Recently, sleep apnea syndrome (SAS) is the fifth leading life-style disease. Snoring, is one of the main symptoms of SAS, is now a major concern. Snorers go to the department of Otorhinolaryngology mostly because snoring is caused from upper airway. In 14 months we counseled 579 patients who would like to improve their snoring, and discussed relationship between snore and otolaryngological disease. Treatments and its' efficacy were shown in this paper. Polysomnography (PSG) was performed on 45.9% patients suspected of SAS. As a result, of 53% patients apnea and hypopnea index (AHI) was over 20. Moreover, 2 cases of Shy-Drager Syndrome were found among the snorers with concurrent stridor wheeze. Severe SAS or neural disorder was found in those who complaining of snoring. Furthermore, reference of snoring sound, and cooperation among departments of Otolaryngology, Pulmonary, and Neurology are considered to be important.

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Airborne cedar (Cryptomeria spp.) pollen and cypress (Cupressaceae) pollen were investigated with Durham sampler at Wuchang district in Wuhan City in China during the pollen season in 2000 and 2001. The sizes of the greater part of cedar pollen were smaller than those of Japanese cedar (Cryptomeria japonica), though the similar-size cedar pollen was sometimes observed. It was beginning to disperse cedar pollen on 29 February in 2000 and on 1 March in 2001. The total cedar pollen count was 84 grains/cm² in 2000 and 194 grains/cm² in 2001. On the other hand, the total cypress pollen count was 502 grains/, in 2000 and 614 grains/cm² in 2001. The count of cypress pollen was greater than cedar pollen with both years. Remarkable plane pollen was dispersed at the end of cedar and cypress pollen season, and the existence of the pollinosis by plane pollen in Wuhan City was suggested.

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A qualitative and quantitative of mite in house dusts collected from the dwellings in Sendai City, Miyagi Prefecture were surveys in February, May, August, and November, 1999. Mites were present in all of 65 house dusts surveyed and mean population density per one gram of fine dust collected from homes with electric sweeper for one week were found to be 443.1 in February (winter), 556.3 in May (spring), 1, 827.1 in August (summer), and 333.4 in November (autumn), 1999. The Acarofauna in 65 samples of house dusts comprised more than 35 species, of which the most abundant were Pyroglyphidae, Tarsonemidae, Acaridae, Glycyphagidae, Cheyletidae, Oridatei and Mesostigmata. The Pyroglyphid mites were found the most abundant, and Dermatophadoides farinae was dominant among the mites detected in the house dusts of Sendai's residences. Seasonal change of mite fauna was studied. As to the most of mites found in the dust, number of mites showed to increase in summer and to decease in winter, but number of Glycyphagid mite increased in winter, and Oribatid mites increased in spring. On the other hand, a survey of 190 samples of house dusts from beddings and floors in 10 homes were performed. Acarofauna in these house dusts were shown similarly with one in the dusts collected for one week, and many mites were found in beddings as compared to floors.

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House dust mites are recognized as the most important agent of allergic disease in the world, and a insect-born dermatitis are considered to caused by some mites living in dwelling. Surveys of house dust mite were carried out in Wujiang City, China and Sendai City, Japan, in May 1999. And mite faunae and mite populations in the house dust in both countries were compared and examinated. Mites were present in all the homes surveyed in China and Japan, and mean population density was found to be 263.2 in a square meter (per m²), 805.8 in a gram of dust (per g) in 53 homes of Wujiang. And in 48 homes of Sendai, to be 43.3/m², 2132.9/g of dust. Number of mites/g of house dust collected from Japanese residences were found to be more numerous than in Chinese ones. On the other hand, number of mites/m² of the place examined in Chinese residences were found to be more numerous than in Japanese ones. Pyroglyphid mites were most abundant of mite detected from the house dust in both countries. Of the isolated mites in 53 dust samples in Japan, 75.6% were Pyroglyphidae with 68.9% of Dermatophagoides farinae (D. f.), 6.5% D. pteronyssinus (D. p.), 0.1% Hirstia domicola (H. d.). On the other hand, of mites in 48 dust samples in China, 70.2% were Pyroglyphidae with 41.8% of H. d., 27.0% D. p., 2.3% D. f. The other mites, Acaridae, Glycyphagidae, Chortoglyphidae, Cheyletidae, Tarsonemidae, Bdellidae, Tenuipalpidae, Haprochthoniidae, Cosmochthoniidae and Mesostigmata are found remarkably. As to examine mites distribution on various places of residence, mites population detected in house dust collected from bedding were found to be more numerous than floor in both countries.

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Recently, the rate of allergy is tending to an increase. The main current of allergy is in infants although it showed gradual increase in adults. The infants leaving in the nursery are increasing together with the women put into the society. The ratio of providing food in nursery is higher than that in kindergarten. This investigation aimed to master the situation about correspondence and problem for allergy-holding kindergartener in nursery by questionnaire. It was conducted from November 1998 to January 1999. The questionnaire was distributed to 1801 nurseries regardless of authorization or no authorization and the answer was obtained from 1230 nurseries (collection rate 68.3%). It was proved that: 1. the age in allergy-holding kindergartener by reporting from their parents or doctors was: 0 years old (15.4%), 1 years old (12.3%), 2 years old (12.3%), 3 years old (11.0%), 4 years old (10.8%), 5 years old (11.3%) and 6 years old (9.9%). 2. the facilities providing the special food to those kindergarteners who need food-removal or restriction were more than 80%, and they made the effort to avoid discrimination between the kindergarteners. 3. the main difficulties for offering food were:“whether the food contain the foodstuff which should be removed or restricted were uncertain (22.2%) ”,“having the experience supplying the removal or limited food by mistake (18.5%) ”,“not understanding the correspondence when allergic symptom occurred (10.3%) ”, etc. 4. the problems in future were:“having uneasiness in use of medicine from the parent or the doctor (21.3%) ”,“correspondence in the emergency and establishment the contact network (20.1%)” etc. We think this may be used as a reference material for mastering the situation about correspondence and problem in the nursery.

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The hypothesis that the decreasing of parasite infection resulted in the increasing of allergic diseases such as Japanese cedar pollinosis was analysed by the epidemiological survey and articles. The result of the epidemiological survey recognize that the positive allergic skin reactions were observed in helminthic infection cases and it was suggested even that the positive rate among infection cases was hither than that of non-infection cases. As for the articles, there was no article which can prove this hypothesis. It can be concluded that this hypothesis is not well-founded. The increasing of allergic diseases never results from the decreasing of parasite infection.

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Hypothesis has advocated for two more decades that the increase of allergic rhinitis such as ceder pollinosis is relevant to air pollution. However, this was never confirmed successfully by any additional tests. As for the paper in which the hypothesis was presented, there was no strict discussion on the cross factors and some of the contents were found lack of believability as well. We held an epidemiological study in Shiraoi Town of Hokkaido Prefecture to check the hypothesis. As a result, no significant relationship between the prevalence of allergic rhinitis and air pollution was detected. We suggest that it is necessary to add more studies on the relationship between the air pollution and the increasing of allergic rhinitis.

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Arnold-Chiari malformation (ACM) is categorized into 4 types on the basis of the severity of hindbrain herniation and cerebellar dysplasia. Type I malformation, also known as adult ACM, there is caudal descent of the cerebellar tonsils only and can be a cause of unexplained headaches, dizziness, blurred vision, vomiting, vertigo, and drop attacks. In this unique case report, a 52-year-old man who suffered a fresh sudden hearing loss (SHL) of the left ear, accompanied with dizziness, tinnitus and difficulty to fall asleep. His history also included a first attack of SHL and tinnitus in the right side 15 months ago. A pure-tone hearing test showed sensorineural hearing loss on the bilateral sides (slight loss on left and moderate loss on right). On vestibular evaluation, a spontaneous down beating nystagmus was seen. Then a head MRI demonstrated the existing of ACM type I. Two months after the neurosurgical decompression, the patient's nystagmus diminished thoroughly, whilst mild improvement of hearing. It is suggested that the finding of abnormal central vestibular nystagmus or abnormal vestibular-visual interaction is a useful sign to help determine whether a ACM is underlying some otolaryngological symptoms such as hearing loss, dizziness or tinnitus. MRI is the first choice to diagnose the ACM type I.

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A case of acoustic neuroma (AN) with sudden hearing loss (SHL) was reported. The patient was a 46 yearold woman who suffered from SHL with previous tinnitus in the right ear. At first, she was diagnosed as SHL and administered to oral steroid therapy in other hospital. Two weeks after the onset the patient came to Miyoshi ENT Clinic. Pure tone audiometry revealed a low frequency sensorineural hearing loss. For a suspicion of AN, she received an examination of MRI with Gd DTPA enhancement. AN was detected in her right internal auditory meatus. Three times of continual audiometries showed a fluctuating hearing loss. Since there was no clinical features that could clearly distinguish the SHL induced by AN from those idiopathic SHL, we strongly recommended MRI for any SHL patient associated with facial paresthesia, unilateral tinnitus preceding deafness, or fluctuant audiogram.

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Hemangioblastoma (HBL) is highly vascularized tumor of not well-defined histological origin. Cerebellar HBL may manifest as a sporadic tumor or act as one of the manifestations of the von Hippel-Lindau syndrome (VHLS). Here we report a 36-year-old female patient with left cerebellar HBL. The patient presented with back headache, nausea, vomiting, and clouding of consciousness.
The symptoms were gotten serious in the morning and then relieved from noon. Nystagmus was detected through spontaneous nystagmus test and positional nystagmus test, both showing parallel or rotative nystagmus with leftward quick component operative resection of the lesion was performed via osteoplastic craniotomy. The mural nodule was a reddish mass about 7 mm in diameter and about 10 ml self-transparent oil-liked liquid was elicited from the cyst. The tumor specimen showed typical histological features of hemangio- blastoma. Post-operative MRI scanning of the abdominal and spinal canal failed to reveal any stigmata of VHLS.

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21 cases of laryngeal stenosis accepted the treatment of nickel-titanium shape memory alloy (Ni-Ti SMA) stent under shoring laryngoscope, from January 1998 to June 2001. After inserting the stent, aspiration dyspnea was obviously improved in all these 21 patients. All the patients were followed up for 2 to 42 months. In 4 cases, granulation was found in the former stent, and Nd-YAG laser under fiberoptic laryngoscope was used for treating it. The granulation disappeared and normal mucosa covered the stent after 6 months. 3 patients died after inserting the stent for 1 to 8 months because of metastasis of tumor (2 cases) and cerebral trauma (1 case). In a conclusion, Ni-Ti SMA stent is a novel method for the treatment of laryngeal stenosis. The dyspnea of patients can be improved in very short time, and the clinical effect is reliable.

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Subarachnoid hemorrhage (SAH) is an emergency in neurology. As SAH sometimes attacks without significant clinical manifestations, it may be misdiagnosed as other diseases. In this paper, a case of SAH with the first complaint of otalgia was reported. Some related literatures were reviewed to discuss its clinical characteristics, early diagnosis and treatment.

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Two cases of suppurative meningitis due to acute otitis media were reported. Both of the cases were male of more than 50 years old and presented with otalgia and headache. And case 2 also showed otorrhea. In pure-tone audiogram, conductive hearing loss was showed in both cases, while the tympanometry suggested B-type curve in case 1 and As-type curve in case 2. No abnormal was found in case 1 through CT scanning, while otitis media and mastoiditis were showed in case 2 by MR imaging. Both underwent myringotomy and antibiotics therapy. However, otalgia could not been controlled as well as the headache lasted for around 2 weeks. Both cases fell into coma and were diagnosed of suppurative meningitis with the pathogenic bacteria of Streptococcus pneumoniae. Then the patients received the neurological treatment and recovered. We discussed the characteristics of meningitis due to acute otitis media in nowadays. In the occasion of adults with acute otitis media, if the symptoms of otalgia and headache last for over two weeks and can not be released according to the formal treatment, otogenic meningitis should be paid high attention to.

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