1. Three cases of dysarthria syllabaris spasmodica are presented. Each case had difficulty only in articulating syllables beginning with the consonant k in the Japanese alphabet. Two of these cases, both boys aged 7 years, were quickly cured of their speech disorder. The remaining case, a 16-years-old boy, was cured after 5 weeks of treatment. 2. On the evidence of sonagrams taken during the course of treatment in a 16-years-old boy and observation of the position of the tongue, there appeared to be a site most suitable for articulation of the consonant k for distinct enunciation of the k-syllables.
The patient, a 3 years 10 months old boy who was first seen on Feb. 8, 1968, caught a cold about 1 week prior to his visit to our hospital and complained of discharge from the left ear and fever, for Which treatment had been given by a nearby otorhinologist without improvement. He had been vomiting frequently since February 3 and was in a markedly debilitated condition when brought to our hospital. Soon after birth the patient had bilateral acute suppurative otitis media and since then otorrhea has frequently occurred. At admission watery discharge from the left ear was evident and, as the results of various tests, the pattern of fever and local findings were highly suspicious of intracranial complication, operation was immediately performed. At operation a bone defect was found in the roof of the antrum, exposing a granulomatous surface of dura mater in which a perforation was seen. Aprobe inserted through this perforated site revealed the presence of a subdural abscess. After draining the abscess and irrigating the cavity with antibiotic solution, the wound packed with gauze and left open. The postoperative course has been smooth and at present, 8 months after the operation no serious sequelae are observed. The child looks much better than before the operation and shows normal development.
A recent trend in the field of otorhinolaryngology is the greater use of enzyme preparations. Among such preparations, lysozyme is reported as differing from other proteolytic enzymes in that it splits up mucopolysarccharides and acts directly on the tunica propria of mucous membrane, aiding in the healing process of the tissue. It is still questionable, however, whether ingested lysozyme reaches the sinus mucosa in chronic inflammation of the sinuses. An attempt was made to solve this problem by giving lysozyme labelled with the fluorescent dye, FITC, by mouth and observing the distribution of the flucorescent lysozyme in the mucous membrane of the sinus. Fluorescence of the sinus mucosa was exhibited in 13 sides in 13 cases of the 33 sides in 22 cases studied. Three patterns in the distribution of fluorescence were distinguishable: a) along the edge of the mucosa; b) scattered throughout the entire mucosa; c) a part of epithelium; d) in clustered patches. Apparently, therefore, ingested lysozyme does reach the mucous membrane of diseased sinuses. In relation to the severity of the mucosal disease, the time of appearance of fluorescence areas in the mucosa was within 1 week in mild lesions and within 3 weeks in severe conditions. In the presence of deviated septums, fluorescence was more extensive on the side of convexity, that is, on the side of the narrowed nasal cavity. It is however necessary to consider and to investigate further the coupling of lysozyme and FITC and the fate of the coupled compound after absorption into the body.
We administeret Ibunac to upperrespiratory disease ; acute infection 8 cases (acute rhinitis, acute tonsillitis, acute pharyngitis and acute otitis media) and postoperation 12 cases (chronic sinusitis, chronic tonsillitis, salivary stone and maxillary cancer). The effect of this drug to these cases were as followed; 1) acute infection: 6 cases (75%) were effective to inhibit fever, local heat and local pain, and to take off swelling and congestion of local mucous membrane. 2) postoperative cases a) Chronic sinusitis 2 cases (50%) were effective to inhibit headache and swelling of cheak. b) Chronic tonsillitis: 2 cases (50%) were effective to inhibit pain in swallowing. c) Salivary stone: 2 cases (100%) were effective to inhibit pain and swelling of local mucous membrane. To maxillary cancer, however, Ibunac has not a remarkable effect.
For correct diagnosis and rational treatment of disorders of the sence of smell, it is obviously necessary to determine the exact area of disturbance, the severity and cause of the disorder, and to apply treatment directed toward removal of the causal and predisposing factors. As accurate information concerning the condition of the olfactory fissure in such disturbances might aid in their diagnosis, a double contrast x-ray study of the olfactory fissure was made. Eight types were classified on the basis of the x-ray findings and their relationship to disorders of the sence of smell was investigated.