Search for K_{L}→π^{0}νν[over ¯] and K_{L}→π^{0}X^{0} Decays at the J-PARC KOTO Experiment

A search for the rare decay K_{L}→π^{0}νν[over ¯] was performed. With the data collected in 2015, corresponding to 2.2×10^{19} protons on target, a single event sensitivity of (1.30±0.01_{stat}±0.14_{syst})×10^{-9} was achieved and no candidate events were observed. We set an upper limit of 3.0×10^{-9} for the branching fraction of K_{L}→π^{0}νν[over ¯] at the 90% confidence level (C.L.), which improved the previous limit by almost an order of magnitude. An upper limit for K_{L}→π^{0}X^{0} was also set as 2.4×10^{-9} at the 90% C.L., where X^{0} is an invisible boson with a mass of 135  MeV/c^{2}.

Fish bone impaction in the supraglottis

The most common sites of fish bone impaction are the tonsils, tonsillar pillars, tongue base, valleculae, and piriform fossa. Impaction in the supraglottic area is extremely uncommon.

Mucin 1 enhances the tumor angiogenic response by activation of the AKT signaling pathway

Although the hyper-glycosylated transmembrane protein Mucin 1 (MUC1) is aberrantly overexpressed in human breast carcinoma, the biological significance of MUC1 overexpression is unclear. This study showed that MUC1 expression promoted the synthesis and secretion of vascular endothelial growth factor (VEGF) through the AKT signaling pathway. Increase VEGF production through MUC1 expression had a number of effect. First, MUC1 transfection increased expression of VEGF in breast cancer cells. Second, MUC1-mediated VEGF induction was attenuated by a chemical inhibitor of AKT or MUC1 knock-down by MUC1 siRNA. Third, MUC1 expression led to the activation of insulin-like growth factor-1 receptor, which correlated with VEGF expression. In addition, when MDA-MB-231 human breast cancer cells were directly injected into NOD/SCID mice, MUC1 expression accelerated xenograft tumor growth in vivo. Finally, MUC1 expression enhanced tumor growth and angiogenesis in a PyMT-MMTV/hMUC1 transgenic mouse model. Concurrent with these results, analysis of a human tissue microarray identified a high correlation between MUC1 and VEGF expression in human breast carcinoma. The current report is the first to demonstrate that MUC1 expression promotes angiogenesis in human breast cancer in vivo and in vitro.

Effect of a Chinese herbal formula, Shi-Bi-Lin, on an experimental model of allergic rhinitis

BACKGROUND

Jia Wei Cang Er Zi San, a traditional Chinese herbal formula, has been used to treat allergic rhinitis (AR) for several centuries. However, its effect on experimental animal models and its therapeutic mechanism remain unclear.

OBJECTIVE

To study the effect of Shu-Bi-Lin, a modified Jia Wei Cang Er Zi San, on an animal model of AR.

METHODS

Shu-Bi-Lin was administered to the guinea pig model of AR. Meanwhile, an antihistamine-treated group for the treatment control, an ovalbumin-sensitized and untreated group for the positive control, and a sham-sensitized, sham-challenged group for the sham control were studied in parallel. Symptomatic and some pathophysiologic variables were evaluated.

RESULTS

Sneezing and nasal scratching after challenges were significantly ameliorated in the Shu-Bi-Lin-treated group compared with the ovalbumin-sensitized and untreated group, but rhinorrhea volume was not reduced. Shu-Bi-Lin significantly suppressed the production of IgG1 in the passive cutaneous anaphylaxis test. The thromboxane B2 level in nasal lavage fluid was significantly deceased in the Shu-Bi-Lin-treated group; however, the reduction in histamine and peptide leukotriene levels did not reach statistical significance. In addition, eosinophil infiltration and endothelial nitric oxide synthase immunoreactivity in the nasal tissues were reduced in the Shu-Bi-Lin-treated group.

CONCLUSIONS

Shu-Bi-Lin could alleviate the nasal symptoms of AR, and its mechanism might be related to its inhibitory effect on type I anaphylaxis reactions and eosinophil infiltration in the nasal tissues, as well as the inhibition of some mediators related to AR.

Management of ingested foreign bodies: a retrospective review of 5240 patients

This review was carried out to assess the effectiveness of our protocol designed for the management of ingested foreign bodies. It was a retrospective review of 5240 patients with ingested foreign bodies admitted over a five-year period to the Ear Nose and Throat Unit. These patients were managed according to a standardized protocol which was adopted and modified from our previous study. Under his management protocol, the mean hospital stay was 1.6 days. Flexible oesophagoscopy under local anaesthesia, and rigid oesophagoscopy under general anaesthesia, were performed in 1.5 per cent and 7.7 per cent of cases respectively. Major complications including oesophageal perforation and deep neck abscesses occurred in 0.19 per cent of patients. There was no mortality. This management protocol for ingested foreign bodies was both safe and cost-effective when compared to similar studies reported in the literature.

Compartmentalized maxillary sinus mucocele

A rare case of compartmentalized maxillary sinus mucocele 12 years after a Caldwell-Luc operation is reported. The two separate mucoceles were drained intranasally by endoscopic sinus surgery. The clinical features of this mucocele are presented and the incidence, presentation and theories on formation of post-operative mucoceles are reviewed.

Endoscopic resection of inverted papilloma of the nose and paranasal sinuses

The results of a retrospective study of 22 patients with inverted papillomas resected by the endoscopic approach are presented with a follow-up of 33 to 96 months. Twenty-one patients had unilateral disease and one patient had bilateral involvement. None of the patients had orbital or cranial extension. One patient had synchronous carcinoma in situ. Eight patients had undergone previous surgical procedures. Following endoscopic surgery, six patients had residual disease requiring further revisions. Three of these six patients eventually required excision via limited external approaches. No patient required lateral rhinotomy or mid-facial degloving procedures. No complication occurred in any of the patients. The advantages of endoscopic surgery include precise determination of tumour extent, preservation of normal mucosa and bony structures and avoidance of external scars. Close endoscopic follow-up is mandatory to ensure early recognition and treatment of recurrent disease. Although the endoscopic approach is gaining popularity for the treatment of inverted papilloma, indiscriminate application may result in a high recurrence rate. The endoscopic approach should be performed by experienced surgeons and restricted to carefully selected patients with nasal, ethmoidal and limited maxillary disease. More extensive disease should be managed by radical external approaches or by combining endoscopic with limited external approaches.

Auditory brainstem responses after radiotherapy for nasopharyngeal carcinoma

The effect of irradiation for nasopharyngeal carcinoma on auditory brainstem responses and hearing was investigated in 19 otologically normal patients undergoing standard fractionated megavoltage radiotherapy. Auditory brainstem responses and pure tone audiometry were performed before radiotherapy, and at 3 and 12 months after completion of radiotherapy. There were no significant changes in the wave I-III and III-V interpeak intervals, or in sensorineural hearing thresholds (bone conduction at 4 kHz and average of bone conduction at 0.5, 1, 2 and 4 kHz), after radiotherapy. In contrast to previous studies, we found no evoked potential evidence of subclinical brainstem damage arising from irradiation for nasopharyngeal carcinoma.

Congenital laryngeal cysts: current approach to management

Congenital laryngeal cysts are a rare cause of neonatal upper airway obstruction which may lead to serious morbidity and mortality if diagnosis and treatment are delayed. We reviewed our experience with nine patients over a six-year period. The annual incidence of this condition was 1.82 per 100,000 live births. The diagnosis can be confirmed safely by flexible laryngoscopy before definitive surgery is contemplated. Contrary to other studies, we found that endoscopic removal of cysts can achieve an effective cure without recurrence. Endoscopic deroofing is as effective as endoscopic excision but is technically simpler and thus is recommended as the treatment of choice.

The etiological role of concha bullosa in chronic sinusitis

The etiological role of concha bullosa in chronic sinusitis is controversial. Previous investigators have not studied the relationship between the location of concha bullosa and different chronic sinusitis patterns. We performed coronal paranasal sinuses CT in 100 Chinese patients with signs and symptoms of chronic sinusitis and recorded the presence and location of the concha bullosa and the pattern of sinonasal disease. The incidence of concha bullosa was 47%. The presence of concha bullosa showed no statistically significant association with different patterns of chronic sinusitis.

Another CT sign of sinonasal polyposis: truncation of the bony middle turbinate

In order to study the features of sinonasal polyposis (SNP) on CT, 100 consecutive coronal sinus CT examinations done for chronic inflammatory sinonasal disease were reviewed. The CT findings of the 27 fully documented SNPs were analyzed. All our SNPs were bilateral. There was a strong tendency for extensive involvement. Nasal polyps were seen in 22 of 27(81%); bony trabecular deossification in 23 of 27 (85%); widening of infundibulum in 26 of 27 (96%). We discovered a new sign "truncation of the bony middle turbinate", where the bulbous part of bony middle turbinate was missing, in 15 of 26 (58%) of SNP patients without a previous history of middle turbinectomy, 12 of 15(80%) were bilateral. The one SNP patient (1 of 27) with previous middle turbinectomy was not regarded to be real truncation. Truncation of the bony middle turbinate is a characteristic and easily recognizable ancillary sign, and is not seen in other patterns of sinusitis. Together with other features on coronal sinus CT, this adds diagnostic confidence in diagnosing sinonasal polyposis.

Hypermethylation of the p16 gene in nasopharyngeal carcinoma

We have recently reported that inactivation of the p16 gene by mutation and deletion is common in nasopharyngeal carcinoma (NPC). The present study demonstrates that hypermethylation of the 5' CpG island can serve as an alternative mechanism for inactivation of the p16 gene in this tumor. Using Southern blotting analysis and multiplex PCR, aberrant methylation of the 5' CpG island of the p16 gene was found in a NPC xenograft (xeno-666) and 6 (22%) of 27 primary tumors, but not in normal tissues of the nasopharynx. In the NPC xenograft (xeno-666) and its newly derived cell line (cell-666), both showing hypermethylation of the p16 gene, no p16 gene expression was found. After treatment with 5-aza-2'-deoxycytidine, reexpression of the p16 gene was detected in the cell line cell-666. These findings suggest that aberrant methylation of the 5' CpG island may participate in the transcriptional inactivation of the p16 gene in NPC. The present results further support that the p16 gene is the critical target on chromosome 9p21 for inactivation during the development of this disease.

A double-blind comparative study of ofloxacin otic drops versus neomycin-polymyxin B-hydrocortisone otic drops in the medical treatment of chronic suppurative otitis media

Active chronic suppurative otitis media poses a management problem when patients are being considered for surgical treatment. Topical antibiotics have demonstrated varying degrees of success in the management of discharging ears. The introduction of quinolones has revived interest in these topical agents. This double-blind study compares two antibiotics, namely ofloxacin and neomycin-polymyxin B, with similar in vitro sensitivities to Gram positive and Gram negative organisms. Fifty-two patients were selected randomly and the results show that ofloxacin eardrops have marginal benefits in symptomatic improvement (89 per cent versus 79 per cent, p = 0.27) and bacterial eradication (81 per cent versus 75 per cent, p = 0.81) in active chronic suppurative otitis media. Significantly fewer patients (seven per cent versus 29 per cent, p = 0.04) in the ofloxacin group had active disease at the end of the two-week treatment. We recommend the use of ofloxacin eardrops in managing active chronic suppurative otitis media since it has high clinical efficacy, contains no steroid component and has no demonstrated risk of ototoxicity.

Preliminary results of photodynamic therapy for recurrent nasopharyngeal carcinoma

Photodynamic therapy (PDT) is a promising new modality in the treatment of cancer. In Hong Kong where nasopharyngeal carcinoma (NPC) is endemic, radiotherapy has been the primary treatment of choice. For recurrent disease after radiotherapy, there is no effective treatment. This latter report summarizes our initial experience in using PDT for these patients. Twelve patients (three females and nine males) with ages ranging from 33 to 65 years were treated with an infusion of hematoporphyrin derivative (5 mg/kg) 48-72 h before exposure to 200 J/cm2 light (wavelength, 630 nm) delivered from a gold vapor laser. All 12 patients showed a dramatic response as judged by computed tomography or magnetic resonance imaging at 6 months post-PDT. Of the eight patients in whom cure was aimed for, three remained disease-free at 9-12 months after a single treatment. Three of the remaining four patients achieved useful palliation. Skin hypersensitivity occurred in two patients and was the only significant complication encountered. This experience indicates that PDT can be an encouraging palliative or definitive management for recurrent superficial NPC.

Ingested foreign bodies--a contemporary management approach

A prospective study of all foreign body complaints presenting through our Accident and Emergency Department was conducted in a population where the condition is endemic. All patients were managed by otolaryngologists. Six hundred and eight patients were attended to yielding 179 foreign bodies. Making use of modern equipment and a practical approach, the requirement for examination under general anesthesia was 6.3 per cent. In this series there was a complication rate of 0.5 per cent.

Alzheimer's disease: how to give and monitor tacrine therapy

Up to one-third of patients with mild to moderate Alzheimer's disease may show improvement in cognitive function with tacrine, a centrally-acting, noncompetitive inhibitor of acetylcholinesterase. Candidates for tacrine must have a diagnosis of probable Alzheimer's dementia based on NINCDS-ADRDA or DSM-IV criteria and should have no history of liver disease. For patients receiving the drug, do follow-up cognitive testing with a sensitive measure such as the Alzheimer's Disease Assessment Scale. The most common adverse effects associated with tacrine therapy are elevated liver transaminases and gastrointestinal effects. Weekly blood tests are necessary to monitor liver function. A reliable caregiver is essential to ensure compliance with frequent dosing and weekly blood testing.

A region of homozygous deletion on chromosome 9p21-22 in primary nasopharyngeal carcinoma

Using 21 microsatellite polymorphic markers spanning both p and q arms, we have performed detailed deletion mapping on chromosome 9 in 18 primary nasopharyngeal carcinomas. All 18 tumors were informative at multiple loci. Eleven of the 18 cases (61%) demonstrated allelic deletion of chromosome 9. Among these 11, 6 cases are likely to be tumors with monosomy of chromosome 9. The other 5 cases demonstrated partial deletion by showing multiple areas of allelic loss. In one of the 5 cases, a homozygous deletion region was identified which includes D9S126, D9S171, and IFNA loci at 9p21-22, situated between loci D9S161 (9p21) and D9S162 (9p21-22). The presence of a homozygous deletion strongly suggests the presence of tumor suppressor gene(s) involved in the tumorigenesis of nasopharyngeal carcinoma. The same region has been reported to include some potential tumor suppressor gene loci in other cancers. This is the first reported finding of frequent genetic loss observed on chromosome 9 in nasopharyngeal carcinomas in addition to allelic loss on chromosome 3p at specific regions. Our results suggest that tumorigenesis and progression of nasopharyngeal carcinomas, like other solid tumors, involves multiple genetic changes associated with the inactivation of tumor suppressor genes.

Speech intelligibility in tone language (Chinese) laryngectomy speakers

Tone language speakers use lexical tone or fundamental frequency to signal meaning. Therefore, native tone language alaryngeal speakers encountering difficulty imparting lexical tone variation would suffer loss of speech intelligibility. This study examines the intelligibility of lexical tone produced by four different alaryngeal speech methods, namely: oesophageal speech, electrolarynx, a pneumatic device and tracheo-oesophageal speech. Isolated and embedded monosyllabic Chinese words produced by 53 alaryngeal speakers were presented to three normally hearing, young adult listeners with no prior exposure to laryngectomy speech. The listeners transcribed the speech orthographically. Significant differences were found in the intelligibility level between the different speech methods. Listeners' responses were also pooled together and analysed for tone and segmental errors. Errors of tone alone were found to occur more often than segmental errors.

Teflon injection for unilateral vocal cord paralysis and its effect on lung function

We present a prospective analysis of the lung function of 22 patients with unilateral vocal cord paralysis before and after Teflon injection. In the majority of patients the vocal cord paralysis was caused by an underlying malignant condition. Full spirometric and flow-volume loop studies demonstrated an increase in airway resistance after Teflon injection which was not clinically evident. The improvement in symptom score for aspiration was greater than that for dysphonia.

The hazards of button batteries in the nose

Foreign bodies in the nose are commonly encountered in ORL practice. Miniature button battery impaction in the nose has rarely been reported. Seven such cases have been encountered, each suffering complications directly attributable to the button battery. The complications included septal burns in five patients leading to septal perforation in one child, one case of severe nasal bleeding and one case of necrosis of the lateral nasal wall. The site of maximal damage corresponded with the negative pole of the battery in every case. The possible explanation for this and mechanisms of cellular injury are proposed. This paper underlines the potential hazards of button batteries as foreign bodies in the nose and emphasizes the need for rapid removal and long-term follow-up of these patients.

Comparison of plain radiographs and computed tomographic scanning in nasopharyngeal carcinoma

Plain radiographs, computed tomographic (CT) scans and clinical records of 100 patients with nasopharyngeal carcinoma were studied. CT scans and plain radiographs provided similar information in 46 patients. There were 54 cases in which the two techniques disagreed. In 45 cases CT demonstrated abnormalities not seen in plain radiographs and in nine cases plain radiographs demonstrated abnormalities not seen with CT scanning. Based on the total information gained from clinical examination, the imaging investigations, biopsies, and subsequent clinical course and investigations it appeared that none of the abnormalities predicted by plain radiographs alone could be substantiated. Conversely the CT abnormalities could be supported as being correct. We conclude that CT alone is the undoubted investigation of choice where this is available. Plain films provide less information, are unreliable and, where CT is available, superfluous.

Myringitis bullosa haemorrhagica: clinical course influenced by tympanosclerosis

Observations based on two contrasting cases of myringitis bullosa haemorrhagica indicate that tympanosclerosis involving the tympanic membrane may have a significant effect on the clinical course of the disease. The evidence suggests that the bullae associated with the condition arise from the epidermal layer of the eardrum.

Diagnosis of nasopharyngeal carcinoma

The diagnosis of nasopharyngeal carcinoma rests on perceptive symptom analysis, a careful clinical examination, and the selection of appropriate clinical investigations. A high index of suspicion is required. When mirror examination fails to provide a satisfactory view of the nasopharynx, flexible or rigid nasopharyngeal endoscopy is mandatory. Serologic examination of IgA antibodies to Epstein-Barr virus early antigen and viral capsid antigen is helpful in identifying high-risk patients. Biopsy material should be sent fresh to the laboratory for analysis so that special staining can be carried out in cases of doubtful diagnosis.