1. 開院来6年半の間に19例の鼻腔•副鼻腔乳頭腫を経験した.
2. 19例中3例に癌との合併を認めた.
3. 癌の合併率は高齢者のinverted papilloma (内方発育型)で鼻腔•副鼻腔進展例に高い.
4. 治療は上顎部分切除にはる腫瘍の徹底的清掃,長期の経過観察が必要と考えられる.
5. 2例の再発を認めたが,いずれも前頭洞であったため鼻外前頭洞手術を行い現在は再発はみとめていない.

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(1) 骨破壊を合併しない成人200症例のコールドウェル法普通撮影法および,同様に143症例のポリトーム前頭断(鼻根部より3cm後方)を用いて,篩骨上顎板の診断上の問題点を解明した.
(2) コールドウェル法における篩骨上顎板の読影可能率は,左右ともに読影可能であったものは68%,右側のみ読影可能であったものは8.5%,左側のみ読影可能であったものは10.5%,両側とも読影不能であったものは13%である.
(3) ポリトーム前頭断における篩骨上顎板の読影可能率は,左右とも読影再能であったものは77.6%,右側のみ読影可能であったものは8.4%,左側のみ読影可能であったものは5.6%,両側とも読影不能であったものは8.4%である.
(4) 篩骨上顎板の所見につき顔面外傷,上顎嚢胞,上顎癌につき症例を供覧した.
(5) 篩骨上顎板は上顎洞経由で篩骨蜂巣に侵入する部位であり,また,上顎悪性腫瘍の好発部位の一つでもある.すなわち,外科解剖学的にも悪性腫瘍の診断上でも,X経診断上で重要なる目標の一つである.

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Otitis media was induced in guinea pigs and chinchillas by intrabullar injection of 1% carrageenins. The animals were sacrificed for histological examinations at 1 to 14 days respectively. In chinchillas tympanogram was performed by means of impedance audiometry. The gross appearance of bulla was most hyperemic, and thickened mucosa reaction were observed on the 3rd or 4th day. Effusion was also most abundant on the 3rd or 4th day, and tvmpanogram showed the lowest compliance and gradient in chinchillas. Each specimen was examined under light and electron microscopes. At 24 hours, the subepithelial layer was edematous, and epithelial cells contained electron dense granules. On the 3rd day, epithelial and subepithelial layers were most remarkably edematous, and macrophages, neutrophils and mast cells were seen in the mucosa. The macrophages contained many electron dense granules and dispersed lyso somes. Some of them were present adjacent to the capillaries, which permeability appeared to be enhanced. The mast cells granules showed less electron density and some of them fused with each other. In the 7th and 14th day specimens, the edema had disappeared and infiltrated cells were not numerous. According to the morphological findings, columnar metaplasia and goblet cells in this study were less frequent than in clinical otitis media with effusion. We suspect that the mucociliary clearance system of the Eustachian tube almost maintains it normal condition. At least carragerenins induced otitis media did not effect tubal mucociliary transport.

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A hybrid cell line (A2L/AH) was derived by cell fusion technique with an EBV-positive lymphoblastoid cell (A2L) and an EBV-negative epithelial cell (2-27-Ad) using inactivated Sendai virus. A2L and 2-27-Ad were obtained from the human nasopharynx. EBV-associated nuclear antigen (EBNA) was demonstrated in more than 98% of A2L/AH cells. Induction of early antigen (EA) and viral capsid antigen (VCA) was investigated using 5-iododeoxyuridine (IUdR), 12-o-tetradecanoylphorbol-13-acetate (TPA) and sodium n-butyrate (SnB). The tumorigenicity of the hybrid cell in nude mice was also investigated.
EA was induced in 28%, 3.4% and 40.8% of the A2L/AH when treated with IUdR, TPA and SnB, respectively. VCA was demonstrated in 12% of the A2L/AH cells when treated with IUdR, in 2.7% with TPA, and in 33.6% with SnB.
When A2L/AH cell was inoculated subcutaneously in eight-week-old female nude mice, a tumor was developed in eight of thirteen cases. When the mice were exposed to 400 rad ⁶⁰Coirradiation before the inoculation of the cell, tumor developed in 8 of 8 mice. Histologically, the tumor was non-keratinizing carcinoma and the cells were all EBNA-positive.

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As a part of the study of host defense mechanisms of the nose, an experiment on bacterial inhalation was performed using rats with and without artificial nasal obstructions. The animals were exposed under nebulized bacterial aerosols in a chamber.
1. Counts of viable bacteria in the lungs of the obstructed-nose group remained higher than those of the normal-nose group for two-weeks after the exposure. This evidence confirms the defense function of the nose as a filter against micro organisms.
2. Antibody titer in the serum elevated even after one week of the exposure. However, no difference in the elcvation of titer was found between the two group. The cells which produce specific antibodies appeared in cultured spleen cells four weeks after the exposure. However, no difference both in the latency period for the appearance of the cells, and in the ratio of specific antibody producing cells to the total number were found between the two groups.
3. After re-infection with the bacterial extract inhalation, the antibody in nasal washing appeared only in the normal-nose group, although, in serum, antibody titers remained similar in both groups.
These results suggest that oral breathing with nasal obstruction exerts a great influence on local antibody responses of the nose, but not on systemic antibody responses.

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成人唾液腺筋上皮細胞のフィラメントの存在様式を明らかにするためアクチンフィラメントと特異的に結合するHMMで処理し電顕的に観察した.また収縮性フィラメントやCa²⁺ポンプに関与するとされるCa²⁺-ATPase活性の局所在についても検討した.
1. 筋上皮細胞のマイクロフィラメントはHMMと結合し矢じり構造を示すことによってアクチンフィラメントと同定された.さらに矢じりの方向によりマイクロフィラメントに極性が認められた.
2. HMMと結合しない10nm前後の太さのフィラメントは中間大フィラメントであり,筋上皮細胞のみならず腺房細胞にも存在していた.
3. Ca²⁺-ATPase活性は光顕的に筋上皮細飽に局在しており電顕的には筋上皮細胞形質膜とミトコンドリア基質に反応産物がみられCa²⁺ポンプに関与すると考えられ,またフィラメント上にみられた反応産物はミオシン型ATPaseを示していると推測された.

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The tonsil is an organ closely related to the bacteria, and plays an important role in an immunological defence activity against a variety of bacterial antigens. As concerns the factors of the immunological reaction, however, there were a few reports of the localization of antigen comparing with the large number of reports of the localization of T cell, B cell and complement. For the purpose of the review of the local immunological reaction in the tonsillar tissue on the side of antigen, the localization of bacterial antigen of the Streptococcus pyogenes (group A) and Haemophilus influenzae in the tonsils surgically removed was investigated using the immunoperoxidase technique. Furthermore, results of the examination of culture were compared the findings with histological investigation on the aspect of ability of detecting the bacteria.
The results obtained in this study were summarized as follows:
1. The particle substances considered as the Streptococcus pyogenes (group A) and Haemophilus influenzae were mainly distributed in the cryptical lumen, intraepithelial area and subepithelial area.
2. The cells containing the bacterial antigen of the Streptococcus pyogenes (group A) and Haemophilus influenzae were mainly distributed in the intraepithelial area, subepithelial area and interfollicular area, and scattered in the germinal center and mantle zone. The bacterial antigen in the germinal center were particularly distributed in the form of net or granule.
3. On the ratios of detecting the Streptococcus pyogenes (group A) and Haemophilus influenzae, the examination of culture and histological investigation were reviewed each other. The ratio of coincidence of the Streptococcus pyogenes (group A) was 75%, while that of Haemophilus influenzae was 74% respectively. When the bacteria were not found in the examination of culture, they were sometimes observed by histological investigation. The ratio of the Streptococcus pyogenes (group A) with the histological investigation showed higher than that of detecting the bacteria with the examination of culture.
The present study leads to the following conclusion.
The tonsil is continuously stimulated by the bacteria even during non-inflammatory period of chronic tonsillitis. It is considered that the bacteria invade into the intraepithelial area and subepithelial area from the cryptical lumen through the micropore, subsequently the bacteria are phagocytized by the macrophage there and transfered into the vessel.
It is suspected that the bacterial antigen is trapped in the germinal center mainly on the route of recirculation, and takes part in the long-term antigen retaining and the stimulation of antibody production. Although the examination of culture is simple and useful method as a daily clinical examination, there is a limit on the ability of detecting the bacteria. It is important, however, that we should always refer to clinical treatment on the localization of the bacteria proved in this study.

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