Hiroyoshi Yoshinami

Saitama Medical University, Saitama, Saitama, Japan

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Publications (11)22.95 Total impact

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    ABSTRACT: Background Upper respiratory illness can adversely impact the lower airway. This study aimed to evaluate the relationship between clinical background and improvement in the lower airway after surgery for treatment of chronic rhinosinusitis. Methods A total of 22 patients with chronic rhinosinusitis surgically treated between January 2010 and February 2011 were included in the study. The presence or absence of asthma and peripheral blood eosinophils count were examined for all patients in addition to preoperative radioallergosorbent tests. Spirometry was conducted and fractional exhaled nitric oxide (NO) was measured at the preoperative, 1-month postoperative, and 3-month postoperative visits. Results The average level of NO in the exhaled air at the preoperative, 1-month postoperative, and 3-month postoperative visits was 51.5 ppb, 42.5 ppb, and 38.0 ppb, respectively. Although the average results of spirometry didn't show any improvement, forced expiratory volume in 1 second percentage improved in 2 of 4 cases with obstructive ventilatory disturbance. There were 10 improved cases, which were defined as those showing more than 1.2-fold difference in the ratio of preoperative NO level to the 3-month postoperative one. The remaining 12 cases, including 4 of 6 cases with asthma, 5 of 7cases with eosinophilia, and 4 of 4 cases with animal dander allergy were unimproved cases. Conclusions Chronic rhinosinusitis can cause latent lower respiratory disease. Endoscopic sinus surgery can improve the status of the lower airway. However, the effectiveness of surgery is significantly less in cases of animal dander allergy.
    Preview · Article · Feb 2012 · World Allergy Organization Journal
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    Masanobu Shinogami · Ryoji Kagoya · Wakako Nakanishi · Hiroyoshi Yoshinami
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    ABSTRACT: Background Seasonal allergic rhinitis could predispose to the development of chronic bronchial inflammation. However, association between seasonal allergic rhinitis and airway function, especially exhaled nitric oxide [FENO], are not fully understood. Objectives The aim of this study was to evaluate the relationship among FENO and airway function and nasal symptoms in patients with seasonal allergic rhinitis without asthma. Methods We included 37 subjects [9 males and 28 females] in this study. Total serum IgE were investigated and specific IgE for 4 pollen allergens and 5 perennial antigens were determined by RAST. Sensitization to a specific allergen was defined as over RAST score 2. We compared 4 groups. Group A: 7 nonatopic subjects [no nasal symptoms and RIST, RAST negative, 1 males and 6 females, mean age: 33.2 24–52 years]. Group B: 10 atopic subjects with a sensitization to Japanese ceder without medication [6 males and 4 females, mean age: 44 20–58 years]. Group C: 10 atopic subjects with a sensitization to Japanese ceder who took oral anti-histamine medicine during pollen season [2 males and 8 females, mean age: 34.9 24–52 years]. Group D: 10 atopic subjects with a sensitization to Japanese ceder who receive intranasal corticosteroid treatment during pollen season [2 males and 8 females, mean age: 40.2 26–56 years]. Score of nasal symptoms, FENO, spirometry, total eosinophils, nasal eosinophils, were investigated before, during, and after pollen season. Results Regardless of having treatment or not, in comparison with the subjects without the allergy, FENO showed a statistically significant increase in all patients with a sensitization to Japanese after pollen season. In group D, v 50/v 25 was the tendency to adversely affect after the pollen season, and correlation between FeNO rate of the change and v 50/v25 rate of the change admitted. As for the other indexes, a statistically change were not showed in the comparison of each group. Conclusions These results suggest that FENO is a primarily marker of bronchial inflammation in patients with seasonal allergic rhinitis during pollen season and intranasal corticosteroid treatment may be effective for improvements in lower airway outcome.
    Preview · Article · Feb 2012 · World Allergy Organization Journal
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    ABSTRACT: Background It is said that the chronic rhinosinusitis influences the lower respiratory airway and there is a report that a tendency to increase the eosinophilic rhinosinusitis later, but they are still unknown. Methods We divided the chronic rhinosinusitis patients with the adaptation of the operation into 4 groups and exaed whether there was a difference in the respiratory function, exhaled NO, and the number of the blood eosinophil. Object 29 patients with chronic rhinosinusitis who planned the endonasal sinus surgery. Results Comparing these 4 groups, it was the worst on the respiratory function (one second rate) in the group with nasal polyps and without nasal allergy. It was recognized the connection between the respiratory function and the presence of the nasal polyps. It was possible that the exhaled NO became the index to the lower airway inflammation. Conclusions We classified the chronic rhinosinusitis and evaluated the lower airway function. It helps the pathologic understanding of the chronic rhinosinusitis. And it leads to understand of the influence on the lower airway inflammation.
    Preview · Article · Feb 2012 · World Allergy Organization Journal
  • R. Kagoya · M. Shinogami · H. Mouri · S. Suzuki · W. Nakanishi · H. Yoshinami

    No preview · Article · Feb 2012 · Journal of Allergy and Clinical Immunology
  • H. Yoshinami

    No preview · Article · Feb 2012 · Journal of Allergy and Clinical Immunology
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    ABSTRACT: We report three cases of hyper-IgG4 disease with synchronous or asynchronous lymphocytic infiltration onset, IgG4 positive plasma cell infiltration, and fibril formation in multiple exocrine glands and extranodal organs. IgG4-related sialadenitis attracting recent attention has yet to be clarified as a clinical entity. Case 1, a 61-year-old man, had a submandibular gland sample showing IgG4-positive plasma cell infiltration. Case 2, a 61-year-old man, was diagnosed with IgG4-related Mikulicz's disease confirmed by a sublingual gland sample. Case 3, a 57-year-old woman, had a diagnosis of IgG4-related Mikulicz's disease confirmed based on labial and sublingual gland samples. All reported oral dryness and bilateral submandibular swelling. Cases 1 and 2 recovered following Predonine administration tapered from 30 or 20 mg. IgG4-related Mikulicz's disease must be recognized as a clinical entity, together with its diagnostic criteria and treatment. Sublingual gland biopsy should be done to confirm its diagnosis following sublingual gland swelling.
    No preview · Article · Oct 2010 · Nippon Jibiinkoka Gakkai Kaiho
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    ABSTRACT: Deep neck infection (DNI) remains an emergent and life-threatening otolaryngologic disease. We examined 69 patients, 52 men and 17 women, with DNI, who were treated in our hospital between January 1995 and December 2004. The mean age of the patients with DNI was 50.0 years and the peak incidence was in the sixth decade. Twenty patients suffered from diabetes mellitus (DM). The primary DNI lesion was found in the tonsils in 34 cases, the oral cavity in 16 cases, and the pharynx in 12 cases, respectivelys. Among the 69 patients with DNI, the infection remained in the suprahyoid region in 31 cases, but it extended to the infrahyoid region in 33 cases and to the mediastinum in 5 cases. The titer of C-reacting protein (CRP) and the duration of admission were considered as parameters of the severity of DNI. CRP was significantly higher in elderly patients, in patients with DM, and in patients whose infection extended to the infrahyoid region and to the mediastinum, however, significant difference was not found between men and women, or among the types of primary DNI lesions. Moreover, the duration of admission was significantly longer in elderly patients, in patients with DM, and in patients with infrahyoid and mediastinal DNI, whereas no significant differences were found between men and women or among the types of primary lesions. Therefore, age, DM, and the extension of DNI are considered to be important factors which determining the severity of DNI.
    No preview · Article · Aug 2006 · Nippon Jibiinkoka Gakkai Kaiho
  • Hiroyoshi Yoshinami · Hideki Takegoshi · Shigeru Kikuchi · Toshitaka Iinuma
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    ABSTRACT: The external nasal dilator Breathe Right is a nonprescription disposable mechanical device worn over the bridge of the nose that supports the outer walls of the nasal vestibule to increase cross-sectional nasal valve area and enhance air flow through the nose. When worn, the device applies a gentle outward pull to the outside walls of the nasal vestibule that helps prevent collapse of the lateral walls of the nasal vestibule. The device appears similar to an adhesive bandage with two polyester springs attached lengthwise to the nonadhesive side of the backing material. The form of the external nose varies significantly between racial groups and some comment is possible about the form of the nasal valve, i.e., Caucasian noses are leptorrhine, Negroid noses platyrrhine, and Oriental noses intermediate. A question exists about whether Breathe Right is as effective in Japanese as in Caucasians against nasal obstruction. We measured the effect by acoustic rhinometry in 35 healthy subjects. We measured 2 cross-sectional areas-the I-notch and C-notch-and 3 nasal volumes-V(0-1), from 0 to 1 cm corresponding to the I-notch, V(1-3), from 1 to 3cm corresponding to the C notch, and V (3-6), from 3 to 6cm. We studied the influence of the nasal cycle on the effect of Breathe Right in the nasal cavity. We evaluated subjects in a stable sitting position before applying Breathe Right, after using 5 minutes, and in a free interval of 25 minutes following. The experiment was repeated 10 times. We found that Breathe Right increases the nasal volume especially in V(1-3) and the cross-sectional area especially in the C-notch. Interestingly, the change in the C-notch decreased gradually with time. One possible mechanism may be the change in compliance between the skin under the Breathe Right and the nasal mucous membrane. The nasal cycle did not significantly influence the effect of Breathe Right.
    No preview · Article · Dec 2005 · Nippon Jibiinkoka Gakkai Kaiho
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    ABSTRACT: The nasal valve area has long been under investigation and has been measured with various methods with varying modifications. This diversity in methodology points to two aspects, namely, the definition itself is vague and the morphological configuration is rather complicated for refined evaluations. We investigated and evaluated the area using coronal CT scans on 133 subjects.
    No preview · Article · Oct 2003 · International Congress Series
  • Yasuhiro Kase · Hiroyoshi Yoshinami · Yasuo Toriyama · Hiroto Nakada · Yoshiki Okasaka
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    ABSTRACT: The different modalities of malignant tumor invasion were presented and discussed. When determining the extent of malignant tumor invasion, it is useful to assess surrounding tissues such as bone marrow, fat tissues, and nerves.In addition, qualitative diagnoses can be made based on such information as the location of bony destruction as well as the preservation of maxillary sinus mucosa. We reviewed diseases having characteristic magnetic resonance imaging (MRI) findings.These findings are useful for distinguishing between malignant and benign lesions that occur in the nasal and paranasal sinuses.
    No preview · Article · Oct 2003 · International Congress Series
  • Hiroyoshi Yoshinami · Yasuhiro Kase · Toshitaka Iinuma
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    ABSTRACT: The nasal valve was studied using coronal scans by computed tomography (CT). Coronal images were 5 mm thick obtained from 133 subjects 93 men and 40 women averaging 46 years of age. The valvular area was studied in 2 slices containing nasal valve, anterior and posterior slices 5 mm apart. After defining standard points for evaluation, breadth, height and area were evaluated using NIH Image Version 1.59 from left and right as an unit. Results were follows: 1. The breadth of the nasal valvular area is larger in men than in women, and the height greater. The angle of valvular area is similar in both. 2. A comparison of anterior and posterior slices showed the smallest breadth of valvular area in the anterior slice to be smaller than in the posterior slice. The breadth of the vestivular area below the valvular area is larger in the anterior than posterior slice. The angle in the anterior slice is larger than that in the posterior slice. The area of valvular area in the anterior slice is smaller than that in the posterior slice.
    No preview · Article · Feb 2001 · Nippon Jibiinkoka Gakkai Kaiho