私は12年以上も前に蝸牛の代謝過程について研究し始めて以来, 数多くの未解決の問題をみつけ, またあらゆる分野で新しい未知の反応過程が解明されるのを期待して来た. 私は他の器官における蛋白およびリボ核酸代謝に関するこれまでの研究に興味を持ち, コルチ氏器官におけるこの問題を研究目的に選んだ.
コルチ氏器官の組織および細胞化学的検索は, 従来のパラフィンやセロイジン標本の場合よりも本質的に巧妙な, そして組織に忠実な技術が要求される. そこでわれわれは, Neubert (1950) による微小標本製作法を採用した. その原理はコルチ氏器官の構造を保護する事である. 主にモルモットを使つたが, 微小標本は常に脱灰を試みないで固定あるいは未固定の蝸牛で作製した. 摘出標本には多くの組織学的あるいは組織化学的染色法が行なわれる. 即ち, ヘマトキシリン・エオジン, ワンギーソン染色を, また同時にフォイルゲン反応, クレジールヴィオレットおよびガロシアニンクロームアラウン染色等を使用した.
既に初期の頃, 研究結果を模式図に記入することを行なつたが, 最近統計学を応用して細胞蝸牛図に拡充した. この細胞蝸牛図は常に蝸牛全貌を理解せしめ, しかも種々の検索方法の相関々係を知る上にも絶対に必要なものである.
この組織化学的検索によつて, われわれは血管条および螺旋神経節細胞におけると全く同様に, コルチ氏器官の内外有毛細胞においても, 蛋白およびリボ核酸代謝が活発に行なわれていることを既に確認している (Oshiro u. Perlman, 1965). 最近蛋白およびリボ核酸合成による核と細胞質問の相互活動を示したのは印象深かつたが, これにより非常に美しい活動循環を知ることが出来た. これはまたオートラジオグラフを用いた方法によつて確認されている (Meyer zum Gottesberge, 1960;Plester, 1960;Koburg, 1961).
螺旋神経節細胞も多くの蛋白代謝を有していることが明らかになつた. 血管条および螺旋靱帯においては蛋白代謝は極めて僅かであるのに反し, コルチ氏器官における細胞の蛋白代謝はほゞ中等度である.
蝸牛管における蛋白およびリボ核酸代謝の知見については勿論, 刺激に対する態度にも興味を抱いた. 最近われわれは正弦波音即ち純音のように, 適当の刺激を用い実験を行なつた. 90～120dBの音圧変化で500～3000Hzの正弦波音で音響負荷実験を行ない, その結果を模式図に記入した. 同時に負荷後すぐに殺した動物については蝸牛電気反応を計測し, 生存モルモットの聴力はプライエル氏耳介反射で検査した. その結果外有毛細胞の可逆的機能低下の最初の徴候として, 細胞質の蛋白およびリボ核酸代謝の低下が起こつていることが明らかになつた. この代謝障害はその時の周波数帯域に密接に限局していた. またわれわれは血管条にも蛋白質の減少を観察した. その場合, 強大音刺激は外有毛細胞の細胞変化とともに明らかな代謝障害を起こす. 核萎縮とともに著明な膨化核の存在を認めた. その他に螺旋神経節細胞の障害がみられた.(Thomsenu. Pakkenberg, 1962;Pakkenberg u. Thomsen, 1964). この結果から見て, 音響負荷後の諸変化には, 刺激音の強さが先ず決定的であるといえる. それに対し周波数および負荷時間は二次的な役割をはたしている. 音響負荷に対する個々の感受性はそれ以上に決定的である.
強大音響刺激に際して原周波数に一致して扇型の障害部位が基底膜上に確認された. その場合, 外有毛細胞に蛋白およびリボ核酸の著明な減少が認められた. このような方法でわれわれは全て蝸牛を検索した.
また, 適応刺激と同時に不適応刺激 (温熱, 寒冷, 超音波), 酸素欠乏およびカナマイシン投与の影響についても実験した. その場合, 蝸牛管の構造に関しては形態学的に同様の像が認められた. 内有毛細胞はどのような刺激に対しても, 外有毛細胞に比較して大きな抵抗を有することが明らかであつた.
われわれはたえず次のような疑問を抱いていた. 即ち生理学的および病的条件下では内外リンパがいかなる態度を示すかということである. そこでリンパにおける蛋白の状態を検討する事を企てたが, どうしたら少量の内外リンパ液を得られるかという疑問にぶつかつた. 長い間研究した後, 共同研究者のHolz (1964) はRauchによつて述べられた氷結切片法を発展させ, 少量のリンパを取り出すことに成功した. このリンパを免疫学的電気泳動法を用いて検索した結果, 負荷後内外リンパに新しい低分子蛋白体が出現することを確かめた (写真2Beck u. Holz, 1965). しかしこれはSM中毒では認められなかつた (Stange, Holz, Terayama u. Beck, 1966).
形態学的および生化学的所見に加えて, 電気生理学的検索方法を用いることにより蝸牛の機能状態を知る事が出来ると考えられるが, 最近われわれはこの重要な目標に一歩近づくことが出来た. このような検索を行なつた結果, 耳中毒性薬物を投与した場合, コルチ氏器官有毛細胞には形態学的変化より先に重要な機能的欠陥が起こることを発見した. 高周波数に対する感覚細胞および外有毛細胞は耳中毒性の薬物の影響には非常に敏感である. 膨化核の状態にある感覚細胞が多くあり, また形態学的に無傷を示す感覚細胞が既に機能低下を現わしている,
音響負荷 (3000Hz, 120dB, 45分間持続) による障害と, 耳中毒性薬物 (10×250mg/kg, SM筋注) による障害の比較では, 形態学的にも質的にもまた量的にも同様の感覚細胞障害を認めた. これに反して正弦波音負荷による順応扇型は, SMによるものと比較して重篤な損傷を示した. この損傷は内外リンパのα- グロブリンの範囲の新沈澱線の出現で恐らく関係づけられる. これはSMによるものでは観察され得なかつた.
先月, われわれの研究班でモルモットを用い, 塩基性SM抗生剤の耳中毒性が明らかに非常に低下したものをみつけることが出来たが, その臨床的解明までにはなお広汎な検索が必要である.
以上われわれが1954年以来行なつて来た蝸牛の蛋白およびリボ核酸代謝の検索の概要を述べた. この代謝は, 生理的条件下では, 非常に活動的であり, 種々の刺激により, 活動力の増加, 更には減少が証明された. この減少は, その時の重篤な細胞変化によるものであろう. 形態学的所見からのみでは各々の機能状態を云々することは不可能であるが, それは内耳リンパの蛋白成分に関する検索を行なつて, その形態学的所見を完全なものにし, 更に生化学的方法や, 電気生理学的方法との相関々係によつて明らかになることを示した.

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The distribution of adrenergic fibers in the guinea pig esophagus, trachea and bronchi were fluorescence microscopically examined by modified Falck's method. In the esophagus, the fibers were seen running mainly along the blood vessels in the submucosal layer and in the endomysium of the muscle layer. There was no evidence to show direct distribution of the fibers to the muscle fibers. In the trachea and bronchi, the adrenergic fibers are supplied to the submucosal and muscle layers after passing through the annular ligament. They course longitudinally to the axis of the tubes within the muscle layer and membranous part.
The fibers reach to the terminal bronchioles. Most of the fibers are seemed to be the vasomotor of the sympathetic postganglionic fibers. The mechanism of relaxation and dilation of the tubes was briefly discussed.

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In den letzten 3 Jahren hat der Verfasser die Gelegenheit gehabt, 3 Patienten mit schwerheilbarer Ménièrescher Krankheit zu behandeln. Trotz aller Behandlungen war es dem Verfasser schwierig, diese Patienten zur Heilung zu führen.
Schließlich konnte aber der Verfasser beim 1. Fall durch die Rosensche Operation, beim 2. Fall durch mehrmalige Stellatum-Blockade(60mal)and beim 3. Fall durch die Verabreichung von Steroidhormon (Dexamethason 36.5mg) vollstandig zur Heilung bringen.
Der Verfasser hat auch auf Grund seiner obengenannten Erfahrungen ausfiihrlich die Methode der Behandlung von schwerheilbarer Menierescher Krankheit beschrieben.

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Lysozyme chloride, which was extracted from egg white was used for 20 cases of vertigo and dizziness including Ménière's disease. This therapeutic enzyme on mucous membrane was administered by mouth in daily doses of from 30mg to 60mg.
Curative effects on the attack of vertigo were observed in 13 cases(65%), while there were no improvement of cochlear dysfunction except 3 cases of tinnitus. As a side-effect, nausea appeared only 1 case developed in a 28 year old male sufferring from cervical syndrom.
By our investigations it is thought that enzyme took part in metabolic process of the inner ear, therefore it is a drug to be applied for aural vertigo generally. Though little discussion has been carried on the detailed functional mechanism or a number of clinical experiences.

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Kimotab is a proteolytic medicine which consists of Bromelain and Trypsin. It was given through mouth to 24 chronic paranasal sinusitis patients.
They consciously responded to it in 5 to 14 days. The intranasal appearance became better in 10 to 14 days. Roentgenologically the effects appeared in 10 to 20 days.
Eleven of the patients (50%) remarkably responded, nine (37.5%) medially, and the rest three(12.5%) were unresponsive. So, the patients who were responsive amounted to 87.5%.
This percentage is very high probably because Kimotab is a mixture medicine and the author selected the patients who had been suffering for a shorter period (one year on an average) and whose intranasal appearance was mild.

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The design of a sound-proofed room has laid emphasis on the protection from outside noise and the sound-damping of inside noise, while ventilation and airconditioning have not been put into so much consideration.
In Yao Municipal Hospital the author studied the temperature and humidity of the sound-proofed room under air-conditioning in summer.
The following facts were obtained:
1) The noise of the air-conditioning machine was pardonably muffled by the silencer, which did not damage sound proofing and ventilation.
2) By ventilation the air humidity was reducced to 70%.
3) In case of the sound-proofed box in the sound-proofed room, the inside temperature was reduced to 0.03 to 0.09 degree per minute by keeping the door open.

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A child, aged 5, previously with normal hearing. One month ago he suffered from mumps with involvement of both parotid glands and high fever. In the course of mumps he developed 3 days after the onset, hearing impairment in the both ears.
With administration of dexamethasone and vitamine Bi, the hearingloss became gradually normal in all tone range after a year and normal hearing was again impaired by the occurrence of epipharyngitis about three months after he had completely recovered.
Whenever the patient suffered from epipharyngitis during recovery from hearingloss, his hearing was frequently extinguished.
It is thought for the infection to invade occasionally the inner ear by way of the tube and middle ear and to lead to allergic alteration in the inner ear.
But toxic neuritis in the inner ear might be a probable pathogenesis, too.
From this result infectious neuro-allergic change on the inner ear might be present in the hearing of this case which was variable due to epipharyngitis or improved on the treatment of dexamethasone.

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Rhinology has an old history It is perhaps the oldest medical recorded and is also that branch of medicine most frequently needed by mankind. In the earliest medical writings, Galen described firstly ; Showing how the air become warmed, cooled its way into the trachea. In 1883, Goodale, 1896, Minknear Leiden, Zwaardemaker, van Dishoeck, and others offered in their nasal physiology dissertations, and have done great works on basic nasal physiology. In 1942, van Dishoeck reported the great theory ; the inspiratory resistance in a normally wide nose is not caused by the conchae but by the ostium internum. In a narrow nose, on the contrary, the resistance of the conchae plays the most important part. This thesis is very important and interesting for studies of the conductivity, pressure and flow in the nasal cavity. He asserted, the study on this must be investigated on the view of anatomy, physiology and so on. The nasal resistance is composed of several moments, according to a narrow and wide, tube, lumen, vertebrae ana tomically. From 1940, mainly in Holland, and, Keuning, Spoor, Norden and especially van Dishoeck have given hope gleaming in our serious wish, before the problem was tragedy and a dark age for our rhinologists.
Of late, 1958, M. H. Cottle reported; it is necessary to investigate on the point of basic view of the air pathways with respiratory tract function anatomically and physiologically. This study, which has been investigated in Holland, Europe, passed in to the U. S. A. In future, for the rhinologic specialist these tests are dependable and objective, for the moments, they are most important diagnostic aids and they serve as a guide for evaluating medical and surgical treatment especially by reflecting on the past, and will reach to forese and anticipate the trends of proceeding.

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A female of 20 years old came for an examination of a pin in the right lateral basal branch of bronchus which had been accidentally aspirated. Under the fluoroscopy with a roentgen-television and the general narcosis by intramuscular injection of CI 581, the direct bronchoscopy was repeated, and the foreign body was successfully removed.
The removal of opaque foreign bodies beyond bronchoscopic vision is very difficult. As the fluoroscopy by the roentgen-television has a very bright image, it is a convenient aid for removal of foreign bodies by the direct bronchoscopy.
The CI 581, an intravenous or intramuscular narcoretica, is prepared by ParkDavis Co. U. S. A. But it is not yet commercialized. The prolongation of its effective time is very easy for the direct bronchoscopy compared with gas anesthesia.
The surgical operation of the chest was for a time considered to be neccessary for our own case. However, the bronchoscopical removal with the aids described above was successfully carried out at the third trial.

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The therapy of malignant tumour is exercised by operation, radiotherapy and administration of some anti-carcinogenic agent, and two or more of these methods are applied clinically to a patient.
When leucopenia is caused by the application of radiotherapy or anti-carcinogenic agent, no more therapy can be continued, and there is no medicine either which is sufficiently effective to prevent the decrease of leucocytes. So that in order to prevent the decrease of leucocytes during the application of radiotherapy or administration of an anti-carcinogenic agent, Cepharanthin was administered by 3 to 5mg. a day per os or intramuscularly to 25 cases suffering from malignant tumour.
Leucopenia was found in only 2 of the 25 cases; one case of maxillary cancer was forced to stop radiotherapy because of the dominant decrease of leucocytes. In the other cases, leucopenia appears mainly in 2 weeks after the beginning of the therapy. These results suggest that Cepharanthin acted so as to prevent the decrease of leucocytes due to radiotherapy or anti-carcinogenic agent.

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