3 cases of pleural form in 112 patients who had been diagnosed as primary cancer of the lung in our department were reported. The 1st and 3rd cases were accompanied by carcinomatous pleurisy with hemorrhagic effusion. In autopsy, the former showed diffuse carcinomatous infiltration of the pleura in the right side, and the latter a wide-spread dissemination to the pleural surface and both showed no main tumor masses in the lung parenchyma except in the marginal region of the apex. The 2nd case showed the pachypleuritis type with accompanying no pleural effusion in the clinical course and could not be differentiated from the pleural mesothelioma even in autopsy findings.
Histologically, the 1st and 2nd cases were differentiated adenocarcinomas; and the 3rd case, low differentiated adenocarcinoma. Microscopically, tumor cells showed a tendency of invasion to the subpleural and peribronchial lymph canals in all cases.
Primary herds of the carcinoma in the 1st and 3rd cases were supposed to be in the subpleural parenchyma of the apical regions of the right lung, and the 2nd case was obscure.

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Owing to research the effects of air pollution inside of fishing boats on fishmen we had examined their lung functions and subjective complaints concerned with lung diseases, because we have rather frequently found patients with lung fibrosis and/or lung emphysema among fishmen.
Subjects examined: 243 fishmen in total, among them 177 of hot valve engine ships, included 44 engineers and 38 of them worked over ten years as the engineers, and 66 of Diesel engine ships, included 19 engineers and 15 of them worked over ten years as the engineers.
Complaints surveyed: cough, sputum, shortness of breathing, stridor, and Fletcher's criteria.
Lung functions examined: VC, FEV, MMF, MBC with 13.5L respirometer, Ventilation at rest and with exercise (V_R & V_E) with Scholander's apperatus.
Results obtained: (1) Frequencies of complaints were higher compared with cities employees of Sapporo and Obihiro. (2) Frequency diagnosed as bronchial asthma was 6.1% (13/243) and eight of thirteen asthmatics had worked over ten years as engineers. (3) V_E showed significantly higher value among engineers compared with other workers in ships.

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The effects of vagotomy or sympathectomy on bronchoconstriction and pulmonary arterial hypertension following an injection of serotonin into the pulmonary artery were studied quantitatively in anesthetized, thoracotomized dogs.
The degree of bronchoconstriction following serotonin administration markedly decreased after bilateral vagotomy, while no changes were found in the rises of pulmonary arterial pressure either by vagotomy or sympathectomy.
These results might suggest the presence of bronchomotor tone in anesthetized dogs, and indicate that it is mediated by the autonomic nervous system.

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In Japan, the case of bronchial adenoma has been rare in comparison with other countries.
Recently, two cases of bronchial adenoma were seen. The 1st case was a 46 year-old female with chief complaints of dyspnea and abnormal chest x-ray. The bronchoscopy revealed a tumor in the left main bronchus, and the biopsy showed a cylindroid type of bronchial adenoma. However, the left lobectomy was unsuccessful, because of the metastasis in the lung.
The 2nd case was a 23 year-old male with chief complaints of hemoptysis or bloody sputa for about 5 years. The chest x-ray showed an atelectasis in the right lower lung field, and a tumor was recognized in the right lower bronchus by bronchoscopy and bronchography. The right lobectomy of the middle lobe and the lower lobe was performed, and a carcinoid type of bronchial adenoma was recognized.
After the operations, both cases showed negative in 5-Hydroxyindole acetic acid test in urine.

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Surface activity of the alveolar lining layer has been recently investigated in many laboratories. We are studying the change in surface activity in pathological conditions. In this study the fundamental problems in Pattle's method were investigated in which the surface activity was expressed by ‘stability ratio’ calculated by measurement of the change in size of bubbles obtained by squeezing a piece of lung tissue in a drop of air-saturated saline. (1) The bubbles produced from rabbit serum or lymph collected from right thoracic lymph duct of dog were unstable and were different from those obtained from normal lung which were stable and the SR was about 0.9. (2) There was no difference in SR among upper-, middle-, and lower parts of the lungs and between right and left lung. (3) There was no influence of pure oxygen or ether on SR when the duration of inhaltion of these gases was short. (4) Tween 20 lowered the SR to 0.39. (5) The SR fell remarkably after 24 hours when the lung was kept in room temperature (20°C) and after 4 days in the refrigerator (5°C), but there was no change in SR for 4 weeks when the lung was frozen.

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We have studied the change in surface activity in pathological conditions. At first, in this study the change in surface activity was investigated by Pattle's method in atelectasis induced in rabbits by prombage of pieces of sponge or by artificial pneumothorax. The decrease in SR was brought about 24 hous after the atelectasis and it returned to the normal value by several inflations of atelectatic lung prior to resection. This recovery of surface activity was observed even in the lung which was atelectatic for 8 days. However, the surface activity remained low when the atelectatic lung was inflated several times after washing out the blood in pulmonary vessels with saline. These results indicate that pulmonary circulation appears to be necessary in recovery of the lowered surface activity observed in chronic simple atelectasis.

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The experimental pneumonia was induced in rabbit lung by injection of one ml of staphylococcus extoxin solution through trachea. The change in surface activity was studied by Pattle's method and the mechanism of non-obstructive atelectasis found in pneumonia was analized. The SR decreased to 0.42±0.16 in pneumonic area and its decrease was found 24 hours after the injection of exotoxin solution. This decrease in surface activity did not return to the normal value by several inflations before excision. The SR was normal one hour after the injection of 0.25mg/ml exotoxin solution into the lung, but it was decreased by injection of 0.75mg/ml exotoxin solution. The SR decreased to 0.46±0.13 one hour after the exudate collected from pneumonic lung wasinjected into normal lung. These resuts indicate that the high concentration of exotoxin solution, which might be observed when there was a number of staphylococci, decreases the surface activity and induces atelectasis, and that the surface activity decreases in the area aspirating exudate from pneumonic area. These factors appear to be causes in development of nonobstructive atelectasis in pneumonia.

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Specimens of 147 patients with respiratory diseases were examined whether they contained PPLO, using Bacto-PPLO agar or Bacto-PPLO broth. They were throat mucus, intratracheal mucus, sputum, scalene lymph nodes, resected lung tissues, saliva and pleural effusion.
In consequent, PPLOs have been isolated from the throat specimens in 27 cases out of 125.
The high incidence of PPLO was observed in such cases with respiratory inflammation as common cold, primary atypical peumonia and chronic bronchitis.
Sixteen strains isolated were investigated their biological properties; they could grow on Bacto-PPLO agar or in Bacto-PPLO broth containing Bacto-PPLO Serum Fraction without yeast extract, did not ferment glucose, and did not reduce 2, 3, 5-triphenyltetrazolium chloride under aerobic conditions. Twelve strains out of 14 tested lysed sheep erythrocytes.
Cold hemagglutination was found positive in the 14 cases out of the 16 PPLO positive patients.

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Chronic pulmonary emphysema, as one of the chronic obstructive pulmonary diseases, is known to be associated with a severe impairment of gas exchange. In an attempt to clarify the real state of impaired alveolar functions in chronic pulmonary emphysema, particularly from a standpoint of the pulmonary weighting function, the functional residual capacity (FRC) that is here considered as an actual space for gas exchange is presumed to consist of at least three functionally different groups of alveoli: 1) fast ventilated space, 2) normally ventilated space, and 3) poorly ventilated space. Under this assumption, a percentage of each space in the FRC, percent distributions of ventilation and perfusion among spaces, and ventilation-perfusion ratio in each space were measured and/or calculated and, consequently, nonuniform distributions of ventilation and perfusion throughout the lungs were revealed. This, together with a calculated percentage of the anatomic right-to-left shunts, pointed to a possible existence of a conceptional “non-ventilated space” in which the predicted ventilation-perfusion ratio would be zero.
Thus, in view of the functional subdivision of the FRC into the above four spaces, the present study was made on the nonuniform distributions of various functional parameters concerning alveolar gas exchange in case of chronic pulmonary emphysema and the data obtained were compared with those previously reported in case of bronchial asthma.
The results are summarized as follows:
1) The fast ventilated space (fast space) consisting of 7.2±3.2% of the FRC participated in 56.4±7.3% of the total ventilation and was perfused by 9.5±5.1% of the total pulmonary blood flow. The ventilation-perfusion ratio and turn over rate of this space were 5.77±1.88 and 7.74±3.86 respectively and improved only a little following the administration of bronchodilator.
2) The normally ventilated space (normal space) holding 19.9±7.3% of the FRC took part in 29.7±6.5% of the total ventilation and received 31.9±7.4% of the total pulmonary blood flow, the ventilation-perfusion ratio being 0.79±0.08. The administration of bronchodilator did not affect these values.
3) Although the poorly ventilated space (slow space) occupied 72.9±7.5% of the FRC, that is, indeed more than two thirds of the FRC, it was concerned with only 13.9±4.7% of the total ventilation and was perfused by 53.1±9.0% of the total pulmonary blood flow. Consequently, the ventilation-perfusion ratio of this space was as extremely low as 0.21±0.06 and the O₂-CO₂ diagram also indicated a severe impairment of alveolar gas exchange in this space. The administration of bronchodilator did not affect the volume of this space but improved a little the ventilation-perfusion ratio up to 0.26±0.08. This slight improvement apparently resulted from both a little increase in the absolute ventilation and a slight decrease in the absolute blood flow, though it was far less than the improvement observed in case of bronchial asthma in which a marked increase of the ventilation-perfusion ratio was associated with a decrease in volume of the slow space itself.
4) Presence of the “non-ventilated space” was suggested by an anatomic venous admixture rate of 5.7±2.8%. This space probably represents a group of alveoli in case of atelectasis and bullae associated with emphysema.
5) Fair correlation between the calculated A-aD_O2 and a-AD_CO2 and those actually measured, as evidenced by the correlation coefficients (r) of 0.876 for A-aD_O2 and 0.961 for a-AD_CO2, may justify the fast and normal space subdivisions as a way of analysis in evaluating the alveolar functions.

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