本研究では，過給リーンバーンガソリン機関の希薄限界における燃焼特性を調査するため，単気筒ガソリン機関を用いて当量比0.6 の希薄燃焼を実現し，筒内圧力計測に基づく燃焼解析，エンドスコープを用いた火炎伝播とノッキングの高速度撮影を行い，燃焼特性，エネルギーバランス，ノッキングについて解析した．

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1988年から1997年までの10年間において、群馬県立がんセンター頭頸科にて初回根治治療として、手術切除が行われた、舌癌110例、喉頭全摘出術が行われた喉頭癌108例、下咽頭癌47例のうち、再発した症例について、再発様式、二次治療を検討した。舌癌、喉頭癌、下咽頭癌各々で再発様式は異なるが進行した症例で再発した例は制御が困難となりがちで、特に下咽頭癌では、術後再発の制御が非常に困難であった。いずれにおいても術前の進展度の評価が重要で、一次治療の見極めが大切であると思われた。また、舌癌では再発例でも二次治療にて手術可能ならば、根治できる可能性が十分あると思われた。局所制御後の遠隔転移も認められ、何らかのadjuvanttherapyが必要と思われた。

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Our study involves the retrospective investigation of two groups of patients that were treated at our hospital between 1987 and 1996. The first group consists of thirty-six cases of T3 and T4 laryngeal cancer. The second group consists of thirty cases of T3 and T4 hypopharyngeal cancer. Total laryngectomy and total pharyngo-laryngo-esophagectomy were performed on 24 of the first group and on 15 of the second group. The five-year survival rate were 61% and 44% respectively. Complete remission cases with chemotherapy and radiation therapy were five cases and four cases respectively. Local recurrence occurred in 2 cases of laryngeal cancer and cervical lymph node metastasis occurred in a case of hypopharyngeal cancer. The remaining cases of laryngeal preservation showed tumors were highly responsive to chemotherapy and radiation therapy and that vocal cord paralysis disappeared after 40 Gy irradiation.

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83 patients with laryngeal carcinoma received total laryngectomy at our clinic between 1988 and 1997. 50 were primary cases and the other 33 were secondary cases. 33 had supraglottic cancer, 48 had glottic cancer and 2 had subglottic cancer.
Of the 50 primary cases, 18 had died; 12 from primary cancer and the other 6 from other causes. Of the 33 secondary cases, 8 had died; 3 from primary cancer and the other 5 from other causes. Among 15 patients who died from the primary cancer, 2 died from local recurrences, 8 died from cervical lymphonodes metastasis, and 5 died from distant metastasis.
The most important factors for improving the prognosis after total laryngectomy are to control neck and distant metastasis.

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当科における喉頭癌症例の臨床統計的検討を行った。
1985年から1997年の間に，当科で治療し5年以上経過観察できた104名を対象とした。年齢は39～82歳（平均61.8歳），男女比は14：1（男性97名，女性7名）であった。原発部位別分類は声門上癌23名(22.1%)，声門癌75名(72.1%)，声門下癌6名(5.8%)で，病期別分類はI期が52名(50.0%)，II期が27名(26.0%)，III期が10名(9.6%)，IV期が15名(14.4%)であった。
5年生存率は全体が86.5%，原発部位別では声門上癌60.9%，声門癌94.7%，声門下癌83.3%で，病期別分類はI期が96.2%，II期が92.6%，III期が100%，IV期が33.3%であった。予後不良症例はI期・II期では声門上癌，N分類ではN2・N3症例の比率が高かった。I期・II期の声門上癌，N分類のN2・N3症例に対しては化学療法を積極的に取り入れることが必要であると思われた。

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Six patients (4 males and 2 females) with subglottic cancer were treated in our clinic between January 1974 and September 1994. Clinical and pathological studies were performed on these patients.
Patient ages ranged from 48 to 82 years old with an average of 62.7.
The ratio of subglottic cancer was 1.1% (6 cases) of all laryngeal cancer (518 cases) treated at our clinic. Of these cases, three were determined to be stage I and three were stage II.
The initial subjective complaint was a slightly husky voice in 5 cases and a cough in one case.
All cases revealed swelling in the subglottic space.
Five cases were treated by radical radiation therapy, but one patient showed recurrence of the primary lesion. This and one other case underwent by total laryngectomy.
All patients are currently alive without recurrence.

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One hundred fifty-nine cases of laryngeal cancer that were diagnosed and treated between 1983and 1992 at the Department of Otolaryngology, Sapporo Medical University Hospital were evaluated. There were 101 glottic (66.0%),53 supraglottic (33.3%) and 5 subglottic (3.1%) tumors.
The overall five-year survival rate was 74.2%, while the ten-year survival rate was 62.7%. Regarding the primary site of the tumor, the glottic type was more curable than the supraglottic type and its five-year survival rate was 82.8%, while that of the supraglottic type was only 63.8%. There was no significant difference in the five-year survival rate of laryngeal cancer patients with and without lymph node metastasis.

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Preoperative neurootological examinations were conducted in 23 cases of acoustic neurinoma and the relation between tumor size and neurootological findings was in vestigated. Although there was no correlation between tumor size and hearing level or frequency characteristics, variations of gaze nystagmus were dependent on tumor size.

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We reviewed 143 patients with laryngeal cancer, who had undergone primary treatment in our hospital between 1983 to 1993. These patients consisted of 45 cases of supraglottic carcinoma,94cases of glottic carcinoma and 4 subglottic carcinoma. The respective five-year survival rates were 55.4%,80.1%,100% and 72.9% for supraglottic carcinoma, glottic carcinoma, subglottic carcinoma and that over all. Successful radiation control rates for primary glottic carcinoma in stage I and stage II were 89.4% and 76.9%, respectively. Laryngectomy was performed on 65 patients, but the larynx could be preserved in 54.5% of all cases.

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74歳女性の胃癌を合併した上顎平滑筋肉腫の1例を報告した.
患者は左頬部腫脹, 左頬部痛を主訴に来院した. 初診時, 左上顎洞全体を占拠する腫瘍を認めた. 生検の結果, 平滑筋肉腫と診断した. 化学療法施行後, 左上顎全摘術を行つた. 術後約2カ月後に腹部膨満感出現し, 精査の結果, 胃癌を併発していることが判明した. その後急速に全身状態悪化し, 術後約2カ月半で永眠した.

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In 52 cases of T2-4 glottic carcinoma, factors that may be responsible for neck metastasis were investigated by clinicopathological and immunohistochemical techniques. These factors included clinicopathological factors such as T-staging, tissue differentiation and the ploidy pattern of nuclear DNA ; ploliferation factors such as the S-phase cell labelling index (SLI) and EGF-R; factors related to the basement membrane such as Type-4 collagen and matrix metalloproteinase 2(MMP-2); and cell adhesion factors including E-cadherin, catenin, cathepsin D and desmoglein. The correlation of each factor to neck metastasis was evaluated statistically.
No significant difference was observed between T2 and T3-4, nor between any two groups of well, moderately and poorly differentiated carcinomas. No significant difference was seen between the diploid and aneuploid groups. On the other hand, cases with a positive expression of EGF-R showed a statistically higher incidence of neck metastasis than those with a nagative expression. Cases with an SLI higher than 30, especially those higher than 40, showed a greater incidence of neck metastasis than those with scores lower than 30. A significant difference was also found between the groups with positive and negative expressions of desmoglein. It was further observed that E-cadherin and catenin show the same pattern of expression, but cathepsin has an inverse correlation to them. As for the components of the basement membrane, Type-4 collagen had a close correlation with neck metastasis, and a much higher incidence of neck metastasis was found in cases with a fragmented or negative expressions. Cases with a higher tissue titer of MMP-2 that may degrade Type-4 collagen showed a higher incidence of neck metastasis. On the other hand, no significant difference was observed between the two groups with positive and negative expressions of p53 oncoprotein.

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