A study was undertaken to investigate the ultrastructural changes of tissue thromboplastin (T. Tbp.) during the coagulation-fibrinolytic process in vitro, the changes of coagulation-fibrinolytic factors after the intravenous injection of T. Tbp. in pigs, and the ultrastructural changes in the lungs of rabbits after the injection of T. Tbp.
There were no changes in the concentrically arranged membrane structures of T. Tbp. during the coagulation process and the structures were destroyed and the procoagulant activity was decreased by the action of fibrinolytic factors in vitro.
Ten seconds after the start of the injection of T. Tbp. in pigs, fibrinopeptide A increased, indicating fibrin formation. Secondary fibrinolysis occurred 1 minute after the start of the injection.
Immediately after the injection of T. Tbp. in rabbits, diffuse pulmonary microthrombi were formed. reflecting the changes of coagulation system mentioned above. Injuries of endothelial cells, interstitial edema and damage of type B alveolar epithelial cells were also observed. These changes remained for over 24 hours when pulmonary microthrombi disappeared. They were observed extensively and most rabbits died showing dyspnea after repeated injections.
These results are consistent with the pathophysiology of ARDS, and suggest the cause and mechanism of the disease.

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The presence of angiotensin converting enzyme activity (ACE) in lung is a relatively recent finding. It is well known that serum ACE activity increases markedly in patients with active sarcoidosis. In this experiment serum ACE activity was determined in patients with spontaneous pneumothorax and in male albino rabbit with artificial pneumothorax.
1) Mean values and standard deviation (SD) of serum ACE activity before and after the reexpansion of lung in patient with spontaneous pneumothorax were 19.2±3.1U and 32.2±5.4U, respectively.
2) In male albino rabbits, mean values and SD of serum ACE activity in controls were 71.3±2.3U. After artificial pneumothorax mean values and SD of serum ACE activity showed gradual decrease and reaching a minimum value, 52.9±3.6U, on the 5th day. Thereafter a gradual increase was seen returning to the control value on the 11th day.
3) The above results may suggest that the decrease of serum ACE activity in patients with spontaneous pneumothorax and in male albino rabbits with artificial pneumothorax results from the decrease of pulmonary vascular beds.

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Sera of 50 patients with chronic respiratoy infection (diffuse panbronchioitis, chronic bronchitis, bronchiectasis, chronic emphysema) were studied for the activity of antilymphocyte antibody (ALA) as assessed by microcytotoxicity test, and the characteristics of such activity were compared to those of cold hemagglutinin (CHA).
1) ALA was detected in sera of 5 out of 5 patients with diffuse panbronchiolitis, 10 out of 30 with chronic bronchitis, 2 out of 6 with bronchiectasis and 1 out of 9 with chronic emphysema.
2) Close correlation was found between ALA and CHA.
3) It was found that ALA was cross-reactive with I antigen on human erythrocyte as shown by partial absorption of activities of ALA and of CHA with human adult O erythrocyte.
4) The target cells of ALA were T cell, B cell and monocyte, and the main immunoglobulin class of ALA was suggested to be IgM antibody.
5) Various antiviral antibody titers and antimycoplasma pneumoniae antibody titer were not significantly different in the ALA positive and negative sera.
6) Frequency of Haemophilus influenzae isolation from sputum of ALA-positive patients was significantly higher than that of ALA-negative patients.
7) We were unable to absorb the activities of ALA and CHA from positive sera with haemophilus influenzae and Pseudomonas aeruginosa.

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In Sapporo, where the outside temperature in wintertime stays below 0°C and humidity ranges between 55 and 80% the room temperature of the rooms of the centrally heated apartment complexes where our experiment was conducted rose above 30°C, while humidity conversely dropped as low as 30%. We conducted an epidemiological study on the dryness symptoms of the mucous membrane of the upper respiratory tract and on symptoms of the common cold caused by these environmental conditions. Simultaneously we studied the therapeutic effects of the ultrasonic humidifier on these ailments. Data were collected from a group of 466 users of the ultrasonic humidifier and another group of 396 nonusers. We arrived at the following conclusions:
1. Measurements of humidity of the room environment indicated that with the ultrasonic humidifier in use, humidity increased from 30 to 70%.
2. Among the group of users of the humidifier the frequency of occurrences of symptoms of dryness of the mucous membrane of the upper respiratory tract, such as dryness of the nose and throat, was significantly less than among the group not using the hunnidifier: The frequency of the occurrence of coughing and sputum among the grop of humidifier users was significantly greater than among the group not using humidifiers.
3. Throughout the whole period of this experiment, the occurrence of symptoms of the common cold was significantly less among the group of humidifier users than among the other group. Corresponding with the accidental breakdown of the central heating system during the thirteenth week of the experiment, which reduced the room temperature, symptoms of the common cold, such as, runny nose, throatache, headache, fever, absence from work dur to cold occurred, in the group of nonusers of the humidifier while, on the other hand, hardly any of these symptoms occurred in the group of humidifier users.
As is evident from the above results, the humidification capacity of the ultrasonic humidifier is outstanding. It has significant effect against symptoms of dryness in the mucous membrane of the upper respiratory tract. It is also considered to have had a prophylactic effect against the occurrence of common cold symptoms (inflammation of the upper respiratory tract) during the low-temperature, low-humidity period of the breakdown of the central heating system.
Furthermore, the analysis of the “white powder” caused by the ultrasonic humidifier indicated that due to its physical characteristics, it has hardly any perceptible adverse effects on human health.

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A 56-year-old man was admitted due to thoracic and abdominal aneurysms. He had giant bullae in bilateral upper lung fields and had a long history of smoking accompanied by hypoxia. Aneurysmectomies and grafting were performed by left side thoracotomy and laparotomy. Because of a possibility of postoperative respiratory failure, ventilatory support was prophylactically carried out postoperatively.
On the first postoperative day the hypoxistate deteriorated further and bullae in the right lung field markedly enlarged on chest X-ray film during artificial ventilation. By exchanging of the type of respirator and the ventilatory pattern, the mean intratracheal pressure lowered and subsequently the bullae reduced gradually. On the eighth postoperative day he was weaned from the ventilator.

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A 44-year-old mother and her 18 year-old daughter with diffuse panbronchioitis were described. The mother and all of her three chidren also had sinusitis.
Because of the frequent coexistence of diffuse panbronchiolitis and sinusitis, the common vulnerability of the upper and lower airway and hereditary immunologic deficiency might be operative in the mechanism of the progression of diffuse panbronchiolitis.

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A 23 year-old male, underwent open lung biopsy for diagnosis of multiple thin-walled cavities in bilateral lung fields discovered on a health check. Macroscopically, multiple induration up to 1cm in size an multiple bullae some as large as 2×1cm were observed.
Microscopically, granuloma with infiltration of histiocytes and eosinophiles were observed and a diagnosis of eosinophilic granuloma was obtained. Electronmicroscopically, the cells contained a characteristically indented nucleus, rare lysosome-like bodies, rich smooth endoplasmic reticulum and a few rough endoplasmic reticulum were found. Special granules, which showed rod or racquet-like shape were found in the cytoplasms. These granules had a tendency to locate in the peripheral portion of the cytoplasm and to connect with the cytoplasmic membrane in some parts.
These specific granules have been reported in lesions of histiocytosis-X as well as in Langerhan's cells of skin and lymph nodes and in many other normal or diseased tissues. The relationship between Langerhan's cells in the epidermis and the cells containing these specific granules in the eosinophilic granuloma or macrophages were discussed.

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31才男性. 胸部X線像上, 右中下葉無気肺様陰影を指摘され入院. 気管支造影で, 中下葉枝は横隔膜上の腫瘤により, 圧排偏位され, CTスキャンで, 前縦隔から発生した脂肪腫が疑われた. 開胸摘出術施行. 腫瘤は700g. 被膜を有する黄色の柔らかな充実性腫瘍で, 多くの成熟脂肪細胞からなる脂肪組織と, 島状に散在する胸腺組織からなり, 胸腺脂肪腫と診断された.

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