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Publications (30)26.75 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Objectives and Methods: Twenty four severe obstructive sleep apnea syndrome (OSAS) patients, 35 sleep disordered breathing (SDB) patients with excessive daytime sleepiness, and 74 simple snorers underwent coblation-assisted uvulopalatopharyngoplasty (cobUPPP) under local anesthesia. Polysomnography (PSG) events, snoring, QOL (SF-36 v2) and excessive daytime sleepiness on the Epworth sleepiness scale (ESS) were assessed 3 months after the operation. The overall assessment criteria of the operative effectiveness on OSAS were proposed using subjective symptoms and PSG events. Informed consent was obtained in writing from all participants prior to cobUPPP. Results: AI (P<0.0001), AHI (P<0.0001), ODI (P<0.0001), minimum SpO2 (P=0.028), SpO2<90% (P=0.008) and the arousal index (P=0.001) were significantly ameliorated. Excessive daytime sleepiness was ameliorated in 34/35 cases and bothering snoring was improved, based on visual analog scale scoring, in 54/55 cases. Treatment of OSAS was assessed as highly effective in 11/24, 9/24 effective and 4/24 ineffective. Transient discomfort of the pharynx was an occasional complaint. Conclusion: cobUPPP was effective for severe OSAS without significant complications and could be very useful to manage excessive daytime sleepiness and socially unacceptable snoring.
    Practica Otologica 01/2014; 107(6):475-482. DOI:10.5631/jibirin.107.475
  • Ken-ichi Hisamatsu, Kiyoshi Makiyama, Ryoji Hirai
    01/2009; 48(4):349-354. DOI:10.7248/jjrhi.48.349
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    ABSTRACT: Our purpose was to investigate mucosal cell injury due to the nitric oxide (NO)-superoxide system in otitis media with effusion. We determined the levels of nitrotyrosine (NT) and NO and the activities of superoxide dismutase (SOD) and lactic dehydrogenase (LDH) in 90 middle ear fluid samples. The NT concentration was significantly higher in group A (<16 years old) than in group C (>50 years old; p < .05), and significantly higher in the acute group than in the chronic group (p < .05). The NO concentration did not show a significant difference among the groups. The activity of SOD showed significant correlations with the concentrations of NT and NO and with LDH activity (p < .05). The LDH activity was significantly greater in group A than in group C (p < .05). Our results indicate involvement of the NO-superoxide system in the pathogenesis of otitis media with effusion, showing evidence of protein and/or cell injury in the middle ear.
    The Annals of otology, rhinology, and laryngology 10/2005; 114(10):804-8. DOI:10.1177/000348940511401011 · 1.05 Impact Factor
  • Ken-ichi Hisamatsu, Mayumi Nakajima
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    ABSTRACT: To investigate the effect of pranlukast on leukotriene- induced airway mucosal epithelial dysfunction, samples of human nasal mucosa obtained during surgery for facial trauma were exposed to leukotriene C4 and/or D4 and observed on a TV screen magnified x 2,500. Leukotriene C4- and D4-induced ciliary inhibition and delayed mucosal surface alterations appeared several hours later. Pranlukast prevented both the mucosal epithelial cell dysfunction and the delayed epithelial cell alteration.
    Life Sciences 11/2000; 67(22):2767-73. DOI:10.1016/S0024-3205(00)00856-0 · 2.30 Impact Factor
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    ABSTRACT: Clinical features of acute epiglottitis were studied in 93 patients, 74 males and 19 females ranging from 19 to 78 years of age (mean age: 46.0 years), who had been admitted to our department over the last 10 years. The mean duration of illness was 2.3 days, and the mean period of hospitalization was 7.8 days. Then white blood cell count had increased to 16, 000/mm3 and their CRP to 9.8 mg/dl on average. A smoking habit was noted in 69 of the 93 patients (73.5%) . Thirteen patients (14.0%) had diabetes mellitus as an underlying disease. Forty-five patients (48.4%) had a prior history of therapy at other institutions. Airway control was required in 7 patients (7.5%) . It was suggested that acute epiglottitis develops rapidly, although it improves smoothly after appropriate therapy. It was also suggested that airway obstruction may occur in patients with associated diabetes mellitus or in those who visit a hospital within a couple of days after the onset of symptoms. Patients with acute epiglottitis often visit clinicians specializing in fields other than otolaryngology. Therefore, otolaryngologists should try to inform other clinicians about the clinical features of acute epiglottitis.
    Nihon Kikan Shokudoka Gakkai Kaiho 01/1998; 49(5):436-441. DOI:10.2468/jbes.49.436
  • 01/1997; 90(4):455-461. DOI:10.5631/jibirin.90.455
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    ABSTRACT: To clarify the effects of leukotriene C4 (LTC4) on human ciliated epithelium, ciliary activity of the ethmoid sinus mucosa was measured photoelectrically in tissue culture. At concentrations ranging from 10(-6)M to 10(-9)M, LTC4 showed minimal effects on the ciliated epithelium during the initial 30 minutes of exposure; thereafter, ciliary inhibition was observed in a concentration- and time-dependent manner. Irrigation of the mucosa with culture medium 15 minutes after exposure prevented the LTC4-induced ciliary inhibition. However, irrigation 60 minutes after exposure failed to inhibit 10(-8)M LTC4-induced ciliary dysfunction and mucosal damage. The LTC4-induced ciliary inhibition was blocked in the presence of FPL-55712 and/or Ly-171883, both leukotriene receptor antagonists. L-serine and sodium tetraborate complex (SBC), a gamma-glutamyl transpeptidase (gamma-GTP) inhibitor, also inhibited the LTC4-induced ciliary inhibition. These findings indicate that LTC4 is converted to LTD4 by gamma-GTP during 60 minutes of exposure, and LTC4 itself has minimal direct effects on the ciliated cells.
    Prostaglandins 02/1996; 51(1):69-79. DOI:10.1016/0090-6980(95)00156-5
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    ABSTRACT: The incidence of oral alpha-streptococcus with inhibitory activity against group A streptococcus, as a defense mechanism against bacterial infection in the oral cavity, was investigated in pediatric individuals with tonsillitis. Infection by group A streptococcus appeared to be common in children, because the detection rate of inhibitory alpha-streptococcus in healthy children as well as pediatric patients with tonsillitis was lower than in adults and elderly patients. In particular, the detection rate of these strains was predominantly low in patients with beta-streptococcus. Among pediatric patients scheduled for tonsillectomy, the detection rate of inhibitory alpha-streptococcus was low preoperatively. However, the rate was markedly increased after surgery. The high postoperative detection rate of these strains reflected the decreased incidence of group A streptococcal infection. The results of this investigation of bacterial interference between oral alpha-streptococcus and group A streptococcus suggested that surgical treatment is a more effective approach for improving the oral bacterial flora in children with recurrent tonsillitis.
    International Journal of Pediatric Otorhinolaryngology 12/1995; 33(3):249-55. DOI:10.1016/0165-5876(95)01220-6 · 1.32 Impact Factor
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    ABSTRACT: We investigated the distribution of oral alpha-streptococci with inhibitory activity against pathogens, which compose an oral defense mechanism. Detection rate of alpha-streptococci with inhibitory activity against S. pyogenes and S. aureus derived from the tonsil was higher than in other portions, the tongue, cheek, gingiva, or saliva. It has suggested that tonsillar bacterial flora are mainly a defense mechanism. The oral flora in healthy smokers was compared with healthy non-smokers to investigate the influence of tobacco on oral bacterial flora. The results showed that the detection rate of S. aureus in smokers was higher while that of alpha-streptococci with inhibitory activity against S. aureus was lower. However, the detection rate of alpha-streptococci with inhibitory activity against S. pyogenes in smokers was as high as in non-smokers. It is suggested that it was easy for S. aureus to adhere to the oral mucosa in smokers, and was considered to influence the strain which produces beta-lactamase for medical treatment. We investigated the influence of gargling on oral bacterial flora by comparing the amount of bacteria before and after gargling with popidine-iodine gargle and saline solution. It was shown that alpha-streptococci, a main component of normal oral flora were decreased after gargling in both smokers and non-smokers. Furthermore, it was shown that group A Streptococcus was not decreased after gargling, and it was concluded that use of gargle medicinal mouth wash in bacillus carriers should be studied further.
    Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 03/1995; 69(2):133-8. DOI:10.11150/kansenshogakuzasshi1970.69.133
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    ABSTRACT: Japanese cypress pollinosis has recently attracted attention and its clinical relationship with Japanese cedar pollinosis has been pointed out. To compare the two kinds of pollinosis, we retrospectively examined specific IgE antibodies to both pollen of Japanese cypress and cedar in the sera of 150 patients with nasal allergy using AlaSTAT assay. During the season in which the pollens of these two species are dispersed, the positive rates for Japanese cypress and cedar increased to 51.4 and 75.0%, respectively. The percentage of patients positive for both of cypress and cedar was elevated to 51.4%, corresponding to 68.5% of the total patient group positive for cedar. Almost all the cases positive for cypress had IgE antibodies to cedar, the value of which was considerably higher than that of cases positive only for cedar. Furthermore, increases in titers of specific IgE antibodies to cypress was observed in four of six cases, compared between specific IgE antibodies to cypress in pre- and post-dispersion of cypress pollen. These findings suggest the following possibility: (i) there is cross-antigenicity between the two pollen species, and (ii) patients are immunologically affected by cypress pollen to express higher levels of specific IgE antibodies after pollen dispersion.
    Auris Nasus Larynx 02/1995; 22(3):158-64. DOI:10.1016/S0385-8146(12)80053-8 · 1.00 Impact Factor
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    ABSTRACT: For a quantitative investigation of eosinophil activation in perennial allergic rhinitis, eosinophil cationic protein (ECP) concentrations were measured by a radioimmunoassay in serum, nasal secretions (ECPWN) and in the supernatant of these nasal secretions (ECPsup) obtained from normal subjects and allergic patients. Levels of ECPWN and ECPsup were higher than that of ECPserum. ECPsup showed a positive correlation with clinical severity, despite the lack of a significant correlation with eosinophilia in nasal smears. ECPWN and ECPserum showed no significant correlation with any of these clinical parameters. There was a weak tendency toward an increase in histamine sensitivity of the nasal mucosa of allergic patients with higher ECPsup although this was not statistically significant. These results suggest accumulation and activation of eosinophils in the allergic nasal mucosa, and also indicate that ECPsup may be a clinical parameter of perennial allergic rhinitis.
    Auris Nasus Larynx 02/1995; 22(3):165-71. DOI:10.1016/S0385-8146(12)80054-X · 1.00 Impact Factor
  • Equilibrium Research 01/1995; 54(5):444-449. DOI:10.3757/jser.54.444
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    ABSTRACT: We analyzed data collected from 134 patients (37 males and 97 females) with dizziness and/or vertigo who were confirmed to have orthostatic dysregulation (OD) based on a questionnaire survey between December 1990 and November 1994. The patients ranged in age from 10 to 80 years with a mean age of 42.5 years for males and 44.6 years for females. Patients with OD consulted our clinic more frequently in summer than in the other seasons.Orthostatic dizziness was the most common manifestation among the major symptoms of OD and was noted in 116 of 134 patients (86.6%). Fatigue was the most frequent complaint among the minor symptoms of OD and was noted in 97 of 134 patients (72.4%).OD was noted in 47 patients (35.1%) with dizziness or vertigo of unknown origin, in 22 (16.4%) of those with Meniere's disease, in 18 (13.4%) with dizziness or vertigo from central disorder, in 14 (10.4%) with hypotension, and 33 (24.6%) of those with other disorders.As for the positive rate on Schellong test, patients with OD and control subjects, showed 49.2% and 27.8%, respectively, and this difference was significant.These results suggest that autonomic imbalance suspected from the OD questionnaire and the Schellong test results probably affects the occurrence of vertigo and/or dizziness.
    Equilibrium Research 01/1995; 54(5):437-443. DOI:10.3757/jser.54.437
  • Tsutomu Nakazawa, Ken-ichi Hisamatsu, Takashi Uchida
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    ABSTRACT: The effect of leukotriene D4 (LTD4) on human paranasal sinus mucosa was investigated for over 1 hour up to 24 hours using a VTR system at 2,500 X in vitro. Ethmoidal sinus mucosal specimens were incubated in tissue culture, and after exposure to LTD4 the mucosal surface profile was viewed under an inverted phase-contrast microscope equipped with a VTR system on a TVscreen. LTD4-induced ultrastructural alterations, ciliostasis, alterations consisted of a coarse profile and epithelial cell exfoliation. Ciliary activity was photoelectorically measured on the screen hourly. The mucosal specimens were morphologically examined before and after exposure to LTD4 by transmission electron microscopy. LTD4 inhibited ciliary activity in a time- and dose-dependent manner at concentrations ranging from 10(-6)M to 10(-10)M, whereas LTE4 had a minimal effect on the mucosa even at the concentration of 10(-6) M. Irrigation of the mucosa with culture medium after 5-min of exposure to 10(-8) M LTD4 delayed appearance of ciliary inhibition and alteration of the mucosal surface profile, but had no effect after 15-min exposure. These effects of LTD4 on the mucosa were blocked by preincubation with the LT antagonists, FPL-55712 and Ly-171883. These results demonstrate the cytotoxic effect of LTD4 on human airway epithelium in vitro.
    Prostaglandins 06/1994; 47(5):379-92. DOI:10.1016/0090-6980(94)90055-8
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    ABSTRACT: The purpose of this report is to examine the effect of Macrolides (Erythromycin and Roxythromycin) on swarming ability and antistaphylococcal activity of Pseudomonas aeruginosa. The standard strain (ATCC27854) and clinically isolated P. aeruginosa were used as test strains. The influence of Macrolides on antistaphylococcal activity and swarming ability were determined by the agar plate dilution method. The antistaphylococcal activity of P. aeruginosa was not affected at the concentration of 1.56 micrograms/ml of both Erythromycin and Roxythromycin. But the antistaphylococcal activity was not observed at the concentration over 100 micrograms/ml. The swarming ability was not affected at the concentration up to 12.5 micrograms/ml. It has been proved that Macrolides reveal inhibition of virulent factors of P. aeruginosa such as protease, elastase, piocianin and so on. Furthermore our data revealed that Macrolides inhibited swarming ability of P. aeruginosa, and did not affect the antistaphylococcal activity of P. aeruginosa under 1.56 micrograms/ml concentration. Consequently, these results suggest that Macrolides have exhibited a previously unknown pharmacological effect, and may be of interest in that there may be bacterial interaction between MRSA and P. aeruginosa.
    Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 03/1994; 68(2):191-5. DOI:10.11150/kansenshogakuzasshi1970.68.191
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    ABSTRACT: In this open randomized study, we evaluated the efficacy of Tranilast, one of the anti-inflammatory drugs, on otitis media with effusion in children. Sixty-two patients (103 ears) were divided into two groups: Group A was given Tranilast and local treatment (nasal and tubal); Group B only received local treatment (control for Group A). The overall improvement rating assessed as "moderately improved or above" for Group A was 63.6%, Group B 47.9%. There was a significant improvement in Group A as compared to Group B (p < 0.05). In subjects who suffered from otitis media with effusion for over 2 months. Group A exhibited 50.0% of efficacy while Group B only 15.4% (p < 0.05).
    Auris Nasus Larynx 01/1994; 21(3):150-7. DOI:10.1016/S0385-8146(12)80137-4 · 1.00 Impact Factor
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    ABSTRACT: The conversion of lyso-platelet activating factor (lyso-PAF) to PAF in cultured paranasal sinus mucosa obtained from normal human subjects was studied. The PAF concentration in the medium was determined after addition of lyso-PAF. PAF became detectable at 10 minutes after the addition of 10(-8)M lyso-PAF, and reached a maximum concentration (3.25 x 10(-9)M) at 20 minutes. The PAF level then gradually declined to become undetectable at 60 minutes after addition of lyso-PAF. Thus PAF is very unstable having a half-life calculated to be 12.8 minutes with an elimination constant of k = 0.05377 minutes-1. In contrast, lyso-PAF is known to be a stable metabolite of PAF as well as a precursor of PAF. The results obtained from this study suggest that the turnover of lyso-PAF to PAF may play a role in evoking prolonged inflammation in target organs or tissues.
    Life Sciences 02/1993; 52(21):PL227-32. DOI:10.1016/0024-3205(93)90483-J · 2.30 Impact Factor
  • Equilibrium Research 01/1993; 52(4):577-583. DOI:10.3757/jser.52.577
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    ABSTRACT: The alpha-streptococci, consisted of normal oral flora mainly, with inhibitory activity against pathogenic microbes in healthy individuals was investigated by group A Streptococcus (indicator strain 6-22 nonmucoid T-12). Rate of alpha-streptococci with inhibitory activity against group A Streptococcus was increased as aging, and the rate in pre-school children was higher than that in school children. These results suggested that more than 90% of the tested alpha-streptococci with strong inhibitory activities (S. salivarius) against indicator strain had inhibitory activities against group A Streptococcus (mucoid T-6), H. influenzae, S. pneumoniae, group C Streptococcus, and from 40% to 70% of the tested strains had also inhibitory activities against other pathogens. As there were many strains of alpha-streptococci with inhibitory activities against pathogens, that usually detected in the upper respiratory infection, the problem on the strains in the future will explain significance of the defense mechanism against upper respiratory infection and this can be applied clinically.
    Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 01/1993; 66(12):1634-8. DOI:10.11150/kansenshogakuzasshi1970.66.1634