Previously, the author differentiated the ECG changes induced by a transient emotional tension from those produced by a persistent stressful life situation ; the former as a reflex and the latter as an adaptation. By studying those patients in whom arrhythmia was confirmed to be transient and from whom preceding mental events were drawn out by analytic history taking, the relations between the characteristic of mental events, age and the pattern of arrhythmia were investigated. Psychogenic paroxysmal cardiac arrhythmia might be a manifestation of an excess counter-regulation.

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A double blind population study of preventive antihypertensive medication was carried out as a more active way of the control of mild cases. The administration of 0.1 mg of reserpine plus 12.5 mg of hydroflume-thiazide daily was carried out safely for three months, resulting in significant blood pressure fall. During one year follow up there-after, 1 6 per cent of those treated and 1 2 per cent of the placebo group always maintained a lower blood pressure compared with their original state. Three cases of apoplectic accident occurred in the placebo group (3/408. 0.8 per cent), and none in the treated (0/426). The side effects of medication were slight and rare. The rebound phenomena were not observed. Under careful examination such preventive medication is applicable effectively at mass control for hypertension.

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Free amino acid concentration in coronary sinus plasma and arterial plasma are measured. Differences between coronary sinus and arterial plasma are various depending on the kind of examined patients, amino acids and experimental conditions. Most of the differences are within error, but some of them are larger than error. With statistic examination, glutamic acid is only amino acid whicn has significant difference between the concentration of coronary sinus and arterial plasma and other amino acids have no significant difference.

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It is considered that cor pulmonale necessarily accompanies pulmonary hypertension, which is caused by the increase of pulmonary vascular resistance, as its occassion, and, as the factors of increasing pulmonary vascular resistance, the existence of some functional factors as well as some organic change in pulmonary blood vessel itself should be taken into consideration. Considerable numbers of experimental studies of acute cor pulmonale caused by disturbance of pulmonary blood vessel have been done, while chronic cor pulmonale caused by disturbance of the lungs coming from airway, which is most frequently seen in clinic, has not been studied very much. In order to find the occasion of cor pulmonale, caused by disturbance of the lungs coming from airway, the present writer produced in adult dogs the experimental pulmonary disturbances by infusing resin into their bronchi, and followed up the changes of circulatory dynamics, ventilatory function and others, in terms of the disturbance part and area as well as of time. And then, comparing these findings with pathological ones, he discusses about them here. Materials and Methods Applying the right cardiac catheterization by a modified Bing-Holt's method to this experiment on twenty-four adult dogs, circulatory dynamics, chiefly residual blood volume and, at the same time, ventilatory dynamics were measured and electrocardiogram was recorded as the pre-experimental values. Then, the dogs were divided into the following four experimental groups after infusing resin in the several areas of their bronchi. Group I : Those dogs, into whose bronchi controlling respectively the right second lobeareas of their lungs and the lowerparts of the left first lobes of their lungs the resin was infused. (the dogs infused in the bronchi controlling the 16% pulmonary area)

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In the biochemical aspect of energy utilization in the heart muscle, it would be of much value to know myocardial protein metabolism. Myocardial metabolism of protein is so closely related to that of amino acids, of which heart muscle protein is composed, that myocardial metabolism of amino acids must be taken into account. Little work, however, has been done to study the practical significance of individual amino acids in the heart muscle. The main purpose of this study is to disclose myocardial metabolism of individual amino acids. Thus the experiment was designed to observe the following events : (1) normal myocardial metabolism of amino acids in the heart-lung preparation of dogs, (2) effects of administration of glutamic acid and alanine on myocardial metabolism, (3) metabolism of ¹⁴C labelled glutamic acid and ¹⁴C labelled alanine in the heart-lung preparation of guinea pigs, (4) concentration of free amino acids and activity of transaminases in the heart and skeletal muscles of rabbits, and (5) change in myocardial metabolism of amino acids under various conditions in the heart muscle homogenate of dogs and rabbits. Materials and Methods A series of experiments was done in dogs, rabbits and guinea pigs. Measurements of amino acids in the present experiment were done as follows : Total amino acid nitrogen was measured according to the method of ALBANESE and IRBY. Individual free amino acids, separated by the procedure of high voltage paper electro-phoresis, were estimated by the colorimetry, with a standard color of 10γ of glutamic acid. Glutamine was determined by the method of IBER and BRUTON. For the determination of transaminase activity the colorimetric method of CABAUD, LEEPER & WROBLEWSKI was used for glutamic oxalacetic transaminase (GOT), and that of WROBLEWSKI & CABAUD for glutamic pyruvic transaminase (GPT). Experimental procedures were as follows : (1) Experiments in heart-lung preparation. Free amino acids, glucose, lactate, pyruvate and fatty acids in the perfused blood were measured 5, 30, and 60 min. after establishing stable circulation in the heart-lung preparation of dogs, either with being kept blood glucose in a normal level or without. The same procedures were done following the addition of 25 ml of 1 % glutamic acid solution or 25 ml of 1% alanine solution in to the perfused blood.

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The disease of coronary vascular origin has been increasingly calling our attention in recent years in Japan, and it has played a prominent part in the diseases of circulation. Although various clinical examinations have been in use in the early detection of the coronary sclerosis resulting in the myocardial infarction or coronary insufficiency, none of them seem to be satisfactory for a diagnostic method of choice. The electrocardiographic examination after exercise had been found to be useful in the diagnosis of the latent coronary sclerosis, and many studies have been reported on this subject, however, no critical evaluation has yet been made on the change in the electrocardiogram after exercise test. The author has made the studies on the changes in the electrocardiogram after Master's exercise test with the one group suspected of the latent coronary sclerosis from their anginal symptoms or clinical examinations ; the other group showing normal electrocardiogram was chosen as the control. From these results, an attempt has been made to establish the clinical evaluation of the exercise test. In addition, the exercise test has been tried on patients with neurocirculatory asthenia simulating coronary sclerosis with the subjective complaints requiring differential diagnosis, and the comparative studies of electrocardiograms were made. Although practice of the exercise test was usually for healthy adults at rest demonstrating normal electrocardiographic tracings, the present investigation stressed in patients with abnormal electrocardiogram at rest and the results were evaluated by comparing between the exercise test in group with normal and abnormal electrocardiograms at rest together with the subjective complaints corroborated with clinical laboratory findings. Materials and Methods of Observation All subjects were classified into the following 4 groups. Group 1, 81 normal adults over 40 years of age. Group 2, 110 patients over 40 years of age who were suspected of coronary sclerosis from their subjective symptoms and the laboratory examinations, showing normal electrocardiogram in resting time. Group 3, 61 patients with the neurocirculatory asthenia. Group 4, 107 patients with the coronary sclerosis whose electrocardiograms showed coronary insufficiency with the symptoms, signs and laboratory examinations, revealing the characteristic findings.

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