(1) A method of determining the position of the heart was advanced. (2) The cases of the position which the heart is, in comparison with those in the other positions, considered to be more rotated in the counterlockwise rotation around its longitudinal axis or in the similar rotation around the anteroposterior axis or in the rotation moving its apex backward or in two or all of these kinds of rotations were markedly increased in the subjects of essential hypertension. (3) Such a position of the heart as above mentioned is, when resulting from essential hypertension, supposed to be almost completed by hypertension before left ventricular hypertrophy is added, although the apex of the heart seemes to be rotated more backward by left ventricular hypertrophy. (4) The axis deviation seemes to be changed especially by the rotation of the heart regardless of what causes that rotation.

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In 14 anesthetized dogs (control group) and 7 anesthetized dogs treated by Hexamethonium bromide (Hexa group), arterial carbondioxide tension (PaCO₂), blood pH; renal plasma flow (RPF), renal blood flow (RBF), glomerular filtration rate (GFR), renal blood pressure (RBP) and renal vascular resistence (RVR) were measured before and during inhalation of 5% and 15% CO₂. Cardiac output was observed in the control group. In the control group, moderate respiratory acidosis caused vasodilatation as evedenced by increase in RPF, . RBF and GFR, and a decrease of RVR. Severe respiratory acidosis caused vasoconstriction as evidenced by decrease in RPF, RBF and GFR, and an increase of RVR. Cardiac output remained relatively unchanged during CO₂ inhalation. In the Hexa group, inhalation of 5% CO₂ caused increase in RPF, RBF and GFR and a decrease of RVR. Hexamethonium bromide did not block renovascular dilatation in such a moderate respiratory acidosis. Inhalation of 15% CO₂ in this group produced marked increases in RPF and RBF, and decreases in GFR and RVR; renovascular constriction observed in the control group was abolished by hexamethonium bromide. This observation confirms positive participation of sympathoadrenal mechanisms in regulation of renovascular responses and renal functions in respiratory acidosis.

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The pulmonary lymphatic system originates from the portion around the alveolar duct and reaches the hilar area through the various lymphatic channel. The lymph flow in each lobe except the left upper lobe returns to the right jugular vein via the right thoracic duct, while the lymph flow from the left upper lobe usually returns to the left :jugular vein via the left thoracic duct. It should be reminded as a experimental condition that the some anastomoses occasionally exist between the both thoracic duct systems. In this experiment, however, the lymph flow from the right thoracic duct was regarded as the pulmonary lymph flow. The cases in which chile was mingled into the right thoracic duct and protein content exceeded over 5.0 g/dl were excluded from the materials studied. The pulmonary lymph flow from the right thoracic duct was normally minimal. By several authors, mean value of it was reported as 0.9 to 8.9 ml/hour in normal dogs. It seems that this variation is due to the individual and conditional difference In the experiments. The pulmonary lymph flow measured was within 0.16 to 1.55 ml/5 min with mean value of 0.55±0.23 ml/5 min in 23 cases of normal adult dogs. Thus, the pulmonary lymph flow is so little that it can't prevent happening of the acute pulmonary edema. It has been considered that the role of the pulmonary lymphatic system was to take up the protein molecule from the tissue space for making fall the colloid osmotic pressure and keeping the lung dry, rather than to drainage the edematous fluid. It was proved by results of experiment (1) and (2) that the pulmonary lymph flow was much affected by hemodynamic of the pulmonary circulation. Experiment (1) represented that the pulmonary capillary pressure was increased backwardly by the elevated left atrial pressure by obliterating the left atrium with balloon. This elevation of the pulmonary capillary wedge pressure caused the filtration rate of the fluid to increase through the capillary wall resulting in augumentation of intrapulmonary fluid volume followed by increment of the pulmonary lymph flow.

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The apex cardiographic index (peak DA/Dt)/A was compared with hemodynamic and angiographic indexes of left ventricular function in 32 patients with various cardiac diseases. The significant correlations were observed between (peak DA/Dt)/A and the following: (peak DP/Dt)/PIP (r = 0.71), (DP/Dt)/P at P = 50 mmHg (r = 0.81), Vmax (r = 0.88), and ejection fraction (r = 0.56). These data suggest that the apex cardiographic index is useful for the assessment of left ventricular function.

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1. Mechanocardiograms of 45 healthy control subjects, 13 cases of acute hepatitis, 13 cases of chronic hepatitis and 12 cases of cirrhosis were measured and analysed. 2. Acute hepatitis group indicated prolongation of EMIc and significant increase of PEP/LVET. 3. Chronic hepatitis group indicated no significant difference from healthy group as to any items of measurements. 4. Cirrhosis group indicated remarkable prolongation of Q-Tc and some extention of PEPc and decrease of Q-II/Q-T. 5. These changes in the measured values of mecahnocardiogram indicated significant correlation with such clinical findings as anemia, dysproteinemia and change of serum Ca concentration.

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A case of primary tuberculous pericarditis with no other clinically recognizable tuberculous lesion was reported. An autopsy revealed tuberculous pericarditis with microscopic miliary tuberculous dissemination in the lungs, liver, spleen, kidneys and adrenals, though there were no tuberculous lesion of neighbouring lymph nodes which could lead to the usual occurance of the tuberculous pericarditis.

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A patient with a variant form of angina pectoris was subjected to continuous electrocardiographic recordings. This case was different from the variant form of angina pectoris as described by Prinzmetal et al., in that the ST segment elevation in the leads reflected the ischemic area during his chest pain, not only at rest, but also at the time of effort. With the cessation of pain, the ST segment rapidly returned to the appearance prior to the onset of an attack. This case also demonstrates the interesting serial changes of electrocardiograms taken by continuous electrocardiographic recordings during anginal attacks. The serial alteration of various serum enzymes in this case remained within the normal range except for the slightly transient increase of SCPK activity. In this case, practolol therapy was effective in alleviating the anginal attacks.

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Purpose: The features of the interatrial septum and its motion were studied by ultrasonocardiotomography and echocardiography. Based on the results of the above study, the detection of the ostium secundum defect of the interatrial septum was examined in the transverse and sagittal section of the ultrasonocardiotomogram. The possibility of detecting the defect by the conventional echocardiogram was also studied. Method and Materials: Ultrasonograph Model SSD-10 manufactured by Japan Radiation & Medical Electronics with a unit for synchronization with the electrocardiogram was used to record ultrasonocardiotomograms (Fig. 1). To obtain an echocardiogram in a certain direction on the tomogram, Model SSD-5 from the same manufacturer was used, connected to Model SSD-10. The frequency of ultrasound used was 2.25 MHz and the rate of the pulse repetition was 937.5 Hz. The transducers used made of barium titanate were round, 30 mm and 50 mm in diameter and concave with a radius of curvature of 20 cm. The azimuth =and distance resolving power of the both transducers was 3 mm at the distance of 20 cm. The patients were examined in the supine position. The transducer was operated in a vinyl bag on the chest wall filled with bubbleless water. The distance of the transducer from the chest wall was set at over 10 cm so that the ultrasound beam was focused nearly at the midportion of the heart and the tomogram of the heart was not disturbed by the second reflection from the chest wall. Sector scanning was mainly used and compound scanning only in cases of remarkably enlarged heart. The angle of the sector scanning was 50 in degrees and the time in one sector scanning was 0.4 sec. In order to obtain a satisfactory tomogram of the heart at a desired phase in a cardiac cycle, the synchronizing unit introduced by Kikuchi and Tanaka was adopted. The R wave of the electrocardiogram was used as a trigger and by a delaying circuit the cathode ray tube was brightened in a scheduled phase of each cardiac cycle. Setting the unblanking time of the cathode ray tube from 25 msec to 50 msec, a tomogram was completed during about twenty successive heart beats (Fig. 2). Features of the echo of the interatrial septum were examined in 7 cases of primary myocardial disease, 7 cases of ventricular septal defect, 1 case of A-V block, 6 healthy subjects and 21 cases of atrial septal defect.

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