The author investigated subjective symptoms concerning auditory apparatus, and somatic, neurosensuous and spiritual function for 237 workers who work in a certain noisy factory. The chief findings are as follows. 1) The number of subjective symptoms was most frequent in the workers of the forging shop when duties were classified. 2) In the age group the percentage of subjective symptoms of spiritual and somatic function decreased with ageing, while the tendency of neurosensuous function were seen to inversely increase with the rise in age. 3) The workers complaining of the disturbance of sleep were seen in 17% of all workers, 38% of the forging shop and 34% of the rivetting shop. 4) Feeling of hard-hearing and tinnitus were the most frequent of all these symptoms. However, emotional feeling such as anxiety, irritable etc. and headache were considerably less in comparison. 5) Subjective symptoms concerning auditory apparatus were observable in the frequency order of hard of hearing, tinnitus and vertigo, with the percentage of 56%, 36% (16% of cases of continous tinnitus), 13%. 6) It was mostly 3-5 years after their engagement in work that the workers were first consious of feeling of hard-hearing, tinnitus or vertigo. 7) Feeling of hard-hearing, tinnitus and vertigo were found more frequently with the progress of the year of service, but it was observed that tinnitus was inversely diminished above 20 years of service. 8) So-called paracusis Willisiana was observed in 13 cases of all workers. 9) A majority of the cases of tinnitus was found in both ears. 10) Vertigo was mostly seen at standing and in their work. Welding shop showed more vertigo than others.
Foreknowledge of the morphological changes on the tympanic cavity and it's sorrounding tissues becomes very important particulars of the preoperative diagnosis on the tympanoplasty. Particularly, preoperative affirmation of many changes on the ossicles, such as the lack of the ossicles, positional and formal abnormalities, calcification, and destructions of the ossicular chain, have many significances on determination of the operative method and prognosis Therefore, many roentgenological studies have been performed by many peoples but those methods are still not available because the ossicles were not observed clearly from it's anatomical reasons. Author reported the result of re-examination the Chausse's method, G. Guillen's method and axial method by using the DAITO-HIRANO's roentgen photographing apparatus.
For the purpose of studying the reliability of GSR audiometry, the author conducted the tests on 14 young children with severe hearing loss. At first, the subjects had been examined with GSR audiometry and, when possible, with Barr's method of play audiometry. Then, after an interval of several years, these cases were tested again with the above methods. The results obtained by these double tests were compared. 1. In the group where GSR audiometry as well play audiometry could be tested in the first test, the threshold difference between GSR audiometry at the first test and play audiometry at the second fell within the range of±10db in 68% of the cases. 2. In the group where GSR audiometry could be applied and play audiometry could not in the first test, the threshold difference between two times' tests was found within ±10db in 30% of the cases. 3. The conclusions are that, in the cases where play audiometry can be carried out, it is also possible to obtain a fairly good result by GSR audiometry on the contrary, with those on whom play audiometry is not feasible, even if GSR audiometry turns out a succes, it will offer little reliable result to evaluate the real hearing acuity.
The startle reflex test was modified by the author, and used as clinical routine examinations of hearing in young children. The test results obtained were summarized as follows: 1. In normal cases, the threshold of hearing by the startle reflex test generally tended to approach 0db with advance in age, while 10 children (29%) out of 34 over 6 months old showed threshold of 30-40db despite of their normal hearing. 2. The test was just as readily applicable to young children with severe hearing loss as to normal ones, and it also revealed a fairly good consistency with other method. 3. It was observed that the initially noticed sound level by ascending startle reflex test proved to be its ultimate hearing threshold in 6 cass (18 %) among 34 normals and 29 (47%) out of 62 suspected of severe loss. 4. It seemed that the startle reflex test was suitable not for the cases with slight or moderate loss, but for rather severe hearing loss.
Epipharyngeal inflammation was found in all the cases of 32 patients who complained of headache of unknown cause or causes. Application of a ZnCl2 solution as a local treatment for epipharyngitis was made to different area of the epipharynx depending upon the localization of headache. As a result of such treatment, a relationship between both symptoms was explored; the improvement of inflammation as well as of pain or bleeding on touch in the epipharynx showed a correspondence with the course of relief in headache.
From a long term observation of many cases of allergic rhinitis, it was recognized that the allergic rhinitis was usually accompanied by manifest or latent epipharyngitis. The result of a local treatment for epipharyngitis in 19 such cases indicated a relationship between the nasal allergy and the epipharyngeal inflammation; the improvement of allergic conditions of rhinitis was found to parallel that of inflammation as well as of pain or bleeding on touch in the epipharynx.
Sixty-two years old male farmer was admitted to our clinic because of nasal obstruction, nasal discharge, nose-bleed and some swelling of the cheek on the right side for 4 months. Complete maxillectomy with radical neck dissection was performed under the diagnosis of the malignant tumor of the right maxilla. The specimen from the tumor revealed the necrotizing granulomatous lesions with angitis. Hematuria, albumiuria and azotemia occurred in the postoperative course. A specimen of the kidney biopsy showed granulomatous glomerulonephritic findings. Antibiotics and predonine were administered without effects. He died 6 months after the onset of the disease. Review of the literature in Japan and description on the clinical features of Wegener's Granulomatosis are presented. (author' abstract).
1) The clinical and histological findings on four cases of W. G. and its literatures are described in this paper. 2) W. G. is a general systemic disease of which characteristic trias are as follows; a) the nasal progressive necrotizing process, b) the general vascular diseases and the granulomatous processes in many visceral organs, and c) the glomerulonephritic process in the kidney. 3) The clinical symptoms of the affected organs are very variable, once appearing simultaneously as a general septicemic disease, but often appears independently one after another, being treated as a localised illness. 4) The histological findings of these cases are in general similar to those of the typical description of W. G., but it must be noted that there are some differences according to each affected organ and to each clinical stage. In two of our four cases marked acellulous fibrostic process was seen. 5) The fibrinoid change and the glomerulonephritic process, both of which many be considered characteristic for the collagen disease, were also observed in our cases. These findings indicate that among the many complex pathogenic factors of W. G., there may be some same or common factors as those of the collagen disease. 6) The clinical prognosis of W. G. is not good. As for the therapeutic procedure for this malignant disease, the cortico-steroid, Decadron, is the most effective, but since its effect is limited, it may not be considered as having an essential therapeutic effect.
The author had reported the method“Trausplantation of Padicled Pathological Mucous Membrave Taken from Maxillary Sinus Covering the Surface of Ethmoidectornized Wound”in 1960. In the report the author had described too that covcring of the mucous membrane was applied to the surface of the border between the ethmoidal sinus and the maxillary sinus and the margin of the antral window. By this grafting-method about 90 per-cent of the Cases of chronie sinusitis were cured. Grafted mucous membrans in these cases showed regular progresses: in first stage the epithelium showed metaplasie to the stratified squamous epithelium and the mucous glands were lost but in the second stage they regained their normal forms. Through these all stages the stroma showed a gradual fibrosis and loss of inflammatory cells. From these results the authar concluded that the drainage defects of the sinuses were the first causes of chronic sinusitis and others were the second causes. We can avoid the development of post-operative transformation and the drainage defects by the author's method. The problems of the common cold were descussed in relation to sinusitis.