The hemodynamic correlation of internal carotid artery and vertebral artery before and after intravenous papaverine administration were investigated by using ultrasonic Doppler technique. (1) The blood flow pattern in vertebral artery is prone to be more discontinuous than that in internal carotid artery in the aged independent of blood pressure or cerebral vascular disease. The result suggests that the cerebral vascular resistance in the territory of vertebral artery is more increased than that in internal carotid artery in the aged. As to the mechanism of increased vascular resistance, the atherosclerosis in the territory of vertebral artery is important. (2) The vasodilation in patient with cerebral vascular disease is prone to be more less than that in subject without the disease. The result suggests that the patient with cerebral vascular disease has more tendency to fall into cerebral vascular insufficiency, since the cerebral blood vessel is already near by maximal dilatation, i.e., failure of homeostatic regulation of cerebral circulation.

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The cardiovascular responses to pressor, de-pressor agents and carotid occlusion in the Spontaneously Hypertensive Rats (OKAMOTO and AOKI) were investigated. Spontaneously hypertensive rats were divided into 3 groups, i. e., the pre-hypertensive or transitional stage (Sy ; 40-60 days old), the earliest hypertensive stage (Sp ; 60-110 days old) and the early hypertensive stage (Sa; 130-210 days old), and were compared with acute and chronic renal infarction hypertension (Ry, Ra), acute constricted renal artery hypertension (Rg) and normotensive controls at the corresponding age, respectively. Direct blood pressure was recorded manometrically on kymograph under chloralose (40 mg/kg, intravenous administration) anesthesia and all pressor or depressor agents were administered intravenously and the following results were obtained. 1) Spontaneously hypertensive rats (Sp, Sa) after the development of hypertension, which seemed somewhat easily depressed by general anesthesia maintained hypertensive blood pressure level under chloralose (40mg/ kg) anesthesia. 2) Response to adrenalin (5γ/kg) was slightly decreased in spontaneously hypertensive rats (Sy, Sa), but response to noradrenalin (5γ/kg) showed an increasing tendency in spontaneously hypertensive rats in the early stage (Sa) as well as in chronic renal hypertensive rats (Ra). 3) Pressor response induced by bilateral carotid occlusion for 20 seconds was significantly increased in spontaneously hypertensive rats (Sy, Sa) and renal hypertensive rats (Ry, Ra) in comparison with normotensive controls. Spontaneously hypertensive rats in the pre-hypertensive or transitional stage (Sy) did not show a significantly increased carotid occlusion reflex until atropine (2mg/kg) was administered. 4) The depressor effect of regitine (0.6mg/kg) in spontaneously hypertensive rats in the pre-hypertensive stage (Sy) was almost the same as that in controls. Spontaneously hypertensive rats in the early stage (Sa) showed nearly the same increased response as chronic renal hypertensive rats (Ra) but a significantly increased response in comparison with acute renal hypertensive rats (Ry). 5) The stable pressure level after hexamethonium (20mg/kg) administration was significantly lower in spontaneously hypertensive rats in the earliest hypertensive stage (Sp) than in acute renal hypertensive rats with constricted renal arteries (Rg). 6) The effect of acetylcholine (2γ/kg) on blood pressure was significantly increased in spontaneously hypertensive rats in the pre-hypertensive or transitional stage (Sy) and in acute renal hypertensive rats (Ry) as compared with controls. 7) These results suggested the probable participation of neural fractors in the development of spontaneous hypertension. Differences between spontaneous and renal hypertension as well as the similarity of spontaneous hypertension to human essential hypertension in early stage were also discussed.

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Our methods of computer applications in spatial analytico-geometrical analysis of VCG were described. Normal standards of the FRANK system VCG based on the quantitative analysis of 73 healthy middle-aged men were presented. New parameters, such as spatial linear, angular and areal velocities of QRS loops; spatial circumferences, spatial angles, and spatial areas of QRS loops were introduced for the quantitative descriptions of the VCG findings, and the normal data of these items were also presented. VCG of healthy middle-aged men were very similar with those of the healthy young men, although the magnitudes were slightly smaller in the former. It was suggested that the VCG criteria specific for the races are necessary for the clinical applications of VCG, because the analytic values were quite different between healthy Japanese and American men.

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As reported previously a concave RS-T elevation in mid-and left precordial leads is produced by conscious persistent mental stress in a period of more than 1 to 2 months and can be normalized by minor psychotherapy with or without minor tranquilizers in certain cases. In order to confirm the psychosomatic significance or psychogenesis of the concave RS-T elevation in mid- and left precordial leads, mental state of patients with this concave RS-T elevation was investigated by the use of the Cornell Medical Index.

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As discussed in Part I, the Cornell Medical Index is impertinent for a patient with actual neurosis who has the spirit of self-respect and is ashamed of exposing himself, bodily or mental, to others. However, in dealing with neuroses, what we physicians must search for is that obstacle which interferes with normal emotional discharge and not the products of reactions of the organism to this obstacle. For this reason, new questionnaires which have no column for the name of patients and consist of concrete questions asking the environment in which they live were specially designed for actual neurosis.

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We have reported two cases of TAKAYASU'S syndrome, in which skin complication of tuberculide- or tuberculoderma-like eruptions are observed. Thirty-three and 40 year-old female patients with characteristic clinical picture of "pulseless disease" have developed during their clinical course, papulonecrotic tuberculide-like exanthema on her forearms and erythema nodosum-like eruptions in her shins in the former and tuberculoderma-like pyoderma on her left forearm and both shins in the latter. Skin biopsy has been done on these eruptions, which indicated nonspecific proliferative inflammation and the culture of tubercle bacilli from these specimen was negative. It has been suggested that the immunoallergic reaction would be well responsible in pathogenesis of both aortic lesion and skin eruptions, most likely based on tuberculosis allergy.

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