Studies on the Tonsillar Focal Infection By Katsuko Hisamochi Department of Otorhinolaryngology (Director Prof. I. Hiroto, M. D. ) Kurume University S
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1 Studies on the Tonsillar Focal Infection By Katsuko Hisamochi Department of Otorhinolaryngology (Director Prof. I. Hiroto, M. D. ) Kurume University School of Medicine Clinical observation in combination with the electrocardiographic, serological, bacteriological and histological examinations on 100 cases of chronic palatine tonsillitis being complicated by the development of tonsillar focal infection or being suspiciously so and on 65 cases of simple chronic palatine tonsillitis were made before and after the removal of the tonsils. The patients were divided into two groups, one of which had preoperative treatments and the other had no treatment, immediately before the operation, and the data obtained from the two groups were compared. The paper mainly dealt with the interrelations between the results obtained by the above mentioned examinations and also with the diagnosis and treatment of tonsillar focal infection. 1. The electrocardiographic examinations revealed that in the treated group the occurance of temporal aggravation of cardiac symptoms after the tonsillectomy was less frequent and the postoperative improvement was more frequent in the treated group in comparison with the untreated one. The results may be indicative of the effect of preoperative treatment. 2. Among the pharyngeal and intratonsillar bacilli of the patients, Streptococci haemolyticus were most frequently found and Streptococci viridans the next. The Streptococci viridans in pharyngeal area were especially abundant in the infected tonsils and were decreased in number by the treatment. In the cases having complication of the heart diseases Streptocci viridans were abundantly found in the patient's tonsils. In a few cases having tonsillar focal infection, the cultures of the blood after the tonsillectomy were positive for Streptococci viridans. 3. Histological changes of the infected tonsils, even those taken from younger patients, were marked. The alterations of the crypts were conspicuous in the infected tonsils and consisted of a mixture of chronic and acute inflammations. The bacterial masses in the crypts were numerous in the infected tonsils, especially of untreated group. The cystformation, the intramural embedding and the atrophy of lymphatic follicles were more frequently found in the infected tonsils than in the uninfected ones. 4. The change of CRP was more sensitive than that of Antistreptolysin titer but both of the two underwent in parallel. The two reactions in the treated group more quickly became negative than those in untreated group. 5. The effect of tonsillectomy on the focal infection was prominent when the operation was perfomed within three years after the onset of the complication. An adequate and effective. preoperative treatment, a careful operation and a sufficient postoperative treatment should be given to the patients for preventing them from the temporal aggravation of the secondary diseases after the tonsillectomy. The removal of the infected tonsils is considered highly beneficial for the treatment of the focal infection, since it completely cuts out the cause of the recurrance of tonsillitis by which the focal infection is progressively aggravated at each time. (author's abstract)
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This report shows innovation of competency of our faculty of social welfare. The aim of evaluation competency is improvement in the Social welfare education effects, by understanding of studentʼs development
1) Heinz Virchow Arch. 122, 100 (1890). 2) Huber: Virchow Arch. 126, 240 (1891). 3) Ehrlich u. Lindenthal: Z. Klin. Med. 30, 472 (1896). 4) Schwalbe, E. u. Solley, J. B.: Virchow Arch. 168, 399 (1902).