The mass survey for cardiovascular diseases with the method discussed in our first report was made on all workers of one factory in Nagoya city, and mainly blood pressure and ECG findings about 4236 workers, consisting of 3565 men and 671 women, were discussed, from the point of view of mass survey and health control.1) In the range of 16 to 40 years of age, hypertensive cases in which the blood pressure was more than 151/91 mm. Hg were found in 4.1 to 4.2 per centage. While, in the range of 41 to 60 years of age, 9.0 to 24.4 per centage was hypertensive.In hypotensive cases in which the systolic blood pressure were less than 100 mm. Hg were found 3.2 to 4.6 per centage in the range of 16 to 30 years of age, while in the range of 31 to 60 year of age, 7.5 to 8.4 per centage were hypotensive.2) In 409 cases that were in 9.7 per centage of all cases, abnormal electrocardiographic findings were found. They included 55 cases (1.3%) of coronary diseases which contained 2 cases of myocardial infarct, 3 cases of myocardial damage, 24 cases of left ventricular strain and 26 cases of coronary insufficiency. Other abnormal cases were 209 cases (4.9%) of left ventricular hypertrophy, 93 cases (2.2%) of complete or incomplete right bundle branch block, 24 cases of right ventricular hypertrophy, 3 cases of sino-auricular block, 4 cases of atrio-ventricular block, 1 case of left bundle branch block, 47 cases of extrasystoles, 3 cases of auricular fibrillation, 34 cases of pulmonary P, 2 cases of parasystole and 5 cases of W-P-W syndrome.3) The older they were, the more abnormal ECG findings were found, especially in older group than 41 years of age (12.7-16.5%). Many abnormal ECG findings of 25.4 to 75.0 per centage in hypertensive group were found, particularly, many coronary diseases in older group than 51 years of age or in hypertensive group in which was more than 181/111 mm. Hg of blood pressue, and many left ventricular hypertrophy in hypertensive group in which was more than 151 mm. Hg of systolic blood pressure.Left ventricular hypertrophy complicated with coronary diseases was found on high frequency rate (11.0%).4) Ballistocardiogram On the examination of 225 cases of older than 31 years of age, more severe cases than grade II of Brown's classification were found frequently in the older group than 50 years of age, hypertensive group and group of abnormal ECG findings.5) During a half year of following observation after examinations 2 workers died. The one case had abnormal ECG findings of left ventricular hypertrophy, left ventricular strain and hypertension, and the other having suffered from auricular fibrillation expired with thrombosis.6) On the mass survey for cardiovascular diseases and health control, special attention should be paid to coronary diseases ; the cases with hypertension and/or left ventricular hypertrophy which coincided frequently with coronary diseases, should be taken special attention, too ; auricular fibrillation should be also cared.

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Lysolecithins were made from the kidneys (of rabbits or oxen) and eggyolk, and lysocephalins were done from the kidneys (of rabbits or oxen) and erythrocytes. Mainly, the effects of these products on blood pressure were observed. In the course of experiment, clinical examinations were made of urine, peripheral blood picture, body weight, body temperature, blood sugar and nonprotein nitrogen level in blood. After the animals were killed, histological examinations were also performed.The results obtained were as follows : 1) In short-term experiments, lysolecithin depressed the blood pressure in rabbits, irrespective of whether it was made from kidneys of rabbits or from eggyolk. Marked hemoglobinuria and hematuria occurred during the course of the experiment.2) In long-term experiments, the blood pressure was not changed in rabbits or rats by any amount of lysolecithin. Hemoglobinuria, slight albuminuria and glycosuria were observed during the course of the experiments.3) With lysocephalin, made from kidneys the blood pressure of rabbit was not so much changed in short-term experiment, namely, the blood pressure level was lowered immediately following the injection, but was restored quickly and it even tended to rise above the normal level.4) In the long-term experiment with lysocephalin made from kidney or erythrocytes the blood pressure of rabbits tended to rise immediately, but was restored to normal level again. In this aspect, the blood pressure was not elevated by salt-loading. In the long-term experiment with lysocephalin made from kidney the blood pressure of rats tended to rise on the 7th to 14th day after the injection of lysocephalin and maintained the slight elevation of blood pressure during one or two months, but thereafter it returned to the normal level. In this aspect, no further use was produced by the addition of egg albumin or acetoacetic acid injection. The change in urine was observed in all of the animals, namely, hematuria, slight glycosuria and albuminuria occurred. But the marked change was not observed in peripheral blood picture, body temperature, body weight, blood sugar and nonprotein nitrogen level in blood.3) The histologic changes in the kidney were very slight and almost the same in all cases. Heart and other organs remained intact.6) The blood pressure level measured by KAWAGUCHI's indirect method, was very labile and was not reliable.From these results it is concluded that lysolecithin showed no pressor effect in either short-term or long-term experiments, and only lysocephalin made from kidneys showed a slight pressor effect when used over a long period of time.

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EXPERIMENTAL DCA HYPERTENSION The author performed the histologic and histochemical study of the adrenal cortex, determination of 17-ketosteroids excretion in urine to investigate the relationship between experimental DCA hypertension and adrenal cortex.1) The first experiment The author divided male rats into three groups : Group 1, DCA 5 mg. parenterally and 0.85% NaCl solution by mouth; Group 2, 2% NaCl mixed with the diet and 0.85% NaCl solution by mouth; Group 3, control, 0.85% NaCl solution alone by mouth. Unilateral nephrectomy was performed in the halves of experimental animals.2) The second experiment The author divided male rats into three groups : Group 1, DCA 5 mg. parenterally and 1% NaCl solution by mouth; Group 2, DCA 5 mg. parenterally and tap water by mouth; Group 3, control, 1% NaCl solution alone by mouth. Unilateral nephrectomy did not produce any appreciable effect on blood pressure. In the course of the first and second experiments, the author performed the clinical examinations including the measurement of blood pressure, fluid intake, urinary volume, body weight, urinalysis and urinary excretion of Cl and 17-ketosteroids.After the animals were sacrificed, the author performed the histologic and histochemical examination of the adrenal cortex.The summary and conclusion of this study are as follows : 1) The administration of DCA together with NaCl could produced a marked hypertension which sustained at the level of 200 mm. Hg. The administration of DCA alone could also produce a hypertension, but the elevation of blood pressure was slight as compared with the case of both DCA and NaCl administration. From these results, it is assumed that DCA hypertension would develop through the intermediate of NaCl.2) Adrenal cortical changes occurred in experimental DCA hypertensive rats were similar to those in salt hypertension, and those changes were a progressive disuse atrophy of zona glomerulosa in proportion to the amount and duration of the administration of DCA. Atrophy of the zona glomerulosa was more pronounced in the case of both DCA and NaCl administration than in the case of DCA administration alone.There appeared an enlargement of the outer part of the fasciculata which is considered the sign of stress and an increased urinary 17-ketosteroids excretion in the case of both DCA and NaCl administration. However, no relation was found between stress and elevation of blood pressure. From the changes of zona glomerulosa, it is assumed that the adrenal cortex would not secrete the mineralocorticoids in DCA hypertension similarly as in salt hypertension, and that this zone would not be concerned with DCA hypertension.OVERALL CONCLUSIONS FROM THE STUDY OF ADRENAL CORTICAL FUNCTIONS IN EXPERIMENTAL HYPERTENSIONS.The histologic and histochemical study of the adrenal cortex, determination of urinary 17-ketosteroids excretion were performed in order to investigate the adrenal cortical function in various types of experimental hypertensions. The author obtained the following conclusions.The zona glomerulosa showed hyperfunction in the hypertension due to denervation of the pressoreceptors and renal hypertension, while hypofunction in the salt and DCA hypertensions. These findings indicate that this zone would not be active factor in the development of hypertension. Therefore, the theory of renin-adrenal axis would not be extended to the general sphere of hypertension.The zona fasciculata reacted sensitively to the stress and presented histological alterations almost proportionately to the change in urinary 17-ketosteroids excretion, accordingly, the author cannot postulate any relationship between zona fasciculata and hypertension, and the idea of disease of adaptation could not be applied to hypertension.

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According to Maekawa, the "true cause" of hypertension is considered to be disturbances of the ATP-ATPase system, and especially release of ATPase of the kidney into blood stream.Here, a precise study on the pressor effect of the kidney-ATPase and at the same time, its effects on renal hemodynamics and other renal functions were studied. Then it was studied to produce hypertension in dogs similar to self-sustaining post-DCA-hypertension of rats by administration of the dialyzed kidney-ATPase.And the effects of ATP on blood pressure and on renal hemodynamics in dogs were observed, too.1) Acute experiment : a) A female dog was anesthetized with iso-mytal sodium ; mean blood pressure was 88-120 mm.Hg before injection. Upon intravenous injection of 60cc of dialyzed kidney-ATPase, pressure rised to 130-155 mm.Hg at the end of injection. Further intravenous injection of 45cc. led to more rise of pressure (140-160mmHg).b) Next, it was attempted to produce the typical pattern of acute malignant hypertension in dog. The same dog was used. With drip infusion of dialyzed kidney-ATPase blood pressure rised gradually to 120→137→170mmHg, and hematuria, albuminuria and glycosuria occurred. The elevation of blood pressure as well as changes of urine became more and more intense with injection. The pattern is undoubtedly that of the acute malignant hypertension.2) Relative chronic experiment : 4 dogs were used, and were daily injected intravenously with 15∼90cc. for 8∼25days. The animals developed a facilitation to the repeated injection of kidney-ATPase, although expected result could not be obtained on the account of lack in time.3) Chronic experiment : 4 dogs, including 2 unilaterally nephrectomized animals, were used. One nephrectomized and one normal dogs were daily injected intravenously with 30∼50cc. of dialyzed kidney-ATPase and other two additionally with 50∼200mg. of cholesterol intravenously.The duration of the experiment was 2∼4 months. During this experiment NaCl load (5∼15gm.) was added.Two dogs without cholesterol load showed a rise of mean pressure by 10∼20mm.Hg, sustaining this level for 2∼3 weeks after withdrawal of the administration of kidney-ATPase. And blood pressure was fluctuated.In the other two treated with ATPase and cholesterol, a significant elevation of blood pressure was not observed.Changes of RPF, GRR and FF were not consistent, but apt to increase in general. This corresponds with the early stage of essential hypertension of man.4) During injection of kidney-ATPase, RPF decreased by ca. 40%, FF rised slightly and urine flow decreased markedly.5) Furthermore, above-mentioned crude "Kidney-ATPase" was divided into two fractions by absorption procedure (Maekawa & Nakajima), i. e. pressor fraction "C-K" and depressor fraction "M".Then, effects of the two fractions on renal tubular activity were observed. By intravenous injection of pressor fraction "C-K", TmPAH decreased by 20%, TmG decreased by 70%, GFR decreased by 83% and urine flow decreased markedly, too.By intravenous injection of depressor fraction "M", GFR and urine flow decreased moderately, TmPAH increased slightly and TmG decreased by 61%.6) By intravenous injection of adenosine triphosphate, RPF and urine flow increased and renal vascular resistance decreased, contrary to ATPase. And TmPAH and TmG increased markedly. Na clearance and pottasium clearance increased too.

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Renal clearance tests have been studied till now by using as indicators some substance (such as urea) that exists physiologically in the body, but it has become possible these days to determine various renal function factors like renal blood flow, glomerular filtration rate, etc. separately by loading various substances as indicators and utilizing the peculiar characteristics of the glomeruli.Although such substances as Inulin, Mannitol and Sodium thiosulfate are being used as indicators in determining the glomerular filtration rates, the two last agents are used more widely in our country because Inulin is rather hard to obtain nowadays.But these two substances are easily reabsorbed while passing through the tubules and the existence of their secretion has also been pointed out. As a matter of fact, this tendency is especially strong with pregnant women and it is said that errors occur frequently especially with Thiosulfate.Although we have solely been using Sodium thiosulfate for the determination of glomerular filtration rates in testing renal functions these past few years, we have this time conducted both Thiosulfate GFR and Mannitol GFR tests simultaneously or in close succession on the same pregnant women to determine if there exist significant errors among individual tests of each group and also studied whether or not there exists a significant difference between the two groups by performing the X² test on each group.For the experiment, we used 14 pregnant women between five and ten months pregnant and administered the indicators with intravenous instillation. The result wat that Thiosulfate GFR showed higher values with ten cases, while Man-nitol GFR, with four cases.As df=1, X²₀=0.5989 and 0.5<p<0.3 (Yates correction), the reliability was 95% and no significant difference could be noted. The same could be said about between the two groups.As the number of cases is small, nothing definite can be said yet but we are of the opinion that both Thiosulfate and Mannitol can be used without any large errors for determining glomerular filtration rates of pregnant women. It is needless to say, however, that the same indicators have to be used as the loading substance, if the tests are to be repeated continuously on the same subjects.

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