Cineradiographic recording and its digital analyzing method were usefull to do detailed analysis of deglutition. In this study were done the cineradiographic examinations on normal and pathologic subjects and dogs under following conditions, adrenaline, ryegostione, pilocarpine or atropine injection. For the hypothalamic experiments were used normal adult cats and dogs, which were operated under anesthesia with Nembutal. A stimulus electrode was inserted into the hypothalamus to stimulate directly. Under the rectangular electrostimulation (3-7 volts, 0.1-2m sec. 7-200 c. p. s.) was done the cineradiographic recording. Cineradiograph was analysed with digital analyser and was recorded with digital printer. According to the experiments, results were as follows. The second stage of deglutition was not altered with these drugs. Cardiac resistance and lower esophagial motility of normal subjects were reduced with atropine but were strongly raised with pilocarpine. Adrenaline and ryegostine altered them only slighly. In the pathologic subjects it was quite different, that is, lower esophageal motility was strongly reduced with atropine but not so raised with pilocarpine (Sceleroderma and Myasthenia gravis) and was slighty increased with ryegostine (Wallenbergs syndrome). Cardiac sphincter was opened and lower esophageal motility was incresed with rectangular electrostimulus of the ventromedial hypothalamic nucleus. Cardiac sphincter was closed and lower esophageal motility was suppresed with rectangular electrostimulus of lateral hypothalamic nucleus.

View full abstract

Patients of pharyngopathy with vegetative stigmata, i. e., those with abnormal sensation in the hypopharynx or the esophagus were studied using serial roentogenography technic, and intraesophageal electric pressure (open tip) in some cases. Subjects studied were 200 abnormal cases and 63 control cases without pharyngopathy.
The results are as follows:
1) Esophageal motility was classified into 5 types, normal type, slow type, static type, mixed type and dilated type, by esophageal passage curve and esophageal movement.
2) In relation to esophageal motility and effect of a 0.3cc mecholyl or atropin sulfricum (intracutaneous injection), it was conjectured that static type is vagotonic (hyper-kinetic) and dilated type is hyporeactive. The effect of Aschner, Cermack and change of intraesophageal pressure also confirmed it.
3) It was also suggested that subcnical abnormal motility may be able to undergo a change into a manifest disease, i. e., Zencker's divertikel, hiatal hernia, and achala sia e. t. c. Achalasia showed hyperreactive contraction and it was restrained by Ascher and Cermack.
4) X-ray films of the slow type showed various crico-pharyngeal disphagia. It was found that the reaction of medicament was different in upper and lower portion of the esophagus due to the anatomical difference of muscular structure, and 3-block-effect of 25mg intravenous injection of internal was limited in cricopharyngeal region
Finally, the relation between esophageal motility and autonomic nervous system was discussed precisely from the above mentioned facts.

View full abstract

This experiment was made to investigate the relationship of the autonomic control to the secretory function of the trachea and bronchus. The results were as follows:
There are some evidences on histological study that the tracheal glands receive the autonomic control, however the goblet cells in the tracheal mucosa work in response to the stimulation on the mucosa indipendently of the autonomic control.
It is clear from the findings of Suzuki's nerve stain that the peripheral parts of autonomic nerve are degenerated by section of the bilateral vagi, and are unchanged by the autonomic drugs.
The enzyme activities-acid phosphatase, succinic dehydrogenase and glucoses-6-phosphate dehydrogenase-in the tracheal glands increase and decrease with the secretory function.
In microscopic movie and electronmicroscopic study, it was found that secretory mechanism in the tracheal 'gland cells are carried out by mean of eccrine type (IV type) and the cycle of this mechanism is quickened by pilocarpine injection.
Some components in the trachee-bronchial secretion, i. e. sodium, potassium, chlorine, soluble protein and glucosamine were determind and Disc electrophoretic study of the fluid was performed. These results suggest that alteration in the various components of the fluid is less as compared with increasing in volume of the fluid at parasympathicotonic state

View full abstract

For the investigation on neurohumoral theory, I have studied histchemically the distribution of monoamineoxidase (MAO), noradrenaline fluorescing substance (NAdF1) and acetylcholinesterase (AchE) in various tissues. The hypothesis thereby was that neuron with AChE activity is cholinergic, and with MAO activity and NAd-F1 is adrenergic. In the course of study, however, some nerve cells with high activity of MAO were found to show marked reaction not only in cytoplasm, but also seemingly in nucleus. Sympathetic ganglia consist mainly cells of this “nuclear positive” type and this type was supposed to be the characteristic feature of adrenergic nerve cell.
In muscle layer and gland cells of esophagus, MAO activity was moderately positive and AChE activity was almost negative, while cholinergic and adrenergic nerve fibers around those tissues were seen. In Meiss ner's plexus, MAO and NAd F1 activity was poor or almost negative, but Auerbach's plexus of esophagus, especially in the lower part, showed high activity of MAO (contained many “nuclear positive type” nerve cells) and NAd F1. Whereas marked activity of AChE was found generally in nerve cells and fibers of both plexuses.
But MAO activity in Auerbach's plexus was extremely poor in operated materials of cardiospasm, and “nuclear positive type” cells were also hardly found.
In muscle layer, nerve fibers and ganglions of trachea and bronchus, AChE activity was intensely positive, but poor or negative in bronchioli and alveoli, MAO activity in epithelium and muscle layer of trachea and bronchus is moderately strong, and many cholinergic and adrenergic nerve fibers around those tissues were seen. In bronchiolar and alveolar walls, MAO activity was strongly revealed.

View full abstract

The autonomic controls of motility of the esophagus were studied electromyographically. In men and rabbits, the electromyograms of the upper, middle and lower parts of the esophagus were recorded simultaneously by means of bipolar leads with 3 pairs of loop electrodes consisted of circular silber wires attached to a rubber tube.
1. Normal patterns of the electromyograms of the esophagus were explained in men and rabbits. Namely, (1) the burst of spike potentials propagated from the upper part to the lower part of the esophagus after a swallow, (2) the rhythmic bursts of spike potentials in the lower part of the esophagus during resting state in rabbits, (3) the burst of spike potentials induced by syringing fluids (5ml) into the esophagus and (4) the burst of spike potentials induced by insufflation of air (10ml) into the esophagus were observed.
2. On the experiments of rabbits, the rhythmic bursts of spike potentials in the lower part of the esophagus were increased by the electrical stimulation of the n. vagus and by the administrations of pilocarpin and imidalin, whereas the bursts were decreased by the electrical stimulation of the cervical sympathicus and the administrations of atropine and adrenalin. On the experiments of healthy adults, the spike discharges of the esophagus did not show any marked changes.
3. The electromyographic examinations of clinical cases such as a patient after exstripation of the cervical part of the esophagus, a patient with vagus palsy, a patient with cicatricial stenosis of the esophagus and a achalasia patient were performed. In a achalasia patient, after the administration of of mecholyl the appearance of multiple sporadic spike discharges in the middle and lower parts of the esophagus were observed.

View full abstract

Bronchoscopy is one of the most effective methods in diagnosis of lung cancer.
We have been making researches and developed the prototype of a new Flexible-Broncho-Fiberscope since 1965.
At this time of accomplishment of this new fiberscope, we make the report on its specification and clinical experience records, as follows:-
A. Specification of flexible Broncho-fiber-scope:
1. External diameter: 5mm.
2. Total length: 75cm.
3. Flexibility of the apex: 180 degrees (Possible bending in the form of “U-turn” by remort control system)
4. Attachments of the biopsy needle and the mucous anaesthetic tube are equipped.
B. Clinical experience records:
1. We have applied the operation of frexible broncho-fiberscope to 148 cases from January to August, 1967.
2. 89%of 62 lung cancer cases have been visible with this instrument.
3. We have taken motion-pictures of these cases which are to be put on exhibition.

View full abstract

We have done cordectomy for 20 cases of the cancer and precancerous stage in vocal cord since 1957 in our clinic. We observed postoperative results for 19 cases in those diseases which we could follow up.
In histological examination, four of them showed precancerous condition, fifteen of them showed epidermoid cancer and one of them showed heigh malignancy which was doubted carcinosarcoma.
Three patients had recurrences after cordectomy and were performed total laryngectomy. They are now living with no evidence of diseases.
Five-year cure rate was 71% and threeyear cure rate was 75%.

View full abstract