Serum levels of soluble IL-2 receptors (sIL-2R) by an ELISA method in 28 patients with sarcoidosis and 16 healthy controls were studied, and the source of sIL-2R was further examined.
sIL-2R in serum was significantly higher in sarcoidosis than in controls. In sarcoidosis sIL-2R in serum significantly correlated with serum ACE level, and was significantly higher in stage II or III patients than in stage O patients. sIL-2R in supernatants of cultured monocytes (Mo) and alveolar macrophages (AM) was significantly higher in sarcoidosis than in controls. sIL-2R in supernatants of cultured T lymphocytes obtained from peripheral blood or BALF was barely detectable in sarcoidosis, while it was undetectable in controls. Furthermore, sIL-2R in serum was significantly correlated with sIL-2R in supernatants of cultured Mo and AM. These results indicate that sIL-2R in serum is an useful index of the disease activity of sarcoidosis, and may be mainly derived from IL-2R on Mo and AM.

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Effects of a β-agonist (isoproterenol) and β-antagonists (propranolol and pindolol) on hypoxic pulmonary vasoconstriction (HPV) and on changes in some chemical mediators were compared between HPV-responsive lobes and non-responsive lobes in which HPV was induced by aspirin DL-lysine (ASA groups). Hypoxic ventilation (4min) was repeated in 56 of isolated, blood-perfused dog lung lobes. Each drug was administrated in a bolus dose of 0.2mg in the intermittent period between hypoxia. In HPV-responsive lobes, the first hypoxia increased pulmonary vascular resistance by 33% or more in all groups. Both isoproterenol and pindolol inhibited the elicitation of HPV completely, but propranolol induced almost the same degree of HPV as control. In ASA groups, HPV was completely inhibited by isoproterenol, but was not influenced by propranolol. However, pindolol's inhibitory effect on HPV was less than that in HPV-reponsive lobes. Isoproterenol significantly increased cyclic AMP from 17.0 to 76.7pmol/ml in HPV-responsive lobes (n=7). Pindolol increased prostaglandin E₂ from 87.0 to 1015.4pg/ml in HPV-responsive lobes (n=7), and from 93.4 to 361.3pg/ml when ASA was treated. Propranolol did not show the different results from the control group whether ASA was present or not. The different mechanisms among β-adrenoceptor-related agents in HPV and pulmonary circulation were investigated.

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Retrospective studies of pleural biopsy, cytology and ADA in pleural effusion were performed in 116 patients with pleural effusion between 1980 and 1988.
Pleural malignant disease was diagnosed in 25 patients (75.8%) by cytology, in 19 patients (57.6%) by pleural biopsy. Thus, cytology should be performed first in patients with pleurisy. Both of cytologic study and CEA in pleural effusion were negative in 3 cases of squamous cell carcinoma. Tuberculous pleuritis was diagnosed in 24 patients (50.0%) by pleural biopsy, in 5 patients (10.4%) by isolation of Mycobacterium tuberculosis.
Both pleural biopsy and adenosine deaminase activity (ADA) were examined in 19 cases of tuberculous pleuritis and ADA was elevated in 16 patients (84.2%).
These data suggested that pleural biopsy was useful for diagnosis of pleuritis and the combination of cytology, tumor markers and ADA with biopsy improved diagnostic rates of pleuritis.

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The difference in the uptake rate through the lungs between nitrous oxide and oxygen has been shown to represent the pulmonary capillary blood flow (Qc). The pulsatility of Qc, defined as the ratio of maximum Qc and mean Qc (Qc max/Qc), the ratio of Qc max and stroke volume (Qc max/SV), and the ratio of systolic Qc and SV (Vsyst/SV), has been also shown to indicate the pulmonary vasodilation as well as vasoconstriction. We measured Qc by means of body plethysmography in dogs with pulmonary air embolism, in order to evaluate its effect on the pulmonary vasculature.
Ten adult dogs were anesthetized with pentobarbital and pancuronium, and were mechanically ventilated. A volume of air (0.5ml/kg) was injected into the central vein. Although there was no significant change in systemic blood pressure, cardiac output, heart rate, and airway pressure after the injection of air, pulmonary arterial pressure and pulmonary vascular resistance increased significantly. Qc, Qc max, Qc max/Qc, and Qc max/SV decreased significantly after the air injection.
Since these findings suggest that the pulmonary air embolism provoked pulmonary vasoconstriction, and attenuated the pulsatility of Oc, optimal pulmonary vasodilation therapy would be recommended to improve the pulmonary hypertension secondary to pulmonary air embolism.

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Using ventilatory lung motion imaging, which was obtained from two perfusion lung scintigrams with ^99mTc-macroaggregated albumin taken in maximal inspiration and maximal expiration, the lung motion ((E-I)/I) of the each unilateral lung was studied in various cardiopulmonary diseases.
The sum of (E-I)/I(+) of the unilateral lung showed a decrease in the diseased lung of localized pleuropulmonary diseases, including primary lung cancer and pleural thickening, and in both lungs in cases of heart diseases, diffuse pulmonary diseases including diffuse interstitial pneumonia and diffuse panbronchiolitis. The sum of (E-I)/I(+) of the both lungs, which correlated with vital capacity and PaO₂, showed a decrease in diffuse interstitial pneumonia, pulmonary emphysema, diffuse panbronchiolitis, primary lung cancer, pleural diseases and so on.
(E-I)/I(+), correlated with pulmonary perfusion (n=49, r=0.51, p<0.001), but not a few cases showed mismatch, which was observed in primary lung cancer, pleural diseases, pulmonary emphysema, diffuse panbronchiolitis and so on. (E-I)/I(+) better correlated with pulmonary ventilation by ventilation scintigraphy with ^81mKr or ¹³³Xe (n=49, r=0.61, p<0.001) than pulmonary perfusion.
The ventilatory lung motion imaging, which demonstrates the motion of the intra-pulmonary areas and lung edges, appears useful for estimating pulmonary ventilation of the perfused area as well as pulmonary perfusion.

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We investigated the relationship between changes in pharyngeal bacterial flora and the immunological condition of 10 lung cancer patients before and after anti-cancer chemotherapy.
There were significant differences in bacterial flora between normal subjects and patients. However, there were little differences in pharyngeal flora in patients before and after chemotherapy.
In 4 out of the 10 lung cancer patients, the ratio of anaerobic bacteria/total bacteria of pharyngeal flora decreased. These 4 cases were in the non-responsive (NC, PD) group of anti-cancer chemotherapy. After administration of anti-cancer drugs, the ratio of anaerobic bacteria increased.
No aerobic gram negative rods were isolated at any time during the observation period, because immunological suppression was mild.
The results indicate the importance of surveillance for the immunological state of the hosts and changes in pharyngeal bacterial flora.

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A case of primary intrapulmonary schwannoma was described. A 72-year-old man was admitted to our hospital because of dry cough. A chest radiograph showed partial atelectasis of the middle lobe, but computed tomogram of the chest revealed no tumor shadow. Bronchoscopy disclosed a pale-yellow uneven endobronchial wall of the right middle lobe bronchus. Transbronchial biopsy revealed benign schwannoma. Primary intrapulmonary schwannoma has been rarely reported.

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Two cases of Trichosporon beigelli pneumonia in severely immunocompromized patients are reported. At autopsy, Trichosporon beigelii was detected in all lobes in one patient who had a small cell lung cancer. Polymycotic infection involving Trichosporon beigelii and Aspergillus was proved in the other patient who had a non-Hodgkin's lymphoma. Miconazole therapy was not effective against Trichosporon beigelii infection in both cases. Although diagnosis and management are difficult, Trichosporon beigelii must be considered as a cause of visceral opportunistic fungal infection.

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A 53-year-old man was admitted to Nagoya City University Hospital with complaining of bloody sputum and an abnormal shadow on chest X-ray film. The chest X-ray film showed a giant bulla in the right upper and middle lung fields and a mass shadow inside the bulla. In addition he had the swelling of bilateral inguinal lymph nodes. He was suspected to having bleeding from the lung bulla, and received a right upper lobectomy. The resected specimen showed a lobular tumor in the parenchyma of lung and an oval lymphoma nodule moving around inside of lung bulla. Histologically, both the lung tumor and inguinal lymph-nodes were non-Hodgkin's malignant lymphoma, diffuse and plasmacytoid large cell type.

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An autopsy case of a 70-year-old woman with sarcoidosis followed up for 16 years is reported. She was admitted for examination of bilateral hilar lymphadenopathy on chest X-ray film and uveitis in 1971. Sarcoid granuloma was revealed by Daniels lymph node biopsy. After steroid therapy, bilateral hilar lymphadenopathy and uveitis disappeared. However small nodular shadows appeared in bilateral lower lung fields on chest X-ray film in 1973. Gradually small nodular shadows increased and reticular shadows appeared. In 1980, chest X-ray film revealed fibrotic change in the bilateral lung fields and giant bulla in the left upper lung field. She developed acute pneumonia and died of acute progression of chronic respiratory failure in 1987.
Autopsy revealed sarcoid granulomas and honeycomb lesions in bilateral lungs and also silicotic nodules near the sarcoid granuloma in the upper lobes. This case suggests that inhaled mineral particles may play an important role in the development of pulmonary fibrosis in sarcoidosis.

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A 46-year-old man was admitted with complaints of fever, cough and anterior chest pain. Chest X-ray examination disclosed an infiltrative shadow in the right upper lung field and chest CT scan strongly suggested invasion of mediastimum and anterior chest wall. Therefore, steroid therapy was selected because biopsy specimen showed proliferation of fibroblasts and mononuclear cells mainly containing plasma cells with no evidence of malignancy. After steroid therapy, chest X-ray examination showed that the infiltrative shadow was greatly reduced. However, since infiltrative shadow was increased again at 3 years after the initiation of steroid therapy, right upper lobectomy was performed.
Histopathological analysis of resected tumor demonstrated proliferation of mature plasma cells and fibroblasts in conjunction with minor infiltration of neutrophils and lymphocytes. At 18 months after operation, new shadows appeared in right S⁸ and S¹⁰ which were shown to have almost the same histological findings as the resected tumor. Steroid therapy was restarted, and then the size of shadows decreased. It is conceivable that steroid therapy is an effective therapy for pulmonary plasma cell granuloma, especially multifocal and relapsing cases.

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A 64-year-old man was admitted because of some infection of the airway. Chest roentgenography showed a bilateral reticulonodular shadow which was similar to the shadow of DPB. Pathological findings obtained by lung biopsy indicated bronchiolitis.
This case was diagnosed as Sjögren's syndrome because of the increase of titers of anti-ssA and anti-ssB antibody, lachrymal dysfunction, pathological findings and sialography.
The relationship between DPB and lung lesions of Sjögren's syndrome was investigated.

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