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Data for 14 patients. Abbreviations: M, male; F, female; ND, not documented; SNHL, sensorineural hearing loss; POD, postoperative day. (PPTX 52 kb)

Foreign body ingestion is a commonly encountered clinical problem. In particular, sharp foreign bodies lodged in the esophagus or hypopharynx can cause complications and require urgent removal. Removal by flexible esophagogastroduodenoscopy or rigid esophagoscopy is the treatment of choice and has high success rates, but cases in which these methods are unsuccessful must be treated with an external incision. A 62-year-old man was referred for a fish bone lodged in the hypopharynx that could not be removed by flexible esophagogastroduodenoscopy. We removed the bone transorally using a specially designed rigid curved laryngoscope. Based on our experience, this method may have clear practical value due to advantages of a wide field of view and use of multiple rigid forceps. Indications may be limited, but this novel method may reduce the limitations of noninvasive removal of foreign bodies.

Objective: Japanese cedar pollinosis is increasing rapidly in Japan. Although analysis has been made concerning the factors influencing the development of the cedar pollinosis, analysis concerning the risk factors influencing the sensitization in asymptomatic subjects has not been done.Methods: Risk factors for sensitization to Japanese cedar pollen were analyzed among 73 subjects (32 men and 41 women) who do not develop symptoms of pollinosis at the time of Japanese cedar pollen scattering. Their ages ranged from 18 to 60 years with the mean of 34.1 years. Possible factors influencing sensitization were investigated through a written questionnaire and doctors’ questioning. Japanese cedar-specific IgE titers and Dermatophagoides pteronyssinus-specific IgE titers in the serum were measured by CAP-FEIA (fluorescent enzyme immunoassay).Results: Of the 73 subjects, 26 were sensitized to the Japanese cedar pollen, for a 36% sensitization rate. Among the eleven factors examined, only one factor was shown to significantly influence the sensitization rate to Japanese cedar pollen. It was sensitization to house dust mites (56.5% vs. 26.0% X 2value = 6.27, p = 0.012). The sensitization rate to the pollen did not correlate to the presence of other allergic diseases, history of rhinosinusitis, family history of Japanese cedar pollinosis, food preference, presence or absence of cedar trees in the surroundings, present living circumstances, childhood circumstances, age, sex, or smoking habits. We calculated odds ratios in order to estimate how much those factors influence the sensitization to Japanese cedar pollen. Significantly high odds ratio for sensitization to house dust mite (6.63; 95% confidence interval (CI): 1.76–32.2) was found.Conclusion: The present study indicates that sensitization to the pollen in the subjects without pollinosis is influenced by sensitization to house dust mite., 本文/Department of Otorhinolaryngology, Head & Neck Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan, 5p

A 27-year-old woman evacuated a hydatidiform mole at 11 weeks of gestation. Her serum human chorionic gonadotropin (hCG) levels declined progressively but reached a plateau of 2-3 mIU/ml thereafter. The patient was treated with two courses of methotrexate, which did not affect her hCG levels. She refused further chemotherapy and, for more than one year, she was managed expectantly until a significant rise in her hCG titer. Fortunately, an unexpected pregnancy and subsequent missed abortion led to a spontaneous regression of her hCG levels.