Systemic and coronary hemodynamic changes, especially phasic coronary flow pattern changes, were studied in experimental aortic insufficiency dogs. Aortic insufficiency severe enough to lower the mean aortic pressure resulted in an increase in aortic total flow and a decrease in aortic foward flow. Aortic pulse pressure always widened while no changes of systolic aortic pressure occurred. The mean coronary blood flow was increased significantly above control condition with the shift of normal diastolic flow to systole in mild and moderate cases, but was decreased in severe cases showing prominent backward coronary flow during diastole. The phasic coronary flow pattern changes had the close correlationship to the aortic pressure and the aortic regurgitant flow in the experimental aortic insufficiency. The mechanism of angina pectoris in aortic insufficiency was discussed from the standpoint of the phasic coronary flow.

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In our previous paper, the authors had reported that the reduction in potassium content in isolated guinea-pig atria, kept in a potassium-free medium was prevented by thiamine tetrahydrofurfuryldisulfide (TTFD), added to the medium. In the present experiment, the attempt was to clarify whether or not this drug effect was caused by a biosynthetic thiamine originating from the TTFD. The effect of TTFD was observed in atria which had been treated once with TTFD, then washed out with Locke's solution, and finally subjected to a medium containing a low concentration of potassium ions without TTFD. As this effect seemed to be due to some biosynthetic compound originating from the TTFD, the amounts of thiamine in both the free and the bound forms were chemically estimated. A direct relation, however, could scarcely be found between the effect of TTFD and the amount of biosynthetic thiamine. The effect of TTFD was therefore assumed to be produced by the biotransformation of TTFD in the atria.

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The hemodynamic and metabolic effects of β-adrenergic blockade by the use of propranolol has been studied to clarify the physiological significance of β-adrenergic receptor activities during exercise in man and animals. Seven healthy men and twelve thyrotoxic patients were the subjects in this study. All these subjects were examined on bicycle ergometer at a moderate work load for 10 min. in a supine position. No significant changes of hemodynamic parameter induced by P. was observed in healthy men, but in patients group, significant decrease of systolic blood pressure and heart rate were observed at rest. Inhibitory effects of P. on heart rate, systolic blood pressure and cardiac work (M.T.T.I.) were marked during exercise in both group. A11 the metabolic effects including oxygen consumption, plasma pyruvate, lactate and XL production were suppressed with P. in both groups. Mobilization of NEFA induced by exercise were also modified, but plasma glucose was kept invariable during the experimental course. Oxygen debt showed a slight increasing tendency in both groups after P. adm. But the changes were not remarkable. Moreover, in attemt to analyze more precisely these metabolic changes in exercising time, author had animal experiments using rats and made exercise test. In rats treated with P., the plasma lactate concentration did not so increase and the glycogen contents in skeletal and heart muscle were not reduced by swimming exercise probably due to blocking on the activation of phosphorylase. But it was found invariably to reduce the glycogen contents in the liver regadress of pretreatment with P. Plasma NEFA in animals showed the similar pattern to that of man, but no marked triglyceride changes in heart and epididymal fat pad were observed. For the purpose of investigating whether β-receptor has any influence on the disappearance rate of lactate, author infused 1 mol of L(+) sodium lactate at the rate of 9 mg/kg/min into the femoral vein of 8 anesthetized dogs, the plasma lactate concentration in a arterial blood was measured at a constant time interval before and after P. adm. It has been demonstrated that P. promote the disappearance rate of lactate from blood in this experiment. It is concluded that β-adrenergic receptor play an important role on the hemodynamic and the metabolic changes to muscular exercise and the mechanisms have been discussed.

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An attempt to measure myocardial blood flow (MBF) in a simple and atraumatic procedure has been made by means of an external counting method using a scintillation counter and a radioactive tracer 86-rubidium chloride. The method presented was based on the indicator fractionation principle proposed by Sapirstein. According to the principle, when a bolus of radioactive indicator 86-rubidium is injected intravenously, uptakes by various organs are proportional to their blood flow fraction of cardiac output. Experimental observations revealed that the relation had been maintained during initial five to ten minutes in human subjects. After a single injection of the tracer, external counting monitored precordially over the heart was made, obtaining radioactivity of first circulation of the tracer through heart as an equivalent of total injected dosis and radioactivity of later equilibration as an equivalent of fractional dosis uptaken by the heart. The myocardial blood flow (MBF) was calculated in the term of flow perfusing unit tissue mass, according to the equation presented, simultaneously obtaining the cardiac output and external cardiac work. Determination were made in thirty-six subjects. The mean value of MBF in ml/min 100 gm were 99 in twelve normal young subjects, 127 in two patients with hyperthroidism, 99 in ten aged subjects without ischemic heart disease (IHD) and 92 in twelve patients with IHD. In all of twenty-eight cases, the second determination were made following the administration of nitroglycerin or carbochromen. In nine young normal subjects without IHD the definite increase of MBF was observed, while in nine subjects with IHD, no increase of MBF was observed and tendency to decrease of the cardiac work was observed.

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Several mechanisms have been suggested with regard to the genesis of the ventricular pre-excitation syndrome. Numerous electrocardiographic studies point to the fact that the various clinical manifestations of this entity are due to the existence of an accessory atrioventricular connection through which atrial impulses can bypass the normal atrioventricular junction. This theory is further supported by several different clinical reports of surgical interruption of anomalous conduction pathways between the atrium and ventricle resulting in eliminating the episodes of supraventricular tachycardia. In this present communication the etiology of Wolff-Parkinson-White syndrome including type A and type B cases was studied using the catheter technique of His bundle recording. Methods The technique of His bundle recordings used in our laboratory is an extension of the method introduced by Scherlag and his associates. The right saphena magna vein was isolated surgically and two bipolar electrode catheters were inserted through a venotomy. One catheter was then advanced under fluoroscopic control, until the tip lay across the septal leaflet of the tricuspid valve. This catheter was connected to a bio-physiological preamplifier at filter settings of 0.003 sec of time constant and 300Hz. Another electrode was positioned at the junction of the superior vena cava and right atrium, and was used for atrial pacing. The pacing rates were gradually increased approximately up to 500/min. A standard lead II elctrocardiogram was also displayed with the intracardiac electrograms. All tracings were monitored with a multichannel oscilloscopic instrument and simultaneously recorded on a direct writer recorder or electro-magnetic photographic recorder at a paper speed of 100 mm/sec. Report of Cases Case 1: The tracings presented in Fig.1 to 5 were obtained from a 24-year old man who complained of occasional episodes of paroxysmal rapid heart beating. The patient's electrocardiogram showed regular sinus rhythm and W-P-W type A. Paroxysmal tachycardia spontaneously disappeared without any specific medical treatment.

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In 1951, Iversen and Brun had first introduced the technique of the renal needle biopsy. In past twenty years, this method have proved to be valuable to diagnose of the renal diseases and to forecast a steroid effect on the patients with nephrotic syndrome. Moreover, we considered that a histological diagnosis should be extended its usefulness to determining the activity of renal lesions and forecasting a prognosis of the patient. The present study was aimed to classify the pathological change of glomerulonephritis from the standpoint of the activity of glomerular lesions obtained by needle biopsy. Materials and Methods Studies were performed on 36 inpatients with glomerulonephritis of the First Department of Internal Medicine of Osaka University Hospital. The specimens were obtained by a percutaneous needle biopsy. These cases were consisted of 27 males and 9 females and their age was among 15 years-old to 51 years-old. The material was fixed with 10% formalde-hyde, then Hematoxylin-Eosin staining and Periodic-Acid-Schiff staining were applied. Diagnostic criteria of the histological activity of glomerular lesions The table shows our classification of histological diagnosis of glomerulonephritis from the standpoint of the activity of glomerular lesions. This classification was derivered from Prof. Ishikawa (see reference N0.4) and modified by authors' concept. Type A: There is usually no adhesion between the Bowman's capsule and the glomerular tuft. Type B: There is adhesion between the Bowman's capsule and the glomerular tuft. Type C: There is adhesion between the Bowman's capsule and the glomerular tuft, and marked hyalinization of the intraglomerular tuft can be seen. Each type is further classified three forms, these are, active, intermediate and repaired. An active form shows mesangeal and endothelial proliferation (mitosis and poikilocytosis in mesangeal nuclei). Polynucleocyte infiltration and fibrin exudation in the glomerular lesions. Mesangeal changes are considered as the most important. An intermediate form shows no remarkable active finding, especially in mesangium. A repaired form shows axial thickening, organization or hyalinization. Concerning the glomerular lesion of nephrotic type of glomerulonephritis, the classification introduced by Prof. Kinoshita was adopted, and about the clinical classification of glomerulonephritis, Prof. Ohshima's one was adopted. (see reference No. 6-8)

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