Language：Japanese   Publisher：(一社)日本耳鼻咽喉科頭頸部外科学会  

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Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: Swimming is one of the most popular extracurricular activities for school-aged children in Japan, but its potential impact on the development of rhinitis has been debated. This study aimed to investigate the relationship between swimming lessons and rhinitis onset in school-aged children. METHODS: We used the data from the "Longitudinal Survey of Babies in the 21st Century," a nationwide prospective birth cohort of 43,767 children born in Japan between May 10 and 24, 2010. We included follow-up surveys until the children were 9 years old, focusing on swimming lesson participation and rhinitis onset. Children were grouped based on swimming lesson frequency, and rhinitis was identified through parental reports. Poisson regression and generalized estimating equation (GEE) model were used for statistical analysis. RESULTS: Swimming lessons and rhinitis showed a notable association in 18,150 children evaluated. The occasional and consistent swimming groups had increased rhinitis (adjusted risk ratio [aRR] = 1.11; 95 % confidence interval (CI), 1.02-1.22; aRR = 1.16; 95 % CI, 1.09-1.23), respectively. The GEE models were consistent with these findings, demonstrating the population average effects across repeated measures data (aRR = 1.13; 95 % CI, 1.08-1.18). CONCLUSION: This study found that swimming lessons may increase the risk of rhinitis in children, highlighting the need to reevaluate their implications for child health.

DOI： 10.1016/j.ijporl.2025.112415

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Language：Japanese   Publisher：岡山医学会  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2025&ichushi_jid=J00175&link_issn=&doc_id=20250421210003&doc_link_id=10.4044%2Fjoma.137.20&url=https%3A%2F%2Fdoi.org%2F10.4044%2Fjoma.137.20&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

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

First-bite syndrome (FBS) is manifested as acute and severe pain in the parotid region occurring at the first bite of a meal. While most cases of FBS arise after surgeries involving the deep lobe of the parotid gland, chemotherapy-induced FBS is extremely rare. Some adverse effects of oxaliplatin resemble FBS, suggesting it may be under-recognized. Here, we present a case of a 72 year-old male with oxaliplatin-induced FBS, effectively managed with the prophylactic administration of duloxetine hydrochloride. The patient, with a history of surgery for appendiceal adenocarcinoma, experienced sharp pain in the bilateral parotid regions at the beginning of each meal after the second to fourth courses of adjuvant chemotherapy with CapeOX (oxaliplatin and capecitabine). He was subsequently referred to our department for evaluation. Upon examination, no organic diseases were identified. Given the reproducible nature of the symptoms, oxaliplatin-induced FBS was diagnosed. We commenced prophylactic duloxetine hydrochloride before the fifth and sixth courses of chemotherapy, which significantly reduced the pain. After completing six courses of oxaliplatin, the patient no longer experienced symptoms of FBS, even without the continued administration of duloxetine hydrochloride. This case highlights that oxaliplatin can induce FBS, which can be effectively managed with duloxetine hydrochloride.

DOI： 10.1007/s13691-024-00732-z

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INTRODUCTION: Gastroesophageal reflux disease (GERD) is characterized by esophageal mucosal injury due to the reflux of gastroduodenal contents. Typical symptoms include heartburn and acid regurgitation. In addition, gastroesophageal reflux (GER) can influence conditions such as otitis media, rhinitis, and asthma. This study aimed to examine the association between dinner-to-bed time and GER-related diseases, such as otitis media, allergic rhinitis, and asthma. METHODS: This was a longitudinal cohort study using secondary data. Data were collected from a large-scale birth cohort study conducted in Japan including babies born in 2001 and 2010. Dinner-to-bed time was categorized as "longer dinner-to-bed time" (>120 minutes), "shorter dinner-to-bed time" (≤120 minutes or less), and "irregular dinner-to-bed time." Modified Poisson regression with robust variance was used to estimate risk ratios (RRs). RESULTS: A total of 60,392 children were included in this study. Children with shorter dinner-to-bed time had a higher risk of asthma (adjusted RR (aRR) = 1.10; 95% confidence interval (CI), 1.03-1.18) than those with longer dinner-to-bed time. However, no significant association was observed between shorter dinner-to-bed time and otitis media or allergic rhinitis. Furthermore, supplementary analyses revealed that the risk of asthma was significantly higher in children born in 2001 (aRR = 1.13; 95% CI, 1.04-1.22). CONCLUSION: This study showed that dinner-to-bed time within 120 minutes after dinner increases the risk of developing asthma. This underscores the importance of considering lifestyle modifications, as certain pediatric asthma cases may be influenced by behaviors that promote GER.

DOI： 10.7759/cureus.77709

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

BACKGROUND: The Longitudinal Survey of Newborns in the 21st Century (LSN21) tracks two Japanese national birth cohorts-2001 (baseline n = 47,010) and 2010 (n = 38,554)-from infancy through young adulthood, capturing parenting practices and family environments. Most studies analyze single exposures or outcomes. We conducted a narrative review summarizing the findings published by the Okayama University group on diverse health and developmental outcomes. METHODS: We reviewed 59 LSN21 papers (2013-2025), extracting data on exposures, outcomes, and methods. Evidence was categorized into four exposure types (infant feeding, sleep, environmental, and perinatal) and three outcome domains (obesity, allergies/respiratory tract infections, and neurobehavioral development), including cohort comparisons. RESULTS: Exclusive breastfeeding was associated with a lower obesity risk at ages 7 (adjusted odds ratio 0.55, 95% confidence interval 0.39-0.78) and 15, later puberty, and fewer hospitalizations. Short or irregular sleep before age 3 was linked to behavioral problems and injuries. Maternal smoking and prenatal air pollution were associated with respiratory conditions and developmental challenges. Preterm birth and small-for-gestational-age predicted delays, especially without catch-up growth by age 2. Pneumococcal vaccination likely contributed to declining otitis media after 2010. Additional findings included associations between outdoor play and reduced obesity risk, and complex relationships between breastfeeding and food allergies that varied by infantile eczema status. CONCLUSIONS: LSN21 findings highlight modifiable early-life factors (breastfeeding, sleep patterns, and smoke-free environments) and identify preterm and growth-restricted children for priority monitoring. While LSN21's strength lies in longitudinal social assessments, complementary perspectives from other Japanese cohorts could enhance understanding of biological mechanisms and intergenerational effects.

DOI： 10.1111/ped.70258

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Authorship：Lead author   Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.jiac.2024.102601

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Language：Japanese   Publisher：香川労災病院  

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Language：Japanese   Publisher：(株)医学書院  

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Authorship：Corresponding author   Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.ijporl.2024.112055

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Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: In 2013, Japan established a standardized classification system for categorizing endoscopic sinus surgery (ESS) into types I-V, yet no evaluation has been conducted thereof. OBJECTIVE: We assessed the ESS trends and status in Japan, focusing on outpatient and inpatient surgeries. MATERIAL AND METHODS: This descriptive retrospective cohort study used Japan's National Database of Health Insurance Claims and Specific Health Checkups between 2014 and 2021. The distribution of ESS types I-V and outpatient and inpatient surgeries was analysed, along with age groups and regional differences, focusing on ESS type III. RESULTS: Overall, 427,813 ESS procedures were performed, with types III and IV being most common. Outpatient ESS type III increased substantially compared to inpatient surgeries. Younger individuals favoured outpatient ESS type III over inpatient surgeries, with substantial regional variations across prefectures. CONCLUSIONS AND SIGNIFICANCE: The adoption of a standardized ESS classification in Japan has facilitated a detailed understanding of surgical trends. The shift toward outpatient surgeries, especially for type III ESS, aligns with global trends toward minimally invasive procedures and reflects changing patient preferences and healthcare delivery practices. Consequently, continuous monitoring and research are crucial for adapting surgical practices to the evolving healthcare needs and patient expectations.

DOI： 10.1080/00016489.2024.2389179

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

Here, we describe the unique case of a pneumocephalus originating from an inverted papilloma (IP) in the frontoethmoidal sinus. A 71-year-old man with diabetes presented with headaches and altered consciousness. Imaging revealed the pneumocephalus together with bone destruction in the left frontal sinus. He underwent simultaneous endoscopic endonasal and transcranial surgery using an ORBEYE exoscope. Pathological diagnosis of the tumor confirmed IP. Post-surgery, the pneumocephalus was significantly resolved and the squamous cell carcinoma antigen level, which had been elevated, decreased. This case underscores the importance of a multidisciplinary approach and innovative surgical methods in treating complex sinonasal pathologies.

DOI： 10.18926/AMO/67550

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Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: There is no consensus on the optimal surgical technique for allergic rhinitis (AR). Furthermore, the appropriateness of surgical intervention in children and older individuals remains debatable. This study aimed to analyze trends and patterns in the surgical management of AR in Japan, focusing on parasympathetic neurectomy. METHODS: Using the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB), we conducted a comprehensive review of procedures performed between April 2014 and March 2022. In addition, a cross-sectional survey targeting otolaryngologists across Japan was conducted to gather insights into surgical preferences and practices. RESULTS: The NDB data showed an increasing trend in neurectomies, with the most frequent age group being 25-29 years; the procedure was also performed in pediatric and older patients. The survey among otolaryngologists indicated that 58.2 % of surgeons preferred peripheral branch neurectomy of the posterior nasal nerve. The findings of this study also indicated a cautious approach toward conducting these procedures in children, with 51.2 % of surgeons considering patients less than 18 years of age unsuitable for the procedure. CONCLUSION: This study highlighted a shift toward simple and minimally invasive surgical methods, such as peripheral branch neurectomy, in Japan. However, further research is needed to understand the long-term outcomes and refine the surgical techniques. The findings of this study also emphasized the need for age-specific considerations when treating pediatric and older patients with AR.

DOI： 10.1016/j.anl.2024.07.005

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Language：Japanese   Publisher：日本口腔・咽頭科学会  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2024&ichushi_jid=J02661&link_issn=&doc_id=20240712380009&doc_link_id=10.14821%2Fstomatopharyngology.37-134&url=https%3A%2F%2Fdoi.org%2F10.14821%2Fstomatopharyngology.37-134&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Authorship：Last author   Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: This study aimed to reveal the efficacy and safety of antivirals in patients with Ramsay Hunt syndrome. METHODS: A literature search was conducted in PubMed, Ichushi-Web, and Cochrane Central Register of Controlled Trials. Published randomized controlled trials and observational studies, which compared antivirals versus placebo/no treatment for Ramsay Hunt syndrome, were included in the meta-analysis. The primary outcome was non-recovery at the end of the study follow-up. Data was analyzed using Review Manager Software, and pooled odds ratio (OR) with 95 % CI were calculated. RESULTS: Two randomized controlled trials and 7 cohort studies met the eligible criteria, and 474 individuals were included in the meta-analysis. The OR of antivirals for non-recovery was 0.68 (95 % CI 0.37-1.27, p = 0.22). In subgroup analysis, the OR were 0.48 (95 % CI 0.15-1.61, p = 0.24) in patients with antivirals monotherapy and 0.73 (95 % CI 0.34-1.57, p = 0.42) in patients treated with combination therapy of antivirals and systematic corticosteroid. CONCLUSION: This systematic review first shows the effectiveness of antivirals. Further study is needed to confirm the efficacy of antivirals.

DOI： 10.1016/j.anl.2024.01.008

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BACKGROUND: Otitis media (OM) is a prevalent respiratory disease in children and poses significant public health challenges due to its impact on child health and economic burdens. However, there have no nationwide epidemiological studies conducted in Japan. This study investigates the epidemiological trends of OM in Japan, taking into account the impact of the 7-valent pneumococcal conjugate vaccine (PCV7) introduction. METHOD: This study was retrospective cohort study using secondary data on the nationwide longitudinal birth cohort. This survey followed two cohorts born in 2001 (pre-PCV era) and 2010 (post-PCV era) until the age of 9. Every year, parents were surveyed about their children's health status, including occurrences of OM. The annual period prevalence and cumulative incidence of OM were assessed in this study, and the two cohorts were compared using a modified Poisson regression model adjusted environmental factors with the 2001 cohort as reference. RESULT: The study included 47,015 children from the 2001 cohort and 38,554 from the 2010 cohort. Peak annual period prevalence of OM varied by era. Cumulative incidence was 13.8 % for the 2001 cohort and 18.5 % for the 2010 cohort by 1.5 years of age and 28.9 % and 33.3 %, respectively, by 3.5 years of age. In particular, from the fourth survey onward, covering ages 2.5-3.5 years, a shift was observed from an increased risk to a decreased risk of OM. CONCLUSION: This nationwide longitudinal study emphasizes variations in OM epidemiology across Japan over time, with changes potentially influenced by the introduction of PCV7. In this study, due to the absence of individual PCV7 vaccination data, the effect of PCV7 was estimated based on the vaccination rate at the population level. The results suggest a notable decrease in the incidence of OM in later years, aligning with the increased uptake of PCV7.

DOI： 10.1016/j.vaccine.2024.05.020

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Authorship：Lead author   Language：English  

DOI： 10.1111/cga.12571

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Language：Japanese   Publisher：(一社)日本耳鼻咽喉科頭頸部外科学会  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2024&ichushi_jid=J07551&link_issn=&doc_id=20240530350003&doc_link_id=%2Fdz0tokei%2F2024%2F012705%2F003%2F0658-0663%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdz0tokei%2F2024%2F012705%2F003%2F0658-0663%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：(一社)日本耳鼻咽喉科頭頸部外科学会  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2024&ichushi_jid=J07551&link_issn=&doc_id=20240530350003&doc_link_id=10.3950%2Fjibiinkotokeibu.127.5_658&url=https%3A%2F%2Fdoi.org%2F10.3950%2Fjibiinkotokeibu.127.5_658&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

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

BACKGROUND: Advanced surgical interventions are required to treat malignancies in the anterior skull base (ASB). This study investigates the utility of endoscopic endonasal and transcranial surgery (EETS) using a high-definition three-dimensional exoscope as an alternative to traditional microscopy. METHODS: Six patients with carcinomas of varying histopathologies underwent surgery employing the EETS maneuver, which synchronized three distinct surgical modalities: harvesting of the anterolateral thigh flap, initiation of the transnasal technique, and initiation of the transcranial procedure. RESULTS: The innovative strategy enabled successful tumor resection and skull base reconstruction without postoperative local neoplastic recurrence, cerebrospinal fluid leakage, or neurological deficits. CONCLUSION: The integration of the exoscope and EETS is a novel therapeutic approach for ASB malignancies. This strategy demonstrates the potential of the exoscope in augmenting surgical visualization, enhancing ergonomics, and achieving seamless alignment of multiple surgical interventions. This technique represents a progressive shift in the management of these complex oncological challenges.

DOI： 10.1002/hed.27724

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Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.pedhc.2023.11.011

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Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

DOI： 10.7759/cureus.49273

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Low-grade papillary Schneiderian carcinoma (LGPSC) is a rare and newly described type of cancer arising from the Schneiderian epithelium. Owing to cellular atypia, it is difficult to differentiate this type from other papillomas and malignancies. Although this condition remains unclear, it is associated with mortality and recurrence. Therefore, treating physicians should be aware of the possibility of LGPSC for prompt diagnosis and treatment. In this article, we present an additional case of nasopharyngeal LGPSC with cervical lymph node metastasis and reviewed the 14 cases reported thus far in the literature. A 76-year-old female was referred to our department for detailed examination of nasopharyngeal and cervical lymph node tumors detected by positron emission tomography-computed tomography. Based on the biopsy of the nasopharyngeal tumor, we suspected LGPSC. Considering the clinical course and pathological findings, the patient was diagnosed with cervical lymph node metastasis through neck dissection. We performed radiotherapy for the primary lesion of the nasopharynx, which led to the disappearance of the tumor. After 13 months following the radiotherapy, the patient died from a recurrence of retroperitoneal liposarcoma without the recurrence of LGPSC.

DOI： 10.1016/j.anl.2022.12.010

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Language：English  

In Japan, near-infrared photoimmunotherapy (NIR-PIT) was introduced in 2021 as a treatment option for unresectable recurrent head and neck cancer. The treatment targets the epidermal growth factor receptor (EGFR), which is overexpressed in 80-90 % of head and neck squamous cell carcinoma (HNSCC). NIR-PIT should theoretically show therapeutic efficacy if EGFR is expressed, even in nonsquamous cell carcinomas (non-SCC). To the best of our knowledge, there are no case reports of NIR-PIT for non-SCC. We performed NIR-PIT in a patient with non-SCC of the head and neck region. After performing two NIR-PIT treatments, small free clusters of residual tumor cells were observed. Immunostaining in this specimen revealed EGFR expression in residual tumor cells. The residual tumor cells had been irradiated sufficiently to achieve necrosis. It is suggested that not only laser irradiation and expression of EGFR but also other factors are involved in the efficacy of this treatment. Further investigation for these other factors is warranted.

DOI： 10.1016/j.anl.2023.09.006

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PURPOSE: A longitudinal study was conducted to examine the effects of handwashing and gargling education for children on the prevention of respiratory tract infections (RTIs) in children in Japan. METHODS: The study included 38,554 children born in 2010 who were enrolled in a longitudinal study. Information on children's hygiene education regarding handwashing and gargling was collected in a survey at the age of 3.5 years. Based on parents' reports of doctors' diagnoses, airway infections and influenza events in the 12-month duration before the survey were evaluated for RTIs at the ages of 4.5 and 9 years. Poisson regression with robust variance was performed to examine the effects of hygiene education on RTIs prevention. The supplementary analysis was stratified by household income. RESULTS: Children were categorized into different groups: 38% in the handwashing and gargling group, 29% in the handwashing group, 0.1% in the gargling group, and 9.7% in the no-education group. Exclusions were made for non-respondent children (23%) and those in the gargling group. Hygiene education was associated with decreased influenza at the age of 4.5 years in the handwashing (adjusted RR [aRR] = 0.8; 95% CI, 0.8-0.9) and handwashing and gargling groups (aRR = 0.8; 95% CI, 0.8-0.9) compared with no education. However, no preventive effects on airway infections at the age of 4.5 and 9, influenza at the age of 9, or hospitalization between the ages of 3.5 and 9 years were detected. Handwashing and gargling could significantly prevent influenza in low-income households (aRR = 0.7; 95% CI, 0.6-0.8).     Conclusions: Gargling education was widespread and mostly combined with handwashing education in Japan. Hygiene education significantly affected prevention of influenza infections at the age of 4.5 years, especially in low-income households. WHAT IS KNOWN: • Previous intervention studies showed handwashing and gargling are effective in preventing respiratory tract infections. WHAT IS NEW: • We conducted a longitudinal study on handwashing and gargling education in Japanese children and found that handwashing and gargling were widely practiced together. • Handwashing and gargling education were related to a reduction in influenza, particularly in low-income households.

DOI： 10.1007/s00431-023-05062-5

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Language：English  

DOI： 10.1016/j.chest.2022.11.036

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DOI： 10.1016/j.alit.2022.03.003

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

DOI： 10.18926/AMO/64033

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PURPOSE: Candidemia is a bloodstream infection (BSI) by Candida spp. and is associated with high mortality. However, there have been few reports about BSI in head and neck cancer (HNC). We aimed to evaluate the impact of candidemia in patients with HNC and compared it with bacteremia. STUDY DESIGN: A multicenter retrospective study. METHODS: We retrospectively analyzed 83 BSI episodes in HNC (2011 to 2020) and divided them into the candidemia and bacteremia groups. We then compared the survival rate and risk factors for candidemia between the groups. RESULTS: The overall cumulative incidence (risk) of candidemia in BSI was 12 out of 83 episodes (14.5%). The 1-year mortality for the bacteremia and candidemia groups was 33.3% and 58.3%, respectively (log-rank p = 0.041). Broad-spectrum antibiotics (odds ratio [OR]: 29.5; 95% confidence interval [CI], 2.49-350), mucositis (OR 11.0; 95% CI, 1.52-80.1), and malignant wounds (OR 79.5; 95% CI 1.33-4737) were significant risk factors for candidemia in HNC. CONCLUSIONS: Candidemia causes high mortality in patients with HNC. To our knowledge, malignant wounds have not been previously reported as a risk factor for candidemia. For early diagnosis and treatment of candidemia, risk factors should be considered, and antifungal therapy started earlier.

DOI： 10.1007/s00520-022-07010-9

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Labyrinthitis occurs because of the inflammation of the inner ear. We present a rare case of labyrinthitis ossificans following an acute otitis media. The T2-weighted magnetic resonance imaging showed decreased signal intensity in the right inner ear due to labyrinthitis ossificans, consistent with the clinical presentation.

DOI： 10.1002/ccr3.5898

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

Sinonasal inverted papilloma (SNIP) can recur; however, the factors related to tumor recurrence remain unclear. This study aimed to analyze risk factors, including human papillomavirus (HPV) infection, as well as other factors associated with SNIP recurrence. Thirty-two patients who were diagnosed with SNIP and underwent surgery between 2010 and 2019 were enrolled: 24 men and 8 women, with a mean age of 59.2 years. The mean follow-up was 57.3 months. Demographics and information about history of smoking, diabetes mellitus (DM), hypertension, allergic rhinitis, alcohol consumption, tumor stage, surgical approach, and recurrence were reviewed retrospectively. Specimens were investigated using polymerase chain reaction to detect HPV DNA (high-risk subtypes: 16, 18, 31, 33, 35, 52b, and 58; low-risk subtypes: 6 and 11). Seven patients (21.9%) experienced recurrence. HPV DNA was detected in five (15.6%) patients (high-risk subtypes, n = 2; low-risk subtypes, n = 3). Patients with recurrence of SNIP had a higher proportion of young adults and displayed higher rates of HPV infection, DM, and advanced tumor stage than those without recurrence. HPV infection, young adulthood, DM, and advanced tumor stage could be associated with a high recurrence rate, which suggests that patients with these risk factors could require close follow-up after surgery.

DOI： 10.3390/diagnostics12020454

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DOI： 10.1001/jamaoto.2021.3392

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Language：Japanese   Publisher：(NPO)日本頭頸部外科学会  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J04210&link_issn=&doc_id=20220311180014&doc_link_id=10.5106%2Fjjshns.21-005&url=https%3A%2F%2Fdoi.org%2F10.5106%2Fjjshns.21-005&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

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

A 34-year-old Japanese person with male gender identity who had been taking intramuscular injection of methyltestosterone depot for 11 years after bilateral mastectomy noticed blurred vision 5 days after the second vaccination for COVID-19 (Tozinameran; Pfizer-BioNTech) in the interval of 3 weeks following the first vaccination. The patient was diagnosed as granulomatous iritis with mutton-fat keratic precipitates and small iris nodules at the pupillary margin in the right eye and began to have 0.1% betamethasone eye drops with good response. The patient, however, continued to have fever and malaise and showed a high level of serum soluble interleukin-2 receptor (sIL-2R) even 4 weeks after the second vaccination. Computed tomographic scan disclosed mediastinal and bilateral hilar small lymphadenopathy together with limited granular lesion in the right lung. Gallium-67 scintigraphy demonstrated high uptake not only in mediastinal and hilar lymph nodes but also in bilateral parotid glands. Right parotid gland biopsy revealed noncaseating granulomas and proved pathological diagnosis of sarcoidosis. The systemic symptoms were relieved by oral prednisolone 20 mg daily. Even though the causal relationship remains undetermined, this case is unique at the point that vaccine-associated uveitis led to the detection of pulmonary lesions and lymphadenopathy, resulting in clinical and pathological diagnosis of sarcoidosis. In literature review, 3 patients showed sarcoidosis-like diseases after COVID-19 vaccination: 2 patients were diagnosed clinically as Lofgren syndrome with acute onset of erythema nodosum and ankle swelling, with or without mediastinal and hilar lymphadenopathy, whereas 1 patient with mediastinal lymphadenopathy but no uveitis was diagnosed pathologically by biopsy as sarcoidosis.

DOI： 10.1177/23247096221086450

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

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2021&ichushi_jid=J01675&link_issn=&doc_id=20220111400012&doc_link_id=10.7248%2Fjjrhi.60.546&url=https%3A%2F%2Fdoi.org%2F10.7248%2Fjjrhi.60.546&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Authorship：Lead author   Language：English  

DOI： 10.1016/j.anorl.2021.04.009

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BACKGROUND: Several surgical procedures for posterior nasal neurectomy have been reported, but no conclusion has been reached about which procedure is best. OBJECTIVES: The aim is to evaluate the improvement in symptom medication scores for resection of the posterior nasal nerve trunk in an underwater environment, with submucous inferior turbinectomy, without injuring the sphenopalatine artery (SPA) in severe allergic rhinitis. MATERIAL AND METHODS: Improvements in symptom medication scores were retrospectively compared between 27 consecutive cases who underwent resection of the posterior nasal nerve trunk with turbinoplasty in an underwater environment without injuring the SPA (Underwater group) and, as a historical control, 16 consecutive cases who underwent resection of peripheral branches of the posterior nasal nerve with turbinoplasty (Control group). RESULTS: The improvements in symptom medication scores in the Underwater group were significantly better than in the Control group (3.07 vs. 1.96, p = 0.02). CONCLUSIONS AND SIGNIFICANCE: By using underwater posterior nasal neurectomy, we can easily and safely resect the posterior nasal nerve trunk under a clear surgical view without injuring the SPA. This technique with submucous inferior turbinectomy may, more than resection of peripheral branches of the posterior nasal nerve, be able to reduce the medication score and symptom medication score.

DOI： 10.1080/00016489.2021.1925151

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Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s00455-020-10196-x

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Language：Japanese   Publisher：(一社)日本耳鼻咽喉科頭頸部外科学会  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2021&ichushi_jid=J01099&link_issn=&doc_id=20210728430010&doc_link_id=%2Fdz0jibik%2F2021%2F012407%2F010%2F1005-1012%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdz0jibik%2F2021%2F012407%2F010%2F1005-1012%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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

Pathologic mechanisms in cochleae immediately following the onset of noise-induced hearing loss (NIHL) remain unclear. In this study, mice were exposed to 120 dB of octave band noise for 2 h to induce NIHL. Three hours after noise exposure, expression levels of the whole mouse genome in cochleae were analyzed by RNA-seq and DNA microarray. Differentially expressed genes (DEGs) exhibiting >2-fold upregulation or downregulation in noise-exposed cochleae compared to controls without noise exposure were identified. RNA-seq and microarray analyses identified 273 DEGs regulated at 3 h post-noise (51 upregulated and 222 downregulated). Bioinformatic analysis revealed that these DEGs were associated with the functional gene pathway "neuroactive ligand-receptor interaction" and included 28 genes encoding receptors for neurotransmitters such as gamma-aminobutyric acid and glutamate. Other DEGs included 25 genes encoding transcription factors. Downregulation of 4 neurotransmitter receptors (Gabra3, Gabra5, Gabrb1, Grm1) and upregulations of 5 transcription factors (Atf3, Dbp, Helt, Maff, Nr1d1) were validated by RT-PCR. The differentially regulated transcription factor Atf3 immunolocalized to supporting cells and hair cells in the organ of Corti at 12-h post-noise. The present data serve as a basis for further studies aimed at developing medical treatments for acute sensorineural hearing loss.

DOI： 10.1016/j.neures.2020.05.001

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

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Authorship：Lead author   Language：English  

Trousseau's syndrome (TS) and tumor thrombosis (TT) are known as cancer-associated thrombosis with poor prognosis. TS is extremely rare in patients with squamous cell carcinoma. In this study, we report an unknown primary squamous cell carcinoma of the head and neck (SCCHN) patient with TS and TT in pulmonary artery definitely diagnosed by autopsy. A 73-year-old man had a past surgical history for unknown primary SCCHN and lung metastases. Three years after the initial surgery, the patient had multiple cerebral infarction, deep venous thrombosis in the legs and mediastinum metastases. Our diagnosis was TS and treatment with chemotherapy and unfractionated molecular heparin started. It could help control the hypercoagulative state and cancer progression, but finally, he died from progressive disease (mediastinum metastases and pulmonary embolism) five years after the initial surgery. An autopsy revealed multiple metastases and thrombosis in the pulmonary artery with squamous cell carcinoma microscopically. Although there is no established treatment for managing TS, intensive therapy such as a combination of chemotherapy and anticoagulant therapy can be effective in improving hypercoagulation therapy. In addition, an autopsy should be considered for patients with thrombosis to distinguish between TS and TT.

DOI： 10.1007/s13691-020-00440-4

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Epidemiological data suggest that inflammation and innate immunity play significant roles in the pathogenesis of age-related hearing loss (ARHL) in humans. In this mouse study, real-time RT-PCR array targeting 84 immune-related genes revealed that the expressions of 40 genes (47.6%) were differentially regulated with greater than a twofold change in 12-month-old cochleae with ARHL relative to young control mice, 33 (39.3%) of which were upregulated. These differentially regulated genes (DEGs) were involved in functional pathways for cytokine-cytokine receptor interaction, chemokine signaling, TNF signaling, and Toll-like receptor signaling. An NF-κB subunit, Nfkb1, was upregulated in aged cochleae, and bioinformatic analyses predicted that NF-κB would interact with the genomic regulatory regions of eight upregulated DEGs, including Tnf and Ptgs2. In aging cochleae, major proinflammatory molecules, IL1B and IL18rap, were upregulated by 6 months of age and thereafter. Remarkable upregulations of seven immune-related genes (Casp1, IL18r1, IL1B, Card9, Clec4e, Ifit1, and Tlr9) occurred at an advanced stage (between 9 and 12 months of age) of ARHL. Immunohistochemistry analysis of cochlear sections from the 12-month-old mice indicated that IL-18r1 and IL-1B were localized to the spiral ligament, spiral limbus, and organ of Corti. The two NF-κB-interacting inflammatory molecules, TNFα and PTGS2, immunolocalized ubiquitously in cochlear structures, including the lateral wall (the stria vascularis and spiral ligament), in the histological sections of aged cochleae. IBA1-positive macrophages were observed in the stria vascularis and spiral ligament in aged mice. Therefore, inflammatory and immune reactions are modulated in aged cochlear tissues with ARHL.

DOI： 10.1371/journal.pone.0258977

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A 70-year-old Japanese man undergoing remission induction therapy for acute monocytic leukemia (AML-M5b) developed fever and headache, and was started on antibiotics and liposomal amphotericin B (L-AMB). There was no improvement, and computed tomography and contrast-enhanced magnetic resonance imaging revealed acute rhinosinusitis and brain abscess. Successful endoscopic endonasal surgery was performed at this point, providing drainage for the rhinosinusitis and abscess. Histopathological findings showed the mucormycosis.

DOI： 10.1016/j.mmcr.2020.09.004

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Authorship：Lead author   Language：Japanese   Publisher：(株)医学書院  

28歳男。出生時から顔貌異常があり、過成長を認めた。10代の頃にソトス症候群と臨床診断されていたが、全身状態が落ち着いていたため定期通院はしていなかった。今回、日中の眠気・頭痛があり、睡眠時無呼吸症候群の精査目的で当科を受診した。諸検査の結果から、下顎低形成による硬組織の異常から口腔・咽頭腔の狭小化をきたし、閉塞性睡眠時無呼吸症候群になっていると考えた。持続陽圧呼吸(CPAP)療法を行い、治療効果判定のためCPAP装着下にポリソムノグラフィ検査を行ったところ、AHI、AIとも改善していることが確認された。日中の眠気・頭痛も改善し、現在CPAPを継続しながらフォロー中である。

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Authorship：Corresponding author   Language：Japanese   Publisher：(株)医学書院  

69歳男性。早期肺腺癌術後4年目に両側進行性難聴を呈したため当院へ受診となった。語音聴力検査では、語音明瞭度に左右差があり、純音聴力検査との乖離が大きく、後迷路性難聴が疑われた。入院9日目に頭部造影MRIが行われたが、聴神経や髄膜、硬膜に腫瘍性病変はなく、両側難聴の悪化を認めたため、プレドニゾロンの点滴加療が行われた。しかし、聴力は悪化、画像検査でも原発巣の特定に至らず、上部内視鏡検査などを予定していたが、入院32日目に患者は死亡し、剖検により癌性髄膜症が明らかとなった。

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Authorship：Lead author   Language：Japanese   Publisher：(一社)日本耳鼻咽喉科頭頸部外科学会  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2020&ichushi_jid=J01099&link_issn=&doc_id=20200409390011&doc_link_id=%2Fdz0jibik%2F2020%2F012303%2F011%2F0257-0263%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdz0jibik%2F2020%2F012303%2F011%2F0257-0263%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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Perforation of the larynx is very rare but may result in severe airway complications that include pneumothorax, pneumonia, mediastinitis, and retropharyngeal abscess. If conservative treatment fails, aggressive treatments including reconstructive surgery with pedicle flap are considered. Negative pressure wound therapy has been used for large skin defects, necrotizing fasciitis, pharyngocutaneous fistula, stoma dehiscence, osteoradionecrosis of the mandible, chyle fistula, flap failure, and lymphangioma in the field of head and neck surgery. We report a case of false vocal cord perforation with abscess successfully treated by negative pressure wound therapy after abscess treatment. The result suggests that negative pressure wound therapy can be an alternative or adjunctive approach for larynx perforation when the perforation is difficult to close after conservative therapy.

DOI： 10.1177/2050313X20915415

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Authorship：Lead author   Language：Japanese   Publisher：高知県・高知市病院企業団立 高知医療センター  

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

OBJECTIVE: The treatment of all forms of sinonasal inverted papilloma (IP) is a complete, wide, local resection. The main surgical purpose is to remove all diseased mucosa and mucoperiosteum, together with a cuff of normal-looking mucosa at the attachment site, followed by drilling and/or coagulation. Our aim is to present our experiences in endoscopic surgical management of IP by using attachment-oriented excision. METHODS: We present 20 cases of sinonasal IP. The data collected includes the histopathological diagnosis, staging, extension of the tumor, tumor attachment site, approach to surgery, serum squamous cell carcinoma antigen (SCCA) level, and recurrences. RESULTS: All patients underwent endoscopic surgery. A Caldwell-Luc operation was required in addition to the endoscopic surgery in one case. There was one case of recurrence (5%). After the additional operation, there was no recurrence. The tumor attachment sites vary, and the case of recurrence had a wide attachment site at the primary surgery. No major intra- or post-operative complications were observed. CONCLUSION: The present study shows that attachment-oriented excision for IP is useful for complete resection of IP. Surgeons should choose the surgical approach according to the location of the tumor attachment site rather than the Krouse staging system.

DOI： 10.1016/j.anl.2019.02.007

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Edizioni Minerva Medica  

DOI： 10.23736/s0392-6621.19.02224-0

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Language：Japanese   Publisher：(株)医学書院  

症例1は40歳男性で、反復性の左鼻出血と鼻の痛みを主訴とした。CTで左上顎洞から一部の前篩骨洞にかけて内部不均一で造影効果の乏しい腫瘤性病変を認めた。上顎洞血瘤腫を疑い、endoscopic modified medial maxillectomy(EMMM)を施行した。症例2は80歳女性で、反復性の左鼻出血を主訴とした。CTで左上顎洞に充満する陰影を認め、脳血管造影で明らかな栄養血管や腫瘍濃染を認めなかった。上顎洞血瘤腫を疑い、EMMMを施行した。症例3は73歳男性で、頭痛を主訴とした。CTで左蝶形骨洞に充満する陰影を認め、脳血管造影で明らかな栄養血管や腫瘍濃染を認めなかった。蝶形骨洞血瘤腫を疑い、拡大蝶形骨洞手術を施行した。手術は正円孔、翼突管を同定し、広く蝶形骨洞前壁を開放した術野で行った。3例とも病理診断は血瘤腫で、症例1は術後約5年、症例2は術後約8ヵ月、症例3は術後2年5ヵ月の現在まで再発を認めていない。

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Swallowing syncope is a rare medical condition. Even though it has been known as a neurally mediated syncope, the definitive mechanism of this condition remains unclear. We show in this study an additional case of swallowing syncope and review the 122 reported cases from the literature. A 47-year-old Japanese man had been suffering from recurrent syncopal attacks, when he fainted immediately after swallowing. Holter electrocardiogram monitoring demonstrated a sinus pause (maximum R-R interval of 3.8 seconds) after he swallowed a noodle quickly. A permanent pacemaker was implanted because the frequency of syncope increased.

DOI： 10.1002/joa3.12130

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

OBJECTIVE: The agger nasi cell (ANC) is an easily identifiable landmark when approaching the frontal sinus. The success of endoscopic frontal sinus surgery may be influenced by the width of the frontal recess (FR). The aim of this study is to examine the relationship between the FR width and the ANC size in Japanese patients. In addition, the effect of various frontal recess cells (FRCs) on the development of frontal sinusitis has been examined. MATERIALS AND METHODS: Multiplanar computed tomography (CT) scans of the nasal cavities and paranasal sinuses in 95 patients (190 sides) before endoscopic sinus surgery were reviewed. The presence of FRCs, the thickness of the frontal beak (FB), the ANC size, and the anterior-to-posterior (A-P) length of the frontal isthmus (FI) and FR were evaluated in patients with and without frontal sinusitis. RESULTS: The prevalence of the ANC, frontal cell types 1, 2, 3, and 4, frontal bullar cell (FBC), suprabullar cell, supraorbital ethmoid cell, and interfrontal sinus septal cell was 85.3%, 11.6%, 0%, 7.9%, 0%, 25.3%, 45.8%, 16.8%, and 15.3%, respectively. The ANC volume showed a significant positive correlation with the A-P length of the FI and FR. The incidence of frontal sinusitis in the patients with FBCs was significantly higher than that without FBCs. CONCLUSION: A large ANC offers a greater potential to facilitating the approach to the frontal sinus because of the extensiveness of the FR in Japanese patients. The presence of FBCs may be related to a higher incidence of frontal sinusitis.

DOI： 10.1177/1179550619884946

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

BACKGROUND: The histological changes corticosteroids induce in nasal polyps, and whether these changes have an impact on the diagnosis of eosinophilic chronic rhinosinusitis (ECRS), currently remain unclear. OBJECTIVES: A prospective controlled multicenter trial was conducted to evaluate the efficacy of the low-dose and short-term oral prednisolone (oPSL) treatment for tissue eosinophil infiltrations in ECRS. METHODS: Subjects with ECRS diagnosed by previous biopsies received a low dose of oPSL for 3 days (PSL 3) or 7 days (PSL 7) before surgery. Changes in the tissue eosinophil count after these treatments were evaluated. Furthermore, the percent change of tissue eosinophil count from baseline and its impact on the diagnosis defined by the JESREC study were examined. RESULTS: There were 23 and 21 subjects in the PSL 3 and PSL 7 groups, respectively. Polyp scores, clinical symptom scores, and the proportion of blood eosinophils significantly decreased after the treatment, and no significant differences were observed between the groups. The entire tissue eosinophil count tended to be slightly decreased in both groups without reaching a statistically significant value. The median percent change of tissue eo-sinophil count from baseline was 83.6%, and only the posttreatment proportion of blood eosinophil showed a mild correlation with it. Seven out of 44 nasal polyp specimens collected from the superficial part of the middle meatus showed < 70 eosinophils/high-power field; therefore, the false negative rate was 15.9%, but decreased to 11.4% when other parts were included in the histological evaluation. CONCLUSIONS: Low-dose and short-term oPSL did not appear to markedly affect the tissue eosinophil count in ECRS patients; however, the potential for misdiagnoses due to the effects of oPSL cannot be rejected. The diagnosis of ECRS prior to the administration of corticosteroids or tissue evaluations using multiple tissue parts is desirable.

DOI： 10.1159/000496437

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

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Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: There is a close relationship between upper and lower respiratory tract diseases. Chronic rhinosinusitis patients frequently have lung diseases including asthma and chronic obstructive pulmonary disease. Eosinophilic chronic rhinosinusitis is considered a refractory and intractable subtype of chronic rhinosinusitis. However, there has been no report on pulmonary function in patients with eosinophilic chronic rhinosinusitis. The purpose of this study is to examine the pulmonary function in eosinophilic chronic rhinosinusitis patients and non-eosinophilic chronic rhinosinusitis patients, and evaluate clinical factors associated with the pulmonary function of these patients. METHODS: Pulmonary function was measured in 53 patients with eosinophilic chronic rhinosinusitis with asthma, 58 patients with eosinophilic chronic rhinosinusitis without asthma, and 30 patients with non-eosinophilic chronic rhinosinusitis. The diagnosis of chronic rhinosinusitis was based on the definition in the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) 2012. Eosinophilic chronic rhinosinusitis was diagnosed based on the Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis (JESREC) scoring system. The relationship between pulmonary function and clinical parameters was assessed. These parameters included radiographic severity of chronic rhinosinusitis, peripheral blood eosinophil percentage, serum total immunoglobulin E level, and eosinophilic infiltration in nasal polyps. RESULTS: The pulmonary function of the patients with eosinophilic chronic rhinosinusitis was significantly affected. The eosinophilic chronic rhinosinusitis patients had more peripheral airway obstruction as compared to the patients with non-eosinophilic chronic rhinosinusitis. CONCLUSION: Our findings indicated latent obstructive lung function changes in the eosinophilic chronic rhinosinusitis patients. The patients with eosinophilic chronic rhinosinusitis should be carefully monitored in order to detect lung diseases.

DOI： 10.1016/j.anl.2017.07.020

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

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2017&ichushi_jid=J01675&link_issn=&doc_id=20180122310012&doc_link_id=10.7248%2Fjjrhi.56.625&url=https%3A%2F%2Fdoi.org%2F10.7248%2Fjjrhi.56.625&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

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

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2016&ichushi_jid=J01675&link_issn=&doc_id=20170323260002&doc_link_id=10.7248%2Fjjrhi.55.515&url=https%3A%2F%2Fdoi.org%2F10.7248%2Fjjrhi.55.515&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Authorship：Lead author   Language：Japanese   Publisher：日本喉頭科学会  

88歳男。6ヵ月前より嚥下困難感を放置していたが、餅を喉に詰まらせ救急搬送となった。喉頭ファイバーでは梨状窩に白色腫瘤を認め、上気道は狭窄し、鎮静下で喉頭鏡・マギール鉗子を用い咽頭異物除去を試みたが、腫瘤表面の被膜が摘出された。造影CTで腫瘤は下咽頭に充満し、内部は造影で増強効果を有していた。白色被膜の病理所見は悪性を認めず、内視鏡下に腫瘤内部の生検でも炎症を伴う上皮組織で悪性所見は認めなかったが、下咽頭癌を疑い、入院17日目に全身麻酔下で下咽頭腫瘤部分切除を施行した。内視鏡下で生検した部位は白色粘膜で覆われ、柔らかい広基性の肉芽腫瘤であり、病理検査でも特異的炎症増や悪性所見を認めず、下咽頭化膿性肉芽腫と診断した。術後腫瘤は自然縮小傾向を認めたためカニューレを抜去し、気管切開孔の閉鎖後に退院した。外来フォローにて1年経過したが嚥下障害や腫瘤の増大なく経過観察中である。

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Authorship：Lead author   Language：Japanese   Publisher：(一社)日本耳鼻咽喉科頭頸部外科学会  

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Language：Japanese   Publisher：(株)医学書院  

鼻口蓋管嚢胞の根治的治療法として一般に嚢胞全摘出術が行われるが、嚢胞が巨大な場合には摘出後の死腔の処理が問題となる。今回著者等は、巨大な嚢胞に対して内視鏡下鼻内手術を行い、嚢胞を両側鼻腔に開窓し、良好な結果が得られたので報告した。症例は38歳男で、嚢胞の大きさは画像検査上57×56×48mmで、鼻腔底部と口蓋部に骨欠損があり、摘出術を施行した場合には鼻腔と口蓋の間に瘻孔を形成する可能性があった。また、手術で口腔内に開窓すると創が汚染され、鼻腔と口蓋の間に瘻孔を形成する可能性もあった。さらに、鼻腔底に嚢胞壁が大きく進展していたため、手術では、鼻腔粘膜よりも強固な口蓋粘膜を温存して嚢胞を鼻腔に開窓した。

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Language：Japanese   Publisher：(株)医学書院  

2012年1月から2015年6月までに保存的治療で十分な治療効果が得られず、内視鏡下副鼻腔手術(ESS)を行った好酸球性副鼻腔炎(ECRS)45症例を対象として、術前後の自覚症状、quality of life(QOL)の変化と内視鏡所見の変化について検討した。術前、術後3ヵ月前後、6ヵ月前後の時点での鼻症状アンケートで自覚症状、QOLに関する質問を評価するとともに、鼻内ポリープスコアを用いて内視鏡評価を比較した結果、自覚症状スコア、QOLスコアの両方において、術後3ヵ月、6ヵ月ともに嗅覚低下、鼻閉やTotal Nasal Symptom Scoreなど多くの項目で有意な改善を認め、概ね良好な術後経過をたどった。

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Authorship：Lead author   Language：Japanese   Publisher：日本口腔・咽頭科学会  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2015&ichushi_jid=J02661&link_issn=&doc_id=20150702480011&doc_link_id=%2Fei4kouku%2F2015%2F002802%2F011%2F0177-0182%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fei4kouku%2F2015%2F002802%2F011%2F0177-0182%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Authorship：Lead author   Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

80歳代女。主訴は両膝関節・歩行困難であった。血液検査で炎症反応の著明な上昇を認め、腰椎MRIで腹部動脈瘤の拡大を認めた。腹部造影CTでは腹部大動脈の腹腔動脈分岐部以下に内腔の潰瘍状突出・壁在血栓および周囲の液体貯留を伴う大動脈瘤を認め、感染性腹部大動脈瘤と診断した。感染沈静後にステントグラフト内挿術(EVAR)を予定したが入院3日目の腹部造影CTにて瘤の拡大を認め、緊急EVARにより左総腸骨動脈から左腎動脈・上腸間膜動脈へバイパスを形成し、腹部大動脈にステントグラフトを留置した。EVAR施行後、両側化膿性膝関節炎に対して関節鏡下で洗浄・デブリードマンを施行し、術後4日目にCT透視ガイド下で経後腹膜腔にて感染瘤を洗浄した。末梢静脈血・両膝関節液・瘤の洗浄液からすべてにメチシリン感受性黄色ブドウ球菌を検出したためニューキノロン系抗生物質経口投与し、術後1年目の状態は安定して腹部CT上瘤径は縮小している。

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2013&ichushi_jid=J02793&link_issn=&doc_id=20131121440010&doc_link_id=10.11407%2Fivr.28.447&url=https%3A%2F%2Fdoi.org%2F10.11407%2Fivr.28.447&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

Authorship：Lead author   Language：Japanese   Publisher：(一社)高知県医師会  

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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