Computed tomography (CT) in diagnosis of laryngeal carcinoma was evaluated among 23 patients. CT can provide clinically important findings which may be “blind spots” in laryngeal endoscopic examination: (1) tumor invasion to deep soft tissues such as pre-epiglottic and paraglottic spaces, (2) status of laryngeal cartilages, (3) subglottic extension of neoplasm. However, CT does not demonstrate superficial mucosal lesions in stage I and II of glottic carcinoma and glottic motion. CT is one of the most useful modalities in diagnosis of tumor extent.

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Laryngeal cancer was retrospectively discussed on 213 patients who deceased or survived more than 5 years after the treatment was started in Aichi Cancer Center. From the observation over 5 years, it was found that an overwhelmingly large number of patients deceased due to other diseases than laryngeal cancer within 5 years and recurrence took place in only a few patients. Therefore, the patients surviving more than 5 years may fulfill their life when they were well controlled for their health so as not to suffer from other serious diseases. Based upon such a clinical evidence, we proposed that the percentage of the 5-year survivors should be deemed as a cure rate of laryngeal cancer in contrast with gastric cancer. Accordingly, we considered that the necessity of health-control system for aged people as coping with a social problem of drastic increase in their population will arise in the near future in Japan.

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A case of combined type of laryngocele in a 47-year-old Japanese male patient is reported. The patient presented with a painful swelling in the right submandibular area and hoarseness, and a tentative diagnosis of laryngopyocele was made. After the infection was controlled, laryngomicroscopic examination disclosed air bubbles escaped from the right ventricle following the external pressure of the submandibular mass. X-ray examination revealed an air-containing cyst in the submandibular area. The final diagnosis of combined type of laryngocele was established. The patient underwent the complete removal of the laryngocele via the external approach.
Laryngocele has not uncommonly been reported in the foreign literature but rare in the Japanese. Only 5 cases including the present case have been reported in Japan. To clarify the difference of the incidence of laryngocele between Japanese and other races, the measurement of 32 laryngeal appendices in 19 surgical specimens of total laryngectomized cases was performed. The results were compared with those reported by Broyles. There was, however, no evidence of shortening of the length of the appendix of the larynx in Japanese. The author concluded that there is no relationship between the low incidence of laryngocele among Japanese and the length of the appendices in the larynx.

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An in vitro histamine release test in the whole blood with house dust antigen was performed in 102 asthmatics. The following results were obtained.
1) The percentage of histamine release was significantly higher in asthmatics than in healthy persons. It was also higher in the group with a positive skin test than in the group with a negative skin test (p<0.001).
2) The percentage of histamine release correlated well with the results of the skin test, the end points of the skin test and RAST scores (r=0.47, p<0.001; r=0.56, p<0.001; r=0.60, p<0.001).
3) The rate of histamine release was 72.6±19.3 percent in the group with a positive provocation test.
4) In a negative skin test, the histamine releasing rate was 3.2±3.0 percent. This result suggested that house dust antigen was estimated as a causative antigen in asthmatics when the histamine releasing rate was more than 9.2 percent.

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Esophageal foreign bodies are usually diagnosed without difficulty in children or adults by their typical symptoms such as dysphagia. Recently the authors experienced an infant with only respiratory symptoms caused indirectly by an esophageal foreign body.
The patient was a 13-month-old boy who had an episode of nausea and vomiting whenever he has fed with solid food for approximately one month prior to his admission. However, such unusual symptoms were not observed during fluid feeding. Accordingly, no special medical care was given to him. He was admitted to Matsudo City Hospital because of stridor and progressively increasing difficulty in breathing. Fiberscopic examination revealed no abnormality in the pharynx and larynx.
Roentgenographic examinations showed normal chest. A thickening of the prevertebral soft tissue was noted on the lateral neck view. However, there were no radiopaque shadows in any conventional X-ray films. CT revealed a high density material in the soft tissue at the level of the first thoracic vertebra. The diagnosis was made of an esophageal foreign body. A foreign body was removed through the esophagoscope under general anesthesia. It was a plastic button.

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