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Patients with pollinosis sometimes complain of oral symptoms (itching and tingling with or without edema of the lips, mouth and tongue) after eating fresh fruits and vegetables. This condition has been termed Oral Allergy Syndrome (OAS). Twenty-three patients with Japanese cedar pollinosis and OAS for fresh fruits and vegetables were included in this study. Their mean age was 31.3 years (range = 5 to 62). The fruits that caused OAS in these patients included melon, apple, peach, and kiwi fruit. Most patients with OAS exhibited hypersensitivity to more than two foods. Specific IgE antibodies to inhaled allergens of mite, Japanese cedar pollen, birch pollen, melon, apple, peach, and kiwi were evaluated using the Pharmacia CAP system. Eleven of the 16 subjects with specific IgE antibodies for birch pollen, did not suffer symptoms during the birch and alder pollen season. In subjects with specific IgE antibodies for fruits, 13 out of 20 patients showed specific IgE antibodies for apple, and 8 out of 9 patients with OAS for apples were also positive for specific IgE antibodies for apples. On the other hand, 17 patients had no specific IgE antibodies for melon, and only two patients and one patient showed specific IgE antibodies for kiwi fruit and peach, respectively. These results suggest that the evaluation of specific IgE antibodies to birch pollen and apple may be useful for diagnosing OAS in patients with Japanese cedar pollinosis.

Pharyngeal or esophageal injuries secondary to endotracheal or nasogastric intubation are not uncommon. Since complication related to injuries of the pharynx and esophagus can be fatal, early diagnosis and adequate treatment are essential. We present a case of hypopharyngeal bleeding following a difficult endotracheal intubation and difficult nasogastric tube placement. Our patient was a 60-year-old man who complained of excessive pharyngeal bleeding. Angiography revealed extraluminal leakage from the left superior thyroid artery. The neck was explored surgically through the left anterior border of the sternocleidomastoid muscle. We ligated the vessel responsible for the bleeding, removed the ulcerated mucosa on the left pyriform sinus, and then closed the defect in the pharyngeal mucosa. The total blood loss was 7000ml from the initial bleeding to the end of the surgical procedure. The patient did not suffer from bleeding, mediastinitis and other complications after the operation. The patient then made an uneventful and prompt recovery.

Background Plasminogen activators (PAs) and their inhibitors are thought to play an important role in tumor invasion and metastasis. However, there have been few reports in which histologic localization of PAs has been demonstrated in head and neck tumors. Methods We examined the patterns of expression of urokinase-type plasminogen activator (u-PA), tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor 1 (PAI-1), and vitronectin in head and neck squamous cell carcinomas using immunohistochemical techniques. We also studied the correlation between the immunohistologic expression of these fibrinolytic proteins and the clinical staging of the tumor. Results Of 28 tumor specimens, 15 (54%) showed immunoreactivity for u-PA; 8 (36%), for t-PA; and 23 ( 82%), for PAI-1. There was a significant correlation between PAI-1 expression and the extent of the primary tumor. Conclusions The present study demonstrates the existence and possible pathophysiologic significance of u-PA and PAI-1 in squamous cell carcinomas of the head and neck. © 1997 John Wiley & Sons, Inc. Head Neck19: 611–616, 1997.