Black pigments deposited in the lung may be the indicator of environmental pollution during one's life. These pigment foci increase their number age by age, and are seen more abundantly in the man's lung than in the woman's lung. The correlation between these pigment deposits and pathological changes of bronchopulmonary system was studied on 196 autopsy cases died of the diseases other than respiratory disease. After macroscopic observation, more than four parts of the lung, i. e., S¹a, S²b, S⁹ and the lower lobe main bronchus, were examined histologically, and the relation between the degree of pigmentation and the frequency or severity of each pathologic change was studied.
The pigmented foci appear usually after 20 years of age, and increase their number after 40 years of age, especially after 60 years of age. These pigmentations are seen most in the apex and S²a, then in S²b, S⁶ and S³, and rare in the basal part of the lung. Squamous cell metaplasia and basal cell hyperplasia of bronchial- or bronchiolar epithelium seemed to have some relation with the black pigment deposit, and these changes are more frequent and severe in the lung of marked pigmentation. But, hyperplasia of mucous glands or goblet cells in bronchial or bronchiolar walls did not show any relation to the amount of pigment deposit, as well as the cell infiltration of bronchial or bronchiolar wall. Fibrous thickening of bronchiolar walls and small scar tissues scattered in the lung had some relation with the degree of pigmentation, and emphysema (mainly centrilobular emphysema) seemed to have relation with the deposition of black pigments.
Although our series contain only a few cases which had been diagnosed as chronic bronchitis clinically, it can be thought from these observations that an inhalation of the polluted air stimulates the bronchiolar wall and causes chronsc bronchiolitis, bronchiolopneumonia and sometimes centrilobular emphysema on one hand, and causes deposition of black pigments in the lung on the other hand.

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I exermined thirty nine pneumoconiotic patients who were divided in Grade 1 to 4 by the findings of their chest X-rays, on their pulmonary functions, including Lung Volume Measurements (Vital Capacity, Forced Expiratory Volume for one second, MBC, Residual Volume, Total Lung Capacity, RV/TLC-Ratio, Ventilation Factor by Dr. Motley, Intrapulmonary Gas Mixing Index), Ventilation Measurements (Minute Ventilation, Oxygen uptake at rest and with step-up exercise, CO2 output, Respiratory Quotient), Arterial Blood Analysis (pH, SaO2, CO2 content, PaCO2, Ht) and right Cardiac Catheterization studies (Pressures measurements in the right heart and pulmonary arteries, cardiac output, total pulmonary resistance).
From the observations I tried to divide the severity in these three grades;
I Grade: Subjects showed some abnormal findings in Lung Volume-measurements.
II Grade: I Grade plus Hypoxemia
III Grade: II Grade plus Plumonary Hypertension or obvious reduction of oxygen uptake with step-up exercise (less than 500ml/min/M² BSA)

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Abnormal bronchial ramification is not considered to be infreqent, but mainly discovered on thoracotomy or autopsy. We recently experienced 3 male cases of abnormal bronchial ramifications by bronchoscopy and bronchography, including a case of so-called apical tracheal bronchus which branches directly (from the trachea above) the bifurcation.

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One hundred and eight cases of pulmonary abscess have been treated with intratracheal injection of penicillin, terramycin and kanamycin. The injections were given by crico-thyroid route every day or every the other day for several months. Seventy-six cases were cured and twenty-three improved.
This route of injection is easy and safe in everyday performance, and convenient in getting tracheal sputum for bacteriological examination to select the best suitable antibiotics.
In this paper the effectiveness of this method was confirmed in comparing the concentration of these three antibiotics with that in systemic administration.
The concentration of antibiotics in the sputum of the patients and in the lobe of rabbits lung injected intratracheally was about 1, 000 times higher and sustained longer than that given intramusculary or intravenously.
The antibiotics injected intratracheally into rabbits lung stayed longer, for more than 24 hours, and in higher concentration at the desired lobe than the other lobes.
The concentration of antibiotics in the serum injected intratracheally was lower in the patients with larger amount of sputum than with smaller one. In the latter and in rabbits it was about the same with that given intramuscularly or intravenously.
The highest lebel of serum antibiotics concentration was obtained later in intratracheal than intravenous or intramuscular administration.
In patients with large amount of sputum, urine excretion of antibiotics injected intratracheally was smaller than in those with small amount of sputum. In the latter and in rabbits the urine excretion of antibiotics was about the same with either of intratracheal, intramuscular or intravenous injection.
In intratracheal, intramuscular and intravenous injection of these three antibiotics, the concentration of penicillin increased and decreased faster than those of the other two in sputum, lung, serum and urine.

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