We have been employing Takahashi's C. F. test, which becomes manifest specifically in the pulmonary aspergillosis, for the diagnosis and the estimation of therapeutic process of the disease, and reporting its clinical availability. In order to verify its validity theoretically, following investigations were done.
At first, we notified that the antigen for the diagnosis of pulmonary aspergillosis is composed of carbohydrates compound. Then being based on 5% methanol HCl extraction method, carbohydrate was extracted by means of vacume drying, Hakomori's and Somogyi, M.'s methods from the antigen and the serum of aspergillosis patients. Both were comparatively studied by means of gas chromatography and attempt was made to demonstrate specific carbohydrates which existed in both of them. As a result, same pattern recorded in the gas chromatography of the antigen was found in the serum of the aspergillosis patients. The specific peaks were shown between 100 and 130-C., and 5% methanol HCl extraction method was found to be best among those methods. This finding disclosed that the same sort of carbohydrates as in the antigen was present in the patients as well and the reactive antibodies were produced in the patients. Therefore, upon establishment of the diagnosis for aspergillosis, the validity of using this kind of C. F. test with the antigen was justified by revealing the characteristic pattern in the gas chromatography. In addition, the height of the peaks of specific carbohydrates coincided accordingly with the C. F. antibodytiter of the patients.

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The composition of mucous ground substance of sputum has been investigated mainly concerned with the glycoprotein, but no substantial work on the acid mucopolysaccharide (AMPS) of sputum have been done.
This study was undertaken to find the appropriate method of the isolation, purification and identification of MPS especailly AMPS and to elucidate the physiological significance of sputum in chronic obstructive lung diseases.
Samples of sputum were collected from 68 patients with bronchial asthma (BA), chronic pulmonary emphysema (CPE) and chronic bronchitis (CB). The crude MPS was obtained by precipitation with ethanol after pronase digestion of sputum, and then digested again by papain and precipitated with cetylpyridium chloride (CPC) for purification. Studies performed were both of these crude and purified MPS and following results were obtained:
1) A large portion of crude MPS not formed a complex with CPC was precipitated with three volumes of ethanol and this fraction was identified as glycoprotein by chemical analysis.
2) There was a positive correlation between crude MPS content and the viscosity of sputum. The coefficiency of correlation was significant at level of 5%.
3) The fractions of purified MPS by stepwise elution from DEAE-Sephadex column with 0.3M 0.5M and 1.5M NaCl, were indicated fraction 0.3, 0.5 and 1.5 respectively. Each fraction gave one band in electrophoresis in barium acetate and fraction 1.5, 0.5 and 0.3 corresponded to F, I and S band respectively which were designated in order of mobility.
4) After the digestion of fraction 1.5 with chondroitinase ABC and chondroitinase AC, the degradated products were applied to paper chromatography and two disaccharides, ΔDi-4S and ΔDi-6S, were obtained by either enzyme. From these facts, the presence of ChSA, ChSB and ChSC was proved. However, there were still more two components in electrophoresis after digestion with CHase ABC and these components were presumed to be heparan sulfate and keratan sulfate according to its mobility.
5) Hyaluronic acid was identified by the fact that the fraction 0.5 was able to be digested with streptomyces hyaluronidase.
6) The fraction 0.3 contained 32.1% hexosamine (GlcN/GalN 1.3), 24.9% galactose, 9.7% fucose, 2.2% sialic acid, 4.5% sulfate and 10.8% total protein. Infrared spectrum of this fraction showed distinct sulfate absorption (1240cm^-1 and 820cm^-1). Therefore this fraction was identified as sulfated glycoprotein.
7) In electrophoretic separation, it was demonstrated that BA and CPE sputum contained mainly S and CB sputum contained mainly F.
8) The carbazole/orcinol ratio was considerably different in three groups of aptients. These ratios were 0.36±0.09 in BA, 0.50±0.14 in CPE and 9.70±0.19 in CB. The differences between three groups were significant (p<0.01).

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Sixty four years old, male patient was diagnosed as pulmonary aspergillosis on the basis of a typical fungus ball shadow which was found on his chest X-ray film. The patient died of sudden hemoptysis which occured during the time when he was under the schedule of surgical treatment.
Autopsy revealed the existence of pulmonary aspergillosis lesions in both the upper and lower lobes of the left lung. In the upper lobe, a cavity containing a fungus ball was detected. In the lower lobe, another lesion was found locating close to the thoracic aorta, and the wall of the aorta was destroyed by the invasive change of the lesion into the aorta. The death resulted from the massive bleeding from the aorta into the thoracic cavity and to the lung.
From the histological finding, these two lension were considered to be binary. No reports have ever been presented on the pulmonary aspergillosis which gives rise to a rupture into the aorta. When considering surgical indication for aspergillosis, therefore, it is necessary to take account of the fact that there actually existed such a case.

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[in Japanese]

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