Hemodynamic characteristics in 22 cases of juvenile hypertension were studied. Cardiac index in group 1 (blood pressure always exceeded 150/90mmHg) was 4.05±0.84 L/min/M², while it increased significantly by 5.39±1.20 in group 2 (blood pressure oscillated around 150/90mmHg). The peripheral resistance was elevated in group 1, 2348±575 dyne sec cm^-5/M², and it remained within normal range, 1534 ±428, in group 2. The increase in cardiac index in group 2 was due to the increase in heart rate and stroke index. Blood volume revealed an inverse relationship to the resistance ; it increased significantly in normal resistance group. The correlation coefficient between peripheral resistance and mean blood pressure was 0.34, while resistance and cardiac index revealed close relationship (r=-0.84). Heart rate and stroke index were decreased after intravenous propranolol by 10.6 per cent and 13.5 per cent respectively, thereby decreasing the cardiac index by 21.6 per cent on the average. The correlation coefficients between the percent decrease after propranolol and control values of heart rate, stroke index and cardiac index were -0.52, -0.37, and -0.43 respectively. Blood pressure changed little, and resistance was increased by 29.9 per cent after propranolol. The results indicated the hyperactivity of the beta adrenergic system in juvenile labile hypertension.

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Rib notching following various congenital or acquired cardiovascular diseases is discussed in connection with its causes and diagnostic implication on the basis of our own cases and reported cases in the literature. This sign was widely accepted as pathognomonic of coarctation of the aorta, but it occurs in various conditions as the authors point out in this report. Moreover, it is revealed that rib notching may be a result from the markedly augmented intercostal-bronchial collateral circulation as a compensation for the decreased effective pulmonary flow due to a large amount of the right to left shunt, if the adhesion in the pleural space would be present in some congenital malformations with decreased pulmonary blood flow and relative old-aged Morbus caeruleus. This finding is considered an important reference on determining the surgical indication in these conditions in regard to the cause, location and degree of rib notching.

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Recently a nephrotic syndrome, characterized by proteinuria, hypoalbuminemia, hypercholesterolemia, hyperlipemia, and edema, has been produced in rats by the subcutaneous injection of an aminonucleoside (6 dimethylamino purine, 3-amino-d-ribose). The serum changes in nephrosis may be reflexed in lymph and tissue fluid. Information on the composition of lymph in nephrosis is, however, limited. The present studies were carried out to evaluate the role of lymph in carrying various components in renal or nephrotic edema to the general circulation.

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The repolarization complex of the spatial velocity electrocardiogram was studied in 502 cases. Normal repolarization was composed of two main deflections, τ₁ and τ₂, and τ₁ was smaller than τ₂. Most typically in left ventricular hypertrophy and in left bundle branch block τ₁ was smaller and τ₂ Was larger than in the normal state. In recent myocardial infarction τ₁ was often larger than τ₂. But typical features of myocardial infarction were the presence of another smaller deflection τ₃ after τ_l and τ₂. In addition to these specific features the spatial velocity electrocardiogram was found to disclose abnormal repolarization more sensitively than the usual electrocardiogram.

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In 1952, CABRERA and MONROY stated that the electrocardiographic patterns of diastolic and systolic overload of the left ventricle were different and would make it possible to differentiate the former from the latter. In 1960, CABRERA and GAXIOLA reported the significant differences between the vectorcardiographic patterns of diastolic and systolic overload. On the other hand, SELZER et al., SEDZIWY et al. and YANO et al. were unable to find any significant differences between the two in either the electrocardiogram or the vectorcardiogram. The author made a statistical survey on the spatial and planar vectorcardiographic parameters of the diastolic and systolic overload of the left ventricle to try to differentiate the characteristics of the two groups. Material and Method : The following subjects were available for this study, including 56 patients with essential hypertension (above 160mmHg in systole and/or 90mmHg in diastole) as the samples of systolic overload of the left ventricle, 38 patients with patent ductus arteriosus (PDA) (below 35mmHg of right ventricular systolic pressure) as the samples of diastolic overload of the left ventricle, 39 patients with ventricular septal defect (VSD) (below 35mmHg of right ventricular systolic pressure) as the samples of both ventricular diastolic overload, and 116 normal adults as the samples of the controls. Frank lead system was used for vactorcardiographic recording. The frontal, horizontal and left sagittal planar vectorcardiographic loops were simultaneously photographed on 35 mm-film and the scaler electrocardiograms in the three orthogonal leads were also simultaneously recorded on the paper at the speed of 10 cm/sec. The following measurements of the vectorcardiographic loops and scalar ECGs were made : (1) direction and magnitude of the spatial maximum (max.) QRS and T vectors, spatial QRS-T angle, spatial T/QRS ratio, (2) direction of inscription of QRS loop in the three planes, (3) direction of the frontal max. QRS vector, direction and magnitude of the horizontal max. QRS vector, (4) amplitude of the initial max. rightward deflection (Qx). that of the max. leftward deflection (Qx) and ratio of the two (Qx/Rx), (5) amplitude of the max. anterior deflection (Rz), that of the mx. posterior deflection (Sz), and ratio of the two (Rz/Sz). (6) direction and magnitude of the spatial mean QRS (spatial QRS) and T (spatial T) vectors, spatial mean QRS-T angle. (7) spatial ventricular gradient (spatial VG).

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