[in Japanese]

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The malignant epipharynx tumor is a relatively rare disease, which occurs oftener in Orientals, especially in Chinese. It is noticeably difficult for treatment and the prognosis is very bad. In this report the author made observations on 72 cases of malignant epipharynx tumor, which were brought into postmortem exa mination in Japan with the special reference to the state of their metastasis.
1. Visceral metastasis was seen in 37 cases (69.8%) among 53 of cancer. The site of metastasis were mainly in bone, liver and lung. While, visceral me tastasis was 8 (47.0%) among 17 of sarcoma, and chiefly in spleen and adrenal gland.
2. Lymphonode metastasis was 36 cases (67.9%) among 53 of cancer and 12 cases (70.6%) among 17 of sarcoma. The site of metastasis in both cases were mainly in cervical lymphnodes. But sarcoma showed the general tendency of having distant metastasis, such as in the hilus of the lung, retroperitoneal space, the intermesenteric lymphonodes and so forth.

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A study was made of the distribution of neutralizing antibodies against adeno virus type 3, in sera of patients with chronic tonsillitis in Kumamoto district during the period from October 1963 to August 1965. Neutralizing antibody titer was regard from 1: 4 to 1: 16 and antibody titer which showed higher than 1: 4 serum dilution (positive) found in 42.2% of 415 patients with chronic tonsillitis, and less frequently in a control group of 64 persons without chronic tonsillitis (26.5%). The antibodies were more frequently seen in patients with both adenoid and chronic tonsillitis (61.9%) than in patients only with adenoid (35.2%).
104 cases with chronic tonsillitis and positive antibodies received tonsillectomy, of them a decrease in the titer was observed in 30 cases (28.8%) one month after tonsillectomy. However, adenotomy produced a decrease in the titer in only 3 cases out of 16.
Neutralizing antibodies against Adenovirus type 3 were found in the tonsil extracts in 5 out of 21 cases which showed positive antibodies in sera. The anti bodies in sera were found more frequently in patients with focal chronic tonsillitis than in those with simple chronic tonsillitis. Of systhemic diseases, the antibo dies were found most frequently in patients with slight fever, but percentage of positive (1: 4<) antibodies was about the same in the other systhemic diseases.

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Tympanoplasty has been carried out for a long time, but techniques of the operation are still under discussion, e. g., kinds of grafting and procedures on mastoid cavity and ossicular chain to be chosen.
Many reporters say that the rate of success is poor in Wullstein's Type III and IV. Because, in these types the operated ear gets smaller tympanic cavity, and new eardrum is prone to adhere to the promontory. Therefore, many devices are presented about columella formations.
Here, tissue adhesives (Biobond) were used for rebuilding of the damaged ossicular chain. By the use of Biobond incudomalleolar-, incudostapedial joint or handle of the malleus were attached to head of the stapes. And good results were obtained in eight cases.
Points of excellence of this method were:
1) easy procedure, 2) rapid and firm adhesion, 3) no toxicity, 4) little tissue reaction, 5) no need to sterilize newly, and 6) feasibility of cleaning out hidden side of the affected ossicles.

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The statistical observations of congenital malformation of the external ear was recorded here. The prevent material consisted of 651 subjects having 773 malde veloped ears, which were found in 29000 outpatients examined at the Department of Otorhinolaryngology of Kyushu University Hospital from 1960 to 1965.
The frequency of each kind of maldeveloped ear was: fistula auris congenita 196 patients (251 ears), microtia 174 (192), atresia auris congenita 161 (184), accessory auricle 66 (78), pocket ear 30 (38) and the others 24 (30)(Table 2). The sex distribution of the subjects was: 410 males and 241 females. There was distinct male preponderance, especially in microtia and atresia auris congenita (Table 3). The sides affected were: 340 right-sided, 189 left-sided and 122 bilateral. Unilateral defect was preponderent mainly in microtia and atresia auris congenita (Table 3). The frequency of the patients who had malformed ear visit ing our Department for one year made no difference.
(1) fistula auris congenita: 113 male and 83 female cases; 91 right-side, 50 left-side and 55 bilaterally affected. Locations of fistula: crural, 166 patients; preauricular, 19; helicine, 9; and the others, 2 (Table 3, 7).
(2) microtia: the total number of patients observed was 174 (192 ears) ; males 122, and females 52. 105 right-side, 51 left-side, and 18 bilaterally affected. The preponderances in male and unilateral cases were distinct.
We divided our subjects into five groups. In determining the degree, the gradation of Marx was followed. Degree I cases, consisting of 5 ears, included subjects with auricles which are normal in all the characteristic features except in their extraordinarily small size. In Degree II, to which 46 subjects belonged, part of the characteristic features of an auricle was lost. Degree III included 132 subjects with distinctly malformed auricles. The cavum conchae did not exist and most of the cases were lacking the auditory canal. Degree IV consisted of 9 subjects. At this stage the auricle was very defective, showing only its trace, often a malformed lobule. Degree V was anot i a (Table 8).
(3) atresia auris congenita: the total number of patients was 161 (184 ears) ; male 116, female 45. 91 right-side, 47 left-side and 23 bilaterally affected. As in microtia, distinct male and unilateral preponderances were observed. Atresia mostly accompanied microtia. The patients were divided into three groups. Degree I: high grade stenosis. Degree II: the canal was almost lost, only a hol low. Degree III: complete atresia which was the commonest (Table 3, 10, 11).
(4) accessory auricle: the patients were composed of 34 males and 32 fema les. 27 right-side, 27 left-side and 12 bilaterally affected. It was very interest ing that an accessory auricle (over-development) and microtia (arrested develop ment) appeared in the same patient both and on the same side or each on the respective side (Table 3, 9).
Malformed ear was often accompanied with cleft palate, hare lip, facial hemiatrophia and facial paralysis (Table 5). There was no relationship discover ed between the month of birth and the congenital malformation of an external ear (Table 4, 6). In the course of reporting the statistical studies, hereditary factors and phenocopy were taken into account.

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The authors reported here a case of Teratoma occurring in the epipharynx of a new born infant who had a cleft palate. Twenty cases, including this case, of epipharynx teratoma have been reported in Japan, and the four cases of them were complicated by the cleft lip. In this case the tumor with a pedicle occurred on roof of the epipharynx and the posterior margin of the nasal septum. It filled the cleft of the plate and was swollen into the oral cavity. This elastic tumor was smooth and light yellowish brown on the surface, capsuled with the epithe lium containing hair, hair-roots, sebaceous glands and some cartilage. It was removed operatively with little bleeding under general anesthesia.

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Wegener's granulomatosis is a rare, fatal disorder. of obscure etiology. It is pathologically characterized by necrotizing granulomatous lesions of respiratory tract, generalized arteritis and focal glomerulonephritis. In the present communi cation two autopsy cases of Wegener's granulomatosis that we encountered recently are briefly described.
In the first case of a woman, aged 57, signs of generalized disease appeared just after the radical middle ear operation, which took a fulminating course of 56 days after the operation. Her autopsy revealed typical characteristic findings of Wegener's granulomatosis.
In the second case, a woman, aged 33, was treated vigorously with steroids in the early stage of the disease when she was suffering from the inflammation of the upper respiratory tract and had a prolonged course of 8 years. Histopatho logical findings in autopsy presented unusual pathologic changes modified probably by steroids and secondary infection, and generalized angitis was relatively mild. This case was regarded as an atypical form of Wegener's granulomatosis.
Similar disorders included in the categories of arteritis and granulomatous disease are mentioned and discussed.

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The authors reported a case of Silver-Protein allergy. The case was a 47 years old man who had complained of nasal discharge and nasal obstruction. Severe symptoms, such as tachypnea, palpitation, erubescene on the face and itch of the body were founded after nasal treatment. The provocation test of Silver-Protein solution showed positive reaction and similar symptoms.
The assertion made by Dr. Taro Takemi,“We are entering into a new age of advanced health and accordingly, safety education is a thing of vital necessity for safe-guarding our health before we have our health basically destroyed and actually contract a disease” should be a target of universal concurrence and res pect.
For the sake of such safety education and in order to prevent an onset of the so-called “Iatrogenic disease”, liable to be induced by medicines and also, for the purpose of guarding the patient from another sensation of disagreeableness when receiving medical treatment, the necessity of a record (provisionally named), containing the patient's past experiences on his reactions to the medicines, would be conceived.
The patient, who is over-sensitive to a medicine, should then be requered to submit the record to his physician when receiving a treatment from him.
The present writer is especially desirous that this procedure be adopted for actual practices in medicine.

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A man, aged 54 years, had a silent tumor of the palate during 37 years, that was recently found to be partially malignant. The patient was treated by trans oral maxillectomy and ⁶⁰Co-radiation therapy.
Since 1907, 98 in-patients who had the palate tumors were treated in our clinic and their half was carcinomas and 19 cases were mixed tumor patients. The clinicopathological examination and statistical analyses of the mixed tumors (or endotheliomas) were performed.

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Rinderon A solution, containing steroid and antibiotics, was applied to acute and chronic otitis media, 13 and 12 cases respectively. Rinderon A ointment was used for 7 cases with eczema of the external ear.
The result was satisfactory in 92.3 96 of 13 cases with acute otitis media, in 83.3 % of 12 cases with chronic otitis media and in all cases with eczema of the external ear. One case of acute otitis media became free from symptom in only four days and other eight cases within one week.

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