The experiments had been performed since the authors' previous report, to study the relation between the intrauterine environment and the development of cleft palate and other malformations. Congo red was injected to female mice subcutaneously on the 8th and 9th day of pregnancy or Evans blue on the 8th day of pregnancy.
The embryos were examined on the 18th day of pregnancy.
The results obtained were as follows:
(1) In the group, in which 0.2cc of 5% Congo red solution was injected, one case of cleft palate and one case of encephalocele were seen.
(2) In the group, in which 0.2cc of 5% Evans blue solution was administered, all the embryos had been dead and absorbed.
(3) In the group, in which 0.1cc of 1% Evans blue solution was injected, no cleft palates and no other malformations were seen and 77.9% of the embryos had been dead and absorbed.
(4) In the group, in which 0.1cc of 0.5% Evans blue solution was injected, also no malformations were seen and, 75.3% of the embryos had been dead and absorbed. The mean weight of the living embryos decreased significantly.
(5) In the control group, in which physiological solution. was given, no malformations were abserved.
(6) As a result of this experiment, Congo red was found to have teratogenic activity. Evans blue produced no malformations, but killed many embryos and decreased the weight of the living embryos.

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The phosphatase activity of the secretion of otitis media and sinusitis with changes in the mucous membrane and the bone was investigated by making use of di sodium nitrophenyl phosp- hate as substrate, with particular reference to the difference due to types of diseases. age and clinical symptoms. Pnosphatase activity in the secretion of other diseases was also compared with that of above diseases. The results are briefly as follows:
(1) After investigating the phosphatase activity of the secretion fromthe ear and the nose, by nitrophenyl. phosphate procedures, the author found the optimal pH of alka1ine phospatase to be 10.4 or thereabout.and that of acid phosphatase 4.8 or thereabout. The optimal temperature proved to be 38°C, and the substrate concentration 0.4-0.5%.
(2) the results of measurmentof the phosphatase activity by means of nitrophenol units were as follows:The alkaline phosphatase of the secretion from the ear proved to be 22 units in average in 26 eases;the secretion due to middle ear catarrh 4.7 units in average in 4 cases;the acid phosphatase 13.1 units in average in 20 cases. The alkaline phosphatase of the secretion from the nose proved to be 19.5 units in average in 20 cases;the acid phosphatase 7.9 units in average in many cases.
(3) Compared with this, alkaline phosphatase in the pus of other diseases proved to be 5.3 units in average is 20 cases. On the other hand, acid phosphatase proved to be 17.5 units in average in many cases.
(4) Alkaline phosphatase contained in the secretion of mastoiditis or advanced sinusitis seems to be generally increased, but is not significant compared with that of mied diseases.
(5) So far as age is concerned, both alkaline and acid phosphatase were found to exist more in he secretion of young people than in that of Adults. Therefore, it is thought to be difficult to infer the condition of a bone disease.

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The author devised an apparatus that can give a current amplitude necessary and sufficiently stable for recording the psycho-galvanic skin response. Namely, with a Wheatstone birdge as the circuit for measuring the psycho-galvanic skin response current is passed through a DC-AC conv-erter, the current chopper, and through the amplifier with the common time constant and then it is passed through a synchronizing rectifier and finally into the ink-writing oscillograph.
Using this apparatus, the author took the recors of the entire course of examinations by PGSR audiometry on persons with different hearing acuity at each frequency of 500, 1000, 2000 and 4000cps. Following up this, subjective hearing tests were conducted, and the results of these two met- hods were compared. Those showing the difference with 5db between the two methods were seen in 65 to 85 per cent of the cases, indicating a sufficient reliability in practical use of the test as the objective hearing test.
Those conditioned less than 50 times amounted to13 (65%) out of 20 children with normal hearing of both ears, 10 (55%) out of 18 children with one normal ear and a moderate hearing loss in the other side, 8(67%) out of 12 children with moderate hearing loss of both ears, and 27 (90%) out of 30 children with severe hearing loss.
Those conditioned less than 50 times amounted to13 (65%) out of 20 children with normal hearing of both ears, 10 (55%) out of 18 children with one normal ear and a moderate hearing loss in the other side, 8(67%) out of 12 children with moderate hearing loss of both ears, and 27 (90%) out of 30 children with severe hearing loss.
Children with severe hearing loss have been found different from other children tested, being their attention more readily called to sounds and more easily conditioned than those in other groups-

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With the purpose to determine the reliability of the results obtained by PGSR audiometry-in young children, as there are many conflicting opinions on such results, the author examined by play audiometry, startle reflex test, and PGSR audiometry 23 young children with severe hearing- loss, whose age ranged from one year and nine months to 5 years and eleven months and who could not be tested by the routine subjective hearing test and who had difficulty in speaking.
Twenty three children were tested and results by both PGSR and play audiometry were obta-ined in 11 children. The difference in hearing loss by these two methods were within ±5db in 55 per cent of the cases at 500cps, 70 per cent at 1, 000cps, 67 per cent at 2, 000cps, and 75 per cent at 4, 000cps.
Those with whom PGSR audiometry was appliable were 16 children out of 23 children in the- age range of one year and nine months to 5 years and eleven months. Those who successfully taken the play audiometry test were 13 children out of the group of 23 in the age range of 3 years and 6 months to 5 years and 11 months.
PGSR audiometry has been proved to be a more satisfactory test for younger children than the play audiometry. Compered with play audiometry or startle reflex test, the results show a consi-derably more reliability and it is an excellent method for the examination of the hearing acuity-in younger children with severe hearing loss, who are extremely difficult to test by other methods.

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The author conducted the experiments to investigate the relation between the magnitudes of temporary threshold shifts and exposure levels (S.L.) following the one-minute, five minutes and fifteen-minutes exposures at low, medium and high levels to the wide band and narrow band thermal noise. The results obtaind were as follows:
1) The magnitudes of temporary threshold shifts are not always proportional to the intensity levels of the exposures. The temporary threshold shift following an 80db S.L.exposure is less than, that following a 20db S.L.exposure both in wide and narrow band thermal noise when the exposure and test tone are both the same.
2) This finding could be considered probably due to the fact that the intra-tympanic muscles, may start in action at an 80db S.L. of noise exposure.
3) It is confirmed that the magnitudes of temporary threshold shifts are directly proportional to the intensity level of the thermal noise exposures when the intensity increased above 90db S.L. or the exposure duration reached above five minutes.

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The author made measurement of diameter, area and weight of the tympanic membranes, audi-tory ossicles, oval and round windows in 35 vertebrates (3 amphibians, 5 reptiles, 6 birds, 21 mammals), and examined the relationship among the measurements.
The conclusions were as follows:
1) The tympanic membrane in amphibia and reptile was large and variable in size in propor-tion to the size of the head. But in mammal and bird, the difference of size of the tympanic membrane between large ones and small ones was less remarkable.
2) Ratio of the largest and smallest diameter of the tympanic membrane was the largest in bird, the tympanic membrane being the most elliptical in shape.
3) Apex angle of the tympanic membrane was from 97 degrees in Barbary sheep to 135 degrees in mole and squirrel in mammals, and 130-165 degrees in birds. In ungulates and carnivores, of which the tympanic membranes sunk forming acute angle, handle of the malleus was generally longer compared with diameter of the tympanic ring. In other animals like horse, rodentias and birds, in which apex angle was obtuser, the " unbo " located near the center of the tympanic membrane.
4) Especially broad Schrapnell's membranes were noticed in some ungulates as sheep, antelope, kyon and Barbary sheep.
5) Ratio of weight of the malleus to that of incus was from 4.5 to 0.84. In mammals, the malleus was heavier than incus except monkey, ox and horse. In those animals which had relati- vely small incus, the folianous process of the malleus was large, and angle of the handle of the malleus to the probable axis of rotation of the ossicular chain was small, for exampe, 13°in mole, 20°in bear, 22° in dog and 23° in bat. If the lever ratio is constant and the angle is small, the long process of the incus may be possible to become smaller, consequently the mass of the ossi-cular chain may become smaller.
6) Lever ratio of the ossicle in mammal measured on the projected picture was from 1.5 to 3.2. It was generally larger than that of human and supposed to be important for the transformer action.
7) Weight of the columella of bird per 1mm2 of tympanic membrane was the lightest (0.021-0.015) in vertebrates; therefore, it is suitable for the columella to move simply in and out like piston. The columella of amphibia or reptile was heavier than that of bird. In mammals, the auditory ossicles of small animals were not only absolutely but relatively light and slender, profitably lessening mass of the auditory organs.
8) The round window was always larger than oval window except in man, monkey and mole, Especially in those animals which live in the water, ratio of area of both windows was large. In bird, however, the ratio was close to 1.0, both windows being almost equal- in size.
9) In amphibia and reptile, ratio dividing the area of the tympanic ring by that of the ovalwindow varied range from 6 in toad to 58 in bull-frog. In bird, this ratio was constant (15-19), and similiar to that of mammals. In mammals, the ratio was from 11 to 36. Carnivoras and rodents showed big ratio.
10) It is thought that auditory organ of the animals which live in the water like fur-seal, sea-lion, otter and whale, are not to be suitable for the perception of air conducting sound, because of their little tympanic membrane, little transformer ratio and narrow external meatus, having been changed to the condition which is efficient to receive the born conduction sound.

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The author studied on Troger's method for mesurement of the impedance of the human ear drum and checked it in detail experimentally as well as mathematically.
The impedance the author obtained by Troger's method is found similar to those of Troger, Geffcken, Waetzmann & Keibs. and Metz, except that of Zwislocki. For example, the impedances are as follows; At 500 cps, 170 ohms by the author, 90 by Troger, 217 by Geffcken, 155 by Waetzmann & Keibs, 120 by Metz, on the other hand 647 by Zwislocki. At 1000 cps. 89 ohms by the author. 125 by Troger, 160 by Geffcken, 73 by Waetzmann & Keibs, 55 by Metz, on the other hand 310 by Zwislocki.
The impedance is higher in a lower frequency range and lower in a higher frequency range.
Finally the author measured the impedance of a rubber membrane by Troger's method and by another's method which is not avilable to the human ear but most exact only in measurement of acoustical impedance. It could be found from comparison of these two results that the impedance obtained by Troger's method as well as the other's are not correct. A more correct method for the measurement of the impedance of the human ear drum should be developed in future.

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On the basis of normal hearing, speech hearing about discrimination loss and mishearing of speech sound in conductive and perceptive deafness was observed clinically in connection with pure tone hearing. The result was as follows:
It was presumed that speech hearing of impaired ear was considerably influenced by distortion of the frequency showing the form of air conduction curve on pure tone audiogram.
Therefore, in order to detect this cause, the author made an audio-frequency charachteristics altering device which acted as a sharp cut off high pass filter at 250 500 1000 2000cps, broad cut off high pass filter, sharp cut off low pass filter at 4000 2000 1000 500cps and broad cut off low pass filter.
And, then, speech hearing of impaired ear in which the air conduction curve showed abrupt and, gradual form of high tone deafness and gradual form of low tone deafness was compared with that of normal ears with the tone experimentally distorted.
The result was as follows:
It was recognized that speech hearing of impaired ear was similar to that of normal ears with experimental distortion.
Accordingly. it was considered that the distortion of the air conduction curve with pure tone audiogram was one of the important factors to influence on the speech hearing of the impaired ear.

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In order to establish the effect of the alarm-bell of the railway crossing, the authors measured the acoustical spectrum for the bell sounds by means of an analyzer, and the masking effect of street noises on the bell sounds in normal hearing persons.
The bell sounds have a peak of 20db at about 3500cps in the acoustical spectrum.
This peak could be hardly masked by street noises and heard by normal hearing persons from a distance of 70 to 80 meters.

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Hearing test was done on I.B.M. operators togather with the analysis of noise of four kinds of the machines.
In hearing test, so-called C5-dip was detected only in the operators using the accounting machine, and in the noise analyzed a characteristic spectrum specific for the accounting machine was obtained.
It has thus been concluded that, as far as the I.B.M. was concerned, only the noise of accounting machine may induce a professional deafess while that of the others may be of no signficance as the couse of deafness.

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Two cases of primary squamous cell carcinoma of thenasal vestibulum were observed. In both cases, the tumor was obviously localized and the tumor cell infiltration was minimal. An incorrect working diagnosis as an inflammatory lesion was made because of remarkable ulcerative change of the lesion. Both cases healed satisfactorily by a simple excision, which was not radical procedure, and the excision of regional lymph nodes was not done. In one case, lymphnode metastasis was deveioped and the node was excised but no hematogenous dissemination was observed. The other case did not show any metastatic lesions. lesions. Both cases received CO60 radiation after the surgery.
It has been considered that the cancer developed gradually grow, infiltrate and extend. However, the type of the cancerand the resistance of the body should be considered. In the skin cancer, 1) Basal cell carcinoma is localized and rarely develop the metastasis, 2) Squamous cell carcinomaextend to regional lymph nodes but hoes not develop the genrealizek metastasis, 3) Melanocarcino-ma shows the generalized hernatogenous extension even when the primary lesion is found. Treating the skin cancer, 1) Basal cell carcinoma can be cured by the local treatment regardless to thecourse of the lesion, 2) Squamous cell carcinama can be cured by the excision of the primary lesion and local metastatic lesions, 3) in Melano-carcinoma, even an early diagnosis and radical surgery are not curative, (Biologic Predeterminism, MacDonald 1951). Same concept might be applied to the malignancy in the field of oto-rhino-laryngology. An evaluation of the type and localization of the cancer and its prognosis might be able to change the method of treatment in individual cases.

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The purpose of this report is to describe a new surgical procedure closing an esophagostome following laryngo-esophagectomy and a tracheostome.
This method is of great value to close the stoma when it is large or the tissue adjacent to the stoma is highly damaged following irradiation.
The operative procedure was as follows;
First operation: A large tubed abdominal flap with buried skin graft was made. The buried skin graft is to provide the internal skin lining of newly reconstructed esophagus or trachea when the stoma is closed.
Second operation: Two weeks after the first operation, one end of the tubed abdominal flap was cut off and transplanted to the wrist,
Third operation; Three weeks after the second operation, the other end of the tubed abdominal flap was cut off, the skin lined tube was opend, and the stoma was closed with this pedicleflap which has the internal skin lining.
Fourth operation: Four weeks after the third operation, the pedicle was cut off, and the repair of the stoma was completed.

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For the study of chronic paranasal sinusitis in children from 6 to 15 years of age, the author made histopathological examination of the mucosa and the bony wall covered with mucosa of maxillary and ethmoid sinuses in 83 sides of 53 cases.
Chronic sinusitis was seen in 1139 out of 3786 children or 30.1% being 25% in the city and 34.8% in the surburbs.
No specific relationship between the pneumatisation of the maxillary sinus and that of ethmoid sinus was observec in half of the cases. The relationship between the histop athological change of the mucosa and the pneumatisation of the sinus was like in the adult, the edema. cellular infiltration and fibrosis were mone promiment in uder-developed type than in well developed type. Especially in children, there was more remarkable tendency of edema but the cellular infiltration was less remarkable than thatin adults. Compoct fibrotic changes were also not remarkable. Epithelial changes and the thickening of basol membrane were less remarkle than that of aduts, being seen in the cases with under-developed pneumatisation. The thickening of the basol membrane was remarkable in ethmoid sinuses The cases with under-developed pneumatization showed marked lymphocytic infiltration. The plasma cell infiltration was remarkable in the cases with well-developed pneumatization. Eosinophilic infiltration appeared to be related to the degree of the edema of the mucous membrane, being some what remarkable in the cases with well-developed pneumatisation. Proliferation of the glands, dilatation of the glandular lumina and cyst formation were remarkable in the cases with well-developed pneumation. This was also more remarkable in children than in adults.
The slight atrophy of gland was also observed in the under-developed pneumatisation. Marked thickening of blood uessel wall was observed in the cases with under-developed pneumatisation, but it was less remarkable than in the adults, the large reticular edema was seen in the cases with well-developed pneumatisation and the small reticular edema was seen in the case with under-developed pneumatisation. Lacunar absorbtion in hcildren was slightly more remarkable than in adults being marked in ethmoid sinuses than in maxillary sinuses. Inflammatony absorbition of the bone was seen in only 3 cases of the maxillary bone and not in the ethmoid bone.

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Audiograms of 287 who had been, in the noisy occupational environment for 5 to 40 years were studied, considering physiological hearing loss with ages.
No progress in the impairment was observed after 10 years' employment. Special from of audiogram showing hearing loss in high tone range (C6) seemed to have some correletion with hypertension.

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The authors analyzed the machinary noises in a factory of locomotive and compared these result with the hearing losses of the factory workers.
There could be found a parallel relation among the analyzed sound intensities above 2000cps the hearing losses and the period of employment of the workers.

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Both sagittal and lateral high-voltage radiograms were taken in order to study morphologic changes of the soft part of larynx and the pharyngeal cavity in various conditions such as changes in pitch, register, force, and vocals.
Twenty-five persons were tested, consisting of 8 vocalists (4 females and 4 males) and 17 ordinary persons (9 males and 8 females).
The results obtained are as follows
(1) The ventricle of larynx underwent the most conspicuous changes.
a) The higher the pitch within the same register, the narrower the ventricle. In the chest voice register, however, the ventricle turned from narrow to wide and again to narrow as the pitch rose.
b) At the same pitch, the ventricle proved always wider in the higher register.
(2) a) Within the same register, the vocal cords were elongated as the pitch rose. But in the male falsetto voice register and the female head voice register, the length of the vocal cords remained constant.
b) At the same pitch, the vocal cords did not differ in length in two different registers.
(4) a) The higher the pitch within the same register, the higher the site of the larynx.
b) At the same pitch, no difinite characteristics were noted of the site of the larynx in two adjoining registers.
(4) Individual differences were noted to such an extent in the relation between the width of the pharyngeal cavity and the changes in pitch or register, that specific relationship was not observed.
(5) The width of the ventricle of larynx and the pharyngeal cavity changed most remarkably in accordance with changes in force. However, the mode of the change was not specific.

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A new surgical method has been experimentally deviced by the present author for the end-to-end repair of injured facial nerve of guinea pigs.
It needs no saying that the method used for the repair of injured nerve is essential in modem surgery. However, suture of injured nerve is so complicated especially in otolaryngological field of medicine that the results obtained are often unsatisfactory. It is, therefore. desirable that a simple and efficient method should be perfected which will always give satisfactory results. The method described in this paper will meet that purpose.
The principle of this method consists in twining the pericapsular connective tissues of the facial, nerve. Namely, the pericapsular connective tissues were twined without using any suture material so as to bring the ends of the nerve into contact each other, and then the injured portion was fixed with surrounding tissues.
Results and Consideration:
1. Following the fixation above stated, the nerve axis was observed, to regenerate from the proximal end at the rate of 1 to 0.2mm per diem, and completely regenerated within 12 to 16 weeks.
2. Implantation of dissected nerve trunk was also undertaken in addition to this method. The nerve axis regenerated within 16 to 24 weeks, and there seems to exist no appreciable relation, between the results and the quality of the material implanted.
3. This method should be performed as immediately after the injury as possible in order to give a satisfactory result.
4. The preferable points of this method were as follows,
1) Material used for repair was readily obtained.
2) No serious foreign body reaction was brought forth.
3) Satisfactory repair was undertaken without injuring the nerve axis with suture material.

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