Eino Vaheri

NASAL ALLERGY WITH SPECIAL REFERENCE TO EOSINOPHILIA AND HISTOPATHOLOGY

According to the opinion generally accepted at present, allergic illness requires six preparatory steps: exposure to an allergen, formation of antibodies, fixation of antibodies in tissues, re-exposure to the same antigen, release of histamine as a result of antigen-antibody union, and the effect of histamine on smooth muscles, mucous glands, and capillaries. The underlying basis of allergy is the increased permeability of the blood vessels and cells and a corresponding disturbance in the tissue fluid balance. This results in a localized oedema. Oedema and eosinophilia are patho-anatomical changes characteristic of the allergic reaction and they are found on the nasal mucosa of persons with nasal allergy. In these patients eosinophilia occurs also in the blood and in the nasal secretions. The exact role of the eosinophil in allergy is unknown, but it has been suggested that it is concerned with the disposition or elimination of foreign or broken-down protein in the blood and tissue. Code has shown that the eosinophil is a carrier of histamine, but it is not known whether it carries this substance to the tissues or away from them. The present article is a report of studies on 30 persons with allergic rhinopathy. Twenty of them had polyps in the nose; the remaining 10 were typical cases of allergic rhinitis without polyps. In each case the blood picture and the eosino-

Malignant Tumours of Paranasal Sinuses

The study is based on 121 cases of tumour treated during the ten-year period 1945–54 at the Otolaryngological Clinic in Helsinki. According to site of origin, three groups were distinguished: tumours of the maxillary sinus (80 cases), the maxilloethmoidal region (39), and frontal sinus (2). There were 110 carcinomas (91 %), and 11 sarcomas (9 %). Of the carcinomas, the most frequent type was the spinocellular, and in addition there were anaplastic, basal cell, and adenocarcinomas. All cases were given combined operative and radiation treatment. Electrosurgery was employed in most cases. Instead of ligation of the external carotid artery, temporary compression with an arterial clamp was successfully used in a great number of cases during the operation.The five-year survival rate was 26 % for the maxillary sinus tumours, 23% for maxilloethmoidal tumours, 27% for carcinomas, and 18% for sarcomas.

Teleangiectatic Polyps Developing in the Nasal Mucosa During Pregnancy

A teleangiectatic polyp of the nasal mucosa is a tumour-like formation resembling histologically a hemangio-endothelioma. However, it is not a true neoplasm but a polyp (polypus teleangiectodes) rich in dilated blood vessels. It develops in hyperemic mucosa. The series studied consisted of 5 male and 16 female patients. Eight of the women, or 50 per cent, were pregnant in the latter half of pregnancy.

Foreign Bodies in the Lower Respiratory Tract: A Statistical Review

The material includes 65 suspected and 155 verified cases of foreign bodies in the lower respiratory tract treated at the Department of Otolaryngology of the Helsinki University Central Hospital in the years 1948 through 1962. The percentage of male cases was 57. The majority of patients were children under school age (80 per cent). Less than two-thirds of the foreign objects were of organic origin. Most frequently it was a nut or seed, the next common group was made up of needles. An ample half of the foreign bodies were located in the main or stem bronchi, the ratio right: left being 76/39. Classic symptoms: dyspnea and attacks of coughing, and the more so the upper the location of the foreign object, were present each in about 60 per cent of the total material. Half the patients were free from symptoms when admitted to hospital, one-fourth were affected by evident dyspnea and only in 4 per cent an emergency was concerned.Removal of the foreign body was successful by endoscopy in 92 per cent (143 cases)...

Zur Klinik und Pathogenese der Stinimlippenpolypen

Summary.The report comprises 19 cases of solitary polypi of the vocal chords. 14 of the cases were men and 5 women. They were mostly situated in the medial third, more seldom in the anterior third and only in one case in the posterior third. The polypi of the vocal chords represent as other polypi a hyperplasia of the subepithelial tissue and develop on the basis of an inflammation, as sequelae to laryngitis, probably from a fold or swelling of the mucous membrane, and very often already in the subacute stage of the laryngitis.Characteristic for their histological structure are loose tissue, containing much oedematous liquor, abundant vascularization and blood suffusions of different age. When the walls of the blood vessels are thin and stagnation is present, blood suffusions will easily appear, and the polypus will be squeezed between the vocal chords. The increase of the polypi is chiefly due to stagnation and suffusions, and is consequently at least partly of mechanical origin.

Experience with Mediastinoscopy

A total of 150 mediastinoscopies have been performed at the Otolaryngological Hospital, Helsinki University during a period of six years. Biopsy specimens were taken in 117 cases: in 93 from the superior mediastinum and in 24 from the middle mediastinum. Pre- and post-mediastinoscopic diagnoses are compared and so me special cases described in greater detail. The series include 10 cases with the superior vena cava syndrome; it was due in 9 cases to metastases from carcinoma and in one case to reticulum-cell sarcoma.

Mandibular Reconstruction with Tubed Pedicle Graft and Steel wire mesh in a case of Chondrosarcoma

A case of very extensive, recurrent chondrosarcoma of the mandible is described. Appraisal of malignancy on the basis of the histological appearance can be extremely difficult in such cases. Because of the exceptionally large tissue defect it was necessary to use a tubed pedicle graft for mandibular reconstruction. A steel wire mesh was placed inside the tubed pedicle.

Acute and chronic scarlatina otitis

The present investigation colriprises 2,606 cases of scarlet fever. Suppurative middle ear infections occurred in 528 patients, or in 20.3 %. Otitis is, next to nasal infections and lymphadenitis, the comnionest complication to scarlet fever. In 34.5 % of the cases the otitis was bilateral.Nasal infections are very common, and run a relatively protracted course, in scarlet fever patients. They begin either simultaneously with scarlet fever or, still more often, during its later phase.The numerical and relative frequencies of otitis cases are highest driring the winter and spring months and lowest in summer.The number of otitis patients and the relative frequency of ear infections were highest in children under 5 years, and decreased with increasing age of the patient. Also bilateral otitis occurred most frequently in infants. The relative frequency of early otitides (beginning within the two first weeks) is highest in the older age groups, and of late otitides in children under 5 years. In persons over 15...