The continuous frequency self-recording audiogram of many ears with impaired hearing obtained by a Eekesy type audiometer was discussed from the view point of its shape, its amplitude of the zik-zak trace and relation of both. Conclusions were as follows : 1. It is not permissible to use this method just in place of ordinary manual audio- metry. 2. It is not adequate to evaluate the results obtained by these two methods in the same manner. 3. This method has many advantages and in its sence the author recognized the necessity of further investigation.

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Sputum specimens from 110 patients with known diagnoses were examined. Papa- micolaon stain smears were made and squamous epithelial cells, ciliated epithelial cells, aveolar epithelial cells, leucocytes, elastic filbers and others were studied. In general, the cells appeared in the sputum seemed to have some relations to ana- tomical location of the diseased areas. In the pharyngo-laryngeal diseases, many flat cells were found and the other cells were scanty. In the tracheo-bronchial and pulmonary diseases, the differentiation was relatively difficult, and elasticfibers were seen in 62% in the later group but not in the former group. It might be said that the cytological examinatin of the sputum should be used as a useful method in the diagnosis of diseases of the respiratory tracts.

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Shinoda studied on the evoked potentials and the unitary activities by means of the superfine micro-electrode (each tip diameter measures 0.1 u)from cerebellum in cat by the sound and electrical stimulations. 1)The evoked potentials by the sound stimuli could be recorded from lobus simplex, . tuber vermis and declive, and they disappeared by bilateral destruction of the inferior colliculus, but not affected by bilateral destruction of the medial geniculate body and ce- rebral auditory cortex.The auditory pathways, therefore, seem to be projected to the cerebellar cortex through the inferior colliculus. 2)The evoked potentials by the electrical stimulation of the cerebral auditory cor- tex were recorded from tuber vermis, lobus simplex and declive.From the results of the experiment, the projection pathway to the cerebellar cortex through the cerebrum, was suggested. 3)The latency of the evoked potentials which were recorded from tuber vermis by the electrical stimulation on the peripheral acoustic nerve was 2∼4 msec.Since the la- tency of the responses by the sound stimulation was 10∼11 msec, the results can be well explained by considering a possibility of stimulation to the vestibular or facial nerve fibers. 4)Only one thirtieth to fiftieth of the unitary spikes which were recorded from tu- ber vermis could be certified to have a certain relation with sound stimuli. 5)From the results described in 3)and 4), it might be thought that several func- tional areas are overlapped each other in the cereberal cortex. 6)The elements responded to sound stimulation had two types ; one was the inhi- bited type and the other was the facilitated type by the sound stimuli, and both of them showed the slow adaptation to the sound stimulation. 7)The unitary spikes by the sound stimulation which were recorded from cere- bellum showed high threshold of more than 80 db.The high responsive threshold in the cerebellar cortex showed resemblance to the threshold of audito-muscular reflexes. On thecontrary, the responsive threshold in the cerebral cortex was quite alike to the actual auditory threshold.

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When sound waves impinge upon the tympanic membrane, the manubrium of the malleus yields mechanical forces.Those forces are conducted by way of the auditory ossicular chain to the inner ear and cause consequently movements of the intralaby- rinthine fluid.Conducting the force from the manubrium to the cochlea, the auditory ossicles produce stresses in themselves.The author has investigated this stress systems in the ossicles. A method of stress analysis adopted for the purpose was three-dimensional pho- toelastic experiment, using models of diallylphthalate that were 15 times as large as the human ossicles and had accurate similarity to them. Three pieces of such model were constructed in the following manner; the long process of the malleus and the short process of the incus were respectively fixed through an attachment of bakelite to a metal frame, and the footplate of the stapes was set on a flat plate (Fig.2).External force was applied on the set of the models by weighing a weight (3.5 Kg)at the lower end of the manubrium in the direction of the stapes.This procedure was carried out inside a closed box, equipped with electric heaters, under the condition of a high temperature (170- C), After applying external force the models were cooled as slowly as possible, and thus the stress produced inside the models could be frozen perfectly.Then each of the models was sliced off in a proper direction.Stress systems in those slices were examined by passing polarized light vertically through the faces of the slice, or more minutely speaking, stress intensities were measured by circularly polarized light and directions of stress by plane polarized one (Fig.4). From the results of such optical examination it was able to know conditions of st- ress distribution in the ossicles. It is a most remarkable fact that boundary stress concentrated in the inner side of the neck of the malleus, from which to the head of the malleus the stress decreased gra- dually, but to the manbrium very steeply (Fig.5) Stress intensities in the manubrium were truely lower than that in the other parts of the malleus.From the line of prin- cipal stress it was recognized that the bending action took place at the neck of the malleus so that the inner side of the malleus produced compressive stress and the out- side produced tensile one (Fig.10). In the incus the distribution of boundary stress was almost uniform against in the malleus, and particularly inside the body of the incus, the lines of principal stress were without definite directions (Fig.7). Stapes indicated such a mode of stress distribution that both the lines of principal stress and the intensities of boundary stress were almost symmetrical in its anterior and" posterior part, involving the head, neck and the foot (Fig.8, 15). Comparing the experimentally measured stress distribution with the real structure of the human ossicles, it is found to exist an intimate relationship between the inten- sity of boundary stress and the thickness of the bony cortex.

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The incidence of chronic sinusitis in adults was compared with that in children to study the tendency of spontaneous healing. Observations were made of those between 15 and 20 years of age and it was revealed that the morbidity rate of sinusitis gradually decreased with the increase of the age and in 20 year old group the morbidity rate was less than one half of that in children. From this result of observations, the author confirmed the opinion that chronic si- nusitis in children has a significant tendency of the spontaneous healing in the follo- wing several years.

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Relationship beetween chronic otitis media and chronic sinusitis was investigated in 9343 children of from 4 to.14 years of age. Chronic otitis media was observed in 1.3 per cent of the children without sinus aff- ection, while the incidence of the middle ear involvement was raised to 3.0 per cent in the children who were suffering from chronic sinusitis, this defference being statistically significant. From these results obtained, the author confirmed the fact that the sinusitis in children played a significant part as a cause of chronic suppurative otitis media.

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1.The salivary gland collects inorganic iodine from the circulating blood and exc- rets it into the saliva in high concentration. 2.The amount of the iodine excreted into the saliva during a certain period is constant showing no individual difference, when the serum iodine level is constant. 3.These processes depend mainly upon a function of the serous cells of the gland. 4.From these observations, the clearance test of the salivary gland function, using radioactive iodide (I131), has been proposed by the author. 5.This method is demonstrated to be satisfctory for a diagnostic test of the sal- ivary gland function because of its sure evalution of the function, not being influenced by various extraglandular conditions and also its availability in the analysis of the function.

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1)The reaction of the palatine tonsil irradiated by radon-seed 1 mili-curi in ra- dioactivity, which was inserted into the tonsil itself, was observed.The radon-seed was applied with the purpose of the treatment of the chronic tonsillitis or the hyperplastic tonsil on 196 cases.The tonsil became small and the attack of the acute inflam- mation decreased after the irradiation. 2)From the histopathological examination of the sixteen irradiated tonsils follo- wing results were obtained.The tonsil showed the remarkable change on its structure after ten days irradiation, and its germinal centers diminished.But after one month, the regenerative process was observed and it returned to almost normal structure one year after the irradiation. 3)As the conclusion from these results it can be said that the irradiation therapy is very effective clinically in the treatment of the chronic tonsillitis or the hyperplastic tonsil, and that this simple and harmless treatment has almost the same effect with the irradiation by the X-ray.

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Oral and pharyngeal ulcerous candidiasis is a hardly curable chronic disease with persisting symptoms and is called a chronic thrush in Europe. The pathogenesis and the production of the antibody have not been clarified and no effective treatment has yet been established.To study these problems it is neces- sary to produce experimental ulcer, which never have been produced successfully. The author produced the ulcer in rabbits and dogs, Candida was injected superfi- cially into the mucosa.Otherwise, the injected suspension of the fungi was rapidly ab- sorbed Following this procedure the chronic ulcers were produced in 45 rabbits without exception.In dogs, however, this ulcer was produced only in 3 cases, in which alloxan glycosuria had been intentionally developed.Dogs appeored to have strong resistence to Candida infection. Then various serological observations were made on those experimental animals with the ulcer. For the skin test, Akiba's polysaccharid antigen was used Positive reaction was de- monstrated in 33 per cent using 1γ/cc antigen and in 63 per cent using 10γ/cc antigen. Agglutination and precipitation tests of the serum showed similar patterns of mild reaction.It appeared on the 5th day after the injection, reached to the maximum on the 15 th day and then gradually decreased.A few exceptional cases showed mild reac- tion even on the 25 th day.

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The focal infection caused by chronic sinusitis was investigated in collectively ope- rated one hundred children whose ages ranged between 6 and 15. The preoperative clinical examination disclosed abnormalities on E.K.G.in 12.5% in liver function in 11.7%, in urinalysis(determination of protein in urine and Addis sediment count)in 2% and 5.1%.Most of them, however, disappeard soon after the operation.

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Authors reported a case (27 years old female)who had been injured the base of the skull and meninges three years ago, followed by repeated meningitis and cerebrospinal rhinorrhea.Such a protracted case was rarely found in literatures. A cerebrospinal fistula was diagn*sed by the intrathecal introduction of 1 cc.of Evans blue solution 0.5g/dl). A Moure's incision was made and the fistula was closed by the replacement of the meningocele into the cranium. The bony defect was closed by the transplantation of fascia lata between the base of the skull and meninges, and its nasal side was covered with the stemed flap from the nasal septum. The flap from the nasal septum was helpful to graft the fascia lata and to protect the area from the infection.

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Guinea pigs were treated with HgCI2 or Cantharidin for the kidneys and CCI4 or dl-Ethionine for the liver, so that no histopathological changes of the auditary organ developed, and the acoustic stimuli were given.The treated animals were asumed to have developed unhealthy intrinsic factors, the ear being Locus minoris resistantae to the acoustic trauma. The acoustic stimuli loaded were 120 Phon at 2000 cps repeated for 10 day(for 2 hours every other day)or 110 Phon repeated for 10 days(for 2 hours daily).It was confirmed that the acoustic stimuli caused no pathological changes of the auditoryor- gan. The results, obtained were as follows: 1)When the animals with the injury of kidneys were exposed to the acoustic sti- muli, degeneration of cells were observed at the 2 nd turn of Corti's organ. 2)When the animals with the injury of liver were exposed to the acoustic sti- muli, degeneration of cells were observed at the 2nd turn of Corti's organ. 3)Preyer's reflex test showed an obvious impairment in the high tone region. It was concluded that the susceptibility to acoustic trauma was increased in those animals with the injury of kidneys or liver.

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Although the maxillary nerve block is an important procedure in the operation of the maxillary sinus, it is not commonly used because of its complexity and uncertainty. The author developed a new, simple and certain technique of the maxillary nerve block Sixty-seven skulls were examined for this study. The principle of the new technique is as follow: With infiltration anesthesia the tissue on the anterior surface of the maxilla is anesthetized.The usual skin incision in the canine fossa is made. This in extended laterally toward the tuberosity and the infratemporal surface of the maxilla is exposed at the area where this surface and the antherior wall of the si- nus conjoin to form a crest.The periosteum is incised and separated to expose the pterygopalatine fossa. Using a curved or an angled needle, the maxillary nerve is easily anesthetized without any danger.

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Based on the fundamental and technical study reported in Part 1, the author applied the new technique of the maxillary nerve block in many maxillary operations(mainly, chronic sinusitis), and the effects of anesthesia were described. 1)The effect of the anesthesia:The analysia was obtained more easily by the new technique than the usual technique.Successful analgesia was obtained in about 95% of the cases. 2)The influence on bleeding;:Using this new method, bleeding during the ope- ration was markedly reduced.These effects lasted for about 50-60 minutes. 3)The blood pressure, the pulse and the respiration rate decreased but they were within normal limits. Also there were no harmful or continuous side effects in all cases. 4)Since there has been no single method to obtain complete anesthesia of maxillary nerve, several different methods have been employed at the same time.The simplicity and the certainty of the new method are emphasized.

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The author investigated the absorption ability of tonsils using Na24 1.The abso:ption ability of not inflamed tonsils throngh a superior tonsilar fossa is very slow and little.It is slow but very strong when absorbed throngh several ton- silar fossoe. 2.The absorption ability of inflamed tonsils shows a large difference depending on the degree of the inflammation. 3.The authcr investigated the excretion of Na 24 in urine, and no specific findings were obtained in all cases.

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Nihon University(Director:Prof.S.Nakamure) The authors investigated the effects of tonsillectomy on protein metabolism. 1.Nitrogen balgance becomes nenative after tonsillectomy, but it becomes positive within 3 to 5 days. 2.Following to the tonsillectomy, the variation of serum protein level and non protein nitrogen level is not remarkable. 3.Effect of the tonsillectomy on the body is not remarkable as far as the nitrogen balance is concerned.

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In free field, part of sound penetrates the skull directly and reaches the inner ear through the bone.Author called this kind of sound transmission " indirect bone conduc- tion". Declining coefficient of sound in the indirect bone conduction was measured in 20 patients whose oneear was completely deaf and normal in the another side, and also in 15 cases with normal ears.Values obtained were from 45 db to 70 db. The author explained the method of hearing test in free field, in details and repor- ted the results on various types of deafness. In persons with normal hearing or perceptive deafness, hearing loss by the test in free field was almost completely equal to that obtained be the test using receiver.But in persons with severe conductive deafness showing 50-60db, hearing loss by the test in free field was smaller than that obtained by the test using, receiver, especially at higher frequencies. This phenomenon was explained that the indirect bone conduction might become stronger than the air conduction especially at higher frequencies when function of sound conducting system in the middle ear is damaged excessively.

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Conchotomy was done on 13 cases and the mucous membrane of the inferior conchae was subjected to histochemical investigaton. An activity of alkaline phosphatase was examined by Gomori's revised method (1946).The infiltrating cells in the epithelium and the connective tissue, and the wall of blood vessels showed remarkable activity.Strong activity was also obseryed in the epith-lium and the glandular cells.The ruclei and nucleoli showed a particularly strong activity.The basal membrane and the connective tissue fibers showed a fairly weak activity No activity of acid phosphatase was observed by Gomori's revised method (1946). Pas stain was positive in the basal membrane, infiltrating cells, the wall of blood vessels, and inner surface of the glands and excretory tubules.Strong positive reaction of PAS stain was seen in the inflamed glandular tissue and the wall of bloed vessels. A small amount of glycogen was found at the base of the cells of the serous glands, but hyaluronic acid was not demonstrated.

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The effect of labyrinthine stimulation by accelerated rotation on the water content of the blood was studied in the dogs and the rabbits by means of rotatoric acceleration apparatus specially designed by Prof.T.Hasegawa. The results were as follows: 1.In normal dogs, decrease of the water content of the the blood was observed after the rotation for 15, 30 and 60 minutes.The decrease was most remarkable in 60 minutes group. 2.In dogs with bilateral labyrinthectomy, decrease of the wather content of the blood was not observed after 15 and 30 min.rotation.The water contents of the blood decreased slightly after 60 min.rotation, but it returned to normal quickly. 3.In normal dogs to which 7% sodium bicarbonate had been injected, the change- in in the water content of the blood was asmost the same as in labyrinthectomized dogs, however the change was mild than that of labyrinthectomized dogs. 4.In normal dogs to which atropin injection had heen given, the water content of the blood decreased after the stimulation. 5.In dogs anesthetized by Evipan-Natrium, the water content decreased temporari'y after the stimulation and then it increased. 6.In summer, the change of water content of blood was remarkable and it was, mild in autumn. These results prove that decrese of water content of blood observed when the laby- rinth is stimulated by accelerated rotation, is due to sympathicotonic disturbance, and; this is prevented by intravenous injection of 7% sodium bicarbonate solution.

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