Metabolism of catechol amines was studied by fluorometric determinations of adrenaline, noradrenaline, dopamine, and dopa in the dog, rat and human hearts. The distribution in cardiac chambers, and biosynthesis and uptake of these amines suggested rather specific metabolism in this organ. Some aspects on uptake-binding-release mechanism of catechol amines was obtained under the pathological conditions, and also by the administration of catechol anines, MAO-inhibitors and reserpine.

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Superprecipitation, ATPase activity of actomyosin, and isometric tension of glycerol-extracted muscle fibers, and also the action of ouabain on these actomyosin preparations were investigated on the skeletal and cardiac, both normal and experimentally failing, muscles of dogs. There were no qualitative differences between skeletal and cardiac muscle actomyosin. Superpercipitation and ATPase activity were depressed in actomyosin prepared from right ventricles compared with that from left ventricles of the dogs with surgically induced right-sided heart failure. Isometric tension-development, on the other hand, was reduced in both ventricles. Low concentrations of ouabain improved superprecipitation, both did not affect ATPase activity. Tension-development was unaffected in a Ca free medium, but in a Ca containing medium, the inhibitory action of 10^-2∼10^-3 M of Ca was eliminated by this concentrations of ouabain. High concentrations, on the other hand, depressed superprecipitation, ATPase activity, and also tension-development. In contrast to low concentrations, high concentrations of ouabain enhanced the inhibitory action of Ca on tension-development. These actions of ouabain in various concentrations were similary observed in all of skeletal, and both normal and failing cardiac muscles.

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The myocardial carbohydrate and non-esterified fatty acid metabolism in the human diabetic heart along with the effect of insulin and the changes of myocardial metabolism induced by the intravenous administration of glucocorticoid and epinephrine were studied by coronary sinus catheterization. In the diabetic heart, there was an unbalance of the supply and demand of oxygen, and disturbances in glucose, lactate, pyruvate and citrate metabolism. The insulin improved the disturbed glucose and citrate metabolism and in some cases the unbalance of the oxygen supply and demand in the myocardium. The myocardial fuel tended to shift from carbohydrate to lipid by the administration of glucocorticoid. The epinephrine also increased the myocardial lipid utilization and at the same time brought about slight myocardial hypoxia. It was proven in another experiment using C¹⁴ labelled substrates in the rat heart slice that the pentose phosphate pathway existed in a fairly large percentage and insulin, epinephrine and glucocorticoid influenced it. Part of the glucose extracted by the myocardium was stored as glycogen and lipid, though this might be temporary.

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The myocardial metabolism of amino acids was observed by the use of the coronary sinus catheterization method, heart-lung preparation and heart muscle homogenate. In the normal dog heart in situ as well as in the heart-lung preparation of normal dog, neither extraction nor release of total amino acid nitrogen was observed and, on the contrary, respective extraction and release were observed as to individual amino acids. With administrating amino acid, individual amino acids were transformed actively each other in the heart muscle. There was, however, the difference of metabolic condition between the administration of glutamic acid and alanine. Based on the result obtained in the normal heart and in the heart undergoing various condition, glutamic acid and gluramine seemed to be the key substances of myocardial amino acid metabolism. The observation on amino acid activating enzyme was also described.

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The S-A and A-V nodes, under strict microscopic identification, and the Purkinje fibers from the false bands of rabbits were examined by electron microscope. The entire cardiac conduction system is cellular in nature ; each cell is completely enclosed by plasma membrane and intimately. connected with the adjacent cells by apposition of their membranes. The plasma membranes bordering on the interstitium are commonly covered by a basement membrane which extends from cell to cell. Where the cell junctions interrupt the myofibrillar axis, dense material is constantly seen ; their structures are occasionally free of any relation to the myofibrils at the cell junctions. The S-A and A-V nodes are characterized by a polyhedral connection of small and irregularly shaped muscle cells, and abundant unmyelinated nerve fibers in the interstitium. Although the myofibrils of the nodal cells appear to be identical in fine structure to those of ordinary cardiac muscle cells, they are very sparse and run in various directions. The nucleus occupies a relatively large part of the small nodal cell. The sarcosomes are scattered throughout the sarcoplasm often without intimate topographic relation to the myofibrils. The smooth-and occasional rough-surfaced profiles of the sarcoplasmic reticulum, circular membrane profiles containing small vesicles and dense bodies often lie in intimate topographic relation with each other. The nerve axons in the vicinity of the nodal cells contain small vesicles and small mitochondria as in the presynaptic nerve axons. No specific neuromuscular junction, however, could be observed. Occasionally axons contain additional small dense granules (0.05-0.1μ) enclosed by a single membrane. Although the Purkinje cells appear to be rather similar to ordinary cardiac muscle cells, their sarcolemma indentated more irregularly, the myofibrils are relatively scanty, the mitochondria are considerably smaller and often aggregate in the wide perinuclear or subsarcolemmic sarcoplasm, and small dense granules may occur more frequently in the sarcoplasm following lead hydroxide staining. In the interstitium of the purkinje tissue, nerve fibers are rather sparse.

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The clinical application of digitals has been established as a cardiotonica since Withering first used it. Concerning it's action mechanism, however, the pattern of muscle contraction advocated by Szent Gyorgi showed us the direction of research on the correlation between the contraction and energy metabolism behind the contraction. According to Wollenberger, digitals administration increases cardiac efficiency. Szent Gyorgi and Ellis stated the important role of K ion on the utilization of chemical energy, i. e. mainly esterification of phosphate. Callorn and Harrison et al reported the decrease of K content in myocardium by digitalis administration. There are also numbers of reports on the specific changes of ECG prtterns by digitalis administration. The density and movement of K ion inside and outside the cells give the theoretical background on the interpretation of resting potential and action potential of excited tissue cells. The clinical application of this interpretation is explained as "New membrane theory" in electrocardiology. However, the movement of K and Na ions is also considered to be the secondary expression of exciting phenomenon. "Chain-doublte's theory" by Prof. Maekawa who saught the electric charge or excitement in the cell parenchym is one of the prominent parenchymal theories in electrocardiology. The action of digitalis on myocardial K and Na as well as ECG is a specific one. To verify this action mechanism the author, by using the toad heart, made a comparative study on the changes on Na and K ions by digitalis. That is to say, the excised toad heart was perfused by Straub's tube method or modified Yagi's method with the solution of 10^-6 and 10^-8 g/cc digitalis concentration.

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Authors recorded a case of continued tachycardia accompanied by exsudative pleuropericarditis in 23 aged woman here. The patient showed tachycardia with 3 years duration after the onset though effusions were already absorbed and vital signs were of benign inclination, leading ordinary daylife thereafter.

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A case of sudden thrombosis or embolism of the right plantar arteries with resultant gangrenes of the digits occuring amidst an attack of an acute myocardial infarction in a 56 year old male patient which has uncommonly been encountered in Japan is reported here.

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