1. Cerebral autoregulation to lowered perfusion pressure was abolished in the dogs pretreated by intravenous beta-adrenergic blockade with propranolol which blocked the metabolic process of glucose in the brain. 2. In these animals, there was neither increase in CSF lactate nor decrease in CSF pH in response to reduced perfusion pressure. 3. It could be concluded from the present observation as well as the previous one that auto-regulation of CBF to lowered perfusion pressure might be a function of CSF lactic acidosis, signifying hypoxia in the brain tissue.

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The hemodynamic effect of several cerebral circulatory drugs (aminophylline, papaverine, cyclandelate and isoxsuprine) on cerebral and peripheral circulation was investigated by means of the new ultrasonic Doppler apparatus devised by the author simultaneously, non-operatively and continuously in man in situ. The circulatoty mechanism of these drugs was discussed based on the obtained results.

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The fatty acid compositions in total phospholipid (PL), cholesteryl ester (CE) and triglyceride (TG) were analyzed in human plasma. In forty-five hypertensives, significant positive correlation was found between the percentages of palmitate and palmitoleate in CE and TG. Linoleate was inversely cor-related to monoenoates in CE, and to palmitate and palmitoleate in TG. There was significant positive correlation between eicosapentaenoate and docosahexaenoate in the linolenate family, but no significant correlation was found among linoleate, homo-γ-linolenate and arachidonate in the linoleate family. The groups of type II, III and IV hyperlipoproteinemias (17, 9 and 14 cases, respectively) and normolipidemic diabetes (11 cases) were compared with a normolipidemic hypertensive control group (34 cases). Small differences were found in the plasma fatty acid composition in type II and diabetic groups, compared with the control. In type III and IV groups, palmitate and palmitoleate increased and linoleate decreased in every fraction, and in PL the percentage of homo-γ-linolenate increased and that of nervonate decreased. Five of the type II hypercholesterolemics were given 2.4 or 3.6g/day of ethyl γ-linolenate for four months. Serum arachidonate content increased somewhat, but the increase of γ-linolenate in CE and homo-γ-linolenate in PL was marked. In hyperlipoproteinemics (mainly type III and IV) administered clofibrate, increased percentages of nervonate in PL, γ-linolenate in CE, and eicosapentaenoate in TG were found.

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The pathological data on the natural history of 30 minutes SMA occlusion of dogs were presented. After SMA occlusion, hypotension continued to the 2nd day and CO recovered on the 2nd day. The peak of slight hypocapnec alkalemia due to hyperventilation appeared on the 2nd day post-operatively. The catecholamine levels changed very slightly. The lung tissue have been changed 1 congestion, 1 edema and 1 capillary change with 3 hours SMV blood perfusion after 30 minutes SMA occlusion. Although, it is difficult to determine what factors changed the lung tissue. The negative inotropic factor described by Williams et al., might be one of the factor. Pretreatment with phenoxybenzamine safeguards against the negative inotropic factor and other factor (possibly the humoral factor) which cause secondary changes of CO and produce acidosis.

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Apexcardiogram (ACG) in 324 patients with various circulatory disorders and 20 young healthy males were analysed under classification by Benchimol and Dimond, Ahuja and Miguel. Average value of the A Wave Ratio (AWR) was relatively high, in so-called Primary Myocardial Disease and congenital heart diseases. Large A wave was observed in the patients with IHSS, third or fourth sound, observed in ischemic heart diseases, and especially Primary Myocardial Disease. Isometric Contraction Time (ICT) by the method of Ahuja was slightly longer in AS than AI, and in MI than MS, respectively. In mitral valvular diseases, O point coincided with opening snap in almost one half of the cases, but pre-existed in else. Inclination of the Diastolic Filling Wave was significantly higher in MI than MS. Relationship between apexcardiogram and esophagocardiogram in cardiovascular diseases were referred.

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The changes of ACG (Apexcardiogram) in patients with thyroid dysfunction and coronary heart disease were reported. Peculiar findings of ACG in hyperthyroidism, were short Isometric Contraction Time (ICT), lower Mid Ejection Height (MEH), and Diastolic Filling Wave Ratio (DFWR), on the contrary, longer ICT, higher MEH, DFWR, and wide A wave were observed in hypothyroidism. More rapid outward and in-ward movement of the chest wall in hyperthyroidism was revealed from the finding of small MEH in it. Difference of contraction rather than relaxation seems to be more remarkable in cardiac movement in patients with thyroid dysfunction. ICT and IRT were prolonged in arteriosclerosis and coronary heart disease. A wave was prominent in these groups, especially in the latter. Prominent A wave was observed on the anginal episode in aortic insufficiency and hypoxic condition in coronary heart disease. This elevation of the A wave was inhibited by nitroglycerin in both patients. Possible mechanism producing a dominant A wave was discussed from the standpoint of venous return and left ventricular function.

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Apexcardiogram after low oxygen and several drugs were examined to develop the diagnostic significance of it. ACG was recorded before and after low oxygen inhalation, administration of digitalis, isoproterenol, propranolol, and amyl nitrite, in patients with ischemic heart diseases, valvular diseases, and noncardiac patients. In-creased A Wave Ratio (AWR), shortened isometric contraction time (ICT) and relaxation time (IRT) were observed after exercise, administration of isoproterenol and amyl nitrite. Shorter ICT and longer IRT were detected after digitalis. However, digitalis invariably prolonged Filling Time in ACG. Various changes of AWR, prolonged ICT and IRT were induced by propranolol. Both in valvular and coronary heart diseases, A wave was significantly increased by hypoxia, though it was stable in noncardiac patients. Prominent A wave was observed at the anginal episode by hypoxic condition in coronary heart disease. Though positive ECG and ACG findings were observed in patients with old myocardial infarction or typical angina pectoris by hypoxia, negative ECG and positive ACG findings were obtained in approximately two thirds of the patients to show slight ST, T changes in ECG at rest. It was revealed as conclusion in this study, that ACG with exercise, hypoxic and pharmacological tests could give the useful pathophysiological informations about the cardiovascular system.

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Electrocardiograms were taken from a 36-year-old female with vegetative neurosis to obtain 174 ventricular premature beats, 172 retrograde P waves, 36 ventricular echoes and 8 atrial echoes through the S-A node or by way of the S-A junctional region. The atrial echo through the S-A node were differentiated only in esoplrageal leads which showed 4 types of P waves; a sinus P wave, a retrograde (nodal) P wave, a retrograde P wave followed by a ventricular echo and an antegrade P wave of an atrial echo. 1. An R-R' interval (an interval between the sinus-conducted beat and the ventricular premature beat) of 0.40 to 0.48 second was observed in 100 per cent of ventricular premature beats with ventricular echoes and in 81 per cent of those without them. 2. An R'-P' interval (an interval between the ventricular premature beat and the following retrograde P wave) of 0.24 to 0.31 second was observed in 78 per cent of ventricular premature beats with ventricular echoes. While, an R'-P' interval of 0.16 to 0.23 second was observed in 79 per cent of ventricular premature beats with-out ventricular echoes. 3. The R-R' interval was inversely proportional to the R'-P' interval. The ventricular echo occur-red when the R-R' interval was less than 0.48 second and the R'-P' interval greater than 0.22 second. 4. When the R-R'-R' interval (an interval between the sinus-conducted beat preceding the ventricular premature beat and the ventricular echo response) was the same, a shorter R-R' interval was associated with a longer R'-P' interval and a shorter P'-R' interval (an interval between the retrograde P wave and the ventricular echo response). While, a longer R-R' interval was associated with a shorter R'-P' interval and a longer P'-R' interval. 5. When the R-R' interval was the same, a longer R'-P' interval was ordinarily preceded by a longer R'p-R interval (an interval between the preceding ventricular premature beat and the following sinus-conducted beat) and followed by a ventricular echo. When the R-R' interval was preceded by a shorter Rp-R interval (an interval between the preceding sinus-conducted beat and the sinus-conducted beat followed by R'), it was followed by a shorter R'-P' interval and not followed by a ventricular echo. 6. An effort was made to explain ventricular echoes in terms of re-entry by retrograde stimulation. The ectopic focus in the A-V junctional region may be discharged by a retrograde impulse and made fire again antegrade in the same way as in the premature beats. 7. In esophageal leads, when the ventricular premature beat was neither interpolated nor followed by a fully compensatory pause, the following P wave showed aberrant intra-atrial conduction. The temporal relation between the regular sinus impulse and this aberrant P wave seemed to indicate that the preceding sinus impulse was blocked by retrograde propagation of the ventricular premature impulse, that the succeeding sinus impulse was abolished by pre-mature firing of the S-A node by re-entry of this retrograde impulse and that a slower conduction in the S-A node afforded incomplete recovery to the atria and enabled aberrant re-excitation of the atria.

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