Immune response of regional lymph nodes in patients with lung cancer

To clarify immune response of regional lymph nodes in 30 patients with lung cancer, the T cell population, phytohemagglutinin (PHA) and Concanavalin A (ConA) stimulation and the T cell subpopulation bearing Ig-G Fc receptors (Tg cells) were tested concerning the clinical stage, histology and the lymph nodes locations. The T cell population, and PHA and ConA response rates in lymph nodes of stage I patients were grossly the same as those of benign lung diseases, but were statistically higher than those of stage III patients (p less than 0.025, p less than 0.005). Among the three histological types of lung cancer, regional lymph nodes of adenocarcinoma had the greatest T cell populations, and PHA and ConA responses. Concerning the location of lymph nodes, the closer the lymph nodes was to the tumor, the greater was its T cell population, and vice versa. However there was no difference in PHA and ConA responses. All lung cancer patients revealed a significant increase of Tg cells in regional lymph nodes and in their peripheral blood lymphocytes compared with peripheral blood lymphocytes in normal subjects (p less than 0.005).

Clinical application of cardiovascular computed tomography

The application of computed tomography to cardiovascular diagnosis was attempted. One hundred and four consecutive patients with various cardiovascular diseases were studied with a third-generation computed tomographic three-second whole body scanner. Identification and evaluation of abnormalities of the great vessels, atria, ventricles and interventricular septum were possible by cardiac computed tomography. Sizes and locations of intracardiac thrombi were accurately assessed by computed tomography. Computed tomography was valuable for the evaluation of pericardial effusion because distribution of the effusion as well as the gross nature of the fluid could be estimated by the CT number.

Intrapleural cough pressure in patients after thoracotomy

Quantitative studies of cough strength seem to be valuable in evaluating cough dynamics and the effectiveness of various procedures designed to raise the cough force. To evaluate cough strength in 20 patients after thoracotomy intrapleural cough pressures were measured with a balloon catheter inserted in the ipsilateral pleural space toward the apex. A balloon catheter designed to measure intraluminal esophageal pressure was used in this study. The balloon was inflated with 1 ml of air and the transmitted intrapleural pressure was measured during the maximum voluntary cough effort in the supine and/or sitting position. The pressure change during coughing seems to serve as an index in evaluating the strength of the respiratory muscles. It was observed that the cough pressure increased progressively following thoracotomy, and that it was higher in the sitting position than in the supine position. The most effective procedure to raise the maximum cough pressure was manually assisted compression of the chest wall in the sitting position during voluntary coughing. Epidural anesthesia following thoracotomy seemed to be effective in inducing higher cough pressure changes.

Catamenial pneumothorax associated with endometriosis of the diaphragm

A case of catamenial pneumothorax is documented. At thoracotomy, there was a small black mass measuring 10 x 6 mm associated with surrounding petechiae on the top of the dome of the right diaphragm. Microscopic examination revealed the presence of endometrial tissue. We could not find any diaphragmatic defect in this case.

Estimation of surfactant lecithin in amniotic fluid and prediction of respiratory distress syndrome

The quantitative and qualitative analyses of lecithin in the human amniotic fluid in relation to the antenatal prediction of developing respiratory distress syndrome were described. Surfactant lecithin (disaturated and/or dipalmitoyl lecithin) was estimated for the first time in 42 amniotic fluid specimens of 21-42 weeks gestation. Surfactant lecithin was present in considerable amounts in specimens obtained near or at term except in the ones associated with infants who subsequently developed respiratory distress syndrome. One infant developed typical respiratory distress syndrome despite the normal total lecithin concentration of amniotic fluid at birth. The fatty acid analysis, however, revealed that the surfactant lecithin concentration was extremely low, showing a great discrepancy between total lecithin and surfactant lecithin concentrations. Thus the estimation of disaturated and/or dipalmitoyl lecithin in the amniotic fluid seems to be the most precise sign of a potential risk of respiratory distress syndrome.