergic rhinitis (AR) (Group I), and others did not have AR (Group II). Nasal mucosa and blood were collected 55 to 130 minutes after oral administration of BB 10 mg. Concentrations of the agent in the serum and nasal mucosa were measured by high-performance liquid chromatography. Results. Concentrations of BB of the serum in Group I and II were 98 ± 32 ng/mL and 112 ± 39 ng/mL. Those of the nasal mucosa tissue in Groups I and II were 101 ± 36 ng/g and 132 ± 44 ng/g. There was no significant difference in the values of concentration of BB between the serum and the nasal mucosa in either Group I or II (P = .757 and P = .2662, resp., Paired t-test). Conclusion. This preliminary study is considered the first report on the concentration of H1-receptor antagonists in nasal mucosa. The prompt absorption and transition to the nasal mucosa of BB seems to have an effect on allergic rhinitis

Effects of a tongue-holding maneuver during swallowing evaluated by high-resolution manometry.

OBJECTIVE: This study aimed to investigate the effects of a tongue-holding maneuver (THM) during swallowing using a novel high-resolution manometry (HRM) system. STUDY DESIGN: Case series with planned data collection. MATERIALS AND METHODS: Thirty-three asymptomatic Japanese adults were studied. A solid-state HRM assembly with 36 circumferential sensors spaced 1-cm apart was positioned to record pressures from the velopharynx to the upper esophagus at rest and during swallowing. The maximum values of the dry swallowing pressures at the velopharynx, mesohypopharynx, upper esophageal sphincter (UES), and distance from the nostril to each point of maximum values with and without the THM were measured. RESULTS: The distance from the nostril to the UES was statistically shorter when swallowing with the THM than without the THM (paired t test, P=0.009). The maximum pressure at UES was greater when swallowing with the THM than without the THM, although there was no statistically significant difference (paired t test, P=0.051). There was no difference in the pressures and the distance between swallowing with or without the THM at any other site. CONCLUSIONS: These findings suggest that the THM may not have a potential to facilitate compensatory swallowing power when swallowing

Relationship between airborne pollen count and treatment outcome in Japanese cedar pollinosis patients.

In Japan, information on daily Japanese cedar pollen counts is made public during pollen season. If symptom severity and treatment outcome are predictable according to these pollen counts, management of seasonal allergic rhinitis may become more precise. The aims of the study were to evaluate the relationship between airborne pollen counts, symptom severity and treatment outcome in Japanese cedar pollinosis patients. In the randomized study, patients with moderate to most severe Japanese pollinosis were treated with fexofenadine (60 mg BD) or fexofenadine and nasal corticosteroids for 2 weeks. During the same period daily airborne pollen counts were measured. A total of 105 adult patients were enrolled. No difference of treatment efficacy was seen among groups. Detailed results of efficacy and safety were previously described elsewhere. In univariate analysis, the mean cumulative amount of airborne pollen exposure for 4 days prior to the study tended to affect symptom severity (P = 0.053) and the mean cumulative amount of airborne pollen during the treatment period tended to show difference among five treatment outcome categories (P = 0.066). In multivariate analysis, the mean cumulative amount of airborne pollen exposure for 4 days prior to the study was identified as the only significant factor of symptom severity (P = 0.0327) and cumulative amount of airborne pollen during the treatment period (P = 0.027) and allergic history (P = 0.027) were significant factors of treatment outcomes. No serious adverse effect was reported during the study. The amount of airborne pollen may be predictive of both symptom severity and treatment outcome

The patulous eustachian tube complicated with amyotrophic lateral sclerosis: a video clip demonstration.

We report a 60-year-old case diagnosed as the amyotrophic lateral sclerosis with patulous eustachian tube (ET). To our knowledge, this is the first case report of the amyotrophic lateral sclerosis complicating patulous ET in the literature, demonstrating the movement of the tympanic membrane, the pharyngeal orifice of the ET and abnormal movement of the uvula because of paralysis of the soft palate on video.In order to view the file "VideoClip 1-3", you will need the Adobe® Acrobat® Reader™ version 9 or later

Evaluation of swallowing pressure in a patient with amyotrophic lateral sclerosis before and after cricopharyngeal myotomy using high-resolution manometry system.

BACKGROUND: This study aimed to evaluate the pharyngeal pressure of a patient with, amyotrophic lateral sclerosis (ALS) before and after cricopharyngeal myotomy by high-resolution manometry (HRM) system. METHODS: A 60-year-old man with ALS underwent cricopharyngeal myotomy for his intractable, aspiration. The swallowing pressure along the velopharynx and upper esophagus was measured using, the HRM 1 month before and 3 months after the surgery. RESULTS: Before cricopharyngeal myotomy, the maximum values of the resting UES pressure, the dry swallowing, pressures in the velopharyngeal muscle zone and in the UES zone were 89, 95, and 171mmHg, respectively. After surgery, the maximum values of both the resting pressure and dry swallowing, pressure in the UES zone remarkably decreased to 21 and 75mmHg, respectively. CONCLUSIONS: This is the first report showing the effect of cricopharyngeal myotomy by demonstrating, the difference in the swallowing pressure along the velopharynx and upper esophagus before and after, the surgery in an ALS patient using this HRM system

Clinical Study Concentrations of H1-Receptor Antagonist in the Human Nasal Mucosa

Aims. To measure blood and tissue concentrations of the H1-receptor antagonist, bepotastine besilate (BB). Methods. Participants included 14 men and six women, whose age ranged from 13 to 76 years, with chronic rhinosinusitis, who underwent endoscopic sinus surgery at our university hospital. Among them, 10 participants had allergic rhinitis (AR) (Group I), and others did not have AR (Group II). Nasal mucosa and blood were collected 55 to 130 minutes after oral administration of BB 10 mg. Concentrations of the agent in the serum and nasal mucosa were measured by high-performance liquid chromatography. Results. Concentrations of BB of the serum in Group I and II were 98 ± 32 ng/mL and 112 ± 39 ng/mL. Those of the nasal mucosa tissue in Groups I and II were 101 ± 36 ng/g and 132 ± 44 ng/g. There was no significant difference in the values of concentration of BB between the serum and the nasal mucosa in either Group I or II (P = .757 and P = .2662, resp., Paired t-test). Conclusion. This preliminary study is considered the first report on the concentration of H1-receptor antagonists in nasal mucosa. The prompt absorption and transition to the nasal mucosa of BB seems to have an effect on allergic rhinitis

A case with tracheo-innominate artery fistula. Successful management of endovascular embolization of innominate artery.

Tracheo-innominate artery fistula (TIF) is known as a fatal complication after tracheostomy. We report a 9-year-old girl with early hypoxic encephalopathy who had a tracheo-innominate artery fistula with exsanguinating hemorrhage from her tracheostoma 10 months after tracheostomy. After temporary control of bleeding, embolization of the innominate artery was performed. The patient has remained well 1 year after the procedure. We reviewed the aetiology, diagnosis and management of the tracheo-innominate fistula, and findings suggest that endovascular embolization of the innominate artery may be an appropriate treatment for patients with tracheo-innominate artery fistula