Electrocardiograms and vectorcardiograms were recorded before and after the resection of the right, the left or the both ventricular free walls of the perfused canine heart. The amplitude of the QRS complex was decomposed into the three parts which were attributable to the electromotive forces of each of the right and the left ventricular free walls, and the septum, respectively. It was discussed as to what degree the electromotive forces of the right or the left ventricular free wall or the septum would contribute to the formation of the QRS complex of the electrocardiogram and vectorcardiogram.

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Atrial fibrillation is one of the most serious kind of arrhythmia, because it is frequently associated with organic heart diseases and other disorders. However, the mechanism and genesis of atrial fibrillation have been made clear only to certain extent and degree. The aim of this experiment is to investigate effects of metabolic alkalosis or acidosis using various drugs, 2.0 per cent sodium bicarbonate, 2.0 per cent sodium lactate, 1/10 N sodium-2-phosphate and 1/10 N sodium-1-phosphate, on the initiation of the atrial fibrillation. It was observed in this experiment that the incidence of atrial fibrillation increased in proportion to the increase of pH, CO₂ vol% bicarbonate ion and buffer base of serum and decrease of pO₂ of arterial blood.

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This paper consists of the following two sections. Section 1 : Blood gas partial pressure and pH in various diseases. Section 2 : Blood gas partial pressure and pH according to disease conditions. Purpose of the Studies: Blood gas and pH which are the results of systemic and various organic circulation and metabolism have, conversely, great influences on the organic circulation and metabolism. Since the fairly accurate determination of blood gas partial pressure and pH became possible, there have appeared reports on the blood gas partial pressure and pH determined in individual patients. There has, however, been no report on studies based on simultaneous determination of PaO₂, PaCO₂, and pH in various diseases. In view of the above mentioned lack of re-port, the present author carried out studies on the general features observed according to diseases on hospital admission of the patients. Those studies are presented in Section I of this paper. Further studies along the above line but according to the conditions in various diseases (relatively normal state, dyspneic state, and serious state accompanied by clouded conscious-ness) are presented in Section 2. The studies are calculated to contribute to the diagnosis of disease conditions and to the formulation of guidelines for their treatment. Methods and Materials Arterial blood O₂ partial pressure (PaO₂) and arterial blood carbon dioxide partial pressure (PaCO₂) were determined with an I-L meter. pH was also determined. Bicarbonate ion (HC O₃^-) was calculated by the HENDERSON-HASSEL-BACH formula. Subjects: Since the determinations were done at or near the patients' admission, subjects of various conditions were included in the present studies, numbering 210 cases in all, consisting of 26 healthy subjects, 56 patients with pulmonary diseases, 55 with cardiac diseases, 18 with renal diseases, 42 with hepatic diseases, and 13 with diabetes.

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Prof. K. HARA and his coworkers have demonstrated that distinct differences in visceral circulation and metabolism during an induced hypoxemia (by inhalating 10% O₂ gas mixture) could be observed between normal subjects and patients with visceral vascular damage. During the induced hypoxemia the splanchnic oxygen consumption was found to decrease in cirrho-tics, while it increased markedly in normal subjects. In liver cirrhosis, partial pressure of oxygen (PaO₂) decrease, pH increase, partial pressure of carbon dioxide (PaCO₂) decrease and a pat-tern of respiratory alkalosis was observed during room air breathing. This suggested that there might be some relation between these results, respiratory volume (VE) and total oxygen consumption (VO₂). Such results are not available in the literature and the present paper will attempt to clarify this relationship. Method s Measurement of VE, VO₂ and analysis of arterial blood gas were performed before and during the 10% O₂ gas inhalation. In measuring VE and VO₂, a 3 minutes' sample of expired gas, collected with the DOUGLAS bag was determined with the SCHOLANDER microgas analyzer. Arterial blood was obtained from the femoral artery through places needles, and the PaO₂ and PaCO₂ were determined with the I. L. meter (Instrumentation Laboratory U. S. A). Bicarbonate (HCO₃^-) was calculated by using the HENDERSON-HASSELBACH equation from the determined values of PaCO₂ and pH. Arterial oxygen saturation (SaO₂) was measured with the VAN SLYKE manometer or determined from the O₂ dissociation curve. Materials This study was carried out on the following table cases.

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The purpose of this study is to obtain the normal ranges of electrocardiograms of Japanese elementary school children and to compare with each group separated by age and sex. Materials and Methods The subjects were 984 healthy children (506 boys and 478 girls) selected at random from all children (3532 boys and girls) in an elementary school in Nagoya, Japan. They were accepted as healthy children on the basis of their daily unrestricted activity and through a series of medical examinations. The subjects were sub-divided into twelve groups by sex and age for further analysis of their electrocardiograms. The 12 conventional leads and Lead V₃R were recorded for all subjects. The amplitudes and intervals of electrocardiographic deflections were carefully measured in each lead. In this paper 95 percentile of frequency distribution was accepted as a normal range for each component of the record. Results and Discussion RR interval was longer with increasing age both in boys and girls. The increasing rate of RR interval was more prominent in the boys than in the girls, and the difference of mean RR intervals reached a statistical significant level in the groups of 10 and 11 years old. According to above data, it was concluded that the normal range of RR interval should be set up separately; 0.48 to 1.00sec. for 6-9 years, and 0.54 to 1.08 sec. for 10-11 years. Although PQ interval also increased along with age, no significant difference was found for boys and girls. The normal ranges of PQ interval were 0.12 to 0.18 sec. for 6-9 years and 0.13 to 0.19sec. for 10-11 years respectively. The increasing rate of QT interval was less remarkable than RR or PQ intervals, and the mean of boys was significantly longer than that of girls in elder age group. A single normal range could be accepted for QT intervals as 0.28 to 0.40sec. for the all age groups. Though PQ interval tended to be longer with increasing RR interval except in the group with tachycardia, no significant correlation was observed for PQ and RR intervals. Correlation coefficients of RR with QT intervals were very high and proved statistically significant both in boys and girls and for all age groups.

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Spectral phonocardiograms (SPCG) were studied in 66 cases of pure mitral stenosis, 49 with normal sinus rhythm and 17 with atrial fibrillation. Method SPCG were recorded by use of Soundspectrograph (Rion Co.) specially designed for analysis of cardiovascular sounds. Quantitative analyses of the frequency-intensity characteristics were made by section pattern display of the apparatus. In this study, a dynamic microphone and a preamplifier with ear-like characteristics were used for recording SPCG. Results 1) The fundamental tone of the first heart sound in mitral stenosis was about 100cps, which is slightly higher than normal (70cps). The high frequency attenuation was about -10dB/oct. In normal cases, this attenuation was about -25dB/oct. In severe cases, shift of the fundamental tone to higher frequency and the decreased high frequency attenuation was more marked. 2) The fundamental tone of the second heart sound was also about 70∼100cps but, approximately equal level of the overtones from 100 to 250cps, fused with the fundamental tone, gave a definitely different configuration-a plateau type pattern-from that of the first heart sound in the section display. The attenuation of the second heart sound was about -12dB/oct. In cases with the elevated pulmonary arterial pressure, the attenuation tended to be decreased. 3) The frequency-intensity characteristics of the opening snap showed a marked attenuation of lower frequency under 100cps. The section pattern of the opening snap in higher frequency range was resembled to that of the first heart sound. 4) Frequency distribution of diastolic murmur was ranged from 50 to 300cps and the attenuation of high frequency was ranged from -30 to -45dB/oct. 5) Although slight changes of the fundamental tone and of the high frequency attenuation observed, the basic configuration of the frequency-intensity characteristics of the first heart sound remained unchanged in atrial fibrillation, after commissurotomy, inhalation of amyl nitrite and exercise test. However, it changed completely after the artificial mitral. valve replacement. Discussion and Conclusion 1 ) Spectral phonocardiography was proved to be a best procedure for frequency analysis of heart sounds and murmurs in mitral stenosis. For precise assessment of the results, several limitations of the method, such as, frequency, intensity and time dissolving capacity should be considered. 2) Irrespective of underlying diseases, the frequency-intensity characteristics of the first heart sound as observed in section pattern dis-play showed a similar contour and differed from that of the second heart sound. From this result, it is possible to assume two different sound-sources for production of the first and second heart sounds. 3) Spectral phonocardiographic changes of the first heart sound after hemodynamic changes and artificial mitral valve replacement will strongly support the conception that the mitral valve is a main sound-source of the first heart sound. This idea was also theoretically proved applying an electrical analog simulation of the left heart construction and hemodynamics. 4) Conversely, the change of the physical property (organic change) of mitral valve can be estimated, to some extent, from the spectral phonocardiographic findings of the first heart sound.

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