Six cases of chronic stenosis of the larynx and cervical trachea in infants and children were reported.
Two cases with localized tracheal stenosis after tracheotomy were treated successfully with excision of scar and the use of silicone T-tube. A widening of the cartilaginous framework was required in four cases of extensive glottic and subglottic stenosis.
Two cases of subglottic stenosis following translaryngeal endotracheal intubation were treated with an open stent method. After excision of scar through a laryngo-tracheal fissure, a silicone tube stent was inserted into the trough to keep it wide open. The silicone tube stent was removed 10 days after operation in one case because of a difficulty of fixation and the stent made of silicone dental impression was inserted into the trough. After a period of three and half months the stent was removed and the trough was covered with the composite auricular graft successfully in each case.
Two cases of congenital simultaneous glottic and subglottic stenosis were also treated with trough methods. The trough had been kept wide open with a silicone dental expression stent for three and half months and was covered with the composite auricular graft in one case. A silicone tube had been inserted into the trough for about two and half years and the fistula was closed with a bipedicle skin graft in another case.

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It is doubtless that the primary cause of pollinosis is type I allergic reaction. But when compared to other all-year-round allergy, there is certain difference between the two in regard to the symptoms and mode of onset of the disease. Also in view of the fact that the frequency of occurence of pollinosis is relatively few for bronchial asthma while it is high for nasal allergy, there is a possibility that respiratory tract allergy caused by pollen is not only caused by antigen-antibody reaction but also it has some relation with the stimulation of respiratory tract mucosa by certain components of pollen. In recent years, the study on the pollen components advanced and it has been reported that it contains various organic acids. The author suspected that oxalic acid and acetic acid which are contained commonly in all the pollen would have certain relation on the complicated pathology of pollinosis and studied the influence of these two organic acids on the mucosa of respiratory tract by observing the ciliary motive function and the conditions of mucous membrane.
The results are as follows:
1. Irreversible suspension of ciliary motion of nasal mucosa and tracheal mucosa of rabbit occured within several seconds when immersed in the 1/102-1/105 solution of oxalic acid and acetic acid.
2. In 1/106 solution, ciliary motion of nasal mucosa and tracheal mucosa of rabbit was found to stop within several minutes. In 1/107 solution, ciliary motion accentuated temporarily and then attenuated gradually but did not stop.
3. Ciliary motive function of human maxillary sinus mucosa indicated similar reaction to those of respiratory tract mucosa of rabbit in the solution of organic acids.
4. When nasal mucosa and tracheal mucosa of rabbit are immersed in organic acid solution, certain changes of cilia cytoplasma and nucleus were observed. When disturbance was remarkable defoliation or collapsing of pithelial cells was also observed.

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It is known that the preponderance of the antiprotease (protease inhibitor) in the circulating blood is related to the high concentration of α₂-macroglobulin and α₁-antitrypsin consisting of glycoprotein.
In the previous reports, however, we reported that the fibrinolytic activity was owing to high activity of plasminogen activator existing in the tracheobronchial secretion of rats, and then we speculated that protease inhibitor might not exist in it. In this paper, the electrophoretic analysis of the secretion was procedured in order to clarify the absence of protease inhibitor. Using the polyacrylamide gel disc electrophoresis, three bands were identified as albumin and globulins by protein staining of Amidoblack. Furthermore, PAS staining of polyacrylamide gel revealed the existence of glycoprotein in plasma but PAS positive substance did not exist in the secretion. From these results, it was clarified that protease inhibitor consisting of glycoprotein, namely PAS positive substance such as α₂-macroglobulin did not exist in the secretion.

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Movements of the vocal cord (s) and biomechanic findings of the glottis induced by a stimulation of each nerve branch to the intrinsic laryngeal muscles at a constant intencity of 1 volt with increasing frequency were investigated in 68 dogs.
1. Shape of the glottis The vocal cord became longer and slightly adducted by a stimulation of bilateral external branches at 30 to 40 Hz. It abducted most widely by a stimulation of the posticus branch at the same frequency, while it adducted most strongly when each branch to the vocalis, lateralis and transversus muscles was stimulated at 60 Hz.
2. Width of the glottic chink The glottic chink became narrowest by a stimulation of bilateral external branches at 35 to 40 Hz. It became widest by a stimulation of bilateral posticus branches at the same frequency, while the narrowest glottic chink was obtained by a stimulation of each branch to the adductors at 60 Hz.
3. Glottic pressure The glottic pressure showed 395 mmH20 when bilateral external branches were stimulated at 40 to 45 Hz. It reached high up to 550, 570 and 290 mmH20 by a stimulation of the nerves to vocalis at 95 to 100 Hz, lateralis at 85 to 95 Hz and transversus at 95 to 100 Hz.
4. Tension of adduction or abduction in the horizontal plane
The strongest tension was obtained by a stimulation of the external branch at 40 Hz and it measured 11.2 gr, while it reached 16, 11.4 and 5 grs by a stimulation of nerve branches to lateralis at 85 Hz, vocalis at 80 Hz and transversus at 60 Hz respectively.
Wider glottic chink, higher glottic pressure and stronger tension of the vocal cord could not be obtained by a stimulation of any nerve branch with higher frequency than those mentioned above.

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A 33-year-old woman aspirated a postcrown during traffic accident, but she did not notice the aspiration. Later, the cough, sputum and fever beveloped and were treated as a bronchopneumonia. The patient had such an episode two times. The foreign body on chest X-ray films escaped the physician's attention. The foreign body was discovered on chest X-ray films in our hospital after having caused bronchopneumonia for the third time.
With bronchoscopy, bronchial secretions and inflammatory changes were noted in the right intermediate bronchus. The foreign body which was firmly embedded was found in the right intermediate bronchus. Bronchogram revealed the bronchiectasis in the middle lobe and right anterior basal segment. After these examinations, the foreign body was removed bronchoscopically and was identified as the postcrown.

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A new laryngofiberscope with a self-retaining system has been developed in cooperation with Machida Endoscopic Company. The scope is developed to meet therapeutic purposes of microsurgery and to overcome the disadvantage of conventional direct laryngoscopy which often gives an uncomfortable experience to the patient when performed under local anesthesia. The scope has large channnels for the use of big forceps for reliable biopsy. The self-retaining system allows bimanual manipulation in which the forceps is manipulated with one hand while the tip of the scope is centered to the lesion with the other hand. In this paper, some details of the scope are presented and a discussion is made mainly from the viewpoint of its clinical application for biopsy and removal of small lesions such as polyps or nodules.

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Sixteen cases of 11 laryngeal and 5 hypopharyngeal cancers required emergency tracheostomy were reviewed. The incidence requiring the emergency tracheostomy of the hypopharyngeal cancer (11.4%) was high about two times compared to that of the laryngeal cancer (6.3%). Sex incidence was 13 males and 3 females and average age was 70.5 years old in the laryngeal cancer and 55.8 years old in the hypopharyngeal cancer.
The glottic carcinoma and the piriform sinus carcinoma were most frequently found in the larynx and the hypopharynx respectively. All cases were classified in T3 or T4. Lymph node metastasis was observed in all cases of the hypopharyngeal cancer but in some cases of the laryngeal cancer. A case of lung metastasis in the hypopharyngeal cancer was precisely reported.
Various factors influencing late diagnosis were pointed out and discussed. Subglottic extension of glottic carcinoma should be determined exactly. An appeal to the other division's doctor for knowledge and recognition of the head and neck cancer was emphasized to make early diagnosis.

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Cancers in the hypolarynx and cervical esophagus offer the surgeon some problems such as the indication of radical neck dissection, the range of resection of the esophagus and esophageal reconstruction, and no universal surgical procedure has been settled. This is a disease on the borderline between otorhinolaryngology and digestive surgery, which makes the surgical technique more complex. In our hospital, the operation has been performed by a team of head and neck and digestive surgeons.
In this paper, we reported the surgical techniques used in 20 cases of pharyngoesophageal cancer in this hospital, and discussed an antethoracal pharyngogastrostomy technique using an orally inserted staple instrument after blunt dissection of entire esophagus with some comments on problems in this procedure.

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Three cases with long-standing foreign bodies obstructing the bronchus or esophagus were reported. The clinical features were compared with those reported by Ono who made a nationwide statistical analysis of foreign bodies and, as a result, a marked similarity was found between the two studies. It was pointed out that long-standing obstruction of the bronchus or esophagus due to foreign bodies could cause severe complications necessitating a major surgical approach such as thoracotomy.

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