(1) The author advanced in this paper a method of determining the position of the electrical heart axis by comparing the standard limb leads with the unipolar limb leads. The axis can easily be pointed by the method within a relatively small angle (30°). (2) Many instances of electrocardiograms were studied by that method. The main point of the results obtained is as follows. The two axes named A₁ and A₂, which consist of the first and the latter halves of components of the mean electrical heart axis, respectively, are separate widely from each other in the instances of right bundle branch block (RBBB) which were observed by the author. On the other hand, A₁ and A₂ are close to each other in all of the instances of RBBB with left anterior hemiblock or left posterior hemiblock which were quoted from the paper by Rosenbaum et al.* Therefore, the instances observed by the author may be those of so-called pure RBBB. Such findings are to be added to the postulates for diagnosis of RBBB.

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Cineangiograms of 20 patients were analyzed with a computer to calculate instantaneous left ventricular volume and the rate of volume change (dV/dt, flow) for a cardiac cycle. Patients were divided into four groups : group I-normal, group II-mitral stenosis, group III-left ventricular volume overload, and group IV-coronary artery disease. The instantaneous flow (ordinate) -volume (abscissa) relationship showed a loop which rotated in a counterclockwise direction accompanied by rapid downslopes during early diastole in groups I and III. The steepness of the early diastolic downslope was markedly decreased in groups II and IV. In order to evaluate the findings numerically, flow at the early 20% of diastolic volume change (F₂₀), F₂₀ corrected with peak diastolic flow (F₂₀/F_d) and F₂₀ corrected with peak systolic flow (F₂₀/F_s) were measured. F₂₀/F_s and F₂₀/F_d were significantly lower in groups II and IV than in groups I and III. On the other hand, stiffness constant obtained during later diastole stayed within normal limits in groups I and II, but the index was increased in groups III and IV. Possible mechanism for the decreased flow during early diastole, i.e., delayed relaxation during early diastole in groups II and IV, and dissociation between early diastolic relaxation and the stiffness constant obtained during later diastole in groups II and III are discussed.

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Computed tomography was performed on five cases of Huntington's chorea. Shrinkage of the caudate nuclei as well as enlargement of the lateral ventricles and atrophy of the cerebral cortex, which have been noticed as characteristic findings of this disease, were clearly demonstrated in series of computed tomogram. A method for measuring the atrophy of the heads of caudate nuclei and the dilatation of the lateral ventricles was shown. The ratio of F-F (maximal distance between bilateral frontal tips of the lateral ventricles)/ C-C (minimal distance between bilateral heads of caudate nuclei) was calculated in each case. This ratio was apparently smaller in value in Huntington's cases than that in control. It became smaller with progression of the disease. So this ratio is considered to be useful for diagnosing and following a course of Huntington's chorea.

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A case of hypernephroma is described who presented 4 years earlier with thrombocythaemia with a platelet count of over 2 million/c. mm. He had clinical features of idiopathic thrombocythaemia but had normal bone marrow and a raised ESR suggesting that thrombocythaemia was not primary or idiopathic but secondary to the asymptomatic renal carcinoma.

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A 23-year-old nurse had sulfonylurea-induced factitious hypoglycemia. She demonstrated the high plasma insulin level relative to blood glucose and the positive prolonged fasting test. The response of plasma insulin to glucagon and tolbutamide was not typical of insulinoma. Furthermore, plasma C-peptide concentration was suppressed following the injection of insulin. These findings, together with no demonstrable radiologic evidence of an insulin secreting tumor prompted us to measure the serum concentration of sulfonylurea though she adamantly denied taking hypoglycemic drug. The presence of a significant amount of sulfonylurea, 13.3mg/dl equivalent to tolbutamide, in her serum assured our suspicion of factitious hypoglycemia. The differential diagnosis between insulinoma and other causes of hypoglycemia is discussed, specially emphasizing the suppressability of plasma C-peptide concentration following the injection of insulin for ruling out the former.

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Two cases of mycoplasmal pneumonia with cavity formation are reported. The first case was a housewife who had a four-day history of cough, sputum, fever and chills. The complement fixation titer to Mycoplasma pneumoniae was 1 : 128 in the convalescence. The chest radiogram showed a homogeneous infiltration in the anterior basal segment of right lower lobe containing a cavity. The second case was a nurse who had a three-day history of cough, malaise and sore throat. The complement fixation titer to Mycoplasma pneumoniae was 1 : 128 on the 12th hospital day. The chest radiogram revealed small cavities in the anterior segment of left upper lobe in the course of convalescence. A search of literature has revealed four cases.

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The unilateral renal vein thrombosis is often associated with the nephrotic syndrome demonstrating histologic findings similar to the membraneous or membrano-proliferative glomerulonephritis. Most studies have suggested that the renal vein thrombosis may be a complication of the nephrotic syndrome, which has been induced by its hypercoagulable state rather than its cause. However, others suppose that the unilateral renal vein thrombosis is an initial event and the membraneous glomerulonephritis is due to the immunologic injuries of glomeruli induced by the renal vein thrombosis. Two cases of the nephrotic syndrome associated with the unilateral renal vein thrombosis have been reported. Case 1 was a 48 year old female. She had the Sjögren's syndrome. She had the left renal vein thrombosis associated with the nephrotic syndrome but no hypercoagulable state. The immunofluorescent studies on kidey biopsy specimens demonstrated the presence of the immune complex nephritis. Case 2 was a 31 year old male. He had the nephrotic syndrome associated with the left renal vein thrombosis and the myocardial infarction. He had a hypercoagulable state. Histological examinations of kidney biopsy specimens revealed the minimal change lesions and no depositions of IgG and β₁C were demonstrated by immunofluorescence.

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