A case of otogenic cerebellar abscess and a case of otogenic temporal lobe abscess are reported. Neither of these patients complained of meningeal symptoms other than headache. Therefore, the brain abscess was not suspected before performing the computed tomographic examination (CT). The enhanced CT scan demonstrated the brain abscess well in both cases as a low density area surrounded with a circular ring of increased density. In the patient with temporal lobe abscess, the primary source of the abscess in the temporal bone, cholesteatoma, was removed but the abscess was not surgically treated. In the patient with the cerebellar abscess, after removal of cholesteatoma the abscess was drained through the operative field. CT gave quite proper information as to the surgical approach to the abscess. Up to the present, no residual disabilities have been complained of by either of the two patients.

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Ten cases of traumatic visual disturbance were operated on with optic canal decompression by the transethmoidal approach between the years 1975-1980, in the clinic of Kinki University School of Medicine. The results of a retrospective study of these cases were summarized as followed:
1. The patients consisted of 9 males and 1 female. The most prominent cause of the trauma of these cases was traffic accidents during either bicycle or motorcycle driving, numbering 7 out of 10 cases.
2. Roentgenological examination revealed optic canal fractures in 5 cases, and fractures of the optic canal were identified during the operation in 7 cases including these 5.
3. In 6 patients who had imcomplete loss of visual acuity and no intraocular lesions, some improvement was gained after the operation. Especially, in the 3 patients who were operated on within 10 days after injury, the degree of improvement was significantly better.
4. Our experience ascertained that some critical factors such as the interval between operation and injury and the degree of impairment of visual acuity seem to determine the functional prognosis after the operative treatment.
5. The method of optic canal decompression under the surgical microscope by the transethmoidal approach is the best operation which, performed in the early stages after injury, contributes greatly to an improved prognosis.

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A 28-year-old male in good general health complained of nasal bleeding. Rhinoscopy revealed a dark red colored tumor with irregular surface in the left nasal cavity. The large tumor of 4×3×3cm in size and 15 grams in weight was surgically removed under general anesthesia. It was confirmed that the tumor originated from the upper part of the nasal septum. The histological diagnosis was a mixed tumor composed of myoepithelial cells with glandular elements. After removal of the tumor, no recurrence has been observed.

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This paper deals with seven patients with malignant lymphoma of the nose and paranasal sinuses. They included six males and one female aging from 30 to 70 years. Of the seven patients, the maxillary sinus was thought to be the site of origin in four patients, the sphenoidal sinus in one and the nasal cavity in three. The most frequent histopathological type in this series was reticulum cell sarcoma, but one was lymphosarcoma and another was unclassifiable.
According to the criteria of the Ann Arbor classification, two patients were in stage I, two in stage II, two in stage III and one in stage IV. Cheek swelling and epistaxis were the most common chief complaints in six patients. They did not present particularly characteristic clinical symptoms. Cobalt-60 or Linac teletherapy was delivered in a total dose of 1600-6000rads. In addition, non-scheduled chemotherapy including 5-FU, COP, BONP or VEMP was given. In five out of the seven, the initial response to this therapy was favorable. In these patients, 83% (five of the six) died within 16 months of diagnosis and only 14% (one of the seven) survived for five years. With this dismal experience in mind, three principles are proposed for the management of patients with malignant lymphoma of the nose and paranasal sinuses. These consist of (1) exact staging of the disease, (2) planned protocol adjusted to the stage for the therapy and (3) irradiation combined with chemotherapy for patients in stage II.

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A case of neurilemmoma of the parapharyngeal space in a 12-year-old boy is reported. The patient complained of swelling in the right buccal region and right ear obstruction with no oropharyngeal or cervical mass. Removal of the tumor was performed by an intraoral and external approach with mandibulotomy. The tumor weighed 59 grams. Histopathological examination revealed neurilemmoma. The age of the patient was the lowest reported in Japan.

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Chronic laryngeal stenosis may be of congenital origin, due to cyst, tumor or secondary scar formation caused by infection, intubation or injury. Secondary posterior laryngeal web is a rare case of these chronic laryngeal stenoses and may be developed as a result of prolonged endotracheal intubation or chronic inflammation like syphilis or tuberculosis.
In this paper, a case of secondary posterior laryngeal web caused by tuberculosis is reported. A 75-year-old female developed laryngeal adhesion and a web between the posterior halves of the glottis following laryngeal and pulmonary tuberculosis and was suffering from hoarseness and progressive dyspnea.
Surgical removal of the web that consisted of thin scar tissue was performed under a microscope with tracheotomy. However, the use of any kind of stent between the raw surfaces of the separated web at the posterior commisure was not attempted. However, no stent was inserted between the raw surfaces of the separated web at the posterior commisure
Up to the present, ten months after the surgical treatment, she has been free from any scar formation or recurrent web and has returned to her previous life without hoarseness or dyspnea.

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Compared with the local findings of cancer in the head and neck region, worsening of the general condition is gradual. That is why countermeasures against pain become very important in treating these patients. Cancerous pain may be divided into three stages i. e. the early middle and terminal stages, and the method of treatment for each stage is explained in the following. Non-narcotic analgesics may be given orally; suppositories are valuable because they can be used simultaneously with other therapies; acupuncture is effective for early and middle-stage pains and has a painrelieving effect which is different in type from the relief gained by analgesics. For the pain of the middle and terminal stages X-irradiation of 450rads given for the fraction of five or 250rads for the fraction of ten in effective. It is also possible to use several chemotherapeutic agents together to relieve pain. Needless to say this must be done under strict observation of the general condition of the patient.
To relieve the pain of the terminal stage, use of narcotics under close supervision may be considered. In such cases, the Brompton mixture may be used at fixed intervals to keep patients in a pain-free condition. Of course it is necessary to keep the local area clean, to encourage the patient to uplift morale and to combine various methods in relieving the suffering of patients tormented by cancerous pain.

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Antibacterial activity, stability of solution and clinical evaluation of a new cephalosporin derivative antibiotic, cefoperazone (CPZ), were performed with the results which might lead to the following conclusions:
1) In vitro antibacterial activity: The minimum inhibitory concentration of CPZ was tested by an agar plate dilution method. CPZ results an excellent, broad spectrum antibacterial activity against standard strains of various bacteria. CPZ had same antibacterial spectrum like those of other cephalosporin antibiotics. The MIC of Staphylococcus aureus isolated from otorrhoea was distributed at a range from ≤0.2 to 50μg/ml of CPZ, showing its peak at 1.56μg/ml. Other strains of Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae were inhibited by ≤0.2 to 12.5μg/ml of CPZ. CPZ showed the MICs of 0.78 to 12.5μg/ml, its peak at 6.25/g/ml against 60 strains of pathogenic Pseudomonas aeruginosa.
2) Stability of CPZ solution: As to the stability of 20mg/ml of CPZ there was no change in its colour and pH however, antibacterial activity decreased when the solution was kept at 5°C or 37°C for 14 days.
3) Results of clinical treatment: When administration of CPZ was applied locally in 31 cases of acute and chronic purulent otitis media, results were good in 21 cases, fair in 6 cases and poor in 4 cases. When good and fair effects were considered together, the rate of effectiveness was 27 cases 87.1 per cent.
No side effect was observed when CPZ solution was locally applied.

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Massive dose of lysozyme was administered in 20 patients with infantile (younger than 15 y. o.) chronic sinusitis and the effect was mainly analyzed by x-ray findings of the paranasal sinuses. The dose of administration was 180mg/day for younger than 12 y. o. and 270mg/day for elder than the above age, and the mean duration was 40 days. As the results, subjective complaints, local findings of nasal cavities and x ray findings of the paranasal sinuses were improved in 70% of the patients. Therefore, it was concluded that massive dose administration of lysozyme would be effective for infantile chronic sinusitis. However, the authors emphasized that maintenance of the therapeutic effect had to be proven by prudent following-up studies.

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Visual fixation of horizontal and vertical eye movements was examined by eye movements which were evoked by horizontal or vertical head rotation with eyes fixed on a target 90cm in front of the subjects and recorded by electronystagmography.
1. Normal subjects showed smooth sinusoidal curves of horizontal or vertical eye movements evoked by horizontal or vertical head rotation with eyes fixed on a target.
2. Pathological cases
1) Failure of visual fixation was indicated by lack of smoothness of the sinusoidal curves. Failure of visual fixation of horizontal eye movements was seen especially in patients with cerebello-pontine angle lesions. Failure of fixation of vertical eye movements was seen in patients with midbrain lesions with upward vertical nystaamus or in those with downward vertical nystgamus. Fixation failure of horizontal and vertical eye movements appeared in patients with cerebellar lesions (cerebellar tumors, spinocerebellar degeneration, etc), in those with pontine lesions and parietal lobe lesions.
Visual fixation seemed to be controlled by the center of horizontal and vertical eye movements as well as by the flocculus in the cerebellum and by the parietal lobes.
2) Amplitudes of eye movements could be measured by this examination. Therefore, amplitudes of eye movements in patients with eye movement disturbance could be shown and measured.

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In order to delincate the physiological function of the vestibulo-ocular system, the transfer function (TF) of the oculomotor system was studied in 11 healthy male subjects, four patients with bilateral loss of labyrinthine excitability and four patients with unilateral loss of labyrinthine excitability.
For this purpose, the following three tests were performed; that is, the eye tracking (ETT) and the pendular rotation tests (PRT) in the dark and light were respectively performed in order to examine the opto-oculomotor, semicircular oculomotor and optosemicircular oculomotor systems.
The results obtained were as follows.
A. Healthy male subjects
1 Horizontal system
a) Regarding the TF of the opto-oculomotor system, the gain and phase were flat in a frequency range from 0.4 to 1.0Hz.
b) Regarding the TF of the semicircular oculomotor system, the gain linearly increased at a rate of 10dB per decade when the frequency increased from 0.2 to 1.5Hz. This system performs derivative control in inducing the eye movement in response to the displacement of the skull.
c) Regarding the TF of the opto-semicircular oculomotor system, the gain and phase were flat in a frequency range from 0.6 to 1.7Hz. The capability of maintainirg of visual fixation in relatien to external objects in spite of head movement increases by the collaboration of the eyes and the semicircular canals.
2 Vertical system
a) Regarding the TF of the opto-oculomotor system, the gain and phase were flat in a frequency range from 0.3 to 1.0Hz.
b) Regarding the TF of the semicircular oculomotor system, the gain linearly increased at a rate of 10dB per decade when the frequency increased from 0.4 to 1.9Hz.
c) Regarding the TF of the opto-semicircular oculomotor system, the gain and phase were flat in a frequency range from 0.6 to 1.9Hz.
B. Patients with bilateral loss of labyrinthine excitability.
1 Horizontal system.
a) Regarding the TF of the opto-oculomotor system, the gain and phase were flat in a frequency range below 1.0Hz.
b) Regarding the TF of the oculomotor system in the PRT in the dark, the gain was scattered.
c) Regarding the TF of the oculomotor system in the PRT in the light, the gain and phase were flat in a frequency range below 1.0Hz.
2 Vertical system.
The TF of the oculomotor system was similar to that of the horizontal system of the patients with bilateral loss of labyrinthine excitability.
C. Patients with unilateral loss of labyrinthine excitability.
1 Horizontal system.
a) Regarding the TF of the opto-oculomotor system, the gain and phase were flat in a frequency range below 1.0Hz.
b) Regarding the TF of the oculomotor system in the PRT in the dark, the gain was irregular but indicated a tendency to increase with increase of frequency.
c) Regarding the TF of the oculomotor system in the PRT in the light, the gain and phase were flat at frequencies slightly exceeding 1.0Hz.
2 Vertical system.
The TF of the oculomotor system was similar to that of the horizontal system of patients with unilateral loss of labyrinthine excitability.
The following conclusion was obtained.
The results thus obtained indicate that the capability of maintaining visual fixation in relation to external subjects is secured through the opto-semicircular coordination. Furthermore, the results show that the semicircular oculomotor system plays an active part in visual fixation during head movement with periodic motion exceeding 1.0Hz.

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Healing processes of the experimentally produced, round-window-membrane perforation were studied light and scanning-electronmicroscopically (SEM) in 33 guinea pigs. Some resulted in spontaneous healing as early as 3 days and all the others healed within 10 days. These results suggest that the round window membrane has a pronounced tendency to heal. In light microscopical examination, the sectioned preparations were stained by Gomori's aldehyde-fuchsin method because there was a great amount of elastic fibers in the middle layer of the round-window membrane.
Histological observations proved that the perforations of the roundwindow membrane were closed by covering with granulation, while the connective tissues of the middle layer were disrupted. The granulation was prominent on the epithelial layer and was less prominent on the inner layer. As connective tissues were the main composites of the round-window membrane to maintain its configuration, they played important roles in the healing process of the perforation.

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