The relation between the urinary catecholamines and the pulmonary arterial pressure was investigated in 60 patients with various kinds of heart diseases. This study disclosed that there was a close correlation between urinary noradrenaline and pulmonary arterial pressure. Therefore, it can be concluded that noradrenaline as a humoral transmitter of sympathetic nervous system has an important role on pulmonary arterial pressure, and they, reversely, can be predicted by the amount of urinary noradrenaline. No relation was found between urinary adrenaline and pulmonary arterial pressure.

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Ajimaline increased the total sodium content of rat hearts including the atria and ventricles. Diphenylhydantoin and propranolol decreased the potassium content of the intracellular compartments. Propranolol caused a decrease of the potassium content of rat ventricles. The decrease of potassium became significantly milder by the addition of digitalis to propranolol. There were no changes in the sodium and potassium concentrations of rat sera treated with the drugs in these experiments.

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The heated thermocouple with constant heating current has been used by many authors for the measurement of the regional blood flow. A new method for the measurement of blood flow is proposed by employing the self-adjusting current heating with a feedback control system. In this method, the temperature difference between the hot and cold junctions is kept almost constant and quite small by setting properly the autornatically regulated heating current so that the effects of local heat accumulation by heating current on biological reaction in tissue may be avoided. Further this method is also superior in linearity, applicability to wider range of flow rate and prompt response than the method of constant current heating on both experimental and theoretical standpoints.

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With use of the myocardial tissue strip of the dog's left ventricle of the heart, the isometric contractility and poststimulation potentiation were measured. The studies were directed on the possible influence of calcium ion, potassium ion and the myocardial catecholamine on the positive inotropic action of the cardiac glycoside by employing the normal myocardial tissue piece. The studies were ex-tended to the use of various types of the autonomic nervous blocking agent on the myocardium in which the action of catecholamine was actively suppressed, and also tried on the hypertrophic heart muscle strip removed from the dog developed of the aortic insufficiency. It was concluded that the myocardial catecholamine exerts the regulatory function in the utilized process of the extracellular calcium ion relative to cardiac contraction in the normal and hypertrophic hearts.

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This study was performed to determine the validity of pre-operative assessment of mitral and aortic regurgitation by cineangiocardiography. The severity of both regurgitation was evaluated from several viewpoints and the results were compared each other. There was a general agreement between them and some indices suggested the regurgitant flow pattern. Cineangiographic assessment showed a good coincidence with operative findings and the indication for surgery was also discussed.

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QRS axes of electrocardiograms were measured in 984 Japanese males who visited the Hokkaido University Hospital. The average QRS axis in smokers was shifted to the left with age approximately 5 years earlier than in non-smokers. This seems to suggest that some individuals are "hypersensitive" to tobacco, among whom tobacco smoking advances the onset of atherosclerotic heart disease.

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Oral administration of potassium chloride to normal subjects and patients with primary aldosteronism had no effect on plasma renin activity. When potassium chloride was given orally to patients with renovascular hypertension, plasma renin activity decreased markedly as compared with the control values. Moreover, an increase in plasma renin activity induced by sodium restriction or diuretics ad-ministration to normal volunteers was prevented by potassium supplement. From these findings it appears that potassium loading suppresses renin release by the kidney. This suppressive effect of potassium on renin release would possibly be mediated through the feedback mechanism of increased aldosterone secretion produced directly by potassium administration.

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Changes in the ventricular fibrillation threshold (VFRT) were studied in 81 dogs to evaluate quantitatively the effect of some newer antiarrhythmic agents (G-I-K solution, Xylocaine and Dilantin) on the susceptibility of the dog's heart to fibrillation in acute myocardial infarction. VFRT was measured in dogs with occlusion of the anterior descending branch of the left coronary artery by a single bipolar stimulation of square pulse of 10 msec duration delivered during the vulnerable period. VFRT fell to an average of 30 per cent of control levels following coronary ligation. A significant elevation of the initial low post-ligation threshold was demonstrated by the application of these agents. It is suggested that the clinical use of G-I-K solution, Xylocaine and Dilantin is recommended to protect against ventricular fibrillation, one of the commonest cause of death following acute myocardial infarction.

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A case of right atrial myxoma with multiple extrasounds which led initially to the false diagnosis of pericarditis together with the systemic manifestation is presented. The phonocardiographic, hemodynamic, and angiocardiographic study revealed that the scraping, hitting, and incarcerating movement of the tumor is responsible for these peculiar auscultatory phenomenon. It was proposed that the inflow-limited hypodynamic ventricular condition similar to that of constrictive pericarditis was the chief basic mechanism for the genesis of low voltage of QRS complex on electrocardiogram in right atrial myxoma. There were some abnormalities in immunoglobulin, however, no antibody to myxoma or cardiac muscle, nor evidence of specific myocardial damage was demonstrated.

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From the relatively high rate of uremic death observed in young hypertensives it is clear that the liability to develop malignant hypertension in those young subjects is considerable and the recognition and treatment in the early stages of the disease is important. In order to study these young hypertensives, especially those with juvenile arterial hypertension (defined as juvenile hypertension), 209 hypertensive patients under 40-year old were selected from 7176 patients studied at the second medical clinic of Juntendo University Hospital from 1957-to 1966. The diagnostic criteria of hypertension were bases on BP values above 150/90mmHg at rest in the lying position. The distribution of various hypertensive states among these patients was as follows. [table]To investigate the possible mechanisms involved in the development of juvenile hypertension together with the clinical pathological findings, the results of precise clinical examinations of these patients were summarized and compared with the findings in chronic gromerulonephritis and in arterial hypertension of older age groups. The characteristics of juvenile hypertension were as follows. 1) There are two types of juvenile hypertension, namely a labile hypertension (A type) and a sustained hypertension (B type). 2) The relative incidence of hypertension in the family history was markedly higher than that of chronic glomerulonephritis. 3) The subjective symptoms of these patients were relatively slight and were limited to CNS symptoms as headache, dizziness or shoulder-stiffness. 4) The urinary findings, renal function tests, blood pictures and the biochemical patterns were relatively normal except for the consistent finding of a lower level of serum potassium especially in the A type. 5) The catecholamines, especially noradrenalin, excretion in the urine were increased, particulary in the A type.

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In recent years the hemodynamics in hypertensive subjects have become a focus of interest to many cardiologists. However, the relation of acid-base equilibrium to the regulation of hemodynamics in hypertensives has not received much attention. Some investigators have studied about the hemodynamics in respiratory acidosis and alkalosis, but none in metabolic acid-base disturbances. This study therefore was carried out to elucidate the influences of metabolic acidosis and alkalosis on the hemodynamics in normotensive and hypertensive subjects. Materials and Methods Three hundred ml of 0.01 N hydrochloric acid solution was injected intravenously in 10 normotensive and 6 hypertensive subjects to induce metabolic acidosis and one hundred and fifty ml of 7 per cent sodium bicarbonate solution was injected intravenously in 7 normotensive and S hypertensive subjects to induce metabolic alkalosis. Pulse rate and blood pressure were measured before and every 5 minutes after the infusion of acidotic and alkalotic solution, for 45 minutes in the former and 30 minutes in the latter. Arterial pH, plasma volume, cardiac output, stroke volume and total peripheral resistance were measured before and after the infusion. Results Changes in metabolic acidosis : Arterial blood pH fell after the intravenous infusion of 0.01 N hydrochloric acid solution. Pulse rate showed a slight fall both in normotensive and hypertensive subjects, but to an insignificant extent. Systolic, diastolic and mean blood pressures indicated no significant changes after the in-fusion in normotensive and hypertensive subjects. Extracellular plasma volume did not show any changes in both groups. Cardiac output showed a slight increase in both groups after the infusion. Total peripheral resistance indicated no significant elevation after the infusion in normotensive subjects, while it showed a moderate increase in hypertensive ones, but the difference between both groups were not significant.

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In a previous paper the author reported that the acid-base equilibrium plays an important role in the mechanism of hemodynamics in hypertension. It was concluded that in metabolic acidosis systolic and diastolic blood pressures did not show any change, but total peripheral resistance elevated moderately, while in metabolic alkalosis systolic and diastolic blood pressures indicated a significant decrease in normotensive and hypertensive subjects. From the point of the electrolyte distribution of plasma and red cells it seems to be important to elucidate the mechanism of the changes of hemodynamics in hypertension induced by the acid-base equilibrium. In this report, therefore, the author has attempted to determine the influences of metabolic acidosis on the electrolyte distributions in plasma and red cells and investigate their relationships to the hemodynamics in normotensive and hypertensive subjec〓s. Materials and Methods The study was done on 33 subjects, of whom 16 were normotensives and 17 had apparent essential hypertension without evidences of cardiac or renal failures. Three hundred ml of 0.01 N hydrochloric acid solution was infused intravenously to induce metabolic acidosis and one hundred and fifty ml of 7 per cent bicarbonate solution to induce metabolic alkalosis. Sodium, potassium, chloride and bicarbonate concentrations in plasma, and sodium and potassium concentrations in the red blood cells were measured before and after the infusion. The red blood cells were separated by centrifugation at 3, 600 g for 30 minutes. Results Serial electrolyte changes in metabolic acidosis and their relationship to hemodynamics : Arterial blood pH fell after the intravenous infusion of 0.01 N hydrochloric acid in normotensive and hypertensive subjects. Sodium concentration in plasma decreased slightly in both groups after the influsion. Potassium concentration rose in normotensives and conversely fell in hypertensives, but the differences between them were not significant. Plasma concentration of chloride did not change after the infusion in normotensives while it was elevated insignificantly in hypertensives. Bi-carbonate concentration rose in both groups, but a statistical significance was noted only in the hypertensive group. Since sodium concentration in red blood cells slightly decreased in both groups of patients, the ratio of plasma sodium to sodium in red blood cells, Nae/Nai, increased insignificantly. Potassium concentration in the red blood cells increased slightly in both groups and the ratio of plasma potassium to potassium in red blood cells, Ki/Ke, had no remarkable change in the normotensive group but showed a mild increase in the hypertensive groups. Interestingly there was a close relationship between changes in systolic blood pressure and/or total peripheral resistance and Ki/Ke in the hypertensive group.

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