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Ultrafast dynamics of highly excited Rydberg states of ${\mathrm{Xe}}^{+}$ is investigated by time-resolved shot-by-shot photoelectron spectroscopy with EUV--free-electron-laser pump (40.8 eV) and near-infrared probe (1.56 eV) pulses. Sorting the single-shot spectra in the order of relative delay between the two pulses allows for investigating ultrafast decays of intermediate states participating in the double ionization of Xe. Observed photoelectron spectra show a biexponential decay within \ensuremath{\sim}100 fs and \ensuremath{\sim}300 ps in addition to constant signals lasting longer than 1 ns. These ultrafast decays reflect the lifetimes of autoionizing Rydberg states converging to electronically excited states of ${\mathrm{Xe}}^{2+}$. The results demonstrate that time-resolved shot-by-shot EUV--free-electron-laser photoelectron spectroscopywith a synchronized optical laser provides a powerful tool for investigating ultrafast electron emission processes.

Compared with the local findings of cancer in the head and neck region, worsening of the general condition is gradual. That is why countermeasures against pain become very important in treating these patients. Cancerous pain may be divided into three stages i. e. the early middle and terminal stages, and the method of treatment for each stage is explained in the following. Non-narcotic analgesics may be given orally; suppositories are valuable because they can be used simultaneously with other therapies; acupuncture is effective for early and middle-stage pains and has a painrelieving effect which is different in type from the relief gained by analgesics. For the pain of the middle and terminal stages X-irradiation of 450rads given for the fraction of five or 250rads for the fraction of ten in effective. It is also possible to use several chemotherapeutic agents together to relieve pain. Needless to say this must be done under strict observation of the general condition of the patient.To relieve the pain of the terminal stage, use of narcotics under close supervision may be considered. In such cases, the Brompton mixture may be used at fixed intervals to keep patients in a pain-free condition. Of course it is necessary to keep the local area clean, to encourage the patient to uplift morale and to combine various methods in relieving the suffering of patients tormented by cancerous pain.

Distant metastases were observed in 28 cases (6.7%) in a series of 420 patients with laryngeal cancer treated from 1965 to 1980 in the Aichi Cancer Center.The probability of distant matastases is higher in patients with advanced primary tumors, i. e. T3 and T4 lesions.The most common first sites of distant metastases were the lungs (26 cases), skin, (8 cases), and bone (6 cases).Forty-six percent of the metastases were detected by one year and over 90% by four years after surgery.Until recently, distant metastases of laryngeal cancer were considered to be rare, but in over 90% of patients with distant metastases, the cause of death was distant metastasis, so early diagnosis and early treatment are necessary.We recommend full metastatic screenicg (i. e. chest X-ray, liver scan, bone scan and radiographs) for these patients.

Fifty-nine cases of hypopharyngeal cancer treated between 1965 to 1980 in our hospital were analyzed statistically especially in relation to abnormal sensation in the pharyngo-laryngeal region.The prognosis of hypopharyngeal cancer is poor, mainly because the patients who visit us already have advanced disease.For earlier diagnosis, screening of high risk patients who complain of throat discomfort should be routine.Various factors influencing late diagnosis are noted and discussed. To make an early diagnosis of head and neck cancer it is essential to consult other specialists with knowledge and experience in this area.Our findings strongly suggest that all patients complaining of abnormal sensation be screened very carefully.

An analysis of long-term survivors after curative treatment of maxillary cancer in our clinic evaluated the influence of various factors on the prognosis.The results of combined treatments were promising. It is important to plan treatments which combine irradiation or chemotherapy with surgery.The authors also analyzed the clinical findings and mental and physical care of elderly survivors of maxillary cancer and compared the results with those in patients with cancers of other regions.

LEIOMYOSARCOMA of the nose, paranasal sinuses, and nasopharynx is an unusual but distinctive entity. The Table contains data on the five published cases.1-5This report presents two additional cases of leiomyosarcoma of the maxillary sinus with confirmation of myofibrils in the tumor cells by electronmicroscopic observation. Report of Cases Case1.—A 60-year-old man was admitted to Nagoya City University Hospital on April 30, 1960, with the complaint of swelling of the left cheek. Initial roentgenogram showed a mass involving the left paranasal bone. Under a diagnosis of left malignant maxillary tumor, the total maxillectomy was performed on May 10, 1960. A red-colored tumor about 5 cm in diameter was excised with adjacent tissues. The surface of the tumor was covered by mucous membrane and sharply circumscribed from the surrounding stroma. On microscopic examination, the tumor cells which were composed of interlacing bands and bundles of spindle cells with long

135 cases of cancer of the maxilla observed in a 10-year period were clinically investigated. For treatments operation was principally employed which was combined with irradiation effected by radium-implantation within the wound immediately following the operation.Post oparative survival rate was 34% for 3 years, 32% for 5 years.Seven types were classified according to the presumptive site of origin, and the prognosis were immediately concermed with these classified types and the operation's method.The prognosis of the posterior type was poor, because the tumor involved the base of the skull and the pterygoid process, and the operation schould be employed the total resection of the maxilla.

Out of 114 cases of cancer of the larynx primarily treated with irradiation in the Aichi Cancer Center for the past seven years and eleven months, 27 cases received surgical treatment secondarily because of residual cancer, recurrence or radiotherapy complications.On reviewing and analysing the contributing factors to the reasons why these 27 patients required the secondary surgeries from various points of view, the most frequent causes were not only residual cancer or recurrence of tumor but necrosis, ulceration or edema of the irradiated area of the larynx.Moreover, the authors described the preventive measures to the develpoment of pharyngeal fistula which is the most problematic among the postoperative complications.

Chemotherapy of hypopharyngeal and cervical esophageal cancer generally is considered to have minimal clinical significance, useful only as an adjuvant therapy.As to the methods of chemotherapy performed on actual clinical cases, there are intraarterial infusion combined with surgery and general adminstration for the purpose of prevention of distant metastasis. The intra-arterial infusion chemotherapy is hardly available for this disease, since it is difficult to infuse chemotherapeutics into the hypopharynx and cervical esophagus by retrograde catheterization through Truncus thyreocervicalis. On the other hand, general adminstration of anticancer agent is performed for the purpose of the prevention of distant metastasis, especially for the inhibition of pulmonary metastasis.As to the effect of Bleomycin in treatment of this disease, the rate of effectiveness is 42.8% in total 35 cases.The posibility of this disease being caused by means of Bleomycin alone was exceedingly small. But, the expectation was greater when the agent was adminstered in combination with irradiation treatment, in which the dosage of the either may be much smaller than when using them alone. The direct local injection of Bleomycin on recurrent foci is a curative therapy.

Anterior neck dissection, a regional neck dissection in which the internal jugular chain of nodes is dissected completely but the posterior triangle is left undisturbed, has been developed by us. Metastases of carcinoma of the thyroid to cervical lymph nodes were studied clinically and pathologically in 54 patients who had undergone therapeutic total neck dissections in order to determine selection guidelines for anterior neck dissections. If the 7 patients in whom nodes in the posterior triangle of the neck were palpable preoperatively were eliminated, there were 47 evaluable patients for this portion of the study. Nine (19%) of the 47 patients had nonpalpable but histologically positive nodes in the posterior triangle. If these patients were divided into 4 groups, I, II, III, and IV in which the number of palpable nodes in each was 1, 2, 3, and 4 or more, respectively, the incidence of microscopically positive nodes in each group was 1/20 (5%), 2/11 (18%), 2/8 (25%), and 4/8 (50%), respectively. Twenty-one evaluable anterior neck dissections were performed and followed from 4 to 9 years postoperatively. In 18 patients, there was a single palpable node and in 3 patients, there were 2 palpable nodes. No nodal recurrence has occurred in the necks with a single palpable node, but there has been one recurrence in the group with 2 palpable nodes. We conclude that anterior neck dissection is beneficial to patients with a single palpable node in carcinoma of the thyroid in reducing cosmetic disfigurement and preserving function.