The paranasal sinusitis in children is much more spread than usually thought. The symptomatology of the pathological process is described in details. The main symptom is a heavy nasal breathing which usually causes a series of further complications such as lesion of the respiratory tract and disturbance of sleep, concentration, hearing, speech, developmental disturbance of thorax and superior maxilla as well as an alimentary disease. In case of chronical rhinosinusitis in children the therapy should be the endonasal operation of the maxillary sinuses. This operation is by no means obsolete and useless because the opening to the maxillary sinus will close again, as stated by some authors.
On the contrary, control examinations of 195 operated maxillary sinuses showed that the connection between nose and maxillary sinus was in 75. 4 % wide open, in 9.2 % narrow and in 15.4 % it had closed again. An essential point for the connection to remain open is a correct operation technique which is described above. The statistically supported success of the operation, as for example the removal of heavy nasal breathing, bronchitis, pharyngitis and predisposition to colds has encouraged us to even more intensify the operative procedure.

抄録全体を表示

Since the beginning of this century, it has well been known that there are some cases with blue- or dark blue-colored ear drum and another cases with black-colored mastoid, called “blue ear drum” or “idiopathic hemotympanum” and “black mastoid” or “mastoiditis nigra”. But even at present, it has remained still unsolved about their pathogenesis or etiology. In this paper, considering the present status and problems on the etiology of this disease bibliographically, the authors attempted to discuss the causative factors of them.
During past three years from 1965 to 1968, the authors treated 3 cases with blue ear drum and 2 cases with black mastoid. Three cases of blue ear drum were treated by simple mastoidectomy but all showed recurrency. In the black mastoid cases, it was observed that the main pathological change were limitted within the epitympanum, and the connection between the air spaces of mastoid cavity and mesotympanum were disrupted by them. These two cases healed completely after the removal of these pathological tissues.
In the literature, there have been many different hypothesis about the causative factor of blue ear drum, namely, anomaly of blood vessels, hematoma, hemangioma, inflammation, bloody inflammation, tubal obstruction and so on.The representative considerations are picked up as following three items;
1) inflammation (SIMPSON 1954 etc.
2) tubal obstruction (ARMSTRONGan d NASH 1962 etc.
3) inflammation and tubal obstruction (BODO 1963)
And the last one, compromissing of inflammation and tubal obstruction, seems most believable at present.
On the observations of the authors' cases and bibliographycal investigation, following conclusions were obtained:
1)“Blue ear drum” is defined as the condition in which the ear drum is colored dark blue or black blue, the cavity of the middle ear or mastoid are filled with black mucous fluid and the pathological tissues including black cholesterin granuloma.
2)“Black mastoid” is diagnosed for the condition in which the pathological changes appeared in “blue ear drum” are limitted just in the mastoid cavity (sometimes with extending to epitympanum), and it will be caused by dividing the whole middle ear spaces into two parts, meso-hypotympanum and mastoid, with epitympanal pathology.
3)“Cholesterin granuloma” has no etiological relationship with the discolorization of this disease.
4) For the occurrence of the “blue ear drum”, it was supposed that the tubal obstruction is necessary condition. However, once the condition of “blue ear drum” has completed, the air pressure in the cavity of middle ear will not be negative, and therefor, the passage of the tube does not influence to the condition of the middle ear cavity separated from the outside circumstance.
5) It is expecting to heal by simple mastoidectomy when the pathological changes are limitted in the mastoid cavity. But when the changes extend to the tympanic cavity, the radical operation of the whole middle ear would be necessary. In some cases, however, it is not able to decide whether this disease would recover by conservative treatment or not.
6) The etiological relatioship between “black mastoid” and middle ear cholesteatoma is not essential but it is supposed that the space separation at the epitympanum by cholesteatoma may cause the black mastoid.

抄録全体を表示

The authors experienced unexpectedly the case of congenital agammaglobulinemia (Bruton's type) in 12 years old boy, and performed tonsillectomy and biopsy from thymus for him. Then, the case was discussed from immunological and histological standpoint.
It was concluded that the development of tonsils was ansatisfactory and follicles was formed insufficiently. Secondary lymphofollicles and germinal center could not be found clear together: the majority of tonsillar cells was occupied by lymphocytes: no plasma cells, but only a complete lacking of immune globulin and tissue-liquid antibody could be found in tissue.
On the contrary, the size of thymus was normal but histologically was under grown for considering his age. Although cellular antibody was seen normally. In consequence, the authors consider tonsils are closely related to tissue-liquid immunity and thymus to cellular immunity: shortly, both tonsils and thymus are central lymphoid tissue themselves.

抄録全体を表示

Obwohl die meisten Fälle der Verletzung der Nasennebehöhlen beim Kopftrauma, bei Verkehrsunfällen oder bei Unfallen in Fäbriken vorkommen, kann sie auch beim Streit oder beim Sport beobachtet werden.
Der erste Fall, einer der von uns behandelten zwei Fälle, war ein 34jähriger Lehrer. Nachdem er beim Streit in der Trunkenheit ins Gesicht geschlagen worden war, hielt die Nasenblutung von der linken Nasenseite an.
Der zweite Fall, ein 17jähriger Schuler, stieß vor 22 Tagen sein Gesicht bei einem Basketball-Training an den Kopf des Gegners. Danach bekam er dauernde linksseitige Nasenblutung.
Durch rhinoskopische Untersuchung wurde festgestellt, daß das Blut bei beiden Fällen vom mittleren Nasengang herausfloß. In den Röntgenbildern der beiden Patienten sahen wir eine diffuse Verschleierung der Kieferhöhlengegend, die den Verfassern durch die Stauung des Blutes in der Kieferhöhle verursacht zu sein schien. Es gab aber kein Zeichen einer Fraktur der Gesichtsknochen in diesen Bildern.
Durch die Ruhigstellung der Patienten, die Maxillarspülung und durch Verabreichen von Antibiotika, der blutstillenden Mittel und der Antiphlogistika konnten die Verfasser diese zwei Patienten vollkommen ausheilen.

抄録全体を表示

From his experiences of reoperation of the nasal septum on 7 cases the author concludes as follows:
1. If there is a deviation caused by the cartilage on front side of the postoperative membranous portion, the reoperation can be performed just as the original operation.
2. If the deviation is situated behind the narrow membranous portion, the membranous portion can be separated with a scalpell or with a sharp raspatorium after incising the cartilage on front side of it.
3. If the deviation is situated behind the large membranous portion, the L -shaped incision should be made just behind the membranous portion without separating it.
The author is also of opinion that the deviation could come again into existence even if the operation is perfectly performed in younger age of the patient.

抄録全体を表示

A case of reoperation, in which iliacbone transplantation in the postoperative mastoid cavity was done 3 years before, was reported. The reasons of reoperation were in the right ear a obliteration of the external auditory canal by a cyst which grew up from the posterior wall, supprative secretion and temporal he adeche, in the left ear a blue transparency of the posterior wall of the external auditory canal. The reoperations in both ears revealed alarge cyst in the mastoid, antrum and epitympanum with chocolate like fluid.
Histological examinations showed atypical cholesteringranuloma and atrophic degenerated iliacbone. On the basis of the findings the priciple of the treatment for postoperative mastoid cavity was discussed. In this operation an inevitable handicape is that complete removal of the mucous membrane from the mastoid cells is not necessarily possible in all cases and there is allways a possibility of formation a cyst when a passage from the mastoid cavity to the tympanum through the aditus is closed by the transplanted iliacbone or cholesteringranuloma which grow up from fat in the marrow under the influence of inflammation.
For the ideal healing of large postoperative mastoid cavity it should be open to the tympanum through the aditus without a direct openning to the external auditory canal.

抄録全体を表示

Man triff t haufig auf Fälle von Mundhöhlengeschwuren, deren Behandlung sehr schwierig ist. Auch ihre Genese ist manchmal schwierig festzustellen. Wir Verfasser haben neulich zwei solche Fälle erfahren, die hauptsächlich mittels Steroidhormons behandelt wurden.
Beim ersten Fall, einer 57jährigen Hausfrau, hat das Hormon zu bemerkenswerten Erfolgen geführt. Die Patientin ist aber leider während der ambulatorischen Behandlung an Pemphigus vulgaris gestorben, der sich als ätiologisches Leiden der Geschwüire vermuten läßt.
Beim zweiten Fall, einem 28jährigen Mann, konnten wir Verfasser ebenfalls mittels dieses Hormons die Geschwüre zum vollkommenen Zurücktreten bringen. Hörte aber das Verabreichen des Hormons auf, so brach das Rezidiv sofort aus. Schließlich gelang es uns, nach Abheilen der Geschwilre durch das Hormon mittels eines nichtsteroiden antiphlogistischen Mittels und der Vitamine C, B₁₂ sowie des Antiplasmins das Rezidiv der Geschwüre zu kontrollieren.

抄録全体を表示

An analysis of 97 cases with vertigo was done about the nature of the nystagmus and vertigo, especially according to positional or positioning nystagmus, several cases were showed and discussed in detail.
Vertigo of peripheral vestibular disturbance was frequently a sense of whirling of the environment or the subject, spontaneous, paroxysmal and recurrent, accompanied with symptoms of autonomic nervous disturbance.
Direction of the nystagmus was most observed horizontal, in the next place mixed with combination of horizontal and rotatory movement. The nystagmus occured when changing patient's head revealed latent deviation of vestibular system.
Positional nystagmus had two main types, one is direction-fixed suggested peripheral and central lesions with laterality, and the other direction-changing, not only organic but functional disorders of central nervous system.
Vertical component of positioning nystagmus, occured when changing suddenly position of patient's head or body, meaned central lesions.

抄録全体を表示

The author found out many school children suffered from motion sickness at the school physical examination. Motion sickness is caused by many factors, but the author says that of school children is mainly due to phychological factor.
So, thirty-nine school children who had been suffering from motion sickness were given Schultz's autogenic training before going on a school excurtion. The result is as follows.
effective 29
effective relatively 6
not effective 4
39
This method is a psychological therapy that patients are trained for concentration of soul and released from nervous tention. It resembles “Zen” in Japan.

抄録全体を表示

The Vasodilator, Isoxsuprine ? HCl (Duvadilan) was given to patients with endorgan vertigo, especially with Meniere's disease and or perceptive deafness. 61 patients were treated with 60 mg Duvadilan/day in 3 divided doses mostly for 2 or 3 month. It was quite effective in treatment of vertigo (13 out of 19 patients), but not in the perceptive deafness except in 4 cases

抄録全体を表示

An intramuscular or intravenous injection of CDP-choline (Nicholin) of 100 or 200mg daily was given to the patients with tinnitus, deafness, dizziness, etc. from the dosis of 800mg to 7200 mg.
Of the 20 patients who were examined most cases more or less responded favorably with suppression of symptoms in treatment.
In short, this drug exhibited excellent relief with the medication for tinnitus and mild relief with deafness, dizziness and facial nerve palsy.

抄録全体を表示