The purpose of this research is to infer when in the process of human evolution septum deviation occurred, taking notice of the fact that a high incidence of the septum deviation is found in man, while a septum of anthropoid ape is vertical. It is said that the ancestor of hominoid had evolved into the Modern man, from a kind of primates like an ape through the processes of the Australopithecus, the Pithecanthropus, the Neanderthal man and the Modern man respectively. At which stage of the frocess of human evolution did the formation of the septum deviation occur? We cannot learn at all any configuration of the nasal chambers of the fossil hominoids between the Australopithecus and the Neanderthal man through their skulls. Consequently in order to find out their configurations, therefore, I studied inductively the following three aspects: I) The comparative anatomical study on a septum II) Study on the septum deviation in man in various respects III) Study on the morphological relationship and transition of the fossil hominoid skulls, especially in the brain skulls and the face skulls, referring to the documents. The purport of the above third (III) study with the documents on the skulls of the fossil hominoid is as follows; 1) From the Australopithecus to the Neanderthal man, their brain cases are long mainly anteriorly and posteriorly ; so the brain skull of the Neanderthal man is markedly dolichocephalic. 2) The brain volume of the Neanderthal man is as large as the present man's or larger. But the maxillo-facial skull of the Neanderthal man is more primitive than the Present man's and similar to the Pithecanthropus'. 3) The remarkable transition in the evolutional process of the Neanderthal man to the Modern man are the brachy-cephalizafion of the brain skull, the formation of the forehead and the progressive reduction of the brow ridges and the maxilla (prognathion) 4) Therefore, it can be thought that, in form of the brain skull of the Neanderthal man to the Modern man, different kinds of transitions than ever before had occurred, and furthermore ; that at the Neanderthal stage the brain skull had started to involve an active effect on the maxillo-facial skull. Eventually, I concluded from the above three studies that the formation of the septum deviation in man occurred at the Neanderthal stage.
Elucidation of the relationship between air pollution and the living body presupposes investigation on the behavior of the receptor organ of the latter as well as envirmonmental factors. The author, having studied for a predisposing factor in the mucosa of the airway as the receptor organ, has been able to demonstrate the consistent presence of such a factor, even in juvenile patients. The pertinent results are presented below while the relationship between the factor and air pollution is discussed. 1. Rhinobronchitis atrophicans gives rise to nasal and bronchial symptoms. Examinations will reveal atrophic lesions in nasal, tracheal and bronchial mucous membranes. Our series of 29 cases of the disease were divided according to the presence or absence of complicating sinusitis into 2 groups: one consisting of 20 cases of the primary type or without a complication of sinusitis and the other of 9 cases of the secondary type. There were 11 juvenile patients (under 20 of age) in the former group, consisting of 6 males and 5 females. 2. In a series of 145 cases of atrophic rhinists, a study was made of the incidence of a complicating atrophic lesion in the mucosa of the airway, i. e., the trachea or bronchi, and the digestive tract or the esophagus and stomach. For the trachea or bronchi, such a lesion was detected in 64.5% of these cases ; for the esophagus, in 62.5%; and for the stomach, in 78.0%. In juvenile patients of the primary type or without involvement of the paranasal sinuses, the incidence was 68.8, 70.0 and 72.2% respectively. When viewed in its relation to the type of symptoms present in nasal cavity, atrophic lesion was exceedingly frequent in cases of ozena with crust formation and an offensive odor. 3. Inquiry by questionnaire was made into nasal, pharyngolaryngeal, thoracic, abdominal and general symptoms as well as some other factors including nutritional status in our series of patients as divided into 3 groups according to the outstanding macroscopic feature of nasal mucosa: atrophic, hypertrophic and normal. 4. The results obtained, together with other. clinical data cited earlier, affirmed the presence of apredisposing factor for atrophic mucosa in juvenile patients. This fact provides a major clue in elucidating the relationship between air pollution and the pathology of the mucosa of the airway as the receptor organ of the body. A filtrative defensive mechanism of several orders in the respiratory system has also been discussed in relation to the onset of illnesses due to air pollution.
Two cases of significant perceptive hearing loss associated with acute otitis media followwing upper respiratory infection were presented. Clinical features contain severe otalgia, bullous formations on the ear drum and external ear canal, prolonged serous otorrhea and combined conductive and perceptive hearing loss. Hearing loss was transient and recovered by the systemic steroid therapy. The sera of both acute and convalescent stage of the patients were examined for the hemaggutination inhibition antibody titer against influenza virus strains. The result strongly suggests that the patients were suffered from the epidemic influenza at the time.
Von Recklinghausen's disease is not at all uncommon, but a case characterized chiefly by nanal symptoms is rare. The authors report a 27-year-old female, who had been suffering from nasal obstruction for many years despite previous resection of a tumor in the right nasal cavity. Surgical treatment was undertaken and the subjective symptom disappeared. Histopathological examination of the resected specimen revealed a neurofibroma. The literature on this disease is reviewed then histopathological and electron microscopical findings on this case are briefly discussed.
In daily practice we encounter many elderly patients who complain of vertigo. As we often find presumptive type of hyperlipoproteinemia in these patients, hyperlipoproteinemia may be regarded as one of the vertigo factors although the value of serum lipid is not simply proportional to the severity of vertigo. The author measured the value of malondialdehyde (MDA), which is considered to be more closely related to arteriosclerosis in patients with vertigo and compared the values with those of cholestrol in the same patients. MDA was measured by the modified TBA method (Naito's method). A total of 148 patients with vertigo and 15 normal subjects for control were studied. The results of the study showed that MDA values were more frequently elevated than cholesterol in cases with vertigo, more proportional to the severity of vertigo, and elevated during the attack of vertigo and lowered during remission. MDA is slightly elevated in Meniere's disease while it is prominently elevated in cerebral vascular insufficiency. It is also found that when MDA is elevated in a patien with vertigo changes of mean arterial pressure is small while when MDA is normal alteration of mean arterial pressure is greater, in other words, MDA and the changes of the mean arterial pressure are inversely proportional to each other. From this study the author surmised that MDA is one of the vertigo factors.
A case of otogenic (cholesteatoma) sinus thrombophlebitis with an early embolic abscess in the left upper lobe of the lung and Bezold's descending abscess deep into the right sternomastoid muscle in a man, aged 29, is reported. The patient soon developed uremia resulting from bilateral hemorrhagic renal infarction and expired. The patient was also complicated by otitic hydrocephalus. The serious intracranial complications of otogenic origin have decreased in incidence during the past two decades due to the introduction of antibiotics and steroid therapy. However, the authors believe that otologists still need to realize the potential dangers of otitis media since the emergence of “cold or masked mastoiditis” as a new entity resulting from failure of antibiotic therapy.
The author found that in infants under two years of age the length of the trachea, that is, the distance between the front teeth and the bifurcation of the trachea, is usually 12 to 15 cm and the inside diameter is 6 to 7mm. Accordingly bronchoscope of 20 cm. would be adequate for infants. An inside diameter of 5 mm or more is desirable for use of forceps. (An inside diameter of 3 mm might be available if only for inspection). The author had three different sized bronchoscopes manufactured for trial. Their sizes are 25 cm long with 6 mm inside diameter, 25 cm long with 5 mm inside diamter and 20cm long with 4 mm inside diameter. These bronchoscopes have been found to be quite useful in older children as well as in infants. These bronchoscopes are designed to connect with tubing for inhalation anesthesia and can be used as ventilating bronchoscopes.