A clinic for children of speech and hearing disorders was opened in 1960 at Shinshu University Hospital. This clinic was the first one in Japan, and it has been eighteen years since the clinic opened.
In this paper the authors wrote about the history of this clinic and showed the data referring to the following subjects.
1) A change of the patients in number per year
2) The ratio of boys to girls and the ratio of children with hearing loss to children with normal hearing
3) The age of the first visit
4) The residential area of the patients
5) The first diagnosis
6) The sorts of audiometry performed
7) Mental test and other tests.

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Little is known about clinical significance of summating potential (SP) recorded from human subjects with normal hearing and with inner ear diseases. An extensive study was performed to elucidate the pathophysiology and clinical usefulness of SP, in association with AP, recorded by the transtympanic technique of electrocochleography. Both SP and AP were recorded from 21 normal hearing subjects, 20 patients with sensorineural hearing loss, and 12 patints with Meniere's disease. Measurements were made on the input-output relation of AP, the amplitude and polarity versus frequency relation of SP, and the amplitude and polarity versus intensity relation of SP, in addition to informations of the waveforms and thresholds of AP and SP.
The conclusions were as follows:
It was clear that both SP amplitude and polarity in man, just as reported in the animal experiments, were highly and systematically dependent upon stimulus intensity and frequency. There was a strong tendency to the negative SP in decreasing the stimulus frequency. The polarity of SP was completely negative (-SP) for the lower frequency than 6 KHz, and it showed a general tendency towards the positive SP to the very high frequencies of 8 KHz or 10 KHz. The most striking phenomenon was a significant enhancement of negative SP amplitude which could be expressed as an increase in negative SP amplitude to AP amplitude ratio. Our suggestion was that the significant enhancement of negative SP might be valuable in diagnosis and elucidation of Meniere's disease, and it might reflect the sense-organ malfunction due to endolymphatic hydrops in the cochlea. On the contrary, the amplitude of SP decreased clearly in sensorineural hearing loss. This might be related to presynaptic subtractive loss of sensory units in the cochlea. The significant changes in AP were the H-curve pattern configuration of the input-output relation in sensorineural hearing loss. This also might indicate the presense of subtractive loss of sensory units in the cochlea.

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Language development in normal children as well as in children with retarded development of language associated with minimal brain dysfunction was compared with that in children with acquired aphasia.
The conclusions drawn from the present study are as follows:
1) The disturbance of language in young children with acquired aphasia rapidly recovers if the cerebral lesion is localized in a small area. If the lesion is widely spread over the bilateral cerebral hemispheres, the recovery as well as the further development of language is markedly delayed.
2) This hypothesis suggests that a disturbance of organization of the linguistic function due to minimal cerebral lesions spread diffusely in the central nervous system may be responsible for the retardation of language development in children with minimal brain dysfunction.

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Optokinetic nystagmus provoked by an angular acceleration of 1°/sec² using a optokinetic stimulator of Jung type was analyzed on an electronystagmogram to measure the number of nystagmus beats, the nystagmus frequency, the optokinetic adaptation limit and the maximal eye speed of nystagmus slow phase. The optokinetic nystagmus potential (OKNP) which was the product of the slow phase eye speed of optokinetic nystagmus (°/sec) and the number of nystagmus beats in 10 seconds was calculated in 3 velocity divisions of the optokinetic stimulation, that is, 0°to 60°/sec, 60°to 90°/sec and 90°to 120°/sec.
The OKNPs of the subjects with equilibrium disorders were plotted on the graph and compared with those of the normal subjects. The patterns of the optokinetic nystagmus potentialogram (OKNPG) of the patients were classified into 5 types: normal type, hypernystagmic type, hyponystagmic type, recruiting type and decrescent type.
The OPNP will be an important indicator of the optokinetic activity, when it is possible to utilize the advantage of a computer.

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The effects of the horizontal and vertical optokinetic stimulation on the body's center of gravity in normal adults were investigated by using an optokinetic stimulator of Jung type, a straingage-platform and a minicomputer. The following results were obtained.
With increasing speed of optokinetic stimulation the total length of the body's center of gravity gradually increased up to 60 deg/sec and then decreased. Meanwhile there was a standard two-phasic course in the position of the center of gravity. Y/X ratio was below 1.00 in the horizontal optokinetic stimulation, while in the vertical stimulation it was over 1.00, showing maximum deviation of the position at about 60 deg/sec of optokinetic stimulation. Spectral frequencies of the movement of the center of gravity showed some peaks at around 0.3 Hz and 1.0 Hz during optokinetic stimulation. The averaged spectral frequencies were calculated to show the change of spectral frequencies in digital values.

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The author developed a computerized automatic audiometer, computer-aided speech audiometer, data teleprocessing system, and automatic audiometry data processing system for storage and retrieval. The operation of these systems was mainly performed on the basis of on-line real-time processing.
The characteristics, logics and merits of these automated equipments and systems were reported.

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For the power spectral analysis of auditory evoked response to 1000 Hz pure tone, five normal hearing children were examined. Major frequency components of 60 dB stimuli responses are 1-9Hz. The power spectra of 40dB stimuli responses are greater than those of the spontaneous brain activity in the frequency components between 1 and 7 Hz, and at 512msec analysis time the total power of 2-7Hz indicates a clear difference between the two. At the total power of 2-7 Hz of 40dB stimuli responses are greater than those of the spontaneous brain activities decided the positive wave form.

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The authors reported a technique of regional chemotherapy with arterial infusion for the treatment of maxillary carcinoma. The idea dealt with a continuous infusion of antimetabolite as long as possible and the results were presented.
The most serious problem of this method has been how to keep the infusion tube in the correct position for a long time and how to prevent circulatory disorders in the arteries supplying to the paranasal sinuses.
A continuous pouring of Heparin and Urokinase in the infusion tube was most important to prevent the arterial obstruction for more than 6 weeks, resulting in the possibility of treating carcinomas of the paranasal sinuses without any defect and yet preserving the normal function.
Several other devices to develope this technique were also described.

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From January 1972 to June 1978, 293 cases with nasal allergy were observed in the south of Ibaraki Prefecture, Japan. There were 81 cases of house dust allergy, 36 cases of pollinosis (Japanese cedar, orchard grass, ragweed and narrow-leaved cattail) and 10 cases of mold allergy. In these pollinosis, 22 cases of Japanese cedar pollinosis were found.
From April 1977 to June 1978, air-borne pollen grains were collected at Tsuchiura, Ibaraki Prefecture. The obtained pollen grains were Cryptomeraceae, Pinaceae, Fagaceae, Ulumaceae, Butaraceae, Graminaceae, Uluticaceae, Polygonaceae and Moraceae.
Among these grains, Cryptomeraceae (Japanese cedar) and Pinaceae (Pine) were conspicuous. In this district, the pollens of Japanese cedar appeared to be the most important cause of pollinosis.

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Lead wires and 76% Urografin are attached to the dry skull specimen and the normal anatomic landmarks of maxillary sinus can be effectively demonstrated on the panex EM.
Distortions of the pantomogram on the anterior wall of maxillary sinus are 9° deviation, 30% reduction, horizontal and 3°deviation, 16% prolongation, vertical. The so-called posterior wall of the maxillary sinus was cleary outlined on the panoramic view, but composed of the posterior, lateral, and interior wall. Therefore, the so-called posterior wall is properly named the lateral-posterior region and lateral-posterior line. The Anterior wall is recognized as anatomic landmarks, but the posterior, lateral and interior wall are recognized only when these wall are covered by radiopaque markers.
The median wall is composed of the anterior region of median wall and anterior wall, so the median wall is properly named the interior Region and the interior line.
Therefore, careful interpretation of the pantomogram is highly essential for the diagnosis of maxillary sinus.

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The present studies were designed to elucidate the role of the tonsils on cellular immunity by the following investigations: (1) Correlation of the incidence of candida isolation from pharynx, skin test and macrophage migration inhibitory test (MIT) of tonsillar lymphocyte.(2) Candida isolation before and after the tonsillectomy.(3) The active E rosette formation of tonsillar lymphocyte.(4) Aggregation of buff y-coat leucocyte and tonsillar lymphocyte.
Candida albicans could not be isolated from the cases of positive skin test for Candida, but was sometimes isolated from the cases of negative skin test. Macrophage migration inhibitory factor of tonsillar lymphocyte decreased in the cases with positive skin test, but not in the cases with negative skin test. In some cases with positive skin test, Candida albicans was isolated for a time even after tonsillectomy.
Rosette formation and ‘active’ rosette formation of human lymphocytes with sheep erythrocytes were examined. Compared to peripherial blood lymphocytes, the cell-mediated immunological abilty of human tonsillar lymphocyte was found to be increased and more important in children group (s). Active rosetting cells were decreased by freezing. Tonsillar lymphocytes had effects over a small range in comparison to blood lymphocytes.
The addition of Tuberculin PPD to whole blood resulted in aggregation of the leucocytes. The degree of aggregation was assesed macroscopically and increased by tonsillar lymphocytes.
These results suggest that tonsillar lymphocyte plays on important role of cellular immunity.

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The treatment for late cases that showed stenosis of the larynx and trachea is troublesome and usually requires a long time and the perseverance of both patients and doctors to be cured.
We deviced an operation designed to produce a one stage cure:
1. The scar tissue of the stenosis area is resected.
2. To reconstruct the inner lining of the lumen, the island pedicle neck flap is inserted.
3. To insure the stable structural framework, the cartilage of the rib is usually used.
4. The stent is inserted into the lumen by using a finger cot, filled with silicon sponge, to maintain an adequate airway for about four weeks.
5. The external covering is done by direct closure or a rotated neck flap.
6. Tracheostoma should remain open for four to six months.
In seven cases, all obtained satisfactory results for airway by this method.
We were concerned at first about the occurrance of necrosis of the flap and the cartilage. However, our experience with hemilaryngectomy (Conley) indicates that the cervical flap is the appropriate choice in these cases. We also believed in the stability of transplanted cartilage and therefore were confident in doing these operations.
When this operation is done very carefully, with special attention given to treatment of the flaps, it is possible to complete the reconstruction in a short period.

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162 patients with acute herpetic gingivostomatitis have been examined for the past seven years and the following results were obtained.
1) There was no annual remarkable difference in frequency regarding the number of patients.
2) The monthly rate of patients with the disease was constant and there was no apparent season in which the rate of the disease was inceased.
3) From the view-point of age distribution infancy under one year old accounts for 3.1%: one year old, 25.3% and three years old, 13%. The number of the patients under five years old was 120, accounting for 74% of the total. The peak of the disease was in the children under five years old.
4) Adults accounts for 11.7% of the total patients.
5) The male to female ratio in infancy was the same in the disease. In the case of adults, on the other hand, the incidence was much higher in female than in male.
6) Familial infection was found in fifteen families.

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This study is based on the review of 41 cases reported in Japan and 4 cases of authorial report seen over a 19-year period (1959-1978). A statistical analysis of cancer of the middle ear and the external auditory canal was discussed (about the spread of cancer). It was found that infiltration of the cancer to the base of skull is resulted from infiltration to the middle ear. These results indicate that massive en block resection of the external auditory canal including parotid gland, mastoid, and temporomandibular joint should be performed. If cancer has infiltrated the middle ear, afterinvestigating intracranial infiltration and infiltration to the base of skull, a subtotal temporal bone resection or radiotherapy following mastoidectomy should be carried out.

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A case of facial nerve neurinoma of the middle ear is described and the literature is briefly reviewed.
A woman, aged 45, complained of a hearing loss in her right ear for 5 years and a facial paralysis on the same side for 3 years was admitted to the University Hospital. On examination a tumor was filling half of the right external auditory canal. A radical mastoidectomy was performed to remove the tumor. Histologically the tumor revealed to be neurinoma. The neurinoma was seen arising from the horizontal portion of the facial nerve and had eroded the right lateral semicircular canal. There was no recovery of facial function. Cosmetic improvement is planned in the future by the use of a fascial sling.
The intratemporal facial nerve neurinoma is defined as a rare benign tumor developing from the Schwann cells. However, so far more than 160 cases have been reported. These slowgrowing neoplasms when untreated may produce conductive and sensori-neural hearing loss, facial paralysis, vertigo and even intracranial complications. Early operation is a reasonable recommendation.

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Twelve cases of sudden deafness during the past year were reported. They were analysed from the views of occurrence of age and sex, period from onset to first medical examination, audiogram types, recruitment phenomenon, and prognosis. Five cases were found to be hypertention, so that the cause of sudden deafness was thought to be attributable to such vascular accidents as bleeding, etc. in the inner ear vessels. Their prognosis was not so good. Three cases of sudden deafness with upper respiratory infection came to our clinic almost at the same corresponding period this year, and their clinical courses are closely alike. These three cases made a complete recovery of hearing in comparison with the hypertention group.

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MIKULICZ's disease was discussed on the basis of a review of the literature and the author's three cases.
The MIKULICZ's disease entity has long been a big topic of discussion and confusion since the original report by MIKULICZ, because many cases manifesting enlargement of the salivary or lacrimal glands were diagnosed as MIKULICZ's disease. MIKULICZ's disease was usually characterized by chronic, painless enlargement of one or more of the salivary or lacrimal glands of unknown etiology in contrast to MIKULICA's syndrome caused by syphilis, leukemia, tuberculosis, sarcoidosis and other disorders.
MIKULICA's disease is similar to SJÖGREN'S syndrome from the following viewpoints: their clinical nature and cause; the tendency to occur in middle-aged women; and the histopathological findings in the salivary and lacrimal glands.
Accordingly, this condition would be thought to be a variant of SJÖGREN'S syndrome as described by MORGAN, and histologically a better name for this condition may be “Idiopathic Chronic Sialoadenitis”. The so-called MIKULICZ's syndrome is just a clinical manifestation of one of the many underlying systemic diseases, so the author recommends the term “syndrome” must be erased from the medical literature. For swelling of the salivary glands, surgical procedures or drug treatment is more preferable than irradiation therapy.

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A case of hemangiopericytoma of the orbit, an unusual vascular tumor with multiple metastatic lesions, is reported. This is the first recorded case of a hemangiopericytoma of the orbit in Japan. The patient was a 50-year-old male with his first chief complaints of swelling and pain of the left orbit coming about 10 years earlier. He eventually died because of local recurrence and general metastasis in spite of frequent surgery and radiation.
This tumor generally shows tendencies to local aggressive invasion, recurrence, and even widespread metastasis. The patient who has hemangiopericytoma should be treated in the same way as dealing with a malignant tumor.

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A 52 year old female came with the complaint of a disturbance of respiration in the night and loud snoring. A swelling like a ranula was found in the middle of the floor of the mouth. The swelling of which the size was 8.0 by 6.0 by 4.5cm was excised under local anesthesia. Histologic diagnosis showed that the tumor was lipoma.

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A case of a child who suffered influenza after tonsillectomy is reported. The present report is designed to explain the side effects of tonsillectomy on immunity by the following investigation before and after the infection. In vitro PPD test, active' E rosette formation and IgA levels in saliva were measured. The in vitro PPD test was negative for a time even after influenza, but other tests were normal. These results are interesting from the cellular immunity viewpoint.

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A rare case of a 20 year old man, who swallowed a chop-stick of a length of 23cm was reported. It was successfully removed using an esophagofiberscope from the stomach.
For the removal of the foreign body from the stomack a special kind of forceps was used which had been developed by Endo, M. D. The foreign body was removed under visual guidance and taken out with the fiberscope. The fiberscope will contribute not only the diagnostic fields but also in the therapeutic fields.

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