In this second part of the report, transthoracic electrical impedance change associated with respiration (respiratory dz) was analysed in relation with intrathoracic ventilatory events manipulating pattern, frequency of respiration, FRC level and distribution of inspired air within the lung of nonthoracotomized dogs and the lung volume in saline filled lungs and thoracotomized dogs.
From these experiments, following results were obtained. The cause of respiratory dz is not mechanical motion at the intersurface between the electrode and the chest wall, but resistivity changes of the lung tissue associated with respiration. The electrical current applied through the electrode on the chest wall passes through the lung tissue with a fairly narrow geometrical configuration corresponding to the electrode. Respiratory dz is in phase with airway pressure change and spirograms and correlates well with the tidal volume change. dz/dv ratio is constant in individual subject. When the electrode is arranged regionally on the thorax, the method can detect regional uneven ventilation in neighboring lung lobes with the electrode without electrical interference.
Based on these experimental results, clinical observations concerned with uneven ventilation in patients of tuberculous bronchial stenosis, tuberculous pleurisy, pericardial defect and severe kyphoscoliosis and with a impedance respiratory monitor which we had newly designed were reported.
Our investigation shown in these first and second reports confirmed that the measurement of thoracic electrical impedance may be applicable to detect physiological events, such as ventilatory and hemodynamic, within the lung and be promising as a medical electronic device to catch these physiological information because of its simplicity and nontraumatic applicability.

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Pulmonary hyaline membrane is well recognized in newborn infants. Similar pulmonary lesions are found in the adults who were treated by oxygen of high concentration. In the present investigation, a large number of autopsy cases treated by oxygen prior to death was studied clinicopathologically in order to determine the frequency and to elucidate the pathogenesis of oxygen pneumonitis.
The study group was composed of 100 cases over one-year-old, who had been administered oxygen with nasal catheter, face-mask, oxygen tent or artificial ventilator. The control group was consisted of 40 cases, who had never received oxygen therapy. Both groups had neither history of uremia, radiation to the lung nor other factors that might give rise to hyaline membrane formation.
Hyaline membrane was found in 24 cases of the study group and none in the contorl group. There was no case with hyaline membrane among 21 cases treated by oxygen for less than one day, while in 79 cases treated over one day hyaline membrane was found in 30%. Seven cases were severe and others were focal or mild.
In the cases with hyaline membrane, thrombi were found in the lungs in high incidence (79%) in comparison with 15% of the control group. Positive correlation was found between incidence of thrombi and the duration of oxygen therapy.
Histologically found were a variety of lesions such as congestion, exudate in the alveolar spaces, interstitial edema, hyaline membrane, degenerated and detached alveolar lining cells, hemorrhage and atelectasis in cases who had been administered oxygen over one to several days. In the later stage the lung revealed septal thickening or interstitial fibrosis.
It is considered that pulmonary lesions are resulted from increased permeability of the alveolar septa, of which alveolar lining cells and endothelia are injured by high concentration of oxygen, and that those changes might seriously impair the respiratory functions.

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One hundred and thirty six cases with spontaneous pneumothorax were reviewed especially on the etiology and the factor of recurrence. In consequence of the investigation, the following results were obtained:
1) Bullae or blebs were found in 68 per cent of the idiopathic and the recurrent.
2) The attack was not related to the season but it occurred frequently in the morning, and the onset of the idiopathic was seen in 89 per cent at rest or in daily life, but, of the secondary, in 65 per cent during exercise.
3) In reviewing the Broca index, the idiopathic was found to be more common in the tall thin man.
4) The valeu of serum α₁-antitrypsin of 28 patients was within normal limits (Mean±SD, 321±30 mg/dl).
5) The recurrence rate was 23 per cent, furthermore 37 per cent of the recurrent occurred again.
6) Age distribution showed that the majority of the idiopathic (79%) recurred between the ages of seventeen and twenty-six. The interval of the recurrence was seen within two years in 89 per cent.
7) The recurrence rate of the patients treated primarily with bed rest, needle aspiration and water seal drainage was between 17 per cent and 26 per cent. While no recurrence was seen after open thoracotomy.
8) The recurrence on the other side was seen at least in 26 per cent.
9) The mortality rate of the non-recurrent cases was 1 per cent, and of the recurrent cases 0 per cent.
10) The idiopathic form typically occurred in tall, thin young males with subpleural blebs or bullae frequently, and the secondary form, in medium-sized old males with pleural adhesions.
On the basis of these analysis we proposed the classification of the spontaneous pneumothorax, which was thought to be useful for the investigation of the clinical course and the prognosis.

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頸部, 胸部に広範な蜂窩織炎および皮下気腫をともなった縦隔膿瘍の症例で, 原因は咽頭後壁の穿孔性潰瘍であった. 本例の胸部X線像は縦隔膿瘍の典型像を示している.

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