By means of SCHMITT'S SVEC III and GRISHMAN'S lead systems, 144 vectorcardiograms (VCGs) of right ventricular hypertrophy (RVH) in congenital and acquired heart disease were spatially analyzed. On the basis of characteristics of the horizontal VCG pattern and the spatial orientation of the maximum QRS SE loop, a new diagnostic classification for the RVH was proposed. Comparative studies between the VCG pattern and the severity of right ventricular systolic pressure or between pre-and postoperative VCG pattern demonstrated that the new classification and related criteria could be useful for the quantitative diagnosis of RVH. SVEC III lead system showed a closer relationship to the degree of RVH, and it was superior and more valuable in the quantitative diagnosis of RVH than uncorrected GRISHMAN'S lead system.

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The present investigation was undertaken to evaluate the change in digitalis tolerance immediately after extracorporeal circulation with eleven patients undergoing open heart surgery for the correction of congenital or acquired heart diseases who were ranged in age from 4 to 56 years and experimentally with eleven mongrel dogs by means of acetyl strophanthidin tolerance test. The decrease of digitalis tolerance following total body perfusion has been clinically observed in all cases of the prolonged duration of perfusion of longer than one hour within a period of 4 to 7 hours after perfusion and experimentally in all dogs of one hour perfusion within a period of 2 hours after perfusion. Metabolic acidosis after perfusion may primarily be connected with the decreased digitalis tolerance. Of the electrolyte measurement, no consistent change was observed.

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Using the FRANK and the TAKAYASU lead systems, 102 clinically and electrocardiographically normal subjects and 10S subjects with left ventricvlar hypertrophy were each quantitated in a series of thirteen instantaneous vectors both in the depolarization and the repolarization phases. Eight instantaneous vectors were determined at time intervals of 0.01 second from the beginning of the QRS complex. While in the QTC Vectors, five instantaneous vectors were fixed at time intervals of 0.01 second from the beginning of the Q wave and normalized in time by the formula of TAKAHASHI²0 Significant observations in this study were as follows : (1) Both planer and spatial QRS-T angles in left ventricular hypertrophy had wider or larger mean values than in the normal. The T/QRS ratio in the LVH group was significantly smaller than in the normal. (2) In spatial amplitude and orientation in the depolarization phase in the present series, the 0.04 sec QRS vector served to separate the normal from left ventricular hypertrophy by comparing the vectors preceding and following this prominent vector (0.04 sec QRS vector). (3) Also in the repolarization phase, the 0.30 sec QTC Vector served to separate the normal from the LVH, by comparing the preceding and the following vectors of the 0.30 QTC vector. (4) Between the two orthogonal lead systems, the FRANK and the TAKAYASU, there was no remarkable difference in the spatial orientation (azimuth and elevation) in the series of the instantaneous vectors. But, in magnitude, the latter lead system showed larger values, and this was advantageous for analyzing the smaller loops and the zero point of the vectorcardiogram.

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1. Enzyme-histochemical study was per-formed on the brain stem of spontaneously hypertensive rats (OKAMOTO and AOKI). Four kinds of enzyme activity (acid phosphatase, diphosphopyridine nucleotide diaphorase, monoamine oxidase and acetylcholine esterase) were examined on 11 nuclei of brain stem of a total of 11 spontaneously hypertensive rats and 11 normotensive control rats of Wistar strain which were subdivided into two groups according to survival duration (40-60 days after birth (Stage I) and 3.5-4 months after birth (Stage II)). Each positive finding in spontaneously hypertensive rats was obtained by comparing it to that of normotensive controls. 2. Mean systolic blood pressure of spontaneously hypertensive rats was significantly higher than that of controls, despite that, it was still in normotensive range in Stage I. Mean body weight did not show any significant difference between spontaneously hypertensive rats and control rats. 3. As to the normal distribution of enzyme activities in the brain stem, an outline of the reactions observed in the brain stem nuclei of normotensive control rats was described. 4. Comparing the results from spontaneously hypertensive rats with those of controls the following findings were obtained. Increased enzyme activities were found in Nucl. originalis dorsalis nervi vagi (acid phosphatase, diphosphopyridine nucleotide diaphorase, monoamine oxidase and acetylcholine esterase in Stage I ; acid phosphatase and diphosphopyridine nucleotide diaphorase in Stage II), Nucl. reticularis lateralis (acid phosphatase in Stage II), Nucl. reticularis pontis oralis (diphosphopyridine nucleotide diaphorase in Stage I), Nucl. reticularis gigantocellularis (diphosphopyridine nucleotide diaphorase in Stage I), Edinger-Westphal's nucleus (monoamine oxidase in Stage I and diphosphopyridine nucleotide diaphorase in Stage II). Decreased activity was observed only in Nucl. reticularis tegmenti (acid phosphatase and diphosphopyridine nucleotide diaphorase in Stage I). 5. From the above-mentioned findings it was assumed that the autonomic nervous sys-tem in the brain stem of the spontaneously hypertensive rats may be in overactive state, being particularly distinct in the parasympathetic zones centering around the dorsal vagal nucleus in this study, though detailed etiological participation of this area could not be clarified.

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1. Enzyme histochemical studies were per-formed on the superior cervical sympathetic ganglia of the spontaneously hypertensive rats (OKAMOTO and AOKI). Acid phosphatase, monoamine oxidase and acetylcholine esterase activities were examined using a total of 18 spontaneously hypertensive rats and 18 normotensive rats of Wistar strain. 2. Acid phosphatase revealed increased activity in the spontaneously hypertensive rats in prehypertensive stage (6 of 7 cases examined), initial stage of hypertension (4 of 6 cases) and advanced stage of hypertension (5 of 5 cases). 3. Increased monoamine oxidase activity in the spontaneously hypertensive rats was observed in all cases examined. 4. As to acetylcholine esterase, no significant difference in the enzyme activities among the examined animals could be found in the present study. 5. From the above-mentioned findings, probable sympathetic overactivity in the spontaneously hypertensive rats was presented and discussed in relation to the functional significance of the enzymes in the sympathetic ganglion.

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Unilateral renal-artery constriction was performed in salt-fed (0.5g/day) rabbits with a silver clip (diameter: 0.9 mm), contralateral kidney being left intact. At the end of 10 weeks after the unilateral renal-artery constriction a persistent rise of blood pressure to over the upper normal limit of 120mmHg was observed in 10 of 22 treated rabbits. The blood pressure remained raised for over 6 months in 8 rabbits. In spite of the persistent hypertension no rabbits died on hypertensive vascular diseases.

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The types of cardiac dyspnea in this study included exertion dyspnea, orthopnea, cardiac asthma, and Cheyne-Stokes breathing. The condition of pulmonary edema accompanies orthopnea which often seems to have been used as a synonym of cardiac asthma. Although clinical reports on the signs and symptoms of cardiac asthma have hitherto been made by many and much has been discussed as to the cause of the disease, precise elucidation is yet to be made in their development. The purpose of the present study is to clarify pathophysiological aspects of cardiac asthma from clinical fingings. Consecutive observation was made of the hemodynamics of cardiac patients during day-time and at night with special reference to the attacks of cardiac asthma, and comparative studies were also undertaken with various cardiopulmonary diseases in acute stage with allied clinical symptoms. The tolerance tests with several drugs as well as exercise tests were tried in the cardiac patients in an attempt to induce attack of asthmatic dyspnea. Method and Materials Forty-four cardiac patients who had been admitted to the First Medical Clinic of Kobe University Hospital were examined. The first examitotion was routinely carried out in the supine position around 3;00 p.m. shortly after admission that is before a specific treatment was instituted. Following the examination the patients were left quiet in the supine position and allowed to sleep until about 8:00 p.m. The second examination was performed at 10:00 p. m. Hemodynamic examination was made in respiratory frequency, pulse rate, cardiac rate, blood pressure., venous pressure, pulmonary circulation time, cardiac output, stroke volume, and pulmonary blood volume. The Riva-Rocci sphygmomanometer was used for taking pressure, a modified MORIZ-TABORA method for venous pressure, UEDA'S method according to Stewart-Hamilton principle, using radio-iodinated serum albumin (RISA), for determining pulmonary circulation time and cardiac output. The pulmonary blood volume was calculated by the following fomula :

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Although there has been marked progress in the development of coronary opacifying procedures and techniques within recent years, a more satisfactory method is still desired. During ventricular systole the ejection of blood from the left ventricle tends to wash the contrast medium away from the coronary ostia. During diastole, with the relative lack of flow in the aortic root and with the maximal rate of coronary artery flow, consequently, contrast medium is minimally diluted with blood in the aortic root and reaches the coronary arteries at a higher concentration. Since it requires several cardiac cycles for contrast medium to cover entirely from the coronary ostia to the minute peripheral branches, more excellent opacification might be obtained by the multiple successive diastolic injections method than by a single diastolic injection method. On the basis of this principle, the author has developed a new method for radiographic visualization of the coronary arteries ("Coronary Arteriography Using Successive Diastolic Injections"), and has attempted to evaluate this procedure experimentally and clinically. Thechniques: The in jector used in these studies was a Davol Heart Pump Model 8500, which was capable to inject contrast medium at any phase in the cardiac cycle in synchronization with a maximum electrocardiographic wave (R wave). The pump ventricle and a circuit including a contrast medium reservoir, two one-way valves and a catheter were specially devised and were very convenient for successive injections. The contrast media used were Diatrizoate (76% Urografin^[○!R]) or Iothalamate sodium (Angio-con-ray^[○!R]). Under general anesthesia, a catheter was introduced into the aortic root through either of the surgically exposed brachial or femoral artery. Contrast medium was injected by the above-mentioned injector under the injection pressure of 3.5 to 4.2 kilograms per square 〓e〓〓imeter for 3 to 4 strokes of the pump ven-tricle which worked in synchronization with the early diastolic phase of the heart. In all experimental animals and the patients with over 100 per minute of cardiac rate, ATP preparation was routinely administered via the catheter for decreasing the cardiac rate and dilating the coronary vessels, prior to the injection of contrast medium. At the same time with the beginning of the injections of contrast medium, serial X-ray filming was started at the rate of 3 films per second for 5 to 10 seconds, in 15 experiments and 9 clinical cases. In 11 experiments, a single X-ray film was exposed at the end of diastolic phase after 2 to 3 successive injections. The dosage of contrast medium ranged 0.13 to 0.80 milliliters per kilogram per stroke in the experimental animals and 0.13 to 0.21 in the clinical cases.

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