The eardrum is essential for the restoration of hearing in tympanoplasty. At surgery, however, the patient's own eardrum is not always available.
We have recently employed a method of total reconstruction of the eardrum using free fascial graft and gelfilm.
After tympanomastoidectomy, the canal skin is elevated from the medial lateralward, starting near the annulus. Then the bony canal is widened anteriorly and inferiorly. The bony shelf is made adjacent to the annulus using a small cutting burr. It is easy to drill out the canal wall to make a wide shelf without opening the glenoid fossa.
A gelfilm disk is placed on the bony shelf. In cases where the posterior bony wall is removed, the disk is placed on the posterior buttress posteriorly. A free fascial graft is placed on the disk. The elevated canal skin is then put back. There is a tympanic cavity under the disk.
Using this method, it is possible to obtain a new membrane at the original position in cases of total perforation. As the tympanic cavity is not filled with gelfoam, the healing process is rapid.

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There is a private method of treatment using a vaccine and the people who developed this method refuse using radiation, operation or chemotherapy etc at same time. We had patients on their deathbed, who were treated with this method.
The author discussed a bout reason why they selected it.

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One case of localized, tumor-formed laryngeal amyloidosis has been reported. The adequate use of special staining techniques was emphasized in the histological diagnosis of localized amyloidosis in the larynx.
A 36 years old man had complained of persistent hoarseness of about 17 months duration. Examination under direct laryngoscopy revealed a marked, tumorous thickening of the left false cord without any ulceration of the overlying mucous membrane. The tissue removed by the incisional biopsy lunder general anesthesia showed massive submucosal amyloid deposition. After preliminary tracheotomy, amyloid mass was removed through the laryngofissure approach. The denuded area was covered by the free mucous membrane graft from the nasal septum.
Histological examination showed extensive deposits of homogenous eosinophilic substances in fibrous, musclar and glandular tissues. These substances were stained with Congo red and showed metachromasia, then the diagnosis of amyloidosis was confirmed.
Although the patient's hoarseness did not fully improve, he has remained free from the disease for 17 months after the operation.

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A case of nasal leiomyoma was reported. The patient was a twenty-six year old female who had developed with nasal obstruction of the age to eighteen. The physical examination showed the left nasal cavity to be filled with soft mass. She was treated surgically with transmaxillary approach (Denker's method) under general anesthesia. Pathological findings showed leiomyoma originated from smooth muscle of the nasal capillary. Either nasal or paranasal leiomyoma is very rare disease. Only sixteen cases including our case were reported up to date. Clinical feature and pathological classification in this disease were briefly reviewed.

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Correct diagnosis of fish bone foreign bodies in the esophagus is not so easy, malinly because fish bones are, in many cases, nonradiopaque. We applied xeroradiography to 3 cases of fish bone foreign body.
Xeroradiography has two main advantages, wide latitude and edge enhancement. In all three cases the fish bones were clearly detected than conventional radiograms because of the edge enhancement.
We concluded that xeroradiography is a useful technique for cases of foreign bodies but conventional radiograms should be taken together to prevent misdiagnosis.

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It is well known that the plasminogen activator (PA) occurs in various malignant tumor cells. Furthermore, it is known that the PA relates to the proliferation and the growth of tumor cell. On the other hand, the development of the metastasis is closely related to the formation of thrombus. Based on the above-mentioned results, we expected that the coagulation and fibrinolytic activity in blood of patients with cancer of head and neck affect considerably the progress of cancer state.
In order to clear the relationship between the coagulo-fibrinolysis system in blood and the progress of the cancer, we examined the fibrinolytic activity, antiplasmin and antithrombin in blood from 9 cases with cancer of head and neck. The fibrinogen content, FDP, lysis area of euglobulin, antiplasmin activity, and antithrombin activity were determined. The results obtained were summarized as follows.
1) Fibrinogen content and fibrinolytic activity of euglobulin in cancer were significantly higher than that in healthy adults (p<0.001). On the other hand, FDP level in cancer was slightly higher than those in healthy adults, but the difference in two groups could not be regarded as significance.
2) Both antiplasmin and antithrombin activity in plasma of patients with cancer were significantly lower than thosein healthy adults (p<0.05, p<0.001). Based on these results, it was appeared that hypercoagulable states occurred in the blood with cancer and then hyperfibrinolytic activity followed. Furthermore, it was suggested that the concomitant administration of the anticoagulant and antifibrinolytic drug was available to control the progress of the cancer.

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The effects of frequency response of hearing aids on speech discrimination scores were studied in 16 normally hearing adults. Sppech discrimination tests were carried out under the conditions of 5 kinds of low-frequency cut-off slopes with 4 high-frequency cut-off points. The other conditions used in this study were 3 intensity levels with and without noise. The results of the speech discrimination tests were analysed mainly from a viewpoint of the effects of low-frequency cut-off slopes on the discrimination scores for consonants. The results of these experiments may provide useful information for hearing aid fitting especially in the patients with conductive hearing loss.

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The cricopharyngeal muscle which has been called a sphincteric muscle maintains a sustained contraction, except during deglutition. This fact is apparent from manometric, radiographic and electromyographic studies. To elucidate the functional specificity of this muscle, investigations are made on the relationship between the histochemical structure and the function of the canine swallowing muscles in the inlet of the esophagus (hyopharyngeal, thyropharyngeal, cricopharyngeal and upper esophageal muscles).
Enzymes of muscles, namely myofibrillar adenosine triphophatase, phosphorylase, reduced nicotinamide adenine dinucleotide dehydrogenase and succinic dehydrogenase were histochemically stained. From the above procedures, the canine swallowing muscle fibers could be divided into two types. The type I muscle fiber showed low activity with myofibrillar adenosine triphosphatase (pH 9.4) and phosphorylase, and high activity with reduced nicotinamide adenine dinucleotide dehydrogenase and succinic dehydrogenase. On the other hand, the type II muscle fiber showed high activity with myofibrillar adenosine triphosphatase (pH 9.4) and phosphorylase, and low activity with reduced nicotinamide adenine dinucleotide dehydrogenase and succinic dehydrogenase.
The ratios of type I muscle fibers contributing in the hyopharyngeal, thyropharyngeal, cricopharyngeal and upper esophageal muscles are 12%, 20%, 57% and 16%, respectively. Since the cricopharyngeal muscle is mostly composed of type I muscle fibers, it is assumed that the type I muscle fibers play an important role as the sphincter in the cricopharyngeal muscle.

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Fine fibrillar structure of apical zone on inner ear receptor cells in guinea pig has been investigated using several fixation methods under transmission electron microscopy (TEM).
1) The structure of hair rootlets and cuticular plates has been observed as almost dense and homogenous material using the ordinary glutaraldehyde-osmium fixation method. The original structure was concealed and unobvious because of selectively destructive effect of the fixatives.
2) The finer structure was revealed by using tannic acid fixation, and modified glutaraldehyde-osmium fixation method which was developed to preserve actin filaments during preparation. These methods enabled to visualize those fibrillar structure in greater detail under TEM.
3) The structure of hair rootlet was proved to be composed of actin paracrystal or its near form. The width of actin filament in hair rootlet was 83 Å and a pitch of the double helix was 2×(332-388) Å. Cross-sectioned actin filaments in hair rootlet were arranged in extremely regular pattern (hexagon) and were chained to one another by smaller filaments (10 Å in diameter). About 80 Å-diametered filaments radiated from paracrystal structure into the lighter zone surrounding each rootlet. Hair rootlet was suspected to have a variable elasticity or flexibility induced by polymorphism of actin. This system may be initiated by mechanical stimuli and controled automatically.
4) Individual filaments (ca. 80Å in diameter) in sensory hair and cuticular plate were also composed of actin filaments. In the cuticular plate fibrillar structure was enhanced by using EDTA (Ca⁺ chelating agent) as pre-treatment before tannic acid fixation procedure. There were filaments surrounding lighter zone and connecting rootlets each other, to the cuticular plate filaments and to the tight junction between the supporting cell. Paracrystal structure in hair rootlet was not affected.
5) Actin filaments in hair rootlet and cuticular plate may have a different regulatory protein each other.
6) The dense material was connecting each sensory hair in a characteristic form. The material was suspected to be composed of glycoprotein.

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This study was performed to clarify the cochlear microcirculation after the administration of Kallikrein in guinea pigs, by the methods of intravital vascular perfusion of the pigment and of the physical measurement of auditory brain response (ABR).
In the animals which received Kallikrein of the dosis of 2 biological units per kg body weight, the fine and clear dilatation of the radiating arterioles, spiral prominence vessel, arterio-venous anastomoses, venules at the basilar membrane and collecting venules were observed, in comparison with the control animals.
The threshold of measurement of ABR to 15000Hz pure tone showed the decreasing of 10dB after the administration of Kallikrein.
These results suggested the activation of the cochlear circulation due to the effects of Kallikrein.

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