Androgenic and anabolic hcrmones have often been used in treating various diseases. The treatment for dysphonia, one of their side effects, has not yet been ascertained. We have employed a new surgical procedure and have obtained successful results.
It may be said that when the cricothyroid muscle is more dominant than the thyroarytenoid (TA) muscle, voice will be high-pitched.
Based on this concept, a method of weakening the activity of the TA muscle was assumed to be effective for eliminating abncrmal high-pitched voice. Prior to clinical application, we designed electrophysiological and histochemical experiments.
Using canine larynx, a portion of the terminal branch of the recurrent nerve in the TA muscle was severed by making an incision onto the vocal cord parallel to its free edge. By deepening the incision, evoked electromyographic activity was gradually decreased presumably due to reduction in action potentials of the muscle fibers to be picked up by the electrodes. Similar results were also obtained in chronic experiments using canine larynx.
A histochemical study revealed that motor end-plates were remarkably degenerated one month after ncision. This finding would indicate that the incision has severed the branch in the TA muscle.
This method have been successfully employed for 8 clinical cases. In this paper, the results were reported and descussed from the viewpoint of phoniatric examinations.

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We presented a case of laryngeal nystagmus combined with myoclonus of the vocal cords
A possibly related condition was an obsessive-compulsive neurosis. The following findings were obtained by high-speed X-ray photography.
1. Rhythmical movement were observed, both in the external and internal laryngeal muscles.
2. Involuntary phonation at the time of expiration was confirmed as the cause of the abnormal sound.

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A one-year-old boy with persisting coughing spells and stridor was seen at the Tokai University Hospital and was found to have a shift of the trachea on chest x-ray. The parents denied an episode of aspiration of foreign body. After being afebrile and asymptomatic for 14 days with an improvement in chest x-ray, the patient developed high fever, aggravating coughing spells and stridor, and the patient was referred for bronchoscopic evaluation.
The evening before the day of bronchoscopy, the patient suddenly developed severe dyspnea and emergency resuscitation was sustained. Immediate chest x-ray study showed pneumothorax of the right lung and atelectasis of the left lung. Constant aspiration of air from the right pleural cavity followed by the insertion of a catheter resulted in no improvement.
Emergency bronchoscopy was performed under general endotracheal anesthesia, and a small plastic piece, apparently a pair of toy wheels on an axle was found at the entrance of the left main bronchus and was removed. The patient's respiration was remarkably improved immediately after the removal of the foreign body. Reexpansion of the right lung was observed on the following day of the operation and the intrapleural catheter was removed.
The etiological considerations were as follows: one inferable cause would be that a foreign body initially lodged in the entrance of the right main bronchus with inspiratory check-valve action caused hyperinflation of the right lung followed by spontaneous pneumothorax, and then the foreign body moved to the left main bronchus producing a complete obstruction of the airpassage and atelectasis of the left lung. Another inferable cause would be that the foreignbody lodged and stayed in the left main bronchus throughout the entire clinical course and produced atelectasis. Increased reipiratory effort and hyperventilation in the right lung caused rupture of bleb or bulla of the right visceral pleura to result in pneumothorax.

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The authors previously reported two clinical cases of tracheal stenosis in children following intratracheal intubation and suggested a possibility of chemical effect of residual ethylene oxideused for sterilization of the tube on the tracheal mucosa.
In the present study, animal experiments were performed on 7 dogs in order to investigate the effect of residual ethylene oxide on the laryngotracheal mucosa. The result suggested that there was a positive relationship between the aeration time after sterilization and the degree of histological changes in the mucosa.
Based on the result of the present study, it was suggested that aeration time should be longer in order to avoid possible damage to the airway mucosa.

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We are carrying on the basic and clinical investigations of transbronchial bacteriological culture studies using the flexible fiberoptic bronchoscope.
This time we would like to present some of the results of bacteriological culture studies with some of the asscciated problems through the transtracheal tube method. Sixty point five % of positive bacterial cultures were obtained from a total of 172 cases, consisting of 16 kinds of chest diseases.
In each disease in which we examined more than 10 cases, the higher positive bacterial culterial groups were, lung abscess 100%, chronic bronchitis 82%, tumor of the lung 80% and bronchiectasis 75%; on the other hand, lower positive bacterial culture groups were pulmonary tuberculosis, 16.7% and the cases examined for the purpose of excluding cancer, 33.3%.
Approximately 10 kinds of causative microbials were identified in the both groups. Secretions came from different diseases and different tracheobronchial areas showed their own microorganisms and different positive culture rates.
No microorganisms were cultured from clear serous and white tenaceous secretions, except those located on hyperemic mucosa and with stenotic or ectatic lumens; however, several kinds of microorganisms were cultured from yellowish, brownish and greenish secretions.
In reference to contamination within the lumen of the tracheal tube immediately after intubation, positive bacterial cultures were obtained from the swab-sponges at 12.5%, so the contamination rate of the channel of the fiberoptic bronchoscope caused by passing through the tracheal tube, will be under 12.5%, however comparative bacteriological identification between the secretions from the tracheal tube (sputum) and from the fiberscope channel should be done for diagnostic and therapeutic purpose.
“PRELEVEMENTS BRONCHIQUES AU MOYEN DU FIBROSCOPE: ETUDE BACTERIOLOGIQUE ET PROBLEMES DE CONTAMINATION DES CANULES ENDO-TRACHEALES APRES INTUBATION”
Nous voudrions presenter, dans le cadre d'une étude clinique et bactériologique, les résultats obtenus à partir de prélèvements endoscopiques par bronchofibroscope en essayant d'apprecier l'influence éventuelle du passage du fibroscope dans une canule d'intubation.
Sur un total de 172 prelevements concernant 16 affections broncho-pulmonaires différentes, les cultures furent positives dans 60.5% des cas-Eu ce qui concerne les maladies pour lesquelles plus de 10 cas furent réunis les pourcentages les puls éléves concernaient les abcès du poumon (100%), les bronchites chroniques (82%), les tumeures broncho-pulmonaires (80%) et les bronchectasies (75%); les plus bas: les cas examinés pour la exclusion de cancer (33.3%) et la tuberculose pulmonaire (16.7%).
Environ 10 espèces microbiennes furent identifiées. Suivant la maladie et le territoire concerné par le prélèvement, les souches différaient par le germe en cause et pourcentage de détection.

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Nine patients are presented having an accessory cardiac bronchus which arose from the medial wall of an intermediate bronchus. The sex ratio is 6 men to 3 women. The age range is from 31 to 74 yrs. These supernumerary bronchi were accidentally discovered by other pulmonary diseases except two cases which were detected by hemosputum of bronchial mucosal inflammntion.
The accessory cardiac bronchus had segmental bronchial structure in the proximal part, and the tip of the bronchus was closed in many cases except two cases with terminal sprigs. Comparative anatomically, the accessory cardiac bronchus corresponds to the accessory lobe bronchus in the inferior mammals (dogs, rabbits). It originates from a bronchial bud within 6 weeks in the human embryo.
Clinically, this kind of bronchus can be a cause of hemosputum, though the number of lung cancer is increasing which is simply regarded as a cause of hemosputum.

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Forty two cases of cancers localized in the hypopharynx and the cervical esophagus, which we have treated in the past five years, were presented and discussed here in this paper with special reference to our treatment policy and the results. Conclusions are as follows;
1. According to the UICC classification, the 92 cases are composed of 4 T₁, 17 T₂ and 21 T₃ cases, including 3 far advanced cases.
2. A carefully planned clinical program of combined pre-operative radiation and chemotherapy has been conducted for all cases. A guidance how to select an approach for resection of the tumor depending cn the degree of invasion and to reconstruct the defect was shown.
3. Se, eral factcrs which are essential to a safer treatment were emphasized, including a proper handling of the recurrent laryngeal nerve, resection of the thyroid and parathyroid glands, problems in the post-operative care and so on.
4. Following up of these 42 cases has been conducted through October 1, 1977. As of that date, 26 patients were alive with no evidence of cancer, while 16 patients had died. Ten were surviving more than 3 years and 2 of them more than 5 years. All of these survivors have well been controled by the primary therapy but one who had been treated secondarily for a local recurrent lesion.
5. All of T₁ cases are susviving, while about a half of T₂ and T₃
6. All of death but one occured within 6 months after the surgery.
7. Five patients were died of cancer and 2 of them from distant metastasis, which is less than those of intercurrent causes.
8. Twelve of 18 patients who were treated by partial hypopharyngectomy with preservation of the larynx are alive with no evidence of cancer, which indicates a wide field resection is not nec- cessarily essential to radical resection of the tumor.
9. Radical neck dissection was performed for all cases but one. Twenty nine (69%) cases showed pathohistologically positive nodes and had poorer prognosis than the negative cases.
10. Contralateral neck metastasis cccurred in none of these 26 survivors up to that date.

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