Intracellular action potentials from toad ventricular muscle fiber were recorded and measured using the flexibly mounted microelectrode. Temperature effect on the intracellular action potential could not be found in heart in situ and in those which were perfused with Straub's method. If the effect of temperature on the intracellular action potential is exactly zero in the range of optimal temperature, the electromotive force is equal to the internal energy of muscle fiber in Helmholtz-Gibbs' equation. Further, the S-T segment of the unipolar surface electrocardiogram deviated from the base line with the rise of temperature. The comparison of the unipolar surface electrocardiogram with the differentiation curve of the intracellular action potential suggests a possibility that the deviation of S-T segment depends upon the impedance change in the cell membrane with temperature.

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Thebesian veins and Wearn's arterio-luminal and arterio-sinusoidal vessels have been collectively named the coronary-luminal communicating channels by the author. As to their functional or physiological properties, little has been known yet, because of the extreme difficulties encountered in measurements of their blood flow. The author experimentally demonstrated the existence of shunt flow through these communicating channels, in fibrillating heart, in heart beating in situ, and in isolated, perfused, beating heart.The proportion of the shunt flow draining into the left heart chambers to the total coronary flow was estimated to be several per cent in fibrillating heart and in isolated, perfused, beating heart. Therefore, the coronary-luminal shunt flow does not seem to influence too much the reliability of the nitrous oxide method in coronary venous catheterization.It has been also suggested that this shunt flow might act as a compensatory mechanism, under certain hemodynamic changes such as the elevation of intra-cardiac pressure on the right side.

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In the present experiments the coronary artery catheter and dogs with unopened chests were used. The influence of cardiac contraction upon the coronary flow was studied during the cardiac arrest, ventricular fibrillation and cardiac weakness. A sudden cardiac arrest tended to reduce the coronary flow, while the ventricular fibrillation augmented the coronary flow. If the cardiac beat was weak enough to produce no systemic blood pressure, no coronary flow occurred. When the myocardial contractility was strong enough to produce systemic blood pressure, the coronary flow appeared. The stronger the cardiac beat, the larger the coronary flow. The increase in coronary flow associated with myocardial activity indicated that the volume of blood passing through the vascular bed of myocardium was augmented by increased force of the heart-beat. With regard to the phasic change in the coronary flow, the ventricular contraction impeded coronary flow and the diastole acted in aid of the flow.

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The authors describe a patient who may be taken to represent a man with abnormally hyperactive "pressor reflex" in response to the distension of the bladder in spite of the absence of gross injury to the spinal cord. His blood pressure rose by 45/25 mmHg in response to the physiological and slow artificial distension of the bladder. Besides this peculiarity, this patient had urographic evidences of the bilateral hydronephrosis presumably complicated with chronic pyelonephritis, and hypertension possibly through this renal mechanism and possibly O'conor type hypertension.

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According to the Maekawa's theory of the electrocardiogram (1944) the integrated monophasic action potential of the heart muscle is to be proportional to its mechanical work. The aim of this study is to investigate this theory in the excised perfusate toad heart in the Starling's law of the heart.Method : For realizing the Starling's law in exercised toad heart a venous reservoir and a peripheral resistance were connected to its inflow side and outflow side respectively. In this experiment only the inflow load was changed and the outflow load was fixed at 25 mm. of water above the inflow level. And the tachography was made by the specially designed recording system in order to show the relation between the inflow and the outflow. The integrated monophasic action potential was obtained by means of the electriacl integrator circuit and the modified Wigger's suction electrode.Results : The Starling's law of the heart holds in the perfusated toad heart at the inflow pressure ranging from slightly above 0 mm. to 30 mm. of water. And the amplitude of the integrated monophasic action potential (E) were proportionally increased with the output at the inflow pressure ranging from slightly above 0 mm. to 10 mm. of water, but decreased at the inflow pressure above this in spite of the increase of the output. This is becase the heart is sufficiency dilated to realize the law of 1/R² where R is the radius of the heart cavity assumed as a cube. So the radii were calculated from experimental data and ER² obtained. Then the values show the direct proportion to the output as in the case of the Starling's law of the heart.From these results, confined the Maekawa's theory of the heart contraction which denotes I=αM. I=∫E·dt E : action potential in monophasic Form M : mechanical work.

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Histological survey was conducted on the innervation of coronary arteries, with special reference to the afferent endings of the depressor reflex arising from the vicinity of bifurcation of the left coronary artery into the anterior descending branch and the circumflex branch.Method : Specimens were obtained from adult dogs. A modified Bielschowsky's silver stain was adopted.Results : 1) Rather thick nervous fibers were always found in a special locality in the adventitia and/or the media of the left coronary artery, in the vicinity of bifurcation into the anterior descending branch and the circumflex branch.These thich nervous fibers arborized abruptly into thin fibers which terminated finally in the muscular layer with free endinfis forming a ring, a brush, a nodule and so on.The structure of this ending was quite similar to those of the sinus nerve and the aortic nerve. On dissecting the vagi distally from the nodal ganglia, degenerative changes were always found in some parts of these thich nervous fibers in the left coronary artery.2) This and fine nervous fibers apparently forming networks were found within thin layers of connective tissue in the media of the proximal trunk of the left coronary artery. This sort of nervous structure was hardly found in the portion of coronary artery distal from the bifurcation. However, similar findings were observed in the aortic wall as well Discussion : It is suggested by these histological findings that the endings of the thick nervous fibers in the vicinity of bifurcation of the left coronary artery represent the afferent nerve coming through vagi. The physiological data which we reported previously suggest strongly that this is a barorecepcor of the depressor reflex which arises from the left coronary artery, especially in view of its localization.The possibility, that this ending conducts the sensation of pain, is unlikely, because it comes through vagi and not sympathetic pathway.As for the function of the network consisting of thin and fine nervous fibers in the proximal portion of the left coronary trunk, we might suggest a role as an afferect ending, because this network was localized in the connective tissue layer in the media, and not in muscle itself. Its exact function is not yet fully understood. In view of the presence of similar structures in the aorta, we would like to assume that this ending might represent another type of baroreceptor which consists of poorly myelinated or unmyelinated nervous fibers. The possibility that certain poorly myelinated or unmyelinated fibers play the role of afferent pathway was already suggested by one of our co-workers and others.Endings of poorly myelinated or unmyelinated nervous fibers should further be investigated in the future, especially in the peripheral parts of coronary, arteries, capillaries and heart muscles.Conclusion : 1) The afferent nervous endings which consist of rather thick nervous fibers and come through vagi, were found in the vicinity of bifurcation of the left coronary artery. These appear to represent baroreceptors of the depressor reflex arising from the left coronary artery which had been found by our physiological experiments.2) The nervous networks which consist of thin and fine nervous fibers were found in the proximal portion of the left coronary trunk. These are presumed to be another type of baroreceptors.

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Many studies have recentry been carried out on changes in the chemical structure of arterial tissues. However, almost all of these studies hitherto concerned themselves with lipids, whereas but few treated the aspect of protein, the presence of which is now known to be much more important than that of lipids for the arteriosclerotic changes in the arterial tissues.The present author therefore aims at investigating the changes in the water-soluble proteins of aortic tissues with special reference to the effect of the diet protein upon them. Methods : A lanolin : cotton seed oil mixture was administered to rabbits fed 250 cal. daily each, on different diets viz. the standard, high-protein and low-protein diets, of which the protein content being 11.2gm., 21.9gm. and 3.0gm., respectively.In order to acquire a sufficient concentration of protein solution neccessary for electrophoresis, every 5 rabbits fed the same diet were sacrificed to take out the thoracic aorta for preparing one sample of aortic tissue material. The aortic tissues were homogenized with a waring blender, after their adventitiae were removed. They were homogized again following the freezing and thawing treatment, at a constant speed of 14, 000 r.p.m. for 30 min. till the supernatant became clear, by means of refrigerated centrifuge.The final supernatant was then dialyzed for 18-24 hrs. after 0.144 M. veronal buffer was added to adjust its pH to 8.45 (μ=0.144), and the electrophoresis was performed. The relative percentage composition was calculated by the gravity method using ascending pattern and mobility, by the delta peak. The aortic arch was used as the human aorta meterial and this was then treated with the same procedures as the rabbit aorta material. For the electrophoresis of rabbit serum protein, the same buffer was used and the calculations were done by using the descending patterns. Results : The normal electrophoretic pattern of the water-soluble protein of rabbit aortic tissues consisted of 4 peaks, which were nominated as fractions a, b, c and d, according to their mobilities in the decreasing order.The relative percentage composition ratios were a, 6.1±2.35%, b, 26.0±3.09%, c, 16.3±4.07%, d, 51.6±4.45% and the mobilities (10^-5cm²/volt.sec.) were a, 12.63±2.869, b, 9.11±1.895, c, 6.15±1.497 and d, 3.53±0.944.Following the lipid administration to rabbits fed the standard diet, an increase in the relative percentage composition of c, and decrease in d were noted, when the atheromatous plaques made its appearance. These changes became more apparent in the phase of high degree atheroma formation, when the fraction c was increased up to 2.4 times, while d decreased down to 1/2 of the control.The high-protein diet fed and lipid-administered group showed similar changes in the fractions of intraaortic water-soluble protein, which, however, were relatively milder electrophoretically in comparison with the control group, although no significant difference was noticed in the atheromatous lesions between the two groups.On the other hand, the low-protein diet fed and lipid administered rabbits showed, early in the pre-hyperlipemic phase, the similar changes in the electrophoretic pattern, that were as marked as those observed after the development of macroscopic atheroma in the control.Following the lipid administration, albumin decreased and β-globulin increased as blood cholesterol as elevated in the rabbit sera of either of the three groups ; among them, fluctuations were the least remarkable in the high protein group.The electrophoretic pattern of the water-soluble protein of human aorta consisted of 6 peaks, which were nominated, according to their mobilities as fractions I, II, III, IV, V, and VI. [the rest omitted]

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Concerning the intimate relation between the heart and liver, the hepatic damage which occur due to congestive heart failure is well known. However, systematic studies concerning the influence of hepatic disease on heart, especially the myocardium, has been scarce.The liver is an important center of body metabolism. On the other hand, as studies on cardiac metabolism progressed, it was found that damage to the myocardium could be brought about by various metabolic abnormalities of the body.An example of this is the non-inflamatory myocardial damage caused by disturbances in metabolism, seen for instance in hepatic disease, which F. Wuhrmann called "Myokardose". In liver disease he felt that the cause was primarily dysproteinemia. However, in his study, the relation between serum proteins and electrocardiographic findings was not investigated thoroughly.In the present study, changes in the serum protein and electrocardiographic findings of patients with hepatic disease, most prone to cause disturbances in serum protein metabolism, were carefully analysed and the relation between the two was made clear. Materials and Methods : A total of 117 cases were studies, including 31 cases of acute hepatitis, 22 cases of chronic hepatitis, 59 cases of hepatic cirrhosis and 5 cases of hepatic coma due to fulminating hepatitis, which were hospitalized in our department of internal medicine. Patients with histories of cardiovascular diseases were excluded.Various serum colloidal reactions, serum protein fractionation by a salting out method and 12 lead electrocardiograms were done on all cases. Results and Conclusion : ❲1❳ Serum Protein Fractions and Serum Colloidal Reactions in Hepatic Disease In general, the total protein (TP) tends to decrease, but the decrease is often covered by an increase of γ-globulin (γ-GL). Decrease of albumin (AL) and increase of globulin (GL), especially γ-GL, were seen in most cases, and this tendency was stronger as the disease was more severe. The tendency was especially prominent in hepatic cirrhosis and hepatic coma. α- and β-globulins were usually within the normal range. (Fig. 1∼12)The serum colloidal reactions in most cases of acute and chronic hepatitis were (+)∼(〓), and in hepatic cirrhosis and hepatic coma(〓)∼(△).As for the relation between serum colloidal reaction and serum protein fractions, the decrease of AL and increase of GL or especially γ-GL, which means the decrease of A/G and A/γ, correlated well with the positivity of all colloidal reactions. The decrease of TP correlated with Gross and Takata reactions.Thus, the principal factors of serum protein changes in hepatic disease are the decrease of AL, increase of γ-GL and decreases of A/G and A/γ. When the various degrees of this dysproteinemia is indicated by the scale (+)∼(△), most cases of acute and chronic hepatitis showed (〓) changes, while cases of hepatic cirrhosis and hepatic coma generally showed (〓)∼(△) changes. (Tab. 4)The prognosis of hepatic disease correlated best with decreases of A/G and A/γ, the severer the case the lower were the values. But when the degree of abnormality was studied in terms of protein-curves (Fig. 23), the A/γ was more sensitive than A/G. Especially, the A/γ was better in determining the prognosis of hepatic cirrhosis.❲2❳ Electrocardiographic Findings in Hepatic Diseases Frequently encountered changes were ; low voltage R (16.2%), low T (46.1%), depressed ST (31.6%) and prolonged QT (40.1%). To these, atrial fibrillation, prolonged PQ and bundle branch block can be added, and these may be considered collectively as the 7 principal findings. (Tab. [the rest omitted]

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It is clinically worth- while to study the regulatory mechanisms and their limits in reference to systematic circulation and respiration in patients with cardiovascular disease, pulmonary disease and anemiam whose conditions are compensated. Studies with this aim, using the acute anoxia test of Levy (1939) with venous catheterization have been done by Motley (1947) and others. However, the reported studies were done under various different conditions, and the diseases studied, in most cases, were limited to pulmonary tuberculosis, mitral stenosis and congenital heart diseases. Hypertension, anemia and liver diseases have not been studied previously.Professor Hara has been engaged in the pathophisiological study of hypoxemia since his report on the Manchurian myocardial degeneration in 1936. And since 1954 our department undertook the study of visceral circulation (heart, brain, liver and kidney) by the combined use of the induced hypoxia test and venous catheterization.The present paper deals with the influence of oxygen want on the cardio-respiratory hemodynamicsin various diseases, but especially in patients with hypertension and anemia.Materials and Methods : The cases studied totaled 74 (62 males and 12 females) and include 8 healthy controls (Group A), 10 cases of liver diseases (Group B), 8 cases of anemia (Group C), 7 cases of cardiovascular diseases (Group D), 18 cases of hypertension (Group E) and 23 cases of pulmonary tuberculosis (Group F). Cases in groups D and F were those scheduled for surgery, and the examination was done to test the patient's ability to withstand the surgery and also as an aid to diagnosis.The pulmonary and cardiac state of patients was compensated during bed rest and they were considered to be in a steady state before and during the examination. Several cases which complained of severe subjective symptoms or went into shock within a few minutes after beginning the test were excluded. The examinations were done without narcosis and when the patient's stomach was empty. The venous catheter was induced in the usual way. Various values of ventilation, circulation and blood gas were measured before and 20 minutes after 10 percent oxygen breathing.Mean and standard deviation of values and percentage changes obtained before and after hypoxemia were calculated in each group studied. Data were analysed in three ways as shown in Table II and differences between two factors were examined by the "Student's t-distribution " (Tab. I-V).Results Obtained : 1) Considerations on use of the values obtained after 20 minutes low oxygen administration.In the study of cardiac and pulmonary hemodynamics in hypoxemia, Fishman and Yu stressed the importance of a "steady state". However, others administered low oxygen for only 6-13 minutes in many cases, and considerations on this point appear to be lacking. In the present study, oxygen consumption and cardiac output were determined in cases picked at random, twice before and every five minutes during hypoxemia. The results showed that the method used placed subjects in a steady state and that the values after 20 minutes of hypoxemia should be used as the value for hypoxemia.2) Ventilation; especially the inspiratory oxygen supply to the lung.All groups showed approximately normal ventilation values when breathing room air. During administration of low percentage oxygen, all groups responded by increasing the minute ventilation volume by 40-60 percent. This was achieved in groups B and C by increases in ventilation rate ; in group A by an increase of ventilation volume and in group F by increasesin both factors. However the inspiratory oxygen supply (oxygen concentration of inspired air × minute ventilation volume decreased by 23-33 percent. Pulmonary oxygen uptake also decreased. (Figs. 2, 3, 10, 12) 3) Hemodynamics; especially the arterial oxygen availability (oxygen supply to the tissue). [the rest omitted]

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