1) The hemodynamic values of fifty-three patients with mitral stenosis were analysed, in respect to the right ventricular function. 2) The functional capacity of the heart was more deteriorated, when the cardiac index was lower. 3) Right ventricular end-diastolic pressure showed significant correlations with pulmonary artery pressures, and significant inverse correlations with cardiac and stroke indices. 4) The decrease in cardiac index occurred concomitantly with the elevation of right ventricular end-diastolic pressures and pulmonary artery pressures, and with the decrease in right ventricular work in a minute or a stroke. 5) Right ventricular work had no significant correlation with right ventricular end-diastolic pressure or cardiac index. 6) An imaginary line was presented in the right ventricular work-end-diastolic pressure relation, and it was suggested that the line may divide the cases into two groups ; a group with compensated and hyperdynamic heart, and the other with decompensated and hypodynamic heart. 7) Relation between pulmonary artery wedge pressure and pulmonary artery diastolic pressure was reviewed, and the clinical significance of the pulmonary artery diastolic pressure was discussed.

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The study of convulsion by means of our new techniques was previously reported. Effects of Chlordiazepoxide as an anticonvulsant on cerebral blood flow, cerebral metabolic activity and EEG were investigated in both normal and convulsive cats by use of the same techniques, which were the concurrent and continuous recordings of EEG, blood pressure, cerebral blood flow, brain oxygen tension, carbon dioxide tension, pH and Na ionic activity.

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An on-line system for the automatc measurement or diagnosis of ECG was devised, whereby operation for data acquisition and processing of ECG was made in a simpler and more effective way. Twenty-five patients' ECG could be automatically recorded and processed by the system a day. Pattern recognition and measurement of ECG was successfully performed by a parameter of radial velocity of the spatial vectorcardiogram. The beginning and end of ECG waves were accurately estimated in ninety-seven per cent of one hundred subjects with various ECG findings. Consideration on several methods to improve the system was made on hard ware as well as on soft ware.

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A total of 52 cases including 4 normal subject and 48 patients with various heart diseases with or without failure were studied in resting state and under the acute effects of drugs with right and trans-septal left heart catheterization, and radioisotope indicator-dilution method. In this study, special attention was directed to the analysis of myocardial mechanics regulating the left ventricular performance and the following conclusions were obtained : 1) Patients with moderate or severe failure showed a decrease in cardiac index, stroke index, left ventricular fraction ejected per beat, MCSR, MSER and an increase in EDV, where-as patients without failure or those with mild failure had normal or increased cardiac index and stroke volume. 2) Measurements of EDP and EDV in association with the calculation of CSR, T and F as shown in our study proved to be useful in the analysis of the effects of drugs on inotropism, chronotropism or afterload of the left ventricle.

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The coronary venous and right heart catheterization were performed on the fifty-five cardiac cases including twelve left-sided heart failures. The left ventricular myocardial metabolism and hemodynamic factors were comparatively investigated from the view of left- and right-side overload, in order to clarify the metabolic shift, when they become to fail. The followings are summarized. 1) The elevation of myocardial oxygen ex-traction ratio, i.e. the disturbance of oxygen supply and demand was brought about by de-crease of cardiac index, increase of pressure work and the lowering of the arterial carbon dioxide pressure. 2) The cardiac cases with high myocardial oxygen extraction ratio were supposed to be in the state of latent heart failure, since they had the tendency of decreased systolic ejection rate and maximal dp/dt. 3) The changes of myocardial metabolism in relation to the hemodynamic alterations were different between the left-and right-side over-loaded cases. When the left ventricle began to fail, the myocardium utilized more carbohydrate than fat. On the other hand, the left ventricular myocardium in mitral stenosis utilized more fat with the increase of pulmonary capillary pressure, right atrial pressure and myocardial excess lactate, and also with the decrease of cardiac index and tension time index. These results were discussed. 4) The evidence of the disturbed myocardial metabolism of free fatty acid components in the idiopathic myocardiopathy was presented and discussed.

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In the present series of patients, no consistent correlations were observed between the plasma ADH level and the severity of congestive heart failure or the stadium of decompensation. However, a positive correlation was observed between the plasma ADH level and the venous pressure. A positive correlation was also observed between the serum osmolality and the venous pressure. There seemed to be a positive correlation between the plasma ADH level and the serum osmolality, and this correlation was remarkable in the course of a patient. The plasma ADH activity after over 14 hours' deprivation of water was usually within the normal limit in patients with congestive heart failure examined in the present study. High levels were observed, however, under certain conditions. There were no consistent data which indicated the impaired osmoreceptor function. The serum osmolality after water deprivation was within normal limits and the decrease in serum osmolality after hydration was accompanied by an inhibition of plasma ADH activity in most cases. Although there was no hyponatremic case in this series, it might be presumed that in some cases of hyponatremia, except for the cases in which the homeostasis mechanism is extremely exhausted, the regulation to maintain the circulating blood volume predominates over the regulation of osmolality. The venous pressure is set at a higher level by cardiac decompensation. An elevation in venous pressure leads to an increase in extravasation of body fluid and a decrease in venous return with an increased oncotic pressure of the venous blood. These changes in body fluid stimulate the release of ADH, which leads to hypervolemia and elevation in venous pressure, thus constituting a vicious circle. Even in this case the ADH seems to act homeostatically together with mineral corticoids in adjusting to the high venous pressure set by cardiac failure. In conclusion, the ADH system seems to play a role in homeostasis of the body fluid in congestive heart failure. The mode of action seems to be a physiological one even in cases with congestive heart failure in the present study. And the action of the ADH is thought to have some-thing to do not only with mineralocorticoids but also with cortisol.

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We could measure many items which show abnormal aspects in congestive heart failure. But their etiological significance is always not clear. Now, we emphasized the significance or rather, say, insignificance of aldosterone, in the pathogenesis of congestive heart failure.

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Twenty six autopsy cases of "truncarteritis productiva obliterans" were collected in Japan according to certain criteria. The morphogenesis of the lesions was studied on the ground of histology of the arterial wall lesion. It has been suggested that infection or allergy following infection of the arterial wall may be the most probable etiologic factor, or may act at least as a trigger in the early morphogenesis. It has been suggested, too, that immunopathological mechanism of a rheumatoid nature also may play a role in the pathogenesis.

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(1) Clinical observations of 33 cases of aortitis syndrome were described. They consisted of 22 cases of pulseless disease and 11 of atypical coarctation of the aorta with or without renal arterial narrowing. Autopsy examination was made on 2 of them. An intimate relation between pulseless disease and atypical coarctation was emphasized on the basis of the similarity in geographic incidence, sex and age distribution, some laboratory data, aortographic pictures and pathological findings. (2) Anti-aorta antibody was detected from the serum in 12 of 14 cases of aortitis syndrome by complement fixation test, suggesting the participation of autoimmune mechanism in the development of aortitis syndrome.

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Immunologic studies were performed in 9 patients with TAKAYASU'S arteritis. 1. γ^G immunoglobulin was increased in all of the 8 cases studied. 2. Circulating antibodies against the outer layer of the aorta and pulmonary artery were demonstrated in 7 cases among 9 cases by BOY-DEN's hemoagglutination reaction. 3. The specificity of this antigen-antibody reaction was confirmed by the hemoagglutination inhibition reaction and the anti human-r-globulin consumption test. 4. From these immunologic findings it is suggested that autoimmune mechanisms may participate in the developement of TAKAYASU'S arteritis.

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