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Papers - Ogawa, Kaoru

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Somatic symptoms in those hospitalized for dizziness or vertigo

Goto Fumiyuki, Tsutumi Tomoko, Arai Motohiro, Ogawa Kaoru

Journal of Otolaryngology of Japan 113 ( 9 ) 742 - 750 2010.09

ISSN 0030-6622

Anxiety and depression greatly affect the prognosis of and burden on subjects seen for dizziness or vertigo, who usually report multiple somatic symptoms. We studied the prevalence of these symptoms in 145 subjects hospitalized for dizziness or vertigo and taking part in 4-day group vestibular rehabilitation. Questionnaires given to determine the prevalence of somatic symptoms assessed headache, insomnia, diarrhea, constipation, stomachache, chest pain, palpitations, dyspnea, general fatigue, and stress. Quantitation used aerical rating scale (NRS). Anxiety and depression were assessed using the hospital anxiety and depression scale (HADS). Disability due to dizziness was assessed using the dizziness handicap inventory (DHI). We conducted correlational analysis between dizziness and somatic symptoms. The top four average NRS scores for somatic symptoms were dizziness at 3.5 ± 2.8, general fatigue at 2.8 ± 2.6, insomnia at 2.4 ±2.6, and headache at 1.8 ±2.3. These symptoms resembled those reported for subjects with anxiety and depression. The correlation between headache and dizziness NRS scores was R = 0.48 (P<0.0001). The total HADS score was 13.9 ±8.1 points (anxiety 7.2 ±4.3, depression 6.7 ±4.3). The average DHI score was 36.3 ±24.1 points. These results indicate that those with dizziness reported several somatic symptoms related to anxiety and depression attributable to dizziness. This underscores the need to treat these somatic symptoms when treating subjects seen chiefly dizziness or vertigo.

Physical and physiological effects on otoacoustic emissions in hypobaric hypoxia

Ide Rika, Harada Tatsuhiko, Kanzaki Sho, Saito Hideyuki, Hoshikawa Masako, Kawahara Takashi, Ogawa Kaoru

ORL 72 ( 4 ) 225 - 232 2010.08

ISSN 0301-1569

Tinnitus and dizziness are symptoms of acute mountain sickness. We investigated the mechanism by which high altitude (i.e. hypobaric hypoxia) affects inner ear function by measuring transient evoked otoacoustic emissions (TEOAE) and distortion product otoacoustic emissions (DPOAE) under conditions of normobaric normoxia (1,013 hPa; 760 mm Hg) and hypobaric hypoxia (540 hPa; 405 mm Hg). The possibility that air pressure effects on the eustachian tube impacted our findings was excluded by the use of tympanograms. The nonphysiological effects of hypobaric hypoxia on TEOAE and DPOAE were also assessed using an ear simulator. Under conditions of hypobaric hypoxia, both TEOAE and DPOAE levels were reduced. The amount of reduction that occurred was approximately 4 dB in the total echo power and signal-to-noise ratio of the TEOAE, and in the 2f₁ - f₂ element level of the DPOAE. Stimulus levels that were measured using an ear simulator were also reduced by approximately 4 dB under conditions of hypobaric hypoxia. These results do not indicate that stimulus levels affected TEOAE and DPOAE levels because these levels were actually only slightly affected by changes in the stimulus level. Instead, this reduction was likely due to the nonphysiological hypobaric effects of the sound pressure emitted from the tympanic membrane. We conclude that the impact of hypobaric hypoxia on cochlear function was negligible up to pressures of 540 hPa.

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Autonomic dysfunction in dizzy patients revealed by pulse analysis

Goto Fumiyuki, Mizutari Kunio, Kunihiro Takanobu, Ogawa Kaoru

Equilibrium Research 69 ( 4 ) 207 - 212 2010.08

ISSN 0385-5716

Autonomic dysfunction is prevalent in dizzy patients. However, evaluating the autonomic nervous system is not very popular, since it is not easy to do. The Pulse Analyzer Plus® is a small device that measures a patient's pulse from his/her finger tip with a small probe, making it possible to evaluate autonomic nervous system function in as little as 5 minutes. The algorithm is identical to the one used in the frequency analysis of electrocardiograms. We report herein on our findings on the autonomic function of 25 dizzy patients who visited our department. Age-matched control data were obtained from healthy volunteers and patients not suffering from dizziness. The measurements were conducted in 5 minutes with the patient in the sitting position. Fast Fourier Transform (FFT) was used to calculate low frequency (LF) components, which mainly reflect sympathetic nervous system function, and high frequency (HF) components, which reflect parasympathetic nervous system (PNS) function. Natural logarithm (Ln) values were calculated for LF and HF components and used for conventional comparison. The ratio of LF/HF was also calculated. The results of the normal controls were LnLF = 5.2 ± 1.6 (mean ± SD), LnHF = 4.3 ± 1.2, LnLF/HF = 1.2 ± 0.3 whereas those of the dizzy patients were 4.4 ± 1.9, 3.5 ± 1.2 and 1.3 ± 0.5 respectively. The HF value of the dizzy patients was significantly smaller than that of the control subjects (P<0.05). These data indicate that PNS hypofunction was present in the dizzy patients. Future studies need to determine whether autonomic dysfunction results from the therapeutic interventions used to treat dizziness.

Vestibular dysfunction in a Japanese patient with a mutation in the gene OPA1

Mizutari Kunio, Matsunaga Tatsuo, Inoue Yasuhiro, Kaneko Hiroki, Yagi Hirotaka, Namba Kazunori, Shimizu Satoko, Kaga Kimitaka, Ogawa Kaoru

Journal of the Neurological Sciences 293 ( 1-2 ) 23 - 28 2010.06

ISSN 0022-510X

OPA1 mutations are known to cause autosomal dominant optic atrophy (ADOA), and some types of OPA1 mutations also cause auditory neuropathy. In the present study, we evaluated the vestibular dysfunction that accompanied auditory neuropathy in a patient with an OPA1 mutation. A caloric test failed to elicit nystagmus or dizziness in either ear. Vestibular evoked myogenic potentials (VEMPs) in the right ear were characterized by a normal biphasic waveform. In contrast, no VEMPs were evoked in the left ear. Model building suggested that the OPA1 mutation, p.R445H, indirectly distorts the catalytic structure of the GTPase reaction center and decreases GTPase activity. The patient complained of instability while walking or moving but thought these symptoms were caused by visual dysfunction. This is the first report of a detailed evaluation of vestibular dysfunction in a patient with an OPA1 mutation. This case suggests that vestibular dysfunction may be involved in motor instability in patients with an OPA1 mutation, even when patients do not complain of vestibular symptoms. Based on this case, we suggest that vestibular evaluation should be performed in auditory neuropathy patients carrying an OPA1 mutation, even if the patients are free of symptoms of vestibular dysfunction.

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Burow's solution-induced acute sensorineural hearing loss

Oishi Naoki, Inoue Yasuhiro, Saito Hideyuki, Ogawa Kaoru

Auris Nasus Larynx 37 ( 3 ) 369 - 372 2010.06

ISSN 0385-8146

This is the report of rare cases to show the potential ototoxicity of Burow's solution in clinical use. We encountered two cases of acute sensorineural hearing loss occurring after the administration of 8% Burow's solution (pH 2.93) into the tympanic cavities. Prior to treatment, both cases presented with tympanic membrane perforations in the posterior and inferior portions and a small amount of serous discharge. Fortunately, hearing loss recovered almost completely except for high tones within a few weeks. These two case reports demonstrate that the ototoxicity of Burow's solution should be considered when it is used to treat otitis media accompanied by tympanic membrane perforation.

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Objective evaluation of the therapeutic responses of patients with psychological dizziness by means of static posturography

Goto Fumiyuki, Hayashi Ken, Tsutsumi Tomoko, Ogawa Kaoru

Equilibrium Research 69 ( 3 ) 141 - 146 2010.06

ISSN 0385-5716

In our practice, we often encounter dizzy patients in whom organic and functional abnormalities are lacking, as assessed by a variety of clinical examinations. In these patients, anxiety and depression are strongly related to their clinical symptoms. We diagnose these patients as having "psychogenic dizziness" and treat them with antidepressants and anxiolytics. Although therapeutic evaluation of patients' subjective complaints and objective evaluation by doctors are usually performed, an objective measurement is necessary to determine whether the drug treatments are effective. In the present study, we used static posturography to objectively evaluate the therapeutic response to antidepressant and anxiolytic treatments in patients with psychogenic dizziness. Thirty-seven patients with psychogenic dizziness participated in this study. All patients were prescribed antidepressants and anxiolytics. We assessed each patient using static posturography before treatment and 4 weeks after treatment. Static posturography was performed for 60 seconds with the patients' eyes open and closed. The Clinical Global Impressions-Improvement (CGI-I) scale was used for global evaluation. On the basis of the CGI-I scores, the subjects were divided into two groups: I, improved (≦3), and N, not improved (≧4). The following static posturography measurements were used for comparison: length (LNG), environmental area (ENV), and LNG/ENV. For each of these parameters, we determined improvement rates by calculating the difference between before- and after-treatment measurements. We found that CGI-I scores correlated with LNG, ENV with eyes open, and ENV with eyes closed. The improvement rates of groups I and N were significantly different for all parameters. Data obtained from subjects that had lower improvement rates relative to control values were selected for further analysis. Control values were obtained from 2201 normal subjects. Group I subjects that had low LNG/ENV values (with eyes open) before treatment showed significantly increased LNG/ENV values (with eyes open) after treatment. Our analyses revealed statistically significant differences between groups I and N in some static posturography values obtained before and after treatment. Our findings indicate that static posturography values can be used to objectively evaluate psychogenic dizziness in future studies.

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Balance dysfunction resulting from acute inner ear energy failure is caused primarily by vestibular hair cell damage

Mizutari Kunio, Fujioka Masato, Nakagawa Susumu, Fujii Masato, Ogawa Kaoru, Matsunaga Tatsuo

Journal of Neuroscience Research 88 ( 6 ) 1262 - 1272 2010.05

ISSN 0360-4012

Inner ear energy failure is associated with disorders such as inner ear ischemia. Recently, we used the mitochondrial toxin 3-nitropropionic acid (3-NP) to establish an animal model of inner ear energy failure that presents with auditory dysfunction. Here we investigated the mechanisms underlying balance disorders in the 3-NP animal model. Spontaneous nystagmus peaked 6 hr after treatment with either 300 mM or 500 mM 3-NP. The nystagmus attenuated gradually and disappeared 3 days after 3-NP treatment. A caloric test using ice water was performed to evaluate residual vestibular function 7 days after 3-NP treatment. The response to caloric stimulation was reduced to ∼40% of the response of the untreated ear following 300 mM 3-NP and was undetectable following 500 mM 3-NP. Structural changes in the peripheral vestibular organs were analyzed by light and electron microscopy. Severe loss of stereocilia was observed following 500 mM 3-NP, whereas disorganized and mildly reduced stereocilia were observed following 300 mM 3-NP. There was severe loss and degeneration of vestibular hair cells following 500 mM 3-NP but only slight loss and degeneration of hair cells following 300 mM 3-NP. These results indicate that acute inner ear energy failure causes balance dysfunction mainly by damaging hair cells in the vestibule, which is distinct from the mechanism underlying auditory disorders.

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Traditional Chinese medicine for treatment of laryngeal papillomatosis

Okubo Keisuke, Saito Koichiro, Fukuda Hiroyuki, Watanabe Kenji, Ogawa Kaoru, Shiotani Akihiro

Journal of Alternative and Complementary Medicine 16 ( 4 ) 427 - 433 2010.04

ISSN 1075-5535

Objective: The objective of this study was to assess the clinical effectiveness of Traditional Chinese Medicine (TCM) as an adjuvant therapy for recurrent respiratory papillomatosis. Design: The design of this study was a case series. Location and subjects: Fifty-one (51) patients with laryngeal papillomatosis who were treated at Keio University Hospital between May 1981 and April 2008 were incorporated in this study. Interventions: Individually formulated TCM was orally administered postsurgically to 20 patients with aggressive laryngeal papillomatosis requiring multiple laser ablations (at least biannually) because of frequent recurrence. Eight (8) patients were excluded because of discontinued visits or medication (6 patients), or malignant transformation of the lesion (2 patients). The remaining 12 patients were enrolled in this study. Outcome measures: Retrospective chart review and review of the patients' recorded laryngeal images were performed. Clinical response to TCM was measured by the surgical necessity and Derkay's severity score for each patient, followed by statistical analyses. Results: Surgeries were required statistically less often (p= 0.0029) after TCM administration compared with the pre-TCM period. Furthermore, Derkay's severity score was significantly lower (p= 0.022) at the patients' last visit compared with the score before TCM administration. Conclusions: TCM may be a useful adjuvant therapy to treat aggressive laryngeal papillomatosis. Further studies are necessary to clarify the pharmacological mechanism of TCM in the treatment of laryngeal papillomatosis.

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Blockade of interleukin-6 signaling suppressed cochlear inflammatory response and improved hearing impairment in noise-damaged mice cochlea

Wakabayashi Kenichiro, Fujioka Masato, Kanzaki Sho, Okano Hirotaka James, Shibata Shinsuke, Yamashita Daisuke, Masuda Masatsugu, Mihara Masahiko, Ohsugi Yoshiyuki, Ogawa Kaoru, Okano Hideyuki

Neuroscience Research 66 ( 4 ) 345 - 352 2010.04

ISSN 0168-0102

Hearing impairment can be the cause of serious socio-economic disadvantages. Recent studies have shown inflammatory responses in the inner ear co-occur with various damaging conditions including noise-induced hearing loss. We reported pro-inflammatory cytokine interleukin-6 (IL-6) was induced in the cochlea 6 h after noise exposure, but the pathophysiological implications of this are still obscure. To address this issue, we investigated the effects of IL-6 inhibition using the anti-IL-6 receptor antibody (MR16-1). Noise-exposed mice were treated with MR16-1 and evaluated. Improved hearing at 4 kHz as measured by auditory brainstem response (ABR) was noted in noise-exposed mice treated with MR16-1. Histological analysis revealed the decrease in spiral ganglion neurons was ameliorated in the MR16-1-treated group, while no significant change was observed in the organ of Corti. Immunohistochemistry for Iba1 and CD45 demonstrated a remarkable reduction of activated cochlear macrophages in spiral ganglions compared to the control group when treated with MR16-1. Thus, MR16-1 had protective effects both functionally and pathologically for the noise-damaged cochlea primarily due to suppression of neuronal loss and presumably through alleviation of inflammatory responses. Anti-inflammatory cytokine therapy including IL-6 blockade would be a feasible novel therapeutic strategy for acute sensory neural hearing loss.

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Long-term prognosis of low-frequency hearing loss and predictive factors for the 10-year outcome

Oishi Naoki, Inoue Yasuhiro, Saito Hideyuki, Kanzaki Sho, Kanzaki Jin, Ogawa Kaoru

Otolaryngology - Head and Neck Surgery 142 ( 4 ) 565 - 569 2010.04

ISSN 0194-5998

Objectives: To determine the long-term prognosis of low-frequency hearing loss and predictive factors for the 10-year outcome of low-frequency hearing loss. Study Design: Case series with chart review. Setting: Tertiary referral center. Subjects and Methods: From 1979 to 1998, 466 consecutive patients with low-frequency hearing loss received initial treatment at the Hearing and Tinnitus Clinic of Keio University Hospital. Of the 49 eligible patients, pure-tone threshold data obtained over a period of 10 years after onset of low-frequency hearing loss were available for analysis. To determine the progression of hearing loss, we analyzed audiometric pattern changes. We also examined how the following factors affected 10-year prognosis: sex, age, side of hearing loss, accompanying dizziness, pre-therapeutic hearing thresholds at low frequencies, initial therapy results, and fluctuation of hearing during the first year after onset. Results: High- and pan-frequency hearing loss increased as time progressed. About half of the cases developed high- or pan-frequency hearing loss within 10 years of onset. Audiometric patterns measured at 10 years significantly correlated with those measured at one (r = 0.57), three (r = 0.73), and five years (r = 0.85). The 10-year prognosis significantly correlated with only two factors: initial therapy results (r = 0.49) and fluctuation of hearing during the first year (r = 0.43). Conclusions: About half of the cases in our study developed high- or pan-frequency hearing loss within 10 years of onset of low-frequency hearing loss. The initial therapy results and fluctuation of hearing during the first year may indicate the long-term prognosis of patients presenting with low-frequency hearing loss.

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Effects of selective serotonin reuptake inhibitor on treating tinnitus in patients stratified for presence of depression or anxiety

Oishi Naoki, Kanzaki Sho, Shinden Seiichi, Saito Hideyuki, Inoue Yasuhiro, Ogawa Kaoru

Audiology and Neurotology 15 ( 3 ) 187 - 193 2010.03

ISSN 1420-3030

We evaluated the effects of a selective serotonin reuptake inhibitor, paroxetine, on treating tinnitus.Tinnitus patients stratified for the presence of depression and anxiety were studied retrospectively. Fifty-six patients were observed for more than 6 months. They were initially treated with paroxetine only at a dose of 10 mg/day for 2-4 weeks; thereafter, the dose was increased to 20 mg/day. Tinnitus distress was evaluated with the Tinnitus Handicap Inventory (THI) and with visual analog scales (VASs) for tinnitus loudness and annoyance. Depression and anxiety were measured with the Self-Rating Depression Scale (SDS) and the trait section of the State-Trait Anxiety Inventory (STAI). The patients were grouped according to their SDS and STAI scores, and each variable was compared at baseline and the 6-month follow-up. Changes among these variables were also examined to determine whether reduced tinnitus distress was related to the improvement of depression or anxiety. Patients with both depression and anxiety showed better results (decrease in THI, VASs, SDS and STAI scores) than patients with anxiety alone, or patients without depression and anxiety. In patients with depression and anxiety, changes in tinnitus variables and changes in depression and anxiety scores were strongly correlated. In other patients, however, changes in tinnitus variables and changes in depression and anxiety scores were not correlated. These results suggest that paroxetine is effective in treating distressed tinnitus patients with depression and anxiety by reducing their tinnitus severity as well as their depression and anxiety.

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Otosclerosis update (2) - Treatment and prevention

Ogawa Kaoru, Inoue Yasuhiro, Saito Hideyuki, Kanzaki Sho, Okamoto Yasuhide, Mizutari Kunio, Suzuki Takashi, Oishi Naoki, Watada Yukiko, Watabe Takahisa, Fujioka Masato

Practica Oto-Rhino-Laryngologica 103 ( 2 ) 103 - 112 2010.02

ISSN 0032-6313

Inostamycin prevents malignant phenotype of cancer

Baba Yuh, Kato Yasumasa, Ogawa Kaoru

Cell Biology International 34 ( 2 ) 171 - 175 2010.02

ISSN 1065-6995

Head and neck squamous cell carcinoma is the sixth most common type of neoplasm worldwide, but its prognosis has not improved significantly in recent years. Therefore, efforts need to be intensified to gain a better understanding of this disease and develop novel treatment strategies. Inhibition of cytidine 5'-diphosphate 1,2-diacyl-sn-glycerol: inositol transferase by inostamycin, an antibiotic isolated from Streptomyces sp. MH816-AF15, induces G1 cell cycle arrest accompanied by a decrease in cyclin D1 and phosphorylated RB protein levels, along with suppression of in vitro invasive ability through reduced production of matrix metalloproteinases (MMP-2 and MMP-9) and cell motility in head and neck cancer cell lines. Furthermore, inostamycin abrogated the stimulatory effect of VEGF (vascular endothelial growth factor) on growth and migration activities of endothelial cells by targeting extracellular signal-regulated kinase-cyclin D1 and p38 pathways, respectively. Because inostamycin has both antiproliferative and anti-invasive abilities, inhibition of phosphatidylinositol synthesis could be a potent therapeutic strategy for head and neck cancer as the 'cancer dormant therapy', i.e. a therapeutic concept to prolong 'time to treatment failure' or 'time to progression'.

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Hearing handicap predicts the development of depressive symptoms after 3 years in older community-dwelling Japanese

Saito Hideyuki, Nishiwaki Yuji, Michikawa Takehiro, Kikuchi Yuriko, Mizutari Kunio, Takebayashi Toru, Ogawa Kaoru

Journal of the American Geriatrics Society 58 ( 1 ) 93 - 97 2010.01

ISSN 0002-8614

Objectives: To examine the association between hearing handicap and depressive symptoms in older community-dwelling Japanese. DESIGN: Community-based cohort study. Setting: Kurabuchi Town, Gunma Prefecture, Japan. Participants: Five hundred eighty residents (261 men, 319 women) aged 65 and older without depressive symptoms. Measurements: In a baseline examination performed in 2005/06, participants answered the 10-item screening version of the Hearing Handicap Inventory for Elderly (HHIE-S). They were divided into two groups according to their scores: a group with no hearing handicap (HHIE-S scores of ≤8) and a hearing handicap group (HHIE-S scores of ≥10). The Geriatric Depression Scale was used to identify depressive symptoms in face-to-face home visit interviews conducted in 2008, and the association between hearing handicap and depressive symptoms was assessed using logistic regression. Results: The incidence of depressive symptoms was 19.6% in the group with a hearing handicap and 8.0% in the group without a hearing handicap. When compared with the subjects without hearing handicap, subjects with a hearing handicap had a multiadjusted odds ratio of depressive symptoms of 2.45 (95% confidence interval=1.26-4.77). The association remained significant even when hearing impairment measured with pure-tone audiometry was added to the multiadjusted model. Conclusion: A hearing handicap can predict future depressive symptoms in older community-dwelling people.

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Skull-base meningioma extending to the parapharyngeal space

Inagaki Yozo, Oishi Naoki, Fujimine Takekatu, Fujii Ryouichi, Saito Hideyuki, Ogawa Kaoru

Practica Oto-Rhino-Laryngologica 103 ( 1 ) 53 - 57 2010.01

ISSN 0032-6313

kull-base and parapharyngeal tumors require intricate treatments due to its anatomic complexity, variations in histological type, and the site often involves the presence of critical blood vessels and nerves. Diagnostic imaging and fine-needle aspiration cytology are thus essential. We report a case of skull-base meningioma extending to the parapharyngeal space in which we made a definitive diagnosis by biopsy (as grade I) and took a wait-and-see approach. A 52-year-old woman had complained of a headache since June 2006 and was seen in the neurology department at our hospital in July. A tumor from around the left jugular foramen to parapharyngeal space was revealed by magnetic resonance imaging (MRI) and she was referred for consultation to the neurosurgical department and our department. It was difficult to establish the diagnosis from the clinical manifestation and diagnostic images due to the tumor's complicated anatomy, therefore it was confirmed by biopsy instead of cytology. It can be said that biopsy is useful to determine therapeutic measures for the skull-base meningioma because it is less invasive and can verify a histological type compared with the complete removal of the tumor.

Chemotherapy for head and neck cancer

Tomita Toshiki, Imanishi Yorihisa, Ozawa Hiroyuki, Fujii Ryoichi, Shigetomi Seiji, Habu Noboru, Otsuka Kuninori, Ogawa Kaoru, Fukada Junichi, Shigematsu Naoyuki, Kogashiwa Yasunao, Yamauchi Kohichi, Kohno Naoyuki

Toukeibu Gan 36 ( 3 ) 273 - 277 2010

ISSN 1349-5747

A meta-analysis showed that chemoradiotherapy (CCRT) improved survival in patients with advanced head and neck squamous cell carcinoma (HNSCC). CCRT has become widely used in treating such patients. The purpose of CCRT in the treatment of resectable HNSCC is to improve survival while preserving organs and functions, and so CCRT is a potential alternative to surgery. However, problems regarding CCRT were revealed such as severe dysphasia and difficulty of salvage surgery. Recently, induction chemotherapy has attracted attention again, the purpose of which is to predict the response of subsequent CCRT or to improve outcomes. Moreover, chemotherapy is concurrently used with postoperative radiotherapy or definitively used for recurrent or metastatic HNSCC. In this article, we review the current state of chemotherapy for HNSCC and consider the problems in Japan.

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The possible contribution of angiitis to the onset of benign paroxysmal positional vertigo (BPPV)

Goto Fumiyuki, Hayashi Ken, Kunihiro Takanobu, Ogawa Kaoru

International Tinnitus Journal 16 ( 1 ) 25 - 28 2010

ISSN 0946-5448

Objective: The aim was to evaluate the oxidative stress and the angiitis in patients with BPPV. Method: Patients with benign paroxysmal positional vertigo (BPPV) within 14 days of onset were analyzed. The level of diacron reactive oxygen metabolites (d-ROM) and circulating soluble vascular cell adhesion molecule 1 (VCAM-1), were evaluated. As a treatment the patients were taught to perform the Brandt-Daroff exercise at home by themselves. The prognosis of BPPV, which is measured as the time until the disappearance of positional nystagmus by a physician during the outpatient visit each week, the relation among the level of oxygen metabolites, vascular molecule and the duration until remission were analyzed. Results: The patients who required longer time for the disappearance of positional nystagmus showed high d-ROM and VCAM levels, whereas those who required shorter time for remission showed lower d-ROM and VCAM levels. Conclusion: There is an increased expression of VCAM-1 and d-ROM confirming the existence of an angiitis and supporting the vascular involvement in BPPV. The identification of the high levels of d-ROM and VCAM-1 can open the way to selective pharmacological treatments able to correct the oxidative stress and activation of endothelial cells.

A novel model for prognosis of meniere's disease using oxidative stress susceptibility of lymphoblastoid cell lines

Hayashi Ken, Kobayashi Ryo, Kitamura Koichi, Goto Fumiyuki, Ogawa Kaoru, Matsumoto Tetsuya

BioScience Trends 4 ( 2 ) 72 - 78 2010

ISSN 1881-7815

The aim of this study was to examine differences of susceptibility to oxidative stress of Epstein-Barr virus (EBV)-transformed lymphoblastoid cell lines (LCLs) established from Meniere's disease (MD) patients and to examine the effect of ATP treatment in the prognosis and treatment MD. LCLs were established from 10 patients with MD and 10 healthy donors by EBV. Cell viabilities were calculated after treatment of H₂O₂ with or without ATP. The relationship between the sensitivity of H₂O₂-treated LCLs to ATP and the staging scale of MD was examined. The nuclear morphological changes of Hoechst 33258-stained LCLs after H₂O₂-treatment were observed under a fl uorescence microscope. LCLs from MD were significantly more sensitive (p < 0.001) to H₂O₂ than LCLs from healthy donors after 3 h of H₂O₂ treatment. All of the ATP-sensitive LCLs were categorized as Stage 1 or 2, while others categorized as Stage 3 or 4 were not sensitive to ATP. There were significant differences (p < 0.01) of cell viabilities after addition of ATP between H₂O₂-treated LCLs classifi ed as Stage 1 or 2 and as Stage 3 or 4 in MD. Both chromatin condensation and swelling of the cell body were observed in H₂O₂-treated LCLs. Our findings indicate that LCLs established from MD patients might be used as a unique model to detect susceptibility to oxidative stress and ATP treatment in MD patients. Also, the difference of the sensitivity of H₂O₂-treated LCLs to ATP might relate to prognosis and treatment of MD. This system may form the basis of tailor-made therapy for MD.

Differetial diagnosis of acute sensorineural hearing loss

Ogawa Kaoru

Otolaryngology - Head and Neck Surgery (Tokyo) 82 ( 1 ) 19 - 24 2010

ISSN 0914-3491

Anxiety and depression levels measured using a hospital anxiety and depression scale in patients with an otolaryngological disorder

Goto Fumiyuki, Tsutumi Tomoko, Ogawa Kaoru

Practica Oto-Rhino-Laryngologica 102 ( 12 ) 1071 - 1075 2009.12

ISSN 0032-6313

Introduction: Anxiety and depression are closely related to mental and physical disease prognosis. This makes it important to know anxiety and depression levels in patients with physical or mental disorders who visited the department of otorhinolaryngology. We evaluated the anxiety and depression levels in such patients using a hospital anxiety and depression scale (HADS). Methods: Subjects were 67 individuals whose degree of anxiety and depression was decided on HADS. Subjects were then divided into 4 groups-group I, no anxiety or depression; group II, depression alone, group III, anxiety alone, and group IV, both anxiety and depression. We then looked at the relationship between these results and their major perceived problems. Results: Groups I had 39 subjects II 7, III 8, and IV 13. Anxiety and depression were correlated (r= 0. 56; p<0. 0001). 90% of subjects reported dizziness, tinnitus, or throat discomfort. Those with throat discomfort had the highest anxiety score, while those with anxiety most commonly reported dizziness. Conclusions: Our results suggest that subjects may have anxiety and/or depression. The evaluation of anxiety and depression based on physical complaints may be difficult for otorhinolaryngologists, but it is important to do so where possible to increase the focus on the subject's physical illness and perceived problems.

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