The effect of hyposensitization therapy of apple pollinosis was evaluated in 10 patients, whose nasal symptoms were not curable by conservative therapies.
To complete the hyposensitization, 0.01x dilution of apple pollen antigen was injected and then increased gradually to 0.1-0.3ml of 0.01x extract. Injections were continued for more than 3 years.
1) Frequency of sneezing was decreased in 7 patients, and nasal secretion was reduced in 7, while nasal obstruction was alleviated in 4.
2) Alleviation of all symptoms was noted in 7 patients.
3) No side effects were observed.
Hyposensitization therapy was considered to be effective for apple pollinosis.

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Laryngeal tuberculosis was diagnosed histopathologically in a 54-year-old female and a 51-year-old male who were thought to have laryngeal carcinoma.
The lesions in most recent cases of laryngeal tuberculosis resemble those of carcinoma because of tumor formation with nodular appearances in the laryngeal mucosa.
The key to the diagnosis of laryngeal tuberculosis is a high index of suspicion plus active attempts to secure bacteriologic and tissue diagnosis. A negative chest X-ray does not rule out the diagnosis. All lesions of a granulomatous or infiltrative nature are suspect. Tissue obtained in such cases should be examined bacteriologically, as well as histologically. Sometimes, acid fast bacilli are revealed by the Ziel-Neelsen method in histological sections of laryngeal biopsy material.
The treatment consists of antituberculous agents, streptomycin, isoniazid and PAS, which usually lead to obvious improvements in the histopathology.

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A 15-month-old girl was admitted to Niigata University Hospital with a suspicion of foreign body in a bronchus. Ventilation-bronchoscopy under general anesthesia was performed, and the “foreign body” was removed. Unexpectedly, it was a branched bronchial cast of a mucoid plug in the left bronchus. In infants the differential diagnosis between foreign body and mucoid plug is difficult without bronchoscopy. Bronchoscopy is necessary in cases of infantile mucoid plug.

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We treated 51 year-old male patient with six carcinomas: right margin of the tongue, left piriform sinus, left vocal cord, right side of the oral floor, left margin of the tongue and E-C junction of the esophagus. Histological examination revealed squamous cell carcinoma in all specimens. He had severe diabetes mellitus and gastric ulcer. Combination therapy with irradiation, antitumor agents and cryosurgery was given. He died of bleeding from his gastric ulcer during the course of treatment.
Sixty cases, 44 males and 16 females, of synchronous multiple primary cancers of the head and neck have been reported in the Japanese literature. Of 60 multiple primary Carcinomata, laryngeal cancers were most frequent (18 cases), and antral cancers were next (14 cases).
Cancers of both maxillary sinuses were most frequently seen, and double cancers of the larynx and lung, thyroid, hypopharynx and stomach were next most frequent. Sextuple primary carcinomata as described here has not previously been reported in the Japanese literature.

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An immunologically normal 61-year-old man had bilateral resection of neck tumors and also a pharyngeal tumor during the past 4 years. A diagnosis of toxoplasmosis was made on the basis of the histological appearance of the resected tissue and a sudden rise of serum anti-toxoplasma titer. He was treated successfully with pyrimethamine and sulfadiazine. Toxoplasmosis should be considered in the differential diagnosis of neck and pharyngeal tumors. Recent reports have described disseminated toxoplasmosis in immunologically compromised hosts (mainly CNS toxoplasmosis) which appears to result from defects in cellular immunity that permit recrudescence of latent infection.
Therfore, CNS toxoplasmosis should be considered in the differential diagnosis of an evolving CNS syndrome in immunologically compromised hosts.

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Naturally occurring fibrosarcoma of the thyroid gland is very rare. Only 5 cases of this tumor have been reported in Japan. Recently, we diagnosed a thyroid fibro sarcoma in a 46-year-old woman. It started as a papillary cystadenoma 26 years ago, followed by the appearance of papillary adenocarcinoma 6 years later.
At that time most of the tumor was removed, except for a small portion which had invaded the trachea, and 5, 000 rads of ⁶⁰Co was given postoperatively to her neck. The tumor was quiescent for 18 years and then fibrosarcoma appeared in the same region. We think that this tumor may be a radiation-induced sarcoma.

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A 67-year-old housewife complained of a painless cervical tumor of ten years duration which had grown rapidly during the past two months. On physical examination, there was a well demarcated, movable, elastic hard tumor in the right middle cervical region. Although it was suspected to be metastatic, no primary lesion or abnormality was found in the head or neck. The tumor was easily removed under local anesthesia, although it adhered to the internal jugular vein. The excised specimen was 43×22×21mm in size and 16.6g in weight with an irregular surface. Histological examination showed large atypical cells with abundant eosinophilic granular cytoplasm, which partly formed an acinar structure. Transmission electric microscopy (TEM) revealed a large number of mitochondria of various shapes and sizes in the tumor cell. These pathological findings are those of malignant oncocytoma. The patient died of brain metastasis two years later.

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Reserpine (2mg/kg and 10mg/kg, i. p.), an adrenergic blocker, was administered to normal guinea pigs, and samples of serum, CSF, scala tympani perilymph, scala vestibuli perilymph and cochlear endolymph were collected. The concentrations of Na and K in these fluids were then assessed to observe electrolyte distributions. Both Na and K concentrations were reduced in serum. In CSF, the Na concentration was markedly depressed, while the K concentration remained unchanged. Scala tympani perilymph showed similar electrolyte changes as those in CSF. In scala vestibuli perilymph, the Na concentration was unaltered, but the K concentration was lowered. Cochlear endolymph exhibited no change of the Na concentration but there was a marked decrease in the K concentration. This is thought to be attributable to the indirect blockage of energy producing systems in membrane transport of inner ear by the reserpine-induced depletion of catecholamines.

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The endocochlear potential (EP) of the cochlea was recorded in 20 adult guinea pigs using the microelectrode technique. The falling pattern of EP after one-shot intravenous injection of furosemide (20, 30, 40, 50mg/kg) was analyzed on the basis of the following equation (model A) using the least-square method with a micro-computer.
y=L(1-e^-r(t-a))
where L: maximum EP fall
r: reaction rate
t: time
a: beginning of EP fall
All cases of EP fall were well fitted to the model equation. The values of reaction rate r fell in a limited range regardless of large EP falls. The falling rate of EP caused by furosemide had constant values in each case though FUR blocks EP pump.
Then we proposed a second model (model B) which has channelization of the EP pump corresponding FUR receptor and examined the fitness of the acquired EP curves and model using the least square method.
The results showed good match between the data and the model. From model B, channelized EP pump was blocked by furosemide on the All or None mode.

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The peptidergic innervation of the guinea pig's respiratory tract was examined immunohistochemically. We investigated 3 kinds of peptides in this study-SP, VIP, L-Enk. SP was detected extensively throughout the respiratory tract-nose, larynx, trachea and it's peripheral. But the other 2 kinds of peptides stained poorly or not at all.
In the nasal mucosa, fine varicose SP fibers were clearly seen in the subepithelial region, and some of them passed through the epithelial layer. Also we were able to find them around the blood vessels and the acini of nasal glands, but SP fibers were scarce around the ducts. Between the nasal glands, there were fine varicose SP nerve bundles, which innervated the nasal glands, blood vessels and epithelial region.
In the laryngeal mucosa, the distribution pattern of SP fibers was the same as in the nose, and some SP fibers were detected in the epithelial region. In the branches of the vagus nerve which run in the laryngeal region, we were able to see many SP fibers and occasionally even SP nerve cell bodies. Around the laryngeal glands and arteries, SP fibers stained well, but there seemed to be very few in the veins.
In the tracheal region, we were able to observe many fibers in the smooth muscle, subepithelial region, glands and tracheal blood vessels. These fibers mentioned above were most numerous in the lower region of the main trachea near the carina and then lessening the number of them in the bronchi and bronchioles. SP immunoreactive nerve cell bodies were found in the tracheobroncheal region, mostly near the carina. Some SP fibers may have originated from these cell bodies along the trachea, bronchi and bronchioles.
Such SP fibers in the respiratory tract were distributed in the same way as the cholinergic nerve fibers, suggesting that SP nerves in the respiratory tract may regulate the vasodilatation, the secreation of the glands and the contraction of the smooth muscle in coordination with cholinergic nerves.

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The relationship between the auditory brainstem response (ABR) and the intracranial pressure (ICP) was studied in 35 comatose patients. The interwave latency between wave I to V of the ABR was not affected by the acute ICP changes. The amplitude ratio of waves V to I was also not influenced by the ICP changes. However, the ABR morphology in the patients who continuously showed high ICP (30mmHg or more) gradually deteriorated as time passed, even though it had been normal in the early stages; and some waves, wave I, for example, disappeared and finally no response was produced. The outcome of the patients who had high ICP (30mmHg or more) or who exhibited wave disappearance in ABR, whether partial or total disappearance, was very poor or death.
Thus, we concluded that the ABR could not be influenced by acute changes of the ICP, but it could be affected by the continuation of high ICP which caused circulatory disturbance and/or herniation of the brain and induced brainstem damage secondarily.

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The development of fungiform papillae (FP) of the rabbit tongue was studied by scanning electron microscopy (SEM). Animals used ranged in age from the 3rd gestational week to maturity. The spatial distribution of FP was also studied in adult rabbits by the method of Fisch, et al..
1) In the 3rd gestational week, small eminences, which were covered by cells with short microvilli, were formed on the dorsum of the tongue.
2) In the 4th gestational week, FP were found on the dorsum of the tongue.
3) FP with outer taste pores (OTP) first appeared during the 4th gestational week. In 5-day old rabbits, a few OTP were found on each FP surface.
4) The maximum diameter of the FP of the adult rabbit was larger than that of the newborn.
5) The FP of young rabbits was morphologically mature 14 to 21 days after birth.
6) Each OTP was seen in the center of a shallow foveola. It was thought that these shallow foveolas were formed from epithelial desquamation around the OTP.
7) The number of OTP on a single FP gradually increased after birth. Adult rabbits, however, had fewer OTP than 8-week-old rabbits.
8) Degeneration or regeneration was occasionally noticed in the FP of 3-week-old animals.
9) Until 2 weeks after birth, the number of FP was around 130. After 3 weeks it decreased to about 110.
10) The average number of FP in adult rabbits was 107.2±12.35 S. D. (n=5, 95% confidence limit). Approximately 66% of all the FP were located within 5mm of the tip of the tongue.

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Hangebyakujutsutenmato, Ryokeijutsukanto and Chotosan are prescriptions of crude Kanpo drugs which have been used for the therapy of vertigo and dizziness. The authors administered Tsumura-Hangebyakujutsutenmato to 23 patients with vertigo or dizziness, Tsumura-Ryokeijutsukanto to 20 and Tsumura-Chotosan to 22 for 8 weeks and analyzed the patients' signs and symptoms. The overall improvement rate was 55.4% in 4 weeks and 69.2% in 8 weeks. The highest improvement rate (65.2% in 4 weeks and 82.6% in 8 weeks) occurred in the patients treated with Tsumura-Hangebyakujutsutenmato. Side effects were reported by 2 patients, diarrhea in one and nausea in the other.
This study indicates that Kanpo therapy is effective in the treatment of vertigo and dizziness, and it can be administered together with contemporary western therapy.

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N-5' was given orally to 21 patients with perennial type nasal allergy for 4 weeks continuously.
Subjective and objective improvement was noted in 85.7%, moderate or better in 47.6%.
The good effects of this drug appeared within 1 week in 33.2%, and within 2 weeks in 72.2% or earlier than with most drugs.
Sneezing, nasal discharge and nasal obstruction (the major symptoms of nasal allergy) were significantly reduced in 80.0%, 76.2% and 73.3% of the patients, respectively.
Gastric discomfort was noted in 1 case, but this was not severe enough to require discontinuation of the medication.
The evaluation of N-5' by the attending physicians, including relative effetiveness and absence of side effects, showed 85.7% usefulness, which is higher than the rating for most drugs. Therefore, we consider that N-5' is a new antiallergic drug which can be recommended for the treatment of perennial type nasal allergy.

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In 20 patients undergoing tonsillectomy for chronic tonsillitis, Avitene was applied to one tonsil.
A quantitative comparison of bleeding between the treated and untreated sides showed a significant (p<0.05) reduction on the treated side. This trial indicates that Avitene is safe and effective in reducing bleeding during tonsillectomy.

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