The pulmonary diffusing capacity (DL) is a value relating to the flow rate of gas across the alveolo-capillary membrane to the pressure gradient. In patients with cardio-pulmonary diseases, an impediment of DL is caused by many factors. The relationship between DL and plumonary hemodynamics or ventilatory functions was studied in order to clarify these f actors. Material and Methods In 14 normal subjects, 20 patients with cardiac valvular disease (mitral valvular disease 13 and aortic valvular disease 7), 15 patients with essential hypertension and 30 patients with chronic pulmonary disease (emphysema 9, asthma 16 and others), the pulmonary diffusing capacity for carbon monoxide (DLco) was measured by FILLEY'S steady state method. Right heart catheterization was performed simultaneously. Ventilatory functions were measured by 13.5 L Benedict-Roth respirometer. Results The average value of DLCO for 14 normal subjects was 15cc per minute per mmHg. These DLco values were divided by body surface area (DLco/M²), because DLco Was cor-related with BSA. Normal values for DLco/M² were in a range from 9 to 11cc per minutes per mmHg per squaremeter BSA. A. DLco in patients with various cardiopulmonary diseases 1) Cardiac valvular diseases a) mitral stenosis and mitral insufficiency DLco was slightly decreased in all patients with mitral stenosis and mitral insufficiency (7∼9cc/min/mmHg/M²). b) mitral steno-insufficiency DLco Was markedly decreased in all patients except for one patient (4.3∼5.9cc/min/mm Hg/M²). c) aortic steno-insufficiency DLco was within normal limits in 3 patients and slightly decreased in 4 patients (6.5∼8.5 cc/min/mmHg/M²). 2) Essential hypertension DLco was within normal limits in 6 patients, slightly decreased in 8 patients (6.8∼8.9cc/ min/mmHg/M²) and moderately decreased in one patient (5.7 cc/min/mmHg/M²).

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The cardiopulmonary function tests including the intravascular catherization were performed on 25 cases of pulmonary tuberculosis and 5 cases of non-tuberculous pulmonary disease. Among them 20 cases were subjected to the anoxia test in addition.
1) There was slight elevation of the pulmonary arterial pressure in the pulmonary tuber-culosis. It was observed that there was a tendency to increased pressure in those cases, in whom the predicted VC was less than 60%, predicted MBC less than 50% and TVC less than 1, 000cc.
2) Increased pressure of the pulmonary artery was seen in the case showing hypertrophy of right ventricle on E. K. G.
3) The cardiac index was increased in the case of patient having a systolic murmur at the base of the heart. The heart murmur was recorded on a phonocardiogram. It is considered that a systolic heart murmur in pulmonary tuberculosis is produced by a volume load of the heart.
4) During the anoxia tests elevation of pulmonary arterial pressure and increase of cardiac index were observed, but in some far advanced cases elevation of pressure and decrease of cardiac index were observed.

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The authors made a study on the relationshipbetween ECG findings and the results of otherseveral clinical examinations in 80 cases ofpulmonary tuberculosis, and the followingconclusions were obtained.
1. Criteria to judge the presence of right venricularhypertrophy on ECG was showen inTable 1, and in case if at least 2 of the 7 itemsmentioned in Table 1 were present, rightventricular hypertrophy was considered to bepresent in such cases. Observing by the extentof pulmonary lesions by N. T. A. classification, right ventricular hypertrophy was found in 10 of34 far advanced cases (29.4%), 4 of 21 moderatelyadvanced cases (14.3%), and only 1 of 16minimal cases (5.5%). Pulmonary P was foundin 6 of far advanced cases, only 1 of moderatelyadvanced cases, and none of minimal cases.Thus, these right heart loading findings onECG were more frequently seen among advancedcases of pulmonary tuberculosis.
2. Pulmonary ventilatory function was measuredby using Benedict-Roth type respirometer.Among 13 cases with right ventricular hypertrophyon ECG, 1 showed normal ventilatoryfunction, another one showed slight restrictiveimpairment, and other 11 cases showed expiratoryincompetency or combined impairments.Among 40 cases without right heart loadingfindings on ECG, only 7 showed normal pulmonaryfunction, and other 33 cases showed someventilatory impairments. The above resultssuggest that ventilatory function was impairedeven in many cases without any right heartloading findings on ECG, and that ventilatoryimpairments in pulmonary tuberculous patientsare not only restrictive but also expiratory orobstructive in some cases.
3. Hematocrit value was normal in all cases.The fact suggests that polycythemia does notparticipate in right ventricular hypertrophy inthe case of pulmonary tuberculosis.
4. Regarding serum electrolytes, no significantdifference was found between sodium concentrationof normal group and right heartloading group. Pottasium concentration washigher in cases with right ventricular hypertrophy, and on the contrary, chloride concentrationwas slightly lower in cases with rightventricular hypertrophy. It is interesting thatthe above mentioned results coincide well withthe changes found in the case of pulmonaryacidosis, but we must be careful about its interpretation.
5. Total seurm protein and A/G ratio showedno significant correlation with ECG findings.

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A) It has been a focus of medical interest that the activity Of lactic dehydrogenase in serum (SLD) is of some value as an adjuvant tool in diagnosing malignancies.
To asses the diagnostic value of this enzyme, SLD was determined in 470 cases with malignancies and other diseases.
The method of Wróblewski and La Due with some slight modifications was used for the determination of SLD. in this study.
1) In 263 cases with malignancies, the range of SLD levels was 157 and 9550. Though the elevation was of course not a sine qua non in malignancies, it is certain that there was a tendency to elevate SLD levels in malignancies, Marked elevations were found in hepatomas, leukemias and cases with widely spread metastasis in any kind of cancer, particularly with metastasis to the liver.
2) In non-tumor diseases, three major categories were examined.
a) In acute hepatitis or liver cirrhosis, elevations of medium ;range were commonly found, and when the course was favorable, the activity l lowered gradually.
b) In myocardial infarction SLD was markedly elevated in their acute phasis, and when the injuries subsided uneventfully, the SLD level lowered, gradually. The speed of reduction, however, in much slower than that of S-GOTT
c) In pulmonary tuberculosis or suppurative lesions in the lung, SLD levels within the normal range were found in the majority of the cases.
B) The ratio of serous fluid to serum activity for lactic dehydrogenase (LD) was determined in 54 patients with effusions due to various diseases.
In 56% of the 32 patients with malignant neoplasms had ratios of more than 1. 0.
In 75% of the patients with inflammatory in nature, however, had too high ratios.
The results of this study indicate that the activity in the effusion fluid of LD investigated does not clearly differentiate malignance from benign effusion.

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(1) As recent trend, an increase in number of patients whose complaints are the presence of a lump or thickening in their breasts has been remarkable. The main cause of this phenomenon is the growing recognition and anxiety for cancer of breast among women.
(2) The greatest majority of patients were in age of thirties, amounting to about 40% of all cases.
(3) The rate of operation has been higher in women beyond the age of 50. This was 50-70 per cent.
(4) Of the tumors of breast, a distinct majority was mastopathia, then fibroadenoma followed by cancer.
(5) The survival rate of cancer patients underwent operation after 5 year was 55 per cent.
In the aspect of the 3 year survival rate, simple mastectomy was higher than radical procedures and/or post-operative rentgenotherapy.
The data suggests that radical procedures and/or post-operative radiation therapy are not always demanded.

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The limit of cardiopulmonary function to surgical treatment of pulmonary tuberculosis in old age was studied. Eighty patients who received surgical treatment in their over 50 years of age in 5 years since 1958 were examined. The results of physiological pulmonary function tests, ECG, and right heart catheterization tests were compared with those in young age. They were also analysed in relation to the time of tests. i. e. before and after the surgical treatment, and to the pattern of surgery, i. e. pulmonary resection and thoracoplasty.
The safe limit of surgical indications was considered to be as follows: %VC>70, %MBC>60, TVC/VC>60, RV/TLC<30, PaO₂>60mmHg and PaCO₂<50mmHg for pulmonary resection; %VC>60, %MBC>50, TVC/VC>50, RV/TLC<40, PaO₂>60mmHg and PaCO₂>50mmHg for thoracoplasty. In regard to ECG, abnormal findings was not always contraindication to surgical treatment. The results of right heart catheterization tests and low oxygen inhalation tests suggested that reserve capacity of cardiopulmonary function in old age was inferior to that in young age.
As the cases of pulmonary tuberculosis in old age are mostly serious, and the patients are very weak against surgical invasion and complications, we are inclined to prefer thoracoplasty prior to pulmonary resection for their surgical treatment.

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There are varying kinds of complications which develop after pneumonectomy. Stated in the present paper are the findings of the pathological investigation of an autopsy case who had developed vascular miliary tuberculosis, pericarditis and bilateral cheesy and fibrinous inflammation of the pleura following the application of the complementary thoracoplasty after receiving the left side total pneumonectomy on account of the presence of cavity in the left upper lobe and capsular cheesy focus in the other lobe.
It was not feasible to clarify, however, whether this serositis developed as a part of the vascular dissipation or the transmission first from the intrathoracic dissipation at the time of operation to the left side pleuritis and then to the right side and further to the pericarditis.
Biopsy findings of the liver are considered to indicate the initial stage of vascular dissipation.

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