Nine atients with blue tympanic membranes(cholesterogl ranuloma)were reviewed.Five of nine patients were treated first by insertion of ventilation tube, which resulted in continuous discharge, or spontaneous extrusion of tube. One patient received a simple mastoidectomy, but soon reverted to the blue eardrum conditioan fter surgery.Six of nine received a simple mastoidectom (ryemoval of granuloma) and insertion of ventilation tube simultaneously and showed fairly good results: no discharge, and improve-ment of hearing.I nsertion of aventilation tube as well as removal of the cholestrol granuloma is essential in treatment of blue eardrum.

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A one year old infant who developed a severe retropharyngeal abscess after incompkete removal of a fish bone lodged in his pharynx is reported here. The child had been holding the bone in his mouth and playing, when he slipped off a table, causing the bone to lodge, and gracture, Although the bone was radiolucent, it was difficult to find the fractured bone in the abscess cavity. Preoperative examination using computed tomography and ultraphy and ultrasonnic echograohy and exploring of the abscess cavity was useful in successfully removing the foreign body and treatment of the retropharyngeal abscess.

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A 54-year-old male with stapedial tinnitus following incidents of facial palsy is reported here. Affer resection of the stapedial muscle tendon the tinnitus and hearing loss associated with contraction of facial mimetic muscles disappeared completely The electromyograms of the stapedial muscle during intentional facial movements werer ecorded before and after the resection. The results showed the pitch of the stapedial tinnitus to be approximately 30 Hz. The mechanism of stapedial tinnitu is discussed.

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Peripheral lymphocytes were isolated from patients with progressive sensorineural hearing loss of unknown origin. The peripheral lymphocytes were cocultured for 120 hours with human inner ear tissue which had been obtained earlier by petrosectomy. ³H-Thymidine was added to the culture for the last 4 hours, and the radioactivity of activated lymphocytes was counted. Cultures which exceed twice the counts of control cultures were rated as positives. The results were as follows: 1. In 50 patients with progressive sensorineural hearing loss of unknown origin, 15 patients were rated positive. None of the control cultures were detected as positive. 2. It is suggested that cellular immunity is one of the possible causes of sensorineural hearing loss. 3. The lymphocyte activation assay is considered to be a useful method for evaluating sensorineural hearing loss caused by cellular immunity.

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A 49-year old female complaining of severe vertigo gait disturbance and headache was admitted to the hospital.A physical examination revealed auricular herpetic vesicles, sensitivity to pain and temperature, horizontal nystagmus and upward vertical nystagmus. Facial palsy and impairment of hearing were not associated, and calorimetry was normal. The patient was suspected of having aseptic meningitis, and brainstem involvement by neurological examination The patient was hospitalized, and gradually improved after steroid and acyclovir treatmen.

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The clinical results from 311 ears of 167 children who had been treated by ventilation tube insertion at the Miyazaki College Hospital between 1984 and 1988 were analyzed In 53.5% of the cases, the tubes were homemade, in 39.8%, Koken tubes, and in 7.1%, Armstrong tubes. Patients were divided into a “cured group” and a “recurrengt roup” after one tube therapy, combined with adenotomy and tonsillectomy if necessary. The average period of intubation of the cured group was7.8 months, while that of the recurrent group was 3.9 months. The average intubation period for the homemadte ubes was 3.8 months, and that of the Koken tube was 7.9 months.The incidence of recurrence decreased as the intubation period increased. Adenotomy and tonsillectomy had no significant influences in the two groups. The following complications were noted: otorrhea 12.5% for homemade tubes, 29.0% for Koken tubes. granulation 0.7% for homemade tubes, 11.0% for Koken tubes, perforation of the eardrum 0.7% for homemade teubes, 3.0% for Koken tubes. There were no instances of chronic otitis media, adhesive otitis media, or cholesteatoma in all cases.

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A 69 year old man was examined for a tumor in the right nasal cavity. He had previously been diagnosed as having renal cell carcinoma and had undergone a dextralnephrectomy 4 years and 4 months earlier. The biopsy of the nasal tumor revealed it to be a metastatic clear cell carcinoma of the kidney. In a short time following the biopsy, the patient had multiple metastases, including the lung, the bone and the brain. Interferont herapy was ineffective, a nd the patient died 3 monthsa fter treatment. There have been 18 cases of metastatic renal carcinomas in the nose and paranasal sinuses in Japanese literature, including this case. We present a brief discussion of their analyses and discussions.

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An immunohistochemical comparison of Langerhans cells and T cell subpopulations was done on oral lichen planus and normal oral mucosa.The specimens were frozen at-70°C and sliced to 4 μm thicknesses on a cryostat. OKT-6, OKT-4, and OKT-8 were used as the respective markers for Langerhans cells, helper/inducer T cells and suppressor/cytotoxic T cells. Monoclonal antibodies and a PAP staining kit (Ortho) were used to detect these cells. The oral lichen planus of 5 patients, ages 16 to 65, and the normal cheek membranes of 28 patients, ages 11 to 78, were observed. In normal oral mucosa, OKT-6⁺ cells, showed dendritic forms, and were only observed in the middle and lower levels of the epidermis. The ratio of the number of OKT-6⁺ cells to epidermal cells was 1.9%-5.3%. In oral lichen planus, OKT-6⁺ cells were observed not only in the epidermis, but also in the dermis. The ratio of OKT-6⁺ cells to epidermal cells was 8.0%-11.2%. In normal oral mucosa, some OKT-4⁺ cells, and OKT-8⁺ cells, in approximately equal numbers, were observed in the superficial layer of the dermis. In oral lichen planus, many T lymphocytes had infiltrated the dermis, and OKT-4⁺ cells were much more dominant over OKT-8⁺ cells.

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High-speepd hotography of vocal fold vibration with simultaneous recordings of acoustic wave forms was done on one male subject. The fundamental period of vocal fold vibration was measured at three different phases: the onset of the opening phase, the onset of the closing phase, and the onset of the closed phase. Phonations with/e/ were made at three different loudness levels: forte, mezzo forte, and piano. The results were as follows:1) the pitch perturbation quotient (PPQ) of the vocal fold vibration was greater in piano phonation than in mezzo forte and was greater in mezzo forte than in forte.2) The PPQ calculated from the fundamental periods measured at the onset of the closed phase phase was greater than those measured at the onset of the opening phase and at the onset of the closed phase.3) Thep erturbations of the open quotient (OQ) and the open/close quotient (OCQ) were smaller in forte than in mezzo forte and piano.4) The perturbation of the fundamental period measured at the onset of the closed phase coincided most closely with that measured from the acoustic wave forms.

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1. Using the gravity method, we investigated airborne pollen distribution in the Kyushu district for three years, from July 1986 to June 1989. 2. The pollination period was divided into two seasons: the tree season (from January to June) and the grass-weed season (from July to December). During the tree season, large quantities of both Cryptomariaceae (Cryptomeria japonica) and Cupressaceae pollens were observed. The pollens of Pinaceae, Betulaceae, Fagaceae, Ulmaceae and Ginkgoceae were also found. Small amounts of grass pollen, such as Gramineae and a few kinds of weed pollens, such as Polygonaceae and Chenopodiaceae were found as well. During the grass-weed season, the main grass pollens were Gramineae. Artemisia, Compositeae, and Humulus japonica (Moraceae) were the main kinds of weed pollens observed. Also,Urticaceae pollen in the Nagasaki district and Ambrosia in the Kumamoto and Miyazaki districts were observed. 3. In the Okinawa district, some special kinds of tree pollens, such as Casuarinales, Leguminosaeand Alnus were observed. 4.Cryptomeria j. and Cupressceae pollen causes rhinoconjunctivitis. Large amounts of these pollens were observed from February to April.Gramineae pollen also causes rhinoconjunctivitis from spring to early summer. Artemisia pollen was found only for two weeks from September to October. 5. During Cryptomeria j. and Cupressaceae pollination season, pollen counts fell in cold or rainy weather, but increased in dry weather.

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In this study, odorant evoked responses (OER) were recorded from the human scalp using our new system in which the average of odorant evoked responses was synchronized with inspiratory respiration. Scalp OERs were recorded from normal human subjects and patient with anosmia. The distribution of OER potentials over the scalp in normal subjects was evaluated. Moreover, the potential gradient of OER potentials over the scalp was evaluated using the source derivation method discribed by Hjorth. The results were as follows: 1) Three types of odorant evoked scalp potentials were obtained in normal human subjects. The first type consisted mainly of two positive peaks with a peak latency of about 350 msec (P₃₅₀) and about 700 msec (P₇₀₀). The second type and the third type consisted of only one positive peak with a peak latency of about 350 msec and 700 msec. 2) Such a P₃₅₀ or P₇₀0 peak as that observed in the normal subjects was not detected in anosmic patients. 3) The high potential area for the OER P₃₅₀ was located in the centro-occipital region of the scalp and for the OER 13, 00 was located all over the scalp in normal human subjects. 4) The source of the OER P₃₅₀ was located in the centro-occipital region and the sink located in the frontal region of the scalp. For the P₇₀₀, the source was located in the front-centro-occipital region and the sink was located in the bilateral temporal regions of the scalp in normal human subjects.

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The effectiveness and safety of fleroxacin (FLRX) in otitis media and otitis externa was investigated in patients at 33 institutions nationwide. At the same time, we evaluated the drug concentration in otorrheal discharge. As a basic study, 200 mg of FLRX was orally administered during fasting to 8 cases of chronic otitis media and its concentration in otorrhea was measured. Results were as follows: the average value at 2 hours post-dose was 1.22 μg/ml (n=6) and at 6 hours post-dose was 1.88 μg/ml (n=6). As a clinical study, 200 or 300 mg of FLRX was orally administered once daily for 7 days to 130 cases of otitis media and 27 cases of otitis externa. The clinical effectiveness of FLRX was 92.1% in acute otitis media and 68.5% in acute exacerbation of chronic otitis media, where its overall effectiveness was 75.4%. In cases of otitis externa, the effectiveness was 100%. Bacteriological studies show that the rate of bacterial growth was diminished by 91.7% in acute otitis media and 77.8% in acute exacerbation of chronic otitis media. The overall rate of bacterial destruction was 82.1%. In otitis externa, the complete eradication of bacteria was achieved. Side effects were experienced by 4 of 142 (2.8%) otitis media patients whose symptoms included nausea, vomiting, stomach discomfort and digestive disorder, none of which were serious. No side effects were observed in otitis externa. Slight increases of GOT and GPT in 2 of 56 otitis media cases were the only abnormalities seen in clinical laboratory findings. In otitis externa, no abnormalities in clinical laboratory findings were observed. The above results have demonstrated that FLRX penetrates favorably to otorrheal discharges and is highly effective, at an oral dose of 200 or 300 mg once daily, in the treatment of otitis media and otitis externa.

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The clinical efficacy and safety of fleroxacin in sinus infections was investigated using a unified protocol in 69 patients from 27 institutions.1) 200 or 300 mg of fleroxacin was given orally in tablet form once a day for 14 days. Classified by diseasses, the efficacy rate was 93.9%.2) Classified by diseases, the bacteriological erakication rate was 100% in acute sinusitis and 80.0% in acute exacerbation of chrounicsinusitis. The overall eradication rate was 91.7%.3) The radiological efficacy rate was 68.8%.4) Adverse effcets included gastric discomfort to two cases and one case each of exanthema, dizziness and sleeping distrubance, but these symptoms were slight or mild. One case of mild neutropenia and another of slight elevation of total bilirubin were noted also.5) Results show that 200 or 300 mg of fleroxacin taken once daily is effective in the treatment of sinus infection.

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A fundamental and clinical investigation was performed using cefepime (BMY-28142, CFPM), a new cephalosporin derivative. The results led to the following conclusions: 1) The antibacterial activity was meassured and compared with ceftazideme (CAZ) and cefuzonam (CZON). CFPM was less effective than CZON against S. aureus, but was more effective than CAZ and CZON against other bacteria. 2) The concentration of CFPM im middle ear mucosa or in the otorrhea was much higher than MIC to all bacteria studied. 3) CFPM was used in 52 cases, and its efficacy rate was 79.2%. 4) The rate of bacterial eradication was 85.2% in otitis media and 100% in sinusitis and tonsillitis. 5) In one case, the side effect of nausea and vomiting occured, and in another case a slight elevation of total billirubin level was noted.

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Clinical effcets of Oxatomide (Celtect) on perennial nasal allergy were investigated. Overall improvement was noted in 83.9% of all patients. The incidence of sneezing, nasal discharge, and nasal obstruction were reduced by 82.8%, 80.6%, and 80.6%, respectively. Drowsiness was observed in 7 patients (3.7%)

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