The influences of vitamin E deficiency on the lung were electron microscopically investigated in hamsters. The hamsters were raised with a vitamin E deficient diet (Vitamin E (d-α-Tocopherol) content under 0.5mg/100g). Stripped corn oil, which contains unsaturated fatty acids, was used instead of lard. The controls were given a 2.5mg/100g vitamin E diet.
The serum vitamin E contents gradually decreased in the experimental food. Serum vitamin E contents were significantly decreased after 10, 30 and 60 days of growth in the vitamin E-deficient diet groups. After 60 days the serum vitamin E content was 8.62±0.68μg/ml in the controls and 1.96±0.91μg/ml in the vitamin E-deficient hamsters.
No remarkable body weight difference was observed between the controls and the vitamin E-deficient hamsters.
Electron microscopic observations revealed that after 60 days in the vitamin E-deficient diet group, mesothelial cells were swollen and tonofilaments proliferated in the mesothelial cytoplasm. The tonofilaments markedly proliferated around nuclei.
An increase of Type II alveolar epithelial cells was observed in the vitamin E-deficient groups. The Type II/Type I cell ratio was 2.36 to 3.41 in the vitamin E-deficient groups, and about 1.6 in the controls. Abnormal vacuoles in the nucleus and a defect of the nuclear membrane in some of the Type II cell were observed in the 60 days vitamin E-deficient groups.
In the 60 days vitamin E-deficient group, large lamellar bodies in Type II cells increased in quantity and the areas occupied by the lamellar bodies in the Type II cell cytoplasm increased.
It was suggested that morphological changes of the mesothelium and Type II cells were induced by the vitamin E-deficient diet with unsaturated fatty acids.
Since morphological changes of Type II cells and lamellar bodies in the vitamin E-deficient groups were evident, a surface active material and mechanical property of the lungs might be different from that in the control group.

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It has been demonstrated that many different bronchoactive agents can cause a vagally mediated bronchoconstriction in animals and in man. Although the effects of local anesthetic aerosols on reflex bronchoconstriction have been investigated in the dog, little is known about the effects of intravenous general anesthetic commonly used in animal experiments on the reflex component of vagus nerve-induced bronchoconstriction.
We anesthetized 32 young mongrel dogs, weighing 6 to 10kg, with chloralose (30mg/kg), paralyzed the respiratory muscle with succinylcholine chloride, and ventilated the lungs through a tracheal cannula at a constant tidal volume (150-250ml) and a frequency of 16/min. Catheters were inserted into the left femoral artery and vein, and measurement of systemic arterial blood pressure (Psyst) and transfusion or infusion of drugs were conducted, respectively. The pressure transducer catheter was connected to the orifice of the tracheal cannula to monitor tracheal pressure (Ptr). The right side vagosympathetic nerve (V.N.) was isolated at the level of thyroid cartilage. We stimulated the cervical V.N. electrically with 5 to 30C from a square-wave stimulator (ME-6052); pulse duration was 1ms with a frequency of 30shocks/s.
1) The percent change of Ptr showed a marked increase by increasing stimulation voltage.
2) The percent increase of Ptr induced by V.N. stimulation showed a dose-dependent decrease with intravenous administration of pentobarbital sodium and ketamine hydrochloride.
3) The percent increase of Ptr suppressed by an intravenous infusion of pentobarbital sodium and ketamine hydrochloride showed a dose-dependent recovery by intravenous administration of neostigmine bromide.
4) The percent increase of Ptr potentiated by neostigmine bromide was suppressed dose-dependently by intravenous administration of pentobarbital sodium.
5) The percent increase of Ptr induced by an intravenous administration of acetylcholine and prostaglandin F_2α did not show any change by administration of pentobarbital sodium.

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To elucidate changes in the metabolism of vasoactive substances in diseased lung, PGF_2α metabolism was studied in lungs with decreased vascular beds induced by pulmonary artery ligation and in oleic acid-induced lung injury in dogs. In the dogs with left pulmonary artery and right bilobar pulmonary artery ligation, 15-keto 13, 14 dihydro PGF_2α, in the arterial blood was 67±17ng/ml during the infusion of 5μg/kg of PGF_2α, which was not significantly different from the value in controls.
In the dogs with oleic-acid induced lung injury, 15-keto 13, 14 dihydro PGF_2α in the arterial blood was 71.4±12.4ng/ml during the infusion of 5μg/kg of PGF_2α. This value was not significantly different from the value in controls. It was suggested that the pulmonary metabolic function of vasoactive substances may be well preserved in the diseased lung.

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Patients with chronic obstractive lung disease (COLD) were evaluated by magnified peripheral pulmonary arteriography. These patients consisted of 16 with chronic emphysema (CE), 14 with chronic bronchitis (CB), and as control 7 with bronchiectasis (BE). A Swan-Ganz catheter was wedged into the pulmonary artery and 76% Urografin was injected. The projection was magnified about 2.8 times. We paid attention mainly to the ratio of muscular artery and elastic artery (B/A), and capillary back group (CBG). These data were compared to arterial PO₂, pulmonary arterial mean pressure (PAMP) and pulmonary function tests. In BE cases, intact segments were evaluated. The results were as follows.
The lower PO₂ and the higher PAMP, the more B/A decreased in BE, but not in COLD. The lower PO₂ and the higher PAMP, the more CBG decreased in BE and CB, but not in CE. In seven patients, magnified peripheral pulmonary arteriography was performed before and after O₂ inhalation. After O₂ inhalation CBG increased, but B/A ratio did not change significantly.
These observations indicate that B/A and CBG decrease with hypoxemia and pulmonary hypertension, but the deformity of the respiratory tracts affects the vasculature in CE more than that in CB.

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On the basis of experience with 2 patients of our own and in a review of the literature, we divide catamenial pneumothorax into 3 groups according to the intrathoracic findings (Group I: diaphragmatic hole, endometriosis; Group II: no abnormal findings; Group III: bulla bleb).
To differentiate from the usual idiopathic spontaneous pneumothorax accidentally coincident with menstruation, we propose the following diagnostic criteria:
Pneumothorax occurrs between 3 days before and 5 days after the begining of menstrual flow.
More than 3 episodes with a frequency of once or more within 2 months may be necessary for a diagnosis of “catamenial”.
If the episodes are less frequent, diaphragmatic lesions (Group I) or lack of bleb (Group II) must be proved.

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The patient was a 60-year-old male complaining of dry cough, exertional dyspnea, and severe dryness of eyes and mouth. Chest X-ray film showed diffuse ground glass appearance bilaterally in the upper and middle lung fields. Laboratory data showed positive rheumatoid factor and antinuclear factor, hypoxemia, and obstructive ventilatory defect. Schirmer's test was positive, and the findings of lip biopsy were compatible with Sjögren's syndrome. The results of fiberoptic bronchoscopic examination were normal, but the transbronchial lung biopsy revealed severe interstitial infiltration of mature lymphoid cells, especially arround the bronchioles. A diagnosis of lymphoid interstitial pneumonitis was made. After institution of steroid therapy, his symptoms and signs improved except for obstructive ventilatory defect, and low dose steroids were required for maintenance.
Although lymphoid interstitial pneumonitis may affect small airways, the most commonly reported respiratory function abnormalities are restrictive ventilatory defects. We concluded that obstructive respiratory defect demonstrated in our case might be caused by widespread severe peribronchiolar involvement of lymphoid interstitial pneumonitis.

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A 78 year old male case conplainting of fever, general malaise and severe dyspnea was diagnosed as aspiration pneumonia, Mendelson's syndrome. He was in extremely poor condition, and arterial blood gas analysis revealed that his PaO₂ was 24.4mmHg. Mechanical ventilation combined with 5 to 10cmH₂O PEEP using a Bennett Ma-1 type respirator was performed.
We successfully treated the patient with high doses of glucocorticoid and antibiotics and also performed trans-bronchial lung biopsy via the fiberoptic bronchoscope before and after complete recovery. The clinical and pathological findings in this case were discussed and the literature was also reviewed.

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A 32-year-old taxi driver was admitted with complaints of coughing and exanthema. The respiratory symptoms and exanthema had appeared in April, 1980 and he had been tatooed on his back and arms about a year previously. His tatoo was composed of four distinctive colours (red, yellow, green and black). Exanthema was seen in only the red, yellow and green parts. Bilateral axillar and cervical lymph nodes were palpable. Chest X-ray films revealed diffuse shadows in both lung fields. Serum and urine test were normal. a biopsy of skin tissues and a lymphotic gland showed granulomatous changes caused by the tatoo dyes. Analysis of the dyes suggested that the red coloring matter consisted of organic mercury.
Pathological findings of the specimen obtained from a lung biopsy showed thickening of the alveolar wall, with infiltration of lymphocytes and epitheloid granuloma. Electron microscopy showed that the tatoo dyes were localized in his skin, lymph nodes and lung. We concluded that this was a case of diffuse, granulomatous interstitial pneumonia due to his tatoo.

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A fatal case of nosocomial Legionnaires' disease with primary lung cancer was reported here. A 79 year-old male with primary lung cancer (squamous cell carcinoma) was admitted to Imari municipal hospital with cough, fever and an abnormal shadow in the upper right lung field on chest X-ray film. The patient was treated with various kinds of antibiotics such as piperacillin (4g/day), amikacin (400mg/d.), cefmetazole (6g/d.), lincomycin (3g/d.), sisomicin (150mg/d.) and minocycline (200mg/d.) in various combinations, and antituberculous drugs (rifampicin, ethambutol, isoniazide and streptomycin). Despite these treatments, his fever continued and no causative organism was obtained from intrabroncheal aspirates, sputum or pleural effusion.
On the 70th hospital day steroid therapy was begun because of the persistent high fever, and the general condition improved slightly. Twenty days later the patient had a high fever up to 38.5°C and had increasing respiratory distress during steroid therapy. Chest X-ray showed diffuse homogeneous infiltrates in both lung fields.
At postmortem examination lung tissue and pleural effusion were obtained for pathological and bacterial examination. Severe bacterial pneumonia and squamous cell carcinoma were diagnosed histologically.
Pleural effusion was inoculated to bacterial media including B-CYE agar and B-CYE broth. Legionella pneumophila was isolated from B-CYE broth to be subcultured to B-CYE agar. No other bacteria was obtained from the other culture media. Legionella pneumopila isolated was determined to be serogroup 1 by the method of direct immunofluorescent antibody (DFA) technique.

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53歳. 男性. 職場健康診断にて右下肺野の多発結節状陰影を指摘され1年間抗結核剤の投与を受けた. その後結核腫として経過観察されていたが, 多発結節状陰影は7年間の経過で順次消滅し弧立性となった. 好酸球増加がみられ臨床および免疫学的に肺犬糸状虫症と診断し Mebendazole 投与を行い現在その経過を追究している.

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