High incidence of circulating anti-heart antibodies in patients with cor pulmonale caused by chronic pulmonary emphysema has been noticed previously. Correlation of the anti-heart antibody titer with pulmonary arterial mean pressure and with arterial oxygen saturation has also been pointed out.
The present study was conducted to compare the incidence of circulating anti-heart antibodies in pulmonary hypertensive patients of different origens and to study relations between the incidence of anti-heart antibodies and impairment of pulmonary functions. Three groups of patients were studied; namely, patients with mitral valvular disease, congenital heart disease (ventricular septal defect and atrial septal defect) and chronic cor pulmonale caused by chronic pulmonary emphysema.
Direct hemagglutination tests using antigen obtained from normal rabbit heart were performed on the subjects studied. Routine pulmonary function tests and cardiac catheterizations were also conducted.
None of the 15 cases with mitral valvular disease revealed positive hemagglutination test. One among 14 cases with congenital heart disease demonstrated positive reaction. This case with positive reaction had ventricular septal defect and showed pulmonary arterial mean pressure of 21mmHg. Seven out of 17 cases with chronic cor pulmonale showed positive reaction. Statistically significant differences were observed in the results of hemagglutination tests among the three groups (x²=11.07, p<0.05).
Patients with positive reaction in the group with chronic cor pulmonale showed elevated pulmonary arterial mean pressures higher than 22mmHg, decreased arterial oxygen saturation less than 94%, lower FEV_1.0% than 55% and arterial blood pH lower than 7.42. Most of the patients with positive reaction in this group demonstrated decreased %VC and elevated arterial acrbon dioxide tension.
The present observations suggested that in addition to the pulmonary hypertension arterial hypoxemia and/or hypercapnea were contributed to the formation of circulating anti-heart antibodies in patients with pulmonary hypertension.

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It is presumed that there may be about 150, 000 cases of intractable asthma in Japan. But its etiology and clinical feature are uncertain.
On the hereditary tendency to asthma, a comparative study of the intractable asthmatics (36 cases) with the non-intractable asthmatics (120 cases) was carried out by taking their family histories.
The hereditary tendency to asthma was proved at a significantly higher percentage in intractable asthmatics (70%) than in the other ones (48%). There was no difference between male and female in intractable cases. In both groups, there was no difference between inheritance from the father's side and the mother's side.
In the family history of intractable asthmatic patients, two or more asthmatics were frequently found in the same pedigree.

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One hundred and twenty-six asthmatic cases were studied by using electro- and vector-cardiograms during asthmatic attack and attack-free interval, and results obtained were as follows:
1. Electrocardiographic changes during the attack were sinus tachycardia, taller and peaked P waves and ST depression in leads II, III, and aV_F, the shifting of P and QRS axis towards the right, deviation of transitional zone to the left, and decreased T amplitude in all leads.
2. The vectorcardiographic changes during the attack were deviation of maximum P vector to right anterior and inferior, increased maximum P vector, narrow P-loop in frontal plane, deviation of maximum QRS vector to right superior and posterior, deviation of terminal QRS vector to right posterior, deviation of maximum T vector to left posterior in horizontal plane, and increased QRS-T angle.
3. Some cases of asthmatic patients showed left-sided heart changes on electro- and vector-cardiograms; ST-depression in leads-V₅ and V₆, deviation of maximum T vector to right anterior in horizontal plane, and deviation of ST-vector to the right in Frank lead scaler electrocardiogram.
4. Most of these changes in electro- and vectorcardiograms during asthmatic attack disappeared after the attack in the same individuals.
5. Transient right heart strains in electro- and vectorcardiograms were predominent in most cases during the attack, but the others showed left-sided heart changes. These cahnges suggested the effect of asthmatic attack on heart functions.

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A 25-year-old, male machinary worker was hospitalized in October 1969 complaining of hemoptysis. Acid-fast organism was not found in smear of sputum but showed by culture three times (1, 3 and 3 colonies, respectively) in the month hospitalized. 10 colonies of acid-fast organism were seen in November 1969 and thereafter no organism was seen until discharge in April 1973. The organism was identified as M. chelonei subsp. chelonei. The patient showed fibrocaseous lesion in the right upper lobe. The lesion improved slightly but remained at a considerable amount even after administration of various antituberculous drugs. In May 1972, the patient received resection of right upper lobe. The resected lung contained two encapsulated, caseous lesions with many small tubercles. From the lesion, 4 colonies of M. chelonei subsp. chelonei were isolated. Other acid-fast organism was not isolated. The pathological diagnosis was tuberculosis of lung. This was because that the lesions caused by this organism were the same findings as tuberculosis.
Clinical feature of lung infection caused by this organism has been presented by Tsukamura et al. (1973) based on the clinical findings of 9 cases. The case shown in the present study is the 10th. In view of these 10 cases, clinical feature of the infection caused by this organism is considered as follows: (1) initial symptome is often hemoptysis (6 out of 10); (2) excertion of the organism in sputum is scanty or absent; hence, definite diagnosis is made by proving the organism from resected lung; (3) the extent of lesion is limited to a lobe or at most two lobes; (4) chemotherapy is usually not so effective; (5) prognosis is usually good.
The reason for scanty excretion of the organism in sputum has been discussed.

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[in Japanese]

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