Data of 27 signs, symptoms or findings were collected on 125 confirmed cases of Meniere's disease. Statistical association, plus the percentage prevalence of these findings were studied to perform a cluster analysis. These findings were used to obtain a statistical picture of the disease in terms of the recorded variable (signs, symptoms and findings). The major finding was the existence of a group of variables (a central core) of high percentage occurrence. They consisted of intermittent rotational vertigo, intermittent to constant nerve hearing impairment, tinnitus, pressure in the ears, positional vertigo, nausea, abnormal caloric nystagmus, headache and normal laterotorsion. The first four are the classic criteria of Meniere's disease, the remainder are additions. The average patient had 8 of the 9 conditions; 44% had all 9. A graphic multi‐factor analysis of the signs, symptoms and findings suggests that these patients had a disease of a specific central origin. An alternative suggestion is that of several closely related diseases arising from adjacent central locations. No indication was found that influenza, hypertension, arteriosclerosis or diabetes were consistent precursors of Meniere's disease. Spontaneous, positional, gaze and optokinetic (tracking) nystagmus showed no demonstrable relationship to the Meniere's signs and symptoms. They showed the ordinary population prevalence except for spontaneous nystagmus which was slightly higher. The possibility of using these associations as a guide for correlation of the disease manifestations with neuroatomic tracts and areas is suggested.

There is a saying attributed to Voltaire which states that "the more things become similar the greater the variations they develop." This saying holds true when hereditary hearing impairment is considered as a disease since there are multiple variations. Hereditary hearing loss may start anywhere from infancy to middle age and may develop as a high tone loss or be as severe as subtotal deafness. In some kindreds it may affect half of each generation as the result of a pure dominant. In other families, little understood genetic patterns with sex-linked variance may occur. In still other families, there seems to be a random pattern to the appearance of the trait.

The LaryngoscopeVolume 79, Issue 7 p. 1275-1280 Article Diagnosis of early parkinson's disease†‡ David A. Dolowitz M.D., Corresponding Author David A. Dolowitz M.D. Salt Lake City, Utah2000 South Ninth Street, East, Salt Lake City, Utah 84106Search for more papers by this authorR. Jon Ord M.D., R. Jon Ord M.D. Salt Lake City, UtahSearch for more papers by this author David A. Dolowitz M.D., Corresponding Author David A. Dolowitz M.D. Salt Lake City, Utah2000 South Ninth Street, East, Salt Lake City, Utah 84106Search for more papers by this authorR. Jon Ord M.D., R. Jon Ord M.D. Salt Lake City, UtahSearch for more papers by this author First published: JulY 1969 https://doi.org/10.1288/00005537-196907000-00005Citations: 10 † Presented at the Meeting of the Western Section, American Laryngological, Rhinological and Otological Society, Inc., Pebble Beach, Calif, February 2, 1969. ‡ Department of Otolaryngology, Memorial Medical Center and Holy Cross Hospital, University of Utah, Department of Surgery. AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume79, Issue7JulY 1969Pages 1275-1280 RelatedInformation

The LaryngoscopeVolume 76, Issue 7 p. 1187-1200 Article Nystagmus versus laterotorsion in dose duration drug studies†‡ David A. Dolowitz M.D., Corresponding Author David A. Dolowitz M.D. Salt Lake City, Utah. From the Department of Surgery (Otolaryngology), University of Utah Medical SchoolUniversity Hospital, 50 North Medical Drive, Salt Lake City, Utah.Search for more papers by this authorT. G. Hiebert Ph.D., M.D., T. G. Hiebert Ph.D., M.D. From the Department of Surgery (Otolaryngology), Northwestern UniversitySearch for more papers by this authorR. J. Ord B.A., R. J. Ord B.A. Salt Lake City, Utah. From the Department of Surgery (Otolaryngology), University of Utah Medical SchoolSearch for more papers by this author David A. Dolowitz M.D., Corresponding Author David A. Dolowitz M.D. Salt Lake City, Utah. From the Department of Surgery (Otolaryngology), University of Utah Medical SchoolUniversity Hospital, 50 North Medical Drive, Salt Lake City, Utah.Search for more papers by this authorT. G. Hiebert Ph.D., M.D., T. G. Hiebert Ph.D., M.D. From the Department of Surgery (Otolaryngology), Northwestern UniversitySearch for more papers by this authorR. J. Ord B.A., R. J. Ord B.A. Salt Lake City, Utah. From the Department of Surgery (Otolaryngology), University of Utah Medical SchoolSearch for more papers by this author First published: July 1966 https://doi.org/10.1288/00005537-196607000-00003Citations: 1 † Presented at the Meeting of the Western Section, American Laryngological, Rhinological and Otologlcal Society, Inc., Pebble Beach, Calif., Jan. 28, ‡ This work has been supported by N. I. H. Grant Number NBO 04G20-03, G. D. Searle & Co., Parke, Davis & Company, Burroughs Wellcome & Co. (U.S.A.) Inc., Smith Kline & French Laboratories, and Pfizer Laboratories. AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Citing Literature Volume76, Issue7July 1966Pages 1187-1200 RelatedInformation

The LaryngoscopeVolume 76, Issue 8 p. 1380-1388 Article A study of cilia and connective tissue in normal and hyperplastic nasal mucous membrane†‡§ David A. Dolowitz M.D., David A. Dolowitz M.D. Salt Lake City, UtahSearch for more papers by this authorThomas F. Dougherty Ph.D. (By Invitation ), Thomas F. Dougherty Ph.D. (By Invitation ) Salt Lake City, UtahSearch for more papers by this author David A. Dolowitz M.D., David A. Dolowitz M.D. Salt Lake City, UtahSearch for more papers by this authorThomas F. Dougherty Ph.D. (By Invitation ), Thomas F. Dougherty Ph.D. (By Invitation ) Salt Lake City, UtahSearch for more papers by this author First published: August 1966 https://doi.org/10.1288/00005537-196608000-00008Citations: 2 † Presented at the 69th Annual Meeting of the American Laryngological, Rhinological and Otological Society, Inc., San Juan, P. R., April 20, 1966. ‡ From the Departments of Surgery (Otolaryngology) and Anatomy, University of Utah Medical School, Salt Lake City, Utah. § This study was supported by a grant from the George and Dolores Eccles Foundation and by Research Grant No. CA 02317-12 of the National Institutes of Health. AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Citing Literature Volume76, Issue8August 1966Pages 1380-1388 RelatedInformation

Fourteen years ago interest was aroused in a single kindred show­ ing hereditary nerve deafness. Studies to try and establish the mode of inheritance, and the anatomic location of the lesions have been attempted during this period. It was hoped that this information might give a clue to the physiologic pathology of hereditary nerve disease, and perhaps yield an approach to its treatment. The Mormon community presents a unique opportunity for the study of hereditary disease. Since it is an agrarian population, which does not move from its farms, its members can be relatively easily located. Because of this, a gene may be followed from a single polygamous male through generations of a rapidly expanding population.

The classical approach to problems of nasal pathology has been a study of the surface epithelium and its ciliary action, using the methods of Proetz.1Since nasal polyposis truly represents grapelike herniations of mucosa filled with intracellular-extracellular-bound fluid, a hole punched in a polyp will not permit water to be squeezed out. As the water is released from its bound form, fluid may ooze out slowly. Therefore, it seems proper to turn our attention to the connective tissue which contains this fluid. This is a relatively new field of study, and, while much is known, in order to discuss the use of endocrines in controlling fluid production and retention by ground substance, we have to rely on educated guesses. Connective tissue (Fig. 1) is composed of a ground substance matrix which embeds fibroblasts, histiocytes or primitive reticuloendothelial cells, lymphocytes, eosinophils, plasma cells, and mast cells. These are interspersed among

In 1951 we reported the genetically predictable occurrence of chronic renal disease with associated nerve deafness in a large family. 1,2 One hundred thirty-four members of the family were examined, and adequate clinical data were available concerning three of seven males in the family who had died of uremia in the recent or remote past. Of the 44 members involved, 43 had pyuria, 32 had hematuria, all had cylinduria, and for 17 of 32 studied, the urine cultures were positive for bacteria. Of 59 patients studied, 14 had abnormal audiograms. Five of those with hearing deficits showed no evidence of renal disease at the time of examination, but two of these were found to be carriers of the trait for renal disease in that the renal lesion was observed in their descendants. Microscopic sections from one postmortem examination showed severe, diffuse interstitial pyelonephritis with inflammatory infiltrate, microscopic abscesses, normal glomeruli,

A type of hypogammaglobulinemia is reported in which certain adrenal cortical hormones enhance the release of antibody. Analysis of our 48 cases showed two main types. First, a predominant type found in the hypolymphatic type of person described by Good. Second, a type found in a small number of cases, about 10% of persons with hyperplasia of the lymphoid tissue. The following study attempts to demonstrate that, despite the fact that adrenal cortical hormones are responsible for the inhibition of lymphocyte formation, they may raise the blood level of globulins by clinically significant amounts. In reviewing the series of hypogammaglobulin cases, we found one report of a mother and a newborn baby, both with marked hypogammaglobulinemia. The child developed pneumonia within the first day of life. The infection did not respond to antibiotics but, on being given gamma globulin, the child recovered promptly. In seeking an explanation of why only

Hereditary hemorrhagic telangiectasia is a vascular disease characterized by dilatation of arterioles, capillaries and venules into angiomata. These lesions are hereditary and the ectatic vessels frequently bleed spontaneously or after the slightest trauma. Although these lesions appear in all parts of the body, one of the most common sites is the oronasal cavity. Since nasal lesions are especially susceptible to injury, severe epistaxis frequently brings patients with this disease to the otolaryngologist. This offers him an opportunity to make a definitive diagnosis and to initiate studies to determine whether similar lesions exist elsewhere in the body.

THIS REPORT deals with a kindred in which many members are affected by a form of renal disease which has led to the death in uremia of several male members of the kindred and which is characterized by most of the manifestations of chronic interstitial pyelonephritis of the type reported by Weiss and Parker. 1 The high incidence of pyelonephritis in a single kindred offered an extraordinary opportunity to study both the clinical manifestations and the genetic background of the disease found in this group. The hereditary occurrence of any form of nephritis is distinctly unusual, and no reports of hereditary pyelonephritis have been found in the literature. Rinkoff and his co-workers, 2 in 1939, reported the occurrence of chronic glomerulonephritis in three brothers. They reviewed the literature as far back as 1875. The disease in their patients was characterized by hypertension, edema, and hematuria. In other reports many instances

A brief survey of the literature reveals that mastoiditis without preceding otitis media is no longer a rare condition, especially since the introduction of modern chemotherapy. According to Hempstead,' Dabrey in 1915 found in the literature reports of 24 cases. By 1929 the number of reported cases had increased to 146. By now the number of cases are so numerous that such reviews are unnecessary. Most of the instances seen nowadays represent a late flare-up following the cessation of chemotherapy. Hanse12 has given a thorough discussion of the pathogenesis of this condition. This report, therefore, is limited to a case in point and to a discussion of those aspects which may help in making an early diagnosis.

are used, is a marked factor in causing the deafness. Further examination, however, shows that the edentulous group is composed of older individuals in whom severe deafness predominates. Furthermore, in this age of indiscriminate extractions, some had teeth removed in an attempt to prevent progressive deafness. Despite all these factors, it is hard to explain why only one of the 19 edentulous persons had normal hearing. The need for further study is indicated.

Practically all infections of the ears and nasal sinuses are secondary to acute coryza or nasopharyngitis and are due to bacterial invasions. The primary inciting agent may be a virus, but prolongation of symptoms and complications are caused by pyogenic organisms. Nasal and throat cultures of large numbers of patients with acute coryza show that the predominating type of organism varies from year to year. A group of nurses at the Johns Hopkins Hospital during the winter of 1943 were shown by cultures to have pneumococci in the nasopharynx and pharynx three times as frequently as beta hemolytic streptococci, while during the winter of 1942 beta hemolytic streptococci had been the commoner type. In other years Hemophilus influenzae predominated. Beta hemolytic streptococci, pneumococci and H. influenzae are the types of bacteria most commonly found in the nose and throat during acute coryza but as mentioned their incidence varies from year

Practically all infections of the ears and sinuses are secondary to an acute coryza or nasopharyngitis. The number of ear and sinus complications seen by the otolaryngologist is growing less each year,· due to the widespread use of sulfonamides during the early stages of infection. There are objections to giving large doses of these drugs by mouth and saturating the entire body in order to cure or pre! vent a local infection. A more satisfactory method of using the sulfonamides to prevent sinus and ear infections is suggested by the publication of Pickrell! on the treatment of extensive skin burns. It has long been known that infection is a serious complication of burns, and Pickrell finds it may be prevented by spraying the burned area with a 2.5 per cent solution of sulfadiazine (2 sulfanilamidopyrimidine) in 8 per cent triethanolamine. This mixture has a pH of about 8.7, is not toxic and is readily absorbed by the tissues. To be effective it must be sprayed on the burned area freely and at frequent intervals, at least every hour during the first day, every two hours the second day, etc. Enough of the drug is absorbed under this treatment to maintain a high blood level, but the pre-