Human nasal secretion was studied by means of immunoelectrophoresis in order to compare the same to the serum and to investigate distribution of protein fraction in various nasoparanasal diseases. The two different antiserums, antihuman serum rabbit serum and anti-nasal secretion rabbit serum, were prepared to analyze the protein in the nasal secretion. Each fraction of protein was identified according to Quchtherlony's method, thereby comparisons were made among the nasal secretions obtained in various diseases of the nasoparanasal diseases. The nasal secretion obtained carefully excluding blood component was centrifuged to determine the protein concentration and then studied by means of immunoelectrophoresis. The results of the immunoelectrophoresis of nasal secretion may be summarized as follows; 1. Nasal secretion contained albumin, haptoglobin, transferrin, IgA and IgG. 2. Watery nasal secretion and mucoid nasal secretion were often found to lack haptoglobin and transferrin, while mucopurulent or purulent discharge also lacked haptoglobin and transferrin but less frequently. Serous secretion always contained all of the five proteins. 3. Haptoglobin and transferrin were often missing in so-called unstable stage of chronic sinusitis. 4. All the five proteins, albumin, haptoglobin, transferrin, IgA, and IgG were identified in almost all postoperative cases of chronic sinusitis. 5. The above five proteins were likewise proved in reactions between nasal secretion and antinasal secretion rabbit serum. 6. No data were available as to indicate the presence of specific protein in the nasal secretion as studied by reactions between human serum and anti-nasal secretion rabbit serum or nasal secretion and anti-nasal secretion rabbit seum.
Two serious complications associated with radical operation of chronic disorders of the paranasal sinuses are intracranial damage and injury to the optic nerve. The use of antibiotics has lessened the dangers of intracranial complications but injury of the optic nerve is still a matter of grave consequence. In view of the seriousness of such complications, any means by which damage to these areas during operation could be avoided or lessened would be highly desirable. It was therefore considered worthwhile to evaluated the various routes for operation of the ethmoid cells as the angle of vision and the field of exposure provided by the different routes would influence the execution of the surgical procedure and help in avoiding damage to the above structures. Skulls of Japanese with intact bony structures of the face, consisting of 100 males and females each, were procured for this study. Using the wire ligatures employed by dentists to fasten artificial crowns, wire coils conforming in shape, length and diameter to the optic foramen in each of the skulls were made and inserted into the canals. Care was taken so that the ends of the metal coils did not project the orbital fossa or the cranial cavity. In a similar manner, wire coils were inserted from the anterior and posterior ethmoidal foramen in the inner wall of the orbit, and landmarks were placed at the anterior nasal spine, foramen of the infra-orbital canal and rhinion. Projections were made in the lateral, posterior-anterior and axial directions. For the posterior-anterior porjection, Gonda's method of nasion-inion projection in which the central bean of X-rays passes in the direction of the inion through the nasion was employed. The axial projection in this study was in the direction parallel to the cribriform plate and perpendicular to the line connecting the inion and nasaion, the center of the beam passing through the hypophysis. Each picture was taken under identical conditions. In some instances, projections of the optic foramen were also taken. Operative Routes Evaluated on the Basis of Roentgenologic Study. Many methods have been described for operation of paranasal sinusitis but they can be roughly divided into 3 maintypes according to the route of approach to the ethmoid cells. The visual angle and field of exposure afforded by these 3 main routes, that is, the intranasal, extranasal and intraoral routes, were studied on the basis of measurements taken on the X-ray film of the skull specimens. The purpose of the measurements taken on the X-ray films of the skulls was to provide numerical values for comparison of the extent of exposure afforded by the different routes of approach to the ethmoid cells. Using X-ray films taken of skull of Japanese in 3 directions, measurements of the visual angle and field obtained with various operative sinus were taken to determine the suitbility of the different approaches. Numerical values were obtained demonstrating the adventages of the intranasal route. It was also shown that the generally employed approach through the maxillary sinus for operation of the ethmoid cells was unsuitable when pneumatization of the ethmoid cells was poor as the visual field and angle needed for operation were unattainable and blind angles existed with this route. Because of the danger of side injuries to the orbital plate of the ethmoid bone or potic nerve canal when this route is employed, it should be combined with one of the other approaches. In other words, it is emphasized that in operation of the ethmoid sinus the route through the maxillary sinus should be employed only as an auxiliary route to other methods of approach.
There are many unknown factors in mechanism of postoperative regeneration of the paranasal sinuses that oftn impair normal healing process following operations. The authors described following two important observations as causative factors for postoperative regeneration of the sinuses. 1) Marrow is encountered in the direction of development of the sinus. 2) The upper termination of the bony wall adjoining marrow is of biochemical juvenescence type. The above mentioned two etiological factors would be considered as local predesposition that cause the enlargemental regeneration of the paranasal sinus after operation. In another word, the local predisposition is a preparative state of enlargmental regeneration and in addition to this external factors, for example, operative stimulation could accelerate the postoperative enlargemental regeneration of the paranasal sinus. In the course of this process, from a view of biochemical stand, the author considers acidosis develops locally and osteocrusts are increased, then repneumatization will be followed as the result.
A remarkable advance in the means of communication, heavy industry and construction has been accomplished in Japan during the past decade. The number of maxillo-facial fracture, on the other hand, has steadily been increasing with its formula becomming more complicated. The authors reported 10 cases of maxillo-facial fracure, five of which were comminuted fractures associated with fracture of the orbital floor. (Table 1)
The authors used 99mTc for scintigram in diagnosis of two cases with chronic inflammatory lesions of the salivary gland. Case 1 was a 28-year-old male with chronic inflammation of the left submandibular gland while case 2 was a 69-year-old male with the same disease. Impaired functions of the salivary glands were shown as a scarcity in intake of 99mTc- Pertechnetate by the salivary glands. Pathological examinations of the salivary glands showed advanced fibrosis in both of the cases. 99mTc has various advantages in use with scintigram for diagnosis of salivary gland diseases, which may be favorably compared to sialography which causes invariably pain on the side of the patients. Some of the other advantages are that the 99mTc has a short half-life of 6.1 hours, emits only the γ-rays with its energy being 0.14 Mev, and has a good scan-effect.
Cat-scratch disease was originally described by Robert Dbre of France in 1950. The incidence of the disease in Japan is considered to be rare. The author reported on a 12-year-old female who was scratched by a cat and subsequently developed swelling of a cervical lymph node. Blood examinations revealed an acceleration of the blood sedimentation rate and an increased ASLO titer. The lymph node removed surgically showed scattered suppurative and necrotic changes on the cut surfaces. Microscopically the sections showed a typical picture of cat-scratch disease.
1. Patients with inflammation of the middle ear were carried out double-blind test with Cephalexin-Lilly (Keflex) and Aminobenzyl Penicillin tablets. 2. The dosage was 1 gr. a day and the duration was, in principle, for 5 days. The efficacy was evaluated by the improvement in subjective and objective findings. 3. A significant difference of effects was observed between Keflex and Aminobenzyl Penicillin tablets. No particular side-effects were observed.4. Keflex showed a fairly good effect in the treatment of cases with inflammation of the middle ear.
The authors reported on the results of Foristal Lontab (dimethindene maleate) administered to 25 patients with nasal allergy, 2 tablets a day for one to two weeks. The authors reported on the results of Foristal Lontab (dimethindene maleate) administered to 25 patients with nasal allergy, 2 tablets a day for one to two weeks. A marked improvement in objective findings was seen in five of the cases while the side-effect of drowsiness after taking the drug was encountered only in one patient. The major feature of the action of this drug appeared to be in its rapidity of onset as well as in prolonged duration of the effect. The dosage used in our study, two tablets a day, seemed to be sufficient to control symptoms in most of the cases.
Ledermycin dry syrup contains demethylchlortetracycline which was isolated from streptomyces aureofaciens by Mc Cormick at the Lederly Research laboratory in 1957. The features of this drug may be represented by its stability under various pH values, potent bacteriocidal effect, and the prolonged maintenance of high concentration in the circulating blood. The results of ledermycin dry syrup administration in 24 children and infants, 20mg./kg for 3 to 12 days, revealed an effective rate as high as 87.5%-markedly effective in two cases, effective in 11 cases, slightly effective in 8 cases and no effect in one case. The results in two cases could not be evaluated. The only side-effect observed was mild diarrhea seen in a child.