The characteristics of sputum viscoelasticity were examined by means of two different rheological techniques, continuous shear and oscillation. A Thixotrometer (concentric cylinder type) was used for these experiments. Sputum samples were obtained from 11 patients with chronic obstructive lung diseases (COLD). Altogether, there were 4 mucoid, 3 mucopurulent and 6 purulent samples. The sputum samples were kept at room temperature (18-20°C) until use. Each test required only 1.5ml of sputum. The tests were carried out at 37°C and were completed within 4 hours of sputum collection. Dynamic viscosity (η′), storage modulus (G′) and loss modulus (G″c) were calculated over the range from 0.01 to 1.0rad/sec in oscillation frequency.
All samples showed the similar frequency dependency; with increase of frequency, the dynamic viscosity decreased linearly and steeply, on the other hand, the dynamic elasticity increased slowly. The absolute values of storage modulus and dynamic viscosity of purulent sputa tended to be higher than those of mucoid type sputa. However statistical analysis showed no clear-cut differences among macroscopic sputum types as regards the absolute values of storage modulus and dynamic viscosity.
Immediately after the measurement of the dynamic properties, the continuous shear viscosity of the same sputum specimen was measured in the same instrument. The outer cylinder was exponentially accelerated to a maximum shear rate of 300sec^-1 and then decelerated, with the sweep time lasting about 13 minutes in both ascent and descent. In these measurements, the areas under the hysteresis loops of purulent sputum were larger than those of mucoid and mucopurulent sputum.
Immediately after the samples had been sheared continuously, the oscillatory testing of the same sputum sample was carried out again. Both dynamic viscosity and storage modulus of mucoid sputum increased approximately twice or three times, on the other hand, both parameters of purulent sputum decreased to approximately half of the values of non-sheared sputum after shearing (homogenization). It was very interesting to find that the homogenized sputum showed different characteristics among the three macroscopic types. It can be assumed that the attitude of the breakdown of the inner structure of sputum is different among the three macroscopic sputum types.
The findings mentioned above indicate that the rheological properties of individual sputum samples reveal various characteristics of the nature of sputum and the methods of measurement of sputum viscoelasticity.

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The effect of expectorants on sputum viscoelasticity was examined by adding them to expectorated purulent sputum obtained from bronchitis patients, using a Wells-Brookfield cone-plate viscometer (Model LVT) and a concentric cylinder Thixotrometer. Because purulent sputum showed high viscosity, the diameter of the cone of the cone-plate viscometer was reduced from 4.8 to 3.2 cm and moreover the distance between the cone and plate was set at 3048μ, more than that recommended by the manufacturer, Sputum samples were kept at room tem-perature(18-20°C)until use. Each test required 8 ml of samples in the modified Brookfield cone-plate viscometer and 1.5 ml in the concentric cylinder Thixotrometer. The volume ratio of the test agent to sputum was adjusted to 1:4, and distilled water was used as a control. The tests were carried out at 25°C to avoid evaporation, and were completed within 4 hours of sputum collection.
Using the cone-plate viscometer, different patterns of sputum viscosity reduction were observed in many mucolytic agents. Especially, significant reduction of viscosity was observed with N-acetyl-L-cysteine (NAC) and with Sea.prose-S, but not with Bromhexine. We selected these expectorants to examine their effect on sputum dynamic viscoelasticity.
At 30 and 60 minutes after adding 20% NAC. the values of both parameters of storage modulus (G') and dynamic viscosity(η')measured with a Thixotromcter were significantly increased compared with those of sputum itself. To the same aliquot, rotation of the outer cylinder for 10 minutes with 0.11 sec-1 in revolution shear rate was given, and the values of both parameters increased further, especially at a low shear rate range in oscillation frequency. Similarly rotation of 2.90 sec_-1 was given to the same aliquot for 10 minutes, and the values of dynamic viscosity revealed only slight decreases, but the values of storage modulus showed extreme reduction.
With Bromhexine (2mg/ml), no significant decrease was observed both in sputum viscosity using the cone-plate viscometer and in sputum dynamic viscoelasticity using the Thixotrometer.
At 10 and 30 minutes after adding 0.5% Seaprose-S, the values of storage modulus and dynamic viscosity were extremely decreased. We observed that the values of the both parameters were so reduced as to be unmeasurable after 30 minutes with 20% Seaprose-S solution.
It was very interesting that sputa showed various patterns in changes of viscoelastic characteristics by adding different expectorants. Additional work is needed on the action of mucolytic agents and as to how they reduce sputum viscoelasticity.

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We carried out selective alveolo-bronchography and three-times enlarged broncho-bronchiolo-alveolograms of the lateral basal segment of the lower lobe were studied to evaluate the morphologic changes of the small airways in type-B patients of chronic obstructive lung disease (COLD). 14 cases fulfilling the criteria of this disease by Burrows et al. were studied. The length of each airway from the segmental bronchus to the end of the conducting airway was trisected (proximal, mid, and distal portions) and studies were done on each portion. Chest plain radiographs of them were also studied. The results are as follows:
1) All of the patients produced large amount of purulent sputum. Chronic paranasal sinuitis and polycytemia were very occasional complications. All showed moderate or severe obstructive impairment and hypoxemia.
2) Blockage of the filling of the contrast media showing three types of the figure, rounded endings of bronchioles which were occasionally dilated, tapering endings, and truncate and rectilinear endings without the change of the caliber, was a finding peculiar to the distal portion (9 cases). In two cases, all of the distal airways ended showing the rounded ending.
3) Throughout the whole airways from the proximal to the distal portion, bronchiectatic changes and irregular contour of the bronchi including beaded or concertina-like appearance were very frequent findings, and the more distal, the more predominant the alterations. In each portion, generalized or local narrowing at branching portion was found in half of the cases. Poor branching was found at the mid and distal portions, especially frequently at the latter. In addition, increased angle of branching was a finding at the distal portion of a third of the cases. Fringes or spikes along the edge of the airway were frequently found at the proximal portion.
4) The alterations mentioned in 3) were more prominent in cases accompanying the endings.
5) Poor or uneven appearance of alveolar figures was very frequent findings (12 cases). No emphysematous destructions were revealed.
6) In all of them, plain chest films revealed abnormal shadows disseminated throughout both lung fields. In the cases without the endings, nodular shadows were main constituents, whereas reticular or linear shadows in those with the endings. In the latter cases other findings such as tram lines, diffuse pleural changes and overinflation were also found.
It is obvious that morphologic abnormalities in type-B patients of COLD are located not in the alveolar region but in the entire bronchi and especially prominent in distal airways. Various types of ending, poor branching, and poor or uneven appearance of alveolar figures which express the difficulty for contrast media to fill the peripheral regions seem to be characteristic findings in this disease.

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One case of chronic farmer's lung was reported. This case was diagnosed by positive precipition in gel diffusion to Thermoactinomyces vulgaris and positive inhalation provocation test. Maximum reduction of vital capacity was obtained several hours after the inharation of the antigen. Among 263 farmers, there were several cases with positive precipitin in gel diffusion to Thermoactinomyces vulgaris, Micropolyspora faeni and Pullularia Pullulans though faint in all cases. More cases of farmer's lung are likely to be found among Japanese when more studies are conducted, although most of them are likely to be chronic cases.

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47才, 女性. 胸部X線像上, 左中肺野に複雑に蛇行する連続した血管影を示し, 肺血管造影で肺静脈瘤と診断された. 本例は. 自覚症なく, 偶然, 胸部X線検査で発見された心肺疾患を伴わない先天性肺静脈瘤と考えられる.

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