The latency and amplitude of the acoustically evoked slow vertex response (SVR) were examined in 10 normal adults and 22 infants. The recordings of the evoked responses and judgements were carried out by the Juntendo method. The results were as follows: (1) The distribution of the latencies of SVR: Adults: The latencies of SVR were 50-100 msec in 21% of the whole examined cases, and 62% in 100-200 msec. Infants: The latencies of SVR were 50-100 msec in 15% of the whole examined cases, 27% in 100-200 msec, and 44% in 200-500 msec. The variation of latencies of the SVR were greater in infants than in adults. Especially, SVR of infants showed longer latencies than 500 msec in 14%. (2) SVR showed shorter latencies in accordance with the increase of the sound intensity both in adults and infants. When the sound intensity was high, the latencies showed no remarkable difference between adults and infants. However, at or around the response threshold, in other words, at low intensity levels, the latencies of SVR in infants were approximately twice as long as those in adults. (3) The frequencies of the examined sound had little influence upon the latencies of SVR. (4) SVR in adults were quite stable, however, test-retest examination revealed that the latencies of SVR in infants differed greatly case by case, especially at low intensity levels. (5) Comparing the distribution of the peak latencies of SVR with those of false positive response, "responses" with longer latencies than 1 second should be neglected because of the high possibility of false positive responses.
A great progress has been made recently in the diagnosis of the retrocochlear deafness by the supraliminal hearing test and the binaural audiometric test. We diagnosed the retrocochlear deafness by the special hearing tests performed at the Kanto Rosai Hospital. In this paper, the data for the function of the central auditory pathway in patients with cerebral apoplexy and in normal hearing persons are to be analysed by means of the discriminant function by age-groups. Of 302 sublects, 229 cases are apoplectic patients, 73 cases with normal hearing. The results of the special hearing tests were subjected to the discriminant analysis. The results were as follows: 1) The coefficient and discriminant point to classify the data for each item of the special hearing tests and the rate of misclassification were clarified. 2) The probability of misclassification decreased in inverse proportion to the number of the test items. 3) The probability of misclassification in the middle-aged group (30 to 40 years of age) was the lowest of all age-groups. 4) The patients suspicious of the disorder of the central auditory pathway could be diagnosed and classified correctly from the data of each item of the special hearing tests, analysed by means of the discriminant function. Currently even the experts find it difficult to diagnose the disorder of the central auditory pathway, and to determine the affected site of the brain from the mere results of the special hearing tests. However, the integral judgment of the data of the special hearing tests with the introduction of the discriminant function would certainly make it easy and accurate for either experts or non-experts to recognize the disorder of the central auditory pathway.
Various speech methods have been devised and applied to examine speech disturbances. However, there have been no methods to determine quantitatively the degrees of the various speech disturbances, and to decide whether they have recovered or not on the basis of the values obtained from tests. Any methods have hardly been proposed to express quantitatively conversational abilities and to evaluate objectively social adaptabilities of speech disorders. The author proposed a new quantitative method for judging the degrees of speech disturbances. The principle of this method is an auditory comparison of the speech of the patients with speech disturbances and the artificially distorted speech. Eighteen kinds (No.1…No.18) of distorted words were used in this test, which resemble speech disturbances. Standard test word sounds were classified into 6 degrees based on the auditory impression and the discrimination in pronunciation. Degree I was the normal speech (No. 1, speech articulation score 98-100%). Degree II was slightest disturbances in pronunciation (No. 2, 3 and 9). Degree III was slight disturbance (No. 7 and 8 articulation score 50-75%). Degree IV was the moderate uttering disturbances (No. 4, 10, 13, 15 and 16, articulation score 30-50%). Degree V was severe uttering disturbances (No. 5, 11, 14 and 17, articulation score 10-30%). Degree VI was the loss of speech communication (No. 6, 12 and 18, articulation score, not higher than 10%). The test was applied to 30 patients with convulsive paralytic dysarthria. The degrees of disturbances in these patients almost coincided with their speech abilities in conversation. There was no difference of scores obtained by skillful and unskilled testers. Therefore, the conversation of patients with speech disturbances could be easily classified into the grades of conversational abilities by this test. It is possible to judge easily the degrees of conversational abilities with this test when this is applied to speech disturbances in the physiological process.
Bacterial counts in otorrhea from 20 patients with chronic otitis media were studied. Samples of aural discharge were collected using a platinum loop with an inner diameter of 2 mm, each loopful of liquid measuring 0.01 ml. And antimicrobial susceptibility test was performed on 36 strains of six bacterial species isolated from otorrhea in patients with chronic otitis media. The inoculum size were 106 and 108 cells per ml. The results were as follows: 1) The bacterial counts of otorrhea ranged from 107 to 109 per ml for Staph. aureus, Corynebacterium, Pseudomonas aeruginosa, Proteus mirabilis and Proteus inconstans. 2) The Staph. epidermidis count showed a biphasic distribution with ranges from 105 to 106 cells per ml and from 103 cells per ml downward. 3) Staph. aureus and Staph. epidermidis strains proved resistant to penicillin G as well as to aminobenzylpenicillin when assayed using suspension of 108 cells per ml and susceptible to those drugs as assessed using suspensions of 106 cells per ml. 4) With one of the five strains of Proteus inconstans tested, the reactivity to aminobenzylpenicillin and to cefazolin was noted to vary from susceptible to resistant with the concentration of bacterial cells in the MIC assay suspension. 5) The results of the present study indicate that it is advisable to use an assay suspension of a bacterial isolate from chronic otitis media at concentration of 108 cells/ml rather than 106 cells/ml in the antimicrobial susceptibility test so that discrepancy often encountered between the results of the laboratory test and the clinical response to antimicrobial chemotherapy may be minimized.
There are several papers reporting a transient proteinuria in some of patients who underwent tonsillectomy. In order to clarify the mechanism of the postoperative transient proteinuria we have investigated the quantitative and qualitative changes of urinary proteins befor and after operation. The protein contents of urine were measured by the microfilter method after Kihara et al., and the quality of the urine proteins was determined by electrophoresis and immunoelectrophoresis. The results are as follows. 1) On the first postoperative day the urinary proteins increased compared with the preoperative ones, but they decreased already in the second postoperative day. 2) These postoperative increases of the urinary proteins were transient and reversible, rising to the maximum at one hour postoperatively. 3) According to the qualitative examination the increasing proteins in the postoperative urine were albumin, transferrin and other proteins of the high molecular weight which are supposed to be the so-called glomerular proteinuria. On the other hand the tubular proteinuria with the low molecular weight was not found. 4) The transient postoperative changes of the renal function were not observed during 2 hours ofter operation. 5) In the cases of renal diseases the proteins after the tonsillar provocation test increased to the maximum within the first hour and decreased to the pre-test level in the following 2 hours. 6) We postulated that the transient proteinuria after tonsillectony or the provocation test is understood to appeare as a part of the so-called irritation syndrome.
Fine structure of the epithelia of the postoperative maxillary cysts has been studied under scanning and transmission electron microscope. Of 23 cases examined, 22 cases had the intact epithelial layer of different types. The ciliated cells were present in 19 cases, but there were large variations in number. Based on the surface structures, we classified the epithelia into the following types. Type I: densely ciliated surface with regular pattern of metachronal wave. (This type is very close to the normal pseudostratified ciliated epithelium.) Type II: epithelial surface with non-cilliated area of various extents. Type IIa: no morphological changes in ciliary structures. Type IIb: marked decrease in number of the cilliated cells with ultrastructural changes in the cillia. Type III: complete absence of the ciliated cells in the surface. Type IV: absence of regular surface structures occupied by various types of elliptical cells. Metaplasia towards the squamous epithelium was observed in 3 cases. The goblet cells were increased in many cases. The fine structure of the mucosa of this disease was compared with those of the frontal mucocele and the chronic sinusitis. There were no obvious morphological differences among them. Theories have been stated on the pathogenesis of this disease, discussed. The sinus obstruction theory seems most probable, although there are some cases not to be explained by this theory.
Observations on the intra-subject variability of articulatory motor function and its bioinformative analysis were performed in order to clarify the sensory motor feedback self-controlled function in hearing and speech behavior at the neuro-muscular level. Mean action potential amplitude (MAPA) calculated through the computer from each EMG recording of the orbicularis oris were displayed together with raw EMG and speech signals by an X-Y recorder. Measurements of the timing of the articulatory motor function were conducted on the intervals from the onset of EMG activity to its peak, to its end, and to voicing, and from the end of EMG to voicing. Mean values of each measurement were almost the same as that shown in previous papers which studied on a monosyllable including bilabial explosive consonant (/Pa/). Inter-subject standard deviations of each measurement were large, indicating wide individual variation in speech behavior. However, intra-subject standard deviations were small and variation in the measurement of 60 times showed normal distribution, which seemed to well indicate a self controlled function, except for the interval from the onset of EMG to voicing. The author claimed that the self controlled physiological function in hearing and speech behavior was verified at the neuro-muscular level, and further suggested that the measurement of intra-subject variability in speech behavior would give us useful information on the pathology, diagnosis and prognosis of speech disorders.
This paper describes the diagnosis and therapy for 89 patients of psychosomatic vertigo, who did not have any organic disorder of vestibular and non-vestibular systems. The interview on the principles of Morita was employed with effective results as a supporting therapy. In conclusion, it is necessary in clinical medicine that patients with vertiginous complaints on the borderline disease are investigated as a group of psychosomatic vertigo and the development of the psychosomatic self is helpful for the doctor-patient relationship.