Adapting the conventional sonotubometric method, we developed a device to detect tubal dysfunction by applying pressure to the middle ear through a perforated ear drum. The pressure applied to the middle ear caused deformation of the tubal lumen, which was shown as a change of the sound pressure level in the middle ear.
Using this device, we examined 8 traumatically perforated ears with normal tubes. There was no change in the sound pressure level in the middle ear under positive or negative pressure, and the sound pressure level increased only when the tube was open. The normal tube has a tight structure against pressure form the middle ear.
On the other hand, in patients with abnormal tubes the sound pressure level changed soon after pressure was applied to the middle ear. Positive pressure induced an increase in the sound pressure level and negative pressure, a decrease to the lowest level, due to the change of the compliant tubal lumen.
This device can detect abnormal tubes such as floppy tubes or tubes with inability to close.

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An experiment was designed to study the target predictability subserving pursuit eye movements.
Horizontal eye movements were measured by binocular recording of the electronystagmography (ENG) in 18 normal subjects. Targets were projected on a screen and moved horizontally at a constant velocity (12°/sec) and fixed-cycle (0.1 Hz). The maximum displacement of the target was 30° from center. Near the center of the screen, targets were caused to disappear by a mechanical shutter for three short intervals (417, 833, 1250 msec). Horizontal angular deviations of these intervals were 5°, 10°, 15° respectively.
Smooth pursuit eye movements were maintained and no saccadic eye movements were recorded by tracking 5° center off stimuli. Under 10° and 15° center off stimuli, searching saccades occurred after 300 msec from the disappearence of the target and corrective saccades occurred after 200-240 msec from the reappearence of the target. Smooth pursuit eye movements were maintained for about 300 msec without visual stimuli. Our results suggest that target predictability contributes to the pursuit system.

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We have recently observed fistula symptoms in patients with chronic otitis media, congenital syphilis and many other cochleovestibular disorders of unknown origin.
The fistula symptoms were not only horizontal nystagmus, but also vertical nystagmus, rotatory nystagmus and sometimes simple deviation.
Since almost all patients in whom fistula symptoms were noted experienced vertigo when their external auditory canals were compressed or decompressed with their own fingers, it is important to ask them about this experience. The incidence is often higher with the finger than with the Politzer bag. It is considered necessary to investigate possible adhesions of the membranous labyrinth to the footplate, which may well be part of the etiology of fistula symptoms.

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To shorten the hospital stay, a secondary skin graft was applied to the operated mastoid cavities made by the open method of tympanoplasty or by radical mastoidectomy.
Pinch grafts (small islands of the epidermal layer) were transplanted on an average of 28 days after the operations, soon after the mastoid cavities were covered with healthy granulation tissue. In 8 of the 10 patients treated, the grafts took well, and complete healing was established on an average of 11.1 days after the grafting operation. The procedure reduced the length of hospitalization more than 2 weeks. We are convinced that the pinch graft was beneficial for mastoid cavities made by the open method of tympanoplasty or by radical mastoidectomy.

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Ventilatory function (inflation-deflation test) and excretory function (dye method) of the eustachian tube were examined in 220 ears with otitis media with effusion (OME): 100 ears of children, 77 ears of adults younger than 59 years and 43 ears of those older than 60 years. The control group consisted of 18 ears with traumatic perforation of the eardrum without a history of ear disease, which included 3 children.
1. Passive opening pressure (OP) was normal in 76% of children and in 62.3% of adults.
2. In 20% of OME ears, the first OP was high and the constant OP (third OP) was within the normal range. In these ears, intrinsic factors of the eustachian tube were considered to be the cause of tubal dysfunction.
3. Applied positive pressure could be equilibrated in 50% of children and adults and in 40% of aged adults. However, applied negative pressure could be equilibrated in only 3 % of children, 14.7% of adults and 7.2% of aged adults.
4. Excretory function was impaired in 60 -.70% of all the ears examined and showed no significant difference among the age groups.
It was concluded that equilibration function of negative pressure was impaired most, followed by excretory function and equilibration function of positive pressure, and that tubal passage was almost normal in ears with OME.

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The charts of 1395 patients who underwent tympanometry at 56 otolaryngologic services in Shizuoka Prefecture were analysed. In more than 95% of the cases the diagnosis was otitis media with effusion (OME) and related conditions.
1. Tympanometry is not essential for the diagnosis of OME, excluding cases of sen sorineural hearing loss or narrow external canal, though it can detect OME at a high rate.
2. Tympanograms agreed well with the results of other objective tests, especially oto scopic findings.
3. Rounded type (BR) tympanograms indicated the presence of fluid with a high prob ability as well as flat (BF) tympanograms. When BF type tympanograms are taken with a handy type of impedance audiometer, artifacts must be ruled out.
4. A single tympanogram cannot provide the prognosis of OME.
5. Tympanograms are useful in selecting therapeutic regimens and evaluating their effectiveness.
6. The advantages and disadvantages of one's own impedance audiometer should always be kept in mind. If the results of tympanometry differ from other findings, one should be ready to retest tympanometry, especially when one uses a handy type of impedance audiometer.

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An analysis of long-term survivors after curative treatment of maxillary cancer in our clinic evaluated the influence of various factors on the prognosis.
The results of combined treatments were promising. It is important to plan treatments which combine irradiation or chemotherapy with surgery.
The authors also analyzed the clinical findings and mental and physical care of elderly survivors of maxillary cancer and compared the results with those in patients with cancers of other regions.

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Rhinoscopic and roentgenographic examinations were carried out in 53 cleft palate patients. The following findings were obtained: 1) 41.5% complained of nasal obstruction; 2) the main cause of nasal obstruction was either deformity of the nasal cavity or a pharyngeal flap; 3) deformity of the nasal cavity was frequently observed in cases of severe cleft palate; 4) 58.5% of the patients had maxillary sinusitis.
Thus, it was revealed that cleft palates had high incidence of nasal and paranasal diseases which need treatment by otolaryngologists as in the case of the ear diseases in cleft palates.

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A 49-year-old man developed vertical nystagmus after treatment of tonsillar cancer.
He entered our hospital in January, 1981, and was treated with irradiation and anticancer therapy. The tonsillar cancer disappeared clinically, and he was discharged in April, 1981. The clinical course after treatment was favorable until July, 1981, when he suddenly developed dizziness, lack of balance, ataxia and upbeat nystagmus. He was readmitted to our hospital, where roentgenogram, electroencephalogram (EEG) and brain scan were all normal. After two months of drug therapy for vertigo his symptoms subsided, but upbeat nystagmus continued until December, 1981. Starting in January, 1982, he was treated with 5 Fluorouracil (5-Fu) to prevent the recurrence of cancer.
Towards the middle of April, 1982, he complained of weakness, vertigo, anxiety, paralyzed limbs and downbeat nystagmus in all dirctions of gaze.
The possible lesion in this case was located in the brainstem, the medulla oblongata and the cerebellum.
Because of a past history of stimulant abuse (amphetamine) for one year and the background of irradiation and 5-Fu therapy, the cause of vertical nystagmus was thought to be a combination of: 1) tonic imbalance of the vertical pursuit system due to fragility of the reticular formation in the brainstem caused by amphetamine, 2) a circulatory disorder of the region under the vertebro basilar artery due to irradiation and 3) medullocerebellar lesions as toxic effects of 5-Fu.

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A 36-year-male had two recurrent, large, elastic hard tumors, one was in the retroauricular region and the other in the inflaauricular region. Blood examination revealed an increase in eosinophils. The tumors were excised, and diagnosed as eosinophilic granuloma of the soft tissue by histological examination.
Electron microscopic investigation of the tumors revealed degeneration of eosinophils, such as the destruction of the granules, release of the tubular or spherical core from the granules, vacuolization, phagocytic vessicles containing amorphous necrotic debris, and enlargement of the perinuclear cysterna in the cytoplasm. The CharcotLeiden crystals were also found around the degenerated eosinophils, as a specific pathological finding.

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There are many kinds of imaging examinations for the diagnosis of thyroid tumors. Among them, RI-scintigraphy and ultrasonography were investigated and their results were evaluated. In 35 patients who had been operated on and diagnosed histopathologically, the correlation between imaging examination and histopathological examination was determined.
1) Histopathological examination showed 14 cases of cancer (7 follicular adenocarcinomas, 6 papillary adenocarcinomas and 1 medullary carcinoma), 12 adenomas, 2 cysts, 3 adenomatous goiters and 4 cases of chronic thyroiditis.
2) RI-scintigraphy was performed with ^99mTc and ²⁰¹Tl. In early scans, 7 of 14 cases showing positive ²⁰¹Tl scans and negative ^99mTc scans were malignant and in delayed scans, 6 of 11 cases showing positive ²⁰¹Tl scans were malignant.
3) Ultrasonic examinations showed 14 of 14 cases to have a malignant pattern by Fujimoto and Oka's classification, and all 14 were malignant histopathologically; 13 of the 14 cases showed malignancy by Shoji's scoring method.

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A 37-year-old male patient was stabbed in the neck adjacent to the thyroid cartilage with a kitchen knife, a broken fragment of which remained in the vertebra behind the hypopharynx. He grew hoarse after the accident, and two months later he started to feel dizzy when speaking. The laryngoscopic examination showed immobility and atrophy of the left vocal fold with overcrossing of the right fold. Blood
gas examination revealed that the dizziness was due mainly to respiratory alkalosis caused by hyperventilation while speaking. Six months later Meurman's operation was performed. Postoperatively dizziness disappeared and phonation time, the blood gas levels and the sound spectrographic findings improved.
Dizziness is a rare chief complaint in patients with recurrent laryngeal nerve palsy, but we should be aware of the possibility.

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As reported till now, the cleft palate population has a high prevalence of middle ear disease. Tubal dysfunction and contamination of the pharyngeal orifice of the eustachian tube, etc., are believed to be the cause of this high prevalence, but this relationship has not yet been proved.
We have surveyed the literature and considered tubal dysfunction in patients with cleft palate. Otitis media with effusion in cleft palate patients improves after the palatoplasty or as the patients grow older, and at the same time tubal function becomes better, too. Therefore, tubal dysfunction is suspected to be the main cause of otitis media with effusion in the cleft palate population. Therefore, it is important to elucidate the mechanism of tubal dysfunction in cleft palate patients not only to treat middle ear diseases in the cleft palate population but also to make clear the clinical role of the eustachian tube in middle ear diseases.

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In order to clarify the effect of cerebellopontine angle tumors on the auditory pathway, an animal experiment was performed. A 4Fr angiographic balloon catheter was inserted to the cerebellopontine angle of guinea pigs under anesthesia by pentobarbital sodium. Tone bursts and clicks were introduced ipsilaterally, and alterations of the auditory evoked brainstem responses (ABR), the action potentials of the cochlear nerve (AP) and the endocochlear potentials (EP) with inflation and deflation of the balloon were recorded. Inflation was continued until ABR and AP suddenly disappeared, and deflation was performed five minutes later.
1) There were slight reductions in ABR: P₁, P₂ with inflation and return to preinflation levels with deflation.
2) There were slight reductions in AP: N₁, N₂ with inflation and a return to about half the preinflation levels with deflation.
3) There were marked reductions in ABR: P₃, P₄ with inflation and return to 64% and 44% of preinflation levels, respectively, with deflation.
4) Alterations of EP made clear that these sudden disappearances were caused by interruption of the blood flow to the cochlea. This simulation indicates that cerebellopontine angle tumors cause sensory and neural disturbances in the auditory pathway.

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The relationship between eye position and body sway was examined. Using goggles equipped with prism lenses of 30 degrees, these goggles produced eye deviation of 17 degrees. Body sway was measured while the subject stood with feet together. The deviation of body sway was expessed as the difference of the center of body sway between the values with and without goggles. During upward gaze, the center of body sway deviated forwards. During rightward gaze the center of body sway deviated leftwards, and during leftward gaze, the center of body sway deviated rightwards. No characteristic pattern was observed during downward gaze. These relationship of eye position to body sway were in accordance with the pattern of tonic neck reflex.

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Clinical studies were made on radiation damage of the salivary gland in 14 patients with a malignant tumor in the cephalic cervix before and 2 weeks after radiation. Seven patients were treated by radiation alone and the remaining 7 were intravenously given YM-08310 (2 mg/kg), a radiation protectant, 30 minutes before radiation. Both groups show characteristic radiation-induced changes in symptoms, clinical findings, saliva and serum electrolyte and amylase levels and serum fibrinolysis activity. However, flow dynamics in the salivary gland decreased slightly more in the group receiving radiation alone.

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We evaluated the titers of anti-cefotiam antibodies in the sera of 44 patients before and after the intravenous administration of cefotiam. The anti-cephalosporin antibodies were detected using the passive hemagglutination inhibition test. Only three of 44 patients became positive for the antibody after the administration of cefotiam, though none of the patients showed no symptoms. It is possible that cephalosporin can induce immunological reactions based on the hapten mechanism.

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A new cephem antibiotic, Ceftriaxone (CTRX) was compared with other cephems as to in vitro antibacterial activities. CTRX revealed an excellent, broad spectrum antibacterial activity against gram-positive and gram-negative bacteria, as well as an antibacterial efficacy, similarly to Cefotaxime which was used as a reference drug.
The MIC of CTRX against S. aureus isolated from otorrhoea was distributed at a range from 0.78 to 25 μg/ml, showing a peak at 3.13 μg/ml. P. mirabilis, E. coli and K. pneumoniae were inhibited by ≤0.2 to 0.39 μg/ml of CTRX. It's activity was similar to that of Cefotaxime, Cefotiam, Cefoperazone, Ceftizoxime, Cefotetan, Latamoxef, Cefmenoxime and superior to that of Cefazolin, Cephapirin, Ceftezole and Cephacetrile against various pathogenic gram-negative bacteria.
CTRX showed MICs of 3.13 to 12.5 μg/ml, its peak being 12.5 μg/ml against 60 strains of pathogenic P. aeruginosa.

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Anti-asialo GMl promoted tumor proliferation of cancer of the maxillary sinus transplanted to nude mice, OK-432 significantly inhibited the proliferation of transplants of the same tumor tissue.
When anti-asialo GM1 was administered to suppress NK cell activity, OK-432 failed to inhibit and even promoted tumor proliferation.
We conclude that OK-432's anti-tumor effects on transplanted cancer cells in nude mice are due to NK cell activation.

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