Pharyngeal Mucous Membrane Research Articles

Experimental studies on the initial focus of invasion of group A streptococci. 3. Scanning electron microscopic observations of rabbits in the experiment with aerosol infection

In order to investigate the initial focus of streptococcal invasion, an experiment was carried out with aerosol infection of group A type 12 streptococci in rabbits, and the fine structures of buccal and pharyngeal mucous membranes, palatine tonsils and tracheas were observed with scanning electron microscopy.Streptococci were adjusted to a concentration of 109 colonyformingunit/ml in saline. A rabbit was exposed to 20ml of the aerosolized suspension for about 120 minutes, and sacrified at 2 hours to 14 days after exposure.In the experiment, interesting findings were observed in palatine tonsils. That is, micropores of crypts in rabbit tonsils were similar in structure to those in human tonsils, and invading streptcocci and cell débris-like masses were observed in the micropore of a crypt. On the other hand, adherence of streptococci were observed in buccal and pharyngeal mucous membranes, but invading lesions were not. And disarrangement of cilia and decrease in number of cilia were observed in tracheas, but invading lesions were not, as well.These data suggest that the micropores of the tonsillar crypts play an important role in the initial focus of invasion of group A streptococci.

いん頭炎に対するＡＺ‐Ｓ錠の臨床評価 アズノール錠との二重盲検比較試験

In order to evaluate the efficacy of AZ-S tablets (GASN 5mg) on pharyngitis, a double blind test was performed with AZ-U gargle tablets (GASN 2mg) as a control. The subjects were 45 patients with pharyngitis for AZ-S and 48 for AZ-U. All the AZ-S tablets were administered into the labiogingival region of the upper jaw.1. AZ-S tended to be more effective for spontaneous pain and reddness of the pharyngeal mucous membrane than AZ-U (p<0.10). AZ-S was significantly more effective for swelling and discomfort in the pharynx (p<0.05).2. Pharyngitis was cured in significantly shorter periods with AZ-S than with AZ-U (p<0.05).3. Overall efficacy tended to be superior with AZ-S tablet (p<0.10).4. No obvious side effect attributable to AZ-S or AZ-U was observed.5. From the above results, AZ-S tablets administered into the labiogingival region of the upper jaw was considered to be more effective for pharyngitis than AZ-U gargle tablets.

The localization of IgA and IgE globulins in the palatinal tonsils, nasal mucous membrane and nasal polypi.

Using the immunofluorescence method, the localization of IgA and IgE globulins was studied in tonsillar tissue, nasal and pharyngeal mucous membranes and nasal polypi of patients hospitalised at the Clinic of Otorhinolaryngology. No difference in either localization and number of cells containing blood and/or secretory IgA globulin could be found in individual patients. Great amounts of IgE globulin were found in nasal mucous membrane and nasal polypi in subepithelial plasma cells even in patients without demonstrable allergy.

Discussion on the Extrinsic Factors of Pharyngeal Fistulae in Complete Laryngectomy Cases and Its Preventive Measures

The procedures in our laryngectomy cases are classified into two groups, A and B: A-1) preoperative radiation. 2) I or T like skin incision, 3) preservation of hyoid bone, 4) closure of pharyngeal wall with continuous sutures, 5) use of a feeling tube through nose, 6) postoperative radiation, B-1) U like skin incision (not irradiated preoperatively), 2) neck dissection, 3) resection of hyoid bone, 4) closure of pharyngeal wall with interrupted sutures, 5) oral nourishment on the third day after operation, 6) postoperative radiation.Occurrence of the fistula-formations in our laryngectomy cases is 30% in A group and nothing in B.If antibiotics are thorughly administered against secondary bacterial infection, we mention the other causative factors as follows: preoperative radiation, conditions of sutured would in pharyngeal wall, preservation of hyoid bone, nourishment by tube, formation of dead space, method of skin incision and closure of pharyngeal opening and procedure to crico-pharyngeal muscle. Refering to literatures, each factor in analyzed about our laryngectomized cases.To attain the successful postoperative course, following methods are recomended: U like skin incision, resection of hyoid bone, reduction of tension on the upper lateral portions of pharyngeal opening. The pharyngeal opening is closed with interrupted inversionssutures. Inferior pharyngeal constrictor muscle is sutured but in patient with convulsive constitution, cricopharyngeal muscles are extended or cut off operatively External of the neck muscles should be redically removed.If pharyngeal mucous membrane is too small to close it primarily, after detachment of posterior wall of pharyngeal mucous membrane from the prevertebral fascia, submandibular glands and external of the neck muscles are used.In avoiding formation of the dead space, mattress suture and pressure dressing are recommended. In neck dissection cases, drain is introduced into the bilateral mandibular angle not deeply and removed the next day.Pressure dressing is not changed for three days after operation. The patients are not nourished by the feeding tube. control urinary volume and its specific gravity and the patients are nourished solenly parenterally (glucose, aminoacid, vitamine preparations and sometimes blood transfusion). On the third day, nourishment is given orally. Problem of feeding posture is of importance and to prevent postoparative pneumonia, early ambulation is recommended. The broad spectrum autibiotics, to which pyogenic cocci have no resistance, are administered for two weeks at least.By the treatment above mentioned, complete primary healings of operative would be accomplished, postoperative radiotherapy is started three weeks after and all tumor dosis is irradiated to the directions of tumor invasion and the probably disseminated site. When operating the patients irradiated preperatively, owing to the volume and direction of irradiation, the time of operation may be decided. But the duration is not yet standardized. We have consideration to the point that the contralateral neck dissection by Seiffert's skin incision is necessary some other time.

AKUTER HYPERPARATHYREOIDISMUS

ABSTRACT A case of a 38 year old male patient is described who was admitted because of severe vomiting and signs of incipient renal insufficiency. Except for a low specific gravity of the urine and an elevated NPN there were no findings compatible with the diagnosis of acute or chronic nephritis or nephrosclerosis. Several months previous to the admission he complained of severe thirst accompanied by a peculiar dryness of the pharyngeal mucous membranes suggesting the diagnosis of hypercalcaemia, which incidently proved to be correct. Values of up to 19.3 mg/100 ml were estimated. At this time the nephrocalcinosis had already progressed so far that a few days later the patient died as the result of renal failure. The possible aetiologies of this acute illness are discussed. There is sufficient evidence for believing that the suppression of the fluid intake and the intravenous calcium injections were the causative factors in this case.

The Observation of Epidemic Specific Type of Acente Pharyngitis

Between the period of Sept. to begining of Nov. 1962, acute catarrhalic oedematic inflammation of pharyngeal mucous membrane, localized at arcus palatopharyngeus, arcus palatoglossus and uvula were observed in our clinic. Some of them had thin pseude membrane on the epipharynx or the back surface of the uvula. They were treated with the antibiotics at the department of Otorhinolaryng. of the Japanese National Railways Hospital in Osaka, especially in the Umeda branch hospital (Umeda. 54 cases in total 63 cases). The circumstance of occuring, condition, process and treatment of this disease were discussed and we have advanced that was a specific type of epipharyngitis.

Inoculation of Human Volunteers with Parainfluenza Virus Type 3

In an attempt to see whether parainfluenza virus type 3 would produce illness in adults, 28 adult volunteer subjects were inoculated with either the virus or a sterile salt solution. Twelve of the 17 volunteers inoculated with the virus, and none of the 11 who received the placebo inoculum, developed laboratory evidence of infection with parainfluenza 3 virus. Nine of the virus-inoculated volunteers and only 1 of the 11 in the contratested group developed an acute respiratory illness. However, 3 of the 9 virus-inoculated subjects who became ill failed to demonstrate laboratory evidence of infection with parainfluenza 3. The afebrile, coldlike illness observed in the 6 infected volunteers was characterized by mucoserous nasal discharge, nasal obstruction, sneezing, dry cough, and erythematous nasal and pharyngeal mucous membranes. The mean incubation period was 2.2 days.

On Histology and Sensory Nerve Supply of Larynx in Flying-squirrel

The epithelium of the laryngeal side of the epiglottis of flying-squirrel is a stratified flat epithelium much thinner than that on its lingual side, but near its median line, it is a 5-6-rowed ciliatated epithelium. No papillae are formed beneath this stratified flat epithelium, as are found on the lingual side of the epiglottis. Taste-buds are found on the lingual side alone in small number. The mixed glands are well developed in the median and the peripheral parts of the laryngeal side. The epiglottic cartilage is of hyaline nature and forms one integral plate.The ventriculus laryngis forms a huge laryngeal sac, which reaches the inner surface of the thyroid cartilage on the ventral side, juts out toward the pharyngeal mucous membrane on the dorsal side, reaches the vicinity of the hyoid bone beyond the upper border of the thyroid cartilage on the cranial side and extends down to the upper end of the trachea on the caudal side. The sac is generally lined by a one-rowed cubic epithelium and partly by a 2-rowed cylindrical epithelium. The propria is very ill developed and mixed glands are found only in a limited area.The vocal cord consists in the main of 2-rowed stratified flat epithelium and a thin propria, but their ventralmost part alone is covered by a 2-3-rowed cylindrical or ciliated epithelium. The ventral one-third of the pars intercartilaginea of the rima glottidis is composed of a 2-rowed flat epithelium and a thin propria, but its dorsal tow-thirds are of a 2-3-rowed ciliated epithelium and subepithelial connective tissue gradually gaining in thickness dorsalwards and containing some mixed glands. The lower part of the larynx between the rima glottidis and the entrance to the trachea is composed of a 2-3-rowed ciliated epithelium and a subepithelial connective tissue layer containing mixed glands.The laryngeal mucous membrane of flying-squirrel is supplied with sensory fibres as in man, dog, goat and rabbit, but much less abundantly than in these, the submucosal and the proprial plexus found very well developed in these mammals being much inferior in flying-squirrel. The sensory nerve terminations are also much simpler in formation, no such corpuscular terminations or complex branched terminations as found in the above animals being ever to be found here.The sensory terminations found in the laryngeal mucous membrane of flying-squirrel are of unbranched and simple branched types formed either subepithelially or intraepithelially. Most primitive subepithelial unbranched terminations are found everywhere in the mucous membrane and in the laryngeal sac in particular most of the terminations are of this type, found here and there in sporadic existence. Thus, the sensory supply to the laryngeal sac may be called very poor in general, but near the entrance of the ventriculus laryngis subepithelial and intraepithelial simple branched terminations are not rare either. The terminal fibres of these terminations are sometimes comparatively thick and sometimes run wavy courses.The laryngeal side of the epiglottis is richest in sensory fibres, rather complex branched ones being found among their terminations, especially near its median line. Branched terminations with several terminal fibres are not rare here and some complex intraepithelial branched terminations are present, but the terminal fibres are usually medium-sized or thin, showing not much change in size. In the peripheral parts of the laryngeal side of the epiglottis, the sensory fibers are fewer and their terminations are simpler, but in these parts, simple brached terminations originating in thick fibres may be observed. Terminations formed by extraordinarily thick fibres, as found in man and rabbit, are never found in flying-squirrel.Sensory terminations are found on the border part between the laryngeal and the lingual sides of the epiglottis but their number decreases rapidly as we pass over into the lingual side

On the Nerve Supply of Pharynx and Oesophagus of Snapping Turtle

It is of interest that, in the mucous membrane of the pharynx of Japanese snapping turtle, my so-called pharyngeal papillae resembling the lingual papillae may be found in quantity. The epithelium covering them is of an unhornified stratified flat type and the subepithelial connective tissue lacks mucuous glands. Longitudinal mucous folds are in formation in the oesophagus, covered by a stratified cylindrical epithelium and containing intraepithelial mucous glands. The lamina muscularis mucosae is absent; the tunica muscularis consists of an inner layer of longitudinal striated muscle fibres and an outer layer of circular smooth muscle fibres, but the former is formed only in the lateral sides of the oesophageal wall.In the pharyngeal papillae, as in the lingual, well-developed nerve plexus composed of numerous sensory fibres and vegetative fibres is in formation. Small ganglia are found in this plexus as well as well as in the submucosal and the proprial plexus in the vicinity of the papillae. The ganglion cells in these ganglia are of sympathetic nature showing weak multipolarity but many of them are apparently apolar. The vegetative fibres end as always in STOHR's terminal reticula in the pharyngeal mucous membrane of snapping turtle too.No corpuscular or complex branched termination but only unbranched and simple branched terminations were found here. These are formed in the stocks of the pharyngeal papillae usuall beneath their epithelium, and originate mostly in medium-sized medullated fibres. Their terminal fibres run either nearly straight or looped courses and usually end sharply, but not rarely some end in small endknobs. Intraepithelial fibres are demonstrable in a very small number and are very poorly developed, penetrating only as far as into the basal layer of the epithelium before ending.My so-called perioesophageal plexus formed in the adventia of the oesophagus, interestingly enough, contains small ganglia in some places. AUERBACH's plexus rich in ganglia is found between the outer and the inner muscle layers and MEISSNER's plexus in the submucosa, and what is of highest interest is that ganglion cells are found in the MEISSNER's plexus here in a much larger quantity than in man and mammals.It is needless to reiterate that the ganglion cells found in these plexuses are of sympathetic nature as those in the pharyngeal mucous membrane above and here too the fine vegetative fibres participating in the composition of these plexuses form STOHR's terminal reticula as their terminations.A rather large number of thick sensory fibres are found in the plexus of the oesophagus too. Most of these run from the submucosa into the propria and end there, mostly beneath the epithelium. Their terminations comprise no such corpuscular or complex branched types as found in the human oesophagus, but only unbranched and simple branched (chiefly bifurcated) types, as in the pharynx, with terminal branches ending sharply or bluntly but never forming such end-knobs or intraepithelial fibres as found in the pharynx. Thus, the sensory fibres found in the oesophagus of snapping turtle are far poorer than the same in its pharynx, in quantity as well as in terminal mode.

The topical temperature of clinically normal nasal and pharyngeal mucous membranes.

The proper preparation of inspired air for acceptable use by the lungs constitutes one of the more important functions of the nasal cavity. Inspired air, during its brief passage through the nasal cavity, is rapidly subjected to a threefold process of cleansing, moistening, and temperature adjustment. In terms of the latter, heating of inspired air depends on an intricate system of blood vessels and cavernous spaces in the turbinal and septal mucous membranes. This vascular network—the blood vessels are described as lying in parallel rows much like a radiator 1 —has the ability to dilate or constrict in response to the need for thermal variations and fluctuations. Actually, a thermostatic apparatus for the efficient heating of inspired air is set into motion when heat is radiated from the blood vessels in the turbinal and septal mucous membranes. Nasal temperature has been variously estimated to run anywhere from 30 C (86

Effect of ether anesthesia and of drug-induced sleep on development of inflammation of the pharyngeal mucous membranes of rabbits

Effect of ether anesthesia and of drug-induced sleep on development of inflammation of the pharyngeal mucous membranes of rabbits

The buccal and pharyngeal mucous membrane in urodeles

SummaryHistological investigation of the buccal and pharyngeal mucous membranes of Triturus vulgaris, Salamandrina perspicillata, Aneides ferreus, Aneides flavipunctatus, Aneides lugubris, Desmognathus, fuscus, Eurycea bislineata and Hydromantes genei suggests that gular vibrations are not concerned with gas exchange but with the sense of smell. They should not be interpreted as respiratory.

Treatment of complete unilateral bony atresia of the posterior nares; a new technique and a brief reference to asphyxia neonatorum.

THE PURPOSE of this paper is to describe an approach, different from any thus far employed, in the treatment of a case of unilateral bony atresia of the posterior nares. This procedure is comparatively simple. It is not destructive to the extent that normal structures are sacrificed to attain a proper result and it enables covering the bare bony surface with mucous membrane to prevent the closure of the newly formed opening. The nasal and pharyngeal mucous membranes covering the bony atresia are utilized to cover the bare bony rim of the posterior nares after the bony atresia has been removed. The entire operative field can be clearly visualized because proper exposure is obtained. The same technique can also be applied in cases of bilateral atresia. In cases in which a deviated septum is obstructing, a submucus resection can be combined with this procedure. It is not recommended for choanal

Treatment of the Cleft Palate By Osteoplastic Urano-Staphyleo-Pharyngoplasty

The auther reported the new osteoplastic treatment of the cleft palate which can be rendered effective by pharyngoplasty.Osteoplastic uranoplasty which can be reduced to the subperiostal resection of the palatine process and pharyngoplasty, briefly the partial resection of the pharyngeal mucous membrane consisted of 1cm. in width from posterior palate arch to posterior palatine arch, are the most logical approach to the cleft palate.The disturbance of speech of the cleft palate is promptly controlled by this surgical procedure.

CARCINOMA OF THE ORAL CAVITY

Carcinoma of the oral and pharyngeal mucous membranes comprises 3 per cent of all cancer and accounts for approximately 3,700 deaths yearly in the United States registration area. It is usually considered accessible cancer as contrasted to similar disease of the internal organs; yet the five year survival rates for it in this location are no better than for disease in some of the more inaccessible organs, such as the cecum and the large intestine. There are only a few large centers throughout the country limiting their work to the treatment of cancer and therefore it is treated for the most part in general hospitals. The excellent detailed reports from such specialized institutions as the Memorial Hospital of New York City are well known but perhaps do not give as clear a picture of the results obtained in a general hospital as might be desired. Our purpose in this communication

VINCENT'S DISEASE OF THE SKIN

This is a report of the case of a patient suffering from Vincent's disease, with lesions affecting the feet, the corners of the mouth, the gums, the tongue and the tonsillar and pharyngeal regions. Vincent's infection of the gums in its chronic form is regarded as fairly common. Acute forms affecting the gums and the tonsillar and pharyngeal tissues and even extending to the bronchi and lungs have been recorded. Cutaneous lesions due to fusospirochetal infection have been encountered but in only a comparatively few instances. An interesting series of cases of acute fusospirochetal angina is that of Goldman and Kully,¹who reported 7 cases of its occurrence in Negroes with lesions of the buccal and pharyngeal mucous membrane, all of which were fatal. Two of the patients had positive serologic reactions, while 3 had cutaneous lesions, ranging from erythematous patches to bullae

INFECTION OF LYMPHOID TISSUE OF THE PHARYNX AND OF THE CONJUNCTIVA

The anatomic structure of the pharyngeal mucous membrane is characterized by the ample occurrence of lymphocytic elements. They appear singly or in aggregations and in certain nodular formations, which are called lymph follicles. Regular arrangements of such follicles are called tonsils. No matter whether they represent real tonsils or other aggregations of lymphoid tissue, they are homogeneous formations with identical histologic structures, in their entirety called the lymphoid apparatus of the pharynx, and they act alike both in anatomic and in pathologic respects. The acute inflammation of this lymphoid apparatus is called tonsillitis, or angina, the latter name being more comprehensive than the former. The same kind of lymphoid tissue is present in the conjunctiva of the eye. It appears after the third month of life and is rather thin, in accordance with the minor thickness of the conjunctiva, forming a superficial adenoid layer over the conjunctiva and showing its

EFFECT OF CIGARET SMOKE ON THE pH OF THE THROAT

Despite the fact that the annual consumption of cigarets by the American public has been continually increasing, little substantial scientific research on the effect of cigaret smoke on the upper respiratory tract of normal persons has been recorded in the medical literature. Recently, the role of the hygroscopic agent—glycerin or diethylene glycol—in irritation of the respiratory tract has received some interest. Various approaches to the problem have been used in the published reports. Mulinos and Osborne 1 and Haag 2 studied the edema-producing properties of smoke solutions in the conjunctival sacs of rabbits. Flinn 3 and Ballenger and Johnson 4 made clinical observations on irritation of the pharyngeal mucous membranes. Holck and Carlson 5 used the salivary response as their index of irritation. All these investigators used glycerin-treated cigarets and diethylene glycol-treated cigarets. EXPERIMENTAL INVESTIGATION In this study I have utilized a silver-silver chloride glass electrode in conjunction with the Coleman electrometer for the purpose

DECUBITAL ULCERS OF THE PHARYNX

Heryng 1 (1890) was the first to describe, under the title Benign Ulcers of the Pharynx, a condition characterized by the following signs: It occurs usually unilaterally, always in the shape of an oblong shallow ulceration or deep excoriation, and always on the anterior pillar over the tonsil. The margins are sharp, the floor in the beginning covered with a gray-white coating which can be removed by scraping. The surrounding mucous membrane is reddened. It does not bleed when touched and is rather indolent. It never originates from vesicles or pustules by confluence (Herpes, Pemphigus) and remains always solitary, and never are similar changes to be found on other places of the pharyngeal mucous membrane. After two to three days' duration red granulations appear on the floor of the ulceration. The papillary layer clears and from the edges the new epithelium proceeds toward the center, the coating disappears and after ten

ACUTE ABSCESS OF THE LYMPH FOLLICLES OF THE CONJUNCTIVA

Concerning pathologic involvement of the lymphoid tissue of the eye, there is still much unknown. One is more familiar with the normal anatomic picture. 1 The lymphoid tissue is found in the superficial adenoid layer of the conjunctiva and is formed only in the third to the fourth month of life. It is thin, and the main formation is in the fornix. It consists of a fine connective tissue reticulum in the meshes of which the lymphocytes are embedded. These lymphocytic aggregations consist, as everywhere in adenoid tissue, for example, the pharyngeal mucous membrane, of two types : simple diffuse gatherings of lymphocytes without special structure and, less frequently, collections of lymphocytes in the shape of nodules, called lymphatic nodules or (secondary) lymph follicles. These lymph follicles, if typically formed, consist of a lighter inner zone with large cells which take a lighter stain and an external darker zone consisting almost