Anesthetic practices and problems in connection with bronchoscopy, bronchography, esophagoscopy, laryngectomy, radical neck dissection, suspension laryngoscopy, tracheostomy, T & A, hare-lip and cleft palate, surgery of maxillary sinuses, and fenestration are briefly reviewed, including some recent trends, with emphasis on general anesthesia and also necessity of preparation for resuscitative measures in local anesthesia.

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In the stricture of the esophagus, it has generally been accepted that either bouginage of the esophagus in the mild and limited stricture, or surgical reconstruction of the esophagus in the far-advanced and extended case are the treatment of choice.
Recent nine cases of corrosive stricture of the esophagus treated in Keio University Hospital were presented in this paper and its operative indication was discussed in comparison with the results of conservative treatment. Our treatments were consisted of conservative esophageal dilatation with bouginage together with the use of corticosteroids and reconstructive surgery of the esophagus.
In two cases the esophagus was reconstructed successfully using the right colon. However, our experience in two cases in which the left colon was used suggests that the prevention of such as necrosis of the transplanted colon, leakage at the site of anastomosis, and particularly regurgitation due to antiperistalsis is most important.
The pertinent management in this disease depends upon an early adequate treatment, however, even after cicatrication of the esophagus has been completed, surgical reconstruction of the esophagus should be performed after a long period of conservative dilation of the esophagus with bouginage in combination with administration of corticosteroids and antibiotics.

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The incidence of distant and lymphnode metastases on 193 autopsied cases of the laryngeal cancer and 48 autopsied cases of the hypopharyngeal cases are obserbed.
Distant metastases are obserbed 72 cases (37.3%) in laryngeal cancer and 14 cases (29.1%) in hypopharyngeal cancer.
And metastases into lung is most frequent and in turn in bone, liver, kidney, pleura relatively high metastases is obserbed.
The incidence of lymphnode metastases are 86 cases (44.5%) in laryngeal cancer and are 19 cases (39.5%) in hypopharyngeal cancer.
And metastases into cervical lymphnodes are most frequent and as the distant lymphnode metastases, the pulmonal and tracheo bronchial lymphnodes are relatively frequent obserbed.

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A 60-year-old male had operation of laryngectomy and telecovalt irradiation 20, 000r for larynx cancer in 1964.
About 2 years later, came to admission, he had heavy subjective sympotoma; dispnea, dysphagia, chest-pain and severe cachexia etc., Left atelectasis was found by chest X-ray so called pan-cost type, and E.K.G. showed heavy inpediment of the heart.
Bronchoscopic examination found expression on the right bronchus and obstructic gigantic tumor on the left bronchus, and it's tumor was determined epitheloid carcinoma by histologic examination.
It was depends upon un-efficacious of operation or irradiation. Accordingly, we had prove, directly injection of Rd. seeds (1mc×7) with bronchoscope.
About 3 days later, subjective symptoma was disappeared, and 7 days later atelectasis was extinguished at the chest X-ray. But patient died due to heart debility on 45 days later.
Autopsy showed pericarditis carcinomatosa, but already bronchus tumor was extinguished by macro-examination. It was considered very efficacious rescure that bronchoscopic application of Rd. seeds to obstructic tumor for acute dyspnea of bronchial cancer at the end stage.

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This is a case of 1 year and 10 month old female baby, who was addmitted to Tokyo Women's Medical College, because of chief complaint of a stridor.
She had been suffering from frequent upper respiratory infection with cyanosis, dyspnoe and occasional pneumonia.
Diagnosis of patent ductus arteriosus (PDA) was confirmed by various clinical examinations, including retrograde aortic angiography.
Also a localized stenosis of trachea was found by bronchoscopy and bronchography under the general anestesia.
A surgical ligation of DA. was carried out for PDA, however, the patient expired postoperatively from insufficient ventilation.

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The diagnostic procedure of esophagoscopy was carried out in a 68-year-old man with a complaint of dysphagia.
Though the procedure was carried out easily without a injury of esophageal wall, the patient complained of dyspnoe (with cyanosis) three hours after this procedure.
Immediate roentgenologic examination revealed a spontaneous Pneumothorax of the right thorax, and he was cured by continuous suctioning of air from his right thorax.
This senile patient had been a coal-miner for 40 years, and suffered from pulmonary silicosis associate coith seuere pulmonary emphysema.
It was assumed that the spontaneous pneumothorax of this patient was probably caused by an increased intra-pulmonary pressure created by paroxysmal cough and breath holding during the esophagoscopic procedure.

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