Objectives: To perform ventilation tube therapy for chronic otitis media with effusion in children, to investigate how the incidences of recurrence and tympanic membrane perforation varied with duration of placement, and to determine the most appropriate duration of placement.
Methods: Using a questionnaire survey in clinics after follow-up, we studied 119 ears 74 children with chronic otitis media with effusion, undergoing ventilation tube therapy between January 2007 and December 2012.
Results: The duration of tympanostomy tube placement was 444 days on average, and recurrence was seen in 5 cases. There was no significant difference in the rate of improvement between patients undergoing adenoidectomy and with no adenoidectomy.
Conclusion: It was thought that 500 days or more were desirable for tube placement and that an a denoidectomy should be undertaken concomitantly wherever possible. A future study should be designed to examine the long term effect. Our results suggested that a high risk of the recurrence was associated with congenital anomaly or retraction within one year after the insertion.

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Antibody titers and tuberculin skin reaction were compared in 2 groups of guinea pigs. One group of animals were injected with heat killed tubercle bacilli while animals of the second group received the bacilli in the form of Freund's adjuvant.
Changes in antibody titers of serum and skin extract were followed by Middlebrook-Dubos hemagglutination and hemolysis during the period of 10 weeks post immunization. Test for incomplete antibody was made by the Sindo-Utahashi's method.
Titers in animals injected with the adjuvant rose earlier and reached higher values than those in animals injected with tubercle bacilli alone. Generally speaking, a parallel relation was found among hemolysis, presence of incomplete antibody and tuberculin reaction as was reported earlier by Hosoda.

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髄膜腫は脳脊髄腫瘍においては比較的頻度の高い腫瘍である。しかし硬膜外に発生するのは稀であり, 鼻副鼻腔領域にこの腫瘍が発生するのは, 原発あるいは転移性に関わらず極めて稀である。今回我々は, 21歳, 女性, 眼球突出のみの症状を呈した節骨洞原発の髄膜腫1症例を経験した。画像診断上頭蓋内, 眼窩内浸潤はなく筋骨洞に限局していたため, 美容上を考慮し内視鏡下に可及的な摘出術を選択した。術後のCT scanにて節骨洞粘膜肥厚と骨硬化像を認めたが, 粘膜生検では再発を示す所見は認められなかった。

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To investigate the relation between the temporal pattern of the tuberculin reaction and the circulating antibody, 21 healthy and the circulating antibody, 21 healthy and 15 tuberculous cases were used for the tests. The tuberculin reaction was performed as described in the previous reports, and the circulating antibody was determined by hemoaggulutination, hemolysis, Boyden's technique and Shindo-Utahashi's method. The fraction extracted from the non-heated tuberculin was used as the antigen. In the healthy cases, the tuberculin reaction rarely showed acceration, and the circulating antibody was frequently accerated, and the antibody was positive ofener than in the healthy cases. In the cases repeated tuberculin reaction tended to be accerated and the antibody titers was ofen elevated. From the relation between the pattern of the tuberculin reaction and the circulating antibody, it was clarified that the antibody titer tended to be higher in the cases whom reaction was accerated. It was known that the substance absorbed from the tuberculous cavity and the tuberculin inoculation may produce the change to tuberculin allergy in the living body and increase the circulating antibody and accerate tuberculin reaction.

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Eight groups of mice were immunized by single or repeated injections of the heat killed organisms of S. enteritidis. Pooled sera were prepared by cardial puncture from five mice at weekly intervals after immunization. Serum samples were examined by Middle brook-Dubos' passive hemagglutination, conditioned hemolysis and Sindo-Utahashi's modified Coomb's test by the use of the soluble antigen fraction derived from the organism. At the same time, the bacillary agglutination was tested also following the conventional Widal test. The incomplete antibodies which are thought to participate mainly in the hemolytic reaction, were proved to be produced dominantly and earlier than the complete antibodies. The agglutinin could not be detected in serum samples obtained from mice immunized by a single injection, while the samples prepared from the groups which were immunized by repeated injections of small amount of the organism, reacted positively in the agglutination. It is considered, therefore, that the incomplete antibodies may play an important role also in immunological studies of mice in salmonellosis.

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Otitis media with effusion (OME) is characterized by prolonged inflammation of the middle ear mucosa and it is thought that improvement of OME requires improvement of the middle ear mucosa. We investigated the change in the total middle ear pressure (TMEP) that accompanied with gas exchange, and it was surmised that the TMEP reflected the status of the middle ear mucosa and was capable of serving as an index for predicting the outcome of patients with OME. On the other hand, it was thought that poor eustachian tube function was an important causative factor of OME, and sonotubometry has used as a noninvasive test method for evaluating the pathological state of OME. We investigated OME patients to determine the changes in the TMEP due to treatment with middle ear ventilation tubes, the changes in eustachian tube function as shown by sonotubometry and the clinical course after removal of the tube.
The subjects consisted of 70 ears of 70 children (49 males, 21 females) aged 3-15years with OME and in whom the course was able to be followed after removal of the tubes. The ears were divided into two groups based on the clinical course after tube removal: 47-ears in “good” group and 23-ears in “poor” group. Analysis revealed that the duration of the indwelling tube had been significantly longer in the “good” group. The TMEP showed a tendency to increase after intubation, reaching a maximum value after 19 or more months. At the time of tube removal, the maximum TMEP was significantly higher in the “good” group compared with the “poor” group. It was thus surmised that the maximum TMEP reflected the status of the middle ear mucosa, and that this parameter can be used in prediction of the outcome of OME. In addition, sonotubometry showed the eustachian tube function to be significantly more improved in the “good” group than in the “poor” group. In addition, the improvement in the eustachian tube function was significantly greater in patients who had undergone adenotomy. It was concluded that not only long-term use of ventilation tubes but also adenotomy were useful for improvement in OME.

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症例は46歳男性, 十二指腸潰瘍にて治療中, 平成3年10月上部消化管内視鏡検査で十二指腸下行脚Vater乳頭対側に粘膜下腫瘍を認めた.数度にわたり生検を行ったが組織学的診断は正常十二指腸粘膜であった.平成4年6月より時々黒色便が出現するようになり, 平成4年12月3日より黒色便持続し12月5日来院.緊急内視鏡検査にて粘膜下腫瘍頂部小潰瘍よりの出血を認め, HS-E局注施行により止血した.平成5年1月胃・十二指腸切除術が施行された.腫瘍は2.7×2.0×2.8cm大の管内発育型で, 表面に小潰瘍を伴い, 組織学的には桿状の核を持つ紡錘型細胞の錯綜より平滑筋腫と診断された.下血を反復する十二指腸平滑筋腫に関して若干の文献的考察を加えて報告した.

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小児滲出性中耳炎の病態は, 鼻咽腔の炎症と耳管を介した中耳含気蜂巣の換気・排泄障害に起因するといわれている。小児滲出性中耳炎症例では, 中耳含気腔内の慢性的な炎症刺激により乳突蜂巣の発育が抑制される。このことから当科における小児滲出性中耳炎の治療方針は, 初診時のシュラー法X線検査における乳突蜂巣の発育程度を基準に決定している。蜂巣発育の良好な症例には保存的な治療, 発育が抑制された症例では積極的に鼓膜換気チューブ留置術, アデノイド切除術を行っている。
1981年4月より1998年12月までに, 当科滲出性中耳炎外来を受診した1歳から15歳までの727例1,338耳に対してアデノイド肥大, 副鼻腔炎の合併の有無, チューブ留置期間, チューブ抜去後経過, アデノイド切除術の有無について検討を行った。
初診時の乳突蜂巣の発育が良好で保存的治療を選択した {保存群} は80%が治癒した。蜂巣発育が良好にも関わらず保存治療で改善がみられず手術を選択した {保存-手術群} は, 84例149耳にみられた。保存治療で改善がみられた {保存群} と {保存一手術群} において, 症例の副鼻腔炎・アデノイド肥大の重症度に有意差を認めた。また, チューブ留置期間においては, 長期間留置するにしたがい再チューブ留置を必要とした再発群は減少し, 18ヵ月以上と18ヵ月未満留置した群において有意差があり, 18ヵ月以上2年程度の留置が有効であると考えられた。さらに, アデノイド切除術の施行の有無において, アデノイド切除を行った群において経過良好であった群が有意に多くみられ, アデノイド切除も滲出性中耳炎の治療に有用であると示唆された。

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In order to learn the immunological relationship between tuberculosis and leprosis, serum samples of 200 leprous patients who were proved clinically and bacteriologically to have no lesion of tuberculosis, were tested by the Middlebrook-Dubos' passive hemagglutination and the hemolytic test after Sindo-Meddlebrook's forumula using the tuberculin fraction Fr. II as the antigen.
In the passive hemagglutination, as a whole, positive rate was 80%, and tde mean value of end titres was 1: 33.2. The positive rates and their mean values in both cases of lepro-matous and tuberculoid leprosies were 85%, 67.7% and 1:39.7, 1:17.6 respectivery.
In the hemolytic test, on the whole, positive rate was 81.0% and it's mean value of end titres was 1:85.8. Further, the positive rate and mean value of end titres in the sases with lepromatous leprosy was 82.9% and 1: 93.0 respectively, and 76.1% and 1: 65.5 in cases with tuberculoid leprosy.
Thus, the positive rate and the mean value of end titres in both seroogic testsin cases with lepromatous leprosy were higher than those in cases with tuberculoid leprosy.
The averaged pattern of the two-dimensional hemolytic test was less steeper than those in tuberculosis.
In the present investigation of leprosy, no correlation between results of both the tube-rculin skin reaction and the hemolytic test was obsered. This fact is quite different from the picture in healthy adults in Japan.
Tee positive rate of hemolytic test of tuberculin test-negative ones was in some degree lower than that of tuberculin test-positive ones, while the mean value of hemolytic titre of the former was higher than that of the latter.

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Fifteen groups of mice (ddN, CF#1, CFW and gpc) were immunized by intraperitoneal, intramuscular or intravenous injection of the heat killed tubercle bacilli (H_<37>RV) or the BCG vaccine. Pooled sera were prepared by cardial puncture from five mice at weekly intervals. Serum sample were examined by Middlebrook-Dubos' passive hemagglutination, conditioned hemolysis and Sindo-Utahashi's modified Coombs' test using tuberculin fractions as the antigens. It was proved that production of specific antibodies against tubercle bacilli in mice, in general, was very low. In cases of immunized mice with the heat killed organisms, no antibodies could be found by those testings in vitro. But serum samples obtained from mice immunized with BCG at the 7-9th week were proved to be definitely positive in the hemolytic reaction and the modified Coombs' test in which the incomplete antibodies are thought to participate. No bivalent antibodies, as a whole, could be detected by those methods under given conditions. Amongst several sorts of mice, CF#1 is considered to be most sensitive and homogeneous in production of antibodies against tubercle bacilli.

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