Idiopathic adrenal hemorrhage.

A case of idiopathic adrenal hemorrhage is reported. A 76-year-old woman exhibited a left adrenal tumor, 3 cm in diameter, on abdominal computed tomography. The patient was receiving aspirin medication for atrial fibrillation. There was no evidence of increased adrenal hormones. The mass enlarged to 6 cm in diameter within 18 months, and malignancy was suspected. The mass was diagnosed as adrenal hematoma by operative findings.

Scanning electron microscopic study of the middle ear mucosa after transtympanic infusion of fluids with different osmotic pressure.

This study focused on the morphological alteration of the mucous membrane of the middle ear after transtympanic infusion of fluids with different osmotic pressure. Our results suggested that fluids with high osmotic pressure will seriously damage the mucous membrane of the middle ear regardless of whether or not the fluids have ototoxicity. On the other hand, fluids with low osmotic pressure were found to demonstrate minor changes on the mucous membrane. The authors have confirmed through this study that Beriplast-P A (894 mOsm) and B (228 mOsm), fibrinogen-based tissue sealants, may be safely used in the middle ear with minimum injury to the mucous membrane.

Abnormal sensations of the pharyngo-larynx.

By use of a chart questionnaire, abnormal sensations of the pharyngo-larynx (ASPL) were analyzed between May 1-October 30, 1984 and followed up uintil 1 year after the first consultation date. Two hundred ninety-one patients from the total were found to suffer from ASPL, the ratio of ASPL to all out-patients being 1.47%. The ratio of sex distinction was 6.2 (males): 10 (females). A significant number of ASPL cases occured between the ages of 30-59 years old. ASPL patients were divided into the following categories: (1) causes originating from the ENT field, (2) internal medicine origin, (3) psychological internal medicine, (4) malignant origin and (5) unknown origin. The authors also conducted an investigation of the relationship between iron deficiency and abnormal sensations of the pharyngo-larynx. ASPL in females aged between 30 to 40 years indicated a significant relation to anemia of latent iron deficiency. The authors also investigated from the psychological internal medicine view and the results revealed sticky sensations of the pharyngo-larynx and autonomic imbalances with position reaction to psychosomatic and neurotic symptoms.

Neuro-otological study of positional vertigo caused by head injury.

A neuro-otological examination was given to 22 patients with paroxysmal positional vertigo within 1 week of head injury. In all cases, reverse rotatory positional nystagmus accompanied by a vertiginous sensation was observed in the positional nystagmus test. No relationship between the affected side and the direction of eye movement in the head-hanging position was found in the positional nystagmus test. From the prognosis and the nystagmus findings, the cause of the vertigo was thought to be partial damage to the inner ear. The clinical course was generally favorable, but recovery was slower in the 11 cases with neuro-otologically demonstrated central nervous system disorders than in the other 11 cases.

Scanning electron microscopic studies of the membranous labyrinth after transtympanic infusion of local anesthetics (lidocain).

Scanning electron microscopic observation of the transtympanic infusion of 10% xylocain revealed twisting and disorders of outer hairs especially from the 2nd and 3rd rows of the basal to the 2nd turn of the organ of Corti, and adhesion and fusion of the sensory hairs of the crista ampullaris and otolith organ 1 and 4 days after injection. Four percent xylocain however demonstrated very minor alteration of the sensory hairs and no missing sensory hairs were detected from any cases. The authors hypothesized from electron microscopic observation that adhesion and fusion of vestibular sensory hairs or twisting and disorders of the sensory hairs of the organ of Corti might act to intercept harmful circulation of exclusion of abnormal excitement of hair cells and the innovation of electrical discharge of sensory hairs due not only to the pharmacological effects of xylocain but also to osmotic pressure.

Long-term investigation of habitual tonsillitis in children.

The authors were in close contact with children who had indications for tonsillectomy and investigated them in both acute tonsillitis and intermittent periods of tonsil inflammation. The results obtained were as follows: Repeated attacks of acute tonsillitis clearly decreased in number. No secondary diseases due to tonsillitis were observed. When repeated attacks of acute tonsillitis occurred, the symptoms were not as serious as previously.

[Scanning electron microscopic study of the sensory hairs of the organ of Corti using transtympanic infusion of fluids with different osmotic pressure].

Morphological examination of the sensory hairs of the lower half of the 2nd turn of the organ of Corti of the guinea pig after transtympanic infusion of the aseptic fluids with different osmotic pressure was performed using a scanning electron microscope. Group A fluids (0-315 mosmol/l) did not have any injurious effect on the sensory hairs of the OHCs (outer hair cells) or IHCs (inner hair cells). In contrast, Group B fluids (720, 743 mosmol/l) appeared to cause disarrangement of the stereocilia of the OHCs. Alterations were found to be more extensive and severe in the 3rd row of OHCs. Group C fluids (1224, 1248 mosmol/l) induced total loss of sensory hairs in the 3rd and 2nd row of OHC. The remaining stereocilia in the 1st and 2nd rows showed coalescence of adjacent stereocilia. Based on these findings, the authors concluded that there is a close relationship between osmotic induction/deduction by transtympanic infusion of fluids and high osmotic pressure on the hairs of the organ of Corti.