The relationship between nausea and motion sickness was studied in 81 males and 234 females who all complained of dizziness. Nausea occurred in 49 males and 162 females. When they suffered dizziness, 39% of the males and 30% of females suffered from motion sickness. The incidence of sickness was 3% in males and 17% in females without nausea. Individuals demonstrating dizziness with nausea thus seem to be more susceptible to motion sickness. The above findings thus suggest that nausea is etiologically related to motion sickness.

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We examined the effectiveness of pranlukast for nasal symptoms in 7 cases of aspirin-induced asthma (AIA) with nasal polyps. 450mg (4 capsules) of pranlukast was administered for 4 weeks. At the end of the study, we assessed the efficacy according to changes in the nasal symptom scores. One patient showed a moderate improvement, and another showed a slight improvement, however, the other 5 patients showed no change. In addition, one case complained of mouth dryness as a side effect. Based on the above findings, pranlukast is thus considered to be very effictive for the treatment of nasal symptoms due to AIA, especially when also associated with nasal polyps.

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We have been conducting an on-going survey of pollen dispersion from Japanese ceder and cypress trees (cryptomeria japonica and cypressaceae) since 1988 at the Hiroshima Mitsubishi Hospital in Horoshima city. We examined the correlation between the annual variations in the pollen counts of cedar and cypress trees and the annual changes in meteorological conditions. The sum of these pollen counts correlated with the sunshine duration in June and July of the previous year. In addition, the beginning of the pollination season correlated with the mean temperature from January 1st to January 20th. However, it is difficult to determine the pollen dispersion only based on meteorological factors.
Furthermore, we have also been conducted a survey on pollen dispersion over the past 6 years at 9 locations in Hiroshima prefecture. Hiroshima City, Hatsukaiti city (western Hiroshima prefecture), Kabe Town and Miyoshi city (northern Hiroshima prefecture), Onomichi city, Innoshima Island and Fukuyama city (eastern Hiroshima prefecture) and Kure city.
In Hiroshima prefecture, the dispersion patterns were simillar to those for Hiroshima city, Kure city and western Hiroshima prefecture, however the total pollen count was higher than that for northern Hiroshima prefecture. In addition, in eastern Hiroshima prefecture, it was only about half or a third as much as that for Hiroshima city. The results thus suggest that these three areas in Hiroshima prefecture need to be further analyzed in the future.

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We have regularly sent medical information regarding Japanese ceder pollinosis to otolaryngologists in Kumamoto prefecture by facsimile since 1995 in order to help prevent and treat pollinosis. The faxed information contains the amount of dispersed pollen, the number of pollinosis patients who had visited the hospital in the previous week and the pollen forecasts for the next week. The amount of dispersed pollen and the number of pollinosis patients who visited the hospital were thus found to be closely related based on an analysis of this information over the two-year period. We ensured that our information was appropriate based on a questionnaire to these same doctors regarding the necessity and usefulness of this information. To improve our present system, improvements in the dissemination of information to general physicians, simplified communication systems and more accurate pollen counts and the prediction of patient systems are needed.

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Objective: To examine the P¹⁶protein expression and its correlation with the degree of malignancy and cervical lymph node metastasis in resected specimens of supraglottic laryngeal cancer from 82 patients.
Methods: The immunohistochemical S-P method was used.
Results: In primary laryngeal cancers, 55 percent showed a positive P¹⁶protein expression. In patients without cervical lymph node metastasis, the positive rate (68%) was significantly higher (p < 0.05) than that in those without cervivcal lymph node metastasis (42%). In low-degree malignant primary lesions, the positive P¹⁶ protein expression rate (65%) was significantly higher (p < 0.05) than that in the high-degree malignant primary lesions.
Conclusion: Our results thus indicated that the P¹⁶gene and its protein products were closely correlated with the development of laryngeal cancer and cervical lymph node metastasis.

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We report a case presenting with a swelling of the parotid gland, flushed face and stridor. The patient was a 35-year-old female doctor. A CT scan and sialography of the parotid gland revealed no abnormal findings, but a severe swelling of the parotid gland, flushed face and dyspnea all occurred just after sialography. The saliva from the parotid gland was not purulent but clear and a large number of eosinophils were observed on smears of saliva. The patient was diagnosed to have allergic parotitis due to iodine. A similar case has been reported in which iodine was suspected to be an allergen. We also investigated the ralation between iodine and the salivary gland and discuss our findings.

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A case of leiomyosarcoma arising from the maxillary sinus is reported. The patient was a 74-years-old female who complained of swelling and pain in her left cheek since October 1994. A CT scan revealed a tumor shadow occupying the entire maxillary sinus. The tumor further extended to the surrounding tissue including the orbital floor. The patient was initially treated by chemotherapy, and later underwent a total maxillectomy on Feb. 3, 1995. The postoperative course was uneventful until a gastric cancer was found. Thereafter, her general condition progressively deteriorated and she passed away on March 29 1995.

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Laryngeal muscles (fan shaped laryngeal muscles) of the Bull-Frog, Trion-chidae and Domestic Fowl (Hens) were observed comparatively and stimularted electrically under a binocularmicroscope soon after the larynx was taken out from the living body.
The function of the muscles was analyzed regarding the anatomical structure and the muscles were stimulated and observed and the results are summarized as follows.
1. In all kind of animals atudied, when laryngeal adit were abducted by the extrinsic muscles, it was confirmed that fan shaped laryngeal muscles fixed the arytaenoid-cartilage.
2. It was thus concluded that the character of the fan shaped muscles and the extrinsic laryngeal muscles were antagonistic when contracting at the same time.
3. Therefor in mammals where these fan shaped muscles have evolves the intrinsic muscles, in vies of the systematic physiology if intrinsic and extrinsic muscles should take its contraction rise at the same time as the articulation, the spasms occur in the vocal cord, but really as the extrapyramidal control acts on both muscles reciprocally the spasms dosnt in the vocal cord, in the result the vocal cord open and close smoothly.

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In order to apply a newly developed anti-fungal agent tp otomycosis, the ototoxicity of lanoconazole (ASTAT® cream/ointment) was investigated using scanning microscopy. The trans-tympanic application of ASTAT®cream or ointment did not cause any morphological damage in either the organ of Corti of in the vestibular end organs of the guinea pig. ASTAT® cream and ASTAT® ointment aretherefore considered to be an effective drug for the treatment of otomycosis.

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The efficacy of Cepharanthin in the treatment of otitis media with effusion was examined in children by means of a well designed clinical protocol. The objective symptoms, pure tone audiometry and a tympanogram were all monitored before and after a tympanostomy, an aspiration of the middle ear effusion and the subsequent administration of different doses of Cepharanthin.
As a result of the above examinations, the global improvement rating was found tobe the highest in the group of patient receiving a 2mg/kg dose of Cepharanthin. This finding is thus considered to indicate the efficacy of Cepharanthin for the treatment of otitis media with effusion which isoften seen in children.

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We evaluated the phonogram of Reinke's edema. Improvements of phonogram in postsurgery were 1.15±0.35 (n=17) in severe cases, 1.16±0.33 (n=19) in moderate cases and 1.09±0.31 (n=5) in mild cases. An average of all cases was 1.15±0.34 (n=41). It was worse than 1.26±0.35 (n=103) of laryngeal polyp.

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When trachea is invaded by malignant tumor, resection of a part of the respiratory tract and its subsequent reconstruction are necessary. A 74-year-old male with thyroid carcinoma which invaded to 4 tracheal rings was reported. He underwent complete resection of carcinoma including right half of tracheal wall. Membranous part of his trachea was simultaneously reconstructed with a use of DPflap. Ten months after, his cartilageous trachea was reconstructed with a use of pectoralis major myocutaneous flap (PMMC). After this procedure he could get a fine clinical course, without dyspnea. Since PMMC flap is bulky, reconstructed part of the trachea will not collapse during respiration. Therefore, although several techniques for reconstructing the trachea have been reported, out technique using PMMC flap is recommended for a limited case from points of view of its safety and accuracy.

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In the case of the treatment of post-traumatic cicatricious stenosis of larynx and/or cervical trachea, decanulation is the most important purpose. However, considering of the quality of life, it is also important to take care of the vocal function of patients. This paper reviewed fifty patients with post-traumatic stenosis of larynx and/or cervical trachea from the view point of vocal function. As a result, important points to bear in mind to obtain a post-therapeutic good vocal function are as follows:
1) When patients have glottic stenosis, raw surfaced wound must be covered with the use of flap and some kind of stent should be placed. Advanced local skin flap should be avoided. In selected cases medialization surgery, such as Isshiki thyroplasty, and/or voice therapy are effective.
2) In the cases without glottic stenosis, after raw surfaced wound is covered using some kind of flap, stents also should be placed at subglottis so that vocal fold mucosa is not injured. In selected cases voice therapy is also effective. In addition, when closing the thyrotomized larynx, inner laryngeal membrane should be sutured to the fascia covering the sternohyoid muscles together with the inner perichondrium of the thyroid cartilage.

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A 55-years-old female with iatrogenic laryngeal web was reported. Fiber scopic examination revealed a wide web around her anterior commisure and movement of bilateral vocal folds was restricted. After this web was removed under a direct laryngoscope, thyrotomy was performed.
Upper surface and lower surface of the sectioned vocal fold membrane was sutured using absorbable stitches. The cut-edge of the laryngeal mucosa around the anterior commissure was sutued to the fascia of the sternohyoid muscle, preventing web formation. After this operation prosedure, her vocal functions, such as MPT and MFRc, improved well. As for the treatment of laryngeal web, when web is thin and small, web might be removed under a direct laryngoscope, while web should be removed under thyrotomy, when web is thick and large.

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The laser surgery has been one of effective surgical procedures for the hypertrophic false vocal cord, however, unfavorable complications may associated with the laser surgery. A 67-years-old female had a history of continuous hoarseness for two years. Conservative medical therapy under diagnosis of hypertrophic false vocal cord failed to improve her hoarseness. Although the resection of false vocal cord under laser surgery was performed at another ENTclinic, she visited our hospital with complaint of worsened hoarseness. Precise observation under endolaryngeal microsurgery revealed the adhesion of bilateral false vocal cord and the mucosal defect of upper portion of right vocal cord. Laser separation of adhered false vocal cord resulted in re-adhesion of bilateral false vocal cord. A glottal intervention of silicon sheet during two months resoleved the adhesion of false vocal cord and improved her voice.

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When laryngomicrosurgery using a direct laryngoscope is performed to treat laryngeal lesions which develop in the posterior glottis under inhalation anesthesia by endotracheal intubation, the endotracheal tube obstruct the view of the posterior glottis and complicates the operating procedure. To allow visualization of the posterior glottis, the endotracheal tube must be placed on the tip of the direct laryngoscope and moved towards the anterior glottis. A further improved model of the direct laryngoscope capable of manipulating the posterior glottis is produced to accomodate easy postioning of the endotracheal tube. A cocave ditch is made on the upper tip end of the direct laryngoscope, making the placement and movement of the endotracheal tube toward the anterior glottis easier.

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Thyroplasty type I is a standard operation procedure for the unilateral laryngeal pararysis, and many investigators reported some special techniques or materials about it. In 1991, Isshiki reported a new surgical material and method, the ultrasonic mess, applied for thyroid cartilage cutting. The tip of this mess is super vibrated 24,000 times per second so the mess can cut the thyoid cartilage sharply with prevent the soft tissue damage, like a internal thyoid cartilaginous menbrane. In this report, we also tried to use this special mess for the thyoplasty type I and we found this material is very suitable for the operation.

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Thyroplasty type I and arytenoid adduction technique have been employed on patients with imperfect closure of the glottis due to unilateral vocal cord paralysis.
Thyroplasty type I has been specially indicated for cases with a small glottal gap during phonation. This technique has been considered to have little effect on cases with a large glottal gap and when there is a difference in level of the two cords. In this study, postoperative glottic configuration and postoperative vocal function were analyzed in cases with unfavorable result after thyroplasty type I for measurement of the optimal operative procedures.
Thyroplasty type I may be applied to cases with large posterior glottal gap by altering of the size, the shape and the location of the prosthesis.

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