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Nasal resistance and the OSA-18 score were useful for evaluating surgical treatments. The sleep disturbance score may also be useful for predicting the severity of obstructive sleep apnea (OSA) in children.We evaluated the effect of surgery on children with OSA using polysomnography (PSG) parameters, nasal resistance, and the OSA-18 questionnaire, and also investigated the cut-off OSA-18 score to screen for pediatric OSA.This was a retrospective study in which PSG parameters and nasal resistance were measured using a rhinomanometer and the OSA-18 score was obtained from the OSA-18 questionnaire before and after surgery in 45 children with OSA.The mean age of the 45 patients was 5.7 ± 2.0 years. The mean value of the obstructive apnea hypopnea index (O-AHI) improved from 16.2 ± 14.3/h before surgery to 1.1 ± 1.7/h after surgery, the mean nasal resistance improved from 0.44 ± 0.19 to 0.32 ± 0.10 Pa/cm(3)/s, and the mean OSA-18 score improved from 61.1 ± 13.7 to 30.4 ± 5.8, and all these improvements were significant. The O-AHI value was lower than 1/h after surgery in 64.4% of patients (29/45). The O-AHI value was significantly correlated with the sleep disturbance score (r = 0.352, p = 0.018). When the cut-off OSA-18 score for screening was set at 40, sensitivity was 100%.

Nedaplatin and S-1 treatment with concurrent radiotherapy was effective, with acceptable toxicities. This regimen does not require extensive intravenous hydration and continuous infusion. Nedaplatin and S-1 may contribute to better clinical outcomes and improve quality of life for patients.We retrospectively analyzed the clinical efficacy and toxicity of concurrent chemoradiotherapy with nedaplatin and S-1 for head and neck squamous cell cancer.Forty-six patients with oropharyngeal, hypopharyngeal, and laryngeal cancer were treated with S-1 on days 1 through 14 and nedaplatin on day 1 every 4 weeks for two cycles of radiotherapy. Therapeutic responses and adverse events were assessed.Primary site tumors and neck lymph nodes exhibited complete response rates of 91% and 64.3%, respectively. The 4-year relapse-free survival and overall survival rates were 76.2% and 85.3%, respectively. The main grade 3 and 4 toxicities were mucositis (30%), leukopenia (30%), anorexia (22%), dermatitis (15%), and thrombocytopenia (9%).

Acetazolamide (ACTZ), a carbonic anhydrase inhibitor, has been reported to decrease the endolymphatic sac (ES) DC potential (ESP) in the guinea pig. To assess the involvement of cation transport in the ESP change by ACTZ we examined the effect of ACTZ upon the K + and Na + activities of the ES endolymph in the guinea pig using ion-sensitive microelectrode. ACTZ (10 mg/kg), a dose that produces the ESP maximum reduction, produced a significant increase in Na + activity of the ES endolymph with no change in K + activity. The results suggest that Na + transport may be directly or indirectly involved in ESP reduction by ACTZ, and that a Na + -H + exchanger may be involved in Na + influx pathway from endolymph to the ES epithelial cells.

Despite low uptake of tracer, 3'-deoxy-3'-(18)F-fluorothymidine (FLT) PET could detect cervical lymph node metastases as well as 2-deoxy-2-(18)F-fluoro-d-glucose (FDG) PET.The diagnostic efficacy of FLT PET was compared with that of FDG PET regarding nodal staging of head and neck squamous cell cancers.Twenty-three patients were examined with FLT PET and FDG PET. PET images were evaluated qualitatively for regions of focally increased metabolism and maximum standardized uptake values (SUV) were calculated for semiquantitative analysis.The mean (± SD) FLT SUV in visualized metastatic lymph nodes was 4.8 ± 2.9 as compared with 6.9 ± 4.9 for FDG SUV (p0.001). Significant correlations were found between the area of metastatic lymph nodes and both FLT SUV (r = 0.8; p0.0001) and FDG SUV (r = 0.84; p0.0001). The false-positive (over-staged) and false-negative (under-staged) rates for lymph node staging by FLT PET were 4% (1/23) and 17% (4/23), respectively. Those for FDG PET were 9% (2/23) and 13% (3/23). All metastatic lymph nodes measuring more than 9 mm in short-axis diameter were correctly detected by FLT PET. However, both FLT and FDG PET had low sensitivity for detecting the lymph node metastases ≤ 9 mm in short-axis diameter and tumor deposits5 mm.

A constant volume of horseradish peroxidase (HRP) was injected directly into the endolymphatic sac (ES) lumen of the guinea pig to investigate the detailed absorption activity and the barrier properties of the ES. The reaction products were analyzed using an ultrastructural and morphometric method 1 to 10 h after the injection of this tracer. The epithelial cells in the proximal portion did not absorb the intraluminal HRP at any intervals after the tracer injection. The epithelial cells of the intermediate portion were classified clearly into two types according to their absorption activity: active-absorptive, and non-active cells. Uptake in the active-absorptive cells reached its maximal rate 8 h after the injection and then decreased. The active-absorptive cells in teh intermediate portion are considered to play a major role in the macromolecular absorption in the ES epithelium. The non-active cells scarcely absorbed the intraluminal HRP, suggesting that these cells are not involved in the macromolecular absorption. The absorption activity in the distal portion was lower than that in the active-absorptive cells in the intermediate portion 1 to 8 h after the HRP injection, while higher 10 h after the injection. Not only the intermediate portion but also the distal portion may play an active role in the macromolecular absorption. In no portion of the ES did intraluminal HRP penetrate beyond the junctional complexes between epithelial cells or through the cytoplasm. It is conceivable that there is a tight barrier to the intraluminal macromolecules in the epithelial linings of the ES.