Master's double "2-step" tests were performed on normal subjects, patients with neurocirculatory asthenia, other neuroses and closely related diseases, and patients with definite coronary artery diseases. In spite of the absence of coronary artery diseases, the "positive" tests were frequently encountered in patients with neurocirculatory asthenia, other neuroses and closely related diseases, and their exercise responses were similar to those in patients with coronary artery disease.

抄録全体を表示

Correlations between the observed exercise responses and the underlying distribution of myelographically suggested subclinical adhesive arachnoiditis were investigated to clarify the possible effect of the spinal sympathetic nervous system on the exercise responses. The most prominent finding concerned the chronotropic effect ; namely, the subarachnoid adhesions occurred with high frequency between D₃ and D₆ vertebra in the ventral aspect of the spinal cord characteristically in association with excessive cardioacceleration after exercise.

抄録全体を表示

A brain stem injury was produced in dog by injection of Indian ink, blood or Metaacryl-ethyl-ester into the pons or the medulla. The cerebral circulation and metabolism were investigated by N₂O method in acute and chronic stages of the injury. In the acute stage, cerebral blood flow was reduced significantly in the majority of cases due to vasomotor reflex and local organic changes. With this and respiratory disturbance, cerabral gas and glucose metabolism were impaired remarkably. In the chronic stage, the disturbance of cerebral circulation remained in the similar degree to the acute stage due probably to progressive organic changes, whereas the metabolism revealed some improvement because of the better respiratory condition. Observations were also made from clinical and pathological aspect, but no significant relations were disclosed between these findings and cerebral hemodynamics.

抄録全体を表示

An unusual case of Adams-Stokes attack was reported. Several attacks of transient ventricular fibrillation were observed in a 13-year-old girl with apparently otherwise normal heart, during suspected influenzal infection. Procaine amide was dramatically effective in the present case.

抄録全体を表示

Experimental studies on the coronary circulation in the past have been done mostly on open-chest animals, isolated hearts, or heart-lung preparations. An investigation of hemodynamic changes electrocardiographically under such unphysiological conditions is open to criticism.In order to study the direct effects of drugs on the coronary vessels and the electrocardiographic changes under physiological conditions, the author introduced a catheter via the carotid artery into the left caronary artery in the closed-chest dog under the fluoroscopic control. Various drugs were infused directly into the coronary artery during continuous coronary artery perfusion with the dog's own femoral arterial blood through the catheter.In Part I, as a control experiment, the effects of different concentrations of glucose solution, and different rate of infusion on the coronary vessels were examined ; this was because glucose solution was used to dilute various drugs in this series of experiments.Method As shown in Fig. 1 a catheter was introduced into the left coronary artery in the closed-chest dog under the fluoroscopic control. Through the catheter the left coronary artery was perfused with the dog's own arterial blood conveyed from the femoral artery via a drip counter. Coronary blood flow was measured by the drip counter and blood pressure by the Hamilton manometer. Leads CψD and Cψs were mostly used in taking electrocardiograms.Results(1) Influence of different rates of infusion(a) When 2 cc of glucose solution was infused over 45 seconds at the same time with the whole blood, coronary blood flow increased, and the electrocardiogram showed depression of the S-T segment as weel as of the T wave.(b) When 2 cc of glucose solution was infused over 90, 120, or 180 seconds at the same time with the whole blood, there was little significant change in either coronary blood flow or the electrocardiogram.(2) Influence of concentration (a) When 5 % glucose solution was used, neither coronary blood flow nor the electrocardiogram revealed any significant change.(b) When 10 % glucose solution was used, the coronary blood flow and the electrocardiogram showed a little changes.Conclusions (1) Details of the author's experiments on the coronary circulation through the coronary artery catheterization in the closed-chest dog were presented and discussed.(2) As a control expetiment, the influences of the rate of glucose infusion and concentration of glucose solution were studied. It was found that the coronary blood flow and the electrocardiogram showed no significant changes when a fixed amount of glucose solution was infused at the same time with the whole blood, over a period of 90 seconds or more.The difference in concentration of glucose solusion between 5% and 10% had scarecely any effect.

抄録全体を表示

Part 1 The Effects of The Sympathetic Nerve Stimulation.It has been reported by Maekawa, at the Symposium on "Angina pectoris", the 20th Annual Meeting of Japanese Circulation Society in 1956, that the angina pectoris vasomotorica which is universally accepted to be a functional coronary insufficiency could be caused neurogenically, and its mechanism may be sympathetic in origin. The diagnosis of such neurogenic angina pectoris depends clinically only on the observable change in electrocardiographic pattern i. e., the depression of ST segments and T waves. Do such changes of electrocardiographic pattern indicate a lack of oxygen in the myocardium due to the contraction of the coronary arteries, or a relative lack of oxygen in the myocardium due to increased cardiac work in spite of the dilatation of the coronary artery by the sympathetic nerve excitement ? In order to probe this problem, the author has performed experiments on dogs whose ganglion stellatum and subclavian loop were stimulated electrically. Electrocardiogram, blood pressure and coronary blood flow etc. were recorded simultaneously to study their changes ; thus it was aimed to clarify the patho-physiology responsible for the appearance of the electrocardiographic pattern of coronary insufficiency.Method Normal dogs ranging in weight from 10 to 15 kg. were used. Cononary blood flow was measured by means of catheterization of the coronary artery with the Cournand's catheter which was inserted into the left coronary artery via the left carotid artery. The coronary artery was perfused under the constant pressure with the reserved blood and the amount of the perfused blood was measured with and electromagnetic flowmeter.Electrocardiograms were recorded with the right chest lead, left chest lead and esophageal lead. Arterial pressure was measured in the left femoral artery by means of an electromanometer. The diagram of experimental arrangements is shown in Fig. 1.Conclusion 1) Sympathetic nerve stimulation resulted always in an elevation of blood pressure and an increase of pules rate. (Fig. 14, 15)2) Sympathetic nerve stimulation tended to decrease coronary blood flow at the initial stage and increase it at later stage. (Fig. 13) For example, the directional change in coronary blood flow immediately after the stimulation was : increase in 4, no change in 7 and a decrease in 5 cases. One minute after the cessation, the observed change was : increase in 9, no change in 4 and a decrease in 3 cases. However, since the influence of the heart contractility and pulse rate etc. can not be excluded from the observed effect, it is not certain whether or not the observed results indicate true behaviors of the coronary artery.3) Sympathetic nerve stimulation caused electrocardiographic changes in ST and T. The produced pattern consisted mainly of ST depression and T inversion, but sometimes of ST elevation and an increased amplitude of T waves. (Table 1)4) The coronary insufficiency pattern of the electrocardiogram which appeared after the sympathetic nerve stimulation was not caused by the change in the coronary blood flow of cardiac work. This would suggest that the sympathetic stimulation exerts a direct action on the myocardium.Part 2 The Effects of The Sympathomimetic substances.Although there have been many studies regarding the actions of epinephrine and norepinephrine, which are sympathomimetic substances, on the coronary vessels, there is still no definitive interpretation about their effect, for there are two defferent theories ; the one insists that the coronary vessels are contracted by epinephrine or norepinephrine and the other insists that the coronary vessels are dilated. [the rest omitted]

抄録全体を表示