Jun Ogino

病原菌発育抑制性α-レンサ球菌の口腔内定着状況と喫煙, 含嗽の及ぼす口腔細菌叢への影響について

We investigated the distribution of oral alpha-streptococci with inhibitory activity against pathogens, which compose an oral defense mechanism. Detection rate of alpha-streptococci with inhibitory activity against S. pyogenes and S. aureus derived from the tonsil was higher than in other portions, the tongue, cheek, gingiva, or saliva. It has suggested that tonsillar bacterial flora are mainly a defense mechanism. The oral flora in healthy smokers was compared with healthy non-smokers to investigate the influence of tobacco on oral bacterial flora. The results showed that the detection rate of S. aureus in smokers was higher while that of alpha-streptococci with inhibitory activity against S. aureus was lower. However, the detection rate of alpha-streptococci with inhibitory activity against S. pyogenes in smokers was as high as in non-smokers. It is suggested that it was easy for S. aureus to adhere to the oral mucosa in smokers, and was considered to influence the strain which produces beta-lactamase for medical treatment. We investigated the influence of gargling on oral bacterial flora by comparing the amount of bacteria before and after gargling with popidine-iodine gargle and saline solution. It was shown that alpha-streptococci, a main component of normal oral flora were decreased after gargling in both smokers and non-smokers. Furthermore, it was shown that group A Streptococcus was not decreased after gargling, and it was concluded that use of gargle medicinal mouth wash in bacillus carriers should be studied further.

[Participation in causing O.M.E. with nasopharyngeal alpha-Streptococcus].

The role of normal pharyngeal flora in the defense mechanism against infections in the upper respiratory tract was studied in 50 children with otitis media with effusion (O.M.E.). In the bacteriological study of the nasopharynx, the incidence of H. influenzae, S. pneumoniae, S. aureus, M. catarrhalis and group A Streptococcus was about 46%, 24%, 20%, 12% and 8%, respectively. The incidence of these species in the cases with O.M.E. was higher than that in the cases with chronic tonsilitis or control cases. In 41 O.M.E. cases with alpha-streptococci (82%), the incidence of alpha-streptococci with inhibitory activity against 5 pathogens (H. influenzae, S. pneumoniae, S. aureus, M. catarrhalis, group A Streptococcus) was examined. The detection rate of alpha-streptococcal strains with inhibitory activity against 5 pathogens derived from the nasopharynx in the cases with O.M.E. was significantly lower than that of the strain in the chronic tonsilitis cases and the control cases. Moreover, the detection rate of inhibitory alpha-streptococci from the nasopharynx was lower than that of from the tonsil. These findings suggest that the decline of inhibitory activity against pathogens by normal flora in nasopharynx is one of the factors causing O.M.E.

Carcinosarcoma of the Parotid Gland; A Case Report

True malignant mixed tumor, or carcinosarcoma, of the salivary glands is exceedingly rare. We present a case of parotid gland carcinosarcoma occurring in a 57-year-old male patient. His chief complaints were pain and swelling in the left parotid region and difficulty in his mouth open. Despite intensive irradiation, chemotherapy and total parotidectomy, he finally died of local tumor recurrence and distant metastases to the lungs approximately 14 months after the onset of the disease. The surgical specimens and tumor tissue obtained at autopsy revealed typical features of carcinosarcoma consisting of various epithelial and non-epithelial histologic components, including squamous cell carcinoma, undifferentiated carcinoma, chondrosarcoma, spindle cell sarcoma, fibrosarcoma and rhabdomyosarcoma. Immunohistochemical study of the tumor specimens also showed characteristic histochemical diversity and specific features of carcinosarcoma (Keratin, S100, NSE etc. were positive). Metastatic lesions in both lungs and pulmonary hilar lymph nodes showed the same histological patterns as the original tumor. These findings indicate that this tumor was a true malignant mixed tumor (carcinosarcoma) of parotid gland, as proposed by Batsakis and other investigators.

An analysis of emotional responses in children facing hospitalization and otolaryngologic surgery.

Children who are admitted to a hospital and undergo an operation frequently exhibit emotional responses such as anxiety about the unknown and thier pain, fear of isolation from their families, etc. At present, there are few research reports on the emotional response that children experience.With questionaires and interviews, we investigated the emotional responses of 210 children, who had received adenoidectomies, tonsillectomies and or tympanostomy tube insertions from 1981 to 1983.1) Emotional responses were most frequently observed in children aged 5 years or less, and they tended to decrease with age.2) Interactions between parents and children, and parents and physicians may be related to the appearance of emotional responses.3) Emotional responses were most frequent in children who received tonsillectomies, since this operation was more apt to operative pain.4) Postoperative conditions can also influence the appearance of emotional responses.We conclude that it is necessary to explain the disease and the operation to the parents and the child: special preoperative and postoperative care is required in younger children: and the proper use of premedication and postoperative pain relief are also necessary.