A 19-year-old man was successfully treated by total glosscctomy for squamous cell carcinoma on the right margin of the tongue. A pectoralis major musculocutancous flap and deltopectoral flap were used to cover that oral cavity and the orophynx reconstructed area. Right radical neck dissection and left supraomohyoid neck dissection were performed, which histologically revealed no lymphnode metastasis. The primary lesion was treated by surgery and was well controlled, but a cervical lymphnode metastasis was found one year later (left side). CT-scan, echography and angiography showed that the metastatic cervical tumor surrounded the internal jugular vein and invaded into the wall of the internal jugular vein.
Angiography especially showed a decreased blood flow. The histological diagnosis was made by fine needle aspiration. The reconstructive surgery was performed by transplanting the great saphenous vein after removal of the metastatic tumor and the internal jugular vein.
Angiography especially showed a decreased blood flow. The histological diagnosis was made by fine needle aspiration. The reconstructive surgery was performed by transplanting the great saphenous vein after removal of the metastatic tumor and the internal jugular vein.

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Transtympanic electrocochleography (ECochG) was performed on 137 definite Meniere ears, 29 normal ears and 383 ears with other diseases. The average SP/AP amplitude ratio (SP/AP) was significantly larger than that of normal subjects in the following four disease groups whose causes are thought to be endolymphatic hydrops: 1) definite Meniere's disease, 2) suspected Meniere's disease, 3) delayed endolymphatic hydrops and 4) labyrinthine syphilis. The SP amplitude could not nor from other sensorineural deafnesses. provide any information for a differential diagnosis of endolymphatic hydrops from normal subjects nor form other sensorineural deafnesses.
The upper 99% confidence limit of normal SP/AP using a 100d$SPL click was 0.37 for 29 subjects. In patients with Meniere's disease the relationship between SP/AP and clinical data such as pure tone threshold, audiogram pattern, results of glycerol test and duration of illness from the first vertiginous attack to the test were investigated. In patients with severe hearing loss, the number of those showing SP/AP of greater than 0.37 was much higher than in patients with less severe hearing loss. There were no relationship, however, between SP/AP and or audiogram pattern, or glycerol test.
ECochG was recorded before and after intravenous administration of 50 gr of glycerol (10% solution, 500ml), and a significant decrease of SP/AP was found in 21 Meniere ears. However, there were no change of SP/AP after oral administration of 50 gr of glycerol (50% solution, 100ml) an disosorbide (70% solution, 2.Ogr/kg of body weight).
After endolymphatic sac surgery a decrease of SP/AP of 10% or more was found in ears, an increase of SP/AP in 3 ears, and no change of SP/AP in 3 ears. In the patients showing no change of SP/AP after the surgery, numerical values of vertigo by AAOHNS were higher than in patients showing an increase or a decrease of SP/AP.
The results demonstrate the usefulness of ECochG in diagnosis of endolymphatic hydrops and indicate a possibility of monitoring the state of hydrops after administration of glycerol and endolymphatic sac surgery.

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直達喉頭鏡を用いた喉頭顕微鏡下レーザー手術は早期喉頭癌の一次治療として確立されてきている。本手術を行うための手技工夫として, われわれが行っている側方開放型直達喉頭鏡を用いて鉗子操作を容易にする方法と気管チューブの保護を中心に紹介した.極小の規格の側方開放型直達喉頭鏡を用いると喉頭展開に優れ, 鉗子の挿入が容易である.また, 排煙用吸引管を挿入できる細径の側管も付属している。一方, 本手術では挿管された気管チューブをレーザーの誤照射から保護することが必要である.そこで, 既存の気管チューブに装着可能なレーザーガードプロテクター (MerocelLaser-Guard) が市販されるようになり, この使用経験についても紹介し, 本手術の問題点についても考察を行った。

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白神山地の奥赤石林道沿いで，生育不良な約20年生スギ人工林の混交広葉樹の構造・組成，及びその変化を1998年から2002年まで調査した。スギの平均立木密度はプロット間で350〜2300本ha^-1の範囲で変動し，胸高断面積合計も3.6〜41.9m²ha^-1と変動していた。著しく低い立木密度や胸高断面積合計を示すプロットは，今後も林相が改善される見込みはなかった。枯損原因の多くが積雪被害であることから，空間的に不均質な積雪深が上記の林分状態の差異の原因と考えられた。混交広葉樹の胸高断面積合計は0〜15.4m²ha^-1と変動し，スギの胸高断面積合計とは負の相関があった。広葉樹の組成は6〜8つの型に分けられ，サワグルミ，キハダ，ミズキ，ウダイカンバなど攪乱依存性の高い樹種が優占していた。サワグルミやミズキなどはスギの枯損率の高いプロットで優占していたが，この原因の一部は，スギの枯損の原因となった豊富な積雪に由来する水分条件によって説明されると推察された。プロットの中には広葉樹の組成が調査期間内で大きく変化したものがあり，現段階で組成は不安定であった。これらの人工林は，組成の変化を見ながら順応的に管理していくことが勧められる。

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