Two types of columella materials made of alumina-ceramics (Bioceram^®) were designed by the author for ossicular reconstruction. CORP-P (Ceramics Ossicular Replacement Prosthesis-Partial)is used as the columella to put onto the head of the stapes, CORP-T (Ceramics Ossicular Replacement Prosthesis-Total) to fit over the footplate of the stapes. For the last 9 months 11 patients have so far been implanted with these prostheses with no rejection and good hearing results have been obtained.

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A case of massive epistaxis from a traumatic aneurysm of the internal carotid artery is reported. The epistaxis was initiated by head injury and repeated eleven times. Left carotid angiography revealed an aneurysm at the C3 portion of the carotid siphon. Ligation of the external and common carotid artery of the left side at the cervical region diminished bleeding. Afterwards the intracranial portion of the internal carotid artery and the ophthalmic artery were clipped and epistaxis ceased completely.
Forty-eight cases were reviewed in the literature. One half of these patients died from uncontrolled bleeding. The diagnostic value of repeated carotid angiography is emphasized. Early recognition of the bleeding source is essential for appropriate surgical treatment.

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Scanning electron microscopic study on the laryngeal cancer (squamous cell carcinoma) was performed to observe the cell surface of normal and cancer tissues surgically obtained from 5 patients.
Each mucosal cell surface of the normal vocal cord appeared flat at lower magnification, but abundant microridges were clearly observed on its surface at higher magnification. In addition, the normal cells were closely in contact each other. On the other hand, tumor cells showed round shape and had a tendency to swell. Intercellular contact also became loose. Microridges on the tumor cell surface were decreased in number and degenerated. In the border region between tumor and normal mucosae, round cells and flat cells were coexistent.

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A 63-year-old woman visited our hospital with complaints of swelling and pain in the right thigh. A specimen was taken from the tumor of the right femur, and through histological examination, the tumor was found to be a metastatic tumor of the thyroid gland. Radioiodine treatment (NaI 131) was applied after total thyroidectomy and bilateral modified neck dissection. Clinically, this thyroid tumor is apparently malignant because of its osseous metastasis. However, both thyroid tumors and metastatic right femoral tumor appeared to be follicular “adenomas” according to the standard pathologic criteria and no definite evidence of malignancy was found in spite of careful histopathological examination. We diagnosed this case as the so-called metastasizing goiter and classified this lesion as a subtype of well-differentiated follicular adenocarcinoma. To clarify the entity of this lesion, we need close, long-term observation and adequate standard criteria for identifying well-differentiated follicular adenocarcinoma to differentiate it from follicular adenoma.

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Based upon the 184 clinical cases treated with CO₂ laser surgery, the clinical merits of laser operation, special necessary techniques, and limitations and future possibilities of the surgical indication of laser were discussed. From our experience with laser therapy, the following conclusions could be drawn.
1) Our operative technique of laser bronchoscopic treatment for thoracic tracheal stenosis is superior to any existing method. It is a “total” indication for that lesion.
2) Laser vaporization or laser excision of benign tumors or other superficial lesions is a “relative” indication, because of the advantages of a bloodless field, minimal damage to surrounding tissue, minimal scaring, and etc.
3) As for the therapy of malignant tumors, no dramatically good results have yet been achieved. The main reason for this is the difficulty in judging if all of the tumor has been vaporized.
In the case of T1S, T1, rT1, the first choice of therapy is single laser treatment. In combination therapy, prior laser debulking increases the effectiveness of radiotherapy. We should remember that for laser to be used successfully, we must consider each treatment case individually, and adjust the therapy or combination of therapies accordingly.

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I) Seroepidemiological analysis of various anti-EBV antibodies in NPC
In view of many suggestive findings in relation to the possible etiological role of EBV infection in NPC, seroepidemiological examinations were carried out of 141 sera from NPC-related patients and control groups. Particularly, anti-EBV-VCA (viral capsid antigen) and -EA (early antigen) antibodies were analysed with respect to IgG and IgA antibodies, respectively.
1) The geometric mean titers of these four antibodies were much higher in untreated NPC patients (VCA-IgG; 1: 848, EA-IgG; 1: 80, VCA-IgA; 1:64, EA-IgA; 1:19) than those in the control group (VCA-IgG; 1:116-320, three other titers; <1:10) containing healthy subjects. Also, the ratios of evaluation-positive cases for the four EBV antibodies were remarkably higher in the NPC patients (about 60-85%), than those in the control groups, showing NPC specificity of them.
2) Titers of anti-VCA- and anti-EA-IgA positively correlated with those of anti-VCA- and anti-EA-IgA each other in NPC patients.
3) Titers of these four antibodies in the NPC patients with good clinical prognosis following radiotherapy (RT) tended to remain unchanged or decreased slightly from the pre-RT values.
4) In general, the concentrations of IgG and IgA in NPC patients sera seemed to be relatively high, as compared to the normal sera, but no relations of IgG or IgA concentrations to the titer of anti-VCA-, anti-EA-IgG or anti-VCA-, anti-EA-IgA, respectively, were found.
II) Experimental confirmation of EBV infection in human epithelial cells by cell fusion, fluorescent antibody staining (FA) and the autoradiography (AR) method. Prior to cell fusion experiments, EBV-genome-positive lymphoid cells were labelled with ³H-thymidine and converted to grain-positive cells when examined by the AR method. Thereafter, experimental studies in vitro to confirm an etiological role of EBV in NPC were performed.
1) When EBV (+) and grain (+) lymphoid cells were fused with nasopharyngeal epithelial 2-27-Ad cells by the UV-inactivated HVJ (Sendai virus), EBV-determined nuclear antigen (EBNA) detectable by the FA method became evident in high frequency in 2-27-Ad grain (-) nuclei of heterokaryons several days after cell fusion. This evidence clearly means that the EBV-genome was transferred to epithelial cell nuclei, showing an establishment of EBV infection in this type of cell.
2) Other human epithelial Hep-2 cells fused with lymphoid cells by the similar procedures were found to behave in the same way but their frequency were not so high as in the case of 2-27-Ad cells.
3) When established epithelial or fibroblast cells derived from non-human origin (NHO) were employed instead of the above human origin cells, no EBNA was seen in NHO's nuclei of heterokaryons throughout the observation period.

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A multicenter controlled trial was performed to evaluate the effectiveness and the usefulness of Asthremedin in 152 patients with nasal allergy.
The patients of the Asthremedin group received Asthremedin intradermal injection once a week for four weeks in addition to the conventional treatment. The patients of the control group received only the conventional treatment.
In the final global improvement rating, the rate of improvement was 73.2% for the Asthremedin group and 45.0% for the control group. There was a statistically significant difference between the Asthremedin group and the control group in final global improvement and final improvement of each symptom.
Side effects were observed in three patients. They were local and minimal symptoms.
The mechanism of action of Asthremedin was attributed to its effect of reducing histamine sensitivity of the nasal mucous membrane.

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