The purpose of this investigation is to research changes of pure tone threshold resulting from white noise exposure in order to differentiate the pathological lesion of perceptive deafness and to evalutate the clini-cal value of noise audiometry.
Materials:
Normal hearing subjects and conductive and per-ceptive deaf person; that is (1) conductive deafness with chronic otitis media, (2) inner ear deafness by acoustic trauma with positive recruitment phenomenon with loudness balance test, (3) presbycusis, and (4) so-called perceptive deafness.
Results:
The change of the pure tone threshold by white noise exposure was recorded as noise audiogram, which enabled us to differentiate two types. The first type was to represent changes of pure tone threshold by white noise exposure of 10, 20, 30, 40, 50, and 60dB above threshold of white noise and the second type was not to represent change of pure tone threshold until white noise intensity increases to a certain inten-sity.
As to the type of noise audiogram and the differ-ence limen value which carried out at 20dB and 30dB above the threshold, no decrease of the difference limen was found in all cases of normal subject and conduc-tive deaf person with chronic otitis media which show-ed the first type of noise audiogram. and of presbycusis which showed the first and the second type of noise audiogram. A maked decrease who evidence in almost cases of acoustic trauma which showed the second type of noise audiogram.
That is, in almost cases of the first type of noise audiogram, no decrease of the difference limen was found. In cases of the second type of noise audio-gram, both decrease and no change of the difference limen was found.
As mentioned above, normal hearing and conductive deafness with chronic otitis media showed the first type of noise audiogram, and inner ear deafness by acoustic trauma shows the second type, presbycusis showed both types of noise audiogram. It is supposed that the first type of noise audiogram results from a lesion of retrolabyrinthine disorders and the second type results from a lesion of Corti's organ.
Furthermore, the second type of noise audiogram is occasionally found out in some cases of normal hearing subjects or no hearing loss frequencies which are adjacent to remarkable hearing loss frequencies.
This result is supposed to indicate to find out some of the latent hearing disorders which is perphaps appeared to manifest in future.
Finally, it is possible to conclude that noise audiometry is clinically applied to differential diagnosis of possible localization of lesion in perceptive deafness to a certain extent.

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Aplasia of the nose is a very rare, congenital anomaly in our field. It emerges as a complete absence of the external nose and all nasal cavities on both sides, or an absence of one half of the nose and its associated nasal cavity. The latter case is called; “halfnose.”
Etiologically, it is akin to tubular proboscis, anomaly with a snout-like nasal appendage on, or by the mid-line of the face. Tubular proboscis is caused by a failure of the embryonal frontonasal process to migrate downward, and aplasia occurs when the frontonasal process and nasal sac fails to develop due to the same and more severe cause.
Hitherto, only several clinical cases of aplasia have been reported in the literatures.
Here a case of half-nose was reported. The patient was a five-year-old girl born with congenital absence of the left external nose and nazis. Moreover, her appearance was featured by epiphora only from the left eye. Left choanal atresia was found by posterior rhinoscopy. X-ray examination revealed complete absence of the nasal cavity, accessory sinuses and nasolacrymal duct on the same side. Systolic heartmurmur by auscultation suggested some congenital heart anomaly, but chest X-ray examination and electrocardiography presented no pathological findings. She had no other serious diseases since the birth. She was one of three offsprings of healthy parents without consanguineous marriage. The two siblings were normal. In the family-tree no other patient of congenital malformation could be seen.
Concerning surgical procedures, intervention to the bony tissues of such a young patient should be avoided not to disturb a further growth of the facial bone. Then, plastic surgery was carried out only on the external nose in April, 1966. Under general anesthesia, incision was made on the left cheek, and tongueshaped pedicle skin flap was raised up. The nasal septum was exposed, on the left side there could be seen no nasal cavity but bony tissues. The left nasal ala was made of the pedicle flap by V-Y suture method. The new nais was lined with free Thiersch graft taken from the thigh. The wound healed up with satisfying result, and the patient left the hospital in June, 1966.

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Twenty cases of plasmacytoma have been reported in the Japanese otorhinolaryngological literatures. This case was a 61-year-old male with a large plasmacytoma spreading from the right maxillary sinus to nasal cavity.
The hematologic and myelographic examination at admission revealed anemia in blood picture and plasma cell proliferation in the bone marrow picture. Now of patholcgical findings were observed in immune electrophoresis, serum protein fractions, serum Ca, etc. which were reported often to show characteristic changes in plasmacytoma.
The prominent features of this case were the followings: (1) Although the plasmacytoma in the previous literatures was a benign, localized tumor, this case showed a shadow defect in the cranial bone which was believed to have either a malignant tumor with metastasis or a systematic disease of bone in a form of plasmacytomatous myeloma. (2) This case had failed to respond to ⁶⁰Co irradiation and also to chemotherapy (Chromomycin A³ and Cyclophosphamide). (3) After the ⁶⁰Co irradiation, malignant change to reticulosarcoma had taken place in the case, thus making this case a very rare one.

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Many electron microscopic observations were reported on plasma cells, but few were the electron microscopic reports on plasma cells in the form of tumor cells. The electron microscopic studies of the plasmacytcsis had the following two purposes: (1) to know the morphology of the fundamental pictures of plasmacytoma cells; and (2) to know how plasma cells were differentiated, since the present tumor showed the presence of many young plasma cells.
The tumor tissue from the case in Report 1 was observed with the electron microscope, getting the following knowledge.
1. The plasmacytoma showed the presence of plasma cells of various stages of development from immature to mature.
2. The young plasma cells were spheroid, with the nucleus almost spherical. The nucleus exhibited a giant nucleolus and intranuclear inclusion. In the cytoplasm, the rough surfaced endoplasmic reticulum was vacuolar, with its section in rosette form and showing a large number of Russell bodies, which was a characteristic finding. The mature plasma cells often showed cell protrusions, a nucleus of complex form, and a swollen outer nuclear membrane. The emergence of a large nucleolus and intranuclear inclusions was more frequently observed in the mature plasma cells than in the immature ones. The endoplasmic reticlum was arranged in layers, with Russell bodies in their spaces. The Golgi apparatus was very well developed.
3. A fiber structure was observed in the spaces between the immature plasma cells.

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Twenty six cases of congenital idiopathic nystagmus were chosen from children of primary schools in Osaka City, and were examined by the authors. The results were as follows;
1) Five cases out of 26 were associated with other patient in the family.
2) Prenatal and obstetrical pathologies had no influence over the congenital nystagmus.
3) Inner ear symptoms such as hearing disorder, tinnitus and vertigo could not be noticed.
4) Vestibular examinations revealed no abnormal reactions in these cases except for two cases of cerebral palsy.
5) All cases had visual disorder and consentric constriction of visual field.6) Spontaneous nystagmus in these cases were divided into 4 types.7) Most of the cases revealed nearly normal reactions to the caloric and rotatory stimulation.
8) Characteristic optokinetic nystagmus were observed in some cases.

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I. The author performed the window operation for the chronic maxillary sinusitis and investigated the relation between the postoperative course and the histopathological findings of the maxillary mucous membranes which were removed from the cases. Ninety-two cases of chronic maxillary sinusitis were selected for the study. For the maxillary sinusitis accompanied by the ethmoidal sinusitis and /or septal deviation, the endonasal ethmoidectomy and /or submucous resection of the septum were performed.
Part of the maxillary mucous membrane removed during the operation was stained with haematoxylin-eosin and other staining techniques. The postoperative courses of the cases were followed up for 1/2-2 years. They were classified into 4 groups in 6 months postoperatively, namely, good after effect, fair after effect, no change and worse. The results were: 48%, 32%, 16% and 4%, respectively.
II. The histopathological findings were classified into four types, i. e., edematous, infiltrating, fibrous and mixed. Each type was observed as with grade of, low and high. The results were summarized as follows:
2) For the fibrous type, the higher was the pathology of mucous membrane, the better the postoperative cure showed after window operation. This suggested that the fibrous type was also indication of the operation.
3) For the mixed type there was no significant relationship between the pathology and clinical course after operation. It was difficult to determine the indication of the maxillary window operation for this type.
III. Following the above date, the special connective tissue stainings were performed for 20 selected cases of the fibrous or mixed types of mucous membrane. The following results were obtained.
1) Elastic fibers were fourd distributed in the wall of vessels or cystically expanded glands without any mutual relation between the histopathological types and the degree of elastic fiber distribution.
2) The distribution of reticular fibers were more dense in mixed type than in fibrous type. The reticular fibers might grow to the collagen fibers.
3) In the advanced fibrous type, mature collagen fibers increased, while the capillaries decreased. This suggested that the inflammatory process was ceasing and the repairing mechanisms started to proceed.

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Recently, air pollution has become an increasing problem for the industrialized countries, since it is thought to be one of the causes of chronic bronchitis and bronchial carcinoma.
The ciliated epithelium of the respiratory tract plays a very important role for the elimination and resorption of inhaled harmful materials. Many studies of cilia have been carried out both anatomically and physiologically. However, the mechanism of ciliary movement, the neural control of ciliary activity and the relationship between the ciliary activity and resorption activity are not well known yet. It is therefore the purpose of this study to elucidate above mentioned problems by means of a new method. The ciliary activity in the trachea in living rabbits was examined.
The ciliary movements were observed by the microscope specially constructed for vertical light.
They were observed as the variations in the light reflexes on the mucous membrane.
These light reflexes were then transfered to the phototube where the variations in light intensity were changed to those in current intensity and these were recorded on an oscilloscope or an ink writer via an integrating circuit.
The velocity of mucous flow was estimated by measuring the time when the India ink on the trachea mucosa moved 2mm distance.
Following results were obtained:
1) The rate of ciliary beat in the normal rabbit was 1140 beats/min. The velocity of mucous flow was 9.0mm/min.
2) Both the ciliary movement and mucous flow were hardly affected by the atmospheric temperature between 25ª and 35ª, however, a low relative humidity brought about remarkable reduction of the ciliary activity.
3) The rate of ciliary beat did not change after electrical stimulation for the vagul nerve or injection of autonomimetic drugs. The velocity of mucous flow, however, increased slightly at the parasympathicotonic condition.
4) The ciliary activity decreased with the exposure of 10p.p.m. sulphur dioxide for 20 days and the absorption of radioisotope (Nal¹³¹) from the lower respiratory mucosa was increased. With increasing of the concentration of SO₂ gas, the ciliary activity tremendously decreaseed within a short time.
5) The ciliary activity reduced after the local administration of 0.5% nicotine solution or 1% 3-4 benzpyrene solution to the trachea mucosa.
6) The ciliary activity increased after the local administration of 0.1% lysozyme solution or saponin solution to the trachea mucosa.

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Many studies have been carried out on the effect of the intense tone upon the hearing. These studies were audiollogically for patients, in most cases, and electro-physiologically on animals'. But, the date from these two methods did not meet always in agreement.
It is well known that after the intense pure tone stimulation human ear shows the dip at frequency, which is 1/2_??_1 octave higher than stimulating tone or the other hand, the same observation was noted on 1_??_1 1/2 lower frequency of given out put on animals by means of cochlear microphonics.
There is no convincing explanation of such difference between audiological date in the human and experimental results on animals. No electrophysiological date, which well coincide with the human hearing, have been obtained.
As action potentials of the auditory nerve have better correspondence to human hearing than cochlear microphonics, the auther studied the effect of intense pure tone stimulation from the view point of the audi-tory nerve action potentials.
Guinea pig was used under general anesthesia by urethan. Via round window, recording, N₁ of nerve action potentials caused by click was observed.
In the first series of experiments. The series of click of 30 db above the threshold made animal ear stimulated by various intense pure tone which varied in stimulating time, strength and frequency, and recovery of the N₁ after stinulation was observed.
Results obtained from these experiments was resulted by special complex tone“click” and we can not know how are the response to the pure tone.
It is known that AP has the masking phenomenon. If the response to masking tone changes after the stimulation, this change should be refrected on the masking effect.
1. The 50% recovery time of AP after the stimulationwas nearly in proportion to strength of stimulating tone and the stimulating time.
2. The 50% recovery time of AP after the stimulation was shorter when the stimulating tone was 0.5 or 1KC.
3. Masking effect of the AP by pure tone was decreased after stimulation.
4. This decrease was found in higher frequency-band than stimulating tone and marked drecrease was found in about one octave higher frequency than stimulating tone.

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The cortical evoked potentials of the waking rabbits to auditory stimuli were observed with Average Res-ponse Computer analog type. The chronically indwelled active electrodes were placed upon extradurally in four bisymmetric points of the frontal, parietal, occipital and temporal areas. The auditory stimuli were tone pips with peak frequencies of 300, 600, 1200, 2400, 4800 and 6800cps. The following results were obtained.
1. Basic types of the cortical evoked potentials of waking rabbits to auditory stimuli consisted of 3 phases of waves; positive (P₁), negative (N₁) and positive (P₂).
2. This potential was largest at or near the vertex and smallest at the occipital area. There was no diffe-rence between the evoked potentials of corresponding areas on the bilateral hemispheres.
3. The minimum reaction intensities of the tone pips (thresholds) ranged from 30 to 60dB SPL. Their projections to the frequency-intensity plane are compar-ed with the equal-loudness contours of Fletcher and Munson.
4. The peak-latencies of the components of these potentials at the vertex were 25.1 to 32.6 msec (P₁), 51.1 to 65.0 msec (N₁) and 81.4 to 97.4 msec (P₂). The peak-latencies of the evoked potentials to the tone pips of low frequencies (300cps and 600cps) were longer than those to tone pips of higher frequencies. As the intensity of the tone pips is decreased the peak-latencies of N₁ and P₂ increase.
5. The amplitude of the component P₁ or P₂ versus the intensity of tone pips showed a relationship which corresponded to Weber-Fechner's law, while the com-ponent N₁ or P₁N₁ had a relationship which was com-pared with Stevens's power law. P1N1 was designated the“Amplitude of the evoked potential”.
6. The absolute refractory period of the evoked potential was within the limits of 0.1 to 0.3 sec, while the relative refracitory period was about 2.0 sec.
7. The amplitude of this evoked potential was var iable day by day.
8. Tubocurarine chloride suppressed the component P₁ and chlorpromazine augumented P₁N₁ and increased the peak-latency of P₂.
9. By simultaneous recording the amplitude of the extradural potential was slightly smaller than that of the subdural potential and the amplitude of the evoked potential recorded on the skull showed about 20 per cents as much as the subdural potential.
10. Habituation of the evoked potential was observed, when those more than 10 or so following auditory stimuli at intervals of 6 sec were given.
11. Conditioning due to same interstimulus intervals was most remarkable, when the interstimulus interval was 3sec.
12. Alertness of the rabbit gave the evoked potentials variety. Attentien to the stimuli appeared to augument the evoked potential and alertness to the environment seemed to suppress the potential.
13. The features of this potential has a strong resem-blance to the human V-potential and the origin of the potential seems to be the same as that of the animal secondary discharge during sleep.

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