Hoya (sea-squirt) asthma is an occupational asthma induced by inhalation of antigenic substances contained in the body fluid of hoyas. It was first noted in a worker of a cultured oyster farm. Long term hyposensitization of hoya asthma patients was conducted and the relationship between the production of specific IgG antibody and the effect of this therapy was studied. Specific IgG antibody was measured by radioimmunoassay using Protein A-Sepharose CL-4B and ¹²⁵I labeled purified hoya antigen “Ei-M”.
1) The anti-Ei-M IgG values of 15 healthy cases, 31 healthy oyster workers, 109 non-hyposensitized hoya asthma cases and 270 hyposensitized hoya asthma cases were 1.3±0.23%, 2.0±0.60%, 2.3±1.03% and 8.8±8.11%, respectively. In comparison with healthy cases, the value of the three other groups were significantly higher (P<0.001). The anti-Ei-M IgG values of hyposensitized cases were significantly higher (P<0.001) than those of healthy workers and nonhyposensitized cases, but there was no difference between healthy workers and non-hyposensitized cases (P<0.2).
2) In the non-hyposensitized patients, the the anti-Ei-M IgG value stayed at a low level without any relation-ship to whether the cases were engaged in oyster work or not. Asthmatic symptoms developed in these cases while engaged in the work.
3) When hyposensitization was conducted, the anti-Ei-M IgG value made a rapid increase immediately after commencement of the treatment and after 5-6 months the value reached a peak, followed thereafter by an almost constant level. The value did not decrease even during the off-season as long as maintenance therapy was performed
4) Cases continuing to engage in oyster work with a low anti-Ei-M IgG value developed asthmatic symptoms, but cases showing a high anti-Ei-M IgG value did not develop asthmatic attacks even when exposed to antigen.
The foregoing results suggest that the effects of hyposensitization therapy are brought about mainly by production of the specific IgG antibody.

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Nephelometric immunoassay of albumin and IgG in bronchoalveolar lavage fluid (BALF) was carried out using a Nephelotek^TM system which consists of a nephelometer and calculator.
Segmental broncho-alveolar lavage was performed; one segment (usually B⁴ or B⁵) was washed 3 times with 50ml of saline using a flexible bronchofiberscope. Subjects consisted of 10 normal volunteers aged 21 to 25 years, 28 control patients with well-localized pulmonary lesions in whom lesion-free regions were washed, aged 56±12 (mean±SD) years, and patients with idiopathic diffuse interstitial fibrosing pneumonia (DIFP, 9 cases), hyper-sensitivity pneumonitis (HP, 3 cases), infectious bronchitis (2 cases) and pneumonia (2 cases).
1) By the nephelometric immunoassay, both albumin and IgG contents of BALF could be measured rapidly and exactly with 25μl of original lavage fluid as test samples.
2) The albumin and IgG contents of BALF were expressed as concentration in original lavage fluid (mg/dl). The albumin concentration was almost the same in normal volunteers and control patients. The IgG concentration and IgG/Alb ratios (mg/mg), however, were significantly higher in the latter than in the former.
The albumin and IgG concentrations, and IgG/Alb ratio in smokers were not significantly different from those in nonsmokers, in both the normal volunteers and control patients.
3) The albumin concentration as well as IgG concentration increased in the patients with DIFP, HP, infectious bronchitis and pneumonia. Therefore the IgG/Alb ratios of these patients were not always higher than those of the control patients. It is concluded that not only the IgG/Alb ratic but also albumin and IgG concentrations in original lavage fluid serve as parameters of the extent of diffuse pulmonary diseases, such as DIFP, HP and chronic bronchitis.

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It has been reported that the elevation of elastic recoil and edema formation observed following positive pressure ventilation in vivo are influenced by the size of tidal volume and also by the volume levels at the end expiration during ventilation. However, the effect of temperature has been neglected in those experiments although several studies were performed with animals under thoracotomy. We tried to examine the effect of temperature on elastic recoil and on edema formation following positive pressure ventilation in vivo and made an experiment with 30 rabbits. These were divided into a control group and 5 ventilated groups in which the animals underwent tho-racotomy and were ventilated at 22±2°C or 35±1°C with EEP of 0cmH-0 or 2cmH₂O with tidal volume of 25ml/kg for 3 hours. Animals in the additional group were ventilated with a closed chest with the same tidal volume for 3 hours. In the group in which ventilation was performed at 22±2°C with EEP of 0cmH₂O, significant elevation of elastic recoil pressure and significant increase of the Wet/Dry ratio of lung weight were observed in compared with those of control group. In other experimental groups, pressure volume curves and Wet/Dry ratio were not significantly different from those of controls. The above results indicate that the level of EEP and environmental temperature significantly affect the changes of elastic recoil pressure following artificial ventilation, with the latter factor appearing especially important, and that changes in elastic recoil pressure significantly influence the production of lung edema in ventilated animals.

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Single-breath N₂ washout tests were performed on 12 normal men in upright posture. Partial pressure of N₂ in expired air (PEN₂) was continuously measured with a mass spectrometer. Regional ventilations in the upper and lower zones of the right lung were measured with impedance pneumography applying 2 sets of 4 electrodes on the upper (ΔZAPEX) and lower (ΔZBASE) zones of right thoracic wall respectively.
The ΔZ-BASE from TLC to RV was about twice that of ΔZAPEX. In the end-expiratory phase, ΔZBASE was kept unchanged while ΔZAPEX continued to decrease. When ΔZBASE became constant PEN₂ rose abruptly an formed phase 4.
These results suggest that the ventilation ceases in the lower lung in the end-expiratory phase while expiration is continued in the upper lung, and that the stop of airflow (airway closure) from dependent zone causes phase 4.

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Ventilatory steady state measurement with ¹³³Xe, using Ventil-Con (Radx) and a large area scintillation camera (Searle, LFOV) combined witha mini-computer system (Shimadzu, Scintipac 230)was employed to evaluate regional pulmonary function of 94 patients with chronic obstructive lung disease (COLD), fibrosis, carcinoma and other lung diseases. The functional image and regional pulmonary functions in these patients were compared with the the data in 9 normal subjects. The functional images of V, V, Q, V/V, Q/V, t (mean washout time calculated from the washout curve for equilibrated gas in the steady state) and V/Q were made in each case. The regional distribution indices of ventilation, perfusion and the ventilation-perfusion ratio were calculated for each lung field divided into 9 zones (whole lung, left, right, bilateral upper, middle and lower).
In the patients with COLD, mean washout times (t) were markedly prolonged in whole lung fields (m130± 33sec.) and ventilation indices (V/V) and perfusion indices (Q/V) were reduced in regional zones, especially in bilateral lower lung zones. For the patients with lung fibrosis, I values were short and the distribution of ventilation indices were uniform, and in contrast perfusion indices were reduced in the lower lung fields. In the area most affected by carcinoma, lung volumes (V) were reduced in parallel with the regional ventilation (V) and perfusion (Q). As the tumor approached the hilum, the relative ventilation and perfusion of cancerous side decreased remarkably in patients with obstructive findings on bronchoscopy.
The mean washout times (t) for ¹³³Xe, calculated by a modified height over area method without background subtraction, were significantly longer than indicated by the data yielded by the least squares curve fitting of initial washout curve after background subtraction. Although the accuracy of these data was limited, it appeared that the prolonged t is a good parameter of regional ventilatory disturbance because significant correlations were found between the whole lung t in patients with lung diseases and their FEV 1.0% r=-0.66, RV/TLC r=0.64, %TLC r=0.43, PaCO₂ r=0.41, PaO₂ r=-0.35.

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A 28-year-old female was admitted to our hospital complaining of dyspnea, periodic breathing and extreme obesity.
In order to clarify the physio-pathological mechanism of her daytime somnolence and periodic breathing, polygraphic recordings of her nocturnal sleep were carried out. During sleep an obstructive type apnea was recorded, in which thoracic and abdominal movements persisted while air flow was absent at nose. Her sleep was very unstable, not accompanied by stage 4 sleep.
The second polygraphic recordings were performed after her body weight was reduced. The breathing during sleep became regular but the frequency of apnea increased slightly. Stage 4 sleep appeared and the sleep pattern was almost normalized.
It is concluded that her daytime somnolence is compensating for sleep disturbance in the night. The pathogenesis of sleep disturbance is due to the obstruction of upper airway tract, which causes the periodic breathing and makes her nocturnal sleep unstable.

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An abnormal shadow was detected on the chest X-ray film of a 44-year-old man on a regular company check-up in 1972. The round homogeneous shadow in the right middle lung field grew slowly and he visited our hospital in Aug. 1978. The second oblique view showed extrapulmonary signs and tomography showed calcifications on the margin of the shadow. Operation on a diagnosis of chest wall tumor was performed in Jan. 1979. The tumor, 4.5 by 3.2cm in size, was based on the third rib and grew into the thoracic cavity. Histological examination revealed benign chondroma.

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