In Japan, cases of allergic rhinitis and vasomotor rhinitis have remarkably increased in recent years. There are many cases which can not be relieved by the present, conservative measures. In our department, trans-antral Vidian neurectomies were carried out on these cases in accordance with Golding-Wood's method. (The literature on this subject was summarized in prologue) The following examinations were pre-and-postoperatively carried out; allergen intracutaneous test, induced reaction, eosinophil count in blood, X-ray maxillary sinus mucous membrane function test and histo-pathological examination in which biopsies were taken from the inferior turbinate mucosa 20 minutes after the induced reaction. Fifty cases revealed complete relief among 55 cases of allergic and vasomotor rhinitis. This shows a success rate of 90.9 per cent Futhermore, 11 cases of chronic sinusitis with swollen turbinate but without sneezing which were thought nonspecific type from over 40 sorts allergen intracutaneous test were operated and 9 cases postoperatively showed relief from the nasal obstruction. Many observations and reseaches point out that the mast cells play a role in allergic states. Their presence, multiplicity and their state of degranulations have important diagnostic values. Histopathological examinations from the turbinate postoperatively showed a little more mast cells than preoperatively in number, and both preoperatively and postoperatively could reveal little difference in the degranulation processes in our series.
An extensive study titled “ Development and the clinical aspect of the nasal septal deformity” was reported by Dr. Takahashi at the Annual Meeting of Japan Otorhinolaryngological Society in September 1954. The present study is a further observation of the intranasal findings and the morphological changes of the nasal septum in the same population of school children. Observations were made longitudinally on the population in two different groups of school children, one in a rural area and the other in an urban area Tokyo. Observation periods extended from 1930 to 1965 in the urban area and from 1953 to 1961 in the rural area. The total number of school children studied amounted 12, 740 urban and rural study combined. Changes in shape and extent of the septal deviation according to an increase in age were characterized by a decrease in number of simple septal deviation and also in simple spina and by an increase in complicated deviation or complicated spina. The observation concerning the type of septal deviation revealed a decrease in C-type curvature and an increase in the superior septal deviation with increase in age. The deformity of the nasal septum appeared to be more extensive in the elder age groups. A statistical study correlating the development of the septal deviation and the general systemic growth which were represented by body weight, body length and circumference of chest revealed a significant positive relation between the two. This would indicate that the development and the extension of the septal deviation are closely related with the systemic growth and that major deformity of the septum frequently occur in adolescence. Spontaneous reverse of the direction of septal curvature was seen in 55 cases among 245 cases observed for consecutive 11 to 13 years. Such reverse of the deviation was exclusively observed during adolescent period and took several years before the completion. The septal deviation or deformity in progress among adolescent subjects did not produce any significant discomfort or complaints on the side of the subjects as studied by collecting questionnaires. In summary, the author presented further and detail information on the natural development of the septal deviation based upon the extensive data obtained during the 13-year period.
A double-blind trial of MS-Antigen was carried out in one hundred cases of nasal allergy. The effect of MS-Antigen was compared with that of the active placebo-d-chlorpheniramige maleate. MS-Antigen was discovered as a new therapeutic agent by M. Soeda in 1965. Treatment with 40 mg daily of MS-Antigen (20mg for under 15 years old) or with 12mg daily of d-chlorpheniramine maleate was continued for 4 weeks. Characteristic nasal symptoms, such as sneezing, nasal obstruction, nasal discharge and rhinoscopic findings were observed, while the other necessary clinical investigations were made before, during and after the administration of the drugs. A global judgement was made at the end of the therapy and 4 weeks after the ceasing of the treatment. The effect of both drugs wese compared by the sequential method, but we didn't find any difference between MS-Antigen and active placebo. However, on the global judgement at the time of 8 weeks (4 weeks after the ceasation of the drugs), the success-rates were higher in MS-Antigen (77%) than in active placebo (59%). The difference was statistically significant (P<0.05). The side-effect of MS-Antigen was rare and not serious.
Since allergy, hypofunction of the adrenal gland, malnutrition, disturbance in metabolism are among those which may be responsible for the development of nasal or sinus infection in children the effectiveness of Cephranthin in nasal diseases among children was studied. Forty patients aged five to twelve were examined after injections of Cepharanthin, 6 to 9 mg. depending on the weight, for a period of one week. Then the patients were divided into two groups: one group of children who showed improvement of the symptoms objectively in one week and the other group that did not. Cepharanthin injection was continued for the former group, while the latter group was treated with a combination of Cepharanthin and other drugs. Evaluation of the 40 cases after one week's injection with Cepharanthin revealed improvement in 50% of the cases. Overall effect at the conclusion of the treatment revealed an improvement of the symptoms in 92% of the cases. Alleviation of swollen turbinates and decrease in discharge were also noticed in many cases. A long-period administration that extended to 12 weeks did not produced any significant. side-effect.
A total of 23 patients with nasal allergy were treated with histaglobin. An evaluation revealed the efficacy was 73% in 23 patients treated. Hyperrhinorrhea was most markedly mproved by use of histaglobin. We suggested that subcutaneous injection of histaglobin may be the first choice of for treatment of nasal allergy. n desensitization, we can puded that sole treatment with histaglobin treatment withoutother drugs was very useful for nasal allergy.
To record shakings of the body of a patient under Romberg' test, we devised a new apparatus by means of a three-colors ball point pen. The pen was fixed with a spring on a pole, and put during the test on a paper stuck on a board, which was fixed with the head of a patient standing with a posture of Romberg' test. A record of the shaking under the opened eye condition was written by means of a black pen, during first one minuite. Then the shaking under the closed eye condition (one minuite) was recorded by red pen, lastly a record under the open eye condition was written again by a blue pen in the same manner. Thus the sizes and the figures of the shakings of the body of a patient under different conditions in every one minuite were shown in a paper (a colored cephalogram).