1. The ventricular propagation process in the right bundle branch block (RBBB) was simulated in the ventricular model stored in digital computer and its QRS complexes were reconstructed mathematically. The block was established in the model by laying a lesion on different levels along the right side of the specialized conducting system in different fashions. In total, five different assumptions in regard to the site and fashions of block were adopted, each of which corresponded to one of interpretations of RBBB obtained from animal experiment. 2. QRS complexes reconstructed from the assumptions where a conduction block was placed on the main right bundle branch showed R configuration in lead V₁ and QrS in lead V₅. These complexes displayed a significant changes in the initial parts in comparison with the normal simulated ones. It suggested that the rather little alteration in the initial parts of QRS complexes in clinical RBBB can not be explained by the lesion laid on the main right bundle branch. On the other hand, QRS complexes reconstructed from the assumption that excitation conducts through the main right bundle branch without block but the Purkinje system in the right ventricular free wall was not utilized for the conduction showed rsR' configuration in lead V₁ and qRs in lead V₅, not showing discernible change in their initial parts. 3. Based on the above results it was proposed that the QRS patterns in clinical RBBB is not attributable to the block at the main right bundle branch but a likely cause for the pattern is the conduction block at the level distal to the main right bundle branch along the right specialized conduction system.

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Data in regard to alterations in circulatory dynamics at rest noted in 72 patients (74 studies) with pure rheumatic mitral stenosis are reported. The resting hemodynamic parameters are assessed and analyzed statistically with special emphasis upon inter-relationship among physiologic variables and their relation to electrocardiographic findings. The patterns of hemodynamic response to exercise in part of the patients are also presented. Catheterization of the right side of the heart was performed in 34 studies and catheterization of both right and left sides of the heart in 40. Only one patients was in Class 1, 22 patients were in Class 2 and the remaining 50 patients were in Class 3 or 4 (American Heart Association Functional Classification.) (There was one patient who was studied twice, once before operation when he was in Class 3 and the other time one year after operation, being in Class 2). Their ages ranged from 16 to 53 years; 37 were males and 35 were females. Thirty-two of the total 72 patients were in auricular fibrillation. The diagnoses were confirmed in 40 patients, 38 at surgery and 2 by autopsy. A majority of the patients at rest showed considerable mitral end-diastolic pressure gradient, elevated left atrial, pulmonary "capillary" and pulmonary artery mean pressures, increased total pulmonary and pulmonary arteriolar resistance, and/or not infrequently low cardiac index and stroke index. In some patients there was also some elevation of right ventricular end-diastolic and right atrial mean pressure, increased right ventricular work, low peripheral arterial mean pressure and some peripheral arterial oxygen desaturation. Left ventricular end-diastolic pressure was elevated in about a third of the patients in whom the pressures were measured. Calculated mitral valve area ranged from 0.4 to 2.5cm² with an average of 1.0cm².

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The 11 cases of infants with patent ductus arteriosus and pulmonary hypertension were presented, and were discussed on the external or intracardiac phonocardiographic features and hemodynamics. There were three different types of murmurs regarding configurations. First type was only a systolic murmur. Second type was a systolic murmur crescendo to the second heart sound and short early diastolic murmur. Third type was a harsh atypical continuous murmur, and its maximal intensity was in early systolic phase. Four patients showed only a systolic ejection murmur, but in all cases typical or atypical continuous murmur was recorded in the pulmonary artery. The value of the intracardiac Phonocardiogram in the diagnosis of patent ductus arteriosus during infancy, especially in the differential diagnosis of ventricular septal defect or pulmonic regurgitation, was discussed.

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The activities of enzymes were determined in isolated renal glomeruli of normal and Goldblatt's hypertensive rats to investigate the effect of renovascular hypertension on the metabolism of glomeruli. In isolated glomeruli of rats with hypertension induced by strangulation of the left renal artery, the activities of HK, FDP-ALD, LDH, MDH, ICDH and GOT indicated a statistically significant decrease. These results demonstrated that the attitude taken by enzymes in isolated glomeruli of Goldblatt's hypertensive rats could not be attributed to oxygen deficiency in glomeruli in contrast to the results of our previous studies on Masugi's nephritis. Possible mechanisms underling these metabolic derangement were discussed.

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Existence of a transcellular-fluid-forming factor in the renal cortex has been reported, Purification of this factor by DEAE-cellulose column chromatography have yielded preparations 5.6 times greater in the ratio of this activity to that of renin than the crude tissue extract.

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Plasma renin substrate has been studied under various experimental renal damages in rats. Substrate concentration was determined indirectly by the addition of an excess dose of hog renin and expressed as equivalent of angiotensin II (ng) per milliliter of plasma. After bilateral nephrectomy plasma substrate concentration increased significantly. Furthermore, the similar phenomenon was observed after mercuric chloride-, sodium-potassium tartrate-intoxication and also after bilateral ureteral ligation. On the other hand, after bilateral adrenalectomy, plasma substrate decreased significantly. The possible mechanisms responsible for an increase in the plasma substrate concentration observed in this study were discussed.

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Computer application in the management of medical information has been recently at many laboratories. This paper describes that a small scale digital computer was successfully utilized to make automatic diagnosis of X, Y and Z scalar electrocardiograms of FRANK lead system and this diagnosis was made within two minutes by pushing a start button of computer one time. This computer was linked to three channel electrocardiograph, through a buffer amplifier with a monitoring cathode ray oscilloscope. This system may be available for any hospital without difficulty.

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The cases of endocardial fibroelastosis in adults reported in Japan are briefly summarized. Seventeen cases were found. Main clinical signs were congestive heart failure without any remarkable murmur, ischemic signs of left ventricle on ECG. A case of endocardial fibroelastosis, 31 year old man, was presented. No particular signs was found clinically except for the low value of serum protein, 4.9mg/dl. We assumed that the disease might be a congenital, not acquired.

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