The clinical and histopathological findings are presented on four cases of idiopathic diffuse interstitial pulmonary fibrosis in which carcinoma of the lung developed.
1) All four patients were male with a mean age of 67 years, and the chest X-ray of them revealed tumor shadows following reticulo-linear and fine nodular infiltrates.
2) Cell types of carcinoma in the four cases were two cases of squamous cell carcinoma and each one case of alveolar cell carcinoma and small cell undifferentiated, carcinoma
3) It is suggested that the carcinoma of the lung in these cases developed from the scarring and bronchiolo-alveolar epithelial hyperplasia which occurred in diffuse interstitial pulmonary fibrosis.
4) In three of the presented four cases, the reticulo-linear and fine nodular opacities in fluororoentgenogram were failed to notice until tumor shadows appeared in it. Accordingly, we should pay our attentions not only to the tuberculous lesions but also to the findings of diffuse interstitial pneumonia or fibrosis when we read fluororoentgenogram.
5) Diffuse interstitial pulmonary fibrosis with lung cancer have been reported chiefly from the histopathological standpoint. Much attention, however, should be given to this problem from the clinical standpoint, as it is very necessary to make an early diagnosis and treatment for diffuse interstitial pneumonia in order to prevent the developement of lung cancer.

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A class of immunoglobulin, IgE as a carrier of reaginic activity, was discovered by Ishizaka and his group. It has been reported that elevated serum IgE concentration is found in atopic allergic diseases and that quantitative analysis of serum IgE level is valuable in diagnosing these diseases.
We measured serum IgE level by the one step method of radioactive single radial immunodiffusion in 73 patients with bronchial asthma, 17 with chronic pulmonary emphysema, 6 with pulmonary tuberculosis, 5 with allergic rhinitis and 37 healthy subjects. Furthermore, we investigated the correlation between serum IgE level and pulmonary function tests, especially per cent maximum breathing capacity (% MBC) and per cent forced expiratory volume (% FEV_1.0). These pulmonary function tests were carried out mainly in the nonsymptomatic period, but these were also done in some patients with mild dyspnea with wheezing.
1) The mean concentration of serum IgE in patients with bronchial asthma was significantly higher than in those with other diseases and healthy subjects. Thirty-nine of 73 patients (53.4 per cent) with bronchial asthma were found to have a serum IgE level exceeding 300U/ml, whereas an excessively high IgE level was detected in only 2 of 37 (5.4 per cent) healthy subjects.
2) The mean concentration of serum IgE in the group with allergic asthma was about five times higher than in the group with non-allergic asthma.
3) There was no significant correlation between serum IgE level and pulmonary function tests (% MBC, % FEY_1.0) both in allergic and non-allergic asthma.
Results of this investigation suggest that IgE may play a role in the pathogenesis of bronchial asthma, and that the determination of serum IgE level may be utilized to diagnose. However, serum IgE level may not be valuable in the evaluation between serum IgE level and pulmonary function tests.

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In order to clarify the influence of air pollution to chronic obstructive lung disease, the comparative study in the Yokkaichi and the non-airpolluted area was carried out.
The patients studied were followed up for over 3 years and examined the spirometries at least 3 times during this period.
The subjects chosen for this study were the patients matched in pairs for such factors as sex, age, age of onset and smoking history, which might influence the course of COLD.
Forty pairs of bronchial asthma and 30 pairs of chronic bronchitis were matched.
1) Hemoglobin decreased in the course of the observation in bronchial asthma and chronic bronchitis in the Yokkaichi area but these diseases in the non-airpolluted area showed the increase of hemoglobin concentration in this period.
2) As to body weight, there was no significant difference between either area in either disease.
3) As to ECG, there was no significant difference between either area in either disease.
4) As to chest X-P, inflammatory and emphysematous findings were not changed before and after the observation in bronchial asthma in both areas.
Of chronic bronchitis, slightly intensive inflammatory findings were observed before and after the observation in the Yokkaichi area, but inflammatory changes became more intensive at the end of the observation in the non-airpolluted area. On the other hand, emphysematous findings were not changed before and after the observation in two areas.
5) As to the pulmonary function, there wes the slight decrease in yearly changes of VC and FEV_1.0 in bronchial asthma in tha Yokkaichi area, but there was no significant difference between either area. Although some decrease in yearly changes of VC in chronlc bronchitis in both areas were observed, there was the significant decrease of VC in the Yokkaichi area comparing with the non-airpolluted area. (the Yokkaichi area: -69.4±123.6ml/yr, the non-airpolluted area: -3.1±82.0ml/yr) Decrease in yearly change of FEV_1.0 was observed in both areaes, and there was no significant difference between either area. As the background factors of the patients in the two areas were almost same, air pollution may be responsible for the decrease of VC in the Yokkaichi area.

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A 71-year old man was admitted on December 4, 1973 in this hospital. His chest X-ray showed a well defined tumor shadow above the left diaphragm and overlaped the heart shadow. That tumor was not found intrapulmonary or extra by preoperative examinations, but was suspected lung cancer by needle biopsy.
The definite diagnosis proved diaphragmatic hernia with operation.

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