"Circular deviation ", the particular fluctuation of urea clearance following abrupt change of urine flow was observed in normal adults. This phenomenon was ascertained also in patients with diabetes insipidus by the administration of pitressin. The circular deviation in patients with renal, diseases showed an atypical pattern. These resuls were discussed from the viewpoint of countercurrent hypothesis.

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Plasma lipid lowering effect of highly unsaturated fatty acids which are contained particularly in large amounts in fish oil has been well documented. Japan Is one of the few countries where fish consumption is exceptionally high, and it was speculated that high fish consumption was one of the major factors in the low incidence of atherosclerotic disease in Japan. This paper describes the general pattern of depot fatty acids of inhabitants of Toyama Prefecture after examination of 210 cases with particular attention paid to the content of highly unsaturated fatty acids.

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Plasma lipid level and body build have been discussed repeatedly in relation to atherogenesis. Known studies leave little doubt that atherosclerotic disease is more common in obese subject and most cases of coronary heart disease are associated with elevated plasma lipid levels. There have been, however, different opinions on the relation between bulkiness or adiposity and plasma lipid levels. In the present study, plasma lipid levels of 195 males between 45 and 55 years of age and were uniform in all respects were examined. The results were statistically analyzed in relation to bulkiness of the body as expressed by relative weight.

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This paper described a case of 44-year-old premenstrual woman who had a feature of variant form of angina pectoris that could be induced, with typical ST segment elevation and chest pain, by various procedures exercise. In addition, quadruple rhythm developed during attacks, and her anginal pain increased in frequency and intensity in premenstrual periods.

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Many reports have been published on the morphology of the electrocardiographic patterns in chronic cor pulmonale, but no available report has been described for the spatial characteristics of the ventricular vectors in chronic cor pulmonale as determined by the orthogonal systems. This study was intended to investigate the spatial changes of the electromotive forces of the heart and to clarify the process how the typical patterns of the right ventricular overloading fully developed in chronic pulmonary diseases. 190 cases with chronic pulmonary diseases were classified in 3 groups as shown in table 3. Group I (84 cases) : normal in pulmonary functions as well as cardiovascular examinations. Group II (66 cases) : pulmonary functions were moderately impaired. Group III (40 cases): pulmonary functions were severely impaired. Vectorcardio-graphic scalar electrocardiograms of the orthogonal systems(FRANK and SVEC-III) and of the cube systems(GRISHMAN and KIMURA)as well as the standard 1 2 leads electrocardiograms were recorded in all cases. Ventricular electromotive forces were expressed as azimuth, elevation, magnitude of mean QRS and T vectors and QRS-T angle using SIMONSON'S Vector analyzer. The results obtained were as follows : I . Electrocardiographic criteria for the diagnosis of the right ventricular hypertrophy proposed by various authors were evaluated concerning their positivities as well as false positivities. SOKOLOW'S criteria showed high incidence of false positivity (32%) in Group I, and MILNOR'S criteria showed low incidence of positivity (2.5 %) in Group III. MORI's criteria appeared to be most useful clinically among these criteria, because it had low false positivity (3.5 %) and high positivity (20%). 2 Electrocardiographic pentalogy of pulmonary emphysema proposed by WASSERBURGER were corrected quantitatively near the normal limits as shown in table 5. These corrected pentalogy and other electrocardiographic findings, which were occasionally en-countered in pulmonary emphyserna, were also examined concerning their positivities as well as false positivities as shown in table 6. It was shown that MACRUZ'S index was not adequate for clinical use because it yielded high incidence of false positivity (16.7 %). 3. Vector analysis of these subjects indicated that the characteristic changes of the spatial ventricular vectors in the right ventricular overloading due to pulmonary ventilatory impairement were marked decrease in azimuth and elevation of QRS and T vectors and decrease in magnitude of T vector.

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Twenty patients, 14 males and 6 females, 18 with chronic renal failure, 14 from chronic glomerulonephrities and 4 from nephrosclerosis, and 2 with chronic glomerulonephrities, were treated with low protein diet and regular insulin administration. The low protein diet used contained essential amino acids in quantities larger than the minimum requirement of amino acids as reported by the Food and Agriculture Organization Committee (F.A.O.). 1) In patients with a GFR of 20.1 to 30.0 % of normal, serum non-protein nitrogen and serum urea nitrogen decreased to normal and maintained a normal level under low protein diets of 0.4 to 0.6 g/day/kg body weight. 2) Patients with chronic renal failure with a GFR of under 30% of normal value revealed azotemia under protein intake of more than 0.8 g/day/kg body weight. 3) Five patients with chronic renal failure revealed increased or unchanged serum non-protein nitrogen and serum urea nitrogen, and an increased serum amino acids solution (3% ES. Politamin R), but unchanged or in some cases decreased serum non-protein nitrogen and serum urea nitrogen, and decreased serum amino nitrogen in all cases when 10 units of regular insulin was added to the amino acids solution. 4) Three out of four patients with chronic renal failure revealed decreased serum non-protein nitrogen, serum urea nitrogen and serum potassium level with a decreased urinary total nitrogen and urea nitrogen output after daily intravenous infusion of 500ml of 5% glucose solution with 10 units of regular insulin over a 5 hour period for 20 days. 5) Patients under low protein diets of 0.4 to 0.6g/day/kg body weight revealed decreased serum non-protein nitrogen and serum urea nitrogen level, and decreased urinary total nitrogen and urea nitrogen output, in almost all cases after daily intramuscular administration of 10 units of regular insulin for 20 days. Hyperpotassemic patients revealed decrease in serum potassium level.

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Studies on the phonocardiogram in hypertension and coronary insufficiency already have been reported by many authors. It seems, however, that only a few works have been reported on the phonocardiographic response to exercise test. The author assumed that the phonocardiogram should be affected by the changes in dynamics of circulation due to exercise test. Therefore, this study was undertaken in an attempt to record phonocardiographically the reaction of cardiac muscle which occurred with exercise in these diseases and to obtain findings useful for anticipation of their prognosis. For this purpose, phonocardiographic observation were performed before and after exercise test. (1) Clinical studies on the phonocardiographic response to exercise test Methods : Coronary insufficiency 41 (first group), hypertension complicated with arterioscrelosis 48 (second group), essential hypertension 19 (third group), hyperthyroidism 16 (fourth group), normal control 17 (fifth group). These five groups of subjects were observed. These subjects performed exercises consisting of streching and bending the extremities in a supine position 60 times per minute for 5 minutes. Blood pressure, phonocardiogram simultaneously with electrocardiogram, amplitude of first heart sound and second heart sound Q-I interval, I-II interval, II-I interval, and Q-II interval were recorded immediately and, at 2-, 4-, 6- and 10 minutes after exercise. On the subjects of the first and second components where the first heart sound could be distinctly recognized, the first and second components were called respectively as I_A and I_M and intervals from Q-wave of electrocardiogram were recorded as Q-I_M interval and Q-I_A interval.

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