Although the reliable results can be obtained from the stapedial reflex for the stapedial nerve and the electrogustometry for the chorda tumpani in the topographic diagnosis of the facial paralysis, the test for the greater petrosal nerve is not established yet. Schirmer's test is commonly used for this purpose but the unreliability of this test is widely known.
The tastebuds in the soft palate is innervated by the gustatory fibers running through the greater petrosal nerve. Accordingly, the hypofunction of the geniculate ganglion results in disturbance of the gustatory sensation of the soft palate. However, the examination of the gustatory function of the soft palate in the cases of facial paralysis is not practically carried out yet. We performed the electrogustometry (EGM) in the soft palate and Schirmer's test in 10 cases of the peripheral facial paralysis with suprageniculate lesions. One patient with CP-angle tumor exhibited the complete facial paralysis before the surgery and the other 9 with acoustic tumor developed the paralysis after the surgery.
The EGM in the soft palate showed the significantly increased threshold in 80% of the cases, whereas the hypolacrimation in the Schirmer's test was found only in 30%.
The results obtained in the present study have shown that EGM in the area innervated by the greater petrosal nerve reflects the function of this nerve far better than the Schirmer's test does and is clinically available for the topographic diagnosis of the facial nerve lesions.

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The authors recently reported the establishment of two Epstein-Barr virus (EBV)-producing epithelial/hybrid cell lines (A2L/AH and NPC-KT), A2L/AH cells were derived from the fusion of epithelial cell line (Ad-AH) with non-producer EBV genome-positive lymphoblastoid cells transformed with the B95-8 strain of EBV. NPC-KT cells were derived from the fusion of Ad-AH cells with primary nasopharyngeal carcinoma cells. In this study, viral DNAs derived from A2L/AH and NPC-KT cells were analyzed in comparison with viral DNA derived from B95-8 cells by use of the restriction endonuclease EcoRI and Hind III and separation of fragments in 0.4% agarose. The digestion fragments of these two viral DNAs were obviously similar, but could be distiguished each other. The molecular weight of DNA of virus from NPC-KT cells was approximately 181K base pairs (Kb), which was 12Kb larger than that of B95-8 virus DNA. Key words: NPC-KT, A2L/AH, Epstein-Barr virus, DNA A90-1177-51360

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Relapsing polychondritis (R.P.) is a disorder of unknown cause characterized by the destruction of cartilage throughout body. A 39-year-old female who suffered from sudden onset of hearing loss in both ears and vertigo during the course of R.P. was reported. By the way, we measured the antibodies to the type II (cartilage) collagen in the serum of the patient by an emzyme immuno assay in combination with electrophoretic transfer of sodium dodecyl sulfate- polyacrylamide gel electrophoresis-resolved collagen to nitrocellulose sheets. In result, antibodies to type II collagen were found in the serum of the patient and no antibodies to other collagen types were found. We demonstrated the antibody activity to type II collagen in the serum of the patient was decreased after plasmapheresis which was done as a treatment.
Audiovestibular disorders observed in the patient was discussed with relation to the underlying R.P.. The onset and course of this audiovestibular disorders resembled that of Meniere's disease. If the type II collagen exists in the subepithelial connective tissues of the endolymphatic duct, which Yoo speculated, there is probability that endolymphatic hydrops was produced by immunologic reaction in the same place. In short, we suggest a possible role for type II collagen autoimmunity in the etiology of audiovestibular disorders with R.P..

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The authors have measured the relative number of Epstein-Barr virus (EBV) receptors on the surface of A2L/AH, NPC-KT, D98/HR-1, Raji, and P3HR-1 cells using an absorption index. It was determined that similar amounts of P3HR-1 or NPC-KT EBV can attach to D98/HR-1 cells, but that only P3HR-1 EBV can attach to NPC-KT cells. Both P3HR-1 and NPC-KT EBVs adsorb to Raji cells to a similar degree and to a greater level than either epithelial cells (D98/HR-1 and NPC-KT). Neither P3HR-1 or NPC-KT EBV adsorb to A2L/AH and P3HR-1 cells. The results suggest that there may be differences in the receptors for P3HR-1 and NPC-KT EBVs.

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Twenty-one patients with hypoparathyroidism were investigated with pure tone audiometry, short increment sensitivity index (SISI) test, Békésy audiometry, speech audiometry and auditory brainstem response (ABR) and the following results were obtained.
(1) Seven patients (13 ears) with severe hypocalcemia for a relatively long term or with uncontrolled serum calcium level, were proved to have hearing impairment.
(2) The inner ear was thought to be responsible site for hearing loss because of the high SISI score, positive recruitment and prolongation of the wave I (N₁) latency.
(3) The cause of hearing loss in hypoparathyroidism was supposed to be low Ca level in inner ear fluid and/or direct effect of vitamin D deficiency upon the inner ear.

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Leukotrienes have been implicated as important mediator in a bronchial asthma. The purpose of this study is to evaluate the degree of participation of leukotrienes on onset of symptoms of nasal allergy.
We measured leukotriene C₄ and D₄ (LTC₄ and LTD₄) in nasal secretion by radioimmunoassay combined with high performance liquid chromatography. This method is superior to the one previously reported in specificity, sensitivity and reproducibility. Subjects consisted of 10 patients (aged 8-34 years, average 19) with house dust nasal allergy. The nasal challenge was performed by applying antigen discs on bilateral inferior turbinates for 10 minutes. During the 10 minutes challenge with antigen, the total amount of nasal secretion was collected by means of suction syringes. LTC₄ in nasal secretion before challenge was 0.41±0.22 (average±SE) which increased to 2.43±0.85 after challenge. The difference was statistically significant (P<0.02). LTD₄ increased in the range of 0.31±0.09 before challenge to 2.72±0.52 after challenge. The difference was also statistically significant (P<0.001). The leukotriene was applied topically on the inferior turbinate unilaterally using a circular filter paper, 3mm in diameter, dipped in LTC₄ or LTD₄ liquid solution in subjects with nasal allergy and in normal controls. The amount of nasal secretion obtained during 5 minutes provocation period was measured by thread method, which evaluates the amount of secretion from the length of the thread dyed with fluorescin. Nasal airway resistance in bilateral nasal cavities was measured separately by anterior rhinomanometry before and after the challenge with leukotrienes. Change of mucosal swelling was expressed by percentage change of nasal airway resistance. Before the challenge with leukotriene, nasal challenge was performed using ethyl alcohol diluted with saline as a control, because leukotrienes were dissolved in ethyl alcohol. In subjects with nasal allergy, challenge with LTC₄ and LTD₄ (0.04μg or 0.4μg) on unilateral nasal mucosa induced ipsilateral watery secretion which was significantly larger in amount compared with that induced by ethyl alcohol (P<0.01-0.05). Challenge with LTD₄ (0.4μg) on unilateral nasal cavity in the subjects with nasal allergy caused significant swelling of the nasal mucosa in the ipsilateral nasal cavity (P<0.05). As for the amount of nasal secretion and degree of mucosal swelling in the contralateral nasal cavity, no significant differences were observed between leukotrienes and ethyl alcohol. In normal controls LTC₄ and LTD₄ induced only minimal amount of nasal secretion and minimal degree of mucosal swelling. And there were no significant differences between leukotrienes and ethyl alcohol in terms of stimulatory effects. The data described above shows that in the nasal mucosa in subjects with nasal allergy, hypersensitivity against leukotrienes are present and that nasal secretion and mucosal swelling induced by leukotrienes are mainly due to their direct effects on the nasal glands and the nasal vasculature. Leukotriens may participate in the onset of hypersensitive nasal symptoms in nasal allergy.

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We have been performing fine needle aspiration biopsy (FNA) for the diagnosis of head and neck tumors, in approximately 200 cases per year, during the past 7 years. In our experience, this diagnostic procedure proved successful in a considerably large proportion of cases, but diagnostic failure was by no means infrequent. In order to further increase the rate of successful diagnosis, an attempt was made, therefore, to perform FNA under ultrasonographic imaging.
This new modified FNA is featured by the use of a gelatin mass placed in a transparent plastic framework developed by us. Preliminary phantom experiments were conducted with the gelatin cube, interposed between the skin and a 7.5 or 5MH. probe, through which to introduce the puncture needle. Thereafter, actual patients were examined clinically in otherwise the similar manner.
Comparisons of FNA biopsy findings obtained with the use of the gelatin cube and 3.5MHz probe and those yielded with a 7.5 or 5MH. probe applied directly onto the skin led to the following conclusion.
(1) With the gelatin cube, clear images of a tumor and the puncture needle throughout its entire length were obtained, whereas ultrasonography failed to visualize the needle to its full length when it was introduced without passing through the gelatin cube.
(2) The use of the gelatin cube, since this makes the needle, so to speak, preset to the probe, rendered manipulation easier.
(3) A frequency of more than 5MHz was found to be necessary for adequate ultrasonographic imaging, 7.5MHz proving to be more effective.
(4) The use of gelatin was demonstrated not to be impedimental to the preparation of sections, their fixation and staining.
In summary, our experiences seem to indicate that the method of ultrasonographic FNA biopsy through the gelatin cube, though entailing some cumbersome preparatory steps, will certainly make valuable contribution to the diagnostic evaluation of head and neck tumors, being likely to prove of value in failures of conventional FNA study.

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We have developed an implantable hearing aid using an ossicular vibrator of piezoelectric ceramic bimorph. In order to determine output power level of the device and to utilize the device to the human ear, it was required to develop a method to assess hearing induced by direct oscillation of auditory ossicle using piezoelectric ceramic bimorph element. During tympanoplastic operation under local anesthesia, the element was attached to either the head of the stapes, tip of columella or the short process of the incus. Then pure tone signals from an audiometer were supplied to the element and the lowest audible intensity level of vibration was measured in dB/V p-p. This value was termed as vibratory hearing threshold. From this value, the sensitivity, equivalent dB SPL at the ear drum, for a given length of vibrator element was calculated. The sensitivity of the element of 7mm was 91dB in 1KHz and 100dB in 4KHz respectively, when it was applied to the head of the stapes of normal motility. In order to establish indication of implantation of the device, it is crucial to assess the sensitivity in the patient. In this sense, we termed this method "intra-operative vibratory audiometry".

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No effective tumor markers are available for squamous cell carcinoma of the head and neck region with the exception of immunosuppressive acidic protein (IAP). Recently, TA-4 was developed by Kato et al. as a marker of uterine cervical squamous cell carcinoma. Furthermore, squamous cell carcinoma related antigen (SCC antigen) was isolated from the tissue of liver metastasis of this carcinoma, and a RIA Kit using the double-antibody technique with antisera to this antigen has been developed. The cut-off value of SCC antigen has been reported to be 2.0ng/ml.
In our study, the SCC antigen level was more than 2.1ng/ml in 69(50.7%) of 136 patients with squamous cell carcinoma of the head and neck. The antigen was positive in 24(36.9%) of 65 patients with early carcinoma (stage I or II) and in 45(63.3%) of 71 patients with advanced carcinoma (stage III or IV). Among patients with early carcinoma, it was positive in 17(40.4%) of 42 with well differentiated, 6(42.9%) of 14 with moderately differentiated, and 1(11.1%) of 9 with poorly differentiated carcinomas of those with advanced carcinoma, it was positive in 12(66.7%) of 18 with well differentiated, 25(78.1%) of 32 with moderately differentiated, and 8(38.9%) of 21 with poorly differentiated carcinomas.
The antigen was positive in 8(80%) of 10 patients with carcinoma of the maxillary sinus and in 7(87.5%) of 8 patients with carcinoma of the hypopharynx. Both of them are difficult to detect, and SCC antigen is considered to be useful in screening for detection of these tumors.

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Cochlear damage of the Hamster induced by injection of Kanamycin into the middle ear cavity was studied using SEM.
(1) The Changes in theorgan of Corti were apparent in the outer hair cells. The changes in the inner hair cells were slight.
(2) The damage of outer hair cells in the basal tum was more severe than those in the middle and apical turn.
(3) The damage of 1st. row was the severest in outer hair cells in both the middle turn and the lower portion of the apicel turn.
(4) The damage of inner hair cells was more severe in the basal turn and the apical turn.
Cochlear damage of the Hamster induced by intramuscuar injection of Kanamycin and protective effect of cepharanthine against the ototoxicity was studied using SEM and ABR.
(1) The latency of wave I was almost nochange in ABR.
(2) Three animals had the sudden prolongation of wave I latency and the threshold shift. Before the prolongation, wave I latency was slightly shortened.
(3) The changes in the organ of Corti were similar to those in the experiment of KM intra middle ear injection.
(4) Cochlear damages of in the Hamster administered both Kanamycin and cepharanthine were slight than those administered only Kanamycin in SEM study.
(5) Protective effect of cepharanthine against KM induced ototoxicity was recognized.

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Twenty-nine cases of human tracheal glands were studied in electron microscopy. The materials used in this study were taken from patients whose ages ranged from 1 to 90 years old of both sexes.
The tracheal glands were composed of occasionally branched tubulo-alveolar glands consisting of the duct and the terminal portion of both mucous and serous type, and furthermore, smoothmuscle type myoepithelial cells surrounding the outside of the terminal portions.
Both oncocytes and oncocytic cells appeared everywhere in the gland, both in the duct and also in the terminal portion epithelium. They were generally seen in a cluster, but sometimes in solitary form within the glandular epithelium.
Oncocytes were tightly packed with an unusually large number of atypical hypertrophied mitochondria. On the other hand, the oncocytic cells contained variable numbers of such atypical large mitochondria in addition to usual cell organelles. These findings in the oncocytic cells are strongly suggestive that the oncocytic cell is a transitional type cell between the normal glandular cell and the typical oncocyte within the gland. Atypical mitochondria in such cells were almost devoid of intramitochondrial granules, and had conspicuously larger sizes than those of usual ones.
These atypical hypertrophied mitochondria were often provided with tightly packed bundles of longitudinally or arcuately arranged cristae, as well as a dilated matrix with either dense globules or crystalloid inclusions. The cells containing such peculiar mitochondria had to some extent similar characteristics to those of the usual glandular cells. However, in this study no myoepithelial cells exhibited any morphological signs of transforming into oncocytes or oncocytic cells.
Increased numbers of oncocytes and oncocytic cells tended to be seen more frequently in aged individuals, and thus this oncocytic degeneration of the gland may be considered as one of the changes due to aging within the glandular tissues of man.
In some cases, a few annulate lamellae connected to the limiting membrane of the rough endoplasmic reticulum were observed, however, their functional significance remains obscure.

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Long-term observations on the ceramic ossicular replacement prosthesis (CORP) were performed. The extrusion rates were 8.3% for CORP-P (partial) and 5.2% for CORP-T (total), most extrusions occurring within 2 years. The hearing results were satisfactory. An air-bone gap at 1 year was within 20dB in 74.0% with CORP-P and 54.5% with CORP-T, and at 3-5 years 66.7% and 53.3%, respectively. It was confirmed that the short-term results were maintained even for a long period of time. The main cause of unsatisfactory hearing gain was the displaced or extruded CORP. To prevent them, in addition to the fixation of CORP with a cartilage plate, making a dimple in the end of the shalft of P type, fixing of the shaft of T type with fascia, and additional fixation of the CORP head with the malleus handle and chorda tympani nerve were found advisable.

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