1 . Left and right ventricular hypertrophy were produced by aortic and main pulmonary arterial constriction, respectively, in male rabbits. 2. The measurement of ventricular weight and fiber diameter revealed significant signs of hypertrophy which could be regarded as of physiologic type. 3. Transmembrane resting and action potentials obtained from hypertrophied ventricular muscle cells were not significantly different from, and furthermore, were nearly equal to, that obtained from control cells. 4. An increase in solid angle subtended by hypertrophied cells to the recording electrode was offered as a main voltage increasing factor in ECG, because of the unchanged dipole density on the boundary surface whether muscle cells were hypertrophied or not. 5. The view was proposed that the conduction delay in ventricular hypertrophy is engendered by something other than a mere increase in cell volume.

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1 . Using Zak-Henly's method, total serum cholesterol levels were determined in 6977 mormal subjects, 4855 males and 2122 females, in 7 large cities in Japan. 2. Total serum cholesterol level rose with advancing age in both sexes. The difference between both sexes was not remarkable. The mean values in the normal healthy subjects in Japan was much lower than corresponding values in the United States and European countries. 3. The normal range of the total serum cholesterol level in each age and sex group in Japan was established.

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EXAMINATION OF METHOD OF MEASURING THE RIGHT VENTRICULAR EJECTION TIME Cardiopulmonary hemodynamics has been clarified by the development of venous catheterization and examinations of coronary circulation and myocardial metabolism have become possible on human bodies. The ventricular mechanical work, chiefly of the left heart, was determined by DEXTER, KATZ, RODBARD and SARNOFF. With the rapid development of studies on pulmonary circulation, importance has come to be attached on observation of the mechanical effect of the right ventricle. The ventricular mechanical work seems to be done during the period in which the arterial valves are open. To investigate the right ventricular mechanical effect, the author considered it essential to confirm the method of measuring the ventricular ejection time. Method and Materials The tip of a double lumen catheter is placed in the trunk of the pulmonary artery with its side hole in the right ventricle and through V. basilica. The pressure curves of both the right ventricle and pulmonary artery are recorded on an Oscillographic paper, simultaneously with the electrocardiograph and phonocardiograph. Among 1 6 patients investigated in this study, eight with cardiovascular disease, six with chronic pulmonary disease and two others were free from evidence of congestive heart failure. Patients with congenital heart failure or atrial fibrillation were not used in this study. The heart rate, systemic blood pressure and hemoglobin cntents of these cases were all within the normal range. Result and Discussion 1 ) Measurement with a Double Lumen Catheter : In the simultaneous recording of the right ventricular and pulmonary arterial pressure curves, duration between the first intersecting point and the second intersecting point, of these pressure curves was 0.23 seconds, which is 30.4 %±4.4 % of the R-R time. This period does not correspond exactly with the systolic phase, but includes the protodiastole. It is highly probable that the right ventricle performs some ejection work in this protodiastolic phase, because the right ventricular pressure is higher than the pulmonary arterial until the second intersecting point of the two curves during which the pulmonary valve is kept open. It may therefore be induced that the time, including the abovementioned period. which is required until the second intersecting point, corresponds to the right ventricular ejection time.

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METHOD OF MEASURING THE AVERAGE PULMONARY ARTERIAL PRESSURE AND MECHANICAL EFFECT DURlNG THE RIGHT VENTRICULAR EJECTION TIME Many papers have been written on the measurement of ventricular mechanical effect. The study in this part was undertaken to observe the value of the mechanical effect per unit of the ejection time on the basis of the right ventricular ejection time measured in the previous part and to compare the result with other methods which are generally adopted. Material and Calculation 1 ) Sub jects The subjects are the same as in Part I. The cardiac output which was calculated by the Fick's method on 12 subjects was 9.34 l/min. at the maximum, 3.28 l/min. at the minimum, and 6.68 l/min. on the average. The mean pulmonary arterial pressure was 1 9 mmHg at the maximum and 6.5 mmHg at the minimum, with the average of 13.4 mmHg. 2) Calculation method of the mechanical effect of the right ventricle A. Calculation per minute i) Calculation of the right ventricular work against pressure by Dextor W(Dexter)=(C.I. × 1.055)(P^^-pa ×13.6) /1000 kg/min/M² where C.I. =cardiac index in liters per min per square meter body surface, 1.055 = specific gravity of blood, P^^-pa=mean pressure in the pulmonary artery in mmHg, and 13.6 =specific gravity of mercury. ii) Calculation of right ventricular cardiac index Cardiac Index=Mean pulmonary arterial pressure × Heart rate iii) Calculation of myocardial tension = PP^^-p × 13.6 × 1.05 ×980/10 × 1.05 × 3√S/3.2 × Heart Rate dynes per cm, where S=stroke volume cc. B. Calculation with the use of the systole or ejection time (TE) as a factor The above-mentioned three methods of do not include the conception of the ejection time. Meanwhile, it is during the poriod of ejection or the period when ventricular pressure ejects blood against the arterial pressure that the heart actually does the pressure work. Sarnoff tried to express the myocardial mechanical effect by putting the systole into consideration.

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Since F. WUHRMANN presented the concept of myocardosis in 1 950, myocardial damage in various hepatic diseases have been reported. Recently, quantitative relationship between electrocardiographic changes and serum protein fraction or serum electrolytes in various hepatic, diseases have been studied. They show that abnormal electrocardiographic findings are closely related to dysproteinemia. Among them, according to T. Nangu in our department, the electrocardiographic changes in hepatic diseases have more important correlations to dyspro-teinemia than dyselectrolytemia. However, STY depression alone was reported not to relate with them. This study was designed to examine the 'coronary circulation and myocardial oxygen metabolism in patients with hepatic disease, and to clear the cause of STY deviation in them. Methods and Materials Two hundred and seventy cases with hepatic diseases were sub jected to the electrocardiographic examination. As hypoxemia test, the Levy's original method of ten percent oxygen inhalation for twenty minutes was used. The coronary circulation and myocardial metabolism at rest and during hypoxemia were studied in the patients with hepatic disease by the right-heart and coronary sinus catheterization. Results Obtained (1) Electrocardiogram at rest and induced hypoxemia test in hepatic diseases. 1 . Electrocardiographic changes related to myocardial damage such as T lowering (44.1 % ), IT prolongation (39.3 % ), STY depression (17.4]%) and low voltage (11.7%) were found in 65% of 230 cases, and these changes were more often seen in hepatic cirrhosis than in acute and chronic hepatitis. 2. Positive hypoxemia test occurred in 15 out of 56 cases with hepatic deseases. The rate of positive test was almost the same as in heart diseases or hypertension, and it was more often seen in chronic hepatic diseases than in acute patient. It is worth notice that in 5 out of 23 cases (21 .7 % ) the test was found positive who had no electrocardiogarphic sign of myocardial damage at rest. This is probably due to the presence of potential coronary vascular and/or myocardial metabolic disturbance in hepatic diseases. Therefore, the hypoxemia test is useful not only for the diagnosis of latent coronary disorders but of latent myocardial damages. (2) Hemodynamics and myocardial oxygen metabolism in patients with hepatic cirrhosis. 1 . The cardiac output was normal before and during hypoxemia. The cardiac work (Dexter) and the myocardial tension (Rodbard) were almost normal before and during hypoxemia.

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The electrocardiographic abnormalities in diabetes mellitus have been understood to be due to the accompanying coronary sclerosis. This report deals with the study on the ECG abnormalities and the related abnormalities in the mechanical efficiency of the diabetic heart in connection with the biochemical and physiological changes proper to the disease other than coronary sclerosis. Materials and Methods 1 ) A^^^QRS and G^^^g at the frontal plane were determined of 101 cases of diabetic (57 normal ECG and 44 abnormal ECG, including 23 cases of complication with hypertension) according to the rectangular coordinate system for comparison with 157 cases of normal adult and 72 hypertensives. 2) 53 cases of diabetic with normal EKG were grouped into 4, by drawing line at the mean value of the fasting blood sugar of 155 mg/dl and the serum cholesterol of 210 mg/dl to measure A^^^GRS, A^^^T, G^^^ and T/R of V₅ T/R of V₅ was investigated of its relation to the age, duration of the disease, obesity, systolic and diastolic blood pressure, serum Na, K and HCO^-₃ levels of the patients. The patterns of the Master's double two step test were classified according to the strict criteria taking ST-T planning or sagging depression over 0.5 mm and QTc change at time intervals by E.G. DIMOND into consideration. 3) 7 cases of diabetic with normal ECG were orally given with 400 cal of glucose or butter to determine the ECG chages, the blood △7P (Fiske Subbarow's methord) at the intervals to 4 hours and the urinary output of catechol compounds, (adrenaline, noradrenaline, hydroxytyramine by T.H.I. method and VMA by Sandler's method.

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