One hundred and thirty cases of head and neck malignant tumors treated in the Center for for Adult Diseases, Osaka, and one hundred and forty cases in a previous study of one of the present authors made in Kumamoto were comparatively studied with reference to the history of tobacco smoking (Brinkman-index) and drinking (Sake inddx). In Kumamoto, "Shochu" was a popular drink and the incidence of cancers of the pharynx and oral cavity was markedly high. A high correlation was found between smoking and laryngeal cancer and, especially for the supraglottic type, drinking appeared to have an additional influence. It was suggested that cancers of the mesopharynx, piriform sinus and oral cavity, especially the oral floor, could be triggered by heavy drinking associated with smoking.
In clinical experiences with 12 cases, the pectoralis major myocutaneous flap used as a "pedicled island flap" was found to be reliable and versatile in major reconstructive surgeries of the head and neck. A long neurovascular pedicle, containing large vessels, provides a means to transfer a large bulk of tissue to various defects in the head and neck region.
An animal model of IgE antibody-dependent nasal allergy was achieved by sensitizing guinea pigs with guinea pig anti-BPO-BGG antiserum. The tissues of the nasal mucosa were removed from one group of sentitized guinea pigs immediately after challenging with the antigen. They were also removed from the other group of animals one hour after the same allergic challenge. Histological changes observed in the first group included hyperplasia of the secretory epithelial cells, edema of the lamina propria and stasis of the blood serum. In the second group, there was evidence of recovery with regard to the three conditions observed in the first group. However, there was a marked increase in the number of eosinophils and a slight increase in the number of mast cells.
The cilia of the human nasal mucosa in chronic hypertrophic rhinitis, chronic hyperplastic rhinitis and so-called nasal catarrh were shown a tendency to decrease in number with the aid of transmission electron microscopy. In proportion to decreasing of the cilia, microvilli were frequently found on the mucosa. It was evident from the results that there were relations between decrease in number and destroy of the cilia and new development of the microvilli. Many linear or granular glycocalyxes have been observed on the surfaces of the microvilli. Well-developed microvilli may take the place of decreased cilia morphologically, however, it was not suggested that the microvilli substituted for ciliary function.
The changes of AP, SP and CM were investigated in accordance with the grade of endolymphatic hydrops which was produced by endolymphatic sac obliteration in the guinea pigs. Also, AP, SP and CM were measured in animals in which the endolymphatic sac was suctioned. The results obtained were as follows: 1. In animals with a minimum endolymphatic hydrops, a super-normal AP and CM responses were obtained in a few eases. 2. With the increase of endolymphatic hydrops, CMs were reduced, where as APs at intensive stimulation were relatively well preserved. 3. With the increase of endolymphatic hydrops, the potentials of positive SP were reduced, and a few cases showed the potential change to be a negative SP. 4. With the increase of endolymphatic hydrops, the AP latency was increased. 5. In endolymphatic sac suction, AP and CM responses at intensive stimulation were well preserved. A slight endolymphatic hydrops was observed. The potential of positive SP was reduced, and a few cases showed the change to cause a negative SP. 6. In this series of experiments, the degeneration of the organ of Corti was hardly seen under the light microscope. It is suggested that polarity of positive SP observed in control was influenced to deflect towards negative SP by the increase of endolymphatic hydrops and the change of the biochemical component of the inner ear fluids.
A 57-year-old woman was first seen in the ENT clinic of Osaka University Hospital with a complaint of recent enlargement of a painless mass at the right parotid region of 35 years' duration. A smooth surfaced, elastic mass of about 5×6cm was palpated at the right subauricular area extending to the submandibular region. The mass was not adhered to the skin. There was no other otolaryngologic, hematologic or urinary abnormality defected, and no cervical lymph node was palpable, and the facial nerve function was normal. Sialography showed a suspicion of obstruction of the duct due to malignancy. CT scanning revealed a partially irregular, round mass at the right parotid region. Subtotal parotidectomy under general anesthesia was performed, and the well-capsulated tumor mostly located in the superficial lobe of the parotid gland and partially advanced to the deep lobe to surround the facial nerve was removed. Light-and electron-microscopic examination revealed malignant oncocytoma characterized by the marked enlargement of eosinophilic cytoplasma.
Urinary polyamines (putrescine, spermidine and spermine), β-aminoisobutyric acid and β-alanine levels in 91 patients with head and neck cancer were determined by using a fully automatic amino acid analyzer (JLC-6AS). Urinary polyamine levels, particularly those of putrescine and spermidine, were useful in diagnosis of head and neck cancer. Sixty-three point seven percent of the patients showed high urinary levels of putrescine and/or spermidine. In laryngeal cancer patients, neither the stage of the disease nor the degree of differentiation of cancer cells correlated with the elevation of urinary polyamines. Increase of spermine was more specific for women suspected of having cancer. Ten out of 11 women patients showed high excretion of urinary spermine. Determination of urinary polyamine levels in patients with early stage laryngeal cancer revealed that patients with high urinary putrescine levels were resistant to radiotherapy, while patients with low levels were sensitive to radiotherapy. Using elevated urinary polyamines, β-aminoisobutyric acid and β-alanine, the diagnostic ratio in patients with head and neck cancer was 86%. It seems very likely that the combined use of these markers is useful in the diagnosis of cancer patients and in the follow-up study of them.