Several risk factors in cardiovascular diseases, incidence rates of cerebrovascular diseases and coronary heart diseases, and dietary intake were compared among geographically, occupationally different 6 groups. The risk factors evaluated in this study are blood pressure levels, ECG findings, ocular fundus findings, relative body weight, and serum total cholesterol and triglyceride levels. Following results were obtained. 1) Factors elevating blood pressure seem to differ geographically or occupationally. 2) Hypertension, which is frequent in traditional rural areas, has little association with obesity or abnormal lipid metabolism, and it tends to develop into cerebral apoplexy. 3) In the special groups of men in urban areas, there exists relationship between obesity and hypertension, and the incidence of apoplexy is relatively low, but the incidence of coronary heart diseases is highest in all groups examined.

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In order to find out some clues to the diagnosis of left ventricular hypertrophy in the presence of right bundle branch block, Frank lead vectorcardiogram of 39 autopsy cases with right bundle branch block were quantitatively analyzed. Based on the pathological correlation, a displacement of the T loop was concluded to be the most important sign for the diagnosis of left ventricular hypertrophy even in the presence of right bundle branch block, while an enlarged magnitude of initial maximal QRS vector was another less reliable sign for the diagnosis. Further detailed measurements of the QRS and T loops were not helpful for the diagnosis of associated left ventricular hypertroyhy.

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It has been reported that the index maxV_CE Which represents myocardial contractility, can be measured in clinical cases from the pressure patterns recorded by catheter-tip pressure transducers. In this study the values of maxV_CE Were calculated from the recordings obtained through a metal cannula inserted directly into the left ventricle and those obtained through an usual catheter connected directly to a pressure transducer on animal experiments. A high significance of correlation (r = 0.98) was observed between these values obtained by two different methods, and it was concluded that intraventricular pressure and dp/dt patterns accurate enough to allow the calculation of maxV_CE could be obtained by usual catheters connected to pressure transducers directly.

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A case of juvenile angina pectoris probably due to congenital syphilis was reported. Both coronary ostial narrowing could be only presumed in usual physical and laboratory examination. And then aortitis and both coronary ostial stenosis demonstrated in vivo by aortography and selective coronary arteriography. The progress of this case has been observed at present with internal treatments, but surgical repair will be necessary in the near future.

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Because of their vasodilating response on coronary arteries, the so-called coronary vasodilators have been administered for the treatment of coronary failure during recent years. However, these results are based mainly on healthy animal experiments and therefore various paradoxes are found between clinical experience and basic pharmacological experiments. To clarify the mechanism of the vasodilating response and determine the significant critical levels of coronary vasodilators, cardiac catheterization was employed to obtain systemic and coronary hemodynamic parameters in healthy controls and in patients with various diseases under resting and hypoxemic conditions, with or without the administration of coronary vasodilators. Methods and Materials The systemic hemodynamic parameters were determined by rightsided cardiac catheterization with direct Fick's method and coronary circulation was measured by coronary catheterization with the N₂O desaturation technique. The parameters evaluated were cardiac output (CO), systemic vascular resistance (SVR), left ventricular work (LVW), Katz's Index, myocardial tension (MT), coronary blood flow (CBF) and coronary vascular resistance (CVR). 1. Induced hypoxemic condition After 10-20 minutes loading of 10% O₂ inhalation, systemic and coronary hemodynamic parameters were determined. 2. Drugs administered Coronary vasodilators ; e.g. Dipyridamole, Carbochromene, PF-26, Iproveratril, Xanthine derivatives, Benziodarone derivatives and Isosorbide dinitrate were used. i) Usual clinical dosis : Coronary hemodynamic parameters were estimated over a 10 minutes period from 3 to 13 minutes after sublingual administration of Isosorbide dinitrate and from 7 to 17 minutes after intravenous administration of other agents. ii) Massive dosage, 5-10 times that of ordinary dosis : Coronary hemodynamic parameters were determined in the last 10 minutes period during the one hour intravenous infusion of Dipyridamole and Carbochromene. 3. Materials One hundred and six cases of healthy controls and patients with various diseases were examined. Forty two of these cases were subjected to the hypoxemic loading of 10% O₂ inhalation and another 55 cases were used to evaluate the hemodynamic response to coronary vasodilators.

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Various types of induced cardiac arrest have been devised as an aiding measure facilitating open heart surgery. Electrical fibrillation (EF) and anoxic arrest (AA) and now most widely employed in clinical use. However, little work has been done to discuss the relative merits of the two methods due supposedly to discrepancy of the experimental method or of the parameters used by the investigators. The present study was designed to investigate comparatively the response of myocardial metabolism to the two methods under condition that the all variable factors but the method of induced cardiac arrest are maintained at the fixed levels. The effect of each method of induced cardiac arrest on intracellular metabolism of the myocardium was studied in respect of lactic and pyruvic acids metabolism expressed by myocardial "excess lactate" (XL) and changes in redox potential (ΔEh) across the heart. The dogs used in this study were divided into the following two groups : 1. EF-group (8 dogs), in which electrical fibrillation was induced for 45 minutes by applying an alternating current. 2. AA-group (7 dogs), in which intermittent anoxic arrest for 15 minutes was repeated 3 times with 2 intervals of a 5-minute's release. During induced cardiac arrest, the systemic circulation was maintained by means of total cardiopulmonary bypass using a SIGMAMOTOR Model TM-2 as a pump and one of several types of sheet oxygenator. The following special considerations were given in order to keep the experimental conditions settled : 1) In each experiment of the both groups, cardiac arrest was induced for the same duration of 45 minutes, which is the time used most generally in clinical application. 2) Mild hypothermia at the same temperature was applied to all dogs in the both groups, for minimizing the unfavorable effect of normal body temperature on metabolism. the mean rectal temperature was 33.0°C at control, while it was 30.5°C at the end of the experiment. 3) Perfusion rate in total cardiopulmonary bypass was 60-70 ml/min/kg. 4) To maintain appropriate systemic circulation, only donor blood primed in the extracorporeal circuit at the start was used with avoidance of any kinds of drugs except the anesthetics and of any additional blood transfusion which might disturb the measurements of lactate and pyruvate.

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Various types of assisted circulation have been clearly classified according to indication through the serial experimental and clinical investigations by Akune and the co-workers. Counterpulsation (CP), a method of assisted circulation for left-sided heart failure, principally provides assist to the left ventricle and augmentation of the coronary circulation owing to a phase shift of the pressure curve produced in the aortic root. In spite of no difference of opinion concerning the assisting effect of CP on the left ventricle, controversy continued as to whether CP can augment coronary blood flow. Thus, the author has attempted to clarify morphologically the effect of CP using a new counterpulsator SIMAS on the canine coronary circulation by means of postmortem coronary angiography. The experiments were done on 20 adult mongrel dogs, which were divided into the 2 groups : the control group (CT group) of 10 dogs and the counterpulsation group (CP group) of 10 dogs. All the experimental conditions including cannulation except the performance of CP were maintained identical in the both groups. Both in CT and CP groups, an arterial cannula was inserted via the bifurcation of the abdominal aorta, its tip being placed in the mid-portion of the thoracic descending aorta. CP was performed for 1 hour under proper synchronization with the cardiac cycle on condition that aortic mean pressure was slightly elevated, in CP group. Such parameters as ECG, aortic pressure, central venous pressure were measured and recorded throughout the experiment. Immediately after CP discontinued in CP group or after 1 hour following cannulation in CT group, the heart was removed and postmortem angiography was carried out.

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