A newly developed ultrasonic laryngeal imaging system, ultrasound laryngography (ULG), can record vocal cord vibrations by the simultaneous use of high-speed M-mode, ultrasonic pulse transmissions, and the other methods. The purpose of this study was to compare normal male vocal cord vibrations simultaneously recorded by ULG at several pitches and loudness with those obtained by photoelectroglottography (PGG). The open quotient (SQ), speed quotient (SQ), and speed index (SI) were measured by these two methods. While only relative glottal area can be obtained by PGG, exact glottal width can be obtained by ULG. So the mean opening/closing velocity as well as the mean opening/closing steepness of the vocal cord vibration plot were measured by ULG.
The results are summarized as follows:
1) The OQ, SQ, and SI values measured by these two methods were very similar. There was a trend for greater mean values in these parameters as measured by ULG compared with those determined by PGG.
2) This difference was presumed to be due to (D vocal cord phase differences in horizontal and vertical components), 12 the location of the light source and that of photosensor from the glottis, and 0 ULG beam width in relation to vertical movements of the vocal cords.3) Glottal width curve obtained by ULG was asymmetrical triangular wave because closing phase was shorter. By ULG observation, as voice loudness increased, opening/closing steepness became greater and closed phase longer, while closing phase shorter. The waveform obtained by ULG was presumed to be relatively similar to glottal flow waveform because there was a trend of more asymmetrical triangular waveform obtained by ULG than those obtained by PGG.
In conclusion, ULG is the only method to be able to obtain exact glottal width compared with the other glottography, and this method is considered to be useful for the investigation of the vocal cord vibrations.

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The etiology of Bell's palsy is still obscure, but the hypothesis that hypoxia and compression of the nerve induced by edema in the Fallopian canal are the main causes of Bell's palsy is widely accepted. Tojima (1988) reported that the motor nerve conduction velocity (MCV) gradually decreased as degeneration of the nerve fibers progressed in Bell's palsy. The majority of facial erve fibers are myelinated, and the greater the fiber diameter, the faster the conduction velocity.For this reason, Tojima suggested that Wallerian degeneration in Bell's palsy would begin from the thicker myelinated fibers. The measurement of MCV, however, reveals only the activities of the fastest velocity motor nerve fiber in the nerve trunk. This weak point can be resolved by measurement of the distribution of nerve conduction velocities (DNCV), which was introduced by Hopf in 1962 as the collision method.
In the present report, the DNCV of facial nerve was measured using the collision method to estimate the distribution of the diameter of nerve fibers in normal subjects and patients with Bell's palsy and to elucidate the pathophysiology of Bell's palsy. The subjects were 14 normal adults (19 measurements) and 14 patients with Bell's palsy who visited our university clinic within 7 days to 18 days after onset, with no other complications such as diabetes.
Results obtained are as follows.
1) The mean DNCV in 14 normal subjects (19 measurements) was unimodal, showing a peak at 20 to 22m/s.
2) In DNCVs of patients with Bell's palsy, loss of thicker fibers with faster conduction velocity was recognized (11/14, 79%).
Thicker myelinated fibers may be more susceptible to compression damage. This finding suggested that the pathophysiology of Bell's palsy would be compression of the nerve.

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Characteristic nystagmus could be provoked by introducing potassium ion into the unilateral perilymphatic space of healthy guinea pigs. At first, irritative nystagmus appeared for some time to the K+ introduced ear side, and then, it was followed by paralytic nystagmus which directed to the non introduced ear side.
During this experiment, the excitabilities of the vestibular nuclei and the central auditory nuclei were investigated by [14C] deoxyglucose method.
In the period of "irritative nystagmus", the increment of glucose uptake in the ipsilateral vestibular nucleus, especially in the superior, median and inferior part, was noticed more significantly than the contralateral vestibular nucleus. On the other hand, the period of "paralytic nystagmus" showed the significant increment of glucose uptake in all parts of the contralateral vestibular nucleus.
As to the excitability of the central auditory nuclei, the significant decrement of glucose uptake, which was noticed in all periods of this experiment, was predominant in the ipsilateral cochlear nucleus and other superior auditory nuclei of the contralateral side.

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Metastatic involvement of the temporal bone by malignant tumors is considered to be rare. The actual incidence of metastatic temporal bone tumors, however, is probably much higher than suggested by reports in the literature. The reason for this is that histologic studies are rarely performed on temporal bones in routine postmortem examinations of patients with possible metastatic disease. Also, in patients with multiple metastatic lesions, otologic complaints and signs may often be overshadowed by other more disabling symptoms.
Twelve temporal bones were histopathologically examined from 6 patients who had metastatic temporal bone disease from various primaries and the results obtained in our present series of 6cases were: 3 cases of hematogenous dissemination from a distant primary (a hepatic cell car-cinoma, a bronchogenic squamous cell carcinoma, and an adenocarcinoma of unknown primary);2 cases of direct invasion from adjacent head and neck tumors (squamous cell carcinomas of the eyelid and hypopharynx); and one case of diffuse metastatic leptomeningeal carcinomatosis (a transitional cell carcinoma of the renal pelvis). Among these, to our knowledge either hepatic cell carcinoma or renal pelvis carcinoma metastatic to the temporal bone has not been reported previously in the world literature.
We reviewed the previously published reports of metastatic temporal bone tumors and found that there were 212 reported cases cited in the literature and that the most common sites of origin in order of frequency were breast, lung, pharynx, kidney, and prostate. Our temporal bone study and literature survey reveal that there are three distinct routes of tumor spread from the primaries to the temporal bone: 1) hematogenous dissemination from a distant primary, 2) direct neoplastic extension from adjacent areas, and 3) diffuse metastatic leptomeningeal carcinomatosis (DMLC).
Our study also indicates that in most cases temporal bone symptoms appeared late in the course of disease, but in some cases the otologic symptoms were an initial sign of tumor, which was particularly conspicuous in the cases of DMLC. In the cases of hematogenous dissemination, the metastatic lesion tends to be overlooked or undiagnosed because occult metastases are relatively common or, when symptomatic, the otologic symptoms often resemble the features charaterized by a severe form of mastoiditis. In the cases of direct neoplastic invasion, on the other hand, recognition of temporal bone involvement is usually simple since the primary disease is quite evident.
Although metastatic temporal bone malignancies are rare, otologist should always be aware of existence of this disease entity in clinical practice. It is expected that, with advances and improve-ments in recent diagnostic imaging technology, earlier diagnosis of these difficult lesions will be possible.

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To investigate the influence of the cervical input to the equilibrium, the effect of neck vibratory stimulation on body sway was analyzed in 49 normal human subjects.
Body perturbations during standing posture were recorded by a force platform with or without vibratory stimulus on the upper cervical region, and analyzed by computer.
During the neck vibratory stimulation, the center of gravity was shifted to the forward, and the amplitude of the body sway was increased especially along the front-rear axis.
These results indicate that the proprioceptive inputs from the cervical receptors largely modifies the body equilibrium in normal subjects.

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Nasal mucosal cilia were observed with electron microscope in 14 patients with immotile cilia syndrome (ICS), 9 with nasal papilloma (NP), 23 with sinobronchial syndrome (SB), 2 with sinusitis combined with dextrocardia (SC), 1 with Kartagener's syndrome (KS), and 5 normal controls (C).
Abnormalities such as complex cilia, cilia with abnormal axonemes and cilia with randomly oriented central microtubles were frequently found in the groups of ICS (8. 1%) and NP (10. 4%)while less in other groups: SB (4.9%), SC (5.3%), KS (4.7%) and C (3.9%).
The percentage of cilia with defective dynein arms (DA) was the highest in the ICS group (94.0%), followed by the groups of SC (53. 7%), SB (47. 5%), NP (41. 2%), C (35. 8%) and KS (33. 3%).
The ICS group was found to be the largest in the number of defective DA per a cilium (4. 1), followed by the groups of NP (1. 0), SB (0. 6), SC (0. 7), KS (0. 4) and C (0. 4). Increased rates of defective DA were also recognized in cilia of tracheal mucosa and flagella of sperm in 7 patients with ICS examined.
In conclusion, neither abnormal cilia nor defective DA of cilia are specific findings for ICS.However, when we observe these findings in high percentage in nasal mucosa as well as in other organs, we may define this condition as ICS.

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Interleukin-1 (IL-1) has been thought to be one of the essential cytokines mainly produced by macrophage. The function of IL-1 are not only activates T-lymphocytes, but also regulates immune responses to several antigens and effects on local and systemic immune reactions. Recently, it is reported that epidermal keratinocytes produces IL-1, and attention has been paid to local immune reaction mediated with this cytokine. In this study, we performed immunohisto-chemistry and immunoblotting on the pharyngeal epithelial keratinocytes and we evaluated the production of IL-1 by these cells.
Pharyngeal mucous membrane of each region reacted strongly against anti-IL-1 alpha anti-body, on the contrary, anti-IL-1 beta antibody comparatively only weakly. Strong reactivity was often observed on the basal layer, then it was seemed that some important relationship exists between the production of IL-1 and maturation of pharyngeal keratinocytes. Infiltration of T-lymphocytes was observed in proportion to the increase of epithalial reactivity against IL-1. There seemed to be no correlation between expression of HLA-DR antigen on keratinocytes and reactivity of IL-1. In immunoblotting study, the 3lkD band, intracellular immature molecule, was identified besides 17 and 52kD. From this finding, it was suggested that IL-1 is derived from pharyngeal keratinocytes. In conclusion, the present study is helpful for well-understanding of local cellular immunity of pharyngeal mucous membrane.

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In order to investigate inner ear barotrauma, guinea pigs were subjected to rapid decompression between 2 absolute pressure (ATA) and 1 ATA in a chamber. After pressure loading and observation for absence of Preyer's reflex, they were sacrificed immediately, 1 day, 1 week and 1 month later, respectively. Then, morphological changes of the organ of Corti and stria vascularis were studied under TEM and SEM. The immediate features noted were fracture of stereocilia with minimal intracellular changes. One day later, there was marked degeneration of outer hair cells and expansion of supporting cells. The damage to stereocilia clearly preceded morphological alterations within hair cell bodies and cannot be interpreted as arising secondary to hair cell degeneration. Most of outer hair cells eventually disappeared and were replaced by supporting cells. Inner hair cells degenerated slowly ; 1 month later, some of them remained almost intact, despite disappearance of stereocilia. The continuity of reticular lamina was maintained not only immediately but also through the period of hair cell degeneration, thus preventing any leakage of endolymph into the organ of Corti. There was reversible dendritic swelling of inner hair cells immediately following the trauma. No changes of stria vascularis were observed over passage of time. The mechanism of hair cell damage due to inner ear barotrauma is presumed to be a deformity of the organ of Corti caused by pressure discrepancy between perilymph and endolymph resulting in an injury to stereocilia.

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Diseases affecting the retropharyngeal space are relatively uncommon, much less a case of retropharyngeal hematoma. However, a space-occupying lesion in this area can be life threaten-ing and require emergency surgical intervention. There have been 46 cases of retropharyngeal hematoma reported in the English literatures from 1934 to 1989, but there has been no reported case in Japan.
Recently we treated a 72-year-old male sustained retropharyngeal hematoma following a bruise of head and neck. The patients was received tracheostomy, antibiotic therapy and intra-venous hyperalimentation in addition to, but this hematoma was resolved in about 2 weeks.
The etiologies, the diagnosis, the therapies in our case and the prognoses of the literaturally reviewed 47 cases of retropharyngeal hematoma were discussed comprehensively.

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To examine the difference between response of nasal mucosa to specific antigen and that to non-specific stimulus in the same patient, specific nasal provocation was performed using the house dust antigen disk while nasal respiratory resistance was continuously measured by Rhinograph. On the other hand, non-specific nasal provocation was performed with inhalation of methacholine while nasal respiratory resistance was continuously measured with Astograph. Thereafter the resulting response curves were analyzed. Subjects were 12 males and 9 females, who had nasal obstruction, watery rhinorrhoea and sneeze, and were proved to have allergic rhinitis by house dust.
To analyze specific response curve, primary nasal respiratory resistance (RrsN), reacting time (Ta) and slope signifying increase of nasal respiratory resistance (ORrsN) were used as parame-ters. To analyze non-specific response curve, primary nasal respiratory resistance (RrsNont), minimum dose of methacholine that caused an increase of nasal respiratory resistance (DminN)and slope signifying increase of nasal respiratory resistance (SdN) were used as parameters. Ta and DminN reflect sensitivity of nasal mucosa. Their values become smaller, it means sensitivity of nasal mucosa becomes higher. QRrsN and SdN reflect reactivity of nasal mucosa. Their values become larger, it means reactivity of nasal mucosa becomes larger. From the analysis of specific and non-specific response curves, value of Ta was smaller than that of DminN, and value of SdN was larger than that of ORrsN. These meant that nasal response was caused earlier in specific response curve than in non-specific one, and degree of nasal response was larger in non-specific response curve than in specific one.
From the above results, following conclusions were obtained.
1) Response of nasal mucosa to specific antigen is mainly composed of sensitivity of nasal mucosa.
2) Response of nasal mucosa to non-specific stimulus is mainly composed of reactivity of nasal mucosa.

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