1. Out of the cases went under autopsy during the period of 1958-1964 at 3rd Medical Clinic of Kyoto University Hospital 36 cases were studied. Macroscopic pathological findings of hearts (cardiac weight, ventricular wall thickness, ventricular volume, ventricular septum position) and its electrocardiographic findings, especially R wave height at V₂ and V₅ (RV₁, RV₅); ventricular activation time (VATV₁, VATV₅), S wave depth at V₁ (SV₁), QRS axis, and QRS transitional zone (T. Z.) are studied in comparison, and the following results are obtained. 2. Immediately after death punctuation was made from body surface with a long needle at electrocardiographic standard chest lead points V₁-V₆. After the chest was opened corresponding points on the surface of heart were decided. Electrocardiographic pattern at each lead point and location of various parts of heart were examined in its relation, especially QRS transitional zone was defined in relation with ventricular septum position. 3. On the basis of cardiac weight and ventricular wall thickness, all cases were divided into normal group, right ventricular hypertrophy group, left ventricular hypertrophy group, and combined ventricular hypertrophy group, and the correlation between T.Z. and ventricular wall thickness and ventricular volume (expressed with the ratio of each ventricular volume against the sum of both left and right ventricular volume). 4. As to the relation of standard chest lead points of electrocardiogram (V₁-V₆) and the position of anatomical longitudinal axis of heart, V₁ and V₂ are mainly at lower part under longitudinal axis, V₃ and V₄ are mainly at longitudinal axis and V₅ and V₆ are mainly upper part of above longitudinal axis. As regards the relation of the position between each lead point and the parts of heart were: V₁ was at right auricle and V₂ in most cases at right ventricle excepting a few at right auriele, V₃ mostly at right ventricle, V₄ as both right and left ventricles containing ventricular septum in the middle, V₅ and V₆ is at left ventricles.

View full abstract

In 56 patients, the QRS voltage and the AQRS were compared before and after the development of LBBB with particular reference to LVH. The QRS voltage was frequently de-creased, occasionally unchanged and rarely in-creased with the appearance of the conduction defect. The AQRS was unchanged in the majority of patients studied. The probable cause of these changes were discussed. Our results support the conclusion of others in that this diagnosis can be made in many only by inference. It was also re-emphasized that the significance of the AQRS deviation in LBBB in the same as that in normal conduction.

View full abstract

The concentration of tocopherol was decreased in the human aorta of atherosclerosis, and the concentration of nonprotein SH was low in the human aorta of atherosclerosis or aged subject. If the concentration of antioxidants such as tocopherol and non-protein SH are to be decreased, lipid peroxidation will be increased. The changes of the content of copper in the human aorta which will promote lipid autoxidation was shown no definite relation to atherosclerosis or aging. It is interesting that metals such as calcium, magnesium and zinc were rich in the media than in the intima.

View full abstract

1. Electron microscopic observation of the neurons in superior cervical sympathetic ganglion was made on a total of 18 spontaneously hypertensive rats (OKAMOTO and AoKI), and 18 normotensive rats of Wistar strain. Evaluation of the findings was performed by quantitative estimation of cytoplasmic ultrastructure with an aid of linear analytical procedures. 2. The ultrastructural organization of neutrons in normal Wistar rats coincided with those of rats already described by certain authors. 3. The neuronsofthe S.H. rats showed submicroscopic features which did not differ in a basic way from those of normotensive control rats. By quantitative analyses of these neurons, however, the following disparate findings were noticed. (1) Granular endoplasmic reticulum was more abundant in the neurons of spontaneously hypertensive rats of all ages as compared with those of normotensive controls. Free ribosomes also showed a similar tendency. (2) Total mitochondrial volume was greater in the neurons of spontaneously hypertensive rats than in those of normotensives through all ages; no remarkable morphological abnormality of mitochondria was seen except for a slight swelling or cristolysis found in some of them. (3) Only in the spontaneously hypertensive rats of prehypertensive stage was the Golgi apparatus better developed than in the controls, though the same tendency was suggested through all ages. (4) More lysosomes were found in the spontaneously hypertensive rats than in the normotensives, being obvious especially in the older ones. 5. From these findings the possibility of higher metabolic level in the sympathetic neutrons and, in consequence, of the increase in sympathetic neuronal activity in the spontaneously hypertensive rats were discussed in relation to functional significance of neuronal ultrastructure.

View full abstract

For the purpose of comparison in the diagnostic accuracy between the decision tree method and the joint probability method, they were applied to the diagnosis of the orthogonal electrocardiograms obtained from 101 patients with myocardial infarction (Infarction) and 601 patients without infarction (Non-infarction). As significant parameters, 14 measurements, including the duration and amplitude of Q wave, the deviation of S-T segment and the maximal T amplitude, were selected. A small-sized digital computer (NEAC-2203) was used for this study. When the correct diagnosis was made over 80 per cent in Infarction with the decision tree method, it was unavoidable for the rate of "false positive" diagnosis in Non-infarction to exceed 10 per cent. The accuracy of pattern classification in Infarction was 95.0 per cent with the joint probability method, and frequency of "false positive" diagnosis in Non-infarction was as low as 4.8 per cent. Thus, the better results in discrimination were obtained with joint probability method than with the logical decision tree method. These results indicate that the degree of diagnostic accuracy may be largely dependent on the classification method used and the joint probability method would be the better categorizer than the logical decision tree method in the automatic electrocardiographic interpretation.

View full abstract

The effect of ultrafiltrate of uremic serum upon the oxygen consumption of rat liver mitochondria was studied. Oxygen consumption in the absence of adenosine diphosphate (State 4) was increased by the addition of ultrafiltered serum of uremic patients, causing decrease of P/O ratio and respiratory control ratio, indicating the uncoupler action of uremic serum. Such uncoupler action was noted when succinate was used as the substrate, and also when α-ketoglutarate was used as the nicotinamide adenine dinucleotide-linked substrate. The mitochondrial respiration in the presence of adenosine diphosphate (State 3) was decreased, suggesting the inhibitory action of uremic serum on energy transfer. Oxygen consumption after 20 minute incubation with uremic serum showed the decrease in either state, leaving ground for the presence of inhibitory action against electron transport. Similar results were obtained in liver mitochondria of rats in acute renal insufficiency caused by bilateral nephrectomy. Based on these facts, the nature of metabolic inhibitors in uremic serum was discussed.

View full abstract

Activity of plasma renin was studied in 16 patients with chronic renal failure. 1) Plasma renin activity was increased in 7 of 11 patients by peritoneal dialysis. Three of them showed a marked increase in plasma renin activity. On the other hand, only one of five patients who had not received dialysis showed a slight increase in plasma renin activity. 2) A marked increase in plasma renin was associated with a severe hypertension and an advanced vascular retinopathy. 3) There is no consistent correlation between the level of plasma renin activity and other laboratory findings such as serum sodium, potassium. BUN, arterial pH and Pco₂, and hernatocrit. 4) The fact that bilataral nephrectomy counteracted an increased plasma renin activity and lowered blood pressure suggests renin release from the excised kidney, and participation of renin in maintenance of hypertension in the endstage of chronic renal failure.

View full abstract

The activity of plasma renin was studied in a 45 year old male patient with renal tubular acidosis. The plasma renin activity, which was abnormally increased while plasma pH remained low, was decreased upon normalisation of plasma in response to treatment with alkalinizing salts. Abnormal renin secretion. in the present case may be explained by the damage of renal tubular cells leading to the disturbance of sodium balance at the site of JG apparatus.

View full abstract

A combined case of HSS, rheumatic myocarditis and mitral insufficiency was reported. Various clinical examinations such as electrocardiogram, left vetriculogram, pullback tracking from left ventricle to the aorta and peripheral pressure curve revealed characteristic findings of HSS. Operation was performed under the diagnosis of HSS and mitral insufficiency with complication of post-operative conduction disturbance to expire the patient. Pathologically, left ventricular wall and ventricular septum were extremepr hypertrophied. Scarring foci and Aschoff Body formation were observed, and mitral valve showed fibrous thickening. Findings of rheumatic myocarditis and mitral insufficiency were obServed. Possibility that left ventricular hypertrophy due to the rheumatic myocardltis and mitral insuffl-ciency provided etiological significance of HSS in this case, was discussed.

View full abstract