When taking medical tablets a 21-year-old female accidentally swallowed a “Press-Through-Pack” piece. Soon afterwards she had retrosternal pain with difficulty in swallowing. It was suspected to be caused by a foreign body of a PTP piece from the history and clinical findings. The foreign body was found in esophagoscopic examination and removed with forceps.
The characteristics of the foreign body of PTP pieces were described as follows based on the present case and other literature:
1) In a case of unconscious misswallowing of PTP pieces accurate diagnosis is extremely difficult.
2) As PTP pieces are sharp-edged as well as fish-bone and chicken-bone they can become foreign bodies if they are rather small.
3) The sharp edge may easily cause perforation on the esophageal wall.
Lastly for the prevention of accidents of this kind the author proposed that medicine manufacturers should give up making perforated lines on PTP plates which allow cutt-off small pieces to be foreign bodies.

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Epidemiological researches were conducted as to chronic bronchitis for 36, 374 cases general population over 40 years old living in 9 different air-polluted areas and as to asthma and asthmatic bronchitis of 39, 834 school children of 4 different air-polluted areas.
The following is a report, obtained after careful study on the result of above researches, concerning dose-response of the environmental air pollution to chronic bronchitis/asthma/asthmatic bronchitis, so as to clarify that the environmental air pollution has obvious influence upon occurrence of the above cases and causes aggravation and prolongation of healing time.

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1) The correlation between air pollution and respiratory diseases in childhood, especially bronchial asthma, asthmatic bronchitis and chronic bronchitis were investigated. The frequency of the asthmatic bronchitis and bronchitis in air polluted area were increased significantly.
2) As to the pulrnonary function, there was no significant difference between the non-air polluted area and air-polluted area, but there was found the slightly increase of air way resistance by oscillation technique in air polluted area.
3) Histopathological classification of chronic bronchopathy in childhood by bronchial biopsy was performed and was found that the chronic bronchitis was the epithelial cell denudation type. It was speculated that the recurrent air way infection in chronic bronchitis was based upon such histological finding.
4) An electron histochemical study of the adult rat and infant rat lung by NO₂ gas inhalation was investigated. The results obtained that the different reactions were demonstrated in type II alveolar cells between adult rat and infant rat.

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Characteristics of the upper respiratory tracts associated with pollution and infection was studied by the following three points of views.
(1) Follicular tonsil of retro-pharyngial wall.
(2) Cilia of the larynx and trachea.
(3) Naso-pulmonary reflex.
The following results were observed.
(A) Reactions were observed on the follicular tonsil of the retropharyngial wall as well as evidence of pollution and infection of the upper respiratory tract. Those reactions were similar to the examinations by macroscopy.
(B) Cilia of the larynx and trachea demonstrated as followed 1: It was observed that the deformation of the cilia due to polluted materials.
2: Disappearance or adherence of cilia were observed after exposed to X rays.
3: Eminence of vacuous of the cilia were revealed by 0₃ gas as well as SO₂ gas.
4: Deformation by 0₃ gas was observed to increase after periods of time.(C) It was shown that the symptoms of the infected patients of the upper respiratory tract became more severe when exposed to pollution.
(D) Allergy prone patients who has suffered from chronic infections of the upper respiratory tract with pollution, will show more severe symptoms.
(E) The effects of the upper respiratory tract due to pollution will spread from the lower respiratory tract throughout the entire body.

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Three basic patterns of lower respiratory tract manifestations of sino-bronchialsyndrome are as follows
(1) chronic bronchitis, (2) bronchiectasis, (3) panbronchiolitis Roentgenologic evidence of aplasia or hypoplasia of the frontal sinus was found in 12 cases (33%) of 33 sinobronchial syndromes.
It should be noted that this finding was particularly common in panbronchiolitis pattern and was seen in 4 (88%) of 5 cases. It is concluded that hereditary disposition is playing an important role in pathogenesis of sino-bronchial syndrome among various factors which disturb the defence mechanism of both the upper and lower respiratory tract.

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Studies on the relationship between infections and contaminations in the airway have been examined, on the basis of localimmunity and transtracheo-bronchial immunization.
Results were obtained as follows:
1. Elevated antibody titers and IgA levels were comfirmed in the serum and bronchial washing fluid by the transtracheobronchial inoculation of antigen than by the subcutaneous injection.
2. Similar studies were performed following the exposure to irritant gases (O₃ and SO₂) and some effects were revealed on antibody titers and IgA levels in the serum and bronchial washing fluid.
3. Many cells IgA were observed in the bronchial epitherium, alveoral wall and surrounding tissues of lung vessels by fluorescent antibody technic. No remarkable influences were abtained following the exposure to irritant gases on these IgA containing cells.
4. Rates of sick and death were increased by the exposure to irritant gases in experimental influenza infection in mice. On the ather hand, death rates were decreased by repeatable exposures to irritant gases.
5. Local-immunity of airway in the chronic obstructive lung diseases has many complex matters, and many problems are still unresolved.

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The rhinolaryngological, olfactometric and phoneatric examinations of the 80 cases of the outpatient from the different residensial districts in our clinic were performed. There were remarkable tendencies of the inferior acuity of the smell and the disturbance of the vocal cord vibration in the patients of the polluted area, especially, with obstructive lung diseases when were compared with those of the control in the non-polluted area, and they had the higher incidences of the upper respiratory inflammations.
The mean concentration of parotid salivary IgA of the normal school children in the polluted district decreased more clearly with the significantly different variance than that of the non-polluted area.
The electrophysiological activity of the respiratory tract in the rabbit after SO₂ exposure were compared with those in the controls. Various kinds of electric potential profiles such as the reduction of amplitude or frequency and the occurrence of spontaneous random discharges were recorded in the experimental cases.
The inflammatory changes in the mice respiratory mucosa in the SO₂ exposure+viral infectihn group were severer and developed much fast than the control. It was also elucidated that the influence of SO₂ could remain continously in an individual within a certain period when the animals were exposed to the gas during intrauterine.
It would be speculated that some of air pollutants may act upon immune response.
From the results which we have thus obtained, it is suggested that the incidence of the upper respiratory inflammation in the polluted districts are intimately related with the chronic irritation of polluted air and it may be promoted by interaction between influence of pollutants and infection.

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