Morphological changes of the intrahepatic venous systems in chronic hepatitis and liver cirrhosis were studied by means of radiological technique. Detailed measurement of the diameters of the venous branches on radiographs revealed an existence of morphological changes in chronic hepatitis, not only in liver cirrhosis. Relation between the types based on a peritoneoscopic classification and the manner of vascular changes was studied in accordance with the changes observed in liver cirrhosis.

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In order to get valuable information for efficient application of PCG and ausculation to mass examination, discussion was made of the characteristics of heart murmurs and sounds of normal children and of congenital heart diseases and acquired valvular heart diseases which are more prevalent among the young. In the first chapter, the heart murmurs of children, especially functional murmurs are examined by both auscultation and PCG and the role of them in mass examination is evaluated. In the second chapter, the use of PCG for mass examination is described especially for re-examination. In the third chapter discussion is made how to differentiate functional heart murmurs from pathologic ones, whose differentiation is difficult by auscultation. In the forth chapter physiologic diastolic murmurs which have not been generally taken into consideration are discussed.

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Ballistocardiography and right cardiac catheterisation were performed in succession in pulmonary tuberculosis as well as silicotuberculosis An amplitude of NO or LM segment was definitely larger in the group of pulmonary hypertension than in the group of normal pulmonary arterial pressure. There was a close positive correlation between pulmonary arterial mean pressure and the amplitude of NO or LM. Such NO (LM) showed a sharp descent with deep amplitude beneath the base line and this characteristic pattern was more significantly observed in Valsalva ballistocardiogram than in rest-breathing ballistocardiogram, "Pulmonary NO (LM)" was presented as a new concept to the diagnosis of pulmonary hypertension.

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An attempt was made to pursue the development of ballistocardiographic abnormalities in human cases of coronary artery diseases. For that purpose, ballistocardiographic changes on experimental coronary stenosis and occlusion produced by a left coronary catheterization and infusion of several substances were observed on 44 dogs by a newly designed three directional ballistocardiograph. Abnormal patterns clinically observed in cases with coronary artery diseases were demonstrated on dogs with experimental coronary stenosis or occlusion. The difference on ballistocardiographic changes in cases with circumflex segment occlusion from those in cases with anterior descending branch occlusion is very likely to be related to the difference on a 'localized' decrease of myocardial contraction other than arterial blood pressure or venous return.

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The purpose of this paper is to provide the frequency distribution and statistical data concerning most of the component parts of the electrocardiograms of the Japanese and to compare with each group separated by ages and sexes. In order to obtain the normal limits of the electrocardiograms of the Japanese, 375 individuals who were proved to be healthy through the thorough examinations more than two years, were selected as a sample representative of a healthy population. Normal range limits obtained from our material were compared with electrocardiographic criteria which are commonly used for diagnostic interpretation. Additionally, the racial comparison of the electrocardiographic samples of the Japanese with those of the Americans was made.

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There have been some studies on the correlation between serum lipid concentrations and blood gases. It has been reported that the intravenous infusion of fat emulsion caused a decrease in myocardial oxygen tension of dogs producing experimental myocardial infarction. It was also shown that hyperlipemia following a large fat meal might precipitate an attack angina pectoris in patient with severe coronary artery disease. In this presentation, the relation between serum lipid concentration and the change in blood gases was investigated in several experiments in order to clarify the effects of serum lipids upon the change of blood gases. EXPERIMENTS AND DISCUSSION Blood gases were analysed by VAN SLYKE'S method. For the measurement of serum lipids, non-esterified fatty acid (NEFA) concentration was measured by DoLE's method and triglyceride concentration by VAN HANDEL & ZILVERSMIT'S method respectively. Serum NEFA was isolated from arterial blood by McCARTHY's procedure and analysed gas-chromatographycally to see serum NEFA composition. apparently healthy rabbits of both sexes in fasting state. In one group of 15 rabbits, the relation between volume of the fat emulsion may injected intravenously or triglyceride concentration and changes in arterial blood gases (Ca CO₂, CaO₂) were investigated. In another group of 5, changes of the arterial blood gases were observed before and one hour after fat injection. Then it was observed that increase of CaCO₂ and decrease of CaO₂ were caused by intravenous injection of fat emulsion. Further-more, the correlation between increase of triglyceride concentration and increase of of CaCO₂ of experimental rabbits after fat injection was revealed, and in each case it was also observed that hypoxia was accompanied by increase of CaCO₂ However, there were little change in changes in hematocrit, pH and O₂ capacity before and after fat injection. Therefore, it seems to be difficult to consider that the fat coats the red cells to interfere O₂ uptake. On the other hand there was no evidence of pulmonary embolism caused by intravenous injection of fat emulsion, because the size of fat particle was too much small (diameter 0.7μ) to occlude the pulmonary vessels.

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There are many studies on the anticoagulant activity of dextran sulphate. In these studies, dextran sulphate is used to given for obstructive endoarteritis and thrombosis instead of heparin. However, recent studies with the low molecular and low S-content dextran sulphate (L. D. S.) approved that this kind of dextran sulphate has hypocholesteremic effect and enhances the lipolytic activity in serum of arteriosclerotic patients. K. YAMADA and co-workers found that the lipolytic activity due to this kind of sulphated polysuccharides was not parallel with the anticoagulant activity, and lipolytic activity was marked although the toxic effect due to this kind of sulphated polysucchride was less than that of heparin. They clinically used the low molecular weight and low S-content dextran sulphate for the disturbance of lipid metabolism in arteriosclerotic patients. According to S. TOMIZAWA, L. D. S. somewhat increased the contractile force in the rabbit heart prepared by the LANGENDORFF'S method. On the other hand blood pressure and respiration were not affected by the intravenous injection of 300mg per kg of L. D. S. However the mechanism of inotropic effect with L. D. S. was not obvious. The present study was designed to investigate the effect of L. D. S. on the coronary circulation and myocardial metabolism in experimental coronary insufficiency of dogs. In addition, clinical effect of L. D. S). on coronary heart diseases was also investigated.

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The clinical diagnosis of chronic cor pulmonale has not yet been easy. The right heart catheterization is too cumbersome as a routine test, hence the clinical diagnosis of chronic cor pulmonale is usually based on the electrocardiogram using the various electrocardiographic criteria for the estimation of right ventricular hypertrophy. However, these criteria, except one reported by the World Health Organization (hereafter abbreviated as WHO), were set up from the cases with anatomical right ventricular hypertroyhy due to chronic cor pulmonale and others. In this study, the electrocardiograms from 24 cases of autopsy-comfirmed chronic cor pulmonale were analysed in order to evaluate the diagnostic value of various electrocardiographic criteria for the diagnosis of right ventricular hypertrophy due to chronic cor pulmonale. The influence of coexisting hypertrophy on the right ventricular hypertrophy pattern was also examined. Materials and Methods Twenty-four cases employed in this study died at the Keio University Hospital from chronic pulmonary diseases and/or pulmonary dysfunction. At postmortem study, all of them had definite right ventricular hypertrophy and were diagnosed pathologically as chronic cor pulmonale. Right ventricular thickness greater than 4 mm and left ventricular thickness greater than 15mm were defined right and left ventricular hypertrophy, respectively. Combined ventricular hypertrophy was present in 6 of 24 cases. Their age ranged between 25 and 83 years, with an average of 49 years. There were 17 males and 7 females. The underlying diseases were pulmonary tuberculosis (10 cases), chronic pulmonary emphysema (3 cases), pulmonary tuberculosis and chronic pulmonary emphysema (3 cases), bronchiectasis and chronic pulmonary emphysema (3 cases), bronchiectasis (2 cases), pulmonary fibrosis (1 case), pulmonary cyst (1 case), and chronic pulmonary emphysema and pulmonary cancer (1 case). These diagnoses were based on pathological findings.

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