Experiments were performed on cardiopulmonary bypass and endotoxin shock in order to study pulmonary surfactant, which has recently aroused attention as the causative agent of pulmonary complication after extracorporeal circulation. The results were as follows :
1) Phosphatidyl choline (PC) in pulmonary tissue was not decreased at 1 hour of extracorporeal circulation, but markedly reduced at 3 hours. The decrease was inhibited by pretreatment with phenoxybenzamine (POB).
2) PC in lung washing was decreased in endotoxin shock. The decrease in this case was not inhibited by POB pretreatment.
3) After the application of the Dermer's method and the author's silver nitrate method to the normal and endotoxin shock lungs, these were observed electron microscopically. After the former method, reaction positive substance appeared as an electron dense mass, which was poorly reproducible. In the latter case, a stratiform structure, 50-100 Å in size, was distinctly visible in the alveolar lining layer. The stratification was similar to that of type II alveolar cell inclusions. This was assumed to be pulmonary surfactant.
4) During the application of cardiopulmonary bypass, pressure in the airway was elevated, eliciting change in its wave form. This is considered to indicate reduced pulmonary compliance.
Thus pulmonary surfactant was decreased in pulmonary complication following the extracorporeal circulation. The etiology seems to be hematogenous stagnant atelectasis produced by peripheral circulatory failure and hemolysis, which are attributable to the application of artificial cardiopulmonary bypass. The complication was improved with POB. It is necessary for the prevention of pulmonary complication after extracorporeal circulation, to avoid sludging of blood and hemolysis by the improvement of the cardiopulmonary apparatus and administration of anti-shock agent and to improve the peripheral, especially pulmonary circulation as well as to evade operative shock.

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This method was investigated to decrease the lung and spinal cord radiation dose and volume dose.
The beam was angled 20 degrees to the left and right from mid-line. Four fields with their medial halves being blocked, 2 from anterior and 2 from posterior, were used in opposed fashion.
The dose distribution around the tumor were ideally obtained setting the ratio of anterior and posterior dose to 1:2.
The radiation dose to the spinal cord was below 65% of total tumor dose. Although volume dose and radiated area of the lung by this method were greater than paralleled opposed 2 field method which was the worst one for the spinal cord injury, they were less than inverted Y method, rotatory method, and other conventional methods.
Thus, the radiation dose to the normal tissue may be minimal in the majority of patients with the esophageal cancer.
This method is easy to perform and easy to apply clinically. In particular, the method may be superior if the cancer involved long area of the esophagus.

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A case of the pleuroperitoneal hernia on the left side in a 6-day-old boy was presented. Symptoms and roentgenological features of the pleuroperitoneal hernia were briefly discussed.
Importance of vigorous pre-and postoperative management as well as an urgent surgical correction of the condition was emphasized in the acute cases presenting soon after birth.
Success with these newborn infants will be more frequent in the hands of the team consisting of neonatologists, anesthesiologists and surgeons who are familiar with the pathophysiology of this anomaly.

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Between August 1970 and July 1973, 307 lymphographies with various diseases were performed at Department of Radiology, School of Medicine, Gunma University. This paper reports our experience of lymphographic interpretation, and techniques and complications of lymphography with literature review. Main study population consists of patients with various malignant neoplasm; 94 of the patients with carcinoma of the uterine cervix, 80 with malignant lymphoma, 31 with bladder tumor, 21 with ovarian tumor and 16 with testicular tumor. The effort was made to decrease “false positive” and equivocal diagnosis of metastasis from lymphogram. For this purpose, final diagnosis was often made after consideration of previous history, local skin condition, typical metastatic pathway and growth characteristics of primary tumor, and other factors which may affect lymph node change in lymphogram.
Pedal lymphogram was interpreted showing metastasis in one to all nodes in 60.4% of all cases : 81.3% of the patients with carcinoma of the uterine cervix showed metastasis, 51.3% of malignant lymphoma, 74.2% of bladder tumor, 30.0% of ovarian tumor, 18.8% of testicular tumor and 58.5% of the remainder.
Initial clinical stage of the disease was reclassified to advanced stage after lymphographic interpretation in 53.1% of the patients with carcinoma of the uterine cervix and 35.9% malignant lymphoma. This reassured us the value of lymphography for correct staging of the disease prior to the initiation of therapy.
Supraclavicular lymph nodes were opacified in 50.2% of the study without preference of diseases. opacification alone did not indicate metastases as long as architecture was normal. We attempted to correlate supraclavicular lymph nodes opacification to prognosis resulting in good prognosis in these patients. There should be further study evaluating the good prognosis in patients with supraclavicular lymph nodes opacification, of which mechanism may be explained partially by human body defence mechanism.
We did not make direct comparison between radiographic and histologic findings of the same nodes in many cases. However, we obtained high accuracy of lymphographic interpretation with operated bladder tumor.
We observed only minor complications; allergic dermatitis in the area of dye injection and mild degree of fever in the day of examination. None of severe complications, such as respiratory distress, neurological complication or cardiovascular disturbance was experienced. Pedal lymphography can be performed easily in any clinical center without much equipment and with minimal technical training. It can provide a valuable information to radiotherapist and oncologist.

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