The change in the potential of the scala vestibuli and in the cochlear microphonics were investigated at various intralabyrinthine pressure. In this study, the intralabyrinthine pressure were increased by blowing the physiological saline solution into the scala vestibuli and by inward pushing of the stapes.
The potential of the scala vestbuli was observed to rise nearly 1mV. in a few seconds when the positive pressure was applied to the scala vestibuli by injecting the saline solution; and reduced very slowly, showing hysterisis-like response, on withdrawal of the pressure. The change of the potential was well maintained as long as the pressure was applied.
Potential elevation was also observed when the stapes was pushed into the cochlea. The value of the elevation was in the range between 100 and 250 microvolts, and it was approximately 1/4 0f the magnitude of the cochlear microphonics induced by stapes vibration, the amplitude of which was eqalized to the displacement of stapes pushing.
Judging from the relation between the potential elevation and the intralabyrinthine pressure, it was revealed that the curve of the potential elevation had a capacitative character.
The microphonic response showed the transient decrease in its amplitued when positive pressure was applied to the scala vestbuli. After 0.2 seconds, the decreased amplitude of the microphonics recovered to the value before pressure increase. At this time, the potential of the scala vestibuli was still elevating as stated above.
From the results, it was concluded as follows:
The Reissner's membrane had high impedance to DC and low to AC. It was verified that it had a suitable character to correspond to the resistance-capacitance coupling circuit. The cochlea had a visco-elastic character with its local relaxation, and it showed functional stability against intralaby-rinthine pressure change. The pressure difference between the scala vestibuli and scala tympani was assumed to be mainly compensated by the downward movement of the basilar membrane.

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By resecting each nerve of the otolithic organs the influence to the change of nystagmus jerks by caloric stimulation was observed. The results were as follows:
1. When the utricule stimulated by cold water, the number of nystagmus to the same side was increased. This phenomenon is suggesting tinythe utricular macula is pressed when cold stimulation was applied. On the contrary, the number of nystagmus to the opposite side was increased by hot stimulation.
2. When the saccule stimulated by cold water, the number of nystagmus to the opposite side was increased. Namely it suggests the saccular macula is pressed when the cold stimulation was applied. When the hot stimulation is applied the phenomenon is contrary.
In conclusion, the otolithic organs take part in the appearance of nystagmus by caloric stimueations.

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By the method of accelerative optokinetic stimulation, the author have studied on the optokinetic nystagmus reaction recording from ENG in normal human subjects and rabbits. Results obtained are as follows;
1. Compared with the ordinary optokinetic stimulation followed by a constant velocity, the optokinetic nystagmus was more manifested and enduring and regular with accelerative optokinetic stimulation.
2. Generally, the afternystagmus and nextly-succeeding secondary phase of optokinetic nystagmus have observed after optokinetic stimulation regardless of either constant velocity or acceleration, as the basic phenomen of optokinetic ocular reflex.
3. In rabbits, when an accelerative optokinetic stimulation was repeated with in a short intervals, there were some cases of which evoked nystagmus was transformed into the eye movements resembling to socalled "Nystagmus Clonus" or "Firing" becomming to completely independent of original stimuli in regard to frequency of beats.
4. The secondary phase of nystagmus does exist not only in vestibular nystagmus, but also in optokinetic one. This phenomenon is the manifestation of basic pattern in nystagmus reaction being in common with each other in the two nystagmus and is organized by primary reflex arc in the brain stem constantly influencing and controlling by the higher optokinetic vestibular tracts such as the cerebellum or the cerebrum.

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The author investigated electron microscopically the fine structures of the serous cells of the human nasal glands. The results obtaind were as follows.
(1) The cells changes morphologically compexly and subtly corresponding to the stage of their secretory function.
When the secretory granules start to appear, the nucleus is situated nearly at the center of the cell and shaped round.
The infranuclear zone is abundant in lamellar endoplasmic reticulum (E R.), and in the supranuclear zone well developed Golgi bodies are recognized.
Morphologically typical mitochondria are distributed evenly in the whole field of the cell, with the apparance and increase of the secretory granules, the nucleus is gradually lowered downwards and transformed, and the E. R. and Golgi bodies lose their lammellar structures and get obscure.
In the loaded phase, the mitochondria show a tendency to expand diminish.
Just after discharge of the secretory granules, R. N. A. granules are scanty, the E. R. is swollen and gets vacuolar, and the mitochondria are scarce and remarkably expanded
In the next stage, the vacuolar E. R. aggregates densely, the cell looks apparently reticulated, and the mitochondria start to increase.
Furthermore, the R. N. A. granules increase and compressed E. R. shows an imcompletely lamellar structure. Thus the cells is in the presecretory stage.
(2) In the early stage the secretory granules are formed in the Golgi apparatus and seem to arise from any of Golgi granules, Golgi membrane and E. R. in the Golgi apparatus. Extending over the preparatory and the loaded phase, they are seemingly formed chiefly in the supranuclear zonea nd arise from the degenerated mitochondria with R. N. A. granules on the circumferences.
(3) The so called "lipochonria" of Baker are encounterd. Lipoid granules and lipochondria are recognized in all the stage of the secretory cycle, and even in the myoepithlial cells.
(4) Transitional picture between the exomembrane of the nucleus membrance and the E. R. was seen.
(5) Between the adjoning cells were recogneized the "desmosome" and "terminal bar" which had not been proved by light microscope. They were very similar to each other, but author realized that there were some differences between them.
(6) There are microville on the free surface of the cell facing to the lumen. They seem to change corresronding to the secretory function of the cell.
(7) Intercellular secretory canaliculi are often found, the lumen of whieh is rich in microvilli.
(8) Remarkable intercellular interdigitation are recognized at the boundary between the adjoining cells and infoldings are seen in the basal part of the cell.
The basal infoldings are not so remarkable as those of striated cells of the salivary glands or epithelial cells of the kidney.

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Past pointing test based upon vestibulo-spinal reflex was reexamined by photo-electric recording. Angle of deviation of the arm evoked by labyrinthine stimulation and its duration was observed. Various strength of rotatory and caloric stimulation were applied as the stimulation. Stimultaneous electronystagmography was performed as an indicator of activity of the labyrinth.
Following conclusions were obtained from the experiments.
1) Threshold of labyrinthine deviation of the arm was 0.75-4.0 degrees per scond2, and showed remarkable personal variation.
2) The time required for maximal deviation by acceleratory angular stimulation was 40 seconds unrelated with strength of stimulaton. The curve showing deviation resembled to deviatiion of the cupula decided calculatorily by v. Egmond and Groen.
3) Logarithmic relation was observed between strength of acceleration and degree of deviation of the arm.
4) Two healthy examined among twelve showed deviation toward reverse direction compared with others. Some discussions were performed on the course of the "reverse phenomenon"
5) Deviation of the arm after cupulometric stimulation delayed about ten seconds compared with activity of nystagmus, represented by eye-speed of its slow phase. The delay was considered to be caused by summation of impulses on the complicated neural pathway of the vestibulo-spinal reflex.

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Part I: Cochleopupillary response in awake state
The author studied on the possibility of objective measurement of hearing by means of cochleopu-pillary response and obtained following results.
To measure accurately. the threshold of this response, it was necessary to give the sufficient duration between each stimulus. In about 67% of normal hearing, the differences of threshold between pupillary response and subjective audiometry were 0 to 20db, while in the remaining 33%, threshold of the former was 30 to 80db above the latter. In advanced deafness, most of the pupillacy response arose near the subjective threshold. Technically it was difficult to observe the response to infants under 3 years old.
These results indicate that the cochleopupillary response is not practically sufficient to apply as an objective audiometry, but is avaiable as a supplemental means of other methods.
Part II: Cochleopupillary response in asleep state
The author found that the cochleopupillary response also arose in asleep state, and confirmed that the measurement of hearing by means of this method was respectably avaiable as an objective audiometry. Though the preparative procedure may be slightly troublesome because of keeping in suitable sleep. the special apparatus is unnecessary and the observation of response is easy.
On measurement, there was no age limit at least above 4 months old. In most of normal hearing, both infants and adults, the threshold of this response was 50 to 80db above subjective hearing level, but it was difficult to respond in deep sleep or general anesthesia.

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The authors applied Toriomin (Perphenazine Hydrochloride) to 22 cases of the patients complained of vertigo with healing results of 64%. Most of effective cases suffered from the rotational vertigo and showed the abnormality in coloric test by Hallpike's method.
From the above mentioned result the authors concluded that Toriomin was effective to the vestibular disorder.

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1. Audiometric data for school children.
The author performed a screening test using pure tone audiometer on 1.584 school children, the first graders to the sixth graders, in Nagasaki City, among whom 508 cases (32.1%) were suspected at the first test and 167 cases (10.5%) were suspected at the second test as having hearing difficulty.
These 167 cases were tested again for air-and bone conduction threshould, and 116 cases (69.5%) were confirmed of their hearing difficulty and the remainder (51 cases, 30.5%) revealed no hearing loss, that is to say the latter were screened under suspicion of deafness in the absence of deafnees.
More than 35 cases (2.5%) of children who passed the both screening tests were found to have hearing difficulty after having further inquiry and audiometry.
In other words, they were not dected their deafness in spite of their hearing difficulty.
The auther recommend a new standard of school audiometry, in which those who have more than two 20db or severe hearing loss in two or more frequencies among eight frequencies (125 to 8, 000cps) and those who have one or two hearing loss of 25db or more at 4, 000 and 8, 000cps.
2. Study on the error of screening test.
To infer the grade of error of the screening test, the author performed two screening tests and air-and bone conduction threshold test on 283 school children the first graders to the sixth graders of another school).
The finding were as follows:
Therefore, the author recommends a method to test the air-and bone conduction threshold of the children screened at the second screening test, to avoid the error of over-and under-screening.
3. Study on the reliability of the response at the screening test.
The author investigated the reliability of response at the screening test in 283 cases.
The accuracy of the response at the second screening test was improved by 6.7% (from 86.7% to 93.4%) as compared with that at the first screening test.
There isno marked difference of the accuracy of the response among the school graders.
The accuracy of the response in lower school graders is somewhat better than in higher school graders, so that the screening test can be performed succesfully on the younger school children.

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A new method of maxillary block was devised improving ostwalt's method which has the highest rate of success in reaching to pterygopalatine fossa, while its rate in reaching to the canalis rotundus is low. Distance between the lowest point on the inferior margin of the orbit and the biting surface of the second false molar of the upper jaw was measured and this was suggested as the distance of needle insertion. The needle is inserted at the possible nearest point to the pterygopalatine fossa on the posterior margin of the tuber maxillae in the oral cavity. Then the point of the needle is inserted exactly into the pterygopalatine fossa using specially devised needle. Thus the maxillary nerve is reached and then the direction of the needle is changed after Matas-Braun's or Sicher's method which have the high rate in reaching canalis rotundus. Thereby, in foramen rotundum, the block of the maxillary branch of the trigeminal nerve is given whithout danger or difficulty.

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Function tests of adrenal cortex, such as Thorn test, 17-Ketosteroid excretion in urine. RobinsonKepler-Pawer test, serum sodium-potassium ratio were done on 46 cases with Meniere's syndrome. Hypofunction of adrenal cortex was seen in 22 cases. In this group, most of the cases showed hypotension, allergic diathesis, slender constitution and many of the cases were overs of age. Fifteen cases out of 22, which showed typical Meniere's syndrome, hearing loss in middle speech range was over 40 dbs (unilaterally, on one ear, ) and over 20dbs (bilaterally. on both ears.) In many of the cases, vestibular function test revealed directional preponderance in nystagmus and reversibility of vertigo attack was low. Predonisolone was given to the cases of typical Meniere's syndrome and in 7 cases, favorable results were obtained on attack of dizziness. In 3 cases, hearing was improved and in 2 cases, tinnitus dis_??_ppeard.

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Clinical diagnosis of rhinogenous optic neuritis is very difficult. To make the diagnosis sure, operative findings of posterior ethmoidal and sphenoidal sinus which situate near the nerve, and its postoperative progress are very important.
The rhinogenous neuritis was classified into 3 types as follows:
I. type: Syndrom of orbital apex (serious type).
II. type: Optic neuritis with papilloedema (medium serious type).
III. type: Optic neuritis without papilloedema (slight type).
4 cases of I. type and 2 cases of II. type were reported. Among these 6 cases 5 cases of good results were obtained. Among these 6 cases in 3 cases removal of medial wall of optic canal by Niho-Sato's operation were performed and bony optic canal were histo-pathologically examined. By this histological observation serious pathologic changes were proved adjacent to the optic nerve and the etilogy as rhinogenous became very sure.
The cases of the slight type are now still under investigation and although its diagnosis is still uncertain, it seems to be very probable to believe in the frequent presence of this type.
For the treatment of the rhinogenous optic neuritis, complete removal of the pathologic mucous membrane thru transantral and extranasal route is very important and opening of optic canal by Niho-Sato's operation is effective.

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Deep-seated submucous Candididiasis of the mouth and pharynx is calling attention of the Otochino-laryngologist. because this disease shows strong resistance to any treatment.
The author and co-operators are studying on this disease and had investigated distribution of Candida myces in the mouth of the patients without Candidiasis as a part of their study.
The investigation was done randomly selected 200 patients, 100 out-patients and 100 in-patients admitted to Nagasaki University Hospital.
72 strains of fungi were found from specimens of these patients (30%). As for the identification of Candida the slide aggultination test which was developed by Prof. Tsuchiya was employed.
Among these cultured fungi C. albicans was identified in 42 strains (30% of all fungi cultured), C. parakrusei in 6, C. tropicalis in 5, C. krusei in 2, Cryptoccus and Aspergillus each in 2 strains. 13 strains of fungi were not classified.
Fungi were identified from the mouth of the admitted inpatients in 46%, higher than in that of the out-patients.
Patients of malignants with caries teeth and prothesis revealed the highest incidence of 65.5%.
In the first decade of life fungi were cultured more frequently than in the fourth decade.
Further more, the relationship between the distribution of Candida myces and administration of antibiotics was investigated.
More Candida was cultured from the patients who were treated with the large dose of antibiotics than from the patients with minum chemotherapy.
Achromycin was given experimentally to 20 patient for 2 weeks and Candida cultivation was carried out. As the results, catarrh stomatitis has occured in 80% of these patients, but Candida was identified only in 25% and the relationship between the dose of antibiotics and the incidence of Candida was not significant.
Stomatitis with catarrh symptomes and occasionally associated with the brown or black coated tongue is not the manifestation of Candidiasis, such as acute and chronic thrush, and it is doubtfull of this type of stomatitis could be ascribed to Candida infection.

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