In order to evaluate the response of specific IgG and subclass antibodies undergoing antigenspecific immunotherapy, 41 patients of nasal allergy with mite-allergen were selected for this study. All the patients were treated with immunotherapy by mite (Dermatophagoides Farinae) antigen for more than 2 years. The mitespecific IgG and subclass antibodies were checked at the point of 0.5, 1 and 2 years during immunotherapy. The IgG and subclass antibodies were detected with the method of ELISA (Enzyme-Linked Immunosorbent Assay). The 41 patients were divided into 4 groups according to the effectiveness of immunotherapy. The change of specific IgG and subclass antibodies value after immunotherapy were evaluated in each group. Obvious elevation of IgG and IgG4 value was noted in markedly improved group and improved group, as compared with non-effective group after 2-year immunotherapy. Mite-specific IgG/IgE RIST and IgG4/IgE RIST ratio also showed remarkable elevation after immunotherapy in the markedly improved group and improved group (p<0.01). The elevation of IgG4 level was greater than IgG and it showed some relationship with the improvement of symptoms. The possibility of IgG4 antibodies acted as “blocking antibody” was suggested. Before the treatment, IgG4/IgE RIST and IgG/IgE RIST ratio showed higher level in the effective groups (both markedly improved and improved groups) than the ineffective groups (both fair and non-effective groups). It was suggested that IgG4/IgE and IgG/IgE ratio may be parameters for predicting the effectiveness of future antigen-specific immunotherapy.
Although skin temperature on a normal nose is lower than that on the forehead, this difference is indistinct among patients with nasal obstruction, and their nasal skin temperature is high. Based on this relationship, the relationship between acupuncture applied to one-hand and nasal symptoms were determined, and the following results were obtained. 1 Effect on Nasal Obstruction. Nasal obstruction was abated by acupuncture, and nasal skin temperature tended toward decreases as obstruction was improved. These changes were more markedly observed in the sitting position than in the lying position. Since acupuncture applied to one hand improved nasal obstruction on the contralateral side, suggesting the presence of bilateral reaction system. Since the improvement of nasal obstruction with acupuncture was also determined based on changes in nasal cavity resistance, these results were suggested that nasal obstruction is related to nasal skin temterature as well as nasal cavity resistance. 2 Effect on Rhinorrhea. When a nasal mucosa provocation test was performed on patients with nasal allergy, nasal skin temperature simultaneously increased as allergic symptoms appeared. Although allergic symptoms were inhibited and nasal skin temperature tended toward a decrease when acupuncture was applied during the test, these symptoms reappeared and nasal skin temperature again increased when acupuncture was discontinued. This phenomenon was inhibited by pretreatment with acupuncture applied; namely, allergic symptoms hardly appeared, and nasal skin temperature showed no increases. When the nasal cavity is sprayed with pilocalpine in a person with normal nasal function, rhinorrhea occurs as well as an increase in nasal skin temperature. In this study, pirocarpine-induced nasal discharge was not inhibited by acupuncture in normal persons, but was it inhibited in patients with nasal allergy to a normal level. As so far mentioned, the state of the nasal cavity could be estimated based on nasal skin temperature measured by thermography. Based on the relationship between nasal skin temperature and the state of the nasal cavity, between nasal cavity resistance and nasal obstruction and between the parasympathetic stimulant used in the study and nasal discharge, it was thought that peripheral acupuncture stimulus possibly adjusts distortion in the body as it simultaneously induces sympathetic stimulation to the vascular system of the nasal mucosa and parasympathetic inhibition of nasal discharge.
Chondroitin sulfate of acid mucopolysaccharides is known to play an important role mineralization. We have been interested in the development of temporal bone because the otic capsule takes unique ossification course and the physiological characters in the cartilage bone. The animals used in this experiment were ranging in age from the 18 th day prenatal to the 5 th day postnatal. Basic procedure in autoradiograical study was the stripping-film technique described by S.R.Pelc. Animals were injected intraperitoneally with 35S and the otic capsule was collected one hour after injection. Serial sections placed by stripping film were stored in light-tight boxes for exposure and stained after processing procedure. 35S activity in microscopic autoradiogram is expressed number of black dots exposed from radioisotope. Regional differeces of the 35S activity in the otic capsule of 18 th day-prenatal-rats were observed. High 35S activity is regarded as concentration of acid mucopolysaccharides. We presume that the vectors correspond with growing direction. 35S activity is coincident with direction of vectors and weakens in the areas grown rapidly.
The psychosomatic condition of vertiginous patients was studied about the results of Cornell Medical Index (CMI), Yatabe-Guilford Test, psychogenic factors influencing vertigo and their personality. In the type I and type II of CMI there were some cases with vertigo that required psychosomatic care. It was important to take detailed anamnesis about their personal history by interview for psychosomatic diagnosis. The incidence of psychosomatic disorders was greater in the group of vertigo with psychiatric factors than in those without psychogenic factors. But, the existence of psychogenic factor had no significant relation with other psychosomatic medical condition of vertiginous patients except for psychosomatic disorder. The frequency of type D in YG was greater in hysteria and the type C, was frequent in expectation neurosis, but there were no significant relation between YG and other psychosomatic conditions.
The application of dual energy film subtraction technique to the diagnostic imaging of the paranasal sinuses was presented. In this study, two X-ray films of the same object were obtained from a conventional X-ray unit using 80 kVp beam filtered with 0.127 mm gadolinium for low potential and 140 kVp beam filtered with 0.1 mm molybdenum for high poten-tial, respectively. Those films were subjected to the computer processing. Using this technique, it was possible to achieve selective soft tissue and bone visualization in the resultant images. The preliminary results of the images with dual energy subtraction technique indicated the possibility of clinical application to the diagnostic imaging of the paranasal sinuses.
A case of frontal sinus pyocele is described. The operation showed a lump of bone wax obliterating the sinus cavity and the naso-frontal duct. We presumed that the bone wax might have been used to fill up the sinus for prevention of intracranial infection at the time of frontal craniotomy 11 years ago. The frontal sinus is often entered in frontal craniotomy. From the rhinological point of view, bone wax is not suitable for such plombage method in the frontal sinus. The authors discuss that successful surgical treatment of the frontal sinus require not only proper attention to naso-frontal duct, packing material but also to leaving the mucosa of the sinus.