The auditory screening test for school-age children is not applicable for a large number of preschoolers, especially younger children aged 3 to 4 years. While most children with severe hearing impairments are detected at an early age, those mild or moderate hearing losses may be unnoticed until the second or third grade in elementary school. This handicap may give thoee children the real disadventage in thier class. Therefore it is important to identify those with mild-to-moderate hearing impairmants as early as possible. METHOD 1) The subjects for this survey were 348 kindergarten children whose age ditribution was from 3 to 6 years. 2) A pure-tone screening test was administered by two trained volunteers, students in the Department of Speech Pathology and Deaf at Osaka University of Education, with two recently calibrated audiometers Rion AA-32, and AA-33. 3) The subjects were tested either with continuous tone or interrupted tone (rise-decay time 25 msec, interruption cycle 2 cps, duty cycle, 50%) at 1, 000 Hz and 4, 000 Hz. 4) The tests were conducted in two rooms (50 phone, Net C) which were considered most quiet in the building. Prior to the testing sessions, it was determined that normal-hearing individuals could be screened easily at 15 dB (JIS). 5) Five children at each time were conducted into the testing room by the lead of a teacher. The screening audiometry was carried out individually with biaural air-conduction receivers. 6) In this procedure, the preselected frequencies were first presented three times at the level of 20 dB, and the child was asked to raise his hand each time a tone was heard. The tone was presented first to one ear and then to the other. 7) If no response was found when the signal was presented, the test repeated at the level of 25-dB, and up to 30-dB in each ear for each frequency. The lack of response to any one of the three presentations at the 30-dB was estimated as the failure of the screening test. 8) For those who were thus screened out, a careful examination of pure-tone audiometry in sound-treated room and otologic examination were administered in our center. RESULTS 1) Percentage of failure at the screening level of 20 dB was found much higher in the younger group aged 3 and 4 than in the group aged 5 and 6 years. However, children who failed screening test decreated with increasing intensity level in both groups, and no marked differences between the two grogps were found at 30-dB level of each frequency. The same trend was found in continuous-tone listening group and interrupted-tone listening group. 2) Out of 348 children 21 failed the pure-tone screening test. 3) Out of 18 chilldren for whom the pure-tone audimetry was administered, twelve had hearing losses at the level of 30 dB and more at 1, 000 Hz or 4, 000 Hz. The remaining six had thresholds below 25 dB. 4) Concerning of the incidence of the false-positive cases, no particular relation between both test tone groups or all age groups was observed. 5) The time taken for pure-ton screeng tests was measured by a stop-watch. The time perchild was about 2 minutes in children aged 3 years, and approximately 1 minute in children aged 4 to 6.
On 40 normal subjects aged 10-19, 20-29, 30-49, and over 50 years, 10 subjects in each age group, caloric irrigation in external auditory canal was conducted. Water temperature was 30°C and 4°C. During the test, reflection photoelectric plethysmograph was attached on the tip of each index finger of both hands and the changes of amplitude of plethysmogram were measured. On 8 subjects, the test was repeated 4 times under the same condition, and the reappearance of this reaction was examined. Results were as follows in : 1. There was a significant difference between the reaction in those under 50 years of age and those over in the rate of diminution of waves on the maximum reaction point. 2. The rate of diminution of waves on the maximum reaction point was considerably consistent in the same subjects, although there were individual differences. 3. The author presumed that the reaction of diminution of waves in this test was mainly due to vestibular stimulation induced by caloric irrigation, although there might be other non-vestibular reactions.
Types of hearing impairments were studied from epidemic and audiometric standpoints in 2, 180 adults (1, 356 men and 824 women) with hearing losses above 40 dB in Miyagi Prefecture. The results were as follows: 1. In general, the occurrence of hearing impairments was the lowest in urban areas, higher in seaside districts and the highest in farming communities. The occurrence of hearing impairments was about 1.6 times greater in men than women. 2. The occurrence of presbycusis increased gradually after 40 years of age and reached its peak among people in their 60's and 70's. Hearing loss increased with advancing age, and the audiometric pattern was generally of the symmetric and gently sloping group. 3. Two types of hereditary hearing loss were observed. One was severe hearing loss which appeared during childhood. Its audiometric pattern showed a residual only in low frequencies. The other was hearing loss which appeared after puberty immediately following an acquired disease. Its audiometric pattern was usually of the flat group. 4. Among men, hearing impairments were very frequently caused by head or acoustic trauma (217o' of all men with hearing losses). The audiometric patterns were usually of the gently sloping group and occassionally of the c5-dip group. In contrast, hearing impairments among women were often related to pregnancy or childbirth (8.4% of all women with hearing losses). Its audiometric pattern was of the flat group. 5. Ototoxic hearing impairment due to the use of streptomycin occurred more often among city dwellers than among residents of farming communities. The audiometric pattern was of the gently sloping and sharp sloping groups. 6. Meniere disease sometimes causes hearing loss and is usually accompanied by tinnitus. Its audiometric pattern was of the gently sloping group, but asymmetric between both ears.
In four patients who showed a sharply bordered semi-circular clouding raising from the bottom of the maxillary sinus on x-ray, allergological tests and determination of serum immunoglbglin were performed. Caldweell-Luc operation was performd and in all of them hemispheric cyst bulding from the bottom of the maxillary sinus was recognized, which corresponded to the semi-circular clouding on x-ray. A histological study of mucous membrane of the maxillary sinus was performed. In one of them protein-compositions and sub-fraction of immunoglobulin of the fluid in the cyst were observed. Results were summarized as follows: 1. Judging from the results of the tests, three of them presumably had relation to atopic allergy, and in two of them mucous membrane of the maxillary sinus showed infiltration of eosinophilic leukocyte. 2. Histological feature of mucous membrane of the maxillary sinus belonged to oedema-infiltration type according to Manasse's classification, and in three of them infiltration of plasma cell was more dominant than that of lymphocyte, and in the other in which lymphocyte was more dominant than plasma cell, growth of granulation was recognized. 3. Fluid in the cyst was exudate which contained same amount of total protein and albumin as in serum, but concentration of r-G in the exudate was much higher than that in serum as well as IgG and IgA, but IgM and other globulins were less in cyst than in serum. 4. Upper wall of the cyst had epithelium only on the side faced to the sinus, and no epithelium was recognized on the side faced to the cavity of cyst. 5. It was presumed that the cyst was formed by accumulation of the exudate in proper layer of mucous membrane of the maxillary sinus.
The antibody against viral capsid antigen (VCA) of Epstein-Barr (EB) virus has been studied in 148 patients with malignant tumors and in 263 patients with non-tumorous diseases of the head and neck for the past two years. The anti-VCA titer was assayed by Kawamura's modified method of the fluorescent antibody techniques (Henle). The P3HR-1 cells, sublines derived from P 3 (Jijoye) strain of Burkitt lymphoma cultured cells, were employed as the target cells. Twenty-four patients with nasopharyngeal carcinoma had a geometric mean titer of 1 : 853 and 19 sera (7977) were positive (titer _ 1 : 640). One hundred and seventeen patients with another head and neck tumors had a GMT of 1 : 190 and the the positive rate was 37%, 53 cases of the maxillary cancer: GMT 1 : 163, positive rate 30%, 14 cases of laryngeal cancer: GMT 1 : 214, positive rate 36%, 13 cases of laryngeal cancer: GMT 1 : 219, positive rate 54%, 12 cases of malignant tonsillar tumors: GMT 1 : 179, positive rate 42%, 10 cases of malignant tumors of the neck: GMT 1 : 159, positive rate 40770, and 15 miscellaneous case: GMT 1 : 305, positive rate 40770. Two hundred and sixty-three sera from patients of nori-tumorous diseases (ex. chronic sinusitis, chronic otitis media, adenoids, chronic tonsillitis, polyp of the larynx, deviated nasal septum etc.) had a GMT I : 120 and 53 sera were positive (20%). According to ridit analysis, the anti-VCA titer in patients with nasopharyngeal carcinoma was significantly higher than that of controls.
Although the concentration of the japanese cedar specific IgE antibody in blood can be measured with RAST, the Phadebas RAST Kit contains no japanese cedar allergen disc. Japanese cedar allergen disc (I : 20) was newly prepared. It was evaluated whether this japanese cedar allergen disc was practical or not in the RAST of Japanese Cedar Pollinosis. Serum samples werecollected from 86 patients with Japanese Cedar Pollinosis and 10 normal adults. RAST was performed with Phadebas reagents and (1 :20) japanese cedar allergen disc according to Phadebas experimental instructions. Results were as follow: 1) Phadebas, mountain cedar allergen discs did not react with the japanese cedar specific IgE in the sera of Japanese Cedar Pollinosis. 2) Japanese cedar allergen was well coupled to paper discs and japanese cedar allergen discs (1 : 20) absorbed so well the japanese cedar specific IgE antibody that RAST with this japanese cedar allergen disc can be carried out without the modification of Phadebas experimental directions. 3) The results of RAST with this japanese cedar allergen disc should be expressed following new criteria other than Phadebas RAST criteria. According to the RAST results of normal persons, negative RAST, doubtful RAST and positive RAST were newly classified instead of Phadebas RAST class. 4) The RAST results of 86 patients suffering from Japanese Cedar Pollinosis were 4 cases of negative RAST. 13 cases of doubtful RAST and 69 cases of positive RAST.