Much progress has been made on the respiratory function test, on which difficulties to procedure are still encountered on some cases. If an easier and better-tolerable test is available, that will be of great importance to the diagnosis. Since Hurtado and Fray introduced the idea of "Radiotogical Chest Volume", Kovach and Rushing found the fact chiefly in normal test subjects that the radiological chest volume had a high degrees correlation with the observed ventilatory volume, though clinical evaluation of the method has not sufficiently appreciated. Then the purpose of this study was to define diagnostic evaluation of the radiometrical method of lung field area as measured on the chest X-ray films in three phases of respiration referring to the pulmonary ventilatory function tests. Materials and Methods The subjects involved in this study were divided into three groups. Group A was consisted 132 of healthy adults whose ages ranged seventeen to thirty-nine years. Group B was consisted 41 of the aged, ages ranged sixty-nine to seventy-five years, and group C was 27 of the patients with chronic pulmonary emphysema. The radiometrical chest volume was calculated by planiometric measurement on X-ray films taken from all of these subjects in the circumstanced with respirometer. On two sorts of directions (i. e. postero-anterior and lateral views) and in three sorts of respiratory phases (i. e. natural exspiration, maximum inspiration and maximum exspiration). The X-ray conditions on postero-anterior views were set as follows ; two meters in distance, 2D + 30kVp, where D is the thickness of chest wall, in secondary voltage, Moe in current, and 0.05 seconds in exposure time. In addition the movement of diaphragma and chest wall was investigated to the consideration at the same. Then usual pulmonary ventilatory function test and oximetric rebreath test were performed to the check, latter of which was originated in my clinic. Ear-oximeter (Erma W-IV type) and Scholanders gas-analyser apparatus were also employed to the purpose.

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Recently, the hepatic circulation in hemorrhagic shock has been investigated by HEINEMANN, BRADLEY, SELKURT, FRANK and others. However, the opinions among the authors have not yet been in agreement but rather controversial, par icularly, as to the relationship between hepatic blood flow and cardiac output. HEINEMANN reported that hepatic blood flow fell sharply following hemorrhage and then returned spontaneously the control level in absence of the restoration of blood pressure. While, the others reported that hepatic blood flow did not recovered and remained in decreased level, having the same trend in blood pressure change. It seems likely that such a controversy will be partly due to the difference of the methods employed in measuring hepatic blood flow and partly to the confusion in recognizing the stage of shock, because the sequence of respective hemodynamic phenomenon is considerably different at the period of observation in this condition. The purpose of the present paper is to classify the relationship of hepatic blood flow and cardiac output throughout the entire course of hemorrhagic shock and its bearing on the irreversibility of shock. Oxygen utilization in the splanchnic viscera was also studied. The Relationship between Hepatic Blood Flow and Cardiac Output 1) Methods : Hepatic blood flow was measured by modified Frank's method. Twenty-two dogs ranging in weight from 8 to 20 kg were used and anesthetized with intravenous pentobarbital sodium of 25 mg/kg. A polyethylene catheter was passed through a right external jugular vein into the hepatic vein and then wedged into one of hepatic lobar veins. The outer end of the catheter in the hepatic vein was fixed at the level of the vena cava and allowed to drain continuously. The rate of hepatic outflow was measured by a graduated cylinder and stop watch. The blood collected was returned by transfer to an elevated burette draining into a left external jugular vein. Heparin (3-5 mg/kg) was given intravenously during the experiments. Cardiac output was calculated from indicator dilution curves according to the STEWART-HAMILTON principle. Two different procedures were used. In one method ³²P labelled red cells were used as an indicator and injected intravenously. Blood samples were collected successively from the femoral artery. In another cases, radio-iodinated serum albumin (RISA) was injected as an indicator. Cardiac output was calculated from radio-cardiograms by using a scintillation detector at the heart region and a rate-meter. 2) Results : We could distinguish the following two stages in hemorrhagic shock in relation to hepatic blood flow and cardiac output. a) The first stage : In the early stage of shock, hepatic blood flow decreases in parallel with the changes in cardiac output. b) The second stage : After same delay from the initial bleeding, hepatic blood flow decreases progressively without marked reduction in cardiac output. Consequently, a difference or "gap" appears in percentile changes of hepatic blood flow and cardiac output. c) Effects of transfusion : Complete recovery of arterial pressure, cardiac output and hepatic blood flow can be obtained by a transfusion performed in the first stage. Whereas, the transfusion made in the second stage give rise only transient recovery of arterial pressure and cardiac output.

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