Aim-To investigate the presence of genetic instability in precancerous lesions of the stomach. Methods-Fifteen cases of sporadic gastric cancers with a background of intestinal metaplasia were studied by microsatellite assay at nine loci. Altered metaplastic mucosa was microdissected, reconstructed topographically, and examined immunohistochemically with an anti-p53 antibody, comparing its positive area with foci of microsatellite instability in each individual. Mutations in mismatch repair genes, such as hMSH2, hMLH1, hPMS 1, hPMS2, and GTBP, responsible for maintaining the fidelity of DNA replication increase spontaneous mutation rates greatly.91-2 Microsatellites are simple oligonucleotide repeat units, distributed randomly and widely throughout the genome. The appearances of additions or deletions within the microsatellites are known as replication errors or microsatellite instability, and are believed to reflect derangement of the mismatch repair system.'3 14 Such genomic instability at microsatellite loci has been observed not only in hereditary non-polyposis colorectal cancer (HNPCC) associated tumours but also in certain sporadic cancers.'5"'7 As for gastric cancer, microsatellite instability has been reported with frequencies ranging from 18% to 38%. 16 [18][19][20][21] However, little is known about genomic instability in precancerous lesions of the stomach.

The posterior nasal nerves emerge from the sphenopalatine foramen and contain sensory and autonomic nerve components. Posterior nasal neurectomy is an effective method to remove pathological neural networks surrounding the inferior turbinate that cause unregulated nasal hypersensitivity with excess secretion in patients with severe allergic rhinitis (AR). We describe the sophisticated endoscopic surgical procedure that allows feasible access to the confined area and selective resection of the nerve branches with the preservation of the sphenopalatine artery (SPA). We retrospectively analyzed the cases of 23 symptomatic severe AR patients who failed to respond to standard medical treatment and underwent surgery. There have been no major complications after surgery including nasal bleeding or transient numbness of the upper teeth. The mean total nasal symptom scores (TNSS) were decreased by 70.2% at 12 months after the procedure. Our comparison of the clinical effectiveness based on the number of severed nerve branches revealed that the improvement of the TNSS was significantly higher in patients with >2 branches. We conclude that this minimally invasive technique that preserves the SPA is clinically useful and decreases the rate of postoperative complications. This trial is registered with UMIN000029025.

Immunohistochemical study revealed the presence of TRPV1, 2, 3, and 4 in the laryngeal epithelial cells. Chemoradiotherapy may reduce the expression of TRPV1, 2, 3, and 4, which might be a result of the mucositis and neuropathy in laryngeal epithelium.

Immunostaining for klotho was observed in stria vascularis, outer and inner hair cells (OHCs and IHCs), and in vestibular sensory cells and dark cells, and less intensely in the spiral and vestibular ganglion cells. Expression of TRPV5 was found in stria vascularis, organ of Corti, vestibular sensory cells and dark cells, and less intensely in the spiral and vestibular ganglion cells. Expression of TRPV6 was found in supporting cells of the organ of Corti, with weak labelling in OHCs and IHCs. Weak fluorescence was also noted in stria vascularis, and faint fluorescence in the spiral ligament. Vestibular sensory and dark cells as well as vestibular ganglion cells showed weak fluorescence. In the old animals, the expression patterns of klotho, TRPV5 and TRPV6 were identical with those in young animals, although fluorescence intensity was significantly weaker.

Immunohistochemical study revealed the presence of TRPV1, 2, 3 and 4 in the laryngeal epithelial cells. TRPV1 and TRPV2 were often co-localized with substance P, while the co-localization of substance P and TRPV3 was rare and TRPV4 was not co-localized with substance P.