To evaluate the clinical use of hearing measurement by means of Pavlovian conditioned response, the establishment of conditioned blinking response and its application to the hearing test were studied. For the conditioning, the speed flash and lantern slides with speed flash were used as optic unconditinned stimuli, and pure tone of 1, 000cps (30-50db) was selected as auditory conditioned stimulus. After the completion of the conditioning, the threshold of hearing was measured about 3 pure tones of 500cps, 1, 000cps and 4, 000cps.
A. The following are the results of the conditioning from 85 examinees.
1. The above-mentioned method of conditioning spent time comparatively.
2. It was difficult to develop this conditioning among the children under 55year of age.
3. The conditioning was established in about 80per cent of examinees, and this rate of establishment was maximum of this conditioning.
B. The results of the comparison of pure-tone thresholds measured by means of conditioned blinking response and by routine subjective methods were as follows: Those who showed the difference of less than ±10db between the results by these two methods were 92, 9per cent of 57 examinees. Those who showed the difference of less than ±5db between the results by these two methods were 63.0per cent; and those who showed the identical data by either methods were 47.2per cent.
From these results, the measurement of hearing by the above-mentioned method is considered to be satisfactory, when it is applied for the examinees having established the conditioned response.

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Lempert conducted the decompression operation as surgical treatment for unilateral meniere's disease and published its excellent results. However, the evaluation of the results was thought to be inadequate from the standpoint of histopathology, that the present author performed the study on rabbits. In 3 to 12 months afthe the operation, histological specimens were prepared with vital fixation. Following results were obtained:
(1) Oval and round windows fenestrated by operation were perfectly obturated by the connective tissue and newly formed bone.
(2) Spiral ligament revealed remarkable calcification, and vascular stria showed squamous metaplasia and marked atrophy. Nevertheless, the Reissner's membrane was bulged indicating hydrops labyrinthi. There was no great difference among specimens obtained from 3 to 12 months after the operation.
(3) In Corti's organ, external hair-cells disappeared at first, and internal hair-cells began to disappear in about 6 months, most of them disappeared in 9 months. Sustentacular cells atrophied in 3 months, tended to collapse and disappear in over 9 months, and finally were supposed to passibly disappear.
(4) In spiral ganglia, ascending degeneration took place, but was not extensive.
(5) In vestibule and semicircular canal, static hair and statolithic membrane disappeared in about 6 months. Particularly statical macula revealed partial disappearance of hair-cells and vacuolation in 12 months.
(6) The histological study demonstrated that the degeneration took place in the vestibule and cochlea due to decompression operation in the course of more than one year and progressed gradually, while there was no preventive method againgt hydrops labyrinthi.
Therefore it is proper that the surgery to be named as degeneration operation rather than decompression operation.

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Barium sulfate was used to study foreign body reaction of the nasal sinus. This substance possesses strong foreign body effect and to the mucous membrane and produces remarkable swelling of the sinus mucosa after instillation into the antrum and the swelling of the sinus membrane can be demostrated roentgenologically.
The observation was carried out on the chronic sinusitis patients. X-ray film was taken 24 hours after instillation of barium in the maxillary sinus in 77 cases, and also on the 8th day in 88 cases. All cases were operated after the roentgenological examination. The changes on X-ray films were com pared with that of obtained histological specimens. From this study the following results were obtained:
The swelling of the membrane was most remarkable in mild cases of chronic sinusitis which showed minimal swelling of the mucosa on X-ray film. In the cases with extensive rnucosal changes, no reaction to barium was seen.
On the other hand, swelling of the mucosa was remarkable in the cases with large sinuses, while it was not so severe in the cases with small sinuses.
This reaction of the mucosa consists of edematous swelling and round celhnfiltration with increased eosinophils. Those findingsin the mucosa resembles to the picture of the edematous type of chronic sinusitis. Allergy test proved to be negative in the cases with marked mucosal reaction.
The author has previously stated that this reaction of the mucosa could be ascribed to the foreign body effect of the Ba SO4, and not to its chemical stimulation. The mucosal change in chronic sinusitis might be the result of foreign body effect of the infected bacteria which have relatively weak toxisity.
This study revealed that the mucous membrane of the sinus displayed different reactions against the same stimuli depending on its grade of pneumatization. The well-developed large sinuses reacts foreign body with edematous change, but this reaction is minimal in the under-developed small sinuses. This reaction against foreign body should be recognized as that of the sinus itself, because the foreign body was insilled in the sinus cavity and not in the mucosa.
The author would like to emphasize that this results of the clinical study can serve as the valuable data to understand pathology of chronic sinusitis. Unfortunately our experiment of similar foreign body reaction in rabbits failed to find significant change to confirm these clinical findings.

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(1) Observations were made of local allergic reactions in rabbits and guiner pigs whose conjunetiuae had beeniniected with antigens. Leitz's panphotometer was employed for studying the animals' changes in blood vessels and blood flow.
(2) There weye observed vascular dilation, slow blood flow fibrinogen thrombosis which suggested plasma space, blood flow defect which suggested a swelling of endothelial cells, petechy, interrupted bloodflow, sludged blood and stasis. The above changes were classified into tentatively designated "Sakai & Hazama's classifications."
(3) The above changes usually developed in 5 minutes, reaching their maximum in 15-30 minutes and gradually recovered in 24-48 hours.
(4) For 48 Hours following injection of an antigen into sensitized guiner pigs' tympanium their vestibuler function was studied with post rotatory nystagmus test. A histological survey was also made with inner ear specimens.
(5) An hour after the injection of an antigen the animal's vestibuler function and inner ear histological finding showed no changes.48Hours after the injection, there developed an increase or an increase followed by a decrease in vestibuler function as well as considerably extensive changes in inner ear tissues.But of 20 cases 11 cases (55%) showed endolymphatic hydrops.
(6) For 48hours after application of an antigen to the region of the internal auditory portus of sensitized gainer pigs, the animal's vestibular function was studied with post rotatory nystogmus test. A histological survey was also mede with inner ear specimens.
(7) 10 to 30 minutes after the application many of the animals developed an increase or increase followed by decrease in spontaneus vestibular function. The results of the post rotatory nystagmus test obviously showed the above changes; an hour after the application inner ear tissues showed slight changes which become considerably marked 48 hours after the application. 25 cases (78%) of the 32 cases studied showed spontaneous vestibular distarbances, and 11 cases (37%) of them showed spontaneous nystagmus. 7 cases (35%) of the 20 cases who had been observed for 48hours showed endolymphatic hydrops.
(8) Since the findings of conjunctival blood vessels and the changes in vestibular function in the inner auditory portus region application group were chronologically correspondent, it was assumed that similar changes had developed in inner ear blood vessels.
(9) The inner auditory portus application group showed slighter changes than the tympanum administration group. It seems that the former showed spontaneous vestibular symptoms developing very rapidly.
(10) From the above experiments it was assumed that Meniere's disease develops due to disturbances in inner ear peripheral blood circulation being considerably attributable to allergic reactions.

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Part. 1: Experimental study of the transplantation of Yoshida sarcoma to the ear, nose, throat and larynx in rat
Experimental transplantation of Yoshida sarcoma was done to the middle ear cavity, maxillary sinus, posterior pharyngeal wall, root of the tongue, larynx (vocal cord), ala of nose and helix of the ear. The transplantation was successfully taken in all cases.
part 2: Study of blood supply within Yoshida sarcoma, using India ink.
Blood supply in Yoshida sarcoma tissue was studied injecting 15 per cent solution of India ink into the aorta of the rat, to which Yoshida sarcoma had been transplanted.
1) Blood vessels around the sarcoma tissue did not penetrate into the sarcoma tissue itself.
2) Newly developed blood channels were seen in the surface of the sarcoma tissue and stained with India ink.
3) Many erythrocytes were seen among the sarcoma cells in many areas of the tumor.
Part 3: Observation of blood supply in human carcinoma tissue.
Histopathological study of three cases of human carcinoma of larynx and two cases of carcinoma of maxillary sinus was made.
1) Blood vessels around the carcinoma tissue were dilated and reached to the surface of the carcinoma tissue, but. did not penetrate into the carcinoma tissue.
2) Only migrated blood component from the blood vessels in surrounding mother tissue entered into the carcinoma tissue.

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On former studies students observed chiefly carcinoma themselves, very few students observed of histopathological changes of the bone.
The author observed in detail the changes of the maxillary bone, comparing the relation between bone and carcinoma in big section specimens by Dr. Miyake's method.
The destruction of the bone by the carcinama and bony response were studied and their relation to the progress of the carcinoma was classified into four types.
1) Bone is destructed and absorbed in direct contact with carcinoma nests.
The author considers this is the most rapidly progressing type because proliferation of carcinoma cells is more rapid than that of connective tissue surrounding carcinomatous tissue.
2) Bone is in contact with carcinoma nests through thin layer of connective tissue and there are no osteoclasts present.
The authour considers that the progress of the carcinoma is relatively rapid in this type.
3) Connective tissue is increased at the edge of the bone and osteoclasts and lacunere rsorption are present at the edge of the bone. Progress of the carcinoma is not rapid in this type.
4) Formation of the new bone or osteoid tissue against the extension of the carcinoma. This is the most slowly progressing type of the carcinoma.
On the relation between prognosis and destructive condition of bone, the prognosis is poor in cases which show dominantly rapid-progressing type and it is good in cases which show slowly progressing type.
Other main results were as follows:
1) Maxillary bone marrow is not red marrow but it is fatty marrow.
2) Fiber connective tissue plays a rale in absorption and destruction of the bone.
3) It seems like that foreign body giant cells appear in the neighbourhood of small pieces of dege. nerated bone, and absorb them.
4) Even in the most destructive type, new bone formation is also recognized.
5) Changes in bonemarrow against the extension of the carcinoma are sometimes recongnized in cases of direct contact of bony wall and carcinoma nests, in cases osteoclasts are present, in cases with fibrotic changes of bonemarrow, and in cases osteoid tissue is formed.

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Bleeding encountered in the field of oto-rhino-laryngology is mainly parenchymatous in nature. However, very little has been studied about the method of local hemostasis.
Using rabbits, the author studied the capillary blood flow in nasal mucosa and auricles under the microscope, and various local hemostatics were applied and their effects were observed. Results obtained were as follows:
1) Capillary blood vessels in rabbit nasal septal mucosa were specific in their arrangement and in reticular pattern, being different from those in other parts of the body. The similar has been observed in human septal mucosa.
2) The author selected Manetol, one of the tissue thromboplastin preparations, to inject into the tissue for the purpose of local hemostasis. Clinically, this was added to local anesthetic, which was Xylocaine with epirenamine and, injected into the tissue with favorable local anesthetic and hemostatic effect
3) Hydrogen peroxide solution, an effective local hemostatic for parenchymatous bleeding, was applied and its hemostatic mechanism was studied. It was found that hemostatis was obtained by the occlusion of capillary lumina by oxygen bubbles.
4) As a new local hemostatic, ferric ammonium sulfate (iron alum) solution was used and its prominent hemostatic effect and astrictive were reported. Olinicaliy, this solution showe no major destructive effect on the tissue, althougth some irritation to the tissue was noted. An attempt was made to remove its irritative effect so that it could be used routinely.

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Two cases progressive gangrenous rhinitis were reported. The first case was a 47-year-old male who expired following terminal stage with multiple small gangrenous ulcer in various parts of the body surface. The ulcer presented first as a small nodule under the skin, revealing histological findings of Weber-Christian's disease, namely, a chronic granulomatous inflammaton accompanied by generalized arteritis in the adipose tissue. In short duration, this nodule changed into a shallow ulcer covered with dark gangrenous crust. Granulation tissue of this ulcer was proved histologically to be proliferation of the reticular cells resembling to the picture of sarcoma. Cortisone treatment did not bring any significant improvement in this case.
The second case was a 23-year-old male who had a localized lesion without complication. Progress of the disease in this case was slower than in the first case and was arrested by cortisone treatment. Histologically examination revealed chronic granulomatous inflammatory reaction.

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On 90 patients with hearing disturbance due to streptomycin administration, the clinical character of the tinnitus was observed. Tinnitus would occur in the early stage of cochlear involvement by streptomycin intoxication and could occur even following to a single injecton of 1 gram streptomycin. On acute cases, tinnitus would occur within several hours after the streptomycin injection and disappear in several hours spontaneously. No change was observed on a threshold audiogram in about 30 % of the ears with the tinnitus. In most of the cases, tinnitus appeared prior to the development of deafness, therefore tinnitus was regarded as one of the most important prodromal symptoms of streptomycin intoxication.

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(Blood coagulation time), (fihrinolytic phenomenon) and (petechial hemorrhage in the mucosa) were examined before and after sinus operation. After the operation, marked change of blood coagulability was noted in about 40per cent of the cases, mostly being increase of the coagulability. Immediately after the operation, accelerated fibrinolytic phenomenon was noted in about 50per cent of the cases. In many of the cases with stable autonomic nerve function, increased coagulability of the blood and accelerated fibrinolytic phenomenon were noted immediately after the operation. In many of the cases in which bieeding more than moderate in amount was encountered at the time of first operation, an acceleration of blood coagulability and an increase capillary resistance were noted 7days after the operation. Very little change in blood coagulability was noted at the time of second operation performed 7darys after the first operation.

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