In recent years, the interests in the microcirculation of tissues and organs have increased greatly in the various medical fields. The description by Kiillker (1852) about the blood vessels of human inferior nasal concha, especially about the plexus cavernosi concharum, was said to be the first morphologic study of the microcirculation in the field of rhinology. Since then, many researchers made histological study of human nasal mucous membrane, and various reports dealing with the structure of blood vessels were published. However. the studies exclusively focussed on the ultramicroscopical structure of the blood vessels of human nasal mucous membrane are still scanty. Meanwhile, the thought that there must be close relations between the advance of diseases of nasal mucous membrane such as chronic nasal catarrh and chronic sinusitis as a disease of the paranasal sinus and the structure controlling the function of the blood vessels has become gradually strong. So researchers have come to pay growing attention to the angioarchitecture of the mucous membrane of paranasal sinus. This attention has increased drastically with the development of the approach to the ultramicroscopical structure. The human nasal mucous membrane occupies the large portion of the lateral nasal wall and acts sensitively upon the stimuli of the inhaled air. It is the part which performs such physiological phenomenon as the swelling, contraction and secretion. Therefoie, it is quite possible that the ultramicroscopic structure of nasal mucous membrane differs from that of other parts. From the above-mentioned point of view, I have observed, using an electron microscope, the blood vessels of nasal mucous membrane of the inferior nasal concha with the purpose of examining the role the special structure of the blood vessels playing for the physiological mechanism of nasal mucous membrane. I have placed special emphasis on the regional difference of the angioarchitecture. The results of my observation are as follows: 1. Small Artery. The small arteries of the nasal mucous membrane had a structure which seemed to be useful for decreasing the resistance of the blood flow, and the passage of some substances through the endothelial cells of the blood vessel was anticipated. Many nerve fibers which were supposed to have the function of regulating the blood flow were observed on the outer circumference of the blood vessel. 2. Arteriole. The passage of substances was supposed to be very active in the endothelial cells of arterioles. 3. Capillary. The capillaries had the fenestrations, and it was supposed that the passages of substances out of or into the capillaries were carried out with ease.
Although the incidence of chonic sinusitis appeares decreasing steadily in Japan, that of allergic nose or associated diseases seems increasing in recent years. Such tendency may pratly be attributed to an increasing pollution of air in urban areas. The purpose of this study is to clarify the entity of allergic sinusitis through clinical, observations in 310 patients with nasal allergy. Three different kinds of criteria were used for evaluation of this series. They were skin test, provocation test and subjective symptoms. All the patients were classified into three groups. according to the results of the above tests. Type I represents those cases which showed positive results for the above three tests, theType II those cases revealed positive for skin test and subjective symptoms, and Type III those, cases where only subjective symptoms were present and negative for skin test and provocation test. 1. Past history and family history: Past history of allergic disease was found in many cases. studied. Bronchial asthma was seen in the highest rate. Family history revealed positive allergic tdisease in 36 to 41% of the cases.
A 28-year-old man came to the hospital on October 7, 1971 with a chief complaint of a swelling in the left submandibular region. He first noted the swelling in June, 1970 and underwent tonsillectomy at a surgical clinic resulting in a decrease of the swelling. The swelling, however, started to increase again in May, 1971. The patient had experienced neither tenderness or sensation of heat in the lesion throughout the entire course. Either his family history or past history was noncontriburory. Physical examination revealed a well-developed, well-nourished man without any remarkable signs either in the respiratory or circulatory system. A diffuse, soft swelling of hen's egg size was found in the left submandibular region. The swelling was ill-demarcated and definitely undulated. There was neither spontaneous pain or tenderness in the lesion. Blood study and urinalysis were negative. On surgery found was a dark-blue cyst of hen's egg size with an extremely thin wall medianly to the left submandibular gland under the thyrohyoid muscle. The wall of the cyst was torn during the surgical procedure, resulting in outflow of viscid yellowish-brown fluid. Histologic diagnosis of congenital cystic lymphangioma of the neck was established. Since its complete removal was not feasible, radiotherapy of 600 R by a linear accelerator was given postoperatively. The patient has taken a favorable course after surgery and shown so far no sign either of infection or recurrence.
A new drug Mebron was tried in 46 patients with acute and chronic inflammation of the ear, nose and throat and in 33 postoperative cases, obtaining significant data that the drug has a potent effect in improving local swelling and pains. The authors judged the drug as effective for inflammatory diseases of the upper respiratory system.
Thirty cases with bacterial infections in otorhyrolaryngological field were treated with Kanendomycin injection, and satisfactory results were obtained. (1) 23 males and 7 females ranging in age from 16 to 72 were included in this study, and given 400 mg of Kanendomycin a day for 2 to 14 injections. (2) The patients consisted of 17 with otic infections, 4 with nasal infections, 8 with pharyngolaryngological infections, and one with oesophagitis. (3) Clinical results of Kanendomycin therapy were excellent in 3 (10%), good in 18 (60%), fair in 6 (20%), and ineffective in 3 (10%). (4) Clinical responses of Kanendomycin were generally rapid in the effective cases and the patients followed favourable progress in a short duration of therapy. In the treatment of chronic cases, however, 6 or 7 injections at least seem to be necessary before its effectiveness can be evaluated. (5) No subjective or objective symptoms due to disturbance of auditory or vestibular functions were observed in this study.