Three cases of the laryngeal cancer were treated by combination of radiation, BLM and surgical therapy. Resected specimens were studied histologically. Most of cancer cells were killed by irradiation or BLM therapy, but a few cells survived at different portion of the larynx. Some of them differentiated poorly, and others well. This fact suggested that preoperative treatments should be combined with irradiation against poorly differentiated cells, and BLM therapy against well differentiated ones, and the range to be resected should include the whole extention of the cancer before treatment. Such procedure will improve the permanent survival rate of the laryngeal cancer.

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Using cultured transformed fibroblasts (RFL-T), an antitumor agents, 5-Fluorouracil, was found to be potentiated in its inhibitory action on RNA formation by vitamin A as well as Amphotericin B. 5-Fluorouracil in combination with vitamin A or Amphotericin-B enhanced more effectively the cellar sensitivity to cobalt irradiation than when 5-Fluorouracil was used alone.
Systemical treatment of the malignant tumor in head and neck region, especially laryngeal, hypopharyngeal and cervical esophageal cancer, were performed by combination with irradiation, administration of 5-Fluorouracil and vitamin A. We scheduled a routine method as follows;
Vitamin A of 50000 IU was given i. m. 6 hours prior to irradiation and was followed by 250 mg of 5-Fluorouracil i. v, which was soluble to 20 ml of 20 % glucose, one hour prior to irradiation. Irradiation of 200 rads (cobalt 60) was given every day. And these combination therapy was performed 5 times per a week. When the total doses reached to 3000 rads, it was determined whether a combination therapy was continued or not, for conversion to a surgical therapy after 2 to 3 weeks interval. During this pause all the reactive inflammatory sign on the mucosa or submucosa was recovered.
As tumor doses, 6000 to 8000 rads were irradiated with gamma rays of cobalt 60 or electron beams of Betatron in the case of conservation. This synergistic combination therapy resulted in heigh percentage of the cure even in the case of the invading cancer of larynx, hypopharynx and cervical esophagus.

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Two new types of illuminating apparatus for endoscope have been designed. One of these apparatuses is the halogen-lamp type, which is the combination of the strobo flash lamp and the xenon short-arc-lamp, the former is bright enough for photograph.
The other is the xenon short-arc-lamp type, the lamp of which can be powered up in the case of taking picture.
On the basis of my past experience, I have reached the conclusion that the new apparatuses should satisfy the following needs,
1. Adequate illumination to observe fine appearances of the organ.
2. Accuracy in taking picture during the examination or the surgery.
3. Light weight and compact type.
4. Easy operation and maintenance.
Thus, the great attention was paid in designing of the new apparatuses. Further-more, the xenon short-arc-lamp type is able to exchange to the other type of endoscope by means of special attachment.

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A 16 years old female with a large calcifying epithelioma in the right preauricular region was presented. The tumor was painless but gradually became larger before she consulted our clinic. It was the size of a pigeon's egg and was stony hard. Sialogram showed normal Stensen's duct and parotid gland. The parotid gland was overlaid with the tumor, simulating a parotid tumor.
The extirpated tumor was surrounded by the subcutaneous tissue outside the parotid gland and was well encapsulated by fibrous tissue. Histological examination revealed a characteristic appearance of the tumor composed of both shadow cells and basophilic cells.

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A case who had continueing respiratory distress after an emergency tracheotomy was reported. As the emergency tracheotomy is often carried out under unsatisfactory conditions, some kinds of complications are likely to happen after the operation.
This patient had dyspnoea with acute epiglottitis and the emergency tracheotomy was performed by a general surgeon in another hospital. As a little of restoration on the general conditions and the respiratory disturbances after the surgery, he was brought to our University Hospital for a sufficient treatment. At that time a tracheostoma was found on fairly high position where was a level of the right thyroid cartilage. Then, for a prevention of the laryngeal stenosis and the decannulation, re-tracheotomy was performed with repairing the wound by the high tracheotomy. Furthermore the laryngofissure was performed for the purpose of the observation and laryngoplasty. On a couple of weeks after operation, the laryngofissure was closed as there were any kind of respiratory problems and tracheotomy was closed on three weeks.
As described above, the complication was likely occured after emergency operation. In this paper, the importance of sufficient surgical management for laryngeal stenosis or decannulation after unskilful emergency tracheotomy was stressed.

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Leiomyoma is commonly found in the uterus, but it is uncommon in the tongue, especially in children is rare. And multiple leiomyomas are much rare in the tongue, although are frequently found in the uterus.
A case of multiple leiomyomas of the tongue was reported. A 7 years old boy complained of the two tumors of the tongue which had been present since 15 days after birth. The one was situated at the right side on the dorsum of the tongue, the other was situated at the right marginal portion of the tongue. These tumors were removed easily by the operation under general anesthesia. The patient discharged on the seventh day after operation. Microscopically, the tumors were composed of bundles of smooth muscle cells of which cytoplasm was reddish in Azan's staining and yellowish in Van Gieson's staining. The skeletal muscle of the tongue was normal. Histopathologically, the tumors were leiomyomas of the tongue.

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Why do animals have intense troubles mainly in the basal turn of their cochlea by sound exposure and by ototoxity ? The author thought that the protein in cells had an important relation to this subject. A silicon model of hair cells was made and was poured three kinds of solutions of protein. And the ionization of the protein and its denaturation were checked by giving strong energy of oscillation to them like the similar idea of photoelectric effect. As the result, as for the protein liquid, the increase of volts was noted just after the model was exposed to sound. About 3 hours later, the figure decreased gradually. From this phenomenon, the author presumed that the protein in sensory cells became a factor of the stimulation by receiving strong energy conversely. Low-percent protein liquid had less effect by sound.
Because temperature absorbs the energy of sound, it was noticed that there was little increasing tendency in the albumin, the plasmanate and the pan-amin.
As for pH, there is no change or a little tendency to increase in the albumin, the plasmanate and the pan-amin, and the significant change of the osmotic pressure was found in the albumin about 30 hours later.

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Operation methods in order to master an esophageal speech in a brief time were undertaken in all cases and landmarks of the clips were fixed on the inferior pharyngeal constrictor muscles. The relationship between formation of a pseudoglottis and function of the inferior pharyngeal constrictor muscles was investigated under a roentgenographycal view. Postoperative observation showed us that a pseudoglottis appeared most frequently at the approximate level of the fifth vertebra and the crico pharyngeus muscle. When a laryngectomee trying to speak, the cricopharyngeus muscle was ascended to take an air in the esophagus and soon descended to belch it out. The cricopharyngeus muscle stayed in the lowest level during phonation. When a pseudoglottis was dilated by an esophageal balloon, its width of 10 to 20 mm was most effective to speak. Wide or narrow pseudoglottis than that criteria didn't create a good esophageal voice. The configuration of a pseudoglottis dilated by an esophageal balloon was easily classified into 5 groups, that is, type 1: simple form, type 2: simple form with subglottic space, type 3: larynx-like form, type 4: multiple formation of neoglottis, type 5: incomplete formation of neoglottis. Type 1 to 3 envolved in good esophageal speakers. The higher the prominence on the posterior wall at the level of a pseudoglottis which was formed by the cricopharyngeus muscle the better the esophageal speech was.

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I) Studies on the antiplasmic activity of some antiplasmic agents i) A new method of determination of plasmin activity
In most methods of determining plasmin activity, fibrinogen or fibrin is used as the substrate of plasmin. The lysis time or lysis area is measured to determine plasmin activity on these methods. But it is difficult for clinicians to determine the proper plasmin activity if they are not skilfull in determining the plasmin activity on these methods.
To remove this defect an attempt was made to devise a simple and rapid method on the determination of plasmin activity. It was tried to form a fibrin clot fixed with the pigment.
Using this substrate, a released quantity of the pigment from this clot was measured with spectrophotometer on fibrinolysis by plasmin. The present paper describes about the possibility of determination of plasmin activity on this method used this fibrin clot fixed with the pigment.
1) Blue Dextran with high molecular weight can be fixed with fibrin clot, but Methylene Blue cannot be fixed.
2) The fibrin clot fixed with Blue Dextran can be used as a substrate on this measurement of plasmin activity.
3) Plasmin activity was assayed by measuring the released quantity of Blue Dextran from the fibrin clot fixed with Blue Dextran by fibrinolysis.
4) On the measurement of the purified hunam plasmin activity, the determination on TAME esterolysis was correlated with a released quantity of Blue Dextran on this method using the fibrin clot fixed with Blue Dextran.
ii) Effects of some antiplasmic agents on human plasmin, in vitro
In otorhinolaryngological treatment, the antiplasmic therapy has recently increased in order to inhibit the fibrinolysis which is induced by inflammation or by the surgical operation. Prior to using some antiplasmic agents in clinical treatment, these antifibrinolytic activities were estimated in vitro. On fibrin plate method, t-AMCHA inhibited the UK-activated fibrinolysis, that is, plasminogen activation process induced by urokinase. The concentration of t-AMCHA for 100 % inhibition was 1.59×10^-1 M in order to inhibit plasminogen activation induced by urokinase (2.5 Ploug units). In the experiment of using the fibrin clot fixed with Blue Dextran, both t-AMCHA and CEP-t-AMCHA inhibited the fibrinolysis induced by the SK-activated plasmin. Inhibitory effect of CEP-t-AMCHA was more powerful than inhibitory effect of t-AMCHA.
II) Fibrinolytic activity in blood on sinectomy with and without the medication of the antiplasmic agents
It is well known that the fibrinolysis in blood has been induced by a various surgical operations. It is thought that the bleeding during and after the surgery might be attributable to the fibrinolysis. In order to decrease the bleeding induced by the fibrinolysis, the antiplasmic agent was given to the patients who underwent the sinectomy.
The present paper describes about the fibrinolytic activity in blood on sinectomy with and without the medication, of the antiplasmic agent.
1) The fibrinolytic activity was measured by affinity chromatography using Lysine-Sepharose.
2) In a group with the medication, the quantity of fibrinogen increased more than in a group without the medication after the sinectomy.
3) In a group with the medication, the quantity of plasminogen slightly decreased more than in a group without the medication after sinectomy.

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