Effect of tubal ventilatory dysfunction on fluid excretion from the middle ear cavity was investigated. Seven adult cats (thirteen ears) were used. Tensor veli palatini muscles were transected and hamulus pteryoidei were resected on the right side of each animal (seven ears). Two to seven days after filling physiological saline with antibiotics into both of the middle ear spaces, residual volumes were compared between operated side and control side. On the operated side, the volumes of residual physiological saline in the middle ear were significantly greater than control side (p<0.01), and in one ear operated, the middle ear pressure was-150mmH2O by transtubal direct measurement. It was concluded that tubal ventilatory dysfunction and irreversible negative middle ear pressure prevented fluid excretion from the middle ear. It was suggested that these two factors might be the primary causes of chronicity in otitis media with effusion (OME).
Eight hundred and eighty seven patients with epistaxis were treated at Sapporo Medical College Hospital from April, 1981 to March, 1986. Epistaxis occurred more frequently, (1) at night, (2) in winter, (3) in males, and (4) in the younger generation (0-19 years old) and the fifth decade. 80.2% of epistatis occurred at Little's area except for the ones of unknown origin. Epistaxis was prone to occur in younger people during the summer, while in the elderly during the winter. Chronic sinusitis in all ages, allergic rhinitis in children and adolecents, and hypertension in the elderly group were the leading causes of epistaxis.
Branhamella catarrhalis (B. catarrhalis) belong to the family Neisseriaceae. B. catarrhalis was found in 50 strains from nasopharynx and middle ear secretion. β-lactamase producing strains were detected by PC G, CEZ acidometric method and nitrocefin chromogenic method. Sixty-four per cent (32 strains) of clinically isolated B. catarrhalis 50 strains were β-lactamase producing. The efficacy of seven antibiotics were analyzed by an agar dilution method against clinical isolates consiting β-lactamase positive and negative B. catarrhalis 50 strains. Both β-lactamase positive and negative strains of B. catarrhalis showed a wide range of MICs with the IO6 cells/ml, inoculum. The MIC values of ampicillin for β-lactamase positive strains ranged from 3.13 to≥100μg/ml, showing its peak at 6.25μg/ml. While those for β-lactamase negative strains were all less than 3.13μg/ml. The β-lactamase positive B. catarrhalis strains were most sensitive to the cephems (CTRX, CMX), GM and OFLX.
Effect of adenoidectomy on treatment for otitis media with effusion (OME) has been evaluated for 6-months regarding to hearing in 107 children (179 ears). The children aged 5 to 7 years were randomly classified into 4 treatment groups; adenoidectomy plus grommet insertion (74 ears), adenoidectomy plus myringotomy (25 ears), grommet insertion only (53 ears), and conservatively treated group (27 ears). The children who underwent adenoidectomy (adenoidectomy plus grommet insertion and adenoidectomy plus myringotomy group) showed significant improvement in their hearing. But, on the other hand, as to the children treated without adenoidectomy, their hearing did not improve unless the ventilation tub ewas in its proper place. This result suggests that children suffering from OME and adenoid vegetation should have adenoidectomy as well as insertion of ventilation tube.
We have treated many patients with cancer of the larynx in the First Affiliated Hospital, China Medical College, Shenyang. Cancer of the larynx occurs more frequently in Shenyang, China than in Osaka, Japan. In Shenyang, cancer of the larynx is quite common. The ratio of males to females is usually given as 10 to 1. However, in Shenyang, its ratio was 1.8 to 1. The mean age distrubition of patients was in 4 th decades, about 10 years younger than that of Osaka. Of classification of this cancer, 75% were of supraglottic type in contrast to glottic type of about 25%. 97% of the patients were smokers. Various kinds of partial laryngectomy and total laryngectomy were attempted according to the stages. The five-year cure in partial laryngectomy was 75.6%(n=276).
Four cases of bullous dermatoses with oral mucosal lesion are reported. Case 1: A 55-year-old female presented multiple erosions on her oral mucosa with bullae of the skin. Histopathological diagnosis was pemphigus vulgaris. Case 2: A 56-year-old male presented only one erosion on his buccal mucosa with bullae of the skin. Histopathological diagnosis was pemphigus foliaceus. Case 3: A 75-year-old female presented multiple erosions on her oral mucosa with bullae of the skin. Histopathological diagnosis was bullous pemphigoid. Case 4: An 82-year-old male presented multiple erosions on her oral, pharyngeal and conjunctive mucosa with bullae of the skin. Histopathological diagnosis was cicatrical pemphigoid.