In this paper, the results of investigation about the findings of nasal cavity and tonsil in the children with bronchial asthma were reported, considering the relationship between the asthma and the nose or tonsil. The subjects were 192 cases with the bronchial asthma in children aged 6 to 13 years old who had visited to the summer school established for the treatment of bronchial asthma in Kamiamakusa Hospital. The enquete and the group examination for symptoms and findings about the nasal cavity and tonsil in the children were performed as the methods of investigation.
As the symptoms related to nasal allergy in these cases, there were founded the sneeze in 75.8 %, the snivel in 70.7 % and the nasal obstruction in 81.8 %. In many cases, the color of the nasal mucosa was pale and nasal discharge was serous. The positive cases in examination of eosinophilic cells in the discharge were observed in 42.2%.
As the tonsil type in the children, the flat type was highest in 41.2 96, then spherical and suspension types showed relatively high persentage, in opposition to the spherical type was highest in the healthy children of corresponding ages. The size of tonsils as for the exposure into the pharynx were less second degree (Nosakas's classification) in almost cases. These findings would be influenced by the use of adrenocortical hormones for the treatments of the asthma. The caseous plugs in the crypts were founded in many cases and the adenoid were founded in 50.8 %. Habitual angina was found in 45.0 % and the aggravation of asthma in many cases related to the acute exacerbation of tonsillitis.
The symptoms of the asthma were improved by the tonsillectomy in many cases, so that the tonsillectomy under the correct indication was performed in spite of the asthma.

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For past one year (from September 1973 to August 1974), nineteen patients who suffered from Bell's palsy were treated in Hamanomachi Hospital. Urine examination of these patients (sixteen of them) revealed that six patients of the sixteen had positive reaction of sugar in their urine and they were examined with glucose tolerance test and other tests for diabetes mellitus. All of the six were diagnosed diabetes mellitus. They were 38 of the sixteen patients who presented Bell's palsy and whose urine was tested at the first seeing.
The six patients did not show severe diabetic symptoms such as urinal aceton, other neuropathy and angiopathy. On our cases, we do not consider that Bell's palsy was not induced by so called diabetic neuropathy, but diabetes acted as a part of the stress which developed the palsy.
The Bell's palsy of the six patients recovered completely as well as the non-diabetic patients after the combined treatments for Bell's palsy and for diabetes.

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Die nasale Liquorrhoe kann sowohl durch das Trauma der Schädelbasis als auch durch die Operation der Nasennebenhöhlen iatrogen verursacht werden. Die Fälle, die die Verfasser hier beschreiben möchten, sind die der nasalen Liquorrhoe, die anschlieBend an die Operation der Nasennebenhöhlen vorgekommen sind.
Der 1. Fall, ein 42-jähriger Mann, hat vor 7 Jahren im AnschluB an eine Radikaloperation der rechtsseitigen Sinusitis einen dauernden wässerigen NasenausfluB bekommen. Inzwischen hat er mehrmals an Meningitis gelitten, die durch die Behandlung von Internisten geheilt wurde. Durch die Reoperation in der Universitätsklinik ergab sich, daB es am Dach der hinteren Siebbeinhöhle einen 0.8×1.2 cm groBen Knochendefekt gab. In derMitte der bloBgelegten Dura haben die Verfasser eine kleine Fistel festgestellt.
Beim 2. Fall, einer 41-jährigen Frau, erfolgte die wässerige Rhinorrhoe auf die Entfernung eines Fremdkörpers aus der Keilbeinhöhle durch die Verfasser. Ein kleiner Knochendefekt an der hinteren oberen Wand der rechtsseitigen Höhle und die Fistel darin wurden mittels eines Operationsmikroskopes durch die rechte Nasenhöhle festgestellt.
Es ist den Verfassern in jedem Fallgelungen, mittels einer freien Transplantation der Fascia lata die Fistel dauernd zu schlieBen, nachdem sie die Knochenfläche um den Defekt bloBgelegt oder die Höhlenschleimhaut entfernt hatten. Dabei wurde das Transplantat 10 Tage lang mit Achromycin-Salbengazetampons gedrückt.
In folgender Hinsicht scheint diese VerschluBmethode vorteilhaft zu sein:
1. Nur Hals-Nasen-Ohrenarzte kOnnen diese Operation durchführen.
2. Wenn der Knochendefekt mit Liquorfistel an der vorderen Schädelbasis verbältnismaäBig klein ist, kann man mit solch kleinerem Eingriff den Zweck erreichen.
3. Es bedarf keiner Trepanation.

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The development of the supraglottic cancer generally takes place by way of glandular tissues. This way of development can be understood from the rapidness of tumor development and such development at the base of the epiglottis as well as at the false vocal cord which are rich of glandular tissues.
At the anterior commissure the development of cancer also comes about, as BRIDGER reports, via glandular tissues. On the contrary the development of cancer in the subglottic region takes place not likely by way of glandular tissues, as this region consists mainly of fibrous and muscular tissues. Even in the subglottic region beneath the anterior commissure apts to occur via glandular tissues.
In consideration of these ways of the development of the cancer of the larynx via glandular tissues the transconioscopy should not be practiced in cases of tumors or ulcers at the anterior commissure, it can be, however, taken place in cases in which the mobility of the vocal cord is unilaterally disturbed.

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It has been generally accepted that the reconstruction of the airway and subsequent decannulation are very difficult in infants with a subglottic stenosis. Lapidot (1968) and Fearon (1972) reported experimental results of a new surgical technique “thyrochondroplasty” performed in piglets and monkeys. Fearon showed three ways in using the cartilage flap; the first method is to use it like a trapdoor, the second to use it as a rotating pedicle flap, and the third as a free graft.
Fearon's experimental second techniqne was clinically applied to a five-year-old boy with a subglottic stenosis caused by the naso-tracheal intubation for 36 days. The cricoid and the inferior part of thyroid cartilage were anteriorly divided and the cicatricial tissue was completely removed. A vinyl tube slightly larger than the subglottic lumen was wrapped in a split free skin graft. This tube was placed in the subglottic raw area as a stent. A block of the thyroid ala was incised with the outer perichondrium connecting to the cricothyroid membrane and rotated as a pedicle and fitted between the cut edges of the cricoid cartilage. The perichondrium of the block was sutured with that of the cricoid cartilage to prevent the slipping. Then the subglottic space was closed and the stent was fixed in place with penetrating nylon threads through the skin.
The stent was removed under laryngomicroscope five weeks after the surgery. The subglottic space has been maintained to be quite wide and the voice is good. The thyrochondroplasty with the usual method using free skin graft and stent is emphasized as the most hopeful treatment to correct the subglottic stenosis in infants and children.

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A femal, aged 2, complained of a dyspnea in her sleep. Her both palatine tonsils with papillary elevation of various size on the surface were noted. Histological examination of bilateral exercised palatine tonsils revealed lymphoid hyperplasia, increased connective tissue in its septum and slightly findings of the chronic inflammation.
We suspect the papillary hypertrophy to be one of the malformation of the palatine tonsils, and papillary formation may be irritable to the tonsil tissue. Inflammative stimmulation to the tonsil tissue is not a main cause of the papillary hypertrophy of tonsil, but papillary form of tonsil may easily follow the inflammation.
In Japan, only 29 cases of papillary hypertrophy of tonsils have been reported. The nresent case was the vounzest in them.

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Papillary cystadenoma lymphomatosum is a slow-growing, encapsulated tumor which is usually developed in the salivary glands. It consists of papillary masses of epithelia and an abundance of lymphoid tissue.
A case of papillary cystadenoma lymphomatosum is presented. A seventy-year-old woman had had a slow-growing tumor inthe right parotid region for three years. Sialography showed no evidence of neoplasm within the parotid gland. The tumor was surgically removed together with the lower portion of the parotid gland to which the tumor had been tightly attached. Histological examination revealed that the tumor was papillary cystadenome lymphomatosum and that there was a capsule between the tumor and the gland, which separated the two structures clearly.

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Seventeen cases of recurrent laryngeal nerve paralysis caused by endotracheal intubation for general anesthesia were clinically investigated. In none of them the recurrent laryngeal nerve was involved surgically. The most frequent causal surgery was gastrostomy which had been done in 11 cases. Among the others choledocholithotomy had been performed in two cases, brain surgery in two cases, commissurotomy in one case and retroperitoneal operation in one case. The ratio of the number of the cases which developed recurrent laryngeal nerve paralysis of the total surgical cases for each types of operation was also the greatest for gastrostomy.
It should be noted that the value of serum albumin was less than the normal in all the cases except for one. It may be concluded that paralysis is caused primary local circulatory disorders due to an overinflated cuff pressure and that the local circsulation is affected by hypoalbuminemia.
Four patients were followed up one year or more and they recovered completely. As treatments of the paralysis, stellate ganglion block, steroids, polyvitamins and peripheral vasodilator appear effective.

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The effect of furosemide on the endocochlear DC potential was studied in kanamycin-poisoned guinea pigs and in control guinea pigs. A rapid and marked decrease in the endocochlear DC potential was found in control animals immediately after the injection of furosemide, and the polarity of the potential turned to negative within 30 seconds after the injection.
The endocochlear DC potential of the kanamycin-poisoned guinea pig showed lesser decrease after the injection of furosemide as compared with the control animal and did not change its polarity to negative. The depressive effect of furosemide on the endocochlear DC potential is thought to be caused by the damage to the stria vascularis. The interaction of kanamycin-poisoning (mainly on the organ of Corti) and furosemidepoisoning (on the stria vascularis) to the endocochlear DC potential was discussed. The fine morphological difference of the cuticular plate on the hair cell which was developed by kanamycin-intoxication might be the site of interaction.

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tendency to metastasis and necessitates complete removal of tumor as the most effective procedure of treatment. A new method of making a diagnosis of malignant tumor of the head and neck regions, by means of employing a catheter semiconductor detector, which the authors have developed, after injection of 32P intravenously previously, was performed in this case. As to the diagnostic efficiency, this method appears to be on equal basis with that of the biopsy with added advantages. The catheter part of the detector is small enough that it could be inserted into most of ENT cavities it could be applied repeatedly in different parts of the tumor without fear of causing metastasis, and in the midst of an operation the extent of the cancer involvement can be determined to which the removal may be necessitated. This investigation afforded a useful aid in diagnosis and treatment of malignant melanoma.

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The authors examined two cases complained of vertigo and visceral symptoms. Case I, with the anamnesis of head trauma, showed vertical spontaneous nystagmus (directed downward), direction-changing positional nystagmus (Nylen type I) and xanthochromia of cerebrospinal fluid. Case II, with the anamnesis of abnormal neck movement, showed direction-fixed horizontal nystagmus. Vertebral angiograms of these two cases revealed the diffuse narrowings of basilar arteries.
The authors discussed about signs, symptoms and causes of vertebro-basilar insufficiency, especially causes of cerebrovascular narrowing. It was assumed that the cause of Case I was subarachnoidal hemorrhage (chemical irritant of blood), and Case II was overmovement of neck (neurovascular reflex). Case I was treated successfully with vasodilator and sympatholytic agents. Case II was given the operation of stripping of perivascular nerve net of vertebral artery and improved markedly.

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The effect of prednisolone on the endocochlear DC potential (EP) was studied. Prednisolone given at 10 mg/kg produced a depression of the endocochlear DC potential followed by a recovery. The EP decreased to 64.6±13.3 % of the initial value within 30 minutes and then recovered. It reached 70.7±13.9 % within 1 hour, 83.6±18.4 % within 2 hours, 90.7±11.5 % within 3 hours and 93.6±11.5 % within 4 hours. The pattern of the EP depression resembled that of the cochlear microphonics after the injection of 10 mg/kg prednisolone. It appears that prednisolone acts to the stria vascularis and causes a depression of EP. The depression of CM would be due to the second effect occurring after the changes in the stria vascularis. Prednisolone would promote the reabsorption of the endolymphatic sodium. The EP would be a potential necessary for the maintenance of the normal concentration of sodium and potassium ions in the endolymph.

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The effect of a new penicillin derivative, aminocyclohexyl penicillin (AC PC) was studied with the results which may lead to the following conclusion.
1) Sensitivity of various clinically isolated organisms: The minimal inhibitory concentration of AC PC was measured by an agar plate dilution method. The MIC of AC PC against 80 strains of coagulase positive staphylococcus aureus isolated from otorrhoea was distributed over a range of 0.39 to≥100 mcg/ml, with a peak being observed particularly at 6.25 mcg/ml. While, that of AC PC inhibited in most of agar cultures of proteus mirabilis, klebsiella pneumoniae and escherichia coli, except pseudomonas aeruginosa, against while the MIC of AC PC ranged from 25 to≥100 mcg/ml.
2) Concentration in blood: The maximal level reached 16 mcg/ml on the average one hour after a single oral administration of AC PC 500 mg to 3 healthy adults, and the level was still 0.3 mcg/ml four hours after the oral administration.

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The isolation, identification of phlogistic bacteria and its susceptibility test were peformed on a total of 180 cases of bacterial infections at the clinic of otorhinolaryngology, Kokura Memorial Hospital, while the same tests were performed on 44 patients with otitis media, and then the latter was treated with GM. The obtained results were as follows
1) The identified and isolated bacteria from 180 patients were 212 strains for one year, and the gram-negative bacteria were 35 strains of proteus, 44 strains of pseudomonas, 31 strains of providencia, and a few strains of klebsiella, alcaligenes faecalis, escherichia coli, enterobacteria-like tbacteria, in a total of 137 strains. On the other hand, gram-positive bacteria were 39 strains of staphylococcus aureus, 16 strains of staphylococcus epidermidis, 11 strains of beta-streptococcus, and a few strains of diplococcus and corynebacterium, in a total of 75 strains. The susceptibility of GM against them was 76 per cent in gram-negative germs and 90 per cent in gram-positive germs.
2) As for the isolated bacteria from 44 patients with chronic otitis media, Gramnegative germs were 15 strains of pseudomonas aeruginosa, 13 strains of proteus, 5 strains of providencia, 3 strains of klebsiella, other 5 strains of serratia, enterobacteria-like germs, and alcaligenes faecalis, etc, in a total of 41 strains ; gram-positive germs were 13 strains of staphylococcus aureus, 3 strains of staphylococcus epidermidis, and 2 strains of beta-streptococcus corynebacterium, in a total of 18 strains, among them, only 2 strains, namely each one of providencia and straphylococcus aureus, showed the resistance to GM.
3) Effects of GM were observed by dividing into 2 groups, namely, one group injected intramuscularly in a daily dose of 120 mg, t. i. d., and another group treated with intramuscular injection in a daily dose of 160 mg. In the former group, 17 out of 20 cases responded effectively, and in the latter group, 21 out of 26 cases responded effectively.
4) As the side effects of GM, the group treated with intramuscular injection in a daily dose of 160 mg showed each one case of drug-eruption, hepatic functional disorders, and acoustic disorders, in a total of 3 cases.
5) The case of acoustic disorder had a history of treatment for the pulmonary tuberculosis, and also had the disorder of hearing at the sound-perceiving system before administration of GM.
6) From the above results, GM is an expectable antibiotic agent for very favorable effects, and was considered to achieve the therapeutic objectives by the intramuscular injection in a daily dose of 120 mg.

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