The present work was undertaken in an attempt to elucidate cell-mediated immune response in human palatine tonsils. Using the tonsils extirpated from patients with tonsillar diseases such as chronic tonsillitis, habitual angina and tonsillar hypertrophy, the cell-free supernatants of ton-sillar lymphocyte cultures with diphtheria toxoid (DT) or streptolysin 0 (SLO) were prepared by the method described by Dumonde et al. The lymphokine capacities of the culture supernata-nts to exert cytotoxicity and cloning inhibition on Chang's human liver cells as well as migration inhibition of peripheral blood leucocytes were investigated.
The results obtained were summarized as follows: i) The culture supernatants of DT-stimulated tonsillar lymphocytes from patients showing positive reaction of Moloney's test, exhibited much greater activities of lymphokines such as lymphotoxin, cloning inhibitory factor, migration inhibitory factor than those from the negative individuals. 2) The majority of the culture supernatants from SLO-stimulated tonsillar lymphocytes sho-wed remarkable activities of three lymphokines. However, those lymphokine activities of each culture supernatant were not always in parallel with the titers of antistreptolysin 0 (ASO) in the corresponding patients' sera. From the above-mentioned findings, it was ascertained that the human palatine tonsils take part in cell-mediated immune response to regional or non-regional antigenic stimuli as well as in antibody-mediated immunity.

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One hundred twenty four operated cases of middle ear malformation were reviewed with special reference to the ossicles.
In the case of complete meatal atresia, the malleus and incus were fused in one mass, and the incudostapedial joint was separated due to maldeveloping long process of incus. In conductive-type malformation with normal or narrow ear canal, separation of the incudostapedial joint was seen more frequently than fused incus and malleus.
As a supplemental study, a normal development of the ossiculer junction was investigated by means of phase contrast microscopy.
In the nineth week human embryo, the cytoblastema of the malleus and incus were observed as a mass concentration of mesenchymal cells. It was confirmed that the malleus and incus were not differentiated at this stage.
In the tenth week, the three ossicles were differentiated individually. At the incudomallear joint, the malleus and incus became pre-cartilaginous already and both ossicles were separated by a few rows of thin compressed fibroblastic cells. But the stapes was still an immature concentration of mesenchymal cells and there were five or six rows of mesenchymal cells on the surface of the incudostapedial joint.
In the twelfth week, the malleus and incus became cartilaginous. The surface of the incudomallear joint was covered by _??_ row of compressed cells and the joint capsule was observed. At the incudostapedial joint, the head of the stapes became precartilaginous and five or six rows of thin compressed cells separated the long process of the incus and the head of the stapes.
In the eighteenth week, the incus and malleus were ossified in the middle portion, and young articulation capsule was observed around the incudomallear joint. However, the connection of the lenticular process and the head of the stapes were still separated by a few rows of immature compressed cells. These findingss would suggest that the incudostapedial joint is more immature than the incudomallear joint at this stage. Observations on the pattern of early development of the incudostapedial joint suggest that there is a possibility that the head of the stapes, the lenticular process and the long process of the incus are derived from one origin.
In the twenty-second week, the long process of the incus and the crura of the stapes were ossified and the articulation capsule was completed to become adult form.
The fact that the incudomallear joint was completed one month ahead the completion of the incudostapedial joint would be a possible cause of higher incidence of separation of the incudostapedial joint than that of fused malleus and incus in middle ear malformations.

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A clinical study was made of electrically elicited blink reflexes in facial paresis. Nineteen patients of facial paresis of various origins such as Bell's palsy, Ramsay-Hunt's syndrome or others were subjected to the long-term serial study and the results obtained were as follows:
1) If the early component (R1) of the reflex response was elicited within two weeks after the onset of the paresis, or it appeared within 4 weeks after the onset and its latency recovered to the normal range within the following several weeks, the prognosis was found to be good in general.
2) As a recovery sign of the reflex response pattern, the first appearence of the late component (R2) was the most important in the majority of cases, and a significant relationship was observed between enhancement of the amplitude of the spike potential and the degree of functional recovery of the mimic muscles.
3) In most patients with synkinesis, R1 was recorded simultaneously in both orbicularis oculi and oris muscles on the same side.
4) In those patients in which R1 first appeared over 6 weeks after the onset of the disease and there was delayed reconvalecense in its latency, typical synkinesis was frequently observed.

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The purpose of this study was to detect some characteristics related to the origin of the waveform of the brain stem response (BSR). Repeating clicks, paired clicks and train clicks with various intervals were used as acoustic stimuli, and the following results were obtained.
1. In the responses to repeating clicks the latency was increased when the interstimuli interval was less than 30 msec.
2. In the response to paired clicks with interstimuli interval less than 30 msec, the latency of the response to the second click was increased.
3. The latency increased proportionally as the interstimuli interval decreased.
4. The responses to a train of 10 clicks with an interstimuli interval of 10 msec were recorded. The latency increased with increasing serial number of the stimulus and reached a plateau after the fourh stimulus.
5. The latencies of the components increased in a different way. The latency of the later components increased more than that of the earlier components. Thus, the interval of I to VI wave was elongated.
6. The increase in latency was different in different serial number of the stimulus.
7. In the paired click with interstimuli interval less than 3 msec, only the response to the first click was recorded. The response to the second click appeared when interstimuli interwal was more than 3 msec.
These latency change may be explained as different activities in the synaptic transmission.

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The patient was a 21-year-old man who acquired unilateral deafness while he was exposed to extremely loud sound of discotheque for about 4 hours.
His hearing type was of a dish, with a mean hearing loss of slightly over 50 dB in the middle frequencies. He was positive for recruitment phenomenon. No abnormal temporary threshold tone decay could be observed. He received treatment for approximately 2 months with slight improvement in hearing. Only 10 dB was elevated in frequencies of 500 Hz or below during treatment.
He had no subjective symptoms such as vertigo, dizziness and giddiness, nor any abnormal findings in equilibrium tests.
He was diagnosed as noise-induced sudden deafness caused by the sound of discotheque.

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By means of antigen antibsdy crossed electrophoresis (Laurell), protein components in endolymph and perilymph of guinea pig inner ear were analized under acute middle ear inflammation.
1) Group of silver protein otitis media: Silver protein was injected into the tympanic cavity. In 30 minutes following injection, all of the precipitation arcs in both fluids were obserbed very distinctly. Especially the peak of *-Globulin arc shifted toward the high position and the area under precipitation arc increased. A/*-GI was 0. 64 in endolymph and 0. 76 in perilymph. In 24 hours following injection, A/*-G was 1.04 in endolymph and 0. 74 in perilymph. In 10 days following injection, immunoelectrophoreograms of both fluids showed same patterns as of normal group.
2) Group of allergic otitis media: An egg white albumin was injected into the tympanic cavity of sensitized animal. In 30 minutes following injection, A/*-G was 0. 60 in endolymph. Several precipitation arcs were not observed in normal subjects and were noted in *-, *-, and *-Globulin fractions of endolymph and perilymph. In 24 hours following injection, this tendency was found in all of perilymph, but was not seen in endolymph. A/*-G was 1.28 in endolymph and 0. 94 in perilymph. In 10 days following injection, immunoelectrophoreograms of both fluids showed the same patterns as of normal group.
From these results obtained, in all subjects following injection of egg white albumin as well as silver protein, the immunoelectrophoreogram was changed immediately and remarkably. Several protein components of serum in acute middle ear inflammation infiltrated into the inner ear fluids. Especially -Globulin increased cosiderably in perilymph in cases of allergic otitis media, but these changes showed a tendecy to recover within 10 days.

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In 35 cases with tonsillogenic focal diseases, IgE levels in tonsillar tissues and serum were evaluated at pre- and post-operative stages by means of radio-immuno-sorhent method. The results obtained were as follows;
(1 ) The tonsillar IgE level was slightly higher in chronic nephritis and lower in slight fever and rheumatoid arthritis, while the serum IgE level increased in rheumatic fever and decreased in Pustulosis palmaris et plantaris both at pre- and post-operative stages.
(2) The tonsillar IgE level was higher in the group showing positive result in provocation test, while the serum IgE level increased in the positive group and slightly decreased in the negative, both at pre- and post-operative stages.
(3 ) With regard to the effect of tonsillectomy on focal diseases, the tonsillar IgE level was slightly higher in cured group and lower in improved group, while the serum IgE level slightly decreased in the improved, both at pre- and post-operative stages.
(4) Two patients of acute nephritis and chronic nephritis with markedly high (over 1000 U/ml) tonsillar IgE were completely cured after tonsillectomy. However, only 12 out of 22 patients with markedly low (under 100 U/ml) tonsillar IgE level recovered after tonsillectomy.
(5 ) Clinical observations on 30 patients for over one year after tonsillectomy revealed that 18 were recovered, 11 improved and one was not improved. The result would indicate that tonsillectomy was effective for tonsillogenic focal diseases in 96. 7% of the cases investigated.

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