Prof. Fujio Matsunaga with many illustrations and charts emphasized the importance of X-ray examination in the diagnosis of esophopeal carcimoma.
Prof. Jo Ono pointed out that along with X-ray study, esophagoscopic examination is imperative in arriving at a definite and conclusive diagnosis as it permits the availability of histologic and cytologic materials.
Prof. Juji Katsura through his wide clinical experience gave detailed talk on the indication and method of surgical treatment in the thoracic as well as cardiac cancer of the esophagus.

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The author has carried out a series of experimental studies and clinical trials on local administration of antitumor agents for advanced malignancies in the areas of head, neck and chest.
A clinical trial with intra-arterial one-shot administration of tumor inhibiting agents through a polyethylene tube indwelt in the stemartery has proved to make it possible to administer a larger dose of the agents in a longer period than intravenous use. Particularly, 14 percent of 86 patients with advanced malignancies placed on intra-arterial mitomycin C survived 18 months or more, while control group placed on intravenous mitmycin C alone expired within 12 months.
A continuous intra-arterial infusion has also been effectively tried on cases of advanced malignancies developed in areas of head and neck, using mitomycin C, cyclophosphamide and amethopterine by means of an infusion pump devised by the author. Selection of antidotes against the agents infused is one of important problems in intra-arterial infusion. It is revealed that sodium thiosulfate and Vitamin B6 have efficacy to inactivate the activities of antitumor agents in vivo both in animal experimentations and on clinical cases.
Standard regional tumor perfusions with cancerocidal chemotherapeutics have been also tried effectively on malignancies in face and head. However, there are left many cases with malignancies in neck and chest to which regional tumor perfusion is not applicable. The author has developed a new method named differential tumor perfusion in which the blood circulation of the upper half body is maintained by the proper heart and lung of the patient under hyperthermic condition keeping high level of the antitumor agent, and that of the lower half body is maintained under hypothermic condition by means of an extracorporeal circulation technique. Details of clinical responses of the patients following the differential tumor perfusion are summerized with analysis of the biological changes in the peripheral blood, bone marrow, renal and hepatic functions.
Furtheremore, the author reports a total body perfusion technique with antitumor agents in combination with exchange blood-transfusion and bone marrow auto-transplantation.
Thirteen out of 15 cases with advanced malignancies (either primary or metastatic) responded favourably the differetial tumor perfusion, revealing relief of subjective complaints, and there were also noticed tumor regression in 6 cases. However. the survival time of the patients undergone the differential tumor perfusion seems not to have been prolongeded remarkably.
In conclusion, it is said that regional tumor perfusion for head and neck malignancies depends on whether more effective agents will be developed in the future.

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Case 1. A man, Age 51: Clinical diagnosis: Glottic cancer.
On mirror examination of the larynx, there was presented a small tumor mass localizing on the middle one third of the right vocal cord. Motility of the cord was apparently normal. The biopsy report indicated squamous cell carcinoma.
Irradiation therapy with total amounts of 7800r. was administered in about 6 months. The tumor decreased quickly in size and dis-appeared in 30th day.
The patient has remained well for 21/2 years.
Case 2. A married woman, Age 63: Clinical diagnosis: Hypopharyngeal cancer.
Examination of the hypopharynx revealed a tumor mass occupying around the posterior part of the right side of the cricoid and also extending to the pharyngeal wall opposite of the cricoid. Direct esophagoscopy disclosed the tumor infiltration toward the cervical constriction of the esophagus.
As the irradiation therapy, fifteen needles of Radon enclosed in were inserted into tumor mass. In addition, a X-ray irradiation of 3000r. was given. The tumor disappeared completly. 1/2 year later, 3000r. of total amounts was irradiated again as an after-care treatment.
She has remained under observation and there has been no warning signals of recurrence in 1/2 year.

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A considerable number of patients have visited our clinic with the chief complaint of abnormal sensation in their pharynx, larynx and esophageal entrance. Recently such cases seem to be increasing in number.
As to the etiology, while many hypotheses have been postulated, no definite theory has yet been brought out. 77 such cases have been studied from the standpointed of age, sex, degree, variety and location of abnormal sensation. Simulataneouly, endoscopic and radiologic examinations have been carried out. Results of these clinical observations indicate that the function of superior cervical ganglion and its sympathetic sensory division (nerve), directly or indirectly seem to play an important role.

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Reflux esophagitis in the total gastrectomized patients is not uncommon. There have been few attempts made to objectively evaluate reflux of duodenal juice to lower esophagus. We tried objectively to evaluate reflux of bilirubin in duodenal juice.
We introduced a duodenal tube with olive tip to lower esophagus under the examination of X-ray and aspirated the duodenal juice with syringe. We examined the presence of bilirubin in duodenal juice according to Watson-Hawkinson's method.
In the patients operated as devised by Prof. Tomoda, reflux of bilirubin to lower esophagus did not occur and these patients were completely free from complaints of esophagitis. During one year after examination, we did not observe the occurrence of reflux esophagitis in these patients.
In some instances, we introduced a duodenal tube into the jejunum interposed between esophagus and duodenum and examined the regurgitation of bilirubin in interposed jejunum. It seemed that bilirubin could regurgeitate in jejunum at 25cm from jejuno-duodenal anastomosis.

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Author used 87 rabbits for experiment, and corrosion was produced at the second constriction of the esophagus by an application of 10% NaOH. This was treated with penicillin and cortison to find out the effect of prevention of esophageal stenosis and the favorable time for its treatment.
Treatment of corticosteroid for corrosive lesions of the esophagus is desirable to begin as promptly as possible. In the animals treated from 3 days after lapse of corrosion started, a good effect was found only in a few of the animals.

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