The secordary infection of the lung in association with lung cancer was found in 152 of 405 cases (37%). The secondary infection was found in 47 of 152 cases at the time of admission. In most cases the secondary infection resulted from narrowing of the large bronchi. Gram-negative bacteria, especially klebsiella pneumoniae were found frequently in sputum. There was a tendency for those who showed weakly positive tuberculin reaction to be susceptible to secondary infections. The level of serum albumin in these cases tended to become lower after infection. Leucopenia and treatment with steroid hormons were the major predisposing factors of the secondary infections. The prognosis was very poor in those cases with leucopenia of below 3, 000. The pulmonary infection was the direct cause of death in 22% of the cases, the diagnosis of which were verified at autopsy. The response to treatment with anti-cancer drugs was unsatisfactory secondary infections occurred. In order to prevent the occurrence of secondary infections, it is recommended to avoid the administration for extended preiods of a large dosis of steroid hormons and to exercise due caution to the number of leucocytes.

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The sensitivity of cultured human lung cancer cells to anti-cancer drugs was tested. For the assay of sensitivity, the inhibition by drugs on the growth of microcolonies of cancer cells in microplates (Falcon, Micro Test II) was measured. Its inhibition of over ninety per cent was evaluated for the drug to be effective. The results obtained were as follows;
1. The drug sensitivity of cancer cells seemed to correlate with their growth speed.
2. The primarily cultured cancer cells or established cancer cell lines of the same cell type and growth speed showed a different drug sensitivity.
3. The drug sensitivity of cancer cells was elevated when they were established or when they changed their character during the passage.
4. The success rate of the test in primarily' cultured cases rose to seventy per cent by the use of discontinuous density gradients that separate cancer cells from other cells or cell debris.
5. The drug sensitivity of primarily cultured cancer cells differed from each other and the clinical usefulness of this test was suggested.

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Thirty-two patients with carcinomatous pleurisy were treated with intrapleural administration of adriamycin (A. D. R.) alone or the combination of A. D. R. with OK-432.
After the pleural fluid was aspirated as much as possible through a 17 gauge elaster, A. D. R. or A. D. R. plus OK-432 was instilled into the pleural space once a week.
Of the total 32 patients, 16 were subjected to infusion of 10-40 mg of A. D. R. and 16 patients to the injection of 20 mg of A. D. R. with 5KE of OK-432.
The former group comprised 12 patients with lung cander (8 adenocarcinoma, 2 squamous cell carcinoma, and 2 small cell carcinoma) and 1 each with mammary cancer, fibrosorcoma, multiple myeloma, and reticulosarcoma.
The latter group comprised 15 patients with lung cancer (3 squamous cell carcinoma, 9 adenocarcinoma, 2 small cell carcinoma, and 1 large cell carcinoma), and 1 ovarian cancer.
Of 16 patients treated with A. D. R. alone, 15 (93.8%) demonstrated cytolozically negative in the pleural fluid and the fluid was eliminated in 10 out of 16 patients (62.5%).
The mean total dose of A. D. R. administered until these effects were obtained was 59.3 mg and the mean period of time was 3.1 weeks.
Of the 16 patients the A. D. R. plus OK-432, 15 (93.8%) showed cytologically negative in the pleural fluid, and the fluid was eliminated in 12 (81.2%).
In this group the mean total dose of A. D. R. until the effects were obtained was 42.6mg and the mean period of time was 2.2 weeks.
In the latter group the mean total dose of A. D. R. was less and the period of time was shorter than those of the former group.
The A. D. R. instilled in the pleural space was maintained In more than 20% of the initial concentration immediately after the instillation with traces in the blood and urine after 24 hours. The side effects were minimal and there was no complication.

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This paper described a statistical analysis of data from controlled comparative trials with matched pairs on TNM classification for lung cancer by different diagnoses.
A McNemar's and a Stuart-Maxwell's chi-square statistics used for assessing the significance of the difference between the two samples.
The analytical result in the illustrative data was as follows;
It was found that a significant difference between clinical TNM and Pathological one and the difference was mainly due to the difficulty in diagnosing lymphatic spread as “N” factor.

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Sputum cytology mass survey were carried out to evaluate the method and clearify the relationship between squamous metaplasia and squamous cell carcinoma. Results were discussed in terms of selection of examinees, methodology, and clinical cases. In order to confirm the reasonableness of listing heavy smokers as one criterion for inclusion in a high risk group, biopsies were performed at the bifurcation of the right upper bronchus and truncus intermedius in 100 cases of heavy smokers and 25 cases of non-smokers, all of which had bronchial symptoms but did not have lung cancer. Both group were chosen at random, and it was shown that the incidence of squamous metaplasia was higher in the former.
These findings suggest that sputum cytology is valuable in detecting squamous metaplasia and tumor cells, and is more appropriate for screening studies than biopsy. Since the validity rate of single-day sputum specimens is low, in order to increase the validity rate and the detection rate of sputum cytology mass surveys, a new type of pooling post tube was used for sputum collection. Significant increases in both sample with 3-5 days pooled specimens in comparison to single-day specimens.
On this basis two groups were examine: 3, 819 high risk employees of Tokyo Metropolitan Goverment, and 1, 025 volunteer residents of an area in Tokyo. One case of occult cancer was detected in volunteer group, and 107 cases of squamous metaplasia which were followed up chronologically, showed increased nuclear atypia in 13.1% and decreased nuclear atypia in 24.3% and no change in remainder 62.2% over 3 years. Although no case of cancer was detected among the heavy smokers, since they have a high probability of developing squamous metaplasia and/or lung cancer we feel there is a need of continued sputum cytology follow-up in these high risk cases.

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Two cases of squamous cell carcinoma of the lung, revealing no abnormal shadow on the chest x-ray, were diagnosed by sputum cytology.
A tiny locarized tumor was observed in the main bronchus under the bronchoscopy in both cases, and diagnosed clinically as early lung cancer.
However, they were decided inoperable because of advanced age, respiratory dysfunction and the location of tumor.
The first case was treated with intrabronchial artery infusion of mitomycin C and the second case was subjected to the radiation therapy.
Thereafter, they have been recieved immunotherapy by the interdermal administration of BCG-cell wall skeleton.
At the present time, there is no evidence of recurrence in both cases.
The details of the cytologicaly findings on these early lung cancer are described.
There is a possibility of complete cure of inoperable early lung cancer locating in the major bronchus by combined treatment.

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A 34-year-old female with a bronchiolo-alveolar carcinoma was presented. Her chest x-ray films were possibly reviewed retrospectively for a 21-year duration after the initial discovery of the x-ray change at 13 years of age.
The infiltrative shadow progressed slowly through her entire clinical course and finally the contralateral lung was also involved possibly by way of air-borne route.
Pathology examination at autopsy revealed that the tumorous changes were limited to the intrathoracic organs except some bony metastases in the lumbar vertebrae.
Multiple cavities associated with infiltrative changes in the bilateral lungs were confirmed at autopsy.
The long-term follow-ups were reported but the duration in our case is unusually long when compared with those reported in the literatures.

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[in Japanese]

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We prefer to apply a single large dose irradiation method in radiotherapy because of its remarkable radiation effect and no significant alternation in the patient's immunologic capacity.
In this report, we treated two cases with carcinoma of main bronchi preoperatively by this method and could obtain the favorable results.
The former was irradiated once a week for 3 times (total 3000 rads) and no cancer cell was found in the speciment of the removed lung, though it was diagnosed as early carcinoma of the main bronchi prior to irradiation.
After the single large dose irradiation, the numbers of lymphocytes and T cells in the peripheral blood did not decrease, and blastoid formation rate of lymphocyte as well as strengten of PPD skin test were enhanced.
The latter was irradiated only once (1000 rads) and the specimen of the removed lung showed Grade II radio-change by criteria fo radiation effect (Oboshi, S., 1971).
No radiation injury was noted during the irradiation in both cases.
This radiation method has some advantages and is more effective than conventional one because of shortness of the over all time and no significant immunosuppressive effect in tumor-bearing host.

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