FOCAL INFECTIONS' FROM CHRONIC SINUSITIS
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概要
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The experimental animals used in this study were rabbits.Chronic sinusitis was produced ina the animals by infusing bacteria and egg-white albumin into the paranasal sinus over.long period of time.These phlogistic substances were also injected into the blood to produce pathologic conditions in the heart and kidney.Subsequent observations on the above phenomena have led to thefollowing conclusions:1)Infusion of bacteria into the paranasal sinus of rabbits over long period of time results:in cardiac and renal dysfunction.The dysfunctions occur in a higher incidence and severity in sensitized groups than in unsensitized groups.In proportion to the this, the agglutination test of serum for bacteria is positive.Histological study of the mucous membrane of the paranasal sinus, shows allergic reaction and also inflammatory reaction.2)Repeated injection of egg-white albumin into the paranasal sinus over long period of time produces cardiac and renal dysfunction like those mentioned alove.The pathologic changes aresimilar to those which follow to the repeated infusion of egg-white albumin into.the blood over a.period of time.The mucous membrane of the paranasal sinus shows allergic tissue reaction.3)In the cases with cardiac complications, the electrocardiograms show depressed ST segment in most of the cases.Low and flat T waves are occasionally seen.Histologically, myocarditis interstitialis is noted together with myocarditis parenchymatosa.The electrocardiographic finding, and the histologic picture are approximately in parallel relationship with each other.4)In the kidney, dysfunction mostly develops in glomeruli and renal tubules.Appearance. of albumin in urine is consistent with the dysfunction.Histological study shows glomerulonephritis accompanied by nephritis tubularis.Results of renal function test are approximately in parallel, relationship with the histological findings.5)Injection of bacteria into the blood over long period of time results in cardiac and renal disturbances similar to those mentioned above.Myocarditis interstitialis and nephritis tubularis attributed to the direct injury by bacterial toxin are produced, and myocarditis .parenchymatosa" and glomerulonephritis attributed to allergic mechanism are also produced.The agglutination test.of serum for bacteria is at first negative but later becomes positive.6)During the cardiac and renal disturbances secondary to bacterial sinusitis, no bacteria could be demonstrated in the heart or kidney.Killed bacteria injected into the blood induced the identical disturbances with those induced by the injection of viable bacteria.This fact suggests that in focal infection what is absorbed is not bacteria themselves but their toxin.7)The bacterial toxin so absorbed is presumed to directly injure the heart and kidney on onehand, and on the other hand to become allergen for allergic reaction, thus damaging tissues.8)In the histological pictures of the heart and kidney, the pathologic changes are relatively mild and do not seem to be irreversible.This fully explains the clinical experience that secondary diseases to focal infection are reversible by removing the primary focus.
- 一般社団法人 日本耳鼻咽喉科学会の論文