1例の耳性小脳膿瘍と1例の耳性側葉膿瘍を報告した.
2例とも脳膿瘍としての症状に乏しく, その診断に際して CT scan の結果がきめてとなった. 小脳膿瘍の治療として感染源の中耳処置ののち, 同術野より連続的に穿刺排膿術を施行し良好な結果を得ているが, 穿刺排膿術施行に際しても, CT scan より得られた情報が有用であった.
脳膿瘍の診断, 治療にあたって, CT scan は非常に有用であり, 必要かくべからざる検査だと思われた.

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外傷性視力障害患者10例に鼻外法篩骨洞経由で手術用顕微鏡下に視神経管開放術を施行し, 以下の知見をえた.
1) 受傷患者の男女比は9対1で男性に多く, また年齢分布は40歳前後が大多数を占めている. 受傷の原因となった事故は, 自転車やオートバイなどの単車事故が10症例中の7例を占め, しかもこれらは無謀な運転中の事故がほとんどであった. 顔面における受傷部位で最も多かったのは眼窩外側縁であり, 10症例中の7例を占めていた. 受傷時に鼻出血があったものは3症例であった. 受傷時に何らかの意識障害があったものは9症例であった.
2) X線検査で術前に視神経管骨折が疑われたものは5症例であり, これらを含めた計7例に視神経管骨折が術中に確認された.
3) 術後視力は, 術前視力が0であった3症例では不変であり, 術前視力が眼前指数弁以上の7症例で何らかの改善がみられた. とくに受傷後10日以内に手術した3症例では改善の程度が比較的良好であった.
4) 外傷性視力障害の予後は早期治療開始に大きく依存するために, 視神経管上壁の骨折や頭蓋内血腫, クモ膜癒着などの頭蓋内病変が否定し得る場合には鼻外法経篩骨洞視神経管開放術を手術用顕微鏡下に施行することが望ましいと考按した.

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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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新 cephalosporin 系抗生物質CPZに関して, その試験管内抗菌力, 水溶液の安定性および化膿性中耳炎に対して局所的に応用した結果, つぎのとおりの結論がえられた.
1) 試験管内抗菌力: CPZは, 寒天平板希釈法で各標準菌株のグラム陽性および陰性菌に対して強い抗菌力を有し bload spectrum であった. 化膿性中耳炎の耳漏分離の coagulase 陽性ブドウ球菌80株に対する抗菌力 (MIC) は≦0.2～50μg/mlの範囲内に分布し, そのMICの peak は1.56μg/mlに認められた. 病巣分離の Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae などには≦0.2～12.5μg/mで0.39μg/mlにMlCの peak がみられた. また, Pseudomonas aeruginosa には. 0.78～≧100μg/mlで6.25μg/mlに peak が認められた.
2) 水溶液の安定性: CPZ 20mg/ml水溶液の安定性は5℃, 37℃14日間保存で色調, pHに変化なく, その抗菌力価は5℃で9日, 37℃で7日まではまったく変動がみられなかった.
3) 臨床治療成績: 急性および慢性化膿性中耳炎31例に対してCPZ 20mg/ml点耳液を用い5～24日間にわたり点耳耳浴治療を行なった結果, 有効21例, やや有効6例および無効4例となり, その有効率は, 有効, やや有効を合算すると27例87.1%の好成績がえられた. なお, とくに臨床的に副作用の発現は認められなかった.

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小児副鼻腔炎に塩化リゾチームの大量療法 (12才未満1日量18mg, 12才以上1日量27mg) を試みた. 投与期間は平均40日間で, X線所見を主体にした総合判定で, 著効有効例併わせて70%に症状, 所見の改善がみられた. このことにより, 塩化リゾチームの大量療法は有用な治療手段の一つとして結論された. ただ, 治療効果の永続性については更に慎重な検討が必要である. 本療法による副作用は認められなかった.

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正面一点固視下に頭部を水平・垂直に回転し, その時解発される眼球運動により固視機能を検討した.
1) 正常例において, 水平・垂直眼球運動共に円滑な正弦波を示す.
2) 臨床例において, 次の障害がみられる.
a) 正弦波の円滑さの障害
一側, 両側内耳機能廃絶例において, 水平・垂直眼球運動は共に円滑な正弦波を示した.
小脳橋角部腫瘍で, 小脳・脳幹の障害を示す場合, 水平眼球運動に対する固視の障害が著しく, 垂直眼球運動に対する固視は正常で, 円滑な正弦波を示した.
小脳腫瘍, 脊髄小脳変性症のような小脳障害, 脳幹特に橋の障害, 頭頂葉障害時, 水平眼球運動に対する固視の障害がある場合, 垂直眼球運動に対する固視障害もみられた.
上眼瞼向き, 下眼瞼向きの垂直性自発眼振がある場合, 垂直眼球運動に対する固視の障害の方が水平系より著しかった.
b) 眼球運動の大きさの障害
眼筋麻痺などがある場合, 眼球運動の大きさを知ることが出来る. 注視麻痺がある場合, 一見正弦波が円滑であるかのように見えるが, 正弦波の大きさの障害としてあらわれる.
c) 水平・垂直眼球運動に対する固視機能は, 水平・垂直眼球運動の中枢でコントロールされる一方, 小脳片葉を介する経路, 大脳頭頂葉の関与がある.

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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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モルモットの正円窓膜に実験的に穿孔をつくり, その治癒過程を走査電顕と光学顕微鏡にて観察した. その結果穿孔は早いものでは3日目に遅くとも10日目ごろまでには閉鎖することが分った. 走査電顕による観察から治癒した穿孔部は肉芽でおおわれているのが確認された. これは光顕標本においても確かめられた. また光顕標本を弾力線維染色することによりモルモットの固有層の結合織線維の染色ができ, 穿孔部の断面構造の観察が容易になることを示した.

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