CLINICAL STUDY ON THE TONSILLAR FOCAL INFECTION (CHIEFLY ON RENAL FUNCTION BY CLEARANCE-TEST) By T. SAKAI From the Department of Otorhinolaryngology, School of Medicine Keio University (Director: Pro.T.Nishihata) Clinical studies, chiefly about renal function, on 97 patients with chronic tonsillitis and tonsillar focal infection (articular rheumatism 8, acute nephritis 14, and chronic nephritis 5) were done. In order to examine the renal function by clearanee-test, Renal Plasma Flow (RPF) was mea- sured by Para-amino Hippurate-Clearance, and Glomerular Filtration Rate (GFR) by endogenous - -Creatinine-Clearance, and then Filtration Fraction (FF) was calculated. Cardiac function was studied by electrocardiogram. One mounth after the tonsillectomy, those renal and cardiac function were again examined. The results were as follows: (A) Impairment and recovery of the renal function (I) Group A; 65 cases of chronic tonsillitis without complication Renal function test on these caces showed impairment of RPF in 23 caces (35.4%), of GFR in 20 caces (30.8%) and of FF in 18 caces (27.7%). After tonsillectomy 88.3%, 92.8% and 73.3% of the abov caces reco-vered to normal.,(2) Group B; 5 caces of chronic tonsillitis with the history of nephritis Number of renal impairment caces was 4 in RPF (80%), 3 in GFR (60%) and I in FF (20%). Among those 66.6% and 66.6% showed recovery.
(1) From 80 to 100% of each gronp was a type of habitual tonsillitis. (2) The findings of the palatine tonsils were as follows: 1) cryptic (burried), 2) abherent, 3) the surface was uneven, 4) superior tonaillar fossa was. deep and filled with pus or plug, 5) local redness of anterior palatine arch, 6) swelling and pain, due to pressure of submaxillary lymph gland and 7) slight fever. Such symptoms were far lighter in group A than in other groups.
1) Alfred Tillich: Dtsch. Med. Wschr. 40: 1095, 1940. 2) Assman: Therap. d. Gegenw. 76: 104, 1935. 3) Billings: Arch. of int. Med. 9: 484, 1912. 4) Billings: Focal Infection. New York London: Appilton & Co. 1921. 5) Bohn: Zbl. f. inn. Med. 60: 251, 1939. 6) Cavazzuti: Zbl. f. H-N-O.47: 126, 1953. 7) Coldring and Chasis: Hypertension and Hypertensive Disease; Commonwealth Fund. N.Y.; 1944. 8) Gutzeit u. Para- de: Ergeb. inn. Med. u. Kind. 57: 613, 1939. 9) Maxwell: New York Med. 3. 116: 3, 1922. 10) Murply and Rastetter: 3.A.M.A. 111:668,1938. 11) Parade: Zschr. f. Klin. Med. 133: 395, 1938. 12) Passler: Verh. Dent. Ges. inn. Med. 321, 1909. 13) Popper, Mandel u Mayer: Zschr. f. Klin. Med. 133:56, 1938. 14) Richards: the Ph- ysiology of the Kidney, 1938. 15) Reilly. A Corn ptgnon, A. Laporte et. H. D. u. Buit: Le 10-60
@Žðˆä= G «a ƒš õ Ì Õ IŒ @62-2185 role du systeme nerveux en pathologie ronale. Paris 1942. 16) Reilly. L'irritation neuro-veg- tative et sonrole en pathologie. C.R. e Soc. Biol. 148:1374, 1954. 17) Rosenow: J.A.M.A. 65: 1687, 1915. 18) Rosenow: Arch. of. int Med. 28: 274, 1921. 19) Stahl: Med. Klin. 33: 1121, 1934. 20) Strauc: h Dtsch. Med. Wschr. 1 : 440; 1938. 21) Smith, H.W., H. Chasis and H.T. Ranges: Proc. Soc. Exp. Biol. & Med. 37: 726, 1938. 22) Smith, H.W.: the Kindy, Oxford Univ. Press; 1951. 23) Peters & Van Slyke: Quantitative Clinical. Chemistry, Inter pret 1937. 24) Volha-.rd: 1) å èˆø p. 25) Winkir. u. Baker: Arch.