Control of ventilation was studied by measuring resting and hypercapnic ventilatory drives using a rebreathing technique in a group of 35 young male swimmers who were compared with two groups of 13 men and 10 women.
1) Mouth pressure during airway occlusion 0.1sec. after the onset of inspiration, P_0.1 at rest in room air breathing were not significantly different in the three groups.
2) Ventilatory responses to CO₂ by V_E/P_ACO2 were 1.89±0.83L/min./mmHg in the group of healthy men, 1.17±0.32 in the group of healthy women and 1.88±0.78 in a group of swimmers. These results were lower than values reported by Read et al. and Altose et al. Hypercapnic ventilatory drive as measured by the slope of V_E/P_ACO2 in a group of healthy women was apparently lower than that of the other groups.
3) Mouth occlusion pressure in response to CO₂, P_0.1/P_ACO2 was 0.39±0.20cm H₂O/mmHg in healthy men, 0.25±0.15 in healthy women and 0.39±0.17 in swimmers. These results indicate that chemosensitivity as determined by P_0.1/P_ACO2 was lower in healthy women than in others, but the difference was not significant.
4) Subjects with decrease in hypercapnic ventilatory drive as shown by ventilatory response by V_E/P_ACO2 and P_0.1/P_ACO2 i.e. so-called “low responders” were observed more in the group of swimmers than in healthy men.

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For a controlled study of respiratory failure, a model of the disease is necessary. In order to establish a method to develop graded respiratory failure in animals, paraquat (10mg/kg) was administrated intraperitonealy to 20 rats once a week 6 times.
The growth rates of the rats were much slower than those of the control rats. One rat died from respiratory distress on the 30th day after the first injection of paraquat. The others were subjected to blood gas analysis and histological study 2 weeks after the last injection.
The rats were lightly anesthetized with intraperitoneal pentobarbital and blood gas samples were taken from the abdominal aorta through a laparotomy incision. Respiratory depression due to general anesthesia was ruled out with a low PaCO₂, but rats had a PaO₂ of 72.0±3.0 torr, which was lower than those of the control.
The light- and electron-microscopic examination revealed destruction of the pneumocytes, an increase of alveolar macrophages, perivascular and peribronchiolar cell infiltration, a thickening of the alveolar septa, an increase of fibrocytes, plasmacytes and lymphocytes in the interstitium.
The rats, with a significant retarded growth rate and a low PaO₂, consistently had a correlated degree of pathological changes specific to the lung. Though repeated blood gas sampling from a small animal is impractical, an observation of the growth rate is easy. The slower growth rate of rats treated with paraquat certainly predicts the development of respiratory failure in these animals.
This method of induction and prediction of respiratory failure promises to be a useful model for the study of respiratory failure.

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Serial EGG records of 31 patients with chronic cardiopulmonary diseases were investigated as to the dynamic electrocardiographic changes of manifestation of right ventricular hypertrophy. The following conclusions were elicited:
1) The initial manifestation of right ventricular overload was recognized as AQRS>+90° without any changes in QRS.
2) The second stage revealed AQRS≥100° and R/SV₅≤1.
3) The third stage revealed definite RVH showing AQRS≥120°, R/SV₁≥1 and R/SV_5.6≤1.
4) These changes were observed fairly rapidly mostly within 1 year.
5) In the second stage, 7 out of 19 patients revealed some improvement on electrocardiogram with compensation of right ventricular function showing that the change is considered to be mainly due to right ventricular enlargement.

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Metabolism of PGF_2α in lung was studied by two methods, namely, through pulmonary circulation using guinea pig lung perfusion on one hand and through the broncho-alveolar system using guinea pig and dog broncho-alveolar lavages on the other. Localization of prostaglandin dehydrogenase activity in the lung was also studied using histochemical techniques.
I. In guinea pig lung perfusion, amounts of up to 23.57±5.32ng/ml PGF_2α-M were detected in perfusion fluids after infusion of 200ng/ml of PGF_2α.
II. In guinea pig broncho-alveolar lavage, up to 71.4±6.1ng/ml PGF_2α-M was detected in lavage fluids after instillation of 100ng/ml of PGF_2α. In dog broncho-alveolar lavage, up to 2.92±0.59ng/ml PGF_2α-M was detected in lavage fluids after instillation of 400ng/ml of PGF_2α. The values of PGF_2α-M in PGF_2α broncho-alveolar lavage fluids were significantly higher than those in control saline broncho-alveolar lavage fluids.
III. The existence of PGDH activity in type II alveolar epithelial cells was confirmed by histochemical investigation.
The above results strongly suggest that not only capillary endothelial cells but also type II alveolar epithelial cells are greatly involved with the metabolism of PGF_2α in the lung.

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As a powerful anticoagulant, heparin is used extensively in clinical practice, but its pharmacokinetics particularly concerning the lung, are not well understood at present. The study reported here was undertaken to investigate some of the mechanism of heparin metabolism by measuring plasma heparin concentration in rabbits following intravenous administration of heparin.
In experiment 1, Japanese Albino rabbits were anesthetized and two cannulae were inserted into the right ventricle and carotid artery. Then, blood sampling was performed through both cannulas almost simultaneously at intervals of 1, 5, 10, 20, 30, 40, 50, 60 minutes after a single injection of heparin sodium at a dose of 200units/kg body weight. Heparin concentrations in right ventricular blood were significantly higher than those in left ventricular blood at 1 and 10 minutes after heparin injection.
In experiment 2.5ml of complete Freund's adjuvant was introduced into the right pleural space of each rabbit two weeks before use, and these animals were referred to as “rabbits with pleuritis”. Pulmonary embolic rabbits were prepared by injecting 50 units of thrombin into the right ventricular cannula 5 minutes before heparin administration. Resolution curves of heparin concentration of the above two groups were compared with those of a control group after a single injection of heparin sodium at a dose of 2000units/kg body weight, and the curves of the former two groups were prolonged.
The above results may suggest that pulmonary vascular endothelium plays an important role in heparin metabolism.

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Rabbit models of pigeon breeder's lung were produced to study histological and immunological changes in “CFA-pigeon serum immunized and insufflated with pigeon serum group” (group I) and in “insufflation with pigeon serum-alone group” (group II). These groups showed high titers of antibodies against pigeon serum and high population of lymphocytes in bronchoalveolar fluid cells. Histologically, in group I, interstitial pneumonitis with diffuse granuloma formations was produced. On the other hand, in group II, interstitial pneumonitis with scattered granulomatous changes were produced. The histological changes in group I were suggested to be associated with “adjuvant granuloma effect”. Lymphocyte transformation test was studied to evaluate the role of cell-mediated hypersensitivity in the pathogenesis of hypersensitivity pneumonitis. Lymphocyte transformation against pigeon serum was measured in peripheral blood lymphocytes, spleen cells and paratracheal lymphnode cells, in these two experimental groups and in normal control group. In the two experimental groups, peripheral blood lymphocytes and spleen cells responded against pigeon serum to the same degree, but paratracheal lymph-node cells responded significantly greater in group II than in group I. These results suggested that local cell-mediated hypersensitivity mechanisms in the lungs played an important role in precipitating hypersensitivity pneumonitis.

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Untreated 30 patients with pulmonary sarcoidosis and 14 healthy subjects were studied with respect to serum chemotactic inhibitor of macrophage. Tuberculin skin test was determined in 27/30 patients from whom sample serum was obtained. Macrophages were obtained from rabbit peritoneal exudate 4 days after intraperitoneal injection of 0.4% glycogen. The chemotactic assay was performed with modified Boyden chambers. Fresh human serum activated with E. coli. endotoxin was used as a chemotactic attractant. Macrophages were preincubated with sample serum for 30 minutes at 37°C and then washed before being introduced into the Boyden chamber.
Macrophage chemotaxis was significantly suppressed by sera from patients who had tuberculin anergy compared with those from healthy subjects and patients who exhibited positive tuberculin reaction. This is probably due to the serum chemotactic inhibitor rather than to the chemotactic deactivation of the cells. This inhibitor exhibited a direct inhibitory effect both on the macrophages and on the polymorphonuclear leukocytes. In addition, the inhibitory effect remained even after serum was removed from the cells by washing. The inhibitor was heat-stable for 30 minutes at 56°C. The features of the inhibitor obtained in this study were close to those of the cell-directed inhibitor (CDI) as described by Ward et al. In this study, it is concluded that CDI is present in sarcoid patients and that suppression of macrophage chemotaxis has highly significant association with tuberculin anergy. CDI may play a role in the pathogenesis of tuberculin anergy in sarcoidosis.

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Pentobarbital was reported to have a protective effect against oxygen toxicity at high pressures in rat lungs. However, its effect under normobaric state is not known. We administered pentobarbital (20mg/kg, i.p., every 24h) for 4 days prior to 95% O₂ or air exposure to the adult rats and compared the effects on the lung, plasma, and liver antioxidant systems with control (non-treated) rats. We determined superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GP) as the activity of antioxidant systems, thiobarbituric acid reactant substance as the extent of lipid peroxidation, and α-tocopherol on lung tissues, plasma, and liver. Antioxidant enzymes did not change significantly after pentobarbital pretreatment except CAT in liver. After O₂ exposure for 48h, antioxidant enzymes of both control and pentobarbital pretreated groups did not change significantly. We observed a significant increase in lipid peroxide formation in liver in both groups after O₂ exposure, and the increase was marked in the pentobarbital pretreated group.
The results suggest that pentobarbital may not have a protective effect aganist oxygen toxicity in rat lung under normobaric condition, and the combination of pentobarbital and high concentration of oxygen may cause liver damage.

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Two different exponential descriptions, Salazar-Knowles: V=Vmax(1-e^-kp) and Colebatch-Gibson: V=Vo-Ae^-kp, for the static deflationary pressure volume curve were applied for ten normal rat lungs and their mathematical characteristics were evaluated.
1) At low and high lung volume, theoretical values obtained by the Salazar-Knowles formula showed significantly large discrepancies compared with the actual measured values. However, the difference was minimal at mid-lung volume in both the Colebatch-Gibson and Salazar-Knowles formulae.
2) Even by the Colebatch-Gibson formula, the discrepancies between theoretical and actual value was fairly large at a low lung volume, so that this may suggest that application of the single exponential form of the pressure volume curves had some limitations in term of the expression of lung elasticity in mathematical terms.
3) A tangent at the 50% of maximum lung volume on the pressure-volume curve showed good correlation with the compliance obtained from the actual measured values between 40% and 70% of V₃₀, suggesting that it may be a useful index for the evaluation of lung elasticity.

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This paper presents a case treated with one-stage bilateral thoracotomy for bilateral pulmonary metastases from the adrenal gland carcinoma. In 1976, when the patient was 46 years old, she suffered from Cushing's syndrome due to the left adrenal gland carcinoma associated with bilateral multiple pulmonary metastatic foci. Op′-Dichloro-diphenyl-dichloroethane was administered and the adrenal gland was extirpated. The pulmonary metastatic foci vanished.
A coin lesion was noticed on the left upper lung field of a chest X-ray film taken in May 1980 but there were no symptoms. However, productive cough and chest pain were encountered 7 months later and another lesion in the right lower lung field was observed. In April 1981 she was admitted to our department for surgery.
On operation, right posterolateral thoracotomy was performed at first and the tumor, weighing 25g, was resected from the S⁸ area and the chest was closed. Then left thorax was entered by means of a posterolateral incision and a 2.5g tumor in S² was excised by wedge resection. Histological examination showed the characteristics of adrenal carcinomas in both tumors. The postoperative course of this patient was uneventful. The one-stage bilateral thoracotomy diminished the lung function, but it was enough to ensure a satisfactory quality of daily life.
It should be emphasized that in those patients whose pulmonary metastatic lesions grow slowly and are sensitive to chemotherapeutic agents, one-stage bilateral thoracotomy and tumor excision may be recommended.

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A 31-year-old housewife with a history of recurrent eczema and otitis media was admitted in March 1981, because of progressive dyspnea. On admission she was semicomatotic, febrile and cyanotic. Inspiratory crackles were heard all over the lung. Eczema was present on the scalp. Chest X-ray showed bilateral consolidation. Arterial blood gas analysis showed marked hypoxemia. She was immediately placed on CPPV, large doses of antibiotics and hydrocortisone. During 10 days stay in ICU, her condition improved gradually.
Her chest X-ray two weeks after admission showed residual scattered fine nodular densities with a partially confluent area. Because she had been using an ultrasonic humidifier in her home for four months before admission, an attempt to provocate the condition using her own humidifier was made. Four hours after humidifing besides her bed for one hour, a fever of 37.8°, leukocytosis and a decrease of vital capacity developed. Chest X-ray 22 hours after provocation showed new scattered fine densities. Microscopic examination of lung tissues obtained by transbronchial lung biopsy showed infiltration of lymphocytes with a few neutrophiles and eosinophiles to the alveolar wall.
Candida albicans was cultured from water in the humidifier and precipitating antibody to this organism was detected in her serum. However inhalation provocation test using this organism was not performed.

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The term BEAP (Bronchiectasis, Eosinophilia, Asthma, Pneumonitis) syndrome, was introduced by Goodman in 1974. He reported that a patient who was intolerant to milk during infancy presented with a history of asthma and suffered repetitive respiratory infections, eosinophilia and bronchiectasis.
The authors reported an 8-year-old boy who has suffered from asthma and atopic dermatitis since infancy. He suffered repetitive pneumonitis and developed bronchiectasis. After his admission, the patient was examined and diagnosed “Food (especially egg) induced BEAP syndrome”.
The results are summarized as follows. Laboratory findings revealed remarkable eosinophilia and high serum IgE level. Prick and intradermal tests showed positive immediate reactions to HD and D. farinae antigen and positive immediate and late reactions to ovalbumin and ovomucoid antigen. Precipitating antibody to ovalbumin extract was positive. The chest X-rays demonstrated the repetitive pulmonary infiltration shadows in the right lower lobe. Bronchography revealed cylindrical bronchiectatic findings in the right B₅. The provocation test with egg demonstrated positive immediate and late reactions with physical and laboratory findings.
The authors reported a case of egg-induced BEAP syndrome, although the first case of the syndrome reported by Goodman was caused by aspergillus fumigatus.

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A 50-year-old man who had undergone resection of both a solitary pulmonary metastasis and a local recurrence 10 years after the resection of adenoid cystic carcinoma of the right submandibular gland was reported.
In this case, because of its characteristic histological aspect, the resected lung tumor was suspected to be metastatic and the primary site was easily determined. This case shows that when the histological aspect of a lung tumor is uncommon, if it is a solitary tumor, a metastatic tumor should be suspected first and examination of the primary site should be performed quickly.

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Tracheobronchopathia osteochondroplastica is a rare disease. Twenty cases have been reported in Japan and 200 to 300 cases in the world. We reported a case diagnosed by fiberoptic bronchoscopic observation and biopsy. A 74 year-old man presented with a history of hemoptysis and 3 years chronic cough. His chest roentgenogram showed old tuberculosis lesions at the apices of both lungs. A fiberoptic bronchoscopic examination revealed diffuse multiple irregular nodular lesions in the trachea and in main bronchus characteristic of tracheobronchopathia osteochondroplastica. Biopsy of the nodular lesions revealed submucosal cartilage covered with normal bronchial epithelium.

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A solitary well-defined round shadow on the patient's chest X-ray was proved to be pulmonary atypical mycobacteriosis due to Mycobacterium Kansasii cultured from bronchoscopic fiber brushings of the lesion. Sputum have became negative by treatment with EB, RFP, SM and the shadow on chest X-ray have been remarkably improved.
The culture of acid-fast bacilli of fiberbronchoscopic brushings was emphasized even if the lesion appears as a tumor-like shadow on chest X-ray.

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