Laser-assisted uvulopalatoplasty with Nd:YAG laser for sleep disorders.

We evaluated the apnea index (AI), the oxygen saturation above 95% (SA95), the lowest oxygen saturation (LSAT), and snoring before and after laser-assisted uvulopalatoplasty (LAUP) in 106 patients with obstructive sleep apnea syndrome (n=59) or snoring (n=47). Type 1 LAUP was performed in 42 patients and type 2 LAUP in 64 patients. A 50% or greater reduction in AI was observed in 15 patients (35.7%) who underwent type 1 LAUP and 37 patients (57.8%) who underwent type 2 LAUP. Snoring was diminished in 18 (51.4%) of 35 patients who underwent type 1 LAUP and 30 (55.6%) of 54 patients who underwent type 2 LAUP. SA95 and LSAT showed no difference. No serious complications such as significant bleeding, postoperative episodes of asphyxia, nasopharyngeal stenosis, or nasal regurgitation were observed. LAUP was an effective outpatient treatment.

[Methicillin-resistant Staphylococcus aureus infection in the Kagoshima University Hospital--special attention to prevalence in otolaryngological infectious disease].

A retrospective study of the characteristics of MRSA (methicillin resistant S. aureus) in Kagoshima University Hospital and its ENT department was reported. There were 231 samples (104 strains) MRSA in all S. aureus 448 samples from Jan. to Sep. 1989 in Kagoshima University Hospital, in which 58 strains (55.8%) were coagulase type II and 35 strains (33.7%) were type VII. The much more predominant numbers of MRSA were observed in all the cases inpatients clinics in surgery, pediatrics, urology, gynecology and dermatology than internal medicine as well as outpatients clinics. In ENT department of this hospital, only 15.4% of all S. aureus were MRSA. On the other hand, bacteriological survey showed 26% of MRSA out of all S. aureus which were detected at Tokyo clinical research center on otorrhea in the patients with chronic otitis media as multicenter clinical trial of Japan. Two cases involved by MRSA after postoperative administration of many types of antibiotics were also demonstrated. These MRSAs were producing type II coagulase and very high concentrations of MICs to many antibiotics were observed. But these cases were not severe and MINO (minocyclin) or GM (gentamicin) were so effective. The effect of combined therapy of some antibiotics or antimicrobial agents was discussed briefly.

[A clinical and immunological study on non-Hodgkin's malignant lymphoma in nasosinus region].

Twenty-eight cases of non-Hodgkin's lymphoma in nasosinus region were studied for tumor-surface marker phenotype, anti-HTLV-I antibody titer and histopathologic correlation with clinical features. The incidence of these cases was 25% of all lymphomas in head and neck region from 1978 to 1987. In 16 cases, 12 (75%) had T-cell markers and 4 (25%) had B-cell markers. Of 11 cases, 6 (54.5%) were anti-HTLV-I antibody carriers. Five year survival ratio of all patients was 4.5%. The survival curve for T-cell lymphoma patients was characterized by a rapid initial decline. The survivals of the group of anti-HTLV-I antibody carriers was estimated inferior to those of non-carriers. Correlation of HTLV-I to prognosis of these patients was discussed.

Three cases of Wegener's granulomatosis treated with an antimicrobial agent.

Sulfamethoxazole-trimethoprim, an antimicrobial agent, was used to treat three cases of cytotoxic agent-resistant Wegener's granulomatosis; one case was refractory to a regimen consisting of azathioprine and prednisolone, and in another two cases the therapy was insufficient to control the disease. By the introduction of sulfamethoxazole-trimethoprim, which has an advantage of fewer side effects compared with the conventional agents, into the regimen, the disease condition was markedly improved in all cases within four months. Sulfamethoxazole-trimethoprim is thus considered as one of the most promising drugs to treat, especially, cytotoxic agent-resistant Wegener's granulomatosis. The possible underlying mechanism of the effect of sulfamethoxazole-trimethoprim is also described.

[A phase II study of Futraful suppository in head and neck cancer].

A phase II study of FT-207 suppository (Futraful Suppository) for head and neck cancer was conducted at the Kagoshima University Hospital Dept. of Otorhinolaryngology and its 6 affiliated hospitals. Forty cases with head and neck cancer were entered in the trial, of which 37 were perfectly evaluable. Partial response (PR) (16.7%) was achieved in one of 6 patients with maxillary cancer, in 2 of 9 cases with oral cancer (22.2%), in one of 7 with laryngeal cancer (14.3%), in 3 of 13 with pharyngeal cancer, while 2 of the same 13 achieved a complete response (CR) (38.5%), for a total response rate of 24.3%. FT-207 suppository was continuously administered as standard, at a dose of 750 mg each twice daily, or 1,500 mg/day. The response rate was dose-dependent; 2 CR cases with a total dose of 105 g for administration over a total period of more than 150 days. Adverse effects appearing in 35.0% of the overall were mainly anorexia, nausea and vomiting; none of them, however, were serious.