Recently, the relationships between cerebral blood flow and pulmonary function have become an important clinical interest. The partial pressure of carbon dioxide and oxygen in arterial blood influences on cerebral hemodynamics. The cerebral blood flow and metabolism were measured by N₂O technics in patients with chronic pulmonary disease, and their ventilatory function tests were also performed at the same period. The results obtained in this investigation showed slightly increased cerebral blood flow in patients with chronic pulmonary disease, although clear correlationships between cerebral blood flow and the severity of ventilatory dysfunction expressed by spirogram were not demonstrated.

View full abstract

The measurement of blood flow by ultrasonic Doppler technique is very unique compared with other technique, although the method has still been controversial from the various points of view. The characteristics of this method are as follows. (1) The cerebral circulation and cerebral arteriosclerosis are objectively and simply evaluated based on the Doppler beat patterns. (2) The dynamic change of the blood flow at the objective vessel resulting from the various stresses to circulatory system can be observed instantaneously without any surgical procedure. In this study, the application of this method to the measurement of cerebral venous return (blood flow in internal jugular vein) in several diseases was presented.

View full abstract

The dynamic change of cerebral circulation in patients with hypertensive encephalopathy in young and old men, and of patients with cerebral vascular insufficiency in mild and severe cerebral arteriosclerosis were investigated by ultrasonic Doppler technique. The pathogenesis of these entities are discussed.

View full abstract

Extensive investigations over the last 20 years have made it clear that the origin of ischemic heart disease (angina pectoris, ischemic myocardial necroses and fibroses, congestive heart failure) cannot be attributed to coronary vascular lesions alone. Augmentations of myocardial oxygen consumption under the dominating influence of the adreno-sympathogenic catecholamines, norepinephrine and epinephrine, contribute fundamentally to the metabolic vulnerability of the heart muscle. Discrepancies between limitations of compensatory coronary oxygen supply and catecholamine-induced incrcases of myocardial oxygen consumption lead to local anoxia and structural damage, especially in the vascularly handicapped left ventricular subendocardium. Over-civilized, prosperous, competitive, and sedentary living causes a detrimental sympathetic adrenergic preponderance in myocardial metabolism, both by emotional direct sympathetic stimulation and by a deterioration of antiadrenergic (vagal and sympathoinhibitory) counter-regulation, which results from lack of physical exercise. Nicotine contributes further to harmful catecholamine discharges. Emotion-induced overproduction of adrenal 17-hydro-xycorticoids may provide an additional aggravating factor. Objective criteria for the early recognition of cardiac ischemia-proneness, and preventive measures to avoid coronary atherosclerosis as well as neurogenic myocardial metabolic vulnerability are briefly discussed. The striking contrast between the incidence of ischemic heart disease in Japan and some Western countries deserves a systematic investigation concerning possibly co-responsible neurogenic and hormonal, emotional and physical activity factors beside the well-known dietary differences.

View full abstract

Recently, we have experienced a case of juvenile myocardial infarction associated with Adams-Stokes syndrome. Since it is a rare occurence, we like to report the case and discuss the cause which seemed to be due to rheumatic coronary arteritis. A 17-year-old high school girl entered to the Kobe Central Municipal Hospital on September 26th, 1961 because of recurring dizziness and convulsions. On September 22nd, four days before the admission, the patient developed a sore throat and hoarseness of her voice accompanied by a fever of 39°C. The temperature became normal in the morning of 24th after she took some antipyretic medication together with antibiotics. However, the fever reappeared in the evening and continued thereafter. In the morning of 26th, on the admitting day, the patient suddenly developed some uneasiness in her anterior chest soon after she arose. Later on she developed nausea and vomiting and her extremities became clammy. She complained of recurring dizziness and she finally developed convulsions. Upon the entry to the hospital, she was found to be in shocklike state. Her pulse was regular with a rate of 50. Her blood pressure was 102/72 mmHg. Her left tonsil was slightly enlarged and was coated by numerous whitish material of pin-point size. There was neither an enlargement of the heart nor the abnormal heart sounds. Lungs were clear to percussion and auscultation. No organs or masses found in the abdomen. A neurological examination revealed only slightly increased deep tendon reflexes but equal on both sides. There were no pathological reflexes. Upon admitting her to her room, the patient suddenly developed a dizziness and convulsion. During this attack, the pulse was not palpable for about 15 seconds. After an immediate administration of Dihydroxypeopyltheophyllin 0.3g intramuscularly, the patient was kept under an absolute bed rest. Unfortunately, no electrocardiogram was taken during this seizure. She complained of mild chest discomfort for all day. An electrocardiogram on admission, shortly before the seizure, showed a complete A-V block with a rate of 50 per minute. There was right axis deviation and the electrical position of the heart to be vertical. There was also R. B. B. B. The R wave in leads I, aVL and precordial leads from V₂ throughout V₆ was somewhat low in amplitude. There were some ST elevations in V₂ and V₃. The second tracing taken 12 hours after the seizure revealed an essentially the same rate, but it now showed left axis deviation and horizontal position of the heart. The procordial leads appeared to be all QS pattern, but a careful examination revealed a small r wave in V₁ throughout V₆. Leads II, III and aVF demonstrated rS pattern with ST elevations. On September 27th, the 2nd hospital day, another tracing was taken which demonstrated a complete A-V block. The QRS configurations in leads II, III, aVF and V₁ through V₄ were now QS pattern seemed indicating the presence of L. B. B. B.

View full abstract