In five unanesthetized sheep in which chronic lung lymph fistulas were made, we infused air emboli (ca 300μm in diameter) into the pulmonary trunk, resulting in an increase in pulmonary arterial pressure (P_pa) and lung lymph flow (Q_lym). Bolus air infusion of 0.5ml/kg increased P_pa to 40.0±1.0cmH₂O from the average base line value of 26.0±1.1cmH₂O in 14 successful embolizations and the elevated P_pa level was maintained for 15 minutes, 1 and 3 hours following air emboli infusion, at a rate of 0.06ml/kg/min. After starting air infusion, P_pa returned rapidly to base line levels.
Q_lym began to increase following P_pa elevation and reached a peak flow one hour following embolization for 15 minutes and for one hour embolization, therafter decreasing gradually. In the three hour air embolization experiments, Q_lym increased progressively, reaching a new steady state within the second hour. The average in-creases in Q_lym following 15 minutes, 1 and 3 hour-embolizations were 61.5%, 151% and 476% of their base line, respectively. The increases in Q_lym were proportional to the durations of air embolization at a constant P_pa level of 40cmH₂O.
In the steady state of the last 2 hours of 3 hours emboli experiments, the protein concentration ratio of lymph/plasma and did not change significantly, resulting in a 211% average increase of calculated fluid permeability coefficient (Kf) from the average base line value of 2.1ml/cmH₂O/hr/100g lung in 4 successful experiments.
The effects of air embolization on P_pa and Q_lym were completely reversible. We produced reversible permeability pulmonary edema in awake standing sheep.

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For the definitive diagnosis of sarcoidosis, pathological examination is mandatory. Transbronchial lung biopsy has been performed for the diagnosis of sarcoidosis, and the ultrastructure of sarcoid granuloma and other architectures including capillary vessels were examined.
TBLB was performed in right S_8b and S_3a in 17 cases of sarcoidosis ranging from 22 years old to 53 years old. Preparations for light microscopy and electron microscopy examination were made. The latter was performed after fixation of the specimen in 2.5% glutaraldehyde.
Anterior scalene node biopsy was performed in 12 cases. Positive TALB identified by the presence of sarcoid granuloma was obtained in 3/8 cases (38%) in stage I, in 6/7 cases (86%) in stage II and 2/2 cases (100%) in stage III according to X-ray staging. The overall TBLB pathological diagnosis was 11/17 cases (65%) of sarcoidosis, and increased to 82% by including the results of scalene node biopsy. Electron microscopy examination was performed in 7 cases. In the sarcoid granuloma, lysosomal epitheloid cells and vesicular epitheloid cells were observed. A number of blebs caused by the breakdown of endothelium was also observed. Alveolar ulcer of the epithelium was noted. Derangement of the pulmonary architecture which is not indicated by chest X-ray is present in the lungs of cases sarcoidosis. Electron microscopic examination of TBLB specimens can afford useful acknowlegement in various kinds of pulmonary disease.

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It has been postulated that beta-adrenergic stimulation leads to an increase in intracellular cyclic AMP level and induces the relaxation of tracheobronchial smooth muscle, and that alphaadrenergic stimulation causes bronchoconstriction.
The present investigation was conducted to explore the effect of pretreatment of asthmatic patients using imidalin, an alpha-adrenoreceptor blocking agent, on salbutamol-induced improvement in various pulmonary bronchoconstriction.
The present investigation was conducted to explore the effect of pretreatment of asthmatic patients using imidalin, an alphaadrenoreceptor blocking agent, on salbutamol-induced improvement in various pulmonary function tests and the increase of plasma cyclic AMP levels.
1) Comparing the pulmonary function tests between the control group in which salbutamol alone was administered and the imidalin group in which salbutamol was administered after pretreatment with imidalin, R.r., FEV_1.0 and V₀₅ showed significant improvement in both groups and the extent of improvement in the imidalin group was greater than that in the control group.
2) The pulmonary function tests in the control group and in the imidalin group showed the greatest improvement 80min after the oral administration of salbutamol, and the extent of improvement in the imidalin group was greater than that in the control group
3) The plasma cyclic AMP level increased significantly after the oral administration of salbutamol alone, but the extent of the increase became more dominant after imidalin pretreatment, .
4) As for side effects in the salbufamol-only group five cases complained of palpitation, headache and giddiness but these side effects were not seen after pretreatment with imidalin.
The above results may suggest that imidalin, an alpha-adrenergic blocking agent, can be used for the treatment of bronchial asthma in combination with various beta-adrenergic stimulating agents.

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The inhibitory effect of the sera from 32 patients with sarcoidosis on the E-rosette formation of normal donor T-cells was studied.
The results obtained were as follows:
1) The serum from patients with sarcoidosis inhibited the E-rosette formation of the normal donor T-cells in comparison to serum from normal subjects. Greatest inhibition was observed in patients with active than inactive disease. The mean of the inhibitory rate was 25±14 percent in the serum of active patients and 3±6 percent in that of resolved patients.
2) Serum of an active sarcoidosis that exhibited a high inhibition rate were purified by the method of ammonium sulfate saturation, DEAE-cellurese chromatography and affinity column chromatography. The derivative from sarcoidosis serum was shown to be IgG, which was responsible for the inhibitory effect. The inhibitory effect exhibited by the IgG agreed with dose response kinetics, namely the inhibitory rate being 3% at 600μg/ml of IgG, 13% at 900μg/ml and 20% at 1200μg/ml, respectively.
3) The purified IgG was observed to bind to the surface of normal T-cell membranes by indirect immunofluorescence. This binding rate also agreed with dose-response kinetics, as those with the inhibition rate of the E-rosette formation in sarcoidosis sera.
4) Normal donor T-cells were incubated with sarcoidosis IgG or control IgG before they were tested for their capacity to form OX·EA-rosettes. The fact that OX·EA-rosette formation of normal T-cells incubated with sarcoidosis IgG was decreased, indicated that sarcoidosis IgG bore a high affinity for the Fc. receptor of the T-cell membrane, whereas normal IgG bore a low affinity.
5) A lymphocytotoxic effect was found in serum from patients with sarcoidosis, and was more active at low temperatures. There was no correlation between the inhibitory effect on E-rosette formation and cytotoxic effect of sarcoidosis serum.
In view of the above fact, it was suggested that the IgG from sarcoidosis sera seemed to have great significance for the immunologic disturbance, especially for the abnormal cellular immunity. This abnormality seemed to be caused by the mechanism that the Fc-region of IgG was bound to the Fc-receptor on the T-cell membrane.

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Pleural effusion represents a very common diagnostic problem. In the present investigation we tried to demonstrate the usefulness of the measurement of adenosine deaminase (ADA) activity in patients with pleural effusion.
We measured adenosine deaminase (ADA) activity in pleural effusion from 66 cases (carcinomatous 43, tuberculous 10, non-inflammatory 5 and others 8), and we also measured ADA activity in sera from patients with various diseases.
1) Mean values and S.D. of ADA activity in pleural effusion from 10 patients with tuberculous pleuritis were 102.5±52.1U/l.
2) Mean values and S.D. of ADA activity in pleural effusion from 28 patients with carcinomatous pleuritis (primary lung cancer) were 24.4±11.7U/l, and those from 5 patients with squamous cell lung cancer, 12 patients with adenomatous lung cancer and 4 patients with small cell lung cancer were 24.5±4.8, 22.8±14.3 and 23.2±7.4U/l, respectively. There were no significant differences among these values.
3) The mean value and S.D. of ADA activity in pleural effusion from 15 patients with carcinomatous pleuritis (metastatic lung cancel) were 20.8±9.9U/l, and there were no significant differences between those from patients with primary lung cancer.
4) The mean value and S.D. of ADA activity in pleural effusion from 5 patients with non-inflammatory diseases were 6.0±2.8U/l.
5) The mean values and S.D. of ADA activity in sera from 8 patients with pulmonary tuberculosis, 8 patients with lung cancer and 6 normal individuals were 50.1±18.1, 20.1±6.9 and 8.8±6.7U/l, respectively.
The above results may suggest that measurement of ADA activity in pleural effusion may be useful for the differential diagnosis of patients with tuberculous pleuritis from those with carcinomatous pleuritis and others.

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Disodium Cromoglycate (DSCG) is now an established drug in the prophylaxis of asthma. It selectively suppresses the specific immunological pathways leading to the release of chemical mediators.
The present investigation was conducted to demonstrate the effect of DSCG on the action of various broncho-active agents in guinea pig tracheal strips.
Male guinea pigs, weighing 250-300g, were sacrificed. Guinea pig trachea was removed, cut spirally in strips 1.0-1.5mm in width and 3.0-4.0cm in length, suspended in bioassay glass jackets, superfused with Krebs-Henseleit solution at 37°C and saturated with oxygen and carbon dioxide (95:5, v/v). Contraction and relaxation of tracheal strips were detected by an isotonic transducer and displayed on a polyrecorder.
1) DSCG attenuated the acetylcholine-induced contractile responses in guinea pig tracheal strips, and shifted the dose-response curve of acetylcholine downward. The shift became dominant by increasing the dose.
2) DSCG attenuated the histamine, serotonin-, bradykinin- and PGF_2α -induced contractile responses in guinea pig tracheal strips dose-dependently.
3) DSCG potentiated the isoproterenol-, epinephrine-, PGE₂- and salbutamol-induced relaxation responses in guinea pig tracheal strips, and shifted the dose-response curves downward. The shift became dominant by increasing the dose.
The above results may suggest that DSCG has not only an inhibiting action on the release of various chemical mediators from mast cells, but also has an attenuating effect on the action of bronchoconstrictors and an potentiating effect on the action of bronchodilators.

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In order to evaluate the effect of lung denervation by transection and reanastomosis of the main bronchus for the treatment of bronchial asthma, denervation was performed in 36 adult mongrel dogs and histamine provocation tests were performed. Tests were also performed in 55 control mongrels which did not undergo surgery.
The effects of denervation for a period of over 4 years were observed.
1) The effects of provocation on the denervation group were slight and transient. Apnea and stridor were rare.
2) Bronchial contraction in the control group on provocation was remarkable, particularly in the peripheral bronchi. In the denervation group contraction was slight even in the peripheral bronchi.
3) In comparison to remarkable increase of PPA in the control group the increase in the denervation group was slight. This showed the relationship between pulmonary arterial pressure and asthma.
4) In the denervation group, recovery of PaO₂ 3 minutes after histamine provocation was observed and VO₂ did not decrease. In the control group both PaO₂ and VO₂ were decreased over a long period.
5) Preservation of the vagus nerve is thought to prevent ectasis of the bronchus immediately following denervation.

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A case of polyarteritis nodosa with lung involvement was presented. The patient, a 53 year-old female, was admitted with high fever, cough and muscular weakness on March 3, 1977. She had a four year history of severe asthmatic attacks.
Laboratory and radiological examinations revealed nonsegmental pulmonary infiltration, leucophilia, marked eosinophilia, anemia and hyper-gammagloblinemia. Abdominal angiography showed multiple microaneurysms and an open chest biopsy on March 24 confirmed arteritis of the pulmonary artery, without granulomatous changes.
Predonisolone was effective and there is no active sign of the disease 3 years after onset.
Clinical signs and symptoms of this case suggest allergic granulomatous angiitis, (AGA) but the pathological findings are not compatible with AGA as granulomatous changes were lacking. The diagnosis of this case might be PN with lung involvement, however, it seems probable that it lies between classical PN and AGA.

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46才, 男性. 血痰, 喀血著明, 咳と前胸部圧迫感があり, 胸部X線写真で, 左肺中野に淡い均等様陰影を認めた. 喀疫細胞診で, Class IVないしVを示し, 腺癌の疑いで左肺全剔術を施行した. 別出肺の一部に, 腫瘍結節を認め, 組織学的に肺悪性血管内皮腫と診断された. 術後, 抗腫瘍療法を行うも右肺に転移し, 約2カ月で死亡.

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