In 890 patients with chronic sinusitis who underwent endoscopic sinus surgery and were followed periodically for more than six months, a set of questionnaires were prepared to gather information on postoperative subjective symptoms and their sinus cavities were observed by endoscopy to investigatethe relationship between preoperative state and postoperative course. The average improvement rate in subjective symptoms was favorable at 95.0%, so subjective symptoms improved favorably in most patients. When the ethmoid sinus was examined postoperatively by endoscopy, there were differences in the improvement rate of nasal obstruction, nasal discharge, olfactory impairment and headache between patients with poor findings and those with favorable findings. Also, when the maxillary sinus was examined postoperatively by endoscopy, there were differences in the improvement rate of olfactory impairment between patients with poor findings and those with favorable findings. The average duration of unstable period (time it took for wound cavities to stabilize postoperatively) was 3.6 months. There were no significant differences in improvement rates of subjective symptoms and objective findings among patients in different age groups. When compared to patients who had never underwent surgery, there were no significant differences in improvement rates of subjective symptoms and objective findings following surgery in patients who underwent transantral sinus surgery. When compared to patients who underwent bilateral sinusitis, subjective symptoms and objective findings were more favorable for those who underwent unilateral sinusitis. When patients were classified based on endosoopic findings of the nasal polyp, the tendency was that the severer the findings, the better the subjective symptoms, but on the other hand, the severer the findings, the poorer the objective findings. When patients were classified based on CT finding of the sinus, the tendency was that the severer the CT findings, the poorer the postoperative objective symptoms, thus extending the postoperative unstable period. However, the improvement degree of subjective symptoms did not correlate to the severity of CT findings. Also, subjective symptoms and objective findings were favorable in patients complicated by allergies and chronic bronchitis, but they tended to exacerbate in those complicated by bronchial asthma.

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After the sensitization with 2.5% of egg white albumin, S. aureus and P. buccae were injected to the maxillary sinus of white adult rabbits in an attempt to develop paranasal sinusitis. Two and four weeks after the injection, we investigated the existence of secretion in the maxillary sinus, and examined the changes macroscopically and microscopically in the mucous membrane.
The inflammation became more aggressive during the time course of 2and 4 weeks. By the 2 nd week, the inflammation in the mucous membrane with aerobic bacteria, that is S. aureus, become more severe than that in those with anaerobic bacteria, that is P. buccae. On the 4th week, however, the degrees of inflammation in both groups became almost the same. These results suggested that anaerobic bacteria is involved in the dvelopment of chronic sinusitis.

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Motion sickness was induced experimentally by pseudo-coriolis stimulation, and from changes in optokinetic nystagmus (OKN) and optokinetic afternystagmus (OKAN), the adaptation process in motion sickness was investigated.
With an increase in the number of experiments, a decreasing tendency was seen in the appearance of phase 1 of OKAN, while a significant increasing tendency was observed in phase 2. Symptons of motion sickness were alleviated with adaptation. It is considered that phase 1 of OKAN is a result of output information reflecting the indirect optokinetic passways and represents the activities of the vestibulai nuclei. With induction of motion sickness, phase 1 of OKAN was inhibited and phase 2 was increased. Therefore, it is considered that changes occurred in the vestibulai nuclei during the adaptation process of motion sickness.

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We attempted to establish a method for a stage classification of the clinical state of chronic sinusitis in order to establish objective and quantitative parameters which describe the clinical state of the disease.
Evaluation was performed on the basis of three factors : radiographic findings (R), the results of allergic examinations (A), and endoscopic nasal find-ings (N). The radiographic findings were classified into four grades (R₀, R₁, R₂, and R₃) by scoring the severity of the lesion using computed tomography. The allergic status was classified into three grades (A₀, A₁, and A₂) representing no allergic disease, nasal allergy and asthma, respectively. Finally, the endoscopic nasal findings were classified into three grades (N₀, N₁, and N₂) on the basis of the presence or absence of polyps, and the status of the middle meatus and olfactory cleft. These three classifications (R, A, N) were then globally assessed in order to classify each case into Stage I through V.
The patients were treated conservatively by administering oral macrolide antibiotics (50 cases) or surgically by performing endoscopic endonasal surgery (217 cases).
The results of this comparison revealed that the therapeutic results deteriorated as the pretreatment disease stage classification increased for both the conservative and surgical treatment approaches. Accordingly, it was concluded that this staging sys-tem accurately reflects the clinical state of chronic sinusitis and thus should be clinically useful.

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Malignant lymphoma is seen among elderly patients. The results of the treatments of the tummor are not always favorable because of the general state of patients affected by aging and the presence of underlying diseases. In the present paper, we studied malignant lymphoma of the head and neck in elderly patients of 65 years of age and older. Lymphomas included in this study were histologically classified as non-Hodgikn's lymphoma and lymphoma at an early stage, which accounted for 82.1%. The outcomes were unfavorable among the patients with extranodal lymphomas arising from regions other than the Waldeyer's throat ring, patients with advanced-stage lymphomas, and even among patients with earlystage lymphomas, when relapsed or were resistant to treatment. Redused-dose chemotherapy, which was adjusted according to the general state of patients, combined with radiotherapy appeared to be effective.

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The authors reports two cases of orbital apex syndrome :
Case 1 is a 56-year-old man who developed a temporary paralysis of the oculomoter nerve and visual disturbance after endonasal sinus surgery. The orbital apex syndrome seen in this patient has been cured by the conservative treatment with antimi-crobials and steroids.
Case 2 is a 34-year-old man who developed orbital apex syndrome characterized by the disturbance of the optic nerve, oculomoter nerve, trochlear nerve and abducens manifesting visual disturbance, diplopia and ptosis. A posterior ethmoidal mucocele was found in CT scan, which was later removed by endoscopic sinus surgery.
The orbital apex area which is a clinically impor-tant area with various carnial nerves related to the eye can be involved in the diseases of the posterior sinus group or by iatrogenic factors.

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Atopic diseases has been increasing in its incidence year by year in Japan. Atopy is a state of allergic response, mediated by IgE. So, it is important to know the state of sensitization against innocurous antigens derived from agent such as pollens and house dust mite. The 918 cases of first-year students of junior high school children in Wakayama 'prefecture were subjected. The quetionnaire for atopic disease was performed. And total IgE antibody and specific IgE antibodies to house-dust mite and Japanese cedar pollen were measured by Lumiward immuno-assay system.
The results showed that the prevalence (present + past) was 29.1% in eczema, 20.1% in asthma and 18.1% in rhinitis including pollinosis. Total IgE level shows various titers. The incidence of specific IgE antibody positivity to DP (house dust-mite; Dermatophagoides pteronysinus) and Japanese cedar pollen were 41.4% and 36.4% respectively. We examined what kind of factors influenced on the levels of total IgE and the positivity of specific IgE antibodies. The levels of total IgE and the positivity of specific IgE antibodies were higher in male, chil-dren who have atopic diseases in the past and/or the present and who have the families with atopic dis-eases within their three generations. However, it was not clear the relation between the IgE antibodies and the history of Various viral infection diseases and viral vaccinations.

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[in Japanese]

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We clinically examined the effect of epinastine hydrochloride on the refractory cases with paranasal sinusitis in childhood.
1) The improvement of subjective symptom is observed in 7 of 13 cases (53.8%).
2) The improvement in the X-ray findings was in 3 out of 13 casses (23.1%).
3) From the results, it is suggested that epinastine hydrochloride is useful for the combination therapy with macrolides for the treatment of the refractory cases with paranasal sinusitis in childhood.

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