The role of lymphocytes and macrophages in the BCG induced pulmonary granulomatous response in mice was studied. Pulmonary granulomas could be induced in mice by the intravenous injection of BCG suspended in light mineral oil. The granuloma formation with mononuclear cell infiltration reached a maximum after 3 weeks of injection (Chronic Granulomatous Response=CGR). An Accelerated Granulomatous Response (AGR) was elicited in sensitized mice (those undergoing the CGR) by an i.v. challenge with BCG suspended in saline and a maximum AGR developed within 4 days.
The proliferative response of lymphocytes which were obtained from the lung was measured by ³H-Thyrnidine incorporation into DNA. In the case of CGR, the proliferative response stimulated by PHA scarcely changed over 1 to 4 weeks of the response. In contrast, in the case of AGR, the proliferative responses stimulated by PHA rose to 10 times higher those of CGR at the point of maximum granuloma formation.
These results suggested that the sensitized lymphocytes, challenged by the antigen, released some mediators related to mitogenic factors, chemotactic factors, and migration inhibitory factors, which might accelerate an en-hancement of migration of T- and B-cells toward the granulomatous lesion. The pulmonary granulomatous response which was supressed by X-irradiation, was restored by intraperitoneal transplantation of syngeneic spleen cells, and thymus cells, but was only slightly affected by peritoneal exudate cells. Consequently it was suggested that lymphocytes played an important role in BCG-induced granuloma formation in mice.

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Primary pulmonary hypertension is a disease of unknown cause, and no therapeutic masures have been successful in relieving symptoms or affecting the course of the disease.
The present investigation was conducted to demonstrate the effect of prostaglandin E₁ and E₂ on the contractile responses of rabbit pulmonary arterial and aortic strips with various vasoconstrictors.
Male rabbits, weighing 2.0-2.5kg, were killed, the pulmonary arterial trunk and the descending aorta were removed, cut spirally into strips (20-30×1.0-1.5mm) suspended in bioassay glass jackets and superfused with Krebs-Henseleit solution at 37°C saturated with oxygen and carbon dioxide (95: 5, v/v).
Tissue contraction was detected by an isotonic transducer and recorded using a polyrecorder.
1) Prostaglandin F_2α, serotonin, angiotensin II, noradrenaline and adrenaline-induced contractile responses of rabbit aortic and pulmonary arterial strips were decreased dose-dependently with continuous infusion of prostaglandin E₁.
2) Prostaglandin F_2α, serotonin, angiotensin II, noradrenaline and adrenaline-induced contractile responses of rabbit aortic and pulmonary arterial strips were decreased dose-dependently with continuous infusion of prostaglandin E₂.
3) These results suggest that prostaglandin E, especially prostaglandin E₁ and its derivatives may become the useful therapeutic agents in primary pulmonary hypertension.

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Studies to produce an experimental model of acute bacterial pneumonia were performed using a new exposure apparatus able to administer predictable numbers of aerosolized bacteria to the lungs of a large number of mice, and the results were as follows.
1. This apparatus can administer almost identical numbers of bacteria to about 100 mice.
2. A linear relationship is observed between numbers of nebulized bacteria and numbers of bacteria deposited in the lungs of mice.
3. The following three species of Gram negative bacilli can make varied types of pneumonia in mice by this exposure apparatus.
1) Klebsiella pneumoniae (B-54, type 1): After the initial clearance within 6 to 12 hours, the bacteria in the lungs of the mice grow rapidly causing pneumonia throughout the lung (in the course of pneumonia multiple abscesses are formed). All of the mice die between 48 and 72 hours. The LD₅₀ of this bacteria is 9.7×10 colony forming units per murine lung.
2) Haemophilus influenzae
i) Non-typable (H-51-133): The bacteria deposited in the lungs of mice are rapidly cleared and mild pneumonia heals spontaneously.
ii) Type b (H-51-107): The bacteria deposited in the lungs grow at once without initial clearance, reach peak level 6 hours later, and then begin to decrease. However, at from 24 hours to 96 hours the numbers of bacteria increase again. Thus the retained bacteria count shows two peaks. Pneumonia due to this bacteria tended to linger.
3) Pseudomonas aeruginosa
i) The bacteria retained in the murine lungs are rapidly cleared. If extremely large numbers of bacteria (6×10⁷CFU/lung) are administered, the bacteria grow at once and kill the mice at about 24 hours.
ii) Mixing 0.5% of gastric mucin to bacterial suspensions have no effect on the bacterial clearance from the murine lungs.
iii) Irradiation of 300 rads have no effect on bacterial clearance.
iv) In the lungs of mice subcutaneously administered 80mg/kg of triamcinolone acetonide 20 hours prior to exposure to aerosols of Pseudomonas aeruginosa (E-2), the bacteria grow after the initial clearance (12 hours), and 70% of mice die between 50 and 90 hours. After that, bacteria retained in the lungs of the mice which survive are cleared and the pneumonia heals spontaneously.

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Conventional X-ray techniques limit the interpretation of intramediastinal tumor. In an attempt to evaluate the usefullness of computed tomography in the detection of the mediastinal tumor, we have compared computed tomograms with surgical results and have also reviewed limitation or effectiveness of the tomography.
CT scanner was a second-generation EMI CT 5005 which has a scan time of 20 seconds. Cases to be done surgery during our first year since January, 1977, were scanned. Total number of the cases was eighty-two.
1) Evaluation of hidden tumor by the mediastinum. Thymoma was distinguished in fat tissue, but hyperplasia was not.
2) Evaluation of tumor localization and extent. The CT scan could separate respiratory tract, great vessels, intrapericardiac chambers, esophagus, variated structures and mediastinal lymphnode enlargement. Change in tissue surrounding a tumor indicated grade of malignancy with tumor. These findings also provided practical information for performance of mediastinoscopic tumor biopsy.
3) Evaluation of the tumor morphology, content and hardness. Minute morphological feature were not well visualized. In tumor content cystic or fat degeneration and fluid were visualized. We experienced a case of thymic cyst. Hardness of the tumor could also be investigated by CT number.
4) Evaluation of observation of pulmonary vein and metastatic hilar tumors. The change in pulmonary vein due to tumors were important information to choice surgical procedure.
The CT scan provided more excellent pathoanatomical information than conventional X-ray examination, but lacked histochemical approach. Indication for surgery and choice of the surgical procedures could be estimated by the CT scan.

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A 55-year-old male, a former coal miner, was admitted on February 14, 1974, with complaining of cough attacks and a heavy sensation in the anterior chest. Results of physical examination, chest roentgenogram and electrocardiogram showed cardiac tamponade. Pericardiocentesis was performed, yielding about 200ml of hemorrhagic exudative pericardial fluid, after which signs and symptoms of cardiac tamponade improved remarkably but tumor cells were demonstrated by cytological examination of aspirated pericardial fluid. As morphologically similar tumor cells were demonstrated later in the sputum, it was considered that malignant pericardial effusion originated from pericardial metastases of lung cancer. Generalized chemotherapy was performed which was effective for about six months, but the patient was expired on September 19, due to the recurrence of cardiac tamponade.
Autopsy revealed a 1.5×1.5cm tumor growth at the hilum of the right lower pulmonary lobe. The pericardium was fibrously thickened and the pericardial sac contained a small amount of bloody fluid. The epicardium showed so called “cor villosum” with some hemorrhagic spots. Histologically the tumor consisted of many glandlike structures lined by cuboidal shaped cancer cells and was diagnosed as primary adenocarcinoma of the lung. Sections of the pericardium showed much fibrous stroma containing metastases of same adenocarcinomatous structures. Other than the pericardium, many microscopic metastases were found in the heart, pleura, kidney, liver and adrenals.
Secondary tumors of the heart and pericardium are gradually increasing with the recent increase of lung cancer in Japan. Because they show no constant clinical signs or symptoms, it is extremely difficult to make definitive diagnosis during life. Of all metastatic cardiac tumors, pericardial metastases occupy the majority of them, and directly impair cardiac function mainly due to the accumulation of malignant pericardial effusion. Usually, most pericardial metastases are found at autopsy but occasionally cardiac tarnponade is related to the initial symptoms and the existence of malignancy is exposed by cytological demonstration of tumor cells in aspirated pericardial fluid. In such case one should bear in mind that cardiac enlargement in the roentgenogram frequently contributes to obscure the primary lesion in lung cancer, especially those located in the hilum.

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A 29 year-old male press worker was admitted with chief complaints of weightloss and mild exertional dyspnea which he noted for six months prior to admission. On admission, chest X-ray films showed disseminated fine nodular shadows, diffuse interstitial markings, right sided pleural effusion and no bilateral hilar lymphoadenopathy. Lung function tests showed a mild restrictive change with moderate hypoxemia. PPD skin test was positive and DNCB test was negative. The yellowish pleural fluid was exudate and contained a considerable number of lymphocytes and no malignant cells. X-ray films of the stomach revealed dotted deposits of a small amounts of barium in the fundal region. Specimens from one lesion obtained by gastric mucosal biopsy showed the lesion consisted of sarcoid like granulomas.
On right thoracotomy, there were whitish grey miliary nodules on the surface of the parietal pleural and the diaphragm. Histological examination of the biopsy specimens of the lung and the pleura showed noncaseating epithelioid cell granulomas. By anoerobic culture of the specimen, 1.2×10³ of Propionibacterium acnes were isolated.
The patient was placed on adrenal corticosteroids.

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15才女子. 抗生剤投与により改善しない肺腫瘤性病変に対して経皮吸引針生検を試み原発性肺クリプトコッカス症と確診した. 肺腫瘤性病変に対する経皮吸引針生検法の診断価値が強調される症例である.

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