In our institute during the past 7 years oesophagoscopy has been performed in 7, 692 cases, among whom urgent oesophagoscopy was carried out in 56 cases with haematemesis and/or melaena. Recently, the flexible fiberscope with an angled tip has been used in oesophagoscopy in almost all cases to lessen the patient's distress. Moreover, the fiberscope is fitted with an automatic apparatus for insufflation of the air, irrigation and suction, so it is possible to examine the lumen of the oesophagus under irrigation for clear observation of bleeding spots.
Among the 56 cases, the ulcer in the upper portion of the gastric corpus and the cardia were most frequently found, i. e., 14 cases, the oesophagogastric varices were found in 8 cases, and the oesophagitis in 8 cases. Oesophageal cancer was found in 4 cases and the Mallory-Weiss syndrome in 2 cases.
In all the cases of haematemesis or melaena from the upper digestive tracts, urgent endoscopy was carried out with combined use of an oesophagofiberscope and a gastrofiberscope without any difficulty. Recently the observation from the esophagus to the bulb of duodenum was carried out with one endoscope, i. e., GIF-D (Olympus) or Panview Fiberscope (Machida).

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A 44-year-old female and a 56-year-old male admitted to Okura National Haspital on Decem. 1970 and Feb. 1971 respectively complaining progressive retrosternal pain, dysphagia and fever for several days. They had been taking medicine for long time because of other diseases.
There were no particular findings in their Chest X-rays. But the esophageal rentgenograms approxomately showed a round defect of 10mm diameter and leakage of contrast media outside the esophageal wall. In each esophagoscopic examination a foreign body was found and removed with forceps.
We thought they had misswallowed PTPs with medicine unconsciously We found (1) the pains were produced by their misswallowing PTPs, (2) round defects in the esophageal rentgenograms reflected the pockets of the PTPs (3) and leaking shadows around the round defects were produced by the sharp edges of the PTPs.

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Since 1965 when the technique of laryngomicrosurgery was developed in our clinic, more than 1200 cases of various types of laryngeal lesions have been operated on with this newly developed technique.
All of the cases mentioned above were classified, and it was found that 34 cases of them, 24 males and 10 females, were vocal cysts.
Phonetic examinations consisted of measurement of vocal and speaking ranges, analysis of soundspectograms and measurement of phonation time were carried out pre and postoperatively.
The results of analysis of phonetic examinations apparently indicated that this newly developed technique, laryngomicrosurgery was clearly valuable for the correction of dysphonia due to vocal cysts.

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A case of three-month-old female infant who was found to have a cyst on the base of the tongue was presented. She has had slight dyspnea with stridor after birth and has been treated as congenital laryngeal stridor and bronchitis asthmatica. But dyspnea gradually increased. A cyst of the base of the tongue was found under direct laryngoscopy. Cyst was resected under general anesthesia. Dyspnea disappeared immediately after surgery. Four cases of this disease, including our case, are reported in Japan.

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A new lateral laryngotomy approach was reported as a function preserving operation of the larynx. Technical details were discussed with some case reports. Rationale of this technique was discussed from the anatomical and neuro-physiolgoical standpoints. Conclusions are as follows;
1. A small transverse incision on the lateral wall of the larynx at the level of the upper border of the vocal cord or the false cord (lateral laryngotomy) offers a satisfactory operative field for the larynx.
2. This incision is easily done after taking off upper one-third of the thyroid ala;
3. This incision is far from the level of branching intra-laryngeal recurrent nerves to the internal muscles and is safe enough to preserve laryngeal function.
4. Through this incision, benign mass lesion of the contralateral side of the glottis is controled more safely and directly than through the suspension laryngoscope.
5. Neuroleptanalgesia without intubation, together with local anesthetics, is utilized for this technique. Tracheotomy is unnecessary throughout.

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