In 49 cases of sudden deafness, 4 cases of recurrence of dysequilibrium and one case of persistence for more than one year were observed. The symptoms at the recurrent stage were not episodic vertigo as Meniere's disease, but positional as paroxysmal positional vertigo. Except one case in which the positional vertigo was persistent since onset, another 4 cases had several months of symptom free periods after the relief of vertigenous attack at the onset.
Neurotological examination reve aled rotatory positional and positioning nystagmus accompanying vertigenous sensation. Caloric test at the recurrent stage showed some improvement comparing with that of the onset stage. There was no hearing improvement in all cases. For relief of dysequilibrium, several times of inner ear anesthesia (4% xylocain perfusion into the tympanic cavity) and streptmycin sulfate perfusion were performed and good results were obtained. Long lasting dizziness and positional vertigo of these cases were supposed to be induced by abnormal irritation of partially involved vestibular labyrinth at the process of recovery from vestibular hypofunction.

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A study of spontaneous nystagmus was made on 100 normal individuals as well as 326 vertigious patients on first visit.
Both slow phase velosity (degree/S) and frquency (number/S) for intensity, were mesured on electronystagmography recordings. ENG recordings were done under four conditions, i. e., eye closed, eye covered and a performance of mental alerting with eye closed and eye covered. Spontaneous nystagmus was found in 41% nomal individuals and in 66% vertigious patients. In both slow phase velocity and frequency of spontaneous nystagmus, its intensity of vertigious patients was remarkably bigger than that of normal individuals in each condition. Statistically, the significance was recognized at 0.01% of the significance level.

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Eine kasuistische Mitteilung über das seltene Vorkommen der Mucocele der Kieferhohle eines 47 jährigen Mannes, einer 76- und 40 jährigen Frau.
Auf Grund der 32 Fällk, über die im Zeitraum von 1931 bis zu 1974 in der japanischen Literatur mitgeteilt worden sind, wird über das Alter der Patienten das Geschlecht, die veranlassenden Momente, die Röntgenbilder, die biochemischen Bestandteile der Inhaltsflössigkeit sowie uber die diagnostischen Schwierigkeiten und die Operations- methoden diskutiert.
Als Atiologie dieser Krankheit möchten die Verfasser lieber der Theorie der Entwicklungsstörung der Kieferhöhle zustimmen, als der Sinusitis mit Verstopfen Ausführungswegen.

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Neoplasms of the hypopharynx other than carcinoma are rather u ncommon. A 43- year-old man first developed a mass of the hypopharynx in 1965 which was removed under direct laryngoscopy in July 1966. Histological examination revealed the mass was lipoma. Recurrences occured three times and they were surgically treated in December 1966, January 1972 and December 1972, respectively. In the fourth surgery the tumor was removed with the surrounding intact mucosa under pharyngotomia transhyoidea. Myxomatous fibrosarcoma was most suspected by histological examination. A three-year follow-up has revealed no evidence of recurrence. On the bases of our experience with the present case as well as of a review of literaturs, we concluded that the best treatment for benign neoplasms of the hypopharynx should be the removal of the mass with surrounding intact tissue.

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Recent studies on tonsillar problems are still to be devided into 2 big parts ; basically the understanding of immunological cellular basis and clinically the determination of the indications for tonsillectomy. Both of them are intimately connected with the specific structures and functions of tonsillar lacunae. In the other words, there arc still many problems to be clarified concerning tonsillar crypts.
Inflammatory tonsillar lacunar cytology provided here is the first trail and report as far as I know, and I believe it may provide us a little more satisfaction and confidence in the diagnosis, treatment and determination of the removal of a tonsil in ad- dition to the previousely provided several indications for tonsillectomy by text books.
From September 1974 to July 1975, 190 cases of chronic tonsillitis divided into 4 groups ; (1) simple chronic tonsillitis,(2) chronic tonsillitis in acute exacerbations,(3) habitual angina, and (4) chronic tonsillitis with focal infections are studied. And it was concluded that those positive findings of lacunar cytology with ; (1) strong cornification, namely increase of cornified and precornified cells,(2) exfoliation of deeper cells, such as intermediate or basal cells,(3) increase of segmental and band leukocytes in those groups other than acute tonsillitis,(4) increase of R. B. C.(5) increase of nuclear lines,(6) increase of bacteria or candida and actinomyces etc. are helpful in the determination of a clinical treatment or the removal of tonsils.

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Among 394 cases of thyroid diseases seen between 1960 and 1974 at our clinic, there were 73 cases malignant neoplasm. They were investigated clinically. The results are as follows:
1. The number of females was greater than that of males (2.3: 1).
2. Symptoms caused by invasions into the adjacent organs, such as hoarsness, difficulties in respiration and or swallowing, or sense of pressure to the throat, were more frequently found in our cases than in the cases reported by general surgeons.
3. Papillary adenocarcinoma was found most frequently and follicular adenocarcinoma was the second.
4. It should be noted that the duration of the disease was rather long, more than one year, in 36.9 per cent of the entire cases.
5. The three-year survival rate for the entire cases was 56 per cent and the five- year survival rate was 47 per cent. The survival rate for operable cases was 75 per cent in three years and 65 per cent in five years respectively.

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Physiological properties of the pharyngeal constrictor muscles were investigated by an electromyogram. The adult dogs were carefully anesthetized under neuroleptoanalgesia. Bipolar hooked wire electrodes were inserted into upper and lower portion of the hyopharyngeal, thyropharyngeal and cricopharyngeal muscle.
The contraction of the middle pharyngeal constrictor muscles showed a regularity of phasic pattern in fashion sinchronized with expiration. However the cricopharyngeal muscle burst unconcerned with respiration.
The contraction of the cricopharyngeal muscle was transitorily inhibited on swallowing. The bursts of the hyopharyngeal muscle were synchronized with thyropharyngeal muscle contracted simultaneously.
Bursts of the upper portion of the thyropharyngeal muscle preceded to the bursts of lower portion with a time lag of 200 msec, which meant us occurence of peristaltic movements.

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Aldosterone is a hormone of adrenal gland which promotes Na-K-exchange in the distal kidney tubules.
It was found that aldosterone causes a depression of cochlear microphonics in guinea pigs. In this paper, effect of aldosterone on endocochlear DC potential was studied. With the injection 0.5mg/kg of aldosterone, endocochlear DC potential caused a de- pression. Therefore it seems that aldosterone acts to the stria vascularis and promotes the absorption of sodium ion the endolymph. The depression of cochlear microphonics caused by aldosterone depends on the changes of ion concentrations in the endolymph and a depression of endocochlear DC potential.

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Fundmental and clinical investigations with a new antibiotic, fosfomycin were performed with the results which may lead to the following conculsion.
1) In vitro antibacterial activity: The minimal inhibitory concentration (MIC) of fosfomycin was measured by an agar plate dilution method using heart infusion agar (Eiken). Fosfomycin revealed an excellent, broad spectrum antibacterial activity against 24 standard strains of various bacteria. The MIC of fosfomycin against 80 strains of coagulase positive Staphylococcus aureus isolated from otorrhoea was distri- buted over range of 0.78 to 100 mcg/ml, with a peak being observed particulary at 6.25 mcg/ml. The MIC against 60 strains of Pseudomonas aeruginosa was 1.56 to 100 mcg/ml of fosfomycin, showing its peak at 12.5 mcg/ml. Other strains of Escherichia coli, Proteus mirabilis and Klebsiella pneumoniae were also examined on their sensi- tivity to fosfomycin as well as other antibiotics.
2) Blood concentration: The blood concentration of fosfomycin in healthy adults who were given 1g a single oral administration reached maximum of 5.77 mcg/ml two hours after administration. Even at 6 hours after administration, clinically effective serum fosfomycin concentration 0.8 mcg/ml was still demonstrable.
3) Concentration in tissues: Fosfomycin activity was demonstrable at the concentration of 0.6 to 0.88 mcg/g in human palatine tonsilla, and mucous membrane of maxillary specimen two hours after the administration of 1 g. Further, the serum concentration of fosfomycin was then 4.8 to 6.2 mcg/ml.
4) Results of clinical treatment: When fosfomycin was oral administration in 32 cases of representatlive infection in the otorhinolaryngologic field, it was excellent in 14 cases, good in 13 cases, fair in 4 cases and poor in one case. When the cases in which it was excellent and good in 27 cases, that is a ratio of effectiveness of 84.4 percent.
5) Side effect: No side effect was shown with the oral administration of fosfomycin. The comparative examination of hepatic function, electrocyte and auditory acuity before and after the administration showed no significant disturbance.

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Basic and clinical investigations with fosfomycin-Na, a new antibiotic, were performed with the results which may lead to the following conculsion.
1) Blood concentration: The blood concentration of fosfomycin-Na in healthy adults who were given 500 mg by intravenous injection reached peak level of 44.7 mcg/ml after 15 minutes of injection. Even after 6 hours, clinically effective serum concentration of 2.3 mcg/ml was still demonstrable.
2) Tissue concentration: Fosfomycin-Na activity was demonstrable at the concentration of 1.4 to 2.3 mcg/g in tissues of human palatine tonsilla, pharyngeal tonsilla and maxillary mucous membrane after one hour of intravenous injection of 500 mg. At the same time, the serum concentration of fosfomycin-Na was then 14.5 to 18 mcg/ml.
3) Results of clinical treatment: Fosfomycin-Na was given intravenously to 26 cases of representative infection in the otorhinolaryngologic field, and it was excellent in 13 cases, good in 11 cases and fair in 2 cases. When the cases in which it was excellent and good were considered together, the rate of effectiveness was 92 per cent.
4) Side effect: No side effect was observed in these 26 cases. The comparative examinations of hepatic function, serum electrocytes and auditory acuity before and after treatment showed no significant disturbance.

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[in Japanese]

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[in Japanese]

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