Electroencephalographic observations were performed during hypothermic circulatory arrest at various temperature levels. Changes in cortico- and subcorticograms recorded from 28 ether-anesthetized mongrel dogs were divided into three stages. The termination of arrest within the 1st and the 2nd stages resulted in a complete recovery; whereas that at the 3rd stage resulted in no recovery. This criterion was satisfactorily applied to 20 patients operated on cardiotomy under hypothermic circulatory arrest. Though EEG(scalp) was used, a characteristic pattern appearing exclusively at the beginning period of the 1st and the 2nd stages led to a precise estimation of the length of the 2nd stage proportionally to the length of the 1st stage from the experimental experiences. The safety time limit of circulatory arrest, by the end of the 2nd stage, was 25 to 30 minutes at body temperature of 28°C.

抄録全体を表示

In order to clarify the vascular changes involved in the kidneys in essential hypertension, a histological study was performed on the renal biopsy materials obtained from 15 patients with juvenile form of essential hypertension, 30 elderly patients with essential hypertension, and 10 ordinary aged persons without hypertension, who admitted in the third medical clinic of Kyoto University Hospital between 1959 and 1963. It was found that the renal vascular disease in essential hypertension was predominantly in the small arteries and arterioles, especially in the media of arterioles, and included spasm, hypertrophy with or without vacuolation, hyperplasia, degeneration, atrophy with fibrosis and fibrinoid degeneration or necrosis of the medial smooth muscle. Intimal proliferation appeared to follow the changes in the media, while in the ordinary aged persons intimal sclerosis occurred from larger arteries with milder degree of severity. These flndings suggest that fundamental importance in the development of systemic hypertension should be attached to the problems on the contraction of the smooth muscle cells of the peripheral small arteries and arterioles.

抄録全体を表示

The effects of low temperature, induced hypertension and arrhythmia on cerebral circulation were investigated by ultrasonic Doppler technique. Rsults were as follows. 1) Effect on low temperature on cerebral hemodynamics. The hemodynamic comparison of the blood flow patterns in internal carotid artery in the same subject were carried out at the different seasons (in March and September). There are no significant differences between the blood flow patterns in March (12°C) and in September (30°C) independent of the blood pressure change. The constancy of cerebral blood flow in low temperature may well be based on the homeostasis of extra or intracranial circulation. 2) Effect of induced hypertension on cerebral hemodynamics. The hemodynamic comparison of the blood flow patterns in internal carotid artery were carried out by the administration of vasopressor drug (adrenalin, noradrenalin). The cerebral blood flow are markedly increased by adrenalin administration. This should be mainly resulted from the increase of cardiac output. On the other hand, the cerebral blood flow by noradrenalin administration falls into two types. The one is charcterized by the decrease of blood flow accompaning with the increase of blood pressure. The other is characterized by the increase of blood flow. The latter are prone to occur in the aged. This should be mainly resulted from the reactivity of the cerebral vassels to noradrenalin. 3) Effect of arrhythmia on cerebral hemodynamics. The normal blood flow patterns are observed in either auricular fibrillation or prematue beat in general. i.e., effective systole. However, under the conspicuous arrhythmia such as severe auricular fibrillation or premature beat accompaning with the very short coupling, the cerebral blood flow were frequently decreased or completely ceased. i.e., ineffective systole. The pathogenesis of ADAMS-STOKES'S Syndrome are discussed based on the results.

抄録全体を表示

Statistical analysis of electrocardiograms on 2, 391 cardiac and non-cardiac patients in Japan aged from 12 years to over 50 years were performed. Of this group 1, 288 individuals (54 per cent) revealed major abnormalities of electrocardiographic findings. The ratio of occurrence for Japanese males and females was shown. Major abnormalities have been expressed in tables terms of rate per hundred for each 10-year age group. Each abnormality and its clinical significance is briefly discussed. Mean ventricular potential for normal Japanese males and females has been calculated and represented.

抄録全体を表示

1. For the purpose of studying intracellular electrolyte metabolism in patients with congestive heart failure and the effect of digitalis on them, sodium and potassium concentrations in erythrocytes in twenty-one patients with compensated heart disease or chronic congestive heart failure were measured. In 13 patients of these subjects, sodium and potassium concentrations in erythrocytes before and during administration of digitalis were measured. At the same time, sodium, potassium and aldosterone excretion in urine and venous pressure were estimated. 2. For determination of normal ranges of red cell Na, K concentrations by the method applied in the present study, 9 normal blood samples were obtained from healthy physicians and nurses. Their means and standard deviations are given next. Sodium concentration in serum is 143.8±2.88mEq/L. Potassium concentration in serum is 4.29±0.29mEq/L. Sodium concentration in red cells is 12.0±1.45mEq/L. Potassium concentration in red cells is 99.3±3.72mEq/L. 3. Sodium and potassium concentrations in serum and red cells before the onset of treatment in patients with congestive heart failure. i) Sodium concentration in serum was significantly decreased, whereas that in red cells was kept in almost normal range. ii) Potassium concentration in red cells was significantly increased along with the clinical grades of heart failure, whereas that in serum was kept in almost normal range. 4. Influence of digitalization on serum and red cell sodium and potassium concentrations in patients with congestive heart failure. i) Sodium concentrations in red cells in 9 of 10 patients were increased, whereas those in serum in 8 of 10 patients were not changed. ii) Potassium concentrations in red cells in all 10 patients were decreased to the normal range; on the other hand those in serum in 5 patients were increased, 3 were decreased and 2 were not changed. 5. One of the influences of therapeutic dose of digitalis on red cell electrolytes may be due to the direct effect of digitalis on erythrocytes (particularly on their membranes) especially in the early stadium of its administration, but during the late stadium with its maintenance dose, there may be some indirect effects due to haemodynamic improvement of congestive heart failure.

抄録全体を表示

Authors observed effects of cytochrome C, which is basic polyelectrolyte, on the serum total cholesterol value, β-lipoprotein index and macroscopic findings of aorta of lanolin fed rabbits, and acquired interesting information after 12 weeks that hypercholesterolaemia and atheromatosis were depressed by cytochrome C injection.

抄録全体を表示

Although numerous reports have been published on the carotid sinus reflex, only a few have dealt specifically with the activity of this reflex in acute hemorrhagic hypotension. The purpose of the reported experiments was to study the carotid sinus reflex in reversible and irreversible stages of hemorrhagic shock. Methods In 23 dogs anesthetized with alpha-chloralose and bilaterally vagotomized or atropinized, hemorrhagic irreversible shock was induced by arterial bleeding to a mean blood pressure of 48mmHg. This pressure was maintained for 4 hours, after which the bled volume was reinfused. Changes in arterial blood pressure, carotid sinus pressure, right intraventricular pressure, cardiac output and total peripheral resistance (TPR) were measured before and during bilateral common carotid occlusion. Continuous recordings of these changes were made in a control period and every two hours during a period of hemorrhagic hypotension. Hemodynamic changes produced by carotid occlusion were also studied 10 minutes after blood reinfusion and thereafter every 30 minutes until the animal expired. Three experiments were performed on chloralosed dogs that were subjected to short periods (5 to 30 minutes) of hemorrhagic hypotension. Results In the control period, occlusion of the common carotid arteries gave rise to an increase in arterial pressure, heart rate, right intraventricular pressure and TPR, while cardiac output remained at the preocclusive level. During the 4 hour period of hypotension, carotid occlusion gave rise to an elevation in blood pressure and TPR, while heart rate and intraventricular pressure did not change. Regardless of the stage of shock studied, carotid occlusion did not cause cardiac output to change significantly. Ten minutes after the infusion of blood, occlusion caused an increase in blood pressure and TPR which, despite the return of blood pressure to near control levels, was not as significant as that observed during the control. In the irreversible state of shock following blood rein-fusion, subsequent bouts of carotid occlusion elicited increases in blood pressure and TPR that were found to be less in magnitude than those observed during the hypotension period. In three dogs subjected to short periods of acute hemorrhagic hypotension, TPR responses to carotid occlusion were found to be far greater at the same preocclusive blood levels than of those animals in irreversible hemorrhagic shock.

抄録全体を表示

Many papers on the renal functional of old age have already been published. Much of these, however, are concerned only with the resting state. The author attempted to examine the reactivity of renal circulation against stresses produced by inhalation of low oxygen gas of old age subjects whose urine was negative of albumin. Method s Renal circulation values were determined by the standard renal clearance method during the inhalation of room air and successive inhalation of mixed gas consisting of 10% O₂ and 90% N₂. The saturation of arterial oxygen (SaO₂) range-d from 46 to 77 per cent (average: 61 per cent). Materials Older men (34 persons) and women (10 persons), a total of 44 persons in an alms-house, who had no particular disease and whose urine were negative of albumin were studied. Ages ranged from 51 to 83, and their blood pressure from 100 to 210mmHg, systolic, and from 60 to 160mmHg diastolic. PSP tests were also performed and the 15-minute values ranged from 51 to 42 per cent. Among these examined, 23 persons (16 men and 7 women) were subjected to the hypoxic loading test and their renal hemodynamics were compared before and after the inhalation of low oxygen gas. The subjects were classified as follows : 1) Classified by age : Group I (Under 69 years old) 23 persons examined under room air inhalation and 14 of these also under the low oxygen gas. Group II (Over 70 years old) 21 persons examined under room air inhalation and 9 of these also under the low oxygen gas. 2) Classified by arterial blood pressure: Group A-Systolic blood pressures lower than 149mmHg accompanied with diastolic pressures less than 89mmHg (senile normotension type). Seventeen persons room air inhalation and 10 persons under 10% O₂. Group B Systolic blood pressures over 1) Age: 150mmHg, accompanied with the diastolic pressures of less than 89mmHg (senile hypertension type). Twelve persons under room air and 5 under 10% O₂. examinations, the seventies gave distinctly Group C Systolic blood pressures over 150mmHg, accompanied with diastolic pressures of more than 90mmHg (essential hypertension type). Fifteen persons under room air and 8 under 100% O₂.

抄録全体を表示

Two-hundred professional motorboat race men have undergone physical examination. Simultaneously, ECG and PCG have been examined. Their characteristic features of stature were depressed sternum, roud back and some deformities of big joints resulted from long termed enforced peculiar posture and extreme vibration of motorboat. The sternal depressions were measured by special rule, and the estimations were 8.3 mm in average. In same aged medical students, these depressions were 3.0mm in average. The depression degree of the sternum seems to be increased with the term of the professional life. Another outstanding feature of the physical examination was the grade 2-3 systolic heart murmurs. These murmurs were audible in 78 per cent of them. In control group, this ratio decreased in 43 per cent. Maximum points of the murmurs were existed along the left sternal border in 96 per cent. These murmurs should be included in functional murmur. It is well known that the functional murmur occupies less than two third of the systolic phase usually. This expression was reformed as follow; SM duration/Q-A time α/3. In this series, α was less than 2 in all of them. On the contrary, in 50 cardiac diseases with systolic murmurs in our clinic, the "α" exceeded 2. But not always, this ratio may provide the functional murmur. Even in another conditions, the murmurs of this series should be included in the category of the innocent murmur. All of ECG but one which showed ventricular beat presented normal sinus rhythm. Peculiar findings of ECG were M or W type of QRS complex in V₁ and V₂ (34 per cent) but incomplete right bundle branch block have existed in only 6 cases (5.7 per cent). These M or W typed QRS complex were seen in 86 per cent of the group whose professional careers have exceeded over 6 years. No relation was found between the ECG findings and heart murmur. This series having functional murmurs in high rate will be interested object for further studies of innocent murmur.

抄録全体を表示