Physiological and pharmacological actions of the adrenocortical steroids, which are important basis for the therapeutic use of the steroids, are discussed. Emphasis was placed on the antiinflammatory and antiallergic actions which may be of special value in the use of the steroid in the field of otorhinolaryngology.
Devise to avoid various side effects was also discussed.

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Eine 26 jährige Frau wegen Atemnot, die durch eine Schnittwunde am Vorderhals (Selbstmordversuch) verursacht worden war, tracheotomiert.
Wegen der hochgradigen narbigen Stenose des Kehlkopfes, die wir mittels des Laryngogramms sowie der direkten Laryngoskopie feststellten, konnte die Patientin durch die naturlichen Atemwege nicht mehr atmen.
Nachdem wir die Patientin in die Universitätsklinik aufgenommen hatten, führten wir die Laryngofissur und trügen das Granulationsgewebe möglichst vollkommen ab. Nach diesem Verfahren versuchten wig das neu wuchernde Granulationsgewebe mit Hilfe des Steroidhormons an der Weiterwucherung zu hemmen.
Trotz genügender Verabreichung dieses Hormons gelang es uns nicht die üppige Wucherung des Granulationsgewebes zu unterbinden.
Deshalb versuchten wir die modifizierte Laryngoplastik nach Arbuckle auszufuhren. Nachdem wir das neu wucherunde Granulationsgewebe durch Laryngofissur vollkommen entfernt hatten, legten wir einen der Wange entnommenen Schleimhautlappen, der mit einem Gummirohr fixiert wurde, an diese Stelle des subglottischen Raumes. Durch dieses Verfahren gelang es uns den stenosierten subglottischen Raum so zu erweitern, lass es der Patientin möglich war, durch die naturlichen Atemwege wieder zu atmen.

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With the advance of the objective recording of ocular movement, it has become possible to record the findings of spontaneous nystagmus easily and exactly not only of the eye opened but of the eye closed. But, however exact the recording may be, its value will be lost unless it possesses items necessary for the findings of spontaneous nystagmus.
From this standpoint, the author has stressed the findings of optic nystagmus apt to lack in the literature of otology, gave indispensable items in spontaneous nystagmus examinations and illustrated by means of electronystagmogram referring to each item.
The findings of spontaneous nystagmus thus obtained contai n those that show the character of nystagmus not yet reported. Of these the author intends to report individually.

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A woman, now aged 48, received a radiation therapy for cervical tuberculous lymphadenitis, and 13 years later she developed cutaneous carcinoma, and still 8 years later esophageal carcinoma in the corresponding part.
Now this is the first report that radiation cancer developed both in the face and depth of the part already radiated.

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The authors reported here a case aged 57 male of malignant papilloma in the left paranasal sinus.
The tumor originated in the middle nasal concha filled the left maxillary sinus reached the roof through the ethmoid extended to the sphenoid sinus.
Macroscopically the tumor suggested papilloma but histopathological examination showed that it cancerated partially in the area of generation deeper parts.
After surgical removal the patient was irradiated w as given anticarcinogenic agents. He has shown no sign of relapse for 2 years.

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Case 1: a woman of 56. At first the author suspected palatine tonsillar tumor but histological examination of the removed tumor showed that it was pharyngeal mixed tumor.
Case 2: a woman of 53. There was tumor-like swelling in the palatine tonsillar submandibular and parotid regions. The author supposed that the swelling in the parotid region was a retention cyst created by the pressure of the duct of parotid gland by a giant pharyngeal mixed tumor.
The tumors in both cases were surgically removed per os and by external incision.

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The authors experienced a woman of 24 who had been suffering from a swelling on the right side of the neck.
After extraction histological examination revealed that it was haemangioma cavernosum containing phleboliths.

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The patient was a male worker o f 17 who had been accidently injured in the preauricular part of the left ear by an air gun shot. He visited our clinic after about 4 hours, complaining of slight swelling and pain in the wounded part. X-ray examination (circus tomograph) showed a complete air gun bullet, firmly fixed in the Fossa pterygopalatina (Fig. 1).
A week later, under local anesthesia (1% procain sol.), Caldwell-Luc radical operation and the trepanation of the posterior bony wall of the maxillary sinus were performed. The bullet buried in M. pterygoideus medialis was. successfully removed after exploring by use of 2 fragments of fuse as the marks in X-ray reexamination (Fig. 2).
Fifty-three cases of foreign body (bullet) have been reported in the otorhinolaryngeal circle in Japan in the past 30 years, except the wounded cases in battle.

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Ein 3 jähriger Knabe, der seit 6 Tagen Gleichgewichtsstörung, Bläschenbildung an der linksseitigen Ohrmuschel und Gehörgangswarld scwie peripherische Facialislähmung derselben Seite bekommen hatte, besuchte unser Ambulatorium. Durch obengenannte Symptome wurde die Diagnose von Huntschem Symptomenkomplex leicht festgestellt.
Als die Behandlung verabreichten wir hauptsächlich das Tetracyclin und Steroidhormon, d. h. das Tetracyclin wurde vom 1. Krankheitstag bis 12.500 mg täglich (Gesamtdose: 6.5 g) und das Steroidhormon (Predonin) vom 1. bis 3. Krankheitstag täglich 10 mg, danach vom 4. bis zum 25.5 mg täglich (Gesamtdose: 155 mg) verabreicht. Die Blaschen der Ohrmuschel wurden mit der Terramycin-Salbe behandelt.
Durch diese Behandlung verschwanden die Blaschen nach 3 Tagen und die Gleichgewichts-störung war nach 8 Tagen genesen. Die Facialislahmung zeigte die Neigung zur Besserung nach 8 Tagen und genas gänzlich nach 26 Tagen. Obwohl die Facialislahmung in diesem Symptomenkomplex schwerheilbar ist, scheint es uns, lass die kombinierte Behandlung von Tetracyclin und Steroidhormon noch wirksamer ist.

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From the experience of the repair of four cases with saddle noses due to congenital syphilis, the authors realized that among the cases of the second type according to Gillies' classification those with no scars etc. on the dorsum could be successfully repaired by means of the insertion o f L-shaped ivory into the dorsum and columella of the nose.
The deep fold of the ala nasi seen in a case could be repaired with the transplantation of the autograft obtained by the window-shaped resection of the aural cartilage without the deformity of the donor site.

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Clinical observation in combination with the electrocardiographic, serological, bacteriological and histological examinations on 100 cases of chronic palatine tonsillitis being complicated by the development of tonsillar focal infection or being suspiciously so and on 65 cases of simple chronic palatine tonsillitis were made before and after the removal of the tonsils. The patients were divided into two groups, one of which had preoperative treatments and the other had no treatment, immediately before the operation, and the data obtained from the two groups were compared. The paper mainly dealt with the interrelations between the results obtained by the above mentioned examinations and also with the diagnosis and treatment of tonsillar focal infection.
1. The electrocardiographic examinations revealed that in the treated group the occurance of temporal aggravation of cardiac symptoms after the tonsillectomy was less frequent and the postoperative improvement was more frequent in the treated group in comparison with the untreated one. The results may be indicative of the effect of preoperative treatment.
2. Among the pharyngeal and intratonsillar bacilli of the patients, Streptococci haemolyticus were most frequently found and Streptococci viridans the next. The Streptococci viridans in pharyngeal area were especially abundant in the infected tonsils and were decreased in number by the treatment. In the cases having complication of the heart diseases Streptocci viridans were abundantly found in the patient's tonsils. In a few cases having tonsillar focal infection, the cultures of the blood after the tonsillectomy were positive for Streptococci viridans.
3. Histological changes of the infected tonsils, even those taken fro m younger patients, were marked. The alterations of the crypts were conspicuous in the infected tonsils and consisted of a mixture of chronic and acute inflammations. The bacterial masses in the crypts were numerous in the infected tonsils, especially of untreated group. The cystformation, the intramural embedding and the atrophy of lymphatic follicles were more frequently found in the infected tonsils than in the uninfected ones.
4. The change of CRP was more sensitive than that of Antistreptolysin titer but both of the two underwent in parallel. The two reactions in the treated group more quickly became negative than those in untreated group.
5. The effect of tonsillectomy on the focal infection was prominent when the operation was perfomed within three years after the onset of the complication. An adequate and effective. preoperative treatment, a careful operation and a sufficient postoperative treatment should be given to the patients for preventing them from the temporal aggravation of the secondary diseases after the tonsillectomy. The removal of the infected tonsils is considered highly beneficial for the treatment of the focal infection, since it completely cuts out the cause of the recurrance of tonsillitis by which the focal infection is progressively aggravated at each time.

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