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The echo state property, which is related to the dynamics of a neural network excited by input driving signals, is one of the well-known fundamental properties of recurrent neural networks. During the echo state, the neural network reveals an internal memory function that enables it to remember past inputs. Due to the echo state property, the neural network will asymptotically update its condition from the initial condition and is expected to exhibit temporally nonlinear input/output. As a physical neural network, we fabricated a quantum-dot network that is driven by sequential optical-pulse inputs and reveals corresponding outputs, by random dispersion of quantum-dots as its components. In the network, the localized optical energy of excited quantum-dots is allowed to transfer to neighboring quantum-dots, and its stagnation time due to multi-step transfers corresponds to the hold time of the echo state of the network. From the experimental results of photon counting of the fluorescence outputs, we observed nonlinear optical input/output of the quantum-dot network due to its echo state property. Its nonlinearity was quantitatively verified by a correlation analysis. As a result, the relation between the nonlinear input/outputs and the individual compositions of the quantum-dot network was clarified.

The mucosal vaccination is a non-invasive alternative approach for not only mucosal pathogens but also parenteral pathogens, since it induces both mucosal and systemic immunoreactions. The purpose of this study was to evaluate the application of intranasal (i.n.) immunization with a recombinant leishmanial protein against Leishmania infection. BALB/c mice were i.n. administered 1-3 times with Leish-111f plus cholera toxin (CT) adjuvant (Leish-111f/CT). Splenocytes from i.n. immunized mice produced high level of IFN-gamma but not IL-4 in response to Leish-111f. When infected with 1x10(6) of Leishmania major promastigotes 2 weeks after the final administration, lesion development was completely controlled in all mice i.n. administered with Leish-111f/CT. Mice i.n. administered with Leish-111f alone showed neither cytokine productions nor lesion control even after 6 administrations, suggesting the importance of CT adjuvant. This report demonstrated for the first time that i.n. administration of a recombinant leishmanial protein induces Th1 type immunity and protects mice from Leishmania infection.

聴覚評価表 (田中式聴覚発達検査, IT-MAIS) が乳幼児の聴力を早期に把握するための一助となることを検証する目的で, 症例の聴覚機能を継時的に評価した. 症例は補聴器や人工内耳を装用した15例の重度難聴群, 高度難聴群, 中等度難聴群の乳幼児である. その結果, 重度難聴群では人工内耳の術前の低得点と術後の聴覚評価表における得点上昇が観察された. 高度難聴群では急速な聴覚発達, 聴力悪化, 困難な養育環境, そして心身の発達の遅れの影響と考えられる得点変化が検出された. 中等度難聴群は他群より高得点であった. これらの特徴は２つの評価法の間で類似し, 症例は聴力が悪いほど低得点であった. 以上から聴覚評価表は聴力把握の一助になりうると考えられた.

難聴乳児1例をビデオで観察し, 症例がその気持ちを察してもらいながらあやされた結果, 生後7ヵ月過ぎから自発的に養育者との関係をつくり, その関係をさまざまに試す (対人的循環反応) なかで, ことばの基盤を形成し始め, 生後11ヵ月頃, 初期のことばを発見する過程を示した.養育者との対人的循環反応における関わりから, 症例は「待つ」という期待感を込めた行動や, 動作と視線と声を組み合わせた表現方法を派生させ, やがてことばを使うにいたった.本症例の自発的な言語の獲得では出生後よくあやされ, 積み木を倒すなどで自発的に養育者との関係をつくろうとすることが重要であったと考えられた.

ことぼと対人的適応の基盤である情動的認知の発達が遅れた難聴児は, 遊び相手に視線を向けること (注視行動) が少なく, 言語獲得が困難である.本研究ではそのような症例で重度難聴の子どもの遊びと言語獲得の特徴, そして療育の要点を情動的認知の発達が良好な症例と比較した.その結果, 情動的認知の発達が遅れた子どもの当初は, 相手と関わることが少ない, 象徴遊びの出現が遅い, 一人遊びとしての象徴遊びが多い, イメージの展開が乏しいという特徴があった.しかし本園での療育で, 子どもは相手との関係を能動的につくり出し, それを繰り返し試す行動 (対人的循環反応) や注視行動を示すようになり, やがて「対人的循環反応と象徴遊びとの中間型」の性質をもつ遊びの出現を経て相手遊びとしての象徴遊びが増加に転じ, 平行してことばが増加した.しかしその言語獲得には, 3ヵ年を要するなど緩慢で, 良好例が読話での言語理解にいたったのに比べ, 遅滞例は指文字・身振り・手話を必要とした.

The results of tympanoplasty performed in 72 ears with cholesteatoma from 1988 to 1992 are analyzed. The patients were followed for 6 to 60 months (average 21.4 months). The canal down method was used in 32 ears, the canal up method in 8 ears, and posterior wall reconstruction in 32 ears. Mastoid obliteration was done in 61 ears. Staged and second look operations were performed in 19 and 14 ears, respectively. Fifteen of the 33 ears with staged or second look operations had residual cholesteatoma. Recurrence was observed in one ear treated with the canal up method and in 3 ears treated with posterior wall reconstruction. No recurrence was observed in ears treated with the canal down method. Tympanoplasty type I, type II, type II, columella type III, columella type IV were performed in 8, 1, 1, 48 and 14 ears, respectively. Autologous cartilage from the auricle was used in most ears as a columella. The rate of success of hearing preservation was 82% according to the Criteria of the Japan otological Society. There was no large difference in the rate of success of hearing preservation among the ears treated with the canal down method, canal up method and posterior wall reconstruction.

Dendritic cells, macrophages and lymphocytes infiltrating the epithelia of sino-nasal lesions were investigated immunohistochemically using antibody S-100 protein for dendritic cells, Ki-M1P for macrophages, MT1 for T-cells and L26 for B-cells, respectively. Seventy-five specimens of sino-nasal mucosae involving 51 cases of metaplastic squamous epithelium (MSE), 12 of inverted papilloma, 1 of atypical hyperplasia and 11 of squamous cell carcinoma (SCC) were studied. Dendritic cells were observed in 12 cases of MSE (23.5%), in 4 of inverted papilloma (33.3%), and in 6 of SCC (54.5%). More dendritic cells were found infiltrating MSE of the infective and fibrotic types than of the mild and edematous types, histopathologically. Furthermore, infiltration correlated with the degree of squamous differentiation in MSE, but not in SCC. The number of macrophages was significantly smaller in MSE than in columnar ciliated epithelium, while that in SCC was significantly greater than that in MSE. With dendritic cell infiltration macrophages in MSE as well as SCC and T-cells in and around the carcinoma were often increased. These findings suggest that dendritic cells may be attracted to maturative squamous epithelium, and may play an important role in the immunologic defence mechanisms of MSE. Dendritic cells, in contrast, may play a role in the cellular immune response of T-cells against the carcinoma.

Forty-two patients with non-Hodgkin's lymphoma were treated between October 1983 and December 1992 in the department of Otolaryngology, Kagawa Medical School Hospital. The twenty-six of these patients whose tumor originated in Waldeyer's ring and who were diagnosed as Stage I or II have been reviewed. In principle, method of treatment was a combination of chemotherapy and radiotherapy. Between 1983 to 1987, COP was primarily used (9 cases) as combination chemotherapy, and after 1988 CHOP was used (17 cases). VAMA was used to treat the poor response and recurring cases. The five-year estimated overall survival rates calculated by the Kaplan-Meier method were 33.3% and 94.1% in the COP and CHOP groups, respectively. We investigated age, stage, cell type and grade, as factors related to recovery, but except for cell type, there were no significant differences in overall survival. The most serious side effect was decreased leucocyte count, but we prescribed G-CSF and were able to continue treatment.

Argyrophilic nucleolar organizer regions (AgNORs) were determined by a semiautomatic image analyzer in a group of 28 patients with T2 or T3 maxillary sinus squamous cell carcinoma. The group was separated into recurrent and non-recurrent groups, metastatic and nonmetastatic groups, as well as groups strongly or weakly positive for epidermal growth factor receptor (EGFR). The mean number and area of AgNOR dots per nucleus and the mean size of each dot were calculated. The mean number and area were significantly greater than those in normal cells (P < 0.001), but not in recurrent and non-recurrent groups, metastatic and non-metastatic groups and groups separated by EGFR. There was also no difference found in the mean sizes of tumor and normal cells. These results suggest that AgNOR is related to malignant transformation, but not prognosis.

Adenocarcinoma of the middle ear is seldom encountered in clinical practice. In the past 20 years, nearly 20 cases of primary adenocarcinoma of the middle ear have been reported, and most cases of these tumors have been described without histologic presentation. To our knowledge, only one case of adenocarcinoma originating in the postoperative middle ear has been reported. We describe a case of primary poorly differentiated adenocarcinoma in the middle ear which was surgically treated for chronic otitis media 50 years ago. Planning diagnostic and therapeutic procedures in connection with middle ear tumors is also discussed.

Pharyngeal fricatives and affricatives in cleft palate speech due to velopharyngeal incompetence have been considered to be produced in the pharynx. Fluorovideoscopic and fiberscopic examinations in five patients revealed that so-called pharyngeal fricatives and affricatives, as judged on the basis of auditory impression, were both produced at a constriction formed by backward tilting of the epiglottis and elevation of the arytenoid. The velopharyngeal port remained open during production of these sounds but was almost closed during stop and vowel productions. These faulty articulations are adequately termed laryngeal fricatives and affricatives rather than pharyngeal fricatives and affricatives.

The effects of granulocyte colony stimulating factor (G-CSF) were evaluated in 9 patients with malignant lymphoma of the head and neck. The effects of 31 cycles of cytotoxic chemotherapy were treated with G-CSF. G-CSF was given by one of the following three routes: 1) administration before or with cytotoxic chemotherapy, 2) administration after cytotoxic chemotherapy with leukocyte counts of more than 2000/mm3, and 3) administration after leukocyte counts had dropped to less than 2000/mm3. The first group consisted of one cycle of CHOP therapy and 2 cycles of VAMA therapy. The second group consisted of 10 cycles of CHOP therapy. The third group consisted of 13 cycles of CHOP therapy and 5 cycles of VAMA therapy.Leukocyte nadirs occurred on around day 14 for CHOP therapy and around day 21 for VAMA therapy without G-CSF treatment. In the first group, the leukocyte nadirs occurred earlier with G-CSF treatment. Additional G-CSF treatments were given in two of the three cycles. In the second group, the leukocyte counts did not drop below 2000/mm3 in three of the ten cycles. Additional G-CSF treatments were given in five of the remaining seven cycles. The two other cycles went without additional treatment. The mean volume of G-CSF was 305±86μg. In the third group, the leukocyte counts increased to more than 2000/mm3 immediately after G-CSF administration in CHOP therapy. The mean volume was 227±78μg, significantly less than that of the second group. The leukocyte counts also exceeded 2000/mm3 3-5 days after G-CSF administration in 5 cycles of VAMA therapy. These data indicate that the most appropriate administration of G-CSF is 50-75μg/body/day×3-5 days after leukocyte counts fall below 2000/mm3.

The ultrastructure and barrier properties of the endolymphatic duct (ED) were examined by light and electron microscopy. ED epithelial cells were classified into two types: type I and type II duct cells. The type I duct cells were cuboidal or low columnar and were characterized by a convex apical surface and a few basal processes. The type II duct cells were squamous and were characterized by a flat apical and basal membrane, many small vesicles and a number of small pits along the basal membranes. After electrophoretic horseradish peroxidase (HRP) injection into the ED lumen, no HRP uptake into ED epithelial cells of either type was observed. There was no reaction product either in the lateral intercellular spaces beyond the tight junctions between ED epithelial cells or in ED subepithelial tissues. The ED epithelial cells were considered to play no active role in apical macromolecular absorption and to be impermeable to intra-luminal macro molecules.

The results of long-term middle ear ventilation with a Koken tube (wide flange, A type) were retrospectively analyzed chiefly with respect to complications in 43 ears with otitis media with effusion in children aged 3 to 9 years. The average intubation period was 11 months.The average pure tone air conduction threshold showed remarkable improvement from 34.5 dBHL to 15.9 dBHL. Otorrhea, extrusion and obstruction of the tube were observed in 8 ears (18.6%), 9 ears (20.9%) and 3 ears (7.0%), respectively. No cholesteatoma or granuloma were seen. The ear drum perforation failed to close in 4 of 36 ears (11.1%) followed for more than 6 months after extrusion or removal of the tubes. Scarring of the ear drum was observed in 4 ears (12.5%). Recurrence of otitis media with effusion was seen in 15 of 32 ears (46.9%), in which the ear drum perforation was closed after extrusion or removal of the tubes.The present results indicate that the Koken tube (A type) is one of the best tubes for long-term middle ear ventilation.

Enophthalmos is usually a consequence of orbital trauma resulting in a blowout fracture of the orbital floor. We report here the case of a 35-year-old male who had a radical operation of the maxillary sinus and the ethmoidal sinus, and 2 months after the operation, developed spontaneous enophthalmos and ocular pain. The left orbit was enophthalmic by 5mm according to Hertel enophthalmometry. Surgical correction was performed under general anesthesia. The left orbit was explored through a transcutaneous incision of the left lower lid which revealed marked periosteal adhesions and absence of the bony floor of the orbit. A rib cartilage graft was used to reconstruct the floor of the orbit, and the globe was brought forward by means of retrobulbar placement. Enophthalmos and ocular pain disappeared postoperatively.

The serum and middle ear tissue concentration of enoxacin, a pyridone carboxylic acid derivative, was measured in 20 patients with chronic otitis media. The drug was given orally in a dose of 600mg 3 times a day for one to 24 days (average 6.3 days) on an average of 13.1 hours before the serum and tissue samples were obtained during tympanoplasty. In the 14 patients, for whom data of both serum and tissue concentrations were obtained, the concentrations were 0.90±0.66μg/ml and 3.32±3.50μg/kg, respectively. The tissue concentration was 384±236% times the serum concentration.

Veloplasty was performed for two patients with micrognathia and difficulty in opening the mouth. They complained of heavy snoring and obstructive sleep apnea. The micrognathia of the patients was congenital in one and acquired in the other. Although they had had operations of the temporomandibular joint, they could open the mouth only one finger breadth between the teeth. Because of the difficulty in opening the mouth, veloplasty was done instead of uvulopalatopharyngoplasty, with complete relief of snoring and obstructive sleep apnea syndrome.

Eperisone H-Cl, which has been found to improve cerebral circulation and to act as a muscle relaxant, was used to treat 30 patients complaining of vertigo. The rate of effectiveness for vertebro-basilar insufficiency (13 patients) was 92.3%, and that for Meniere's disease (13 patients) was 76.9%. Eperisone was relatively effective for moderately intense vertigo, with the onset within 3 months. Rotating, floating and motion sensations decreased in most patients. On the other hand, the rates of effectiveness for hearing loss and tinnitus were low.In patients with peripheral vertigo, the overall effectiveness of Eperisone was significantly greater in those whose shoulder muscle pain was alleviated than in those whose shoulder pain persisted. This suggests that the muscle relaxant effect of Eperisone plays an important role in the treatment of peripheral vertigo, including Meniere's disease.

A statistic analysis of 372 patients with maxillary sinus carcinoma treated between 1972 and 1983 was undertaken. One hundred eight patients were treated with the combined method consisting of 50 Gy irradiation, 2,000 mg 5-FU intraarterial infusion and tumor reduction surgery, the socalled extensive Denker's operation. Two hundred twenty-two patients were treated with the combined method not including extensive Denker's operation, and the other 42 patients with radiotherapy alone. The 5-year survival of these three groups were 48, 43, and 17 %, respec tively. The cumulative local control of the two groups with and without extensive Denker's operation was 51 and 33 %, respectively. Maxillectomy as the second treatment was performed in 24 cases (22 %) and 71 cases (32 %) of the two groups of the combined method with and without extensive Denker's operation, respectively. On the other hand, 5-year survivors without maxillectomy of the two groups were 41 cases (38%) and 54 cases (24%), respectively. It was concluded that extensive Denker's operation plays an important role to increase the success rate of the initial treatment, decrease the rate of maxillectomy and increase the survival rate although it has a certain limit for the indication.

The effect of lysozyme (Leftose°) on bleeding during tonsillectomy and adenoidectomy was investigated in children. Leftose° was administered for one week before and two weeks after the operation in 31 of 60 patients in whom tonsillectomy or adenotonsillectomy was performed.1) The blood loss during surgery was not significantly different between Leftose°-treated patients and the others.2) Blood coagulation tests before and after Leftose° administration showed no significant difference, but the bleeding time and partial prothrombine time decreased slightly in administration of Leftose°.3) No side effects of Leftose° administration were noted.Leftose° had no major effect on bleeding during tonsillectomy and adenoidectomy although it had a slight influence on blood coagulation.

The capillary permeability and the basolateral endocytic pathway of the mouse endolymphatic sac (ES) epithelium were examined in vivo using intravenous injection of horseradish peroxidase (HRP). The capillaries of the ES were classified as either fenestrated or non-fenestrated. Because dense reaction products were observed soon after injection of HRP in macrophages near both types of capillaries, they were both considered to be permeable to macromolecules. In non-fenestrated capillaries, the basement membrane and small vesicles of the endothelium of the ES were stained with reaction product. These non-fenestrated capillaries were considered to be of muscle type. After 15 min, ES epithelial cells absorbed HRP basolaterally, and the multivesicular bodies and lysosomes of epithelial cells were stained with reaction product. The process of basolateral absorption in the ES epithelium was similar to that in the intestinal epithelium. Our results provide further evidence that the ES is a metabolically active organ which plays an important role in fluid transport in the inner ear.

We had a total of 372 patients with maxillary carcinoma in the period from 1972 to 1983. 108 patients were treated with 50Gy irradiation, intraarterial infusion of 2000 mg 5-FU and extensive Denker's operation in combination. 222 patients were treated with 50 Gy. irradiation and intraarterial infusion of 2000 mg 5-FU. The remaining 42 patients were treated with radio-therapy alone. The 5-year survival in these three groups was 48%, 43%, and 17%, respectively. The cumulative local control of the two former groups was 51%, and 33%, respectively. Total maxillectomy was performed as a second treatment only in 24 of 108 patients (22%) of the first group. Nine of them survived for 5 years and 15 died. On the other hand, 84 of 108 patients not treated with total maxillectomy consisted of 41 five year survivors and 43 deads. From the above, we believe that extensive Denker's operation plays a role to increase success rate of initial treatment, decrease in the necessity of total maxillectomy and improve survival rate, but its indication is limited.

To test the possibility that catecholamines have an influence on the function of the endolymphatic sac (ES), which is known to absorb the endolymph, the effect of catecholamines on the ES direct current potential (ESP) was examined in the guinea pig. The ESP was recorded extradurally by the posterior occipital approach. Isoproterenol (Iso), epinephrine (Epi), and norepinephrine (NE) were administered intravenously for 4 min using an infusion pump. Catecholamines reversibly depressed the ESP with the rank order of potency Iso greater than Epi greater than NE. The threshold doses were 0.021, 0.27, and 1.94 micrograms/kg for Iso, Epi, and NE, respectively. beta-Antagonist (propranolol) blocked the action of catecholamines on the ESP but alpha-antagonist (phentolamine) did not. This indicates that beta-adrenergic action induces the ESP change. This study implies that catecholamines may regulate the function of the ES.

The effects of the anti-cholinergic drug scopolamine, an anti-motion sickness drug, and of the cholinergics physostigmine and neostigmine on habituation to motion sickness in rats were examined using pica, measured as eating of kaolin, as a behavioural index of motion sickness in rats. Rats were rotated around two axes for 1 h once a day for 10 or 11 days. Rotation-induced kaolin intake of control rats gradually decreased from day 9 of daily rotation. Test rats were not treated for the first 3 days, given drugs on days 4-7 of rotation and then again given no drugs for the next 3 or 4 days. Rotation-induced kaolin intake of test rats was compared to that of controls. Results showed that TTS (Transdermal Therapeutic System)-scopolamine administration facilitated habituation to rotation, whereas physostigmine, a centrally acting cholinesterase inhibitor, suppressed it, and neostigmine, a peripherally active cholinesterase inhibitor, had no effect on habituation at all. These findings suggest that the central cholinergic neuron system plays an important role in the neural mechanism of habituation to motion in rats.

上顎洞癌T1症例14例について臨床的検討した。男9例, 女5例, 平均56.7歳で, 初発症状は主に鼻出血, 血性鼻漏, 頬部痛。平均罹病期間は7.4カ月であった。鼻Xpの上顎洞の片側性病的陰影は11例, 両側3例であった。発見の機会は試験開放術によるもの9例, 術前良性の病名で術後病理検査により癌と診断したもの5例であった。腫瘍存在部位は自然口部に10例, 外側上方2例, 不明2例であった。一次治療は放射線単独 (動注も含む) 8例, 放射線+手術2例, 手術単独1例, 三者併用3例であり, 再発は3例に認めた。片側性上顎洞陰影と鼻出血は要注意であり, 積極的に試験開放し, 癌の早期発見に努め, 早期癌であっても十分な治療が必要だと考えた。

A 23-years-old female with no known previous contact with tuberculosis complained of right otorrhea. Treatment with antibiotics agent was resisted, and a tympanic perforation became two. Her tuberculin test was positive, but her chest X-ray showed no signs of lung tuberculosis. Posterior rhinoscopy revealed a granuloma in the epipharynx. Histological examination of a biopsy specimen revealed tuberculosis changes. Treatment with antituberculosis agents, SM.INH.RFP greatly reduced the mass and the tympanic perforation.

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The effect of canrenoate, an aldosterone antagonist, on the ampullar endolymphatic potential (AEP) was examined to assess a possible role for aldosterone in the ampulla. Intravenous administration of canrenoate increased the AEP amplitude in a dose-dependent manner, with a significant reduction of the AEP negative component induced by anoxia. Pretreatment with aldosterone attenuated the AEP change produced by canrenoate. The results suggest that aldosterone may be involved in the modulation of ampullar function.

The aim of this retrospective study was to investigate a correlation between histopathological differentiation and metastasis in patients with carcinoma of the nasal cavity and paranasal sinuses to improve the survival. Between 1984 and 1992, 52 cases of sino-nasal malignant tumors were treated at Kagawa Medical School Hospital. Squamous cell carcinoma was evaluated in 29 patients and undifferentiated carcinoma in five patients. Treatment in most cases consisted of radiotherapy, 50 Gy/25 fr/5 weeks, continuous intra-arterial infusion of 5-FU 2000 mg/4 weeks, and an extensive Denker's operation 2-3 weeks after the completion of radiotherapy. The 5-year survival rate was 53%, and the local control rate was 82%. Patients died of local failure (six), distant metastases (six), lymph node metastases (one) and other causes (three). Twenty-eight patients with local control were classified into G1-2 (well- and moderately-differentiated) and G3-4 (poorly-differentiated and undifferentiated) groups. Lymph node metastasis was unrelated to the degree of differentiation, but distant metastasis was significantly correlated to the degree of differentiation (P = 0.014). The 5-year survival rates in lymph node metastasis (n = 7), non-lymph node metastasis (n = 21), distant metastasis (n = 7), non-distant metastasis (n = 21), and the G1-2 (n = 17) group and the G3-4 group (n = 11) with local control were 57%, 63%, 14%, 78% (P = 0.002), 72% and 44% (P = 0.0384), respectively. The results of combination therapy were poor in patients with poorly-differentiated or undifferentiated carcinoma because of distant metastasis, and adjuvant chemotherapy may be necessary in such patients to prevent distant metastasis.

Expression of mineralocorticoid type I receptor (MR) gene in the rat cochlea was determined using molecular biological techniques. We synthesized complementary DNA (cDNA) from rat cochlear total RNA and then amplified MR cDNA fragments by polymerase chain reaction (PCR). The amplified cDNA fragments were subcloned into an expression vector and the nucleotide sequence was analyzed to confirm the expression of mRNA encoding MR in the cochlea. We then synthesized digoxigenin-labeled riboprobes with this cloned DNA template and examined the localization of MR mRNA in the cochlea by in situ hybridization. The amino acid sequence of MR cDNA expressed in the cochlea was identical to that of the MR first cloned in the rat hippocampus. In situ hybridization showed the expression of MR mRNA in marginal cells of the stria vascularis, suggesting that aldosterone may regulate microhomeostasis of the endolymph, presumably by modulating Na, K-ATPase activity. Intense MR signal was also identified in spiral ganglion cells, the function of which remains to be determined.

Nine oral and oropharyngeal squamous cell carcinomas were removed with a contact Nd-YAG laser. Clinical and morphological studies on wound healing and effects of the Nd-YAG laser were performed. The wounds were not sutured and patients did not complain of any severe symptoms. The wound healing was prolonged to 3–6 weeks. Cells and glands degenerated at a depth of 2–3 mm by the direct effects of the laser. The epithelium exhibited acantholysis 5 mm from the site of laser injury. Scanning electron microscopy showed no coagulation or other coated material in the wound created by a surgical knife, while the wound surface by laser consisted of carbonization, well-coated and non-coated areas. These findings varied with the laser power. The coagulation and thermal effects of the Nd-YAG laser resulted in autolysis of tumor cells at least within 5 mm of the cutting surface. The contact Nd-YAG laser was useful for the removal of the malignant tumor in the oral cavity and oropharynx where it is difficult to maintain a generous safety margin.

A constant volume of horseradish peroxidase (HRP) was injected directly into the endolymphatic sac (ES) lumen of the guinea pig to investigate the detailed absorption activity and the barrier properties of the ES. The reaction products were analyzed using an ultrastructural and morphometric method 1 to 10 h after the injection of this tracer. The epithelial cells in the proximal portion did not absorb the intraluminal HRP at any intervals after the tracer injection. The epithelial cells of the intermediate portion were classified clearly into two types according to their absorption activity: active-absorptive, and non-active cells. Uptake in the active-absorptive cells reached its maximal rate 8 h after the injection and then decreased. The active-absorptive cells in teh intermediate portion are considered to play a major role in the macromolecular absorption in the ES epithelium. The non-active cells scarcely absorbed the intraluminal HRP, suggesting that these cells are not involved in the macromolecular absorption. The absorption activity in the distal portion was lower than that in the active-absorptive cells in the intermediate portion 1 to 8 h after the HRP injection, while higher 10 h after the injection. Not only the intermediate portion but also the distal portion may play an active role in the macromolecular absorption. In no portion of the ES did intraluminal HRP penetrate beyond the junctional complexes between epithelial cells or through the cytoplasm. It is conceivable that there is a tight barrier to the intraluminal macromolecules in the epithelial linings of the ES.

The localization of carbonic anhydrase (CA) in mouse and guinea pig endolymphatic sac (ES) was determined by immunohistochemistry. In the distal and intermediate portions of the ES of both species, epithelial cells reacted with anti-CA antiserum. All epithelial cells in the distal portion stained for CA. In the intermediate portion, immunoreactivity was prominent in about half the epithelial cells, but less intense in the remaining epithelial cells. The proximal portion of the ES lacked immunoreactivity. CA may play a crucial role in ES electrolyte transport.

The expression of epidermal growth factor receptor (EGFR) was determined immunohistochemically in two groups of maxillary sinus squamous cell carcinomas, one with recurrences at the primary site after combination therapy with radiotherapy, chemotherapy and/or surgery and one without local recurrences. Using a four-graded scale (-, +, + +, + + +), 9 of the 10 recurrent carcinomas had a staining intensity and proportion of stained cells of + + or more. A comparable staining intensity was found in 9 of the 18 non-recurrent carcinomas. This difference is statistically significant (Fisher's exact probability test, P0.05). These results indicate that an increased expression of EGFR may influence the recurrence rate of squamous cell carcinoma of the maxillary sinus after combined therapy.

The effect of acetazolamide known as a potent carbonic anhydrase inhibitor of the endolymphatic sac DC potential (ESP) was examined in the guinea pig. Intravenous administration of acetazolamide produced a dose-dependent decrease in ESP amplitude at doses of less than 10 mg/kg. the effect of acetazolamide on ESP was saturated at doses exceeding 10 mg/kg. the maximum reduction of ESP induced by acetazolamide was approximately 50% of the original ESP amplitude. the results suggest that carbonic anhydrase is involved in the generation of ESP.

The ultrastructure of the endolymphatic sac (ES) in the mouse was examined by light and electron microscopy. This organ was divided into three parts: proximal, intermediate and distal. In the proximal portion of the ES, the epithelium consisted of thin squamous cells. The epithelial cells had acquired basolateral processes, numerous small vesicles and well-developed Golgi apparatus. In the intermediate portion, the epithelium consisted of columnar or cuboidal cells. The epithelial cells could be classified into two types: type I and type II. The type I cells had abundant microvilli, pinocytotic vesicles, vacuoles, multivesicular bodies, lysosomes and mitochondria. The type II cells had fewer numbers of these organelles. A few free-floating cells could be observed in the lumen of this intermediate portion, most of which were macrophages. In the distal portion, the epithelium consisted of squamous or cuboidal cells. The epithelial cells had a few cytoplasmic organelles. In the ultrastructural study, each portion of the mouse ES was found to have a very distinct morphological feature. It was suggested that each of these three portions has a different function.

The effect of aldosterone and canrenoate, known as an aldosterone antagonist, on the DC potential in the endolymphatic sac (ESP) was examined in the guinea pig. Intravenous administration of aldosterone (1 mg/kg) induced no change in the ESP for 60 minutes after the injection. However, canrenoate, an aldosterone antagonist, produced a dose-dependent decrease in the ESP. Pretreatment with aldosterone attenuated the decrease in the ESP by canrenoate. The results suggest the possibility that aldosterone may play a role in the endolymph absorption of the endolymphatic sac.

Symptoms at first onset and on initial examination were analyzed in 845 patients with maxillary sinus carcinoma. About 20–30 per cent of the patients became aware of swelling of cheek, nasal obstruction, nasal discharge and epistaxis as first symptoms. About 50–80 per cent of the patients complained of such symptoms on initial examination. Symptoms of maxillary sinus carcinoma are similar to those of chronic sinusitis which results in a delay in diagnosis. Such symptoms should be recognized to improve survival rate. CT and MRI scans are useful for early diagnosis and determination of tumour extension. Sinoscopy with biopsy is most important to detect the earliest tumour stage.

Sinusitis was produced in rabbits, after which animals were separated into three groups: allergic sinusitis, induced purulent sinusitis, and spontaneous purulent sinusitis. Mucosal specimens were taken from these animals and normal controls. Na/K-ATPase was localized cytochemically and its activity studied in order to define the energy metabolism of secretion. The Na/K-ATPase reaction was unable to be clearly distinguished in either the allergic sinusitis specimens or the normal mucosa. In both purulent sinusitis groups, an intensive reaction was observed in the subepithelial glands and a weak reaction was found in the goblet cells. The Na/K-ATPase activity in the purulent sinusitis groups was significantly higher than that in the normal control group. The increased Na/K-ATPase activity may be an affect of hyperactivity of the secretory cells.

We investigated the effects of furosemide, a loop diuretic, and canrenoate, an aldosterone antagonist, on the endocochlear potential (EP) and the endolymphatic sac potential (ESP) in the guinea pig. Furosemide produced no significant change in the ESP at a dose of 100 mg/kg after an intravenous infusion for 20 min. However, this dose decreased the EP to a negative level. Canrenoate produced no significant change in the EP at an intravenous dose of 300 mg/kg for 20 min, but it did decrease the ESP. The differences in the EP and ESP in the repsonse to the diuretics indicate a dissimilarity of the origin of both d.c. potentials in the endolymphatic space.

1965年1月～1978年12月までに, 大阪大学医学部耳鼻咽喉科, 大阪回生病院耳鼻咽喉科および大阪大学医学部放射線科で治療された上咽頭悪性腫瘍患者107例 (癌腫88例, 肉腫19例) につき, その臨床統計を行った.1. 性・年令は癌腫では男性60例, 女性28例と男性が多く, 40～50才代にピークがあり, 肉腫では男性8例, 女性11例とやや女性に多く, 各年代に分布していた.2. 初発症状は癌腫では鼻症状53.4%, 耳症状47.7%, 頸部腫瘤37.5%, 脳神経症状15.9%であり, 肉腫では耳症状47.4%, 頸部腫瘤36.8%, 鼻症状31.6%, 脳神経症状15.8%であった.3. 脳神経症状 (初診時): 癌腫ではV (18例) VI・XI (各9例) IX (8例) の順であり, 肉腫ではVI (4例) II・IV・V (各2例) であった. Iは1例もなかった.4. 原発部位は癌腫では後上壁43.2%, 右側壁29.5%, 左側壁27.3%であり, 肉腫では後上壁63.2%, 左側壁21.1%, 右側壁10.5%で, 肉腫の方が後上壁に多発する傾向がみられた. 下壁のものはみられなかった.5. 病理組織像は癌腫では扁平上皮癌 (リンパ上皮腫・移行上皮癌を含む) が64.8%を占め, 未分化～低分化型のものが61.4%と過半数を占めていた. 肉腫は全例が悪性リンパ腫の範疇に属するものであった.6. 治療は主として放射線治療を行った.7. 癌腫・肉腫の5年粗生存率は各々37.7%, 27.3%で癌腫の方が良かった.8. 癌腫についてUICCとHoの二つの病期分類による予後の比較では, あまり明確な差は認められなかったが, Hoの分類で Stage I+II, Stage III+IV, Stage V にわけると, その5年粗生存率は各々45.0%, 33.3%, 0%となり, この分類において, 多少とも Stage が予後と関係していた.9. 癌腫の組織別では, リンパ上皮腫の5年粗生存率が66.7%ともっとも良かった. 組織の分化度と予後は平行していなかった.10. 肉腫では, 5年粗生存率は Stage I 50.0%, Stage II 28.6%, Stage III 0%であった.11. 死因は遠隔転移死が49.1%と半数近くを占め, 原発巣死は16.4%であった.

Nocardia-CWS (N-CWS) was examined for adjuvant-immunotherapeutic effectiveness in patients with head and neck malignancies whose tumour mass has diminished after radical operation and/or radical irradiation.The evaluation of effect of N-CWS was done with comparing between the nonrecurrent rate of patients who had been injected N-CWS and that of patients who had not injected under randomized control study.The subjects comprised 36 patients who were given N-CWS injections. They completed both their therapeutic courses and subsequent 6-month or more observation periods in or before April, 1979. The control patients numbered 35 and matched for disease and severity.The rate of sufficient control, as difined by the rate of no local recurrence of tumour mass or metastasis after radical treatment in the subjects and control patients, was 75% (27/36) 71% (25/35), respectively, at 6 months; 61% (17/28) and 41% (9/22) at 12 months; and 50% (11/20) and 25% (3/12) at 18 months.The patients on N-CWS were better controlled than the reference patients by ca 20%, and these findings clearly showed the excellent immunotherapeutic effectiveness of the agent.