In the present paper, we present further results of 26 patients with chronic cor pulmonale, who underwent follow-up for a period of seven years, and explore the prognostic usefulness of determining the occurrence of circulating anti-heart antibodies in patients with chronic cor pulmonale caused by pulmonary emphysema.
Eight of 26 patients (31%) died from right heart failure and respiratory infection and 12 of 26 (46%) worsened, while six of 26 patients (23%) were unchanged clinically.
Circulating anti-heart antibodies were positive in 14 patients, doubtful in one and negative in 11 cases. Fourteen cases with positive results for anti-heart antibodies consisted of six cases which died (43%) and 8 worsened cases (57%), while 11 cor pulmonale cases with negative results consisted of two cases which died (18%), 3 worsened cases (27%) and 6 unchanged cases (55%). Circulating anti-heart antibodies were positive in six of 8 cases which died, whereas the remaining 2 cases were negative.
Specimens were divided into three groups, positive; negative and doubtful groups on the basis of the appearance of anti-heart antibodies. The mean value of the pulmonary artery mean pressure (PAm) in the positive group was significantly higher than that in the negative group. The maximum breathing capacity (%MVV) and arterial oxygen saturation (SaO₂) were also significantly lower in the positive group than that in the negative group.
This evidence would suggest that the determination of the occurrence of circulating autoantibodies against cardiac tissue is useful in determining the diagnosis and prognosis in patients with chronic cor pulmonale.

抄録全体を表示

Courses of chest x-ray findings of sarcoidosis generally reveal modifications through corticosteroid treatment.
This report is about a study conducted on various courses of chest x-ray findings obtained from 57 patients with sarcoidosis who were observed for more than 12 months and underwent treatment by administration of corticosteroid. The results of the study and conclusions obtained are as follows.
1. All chest x-ray courses were classified into 5 types; recurrent type (47%), disappearing type (33%), improving type (16%), stationary type (4%) and progressive type (0%). It was noted that the patients included in the recurrent type were about one half of the total.
2. Sixty-seven percent of the patients in the recurrent type suffered relapses more than 3 times, most of them being observed for over 5 years.
3. Of all the patients who had only BHL (bilateral hilar lymphadenopathy) in chest roentgenograms at the beginning of observation, 45% of them developed other abnormalities in the lung field later. This fact shows that even patients who have only BHL should be kept under careful observation over a long time.
4. Chest roentgenograms showed that patients showing no characteristic BHL and showing lung field abnormalities at least once during the x-ray course were about 1/3 (28%) of the total, indicating a need for caution. The number of patients whose chest x-ray findings showed only lung field abnormalities all through the observed course of the disease was only 2 (4% of all patients). In such patients it is important to make a survey of the past x-ray findings to discover BHL.
5. Chest roentgenograms showed that recurrence took place in 74% of the patients who had had lung lesions of sarcoidosis and in 59% of the patients who had had only BHL. However, there was no significant difference in incidence.
6. Corticosteroid was administered to 65% of all the patients. This drug was considered to be effective.
7. Recurrence of sarcoidosis occured in 58% of patients given corticosteroid and 40% of the patients not given it, but the ratio of recurrence did not revealed a significant difference.
8. Tapering dosages of corticosteroid reduced to a dosage equivalent to 1mg of less than 1mg equivalent of betamethazone per day induced relapses in the patients of the recurrent type and moreover 78% of them showed the relapses within 4 months after the start of the administration of the tapering dosage 1mg per day. Consequently, it is desired to taper the dosage of corticosteroid gradually from 1mg per day to 0.75mg, 0.5mg and 0.25mg, respectively, each dosage being administered for 3 to 4 months after the reduction of the dosage.

抄録全体を表示

Enzymological comparisons of epithelioid cells were made between a lymph node obtained from a case of sarcoidosis, the BCG lesion of a normal man 7 days after inoculation and various stages of rabbit BCG lesions. The activity of acid phosphatase and acid proteinase were highest in the sarcoidosis case as measured by the histochemical stain and substrate film method respectively. However there were not significant differences in other enzyme activity. Our results seem to agree well with studies showing no clear histological difference between sarcoidosis and sarcoid-like granulation. Enzymes against lipids and polysaccarides did not show very high values. In general enzyme activity in macrophages of experimental BCG lesions was high, the strong activity of β-galactosidase, β-glucoronidase and hyaluronidase being thought to indicate the difference in strains and the character of Noxe.

抄録全体を表示

Six silicosis cases, which occurred among home-industry furniture manufacturers, were reported. All of them had used polishing powder for many years to fill up the grain of the wood. The powder is of baked clay containing free silica (68%-76%), aluminum oxide (14%-30%) and iron oxide (2%-6%). Two of the patients died of pneumonia and autopsies were done. Microscopic examination of specimens of the lung, liver and spleen revealed numerous nodules showing the proliferation of collagenous fibers. These fibers in the lung and spleen were arranged in an interweaving concentric bands. With polarised light microscopy, crystals of silica were recognized in the liver and spleen as well as in the lung. These results led the authors to the diagnosis of silicosis. Further attention should be given to the possible occurrence of silicosis in these workers.

抄録全体を表示

病覚のない15歳女性, 右下肺野内側に円型の明るい領域あり, その中に横隔膜内側より斜め上方に索状影を認めた. 肺内肺分画症を疑い, 腹部大動脈造影, 肺動脈造影及び手術を行い, 病理組織学的に, B7の気管支欠損症を伴った肺内肺分画症であることを確認した.

抄録全体を表示